After having had preterm labor and been on bedrest for two months, on Tuesday, October 6 1998, I started having contractions that were three minutes apart. David came home from work and found me bawling. I told him that I couldn't take two more months of this. At 32 weeks along, I looked and felt overdue!
We went to the hospital that we had finally decided on, which didn't move the mom to a different postpartum room and kept the baby in the same room as the mother during the entire hospital stay. This was important to us.
Once again, I was strapped to the monitors and sure enough, my contractions were three minutes apart. I had the series of Terbutilene shots again but the contractions didn't stop. I received a fourth shot and that still didn´t help. I was then given two bags of electrolyte solution to hydrate me, but still the contractions continued. Then they brought out the "big guns" and started me on Magnesium Sulfate. At this point I was more nervous about the Magnesium making me sick than actually feeling sick from it. My contractions still didn´t stop and when one nurse checked me she thought I had dilated to 3cm., but another one said I was only at 1 cm. David and I got nervous and made arrangements for our daughter Melissa to be watched the next day, while he stayed to spend the night with me.
On Wednesday morning, my OB checked me and was very concerned. Though I was still at 1 cm., there was a very high sugar level in my urine (plus three). He arranged for me to be transported to another hospital which is equipped for high-risk pregnancies and premature babies.
The ambulance ride didn't seem real. I never imagined being the one to need it...As I was pulled out of the ambulance, the sun was bright and felt wonderful on my face. Little did I know that this would be the last sunlight I would see for a week. I remember being rolled to my hospital bed, and having a "double take" at seeing my nurse, whom I recognized from church several years ago. She gave me a big hug and said how sorry she was to see me in this condition. I still didn't get it.... I knew I was having pre-term labor but geez, maybe she was referring to my weight gain and the pregnancy-related swelling!
My OB had referred me to a team of perinatologists. I have never had such attentive doctors! My new doctor told us that I had gestational diabetes and that preterm labor was a concern, but that his first, second and third concerns were getting the diabetes under control as I was in ketoacidosis. Keto what? A new word for my vocabulary.
I had started becoming extremely nauseated and was vomiting because of the Magnesium Sulfate, which was still not succeeding in stopping my contractions. My vision was blurred and I felt dizzy or, as the doctor put it, "magged Out."
Hmmm, gestational diabetes. I knew a few people who'd had this. No big deal, just have to learn to eat right, correct? I started learning how to do my own blood sugar checks and received insuline through my IV. Ketones were still showing up in my urine though. Not a good sign.
Ketones show up when the cells start feeding off the muscle in the body because they aren't receiving any sugar, due to the lack of insuline to put the sugar in the cells. Ketoacidosis can be fatal if not treated immediately. My doctor told David that I was on the verge of a diabetic coma. And to top it off, the medication I had been give to stop the contractions (Terbutilene and Brethine) are not to be used by diabetics, so my body was freaking out by the time I was put under my new doctor´s care.
Wednesday was such a horrible day. I had IV pumps all around me and nurses working on me around the clock. I continued vomiting from the magnesium and my contractions hadn't completely stopped, although they seemed to be under control after being on the Magnesium Sulfate for two days. Finally on Thursday I was getting regulated on the insuline and with the help of two nurses, I was able to shower. I remember even my finger nails felt dirty.
On Wednesday afternoon the doctor did an ultrasound, and found that my baby was measuring 37 weeks at 32 weeks gestation. He recommended an amniocentesis to see if the lungs were developed. David and I were nervous about the procedure, as we knew there were risks though those are associated with starting labor--which I was already having. We're also nervous about invasive procedures and had elected not to have the amnio when I was pregnant with Melissa. But this time the reasoning was very different. We decided to go ahead. If the baby's lungs were mature enough we could stop the meds. and get this all over with!
The amnio was very uncomfortable and I was so glad that I had learned relaxation techniques with Bradley classes. If I didn't learn anything else, relaxation got me through many painful procedures that week; needle after needle, cervical checks, catheters. I had to be poked twice since the first needle didn't go into the amniotic fluid. Relax, Relax, Relax. This was when we learned our baby was a GIRL!
The test came back negative. The baby's lungs were still immature and needed time to develop. So, we were bummed but could deal with it. I would just have to wait it out and be on bedrest for a while longer, right?
My doctors were confident that I was recovering well and had me transferred from Labor and Delivery to the main floor where the rooms cost much less. I started learning about diabetic diet and how to give myself insuline shots, and rested a lot. I was taken off the Magnesium Sulfate before I was moved, and started on a new medication to halt contractions. They still didn't stop, but the doctor said not to worry, we wouldn't completely get rid of them. So I only informed the nurse if I was having six or more contractions per hour.
Back in Labor and Delivery I showered and David went home for a while. When he came back the doctor did another ultrasound, the baby´s heart seemed fine. He kept commenting on how big this baby is. We have a picture of her "sasquatch foot," and we saw tons of hair even on the ultrasound! So, we felt some relief and basically had to just stay on the monitors and wait it out. I started realizing that I wasn't going home before I had this baby.
At about 10 p.m. my nurse asked me how I was feeling and I said I was having some "good" contractions, which she really got a kick out of. Obviously my meaning was that the contractions meant business, not that I was enjoying them! She checked my cervix and sure enough I had dilated to 3cm.
