TESS’S BIRTH STORY: AN UNPLANNED C-SECTION
Just to preface – this is detaaaaailed. I wanted to cover everything for both you all and myself — you never want to forget the details of your child’s birth!
From 37.5 weeks on, I remember waking up every single day and thinking
‘Today is the day. I just know she is going to be here early.’
But the days drug on, and baby girl Nielsen had still not made her debut. Starting at 36 weeks, my OB had me coming in for non-stress test fetal monitoring. I had also been scheduled for an ultrasound at that appointment because one of the other OB’s in the practice had covered my appointment at 35 weeks and she was convinced baby N was breech (although I knew she was head down and had been for weeks!). At that time, the ultrasound tech also estimated my fluid levels to be “border-line high,” healthy range measures at 5 — 25 cm on the monitor and mine was 25.3 cm. So, by borderline they meant VERY borderline. Regardless, I was worried enough to consent to the third ultrasound. If you want a scare just Google “polyhydramosis.”
Every week I would sit in the chair, the monitor strapped to my belly, scrolling through Pinterest. The tech would come in to check on me, and glance at the monitor. Then she would always do a double take, grab the tape and scan it once then look back up to my face.
She would smile and ask “Are you doing ok?”
I would smile back and nod, “Yeah, I’m fine!” Still casually scrolling through my pins.
“Hmmm,” she would respond, “It looks like you’re having some contractions.”
I would shrug, “I don’t feel anything.”
The doctor would come in after about 20 minutes and repeat the same thing the tech had mentioned.
“Looks like you’re having contractions. Baby’s heart rate looks good, good movement. It could be any day! I don’t think you’ll be in here for your 38 (39, 40) week appointment. I bet we’ll be at the hospital,” she’d say.
But I was able to make my 38-week appointment, and my 39-week appointment and 40-week. I was due on a Saturday – January 12 – we spent the day doing things around the house. My husband, Jared, was working on renovating our bathroom. Around 6pm, I was laying in bed with my ever-swelling feet up when I had the urge to pee. An urge I was very familiar with at that point of my pregnancy. I rolled off the bed and climbed over my sweet husband who was sprawled out on our bathroom floor, working on the plumbing for our new bathtub.
“You better get up or I might pee on you,” I said, squeezing into our bathroom.
He grumbled sarcastically, but moved – I had already been in the bathroom several times that evening – forcing him to stop what he was doing and move for me.
My water gushed — they tell you not to expect what happens in the movies, but that is exactly how it happened for me. I could see how round my sweet husband’s eyes grew, and I just laughed.
“That wasn’t pee.” I said
“Are you serious?” he asked. Which was, ironically, the exact same thing he’d said when I told him I was pregnant.
I still didn’t feel any contractions or real signs of labor other than my water breaking. But, as instructed by my OB, I called the office on-call number and spoke with another doctor from the practice who told us to make our way to the hospital. Of course it happened to be right in the middle of what had been the biggest ice storm that year. I called my mom who lives two hours north, and told her to plan on heading our way soon. She was in a complete panic because all of her babies were born less than 4 hours after her water broke. Lucky lady. All throughout my pregnancy, I’d prayed that I inherited her short, smooth labors. That, unfortunately, was not my experience. After hanging up with my mom, I called my sister, Amy, who lived less than ten minutes away to let her know we were going in to the hospital. She’s a nurse and she knew it might be a while, so I promised to keep her posted on our status once we were in triage.
We scrambled around gathering all our last minute items for the hospital bag before finally heading to the hospital, two hours later. It all seemed surreal, a huge blur. At that moment, buckled in to the car and driving to the hospital, you realize how underprepared you are — regardless of the books you’ve read, the stories you’ve heard, the questions you’ve asked. Nothing truly prepares you for motherhood, until you become a mother.
We made it to the hospital and I was still feeling no signs of labor aside
from what I would describe as tightening in my uterus. One trait Jared and I share is that we don’t really plan. We’re pretty go-with-the-flow type people. Which proves to have its pros and cons. I tend to plan a little more than he does, or at least I think about planning. Much in the way that I thought about a birth plan. Did I actually have one? No. But I’d thought about it. I had ideas of what I wanted and didn’t want. I’d researched things and I knew answers to almost every question we’d be asked along the way. But I didn’t have a physical, written plan. Chalk it on up for the go-with-the-flow-ers, in our case. Needless to say we didn’t even know what floor L&D was on at the hospital where we were delivering. We hadn’t visited, or gone through the classes. Again, we kind of do our own research and wing it.
