This might be my longest birth story yet! Here is a short version if that's what you prefer (I've included pictures in the long version):
My water broke around 11:30 pm on February 20th. We went to labor and delivery and I got started on pitocin since I wasn't in labor yet. In the afternoon the baby's heart rate dropped, but after several position changes and a shot of terbutaline to stop labor, her heart rate finally came back up. We started the pitocin again and after a while I was in real labor. It was starting to get quite painful, so around 6:45 pm I asked for an epidural. By the time the anesthesiologist arrived half an hour later, the baby's heart was dropping with each contraction and the amniotic fluid was getting thick and brown (a sign that the baby was in distress and had passed, and probably aspirated, meconium), and a couple of minutes after the epidural was in place my doctor came in and ordered an emergency c-section. The epidural took effect just in time for me to be awake for the baby's birth. I got a quick look at her before they took her to the NICU. She had aspirated meconium. She spent almost three days in the NICU on a CPAP machine and a feeding tube, but on February 24th she was moved to my room and the next day we went home together.
Long version:
The last weeks of pregnancy were increasingly stressful for me as the due date approached and then passed and at every appointment I learned that I still wasn't dilating at all. The doctor didn't want to go much farther than 41 weeks because the risks to the baby start increasing after that, so considering that the girls were two weeks late it was looking like I was facing an induction. I was pretty unhappy about that prospect, especially since my body didn't seem to be getting ready at all. My induction with Kevin started with zero progress and it took two days, then recovery was much harder than after my natural labors with the girls, so I didn't want a repeat of that experience.
On the 20th I came home from a doctor appointment and cried in the car for half an hour because I still wasn't dilated (this was three days after my adjusted due date/six days after the original/estimated due date). Then I went to pick up Ann Marie at preschool and when my friend asked how I was doing I started crying some more. My friends at preschool were really sweet to sit and talk with me for a while about it and reassure me that I wasn't being selfish.
I had really mixed feelings about what would be the best course of action. I didn't want to base my decision on blogs, which is what you tend to get in a Google search. A Facebook friend told me that there's a lot of good information on the National Institute of Health website, so I was able to look up a lot of good quality research on there that helped me get a sense of what the actual science says.
I managed to come up with something for dinner so that people were fed, then I made some chocolate cookies and ate four or five with no regrets, then switched to baby carrots.
Before the kids went to bed we had scripture study. We were reading in Ether 3 where the brother of Jared asks the Lord to touch the stones, and I was really struck by these verses:
4 And I know, O Lord, that thou hast all power, and can do whatsoever thou wilt for the benefit of man; therefore touch these stones, O Lord, with thy finger, and prepare them that they may shine forth in darkness; and they shall shine forth unto us in the vessels which we have prepared, that we may have light while we shall cross the sea.
5 Behold, O Lord, thou canst do this. We know that thou art able to show forth great power, which looks small unto the understanding of men...
9 And the Lord said unto him: Because of thy faith thou hast seen that I shall take upon me flesh and blood; and never has man come before me with such exceeding faith as thou hast; for were it not so ye could not have seen my finger.
I was really touched by these verses, and they led me to ponder for quite a while about prayer, faith, and asking God for things. Sometimes I really struggle praying for things if I don't know for sure it's God's will. I don't mind asking for help through a trial or for guidance, but I wasn't sure about praying to go into labor naturally. I didn't know if I had enough faith for it to happen if I did pray for it, and I wondered if it was selfish to pray for that if it wasn't what God had in mind.
Once the kids were in bed I spent some time talking to Ryan about it, and he shared some thoughts about the role that spirits in Spirit Paradise play in our lives and how they work with God to help us (which is why it's super important to do temple work for our ancestors).
I finally got on my knees and said a very sincere prayer telling Heavenly Father my feelings and asking that I could have my desires to go into labor naturally, and I said I had faith that he could bring this about. I don't really remember exactly what I said, but those were some of the things I prayed about.
