I just wanted to post Eleanor Grace's birth story. She was scheduled to be born by rcs on 11/21 at 6am due to a persistent transverse lie. My two DSs were cs as well. The first due to fetal distress after a failed induction (I know, we all make dumb mistakes the first time around) and the second due to distress and failure to progress after 48 hours of labor with a midwife then family practice doc as a planned HBAC.
We planned at least a trial of labor this time around, but went in knowing my chances weren't good with my prior history, adding to it that my DSs were large and I have Type 1 diabetes. However, this LO decided pretty early on that she preferred to be transverse and sometimes oblique (tending toward breech). We tried pretty much everything to get her to turn with no success. After my failed ECV on Friday 11/18, we scheduled my rcs for Monday morning at 6am (right at 40w, when my others were born as well). It was the only available opening for over a week due to the Thanksgiving holiday. I was not happy about it at all, and considering not showing up. The attending on call was not someone I had ever met and when I researched her, did not rate terribly highly. Most concerning to me was that she was likely only doing OB attending rounds as a requirement of her faculty position since her specialty is listed as gyn and her research interests are HIV and STDs. Not a word about pregnancy, birth, post-partum care, nursing or patient advocacy to be found. I was truly upset and in tears for a couple days about it. But, my prodromal labor kept picking up and I didn't want to be at the mercy of an emergency considering the situation of her position and knowing that the staff over Thanksgiving would likely not be great either.
We went in Sunday for my pre-op appointment (I'd never had one of those before). I was having pretty intense contractions, but could still talk through them and had been losing mucous plug since Saturday. I was also suspicious of a slow fluid leak. I also knew my OB was attending and hoping that they'd decide I was in labor and keep me. However, the nurse in triage that hooked me up to the monitors zero'd the toco out at the peak of a contraction and didn't believe me when I told her, so it looked like I wasn't having any. The also chose not to test for a fluid leak since it wasn't dramatic and they already knew I had a history of trying to avoid my rcs with the Dr. on the schedule. So we did the blood work and met with the anesthesia team and were sent home. I just wasn't at peace with any of it, but I did at least feel better after meeting with anesthesia. I'd had an epidural that hadn't worked well with my first and a terrible bp crash and bad reaction to the medication with my second. This Dr. took it all into account and seemed to have a plan that made us feel good about a good spinal and anesthesia plan. They were also going to do the epi/spinal combo since apparently later c/s can be longer due to adhesions and I was planning on having my tubes tied as well. That would allow them to add medication if needed during the surgery.
So after no sleep due to worry and stress on Saturday, we finally got ourselves to bed around 10:30 Sunday evening to try and get some sleep before we had to get up at 4. I just couldn't get comfortable and kept tossing and turning and getting up every few minutes to pee and feeling contractions pick up. I really felt like I needed to have a bm and kept going to try since I didn't want to head to surgery constipated. But, it just wasn't going to happen. Around 11, I felt a pop and my water broke quite dramatically (never happened with my others). What an odd sensation! Anyway, it was full of meconium and we kicked it into gear. Between the mec and the transverse presentation, we knew we were now in a pretty emergent situation, so we headed to the hospital.
Once my water broke, there was no hope of talking through contractions, they took all my focus and were coming regularly at 3min apart. It was a rough 45 minute ride and I started worrying because I couldn't feel her moving any longer. I was starting to wonder if we had made the right decision to go to our hospital instead of the one 5 min away, although L&D encouraged us to come and said we should be fine. Once we got there, they hooked me up to the monitor and found her heart beating strongly right away, so I breathed a little easier. For some reason (providence, the grace of God) that I don't understand, my OB was the attending, even though he was supposed to be off by then. We got moved ahead of two other emergency c/s, but were still treated respectfully and unrushed. When I discussed my concerns about DDs possible low blood sugar if she couldn't/wouldn't nurse and wanted to know my options, I was told they don't use any formula until you sign an informed consent form detailing the risks of formula feeding (their words!) and used only donor milk or glucose in extreme cases!
We waited for the one c/s happening when we got there, then sent to the OR. I still walked myself in and climbed on the table myself. Dealing with get the spinal still sucked as much as I remember. I truly hate that part. But once it kicked in, it worked perfectly. They numbed what should be numbed and nothing extra. There was no desire to pass out or throw up when they laid me down. They were incredibly attentive to what I did and didn't feel and my perceptions, as best as I could tell it was working perfectly. No one strapped my arms down, I was free to move them as I felt I could. Then it was just a long wait for DH to get there. He was more OK for this one than the others. We'd talked it through quite a bit and was as relieved as I that even if it was an rcs, our DD had picked her birthday and my OB was in charge.
Anyway, it started out like all the others, but then it seemed to go on forever. I know I had suffered from pretty wacked out perceptions during my first two, so I though maybe the amount of time was normal and I was just confused. Everyone was talking quietly on the other side of the drape. The NICU team was standing by (due to all the meconium), after a while, they started looking bored and confused which made me think things were taking too long. But at least the table where they would check her out was directly in my line of sight, which hadn't been the case in my other two. After more time passed I was getting really concerned and DH was as well. It turns out he was worried about me and how I was holding up, but the anesthesia was perfect. I was worried about DD and why it was taking so long. I was really getting worried that something was wrong. So we asked one of the anesthesiologists and it turned out that there were so many adhesions and scar tissue between my incision and her, they were having trouble getting through it all to get to her. My abdominal muscles had separated during my previous pregnancy and had apparently made a very tight band of scar tissue around my belly at my belly button when they healed. The OB that had done my previous cs had also done a crap job of sewing me up externally (internally was fine) and had left a lot of damage to get through. So, the delay was getting to where she was, above my belly button. It also explained why she could never turn to get head down.
*Finally* we heard her cry and she was whisked over to the table for the NICU team where she was briefly and gently suctioned, given a 9/9 apgar, the Vit K shot (I was asked again in the OR to make sure I consented), weighed, not bathed, wrapped in a blanket and handed to DH to be with us for the rest of the surgery. We couldn't quite get her on my chest, but I did get to touch her and look at her while the surgery was finished. It still took quite some time to repair the damage from the adhesions, check my bladder for damage (thankfully there was none), tie my tubes and use sutures instead on staples to close. Once the OR cleared mostly out, DH and DD were sent to recovery for them to take out my spinal and transfer me to a stretcher and for her blood sugar to be checked.
Once I got to recovery I was told she needed to nurse now (her blood sugar was 27) and she latched on beautifully and nursed well. We got her blood sugar up with nursing and eventually transferred to a room. Eleanor Grace was born at 2:57am on 11/21 and weighed 10lbs, 3oz. When she was eventually measured she was 21.5" long (the shortest of our three). Recovery has been a little harder this time, it's the first time I've taken any narcotics once I left the hospital, but there was a lot of abdominal trauma that didn't happen the other two times. We left for home Wednesday evening and are glad to be home. :)