I feel like Huck’s birth story starts where Whitlee’s left off. You can read her birth story here but the gist of it is that I was diagnosed with preeclampsia at 34 weeks with her and my doctor decided she was safer out than in so we did an emergency cesarean with her. When we decided to have another baby, I had a pre-pregnancy consultation with my new OB and he advised us to absolutely pursue another baby and that while I did have one or two risk factors for having preeclampsia a second time, I didn’t have all of them. At that time we also discussed the possibility of a VBAC (vaginal birth after cesarean). In Beaumont, at the hospital where we would deliver, there are a handful of doctors that share on call duties. So while my OB was considered “the VBAC guy”, he said one of his requirements was that I go into labor spontaneously because he had no record to go on of how I would react to an induction. He wouldn’t induce for a VBAC unless I’d been previously induced or had a previous spontaneous labor. And on that note, promising to support a VBAC with spontaneous labor would put me at risk for showing up at the hospital with a 1/5 chance of him being there and a 4/5 chance of having a doctor that did not support my birth plan. So at that point, we agreed to a repeat cesarean and I felt peace knowing that it would be scheduled and we would know what to expect.
When we actually got pregnant with Huck, we went into it knowing he’d be born via repeat c section and it would most likely be scheduled and hopefully be full term. But then we found out about his heart defect, we had to transfer care to the facility where he would have his treatment. During my first visit with my new doctor, a Maternal Fetal Medicine specialist, we discussed my plans for delivery. At which point she casually asked “so for delivery, would you like a repeat c section or would you like to tolac?” (Tolac is “trial of labor after cesarean”) I asked what was best for our situation and she very matter of fact laid out the risks of both but then said a vaginal recovery would be better and faster for me and would also be beneficial to Huck’s lung function. So we went down the path in pursuit a tolac/hopeful vbac. She said that spontaneous labor would be best but that depending on my blood pressure staying stable throughout the pregnancy so that we could make it to the point where my cervical conditions were favorable, she was not opposed to inducing.
All throughout my pregnancy I have been on a low dose blood pressure medication because around 8 weeks it started creeping up. They labeled me as having “chronic hypertension” but my blood presssures have been really great since being on the medicine. Towards the end of my pregnancy, they’ve had me check it twice a day and keep a log. And they’ve continued to be excellent, as well as no signs of preeclampsia- no swelling, no vision changes, no excessive weight gain, no weird headaches, no protein in my urine. From here it will be a timeline to show how this all happened.
Thursday, May 11, 2017 | 7:30 PM – At 38 weeks, I checked my pressure for my log that afternoon and it was a little high. I rested, checked it again and it was much better. So I kept resting and decided to check it again later to make sure it stayed down, but it was actually back up again. I called my nurses line and the advised me to go get checked at L&D. While there they hooked me up to the monitors and checked blood pressure, which was high and it didn’t take long before they decided to keep me and induce. I started calling Nolan and my family but after a good while of monitoring, the doctor on call came back in and said my blood pressure was a lot better and they were actually going to send me home. What a rollercoaster! I called everyone back and told them it was a false alarm.
Friday, May 12, 2017 | 8:00 AM – Whitlee and I went to what would have been my last appointments anyway since they were planning to induce next week, but my blood pressure was high again. We went through all of the normal appointment stuff but my doctor ended with, we ARE going to go ahead and induce today. She said their standard care for chronic hypertension is to deliver at 38 weeks, but since mine had been so great she was willing to go to 39. She also said at this point, it was possible that if I stayed pregnant, I could end up with preeclampsia in the next week.
9:30 AM – She told me to go get my stuff from the apartment in Houston and to be back around 11 to start the induction. I called Nolan and the rest of our family so they could all head that way.
11:15 AM – Whitlee and I got to hospital to get checked in for the induction process to start. Unfortunately, May is apparently a busy month for babies so they were extremely backed up in labor and delivery and we had to wait F O R E V E R for a room. Like 10 hours.
9:00 PM – We finally got moved to a labor and delivery room to get set up. After that, it seemed like things went fairly quick for the most part. At this point I was dilated on my own to a 1, maaaaybe a 2 and 50% effaced but Huck was still really high at a -3 station.
