Change of Plans

If you were to look at my birth plan and then compare it with the events that actually unfolded to bring Ellie into this world, you’d have to laugh at how the story unfolded exactly opposite as planned. Our goal from the beginning was healthy baby/healthy mom and as short a recovery time as possible. The way we were going to get there was to do as natural as possible of a birth. No induction, no IV’s, no pain medication. Based on the statistics and having done a ton of research, that would get us a healthy baby and mom and quickest recovery time. (The more interventions you add the more likely you’ll end up with a c section).

So what actually happened?

Well on Tuesday 1/30 we had a routine OB appointment that led to the provider wanting to just double check that she was head down via ultrasound. We went in at 2:30 that afternoon for what was a very quick and easy ultrasound confirming her head position. At about 6 pm we got a call from the provider saying everything looked great except the amniotic fluid level was just slightly lower then they wanted and because of that could we go in at 8:30 to be induced THAT NIGHT. Whoa! That was a quick change of plans. We discussed the reasons to move forward with induction and ultimately decided it was the best option. So we called up our support team and set the ball in motion.

The first thing that happened when we got to Deaconess is we found out the elevator was broken and we had to walk up to the emergency room entrance and then get wheeled in from there. The elevator stayed broken our entire stay. Mildly frustrating. We had a lot of things to bring in from the car including gifts and snacks for the medical staff (we wanted to be the popular room).

That night the plan was to do a low dose of a cervical ripening agent called Misoprostle which is designed to kind of nudge your body into labor. They gave me an ambien and said something like “enjoy your last good night of sleep ever”.

The next morning after a cervical exam that confirmed the Miso had done basically nothing we decided to do another few doses of Misoprostle and check back in a few hours. Needless to say after a few hours of regular doses of the Miso, I had dilated to about a 1. Just enough to do this thing called the Cooks method. It’s a catheter they inserted into my cervix and then blew up this little balloon with water and it sat inside putting pressure on my cervix. It’s another method to nudge your body into labor. That fell out when I was dilated to 3.5 (the goal is to get to 10). At this point we were probably 18 hours into inducing labor. The next step was to start Pitocin. They start a 1 and then increase by 2 every 1/2 hour (at a minimum) until at the max dose of 30. If at any point the labor really gets going they hold steady. It was described to me as a light switch. It’s off until it’s on and then it’s ON. We never got to ON.

Wednesday day and night were long. It took about 17 hours for us to get up to the max dose of Pitocin. After staying at the max dose for awhile we did a break to try to let my body catch up. Contractions at this point were like mild menstrual cramps that worked up to maybe a 3 out of 10 on the pain scale. So, not much.

By Thursday it was starting to be obvious that my body was not even acknowleding the pitocin. We tried some different labor positions which seemed to get her to drop into my pelvis a little bit but that was about it. I started to feel very protective of each contraction. While sometimes they were pretty uncomfortable I was very scared of running away from the pain or trying to get into a less uncomfortable position. What if the contractions stopped? I noticed if I laid on my side I was very comfortable and the contractions felt milder, so I didn’t lay on my side because I wanted the contractions to increase not decrease. Very counter intuitive. We needed to be IN labor not avoiding labor.

On Thursday our day shift nurse was named Sarah (I want to cry just thinking about her). I think she might have been an angel (like actually). Coincidentally she was the nurse who taught the Coping With Unmedicated Labor class we took on 1/4 (the day Xion got attacked and we almost skipped the class to take care of him). Sarah was a doula for 10 years and had been a nurse for 18. She was AhhhhMAAZZZing. She had a little heart to heart conversation with me about what a good job my body did making this baby and how I should focus on getting my mind aligned with releasing her. I hadn’t thought about it like that yet. Infertility was so hard. IVF was so hard. We wanted so badly for her to “stick” as a little embryo. My body was refusing to let her go. It was holding onto her for dear life and I needed to actively thank it for what it did and also help it let go of her. This was the first time in a long time that I truly felt proud of my body. It’s so easy to disappointed in your body. It dosen’t look the way you want, or it’s not as strong as you want, etc etc. But right in that moment I realized she was right, my body was incredible! It had grown this tiny little human AND given me an incredible year. I got to do so many wonderful things and have so many great experiences because my body loved being pregnant. I didn’t suffer from pregnancy like some woman do. I was empowered by it. That’s a pretty incredible body.

