Sunday, April 12, 2015

Maverick's Birth Story

My birth plan was simple. 
So simple, in fact, that I didn’t even give a copy to my nurse because we didn’t want to jinx anything. All of my wishes were the standard of care for the baby-friendly birthing center that we chose for our delivery. The plan was to deliver our son naturally and vaginally at the birthing center with dual care from an OB and midwife. We enlisted the help of a doula and hoped to utilize the birthing tub for hydrotherapy during my labor for pain management. After our son was born, I hoped to have delayed cord clamping, skin-to-skin time and have him room-in with us so that I could start breastfeeding. 

But nothing about our son’s birth went according to plan. When I wrote my birth plan, I knew full well that it was nothing more than a list of wishes for my labor. But it was still disappointing when none of them happened. 

It’s normal to have a plan. Even if you know that you ultimately have no control of how things turn out. It’s natural to have hopes that things will go a certain way. Just like when you do a fertility treatment cycle. No one plans to get a cyst, have a cancelled cycle, not respond to stim meds, have a low number of follicles, etc. But sometimes, things don’t go as planned. 

In week 38 of my pregnancy, I developed (PIH) pregnancy-induced hypertension and severe edema. As a result, I was placed on full bed rest and had to monitor my blood pressure levels daily. Every few days, my blood pressure would spike higher requiring a trip to the doctor’s office or birthing center for monitoring. The monitoring usually consisted of blood work, urine analysis and a non-stress test for the baby. The doctors were watching me very closely to make sure that I didn’t develop full-blown preeclampsia. 

After almost 3 weeks of the continued rise in BPs, we arrived at the birthing center at 1pm on 3/25 (at 40 weeks and 6 days) and the medical team decided it was time to admit me for an induction while we still had the time. Preeclampsia was close at hand and I don’t think the OB wanted to take any chances. The doc did a cervical check at 2:30pm and found that I was only 1 cm dilated, -2 station and 40% effaced. They administered a dose of Misoprostol at 4pm to get things going. Contractions began. My water broke with meconium staining at approx. 11pm that evening. 

At 5am, A called our doula to come to the hospital to help as my contractions were beginning to get more difficult. At 7:25am, the midwife ordered labs to check for preeclampsia and an hour later sterile water papules were administered to help me manage the pain. 

Around 10:15am, my contractions began to space out (5-6 minutes apart) and the doctor and midwife decided to administer Pitocin to better control my contractions and get them closer together. At 1pm, the midwife checked my cervix and stated that I was 4cm dilated, 80% effaced and -1 station. She also mentioned that she could see black hair on the baby’s head. As the Pitocin was increased, I had more difficulty handling the contractions. By 2pm, I needed an epidural. I was so bummed because I felt like a failure. My doula reminded me that Pitocin contractions are much more harsh than natural contractions. There aren't many people that could handle the intensity without drugs.

Over the next few hours, the doctor continued to increase the Pitocin until our baby’s heart rate started to decel. They increased the dosage and then the baby’s heart rate would dip again. This cycle continued until 8pm when blood work was drawn again and a cervical check showed that I was 6cm dilated, 80% effaced and -1 station. An IUPC (intrauterine pressure catheter) was placed to more accurately monitor the strength of my contractions if baby’s heart rate continued to dip. 

My lab work came back fine but my blood pressure was very sporadic – ranging from 153/106 to 95/56. The doctor continued to increase the Pitocin throughout the night and ordered blood tests and urine tests to monitor for preeclampsia.

At 6am, the OB found me to be 8cm dilated, 90% effaced and 0 station. She suggested we turn off the Pitocin to let my body rest and then start it back up again at 8:30am. The Pitocin was steadily increased throughout the day to the max dose. 

I was checked again at 1:30pm. The doctor felt that if I was complete, I could start pushing. If I had not progressed since my last exam and my contraction pattern was not effective, it was time to move onto a C-section. I had not progressed - still 8cm after another 8 hours of Pitocin-induced labor. 

To my dismay, I was prepped for surgery. Accepting that I needed a C-section was difficult but I was exhausted and knew that my body had had enough and wasn’t going to cooperate. I’d already been in hard labor for two days trying for a vaginal birth. 

Unfortunately, I don’t remember much about the C-section except that I felt like I wasn’t really there. The doctors were retrieving my son on the other side of the curtain and I was on the outside. Separate from this event. Then when my baby was born, he was immediately whisked across the room for examination. I couldn’t really see over there and didn’t know what was going on. However, my husband later told me that he had to stand by and watch our son turn blue and stop breathing 5 minutes after birth. 

Once baby Mav was stabilized, he was taken immediately to the nursery. No skin to skin. I didn’t even get to see his face. Hubby went with our baby and I was left alone. I didn’t know what was going on and whether my baby was okay. 

The next few hours were extremely hard emotionally because I had to lie there and get stitched up, then wait in recovery until the meds started to wear off and then wait until my postpartum room was ready. Hubby eventually came in to tell me the concerns the doctors had with Maverick. 

My bed was finally wheeled into the nursery so that I could see my son for the first time. It was such an emotional moment. Seeing his face and holding him was like no other feeling in the world. My heart swelled with love for this tiny little being. I just wish I could say that I remembered it more clearly but I was in a fog of exhaustion and worry. 

Instead of rooming-in as planned, Mav had to stay in the nursery overnight for observation. 

Apparently, Mav wasn’t able to ingest the colostrum that I had pumped the night before and was given the food via feeding tube that morning. At that point, we were told that he would be transported to UC Davis Children’s Hospital NICU to get the help he needed to breath and eat. 

A and I stayed in the nursery holding him all day. Thankfully the hospital staff allowed me to stay in my hospital bed in the nursery with my son until the paramedics came to transport him to the NICU. It broke my heart to see him get carried away in that incubator with all of the monitors and IV. My precious baby, less than 24 hours old, was being carted away from me to another hospital. Hubby followed behind the ambulance in his truck to be with our son. I was left behind to recover from my C-section. 

Post on baby's stay in the NICU…coming soon. 

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