The Birth

Being on the other side of our infertility journey has left us with the most  beautiful little girl we could have ever asked for. Infertility will always be apart of who we are as a family. Our daughter will know the lengths we went to get her here and her siblings that are looking down on her. I don't think that part of my life will ever completely go away. But my other blog is dedicated towards those lingering Infertility posts and thoughts. This blog is dedicated to the life of our daughter the ups and downs. A way to document her precious life.

With that I want the first post to begin where she entered into this world. Her birth story. Prepare for a long read I'm sorry in advance.

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I did track a lot of little going ons on my phone, easier in the beginning of labor much harder near the end

Friday - 39 weeks on the button. Friday I had a NST appointment with one of my OB's. We went and she noticed very small contractions on the monitor in a semi regular fashion. I was feeling the cramping sensation about a few hours before so I wasn't surprised.

She then said she wanted to check my progress (not something I was expecting due to having just been checked on Tuesday). She said I was a tight 3cm. Which surprised me given I was a tight 2cm. She was a little rough lol. She said that I was thinning out to a point that she was notifying our offices oncall doctor as she felt it wasn't going to be long now. I thought "Great maybe things will start happening by Sunday/ Monday and we won't need an induction." As soon as we left the offices the cramping turned into a bit of pain. So I had Paul start to time them. Since we live an hour away from the hosptial and my OB we decided to stay in town for a few hours to see what was going on. I went to Caters to pick up some outfits for my friend and or SIL as I have a feeling one of them is having a girl and I had a coupon. I was stilll having the pain and in 10 minute intervals. So Paul and I decided to go to Olive Garden. The pains were picking up to a point that I had to stop when eating and breath a bit through it. So we finally got to a point of having them 5 minutes apart and called the oncall.

My mind a bit of a 'holy crap' mode. So we went in and they had us in for observation. Again the contractions (this point they were much different) were painful and to a point of breathing through them. We got in there at 7:30. The nursing staff was really great to us. I was getting a little put off because I was having contractions but the problem was they weren't even registering on the monitor. That played so many mind tricks on me I can't even begin to explain how it made me feel. I always thought I had a high pain tolerance so the fact that these weren't even a BLIP on the screen got me thinking I was obviously a wimp and if this was just the 'tiny' start of something I was in for one hell of a wake up call. It also made me feel bad for going in although no one made me feel this way. My OB came in checked me again and even did a little stretch (OUCH!) then we got sent home. Because of how everyone was talking at the hospital I decided it was ok to continue my medication regime.

We went home and I was still contracting but nothing bad. I was tired so we went right to bed. DH was so great about all of this as I was feeling bad for having him go in with me.

11:30 - the fun really kicked into gear. I went to sleep almost right away and then I got hit with a contraction that had me out of bed so fast I almost gave Paul a heart attack. This is when I knew we were into the real deal. There was certainly no mistaking it this time. Paul helped me into the tub after an hour of the contractions. It really was nice and soothing. After about 20 minutes we decided to go back to bed. Again contractions only being about 10 minutes apart. By the time we were in bed my contractions started picking up and they were 6-5 minutes apart. Being an hour away from the hospital we figured we'd call the on call again. I waited a bit longer because frankly I didn't want to have to get sent home again. I'd really feel like an a hole then.

2:30- Paul and I start our trek into the hospital and got there around 3:30. The ride in wasn't very pleasant as contractions were worse for me sitting down.

3:30- We were again sent to observation. I was checked, still a tight 3. (By this time I was mildly annoyed no progress had been made.) They had me laying down being monitored for close to 2 hours. I again was having contractions this time some were seen on the monitor while others weren't, and my upper belly wasn't getting hard like it should. It didn't make sense to me because the pain level of the ones that were on the monitor were the same as those not. I kept telling them perhaps they have it in the wrong area because I know what I was feeling. We had an amazing nurse named Sabrina who was a great coach and was a big advocate for us. She got us permission to get up and moving around while bringing in a birthing ball. Paul and I walked the halls stopping a lot along the way. I seemed to handle the contractions better standing up. Paul at that time was being such an amazing supporter. He just was a natural at coaching me and being such a positive influence. Something the nurses simply adored.

