Thursday, September 15, 2011

time to do this - birth story

For a multitude of reasons, I never sat down and wrote this out, but my friend had her little boy today and looking at pictures brought it all back so its fresh in my mind again.  Just a warning though, if you are currently only trying to surround yourself with easy birth stories, stop reading after the actual birth part.

I woke up Memorial Day feeling a bit off.  I thought I was having Braxton Hicks again so I ate breakfast and they seemed to go away so I went on with our day as normal.  By dinner time I was having to breath through some of the pains but they were still irregular and went away when I changed activities.  9pm at night I told R that the pains were bad enough that I wouldn't be able to sleep, so no matter what they were (I really thought it was intestinal pain) I needed to call the doctor.  As expected, we were sent to L&D to rule out pre-term labor.  I think we checked in to triage somewhere around 11pm.  The doctor that came in was actually the same doctor that saw us when we thought we were losing C at 10weeks because of the SCH.  I doubt he remembered us, but it made it a little surreal for me.

As soon as they hooked up the monitors, the contraction monitor spiked to an 11....on a 1 to 12 scale.  So I knew I wasn't over-reacting about gas pain at that point.  The Dr. came in to do an internal, and I really expected to be told I was a 1-2 and would be on bedrest from here on out.  Well, the bedrest part was correct, only it was a L&D bed because I was 3-4cm and he could feel the head so I was 80% effaced.  We were told that we'd be admitted, but this far along they wouldn't do anything to stop the contractions.   I asked about steroid shots, and was told that they couldn't give me the shots because there was currently not enough medical data to support administering steroids between 34 and 36 weeks, but that there was a study currently being done at the hospital to examine possible benefits to late pre-term babies.  Since participation gave us a chance at getting the steroids, we opted in.  He did a quick u/s to confirm the baby was head down, I got an IV (twice, she blew the first vein..that was a lovely bruise later) and I was sent upstairs.

We got settled in to our L&D room around 2am and by this point, the back labor was pretty bad.  I knew that if things progressed quickly I would need whatever sleep I could get so opted for the epidural.  It was in place by 3am and I was numbed up by the time the medical study person made her rounds to give the first steroid (or maybe placebo) shot.  I managed to sleep for a few hours after that.

Tuesday morning I was still around a 4, so the new game plan was to turn off the epidural around noon and hope that things stayed calm and I could be moved to observation until at least 35 weeks.  So off it went at 12 and I was able to get up and use the bathroom a few times, the second time I got up I lost my mucus plug.  By 3pm, the contractions and back labor were bad enough that I asked to turn the epidural back on.  Once it was back on, everything slowed down again and I more or less hung steady until later that night.  At 10:30pm I was around 5cm and 100% effaced.  Over the course of the night my epidural wore off several times...each time the pain had shifted lower...first mid lower back, then my right hip, and finally low and in the front.  The 3rd time it wore off I asked to be checked again.  I was told they wanted to wait until my water broke but the pain was so bad I demanded that they check me then.  The Dr. came in shortly after 3am and I was at an 8.  As she asked for the hook to break my water, it broke on its own and gave me momentary relief of the pain, but a few minutes after the doctor left the pain became so bad I started vomiting (not a whole lot, because I'd been on a liquid diet for more than 24hrs at that point, but it still sucked) and R paged the nurses.  Because my left leg was now entirely numb from the epidural, while my right side could still feel the pain, I opted to have the epidural redone.   R held me steady with a bed pan as a barf bucket while they redid it.  Thankfully the relief came soon after and I slept until 7am.

Right before morning shift change, my admitting doctor checked me and I was at a 10.  She decided I still needed to labor down a bit so she wished me luck and headed out.  I napped for another hour and then the next shift made their rounds.  The primary OB on the floor at that time was not from my practice, and snapped something about the head molding and that I shouldn't have been sitting like that for so long.  WTF?   Luckily there was also a doctor from my practice on-call with her so she actually performed the delivery and was awesome.  When it came time to push, it was R on one leg, a nurse on the other and her.  Not the chaotic scene I'd always imagined.   They did need to give me pitocin because my contractions still weren't consistent, but I pushed through 3 contractions (12 pushes) and he was out at 8:43am.   He cried right away and the pediatric team took him off to the side to be examined.  Everything looked great initially and I was able to hold him and put him to my breast for a minute or two.  Shortly after that it was determined that his glucose level was too low and he would need to go to the NICU.   I would not see him again until 8pm that night.

While they were checking him out, the OB and nurses were also checking me out.  As soon as I saw him, I completely forgot about that pesky placenta that I'd need to deliver as well.  Let me just tell you, the abdominal/uterine massage they do to get it out and make sure your uterus is shrinking properly is almost as painful as the contractions.  What came after that was 10x worse.  After they took C, the massage produced a huge gush...from the look on R's face I knew I hadn't just peed myself even though I asked hopefully if that was all it was.  The nurse gathered up the blankets and pads and they waited a few more minutes in hopes that things would straighten themselves out.  The second massage produced an even bigger gush and the top of my uterus was nowhere near where it should have been.  At this point the OB said I could either go into surgery or she could try manual extraction.  She made it sound like the manual extraction would be easier so we agreed to that.  Now at some point which I can't remember, my epidural had been removed.  Still not fully grasping what was about to happen, I asked for Stadol...since my IV was still in.  The Dr. said it wouldn't help with the pain, but I didn't care...at least it would help me forget it.  Unluckily, that was not the case, and I can say with certainty that it was the worst pain I've ever felt in my life.  Manual extraction meant she reached all the way up inside me and felt around for the remaining placenta.  3 times.  I screamed through all of it and on the 3rd attempt I remember screaming "please stop" and it was then, being one gush away from needing a blood transfusion, that it was decided I would need surgery after all.  

Everything from then on is pretty much a blur...they doped me up on several different drugs and multiple doctors came in to talk to me.  I remember checking with R when one pair left my bedside because I wasn't sure if they had really been there or if I'd just imagined them.  Once on the operating table, they placed the epidural for the 3rd time and I lay in my drugged up haze while they did the D&E.  Looking back, the surgery would have been a much, much simpler option.  I suppose the only benefit would have been that, if the extraction had worked, I wouldn't have needed to be in post-op recovery.

Somewhere around 2pm I was on  the high risk floor in recovery, and then moved to regular post partum in the late afternoon.   I had to wait until I got walk on my own before they removed my catheter and cleared me to go down to the NICU.

So there it is.  I still have a difficult time with how things played out after his birth.  There is no blame to place anywhere, my doctors were amazing and we have no answers as to why he came early.  Unluckily, chances are I could be looking at repeat of these issues with the next one.  At least next time I will be a little better prepared....I hope.

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