She is beautiful! I hope you are all adjusting well. Looking forward to reading about your birth!
Ericka~Mommy to David, Paul and Adam
Despite my best efforts to stimulate natural labor, I had to be induced on Monday, December 8th. I was 8 days over due and although all my NST and amniotic fluid indexes were all fine, I had small calcifications forming on my placenta and therefore needed to deliver pretty soon. I was not dilated or effaced at all upon arrival to the hospital Monday night. The best the nurse could give me was “soft.” I had my first dose of the Prostaglandin gel at 9pm after an hour of monitoring. The gel was suppose to help soften my cervix and was to be administered every 4 hours. I had to have 30 min of monitoring before the gel and 1 hr afterwards. Unfortunately due to my body composition and size the monitors did not stay on very well. Brad offered to help hold them on for the first monitoring session. After the first dose was in and all was fine on the monitor we settled down to try and get some rest. During the next exam prior to dosing, I did not have any change. My nurse was so kind and supportive. She told me that the gel usually takes 3-4 doses to really make any change. I was so skeptical that this was going to work, I just had a feeling that I would end up with a c-section for failure to progress. I told Brad that if after the 4th dose I still had not made any progress I wanted to go home and try again another day. He was a bit worried about the short amount of time he had to be off of work but understand my risks of going forward with more invasive induction methods if I was not progressing. My nurse, Janna, sat with me during the second monitoring session, holding the monitor and just talking. I found out that she was a CNM in training. I felt so lucky to have her as my nurse. We talked a long time about natural birth, our current medical society and the various procedures I could possibly have. During her stay with me another nurse came in and gave Janna a bunch of home made incense. It smelled so good! Janna was kind enough to offer us a few sticks and even said that we could leave them open in the room if we wanted to infuse the room with the sent. It made it such a relaxing environment for me, I was very grateful.
At 5am just before Janna checked me I was starting to feel some contractions. The gel was not designed to produce any contractions, just help soften my cervix. I was encouraged thinking that maybe my body had just needed a little nudge to get labor started. My cervix was now midline instead of posterior, slightly effaced and 1cm dilated. She administered my next dose of the gel. She warned me that she was off shift at 7 and that I was “scheduled’ to start Pitocen at 9. My new nurse came in at 7 to switch out. Janna was great, introduced us, told her of my progress then went right to my birth plan and walked the new nurse through my entire plan, explaining that although I was going against plan with this induction so far, I still wished for very little interventions. My new nurse Michelle, was accompanied by a student nurse. The student nurse, Beth had never seen a birth plan and said she was impressed by it.
By 8am I was having contractions about 7-10 min’s apart. My Dr. came in just a bit before 9. She checked me and said that I was now at 2 cm and about 45% effaced. My cervix was still at midline. We talked a while about the next steps. She said that I could start Pitocen or she could break my water. She thought that breaking my water was a better idea since she knew I didn’t want Pitocen. I disagreed with both. I knew that breaking my water would put me on a clock and I wanted to avoid Pit as best I could. I asked her to give me a little longer to work with my new contractions and use gravity to help make more progress. She agreed to give me till noon and also mentioned that we could try Cytotek or Cervidil and see if either of them would soften my cervix more. She asked the nurse to let me be until noon, then check me and report my progress.
