Birth Story Part 2: In Labor and Delivery

This part of the story takes place in my Labor and Delivery room. The timing of this portion is all a blur to me, but I do know the basic order of events and I will try to piece it all together.

The first challenge was finding a hospital gown that I didn’t want to rip off of myself- because the material aggravated my Obstetric Cholestasis and made me super itchy. When I mentioned my discomfort to one of the doctors he offered me a dose do benedryl via my iv. I’m not usually one to say yes to drugs but I was desperate for relief. It was also supposed to make me drowsy- and I was hoping to be able to rest. Sadly the benedryl didn’t work as well as I had hoped and I was too uncomfortable from the contractions to be able to sleep.

Right away when I got to my room I was hooked up to the monitors for the babies and for my contractions. I wanted to take a bath so badly, but I wasn’t allowed to (can’t remember why at the moment) I think they just wanted to monitor the babies. Eventually I was allowed to take a bath for about 20 minutes in between monitoring sessions.

I rotated between soaking in the bath to the bed (when I had to be monitored) and then to the birthing ball and back to the bathroom to lean on the towel rack while someone put pressure on my lower back. I would also try to stand up and sway back and forth and make figure eights with my hips in between contractions. These things all really helped me stay on top of the pain. After about 10 hours of constantly having to get back in bed to be monitored I finally realized that if I put the birthing ball next to the bed I could ask the nurse to attach the monitors to my belly while I stayed in the ball. This was so much better than having to lay in bed during my contractions.

Something I learned from my Bradley Method class was to make sure all of my muscles were completely relaxed during a contraction. During labor we referred to this as “going limp”. If I started to tense up someone (mom, sister or husband) would remind me to “go limp” and I would hang my head down, dangle my arms at my sides and basically focus on focussing on nothing. This was the only way I could get through my contractions. It was like being in a zone. If I could get there I could make it through. A few times when I tried to make it from one if my stations to the next and I ran out of time before the contraction started- this was when I really struggled to relax and the contractions were much harder to make it through. So my tip for anyone preparing for labor is to go limp BEFORE a contraction starts.

I felt like my labor was moving along well and I kept assuming that I was further along than I actually was. I was progressing, but my cervix wasn’t dilating as quickly as I thought it would. Sometime in the afternoon the doctor gave me the option of stripping my membranes or breaking my water. I opted for the membranes, and while the doctor was doing that I felt a gush of fluid. We thought my water had broken but a few hours later found out that it was just my membranes. So we had to break my water later on. This felt like a massive gush of hot water. Not warm like I expected but almost to the point of being uncomfortably hot. And the water just kept flowing and flowing and flowing… Now I know that the smaller gushes I felt were nothing close to being my actual water breaking. Shortly after this though the nurse began to monitor the babies constantly so I had one last soak in the tub and then I was confined to the bed and birthing ball.

Almost as soon as my water broke my contractions intensified and I really struggled to stay on top of the pain. At that point I considered getting the epidural earlier than I had planned. Originally I wanted to wait till right before going into the OR for delivery so the babies wouldn’t have much time to be affected by the drugs.  Since I had already been in labor for around 30 hours and I hadn’t slept for close to 3 days I was wondering why I should wait to get the epidural. My husband tried to get me to hold off, so I waited another hour. Then I started feeling a lot of pressure so I thought the babies were getting ready to come out. Then I panicked and thought I waited too long to get the epidural. So I was placed in the waiting list for my epidural. Once I was in the list then time passed so slowly. All I could think about was getting the epidural. The anesthesiologist finally arrived and prepped me (and everyone else had to leave the room including my husband). Right before she was going to place the epidural she got an emergency call and had to rush out to a c-section. I felt bad for the other woman needing the emergency c-section (but mainly I felt bad for myself- selfish I know) but at that point I was so ready for the epidural that I wanted to scream “are you kidding me!” after the anesthesiologist as she left the room. Thankfully I refrained. The contractions were coming one right after the other. Maybe a minute between but it seemed like as soon as one diminished another wave would start. I was left alone with a nurse (who wasn’t very kind and understanding) I don’t think she said a word to me while I waited. Because of that though I was forced to focus on getting through the contractions on my own. I was able to deal with them and stay on top of the pain better than I was when I had my family members caring for me. I think I was forced to be strong- and it kind of worked for me. I still am so thankful for my mom, sister and supportive husband who labored with me the entire time.

Finally (after 20 or so additional minutes of waiting- that seemed like an eternity) the anesthesiologist returned and placed my epidural. After they had placed the catheter and set me up in my bed they administered the drugs. I was given a button to push every hour to give myself additional doses. I actually tried to give myself more meds too early and it won’t let you. Once you get the epidural you can’t get out of bed (because your legs basically stop working from the drugs). So at last I was able to rest for about an hour- and my helpers took a much needed rest as well.

