As I've previously written, around 28 weeks my blood pressure skyrocketed. As a person who usually has a normal BP, this was alarming. I was put on Procardia three times daily, and began weekly NST's and Biophysical profiles (a detailed sonogram).
There are all kinds of risks associated with PIH- namely, that it will developed into Preeclampsia, organs in mom will shut down and baby will need to be delivered quickly. Thankfully, in my case, it never developed. There were a few times when there was concern that the high bp was restricting blood flow to baby- but it ended up being just that- concern. Basically things just went from week to week, I knew that at any given appointment or at any given time, baby could need to be delivered. NOT the easiest most relaxing way to spend the last part of a pregnancy :) Especially for someone who had such high aspirations for a normal, natural birth. At some point during the last part in my pregnancy, it became apparent that induction was a very real possibility- as was a c-section. This disappointed me, but I knew that the goal was healthy mom, healthy baby.
Added to the stress was the realization that my midwife might not be the one to deliver the baby. She had personal family circumstances arise that kept her out of the office for big chunks of time. Thankfully, both she and my ob wanted to keep me pregnant as long as possible - so it was 5 bazillion office visits for me! I began to know the whole staff on a first name basis. I worked up until about 2 weeks before I had her- this is when the water weight began piling on. I went from a net gain/loss of 0 lbs, to gaining 20 lbs in the matter of a week or two. 10 of those lbs were in 3 days. At this point, the midwife put me on bed rest. I went home with my gigantically swollen ankles ( who am I kidding? my gigantically swollen EVERYTHING) and tried not to do much. I truly feel for women who end up on long term bedrest- it drives you crazy!
On Friday, July 31st I went in for another NST. At this point I was barely dilated at all, baby had not dropped and my due date was still over a week away. I saw the OB who wanted to go through the weekend, and if nothing had happened by Monday, have one more sono/NST and then induce on the following Monday. I was really bummed- it didn't seem like baby wanted to come out, and induction would follow.
After the weekend I went back in- had a sono and the sonographer noticed that my amniotic fluid was low. As we left to go to the NST room, she made a comment that I didn't really notice then- she said ' see you later today, little one'. A normal NST followed, and then the exam. I went in defeated because as of that morning, I knew baby hadn't done anything new. To my surprise and shock, his words after the exam were 'well, you're dilated to 2, baby is engaged, and have you noticed any leaking fluid?' to which I replied ' umm no, nothing really'. Apparently I somehow missed that my water was breaking..but very slowly. He then called over to L&D and got a room set up for me..I called hubby- my mom and sister were in the waiting room so I called them and told them what was happening. The OB had an intern walk me over, which was silly ( I work in the hospital and know it up from down, but I digress)..so we chatted and I tried to get over my nervousness.
You see, I didn't feel crampy. By standing I did see that the baby indeed had dropped- but I really felt the same. I feared a long, pitocin induced labor that didn't progress, resulting in a c-section for lenth of labor ( since my water was breaking I was on the 24 hr clock)..or stress in the baby resulting in an emergency c-section. We knew the cord was wrapped around her neck twice, so any dip in her HR would mean immediate action. In other words, I was a crazy ridiculous ball of nerves.
I got my iv, got settled..was put on the external monitors, and to my surprise, I was contracting regularly on my own! In a short amount of time the contractions intensified and kept coming..I was going into labor without any help! Then the OB and intern came back in, broke what little was left of my water..and I was put on an internal monitor for contractions. This didn't thrill me, as I was then stuck to the bed or just next to it. I had made peace with the pitocin, as long as it was increased very slowly, to just what was working an no excess. Even though my PIH risked me out for a water birth, I still desired the best experience possible. At this point it was about 2 in the afternoon, and I was still fairly comfortable. My husband went home and got my suitcase, my mom and sister ran to get me last minute things I needed.
A friend came to visit, my in laws stopped by. This began the influx of well-meaning family and friends who were part of the day. I began to get uncomfortable, but my BP was doing okay and baby's HR was stable. By 5pm, I had been progressing at about 1 cm/hr and it became increasingly difficult to talk to the people in my room. When I realized pitocin was going to be in the equation, and I found out that Epidurals generally lower blood pressure, I decided I would have one. I figured heck..if I'm stuck to the bed anyway, can't try different positions, and can't have a water birth..and if it can keep my BP lower thus reducing my chances of a c-section, why not? But I wanted to wait as long as possible, to make sure I was progressing since Epidurals can slow down labor.
