Sunday, September 23, 2012

You Can't Always Get What You Want- But You Get What You Need

Or, the tale of Katie Sue's dramatic entry into the world.

I had planned, all along, on trying for a (unmedicated, Hypnobabies) VBAC this birth. My doctor is very supportive of this. He's pretty anti-intervention in general, happy to let things go. So when I went in on Wed., Sept. 19, and he began to tell me that he felt I needed an induction, I was surprised- but because this was not at all like him, I listened.

I'd been having fairly strong contractions, getting more frequent, since the previous Friday. However, things were only progressing very, very slowly. When I went in that Wed. to be monitored (because I felt her slow down- uh, turns out she just really likes long naps in the afternoon!) Katie Sue was doing fine, but my uterus was not. My contractions were frequent and strong enough, and had been going on long enough this way without doing anything, that my doctor told me he was worried about the risk of rupture. Basically, my uterus was hypertonic and if this continued for another week, I was at fairly high (relatively speaking) risk of rupture. He asked me to agree that if she was not born by Friday, we would start a gentle-as-possible induction. After his explaination, based on his experience (and knowing that he really doesn't suggest stuff like this unless he really, really thinks it's warranted) I agreed.

On Friday, we headed in (a bit late, but it turned out we had to wait anyway!) I was a little more progressed, but she was still very, very high. My doctor checked my cervix and found that I had a very tight band of scar tissue, so I asked him to stretch it out, which he did. She was so high, and her hand was above her head, that he asked me, instead of immediately rupturing the membranes to start, to consent to a very, very low dose of Pitocin to try to bring her down and get her hand back with her body. I agreed. I also agreed to an enema because I had some stool impeding the cervix a bit. I had the enema right away (and actually felt a lot better.) I was contracting some, so I spent quite a bit of time with my "light switch in the middle" enjoying the squeezing sensation without discomfort.

We waited quite a while in Triage, because all the rooms were full! Finally enough were cleared out that I was settled in a room (I got the isolation room, lol, because of my life-threatening allergy to rubbing alcohol.) Shortly after this, my (internet, but we've met before) friend Qarin arrived. I'd asked her to be labor support for me, because I had a feeling that this birth would bring up strong emotions for Jeff, and there might come a time when he needed to focus on himself and take care of himself but I would still need someone to be able to be there for me. Qarin was there for me.

At first I just laid mostly flat (a little on the side) because my back ached. Once the contractions began to get a little more frequent and intense, I got my body pillow and laid full over on my side and listened to a couple Hypnobabies tracks to get me really focused. After that, I felt so good that I got myself sitting up at the end of the bed, leaning forward, trying to get Katie to move down and turn anterior (she was posterior much of this time, but was still spinning around.) I felt great, light switch in the middle, and decided to watch a little tv. We saw a few shots of the Endeavor flying over San Fransisco, and I flipped through until I found The Price is Right (with Snoop... Lion is it now? as a celebrity guest.) I amused Jeff and Qarin with my bloodthirsty jeers hoping the lady would fail at Plinko. (She didn't, won quite a lot actually!) Shortly after it ended, my doctor came in to check and see if she was down and I was a bit more progressed. So we turned off the tv.

I was and she was! I'd gone from 3 cm and -3 station to 4 cm and -2 station- where he wanted me to be to rupture the membranes. So he had me go to the bathroom, so I'd be comfortable. I did, and while there, lost my mucous plug and had bloody show! The exclaimation point is because it was fascinating to me- I've lost small chunks of mucous before but never the whole thing at once or had bloody show. So we were all ready to go. The doctor came in with my nurse, an extra nurse, and a resident, and we prepared to get things going (as we thought.)

They put plenty of towels down, Qarin stood back, and Jeff went to watch. The doctor ruptured the membrane- and I heard him explain that there seemed to be two layers, a little pocket that had formed of water. Aha! this would explain why my nice strong contractions had been doing so little and she'd been unable to get her head down to progress me. Then he went to do it to the actual sac membrane- and that's where things got tricky. He said it was very thick. He asked Jeff to push down at the top of my fundus, to assist with some pressure- it was about four times as thick as a normal membrane would be, he said. Jeff did, he got it punctured, and all of a sudden the gushing was uncontrollable.

I'd been measured the previous day as the water being at 15.3. (10-20 is what they would consider normal range.) My doctor later told me I had far, far more, that measurement must have been inaccurate- I had what is known as polyhydramnios. It was so much and so forceful that it rushed out all over the floor, flooding the bed. And that's when things got scary.

All of a sudden, everything was happening at once. The doctor asked Jeff to stop pushing and stand back. The nurses rushed around and the resident began handing the doctor things I wasn't fully aware of what they were as he urgently requested them. The baby's heartrate dropped to 60. And I began to panic a bit. No. A lot. I'd heard that drop in heart rate before, and it was not a sound I wanted to be hearing. (In fact, it's one I'd like to never hear again!) The nurses first told me, "It's ok, this happens sometimes, it will usually come right back up." And then they stopped saying that.

