I have a sleeping baby
at my side so I finally have a few free moments (that I should be using to do last night's dishes, but oh well
) to write out Astrid's birth story. It's long, so I divided it into sections so you can skip to the juicy part if you want.
Overall my pregnancy was fantastically easy, but things starting going awry around 32 weeks when my blood pressure started climbing. It was going up very slowly and for weeks it just hovered around 130/90 (which is my midwife's limit for "low risk" and allowing a home birth. So I was doing everything to keep it from going up). Once it got up there though, we also started doing the urine protein tests. First one came up as "trace". The following week it went up a bit and led to a 12 hr urine collection which came back high but, like my BP, the consulting doc told my mw that it was right on the edge of the official diagnostic limit for pre-e. Two weeks later I took another 12 hr test. The result was almost identical so I'm thinking "great! we're keeping this at bay and my home birth is still on!". But this time the consulting doc (different one on call) said I was over the limit (and that the first doc has misinterpreted the results... had confused the limit with a 24 hr collection). He said I had to go to the hospital IMMEDIATELY.
At this point, I was 35 wks 6 days and officially risked out of home birth. I was freaked out and disappointed and scared and dreading the hospital. To make matters worse... I was sick! I had caught this stupid cold which clogged my sinuses so I couldn't breath out of my nose, my head hurt like mad (until I blew my nose- so I knew it was sinus related and not pre-e related), my chest was all tickley so every time I breathed deeply, I coughed uncontrollably, and I was just exhausted from stress, illness and lack of sleep.
So off we go to the hospital- me, dh and our fabulous doula. The doc they assigned in triage was a fellow, who is brand new to high risk pregnancies. She is making a hard sell for us to induce right away, and she misinterprets my test results (reads the protein numbers wrong, making the situations seem way more dire.... but to her credit, she eventually saw her mistake and came back to tell me that I was right and she was wrong), and she was totally failing to address my concerns (risks of preterm birth versus risk of pre-e that seems very mild and stable). My blood tests looked normal, and most importantly, an u/s showed that the baby bun was doing great, was big and healthy and ahead of schedule, the placenta looked good, and fluid looked slightly low but good. I kept pushing for a compromise- couldn't I come back in for tests every day? We could re-check my blood for organ function markers and check the baby as often as she felt necessary. But she just kept saying this situation was black and white and induction was the only answer. So the night was not going well. I was being a stubborn pain in her a$$ and she wasn't convincing me that immediate induction was the best option. So, even more exhausted and sick than before, I left the hospital "against doctors orders".
I went back the next day to recheck my stats and they assigned a new doctor to me. My blood pressure was up to 150/100 now (140/90 the night before) which was a fast enough change to catch my attention for sure. The new doc was wonderful and totally got my concerns. She described how she had envisioned her own birth plan to just "squat in the corner and push that baby out like everyone her family in Mexico had done" but it didn't happen that way for her either. She was just as eager to induce as the previous doc, but she managed to acknowledge my concerns and validate my desire for a natural birth. That went a long way in making me trust her advice. She also managed to convince me that inducing sooner, rather than waiting, would get me the closest to my desired birth experience as possible. She was sure that given the speed my blood pressure was rising, that waiting would lead to either an emergency situation and a c-section where I would have to be knocked out and not meet my baby right away, or to a case of "severe" rather than "mild" pre-e, which, even if not emergent, would dramatically reduce our options due to the diagnosis and would again, lead to a c-section.
So at this point I'm exactly 36 wks along, with a baby who appears to be a week ahead from the u/s. I was so incredibly torn. The hardest part was I felt FINE! I felt like I could go to 40 wks without a problem! But they kept telling me that that was the danger with pre-e.... it feels like nothing until it quickly goes out of control and suddenly leads to seizure, organ failure or placenta previa. And the fact was I was already stuck in the hospital no matter what I chose. The longer I waited, the higher my BP and worse my official diagnosis would get and the less options I would have. I so badly I wanted to give my baby all the time she needed in the womb. But I also couldn't stand the thought of having an emergency c-section or something else where they would separate us after the birth. That just hurt my heart to even think about. The doctor promised we would start out with the mildest induction possible to encourage my body to go into labor on its own. She said if my BP was ok, I could use the bath, the birth ball, and make this labor as close to my vision as possible. So..... I said yes. Let's get this party started.
