Tuesday, July 13, 2010

Birth Story - Part II: Laboring at Hospital

Continued from Part I: Laboring at Home. Sorry it has taken me so long to get this one out, it was a doozie to put together. I was very fortunate in the sense that I had a ton of help capturing my birth story. Every nurse, midwife, mother, doula and husband took turns journaling, photographing and videoing the entire birth from beginning to end. Being able to put all of this info together would not have happened without all their time and effort considering what a marathon birth experience this ended up being. It was like putting a puzzle together lining everything up in a timeline, but now I will have a birth story to reflect upon and someday share with my little guy. So thank you to all that helped me in this effort.

Part II goes through a very long process of laboring at the hospital. I've hesitated posting the following photos and videos as labor was not very kind to me and I gradually swelled up like a beached whale, but this is reality so I decided to share all (minus the x-rated ones of course). Enjoy!

Tuesday June 22, 2010

1:30 pm
Arrived at hospital. Filled out paper work and moved into room. Contractions slowed way down during car ride, I guess due to being stationary instead of moving around.

2:00 pm
Hooked up for 1st session of intermittent monitoring and BP check. Baby doing great.

Video Diary - Getting ready to be checked:
video

2:20 pm
1st cervix check, about 8 hrs into labor. The midwife spent quite a bit of time "up" there with me yelling in pain. She said I was only 1 cm dilated, ONE! Crazy after I spent all these months worrying that my cervix wouldn't hold up due to a leep. She then said I was 3 cm after the check as she broke up a bunch of scar tissue from the leep. That explains why it hurt so bad. She said I was 90% effaced and -1 station.

2:45 pm
The nurse put an IV in. She blew a vein on the 1st try and succeeded on the 2nd try.

2:55 pm
First dose of IV Penicillin. This is for group B strep which is a bacteria that lives in the intestinal tract in about 40% of adults. It is completely harmless to adults. While it is very rare for a baby to catch this during delivery, if they were to catch it, it can have devastating results such as meningitis or even death. They give Penicillin in your IV every 4 hrs if you are in active labor or if your water has broke.

Video Diary - About to get 1st dose of Penicillin:
video

3:45 pm
Contractions stalled after laying in bed for intermittent monitoring and Penicillin. Given an IV hep lock. Started walking the halls with my doula. Contractions picked up significantly with walking. I had to stop and hang on the wall rail and sway during contractions to get through them.

4:20 pm
Doula suggested getting in the shower to help with the pain. Kerry sprayed my belly and back with hot water. It really did help. I wanted to sit down so bad but had to keep standing and swaying as my contractions would slow way down every time I sat down.

Getting ready to get in the shower as I held onto the sink trying to get through a contraction. Wowsa, I'm looking HOT!!!

Video Diary - About to get in shower:
video

4:55 pm
Intermittent monitoring and BP check. Baby doing great. Swayed on birth ball.



Video Diary - Getting monitored:
video

Video Diary - Our room:
video

5:30 pm
Got in labor tub. All I can say is a-w-e-s-o-m-e!!! I would have gladly stayed in there for the rest of my labor and given birth if they would have let me. Unfortunately the midwife made me get out because it relaxed me too much and once again, my labor stalled.



Video Diary - Laboring in the tub:
video

6:15 pm
Walked the halls with my doula again. Contractions picked up and became very intense. I didn't even care that everyone in the halls stared at me while I silently grimaced through them while hanging onto the rails.

Walking the halls with my doula and barf condom:

7:00 pm
Got in bed for 2nd dose of IV Penicillin, some more intermittent monitoring and BP check. Baby still doing great. Midwife came in to talk to me about my progress, or lack of. She suggested Pitocin to get my contractions stronger and more consistent as my water had been broke for 12.5 hrs and I just wasn't making good progress. She said it was up to me and that she wouldn't push it if I really didn't want it, but if I was willing, she promised to start out at 1 and only increase when needed. This was not what I wanted to hear as I knew the Pitocin would significantly increase the pain. I declined and asked for a little more time to think it through.

My doula prepped me to try and get some sleep. You could always tell when I was having a contraction as I gripped the bed rail.


Back up and leaning on Kerry to get through a contraction:

8:37 pm
Midwife came to see what I decided. I surprised every one in the room by stating that I wanted an epidural. My reasoning was that I was exhausted, in a lot of pain and the pain would only significantly increase with progress and Pitocin. I was at peace with this decision as I went all natural for 14 hrs and gave it my best.

