Saturday, June 18, 2016

My Hellish Birth Story - WARNING-GRAPHIC


So here's our story of how little Legan came into this world. Its very long, and very hard to type out. It's probably not an easy read either.

Let me preface this with a disclaimer. It was awful, and quite honestly I hope sometimes to not remember it. Yes, I realized this means forgetting the first time I saw my son. Yes, it might be worth it to me.

Also note, 90% of the time during this story when I use the phrase "I asked..." or anything similar, I do mean that either my husband or I questioned each decision and action. He was 100% supportive and tried extremely hard to help me advocate for myself and my wishes. He was part of absolutely everything from the time he got home until about 10:50 pm.

I started contracting around 1 pm Monday, June 6th. The contractions were only mildly uncomfortable, so I thought it was more braxton hicks, but I timed them just in case. So I made some lunch, chugged a bunch of water, and watched a movie, hoping to calm things down. 

They didn't really slow down, so I called my midwife group. Contractions were 5-7 min apart and lasted 25-45 seconds long. Mary Kay suggested that I go into their partner hospital (out by them - so roughly an hour from us with only minor traffic) to get checked out. I explained that it would take a while, but she suspected we weren't in a terrible hurry. So I called Eric to tell him to come home now (he left work at 4 pm). I got our last minute stuff thrown into our bags (that I had packed the week before-yes!) and we left shortly after he arrived home. We got to the hospital at about 7 pm. They put us in the waiting room there for 35 minutes. Then took me to triage, took vitals, had me give a urine sample and put me on monitors (fetal heartbeat and contractions) and left for 45 ish minutes.

I was a little concerned at first when they left us in the waiting room for so long, but it was in the triage room that I really started to suspect there could be a problem. No one EVER took care of that urine sample. It is important to note that it was barely yellow because I was super hydrated after all that water I drank - and had continued to drink. The midwife finally checked me at about 8:15 and said I was at 3.5/4 cm and 90% effaced and was most likely in active labor. Then I reminded her that my little one was breech. I so wish I had NOT done that. It's possible that they would have been forced to catch him vaginally had I not reminded her of this, considering how fast things went from here. The doctor came in once I announced the breech position. They did an ultrasound real fast and confirmed that his body was exactly where I had suspected for the past few months.

So I asked if we could do a steroid shot to help his lungs and try to stop labor OR do a version (the manual baby turning). The doc said he wanted to wait for another cervical check in 60-90 min to decide if it was actually active labor, and then we'd go from there. He didn't want to do a version because that might further labor along. He seemed to be under the impression that labor might just stop on its own, and then we could try a version, steroids, and bedrest for a little while.  I was concerned because contractions were definitely still 4-5 min apart and 60 seconds long, but OK. I decided to trust his judgement. I should have pushed the issue of the version and stopping labor, but I really thought he knew what was best, and I honestly wasn't in a ton of pain. Contractions were totally easy for me to manage, I spoke through most of them, a couple of slow deep breaths, but honestly running a half marathon was worse than what was going on, so I accepted the fact that maybe it was in my head, and this wasn't active labor.

So now it's nearly 10 pm. I get another check and we're at 4.5/5 cm dilated, bag bulging. So I request steroids and a version again. They tell me they don't want to do a version now because that could cause the wrong presenting parts (ie in this case his butt) to descend into vagina and it's too late for steroids or to stop labor. They try to scare me with the fact that if they try to turn the placenta could rip free or the cord could come out first - both of which would be true dangerous emergencies to my baby, so therefore a version is a terrible idea. I might add at this point that I had done my research and read in multiple places that versions have been tested in early stages of labor successfully. Oh well, apparently this doc doesn't believe in that idea. So I ask them if they're planning a section and they won't confirm that either, they say they want to see how things go, and maybe he'll flip or labor will stop?

Then immediately they send someone in to start an IV and I ask why, and what's going with it. They said it was just normal saline in order to be ready for a c-section, and because maybe contractions will stop if I just get hydrated (uhm, haven't stopped yet, and my clear urine sample is STILL sitting on the table not 3 feet from my bed - I'm still in triage). The IV they want to start isn't going to have any steroids or drugs to slow labor so I turn it down for now. I ask for a second opinion on surgery. Another doctor is sent in. The two of them pretty much tell us that we have no option besides c-section, so if I refuse it then they will ask us to leave and go elsewhere pretty much. They tell me that they will not condone or support a vaginal breech delivery, they won't even be present for it. It had just been 15 minutes since they refused to confirm that they intended a surgical birth in the first place...wtf people?

