Saturday, July 23, 2011

Who knows what to expect? Part 2 - The Necesarean

After the BPP, things began moving. My nurse came back into the room and announced, "I was right! You're being admitted and we're going to deliver the baby." She had prepared us for this possibility earlier, when Bob and I had still thought that it was likely that we'd just be monitored for a while and then go home. Of course, after the baby completely failed the BPP I knew that it was time for him to be evicted. During the time we'd spent monitored at the hospital, the contractions I'd been having started becoming more regular and distinct, although they were still not that strong. His reaction to the contractions also became more obvious. I heard the resident doctor and nurses discussing the fetal heart rate strip in preparation for calling my own doctor, and I was surprised to hear them using terms like "some late decels, little to no variability, no accelerations." There are different kinds of deceleration patterns, some worse than others, and I knew enough about fetal heart rate monitoring to know that this terminology meant that the fetal heart rate pattern was worse than I'd thought.

The resident doctor called my doctor, Dr. D, while she was in my room and while they were finishing up my admissions paperwork. I was surprised that after she'd spoken to him for a while, she handed the phone to me and said "He'd like to talk to you himself." He asked me what had brought me into the hospital so he could hear what had been happening in my own words, and he talked about the test results from the heart rate monitoring and the BPP, and why he thought it was best to go straight to a cesarean. I was in complete agreement with that, though I'd never have predicted before hand that the word "cesarean" would be a relief to me. I wanted to know my baby was safe, and I didn't see how he could tolerate stronger contractions when he couldn't handle weak pre-labor ones. I handed the phone back to the resident so the doctor could give his orders, and I started getting prepped for the section.

I absolutely thought this section was the right choice, medically, but I was completely terrified. I was worried about the baby's safety, but I was also worried about the section itself. I'd never had significant surgery, and since I'd had four natural deliveries I'd never even had an epidural. I wasn't sure what to expect from the experience itself, it was totally different from what we'd done before and what I'd been preparing for.  While they weren't wasting time, it was also not a desperately urgent section. Baby continued to be monitored while we prepared for the section. I talked to the resident doctor, the anesthesiologist, and signed the necessary paperwork. The nurses tried to keep the mood as light as possible to be reassuring. We joked about how good Bob looked in the blue surgical scrubs, and lamented the fact that the camera was out in the car, we hadn't expected to meet baby that night. My OB arrived, and I was never more grateful for his sense of humor. The first thing he said was, "See what happens when you choose an OB for prenatal care? You have all kinds of complications."

Still, by the time we got to the OR I was terrified. The nurses and anesthesiologist were wonderful, but it was still very difficult for me to relax. The idea that I'd be able to feel what was being done, but it just wouldn't hurt, was very scary. I finally began to relax some and was able to chat with the anesthesiologist and the nurse once I was pretty sure they'd begun the surgery, and I hadn't felt any pain. When the doctor ruptured the amniotic sac, he noted that there was a lot of meconium, another sign that baby had been significantly stressed in utero. They suctioned out his mouth and nose before he was even all the way out, then unwrapped and cut the cord (it was wrapped around his neck and shoulder twice) and handed him to the nurses. He shocked everyone by making his first weak cry on the way over to the warmer. They'd been prepared for a medically compromised baby, but he really did quite well. Bob tells me that he was purple and limp when he was born, but he began to breathe on his own right away and soon began to pink up and regain his muscle tone. I was so happy I was practically crying as I watched them examine him in the warmer. His wiggles and stretches were all the more precious because they'd been absent for the last several hours before he was born. Soon the NICU pediatrician attending the delivery said that he was obviously not needed here, they quickly weighed and measured the baby, and he was brought over to be with me while we waited for them to finish the closure of the incision. Everyone thought he was beautiful, of course, and there was much discussion about whether or not he had red hair.

After the section, Dr. D told me, "Your tubes and ovaries look great, and the incision is a low transverse one. You should be good for four or five more vaginal deliveries with no problem." Bob appreciated this, but I don't think we'll take him up on his suggestion. We joked that I'd "gone over to the dark side," since I'd had a completely medicalized delivery after four natural, low intervention ones. The dark side seems to have cute babies.

When we got back to the same labor-delivery-recovery room that I'd been monitored in, they unwrapped baby and we got the skin-to-skin cuddle and breastfeeding time that we'd missed out on right after the delivery. I got some juice and crackers to snack on. Bob fell asleep.  Overall, the experience was far, far better than I had thought a surgical birth would be, and luckily the recovery has also been easy so far. I hope that stays true. In any case, I have a beautiful healthy baby.

Here's a gratuitous cute baby pic -- Julian at two and a half days old, ready to go home.

1 comment:

  1. He is beautiful!

    Thank you for sharing your story -- so happy that everyone is doing well! And his hair is totally red, IMHO ;)

    (Btw, Natalie also passed meconium at some point before she was born -- she was stained, so it had been there a while -- and the couple of minutes after she was born and they were suctioning her and checking her lungs were some of the longest of my life!)


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