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Birth Stories
Andrew Lawrence
Hi Leslie:
I have lost my birth partner's email address so I hoped that you could share my story with the Thursday evening yoga class. It was quite an ordeal, but with a wonderful, happy ending!
My water broke on Sunday, May 18th at 4 pm. I had been up all day on my feet, cleaning the house, running errands, and preparing enchiladas for the evening. Since I was so convinced that I was going to deliver late (as my mother did 3 times out of 4), we had decided to contract our friend to put a tile floor in our kitchen the following week, so that it could be done before Drew arrived. We were expecting our friends to come over at 5pm to help pick out the tile and then enjoy dinner with us. Regardless to say, those plans quickly were canceled.
I woke my husband up from the nap we had been taking and he instantly wanted to call the doctor and our doula. I got him calmed down, and headed into the shower, sure that contractions would be starting soon and I wanted to be clean! We worked on packing our last minute things to our 'bags' and still no labor pains, so I called my doctor. I was a bit surprised when he wanted me to come into the hospital to be checked-as I was quite sure that that gush of clear fluid down my legs, saturating my khaki pants, had to have been one thing and one thing only and that labor should start soon. But we headed in around 6:30 to MCV anyways with our doula meeting us there. I was checked by the attending physician, Dr Peng, and there was some confusion as to whether or not I had broken my water, since the little strip was not conclusive and there was no ferning at first. However, the doctor was patient and checked again and said that I had not resealed, but really had broken my water and should start laboring soon. I was fingertip and 50% effaced and the baby was high but he thought would be an OA baby. He encouraged me to get up and walk and so we went downstairs to get some dinner. I walked up 14 flights of steps as well, hoping to 'kick-start' the process. When I got back, no progress. The doctor who was at MCV that night was willing to wait until 18 hours of labor rupture prior to starting pitocin, but my doctor was a bit more conservative (they were conversing on the phone) and I was started on pitocin around 1am after no contractions were really detected. I slept quite anxiously, awaiting the impending contractions. Little did I know that I would wait a long, long time.
When I awoke Monday morning, they started being more aggressive with the pitocin. I would go into a mild contraction pattern, get excited, and then it would fizzle out and I would get my pitocin increased. I was walking and walking and walking all over MCV with the portable monitors. I asked to only keep my IV rate running at the lowest possible rate to keep my vein open since I was already so puffy and preferred to stay hydrated with water and food. Everyone was okay with that, for which I was grateful. By the end of the day, I had reached almost double the usual MCV max rate of 20 of pit (I had reached 36) without going into successful labor. I was still fingertip and 50% effaced at the end of the day with the baby floating in the pelvis. Dr Karjane recommended stimulating my nipples, so I hooked myself up to the Symphany breast pump and although it did not start any contractions, I was reassured to find that I had colostrum on hand when the little guy would arrive!
So, Monday around 5pm I got the max dose of misoprostel to ripen my cervix. Around 9pm I started contracting every 3-5 minutes, got excited, and got into bed, sure that I would be awoken with strong contractions and have some work to do. Each time they woke me to take my temperature and blood pressure, I would ask if I was in labor and not get a very reassuring answer. Around 3am Tuesday morning, I was checked, found no change and they repeated the dose of miso.
Throughout this process, my blood pressures were a bit labile and I had developed protein in my urine. However, my lab work was negative for Pregnancy Induced Hypertension or Preeclampsia, but my doctor did say that I was 'on the spectrum' but that they would continue to watch and see if I could labor and delivery vaginally. Also, there was the huge concern that my membranes had been ruptured for over 18 hours and with no delivery in site. Being a Newborn Nursery Nurse Practitioner, I was well aware of the complications of prolonged membrane rupture, and was constantly checking the monitor for any sign that my son was not handling the challenge before us. However, Drew NEVER had any decelerations or tachycardia or anything. He kept up with accelerations and great variability throughout the entire thing! I was so worried about the internal struggle to avoid a C-section but yet protect my son from complications. My doctors were also worried about uterine atony after so much pitocin and the fact that it might not clamp down. However, my doctor kept checking in and reassuring me that each of us was still handling the challenge well, and that there was no need to push for a C-section just yet.
Around 7 am Tuesday morning, the attending, Dr Matthews, asked if she could check me just to be able to give my doctor, John Pierce, an updated report. When she checked me, she said that my cervix was soft, I was fingertip and 50% effaced, but that there was some scar tissue present. She asked me if I had ever had any surgery and I replied that I had once had a colposcopy for an abnormal Pap smear and that they had given me one dose of cryotherapy. She asked me to work with her and she proceeded to break up some of the scar tissue with her fingers!!!! It was incredibly painful but she applauded my pain tolerance, which encouraged me that I might be able to continue with this process epidural-free. She then did a speculum exam and cut most of the rest of the scar tissue! I then went to 3 centimeters dilated and 70% effaced and the baby was at 0 station by the end of that 5 minute exam. She then wanted to restart pitocin and see if we could make better progress now that the 'door was open'. I and my husband were ecstatic! She said that no one could have felt the scar tissue until the cervix had softened. I was so happy that she did that extra check before signing off from the night.
