Wednesday, May 24, 2017

Sloane Marie's Birth Story

As I mentioned in my 38 Week Bumpdate, the week leading up to Sloane's birth we had been battling high blood pressure and my doctor was worried about me getting preeclampsia. We had a check up on Thursday March 23rd where I had to turn in my 24 hour urine collection and get checked out. We left that appointment feeling like we were looking good to continue to stay pregnant and not need to be induced. My blood pressure was still a little high, but nothing like it was earlier in the week. So we really thought that we would possibly be able to wait until I went into labor on my own. Richard was more convinced of this fact than I was. We checked my blood pressure a few times over the weekend at home and it was not great, but not terrible.
We went into our Tuesday (March 28th) appointment hopeful and did not really think too much about it. The doctor came into our room and told me my blood pressure was high still and then he decided to check the result of my 24 hour collection. He then informed us that I had protein in my urine which is the biggest indicator for preeclampsia. They look for there to be less than 300 units (whatever they measure in I don't remember) and mine was at 460. He also told us that for the first time I had protein in my urine from the sample I left with them that day. After telling us that he then goes, "Well, it's time for you to go have a baby." He just said it so casually. We were told to go home, gather our things and head to the hospital in the next few hours to go get induced. It is really a weird feeling when your doctor tells you to get induced knowing that you will get to meet your baby in such a short amount of time. I was fully ready to hold on and be pregnant until my due date or later so it was really shocking to me.
By this time it was about 5pm on the 28th, Richard and I had drove separately to the doctor's office so we both drove our cars back towards home stopping at Chickfila for dinner. I knew I was not going to be able to eat once I got to the hospital so we made sure to stop and fuel up. Eating was really the last thing I wanted to do, but I knew I had to. Then we headed home, informed our family what was happening, finished packing our hospital bag, dropped Paisley off at doggy day care, and headed to the hospital. By the time we got to the hospital it was about 7 pm. We walked up to the nurses station to get checked in and it was right after shift change so the nurses were all gathered having a meeting. We told them who we were and who our doctor was (I'll call him Dr W from now on since that is easier). We had heard rumors about the battle between the nurses at this hospital and Dr W and they were very evident the moment we walked in. Basically, the nurses don't always agree with Dr W's practice and he has had words with them in the past. But, we love Dr W and we picked him because of his reputation so it did not bother us, it was just funny to see.
We were brought to our room and the nurse asked me to change into a gown. I asked her if I had to and she grudgingly said no, but that they needed access to my belly for the fetal monitors. So I wore my sports bra, a cardigan and maternity leggings instead. I really did not want to be in a hospital gown for my entire labor. My nurse came in and started the intake form and gathered all sorts of information from us. Then finally by 8pm they gave me my first dose of a drug thats purpose was to ripen my cervix and get the dilation started. Once I got to 2 or 3 centimeters then they could administer Pitocin which induces labor. Dr W told us that after a few doses of that drug it was likely that my body may take over on its own and start having contractions close enough together that Pitocin may not be needed at all. That was our hope. The cervical ripening drug was given both orally and vaginally every four hours. After the first dose, we got settled a little more, met with our doula for a bit, and then tried to get some sleep.
At midnight, the nurse came in again to check me and give me my second dose of medicine. So far there had been no progress and I was still 0% effaced and not dilated at all. I was hooked up to a blood pressure cuff on my left arm that would take my blood pressure every 30 minutes and I had an IV on my right wrist. I also had two monitors on my belly, one that monitored the baby's heart rate and one that monitored my contractions. The one that monitored the baby's heart rate kept moving around and losing baby's heart rate so the nurse came in often to find the heart rate again. So between all this constant monitoring, I had a really hard time getting any sleep.
Around 2:40 in the morning, there was a code gray called which meant there were thunderstorms in the area and they made Richard move his chair away from the window. If the weather got more severe we were going to get moved into an interior room that had no windows. Shortly after this, I felt really sick and ended up vomiting. Since I wasn't feeling good it made the baby's heart rate drop so the nurse came in and gave me a bag of fluids, some ice chips, and a finger monitor to make sure everything was ok. All this took about an hour and then it was time for another dose of my medicine. However, the nurse monitored my contractions for a bit and knew that they were too close together to administer another dose. She decided to wait and see what happened.
Around 5 in the morning, the nurse came in again and checked me and I had still had made no progress. She brought in her charge nurse and they debated what to do next. They knew I needed another dose and my contractions had slowed down a bit so I got my third and final dose. Things really started to pick up after this last dose. By 7 am my contractions were really starting to get painful and by 8 am I woke up Richard because they were pretty intense and I needed his help. We then called our doula to come because I was already in a lot of pain.
Most of my pain was in my low back so we asked if we could go get in the shower to get some relief. The nurse said we could have 20 minutes without being monitored. By this time we had a new nurse who told us she was only temporary until they could get another one. The ratio was supposed to be one to one, but they were understaffed so my nurse was bouncing between at least two rooms. I ended up being in the shower for close to an hour because our nurse never came back to check on us and tell us to get out. While I was in the shower, I sat on my exercise ball with the warm water running. The water felt good and relieved some pain but the water pressure and temperature was not great so I was cold. I ended up getting sick again and I noticed that both times I got sick it was three hours after taking the medication so I think it was a result of that.
Shortly after getting out of the shower my doula arrived and was able to help us with pain management a little better. Around 10 am I was checked again by two different nurses and was informed that I was at 2 or 3 cm dilated and 80% effaced. So we had definitely made progress. My nurse then started talking about Pitocin being administered and we basically told her no thanks. Dr W had already said that if my contractions started up when I got to a 2 or 3 that I would not need Pitocin. The nurse did not really like that we said no, but she had to follow the doctor's instructions. My doula then had me do some different positions to try to get baby in a more optimal position.
