The Birth Story of my younger daughter Addah, with my older daughter Lakin's story at the beginning...
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The Beginning:
I guess I should start this story off with the birth of my first daughter Lakin, since it is through her birth that I decided on the path to Addah’s birth. I was induced at 37 weeks with Lakin because though I was not in active labor, I was dilated to 2cm and the doctor thought we might as well. I didn’t know any better and went along with it. After 12 hours of Pitocin and a nasty dose of Stadol, I had only dilated to 5cm. I was declared “failure to progress” and a c-section was performed. Lakin Leigh was 5 lbs 14 oz and 18 3/4 inches long. Although at the time I was thrilled to finally have my baby, in the weeks afterward I realized just how wrong my birth went. I never intended to have a c-section, I didn’t and don’t feel it was necessary. My body did not fail to progress, my doctor failed to be patient and wait for my body to labor and progress on its own timetable. I resolved to never have an experience like that again and planned for a home vaginal birth after cesarean for our next baby.
We never used birth control after Lakin was born. It had taken us 15 months to get pregnant with her and since we wanted our children to be close in age, and since I was breastfeeding, we didn’t want to add any more elements to keep us from conceiving as soon as possible. We were never clear on our actual conception date because I was nursing our older daughter Lakin and had not yet gotten my menstrual cycles back. I do know that the date we took our first positive pregnancy test was March 23, 2002, putting our due date at approximately late December/early January 2003.
My pregnancy was very normal, seemingly as textbook as my pregnancy with Lakin. I felt fine, gained very little weight (10 lbs, which is normal for me). My blood pressure never went over 120/80, fundal height consistent with a late Dec./early Jan. due date; baby’s heartbeat remained between 140 and 162 every time we checked with our rented Doppler and from late August on, baby’s movements were very active. We chose not to have any ultrasounds since all signs pointed to a normal pregnancy and baby, and since we had no desire to know baby’s sex. We planned a home vaginal birth after cesarean: read everything we could get our hands on, gathered our supplies, and got ourselves as ready as we could.
On October 22 I woke up having mildly uncomfortable contractions. I took a hot bath, drank several glasses of water and went back to bed. After several hours the contractions slowed and then stopped. Contractions continued to come and go throughout November, some so hard that I just “knew” I was in labor but they always slowed and stopped after a while.
On December 4, 2002, our county was hit with a hard electrical storm and we lost our power. After a long night of contractions by candlelight, it was getting cold enough in the house that we decided to head to my mom’s house. It was the first time in over a month that I thought, “please don’t let me go into active labor right now”. All I wanted was to get back into my home with my privacy before labor started.
Off to the Hospital:
On December 7, 2002 at 4:00 am, Andy, Lakin and I were relaxing on my brother’s bed when I felt a “pop” and a gush of fluid. I told Andy that I thought my water had broken, but when I put my hand down to check for fluid, there was bright red blood instead. I rushed to the toilet and sat for a few minutes, thinking that the bleeding would slow or stop, that maybe it was nothing. In hindsight, I wasn’t really thinking clearly at all, I was panicking and my head was pounding. I started crying and told Andy I was scared to go to the hospital. Visions of a repeat cesarean were already rushing through my head but when I stood up and the blood gushed out again onto the floor, I knew I didn’t have much choice.
We arrived at the hospital at 4:30 am and were taken immediately to Labor and Delivery Outpatient for monitoring. Blood was still gushing out and I had soaked three towels by this point. I was hooked up to a fetal monitor, which showed that baby was doing wonderfully. I was swabbed for several tests and an ultrasound machine was brought in to verify that baby was okay. At this point, baby was head down and my placenta was low-lying but not over my cervix. 2½ hours later another ultrasound was performed and our baby had flipped to a back up, transverse lie and was being blocked from flipping back down by my placenta. An hour after that we had a 3rd ultrasound and baby was still transverse.
