Wednesday, March 28, 2012
Birth Story: Meeting Alice.
I woke up on Thursday, March 22nd sort of annoyed. Six days after my due date, I was still pregnant. And during the night I was certain I would go into labor! I had been to my OB on Wednesday and she had done some things down there to help bring on labor. I went home. Did laundry. Walked. Bounced on the exercise ball. Something was definitely happening. We went to bed around 9PM and, at that point, I was having what I would call really bad menstrual cramps about every 7 minutes or so. Nothing unbearable, just uncomfortable. I was excited. And I was convinced that tonight was the night!
And then I woke up the next morning with a quiet uterus. No cramping. No pain. Just big and pregnant. Lee decided to work from home that morning (secretly he must have known!) so we enjoyed a cup of coffee together as he got his day started. I had a 9AM ultrasound so I got ready and walked the few short blocks in the beautiful spring weather. Before I left, I told my husband I'd bring him home a donut from the hospital (they have a Dunkin Donuts in the lobby which is wrong on so many levels). Little did I know.
I bought our donuts and realized I hadn't eaten breakfast that morning. So not like me. I am usually a bowl-of-cereal-right-out-of-bed kind of girl. Luckily I bought three delicious treats and I enjoyed a chocolate cake donut before my ultrasound.
I was having another ultrasound for a few reasons. Of course I was having one done because I was post-due. But on Monday, the ultrasound showed that I had low amniotic fluid levels. Anything below 5 is considered grounds for induction based on risk for cord accidents and nuchal cord. I was at a 6. Shockingly, my overprotective OB let me go home that day and asked that I have a repeat ultrasound done on Thursday.
So there I am, lying on the table, the ultrasound tech is telling me how beautifully the baby is moving and she is practice breathing and she's kicking and oh, by the way, your amniotic fluid level is now 4. Prior to getting this ultrasound done, I had done some research on how to increase amniotic fluid and I had done everything possible to ensure I'd have more than I did on Monday. Nope. Less, in fact. That just meant my placenta was aging and was working less efficiently (hey, it put in a good 40 weeks + 6 days!). So the ultrasound tech leaves the room and asks that I wait for the MD in ultrasound who will come take a look.
As I laid there I thought to myself This could be the day I meet my daughter!! The thought put a smile on my face and a bit of fear in my stomach. This could be it. I heard a soft knock at the door and in walks my OB, who I totally wasn't expecting, saying I think we need to induce you based on this ultrasound. Whoa. Okay. So I said I'd go home, tell my husband and quickly grab a few things and she asked if we could forgo all of that and go straight to labor and delivery and check in for induction. Um. Sure.
It was go-time.
When my nurse put me on the toco-monitor I was already having pretty regular contractions. Five to six minutes apart and bearable. Good, I thought. My body was already ready to go into labor. Maybe I just needed a little push. An IV was placed and pitocin was started at 10AM to help ramp up my contractions and bring them closer together. My OB came in to check me at that point and I was 2 cm dilated and 80% effaced. She was very happy with that and said she believed we'd have a baby before midnight! Wow. It was happening!
The pitocin at small doses wasn't that bad. The contractions started coming more frequently and soon they were 2 to 3 minutes apart but still bearable. Occasionally the nurse would come in and ask me to roll onto one side or the other as the baby's heart rate would drop but as soon as I moved her heart rate would come back up so my nurse and my OB weren't concerned yet. I asked why this could be happening and my nurse told me that the baby was most likely laying on the cord and since there isn't much amniotic fluid, her body could be compressing it causing her heart rate to drop. Of course this worried me but everyone seemed okay with it as her drops in heart rate weren't sustained.
My husband arrived just as they were getting ready to break my water. After 2 hours on pitocin, I was 4 cm and 80% effaced so breaking my bag of waters would definitely get things moving along. It also made the contractions hurt like a bitch. This is when I began swearing like a sailor. Every other word was fuck or goddamnit or oh shit repeated over and over and over and over. Lee was wonderful and sat next to my bed and comforted me as the waves of pain overtook my body. I had no intention of having a medicine-free birth and had planned to go as far as I could without pain medicine but I had reached a point where I was ready for some relief. My nurse notified anesthesia and they were quickly at the bedside to give me an epidural.
The epidural placement wasn't bad at all. What was bad was having to sit completely still as the contractions came on as there was a needle in my spine which could cause serious damage if I moved even a centimeter. It took the anesthesiologist a few attempts and a bit of manipulation to get the epidural catheter in place but, once it was in, and after about 15 minutes, I was smiling and happy and pretty much pain-free. The baby, unfortunately, continued to have drops in her heart rate. The pitocin was turned off at that point to help with the baby's heart rate and I was placed in every position imaginable to help raise her heart rate. Left side. Right side. Laying on my back. On my hands and knees. After a minute or so, her heart rate came back up and things looked good. My OB checked me and, at 1PM, I was now 6 cm and 90% effaced. She said to keep the pitocin off as my contractions continued to be 2 minutes apart without help from the drug. Lee and I settled in, holding hands and excitedly talking about the arrival of our daughter.
