Birth Story Part III : Hospital

Not so hot picture of myself on drugs.

Hospital – 9 hours

We arrive at the hospital around 6 PM on Thursday, July 5. Mike drops me off at the front door where midwife Allison meets me with a wheelchair. I have several contractions on my way up to the 4th floor of labor and delivery. We arrive in my room; it is big, the walls are painted a dusty blue, there’s a hospital bed, a bathroom with a shower and tub, a couple of windows, a sleeper couch (that Mike spends the night on), a place for the baby to sleep, and lots of monitors. I just stand there rocking to and fro when nurse Darci walks in. She has dark hair with a pixie cut and she is spritely. She says, “I will be your nurse for the next one and a half hours.” Her shift ends at 8. She sits on the rolling stool and pulls out a little scrappy piece of paper that looks like it could be a paper napkin and begins asking me questions like, “Are you allergic to any medications?” “Do you want your child to be circumcised?” I have a contraction while standing there and say, “I’m having a contraction, just a moment.” and I breathe through it, rocking back and forth on my feet. After she asks me the official questions she asks me how long I was at the birth center and I tell her a short version of the beginning of our journey. She is impressed with how chipper I am after all I’ve been through. Mike finally makes his way up with all of our bags. I know he is ready for sleep. Darci tells us about the philosophy of UNC Hospital’s birthing program. We are really impressed. They practice putting the baby directly on the Mom’s chest after delivery and they let the umbilical cord pulse out before cutting it. They do all of the tests (APGAR) on the baby while he is with the mother. They can change the lighting and the temperature in the room. They encourage breastfeeding. Apparently UNC and Asheville are the only two hospitals in North Carolina that really push and practice these philosophies. I finally sit in my bed and Darci hooks me up to my 3rd or 4th dose of penicillin as well as some fluids. She puts the heart rate monitor on my belly so that we can keep tabs on the baby’s heart rate throughout the delivery. She also attaches this other monitor to my belly that tracks my contractions. Since I will be given an epidural this monitor will help the nurses and doctors know when my uterus is contracting. It displays the patterns of my contractions on the computer screen. Darci even comments on how long my contractions are.

The red line above shows the baby's heart rate. The black line below shows my contractions.

