Thursday, February 21, 2013

Baby III Week 42: AMA

Week 42


I considered just leaving my laptop in the bag or just putting out a vague, "we're fine, we'll let you know when baby is here," post... but I know if I knew me I would hate me for that. I'd want to know what happened... and according to the 52 notifications on my facebook and the inbox on my cell, some of you do to.

Eric called Natividad just before we were set to leave. The nurse was not happy that we missed our prior appointment and now wanted to come in without one. Eric said we didn't know it would be a problem because on Saturday we came in for an non stress test and they wanted to admit me for an induction. Eric mentioned I was 42 weeks and she asked how that was allowed to happen... which Eric didn't address. We had agreed  to take on a "do not engage" attitude about this and just let things be said, but hold our ground on what was done. She said come in and we called our OB, Dr. Chandler, on the way and left a message for him.

In the elevator a nurse whose look I really liked said "Oh, another one! I'm headed up there too," clarifying she was a labor and delivery nurse starting her shift. She asked if I was in labor and I said no, asked why I came in and I explained the 42 weeks thing and she said "Oh! You are the one that didn't want to come in!" When Eric called he got a couple other nurses who knew who I was too, apparently I'm building a reputation.

Labor and delivery was full and it seemed there was a lot going on. We understood why they weren't happy about us popping in. We waited about an hour for a room. While we waited Dr. Chandler called and said he had wanted to meet me here but we got there a little later than expected. The on call doctor is  Dr. Heiner and I should like him, he thinks they assigned me a nurse who is also a midwife. Dr. Chandler said he talked to Dr. Heiner and he should be familiar with why I am there. I thanked him and he said he'd be in in the morning.

Waiting next to all the kids they wont let in L&D because of flu season.  I literally watched one put his hands in his on the floor and then lick them

We were set up in our room. One thing that is nice about Natividad is that nurses, residents, and OBs tend to ask you if you have a birth plan and are interested in seeing it. We went over ours and while I don't think I got the nurse that was also a midwife, she was supportive of all our choices. She checked my cervix and I was surprised to hear I was now 3cm, not 4 or more which is of course what I was hoping for. I was hooked up to the monitors and I waited for the OB.

At least an hour went by and I had to pee. As I came out of the bathroom a resident came in and said she saw me go off her monitor so she came to check on me. Being checked on any way would be nice, but whatever. She said that my contractions do not look regular and are still only 7-8 minutes apart. Confused, I told her we knew. She said why don't I walk around to see how I progress and then maybe start Pitocin. I realized she didn't know that I was not in labor. I don't remember this, but Eric said I actually blurted out, "Wait, you think I'm in labor!?" I was kinda offended she thought I thought this was labor, but then how is she supposed to know what I know... either way someone should had told the doctor who is now in here wanting to help me make induction choices that I'm not in labor. I filled her in on the last few days and why we believed we were there.

She did a lot of mirroring questions back to me at this point, and I wondered if it was because she knew nothing. I asked her what my options were with my dilation, effacement, etc. and she'd say "Well what options are you comfortable with?" We talked in circles until she mentioned baby's -2 station. I stopped her and said I thought baby was at a 0. She said no. I told her I needed to see Dr. Heiner and I wanted to be checked by him. Obviously I'm not going to be asking for my membranes to be ruptured if for some reason baby has sucked back up two stations.

It was 10:30pm, almost four hours in that we saw an OB for the first time. At this point I was confused, frustrated, and exhausted. I liked him, he reminded me of Chandler in that he is obviously keeping abreast of research and brought up some various studies not in a "I know stuff, shut up patient" kinda way but in a "here's some information that might help us make a decision here" kinda way. He shared some of his history, he came from a hospital in El Paso with a cesarean rate of 12% and said he was one of the more pro-vaginal OBs. At this point I knew my options were probably slim since I was not as far along as I had thought. He said he wanted to try a low dose Pitocin regimen keep me at a 2 milliunit/minute throughout the night. He said there's some good information out there supporting this approach vs increasing the dosage until the desired pattern is achieved. He added that he has friends who swear by this approach. I shared my history and my concerns about Pitocin's affects on the baby, but deep down I just knew that the thought of being tethered to a bed with an IV in my arm was devastating and the science didn't matter. This was the first time where I realized I might really be losing this birth.

We were at a bit of a stand still, I realized I was standing on the opposite side of the bed with my arms crossed, and probably looked a little confrontational even though that wasn't my intention. He was offering an option and I had nothing to counter with. He suggested that he double check my cervix and I jumped on the bed, hoping the nurse was wrong. He said I was 3cm, maybe 4, 50% effaced (from 80% Monday) and -2 station. He said it wouldn't be the easiest rupture he'd done and I told him no, with those numbers I wouldn't ask him to try. Not wanting to cry in front him him, the grumpy resident, and the nurse I told him that Eric and I needed to talk for a minute.