I bring out my birth plan (so glad I had 3 different versions of it and one was for a c-section).I wanted to know if we could do this without the surgical drapes. I had seen a c-section video without drapes last week. They said no. I asked about a clear drape, so I could see birth. They said they didn't have any. I asked if we could lower the drape for the final pull out. I was turned down. EEK!

They did agree that Eric could come in with me, he could announce the sex, and they would delay the cord clamping. They also agreed that they would leave the cord super long and he could trim it. They told me that they would allow baby to be brought straight to me and I could have skin-to-skin for a moment and that they would do all of the exams on baby in the room, visible to me, and that I would be allowed to try nursing in the recovery room as soon as I was stitched. So I tried to be positive - maybe this would be OK.

The anesthesiologist comes in and we talk options for pain control. Top 3 options are spinal shot, epidural, and general anesthesia. Spinal is a single shot into your back around your spinal cord. This is nice because it wears off pretty fast, it's a very low dose of drugs, and still gives great pain coverage. Epidurals are the most common pain relief option for any birth. It's very similar to the spinal but instead of a single dose injected, they leave an IV catheter in your back, so it can deliver a constant drip of drugs to keep you numb for longer. It's still a pretty quick recovery and you are still awake to meet your baby at birth, so it's a solid choice for many women. The general anesthesia is putting you completely out cold. You don't get to witness birth or meet your baby right away. Also, your husband/partner can't be in the room with you, so he/she can't meet baby right away either. They recommend to me that as a young healthy woman with no previous surgeries and only a single baby, the spinal should be sufficient - they don't anticipate needing more pain meds than that. I almost opted for the general knock out - as I'm so terrified of doctors and surgery, but I decide that I can be strong for this baby and I can mentally handle meeting him/her at birth, even though it's not a birth even remotely like what I want. I go for the spinal to keep the drug dosage as low as possible and hopefully keep me from feeling too out of control for too long.

So I finally sign the surgical consent and they take me back from triage right to the OR. They take about 45 min to get me set up and the whole time I'm crying and scared and they won't let Eric in until I'm done. They insert the urinary catheter before doing the spinal. That did not feel awesome. Oh, and did I mention I'm still contracting? Now contractions are lasting about 90 seconds, and they're coming every 2 minutes. So barely any rest between them. This is what they call "transition" in labor. It's frequently the hardest part for moms to get through without drugs. It also means that you are just minutes from entering the pushing stage of birth - baby is literally moving through the cervix and into the birth canal at this point. After the catheter is inserted, they make me sit up curled up for almost 10 full min while she "preps" for the spinal, but I'm pretty sure the actual part she needed me in that position for took about 60 seconds. They ask me if I can swing my legs up onto table, and I totally can. They lay me down and start draping. They DID find a clear drape, thank god. So I'm trying to be positive. They ask me if my legs are numb. I let them know that they are kinda tingly but I can move just fine. I start twitching my toes and curling my feet around a bunch, as much as I can without moving my legs.

Right now, the drape that is supposed to separate my upper body from abdomen is at my chin. So I'm a little confused because I've seen other photos of c-section births where the baby is laid onto mom's breast/chest for a quick photo op - but my breasts are on the wrong side of the drape. Consequently, Eric and I spent a lot of time continually moving the drape off of my chin. It makes me tickle and feel claustrophobic when it's literally resting on my face. I feel a strange weight on my legs. I ask them if they just strapped my legs down. They tell me they did. I'm kinda getting confused as to why they aren't narrating for me what's about to happen. I'm further confused that I felt them strap my legs down.

They took some weird pincer looking guys and pinched my stomach with it. I definitely exclaimed "Ow!." It felt like they had giant tongs with needles attached to them and they were pinching my stomach fat just to make me squirm. They would pinch 3-4 times and then stop for a minute or so. They did a few sets of this, not explaining what they were doing or why. They asked me if my legs felt numb, and I was like "Uhm, not really?" The skin was still slightly tingly but I can shake my toes around and feel like I could walk if I needed to. I was that aware. I was confident my legs would support me, albeit a bit awkwardly. They kept pinching me. I stopped saying "ow" around the 5th or 6th time because they obviously didn't care. Then they finally brought Eric in. almost as soon as he sat down they started cutting. And I screamed. I had labored silently through this whole thing, even though while they were doing the spinal and I had to hold still during my strongest contractions. But now I was screaming and telling them I could feel each cut. They told me that I would feel pressure and not to worry. They reiterated again and again that I was going to feel pressure. Eric assures me that I wasn't literally screaming at the top of my lungs - although at the time I felt like I was. It was like a dream where you try to hard to yell and no sound comes out, except that some sound WAS coming out. I have been assured that I was at least at or slightly above normal voice level, so everyone in the room could definitely hear me. I wimpered, I cried, I yelled. I begged and pleaded for them to stop.

