The Birth-12 hours -- Tuesday 8 a.m.
I woke up because I had to pee. I had been told to expect a phone call when they were ready for me to come in, and to give them a call if I hadn’t heard by 10 a.m. DH and I had some breakfast, cuddled on the futon in the office, and watched Veronica Mars, as DH tried to help me to relax.
When I called the unit at 10:30, I was told they were having a very busy day so they weren’t ready for me yet. They asked me to come in for an NST, so we went in around 2 p.m. They were still swamped so we waited in triage. And waited.
I was starting to get a little freaked out, and then I thought maybe they wouldn’t have time for me and I would have another day to see if my body would go into labour normally. It was an attractive thought, although I was really concerned about going in the next day with a potentially unfriendly doctor on call. My peri had guessed that 3 out of the other 10 doctors would be supportive of my desire for a low-intervention birth, and I was specifically scheduled for a day when one of the suspected supportive ones would be there.
Finally, the perinatal director pulled a nurse out of her usual educator role to do my NST. Everything looked fine, so they sent me home to wait until they had staff and space to handle another birth. They called early that evening and asked me to come in around 8 p.m.0 hours -- Tuesday 8 p.m.Note: I am including my blood sugars here, because they are the numbers that guide my life, and they are especially important to this story. Nondiabetic readings usually range between 3.8 and 7.4 mmol/L. For me as a type 1 diabetic, good readings are roughly between 3.3 and 8.0, or up to 10.0 if I've just eaten. Anything in the nondiabetic range is excellent.
I was nervous and unhappy about being in the hospital, but was trying to focus on being excited about the prospects of meeting my baby. I had been checking in with him/her throughout my pregnancy. Five days earlier, I finally got the sense that s/he might be ready to come out.
I was optimistic because of the rapid progress my body had made towards labour in the previous week. I had had a lot of positive encouragement from Lisa W., my backup midwife, and Lisa D., my acupuncturist/naturopath. Carolynn was more cautious in her comments, but agreed that it was a good sign that I had gone from hard and closed to about 50%-75% effaced, 1-2 cm dilated, and soft. The baby was at station -3, though s/he had been at -1 a few days prior. S/he was anterior after being posterior in the previous weeks. I was not having any contractions that I noticed.
I had agreed to ARM (Artificial Rupture of Membranes), the thinking being that since my body appeared to be getting ready to go into labour, that might kick it into action and no other interventions would be required. I desperately wanted to avoid an IV.
The nurse who checked me in seemed reasonably friendly, although she was making disapproving noises about the woman in another room who was pushing -- and vocalizing pretty loudly as she did it. When the nurse was asking me all sorts of questions from her checklist, and I responded, "No," to, "Are you planning to have an epidural?" she gave me a hard time. "Come on, you never know …" I told her that while I would never rule anything out completely, the question was whether or not I was *planning* to have one, and I wasn't.
The resident who did the ARM was the only obstetrical staff member I really disliked. DH was not a fan, either, and thought he was kind of a jerk. When he had the hook in, I remember having a strong feeling that this was a very bad idea, but I chalked it up to nerves and/or my dislike of him, and let it happen. (As I write this, I am feeling a little sick to my stomach at the memory.) When my water broke, I was oddly surprised at how warm the amniotic fluid was, and also by the amount of it.
I started having contractions right away. I had to focus on them, but they were pretty manageable, and about 5 minutes apart. I changed into the skirt and bathing suit top I had brought with me so that I wouldn't have to wear a gown, and so that I had someplace to tuck my insulin pump.
I wanted DH and me to control my sugar as long as it remained stable. This was not a popular decision with Dr. AK, who was the endocrinologist on call, even though I was willing to discuss IV insulin and dextrose if it turned out I needed it. I thought that my best chances of having level sugars were to control them myself. I've been doing it for years and know my body. My number one priority was keeping my blood sugar at 7.0 mmol/L or below in the 2-3 hours before birth, since it minimizes the chances of neonatal hypoglycemia (low blood sugar for baby.)
I started walking. I was on continuous fetal monitoring. I had been assured that only intermittent would be necessary, so I asked about the change. According to my nurse, the on call OB and the med student, the CFM was suggested by the endocrinologist.
