The story of Little Man

Having a healthy full term baby is all the more satisfying if you know what it’s like to have a preemie first

My husband and I entered parenthood with the intention of having at least two children.  The discussions have gone anywhere from wanting two to four.  We both were raised in families of three kids which makes us inherently partial to families of multiple children.  I believe that siblings are a special and rare gift, and much of my motivation for wanting more than one child is based on the fact that I love my babies so much that I want to provide them with brothers and sisters.  It has been heartbreaking for me to discover that the road to delivery is much harder for me than the average woman.  I do however believe that in the end it will make me a more compassionate nurse to obstetrics patients.

Talk of having a second baby started when my daughter was about six months old.  She was hitting her milestones, and I just couldn’t believe how quickly she was changing from the wide-eyed infant to a precocious toddler.  My baby lust was borderline obsessive.  I always wanted to be a mother, and holding and caring for my own child was fulfilling in a way I had never known possible.  I finally understood the old adage, “I’d die for my child.”  I don’t know why, but my first-born has always looked so grown up to me.  It might be that she slight frame and relative lack of baby fat make her appear more like a small child of a year or two older age instead of the tall lean child that she is.  It may be that I feel like she has been with us forever some days, and just perceive this aura of age with her.  Either way, by the time she was nine months old, all I could do was look at her and think, “she’s not a baby anymore!”, and longed to expand the family.  For practical reasons we held off for longer to get pregnant.  However, when we where truly ready, it seemed like I was pregnant instantly.  My co-workers joked with me and gave me the nickname “fertile mertile”.

Having gone through the process before, I knew that it was very possible I could have morning sickness again with a similar severity.  Sure enough, as soon as week six struck, so did the misery of constant nausea.  This time I did not suffer through as long as I did with Little One.  As soon as I couldn’t keep my vomiting under control I dialed my Ob’s office for a prescription of Zofran.  I was not going to wait again until I was 48 hours dehydrated every again!  I was also extremely careful with my diet.  I watched my calories and nutrients very carefully.  I did my best to make sure that every food I ate was as nutritionally packed as possible.  I avoided as many empty calories as a pregnant girl can.  My reading and research led me to information that shows rapid weight gain and high blood pressure are like a positive feed back system in a pregnancy, one increases the other, which increases the other.  I wanted to protect this baby for as long as possible.

My series of surprises started with my first Dr. appointment.  I was under the impression that because pre-eclampsia is related mostly to first pregnancies, and not subsequent pregnancies with the same father, that I would not be considered high risk.  This is not true.  While pre-eclampsia IS mostly related to first pregnancies, once you have had a preterm infant, you are pretty much labeled as high risk for every time there after.  Also, my OB suggested I be put on a hormone injection therapy to decrease the risk of preterm labor.  20 weeks of weekly in office deep muscle injections.  For those of you who don’t know me, I have (or had) an irrational fear of injections.  The thought of 20 weekly, painful injections was not exactly a happy thought for me.  I asked her to explain her rational, and after hearing her out, I was ok with it.  I would do anything for my babies, anything, if the doctor says it is in their best interest.  So, from 16 weeks to 36 weeks, I drove to the office with my daughter, and let the nurse give me the very painful shot and never once complained.

The second surprize came at my routine 20 week ultra sound.  We wanted to know the sex of the baby both times, and we were happy to find out that we were having a boy.  The tech commented on his nice average body size and weight, congratulated us and shipped us off to the doctor’s office.  There we got the bomb shell dropped.  My doc sighed, looked me over and said, “Boy, if it’s not one thing for you, it’s another, isn’t it?”  My mom and husband and daughter were all along, and we all looked back and forth to each other confused.  “Excuse me?” I asked, “what is wrong?”  “Oh, the tech didn’t tell you?  You have placenta previa.”  I think at this point the blood drained from my face, but my husband and mom were just still confused.  I worked in the lab at the hospital, including the blood bank.  This gave me all the negative insight to placenta previa I would ever need, but my mom and my husband have no medical background.  The doctor asked me if I understood what placenta previa was, and the complications it has and I said yes, but that my family did not, so would she please explain for their sake.  I was worried that if I was the one to say it, I would frighten them more, because I had nothing good to say.  If you don’t know, I will fill you in here.  Placenta previa is a condition where the placenta lies on the opening of the cervix.  The placenta is a blood rich organ which exchanges oxygen, nutrients and waste products between the growing baby and the mother.  Both mom and baby’s blood flows through, but are not directly mixed.  If the cervix dilates with the placenta on top, mom can hemorrhage and die.  The momentary joy of knowing we would have a boy to join our little girl became clouded.

