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Welcome to the world, Collin

By on Sep 11, 2011 in Birth |

Warning:  This post is very long and graphic.  If you are squeamish, you might want to skip it!

Collin’s birth started weeks ago, when I started having contractions at 34 weeks pregnant on the ride home from my parents’ house on July 30, 2011.  After having some back pain the week before and realizing that I’d already started dilating and effacing my cervix, it became a reality that our second son very well might be joining us a bit earlier than we planned.  And quite honestly that terrified me!  Thankfully the contractions stopped that evening before it became necessary to go to the hospital, but at the time, I didn’t know I would make it as long as I did, which was so scary.  Everything with Carter’s pregnancy had been so textbook and simple that it never occurred to me that everything wouldn’t be the same for his little brother, and I was terrified that he would be born early and end up in the NICU.  So I took my doctors’ advice and started riding the couch.  Our goal was to get to at least 36 weeks, preferably 37 or longer, which required some modifications to my life.

So instead of being social butterflies, Carter and I spent the next few weeks taking it easy.  We were so, so lucky that my mom was able to come and “babysit” me whenever Glenn wasn’t around.  With the potential for labor coming so early, I needed someone to be around that could get me to the hospital if labor officially started so I could get medication to stop it, and I definitely needed help with my wild man toddler!  I had contractions on multiple occasions over those next couple of weeks, and I was moments away from heading to the hospital on several occasions, but thankfully each time they would go away after I took a hot bath, or even on a few occasions, after I went to sleep.  On one occasion I told Glenn, “I’m going to sleep.  I’ll wake you up if the contractions wake ME up.”  It was hard on my body to be contracting over and over again, and I was very sore and cranky by the end of my pregnancy, but I’m so grateful that my body allowed me to keep Collin cooking as long as I did.

When I first found out I was pregnant and that my due date was 9/10/11, I just KNEW that he was going to steal our wedding anniversary.  Glenn and I were married on 9/4/04, and intentionally planned our wedding around Labor Day weekend so we’d be able to take vacations to celebrate our anniversary.  I swore my baby was not going to be born that day, but as time passed and I grew more and more uncomfortable, I started to think it might not be such a bad idea.  After all, is there really any better way to celebrate our love for each other than bringing a child into the world?

So on Sunday, September 4, our 7th wedding anniversary, Glenn stayed home from working on the house so we could spend time together.  And I decided it was finally time to do some “nesting.”  When Carter was born, his nursery was done weeks prior to his arrival, and that certainly was not the case with Collin.  All of his baby shower gifts were filling the crib, laundry was everywhere and nothing was the least bit organized.  So I started organizing.  Carter “helped” and ran back and forth between Dada watching a football game in our bedroom and Mama cleaning like a crazy woman in the boys’ room.

The contractions had started that morning and were coming about an hour apart all day.  Once my nesting reached full force, they picked up the pace and by that evening, they were coming every 5-15 minutes.  I was still unconvinced that this was “it” since they had started and stopped so many times before, but it was definitely starting to feel a lot more like the real thing.  We’d planned to go out to dinner to celebrate our anniversary, but we decided that wasn’t the best idea, and we instead went to pick up Outback takeout for dinner.  I told Glenn that if my contractions were still at least quasi-regular by the time we drove to and from Outback and ate our food that I would call my doctor and we would head to the hospital.

So while I was in labor with my second son, we drove to Outback for takeout and I proceeded to eat some steak, baked potato and veggies.  I made sure not to eat too much since I knew I would probably regret it later, but since I assumed they would probably be sending me home from the hospital anyway, I wanted to have something in my stomach so I wasn’t starving to death!

The contractions were still coming, so I called my doctor’s office, found out that Dr. Kilbride was on call, and I starting getting everything together for Carter while I waited for her to call me back and give us the green light.  Now I will start by saying that when I heard Kilbride was on call I was less than thrilled.  She’s one of the older female doctors in our practice, and the few times I’d interacted with her (never saw her during Carter’s pregnancy, but I’d seen her once during Collin’s and she’d been on call the first time I started having contractions) I hadn’t gotten the best impression.  She seemed a bit bitchy to be honest (sorry, Dr. Kilbride!), and I was really hoping that one of the younger female doctors would be on call since they were always my favorites.  But as the night wore on and became a very scary morning, I couldn’t have been happier that Kilbride was the one who was there for me.  But we’ll get there.