To this day, I cannot wrap my head around why I didn't just take the stupid straps off. I think I was just so out of my element that I couldn't think straight. It really shook my confidence that after so many assurances that I would be treated very much the same as any other woman in labour, all of a sudden people felt that my baby was in such danger that s/he needed constant monitoring.
And I felt almost as though I couldn't complain, because the monitors were telemetric (wireless), so I was not confined to bed. Still, the range of the signal was not very long, and I could only walk around the tiny little six-room unit. Around and around and around.
Tuesday 8:40 p.m. 5.2 mmol/L
Tuesday 9:41 p.m. 6.0 mmol/L
Tuesday 10:13 p.m. 5.0 mmol/L
4 hours -- Wednesday midnight
I was still walking. I told DH to grab some rest. My contractions were still manageable, and I thought he should get some sleep while I didn’t need him.
Wednesday 0:10 a.m. 6.4 mmol/L
Wednesday 0:59 a.m. 5.2 mmol/L
Wednesday 1:53 a.m. 3.2 mmol/L
Nearing 2 a.m., my sugar was a bit low, so I had some juice. I was finding the contractions a little more difficult to manage, and I was cold, so I decided to take advantage of the shower.
6 hours -- Wednesday 2 a.m.
I laboured in the shower for close to an hour. It was tough to get comfortable; my legs were tired from so much standing and walking. I tried sitting on the bench, but that was tough to manage with the contractions. Finally, I brought the birth ball in and bounced on that for a while under the water. I really enjoyed the shower.
Wednesday 2:55 a.m. 6.2 mmol/L
6 hours -- Wednesday 3 a.m.
I was hungry, so I got out of the shower, toweled off and grabbed an apple and an oatmeal cookie. I kept walking around the tiny little unit.
Wednesday 3:59 a.m. 5.7 mmol/L8 hours -- Wednesday 4 a.m.
I was getting really tired, and it felt strangely like my uterus was getting tired, too. My contractions had eased off. I was dead on my feet and decided to try to get some sleep. It was around this time that I started to regret coming in for an induction that started at 8 p.m. I felt trapped -- there was no going back now.
I knew it might possibly help to walk some more, but I really needed to sleep. I slept for 2.5 hours.10.5 hours -- Wednesday 6:30 a.m.
Wednesday 6:30 a.m. 2.6 mmol/L
I woke feeling woozy and anxious (I get very anxious when my sugar is low) so I asked DH to get me some juice. I drank it in bed and waited for my sugar to come back up so I could get up without toppling over.
While I was waiting, the jerky resident who had performed the amniotomy came in and gave me some pressure about needing to get further along in the labour. He wanted to start an IV of pitocin, and when I stated that I would like to try some more walking first, he got aggressive and started trying to use big words to intimidate DH and me. He told me that because of my ruptured waters, I was at high risk for chorioamnionitis (an infection of the membranes of the placenta and the amniotic fluid -- dangerous for both mom and baby.) He seemed taken aback when I asked for the incidence of chorio. He didn't know and said he would go find out.
By the time the conversation was over, my sugar was back up, so I got up and called Carolynn, who told me that this was was one of the participating hospitals in a study that showed that with proper management the elevated risk for chorio occurs 72-96 hours after rupture.
DH and I discussed calling Lisa D., the ND who had been doing the acupuncture in the preceding weeks. I had responded really well to the acupuncture -- each time, I got 8-12 hours of good, regular contractions. Lisa had said she would be happy to come to the hospital. I felt (stupidly) like I didn't want to impose on her, and DH didn't push the idea again.11 hours -- Wednesday 7 a.m.
Wednesday 7:03 a.m. 4.4 mmol/L
I was bouncing on the birth ball, trying to get something going. I was having no noticeable contractions.
The OB on call came in, along with two residents, a med student, and my nurse. I couldn’t tell if the OB was using it as a teaching moment (“How To Deal With A Recalcitrant Patient”) or if it was more of a power and safety in numbers thing. She talked some more about the need to get things going, and said, "I know that you're evidence-based, and I respect that, but you aren't having good contractions, and we're going to have to do something about that before too long."
