Induction

I've already written about going to labor & Delivery Triage on the night of Tuesday, Dec. 8. The next day, Wednesday, Dec. 9, I spent the day at home working and then drove up to Orange County for my old job's Christmas party. I got home from that at about 10 p.m. and crashed. Apparently, Mike and I were both so tired that we slept through the alarm that was supposed to wake us in time for my 10 a.m. OB appointment, because we woke at 9:50 instead! Rushing, knowing we HAD to make the appointment because of my L&D Triage experience a couple of nights before, each of us threw on the clothes we wore the day before and hauled ass to the OB's office. No breakfast, no teeth brushing, no nothing. We also had an NST immediately after the appointment, so we knew we needed to hurry to make that on time, too.

Got to the doctor's office, checked in, were seen. My OB asked us what had been going on and I told her about the Triage visit. She looked at the info in my files, did an internal exam (pronouncing me slightly dilated and effaced), looked at the swelling in my feet (which was pretty heavy, if you ask me), and, oddly enough, checked my reflexes. She tapped my knees and my legs sprang out. I asked if that was good and she said no. Then she said she wanted to run some tests on me and to go to the lab after the appointment to have some blood drawn and to give a urine sample. She said not to leave the NST until she'd seen the test results.

We got to the hospital, which is where the NSTs are done, and did the test. Our nurse had the doctor on call in the NST lab look at the results of the blood and urine work and he said we were fine and could leave-- this time. Mike and I walked out of the office talking about how crazy it is to think about one day coming to the hospital and being told, "sorry, we're going to keep you here." We'd just gotten to the elevators when the NST nurse came running after us, calling my name and saying my OB had called just after we left and that the results weren't good and that she was going to induce.

Yup, that's right. Induce. Right then, right there. No leaving the hospital, no going home. Do not pass go, do not collect $200. Just go to the L&D ward and have a baby.

I was 35 weeks and 5 days along.

I was in shock. Total shock. I got scared and teary. We went to the check-in area and signed some papers and were able to convince a very nice admitting staffer to let us go get some lunch, given we hadn't had breakfast and didn't know how long anything would take. Mike wanted to go out somewhere but I said we should just go to the cafeteria and eat there, so that's what we did. While there, we made some phone calls. I called the dog sitter, who fortunately was able to come and get the dog and watch him, and Mike let his family know. I sent a text message to a few friends, but held off on telling my family because it would have been extra stress I didn't need or want.

Once lunch was done, we went back upstairs to L&D and were settled in "High Risk 1." I stripped down and they put an IV in me to run pitocin and miso-something or other to bring on labor, and magnesium sulfate, which was to ward off seizures. My OB came and explained that some of the levels associated with my liver were off, that my blood pressure was up, and that the edema in my feet and jerky reflexes were signs that I was pre-eclamptic. The mag sulfate was to warn off seizures, which is what happens when you become eclamptic.

I sent Mike home to get some stuff, giving him a list I'd made out at lunch of things I wanted/needed. Camera. Socks. "What to Expect When You're Expecting." Random stuff. It was very strange because we had no idea how long we'd be there, and I hadn't paid much attention to the "what to pack" info in any of my books because we still had a while. (Ironically, one of the things I'd planned to do during the weekend was to pack my bag.)

Thursday went by pretty slowly. At 4 p.m., I was 1 cm dilated andd 50 % effaced. I tried to sleep when I could because I knew I'd need the energy for labor. People kept coming in to take my blood pressure and vitals. At 9 p.m., I was still only 1 cm dilated and 50% effaced.

Later, like 1 a.m. (I think) Friday morning, we were moved to "L&D 10," a labor and delivery room that would be our home for the birthing process. Mike was with me and slept in a chair that sort of reclined into a bed. I was dilating and effacing very slowly. At 8 a.m. on Friday, they broke my water. I was concerned because of the velamentous cord insertion issue, but it was fine and there were no problems. The water breaking should result in stronger contractions, they said. That happened, but they still weren't very strong and I was still not moving along well.