So we started pitocin and I started having some contractions and some incredible back pain. I was on pit for 6 hours straight before I was checked at 1:30pm, and there was NO change! This is when I hit rock bottom and started to cry. My husband cleared the room and we had a serious talk about our options, fears and concerns. We even did rock-paper-scissors as to whether or not to have a C-section. I won't tell you what won.... The attending, Dr Nicole Karjane, called my doctor, John Pierce, and we had a little conference around 3pm. Dr Pierce stated that I had given it more than the college try to have a vaginal birth and no one would fault me for requesting a C-section at this point. He said that he did not know why I could not get into real active labor. Statistically he said that most women would definitely have gone into labor at this point, even without all the interventions. With all the interventions they had tried, they were baffled! However, Dr Pierce stated that he knew me and knew my intentions, and that I had to be comfortable with my decision now and in the future. He suggested giving it a little more time for me to be comfortable with the decision, since we were both still doing very well. We agreed to set 6:30pm as the make or break point (when to get a C-section). Nicole Karjane then asked me if I wanted a shower-and I was thrilled!
So into the shower I go, doing all this yoga and squats and hip rolls to try and alleviate the back pain and get him down in my pelvis. I was on the portable monitor and tried to keep my IV as dry as I could. I was in there for almost an hour! Just as I was getting ready to get out, thinking of doing my hair and putting on some make-up, something just clicked and I realized that I had to get out of the shower and that I could not be alone....The contractions started rolling every 1 to 1 1/2 minutes and I got really sick, unable to talk at all. The back pain was constant and was worse than the contractions. My husband was the best coach I could ever have asked for, guiding me to breathe, relax, and give in to the pain. I tried squatting, sitting on the toilet, on the back of the bed, and in puppy pose (my favorite that day). I had never been in so much pain and did not think that I could handle a minute more. At one point, I felt like I had to go to the bathroom so badly. The nurse was scared that I was in transition and was about to push the baby out into the toilet. She called for Dr Nicole Karjane (after she let me go sit on the toilet after I promised her I would not let the baby be born in the toilet) to check me. It was almost 6:30 anyways, and I was 5 centimeters and the baby was at +2 station. She reassured me that I could do this vaginally and that we were going to have a baby that night and that she would be with me the whole time. I then said that I could do it, but that I needed an epidural. My husband and doctor wanted to make sure that I was okay with this decision, since I had been adamantly opposed to them for 9 months. However, I knew that I needed some help since the pain was unrelenting and the contractions so strange with all the pitocin in my system. My contractions at this point were 1 minute apart and 1 minute long, and they had scaled back on the pit. So the anesthesiologist put one in in a few minutes and gave me a spinal block for instant relief. It was wonderful to get some relief. The anesthesiologist then hung out in the room talking about music with us, making sure that I was comfortable but as mildly drugged as possible. 1 1/2 hours later I was checked, and I had no cervix left! I could not believe it! The doctor got the delivery equipment ready and we reviewed how to push. The epidural was so light that I could definitely feel where to push and pushed Drew out in 75 minutes! He even surprised the doctor by 'helping' come out, by shaking his head and trying to corkscrew his way out! She said that she had never seen a baby help by moving their head that way! Andrew Lawrence was born on Tuesday, May 20th, at 10:16 pm right on his due date, weighing 7 pounds 9 ounces and 20 inches long!
Nothing ever prepared us for the moment when our son was born. Having him on my chest was the most incredible moment. Drew was able to be there for a long time. He had Apgars of 9 and 9 despite my membranes being ruptured for 56 HOURS! One of my friends who is a 3rd year Pediatric Resident was on call that night in the ICU and she came down and examined him for me to reassure me that he was just fine. Unfortunately, my uterus would not contract (as they had feared) and the doctor had to manually remove part of the placenta and help it contract. I lost almost half my blood volume that evening but was able to avoid a transfusion and just needed a lot of fluids. One of the nurses helped Drew latch on and feed lying sideways even though I was hooked up to oxygen and lying flat on my back. In the morning, mom was feeling better and we all went up to the postpartum floor together and then went home on Thursday. I may be one of the few people who weighed more after leaving the hospital then I did when I went in. I couldn't fit into my maternity jeans and had to wear my husband’s clothes and shoes! I was so puffy and swollen, it was amazing.
I have since developed some high blood pressures over Memorial Day weekend, and am quite weak from losing all that blood. I have also lost 30 pounds in 5 days so I think my body is in shock from getting rid of all of that fluid. So I am on blood pressure medication and on some bed rest, but my milk has come in and my son is doing great! It was an amazing journey and a real bonding experience for my husband and I, and it is hard to believe that a week has already gone by. I hope to see some friends in mommy and baby yoga soon!
Thank you for sharing my story.