10:40 PM – They decided to start with a Cook Balloon which they insert into the cervix and inflate one small balloon inside the uterus and one small balloon outside the uterus with a middle section meant to dilate the cervix manually. They said we would leave it in for 12 hours, then take it out and from there I would either be dilated to a 4 or 5. The balloon going in hurt. like. hell. Oh man, it hurt.
12:00 AM (Midnight) – They warned me I could feel some strong cramping and then it was possible that the balloon would intensify the prodromal labor contractions that I’d already been having. Well it did and they started coming super strong and I puked during a particularly hard one. It was at that point that I honestly started questioning this whole vbac thing. I ended up getting two Benadryl to help me sleep and nubane in my IV for pain. The nubane didn’t do much for the pain of the contractions but it did help me sleep between them. So basically I was already having to work through the contractions. They were super strong and I couldn’t talk through them but never very consistent. Some were 4 min apart, some 6, some 12 but all lasting about minute and a half to 2 minutes.
May 13, 2017 | 8:30 AM – The residents for the day came in and said I’d get the balloon out in a couple of hours, then we’d start low dose pitocin, check to see how low Huck was at that point and if he was low enough, they’d break my water. I went ahead and requested an epidural before all of that business. I’ve heard from several people to get. the. freaking. epidural. I was told pitocin contractions plus no amniotic fluid for cushioning after they break my water is no joke.
11:00 AM – They took the balloon out and checked me. It did its job! I was dilated to 5, and 60% effaced, but Huck was still at -3 station, so they were going to wait on breaking my water.
1:00 PM – Anesthesia came in to place my epidural, while my nurse (who was absolutely the most amazing labor and delivery nurse ever) got my pitocin set up. I didn’t care much for the epidural process. I was kind of scared of the pinching pain I’d felt suddenly when I had my c section so I kept having trouble not tensing up. But my nurse just talked me through it and we got it in. Once the epidural was in and I started going numb, I started feeling really bad and proceeded to puke again. I was actually pretty numb from about mid belly down so that was weird. When I puked, I felt like my stomach muscles were numb and almost like I would aspirate. After they started the pitocin, I was having contractions almost immediately and very regularly but I couldn’t feel them. General thoughts on epidurals – they’re super weird and glorious.
3:00 PM – Huck had a few heart decels so they came in and put me on an oxygen mask and checked me again and I was still a 5 and now 80% effaced, but he was at a -2 station. They decided to go ahead and break my water and see what would happen.
4:30 PM – I was able to actually catch a nap between 3 and now and when I woke up I asked my mom if I was still having contractions. She said oh yea, definitely, so I got her to take a picture of the screen because it was above my head and I couldn’t see it.
This is showing how fast and regularly the contractions were coming (about every 90 seconds) but if you look at the top section towards the end, you see Huck’s heart start to drop off. I actually heard this happening on the monitors and said “something’s wrong” and about 2 seconds later my nurse came running in and kicked everyone out except Nolan. She called for a resident and another nurse. They threw my bed back, flipped me to my other side, started pulling iv lines loose from their connectors (not like from my arm), and started massaging my belly a little. After about 5 minutes his heart rate recovered. They said that the contractions were basically drowning him and his heart rate wasn’t recovering like it should have between them. They decided to stop the pitocin and give him a break for a little bit. They also decided to put in an internal monitor to see how strong my contractions were and would start the pitocin again in 30 minutes. At that point, they said if that happened again, we’d go straight back for a c section. By this time it was almost 5:30 so they went ahead and checked me again and said I was still a 5 and 80% effaced, no change at all. But they asked some specific questions about how I was feeling and I told them I was starting to feel my contractions. I was kind of having to breathe through the pressure of them but I couldn’t really feel the pain of them. They said they’d check me again at 7:30 and see how things were going. I think that was the point that I said if I hadn’t changed by then at all, I was ready to talk about another c section. The heart decelerations scared me and I was so tired. I’d been stuck at a 5 for 7 hours or so and the problem I had with that is my body didn’t go to a 5 on its own, it was a mechanical dilation. So if I wasn’t progressing past that, then my body wasn’t doing its job.
