Oh Baby, Baby!

Sunday night, July 10th, Mr. Wright and I went to the hospital for the medical induction of Sunshine (formerly known as Baby Girl). I was SOOOO nervous! I was crying uncontrollably. I felt ridiculous. I mean, it's not like I haven't pushed out a baby before, and it's inevitable, so what was I worried about?

Cartoon by The Medical RNinja

As a nurse, I found it very hard to be a patient in a hospital. I was trying my best not to be a difficult patient, but I wanted to have as much control as possible. I asked that I be allowed to wear my own nightgown during labor, instead of their hospital gowns. I asked for a portable monitor so that I could be allowed to walk around, and not be confined to my bed. Unfortunately, none were available until later.

I also asked if I could hold off getting an IV put in until it was absolutely necessary (I lost that battle, but they agreed to not give me any fluid, so I wouldn't have an IV pole attatched to me). The nurse who put my IV in was a new nurse, and it hurt a lot. I was trying to be patient, since I know what it's like to be a new nurse.

When I got there, I was 50% effaced, and dilated to a 1. (For those who don't know, you have to be 100% effaced, or thinned out, and dilated to 10 cm to have a baby.)

Around 8 p.m. the doctors placed a medication called Cytotec inside to help soften the cervix for labor. The medication made me have several contractions.

Mr. Wright lost his wedding ring a few months back, so I decided to surprise him by giving him a new wedding ring. He was so thoughtful, and really tried his best to give me something sentimental and special. He bought me a charm bracelet, with beads representing me, Spitfire, and Sunshine. I really REALLY wanted to like it, since he had put so much thought into it. But I HATED it.

Perhaps it's just me, but I feel charm bracelets are only for little girls and grandmas. I felt like such a horrible person for not liking his gift, but I couldn't bring myself to tell him, so I put it on. Between being nervous about the delivery, and hating myself for not liking the bracelet, I could not stop crying all night. I have no idea what the nurses thought was wrong with me.

Four hours later, at midnight, the doctors checked me to see if I had made any progress. I was disappointed that I had not made any progress. They inserted more medication, and I tried my best to get some sleep. Incidentally, the labor and delivery beds are the most uncomfortable beds EVER.

At four o'clock when they checked me, I was about 80% effaced, but still only dilated 1 cm. At five a.m. they decided to start Pitocin in my IV, which is a medication that causes contractions. Pitocin makes the contractions stronger, harder, and faster, than natural labor. At one point they broke my water, but I don't remember what time that was.

My sister Skinny arrived around 7 a.m. with Spitfire. Skinny is a massage therapist, and she agreed to help me do some Pain Relief, and Labor Progressing Accupressure. I wanted to see if I could go without an epidural. Finally, the portable baby monitor arrived, so I could get up, stand, and walk around a bit (though I was still connected to the IV pole.)

The accupressure definately didn't take away the pain, but perhaps it did help me to handle it better. The contractions were coming 1 minute apart, so they turned off the Pitocin. Even without the Pitocin I was contracting 1 minute apart. I had already been in labor for two hours, and the contractions were so strong.

I was putting a lot of pressure on myself to go through labor without an epidural, because my mom, my sister-in-law, and my sister had done it. I still hadn't stopped crying since the night before, and the pain was getting so intense. My sister Skinny told me not to beat myself up about it, and if I wanted the epidural it was no big deal.

I asked if I could get some pain medication through my IV, but I would have to lay in bed to have it, as it makes you dizzy. The nurse gave me Fentanyl, but it didn't do anything at all for the pain.

I decided to have them check me to see if I was close. I figured if I was close to having the baby then I could just perservere, but if it was still a while away, I would have the epidural. I was only dilated to 4 cm. I couldn't believe I was in that much pain, at only a 4, so I opted to have the epidural.

It took the anesthesiologist 20-30 minutes to get there after he was called. Then it took him another 10-15 minutes to get set up. It took him another 20-30 minutes to place the epidural in my back. Meanwhile, I was still having HUGELY painful contractions every minute, while having to hold perfectly still as he placed a ginormous needle into my spinal cavity. I seem to remember that when I had the epidural when Spitfire was born, it only took about 5 minutes to get it in. This guy was taking FOREVER!!!

I think he was a new doctor. He didn't seem to know where to place the catheter. He kept asking me if it felt like it was on the right, left, or center of my spine. I kept saying the left side. Finally, I said that it felt like the center, but it still felt like he moved it out of place and to the left again before he taped it up. He asked if I could feel the medication making me numb, and I could, so he left. However, I could only feel numbness on the back of my legs and buttocks. The front of my legs, abdomen, and groin I could still feel. I could definately still feel the contractions, but I figured that maybe that would be okay, so I could feel enough to push the baby out. However the pain did NOT stop, or let up!

I suddenly started feeling a lot of pressure, so I asked the nurse to check me again. She said, "you're about an 8.......oh wait, you just went to a 10, right as I was feeling you, I'll call the doctor."

My OB/Gyn doctor arrived 10 minutes later, and I started to push. The pain was excrutiating, and I could feel everything! "It burns!" I groaned, to which my OB/Gyn replied, "it's like that Johnny Cash song, 'Ring of Fire.' I was not amused. But I'll think of that every time I hear that song, and can laugh about it now.



"....and it burns, burns, burns....that Ring of Fire....."



