birth story
At my regular prenatal appointment on Saturday October 20th my swelling was still out of control and I felt like total crap. When I did the dipstick for the pee test I knew we had some trouble. Everything else was fine, but I had trace protein. When Sena checked my blood pressure it had really risen. Everything checked out perfectly with the baby, though I was measuring just a tiny bit (like a half centimeter) behind on fundal height, when I'd been exactly on or a little ahead the whole pregnancy up to that point. Sena told us that we were at a real crossroads - we could take these as warning signs and do something about them now - thus giving us a better chance of getting the blood pressure down and continuing with a healthy pregnancy and having a healthy home birth - or I could keep going as I was and be looking at toxemia/pre-eclampsia. She laid out the path I'd be on if we couldn't get it under control - a path that involved hospitals, inductions, c-sections, etc. She told me to quit my job, pound the protein, rest rest rest and do very light exercise.
So, I called my boss and told her that Monday would be my last day and I'd be just going in to clean out my desk and make sure everything I had in process was moved over to another banker. She was super nice about it, and so Brandon's vacation week at home turned out to be my vacation week at home, too. (He said that he knew I'd find some way to stay home that week.) During the week I did what Sena said - swam at Bally's, ate craploads of protein, rested, felt like crap, threw up every day, etc.
I slept really poorly Thursday night, but we had some passes to the Denver Museum of Nature and Science that we wanted to use before Wiley came, so we were going to go see the Titanic exhibit and IMAX there on Friday. I had a headache Friday morning and threw up my cereal, and when I went to the computer to check entry times available for the Titanic exhibit, I realized that my vision was being all screwy. I freaked out a bit because both headaches and vision screwyness (especially together) are signs of pre-eclampsia, and debated whether or not it was a "page the midwife" situation or not. I asked Brandon and called my mom, and they both said to page her. As I did, Brandon submitted his fantasy football lineup, took a shower, and shaved (how prescient of him). He even suggested that we get a bag ready, and I'm all, "no, that's silly!" When I called Sena, Arian answered and listened to everything and said she'd have Sena call me back after the meeting she was in at that moment was over. Sena called around 12:30 and said to come in right away.
When we get there, I take another pee test and I knew I was screwed at that point. My protein was the highest level the little dipstick reads. It's normally none. My blood pressure was even higher - now way over the normal level - and thus began the insane amount of pin-cushion imitation I would be doing for the next week. Sena tried to get a blood draw to do a liver panel, but I am insanely difficult to get blood from, and after two tries, she quit and sent us to Quest with a stat order for a blood panel and also attempted to get ahold of her backup doctor to get me in that afternoon. I asked for her best guess, what are we looking at. She was fairly certain I would not be having a home birth, but the liver panel and doctor visit would determine if I was healthy enough to deliver vaginally and when, or if I'd need an immediate c-section. Great.
So, I got the blood draw at Quest, and as we were heading home we got a call from Sena to proceed directly to the doctor's office in Brighton. I'd seen him before when I was throwing up blood, so I felt pretty comfortable with him. Since it was after 3pm and I hadn't eaten anything other than the bowl of cereal that morning that I'd thrown up, I had Brandon stop at McDonalds and get me a cheeseburger and iced tea to "tide me over" until I could get home and eat. Heh. Good luck with that.
At the doctor's office, I get another exam, and without even needing to see the bloodwork (we were still waiting on it from Quest), he diagnosed severe pre-eclampsia. We asked what this meant for us in terms of the continuation of the pregnancy, still not really understanding the urgency of it, and Brandon asks if it's possible we could have the baby this weekend. The doctor said we were definitely having the baby that weekend, and it was a matter of waiting for the bloodwork to see if I'd have an emergency induction that day or an emergency c-section that day. We were then left alone in the exam room for awhile where I proceeded to have a little freak out since Wiley wasn't due for another 4 weeks, and Brandon proceeded to be calm and collected as always. The doctor came back and said that he'd still not gotten the bloodwork, but he'd spoken to the high risk OB at Presbyterian St. Luke's hospital, which apparently is the hospital with the super NICU and super high risk maternal/fetal medicine department, and that they had agreed to admit me immediately. We asked if we could go home quickly and pack a bag. The answer was no. We were to go directly to the hospital.