Three different doctors came in to tell me how dangerous and negligent we were being by having planned a vaginal birth after cesarean and one told Andy he would never “allow” his wife to make such a decision. We were feeling pretty antagonistic towards the staff by this point and just wanted an answer as to what was going on so we could know what would happen next. I was still very much planning on having a vaginal birth and since the ultrasound showed the baby to be pretty small, I wasn’t concerned with the transverse lie. After all, baby had just turned from head down to transverse so baby could still turn back, right?
Tests all came back normal. I was moved to a regular Labor and Delivery room and shortly after 9:30 am, the bleeding slowed and then stopped.
At 12 pm the bleeding was still stopped and I felt much better. The doctor wanted me to stay for another few hours for monitoring but Andy and I decided to go on home. We left the hospital at 1 pm, I ate a sandwich and went to bed.
At 11:30 pm I woke up, went to the bathroom and ate some dinner. We were lying in bed watching TV when I felt a gush. I said, “I think I’m bleeding again” and then I felt something coming out of me. I reached down in time to feel a 2x3? blood clot slide out of me. I didn’t know what it was or what to think and was freaking out. Andy called 911 and I called my mother to come pick up Lakin.
The ambulance arrived very fast and at 12:30 am I was re-admitted to Labor and Delivery. My blood pressure had spiked to 160/100 in the ambulance but it stabilized and went down quickly. Fetal monitors still showed baby doing great and another ultrasound showed that baby was still transverse, with feet dangling by my cervix. Measurements showed our baby to be 33 weeks and 2 days, completely inconsistent with our test date, and totally impossible since we had a non-existent sex life because I had such awful morning sickness until mid-May.
Doctors began considering that our baby had intra-uterine growth restriction (IUGR) and the preliminary diagnosis given was a sub-clinical placental abruption, a fissure too small to be seen by ultrasound and too small to hurt the baby, but large enough to cause frank vaginal bleeding and large enough to have caused IUGR in our baby. I had fallen over a baby gate in our house back in August… the abruption could have happened then and just not been big enough to cause bleeding until now.
Bleeding slowed again at around 10 pm on December 7, 2002 but at this point neither Andy nor I even considered leaving. It had become apparent that this was quite serious and that it was not going to go away. I was quickly seeing my VBAC dreams go out the window and Andy and I spent much time talking and crying, trying to make peace with the huge possibility that I would have a repeat cesarean.
At 1 am on December 8, 2002 I was moved to the High-Risk wing on the Labor and Delivery floor and I was given a steroid shot to hasten lung maturity. The next morning I was taken across the hospital complex for a level 2 ultrasound. Measurements still showed baby at 33 weeks 2 days. The only abnormality found was a 2-vessel umbilical cord instead of a 3-vessel cord. We were told that while not common, this is not exactly uncommon either and probably was not a big deal.
The heads of High-Risk OB and Maternal/Fetal Medicine asked us to consider an amniocentesis so that if an emergency occurred and delivery became necessary, we would have some idea of baby’s lung maturity. We decided to do the amnio at 11:45am. It was not as painful as I’d feared it would be, but certainly very uncomfortable and more than a little scary. Amnio results came back that baby’s lungs are not mature, only rating a 24 when 50 is considered mature.
I went back to my room in high-risk L&D. I had some cramping, which I was told was normal with an amniocentesis. Three doctors came in and all mentioned discharging me within 24 hours and scheduling me to come back in for another ultrasound and amniocentesis in a couple of weeks. With baby lying transverse and my placenta partially abrupted, I was told I had no choice but to have a c-section. In my head I was still defiant — I thought I could go home, no more bleeding, baby would flip head-down and I could still have a VBAC. I made arrangements for Lakin to come up to the hospital to be with us and was feeling much better all around. It was a wonderful relief to know that baby was doing so well on the monitors and that I could go home soon.
Andy left to go run errands and my mom was on her way to bring Lakin at 5pm. I called Andy at home to remind him to bring Lakin’s pajamas and we hung up when my nurse came in to take my vitals. She commented that the baby and I were doing very well, said she was planning to take the monitors off in a while so I could get some real sleep and asked if I felt okay. I said yes, that the bleeding had almost stopped completely again. She left and had been gone no more than 90 seconds when I felt a big gush of fluid again. I hit the nurse call button and she came back in; I told her I thought I had started bleeding again. She pulled back the covers and freaked out! I had passed another large blood clot and I thought this nurse might just faint. She ran for the doctor, who ran in the room…. Everything started happening so quickly. The doctor thought my water might have broken too and decided to do a litmus test to check. Andy walked in the door while I was being tested and a moment later, my sister Hilary and Lakin appeared at the door. I had been waiting all day to see Lakin and I had to tell them to leave, that we would call.
