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Birth Stories
catsinawindow
member
Med-free turned high-intervention birth due to PreE complications
catsinawindow
member
Throughout pregnancy I had been preparing for a low-intervention, medication-free birth. My pregnancy had been completely uncomplicated up until 37 weeks when I developed pregnancy induced hypertension (PIH). My OBs were hoping to let me go as long as I could (neither they nor I wanted an induction) but the plan was to induce before I turned pre-eclamptic if my condition was moving in that direction. Unfortunately, my PIH turned into PreE quicker than we had expected (sometime between weeks 38 and 39) and I got the call on Friday 3/4 that my bloodwork showed PreE and I needed to come to the hospital immediately to be induced. I was 39 weeks, 3 days along.
They started pitocin around 5PM that evening (I was already 2-3cm dilated, 80% effaced so no ripening was needed). At the hospital my BP was WAY higher than it had ever been before. The highest I had ever seen it at home was around 160/105. In the hospital it was running as high as 200/115. Even with rest it didn?t go down very much. Because of my high BP they needed to put me on Mag-Sulfate to prevent seizures. Once I was on it, they wouldn?t let me out of bed for fear that I could fall on my belly (it is a nervous system depressant and also makes you crazy dizzy). I had hoped to labor in different positions and in the shower, so this was a big disappointment for me.
After a few hours of pitocin, I was making no progress. I couldn?t feel contractions at all, and when the doctor checked me, I was still around 2-3cm. From what I heard, this could have been because Mag Sulfate also has an effect of stopping contractions. The doctor decided to break my water around midnight/1AM in hopes of getting things moving. When she ?broke my water? contractions became noticeable, but still didn?t become strong or painful over the next several hours.
The next morning, I got more bad news. My platelet count was dangerously low, in fact it was just above the threshold where it is considered safe to do an epidural. I was told that if I didn?t get an epidural placed soon, my platelets would likely drop more and if I did eventually need a c-section, it would have to be under general anesthesia. I didn?t want the epidural, but in my mind the chance of not being awake for the birth of my son was a much worse option. Therefore, I OKed placement of the epidural catheter (but without numbing medication).
Shortly afterwards a different doctor came to check my progress. There was still no progress. As he checked me, he looked confused and asked me ?Dr. M broke your water?? ?Yes? I responded. ?Well you?re water?s not broken? he told me. Then this new doctor broke my water for real. Almost immediately I had my first REAL contraction. I went straight from barely noticeable contractions to painful contractions that I needed to breathe through the minute my water was broken. I labored without medication for about 3 hours, and felt that I was doing really well dealing with the contractions. Breathing through them really helped, and my DH and the nurse were so supportive and wonderful. The continuous monitoring was REALLY annoying, though, because the monitors would shift when I curled up with every contraction and so the nurse would fiddle with them in-between when all I wanted to do was rest and be left alone. When the doctor came to check on me I had progressed to a 4.
About an hour after I was checked, the anesthesiologist placed my epidural and gave me the test dose of medication to make sure it was placed correctly. I initially stuck to my guns and told her that I didn?t want the real dose of medication added, but once the contractions started coming back after the test dose the temptation was too great. I was feeling loopy from the mag sulfate, the needle was already in my back, and the test dose gave me a taste of how I would feel with the epidural. I let them know that I wanted the medication added. An hour later, they checked me again and I was a 7.
Less than an hour after being found to be a 7, I started getting intense pain in one hip. I later learned that LO was turned sideways in the birthcanal, so I?m convinced that this pain was my body telling me to get up and change position to help him turn. Unfortunately due to the mag sulfate, I was confined to bed and couldn?t do much more than shift from side to side (which didn?t help). The nurse checked me and I was a 9, so she went to call the doctor. When he came to check on me, I only had a lip left and gave the OK for me to start pushing.
I had heard from other friends who had epidurals that they couldn?t feel anything. They told me that they had no idea when they needed to push and the nurse had to tell them. This was not the case for me. I knew when I was having a contraction and it was excruciating not to push during them. My nurse got me started with the pushing and was amazing about helping me push correctly, and showing me the progress I was making in a mirror. After a while, she suggested we try some other pushing positions. She didn?t tell me initially, but eventually I found out that this was because LO was turned 90 degrees off of the ideal position for the head. Pushing on my side moved him 45 of those degrees, but for the last 45, he wouldn?t budge. The nurse asked me if I felt strong enough to push on all fours, but warned me that if I fell on my stomach, it would be very dangerous. At this point, I was exhausted from pushing and feeling increasingly loopy from the mag, so I didn?t want to risk it. After 2.5 hours of pushing, the doctor told me that I wasn?t making progress and he could try vacuum or forceps to help me deliver. If these didn?t work we?d have to go to a c-section.
At this point, about a million more people came into the room. Funny thing was I didn?t even care. I even OKed a male nursing student who stood in the corner watching and looking horrified during the whole thing. I like to think I may have single-handedly made him consider a change in professions. First the doc tried the vacuum which failed. Then he decided to try forceps. He called for another dozen or so people to come in (evidently forceps deliveries are very rare and he wanted to demonstrate proper technique to some of the residents) and after a few more big pushes and two large tears, my son was born at 5:43PM on 3/5. Baby Q was 8 lbs, 3 oz and 21 inches long.
