Thursday, June 17, 2010

The (extremely long) Birth Story

So, yeah, I've been working on typing up the birth story (and a bit about the day or two beforehand) in between tantrums from Little Mister, who sometimes loves his sister to bits and sometimes wants her as far from him as possible, and baby feedings, and bouts of preteen melodrama ... The husband has been quite helpful this week, fortunately, or I think we'd all be in the nuthouse.

On Wednesday, 6/9, I saw the OB who would be delivering her on Friday. She was transverse again. When she was transverse, my contractions weren't accomplishing anything as my cervix hadn't changed in a week or more, though was favorable for induction at 3 cm and 80% effaced, and her sideways-ness would pull my cervix so high no one could reach it. So I'd been in pain and/or discomfort all this time for no reason and was just getting more exhausted every time they started up. We discussed the version and induction, and he let us know the real possibility of serious complications. And we talked about the plan. After getting my IV antibiotics going for MY heart condition and me prepped for a C-section just in case (including an epidural), he would then turn her to a head down position, but it is impossible to get a baby to engage from the outside. Once she was turned, he would then break my water. The risk there is that because she was so free floating and way up high, her cord could prolapse (come out with the fluid), which is extremely dangerous for the baby and would indicate an emergency C-section. Another very real problem was that she might take a long time to descend and could end up in distress, and since this little girl had been having a hard time lately anyway with two NSTs that started out rough, she could end up in distress from the contractions once they get going, even if the labor and delivery were faster. With Kiddo, when they broke my water, she went into distress and they had to pump fluid back into me to keep her heart rate up, or she would have been a C-section, too. I didn't think that was a viable option with this little one since she'd just use the fluid to swim away from the exit. Or she could flip again in labor and/or get the cord wrapped around something. Any of those things were very real possibilities, but I felt comfortable with going ahead with the version and induction route -- as long as we were at the hospital when my water broke, I felt like anything else that happened would be okay.

I felt very at peace about this decision, though it was still a difficult thing for me to handle. I had a very natural childbirth with Little Mister with no drugs of any kind, and I recovered SO quickly and had such a birth high. It was amazing, and extremely different from my induction and epidural birth with Kiddo. Ever since I found out about this surprise pregnancy, I'd planned in my head that we would have another natural birth without interventions. But little K has a mind of her own, and this pregnancy was riddled with various complications that hadn't even entered my mind and weren't in the picture with Little Mister -- insulin dependent diabetes for starters. But I felt very strongly that we'd both be okay at the end, no matter how she was born, and for whatever reason, baby K needed to be born with medical help. Whether we ever knew that reason was another question entirely.

After some processing and crying, I busied myself with housework and sleeping over the next couple of days. Laundry, floors, cooking, baking, and a little last minute shopping. Plus some big cuddles with Little Mister and lots of Kiddo hugs. I knew I'd miss them both terribly. And I cried every time I held Little Mister because I wasn't ready for him to not be my baby anymore.

We got to the hospital at 6:30 on Friday, 6/11, and went straight to the L&D floor. They had the room ready for everything, including a teeny tiny little hat and diaper next to the isolette. After lots of medical history and questions, and a couple of ultrasounds showing that she was head down right then, they got the IV going and started my IV fluids. They wanted 1 liter in before they got the epidural going, and I needed the antibiotics. That took an hour.

Then the anesthesiologist came in to do the epidural. Lots more history, but he apparently missed the spot in my chart where the perinatologist said to avoid a rapid epidural because it would probably cause my blood pressure to drop, and I forgot to mention it. The first time he placed it, he nicked a vein: I got a fast headache and nearly passed out. He placed it again and the test dose was fine, but when he started the actual meds, my blood pressure dropped like crazy. I think the lowest it went was 60-something over 40. It took another hour to get stabilized, and by that point it was 10:00 and the OB's partner wasn't available. They both needed to be there just in case it became an emergency when they broke my water so that there were two sets of hands instead of one. They started the Pitocin at OB's instructions, hoping my cervix would dilate more and baby would descend some. Two hours later, he came in to break my water. She hadn't descended, but I was 5 cm. It was still so high, though, it took him a while to be able to reach it well enough to break my water.