I am fascinated by this hospital room. I tell Darci that I’ve never been a patient in a hospital before so I am amazed with all of this stuff. She shows me this big ol’ retractable light that looks like the Starship Enterprise. With the push of a button it comes down and out of the ceiling and just like a light at the dentist you can position it to shine on just the right places ifyouknowwhattamean. She calls the anesthesiologist (Wow, I just spelled that without looking it up or making an error, pat on the back.) to let him know that I am there ready for the epidural. He comes in 15 minutes later, tall, lanky guy with blue scrubs, very friendly. Darci puts a shower cap on my head. I sit up in bed and he and his superior comes in mid contraction and introduces himself – I hold up my hand to him while breathing through it. When I’m done I apologize to him and say, “What was that?” He reintroduces himself and everyone says I shouldn’t apologize for having a contraction. Ha. They continue to do the thing they do with the epidural. I cannot see anything. I assume they are putting a needle or IV in my spine somewhere. It involves tape because the sticky residue of it remains on my back one week later. When they are done I lay back and the tall lanky doctor says he’ll be back with a cup of ice in 30 minutes or so to do the ice test. When he comes back he puts an ice cube on my left lower abdomen and asks if I can feel it, nope. He puts it on my upper left thigh, nope. He puts it on my lower abdomen, nope. Right side, brrrrr, I can feel it. He says that I should lay on my right side to get the medicine to drip to that side, all it takes is a little gravity to change the flow – how very low tech. We do that for a bit and it helps a tad. He gives me this little button that looks like a toy rocket ship painted kelly green with white stripes and tells me that if I need to up my epidural to press the button. He has put me in charge of my own pain, how strange. I tell him that he must be a popular guy around here. My first contraction comes and I can feel it but it’s a lot less painful. The next one comes and I don’t feel it at all except for a very painful pressure in my rectal area. It hurts enough for me to say OW outloud. I tell the new nurse (her name is Cathy I think - I can't believe that I don't remember this for sure because she was there for the birth and all of the pushing!) and they tell me that it’s hard to get rid of rectal pressure like that with an epidural but she pushes the green rocketship button once. The next contraction I have, the rectal pressure is still there. It feels like someone has taken a bocce ball, put it in my pelvic bone and is standing on it so that I can feel it on the back side of the pelvic bone. I think it must be that darn occiput posterior head. I push the green rocketship button again and midwife Allison walks in and asks how things are going. I tell her about the rectal pressure and she pushes the green rocket ship button again. Ha! I’m going to be in outer space pretty soon. Nurse Cathy apparently called the anesthesiologist to let her know about my right side being somewhat less numb (my foot is even colder on the right side. My left foot is super warm. So a lady doctor comes up, she administers me more epi with a big ol’ syringe. I hope she doesn’t kill me. My legs become jello, can’t feel ‘em. Rectal pressure is almost zip. I ask if this affects the baby, they say it doesn’t. I trust them plus I can’t feel pain anymore which is amazing especially after days and days of intermittent pain. I tell them to give Mike an epidural too, they just laugh. They administer a minimum amount of pitocin in order to get my contractions closer together and stronger because after all this time they are still not close or regular! My body is a mystery. I can still tell when I’m having a contraction without looking at the monitor because my tummy rises up and takes the shape of Yosemite’s Half Dome. The right side goes higher than the left. They tell me that I can push when I have a contraction. We start with me on my back and Cathy holding my right leg and Mike holding my left leg. My hands are behind my thighs they tell me to push three times each time I have contractions but I feel like I can push 4 or 5 times. They have me push for a count of 10. One one thousand, two one thousand... Mike becomes the official counter by the end of the night. I push with all my heart. I want this baby out! We try this position for a while and then we try with me laying on my left side with my right leg up, I curl my back and keep my chin down, count to ten. Then we try it on my right side. The baby’s heart rate is still as regular and strong as ever. He is a happy camper in there. I move to my back and Cathy gives me one end of a rolled up towel or piece of fabric. I hold onto it with both hands and she holds on to it in front of me. I push during the next contraction while pulling on the towel. We do this many times. We try it while on my sides as well. They up the pitocin. They bring a U shaped bar and hook it to the bed. I use it to hold on to while squatting. I try pushing that way for awhile. We attach the towel to the bar and try pushing that way while I pull on the towel. We seem to be making a wee bit of progress. The way that Allison explains it to me is by holding up her hands, pinky sides touching and pulling her hands apart and then putting them back together again. So she can see the baby’s head a little during each push but then the curtain closes again. Open, close, open, close. Apparently we are not having a baby before the stroke of midnight. The baby’s position remains this way for hours, no progress. It’s probably around 2 am on July 6 when Allison talks to me about the lack of progress. She recommends having the Obstetrician come in to see what they can do. So 10 minutes later The lead OB comes in she is young, probably in her 30s, big pearl earrings, golden hair and skin with big blue or green eyes. Her name is Kacey. She used to be a kindergarten teacher. With her is, as Mike calls him, the “Hot Doctor”. He is the chief resident, blond, blue-eyed, young. His name is Jason. They give the Grey's Anatomy cast a run for their money. Kacey is very friendly and explains to me the situation. She wants to try vacuuming the baby out. She says we can either use forceps or vacuum but that vacuum will cause less damage than forceps. She says that if this fails they will have to do a C-section. She explains that they will apply a little suction cup (which is about 2.5 inches in diameter) to his head and will attempt pulling him 3 times. If it pops off or fails for a third time they will cease using the vacuum because they don’t want to cause a hematoma on the top of his little head.

This is kinda what the vacuum looked like, from what I can recall.