By 5PM I started to feel nauseous and I was having full body shakes. My nurse told me this was totally normal and meant that I was heading into transition, which is the stage right before labor and pushing. I was so excited! We were moving along. My OB checked me and happily reported that I was 8 cm with a small cervical rim that needed to efface but unfortunately the baby was still high in the pelvis. She was confident, though, that we'd be pushing within the next 2 hours.
By 6:30PM I was extremely nauseous as the contractions came on. Although I couldn't feel them, I could tell when a contraction would start and reach its peak as it made me dry-heave and shake almost uncontrollably. Thank god for epidurals is all I can say.
At 7PM, after a quick check, I was told I was 10 cm and fully effaced and Would you like to try pushing? Holy shit. This was it. We were having a baby! After a quick tutorial on how to properly push, my nurse held one leg, Lee held the other and I was suddenly counting to 10 and pushing as best I could. After the contraction subsided and the Great jobs! were said, the nurse looked at the monitor with the baby's heart rate and just kept saying Come on, baby. Come on, baby. When I asked what was up she told me it was normal for the heart rate to drop during a contraction but that it needed to come back up quickly in order to get blood flow to the baby. Her heart rate soon came back up and then my OB arrived to help move things along.
The pushing was going very well but, unfortunately, the baby did not like it all that much. This is when I started to get scared. Really scared. And out-of-control. I just felt that something wasn't right. My doctor said we would wait and not push through the next contraction to see what happened. The baby did well and responded to the contraction appropriately. And then we pushed through the next contraction and her heart rate stayed low again. My OB asked for the help of another doctor and he was quickly at the bedside. He did a check and said that the baby's head is still very high in the pelvis and they all suspected nuchal cord, or that the baby had her umbilical cord wrapped around her neck. And, with every push and as she made her descent into my pelvis, the cord could potentially be getting tighter and tighter around her neck. My doctor asked my nurse to ready the OR for an emergency c-section and came to the head of the bed to talk to me. She told me her concerns about the baby and the heart rate and the potential nuchal cord and, without hesitation, I told her to take me to the OR as quickly as possible.
Lee was handed a pair of scrubs and asked to step out of the room. He later told me that the second doctor stopped him in the hallway and told him that he suspected nuchal cord and, had the baby been lower in the pelvis, they could possibly use forceps to help her out but even that was risky. I was glad to hear the consensus of the doctors that she needed to be delivered immediately by cesarean.
I was wheeled into the OR at 7:30PM. The flurry of activity could only be described as controlled chaos. There were at least 15 people in the room, hurriedly preparing for the procedure. At this point I was still trying to remain calm even though I was completely panicking on the inside. They hooked up the heart rate monitor for the baby and I obsessively listened for the quick whoosh whoosh whoosh of her beating heart to help calm my fears. My thoughts were racing with all that could go wrong. My healthy baby girl. She was inside of me and needed to get out immediately. And there was nothing I could do at this point to help her. I was so scared. Terrified. A medical student wearing a surgical mask looked at me with her sky-blue eyes and kept repeating It's going to be okay. Your baby will be okay. I clung to her words, hoping she was right.
Lee came in the room and sat next to me. I began crying hysterically. I kept saying over and over Hurry. Just please get her out of me. Please let her be okay. The blue drape was placed across my chest and they began the process of opening up my abdomen to deliver our baby. Time seemed to crawl. I wanted to yell for them to Hurry. Don't worry about me. Focus on getting her out. Because she was already somewhat into my pelvis and once they got into my uterus, a nurse had to put her hand up the birth canal to push the baby back so that the doctors could pull her out. After what seemed like an eternity I felt a release of pressure and something blurry being handed to a waiting doctor and then someone said We have a baby girl! Time of Birth: 8:03PM.
I waited to hear that all important cry. Waited in fear. Please let her be okay. Please let her cry. I kept asking Lee if she was okay and he was assuring me that she was and that they were just cleaning her off and warming her up. Suddenly I heard the most magical, the most beautiful, the most wonderful sound I have ever heard in my life. My little girl squealed a loud, high-pitched scream and I finally knew she was okay. I once again burst into tears.
She was here. She was okay.
Due to the nature of the situation, the NICU team had been notified and were in the OR awaiting her arrival. Fortunately, they didn't stay long and all was well. The nurse handed a still whimpering Alice to Lee and he brought her close to me so that I could kiss her sweet face, see her beautiful eyes, and feel the warmth of her skin against mine.
The hour or so it took to finish the procedure felt excrutiatingly long. When they were finally finished, they transferred me back to my hospital bed and handed me my daughter. Words cannot describe the feeling I felt as I held her in my arms for first time. It felt so right. She is here. And she is healthy.
And I love her so much.
And she did, indeed, have the umbilical cord wrapped tightly around her neck. As much as I complained about my overly protective and borderline paranoid OB, I am so grateful for her caution and her quick move-to-action in getting our little girl out safely.
We are so grateful.