Annalise's Entrance: Our Birth Story

Warning:  This is the full account of my labor and delivery with some medically graphic photos as well

July 3rd, 1:30am: I woke up for the third or fourth time that night and was just so uncomfortable that I eventually gave up and got out of bed around 2am.  I went downstairs and bounced on my big exercise ball a bit, tried to get comfy on the couch, and paced the living room, all with no relief.  The confusing part is that I was feeling persistent low back pain and lower abdominal pain (similar to menstrual cramps), which was new.  I tried to time contractions with my hands on my abdomen but was so distracted by the back pain that it was a fruitless effort.  Finally around 3:30 I admitted that something is different, whether it is labor or not will remain  to be seen, and I called in to work for my morning shift.  Just saying the words "I think I may be in labor" out loud triggered the cascade of tears, which would happen multiple times in the next few days.  I can't decide if it was fear, pain, hormones, excitement, or a combo of it all, but it sure did bring on the waterworks.  When Eric got up for work around 4:30 I assured him that I would call if things progressed but I had no idea if this was really labor or not.  I took a bath, which provided some relief, then tried to get some more rest, which did not work out.  I finally admitted that this was definitely different but I felt extremely silly since I still could not distinguish actual, discrete, abdominal contractions (as I had imagined them), I mean, I'm a nurse for crying out loud!  I called my OB as soon as their office opened, explained my persistent discomfort, "No I can't tell how far apart my contractions are, I don't know if they are contractions and I feel stupid for saying that" as well as the growing nausea and general feelings of crappiness.  They told me to come on in to get checked out.  Again this triggers the tears as I have a mini breakdown in my bathroom, then I took a deep breath and calmly asked my Mom to please drive me to the doctor's office.

9:00am:  As we waited I had visions of getting my cervix checked and being told to head straight over to the hospital for a speedy and easy delivery.  Boy was I wrong.  As we waited I became more uncomfortable and my mom agreed that I had "that look" that this was, indeed, labor.  Again I explained what I was feeling to my OB and apologized (again) for not knowing if I was having actual, regular, true labor contractions, which, of course, they assured me was not uncommon for first time Moms ( I think they were just trying to prevent the waterworks from starting again!)  After the cervical exam I got the unbelievable news that I was still only at 3cm, the same as I had been at my most recent check up the previous week, I was more effaced though, so that was something.  My OB wanted to hook me up to a fetal monitor so that maybe I could differentiate the contractions and they could see if I was having them regularly.  I still pretty much just felt uncomfortable but at least the monitoring did show that I was having regular contractions and this was probably the real thing.  Then they proceeded to tell me that they wanted to get an ultrasound to measure amniotic fluid levels due to a few low patterns of fetal heart rate.  As we waited our turn for the ultra sound the fear continued to build and I tried to keep the tears in with little effect.  Little did I know that this would not me the first terrifying wait I would have to endure over the next 72 hours.  Luckily (this time) the ultrasound showed normal fluid levels and I was advised to go home and get some rest, eat and drink, and head in to the  hospital once things intensify. 

11:00am-7:00pm:  I labored at home with lots of counter pressure on my sacrum, warm baths, massage, heating pads and even a brief nap after taking some Tylenol.  Finally around 5 things started to feel as if they were intensifying so we get down to business with our contraction timing app (yes, there is an app for that!)  and after and hour and half I agree that things are finally changing and progressing so I call and talk to the triage nurse who tells me to head on in to the hospital!  Hooray!  Now things will REALLY get going!

7:30pm (or there abouts):  We arrived at the birthing center and got all settled in and anxiously await that next cervical check.  As the nurse completes it without announcing right away I knew, 'Still 3 cm, right?"  She confirms this fear (I mean, COME ON!) but wants to watch the baby for a few hours and then check again before sending me back home.  So meanwhile I enjoy the giant bathtub and try to get comfortable even as my low back pain is worsening and starting to actually feel more rhythmic and contraction-like.  Then the general feelings of crappiness started to worsen and I start getting that chilled, here comes a fever, feeling, but, of course, I'm in labor so temperature swings are all just part of the deal.  The nurse says she's still waiting for the baby to show some reassuring signs in her heart rate like more variability and some accelerations and the doctor agrees to go ahead and admit me and see where things go.  Hooray!  I don't have to go home, but boo to still at 3cm and possible unhappy baby.  I continued to cling to that perfect, music to my ears, baby heart rate as I became more uncomfortable and struggled to find a position that was bearable.

