Dearest little Sara Elizabeth,

Where does one start with a birth story, little one? He knit you together in my womb many days before I even noticed the first little signs and took that test. The insatiable craving for pickles really should have been indication enough. But it was August 16 when I saw those two pink lines. And I cried in your daddy’s arms.

I cried a lot in the next few months. Mommy’s pregnancy hormones always do that to her. But the emotions surrounding the anticipation of your coming were soon magnified by the news that my grandpa had gone home to Heaven on September 11. I cried in your daddy’s arms again.

Exhaustion was the hallmark of my pregnancy with you, little Sara. But I had three energetic kiddoes already—being tired was nearly a state of being. Once the initial morning sickness had passed, I felt well. My weight gain was normal. And I measured right on each week. My doctor appointment on February 19 was the last before we set off on a two-week trip to visit grandparents and great grandparents. My blood pressure was typical for me in my non-pregnant state: 110 over 65 or thereabouts. My doctor said all was looking well and I was fine to travel.

I was beginning to feel rather large during those two weeks on the road. But I enjoyed the beautiful weather we were experiencing, thrilling at the chance to get out and do some walking on trails. I felt well and was rather proud of myself for keeping up with my kids on some of the walks.

We were on the next to last leg of our trip, at my parent’s house, when I realized one evening that my feet and ankles were all of a sudden very swollen. In your daddy’s very loving words, “Your feet are fat!” Your grandpa immediately got out the blood pressure monitor and we found that my numbers had skyrocketed in two short weeks. It was March 3. One month to the day from when you would be born.

I remember the peace of that day and evening. Sweet Emily, my cousin Matthew’s newly affianced, sat and rubbed my feet. My cousin Rebekah had taken maternity photos of me that day. I’d been able to feel beautiful and pregnant on that last day I was completely on my feet.

I called my doctor the next day and she told me what to watch for and to keep my appointment as soon as I got home. My blood pressure stayed around 122 over 81 as long as I lay low. Not high, but high for me.

Your big sister Mary was the only one of my babies that came of her own accord, without any complications or induction. With your oldest sister, Ruth, my blood pressure went sky high the Monday before Thanksgiving, and she was induced two days later, at 38 ½ weeks. Everyone said toxemia only happened with first babies. It had worked that way for your Nanna with your oldest auntie. And sure enough, Mary came without any help, ready to take on the world almost two weeks early. Then there was Daniel. My blood pressure went up, I went down on bedrest, and he had to be induced early, as well. (My dates with Daniel were a bit iffy, but by the same calculations, he was due April 21 and you were due April 22.)

I was so hopeful for an easy, normal, natural labor this my fourth time around. I knew how nice it was to labor at home with Mary, waiting in my own surroundings until it was time to go to the hospital. (The nurses had teased me when I delivered Mary, telling me I hadn’t given them enough time to do their paperwork before she came.) So my heart sank when I realized I once again had the same symptoms that would likely force an induction and early delivery.

The remaining days of our trip were spent with me sitting in the car watching your siblings and daddy, or napping in the hotel room while they were off on adventures. I got out and explored a few paths, only to check my blood pressure and decide it was time to lay low again. I felt best at the beach when we visited your auntie Marlys. I was fairly sure that being barefoot in the waves and the sand was the best possible treatment for pregnancy induced hypertension. But that didn’t stop the tears from flowing when I would lay back down to rest and realize how far we were from your due date.

We arrived home Sunday, March 8. I went straight to bed.

The next weeks were a blur of bedrest punctuated by appointments.

Your daddy juggled meals and laundry and baths and housecleaning so well. But we were so very grateful for the help of loved ones. Your uncle “Cake’s” girlfriend Hannah spent 10 days with us.

Mommy’s childhood friend Sabine spent the better part of a week with us.

Countless friends brought us food.

And then your grandma arrived. Each of them did so much to keep Mommy resting mentally as well as physically, which helped keep you safe and growing inside Mommy for just that much longer.

I sorted baby clothes from a reclining position. And I cried in anticipation of holding you.

Your Grandma came one week before Easter Sunday. We hadn’t wanted her to come too early, not knowing how long it was going to be until you came, and hoping for her help awhile after you were born, too. But I know that when she arrived, I internally breathed a sigh of relief. My mommy was here. I could have the baby.

