Thursday, January 19, 2012

Natalie's labor and delivery story

Every woman who has been through labor and delivery has an amazing story to tell. Amazing and graphic, no doubt. I am no exception here. I am going to be incredibly frank, so get ready. I think it's useful for all my friends and family who've been asking questions and want to know the gory details. I will give them to you. If you don't want those details, please don't read this post.

My labor and delivery story can be summarized as follows:

1) If it could happen it did happen. Thank god I went in well informed.
2) I am way stronger than I realize. This is my new mantra and one I've already started sharing with my lady friends to encourage them as well.

My labor story really begins Dec. 8 at my 36-week appointment. My doctor performed my first cervical check and discovered that I was already 1 cm dilated and 75% effaced. She was really excited, saying that for a first-time mom this was excellent progress and she was convinced I would go into labor early, or if nothing else I would not go past my due date. She recommended I pack my bags and get everything in order. I started to freak out at work, getting all my grading and planning and packing done in case I wouldn't make it to Dec. 22, the start of my maternity leave.

Well, as you know, I clearly delivered 10 days late and went a little stir crazy at home in the process of waiting for Natalie to show up. By 39 weeks I was 3 cm dilated and 90% effaced. And that's where I stalled out. I had three different non-stress tests at my doctor's office leading up to Natalie's arrival. (If you're unfamiliar, this is a test where the mom is hooked up to two monitors: one for the baby's heart rate and one for the mom's contractions. Natalie took contractions like a champ, showing that she was well-suited for labor. Turns out I was having lots of contractions, some rather intense, that I could not feel. During one somewhat significant contraction at 39 or 40 weeks I told my doctor a story and she said, "Did you not feel that last contraction, because it was rather intense." No, I did not.)

So then I started worrying that I wouldn't know true labor when it finally arrived. I figured this was absolutely ridiculous, but I still worried. Overall, though, my fears of childbirth had subsided and I reached a really Zen state, ready to bring this baby into the world at the time she decided was right.

Then I went in for my 41-week appointment on Tuesday, Jan. 10. My doctor stripped my membranes for the third time. This is barely a procedure. It pretty much involves the doctor digging around the cervix while she's performing the cervical check for dilation. It's just more vigorous digging. Usually doing this procedure once can help some women go into labor within 24-48 hours. Not so much for me! But, good news is that I spent pretty much all day Wednesday having noteworthy contractions and my "bloody show."

By 8 p.m. Wednesday night I told Matt I could no longer focus on watching our Netflixed episodes of session one of Downton Abbey. So, I went upstairs and settled into bed, reading my latest novel selection, Room.

By 10 p.m. I was fast asleep.

Here's where I am going to let the timeline take over:

11 p.m. Wednesday -- I bolt out of bed. I had a huge pregnant stomach, yet I had a strong enough contraction that I actually jumped out of bed. Such a feat had not occurred since approximately August. I attempt to time contractions to no avail. They seem constant.

11:30 p.m. Wednesday -- I call my doctor. The doctor on call is not picking up, so the nurse talks me through my contractions to assess the situation and puts in word for the doctor to call me back asap.

Midnight Thursday -- Still haven't heard from the doctor, and now I am worried I won't make it to the hospital in time.

12:15 a.m. Thursday -- The doctor calls and advises me to get to the hospital. We take our bags to the car, throwing in the few remaining items like our cell phones and iPad. I remember to turn off the computer and turn down the thermostat to 62 degrees.

1 a.m. Thursday -- Arrive at labor and delivery registration. They take me to triage to assess the situation. Another non-stress test reveals I am contracting every 1.5 to 3 minutes. I take this as a good sign, seeing as I'd been advised to come to the hospital when my contractions were 5 minutes apart lasting 1 minute at a time. The baby's heart rate still looks outstanding. The nurse performs a cervical check and discovers that I am still only 3 cm dilated (after nearly a day of noticeable contractions). They give me two options: I can walk around the labor and delivery floor in circles, or I can go ahead and get pictocin (a drug that stimulates contractions...and is known by some to cause contractions to become very painful). I opt for the walking option.

2 a.m. - 5 a.m. Thursday -- Matt and I walk for 3 hours. I hope that when this is over I will have gained at least a couple centimeters dilation. The only contractions that matter are those that lead to dilation. My contractions are definitely feeling more painful, truly like awful period cramps, and I have to pause periodically on the labor and delivery floor and put my head on the guard rails on the walls and swing my hips back and forth.

5 a.m. Thursday -- I am in a bed in the labor and delivery wing and Matt and I are ready to settle into real labor. I stay in bed for a while, hoping I've made progress. I am still at 3 cm. They ask me if I want to start pictocin, and I say not yet, give me one more shot.