Cue [a little bit of] panic for the first time mama in me as we wandered around the lobby of the dark, night-shift hospital. Plus, little one was born in January, smack in the middle of flu season, and the hospital had some safeguards in place making it difficult to even get onto the floor! Those restrictions are great —don’t get me wrong, they protect mamas and babies— but they make checking in a small battle. Once we were able to settle into a triage room, I calmed down a tidge (if you’re not from the Midwest, “tidge” is basically synonymous with “smidgen” or “bit”).
The admitting nurse explained that they would do a swab test to make sure it was actually my water that had broken and I hadn’t just peed myself. Apparently that’s a normal occurrence? Either way, I wasn’t concerned about that being the case. Not with my Hollywood-style gush. She hooked me up to the fetal monitor and swabbed between my legs before sending the sample to the in-house lab for testing. In those moments, waiting for the results to come back clarifying that amniotic fluid was leaking rather than urine, I trembled with fear and excitement. Poor Jared just seemed to be in a daze, and all I could do was laugh at him. After a few minutes the on-call OB came in to explain a little bit of what would happen if they found my water had actually broken, although it was hard to understand him through his accent and how quickly he spoke. We both just nodded and smiled and thanked him before he buzzed out of the room.
Fifteen minutes or so later the nurse came back, “Well, it was definitely your water that broke!”
Glancing at the monitor she said some all too familiar words, “Looks like you are having some contractions! Let’s check and see how dilated you are.”
Ugh. That truly was my least favorite thing. If you can convince your OB that you don’t want to be checked, avoid it at all costs. I swear, I’d rather go through labor again than have my cervix checked. I’ve heard many mamas express the same feelings! But, in the hospital they check and check again, then check some more.
At that point in the triage room, I was only ONE CENTIMETER dilated.
You gotta be kidding, I thought.
My doctor had explained in the weeks prior that it’s super common for your water to break after you’ve been in active labor for a few hours. At which point you’d probably be close to a transition, and possibly even ready to push. But not me. One stinking centimeter. Nine to go. If my water hadn’t broken, they would have sent me home to progress before admitting me. But since they confirmed my water breaking, I was admitted.
Within a few minutes of settling in to my room my mom called to say she was in the parking lot with my sister — even being two hours away she almost beat us to the hospital. Whoops. Mom and Amy sent my dad with my brother-in-law, back to their house. The flu restrictions only allowed for 4 people in your room, including your partner. Which was fine – I hadn’t planned on a big audience. In fact, my mom thought it was odd that I was letting anyone in the room at all, besides my husband. She hadn’t ever let anyone, but my dad in, not even her twin sister.
We all settled into my room – Jared, Amy, mom and me. My nurse came in to introduce herself and start an IV just in case since I had told her I wanted to go without pain meds. My unofficial birth plan was all natural. While she worked, we chatted excitedly about the baby we’d soon eventually meet. Once the nurse finished up, she asked if we needed anything before leaving us to relax. Everyone else nestled in for some sleep, but I was wide awake. Although I’d been encouraged to rest, I knew there would be very little sleep for me that night. I’d bounce on the birthing ball, pace back and forth, drink extra water, frequent the bathroom, and obsessively check the fetal monitor for movement and contractions. Each time my nurse came to check on me, I could tell she was surprised that I was awake to greet her. Around midnight, she checked my cervix again and found that I was 3 centimeters dilated. I was relieved that things were progressing.
After that I slept for about an hour before returning to my routine of bouncing, pacing, hydrating, peeing and checking. It was right before shift change, about 7AM when my nurse checked me again to find that I was still only about 3–3 ½ cm dilated. She ran through some options with me and mentioned Pitocin as a possible next step, since things were slowing down. During my pregnancy, I had spent lots of time researching and educating myself on things that could happen during labor. I’d read some horror stories about Pitocin, but I’d also read women who swore by it for speedy labors. Even my mom had received a “pit-drip” during her first labor. Honestly, I think my eagerness to meet my baby, and the discouraging rate of my progression were the biggest determining factors for me. Be warned that once they start a drip you’ll be,
- Hauling an IV pole around with you everywhere
- Also receiving fluids which will make you pee even more
- Asked about “upping the dose” every half hour or so (or if you have a nurse who isn’t quite up for conversation, she’ll just come in and up it without saying anything)
For the first hour or so I didn’t notice any change, except in the number of times I had to pee. But right around the hour and a half mark, I started having long, hard contractions that forced me to all fours. It was like wave after crashing wave broke over my body. Before I could even straighten up or take a breath, another contraction would come. Each time my nurse would come in, she would look at the monitor and say something along the lines of, “Oh wow, those are long contractions!”
