Labor: Day Two

This post is a continuation of my labor, delivery, and postpartum story. When we left off, the first 24 hours of labor had drawn to a close and I was still only one centimeter dilated!!

See Labor: Day One for a breakdown of the going-ons on the first day. Read on to find out what happened on day two.

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So my second evening in the hospital began similarly to the first evening. They nurse turned off the Pitocin and ordered me a tray from the cafeteria. I was allowed to take a shower and eat a little something before the foley ball would be inserted. Before I was able to shower, though, I started to get pretty significant contractions. This was a surprise to all of us because we had stopped the Pitocin. Luckily the hot shower helped to alleviate the pain and the contractions subsided before the foley ball insertion.

A foley ball is a balloon-like device that is inserted into the cervix through a catheter. Once inserted, the doctor fills it with water to expand the cervix. The expansion is relatively painless. But the insertion is less than pleasant. The doctor could not seem to get the damn thing in the right place. And it hurt. Bad.

The second night passed much like the first night. Testing and waiting and trying to nap between interruptions. Now that we were more familiar with our surroundings, we could make out the activities going on in the rooms around us. We could watch the contraction monitors by the bed and match them to the rooms where the deliveries were occurring. All around us, women were screaming, babies were coming, and families were celebrating. And we were still testing and treating and waiting. By morning, we were more than ready to get this show on the road.

When the doctor removed the foley ball, at least we had some good news. I had dilated to 5 centimeters. Yea! So the next step was to break my water. Which caused immediate, painful, full-on contractions. They came fast and furious. So fast that I hardly had time to catch my breath between them. It seemed like an eternity while I waited for the anesthesiologist to show up and administer the epidural.

So the lesson here? Request the epidural before they break your water. And require painkillers before they insert a foley-ball.

Once the epidural was in and I was comfortable, they started to push the Pitocin again. But every time they increased the level of Pitocin, the baby’s heart rate would drop. At one point it dropped so far and for so long that they started to prep me for an emergency c-section. My husband and I were both scared to death, because they don’t even tell you what’s going on until they have you half wheeled into the hallway. All we could hear was a lot of alarm bells ringing and people talking. There was absolute chaos in my room and a great deal of urgency. And then, just as fast it started, it stopped. The baby’s heart rate returned to normal, and the excitement was over. But as a result, I spent the rest of my labor wearing an oxygen mask and being turned from side to side. Which is especially hard to do when you can’t feel your legs.

At the end of day two, we were exhausted and beat down. The on-call doctor checked my progress and I was still at only five centimeters. Certainly not dilated enough to deliver a baby. So my doctor came in and said we’d be doing a c-section. I was so disappointed. So tired. This was exactly what I didn’t want. But there was no other option. I got a little teary, and started to stress out about what was coming. Major surgery. Yikes.

Check back tomorrow for the details of day three.

Labor: Day One (Finally!)

Scrolling through the archives of my blog the other day, I realized that I never really told you all about my labor, delivery, or postpartum experiences. I started a collection of posts on these topics some time ago, but never finished them.

It’s just so hard to explain the rush of activities and emotions that occurred over the course of those seven short days. I  kept trying, but was never satisfied with the results. And then my netbook died, taking those draft posts along with it.

So I thought I might try again. And this time I’ll be sure to back up my files.

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You might recall that the day before my induction, we had an amniocentesis which confirmed that BabyNoName was ready to be delivered. The office assistant gave us instructions to arrive at Labor and Delivery the next day at 5pm.

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We arrived at the hospital right on time at 5pm and the nurses were ready for us. I was surprised by the amount of paperwork to be completed and the details to be finalized. But I was comforted by the fact that the nurses seemed confident in their ability to deal with my “special” circumstances and their seeming interest and concern about my baby’s well-being.

It seemed to take forever, but it was probably only a couple of hours before we finally got started with the IV and then the Cervidil. As a reminder, Cervidil is a gel that is applied to the cervix by means of a tampon-like device that is placed in the vagina. It’s supposed to thin the cervix and, in some cases, can even dilate the cervix. As expected. It caused light cramping, but was not difficult to deal with. I was still allowed to get up, walk around, and use the bathroom on my own.

My husband and I fell into a routine of testing and logging my BG every hour. At one point, I was low and the nurse let us treat it with our own stash of supplies, so from there on out, we took care of my BG.

The Cervidil stayed in all night, and in the morning, the doctor on call checked my progress. Boy was I disappointed to hear that we’d only progressed to one centimeter. One! So next we started with Pitocin through the IV. The Pitocin increased the discomfort of the cramps, but they were still not debilitating. They gave me morphine every four hours or so to keep me comfortable. We also used the exercise ball to sort of massage away the pain and to try to take advantage of gravity.