I called my parents and told them to meet us at the hospital, and as soon as Kilbride told us to head in, we hopped in the car and made the drive to St. Joseph’s Women’s Hospital, which is about 40 minutes from our house.  Carter was very confused as to why we were in the car after his bedtime (it was around 9:30 at this point) but excited that we were going to see Cee Cee and Grampy.  My mom and I had been coaching him for weeks that when Mama and Dada went to the hospital to get Baby Collin, Carter was going to stay at Cee Cee and Grampy’s house, sleep in his big, big bed, and the next day would go in Cee Cee and Grampy’s car to the hospital to see Mama, Dada and Baby Collin…and yes, he would recite this back to us!

We got to the hospital and took our ID pictures and sat in the waiting room waiting to be called back to triage.  Thankfully Carter didn’t flip his gourd like I was expecting him to (he HATES doctors right now!) and just seemed excited to be out with us, even more excited when Cee Cee and Grampy got there a few minutes later!  I choked back some tears as I gave him a hug goodbye and back to triage we went.

I was kind of surprised by the lack of any sense of urgency in triage.  It was very quiet, but apparently they were busy, and I had to leave a urine sample in the one bathroom, but someone was already in it and someone else was waiting, so I changed into my hospital gown and then stood around waiting for my turn.  The contractions at this point were very intense and probably about 3-5 minutes apart, though I’d stopped timing them.  I left my sample, then came back to our room to be checked.  Sure enough, I was 5 cm dilated and they started the admission process!  My parents stuck around until this point (about 10:30) in case they sent us home, but they headed back to their house with Carter, who again, thankfully, did not seem the least bit concerned that he was away from Mama and Dada for the first time in his 22 months!  Back in triage, I asked if they could start my IV so I could get my epidural (contractions aren’t fun!!) but they don’t usually do that and said they would try to if they could.  At this point I started getting dizzy and nauseous, which I recognize as signs that I’m about to pass out…oh goody!  They cranked me back and Glenn doused my head with a cool paper towel, and I managed not to barf or pass out, but I think they realized they needed to get their act together and get me moving.

Enter Gidget.  Yes, Gidget.  My labor & delivery nurse was named Gidget.  She seemed perfectly nice, but after she attempted to put the IV in my (huge, extrememly “easy” according to anyone who’s ever taken my blood) vein TWICE and failed, she confirmed the stereotype she’s probably faced her entire life with a name like Gidget.  She left to find someone else to start my IV, and Molly came into my life.  I told her if she could start the IV on the first try we would be best friends, and thankfully she did.  There was some mix-up over who was actually supposed to be my nurse, and thankfully Molly won!  Normally they would have taken me in a wheelchair to labor & delivery, but since I’d almost passed out, they just wheeled my stretcher right down there, hooray!  Time to go have a baby!

From this point forward things happened SO quickly.  I got to labor & delivery and they immediately hooked my IV up so that I could get the fluids needed for my epidural.  They checked my cervix and I was already at 8 cm and his head was LOW. Dr. Kilbride came in, cool and collected, but perfectly nice, and told me she was going to break my water, which normally I would be against, but at this point, I knew it was going to happen soon anyway, so I let her.  I think I had another wave of nausea/dizziness somewhere in there as well, and I remember thinking that my post-labor pictures were not going to be pretty since Glenn kept putting cold water on my hair and I was a mess!

Then anesthesia came in to get my epidural started.  I was hoping that Dr. Van would be there again since he’d done such a fabulous job on my last one, but Dr. Masters (I think??) was there instead, and I remember him telling me he would have me feeling like a princess in just a few minutes.  I had to lie down to get the epidural this time (last time I sat up), and while it was definitely a bit uncomfortable, and yes, a bit painful, I was thrilled to finally get the good drugs in my system.  Ten minutes later the horrible contractions faded away and I could feel the pressure, but not the pain.  What an amazing invention the epidural is!!  They gave me a couple of extra shots of the medication into my back catheter so I would be numb by the time it was time to push.

At some point during this process, Dr. Kilbride, who was sitting on the side of the room, asked how long I’d pushed with Carter and after I told her it had been about 45 minutes, she said that I would only have to push a few times before Collin was going to be here, so we would have a baby in just a little while!  It was so surreal at this point, as I’d assumed we had at least a few more hours to go.  It was after 11:00 at this point, so we joked that we would either have an anniversary baby or a LABOR day baby, which really, is that just not the best day to be in LABOR?

