Please bear with me as I ramble through the details, as the details set up some of the rest of the story of his birth and to see how little decisions can snowball very quickly. The story of Cole’s birth actually begins with my 36 week appointment. Up until this point I had been seeing the practice’s midwife, who I absolutely loved. The practice was part of a large well known teaching hospital. This was the first appointment with the OB and my first appointment to discuss my birth plan. The appointment started out ok. Then we began to discuss my birth plan. Almost everything in my birth plan was proceeded with, ‘if possible’. I knew going into birth that birth was like life and that it would require a great deal of flexibility. The only absolute on my birth plan was that my husband was to remain at my side at all times. I had looked into a lot of birth topics, done tons of research, and watched all of the natural birth movies. I leaned toward the scientific side of things, but still believed that nature had developed our bodies over hundreds of years so natural would be best whenever possible. I felt confident in my birth plan and that if things veered from there it was because they truly needed to change. The thought of an epidural scared me, so I research various movement techniques to deal with the pain during labor.
When the OB was done with the exam, she started reviewing my plan with me. She immediately said there was no possible way to avoid pit post-partum, to delay cord clamping, to have an unmanaged third stage of labor, if a c section was necessary that my arms would have to be strapped down and that I would not be allowed to hold my baby until recovery at the earliest and maybe longer than that. I had come prepared with information on pitocin, including the Physicians’ Desk Reference copy of the page which indicated that breastfeeding should not be started if pitocin is administered for post partum hemorrhage. She had no response for that, but once again repeated that it wasn’t an option not to receive it under any circumstance. She also stated that if cord clamping was delayed that all of the blood would flow out of the baby and back into the placenta. While I knew this not to be the case, I didn’t have any supporting documentation with me as I didn’t think that it would have been a big deal. She then also stated that I was measuring big and wanted to send me for an ultrasound as soon as possible. I didn’t think anything of it, and was actually looking forward to having another opportunity to see my little one. I left the office with my head swimming. Not sure whether I should switch providers or just continue and refuse to sign the consent forms to allow for the pit and other interventions. I felt that there was still a possibility to discuss the other issues with her at my next appointment when I would have more supporting documentation.
The ultrasound appointment was scheduled for that Wednesday afternoon, 36 weeks 4 days. We weren’t sure if my husband should take yet another day off work to attend the ultrasound or to save his time for after the birth. He was able to go into work later, and so was able to attend the appointment with me. Now, I have to make note of two facts. I always, always have a drink in my hand. I am constantly thirsty. I have been checked for all of the common medical causes of this including diabetes, everything has come back normal. My doctors have just said that some people just need more fluids that other people. I was also sick with a cold, during which time I generally drink 1/3 of what I normally drink. We went in for the ultrasound appointment. I watched the monitor closely. I was worried that there would be high fluid levels since I was measuring big. I was clearly able to see that the fluid levels were not high. The baby was moving around. The technician told us to clean up, go wait in the waiting room and the doctor would call us back shortly. We waited and waited.
Finally a nurse came and found us and told us to go grab some food in the cafeteria as I would not be allowed to eat for awhile. I looked at her funny and asked, when I was going to be allowed to eat again, not realizing yet that something was not right. She replied until after I had the baby. There is no way I could have possibly been more surprised. She realized from our expressions that no one had spoken to us yet. She asked if the doctor had spoken to us. When she found out that they hadn’t she quickly explained that they were planning on inducing me that night, but had to wait for a room to open.
My husband and I went down to get food and start to make phone calls to work and my mother to pick up my bag. I was in a state of utter shock. I could barely eat anything, it all tasted like sand. I was shaking like a leaf with nervous energy. I didn’t understand what was going on. I was excited with the possibility of meeting my little guy, but not realizing truly what was going on. Then it struck me that I was only 36 weeks 4 days, not even full term.
We went back up and were led to a room. Which I realized immediately was a delivery room from our tour. At this point we still had not seen a doctor. I was told to get into a gown and a doctor would be in to examine me shortly. I got into the gown and they started to take my vitals. My blood pressure was elevated, as it usually becomes when stressed. Finally the doctor came in and started to explain that they found really low fluid levels so they felt that they needed to deliver him immediately. This was not a scenario that I had researched at all. They handed me a lot of literature from many different sources on low fluid levels. I questioned being sick and being dehydrated and was told that it does affect fluid levels that they were pretty static unless there was something else going on. I questioned the fact that I was only 36 weeks 4 days. The doctor, who I had not met before, insisted that I was 37 weeks according to their ultrasound. He left to try to get a hold of my OB. We were left sitting in the room for a long time.
