Sunday, October 18, 2015

Stella's Birth Story

The way my daughter entered the world wasnt how I pictured or envisioned it. She arrived safely and was screaming within a few seconds of her birth, but I can't say I was prepared for how everything would unfold.

It all started on Thursday October 1st. I woke up feeling similar to how I'd felt all week; super nauseous and exhausted. I planned to take the girls to story time at the library at 10:30 and my mom was going to join. Sometime during the morning I went to the bathroom and when I wiped I noticed I was losing my mucous plus. Since I was already feeling super nauseous it actually made me gag and throw up. 

Not feeling much different (maybe a little more crampy) I stil decided to go to the library. My FiL also met us there and my mom rode with me. When we arrived Clara wanted nothing but me. She was crying and carrying on so I carried her some. At 39+ weeks pregnant I was struggling with carrying her. 

After the library we headed to the bakery for donuts. Once again, Clara was just inconsolable unless I was carrying her. In pain, I carried her the four or so blocks it took to get there. I was seriously ready to cry it was so uncomfortable, but we made it. At that point I still hadn't had anything to eat so ordered a smoothie and managed to have about 2/3rds of it. I was still feeling really nauseous. 

After lunch Lucy refused her nap. She cried and carried on for nearly an hour as I begged her in my head to go to sleep so I could also get a little rest. I was exhausted and defeated and wasn't able to really take care of myself. I didn't eat much of a lunch and was feeling so stressed from my day with the girls. 

When W arrived home I was so grateful. I'd been feeling crampy and having lots of pressure and was glad he was home to take over with the girls. Around that time I texted our doula Jen to tell her I had lost my mucous plug and that I was feeling really crampy. 

Since the girls continued to be cranky we decided to take a walk. It was a beautiful day so it seemed like a good idea. As we walked I felt more and more contractions and started tracking them on my phone. They were about 10 minutes apart at that time. Clara ended up throwing another huge fit on our walk as she didn't want to be in the stroller and only wanted to be carried. It was exhausting to say the least. 

We got back and had dinner. I still wasn't hungry so didn't eat much. The contractions and cramping continued pretty consistently but we still did baths and put the girls down for the night. I again texted Jen to tell her things weren't really slowing down and to give her the heads up. 

As the evening progressed the contractions weren't stopping. I bounced on my ball, relaxed as much as possible on the couch, and then decided to take a shower. I made W come with me to keep track of contactions while I was in the shower and because for some reason I didn't want to be alone. 

Around 10:30 I called my drs office. I spoke with the one dr I hadn't met yet (Dr. B) and she suggested I go to the hospital to get checked. She also said I could skip my evening Heparin injection. It didn't feel like we really needed to go in at that time so I texted our doula. W made me a quesadilla and I was able to eat that. It was one of the few things I ate all day. At 11:30 we asked Jen to come to the house. A little earlier we had told my FiL to also come to stay with the girls.

The doula arrived about an hour later and I labored at home for quite some time. Since it was a VBAC Jen suggested that at around 1:45 am we leave for the hospital. My contractions were regular and I was unable to talk or rest much during them. Jen helped to get me situated in the car and suggested I lay down in the backseat rather than ride in the front. She followed behind us. 

The car ride felt really long. I tried to stay calm and relaxed, but it was difficult. It took us about 35 minutes to get there. The final turn to the hospital corresponded with a huge contraction and I remember that feeling like the hardest part. 

We arrived at the hospital around 2:00 AM and they took me to triage on the labor and delivery floor. The first contraction I felt I tried to get onto all fours, but the nurse yelled at me and told me I needed to lay back so she could get me hooked up to the monitors. I was a little shocked to say the least. A resident checked me and I was 4 cm dilated, -2 and 70% effaced. They said they'd call my Dr and come back to let me know the plan. My dr decided to admit me and at 4 AM they drew my blood. By 4:30 I was in a room and hooked up to monitors. I had no idea how awful those monitors would be. 