My mom flew into town as soon as I told her I was going to the hospital the first night, so she was there for the decision. My dad flew in as soon as we called and told him we decided to induce. So the stage was set and now we'd just have to see how things played out.
INDUCTION AND LABOR.....
The plan was to start with a low dose misoprostol to ripen my cervix (which was only 1cm dilated.) The hope was that after a few doses (waiting 4hrs and checking progress between each dose), my cervix would dilate and trigger spontaneous labor. If that didn't happen, we would move on to a low dose of pitocin and gradually ramp that up until labor got going. And if that didn't work, we were left with c-section.
After popping the first pill at around midnight, I was excited. The excruciating decision making part was over and there was no turning back now. We were going to meet this baby soon, one way or another. After 4hrs, I was starting to dilate a bit, and ready to take pill #2. 4 hrs later I was 3cm dilated and 20% effaced. We were all happy to see progress and I took pill #3. Another 4hrs passed and I was still 3cm, but now 70% effaced. It didn't sound like much to me, but they said it was a good step. One more pill. The nurse seemed concerned that I wasn't feeling any pain yet. If I were making good progress, I should be feeling something more. I kept saying "I think I felt a little cramp... or maybe that was just the baby stretching." I was getting nervous that the dreaded cascade of interventions was around the corner. But lo and behold, 3 hrs later I felt a gush. A very, very wet gush. I buzzed the nurse who gave out a cheer and did a little dance at the nurses's station when they passed on the news- we needed her... my water had just broken. Someone warned me that a little moisture can feel like more than it is, so it might not be my water. Then I stood up and the splash all around my feet left no one in doubt. This was it! My body got the message and was taking over from here!
Since my water had broken, the doc couldn't check my cervix and so we had no idea how far along I was. But the contractions finally started to feel like something. They quickly ramped up from period-like cramps to ho!& cr@& type contractions, with very little rest time in between. The entire stay in the hospital, they had been monitoring my BP every couple of hours. When they tried to take it during labor, and especially during transition, I thought I was going to go ballistic on someone. Are you serious??!! Get the he!! away from me!!! But I was in such a fog at this point that I just groaned my way through another contraction and did my best to ignore everyone other than dh (whose hand I was practically breaking, I was squeezing so hard) and my doula who kept talking me over the humps and promising a rest before the next one. The rests, however, stopped coming! It was now a matter of degree... the beginning and end of each contraction were my only "rest" at this point.
And then, a little over 3hrs after my water broke, I needed to push. Unfortunately, I had a cervical lip and had to perform the mammoth task of NOT pushing. Eventually (all sense of time is totally gone at this point) they gave me the go ahead and the doc left. He expected it would be a couple of hours before he was needed again. After a few pushes, the nurse coached me to "push right into that pressure, push into your bottom." Well, it felt like I was surely about to just start pooping all over the bed if I did that, but at this point I didn't care. Whatever got that baby out was fine with me. It turns out I didn't poop, but it sure did feel like the same muscles and location of the pressure. And her advise worked, because suddenly she went running from the room to get the doctor. I was able to come out of my fog long enough to be thoroughly amused by his surprise as he saw the baby's head crowning after 15 min of pushing and started frantically trying to get his gloves on in time to catch her. One more push and her head was out. He barely made it in time!
And then she was here! DH announced that she was a girl, and although I thought I didn't care either way about the sex, I suddenly felt like I had won the lottery. We had a daughter! She came out with an apgar of 8 and so they put her on my chest right away. She kept making these precious little cooing noises that absolutely melted my heart. And a few minutes later she was suckling away. We went home 24 hrs later.
She was 6lbs 1.5oz and 19in long. Not bad for a premie! It took about 3.5 days for my milk to come in and she did lose too much weight and developed jaundice. That unfortunately sent us back to the hospital for a very long and sleepless night with her under the lamp. It was far more traumatizing for me than it was for her, thankfully. She made it much easier on her mama by acting unphased by the whole experience
And now, all is well. Astrid is here and healthy. Although I really hated a lot of the hospital experience (constant monitoring and having to fight to make decisions each step of the way), I also feel very lucky to have had a couple of really great, understanding doctors and nurses, and I feel so, so lucky that my labor was about as natural as it possibly could have been given the situation. Of course, the thing I feel the most lucky for is that my girl is here and healthy. I could just eat her up. She is so sweet and gentle and cuddly. I absolutely adore her.