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The Induced labor and birth of Maia Ellen

post #1 of 12
Thread Starter 
My induction…

Some would call it elective because I asked Dr. Campbell to strip my membranes at 36w1d. If that didn’t work then I was willing to let things go a while – at least until the next week.

But really I do not consider my induction Elective – or at the very least I would never call it convenience related. For multiple reasons they are listed below:

1)I was very nearly immobile the last few weeks. I required assistance to get up from any position and walking was unbearable. Enough so that Dr. had me on lortab just to be able to get up and pee. And I am NOT a pain wuss.
2)Adam has very limited time off. Had we not had Maia during the three days he had already been scheduled off we literally would NOT have been able to pay rent because his hours have been cut back that much.
3)Ultrasound done at 36w1d estimated weight at 8lb6oz. Dr. Campbell’s words – “we might want to think about getting her out before she walks out”. People can say all they want about u/s measurements being off up to 2 pounds that late in PG – usually the weights are OVERestimated. Well, in this case not only was it off but it was seriously UNDERestimated. Maia weighed 10lbs, 20z less than a week later when she was born at 36w4d.
4)I was admitted to the hospital in labor on Wednesday, labor petered out. My blood glucose numbers however did not peter out. They shot up, went crazy and started having a pretty major effect on both me and Maia. Enough that I was kept under observation for the rest of the week until my induction was scheduled. I was put on insulin and monitored more hours than I wasn’t.
5)Thursday morning: Glucose numbers over 300, Dr. Suggests amnio to confirm lung maturity so he can schedule induction. As a matter of policy both he and the hospital will NEVER induce prior to 39 weeks without amnio to confirm lung development. Amnio confirmed maturity at 96% Dr Campbell scheduled induction for the following day – however he was in TN the next day so he scheduled it for when he was back – later in the afternoon. At this point I do not know a single doctor that schedules something for “convenience” late in the afternoon of a Friday when he’s been on the road out of state for the day.
6)Dr. Was legitimately concerned with fetal size and Maia being hypoglycemic due to my glucose numbers. At this point Adam and I were as well. Our concern was indeed not unfounded. Dr. Campbell had issues getting her out due to shoulder dystocia and her glucose level was 20. She HAD to eat every hour at least .5 oz to elevate her glucose level for the first 12 hours and endured needle sticks each hour to verify BG numbers to confirm that it was rising instead of falling or it would necessitate a trip to the NICU for IV.

It is for these reasons that while Initially I did ask about induction (and concluding that was the right option for me was the single hardest decision I have EVER made in my life) I (and Dr. Campbell) do not consider my induction elective, or convenient. Though many who put great stock into Crunchiness vs. Sogginess would consider it that way. I know, without doubt that if I HAD chosen to wait until Nature decided it was time – regardless of WHEN that might have happened – that I WOULD have required surgical intervention – by both Adam’s testimony (he was fairly traumatized watching Dr. Campbell maneuver her out enough for him to Catch her) and Dr. Campbell’s as well.

That all being said… I struggled with the decision to do it in the first place. I felt as if I was betraying my own body in a sense. Something about not trusting in it enough to let it do its work in its time I suppose. But for me the bottom line was that I could NEVER get rid of that horrific nagging feeling that I had that I *needed* the hospital this time, that I *needed* the doctor and I *needed* to be there and so whatever was necessary to get her out within the time frame that I had that week. I do not claim to know what or why. But something outside of myself drove me there. Mary Ann – the midwife who attended Morrigan’s birth told me time and again that I could birth a 10 pound baby and that she would come when she was ready. I fought her on that, but She knows Dr. Campbell and knows also that he wouldn’t’ have done the induction without reasonable cause for concern – at the very least for my mental health. So, she said I could birth a 10 pound baby, I told her That Maia was indeed ready – turns out we were BOTH right!

