As you may have noticed, there has been a significant gap between my last post and now . . . well, there was good reason for it: after 3 days of labor, our daughter Guinevere Grace, made her entry into this world.
Three days of labor??? Yes, three days of labor. Here’s why: I ended up having to be induced because my baby was too small. It sounds weird, I know. I had heard of women being induced early because their baby was too big, or induced because they were over 40 weeks and their baby was making no signs of being ready to come out of its own accord. But apparently, there is a third scenario for induction: if the baby is too small and appears to have stopped growing in the womb.
Here’s the birth story (warning, it’s a long one):
Day 1 - Wednesday, June 27
Aaron and I had an ultrasound scheduled for 8:30am, Wednesday morning. At my last pre-natal appointment, I was measuring small (they measure your belly from the top of the uterus down to the pubic bone, and the measurement is supposed to correspond to the number of weeks you are gestationally). I had started measuring small a couple weeks earlier and I guess my belly had stopped getting bigger, so they scheduled an ultrasound to make sure everything was ok with the baby. I was just excited to get one more peek at my baby before she made her arrival.
At the ultrasound, the technician said, “Did they schedule this ultrasound because you were measuring small?” She told us that our baby was measuring really small, approximately 5 lbs 10 oz, and, while that wasn’t completely outside the realm of “normal,” she needed to call up to Labor & Delivery to check on whether they wanted to see me immediately or let us go over the results of the ultrasound on Friday at our next OB appointment.
L&D said to send us upstairs for some more testing. When we arrived, the Labor & Delivery nurse showed us into a labor room and strapped me up to some monitors to check and see if I was having any contractions and check on the baby’s vitals. Little did I know then that would be the beginning of this birth story. It turns out, I was already having minor contractions and didn’t know it. I looked at the monitor as I was having one and said, “Oh that?! I’ve been feeling that since Monday! I just thought it was the baby moving around.” Then we got the bad news – our baby had essentially stopped growing inside my belly. She was in the 1% for size for her gestational age, meaning 99% of babies are bigger at the same gestational age. Given that she did not appear to be growing, and that I was having mild contractions, and that my amniotic fluid was on the low side, and a host of other reasons that I cannot remember now, the doctor was strongly recommending that we induce immediately. As in that day. As in, I wasn’t leaving the hospital until the baby is born.
After Aaron and I picked our jaws up off the floor and got over the initial shock, we settled into our cozy labor room, broke out the iphones and blackberries and started notifying people who needed to be notified. The doctor and nurses warned us that with induction it could take up to 5 days before the baby was born. Given that information, we chose to only tell close family and friends (and work, of course) that we were in the hospital. We didn’t want the facebook world to know just yet because then everyone would think baby was imminent, and I didn’t want to deal with a bunch of “Is the baby here yet?” type questions.
After making the requisite notifications, Aaron ran home to get the bags we had so diligently packed to take to the hospital with us for when I was in labor. Of course, neither of us thought to bring them with us when we left the house that morning for the ultrasound. I’m really glad I packed a couple of changes of clothes for me since I entered the hospital all dressed in my nice work clothes that morning.
They started with a cervical check (I was only 1 cm dilated and 50% effaced) and then gave me a drug called Cervidil, which is used to soften the cervix. The cervical check and administration of Cervidil are not the most pleasant things in the world – in fact, it’s pretty darn painful! This may be a bit graphic, but for those of you who have no idea what is involved in a cervical check, basically, the midwife inserts her gloved fingers up inside you and feels around to try to get an idea of how dilated you are. Then the Cervidil has to be administered manually. The midwife inserts it with her fingers up into the cervical area. It was not fun! But there was a chance that just using this drug could spark me into active labor and then we wouldn’t have to use Pitocin or any other drugs.
The nice thing about the Cervidil is that I was still allowed to take walks outside occasionally for about an hour at a time. They even let me change back into my regular clothes so that I didn’t have to wander around outside the halls in my hospital gown. While in the labor room, though, I was continuously hooked up to machines that monitored my contractions and my baby’s heart rate. For those of you who know me well, you know that being stuck in a hospital bed, hooked up to machines is tantamount to torture, so I really wanted to take advantage of those walks. The nurses actually encouraged the walks because, theoretically, they could help kick me into active labor. I was also allowed to eat and drink a regular diet on the Cervidil, so the nurses brought me lunch and dinner (for hospital food, it wasn’t that bad).