7:30 PM – The resident came back in to check me and I was fully expecting her to say “no change” but she felt around a lot and then looked up and said “well, looks like you’re at a 9, 100% effaced.” I started crying out of pure relief. I could not freaking believe it. I asked “Are you serious?? Are you sure??” And she said “Yup! Your cervix is almost completely gone.” He was still at a -2 station though so while my body worked through the last bit of cervix, they had me sit straight up and let him start laboring down so I could get ready to birth our boy! My nurse started getting the room ready for delivery and they made all of the appropriate calls to the NICU and cardio team.
9:47 PM – The resident came back in again and checked me and said I was complete and Huck was now at a +2 station. She then explained how to push and said we were going to try a few and see how it went. They had me reach down and hold behind my legs while Nolan held one leg up and my nurse held the other one, and they had me push for 10 seconds and do 3 pushes inside one contraction. So I would push really hard for 10 seconds, get a breath and do it again, 3 times. The maternal fetal medicine on call had made it in the room by this point and was coaching me through the pushing as well. In between one, she said “you’re pushing really good. If you keep pushing like that, he’ll be out in a couple more.” That was super encouraging to hear. I just kept thinking about all of the birth stories I’d read and listened to on podcasts about how to push and I kept trying to remember to apply those things. I think the next contraction and set of pushes, they all started saying “whoa whoa whoa, okay stop pushing!” I heard something about getting nicu in the room; nobody had made it yet besides the resident and mfm. Nolan said all of the sudden “was that his head???” And they said “Yes, that was definitely his head.” I asked if they were serious?? And they said “Yup! Do you want to see?” I said yes so they moved a mirror over and I could basically see the top of his head, which kind of went back in as the contraction ended. They took my internal monitor out and said “Okay momma, next one is on you. When you feel the contraction, push as hard as you can.” So I waited until I felt the pressure and then pushed with all of my life, took a deep breath and pushed as hard as I could again and out came his head! Nolan said on the third push they guided out his shoulders and the rest of his body.
10:09 PM – They told me to look down and I saw our baby boy enter this world! He instantly cried, which was a great sign and Nolan got to cut the cord. I cried like crazy too, of course, just like I did when Whitlee was born. They took him over to do their initial checks and to decide if he needed prostaglandins at the bedside (he didn’t). They did his weight and measurement – weighed 6 lbs 11 oz and was 20″ long. Then they brought him over to let me hold him for a few minutes. We got a good look at him, then they let Nolan run to the waiting room to get Whitlee so she could meet him. She looked at him and said, “he’s pushed out??” We all got a good little giggle at that. Then Nolan took her back out to the waiting room and they took Huck back over to his warmer so they could start placing all of his lines. During all of this, I delivered the placenta and got a little stitch for a superficial tear. I felt so. much. relief. as soon as Huck and the placenta were out. They also turned my epidural off so I started feeling my legs again which was nice. I kept watching Huck’s team of people working on him and he was so quiet that I thought they’d sedated him but when one of the doctors commented that he was so calm, I realized he was just hanging out. They said he was just laying there watching them do their job. Random side note, right as I was delivering him, the NICU team kind of ran in the room. I didn’t really notice them come in but when I looked up, the room was full. They said something later about how they expected me to be pushing for a while and I asked how long I pushed and my nurse looked at her notes and said “about 10 minutes”. I was shocked! Also, another random observation – Nolan and Huck were the only males in the entire room. The entire nursing staff, mfm, and nicu/cardio staff were women. Kind of neat!
11:15 PM – They transferred him across the sky bridge to the CVICU and Nolan went with him. Once they got him over there, they started all of his testing and trying to get a better idea of his heart. He was doing really well and breathing great on his own. We were told the next couple of days would be spent gathering data on his condition and we would most likely get an update on Monday from the cardiac team on plan of care.
12:30 AM – I was in a postpartum room, up walking, using the restroom and overall feeling great. Exhausted, but great!
So that’s his story! I can’t believe I did it and it was such good closure to the pregnant part of my life. I feel now that I had one emergency c section which was the best choice for that child and I had a successful vbac which was the best choice for that child. I have recovered from both major abdominal surgery and a vaginal delivery and we are so blessed to have two beautiful children.
Southernly Ever After 