I feel oddly far more at peace with this birth and pregnancy than I had ever dreamed I would. As a rule I hate intervention that isn’t merited on some level. I’ve actually been able to rectify the whole situation oddly enough. Even Dr. Campbell commented to me on it before he discharged me from the hospital. He said “I’m proud of you. You did a GREAT job, it’s not an easy thing to go from the kind of birth you had previously to the kind you had this time and let it take the course that is best for both mom and baby when it means intervening in ways you have previously not liked or had issues with. I think you made the best decision for all of you and I’m proud of your ability to do it that way.” I have to say I never have heard a doctor speak like that – EVER. One more point in Doc’s favor.

The other thing I need to point out is that despite it being a hospital situation and despite it being an induction I had everything exactly the way I wanted it. My birthplan was not only adhered to but I was thanked by the nurses for being as clear as I was in it – it made their jobs easier in that they didn’t’ feel they had to ask any questions because I was so clear – this is never a bad thing. I also have to say that even though it was a pitocin induction with ruptured membranes I was allowed things I did not expect to be allowed to have – I was allowed to labor in the water as long as I was not on narcotic pain relief. EVEN with ruptured membranes and pit. They left the internal monitor off until I was on pain meds – at which point I was 8cm anyhow so I wasn’t about to bitch about it.

But now onto what you are waiting for – Her birth story…

Though I will warn you that there are probably a great many edits and additions to come. Nearly three weeks out and I’m still having moments of selective recall – that Stadol is some loopy stuff I tell ya!

January 30, 2009, Today is your birthday…
You managed to arrange things just so. I’m nearly inclined to think that you arranged the snow and ice storm, too.
Day three in the hospital. Sugars are still crazy and I’m on insulin now. But whatever – you’re healthy and safe. Lili and Morrigan are excited to be able to meet you soon.
You, dear one, have been a trial and a mystery, but the most welcome gift I could ever imagine. I’ve been through constant nausea and vomiting, uncontrollable leg cramps, pelvic pain like I’ve never known before, and ultimately a needle in my belly to make sure you are ready to be out and a medical induction the next day. Right now we are waiting for the induction to happen later this afternoon.
But hey, you got us the good room – yeah for the jacuzzi!!
At 14:20, the pitocin was started. Here goes your first ride!
4:30ish Dr. Campbell ruptured membranes…..

Around 5 – 5:30ish I opted for the jacuzzi – good option – helped a bit for a while. But still this is much harder, much more intense than any other labor. Why should I expect different – goes right back to that whole mystery thing… After about an hour of the tub I wanted – no, needed pain relief. Dr. had ordered Stadol for me already having discussed pain control prior to labor in my birthplan. I told him my preference was for sedatives or narcotics. Well. The Stadol… not sure what the intent with that stuff is but it sure as heck didn’t do much for the pain but damn, I didn’t really care I was loopy as anything and sleeping between contractions so that was OK. I vaguely remember saying something to that effect to the nurse on duty. I think her response was something like “once you are in hard labor not much other than an epidural is going to help the pain” at which point I was around 8cm according to the nurse placing the EFM. So I figured good deal I was 8cm and less than 20 hours had passed so great! Actually at that point it had been close to 6ish hours, maybe 7.

At that point things got very very intense, I don’t remember if I was moaning, crying or breathing at that point but I do remember doing all of them at some points in the process. Usually I’m just a moaner but this time – as previously stated – was much different. This time I was in a quieter place, a place of acceptance of all things maybe. I dunno really I just knew it was a close thing and I knew I had to get you out. SOON. I had no real concept of time then, I only knew it felt like I had waited a lifetime for you to arrive and that was all I cared about.

I next recall telling the nurse I wanted the pit turned down, she fought me thinking I didn’t know what I was talking about until Dr. said it was ok to do, that worked for a while, then I told her to turn it OFF, she had the nerve to ask me what I thought It would accomplish – I told her “I don’t’ know, all I know is the my gut is telling me it NEEDS to be OFF” Again, she fought but then dr. said it was ok. But then I NEEDED to push (ok I don’t’ need pit to help me push at that point it’s all involuntary anyhow!) But I told her this and she said I HAD to wait for Dr. Campbell, I said Adam is catching she returned with “not without Dr. Campbell!” Just then Dr walked in, I screamed “She’s THERE!” Dr told someone to support my leg, by god you WERE there I *think* I told Daddy to get down there to catch you. Dr. agreed and told Adam to get on down there. Needless to say the nurse was more than a tad bit shocked that I was right it seemed. Eight minutes and three mighty heaves and you were out. TEN POUNDS of you – OUT, Finally! Someone laid you across my side (I was on my side at that time) and I could not believe it was really you. After all of this you were here – finally blissfully here for all of us.