And contractions started in earnest the next day, Monday, March 30. One day short of 37 weeks. At my appointment that day, my doctor was concerned to find some signs of clonus. I was at 2cm, with contractions on and off. I went to the hospital to continue my regime of nonstress tests. And they took bloodwork—which would turn out to be my latest normal bloodwork during the pregnancy. That day’s nonstress test I had a blood pressure of 156 over 102, but no symptoms of clonus manifested at the hospital. They started talking about induction later that week.

And then, on April Fool’s Day, you played a bit of a trick on us. Mommy couldn’t sleep for contractions. Your daddy woke in the middle of the night to find me crying in pain in the shower. We went to the hospital at 3:40 a.m. But as soon as we got to the hospital, things calmed down. Between the exhaustion and the dehydration, it had been false labor. But we thanked Jesus for kind nurses at 3 a.m. And if it hadn’t been for that false alarm, no one would have realized until too late that amid all the other testing I’d missed having a strep test. If I had been in labor right then and there, I’d have had to be on antibiotics while giving birth to you. So that “joke” (which didn’t feel very funny!) was a blessing in disguise. I had the test and went home at 6:40 a.m., exhausted and oh so sore from 3 hours of constant contractions. And mommy played The Sons of Korah’s albums of the Psalms on repeat while I waited.

This was the first time I was going to give birth at this hospital (the smaller hospital where your siblings were born was no longer delivering babies). What had seemed like it would be a scary unknown place became all too familiar to me, with thrice weekly non-stress tests and ultrasounds and even a false labor visit. I grew to know all the nurses by name, and discovered that many were mutual family friends.

April 2:

One of my nurses had preeclampsia with her first pregnancy. She was especially in tune with my symptoms. And she was increasingly worried each time she saw me. Thursday, April 2 found her chatting with the doctor during my nonstress test and recommending an ultrasound and a more close watch on my protein output.

Your ultrasound that afternoon was the first time your grandma had ever seen any of you little ones “live” on the ultrasound screen. The tech didn’t tell us much except that you were head down but sideways, with your spine on my left side. That explained all the back labor I’d been having. I attempted bedrest on my hands and knees with little success. Of course, that night, your big brother informed his daddy: “When the baby comes I think we will see its feet first.” I hoped and prayed that wasn’t prophetic!

April 3:

Good Friday morning found me feeling miserable. I’d been dropping weight for several weeks, and beginning to measure a bit smaller than normal. But my appetite had completely disappeared within that last week. The persistent headache was getting worse, and with it my sensitively to light was increasing. And while initially Tylenol had relieved the headache (which relieved the doctor’s concern), I was experiencing no relief from any symptoms now.

But the worst sign to me was that my waking blood pressure was so very high. Normally, I’d awaken with a lower blood pressure and it would rise throughout the day. My blood pressure had continued to gradually climb throughout my weeks of bedrest, but the numbers greeting me that morning were getting scary.

I was in tears. I was so weak. I couldn’t cope very well anymore. Yet I kept my Psalms on repeat and tried to rest. I knew God was in control.

I called my doctor at noon and left a message that my blood pressure was continuing to climb while I was physically feeling worse and worse. In half an hour she called back and told me to go to the hospital for an induction. I think that she knew I’d been trying to hold out, and that I wasn’t going to give in easily. But thankfully, she trusted me enough to know I was listening to my body and knew it was time.

I remember standing by the front door knowing that I wouldn’t be walking back through that door until you’d been born. And oh how I prayed I’d be returning with you tucked safely in my arms. I kissed your daddy goodbye and prayed wordlessly. I texted a few friends as your grandma drove me to the hospital. I was fearful and yet at peace. I was exhausted and yet excited. I was feeling so very miserable and yet I knew I was finally going to be under the constant, watchful care of the nurses and my doctor.

We got to the hospital about 3 p.m. The delivery rooms were all full. They had nonstress tests going on and needed to change sheets. But one of the nurses I’d seen so often came out to talk to me in the waiting room and quickly decided that I needed to lay down even if it wasn’t in a delivery room. I found out later that she took one look at me then and knew that things weren’t good. I lay on my left side on top of clean blankets and tried to rest.

The induction finally got under way at about 4:30 p.m. It had taken a special visit from the anesthesiologist with his little ultrasound machine to get an IV site established. The failed attempts resulted in bruises all over my hand.