6 a.m. Thursday -- Still stuck at 3 cm, so I opt for pitocin. I am told by my nurse that I need to anticipate the pain I'll be in 45 minutes from the time being when I consider requesting an epidural because it takes about 45 minutes to get the anesthesiologist there and to get the epidural inserted. I think this sounds crazy. How can you anticipate pain in the future? But I try to keep it in mind.

7:15 a.m. Thursday -- I decide that while my contractions are manageable now, by 8 a.m. they may not be, so why risk it? I request the epidural.

 7:45 a.m. Thursday -- The anesthesiologist arrives and tells me to hold still (as I had heard before) and that the epidural insertion would feel like a bad bee sting. I intentionally never looked at any of the equipment being used so as not to worry. I remained shockingly calm. The nurse gave me a pillow to grip and hunch over and I barely needed her to hold me still. The whole thing only took about 5 minutes to administer, and I felt no pain at all from the epidural insertion. It immediately goes to work. I can feel my legs and move my feet and toes, but I no longer feel any contraction pain. According to what I had been told at our childbirth class, this sounded like the ideal epidural experience.

7:55 a.m. Thursday -- Thank god I got the epidural when I did because my water broke on its own. My doctor told me that my amniotic fluid levels were healthy (aka high) and when my water broke I would know it. Well, I did. People had said it would sound like a ping. It was a little deeper sound than that to me, but when it broke there was a huge gush and I said to the nurses, "I'm pretty sure my water just broke." Good news, the fluid was totally clear. I am so glad I had my epidural when my water broke because I've heard contractions after the water breaks are more intense, and contractions with pitocin are more intense, so contractions with pitocin and broken water with no epidural would have been a recipe for disaster.

The majority of the daylight hours following are anti-climactic. We just waited. I felt no pain. Matt slept. A lot. So much so that when I finally needed him for something I shouted his name 15 times before he woke up. He finished reading his book. I watched the fourth hour of the Today Show. Kathie and Hoda are truly more entertaining that the Saturday Night Live parodies of them. I flipped through some magazines. I even slept a little myself.

11 a.m. Thursday -- Cervical check: 5 cm dilated! The doctor reduces my pictocin because my body is finally laboring well on its own.

3:30 p.m. Thursday -- Cervical check: 9 cm dilated!

4:45 p.m. Thursday -- Cervical check: fully dilated and effaced and ready to push.

5 p.m. Thursday -- just as I am starting to push my contractions slow down to one every five minutes! We cannot believe this. This is when you're supposed to call the hospital initially to come in. When you're ready to push contractions are nearly constant with hardly a break in between. Still, I continue to push as I'm able to. I push well. The secret to pushing? Take a deep breath like you're about to go under water (I used to be a swimmer); lift up your legs by grabbing your thighs (I am flexible); push arch your chin over your stomach and, in my doctor's words, push like you are about to have the biggest bowel movement of your life (thanks to pregnancy side effects, I am good at being constipated). So, the nurse and doctor were impressed with my technique!

5:45 p.m. -- My doctor tries the vacuum extractor since I only need a little help to get the head out. No dice.

7 p.m. Thursday -- Still pushing. Her head is almost out. Every time I push, though, her head goes RIGHT BACK IN. ALL THE WAY. My doctor is confused and starts to look concerned. I am doing everything right. The baby is not too big for my body. Why won't this baby come out? All of a sudden, I look over at my nurse, who has a worried expression on her face. My temperature, which has been a solid 98.6 degrees during the whole labor and delivery process, has spiked to 101.4 degrees. They're worried about possible infection. My doctor says the word c-section. I start to push with everything I have, telling myself I have nearly birthed this baby, I have got to avoid a c-section.

7:20 p.m. Thursday -- A woman in operating room attire comes into the room. My doctor says, "Uh-oh, here comes the Grim Reaper." This is apparently the woman who starts the c-section preparation. My doctor says, "Let's not do that yet. I'm giving her one more chance." I hold my breath like I've never held my breath before. I imagine the baby's head just spilling out. Her head is RIGHT THERE. No dice.