She also explains that once they start this the Pedes team of 5 or 6 doctors and nurses are going to be coming in and it’s going to appear a little bit chaotic. She doesn’t want me to freak out. They are there to help and check on the baby. Before they attach the cup she wants to see “what she’s working with”. On my next contraction she asks me to push to see how strong my pushes are. If I was weak they probably wouldn’t have even attempted the vacuum. She says that if I push 100% that the vacuum gives me an extra 10% of push. The next contraction rolls around and I push. She is the ultimate cheerleader, “Good job, push harder, push even harder! A little more! You can do it! I know you can push harder!” Her cheers really rile me up and I push with everything I’ve got. When the contraction passes she looks at me and says, “Oh yeah, I can work with you.” So, Hot Doctor attaches the suction cup, nurse Cathy holds this hand held pump to administer the suction. I’m watching all of this with front row seats. The Starship Enterprise light is the only light on in the room besides the lights glowing from the monitors behind me and the heat lamp above the baby bed. It is dramatic. Kacey’s face is dramatically side lit, and lit softly on her face, her pearl earrings all aglow. There is a table behind her with sparkling tools like scissors and clamps laid out in perfect order on a sky blue drop cloth. I see Allison standing behind the Hot Doctor. Cathy near my right foot with the pump. Mike is to my left side. I see the Pedes team on the ready towards the back of the room, their faces lit only by the heat lamp above the baby bed. It’s quite the scene with dramatic lighting. On the next contraction, Hot Doctor pulls, I push, Kacey cheers me on. Mike says that we make progress so much that the suction cup is now outside of the birth canal so the baby’s head is just behind the curtain. Hot Doctor/Jason repositions/resuctions the cup and on the next contraction we repeat the pull/push routine. It is not painful but I can feel the baby coming out – making his appearance. I push several more times and then my contraction ends but I imagine that his head is halfway out and I say loudly, “Can I push again?!!!” Kacey says, “YES! Push again!” I do. His head is out and she holds it and looks at Mike, “Here’s your baby boy!” and I must push again and out comes the rest of him. It’s 2:56 AM on Friday, July 6, and with the help of all these people Stanley Akibjorn makes his big appearance. Kacey holds him as Jason holds the umbilical cord to Mike and Mike cuts the cord. They sweep him away and the Pedes team checks him out and makes sure that no damage was done with the vacuum. He scores a 9 on his one minute APGAR and a 9 on his 5 minute APGAR. They bring him to me, he has a little blue and white hat on his head.

We attempt to breast feed but he seems sleepy which is weird because what I’ve read they say that newborns usually have a 2 hour alert period right after they are born. But nothing has gone as planned, my contractions were never regular although I was dilated 9 cm., the maximum amount of pitocin was not really making my contractions do what they are supposed to do, so I figured baby was just pooped from the whole ordeal even though his heart rate stayed a healthy 140-150 the entire time! The room had quickly cleared out and it was just Mike and me. I look around and see that table that once was impeccably organized with sparkling scissors and clamps was a bloody mess. I told Mike to take a picture but he refused. Apparently right underneath my feet was a big puddle of blood and chunks of uterine mish mash. Mike said it was horrible. I asked Mike to call my parents and I spoke with them as Stanley rested on my chest. He started making funny but adorable breathing sounds. It was an inhale that sounded a little bit like a chortly gasp and then the sweetest sounding exhale like, “Aaaahhhh.” Five seconds would go by and the same gasp and then sing songy exhale. When Cathy came in with a tray of food for me we told her that his breathing was odd and she took him to his little bed and listened to his heart and then called the Pedes team back up. I was surprisingly calm and unemotional. I didn’t touch my food but just sat and watched the Pedes team listen to his heart, put an oxygen mask over his little face. The lead doctor came to me and said that they were going to take him down to the NCCU (NICU) and run some tests and observe him for 48 hours. In Stanley’s discharge papers it says,

FINAL DIAGNOSES

Reason for Admission:

Dusky spell with some irregular breathing while breast feeding that resolved slowly with vigorous stimulation.

Primary Diagnosis: Cyanotic attack of the newborn

Secondary Diagnoses: Sepsis Evaluation, Physiologic Jaundice

Intrapartum Factors:

Meconium staining

Additional comments: Cyanotic attacks of newborn. Stanley was reported to have a cyanotic spell while infant was breastfeeding with delay in recovery despite vigorous stimulation. Upon arrival of NICU team Stanley was noted to be pink with good spontaneous respiratory effort. however, he was transferred to NCCC to facilitate continuous CR and pulse ox monitoring. Stanley has had no episodes of apnea, cyanosis since admission to NCCC.

So he was put in the hands of the good doctors. Mike and I were exhausted. I ate some food. Apparently the OBs gave me some sort of anti-hemmhoragic suppository which has a possible side effect of chills. Of course I got them. Violent chills. Here I thought I would get a good nights sleep without contractions! The nurse brought me in two heated blankets but I was still audibly chattering my teeth and shaking. I eventually began sweating and finally towards the later morning my body temperature was under control. When we were up we went to visit Stanley in the NICU. This was the beginning of 2.5 more days at the hospital.

Birth Story Part IV : NICU coming next
Read Part I
Read Part II
Read Part IV