Sunday, June 23, 2013

Due Date: Emma Vance's Birth Story

How did this little lady make her way into this big world? With a bang, that's how!

Today is my due date! Okay, so actually it's the anniversary of my due date, but it's still a big deal. As we ramp up to celebrate E.V.'s real birthday on Thursday, I wanted to take a brief pause and remember how she made her grand entrance into this big ol' world. I'm laughing to myself as I write this all down because I meant to write this post immediately after having Emma Vance--that is, almost a whole year ago. In fact, in preparation for it, I kept a journal of everything that was happening so that I wouldn't forget a single detail. However, when E.V. came into our lives, it was like time stood still for a while. All I cared about was hugging her and taking a million pictures of her; it felt like a surreal dream that I would soon wake from, and I was ravenous to revel in every second of her presence for fear that her presence was fleeting. In those first few precious days, I gave a quick thought to sharing my journal entries--and then decided to put it off until she was a month old. It can wait. And it could. And it did. And now here I am, a WHOLE YEAR later, smiling at the thought of how E.V.'s birth story played out.

If you're bored, the long version's below after the pictures. If you're glancing at this on your phone or iPad, or if you can't stand the way I write (ha!) but are a curious voyeur, here's the short of it:

I was due on Saturday, June 23rd. I had been convinced that E.V. was going to be early, but as the days passed and my due date approached, it seemed that wouldn't be the case. I went to my doctor two days before my due date and was told my blood pressure was a little high and that they thought I was going to develop pre-eclampsia. I refused induction (since I wasn't officially pre-eclamptic) and opted to wait until after my due date to do anything. It was the worst weekend ever, filled with extreme highs and extreme lows, and I tried everything to put myself into labor: certain foods, walking the mall, sitting on the ball, reflexology. (By the way, I think all of that stuff is coincidental based on my experience; Ryan and I got to the point where we'd joke after every meal that if I went into labor, we'd exclaim, "Panera put me into labor! I had the baby right after eating a Greek salad, so it MUST be something in their dressing... " :) ) It didn't work (because E.V. wasn't ready), and my induction was scheduled for Sunday night. That morning I freaked out and told my doctor's office that I wasn't coming in; I had mentally prepared for every scenario except induction. I really wanted a medicine-free labor, and starting off with Pitocin was not ideal. To say I was upset is an understatement.

I ended up going to the hospital, getting a great nurse who calmed me down, and finding out that my condition had, in fact, developed into pre-eclampsia. I did the Cervidil-then-Pitocin thing, but by Monday afternoon nothing was happening. Nothing. (P.S.: The doctors asked to c-section me about a bajillion times throughout the whole process--including as I was getting ready to push!--but I refused. I think they were annoyed. Oh well.) We opted to do a staged induction and did another round of Cervidil-then-Pitocin. When I was at the highest dosage possible and still at ONE CENTIMETER with no contractions (because, once again, E.V. wasn't ready yet), the new on-call doctor (coincidentally, Dr. Jackie from Bravo's "Married to Medicine") told me she was confident that I was going to end up in surgery, but I refused. She broke my water just before lunchtime to appease me. I went into immediate labor (finally!), and for a variety of reasons (read below if you're curious about my decision), I opted for an epidural eventually. It only hit half my body and was completely gone by the time I was pushing, which was fine with me because I hadn't originally wanted anything anyways. In fact, I think not having an epidural while pushing made it easier in hindsight.

At 11 p.m. I was ready to go! I pushed for two hours (which felt like running a marathon, was quite comical to those around me and flew by like lightning), and E.V. arrived! She had some meconium and was taken to the NICU for a few hours. I felt GREAT immediately afterwards, ready to stand up, walk out the door and into a bar for a margarita, but when they pushed me up to my recovery room, I passed out. Like passed out: Stone cold, blue lips, unable to keep myself awake without ammonia... Poor Ryan had to suffer through all the trauma of having his newborn in the NICU with his wife laid upside down on a bed, unconscious! (At least we can laugh about it now!) It took me some time to get my act together and rejoin the conscious world, but after a sandwich and some relaxing I recovered. Around 4:30 a.m. we finally got to sleep, and at 5 a.m. they brought E.V. back from the NICU to us...and the rest is history! :)




(holy pre-eclampsia swollen face!!!)


(Ugh. Pain Arm!)



Sad day! Failed induction...

...but FINALLY! Labor! And then...

...FINALLY! A baby!

 

















"See ya', Mom! Off to the NICU for a while!"



Bright and early the next morning, ahem, I mean a few hours later...we were a family!




(a family tradition)








That's our Emma Vance!

