Sunday, May 25, 2008

Introducing Baby N

Well ... after months and months of bed rest and ongoing complications, our new little baby is here. It's a boy.

I was being seen in hospital every other day by the end of things. More kidney stones, more bleeding, etc., etc., etc. When we reached 38 weeks, the doctor decided the baby was in good stead and that the pregnancy was adversely affecting my health. With virtually nothing to be gained by continuing the pregnancy to 40 weeks, the doctor decided that I could be induced around 39 weeks to save my own health.

We were scheduled for an induction last weekend. We made arrangements for J to spend time with our friends, L&P and K&K, and their respective children. J had a great time, and we are forever grateful to our friends for taking such good care of our little man. He had his first sleepover ... and with a girl, no less! Us? Well ... all's well that ends well, so we really can't complain. But we will always want to remember how it went. So ... here's how it went.

The hospital was really busy on Sunday. Ordinarily, they call people around 6:00 a.m. and try to get them admitted by 7:30 or 8:00 a.m. But there were so many people admitted in labour through the night that they had no room for us in the morning. We had a wait. Eventually, we were told to head in for 3:00 p.m. They did a non-stress test on the baby, where they hooked me up to monitors to look for contractions and check baby's heart rate. Everything looked fine with baby. No distress. Baby's position was good. I had no contractions, and the cervix wasn't ready. All of this, we already knew. So we were good to go as soon as a bed became available.

Around 5:45 p.m., they got started. They used Cervidil. It's the first step of a two-part process, and is used for "cervical ripening". Once the Cervidil takes effect, they start a drip (usually Pitocin) to bring on stronger contractions. We were told that the Cervidil can take up to 24 hours to work, and may not even work at that point. It may need to be re-applied. Induction is a long and drawn out process when the cervix isn't ready.

Are they sure it's going to take a really long time?
Yes, they're sure.
Ok ... because I want an epidural as soon as things are well under way, and I don't want to miss the opportunity.
It's fine; induction takes a long time, but if the opportunity is missed for whatever reason, they have lots of experience talking women through labour without drugs.
Ok ... yes ... but I want the epidural.
Just wait. It's going to be a long time.

I told H that he should just go home, and we'd call him back in if anything happened during the night. H declined, feeling quite uncomfortable with this suggestion. He decided to use the fold-out bed available in my room. We'd brought a lot of the comforts of home, having anticipated that induced labour can take some time. So H curled up with our portable DVD player and watched some movies until he drifted off. And I slept as much as I could while I waited for any indication that something was happening.

The nurses checked in periodically. Checked with monitors. Baby's heart rate is still good. There are no contractions at all. Nothing is happening.

And then, I started having pain. It didn't feel like the contractions I had with J. The location of the pain was hard to describe. Some in the back, by the kidneys. Some in the front, but only low down in the pelvis. The pain comes in waves, but without a break between. Are these contractions? Or is it something else? I don't know. But it really hurts. So I called the nurse, and she came.

I'm lying on my side, hooked up to monitors. No contractions are visible on the monitor. The nurse can't feel any contractions manually either. A check of the cervix shows it is unchanged. These are not contractions. We don't know what they are.

Could it be the kidney stones again?
Could be. Does it feel the same?
Well, it feels like that in the back. But the pelvic pain is different.
Do you think it's the kidney stones?
If it's not contractions, it's got to be the stones.
We'll give a shot of morphine and gravol to handle the pain.

Kidney stones are always handled with pain control. Same shot of morphine and gravol. It works well. Takes effect quickly, too when the problem is stones. I know a shot of morphine doesn't touch labour pains. But these aren't contractions. Got to be more kidney stones. So I get the morphine.

And then I roll onto my back, and wait for the shot to take effect. It doesn't take effect.

The nurse feels my abdomen as I lie in my new position. And she says "Wait. I think maybe these are contractions". And I shriek as I search for a more comfortable position. I settle on sitting up on the edge of the bed and pushing forward with my hands. At this point, H finally wakes up and wants to know what's going on.

The nurse tells me to get ahold of myself and breathe through the contractions. It's going to be a long time, and it's going to get much worse. This is just early labour. I have a long way to go. Focus. Breathe. The cervix isn't being affected by these contractions. The contractions may not even progress, since the cervix isn't ready. But it's going to take a long time.