The nurses really went out of their way to keep me as comfortable as possible, and they were very hands off with the whole BG control thing. They wrote down everything I did, from BG tests to basal adjustments, to low treatments, but really stayed at arm’s length. One nurse told me that as long as I was able to keep everything under good control, they would let my husband and I handle it. But if things got out of control, they would step in. And they kept their word. I was impressed.

So after a whole day of labor with low levels of Pitocin, another on-call doctor checked my progress. Still one centimeter. No, I’m not joking. Oh, how I wish I was! At this point I had been in “labor” for about 24 hours. My doctor stopped in and advised me that they would next try a “foley ball”. I’d never heard of this procedure before. Fair warning: if anybody ever suggests it, consider running in the opposite direction.

Stay tuned for “Labor: Day Two”

Finally, an Update

First, let me thank the couple of readers I have who have hung on with me through my most recent hiatus. Things are getting kind of crazy in my little world now and blogging has definitely taken a back seat. Without further adieu, here is an update on what’s going on and how things are going.

I am officially 36 weeks pregnant today. Baby NoName is still passing his non stress tests with flying colors. I was scheduled for one yesterday, Memorial Day, and the Fetal Eval Department was closed, so I had to go to Labor and Delivery for the appointment. It was kind of nice to get a sort of dry run for finding L&D and where to park again. The maternity ward was pretty quiet. I’m hoping for the same environment on the big day.

Luckily, when we arrived at the reception desk, I recognized the L&D nurse from the Fetal Eval Department. She fills in there from time to time. Along with Baby NoName’s regular kicks and heart beats, she also recorded two contractions. She says this is normal at 36 weeks. They are just “practice” contractions. They were so weak that I didn’t even realize that they were contractions. They felt kind of like Baby NoName was stretching inside my uterus and just pushing his little walls to their limits. If I have more than six in an hour, I should call my high risk OB.

We officially have a plan for the birth now. Seeing as both baby and I are healthy, we have planned a tentative induction for 37 weeks. That’s next week! I think that if I had resisted and tried to wait this out until closer to 40 weeks, my doctor would have agreed, but the truth is I am tired and grumpy. The testing and prodding and doctor appointments are really starting to get to me. I’m not sure how much longer I can take this routine. Couple that with an increased risk of fetal death in the last month for type 1 diabetic moms, and I am more than ready to get this show on the road.

So the plan is that we have an amniocentesis scheduled for next Monday. The amnio is used to check the maturity of Baby NoName’s lungs. Apparently, the only real risk with an amnio is contractions. When you get an elective amnio in the earlier stages of pregnancy this is more of a risk because it can lead to miscarriage, but at this late stage, the risk is much less because the baby is much more likely to survive if you go into early labor. Basically, contractions at this stage are OK because we are more or less ready to deliver the baby anyway.

If the amnio shows healthy, fully-mature lungs, then we are ready for the induction. If my cervix is not yet dilated, I will be admitted to Labor and Delivery the same evening for Cervidil. This is a prostaglandin gel that they apply to the cervix to soften and thin it. Then they will start the Pitocin through an IV in the morning. Pitocin is an artificial version of oxytocin, the hormone that my body would make naturally during labor to cause contractions.

If I am already starting to dilate on my own, then we will just wait until the next morning, skip the Cervidil, and start with the Pitocin.

I am a little freaked out about the whole induction process. I’m reading that Cervidil can cause painful but non-progressive contractions. And Pitocin can cause contractions to be more painful, but ultimately not work well enough to progress the labor. I have heard horror stories of inductions that last three agonizing and exhausting days and then result in c-sections anyway. It seems that sometimes induction works and sometimes it doesn’t. I expressed my concerns to my doctor who told me that these scenarios are all possible, but that there is no way to know if induction will work until we try it.

He is strongly in favor of induction over a straight c-section given that Baby NoName and I don’t have any of the standard diabetic complications. It is hard for me to believe, but my eyes, my kidneys, my blood pressure, baby’s heart, baby’s weight, and baby’s spine are all perfect. I guess all of those late-night BG checks and the never-ending appointments are finally paying off.

So I made a deal with him. We will try induction for one day (24 hours if we have to use the Cervidil the night before.) If I am not progressing and am not at least semi-comfortable, we will move forward with the c-section rather than waiting another day or two as is his standard procedure.

In the end, I think it just comes down to me freaking out about the whole labor and delivery thing. No matter what route he takes to get out here, it is not going to be a walk in the park,. So ultimately, it doesn’t really matter which avenue he chooses as long as he is healthy.