FROM JUNE 2012:

I'm excited to share all about our labor and delivery, but it was quite an emotional experience, leaving me a little unsure of how much to share. At the time, we didn't want to put people on watch without any real progression, so I recorded my experiences day-by-day with intentions to post as soon as the baby arrived. However, our experience ended up being much LONGER than expected, much more draining than we had hoped, and very unusual compared to everyone else we know, leaving me with a LOT of content and in need of some time to process before sharing. 

I've decided for the sake of being transparent, and in hopes that maybe someone out there will benefit from our story, to post what I wrote in full. It's long, it's a bit dull at times, it's reflective of my roller coaster of emotions...so read at your own discretion. 

Once again, remember, I wrote each of these entries before the next, not as a recap post-birth, so there are raised hopes and dashed hopes throughout the entirety.

Oh, and to remind everyone of our goals, we had originally aimed for an unmedicated birth. However, I realized early on that I would need penicillin during labor due to having GBS. Thus, our secondary goal was to not have any OTHER medications--extra fluid, an epidural, etc.--and to have a natural delivery free of medical aid (such as forceps, vacuums, c-section, etc.). 

Thursday, June 21: Disappointing News
So it's Thursday afternoon, and we had our 40-week appointment this morning. I must say that I truly felt this little girl was going to come early, so I never even fathomed making it this far, meaning it's a bit bizarre to be thinking about being overdue--but it's almost here!

Because we wanted to bide our time as much as possible, Ryan and I had discussed voicing our desire NOT to have my membranes stripped at this appointment, which can help onset labor. (We have several friends whose doctors had done this "procedure" without asking first, and we were set on not letting that happen.) I was prepared to voice my opinion to Dr. Jo, but within a few minutes of being at the office, I totally lost my brain...

When I sat down to have my blood pressure taken, the nurse didn't automatically comment on how low it was (which they have at almost every appointment thus far). In fact, she furrowed her brow and took it again, manually this time. My blood pressure was 126/90, the bottom number of which was especially NOT good. Crud. Thus, as soon as the doctor walked in the door, before even checking me, the topic of conversation was induction. Double crud. I must say that I was a little disappointed in myself; even though (logically) I know I can't control my blood pressure, as soon as I had finally released myself from worrying about pre-eclampsia/toxemia, it reared it's ugly head...potentially.

My blood pressure's not technically in the pre-eclampsic range yet, but it's of concern and in most cases will only get worse. Plus my eyesight's been blurry and I'm swollen to the max...I haven't been diagnosed with toxemia yet, but here are the range of symptoms:


  • High blood pressure of 140/90 or greater
  • Excess protein in your urine
  • Severe headaches
  • Changes in vision, including blurred vision
  • Upper abdominal pain, usually under your ribs on the right side
  • Nausea or vomiting
  • Dizziness
  • Decreased urine output
  • Sudden weight gain
I understand Dr. Jo's concern. I mean, as she explained, the baby's fully developed, she's BIG, she's not breech, my body's ready but just not doing anything yet, and the closer to pre-eclampsia I get, the worse the outcome could be--especially if my desire is to not end up in an emergency c-section.

Then she checked me so that we could assess how close I am to labor. A whopping ONE CENTIMETER (at least it's more than last week!) wasn't going to do it. Triple crud. So to further evaluate how the baby's doing, we did a stress test and thankfully found out that she is moving around well. Once we figured that it's NOT an immediate threat (as in, walk across the street to the delivery room), she asked if we could check into the hospital tonight--to which I said a fervent NO. I opted to do some additional blood work to discern how impacted the baby is by my potential toxemia, and we'll get the results tomorrow. Either way, at the end of all of this, Dr. Jo said, "The latest you can have this baby is Monday; this is NOT an elective induction situation." Quadruple crud. In fact, it's not very Christian-like, but my honest, literal reaction to her was, "Son of a bitch." :) She laughed.

My fear of a medicine-laden, induced labor seems to be getting closer to reality, but during the stress test I took the time to mentally accept that induction might be inevitable. Ryan, of course, accepted the reality of the baby coming soon and with interventions much more  quickly than I did. (Don't cry, don't cry, don't cry!) When Dr. Jo came back in afterwards, I reminded her of my desires to have a natural birth and asked if she would strip my membranes (which makes me laugh since I had prepped myself for the opposite conversation). She just smiled at me and said she already had when she initially checked me. Huh? It really didn't hurt like everyone had warned me, so that was good. (Thankfully I ended up wanting it done, otherwise I'd have been really mad.) After some discussion, we decided to do a more aggressive stripping to try and get this process started, which wasn't pleasant but wasn't terrible.

