Carson's birth didn’t go at all according to the way I planned or prepared for, but, in the end, after a long and bumpy ride, it all worked out.
I had a great plan for a "natural" birth, with no epidural or interventions with a doula and the midwives at Ochsner Baptist. Around 36 weeks I started having high blood pressure at my prenatal appointments. The midwives, concerned about preeclampsia, decided to require twice weekly non-stress tests on the baby and once a week ultrasounds, lab work, and blood pressure checks on me. This quickly became very stressful for me as I would get anxious about the blood pressure checks thinking it might lead to an emergency induction. This, of course, would raise my blood pressure. But, for the most part, after about 30 minutes to an hour, I was able to calm down enough to get low enough readings for them to let me leave.
As long as my labs were fine and I had no protein in the urine, they were ok with letting the pregnancy progress to 40 weeks on bed rest and I planned to refuse induction as long as the labs were fine. I started doing everything I could think of to induce labor naturally over the next couple of weeks - eating dates, taking walks, using evening primrose oil, bouncing on the yoga ball, massage, acupuncture (which was intense!), moxibustion, etc. None of it seemed to work.
Thursday, July 14th, 2016
I’m 39 weeks, 6 days, and my lab work comes back with protein/creatine levels that have jumped and I am officially diagnosed with preeclampsia and the midwives want to induce that day. The only cure for preeclampsia is delivery of the baby. Preeclampsia can affect your liver & kidneys and quickly escalate into eclampsia, which causes (sometimes fatal) seizures, so I could no longer deny that induction needed to happen but I was heartbroken that my plans and preparation for going into labor naturally and laboring at home were gone. I was still hopeful that with waterproof and wireless monitors, I would be able to labor in the tub and move around and still have a vaginal birth.
We arrived to labor and delivery around 2pm on Thursday and they had put someone else in the room with a tub, so I was put in a regular room but told as soon as one opened up, I would have it. Mattie, the midwife, suggested we start with cervidil to soften the cervix. Cervidil is a small tampon-like insert that is put against the cervix and then removed after 12 hours. My cervix was completely closed and hard when we began. She inserted the cervidil and we tried to rest. Throughout the afternoon and night my blood pressure was being taken every 15-30 minutes and labs were drawn periodically to monitor my condition, so resting was difficult. Although the constant blood pressure checks were annoying, everyone seemed on board with letting me get the room with the tub and letting me move around during labor. I remained hopeful in salvaging some of my birth plan.
Taking an Unexpected Turn
Around 7pm, the nurses came in and said a room with the tub had opened up and that we were moving. Chad began packing all of our things and I started to make my way toward the door.
Just as we had packed everything up and were about to walk out the door, Mattie busted in with the results of my lab work. It showed that my platelet count had dropped dangerously low (from 256 to 76 over 24 hours), which put me at risk of bleeding out and I was now classified as having severe preeclampsia and possibly HELLP syndrome. The midwives could no longer continue my care and I was turned over to the staff and OB on-call. The room with the tub went out the window.
A swarm of people immediately entered the room. Some of the doctors were talking to Chad mentioning that they were in contact with blood banks to make sure they had enough of my type of blood just in case. They started taking more blood, hooked me up to magnesium sulfate to prevent seizures, and put a catheter in. Moving around for labor was now also out of the question.
During the flurry of activity, I asked the nurse if there were any side effects to the IV drip of magnesium they had put me on and the she casually mentioned “Oh, yes it makes people feel really bad. Hot flashes and nausea.” A few minutes after she said that I was vomiting into a bucket and felt like I was on fire. They brought in a box fan for me, which helped for the heat. The magnesium is also a muscle relaxer so I became very groggy and limp. I could hardly move. I felt drugged up, nauseous, and had a headache. It was a horrible feeling.
An anesthesiologist came in and started talking to me about how my pain relief options were now also very limited, due to the possibility of bleeding out. No epidural, and if I did have to resort to a c-section, it would be under general anesthesia and Chad wouldn’t even be able to be in the room and no one would see our son be born. I was devastated, but honestly was considering having a c-section at that point because I felt like I could not labor in the state I was in.
After bearing the IV meds for a few hours, we were contemplating just going ahead with a c-section since it seemed like that was where this road was taking us anyway. Suddenly, one of the residents came in and told me that they repeated my lab work, and it turns out my platelet count was fine. It was a lab error!
One of the staff made a comment about how they thought I was the sickest patient in the hospital for a while there. Taking it in stride, I immediately asked to be removed from the IV drip of magnesium because it made me feel so horrible. However, since I was now under the care of the OB, they didn’t want to take me off of it as it is a standard protocol for preeclampsia patients. They stuck with this recommendation even after I reminded them that just a few hours earlier, being in the same state of health, I was about to move into the tub room with wireless monitors.
I was really frustrated, but stayed on the magnesium overnight and tried to get some rest.
Around 7am on Friday, the next shift came on. A new midwife, Cathy, was on call and after I expressed my desire to get off of the magnesium, she consulted with the new OB on call and they decided they would remove the magnesium drip. Hooray for small victories!