And by talk, I mean I needed to sob for nearly an hour.

I don't even want to write everything I had to think about, or am still thinking about. I'm already crying again trying to put these sentences together. I don't want to expose myself or the baby to Pitocin. I know though we sing its evils all the time that it has a time and a place, I just don't want either to apply to me or my baby. I know the risks, I know how I responded in the past, and I don't want to take myself there again.

I also knew I had finally fallen into the pit I'd been teetering on the edge of for days. My body is failing me and the baby. I would tell a million women that their body is not a mistake, and I believe it, but between the polycystic ovary syndrome  gestational diabetes, and now this... mine is without a doubt flawed and I hate it. All I want is to be able to take part in this miracle set apart for us women and I can't, and there are so many other women who can and don't. I would give anything to work through one really hard contraction and the satisfaction of getting through it and in the rooms that line the hall just outside my crumbling universe there are women choosing detachment and numbness over that incredible experience. Somewhere between self pity and bitter jealousy I completely broke and mourned the birth I had been looking forward to for over 10 months.

When the nurse asked what we decided I said through pitiful sniffles that we needed to go home. The OB had pleaded, literally put his hands together in prayer, that I at least get an ultrasound and I had no problem with that. Unfortunately, it would be two more hours of sitting in my gown, in a cold chair staring at the wall just losing my mind before anyone could come get us for it.

The ultrasound table was hard and it took forever. I got nauseated and dizzy laying flat for so long. The tech told us nothing. The nurse took us to our room and gave us papers to sign since we were leaving AMA, against medical advice. I asked about the ultrasound results and she said the resident said it was fine for us to leave. I asked how the placenta looked, after all, one of the main reasons for the ultrasound was to check for calcification on the placenta. The nurse came back and said the resident didn't know, but it looked fine. It was almost 2am, I wanted to at least know what the ultrasound said. The resident came back, clearly annoyed by me and snapped, "I'm not an OB, I can't read an ultrasound, I don't know what this says." I asked how she knew it was ok for us to leave, didn't the tech put anything about the placenta? She said "Look, it's a 2-3 grade placenta, it has extensive calcification just like I told you it would because that's what happens when you are 42 weeks." I officially hate residents.

She left and now I'm standing there, dressed, bag in hand, ready to leave and the placenta has extensive calcification?" Am I even safe to go? I looked at the nurse totally confused, speechless. What is wrong with this place? I'm glad she could read my face, she said it's night, no one is here that can really read the ultrasound.

I had to just piece together for myself that the fluid was good, though lower than it was, baby was very active, I could at least go home and sleep.

On the way out I decided to avoid all this again and make, and promise to keep, another appointment to induce. I didn't know what to think about my placenta, but I did know my fluid had come down quite a bit. The next opening was 9pm Friday, and the on call OB was Dr. Aguliera, the OB that had encouraged me to have a homebirth and said if I came in that he hoped he could be there. Maybe this was a sign.

I didn't wake up once from when I got in bed til the phone woke me around 10am. Today and tomorrow I'm just going to rest. I'm wondering if everything I've tried to start labor over the last week has had the opposite affect. No excessive walking, herbs, bouncing, pumping, or eating anything weird today. I probably won't be online much, there won't be a 42 weeks + 1 day post... I just need to not think about birth for a little bit. I know I could still go into labor and I hope that happens, but if I have to make that death march up to labor and delivery at 9pm tomorrow night I have to go in ready to do whatever it takes. Don't worry, I haven't given up on myself or my baby and I know I have choices. I know if I need Pitocin I can have it turned off if we establish contractions, I know I can eat and do the best I can to move and take an active role. I haven't forgotten any of that... this is just one very heavy compromise that I never intended to face again.

2 comments:

  1. I know you're upset by everything going on right now but, it's all for a reason. One of the best midwives I know, has had 2 c-sections. Her babies are weirdly positioned and she has other issues that just make it so she needs a c-section. She words it perfectly though: I have to have these c-sections so I can better help mamas through the not so great births. I'm not at all saying you will end up with a c-section but, what I'm trying to say is, you are going through all this, because you can handle it, you know the right decisions to make for you/your family, and it will help you be a better child birth educator in the future. Hopefully, by the time you read this you'll be feeling a bit better (or a lot worse and having contractions!)

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  2. Oh mama... I'm sorry this experience hasn't been stress-free for you after all you already had to deal with. Praying for a beautiful birth whenever that time comes. Take care of yourself. Rest... and can't wait to rejoice in a healthy baby with you soon!

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