My nurse asked me if I was planning on an epidural and I said no. She was pretty shocked and said the doctors would want me to have one in case I needed an emergency C-section. I started bawling. I explained that my birth plan was being blown to pieces. I'd had every intervention possible and I wanted to experience my birth this time. David helped me explain how my birth experience with Melissa had been disappointing because I'd been way too numb to feel anything, and had to be told how and when to push, that Melissa couldn't suck for a week, the list goes on... She tried to convince me that an epidural wouldn't affect the baby. I said I didn't believe that. She called the doctor, who basically begged me to have an epidural. He said if it was his wife he'd have her do it, because of the health risks involved. I was so tired and emotionally drained that I finally agreed. I tried to dismiss my disappointment and focus.
I'm guessing I was dilated to about 6 or 7 cm. by the time the anesthesiologist came. So I had time to practice relaxation and David coached me, reminding me to tummy breathe and to think of my peaceful place. I remember reliving our visit to Hawaii, picturing myself snorkeling and seeing a sea turtle and rocking with the waves in the ocean.
Rocking became my favorite way to get through contractions. I remember hearing myself "crooning" through the pains, well, I guess you'd call it moaning. I also knelt on the bed to do pelvic rocks and put a pillow under my tummy and buried my head in the bed.
When the anesthesiologist arrived I had to lay on my side and curl up. What a joke. Trying to lay on one's side and not move through transition labor should be outlawed. This was the most painful part for me, both with this birth and Melissa's. They said to breathe through the contractions. Shut up! Breathe, yeah, right. I felt like such a victim. The epidural seemed to take forever. When my nurse broke my bag of waters the amniotic fluid shot out and splashed all over her and we all had a good laugh.
Slowly I felt some relief from the killer contractions but the aneshesiologist had given me a very low-dose epidural as we requested, so I could still feel a lot of pain and I was starting to feel major pressure, like I had to take the biggest crap of my life (no apologies). I had the nurse check me for dilation. My cervix was ripe. I got to push, only to clean out my bowels though. They called the doctor, it was time to have a baby.
David and I were both unprepared for what follwed. I started violent shaking without any notice while we were waiting for the OB to arrive. I was cold, but I wasn't shaking because of that, it was such a weird sensation. My teeth were chattering so hard that my jaw was throbbing and there was no stopping it. The nurse said to not fight it, but I didn't know how to relax through it, my muscles were sooo tense! I remember David looking really scared.
Finally the OB arrived (my nurse said he'd better hurry or we'd be having the baby without him!) and the room filled with people. Neonatologoists, a lady who specialized in intubating premies (putting the tube down the throat), neonatal staff from the hospital, my nurses and my doctor.
I can't even tell you how many people were there, however, everyone was cheering me on and being so supportive. It was great to feel the contractions and not have to be told when to push. Within three contractions Mikayla was born.
The room turned into a whirlwind of people working on Mikayla. Everyone ooooed & ahhhhed at how big she was. At eight pounds, four ounces, she was the biggest baby they had seen born at 33 weeks gestation. The fact that she was so big was very validating for me because I felt beyond full-term size. I got to see Mikayla briefly when she was on the table with her eyes wide open and yearned so much to put her to my breast and cuddle her. David went to the NICU briefly but wasn't allowed to stay through all the procedures, those are so traumatic for parents to witness...
After I delivered the placenta the doctor said I had placenta previa. The placenta was 40% detached. This was news to us. Geez, how many things can go wrong in one pregnancy! I had developed a temerature of 104.5F so the nurses put big bags of ice all around me to bring it down, at which point I was cleaned up and started pumping to help bring in my milk. It took 5 days with both my babies. I really wanted to have breast milk ready in the NICU ready for Mikayla when she could start being tube-fed. She did have a little bit of formula before my milk finally came in. They asked me which formula I preferred and I felt sick. Then for the first time I was thankful to have that option because Mikayla needed nourishment, especially since I couldn't pump my colostrum out.
Leaving the hospital without my baby girl was the worst of this entire experience. I bawled all day. I broke down crying in the NICU and had to go back to my room. It seemed so strange to come home without her, although I knew that Mikayla was receiving the best possible care available. She was hooked up to so many IV's, monitors and tubes in addition to the ventilator. We put a few stuffed animal gifts in her bed to keep her company.
After about a week Mikayla could breathe on her own, and she was moved to a bassinette. There was talk of a spinal tap or an antibiotic to treat an infection. Oh, my sweet little girl... how I wished I could go through all this for her.
Well, it turned out that the doctors elected to forego the spinal and just start her on the 21-day antibiotic as a precautionary measure.
Mikayla is making great progress at learning to breastfeed. Despite my wishes to avoid artificial nipples she has been learning to suck a bottle too. I was so worried about nipple confusion and started using the SNS (Supplemental Nursing System) to help her learn to breastfeed. Now I'm feeling like, oh well, if it gets her home sooner, then I can deal with it. At least it's breastmilk in the bottle.
Looking back on this experience now that my baby is a healthy toddler, we feel so blessed to have had so many people offering to help, calling on the phone, emailing, visiting at the hosptal, bringing in meals and gifts and babysitting Melissa while all this was going on.
Thank you, all of you.