I immediately got onto my birth ball and started bouncing. I alternated between bouncing, pacing, squatting at the end of the bed and bending over my ball for the next 3 hours. My contractions were getting stronger and stronger and requiring all my concentration. Just as Michelle came in to check me another nurse came to tell her that she could take the day off if she wanted as they were overstaffed. It was obvious that the new nurse was “top of the totem pole” and enjoyed her position. Her name was Sarah. Sarah was not interested in Michelle’s hand-off of my information and said she’d read the birth plan later. She also commented “I can’t believe she hasn’t been on the monitors the whole time! And where’s her IV?” I was a bit worried. She was obviously very “by the medical book” and not sympathetic to natural birth. It was her conveniences she was more interested in. Instead of talking to me, she spent the next 30 min’s while I was on the monitor, re-arranging the desk to her liking and explaining to the student nurse, Beth, why her way was better. Once I had done my 30 min’s, Sarah checked me and said that I was now at 4cm and 80% effaced. I was so excited! I asked her to let Dr. Hutcherson know that I was making progress on my own and would like to give it another couple hours before we intervene any more. I wanted her to inquire about the Cervidil. I wanted to know if I would have to be on the monitors 100% of the time it was in or if I could get off the monitors. My thought was that if after two more hours I had not made more progress or if my Dr wanted to intervene now, using the Cervidil was better than amni-rupture or pit. Immediate Sara tried to tell me that I would have to be on the monitors and that I could use the telemetry monitors to move around. I could tell by her attitude that she was not going to be the advocate my first nurse Janna was. I reminded her that the regular monitors didn’t stay on me very well as is let alone the telemetry monitors so it was most likely not an option. I requested that she just ask the Dr if I could be off the monitors or do “strips” every hour to ensure that the baby was tolerating well. She agreed.
Sara came back and said that Dr. H agreed to give me two more hours, off monitors, using gravity, to see if I continued to progress on my own. She then said though, that she happened to “bump” into her nurse manager in the hall and the manager informed her that I HAD to be on the monitors 100% of the time starting now and I had to have an IV, no exceptions. I asked Sara if she told her manager that my Dr approved me being off the monitors. She said that she did but her manager said I had to be. I knew that arguing with Sara was pointless as she wasn’t making the rule, although I’m not sure that she didn’t seek out the manager just to get her way approved, so I asked to speak to the manager. When nurse Paula, the Manager of Labor and Delivery came in, she was all business. She came over, introduced herself, title and all, shook our hands and handed each of us a business card. She said that Sara had informed her that I wanted to be off the monitors. I said that my Dr. had agreed that I could have two more hours to make progress on my own, no monitors. Paula said that it was “her” policy that all women be on the monitors 100% of the time. I asked her why that was when even my Dr. said I did not need them. She then “reminded” me that I was past date and because of that my risk of fetal death was elevated. She said “your baby could die inside of you and with out the monitors on we would have no way to know and help and with out an IV we wouldn’t be able to quickly give you medications if something went wrong.” I was absolutely floored that she would use such scare tactics! I said that I was willing to be on the monitors every hour long enough for them to get a good strip and that if the baby indicated any signs of stress I would consent to 100% monitoring. She said that it wasn’t good enough and “her hospital” policy was that I have 100% monitoring and an IV despite what the Dr.’s say. She said that I was ultimately her responsibility since the Dr was not there the entire time so if the baby died it would be on her, not the Dr. She even said that she would call my Dr and tell her the policy. I could see that there was no reasoning with her and I didn’t want to start a problem between her and my Dr. so I just politely thanked her for taking the time to talk to me and shook her hand.
My contractions were so much more painful in bed but I figured I would try the telemetry monitors and any position I could while still hooked up. Sara then spoke up and said that she would just give me a hep-lock since I didn’t need any medications yet. I was at least pleased with that alternative. As they were gathering the supplies for the IV, Paula came back in with paperwork. I assumed it was a copy of “her hospital” policy. I was pleasantly surprised when she said: “I reviewed my policy and since you have not had any interventions or medications since 5am this morning, you do not have to be on the monitors the entire time.” She said that I could be off for 2 hours then on for 30 min’s. She was careful to never apologize, make amends or weaken her business like manor but I thanked her for going back and reviewing the paperwork and coming to let me know. After she left, Sara commented on how she has never seen that happen!
Once I was off the monitors, at 1pm, and back on my birth ball, the Beth tried to insert my hep-lock into the back of my right hand. She was unsuccessful. Sara tried next on the thumb side of my right hand, she was unsuccessful. They then called in the “resident expert” nurse she said she found a good vein on the thumb side of my left hand, she was unsuccessful. They then called in the anesthesiologist. They all warned me that usually they just go for the veins in the inside of the elbow which was unfortunate as it made holding the baby difficult. When the anesthesiologist came in she had me get back up on the bed so my hand was hanging low. She said she’d try once on my right hand and gave me some lydocane incase she had to dig for it but fortunately she got it on the first stick! Sarah and I discussed if I should get my first round of antibiotics as I was GBS positive. Since I was progressing very slowly, we agreed that I should probably wait.
