Friday, August 6, 2010

The Best Laid Plans - My Birth Story, Part II

Did you miss out on Part I? Read it here. Then come back!

After calming down a notch (or twenty) we headed off to the maternity ward of our hospital. We had finished making our phone calls, my parents were starting their long drives to get here in time, and Brent's parents were going to pick up and keep Tanner for us and collect our hospital bags for us. We had done all that we could do up to this point, and there really wasn't anything else to do except check in, settle in and have this baby!

We walked up to the nurses desk, and true to her word, my dr had already notified them of our pending arrival. They had a room all ready for us, and showed us where to go. I was instructed to disrobe, put on the hospital gown and get into bed - the nurse would be back in a few minutes to start the check-in procedures.

Check-in procedures. Yeah, read "start your IV." Which for me, was the second biggest thing that I was dreading. Yes, I know that you have to have an IV, as I've done this before. But I didn't like it then either. My biggest fear? Ending up in the OR for a c-section. That involved more than needles. There's scalpels, staples, breathing tubes, lines and incisions. Ugh. I'm getting the shivers just typing out the words.

Anyway, we explored our L&D room a bit - it was pretty large, and Brent was really taken with the baby's corner of the room where the warming tray and lights were already set up and all. He thought that was just the coolest thing ever! And he kept saying over and over "Babe - imagine, our baby boy is going to be here (gesturing with his hands to the baby bed) in a few hours!" There was a large bathroom with a double-size shower, and a closet full of laboring tools such as birthing balls, etc. Not to mention both a rocker and a couch that folded out to a full-size bed. Don't get all excited, Brent assured me that it wasn't nearly as comfortable as a real bed!

We settled in, me with my back naked for all the world to see, and waited for the nurse to come back. When she did, she settled in at her computer to input all sorts of information about both of us and the baby and our pregnancy thus far. She warned me ahead of time that she had 50 million questions, and she was right! It took almost an hour, but at the end of it the hospital knew everything about me, Brent and the baby that they could possibly need to know and more.
Then came the consent forms. Everything that I was being admitted for had risks associated with the procedure, from the aversion therapy to the induction process, and I had to sign my life away on three or four short forms. After signing the forms and consenting to the treatments, you're pretty much done. Signed, sealed and delivered. Or soon to be delivering?

The nurse had warned us before the game of twenty questions started that the aversion therapy session was going to run a bit later than they had originally thought. My dr wanted to have an anesthesiologist on standby in case I couldn't deal with the pain - just what I wanted to know right then, right? And the anesthesiologist on call that night had just gone into a surgery that would last about an hour. So, the dr wasn't planning on coming in until the good drug dr was ready, and that gave the nurses plenty of time to admit me and prep me.

By prep me, read "start IV line." I had pre-warned the nurse about my troubles with needles and sticks and she came prepared. I think that she brought not ONE extra nurse, but TWO! I guess she took me seriously, huh? One of the nurses, Becky, proclaimed to have an anti-fainting trick up her sleeve and wanted to try it. Her trick? To open up an alcohol wipe and hold it under my nose (kinda like smelling salts) to give me something else to focus on. I have to admit that it worked. I got a little weak-behind-the-knees at one point, but held on and pushed through it just like a big girl. I would say that I had my big-girl panties on, but I've already admitted to being nakey-nakey beneath my gown, so there goes that.

Once that was done we settled in to wait. Around 8pm my dr came in and told us that it was almost time to start. She offered me the epidrual from the get go, but I chose to try to make it through without anything. Don't ask me why, I honestly don't know. I mean, it's been my experience in the past that when you're in labor and someone offers you drugs, it's ok to say yes. I guess maybe since I technically wasn't in labor yet I didn't want to take them? Who knows.

Either way, she gathered the nurses, had me sign off on one last form and positioned the bed and Brent to where she wanted them to better assist me. Then she picked up that tube of gooey stuff that they squeeze on you during your sonograms and took the cap off. Yeah. The cap came off. And the ENTIRE contents of the bottle were then put onto my baby bump. I think that it was at this point that I started making jokes about the process being sort of like a "massage." The fact that the dr and both nurses started laughing should have clued me in. Not that I really thought that it would be like a massage for real, but I was trying to lighten the moment and it worked.

She rubbed the gooey stuff around on my belly and then positioned my bed all the way down so that she had a good position to start pushing Jax around and then she began. I would like to say that I completely remember all of the details about this process, but I don't. It hurt. A lot. But it wasn't unbearable. She pushed and pushed and then would pause and give me a rest while leaving pressure on my belly to prevent Jax from going right back. She gave me big breaks at each quarter turn that she completed, but I couldn't wait for the last quarter turn to be done and over with.

The great news is that the aversion therapy worked like a charm. Sure, it hurt a bit, but honestly it wasn't as bad as I had been expecting. I wouldn't recommend it over a picnic in a park, but it had to be done and it worked beautifully. Now that Jax was in the right position, head down, he needed to engage and not turn around. Which meant that my water had to be broken.

This is a small point that I missed during the previous talks with my dr. I knew that being induced meant having Pitocin to initiate contractions, that much I knew.