At some point on Thursday we started Pitocin again with an added goal of at some point breaking my water if we could get her engaged enough in my pelvis. Most of Thursday went the way of Wednesday, increasing Pit, waiting, increasing Pit, waiting…over and over and over again. At some point during the day they broke my water and like 1 drop of liquid came out. Quite odd they said but not necessarily concerning.

During this whole time both of us were being monitored by these probes they had on my belly held on with a belly band. They could tell that she was tolerating all of the drugs and stuff fine. Good heart rate, no problems.

Thursday night came and went with little to no change. Maybe the contractions started to get up to a 4, but they stalled out. On the last increase of Pit to 30 (this is now the second time were at the max dose), I felt pretty good so decided to take a nap. I actually fell asleep and if there were any contractions, slept right through them. Apparently that’s a pretty rare thing to happen (I have never described myself as normal and average though!).

I went to use the bathroom and the door to our room flew in and all the nursing staff on the whole floor came rushing in. Apparently Ellie didn’t like when I sat down to pee. Her heart rate had dropped and stayed low. The rushed me off the toilet and back into bed which made Ellie’s heart rate go back to normal. This was the first sign of any distress for baby. Now things were getting serious.

The doctor came in and we started discussing what other options we had and what we came up with was….nothing. Maybe one or two more positions that might help but were very doubtful. The last resort was a C section. Man am I glad they cover everything in all the books I’d read and the classes I’d attended. I had kinda zoned out on some of the medical interventions because in my mind we were doing a natural birth, so why did I need to know about the non natural stuff? I guess this is why! You never know when you’re going to have to do something that isn’t planned. Best to know ahead of time what the options are going to be. As a team we made the decision around 2 PM that a c section was the only option remaining. It was scheduled for 5:30 that night.

Sarah came in a few times and made sure I felt good about my decision. She knew it wasn’t our plan and wanted to make sure I was processing the change in plans well. She asked if I wanted to try anything else while we waited for 5:30 to come. She said that at some point in the future I’m going to look back and wonder if I’d really done everything possible to avoid a c section. I know that feeling of looking back and wondering if I left it all on the field. It’s a feeling I get during every race when it gets hard. When you’re not quite sure if you can make it. I’ve had the conversation with myself many times of “tomorrow you’re gonna be done with this and look back and wonder if you gave it everything or if you could have kicked into another gear”. The fear of regret has made me push myself really hard, but it’s also made me not want to cling so hard to a goal I stop having joy surrounding the situation. Sometimes I decide to give it more juice, and sometimes I accept that my original plan isn’t going to work anymore and I release the cling and accept that today is just going different then planned. A business mentor once described this as being committed not attached. We were committed to the outcome of healthy baby/healthy mom but not attached to the method to get there.

By the time 5:30 rolled around I felt very confident that even though this isn’t what I had originally planned or wanted, and I was very scared, I knew it was our best option.

As a non emergent c section (this one was considered unplanned but not an emergency) Drew was allowed to be in the OR with me. The Anesthesiologist did a spinal block which was actually far less painful and scary then I was anticipating. I laid down on the table and my body started to go numb. Such a weird feeling. Dr. E (the anesthesiologist) asked if I felt nauseous to which I replied no and then promptly vomited all over myself (throwing up flat on your back sucks). He gave me some anti nausea medication through my IV and then a few minutes later asked how I felt, I replied “good” and then threw up again.

A c section is major abdominal surgery. It’s no joke man. There is a clean screen that blocked most of the view but Drew and I could feel the table moving around quite a lot. Lots of pulling, pushing, shoving, and talking. Pretty quickly she was out and they were showing her to me through the screen. My first indication that she was out was that I heard her crying which soon turned into screaming. She was kind of grey but I was expecting that from my reading prep ahead of time. They brought her around the curtain and I got to touch her briefly before the NICU staff whisked her away across the room to work on her. I kept asking if she was ok and if she had all her fingers and toes. I don’t know why I was so stuck on that question. I think it was the only one I could think to ask. Drew went over with them and just stayed close to her. What i found out later is that he was begging them to please please do as much work in the room as possible and could I please hold her before they took her to the NICU. While nothing was seriously seriously wrong, she was struggling with breathing a bit and definitely had a lot of meconium (in utero pooping, not uncommon in post due date babies) in her lungs. His pleading with them resulted in them being in the OR with her and me for 20 minutes instead of 10. So we had one more item on our birth plan go awry, no Golden Hour. I think Drew wanted to stay with me but I wanted him to go with her to the NICU. I didn’t want her to feel abandoned. She knew his voice.