I asked about walking outside the unit. Walking around the tiny halls wasn't doing anything for me. She was not thrilled with that idea. I pointed out that the original plan was for me to have intermittent monitoring, so why couldn't I leave for short periods and come back for regular monitoring? She replied that Dr. AK had really stressed the importance of continuous monitoring and the monitors only had a limited range, but she would be OK with me walking around the floor outside the unit. DH suggested the stairs; the OB was shocked and mentioned that I could fall.
At this point, the conversation was getting ridiculous. I exclaimed, frustrated, that I wasn't planning to go hiking; I simply wanted to get some fresh air and a change of perspective. I mentioned that I had taken the stairs multiple times the previous day when I was in for the NST. I was starting to cry and explained that I really needed to have the straps off my belly, they were uncomfortable and I desperately wanted to shower without them. The OB looked torn and sympathetic, and agreed that a shower was a perfectly reasonable request and that I could be off the monitor for ten minutes every hour.
I decided to call Carolynn and ask her to come. I told her, "I really need a friendly face."
I took a shower and came back to talk to DH. I was really upset, and having no contractions at all. I think I was so freaked out that my body had decided that it was not safe to be in labour. DH was rubbing my back as I bounced on the ball some more while we decided what to do. I was crying.12 hours -- Wednesday 8 a.m.
Dr. AK (the endocrinologist who, according to the obstetrical team, had insisted on continuous monitoring) came in and asked how things were going. We had a short, terse conversation where she denied having anything to do with ordering the CFM. She left, and went to make a note of the conversation in my chart.
I still don't know who lied to me, but someone did.
DH and I went walking around the floor. I was having very occasional, mild contractions.
Wednesday 8:39 a.m. 6.5 mmol/L
Wednesday 9:34 a.m. 5.8 mmol/L14 hours -- Wednesday 10 a.m.
Carolynn arrived, having taken her kids to school and braved rush hour traffic. Nothing was happening. I was completely exhausted and unsure what to do. We talked a lot -- I can't even remember about what, but I think I asked her questions about pitocin -- and eventually she sent DH to get some food. I asked for something hot; he brought me back some soup. She left around 11:30 or noon.
Wednesday 10:39 a.m. 3.5 mmol/L
Wednesday 11:28 a.m. 3.7 mmol/L16.5 hours -- Wednesday 12:30 p.m.
I can't remember at what point I met the new OB (there had been a shift change) but he seemed OK. At this point, I was still having only a few, irregular contractions, so I agreed to start pitocin. I wanted to gather some energy first, so I slept for about an hour and a half.
Wednesday 12:41 a.m. 6.4 mmol/L18 hours -- Wednesday 2 p.m.
I consented to a vaginal exam to get a baseline for the pitocin.
During my pregnancy, I had had no vaginal exams by my peri, only by my midwives when I asked them for stretch and sweeps. The midwives always took a moment to ask, "May I?" before doing anything, and I always found it slightly odd. I trusted them, and had asked for their help -- of course it was fine.
When I was in the hospital, I realized how much dignity that brief conversation always gave me. No one ever asked that in the hospital. Each time I had a vaginal exam, even though I consented to them beforehand, I felt really uncomfortable that everyone just assumed that it was fine to put their hand inside me without explicitly asking my permission in the moment.
I wasn't able to articulate that discomfort until now, while writing this, but it really, really bothered me at the time and continues to do so.
I was still at 2 cm. I started a low pitocin drip. The nurse knew about my problems with IVs, she called the anesthesiologist in to do it. It was definitely the least painful IV I’ve ever had.
Wednesday 2:08 p.m. 5.8 mmol/L
As soon as the pitocin hit my system, I started having very different contractions than anything I had had previously. I can't even describe how they were different -- not without using math terms, anyway. The only description I have in English is that it was like the difference between a wave that you can ride and a wall of water that takes you by surprise and pushes you under. Hypnobirthing helped a lot.
I was happy to learn that I could still labour in the shower. It was an enormous hassle to get into the shower with the IV connected and the monitors strapped to my belly, but the water certainly made labouring easier. DH stood outside the shower, talking me through each contraction. Unfortunately, the IV lines prevented me from being able to close the shower door, so we flooded the floor. My nurse assured me not to worry about it and to stay in if I wanted to, but I was getting cold and kind of queasy anyway so I decided to come out for a while.
