Thursday, January 1, 2009

Olivia's Birth Story

Okay, so the part you know is that I had a very "unripe" cervix over the weekend, but did lose my mucous plug which meant very little except reassuring me that maybe this baby was going to come out on her own after all. So Sunday evening I was feeling kinda slow and hermit-y, like I just wanted to hunker down and watch all the shows I'd been saving up on the DVR. Steve convinced me to go with him to grab a bite to eat, and I noticed a couple times that the baby was pressing hard on my belly, somewhere in between my navel and bladder. This had happened before, but never this often and usually in conjunction with the baby moving. By the time we got home I was like, "There it is again," and then we started timing them.

By 7:00 Sunday evening the "kicks" had become pretty regular, around 8 minutes apart and 30 seconds long. We timed some more, I took a shower, we watched more TV and finally put on a movie to have something to distract me. The contractions were becoming more intense painful and closer together, and around 1am they had been the requisite 5 minutes apart for an hour so we went to the hospital. In L&D Nurse Sarah checked my cervix and it was thinning nicely and had dilated to 1-2 cm, which unfortunately was not that impressive to the staff (they wanted to see more progress). We were told to walk around the halls for a while and come back to get checked out, and Sarah also told me that the intense pain in my lumbar region that came with every contraction was due to the baby presenting posterior, in other words I was in Back Labor. I don't recommend it. Steve and I slowly walked the halls and swayed back and forth; he was a wonderful shoulder to lean on. After a couple hours of walking and contracting we went back to L&D to get checked and my cervix was at the. Exact. Same. Place (1-2 cm), meaning I wasn't progressing. So at 3:30am they sent us home and I was starting to panic. (Are they kidding? Try some TYLENOL?! How much longer am I going to have contractions this hard with no dilation?). Since starting labor at the end of a day is probably the worst possible time as far as exhaustion, I had Steve get some shut-eye while I bounced on the exercise ball, walked around, and tried to lie down and sleep (ha!). No position was comfortable and about every 5 minutes I had an awful contraction. Finally I couldn't take it any more so we went back to the hospital around 7am on Monday.

Nurse Jill was now on duty and, after an internal exam, let me know that I still hadn't dilated enough to be admitted. She introduced me to our L&D nurse (Cathy) and hooked me up to the baby monitor, but laying down for contractions was even harder than walking around. We were given the option of walking the halls some more or going home, and the latter was too much for me to take mentally. By now the fourth floor was bustling with activity, which was pretty tough in terms of privacy when dealing with painful contractions. In general what makes a difficult situation even more challenging for me is to have a third party even acknowledge what's going on, or when I'm forced to verbalize it (like when I had my first NST and didn't call anyone until it was over) . People would see me have a a contraction, ask if I were okay, offer me a wheelchair, and otherwise sympathize with our Walk of Pain ("Been THERE!"), but it was all I could do not to have a meltdown and scream "Leave me alone!" Steve tried massaging my back, but for some reason even gentle touch would kick me out of my zone, so I asked him to stop. (Each time he tells the story it gets more severe. "Don't... touch... me!") We checked back in at L&D around 10am and Cathy, aware of our frustration and pain, said I was dilated about the same (2-3cm) but proceeded to use her fingers to stretch my cervix out to 3-4cm so they could admit me. (This was incredibly painful, but so worth it because of the results.)

---Turning Point---

To have a quiet, private room in which to labor was HUGE after walking around for nine hours, but it also turned out that I was also dilated enough to receive an epidural. It took about an hour to get an anesthesiologist, but in the meantime I got a dose of Nubane "to take the edge off." It made a huge difference in the amount of pain I was feeling and also made me feel drunk and happy after being so miserable. I highly recommend this if you're in labor and holding out for an epidural.

I rolled/bounced on the exercise ball and did some more walking/swaying for a while, then anesthesiologist Dr. Thompson came and started the epidural. I know these guys are trained to do this procedure and have a lot of experience, but I still had a healthy fear of having irreparable damage to my spinal cord. Cathy helped keep my shoulders forward and back rounded (like a mad cat at Halloween), but I had a contraction right in the middle of the procedure and it was all I could do to stay still. So for those of you wondering how much it hurts to have a huge needle in your epidural space, I'll have you know that the bee-sting shot of numbing medication beforehand was the worst part for me. They did have Steve sit down where he could see my face but not my back, but the epidural was anticlimactic in general. And now that walking was no longer an option I also got a Foley catheter and *finally* a little sleep.

