Monday, June 18, 2012
Levi's Birth Story
I am pragmatic, I am told. Thus, the title of my blog. Also, I'm a nurse, so if you can't swallow a fairly straightforward birth story, PLEASE DO NOT READ THIS POST! Two weeks ago, on an overcast Saturday, we birthed our first child, a son named Levi Wrangler Lee. I say that WE birthed him because Cameron never left my side. You'll see later other ways that he "helped". It all started on a typical (for me) Wednesday. I rode my bike 10 miles to my midwife's birth center in Bellevue. Thoroughly sweaty and pregnantly exhausted, I arrived just on time to meet Cameron, do my urine dipstick (which showed, for the 1st time, slightly elevated protein), and walk in for my 30-minute visit. Andrea, my midwife asked if we had any questions, talked for a bit about the glucose test for next time, gave me my lovely orange drink to store in the fridge at home, and proceeded to check for Levi's heartbeat via Doppler. She could not hear the heartbeat after about 15 minutes of trying different positions and amounts of ultrasound gel, so she asked her colleague to come give it a try. Lauren, the other midwife was not able to find his heartbeat, either. At this point, Andrea was a little on edge, but I was not concerned in the least. We have had issues because of an anterior placenta (meaning it lies right behind my belly button, impeding many things such as the Doppler and my ability to feel Levi's kicks). She asked me to go for Ultrasound, so of course, the logical response was for Cameron to stand up and tell her, "Let me try." In a flurry of giggles and "Ow's" from me, he proceeded to press the Doppler against my abdomen in a manner quite unsuitable to a full bladder. He has had experience with ultrasounds, as he worked in Critical Care for a few years and sat for many hours holding pressure to the groins of many a person who had just had a femoral catheter removed. Nevertheless, after no heartbeat from Cameron's prodding, Andrea suggested I come back the next day for her to try again (position change?). Thursday, I arrived to my appointment at 1pm. This time, I drove, since I had to work at 2:45. No heartbeat, quick phone call to Eastside Maternal Fetal Health for an immediate appointment. I drove to the MFH office, which is right across the freeway from the hospital where I work for a 2:15 appointment. I am feeling bit rushed at this point, and the tech who brought me back to the ultrasound room was running late...of course. She had me recline in a chair and immediately slapped a blood pressure cuff on my arm. "147/80 - that's a little high. We might be concerned about that." I gave her a polite smile and told her that perhaps she might want to try it again after my ultrasound, since I was going from appointment to unplanned appointment, running late for work, to boot. She left, and Tom, the US tech walked right in and got to work. For the first time, I got warm US gel on my abdomen (why aren't they all warmed?). Tom got a good view right away, but I knew as soon as Levi came on the screen that something was wrong. That little pitter-patter of his heart valves was gone. For the 1st time, I panicked. I told Tom, "I can handle any news you give me. I don't want you to wait until the end. Please tell me as soon as you know something." He measured femur length, head circumference, and gave me an estimated gestational age of 19 weeks, 6 days, and told me, "I'm so sorry, but I can't find a heartbeat and it looks like we're dealing with a fetal demise. I'll go get the doctor; he should be right in." When Tom left the room, I took a deep breath and called Cameron, telling him the news and to get here immediately. Then, I sobbed the first deep cries. A million thoughts ran through my head: "I should call my mom and dad - they've been praying"; "What about Danielly (my pregnant friend)? How will she take this?"; "What will Cameron say when he gets here?". I went through half a box of Kleenex before the perinatologist walked in the room. He was very sympathetic, offering me his sincerest apology, then began telling me that they did not know what caused this, this was not my fault, there were a few options to choose from, and I would have to follow up with my midwife for where to go next. Then, Cameron came in the room, stoic as all get-out. I had called him earlier, on my way to the US, and I thought he may not have received my 2nd voicemail, thus being clueless as to the results of the scan. He told me later that he'd listened to my message and had to go in the bathroom at the clinic to compose himself for me. The doctor told us that I could have a D&E (more advanced than a D&C because of Levi's gestation), that I could wait for labor to begin (could be weeks or months), or that I could be induced. I could NOT imagine going through either of the first 2 options, so we left the clinic to go back to my midwife's office. Chris, the primary midwife at the birth center, got us in despite a full schedule and just hugged me for what felt like a few minutes. She told me she'd like me to go to Valley Medical to see Dr. Jolly. Her 2nd choice would be Dr. Brown at Valley, if we couldn't get in to see Dr. Jolly. Cameron and I know Dr. Dennis Brown and his wife, Jean, from our church community and told Chris we would prefer to see him. What transpired could have only been the work of the Holy Spirit. We left the birth center and drove to the nearest parking lot, where we hoped to have some privacy as we called family and friends. We called both sets of parents first. Both our mothers responded as though we were joking; in retrospect, I can't personally imagine my child calling me to tell me this news. Then, siblings (the hardest part of all of this was having my younger sister, Jill, in India, where I could not immediately reach her). Then, Cameron's grandparents, and our very close friends. We waited to hear from Chris all night, who assured us she would