Thursday, July 17, 2014

The First Adventure of Vianca Violet (A Birth Story)

The weeks leading up to June 23 were a blur of horrible contractions coupled with no change and MUCH frustration.

I left my 37 week appointment with my doctor almost certain I would be in labor before the end of the week. I was only 1 cm dilated, but I was 70% effaced. The doctor believed that surely I would HAVE to be in labor with the cervix being as soft as it was...

I showed up at my 38 week appointment exhausted and in pain. My weekly ultrasound revealed that the baby had their heart set on being posterior (sunny side up, facing up, however you want to say it.) By the ultrasound tech's measurements she was long and already nearing 8 lbs... I was still only 1 cm dilated, but 85% effaced...this is when the doctor became concerned. Sometimes, a posterior baby has a head that is too big to descend and cause dilation. He was also concerned if we waited much longer, she would be too big to deliver because, by the measurements we had, she had grown 3 1/2 pounds in the last 2 weeks.  (and I was taking stock in the measurements because 2 friends that had the same techs measure them in the last few months before delivering their babies had their measurements be almost spot on at over 10 lbs for one and almost 10 lbs for I too was concerned about the size of the baby considering my biggest at this point had been 6 lbs 9 oz.)  

My doc opted to go ahead and schedule the induction for medical reasons. He was concerned about growth being too fast because of the gestational diabetes, and he was concerned that I wasn't going to go into labor on my own because of baby's position and head size...He put us on the schedule for the following Monday (the soonest he could do it since the hospital was booked for the rest of the week and they don't do inductions over weekends unless there is an emergency situation).

The weekend was painfully slow (literally, painful...contractions came steadily but never got hard enough to warrant going into L&D.)

Monday morning, I set my alarm for 4:55 AM. I woke up, tried to get myself alert and called in at 5 AM on the dot to see what time I needed to come in for my induction. I was expecting to be told they would call back in a few hours, but the nurse looked up my file, saw the reasons for induction and told me to come in at 7 AM. I was shocked it would be so soon, but eagerly accepted the time.

Jeff and I went and got donuts and orange juice for breakfast for everyone, gave my parents some last minute instructions about watching the girls and we made our way to the hospital.

We were a few minutes early, but the nurses were excited to see that we were and took us right back. They put us in a room right across from the nurses' station so that they could monitor us more closely given the doctor's concerns. The nurses were AWESOME! They were all chipper, kind, and eager to make my birth experience as easy going as possible.

I let the nurse taking care of me know that I was more nervous for the IV placement than the actual labor. Considering it had taken 5 pokes for them to get an IV with Phillie (my veins are juicy and great for blood draws, but they rupture and roll easily when it comes to IVs). She made my day when she told me that she was going to numb the IV site before sticking in the catheter needle.

It still took 2 pokes...which made me all the more grateful for the numbing power of the anesthetic she used. The first site she picked had a branch in the vein and she accidentally ruptured the site (she apologized and felt so guilty. I smiled and assured her that as long as she was going to numb me up first, she could poke me as many times as she would like...)  Attempt #2 was much faster. The needle went in like butter. She actually was concerned she had ruptured the vein because it went in so easy, but she clapped her hands together and proudly proclaimed "We're in business!" when the bolus of IV fluid showed that all was well.

She then checked me, watched the monitor for a few minutes to see what the contractions I was already having looked like, and explained exactly how she was going to proceed with the Pitocin. She was so sweet and reassuring.

Seriously- no matter how many times you give birth, you always need that...and you ALWAYS need someone to explain something to you again because you forget a lot. I think that is the one theme I saw this time in my labor and delivery- I was shocked at how much I'd forgotten in 22 months between babies. It was so nice to have nurses that explained it like it was my first time.

Things from that point were pretty straight forward. The contractions gradually got more and more uncomfortable as the nurse gradually turned up the Pitocin after checking me and finding that no progress, or very little, had been made. The doctor came in to see how I was doing and broke my water around 9 AM. It was nice to see him in person. My last doctor had the nurses break my water and I didn't see him until it was show time. Dr. Olsen was awesome and made sure to let me know that if I had any questions or concerns that he was willing to come back up at any time to talk with me.

The nurse had turned the Pitocin up 3 times by 11 AM... After the third time she turned it up,my body went into shock because of the contractions. I started shaking, my teeth were chattering, and I couldn't do anything to stop it. I was dealing with the pain, it was probably a 6 on a scale of 1 to 10, but as soon as the nurse saw that the shock had set in, she asked if I was ready for the epidural. My water had been broken, so there was no going back at that point and I could have it at any time. I had been trying to go as long as I could without it. My motto definitely is that you don't get a medal for the hardest or longest labor without an epidural,but I wanted to wait until I couldn't take it anymore and I felt I was okay pain wise,but I deferred to my nurse...I am so glad I did...About 10 minutes later, I got up to go to the bathroom and the shaking was so bad that I had to be held up to make it. I realized that, even though pain wise I was tolerating labor, my body needed a break and the shaking and shock were both signs that it was time to give in and have the epidural.