I went and did some family history for a while and then I snuggled up to Ryan on the couch and watched some YouTube videos with him. It was around 11:30 and I was starting to think about going to bed. Then I felt a small gush of fluid. That was kind of weird, so I went to the bathroom to see what it looked like, and on the way there was an even bigger gush of fluid and my pants were all wet. When I sat on the toilet a ton of fluid rushed out into the toilet, and at this point it was pretty clear that my water had broken. I told Ryan what was going on and he said, "What did you say in that prayer?"
"I don't remember exactly! I just prayed that I could go into labor and not have to be induced or something!"
I had never really considered the possibility that it would happen like this, and I had no idea that when your water breaks you pretty much keep leaking or gushing amniotic fluid until the baby comes (with my other kids I asked them to break my water when I was almost pushing). I pretty much spent the next hour on the toilet because every time I got up stuff came out everywhere. Eventually I was able to get away with wearing a pad for the most part. I was so shocked that this had happened and I needed time to process it all enough to calm down and figure out what to do. I finally called labor and delivery, but for some reason the phone just kept ringing and nobody answered, so eventually I hung up, and I ended up falling asleep until morning. By that point I figured it would be easier to just get the kids off to school and then call my doctor, so that's what we did. I found a friend who agreed to take Ann Marie and then we worked on getting final things ready to go to the hospital.
Ryan gave me a blessing before we left, and in the blessing he assured me that God knew my worries and fears and that He wanted me to know that angels would be ministering to me. It was a very special blessing and gave me a lot of comfort. I wasn't really having contractions, so I figured we were probably looking at induction once we got to the hospital, but for some reason I felt like it was going to be okay and I was in good hands.
We got to triage around 10 am and did all the checking in stuff. The nurse said I was dilated about 1 1/2 cm, so I knew we had a long ways to go, but at least it was something. Dr. Hatch came by briefly to talk about the plan. We had to wait a while to go to labor and delivery, but I was starting to have mild contractions, so we were hoping that with a little bit of pitocin things would get going. There was a bit of a deadline since they don't like to go past 24 hours once your water has broken.
I was finally started on pitocin around 12, and it didn't take long before I was settling into a regular pattern. We started at a low dose and they were gradually increasing it. Ryan needed lunch, so I told him this would be a good time before it got too painful. I was having to breathe through the contractions, but it didn't feel like real labor yet. I had downloaded a playlist of my favorite songs onto my phone (which was one of my better ideas--I highly recommend it), so I listened to that and tried to focus my mind on making the contractions effective.
After a while the nurse came in and said I needed to turn over on my side because the baby's heart rate was decelerating. We tried several position changes, but her heart rate wasn't coming up. Before I knew it there were about five nurses in the room making calls and helping me try different positions. My nurse had me put on an oxygen mask for the baby to get more oxygen. They turned the pitocin off completely and gave me a shot of terbutaline to relax my uterus. I think it took a while for me to realize just how serious this was, but when I did I started to cry and pray. Then I felt very strongly that my Grammy was there beside my bed and she was reassuring and helping us. It took a long time, but we finally settled on me being on my right side, and her heart rate started looking better. I remember lying there on my side with tears still on my face and feeling/hearing the words, "You are in the right place." The nurses were all really amazing in the way they helped me through this.
Once things calmed down a little I texted Ryan to let him know what was going on. When he got back I was still wearing the oxygen mask. At some point the nurse also checked my cervix and said I was about 4 cm. Dr. Hatch came in and took a look at the printouts. He said probably what happened was the baby grabbed the cord or the cord got compressed somehow, and since my water had broken there wasn't that cushion there. He said if it happened again we'd do a C-section, but he thought it most likely wouldn't happen again.
We waited a while for the terbutaline to wear off, and the baby was still looking good on the monitors, so the nurse started the pitocin again (back at the lowest dose). By this point it was around 4:00, so I was getting a little worried about running out of time. The nurse said I had a really good doctor because Dr. Hatch doesn't like to do c-sections for no reason, so I didn't need to worry that he'd insist on a C-section at 6:00 just because he wanted to go home.
I started having mild contractions, although it took a while for them to get regular. We kept watching the monitor and commenting on the wimpy ones. It felt like if I concentrated on them I could help them be stronger. The nurse suggested the birth ball, and that worked well for me. It seemed like the contractions started to pick up once I made that switch, which is what I wanted. I was having to moan deeply to make it through, and they were getting pretty painful, so I knew I was in real labor now.
