Our sweet baby boy made his arrival into the world three weeks early on Sunday, February 28th at 10:01am. He was a bundled 5lb 12oz of love. It took 34 hours of labor and 30 minutes of pushing.
When asked how labor went, my instinct says “smooth”. After all, the doctor’s goal was to get him here as safely as possible, and they succeeded. However, 34 hours is a long labor, and there were ups and downs. This is his birth story!
On Friday, Feb 26th I had an impromptu BPP. As part of my care plan to monitor Grady’s IUGR (see my blog post here), I was getting one BPP a week. While I had a BPP with MFM that Monday, I saw my OBGYN on Tuesday and she told me to schedule another with her office on Friday. Why not, right?
Biophysical Profiles check 8 indicators of good health, including heart rate, movement of the diaphragm, etc. It also includes a Doppler of blood flow in the umbilical cord. That Friday, the Doppler showed an elevated blood flow. The doctor described to me, “The placenta is working too hard for the baby. It’s time.”
It was my last day of week 36, and I was already one centimeter dilated and having light contractions.
I called Mark and instructed him to take a shower and grab the last few things for our hospital bag. The hospital said to come in at 9pm to be induced at midnight on the dot- once I officially hit 37 weeks/full term. I was calmly excited. My doctors had done a good job preparing me for an impromptu delivery.
We took our time getting comfortable in the hospital room. I did my skincare routine, changed into a robe, brushed my hair, put my jewelry away, sipped my gatorade, and asked for all the pillows.
Two things to note during this time: first, we got to know the overnight charge nurse. I asked her to tell me all about the epidural. While everyone has different opinions on the epidural, the piece of advice I clung to was: Get the epidural before they break your water. Second, she thought I was a bit dehydrated when looking for veins to prep for an IV.
At midnight on the dot, the on-call doctor came to start the first round of cervical ripening. Because Grady was small, he was higher risk for not tolerating labor. It was important to use methods of cervical ripening that we could remove at any sign of distress. That eliminated the commonly used miso pill (which is the quickest method they described to me).
They used what they described as the “tampon” method. They insert the medicine into my cervix and a string hangs down like a tampon. The goal was to soften my cervix and potentially dilate. It would stay in for up to 12 hours to do its job. If at any time Grady showed he was under distress, they could pull the string and remove it.
Grady tolerated this method perfectly.
But I had a complication.
A little after one a.m., just as we started to doze off, I started feeling anxious. It felt like my heart rate was increasing, like I wanted to vomit, and like I wanted to panic. I waited a minute to see if the feeling would go away. After all, I really hadn’t been anxious about going into labor. I honestly didn’t believe the feeling was real.
Then spots popped up in my vision. That was when I woke up Mark and said something wasn’t right and to call the nurse because I felt like I was going to pass out. That’s the last thing I remember saying to him. I heard the nurse come in and he relayed my message. Then I fell into a sort of sleep.
I felt my bed be lowered and when I heard the nurse say my name I replied, “yeah?”. I heard her yell that my blood pressure was 70/30. All of a sudden, I felt a cold and refreshing sensation in my left arm.
When I opened my eyes, I saw multiple nurses and the on-call doctor surrounding me. I was hooked up to an IV, the blood pressure monitor, and the heart rate monitor. I was immediately concerned for the baby, but they assured me that the baby’s heart rate was strong.
The medical term for what happened is, “Vasovagal”. The doctor didn’t think that it was the cervical ripening that caused this. She thought that I would have reacted much sooner. The nurse assumed that the reality of going into labor hit me suddenly, caused immense anxiety, and my body’s reaction was to pass out. I’m not so sure- I don’t remember even thinking about labor when it happened. I remember thinking how unfortunate it was that Mark fell asleep with the remote and I was stuck watching a re-run of the Bruins game. Remember when I said I was a little dehydrated? That could have been a contributing factor. My friend who is a nurse said that pressure on your rectum can also cause a Vasovagal (hello baby dropping!). Many options, but ultimately no answer.
Mark says this was the scariest part of the labor. I became unresponsive to him. Remember how I heard the nurse say my name? According to Mark, she yelled it. Before he knew it a team of nurses rushed in and he got pushed aside. When they yelled out my blood pressure, all he knew was that was too low. He said he almost passed out himself. I recovered from the incident much faster than he did. Within minutes of re-gaining consciousness and getting a full bag of fluids, I felt great.
The next ten hours were inconvenient and uneventful. I had a full bag of IV pumped into me and was told I needed to be hooked up to one for the rest of labor. This meant I needed to pee CONSTANTLY. What’s more inconvenient than needing to pee every forty five minutes in the middle of the night when you’re trying to rest for labor and delivery? Being instructed to call the nurse every time to and from the bathroom.
Come morning, I was allowed to take myself to the bathroom – though Mark helped almost every time since I had to bring the IV. I was able to enjoy breakfast and some mid-morning snacks before the next on-call doctor came in to check on my progress. My cervix had softened, but I was still just one centimeter dilated.