He broke it and a little trickle came out. I asked if I could please sit up again, and immediately upon doing so, a FLOOD came out. They had to change the towels at least 4 times, and after she was born, even more fluid came out! There was no cord prolapse at the time of rupture though, and baby K was fine, so I just stayed sitting up as much as I could. I knew gravity would help me progress and baby to descend, and since I couldn't walk around because of the epidural and monitors, that was the only way to do it. My belly deflated a lot with the water and it wasn't as tired anymore.

She took a long time to descend and eventually her heart rate started dropping with every contraction, but it came right back up as soon as the contraction was over. They ended up placing internal monitors once she was low enough because she was still squirming away from the external monitor, though not turning at all (fortunately). Around 5:30, I was complete and they called the OB. He was at a different hospital but on his way back. Before he got back to the hospital, however, another one of his patients was complete and her baby was nearly born before he got there! So he delivered her baby and stitched her up, then came in our room. All in all, we waited nearly 3 hours for the doctor during the course of the day or she probably would have been born way sooner!

By the time the doctor got to the hospital, baby K's heart rate wasn't recovering as well, and we knew we needed to have her soon. It was hard waiting for him, but he came into the room really quickly, and I started pushing. Because of the epidural, I couldn't tell where to push and was having a hard time, and the doctor said that was fairly normal because you can't feel down there. With Kiddo, the epidural had mostly worn off before she was born and I watched in a mirror, so I knew exactly what I had to do to get her out and did so in just a few pushes. With Little Mister, no drugs and an incredible urge to push meant he got pushed out as soon as I quit saying I couldn't do it and made up my mind to do it. So it was a bit frustrating to push for 10 minutes and not make any progress, and then hear the OB say we'd be there a while. My nurse was scheduled to leave 10 minutes later and she told me she'd only be able to stay for two more contractions. That's not what did it, but realizing the baby needed to be born right NOW because of her distress, getting the head of the bed lowered a bit at the nurse's suggestion, and actually having an urge to push, with the next contraction, she was being born. The doctor was very encouraging and told me I was doing exactly what I needed to do and to keep pushing, so I did. Then he said, "Whoa, slow down!" So I did. Apparently, the cord was around her neck and her arm, and her shoulder was stuck, so he had to get ready to quickly untangle her as soon as I pushed her all the way out. Moe was watching all of this and said the doctor has fast hands and was glad for it -- seeing the cord wrapped around her like that really freaked him out. The cord was also the reason her heart rate kept dropping toward the end. I didn't have any tears or anything, so I'm feeling pretty good today (she's 6 days old as I'm typing this), just sore belly muscles from the birth.

She was born at 6:25 p.m. after 8 hours on Pitocin and 6 or so hours after fluid rupture. She was 8 pounds 3 ounces and 19 inches long, my biggest baby by half a pound. She did just fine in the hospital with only slightly borderline low blood sugars, so we ended up staying two nights instead of the one I wanted so they could monitor her a little longer, but they never got into the dangerous range. My sugars started coming back to normal the next day, and I started feeling better almost immediately after her birth.

She started nursing about an hour after she was born and has nursed better than either of my other two babies. She's had fewer problems than they did, too, though jaundice seems to be par for the course with my kids. If I ever have another baby and have a say in things (which I didn't with Little Mister because he was in a hurry to be born!), I'd wait to at least 38 weeks to deliver. She is just doing better overall than the other kids.

We are thankful that things went as well as they did and, though there were a few scary things that happened, we are extremely grateful that we were able to deliver without a C-section or any major complications. I honestly feel like this was the best thing for our baby and myself, and my husband said he liked the drugs because I didn't try to break his hand. Ha.

So there you have it. If you read the whole thing, thanks. If not, I understand!


Tyson, Katie and Amelia said...

I read the whole thing :) You're welcome. I had an internal monitor too. I ended up pushing both of them out while I was pushing. What doctor delivered you?

I'm so glad you were able to avoid the c-section and that the end result was a healthy baby and a happy mama! I'm glad you didn't tear too! That's rough recovering from that! I tore to a 2. :( Anyway, loved reading this! You're amazing!

SRA said...

Read all of it too. Good story and glad things turned out so well.

amyb5984 said...

Enjoyed reading the story!!! Sad that I wasn't in the States to be called as I was after Mojo's birth. But very glad you and the baby are healthy and for no c-section!!! Well done you!!!

Rockelle said...

I was in Cali....just now saw that she is finally here.Well Congrats my friend! Cant wait to see pictures. post or email some soon!