Saturday, September 20, 2014

Olivia's Birth: The Aftermath

In Olivia's birth story, I mentioned the difficulty with getting my placenta to come out. We'd hoped Jessica had gotten it all, but knew there was a possibility of my having retained some tissue. I actually retained placental tissue with Amy, which led to a uterine infection (treated at home with antibiotics). Apparently my body is super proud of the plactentas it makes and just doesn't want to let them go.

Well, late Sunday night August 31st, I took a shower and then started having some cramps. For the first few minutes they weren't bad, just sort of menstrual cramp-y. Uncomfortable but not terribly painful. Within a few minutes, they rapidly became sharp, stabbing pains to the right side of my pelvis that had me sobbing hysterically, unable to move or really talk much. I had Brett call the midwife, and briefly talked to Nicole, who told me to definitely go to the ER. Brett got our neighbor from across the street to be in the house with the older kids (thanks, Rich!) while he, Olivia, and I headed to the hospital. I was in so much pain Brett had to lift me out of bed and carry me to the car.

Despite the fact that I was more or less in hysterics and sobbing uncontrollably, the ER took their dear sweet time helping me. I sat in a wheelchair in the waiting room for about 15 minutes, and then spent another 45 in an exam room without being seen. Brett made several trips out to the nurses' station to no avail, and finally got harsh enough with the right person that a doctor and two nurses came in. Shortly thereafter I was given some morphine. Hallelujah! It was my first experience with morphine, and I have to say, I was immensely grateful for it. And, I didn't feel high! A little loopy, but thankfully nothing more than that. (Translation: unlike my experience with Stadol, there were no cartoony purple-spotted cows hopping through pastures.)

The next few hours were spent having labs and blood cultures drawn and getting a CT, a pelvic exam, and a pelvic ultrasound. The doctor was very obliging regarding my breastfeeding and was careful to make sure I could still nurse Livvie. (Mainly this meant not giving me contrast for the CT.) Around 3am, she was getting extremely fussy, and I gave Brett the go-ahead to take her home because it looked like I was going to be there for at least a few more hours.

Just before 4am, the OB resident on call came back in. She told me the ultrasound and CT both showed what looked like retained "product" in my uterus, as well as some definite irritation/inflammation of the lining of my uterus, which meant I had an infection. I was pretty unsurprised. THEN she told me they'd be admitting me! That surprised me, since my infection post-Amy had been dealt with at home. But because of the amount of time elapsed (10 days) and the fact that I hadn't passed the tissue myself, they were concerned they'd need to do a D&C to remove the leftover tissue. For the moment, they would be giving me regular doses of 2 different antibiotics through my IV and monitoring me. Olivia could still nurse, but she could be with me only while another adult was there. (Hospital policy since Olivia was not a patient and couldn't be sent to the nursery, just in case something were to happen to me--the hospital couldn't be responsible for her.)

I got up to the Women's Health floor around 5am Monday morning. A couple of hours later, I called Brett's mom, Barbara, to let her know what was going on and see if she could come back to help out again. (Poor woman had just gone home Friday afternoon, but she packed a bag and drove back without complaint. I would've been lost without her help.) The hospital provided a pump for me so I could still provide milk for Olivia while she wasn't there (although I hated their pump and had Brett bring my Medela when he did come). Once Barbara was back to take care of the older kids, Brett and Olivia spent the majority of their days (and all of their nights) in the hospital with me. The nurses were kind enough to procure a bassinet for Livvie to sleep in, as well as anything else we needed.

Basically, I just had to hang out. Monday and Tuesday I spent the days getting antibiotics every 4 hours and trying not to be bored out of my mind. Several friends from church came up to spend time with me both days, which helped immensely since I was NOT happy to be stuck away from my kids. Tuesday evening the OB resident let me know that they would, indeed, be performing a D&C on Wednesday, after which I could be discharged. I was pretty nervous at the prospect of a D&C, not so much because of the actual procedure, but because of the emotional ramifications. Since the only other time I've had a D&C was when I lost Hannah, I was afraid it would trigger those emotions again (and to some extent, it did).