Around 11 am the nurse came back telling us that she was concerned about baby's heart rate because the monitor was not doing a great job of picking it up and she thought there may have been some dips in the heart rate. She told us that she had sent the record of baby's heart rate to Dr W and that he was on his way to the hospital. She told us that when he got to the hospital he was going to break my water so that they could insert internal monitors for both the baby's heart rate and my contractions. I was really upset hearing this because I knew contractions would get more painful once my water broke and that I would be tied to the bed with those internal monitors. I was already dealing with a lot of pain and I wanted to give up at that point because I did not think I could handle anymore pain. The nurse described the situation in a way that made it seem like this was a guarantee and Dr W had already decided this was the case. I should have known better because it did not sound like something my doctor would do since he is extremely hands off.
It took Dr W over an hour to actually show up after we were told he was coming. As soon as he got there you could tell he was upset. The nurse immediately said that baby's heart rate had dipped a few times, but that it had not happened in a while. Dr W questioned why she had not called him and told him not to come at that point because he was clearly not needed and he had other patients to see. Dr W then decided that baby had recovered and nothing needed to be done at that point so I could carry on without my water being broke. Thank goodness. After Dr W left, my doula went to lunch so it was just Richard and I for a little while. I went to the bathroom and I am pretty sure that my water broke, but we were not sure. We decided not to tell our nurse because we knew that she would try to put internal monitors in if my water had broken and since we weren't sure we just did not say anything.
Around 2pm, we finally got a new nurse and we were her only patient so she was actually able to hang out in the room with us and monitor baby's heart beat. We really liked this nurse. She was much more attentive and patient with us. She would move the heart rate monitor around to find baby's heart rate and then hold it in place to listen to it since the monitor did not want to stay in place on its own. She then checked me and I was 100% effaced and 5 cm dilated.
The rest of the day was kind of a blur for me. I was most comfortable laying on my side in the bed. I remember wanting to go to the bathroom a lot and at one point trying to eat a popsicle that was not doing it for me. I also tried to eat ice chips and take sips of water because I was really thirsty. When I was in bed on my side I would fall asleep in between contractions because I was so exhausted by this point. I vaguely remember listening to my doula, my nurse, and Richard have conversations mostly centered on me, but I did not engage with them much at all. I was still having mostly back labor and I needed someone to push and rub my back the entire time. They kept using coconut oil and other massaging products to help with the pain. My back was pretty sore the next day, but it was what I needed in the moment. I basically did this for the next 4 hours and kept flipping from one side to the other and getting up and going to the bathroom. I remember this being my least favorite part of the whole day and watching the clock tick by and asking if I was done yet. At one point I told them I could not do it anymore and I wanted to get an epidural and be done with the pain. My doula convinced me to wait a few more contractions to see how I felt. She also told me that an epidural does not always help with back labor and that is what convinced me to continue with what I had been doing. Richard told me that every time I had a contraction I had to be able to look at him and grab his hand. Even when I was facing the other direction I would turn to find him. He was a great helper and I loved having him by my side.
Some time around 6 pm I told the nurse that I felt like I needed to push. My nurse checked me and I was at 10 cm! Finally! My nurse called Dr W to come deliver the baby and told me that I could start pushing if I felt like I needed to. I had a squat bar on the bed and I would stand on the bed to push when a contraction came and then lay on my side in between contractions. The nurse said she would be ready to catch if baby came before Dr W did. Finally Dr W got there and he had the nurses set up the bed for delivery and then had me lay down to get ready. I pushed for about 5 or 10 minutes before Sloane finally arrived! Once she got here it was all a crazy blur of activity. One of the nurses was wiping Sloane off and while doing that she pulled my IV out of my wrist. Since I no longer had an IV they had to give me a shot of Pitocin in the thigh to help with the bleeding.
Once she was born we tried breast feeding which she did ok with but was not super interested in eating right away. We hung out for a bit while everyone gave us a whole lot of information. We had to wait a while before I would get moved to a postpartum room. Eventually, Richard got to hold Sloane for the first time to do some skin to skin while the nurse made me get up and go to the bathroom. The pediatric nurse checked Sloane's temperature a few times and it had dropped enough that she was concerned and wanted to get her under the warmer. So they checked her weight, 5 pounds, 6 ounces, and then put her under the warmer to check her height. They also had some footprints taken and Richard got a shirt with her footprints on it. Since Sloane was so tiny she technically was considered small for gestational age, meaning that even though she was early she was still considered small for how far along I was. Because of that they had to check her blood sugar 5 times in the first 24 hours of life. So every few hours they would come in for that to make sure she did not need to go to the NICU. She passed that with flying colors so that basically means that she is just a tiny peanut, but there was nothing else to be concerned about.
Overall, I am really grateful for the way things turned out. When I was told that we were going to get induced I was really nervous and scared about how labor was going to go. I was afraid that not only would my natural labor plan disappear, but labor might end in a cesarean that I was really hoping to avoid. The natural child birth class that we took (it was called Birth Boot Camp) was so worth it and I am so glad that we did it. I felt extremely prepared and ready to attempt a natural birth. Richard and I attended those classes together and they also helped him learn more about birth so that he could support me. He really and truly was the best partner and I could not have done it without him. I was able to go through my entire labor without any pain meds or additional intervention other than the induction. I know that is not the choice everyone makes and I don't judge anyone for the way they choose to give birth. I just am extremely happy with the way things turned out for me and I am so glad that I was able to go through labor and birth in the way that I wanted to.


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