Sunday, September 30, 2012

Calvin's Birth Story

I've been trying to find time to write this post all week and have discovered that a newborn makes it very hard to find time for much at all. :) Well, that's not true. A newborn does give you some time during the day, but with that time, you will most likely choose sleep over anything else.

Let me begin by saying that Calvin's birth went the exact opposite of what I had envisioned for myself. In my mind, I had been preparing for labor to go along with what is statistically most likely (especially considering my genes and what had happened to others in my family). I planned for contractions to begin mildly and far apart, and then gradually get closer together until they became the standard 5-1-1 (five minutes apart, one minute long, for an hour). Then I would continue to labor for as long as possible at home until I felt quite certain I was in active labor, at which point TJ and I would go to the hospital. Once there, they would declare me in active labor and at least 5 or 6 cm dilated, I would be admitted, and continue to use the techniques I had practiced in my natural birth classes and at home to cope with contractions. TJ would be my coach and we'd power through together until it was time to push. My water would break in transition, I'd push the baby out in 1-2 hours, and he'd be wrapped in my arms and all would be said and done within at least 24 hours. Now let's get to what actually did happen.

At 12:15am on September 21st, I had just entered my fifth day past my due date. TJ had been in bed for about 15 minutes and I was settling into my nightly insomniac routine of watching YouTube videos featuring Conan O'Brien. Lo and behold, I felt an enormous gush as I sat at the computer and jumped up to run to the bathroom. It's a good thing that I was wearing exercise pants that are designed to absorb water well, because I didn't get amniotic fluid all over the carpet. Once in the bathroom, I wrapped myself in a towel and shouted to TJ through the door, "Teeje! My water broke! TEEJE!" He was still half asleep and completely confused at what was going on. He lifted his head off the pillow and started mumbling, "Huh? What.... what?? HUH?! What do we do?!" I felt bad for startling him like that, but I was in shock myself! At every appointment for the last month, my doctor had declared me 1 cm and 50% effaced and had told me at my most recent appointment to definitely not anticipate my water breaking before contractions began. Well, that's exactly what happened. My water had broken before real contractions had even started, and I was immediately realizing that a huge wrench had gotten thrown into my plan. My doctor had previously told me that she would like me to come to the hospital as soon as my water broke because, at that point, they want to monitor you for any chance of infection and fetal distress. I called labor and delivery, told them what had happened, and they said I could get cleaned up and then head on over to the hospital. I took a shower while TJ ran around like a madman getting everything packed and ready to go. Before we knew it, we were in the car and headed to the hospital. It was so surreal!

Once we got checked in and I had changed into my hospital gown, the nurses checked me to see where I was at. Still 1 cm, 50% effaced. Awesome, I thought, It's going to be a very long day. Luckily, my doctor was the one on call, so she was great about checking on me and being an advocate for me and my natural birth.  She let me labor naturally until 5:00 am to see if contractions would begin on their own. So, three hours later, they checked me again. I still hadn't really experienced contractions, so I wasn't surprised when they told me I was still the same. I was trying to not get discouraged. They decided that they needed to help contractions along, so they gave me Cervadil, a small pill you let dissolve in your cheek that is supposed to help the cervix soften in preparation for labor. It's a precursor to Pitocin - something I had wanted to avoid at all costs because I knew it made contractions longer and stronger than what they would be normally. They were going to let the Cervadil do its thing for another 3 hours and then would check me again. In the meantime, however, the nurses were noticing that my contractions were having a small effect on the baby's heart rate. Nothing to be too concerned about, but it meant I needed to be confined to the same position on the bed and continuously wear monitors. Not only that, but once the Cervadil was administered, I needed to be on IV fluids and oxygen as well. So I am having to deal with contractions in one position, with oxygen on my face, a blood pressure cuff, IV fluids, and two fetal monitors on my belly. Again, I'm trying to stay positive, but it's getting very challenging at this point. I can't move around like I had planned - how am I going to handle contractions when they get more intense?? Even worse is what I felt happening in my head. I have a history of getting migraines, and a couple of my triggers are no sleep and no food. Sure enough, both triggers had happened that night (you're not allowed to eat in the hospital). I could feel the beginnings of a migraine. The absolute last thing I needed on top of labor pain was an additional pain that made it challenging to relax at all between contractions. My composure was quickly crumbling all around me. Nothing, not one thing was going according to plan.

As my migraine got worse, so did contractions. The Cervadil was working. It wasn't necessarily making contractions worse, it was just kick-starting my body into labor. I didn't find it too hard to breathe through them, and they were only 30-45 seconds long and 5 minutes apart. Not too bad. Still, I'm sure they would have been more manageable had I been able to walk or sit up or use a birthing ball or something. I hated that I had to be in bed on my right side only. If I moved, a nurse would come in and tell me to move back.

The Cervadil got things going, at least. I was checked at 8:00 am and had finally progressed to 2 cm and 70% effaced. My doctor said she felt comfortable continuing to let me labor on my own to see if I kept moving along. I got a brief reprieve from the oxygen mask and TJ and I felt a small glimmer of hope that maybe my whole plan wasn't going to go awry. Until...

