Hospital & Induction - Whitney Pt IV

Induction 

At this point in the process, completely confirmed I was going to do it all alone, I was inconsolable sitting there sobbing in a hospital bed. The nurses sat in the somber atmosphere of my room as I started to really think clearly. Adam wasn’t coming, that ship had sailed and I needed to accept it. Now I had to start worrying about the baby and the sheer panic of how this would affect his birth and his health. 

I never made a “birth plan” but my hopes were to have a vaginal birth without the assistance of induction and definitely with the epidural. I let the nurses know right off the bat that an epidural was in my future and they said while I could have it at any time, it’s best to wait a bit for labor to start. 

They hooked me up to two monitoring systems - heart rate for the baby and a second to gauge the intervals of contractions. You can see the intervals on the screen and the “waves” are also printed on paper. At this point, they also placed the IV knowing I would need a bag of fluids prior to any epidural. The baby seemed fine with a normal healthy heart rate but my contractions were small and varied. Because my water had been broken for about 12 hours (slow leak from the night before) there is an infection risk to the baby and the best next step for the health of our son was to start induction. The doctors explained they were going to use two methods of induction: 1) a foley bulb which would work to dilate my cervix (I was at 1cm +1 station) and 2) pitocin which would start stronger contractions. They started to place the foley bulb which was uncomfortable but couldn't really be described as painful. I remember hearing what sounded like buckets of water being thrown on my floor and the nurses explained there was a lot of amniotic fluid being released which was making it hard to place the bulb. Finally, enough of the fluid had drained and they were able to place and inflate the bulb which started to put pressure on my cervix. 

Next, they started the IV with pitocin and left me for a bit while labor got started. Under a “Non Covid'' delivery, a partner would be there to help you when you needed to get out of bed or go to the bathroom. For me to get to the bathroom, I had to unplug two monitors, unplug my IV, and take this mass of cords in one hand and my IV stand in the other, wheeling it over to the bathroom - all while a bulb and tube hung from you know where. It was a process and I couldnt help but feel helpless on my own as something as simple as going to the bathroom was an ultimate process.  

I tried to distract myself with my phone, facetime Adam or sending updates to friends and family who had heard the news that I was in the hospital. I was waiting on COVID test results, waiting on contractions, alone in the room watching the monitor. At one point things started beeping at me and I nervously paged the nurse to shut off the horrendous offending noise. I was already drowned out by the hum of the large filter unit in the corner of my room and the beeping was enough to drive you mad. When no one “heard the beeping” until I paged, I started to wonder if anyone was even watching the computers. With no one in the room with me, how did they know when the heart rate sank? Was there something I was supposed to be doing. When the nurse made her way in I sheepishly asked her if they were able to watch my monitors outside the room and she assured me that yes, the nurses and even the doctors had access to the monitors from a safe space outside my room. We stopped the beeping machines and I started to breathe through contractions. We didn’t have a timeline but the way things were progressing, the nurses said it would probably be some point tomorrow when I met this little baby boy. 

 Heart Rates

As the pitocin dripped and the foley bulb did it’s thing, I noticed a pattern on the monitors. With the increase of every contraction came the decrease in his heart rate. The nurses kept their poke faces and when I kept probing on this pattern, they mentioned that the pitocin and the foley bulb were stressing the baby out and they were going to stop the pitocin to give him a bit of a break. He seemed to respond better to the slower contractions and the nurses had me switching positions every few minutes. The thought was that the cord was likely wrapped around him somewhere (neck, wrist) and with every contraction, the compressed cord was cutting of vital blood and oxygen that he needed. I would go from flat on my back to my left side, my right side, and then in this chair position. It was an acrobatic fete moving this 39 week pregnant body around while hooked up to IVs and monitors. The nurses helped me and commented on my dexterity as I positioned myself in all these wonky ways trying to get the baby some relief. The pitocin was started again and soon enough, I was reaching the point of unbearable contractions. The breaks in the middle were like nothing had happened but when a contraction was happening, it was a pain that was impossible to describe. Period cramp doesn't even touch this as at the height of each contraction I experienced an unbearable pain you just cant get away from. 

In all my research and child education classes, I knew epidurals had a sweet spot. Get them too soon and you slow down your labor. We were already trying to speed mine up due to the broken waters. Get them too late and you will suffer agonizing pain and more importantly, not be able to sit still long enough to place the large needle in your back. I talked to my nurses and we decided that when the foley bulb came out at 4cm, it would be a good time for the epidural. The nurses gave a little tug on the foley bulb, dislodging it from my cervix and confirming that I was at 4cm. I confirmed that I was going to get the epidural and as soon as possible would be the perfect time for that sweet relief. 

The pain came in unbearable waves that left me in tears and begging the nurses to check on the epidural team. Being in a COVID labor and delivery unit i’m sure slowed things down as dropping into my room quick between patients was not an option (whole garbing and ungarbing process). Two nurses were staying with me at this point, watching the heart rate monitor to see if the little guy was handling the strong contractions. The pitocin was stopped again but my body continued with powerful contractions that absolutely rocked me. They offered me a short term pain remedy but after explaining it would affect the baby, I decided to wait for the good stuff. Laying down in the bed was absolutely unbearable and I could not go through labor in that position. I mostly stood at the edge of the bed until the nurses mentioned that some women found it helpful to crouch down with each contraction. At the next contraction, I did just that and soon found myself virtually on the floor gripping the base of the bed waiting for the contraction to end. The doctor was pretty sure he was “sunny side up” and we were spine to spine which meant back labor was underway and was even more painful than normal. The nurses offered words of support and offered to rub by back but I was emotionally distraught and physically wrecked by the contractions and Adam’s absence. After what felt like a lifetime (but was probably 45 minutes to an hour) the nurse checked out in the hallway and saw the anesthesiologist in the hallway. Relief was in sight and I've never been so happy to see someone in scrubs. The anesthesiologist saw me crouched down on the ground gripping the bed and calmly but very sternly read me my miranda rights as far as epidurals go.