7:00- Nurses change up and I'm back in bed for the chane of shift monitoring. Again contractions to them weren't showing up consistant at all but if I timed them they were between 3 to 5 minutes apart. They did another check, still a 3. By this time I can't tell you how discouraged I was begining to feel. The OB said it may have even just been a 2 cm. But he stretched me, god did that hurt and said he was going to check back in a few more hours. They had me stay in bed. Then when the Nurse was charting and taking more information I started to get very shaky and light headed. I let her know, then things got a tad hairy. She put my bed down all the way and I just kept saying "I can't, I can't." I remember just putting my hand on the wall to try and feel grounded. Rush in nurses and BP cuff. My BP was 64/41, poor Paul didn't know what to do. Luckily during this time Baby girl was doing great. They tried to put in IV's in my hand but they had no luck. Then I started to feel a bit better. They tried again in my forearm and they were able to get a vein not before spilling a bit of blood all over the pillow damn near made it a new color of pillow case all together. No biggy though. They had me on fluids right away.

Paul told me never to do that again. I noted it and agreed. I was petrified about what was happening. Doctor came in at 9 and the nurses wanted me to finish my IV fluid bag first. So he made a decision to keep us on again. I was checked and still a tight 3. UGH! And apparently now only 50% effaced. Ummm WHAT!?

During this time he told me they weren't allowed to have me laying on my back like that any more and I was to do some rounds etc. Fine by me I labored better standing up So off we went. By this time I had on my pretty pusher outfit and I can't tell you how nice it was to have this on during all that time.

We walked the halls, got changed into a l&D room for comfort but they still weren't going to admit me. I turned to Paul and told him by the next time they check me if I hadn't made progress I was going to cry. I just felt like I was failing myself, my daughter and husband. We got another nurse at the nurse change and she was a gem. (all of them were). They all seemed to be really smitten with Paul and I. The thing I loved about her is she told me no matter what she counts contractions So I was a bit happy about that. They kept us until 5:30 by then I was checked and no progress so I had to be sent home. Cue frustration, tears and complete shock as I'd been in labor for almost 24 hours and had no progress what so ever. If these contractions weren't doing anything I was dreading what was to come. Not to mention very very exhausted at this point as the last time I slept was the Thursday night. Same with Paul (felt bad for him. I snuck out of the room and walked the halls so he could catch some z's.. Poor guy).

So off we went home and the ride just sucked once more. We got home and I made sure we didn't take any medication this time to ensure it was completely out of my system. I knew this was it just didn't know when. This time Paul and I were very militant about our contractions. Something about being sent home twice while in the pain I was in just really messed with both Paul and I's mind on when we should go back in. The criteria they give you is every 5 minutes apart and they were for me at least from what I felt and not going off of the monitors. So I was very emotional about when was the right time? Everyone says you know but for me that time came and went and i was still sent home. Talk about mind games. The contractions gradually picked up to the type that had you yelling, trying to grip anything in sight and some even crying. I just kept saying to Paul "I don't know how much more of this I can take. Going on day 3 of laboring was just mentally shutting me down especially with no progress." I was just down and felt like I was a failure at this entire laboring process, that I was a wimp and apparently these weren't even strong enough to dilate me. Wonderful!

At 3am I wanted to go back in. Paul reminded me about the 5 minute rule and my contractions were anywhere from 5 to 10 minutes apart again.But the length of them were between 2 to 4 minutes. One I had at the hospital lasted 7. yeouch. So I toughed it out and just kept on laboring.

Sunday 11/10 - 8:30am they started to get close again just after our shower just when I thought we'd have an hour of 5 minutes and under then i'd go to have a contraction 10 minutes later. Start the timer again .

12:30 I get a contraction that rocked my world. Almost buckled my knees. At this point Paul and I figured out a good laboring rhythm. Sit down until a contraction hit then get up and sway with Paul. This contraction hurt hurt hurt. Then comes the small gush. I knew right away what it was. "Paul my water broke." Paul perked right up I hadn't seen his eyes light up like that before. It was cute and funny. Then he goes "are you sure? Let me check." He goes and looks at my leg as it trickles. I head to the toilet and just managed to catch it. Told Paul to put a trash bag on the seat and a towel to absorb.

My mind I said the following. "Thank god there's an end in sight! They can't make me go home now." Paul put in the call to our OB. I think our OB was praising this for happening as well lol.