Wednesday 2:51 p.m. 5.2 mmol/L19 hours -- Wednesday 3 p.m.
My queasiness quickly turned into full-blown nausea, and I began vomiting like never before. With each contraction, I was throwing up with my whole body. I kept throwing up over and over, and each time I did, I peed and gushed amniotic fluid. I threw up in bedpan after bedpan, in the toilet, in the sink, and on the floor. I remember standing in the room, naked, holding on to the bed, throwing up over and over, and apologizing for making such a mess.
DH kept helping me through each one. I can still vividly remember the sound of him saying calmly, “Focus on my voice.” I vomited again and again, first bringing up soup, fruit and juice, then quickly nothing but stomach acid. My throat was burning and I couldn't keep water down. In discussing it afterwards, DH and I estimated that I threw up approximately 40 times in the first two hours. (The estimation was based mainly on his recollection of how many times he washed the set of 7 bedpans.) We lost track after that.
Wednesday 3:27 p.m. 8.7 mmol/L
Wednesday 4:07 p.m. 10.2 mmol/L
Wednesday 4:30 p.m. 9.0 mmol/L
I had a few high blood sugars, and I thought it was just that my body was stressed out by the vomiting. In retrospect, I should have suspected an immune challenge. Those types of numbers with no apparent reason are typical early warning signs of an infection for me.21 hours -- Wednesday 5 p.m.
A little while into the pitocin time, I started having leg pain. It was completely independent of the contractions. It felt like there was something else going on, but I couldn't imagine what. I think now that it might have been that my body was dumping waste products from the infection and it was affecting my muscles the way lactic acid does.
I was having a tough time handling the leg pain on top of the contractions and vomiting. It felt like my leg muscles were in a gigantic never-ending spasm -- charley horses in all my major leg muscle groups.
Wednesday 5:08 p.m. 8.2 mmol/L
Wednesday 5:39 p.m. 6.8 mmol/L22 hours -- Wednesday 6 p.m.
Around 6 p.m., I asked DH to call Carolynn to come in. I still wasn't at 5-1-1 (contractions five minutes apart, lasting about a minute, for at least an hour) but I felt like I could really use some labour support. My contractions were really wonky -- I would have three or four right on top of each other, then one every two or three minutes for ten minutes, then one long one, then none for six minutes, etc.
Wednesday 6:11 p.m. 5.6 mmol/L
Wednesday 6:36 p.m. 3.9 mmol/L
Wednesday 7:08 p.m. 3.3 mmol/L
Wednesday 7:23 p.m. 5.6 mmol/L
24 hours -- Wednesday 8 p.m.
At 8 p.m., I finally told DH, “I don’t know how much longer I can do this.” We decided to do a vaginal exam to check how I was doing. I was at 3 cm. That was a huge blow.
My energy reserves were quite low at this point. I was exhausted and dehydrated from the contractions, vomiting and leg pain, and while I thought I might be able to go for another 7 cm, I was pretty sure that if I were to do that, I would have nothing left for pushing.
I decided to request an epidural to see if I could relax and get some energy back. Carolynn and Charmaine (midwifery student) arrived as they were wheeling the epidural cart in.
The anesthesiologist came in. I already liked him from the painless IV, and he was just such a mellow, calm, patient presence. He said he needed to tell me about the epidural before he inserted it, I asked if he was going to tell me more than that it involves a catheter being placed in the epidural space, that it carries small but not zero risks, such as death and paralysis (very unlikely) or headaches afterwards (more likely). He seemed a little surprised and replied that no, I had pretty much covered it.
Wednesday 8:10 p.m. 3.8 mmol/L
Wednesday 8:27 p.m. 3.6 mmol/L
I had some Life Savers for the low blood sugar, and once again got pressure from Dr. AK by phone to go to IV insulin/dextrose. I actually considered it at this point, but found out that it would require a second IV line, because they can't mix pitocin and insulin. I was not willing to have another IV inserted. I asked about continuing to use my insulin pump for insulin, but having IV dextrose to quickly correct for lows. She said that I had to choose: either both insulin and dextrose by IV or neither one. I chose the latter. She was annoyed.