The doctor told us to expect an all-night induction. They were going to use magnesium to help with my blood pressure, but that was supposed to slow things down even more. I texted your daddy and told him to try to get some rest, because we were going to be in for a long night. (Rest for your farmer daddy ended up meaning plowing! I think he knew he couldn’t sleep while I was being induced.)

Contractions were starting to pick up a bit. As the doctor had warned, the magnesium made me feel flushed and rather miserable. My greatest fear at that point was an emergency C-section. But I knew I might be in for a very long labor with this miserable magnesium.

I wanted to get up to use the restroom, but was told that wouldn’t be allowed. That was my first clue that they were more than a little concerned about my blood pressure.

Then the test results came back from the blood draw they’d done upon my admission to the hospital that afternoon. My platelet counts and other levels, especially relating to my liver — all still normal on Monday — had changed dangerously. My platelet count was at 50 (standard range being 150 to 400).

Suddenly, my doctor was there talking about platelets and bleeding and putting me on a life flight to a larger hospital. The syndrome was called “HELLP” and I had it and it wasn’t good. Your grandma was texting your daddy to come to the hospital now before they flew me to the bigger hospital. My doctor was on the phone with a specialist. She wanted to see how dilated I was, and checked me in the middle of a very painful contraction.

My doctor returned and said that they’d decided they didn’t want to put a fourth-time mom at 4cm on a life flight. Not only would those on the helicopter not appreciate the very real prospect of delivering a baby in the air, but they would have to stop the Pitocin for the flight. The very best thing for you and for me was for you to be born as quickly as possible. The specialist recommended upping the Pitocin quickly to get you out as soon as possible. They were driving platelets from the big hospital so that they would be available if I needed them. And the big hospital would still be aware that I may yet be coming their way.

It was at this point that the severity of the situation should have dawned on me. But that was when your daddy arrived. And I was simply worried for him when I saw the worry on his face. I was in good hands — the doctor’s and the Lord’s — and I was on a lot of medication.

Another lab tech arrived to put another IV site in, so that it would be ready if I should need platelets. He, too, had to use the ultrasound machine to get it in. (Redheads are apparently difficult to get needles into on normal occasions, but a redhead whose body is under stress presented quite a challenge to the hospital staff.)

They took my blood pressure oh so regularly and gave me double and triple doses of blood pressure medication constantly, even as they continued to ramp up the Pitocin to the highest levels. Some of the blood pressure readings were scary. I quit listening or asking: I didn’t want or need to know anymore.

Eventually your grandma moved to the waiting room, where our pastor had arrived. When I mentioned calling Pastor to put us on the prayer chain, our doctor emphatically agreed that it would be a good idea. Her faith in God and belief in the power of prayer was one of her attributes that recommended her to me when I was expecting your oldest sister. We’re thankful for a doctor whose testimony is well known in the community.

Your daddy was there wiping my forehead with a cool cloth, putting chapstick on my dry, dry lips, and giving me ice chips between contractions. He kept having to move from one side of the bed to the other as they rearranged machines around me. I don’t remember nearly squeezing the fingers off his hand this time around. But much of the labor was like watching a movie rather than participating it in myself.

I was concerned about your siblings. I knew they were worrying about me and you. I asked your grandma to go home and try to give them a normal bedtime routine. The fact that she went to be with them relieved my mind greatly. I didn’t have the mental capacity to worry about too many things at one time. (She would later regret that she hadn’t stayed nearby, and your siblings were certainly disappointed that they didn’t get to stay overnight at their cousins for the first time. But knowing your grandma was going to take your siblings home, I was able to relax and not worry about them having a rough night.)

I’ve never taken pain medication during my deliveries. I birthed all of you naturally. And this time, my doctor informed me, I had no choice. Even if I had wanted an epidural, I couldn’t have had one, because my low platelets put me at such risk for bleeding. So I was surprised when they asked if I wanted something for my painful headache. They explained that they could give me some pain medication through the IV for the headache, and I gratefully accepted.

The room filled with people. My doctor never shows up for my deliveries until it’s time for me to push (and I usually only push a few minutes). But this time, she’d been close enough I could hear her voice all evening, and had been in the room almost constantly for several hours. Now there were nurses briefing each other and the lab guy was back in case I needed something and there was a doctor on hand for you, too, I realized later. At that point, however, the number of people attending the birth didn’t bother me in the least.

