Tuesday, June 21, 2016

Birth Story

Typically, I don’t like to share birth stories. To me they are deeply personal and I don’t really like to talk about it. We have had scary complications with other deliveries, but this is the only one I feel compelled to tell because there are clearly so many tender mercies. It is a miracle that this baby survived and I want people to see how closely Heavenly Father works in the lives of His children because He loves us so much.

The paper on the table rustled as I sat up after my 39-week exam.
“You’re a centimeter dilated and about 50% effaced,” the doctor said.
“Ok,” I replied. The information met my expectations. This was my fourth pregnancy and I never dilated until I had been in labor for quite a while. Typically, I dilated to a three on my own and then needed an epidural to progress any further.
“Are you interested in scheduling an induction? I can get you in quick. I just scheduled my previous patient for tomorrow morning.”
“No,” I answered. “I’d like to give my body as much time as possible to go into labor on its own. If I haven’t had him by my due date, then I’ll schedule an induction for 42 weeks.”
The doctor studied me for a moment. “You know, we are currently participating in a major study which has found that NICU admittance for newborns increases drastically after 40 weeks gestation. There’s no point in waiting.”
“I’d really rather not schedule yet,” I insisted.
“Well, let’s not worry about it until your 40-week appointment,” he said, letting the issue drop. “Do you have any other questions or concerns for me?”
“No.”
“Then we’ll see you in a week.” He shook my hand and left the room.
As I dressed and gathered my belongings, I felt slightly irritated by the pressure to induce and resolved to insist on a 42-week induction at my next appointment. It would be with a different doctor and I knew that some were not as adamant as others about how things should be done. My previous baby had been induced at 12 days overdue by an OB/GYN with the same practice.
Three days later my Saturday due date came and went. It wasn’t surprising, but knowing I would be overdue because I always had been didn’t make it any easier to endure. On Monday I learned that a woman due a week after me had already had her baby, which made every passing minute with no sign of labor even more difficult and frustrating.
I attended my Tuesday evening cub scout meeting with reluctance, wishing I’d had my baby so I could miss it. After the meeting I walked home and helped my husband put our three boys to bed. Then we settled on the couch for our evening ritual, a show and some ice cream.
During the show I began having regular contractions. They were about seven minutes apart and strong enough that I wondered if I should skip the gigantic banana split my husband had served up for me. I ate it anyway. By the end of the show, my contractions were about five minutes apart but not painful or close enough to warrant a trip to the hospital. Before going to bed I texted my mom to let her know I might need her during the night to babysit.
The contractions continued all night, very gradually getting stronger but not any closer together. I didn’t sleep much, too focused on timing contractions and analyzing my pain levels and cleaning the house so it wouldn’t be filthy when my mom came over. At 6 AM as my husband got ready for work, I wondered if I should just have him stay home, but I still didn’t feel ready to go to the hospital. Instead, I sent him to work and told him to keep his phone on so I could call him home when it was time, expecting that he would only be able to teach one class before he had to return. Sometime later, he texted me to let me know he had taken the next two days of work off and requested a substitute to cover his classes.
As I got my kids ready and drove them to school, my pain was bad enough to make me feel shaky and nauseated, but the contractions were still only 5 minutes apart. When I got home, I called my mom and asked her to come take my third boy to his speech therapy class as I didn’t think I would be able to concentrate enough to help him through the therapy.
When my mom and youngest boy returned from the therapy class, we proceeded to try to make my labor progress. I did household chores and we went for a walk around the neighborhood. By lunch time it was clear that my labor had stalled. My contractions had spaced out to 10 minutes apart and the pain was much more manageable.
Fortunately, my 40-week appointment was scheduled for that afternoon at three. I went to it feeling very frustrated. I was four days past my due date. There was no reason I should be having Braxton-Hicks contractions now. It should be the real thing.
The nurse sat me down and took my blood pressure. It was 156/90, unusually high. Throughout my entire pregnancy my blood pressure had always been around 120.
“I’m going to need a urine sample,” she said and handed me a cup.
After I provided the sample, the nurse put me in an exam room.
When the doctor entered he asked, “How are you doing?”
“I’ve been contracting for about 15 hours,” I explained. “They were five minutes apart all night and most of this morning, but now they’ve slowed down quite a bit.”
“Five minutes apart all night and you didn’t go to the hospital?” he asked, surprised. “You’re certainly not an alarmist.”
“No,” I agreed with an amused smile.