For some reason the nurse kept making me turn from side to side. I remember this because each time I had to turn over my bag of urine from the catheter had to be passed over me and hung on the other side of the bed. I mainly was spending time resting on my right side which meant that the drugs were settling in my right side and my left side was no longer numb. I was annoyed that I couldn’t lay on my left side so I could numb the left side that was hurting pretty bad again. Then I found out the reason why.

Every time I had a contraction baby A’s heart rate was dropping into the low 70s and then spiking higher and continued to do this for a few hours (I think, I’m still fuzzy on all the details) the doctors think it was due to a low volume of fluid of amniotic fluid left after my water for Baby A broke which was causing the cord to be compressed. At one point his heart rate was down for over 4 min so they decided it was time to deliver. My husband, who is in medical school was actually surprised that they had let me continue to labor for so long rather than taking me in for a c-section right away. He told me that most doctors would have done that but my doctor just kept monitoring me closely. She told me afterward that she was right on the border of making the decision to do a c-section.

I still wasn’t fully dilated yet (so the resident doctor tried to open my cervix manually while I pushed. We were still in my labor and delivery room and I knew the plan was to deliver in the OR. I started to sense that there was a need to get things going faster and this was super stressful. At that point about 5 additional nurses plus my doctor rushed in. They put my oxygen mask on (I had been using the mask earlier but it was hanging around my neck during the pushing session.) They told me that I needed to get more oxygen to my baby because his heart rate was too low. I got really scared and my first thought was to have a c-section in order to get the babies out immediately so I suggested this to my doctor. I was thinking that cutting me open was sounding like a much less risky option for the babies at that point. My doctor said we didn’t need to operate so we headed to the OR to attempt a vaginal delivery anyway. My doctor was confident that with the help of forceps (that thought terrified me even more) she could help get baby A out quickly.

Someone threw a pair of scrubs at my husband and yelled “let’s go” we were already wheeling out of the room leaving my husband behind in the bathroom changing. I fought hard to fight back the tears (but now as I recall the events and write this post the tears are flowing freely).  I raised my fingers while clutching to my oxygen mask in an attempt to wave to my mom and sister who were not allowed in the OR. They looked just as scared as I felt and I knew they would be praying for me the entire time.

On the way down the hall my doctor squeezed my hand and reassured me that everything would be fine. As much as I trusted my doctor I was still more terrified than I had ever been in my life. I needed more than trust in a capable doctor, I needed God. I was praying silently and then not so silently for my babies to be delivered safely. Then I couldn’t even pray in full sentences so all I could do was keep repeating  “Oh God, Oh Lord, Oh Lord Jesus.”

The rest of the story takes place in the OR. I’ll post about Delivering Twins soon! I’m slowly typing out my story during 15 min. breast pumping sessions (the only time I can find to blog these days) which is why this has taken me so long to post! Thanks for your patience!

Birth Story Part 1: Early Stage of Labor

Today (Wednesday January 21st) I would have been 38 weeks pregnant. However, because of the events that I am about to describe (for my own records and to fill you all in on the details) I am not 2 weeks postpartum and my boys are celebrating their 2 week birthday!

At 35 weeks 5 days I had been experiencing what I thought were signs of pre- labor. I had been losing my mucus plug for about ten days and I was having menstrual-like cramps. When I went to my regular doctor’s appointment on Monday, January 5th I was surprised to find out that I was already 3 cm dilated and having regular contractions. I was in the early stage of labor. My OB was pretty sure that I’d have the babies in the next day or two.

Sunday, January 4th:

In bed with cramping and back pain.

Monday, January 5th:

10:30am

I returned home from my doctor’s appointment and took a shower (partly because I had always planned on showering in the early stage of labor so I would look good in the hospital pictures) but mainly because I was having back pain that was only relieved by the hot water. I called a few friends to let them know that I was starting the laboring process- and found someone to cook dinner for another friend who had just given birth the week before. I had signed up on a meal schedule to bring her dinner- but realized that it wasn’t going to happen.

11am

My mom and I began running/waddling around the house collecting things that we thought we needed to bring to the hospital. Up until that point my hospital bag only consisted of card games and sudoku (because I thought it was important we have things to do at the hospital while we were waiting for active labor to begin).

The contractions I was having were similar to the cramps I get during my period only they were stronger. The back pain was constant, but the cramps would get worse in the front of my abdomen and that’s when I would be aware of the contraction.

12pm

I tried to lay down and rest- I might have napped for an hour or maybe two, but I was constantly being disrupted by the cramping.

12:30pm

Called my sister to let her know I might not make it till Wednesday. She changed her flight and arrived roughly 12 hours later.

1:30am

My sister arrived and jumped right in to laboring with me. Contractions were intensifying (but some were smaller and then bigger and some were 5 min. apart, then 7 min. apart or 4 min. apart.) It was difficult to tell when contractions were beginning and ending because the back pain was constant and it interfered with my ability to differentiate between the two types of pain.

