I get checked in and nothing is really happening. They confirm I broke my water, but don't try to check dilation or anything. They call my doc, he's at the office, but will come by after hours. The nurse wanted to start pitocin about an hour after I get there, but I said no-I don't want to deal with that and with the speed of my earlier labors, I don't need it.
Doc gets in around 5 and checks me, I'm around 3-4 cm and I stay there basically the rest of the day, contractions never really getting stronger. They were there, but not a lot or productive. Seth wasn't really tolerating the contractions too well. Not too bad, but not great. They said the decels weren't bothering them, but it was b/c the decels were coming after the contraction, not during, that was concerning them. They said if I had 1/2 hour of him tolerating the contractions, I could get off the monitors and walk around but usually toward the end of the 1/2 hr, he would do something that looked funky and made them nervous.
Finally, around 11 that night (almost 18 hrs after my water broke) we discuss and I decide to start a very low dose of pitocin, just to see if he can handle the contractions and if it helps any as I'm still at 3-4 cm and only about 60% effaced (no change all day). I did manage to make it to 5 cm overnight (by 7 the next morning), but he was about the same as far as tolerating the contractions, not bad, not great. The contractions still not bad-almost no pain.
At 7 the next morning, doc mentions c-section, but I ask if there's anything else we can try. (Doc couldn't really tell for sure how the head was presenting- he was pretty high up-but we knew he was head down.) We decided to do something called amnio infusion, which is basically adding water back into the uterus to hopefully get baby to move around a bit and handle the contractions. This helped a lot. I progressed to 8 cm by 11 that morning, contractions are stronger, but very tolerable. It's very true that contractions are easier to deal with when the fluid is there.
During this, I have to have baby on an internal monitor and I'm also on an internal monitor to check strength of contractions. They didn't think my contractions were strong enough b/c I wasn't uncomfortable enough- turns out the numbers were pretty intense and pretty regular, they said I just have a high pain tolerance. It works- he's tolerating contractions very well and I get to about 7-8 cm around 11 in the morning.
The contractions are getting stronger, not unbearable, but stronger. I get checked around 3, still no more progress, checked around 4:30, still no progress. Doc asks what we want to do, I ask dh, we talked about it and decided to have the c-section. I didn't want the surgery, but something just wasn't right- especially since the first 2 basically fell out once I hit 6 cm. The last 3-4 hrs I was in about the same amount of pain that I was in for the last hour of each of the other two, but I wasn't doing anything.
Once we made the decision, things went pretty quick. The operating room was available at 6, so after I made the decision, I had to sign the consent form and they told me it took about 5 min to get the baby and 25 min to put me back together. The person came to give me the epidural (which I didn't like-it hurt going in) around 5, they got me all prepped, asked if I had any questions and rolled me over to the operating room and he was born at 6:48 at 6 lb, 2 oz. He cried right away- his apgars were 9 and 9. He had to go to the nursery (b/c he was only 34 weeks 4 days) for observation, but was back with me before I left recovery to go to my room, thankfully.
When they took him out- they found the problem was that he was trying to come out forehead first- and he had a big conehead on his forehead instead of the back of his head. He had huge bruises on the top of his head, his forehead and even his nose and lip a bit. They think that's why he wasn't tolerating the contractions well and maybe why I wasn't dilating. I'm glad we did it, even though I wish we hadn't had to, KWIM?
I had morphine in the epidural during the surgery, which I didn't like. It was really hard for me to breathe, I had to concentrate-it was like the stuff moved into my lungs while I was lying down. I also had the shakes in my arms and chin. When the morphine wore off, I started getting sick every time I tried to drink something- not fun with the stitches, and I was very itchy. It finally wore off completely by the next morning.
He's doing well. He got a bit of jaundice and had to be under the lights for a day in the hospital. He gets tired when he's eating. I nurse him, then give him breastmilk (by fingerfeeding), then pump. Hopefully- he'll be nursing full time in a week or so. I still need to wake him to eat- he rarely wakes himself, though he has a couple of times yesterday, so I think we're toward the end of supplementing. (At least it's breastmilk, not formula.)
I don't know what I could have done differently b/c I think he wedged himself in forehead first when my water broke and without the water he couldn't move around. In hindsight, when we did the amnioinfusion, I could have tried to get him to move around, but it was hard to move b/c of the tube they were using to get the fluid in. I'm sure if he had been positioned better, he would have come out well, just like the others.