I would barely nod at her – I could hardly even hear let alone process what was being said. Jared was holding pressure on my lower back throughout almost every contraction just so that I could breathe. HUGE thanks to Amy for instructing him on how to do that, otherwise he would have been clueless (he neglected to read the natural birth partner book I gave him – HA). Everything was a huge blur from there on – I know that Amy and my mom were worried about me, mom especially since the only births she knew were quick and smooth. It’s hard for anyone to see a loved one in pain – and I get that. But honestly, I was so glad they were there if for nothing else than to support poor Jared. He doesn’t know how to handle situations like that, AT ALL. During contractions, I was moaning so loudly I am sure I scared the other laboring women – my bad. It was probably about 10AM when my mother-in-law arrived to check in with us. She is an Operating Room nurse and she is super familiar with hospitals, laboring mothers (who get wheeled in for emergency cesareans) and the constant stream of hospital personnel in and out of rooms. I know there are plenty of women who wouldn’t want their MOIL anywhere near them during their labor, but I was thankful for her support and optimism. Lois is always even-keeled and positive. Throughout the day she acted as the messenger, back and forth between the waiting room and my room, keeping my Dad, father-in-law and brother-in-law updated.
Somewhere around noonish, my nurse convinced me to try some IV pain meds, I’m not even sure what it was, but at that point it felt like my body was just one giant contraction. Honestly, all that did was make me feel like I was drunk during each contraction – it didn’t hurt any less, but it made me less aware of each one. Somewhere around 3PM my nurse checked my cervix and I had progressed to 8cm, but I was to the point where I was nearly blacking out with every contraction. She suggested an epidural. This was only the second time she had mentioned it. Which I appreciated since I had told her I wanted to try without one earlier that morning.
Jared, who you’ll have to forgive, had told me many times in the days leading up to delivery that “we” would not be getting an epidural because he had been told they cost $3,000. But in that moment, he was looked at me and said “Get it.” If you know my cost-conscious husband, you know that is major. He had to have been extremely worried about me in order to consent to what he thought was going to cost him three grand. Either that or his arms were tired from holding counter pressure.
Regardless, the anesthesiologist swept in and placed my epidural so quickly I barely knew what happened. Jared says that was the first point where he got a little woozy – after he removed the epidural needle and placed the line there was apparently more blood than he had anticipated. We finally got some much-needed rest. My plan had been to be completely natural – but I think the minute I agreed to the pit-drip, that was no longer a reality for me. In my non-medical opinion, I think that the Pitocin DEFINITELY changed the way contractions affected my body. Especially since I had been having regular contractions without black-out-type pain before the drip. Either way, its something I’ll try to avoid in my next pregnancies.
Around 6PM my nurse checked again to see how close I was to reaching 10cm dilated – and I was good to go!
When she asked “You ready to start pushing?”
I could’ve kissed her. At this point, I was beyoooond ready to meet Little Miss Nielsen. With my husband on one side and my sister on the other, I pushed for two solid hours. My little one was presenting facially – which I had never even heard of before that moment. Facial presentation basically means that instead of having her chin tucked my little one had her chin jutted out.
“Face presentations account for 1/600- 1/800 deliveries. This occurs when the fetal neck is extended and face from forehead to chin is the leading body part. The likelihood of vaginal delivery depends on orientation of the mentum (chin). With mentum anterior, occuring in 60 % of face presentations, vaginal delivery is often possible. Normal labor forces result in neck flexion in the second stage of labor as the chin passes under the pubic symphysis allowing expulsion of the fetus. If the fetus is mentum posterior, flexion of the neck is anatomically impossible. Spontaneous rotation to mentum anterior occurs frequently.”
