Wednesday, April 13, 2016

Labor and Delivery

Hi everyone! 

Alright, so my last update was at 37 weeks, and while a whole lot didn't happen between then and delivery, I will update you on my doctor's appointments leading up to labor and delivery. 

At 38 weeks I had my last growth ultrasound done to check fluid levels, and to check on baby's growth. While one of these ultrasounds is the most inaccurate for weight this late in a pregnancy, they still wanted to get a look at baby and try to predict a weight. 

Heartbeat was strong and normal during ultrasound, and everything was measuring at least 2 weeks ahead of what I was. They estimated that he weighs 8 lbs, 15 oz at 38 weeks and 3 days. Yep, was definitely freaking out a little bit! I saw my doctor right after the growth scan. She started talked about inducing me the next day based on my fluid levels during the ultrasound. I had a lot, and with the big baby weight estimate, she could technically get away with it. She decided to check me and then we would go from there. Was still dilated to a 1, and she said it felt different from the first time she had checked me, but not in a good way. As is, she wasn't able to say that the induction wouldn't end up in a c-section and she though that waiting the extra week, and sticking with our original plans would be best. I agreed, because even as uncomfortable and in pain as I was, I wanted the best chance at a vaginal birth as I could get with an induction. 

So my last appointment with her was scheduled for Wednesday, the 6th, with plans to go in that night, and start cervidil that night, and then they would start pitocin early Thursday morning. At my appointment, my doctor checked me one last time to see if I had made any change in the week, and I did! Was dilated to a 2, and cervix felt better than last week's exam. Good news! 

The parents were officially on a plane to KC, and so I went home and did my last minute stuff, cleaned the house one last time, made sure kids had everything they needed in my absence, and packed my hospital bag. Yeah, I was just then packing my hospital bag. My body likes to hang on to babies, and they aren't in any hurry to come out either, so what was the point? :) 

We met the parents and their daughter at a nearby restaurant, and had dinner together. They were so excited, and anxious for the next day! I was anxious about it too, and was so very excited for them, and to not be pregnant anymore!! 

I checked in to the hospital around 7:30 Wednesday night. Troy and my kids came with me, and the mother came along as well! I got set up in the hospital bed, started an IV, and hooked up to the monitors that show baby's heartbeat, and that show my contractions. 
I sent Troy and the kids home, as well as mother and told them all to get a good night's sleep! Tomorrow could be short, but could also be a long day! After an hour or so on the monitor, the nurse came in and said: you're having contractions, can you feel them?" 
Me: "heck yes, I can feel them. They've been like this for about two months now!"  
Nurse: "okay well, Dr is going to come and check you to see if you're making any change with these contractions and go from there."

Doctor came in, said I hadn't made any change but was concerned that the cervidil we had planned on doing might kickstart my labor and result in me calling people in the middle of the night. None of us really wanted to do that, so doctor decided to do a low low dose of pitocin, and it would do the same thing as the cervidil would do, but could be more controllable should labor actually start overnight. 

So, we started low dose pitocin, and I started feeling more and more, and was starting to get uncomfortable through them and was beginning to wonder if I was going to be able to sleep through them. I updated Troy and the parents on the change of plans, then I tried to fall asleep, and was able to sleep through them, thankfully! I had to get up every few hours to pee, but thankfully I wasn't having any issues with the contractions! The hospital bed was extremely uncomfortable and the nurse kept having to come in and reposition the monitor for the baby because he kept moving too much. The carpal tunnel pain was unbearable and kept me awake most of the night. Ice packs weren't helping either, but by the time morning came, I was ready to get this show on the road! 

My day shift nurse was absolutely fantastic!! So thankful for her. My night shift nurse? Not so much! More on that later! 
Troy came to hospital around 6:45, and the parents arrived around 8:30. My doctor came in at 8:00 to check me and see if the pitocin had done its intended job. I was dilated to a 4 now! Great! So my doctor decided to break my water, and to start upping the pitocin every twenty minutes by 2. I was anxious about her breaking my water, but since I was already dilated to a 4, she was optimistic that I could get the epidural shortly and get some relief if it got too bad. About an hour in, I requested the epidural and so my nurse got things rolling for that! 

Anesthesiologist came in and administered my epidural. It took quite a while for me to go numb, and some of the contractions were pretty uncomfortable. I was thankful he came when he did and was trying to gear up for what was ahead. 

The nurses were checking me every two hours or so, unless I was feeling any pressure, which I wasn't. Went from a 4, to a 5, then a 5 1/2, then 6, then an 8. Contractions were spacing out, not as strong sometimes, and I got stuck at an 8 for 3 hours or so. Me epidural also became worthless around that time too. It was around 6 o'clock when I was stuck at an 8, and I really wanted to deliver with my day nurse but that didn't look like it was going to happen. I kept pushing the button that could give me extra pain medicine through my epidural but it was not helping at all. All the while, the pitocin kept getting increased every twenty minutes. I think I was up to a 18 or 20 by then. I was able to move my legs, and to feel the contractions that I was having. Very frustrating! It's one thing to go into labor with the decision of no pain medicine, but to actually go in, expecting relief through the help of an epidural and not getting it, is beyond frustrating! 