About four more nurses rushed in. The doctor began to intervene to try to resucitate the baby somewhat. He had the nurses trying to manually push her up from the outside (like an external version, but lifting, not turning.) One gave me pure oxygen to make sure the baby got as much oxygen as possible. He called for saline bolus to do an amnioinfusion. I was scared and called for Qarin, because Jeff was obviously going into shock. She came and held my hand and looked me in the eye. She kept my focus on her, and we talked about inanities (like, what kind of tree would you be if you were a tree?) while the doctor forcefully stretched my cervix from 4 to about 6 (remember, I had no pain medication, only my hypnosis); I began to lose my hypnotic focus and it HURT. Qarin reminded me to center, breathe, go deeper into hypnosis. I had a hard time but tried and it didn't hurt quite so much as he shoved his entire hand up trying to push the cord back. He explained that the cord was basically prolapsing- it was trapped between the baby's body and the opening. He manipulated as he could, and then they pushed bolus after bolus of saline, trying to float the baby off the cord.

While he did this, Jeff stood stricken. I tried to talk to him but he was out of it. Qarin kept reassuring me, or trying to. She didn't say much but I could see in her eyes that she was willing it to be ok, that she was believing with all her heart that it WOULD be ok, and was willing me to believe the same thing. I asked Jeff for a blessing. He anointed me with oil but stopped, stumbling over words, not remembering the correct form of address. I said, "It's ok, just bless me. God will understand." He placed hands on my head and said from the bottom of his heart, "Dear Heavenly Father, by the power of the Melchizidek Priesthood, please, let Anne and the baby be ok. Let the baby get the air she needs. In Jesus' name amen." All the time the doctor watched the clock. When we hit the two minute mark without the heartrate going up at all, we began to move toward the door. I practically threw my glasses at Qarin. (I found out later that she had the presence of mind to make sure they made it into Jeff's pocket before he ran out the door after me. Thank you Qarin- you made sure I could see my baby when I woke!) As they ran, pushing my bed toward the operating room, they continued to push the saline to give as much room as possible between baby and cord, to let it function, let it give the baby air. I kept recieving oxygen. The anesthesiologist was annoying me with questions about my reactions to narcotics, suggesting I would need them because "You're going to be in a lot of pain!" Thanks a lot, lady. I informed her that I've done this before and would do FINE on toradol or ibuprofen, acetaminophen and Tramadol.

We entered the operating room and new people rushed in. I couldn't really see them but one of them came to stand by my head and told me her name (I, uh, don't remember, it was a blur) and that she was from the NICU. As nurses shaved me, swabbed me with betadine, put in a catheter, and the doctor scrubbed in, she talked to me. She held the oxygen for the anesthesiologist as the meds were prepped and she talked to me and looked me in the eye and held my hand. She told me that they were going to take care of my baby. About two minutes in, just before I recieved the anesthesia, she stopped talking to me, listened for a second and said, "Stop and listen. Hear that? The baby's heartate has gone up. She's going to be fine!" I listened and it was true. It still wasn't as fast as it should be but people began shouting to the doctor that it was up to 120. I felt peace come over me. We were going to make it in time.

The nurse from the NICU told me that they were going to give me the medicine to make me sleepy now. I asked her to count backward from 100 for me so I could focus on the numbers. She looked confused, I said, "Like, 100, 99..." She said, "Oh! Ok! 100, 99, 98..." She calmly counted down. At about 92, I stopped noticing the numbers. All of a sudden the paralytic agent took hold. I've had general anesthesia several times before and never had this happen- the paralytic hit before I was fully out. All of a sudden I couldn't breathe, couldn't move, couldn't TALK to tell them I couldn't breathe. All I could think of was "IF I CAN'T BREATHE THE BABY WON'T GET AIR!" But then I heard them moving to intubate me. I fell asleep with the knowledge that they wouldn't let the baby not get air, she would have the oxygen she needed.

(This next part is a report from Jeff, as I was unconscious.) Jeff had, meanwhile, been told by the NICU staff to get in sterile suit and cap. They didn't realize I'd be under general, so they came back out and told him he had to wait in the hall (but he kept the suit on because they would also need it if he had to run with the baby to the NICU.) So he waited. A minute later someone popped out to let him know her heart rate was coming up (so, right before I went under.) He stood and waited there because they told him they needed to know where to find him. He saw a chair and considered kneeling to pray- but he was a vet tech for many years and remembered that he needed to stay sterile. So he stood in the hall and prayed standing and waiting. Then he called my mom, who had the kids. He needed to call someone and he felt she needed to know. (Oddly, she told me that as he called in she was picking up the phone to dial his phone. She just knew she needed to call, just had a feeling.) She listened, and she told me later that her heart sank and if she hadn't been with the kids she would have begun crying. But she held it together for them, and for Jeff. She reassured him that what happened last time was NOT going to repeat. This was NOT the same circumstance. And it wasn't. As they talked, a nurse came out and told Jeff words that made him incredibly happy- "You can't come in but do you hear that crying? That's your baby." She was born, healthy and screaming, less than 6 minutes after I left the LDR room for the OR.