They noticed that as contractions got stronger, my baby's heart rate would drop a bit more. They liked to have his heart rate between 125 and 145 beats per minute, and his was dropping to 110 or 100 beats per minute during contractions. They put the oxygen back on me and kept trying interventions to see if we could stabilize his little heart better. They inserted a catheter into my uterus to supplement the amniotic fluid supply, in the hopes that if my baby was pressing against the umbilical cord, the fluid would help cushion him. It was really very unpleasant to have that thing in me. It felt like I was constantly wetting myself, only with icy cold water. Not only that, but I had only progressed an additional half centimeter in the last 3 hours of contractions. And my migraine was full-blown at this point. I was getting quite discouraged, I have to admit. I knew it was time for the dreaded Pitocin, and I was already beginning to struggle during contractions.

Sure enough, around noon, my doctor came back in and broke the news that this baby needed to come out sooner than later, and if we wanted to do it vaginally, it would have to be with Pitocin. I consented and was given Pitocin in my IV. And for the record, yes, it absolutely makes contractions worse. Along with my migraine, the IV fluids, the uterine catheter, blood pressure cuff, oxygen, fetal heart monitor, contraction monitor, and being confined to only one position on the bed, the long, powerful contractions that were coming every 3 minutes were quite unbearable. I should add that TJ was still being an absolutely wonderful support through all of this, even though all he could really do was rub my back and say I was doing great. He hated seeing me in so much pain and with so much medical gear hooked to my body. Poor guy - I could tell it was tearing him up. I really do think husbands go through their own form of torture seeing their spouses handle the pains of labor. When TJ would gently ask how I was doing, I could only whimper and moan. I thought to myself, this is what the cruciatus curse feels like (Harry Potter reference for my fellow nerds out there).  This continued for about 3 hours, and I had contracted to 3.5 cm.

Meanwhile, the nurses and doctor would come in periodically to check on me and my baby's heart rate. No matter what they did or what interventions they tried, this little guy's heart was just not responding well to labor. During the hard Pitocin contractions, the baby's heart rate would drop all the way to 60, and there was no reason to believe it wouldn't just continue to get more distressed as labor progressed. A kind nurse came in and told me to prepare myself mentally and emotionally for a C-section. I immediately burst into tears, and the news hit TJ just as hard. This was the absolute last thing that we wanted. This was the whole reason I wanted to go unmedicated in the first place - to avoid a C-section. Unfortunately, around 2:30 pm, my doctor came in and gently told me that this baby needed to come out now if we wanted to make sure he was healthy. I was still crying at this point (and pretty much didn't stop until his delivery) and asked if there was anything I could have done differently to have this not happen. She said there was nothing at all I did wrong and reassured me that sometimes these things happen - but our ultimate goal was a healthy baby and a healthy mom. They explained to us both all the risks and complications that can come from a C-section and asked us if we had a living will (we didn't... but were freaked out at the question just the same). Before I knew it, they were wheeling me to the OR after giving me a shot to stop contractions entirely. They left TJ behind, told him to scrub up, and they'd come get him in about 5 minutes.

As I'm entering the OR, the nice anesthesiologist administered the spinal block and told me to make sure I told him if I "was feeling crappy". I asked him to be more specific, please :). He told me if I started feeling nauseous, dizzy, or light-headed to tell him right away. Sure enough, as soon as he administered the spinal block, I felt really nauseated and ready to pass out. All I could mumble was, "I'm gonna throw up," and he and the nurses jumped into action. I guess my heart rate had dropped quite low and my blood pressure declined to alarming levels, so they pumped me full of who knows what fluids to get my blood pressure back up and running. In about 10 minutes, the nausea and dizziness subsided. Before that, though, I was thinking, what if this is it? I'll never meet my baby! I know, I know... it all seems so dramatic now that I'm fine and the baby is fine, but still - after all those hours of pain and uncertainty and nothing going right, to me, death wasn't out of the question. Hey, I was a crazy, pregnant, hormonal lady - cut me some slack! I found out later that TJ was worried about the same thing. He was left waiting for 45 minutes as opposed to the 5 they had promised. At that point, he had convinced himself I was dead and they were waiting to break the news to him. Poor TJ! If I was in that position, I would have been going absolutely crazy. Sure enough, though, after all that time, they got him and sent him into the OR to hold my hand during the operation.

