Thursday, November 21, 2013

Daniel's Birth Story

On October 30th at 5:53pm our family grew from four to five and our hearts swelled with the birth of our son, Daniel Vicente. He weighed 9lb 5oz and was 21" with Apgars of 9 and 9. Big sister is in love with her new baby brother while it took big brother a little while to warm to the idea. We are so blessed to have our three beautiful, healthy children.

I'm going to share D's birth story here as I've done with M and E in the past. I'll do a summary and then the detailed version like I did after E's birth more for my own memories years down the road. Feel free to skip the detailed version if you don't want the nitty gritty (possibly TMI) details.

The summary:
We checked into labor and delivery just before 8am on October 30th and were scheduled for an attempted version or a c-section at 9:30 if the version failed. Here's a summary of what transpired.
8-8:30 Got checked in to the triage side with blood draws, IV lock put in, and monitored baby and contractions or lack, thereof. 3cm dilated. 
9:00 Dr. Webb came by to explain what would happen with and without c-section while we waited for the ultrasound machine to see if version was still an option. 
9:10 anesthesiologist came by to go over meds in case of c-section or for epidural later should I be allowed to labor on and I signed releases. 
9:20 Dr. Webb came back and did an abdominal ultrasound to see how baby was positioned and if he was still transverse and then a vaginal to make sure there was no cord or hands/arms near my cervix for when they broke my water. She was confident we could do the version and gave is the final option. We went for it as I didn't want surgery with two kids at home already. 
9:30 water broken while version took place and I was 4cm after it was over. It worked!! I stayed in triage for a couple hours for monitoring to make sure he didn't move back and was handling contractions okay. 
11:30 moved to L&D room 610 started IV drip to push fluids
11:45 still 3-4cm and baby boy was high started Pitocin at a 1 (max dose 21)
12:07 temp of 100.3 (probably nerves as it later came down again)
12:56 still 4cm. Internal monitor fell off. Pitocin at 3 contracting regularly every 3 minutes and starting to intensify
13:45 got epi just as things got intense
15:00 pit increased to 5
15:20 break through contractions in my pubic bone brought me to tears as I feared epi was failing again like it did with Evan
15:56 epi boosted, 5cm, flipped sides. Lots of pubic pain brought me to tears.  Boost worked within 10 minutes
17:00 2nd epi boost, all over pain, flipped sides, feel him in my left rib and got scared he turned again. Pit turned off as I was starting to contract too much. In hindsight, I think I was complete at this point just nobody checked me. 
17:37 fully dilated, felt pelvic pain as he descended and intense pressure. Could feel contractions through epidural in my stomach and front pelvis. Told them to have Dr. Webb hurry because he was coming fast. I could feel him coming down and my body pushing on its own
17:53 1st push and he was born 9lb 5oz 21" apgars 9/9. No tears. 

Detailed Version:

On October 29th I had an appointment at 41 weeks pregnant for an NST and ultrasound to check on baby boy. He failed the NST, but passed the biophysical profile ultrasound. After those, I met with my OB, Dr. Webb, and she said he looked good with the practice breathing and my fluid levels were good (13.1, I think), but he was transverse or sideways.  She thought based on feeling his position during cervical check, externally, and via ultrasound pictures and due to the fact I'd had three previous births that I was a good candidate for a version. She wanted us to report to the hospital the next morning to attempt it while they broke my water and got things going since I was already a week past due. Also, due to the baby's position if I did go into labor on my own I had a huge risk of prolapsed cord or a limb coming down the birth canal first. If I went into labor that night or even thought I was in labor I was to report immediately to the hospital. If the version failed or his position changed worse overnight, I would get an immediate c-section at 9:30 the next day. 

She left the room and gave us a chance to process everything. I started crying more from fear than anything and disappointment I might need surgery. I feared he was just too big and that's why he wasn't in a good position. I did NOT want surgery with two kids at home already. When Dr. Webb came back in she went over the c-section paperwork and releases with us and answered all of our questions (would I be knocked out for the c-section if version failed, could Alexi be there for surgery, could we take pictures in the OR, etc). We were to report to the hospital at 7:30am to get checked in and figure out what course we'd take.  

On October 30th we got up before the crack of dawn (who am I kidding?! I didn't sleep a wink all night and was up basically every hour and I even went to lay with Mari for awhile in her room) and packed the kids in the car and headed to drop them off at my parents-in-law's house. We stalled there partly from fear of what we'd be facing that day and partly because we had a hard time saying goodbye to M and E. Especially, E knowing he wouldn't be the baby of the family for much longer. We got to the hospital just before 8 and checked in to L&D. They had me down for a c-section only and no version, so I panicked that my OB just gave me hope the day before when there really was none. It was just a paperwork snafu, though, since I was scheduled after 3pm the day before the paper trail hadn't caught up yet. My fears were squashed after Dr. Webb came by to say good morning and give us a rundown of what was going to happen. Everything boiled down to getting one last ultrasound to see where baby was positioned.  

