Monday, October 17, 2011

Part 1 Of My Birth Story; The Labor

WARNING:  This post is extremely long and may contain information that may have a little too much personal/medical details for you.  If that scares you, you can quit reading now-cya later!  If you are not intimidated, then continue on my friend.

I know it's been over 2 months since I've delivered, and my birth story probably seems like old boring news, but I think I need to write about it anyway.  If nothing else but to come to terms with it myself.  I haven't shared it before now because I've been struggling with a lot of feelings that I have had about it since then.  Feelings about the pregnancy, about the birth, about the medical personnel, about the decisions made, about my control of the whole situation, and about my perception of the whole occurrence.  People have asked me about how it went and up until now, I kind of just gave a vague answer and quickly changed the subject so I wouldn't have to talk about it.

I'll start this out with a very fitting quote:

"We make plans.  And God laughs."

It started on Tuesday, July 26th.  The very day that I turned term (37 weeks).  I had a routine prenatal appointment.  I was really excited for this appointment, because I was hoping that I might have dilated and effaced more than last week (I was 80% effaced and 1.5 cm dilated the previous week).  I was also excited because my OB was going to strip my membranes, which would hopefully then jumpstart my labor.  Jeremy came with me to this appointment.  I'm not sure why he came, but I'm glad he did.  First thing that happened was my vital signs and weight was taken.  

Blood pressure was 151/98 on the machine.

holy crap that's high.  

Weight was 9 lbs more than a week ago.

wow that's a lot to gain in one week.

Both these number made me nervous.  High blood pressure and quick weight gain immediately triggered a thought in my mind that scared me.  

Pre-eclampsia.  Maybe even eclampsia. I'm at high risk for this condition because it's my first pregnancy and there is more than one baby. 

I freaked out for a minute, but then just thought maybe the blood pressure was just because I've had a lot going on lately, and I was tense.  (I had gotten rear-ended in my care 2 days before this, and had to stay overnight at the hospital in observation, but all was well and no one was injured).  I blamed it on that and on the machine (those things can be a little off sometimes right?).  The weight?  Maybe I've just been eating like crap this week and gained a few extra pounds (I'm trying to ignore the fact that my legs and feet have been more swollen this week as well). 

I get in the room to see my OB, and she orders a urine test.  To check for protein.  Yet another sign of preeclampsia/eclampsia.  Luckily, I only had trace protein in my urine (good sign).  My OB came in and checked my blood pressure manually.  It was still high, at 141/92.  My baseline throughout my pregnancy was 100-115/70-85, so this was up quite a bit for me.   


I started to cry because I knew what this meant.  This means that I'm either going to have to have a scheduled c-section or have to be induced, which very well may end with a c-section.  My OB tried to comfort me.  I think she said something to the effect of..."It's ok, you can fix this problem very easily...by delivering those babies."  Yeah, that didn't really help.

The OB told me to go home, pack a bag and go to the hospital, because I'm going to have some serial blood pressures done and may possibly be induced.

Crap!!!!

I cried the whole way home.  I called my mom, I called our doula, I called Jeremy's mom.  I whined and complained to everyone about how I can't believe this had to happen the day I turned term...I had made it the whole pregnancy without any complications, etc.  Jeremy tried to calm me down the entire ride home, by trying to get me to see the end result, our babies.  He kept saying, "but honey, we're going to meet our baby boys really soon!"  As excited as I was to meet them, this is NOT how I wanted it to happen.  If you know me at all, or if you have read any of my previous posts about my pregnancy and delivery hopes, you know that I was hoping for an all-natural, no pain medicine, no medical intervention delivery.  I knew that most-if not all of those things were going to get tossed out the window if I had to be induced.  

Our doula made a great suggestion.  She said on the way to the hospital, that we should stop and eat a big meal, because they wouldn't let me eat in the hospital.  We ran home, threw a few things into our bag (most of it had already been packed for a few weeks), and headed out.  We stopped at Harris Teeter on the way to grab some food.  We each came out with just a sandwich and salad that was mediocre.  Looking back, I totally wish we would have went out to eat at one of our favorite restaurants and just had a relaxing dinner, but I was so upset and anxious and excited and nervous all at the same time, that I couldn't really think of much else except what was about to take place.