Everyone left the room for a few minutes to prepare for delivery, and Glenn and I just looked at each other in shock of what was going to happen in just a matter of minutes.  I started feeling a HUGE amount of pressure, to the point that I was worried he was going to fall right out, and at the same time, his heart rate started dropping on the monitor.  Glenn stepped out to make sure they were aware and was almost bowled over by the crowd of people who soon filled the room.

Dr. Kilbride came in and told me that his heart rate was dropping and we needed to get him out right away.  My legs were so heavy since they’d given me extra medication, especially the right one, and I needed help hoisting them into the stirrups.  But seconds later I was surrounded by people encouraging me to push, push, push, harder, harder harder, and even though I could barely feel the bottom half of my body, I did what I remembered doing the last time and just a few short pushes (3, 4?) later, Collin was out in the world, crying, being placed on a cloth on my chest.  Again, I was in tears, overwhelmed by the magic of seeing my son for the first time…this stubborn little person who’d threatened to come early but managed to hold out until he was 39 weeks and 1 day along…this perfect, tiny little human who I already loved with all my heart.

Dr. Kilbride started the repair work and I got to hold Collin on my chest, skin to skin.  I asked her how we did and was told “about the same as last time” which made me groan since I remembered how horrible my recovery had been from Carter’s 3rd degree tear.  She was stitching for about 20 minutes and I think in the meantime, they took Collin over to get cleaned up and dressed, and then I got him back, slightly cleaner and oh, so sweet to nurse him.  That kid is a champ, let me tell you!  He latched on perfectly the first time, which was such a different experience than what I’d gone through with Carter!  I nursed him for a little while and we hung out in labor & delivery, sipping apple juice, eating graham crackers, and marveling over the beauty of our tiny human for about an hour before they took us up to our room in the NEW WING of the hospital, which we were thrilled about.  I was so happy, and at this point, all seemed right in the world as they wheeled me upstairs in a wheelchair and I got to smile proudly as everyone smiled congratulated us (even Gidget!) like a baby parade on the way up.

And this is where it gets very, very fuzzy.  We got to the room, and remarked on how pretty it looked, but as they got me from my wheelchair into my bed, I started getting nauseous and dizzy yet again.  This time I actually threw up.  I’m not sure how long we were in the room, but as the epidural wore off more and more, I was in more and more pain.  After you have a baby, your uterus continues to contract to shrink it back down to its normal size, but the pain I was having was getting really bad.  I called for the nurse, and somehow Dr. Kilbride ended up there, too (not sure if she was coming to check me anyway or if she was called).  To check your uterus, they knead on your belly to feel the size and that it’s contracting.  When Dr. Kilbride kneaded on my stomach, my uterus had become “boggy” which meant it had started retaining blood and not contracting, and I suddenly started hemorrhaging blood.  Lots of blood.  Everywhere.  I didn’t actually see anything, thank God, but I could feel it happening, and I could feel the panic in the air as everyone rushed around.  My blood pressure was very low and my heart rate ridiculously high.  Not to mention I was white, white, white.  Dr. Kilbride immediately knew something was wrong, and she attempted to explore inside my body to figure out what was wrong.  It hurt.  Bad.  I was crying, whimpering, screaming and everything in between, begging her to stop because it hurt so bad.  But I just kept bleeding.  She told me they were going to take me down to the OR immediately to do exploratory surgery and find out what was wrong…that she could probably figure it out there in the room, but I was in too much pain to do it without being knocked out.  Since Glenn wouldn’t be able to be in the OR with me, he stayed with Collin.  The nursery really wanted to take Collin away from him, but he insisted that he stayed and Dr. Killbride snapped at them and scared them away.  (There was a lot of that going on…she definitely scared the bejesus out of a lot of people that night!)

Next thing I know I was being wheeled down the hallways in a dramatic fashion, surrounded by people discussing their course of action, saying all kinds of things that I wouldn’t have been able to understand even if I weren’t completely out of it.  It really felt like something out of the TV show ER.  I had lost so much blood at this point that I was exhausted.  All I wanted to do was go to sleep, but I was so scared that I wouldn’t wake up again that I fought to keep my eyes open.  But I wanted nothing more than to be knocked out under medical supervision so my body could stop fighting and rest for a while.

