27 April 2007

Margaret Rose's birth...long version

Here is the story of my unexpected preterm labor and c-section delivery, as promised.

Margaret Rose's path into life was not uneventful. I had an easy pregnancy, no complications. Only some Braxton Hicks contractions, starting about the 18th week, which were deemed normal, especially for a third pregnancy. In my 32nd week things took a sudden turn.

On the morning of April 2nd, Monday, I was jolted out of a dream sleep by a rush of fluid. I thought I was wetting the bed, so when I got up and tried to stop the flow, I was pretty shocked. I ran to the toilet and the the fluid kept coming.. Mitch woke up and asked if I was ok, that's when I said, “I don't think this is pee, honey.”

I was scared, I kept thinking that this couldn't be possible, this was bad, this was too early. Mitch calmly got out of bed and told me it was going to be ok. He called the midwife and left the message that my water had broken. Then he called Steve (his dad) and Aida and told them it was time. They headed over.

Marie was the midwife on call. She called back and told us to go to the hospital, she would call over so they knew to expect us.

As we waited for Steve and Aida, my contractions started, they were 3 to 4 minutes apart, but I was having a hard time focusing to keep track of the time.

When we got to the hospital and walked into the er entrance, they looked one look at me and before they asked what the problem was, they put me in a wheel chair and took me up to the 3rd floor.

Mitch couldn't come into triage with me at first. He went and parked the car. The admitting nurse wheeled me to triage, I peed in the cup, put on a hospital gown and then the triage nurses checked to be sure that my water had broken and checked to see if I was dilated, I was, about 2-3 cm. Then the nurses started telling me what to expect in the birth. Because I was approx. 7 weeks early, there would be the ob (the midwife couldn't deliver), a team of nurses for me, the neonatologist and a team of nurses for the baby. Then Mitch showed back up and I was wheeled on the bed into a labor & delivery room. I think it was sometime between 4:30 and 5am when I was admitted.

Marie came to the L&D room to check and see how I was doing. She talked to us about what was going to happen, making sure we were both prepared. The nurses came in and started an IV with an antibiotic and then gave me a shot of steroids to help mature the baby's lungs. I was put on the fetal monitor, which kept track of the baby's heartbeat as well as when I had contractions and the duration of each one.

At that point I asked Mitch to call Pastor Rick, because I remembered he usually worked as hospital chaplain on Monday's at AGH, it was probably close to 6am. The time is so fuzzy to me. Mitch had to leave a message with Rick, who came to our room as soon as he got the message.

This is when all the waiting began. Rick stayed with us for all of the morning until he had to go to an appointment. He sent Mitch to get some breakfast and stayed to keep me company. At some point in the morning Dr. Buchanan came and examined me, he said I was dilated “a good 2cm” and I was to stay on bedrest so we could prolong the labor as long as possible. His goal was at least 24 hours so I could have another steroid shot. I spent the time in labor resting on one side until that hip got sore then rolling to the other side, Margaret did not tolerate the contractions well when I was on my back.

Again, at some point during the morning, I'm not sure of the time, the midwife on call changed to Libby (she helped deliver Joseph). She came in to let us know of the switch and to see if we needed anything and to let us know she would be across the street (in their office) should we need her for anything at all. Even though the midwives were not in charge of assisting the delivery, they were consistent in their support of me during labor.

So the morning progressed. I remember looking at the clock at about 10 and thinking that by this time Joseph would have already been born. I got up to use the bathroom a couple of times. A little while later a nurse brought in some compression cuffs for my legs, by order of Dr. Buchanan, he didn't want me to develop deep vein thrombosis because of being on bedrest for the duration of labor. Libby came in again to check on us later, I told her at that point that I felt that I would deliver before the 24 hours.

I think it was around noon at that point, I remember thinking that this was the longest I had ever been in labor. Contractions were starting to get stronger and longer, but not closer together. Mitch had been making and receiving phone calls all morning between people coming in and out of the room. I was trying to close my eyes to rest, which was hard considering that my contractions were coming every 3-4 minutes still. Sometime during the morning Margaret's heartrate had dipped for the first time. The nurses were monitoring everything from the nurses station and one came in to check when it happened, but everything resumed as normal, with the dip only being a few seconds. This happened a few more times during the day.