Dr. Hatch came in and did a cervix check at some point, and I said I didn't even want to know. He just said I had a ways to go, but the baby was still doing okay. I got back on the birth ball and saw on the computer that he had put that I was 2-3 cm, 90% effaced, so that was really discouraging, although the nurse said since I had thinned that much I would probably progress faster.
I labored some more. It seemed like standing up or being on the ball was helping things progress better, so I stuck with that for quite a while. I was starting to get really tired and I didn't think I was going to be able to make it without some pain relief. So I was thinking about getting an epidural. I looked at the clock and saw that it was 6:30, so I decided I would hang in there till 7 and then reevaluate. At 6:40 when Ryan asked how I was doing I told him my plan, and the nurse said she thought that was a good approach. She was really supportive of my birth plan the entire time. Then after a couple more contractions she said it might be good to keep in mind that it can take the anesthesiologist a while to come sometimes if they've gone home. I thought about it for a while and I had this really strong feeling that I should have them call the anesthesiologist now.
The nurse got that process going and confirmed that it was going to be about a half hour before the anesthesiologist could get there. She had to leave, so she was briefing the new nurse on the situation. I was having a harder and harder time getting through the contractions, and I was also watching the monitor and starting to feel uneasy because the baby was having heart decels again. They weren't as bad as before yet, but I was feeling really glad I had asked for the epidural because in case something happened I could be awake for a C-section.
By the time the anesthesiologist got there we were back to position changes on the bed and using the oxygen mask. I was making a lot of noise. The nurse was telling me what to expect while getting the epidural and doing her best to keep the monitor on the baby's heart beat. We had to wait for the heart rate to start looking better before the anesthesiologist could start.
Ryan went out of the room (husbands aren't allowed during the procedure and he can't stand needles anyway). I sat on the side of the bed bent over a pillow while Dr. Jones put everything in. It wasn't too bad of a procedure. I think he did brush up against a nerve a couple of times, which was painful and weird.
I had to get through a couple of contractions while he was working. The nurse was in front of me trying to coach me through it and keep the heart monitor on the baby, and she asked if the baby had a name yet. I felt angels in the room again, and suddenly I knew so strongly what her name was that I almost said it out loud: Ruby! Then another contraction hit, and I was moaning and pushing my face into the oxygen mask, but my eyes were filled with tears because I knew the baby should be named Ruby, and I was so grateful to know that angels were there in the room helping us.
Finally everything was in place, and Dr. Jones said I could expect to start feeling the epidural in about six minutes, but it wouldn't really take effect for about fifteen minutes. It seemed like too much to have to handle several more contractions like this before getting relief, but I said, "I can do a lot of things for fifteen minutes." Dr. Jones said I did a really good job and I had made his job really easy. Apparently a lot of moms wiggle around quite a bit.
They helped me move to my back, and the nurse called Dr. Hatch and asked if he had seen the monitors. The baby's heart rate was decelerating with each contraction. A few minutes later Dr. Hatch came in and said, "We've got to get this baby out." He took a look at the printout from the monitor and checked my cervix. I looked down and when his hand came out it was covered in brown amniotic fluid (bad). "I'm sorry, Marcelaine, but we've got to do a C-section. You're only dilated to a five and the baby's in distress." I said I understood. Honestly I wasn't surprised. So Dr. Hatch said, "Okay, I'm ordering an emergency C-section, stat." Everyone started moving really quickly after that. I was still moaning and in a lot of pain, but my legs were starting to feel weird, so I was hopeful that the epidural would take effect in time.
There's actually a lot that has to happen to get ready for a C-section, and I didn't even really follow most of what was going on. Dr. Jones was back in making adjustments to the medicine in the epidural to make it go a little higher on my torso, so he was explaining that to me, and several nurses were in there doing other stuff. Dr. Jones was also telling Ryan what to expect and giving him instructions for getting dressed for the operating room.