We head back in and my gosh the ride.. Sorry I keep saying this but it SUCKED! Especially since after my water broke it seemed to bring with it back labor. I just remember hitting my head a few times against the back of the head rest and trying to get my back off the back seat. I just wanted to stand up. And the water breaking at home? It was nothing in comparison to what continued to happen in the car. Every contraction stronger gush after the other. I think by the end of it all I could have made a decent sized pool.

1:10 pm - So we make it to the hospital and I'm standing in Emerge while Paul registers for me. I stood on their carpets because I was still gushing. Nothing better than standing in the ER while people pass by and you have liquid trickling down your legs. Humiliating doesn't touch how it felt. I didn't want to move for fear of more and more coming out. So there I stood on the carpets frozen. Paul wanted me to come onto the concrete floor. I did not lol I didn't want more people noticing there was stuff coming down my leg lol.

1:30pm admitted and all the nurses that seen us I think had a sigh of relief as we did to know we were being admitted. Many said Finally . Paul and I felt the same way. We were ushered into our room that was beautiful spacious and overall very comfortable. I arrived already in my 'pretty pushers' gown so there was no need to change.

OB came in as I was having a contraction and he said "Wow that was a good one. I bet your a good 6 if not 7 by now. Asked me what I wanted. "Anything more than a 3 lol". Turns out I was a tight 4. Talk about disappointment all around. I stayed up and continued to labor for another 2 hours.

3:30 OB came in to check me again still a 4. Holy crapola. He lets me know that they want to put me on pitocin as my contractions again weren't registering as regular or as regular as he'd like. Then he said that I'd get my Epi as soon as they knew the Pitocin was doing it's job.

4:00 Pitocin was administered and right away the contractions pick up in bed and the back labor was just the worst laying down. All 4's really helped alleviate the pain. I then asked to hydrobirth for a little and they connected me to this really neat transmitter device that would allow me to walk freely in my room and even labor in water (device couldn't get wet though but the paddles could no problem). I was really worried about being put up in bed once I had pitocin so was very happy about that. I labored in the jetted tub one jet on my back helping me big time. I mean it didn't take away the pain all together but it was soothing over all.

4:40 - Nurse submitted paper work into for an EPI as the pitocin was doing it's job. They upped my dosage to a 6 (still not high obviously) but doing a good job of regulating things and the strength was damn strong.

5:20 - Anesthesiologist comes in and gives us the epi. He let me keep my own gown on for this process. He was a bit reluctant but came to. He was even kind enough to let Paul stay in the room. It is certainly hard to experience back labor while having to extend your back for the epi. The Epi itself was a breeze didn't hurt almost the same type of pain I got with my daily injections during the pregnancy.

Almost immediately my body starts to feel amazing. and I did what every pregnant woemen does I'm sure and tole the Anesthesiologist I loved him lol.

it seemed to be really really working well on my right side as I could not move it at all. The left it was hard to move but still doable.

They upped the dosage

6:30 - My OB gave me a really really good stretch once I was numb. He commented on how high up she still was and wasn't happy about that. He let me know that they'd give me 2 hours and if no progression was made they'd have me do a c/section. At that point I completely agreed with them. WIth being in labor for so long at that point and with the dosage they put the pit up to I knew we'd be delaying the inevitable if no progress was made.

They had my guests leave and told both Paul and I to try and get some sleep. So we both tried. they had me switching sides as baby girl wasn't responding well to the contractions and her hb went down with every contraction nothing that stayed down and always recovered but enough to be a mild concern. Again we kept switching.

8:30 - OB checked me and again no progress. C-Section was put in and we were waiting on the anesthesiologist. Luckily he was in house taking care of 2 other patients.

10:50 - rolled into the OR and my body just was shaking badly. I couldn't stop it, apparently it was from all the hormones? Not sure, but it had my mind side tracked for a bit. My Primary OB came in to do the c-section which I was happy with as I heard he's the man you want to have doing your c-section.