Video Diary - Calling "Uncle":
video

8:45 pm
Anesthesia arrived to put in the epidural. I sat on the edge of the bed leaning into a pillow. He cleaned my back with iodine and put a drape over it. He gave an injection to numb the area. It was just a little sting, no big deal. He then inserted the catheter. I didn't feel a thing. He injected a bolus of anesthetic. I felt a cooling sensation and within 15 mins, I was numb. I could still move my legs, but they were heavy and tingly. Continuous monitoring and BP was started.

Video Diary - Post epidural:
video

10:38 pm
Pitocin started at 1 unit (max is 20).

10:45 pm
3rd dose of IV Penicillin.

11:15 pm
The nurse came in to insert the foley catheter to keep my bladder empty. I yelped in pain with every little push of the catheter. The nurse was really surprised I was able to feel this with an epidural. I told her I could feel everything in my girl part, even cervix pain. She asked if she could keep going in hopes that the burning pain would subside once in the bladder. I agreed to it. Even after all the way in, the burning was so bad, I just couldn't handle it and yelled for them to remove it immediately. The nurse promptly pulled it out.

11:30 pm
Pitocin bumped up to 2 units. Had consult with anesthesia and the midwife to discuss the pain. The epidural had numbed me from chin to the tip of my toes, but had no affect on my girl part whatsoever. The epidural was helping with abdominal contraction pain, but I could fully feel my cervix. They had never seen this happen before. Anesthesia went to consult with the head of anesthesia.

Wednesday June 23, 2010 (due date)

12:00 am
Pitocin bumped up to 3 units. The epidural seemed to be wearing off as contractions were becoming more and more intolerable.

12:40 am
Pitocin bumped up to 4 units.

12:55 am
The midwife insisted that I have the catheter inserted as my bladder needed to be emptied. A full bladder will delay progress. I begged them to not reinsert it and asked for a bed pan. They let me try. They put the bed pan under me and within a couple of mins, I practically over-filled it. They were shocked, said they had never seen someone be able to urinate on their own with an epidural. Since I could feel everything in that area, it wasn't too hard.

1:23 am
Anesthesia arrived to inject a 2nd bolus of anesthetic in my epidural. This took away the abdominal pain, but I could still feel my cervix and girl part.

1:40 am
Pitocin bumped up to 6 units. Having bad heartburn.

2:00 am
Kerry, the doula and I all went to sleep.

2:30 am
Pitocin bumped up to 8 units. Heartburn getting really bad.

2:40 am
Pitocin bumped down to 3 units.

3:30 am
Nurse came in to check on me. She asked how I was doing and I said I felt nauseous. Within seconds, I started throwing up violently. The nurse was trying to catch it in this little basin. It just kept coming out, at least 6 times. This awoke Kerry and the doula. Kerry said it was quite a sight to wake up to a side view of me projectile vomiting. He grabbed a wash basin and helped try to catch it. When it was over, the bed and I were covered in vomit. The nurse, doula and Kerry changed me and the linens. I now felt better.

Video Diary - "Mmmmm... good toothpaste!"
video

3:45 am
2nd cervix check, about 21 hours into labor. Only 5 cm!!! 100% effaced and 0 station.

4:54 am
Nurse attempted to reinsert the foley catheter. Same thing, horrible burning pain and they ended up removing it. Successfully peed in bed pan.

5:00 am
Pitocin bumped up to 8 units. Trying to get contractions stronger and more consistent.

5:30 am
Fetal heart tones dropped. Midwife and nurse rushed in, turned off the pitocin, put an oxygen mask on me, rotated me to my side and turned the IV fluids up. Baby recovered quickly.

6:45 am
Pitocin restarted at 4 units.

7:15 am
Zofran put in my IV for heartburn and nausea.

7:30 am
Peed in bed pan.

7:45 am
Pitocin bumped up to 6 units.

8:27 am
Peed in bed pan.

8:37 am
3rd cervix check, about 26 hours into labor. Everyone was on pins and needles as we knew I had to have made significant progress or I was facing a c-section. 9 cm!!! Just a small cervical lip left and +1 station. Everyone in the room erupted in joyful tears.

So so swollen!

More to love!

9:20 am
Epidural failed again, anesthesia is tied up with an emergency c-section. After spending an excruciating hour in transition with no pain relief, anesthesia finally arrived. They injected a 3rd bolus of anesthetic in my epidural.

Poor legs and feet sooooooooo incredibly swollen!!!

My legs are buried somewhere in there!

