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Amy’s Births of Jack and Xander

JACK’S BIRTH STORY

A Scheduled C-Section

My due date was October 5, 2008.  And as the end of September rolled on, there was absolutely zero sign that Jack would join us any time soon.  Not a single contraction, nothing.  Each week at my doctor appointments, I got the same news.  A fingertip dilated and not really effaced.  Going into my 39 week appointment, I knew there would be nothing different to report.  I even briefly considered declining the internal exam, but who am I kidding, it would have killed me to not know.

As I lay on the exam table, the doctor got out his doppler and began looking for a heartbeat.  As he kept moving the doppler around, his face began to show concern.  I could feel my baby boy squirming all around (like he was avoiding the doppler) so I told my doctor as much.  The doctor kept searching and eventually found a nice strong heartbeat.  Then it was time for the internal.  There was that look of concern again.  This time I had no idea why he was concerned or what to say.  The doctor checked my chart then looked at me and said “Was he head down last week?”  Yes, of course he was, I replied.  The doctor’s response, “Well, I’m pretty sure that I just felt his butt and not his head.”  Me: 0_o

I went to sit up, but the doctor had me stay down and spent a good couple minutes feeling my belly trying to determine where the baby’s head was at.  He asked if I had ever felt him flip.  I hadn’t.  As I lay there, I was thinking there was no way he was right.  I mean how could he be?  My due date was in five days.  My doctor thought that Jack was about 8lbs.  He couldn’t possibly have turned breech this late in the game.  Then I sat up.  And as soon as I sat up, I knew.  I knew that my little stinker had turned breech.  He did it while I was lying on the exam table.  I knew the second his hard little head hit my ribs.  I knew without a doubt that the doctor was right.

My doctor and I briefly discussed trying to turn Jack, but my doctor doesn’t actually do the procedure so I would have to see another doctor.  On top of that, the doctor said given that I was so close to my due date, a first time mom (with stomach muscles that were less “stretchy”) and Jack was estimated to be about 8lbs, he didn’t think it would be successful.  I had no idea what the procedure entailed so I could do nothing by agree with my doctor.

The doctor said he was 99% sure that I would need a c-section.  He wanted to confirm with an ultrasound, but he also wanted to do the c-section the next day.  I looked at him and refused.  The next day was October 1.  I couldn’t have a baby on the first day of the month.  It was the day of my quarter-end close.  Not only did I want to do the close myself, but I couldn’t miss my baby’s birthday every year because I had to work late.  My doctor agreed to do the section in two days, October 2.  So my husband and I headed out of the office and over to the hospital where the ultrasound confirmed that Jack was indeed breech.  My c-section was scheduled for noon on October 2.

I’m not going to lie.  That night while my husband was asleep, I sat in our office and cried.  I was devastated.  I knew that I needed the c-section but I was not happy about it.  I was not happy about not having a single contraction, not being able to labor or deliver my baby on my own.  I cried for a while and then a quiet acceptance came over me and I went to bed.

I went to work the next day and before I knew it the day was over, and I was waking up on what would be my first child’s birthday.  I was excited and nervous all at the same time.  We had instructions to be at the hospital admissions area at 10:00 am.  After arguing with my husband about how early we should leave, we arrived right at 10.  I was admitted and then wheeled up to L&D in a wheel chair.  As I was being wheeled up, I realized that we would be going right through the L&D waiting area.  I knew that some family was going to be waiting at the hospital and didn’t want to see anyone beforehand.  I was relieved to see that the waiting room was empty as we passed through.

Once I was in my pre-op room, the preparations began.  I was attached to some monitors, got an IV, had an ultrasound to confirm that Jack was still breech, had the catheter inserted (YUCK!), and 587 doctors came to see me.  My doctor, the anesthesiologist, residents, medical students.  You name it they came in.  At one point there was a knock at my door.  I fully expected it to be a yet another doctor, but when I looked up, it was a student nurse and she had my mother with her.  My mother had strict instructions to wait in the waiting area and that Jim would come out after the baby was born.  Well, apparently, she had convinced this student nurse that I was expecting her and that she was going to be in the OR with me.  I was none too pleased that she wound up in my room.  My nurse was sitting next to me.  She took one look at me, stood up and ushered my mother out of the room.  Nurses are awesome!

My nurse then explained everything that was going to happen.  I signed a bunch of consents and the resident came back with some yucky liquid that would help reduce the acid in my stomach (and hopefully keep me from throwing up).  After that, we headed to the OR.