I only pushed a few times, and at 10:15 a.m. on Monday, July 11th, Sunshine was born. She weighed 6 lbs, 1 oz, and was 18 and a half inches long. She was a tiny little thing, no bigger than a loaf of bread.

While the nurse was drying the baby and doing her assessment, my doctor examined me for any tears. "Did I tear?" I asked. "No," he replied, "but we can still do an episiotomy, if you like." Ha ha. What a kidder. (To those who do not know what that is, it involves cutting things 'down there' to make room for the baby's head. This used to be a wide-spread practice whether you needed it or not. Nowdays, most doctors don't do it unless it's necessary, and some don't do it at all. Either way, it doesn't need done AFTER the baby is born. My doctor was making a joke.)

Believe me, there were a lot of very graphic episiotomy pictures. I spared you.

Anyway, the labor was only 5 hours long, which is pretty fast, considering the average labor lasts between 8 and 15 hours. And I basically ended up having the baby without the assistance of the epidural, since it didn't work. But everything turned out great. Sunshine did have the cord wrapped around her neck, but once they untangled her and clamped the cord, there was no more danger with the Umbilical Vein Varix, and she was healthy.

Baby Girl scare

I have officially been downgraded from normal pregnancy to high risk pregnancy. It all started when my doctor said I was measuring large for my dates. (At every doctor's appointment from 20 weeks on, you lie on the table, while they take a tape measure from your pubic bone to the top of your uterus. The number of inches should correspond with the number of weeks pregnant you are. There is about a 2 inch leeway plus or minus, but I was measuring 4 weeks bigger.)

There are a lot of things that can cause this, namely the baby being HUGE, or you're farther along than they realized, or you have too much amniotic fluid, so they sent me to get another Ultrasound at 31 weeks. By the way, how much belly fat you have usually doesn't impede this measurement.

Well, on the ultrasound they saw that the baby measures as if she is 31 weeks along, and she was a normal size. I also didn't have too much amniotic fluid, in fact if anything, they said I was on the low side.

Cut to two weeks later when I'm having my doctor's appointment. My doctor tells me they found something on the Ultrasound. The baby has an Umbilical Vein Varix, which is kind of like a varicose vein. He says, "I don't want to worry you, but there's a chance, although a remote chance, of stillbirth (meaning the baby dies in utero)." Right, like I'm not going to worry after he says that!!!

My doctor has been in practice for at least 25 years, but this is only the 2nd time he has seen this. It's pretty rare, but they may be picking it up more as more women are having 3rd trimester ultrasounds, and ultrasound technology is getting better. He didn't seem to know very much about it, but said that they definitely wouldn't let me go past my due date of July 31st. He said I should do weekly Non-Stress Tests, which monitor the baby's heart-rate, movements, and amniotic fluid.

Friday was my first Non-Stress Test, or NST. They also did an ultrasound to check the blood flow of the cord. Both were fine, which was very reassuring. But I knew my baby's status could change from day to day. What if something happened to her before my next NST?

I spent all weekend worrying about it, of course. There wasn't very much information on the Internet, and what little info there was, wasn't very reassuring. I found myself thinking of every pregnant woman I took care of as a nurse at the U, who had a baby die in utero.

Monday morning, I searched for specific articles in medical journals about Umbilical Vein Varix, and was able to arm myself with some more information. Now I knew which questions to ask, and what the recommended protocol for this was. I also read online that I should see a Perinatologist, a specialist in Maternal and Fetal anomalies. I made an appointment to see one, and was pleased that they could get me in that day.

After my NST on Monday (which was also good), I saw the Perinatologist. Since I had done some research on my own, I was able to ask intelligent questions, and understand what she was talking about. She was very reassuring.

An umbilical cord has 2 arteries, and only 1 vein, so if there's any problem with the vein, it can cause the baby to not grow. Umbilical Vein Varixes start to become a real problem when they are 9 mm, or if the blood flow is very turbulent. Sometimes a baby can also develop a clot, which would cut off blood flow, oxygen, and nutrients to the baby's body. We were relieved to hear that Baby Girl's varix is only 1.4 mm. The problem goes away the minute the umbilical cord is clamped off, once the baby is delivered.

It seems that Umbilical Vein Varix is often associated with other problems such as heart, liver, birth defects, chromosomal abnormalities, and anemia. Luckily, she felt that Baby Girl did not have these other issues, or it would have been picked up on my other ultrasounds. (Whew!) It seems to be just an isolated issue. They do not know what causes it, and they did not notice it at my 20 week ultrasound, so it must have been something that developed in utero.

She also recommended even more monitoring of the baby. We would do weekly ultrasounds to view the cord, and do NST's TWICE weekly. I was also to monitor her kick counts. This was a HUGE relief to my mind!

Finally, she said there was some debate as to when to deliver. Some schools of thought say 34 weeks, (which is what I am at right now), and some say you should keep the baby in until 40 weeks (full term). Her school of thought and University Policy was to deliver somewhere in the middle, at 37 weeks.

She said that before 37 weeks, the baby is more likely to have other problems associated with being born premature. Before 37 weeks, it is safer to keep the baby in. After 37 weeks, there are fewer problems, and many babies do great. At this point the risk of taking her out is less than the risk of keeping her in.

She said that she shares a lot of patients with my doctor, and that she would be happy to call him and discuss her recommendations for care.

It is a HUGE relief that they will monitor her even MORE closely, and that they will deliver her as soon as it is safe to do so.