Video Diary - Transition contraction with epidural worn off:
video

9:50 am
The midwife discussed her concerns regarding my last cervix check. She said the baby's head is coning, meaning his soft spot was coming down, but his skull was not. She's concerned that he may be too big for my pelvis, or he's not facing the right direction to descend. She asked if I would consider a c-section. I asked if there was anything else we could try first since the baby wasn't showing any distress. She said absolutely and that she would go consult with another midwife.

10:10 am
Midwife came in to discuss the next step. They want to insert an intrauterine pressure catheter (IUPC) to evaluate the strength of my contractions. They know that my contractions are strong enough to dilate my cervix, but they need to find out if they are strong enough to bring the baby down. If the contractions are strong enough and they see descent, great, then we continue on. If we don't see descent, then they feel it's time to say we gave it our best shot and for whatever reason, this baby is not coming down and we need to consider a c-section.

She then asked me if I would be willing to sign a consent for a c-section just in case we ended up in any kind of emergency. While baby's heartbeat was fine, if it dropped down and didn't come back up, they would need to go straight to c-section. I signed and then anesthesia came to talk to me about pain management for a c-section. He said that my current epidural would be used, but if it did not provide the pain relief needed, they would have to put me under. I asked him how long an epidural should last and he said it should last the entire labor/delivery. Considering that the epidural has already failed 2 times and has no effect on my girl part/cervix area, having to be put under and missing the birth of this baby was a very real possibility. I became very determined to do whatever it took to help get this baby out vaginally as long as he was in no distress.

I had been stuck lying flat on my back, so I asked if we could move the bed into a supported squat position to see if that helps. She said absolutely.

Kerry asked what we needed to be believing for and the midwife said for his head to turn and descend. She also said that while baby is doing good, we don't know what his threshold is. He's getting tired and not loving the Pitocin. When the Pitocin gets to a certain level, they have to turn it down. That doesn't surprise me since Pitocin contractions are much harder on mom and baby than natural contractions. We asked if it's risky to continue on and she said they would watch him closely and let us know if they start to see heart decels. She then said when your water breaks and there's no real active labor, that's a hard thing to get back from and that medical intervention just doesn't do as good as the body does naturally.

Pitocin bumped down to 4 units.

Exhausted!

10:15 am
Midwife attempted to insert an intrauterine pressure catheter (IUPC) to evaluate the strength of the contractions. She couldn't get it inserted.

10:20 am
4th cervix check, about 28 hrs into labor. 9+ cm dilated, smallest cervical lip left. Head lower but still a +1 and facing posterior (forward).

10:30 am
Midwife came in and said that the IUPC needs to be inserted for a correct picture of if the baby is making progress.

Family came in for a few mins to provide some support after waiting in the waiting room since yesterday. This is the supported squat position. I think they were disturbed by how swollen I was.

I'm almost disturbed seeing myself, I look like I have a sumo wrestler suit on under that gown!

10:52 am
A different midwife arrived and reinserted the IUPC successfully. She rechecked my cervix (5th check). 9.5+ cm, small anterior cervical lip left, baby is -1 and traverse (facing right), that's progress!

11:00 am
Midwife repositioned bed to tilt me head down. Their hope is that gravity will release some of the pressure of the baby on my cervix and allow the baby rotate into position. Kerry and the 2 moms held my arms down for an hour so I could get some sleep. My arms were shaking uncontrollably from all the IV meds and was preventing me from falling asleep.

11:20 am
Nurse reinserted foley catheter 3rd time. Very painful. Drained 400 cc.

11:30 am
Applied ice on perineum for pain caused by foley catheter.

11:50 am
Foley catheter pain unbearable, nurse applied Lidocaine to numb the area. Didn't make a difference, catheter removed.

11:58 am
Monitor - Baby's heartbeat at the top and my contractions at the bottom:


12:10 pm
Midwife repositioned me into an upright position. Temp 98.2. Epidural has worn off again, asked for anesthesia.

12:30 pm
Pitocin bumped up to 12 units. BP at 127/71. Midwife placed me in a pretzel position which the baby doesn't like, in hopes that the baby will rotate. Waiting for pressure to push.

12:35 pm
Anesthesia injected a 4th bolus of anesthetic in my epidural.

1:06 pm
Pitocin bumped up to 14 units. IUPC monitor showing contraction strength of 140-160. Needs to be 200+ in order for contraction to be strong enough to push baby out. Midwife said we have 1 hr to make major change or it's time for a c-section. I asked the nurse if there was anything we could do to get my contraction strength up to 200. She gradually increased my pitocin till it was at 18 units.