Shift change and my night nurse came back from the previous night. Didn't really care at that point too much, just wanted to be done soon! 7 o'clock, 8 o'clock, 9 o'clock, was crying through contractions, extremely uncomfortable, and had to breath some oxygen in between contractions. The nurse had me trying different positions, with a peanut ball, in between checks to maximize the baby's head coming down naturally. My doctor came in and checked me. I was shaking uncontrollably, had developed a fever, and she could see how uncomfortable I was. She told the nurse to call anesthesia again to come and give me a bolus of pain medicine. I was dilated to a 9 at that point, so hopefully not too much longer, right? I told the parents who had been in the room with me the entire time, to go to their room and get some rest before pushing started. 

Anesthesia came in and gave me that bolus. It took 30 minutes to take the slightest effect, lasted literally 10 minites, then I was back to crying through contractions. Pointless, and I was so frustrated with my pain level with what was supposed to be an epidural delivery. Around 10:15, my doctor came in and checked me and said I was a 10, and baby was far down enough that I could also start pushing. Based on our previous discussions between my doctor and I, I was encouraged that she thought I could start pushing! 

Called the parents back in, and at 10:20 pm, I started pushing. I kept my eyes closed, tried every position they suggested, pulled against a sheet, used a bar, and the good ol' stirrups. All the while in full blown contractions every minute or so, and awful awful pain from them. 

I pushed for 2 full hours with no break. Troy and the mother were trying to be encouraging in telling me that I was getting somewhere but I knew they were lying and that with the very first push that he was bigger than any other baby I had delivered and he was gonna take extra work. The father was up by my head, and would exchange warm wash cloths for cold ones for my forehead upon request. I got a few doses of Tylenol to help my fever, and I think it broke during pushing at some point. 

I was nearing the end of my rope, my pain tolerance, and my strength. At the two hour mark, I said: "Dr. I need help getting him out, I don't think I can do this much longer." She said: "open your eyes and look at me." 
I opened and looked. 
Dr.:"if I do a vacuum, you have to do exactly as I say, and push as hard as you can."
I said: "I can do that, I just need help."
So we prepped for a vacuum and I continued pushing through my contractions. 
The night nurse I had started getting a very stern voice with me and again said: "open your eyes and look at me. You need to stop pushing when your contraction isn't peaking, and save your energy. Stop it! And you need to keep your eyes open and be alert to what the doctor is saying." 

"Yes, ma'am." 

Doctor put the vacuum on baby's head, at 12:30 am, and baby was born at 12:32 am!!!! Once his head was out, they realized his shoulder was stuck on my pubic bone, and so one of the nurses had to get on the bed with me, and push as hard as she could on my stomach, to help dislodge him. That was definitely painful, but was so relieved they got him out!! 

Baby boy, born on 4/8/16, at 12:32 am! 9 lbs, 6 oz. 😳

Baby is healthy! They did x-rays after he was born to check to see if his clavicles were broken, and thankfully they are not. They think his shoulder is sprained. The technical term is shoulder dystocia. It is nerve damage from delivery and will either repair itself or he will need physical therapy and will be fine.

My placenta would not detach from my uterus wall, and I was hemorrhaging so after 28 minutes since baby had been born, my doctor had to go in and scrape it out with her fingers. That was not pleasant, but she said it came out in one piece which is great! The other option would have been emergency surgery! So thankful I didn't need that! 

Recovery is going very slowly for me. Slower than other births. I had a blood draw the morning of birth, just a few hours after I delivered to check my hemoglobin (iron in blood), level. It was 10.8 on admission, and 7.1 that morning. Below 10 is considered severely anemic, from what my doctor said. So, the on call doctor came in and told me that it was dangerously low, and told me we needed to do something about it. His first suggestion was to do a blood transfusion. Said I would feel significantly better almost right away. The other option was an iron infusion. Said it would give me a boost, but would need to take it easy for the next several weeks and let my body recuperate from birth. They needed to start an IV for the infusion. They poked 5 times before they got a good one. Had to have someone from ER come and do it. I was very swollen from all the fluids I had received during labor and delivery so that didn't help matters. 

The iron burned a great deal going in, and I didn't feel any different afterwards. The blood draw the next morning showed change from 7.1 to 7.6. Doctor said I could still go home but needed to be very careful and mindful of my body and how I'm feeling. If I start passing lots of clots, or soaking a pad every hour, I needed to get my butt back to hospital asap. He said if I were to leave the hospital and have a car accident, and was injured, I wouldn't make it because I don't have any reserve! Scary, so I'm taking care of myself as much as possible. Troy has been absolutely fantastic and helping me with everything and letting me rest. 

Parents and baby are home in NYC and are doing well! They have been absolutely fantastic to carry for, and I look forward to many years of updates and friendship with them! 

We close on our houses on Friday! So excited to get moved in and get renovations done, and settled in!! :) I will come back with an update after my 6 week checkup! 

Thank you for following along on this journey with me! Means a lot!