While we waited for the ultrasound machine, the anesthesiologist came in to go over spinals (if I got c-section) and epidurals (if I was allowed to labor on) and had me sign the releases and answer a zillion questions. I was also hooked up to the monitors for baby and got an IV port installed. During his speech I actually had a contraction on my own and baby's heart rate deceled and didn't recover right away. A slew of people came in including Dr Webb and had me roll to my side. I'd been on my back awhile and they thought that was all it was, but Dr Webb warned me if it happened again our decision for a c-section would be made.  Luckily, it was just a fluke.  She kept asking us if we had any questions and if we were okay. We were both just nervous and quiet as we just wanted to know if I'd need surgery or not. 

Finally, around 9:20 Dr. Webb started our ultrasound to figure out where baby was. She did an abdominal one first to see general position and then a vaginal one to make sure there was no cord or limbs between my cervix entrance and baby as they planned to break my water as they turned baby in the hopes his head would settle into my pelvis and prevent him from turning back where he was. Thankfully, there was only fluid between baby and his exit!  Dr. Webb then gave us the final option. I could most definitely go for the version or do a c-section.  We opted for the version hoping to avoid major surgery. During the ultrasound, our OB was amazed at how Daniel could possibly fit inside me with his size the way he was. His back (spine) was basically parallel to the floor while his head was arched over my right leg (totally explains sciatic pain!) with his chin jutting out instead of tucked in. I wasn't going into labor because there was no pressure on my cervix from his head and he was ill positioned for birth. Dr. Webb actually drew a diagram on my chart of how he was inside me and everyone kept checking it out once they found out I was "that woman!" that avoided a c-section with a successful version. 

Next, was version time.  I'm pretty sure I held my breathe the entire time. The chief resident was going to break my water, while Dr. Webb turned Daniel, and our nurse held this special phone to alert the OR if we needed them.  The OR staff was literally waiting to hear if I was coming or not and was set up already for me just in case. That was a little freaky to know. Since I was only 3cm they tried using a tiny string like think to break my water and were able to, but only a trickle was coming out. They put the ultrasound on me and got the bigger hook (think crochet like hook) and used that to make sure my water really was broken while using the ultrasound to see baby. It was actually pretty freaking amazing to watch. We could see the Chief Resident breaking my water in the ultrasound machine and baby's head moving into position!

They asked me to cough a few times to see if more fluid would leak and we all got a laugh out of my nervous and very pathetic fake coughs. It's hard to do on demand!  I felt no pain during the entire process which I did med free. There was just a lot of pressure and some intense moments. Dr. Webb had one hand on baby's head to shift him and the other on his tush holding him so that when my water was broken he wouldn't flip the wrong way. Thank goodness it worked!!!  I was the talk of the whole L&D and postpartum floor that day being able to avoid surgery. I was given the okay to eat breakfast at this point and they wanted to monitor me in triage (closer to OR) for awhile to see how Daniel handled things going forward. I started having contractions within twenty minutes and AR brought me a sausage, egg, and cheese asiago bagel from Au Bon Pan for breakfast. I also got hooked up with a stash of cranberry juice (a hot commodity on the L&D floor!) and we just chilled and called family to let them know I'd escaped surgery so far and Daniel was safe. I texted a few people (friends and labor buddies) to bring them up to speed and then we waited after breathing a huge collective sigh of relief. 

At 11:30, I was moved to the delivery wing and even walked there on my own. At 11:45, I was checked again and was still at 4cm and contractions weren't regular or strong, so they started me on Pitocin. I started at a dose of 1 (Max dose is 21 and I'd never get above a 5. For reference, with Evan I had a dose of 18!!).  I was so hot I had them turn down the air in my room. I had a low fever and I think the rest was adrenaline and nerves as the fever went away. They opened my room door for awhile, so I'd get more cool air. I was sipping Gatorade and cranberry juice, resting, lurking on Facebook and Candy Crush, and we were watching HGTV to pass the time. I was still pretty much okay during contractions at this point, but knew it would get intense soon as the Pit dose increased with my water already broken. 
Just before 1, I was checked again as the internal monitor had fallen off (they took it out and hooked me to external monitor instead).  I was still only at 4cm, but I was contracting every 3 minutes and the Pitocin was now at a dose of 3 and my pain was picking up.  The nurse ordered my epi at 1:15 as there was a c-section scheduled for 1:30 and she didn't want me to miss my window and have to wait as I warned her that one second I'd probably be fine and then the "shit would hit the fan" as that's how my other labors were. I didn't want to suffer through the shit hitting the fan this time (for lack of a better way of saying it) and thank God she heard me. 

