This is a bit lazy, but instead of rewriting the birth story and going through it yet AGAIN (which is equally teary and traumatic for me to do) I’m going to post the email I sent a few close friends this past Thursday evening when I was too full of adrenaline to sleep when I should have been.
I went in on Saturday night to start receiving cytotec as my cervix was only 50% effaced and 1-2 cm dilated as of Friday. However, I’d had my membranes swept on Friday and Ravi and I had made a point of having sex on Saturday, and both of those had actually pushed my body into early labor on it’s own. I was monitored for about an hour, and they decided my contractions were too frequent to add cytotec to the mix, and they sent me home and told me to come back in the am. However, the contractions (which I hadn’t even realized were contractions…my exact words were “wow, she’s shoving her butt against my stomach”–she’s been in a firm heads down position and I could always feel her little butt next to my belly button, so it felt like she was pushing out against my stomach, not that my uterus was contracting in around her) petered out in the night.
I went back in on Sunday morning at 8:30. I was put into a labor room by 9 and because the contractions had petered out, I was given cytotec at 9:30. My hospital uses a low dose and will do up to three doses, but I only needed the first to do whatever dilating or effacing they thought I needed to do to graduate to pitocin. I was started on pitocin in the early afternoon after eating (and throwing up, sigh) lunch, and taking a nice long shower. I slept intermittently but woke up around 6 in a ton of pain–the contractions were bad, but it was the pain I was feeling in my low back (where the back surgery had been) that pushed me into begging for an epidural, which I got around 6:30 at night. I think all of you have had kids, so you won’t be surprised to hear that my body’s reaction to losing sensation in my lower half was to lose control of my bowels, but I was pretty upset by the experience (even though I’d heard it could happen). My blood sugar kept dropping, but we were able to control it by juice (which I threw up at one point as well).
The epidural was both a huge blessing and a giant curse. Blessing–it made labor mostly manageable. Curse–it was super effective on one side and had two bad blind spots on the other (one in front of my hip bone on the right side, one on my back on the same side just above my waist–near my surgical site and the weakest spot in my entire back). I was able to mostly sleep through labor rousing here and there when the contractions got intense. However, the blind spots made it necessary for me to push the button and to ask for more concentrated doses to top off the epidural when I hit transition and several other points. This topping off, while keeping labor manageable is part of what destroyed delivery for me.
Because I was on pitocin, I had continuous fetal monitoring of her heart rate and of the contractions. Once I started to hit transition, we began to see some dips in her heart rate whenever I labored on my back. According to everyone I’ve asked, this usually means the baby is laying on the cord and it’s no big deal, especially as she was fine as long as I lay on one of my sides, which I did. After I hit 7 cm, we switched to internal monitoring (they attached something to the baby’s head, and slid a plastic rod up next to her to monitor contractions).
At 3am on Monday I hit 9 cm and woke up feeling like I was pushing. I got one last top off of the epidural and napped until about an hour later when I hit 10….and the consequences of so many epidural toppings hit me. Anaesthesia came in and turned off my epidural (they couldn’t make it better and it would take an hour or three for the effects to wear off so keeping it on wasn’t helping) but it was too late because I was already in pain.
A potential side effect of too many epidural top offs is that you get too much fluid (in your spine, I guess) and you get intense searing pain across your shoulder blades and up your neck.
When you deliver with an epidural, you deliver on your back with people holding your legs, you grabbing your thighs and basically doing a sit up (which requires the use of the muscles across your shoulders and your neck).
My OB arrived at 4:15 am and we began pushing. I couldn’t push effectively because of the pain from the epidural toppings. The baby’s heart rate was dipping because I was on my back.
At that point she made the decision that I believe saved my daughter’s life. She decided to do a vacuum extraction, which required the presence of a NICU pediatric team in the room. She gave me three contractions (three pushes each) to get her out or we’d do an emergency C section. I literally was on my last chance when she crowned.