7:30 p.m. Thursday -- My doctor says, "This baby is not coming out. We need to get you prepped for a c-section." I start bawling. Tears are streaming down my face. A team of highly efficient doctors and nurses burst into the room and take over. "Stephanie, this is Dr. Kennedy." "Stephanie, now we're going to do this....and that....and blah blah blah." I felt like I was having an out-of-body experience. All I can do is stare at the ceiling and cry. I do not cry because I have been robbed of a vaginal delivery. I freakin' had a vaginal delivery. I cry for surgery, for the possibility of death, for loss of blood, but mostly for fear of not getting to bond with my baby, for it all being so clinical and depersonalized. Despite it all, I manage to whimper to my doctor, "If you must perform a c-section, please use stitches to sew me back up rather than staples." She agrees. I'm thankful my friend told me to request that.

7:45 p.m.  Thursday-- I am in the operating room, laid out like people have pictured Jesus on the cross with my arms spread out and strapped down, staring into the intensely bright lights of the operating room. Matt is not there with me. He's still scrubbing up and putting on OR scrubs. I am just crying.

7:50 p.m. Thursday-- Matt joins me. Since I had an epidural I am already numb, but then the anesthesiologist adds more...something...that numbs you. Whatever. At this point I give up.

right around 8 p.m. Thursday -- I say to Matt, "Our daughter is going to be born during the session premier of 30 Rock." At least I have a sense of humor as I am being ripped open. The doctors say I might feel some "pressure." I've watched enough episodes of A Baby Story of TLC to know this line. In all c-sections, right before they take the baby out they reference "pressure." Well, at that moment, it felt like a Sumo wrestler was jumping on my upper ribs. All during labor and delivery I remained virtually silent to the point that my doctor and nurse called me a trooper and said they wished all their patients were as calm as me during the whole process. The "pressure" moment, though, is when I lost it. The Sumo wrestler jumped on my ribs three times. I screamed out three times. Right after my third scream...

8:03 p.m. Thursday-- I screamed, then she screamed, and out Natalie emerged into the world. Matt and I immediately started sobbing. The tone of my cries immediately changed. All the pain was gone. People were talking to me, but I was just staring off into the corner of the operating room, watching Matt take the first photos of our daughter while the nurse cleaned her off and performed her Apgar tests (which she passed with flying colors!).

My doctor says, "There was no way that baby was coming out. The cord was around her neck twice. And she was lodged underneath your ribs" (which explains the Sumo-wrestler sensation and my last-minute yelling).

The nurse asks Matt if he would like to cut the cord. At first he says, "Sure," and then immediately says, "You know what, I am bad with scissors, why don't you do it?"


8:15 p.m. Thursday -- Natalie is all cleaned off and they bring her to me so I can kiss her. I am shivering despite having warm blankets all over me, but I am distracted by my daughter. Then she and Matt are taken away to the c-section recovery room and I am left to be put back together.

After they take Natalie and Matt away I ask, "When can I have some water? When can I have something to eat?" It has now been over 24 hours since I had food and 20 hours since I had anything to drink.


8:45 p.m.  Thursday-- I am finally being wheeled into the recovery room, and I finally get to really be with my daughter and my husband. The nurse asks me if I have any sensation in my legs. Immediately I move my knees and wiggle my toes. "Wow," they say, "That was fast! We were going to see if you could just wiggle a toe." Matt calls his parents and I call mine to share our happy news. Then we call our siblings. Finally I email my best friends. Then later on we send out our bbc'ed email to the rest of the world announcing Natalie's arrival.

9 p.m. -- Once the nurses are done attending to Natalie they place her on top of me. My shivering stops. I look like the Bride of Frankenstein, but I am totally calm and content and with my daughter. Then they unwrap her and unwrap me and place us skin to skin. I feel her kicking on top of my stomach, and it feels exactly like it felt when she was in the womb.

As they are taking her away from me so we can get ready for transfer to our room upstairs, I notice that Natalie is breathing like a pug and is turning more red. I ask the nurses, "Is she going to the NICU? She doesn't seem right." The nurses say, "That baby? No, that baby is perfectly healthy. Not going to the NICU."

10 p.m. -- We are up in our room in the Family Centered Care unit where we'll be staying until we're discharged from the hospital.  I remember how it felt painful as I was being moved from the transfer bed to my bed in my room. Being lifted after having just had major surgery does not feel good. But Natalie is there in a bassinet, so everything is fine. And they let me drink water! Sweet, glorious water. It never tasted so good.

11 p.m. -- Natalie and I breastfeed for 35 minutes. She is a champ.

12:30 a.m. Friday -- Nurses come into my room to check on Natalie. Something isn't right. They say they are going to go assess her, so they wheel her away.

1 a.m. Friday -- Natalie is whisked away to the NICU. She has fluid in her lungs (aka pneumonia). She swallowed my amniotic fluid. Because my water broke on its own 12 hours before I gave birth the risk of infection that always comes along with water breaking came to fruition when my temperature spiked. If she had been born vaginally the bad fluids would have been squeezed out of her and she probably wouldn't have pneumonia and probably wouldn't be in the NICU. So, for all intents and purposes, my c-section sent Natalie to the NICU.