Eventually he came back and said that my OB agreed with my dates, so we were going to push the induction off until Saturday in hopes that baby would make his way into the world on Sunday when he was full term. Until that point I was being admitted and put on bed rest and that he was a little worried about my blood pressure. That they were going to do a 24 hour urine collection. I was eventually given a room in the post partum area. The placed the Sequential Compression Devices(SCDs) on my legs as I was not to get out of bed except to use the restroom. I used them part of the time as they kept giving me an error message that I was having to try to reset with my toe as my mobility was extremely limited with my large belly and the SCDs. They actually felt like a constant leg message when they were working so I didn’t mind them at this point.
I started to eat really, really poorly while at the hospital. I had become lactose intolerant during the first part of my pregnancy so my calcium was deficient. I am also very, very picky about which meat products I will eat. During this time, I don’t think I ate any protein. Also since becoming sick earlier that week I had not eaten as much as I should have. I got very few veggies or fruit, my diet here contained mainly starches. Anyway, the doctor came back and said that my 24 hour urine had protein in it so they were diagnosing me with preeclampsia although I had no symptoms other than elevated blood pressure, still not too high, and protein in my urine.
Friday night they came and put in a hep-loc. It was horrible. The nurse tried multiple times to get it in, and even offered to have someone else paged to do it. Eventually she was able to get it in, little did I know how hated that would become very, very soon. Saturday came and they wheeled me down to start the induction, without warning after waiting most of the day. I wish I had been given the opportunity to shower and brush my teeth before this. The nurse was very brisk and business like. I was a little worried. She was rushing around getting everything set up. She hooked up line, after line to me. I looked down and I had locks going the whole way down my arm as I also had a line for antibiotics as I was gbs+. They also started Magnesium Sulfate for the preeclampsia. They said that there should be no affects other than making me feel a little hungover, but I wouldn’t be allowed to eat or drink or be allowed off of my back. They also said that the baby would be receiving such a small amount that there were no worries.
I started to have doubts that I would be able to go without the epidural since all of my pain management techniques revolved around movement. Shortly thereafter, she said that she had to insert a catheter. I was dreading this part. It actually was no big deal for me, it was a very weird sensation, but not painful. The OB on call came in to start the induction, I had no dilation, no effacement, my cervix was high and tight. I was starting to doubt this, as I knew that meant I had a very, very low Bishop’s Score. She said that they were going to start with the Cytotec. I had done my research, I had read the horror stories, I knew it wasn’t FDA approved, though she made no mention of this. I had said before this all took place that I would never allow them to use Cytotec on me.
I had a tough decision to make, I knew with such a low Bishop’s score the likelihood that an induction would work was extremely low. I knew that the Cytotec gave me the best shot a vaginal birth at this time, I let her put the tablet in. I know that given different circumstances I would not allow it. I started to feel the effects of the mag sulfate, I couldn’t lift my head off the pillow. I could barely move. Shortly thereafter my throat was so dry that between the affects of the mag sulfate and not being allowed to drink I could barely talk. I asked for a stick of gum. It quickly stuck to the inside of my mouth. I found out quickly that it doesn’t work if you have no saliva, but I held onto it throughout the process, it stuck firmly to the inside of my mouth. I started to lose track of time, lose my senses. My husband, mom, and the nurse were sitting by my bedside waiting. The OB would come back in and check, report no change and insert another pill. The nurse who I was originally put off by her business like demeanor started to warm up. You could tell that she was very good at her job. Every time she took my blood pressure the IV felt like it was going to be ripped out of my hand right though the vein. She had to take it in both arms because there was such a difference between my two arms. She would frequently whisper to me to relax that she wasn’t going to record that reading, and took it again. I have no doubts with another nurse I would have ended up with a c section. Every time I went to move I put pressure on my hand and once again the IV felt like it was going to rip right through my body. The most enduring memory I have of this time was the pain associated with the IV. She also did hourly urine protein checks, even with the sticks with the highest sensitivity there was never any protein in my urine during the entire induction process. I was mildly contracting, nothing major they weren’t even as bad as my normal menstrual cramps.
This went on for 12 hours. The OB came back in and said that they had given me all of the Cytotec that they could and that she felt that we needed to do a c section. She said that I had the Fort Knox of cervixes. I will say that my birth plan clearly stated that a c section for me would be the worst possible outcome given what my OB told me about not being able to hold my little one and having my arms strapped down, not to mention that it was major surgery and the increase in lung issues, SIDS and asthma for the baby. I gave her my best ‘teacher ‘ look. She said that couldn’t do the foley bulb since I wasn’t dilated at all. She said they would try the pitocin and quickly left the room.