The Birth:
The litmus test was positive for amniotic fluid, the head doctor of high-risk OB was called and it was decided that our baby needed to be born. A quick ultrasound was done and baby was still transverse and very high. Of course this means we had no option but to have a repeat cesarean.
Everything seemed to be happening at the same time all around us and we were more than a little scared. We were rushed back to the Operating Room Recovery Room, where it was discovered that my IV line was no longer running. It was taken out and 3 different people starting trying to get another IV, plus 1 nurse trying to draw blood. I had 2 people on each arm, poking and prodding and then starting over since they couldn’t find any veins. I ended up with cotton balls and tape on the inside of both wrists, on top of both hands and in each elbow. The IV ended up being placed on the inside of my left wrist, a really painful spot. I was in tears and in horrible pain from all of the needles.
At this point the doctor came in and explained that since no abruption was showing on ultrasound, that there was also the possibility that I had the opposite problem, a placenta acreta, where the placenta fuses to the uterine wall. To remove it forcefully can cause massive blood loss and maternal death, so he said that if he encountered that problem, that he would perform a hysterectomy. I was losing it by now. I was so tired, having contractions, lying in a pool of gushing blood, needles in both arms, facing an eminent repeat c-section and being told that I might have to have a hysterectomy. I think I started to shut down at this point, I remember feeling dizzy and then I drifted in and out of sleep for what felt like hours but was really only 5 minutes.
We were waiting for 4 units of blood to be sent up from the lab in case I needed a transfusion. Since the baby was still doing well on the monitor, it was decided that I had time for an epidural rather than the spinal I had asked for or the general anesthesia that we had feared as a possibility. The epidural was just as awful as I remembered from Lakin. My lower back is the most sensitive spot on my body and I could not hold myself still to save my life. I finally had what felt like an out-of-body experience; I focused on the spots on the chair in front of me and disconnected my brain while the epidural was inserted. A test dose was given and within 3 minutes I couldn’t feel my bottom or hips.
The blood was brought up, Andy changed into his scrubs and I was whisked into the OR. The nurse-anesthesiologist tested to make sure I couldn’t feel anything and the drape was put up. I asked for Andy “before they start” and the anesthesiologist said that they had already started, that my belly was opened already.
I remembered the intense pulling and pressure from when Lakin was born but it seemed to be taking so much longer this time. I later found out that the doctor initially opened my belly and uterus on my previous cesarean scars, both of which were low transverse incisions, but that the baby was so high that my uterus had to also be cut vertically, leaving me with a T-shaped incision on my uterus.
I heard a suctioning sound and then a loud cry, followed by “It’s a little girl!” and I started crying. Addah Shannon was born at exactly 8:00pm on December 9, 2002. She was crying so loudly and sounded wonderful. The NICU team checked her over and gave her the Apgar scores of 6 and 9, wonderful for such a tiny little early baby. She was brought around for us to see briefly and then Andy left to follow her to the NICU. I was closed up and taken back to the Recovery Room, where my mom and aunt were waiting for me. My vitals were checked again and at about 10pm I was taken to the NICU to see Addah and then moved to a regular Mother/Baby room. My first impression was of how tiny she was, my fingertip filled her little hand and her head was no bigger than an orange. She weighed 4 lbs 5.8 oz at birth and was 17 inches long.
The Story Continues:
She was put on a forced oxygen breather at 25% oxygen, which we were told was very good since we only breathe 21% and this wasn’t much different. By 6am she had been taken off of the oxygen and was breathing regular room air.
A breast pump was brought to me that morning at about 8am and I started pumping. I was so proud of the 1 oz. of colostrum I was able to pump! As far as I was concerned, breastfeeding was the last thing that I had any control over of with this birth and I would not allow it to be messed with in any way. I started pumping every 1½-2 hours and got a pretty good amount to send down to the NICU.