For the next few hours I labored in the room. I rested, bounced on the ball, labored on all fours, walked, and tried anything else our doula suggested. At 5:30 AM Dr. B checked in and told me there was no need to check my cervix again unless my water broke or I felt the urge to push.

At 7 am the nurses switched and somehow I got two nurses assigned to me. By 9:15 I found out the Drs also switched shifts and Dr. L came in to see me. She wanted to check me and I agreed. I was 5 cm dilated, still -2, and 80% effaced. Around that time my contractions slowed so we tried walking. I can honestly say that there wasn't a 10 minute timeframe during my whole labor where the nurses didn't come in to mess with and adjust my monitors. The most comfortable position I found was folded over, yet any time I'd get in any variation of this position the nurses would come in and insist on adjusting the monitor. I don't think there's anything more unpleasant than strangers touching, poking, pushing, and tightening two belts around your waist while you're contracting. I would beg them to let the contraction end before touching me and pushing on my belly, but they never listened. Even if I was sitting on the toilet they'd come in and insist on making their adjustments. I didn't want to really be touched at all in labor and to have strangers doing it every few minutes was really unpleasant. I really feel like this impacted my ability to relax. It's hard when there are tight belts around your waist and people constantly in your face messing with them. Not to mention, any comfortable position was out since the monitors couldn't pick up a signal when I was in them. Being upright, walking, or in bed were the only reliable positions to pick up the signal. As a result I did a lot of laboring leaning on W or Jen and  basically slow dancing. I didn't realize how great it would be to have a doula who was short like me because she was the perfect height to lean on during contractions.

Around 12:30 pm they suggested the whirpool tub and I agreed. Jen left to get herself some food and I labored in the tub. They really only let me stay in the tub for about 20 minutes before they asked me to go back to my room so they could get me back on the monitor. While I was in the tub we used wireless monitors. The tub was nice and seemed to help me relax, but once again the nurses were in the room every few minutes and I wasn't allowed to stay in very long.

Around 1:30 PM Dr. L wanted to check me again. At that point I was only 6 cm dilated and still -2 and 80% effaced. She wasn't very encouraging about my lack of progress so at 2:30 I tried walking again.

At 3:30 PM a hospital midwife came in to see me. I remembered her from Lucy and Clara's birth and also knew she delivered one of my friend's babies. She commented on how exhausted I seemed, how she could smell ketones on my breath, and how I seemed to need a little push to get things moving again. My contractions had started to space out and she said we needed to get them closer together to get things progressing. She was worried about my level of exhaustion and dehydration and suggested we start IV fluids and a bolus. I was so exhausted and didn't want to hear what the midwife had to say. She wasn't super optimistic about things and really focused on my level of exhaustion. The whole time I was in labor I was so afraid of feeling more nauseous and vomiting that I wasn't able to drink much water. I wasn't allowed to have any food. Jen offered me a drink after every contraction and I would take little sips, but my body needed more. It was obvious by the ketones on my breath.

At 4:30 PM I finally consented to start the lowest dose of Pitocin (2 mg) in order to help things progress. I really feel like this was a turning point and wish more than anything I would have made a different decision at that time. I was just that Dr. L and the midwife made valid points. I was so exhausted I started to fear I wouldn't have the energy to push my baby out. I remember talking with Jen and her saying pushing would feel different because I would be more active rather than passive like getting through the contractions.

Little to my knowledge, the pitcoin got turned up every half hour. No one asked, no one told me, and I had no idea. All I know is that I went from feeling like I could stay on top of and ahead of my contractions to feeling totally out of control. Jen had told me to picture each contraction as a wave and myself as surfing those waves. To picture myself staying just ahead of those waves in order to stay on top of them. Things got so intense so fast and I had been laboring for nearly 24 hours. It was amazing to me the difference between natural contractions and contractions on Pitocin. At 6:30 the Pitocin got increased to 6 mg and by 7:00 PM I was asking about pain relief. I debated the narcotic pain medications but after a few more contractions I asked about the epidural. When the dr told me the anesthesiologist could be there quickly, I told her that's what I wanted.