Then people were wheeling out the bed and in a minute we were in the operating room. New people were introducing themselves to me and they moved me over to the operating table. Dr. Jones and another anesthesiologist were poking my belly and my arm to get a sense of how well the epidural was working. It must have been the Holy Ghost telling me to go ahead with the epidural because it took effect just in time, so I was awake for the entire procedure.
Dr. Hatch came in and got started, and once he had made the first cut they let Ryan come in. I was shaking like crazy. The other anesthesiologist was there by my head the entire time talking me through what was going on and making sure the pain meds were working.
I don't think Dr. Hatch was happy that this was ending in a C-section, but once things got started he became super focused and worked fast. There was a lot of pulling and tugging. It felt unreal; there's really nothing else like it. It wasn't really painful, but I still felt everything, and it was super intense. For some reason I was actually kind of glad I was able to experience so much of it. It was good to feel like I was present. I was getting really nervous about the baby and I kept praying that she would come in time and be okay. I could feel that my Grammy was there with me.
Finally someone said he was pulling her head out and pretty soon I could feel her coming out. I think she cried a little bit, but not a ton. A woman briefly brought Ruby behind the screen (still covered in blood and all sorts of other stuff) and said she was going to be okay, but then they hurried to take her away to work on her. As we expected, Ruby had aspirated meconium from the amniotic fluid, and I could hear them suctioning all of that from her lungs. At some point Ryan went over to see her and was able to take some pictures.
It took a lot more time to get me sewed up than it did to get the baby out, so my adventure was just beginning. The anesthesiologist stayed right there with me and coached me through it all. Like I said, it wasn't really painful, but it was all super intense. I was starting to feel really panicky because I was shaking so bad, and I asked the anesthesiologist if he could just hold my hand because I needed some deep pressure. Instead he offered to go get my husband. So Ryan came back and squeezed my hand for the rest of the time, which helped me a lot.
Through this entire thing I remember feeling very aware that this was going to be a defining moment for me and I needed to be vocal about what I needed in order to reduce the trauma as much as possible (this is not to say that people who are traumatized by c-sections should have stood up for themselves, but I will say that I'm grateful for the inspiration and guidance I received, as well as the experiences some of my friends have shared in the past, that helped me have the presence of mind to be able to ask for what I needed). For the most part I actually have really positive feelings about how everything happened. All of the medical personnel handled the situation really well and took really good care of Ruby and me, and I truly believe that I had the ministering of angels just as I was promised in the priesthood blessing. I think 95% of my birth plan went out the window. Thinking back on the labor, I think a natural delivery just wasn't going to happen this time. We're not sure why Ruby wasn't tolerating labor (probably the cord was getting compressed), but I don't think it could have been done any differently and still resulted in a healthy, living baby. I remember all those doctor appointments where I still wasn't dilating, and now I think this must have been the reason. If Ruby had been descending into my pelvis earlier I don't think she would have been doing well in there.
I was pretty much stitched up, and I asked if I could see the baby again. They said they would bring her over, but to my disappointment they just wheeled the little bed over enough that I could kind of see that there was an infant inside, and they said, "Here she is, and she's going to be fine, but we have to take her to the NICU now to get her stabilized." So that brief glimpse right after she came out was really all I got until the next day.
They moved me back onto a bed and wheeled me to a recovery area. I'm not sure where Ryan went. The nurse was really nice. I was kind of in shock trying to process what had just happened, and I didn't stop shaking for about three hours, and the shaking made me feel really panicky. I did get a couple of doses of Demerol, which helped a little. They also put things on my legs that would compress my legs to prevent blood clots, and that deep pressure actually helped a lot too with the shaking. Still, it was really unnerving to be shaking uncontrollably like that.
Eventually they moved me to the room where I stayed the rest of the time we were in the hospital. Ryan was there and we both went to sleep. In the morning nurses and other people came in to do things. Dr. Hatch came by and when he asked how I was doing I said jokingly, "Well, I have a tummy ache; do you know why that might be?" I got out of bed for the first time with the help of two nurses. It was rough, but I did okay and I got a shower, which helped me feel human again. I gradually figured out how to use my legs and pull on the bed rails to get out of bed.
