Friday, August 29, 2014

Labor and Delivery!

Okay people, guess what!? I'm not pregnant anymore!!! WOOHOO!!!

What an absolutely crazy day yesterday! My day started around 5 am. I slept okay at the hospital hooked up to the monitors that were watching the baby while the Cervidil was inserted overnight. I kept waiting for labor to start during the night but nothing really happened. When I got up at 5 am, I needed to pee so I went to the restroom. When I got back in bed, I noticed some small painful contractions starting at pretty regular intervals. I only had half an hour left with the Cervidil and then the nurse was going to come take it out. At 6 am, she came to take it out and I let her know that I was having some contractions but nothing too strong just yet, but definitely different from the Braxton Hicks I had been having. She checked me after removing the Cervidil and basically nothing had changed from the overnight drug. Still only 1 centimeter and still 50 percent effaced. I was a little bummed that some progress hadn't been made at least with the effacing part! She did say my cervix was softer and more ready to do the rest of what it needed to do during labor. Around 7 am, she started the Pitocin. I noticed a difference right away with the contractions. They became stronger, more painful, and closer together. She started at 2 micro units and was increasing by two micro units every 20 minutes or so. My husband arrived to the hospital from dropping off the kids with my friend who would be watching them for the day around 8:45. By 9 am, the contractions were getting very painful, I couldn't talk through them, and they were sometimes right on top of each other. My nurse was absolutely awesome! She let me know right away that I had rights as a patient and that if I didn't want something to happen the way the doctor was saying it should, that I could speak up and do things my way. I told the nurse that I would prefer to get the epidural before the water is broken, and she agreed with me that it would be the best way to do it, and told the doctor that that is the way we would go when it was time for the epidural. By 10:30, I was up to 12 micro units of Pitcocin and hurting pretty badly. Contractions were very strong, very close together, and I was starting to wear down a bit. The nurse checked me and said that I was at 4 centimeters and almost 100 percent effaced! Yay, progress! I was surprised at the progress, and thankful for it, and then consented to the epidural shortly thereafter. It took about 45 minutes for the anesthesiologist to come up and administer the epidural and by that time, I was definitely ready. This time, the epidural was different for me. With my previous births, Brae's epidural was only for 4 hours of the 45 hours labor, and with Kynlee's birth, the epidural was administered and then turned off almost immediately because I was almost completely dilated and they wanted me to be able to feel something and not be so numb. So with this birth, it was the earliest I have gotten it during labor and it also took the longest out of them all to take effect. After about 30 minutes, I was pretty numb and couldn't feel the contractions with pain anymore, just more pressure and tightening than anything. I was grateful for that because if the monitors were any indication, I was having some pretty strong ones. At this point, I hadn't eaten since 5pm the night before, and I was starving. They wouldn't let me eat anything which I expected, but I also didn't expect to feel so hungry!

Shortly after the epidural took effect, the doctor came in to break my water. After they broke my water, they increased the Pitocin again, and I was so thankful that I couldn't feel them! She checked me again about an hour after my water was broken, and I was dilated to a 5 and completely effaced. Yay, more progress! To tame some of the hunger, I started chewing on ice chips since that was the only thing I could have. BAD IDEA! I have had very bad heartburn during most of this pregnancy and it was really bad for the last month or so, and during labor it was just at an all time high. Laying on my back did not help and having nothing in my stomach but stomach acid from not eating for 18 hours at that point did not help it either! The water just made it 10 times worse! Another hour or so went by, and I started to feel a lot of pressure and also started to feel the effects of the epidural wearing off. My legs started to have more feeling in them and I started to feel the pain of the contractions again. The nurse checked me again, and I was dilated to 8-9 cm. Great! After about 30 minutes of feeling the contractions again, and not being able to talk through them again, the anesthesiologist came up again and gave me a bolus of numbing medicine and it slowly took effect and I was back to numb again. At this point, it was closer to 3 pm, and I was thinking to myself: "Wow this is going pretty great! No complications so far and I'm progressing and almost there!" And then, everything hit the fan!

A couple of minutes after 3 pm, the nurse checked me again, and said that I was complete and ready to push! She didn't call the doctor just yet, and just wanted to do a couple of practice pushes to see how I push and if it would bring the baby down at all. She was still pretty high and so I knew I would have my work cut out for me. By 3:20 I had started pushing. I pushed with every contraction for over an hour and she was not really coming down very much. The doctor came in about half way through pushing and she told me that the baby was stuck on my pelvic bone, and that her head was turned in a sideways position that was making it even more difficult for her to move down. She would try to turn the baby's head during a contraction and was trying to move a little lip of cervix that was still there at the same time, while I pushed. For this sake alone, I am so glad that I got the epidural and couldn't feel more than just pressure. One of the other side effects I started having from the epidural was uncontrollable shakes. My whole body shook from when I started pushing to when baby was delivered. I couldn't control it, and I didn't know which was worse, the shakes or the heartburn which was raging at this point. Every time I would push, I would feel the acid come in my throat, and I would try to swallow real quick before taking another breath to push again during contractions. It. Was. Torture! All of a sudden, before I knew it, I was throwing up. You wouldn't think I had much to throw up but apparently those ice chips I had been chewing on were just enough. NOT GOOD!