By midnight, I was definitely feeling the contractions. They were uncomfortable, but still not super painful - definitely not the type of labor that you see in the movies. They checked me again and I was still only 1 cm dilated. My contractions were very irregular, so they inserted one more round of Cervidil. I did my best to get some sleep. Do you know how hard it is to sleep when strapped to monitors? Every time I rolled over to try to get more comfortable, the nurse would have to come in to readjust the monitors that were strapped to my belly.
Day 2 – Thursday, June 28, 2012
After a not so good night’s sleep, Aaron went home to take a shower (he slept on the pull out chair next to my hospital bed). The nurses brought me some breakfast. I ate as much as I could, fully aware that it might be my last solid food before my child was born. Around 10am, Aaron and I took one last walk. Apparently Thursdays are Farmers Market days at Kaiser. We walked past all kinds of delicious smelling produce – fresh peaches, nectarines, oranges, etc. Then we walked past a guy who looked at me and my ginormous pregnant belly and asked if he could bum a cigarette! We laughed so hard! Seriously – who asks a pregnant lady walking around the hospital grounds if she has a cigarette?!
After our walk, the midwife did another cervical check – I was still only 1 cm dilated, but now 80% effaced. My contractions were still very irregular. Sometimes they were as close together as one minute, other times there were ten minutes in between. They varied in length, but none were longer than a minute. I was still only in “early labor” after a day and a half, so it was time to move to Pitocin, which is administered via IV. The problem with the Pitocin is that I was no longer allowed to go for walks and I could only “eat” clear liquids – i.e. broth or water. By 2pm, I was starving, so I asked for some chicken broth. It was truly the most disgusting chicken broth I have ever tasted!
One nice thing about the way Kaiser operates is that they actively monitor women in labor and the unborn babies on Pitocin. One of the nurses explained to us that other hospitals automatically increase the dose of Pitocin every half hour to hour in order to advance labor. The problem with doing that is that Pitocin can affect the baby’s heart rate. If the baby’s heart rate drops too far, then it can cause the baby to go into fetal distress, which can result in a c-section. Kaiser, on the other hand, will increase or decrease the dosage of Pitocin depending on the baby’s well being. Throughout the day and night, the nurses would constantly come in and adjust the dosage that was dripping in my IV. If the baby’s heart rate dropped too much, they would completely stop the drip and put me in an oxygen mask to help her heart rate return to what it should be. I was not a big fan of the oxygen mask, but for the health of my baby, I made do.
I really didn’t like being stuck in the hospital bed all day and not allowed to get up and walk around. After a certain point, my back started to really hurt – not from the contractions, but from being stuck in bed for hours on end! There were times when I would ask to go to the bathroom, not necessarily because I needed to go, but just so I could stand up for half a second and maybe stretch a little bit.
By Thursday night, I was in moderate pain from the contractions, but still hadn’t progressed to active labor. They did another cervical check, and I hadn’t progressed at all. I honestly think the cervical checks were the most painful part of the whole experience. I’m not sure if they hurt all women like they hurt me, but it was bad! I think part of the reason they hurt so bad for me is that I wasn’t dilating at all. By this time it was midnight of my 2nd day in the hospital, and I was exhausted. I think it was a combination of the pain of the cervical check, plus exhaustion, plus the emotional roller coaster I had been on for the past 48 hours, but after that last cervical check on the 2nd day, I broke down in tears. I just couldn’t stop crying. I felt so bad.
It was at that point that the midwife suggested that if I wanted to get the epidural that would be a good point to do it. As I think I’ve mentioned before, my goal had been to have a drug free childbirth – but I recognized the reality that it might not end up that way. Aaron and I discussed it. The idea of the drug free birth was already out the window as I had already been on two drugs since being admitted to the hospital. Also, one of the main appeals of not getting the epidural was that I wouldn’t be confined to a hospital bed. I could get up and move around and change positions as need. But, since I was on the Pitocin, I was already confined to the hospital bed. I was so exhausted and my back was in a lot of pain, so we called the nurses and midwife back in and requested the epidural. Honestly, I am so glad I made that decision! I was actually able to get some sleep that night. They still had to keep readjusting the monitors strapped to my belly, but at least I wasn’t in any pain.