I don’t think anyone could have anticipated just how much you’re being here would mean to all of us. I’m still in complete awe of you. I somehow don’t think that will change all that soon…
post #2 of 12
congratulations!!! It sounds like you trusted your mommy instincts and did just what you needed to get the birth your baby needed.
post #3 of 12
Perfect! You did it all just right....
post #4 of 12
Thread Starter 
Thanks...

I didnt' have a bad birth experience with either of my first two daughters but oddly I felt very healed this time.

I know I did the best possible thing... Thanks for thinking that I did!
post #5 of 12
Wonderful story mama! way to trust your instincts and stand up for yourself in labor!!

I am just wondering.. any way they got your dates wrong? for you to be 36 weeks and in that much duress and have a 10 lb baby??
post #6 of 12
Thread Starter 
Quote:
Originally Posted by LadyCatherine185 View Post
Wonderful story mama! way to trust your instincts and stand up for yourself in labor!!

I am just wondering.. any way they got your dates wrong? for you to be 36 weeks and in that much duress and have a 10 lb baby??
No, no way possible. I had my last m/c on 4/15, I was under the care of an RE at the time being monitored with blood work and ultrasound for any new anomalies since my previous m/c's, my next cycle began on 5/19.

A baby that large is not uncommon with gestational diabetes - which was a factor for me even though it was under control up until I was admitted to the hospital.
post #7 of 12
Well that was a great story, and I will second all of the people who congratulated you on following your instincts. I have vowed to listen to my body this time too, unlike last time when I let other people tell me what to do, to my daughter's detriment.

If I may ask, what was your wonderfully clear birth plan? I have seen so many, and I know most get disregarded by hospital staff... Would you mind sharing?

Welcome to your brand new baby, she has a wise mother!
post #8 of 12
Thread Starter 
Quote:
Originally Posted by MamaCaveBear View Post
If I may ask, what was your wonderfully clear birth plan? I have seen so many, and I know most get disregarded by hospital staff... Would you mind sharing?
Thanks not at all!

Labor:

* If membranes rupture prior to onset of labor I want no time restrictions (within reason).
* My partner, doula and birthteam present at all times without restriction
* Little to no intervention – nothing not absolutely necessary and only with time to consult my partner and doula
* I would like the use of a birthing ball, bed, beanbag, birthtub, stool, or squatting bar
* Dimmed lights and soft voices, Music and TV options for use, and I want my birth to be photographed or videotaped. Door closed at all times
* No restrictions on food or drink, movement, sounds or position
* Prefer Heplock to IV but only if absolutely necessary
* Do not offer pain meds unless I ask first. I am prepared to handle pain with many alternative and natural methods, if I choose drugs I prefer a sedative and/or narcotics
* External intermittent monitoring unless medically necessitated



Pushing:

* NO restrictions on time or position unless baby or I am in distress
* Do not cut me – no episiotomy, I prefer to tear - Encourage slower breathing to prevent tearing and use only a local if repair is needed
* Please support my perineal area with warm compresses and oil massage (Adam is prepared to do this – he has before)
* NO STIRRUPS unless I request them or I/Baby is in an emergent situation
* I expect my partner to catch the baby unless in medical distress
* Minimal talking and please NO directed/Counted pushing
* Skin to skin contact after birth and delay ALL routine procedures – No separation unless Baby or I are in an emergent situation
* Adam will cut the cord AFTER pulsations stop – we prefer to KEEP the placenta and will bring receptacle for it – please do not dispose of it.

