Monday, March 9, 2015

Daniel's Birth Story: Part 1



It's a birth story... so let's take all TMI disclaimers as read, okay? Also I'm going to be very detailed. This is also for me to remember everything, because it's already a little hazy four weeks later, although sleep deprivation could be part of that. This is what I have so far and the rest will come when it comes.

Daniel Louis Keane came into this world on Thursday, February 12, 2015, 12:16 a.m.  Those sixteen minutes mean that he just missed being a full month ahead of his due date of March 11, that he gets to share a birthday with his great-grandmother, and that he was born into this world on the very same date that his great-grandfather left it. The date of February 12 is only one of a great many providential circumstances surrounding his birth.

Daniel on his birthday. Although we won't get quite that far in this post. ;-)

 He was born at 36 weeks, but we’d been pretending to have a baby for a full week already, much to the chagrin of our friends and neighbors who were “on call” for when the time came! We had to go to the hospital in the night on Thursday the 5th because my water might have broken (it hadn’t). Sunday afternoon and evening I had contractions that were stronger than the regular Braxton-Hicks ones and kept me awake, but they were never frequent enough to justify going to the hospital. Just enough that I was tired the next morning! On Monday, I was scheduled for an ultrasound to check the placenta.

We discovered that Daniel was not growing as he had been. He’d been at about the 45th percentile for weight all through the pregnancy, but now suddenly he was at the 10th. A one-hour appointment quickly became a grueling day of non-stress testing, monitoring, and doctors throwing around phrases such as “risk of stillbirth,” “borderline pre-eclampsia,” “oligohydramnios” and “emergency c-section.” However, every other indication showed that the baby was doing very well.  We saw no structural deformities, blood flow seemed fine, his heart rate was consistently strong. My amniotic fluid was barely enough to be within normal limits, but that had been the case for months. So we elected to stay the course but with additional monitoring twice a week, rather than risk delivery before the baby was ready to be born. That night I had a horrible headache with some fuzzy vision. It seemed like a migraine, but a headache like that is a sign of pre-eclampsia and my blood pressure had been kind of high… so the midwife sent us back to the hospital to get checked out.  We were home at 3 a.m. with orders to rest as much as I could. Tuesday night, I had contractions again, but never enough to make me think I was in labor.

Wednesday morning I decided to go to my mothers’ group. About halfway through the meeting I felt a little… wet. I went to the bathroom and used the toilet. It wasn’t much fluid so it was probably just whatever wasn’t amniotic fluid last week… but when I was at the sink washing my hands, suddenly it WAS much fluid.  I was soaked! Thank the Lord I was there and not at home, because of course Sr. Kay (my wonderful midwife) didn’t want me to drive and my husband had taken the bus to work that day.  Dear Ellie, whose bathroom I’d just soaked, calmly helped me load up Anthony and Katie Rose into the car and drove my car downtown to collect Ryan, with Jean following us in her car in order to take Ellie home again.  Ellie led us in the Rosary while she drove. I was not having any contractions, which helped with the car ride. I was worried about needing a cesarean because the baby was breech. I wasn’t too worried about stillbirth, despite Maternal Fetal Medicine’s soothsaying, because Daniel was still kicking like crazy. Definitely my most active baby in utero thus far!

So we got Ryan behind the wheel, said goodbye to Ellie and Jean, then drove over the river to Kentucky. We dropped the children off at Fatima’s house near the hospital (arranged in between Hail Marys), then on to labor and delivery. By now it was about noon. Sr. Kay was already there for the day, and she met us as soon as we arrived. It was still necessary to test me to make sure that it was in fact my bag of waters that had broken. I couldn’t imagine that it was anything else, but I “failed” the first two of three tests. First, visually inspect for pooling of fluid in the vagina. Next is a strip of paper similar to litmus paper. If the fluid that touches it is amniotic fluid, the strip turns blue. I got green. Last is putting some of the fluid on a slide, and looking for “ferning” under a microscope. (When it dries, amniotic fluid forms a pattern that looks like a fern.)  We were waiting for the slide to dry, but it looked like I was going to be sent home from labor and delivery for the third time in a week. Ryan and I were incredulous. If it’s not amniotic fluid, what could it possibly be? It wasn’t urine since I’d just gone! This can’t be normal! While we were going on about this with Sr. Kay, somebody threw away the slide. Guess we needed to swab me again. Thank the Lord for that, because I’d been hooked up to the fetal monitor for several minutes while waiting, and oh, look, fluid pooling. And ferning. Guess we’re having a baby today after all. While I did not really want to have a premature baby, part of me was relieved because all of this in and out of L&D was really getting ridiculous!

The next thing to be dealt with was the baby’s position. He was presenting Frank breech—bottom first. We opted to attempt a version. There is one OB at this hospital with a reputation for being very good at getting babies to turn, and he was there in L&D without any pressing need to deliver a baby, so we could try it right away! I was still not having any contractions, and the baby being small were factors in favor of success. Sr. Kay watched on ultrasound that Daniel was tolerating it well. I’d read up on external version a few days before, after my ultrasound that showed him being breech. The internet told me that women often have epidurals placed for this and that it was quite painful. Epidural wasn’t even mentioned, since I wanted to have a natural birth if at all possible. Truthfully it didn’t hurt exactly. It was extremely uncomfortable, for sure. I used the same sort of relaxation techniques as during labor in order to keep my abdominal muscles loose, and that worked fine. Daniel’s heart rate was perfect throughout. I don’t know how long it took exactly but I would guess about ten to fifteen minutes of the doctor kneading my abdomen put Daniel head down! He was still very high up in my pelvis, so to keep him in position I was strapped into what I can only describe as a girdle. It was a very heavy elastic band about a foot wide.

Now we had to get labor going. Sr. Kay was willing to try natural methods first. She even suggested using the breast pump to stimulate contractions, and walking the hallways in between monitoring sessions. We had missed lunch, so Ryan got us some food from the cafeteria to sustain me in labor. (Yes, I was allowed to eat!) We talked about what to do with the children for the next couple of days, since our labor and delivery “on call” list didn’t address who would be on a month ahead of the due date. We managed to arrange for Beth to take over for the evening, and Lisa to take them home and spend the night with them. We also talked again with Sr. Kay, since after two hours nothing was happening with contractions, even though I’d been having them pretty often for weeks. We decided to send Ryan to transport the children to Beth and change out of his nice dress clothes while I would walk the halls and arrange child care for the next day. When he came back, we would start Pitocin if I was not in labor yet. I was already pretty worn out from the events of the previous week, and it didn’t make sense to waste the energy I had just on getting labor started.

He left, and I started walking. I had several conversations on my cell phone that went along the lines of, “Hi, guess where I am! Want to take care of my children?” In the end my neighbor was able to watch them at her house in the morning so Lisa could get to work, and then Anthony’s godmother could pick them up after doing the morning school drop-offs. I also called my friend Kate, who had been my doula for Katie Rose’s birth. She was available and would come after she’d had dinner with her family. 

It took Ryan a very long time to get back to the hospital. He had a long way to travel, and he hit rush hour traffic as well as a couple of accidents making things even slower. Still not a single contraction. I felt better about the decision to use Pitocin, even though Sr. Kay was okay with waiting longer if we had wanted. I was not on any “schedule” for delivery. When I was in nursing school on my OB rotation, we were taught that once the bag of waters had broken, delivery MUST occur within 24 hours. Even if the woman was close to pushing, once that 24 hours was up she would get a cesarean. I was certainly relieved that wasn’t the case here, but I was ready to get started. By 6:00, Ryan was back and we got ready to labor.