Tuesday, August 28, 2012

the birth story

Looks like my instincts were off a bit. I had really really thought I would not go into labor early. I thought I would go all the way to my induction date of Sep 4th and that we would look back on the bedrest and think it was over-kill. But on Monday July 30th at 32 weeks and 5 days I got a reality check.
Corynn was at my sisters that day as usual for mondays and I was just laying in my recliner as usual. It was a cloudy overcast day and I had woke up at like 3am that morning and just felt "off". Couldn't get comfortable, couldn't sleep yet I was really really tired. I napped on and off through the morning and did a whole lot of nothing. At around 3pm I spent about 20 minutes painting the letters O and E to hang on the nursery wall. 
What's funny is that all day I had been wondering what it's like to go into labor on your own. Yes, I knew what contractions felt like but with Corynn I was induced so I went from nothing to full labor in a matter of minutes. So I just wondered if I would know when labor was starting. I wondered if it would start mild or would it be just like the induction or would it be a much longer gradual process? I even posted some questions about it on baby center. It was heavily on my mind that day.
I also didn't know this until after they were born, but it was also a full moon and apparently if you're "ready" a full moon is likely to send you into labor.
 At my 32 week check up just 6 days prior, I hadn't been having any contractions and no more dilation since 28 weeks and Owen was breech so we weren't worried about the pressure of his head anymore, so my OB gave me permission to do some small things again and one of those was driving. She said since my cervix had no change at all and my meds were working to keep contractions away, she felt confident that I wasn't going into labor and felt safe reducing my restrictions just a bit.
So, at 4pm on July 30th I left my house to go pick up Corynn from my sisters house so that we would be home when Erik got home from work a little after 5:00. As soon as I sat down in the car I felt a crampy pressure, but I'd had lots of feelings like that before so I just thought it was my usual discomfort. I stopped at sonic to get a vanilla ice cream cone for a snack and while I was sitting there I realized I kept getting these cramps every 5-6 minutes. My scheduled procardia dose was due at 5pm so I just thought my med was getting close to wearing off. No big deal, happens all the time. I would just get home and take my med and they'll go away. So I ate my ice cream and started driving and as I drove they kept coming 5 min apart and were gradually getting a little more uncomfortable. I started to wonder if I should worry when I realized I was having an abnormal amount of road rage and irritability toward all the traffic on I35. They were making me uncomfortable enough that having to sit in rush hour traffic was really getting to me. 
I arrived at my sisters house and at this point they were still just cramps so I easily walked in, used the restroom, could talk through them no problem and I told my sister what I'd been feeling but told her it was probably nothing. She loaded Corynn in the car for me and I went on my way with one half of me wondering if this could be it and the other half of me thinking "no way". 
As I drove home, they continued to grow in intensity but still not to the point where I would call them "contractions". 
I got home at about 5:15pm and as soon as I stood up out of the car I had my first pain that I would call a contraction. It was the familiar pain I remembered from Corynn's birth. As I walked up my sidewalk I had a ton of pressure that made it a little difficult to walk or stand up straight. This is when I actually started to get a little worried. 
I took my procardia along with a PRN vistaril in hopes that the two meds together would knock out the cramps. I sat in my recliner and waited to see what would happen. I told both grandmas what was happening but told them I wasn't really sure if it was labor or not. I knew that if it wasn't real labor, my meds would get rid of it but if it was "real" the meds would not work. Eriks mom who lives in manhattan KS was already in Lawrence for a meeting and asked me if I thought she should just come this way or head back home to Manhattan? I told her I wasn't sure. I also didn't tell any of my close friends or other family because I hate getting everyone excited over false labor. I knew if I went to the hospital, they would just do the same thing I did at home.... give me meds and wait for them to work. So I decided I would wait an hour to see if they did the job. I took the meds at 5:30 and by 6:30 the contractions had gotten to the point that I couldn't talk through them. I would have to stop and grip the chair in pain. If I stood up, they would get really bad. At this point Erik was trying to convince me to go to the hospital. He was pointing out that none of my previous false labor/ braxton hicks contractions ever caused pain and that if I was in pain it had to be the real thing. Part of me knew he was right but I still thought the meds could kick in at any moment and I would hate to get to the hospital only for everything to stop and I feel like an idiot and get everyone worked up over nothing, so I told him I wanted to wait until 7:30. That would give the meds two whole hours to try and work.
Erik thought I was insane and proceeded to pack our hospital bag while I was in denial.
He was worried because my labor was pretty quick with Corynn and he was afraid I would end up trying to deliver a breech baby in the car and they would die in the process. Once he made this arguement I decided that yes maybe I should at least call the on call OB and see what they think I should do. At about 7pm I put in the call and waited for her to call back. After I left my message I got up to use the restroom and HOLY HELL contraction! I had to hold on to the walls and then I had a bit of bloody show and decided I better get to the hospital. I yelled out to Erik "umm yeah, we need to hurry up and go" and he replied "I told you!"
As I was getting in the car the OB called back and I didn't ASK her what I should do, I told her "I'm  almost 33 weeks with twins and have been having painful contractions 5min apart since 4pm so I'm headed to the hospital." She replied with a panicked sounding "SINCE 4:00?!" Oops, guess I should've gone sooner?
She then inquired what pregnancy this was for me and then asked how quick my first labor went (2.5hrs) and then told me "OK I just ran a red light, I'll see you at the hospital."
At this point I called my mom and Erik called his mom who had now made it all the way home to manhattan and now had to turn around. These were the only people who got the memo. By this point I was just so focused on the pain on the way to the hospital that I neglected to tell anyone else about what was going on. One of my sisters didn't even know what was happening until Erik texted her right when we were going in for csection and Erik's mom apparently didn't arrive until right as they were being born. Once I had realized I was in real labor, things just moved so quickly.
