Arissa Elayne is here - a bit early!
My sweet baby girl decided that she needed to get here just to meet her Granmom, who just happened to be in town for a little Grandparents Day lunch thing at DD1's school last Friday.
September 11, 2015, at 7:15 a.m.
6 pounds, 12 ounces
19 inches long
Born at 36w3d
Here's the story (long):
Things will be a little out of order here because of the recent turn of events! I'm going to back date so that things end up in order.
I saw Dr. Bushart on Monday the 7th. After he had taken measurements he made a comment that he thinks this baby was "fluffy" and would be much bigger than Kiarda was. I have been measuring ahead since the mid-pregnancy ultrasound, so it would seem reasonable that given that trajectory that I would have a bigger baby.
Fast forward: I had my last iron infusion the following Thursday, September 10. (Pregnancy stage: 36 weeks, 2 days) While I was receiving the infusion, I was having intermittent but more frequent BH contractions. At least, I *thought* they were BH. They felt different though - more like mild period cramps, rather than a tightening over my whole belly. They didn't really change in intensity nor did they have any kind of regularity, but I had more than four an hour. I chalked it up to dehydration (to which I am prone, as my body doesn't seem to recognize the need to drink until it's dire) and had my water filled up as well as filling up my water bottle on the way out the door.
The contractions subsided a bit but picked up again at dinner. Jason's mom had come into town that afternoon, as there was a little Grandparent's Day celebration lunch at Kiarda's school that she wanted to attend. She was planning on staying through Saturday. At dinner, I had to keep focusing on the contractions because they were *just* uncomfortable enough to distract me and make it hard to move even at the table, but they still didn't hurt. When we got home, I decided to start timing them since they seemed to be relatively frequent.
I was having contractions consistently every five minutes, and each one lasted for about a minute apiece. This was the pattern for over an hour.
Hello 5-1-1 rule.
I told Jason that I wanted to go to the hospital and get checked out. Because the contractions were really hurting despite getting a little more intense, I thought that I was having prodromal labor but I wanted to be sure. Jason packed a bag for himself quickly and grabbed my already-packed hospital bag. Candy said she was glad she was here to stay at the house with Kiarda. We said we'd keep her updated.
En route to the hospital, the contractions got more intense to where I was moaning through them, and they also got between 3-4 minutes apart. I got checked in. I found out that Buzz was the doctor on call that night - yay! They got me back to a room and hooked up to monitors. Arissa was doing fine and I was indeed having strong contractions. The nurse did medication reconciliation and paged Buzz. He finally came and did a cervical check. I was 60% effaced but only 2 cm dilated. He ordered that I get a liter of IV fluids and see if that would stop the contractions. If it was indeed prodromal labor, dehydration can be a trigger. If the fluids worked and the contractions tapered off, it was not real labor.
The tough part is where I was gestationally. Babies are term at 37 weeks; if I was actually in labor, Arissa would be considered a late-term preemie. Depending on the baby, 36-weekers can vary quite a bit in terms of where they are developmentally, and big risks include inability to maintain body temperature, poor feeding, hypoglycemia, apnea, and jaundice. Buzz said that stopping real labor medically was contraindicated at this point, as the risks were higher than the benefits of delivering a late-term preemie. If it was indeed real labor, we'd be having a baby for sure and he'd get the OR ready for the c-section.
It took several sticks to get the IV in (I'm a "hard stick") and I eventually ended up with a painful one in my hand on the third attempt. I was pleased that the nurses would only give themselves one chance before getting someone else to try. Once the first third or so of the fluid bolus was in my, the contractions slowed and were both less frequent and less painful/uncomfortable. Buzz came back after my bolus was done and asked if I wanted to stay for more monitoring or go home and try to get some rest. He said that he thought it was more likely prodromal labor, especially since the contractions had all but stopped and had definitely tapered off in frequency and severity. We decided to go home.
On the way home from the hospital, I started having contractions...again. They weren't bad but I had at least four or five on the drive home. Once we got in, we let Candy know that we were home and were going to try and sleep. The nurse had recommended I take Tylenol and a Benedryl to help me sleep, especially if I were still having contractions. I did this but wasn't able to fall asleep. Jason slept for maybe an hour or so.
I couldn't get comfortable no matter what I did - I tried laying down, sitting up, crossing my legs, bending over the bed, anything I could think of. The contractions started getting worse - and this time they were also in my lower back (the dreaded back labor). It got to where I couldn't keep quiet and let Jason sleep anymore. I still wasn't sure if this qualified as prodromal labor or not so I called and left a message on the nurse OB line. Jason made the point that if I couldn't sleep and I was having contractions this badly, there was no way I could go to work in the morning so we might as well go back to the hospital. I obliged.
On the way, the contractions were consistently five minutes apart and one minute in length. They were so bad - it brought me back to when I was laboring with Kiarda and was stuck in transition. I was howling with each contraction. I'm not sure how Jason kept his focus driving.
We got to the hospital and it felt like forever for the lady to get me checked in. I would have a contraction and start hollering, and she'd try to ask me questions mid-contraction!! Aargh. I finally got back to my room and the nurse did the intake. I was checked and I was 100% effaced but still only 2 cm. It wasn't clear that I was in active labor but it seemed likely. The nurse thought I was at 8 cm dilated, but she couldn't tell because the amniotic sac was bulging through my cervix. She didn't want to sweep all the way around for fear of breaking the sac and making the labor even worse and faster.