At 7:00 PM a new nurse also came on. At 7:30 my water broke in a huge gush as I stood up to lean on Jen during a contraction. It was a really weird sensation and felt like a huge water balloon came out of me and gushed onto the floor. Jen happened to be right in the line of fire and her pants and shoes got covered in my amniotic fluid. She said since my fluid levels had been high that was likely why there was so much fluid. The Dr checked me agin and I was 7 cm dilated, and still -2 and 80% effaced. By 8:00 PM the epidural was in place. I couldn't believe the difference. I went from feeling totally out of control of my contractions to not even being able to feel most of them. It was absolutely amazing and allowed me to rest for a bit.

At 9:30 Dr. L came in to tell me that the baby was experiencing decelerations with each contraction. She started to seem concerned, yet let me try different positions. I laid on my left side and they came in to tell me it was still happening. They tried oxygen and switching me to my other side but the baby wasn't tolerating things. With each contraction her heart rate would fall to around 100 and take a minute or so to recover. I started to watch the monitors and I saw her heart rate falling. It wasn't recovering after the contractions and I watched the door waiting for the dr to come back. The dr checked me again and I was 8 cm dilated. It was at that time that she also discovered meconium in the amniotic fluid. I knew at that point it was likely over. The dr let things continue with the decels until 10:45 PM when she came in and said she strongly suggested a c section. We asked for a few minutes to discuss things, but I knew it was over. At 11 PM I consented to the c section and I was wheeled into the room at 11:50 PM.

When I got into the OR they upped the epidural and I started to feel really numb. I was so cold and shivering like crazy. My teeth were chattering so hard it made my jaw hurt. They brought W in at about 12:10 and Stella was born at 12:25. I felt lots of tugging, pulling, and it smelled really bad when they cauterized things. They didn't lift Stella above the drape, and instead brought her right over to be suctioned. It took a few seconds and then we both heard her cry. They put a diaper on her and gave her to W to hold skin to skin. It was then that I was able to see her little face. Originally they said I could do skin to skin but at some point that changed. To be honest, I'm not sure I would have been able to hold her because I was shaking so much. The anesthesiologist had a heater that he was blowing on me. It helped to warm me up, but didn't make the shaking go away.

When they brought me to recovery (around 2:00 am) the Dr came and talked to me. She told me that my c section was "exceptionally difficult" and that there were a lot of adhesions and scar tissue, especially on my right side. Her scrubs were covered in blood and she said it was a good thing it hadn't been a true emergency because she may not have gotten the baby out on time. It took her 25 minutes to get to Stella.

Our doula Jen stayed with us in recovery for a while and helped me get Stella to nurse. She is also an IBCLC and was very helpful. It felt super awkward to be reclined, but Stella still latched and tried for a bit before falling asleep.

What wasn't shared with me immediately after surgery was shared the following days. Dr. L came in the following day and reiterated the difficulty of my surgery. She also said my incision was "paper thin". I honestly had no idea what that meant at the time.

At one week I had a follow up to look at my incision. I saw Dr. L and we discussed everything. I asked for clarification and she said that when she opened me up I had a "window" and that had she poked with her finger she could have opened my uterus. 

The next day I messaged one of the others Drs in the practice on Facebook. She is the one who is in our local mom's of multiples group and who got me into the practice. I asked her about the "paper thin" description and she explained things further. Apparently I had a "dehiscence" or "window", meaning the muscle layer of my previous incision had separated. The uterus has three layers; the endometrium which is what we shed every month, the myometrium which is the muscle layer, and an outer thin mucousal layer. My myometrium was no longer intact and that's why my incision was so thin. My uterus had started to rupture and Stella's decelerations were a result and signal of that. 

The days and weeks following her birth have been difficult for me. I'm still processing things and having all the post-partum hormones certainly don't help. Each day I feel a little better and I know I'll be fine, but talking to friends, W, and our doula has really helped. I'm so grateful we hired Jen and that she was there to support me in labor. I honestly don't know how anyone labors without a doula. 