The procedure (to my knowledge) went well, without complication. I was actually under sedation rather than being put under general anesthesia, and I have to say I definitely prefer it that way. I woke up more quickly and didn't have the lingering effects of GA that I usually do (including nausea/vomiting). Apparently they got quite a bit of tissue out, so I'm glad they went ahead with it. I was discharged later that evening around 7pm, and was grateful to be home again!

Fast forward another 10 days, and I was back in the ER on Saturday the 13th with a high fever. I was terrified that maybe they'd missed something (which they warned me could happen) and that I'd have to have a repeat D&C. Fortunately (?) it turned out to *only* be strep throat, and I was sent home from the ER with a prescription for antibiotics.

Here's hoping I can actually stay healthy now! My recovery has been pretty slow, thanks to the blood loss and the infections. Hopefully I've turned the corner now and can start getting back to my usual self. In the meantime, Livvie has been such a great little girl, and Amy & David have both been helpful (some of the time) and their usual selves (most of the time).

Baby Ender is here!!!

I haven't posted in almost a month, because WOW, what a busy few weeks we've had!

IT'S A GIRL!!!!!

We welcomed our sweet girl, Olivia Katherine, on August 22nd at 3:26pm. She weighed in at a whopping 9lbs 6oz and measured 21 1/4 inches long, making her our biggest baby yet!

What follows is her birth story. I am including some details, so if you're squeamish...well, you've been warned.

I'd been having what seemed like contractions off and on for several days. They'd get to about 8 minutes apart for a few hours, and then disappear. (Which believe me, got increasingly frustrating.) Thursday night I started feeling pretty crampy and just shrugged it off, since my uterus had cried wolf one too many times already in my opinion. Around 3am, though, despite still only being 8 minutes apart, the contractions were strong enough that they started waking me up. Every 8 minutes. For the next few hours. I think I gave up on sleep around 6 or 7 in the morning and just got up. At that point, I was pretty sure the real thing was starting, so I told Brett to go ahead and call in to work. Then I worked my way down my "call list", starting with my midwife, then my mother-in-law Barbara who would be driving in from Ohio, and finally our dear friend Stacy who had volunteered to watch the older kids for us. A little while later I called a longtime friend, Katie, who was planning on attending the birth.

Between about 9am and 9:30, my contractions pretty abruptly went from being 8 minutes apart to being 4-5 minutes apart. After another call to my midwife, Jessica, we decided to wrap things up, drop the kids off, and head to the birth center. We got to the birth center around 11:30am. I could tell the contractions were definitely stronger while I was standing, so I tried to walk and stand as much as I could to help move things along. We walked through the birth center a few times, stopping each time a contraction started so I could lean against Brett with my head on his shoulder. It was by far the most comfortable way for me to spend contractions, leaning on him like that. I spent some time sitting on a birth ball, which was comfy for a while, and even laid in bed on my side, although that wasn't the greatest. A lot of moving around, since one position would be comfortable for a little bit, and then I would get all antsy and need to move. I tried to make sure I was staying hydrated, which meant pretty frequent trips to the bathroom. I HATE  having contractions while I'm peeing. There's just no way to stay comfortable on a toilet for me. Ugh.

Katie got up to the birth center around 1pm, mercifully stopping to grab some food for Brett, who was starving thanks to our busy morning preventing him from eating. It was so fun to have her there. The three of us chatted between contractions. It was just such a relaxed environment. Yes, I was uncomfortable, but I could still laugh and have fun!

Jessica was in and out of the room occasionally, checking on me and using the doppler to check on Ender. She had a student midwife with her, Andy, whom I'd met before and had okayed to help attend me during the birth. They were very unobtrusive, quietly checking on us and helping remind me to relax when the contractions were more intense and I started struggling a bit, applying some counterpressure on my lower back. (Most of the time, Brett was the one putting pressure on my back. It was SO helpful and was really what got me through the last hour or so before I got in the tub.)