11:00pm-ish:  It's  pretty obvious that I'm spiking a temp, I'm up to 99.7 and we start some IV fluids and draw some labs.  I meet the OB on-call who makes the first hints at implementing some interventions to "get things going".  I am still in absolute shock that I have not dilated more (well, they gave me a half cm, but I think they were just trying to keep me from crying).  Now here is my disclaimer on my plan, I didn't have an "official" birth plan.  I am well-informed and new what I preferred, which was Pitocin as a last resort and a wait and see attitude towards pain management.  I knew that outcomes were better with fewer interventions, so that was what I was going for.  Healthy baby, healthy me was really my birth plan.  I new I would be more willing to have my water broken before jumping to the pitocin, so that was what I was ready to advocate for.

July 4th, midnight:  The OB starts asking me about being exposed to anyone sick, UTI symptoms, kidney infection symptoms (due to my low back pain, I'm assuming) then breaks the news that my white blood cell count is 30 (ten and under is normal) and my CRP (C-Reactive Protein, a generic measure for inflammation, can indicate acute and chronic inflammatory processes) is 150, normal is 10.  So something is going on, I'm sick with something, so let's hang a bag of antibiotics and see where you're at.  Let's all be shocked....Still at 3cm.  And I had no idea what I could be sick with, I mean , I'm a nurse, who knows what I could have been exposed to at work let alone the grocery store.

Approx 1:15am:  The doctor returned and sat down to have "the cesarean talk", as I got ready to defend against this he made the very valid and rational point that I obviously have some infectious process occurring and the baby is not a happy camper as evidenced by her continued lack of heart rate variability and accelerations.  He said he did not even feel comfortable breaking my water due to how she was presenting.  At this point he gave us a minute to discuss, I broke down in tears but admitted that this was the appropriate situation for a C-section, to which my husband and Mom adamently agreed with me.  After consenting to this means of birth things started to get scary.  Within minutes all three of us were being prepped for surgery with the appropriate attire, my abdomen was prepped by the nurse and the anesthesioligist came in to discuss and consent to a spinal block.  We were then wisked down the hall as my contractions were becoming pretty  horrendous and I was required to stay still as the anesthesia was inserted in to my spine, at least after that I got some pain relief!  Then the area was draped and Eric and my Mom were allowed in (after what Eric later described were the longest ten minutes of his life, waiting in the hallway).  I lay there on the table, with tears streaming down my cheeks (I finally stopped trying to hide them) as I waited for the unknown: They said there would be pressure, how much? Would it hurt? Dear God please let my daughter be alright, as I again, clung to the sound of her heart rate as if it were keeping me alive as well as her.

Within minutes, I'm talking maybe 3, the doctor asked if we had cameras ready because here she comes!
And then there she was!  Crying!  And they briefly held her over the drape so I could see that beautiful screaming, wriggling body.  I was flooded with emotions as I let out a sob of gratitude, relief, and still fear as I only caught that one fleeting glimpse of my daughter.  But now I could cling to her cries instead of those distant heart tones.

After a few moments my Mom came over and said they would probably take her to the NICU briefly because of some mild respiratory distress, I demanded to know why, what is going on, I can hear her crying, what do you mean respiratory distress?!  Again I got only a brief second glance before she was wisked away.  Luckily they allowed a family member to go with her and I just so happened to have a retired NICU respiratory therapist as a mom to oversee her transfer.  At that point, all I could do was lie there and take deep breaths as the surgical team finished up their work on me.  The next few hours are a bit of a blur as I was getting updates from Mom and Eric as they took turns between her and me.

 
They kept pushing back taking me in to see her but  I was finally wheeled in, a few hours later, hospital bed and all to get that much awaited and longed for skin to skin time with my baby girl.

Neither the trauma of the last 24 hours nor the trials we had awaiting for us over the next few days mattered at that moment, because we were together and all ok.  And we decided on her name, Annalise, meaning "Grace from God", from the Scandinavian roots of her maternal great grandmother and Vera, meaning "Faith" after her other maternal great grandmother. 

A cesarean section and a full term baby in the NICU are about as far from what I envisioned for the birth of my daughter, but then, who really does dream of that scenario?  I feel no regrets about the decisions made that night, nor do I feel angry or as if I was robbed of a the ideal birth.  I know that the doctors would not have moved as fast as they did without true concerns and I will be forever grateful that they acted accordingly.  Healthy Mom and Healthy (Well, almost) Baby, the ultimate, perfect, outcome.

 The next week continued with it's challenges and more bathroom breakdowns, but that is for a different post.