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There She Grows

Upon discovering I had oligohydramnios, we were told Lilah had to come out. The induction was scheduled for the following day. I worked a normal day at the office (my last) and ate a hearty dinner with mike as instructed. At around 11:30 we checked into the hospital. They were going to administer a gel called cervidil to help progress my dilation.

I had heard a fair share of horror stories from mothers who’d been induced with pitocin, and was hoping to avoid it. I had started dilating a week and a half ago, but some scarring on my cervix (from a biposy many years prior) was preventing me from dilating beyond 1cm. That seemed to be the only obstacle standing in the way of Lilah’s arrival. It was hoped the Cervidil would take care of this problem by morning and things would start happening on their own shortly after.

We settled into our room and I had a monitor placed on my belly to keep track of Lilah’s heart rate and my contractions. I was also given an IV to keep my fluids up. Then the nurse administered the cervidil. She doused a bit of gauze with the gel and rubbed it up against my cervix – with authority. It wasn’t the most pleasant experience. It was late and we were told to sleep; I would hopefully be dilated to about 4cm by morning. My husband was in a reclining chair by my side. Despite the surroundings and anticipation, we slept.

Dr Wu arrived around 8am and came to check our progress. Unfortunately I was STILL only dilated about 1.5 cm. This scar tissue was a real bitch, and the cervidil wasn’t effective enough on its own. But Lilah had to come out, we had to get things going. He reached in and began roughly massaging the cervidil into my cervix. And holy crap did this hurt. He did this for a few minutes and dilated me a few more centimeters. Basically this accomplished in a few minutes what would normally occur over the course of a few hours of early labor. I will tell you, it did not feel good. When that was over I felt fine and wasn’t worried, but it took my body a good amount of time to stop shaking. It was weird. Mike was very helpful in getting me to relax myself again.

Dr. Wu had really moved things along, I was feeling some contractions now. Not too strong or painful but definitely noticeable. Things were finally happening. It was around 8am on the 21st, and even though we had been in the hospital many hours already, this was about the time when labor officially began.

A few more hours went by. My contractions were becoming stronger, though still completely manageable. It was feeling like really bad menstral cramps, but radiating around from the sides of my body to the front. I still didn’t feel like I needed pain meds so I was just hanging out with Mike, and he was playing relaxing music from his ipod for me. My mother’s plane from Chicago had landed and she was on her way to Glendale Adventist. Lilah’s heart rate was still being closely watched, because of her high-risk situation, but she was doing fine.

The doctor returned after awhile and found that I still had not further dilated on my own, beyond where he had left me. So he had to do the dreaded manual dilation process again. I braced myself knowing what to expect but it didn’t really make it any better. Again I was left shaking for awhile afterwards and Mike helped calm me down. But again, he had brought me in 5 minutes to where the last few hours should have: 4 cm. By this time my mother was around. She came in to see us in the room and hung out for a bit. I was still doing fine, able to carry on conversations while feeling those contractions a bit more.

The cervidil gel is only to be left in for 12 hours. So around noon, the cervidil-soaked gauze had to come out. Unfortunately it was clear that I did not dilate enough on my own, even with the help of the cervidil so it was time to bring in the big guns: pitocin. From all I had read and heard (believe me I researched this stuff to death during the pregnancy) I knew that this was the time, if any, to have my epidural. Because once the pitocin got going the contractions were going to be extreme. So I let them know I was ready for the epi, and the anesthesiologist was summoned. This part was something Mike was really nervous about, and I was a bit too, but it was not at all bad. They gave me a few tiny shots of novacaine in my back, to numb the area so I wouldn’t feel the bit needle, and I didn’t. As soon as the epi was administered, the nurses could tell I was having a big contraction (the monitor was keeping track). I couldn’t feel it at all. nice. Once you get the epi you can no longer leave the bed, so no more bathroom breaks. Instead I had to have a catheter down there. They hooked that up after the epi was already starting to take affect, so I didn’t feel it one bit.

As the epi kicked in more and more, my legs became numb. At first they felt tingly and weird, kind of cool actually, until eventually I lost all feeling from the hips down. This was expected but alarming nonetheless. I was extremely concerned that i would be unable to actively push when needed, since I couldn’t even move a toe no matter how hard i concentrated and tried. But it wasn’t time to push quite yet. there was still the issue of my stubborn cervix. So now, with the epi in place, it was time for the pitocin.

The pitocin was administered via IV drip. Immediately, my contractions increased dramatically in strength and length. they were so long and hard they were overlapping one another with little to no break between them. i couldn’t feel any pain at this point, but the experience was extremely stressful for little Lilah. Aparently the baby holds her breath during each contraction, and now she was barely breathing at all. The monitors indicated her heartrate dropping drastically. I had to have an oxygen mask to help Lilah get the oxygen she needed. The nurses were running around, clearly concerned, which made us very nervous. When they administered the o2 mask i felt scared, and Mike could see the heartrate dropping on the monitors so he was very scared as well. We could sense it was serious because of the attitudes of the nurses – more and more kept running in and they were in a clear state of alarm. Suddenly her heartrate dropped from 140 down to 75 in an instant! The pitocin was way too much for Lilah and had to be removed after only a half hour.