At 6 p.m. on Friday, we were at a decision point. Should we keep going with the pitocin or do a c-section? By that point, I was on internal monitors to monitor the baby's heart rate and the strength of my contractions. The pitocin was being given at "10," the highest level they usually use, and it clearly wasn't doing much. My contractions were regular, but they weren't strong enough to be considered "active." At the same time, because of the baby's size, the OB was seeing some swelling of her head, which is sometimes a sign that the baby is too big to be pushed out vaginally. So that was another thing in favor of doing a c-section. I wanted to try to do it vaginally, but didn't want to have it get to a stress point where they'd need to do an emergency c-section. The doctor who was with us (not my OB) was amazing and really wonderful. She presented us with our options, which included upping the pitocin up to "30" if the baby would tolerate it. Mike and I decided that's what we would do, and we agreed with the doctor that we'd give it another 2-4 hours to see if that would work. Every 1/2 hour, they would bump up the amount of pitocin. Eventually, I got up to 4 cm dilated and we called in the nurse anesthetist to give me an epidural

The epidural was a godsend. It made everything so much easier (though Mike's use of the breathing technique we learned in childbirth class was nice, it wasn't as nice as the epidural!). The drugs had worked and I was definitely in active labor and was feeling the contractions, which were pretty intense. It was a relief to feel numb except for some pressure, and to be able to push a button for additional pain blocking power every 10 minutes as needed.

(Side note: scariest experience during labor came just before the epidural was done. The baby's heartbeat dived and everyone sprang into action. I've never seen people move so fast. They demanded I roll over onto my side and started doing something or other. In a weird twist, I was so out of it because of the mag sulfate-- which induces stupor in most people-- that I wasn't even fully aware of what was happening and couldn't understand why all of a sudden everyone was yelling at me to get on my side. As it turns out, they weren't sure if the baby's heartbeat really did take a dive or if it was a monitor issue or what. But it was pretty freaky.)

Finally they did another check and I was 8 cm dilated, 100% effaced. It felt like a huge victory. That was sometime Friday night. Then, later, I felt the urge t push and told my nurse. She told me to hold off on pushing and started to get a bunch of things ready and to call the doctor and to do all these things. It felt like she was taking FOREVER. All I wanted to do was bear down. When I finally was allowed to start pushing, the nurse took one of my legs and Mike took the other. Mike did the count (1-10, signifying how long to push) and each contraction, I'd do three pushes. The first one was relatively easy and I always started off strong. The next two were progressively harder to exhale for 10 seconds apiece and to push for 10 seconds apiece. The contractions were about every three minutes, and I pushed for about 1 hr, 45 minutes.

During the pushing, they would tell me, "oh, we can see the head!" or "she has lots of hair!" and things like that. They asked if I wanted to see the head and I said no, and they asked if I wanted to watch the baby crown and I said no. I pushed and pushed and pushed. When her head came out, I could definitely feel A LOT of pressure and knew it was coming out. The OB was there then (the 4th of our nearly two-day labor experience) and he had his hands inside of me as well. Thank God for the epidural. Once the head was out, then came the rest of the body, and at 12:17 a.m. on Dec. 12, 2009, Michaela was born.

(Because she was born on Saturday morning, she made it to 36 weeks. Still 1-4 weeks from "full term," though.)

I couldn't see it, but Mike said it was amazing to watch. I found it really fascinating and cool that my body just knew what to do.

The nurse took the baby to a different part of the room to administer the APGAR test and all of that and Mike stayed with me for a minute before going to be with the baby. In the meantime, the placenta didn't come out in one piece, so the doctor had to manually sweep my uterus to get it all out. It's really important that the entire placenta be delivered (or removed) because it signals your body that the baby has come and leads to all sorts of metabolic and hormonal processes for mom and baby. The OB also stitched me up because I tore as the baby was coming out. That was NOT pleasant and I hit the extra pain medicine button multiple times during each of those procedures.

Once the baby was done being checked out-- and I have no idea how long that took-- they brought her over to me and I got to hold her on my chest. She was so amazing. Not small at all, in spite of being premature. She weighed 7 pounds, 8.3 ounces (which makes me wonder how big she would have been if she'd stayed in another month) and was 20 inches long. She has a head of dark, soft, beautiful hair and sort of slate-blue eyes. Her feet and toes are long, and her hands are tiny.

People cleared out and then it was just us and the nurse. I can't remember where the baby was after that. Things were such a blur. We were in the room for a few hours before being moved to a room in "Four North," the high-risk L&D recovery unit. Fortunately, we had our own room. This was huge because one of the things I was dreading about Kaiser was having to share a room with another woman and her partner and their baby plus Mike and my baby. It became even more important later, because we ended up having to stay in the hospital a long time. (More on that in another post.)

I'm sure there's more, but this is all I can remember right now. Funny how a doctor's appointment turned into having our little one.