we arrived at the hospital shortly after 7. i was excited to change into my hospital gown and get the ball rolling to meet our baby! i had resolved to start my induction with pitocin, as my previous experiences with rupturing of membranes didn't help my progression extensively. i was a little nervous, but felt brave all the same. my sweet nurse shauna entered, introduced herself, and we talked about our plan-- to start pit, have dr. thackeray rupture my membranes asap, to not run any extra fluids (to avoid swelling), and to have a baby before noon! we were all on board. pca michael entered, but no introductions were needed since i already knew him from maternity. he gave me a piece of gum from his personal stash, and i knew i had a great team taking care of us.
shauna placed my iv and put baby and i on monitors before starting my admission questions. around 8 am, she mentioned she did not like what she saw. she immediately had jer's and my attention. minimal variability, or a flat fetal heart baseline, indicated that our baby wasn't being oxygenated enough. while shauna put an oxygen mask on me and repositioned me to my left side and started a bolus of NS, she asked if i had felt the baby move this morning. i wasn't sure; evelyn had always been more relaxed (less movement, less kicking) than my other two babies in utero. shauna told me that she didn't feel comfortable starting pitocin with evelyn's tracings; it wasn't wise to put additional stress on her. shauna mentioned multiple times that day that she was so glad i was at the hospital delivering as she monitored our tracings.
dr. thackeray entered around 9 am to rupture my membranes; he also placed a fetal scalp electrode to monitor evelyn more accurately. i had tons of fluid gush out; he had his phone in his back pocket and joked, "oh, i almost had to turn it in for water damage." both he and shauna were hopeful that my labor could be provoked this way. i was almost positive they would be wrong. after they left, i watched the monitors as a few inconsistent contractions popped up. you're going to end up with a c-section. i looked at jeremy and said, "i'm scared of what's probably going to happen. i'm not going to say it out loud, because i'm still in denial... but i'm scared." and he said, "babe, i'm going to be right here. she's going to be fine and you're going to be fine, no matter what." and i said, "that's the most important thing, right? it doesn't matter that things aren't going according to plan, it just matters that she's safe. everything's going to be fine." i inconveniently had to go to the bathroom so often during this labor; i was hooked up to fetal/toco monitors, an iv pole, and my oxygen mask; and jeremy graciously helped me through each trip. these are the glorious moments of marriage that make me fall in love over and over again. megan came in after her shift upstairs (she stayed late to help the unit) to wish us luck while i was working on evelyn's birth certificate.
at 1030, dr. thackeray returned for a little discussion. i knew it was serious because he sat at my bedside. we talked about absent/minimal variability, how evelyn's condition had remained stable this morning, and how he felt comfortable starting pitocin at a low rate. he cautioned, "but, if she doesn't continue to remain stable, we'll have to stop the pitocin immediately." and then after a pause, "and then pretty much our only option is a c-section." i looked over at jeremy and teared up. he said it out loud. i didn't really have a chance to process how real of a possibility a c-section was when shauna walked in with the pit. she started us on a low dose of 1 unit (instead of 4 units). she told us this was only happening because both of us were nurses-- the nurse's curse, you know?
by 1130 am, pitocin was increased to 2 and by noon, it was increased to 3. my contractions were still moderate and coming about every 4 minutes. jer and i stared at the clock and talked about how we were both expecting to have a baby in our arms already. i was still laying in bed with my oxygen mask and 3 liters of fluids had ran in through my iv. the situation was so not ideal. evelyn pumped out a few decelerations, so we waited until 1 pm to increased pitocin to 4 units. at that point, i was 4+ cm and 50% effaced, and my contractions had slowed to every 5 minutes. jer reminded me that repositioning myself always helped my body progress; i was comfortable with just laying in bed, but committed to getting out of bed if i didn't have another contraction within 4 minutes. 4 minutes later, i got out of bed and started doing squats. i was still confined to my bedside since the oxygen mask and monitors could only reached so far; jer pulled up a chair and talked to me while i pumped out contractions-- now coming every 1-2 minutes. jer and i agreed that we could have our babe by 4 pm if the contractions continued coming regularly.
at 2 pm, i was 5 cm, 90%, and -1 station. dr. thackeray felt comfortable with increasing my pitocin, but shauna noticed decelerations and the continued minimal variability and was not comfortable. although my my contractions slowed when i wasn't squatting, we both agreed that i could continue my squats instead of increasing pitocin. my contractions were distressing enough that i had jeremy start counter-pressure on my flank. i had tons of bathrooms breaks with all my fluids (5 liters total: 3 bags of NS, 1 bag of D5, 2 bags of pit), and i started to noticed my generalized edema. my face did not look like the same face that had entered the hospital at the start of this labor.
