We got to triage and I was hooked up to the monitors. I was 4 cm and contracting frequently. I was to be admitted! We called our families and told them the good news. A friend of mine in the anesthesia residency came by to congratulate me and discuss epidurals. She said that if I wanted to have an attending perform the procedure then that would be fine, but I decided that if she was comfortable doing the procedure on a coworker then I was ok with letting her.
The nurse asked me to rate my pain. I said that was difficult since I often make fun of that stupid pain scale. I decided I was a 6 out of 10. The face was frowning some but not crying, which matched me more or less. The pain was rough, but I could think of worse (like having my arm cut off). Plus, 6 is my lucky number.
My family showed up after I was taken to my room. My mom (Gingy) was sick with a cold from one of her preschool students, so she wore a mask. She was beside herself with excitement! Everyone was ready to meet little Elliot! The Dyers arrived as well and Gam Gam and Aunt Linzy showed up also in masks, I guess for the fun of it.
Logan and I decided to get the epidural. My only concern was that it might slow down my labor again, but we were so tired that we decided a little rest would be beneficial before the main event. The anesthesia resident had us watch a video and then set up for the procedure. I sat on the side of the raised bed with my feet on Logan’s knees. We discussed the new Doritos Locos Tacos. The resident asked if we were in fact really discussing tacos during the procedure and I explained that it was good distraction. I also had an iPod with my favorite tunes which was also excellent distraction!
The procedure was a success except that it did not work instantaneously. They did a test half dose to make sure that my blood pressure would stay stable. It did and so I got the full dose. I even got a happy yellow button to press if I needed more medicine! At that point, Logan and I tried to get a few hours of sleep. I started to get itchy from the medicine so the nurse brought me some Benadryl, which helped immensely with the rest but not so much with the itching. Our room was beside the nurses station. I think they might have been having a party or something. One person even bounced one of the big rubber birthing balls! Fortunately, when we asked them to be quiet they did, and Logan and I got a few hours of much needed sleep. While I was trying to get to sleep the iPod played Logan’s and my current song, Peter Frampton’s “Baby I Love Your Way” which was nice.
Logan putting my socks on me, a service he had been providing for me for the past month.
I think I awoke again at 6AM. The nurse mentioned that my mom and mother-in-law had come by recently but were turned away since we were sleeping. I asked for them to come back but through some miscommunication my mom had gone to the hotel.
The doctor arrived at about 8AM. She told me I was about 7 cm and asked me if I would like my water broke. I said emphatically that I would. She broke it and there was a pause. I asked if the fluid was clear and she told me that there was “light meconium.” This meant that I would not be able to have my requested “skin-to-skin” initial contact where the baby would have been delivered and put immediately on my stomach. I was disappointed to have missed that bonding experience but I understood it was important for him to be suctioned right away once he was born.
I was glad at that point that I had gone into labor on my own. I could have been just starting the process that morning with my induction. Plus, it was nice to know that my pituitary gland could get the job done, even if it did take awhile.
So labor continued on. For much of the morning I had the entertainment of Logan, my mom, my mother-in-law, and my sister-in-law. When I got tired I tried to nap. I was allowed Popsicles and slushies if I was thirsty but no solid food until Elliot was born as there was always a chance that I might have to go to surgery. I remember at one point my epidural button stopped working. I could tell because I could no longer feel the cool medicine flowing through the tube attached to my back. It had run out of the extra medicine. I joked with the day anesthesia resident (also a colleague of mine) that I had been overly enthusiastic about the yellow button. He got me some more medicine and we continued contracting along.
I got to explain the monitors to my various visitors. The bottom section was my contractions measured by an external pressure sensor. The top was Elliot’s heart rate. If the doctor or nurses did not like the look of Elliot’s heart rate, they came in my room and repositioned me so that he could get better blood flow. They would also occasionally reposition me at my request since my epidural medicine would flow to the dependent side of my spinal canal and numb one side better than the other.
In the mid morning, Elliot’s heart rate became less variable, which is a cautionary sign though not an emergency. The nurse came in and gave me some oxygen through a mega non-rebreather mask. That surprised me since I thought I would only get a nasal cannula. They were serious about getting oxygen in me.
The doctor returned and checked my cervix again. 9 cm! Almost there! An hour later she returned. Still 9 cm… We asked which position his head was. It was occiput transverse, which means that he was facing my hip. Ideally, he should have been facing my back. Still meant that I could deliver vaginally, but once again, things were concerning.
Elliot’s heart rate became difficult to monitor externally, so they placed an internal monitor, which is a small corkscrewed wire that screws into the baby’s scalp. Sounds barbaric, but works and is better than getting a shot. I also was not getting full credit for my contractions so they placed an internal pressure monitor, which is just a tube that goes into the uterus beside the baby. My contractions were alright, but they decided to give me some of the pitocin that had already been made for me and my scheduled induction which was to be that day.
