Well, then. Three months later I’m posting my birth story. You could say I’m prompt. It’s one of my many strengths.
Going from three to four has certainly been eventful, but though my evident procrastination may belie this sentiment–it’s actually not been too terribly difficult. Her entrance was not unlike the pregnancy, with the multitude of unknowns that consistently reminded me I am not, in fact, in control. She has humbled me, which is a gift I’m not sure I could ever repay my bright-eyed little darling. What am I to do but try, however, and help make her life as joyous as she has mine. Without further ado…the birth of Adeline Grace.
This was a routine appointment; as routine as any terrifying growth scan had been up until that point, anyway. The last two weeks were met with hesitant optimism as the prior ultrasound had her jumping from under the fifth percentile to over the tenth, which was absolutely astounding and left the high risk team scratching their heads but confirming that the last scan was, in fact, accurate. At 34 weeks gestation, the baby had been well under the second percentile for growth. This appointment was met with furrowed brows and a lot of correspondence with the obstetricians who oversaw my case, back and forth for an hour as to whether or not I should be hospitalized for induction or to risk letting the pregnancy progress. Everyone was hesitant, but all agreed 34 weeks and an extremely small baby did not bode well for a pleasant outcome, should she be born. Mostly they were concerned about the stress induction would have on the clearly failing placenta.
At the next scan, 36 weeks gestation, she had somehow measured at over four and three quarter pounds, which was a massive growth spurt. We shall refer to this as the last hurrah of the poor, aged placenta which was already showing grade four calcification. After the dismal scan last time, I had been put on additional monitoring for a total of three appointments per week, plus two unforeseen very scary labor and delivery appearances between then and the birth for failed kick counts. Every single appointment gave me another wrinkle, I’m sure of it. My worry lines are now permanently etched into my face, and all spell out “IUGR” in neat little rows across my forehead. Nonetheless, it wasn’t until this aforementioned routine appointment at 38 weeks that things took a turn for the worse.
She smiled differently during the scan. Her lips were set more firmly, and her face took on almost a waxy quality. This was the face of someone who was forcing herself chipper so as not to worry the over-worrier. By that point, they knew any bad news would send me spiraling into the black soot of despair. I assume she didn’t want to see me flood the ultrasound room with my fits of sobs, so she smiled. My chest was heavy watching her, then looking toward the screen. The baby had been more lackluster those two weeks (bearing those impromptu L&D visits) and I was already nervous. Then she said, “Has your water been leaking any?” and my stomach sunk far below me. “No. Not at all. Not even more discharge,” I responded tightly. “Hm.” A puzzled look and then the smile again. She tried making small talk but I honed in on the monitor. Left to right my gaze shifted until I saw the numbers I was looking for. AFI. Amniotic Fluid Index. Last biophysical profile it measured well above 15, and that was only days ago. Now the AFI number was a scant 5.2 cm. I was shaking. I knew what that meant. Everything they told me about IUGR, everything I had voraciously read from case studies to anecdotal stories on internet forums confirmed the one thing I had been dreading from that horrible 22 week appointment that confirmed the baby’s restricted growth: the placenta was failing and my baby could die if I didn’t birth her right. now.
It was a long wait in that conference room. I searched the walls for medical text I could read to distract my brain from seeking the worst conclusions. I had promised myself not to search Google, as though it was informative, it tended only to exacerbate my anxiety and I needed to stay grounded. Focused. The textbook I had chosen was essentially a troubleshooting guide to handling high risk cases. In it, the importance of keeping the pregnant woman calm and feeling supported was expressed numerous times. It was a green book. I had read six large pages, forcing my eyes to seek the letters, forcing my brain to process. “Are you bored?” Danielle said, gesturing toward the book. “No, I actually enjoy reading this sort of thing.” They sat. The high risk OB was to my right. Danielle was to the left. “Well, your AFI is borderline, but we aren’t prepared to induce you right now,” he said. I wasn’t prepared for this response. I asked why in a dozen different incarnations, and then I began to cry. Heave. Sob. He told me the baby appeared to be doing well. I explained that she’d failed her kick counts twice in the last week. He told me the NSTs and BPPs were technically fine. I said it had taken twice as long to reach the movements they were looking for in the last week. Armored with my forest green text book and its contents, pleading with them to understand that I did not want to go home only for my baby to die in utero while I wait for the next appointment, they gave me two options: continuous hospital monitoring or wait-and-see. I was distraught, and I left the appointment as soon as it concluded, face-forward, tears streaming down my red face, angry, and I didn’t respond to any of the nurses who had bid me goodbye. I practically ran to my car and sobbed.