IF Cesarean is necessary:

* My partner(s) is(are) to be present at all times during the c-section.
* I would like to have contact with the baby as soon as it is possible in the delivery room.
* We would like to photograph or film the operation as the baby comes out

o If Cesarean section is required Do not place Epidural or spinal under any circumstances
Recovery:
o If my baby is healthy and I am awake, I would like to hold my baby and nurse it immediately in recovery and will sign any waivers necessary to permit me to.
o As long as my baby is healthy, I would like my partner to be the babys constant source of attention until I am free to bond with her (i.e., holding, skin-to-skin contact, etc.).
o I would like to have my catheter and IV removed ASAP
o Please discuss with me what I can expect to feel immediately following the procedure and any post-operative pain medication options.



Newborn Procedures:

* If the baby has any problems, I would like my partner to be present with the baby at all times, if possible.

* I would like all newborn routine procedures to be performed in my/Adam’s presence.

* Please Do Not bathe, immunize, Inject Vitamin K or administer Eyedrops.

* PKU: immediately prior to discharge – will retest at 1 week if necessary

* Feedings: BREASTFEEDING NO BOTTLES OR PACIFIERS UNLESS WE ASK!!!!!

* I would like to see a lactation consultant as soon as possible for further recommendations and guidance. Requip is known to lower prolactin levels I may need to pump or have an SNS to maximize production immediately after birthing



* If my baby's health is in jeopardy, I would like:

o To be transported with my baby if possible. If not Adam will go with her

#

* To breastfeed or express my milk for my baby.



*

* I would like my in-hospital routine to be: Full rooming in, no separation, no exceptions, unless my baby is sick or we request otherwise.



* Medications taken:

o Daily:
+ Requip 2mg x1 @ bedtime – severe RLS
+ Flexeril 10mg x1 @ bedtime – Severe intermittent leg cramps/spasms
+ Prenatal Plus x1 daily
o As Needed:
+ Phenergan 25mg every 6 hours as needed - hyperemesis
+ Lortab 5/500mg every 8-12 hours as needed – severe pubic symphysis pain
post #9 of 12
Wow, great story! Congratulations!

I was also induced for medical reasons - sky high blood pressure, any time I got up off my chair. It was a very tough decision, but like you, I had a great support team, both medical and personal. It's hard not getting exactly the birth you dreamed of, but it sounds like you got exactly the kind of birth you and your daughter needed. Good for you knowing how to listen to yourself. For me, it was a great lesson that intervention isn't necessarily bad. It's unnecessary intervention that is the problem. Snuggle your baby girl - mine just turned one!
post #10 of 12
Thread Starter 
Quote:
Originally Posted by Girlprof View Post
Good for you knowing how to listen to yourself. For me, it was a great lesson that intervention isn't necessarily bad. It's unnecessary intervention that is the problem.
Thanks and that is the key - unnecessary. And the other thing is that elective doesnt' always mean convenience. Yes I elected to have the induction BUT Had I not done that I'm sure I'd have ended in a c/s emergently most likely so whiel it WAS elective and wasnt' convenient (other than the fact taht it kept us in the hospital when we would otherwise have been stuck in a house without power in the ice storm here in Central KY)
post #11 of 12
Quote:
Originally Posted by Mommy StormRaven View Post
Thanks not at all!

o If Cesarean section is required Do not place Epidural or spinal under any circumstances
Totally off-topic, but were you opting for general anaesthesia, or are you just more woman than I? I have thought and thought, and I would rather have a spinal than an epidural, because I want it over and done with once, nothing left in my back. But I thought the only other option was general knock-you-out?

Thanks for posting it BTW! it sounds good.
post #12 of 12
Thread Starter 
Quote:
Originally Posted by MamaCaveBear View Post
Totally off-topic, but were you opting for general anaesthesia, or are you just more woman than I? I have thought and thought, and I would rather have a spinal than an epidural, because I want it over and done with once, nothing left in my back. But I thought the only other option was general knock-you-out?

Thanks for posting it BTW! it sounds good.
I was opting for general. For a couple of reasons.

1) if I'm in a TRULY emergent situation there isn't going to be time for anything outside of GA (even my OB has this thought)
2) I have an extra lumbar vertebrae - it creates a spinal malformation which can make placing spinal anesthesia difficult and could cause potential permanent paralysis so General it is for me no matter what. I'm not riskign my ability to walk for pain relief.
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