piper's birth story

Piper's Birth Story

week 39

it kind of started with my week 39 week appointment, which was on july 12th.  after we checked progress (i was 2cm dilated and 50% effaced), my doctor was very happy and actually offered to schedule an inducement for two days later!!  this caught me completely off guard. this idea had NEVER crossed my mind.  i didn't even know they offered this sort of thing.  and i was in a completely different mindset, since during the previous appointment i asked how long we'd let the itty bitty stay in there (which would have been until july 28, barring any distress to the baby).  i was in no hurry to rush her.

so the reason he offered to induce?  completely elective - we knew he'd be out of town on vacation the week of my due date, so he offered in case i wanted to ensure a delivery with him but only because he was encouraged by my progress and believed chances were good it would be a productive inducement. however, it just felt too early to me and didn't feel right.  so the offer was turned down. 

week 40

my due date came, and passed, as i expected.  it was kind of fun to sit at benefit, getting my eyelashes and eyebrows tinted (so unneccessary), and have people ask when i was due. to which i'd get to respond with a triumphant, "today!" 

the first time i announced it, my eyebrow girl, eliza (who blogs here), quickly reacted with, "don't worry, i'm health-inclined!!"  this had us all laughing for an hour. what does that even mean? 

***

i had 3 appointments scheduled for the week:

• #1 on monday the 19th for my regular weekly;
• #2 another on wednesday the 21st for an ultrasound and non stress test (NST) to check on baby. dr. f was technically on vacation but was going to be in town on wednesday for a c-section that he had scheduled long before he planned his vacation (he was just going to be two states over in michigan visiting his son). he wanted to personally see my ultrasound and NST results on wednesday while he would be in town;
• #3 another on friday the 23rd for another NST. 

... and i never made it to #2 or #3.

appointment #1

since dr. f was out, i saw a different doc in the practice, whom i happen to really like as well, dr. f2. after examining me, he actually complimented my cervix (i believe it was, "you have a great cervix!"). being pregnant is so bizarre.

after the examination (i had dilated just a smidge more), as he consulted my file, he asked if i wanted to be induced this week on wednesday when dr. f1 would be in town.  this didn't throw me off like it did the first time the idea was introduced.  i was in a better place to think about it and out of curiosity asked what the logistics were . . .

wait-listed

the way this works here at northwestern memorial hospital, is that the doctor can schedule an elective inducement appointment only if the hospital is not already full.  f2 checked and it turned out that the hospital was already full for wednesday anyway (is this a hospital or a hotel?).  doc f2 said that i could always be wait-listed, and then if something were to open up (e.g., someone delivers before their appointment), i would be contacted.

so patrick and i talked about it, again.  after my week 39 appointment, i had read up in the journal of obstetrics and gynecology the risks of inducing early and resulting c-sections in the july issue, which made me feel like turning down inducement at that point was right for us (patrick was all for it, but wanted me to make the decision i felt comfortable with).  but i definitely felt more at ease talking about this option than i did a week earlier, since the baby was now past due and she'd had another week to get ready.  we both also really liked how dr. f was giving us alternatives  on both ends of the spectrum without any pressure (early, past due, waiting as long as possible) and figured the wait-list was a non-commital way to extend our options.

this also gave us time to see how we actually felt about inducing in our particular case.  i still was not 100% comfortable with it.  i also still didn't want to tell anyone about the option, since everyone has their own viewpoint on non-medical inducement and i feel it's such a personal decision.  but i also realized that i was very concerned over what other people would think.  pretty much the only reason i was hesitant this time around was that i worried others might think it was a poor decision.  but at the same time, we didn't even have an appointment, so i stopped worrying about it. 

tuesday

then tuesday came along, and things started to change.  i started getting crampy.  i started feeling more pressure in my belly as the baby moved.  these were signs that my body was definitely getting ready. it was an exciting feeling, knowing that she was making preparations and telling us she would be coming soon.

and that afternoon, we got a phone call from the hospital asking us if we'd like the 5:30am slot!?

yet there was still no guarantee, as we'd have to call at 4am the next morning to see if it was still available (if too many patients came in overnight, they would cancel the slot).  well, should we take it? i definitely felt comfortable with taking the appointment when my body was getting ready on its own already.

so yes, we took the appointment, and it felt much better that we had waited that extra week.  and i was glad that dr. f would be delivering, should that spot remain open come the next morning.  plus i liked that there was still no actual guarantee.  to me, this was perfect ... we went to an early and relaxing dinner and went to sleep still not knowing what would happen between then and the morning.  would i go into labor overnight?  would we go to the hospital in the morning?  nothing was certain. 

wednesday - the big day!!

wednesday morning came. alarm went off at 3:45am. we called.

and they said to come in ...