“Let’s check and see if all that work has done anything.” As he examined me he said, “You’re three centimeters dilated and 90% effaced. I’m going to strip your membranes to see if we can get you going again. The more aggressive I am, the more effective it will be.”
“Ok,” I said.
Once the procedure was completed, he helped me sit up. “I expect we’ll see you in the hospital in an hour or two, but if not, just err on the side of caution and come in even if you’re not sure if you need to.”
“What about my blood pressure?” I asked. “The nurse said it was high.”
“There’s no protein in your urine so it’s not preeclampsia and it was just the systolic that was high, not the diastolic. I’m not worried about it. But when you go into the hospital, tell them that it was high.”
“Ok,” I repeated.
“Why don’t we go ahead and schedule an induction for tomorrow morning just in case nothing happens?” he asked.
Just a week before I had been insisting on an induction two weeks past my due date. But knowing that my husband had already requested a substitute and taken the next two days off and remembering the previous doctor’s comment that NICU visits increased so dramatically, I agreed to the induction. That way my husband wouldn’t have to miss Thursday and Friday and then even more days two weeks later. The doctor called the hospital and scheduled me to be induced the next morning at 6:30 AM.
Back at home my mom and I waited to see if having my membranes stripped had helped my labor progress. The contractions were harder and more painful but they were still hovering around seven to ten minutes apart. My husband returned from work and we proceeded to prepare dinner.
“I should go home,” my mom said. “My family will be hungry too, but I can stay if you want me to.”
“I don’t know,” I said. “I’m just not sure if this is going to go anywhere.”
“Well, it’s up to you,” she said. “If I leave and then have to turn right around and come back, that’s fine.”
We debated whether to send my mom home or to have her stay and never really came to a conclusion, but she ended up eating dinner with us. After dinner the discussion continued. Should my mom stay with us or go home?
“I just don’t know if it’s the real thing!” I complained. “I don’t know if we should go to the hospital or not.”
“It’s real,” my mom reassured me. “Just go in.”
With her advice and remembering the doctor’s orders to “err on the side of caution”, I finally decided to go to the hospital. At the very least they could check my cervix and see if I had made any more progress.
I grabbed the bag I had prepacked, my husband quickly packed a few things, and we headed off in the car. During the drive I waited anxiously for a contraction, wondering if my labor had stopped completely. One contraction occurred during the trip and another occurred while we were walking up to the hospital that was so painful it was difficult to walk through. But they were so far apart that I was certain we would be sent home.
After signing the paperwork, we were taken to a room on the labor and delivery floor. I took off my street clothes and put on a hospital gown and then climbed onto the bed. The nurse wrapped two elastic belts around my belly with devices to monitor the baby’s heartbeat and my contractions. The baby’s heartbeat was steady but my contractions were irregular with rough peaks and plateaus.
“I’m supposed to tell you that my blood pressure was high at my appointment this afternoon,” I said. “The sist-, the sista-…” I couldn’t remember what it was called.
“The systolic?”
“Yeah. That. Also, I have an induction scheduled for 6:30 in the morning.”
“Ok,” the nurse said. She attached a blood pressure cuff to my arm. “It’s still high,” she announced after the cuff gave my arm a tight squeeze. “Let’s check your cervix.”
When she informed me that I was dilated to a three, my heart sank. I hadn’t made any progress since my appointment. Having my membranes stripped hadn’t done anything. She was going to try to send me home, I knew it.
Sure enough, she said, “We are really busy this evening. Most likely we’ll have to send you home, but your doctor is here. Let me go talk to him since your blood pressure is high.”
As soon as she left the room, I turned to my husband. “Will you give me a blessing? I really, really don’t want to go home.”
“I don’t have any oil with me,” he said.
“That’s ok. I’m not sick.”
“All right.”
I don’t really remember exactly what he said, but basically he blessed me that I would be able to stay in the hospital and have a safe and healthy birth.
About five minutes after he concluded, the nurse returned. “Good news! The doctor said we should keep you. Since you are four days overdue and your blood pressure is high, he thinks we should just get that baby out.”
I smiled in relief but was cheering internally.
“Do you think you’ll want an epidural?” she asked.
“Yes,” I answered.
“Ok. The anesthesiologist is assisting with a couple of C-sections right now. I’ll have him come here as soon as he’s finished.”
“That’s fine. Thank you.”
Around an hour later the anesthesiologist arrived and administered the epidural. Within minutes my contractions became four minutes apart and were much stronger with perfect, tall bell curves.