They wheeled me in to the OR and I was surrounded by a huge group of people, again, discussing what was about to happen.  Anesthesia came back in, and told me they were going to give me a spinal block because I’d eaten those graham crackers and that was too big a risk that I would choke while under general anesthesia.  I panicked, because I knew that meant I would have to be awake, and that was the last thing I wanted!  Dr. Kilbride immediately snapped at them and told them they were being ridiculous and that my blood pressure wouldn’t sustain the spinal block, that they needed to do the general.  She also told me that the worst-case scenario at this point was that they would need to do a hysterectomy, and I was handed a consent form to sign.  While I don’t remember much, I remember telling her how scared I was, and she was just so sweet and really consoled me and told me they were going to take good care of me.

They gave me an IV in my other arm at this point for the blood transfusion, and I remember them telling me it was going to hurt, but I was hurting so badly that it barely fazed me.  Dr. Kilbride continued kneading on my uterus this whole time, keeping my body functioning.  The blood still hadn’t arrived at this point and Dr. Kilbride jumped down someone’s throat when they made an excuse and said, “well then maybe someone needs to go GET IT!”  To knock me out, they placed an oxygen mask over my face, but instead of being a bigger mask like I’d had while in delivery, it was small and tight fitting, and I totally felt like I was being smothered and panicked.  They told me they had to get a good suction to give me the medicine, so after I panicked a few more times, they were finally able to knock me out.

I obviously don’t remember what happened next.  But while unconscious, they gave me a breathing tube, immediately vacuumed my stomach so I no longer had anything in there, gave me the blood, gave me a catheter, and performed a D&C (dilation and curettage…minus the dilation since I was already dilated) to scrape everything out of my uterus.  They found a piece of placenta that had remained in my uterus (about the size of a grape, I think) and because it was still in there, the blood vessels had been unable to seal themselves off, so I was just bleeding and bleeding and my body kept trying to stop it but couldn’t until that piece was gone.  Even after they got it out, I continued to bleed, and they were about to place some sort of bulb syringe into my uterus to keep pressure there, but thankfully I stopped bleeding right before they did this.

Here’s what I’ve found doing research after the fact about my condition…

Excessive blood loss or “postpartum hemorrhage” complicates approximately 4% of vaginal deliveries.  A common cause of hemorrhage around the time of delivery is uterine atony, a term used to describe the failure of the uterine muscle to contract normally following delivery of the baby and placenta. This condition is responsible for up to 90% of all cases of postpartum hemorrhage. Separation of the placenta from the wall of the uterus results in shearing of the mother’s blood vessels that previously supplied blood to the placenta. Normally, bleeding from these severed vessels is stopped by contraction of the uterus and compression of the vessels. If uterine contraction is not adequate, bleeding can continue. At times, the uterus is prevented from contracting effectively by fragments of placenta that remain in the uterus after delivery or by benign growths of uterine muscle within the uterine wall known as fibroids. In these cases, the term “atony” usually is not applied. In most cases, the uterine muscle simply fails to contract adequately. Prompt recognition and intervention are the cornerstones of successful management of uterine atony. Alternate sources of bleeding, such as vaginal or cervical lacerations or retained placental fragments, must be excluded. Blood and fluid must be replaced as needed. Conservative measures for control of bleeding include uterine massage, uterine pressure and administration of medications to stimulate uterine contractions (oxytocin, methylergonovine, prostaglandins). Surgery may be necessary to occlude the blood supply to the uterus. If this is not successful, hysterectomy may be required.

Sounds about right.  I will see Dr. Kilbride in a few days to discuss the procedure with her after the fact and find out what this means for us having future children, etc.  But what I’ve determined myself is that I am a very lucky woman.  I’m lucky that I had a bulldog of a doctor there who was able to recognize what the problem was and fix it.  Who was willing to bully whoever she needed to bully to get things done the way they needed to be done.  And who was able to stubbornly battle my body until she was able to fix the problem.  When I found out Dr. Kilbride was on call, I was less than thrilled, but now I know that she was the doctor I needed to be there for me, and I couldn’t be more grateful.  (Update: Dr. Kilbride told me at my appointment that I should definitely be able to have more children if we decide we want to, and that we would just need to be a bit more cautious, for example, having the medication ready to take immediately following delivery, but that I wouldn’t be at significant risk for this happening again.)

The next thing I remember, they were pulling out the breathing tube from my throat and giving me an explanation of what had happened, though I was so groggy that I couldn’t even tell you what was said.  They took me to recovery where I slept for at least a few hours.  I remember hearing the nurse at the desk talking on the phone to someone whom Dr. Kilbride must have ripped a new one and trying to soothe their ruffled feathers.  There were some sort of pressure bandages on my legs that kept tightening and releasing, I’m assuming those were to keep me from getting clots in my legs?