I walked out of the bathroom right as the Anesthesiologist showed up...he took one look at me and said, "It looks like I made it just in time, eh?" (He was super nice and super funny).

The last time I had an epidural, the nurses wouldn't let Jeff anywhere near the bed. This time, he was encouraged to come to my bedside and help hold me up. To be honest, it was so nice to have him there. I was so grateful to be able to lean on him as opposed to a stranger...don't get me wrong, nurses are great, but they aren't your husband at a time when you want to feel his strong arms around you.

I forgot about the loud snapping sound the needle makes as it goes into your spinal column to place the catheter...I jumped...and then I apologized and started crying. I just couldn't control my body or my emotions at that point. The Anesthesiologist was sweet and assured me that I hadn't messed anything up. He attempted to place the catheter, but kept tweaking a nerve, causing me to kick my right leg...He finally had to give up and try to place the epidural a 2nd time. (That's right, 2 times to place the IV and 2 times to place the epidural...I was an overachiever that day, I guess.)  The 2nd time was a charm, except for the fact that for some reason I wasn't as numb on my left side and my pelvis wasn't numbing at all. The nurse opted not to place a catheter and to drain my bladder manually instead...I felt the tube go in EVERY.SINGLE.TIME... spite of its flaws, I was SUPER grateful for the epidural. The nurse kept encouraging me to sleep...she could tell I was tired...and I kept trying to stay up because I felt guilty that Jeff was sitting there all alone with only his computer to keep him company. Once I finally gave in to sleep, the shaking started to subside and the shock went away for a while.

We also had some issues with my blood sugar throughout the labor. It went from too low to too high, and then to too low again. It was definitely a rollercoaster...first I could have popsicles and flavored ice chips, then I couldn't have anything, then they were scrambling to get my blood sugar up again...just UGH...I have to laugh because I felt so bad. I kept apologizing to the nurses for being a difficult patient. They all laughed and reminded me that I couldn't help it and that I was FAR from the most difficult patient they had been dealing with that day.

Finally, a 5 PM, during the shift change (because I'm cool like that), I started to feel pressure to push and the "ring of fire" (remember, the epidural hadn't numbed my pelvis for some reason).  I mentioned it to the nurses as they were doing the shift change. They checked me and I had gone from a 5 to an 8 in an hour. Of course, they reminded me not to push because it could cause deep cervical tears and they said they'd keep a close watch on me. My new nurse and old nurse discussed whether or not they would call the Anesthesiologist to give me a bolus of different epidural medicine in order to try to get my pelvis to numb up. The new nurse thought that maybe they wouldn't because, once I was fully dilated, I could have the baby out in a few pushes(especially because I'd gone from a 5 to an 8 in an hour), but the nurse that had been with me all day was sage and wise...she said to call him. They deferred to me and I said that it would probably be easier to deal with the pressure and NOT push if my pelvis was numb.

At 5:20, the Anesthesiologist came. He checked lines, asked some questions about how I was feeling in order to assess if he could give me anything else, and gave me the bolus. He honestly explained that at this point he didn't believe it would have enough time to help, but he wanted to try...I'm so glad he did.

By 6 PM, the bolus hadn't taken full effect, but the ring of fire was gone...however, I started feeling CONSTANT pressure. I knew her head was RIGHT THERE. I hit the call button.

My nurse walked in the room:

Nurse: Hey, what can I do for you? Do you want some more ice? Another pillow? Another popsicle?

Me: Ummmm I think you need to check me

Nurse: I just checked you after the Anesthesiologist was here 20 minutes ago. You were still an 8. Why? You feel different?

Me: Ummm...I need to push...LIKE NOW!

The nurse scrambled to get on some gloves and quickly checked.

Nurse: Wow! You are definitely a 10 and her head is DEFINITELY right there. I will call Dr. Olsen. PLEASE don't push until he gets here...No matter how much you feel like you need to. Just BREATHE through it...(I later found out that baby was actually crowning and my poor nurse DEFINITELY didn't want to have to catch a baby before Dr. Olsen got there.)

It felt like it took FOREVER for Dr. Olsen to get dressed and get was more like 10 minutes...but when you HAVE to push and you can't its a special kind of torture.

Dr. Olsen came in the room all chipper and announced that I had "won"...Apparently, me and another patient of his were being induced at the same time. We were neck and neck when it came to who would deliver first. Dr. Olsen came towards the table to start delivering when a nurse frantically ran into the room.

"You're other patient is fully dilated."

Dr. Olsen's eyes got wide as saucers.

"I am SO SORRY." He said "She is going natural. I can't make her wait."

My poor nurse looked like she was ready to throw up. I was shaking again, uncontrollably, as adrenaline surged through my system.

I smiled through my shakes and told him to go. I had an epidural and it was almost unbearable not to push. I couldn't imagine not having one and being told to wait.

Dr. Olsen ran out of the room like a bullet shot from a gun...

My poor nurse sat down at the end of the bed begging me to breathe through the contractions... She kept chanting "I don't want to, but I can catch this baby if I have to."  It must have been her mantra to keep her calm...