I'd told Jessica I knew I wanted to labor in the tub, and possibly deliver there, depending on how comfortable I was at the time. Probably between 2 and 2:30, as my contractions were REALLY getting intense, she asked if I wanted the tub filled up. It sounded good, so I said yes. Once it was ready, I climbed in, and oh. My. Goodness. It felt AMAZING. The buoyancy of the water really helped take the edge off the contractions, and I was able to focus better, relax, and breathe through each contraction. It made such a difference in my labor. I'm not sure how I managed with David without a tub.

My timeline is pretty fuzzy since we were all focused on what was going on, not what time it was. :) Around 3 or so (maybe a little before), Jessica, Andy, and a nurse (Natalie) came in and stayed in the room. I could tell I was definitely in transition and it was getting close.

That last little while before Olivia was born is what really stands out in my mind as marking the difference between this birth and my hospital births. Jessica was so calm and reassuring, reminding me to relax and breathe. There were numerous expressions of, "You can do this" and gentle touches to my back and shoulders. There were no bright lights or loud bustling about, just the natural light from the several (shaded) windows. I was encouraged to listen to my body, and that I could push whenever I felt like it was time. Someone helped to hold one of my feet because I couldn't get a good position for my right foot. After a while (maybe 3:20ish?) I was definitely feeling some pressure, and started gently pushing a little to test it out. I had a few contractions while I gently pushed a bit, and I could tell she was moving down as the pressure increased. Then it was DEFINITELY time to push. After a couple of big pushes, her head was out, with the amniotic sac still intact. The membranes ruptured when Jessica caught her head. Another couple of big pushes and she was out!

Jessica immediately put her on my chest. Someone asked, "What did we have?" I lifted her up to look and was thrilled to announce she was a girl! She still hadn't taken a breath, despite being rubbed and encouraged, so they quickly put a mask on her and gave her a few puffs of air. She took a big breath and then started wailing, though she calmed back down quickly.

And then the "fun" started. My placenta had started to detach already, and I was bleeding pretty badly. Once the placenta was out, Jessica started giving me some meds to help me stop hemorraghing. I can't remember what all I got that afternoon, but I know I got some oral Cytotec, I think 2 shots of Pitocin, and a shot of something that started with an 'M' that burned like hell. After the Cytotec and one shot of Pitocin, they got me out of the tub and to the bed. It was clear the placenta hadn't come out in one piece, and they needed to start working on me to get the rest of it out. I won't go into tremendous detail because it wasn't pretty, but suffice it to say it involved a lot of pushing down on my uterus, and a LOT of blood. Poor Katie was probably traumatized.

Eventually my bleeding settled down and there weren't any more clots coming out. (Yeah, I know, gross. You were warned.) Olivia nursed a bit, and Brett and Livvie and I got to have some family cuddle time. Katie left so we could have some space to ourselves. At this point, Natalie took over being in charge of me. We made several slow, careful trips to and from the bathroom so I could pee, making sure I wasn't going to pass out or anything. Brett and I took a quick little nap, and finally packed up our new little bundle around 7:30 or 8pm.

It was so nice to be able to sleep in my own bed that night, and to not have people (other than Olivia) constantly waking me up all night.

I loved this birth experience. It was beautiful. It was exactly what I wanted (minus, of course, the hiccup with my placenta which couldn't have been prevented). I felt comfortable. I felt safe. I felt loved by every person in that room. I was allowed to birth how I wanted, without interference. I was supported and encouraged. It was by far the most empowering experience I have ever had. I adore my team of midwives: Jessica, Lisa, and Nicole, as well as the rest of the staff at the birth center (Marci and Leanna). Natalie was a fantastic nurse and I loved her, too. I couldn't be happier with my experience and the care I've been given!