24.5 hours -- Wednesday 8:30 p.m.
I had originally been really afraid of the epidural (an enormous needle in my back -- no thanks) but it was not that bad. The most difficult part was remaining absolutely still through several hard contractions while the needle went in.
Once it was in, the anesthesia hit within about 10 minutes and I stopped vomiting, though I felt very weird and spaced out, as though I could sleep for days.
Wednesday 8:37 p.m. 3.6 mmol/L
My nurse checked my vitals -- my blood pressure was fine, but I had a temperature. Things get a little hazy for me from here. Pretty soon, I had an armpit temperature of 40 degC (105 degF) and I was delirious.
I have a few weird memories from the next couple of hours. I remember them trying to get blood to do a culture, but my veins kept collapsing. After a number of efforts, apparently I refused to let them try my arms anymore. I tried to convince them to try different locations, including my ankles. I'm really sensitive about anyone touching my wrists or ankles, so after a couple of failed efforts, I wouldn't let them try any more there either. I remember the anesthesiologist was surprised I was finding the attempted ankle draws so painful, and turned up the base amount on the epidural.
I suggested that since DH and I were able to get enough blood from my fingertips to do blood sugar readings, that might be a way to get enough blood. Carolynn, DH and I pricked each finger over and over again, and managed to squeeze out enough into a pediatric vial for them to do one of three tests they wanted to do. My white blood cell count came back elevated.
They turned down the pitocin -- my contractions slowed down accordingly -- started me on broad spectrum antibiotics, and put ice packs in my armpits, on my chest, under my lower back, and between my legs.
Wednesday 8:52 p.m. 3.6 mmol/L
Wednesday 9:12 p.m. 4.8 mmol/L
I spoke to Dr. AK on the phone (again) and she urged me (again) to use IV insulin and dextrose. I asked her why she wanted so badly for me to use IV rather than subcutaneous insulin, and she responded, "It's faster." I didn't think that was a sufficient reason when my sugars were doing just fine, and still don't. She also talked about testing my blood gases for signs of acidosis, explaining that because of the infection, I could have ketoacidosis even without high blood sugar. The anesthesiologist explained that testing for gases requires arterial blood, so I could have it taken from my wrist or ankle, I was feeling really protective of my wrists and ankles, so I asked if there were other locations. He told me that the femoral artery was also an accessible option -- I thought that sounded best, since that area was anesthetized anyway. He got the blood, warning me first that I might see some spurting, and not to worry about it. The tests came back normal. They turned the pitocin back up.
25.5 hours -- Wednesday 9:30 p.m.
The baby started to have some fetal tachycardia. His/her base heart rate went up to 170 bpm and wasn't moving around as much as it is supposed to. The OB staff weren't sure whether the concerns over his heart rate were due to measurement error, so they suggested placing an internal monitor, which involves attaching wires to the baby's scalp to get a more direct reading of his/her heart rate. Since the risk factors for this (infection) were moot for me at this point, I agreed. They couldn't get a good signal, though, so eventually they just gave up. They had me lie on my left side and gave me an oxygen mask.
Wednesday 9:37 p.m. 7.0 mmol/L
Wednesday 9:55 p.m. 8.9 mmol/L
I was really upset about the tachycardia and thought that asking for the epidural had been a huge mistake. Carolynn reassured me that it was almost certainly something else. She said, "These are not the types of problems you would see because of an epidural."
26 hours -- Wednesday 10 p.m.
When we took the hospital tour, the doula running it showed us the "best" room -- the one I was in. I was not planning to have an epidural, but I listened anyway when she told us that since the epidurals are patient-controlled, we should be careful to use it properly. We wouldn't be able to overdose, because you are only allowed to press the "give me drugs" button once every twenty minutes, but if we failed to press the button when we felt pain, we could end up being too far behind. She explained that in absence of anesthesia, the body makes endorphins, but if you get an epidural, the endorphins won't happen, so you need to stay on top of the dosing.
