Wednesday, September 26, 2012

An Induction, a Beautiful Birth, & a Retained Placenta - a little graphic, a lot amazing.

I've been sharing birth stories from moms in Monterey County, but I just had to share the birth of my friend's baby, Ziva Claire, even though they had her in New York. This is the first person I've met with a retained placenta. It's something that I don't love reading about in my books because it always makes me a little queasy, so knowing a mom that actually experienced it just makes me want to bow down to her. If you ever meet Ali Enoch, buy her a drink, or at least give her a high five. For the squeamish mamas, this one is a little graphic.

Ziva’s Story

Day 1:
So, I went in for the induction on June 15 at 41 weeks and 4 days.  I really didn’t want to do the induction because I knew it went against everything I wanted – laboring at home, no IVs, no monitors, etc.  But, the midwives pointed out that I was healthy now and that we’d have a better outcome if I did it. 

41w4d, off to the hospital!
We got there around 6:45pm and waited and waited.  I went to triage, a nurse blew 2 veins trying to hook me up to an IV.  I told her she had one more chance or I was going home.  She brought in another nurse who got me right in the side of the wrist so now I was weirded out to move my hand/put too much pressure on my wrist for the next few days.  Oh well. 

Mark and I were brought to a room.   I got hooked up to the fetal and contraction monitor.  Jessica, a midwife I knew, inserted the cervidil around 10pm.  They gave me some benedryl so I could sleep but it was so uncomfortable and I was so completely aware of the monitor and IV that I barely slept.  I also kept getting horrible heartburn.  Mark was stuck on a recliner that barely reclined and they didn’t have a sheet or pillow for him. 

The nurse, Pam, came in and woke Mark up at one point to show him that I was having tiny contractions.  “Look Mark, Ali has hills!”  Because we kept watching the other rooms and seeing all the strong contractions while my line was pretty flat.

Day 2:
Another midwife, also named Pam, who I’d never met, was on duty.  She removed my cervidil and told us the bad news – no progress.  Still maybe 50% effaced and 1 cm dilated.  She asked if I wanted to eat or start the second cervidil.  It was already noon so I didn’t want to eat and then have to wait until 4pm to insert the cervidil – I opted for the liquid diet (Italian ices, broth, juice) and just went for the cervidil.

That afternoon my mom and sister showed up.  By the evening I was sitting on a birthing ball and bouncing and rocking around and starting to feel random contractions.  We were all thinking maybe I could do this without the dreaded pitocin. 

A new midwife was on that night to take out my cervidil – Ann.  I liked her.  She checked me and said I was fully thinned out and about 2cms.  Slow progress but progress none the less.  She told me to get something to eat and we’d wait an hour or two before starting pitocin because maybe my body would take over on its own. 

Mark and Melissa went down to the cafĂ© to get me food while my mom hung around.  This was around midnight.  My body was kicking into labor.  By the time they got back I was getting uncomfortable.  Contractions were coming around 3-4 minutes apart – they weren’t painful, they were just there.  I ended up eating about an inch of the bagel and couldn’t stomach any more of it.  The midwife came in excited I was having contractions but when she checked me there was no difference. 

She suggested we start the pitocin.  Mark asked if there was something I could have to help me sleep for a little bit because I was already exhausted.  She suggested Stadol.    I just let them do it since I was so tired.

I slept solidly for about 2 hours.  Then the contractions started to hurt like hell.  I would wake up and scream to Mark “Get the nurse, something is broken!” and by the time he could turn his head I would be passed out.  I had incredibly vivid 2 minute dreams and would try to explain them to Mark but instead would say things like “new appliances” or “Mark you’re wrong,” He was confused and amused.  He sat by my bed and rubbed my leg and tried to comfort me during every contraction.  They were coming probably around 2-3 minutes apart. 

Day 3: Friday
Sometime that morning, the midwife suggested that we call the doula cause it was going to start getting rough for me.  I remember Mark saying that Danielle was on her way and then it felt like hours until she showed up – really it was about an hour.  I also kept saying I wanted to get up and pee.  They wouldn’t let me walk cause of all the drugs so the nurse wanted to give me a bedpan.  I refused but kept insisting I was fine enough to get up and walk.  Luckily, I was way too out of it to even try to get out of bed on my own. 

The midwife came in to check me around 8am and I was 3cm dilated but the baby was still -2.  Her head was caput?  Basically her head was starting to form to my cervix – generally this doesn’t happen so early on unless it’s a huge head/baby or your body just isn’t going to work.  This really wasn’t great news at all.  The baby was starting to have a few heart decels as well.  All things were not going well but I was trying.  I was crying cause of all the pain.