At this moment, though, 1 a.m. on Friday, after having basically been awake since 8 a.m. on Wednesday I am a rag of a woman, so the severity of what is happening hasn't really set in with me. I somehow manage to sleep a little under the stupor of Percocet and heavy-duty ibuprofen.

5:30 a.m. Friday -- My amazing nurse Lauren wakes me up to use the breast pump because I want to breast feed but can't since my daughter is in the NICU. We manage to get out a lot of colostrum (the milk moms have before the real milk comes in 3-5 days after delivery), which is great. Lauren explains to me that because I have a fever and because my daughter is in the NICU I can't see her until my fever has been gone for 24 hours. I'm on antibiotics for infection as well.

All day Friday we have visitors, and all of them get to travel down to the NICU to see Natalie while I am stuck in the upstairs recovery room. The baby I have had in my belly for 10 months is now away from me and with others. It all seems highly unfair.

I finally get to see her Saturday at 9:30 a.m. Once I could start visiting her, Matt and I were in the NICU every three hours for her scheduled feedings.

She is still as of this writing in the NICU and has been in the NICU ever since she arrived there Friday, January 13 at 1 a.m. (I just realized she went in on Friday the 13th...superstitious, anyone?).  My initial hospital discharge date was going to be Sunday, Jan. 15. Sunday at 1:30 a.m. we were with Natalie in the NICU and got to talk to a doctor. We had initially been told she might be discharged with us. But Sunday at 1:30 a.m. we found out she'd be staying until at least Thursday (today). Our hearts broke. Matt wheeled me back to our hospital room and we just broke down. At 3 a.m. my nurse came in to take my blood pressure and it went through the roof. I was at heart attack levels. My blood work all came back normal, though, indicating that my suddenly high blood pressure (I've never had high blood pressure in my life) was the result of anxiety over leaving our daughter.

Thankfully, because my blood pressure spiked to intense levels, I earned myself an extra free night in the hospital. My doctor said it was for the best. I agreed.

My new discharge date and time was Monday, Jan. 17 at 7 p.m. Matt and I went to the NICU on Monday for Natalie's 6 p.m. scheduled feeding. We snuggled her and bundled her back up and put her back in her incubator. We left the hospital with an empty car seat and empty hearts.

Tuesday and Wednesday we spent the majority of the day at the NICU, visiting her every three hours for her feedings. When she's not feeding, though, she really needs to be in the incubator under the bilirubin lights. So, as much as we want to keep her out and snuggle, we know she needs her treatment.

She did in fact have pneumonia which she is cured of now, but she needed a week's worth of antibiotics to make sure she was fully healed. She also had jaundice. They were proactive and put her under the bilirubin lights Saturday morning before her jaundice got any worse. While in her incubator under the blue lights, wearing her baby sunglasses we dubbed her "the baby of the future."

Yesterday (Wednesday) at 9 a.m. Matt turned off the bilirubin lights for the last time.

Here's Natalie in her bassinet yesterday! Free from the incubator! Looking like a normal baby.


She is also on an IV to get extra fluids in her body to get the jaundice out. Despite all the odds against us, we are breastfeeding (albeit in front of everyone in the NICU, with sirens going off every minute from various baby's machines and Natalie's IV and other cords in the way). The nurses are supplementing with my milk that we bring to them that I am pumping (rented a hospital pump....not buying our own heavy-duty pump was a great decision because renting the hospital one is a better deal for us and it's super efficient). They are also supplementing with formula. 

Now that Natalie appears to be just about recovered, we are hopeful that today will be her official discharge day. Please keep us in your thoughts today, and I'll update on her status.

(And if you haven't yet had children, I hope this doesn't scare you off. You really should have babies if you want them. They're pretty awesome.)

5 comments:

  1. Wow, what a birth story!! I am so glad everything came out OK and I hope your recovery goes smoothly!

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  2. Thanks so much for sharing, your story brought tears to my eyes. Congratulations!

    P.S. I love her name. ;)

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  3. You all are definitely in my thoughts and prayers today! You are one amazing mother already.

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  4. Oh, poor baby! Good thing they did the c-section though, since the cord could have caused some damage if they hadn't, right? And congrats on still being able to breast feed. Hope you get to take her home soon!

    Katie young

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  5. What lovely photos, and what a beautiful baby. Quite a birth story--all's well that ends well, I guess! How brave of you to write it all here.

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