Caleb arrived at 40 weeks, 6 days.
Daisy arrived (with some prompting) at 41 weeks, 2 days.
Lily arrived at 41 weeks, 4 days.
I was honestly expecting Eli to be a 42-weeker. So when my water broke at 34 weeks, 6 days, I was more than a little bit surprised.
My pregnancy with Eli was textbook: getting pregnant was a piece of cake, I began seeing my midwife at 7 weeks, I felt great throughout the pregnancy, and I had no complications whatsoever. We were on track to celebrate our third home birth, probably sometime in mid-March. Months before we got pregnant, Caleb began talking about our next baby. He was quite confident that we would have baby #4, it would be a boy, and his name would be Yoey. So when we found out that we were pregnant with #4, "it" was immediately a "he", and "his" name was Yoey.
We celebrated our 12th wedding anniversary with this photo.
After having three uncomplicated deliveries that all occurred well after 40 weeks, I felt like I didn't have much work to do to prepare for Baby's arrival. Chris and I decided that February would be our month to do things like buy a minivan (since a family of 6 won't fit in a Toyota Camry), make and freeze meals for after Yoey's arrival, and prepare Lily to no longer be the baby of the family.
When my water broke at 7 am on Tuesday, January 27, at 34 weeks and 6 days, I was at a loss.
Just like any weekday morning, Chris came in to wake me up before he left for work. Caleb and Daisy were up and playing, and Lily was still asleep in her room. I groggily got out bed, used the restroom, and began opening curtains in the bedrooms. I got as far as Daisy's curtains when I noticed that my pants and underwear were wet. Really wet.
Had I peed my pants?
I walked delicately to the bathroom and another gush of fluid hit the white tile floor. I stared at it in disbelief and said, "That's not pee. That's not pee. Oh, God. That is not pee." My voice shaky, I called out to Chris, hoping he hadn't left yet.
"Chris? I don't think you can go to work yet! Will you bring me my phone?"
As fresh trickles of fluid came every few minutes, I called my midwife's after-hours number. She returned my call within minutes, and she was matter-of-fact: I needed to go to the hospital to determine if this liquid was amniotic fluid, or just pee. I could come to her birth center, but her suspicion was that she would have to turn around and send me to the hospital anyway. She didn't want me to wait; she would be most comfortable if I could be seen within the next hour.
The gears in my brain started whirring as I planned what we would do with the big kids, how we would get to the hospital, who would watch Lily, what about Chris' work schedule, HOW ON EARTH COULD MY WATER HAVE BROKEN SO SOON?!?!?
Luckily, Tuesdays are preschool and school days. Chris got Caleb on the school bus, took Lily across the street to the neighbor's house (they were blessedly home, awake, and happened to be babysitting their niece and nephews who are the ages of our kiddos so they had no plans for the day), and we hopped into the car to drop Daisy off at preschool and go to the hospital. I was really hopeful that we would be told that I wasn't in labor, but just in case, I took Chris down to the basement and showed him where all of our baby/birth things were. Since we weren't expecting a baby for another 7 weeks, everything was scattered about, in various boxes and cobwebby corners. The infant car seat. The newborn clothes. The blankets. The postpartum stuff.
Then we dropped Daisy off and went to the hospital. We had 3 hours until we needed to pick her up again, and I was hopeful Chris could be back at work by lunchtime. We told the neighbors that they would only have Lily for an hour or so.
Wrong.
At the hospital, Chris and I followed signs to the Labor and Delivery ward we had never seen before, and never planned on using. Miraculously, they had my information in their computers from Lily's ultrasound two years ago, so I was quickly sent to triage. The house OB was great, though the nurses were baffled as to why my blood pressure was so high. Hello? I suspect that my water just broke at 34 weeks? I'm in a hospital, which is the last place I want to be? I don't know who any of you are, or where I am, or how this baby is doing, or what I'm going to do with the rest of my children? I have no idea why my blood pressure is high!
A visual examination led the doctor to say with 95% certainty that my water had broken, and if I was dilated at all, I was maybe 1 cm. A quick test indicated that my water was, in fact, broken. It was not pee; it was amniotic fluid. She elected to not perform an internal exam, which would increase the risk of infection. From the get-go, the staff was doing everything they could to buy me as much time as possible. Still, the doctor informed me that after 34 weeks, they generally don't try to stop labor from happening, so I would be having this baby much sooner than we anticipated.