Once we arrived at the hospital, we were given a form and escorted to a labor and delivery room and I was told that there was a gown in the bathroom and I should put it on. At that moment, I realized that I was here to actually have a baby, however that was going to come about. I was afraid and uncomfortable. We were STILL waiting for bloodwork, and a few nurses were in and out of the room. I got bracelets (one I'm not sure what for and another with a Keely-specific bar code that they had to scan every time they gave me medicine), and they wanted to take another blood draw to do their own bloodwork. The nurse assigned to me and the nurse practitioner on duty (Ponytail NP) wouldn't allow me anything to eat or drink - not even water - in case it turned out that I was needing an immediate section. I was starving and thirsty and exhausted at this point. The doctor on call that my doctor had spoken to was in the OR with another section, and we were waiting and waiting for her to be done in order to determine what was going to happen. Sena and Arian had arrived at this point, and we talked Brandon into getting himself something to eat. It was after 8pm and the doctor still hadn't shown up - Ponytail NP while speaking with Sena across the room (but my ears were fine, completely unaffected by the pre-e) and said that the doctor was still in the OR and that it was a "bloodbath" in there. Oh, thanks. Take it out of my room, please. Two different nurses attempted to get my IV in, as they were going to start me on magnesium sulfate to avoid me having a seizure from the blood pressure. We tried to get more information about the meds, but were met with a lot of resistance. It seemed that the entire hospital staff thought we were being difficult by asking questions - they all were expecting hostility since we were planning a home birth. When I asked about the mag sulf, I was told that I was ignoring the "huge morbidity rate" if I refused it. Great, thanks. Ultimately, they had to have a guy from the emergency room come up and put in my IV since no one in L&D could get it in. I ended up leaving the hospital with some massive bruising and tons of poke holes.
Finally my bloodwork came back bad, but not indicating that my liver was in danger of killing me within the hour and they had an on call doctor come in - Dr. Gray - and she did an ultrasound (and couldn't believe I didn't have an anatomy scan performed) while Brandon and Arian were with me. She said that everything looked great, and that he was going to be 4lbs 13oz. She wanted to begin my induction right away with Cytotec to dilate and efface my cervix. 1/4 of a pill per 4 hours. Having read about Cytotec and how it is contraindicated for labor induction (the manufacturer, the World Health Organization, etc, are against its use for induction of labor and it has a huge history of causing uterine rupture in VBAC patients - and while I'm not a VBAC, still, WTF?) I was understandably hesitant. Dr. Gray and Ponytail NP acted like I was crazy again for my concerns, and we asked for some time to talk about it amongst ourselves. Ultimately, I let them do the mag sulf and the Cytotec. I was hooked to the contraction monitor and the fetal monitor, as both of those meds require continuous monitoring because they can make bad things happen. I was stuck in the bed anyway, so whatever. (I did end up being on the monitor so long with no new ultrasound gel that I got a heat rash in a perfect circle where the fetal monitor was on my stomach) The mag sulf was put in my IV at a super high saturating rate for 20 minutes before the regular drip, and it burns and feels evil and hurts worse than I can describe. The fun parts of this medicine include the fact that it makes you foggy and sick feeling as well as its being a smooth muscle relaxant (and ridiculously, is actually the medicine they use on people who are having preterm labor in order to STOP their labor and contractions) which means you can't get out of bed - like even to stand up. So, I had to be catheterized. Brandon had run home to get us some provisions and let out/feed the dogs, so he didn't get to witness the humiliating catheter insertion. On top of the fun of the insertion, it was so uncomfortable, inside and out, so I had to be on another medicine to stop the bladder contractions. Fun! I was finally allowed to eat and drink, and the nurse I had brought me a turkey sandwich meal thing.