My babe was unfortunately in Mentum posterior position and while we continued to try to flip her to Mentum anterior position by changing my position with each push, little one began to decelerate without recovering. I was given an oxygen mask and instructed to keep it on during the pushes.
Along came the THIRD shift change I had labored through – my new night-shift nurse buzzed into the room. She introduced herself as Theresa and swooped in to start prepping the warmer for my babe which gave me all the good vibes. I had a little break from pushing while the new nurse and current doctor on-call from my practice familiarized themselves with my chart.
Once I resumed pushing, I could tell that Theresa wasn’t taking her eyes off the fetal monitor. She watched the baby and my stats constantly, all while encouraging me, coaching me and keeping everything clean and organized. Thinking back, I should have been a little bit alarmed, but I was more focused on getting my baby out. Shortly after 7:30PM, the doctor came in to check on me and she lingered by my bedside for about 30 minutes – which, looking back – I should have realized was not normal. Fast forward to 9:07PM, I was exhausted, I could tell Theresa was apprehensive and the doctor was again at my bedside. After a stent of 4 pushes, she looked at me, and she gave me a sad smile,
“Leah, I will let you push for another thirty minutes and try to get that baby turned – but after that, we’re going to do a C-section. She isn’t recovering from your contractions and pushes like she should be and if we let her go any longer we could run into some other issues.”
I burst into tears – I wasn’t disappointed or sad, I was just so overwhelmed. Here I had all these plans, natural birth, quick, smooth delivery, healthy baby in a few short hours – all of these plans were obliterated. Seriously, smithereens. I could barely catch my breath. She asked me, in literally the kindest voice I’ve ever heard,
“Do you need to take a minute? To talk about it?” she looked from Jared back to me.
I didn’t even look at my husband before responding,
“Let’s go, the C-section. Let’s go now.”
I mean – when you hear “run into some other issues” you aren’t thinking about your birth plan, or what you wanted, what you envisioned – it’s all about that baby. Jared squeezed my hand just a little and I knew he agreed – he’s not a PDA kind of guy, so that was enough to reaffirm. My mom and sister were sent to the waiting room and as they walked out, the anesthesiologist swooped in to increase the dose of my epidural.
“I’ve kept my eye on you throughout the day. I was afraid this would be where we’d meet again. Sorry about that – but you gave it your best effort. This is just the unfortunate course of events sometimes, for a healthy baby,” he offered.
All I could do was nod, because if I tried to answer I knew I would cry.
For real, the NICEST man. He was super concerned about me, and I felt comfortable with him by my head through the entire procedure. He even held a bag for me to vomit into – TWICE – I don’t know many anesthesiologists who wouldn’t have called on a nurse to take care of that instead.
He was barely finished when they started wheeling me down to the operating room on the L&D floor designed specifically for C’s. Something had caused my body to shake uncontrollably – I’m not sure if it was the dose of epidural, the adrenaline, the anxiety, a transition…the anesthesiologist could not get a read on my blood pressure. He tried so many times that my arm was bruising. Several people asked me if I was cold because my body was shaking so hard my teeth chattered. I had multiple blankets piled on top of me on the way to the OR. Jared stopped to gown up before he followed me in. It was no longer than five minutes after I’d agreed to the C-section that I was being draped on the operating table. Everyone was buzzing around and I remember so distinctly hearing the doctor ask Theresa,
“Did you notify the NICU?”
I thought my heart was going to explode, all I could hear was it thundering in my ears. Tears clouded my eyes and I swallowed hard so they wouldn’t spill over.
‘Please, God’ I prayed ‘Let this little girl come out OK.’
At 9:18PM Tess Amelia was born – but I couldn’t see her, or hold her, or hear her – I sent Jared over to where the nurses had her and told him to take a video and make sure she was OK. Praise the Lord, she was breathing – and screaming – within a few minutes. It was about 10 minutes before they closed and another five before they moved me back into my bed and let me hold her, that felt like an eternity! But she was perfect. I’m 5’1’’ and I weighed about 117 before I got pregnant. Tess was 8lbs 2oz and 21 ¼ inches long – 99th percentile in height – she hardly felt like a newborn!
Truly – in that moment – when you first hold your child, you don’t care how they came into the world, you’re just happy they’ve arrived. So, remember that when you’re writing your birth plan, or when you’re in the hospital faced with what seems like hundreds of decisions – the end goal is always the same – health baby + healthy mama, everything else is just details.