Post by gingerlady on May 29, 2016 11:19:36 GMT -5
Better late than never! Baby Ian was born on 5/23/16 at 5:21am, weighing 5lb 8oz, 19 inches long. We were at 37w3d (official GA based on LMP), or 37w6d (the GA I like based on O date).
tl;dr After psyching myself up for a possible induction due to gestational hypertension I had a spontaneous rupture of membranes followed by rapidly progressive labor and delivery in about 4 hours on one of the busiest nights of the year on the L&D floor. I almost ended up with an unintended "natural" delivery, had last-minute spinal anesthesia, and the OB barely made it to the bedside in time.
Background: The last 2-3 weeks of the pregnancy I had been diagnosed with gestational hypertension, and three days before delivery had an ultrasound that was concerning for growth restriction, with baby's estimated weight at about the 10th percentile. Everything else was looking good though, and all the tests for pre-eclampsia were negative. All that being said, my OB and I had started a conversation considering induction the following week, when I hit 38 weeks. I was incredibly upset but had started to come around to the idea of a potential induction. DH and I spent the weekend preparing everything we could. But this baby had his own plans. He did not wait for an induction.
Whirlwind delivery:
At about 10pm on Sunday night just after I climbed into bed I had a single, mild contraction and felt a "pop". I went to the bathroom and there was a small amount of bright red blood. I waited for a bit, not making too much of it, thinking maybe it was mucous plug, but kept going back to the bathroom to check. The bleeding continued, so eventually I called the OB on-call line. The answering service took a message, paged the on-call, and said to call back if I didn't hear from them in 30 min. I didn't hear anything for an hour but I waited because the bleeding had slowed. Then I had a second contraction, so I called back. Again, I didn't hear back for half an hour. The third time I called the answering service forwarded me directly to the on-call OB (who happened to be my own! Amazing coincidence considering that there are over 30 MDs in the practice). I described what was going on and she said "it doesn't sound like you're in labor but we should try to understand the source of the bleeding so why don't you come into L&D".
We arrived in L&D at about 1am. En route I had two or three more contractions, one associated with a gush of fluid. In L&D I was triaged as "rule out rupture of membranes" - low priority, in other words. It was a very busy night. The L&D floor was full. I lost track of time but I know it was a while before anyone saw me in triage. Meanwhile, I started having contractions and they built very rapidly, both in frequency and intensity. By the time I was assessed I was having them every 1-2 min, and was doubled over in pain. The test for fluid was positive, and I was 4cm dilated and 100% effaced. I would be admitted. I asked for an epidural at this time. When I was walking to my room I heard them call for the anesthesiologist in the room a few doors down from me. I was told I would be next in line. In the room the contractions built even more rapidly. They were back-to-back. I could feel an enormous amount of pelvic pressure and had an overwhelming urge to push. They told me not to push, but I knew this baby was coming - FAST. Sure enough, on re-check I was 10cm dilated. The anesthesiologist was still not available. I was terrified of having an unmedicated birth and started screaming bloody murder, cursing everyone out. Someone said "put some more pressure on them" but still no one came. So they called the back-up anesthesiologist. She arrived and attempted the epidural twice but my contractions were nearly continuous at this time and she could not position me appropriately, so she ended up doing a spinal anesthesia.
Spinal anesthesia was beautiful and VERY strange. Instantaneously I went from the worst pain in my life to being totally numb and paralyzed. My legs were dead weights. I couldn't even feel my breasts. Even my fingers were tingly. I could not push because I felt nothing. The problem was that we were now battling the clock. We had to wait for it to wear off enough so I could push but knowing that it would completely wear off in 1-2 hours. Timing was critical. So I waited until I regained awareness of my contractions and then started pushing. I pushed for about 40 min and they called in the doctor. There was a bit of a delay because the OB was finishing another delivery but wanted to be there for mine (it's very unusual to be able to deliver your own patients!). At some point I was told "DON'T PUSH!" and there was a frantic call out to get my OB in the room. I tried not to push but baby delivered himself at 5:21am with the next contraction, just as my OB entered the room. She didn't have time to put on gloves, but caught him. He cried right away and was placed on my chest. I had two small tears that required repair, and she finished these up just as the spinal anesthesia started to wear off completely. Really, the timing was perfect. As was my tiny baby boy, who weighed in at a mere 2505g (5lb 8oz).
I later found out that there had been an unprecedented number of deliveries happening that night and the few days prior. This explains why no one got back to me after I called the answering service earlier in the evening, why there was a wait in triage, and why there was a delay in anesthesia. Due to lack of rooms, they had to double up patients on the post-partum floor too, so my poor DH had to sleep in an upright chair the first night.