The night went by very slowly - the midwives left when Brandon came back, and he slept in the pull out chair bed and I tried to be as still as possible so as not to move the catheter. The contractions were crap - there wasn't any break between them like regular contractions, they were like a really bad period that didn't stop. And I couldn't move because my legs didn't work from the mag sulf and the catheter hurt. So, I didn't sleep, every two hours they checked my vitals and every four hours they put a new bit of Cytotec in me.
I got a new nurse at 7am. The night nurse was really nice, very positive, very pro-me having a good experience. My new nurse (Mean Redhead) came in, sat down, and told me she was there to "shatter my dreams" and that I had to get used to the fact that the birth was going to be nothing like I wanted. I had no choices. Nothing like home birth, I was not going to be able to go without pain meds, I was probably not going to be able to nurse - definitely not right away - and the baby would most likely need lots of NICU care. Oh, and that the mag sulf has to stay in for 24 hours after the birth thus confining me to the bed, so I wouldn't even be able to see the baby in the nursery. I, of course, cry. When she leaves, Brandon notes that every nurse, every doctor, every one entering our room has a different story.
The day (now Saturday) wears on, and with each new dose of Cytotec the contractions get worse along with all of the other nasty medicine. I feel like crap, haven't slept in ages, and have been eating little bits of things - some eggs, fruit, and the chicken from a chicken sandwich. Mean Redhead comes in to check my vitals about one in the afternoon and says, "The nurse practitioner (a new one now - we'll call her Blondie) is going to come in at 2 and break your water." Not, "she's going to talk to you about breaking your water" or why we'd want to do it or anything, but rather, she's going to break your water. Really. Brandon calls Sena as soon as Mean Redhead leaves the room, explains what's going on, and gets a lot of good information. Two o'clock rolls around and in come Mean Redhead and Blondie. We ask why they feel the need to break my water now, why can't we try something like Pitocin, since they're planning to give it to me eventually anyway. They sit down, and I swear to God, they proceed to tell us that they feel as if we are being HOSTILE. They don't fucking know hostile, and had I been in my right senses I'd have had a lot better response to this, but I'm thinking, "shit! everyone that's come in here has been hostile!" It's like every hospital staff member had a pre-conceived notion of what home birth meant and how people who had planned a home birth and had to be in the hospital would be. It's like they all had a chip on their shoulder about how my planned home birth somehow invalidated their chosen career path. However, I knew I was very sick, hospitals are for sick people, and I was glad that there was somewhere I could go in that event. I just wanted to understand what was happening to me as I was used to having informed consent.
I tried to be diplomatic and explain that we wanted informed consent and were going to ask questions. Brandon did a much better job at the question asking and responding, as I was in a bit of a fog from the meds. We agreed that they could check me, and then depending on where I was dilation/effacement-wise, we would decide whether we agreed to a water breaking. I was still two, so we didn't want them to break the water, and Blondie says at this point that she wouldn't have anyway since I wasn't dilated enough. Whatever. I asked why this check seemed to hurt more than the others, and Blondie tells me that she swept my membranes. Just after our discussion of informed consent where she assured me she understood where we were coming from. I was too tired and hurt and sick to smack her. She's lucky. So, then here comes the Pitocin. At some point, I know not when, the antibiotics IV also came.
With the Cytotec and the Pitocin and the Mag Sulf and the inability to move off my back and the tiredness and the scaredness, things started to hurt more. I was checked more times and only got to about 3 almost 4 by the time that Aileen (new nurse) came in at 7. I remember thinking, oh God, what shitty attitude do I get to deal with now, but Aileen turned out to be really nice and positive. Luckily, it would turn out that she was our nurse for delivery - not that it REALLY mattered since there were 3495873495 people at the delivery, but it did somewhat.