It seemed like it took forever to get me stitched and cleaned up. I kept looking a the clock and more and more time was going by and we weren’t done. Dr. E was wonderful. He gently and calmy was explaining everything that was happening. I felt safe. I felt taken care of. I felt super thirsty. I felt ok but I wanted to be done. You know that feeling when you’re just over something? That’s how I was starting to feel. Oh the other thing that had started to happen much earlier, before she was born actually is that I started shaking uncontrollably. It was getting worse and worse. Finally, they were wheeling me back to my room where my night shift nurse took over. There were a lot of boxes to check. I was so thirsty. Could I please have some water? They gave me ice chips in a huge cup and I ate them as fast as I could. Ice had never tasted better! Could I have more? What about with some water? Was juice allowed? They said I could have whatever I wanted. I sucked down about 10 little cups of the hospital juice and probably just as much ice water. Could I have more? All this time the shaking wasn’t stopping. They gave me Demerol to help with the shaking and I could feel it kick in almost immediately. As the shaking started to calm all of a sudden the nausea came back. Before I knew it I was throwing up all that juice and water I had just chugged down. Usually when you throw something up, the mere thought of it in the future is nauseating. Not in this case! I immediately wanted more water and juice which they kindly got me. Another round of puking ensued but after that I was able to keep everything down.

Eventually they brought me a hand pump and I was able to pump about 6 mls of colostrum which got put into these adorable tiny syringes. We would take that to recovery for Ellie’s first feeding.

It was finally time to get wheeled down the hall to the NICU to see her. She spent a total of about 5 hours in the NICU (at 6 hours they would have had to admit her). The biggest issue was her lungs and the meconium. She was on a cpap for a little bit but I don’t really know those details because I wasn’t there. When I got there she was swaddled up and looked perfect. Did I mention that she was born at 8 lbs 8 oz and 20 inches long? She was by far the biggest baby in the NICU.

They let me hold her and of course I immediately started bawling. I couldn’t (and still can’t) believe that she was here. She did it. My body did it. I have a lot of feelings about this. I’d say pretty much the entire pregnancy I was waiting for something bad to happen. Even when we went in on Tuesday for induction I didn’t really believe we would walk out with a baby. I don’t know what I thought would happen but I didn’t think I would get to have a baby at the end of the experience so when she was there, in my arms…it was unbelievable. Staggering.

We stayed in the NICU for about 45 minutes with the nurses helping me for the first time to get her to latch and when she didn’t Drew fed her the colostrum I had pumped.

The 40ish hours we then spent in recovery was simultaneously a whirlwind and almost felt like time was standing still. There were so many people in and out of the room, lots of wonderful nurses who helped with everything from going potty to showing me how to get her to latch. It was on Saturday morning (day after delivery) that the surgeon came in and really explained how serious my surgery had actually been. Getting her out was no problem. But when they went to deliver the placenta it was “glued” to my uterine lining and they had to “scrape” it out which caused hemorrhaging. She explained that I lost about 1700 mls of blood. When I told my Grandpa about this (he was a family practice doc for decades and delivered hundreds of babies) he said in his day they would have just performed a hysterectomy and removed my whole uterus (yikes!). The blood loss was pretty serious and she was asking us to have a blood transfusion that day and even the bare minimum amount of blood would be 2 units (250 mls each). She also said that in the future she wouldn’t recommend a vaginal delivery. The next provider we used for OB (should we want to have more babies which at that point we were a bit traumatized so the thought of that seemed unlikely) she said needed to know about this experience so they could provide proper care.

Despite how serious the surgery was I never once felt the emotion of being scared in the OR. It might have been because of how calm the staff was. Dr. E was so calm and cool as he explained what they were doing while leaving out the scary parts. It might have been though that I wasn’t letting myself feel scared because what good would that do in that moment? I remember being so focused on how much I was shaking and how much time was passing that I forgot to think about the baby! And then it kind of worried me that I had forgotten about the baby.

We were discharged on Sunday at around 40 hours post birth. We loaded up the car and both Drew and I cried as we drove away. We had a baby. She was perfect. The adventure we’d waited for for 8 years was beginning.

Last Note about her birth: I want to emphasize that I know many women have a lot of trauma to process over how their delivery went so far off of their plan. I don’t feel that way. I never once felt pressured by the medical staff. They were 100% supportive of every decision we needed to make. They made us feel empowered and in charge.