The view from lying on my back in bed (after the first couple of times I was able to get out by myself):
We had some amazing friends who had watched our kids the day before and then let them stay overnight at their houses. I was so grateful. Ryan left to go get Ann Marie and meet Kevin and Heidi after school.
Ann Marie says she put the blanket over her head because she was sad that it was Dad picking her up and not me.
Heidi wasn't happy to hear that I wasn't coming home either.
Breakfast was chicken broth and Jell-O. At lunch I graduated to cream of potato soup and Jell-O. I think I was on the liquid diet until Friday evening.
I mostly had to take things fifteen minutes at a time. Just getting to the bathroom was very tiring that first day. A lactation consultant came in and she showed me how to use the hospital grade breast pump and we talked about the pumping schedule. I tried to pump every three hours. I actually was producing a lot of colostrum. They had given me little syringes to save the milk for Ruby, and I ended up using bottles instead because often I was getting 10 mL from one pumping session. I was proud that at least something was working right, although a Medela Symphony doesn't exactly induce the same happy feelings you'd get from holding a new baby. So at any given time I had to think about what the next priority was: get to the bathroom, pump, eat, sleep, etc.
Finally in the evening I got to go see Ruby in the NICU. The nurse took me down in a wheelchair. Just to be clear, it's not that I wasn't "allowed" to see her earlier, it's just that until then I wasn't recovered enough to make it over there. It felt so weird that almost a day after her birth I was just seeing her for the first time, but it really took that long for me to be physically able to go to the NICU. Ruby was on a CPAP machine and had a feeding tube. There were some other monitors and she had an IV through her umbilical cord. I wasn't able to hold her, but it was okay to touch her. When they brought me in I was so surprised at how much hair she had! She was so beautiful, and it was so great to finally see her, although it was hard not to be able to hold her. I think because of the initial separation it took a while for it to register that I wasn't pregnant anymore. I probably stayed too long, but I wanted as much time as I could get with Ruby. When my nurse took me back to my room she said I looked exhausted, and I was surprised at how much just that trip to the NICU took out of me. I think I had to take some extra pain medication, and I had to rest a lot.
In the morning I was feeling a lot better. I walked up and down the hall once and I was feeling pretty proud of myself. After that I rested really well and then walked to the NICU. I had learned my lesson from the night before, so I just stayed for a few minutes and then walked back. That was a lot of work!
In the afternoon Ryan and Ann Marie came to see me for a little while. Ann Marie was pretty upset because I was in the hospital and everything was different, and she was also sad that she couldn't see the baby. I read some books to her while Ryan went to see Ruby for a few minutes. Then we called Ryan's parents and they started talking about coming down to help us. It was a big relief to me to know they were coming because I was struggling just to take care of myself. Ann Marie cried pretty hard when they left. I really hadn't thought to prepare the kids for the possibility that it would be like this when the baby came. I had just expected it would be like my other deliveries and I'd be home after a day. Apparently Heidi had gotten upset at school as well--her teacher is really fantastic and took the time to comfort her.
Ryan sent me this picture of Ann Marie at Costco after they left, with the caption, "It's nice to know that least one of our kid's affection can be easily bought. #someoneisnotsadanymore #itsallaboutperspective"
In the evening I walked to the NICU again, and this time I finally got to hold Ruby! So exciting! I was so happy. I did a video call with Ryan, and Kevin and Heidi were excited to get to see Ruby (Ann Marie was asleep). Ruby was doing well and making progress. The goal was for her to get off the CPAP machine completely, and then she needed to be able to eat by mouth either by breastfeeding or bottle to get out of the NICU.
I had wondered how well I would be able to bond with Ruby since we were separated so much for the first few days and she had other people taking care of her and talking to her. But while I was holding Ruby that night I said something to her after she yawned or something, and when she heard my voice Ruby instantly turned her head towards the sound, and there was a look of recognition on her face. I realized that even though we hadn't spent the last couple of days together, she had been hearing my voice in utero for several months and it was very familiar to her. So that was comforting.
The next worry was that they were thinking of discharging me the next day, but Ruby wasn't going to be ready by then. So if I got discharged I would have to choose between boarding at the hospital (basically you can stay in one of their rooms, but nobody brings you your meals or comes to take care of you) or going home. The first option would have been hard because I would be on my own, but the second option would also be hard because I wouldn't be able to go see Ruby very much. I was getting really upset about it.