Blondie checked me again and said that the doctor (who we hadn't actually ever seen) was really wanting my water broken to get things moving, as I was very sick and the only cure was delivery. It was finally too much to handle - the pain and the sick and so forth, so I agreed to the water breaking after an epidural. Honestly, they promised me if I did those two things that they'd leave me alone for 4 hours so that I could get some rest. More medicine and fluids prior to the epi, and then the anesthesiologist came in and did the deed. He was followed soon after by Blondie who broke my water - which just felt like a whoosh of warm. Unfortunately, I didn't get my rest. My anxiety mixed with the epi gave me the uncontrollable shakes. They lasted pretty much the rest of the labor under varying degrees of my ability to control them. As soon as I was able to sort of relax and the water was broken, things started to really pick up and I was dilating fast and contracting in a very productive way. At about midnight Brandon talked to Sena and she said she'd come about 2:30am if that was all right. By 1 I was feeling crazy contractions and really felt him moving down, so I had Brandon call her back and tell her to come then, as it might be too late at 2:30. (Wishful thinking of someone who'd never done this before.) Wiley's heart rate was being weird after the epi, so they brought in an oxygen mask and made me put it on. They also brought in the warmer and baby things so they could be there in the room and ready.
The next bit turned out to be the most comfortable part of the whole labor. Brandon, Sena, Arian, and I were mostly left alone in the dim room and I was able to breathe with the contractions and feel them change from contractions that OPENED things to contractions that pushed downward. Brandon talked me through deep breathing and Sena ultimately took a nap in the pullout chair. Then. Of course. Because I am me. I started throwing up. I had been drinking apple juice, so all the apple juice came back up between two pink bins that the people around me rotated and rinsed out. I remember not wanting to let go of the puke bucket. People tried to hold it for me and I was not having any of that. I clung to that pink bin for dear f'ing life. The motions in my abdomen of the throwing up was actually doing the work of pushing him down and out. I made the mistake of mentioning this to the nurse when she came in and she checked me and found me to be fully dilated.
Thus began the muppet show of the actual delivery. All of a sudden when I was discovered to be complete, big bright lights in the ceiling came on shining directly on the end of the bed, the end of my bed was removed, stirrups were put up, and 3485739573 people came into the room.These things they did automatically, but I had to ask for the catheter to come out (I had been promised its removal for pushing). Brandon was to my left next to my head, Arian was on my right holding my leg, and another nurse was on my left with the other leg. There were two more nurses from L&D and several people from the NICU. Dr. Gray was back and had swept into the room saying that she'd just come from doing a c-section at Swedish (another hospital, clearly) and got here just in time. She had scrubs and a big plastic mask (like I was going to spurt out the baby at her or something) and a tray of scary silver cutting implements was wheeled in next to her. I said that I wanted delayed cord cutting and she said no. I said that I did not want an episiotomy and if it came to it would much rather tear. She said "I'll only cut you if I need to." I was told to push with the contractions, and then we waited. While my contractions were strong and doing good work, they were strangely far apart by this time. Everyone looked bored. When I was finally contracting again and started to push, the nurse on my left told KELLY to push harder. I looked at Arian and she corrected the nurse, but good freaking lord. KELLY.
In about 4 pushes (which took longer than it seems, as my contractions were not back to back) he was out. I didn't have my glasses, so I could just see that he was kind of gray and he was crying. (They told me later that the little acrobat's cord was wrapped twice around his neck.)The doctor immediately clamped and cut the cord (didn't ask Brandon if he wanted to) and handed him off to be put in the warmer. The nurse on my left dropped my leg, which flopped over because of the mag sulf and the epi. Brandon went immediately to the warmer and didn't leave Wiley's side again until they were both back in the room hours later. People were standing all around the warmer and I couldn't see - didn't have my glasses anyway, but I tried. Someone asked people to move so I could see, and only one person did and she wasn't standing anywhere that actually blocked him, so I still couldn't see. Sena made them bring him to me to try and nurse, but he wasn't ready yet and they were hovering ready to grab him back, so they took him again after about 30 seconds. I noticed that there were even more people in the room, and I mentioned to Arian that there were a lot of people there. Another nurse asked if I'd like her to have the students(!) who had come in to watch who knows when leave, and Arian told her what I had said. The nurse shooed them away just as Brandon and the NICU/Nursery people went away with Wiley. On the way out someone shoved him in my face and told me to kiss him. It was the most unnatural display of affection I've ever done.