At this point my legs felt like they were asleep, but I had no pain anywhere from the chest down and could feel very little else (temperature, pressure, etc.) At some point (4pm?) Cathy said my cervix was "tissue thin" and dilated 6cm so she broke my water. But through the afternoon my contractions had become less regular and farther apart, so I was given a small amount of Pitocin to get things going again.

I took another nap (again, I'm a big fan of the meds!) and the next thing I remember is Cathy and Jill waking me up to put an internal monitor on the baby. After the monitor was installed they took me off Pitocin and gave me an oxygen mask. I mentioned that I thought I could still feel a little wetness under my legs, then we realized that I had been sitting in bedding that nobody noticed had gotten soaked with amniotic fluid. With teamwork reminiscent of choreography they changed the entire bed with me lying in it. Once everything settled down they let me know that the internal monitor and oxygen were because Olivia's heart rate had dropped, setting off alarms at the nursing station and causing a general freak-out which I had been too loopy to notice. Cathy checked my cervix again and was very surprised to find it thickened (swollen) and the dilation was down to 3-4cm indicating that things were regressing. She thought the swelling was probably due to a condition where the baby's head was too big for the pelvic opening and I was all like, "You mean I've got CPD." And she was all like, "How do you know what that is?" And I told her that CPD and having a gargantuan baby has been my concern (nightmare?) ever since we learned about it during our childbirth prep classes.

Dr. Nashed (my OB on call) came up to discuss the options: Wait it out to see if things started progressing again, or have a C-section. Then Steve and I discussed it in private and it went something like this: "What do you think I should do?" "Well, when we were walking the halls I was thinking about this and realized that if you have a C-section you never have to go through labor again." "Awesome, that's what I was thinking. I was secretly hoping for a C-section all along!" Dr. Nashed and Cathy came back in and agreed that the section was what they thought was best, so I was wheeled into the OR and prepped for surgery right away. Since I couldn't feel my legs I was moved by the team to the operating table ("on three") and within a few minutes the barrier was hung and Steve and I could only listen to Dr. Nashed say as little as he could during the surgery ("Irrigation." "You're going to feel a lot of pressure.") Meanwhile the anesthesiologist, Dr. Hagan, was saying as much as he could, telling jokes to keep things upbeat. ("Dr. Nashed has good hands." "So where did you guys meet?" "How many times did he have to propose?") He also took a bunch of pictures and printed several out for us by the time I was stapled shut. Olivia was born at 6:03pm; the surgery took 45 minutes and then I was in the recovery area for an hour. Meanwhile Steve watched the team clean up the baby and take her stats (weight and height: gargantuan), and then he called our parents. I was wheeled to my room in the Mother-Baby unit at 7:30pm, a day after my contractions had started.

Recovery has gone well, although a lot of it has been a blur because of the repetition. Highlights were definitely all the visitors that we got (the friend variety, not the vitals lady). We're looking forward to going home tomorrow!


Elizabeth said...

1) I'm still inwardly cringing about the cervix stretching part.
2) AMEN on the taking drugs while waiting for the epidural! I'm nervous about the epidural this time because I can't have the drugs to relax me.
3) Dilation regression - same thing for me. Made it to 9cm, then swelled back down to 6-7.
4) I think I secretly wished for a c-section too. :-) No more labor! EVER! HALLELUJAH!!
5) I liked Dr Nashed when I met him and think he and Dave would click, but I already picked Dr Lowder to do the c-section. Should I change my mind??

~ Dawn ~ said...

Congrats Anne and Steve, what a precious gift from the Almighty! So glad that you all are safe and healthy and pray you have a wonderful first week of your new life in the new year! Hugs...
She is beautiful... of course!

Tammy said...

Congrats Anne! Olivia is too precious and the same size Nicolaus was when he was born. I am glad you and your family are doing well. Take it easy and accept all the help you can get while you recover.