My catheter was removed at 3pm on Tuesday, December 10 and I got up to move around some. I remembered having to relearn how to pee and walk from when Lakin was born, but this was much more excruciating that I remembered, I guess because I had the extra vertical incision this time around. By 6pm I felt good enough to take a wheelchair ride to the NICU to see Addah. She had been moved to a heated isolette and was doing very well. I got to hold her for a few minutes. She was so beautiful, so perfectly formed, like a little china doll.
The next day was a long day of aching, soreness, bruising and visitors. My father and his wife had come up from FL to be with us and late on Wednesday night, Andy’s mother showed up as well. My IV was removed and I was astounded at the massive purple and black bruises that were left from the poking in the OR. I looked and felt like I’d been in a major car accident. I had a 3x4? black bruise on my belly from where my skin had been clamped in surgery and a bruise on my upper right arm from the bedrail.
On Thursday I was discharged. We puttered around for most of the morning, mostly because I was still having so much trouble walking and moving around that it took me until noon to get dressed and feel comfortable enough to leave. We visited Addah one more time and then left with my mother around 1pm. It was so depressing to leave the hospital without my baby, but so wonderful to be going home to my sweet toddler girl. I had missed Lakin so much, I never spent more than 3 hours away from her at all until Addah was born.
Lakin is very confused, first from being at Grandma’s with us when the power was out, and then being at Grandma’s without us when we were in the hospital. She is so happy to be back with us but I think she wonders about the baby. She knew that the baby was in Mama’s belly, now she pats my belly, says Baby and when I tell her “no, your baby is in the hospital and will be coming home soon” she looks totally perplexed. She does have pictures of Addah and likes to point to them and tell us “baby”. I can’t wait for these sisters to meet!
Friday, December 13, 2002:
I got to nurse Addah today for the first time! It took her a few minutes to figure out what to do but she did latch and nurse for a few minutes before she got too tired. I was ecstatic, I forgot how wonderful nursing a newborn is!
We left the hospital at 10am and within 10 minutes we were sitting on the side of the road with a flat tire. We already were using the spare tire from a flat tire 6 weeks ago that we couldn’t afford to get fixed and now we were stuck here. It was pouring down rain and so, as much as I hated calling my mother because she has already done so much for us, I really have no choice. She came to get Lakin and I and Terry took Andy to get our tire fixed. Turns out it could not be plugged because the steel belts were showing so we had to buy a new used tire - $18. We had $30 so now we’re down to $12 left, the last $12 we have. Can things possibly get any worse?
Saturday, December 14, 2002:
Addah is supposed to be moved to an open crib today. Her isolette is being weaned down to 27º C from 32º C. At 3pm it was raised back up a degree because she’s still too chilly. She latched on right away today and nursed like crazy on both sides, but I am lectured by a disapproving nurse because since she nursed so well, she can’t finish the last 10 ccs in her bottle. I don’t think it should count against her since she did nurse so well; apparently the nurse disagrees. I am getting to the point where I feel antagonistic toward all of the nurses here and I can’t wait to come home with my little one.
Sunday, December 15, 2002:
Addah was moved to an open crib today at 10am. Her temperature needs to stay above 97º F for 24 hours so she can go home. It drops to 96.9º at 3pm so the counter is reset. It is very frustrating not knowing anything for sure about when she will come home. We are optimistic that it will be no later than Wednesday. At 10pm she is still doing very well, temperature is 98.1º.
Monday, December 16, 2002:
Addah is one week old today and her big sister Lakin is 17 months old today! At 10am, Addah was doing very well: temperature still over 97º. She was wide awake when I nursed her at 10:15am and she is on ad-lib feedings by bottle now, meaning that I can nurse for as long as she wants and then see if she wants any bottle. If not, that’s fine too. I am much happier this way… it’s much easier to maintain a milk supply when I can actually nurse my baby without fear that she needs to stop and take a bottle or have it counted against her.