They quickly stopped the pitocin, but it did not immediately help the situation; strong active labor was already underway. They had to slow it down to give Lilah a chance to recuperate, so i was given a quick shot of terbutaline, something that immediately slows labor. There were tons of nurses around me now; so many more had been called into the room to deal with this emergency, so they were all buzzing around me frantically which really made Mike and I nervous. Some were calling for the shot of terbutaline and then administering it while others kept adjusting my o2 mask and trying to flip me around to change my position. I could not do it myself due to the utter and complete numbness of my legs, so I felt damn near useless which added to my frustration and nervousness. Each time I need to move I had to have nurses and Mike help turn me over, while I grabbed the bars and tried to pull myself over as best as i could with the strength in my arms. Having no feeling in your legs and watching people move them around for you is a very strange sensation, like you are watching them do this to someone else’s body. still, i’m glad i wasn’t feeling any pain at that point. ;p

After experimenting with various positions (lying on either side, being propped up in bed or completely flat, etc) and after the terbutaline took affect, they finally got me to a point where Lilah was safe; her heartrate was back up and labor had been slowed down enough to allow her to recuperate her oxygen. That brief period of chaos and concern were some of the scariest of my life. I know Mike was going through the same feelings of fear and concern watching this all happen. Poor guy – he could have had a heart attack from his worry but he didn’t show it at all, he remained stoic and supportive as can be, holding my hand and talking to me, helping me remain calm.

Things were back to ‘normal’ now, although I had to wear the o2 mask for the rest of the delivery just in case. I was suddenly so tired out from the experience that I closed my eyes and actually fell asleep for about a half hour. Even though the pitocin had only been administered for such a short time, it had done its job of solving the cervix issue; after so many hours of waiting, I had suddenly dilated from 4 to 10 cm in under an hour – amazing! Since everything else had been rearing to go, I woke up from my brief nap to more alarm from the team of nurses – it was time to start pushing, Lilah was ready to come out NOW.

But where was Dr. Wu? He was dealing with other patients at that precise moment. Lilah wasn’t waiting though, she was coming! The nurses were scrambling around trying to find the Doc, and other nurses suggested more terbutaline to slow labor until he arrived. I was very against this – the terbutaline makes me feel weird, out of it and somewhat hungover – and besides, after all this, if she is ready to come now let her come! Luckily they were able to find the doc in time. After several pages, he ran down the hospital hallway to my room. My mother was sitting outside and saw him running to my room – a scary sight for her I’m sure.

Now that the doc was here, it was time to push this baby out. They lost her heartbeat on their monitors, so in order to keep tracking it they had to use an internal monitor. This was something that had been introduced to mike and I during our birth class. It is a long white stick for lack of a better description, with a tiny hook on the end that actually attaches to the baby’s skull (!!). I of course, wanted to avoid this no matter what, so when I saw them brandishing this familiar object and sticking it inside of me I pretty much lost it. So many things I had hoped to avoid in my ‘birth plan’ ended up needing to be implemented due to emergency … and now this? For some reason this was the last straw that kind of broke me and I started bawling uncontrollably out of fear for the baby. Behind the 02 mask and unable to move, watching them stick that in me made me feel completely helpless. Mike and the doc/nurses tried to calm me down, the doc assured me that Lilah was going to be absolutely fine and that I had to calm down now and focus on pushing, so thats what I did.

I was convinced I would be unable to actively push with no feeling below the waist, but the nurses and doc told me it was mostly mental – just to concentrate on pushing. Because of my body shape, the doc had told me weeks prior that i was ‘born to have babies’ – I have a wide pelvic opening that would make birth easier. I think I have this to thank for what happened next. doubtful as I was, she came out in about 2 minutes! It was amazing. Suddenly, there she was! I closed my eyes, pushed a few times, and when i opened them I saw Dr Wu holding my baby! It was unbelievable.

a proud and happy mike took our very first family photo. an image we will always cherish! welcome to the world, lilah joy.

Lilah’s due date was July 1st, the same as Mitch and Sara’s wedding. The pregnancy had gone really well and things seemed on track for a healthy birth. But when I went in for a routine check-up on June 19th, I got some news that changed things a bit.

Aparently Lilah had not grown much during her last three weeks in utero, and the lack of any growth at all during this last week was particularly alarming to Dr Wu. He ordered an ultrasound and saw that there was now virtually no amniotic fluid supporting Lilah. I was diagnosed with oligohydramnios, the condition of having too little amniotic fluid. The cause of this is unknown, but there are two risks associated with it. For one thing, there is a greater chance of the cord becoming wrapped around her without enough fluid to be floating around in. And, the low fluid indicated that the placenta had ceased functioning as it had been; she was no longer receiving the proper nourishment.

For weeks, the doc and nurses had been telling me how low and ready Lilah was, and that she would be coming any day. Because of this, we were prepared for an early birth, and it probably would have happened naturally were it not for some scar tissue on my cervix preventing it from dilating beyond 1 cm. The rest of my body knew she was done cooking in there, which is perhaps why the placenta had begun to slow down its fluid production.

Upon this troubling diagnosis, I was immediately sent to a testing room where I was hooked up to a machine to monitor Lilah’s heart rate for about an hour. The doctor recommended delivering Lilah asap, to ‘rescue her’ which was very alarming to hear. Based on the results of this hour of observation, I was either going to be induced right then and there, or be able to wait until the following day. If the tests indicated that she was really in distress, an emergency C-section would have been ordered.

It was a very frightining hour, waiting to hear how my little one was doing in there. But aparently she was ok with a strong and steady hearbeat, and could wait one more day. I was told I would return to the hospital the following night, and wouldn’t be leaving until I had a baby in my arms!

That is how we found out that, contrary to the birth plan i had written, i was going to be induced and we were going to meet Lilah sooner rather than later.