Alexander James

You’ve been waiting for this right?  Xander’s birth story.  I should probably apologize for how long it will be, but I’m not going to.  It is what it is.  What I will say is that this post will purely be a birth story.  Just like Jack’s birth story, I’ll do another post about the good, bad, etc.  I don’t want this to be the place where I drone on about VBAC and c-sections.  There will obviously be some VBAC talk (cause duh) but only in relation to the actual story.  Ok, enough talk, here it is.

For about three weeks before Xander’s due date, I had regular, relatively strong contractions.  I actually went to L&D twice because they were so regular and strong.  Each trip and each doctor’s visit yielded the same result. A finger tip dilated and 75% effaced.  I was growing frustrated. I never dilated with Jack, but then again, I  never had a single contraction with him either.

I made my husband go with me to my 39(1/2) week appointment.  I knew that there would be a lot of “what do we want to do” talk.  After confirming that yes, I was still only a fingertip dilated, we had a serious discussion of what to do next.  Our original plan had been to let me go 5 days past my due date and induce me then if necessary.  My doctor felt that given the intensity of the contractions that I was having, I was not going to go into actual labor on my own.  He said he could be wrong, but that was his opinion.  Basically, we had three choices.  Wait until 5 days past my due date, do a scheduled repeat c-section, or try to induce me the next evening, the day before my due date.

My doctor was awesome. He spent at least 30 minutes answering my questions (sorry to all the patients after me!).  I asked about the recovery time from a second c/s, when I would be able to pick up Jack (who was just shy of two years old), I asked about a c/s after laboring or pushing, I asked it all.  During our conversation, it became clear that he wasn’t fond of waiting until after my due date.  He told us that we didn’t have to decide right away, just call and let him know what we decided.

I’m not gonna lie. I was leaning a little toward the c/s. And I know that  my husband would have chosen the c/s if it had been up to him.  We talked about it and he told me that it was my decision.  In the end, I knew that I didn’t want anther major surgery if I could avoid it and I would always regret not trying the VBAC.  I called the doctor and we were told to report to the hospital at 4:00 the next afternoon.

At 4:00 the next afternoon, we arrived at the hospital.  We got checked in and talked to my doctor about exactly what would happen and when.  At just before 5:00, they inserted a foley bulb.  The foley bulb is inflated using saline and then over the course of several hours, the pressure from the bulb manually dilates the cervix.  Hopefully when the bulb falls out, the cervix is dilated around 2 or 3 cm.  My doctor warned that it could take 10 to 12 hours for the bulb to fall out and if it did fall out and I wasn’t 3 cm, they would re-insert it.  The resident who actually inserted the foley said she didn’t think it would take 10 or 12 hours, but she didn’t speculate on how long it would take.

Around 6:00, my contractions picked up. They were painful and very low in my abdomen.  About every 90 minutes the resident came in and readjusted the tension on the foley.  She said that readjusting the tension helped with the dilation.  At some point, I forced my husband to go get some dinner and I got a shot of Stadol to take the edge off the pain.

Around 11:30, I felt the foley fall out and called the nurse.  The doctor checked me and we were both happy and shocked to learn that I was at 5 cm.  The resident said that she would order pitocin and I requested an epidural.  The epidural man arrived.  After my spinal experience with Jack, I was terrified of the epidural. Turns out, I had no reason. A little pinch from the numbing agent and then that was it.  I told him what a great job he did and settled in.

The pitocin was started around 12:15 (my OB had agreed to low to moderate levels of pitocin since I was a VBAC candidate).  Things seemed to be going smoothly. At 2:00 I was 6cm.  I dozed off around 3:00 and around 3:45, the nurse and resident came in saying that Xander was having a few decels.  I turned on my side and things improved.  The resident checked me and found that I was 7cm so she decided to break my water.  Minutes after breaking my water, all heck broke loose.  Xander’s heart rate bottomed out.  I ordered to roll onto my left side, the pitocin was turned off, I was given an oxygen mask and my IV was opened up.  After what seemed like an eternity, everything was fine. X’s heartrate recovered and the resident explained that sometimes when they break the water, that happens.  It was without a doubt the scariest couple minutes of  my life.

I labored without the pitocin until about 7 that morning.  My cervix remained unchanged so they tried the pitocin again.  Unfortunately, my contractions never again became regular.  The would be strong and regular for a while then they would weaken and become irregular.

Around 10:00, Jim and I were had a serious discussion.  We were fairly certain that we were headed for a c-section.  Neither of us wanted to wait until we were in an emergency situation.  We agreed that the next time the doctor came in, we would discuss it.  Just as we made that decision, the resident, nurse, and the OB on call from my office walked in the room.  Xander was having more decels and they felt that it was because he was either laying on the cord or it was wrapped around his neck.  They wanted to do an amnio-infusion.  This is where they push saline into the uterus and hopefully restore the “cushy” environment.  The thought was that if he was laying on the cord, the fluid could help relieve some of the pressure.  We agreed with the stipulation that if this didn’t work, we would move on to a c/s.

Around noon, the doctor came back and checked me.  I had not made any more progress.  I was still 7 cm.  And while the amnio-infusion had helped, there were still decels.  I had been at 7 cm for 8ish hours without any progress.  The doctor wasn’t comfortable using any more pitocin (and frankly we weren’t either) and she felt that without a much higher dose, I would not dilate any further.  She recommended a c-section.  I said yes without hesitation and then promptly burst into tears.  I calmed down and gave a list of requests to my nurse.   I also asked that my primary OB (who was seeing patient upstairs) be the one to perform the c/s.  Every request was granted, except my OB request.  He wouldn’t be able to be the primary, but he would try to assist.

I was wheeled to the OR, they increased the meds in my epidural.  There was an issue with a spot on my left hip, but they fixed that and got started.  I started shaking terribly.  If I concentrated really hard, I could make the shaking stop, but the second I stopped thinking about it, the shaking started again.  I could feel that I was being worked on, but felt no pain.  At one point, my blood pressure dropped and they gave me something in my IV to help.  I remember paying attention to what was happening on the other side of the curtain. I didn’t pay attention with Jack, but this time I wanted to know what was  happening.

At 12:49 pm (20 hours after my induction started) Alexander James was born.  He cried a beautiful cry.  He weighed 6lbs 5oz and was 18.5 inches long.  He had to cord wrapped fairly tightly around his neck and had a death grip on it with one hand.  I was told that my uterus was in great shape and they were certain that none of the decels were caused by my prior c/s (they had been fairly certain that the prior c/s was not the cause while I was in labor, they just confirmed it during the surgery).

I saw Xander just seconds after he was born, then once the NICU team declared him healthy they brought him back around the curtain for another look at him.  After that, he was wrapped up, given a hat and given to Daddy to hold.  I cuddled with the two of them while the doctors finished.

At this point, my regular OB stopped in.  He apologized for not making it down to assist. He said he was pleased that I made it to 7 cm and that without the cord issues he was certain that I would have eventually been able to deliver him vaginally.

As the doctors finished up, my husband was sent to recovery and I was transferred to a gurney.  I was handed Xander to hold for the first time as I was wheeled out of recovery.  I wasn’t sure they would let me hold him because of my shaking, but they said it wasn’t bad so I could hold him.  I think I stopped shaking about 10 minutes after we reached recovery.  I nursed him while we in recovery and a while later we were headed up to our room.  A few hours later, our new family of four was together for the first time as my sister-in-law brought Jack to visit.

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