Despite the dire warnings about the magnesium extending the labor, it seemed only to relax me and my body. I progressed quickly. They broke my water. I was at 7cm. I begged the nurses and your daddy to let me try a different position to see if that would help. They moved me to my side (I was beyond being able to move myself). And what seemed like 10 minutes later, but may have been more, I told them I felt something. I had the urge to push. In fact, I was pushing involuntarily. Please check me. They had just checked me. But they listened to me. Sure enough. You were crowning. I knew I felt something. The doctor commented on all your hair. And I pushed. And you were born. In just minutes.

And I cried, “Thank you, Jesus!”

Except, the exclamation point was more felt than heard. I was pretty exhausted. And clinging to the bed rail for dear life. I remember them having to remove my hands from the bed rail in order to put my baby in my arms. You—my baby!

And I don’t even remember if you cried. Neither does your daddy. I should have asked the doctor later. But I do not remember you crying. I remember the doctor saying you were a girl. And I wanted to cry with joy. Joy that you were alive. That I was alive. That you were here. That we’d made it.

For some reason, I thought you were a boy. I’d thought so all along. Whether it was from the timeframe during which I assumed you were conceived, or just the simple fact that my mom had two girls and two boys, I don’t know. But there you were. My daughter. An absolute and utter surprise in every way. But so perfect and tiny. And I was overwhelmed with gratefulness.

During this pregnancy, I’d specifically questioned the doctor about the cord cutting practices. And even in my utter exhaustion I heard her speaking to ease my mind, “The cord has stopped pulsating now so we’re cutting the cord.” She’s always been so thoughtful about catering to mommy’s questions and concerns.

You were pink and hungry. You latched right on. You ate for 45 minutes before you were even out of my arms to be weighed. I’m guessing you’d have weighed in at less if you’d been on the scale right away!

The IV sites in each arm turned out to be the most inconvenient part of the whole thing. Holding you with a bent arm resulted in the IV port being blocked. We tried switching between IV ports. But nothing really worked except for super creative nursing positions. And constant visits from the nurses to quiet the beeping IV pump.

I don’t remember a lot about that first night except that my normal post-delivery high took a bit longer to arrive. So by the time you’d finally eaten to your satisfaction, Mommy was wide awake with the glory and the pain of it all. Your daddy slept on the fold-out couch and the nurses stepped around him to check on me and you so many times in the night. We quickly got to the point where they were checking me much more often than you. I knew that meant you were doing well. And I was so thankful. They said that you were born so quickly that the pain medication they had given me didn’t even seem to have had a chance to get to you. It can often make babies a bit sleepy or lethargic, but you were bright and chipper and hungry.

I called to tell your siblings. And I let everyone else relay the rest of the messages because I was supposed to rest. But I felt better. You were born. I must be okay now. Even if my blood pressure was still crazy high. And my platelets had dropped to a low of 48.

It was a busy night at the hospital. My doctor went straight from delivering you to a C-section downstairs. I thought later about how ironic it was. That morning, my fear had been that you wouldn’t come and I’d have to have a C-section and my recovery would be so very prolonged as a result. In reality, a C-section was completely impossible because of my risk of bleeding. And my recovery would be far from speedy, regardless.

The after cramps were horrible. The nurses reminded me that they get worse with every child. I noticed! You were by far my easiest delivery, and in reality my quickest from barely dilated to birth. The cramps were the worst part of recovery. But the fact that I had to remain on bedrest meant that my body healed relatively quickly. I was grateful for that aspect of enforced bedrest.

April 4:

The first sign of my returning health was my voracious appetite. When the dietician visited Friday afternoon (before your birth), I’d ordered an omelet for Saturday morning’s breakfast, in good faith that you’d be delivered and I’d be ready to eat again. When it came, I ate every last bite. And proceeded to thoroughly enjoy the delicious hospital food served to us throughout our stay. They even served us a lovely Easter dinner of ham, scalloped potatoes, and asparagus.

But I’m getting ahead of myself. Saturday morning found you still without a name. When it comes to naming children, your daddy and mommy have always had very different approaches. Mommy combs through books and lists of baby name ideas and makes notes from the time she knows you’re on the way. But your daddy has never been able to name any of you until he holds you in his arms and gets to know your personality a bit. And you were no exception. In fact, none of the names on Mommy’s list fit you. So Saturday morning it was back to the drawing board. I used my smartphone to pull up the same list of Bible names that I’d found online many months earlier and started texting your daddy with ideas (he had gone home to get your siblings). I saved that text message conversation for you because I know you’ll enjoy reading it someday.