I left the office knowing that I will be induced starting Sunday night at the latest, which I will schedule tomorrow once I hear the blood test results. Dr. Jo's at Northside Forsyth on Monday, but we want to go to the Perimeter location, so I need a little time to determine my priority. I guess after the aggressive stripping, a Foley bulb (more natural than medicine) won't be helpful, but if I do indeed need to be induced, we'll start with Cervidil (to soften me up) before Pitocin (which I'm fearful of using). I'm going to try to give myself every chance to avoid too many interventions, so the first thing I did after our appointment was call a masseur (the one who did my prenatal massage) to book reflexology for tomorrow to see if we can get this baby out via alternative means. I have had some cramping and pressure in the hours since being stripped, which I take as a good sign, and am feeling hopeful.

Let's cross our fingers that she comes on her own (not today/tonight, but maybe this weekend ideally!). I've decided that today I'm going to relax, lay in bed, nap and watch TV so that Ryan can tie up some loose ends without me purposely forcing myself into labor. Tomorrow I'll get my massage and start the typical walking around; if we make it to Saturday or Sunday, I'll be more aggressive in testing out the old wives' tales of how to induce labor.



Friday, June 22: Alternative Means and a Nighttime Ride
The story of today? The countdown's begun, the hourglass has been flipped, and the seconds are ticking down...10, 9, 8, 7....you know how it goes.

Late yesterday afternoon the baby started getting feisty! She was a wiggle worm all throughout dinner (we figured it *might* be our last night out, so we had a grown up meal at Sage Woodfire Grill...yum!), probably as a reaction to my adrenaline and stress hormones as Ryan and I tried to predict what the next few days would look like.

The baby did quiet down as the night progressed, but I still didn't sleep all too well (par for the course). At 5:30 this morning, I was alert and awake. I decided to clean up a bit downstairs so Ryan could continue to sleep, and the dogs kept watch over me (again, par for the course) until he got up.

We got a call from the doctor's office around 10:30 a.m. with the blood work results and everything looked fine--a huge relief since I voted "no" when Dr. Jo offered to induce me yesterday. My uric acid levels were up a little bit, but nothing that was of immediate concern, so the nurse asked if I wanted to come in tonight or Sunday night...and, of course, I voted Sunday. We decided to schedule the induction at the Forsyth campus in lieu of the Perimeter campus so that we could have Dr. Jo deliver the baby. It was a tough decision, but ultimately the who was more important to us than the where. IF this girl comes on her own (crossing fingers!) before then, the plan is still to head down to the main campus.

I had my massage/reflexology appointment at 1 p.m. (I know, totally granola), and the masseur was so excited to see me again! Since I met with her a few months ago, she had another (third this year) pregnant lady come in for an "induction" appointment, and it had worked the same day. That anecdote made me hopeful, and the appointment went smoothly. (Not much to recount other than what you'd expect--a lot of thumbs and pressure points in my scalp, feet and back.) Afterwards I was a little disoriented and shaky (read: NEED FOOD AND WATER NOW), and headed home to find that Ryan had worked on some of his "To-Do Before Baby" list. Sweet guy.

I was tired after the reflexology, so I took a really deep nap before dinner. We went to Taco Mac (classy) and then walked around Target (and, as usual, bought stuff we didn't know we needed until Target's amazing marketing convinced us). We stopped at CVS to check my blood pressure on the way home, and my bottom number went down to 88, which was good news.

It turned out to be such a beautiful evening, so we took the dogs for a nighttime ride in the Scout, whose top just came off for the summer/fall season. (For those of you who don't know Ryan too well, an International Harvester Scout has always been his dream car, and last year he finally got a 1976 model--his pet restoration project.) We had an amazing ride: Black skies and bright stars, a cool breeze, and two VERY excited dogs. Magical. A great end to a relatively uneventful day.

Today my attitude changed: I've been wanting this girl to be late, to delay the inevitable as long as possible, but with the impending induction, all day I've been getting excited about getting this process started sooner rather than later. Hopefully my subconscious and my body will have a conversation very soon to discuss the fact that we're all on the same page now: Get this little lady here!


Saturday, June 23: D-Day
I woke up feeling let down this morning. I thought of how in 36 hours I'll be sitting in a hospital, being induced, which I really don't want. I didn't rest very well at all, and around 6:30 a.m., my mind wouldn't let me back to sleep. Since I was feeling really frustrated and lacking control, I started praying. In an unusual occurrence, Ryan woke up around 7, and I was able to talk to him about my disappointments. Shortly thereafter I got up to use the bathroom (surprise, surprise), and there went my mucus plug (surprise)! Gross, but exciting because at this stage of pregnancy, it's a hopeful sign that I'm dilating at least a little on my own.