The next two hours were quite a blur, my contractions starting coming on very strong and right on top of each other. I was having a hard time catching my breath between them and started to loose my composure. I even just screamed through an entire contraction just to get the energy out. I asked Brad to call the nurse. When she came in I was a sobbing mess. It had now been almost 3 hours since my last check and the last 2 of those were intense contractions lasting over 90seconds coming every 30 seconds. Sara checked me and said that I was now at 5 but she could stretch me to 7. She also said that I was now completely anterior and 90% effaced. She started the monitors so we could see how Makenna was tolerating these. At first, she thought the contraction monitor was broken as it was registering a contraction the entire time. It wasn’t until I informed her that I was having a complete contraction with no rest in-between that she said my uterus must be hyper stimulated into continuous contractions. I then asked for an epidural as I knew I could not go on with out it. Sara called the anesthesiologist back, started my bag of fluid and my antibiotic as I needed two 4 hour courses and had not received any yet. I couldn’t talk, I couldn’t move I just stared at a cross that was on the wall above the clock. Sara had to disturb me at one point to have me sign admittance paperwork as I was still not considered admitted until I was in active labor and now, I was considered active. Fortunately I had already read all the admittance paperwork and could just sign them with out reading over them because any time I was “present” vs. “checked-out” my head was just screaming from the pain.
The anesthesiologist was the same woman as before so I had high hopes that she would be as quick and as efficient. She started my epi at 3:45p. Unfortunately, it took a lot longer than expected and she had to poke me twice to get it right. I just leaned over Brad and stared at a black spot on the floor. When she finally said all done, she asked me to lie back on the bed. I kept waiting for a lull in the contractions so I could move otherwise it was excruciating pain. Secretly, in my head I was waiting for the epi to start working a bit before I moved. Time ticked on and on and I asked her when it should kick in. She looked up from her paperwork and informed me that she couldn’t start the medication until I lay down. I was so mad; I thought that “all done” meant that I was receiving pain medication. I had to have Brad and the two nurses help me move so we could do it quickly. The pain after I lay down was so bad I just completely shut down. I don’t remember any more except crying until the epi started working.
Once the epi was in, my contractions spaced back out to every 5 min’s, but kept up the intensity. Sara tried to place my catheter in and had an equally difficult time with that. At first, she thought that Makenna’s head was so low that it was compressing my urethra but when she checked me she said that she was still too high for that. It took two catheters and me yelling at them twice before they got it in right. Brad said that it was very bloody and advised me to suck down cranberry juice for the next few days to help avoid getting an infection.
My Grandma showed up at about 4:30 and sat with us for a few. .I asked my Grandma to leave for a bit when Sara came back. She said she wanted to check me so she could advise my Dr if she needed to come over now from the office or stay for a bit. I was now at 8 almost 9 centimeters and 100% effaced. Sara said that she did not feel a bag of bulging waters so she assumed that it was all corked by Makenna’s head which was very low by now. She left to call my Dr. I asked her to have my Grandma stay out for a bit so we could rest, knowing that it would be soon. My Mom, Step-dad, other Grandma, our son and daughter all showed up at about 5:15. We chatted for a few min’s but then my Dr came in. The family all went out while the Dr checked me. She said that she was going to try to break the bag of waters. She could not get the amni-hook onto the bag and agreed with Sara, that Makenna must be corking it completely and there was no fluid between her head and the bag. By this time I was ready to start pushing. The nurses all went about setting up the room while I pushed a few times to turn Makenna as Dr H said that she was facing the wrong way. The look on the student nurses face was priceless as she watched Makennas head rotate with each push, I’m guessing she has never seen it before. I reminded the nurses that I did not want anyone counting while I pushed and that I did not need to be reminded when to push that I would just go with what my body told me. Once Makenna was turned around I pushed for about 5 pushes before her head was out. I had to hold off pushing for a second as the umbilical cord was wrapped around her neck. Just like in Haileys birth, I commented on how WONDERFUL the feeling of the baby coming out was. Dr. H said that I had no amniotic fluid and that Makenna was sticky indicating that she had been with out fluid for a while. That explained why they couldn’t break the bag earler. She asked the nurse if my bag broke at some other time and both of us said No. The student nurse said she had heard of dry births but never seen one. Makenna was put right on my chest while they cleaned her up. Because she was “dry” they had to get a wet towel to clean her off. Dr. H commented that my umbilical cord was “so long, I could walk out of the room with your placenta and not tug on the baby.