Day 3 – Friday, June 29, 2012
Around 6:30 am on Friday morning, the midwife came into my room to check on my progress. My contractions still hadn’t become regular, but I was now 3 cm dilated . . . at least it was some progress. They decided to break my water to advance the labor to the next stage. For those of you who don’t know, when they manually break your water, they take an instrument that looks a lot like a knitting needle and insert it into you to break the bag of waters. Thank goodness for the epidural! The cervical check and the breaking of my water didn’t hurt at all! I am positive the pain would have been absolutely unbearable had I not been on any drugs.
About an hour later, the nurses came into my room and told me that they were going to move me into Labor & Delivery Room 10. (In case you don’t remember from one of my earlier blogs, L&D Rooms 9 & 10 are the two nicer, renovated delivery rooms). Bonus, Room 10 is the one with the window – it was the room I wanted. Finally something going the way I had hoped in this whole birthing process! It was at this point that I could finally start to see the light at the end of the tunnel. After all, if they were moving me into a delivery room, it meant that a) they were reasonably sure I would be delivering that day and b) they were pretty sure I would be able to deliver vaginally. Had they been thinking c-section, I probably would have had to stay in the labor room until they moved me into the operating room. I have to give the staff at Kaiser props for never even mentioning the word c-section to me throughout this entire process. I know it had gone through my head a bunch, but I did really want to avoid it if at all possible.
When they wheeled me into the room, my mood suddenly lifted.
Around noon, the midwife came in to check me again. By this time I was now 8 cm dilated! It’s amazing how quickly things move after your water breaks! The midwife told me that she thought it might be time to push in about 2 hours! Hallelujah! The light at the end of the tunnel was coming closer and closer!
Even though I had the epidural, I could still feel some of the contractions in my back. I’m almost glad I could feel them, though, because at least I knew things were happening and my baby would soon be in my arms and this whole ordeal would be over. Aaron was amazing throughout the entire process, bringing me ice chips and chapstick when necessary and providing moral support.
Two hours later, as promised, the midwife came in to check on my progress, and said, “Well, I can see the head! Looks like it’s time to start pushing and see how we do.” Of course, because of the epidural, my legs were completely numb. It took Aaron and the nurses working together to move my legs into the stirrups to get me into position for pushing. I’m not sure exactly how long I was pushing, but it felt like only half an hour. Aaron looked at me and said, “Oh my gosh, I can see the head! Look at the midwife’s hands – she has our baby’s head in her hands!” And then I watched the midwife pull my baby out of me. It was such a surreal experience! I still can’t quite comprehend that I pushed another human being out of my body! She was long and skinny and covered in goo. Sorry to sound cliché, but it really was a magical moment.
Her heart rate had dropped during the pushing, so the midwife called in the neonatal team to check her as soon as she came out and make sure everything was ok. While they were doing that, I delivered the placenta. It was a lot bigger than I had expected! Then the midwife examined me to see if I had any tearing. I only had one small tear that required just two stitches. I was really impressed with that, considering how long my labor lasted and how nothing had seemed to go to plan.
After the neonatal team checked the baby out, the doctor came over to me and said, “Honestly, they didn’t need to call us in, she’s fine. But it’s always good to double check.” Her birth weight was 6 lbs even, and she was 20 inches long. So the ultrasound that got us into this whole mess was off by about 6 oz. Her weight was still pretty low for her gestational age (in the 2%) but her length is in the 50% - so she’s long and lean.
After the doctors were done checking her out, the nurses brought her over to me and then left the room so that we could have some family bonding time. Aaron and I stared at her and cuddled her for a moment before I said, “I guess we have to pick a name now, don’t we?” Aaron asked which name I was thinking. I looked at her adorable little face, and said, “I like Guinevere.” Aaron said, “Me too!” And with that, little Guinevere started bopping her head around my chest looking for food and we had our first breast-feeding session right then and there.
And there you have it, my birth story. I joked several times over the course of it all that it was karma, considering how relatively easy the pregnancy had been. And I find it quite ironic that our birth “plan” had been “we’d like to do natural, but will just roll with the punches” and yet, this experience was so vastly different from anything I had ever even imagined. I imagined “rolling with the punches” would mean getting the epidural or having a c-section. I never in a million years thought it would mean being induced early because my baby was too small and spending three days in the hospital before the baby was born. All the stuff we had packed in our hospital bag for the labor (the tennis balls for massage, the exercise ball, etc.) didn’t get used at all. Aaron and I were both actually looking forward to the at home part of labor. Oh well, we are just happy that both baby and I came out of the situation happy and healthy. And maybe I’m biased, but I think we ended up with a super cute baby. :)