I called my midwife to relay the news, and she gave me a rundown of what to expect. My midwife and her partners were in the process of becoming the first midwives in the area to gain privileges to deliver babies at this hospital, but they were still a few weeks from being done. Luckily, they had a really excellent cooperating OB who would be technically overseeing my care. In reality, he allowed my midwife to make most of the decisions, though he always had the final say. I can't emphasize enough what a big deal this was: in many areas, and even in my area up until a few years ago, there is open animosity between OBs and midwives. Women under the care of a midwife who end up in a hospital can be treated great hostility. However, Chris and I are blessed with a midwife who has been working diligently for years to open inroads between midwives, like-minded OBs, and the hospitals in the area. Even though my birth was taking a sharp turn away from everything I had planned, I would still be able to have continuity of care. My midwife would be there with me, I would be under the supervision of a doctor who would do his best to respect my wishes and desires for this baby's birth, and I would be at a hospital whose staff was committed to helping me deliver this baby in a manner as close as possible to what I wanted, given the circumstances. In the midst of a terrible situation, God had given us very good circumstances.
Because we hadn't gotten far enough in the pregnancy to test for Group B Strep, I would be given IV antibiotics. Of course, I am skeptical of unnecessary interventions, but in this case my midwife assured me that it was necessary: with this little one being preterm, we didn't want to take any extra risks. My new OB, Dr. M, came in during his morning rounds to meet me and chat with me about how we would proceed. He agreed to wait several hours to see if my body began contractions on its own, and said he'd come back late in the afternoon to reevaluate.
Once we knew we were there for the long haul, we had to figure out what to do about the kids. My mom was at work and had forgotten her cell phone at home, but I finally got in touch with her and she was able to find someone to cover the afternoon portion of her shift. Chris left to pick up Daisy and Lily, and Mom came over to stay with the girls while Chris and I had a baby.
Meanwhile, contractions did not start. We waited. Played on our phones. Napped. Chris researched minivans and did work on his laptop. I begged for food, and the nurses offered me ice chips or gelatin, until Dr. M decreed that I could eat. Around 3pm, I asked for a breast pump to be brought in, hoping that nipple stimulation would spur contractions to start. It didn't. Around 5 pm, Dr. M stopped by and determined that it was time to start the pitocin. Then we waited. My first nurse, Lily, started the pitocin at level 2. Every thirty minutes, she increased my dosage by 2. Up and up and up we went, with nary a contraction in sight. I sent Chris home to do dinner and bedtime with the kids.
Around 8 pm, my friend and photographer, Sara, came up to the hospital. By 9, the pitocin was at level 18 and I was starting to feel regular contractions. It definitely wasn't active labor, but it was something, so my midwife, Jessica, decided to come up to the hospital. And then, more waiting.
Sara and I did approximately 74 laps around the nurses station, and I paused maybe once per lap for a mild contraction. It reminded us of my night of false labor with Daisy, when Sara and I walked the streets of my neighborhood at 4 am, hoping to make my contractions stronger. It didn't work then, and it didn't work now.
Eventually, Chris returned.
I was happy to see him for many reasons. Mostly because he was my moral support, but also because he was my chance at food. The hospital's kitchen had closed for the night, and I was far enough into my labor that the nurses didn't really want me to have food. But my man is a rule-breaker, so I sent him out to get me a cheeseburger.
Best. Cheeseburger. Ever.
Except that I could only eat half of it.
Then, more waiting. This was not how I was used to doing labor, and I didn't like it. I couldn't even take off or put on my sweater because of all of the wires and IVs and yuck.
It was a long night. The contractions didn't really intensify on their own, so we kept bumping the pitocin up and up and up.
I can't even begin to express what a big deal it was to have Jessica there. She was just as comfortable in the hospital as she was at a home or birth center birth, and I was at peace knowing that she had my back. Jessica delivered Daisy and Lily, and I knew that she would fight fiercely for the best birth possible for me. She also came bearing root beer, remembering how much I had enjoyed it during my last labor.
contractions.
More laps. This time, I had to really work through the contractions with each lap. Things were progressing!
Around 3 am, I felt like we were getting somewhere. My contractions were intense, and felt comparable to what I had experienced before transition in my previous births. I thought I was about 8 cm dilated, so the nurse checked me to see how I was progressing.
3 cm.
50% effaced.
In other words, nothing.
I had been at the hospital for 20 hours.
Laboring for 12.
Working hard for 3.
And I was three centimeters dilated.
To make matters worse, Baby's heart tones were not looking good. Yoey's heart rate was dropping with each contraction, in a manner that was very concerning. I was approaching the 24-hour mark of broken waters, my baby wasn't tolerating labor well anymore, and I wasn't progressing.
We were headed toward a c-section.
Jessica, Chris, and I discussed our options. What it came down to was that we had pretty much run out of options. Jessica had one last idea: a break from the pitocin, and amnioinfusion.
