I was admitted for a scheduled induction at midnight on Saturday morning, November 1st, due to the worsening preeclampsia. The intake process took a while, and they finally inserted the Cervadil around 2:30am. The doctor at this point told us that this is usually kept in place for 12 hours, at which time they reassess if I need a second round to continue softening my cervix or if it would be ready to begin the Pitocin to initiate contractions. They warned that I might feel some mild cramping but that full contractions would probably not begin until the Pitocin was initiated. At this point, C and I were preparing for a very long night/day and bracing ourselves for the likely possibility that Beuhla** would not be born until Sunday.
I was not allowed to get out of bed for the first two hours of the Cervadil, which is why I remember that by 4:30am the pains were starting become very bothersome. It was impossible to get comfortable enough to sleep and I was mostly feeling a lot pain in my back.
Between 4:30 and 7:00am is when things started to get stressful. My blood pressure continued to rise, with the diastolic surpassing 100, and labs were coming back problematic. They decided that I needed IV medication to help with the blood pressure and ended up requiring at least a second dose to begin lowering it. Because of the high risk of seizures, I was also started on Magnesium Citrate via IV, which required complete bedrest, more frequent monitoring for the risk of respiratory problems, complete fluid and food restriction, and a foley.
The pains also began worsening. C asked if I was having contractions and I remember responding, "I sure hope so!" He attempted to time them and said that they never really achieved any regularity in terms of how often they occurred or how long they lasted. They started to get unbearable, but I felt like a real wimp because at the last check I was only 1cm dilated and kept remembering that the "real" contractions weren't even supposed to begin until after given the Pitocin. I started panicking a little in thinking I would have another 12-18 of this and then I made a deal with myself to make it until 7am before asking for the epidural. At 7am was the shift change and the CRNA that knew my mom was coming on. She came in by 7:10.
The epidural was in place by 7:30 and I felt pretty immediate relief. I could actually get comfortable in the bed and then started returning to mentally preparing for being bedridden and hooked up to IVs and the foley for a whole day.
This relief lasted for about an hour and then I started feeling pressure at the bottom of my cervix that was transient. The nurses determined that the pressure was associated with each contraction and I was reminded again that the epidural can help with pain but not with the feeling of pressure. The intensity of pressure continued to worsen and increase in intensity fairly rapidly. I started feeling the distinct urge to push The nurse checked again and I was only 4cm dilated, which was very disheartening because the feeling to push was very distinct and growing.
Around the same time, the baby's heart rate decelerated and many more people starting hanging around the room to monitor her, with hushed voices about how to manage this situation. There were frequent calls in to my doctor and constant re-assessing of the situation.
The urge to push became unbearable pretty quickly. C and the nurse did a great job of coaching me to blow out air, which is incompatible to pushing, but each contraction was more and more difficult. I remember hearing the nurses talking, and then decided to check my cervix again even though it had only been 15 minutes from the last check at 4cm. "Stranger things have happened" said the one nurse. Turns out, in 15 minutes I went from 4cm to "8-9cm".
At this point, there was a much more frantic attempt to get my doctor in the room and a flurry of activity around me that I was only slightly aware of. My resolve to resist pushing was diminished but C stayed by my head and kept reassuring me.
My OB quickly arrived, finished getting set up, and finally I was allowed to give into the urge to push. Then the nurse went immediately from feverishly discouraging any pushing attempts to now being very adamant about the pushing. I recall being slightly annoyed by her change of pace, but more relieved that I could now listen to my body.
I likely pushed around 5 - 10 times. I distinctly remember two pushes being tied to her head and then one to get her shoulders out. I remember thinking that she must have broad shoulders, because this was most uncomfortable episode of pushing.
Our daughter was born at 9:26 am, approximately 7 hours from when labor was medically initiated. She was initially blue and took too long to cry for my comfort. I found out later that this was because she had the umbilical cord wrapped around her neck and that my placenta had begun abrupting. I did not know about this complication ahead of time, but learned that a placental abruption is a serious complication that can result in the mother bleeding out and the infant losing all sources of oxygen, which is likely the cause of her decelerated heart rate earlier in the morning. It was very good that she was born when she did.
Despite all of this, her APGAR at one minute was 7 and at five minutes was 8. She was was born weighing 7 pounds, 3.5 ounces and at a length of 19 1/2 inches. After a short and dramatic morning, we are now the proud parents of a generally healthy daughter.
**For the sake of anonymity, I have decided to retain her "place-holder" name of Beuhla for this blog. Rest assured, that she was given a more modern and fitting name in real life.