smismar: Sylvia's Long Delivery

Posted Wednesday, July 08, 2009 5:38 PM

"I used my Bradley training to stay relaxed during each contraction and just knew that it would pass."

First pizza, then baby

I went in at 4:30 on Thursday, April 30th, 2009 for my routine 39 week appointment at 39 weeks, 1 day.  When my blood pressure was taken it was 138/85 so the doctor asked me about fetal movement.  I had been fighting a slight upper respiratory infection for about a week, so I had not paid too much attention to movement, but I thought it was a little sporadic.  I was measuring 2-3 cm dilated and about 60% effaced.  The doctor decided to take an ultrasound and measure the baby’s heart rate, size, and fluid levels.  Fluid levels were supposed to be between 5-24 and I was measuring at approximately 5.8.  BP was taken again and found to be 142/94.  I had no protein in my urine, but the doctor thought we were at the point where an induction would be best.  She wanted me to go to L&D and start Pitocin immediately.

I called Jason (DH) and gave him the heads up about what was going on.  Then I called Lisa (my doula) to let her know what the doctor had said.  She recommended at least trying to put off starting the Pitocin until Friday morning.  So, I left the office and headed towards L&D.  I stopped at the cafeteria and grabbed a piece of pizza along the way.  I didn’t know what was going to happen, but I wasn’t going to go into it starving.

Off to Labor & Delivery

When I got to L&D they hooked me up to the external monitors.  I was having small contractions that I couldn’t feel.  I managed to talk the doctor into delaying Pitocin until the next morning to allow myself some sleep and to let the whole idea sink in a little more (I had been mentally prepared to go past my due date since that is common in my family).  I had asked if starting with Cervadil instead would be an option, but they told me my cervix was already favorable and that it was already at the point they would hope to see after Cervadil.  Jason arrived after stopping at home for an overnight bag and to let Sprocket (our dog) out.  The evening was pretty routine other than a bunch of checks by the nurse and needing to juggle the IV pole when I got up to go to the bathroom.

The Pitocin drip was started at 5:15 the next morning at 2 milliunits/hour.  I also started receiving Penicillin every four hours since I am a carrier of Group B Strep. The day progressed slowly.  I had regular steady contractions all day, but they were not painful (similar to menstrual cramps).  I was allowed to eat a light breakfast at about 9:30.  The Pitocin was turned up at regular intervals throughout the day, but the contractions never progressed.  Every once in a while, the baby’s heart rate would drop low during a contraction.  I refused all day to allow my water to be broken.  By the end of the day, the Pitocin was being delivered at 20 milliunits/hour.

Waiting for baby

Around 6:00pm the doctor came to talk to me.  I was getting very frustrated with the lack of progress and I was starting to convince myself that I just wasn’t ready.  My BP had come back down (under 120/80).  I really wanted to go home and return in the morning with a fresh head to be re-checked for progress.  I threatened to walk out against medical advice and the doctor told me that if I chose to do that, I would need to find another doctor because she was not comfortable letting me leave with my fluid levels still low.  She wanted to break my water, but my argument was that if my levels were low, then breaking my water would just lower them more and there was no guarantee that doing so would trigger labor.  Eventually, I agreed to restart the Pitocin early the next morning. After steady contractions we would see what progress I had made and then they would break my water.

The Pitocin was stopped for the night since my receptors were essentially saturated and the contractions weren’t doing any good.  Jason ran out and picked up some Chinese food for dinner and brought it back to the hospital for me.  After we finished eating, he went home (with my blessing) to take care of Sprocket and get some sleep himself.  I spent the rest of the night alone and feeling very frustrated and upset about all the interventions that were happening.  I felt completely out of control and powerless.  My BP was measured throughout the night and was even considered low at some point.

Lets try this again

At 4 a.m., the Pitocin and Penicillin were restarted.  I was allowed to continue to rest for several hours while the contractions restarted.  Jason arrived back at the hospital around 9:30.  I was not allowed anything to eat.  At noon, the doctor decided that my contractions were regular and strong enough to break my water.  The contractions felt similar to the day before – no stronger than regular menstrual cramps.  I was around 4 cm dilated.  

