The last thing I shared on the blog was that it was decided I was going to be induced. This happened around 10:30am Thursday morning, and by 3:30 that afternoon, I had been given Cervidil. This drug doesn't cause contractions, but rather gets your body "ready" to be in labor. Considering when we started this process, my body hadn't really done anything to "prepare," things like Pitocin definitely wouldn't have been able to work. This was all so surreal, since we were counting on having at least 2 more weeks of the pregnancy. I was convinced the hospital visit was just a blip on the radar and that I'd be heading home soon, so to actually be starting the process that would end with a baby was very hard to absorb. Even thought I was struggling with all the not so fun end of pregnancy symptoms, I was still very happy to be pregnant and wasn't ready for that to end.
One of the hardest things with the induction process was that as soon as I was on induction medications, I was no longer allowed to get out of bed, besides using the bathroom, and I had to be on continuous monitoring. This meant that I had these belts going around me to check on my contractions and on the baby's heartbeat. I'd be on those monitors with more or less no breaks from Thursday afternoon until I delivered Sunday afternoon. By far, these were one of my least favorite parts of the process. Also, since my blood pressure was the whole reason I was in the hospital, that was being monitored at least every hour, and sometimes every 15 minutes.
The medication was slow to take affect, so the first afternoon wasn't too bad. Ed and I watched "Roman Holiday" and regular tv, willing my blood pressure to stay low and contractions to kick in. By around 9pm that night, we transitioned into real contraction land, and I was pretty miserable from then until around 3am, when the cervidil was taken out and the contractions died down.
My spot (with my million pillows) that first night of labor.
Friday, they decided to start me on cytotec, another medication to get my body ready for labor. I had made some really good progress that first night, and the hope was this would keep things going. Surprisingly, I didn't have any contractions on this medication, though I was reassured that contractions weren't necessarily the goal. I kept Ed at the hospital with me, just in case it became intense like Thursday night, but he wasn't really needed. Lots more TV and movie watching. On the plus side, since my blood pressure medication was working pretty well, I was allowed to take a "break" between each 4 hour dose of medication to come off the monitors. After no bathing for over two days, I took a shower on each break, and we went for a short walk. These breaks were by far the highlights of the next 16 hours and were incredibly mentally helpful.
Each walk would take us to this tree at the end of the garden, and back.
The silver lining of no contractions was that Ed and I were also able to catch up on some rest. The first two nights, I didn't sleep more than 2 hours each night, so I was really dragging and worried about energy for labor.
At around 7pm, I finished my last dose of cytotec, and was checked for progress. My midwife was happy with the progress I made, so we were moved onto our third induction drug - pitocin. Her strategy was the start very low and slow, to hopefully mimic a natural labor, and help my body react positively.
I got some mild contractions, but not much, so my midwife made a suggestion that was music to our ears. We could get out of bed! Granted, since I was still hooked up to monitors and an IV, it wasn't exactly total freedom, but it was still great.
She recommended Ed fix my hair for me, so that I could feel more "in the game" (we had told her about our running background and comparison of ultramarathons to labor).
Then, she encouraged me to put on some real clothes. I'd brought a sports bra for the super active natural labor we were planning, so it was fun to throw that and a skirt on after living in a gown for days. We were having some issues with the monitors, so Janice (our midwife) found this fabric tube top type thing that I could wear that held the monitors better. We kept this up for about an hour, and it was fantastic.
Of course, we eventually had to move back to bed, due to my blood pressure, but it was fun while it lasted.
Once the pitocin had been cranked up to a 6, it was time to start some more drugs. Due to the stroke/seizure risk with preeclampsia, they wanted to start the magnesium. Magnesium, unfortunately, is a muscle relaxant, which makes it tricky when you're trying to get your body to have contractions, but it was a necessary evil. Luckily, I only had mild side effects from it - the promises of feeling like death were happily unfounded. Since I was GBS +, they also wanted to start the antibiotics, so that it wouldn't get passed onto the baby during delivery.
Finally, Janice broached the introduction of a final drug - the epidural. Obviously, we weren't super into getting once, since our whole training was focused on doing things naturally. Plus, I wasn't in any pain at this point. However, a common side effect of an epidural was a drop in blood pressure. While my medication was generally working, this was a side effect my body really needed. So, at around 3 in the morning, the anesthesiologist arrived and gave me the epidural.
Once I had that, I had to only lay on my side, with a "peanut" (a large peanut shaped inflatable object) between my legs and was rotated once an hour. My pitocin was also upped by 2 each hour when my nurse came in. We were able to get a bit more sleep as we waited for things to kick in.
Sunday morning was when things started to get real. Contractions started to kick in around 6am or so. Surprisingly (or maybe not if you know my background with medications) I was still in a fair amount of pain with the contractions. I was even starting to feel sick during some of them. My nurse was very sweet and kept trying to convince me to call for the anesthesiologist to give me another epidural since "I shouldn't be suffering" and get a drip of zofran to help with the nausea. However, even though being in pain is never fun, it made me feel, at least a little, like I was in normal labor. Ed and I got to use of labor techniques to work through the contractions, and I focused incredibly hard at visualizing how the contractions were opening up my body and getting it ready to birth our baby. We finally had to explain to the nurse that we definitely weren't in this labor to be "comfortable" - we were trying to birth this baby. And adding more drugs in the mix would do nothing towards that goal.