I was wheeled into the OR.  The OR was packed.  My doctor, a resident, a medical student, the NICU team (the NICU team is present for every c-section at my hospital), nurses, student nurses, the anesthesiologist, his resident and medical student.  There had to be 20 people in the room.  My husband wasn’t allowed to enter yet, so I jumped (literally) onto the table and they began prepping me for my spinal.  The spinal was by far the worst part.  They numbed my back with a local.  Then the resident took her first try.  Yes, first try.  She flat out missed.  Now remember, I had a baby’s head in my ribs, so while your average pregnant woman struggles with curving her back to open up the space the needle needs to be inserted, it was impossible for me to do so.  On the resident’s second attempt, I felt an electrical sensation down into my hip.  On her third attempt, I felt the same sensation, my right leg shot straight out.  During this whole time, I sat holding onto my wonderful nurse, who never left my side and was reassuring me.  I remember wondering why I was having a baby at a teaching hospital.  After the attending anesthesiologist saw my leg kick, he took over and got the spinal in on his first try.  So for those of you counting, that was FOUR attempts.

After that things kicked into high gear.  The curtain went up, they began prepping my belly and the anesthesiology resident began pricking me with a pin to see if I could feel any pain.  I remember being really irritated because I couldn’t tell if I could feel pain or not because she was pricking my belly as they were prepping it.  Then they put an oxygen mask on me.  After that my husband came in and I felt like there was an elephant sitting on my chest.  A few deep breaths and that feeling went away.  My arms were spread out but not strapped down, although I had instructions to not touch anything.

My husband held my hand and started telling bad jokes.  I asked when they were going to start and was told that they had started several minutes ago.  I was shocked that I couldn’t feel a single thing.  The anesthesiology team began discussing how they would know if I had some kind of aortic condition.  My husband later told me that he found the discussion comforting because in his mind, if they were going through what-ifs, everything must be going ok.  I was thinking “why aren’t you paying attention to me!?”

After what seemed like an eternity, I remember everyone telling me that they baby would be born in just a few minutes.  They said that I would fee lots of pressure and lots of tugging.  I felt absolutely nothing.  They told my husband that he could stand up, which he did.  He stood and watched as Jack was born.  He came out butt first and with both of his thumbs in his mouth.  After a second or two, he took his first breath and voiced his displeasure with a quiet little cry.  My husband was escorted over to the baby warmer where they were working on cleaning Jack and assessing him.  As he walked toward Jack, I heard someone say “five twelve”.  Jim asked what that meant.  The nurse said that Jack weighed 5lbs 12oz.  A far cry from my doctor’s estimate of 8lbs just two days before.  My doctor laughed and said “Boy I was WAY off on that one!”  I was told that Jack was gorgeous and healthy.  A few moments later, Jack was brought to me.  He had a hat on and was swaddled in a blanket.  My very first thought was “He looks EXACTLY like Jim”.  Jim sat down next to me and held Jack so that I could kiss his cheek and touch him.  He sat like that for however long it took them to put me back together.

Once they finished, a nurse took Jack and sent Jim to the recovery area.  I was moved to a gurney and once I was situated, the nurse handed me my baby.  I held my baby for the first time as I was wheeled from the OR.  It was one of the best moments of my life.

XANDER’S BIRTH STORY

A VBAC Attempt

For about three weeks before Xander’s due date, I had regular, relatively strong contractions.  I actually went to L&D twice because they were so regular and strong.  Each trip and each doctor’s visit yielded the same result. A fingertip dilated and 75% effaced.  I was growing frustrated. I never dilated with Jack, but then again, I never had a single contraction with him either.

I made my husband go with me to my 39(1/2) week appointment.  I knew that there would be a lot of “what do we want to do” talk.  After confirming that yes, I was still only a fingertip dilated; we had a serious discussion of what to do next.  Our original plan had been to let me go 5 days past my due date and induce me then if necessary.  My doctor felt that given the intensity of the contractions that I was having, I was not going to go into actual labor on my own.  He said he could be wrong, but that was his opinion.  Basically, we had three choices.  Wait until 5 days past my due date, do a scheduled repeat c-section, or try to induce me the next evening, the day before my due date.

My doctor was awesome. He spent at least 30 minutes answering my questions (sorry to all the patients after me!).  I asked about the recovery time from a second c/s, when I would be able to pick up Jack (who was just shy of two years old), I asked about a c/s after laboring or pushing, I asked it all.  During our conversation, it became clear that he wasn’t fond of waiting until after my due date.  He told us that we didn’t have to decide right away, just call and let him know what we decided.

I’m not going to lie. I was leaning a little toward the c/s. And I know that my husband would have chosen the c/s if it had been up to him.  We talked about it and he told me that it was my decision.  In the end, I knew that I didn’t want another major surgery if I could avoid it and I would always regret not trying the VBAC.  I called the doctor and we were told to report to the hospital at 4:00 the next afternoon.

At 4:00 the next afternoon, we arrived at the hospital.  We got checked in and talked to my doctor about exactly what would happen and when.  At just before 5:00, they inserted a foley bulb.  The foley bulb is inflated using saline and then over the course of several hours, the pressure from the bulb manually dilates the cervix.  Hopefully when the bulb falls out, the cervix is dilated around 2 or 3 cm.  My doctor warned that it could take 10 to 12 hours for the bulb to fall out and if it did fall out and I wasn’t 3 cm, they would re-insert it.  The resident who actually inserted the foley said she didn’t think it would take 10 or 12 hours, but she didn’t speculate on how long it would take.