Mitch and I were alone in the room after 1pm. About 1:30 or 1:35, I had a contraction that did not let up. Alarms started ringing and a bunch of people came rushing into the room. Mitch said he had seen Margaret's heartrate slow and was just about to press the call button when everyone rushed in.

This is where it all gets fuzzy and I have flashes of memory of what happened in the next few minutes. I remember someone saying that they couldn't get the baby's heartbeat and then they inserted a monitor vaginally to put it on her head, to call Dr. Buchanan, that I needed to have a c-section, Mitch asking if I understood what they had to do, they inserted a catheter, someone saying Dr. Buchanan couldn't get to the hospital in time that Dr. Cottar would operate, and did I want them to call the midwife. I told Mitch to call Mommy. They started to wheel me out and told Mitch he couldn't come because I needed to be under general anesthesia, he had to stay where he was and they would come back to let him know what was going on.

Libby arrived as I was in the hallway on the way to the or. She told me she would get scrubbed in and be right back. My whole body was shaking as they were telling me that they were going to administer the anesthesia, I would feel someone touching the pulse points on my neck before I went to sleep. Someone asked if I was shivering because I was cold or because I was scared, I was scared.

Once in the or, I had to scoot onto the operating table. Then I heard someone say there was no time to prep, the doctor saying he was ready to put me under, I remember thinking about whether they were going to put me under before the doctor started to cut or not. I remember seeing Libby's face above me, telling me it was all going to be alright.

Later, Mitch told me that when I was wheeled out, he was left alone in the L&D room and no one had turned off the monitors, they were left beeping. My dad called to check on things right after I was wheeled out, Mitch could barely speak, but told him what had happened. Mitch then called his mom, his dad, my mom and Rick. He says a few minutes later a nurse came back in and said, “You have a girl, she's out, she's pink and she's screaming.” Then she left. Shortly after they came down the hall with Margaret, Libby gave her to Mitch for less than a minute to hold, then they whisked her off to the NICU. She continued to breathe on her own, never needed oxygen, she was 4lbs 10 oz and 17 inches long.

Edited to add: Margaret's umbilical cord was wrapped around her neck twice, this was the reason for her distress.

I woke up about 2 hours later, 3pm. My sister (Rebekah) was in the recovery room with me, and someone else, I don't remember who else was there when I woke up. Becka had brought me a March of Dimes teddy bear with sunflowers on its sweater. I was in so much pain, I couldn't move. I was hooked up to a morphine drip and told how to use it. Then I was taken to my room.

The rest of the day is a blur. People came in and out, brought flowers, food was delivered, I slept on and off, pushed the morphine button, wached tv, asked when I could see my baby, Mitch showed me pictures on his cell phone, Libby went to the nursery to ask when the baby could be brought to me, Mitch filled out the birth certificate form, the kids came to see me and Margaret, Becka stayed the night with me. Finally at 9:00pm, one of the NICU nurses brought Margaret in my room for me to hold. I was only able to hold her for a few minutes though. Then Becka and I watched the NCAA Baskeball championship game, the Gator's won.

The next morning at 6:00 the nurses came in and removed my catheter and helped me get into a chair and showed me where the pumping supplies were so I could start expressing milk for Margaret. I sat there in the semi darkness, Becka got me everything I needed to wash my face, then handed my my knitting and she had to leave for work. I pumped milk then sat watching tv and knitting.

I am leaving off all the post-birth information, that is for another day.


Mira said...

I just read your post and I'm glad that you and the baby are doing well now. *Hugs* for the wee one :D

mames said...

hi sharon...maybe i should have waited to read...it makes me a little teary. my boys were c-section, not emergency but i had ptl for 12 weeks and that was all i could take. out lil guy was 4/12, no nicu for him either. but all is well, thanks for stopping by the blog, cannot wait to 'see' charlotte grow. smiles.

mames said...

sorry sharon, i meant margaret, not charlotte....sleep deprivation.