2:10 pm
Midwife came in to check me. My last 3 contractions were finally over 200, whew! She performed my 6th cervix check, after about 32 hrs of labor. We all sat on pins and needles waiting for the verdict. We all screamed and cried when she announced I was finally at 10 cm!!! She continued checking for quite awhile and then said that she just didn't think he was going to come out this way. While he did rotate some, he was only facing 1 side instead of my spine. She suggested that c-section would be the best next step and to know that I did everything I could. I was crushed. I had worked soooo hard to get to 10 cm. Everyone in the room was very supportive and kept telling me I did everything I could and that it's ok. I cried and cried, you have got to be kidding me, a c-section after 32+ hours of labor and finally getting to a 10???

To be continued...

15 comments:

  1. Wow Jill, amazing birth story. It is amazing what our bodies can go through and recover from. I'm so glad you have such an amazing support system. What a painful 32 hours! I can't wait to read the rest of your story!

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  2. You are one brave woman and I can't wait to hear the rest of this dramatic story.

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  3. That is some heck of a birth story so far! Thanks for sharing!

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  4. Oh my goodness! This is crazy! I can't wait to hear the rest!

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  5. OMG! Cliffhanger!! Even though I know a baby comes out of this in the end....OMG, what happens next????

    You are a rock star, a trooper and an amazing woman.

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  6. Ugh. I was hoping it was going to be easier from the nice start you had!!! I also couldn't handle the foley catheter and was crying in pain that I had to urinate so badly, but they seemed to think it was because as soon as they broke my water and I got an epidural, I progressed so quickly so they didn't realize the baby's head was pushing on the catheter in my bladder...I wonder if it was something similar. And, even with the epidural, boy was it painful at the end there!!! Your birth experience doesn't sound ideal, but I don't think any of them really are...and you have quite the beautiful end result!!!!

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  7. Oh my goodness...you poor girl. I can't even imagine going through all of that.. Why did you swell so bad? Was it from all the IV fluids? I too can't wait to hear "the rest of the story"....I already know the end result...you got your beautiful little miracle. I know how crazy and exhausting it is to have a newborn in the house and can't wait to hear how all that is going!

    love ya!

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  8. WOW! Very exciting labor story...I felt so bad seeing you in so much distress, but it helped knowing you had a wonderful outcome! I was pacing at home too and what a relief when your Mom called and said you and Tyler were doing great! My labor days were very long too and Julie was delivered the normal way, but Lance was delivered by c-section after 20-some hours of hard labor...I was VERY mad! I'm glad you had him natural, if that's how you'd put it! Actually, I think there's nothing natural in child-birth! Thanks for the exciting play-by-plays! Love you all...Aunt Carol xo

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  9. I'm SO thankful that we know there is a happy ending to this birth story!! YOU POOR THING!!! You are really to be commended for your persistence and stamina. Way to go, Mommy!!!!

    LOVE the detailed post. You are so good to have kept all this together (with help). Kudos.

    Can't wait for the happy ending and more pics of Ty!

    Love,
    The Other Jill

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  10. Nooooo - don't leave me hanging like this! Love the narrative. You're a real trooper. I'm surprised they didn't decide to try redoing the epidural to see if it could cover the cervix and girly bits. Totally weird - I've never come across anything like that in my (short) career!

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  11. Jill, I cannot believe you left us hanging!!! But I'm glad to know that at least your adorable little man is here, however your story ends! I'm sorry you had to go through SO much, but it sounds like you did an AWESOME job. I can't wait for part 3! Come on girl, get it posted! I'm on pins and needles!

    And post more pics of your punkin, too!!!!!!!!!!!!!

    *hugs*

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  12. Ack! How can you leave us hanging like that?!!

    So far though, what a birth story girl! I cannot believe how long it went on for and you do look so swollen under the blanket. I can't believe that you were numb from your chin to your ankles but could still feel your girly bits although I now wonder if that is kind of what happened to me as I could feel everything going on down there. However, when they topped me up, I did lose sensation down there eventually so maybe not the same thing. You are a real trooper though and I can't wait to read the rest of your birth story!

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  13. OMG you're leaving us hanging!!!

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  14. I left a comment and I see it's not here, so I am trying again. I have relived this birth in my mind..over and over. At times I can't even sleep... it was a very exciting time and I am so happy I was able to be part of this.
    I am very happy to be Tyler's Grammy.
    Love you as big as the sky... Mama

    PS I LOVE THE VIDEO'S

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Thank you for your comment! Hugs, Kerry and Jill