The social worker came in to tell me that the doctor thinks Addah can go home tomorrow morning, as long as her temperature remains up through today. She is supposed to have a car seat test, where she is put in her car seat and monitored for an hour to make sure she can breathe okay while upright, and a hearing screen test this afternoon. We are told that either a nurse will come to our house twice in the first week to check Addah’s temperature or we can take her to our pediatrician to check her temperature and weight. I would prefer to make an appointment with our pediatrician to having a nurse in my house, but I will do whatever needs to be done. I am so excited at the prospect of my little girl coming home. I am catching up on nesting now…. doing all the laundry and dishes from when our power was out.
Tuesday, December 17, 2002:
We were told that we could take Addah home today but when we came in at 9am, her temp had dropped to 96.9, which reset the doctor’s orders to have temps over 97 for 48 hours. I am so upset. I nursed her and cuddled with her… we took her temp 30 minutes later and it was 97.4. The room feels cold to me… is there no way the low temp could have been due to the AC being on in December, or maybe due to nurse’s error. The neonatologist came in and said that if she still looked this good tomorrow with no more drops in temp, we could take her home.
Wednesday, December 18, 2002:
We got up early this morning to bring our baby home finally! My sister stayed out of school to watch Lakin and we were up at the NICU by 7am. We hung out all morning up there, only taking one 30 minute break to grab some food. At 11am, a different neonatologist came around, assessed Addah, consulted with a resident and then came in to talk to us. He says “she looks great, if she looks this great tomorrow morning she can go home”. Sound familiar? The nurse even told us that she thought it was silly… at this point Addah had almost 84 hours of perfect temps with only that one quick drop, WHY can’t she come home? I want what’s best for her, obviously, but what’s best for her is to be home with me, nursing when she wants to and not on the hospital’s schedule, cuddled up with me in our big warm bed. I cried for a while and then we left. I am so disappointed.
Thursday, December 19, 2002:
I decided that I could not sit in the NICU for another morning only to be disappointed again. I went in at 10am to nurse Addah and then as I was getting up to leave, the nurse said that the neonatologist was right there wanting to talk to me. He came in and said “she looks great, go ahead and take her on home”. I thought I might just leap into the man’s arms and kiss him! I have never heard such wonderful news! I practically ran out to the waiting room to tell Andy and Lakin the good news. We left briefly to take Lakin to my mom’s and then came back to pick up our little baby. We left the hospital at 2pm. Addah Shannon weighs 4 lbs 3.5 oz. as of this morning, and she is 10 days old.
UPDATE: Tuesday, January 14, 2003:
In many ways it seems like it’s been forever since Addah was born, and in many ways it seems like yesterday. We fought nipple confusion for about a week but now my little one is nursing wonderfully and all the time. She’s made up for lost time… we weighed her yesterday and she was 6 lbs 4 oz, 2 whole pounds of weight gain in only 3½ weeks. She was 5 weeks old yesterday and is just now starting to wake up more frequently and behave like a normal newborn acts, if that makes sense. She has pretty much slept the past 3 weeks away and now she has more frequent awake and alert periods. She is gorgeous, looks just like Lakin did at the same age. Lakin adores her sister, she kisses her and tries to pick her up if we don’t watch her constantly. Addah loves her sling, she settles right down into it and snoozes away, which is great cause without it I don’t know how I’d keep up with Lakin, especially since Andy has a new full-time job that he started the week after Addah came home. She sleeps happily between us.
I had a lot of unresolved feelings about Addah’s birth but I think I’ve put most of them to rest. The birth could not have been further from what we had planned and what we wanted so badly, but I know that had I not gone to the hospital when I did, things could have been disastrous. To my mind, hospital’s are intended for emergencies, and that is what we were having. I feel no guilt about having planned a UC homebirth and if I had it to do over again, I would have done things no differently. It took me a while to realize that I did not cause the abruption and I could have done nothing to prevent it. I still mourn the fact that I have never had the gentle, vaginal births that I wanted, and since we are not having any more children, that I never will…. but I do have 2 wonderful, beautiful and intelligent little girls and that does help to soften the blow quite a bit.
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