A Birth Story, Part II


(Like many Americans, I am thinking about health care and health insurance lately. I’ve really only ever had one major run-in with health issues and the health system, and it was intensive, both literally and figuratively. I had a baby that was born at 25.5 weeks in 2008. He’s a blooming, Minecraft-and-Star-Wars-loving almost-nine-year-old now, but this experience was harrowing and involved. Since my pre-existing conditions are pregnancy and premature labor, and I am guessing I have handed the latter condition down to my boy, I thought I would retell the story. I wrote about it as it happened, and it has been shared on an old blog. Part one is here.)

Happy Birthday, Part II: The Rest of Wednesday (May 2008)

When we were getting out of the car at the clinic, the clinic called. The nurse said that the doctor who had reviewed my file and who was going see me wanted me to go straight to the hospital.

“Well, I’m here,” I said.

“Oh. OK. Never mind; come on in.”

I checked in and waited until my appointment time… 20 minutes, which was bothering Pete, as they just said that they wanted me to go to the hospital. I was trying not to get upset about anything at this point. It’s just not helpful. They brought me in and weighed me (165 pounds), and put me into a little room, just like at a usual appointment. The nurse took my blood pressure, and had me wait on the table in my socks and shirt with a drape over my legs.

Waiting is fun.

This doctor was new–not my midwife, and her manner was very calm and a little too therapeutic for me. It did not make me feel more relaxed; rather, the opposite. She asked me my symptoms, checked for the heartbeat, which was thankfully there, and then checked me with the speculum. When she inserted it, a lot of fluid came out. I heard it raining onto the metal basin, and I knew that was not good. I had still been hopeful that I was just having some urethral control issues–odd how something that would be otherwise so undesirable would have been a gift in this instance.

She put her hand on my arm and said, in her quiet, supposedly consoling voice “You’ve definitely ruptured. I am going to test this and double check, but I am not going to pretend it’s not very serious,” and she left. I looked at Pete, and said “This might not be our baby.” Pete was being very calm and supportive and positive; I could not have asked for better. He’ll have to tell you how he was doing inside.

When the doctor came back in, she had checked me in to Abbott Northwestern Hospital: “You have to go there because of their nursery.” She gave us directions, and we walked out into the bright sunlight and headed across town to the hospital, in a daze.

Nursery.
Hospital.

No one had said “You are delivering a baby today,” but all indications pointed to that outcome.

It was slowly sinking in, on some level. This was either happening today, or in the next couple days or, if I was very, very lucky, I would be on bed rest in order to eke out as much time as possible for Squirmy. I was thinking about what kind of life this baby had were it to survive, what I would do if it didn’t, if there was anything at all good that could come out of this if it didn’t, how this happened, etc. etc. The doctor had said “we don’t know why. We’re just not smart enough.” I was not laying blame or feeling guilt or even concerned, it was just a wonder. It did not matter how it happened. It had happened, and now we had to deal with the circumstances. Nothing would be able to change that.

At the hospital, we parked in a lot where we should not have parked, and walked up to the Maternal Assessment area, where I was admitted, sampled, and tagged. By the time I arrived, I had started cramping, and I knew that they would hopefully try to stop that. A nurse led me to a room and said “Enjoy this walk. They won’t let you walk again for awhile.”

Everyone was very calm, very professional, and very nice. No one was making me agitated or upset, and I pretty much just went where they told me to go and did what they told me to do. In my room, I put on a lovely robe that opened up the back, stashed my clothes in a plastic bag, and got into bed.

They did an ultrasound to check on Squirmy. It was head down, in position, which was good news. At least that cut down a bit on the C-section chances, which were quite high, were I to progress into full-blown labor. Out came the monitors. Fetal monitor, contraction monitor, blood pressure cuff. They had given me a belly band, basically a giant Ace Bandage tube, and the fetal and contraction monitors went under that. I had to poop–for quite some time–but I had not wanted to use those muscles. I would not be pooping for awhile; I would not be getting up at all. The doctor came in and did another ultrasound so he could check things out himself. The fetus’ heart rate was dipping with every contraction, probably because of cord compression, and that was worrying them. If that continued, it was definitely going to be a C-section, and sooner rather than later. He saw that my bladder was very full and hoped that emptying it would perhaps cause the contractions to abate and help the fetus out. I became the lucky recipient of a catheter and an IV. Going from no memory of hospitalization to all the hospitalization was an experience.