On top of all that worry, the dining people completely forgot to bring me dinner, and when I asked about it I found out they had already closed up. They did get me a turkey sandwich on airbread and a bag of pretzels, so I was okay, but for some reason that was enough to throw me over the edge, and I did a lot of crying. I was so frustrated that I couldn't even take care of myself and I couldn't get down very often to see my own baby, and I felt like I was being thrown to the wolves with the prospect of being discharged the next day. And then on top of it all the dining service just forgot about me.
My nurse walked in on me crying and was very sweet to stay and talk to me about it. I don't know if she really grasped what I was feeling, but I was still grateful that she cared. She suggested that I could get some good rest and then she would take me down to the NICU in a wheelchair (so I wouldn't be so tired) and I could stay as long as I wanted. It's easier to stay at the NICU for a long time at night because there aren't all the scheduled shift changes and doctors visiting.
I took some time to call my parents (I had been wanting to for a while but hadn't had a chance), and talking it through with them really helped me out.
After a good rest I went down to the NICU and was able to stay for a long time, which was great. Ruby was finally off the CPAP machine and just had the feeding tube left, so that was really exciting.
In the morning I went down to the NICU again and there was great news! They had taken out the feeding tube and as long as she could tolerate eating by mouth they were planning to discharge her to the nursery that afternoon! I actually saw Dr. Hatch there (he had been stopping to check in on Ruby each morning before coming to see me), and he asked them to make sure my insurance would cover me staying one more day so Ruby and I could be discharged at the same time. So that was a huge relief for me.
I stayed for a while in the NICU and gave her a bottle. I think the goal was for her to take 30 mL, which she did easily, so that was a good sign.
The nurse said to come back around noon and I could try breastfeeding her then. She nursed really well on one side and then fell asleep. The nurse said the plan was to discharge Ruby to the regular nursery at three o'clock and after the nursery did some basic checks they would bring her to my room.
So around 4:00 my nurse brought Ruby in! It was so exciting, although it took a while for it to register that I was finally a regular mom rooming in with her baby. For a while I just sat and watched her without picking her up.
I think for me that evening and the next day were more like what's normally the first day. I had to start figuring out how Ruby likes to be soothed and work on establishing breastfeeding. The plan was to breastfeed her first and then supplement with my pumped milk (I had about 30 mL saved) afterwards so her blood sugar would stay up, but I only ended up doing that once because she was always plenty satisfied after breastfeeding and wouldn't take any more. I feel really fortunate that at least breastfeeding started off well despite us being separated so long at the beginning.
As much as I wished I could have held Ruby right away and had her rooming in with me, I must admit that having her in the NICU probably helped me a lot with recovery those first few days. I was able to focus on my own physical needs and get a lot of rest. I could barely get out of bed those first couple of days, so I'm sure it would have been a huge challenge to also go pick up a baby and take care of her.
The next day was Sunday, and we were working on getting ready to be discharged. Ryan's parents arrived and went to church with Ryan and the kids. Both of our doctors came and gave us the okay to be discharged. Ruby had to have her bilirubin levels tested one more time, and I had to have my staples taken out and replaced with steri strips (which wasn't nearly as bad as I thought it would be). Then the nurse gave the discharge instructions and Ryan showed up in the middle of those. That was actually the first time he got to hold her. We finally left around 1:00. It was so good to be outside again, and the temperature was perfect.
Ryan holding Ruby for the first time:
Dressed and happy to finally be going home:
One of the best pieces of advice I received was from a friend who said to be gentle with myself while processing everything that had happened. After my miscarriage last year I learned that it's really important to process negative emotions instead of resisting them, so I was grateful for the reminder and I've been taking it to heart. Right now I feel like the most traumatic part was recovering and being separated from Ruby so much, especially when I thought I was going to have to go home without her. I feel a lot of grief that I didn't get to hold her right after she was born. Even though I knew she needed medical care, it was super disappointing when they took her away and all I got was a quick glimpse of her.