Jessica explained that if we stopped the pitocin for a little while, the drug would leave my system, but my body's oxytocin receptors would remain primed and sensitive to the drug. When we re-introduced it, there was a chance that my body would respond differently, and more strongly, than it had before.
It was also possible that my contractions were so ineffective because I had very little amniotic fluid left. Amnioinfusion, which is the introduction of saline solution into the amniotic sac, could give the baby a bit more breathing room. It might help with Baby's heart tones, and it might help make my contractions more effective.
Emphasis on might.
If this didn't work, we would be headed to the OR. I asked Jessica what the chances were that it would work, and her honest response was, "I don't know."
But we grabbed at our last chance. My night nurse, Tara, inserted an internal fetal monitor to more accurately track Yoey's heartbeat. The monitor, which was inserted into the skin on top of Baby's head, indicated something very disheartening; those contractions I'd been feeling, which seemed really strong? They weren't. They were nowhere near strong enough to deliver a baby. Just before 4 am, Tara turned off the pitocin, and the contractions stopped. We began amnioinfusion, and hoped for the best.
Around 4:30, Baby's monitor stopped its thumping. For one awful moment, I was afraid Yoey's heart had stopped beating. Thankfully, it turned out that the internal fetal monitor had just fallen out. Apparently all of the fluid from the amnioinfusion had washed the monitor right out. Three different nurses tried to re-insert it, but Baby's head was so far posterior that they just couldn't get it. It was blisteringly painful.
At this point, I was broken. I had labored as long and as hard as I had for any of my other births, only to learn that I wasn't anywhere near having a baby. The past twelve hours felt like a sham; I had worked and given all I had, but I wasn't even halfway there. I had been awake for nearly 24 hours, and I was physically and emotionally spent. I just wanted to quit. Nothing was working like it was supposed to, and I was done. I wanted a c-section, because it seemed like it would be easy. I wouldn't have to do anything.
Thankfully, I didn't say that out loud. What I did say was, "I quit. Get me a popsicle and an epidural."
So they did. Right around 6:00 am, I got my first epidural. I say "first epidural" for a few reasons: of my four births, it was the first time I had an epidural. Also, it didn't work, and I had to have a second epidural. But boy, it took some convincing to make my day nurse, Paula, understand that it wasn't working. I think it was the fact that I nearly jumped out of bed when she tried to catheterize me that made her realize I wasn't joking. After I repeatedly told her that I could feel each contraction and that I could move both legs with ease, a new anesthesiologist came in and quickly determined that my epidural was definitely not working. She gave me a new epidural, and I felt blissfully numb. I was finally able to do what I desperately wanted to do, which was disengage from this awful labor that was not happening when or how I had hoped. I settled in to get some sleep.
Chris made a spreadsheet of different minivans for sale.
Chris got breakfast for Jessica and Sara, but I wasn't allowed to eat.
Seriously. Laboring with an epidural is boring. It takes no work, no effort, no awareness of your body. You just lie there and wait. But in that moment, it was exactly what I needed.
Now, I was hooked up to an epidural, IV fluids, IV antibiotics, and saline solution for my amnioinfusion. The amnioinfusion did just what we hoped it would, and Baby's heart tones looked much better. However, every contraction brought a gush of water. Almost as fast as the water was pumped inside of me, it gushed back out. I was continuously lying in a puddle.
At one point around the time the anesthesiologist administered the second epidural, I had a whole crowd of people in the room. My midwife, the anesthesiologist, nurse Paula... I was shaking from hormones or cold or whatnot, but what I wanted, more than anything else, was not to be lying in a puddle. I asked Paula to change the pads underneath me, but she didn't do it. She bustled off to get me warm blankets. When she returned, I asked her again to change the pads. Again, she ignored me and did something else. Finally, I began crying. But I was trying so hard to be brave and not be a baby, so I tried to stifle my tears. However, the anesthesiologist was watching my monitors carefully, and she stepped in to scold me: "It's okay to cry, and you have every reason to cry, but you have to just let yourself cry and not hold your breath. Every time you try not to cry, it sends your heart rate soaring."
Well, that got Paula's attention. She came over and asked me why I was crying. Jessica tried to explain, but finally I was able to blubber, "I feel like you're not listening to me! All I want is to have dry pads underneath me and you won't do it!" And then I began sobbing even harder.
That changed everything. Suddenly Nurse Paula was super apologetic and attentive. Suddenly she was willing to listen to me and pay attention to what I was saying. It makes me wonder how many newbie moms get bullied or neglected by nurses because they don't realize that they can speak up? I was lucky because my prior birth experiences had led me to believe that I deserved to be heard during my labor. Not every mom has that experience.
