Tuesday, March 03, 2009

Birth Story Part One: A Commonplace Miracle

Tuesday, February 24th:

Last week Tuesday I had the first of my biweekly scheduled NST's along with my weekly prenatal checkup with Dr. Fab. Before my appointment that day, I was busy at work, setting up calls with my client contacts to introduce them to my colleague that would be replacing me when I would be going on maternity leave. I didn't feel particularly bad or anything--I was just feeling really, really tired, but I chalked that up to the fact that we had made our pre-baby trip to Costco the night before and that took a lot out of me.

When Aaron and I arrived at the clinic, the nurse took my BP--161/100. I groaned, but I thought that maybe after sitting for a while for my NST, they could recheck my BP and it surely would come down a bit. So, we completed about half of the NST (Tater looked great), and then my nurse rechecked my BP--it was 160/104. Ugh. We decided to wait until the end of the NST to check it again, just in case, but again, it was elevated enough to be considered severe, so the nurse went to alert Dr. Fab. The nurse mentioned on the way out the door that she would probably be coming back to help me schedule an induction. Once we were alone, Aaron and I ventured some guesses as to when my induction date would be and we mentioned how glad we were that we had had a chance to get a lot of our pre-baby shopping done the night before. We felt a little more prepared now that we had finished that up.

I frowned at Dr. Fab as she came in the room because I could see that she was concerned, and she looked at both Aaron and I and said, "So, is today Baby Day?" It took me a minute to process what she had said, but when I recovered, all I could ask was, "Today?" I looked at Aaron and I thought for a moment that he might fall out of his seat. Dr. Fab told us that she was extremely concerned about my BP, especially since it didn't come down at all after I had been resting for more than thirty minutes. She told us that since I was 36w2d and had been consistently measuring two weeks big, baby would be considered preterm but that the risks of keeping him inside much longer far outweighed the benefits. She said Tater might have to spend an extra day or two in the nursery but that he would most likely be perfectly fine.

At this point, Aaron spoke up. I could tell that he was a bit frustrated because Dr. Fab and I were throwing around terms and acronyms that he wasn't familiar with (this was his first time going through this, after all), and he said, "Wait a minute. You're speaking in code. Are we having the baby today?" Dr. Fab told him yes, that I would be induced that day. She explained that if my BP stayed at the level it was at or went even higher, several bad things could happen. I could seize. I could have a stroke. My placenta could abrupt and we would lose the baby. I watched Aaron's face change as this all sunk in, and he quickly agreed that we needed to get the show on the road so that none of that would happen.

My head was buzzing, processing all of this as Dr. Fab checked my cervix to get a baseline and figure out the best method of induction. I was very, very slightly dilated (Dr. Fab called it "not even a fingertip"), but I was about 50% effaced, so that was something. Since I had not dilated much at all, Dr. Fab said Pitocin was out because she only likes to use that if the patient is dilated a few centimeters. So the method of induction would be a series of Cytotech pills that she would place in my cervix every four hours to force dilation. Dr. Fab mentioned that it might take a couple of doses to get things moving, but she assured me that women rarely need more than three doses to achieve to an active labor pattern.

Dr. Fab asked us when we could be at the hospital, and I asked her if we would be able to head home to pack our bag before heading over there (we were planning to pack our bag that very night). She said yes, so I told her we would arrive at the hospital around 2:00pm (it was noonish at this point). She left the room to make the calls to arrange everything and alert the hospital that we would be on our way, and then she sent me down to the lab to have the pre-eclampsia labs repeated, just in case. (If the gestational hypertension had morphed into pre-eclampsia, I would need to be on IV mag for labor and delivery, so she wanted to find this out before we arrived at the hospital.)

I sent Aaron on his way before I headed to the lab, because he wanted to stop at work and alert his boss about what was happening, and then I sat and waited for my blood to be drawn. An eternity passed before I was finally called back, and when they finally finished up, I rushed out to my car and started making phone calls. My first thought was of Gracie...she was at school and would need to be picked up and taken care of for the next few days. I called my dad, who told me that he had already spoken with Aaron and was aware of what was happening, and that he would be more than happy to come down to Milwaukee to pick Grace up from school. He told me that he and my mom would spend the night at our house with Gracie and that I shouldn't worry about anything. He asked me how I was feeling and I said, "Terrified," (because I really, really was) and then I cried for a while. My dad offered me some much-needed words of encouragement, and then I made a couple more calls on my way home, mostly to tie up some loose ends at work. Finally I called Grace's school to talk to her to let her know what was going to be happening, and to let her teacher know that my parents would be handling school pickups and dropoffs for the next few days.

Aaron hadn't arrived at home yet when I got there, so I took the opportunity to update my blog and send a couple of quick emails, and then I started packing. I planned to be at the hospital two or three nights (depending on how the induction went), so I just packed a few shirts and some comfy pants. When Aaron got home, he finished up the packing while I unpacked our new baby car seat so that we could get that in the car. After a whirlwind of checking lists and packing and quick cleaning, Aaron and I decided that we would leave home a few minutes early so that we could stop and pick up something small to eat on the way. After all, I wasn't sure when I would be able to eat again since I was famished and I didn't think I'd be allowed to eat once I arrived at the hospital and the induction got underway.

On the way to the hospital, I kept looking at what was happening in the world around me. People were going about their normal daily routines, commuting to and from work, shopping, going to school, and no one knew what was taking place inside our little blue car. Everything outside seemed so normal, so ordinary, but my entire world was about to change. I mentioned this to Aaron. He thought for a moment and said, "Yes. It's a commonplace miracle."


Carrie said...

Cytotech? Did she show you this?

I know I'm treading on "none of your business" grounds here, and I know you love your doctor, but I'd consult some other doctors if I were you before you decide to go back to this one. She prescribed you a dangerous drug not FDA approved for labor induction.

On the happy side, isn't it wonderful to have family who can step up with the slightest warning? A big part of why we moved back to the Midwest.

Carrie said...

OK, maybe I overreacted in my previous comment. I imagine responsible doctors do prescribe Cytotec. But I hope she provided you with warnings of the risks.

I hope I didn't offend you by sharing my concern. Obviously you and baby came through healthy so it's not much matter now anyway.

Sara said..., we didn't talk much about Cytotech and it's potential side effects...I guess I just trusted my OB since she had been so cautious with me for my entire pregnancy and that everything else she had done thus far had been on the up and up. I imagine that she looked at the risks of keeping the baby inside versus the potential side effects of using Cytotech and decided that this was the right course of action. But, I will bring it up with her at my postpartum check, because now I am curious...