Upset about requiring extra monitoring, I sent everyone out of the room except Logan. I expressed my concern, doing my best not to cry for fear that Elliot would not get enough oxygen if I did. Logan comforted me and reassured me that everything would be alright. We watched my contraction and Elliot’s heart rate on the monitor for awhile and I noticed that he was having some dips in his heart rate. A nurse came in (they were watching my tracing outside) and I asked if I was having decelerations (dips in the baby’s heart rate with contractions). It has been awhile since my obstetrics rotation. She explained that I was and that Elliot did not seem to like the pitocin which they were using to augment my labor. They shut it off and his tracing improved.
The doctor checked my cervix again. Still 9cm and now starting to swell… We had been at 9cm for three hours now and things were not progressing. My doctor said, “It’s time to discuss C-section.” She went through the risks, including bleeding, infection, hysterectomy, and death. I asked if I had a choice and she told me that maybe if my cervix had not started swelling we could wait a little longer, but as things were we really need to start heading to surgery.
She left to prepare and I sat in shock while the nurse started adjusting my lines. I finally exclaimed, “I feel like my body has failed my baby.” once again doing my best not to cry and to breathe. Logan looked me in the eyes, patted my hand, and calmly said, “I know and you’ll have to try harder next time.” I laughed at his and my ridiculousness.
The nurse, my mother, and I spent the next several minutes trying to get my bra off of me and all of my lines, since I had not followed the instructions to remove all clothing earlier. Doctors make the worst patients.
My mom related a horrible birth story to me at that point. I gave her a Katherine the Great biography for her birthday at my Aunt Suzanne’s suggestion. Apparently, Katherine the Great’s niece went into labor but the baby was too big. Caesarean was not an option so the poor girl was in horrible labor pain for days and days until she and the baby died. Not exactly a birth story I wanted to hear at the moment but it made my mother so grateful that surgery was an option for me. I was glad for that too but still unhappy that after 33 hours of labor it had come to that.
I rode to the OR. My anesthesia resident co-worker was there. I was glad to have a friend in the OR in spite of the awkwardness. I stared at the operating room lights while they got me ready. I commented that it was surreal to be on the other side of the operation. The nurse was having some difficultly removing the heart rate monitor from Elliot’s head. I reminded her “Lefty loosey. Righty tighty.”
An OB resident introduced herself and explained that she would be helping with the procedure. I said that was fine but promptly turned to my anesthesia friend after she left and asked who she was and what year she was in her training. My friend told me not to worry and that she would not be doing very much.
They ramped up my epidural so that I would absolutely feel nothing. I started to shake from the meds. I did my best to keep it under control but I shook throughout the entire operation. Logan rejoined me, dressed like a painter who was extremely concerned about messing up his clothes. They draped me and the obstetrician asked, “Can you feel this?” I told her that I could not. My anesthesia resident friend said, “That’s good because she just pinched the fire out of you with a hemostat!” I didn’t really need to know that…
The surgery began. I remember the obstetrician asked me what I thought of my OB rotation. I said I liked it. Everyone seemed ridiculously busy but also ridiculously happy. Within minutes Elliot was out and crying! I was crying too. I was so happy that he was ok. It was the best noise in the world!
Logan stood by me looking torn. I told him to go bond with the baby. I had my anesthesia friend to keep me company.
Logan went over to the warming station where they were suctioning Elliot. Per his report, Elliot had his arms and legs stretched out as far as he could. He was glad to be out of me! He had a round partial cone on is head where he had been engaged in my cervix for hours. Then we heard the news. 9lbs. 12oz.! The obstetrician remarked, “You were never going to deliver that baby vaginally!” I agreed. It was a very good thing that we had gone to surgery.
Logan showed me some pictures on the camera while the pediatricians were still working with him. They did not do him justice. Finally, Logan brought me the real thing. He was beautiful! He was large for a baby, but still a tiny tiny person. We got our first family picture while they were sewing me up. I remember Logan started teaching him the elements of the periodic table. We got through neon together… The anesthesia resident thought we were colossal dorks.
Sewing a person up takes much longer than cutting into them. I remember asking if they were using my stretch marks to reapproximate my incision. They said they were. It reminded me of a patient on my surgical rotation whose body was covered in tiger stripe tattoos and how the surgeons went to extra effort to line those tattoos back up exactly.
Afterwards we headed to recovery. Logan went to tell our families the news. I wish I could have been a fly on the wall when he told them that Elliot was 9lbs. 12oz.
To be concluded in “The Caesarean Saga, part 3: The Afterbirth”
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