T: Just give me a c-section!
H: Honey, you don't want a c-section. You said that.
T: I lied!

A different nurse comes in to join the first nurse. And that's when I hear a pop and feel a gush. "I think my water broke". They check. There may be meconium in the fluid. They're not quite sure. Nurse #2 wants to check the cervix. Nurse #1 tells her the cervix is still not ready, and certainly not dilated at all. Nurse #2 checks anyway. I'm suddenly 6 cm dilated.

Nurse #2 runs to call the anesthetist to get the epidural going. She returns moments later. The anesthetist is on his way in. He only lives 5 minutes away, so it will be soon. Just hang on. She checks the cervix again. And now, I'm 9 cm dilated.

Nurse #2 calls the anesthetist again. Don't come in. You'll never make it.

Nurse #2 tells me there's no time for an epidural. (She later told me that she thought I was going to leap off the bed and strangle her.) Nothing can be done.

No time for an epidural. The morphine shot hasn't kicked in yet. And I keep forgetting to breathe through the contractions. Laughing gas solves this problem. I can hear my breathing through the mask, and it reminds me to keep breathing through. But the baby is now in distress, and the heart rate has dropped to 50. The intern orchestrating delivery tells me that I have to get mad and push the baby out right away. There is no time to wait.

And so there is no crowning, then the head, then the shoulders ... which are the normal steps in delivery. Oh no. One solid push for all I'm worth, and the baby comes out. No one is ready. No one catches the baby. The baby falls on the bed. Staff recovery is quick, and the baby is scooped up quickly. We pretend that didn't happen.

According to the nursing staff, 40 minutes to dilate from 0 to 10 cm and 7 minutes of pushing. All told, a 47 minute labour, ending at 5:41 a.m.

They clean up the baby, put the drops in the eyes. Weigh him: 6 lbs 14 oz. Measure him: 18 3/4 inches. Baby is healthy and happy. Scores 8 and 9 on the Apgars. Came out crying right away. Nice pink colour. Baby looks very good indeed. My OB (who missed the entire birth) arrives and stitches me up. The nurses give baby to his daddy. And once I am ready, H gives me the baby to hold. The staff leave the room. I get ready to nurse our new son. H starts to make phone calls to give the good news to our families.

I look at my son with pride and joy. And realize that he has turned blue. We call the staff back. They run for all they're worth. The morphine, which did nothing to help me, was absorbed by the baby. He has forgotten to breathe. Baby needs a shot of Narcan and some oxygen. They work to anger the baby to make him breathe. They speak of bagging him. But in the end, they do not have to take this step. Baby begins to breathe on his own again, and he returns to my arms. We are told to pay special attention at certain times over the next day and to hit the yellow emergency button if it happens again.

We are happy and relieved. We phone our families to give the good news. We do not realize until later that the speed of the delivery has resulted in a further complication. The uterus is not contracting as it should, and I am bleeding too much. Blood loss is becoming a concern. Several doses of medication are required to control the bleeding and force the uterus to contract. Thankfully, the medication eventually works. The bleeding is controlled. And we are discharged the following afternoon.

Welcome to the world, baby N. You are a sweet, wonderful little package. And as much as you have put us through, you are totally worth it!

I love you so much, my sweet son.

3 comments:

Wyrd's Little sister said...

AAW!
Welcome to the world, little Nathan. And I hope mummy gets all the rests she needs as well!

He looks beautiful!

anymommy said...

An incredible story. Thank goodness for the happy ending. I absolutely cannot imagine a 47 minute labor. I actually think it would be worse than a long labor. No time to get the hang of things and get your mind around what's going on. He is gorgeous! Congratulations, a little belated.

Trish said...

Thanks, anymommy. We were pleased with the results, though it was pretty harrowing at the time.

I never had a long labour. My first, a preemie, came after only about 12 hours of strong contractions. But I know that of the two, the 47 minute one was decidedly worse. You just dilate way too fast. Having said that, a labour that goes on for days would be no picnic either. Just too much time with too much pain. Owie!