It was a large needle being placed in my back that would require me to be absolutely still and follow each instruction carefully. I would have balanced on my big toe if that was what was required and I immediately followed orders. When I played out this scene in my head the months before, I pictured Adam there to help hold me while the needle was placed. Instead, I asked the labor and delivery nurse, all 90 pounds of her, to brace with me in front of the bed to help me remain still during the next few contractions while the needle was being placed. To say I had a death grip on this poor girl was an understatement and I grabbed onto her like my life depended on it as the doctor worked on placing the needle. I felt the prick and the pressure but any discomfort was welcomed if it meant I would soon be on the other side of pain and getting comfortable in sweet relief. Yale is a teaching hospital and I had friends mention their apprehension on having someone who was a resident or student place the epidural. I was in so much pain at that point that I would have let the janitor place that needle if there was a slight chance in hell I would be out of pain. 

The needle was placed and both the nurse and the anesthesiologist were impressed with my statue-like performance. In about 15 minutes, the pain was gone and the nurses continued to watch the heart rate and contractions on the screen. I could no longer feel the pain or the contractions and thankfully, still had mobility in my legs. The nurse had me constantly changing positions just like before, left side, right side, all fours, chair position - all in effort to get some of the pressure off the cord and to help out the little babe whose heart rate was still sinking with each contraction. 

8 Doctors and Surgery 

The next scene I remember so clearly - I was on the all fours position leaning over the bed in attempts to get some pressure off the cord. I couldn't see the monitor or the nurses faces, just the back of the room as I leaned over the bed waiting for labor to be over. All of the sudden, things beeped a little louder and about 6-8 people were in my room, including one of the Doctors from my OB GYN (Dr. Baumbusch), a guy I had never seen before, and several others. I could tell this was some kind of emergency and I immediately started to panic by the onslaught of medical staff in my room. Dr. Baumbusch explained that the cord was wrapped somewhere and his heart rate had dipped lower than they liked- they were close to wheeling me in for an emergency c section. Thankfully things had stabilized shortly after their arrival in my room, but she explained that if this happened again, they would be performing an emergency c section to get the baby out. It wouldn’t be a RUSH RUSH emergency but would be urgent enough to stop labor progressing and take him out. 

We went back to our rotation of positions and it wasn't much longer before the doctors entered my room again. His heart rate was approaching that danger zone and it was time for a c section. The anesthesiologist was called back to the room and I was prepped for a c-section. At this point, I was too defeated to even care that things were ending like this. I was hoping for a vaginal birth with the support of my husband, to labor as long as I could at home before getting to the hospital and continuing labor without induction and with an epidural. Instead, I was there by myself after a traumatic COVID diagnosis for both of us, afraid for my health, my husband’s health, and our baby’s health. I had been dropped off at the hospital alone, induced, loaded up on pitocin with a foley bulb placed and now I was being prepped for major surgery. It’s most women’s fear… going through painful stages of labor just to end up with a c-section. 

I agreed, threw my hands in the air, and i was read my second set of what I referred to as my miranda rights, this time all the dangers and perils of a c section. I was read some things about complications, risks of surgery, possibly having to remove my uterus, bleeding and so forth before I signed some form, and was transferred to a different bed that would make my travels through the halls and into a special COVID operating room a bit easier. They asked if I wanted to let my husband know before they wheeled me away and I initially said no, not wanting to worry him. At this point, I hadn't spoken to him much, a quick phone call before the epidural was set letting him know I was in a lot of pain and would call him when the epidural was placed and I was resting. They looked at me a little skeptical, urging me to fill him in on the situation before I went under the knife. I called him at about 2am to let him know and a sleepy half conscious Adam woke up to the news that the baby’s health was suffering and I was going in for surgery. The quick call ended and I was wheeled down the hall to the OR. 

The nurses warned me that the OR would feel sterile, with bright lights and a lot of people wearing a lot of protective gear. She told me it would be okay to shut my eyes and that’s exactly what I did as they closed the doors to the operating room and prepped me for surgery. It’s all sort of a blur at this point but I can remember the original anesthesiologist near my head, offering comforting words and taking photos for me. I was prepped for surgery and can half remember answering questions “yes I can feel that, no I can’t feel that”. Next, the curtain was pulled up and my eyes were clamped shut as the team worked to get the baby out. Dr. Baumbusch was performing the surgery along with a gentleman I can assume was a resident. I could hear her instructing him on certain things and also remember a conversation about their dogs. It was comforting to hear them so relaxed as they worked which took some of the stress off my mind as they worked to get him out. It wasn’t long before they had him out and I heard the first cry of my son. I burst into tears, so thankful to hear him making noise as they worked to get him weighed, measured, and cleaned up to bring him to my shoulders for a photo. They declared he was a chunky baby, at 8 lbs and 5 oz and that the cord was in fact wrapped around his neck. He had a cone head and a large indent where he was trying to get through my pelvis and was stuck. The doctor confirmed he would have had a hard time getting out in this position and we were glad to have performed the C section when they did. She also tried to comfort me stating that future deliveries would not be affected by this experience and there was no reason a future birth could not be completed vaginally.