Friday, January 14, 2011

Aishani's birth story

Even if it's been over 20 months I guess I never got a chance to post Aishani's birth story!
This is how it goes--
So I go to my usual OB appointment on the 27th of May at 8:30 am after a routine antenatal non stress test at 7:15 am.
Testing was uneventful. Nurse set up an appointment for 29th May, Friday, in the afternoon for the next NST. I’d been set up for twice weekly testing since my blood pressure was quite high. Since I was just a day shy of my due date Nurse said I should ask my OB in the appointment if I could be induced soon. Of course it all depended on the progress that my body had made. And I thought, “Yeah, right! I should be so lucky!”
Well, looks like the stars were in my favor---my OB did the first pelvic examination and declared that I was a good 2 cm dilated. I’d lost my mucus plug a week ago and she confirmed the same too. She then went on to check my pressure and seeing I was at 146/90 suggested that I go ahead and get admitted in Labor & Delivery for an induction right then itself. I did a “woo hoo!” and thanked her before rushing to L&D for getting admitted. I was warned that L&D may keep me in Triage for a while and monitor me before actually setting me up in a labor room. But as soon as I reached the nurses’ station an elderly looking midwife introduced herself and instructed the nurses to set me up in labor room 4 immediately! I was a little scared----did they find the pressure high enough to start me up on the induction without delay?!
I was shown into a labor room with a suitably impressive view of SF downtown. After changing into the hospital gown and getting the contraction and baby HB monitors hooked up (around 9 am) I was told that pitocin would be started for me soon. Rohit took the opportunity to rush back home to get some of the essentials that were missing from my hospital bag---my toothbrush, his snacks, an extra blanket and stuff like that.
At around 11 am Pitocin was started for me at 3 milliunits/min. The anesthesiologist came around when the IV was being inserted into my arm and he explained the pros and cons of using different pain management medications like narcotics, analgesics and the epidural. I told him I would definitely need the epidural. Rohit wasn’t back yet from home. My contractions were starting to show up in the contractions monitor and all I could feel was a slight tightening in the back---I hoped it wasn’t back labor!
Pitocin was gradually increased to 4 milliunits and then 5. By the afternoon my contractions showed up as beautiful funnel shaped cups with a flat plateau lasting for about a minute at 70-80 strength and about 3 minutes apart. They looked classic on the graph! I still didn’t feel all that uncomfortable and could easily go through lunch and evening snacks. Boy! Was I hungry! I was hungry all the time! I kept eating and still felt hungry! Hadn’t felt that way in a long, long time!
One more pelvic exam (which hurt like hell, by the way) confirmed that I was only 3 cm dilated. My membranes were also swept to help speed up labor. From 6 pm onwards the residents and MDs on duty came by one by one to say bye for the night as their shift was ending and assured me that from the looks of my progress it seemed quite unlikely that the baby would come in the night. They seemed confident that baby would arrive only the next day, in the morning at the earliest.
At around 10 pm the anesthesiologist came by again asking if I felt uncomfortable enough to go for the epidural and I informed him that I was still feeling quite spunky and would definitely call him as soon as I reach the pain threshold.
My nurse for the night was an extremely motherly lady, albeit not very much older than I. She was kind and very understanding of my discomfort, which by now, had gone up a couple of notches. Every time I would go to pee she would ask me if there was any bloody show. None, I would inform her. By 2 am things got really uncomfortable, with the pitocin bumped up at 12 milliunits/min. The contractions, though not mind numbingly painful, were on top of one another. I stayed off the epidural knowing that I would not be able to eat if I did take it at that point and with the hunger I kept feeling all the time, I though being off food would be harder to handle than the contraction pain. My nurse suggested that I could take Fentanyl, an analgesic given through the IV that’s supposed to get you a little lightheaded and take the edge off the pain. Each dose, which can be 100 mcg at the max, is expected to be effective for 20-45 minutes. I could take max 600 mcg. This meant 2 hours of relief at worst or 4 ½ hours of relief at best. I went for the first dose and immediately felt a morphine sort of a high! It did help a lot! I managed to doze off. Around 2:45 am I felt the effects of the first dose wear off and asked for a second shot. In the meantime, I did see some blood when I went to pee, and thought it was a good sign!
Around 3:30 am I was woken up with the trickle of water that seemed to come like a spurt and then stop. And then came the “OMG, what the h***hit me” contractions!! I immediately knew it was the real thing!! With each contraction, I would feel a little more water spurt out. I went to the bathroom and saw blood and fluid running all over my thighs! I didn’t need to have a PhD to tell that my water had broken! Nurse was a little skeptical, though; she thought it could still just be my bloody show.
The contractions were right on top of one another with the pitocin pumping away furiously at 14 milliunits/min. I was crying away in the pain and felt so nauseous that I threw up in the closest plastic bag I could lay my hands on! It was the worst kind of pain in a long, long time! Every time a contraction would hit me, which was within a minute of the last, it would feel like someone was running a hacksaw on my back---I was sure by now that I had back labor!!
I screamed for the anesthesiologist---he was in the OR! Damn! I couldn’t take the pain anymore! Finally the epi-man came in! He had a tough time putting the lidocaine on and the catheter in for the epi since I couldn’t manage to hold still for more than a minute at a time. Pitocin was brought down to 12 milliunits from 14 since my contractions were getting out of hand---the nurse commended on my ability to remain calm and said that I was breathing just right! I managed to keep slow, deep breaths on though I must’ve yelped like a dog run over! Finally the epi was in around 4:30 am. Within minutes I felt the pain go away, with a slight bit remaining in my left thigh. It was fixed by the anesthesiologist with an expert dose of Fentanyl. He deserved a Nobel! I could have kissed him for the excellent administration of the pain med---I hadn’t felt that good in months!!I felt nothing at all!!Not even the slightest discomfort!
The MD on call did a quick pelvic exam and announced that I was a good 6 cm dilated! I thought, “Holy S***! So, that’s how a 6 cm dilation pain feels like, huh?I wonder why some women choose to go all natural when there’s such a wonderdrug like the epidural available!!!”