And labor went on and on and on. Chris' cool hand felt great on my forehead. Everything felt great, because I couldn't feel anything. But boy, was I bored.
At one point, Paula came in to talk with me about my hopes and expectations for the birth. I began to rattle off all the things I wanted: immediate skin-to-skin, delayed cord clamping, no shots or eye goo, baby doesn't leave my side...
And then it hit me. Those things are all acceptable for healthy babies. But this baby was a 35-weeker. We wouldn't know how healthy it was until it arrived. Common problems with a late preterm baby include trouble breathing, regulating body temperature, and regulating blood sugar. White, male preterm babies seem to fare worse than females. Since we didn't know our baby's gender, we really didn't know what to expect. With all of my other births, Baby's arrival meant that all of the work and stress stopped. Once the baby was born, I was able to lie back in the bed and nurse my baby, knowing that all was right in the world.
But in this case, delivery wouldn't be the end of the stress. Our baby could arrive with a whole host of issues, and would likely end up in the NICU. All of my hopes and wishes no longer applied; if my baby wasn't breathing, of course skin-to-skin wasn't going to happen. Delayed cord clamping would be out the window. They would cut that baby's cord and take it away immediately. I had to accept that I had no control over any of this, and just pray for the best.
My labor may have been long and boring, but it allowed for two things: we were provided ample time to pray for our Baby's arrival, and with each contraction, my body produced hormones which strengthened our baby's lungs. Every extra hour of labor was an extra hour for our baby to prepare for its untimely arrival into this world.
So we waited.
I definitely wasn't allowed to eat real food, but Jello was allowed. I requested green, and my doting husband fed it to me.
Things were progressing, but sloooooowly. I sent Chris home to give my mom a break from the girls for lunch and nap time, and to pick up some things we would need. Jessica went off to an appointment, and it was just Sara and me.
I slept.
My sister, Emily, came by on her lunch break with encouragement and a basket of daisies.
More sleeping.
Have I mentioned how boring a medicated labor is? It's awful. At least with unmedicated labors, you feel like you can do something. It's kind of like being stuck in a traffic jam on the highway. You can choose to sit in the traffic and have it take an hour, or you can choose to exit and take side roads and it still takes an hour. I'm the kind of person who would prefer to be driving, even if it doesn't get me to my destination any faster. I hate having to sit and wait and be out of control.
At 2:00, the pitocin level was up to 14. Normally, women's bodies start responding to pitocin and begin producing contractions on their own. Not mine. But I was making progress, and was about 5 cm dilated and 75% effaced. It only took 32 hours to get there.
By late afternoon, Yoey's heart rate started looking worrisome again. We determined that my positioning was a problem, and I was rolled onto my side and they brought in "the peanut".
That yellow thing is a peanut-shaped ball that kept my knees spread wide, because Lord knows I couldn't do it.
A little after 4:00, Paula checked me and determined that I was nearing 10 cm, with a lip of cervix still present. Paula and Jessica kept asking me if I felt any pressure or "pushiness", but I didn't feel much of anything. Still, after a few practice pushes to see if we could get rid of the lip of cervix, we determined it was go time. Paula turned up my IV antibiotics, to get one last big dose in me before Baby arrived.
Then my IV blew.
34 hours with an IV in me, and it blew when it was finally time for this baby to come.
So Paula put an IV in my left arm, but as she began arranging all of the delivery tools, I watched the skin around the IV site begin to balloon. I asked Paula about it, and she said it was fine. It took Jessica insisting that, while Paula had done an admirable job inserting the IV, it was, in fact, not fine before Paula was willing to re-do the IV elsewhere. For the 97th time that day, I was thankful for Jessica.
After 35 hours, it was time. They turned my epidural down, Dr. M showed up, and we began to do this thing.
Luckily, I had enough sensation in my lower body by then to push effectively. All it took was three good pushes, and my baby emerged. From the get-go, Chris and I knew that if we heard our baby cry right away, things would be okay. It would mean that its lungs were developed enough that they wouldn't have to whisk it to the NICU. It might have breathing problems or other issues, but for the immediate moment, things were fine. As I birthed our baby, we were anxiously waiting to hear it cry.
When Baby came out, they immediately put it on my belly, because its cord wasn't long enough to reach to my chest. The nurses rubbed and rubbed and rubbed... and Baby began to cry! Chris and I breathed a sigh of relief, and I was able to look down and say, "It's a boy!"
It was Eli Christopher, arriving at 5:08 pm on Wednesday, January 28th, 2015.
