More questions than answers

Posted On Saturday, June 25, 2011  by Ashley Snyder

My pregnancy was nearly perfect. I felt better than I had my entire adult life.  I didn't have any morning sickness, I avoided many of the typical pregnancy complaints. I absolutely loved being pregnant.  Then at 36 weeks I went to my OB told me I was measuring big and sent me for a follow up ultrasound at the hospital.  I was 36 weeks 4 days.  I arrived at the hospital nervous, but not too concerned after all I felt fine and baby seemed to be doing well.  Thankfully my husband was by my side.  There had been a debate on whether he should take more time off work for another appointment.  I was happy we would get to see baby one more time before he was born.  Since I was measuring big, I was worried about having a high fluid level.  We watched the ultrasound and saw our baby moving around, listened to his steady heart rate it never changed from 150 my entire pregnancy.  The tech told us to wait in the waiting room until the doctor could look at the ultrasound and come talk to us.  We waited and shortly after a nurse came to us and told us to go eat that we wouldn't be able to for awhile.  Obviously I was curious as to what she meant that I wasn't able to eat for awhile, so I asked when I would be able to eat again still not really realizing that something was off.  She replied until I had the baby.  You could have knocked us over with a feather.  The nurse realized at that point that the doctor hadn't spoken to us yet.  She said that the were going to induce me that night, that I wasn't going to be allowed to leave the hospital.  Thankfully since we were expecting near Christmas, I already had everything prepared so I made a frantic call to my mother to bring my bag.

We still hadn't spoken with a doctor at this point, but went down to the cafeteria to eat afraid that we would loose the opportunity.  I could barely eat, I was shaking so much from nerves.  My sandwich tasted like sandpaper.

We went back up to the original waiting room where we were lead through the halls and finally arrived at my room.  I immediately realized that this was a delivery room.  I was about to jump out of my skin.  The nurse handed me a gown and told me to change, mind you at this point I still haven't seen a doctor.  They took my blood pressure and it was high.  My blood pressure always jumps when I am anxious.  A doctor finally appeared and told me that they found low fluid levels.  That they were going to induce that night.  I questioned him since I was not full term at that point and he said that the ultrasound indicated that I was.  We argued back and fourth a little bit.  He finally decided to contact my primary ob who confirmed that I was only 36 weeks 4 days.  He said that they were going to hold off inducing me until Saturday with hopes that the baby would arrive Sunday when he was full term. This was Wednesday evening.  He said that they were also worried about my blood pressure and were going to order a 24 hour urine collection.  I was put on bed rest and transferred to the postpartum area.

During the next day my blood pressure went up and down depending upon who was taking it, which arm they were taking it from, which cuff they were using, ect.  The doctor came in the next morning and said that they found protein in my urine and were diagnosing me with preeclampsia.  He said that they were going to be starting me on magnesium 24 hours before they began the induction.  This was Thursday.

Friday came and they started the ivs and magnesium, but at a low dose.  Saturday came with no word on when they would start the induction.  Saturday evening a nurse suddenly appeared and said we are ready.  We obviously were not.  My mom and husband scurried around trying to gather up my belongings from around the room.  They wheeled me down to the delivery area.  I met my first labor nurse, Maria.  The doctor came in and said they were going to start the induction with Cytotec.  I had done a lot of research on labor drugs during my pregnancy and had said at that time that I wasn't going to allow them to use cytotec on me because of the possibility of uterine rupture.  I had the first difficult decision to be made.  Do I use the cytotec or do I refuse and only use drugs approved for cervical ripening?  I knew intuitively that my son did not want to be born then, that given a natural progression he probably would have arrived late.  I decided that cytotec gave me the best shot at a vaginal delivery.  In went the catheter.  They then upped the dose of magnesium.  I really wish they would have warned me how bad it would be.  The nurse said I might feel like I was a little, 'hung over'.  Try feeling like I was hit by a mac truck.  I couldn't lift my head off the bed.  My thoughts were getting hazy.  I lost the ability to speak because I wasn't allowed to drink.  I felt like a prisoner in my own body.  Maria was briskly hurrying around the room and was in and out.  Eventually she seemed to have everything in it's place and settled in beside me to watch the monitors and to check my blood pressure.  She was a woman of little words, but was obviously good at what she does.  You could tell that the other nurses on the floor respected her.  She would take my blood pressure and if it was a high she would remind me to relax, turn me to my side and retake it until it was within the acceptable range set fourth by the doctor.  By this time she had read my birth plan and knew how devastated I would be by a c section(cs).