3:45am and so we got ready, collected our bags and headed out to have a baby! i was surprised at how active the baby seemed. i figured she was just excited. as for me, i think i felt kind of calm. except maybe on the train my temper flared.

4:50am we took the blue line downtown and hopped a cab to prentice women's hospital. (sidenote: patrick says it only took a few seconds, but i swear no one offered me a seat at first. love that i was on my way to hospital to HAVE the baby, and everyone on the train played 'maybe someone else will offer their seat.")

5:25am we arrived at the hospital, where brian of valet helped me out of the car and serenaded my belly with 'happy birthday to you."

5:30am we were admitted and headed upstairs to our labor+delivery room.

sunrise from our room

6:00am i was hooked up to the external monitors.  the nurse said, 'oh, did you know you're having contractions?  do you feel that?' 

ha!  i thought that was just the baby moving and putting some extra pressure on me!!  i didn't know those cramps were actually contractions! they weren't close enough together though... so pitocin, here we go!

6:30am i was hooked up to the pitocin and contractions continued. the nurse said that someone from anesthesiology would be in to talk to me.

7:00am i was briefed on the epidural procedure and asked if i wanted it yet. even though i was advised by some to take it as soon as the option presented itself - because there is no telling the next time the anesthesiologist would be available - i wasn't ready.  i wanted to feel what these contractions were like. at least a little.



7:00am dr. f arrived into town, fresh in from michigan. goodmorning!

7:15am after taking a looksy, he broke my water.  this was to augment labor. i was a little surprised, i didn't know it would be manual, nor did i know it would be so early on.  and yep, they used something that looks like a crochet hook. 

7:30am i continued to feel the contractions in my lower back, and was amazed to find out that this is what contractions feel like.  not at all what i expected.  it really felt like i was going to get my period.  i thought that was just a sign before you started having contractions, not that those sensations were actually the contractions! i pictured that the pain from the contraction would extend higher and wrap itself around my entire uterus.  i thought i'd be able to feel the uterus contracting like i did with some braxton hicks in month 5. but all i really felt was the pain from the contraction., low and in my back.

as i tried to rest, so did patrick. he refused to bring a pillow, hence the duffle bag head rest.

8:00am contractions were getting stronger and closer together (1.5 minutes).  ice chips - the only thing this hospital allows you to eat or drink while in labor - were my new best friend.

seriously, more ice chips?

patrick was very busy resting for the big event.

8:30am the nurses turned down the pitocin so that i could rest a little between contractions.  patrick and i learned from one of the nurses how to read my monitor, how to read the screen that shows what was going on in all the other rooms, how the graphs were not relative to each other, and how to see the progress of our nurse's other patient.  hightly educational. and entertaining.

my monitor: baby's heart rate in the blue range. contractions on bottom graph. average 2 minutes apart when this photo was taken.

9:30am after another hour of experiencing increasingly stronger contractions, i decided to request the epidural. this is how i would describe the feeling at this point:

let's say i felt this pain on a normal non-pregnant day while walking on michigan ave., at the grocery store, or at work. i would have no choice but to stop whatever it was i was doing - like immediately - and curl into a ball on the ground in public and ask someone to please find help. 

i walked around the room a little since i knew i'd be stuck in bed after they started the epidural. patrick rubbed my back some, but the anethesiologist came quickly and patrick was asked to leave the room.

epidural power-on!

