Broken Water, Cord Prolapse
That was what I thought when I read this birth story. It is quite a story. I don't even know what to say besides that except I am glad all are well.
I hope reading it it helpful for somebody. Thank you to the mother for sharing something that must have been so horrifying at the time.
I found out I was pregnant after a 3 week vacation to my parent's house by the beach. Turns out, it doesn't take two months to get your cycle back after nursing - like I thought. By the time I took the test, I was already 9 and a half weeks pregnant (although bloodwork said approximately 7 weeks). My husband and I were completely stunned. We have a 2 and a 1/2 year old, an 11 month old, and a new puppy. We were careful. We were cautious. We were sleeping in separate beds! The baby was still waking through the night and so was the puppy so we just found it best to sleep apart and tend to our "babies" separately.
By the time we could see my OB/GYN and get an ultrasound, they confirmed we were 12 weeks pregnant - which completely threw our whole timeline off. Now we were even more stunned, and scared, of what lie ahead. Life with 3 under 3. Will this baby have problems? Did those drinks I had while celebrating non-nursing motherhood hurt this tiny, unknown fetus? What will happen while Jeff goes to grad school for 8 days while I'm 8 months pregnant? The questions swirled around and around.
By 20 weeks I had several dreams/predictions of what may come with this baby. I dreamed for sure that I was going to have my third girl. She would be tiny, very early, perhaps precipitous, and I may have to give birth alone at my home. In my dream, I pulled her out of me and exclaimed, "It's a girl!" while cradling her small, perhaps premature, body. At the anatomy ultrasound, I should have known that all of my "mother's intuitions" were completely and utterly WRONG.
It was a boy.
"Are you sure? We don't make boys!"
So we ventured through Halloween, Thanksgiving, Christmas, and 2 birthdays. We survived eight days alone while Spud attended his limited residency program in Vermont - with only one minor incident. Seems that the "puppy," in all her gangly, teenage dog ways, blended into the carpet while I was walking and I tripped completely over her back, landing directly on my belly. Contractions soon ensued but 35 week old baby and I were perfectly fine.
At 36 weeks, another night of contractions. Painful, regular, and to the point of calling a doctor at midnight, just to see who was on call. Then nothing.
37 weeks. Same again. My mother is in town, determined not to miss this birth again. For my 3 year old's (Tater Tot's) birth, Grammy was on an airplane. And Small Fry (my fast-approaching 18 month old) was 3 weeks early, leaving all of us scrambling to find transportation, childcare, etc. After a night of steady contractions, swinging into the morning, my husband and I decide to go to the hospital just to get checked out. I'm 37.5 weeks, 3 cm, 60% effaced, contracting every 2-3 minutes, but not in active labor. They send us to walk, eat lunch, and come back later, hoping for change. I am admitted around dinner time that night and Spud and I walk the halls. Over and over again, up and down the stairwells, bouncing on the birthing ball, hoping for some change. Any change. After 14 hours since we first arrived, we decide to go home and relax, hoping to be back soon the next day. It never comes.
While we were at the hospital for early labor, we met my OB's colleague who was on call while my doctor was in Disney World. We fell in love with him instantly, his jokes and his cautious and natural approach to birth. When we left for a short time to get lunch and walk, we asked if he needed anything and he replied, "Ooh yeah, those little Reese's peanut butter cup eggs!" And so we did. Some for him and some for the nurses too. Helps to have happy nurses on your side.
This doctor told me that, while I was dilated, the baby's head was not engaged and he didn't feel comfortable breaking the water because he once had a cord prolapse and the baby almost died. He seemed so visibly shaken up by that memory and said, "I NEVER want to do that again!" It should have been a sign of things to come. I was tired and sick of contracting so often, and had resigned myself to allowing AROM (artificial rupture of membranes), as long as the doctor and I agreed to withold Pitocin unless I absolutely needed it. But his unwillingness to break my water and my unwillingness to accept drugs led us to a (peaceful) stand-still. We decided to go home.
We waited. And contracted. And waited. I felt like a fool. I had called into work, given away my shifts, texted my friends, and posted on Facebook that 'Tonight may be the night!' How foolish of me. We went in for my 38 week appointment, certain that some changes had been made, but again - no change and the head was still not engaged. We went home again, defeated and waited another week.
At my 39 week appointment, my regular OB was back in town and -to much joy! - was 8 weeks pregnant! I was happy for her and happy she was home, but dejected once again because I was still 3cm. The head had become engaged though, so she asked if I'd like to induce. I quickly said no, thinking she meant Pitocin, but then asked, "Maybe could you break my water?"