I had gone in expecting to be able to feel the pressure and sloshing around inside of me. I guessed it would make me nauseous and uncomfortable. I've had wisdom teeth broken apart and removed in several pieces while only under Novocaine. I know what it's like to have the true pain blocked but still feel pressure surrounding the work. This was NOT pressure I was dealing with.

This hurt way more than anything else ever had, worse than kidney stones and about 20 times worse than the contractions I'd been having just moments ago. I told them in was pain, I almost couldn't hold my abdomen still but I was terrified not to. I kept curling and uncurling my toes to show them I could, my feet were in a constant state of movement just to give me something to focus on. I told them I could feel the band that was holding down my legs. They didn't respond. They kept cutting and pulling and I kept screaming. They took several minutes to maneuver his rear end out. Eric said maybe 3-4 minutes to deliver his butt. They actually had to pull most of his body backwards, against my contractions, back up into my abdomen. Everything besides his head and shoulders was already descended into my pelvis. They were nice enough to let Eric announce the sex. Then they took several more minutes (all while I'm screaming bloody murder or trying my damnedest to do so) to get his head out. It took a lot of shifting and re-positioning. Once one of the surgeons (or maybe assistants) nearly laid down on my upper stomach to shove from the top. That made me nauseous but was less painful than anything else. They finally got him out.

They did let Eric trim the cord - they didn't do a delayed clamp like we had agreed on. Legan did cry immediately, quite well. They gave him a 1 min apgar (which I couldn't hear because I was screaming as they yanked me around more), but he scored a 9 out of 10. They let Eric hold him for about 15 seconds, I got to touch his head, and then they took him and stood between him and I while they rubbed him off and did other things. I'm not sure what, as I couldn't see and no one was talking to me besides Eric. I find out later that apparently in the time between when they first started cutting and now they had administered 10 mL of morphine to me through my IV, twice. I didn't feel any relief.  Somewhere in there they had asked his name and how to spell it. I confirmed it with them somehow. I couldn't tell you, but at least it gave me something to focus on.

Did I mention again that he was great during this? He held my hand and told me to yell if I needed to. He told me I could squeeze his hand as hard as I wanted. He narrated what I could see and figure out. He was great.

At this point, seeing as there's nothing left to see, I had shut my eyes and continued screaming. Eric tells me later they had pulled my uterus out, inverted it, and scraped it out. Then they started stitching. Eric was about to tell me, but I told him instead. I just kept asking "can't you just not?"

Less than two minutes after they had pulled Legan out of my sight they said he needed to go to the nursery and asked if Eric should go with. Eric sounded like he wanted to stay with me, but I told him to go even though he wanted to stay with me while I screamed. I didn't want Legan alone, so I chose to be alone. By now, my uterus is back in and stitched up. So they start piecing the rest of me together. Tears are streaming down my face, I'm now alone, scared for me, scared for my baby, and in intense pain. There's no longer anything else to focus on.

Insert BRILLIANT new idea here. I started counting each individual stitch. At this point, I think I finally got taken seriously. The charge nurse (a nurse for sure, and I think that was her title) told the anesthesiologist that they had to DO SOMETHING for me. Then I woke up in recovery. I was never warned that they were putting me out, or asked. But it was great to just wake up done at this point. In fact, I have NO idea what drug was used for my spinal OR the general anesthesia either, but I can tell you one was great and one was terrible. I am not going to make accusations of any sort of error made in actually applying the spinal block. It's entirely possible that my system/body just did not react as it was supposed to, or that for whatever reason the dose that should have been sufficient was not. All I know is that it clearly did not do its intended job. On the other hand, the general they gave me was great. Instant out, instant back in. I did not feel groggy or sick or especially weak, considering that I'd just been cut up and put back together.

That same (charge?) nurse was there in recovery. She told me that she'd never seen anyone in as much pain as I had been, and that she tried to help, but she wanted me to have the chance to meet my little guy and see his birth. She was the one that had suggested the morphine (this is when I found out about that), and the one that apparently suggested the general as well. She let me know that my son was in the "Special Care" nursery, although she wasn't clear that that mean NICU (neonatal intensive care unit), or at least the closest this hospital had to one. They did at least wheel my bed to the nursery window for about 4 seconds before they brought me to my room. He was on the far side of the room, laying spread-eagle in just a diaper under a heat lamp, all alone. I got to my room around 1, 1:30 am on Tuesday.