9:35am luckily we knew from our "great expectations" class that patrick would be asked to leave the room for the epidural. this is requested under the guise that it is for maintaining a sterile environment, but we all know it is because the husbands pass out! 

we also knew beforehand that it could be a resident or fellow administering the epidural, as opposed to a lead physician, unless a specific request otherwise is made.  we discussed the pros and cons and decided that we were fine with whichever doctor we had (while some people are nervous with newer docs, we figured they are more careful and older ones can get lazy, so it didn't matter to us either way).

the anesthesiologist came in and asked if it was ok if a med student watched on (it is a teaching hospital) and i said that was fine.  the neat thing about that, was that i could hear him explaining each little step.

so i sat on the edge of the bed and was asked to slump and completely relax. kindly, the nurse held my hands.  i called behind me, "you're going to do this BETWEEN contractions, right??" and the response was, "well, we can start between contractions." oh boy. not easy to stay slumped over completely relaxed when there is an overwhelming contraction taking over your body.

so the anesthesiologiest went ahead and numbed the local area and then started on in with the big ol' needle.  something was not right.  not, not right.  i voiced it, the nurse asked what it felt like.  i said it was hard to explain ... she said is it like a "zinger?"  "yes!" and they pulled out the needle. 

so, the anesthesiologist remained quite calm, and walked the student through what could have been wrong.  "the space between those two vertebrae could be too small, or," something like, "the angle could have been slightly off."

so they went for attempt #2.

yikes! the same thing happened!

i was super calm through this and not freaking out. i wasn't scared about the big needle imposing permanent damage upon my spine, really. my primary concern was that they were going to tell me, "sorry, you just weren't built for this" and that i would be denied the pain medication. 

at this point, there was a little commotion and the Attending came in and introduced herself.  at first i thought she was there to bear the bad news.  then it was clear they were going for attempt #3.

i fully expected that the attending was going to take over.  but no.  she stood behind me, but just to observe.  oddly, this comforted me, as i decided it meant she was confident in this doctor.  the same doctor explained to the med student that the cavity between those two vertabrae must be too small, and that he should have moved up a vertabra last time.  even though he admitted that he should have done it another way, i think it was implicit that there was no way for him to know without the second attempt what the cause of the problem was.  so he set up for the new location.

in they went again, better this time.  then, yikes, once the needle was in there, i got another wave of that "you've hit a nerve" feeling.  the attending asked if the pain was to the left or right, i said it was ever so slightly to the left, and she said it was just brushing against nerves and would subside, and sure enough it did. 

voila.
the medicine was injected.
the catheter thread into place.
and presto.
almost instantly the contractions seemed to disappear.

the story might sound a little scary, but nothing about it seemed to faze the doctors or the nurses, which made me feel completely comfortable. it was all handled as if it was totally routine.  and while there were a few seconds of that feeling like when you hit your funny bone, or a nerve at the dentist, it was just a few seconds each.  so overall, i'd say it didn't really hurt much.

patrick was allowed back in.

the nurses spouted off notes to each other.

and patrick jotted down the following into my notes:

10:08am epirdural power-on!

10:30am a nurse came in and inserted a lovely foley catheter since the epidural now confined me to the bed (no restroom trips!).

11:00am the doctor came in and checked me, and i was 90% effaced! i had only dilated another centimeter, but in first time moms usually effacing happens first.

the nurse said i might be glad to know that i had probably timed my epidural well because contractions sometimes come on stronger once the cervix is completely effaced.

11:30am my brother showed up at the hospital and came on in to say hi. i suggested that the boys go grab some lunch so that i could try to nap a little.

12:00pm i could not believe it was noon already. the morning went by in the blink of an eye. i felt like i just got there. my contractions were getting stronger and i was glad to have a little quiet time to myself.

the magic button
i rested, but could not fall asleep, as the contractions were hurting worse.  so i turned to the little "magic button" that would dispense a little more epidural for break-through pain.  it is limited to three presses per hour, but the anesthesiologist can adjust the constant drip dosage or the break-through dosage if needed.

1:30pm the boys were back and i had not really rested yet.  we had brought movies, but i didn't feel like watching them.  their chatter was grating on my sensitive state so eventually i asked them if they'd hang out in the lobby. they had a game with them and it was no problem.

i tried to nap, but napping through contractions IN A HOSPITAL is a total joke.  every half hour, the blood pressure machine would squeeze the bejeeeezus out of my arm.  and every half hour the nurse would come in and take my temperature.  but of course they didn't sync, so every 15 minutes i was interrupted by one or the other.  plus the beeping of everything.  and one of my IV alarms went off because a back up battery was low. 

and the contractions.  oh, magic button.

so after an hour, at least i had rested a little, but no napping had really occured.  i couldn't believe it was already 3pm.