We arrived at the labor and delivery floor and were admitted to our room.  I handed over our birth plan to the nurse, knowing that the majority of it was probably going to get ignored.  It was just before shift change where the night shift nurses would come on.  I explained to the day shift nurse who was about to leave the most important points of our birth plan (I wanted no pain medication offered to me, I wanted intermittent monitoring, I wanted to be able to get up and walk around/shower, I wanted the babies to be immediately placed on my chest and not taken away, etc.).  She was very nice and made it seem like all those things would be very likely to happen.  She also said she would pass it on to the night shift team.  Night shift came on.  Night shift nurse was very nice also.  She came in and gave me an IV.  Said it was protocol.  Fine.  I'm ok with having a saline lock IV.  Being a nurse, I understand that in stressful situations, it can be hard to get an IV.  I'm ok with having one in place, but I'm not ok with having a bunch of fluids pumped into me without any signs of dehydration.  I will drink water thankyouverymuch. 

The medical team all came in and introduced themselves, and one of my favorite OB's was on that night.  It made me hopeful.  Some time passed, and one of my biggest induction fears came up...

pitocin.  

Yeah right!  Get that stuff outta here!!! Ok. I didn't say that. out loud, anyway.  My nurse said that the team wanted to start me on pitocin.  I said, "Um no.  Can we please try other things first?  Such as a foley catheter to get me dilated?"  She went and asked the docs.  Came back a while later and said we could do it.  Yay!  I got what I wanted for once!  The foley catheter, for those who are wondering, is normally used as a urinary catheter.  It has a little balloon at the end of the catheter that is used to hold it secure in the bladder.  To use it for dilation, the catheter is inserted into the cervix and the balloon is then inflated and increasingly pulled down, putting pressure on the cervix to cause dilation.  Once it is in place, the nurse will pull it down every 15 minutes or so.  The pressure of the balloon on top of the cervix causes dilation. Maximum dilation that the foley can reach is 4 cm.  Not a half an hour after the foley was inserted into my cervix, the balloon popped out.  I was at 4 cm!  Woo hoo!  I know that that is not very much, especially for a first time labor, but I was excited anyway.  

Things sort of stalled out after this, and they started me on pitocin.  BOO!!  Not cool.  but oh well.  I'm still determined to do this without any pain medicine.  Since I was on pitocin, I had to have monitors around my belly constantly, to watch babies' heart rates.  I was NOT about to let this stop me from being active.  I was up out of bed walking around, doing squats and different positions during my contractions.  It helped so much more with the pain rather than just sitting in bed.  I'm pretty sure I annoyed the crap out of my nurses, because I was always popping off the monitors and not allowing it to read correctly all the time because I moved so much. They gradually turned the pitocin up in order to get the contractions to the intervals they wanted them at.  This continued throughout the night.   I got some sleep, but not a whole lot.  Maybe 3 hours?  

The next day (7/27), I had still not dilated much more.  The OB decided to break my water to try and get things going.  I didn't want to have this done, but I didn't know what else to do.  My fear was that once they break the water, they start a time clock.  Docs say that the risk of infection goes up the longer the water is broken.  I pretty much had 24 hours to deliver these kids, otherwise I would have a cesarean...(which in my opinion is WAY more of an infection risk).  I don't agree with the 24 hour infection rule, but whatever.  I continued throughout the day on pitocin, dilated to 7 cm and stalled out again.  The night shift team decided that maybe my contractions were not strong enough.  Not strong enough!?  I'm on pitocin-a pretty high dose of it.  It makes stronger and longer contractions than natural contractions.  So the resident decides to put in an intrauterine pressure catheter, to actually measure the strength of the contractions.  After multiple (as in 4 or 5) attempts at putting this thing in to no avail, they give up (and having them try and shove something up somewhere that is already hurting does NOT feel nice).  They kept going on about how my contractions aren't doing anything cause they're not strong enough.  Everyone was getting so very frustrated.  We asked to see the attending on for that night and to ask his opinion on what to do next. He came in and said that he thought the pressure catheter would be pointless.  Awesome.  Thanks doc, you put me through a whole lot of uncomfortableness for nothing.  The attending said we could do whatever we wanted.  We could continue to hang out on the pitocin, or we could turn it off and see if anything happened without it.  We immediately decided to turn the pitocin off.

