Monday, September 23, 2013

You've got to know when to hold 'em, know when to fold 'em

A few weeks before my due date, my doctor warned me that I was measuring large and she was afraid the baby was going to be over ten pounds. She offered to let me schedule a c-section if I wanted, but I thought that was a bit extreme. I'd much rather at least attempt to labor, and if it ends in a c-section, so be it. Anyway, I didn't think the babe was as big as the ultrasound/measurements predicted. It is in fact less accurate the bigger they get, so it was really all a crapshoot. But I was also mighty sick of being pregnant, so I agreed to induce on my due date.

The admitting nurse was pretty impressed that I used the term "macrosomia" when she asked why I was being induced, but by this point I'm kind of an armchair OB. (Ask me about my Bishop score!) I knew that conditions weren't super favorable, but if she really was as big as they thought, putting it off wasn't going to decrease my odds of a c-section either. So we went in at 8 pm on the 8th and got the party started. 

After a lovely evening of nothing happening on cytotec, they started my pitocin in the morning. And I did start contracting--30 second contractions with no rest period. You know what that feels like? One long contraction! It wasn't too bad; on the 1-10 pain scale I was at maybe a 3 or 4. But that's not exactly a good, productive contraction pattern, so they kept upping my pitocin to try to get some normal contractions. I hadn't really dilated much since I was admitted, either, which I suppose isn't surprising when your contractions are being funky. Then around 1pm my water broke. (Fun story: you can hear kind of a blip on the fetal heart rate monitor when she kicked. There was a big blip and I said, "Oh, wow, she kicked so hard I just peed a little." Except it kept coming. I was like, "Uh, I don't think this is pee!" My nurse happened to walk in just as I pushed the call button, and sure enough my membranes had ruptured. It does feel rather like a water balloon breaking.)

Without the cushion of amniotic fluid, I was feeling the contractions more. A lot more. Now I'm still having constant, short contractions, but they are like, two and a half times more painful than before. I was like, "Nuts to this, get me the epidural. I can't do hours of this." They called in the nurse anesthetist (those people are worth everything they pay them and more!) but my blood work from admission was getting kind of old, and my platelet count was low, so they had to re-run it. "How long does that take?" I asked. Usually 45 minutes. Great. So an hour before I can anticipate pain relief? An hour of constant contractions? And what's this about platelets? What if they're too low? Will they still let me get an epidural? "We don't know." At that point, I was like, if they won't give me the epidural, you use general and do a c-section because I'm not doing this.

They cut my pitocin in half to try to get me some relief on the contractions and managed to rush the blood work back in 15 or 20 minutes. Although my platelet count was even lower, I got my epidural. Saints and angels sang. And now that I wasn't in so much pain and things were more relaxed, we were hoping my contractions would normalize. Yeah, no. They did start having breaks between them--not that I cared anymore!--but there was still no pattern. I'd have a few minutes of normal contractions, several minutes of nothing, and then just as she was about to turn my pitocin back up, a few more normal contractions. They never were able to increase my pitocin dose again. We tried a bunch of positional tricks to try to get baby to descend/me to dilate, but nothing was working.

Around six o'clock our awesome, awesome nurse was like, "The doctor is coming in soon, and is going to want to talk to you about a c-section." We knew that was always on the table, and it wasn't looking good. Despite the on-call doctor having something of a reputation of being a cutter, he didn't push it. Could we wait and make the decision in 12 or 24 hours? Absolutely. Baby was never in any kind of distress, so there was no real emergency. But was it looking like I was going to be able to push this baby out? Not so much.

I didn't want a c-section, obviously, but I also didn't want to hang out in the hospital forever. Thanks to the epidural I could have waited it out forever, and maybe another 24 hours would have yielded some results, but because my water had broken we didn't have a ton of time to wait. (Especially since I'm group B strep positive, and even with the penicillin didn't really want to push things.) So I decided, if I'm going to have a c-section anyway, I might as well have it now.

So Monday the 9th at 8:09 pm, I heard my sweet baby's first cries. They lifted her up over the the drape to show her to me, and all I could see was a giant cone head. They assured me it would go away within hours, but you could actually see the ring of how far I had dilated. That head was not coming through.

The recovery hasn't been as bad as I thought it'd be. Sure, it was pretty hard to hoist myself out of bed for a week or so, but the pain was pretty manageable. They kept telling me to not let the pain sneak up on me, but it really wasn't! I was okay on just the Motrin. I did take Percoset once, but it was too much. I get too loopy; can't even hold my head up on 'em. And the difference two weeks later versus one is HUGE. I feel practically normal, and I haven't even had my steri-strips removed. I've also lost nearly all the weight I gained, which is awesome even if there is lots of doughiness and skin in new places. Frankly, after an 8 pound, 10 ounce baby has made double occupancy of your belly, just having them evicted makes you feel tiny.

So it didn't happen exactly how I was hoping, but I have no regrets. I'm not bitter about the c-section--everyone agreed I made the right choice--I'm recovering fine, my baby is the most wonderful thing in the world, and I understand why people would do this more than once...although at this point I'm only willing to do it if I can somehow magically stay home for the entire pregnancy, because working and being pregnant was hard enough in itself and taking care of a toddler on top of that would probably kill me. But that's a problem for another day. For now, I'm enjoying a sweet, beautiful, delicious baby and that's plenty.