3:00pm the doctor checked me: 100% effaced and 8cm!! great progress! we discussed what i wanted to do when i was complete. i was going to use a strategy called "laboring down" where instead of pushing right away, i'd let my body and the contractions do the work of moving the baby further into the birth canal while i conserved my energy.  i'd do this until i felt an overwhelming urge to push. 

i figured that if i progressed a centimeter an hour (average rate with being induced), i was two hours from being complete.

4:00pm my contractions were strong and i was definitely feeling new sorts of pressure.  so i called patrick from the lobby.  i felt like things were changing and needed him in there now!  he reminded me to breathe, like a good husband/partner/coach, "cleansing breath!"

4:30pm complete!
just then, the doctor came in and checked me.  i was complete!  it was time to labor down... he also said that he was heading into his second c-section of the day and he'd come see me right after, guessing i'd be ready to start pushing in about an hour.

4:35pm began laboring down
this stage started out really easy, because you really don't have to do anything, as you are letting the contractions do the work for you. everything had been going really smoothly, and laboring down was no exception.

the nurse explained what would happen once i started pushing and it sounded simple enough.

5:30pm after an hour, dr. f was not done with the c-section yet, as there was some sort of complication. 

the nurse came in with a message from him, which was to see if i felt like i could continue laboring down. she explained that they like to have a doctor in the room once the mother starts pushing in case the baby's heart rate starts dropping, so if i could wait then maybe the doctor could finish.  since i did not feel an overwhelming urge to push, i said i'd keep laboring down, but the pain of the contractions started breaking through my medication and i wanted to administer more epidural, as i'd run out of "magic buttons" for the hour.

just then doctor came out of the c-section to check on me while the c-section lady was being prepped for stitching. he advised against more epidural but had to run back to the c-section.

the anesthesiologist had already been called and came in, but she knew what the doc had advised. however, i had to make the call - whether to up the epidural dosage or not.  i looked at the nurse and said, "i don't want dr. f to get mad at me!" and she said, "it doesn't matter, this is your call."

i turned to patrick, and he agreed. 
so we cranked it up a little.
feeling relieved, i continued to just hang out.

6:30pm another hour after i started laboring down, dr. f was still in with the c-section and i was told he wouldn't be long now.

6:45pm i told the nurse that i felt like i had to cross my legs now or the baby would start peeking out, so maybe this was the 'urge to push.' she asked if i'd like to start pushing now, and i said yes.

6:50pm began pushing
it was very calming and soothing, the way pushing was initiated. i had pictured that there would be some sort of commotion when it was time to start.  but patrick held my left leg and the nurse held my right right, and we all very calmly just began with the next contraction. 

7:00pm finally the doctor was done with the c-section and came in to see how it was going. then left again to let me do some pushing.  i really wanted to get the baby out of me by 7:30 because that was when my nurse's shift was over.  i was starting to feel all of my pain in my lower back, and the nurse suggested that i turn on my side between contractions. 

7:30pm came and went, and the nursing shifts were changing over. i told the nurse, maybe i could get my baby out in the next few minutes.  i mean, i was really trying to get things done.  plus, the pain was getting bad, and i was ready to have the baby out.

7:45pm as we all know, i didn't deliver the baby for my nurse to see and i thanked her as she left.

7:50pm about an hour after i started pushing, the doctor checked things out.  he said i really had not moved the baby. i was crushed. not only had i not pushed her out in time for the first nurse, now a full hour had passed, i was exhausted, the pain was the worst i'd felt yet, and i hadn't moved the baby any more than when i had started pushing?!?!? 

a lot of things ran through my head at that moment, but the one that i remember was that i tried to figure out how to phrase "i quit" in a less defeated manner.  i guess i'm lucky that nothing came to mind right away, because after a few  moments pondering how to get out of this situation i'd gotten myself into, i decided if i didn't keep trying, i would be really, really, mad at myself.

at this point, i was in a lot of pain. 
and they had disconnected the magic button when i started the pushing process.

i voiced my desire for more pain medication and the doctor felt that the reason i wasn't pushing efficiently was because of the epidural was masking my ability to feel how i was pushing, and was concerned if i had more, that i would end up in a c-section. i don't really remember how it went down, but all i know is that after this point, i wasn't "allowed" any more of the epidural!!! i was cut off the drip - no more pain medication!!!