The midwife said she’d come back in 3 hours to check me again.  I turned to Mark and Danielle and said “I can’t do this.  The thought of three more hours of this is unbearable.  I just can’t.”  But I really didn’t want the epidural.  All signs were pointing to me ending up with a c-section even if I wasn’t aware of it at that point.  I didn’t want to go through 3 days of pain and then get an epidural.  Why not just get it now so I’m comfortable.   I was standing and sleeping between contractions.  Mark and Danielle were holding me up while I slept and providing hip pressure/rubbing when I had contractions.   Mark, although he didn’t want to, suggested an epidural.  I said "yes get me one now."  The pitocin is a bitch and my contractions were still about 2 minutes apart.  There was no real break. 

The anesthesiologist came in and read me a consent form.  I started crying.  I was scared and everyone had to leave the room.  It wasn’t nearly as bad as I had imagined.  It felt like seconds but apparently it was close to an hour before Mark and Danielle could come back in.

When they did I said “Look at me, I’m just riding the rollercoaster of interventions!  We all know where this will end up”  I’m always so positive.   The epidural was fantastic and allowed me to relax.  I was checked again and was 7cm dilated but the baby was still -2.  I was so excited.  I was progressing. 

Melissa and my mom showed up and I told them.  They were super excited.  I told Melissa I was beating her and she was happy.  The nurses didn’t love that I had 4 people with me but the midwives didn’t care.  Melissa was going to leave once I was ready to push so it would just be Mark, my mom, and Danielle.  They were fine with that.  We mostly sat around talking and chatting.  I know they left to get food at some point. 

Goldie came back in and checked me again before her shift was over.  She said I had an anterior lip and the baby was -1 station.  Goldie quickly went over the caput thing again with the baby’s head, she mentioned shoulder dystocia, and other bad things that could happen – just so I’d be prepared.  It sounds crazy, but I did appreciate it.  She also mentioned that, at some point, my water had broken because it was nowhere to be found.  I never felt it break so I have no idea how/when that happened.

At one point, Mark went to get food and the baby’s oxygen levels were decreasing.  He walked back in the room and a ton of people were there moving me (I had no control to move my body) and rolling me on my side, I had an oxygen mask on and it was scary.  He had no idea what was going on so he freaked out a little bit (reasonably so).  But, once I rolled onto my left side, everything was okay.  They could monitor the baby, I just had to be on oxygen so the baby could get it easier.  Easy enough.  (Side note, months later Mark told me that they were wheeling a bed into my room because they were about to rush me into an emergency c-section but the midwife stopped them and repositioned me.  I’m grateful for that).

We sat around like this for a few more hours.  Susan came on shift.  She was the first midwife I met with and was the one who set up the induction for Wednesday.  I was glad to see her.   She told me she’d come and check soon but if I felt constant pressure to poop that probably meant I was ready to push and to let someone know.  I was excited and scared at the thought of pushing. 

I was definitely feeling pressure.  Melissa was so excited that I was in pain WITH an epidural.  Everyone would take turns holding my hand or rubbing my side/leg.  It was nice.  I just felt incredibly supported.  I was still scared of having to push out a baby (or it getting stuck) but I felt very loved.  Mark put on the soothing/slow songs labor mix he had made for me.  It was all calming.  Finally, I was getting uncomfortable a lot more often.  A few times I felt my body push without me doing anything – that was weird.  The nurse said Susan would be in soon but it took about an hour.  She checked me – baby was +1.  She said we could start pushing. 

I was so confused.  How could we be pushing already?  They told me how to do it.  Mark grabbed a leg and Danielle grabbed the other.  The nurse was annoying me and kept telling me when to breathe and push which I didn’t love but I just went with it.  There was a shift change at one point that nurse left and Pam (the nurse from the first night) came in all excited that she could be there for the beginning and the end.  Melissa stayed in the room but out of the midwife’s way and my mom was all about staring at my crotch every time I pushed.  Very weird haha. 

Between contractions they had been putting my legs down, it got to the point where I’m like no you need to keep holding them up!  The baby’s head was crowning.. the energy in the room was getting excited.  I wanted contractions to come quicker so I could get the baby out already.  I just wanted to know what he/she was!  The baby’s head was almost out.  They asked if I wanted to touch it.  I said "No I want to push it out shut up!"   Susan said “The baby’s head is out Ali, you’re doing great.” I kind of freaked out.  I kept thinking about giant baby shoulders and the baby getting stuck then I said “Oh fuck I want this thing out of me” and gave a good push and the baby came flying out.  I yelled “Holy shit I pushed it out!  I did it!  What is it??”  Susan turned the baby to Mark and said “well, Mark what’s your baby” and he’s said "It’s a boy!"  We all yelled "It’s a boy OMG It’s a boy!"  Susan was like "Mark, look again!"  (it was all very confusing, I would’ve done the same thing)  Mark was like "It’s a girl! " The room erupted in cheers again all yelled "It’s a girl it’s a girl!!"  Unfortunately, she had pooped so the NICU was there and Mark couldn’t cut the cord and she couldn’t go directly on me.  I just stared at her until she started crying and Susan kept saying "She’s doing great, Ali she’s doing great!"