She knew that wasn't what I really wanted and told me she didn't think there was any room for inductions in the hospital for that night. But we set up an appointment to meet for my 40 week NST (non-stress test) and a BPP (biophysical profile) just to make sure baby was growing healthy and strong and could make it another week. She and I both agreed that we did not want this pregnancy to go past 41 weeks. I know people have babies at 46 weeks and are wonderfully healthy, but I just could not do that to myself.
The next week - I caved.
By Wednesday, I made up my mind to have my water broken. It was the worst decision I've ever made in my life.
My husband and I decided, of our own volition - without any doctor's sway, that something had to be done to progress this labor that had been stopping and starting for nearly 4 weeks. I was exhausted, completely sore, and was fearing my blood pressure was having problems because it was very high and I was starting to swell in my hands and legs/feet. I called my doctor's nurse and asked if she had any time to break my water after our 40 week appointment on Friday. The nurse called back and said that the doctor was not on call that weekend and didn't feel comfortable leaving an induction with another doctor after she went home for the evening. She would want to use Pitocin to speed things up before she went off call. But if I went in Thursday morning at 6am, she would break my water and I could labor drug free all I wanted to for 36 hours (a reasonable amount of time for me).
We called back and agreed, packing our bags and settling our children for the night. In the morning, they would be big sisters!
Remember how I had mother's intuitions? Everything was the opposite - he was a boy, he was the longest pregnancy I'd ever had, he was definitely not premature or precipitous or born on my kitchen floor while Spud was in Vermont. And, it turns out, I wouldn't be doing any catching of my own baby or even having delayed cord clamping like I would have liked. No, once we checked into the hospital at 6am Thursday morning, everything went completely and utterly wrong.
It seems the hospital lost my pre-admission paperwork. The shift changed at 7am and the new nurse had 15 minutes to ask me all of my admitting questions. I said, "I pre-registered, don't you have that information?" She was about to hunt down whether or not I'd ever had TB or if I had a last will and testament, when my doctor arrived to break my water. The time was now, I was ready, let's labor as naturally as I can with this augmentation and then have a healthy, natural, hippie crunchy birth.
7:15 The sac was very thick and took several tries to break. My doctor claimed to get it, but nothing was coming out so she asked the nurse for a little fundal pressure. I gave a small push and a little came out, clear without meconium, but in short bursts. We talked with her a few minutes more, about her trip to Disney World and my husband congratulated her on her pregnancy. We talked about how long she cares to let a progressively laboring woman go with a broken bag of waters (past 24 hours, by the way, as long as baby and mom are healthy). We seemed happy, but something was wrong. There was no water coming out.
Just as my doctor was getting up to leave, I asked if she could check again.
Something was wrong. Maybe the hole sealed back up or the baby's head was blocking the hole in the bag? She broke out another amnihook and tried again saying, "Remember, you asked for this. I'm sorry it hurts!"
I felt a huge gush of water this time, much better. I joked, "Sorry, did I get your pants wet?"
That's when I noticed her face changed.
"You know what? I just felt cord." She looked into my eyes. I'm not dumb. I know exactly what this means. It means no kissing my sweet baby before they can wipe away the vernix. It means no creative positions or holding my husbands hand and looking into his eyes while I give that one last push. It means no sweet skin to skin moments and instant breastfeeding and never ever giving him up.
It means instant c-section under general anesthesia.
"All right. Let's go." I say. I've accepted this. I made my bed, now I have to lay in it.
Then a string of expletives. Which I apologized for.
Within seconds, the room went from 4 people (doctor, nurse, my husband and I) to being filled with people. Lights were turned on bright. The nurse tried to help me take off my Bella Band (which I wore religiously throughout pregnancy due to a hernia), but we were unable to take off my sports bra without sitting up. When I tried, the whole room shouted, "Whoaaa!! Lay down Mama!" Whoops.
An anesthesiologist came in and was very calming and soothing to me. I told my husband to call my mom and, in the panic, he forgot how to use an iPhone. I called her, while being milled around by 30 nurses and workers, and yelled into the speaker phone.
7:22 "Do we have a baby yet?" she answered sweetly.
"Mom! I'm having a c-section! The cord fell out! I gotta go! I love you!"
Spud looks at me and says, "Honey I have to stay here, but I'll see you when you come out."
"Stay with the baby, ok? Be with him."
Suddenly, a woman my husband describes as having the smallest arms in the room, squirts medical jelly all over her hand and forearm. She climbs onto the bed and, in the most painful thing that has ever happened to me, she holds the baby's head off of his umbilical cord.
I swear some more.
They start to wheel me out of the room. Someone grabs at my necklace and I thought she took it off. The head charge nurse says, "Ok, let's cover mom up," and that's when I realize I'm spread-eagle with another woman's arm inside of me, about to be wheeled down a hallway, with every bump and corner, going 70 miles an hour while my baby slowly dies inside my belly. Obviously, I'm a little upset.
