Monday, March 10, 2014

Ben's Birth Story

Flash forward one year to Ben's first birthday!
I had been pregnant FOREVER it seemed. My due date was February 21st, but I was still chugging along with no real indication that Ben was coming anytime soon when that date came. I wasn't too concerned, but I had to have that talk with the doctors when you decide when you will induce if it doesn't happen on its own by a certain point. Of course, I read a lot about it, and I was very worried about the negative effects of inducing, of starting out on the "intervention" train at the very beginning. By that point in my pregnancy, I had decided that I would most likely have an epidural, but my plan was to just go along with it and try to be able to move as much as possible, etc., and just play it by ear. I knew that I didn't want to have any opiates (or anything along those lines).

I had a birth plan and everything, but I was really mostly concerned with the newborn procedures (i.e. the Hep B shot, the Vit. K shot, the eye ointment, and cord cutting). I really wanted to be able to hold Ben and attempt to breastfeed before any of those things took place (besides maybe the cord cutting).  I was told I could delay most of it until after the first cuddle, so I was happy about that.

My doctors and I decided that we would induce on March 1st (a Friday) if I didn't go into labor on my own by then. I researched induction, and the camps were fairly split. Some said that your body knows best and no one stays pregnant forever, don't induce! Others said that after a while, the placenta isn't great anymore and there is not enough room in there, induce after 41 weeks! I decided the best thing to do was to be well-informed, but to trust my doctors. When I knew it was likely I was going to be induced, I altered my birth plan. It was basically the shortest birth plan ever, because I didn't really have much control over anything anymore when it came to the actual laboring process.

The night before my induction date, I went to the hospital for a prostaglandin treatment. It was pretty easy, and I was home before I knew it. I was scheduled to begin my induction at 7am. When I got there, they took me right back to a delivery room where I began all of the pre-stuff. Outstanding paperwork (I had pre-checked in, but there are still some forms to fill out), got my IV in, etc. I was assigned the most lovely nurse. She was so sweet and reassuring. We got to the point where she was about to start my Pitocin drip, but I asked her not to do it until I was able to speak with my doctor. He came in and talked to me about starting me on the Pitocin and how it would progress. Then, a hour or so later, my other doctor came in and broke my water. (I went to a practice of three doctors. The one on duty during my labor was busy birthing a baby at that moment, so another doctor from the practice that I was very familiar with came in to break my water. It was nice to see her.).

Then it wasn't very exciting for the next few hours. My doctor regularly checked in on me. I basically didn't feel anything for a while. Then, I started getting mildly uncomfortable at each contraction. I have a very clear memory of my nurse telling me that I had a high pain threshold. I don't really, so I was pretty proud of that. I think she was just trying to give me confidence. Then it snowballed, and I was in so much pain at each contraction that I didn't know how I was going to make it. This was in the early afternoon, basically right during lunch time. I remember this because my nurse was on her lunch break, and I felt bad because I told her that I didn't think I would want my epidural until she got back. But then, the pain got to be too much, but I was attached to her emotionally already, and I really wanted her to be with me when I got it. I couldn't do anything to mitigate the pain, like move around or stretch, because I had to be monitored constantly because I was on Pitocin. My doctor asked me if I wanted something to take off the edge (an opiate), and I was SOOOO tempted. But I held off, only because I knew I could get the epidural soon. I also managed to hold off on getting it until my nurse came back, and the epidural was put in around 2:30pm.

The epidural process was pretty uneventful. They made Dan go and sit in the corner (he gets woozy about blood sometimes), and my nurse held my hand. Sweet, sweet relief. Sort of. It only took to half of my body at first, and it took about a solid half-hour for the other side to get the memo. But, eventually it did. Oh man. What. A. Difference. At that point, I was feeling pretty good, and I was so ready to have the baby. However, at about 3pm, I was only at 4cm.

I was checked again around 5pm and was at 5-6 cm. Better, but I wished I was farther along! However, I wasn't too upset now that I wasn't doubled over in pain. I remember having a popsicle an hour or two earlier. My nurse asked me if I wanted another one, and I held off. I was going to wait for an hour or two, give myself something to look forward to, to break up the time. But ladies and gents, I never got that second popsicle.

