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The Birth Experience

by: Kelly W


I had a regular OB appointment on October 2nd during which they did a cervical exam and found that I had dilated to 4cm while home on oral tocolytics. So, I was immediately admitted to Labor and Delivery and started on IV meds. They first gave me ritodrene as that was the one that I had responded to the first two times that I had been hospitalized since September. After some time with no response to the meds, they switched me to magnesium sulfate once again. I still wasn't responding (meaning that I continued to have contractions every 2-5 minutes). Let me say first that these contractions were not at all painful. I actually didn't even notice that I was having them at all. So...they continued to increase the mag sulfate in the hopes of stopping the contractions. They put me on a dose of 4 gm/hr which put me over the edge. I told the doctor that I couldn't take any more. I was vomiting like the exorcist every few minutes and had severe double vision. I knew that my body was at its maximum level of the drug and I tried my best to make that clear to them. However, they must have been used to patients saying that simply because they were uncomfortable because they did not decrease the dosage - they increased it to 4.5 gm/hr. Shortly after that, I lost consciousness and reflexes. I remember awakening to someone shouting in my face "Can you tell me your name?". I think I nodded to them. Anyway, later on I found out that the magnesium level in my blood was 12.4. Supposedly a level of 7 is therapeutic, 10 is toxic, and something like 20 is dead. When I said, "So, I was only about half dead?" nobody laughed. After that, they tried the ritodrene again to no avail. After 4 or 5 days on these drugs I finally lost it. I had been in the same bed on all of the fetal monitors and these drugs that either made me totally sick or shaky with a resting pulse of 130 or better. I told the doctor that I wanted to be taken off of the IV drugs when my lungs started filling up with fluid (one of the side effects of the ritodrene). He told me that it was easier to treat me for pneumonia or fluid in the lungs than it was to treat the babies. I told him that even if these were my children that I would be making the same decision. I had a husband and a child at home that were alive and well and needed me and that I was not willing to take any more risks to my health as I had the past number of days. He gave me a pep talk about how making it to 36 weeks would be so great and didn't listen to a thing that I said. Jason was in the room for this conversation and finally turned around on the stool he was sitting on and looked at the corner of the room with his back to the doctor because he wanted to kill him. Anyway, the next morning I spoke with one of the female resident doctors in charge of my care that I had gotten to know quite well over the past couple of months during my inpatient stays. I told her that I did not want the IV meds increased for any reason and that I wanted to be "weaned" off of them and transferred downstairs to the ward on oral meds only so that I could get out of bed to use the bathroom and not be hooked up to IVs and monitors and have my vital signs taken every hour. I was absolutely exhausted and needed some sleep.

That resident had to go into a meeting the next morning. The day nurse (always a different person) came into the room and starting changing the pump that was used for the ritodrene. I asked what she was doing and she said that the doctor told her to increase the dose. I asked which doctor and she told me. It was someone else and I said that I wanted her to get one of the staff perinatologists that was in charge of my care and send him to my room. I started sobbing and couldn't stop. I couldn't believe that they were not listening to anything I told them about my care. So the staff doctor came in and attempted to understand what I was saying through my blubbering. I guess that it was finally clear what I wanted. Immediately he turned down the dosage and made orders to wean me from the IV meds and load me with a dose of the orals and have me transferred to the ward the following morning. That night I contracted every 2 minutes non-stop. They were convinced that I was going to deliver that night. I, however, could not feel any pain with the contractions. They did a couple of cervical exams and I was unchanged. I went to the ward the next morning and was there for 12 days without incident. I completed all 4 series of Celestone shots for the babies lungs.

The last few nights before I delivered I didn't get much sleep. I was growing increasingly uncomfortable and knew that the time must be drawing near. The night of Monday the 20th I got almost no sleep at all. The next morning the doctor came by on her rounds and I told her that my back and hips hurt and that I couldn't get comfortable enough to sleep. She said that it was understandable with as much time as I was spending in bed. I knew that something else was up, but I wasn't sure if it was labor starting since I wasn't in any pain. I ate lunch and was exhausted but still couldn't get in a comfortable enough position to sleep. I was twitchy and irritable enough to throw something. I asked the nurse if I could have an NST to see if my contractions matched up with the shifting of positions I was doing. Sure enough, I was having contractions every two minutes that were uncomfortable to the point that I would change positions, but they weren't "painful" yet.