Jeff told my mom. My mom heard the cries over the phone. As soon as she heard, she told Jeff, "You need to tell Emma." Emma had been worrying for months about the baby dying. Well, the whole pregnancy really. She had come over when the phone rang and could see Grandma was worried. Jeff told Emma that the baby was born, alive and healthy. My mom told me later that as soon as she heard, Emma's body visibly relaxed, like a great weight was lifted from her shoulders.

Jeff then saw people coming out so he said he had to go. He asked two nurses what the APGAR was but they had been working on me, not Katie, and didn't know. Soon someone came to take him to recovery. He was able to find out that her APGAR had been 8 at 1 minute and 9 at 5 minutes- both excellent indicators of a healthy baby! He waited in Recovery and shortly they wheeled Katie Sue in. He managed to call Qarin, who was still in the room (she managed to see the space shuttle Endeavor fly by over Griffith Park out the window! Even took a picture!) and tell her what was going on shortly after they wheeled me in to wake up. (Apparently I assaulted the nurse when I came out... oops. But she forgave me. And I was a bit shaky and out of it, but was calm by the time they took me in.) He tells me that I asked "Is she ok?" at least four times. Then I wanted to see her. He brought her close but I couldn't see (I had no glasses on!) The nurse put my glasses on. I looked and asked to touch her. He brought her close to let me touch her cheek. I still don't remember this.

The first thing I remember is realizing that I was awake, and could see- and that Jeff was smiling and holding a baby in his arms. I asked (this time I remember) "Is she ok?" He said "Yes, she's perfect." And to his credit I had no clue from his voice that it wasn't the first time I asked.

Recovery got a little weird; I had an accidental rubbing alcohol exposure (but got my meds in time to prevent shock- thank you again, Qarin for realizing they'd be in my purse with my inhaler and giving it to the nurse!); I hallucinated a bit; I had an allergic reaction (localized) to the injected methergine; I had two infiltrated IVs (actually, I had one IN surgery, and they had to hastily shove one in my right wrist. Ouch.) Katie Sue took a while to latch on even though she was mouthing for milk because she was so knocked out by the general anesthesia. But really, these things were minor. I didn't care. My pain really wasn't as bad as I expected- possibly because I was flying emotionally high as a kite, looking at my adorable, beautiful, healthy and alive baby girl. My Katie Sue, my drama queen who can't seem to do anything the calm way- but that's ok because she's here to stay.

My recovery from there is going great. I'm doing well and will be released tomorrow. Katie Sue has such a healthy, full-term liver she is clearing her very slight jaundice on her own, and is unlikely to need phototherapy at any point. She nurses like a, well, like a really good nurser. ;) She's wonderful and beautiful and she's staying with us, no doubts about it.

Her birth wasn't what I planned or wanted as far as how she got here- but she got here and I wouldn't hesitate to make every choice the same because we did everything we could to keep her safe AND IT WORKED. And when the time comes, my doctor says we'll try again for a VBA2C, which he and the hospital are fine with- just had one the other day. I didn't get what I wanted in a birth experience. I'd like to never have that happen again, please! But I got a healthy baby- and that's what I needed most out of her birth, her.


Introducing Katherine Susanna, otherwise known as Katie Sue

September 21, 2012, 11:30 AM

8 lbs., 4 oz.

21 7/8" long

Dark brown hair, hazel-ish eyes (are we sure this one is mine? ;) )

An absolute delight and blessing, even if she is a drama queen.


Awesome Mom said...

Congratulations! She is beautiful! I am so glad that she is healthy and happy!

Jenna said...

Congratulations! Man, I was sweating it out with those nurses as I read this account! You keep 'em on their toes! So glad you were in such capable hands. Your doctor sounds like a dream. Heal quickly! And enjoy that bundle of love.

Calleiah said...

Oh Anne. I just totally lost it. When I got to the part where she was screaming, I turned into a big puddle of extatically happy hormonal mushy mess. I'm so happy for you, Jeff and your girls. So many precious happy times ahead for you.

Miss-buggy said...

I am in TEARS here. A happy note for the number 21. I bawled when I read about Emma. Such a sweet sweet soul. So innocent and loving. All your girls are but I tell you that little Emma is a gift.
Oh Katie Sue is so here to stay. Her older sisters made sure of that. I have been praying and I will continue to.
Anne, she is beautiful. What a blessing. My heart is in my throat and I ache for you but I smile knowing that she is here. For keeps. She is all yours.
God is Good. Thank you Lord

Anonymous said...

Sobbing tears of joy!
xo Jilly

Sam said...

Had me tearing up Anne!!! I'm so glad she's here and alive and well. I'm sorry you didn't get the birth you wanted, but I'm glad that everything was done perfectly so that she DID get her safely!
She's beautiful hun!!!
Congratulations again!

Unknown said...

Oh, Anne, what a miracle! I am so thankful for your beautiful, healthy Katie Sue!

TheTrumpEffect said...

Oh Anne, I've never cried this hard in my life over a birth story.

Love, J <3