During my second ultrasound, the doctor said “What is that?” That’s not something you ever want to hear from your health care professional, whether in a normal office visit or when you are flat on your back in a hospital bed. He saw something on my bladder that he wanted to have a urologist look at. I had that thought of “Oh great. I’ll be one of those ‘No, I felt totally fine. It came from out of nowhere’ people, and that in the middle of a completely separate crisis.”

I was getting antibiotics because the best I could determine, the rupture had happened over the weekend. That was days where Squirmy would have been vulnerable to infection. I was also getting fluids for me and magnesium to hopefully slow or stop the contractions.

It didn’t help. The contractions were getting worse, and they were making me stressed and worried because I knew it was too early. I thought that I would have been able to handle it were it happening in August or September, and the fetus was full-term, but this was the end of May, not even 26 weeks along.

At around 6:30 in the evening, Pete went to make phone calls to the people who needed to know and make other arrangements for himself. He had a three night gig with his Irish group beginning Thursday, and it certainly did not look like that was going to happen, though my first reaction to that was an idea that he could still maybe make one of the nights. Funny how the brain works. Oh, and our car was towed, too, so we had to figure out what to do about that. I didn’t even have my purse because I had forgotten it at work. Luckily, I had not needed it to go through admission. Pete arranged with my brother to get the car out of jail, and I figured that the $280 it cost would be partially covered when we got back our $195 for the childbirth classes we would no longer be needing. I would be doing this little test without preparation.

People kept coming in to tell me things, to check on me, to consult. I talked to the anesthesia team, two doctors, nurses, and people from the NICU at Children’s next door. They all told me that I was in the best possible place; that they had a 90% success rate with premature infants; that we would be in good hands. These people usually had about two minutes to get their words out in between contractions. I never had that 7-8 minute window. I went straight to 2 minutes and stayed there for a long, long time. The first time they checked my cervix, it was 1 centimeter.

If they did a C-section, they would use an epidural. The anesthesiologist asked me a few questions; I told him that I thought I was a fast metabolizer, and he said “Of course. You’re a red head.” That made me feel better. The last thing I would need in the middle of all this would be pain killers wearing off during invasive surgery, and hearing him recognize that he was aware of the strange correlation between redheads and anesthesia was reassuring.

By the time it was starting to get dark, my contractions were not going away like we had hoped, and it was causing me worry and stress. They decided to give me an epidural because it was looking more like C-section time. This was the only occasion on which there was a lot of bustle. They got the anesthesia team in, and it seemed like there were dozens of people in the room. There were probably six, but there was a lot going on. They had to get things ready and try to get the drug administered between contractions. This came off without incident, with only a mild pressure and warmth when the needle and medication went in, and it almost immediately relaxed me. They put a catheter in my back and gave me a button to push when the pain came back. Then they propped me up, tilted me a little to my right because that’s where Squirmy seemed to be most comfortable, and put all the monitors back on. I was expecting to be prepped for a C-section at any time. They gave Pete scrubs to wear, and when he came out in them, my first thought was “Hey, Pete looks good in scrubs.”

For someone who was planning a natural child birth in September*, a fully medicalized one in May was quite a change of pace. The only thing I was thinking about, however, was getting through this and getting Squirmy through this, if at all possible, and making sure that Pete and I would be OK in the end. It was lovely to not feel the contractions not because it took away my pain but because it took away a lot of the stress. I knew what was happening; after all, there were plenty of monitors and every-15-minutes blood pressure checks to remind me. I was able to relax and be calm, breathe, and think.

Whether it was this relaxed state or just the passage of time, who knows, but the doctor eventually came in and said that the fetus’ heartbeat was stabilized, and that he wanted to try for a normal delivery. I worried that this might be too much for Squirmy, but I was hoping for a normal delivery, so this was good news.

The little pain medication button was hanging there near my right hand but I had not used it. I wanted to use as little as I could, so I was waiting for the first twinges before I hit it. It had a 15-minute lag time, which would probably be longer for me. I pushed it after I was feeling a bit of pain, and nothing happened. They told me to push it again about 30 minutes later. Again, nothing. By then, the epidural had worn off on my left side, and it was odd to be feeling contractions on only one side of my body. They tested me out with ice packs to see what I could feel, and it was definite. They tried out a couple of doses of pain medication directly into my arm IV and that evened things out so that I could still feel the contractions, but they were not causing me stress.

They had checked my cervix again earlier, and it was at two centimeters. It then jumped from two to seven and then to nothing. It was time to get the little bugger out.

*Oh, the halcyon days of crunchy birth plans. I’m better now.

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