Doc also confirmed that my water had indeed broken and then she went on to break the bag even further (the hindbag had broken so she broke the forebag). I felt a whoosh and lots of warm fluid. But no pain at all!
I drifted off to sleep and woke up around 6:30 am. Slowly but surely, the day staff of MDs and residents started trickling in. Another pelvic exam around 8 am confirmed that I was at 9 cm and close to pushing time, a progress which seemed like quite a feat for induced labor with epidural. A heartbeat monitoring probe was inserted and placed on the baby’s scalp.
I couldn’t feel the pain of my contractions at all—just a little tightening on the upper abdomen. For the next hour I kept shifting position from side to side as I heard the baby’s HB dip. As soon as I changed position, the HB picked up. Rohit was asleep on the couch. He didn’t hear the midwife come in with the MD and discuss my progress—they expected me to start pushing by 9:30 am. Things looked that good! Baby was way down!
Around 9:20 am I woke Rohit up and told him that it’s soon going to be time to push and he’d better get freshened up. He brushed and was ready to help me with the pushing within the next 20 minutes. I told the nurse that I didn’t feel any pressure yet but I definitely felt a tickle way down below there—I felt ready to push. The nurse got one of the MDs and explained to her how I felt. The MD got me to do a trial push as the nurse held one of my thighs and Rohit the other.
With one push the head was peeping out and the MD asked me to hold off pushing! The midwife and the residents rushed in along with the chief MD and I was shown with a mirror the baby’s head with the scalp probe on!! It was unbelievable!!
I gave a couple of more pushes and the baby’s head was completely out! Two small pushes, a nasty hemorrhoid and a second degree tear later the baby was taken out at 10:14 am and placed on my chest!!!Whoa!! And the pushing was all of 19 minutes!!A totally awesome and indescribable experience! The little darling kept gaping with her left hand in her mouth…for a good 10-15 seconds before letting out her first cry! And all I could say, as my memorable first words to her, was “Why are you so scared?” D-uh!
She was cleaned, her cord cut by her Dad, weighed at 7 lbs 10 oz, measured at 52 cm and blood sugar checked before she was given back to me again. Her blood sugar was a little low needing her to latch on my breast for a few minutes. Doctor took 45 minutes to stitch my tear up.
The epidural was shut off. I could feel my legs quite well though the residual effect of the drug made sure I didn’t feel any pain of the stitches and the likes yet. And I was so relieved to know that it was not back labor that I’d experienced!
When I look back at the birth experience, I’d say it went so unbelievably smooth, I’d do it again in a heartbeat!!