Starting at about 5pm, the baby's (it is hard for me to refer to Ben as "Ben" at this point in the story, since this is when he started having a hard time) heart rate would get very low during each contraction. My nurse started putting me in different positions to see if that would help and relief some pressure on the poor guy. We thought he was getting too squeezed during each contraction. At first, my doctor wasn't too concerned, because the baby would recover very nicely each time. But, the changing of positions didn't help too much. And then, there was a shift in my doctor's opinion. I am not sure what did it, but it got more serious. They inserted an internal monitoring device and kept shifting me around. Then, my doctor decided to do another check. I had just had one 5pm-ish, so they normally don't do one again so soon (it was getting near 6:30 around this time). He checked. Then, everything moved at the speed of lightening. He told me that this was going to be a C-section, and it was going to be NOW. The cord was prolapsed, and it was getting compressed by his head, cutting off all air supply to him. Later, I found out that I was pretty much fully dilated at this point.

Everyone was working in a whirlwind around me, getting me ready to move to the surgery room. I was insanely scared, and began to only focus on very small details. For instance, I remember telling one nurse (because now there were about ten around me), "Don't forget to wheel the IV with me, I'm attached to it!" Otherwise, I was pretty quiet. Dan was whisked away to put on scrubs so that he could go into the room with me.

I was wheeled into the surgery room, and my doctor picked me up and put me on the table himself. From talking to my nurse afterwards, this is pretty rare. Then, the anesthesiologist was there, and she was extremely stressed out. She asked my doctor how much time she had, and he said 2-3 minutes tops, and she said "That isn't enough time!" Even though I had an epidural already, I guess it wasn't up to the strength they use for C-sections. She dosed me up higher, but I could still feel one side (similar to when I first got the epidural and one side took longer). The doctor began doing something and asking me if I could feel it. And I *could.* And it was not good. The whole experience was terrifying. After what seemed like minutes, but was actually seconds, I was told that I was going under general anesthesia, and that was the last thing I remember. Ben was born at 6:34 pm. Dan never was allowed in.
Poor Ben right after birth. This picture actually makes me sort of sad, because I think of how miserable he must have been feeling. But I am so thankful to have it! It was taken with Dan's phone by a nurse. She nicely went out and got his phone and then brought it back to him. This must have been right after 10 minutes, because he looks pinked up.
When I came to, I was in a general recovery room, which was a big room with other patients. My area was sectioned off with a curtain. I was by myself. I felt miserable, but also still very numb. I had a hard time swallowing, and, oh yeah, I really wanted to know what happened to my baby! Was he OK??? I had no choice but to sit there and wait for someone to come talk to me. I felt so helpless. Finally, either my doctor or Dan came in and explained things to me. Turns out, my doctor had come in earlier, I just have no recollection of it. I was told that Ben had to be resuscitated at birth. Due to the amount of time that he was without oxygen, they were concerned about possible brain damage and seizures. He was currently being treated by being in a low-stimuli environment and having cooling treatment. The cooling treatment was supposed to mitigate brain damage. I was told that if he had any seizures, he would need to be transferred to another hospital that had the highest level NICU.

They told me that I couldn't go see him until I could move my toes. So that was my first physical challenge as a new mother. I concentrated so hard on those damn toes. After what seemed like an eternity, I was able to give one a slight wiggle. I was hauled into a wheelchair, and pushed to the NICU.

Ben undergoing the cooling treatment.
My poor sweetheart. Ben was high up on a table, in only a diaper, with a bunch of cords coming from him. I wasn't supposed to even touch him, because of the low-stimuli environment treatment, but I forgot about that and reach up to touch his toe. That was basically the only part of him I could see, because he was high up on the table, and I was way down low in the wheelchair and too numb to stand. I asked Dan to take a quick picture of him with his cell phone and show it to me. He had already taken a few pictures, but I wanted one of right that second so that it was like I was looking at him. He was all red and splotchy, and I felt so sorry for him that he must be feeling cold and miserable.
This is the picture that Dan took for me the first time I saw Ben.
The NICU doctor gave me more information and said that a lot would be determined on how Ben did throughout the night. I really tried to use all of my persuasive techniques to get the doctor to tell me if Ben would have any permanent damage or not. But he absolutely could not say either way. So it was a waiting game. Looking back, I should have been so thankful that he was even alive. Instead, I was greedily wanting him to be 100% healthy, immediately. I don't think I even thanked the doctor for saving his life.