Around 6:00, my contractions picked up. They were painful and very low in my abdomen.  About every 90 minutes the resident came in and readjusted the tension on the foley.  She said that readjusting the tension helped with the dilation.  At some point, I forced my husband to go get some dinner and I got a shot of Stadol to take the edge off the pain.

Around 11:30, I felt the foley fall out and called the nurse.  The doctor checked me and we were both happy and shocked to learn that I was at 5 cm.  The resident said that she would order pitocin and I requested an epidural.  The epidural man arrived.  After my spinal experience with Jack, I was terrified of the epidural. Turns out, I had no reason. A little pinch from the numbing agent and then that was it.  I told him what a great job he did and settled in.

The pitocin was started around 12:15 (my OB had agreed to low to moderate levels of pitocin since I was a VBAC candidate).  Things seemed to be going smoothly. At 2:00 I was 6cm.  I dozed off around 3:00 and around 3:45 the nurse and resident came in saying that Xander was having a few decels.  I turned on my side and things improved.  The resident checked me and found that I was 7cm so she decided to break my water.  Minutes after breaking my water, all heck broke loose.  Xander’s heart rate bottomed out.  I ordered to roll onto my left side, the pitocin was turned off, I was given an oxygen mask and my IV was opened up.  After what seemed like an eternity, everything was fine. X’s heart rate recovered and the resident explained that sometimes when they break the water, that happens.  It was without a doubt the scariest couple minutes of my life.

I labored without the pitocin until about 7 that morning.  My cervix remained unchanged so they tried the pitocin again.  Unfortunately, my contractions never again became regular.  They would be strong and regular for a while then they would weaken and become irregular.

Around 10:00, Jim and I were had a serious discussion.  We were fairly certain that we were headed for a c-section.  Neither of us wanted to wait until we were in an emergency situation.  We agreed that the next time the doctor came in, we would discuss it.  Just as we made that decision, the resident, nurse, and the OB on call from my office walked in the room.  Xander was having more decels and they felt that it was because he was either laying on the cord or it was wrapped around his neck.  They wanted to do an amnio-infusion.  This is where they push saline into the uterus and hopefully restore the “cushy” environment.  The thought was that if he was lying on the cord, the fluid could help relieve some of the pressure.  We agreed with the stipulation that if this didn’t work, we would move on to a c/s.

Around noon, the doctor came back and checked me.  I had not made any more progress.  I was still 7 cm.  And while the amnio-infusion had helped, there were still decels.  I had been at 7 cm for 8ish hours without any progress.  The doctor wasn’t comfortable using any more pitocin (and frankly we weren’t either) and she felt that without a much higher dose, I would not dilate any further.  She recommended a c-section.  I said yes without hesitation and then promptly burst into tears.  I calmed down and gave a list of requests to my nurse.   I also asked that my primary OB (who was seeing patient upstairs) be the one to perform the c/s.  Every request was granted, except my OB request.  He wouldn’t be able to be the primary, but he would try to assist.

I was wheeled to the OR, they increased the meds in my epidural.  There was an issue with a spot on my left hip, but they fixed that and got started.  I started shaking terribly.  If I concentrated really hard, I could make the shaking stop, but the second I stopped thinking about it, the shaking started again.  I could feel that I was being worked on, but felt no pain.  At one point, my blood pressure dropped and they gave me something in my IV to help.  I remember paying attention to what was happening on the other side of the curtain. I didn’t pay attention with Jack, but this time I wanted to know what was happening.

At 12:49 pm (20 hours after my induction started) Alexander James was born.  He cried a beautiful cry.  He weighed 6lbs 5oz and was 18.5 inches long.  He had the cord wrapped fairly tightly around his neck and had a death grip on it with one hand.  I was told that my uterus was in great shape and they were certain that none of the decels were caused by my prior c/s (they had been fairly certain that the prior c/s was not the cause while I was in labor, they just confirmed it during the surgery).

I saw Xander just seconds after he was born, then once the NICU team declared him healthy they brought him back around the curtain for another look at him.  After that, he was wrapped up, given a hat and given to Daddy to hold.  I cuddled with the two of them while the doctors finished.

At this point, my regular OB stopped in.  He apologized for not making it down to assist. He said he was pleased that I made it to 7 cm and that without the cord issues he was certain that I would have eventually been able to deliver him vaginally.

As the doctors finished up, my husband was sent to recovery and I was transferred to a gurney.  I was handed Xander to hold for the first time as I was wheeled out of recovery.  I wasn’t sure they would let me hold him because of my shaking, but they said it wasn’t bad so I could hold him.  I think I stopped shaking about 10 minutes after we reached recovery.  I nursed him while we in recovery and a while later we were headed up to our room.  A few hours later, our new family of four was together for the first time as my sister-in-law brought Jack to visit.