My doctor has raced ahead to scrub in and I can hear her once we get into the operating room. That was the best, most reassuring thing I could have ever heard. "It's ok, Mama. You're ok."
I'm awake while they swab me with iodine and place a catheter. Three more very loud swears and then profuse apologies. Everyone around totally agrees and says, "No really, it's ok. We understand."
She gowns up and I can't see her (because someone has removed my glasses early on), but I can hear her say, "I'm ready if you guys are ready." "I'm ready, ok."
The anesthesiologist puts an oxygen mask over my nose and I hear him say, "When you wake up, you'll have a beautiful baby. Everything will be ok."
"Tell my husband to watch the baby. To be with him. Please."
:24 "His name is Cooper."
When I wake up, I feel like someone only paused the movie and then it starts up with full speed again. I jump into reality and ask to see my baby. Where's Spud? I need my glasses. What time is it? 8:20. It took 6 minutes? Is he ok? Yes I'd like to see pictures.
My doctor comes in. I'm so relieved you were here. She's so relieved I was in the hospital when it happened. "I don't even want to think about what would have happened if you were at home when your water broke."
In some flashes that are starting to dissolve in my memory, I regained my glasses, my phone, my husband, my voice, my thirst, and finally, my baby. I instantly put him to the breast and all of the nurses comment how well he's doing. They didn't feed him formula or sugar water, right? Of course not. Oh, but they gave him a bath, I say dejectedly. Jeff was busy calling people and posting pictures to Facebook. He couldn't be with him, something that I still regret, and they claimed that the baby needed some time under the warmer to warm up. There's a perfectly good, warm, fuzzy daddy right here, but I can't do anything about it now.
Now, he's here. He's mine. I won't let him go.
Except that... recovery from general anesthia is hard work. The nurse forgets that I didn't have a spinal and almost forgets my pain meds. A lovely little pain pump that can be pushed every eight minutes if my heart so desires, and boy does my heart so desire. However, somewhere around minute 3, I drift off into a rapid sleep and worry that I'm going to drop little Cooper.
He's 8 pounds, 6.9 ounces, and 21 inches long. His weight is the only thing I predicted correctly. My girls were 6lb, 4oz and 7lb, 5oz, each going up a pound and an ounce (or two) at a time. He's my biggest baby, my longest baby, my longest pregnancy, and my last. We had made the decision before that we weren't going to have any more, but I still had a few doubts about completely getting rid of my fertility. Not quite thirty, I'm just not ready to take that chance in case I have another marriage or want to be a surrogate for someone else. After this, I'm done. I don't want to take any more chances.
I blame myself every day for what happened. I know my doctor blames herself too and I know that some people would try to use that legally against her, but I'm not one of those people. I made the decision to have my water broken. I made the decision to ask her to try again because something didn't feel right. My doctor told me later that she was not aware that 2 weeks prior, the ultrasound showed a cord by his face. At the time, I didn't think that was an issue. Cords move and float around, right? And once the head is engaged, that shouldn't be an issue, right? Apparently, wrong.
There are many "what ifs" that surround my head with this birth. What if the bag never broke? She said it was very thick and probably wouldn't have broken on it's own. Some people birth in the caul, and I was prepared for such an event, but it seemed like that was the one thing holding me back from progressing. What if my water broke at home? Would the cord have come out? Would I have known something was wrong, or just waited at home for my contractions to get stronger like every natural birth site advises me to do just to avoid interventions from the doctors? Would I have known to reach in and feel the cord, and if I did, would I have known to try to keep it inside and stay level?
There is a .5% chance of cord prolapse in a labor without Pitocin, under normal circumstances. Yes, I had an augmentation, something that I had with my first - a planned induction due to previous doctor's "commitments" (nose job), and with my second, a drug free birth. I'm not saying I ever wished for this to happen, but if it had to happen, I'm glad it happened quickly so I didn't have to think and worry about it, and due to a real medical emergency and not an OB's "failure to wait." Truly a "necceasarian," I feel that I am blessed to have had my own doctor on duty, my husband with me, my children with my mom safely at home, my baby born pink instead of blue, screaming instead of limp. I'm glad I live in a world that has access to hospitals and quick responding code team members and good sweet pain meds when you've been sliced from stem to stern (apparently, my doctor was in such a rush to save him, she went a little crooked and long with the incision. Which is perfectly fine - all that matters is that he's out and safe).
I'm not saying home birth is a bad idea - and would NEVER say that - but all along I always thought that it was a bad idea for ME. I would say, "My husband's not a doctor. He wouldn't know the first thing about how to take care of me if something went wrong." And that's the truth. He's not meant to know and that's fine. I would have loved to have a great, relaxing hippie crunchy au naturale birth like my second baby, but this one was not meant to be.
Cooper James, however, was meant to be here, on this earth. And is so very loved.