Sunday, October 24, 2010

Birthday Story

Warning: long, detailed, and probably a little TMI

Monday, October 18th, I went in for my routine 39week appointment. Ben and Miles tagged along as we were pretty sure we were ready to set an induction date and evict this baby girl. I was feeling tired, sore, emotionally worn and ready for her to come out! I never hit that point with Miles, but this pregnancy was all together different!

I went to my appointment hoping to learn that my cervix was prepared for eviction day. The week before, it was 2cm on the outside, fingertip on the inside, and really soft, but not effaced. I needed some serious effacement to feel comfortable scheduling an induction for later that week. It was my lucky day. It was 2cm and 70% effaced. My doctor was on-call on Thursday, so offered to schedule a birthday party for that day. I was so happy to have an end in sight!

We were scheduled to go in for induction at 6am on Thursday morning, where I would get hooked up to an IV, get some pitocin, have my doctor break my water, and deliver a few hours later...or so we thought. My induction with Miles went about like that, except that I had gone in the night before for some Cervidil (for cervical ripening). My doctor broke my water at 0744 and I delivered Miles at 1016. We were thinking this would be about the same, or possibly a little quicker. Isla had other plans...

The alarm clock went off at 4:15am, though we were already pretty much awake. We got ready, finished packing our bags, did some last minute cleaning, and headed out the door. At the hospital, I got checked in, got an IV and fluids and started Pitocin. The nurses were certain that my doctor would be in between 7 and 8 to break my water, so we waited, and waited, and waited. Meanwhile, my nurse turned my pitocin up every 20min until my contractions were regular at about 3minutes apart.

Around 8:30, my nurse, Jenna, came in and told us that my doctor was in surgery from 8:30 until about 10:00 and would come break my water then. She didn't want to break my water before going into surgery for fear that I would then deliver while she was in the OR. So, we waited some more. Ben was obviously getting anxious since we had thought this would all be over before 10! My nurse came in around 8:30 to check my cervix to make sure I wasn't progressing too quickly. At that time, I was 2cm and 80% effaced. I was still pretty comfortable and glad I was at least making some changes.

I continued to contract every 2-3min, but was fairly comfortable just breathing through the contractions. We continued to wait. At 11:00, my doctor finally arrived. She checked me and said I was 3cm and 80%, but baby was at a -3 station (not engaged in the pelvis yet), so she wasn't comfortable breaking my water. My nurse turned up my pitocin, which increased the intensity of my contractions, but I was still pretty comfortable while we waited some more.

At 12:45, my doctor came back. I was then 4cm and 80% effaced and baby was at a -2 station. She broke my water, which was considerably more comfortable this time than with Miles. We thought things would really pick up at this point. I was officially ruptured at 1253pm.

My nurse turned up my pitocin again to get my contractions to a certain level of intensity (I had an intrauterine pressure catheter at this point). They got fairly intense, but were still 2-3minutes apart and I was able to breath through them fairly easily. All the pain from the contractions was concentrated in my lower back, hips, pelvis, and tailbone. Not fun!

By 2:30, I was ready to be checked again. I was only 5cm and 80%. I was feeling pretty discouraged to say the least. I really thought she would have been born by this point, as did Ben. By 3:40 I was feeling a lot more pressure, so Jenna checked me again, but I was only 6cm and 90%. Again, I was feeling very discouraged! This was going to take forever...

My contractions were growing in intensity and I was starting to have a harder time focusing through them. I had about a 60-90second break between them, which was long enough to collect myself for the next one. My nurse offered me narcotics and told me it was probably my last chance for them. I was slightly tempted to give in and go with a small dose or get an epidural, but I just couldn't do it for some reason. By mid contraction, I'd want something, but in between I'd convince myself that I didn't.

At 4:15, I was starting to feel like I couldn't do it anymore. I was having a harder time relaxing between contractions and starting to get shaky, hot, and lightheaded between contractions. My nurse checked me again and I was 8-9cm and 100% effaced. Classic transition phase and symptoms. I still had a pretty prominent anterior lip and my nurse thought maybe Isla was posterior (sunny side up) judging by the anterior lip, back labor, and slowish progression. She called my doc to come stand by, hoping delivery would be soon.

When my doctor showed up, and checked me, she, too, thought that Isla was probably posterior and needed to turn. She offered that I could still get an epidural if I wanted. My contractions were very intense and close together, but I just couldn't get an epidural for some reason. At that point, I just wanted it to be over and holding my baby!

I continued to breath through contractions and did some small pushing to try to get rid of the anterior lip, but was having a difficult time focusing. Around 4:50, I felt Isla move and had another big gush of fluid. My nurse was encouraged by this and thought it probably meant that Isla had turned and I'd be complete at anytime.

About 5minutes later, I felt the urge to push. She checked me and confirmed that I was 10cm and 100%. I was so excited to know that I could push and would be holding my baby in the next 20min! I started pushing at 5:00 and Isla delivered at 5:16pm.

Isla was placed up on my chest and got 8 and 9 on her apgars (for color). My doc was repairing a 2nd degree tear and trying to deliver my placenta. My nurse finally took Isla to weigh her, clean her up, etc, while my doc finished. She weighed 8# 3oz and was 21inches long.

It took about 20min for my placenta to deliver, which is a little longer than average. Because of this, my uterus didn't want to contract down, causing a fair amount of excess bleeding. My doctor gave me some extra medicine (Misoprostol) to help it contract and had my nurse run in my pitocin as fast as it could go. This meant a lot of contractions and a lot of pain! I felt like I was still in transition phase of labor, but I'd already delivered. I was not a happy camper. My uterus finally cooperated just before my doctor was going to make sure my entire placenta had come out. Thank God I got to skip that experience!

After breastfeeding for the first time around 6:00, I was in so much pain I needed meds. I took 3 ibuprofen, but shortly realized this wasn't going to be near enough. I finally consented to a half dose of Fentanyl and a third of a Norco. I made it through a very intense and painful labor and delivery without pain meds or an epidural and then needed the big guns for my recovery.

My bleeding continued fairly heavily for the better part of the night requiring a pitocin drip throughout the night. I was still in a lot of pain and feeling like I was in early labor again! That morning, my doctor came in and told me that my red cell count (hematocrit) was low at 24 and that I needed to stay an extra night to make sure it didn't fall below 20, requiring a blood transfusion. I was fairly asymptomatic, though. My blood pressure was fine, heart rate good, able to get up and walk without getting light headed or dizzy.

Saturday morning, my hematocrit was down to 22 and I was still asymptomatic (besides very very tired). My doctor (her partner, actually) told me I could go home! We got home around 3pm on Saturday and spent our first night with Miles still at his grandparents. It was so nice to sleep in my own bed in my own home. I'm now on iron 3 times a day and walking up a flight of stairs just about takes everything out of me, but otherwise I'm recovering well.

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