Lily was born on a cold Thursday morning at 38 weeks. Since week 18 I had been having Braxton Hicks contractions and this continued to worsen as the pregnancy progressed. At 36 weeks I started getting episodes of contractions a few nights a week that were more intense and regular (5-7 min) and could not be stopped with water/rest/food/shower (unlike BH contractions). Those contractions would last 3-5 hours and then stop. I was worried I wouldn't know when to go to the hospital, but I figured as long as I could talk through them I wasn't going to go in. Plus I read only a very small percentage of people actually have their water break before going into labor prior to the time they go to the hospital.
The days prior to her delivery I kept telling Jake I felt like I was a bear wanting to hibernate. Every free second I just wanted to lay in bed, and when I woke up just eat carbs. Throughout the pregnancy I had no real symptoms until week 36 when I started to get slower at work and uncomfortable on my feet all day. Earlier that week at work I even traded a morning case for afternoon so I could lie down. I wondered in my head if the strong desire for food and rest meant she was coming soon.
Wednesday night I was so tired I ate dinner at 4:00 pm and then was in bed asleep by 8:30 pm. I shot straight up in bed after feeling a "pop" (or something bizzare) at 11:30 pm and shouted at Jake "My water just broke!!" . And then I hopped out of bed to not make a mess, and realized there was no water anywhere...I said "Oh never mind what a weird dream" and then I took a step and then the floods came. This was the one time I wasn't having contractions so I knew we had plenty of time, plus I was a first time mom so I figured I had plenty of time.
We called the hospital, got organized, and arrived at the hospital around 1:00 am. By this time I was having intense contractions every 5-7 minutes. The nurse made me go on a walk to progress things faster, and it certainly did that. I was so excited but getting nervous the pain was going to get worse so I told them to call the anesthesiologist.
I got my epidural at 3:00 am, placed by my former UNMC resident mentor (he recently accepted a job at the hospital where I delivered!). It was fun because he was one of the people who taught me to place epidurals when I was learning! It was also fun to be that patient that calls anesthesia at 3:00 am. (well, it taught me empathy for when the roles reverse again!) After the epidural I felt like a million bucks and once they started a little pitocin I developed a hot spot that was fixed with a lidocaine bolus (which also paralyzed my legs), and I don't think I was more comfortable in my entire life than I was during that hour and a half. I came in at 4 cm with a low baby, and by the time that lidocaine wore off some I wondered if the "need to push" was what I was feeling. Indeed I was complete. Also at this point...I hadn't eaten since about 4pm the day prior I was STARVED and since I couldn't have anything but clear liquids I asked them to bring me all of the highest calorie clear liquids we could find. I did get caught sneaking a banana in my mouth by the nurse, yes I should know better given my profession is the one who made this rule, but that morning I had a skills session on difficult airways and how you can suck the stomachs from the pregnant woman through LMAs and I trusted my anesthesiologist, so I figured why not. .. . . . anyway I digress....*and I strongly recommend following the guidelines for your own safety (food flowing into your lungs if you have to go under anesthesia is not something you should risk).
The nurses were so wonderful and told me we were going to start pushing before the doctor arrived and I was definitely nervous "what if the baby comes before she gets here!". I pushed for a total of 15-20 min and when the doctor walked in the room I had only two contractions of pushing before she was born. I had a great time with delivery, I was laughing and really enjoying the entire process. I thought to myself I'm going to have five more children.
A few minutes later everyone was more hush hush and I was trying to overhear the whispers of the doctor and nurses over my screaming baby (beautiful working lungs) on my chest. I have seen over a hundred labor and deliveries and so I knew a lot of bad things that could be going on....plus there was a lot of blood on clothing and garments, etc. I started to black out and get really nauseous and told the nurses that my blood pressure needed fixed, NOW (my anesthesiologist brain was now on). They were already hanging pressure bags, and when I looked at my vital signs my systolic pressures were 60s-70s. I handed Jake the baby and just waited for over an hour sick while they kept stitching. These were all "superficial" bleeding lacerations, no bowel/bladder damage, no deep perineal tears, the uterus had contracted down fine and wasn't excessively bleeding. She was a healthy 6lb 7oz baby (never did I think I'd have a baby so small! We had only two clothing items that (sort of) fit her when we got home!)
That being said, I still lost half my blood volume. My hemoglobin was at 6 by the following morning (down from 12) when I did finally get a few units of blood. The entire 24 hours prior I tried not to be the annoying anesthesiologist but I was telling every nurse with ears "I think I need some more resuscitation" " Excuse me, Possibly, maybe, I think I need blood" -- or when they considered to shut off my fluids that were at 125ml/hr "Wait can we just keep them running". Keep in mind, for those who don't know all of the behind the scenes of anesthesia, resuscitation and balancing all of these hemodynamic changes (bleeding/fluids/blood/etc) is something I do every single day at work. And I wasn't able sit up without blacking out and having intense ringing in my ears. I felt much better after getting blood, I felt like I could finally take care of Lily a little better than just feeding her and passing her to Jake.
I'm so grateful to my doctor and the great nurses we had.
We were discharged home after two nights, at that point I had not even put clothing on and was just wearing hospital gowns (I was still weak and feeling ill). I also hadn't walked other than to the bathroom so I was very nervous! After an hour and a half of heating up the car and trying to figure out how to put her in her car seat we were homeward bound!t I continued to recover each day after that, and at two weeks postpartum I am still on the mend. Baby has been perfect.
For more pregnancy posts click here
For a letter I wrote to Lily while pregnant click here