20 minutes went by incredibly slowly...but, as the grace of God would have it, the bolus of epidural meds kicked in, in full force at that time.  I felt pressure, but not the intense, uncomfortable pressure I'd been feeling before. I was able to breathe through the chattering teeth and contractions. My jaw felt like it was going to fall off because I was shaking and my teeth were chattering so much. The nurse did her best to remind me to breathe and relax so that the shaking would lessen.

Finally- When the nurse was starting to get REALLY concerned she was going to need to catch a baby, Dr. Olsen rushed back into the room and quickly washed up and dressed in a new gown.

True to my past labor experiences, I was a champion pusher. 4 contractions later, Vianca Violet made her appearance.

As suspected, her position and head size were preventing her from moving down the birth canal. Dr. Olsen did manage to turn her, but said she turned right back. She was bound and determined to enter the world face up...I guess she just wanted everyone to see how beautiful she was right away...

However, she was not the over 8 lbs bohemuth that the doctor had feared from the ultrasound measurements. One nurse estimated 7 lbs 5 oz...but was a "tad" off...Vianca weighed in at 6 lbs 13 oz.

I got to have another very different experience this time. With Faith, the nurses had attempted to put her on my chest after birth, but it was apparent she had respiratory issues. She was on my chest for 2.2 seconds before they whisked her to the warmer...I didn't even see her face until 8 hours later. With Phillie, the hospital didn't offer to or even try to put her on my chest and when I asked about skin to skin, I was told that they wouldn't do it... I was pleasantly surprised when the nurses asked about putting her on my chest to clean her off and skin to skin right when I checked in for the induction...and now I wish so badly that Faith hadn't had the issues she did and that I'd had the opportunity with Phillie... The nurses were able to put her right on my chest and clean her off after she was born. I got to look into her big, beautiful eyes and I probably held her for a full 10 minutes before they took her over to the warmer to finish cleaning her off, weigh her and measure her. Then, RIGHT after she was weighed and measured, the nurses helped me undo the top of my gown and she was placed against my chest. I won't lie...I cried as all of this was going on. It was definitely a bonding moment that I'd never been able to have before and it was almost physically relieving to experience it. I was shaking so badly I could barely hold her but the nurses were right there to facilitate it all and help me because I didn't have the strength.

When Vianca started to root around, they helped me get her into a hold to nurse and miraculously, unlike her sisters, she had a mouth that was big enough to get a good latch, and she did it instinctively with no assistance. While I have some more reflections on breastfeeding that I will share in another post (spoilers: it didn't work out again and we are using formula again, but, like I said, that is for another post), I will say that moment was different and so special. It was definitely a moment that created an instant bond that I was grateful to feel and was overwhelmed by.

After another hour in Labor and Delivery, we were moved up to Recovery. The nurse and I laughed that we kind of had to do a "Weekend at Bernie's" type maneuver to get me into the wheelchair because the epidural hadn't completely worn off, but I had enough movement that I could move to the side of the bed and scoot off myself (unlike with Phillie where they had to move me about 20 minutes after delivery and 2 nurses had to drag me into the wheelchair...) and finally, we got some rest.

The post partum period wasn't nearly as painful as it had been with Faith or with Phillie. The nurses did a great job staying on top of my pain meds and they did a good job massaging my stomach so that the post partum contractions didn't have to do all the work of shrinking my uterus back down. I was pleasantly surprised that I was actually able to sleep that night instead of being up dealing with contractions that were as painful as they were during delivery.

I tried my best to keep the baby in the room with me, but I desperately needed sleep after being in labor all day and every little sound she made was keeping me awake. I was so grateful that they had a well child nursery (the hospital I delivered in with Phillie didn't have one). The nurses happily took her and agreed to bring her back for feedings.

I had a really pleasant experience with the lactation consultant this time around. She was super positive and she was super supportive of whatever my decision would ultimately end up being. She was very aware of the struggles I would have given that I have problems producing enough milk and that I can't take the herbal supplements that increase your supply and gave me all the tips she could to try to make the process as easy as possible.

In the end, we were able to leave after 24 hours. I still wonder if I should have stayed one more night just so I could get a little more sleep, but Jeff felt like being back at home in our own bed would be the most therapeutic for both of us. The jury is still out as I didn't get much sleep. I will say that with the next baby, I may opt for one more night just so I can be sure to have one more night of sleep and I will tell Jeff to go home if he is so eager to be in our own bed...LOL. I wasn't horrible to be home, but I definitely feel like I didn't get any rest at all once I walked through the door.

Recovery has been tough since coming home, but that too is for another blog for another day.

In the end, ViancaViolet made it here safe and strong. My sweet husband was awesome and stayed by my side the entire time, even heeding my request that his computer didn't come out until the epidural was in place, and the nurses and my doctor made the experience all the better with a level of care and compassion that I found severely lacking during my last birth experience.

I could have a dozen more babies with care like that...and I'm not even joking. Logan Regional Medical Center was awesome and I am grateful that we were living here so I could experience it.

1 comment:

Lisa said...

Wow. What a LONG day!! You're a champ! And she is BEAUTIFUL! Congratulations!