At some point, the contractions really ramped up. It was awful and excruciating, even worse than when I in transition with Kiarda. The back labor was HORRIBLE - it felt like someone was stabbing me with a fire-hot knife and twisting in addition to the feeling that my uterus would implode from the strength of the contractions. A difference this time was that not only did it make me let out the loudest primal screaming imaginable - that I couldn't replicate volitionally if I tried, and made me hoarse - but I was hyperventilating and sobbing all at the same time. I heard the words "emergency section" and there was a sudden flurry of activity in the room.
There were at least six other people that came in. They laid me down flat (WORST possible position for back labor pain) to do checks and try to get IV access. They kept telling me to breathe, but couldn't understand that I was hyperventilating, couldn't take deep breaths when NOT in labor because Arissa was so high up, and that was all worse by being on my back. I was breathing in through my nose and out my mouth with as big/long as I could. but one nurse kept telling me to do bigger breaths. :-( I also had to drink the same nasty sour liquid that makes me gag and vomit to clear my stomach for surgery. That stuff is naaaaasty.
It took multiple people multiple tries to get an IV on me. Once they finally got it in, they started wheeling me down to the OR. I saw Buzz on the way in. He jokingly asked if I were mad at him. I said yes but that he was forgiven because he stayed to deliver Arissa (he would have been off at 6:00). Once we got into the OR, things were happening all around. They got me onto the gurney and sitting up for the epidural. When I had the epidural with Kiarda, I didn't even feel it because the contraction was constant. I also had Jason there to brace me and keep me from moving. This time, due to difficulty breathing easily, pain, back pain, and only having a nurse to hold my hand and let me rest my head on her shoulder, it was much harder to stay still. (Jason had to wait in the hall while they got me and the room prepped.)
I definitely felt it this time. I have a generally high pain tolerance, but my whole system was not only spent but my autonomic nervous system was clearly in "flight" mode. It took about four sticks to get not only the correct catheter size determined but also to get it put in the correct place. Each one felt like an electric jolt that continued down the course of my back. It's a freaky feeling and quite unsettling. I tried so hard not to flinch and move. I think under calmer circumstances (like that scheduled c-section we had planned?) I would have been fine and handled it much better. Once the epidural was in place, I started feeling the effects shortly after the medication started.
My legs got heavy and tingly and I couldn't even move them at the hip level. Staff had to pick up my legs and get me positioned on the table. I felt pressure from them moving around, but apparently it worked so fast that I didn't realize that Buzz had actually started cutting! Thankfully this time I didn't puke halfway through.
They put the drape up to block off the sterile field. A nurse asked me what was most important to me to have a good experience besides the obvious of delivering a baby without complications to either one of us. I asked that my hands not be tied down like last time so I could actually touch Arissa (she was shocked that I had been tied last time and said that would be no issue at all) and that I be allowed to nurse her before she left the OR for bath and footprints. She said that was fine and so long as Arissa didn't have issues once born, they would be more than happy to accommodate. She also took the time to give me detailed explanations about what was to come, such as reminding me that c-section babies don't cry immediately because they need to be suctioned, where she would be taken in the room for vitals and measurements, etc. She didn't tell me anything new, but I appreciated how thorough and detailed she was and I wish someone would have done that last time.
Jason decided to peek over the curtain this time and he got a few pictures. He got to watch Arissa being born!
When she cried it was more of a whimper. I had a hard time hearing what was happening with all of the bustle, but apparently she had APGAR scores of 9 and 9 - awesome!
While I was waiting and Buzz was finishing the surgery, I started feeling nauseated and a little lightheaded. The anesthesiologist gave me some IV antiemetics and upped my oxygen a little. I felt better pretty quickly. I was glad I didn't puke.
A nurse finally brought her over to me and laid her on my chest. OH THE BABY SMELL. I LIVE FOR THE BABY SMELL. Arissa made a beeline for my right breast and attempted to latch herself from above. Our positioning was difficult and awkward, but she did latch for a little bit but I had to keep relatching her because she'd pull off and look around. I was pleased that she got the chance immediately and we had a promising start. I finally gave her back to the nurses so she could get her bath while Buzz finished stitching me up.
While I was in recovery, Buzz came by to see how I was doing. I asked if we got a clear picture as to why my babies don't "drop" lower. He confirmed that I have a very narrow pelvic opening. Arissa never got past a -3 station, and her head was WAY smaller than Kiarda's giant noggin! Yay for modern medicine - I am definitely someone who would not have survived childbirth "back in the day."
It's interesting comparing my experience with Kiarda vs. Arissa. With Kiarda, I had no emotional release until *after* delivery, whereas this time I was sobbing throughout the labor until I got relief from the epidural. The pain and distress was much worse with Arissa, and combined with the suddenness of it all made it much more traumatic. That said, I carried the emotional trauma of Kiarda's labor and birth for a long time, in part due to PPD. I feel much better emotionally this time around, and I do believe that having medical issues taken care of in advance have helped (thyroid, anemia, and being on the correct SSRI) as well as being really pro-active with things like breastfeeding/supplementing.