Anesthesia arrived and the head doctor was also named, Heather. They started going over the standard release info until they realized I'd already done it in triage. They realized I was "that" woman who had the version and were excited to meet me and checked out my chart's notes. I was prepped right away and my contractions were getting super painful at the same time. Sitting in epidural position during intense contractions is tough. I'm so glad my delivery nurse called them when she did or I would've been out of my mind in pain like I was with E in labor.  It took forever to check my epi as they thought it hit a vein and they checked twice to be sure it hadn't. I was given the all clear and they finally started the drugs at 1:45pm.  This epi hurt a bit and took longer than usual to put in as every contraction they stopped (normal).  I was relieved when it was over and I started to get the tingling in my legs signaling it was working.  After the epi kicked in, I napped for awhile and at 3pm my Pitocin dose was at a 5. At 3:20, I started having break through pain in my pubic bone which brought me to tears. I was so scared my epidural was failing again like it did with Evan. I just breathed through them while I silent cried and AR paged the nurse. He had left to get a coffee when I started to feel pain and when he got back, I was in tears and he walked in and panicked a second. At 3:56, my epidural was boosted and I flipped over to lie on my other side and thank goodness I got relief within 10 minutes.  At 5pm I started to feel break through pain all over my belly again. The nurse helped me flip again and as soon as I did, I felt him in my left rib.  I think it was his tiny tush, but it worried me that one second he wasn't there and the next he was...I thought he had somehow flipped back again.  My epidural was boosted again and I continued to feel the contractions in my belly and complained to the nurse about him in my ribs.  I think I was actually complete at this point (fully dilated), they just didn't check me yet.  

Finally, at 5:37 the nurse checked me and said I was fully dilated.  AR and I were shocked, though we suspected it with my break through pain.  As soon as she was done checking me, I felt the urge to push and could literally feel him dropping down and my body pushing.  They called Dr. Webb and I told our nurse, Shonna, to make sure she hurried because he'd be here quickly.  Dr. Webb was in the room maybe 5 minutes later (but felt like forever) and checked me and asked me to give a practice push to see about turning his head to a better position.  She immediately told me to stop pushing (my body was even doing it on its own) and got dressed in the delivery gown and mask and they converted the bed quickly for delivery and I asked for a mirror again.  I barely had my legs in position when I could feel another contraction coming and told her as such.  Dr. Webb asked if I remembered what to do and I blanked out for a minute and then AR helped hold one leg, while I half grabbed the other (the adrenaline was giving me the shakes).  Alexi turned his back for a second and Dr. Webb said, "Look!  Here he comes!!" and we were shocked and said no way.  They'd asked me at least a half dozen times how long I'd pushed with my previous births and both M and E were 20-25 minutes (longer for M), so we fully expected that.  I yelled at the resident as he got in front of my view of the mirror and stopped pushing until he moved.  Not pushing did nothing as Daniel still came and as soon as I saw the mirror again I gave a final half push and he popped out!!  He had the cord around his neck once, which Dr. Webb quickly unwound and then his shoulders and body flew out.  I literally half pushed him out the first try!!

Daniel was placed right on my chest and we were all just stunned he was there so quickly and then he promptly peed all over me.  Dr. Webb was as shocked as we were and AR later said it felt so anticlimactic because one second they said I was complete and in one push he flies out!  He expected it to take longer and have more anticipation, as did I.  I mean we went in thinking I'd end up with a c-section and instead out flies Daniel after a single half push and he was a big baby!  The nurse was so excited to weigh him, but we did the delayed cord cutting and skin to skin for a bit.  Alexi took pictures of us and then put the camera down to cut the cord, which I got to watch this time.  Dr. Webb kept saying over and over what a rock star I was and that I could totally birth a 10 pound baby easily (um, no thanks!?).  The whole room was a flutter with excitement at the fast delivery, successful version, and avoided c-section.  Bonus: I didn't tear or need an episiotomy this time.  I just had a few minor tears near my urethra, but nothing that required stitches.  Not tearing made a HUGE difference with the healing process.  Huge.  I felt great pretty quickly and within 2 days the minor tears around my urethra didn't even sting at all.  We finally let nurse Shonna weigh Daniel and get him cleaned up.  She did his length twice to be sure it was right and he weighed 9 lb 5 oz and was 21" long.  After he was cleaned up he came back to me for skin to skin and to nurse.  The kid came out starving...he was rooting the moment he was born.  He also had a lot of swelling on his face and bruising on his right cheek and eye from coming out so quickly.  Thankfully, he's nursing and gaining well.  He's got cheek dimples when he smiles and the softest baby fuzz hair.  He was nursing promptly every 2-3 hours around the clock until 3 weeks old.  At 5 days old he was already back to gaining and weighed 9 lb 3 oz and by 10 days old he was already 10 lb 3 oz.  We think he looks a lot like E as a newborn, but he's much lighter skinned like me.  
Happy birthday, Daniel, and welcome to our crazy family!


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