The nurses were respectful of my wishes, and even supportive- one nurse told me she thought I was doing the right thing instead of getting it as soon as I possibly could ( which according to my OB is as soon as you're in labor..blah...but moving on). By 7pm I was starting to ask where those lovely anesthesiologists might be..and one was located, and could be called whenever I wanted. By this point I was about 7cm and decided it was time. I firmly believe that labor would have been much more manageable had I been free to move about the room. The epidural was put in, and that was one of the most uncomfortable parts of the whole experience. I was contracting like CRAZY and had to sit still while it felt like aliens were crawling up my spine. Once it was in, my right side numbed up but my left did not. The anesthesiologist came back in, adjusted things..and it seemed to get better. After a few hours, more family came and went, and the nurses had a shift change.
The new nurse came in, kicked all of the family out except for the 3 person limit..and I thought I'd ended up with nurse Ratchett. Despite being the only nurse to enforce the visitor limit- she was wonderful. After 7cm I stalled out, and she worked hard to keep rotating me and helping me get in positions where the baby could move. Baby seemed to get stuck but she was so encouraging, telling me I could do it, lets try this or that, etc. I got a little sleep..and by this time the only people waiting were my mom, mil and sister..and hubby of course. One spot never truly numbed and that was an odd feeling- intense pain in one spot but nowhere else. Despite the turning, different positions, etc..I was not progressing. I began to get worried. I fell into a fitful sleep around midnight, just waking for the nurse to check me. I don't remember much here - just pain, and small periods of awareness. After what seemed like an eternity, I felt a new sensation. It felt like tons of pressure all of a sudden. I called the nurse, who checked me and found I was at 10cm!
I started feeling really pushy, and pukey. Not a good combo. My mom came in, with hubby, and my sister and mil waited in the waiting room. ( My sister is autistic and while being super excited, wasn't sure she could handle seeing the baby born) This was about 3am. I'd accepted that probably the OB would deliver the baby, but to my surprise my nurse told me that when my midwife heard I was in labor, said she'd do the delivery even though she wasn't on call. I was so happy with this, but then I wondered..WHERE is she? I knew she lived close by and I needed to push, or puke, or both- RIGHT NOW. The room became a flurry of activity as as scale was brought in, light set up, and things were prepared. I couldn't believe it was time!
Finally, when I thought I couldn't take it anymore, my midwife came running in the room, apologizing profusely. She'd been pulled over for speeding, and while the cop let her go, it slowed her down quite a bit. She gowned up and I pushed once, twice, three times..and on the fourth, we had a baby! I was really out of it and still feeling sick, and hubby was dumbfounded, so my mom finally asked if we had a boy or girl. To all of our surprise, we had a baby girl! As we thought, the cord was indeed wrapped around her neck twice. My husband said the first few moments were scary because she was so purple- but the midwife expertly unwrapped the cord quickly and all was well! She started crying, I was crying, my mom was crying..it was a teary event! She was immediately set on my chest, and after some IV zofran I was feeling great much less pukey. She was born at 3:16 AM, at 7 lbs 14 oz, and 19 1/2 inches long.
After some stitches ( I almost didn't tear, but her darn shoulders changed that!) and some initial nursing, we were left alone to soak in being a new family. My sister and MIL got to meet Evelyn, and soon Evie and hubby were passed out. Around 5am we were moved to our new room- amidst a gigantic thunderstorm..and I was too excited to fall asleep. My blood pressure was still high for a while, but otherwise I felt fantastic. Looking back on it all now, I'm just so thankful. Her birth, despite the complications, really couldn't have gone better. While I hoped for a natural birth, I know that medical intervention is there for situations where its needed..and in our case, it was. PIH and Preeclampsia can have dire consequences if left unchecked. In addition, my midwife was sweet enough to deliver her despite being not on call and really off work for the week b/c of family circumstances.Also, I'm forever thankful for the experienced, kind, overnight nurse I had who encouraged me the whole way and worked tirelessly to help me avoid a c-section. But here's the BEST part :