Despite the removal of the magnesium, it took some time to wear off and I still felt nausea and headaches so we kept the catheter in while I tried to rest some more.
Meanwhile, the cervidil softened the cervix but labor still wasn’t progressing. At this point, Cathy came in and told me I could go home due to the lab error and since the induction wasn’t progressing. She said to go home and we’ll see if you go into labor naturally by 42 weeks. Despite my strong desire to go home, I had to correct her and let her know that I was being induced due to protein in the urine/preeclampsia, not because of the low platelets from the lab error. She looked a little surprised, left the room to reconsult with the doctor, came back and agreed.
Keep on Keepin On
Throughout the day on Friday I was given 3-4 doses of cytotec which is just a small pill. There was little change in dilation, but the cervix was definitely softening and they could tell the baby was pressing down. Cathy was upbeat and told me “I’m delivering this baby this weekend!” which made me feel better - no more revolving care providers. Cathy was on call until Monday so I knew she’d be with me the whole time which was a huge relief.
In the evening on Friday, we decided to try one more dose of cervidil. I was feeling very mild, period-like cramping at this point, so I was hopeful that things were getting started. Cathy suggested I take a couple benadryl and try to sleep through the easy contractions, so we did that. Around 7pm, I took the benadryl and Chad & I turned the lights off and tried to get some rest.
Let’s Get this Show Started
All of a sudden, despite my desire to just sleep after being awake for so long and with the benadryl kicking in making me groggy, the contractions were no longer “easy”. They were extremely strong. I labored in the bed for a couple of hours, very drowsy from the benadryl and in serious pain. As things ramped up, Chad let my doula know what was going on and she came back to the hospital around 10pm after having left to let us rest. They both took turns putting counter pressure on my lower back as it was the only thing that made the contractions bearable.
I could feel the contraction start down low and wrap around my back - exactly as I heard someone describe - like there’s a thick elastic belt around you tightening so much you feel like you’re going to break in two. I even felt my body pushing and felt tremendous pressure like I needed to have a bowel movement. I was grunting and bearing down and was so confused why I was feeling the involuntary urge to push so I asked to be checked. I was hopeful that maybe I had dilated amazingly quickly and I was about to have a baby.
The charge nurse came in and checked me. After a short pause, she basically laughed and said I was barely 1 cm. Shocked at how strong the contractions were, I wanted them to take the cervidil out and see if things would progress on their own. They did that and the contractions kept going. The contractions were on top of one another and lasting for what felt like an eternity with little rest in between.
I labored in the bed for about 12 hours total in the evening/night on Friday, and got to 4 cm before I couldn’t take it anymore and asked for the epidural. At that point I had been in the hospital for 36 hours getting hardly any rest, so we thought the epidural would allow me to sleep and hopefully dilate the rest of the way. Before I got the epidural, I asked to take a shower which the staff allowed, with some prodding by my midwife Cathy. I had a few contractions in the shower and needed Chad to come in and put counter pressure again. It was so unbearable, I couldn’t wait to get some relief! I would have literally done anything to make that pain stop.
I was nervous to get the epidural but it was fine, did not hurt one bit (comparatively!) and the anesthesiologist was amazing and explained everything to me and answered all my questions. I felt like a different person with the epidural and was so glad I got it. Honestly, the worst part of it was that they had to move the IV from my forearm to the top of my hand, which was much more uncomfortable.
Looking back thinking about the contractions, it felt like I was in a dungeon or a dark cave writhing in pain and screaming. I felt like I was the demon girl in the Exorcist. So much pain. Chad mentioned to me later that the weather seemed to predict how the day would go. Thursday & Friday were dark, rainy and gloomy days. After they let Chad back in the room once the epidural was in place, the sun was just beginning to rise. Saturday morning was a bright, beautiful, sunny day and my demeanor had changed right along with the weather.
Saturday morning, they let us sleep a bit and Cathy said hopefully we’d have a baby by lunchtime! Well, noon came and Cathy checked me and I was still at 4 cm. It seemed the epidural had stopped labor so we decided to start the pitocin to make sure things kept progressing.
Monitoring the baby on pitocin was a little stressful, at one point 3 nurses rushed in and asked me to move to a different position because the baby didn’t like the one I was in and they gave me oxygen to help him recover. I wanted to keep changing sides to make sure the baby could move down lower into the birth canal but every time I moved, the monitors would lose his signal and they’d have to come in and adjust it or his heart rate would dip and I’d need to move again. It was a little scary hearing his heart rate dip when some of the stronger contractions started. I took lots of deep breaths to make sure he had oxygen and sent good thoughts to him to be strong.
After a while I started feeling a lot of the contractions again, so I received another dose of the epidural. I had a little button where I could give myself more doses whenever I wanted it. The medicine felt cool on my back going in. It was a very neat feeling. I still felt a lot of pressure. They explained that still feeling pressure down low was normal, it was the baby descending and that would not go away (basically felt like I was about to take a massive shit!) I was amazed that I could still feel that and move my legs pretty well, as were the nurses and Cathy. They kept saying I had a “great epidural” because I could move so well. Cathy checked me later that afternoon and I was at 6 cm but extremely soft, so she stretched the cervix a bit around his head to hopefully open it up more. I was getting worried things weren’t progressing fast enough but thankfully Cathy never made me feel that way or that the clock was ticking.