Erik dropped me at the door and I hobbled myself in to the front desk to check in while hunched over the counter swaying back and forth during contractions. Erik parked the car and he and Corynn joined me in the waiting room. By 7:30 I was checked into my room and was now in tears with the contractions. Shortly after, my parents arrived and one of my sisters came to get Corynn.
The OB came in at about 7:45 and checked me and I was 4cm 80% with significant bloody show. I had previously been 2cm 30% at my last OB appointment and had been the same for four weeks. The doc did a quick ultrasound to confirm that Owen was still breech. He was. She said the plan would be to watch me for a little bit and see if I progressed quickly which would tell them that it's unstoppable real labor and then proceed with a csection or if I didn't progress much they would start magnesium again in an attempt to stop labor. They also gave me another steroid shot in addition to the ones I had at 28 weeks. My contractions were coming about 2-4 min apart although they looked tiny on the monitor. This happened with Corynn too.. My braxton hicks contractions always looked bigger and more "real" than when I was actually in labor. The real contractions are so much deeper/ internal and harder to detect from the surface.
But because of how I was reacting to these "small" contractions, the OB decided to check me again at 8:15 and I was 5cm and 100% so she made the decision to go ahead with the csection. At this point I was in bad pain and asked for my epidural to which my nurse said I could have once we get in the O.R.
I was thinking that we would be heading that way immediately and voiced my concern that I progress quickly and I wanted to make sure that I didn't progress so fast that there would be no time for an epidural. It was very important to me that I NOT be put under general anesthesia!
My nurse stood there and proceeded to chart on her computer!! After about 20 minutes went by, I had a strong contraction and yelled "HURRY"! The OB was also in the room at this point and she looked up at me and then at the nurse and said "alright, we need to be getting her in the O.R." and she started to unplug my bed and then yelled out to the nurses station "I need some help in here". My current nurse then pipes up " Oh,I've got it dr L" and the OB said "well, you need to get off the computer and get moving." There was definitely some tension between the two of them, but I was glad she was so pushy with her. If I had been a vaginal delivery, I would've had my epidural already but because I was going to be a csection and they preferred to just do everything in the O.R., I had to deal with the pain for an extra 45 minutes while my nurse poked around. I was rather annoyed about it, especially because I knew we could possibly run out of time.
At 8:45 I was taken to the O.R. and got my epidural. Sweet heaven! Again, just like my last two epidurals, it didn't hurt at all and went in easily with no problems. The Doctor checked my cervix one more time just to see how far down she would have to pull Owen out of the birth canal. She said I was now 6cm with feet hanging down. I was dilating about 1cm every 30 minutes.
They had a little trouble getting enough medication to make me completely numb which worried me because I did not want to be put to sleep and miss the birth. I think that would be horrible. But eventually it worked.
First came Owen at 9:19 pm. I heard a beautiful cry that brought tears to my eyes. He was pink and perfect and had apgars of 8 and 9 and needed no oxygen immediately after birth. Perfect. He was 4lb 6oz. Then I waited for Eden. I could feel a lot more tugging and pulling and manipulating with her. I didn't know until that day that the epidural does not take away the feeling of touch, it only removes pain. I could feel every hand and finger poking around in my abdomen. The mood in the room went from laughter and joy to a tense and serious situation. The OB was having trouble getting Eden out. I wasn't worried at this point though because I always thought a csection was such a controlled situation that really nothing could go wrong as far as delivery of the baby/ birth trauma. Apparently I was wrong about this. After about five minutes of manipulation and a couple extra cuts to my uterus, Eden was out. No cry. She was purple and floppy. The OB gave her a strong sternal rub and Eden let out a cry and I breathed a sigh of relief. Once they had her on the warmer we could see how horribly bruised she was, especially her left arm which was completely purple and swollen. She would cry a bit but then stop breathing again and the team would have to bag her (give manual breaths with the resuscitation bag). After several apneic episodes (not breathing) they decided to take her out to the NICU. Her apgars were 3,5 and 7. She weighed 4lb 2oz. It is unclear what time she was born. When I asked in the delivery room, everyone was like "ummmm I'd say about 9:23 or so". I think the situation was so intense that no one had bothered to look at the clock when she arrived. Her birth certificate says 9:23 but her NICU bracelet and documentation says 9:26 but if you watch the video Erik took, she was actually born at 9:24. Five minutes apart is a long time for a csection! Apparently what happened was after Owen was born, Eden took advantage of all the space and flipped from a head down position to  transverse and curled up in a tight ball with her left side facing the small incision. According to my doctor, it is near impossible to deliver a baby in this position from a tiny typical csection incision. She explained that if they cut me completely open, then yes a csection would be uneventful no matter what, but she said that delivering through a tiny bikini incision is just as limiting as delivering through the vagina. She said you really need the baby to be head or butt first. The only thing that makes the csection safer is that you can make the hole bigger if needed.
The OB that delivered me attempted to turn Eden and managed only to get her left arm out in the process. At this point my uterus started to clamp down as it would normally do after the baby is delivered. This can happen in twins once the first baby is out. So, Edens arm was stuck outside of the uterus getting squeezed while the rest of her is stuck on the inside. At this point the OB had no choice but to widen my horizontal incision more as well as make a vertical incision to my uterus in order to finally release Eden. As she was sewing me up she told me I could never try a vbac if I ever wanted more kids because my uterus was DONE after this. Luckily, we are also DONE having kids.
After Eden was taken away, they swaddled Owen and let me hold him for a couple minutes before taking him to the NICU. My babies were finally here and I was happy and relieved.

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