Preface:
1. This post WILL include some TMI moments. I very well may not hold back in my description of certain events. The details of the whole affair are still fresh in my mind.
2. Pregnant ladies please let me stress that if things aren't smelling fresh down there, despite your normal care routine, call your doctor and request a culture right away. UTIs and infections in the vagina can lead to cramping and preterm labor. Bacterial Vaginosis is very likely to have caused my preterm labor.
Let's start at the very beginning...
You may remember that I had an appointment scheduled for this Friday, which I expected to be completely normal. But then I woke up in the 3 o'clock hour with cramps that would come and go. I laid there for a while and decided that maybe I needed to have a bowel movement. After a successful bathroom trip, I returned to bed hoping to sleep. Needless to say, I didn't. About an hour later I moved to the couch with a glass of water, thinking that if these were Braxton Hicks they would hopefully stop with hydration. They didn't. Around 5:30 I decided to take a shower, pack my hospital bag (mother's intuition!), and then hopefully catch some z's before heading to the appointment. This plan worked and I got about an hour and a half of sleep before Jr. woke up. The whole time cramps were coming and going and sometimes stopping me in my tracks.
The Doctor will see you now.
I got to my appointment around 9:00. After explaining what I was experiencing several times, a resident came in and did a vaginal culture to check for infection, the Group B Strep test, and a cervical exam. At this point (maybe around 10?) the cervix was completely closed but she couldn't tell how effaced because the cervix was up under the babies head. I don't understand how that works, but whatever.
Once the resident talked to Dr. H it was decided that I would have a non-stress test and they monitored me for about 30 minutes. By that time they determined that I did have Bacterial Vaginosis, which was very likely causing the cramps. Also at this time the terminology changed. The resident looked at the monitor printout and said that I was having contractions every 3-4 minutes. Dr. H made the decision to send me up to Labor and Delivery for further monitoring. This was about 10:45.
Upon arrival in triage, I met the wonderful Robin, who may have been the best nurse I've ever had. She explained everything, usually before I asked, and was very obliging and understanding (like when she allowed me to drink the whole cup of water instead of just a sip to take a pill).
While in triage I went through the unfortunate experience of having two nurses try to find a vein for my IV (the IV was put in to get fluids in me in the hope that being super hydrated would stop contractions). I think they tried three times before being successful. Contractions continued and around 1:00 they did a cervical check. This time I was 3 cm dilated and 80 or 90% effaced, which led to me being admitted.
Stop the world and let me off
Once admitted the goal was to stop labor and get some good stuff in me to help Patrick's lungs mature and reduce his risk of cerebral palsy (steroids and magnesium, respectively). I took a pill that helps to stop labor, which was much nicer than the steroid shot in the butt and the magnesium drip, which wasn't as bad in regards to side effects as it is often known to be.
... I'm going to take a break to talk about the timing of all of this. My husband was supposed to give his second doctoral recital on Friday night. Oopsie. He came to spend time with me once I was sent up to Labor and Delivery. The plan was that he would do his recital and when he left to get ready (around 3:30?) things were still status quo. Back to the story...
Contractions started to pick up despite the pill I took, so they decide to give me a shot of a different medication (2:30 or so). This was the last option. It cooled things down and made the contractions irregular until about 10-15 minutes after David left. At this point they were back to making me want to crawl out of my skin and quickly getting stronger. I was starting to have some anxiety and trouble keeping my cool. I needed to know if I was having this baby today and if so I wanted to get out of bed. Robin was fantastic when she came in the room to a crying momma, and quickly found Dr. L, who was equally fantastic. Dr. L did an exam and found that I was fully dilated and she could feel the bag of waters bulging out of the cervical canal with Patrick's head a little above. She went off to get an OR room set up (any probable deliveries of NICU babies deliver in the Labor & Deliver OR because the NICU is on the other side of the wall) while I choose to receive the only pain medication I could get (too late for an epidural!). I decided that given the mounting anxiety I felt and already had to combat that it would be best to take the edge off a little (and if that was taking the edge off I'd hate to know how much it really hurts). I had to leave my husband a voicemail telling him it was go time, that he would have to postpone his recital and come back to the hospital (4:50). It took him much longer than I hoped to get there.
Show time!
I was in the OR for maybe 5-10 minutes before my husband arrived. It was maybe another 5-10 minutes before it was time to push (5:20, give or take). I should point out that when Dr. L returned to help transport me to the OR she informed me that I would deliver with the bag of water intact. Since the head was still high when she checked me there was great risk of cord prolapse (the cord coming out before baby). This is a problem because the baby then puts pressure on the cord and deprives themself of oxygen.
I am very lucky to only have pushed for 20-30 minutes. It seemed like an eternity and there were definitely times where I thought to myself that I didn't want to do this, but I succeeded. The whole team was fantastic and I'm quite appreciative of the nurses that held my legs while I pushed.
About halfway through descent my water broke. I experienced a gush with Jr. but this was more of a projectile gush. At one point before it broke Dr. L informed two NICU nurses that we were delivering with the water intact and that they should move somewhere else. They had been standing in front of me but about 3 to 4 feet away and I'm pretty sure some fluid made it that far.
After my water broke Dr. L (who had no previous experience with my case) asked for some clarity about my vaginal septum (not to be confused with the uteran septum). Up to this point the understanding was always that the vaginal septum created a pocket and did attach to vaginal wall just before the cervix. We learned that this was not the case, as fluid was definitely flowing from the non cervix side of the septum. A push or two later I was informed that the septum did tear and it tore enough that should it not remove completely during birth they would remove it (YAY!!)
Birth is a very messy business. I'm pretty sure I let out shrieks of surprise every time there was a big gush and splatter of blood. There is definitely a reason why they all wear protective eyewear.
As I said before it seemed like an eternity, but it was over before I knew it and there was this precious little boy blinking those big cobalt blue eyes at me. It really is all worth it.
Immediate recovery
After delivering the placenta, the first order of business was determining if they needed to make any repairs where the vaginal septum tore. The investigation was painful but thankfully they found no need for stitches. Plus I didn't tear or have an episiotomy!
I plan to do a comparison of recovery between c-section and vaginal birth, but let me just say now that I have felt absolutely fantastic! I'm tired, but physically I don't feel like I think I should and I am okay with that.
Sweet baby boy
Patrick is in the NICU under the lights and sporting a wonderful CPAP. They, of course, have told us not to expect him to go home before his due date. This is the worst outcome of the best case scenario. If he continues to grow well and has few complications he could come home sooner.
He has a few things he has to be able to do on his own before going home:
- breath
- eat
- maintain body heat
- pass the car seat test
- and of course have no complications that require hospital style care
We are very happy that he is doing as well as can be expected (which really is pretty well considering).
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