What I didn't know is that before they start the Pitocin, they break your water. Or maybe I should say with my unique situation that meant that they needed to break my water first. This would prevent Jax from turning back around into his favorite position (transverse) due to the lack of fluid allowing him to turn. You see, when she did my sono back in her office, she also measured my fluid levels. Apparently you have to have a good amount of amniotic fluid left in order for aversion therapy to have a better chance of succeedng. Normally the week before your delivery date, your fluid level measures around 10. I had 18. (I'm not entirely sure about what the water is measured in - Liters, Gallons, whatever - so I'll refrain from saying what it is. Either way, normal was 10 and I was at an 18.)

I'll be perfectly honest here and tell you that her breaking my waters hurt a HELL of a lot more than the aversion therapy. I meant a LOT more. Maybe that had something to do with the fact that while she was down there trying to speed things along, she also stripped my membranes. Then she used the big "crochet hook" to break my bag. Or maybe I should say tried to break my bag.

Some fluid came out, but not the big gush that she was expecting with my fluid levels. She didn't think that she got a good puncture out of the procedure, so she left me for an hour to see what would happen and then come back to check me in an hour. In the meantime they started the Pitocin on me to get my contractions going.

Right before all the excitement started, my friend T (MOH) got to the hospital so she was there for all the procedures and to help Brent take my mind off of things while the hour long wait passed. Brent's parents had also been by to visit for a minute before all the "fun" began so that we had our things. We were sending texts out to family and friends to give updates, and knew that we were just playing a waiting game at this point.

My dr returned to check me an hour later. As she had suspected earlier, she did not get a good break on my water, so we did the procedure again. It wasn't really any less painful the second time around, but it was slightly better since she didn't have to strip my membranes. This time, when she was done, there was the expected big rush of fluids out and the nurses proceeded to "pack me" with towels. I guess that I should mention that I was not allowed out of the hospital bed from this point forward as they were having troubles keeping the monitors where they needed to be.

Even though the nurses were good about moving me around from side to side and trying various positions to help me labor better/easier, I got stiff as the night wore on. I was having contractions regularly, like every three minutes, but I wasn't really feeling much pain. Of course, when the nurses checked me, I was only dilated to 2 cm. I was making progress, and Jax was staying where he was supposed to be, but it was slow going.

By 1 or 2am, I was feeling the contractions and breathing through them. My Mom and step-dad had arrived right after 11pm, and my Dad and step-mom had also gotten there. As my Dad has his own motorhome, and that's what they had traveled in, they left early on to get some rest. Around 1-2am, I had decided that I was ready for the epidural. I was measuring 3 cm at that point, and my dr had already signed off on me receiving the epidural. The anethesiologist came in and got to work. Now, I don't remember much about the process of receiving the epidural with my daughter's birth. Mainly because the anethesiologist had an assistant who had rather large breasts (very buxom) and all that I remember was that she grabbed my face and planted it into her cleavage. So I was a little distracted through the actual epidural process that time around.

There was no assistant this time, and I was very aware during the process. It didn't really hurt, but wasn't completely comfortable. At this point though, I wanted some relief and some sleep. And I really wanted some food. I had last eaten at lunch, and I was allowed all the ice chips, water and popsicles that I could eat. But let me tell you, those popsicles were a lifesaver! Just not really all that filling.

By 2am, everyone else had left except for Brent. My Mom and step-dad and T had left to go to our house to get some sleep. My step-sister was the only person left, and she came in for a bit to visit until I started to drift off. Brent and I both tried to get some sleep, but with nurses coming in every 30 minutes to check this or that, sleep is hard to come by.

Around 4am, things started to get really interesting. The baby's monitor had started going off every 5-10 minutes. Now, when it would go off, nurses would rush into the room and re-adjust the monitors on me to try to get a better reading on his vitals. Around 5am, the dr had been notified and she visited us to check out the situation for herself.

When she did a pelvic check on me, she noted that I was dilated to 4cm, but the baby had not engaged or descended very far into my pelvic canal. And even though the Pitocin had been administered all night, they kept having to shut it off when the baby's heart rate would drop. So I was having to start back at level 2 on the Pitocin every hour or so. In other words, we weren't making much progress.

She said that she would give me another hour to try to make better progress and she increased the Pitocin to 10 to try to help me out, but warned me that if in an hour I hadn't made progress that we would have to discuss other options. The baby was not responding well to either the positions, the Pitocin or whatever and his and my well-being had to be put first.

During the hour that passed, the nurses tried all sorts of positions for me. Although I'd been given an epidural, I still had control of my legs and could help them move me around. We tried my left side, my right side, on my hands and knees.

But no matter which position that they put me into, within a few minutes Jax's heart rate would fall again and they would all rush in to massage my belly. When I realized that the dr rubbing my belly and making me rock back and forth on the bed was sort of like CPR through my belly, I understood that the situation was maybe a little more serious than they were totally telling us.

Don't get me wrong. Our dr was honest with us from the get go. But I think that she was trying not to alarm me or cause me any distress that might also affect the baby at that point. But when I got what was happening and that unless she was rubbing/rocking my belly his heart rate was falling, I knew that we were in a little bit of trouble. I knew then that thiings were serious and we were going to have to make some serious decisions. Fast.

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