11:00 (ish) and on lol - they're chatting away. I'm just shaking and they put the oxygen on me while i had a stuffed nose. All I could think of was how I couldn't really breath. I always heard that c-sections take merely a few minutes. SO I was a bit surprised when I felt like more than that time had passed. Then came the shaking of my entire bed. Both of my OB's were grunting "Strange" I thought. Then I hear "I wonder if we can push her up let me try." ... "Nope not working." I hear my doc talk to the anesthesiologist about putting me under and thats when I start to worry that something was wrong. So more shaking of the bed, they made more cuts I guess to my uterus. Then they tell Paul to get his camera ready (30 minutes after they started everything), I hear girggling cries (at 11:28pm) and a tear goes down my cheek. I wasn't properly processing things. So when Paul brought her to me all I could say was "Oh my gosh so cool." Still shaking up a storm. Paul leaves and I was alone I hear the ob's talking about how one OB had always said she has these types of cases but that they could finally tell her they actually experienced the real thing.

Rolled into recovery and within 15 minutes Paul brought baby girl to me and they had her skin to skin with me bf'ing right away. I'm still out of it but it felt so amazing, I was in a daze and just hadn't fully 'seen' my daughter yet. If you know what I mean. A mix of everything I just couldn't grasp she was here.

There it was explained to me what had happened. The OB told me that no matter what we did I was not going to have her vaginally. He said that what I had was something called Bendls ring. That in the 22 years of his practice he has never had such a hard C-Section. I still didn't have a clue what had happened but he let me know they made quite a few cuts to my uterus (t incision) and that for future pregnancies we wouldn't be able to do anything other than a c-section (meaning no VBAC) which I was confused about and wanted more answers for but the fentenol was knocking me out fast. So we cut things short I was rolled to our room. Paul had taken Anastasia back for a little bath and they stopped my bed at the window. There I stared as Paul glowed from ear to ear giving laughs as Anastasia cried and went on. It at that point made me cry. The next morning when I held her in my arms.. I was blown away. It's then when I truly saw her and could say loved her with every fiber of my being You could see the same expression on Pauls face.

A quick explanation on Bendls ring as I've never heard of it so figured many others haven't as well. I honestly feel so lucky especially after reading up on this that my water broke. Since in some cases this can lead to still birth. Someone was watching out for us. This also explains why not all of my contractions were showing up on the monitor and when they checked my upper belly.

"There are two types of uterine muscles, one to help the cervix dilate and the other to help push the baby out. At their juncture, rarely (usually during a prolonged and/or obstructed labor) a ring develops around a “depression” in the fetus, usually over the neck (with Anastasia it was around her shoulders a big saving grace). Sometimes when this happens, even a birth by C-section is difficult, because the ring prevents the birth of the shoulders and the rest of the body. Usually, the uterus will greatly constrict, which disrupts placental blood flow, and therefore oxygen flow, to the fetus. Bandl's Ring was named after the doctor who first identified it."

"symptoms"

-Hypertonic contractions

-presenting part driven/jammed

-mother experiences severe pain and excited or restless emotions

-maternal pulse, temperature rise

-palpable, taut round ligaments; may also be visible

-Baby entirely or almost entirely in lower uterine segment.

-ring felt as transverse ridge, as high up as umbilicus or potentially even higher

Differential Diagnosis: May appear to be constriction ring. (see chart Frye p. 1043)

Complications/Sequelae:

-rupture of the lower segment, maternal hemorrhage

-placental abruption

-maternal exhaustion, inertia, and arrest of contractions

-uteroplacental insufficiency with resultant fetal hypoxia and distress.

-maternal fistula, lacerations more likely"

What this means for the future is
1. No vbac (because of T incision and the possible re- occurrence of the ring). I'm not sad about this because no 'birth' plan is ever worth putting my child at possible risk for a vbac knowing the potential risks I'm putting him/her under.

2. Much higher risk of placental abruption if we get pregnant again.

3. Placenta growing into the uterus? (I believe this is again associated with the T incision).

Overall I'm happy but a tad upset that this wasn't taken care of sooner. Not that they knew really what was going on. But I wish they would have trusted me on Friday when I reported the frequency of the contractions. Especially when they sent me home a second time. But the important thing is baby girl is here she is OK and we couldn't be happier. What we went through will have to play heavily in our decision to get pregnant again as it's another possible risk factor on top of what problems we already have. For now we're enjoying her and will re visit the possibility of more children later. But right now we're actually happy with one.