Sena stayed with me while we waited about 30 minutes for my placenta to deliver. They got me cleaned up and the bed put back together and I refused re-catheterization. I had to sign a form, but Arian had told me earlier that it's more work for the nurses, but I could use a bedpan if they didn't want me out of the bed. Honestly, a bedpan sounded awful, but I'd have done anything to not have that catheter. I had been asking since finding that out if I could do that and got a consistent no, but once that thing was out I was not having it back in. I, of course, didn't mention that I was going to refuse it until it was already out just in case they were evil and didn't take it out if I said that :)
Pretty suddenly, I was all alone. Sena had gone down to the nursery with my phone to take some pictures of Wiley since I'd barely seen him. Sena and Arian left me to rest, and I ordered breakfast and had a shot of Zofran in my IV because I felt so sick and weak. About 2 hours after the delivery just as I got a little settled in, Brandon and Nurse Alina from the nursery came in with Wiley. Alina was great. She told me that his glucose level was low, so she wanted me to nurse him, and his temperature wasn't regulating super well yet, so she got warm blankets and put him skin to skin with me to see if we could get it up. She showed me a nursing hold and how to get him to latch, and we were successful with our nursing start. His glucose went up to 72 from the 30's, so clearly he was getting something. (Ultimately they brought me a pump and had me nursing, pumping, supplementing, and pumping more to get the milk to come in, and we ended up buying milk from the milk bank and renting a pump because they scared me so much that I wasn't going to work properly) and He was still not up to temperature, so she asked if she could take him back to the nursery for a half an hour to warm him in the warmer. I agreed because I trusted her to take good care of him. Brandon and I tried to get some sleep, but I could not fall asleep. Honestly, it felt like I had forgotten how - that's the best way to describe it - because as tired as I was, my mind was just racing and I was so out of it. Alina brought Wiley back, and after that he was never out of the sight of Brandon or me. I still couldn't get up, and I was told that if Brandon left and I was alone, Wiley would have to go to the nursery. I did not let Brandon leave.
Highlights of the rest of our stay:
-Evil freezing cold handed "lactation consultant" Kathy who was the worst of the bunch of crappy pseudo-lactation consultants at the hospital who was extremely mean. She and her icy hands tried to squeeze colostrum or what have you from me and it HURT. Doesn't hurt when I do it. Then told me that my right breast was more mature than my left and my left may never get milk (?) and really I might not be able to nurse because it might take a long time for the milk, which really might never come in on either side. Also that we shouldn't be using our slow-flow nipple on the supplementation bottle because nipple confusion was "just a theory." Oh, and when my milk started to come in, she did her normal feeding time barge into our room and I was very excited because Wiley had nursed a lot and I felt like he got a lot - he was really swallowing - and when I told her that he got a lot she said (I quote) "He's not getting as much as you wish he was, honey." How supportive. I said that I was sure he was doing great. So, as I'm undoing him from that side, she needs to find another thing to be discouraging about, so she said "Well, but remember you have to have a good latch, the nipple shouldn't look flat," and he undid and I showed her my nipple which was perfectly round and totally non compressed because he has a great fucking latch. "Well, that's good, I guess." she says. Then as I was in the process of trying to latch him onto the other side and aghast at what she had just said to me, she then asked if I wanted a drop of my pumped colostrum from the bottle to put on my nipple to get him to latch. I said that I was expressing it onto my nipple and she didn't believe me and I pointed my nipple at her and squirted a whole bunch out (because she totally didn't believe that my milk or anything was there or coming in or had come in, etc), and she was like, "Oh."