Makenna was born at exactly 6pm, 7lb 6oz, 20 in long and just perfect. Apgars of 9 and 9. I had no tears or abrasions and my placenta detached right away. With out telling me, Sara pushed a bag of Pit onto my IV. I was too involved in everything else to argue and was at least grateful that I avoided it during labor. My family was a bit hard to get a hold of as they had all gone to the cafeteria which was in the basement where the cell reception was horrible. Once they came back up, we introduced everyone to our newest edition. Our son Anthony was just in love immediately and our daughter, Hailey kept repeating “shh, shh, shh” to Makenna. Everyone took turns holding her and coo’ing over how wonderful she was. Anthony spent a few min’s holding her and singing a song he made up for her. He then came over to me and said “I don’t need any birthday present from you or dad for my birthday, a new baby is just perfect!”
At 7pm, Sara and the student nurse, Beth were off shift and handed me back over to Janna who was back for the night. Before leaving, Beth thanked me for allowing her to be a part of my labor and delivery. She complemented on how strong she thought I was and how well I handled the situations presented to me. I could see that she was genuinely impressed and hoped that maybe she learned a bit about “natural” labor and would be more like Janna than Sara once she was a nurse.
Janna was a breath of fresh air! She immediately removed my IV and epi since she knew I didn’t want it to begin with. She asked about my story, saying that she had heard there was some drama. She was as floored as I was about Paula’s behavior as well as Sara’s coldness. We talked about the physical anomalies as well. How Makenna had no fluid yet showed no signs of distress ever and I never had a “water break” that I was aware of. Janna asked if the Dr. ever checked my fluid and I told her that just 3 days prior to the induction, my fluid index was a 12. I never had a leak, never felt a gush or had any type of show indicating a break. We also talked about how her cord was so incredibly long yet aside from being once around her neck, never tangled or knotted up. She asked what lead me to choosing an epidural and I told her about the intense contractions and I asked her if they could have been a result of the gel. She said that it’s not likely as my last dose was about 7 hrs before. Janna helped me up out of bed to use the restroom and clean up a bit. She gave Makenna her first bath as well. We noticed some scratches on her head that were starting to scab over. It took us a while to figure out, but eventually we concluded that they were from the amni-hook when the Dr was trying to break my bag of waters.
We moved up to the post-partum room around 11pm and slept. The next morning at 9a the pediatrician came in and cleared Makenna to be released, at our request, immediately. Dr H came in an hour later and released me as well. It took the hospital a bit to get through all the paperwork but we were home by 2 in the afternoon.
DH Brad ~ Married 6, together 8yrs
Mom to Anthony ~ 7yrs old
"There is only one perfect child in the world, and every mother has one" Chinese Proverbs
In memory of Reed and support of those who love him...
I almost texted you earlier this week to check on you
What a story! I'm glad you got a great nurse at the beginning at least! That stinks about how the rest of it went I can't believe your fluid was gone. That's why I ended up with a c-section with Ethan.
How are you adjusting?
Great birth story! Sorry you had to fight with the nurses, but I'm so proud of how you stood your ground! Fantastic job mama!!
Molly & Elton 10/2/04
Mary 5/24/06, Celia 6/9/09
Baby #3 due 6/21/13