Hours went by, the doctor came in and inserted more and more cytotec. Each time reporting no change in my cervix.  Eventually she said that this was the last dose that they could give me that they were going to start the pitocin, but if they didn't see any change in me at that point that we would need to talk about a cs. I wanted to scream at her of course I wasn't dilating, I was flat on my back with no pressure on my cervix, I should be up walking.  I just looked at her unable to speak.  They started the pitocin.  Immediately I felt one long hard contraction after another.  I felt like I was jolted out of bed.  I started begging for an epidural, I had so wanted a natural labor, but I knew I couldn't handle it in the condition I was in with the magnesium being that I wasn't allowed to change positions.  Getting the epidural was the worst decision of my life, and yet there was no other decision I could have made.  My blood pressure plummeted and I lost consciousness.  I came to seeing my mother and husband clutching each other and I knew it was bad.  I heard Maria yelling for more hands.  Then for someone to prep the OR.  I heard her say we can't find baby. The room was suddenly filled with people.  She was putting an oxygen mask over my face and telling me to get on all fours.  Some how I found the strength with a couple of other nurses helping me to flip over.  She whispered to me to breath deeply that the baby needed oxygen.  I had a lot of nurses down below spreading me open, inserting this monitor and that inside of me.  I was paralyzed with fear.  My ivs felt like they were going to pop out and rip right through my skin. They found the baby with an internal monitor.  He was doing ok.  Maria flipped me back over and whispered again for me to breath in the oxygen. That is the last  good memory I have of my son's birth. My water broke with a pop, Maria had stepped out at this point.  I remember thinking no one is going to believe me that my water broke.  My husband told me later that there was no question about it.  Maria came back in and confirmed that my water had not only broken but that there was a large amount of fluid.  She started questioning me as to whether they had diagnosed me with high fluid levels.  She was concerned that she had the wrong records.  I said no they said I had low fluid levels to which she said well I had a lot when my waters broke.

Maria was replaced by my next nurse.  We could tell that Maria did not want to leave.  She stayed much past when her shift had ended.  We called my next nurse Florence because she reminded us of Florence Nightingale.  She was a sweet older lady who looked after everyone's needs.  She brought my husband and mother a blanket and made sure that they also had everything they needed.  I was in and out during this whole time. They gave me a button to push to get more epidural, but I kept losing it. I kept trying to get the energy to whisper to the nurse that I needed the button.  It seemed like forever before I could muster the energy needed.   I got sick, I thought at the time that this was because of the magnesium but now I realize that it was that I was hitting the transition phase.  The doctor came back in and said I could try to start pushing right now or I could labor down and let the baby move down on his own.  I stared at her at first.  I knew I didn't have the energy to push.  Then it hit me, I was going to have to try to push the baby out while feeling like this.  I said later.  She said there was now muconium in my fluid.  That when it was time for baby that they didn't want him to cry.  I passed out again.  I woke to feeling like I had to use the restroom.  Florence told me it was time for the baby to come.  Suddenly my room was again filled with people.  They had a full set of nurses and doctors for me and two full NICU teams for the baby.  I pushed.... I pushed for four hours.  Finally, my son Cole was born Monday morning nearly 40 hours after the induction began.  He had an apgar of 2.  The only reason he got the two was because his heartbeat was strong.  He was white.  They took him and immediately started to work on him.  He inhaled some of the muconium, but started to breath.  I lay there waiting for word on how he was.  The nicu doctor finally said that he was stable, but that they were going to take him up to the nicu for a couple of hours.  I was allowed to hold him briefly before they took him.  That was the last I saw him for days.

They would not release me from bed rest.  I did not hear anything about what was going on with him.  The nurses were too busy to help me with anything.  I lay in bed wondering, worrying.  I had planned to breastfeed.  My mom was begging the nurses to get me a breast pump during that time but no one seemed to know where they were.  They had moved me to the overflow section in the woman's health area rather than in the postpartum wing.  I was never able to get my milk to fully come in.  Being separated from him all of that time did us such harm that I can't even begin to explain.

Finally when I got up to the nicu, I found my son doing well.  He was having difficulty clearing all of the magnesium from his system and didn't want to eat, but he was otherwise doing well.  He spent 7 days in the nicu.

He is now a happy 6th month old who seems to know how good life is now.

However, I am left wondering if I really did have low fluid levels.  I never had any of the physical symptoms of PreE, no headache, no edema, no abdominal pain.  My blood pressure never returned to normal.  I wonder if I really had PreE or if I had PIH or some other disorder.  I wish I would have requested repeat testing.  I know next time that I will ask for repeated tests of anything abnormal.  I know that I will make sure that I have everything that I could possibly need with me at all times.  I will make sure that I will find a way to be with my child after delivery, I didn't realize how detrimental that this would be.  I know next time that I need to be prepared for the worst.