We ate lunch at J. Christopher's (do you see the pattern of indulging since each meal might be our last?) and then headed home for a little bit. Ryan played some video games (last vestiges of being a kid himself) while I bounced on a ball and re-watched "The Business of Being Born." After an hour and a half of squatting and reminding myself of all of the benefits of natural birth, I was ready to get walking. We headed to the mall, stopping at CVS again to check my blood pressure (and for Ryan to get his whooping cough vaccine). It was high--146/90, which is like go-to-the-hospital high--when we first arrived, so I drank water, did some visualization techniques (granola again!) and cooled down while Ryan was at the Minute Clinic. After a second reading, which was in the safe range at 126/90, we decided to continue with our plan and walked the mall, which was so HOT (seriously, General Growth Properties!); we walked and shopped for a couple of hours, feeling weird when we answered "today" to the several due-date inquiries we received from strangers, and then headed home after dinner.

When we got there, Ryan and I started making sure everything was packed and prepped while the dogs, obviously in tune with the pending excitement, ran around like true "animals." Ryan's so sweet to put up with my "nesting," helping me reorganize a few areas that have been bothering me, and to put up with my obsession with documentaries (nowadays especially ones on babies and kids), which I had playing in the background as we tinkered. His "reward" for good behavior? My "permission" to go to Blind Murphy, a craft beer store that just opened in downtown Alpharetta. Classic Ryan. :)

I then discovered that I had only lost half of my mucus plug this morning (yuck), so I take it as another good sign that the rest of it (or at least hopefully the rest of it) came out--maybe meaning more dilating? It's the weirdest feeling NOT knowing what your body's doing. I wish that there was a weekend OB that I could just run into quickly for an update! I mean, if I am dilating, then that means I'm having contractions but just not feeling them, which would be a dream come true. I'm trying not to get my expectations up too high, though, for tomorrow. If the hospital nurses check me and I'm only 2 cm, then that's fine. Progress is progress.

When we were walking around the mall, I ran into a former co-worker, who was so sweet to me despite my flushed face and swollen body. Her daughter had been induced successfully without ending in a c-section, so she encouraged me and reminded me that however our baby's meant to come, she'll come. I've been a bit euphoric this evening, coming to terms with the idea of checking into a hospital for an induction and releasing myself from the feeling of "needing" to go into labor on my own. (This decrease in anxiety probably explained my lowered blood pressure tonight, which measured 130/81.) At dinner, I looked at Ryan and realized, "In no more than 48 hours, we're going to have a BABY." Wow. Light at the end of the tunnel!


Sunday, June 24: Courthouse Wedding
The one consistent thing I can say about the past few days has been the roller coaster of emotions. I have definitely gone from acceptance and excitement to hopefulness to hopelessness to disappointment and back again over and over again, and it's exhausting! I woke up this morning at 4:30 feeling anxious and disappointed: another night and no labor. Induction was imminent, and my gut tells me that c-section is also thus imminent.

Basically I spent the morning and afternoon crying. (I swear that I must have lost a pound or two of water weight in tears!) I called the on-call midwife from my practice to express all of my fears on her. The biggest concern for me was that because my blood pressure didn't seem to significantly change over the dozen times I checked it this weekend (meaning I didn't have any "hard evidence" that I was truly pre-eclampsic), I felt like I was being induced for a potential problem, and that wasn't ideal for me. She advised me to go ahead to the hospital as planned, but reiterated that they couldn't make me do anything I didn't want to. If I declined my induction, she wanted me in the office first thing Monday morning for an ultrasound, more blood work and fetal monitoring; logically I knew that their recommendation for induction wouldn't change at such an appointment, so I got off the phone unhappily resolved to check in to Northside Forsyth that evening. The midwife did say that we could opt to check in, get blood work done and my blood pressure checked, and then if it didn't seem like anything had changed and I wanted to leave I could. That became our game plan. 

I immediately called a friend whose strength is "talking me down off the ledge" (doesn't everyone need a reasonable, logical person in their life?), and she helped me calm down a bit--until the other line beeped in; it was the hospital asking us to check in at 4 p.m. instead of the expected 8 p.m.  I told them "not likely" since I was neither emotionally or literally prepared. I got off the phone and Ryan and I sat in bed and talked about what was about to happen as I cried, and it was then that I realized how helpless he felt, which made me feel worse because I knew if my attitude had been better his would, too. Guys don't have this easy either, ladies.

We finished packing our bags, straightened the last of the things around the house, and headed up 400. I hate that our labor "story" began this way; Ryan looked at me and said, "I feel like this is supposed to be the exciting part, and I just feel sad." I do have to admit that I feel a little robbed of the experience of laboring at home, driving to the hospital, being full of adrenaline and excitedly surprised by spontaneous labor. And even worse, I feel like I robbed Ryan of the experience of playing his role in that scenario.