We timed the contractions all night except when I was showering. Then when I showered my mom and sister rested as much as they could.

When I was not in the shower my back pains were getting really uncomfortable and so my sister would put pressure on my lower back (just like I learned in my Bradley Method class) and that really helped relieve the pain.

In the morning we called the doctor to see what we should do since I was never having the 5-1-1 (contractions 5 min. apart lasting for 1 minute for an entire hour.) Because I was a high risk pregnancy with twins and obstetric cholestasis and my blood pressure had been high for the past week my doctor wanted me to come in.

9am

We arrived at the Women’s Assessment Center to be evaluated. I was in labor, but hadn’t dilated any more (in fact, the doctor said I was only 2 cm dilated- so apparently the measurements really depend on the doctor who is checking. Again my doctor wanted to keep me (but gave me the option of going home if I wanted to). We decided to stay because the doctor felt like things could progress quickly.

*What I didn’t realize that was once I was admitted I wasn’t allowed to eat anything- but could only have clear liquids. This was a challenge because I was not only exhausted but I was getting hungry and needed energy. My labor and delivery class mentioned this, but I didn’t realize I wouldn’t be allowed to eat the snacks I brought with me to the hospital- and I would have tried to eat more before going to the hospital if I had remembered this!

More of the story to come in Birth Story Part 2: In Labor and Delivery

30 week twin pregnancy update

Week 30 belly shot

We’re in the 30s!!!

This is just a super quick update to share my 30 week pregnant belly shots with you all! It’s Thanksgiving, so we are planning to drive about 2.5 hours away for the weekend and I’m just about packed and ready to head out the door. We’ve been a bit apprehensive as to whether or not we should make the drive due to our exciting week full of contractions, cramping and cholestasis.

My OB wasn’t comfortable with us going so far and she gave me a good list of possibilities of things that could happen like- you could be hospitalized away from home, your babies could be born there, they could end up in the NICU for a month or more and you’d be stuck in a hotel for their entire stay. She succeeded in freaking me out pretty good, but honestly I just don’t think these babies are coming this weekend. I know things can happen that we never expect, but even with all of my contractions and cramping my cervix is still completely closed- and has not changed at all!

I had an appointment with my MFM specialist and asked him what he thought about me traveling for Thanksgiving and he was okay with me going 2.5 hours away. He did give me a copy of my ultrasound report to give to an ER doctor in the other city if for some reason we end up needing to go in. All in all my husband and I still feel good to go, but we will be praying the entire time we are away and I will be taking it extremely easy (couch potato status). If you think of us this weekend please pray that there wouldn’t be any complications while we are out of town!

An update on my Obstetric Cholestasis (OC):

I mentioned in my last post that after taking Ursodiol for a few days I thought the itching was improving, but then it started to be even worse than before. It has continued to stay pretty consistently irritating. I found out while talking to my OB that the dose I was originally given (300 mg 3 times a day) was actually the wrong dose! I was supposed to be taking 600 mg 3 times a day. I’m told that this is why my itching hasn’t cleared up. I’m now on day 2 of taking the higher dose, so I’m hoping it will start to work. More importantly when the itching goes down this should be a sign that the bile acid levels in my blood are also going down- which is what I’m mainly concerned about.

That’s all for now, hope everyone has a wonderful Thanksgiving!

Belly button starting to poke out

My first hospital visit: 29 weeks 1 day

This is not my usual weekly pregnancy update. I just wanted to check in and give you all an update on what’s been going on over the past few days. I’ll start with the most eventful item which was my fist visit to the hospital.

Last Thursday (right after my 29 week post) I was walking through the parking lot to my car when I felt a strong pain like one of the babies was kicking me hard down by my cervix. Immediately following the sudden “kick,” or whatever it was, I felt a very strong cramping in my lower abdomen. This cramp was low but I also had the more familiar tightening of my whole abdomen. It took my breath away (like the Braxton Hicks that I’ve felt for a while now) but this cramping was something I hadn’t felt yet. It was more like a really intense menstrual cramp that also sent cramping pain through my lower back (similar to the back pain I used to get during my periods.) I had to stop walking and breath deeply for about 30 seconds, then I got in my car to sit down and continued to watch the clock. I think it lasted for about 1 minute. The intense cramp then loosened, but I continued to feel dull cramping in my lower abdomen and back (and a lot of movement from the babies).

This was around 4:30pm just as I was getting off work. As I drove home I had more Braxton Hicks (my whole abdomen tightening) but since I still had the abdominal and back cramping I’m not sure if these were actually considered Braxton Hicks (since I’ve heard that Braxton Hicks are not usually painful). I figured I should call my doctor just to check in and see if this was something worth coming in for. Sadly the office had just closed and I couldn’t seem to get through to anyone through the answering service (since I’ve never called in after hours about anything during this pregnancy).

