Monday, May 26, 2008

Birth Story

I can't really pinpoint when labor started, but as Brian said in his post, by 2:30 am Sunday morning my contractions were less than 5 minutes apart. It wasn't too bad at that point, but after 6 hours worth we figured we should go to the hospital to see what was going on. We got there and checked in figuring we were probably there to stay, but when the nurse checked me she informed me that I was still stuck at 2 1/2 cm, same as I'd been for 2 weeks. Ugh. My doctor happened to be the doctor on call and was doing rounds so he came in to talk to us. Apparently I was showing some indications that I might be developing preeclampsia-- a couple high blood pressure readings and a little protein in my urine. My doctor said we could stay and they would break my water or start me on pitocin, or we could go home. He said he'd prefer that we stay, but if we wanted to go home we should just come in to his office in the morning for a UA and a blood pressure check. I knew that if we stayed I wouldn't be able to eat or take anything to help me sleep, so I opted for coming home.

Once we got home (around 11 am) I took a couple of benadryl and had some toast and went to bed. I slept for a few hours but woke up feeling uneasy. It was about 4:30 pm and I started asking Brian if he thought we were doing the right thing by waiting for the morning to go in. He felt uneasy about it as well, so we prayed about it and decided we should go back to the hospital and, if I hadn't progressed any further, go ahead and have them break my water at that point. I had some cereal since I knew that was my last chance to eat and Brian rounded up stuff so we were ready to go. I didn't think I'd progressed any further since my contractions hadn't gotten any more intense, but when I went to the bathroom right before we left my water broke. It was full of meconium, a bad sign as it means the baby is in distress. If we hadn't been on the way to the hospital at that point, we would have been then.

This time at the hospital, things got a little crazy. The nurse checked me and then started an IV (after thoroughly bruising my hand trying) then my doctor came in and checked me. As soon as he was done he came around to the side of the bed and said, "Elsha, you need a c-section. Now." The baby's heart rate was dropping into the 30s and he couldn't get it to stabilize even for 45 seconds. Normally my doctor is all about options and choices, pros and cons and all of that. So when he said I needed a c-section I knew he didn't come to that decision lightly. He told me that even if I were going to deliver the baby in an hour he would do a c-section now and since it was my first baby I would probably be in labor for another 12-14 hours at that point. He didn't even let the lab technician finish drawing blood before they wheeled me into the operating room. We also found out after the fact that the PA didn't even make it to the operation, my doctor just did it with nurses assisting. Less than an hour after we checked in Kalena was born.

After the operation was over everyone kept asking Brian and I what made us decide to come back in because it was such a good thing we came in when we did. Even the doctor told us if we'd waited until Monday morning to come in we might have had a very different outcome.

They put me to sleep during the post-op so Brian went with the baby and told me later what happened. Sometime after my water broke, Kalena aspirated meconium. Aspirating meconium can cause chemical pneumonia in newborns, so immediately following the delivery they took x-rays and started her on IV antibiotics. The x-rays showed that she had developed pockets of air between her lungs and her chest wall. They put her on 100% oxygen to try to correct it and said they'd take periodic x-rays to check the progress. All this meant that we couldn't even hold her until she was off oxygen. I got wheeled into the nursery to see Kalena once I was out of post-op, but we couldn't even really touch her because too much stimulation would make her breathe harder which could make her condition worse. After that they wheeled me into my room where I was tethered to an IV and a catheter until Monday afternoon.

X-rays taken Monday morning showed that the air pockets had actually gotten worse overnight, but since Kalena still looked so good (most newborns with this condition have blue fingers and toes and are blue around the mouth, Kalena was still pink all over) the pediatrician decided just to leave her on the oxygen. An indication of how bad she was is that while the average newborn breathes 40 times a minute, Kalena was breathing 80-90 times a minute since her lungs were almost totally collapsed. The other option besides oxygen would be to put tubes in each side of her chest to get the air out. They actually had an emergency table set up next to her in the nursery so they could do that instantly if she got bad enough. Monday afternoon x-rays showed the air pockets starting to resolve so the pediatrician was optimistic that oxygen was all she would need. She ended up being on 100% oxygen until Monday evening when they lowered it to 30%. She was taken off oxygen altogether on Tuesday morning but they kept a monitor on her to watch her oxygen saturation levels. So Tuesday morning was the first time we actually go to hold her and I got to feed her for the first time. While she was on oxygen she got glucose solution in her IV. Luckily since she never got a bottle she still took to nursing fairly easily.

She had to wear the oxygen saturation monitor until Wednesday morning and they took out her IV Wednesday afternoon when blood cultures came back showing no indication of infection. Wednesday night we got to keep her in our room overnight and the pediatrician discharged her Thursday morning after checking her out once more. They actually discharged me Wednesday afternoon, but the hospital lets moms stay if the baby hasn't been discharged yet. So Thursday morning we finally got to come home! And that's how it all happened.

We have an appointment with the pediatrician tomorrow so hopefully everything will still look good. She is eating well and sleeping well and seems to be an easy-going baby. Hopefully that is an indication of temperament and not just that she's getting some of my prescription painkillers through my breast milk :) From what our parents tell us, both Brian and I were easy babies so we're hoping that's the case here too. I guess we'll just have to wait and see.

Here she is with her oxygen bubble on, along with an IV and the oxygen saturation monitor (on her foot).

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