I think my doc was great. He didn't pressure me into anything. When we made the decision for surgery, he said we could wait and see or do the surgery, but he wanted me to be ok with the decision. He's a family doc who also does OB, so he rarely does c-sections. Except for in emergency situations, he doesn't do his own surgeries- he gets someone else to do it and he assists. He said after that he never imagined my birth would end this way and even apologized that we ended up having to do it this way. I don't think it was his fault at all.
I'm glad my baby is healthy and that is the most important thing, but I really wish I didn't need to have him this way. My recovery is going well- not as well as a vaginal delivery, of course, but DH is awesome.
Congratulations on your baby boy, Seth is a beautiful name! It is so hard when we think or hope our births will be one way, and they turn out to be another. It doesn't sound like there is ANYTHING you could have done differently. You should be very proud of making such conscious decisions as you went along. Obviously by Seth's bruising, he was in a funky position and not "headed" out the best way! Poor little guy.
I had a c- section with my second, tho not after so much labor as you and I experienced everything you described. I wouldn't wish it on anyone. It sounds like you and Seth are doing well with nursing. Thank goodness your dh is such a peach. Mine was too and it helps so much.
I have to get dinner, it's ringing, but I wanted to tell you congratulations and to take care of yourself.
Having your birth go differently than you wanted it to can be hard to deal with. Just know you did the best you could and you have a healthy baby which is way more important than having the *perfect* birth!
My doc was absolutely awesome, BTW. He was at the hospital with us ALL day on Tuesday, from about 8 am until about 8 pm. He cancelled all of his office appointments and was there for EVERYTHING. I didn't even know there were docs that did that anymore and I didn't even realize that he had done that until the nurse mentioned it. I had wondered how he was there for so many checks as the office is quite a bit away from the hospital. I know it wasn't the outcome he wanted either, so that helps me too.
Those crazy babies with their malpositioned heads. Seth should have moved his head straight before poking that hole! s
Enjoy your babymoon, mama!
Congratulations on your beautiful baby boy and enjoy your babymoon!
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Gets lots of rest and don't try to do too much too soon!
sorry your birth was different than you had planned, but it really sounds like you followed your instincts when you signed those papers. that is one of the most important things you can do. and you really had a hand in how your birth went, so that is good. get some much needed rest, mama!
I did feel that something was not quite right while in labor (actually for the day or so before my water broke), but I'm not sure if it was just b/c it was taking longer than my other 2 labors.
Obviously, I can't change anything now and I do feel comfortable with the decisions I made at the time, but was there anything I missed? It's just so weird to have had 2 completely uncomplicated deliveries followed by this.
Originally Posted by shelbean91
Ok- can anyone offer some 20/20 hindsight as to how this surgery could have been avoided? I've gone over and over in my head and I really can't come up with anything except to have stood on my head while getting the extra fluid put back into me to get ds to reposition himself to come out better.
First of all, congratulations!
Secondly, I'm not really sure how surgery could have been avoided since I do think sometimes surgery is necessary for both the mom and baby to survive. The one thing I was curious about, however, was what kind of positioning exercises you did before going into labor.
My first daughter was OP even as I was pushing, but then turned and all of a sudden came out very quickly. I'm not really sure why, even to this day. I had an epidural and was on my back, but I got the epidural turned down so I could feel my legs and move around, the doctor came in and had the nurse and doula help me move to a more upright position, and I had an amnio infusion from the time I got to the hospital because of the meconium in the water. I think all of those things helped. I know there was concern with my baby's heart rate "pooping out" after the contractions, so they gave me oxygen and that seemed to help. I don't know if it was decels or not, since it wasn't explained in those terms, but I assume that was the case. My friend's son had no variability in heart rate, so she had to have a c-section because of that.
With my second, I started reading the optiman foetal positioning sites and was careful how I sat or lay. I never sat on our living room furniture because I always wanted to be leaning slightly forward, so I either squatted, leaned over the back of the couch or sat on the floor with my legs spread. I also went swimming a lot. I don't know if it helped, but her head was perfectly positioned, chin tucked, and my labor was half what it was with my first.
The forehead first presentation--isn't that one of the most rare and difficult to deliver vaginally? There is talk about it in Spiritual Midwifery and the brow presentation means that the presenting part is the widest. I think she said that she was able to deliver one vaginally, but some had to have surgical births, and you would think that on a place like The Farm it would be avoided unless an absolute necessity. So it could be that there really wasn't anything you could do.