When I got home I laid on the couch with my feet up and drank water (as instructed by a friend who had dealt with frequent Braxton Hicks during her pregnancy). This didn’t seem to stop the cramping or the Braxton Hicks. I needed to run to the store to get some ingredients- I was planning to have some friends over to make caramel apples- and I was pretty sure I would be feeling better by 8pm so I made my husband drive me to the store. Walking around the grocery aisles caused my cramping to increase and I realize that it probably wasn’t wise for me to go shopping. Back at home I stayed on the couch with my feet up and my friends made the caramel apples without me, they were concerned but I assured them that I might go in to the hospital once they left.

At 10:45 the girls headed home and I again tried to call the after hours line at my doctor’s office- and still couldn’t figure out how to get through. I felt stupid for not knowing what to do in a situation like this, but I just really haven’t needed to call the Dr. until this point. I ended up looking through all of my papers and pamphlets for my hospital and found a note saying that after calling the office you have to stay on the phone until the line goes dead and then someone will answer- oops- didn’t know that! So I finally got through and they notified the on-call doctor. I got a call a few minutes later from my doctor and after listening to my symptoms she told me I needed to come in. I asked if I could wait until the morning to come in, but she insisted that because I’m pregnant with twins and it’s too early for me to have them that we needed to check it out. I was also concerned with the situation due to my possible Obstetric Cholestasis because it can sometimes lead to premature labor but I was trying not to let my mind go there because it was just too soon for the babies to come.

I had to wake up my poor husband and we headed to the hospital. Thankfully the hospital where I will be delivering has a floor specifically designated as the “Women’s Assessment Center” so we didn’t have to go to an ER. When we arrived we found out that I was 1 of 2 patients on the entire floor, so we got pretty immediate care. I was quickly checked in and set up in this room:

My first hospital bed

They hooked up my belly with monitors so they could keep track of the babies heart beats and also measure if I was having contractions. It took a while for the nurse to lock onto the babies’ heart beats because they were swimming around so much in my belly!

All hooked up to the monitors

The babies heart rates were fine, nice and steady- so they were not in distress- thank You Lord! My monitor showed that the tightening I was feeling were indeed contractions and they were occurring every 5 minutes. They say you should come in if you are having contractions every 10 minutes, so I guess it’s a good thing that I came in when we did.

Monitoring the babies and contractions

I did have a moment of concern when I found out I was contracting so often and realized that the tightness I was feeling wasn’t just from the babies moving around. I began to silently pray for the babies to stay put. It was too early for them to be born. Overall my husband and I felt relatively peaceful though especially since the babies heart rates were stable and not distressed. So all that was left to do was get my cervix checked.

I know women say this is painful so I was ready for it to be unpleasant. I wouldn’t say that it was painful as much as it was extremely uncomfortable and made me feel overwhelmed with the desire for it to be over. The good news was that my cervix was still completely closed! The doctor said it wasn’t thinning or opening due to the contractions so I was free to go! I am so thankful that my body is doing its job to keep these babies in the oven longer.

We were also able find out the results for my bile acids test while we were at the hospital. It turns out that one of my bile acids was elevated. This means that technically I do have Obstetric Cholestasis (OC). Because we did the blood test and started on the medication only a few days after my first symptoms of itching the doctor feels like we can keep it under control. I will continue to get weekly blood tests to check my bile acids and liver function. I will also begin weekly Non-Stress Tests (NST) on Monday. The NST are basically exactly what I had done on Thursday night- where I get hooked up to the monitors and they check the babies heart rates to make sure they are doing well while resting, while moving or during contractions. This test also can tell whether the babies are getting enough oxygen.

As for my OC, I have found that some days are worse than others. On Thursday I wasn’t as bothered by the itching, but this could have been because I was more focused on the contractions. Yesterday and today the itching has been back in full force and maybe worse than I’ve experienced up to this point. I’m not sure why some days are more unbearable than others. I am continuing to take my Usodiol pills three times a day and I cover myself in a nice thick layer of aloe vera gel multiple times a day.

My husband researched other liver conditions (like jaundice) and found that some were helped by light therapy. So I sat out by the pool for an hour today (it just happened to be 78 degrees today in the middle of November). We’ll see if there is some long term benefit to being in the sun because there was definitely no immediately relief today. Regardless of what we are able to do to lessen the itchiness I feel like I am having an easier time mentally accepting that I may just be itchy for the next 6-8 weeks. I’m more than willing to bear it for a full 8 weeks if it means my little boys will not come too early!

I’ll still share a short update with belly shots in a few days when I hit 30 weeks. Thank you all for your prayers for these babies and for my new condition. Knowing that you all are standing with us is such a supply and a comfort.