I really, really needed that hand to hold on to! It was scary to know that someone was cutting into you while you were awake, even though you couldn't really feel it. The doctor was literally slicing this baby out of me. They told TJ he better be looking, because he wouldn't want to miss it, and at first he shook his head and said he'd rather not. The anesthesiologist literally grabbed his arm and yanked him up over the curtain that separated my head from the rest of my body so TJ could see them pull our baby out. TJ told me later that he could see my intestines! Gross. And he still likes me? Who'd have thought? :) Our baby came out at 3:55 pm with his eyes wide open. He cried shortly after and when they showed him to me, all the pain, fear, and sadness of the day was replaced by a joy more pure than anything I had ever felt. This was my baby! I knew him, and he knew me! TJ got to watch as they cleaned him off, weighed him, and got all his vitals. I just cried quietly behind that curtain and thanked God that he was healthy and safe. TJ brought him over after a few minutes and we just stared at him and gushed over how cute he was. Our special little man! All I had the strength to do was reach my shaking hand over to his cheek and brush it with my finger. I couldn't get over how soft and perfect his skin was! Instant love. It was so amazing. Calvin Jace Nicholes was 7 lbs even and 20 inches long.


Once my doctor delivered the placenta, she exclaimed that she finally understood what his problems were during labor. It turns out I had a rare condition called Velamentous Cord Insertion. Normally, the umbilical cord implants right in the center of the placenta. For me, it implanted on the side, wedged between the placenta and the uterine wall. Every time I contracted, it pinched the umbilical cord and slowed the flow of oxygen to the baby, resulting in his heart rate declining. That's why no matter what interventions they tried, nothing improved. My doctor later explained to me that had I labored much longer or even to delivery, this baby would have been severely compromised and possibly stillborn. This was incredibly humbling for me and TJ. It turns out if God had allowed things to go according to my plan, I probably wouldn't have my baby. Rather, He took things a different direction by allowing my water to break before contractions started, which statistically only happens in less than 10% of pregnancies. Had they not, I would have labored at home as long as possible and contracted far more than I should have. Instead, my water breaking got us right to the hospital where the monitors could track what was happening and prevent serious complications later. Lesson learned - God's plan is always better than our own. I need to remember that in the future and put more faith in Him.

After Calvin was born, we stayed in the hospital for 5 days so I could adequately recover. Some people hate the hospital, but I loved it! We were waited on hand and foot by the most amazing nurses ever, my doctor and our wonderful pediatrician made frequent visits to make sure we were doing alright emotionally as well as physically, and all my meals were brought right to me in bed (and they even provided TJ with food). Thank goodness we have great insurance to cover what is going to be an enormous bill. We also have supplemental insurance that gives us $500 for each day I'm in the hospital. Total bonus! :) I must say, after the emotional day I had in the hospital when Calvin was born (and months of not being able to sleep at the end of my pregnancy), I had the most magical night's sleep of my life. Being numb has its perks. :)

Our first week with Calvin has been both wonderful and challenging. It is a lot of work to take care of a newborn! This little guy is just adorable but he loves to wake us up a lot at night. I think he just loves to be cuddled and has a hard time sleeping alone in his crib. He also loves his boppy pillow and being swaddled. We are learning as we go but enjoying every minute of it. And who wouldn't enjoy this face?




And, alright - here are two final bump pictures for you. 

41 weeks and 42 weeks, respectively. :) 

Thank you to everyone who has been so kind and cared so much about our little one! Your prayers, meals, and visits have meant the world to me. Motherhood is tough, people. That's no lie! But the rewards make it so very worth it. Hooray for my baby's birthday! And hooray for the end of pregnancy! For now, at least. :)

8 comments:

  1. I LOVED reading this post. I especially love the last picture of you holding your baby. Too funny! I laughed hard when you asked the anesthesiologist to specify what "crappy" meant. I'm dying to see Calvin over Skype. So as soon as you are able, call me. Call both phones. That way the percent increases that one of us will hear our phone ring. It's so fun to look at your blog and see a little baby on there. Someone to constantly gush over. I'm a very proud Aunt! He is so adorable! I can't get over his little body. SO SWEET he is. I'm sure you guys have done a fantastic job as new parents this past week. I'm so glad you married my brother cause I love you to pieces. Also, that is so great to know the reasoning behind Calvin's heart rate declining with the placenta and all. What a huge blessing and testimony building experience that Heavenly Father will always watch over us. Fabulous birth story.

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  2. Congratulations, Ashley!! He is such a sweet little boy. I'm glad you are both healthy and that the delivery went well.

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  3. Omg he is so adorable! I want to meet this guy!
    And dont let anyone tell you all of your kids have to be c-sections now! My sister had a VBAC!

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  4. Okay. I have WAY too much to say right now! I am just going to call you. I don't know if I have your phone number though....I guess I could get it from Jamie :) I will say one thing- I can NOT believe what happened to you! It brought forth so many emotions in me.

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  5. Congratulations! He is too cute!!

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  6. Oh Ash, I am so happy that everything worked out...even if it wasn't as you had planned. :) He is absolutely darling. And thank you for the Harry Potter reference! xo

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  7. Ashley! I cannot wait to meet little Calvin! I am so glad that he is here safe. The Lord really watches and cares for us. And you must convince TJ to plan on Europe. I will watch Calvin any day/week/month that you decide to take the best trip of your life! I hope your recovery continues to go well. Loves from Switzerland!

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  8. Congrats! He is so cute. What a crazy story! The Oakland 9th ward misses you guys! Cassandre Briggs

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