Once she was crying (APGAR was 8 and 9) Mark got to hold her and you could just see the love on his face as he brought her over to me.   He handed her over and I started to cry.  I did it.  I pushed a baby out!  I took every freaking intervention offered to me (and even the epidural that wasn’t) and was still able to do it!  I was there for 48 hours and pushed for a little over an hour.  Ziva Claire was born at 7:35pm on June 17, 2011 and weighed 8 pounds, 1 ounce and was 19.75 inches long.

It was an amazing feeling.  Unfortunately, although I can push a baby out, I cannot push a placenta out.  We tried for about 45 minutes to an hour and finally the midwife said she had to call a doctor in because it wasn’t coming out.  I wasn’t really sure what that would entail but part of me is glad they didn’t warn me.  The doctor (luckily a small woman) suited up and literally stuck her arm in and up (between her elbow and her shoulder) and pulled out my placenta.  For all I know she was tickling my tonsils at this point.

I know I was very quiet/calm/relaxed while pushing out Ziva  (my sister took video and I’m barely making noises)– at this point I was screaming bloody murder and damning everyone to hell.  I know Mark was holding my hand and kept trying to press my epidural button (I was later told that it had already worn off by this point that’s why it was so horrible).  Melissa and Danielle were on either side of me trying to calm me, make me breathe, and literally hold me down.  The doctor was using such force that the bed was moving.  She yelled to the nurse to lock the bed and that’s when the nurse yelled “It is locked!”.  I’m pretty sure it was at this point when Mark said blood was just pouring out of me.  Lovely, right?

Once that was over, you’d think they’d let me rest.  Nope.  Tweedle Dee and Tweedle Dum decide to come in and do my stitches.  They had no idea what they were doing.  It hurt like hell and I kept screaming at them.  My sister said it looked like how she would stitch someone up – meaning that they had NO idea what they were doing and were just randomly pulling and stitching.  I started yelling at them to just “Fucking stop.  Maybe if you give it a break I’ll stop bleeding on my own.” This was shortly after they told me I was very tense and should relax.  I wanted to kick them in the head.  Finally, they decided it’d be easier if I just went to the operating room for a “quick 10-20 minute procedure.” 

I got wheeled in, the anesthesiologist gave me drugs so I wouldn’t feel anything.  He also nicely rubbed my head throughout the operation and kept me calm/sane whenever I was actually awake.  I was shaking from being cold and having lost a ton of blood so he got me a warm blanket.  I remember the surgeon came in, looked down and said “What happened here?”  At that point, I just closed my eyes because I didn’t want to hear anything else.  The midwife came in and held my hand and talked to me for a while.  Finally, I was done – after about 2 hours of stitching and bleeding.  I was on my way to recovery.  But, I couldn’t see Ziva since she was already released to postpartum with Mark.  I cried. 

I was stuck in recovery from midnight until 12:30pm the next day and they wouldn’t let me see Ziva.  Mark texted me pictures because I was crying and upset .  The nurse was cleaning me up and telling me all about Ziva and how pretty she was and how awesome of a job I did.  I was trying to remain positive, I pushed my little girl out, but I was hooked up to so many machines and monitors that it was incredibly hard to stay positive.  Especially when the woman next to me in recovery had a c-section and was in and out within 2-3 hours and could see her baby.  I was still stuck there.

In the end, Ziva was born at 7:35pm and I got to be with her for a little bit.  Once the placenta issue happened I didn’t hold her again until the next day at 12:30pm and that sucked.  I had a horrible nurse yell at me around 1pm that I wasn’t feeding her enough and she should be latched for 10 minutes on each side.  I calmly tried telling her that I hadn’t seen her in 16 hours so she didn’t know who I even was.

I was given a ton of fluid, my legs/feet were so swollen I couldn’t walk for days and cried getting in/out of bed or going up/down the stairs.  I ended up gaining 15lbs by the time I got home from the hospital.  I know I was given platelets in the OR and they wanted to do a blood transfusion as well but I opted out of that.  Instead, I took iron pills twice a day for the next 6-8ish weeks.  Breastfeeding didn’t work out like I wanted it to, but, with the blood loss and everything we went through, I’m lucky to be alive.  I’m okay with not really breastfeeding her at this point.  In fact, at 3am, it was rather nice to roll over and say to Mark “It’s your turn” and then go back to sleep.

1 comment:

  1. Wow! What an event! All the best to this mama and her babe.