Early induction, IUGR, pain-med free, fast delivery! (long!)

kdiguise · February 2012

On Tuesday, January 17^th(34w6d) I had another follow-up appointment with our Perinatologist about the baby?s poor growth due to IUGR. It was explained to us that the combination of me having a small uterus and a tiny placenta was the problem (with my other kids as well, but especially my daughters). My body would grow the baby as big as it could and then would stop. So as predicted, she had only gained a couple of ounces during that week so as soon as he took a few measurements he said, ?Okay, how about having her tomorrow?? We were shocked. We were expecting an early induction (same thing happened with my first daughter) but not that early. After a few minutes he said, ?Actually, let me call over and see if they have a bed now.? He called and they did so he said, ?Let?s go ahead and get this started now.? We left the office and used the pedway to get to the hospital across the street. I got in my room and they started registering me (I had already pre-registered at my usual hospital, but since they don?t have a NICU we had to deliver at a different hospital). I made a list of things to get for Corey and he headed out to get all of our things.

My super awesome nurse started my IV and at 3pm I got my first oral dose of Cytotec. She checked me before I took it and I was 1cm, 70%. I had been having preterm labor contractions for weeks, but had been on many medications to STOP them so we figured it wouldn?t take much to get me into labor. I could have another dose every 3 hours. But I would not be able to get any more if my water broke and then we would have to rely on pitocin, if needed. I had pitocin with my other kids and was really hoping to skip it this time around since I like to deliver without pain meds and the pitocin made it much harder. I really wanted to experience it without the pitocin!

While we were waiting for things to pick up, a neonatologist came in to speak with us about what to expect with a preemie at this gestational age and what kinds of issues to expect, given her small size. He had also told us to expect her to have to stay until her due date?5 weeks. I had been feeling very strong and positive about everything up until that point, but as soon as he left our room I just broke down. After many, many issues with each of my pregnancies, I just really felt like a failure at that point. I?ve had so much guilt over the fact that my body can?t grow babies properly and on top of that all of my preterm labor issues. I didn?t want her to have to struggle because my body couldn?t do its job. That is the worst feeling. It was at that point that I told myself there was nothing I could do about it now except to do my best to get her out safely. We knew there was some risk of the baby going into distress during the delivery because of her growth restriction. Holding on to that thought helped me to stay strong and focus for the rest of my delivery.

There were lots of contractions being picked up, but they?d die down in intensity every now and then which was not what we wanted. At 6:30pm, I was given my 2^nd dose of Cytotec. That did the trick and around 7:10pm, my contractions really started to pick up in intensity. I rated my pain at a 3?about what I had been rating my preterm labor cramping as for weeks. I was checked again at 9pm and I was 3cm, pain was about a 4 at this point. At 11:00pm, my water broke (3cm, 80%). At this point my nurse told me I would have to stay in bed since there was a risk of umbilical cord prolapse. My pain was immediately worse after my water broke (something I remembered well from my other deliveries) which I was rating at a 5 and about 20 minutes later at a 6. At 12am, I was rating the pain around 7 and was relying on music from my iPod to keep me focused through the contractions. It was at this point that I had a horrifyingly huge urge to poop (actually poop, not push). I knew I needed to stay in bed and would have to use a bed pan. And although I?d had no issues with peeing in the bed pan, I just really didn?t want to poop in it with the nurse in the room. So it was up to my wonderful husband to help me out. I?ll spare you the gory details, but let?s just say that he is the BEST husband in the world and he dumped and cleaned the pan for me when I was done after a lot of laughing and apologizing on my part. What a trooper.

At 12:20am, I was still rating the pain at a 7 but I was now 3-4cm, 90%. 20 minutes later I was 4cm, 95%. Around 1 am, the pain started getting worse and I was rating it at an 8. At 1:40am, I was checked and was 4-5cm. With my two other deliveries, once I hit 5cm, I was complete within 30 minutes. My body just hits that point and goes into overdrive. My doctor knew this (we told him and my regular OB had also mentioned it to him as well) and told us to make sure the nurse called him once I hit that point so that he could get there in time. He had also given us his cell phone number just in case they didn?t call him so that we could. But our nurse assured us that she would call him right away. At 2:00am, I started shaking, which I knew meant that I was probably in transition. I started to feel some light pressure during contractions, but it would stop as soon as the contractions would end. I was in a very good mood my entire labor and laughed and joked around a lot with my husband. Not having the pitocin in my system this time around made a huge difference! At 2:15am, I was checked and was 6-7cm and 100%. I was still having that same light pressure during contractions and the pain was at a 9.

Very quickly, the pain got to a 10 during my contractions. Someone came in to set up the supplies for myself and for the baby after delivery. Then the craziness started. With my other kids, I felt a huge urge to push through at least a few contractions before I was actually allowed to start pushing. Since I had only been having light pressure, I thought it might be awhile until I would actually feel the urge to push. I actually said to Corey, ?My pain is at a 10, but I feel like I?m managing the pain really well. I could probably do this for a few more hours.? (Later he would tell me that I made it all look really easy?which was pretty much the best compliment ever). About a minute later I had THE contraction. The whole thing lasted about a minute and here?s what happened during that time: I had my patterned breathing going, just waiting for the peak of the pain. Right after the peak, I had a TON of pressure and my body started pushing on its own. I looked at Corey with huge eyes and told him the baby was coming out. He lifted up the blanket and saw the baby?s head starting to come out. He immediately pushed the call button for a nurse. A nurse close to our room must have heard all the commotion and ran in just in time to catch the baby. My body had pushed the head out on its own and I just pushed a tiny bit to get the body out. At this point, people started rushing in (including the desk nurse that answered the call!) to take care of me and the baby. The baby was suctioned out and Corey cut the cord before they took her to be measured.

Lilah Katherine was born at 2:46am, 4lbs 4oz (an ounce more than estimated the day before) was 18 inches long and scored a 9/9 on her Apgar?s. My doctor walked in probably 5-10 minutes after my daughter was born and looked around the room all confused. He was able to deliver the placenta himself though which he told me was more important to him since there was apparently more risk involved there than the actual delivery of the baby.

After she was cleaned up and they were finished getting all of her measurements, I got to hold her for a couple of minutes before they had to take her to the NICU. A few hours later, after I had been cleaned up and Lilah had her initial check-up done in the nursery, we were able to go see her again. Long story short, she had an NG tube, but it never had to be used because she took her feedings so well by bottle (breastmilk, then nursing later on). She had an IV providing electrolytes to her for a few days. She never had any breathing issues which I totally attribute to getting the Betamethasone shots to mature her lungs a few weeks before during one of my hospital stays for PTL. So she was in the intermediate nursery as a feeder/grower. We were told that there were three things she would have to do in order to come home: be actively gaining weight, eating/tolerating feedings well, and keeping her temperature up. The only thing she had any issues with was keeping her temperature due to being so small. But we were able to bring her home after 12 days. I feel so fortunate that our stay was so short compared to what it could have been and that she never had any real medical issues. She is a strong little girl and we couldn?t be happier that she?s doing so well now.

In the nursery.

With her big brother, Noah.

Finally home!

miranada · February 2012

What a total rock star you are! That was an inspiring and awesome birth story. It my strongest desire to deliver pain med free and this story really helps!

Congratulations!