Friday, November 19, 2010

The Birth Story

Warning: this is a very long post, being an L&D nurse I love to hear birth stories, so for those of you who are like me I will try to relate the days events as best as possible. For those of you who couldn't care less, just ignore this post. This may take me a while as my new little angel is just like her big sister in that she is FUSSY from 6 to 9. The only cure to this "witching hour"? Being in mommy's arms. Good thing she's cute...irresitibly so.

As I mentioned, I was scheduled for an induction on the 13th, Audrey's due date. I was nervous about inducing because often times interventions lead to more interventions which can land you in the OR pretty quickly. But our baby was staying put, so we woke up nice and early Saturday morning and headed down to the hospital. One of our charge nurses called me the night before and asked which room I would like and who I would like to be my nurse which was awesome. The nurse I requested works per diem which means she would be first to be cut on a slow day, which indeed Saturday was. However a couple of other nurses had already requested off, so she came in...God's hand already at work.

When we arrived at the hospital and I saw that my night nurses had decorated the entire room for me I began to feel more at ease and very loved. Also, one of my favorite nurses who trained me during orientation was charge that day...another God-send.

I went through the routine that I have been through a hundred times with my patients...the whole thing a bit surreal being on the other side again. I was hooked up to the external monitors, an IV was placed, and pitocin was started. Pitocin is a synthetic form of oxytocin which is a hormone the body naturally produces that stimulates uterine contractions. It is important to be monitored continually when on pitocin because it can overstimulate the uterus and cause the baby more stress.

Everything was going very well for the first few hours. The baby's heartrate looked beautiful, I was having mild contractions and I was able to ambulate around the unit. At around 10:30 am the doctor on call showed up and wanted to check me to see how I was progressing. I got back into bed and just as I layed down on my back the baby had a significant deceleration (heart rate dropped) to the 90s for what seemed to me like an eternity...probably 90 seconds. Here is where the "nurse curse" became real to me. Our ears are trained to hear every little decel and accel while we are going about our work...so immediately I got onto my side, then the other side when that wasn't working.

My heart started racing and I could literally see my doctor planning my c-section and I freaked out. I think my first thought was, "oh no, I haven't prepared Annika for the fact that I may not be able to pick her up if I have surgery." Then worse thoughts like, "what if something goes wrong." I literally wanted to rip off the monitors and walk out of the hospital. I don't remember a time when I was so scared. All the while the nurse and doctor were talking about the possible causes of the decel...it was likely a cord that the baby was laying on. The doctor asked my nurse for an amniohook (device used to break the water) and said she would apply internal monitors to monitor baby and contractions better. Mind you the doctor had just said that she was able to "bounce the baby's head around" meaning it was not fully engaged, meaning there would be danger that the cord could slip down past the baby's head necessitating an emergency cesarean. I looked at Eric pleading for him to say something (I think I felt like I shouldn't say too much being that I have to work with this doctor). So bless his heart Eric asked what the internals were for and why we needed them at this point.  I pleaded with her not to break my water just yet. She agreed that she would leave me for 30 minutes, give the baby a chance to recover and we would reevaluate. She left the room and immediately my nurse Star grabbed my hand and Eric's and prayed that God would move the cord and protect the baby through labor. Slowly I stopped shaking, slowed my breathing, and my heart rate and the baby's returned back to normal. (The baby's heart rate had risen quite a bit in what the doctor called "overcompensating" for the decel. I think it was because I was so worked up.)

The baby continued to do better and better, but I then started having variable decels with contractions. (there are 3 types of decelerations: early, late, and variable. Early decels usually indicate head compression and are reassuring, late decels indicate placental insufficiency and are not reassuring and variable decels often indicate cord compression or decent of baby). I was still in very early labor so this was disconcerting for me. We put on music and I just started praying and praying. I moved into every position possible to try to relieve the pressure on the cord. Finally I stood up at the side of the bed and just swayed with Eric and the decels went away. We stayed like that for about 3 hours...baby looked better than it had all day.