Finally I was wheeled back up to my room where poor Glenn had been waiting on pins and needles for hours with our sweet baby.  (Dr. Kilbride had called him after surgery and let him know I how things went and that I would be in recovery for an hour, and then called again to let him know I would be another hour, but he didn’t know much.)  Again, I don’t really remember much of this, but by this point, I think it was about 6 in the morning, just a few hours after I’d given birth to Collin, but it felt like days had passed.  Instead it was the morning of Labor Day.  Instead of having that scary first night of being parents in our hospital room, I’d spent the night with my life in the hands of a team of wonderful doctors.  Could it possibly be any more surreal?

After the fact, I was checked constantly by the nurses, and my poor uterus continued to be massaged to make sure it was contracting.  At this point it finally was and soon they would just gently probe me instead of mashing my insides in.  I was given IV Methergen to help with the contractions, and I still had a catheter so I didn’t have to get up, which was a relief, as I was scared to death I was going to keel over again!  (When they took it out the next day, I actually asked them not to, but I did fine when I got up.)

I had to have blood drawn every few hours…I think the test was called the hematocrit and it checked my iron levels to make sure I didn’t need to have another transfusion.  My levels were down in the 6’s, and I needed to be above 8 for them to be content that I was on the mend.  (You have to be above 12 to be “normal” and I found out after the fact that I’d had 12.7 when I came in, thanks in part to being on pre-natal vitamins for so long.  Dr. Kilbride told me that if it hadn’t been so high when I came in, that I probably would have needed six units of blood instead of the two I’d received!) I credit those two units of blood for the fact that I felt like a human the day after this happened.  I was still very anemic though, and while my blood pressure stabilized, my pulse rate stayed high.  (Even today, it sounds like a drum in my ears every time I stand up.)  My arms look like giant pincushions.  Between the blood draws, the injections, the IVs, and yes, the massive quantity of TAPE they had on my body, I’m still a mess!

But thankfully I feel amazingly good for what I just went through, compared to the misery I was in after Carter was born.  I think the fact that I had a D&C helped get most of the “gunk” out of my system, so I haven’t had a lot of the grossness factor to deal with.  I was pushing for about 30 seconds compared to 45 minutes for Carter, so I don’t have a lot of swelling.  And I know some of the “mistakes” I made last time that I’ve been able to avoid.  So while I had a third degree tear again and I don’t feel great, I’m also not a whimpering puddle of a mess having nervous breakdowns like I was last time.  I’ve really been able to enjoy my sweet little Collin so much more without my pain goggles on.

And oh is he sweet!  Up until today, he didn’t realize that he could stretch out, so he’s just been curled up in a ball with his arms and legs tucked up around him.  I’ve taken to calling him Squishy because his sweet little face just squishes up around him.  He’s such a beautiful baby, probably because he came out so quickly, and he has such a sweet, mellow temperament.  He barely ever cries, and he SLEEPS.  Granted that could all change, but I’m just enjoying every sweet second with him for now, enjoying the sweet baby smell and snuggling with him at every chance I get.  It’s amazing just how much I loved him the moment our eyes met…truly something you can’t understand until you have kids of your own.

We’ve been much more confident this time around, too.  With Carter we were terrified we were going to break him, and we honestly had no clue what we were doing.  Now it’s second nature, and Glenn and I are both so much more relaxed with him, which probably helps because he isn’t feeding off of our nervous energy!  Last night he gave me one 3 hour block of sleep and one 4 hour block, which was blissful.  And when I put him down, he actually went right to sleep.  Ahhhhhh….  Granted we have him sleeping in his bouncy seat because he cried when we put him on his back in the pack and play a few nights ago, but I told myself I wasn’t going to fight with Collin nearly as hard as I fought with Carter about the sleep issue.  However he will sleep, that’s what I will let him do.  He’s even slept next to me (on the opposite side of Carter) for a few mornings, just so I could catch some extra shut-eye.  We certainly didn’t intend to co-sleep with Carter, but it’s been a wonderful solution to his sleep drama for our family, and if we end up with both of them in our bed, we’ll survive.  While Glenn and I were both initially very against co-sleeping, we love it now.

So that’s my story!  We are now a family of four, and we’re so grateful that all of us are home and healthy despite the drama we almost faced with Collin threatening to come early and did face with my surgery.  We have two beautiful, wonderful boys, and we consider ourselves so, so lucky!