“What do I do?” I begged D. over the phone, who was per usual the calm amidst the storm. “What can I do?” He instructed me to call my regular OBGYN and discuss this with one of the physicians overseeing my care. He comforted me. He was equally confused and enraged. So I did what he suggested. And though this same doctor had once upset me with his laissez faire attitude about this situation, I found solace in his words. “I’ll tell you what,” Dr. H said, in his way that seemed like he was always smacking gum in his mouth, though he had none, “I’ll fit you in for another BPP in two hours. Can you make it? We’ll measure the amniotic fluid and go from there.” I downed fifty ounces of water within that time, hoping that the reason I was showing such low numbers was easily explained by simple dehydration (though I knew from my earlier appointment I was not at all dehydrated). I was, for once, talking myself into the best case scenario. I went through the rounds of specimen taking, blood pressure reading, and finally I sat in the chair with the wand moving warm jelly across my abdomen. I didn’t wait long for the results, mainly because I could see that the numbers had fallen. “Well, it looks like you’re having a baby today or tomorrow,” he said. The AFI had dropped four centimeters in two hours, and the range of disparity all but ensured this was no mistake.
I was able to go home. I called D., shaking but less helpless than before. A plan in place always makes me feel better, even if I was still excruciatingly scared of what the outcome might be. He was nervous, as I saw when I met him home, hurriedly shoving last-minute items into the labor bags, equally worried about the baby’s health as he was about attending his first birth with me. He held me. Throughout this ordeal D. has been my absolute ally. He is my strength outside of me. Not all of my concern abated, but being dwarfed in his arms melted my worry just a bit. I knew he would be there for me, I know he loves me, and even if he had only felt Adeline kick from the outside very periodically (as she was small and I had an anterior placenta, the kicks weren’t often felt by others) I know, full-stop, he would do anything for our daughter. His muffled words spoken to her through my belly every single day, “I love you very much, baby girl, I can’t wait to meet you,” are etched into my memory for the rest of my life. So I stopped thinking about the worst outcome and started hoping.
We had a detour at a local hospital which impeded the induction for several hours. Initially I had wanted to deliver at the hospital with the NICU, and was absolutely adamant that I do so despite my OB staff’s assurances that they could revive and transfer–but I wouldn’t be able to transfer patient status there should that occur. However, once at the NICU L&D, it became clear that not only was their equipment malfunctioning, prohibiting proper monitoring of the baby during induction, but that should I induce there I would be under the care of the most horrifically arrogant, compassion-lacking obstetricians I couldn’t have envisioned even in my nightmares. So we transferred after arguing with this asshole for close to half an hour about what was best for the baby. He had spoken with my team repeatedly until our arrival and according to Dr. H all was well, yet when we sat there in his presence he claimed that he did not know them, their competence (high risk specialists with over 80 year of experience between them, I might add), and that he was the authority in that hospital and we would be doing what he wanted, his way. For me, this obviously did not work. I did not want more drugs than was necessary to ripen my cervix and put me into active labor. I did not want my baby to become stressed or have heart rate dips because of the generous pitocin use he suggested, so we left. We risked the transfer because it was in the best interest of the life I sheltered, and I had just prayed that I did not need a cesarean section so that I could be with my baby the moment she stabilized, should that occur. The only positive thing I could state about that experience was that I was on continuous heart rate monitoring the whole time, and that gave me piece of mind in the interim.
It was late when we arrived at our delivering facility. After 11 p.m. I was tired and my face was extremely puffy from spending hours upon hours crying into D’s outstretched hand. I was contracting fairly regularly even before the induction, as we saw on the monitoring, so I had hoped that my very low Bishop score (1) would have increased. Luckily, I had advanced an entire centimeter since that morning and though I still needed Cervadil to ripen my cervix, the Bishop score was thus more favorable. I spent twelve hours lying supine so that the medicine would work. After removing the Cervadil, I was checked and I had effaced enough that I could begin the Pitocin in two hours. We slept that night, but mine was fitful. I was still contracting every 6-8 minutes and toward the morning it became so intense I could no longer sleep through them. I never intended to fast through the induction and I was SO hungry so D. and I walked to the cafeteria for the planned feast. However, I was still contracting painfully, particularly while upright (here’s some foreshadowing for you), and found myself unable to consume more than a few bites of each breakfast food. We walked back to my room and began another round of antibiotics (I was strep B positive yet again), fluids, and the lowest dose of Pitocin possible.
