Monday, July 21, 2008

Not What We Expected - Part II

(Warning: REALLY LONG birth story to follow.)

(And, hey, it only took me three and a half weeks!)

(And, oh yeah, about halfway through I stopped trying to write well at all.)

Cascading consequences indeed.

By Friday morning, it seemed the cervidil had worked wonders: I was 2 cm dilated and was having regular, strong contractions. Yay! PJ and I walked the halls of the hospital, stopping periodically to practice all the pain coping techniques for early labor that we had learned. Celeste, our doula, arrived, and all the grandparents came to sit in the waiting room. I had no doubt in my mind that the cervidil had helped jump-start the birth process, and I was almost joyful in labor. By late Friday afternoon, we had to admit that labor had pretty much come to a standstill. My doctor agreed to another night of cervidil before resorting to pitocin. We sent Celeste home for the night and settled in with hope.

Saturday morning it was clear that the second dose of cervidil had done nothing. I was having contractions, but they were irregular and unproductive - I was still only 2 cm. My doctor laid out the options: pitocin or c-section. He wasn't seriously suggesting c-section at that point; he was just trying to be clear about what was possible, and he definitely was not willing to let me go home. I don't think I'd have been willing to go back home without a baby at that point anyway, even barring the low amniotic volume!

The next doctor on call ordered the pitocin drip and we got ready to labor. Once the pitocin started, my contractions began quickly. We turned on 80s music via Sirius web and asked each other Trivial Pursuit questions between contractions. Okay, so Celeste did the asking while PJ and I tried to come up with answers. However, it didn't take long for the contractions to come so hard upon one another that we had to do away with the Trivial Pursuit; I couldn't come up with an answer before another contraction started and then couldn't remember what the question had been once the contraction was over!

Coping with contractions? I hung onto PJ and swayed and moaned and relaxed everything while Celeste talked me through them and then later applied counter-pressure as they got stronger and closer together. Trips to the bathroom were a challenge; I had to unplug two different connections to the machine monitoring fetal heart rate and contractions, unplug the IV, and then wheel the IV with me over to the bathroom - all while having contractions. But we were doing great. I felt like all of our reading and meetings and practice with our doula (as well as having her there, of course) were really paying off. We were doing this! We were going to have a baby!

Then the nurse was in the room to readjust the monitors, saying the doctor was concerned about the baby's heart rate. Then the doctor was in the room, saying she wanted an internal monitor on the baby's head. Things got pretty crazy pretty quickly from that point. I asked her to please wait to see what the readjustment of the external monitors showed, and the nurse's comments regarding how well she'd been able to monitor the baby before the belts slipped backed me up. I didn't want to be confined to bed - contractions are A LOT harder to manage when you're stuck in a bed. The doctor argued something about not wanting anything bad to happen and be liable in the whole scenario, and I - less worried about her freaking liability and more worried about my baby - shot back something about how it was MY baby and I wanted something bad to happen even less than she. It absolutely infuriates me how obstetricians seem to have a knack for implying that they have a baby's best interests at heart while the parents are somehow being reckless and selfish for not blindly accepting what they often admit are liability-reducing actions. Anyway, the doctor assured me that I would be able to labor standing up again after the internal monitor was attached to the baby's head. She did not tell me how much the procedure was going to hurt. I think I might have actually screamed. She noted that I was about 4 - 4.5 centimeters dilated and still not totally effaced (part of the reason it hurt so much). Oddly, even through the pain and confusion, I registered the student nurse's face - she was totally freaked out - and felt amused. I was still having contractions; the doctor still had her hand up in me, wanting to know if I want her to break my water. I didn't know what the right answer was at that point. I couldn't get a read from either PJ or Celeste in the midst of the chaos, so I said yes, thinking of the stories I'd heard of pitocin labors being sped along by breaking the water. In retrospect, I think it was probably a bad idea to break my water - why did the doctor even seem to want to do so? Having no water to ease the pitocin contractions was going to stress the baby; maybe waiting until I was much closer to 10 centimeters would have kept the baby from being so stressed. The baby certainly got stressed. As soon as my water was broken, the baby's heart rate was all over the map, dipping frighteningly low. No position change was helping. The number of people in the room kept increasing seemingly exponentially. Celeste mentioned an amniotomy, a procedure that involves maneuvering a catheter around the baby's head to infuse fluid. The doctor tried it three or four times, but couldn't get around the baby's head. This was the most excruciating pain I have ever felt in my entire life. I'd have to be a much better writer to find words to describe it. I know that I screamed through each attempt. I remember hearing the doctor ask for a third (or fourth?) catheter and having the panicky thought, "I just want a c-section." I feel the need to point out that this was a pretty radical thought for me, considering that's the last thing in the world I had wanted. I remember telling PJ and Celeste that I couldn't do it. They kept me focused. After the third or fourth attempt at the amniotomy it was clear this all wasn't going to work. The baby's heart rate was still erratic and dipping, so the doctor told me I had to have a c-section and that it might have to be under general anesthesia if they couldn't get the spinal block done. I was very scared. My limbs were trembling uncontrollably, and the herd of nurses in the room was prepping me for the c-section already. As contractions ripped through me, the doctor was yelling (most of all of this was done in yelling because of my own vocalizations and the large number of people in the room) all of the possible horrible outcomes and shoving paperwork on a clipboard at me to sign. I remember saying, at some point, "If they're not doing any good anyway, why won't these fucking contractions stop?!" Nurses were hustling PJ into a surgical suit; he made a quick call to our parents to let them know what was going down. Then the anesthesiologist was there talking about the spinal block. Before I knew it, I was being wheeled to the OR, with PJ left behind in a bright, sterile hallway. I don't know why they wouldn't let him be there with me while I got the spinal block; I was terrified of the spinal block. Instead, they put the student nurse (who was too new to be supportive) in the support position while the anesthesiologist did his thing and I tried to stay still. It wasn't all that bad, actually. Compared to what I had just gone through, it was a mosquito bite. Finally, PJ was there with me, and they seemed to have started the surgery. I remember asking PJ to distract me from the tugging I could feel happening below the blue drape; I didn't want to think about exactly what they were doing to me down there. It seemed to take a long time, but then the anesthesiologist, who was behind my head the whole time supplying cool washcloths in addition to the drugs, was tapping PJ on the shoulder and telling him to stand up and look. PJ got to see the doctor pull the baby from my abdomen, and he knew right away that we had a son. I got to watch PJ's face as he saw the baby for the first time, and it was a beautiful, beautiful moment. They whisked the baby across the room to do all the newborn procedures and also to make sure he was okay since he had been in distress. PJ got to watch and be with our son while that was happening. Unfortunately, I hadn't seen him yet and couldn't see anything that was going on. Finally, PJ got to bring him over for me to see. What an amazing moment. I had a little, beautiful, baby boy. I couldn't believe I was finally looking at this little person who had grown inside me. The student nurse and even the anesthesiologist videotaped these first moments for us. What great people. All too soon, PJ went off with the baby to the nursery and it seemed like it took forever for them to stitch me up and get me to recovery. The trembling finally stopped because they injected medication for that, too. I was in recovery for about an hour, but it didn't seem even that long. I was groggy and sleepy for a little while. They cleaned me up, Celeste got to come in with me, my nurse showed us the placenta and the umbilical cord (very cool). Finally, they wheeled me to my room, stopping at the nursery on the way to "pick up" the baby. The afternoon is a little hazy to me due to the spinal block and other medications they injected during the c-section. I got skin-to-skin with the baby and fed him a little right away, and PJ spent some skin-to-skin time with him to warm him up. Our parents got to spend some time with us and the baby. I was nauseated and threw up several times and then pretty much passed out for several hours with the second anti-nausea medication they pumped into me. Probably a good thing because our son also didn't get the memo about newborns sleeping through the first night. But that's a different story. We finally got to welcome Kieran Patrick O'Hanlon Laughner into the world.