But just because our baby cried didn't mean everything was okay. I was riding the high of endorphins at the time, so I didn't realize a few things about our baby's birth. In fact, there were a lot of things I didn't realize about Eli's birth until a month later, when I finally got to see Sara's pictures of Eli's birth. Apparently, Eli came out looking really long and limp. That's a bad sign.
Stimulating a baby is the first form of intervention if it's not looking so good at birth, and that's what our nurses did. Luckily, Eli responded to that stimulation. He immediately cried harder and pinked up, and his long, limp limbs became more responsive.
The house pediatrician checked him, and gave us the okay. Eli had a 1-minute APGAR score of 8, and a 5-minute score of 9. Our baby would be fine, praise the Lord. Because it was 35 hours from the time my water broke until the time he was born, Eli was born at 35 weeks exactly.
The hospital's policy is that every baby born 34 weeks, 6 days or earlier must go to the NICU for a week for monitoring, no questions asked. Because Eli was born at 35 weeks, they were able to evaluate his condition and determine that the NICU wasn't necessary for him. Praise God.
But Sara's pictures of Eli's birth revealed something that really shocked me: there was a lot of blood.
Now, I'm not going to post the graphic birth pictures here, because no one needs to see it. But there was a LOT of blood. My past two births were in the water, so at first I thought that maybe blood was normal, and I hadn't noticed it with the last two because they were in the water.
But there was A LOT of blood. Like, pools of it underneath me.
So as soon as I went through the pictures, I called Sara and began asking her questions. The next day was my 4-week postpartum check with my midwife, and I asked her even more questions.
Sara said that, in addition to watching me with her camera, she paid attention to the faces of all of the doctors and nurses in the room as Eli arrived. She told me that they all had their "Oh, *$%!" faces on as he was born. She also noticed that, while they had turned the pitocin off before I began pushing, at the first gush of blood, Paula raced over and turned the pitocin on, full blast.
My midwife explained that the blood caused the concern that I was hemmoraging, or having a uterine rupture, or something awful. But it quickly became apparent that sometime during delivery, my placenta began detaching from my uterine wall. In normal circumstances, this happens between 10 minutes to an hour after birth; however, if it happens before a baby is born, it is a really serious condition called placental abruption. Our case was neither of those. Eli's placenta must have begun to detach as I was pushing him out. As much as I wanted to delay cord clamping, it was just a few minutes after his birth that my midwife informed me that his cord was doing him no good, because the placenta was no longer attached.
For some reason, Eli had a really short umbilical cord, and an unusually small placenta. Again, I won't show pictures here, but the images of his 35-week placenta compared to Lily's lovely, 41 week, 4 day placenta are shocking. However, my midwife doesn't think that the small placenta/short cord factor had anything to do with Eli's arrival. We still have no idea why on earth my body decided to deliver him as early as it did.
As I labored and watched the day slowly tick away, I had told myself that I wanted to give birth before the sun set. (I'm such a geek; my reason for this was that the lighting would be better for photos!)
Mission accomplished. I watched the sun set with Eli in my arms.
I turned the camera on Sara to capture this shot of her holding Eli for the first time. What a faithful friend she is! I am so thankful that she put her life on hold for over 24 hours so that we could have this record of Eli's birth!
Even though Eli wasn't born at home, he still got to be weighed in the same sling that weighed Daisy and Lily. The result? 5 lb, 8 oz.
The nurses examined Eli, and he was not pleased.
Meanwhile, I ate my first meal in nearly 24 hours. Lasagna. And salad. And a roll. And cheesecake. And yogurt parfait for later. It was delicious.
The verdict? Though small, Eli was healthy and strong. Praise be to God!
Nurse Paula was bound and determined that this baby would be born on her shift, because it was also her birthday. For all the issues I had with Paula, she performed her job admirably. I'm sure her toes felt stepped upon more than once when I looked to my midwife for advice and assistance, instead of her. But by the end, she allowed Jessica to be part of her team and they worked together to help me deliver a healthy baby.
Hi there, you handsome man!
Who knew it would turn out this way? Eli's arrival was nothing like we had expected. God sure has a funny sense of humor!
During labor, we joked that we should name the baby Murphy, as in Murphy's law. It seemed like everything that could go wrong, did. But really, we were so blessed. Things could have been so much worse, and with every bad circumstance, God showed us His grace.
Though we had a hospital birth, my dear friend and midwife Jessica was there.
Though Eli came at 35 weeks, he was healthy and strong and didn't have to go to the NICU.
Though my labor was long and discouraging and not what I wanted, it didn't end in a c-section.
God is good, and we are thankful.
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