At this point, I continued to push for a bit, but after nothing still was happening, the doctor decided to take a break and let me labor down for a bit in different positions to see if that would help the baby come down on her own and get unstuck from my pelvic bone. I changed positions two or three times, and labored down for about an hour. The nurse checked me again, and said that the baby had come down further and that she thought I would have better luck pushing this time around. So she called the doctor back in and we started pushing again. As I started pushing again, the heartburn got bad again, and the doctor said that while she had come down from my pelvis, her head was still turned funny and so during the contractions and while I pushed, she would try to turn her. My epidural started wearing off again, so I just tried to use that extra feeling and pain of the contractions and to push through them. It was about 5:15 when the pushing started again, and she wasn't born until 6:55 pm. At around 6 pm, the doctor said that it was time to do something different. The baby's heart rate was consistently tachycardic (too high), and mine was getting high as well. I had just thrown up again, and was nearing the end of my rope. I didn't know how much longer I could push effectively and since I wasn't feeling like she was making any progress down the birth canal, I was getting frustrated and exhausted quick! The doctor's suggestion was to try a vacuum to help bring the baby down. She asked if I was okay with that, and then things got complicated. I asked what the risks were, and she said that it was possible it could cause brain hemorrhage for the baby. The intended parents heard that and freaked out. I don't blame them one bit! They ended up in the hallway, sobbing, while I was in the hospital bed, crying because the other option was a c-section. The doctor was saying that it would be a very long recovery for me, at least two weeks of not driving, extra pain, an incision, and everything else it would bring. I kept thinking, Troy goes back to New Jersey in 8 days, and I won't even be able to take Brae to kindergarten, or hold Kynlee, or do any of the other mom duties I have! I was crying during contractions and pushing, and Troy was trying to tell me that everything would be okay, and that if he had to, he wouldn't have to go back to Jersey right away and that he could stay and help for as long as I needed. I felt bad that I would be the cause of him not being able to return to work, and I also was worrying about what the intended parents must be thinking and going through at the same time. My doctor kept saying: "You're my patient, the only person I need consent from to do the vacuum is you." I heard the intended father say that he didn't want to the vacuum and that he would prefer for me to do the c-section. The doctor explained that even that wasn't the greatest of options either since they would have to push the baby back up the birth canal, and then rush me to c-section room and open me up, and still have to pull baby out of birth canal and then out of my uterus. I was terrified this was going to happen. My nurse, at this point, said that she was going to go talk to the nurse manager and figure out what legally could be done and who's ultimate decision it would be. I was worried I would jeopardize the relationship I have with the intended parents if something were to go wrong during the vacuum procedure, and I was also terrified to do the c-section. After a little while, the couple came back in, and since the nurse manager had taken some time to explain the procedure to them in more detail, along with my doctor who had stepped out to answer any questions they might have, they were ready to try the vacuum. My doctor started setting up for the procedure, and she said: "Okay Sarah, I am not going to use the vacuum for more than 3 contractions. If it isn't working after 3 contractions we will go to c-section." GULP! I had to sign a consent form that said: Patient agrees to vacuum assisted vaginal birth, if unsuccessful, will proceed to emergency c-section." The doctor then said: "Okay, Sarah you have got to push with everything you've got. Let's get this baby out!" I don't know where I found the strength from, but I pushed like my life depended on in! The doctor put the vacuum on the baby's head, and then told me to push. In one and a half contractions she was born!!! I heard the baby cry right away, realized she was out and that I had finally gotten her out, and I burst into tears. There were 13 people in the room, all nurses and nursery nurses, the nurse manager, the intended parents, my nurse and a paramedic student that was watching, and Troy. I don't think there was a dry eye in the room, except for maybe Troy :) The couple was sobbing, I was bawling, and I was so relieved that I didn't have to have a c-section! lol The doctor delivered the placenta after quite a while of pushing and tugging on my uterus. I was bleeding a little too much, so I got some cytotec to slow down the bleeding and then doctor had to get some leftover membranes that were still in my uterus. Once she got that out, she looked for any tears or lacerations. Surprisingly, there were none! I didn't tear which is great! The nurses and nursery nurses were doing the initial tests on the baby in the room and so it was pretty chaotic for a bit, but then all of a sudden, it was just me, my nurse, the doctor, and Troy! The doctor finished up her job, and they made me as comfortable as possible, and then I got to finally eat something! Food never tasted so good!

This process has been interesting, exhausting, unpredictable at times, but mostly very exciting! I am so happy and excited for the couple to begin their journey as parents now! I got to hold the baby last night for a little while. She is a cutie. I will post another blog with a couple of pictures as I take them, probably in the next few days. I want to respect the parents and let them bond with the baby as much as possible! They will be in the country until September 19th, and then will be headed back to France as long as birth certificate and passport arrive in time. I have had several questions from the nurses asking me how I'm doing emotionally, and the answer is that I'm doing just fine! I don't feel any attachment to the baby, or sad in any way. I was so happy to see my babies this morning after Brae got out of kindergarten. They are my world and I am so thankful for them! I'm so happy and proud of myself that I was able to provide a sense of family to another family that was so desperate for it! I will probably post another update in a few weeks with how everything is going emotionally for me for those of you that want to know! If you have any questions, I would be happy to answer them! Thank you all for reading and following me on this journey! It's been grand! :)


Baby Alice
7 lbs 13 ounces
Born at 6:55 pm.
21 inches long

Sarah

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