Thursday, July 10, 2008

Not What We Expected

This hasn't really gone down at all the way we expected. We had drama on Monday with low amniotic fluid and the threat of induction, but I was able bring up the amnio level by hydrating the hell out of myself for six hours before a retest. Whew.
This morning, we had another non-stress test and check of fluid. Non-stress test was great; fluid was low again - particularly bad news since I got up at 4:30 this morning and immediately started drinking water. The doctor was concerned and recommended inducing today. So not what we had wanted or envisioned. We took a while to decide - talking to the doctor and our doula. We had to really think about it.

It's not just that induction wasn't what we had planned; it's that all indications otherwise were that the baby was healthy and vigorous and concern about what inductions can involve and lead to. The cervidil used to ripen the cervix can cause contractions that are stronger than natural. The pitocin that might be used to start contractions if the cervidil doesn't do it definitely cause contractions that are nastier than natural ones and harder on the baby - with the added bonus of denying you the natural rush of the pain killer oxytocin that the body produces with "real" contractions. This often leads to an epidural, which can, in turn, lead to a cesarean section. An upsetting cascade of consequences to consider.

Ultimately, we decided to stay and let them induce today, knowing that if we didn't, we would have to return tomorrow and they would, in all liklihood, not let us get out of an induction tomorrow. I figured if I was going to go into labor before tomorrow, then the cervidil would work to send me into labor today. Overlying all of that was the concern that the low fluid really could be a bad indicator.

So now we are in a hospital room, waiting for the cervidil to do its thing and hoping that it sends me into labor so we don't have to resort to pitocin. The baby is as active as ever, and it's even kind of fun to listen to his/her heartbeat and hear his/her movements on the monitor. I admit I'm nervous about the coming pain, but I'm also looking forward to finally holding this baby in my arms.

Sunday, July 6, 2008

Still Awaiting the Next Stage of This Adventure

So, I decided to take a cue from Melissa and distract myself from being 41 weeks pregnant (apparently no one told the baby he/she had a 40 week deadline) by creating this blog. The picture is of me before I sailed right on past the due date. I think I probably don't look as happy now.

I figure this blog will also help us keep grandparents up to date after the baby has decided to show him/herself. We'll be able to post a report of the baby's first camping trip at two weeks old... just kidding... we'll wait until he/she is three weeks old at least!

I guess for now we'll just wait and occasionally wander into the nursery and look around, wondering when this room will be occupied, and try, try, try to enjoy these last hours of quietude - that's what all the been-there-done-thats advise, anyway.

So today we perused the Berkeley Springs Farmers' Market, buying up eggs, peaches, blueberries, cherries, and zucchini (PJ insisted we add at least one vegetable). I love our farmers' market. Then we took Seamus to the C&O Canal for a walk and some stick chasing into the Potomac River. The water felt great on my swollen feet, and Seamus got a great workout swimming against the strong current.