At some point, I felt warm fluids running all over my legs and since I had a catheter in I knew it wasn’t pee. Cathy checked and my water had broken. Not only that, but there appeared to be meconium in the water. I was a little worried about that but I knew the NICU at Ochsner Baptist was one of the best so I felt reassured everything would be ok.
My blood pressure started rising again in the evening and the OB staff started talking about putting me back on the magnesium drip which terrified me. I did not want to be on that again. I pleaded with Cathy to not let them put me back on that awful drip. She left to go talk to the OB to see what she could do.
Cathy came back around 8pm to tell me the good news that she got them to hold off on the magnesium a little longer. While she was there, she decided to check me since I hadn’t been checked since earlier in the afternoon.
“Oh, I think we’re going to have a baby!”
I was completely dilated and could start pushing! I was so relieved the time had finally come. With a flurry of activity, the NICU nurses came in and we started preparing to push. Cathy said that if the baby came out crying we wouldn’t need the NICU and they could put him right on my chest. I was hopeful that would be the case. The nurses helped tell me when I was having a contraction and when to push, but surprisingly I could also feel when the contractions were happening and knew when to push on my own as well.
Pushing was hard work. It felt like my head was going to explode, but I was so happy to be doing it! At this point I had been in the hospital almost 55 hours. I pushed with all my might as Chad was on my left side and my doula, Kimberly, on my right. Kimberly kept me supplied with ice chips in between contractions which tasted like heaven. Cathy kept things light, talking and laughing and telling me how much hair the baby had. I used a mirror so I could see and although it was all kinds of gross it was also cool to see the progress I was making.
I pushed for about an hour and a half. It was definitely uncomfortable when he was crowning and I felt some burning, so I wanted to push harder to get it over with. They told me to slow down but I didn’t. In hindsight, I should have taken that part the slowest because I did need 3 minor stitches.
At 10:06pm, I felt him come out and he cried right away and they put him on my stomach. I had no idea what to do with this warm, squirmy little thing but I was so grateful that he and I did this together and he made it out safely and was healthy. The first words I said to him was “We did it, you did such a great job, baby! You are so strong!” He was finally here and it was worth it!
Not Over Yet
The preeclampsia saga didn’t end there though. After delivery, my blood pressure spiked to 190/110 which is definitely seizure/stroke territory. Funny thing is that my blood pressure had actually gone down while I was pushing! They put me on the magnesium again (I didn’t fight it this time), but I did ask for zofran to help with the nausea and it worked.
Chad's mom and Mike came to the hospital around midnight to see Carson. It was really nice to see her and get her opinion about my whole medical saga.
It was difficult feeling so drugged up and immobile with a new baby. Chad had to do everything for him: changing his first diaper, swaddling, calming, etc. and help me at the same time. I'm so grateful for him. They took me off the magnesium the next morning once they decided that I probably wasn’t going to have a stroke and put me on strong blood pressure meds.
The next morning my dad came and I was so glad to see him. I think I started crying a little telling him how bad the magnesium made me feel. It was all so overwhelming, but really good to see my dad's face.
I was on the blood pressure meds for about 5 weeks. They made me feel dizzy and lightheaded when standing up and moving around, which was terrible. I couldn’t walk around holding Carson because I was afraid of fainting or falling. Chad changed every single diaper for the first month at least! I gladly let him take care of that. :) Chad was very supportive throughout breastfeeding, even when I got so frustrated and wanted to give up. We got through it one feeding at a time.
I do wonder how the birth would have been different if it weren’t for the lab error and we would’ve gotten the room with the tub and wasn’t confined to the bed. Maybe I would’ve progressed faster and maybe I would’ve been able to bear the contractions and not get the epidural, who knows?
Oddly, I wasn’t upset then and I’m not mad about it now. I believe it was my mom who gave me the grace to make it through. Maybe it happened “for a reason” and I needed to be on the magnesium to prevent a seizure. I’m just thankful Carson and I are both alive and well. I’m extremely grateful for the care that I received from all the nurses, OBs, midwives, Chad and our doula, Kimberly.
Having a midwife made such a huge difference in the experience - I was able to eat & drink throughout because I was a midwife patient. The nurses would tell me I wasn’t allowed to eat & drink but when I told them I was a midwife patient they backed off. Can you imagine not being able to eat OR drink for over 48 hours?! I was also given so much time to progress and have a vaginal delivery instead of the OB timeline which would’ve ended up in a c-section probably after 24 hours regardless of medical need. Even though I didn’t need a doula for a natural birth, Kimberly was helpful in giving Chad little breaks and bringing him food and supporting us as we talked about what was happening and making decisions. Chad was there by my side the whole time. He got a little squeamish cutting the umbilical cord, but he did it. It amazes me what women go through to give birth and I'm thankful I was able to experience it for myself.