be calling Dr. Jolly's cell to let her know what had happened and to try to get us in for induction as soon as possible. Our families met us at home around 7PM and we all sat around comforting each other and talking about the What-Ifs, which were quite variable at that point. We got a call around 9:30PM from Chris, saying that she couldn't get hold of Dr. Jolly, which was very odd since they're friends, and that she would call us in the morning after she called the office number. I slept very well that night, despite being very upset. On Friday morning, Cameron went to work and I got a call from our Pastor Dave, who wanted my permission to call Dr. Brown personally with the news. About 5 minutes after hanging up with Dave, Dr. Brown called me and offered his apologies for what had happened. He said he'd call the head charge nurse of Labor & Delivery to book a room for me that evening and they would start preparing my cervix in anticipation of potential induction with Pitocin, which would start Saturday afternoon. He said he would specialize in my care, meaning that, although he was not the on-call doctor that evening and night, that if anything needed to be done or I had any questions, the nurses would call him personally (not Dr. Olson, who was on-call). He also gave me his home and cell numbers and told me not to hesitate to call him for anything. My mom, sister Kirsten, and bosom friend, Lauren spent Friday with me. When Cameron got home from work, we packed our bags for the hospital and I was admitted at 6:30PM. Tiffany was my nurse. She didn't have to go through the packet of paperwork (somehow, this had been taken care of between the charge nurse and my birth center), but did orient me to the room and the plan of care. She answered all the questions I had for her at the time and soon went off shift. My night nurse was Leslie, who was also a midwife and went to school with Chris. Leslie was a blessing from the LORD, a peaceful spirit and a kind woman, who was precisely what I needed that night. Leslie tried 2 IV starts unsuccessfully, then another floor nurse attempted twice with the same result. About 10 minutes later, an IV nurse (thank God) came with a warm pack and successfully placed an IV in my left forearm (the site of choice for Cameron and me, so that he could hold my right hand during labor). At 8PM, I was given my first dose of Cytotec, a tablet that is inserted vaginally to soften the cervix for delivery. Then, I took half an Ambien for sleep, wrote in my journal to Levi and to God. I slept well until 3AM, when I was given another dose of Cytotec and the other 1/2 of my Ambien. At 4AM, I awoke with back labor; Leslie checked on me, brought me a heating pad, and lightly rubbed my back with her fingertips while I lay on my side. I must have fallen asleep during that time - it was heavenly. Cameron and I had talked about his work schedule on Thursday evening and agreed he would complete all pre-scheduled days. He is in his last few weeks of a paid internship at the PRO Sports Club as a personal trainer, after which he'll move to commission and a permanent position. He is currently on a 6 day-a-week schedule, with Sundays off. The ability to sort of time delivery for Saturday evening was part of what led us to choosing to be induced, so he could be with me the whole time. Cameron left for work (a 4-hour day) at 6:20AM on Saturday. I kissed him goodbye and slept another few hours. I remember my mom and dad coming in and saying something and I just waved my hand at them in recognition, but kept sleeping. I think I'll stay away from Ambien except for those rare occasions, when it would really benefit me to sleep through labor pain. ;) Leslie went off shift at 7AM, when my day nurse, Tammy came in to meet me. She told me that Leslie had spoken of my faith, and asked if she could pray with me. I was ecstatic to have a nurse who would ask me this and to pray the words that she did. It was part of what gave me continued strength to go though that very difficult day. I spent the morning with Mom and Dad, Lauren, Kirsten, and Debbie (Cameron's mom). Dr. Brown came to see me and gave me a 3rd dose of Cytotec at 9:50AM, when I was found to be 70% effaced. We talked about my wishes against epidural and narcotic pain management, and he asked me to think about the use of epidural if it were a long labor. Cameron arrived with his friend, Ryan around noon. I had a light lunch, but didn't have much of an appetite, and didn't want to have a full or upset stomach when my contractions started. I was given my 4th and final dose of Cytotec around 3PM, when I was found to be 90% effaced. Tammy went off shift and I met Kim, who was finishing the last 4 hours of her 12-hour shift. Cameron and I took a walk around the hospital, and I started having more and more cramping. At 5:05PM, Kim started my Pitocin drip at the lowest setting and began monitoring my uterus for contractions. She would look at the monitor and say, "Do you feel that?" I only felt more cramping and discomfort, but not pain, yet. Dr. Brown had notified our family and friends, as well as Pastor Dave and his wife, Suzette, that Levi would not arrive before 4 hours, and that labor could be as long as 14 hours. Cameron, Debbie, Ryan, and Shanna (Cameron's sister) were in the room. We were all joking and laughing and then my contractions started. The first one was 45 seconds long with a 15-second break. I was able to laugh through the first few, but the contractions continued at this 1-minute interval, getting stronger and stronger. When Cameron had to help me remember to breathe (note: we have not taken birthing classes, yet), everyone else left the room. It was only about 5 minutes into the Pitocin drip, I'm told, when my IV infiltrated (the fluid and medication was not going into my vein, but into the surrounding tissues). Kim stopped the drip and went to call Dr. Brown, telling me we would need to start