Each contraction got stronger and stronger and came more and more regularly. I remember when the pain got to the point where I thought about an epidural. Eric asked me one time if I wanted it, and all I could think was that I had to be able to move around if the baby had more decels. Also, there is a possibility that your blood pressure can drop after an epidural which can in turn cause further problems for the baby. I didn't want to do anything else that could hurt the baby. So I decided we would do it without. Thank goodness nobody asked me again if I wanted the epidural, cuz I would have caved. Star never even mentioned it. I did ask for Fentanyl when I was about 5-6 cms dilated which was amazing for about 40 minutes.

The doctor came in shortly after and decided to break my water. The head was now well engaged and I the nurse and doctor felt that labor would really speed up if I was ruptured. She broke my water, labor REALLY kicked in...I mean wanting to climb the walls and beg for the epidural and gripping Eric's hand with all of my strength and making sounds I didn't know I could kicked in. I went from 6 cms to 10 in under an hour. Eric was amazing and helped me through every single contraction. Counting them down, telling me how many more breaths to take, cheering me on. I didn't feel like I could make it through one without him there, so I never let go of his hand.

Just when I thought I could not wait any longer I heard the doctor say "she's complete." I just thought "thank God I can push this baby out." I started pushing at 5:45 pm and delivered our beautiful baby at 5:52. The entire time I pushed the baby's heart rate was again in the 90s, but with good variability (not a straight line, but varying 6-25 beats from baseline). All I could think about when pushing was how in the heck women do this and push for 1-2 hours WITHOUT an epidural...amazing! I could not believe it when the doctor put the baby on my chest. We did it. After a few seconds I realized we didn't know what we had. I reached for her legs and asked Eric what we had. As they took the baby to the warmer to dry and stimulate I heard him say, "we have another little girl." I remember saying over and over, that's what I wanted. As soon as she started crying more strongly (she was a little stunned from the birth...took her about 45 seconds to really cry hard) they took her back to me and I felt like I was looking at Annika again...it was surreal.

The first words out of my mouth after Annika's birth (WITH EPIDURAL): "That was fun, I want to do that again."

First words out of my mouth after Audrey's birth (WITHOUT EPIDURAL): "I never want to do that again."

Seriously. BUT, now that a week has gone by I agree that you really do forget the pain. Thank goodness because otherwise there would be no children.

I know that my experience with Audrey's birth will make me a better L&D nurse and though it was difficult I am very thankful for how it happened.

Things I have learned:
1: a good labor coach/support person is worth his/her weight in gold. Do not underestimate your value daddy's.
2: it is CRUEL to tell a woman who feels like she wants to push not to push...CRUEL.
3: Pray

8 comments:

Cindy said...

Wow ! What a story to tell Aubrey when she grows up! Especially, the lesson's learned. Kara, you are a great writer...use that gift! Hugs with Love Cindy

Jen Stutzman said...

Oh Kara what a sweet sweet story. I cried through it, thank you for taking me along with you. I was praying for you that day so it was so fun to read what was going on that day. So beautiful!!! love love

Jen Stutzman said...

Kara!!!!! You are awesome!! What a sweet sweet story. I was praying for you that day so it was so fun to read what was going on that day. Thank you for sharing, I cried through it. So beautiful!! Great job Eric!!

KELSEY C. said...

good job mama!!!!!!!

Tatum said...

crying! crying! crying! that was beautiful kara! i had no idea and i have BEEN DYING TO TALK TO YOU, but i know how important these first few weeks are :) Man no wonder you guys were so heavy on my heart ALL DAY...Love you so much and am so excited to meet your little angel.

Corrie said...

Thanks for sharing all the details. I love feeling like I get to be a part of things even far away. Have been thinking about you lots today.

I could not agree more with your final thoughts. I get overwhelmed whenever I think about how grateful I was for Adam when Eva was born. The craziest, but most intimate moment of our marriage was his coaching me through that birth. And you may recall my reaction when they told me to not push. Cruel is right.

I am so happy for you and SOOO impressed with you for being such a strong Mama for your girl. Hope you are enjoying the glow.

I love you so much.

domesticjoys said...

Kara, what an amazing story! Praise the Lord all is well! She is gorgeous just like her mama. I pray that the transition to 2 kiddos is very smooth for you!

Take care,
Kelly

Debbie said...

I didn't comment when I first read this story Kara, but I DID eat up every second of it. YOU ARE AMAZING.

Thank you, thank you, thank you for sharing so I can be a part of your life, even as a lurker. :)