The pit was started. I immediately felt like there was a vice grip across my whole abdomen. I whispered to my husband to get my music out. I still hadn’t gotten a playlist set up for the birth, but I was going to try to distract myself a bit. Very shortly I knew that it wasn’t working. I could feel my blood pressure rising. I knew intuitively that I wasn’t going to be able to keep my blood pressure under control while having to lay on my back and having no movement. I decided to ask for the epidural. The anesthesiologist came to insert the epidural. The next thing I knew I was waking up and saw my husband and mom clinging to each other. I heard my nurse yelling for more hands. She asked me if I passed out. I said no at the time, not realizing that I had. The room filled up with people. Suddenly they were asking me to turn over onto all fours while trying to help me and spread my legs at the same time. I felt an oxygen mask being slipped over my face. The nurse whispered firmly in my ear that I needed to breath in deeply my baby needed the oxygen. I had more people than I can count trying to insert internal monitors into me. I heard them shouting we can’t find baby’s heartbeat, prep the OR. I heard my nurse yelling to ask if the OR was ready. The damn IV was about to tear through my skin again. It was as if I was an outside observer during this whole situation. I heard the nurse say that mom can’t tolerate this position anymore as I felt my arms collapsing. Finally they got his heartbeat back. It came back up to his same steady 150 bpm that it had been all pregnancy. Took a big breath and collapsed back onto the bed. After all of that the epidural only fully covered one side, the other side had spotty coverage but I wasn’t going to say anything about that. They gave me a button to push to get more drugs, but I kept loosing the button. Shortly thereafter progress finally!! I had gone from 0 to 7 cm in less than an hour.
I continued to progress after this. I felt this strange pop-pop in my belly followed by a gush of water on my legs. I whispered that I think my water broke, hardly believing it myself and thinking that no one else would believe me. My husband ran out to get the nurse who had briefly stepped out of the room for the first time in hours. She quickly exclaimed that there was a lot of fluid and started to question me as to whether she had the right chart because there was so much fluid.
The next nurse came in for her shift. We all could tell that my original nurse did not want to leave. She stayed long past when her shift had ended. Eventually, she left and I was left with a grandmotherly like nurse. She got everyone blankets and what they needed to be comfortable. Somewhere along the line someone mentioned something about brushing teeth. This sounded like the most heavenly thing to me at this point. The nurse quickly got a toothbrush and water. This was the first bit of moisture I had in my mouth in well over a day. There was nothing sweeter than at that point in my life. Shortly thereafter I threw up. I didn’t realize that it meant I was in transition, I thought that the mag sulfate had just gotten to me that much. The OB came back into the room and said that I was fully dilated. There was now meconium in the fluid, and so they were hoping that he would not cry when he was born. She said that I could start pushing now or I could labor down and let the baby move down on his own. At that moment it finally dawned on me that I was going to have to push out the baby in this condition. I couldn’t hold my head up I was so weak, I couldn’t speak above a whisper. I had never felt that horrible in my entire life, even when I had a case of the flu and couldn’t walk. I just looked at her for awhile and then said that I would labor down. All while l kept loosing the epidural button. I kept floating in and out of waking and ‘sleeping’. Eventually I thought that I had to use the restroom and told the nurse, who promptly told me that it meant it was time to push.
Suddenly the room filled back up with people. There was a whole wall of people down below. There were two full nicu teams in the room for my son. I didn’t understand why at the time. I started to push. And push. I was slowly losing my vision, I could only see a very narrow focus of people. They had my husband holding my leg, the only thing that I could think of was that he has a bad back and shouldn’t be holding up my leg. I pushed and pushed for four hours. I wanted to scream at them to get the forceps, but I couldn’t talk at all at this point. I felt like the ring of fire, then I felt what I thought was me tearing but was actually being cut and then another tear. I couldn’t scream, I had no energy, no voice. It didn’t matter anyway it was already done. At least I had partial dulling on the one side. Then he was here. It was Monday morning a full 40+ hours after the induction began. I didn’t get to see him. He wasn’t crying, but I was happy about that after what the doctor had said with the meconium in the fluid. I later learned that he was born with an apgar of 2. He only got points for having a steady heartbeat. They stabilized him and brought him over for me to see. I could only see the top of his head and his eyes in the position he was in. They told me they were going to take him to nicu for a half an hour to an hour and bring him back to me shortly thereafter. That was the last I saw him for a day and a half. When they started to stitch me up the OB noticed my reaction and asked if I could feel it. Finally she gave me some pain relief.