The best way I can describe feeling is to compare this pregnancy to an engagement. I've spent ten months planning a wonderful "wedding," dreaming of how the experience would be one of the greatest I'll ever have, but also mentally preparing for the details that inevitably go wrong with wedding days. Then, at the very end, just days before The Big Day, I got the news that my wedding was completely cancelled and I had to go to the courthouse to get married; I had prepared for bad weather, unreliable vendors, the limo to break down, etc...but a complete cancellation? No. Everyone's consolation to me? "Oh, the most important thing is that the baby gets here safely, and it doesn't matter how." Well of course. When Ryan and I got married, I would've chosen a courthouse and two signatures over NOT getting married, but the EVENT of the wedding was ALSO very important, and I wouldn't be honest if I said otherwise. If one more person tried to console me with this obvious fact, I was going to scream. Clearly I'd take a healthy baby over a good labor experience, but there wasn't a true reason yet to give up all hope, and it was frustrating that everyone else around me had already called it a day. Given the option of trying to make the wedding work at all costs versus just giving up at the first sign of a rainy day, I wouldn't be running to the courthouse immediately, and only Ryan seemed to understand how I was feeling.

So we checked in with my anxiety at an all-time high.  

*Let me just take a minute to say that I've been a visitor at Northside Forsyth and and Perimeter, so I knew that the Forsyth campus's rooms were newer and nicer, but upon checking in, I mean, wow. Honestly I thought for a moment that we had been given a special room since we have a few friends who work at the facility...but no! It's as big as a living room, has two twin-sized "couches," a big bathroom with a huge jet tub. Uh-mazing. Totally the right choice for us in hind sight.*

Our first nurse was awesome: She took a lot of time to talk with us about our game plan, was very understanding (especially since I kept going in and out of crying) and totally supported us. She was great at explaining everything that might happen, giving nitty-gritty details on the medicines that might be used, sharing her own similar experience, answering questions, etc. She was very supportive of our philosophy and desires. At the end of her shift, I seriously would've tried to bribe her to stay!

After getting settled, she checked my blood pressure, which read better than it had all weekend. (Now I know NOT to trust those stupid CVS machines! Who knew?) I started to think that perhaps we would be able to go home afterall, but to be prudent, I had my blood drawn and hung out for a bit. When the results came back, they were worse than the results we had gotten back on Friday, confirming that I officially have pre-eclampsia. Although this is terrible news, I do believe that God knew it was necessary for me to get back unbiased, bad results in order to get me fully admitted into the hospital and committed to being induced. So after talking with the on-call doctor and expressing our concerns to him, we started with Cervidil, which is, um, "topical" and needs 12 hours to work. (I measured at still just 1 cm.) We settled down for bed, waiting for Dr. Jo to come in the morning. Little did we know what tumultuous night was to ensue...

We were exhausted. Being up since 4:30 a.m. coupled with the emotional exhaustion had left us totally wiped. The doctor had offered me Ambien (which we all know I politely declined), and I definitely didn't need it. I passed out immediately despite being hooked up to a fetal monitor and having a sore IV feed in my arm, but about 30 seconds later, the new nurse, who had not taken a total of 30 seconds to talk to us the first time she had come in the room, came in, announcing that she was attaching my IV feed to fluids, something that we had expressly discussed NOT doing until the morning with the first nurse. I was so disoriented, but as I tried to explain that I didn't give her permission to do so (and at the same time trying to sleepily discern why she was even in my room), she was attaching me and flippantly commenting that the baby's heart rate wasn't in the range that she wanted it to be. Before either of us could even respond, she told me to lay on my other side, strapped an oxygen mask to me, and walked out of the room as she said, "See you in 15." Huh? OH, this is why some women say that they felt "helpless" when they had a typical hospital birth. Now I get it. I started bawling and Ryan got really mad.

We waited 15 minutes, not understanding what was going on, why she wouldn't listen to me, and if something was actually wrong with the baby. She inundated me with fluids so quickly that my teeth were chattering badly, my body convulsing that I couldn't talk or function. When the nurse didn't come back, we paged her and Ryan asked to chat in the hallway. (Love my protective hus.) The nurse (understandably) was irritated, and came back with the doctor on call (poor guy literally just walked out of a c-section and still smelled of antiseptic) who did NOT understand the situation. (I believe from the conversation that she had told him something totally different than our actual issue with her.) It was a very tense and bad conversation where we tried to explain that it wasn't necessarily what she had done, it was how she had gone about it that upset us. I don't think we ever resolved anything (or even really discerned what was wrong with the baby's heart rate and how severe it was in the first place), but the doctor said it was okay to unhook my IV, and since we "didn't have a good working relationship" with this nurse, we never saw her again. 

Throughout the rest of the night, the new nurses were amazing, non-invasive, and we tried to sleep as much as possible, which wasn't much. 