So it was that we introduced your siblings to their new baby sister Sara Elizabeth on Saturday morning. They were delighted. Even your brother, who had a few moments Friday night of adjusting to the fact that he didn’t get a brother, was instantly smitten with you.

I spent the day Saturday feeding you and trying to sleep between all our checkups and my blood draws.

I drank more water than I thought possible. But the nurses were still amazed by my fluid output. To say I’d retained a lot of fluid was an understatement.

We had the best nurses ever, little Sara. I’ve never been so humbled and so grateful. They cheerfully cleaned up every mess. They tended to our needs so patiently. They were each like special ministering angels sent to care for us in our time of need.

Your grandma Sara switched places with your daddy and spent both Saturday and Sunday night in the hospital room with you and me. She held you so Mommy could sleep. And your daddy got some much needed rest while giving your siblings the normalcy of his presence at home.

April 5:

Resurrection Sunday brought more visitors and quiet reflection on the miracle I held in my arms. It also brought relief when the nurses were told they could take out one of the IV sites. We had thought maybe we’d get to go home Sunday, but Mommy’s blood pressure still wasn’t great. The doctor wanted Mommy’s headache to get better and go away for good, so she told us to shut the window shades (the nurses had opened them to help your color), stay quiet, and just rest.

By Sunday evening, you seemed to finally awaken to the startling fact that you’d been born. And you weren’t that happy about it. Despite nursing constantly for the past 48 hours, you suddenly had trouble latching on. You cried nonstop for several hours. The only thing that could comfort you was your daddy’s arms. He was tired but he walked with you and held you and played white noise for you in between mommy’s attempts to feed you.

And the nurses always came in to check my blood pressure right about when you were screaming your loudest.

I don’t know how late it was when you finally calmed down. But you finally did. Your daddy went home to stay with your siblings and your grandma came and held you when you weren’t eating.

April 6:

They drew my blood again early Monday morning. And we were released to go home.

The UPS truck arrived at the same time we did. It was like you had a special delivery arrival in every way. Your siblings were so very thrilled to have you at home. And so was your mommy.

I sank gratefully into my own bed. And once you awoke amid the admiration of your siblings, you curled up on my chest. I was supposed to maintain bedrest and keep an eye on my blood pressure, because with my condition, symptoms could pop up again even after delivery. But gradually, my constant blood pressure readings began to show improvement. And I began to ease back into being up and around.

I think it was that first doctor’s visit after your birth when it all began to hit me. The doctor sat with your grandma and me and went back over all that had happened. She explained that she’d only ever had four patients with HELLP Syndrome. And our case turned out the best, she said. I didn’t want to ask what had happened with the others. I only knew we were so very, very thankful. The tears came as I sat in the car with you after our appointment, while your grandma got us coffee (decaf, of course). The doctor’s words were sinking in and I was just beginning to grasp what we’d been through.

My strength and stamina returned ever so slowly. There’s nothing like feeling well again to realize how very sick you’ve been. Sometimes it was the little things, like the fact that I was actually able to focus on reading a book again. Sometimes it was the big firsts, like going back to church or making a meal on my own again. But mostly it was kissing your soft little head, marveling at the tiny weight of your body on my chest, and listening to the sweet sounds you made in your sleep.

The tears would come when I expected them (putting away those first little clothes you grew out of) and when I wasn’t looking for them at all (too often, it seemed, those first few months). But each time, I worked a little more through what happened. And always, I came back to the fact that, just like your sweetly swaddled self, we’d been wrapped in God’s love and grace. And nothing had touched us that He hadn’t allowed.

At your one-and-a-half-week checkup, the doctor was delighted with my lower blood pressure reading, exclaiming, “We’re getting our Gretchen back!” At my six-week checkup, the nurse drew my blood again. And my numbers were back in the “normal” range for the first time since that appointment five days before your birth.

We said goodbye to your grandma.

We gratefully accepted the freezer meals from friends. And we gradually eased into our new normal. A family of six. With the sweetest little miracle constantly reminding us of God’s grace.

I love you, Sara Bear. And I’m ever so grateful to God for the privilege of being your mommy.

With love,
Mommy

Sara: princess
Elizabeth: promise of God

born April 3, 2015
at 7:54 p.m.

weighing 6 lb. 3 oz.
measuring 20 in. long