Just after noon, my water was broken.  My fears were slightly eased when the contractions greatly increased and I found myself in active labor within about 5 contractions.  First pizza, then baby

I went in at 4:30 on Thursday, April 30th, 2009 for my routine 39 week appointment at 39 weeks, 1 day.  When my blood pressure was taken it was 138/85 so the doctor asked me about fetal movement.  I had been fighting a slight upper respiratory infection for about a week, so I had not paid too much attention to movement, but I thought it was a little sporadic.  I was measuring 2-3 cm dilated and about 60% effaced.  The doctor decided to take an ultrasound and measure the baby’s heart rate, size, and fluid levels.  Fluid levels were supposed to be between 5-24 and I was measuring at approximately 5.8.  BP was taken again and found to be 142/94.  I had no protein in my urine, but the doctor thought we were at the point where an induction would be best.  She wanted me to go to L&D and start Pitocin immediately.

I called Jason (DH) and gave him the heads up about what was going on.  Then I called Lisa (my doula) to let her know what the doctor had said.  She recommended at least trying to put off starting the Pitocin until Friday morning.  So, I left the office and headed towards L&D.  I stopped at the cafeteria and grabbed a piece of pizza along the way.  I didn’t know what was going to happen, but I wasn’t going to go into it starving.

A little help from DH & Doula

Lisa arrived a little while later with some lunch for Jason and she helped calm me during the intense contractions.  I labored on the birth ball for a little while and sitting in the reclining chair.  When the nurse noticed the baby’s heart rate was slowing with each contraction again, they replenished the amniotic fluid via a catheter within the internal monitor (I didn’t know they could do that!).  Labor continued to progress this way for several hours.  Jason was absolutely awesome and since he stayed calm, he was able to keep me calm and he encouraged me throughout the process.

About 6 p.m., everything seemed to be steady and I was at about 7-8 cm, so Lisa left to run down to the cafeteria to get dinner for herself and bring something up for Jason.  I had moved to the bed and was just trying to rest between contractions.  Jason tells me that I looked like I was asleep in between – I just wanted to conserve my energy since the contractions were starting to take a lot out of me.  I had had the shakes between contractions since labor started.  While relaxed, they were getting worse.  They would suddenly stop and I knew I was about to be hit with another contraction.  The only relief from the contractions were the shakes, and the only relief from the shakes were the contractions.  About 5-10 minutes after Lisa left, transition hit.  The contractions started coming very, very close together with little time between; maybe just seconds.  This was the most intense part for me and the only time I started to doubt myself.  This lasted a short time, thankfully; maybe 10 minutes.

Here comes Sylvia!

Very suddenly, I felt the urge to push.  I could not suppress it.  Jason called the nurse in and I was begging for the Pitocin to be turned off.  She checked me and told me I was at 10 cm and to go ahead and push.  The doctor was called in and there were a couple other nurses.  I honestly don’t know how many pushes I did – I would guess about 10.  Lisa came back about halfway into pushing and was surprised to find me delivering.

Sylvia Caron was delivered at 6:44pm.  She weighed 7 pounds 2 ounces and was 19.5 inches long.  I had a small first degree tear (repaired with one stitch).  She was immediately placed on my chest and Jason was allowed to cut the cord.  After getting her initial check and clean up (one minute Apgar was 8, five minute was 9), we had our first feeding and she latched immediately with a strong sucking reflex.  At about 8:20, we were moved up to the recovery unit.  We were released the next day and 24 hours after birth we were finally allowed to go home.

I've decided that my next birth will definitely be with a midwife.  Probably at a birth center, but I won't rule out doing it at home.  Between, I was able to relax and talk.    The pain level remained manageable and I was able to handle them just fine.  I never paid attention to the timing – I just let them come as they did and took them one at a time.  I was able to remain calm and relaxed.  After a little while, they were having trouble maintaining the external monitors since they would slip out of place just about any time I moved.  I agreed to allow internal monitoring.  If I hadn’t, I would have been confined to the bed and I didn’t want that – I needed the freedom to move around.

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