One of the biggest take-aways of today for me is that the term "natural birth" can be interpreted VERY differently by different people. This has been one of the hardest things for us since there are so many people caring for us. What I really needed to express (even to my doctor) is that I wanted to try for an "unmedicated" birth (NOT "unassisted," so don't freak out people; I'm not advocating going into the woods alone and then emerging with a baby!). Most people have been interpreting "natural" as simply "no epidural, no c-section," which is the goal, but the means by which I want to accomplish that form of "natural" birth is by NOT interfering with my body's normal functions with medicines. I did have to give up a little of my "unmedicated" dream early on because I knew I'd have to have antibiotics, but Cervidil and Pitocin were NOT on my radar, and even though I understand that they're just synthetic versions of things that occur naturally in the body, I still didn't want to go that route. (I'd eat an organic tomato before a non-organic tomato before a GMO tomato, which is the best way for me to describe why I feel like I do.)


Monday, June 25: Nothing Doin'
When my doctor came on duty at 7 a.m., she was briefed by the on-call doctor (who I'm certain thought we were ridiculous and crazy), and then she and the nurse who would be caring for us all day came in to talk. I literally had just woken up, and it was a bit unsettling to explain and defend ourselves, so I immediately started crying (a constant throughout these past few days). We talked for about an hour, trying to relay to her that we're not unrealistic or crazy, we just want to try to have the labor we believe will be best for me and for the baby. Basically, we need to be informed, we want to go slow, and although we know that c-section might be inevitable, that doesn't mean that we want to just go ahead and schedule one. She was very understanding but reiterated that we basically have no true options but to start Pitocin. The new nurse was absolutely amazing, and I was able to inundate her with a million questions that I had after Dr. Jo went to attend to her other patients.

We ate breakfast, showered, got situated since I was going to be hooked up to the IV all day, and at 11 a.m., they started Pitocin. The regimen was to start at Level 2 (out of 36), go up by 2 every 20-30 minutes, and then hopefully be dilated! They told me to expect to feel some cramps and contractions within about an hour, but not to expect to be fully dilated for 12 hours--at least. Ryan and I, after talking at length about our concerns with the doctor and nurse, were at peace and in good spirits. And then we waited...

...and waited...and waited. 

Thankfully we were both in great moods, I had no pain from the Pitocin, our room was really nice, and the staff was awesome because the phrase "nothing doin'" defined our day. I think that God knew we needed a little relief after such a tormented few days trying to induce labor on our own and then having a stressful adjustment to the hospital. (Not surprisingly, I had several totally normal, almost low blood pressure readings today due to our lack of stress.) We napped a little, watched a "Pawn Stars" marathon (literally, it started to repeat over before we called it quits), and just hung around. (Oh, and in true male fashion, Ryan tinkered with EVERYTHING electronic in the room.) We asked for no visitors because we needed to be alone and recover emotionally, and plus we didn't know if labor would kick in at any moment. Which it didn't.

After lunch (actually, after I sent Ryan out to eat lunch since I was no-food at that point), we started to inquire what was going on--or rather what was NOT going on, since I hadn't felt a thing all day. Although the Cervidil did its job relatively well, the Pitocin wasn't "taking," despite being at 20/36 by the end of the afternoon. I was having contractions, but they felt like Braxton-Hicks, and I was STILL only 1 cm. Around dinner time we called it quits, unhooked the Pitocin, and opted for "staging," which means starting the process over again to hopefully create a better result the second time around. What does that mean? I got to eat and shower, then get ready for another 24 hours before having this baby.

The reality is that the Pitocin not working really means my body isn't ready to go into labor, which is evidenced by my lack of going into labor on my own (duh). If this pre-eclampsia wasn't a reality, I wouldn't have opted to induce only one day after my due date, and after failing on the Pitocin today, I think that would've been the right decision. Hopefully more Cervidil and another day for my body and the baby to conclude that it's "time" will result in a good result tomorrow! If I still don't progress after the next round, I'll feel like I've done everything possible, and if we end up as a c-section, we'll be at peace.

Today was relatively uneventful, but hospital life isn't easy. I commend all the women who've done months of bed rest! Being hooked up to a monitor is annoying because it needs to be adjusted with every bodily shift; having an IV hooked up to your hand hurts a little (especially the penicillin drip--like a million bees stinging me, especially when the proportion of fluid:penicillin is off a bit!); going to the bathroom (which is at least an hourly event for me) requires two people and being unhooked/assisted; sitting in bed gives you sore spots...overall not a comfortable way to live. I've been so thankful for Ryan today. His patience and eagerness to help me with every little movement and need has really demonstrated his love for me, and for that I'm thankful. I definitely married the right guy, and this little girl is lucky to have him as a dad.