I feel completely sympathetic for women who go in and give birth in the hospital and are made to feel as if they cannot nurse or that it is too difficult or that they are in some way defective. I was armed with tons of information, had great outside of the hospital support, but the whole experience was so demoralizing topped off with the fact that I was separated from him for so long after birth that they bring this baby back to me and I never got that, "omg, my baby" thing. I didn't cry when he was born. I couldn't even see him. It was awful. If I had cried it would have been for how scary and hurty and sick it all was. I didn't have the wherewithal to bond with him until much later when the IVs all came out.
-Evil last day pediatrician who barged into the room armed with the knowledge given from the nurse on duty that Wiley had lost 300 grams. He interpreted that as he had lost 300 grams in the previous 24 hours, when it was the total lost from birth to that moment. He didn't bother looking at the chart or anything and basically accused us of STARVING our child. He was EXTREMELY hostile. I had to gather myself from my total shocked silence and tell him to LOOK AT THE FUCKING CHART and see that his weight had stabilized and that we were supplementing with every feeding and that he had tons of input and output because we had to tell the nurses every poo, pee, and how many cc's and minutes at each breast per feeding. In the previous 24 hours he had only lost 8 grams, which was better than 100 the 24 hours before and 200 the 24 before that. He did finally look at the chart, but he never dropped his attitude that Brandon and I were somehow crazy child abusers who refused to feed our child and literally put it in the discharge instructions that we had to have a verifiable appointment at our doctor for him to be weighed both the next day and the day after before we could be discharged. Asshole. For his information, we only supplemented the day we came home. By the next day we were only breastfeeding and by 2 weeks and 2 days Wiley was above his birthweight having been consistently gaining an ounce or more a day. Motherfucker.
-The doctor from the delivery coming to check in and telling us that the milk from the milk bank is useless and that she doesn't even know why they have it.
-The third nurse practitioner in L&D that came in after the birth and before Wiley and Brandon were back and seemed so nice, introducing herself and congratulating me. Then she proceeded to tell me how irresponsilble home birth is and how she would never recommend it or have anything to do with it because it was so dangerous and she had seen so many times when if people hadn't have been in the hospital they'd have died. (well, she works at a fucking high risk L&D hospital, so no freaking duh. Home birth is for normal and low risk delivery - hence me being at the hospital.) And how she'd just feel too guilty if something happened to the baby. I did have the sense at this point to tell her that in peer-reviewed research, statistically home birth and hospital birth are even in terms of maternal and fetal demise. Home birth actually comes out a little ahead. She disagreed. Because she just knows so much. This is how all of our people interactions were, pretty much. Even though my midwife provided NINETEEN PAGES of thorough prenatal records on me and got me to the hospital the moment I became sick out of her abilities, I was getting substandard care and risking the life of me and Wiley. And probably Brandon, because they'd be able to correlate it to paternal issues since it was so bad in their minds.
The whole thing was pretty much the worst and most frightening experience of my life. I have since bonded with the dude, and I love him more than anything in the world, and really I would take all of the poking and the meds and the sick and the scary and hurt so that he could have none. He spent no time in the NICU, he had no tubes, no scary breathing problems - didn't even need oxygen after birth - and was totally healthy. He was tiny and he did lose a lot of weight to start, but he gained it back gangbusters and he eats like a little piggy. I love it.
I am leaving out a ton. There were just so many times that I was ready to pull out my tubes and walk out the door. People were so mean and condescending and the whole thing was just terrifying because rather than the support that they provide to moms who come in on purpose for hospital deliveries, they were all on edge as soon as they walked into our room and they set up an adversarial relationship from the get go.
I am sure no one got this far :) I'm still working on getting over all of this.