8:00pm i explained to the new nurse that i was turning onto my side between contractions with the first nurse because of the pain in my back.  she asked if i'd like to just push from that position.  umm, yes!!!  why didn't we think of that before!?!?

it was so much better pushing from my side:
1) i did not have to flip back and forth from my side to my back
2) i am sure that this saved me a lot of energy
3) i could face patrick and he didn't have to hold my left leg up any more
4) also the nurse had a better angle and could tell when i was pushing the 'right' way - she could say "there, like that!" when i was pushing correctly.  it was very helpful!

patrick took over coaching me through contractions/pushing and he was helping me breathe through the pain.

but the pain kept getting worse. 
i could not stand the lights. 
we turned the lights down.
i needed so much ice - i was so thirsty.
i needed a cool compress on my forehead.
and on the back of my neck.

9:00pm right around 9:00 she started to crown.
the nurse asked patrick if he would like to see.
uhhh.
patrick looked at me.
i said he might as well take a look!
yep.
after that, the nurse asked me if i wanted to see.
i could barely open my blood-shot eyes at this point.
also, i could barely talk.
but i somehow communicated that i wanted to see.
so she brought a mirror over that stood on an easel-like apparatus.
i managed to open my eyes for a second.
and yep, sure enough, you could see her head.
all you could really see was the tippy top of her head.  but it sure was a baby i was looking at! weird.
after awhile, the nurse told me to try to watch the mirror through the pushing.
when i did, i could see the top of her head move out a little with the pushes, but then sink back to almost the same spot when i was in between contractions.  kind of frustrating, right?

9:15pm all i have written down in my notes for after 9pm is:
"PAIN oh my god."

of course i finished up those notes the next morning, because after i started pushing, i was no longer jotting things down in my notebook. but basically, pain was ripping through my back. i can't remember the feeling of the pain (my mind must have blocked it), i just remember that i was in a lot of pain.

at this point, the doctor was with back in with us for the delivery, and i was on my back again.  the baby was crowning for a long, long time.  it was very hard to get her head out.  usually, the shoulders are the problem, right?  well this girl's head was my problem. 

then we heard the navy pier fireworks going off, and joked that it was time for a real finale!

then, what seemed like out of nowhere, the doctor said, "do you want to see? lean forward, LEAN FORWARD!!!"

i didn't really know what i was doing, but i leaned forward and opened my eyes, and there was my baby from her head to her waist, literally being pulled out of me!

woah! i sure was not expecting to see that when i walked into the hospital that morning!

9:43pm piper was born
after almost three hours of pushing, i leaned back, and she was out!

she didn't cry right away, and no one looked worried.  but it scared me.  turns out she just needed to be suctioned, but in the movies they always come out screaming and so i was worried. she was whisked to the warming bed.  it seemed like a lot was going on.  patrick was with me, and i think i expressed that i was worried about her not crying. but i don't know if i said it or not.  it was the only thing going through my head. but she started crying and i told patrick to go see the baby!

but i thought, where's the part where they put the baby on my chest?


the doctor was work-work-working away. pushing on me. pulling on me. delivering the placenta, i suppose. i kept wondering why they hadn't brought the baby to me.  was something wrong with her?  i don't know why, but i didn't ask. 

miss piper, just fine! but zoom in on me in the upper right corner!! blahhhhhh!!!
btw, that's her umbilical cord stump all sticking out kinda penis-like.

the doctor and nurses were buzzing around but no one was talking to me.  eventually the activity slowed down and the doctor rambled off some things to the nurse to type into the computer ... post-partum hemorrhage. 

turns out that i started hemorrhaging with the delivery and the doctor had been busy trying to slow the blood loss as my heart rate was dropping.  i didn't even know! patrick later said that he saw my monitor but none of the nurses would talk to him and that it was pretty scary.  dr. f explained to me that i passed a blood clot, and the blood loss had slowed, but they were hooking me up to an IV to prep me for a blood transfusion, just in case i lost any more blood.

i had to be monitored for two more hours before they could release me to my recovery room. 

once i was stitched up in special places and stabilized, they brought the baby over to me.  patrick had held her before even i did.  but at last, our little baby was in my arms.

and so we became a family.

---
piper was born at 9:43pm, 8lbs 10oz., 20 1/2 inches, with apgar scores of 8 and 9.