  I know that the most important thing is that my daughter is safe and healthy, but I can't say I wasn't disappointed and sad about her birth. Even though I wrote a birth plan in case of a cesarean section, I honestly didn't have an open heart and mind to that possibility. I changed OB's at 20 weeks, hired a doula, and educated myself about vbac via documentaries and books. I truly thought if I wanted it and tried hard enough it would happen. I wanted this experience to be healing from my last birth. Throughout my pregnancy I said the most important thing to me was that I be able to hold my baby when she was born. I didn't get that experience of holding my daughter on my chest immediately after she was born and I think I'll always be sad about that. 

On the other hand, Stella's birth was a much better experience from Lucy and Clara's. I was conscious, we both got to hear her cry for the first time, and W was able to hold her skin to skin. I held her in recovery and was able to nurse her within the first hour of her birth and she never left our sides. I labored for 29 hours surrounded by the love and support of my husband and doula, and gave birth to my beautiful daughter. I know that the Dr gave me the best possible chance for the vbac and also let the decelerations continue for quite some time before insisting on a cesarean. For everyone's health and safety it's best I had a cesarean. 

I'm so grateful to have another beautiful daughter to love and snuggle. It's been a difficult recovery physically and emotionally, but my heart is so full!





My first time holding her.
Nursing in the recovery room. 

Lucy meets her baby sister for the first time. 
Kisses from Clara. 
First family photo. Perhaps not our best, but its our first one all together. 
All my girls. 
Kisses for baby Stella. 
Proud big sister. 
I think she loves her!
Ready to go home. 

Proud mama. 



5 comments:

  1. Congratulations on Stella's arrival! Love the photos, especially the one of the older girls kissing their new baby sister.

    I'm sorry you didn't get to have the birth experience you'd hoped for. It sounds like you are lucky your uterus didn't rupture. That would have been a major surgical emergency for both you and Stella.

    Best wishes adjusting to life as a family of five.

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  2. So sorry you didn't get the birth experience you hoped for, but I'm so happy for you that in the end everyone was healthy. Thanks for sharing your story with us.

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  3. It may not have been the birth story you had hoped for, but Stella is here and she is absolutely beautiful! In fact, you have a really amazing and beautiful family. I'm so happy that everything turned out okay and that you both are safe and healthy. Pregnancy and birth is in reality, quite the scary thing! I was holding my breath the whole time reading your story. I hope the rest of your recovery goes smoothly and that the post birth hormones pass quickly so you can fully enjoy your three girls!

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  4. Ugh, I've saved this in my reader for weeks trying to get the time to come and leave a proper comment. I'm so sorry you didn't get the birth you had hoped for. Continuous monitoring is such bullshit and NOT required or shown to be advantageous by evidence based medicine, and it IS shown to adversely affect laboring mothers who aren't comfortable and can't move in ways that help them handle contractions. I know that's not a difference to you now, but I so hope that more providers will get with the times and allow intermittent monitoring as the standard soon. As for the pitocin increases without notifying you. UGH. Makes me so mad for you. At any rate, you did SO much to educate yourself and give yourself every advantage possible in this birth experience and I am SO proud of you for that! I'm so glad you and Stella are both healthy as well of course. ((HUGS))

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    1. It's funny because I was hoping you'd comment on this post. I know you're passionate about birth and birth options so I was wondering if you read this or not. Thanks for reading and commenting!

      The monitoring really was crappy, but I guess because I was a VBAC I didn't have any other option. It felt like a huge injustice at the time but I now realize plenty of women have monitoring like this during pregnancy. I can't say I agree with it, but in the end it did keep us safe. Once my water broke they did the internal monitors but I also had an epidural so wasn't going anywhere. I didn't realize with the internal monitors they don't even let you leave your bedside. I'm so glad I didn't know that at the time. In the end, the monitoring is what alerted us to the baby having difficulty which was because of the partial rupture. I guess it was for the best.

      I really feel like I did so much to give myself the best chance possible to have the type of birth I envisioned, but some things are out of our control regardless. I wish it had gone differently, but I'm much more okay with things now.

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