Monday, March 7, 2011

She Who Was Finally Named in the Delivery Room (Birth Story)

As I'm sure many of you have heard, Derek and I welcomed our little girl on February 22 at 7:47 am.  She was 6 lbs 1 oz and 18 inches long and beautiful of course.  

Here's her birth story.  TMI warning, it includes information on the status of my cervix and the discussion of other nasty pregnancy related things down below.  

Background: At my 36 weeks appointment, my cervix was long and  closed.  At my 37 weeks one, I had progressed to 80% effaced but still no dilation.  At 38 weeks I was 1 cm dilated still 80% effaced.  On Sunday, February 20, at 38 weeks and 2 days, I woke up at around 3 am to a little gush of something.  I really had to go so figured it was just lovely pregnancy induced incontinence setting in or just an increase in discharge.  Pregnancy is gross.  It happened again once or twice that morning in bed.  I still didn't think much of it since the volume was so small and it was intermittent and since I wasn't dilated very much on Thursday.  Nothing else happened that day until late in the evening when again the same thing.  And then twice Monday morning.  At this point I became a little concerned.  However, because of my blood pressure and She Who Must Not Be Named being lazy, I was scheduled for an extra appointment at 1:50 on Monday afternoon.  

At Monday's appointment, I asked the doctor about the discharge/leakage and he decided to do two tests, pooling and ferning, to see if it was amniotic fluid I was leaking.  He didn't seem to think that it was.  We did the usual check.  I had progressed slightly to 1-2 cm.  Then, I went back for the fetal nonstress test.  She Who Must Not Be Named got the hiccups at some point and we got to hear it on the monitor.  This was neat since she got them all the time in there but we'd never heard them.  We discussed whether she would have them as often on the outside.  After a while, the doctor comes back, and said that the pooling test for amniotic fluid was negative but the ferning was positive so he wanted us to go to the hospital for a third test.  

We got to the hospital around 4 pm.  We checked in through the er and the labor and delivery unit sent a wheel chair down for me.  They forced me to ride up.  We skipped triage and got settled in labor and delivery room 3.  I was hooked up to the monitors and the tie breaker exam, amnisure, was performed.  It was positive as well.  As a side note, the test stick results looked exactly like a pregnancy test and the nurse was joking that I might be pregnant.  She also commented that usually my doctor relies on the ferning test and that he can do the amnisure in the office.  After the third test, the doctor still wasn't convinced that my membranes had indeed ruptured so he wanted to wait a while and redo the exam.  While waiting for the repeat test, we completed all the admissions paper work.  After probably 2ish hours, the next amnisure was performed and it also positive.  The labor and delivery unit was hopping during this time.  There was a bit of a nurses shortage and they were shifting people around trying to get everything covered.  I'm not sure how many nurses I had in a short period of time until everything got settled.

The doctor came in around 7 pm.  Because of the risk of infection with prolonged ruptured membranes, he felt it was better to induce immediately.  My nurse tried to get the iv started.  She tried both hands with no luck.  She then got another nurse who tried my arm and failed.  They finally decided, after discussing how horrible my veins are, to get the anesthesiologist to do the iv.  He also wasn't impressed with what he had to work with.  Fortunately though he succeeded on his second try with a smaller gage needle.  He told me not to move my wrist or I might occlude the line.  And usually they draw blood directly from the iv port but were unable to from mine.  I thus had the pleasure of a sixth stick.  (I have plenty of bruises from all of this.  And also from the blood pressure cuff.) Once the iv was in, I was hooked up to pitocin, fluids, and antibiotics.  The pitocin was started at a low dose just to see what would happen, as I had been having mild contractions for weeks.  After the iv was finally in, Derek ran home to get our bags and the car seat.  He got back to the hospital at about 9:30.  We made calls to our parents and close friends and then just hung out for a while.

She Who Must Not Be Named decided to be lazy during this time.  She wasn't having a satisfactory number of accelerations in her heart rate.  To try to wake her up they were pushing fluids into me like crazy.  (I was more swollen post delivery than before).  Because of her laziness and my high blood pressure, I was stuck in bed and preferred to be on my side.  However, if I was completely on my side, the contraction monitor wouldn't pick up my contractions.  Since they needed to know how I was responding to the pitocin, I had to stay propped up in a mostly on my side position.  At some point during this period, I felt a pop followed by a gush of fluid.  Interestingly, what I had been feeling on Sunday and Monday morning felt very similar to this, only less volume.  I feel bad for not going in to get checked out sooner.

The contractions were starting to be more painful.  And my hips were killing me from staying in bed in one position too long.  My doctor checked me and I had only progressed to 2 cm (or 2-3 cm, I can't remember exactly) from 1-2 cm in his office Monday afternoon and her head still had not descended.  There was discussion of her head being too large to fit into my pelvis requiring a c section.  At this point, I decided that this was going to be a long night and I should just go ahead with the epidural since I couldn't get out of bed anyway.  The anesthesiologist came in shortly after this and my nurse was giving him a hard time about using the smaller needle for my iv.  I told him I'd give him one try this time.  The epidural really wasn't that bad for me.  It made me supper itchy and added another tube from the iv pole and a blood oxygen meter, in addition to my two original iv lines, blood pressure cuff, and two monitoring leads.  (Getting up to pee pre epidural was a feat in and of itself.)  She Who Must Not Be Named was not impressed with the epidural though.  She started experiencing decelerations in her heart rate.  After the decels started, I was confined to my left side in the propped up angled position, the pitocin was turned down, and I added an oxygen mask to my accessories.  The epidural is at least partly dependent upon gravity so because of my position my left side was way numb but my right was just barely numb.  With the stress on the baby, there was again talk of a c section.  The nurse said that if I did not progress quickly, that would be the end result.  When the nurse was trying to monitor her heart rate and she get got the hiccups again.

Around 4 am Tuesday morning, my doctor checked me.  I was 4 cm and 100% effaced.  I then fell asleep until around 5:30 am.  I was really, really uncomfortable when I woke up and I couldn't stop shaking.  I called the nurse.  Conveniently, the doctor came in right around this time.  I was shocked to learn I was fully dilated and ready to push.

The pushing and delivery part was surprisingly painful even with the epidural.  Fortunately, it went pretty quick.  I started pushing a little after 6 and She Who Must Not Be Named was born at 7:47 am.  When she came out, the nurse remarked that she was a little peanut.  For a bit more excitement, she had an unusually long umbilical cord which was wrapped around her arm, chest, and neck.  This prevented her from being moved to my chest.  (and also likely contributed to her lack of movement in the womb)  There was a definite pause in the room as the doctor and nurses tried to decide what to do.  After some acrobatics on the nurses part, they quickly cut the cord and placed her on my chest.  She didn't pink up as fast as they liked to they soon took her over to the heat lamp.  At this point she started screaming.  Quite a loud cry for such a little peanut.  Sometime during this, some asked what it was.  I answered a girl I hope.  Someone also asked what her name was.  Derek and I looked at each other, and Derek asked how about Maya.  And I think I said sure.

Oh, and she does get the hiccups all the time now, just like in the womb.  It's the cutest thing.

Also, my doctor is the greatest.  He wasn't on call that day, but was still the one to check on me all night and deliver me in the morning before heading to the office.  We had a nursing students there for the pushing and birth.  She told Derek it was her first delivery experience.  Hopefully I didn't freak her out too much.



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