Also, I never learned my GBS status. The swab had been taken that Friday prior to delivery. I was either labelled GBS positive or GBS unknown and they started running antibiotics, but there was not enough time for the 4 hours of intrapartum coverage.
tl;dr After psyching myself up for a possible induction due to gestational hypertension I had a spontaneous rupture of membranes followed by rapidly progressive labor and delivery in about 4 hours on one of the busiest nights of the year on the L&D floor. I almost ended up with an unintended "natural" delivery, had last-minute spinal anesthesia, and the OB barely made it to the bedside in time.
Background: The last 2-3 weeks of the pregnancy I had been diagnosed with gestational hypertension, and three days before delivery had an ultrasound that was concerning for growth restriction, with baby's estimated weight at about the 10th percentile. Everything else was looking good though, and all the tests for pre-eclampsia were negative. All that being said, my OB and I had started a conversation considering induction the following week, when I hit 38 weeks. I was incredibly upset but had started to come around to the idea of a potential induction. DH and I spent the weekend preparing everything we could. But this baby had his own plans. He did not wait for an induction.
Whirlwind delivery:
At about 10pm on Sunday night just after I climbed into bed I had a single, mild contraction and felt a "pop". I went to the bathroom and there was a small amount of bright red blood. I waited for a bit, not making too much of it, thinking maybe it was mucous plug, but kept going back to the bathroom to check. The bleeding continued, so eventually I called the OB on-call line. The answering service took a message, paged the on-call, and said to call back if I didn't hear from them in 30 min. I didn't hear anything for an hour but I waited because the bleeding had slowed. Then I had a second contraction, so I called back. Again, I didn't hear back for half an hour. The third time I called the answering service forwarded me directly to the on-call OB (who happened to be my own! Amazing coincidence considering that there are over 30 MDs in the practice). I described what was going on and she said "it doesn't sound like you're in labor but we should try to understand the source of the bleeding so why don't you come into L&D".
We arrived in L&D at about 1am. En route I had two or three more contractions, one associated with a gush of fluid. In L&D I was triaged as "rule out rupture of membranes" - low priority, in other words. It was a very busy night. The L&D floor was full. I lost track of time but I know it was a while before anyone saw me in triage. Meanwhile, I started having contractions and they built very rapidly, both in frequency and intensity. By the time I was assessed I was having them every 1-2 min, and was doubled over in pain. The test for fluid was positive, and I was 4cm dilated and 100% effaced. I would be admitted. I asked for an epidural at this time. When I was walking to my room I heard them call for the anesthesiologist in the room a few doors down from me. I was told I would be next in line. In the room the contractions built even more rapidly. They were back-to-back. I could feel an enormous amount of pelvic pressure and had an overwhelming urge to push. They told me not to push, but I knew this baby was coming - FAST. Sure enough, on re-check I was 10cm dilated. The anesthesiologist was still not available. I was terrified of having an unmedicated birth and started screaming bloody murder, cursing everyone out. Someone said "put some more pressure on them" but still no one came. So they called the back-up anesthesiologist. She arrived and attempted the epidural twice but my contractions were nearly continuous at this time and she could not position me appropriately, so she ended up doing a spinal anesthesia.
Spinal anesthesia was beautiful and VERY strange. Instantaneously I went from the worst pain in my life to being totally numb and paralyzed. My legs were dead weights. I couldn't even feel my breasts. Even my fingers were tingly. I could not push because I felt nothing. The problem was that we were now battling the clock. We had to wait for it to wear off enough so I could push but knowing that it would completely wear off in 1-2 hours. Timing was critical. So I waited until I regained awareness of my contractions and then started pushing. I pushed for about 40 min and they called in the doctor. There was a bit of a delay because the OB was finishing another delivery but wanted to be there for mine (it's very unusual to be able to deliver your own patients!). At some point I was told "DON'T PUSH!" and there was a frantic call out to get my OB in the room. I tried not to push but baby delivered himself at 5:21am with the next contraction, just as my OB entered the room. She didn't have time to put on gloves, but caught him. He cried right away and was placed on my chest. I had two small tears that required repair, and she finished these up just as the spinal anesthesia started to wear off completely. Really, the timing was perfect. As was my tiny baby boy, who weighed in at a mere 2505g (5lb 8oz).
I later found out that there had been an unprecedented number of deliveries happening that night and the few days prior. This explains why no one got back to me after I called the answering service earlier in the evening, why there was a wait in triage, and why there was a delay in anesthesia. Due to lack of rooms, they had to double up patients on the post-partum floor too, so my poor DH had to sleep in an upright chair the first night.
Also, I never learned my GBS status. The swab had been taken that Friday prior to delivery. I was either labelled GBS positive or GBS unknown and they started running antibiotics, but there was not enough time for the 4 hours of intrapartum coverage.