D.’s parents had come to visit after the Pitocin had been increased. I had planned to allow his mother to be in the room with us during the labor and delivery, but things weren’t progressing very quickly and I sincerely underestimated how painful the Pitocin contractions would be without pain management. I was cocky. I had had three previous natural births. I had this. As it turned out, I did have it but it took a helluva lot more focus than before. At some point after going to the bathroom and having earth-shattering, fucking brutal contractions while standing, I asked her to go talk to her husband in the waiting room so I could lean on D. for a while. D. never called her back in (he just didn’t think to) and she ended up going home for the evening. The induction had lasted 24 hours at this point. I was utterly exhausted. My body was done. After I entered active labor (about 18 hours into the induction) I had the Pitocin removed and my water broke on its own. D. was there to help me to the bathroom each time I needed to go, and each bloody time I got up from the bed the contractions became unbearable. It was all-consuming. I couldn’t believe a human being could survive with this much pain. I still can’t. This is where I tell you I should have stayed upright. If I had it to do over again, I would tell myself that more intensity means less time laboring. I would have been sitting up, I would have been leaning on D., anything to help the baby descend.
My contractions had slowed to every 8 minutes, and when I was able to sleep for what seemed like a long time each instance I awoke with a contraction, I knew I was stalling. Dr. D. checked my cervix and determined I was complete, but the baby hadn’t descended. I had no urge to push whatsoever. This completely freaked me out, because I had no intention of going back on the damn Pitocin (devil drug which was suggested to me after stalling) and because I had never once experienced my body completely. giving. up. It was the must surreal sensation I have experienced to date, this total body exhaustion. I cried (yet again) to D., “What do I do?” and the doctor was called in to discuss options. Though I was adamant the entirety of the pregnancy that I would refuse an epidural unless it was a medical emergency and I needed a crash c-section, his argument for it in that situation was appealing. He said I would be able to rest for a few hours and then start pushing. He said it would be a shame to give me a c-section at this point. So I looked to D. and I said, “What do I do?” (notice a pattern here? He is seriously my rock, as cliche as that is) to which he responded, “I think you should go ahead and do it. We don’t want the baby to get into distress after being in labor this long.” So I agreed.
But here’s the caveat, and here is what saved me from making a decision I would regret and feel guilty about forever and ever (and honestly, I’m not knocking your decision to get an epidural but I have made the personal decision based on lots and lots of research that it’s simply not worth the risk to myself or the baby–so there’s that disclaimer): I sat up, and that allowed the baby to descend.
“Curl her shoulders more,” the anesthesiologist told D. I was leaning against D., the bed perched in its highest position. “Keep her still,” he said, as he prepped the lidocaine needle. I grunted, “Uuuuuh, I’m pushing the baby out!” but no one heard me. One lidocaine shot went into my back and I screamed this time, “I’m pushing the baby out!!!” The nurse, unconvinced, said–and I’ll never forget this either–“You aren’t pushing anything out sitting on the bed like that. The baby’s gonna come out flat. You need to be on your side.” I vaguely remember the anesthetists zipping up their bags and hastily retreating and thinking, “They left fast.” I was on my side and finally, that familiar, comforting sensation of involuntary pushing was upon me. D. lifted the sheet and told the nurse the baby’s head was out and to get the doctor, and the next second my baby girl had entered the world onto the bed and into D.’s hands. Again, the bed was still perched precariously high and if it were not my darling D. having been beside me this entire time she may have fallen onto the floor. The next several minutes were a blur of movement as the doctor and staff finally entered the room after what seemed like too long a lapse, and my baby, my sweet Adeline, covered in vernix from head to toe was snug against D. and the front of his black shirt was then white, and he kept her warm while I sat stunned from it all. Let it be known that he, too, was stunned, but in that moment he was not only my rock and support, he was Adeline’s as well, and he was there, fully present and aware and awake, crying while looking into our beautiful baby girl’s eyes. And then he said that it seemed like I was bleeding too much, and everyone just mumbled that it was normal, but he looked scared and I felt the bed wet underneath me, so I said, “Can someone please look at me before they say it’s normal?!” and they palpated my abdomen and administered more Pitocin to stop the bleeding while they delivered the very small, very calcified placenta. And D. cut the limp, pale cord while I held my sweet Adeline, wincing as I was being stitched from a first degree tear (which was surprising as she had exited so quickly–one would think I would have had more stitching).
They took her from me very briefly and I was alright with her being aspirated until they began taking her measurements, so I demanded D. bring her back to me immediately because “they could do that later.” So he did. And in that moment this great sense of relief finally washed over me as I heard the Pediatric Specialist tell me that she seemed perfectly healthy. And, of course, I cried. She was here, in my arms, and she was only 5 pounds 6 ounces at discharge and so very tiny and fragile, but she was out and in my arms and finally…finally safe.
The end…and the beginning.
And now here she is, topping out at a whopping 16 3/4 lbs. at just over three months.
And she is so, so loved.