“Now that’s better,” the nurse observed.
“It has always been that way,” I said. “My labor progresses much better once my epidural is in. Why is that?”
“Sometimes your body can produce hormones that actually fight labor. The epidural allows you to relax so your body can work the way it needs to.”
“Weird.”
“Do you want to do skin-to-skin?” she asked.
“Yes, please.”
“And do you want to cut the cord, Dad?”
“Sure,” said my husband.
She wrote the information on the white board.
Soon after the epidural was in, the doctor chose to give me a dose of Pitocin to help my labor progress even more. Things went along smoothly after that. Occasionally the heart monitor would slip on my abdomen and lose the baby’s heartbeat, but I just had to slide it back into the right spot to pick it up again. At least, that’s what I assumed was happening. Now I wonder if his heartbeat was actually faltering already.
Watching the screen, I was so grateful that I could no longer feel the contractions, which were knife-sharp peaks so high that their tops were off the chart. The epidural was working perfectly. My body was comfortable and pain free, but I could still move my legs easily.
At 11:30 PM, the doctor came in to check me. “You’re dilated to a five and completely effaced. I’m going to break your water now.”
“Ok.”
He inserted the hook and then commented. “There’s not much in there.” He made another attempt. “I still didn’t get much, but that should help things move along. There is some meconium in the amniotic fluid so we’re going to have some respiratory therapists here to help with his breathing. Let us know if you start to feel any pressure.”
It seemed he had hardly left when I began to feel pressure. I waited through two contractions to be sure and then paged the nurse. “I’m feeling pressure,” I announced when she answered her phone.
“Ok. I’ll be right there.”
As soon as I hung up, I noticed that the baby’s heartbeat was no longer showing up on the computer screen. I attempted to slide the monitor back into place but couldn’t get it to pick up anything. Several people rushed into the room simultaneously with the doctor right on their heels. The nurses surrounded my bed while the doctor began dressing to catch the baby.
One of the nurses grabbed the monitor out of my hand and slapped it to my belly. Nothing.
She tried again. Still nothing. Again. Nothing. Slap. Slap. Slap. Nothing.
Her aggression and extra force when pressing the monitor on my belly made me realize that something more could be wrong. Had the baby’s heart stopped?
Nervously I asked, “Should I try rolling onto my side?”
“Yes, try that,” she said.
I turned onto my left side and again she pressed the monitor down several times with no results. The baby’s heart had stopped beating.
The tension in the room mounted significantly though the doctor and nurses continued to speak calmly. Someone started lowering the bed to its flat position. Someone else put up the left stirrup and helped me put my leg in it.
The doctor said, “Let’s get this other stirrup up please.” Then to me, “Push.”
I pushed as hard and as long as I could while the nurses raised the right stirrup and got my leg into it. I felt the baby’s head begin to emerge, but as I ran out of gas, it slipped back a bit. I was dismayed. My last baby had come out with literally half a push and I had expected this one to be easy too.
“Push,” the doctor said.
Again, I pushed. There was no waiting to time the pushes with contractions as was normal. The baby had to come out immediately. Again his head started to emerge and then slipped back when I lost the strength to continue pushing. The emotional pressure was intense. It was all on me to get him out fast enough to have a chance of saving him. Later the nurses teased me about how he “shot out like a rocket” but in the moment when it was critical that he come out NOW, more than one push was excruciatingly too many.
The doctor looked at me. “Do you stretch or tear?”
“Tear.”
“I’m going to give you an episiotomy,” he said.
“Fine.”
He made the cut and then said, “Push.”
The baby’s head finally emerged. “Look here, guys,” the doctor said to the support staff. “He has two loops around his neck and a true-knot in the umbilical cord.” As he spoke, he worked quickly to pull the loops of cord off the baby’s neck.
As he pulled the baby into his lap, I saw my son for the first time. His face was not scrunched up against the brightness of the lights and the trauma of birth. There were no gurgling first cries. His eyes and mouth were closed, his face as still as if he were sleeping, disturbingly composed. Tranquil. Serene. His arms and legs dangled limply. He did not startle as the doctor moved him. He did not clutch tiny fists to his chest. His skin remained gray. His peacefulness was so very, very wrong.
My eyes strained to see the minuscule twitch of a finger or hear the faintest sigh. The room was so quiet. He just wasn’t there.
“Come on, baby! Come on, baby!” I pleaded.
The doctor grabbed the scissors and cut the cord. “I’m sorry. I’ve got to get him under the warmer.” He lifted my baby with two hands and handed him to a second group of people waiting anxiously to resuscitate him.