Tuesday, June 26: Naturally, It's Opposite Day...
We had another rough night's sleep, although it was thankfully much less dramatic. The nurses just had to adjust various machines (most of which were attached to me!) several times, and poor, tired Ryan got a little cranky with them when they didn't respond promptly to one of our machines started beeping for more paper. :)

Dr. Jo came by at 6 a.m. to check me, and unfortunately the second round of Cervidil didn't accomplish much. I was still 1 cm, +2 and not totally "pliable." She recommended that we do a more aggressive round of Pitocin, especially since the baby and my body tolerated the gentle round very well. Yesterday's plan was to go up by 2 every 20 minutes, and today we planned on going up by 6 each time...which, after four hours, still wasn't working. During that four hours, we tried to relax and take it easy, but mostly we just watched TV and I tried to let Ryan sleep.

A new doctor (not from my practice) came on-call once we started the Pitocin, and she was a no-nonsense kinda' lady. Thankfully Dr. Jo was at the Peachtree Women's Clinic offices at Northside Forsyth tall day, so they talked, along with the midwife on duty (the one I like came on--yay!), trying to help me reach my goal and avoid a c-section. When the midwife checked on me around 9 a.m., she offered me a Foley bulb,  but since my cervix still isn't soft, my intuition said it wouldn't be effective so I opted out. At 11 a.m., Dr. No-Nonsense broke my water (despite only still being 1 cm)--totally crazy sensation!--as a last resort to induce labor...and it did!

The short of it (to save the gory details) is that after four hours, I got an epidural. I had read and practiced for a non-medicated, non-epidural labor, and for those first four hours, I was in a ton of pain, but was able to find ways to relax relatively well--until the lovely hospital "necessities" drove me insane. You see, at this point, my blood pressure was extremely bad, so I had to be hooked up to a million machines, which made things complicated. (I had SIX "lines" attached to me--one blood pressure cuff, three IVs, and two monitors for the baby and for contractions--which is probably pretty normal, but made me feel like I was a fly trapped in a spider web.) I couldn't move much, which I really found to be helpful in pain management, but even more importantly, I wasn't allowed to sit up. My blood pressure was scary during the contractions (especially when the blood pressure cuff went off, my IV arm received a burning dose of penicillin, AND I had a contraction at the same time--I was one angry, frustrated lady, and seriously considered ripping those six lines off my body and letting them think I had flatlined), and since your blood pressure goes UP when you're vertical, they eventually made me lay down. Because I was so strapped in, I had found sitting on a ball to be the best option: I could bounce around for movement and when a contraction came, I could essentially breathe deeply an slump down, which made the pain really dissolute the best. Now I definitely understand why women who don't want an epidural stay at home for as long as possible, because once I was stuck in bed, I literally was unable to relax my torso--so when a contraction came and I used my breathing/slumping technique, instead of being pulled down toward my feet by gravity, my stomach was being pulled to the side by gravity. (It was about as effective as stubbing your big toe and then rubbing your ankle for relief.)

So I started to consider an epidural, and when the nurse checked on me at the four hour mark and told me that I was STILL 1 cm (despite my contractions' increasing intensity), I realized that something had to give. I've never been against epidurals, I just never thought I'd need one, so I felt a little like I was embracing failure on a personal goal, which was disheartening. The epidural hurt like hell--I felt every millimeter moving down the righthand side of my spine, and that's when I broke down. Once it had kicked in, a new nurse came in to check me, and within 20 minutes of being able to fully relax, I was at 5 cm--which totally confused me. I asked the nurse what the explanation was--and got back two potential scenarios: Either the other nurse who checked me totally misread my dilation (she did say that she was having difficulty, and the second nurse explained--in gory details that I'll leave for the imagination--how that could happen)  OR my inability to relax was making my body manually clench closed so that the relaxation of the epidural automatically allowed my body to catch up with my contractions. I have to say I have mixed feelings about these scenarios--I do wonder if I had been told I'd made it halfway if I would've opted to endure, but if the second explanation is the truth, then the epidural was necessary for my body to dilate. Who knows? The moral is that I got an epidural--sort of.

The reason the epidural hurt so much, it turns out, is that the guy didn't go directly down the center of my spine. It went down the righthand side, which I know because it never "took" on my left side. I had always imagined that having an epidural would make me feel paralyzed, but the dosage was so low and only on half my body that it really wasn't as bad of a feeling as I had imagined. It at least allowed me to manage my pain decently while laying down, so mission accomplished! The next few hours was a blur, mostly because in the moment everything was slow motion but overall time flew. I was concentrating on dealing with the contractions, and after a few hours I requested a check by the nurse. My intuition had been right: I was 10 cm! FINALLY. However, the baby was still sitting high, and since the nurse knew I was really, really trying to avoid a c-section, she advised me to sit up for a while before starting to push. So I sat up. I sat and sat and sat until I couldn't stand it anymore. It was time to push!


Wednesday, June 27th: Emma Vance's BIRTHDAY!
Technically this entry begins on June 26th. At about 11 p.m. I was ready to push. I just knew it in my soul. The nurse's shift had changed, but I didn't even want to get to know this new nurse. It was time, and I was ready!