At noon on Feb 27th, they inserted a foley balloon to continue cervical ripening. Again, this was a method that could be removed immediately should the baby show signs of distress. They expected this to dilate me to 3-4 cm and put me in active labor. They said to expect strong contractions in the beginning. If needed, they could give me a sedative.
For your sake, I REALLY hope you never need one of these. I found it incredibly uncomfortable and painful to be inserted (picture a water balloon being inserted on either side of your cervix and filled up with water…that’s how they described it to me). This was another 12-hour procedure.
Immediately my contractions strengthened. I tried walking around the room, “dancing” with Mark, and bouncing on a ball, but as the contractions got stronger I just wanted was to be in bed. I found that sitting, whether trying to pee or on the ball, was extremely painful in my back. I simply wanted to be in the fetal position holding onto the bed railing. After about two hours my contractions were very strong and only a minute or two apart. Knowing this 12-hour method would only bring me to 3-4 cm, I knew if I continued going on no sleep I would exhaust myself. I asked about the sedative and the nurse encouraged it. I was able to sleep for four hours, and by the time I woke up the pain had subsided.
At 10:30pm they came in and removed the balloons (not painful at all). I was just about 4cm dilated and effaced enough. The cervical ripening was over and they were going to start the Pitocin and break my water later on.
Remember how my nurse recommended I get my epidural before they break my water? I immediately told my doctor I wanted the epidural and…she basically said no. She said I didn’t need it because of how “comfortable” I was. That I wouldn’t need it until AFTER they broke my water. I was furious.
As soon as the charge nurse got back on duty (midnight) in I immediately told her what the doctor said and that I wanted the epidural regardless. I could see that, despite her holding her composure, she was also displeased with the doctor’s reaction, and said she would go talk with the doctor.
It pays to have the charge nurse on your side! At around 3am on Feb 28th, the anesthesiologist came to administer the epidural (despite me still being quite comfortable). This was the part I was most nervous for.
I was to tell them if I felt numbness or a ringing in my ear. “Well”, I said, “I don’t hear a ringing, but everyone is starting to sound like a robot.” Sure enough the charge nurse announced that my heart rate was elevating and he was able to stop what he was doing just before I felt like I was going to pass out for the second time.
He replaced the catheter and they administered the medicine. I was told to push a button to administer more medicine when needed (or every twenty minutes per the button turning green). Considering it being 3:30am, I didn’t push the button and fell asleep for about three hours.
I woke up at six thirty to hear that I was still 4cm dialated, but this time a “good” 4cm, and they were going to break my water.
And this, ladies, is why you have to advocate for your own health in the hospital. Had I listened to that doctor, I would have never been able to get the epidural because…
Immediately my contractions got PAINFUL. I started pushing that green button as often as I could, but it didn’t help. I was unable to sit still during the contractions (hence why I wouldn’t have been able to get a needle inserted into my spine). The nurse had the anesthesiologist come “top me off”, but I felt no relief. The nurse was sure something had gone wrong with the epidural and the anesthesiologist came back to re-do my catheter. He “topped me off again” and I was able to relax…for about twenty minutes. The contractions were a minute apart, and every single one caused my body to uncontrollably convulse/quiver. The epidural wasn’t working. The nurse said that she only saw as extreme of physical reaction in women who give birth without any pain medication.
The next time they checked me I was 7cm dilated. But what felt like minutes later I was telling Mark to call the nurse because it was time to push. At this point I had my eyes closed, but the doctor must have come in the room at some point because I heard her say she didn’t think I would be ready to push – it was too soon.
Again, women NEED to advocate for themselves when in labor. You know your body better than the doctors. I insisted Mark get a nurse or doctor to check my dilation. The doctor came back and, sure enough, told the nurses to prep the room for delivery. At 9:30 a.m it was time to push.
Though I won’t give you the gory details of delivery, the benefit of not having an effective epidural was that I was in tune to when I needed to push. For the first fifteen minutes, the nurse had her hand on my belly to feel the contractions and instruct me on when to start pushing. Her instructions didn’t align with when I felt the sensation to push, and finally I started telling HER when I was going to start pushing.
At 10:01 am, Grady Kenneth arrived 😊
After 34 hours of labor, we stayed in the hospital for another 58 hours (Grady was jaundice so we had to stay longer than the 48 hour stay for extra testing). Our hospital’s COVID protocol was that we couldn’t leave the room. Mark was antsy to leave a full day before me – after all, I was the patient receiving care. But even I was dying to stretch my legs and get some fresh air by the end.
What astonishes me is, after the delivery, there was no follow up discussion on the medical concerns for why I was induced. Grady came with ten fingers, ten toes, crying, and that seemed to be enough. Similarly, no doctors followed up on any conversations regarding the IUGR. At our first pediatrician appointment I asked if he was aware of the IUGR, and he said yes, “What about it?”
As a patient I still would have appreciated some reassurance from the doctors or some clearer idea of what caused the IUGR.
That sums up Grady’s birth story. It was a LONG 34 hours, but in the end he arrived safely and healthy, and that’s all any mom can ask for.