around 330 pm, shauna came in with michelle for bedside report. i barely listened or participated because around this time, i started utilizing the birthing ball-- i leaned over the raised bed while jer provided counter-pressure on my back. i was breathing deeply and moaning lowly; this is where i was grateful for the uterine irritability throughout my pregnancy and the opportunity to practice "welcoming the pain." we noticed evelyn's variability had increased to moderate and the nurses okayed my laboring without the oxygen mask. shortly after report, michelle returned with dr. thackeray; they had another patient who was also close to delivering and they wanted to check how fast my progression was in comparison. he initially reported my cervix to be 6 cm, but continued to check through a contraction and pronounced me to be 7 cm and completely effaced. that contraction was the first of my "hysterical contractions," where i gasped, screamed, cried, and no longer welcomed more pain through. dr. thackeray informed me that he would hold off on the other delivery and deliver evelyn first, since i could be only a few contractions away from complete/complete. michelle left to inform the nicu team that i would be delivering soon, so they could be present for any complications.
i returned to my birthing ball position/counter-pressure method to labor. i started sobbing with each contraction and noticed how much harder it was to recover after contractions. my body temperature went up and i felt uncomfortably warm. in my head, i gave myself 2 contractions for each centimeter dilated: 2 difficult contractions to an 8, 2 agonizing contractions to a 9, 2 excruciating contractions to a 10. but after 6 contractions without feeling any indication of change, i decided to give myself 3 more contractions.
after the first contraction, i mentioned to jeremy that i felt some pressure down low, "i think i might have to push soon." michelle had returned and said she'd go get dr. thackeray. i protested, "he's going to tell me i'm only an 8" michelle assured me that she was positive that i was complete with the sounds that i was making. she left and i sobbed to jeremy, "he's going to check me and tell me i'm only an 8. i'm only an 8..." jeremy mentioned how badly i was shaking through the last few contractions and tried to reassure me that i must be close. another contraction came and passed; i immediately felt burning in my perineum and screamed out "she's crowninnnnnnnnnnnng!!!!!! i need to pushhhhhhhhhhhhhhhh!" jeremy lowered the bed as quickly as he could and helped me into bed. a flurry of medical staff flew in to join the party. i was unsure who and how many were present, but jeremy later told me that there were 3 labor nurses (including michelle and shauna), 2 nicu nurses, a respiratory therapist and a nurse practitioner.
i was obviously hysterical at this point. i started crying out (for the first time), "i can't do this!" and all of a sudden shauna was in my face, "you. can. do this! you're doing it!" my body starting pushing without anyone counting for me; i was pushing as hard as i could without any instruction. dr. thackeray ran in just in time to catch her head. there was no time to break the bed down, so he sat at the end of the bed to help me deliver. i vaguely heard him say, "loose nuchal cord, times 2. oh wait, make that times 3" after the insane relief related to evelyn's head being out, i stalled for a minute. both dr. thackeray and shauna urgently coaxed me to push her shoulders and the rest of her body out. i beared down, pushed as hard as i could, and felt her entire body slide out at 1554. jeremy cut the cord, dr. thackeray held her up, and instead of whispering she's perfect! i screamed out, "she's too grey!" and she was handed off to the nicu team.
i asked jer to go be with evelyn. her first apgar was assigned as a 5. the adrenaline running through my veins seemed unstable and i was feeling insane pain attempting to deliver my placenta. between the pain and emotional concern for ev, i was overwhelmed with tears. dr. thackeray offered me some fentanyl and updated me that evelyn was now pink; her 5 and 10 minute apgars were 7 and 9; she didn't want to breath on her own and the nicu team was providing positive pressure; that she was in good hands. jer came back over to tell me how beautifully pink she was; he kissed me and told me she was going to be okay. dr. thackeray told me there were no lacerations and agreed to hold the second bag of pitocin. michelle held together the two pieces of cut umbilical cord and presented an insanely long masterpiece-- i'm grateful that it nourished fetus evelyn for 9 months and didn't cause any permanent damage with its length.
the flurry of medical care seemed to start to calm. evelyn was brought back to me to nurse, but started to choke and needed additional attention before the real deal. i started to bleed more heavily and pass large clots; it was necessary for michelle to hang the second bag of pit, so she also gave me my motrin and fentanyl for the impending cramps. when i finally got to hold evelyn, my heart just stopped. i can't even express how perfect she was and how blessed i felt; it was love at first sight. evelyn latched immediately and nursed for over 10 minutes on both sides. michelle handed me a piece of paper to help me remember her stats: 6 pounds 15 ounces, 20.5 inches tall, and 33 centimeters OFC. i ended up staying in labor and delivery for further evaluation, and jeremy went with evelyn upstairs for her well-baby nursery assessment and vaccinations. (it was such a fun coincidence that evelyn was the exact same weight and height as amelia at birth, and that we stayed in the exact same maternity room (221) as we did for scarlett's postpartum recovery.)
the fentanyl made me drowsy, and i phased in and out of sleep alone while the pitocin ran through me. in one of my lucid moments, i remembered to send jeremy's and my mom a picture and asked them to update the rest of the family. (i felt extremely exhausted and had lost about a total of 700 ml of blood.) during this time, i reflected on how blessed i was. we had been able to bring evelyn into this world as planned, despite unforeseen complications. she was healthy and safe, and we were all so, so happy. heaven was in my room, and i just felt so at peace with the universe.
|i love that evie looks like she's smiling in this picture!|