During pregnancy, I had planned to have the baby immediately placed on my stomach, to wait for the cord to stop pulsing before it was cut, and to breastfeed within the hour. None of these things happened. DH tells me that the doctor held the baby up for me to see right after he was born, but if I saw, I don?t remember it. Because of the forceps birth, he had to be immediately evaluated by pediatricians (he was fine), and due to blood loss and that darn mag I couldn?t even sit up for an hour or so after I delivered.
Needless to say, my birth was not as I had expected, but I do feel like most, if not all, of the interventions were necessary in my situation. Even the epidural meds, which I was kicking myself for at the time, allowed my blood pressure to stabilize enough that the doc allowed me to go off the mag immediately after delivery rather than 24 hours after. Because I was off the mag, I was no longer considered high risk by the hospital, and therefore little Q could room-in (something for which I am forever grateful). I now know that I got through about half of hard labor without an epidural, and the contractions were challenging but completely manageable. I keep telling myself that PreE is usually a disease of first-time moms and next time I?ll be able to have the med-free birth I had planned.
BFP#2: EDD 2/11/14, MMC confirmed 7/15/13 (growth stopped at 6 weeks), D&C @ 12 weeks 7/25/13
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Re: Med-free turned high-intervention birth due to PreE complications
I'm sorry you didn't get the birth experience you were hoping for. And of course, that you and your son both made it out okay
I'm always curious, how are you doing emotionally with wanting a med free / low intervention birth and not being able to have it? I'm want a med free birth too, but I know it's important to be prepared for the possibility of it not happening. Did you feel prepared going in for what might happen?
Wow, thanks for sharing your amazing birth story! I feel the same way as you about med-free....but if it's for the best or medically necessary I will accept what is suggested.
You made me crack up about the male nurse!
It's obviously been hard, emotionally, to think about my birth experience being that it was so different than I had hoped. I was one of those people who was actually looking forward to labor and birth, I had read numerous books, taken classes, and written up a well-thought-out birthplan. It hurt to have that experience taken from me.
What made it easier was the fact that I honestly believe all of my interventions were necessary. PreE is nothing to be messed with and mine was progressing quickly, so the induction was necessary. Unfortunately, the mag was necessary b/c seizures are dangerous. The epidural was a choice I made, and as I mentioned in my birthstory, it worked out to my advantage. I really was not progressing, and so the forceps were also necessary.
I'm also very lucky in many ways. Baby was full-term once the PreE came on. Both baby and I are fine, he was able to room in, and I was able to experience half of my labor without the epidural. Most fortunately, the doctor who delivered me was skilled in forcep use. From what I've heard most new docs never learn to use them, and would have gone straight to a c-section after the vacuum failed. I am so lucky that I was able to have my son vaginally and I have that doctor to thank for that.
I'm worried about next time (I do want to have more kids) but I'm also hopeful. PreE usually doesn't hit a second time and if it does it is usually milder (and because mine came on so late there's a good chance it won't come at all). My advice would be to make a list of priorities. Mine were 1) Healthy mom and baby 2) vaginal birth 3) med-free birth. Knowing that my first two priorities were met helps me feel better about the third one not being. Best of luck in your birth!
BFP#2: EDD 2/11/14, MMC confirmed 7/15/13 (growth stopped at 6 weeks), D&C @ 12 weeks 7/25/13
I developed Pre-e & HELLP Syndrome at the VERY end of my pregnancy (41w5ds), so I understand the worry, concern and, most of all, the mag drip. It is necessary, but man, it is rough! It sounds as though your nurse was very helpful and realistic.
I had to chrckle at your comment about the male nurse. I had a resident who wanted to send me home, despite me being 41w5ds along and in extreme pain, because L&D was full. It's a long story, but basically, the gist is that she felt that I was either faking or trying to manipulate my way into L&D. Her plan was to send me home and have me return in 36 hours for my scheduled induction. Fortunately, the attending OB saw my blood work and amazingly, a room in L&D opened up. All of a sudden, not only do I have a room, but I'm getting an epidural and signing paperwork for an emergency c-section. Because he was so overdue, my LO had meconium in his throat, so he spent 12 hours in the NICU while I went back to L&D for 36 hours of treatment and observation (30 of those hours were on the mag drip). The original resident appeared in my room two days later to apologize and to make sure I was okay. A friend of my SIL works in the OB office and we later learned that the resident had decided to change her specialty. I like to think her experience with me had a HUGE part in that. She sucked! (Sorry the story got so long!)
I am impressed with your attitude because, after two years, I am still bitter about my birth experience. Our situations are different (I feel that my OB missed a lot and might have been able to prevent what happened, or, at least, minimized it), but I wish I had a better view of things. You are right on several counts--you and your LO are healthy and safe and, Pre-e tends to be a first timers condition. I wish you and your LO--and your DH, all the best!
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