a new IV. It took about 10 minutes for her to come back in the room; by this time, I was really having to work through the contractions. The room felt about 120 degrees and I just wanted my hair back and a fan in my face. Truthfully, I didn't really care if I had a gown on at that point! Kim took the IV out of my arm, giving me a compression bandage. My left arm was quite swollen. I mostly labored lying back at about 70 degrees. We tried side-lying which I knew immediately wouldn't work. We tried kneeling on the bed with my elbows on some pillows - wasn't gonna happen, either. Kim kept asking me when she could put the new IV start in. All I could think to tell her was, "When am I gonna get a break longer than 15 seconds in which to breathe and relax?" And, "How can one possibly start an IV in 15 seconds?" She moved on to another subject, asking me to get up to try to urinate. Well, my bathroom was pretty close, but I told her I could only do it if she flung the door open and got out of my way. I sat on the toilet for about 10 contractions (5-10 minutes) with Cameron supporting me in front. She wanted me to get back to bed, so again, I told her to get out of my way and I might be able to do that. Back in bed, the contractions got worse. When Kim asked, I told her my pain level was at a 9/10 (10 for me was when I had an earache and Cameron obliged me by putting warmed olive oil in my ear - won't do that again). So, she pulled up a chair across the bed from Cameron and asked me what my birth plan was. Side note: given the urgency of our situation, we didn't have time for this. However, I strongly suggest that you develop your birth plan in writing for the multiple people who will ask you about it. I had told my very 1st nurse, Tiffany everything I ever wanted in a delivery, including the most important and final step in labor: a water delivery. However, the 10-minute speech wasn't passed on in its totality. :) Back to Kim. Cameron started telling her about the 'No epidural, no narcotic medications' policy that I had so distinctly told him to recite the first time we talked about having children (when we were dating). I was sitting in bed, watching these 2 people converse about MY body, and I told them, "No, no, no...I can't do this for 12 hours! I didn't think labor would be like this!" At this point, Kim told me that normally, even induced contractions do NOT start at 1-minute intervals and that I may or may not have received enough Pitocin, but that my body had fully taken over and delivery was imminent. She had already called Dr. Brown to come, which I wasn't aware of. Cameron then told her about the water delivery, but I was so hot, I couldn't imagine getting in a warm tub. So, she drew a tepid bath and got out of my way so I could run in and start soaking. The second I hit the water, that 9/10 pain was completely gone. I relaxed and felt a pop. Not a minute later, Kim called at me through the door, "Dr. Brown's here - he wants you in bed so he can do a vaginal exam!" I told her there was absolutely no way I was getting out of the tub for a vaginal exam when she had specifically told me I could deliver in the water, as was my plan. Furthermore, I was going to drop Levi on the floor if I got out of the tub. I really didn't realize how close his delivery was. But, with further insistence that Levi would not drop out of my body and that I would be able to get back in the tub in time, I ran across the room back to my bed, leaving my wet gown in the tub. I lay back to that 70 degree position, but Kim dropped the head of my bed to 30 degrees. Another note: I HATE lying flat. My mom was pulling my hair back and Dr. Brown was getting his gloves on when I came out of the fog that had enveloped me for the past hour and sat up, saying, "He's here." Cameron put his hands on the bed and caught Levi as Dr. Brown frantically rushed to finish getting ready. At 6:13PM, our perfect little boy arrived to this world with the umbilical cord wrapped around his neck, then his arm, and again around his neck the opposite direction. Though he never breathed a single breath this side of heaven, Cameron and I were both beaming, happy parents. I told Cameron that June 2, 2012 was the worst and the BEST day of my life. Levi had perfect features: 10 tiny toes and 10 tiny fingers, eyebrows, muscular legs, all his boy parts, eyelids, nostrils, lips, ears. Over the next 12 hours, I loved getting to know my son. We slept well Saturday night, as well. Sunday, I showered and got minimally ready. I told Cameron that I've never felt so un-glamorous and yet incredibly beautiful. Leslie was again my night nurse, from 7PM-7AM. We told her we would be taking a walk as a family, bringing Levi in the Moses basket I had bought for him. We were allowed to do so, but required to keep his body covered while in the hospital. We walked outside to the fountain, where Cameron snapped the last photograph before our camera died (it was fully charged when we got to the hospital). We turned on the video camera and took many videos of us with Levi. Cameron held him and we took videos of Levi touching the grass and the flowers, and Cameron explaining to him what a bumble bee was. :) That time outdoors is a great time to reflect upon and definitely a critical part in our healing together. I am honored to have carried Levi for 23 weeks. I will never forget that day, the following weeks of healing, and the immense pleasure of being Levi's mommy. I can't wait for more children, to get to experience the miracle of life all over again, and for the growth that Cameron and I will continue to see in our relationship. God is good and has a plan for Levi's life and death; he knows why this happened; and he is the great Healer. If you have questions for me, please ask them. I am an open book - it is part of my healing process to be able to talk about everything that happened. More in the coming weeks about how we are doing!