During the brief second that he lay in the hands of almost everyone in the room, he finally gave a tiny, almost inaudible cough. It was so small that I immediately wondered if I had actually heard it, but the fear washed away and I knew he would be ok. I covered my mouth with my hand and collapsed back onto the bed.
“That was so scary!” I whispered and looked to my husband. He clutched my hand tightly, his eyes full of tears. We stayed there for a time, holding hands, silent, overcome with emotion.
“I’m sorry I didn’t let you cut the cord,” the doctor said. “I needed to get him under the warmer.”
“That’s fine,” my husband replied. How could we be upset? He had been saving our baby’s life. It would be stupid to be mad that our birth plan didn’t go as we wanted.
“Look at this.” The doctor held up a piece of the umbilical cord for us to see. It was a dark red color and right in the middle was a perfect knot, just as if a boy scout had tied it. A Google search of “umbilical cord true knot” will show images of what it looked like, but some of them are disturbing because the knots are in the umbilical cords still attached to obviously dead babies.
I glanced at it but was distracted, listening for any sound from my baby, but unable to see him because so many people surrounded him.
“You had an induction scheduled for the morning, right?” the doctor asked.
We nodded.
“Your baby probably wouldn’t be here if you had waited another twelve hours and come in for your induction. It’s a good thing you came in when you did. In fact, if he had been born anywhere else, in a third world country, I mean, then he wouldn’t have made it. They just don’t have the training to save a baby like that.”
Our nurse said, “Yeah. When I first started working here, we had this exact same situation. A woman came in and we were really busy. She was only dilated to a three so we sent her home. When she came back in the morning to be induced…” She trailed off, perhaps sensing that it was not the best time to share such a story.
“The baby didn’t make it?” the doctor asked.
“No,” she said.
The doctor changed the subject. “What was his first Apgar score?” he asked the nurses who worked on my baby.
“One,” said a nurse, although later I saw it was recorded as a four.
“What was the 10-minute score?”
“Eight.”
Finally, I said to my husband, “Will you go check on him?”
With all our other births, my husband always followed the baby, abandoning me and hovering nearby while the nurses washed and measured him. I wanted him to be with this baby too. He left my side and crossed the room to stand near the circle of nurses surrounding our son.

The doctor said, “They are suppressing his cries so he doesn’t inhale the meconium.”
I nodded, wordlessly. He was trying to comfort me, but I wasn’t afraid.
While the doctor delivered the placenta and sewed me up, I relaxed, waiting patiently for the moment I would get to hold my baby.
Finally, a nurse brought him to me and placed him in my arms. He was wrapped tightly in a blanket and wore a little hat. All I could see of him was his small face. His lips were pursed and his eyes barely opened as he squinted into the light of the room. His lashes were coated with vernix.
“Hi, sweetheart!” I said, cuddling him to my chest. “You scared mommy! What were you thinking doing all those loop-de-loops in there? That’s not safe!”
The nurse laughed.
“Are you going to be another crazy kid like your brother? Are you going to make me tear my hair out?” I paused as I contemplated the other possibilities, how close he had come to not being here. “It’s ok. Go ahead and make me crazy. I don’t mind. I love you.” I kissed his forehead and handed him back to the nurse so she could take him to the NICU for further care because of the meconium. He was back only 30 minutes later, having completed his time on the CPAP machine like a champ. He didn’t need any further special care.



We have been blessed in so many ways both seen and unseen to be able to take home a healthy, normal baby. I’m guessing his heart was only stopped between 3-5 minutes, not long enough for permanent damage. I am so grateful for the power of the priesthood and for all the heavenly intervention that arranged everything to get my baby here safely: the doctor who pressured me to induce, the doctor who told me to “err on the side of caution” and go in even if I wasn’t sure I needed to, my mom for reassuring me that the labor was real and that I should go to the hospital, for the doctor who chose to keep me in the hospital and who safely delivered my son. Modern medicine, doctors, and hospitals are a tremendous blessing! I believe that my blood pressure was not randomly high, but that it was a tender mercy granted by Heavenly Father to keep me in the hospital when I would otherwise have been sent home. It went away again soon after I delivered. I don’t really feel like I was personally inspired by the Spirit in my actions or choices. I was just going with the flow. But I’m certain that the Spirit inspired the doctors and others to give the right advice and to make specific choices that would save my son. We have been incredibly blessed with this little miracle baby.

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