I scheduled a follow-up ultra sound for around 27 weeks.  I was informed that if the placenta had not moved away from the cervix, a cesarean section would be scheduled.  I was very unhappy about the thought, but knew that a C-section was the only way we could have this baby.  The next seven weeks were tainted with the fear that I may start bleeding at anytime, but it never happened.  I stopped lifting everything including my daughter, and tip toed around work, worried about everything.  The ultra sound date came, and so did the good news, the previa had resolved!  The rest of the pregnancy should progress as normal, plus the weekly injections.  But of course, it didn’t.

One a dark and stormy night visiting with my In-Laws, I started having contractions, at 28 weeks.  We left for our 45 min drive home durring the loud and flashing thunderstorm so I could relax and lay down at home.  My contractions became stronger and more regular as we got closer to home.  Thanks to cell phones,we called the on call doctor on the drive.  His instructions were to go to bed and see if the contractions stopped on their own.  I obeyed, and watched the clock as I timed the contractions 10 min apart.  They were not as strong as my labor contractions with my daughter, but the regularity was very alarming.  After an hour or so I called back and asked to be seen.  I would do anything to protect my baby and did not take “wait and see” as an awnser when my contractions were shrinking steadily to 7 min apart.  So, in the middle of the night, we pulled our sleepy angel out of bed, hopped in the car and drove to a hospital further from home (the one near was full).  I was hooked up and shown to be contracting regularly, but thankfully had not dilated.  My husband sat near me the whole night holding our daughter who never woke, I slept a little off and on after being given an injection to stop the contractions, and the longest night of my pregnancy eventually came to an end.  I was put on full bed rest, and had one more little labor start-up at 30 weeks or so, with another round of labor hualting drugs, and at 32 weeks, was told to go back to work.  Both my doctor and I believe that the injections I was receiving saved me from dilating prematurely, and for that I will be forever thankful.

I was not happy to be back at work, because of the timing.  Due to being gone for a month, I only had a certain amount of time that I could remain without loosing my maternity pay.  My vacation had been used up with bed rest (which is how my job paid leave) and I only qualified for short-term disability if my delivery date was within a certain amount of time to the end of my bed rest.  Basicly, if I delivered at true full term, I would lose any and all pay for my leave.  The most tense week for me was my 34th week.  This was as far as I ever got with my daughter.  I didn’t want to leave the house, or even get out of bed, but I did.  However, the 34th week came and went with no problems.  Then the 35th, 36th, and then we marked the end of the 37th.  It is hard to describe how excited we were to know we had made it to the week that is considered full term.  But the joy was quickly replaced with the fear of going too long and not having enough money to pay for diapers or groceries.  After that 37th week I started pleading with my son to be born.  In fact, the last day of my 37th week I thought that maybe my water had broken and scooted off the hospital bubbling with joy, however, I was wrong, and I went home still pregnant.  To my great relief however, at 38 and a half weeks (with 4 days to go till I lost my leave pay) my little man decided to cooperate.