What no one could have known was that the cord was around her neck…tightly. My OB immediately cut the cord and we got her out in one more push, and handed her off to the NICU team who began to work on her on the warmer. Ravi stayed with the baby and the NICU team and watched them. They got her breathing before her 1 minute APGAR, but she’s missed out on the last rush of blood from the cord and she wasn’t breathing well so after I saw her long enough name her (we’d been thinking Elanor for quite some time and had been debating between two middle names and Ravi let me decide) and hold her for ONE minute they took her immediately to the NICU.
Her birth stats were–born 5:27am, 6lbs 11oz, 19.25 inches long.
Ravi went with her to the NICU and stayed with her until 7:00 when the shift change happened. During the hour and a half while I was still in the room delivering my placenta, getting stitched up (2nd degree tears, all interior), and recovering we were texting back and forth. My OB actually encouraged this as it was the only thing keeping me sane.
I got to see her in the NICU by 8am on Monday, where I got to hold her finally. Which is when we got the next dose of news. Her breathing had gotten under control, but her blood sugar wasn’t. She was on an IV and we’d have to wean her off it slowly. I could try to breastfeed but it would require formula to give her enough nutrition to keep her blood sugars where they needed to be. I consented to the formula (duh). After her first feeding they turned down her IV by 1/2, which was way too aggressive a wean, and her blood sugar tanked. We then basically needed to go through 8-10 or so feedings with good blood sugar numbers afterward to get her released from the NICU which happened on Tuesday afternoon.
We had an awesome Tuesday with our first successful breastfeeding attempt (I’m pumping and we have to supplement with formula for the moment) and her in our room and with what felt like a happy ending to our story as we were getting discharged on Wednesday.
Wednesday morning we were told that a blood test had come back positive, indicating that she had a serious infection and would need an additional two days in the hospital. We were told that they were relatively sure that it was a false positive for a variety of reasons, but that they were going to repeat the test and start her on the antibiotics just in case, and the earliest she was going to come home would be Friday. If the test were positive for real, they said, she’d be in the hospital for 3 weeks to complete the course of drugs. Later that day they said that they were certain it was a false positive because she was eating well, had NO elevated white blood cell counts, and the lab had said they thought the test was likely contaminated. But that she’d still need to wait the 48 hours JUST IN CASE.
We were able to stay at the hospital on Wednesday night, but the parent room had a hard one night stay rule.
Today we were facing leaving the hospital without her. Both of us broke down about ten minutes before we had to take her to the nursery before leaving. Ravi had to take her to the nursery because I just couldn’t. When the pediatrician came to talk to us, she saw how upset we were and tried to comfort us by telling us how sure she was it was a false positive and trying to get us thinking about tomorrow and what going home would look like in terms of breastfeeding and such.
About fifteen minutes later she came back and said she had good news. Elanor had knocked out her IV again (it was her 4th) and that they’d decided against putting in a fifth. We were so grateful…but that wasn’t the good news, she said. She and the NICU doctor had talked and decided to send her home with us today! There was no point, they said, in prolonging our pain over something they KNOW is going to come back proving that the first test was a false positive. We had to promise to get her to her pediatrician tomorrow and to call for the official results at 10am tomorrow, but otherwise, we were free to take her.
I came very close to living out two nightmares in the last 4 days–carrying my daughter to term only to lose her at birth, and leaving the hospital without my baby—and was lucky enough that neither happened. I generally profess to be an atheist, but right now I’m sitting at home looking at my sleeping daughter and just have to wonder what stars aligned that I got this lucky.
We’re lucky…Elanor is healthy (there will be NO long term issues resulting from what happened at birth), my milk is coming in very well and we should be able to transition to breastfeeding with some help, and we are home and safe.
I’m just glad I could end this email with that kind of happy news.
For the record, when I called on Friday morning, the blood culture was, of course, negative.
Breastfeeding is another topic altogether, and I’ll save it for another day.