I was wheeled to a post-partum room in the maternity ward. It was hard hearing the cries of newborns in the other rooms. Dan and our parents came back with us. I wasn't much company, but we did finally tell everyone Ben's name. As an aside, before we came to the hospital, I told Dan not to tell anyone Ben's name until I was there. I really wanted to see everyone's reactions, especially Dan's dad, because Ben's middle name, Steven, is named for him. In my head, the only scenario where this could happen would have been when Dan went into the waiting room after Ben was born and told everyone to come back. I had planned on having everyone in shortly after Ben was born, so I thought the suspense wouldn't last long. Well, Dan kept to his word, and no one knew Ben's name! Even the hospital staff were just referring to him as Baby Petouvis. It is funny looking back on it, because I would have totally been OK with Dan telling Ben's name in this situation, but he stuck to his word dammit!

They cleared out pretty quickly, and Dan and I were left in the room. I couldn't get out of bed, so I had Dan bring me some toiletries that my sister had put in a care package for me. I remember being very methodical about this, really seizing control of this small thing. I went though each product. The lotion, the face wipes, the little disposable toothbrushes, the deodorant, the mouthwash, brushing my hair. Eventually out of exhaustion, I zonked out.

I woke up with a start around 2am. I was in a panic. What could I do to help Ben? I felt so helpless. And that is when I seized on pumping. It was perfect, and really the only thing I could do to help at that point. As soon as I thought about it, I had to begin it that second. So I switched on the light (Dan was thrilled), called the nurse, and she wheeled everything in.

Ben had no seizures through the night, and they felt confident in taking him off the cooling treatment by morning. In fact, I was given the clear to pick him up and attempt to nurse. I won't get too into the nursing stuff, because I talk all about the beginning of nursing here.

Ben was a healthy weight when he was born (8 lbs. 1 oz.), so he had that going for him. And he just kept getting better and better. By the third day (I think) the NICU doctor was confidently telling me that Ben would be fine. The relief I felt was indescribable. But also, at that point I felt like, of course. Of course, he would be fine. He is Ben; he is so strong. I feel like having that thought is offensive to mothers of babies that do have problems, and I don't mean it that way at all. But that is how I felt. So thankful, but also like I expected that. I expected for him to be 100% OK. (I did not feel like this the first night, only after being with him the few days after).

Ben's first outfit! Loved that outfit. He grew out of it by the end of the week.
Later, I found out more details of his birth. He was pale and not breathing when he first came out. His first Apgar score was 1. They performed manual ventilation, and his color improved by two minutes, but he was still having trouble breathing, so they kept the manual ventilation going for about 5-6 minutes. His five minute Apgar score was 5. They kept suctioning and they used a neopuff (a sort of electronic ventilator) until 10 minutes of age. His Apgar score at 10 minutes was 9.

After his birth, I had all sorts of self-doubt. I thought maybe my choice to be induced somehow contributed to the prolapsed cord. My good friend who is a cardiac neonatal intensive care nurse told me that the cord probably was in that position regardless. She thought that actually being in the hospital for an induced birth might have help, because otherwise it may have happened if my water broke on its own at home. My sweet labor nurse (who visited me in my post-partum room the next day) echoed these sentiments. Who really knows one way or the other. The important thing is that Ben is great. I would drive myself crazy thinking of whether the decisions I made contributed to or saved him from his complications.

So happy to be going home. Ben was peeved that his morning included his circumcision and Hep B shot. As if he hadn't been through enough already people! No cameras!
A few months after Ben was born, they had a NICU reunion and I made little thank you notes for the NICU nurses with pictures of Ben. I received a letter back from one of the nurses. I really treasure that letter. Here is a bit of what she said:

"Honestly, I can say to you that Ben is a miracle. The doctors, nurses, and quick medical intervention saved him. When I left, shortly after admission, because it was a shift change, I really thought he would be moved to Fairfax [the hospital with the highest level NICU] for more medical intervention, but...He miraculously turned himself around as he transitioned. I was so thankful when he was there the next day. I think of him occasionally when I grab a pair of earrings, because I have one lonely earring sitting in my box. The other is someone near the entrance to the OR. I was rushing to get gowned and it flew out of my ear. Anyways, when I see it, I wonder how Ben is."

So that is Ben's birth story. He was born on a Friday, and discharged on a Wednesday, in a late winter snow storm. After getting home, I would just cry all of the time, because I was so thankful for everyone's kindness (and maybe from the hormones). My family, my friends, the staff at the hospital. It was just so humbling. It's hard to believe that he is a year old now! I love him so much, and I honestly could not picture my life without him in it. It is cliché, but real. His birth, while traumatic, made me even more thankful for his amazing existence. It also made me incredibly thankful for Dan. I hate to say "he was my rock," because that is so cheesy. But ya'll, he was my rock.

Happy Birthday Ben! May your life continue to be wonderfully way less exciting than your birth!

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