Before starting to push, the new nurse (who clearly didn't know anything that had happened up until that point with me), grabbed the doctor and asked her to check on me. Dr. No-Nonsense, who definitely did NOT believe that I could deliver this baby the traditional way, took a quick look at me, then said, "The baby's head is too big. It will never fit. We should send you to surgery." Ugh. Really? Really?!? Here I was, so ready to push that I had to try to NOT push out the baby, and the doctor was STILL trying to convince me to opt for a c-section? I said no one last time and began to push.

It took two hours and fifteen minutes for E.V. to arrive. A lot happened during that time. The best way I can describe it was like running a marathon. Lots of energy expended. Lots of sweat. Lots of focus. I didn't open my eyes the whole time it seems. Ryan had the difficult job of keeping the fan directly on my face and holding my leg at the same time (not easy!)--and apparently even though the fan was inches from me, I was complaining that it wasn't cool enough. :) At one point I was so annoyed that the nurse holding my other leg had a vibrating phone in her pocket--and thus under my foot--that I cursed at her. At that point I told everyone to leave me alone, let go of my legs, and let me do my thing. It took a while to figure out which muscles and which motions made for the most effective pushing, and at the time I was actually happy my half-edural had worn off. I needed to be able to feel my lower half in order to push correctly. I ended up needing an episiotomy, which was fine. At that point I was running a temperature, and (once again, at the threat of a c-section) it was time to have the baby.

Emma Vance arrived at 1:06 a.m. She was perfect! The NICU team had already arrived because of my temperature, but she had also had some meconium in her fluid that concerned them. Because of the meconium, Ryan wasn't allowed to cut the cord, which saddened me. However, it allowed Ryan to take about a million pictures, a flipbook of her first moments of life. Once the NICU team was handling her, I immediately felt a surge of adrenaline! It was over! She was here! I had done it! There was a lot of blood--a LOT--to deal with, and as the doctor said, "You're bleeding more than the average person," I mentioned that my mother had complications of the same sort with her births. Yikes. But everything was fine. I was stitched up and ready to go when they let me hold E.V. for a few minutes. She was so tiny and warm in my arms! She looked up at me with these sweet, dark eyes, and I was enamored. She was completely alert but quiet, and I could just see her content, happy personality right away. Our encounter was brief but meaningful as they whisked her away to the NICU.

Ryan went with the baby at my request, and I had some crackers and water while I waited for him to return. I called my grandmother, E.V.'s namesake, Mrs. Emma Vance, to tell her the good news(es): She had a new great granddaughter, and that tiny baby was named after her! It was the middle of the night and my grandmother was flattered and (truthfully) a little confused, but now that she knew our big name secret, I felt like I could relax. When Ryan returned, he gathered up all of our things to take to recovery. E.V. was doing great and I was doing great and everything seemed great. For the moment.

When I stood up to get into the wheelchair, I told the nurse I felt a little lightheaded. We began to roll down the hallway, and about ten seconds into our trip, I blacked out. I blacked out. Stone-cold, hit my head on the wheelchair, lips turned blue, face drained and turned green, non-responsive blacked out. The nurse rushed me up to a room--leaving poor Ryan to fend for himself and worry about his comatose wife. The next thing I remember is having a dream-like, momentary vision of lots of women standing over me, talking. It took a few of those brief moments of wakefulness for me to realize what had happened and that they were trying to revive me with ammonia. But I couldn't stay awake for more than a second or two at a time. So I started to apologize that I couldn't stay up--one word at a time in between passing out. Sorry. I. Can't. Stay. Awake. I'm. Trying. Really. I. Am... :) Eventually they moved me to a bed, put me upside down and tried to give m more fluid. (Ugh, the amount of fluid that had been pumped into my body after four days in the hospital!) Unfortunately my IV had worn out (I think the term is "intibated?"), so they had to stick my other wrist, and even in my sleepy state I protested, trying to explain my Pain Arm to them. But they ignored me.

After the fact, I found out that apparently my high blood pressure from the pre-eclampsia had resolved itself in 30 seconds instead of the normal 30 days, which is why I blacked out. 

The next hour or so I was out of it, exhausted and still a little loopy from passing out. The nurses brought me food, and then it was finally time to rest. It had been such a long process, and I was ready for a few hours of monitor-free sleep! At about 4:30 a.m. Ryan and I turned off the lights and said goodnight to one another...and then at 5 a.m. on the dot, the door flew open, the lights flipped on and Emma Vance was wheeled into our room. From that moment on, we were on Mommy and Daddy Duty, and it hasn't stopped since...

1 comment:

  1. Being father is a awesome feeling. In our family we are 3 members, living the life we have always dreamed of living in suburbia, working for ourselves, very happily married, loving our family

    Regards,
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