For some reason -- perhaps the fever-induced delirium -- when I got the epidural, I mapped that speech to a need to press the button every time the machine beeped that my twenty minutes had passed. I have a vague memory of getting angry with DH for not pressing it for me, then, after Carolynn explained that he was not legally allowed to do that, entreating him to stay on top of it for me, and help me notice the beeps.
So, two hours later, I could barely feel my legs. Since I was lying on my left side, the epidural stopped working on my right side and I started feeling the contractions hard on the right side of my back. That was the most painful part of the whole experience. I so desperately wanted to move, and I couldn't. I turned over for a little while to allow the medication to reach both sides.
Wednesday 10:16 p.m. 7.2 mmol/L
Wednesday 10:55 p.m. 5.8 mmol/L
27.5 hours -- Wednesday 11:30 p.m.
I was at 5-6 cm at this point. The baby was starting to have more nonreassuring fetal heart tones. There had been a few eyebrow-raising heart rate decelerations along the way, but the OB said that while they were concerned, they know that monitoring is not as accurate as they would like it to be.
It was starting to look a little more concerning -- the base heart rate was up at 180 bpm now and not varying very much at all -- so the OB suggested getting drop of blood from the baby’s scalp, because the pH of that is a much more objective measure of fetal distress. It involved inserting a wide tube with an extremely bright light, and nicking the baby's scalp. I remember Carolynn telling me excitedly when they had the light in, "Your baby has hair!" They told me that the baby's heart rate did not change much when they did it, which was slightly concerning. The baby's head was being forced out of my cervix, though the 5-6 cm opening. It was starting to develop caput (swelling of the soft tissues of the scalp.)
While waiting for the result, Carolynn asked me what my gut feeling was. I told her that it was that I wasn’t going to have a vaginal birth. I was pretty upset about it. I think it was at this point that she made a comment about how impressed she was with the way the staff was respecting my preferences. She said the hospitals in Scarborough (at which she has clinical privileges) are much worse.
They put me on the phone again with Dr. AK. She told me, "I really think you ought to consider IV insulin in case of surgery." I was so incredibly tired of fighting her on this, and I wasn't sure how well I would be able to manage my sugars during surgery -- an entirely unfamiliar scenario for me -- so I gave in.
The pH test came back just within normal range, and a seed of hope was planted. The OB suggested testing every half hour for a while.
Wednesday 11:30 p.m. 4.1 mmol/L
Wednesday 11:51 p.m. 3.9 mmol/L28 hours -- Thursday midnight
The baby's heart rate didn’t change with the second nick, but the test came back within normal range again. I started to get my hopes up, and waited patiently. I had stopped pressing the epidural, having decided a while back to see if I could let it ease off so that I might be ready for pushing.
Thursday 0:16 a.m. 3.3 mmol/L
I don't know why I wasn't treated for this low. I was clearly dropping. I don't remember exactly what was happening.29.5 hours -- Thursday 12:30 a.m.
The third test came back just within normal range (still no response from the baby, though.) I was told that the baby was having late decels, but that the normal pH readings were a good sign. I was really getting my hopes up.
A few minutes after we got the test result, though, the baby had a deep deceleration following a contraction. I couldn't see the monitor, but I could see the faces of everyone in the room, including DH and Carolynn. That was the first time I had ever seen Carolynn look alarmed. She jumped out of her chair and came to the side of the bed to stand with DH. The heart rate paused for what seemed like forever at 40-50 bpm, and very slowly came back up.
They turned off the pitocin (my contractions stopped again) and did another vaginal exam. They told me I was still at 5-6 cm. The OB told me that we needed to make a decision. He said, "We can't keep doing these tests every half hour all night." This is the one thing about this OB with which I took issue afterwards -- in my chart they wrote that I was given the option of continuing tests every half hour.
I asked everyone to leave the room so I could talk with DH. As everyone filed out, I called out to Carolynn to come back for a minute. I asked her what she thought, and she responded, "I don't think this is a baby that can tolerate much more pitocin." I realize now that she may have meant that continuing on without pitocin was an option (although it may have taken 18-24 hours for my body to even start making its own oxytocin) but at the time, because no pitocin meant no contractions, I didn't even think of that. I looked and DH and asked him what he thought. He said, "I think we should do the c-section." I was worried, and I felt like the baby was tired and scared. Maybe I was just projecting, but if someone had asked me to articulate the baby's thoughts at that moment, I would have said, "Help me, mama. I'm scared and I don't feel good."