All I wanted to do was meet my baby, but my bed didn't fit into their nursery, and he was "too sick" to come to visit me - so he couldn't leave. Now, I understand that they don't want me up and walking around too soon after surgery, but after everything I'd been through, plus a lack of a clear message as to what was wrong with him, and all the stress of the last few hours, I couldn't sleep. I didn't at all feel as if I'd given birth. I felt like my son had been forcibly and violently extricated from me, and stolen away. After months of falling asleep to his little kicks and squirms I was instead hollow and still inside. I was told that I would be allowed out of bed 12 hours post-op and I could see him then.

My mother and I started asking everyone about 2:30/3 am when they could find me a wheelchair to visit the nursery. They balked. I didn't understand. I didn't ask to walk, or get the catheter/IV out. I just wanted to see my baby. They told us there was only one wheelchair on the entire floor of the hospital, but that they'd "see what they can do." At 5 am we were finally told that I could go see him at 6. At 6 am we waited anxiously. It was finally 6:30 am when that same charge nurse came for m. Then we had to do all sorts of dumb vitals and crap, and I had to get cleaned up some before I could sit. I willingly carried by own urine bag on the wheelchair to facilitate this operation. It was 6:45 am when I finally got to meet and touch him. It had been 7 hours since birth.


And still no one told me what was really wrong, just that he was breathing "kinda fast" and he couldn't keep his pulse oxygen level up. They just said he needed help breathing. We watched his numbers stay about the same all day Tuesday, they even let me hold him skin to skin just a little. The first time I did, it improved his pulse ox. The second time it didn't so we had to stop. At some point his doctor said that they were giving him antibiotics and had done a blood culture to stave off and find out if there was an infection that led to his early birth and difficulty breathing. They had done a chest x-ray and it didn't look like pnuemonia, but perhaps "premature respiratory disease." They didn't really explain what that meant. To me is just sounded like his lungs were immature, but they weren't clear. He was on 30-40% oxygen (normal room air is about 21-22%. We were hopeful that he'd bounce back quickly.

Overnight Tuesday he got worse and worse. His doctors came in at roughly 6:30 am on Wednesday and told us that he needed a level three NICU and they wanted to move him to a children's hospital downtown (read: nearly 2 hours from home with only moderate traffic). We instead suggested another hospital out by us that has the same level of NICU (neonatal intensive care unit) as the downtown location. The original hospital wasn't too keen on the idea, but they made the phone calls and everything was approved. They also offered to discharge me early, at 36 hours post op, instead of the usual 72-96. I jumped on the chance. I felt like hell, but being confined to one hospital while my little man was nearly an hour away was unacceptable. 

 They did make us watch about 40 minutes of educational discharge video before they would let me go. Unfortunately, 90% of that video was about caring for your newborn when you take him home. That was terrible and didn't help how awful it felt to see a breathing tube in my little guy, and to watch him get rolled away in the scariest looking incubator/gurney contraption. That was one picture I just couldn't take.


The new hospital has been lovely since then. His breathing tube was pulled after 5 days, and we're now working on weaning him off of the last little tiny bit of air support. Of bigger concern at the moment is his unwillingness to eat so far. He digests feedings through his feeding tube no problem, but we're having a little trouble convincing him to stay away and to suck in order to eat.

I have no doubt we'll get there, but in the meantime, I'm pretty busy shuttling around from home to hospital, in addition to trying to make as many of his feeds as possible, while still pumping him breastmilk and finding time to eat and sleep. He's had nothing in his stomach besides what I've produced, and I've been lucky to produce a ton. So we're looking into options for milk donation as we have almost a one month's supply of milk frozen already, and he's less than 2 weeks old!

We'll have more updates on little Legan shortly, plus I'm working on posts about my physical recovery, as well as a look into depression and the role that plays in his birth.

Maybe one day I'll be able to look back on this med-free surgical delivery and feel as if I gave birth, but for today, I still feel like it was merely a traumatic event I had to live through in order for my son to come to be. It was at least 2-3 days before I even really was able to feel like a mom or able to say "my son." So Legan and I, we'll work on healing together. I have a feeling he's going to manage it faster, and for that I'm glad. At least he shouldn't have any emotional scars from this experience. The NICU nurses do their best to make sure he never has to cry for anything!

Legan Scott, 6 lbs 11 oz, 19.5", 6-6-16


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