I got checked again around 10 am and we all cheered when we heard I was dilated to almost 7cm. I really want to remember that moment, because it was such a huge high. After nothing going right for most of this labor, here was a victory we could celebrate. People were starting to get a little less happy about how long I had been in labor, and this moment reassured everyone that I could do this.
The pitocin had been briefly turned off, so it was turned back on and continued to increase. At the next check, I was up to 8cm, which wasn't quite as much growth as people wanted, but still good progress. I was just so thrilled that I was in "real" labor. My parents were, at this point, on their way and due to arrive soon, which was exciting. It really felt like we were going to have this baby.
The next chunk of laboring was when things got a little weird. I was still having hard contractions, but I was losing my ability to visualize through them. Somehow they were just feeling less effective. After about an hour of this, my nurse was in fixing my monitor, which had moved (as it did a million times during labor), when suddenly a loud alarm started going off.
It felt like an eternity, but was really about 30 seconds, and Evan's heart rate had gone back to normal, but the entire tone of my room had changed. Dr. Van Eken, the doctor on call who had taken me on, due to my preeclampsia, and Janice, told me that our baby just couldn't tolerate any more pitocin. I was checked and found I was almost completely dilated. However, they told me that they were concerned about our baby's ability to handle any more labor. I really appreciated how they explained everything and then left to give Ed and I a chance to discuss what we wanted to do.
During the 20 or 30 minutes we were left, it was clear what our decision should be. I knew that the pushing phase could be hours and wasn't always easy on a baby. Plus, I also noticed that without the pitocin, my body was no longer contracting, and I didn't really think that it would start laboring again on its own. In perfect timing, my parents had shown up just after Evan's heart rate had dropped, and were there for emotional support as we made the decision to have a c-section.
From the beginning, I knew that a c-section was a likely end result. I was trying to birth 2 weeks early, limited to being in bed due to extensive monitoring, and given drugs that worked against labor. But, spending that morning in active labor, I'd let myself believe that I really could have the labor I wanted. And honestly, while I was a little sad in the moment about losing a non-surgical birth, in the moment I was more scared for our baby. I was scared that even with the c-section, he wouldn't be okay, that his heart rate would drop again. And I was scared for me. I'd never been in surgery before. Also, since the epidural didn't fully work, there was talk that I might have to be completely put under if the epidural for the c-section wasn't effective.
But, our little baby had to come out, one way or another, so Ed was given some scrubs to put on, I said a tearful goodbye to my parents, and away we went to the operating room. That moment where we were leaving our room was really hard. I felt really sad that the moment when we knew we were going to be meeting our baby was one of fear and sadness rather than excitement. Ed was wonderful and did his best to be calming and reassuring to me.
Leaving surgery, which is a much happier picture than being wheeled to surgery.
In very little time, we arrived at the operating room. Ed had to stay in the recovery room next door until I was prepped, so from here I went on alone. My anesthesiologist was fantastic. He explained everything that was going on as people got things ready and was incredibly reassuring, promising to stay with me the whole time and be paying complete attention to me to make sure everything was okay and that I wasn't too scared. It took two doses of medication before I got numb (after the first one, I could still feel a little prick on my stomach that I think they used to test the effectiveness of the medication). Ed was allowed to join me and stood right about my shoulder. Just like you see in pictures, they had a big blue screen up to hide the view of what was going on.
Before I knew it, they let me know they were going to begin. To keep me distracted, I had Ed tell me one of the relaxation stories we'd practiced in Bradley class. He began telling me to imagine walking through redwoods, feeling the soft dirt between my feet, as we climbed up the trails together. I felt lots of sensations of pressure and pulling and then, in what felt like no time, they told me they were pulling our baby out.
A loud cry rang out into the air and as I looked up, a pink and white baby, covered in some blood, was being held up into the air. Our son. Evan.
They immediately brought him over to me and put him up against my cheek. I asked if I could touch him and pulled my hand out from where it was under part of the screen and touched his beautiful face. Then, he was taken to the side table, where Ed cut the cord and he was cleaned up a little.
He was also weighed, where we learned his impressive size!
Then, he was brought back over and laid on my chest for some skin to skin time while they finished the surgery. I remember him being so warm and wet and slippery, and I was so worried he would roll off. Ed was thankfully right there to hold him with me. It was so special being together as a family of 3 for the first time. Meeting our sweet son together.
Once they were finished, they handed Evan to Ed and we all headed to the recovery room.
Once we were in our new room, they placed him back on my chest.
I wasn't feeling well to start, so after a few moments, I passed him back to Ed.
And then it was my turn again. We got to figure out feeding for the first time, which was so special and surreal. We just couldn't get over the fact that this was really our baby.
A week later, it's still hard to believe that the pregnancy is over and we're onto this next beautiful phase as a family. Evan's official due date is Tuesday and he'll already be 9 days old. While his birth story is long and at times frustrating and painful, I wouldn't wish any of it away. Those 4 days gave us a chance to, first, prepare mentally for the early arrival of our son. But they also allowed Ed and me to be a team in the birth of our child and to feel involved in the process. While we don't know this, I like to think that being able to put my body through all the contraction and labor that I experienced help Evan to feel ready to come out, even though it was a c-section instead of a normal delivery. He came out happy and healthy, which was the goal the entire time.
And, as my midwife said, next time we can try for that labor we wanted :).
For now, we will just feel incredibly blessed that despite all the complications and interventions and medications, we came through everything okay. And now, a week later, it doesn't really matter how he got here.
All that matters is that he is here.