Turning it off and being able to come off of the monitors was amazing.  I could get up, walk around, take a shower, and actually move without pissing off nurses that have to keep repositioning the monitors.  I did in fact continue to contract while off of pitocin.  They were pretty intense contractions too.  Jeremy and I got in the shower to try and help with the pain, and it did.  Judah's head was in the posterior position at this point, so I was having lots of back labor.  This continued on for a few hours, and I was checked again, only to discover that I was still at 7 cm.  At this point, I started to get really worried.  I started to doubt my body's ability to do this.  Maybe my contractions really weren't strong enough, because clearly they weren't making any cervical change.  The team was starting to get pushy with us, saying that we needed to back onto the pitocin to try and get me to dilate more.  (Sidenote because I don't think I mentioned this earlier:  Whenever we would turn up the pitocin to a higher dose, my contractions wouldn't get stronger, they would just get closer together).  Going back on pitocin seemed pointless to everyone (except for the medical team) because (a.) as was evidenced before, it didn't increase the intensity of my contractions.  It only made me contract almost constantly, without much of a break at all in between, and (b.) I was contracting on my own.   I was very torn as to what to do.  I had the pressure of the team wanting to pump me with drugs, and then I also had the pressure of knowing that the longer I go without making any progress, the more likely my chance of having a cesarean.  

I started crying because I was so frustrated.  Jeremy then asked all of the medical personnel (attending, resident, med student and nurse) to leave the room for 30 minutes so that we could talk and calm down.  The doctors said "of course" and immediately left the room.  The nurse sat down on the bed and started telling me how much easier this would be if I would get an epidural.  Jeremy repeated, "Can you please leave us alone for a little bit?"  The nurse said something to the effect of "Yes, I can, and I will but I just want you to know that if you get an epidural...

"Leave the room now! Just leave please!"

That was Jeremy, yelling at our nurse.  He actually had to yell it a few times because the nurse would not stop talking and wouldn't leave the room.  Finally she did.  I was bawling at this point.  I was so stressed out and upset that I couldn't take the pain anymore.  I couldn't calm myself down.  Jeremy tried so hard to help me get calm, but nothing was working.  I was so tired, so worn down, so upset and hurting so much.   After a while of trying different things to try and get calm, I decided I was done.  I know that maybe I shouldn't be, but even now as I type this, I am ashamed.  I was trying to be so strong, and it just wasn't working.  I agreed to get an epidural.  And once I agreed, it made me even more upset.  I felt like a complete failure.  I was so determined, and it all just went to the ground.  Epidural in.  I immediately fell asleep.  

I was checked throughout the wee morning hours and slowly dilated to 10cm (complete and ready to push).  I was still extremely upset, but I got excited at this point, because I'm about to push out my baby boys!  This occurred right around shift change.  Day shift nurse came on, the same one that we had the day prior, and we liked her.  That makes things a little better.  I start pushing.  I get to a +2 station (+4 is crowning).  Problem.  Judah's head is cockeyed....as in the nurse/doctor could feel his ear while checking his position (optimal position for birth is his face down).  Our awesome doula had some techniques and positions that we could do to try and get him turned.  We did them and it worked!  Judah is now in the go position!  I push and push and push.  For 3 hours.  Throughout this 3 hours, different people keep checking the position of Judah's head.  Every time someone would check, we would get a different station.  It was so frustrating because everyone's perception was totally different.  I kept pushing and nothing was happening.  I was getting really angry and nervous, again doubting my body.

3 hours had past.  Hardly any progress was made.  I was extremely drained of energy and swollen from all the fluids and from pushing.  It was almost 10:30 am on 7/28.  it was an hour away from that 24 time clock I mentioned earlier.  We took a break from pushing.  A little bit later, a doctor I had not seen before came in and introduced himself as a surgeon.  crap.  I knew it was coming.  I predicted it from the time that they broke my water.  I just kept pushing it to the back of my mind, determined to beat it out.  I can't remember exactly what this guy said because I was in a haze at this point, but he said something to the effect of "You can either continue to push like this and end up rupturing your uterus, or we can take you back to have a c-section."  He also mentioned something about how he wants us to be able to have future children and we may not be able to if we continue like this.  oh. my. goodness.  I just got an ultimatum from a surgeon.  I couldn't process any of this.  All I kept hearing was, "uterine rupture", "no future children", and "if we continue this way".  I look at Jeremy.  He has a disappointed look on his face and says, "let's meet our boys".  He was also extremely scared of the "uterine rupture"and "no future children" discussion also, although he didn't tell me that until later.  I started bawling once again, and reluctantly agreed to have a cesarean section.


Click HERE to read the second part of our birth story.

                        
    







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