I woke up suddenly at 2 am on the 26th of October with the most intense back pain I have ever had in my life.  I sat on my exercise ball leaning against the bed trying to get relief, but had no luck, I tried to go to the bathroom and realized the pain was regular and it dawned on me that I might be experiencing back labor.  I headed back to the bedroom and woke up my husband to help me out with counter pressure.  However, after rubbing my lower back for a minute, he went back to bed in a sleepy haze, not understanding that I was in labor.  To be fair, it was 2am, and I was not clear.  I was ticked, so I headed back to the bathroom to ride out the contractions on my own.  They changed in intensity very quickly and before long I was yelling for my husband to call the doctor and tell them were here heading in, grab my bag and scoop up the little one.  He started awake in total surprize and called my parents to watch our girl, the doctor to let the hospital know we were coming, and put our little one in the car.  My labor was blindingly painful and intense.  By the time were in the car, my contractions were about three minutes apart and I had to muster up all my courage to have the seat belt against my belly.  I could hardly sit from the pain of back labor.  I know that at least once (if not multiple times) I cried out “never again! never again!”

We got into our room by 3am, and at 3:30 my son was born.  I spent my entire time in my hospital bed on all fours, right through delivery.  It was the only way I could handle the pain.  It was great for me, but it drove my nurses nuts.  I wouldn’t let them put the bands of elastic on my belly to hook up their instruments because the pressure was too distracting and painful.  They did get them on for a moment and I saw the younger nurse watch the contraction reading fly to the top of the chart and she gasped “oh my god!” after which time I ripped them off.  One of the beauties of being in that position was my ability to close my eyes and put all my focus internal.  The world went away when I closed my eyes, including the freaked out younger nurse.  I could just hear the voice of the calm older nurse, which helped me quite a bit.  I begged them to call my doctor, but they did not listen.  What did I know, I was just the laboring mom?  I was told I’d be made comfortable and get ready to ride out a long labor, but I knew this was not the case.  When they admitted me I was 4cm dilated and full effaced.   I over heard the phone call they finally made from the nurse’s station just steps from my room about 10 minutes before my son was born “Hi doctor, she wants us to call, but I am sure it will be hours”  The next minute I was in transition and my body started to push.  There was a frantic over head page for any OB in the hospital to come STAT, and my doctor was called again.  My son was caught by the doctor who happened to be in the break lounge.  He entered the room, sat down, said “ok, I am here, push” and it was all over in less than a minute from the moment he walked in the door.  With my baby delivered, I could finally roll over, and all of a sudden, I was in no pain and happiness prevailed for all of us in that room.  I was beaming, my husband was beaming (still blurry eyed, but beaming) and a sense of calm and peace instantly swept over the room.  Due to the sheer speed of it all, I had a totally natural delivery (in fact, an anesthesiologist came up 15 min after I delivered to see if I wanted an epidural), and also lots of bleeding.  I had to get a shot of hormones (pitocin) after delivery to try to control the hemorrhage.  The charge nurse explained that going through labor so quickly can cause your uterus to go into a bit of shock and not contract down to stop the bleeding.  Thankfully the shot in my thigh was enough and I did not need any further interventions.  To show for the most intense hour and a half of my life, I had my perfect little son.  Full term, and beautiful.  He was even kind enough to be born in time for leave pay.

So what did I learn after my second pregnancy?  For starters, I will never go back to an epidural if at all possible.  Not only did I recover much faster post delivery, I learned that in fact, the delivery is easier than the labor pains (especially when I have full control of my body).  Once you reach transition, it’s all a very happy down hill.  Also, I may never have a “normal” pregnancy.  This means that I am not a candidate for having the care of a midwife, the very profession that I am training for.  I also distinctly remember on several occasions through out my pregnancy stating that I never wanted to go though the bad parts ever again: the nausea, the bed rest, the painful labor…. and yet as I watch my children grow, all I can think about is what the next baby will be like.  Hope springs eternal in the hopes that each pregnancy will be more successful and fewer complications.  I learned that the birthing process is normal and healthy, but can be prickled by unforseen complications.  I learned that a calm and collected nurse is worth at least 5 doctors in a delivery room, and that a frantic terrified nurse is better off in the hall (and in my room delivering my son, I had both).  I hope that at the end of my schooling, I will be the nurse who can manage the situation and keep the team running smoothly, and I will always take a mother seriously when she states the need to push.  What happened after we left the hospital was a path of discovery that led me to the midwifery career.

I feel that my journey to school deserves its own full post ( or several).  For now, I hope that this information helps you to better understand where I started when my search for “a better way” began.

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