I agreed to the cesarean.29.75 hours -- Thursday 12:45 a.m.
They took DH to scrub and change for the OR. Carolynn and Charmaine weren't allowed in the room for the surgery. They stayed and waited for me in recovery.
As I was wheeled into the freezing cold room, I felt scared and queasy. I felt myself crashing low. I told my nurse, and she brought me my test meter. I was at 2.4.
Thursday 0:49 a.m. 2.4 mmol/L
The team didn't appear to have any instructions about how to correct for lows. I was going to pass out any moment. I told them that if I were correcting with food, I would take about 20-25 g of carbohydrates for a reading of 2.4. I was sliding in and out of consciousness as they started a dextrose drip.
Thursday 0:59 a.m. 9.1 mmol/L
Thursday 1:00 a.m. 9.7 mmol/L
Within minutes I was rebounding up way too high way too fast. I was really upset about this, since the whole point of having such a stringent plan for glycemic control was to maintain my sugar below 7.0 in the two to three hours prior to the baby's birth. I had freaked the team out with my extreme low, and they corrected much more conservatively to bring me down, despite my pleas to normalize my sugar as quickly as possible. I'm still furious that Dr. AK botched this so badly by not even bothering to tailor the insulin and dextrose ratios to me and my body. After all that bullying, when I finally gave in, she completely messed it up.
Thursday 1:09 a.m. 7.4 mmol/L
In preparation for surgery, they were testing my sensation. I could feel things on my abdomen for a long time. I don't remember how many times they added more anesthesia, but I remember again and again, they tapped my belly with something sharp, I said ouch, and they added more anesthesia. DH came into the room as I could feel things around my navel, but no lower.
I had requested in my birth plan that in the event of a cesarean, I would like to see as much of the procedure as possible, but when they put the screen up, I didn’t bother asking them to lower it. I was so tired at this point.
DH got to see the whole thing, and has described it all to me. He said that the resident who was doing the incision looked nervous, and her right hand was trembling, but her left hand held the scalpel completely steady as she sliced me open.
The surgery was painless; I didn't even really feel the pressure that people talk about with respect to cesareans. I don't remember how long it took to get DS out, but it wasn't long. Maybe 5 minutes from the time of the incision.nearly 29.5 hours -- Thursday 1:25 a.m.
DS was born. Someone held him up so DH could see and announce, “It’s a boy!” The liquor was thick with meconium. I felt completely disconnected from this, and in fact, have no memory of seeing him for the first time. I didn't really feel any joy. I didn't feel anything at all.
They whisked him over to a warming table with a neonatology team. DH went with him. I could hear DS crying but couldn’t see him, and was straining my neck trying to look behind me. (According to the director of perinatal services, they have plans for a camera system in the future.)
He was 4218 g (9 lbs 4 oz) and 51 cm (20 inches) long. His Apgars were 8 and 9.first photo
They finally brought him to me, wrapped in a blanket. I got to hold him for a few seconds, and then he was whisked away to the NICU.a few seconds to hold him
DH went with him and I was alone with the surgical team.DH and DS in NICU assessment
They finished suturing and stapling my incision, and then the nurses wheeled me to recovery. They took me over to the NICU first (for which I am very grateful) and I had three beautiful minutes with DS. Sometimes I wish now that I had just refused to give him back.a few minutes in the NICU 1a few minutes in the NICU 2
While I was in recovery, DS was having his blood sugar tested. It was very low: 1.4 mmol/L (that's 25 mg/dL for American readers) -- due almost certainly to the mismanagement of my sugars just before and during the surgery, and the fact that it had been nearly an hour and half since he was born, he was cold and hadn't been able to start breastfeeding.
They fed him the colostrum I had been pumping for weeks before his birth. DH told me later that the NICU nurses were very pleased to see it, and it was the first thing he got.
I cried hard when he told me that. I was heartbroken that I didn't get to be with him, but it meant a lot to me that he at least got something from me to help him adjust from the inside to the outside.