They sent me up to L&D for a cervical exam and another NST. After about 40 minutes, I knew that I was in labor. I couldn't stand to be on my back when a contraction hit and I ended up getting up off the bed to lean on the wall or do any number of other things to make it through them. The doctor came over and checked me...still a four. He said that they were going to send me back to the ward. I almost laughed. There was no way that I could sit in a wheel chair long enough for them to get me back to my room. I said "when, exactly, would you like for me to come back? when my water breaks? when I give birth?" Finally, after about another hour, he came back to me and said that they had a labor room for me "in case" I went into "active" labor. I wanted to tell him to kiss my (well, you know).

So...they sent me to another room and started an IV. I once again refused any tocolysis. So, they refused me any pain meds. I reminded them that the anesthesiologists wanted me to have an epidural in the event that they had to perform a c-section. The doctor said that "if I went into active labor" then they would order one. There I sat blowing through contractions. They put me on oxygen when my saturation level dropped too low. But they still refused to admit that I was in labor. Fortunately, the time came for the doctors' change of shift. Another resident whom I had the opportunity to get to know quite well came on. He came into my room and saw me lying there with tears streaming down my face from the pain. (One of the babies was on my spine and was bruising my tail bone while the other was directly in front of my abdomen. I thought I was going to burst at the seams. And I had my daughter unmedicated on Pitocin after 16 hours of labor so I was no stranger to pain.) Anyway, he appeard absolutely incensed at the other doctor's immature way of refusing pain meds. He did his own cervical exam (and his own assisted dilation maneuver). He declared me a "5" and ordered the epidural. After 3 attempts, the drugs were started and within a few minutes, I was in heaven. The nurse in the meantime had gotten ahold of Jason. He took Alexis to a friend's house and arrived at the hospital within the hour. Susan had just left to go shopping at the mall and he had no way to get ahold of her. He got to the hospital at about 8 p.m. We talked for a short time and he said that he hoped that this birth wouldn't be like Alexis' was. I told him that if he got too tired that he could go lie down in my room in the ward or something. At about 8:30 a doctor came in and checked me. Her eyes got really big and she said, "we're moving to the OR NOW!" All of a sudden everyone was running around and disconnecting things. A nurse threw a set of scrubs and a mask and such at Jason and told him to change right away. The next thing I knew they were wheeling me down the hall at a fast clip to the OR that had been prepared to handle an emergency c-section and/or a vaginal delivery.

There were 17 people in the OR ready to handle whatever was going to come up. All of the doctors from L&D were attending. I guess nobody else was giving birth at that time. There were perinatologists, neonatologists, nurses, anesthesiologists..... It all was very organized and quiet and soothing in its own sterile way. Once they got the oxygen and monitors hooked up, they checked me once again and said, "go ahead and push". After about 3 or 4 contractions, Jake was delivered. He screamed right away, which put me at ease. There were a few doctors caring for him and everyone kept saying, "don't worry, he's totally fine." They gave him an apgar score of 8.8. After a few minutes, he was wrapped in a blanket and a hat and was taken down to the NICU. They did an ultrasound after he was born to check the position of Lia. Fortunately, she was still head down. After pushing through some contractions to no avail (she was really high and wasn't entering the birth canal), the doctor took a spinal needle and pierced her amniotic sac. (They broke Jake's just before they told me to push.) A slow trickle of fluid came from Lia's sac. Then a contraction hit and it ruptured completely. They manually pushed on my abdomen to help her into the canal and I started pushing through contractions again. By this time the epidural had worn off and it wasn't painless anymore. Finally, she came down and was delivered. I was so lucky that I had no episiotomy or tearing. She also let out some cries right away, but hers sounded wet like she had some fluid in her lungs. They gave her an apgar of 9, swaddled her and sent her to the NICU also.

In the recovery room, I told my nurse that I was really bleeding a lot. She said that it was pretty normal to have some heavy bleeding. I looked her square in the eye and said, "No, I am REALLY bleeding A LOT." She understood and said she would take a look. After seeing the pool of blood that I was sitting in, she gently pressed on my abdomen and it felt like I delivered the placenta all over again. In her best "I'm not going to sound hysterical" voice she yelled for someone to get the doctor. He came in and immediately started squeezing my uterus from the outside of my abdomen and emptying its contents from the inside. I was in more pain than the whole birth process. He wanted to give me more epidural meds, but someone had already removed it. He gave an order for demerol (sp?), but there wasn't time to get it. Anyway, I started moaning "OWWWW" and he kept apologizing. It was actually sort of funny and we both knew it. Fortunately, that one time was all it took to remedy the problem.

I spent a couple of hours in recovery so that they could make sure that the bleeding was under control. During that time, Susan arrived at the hospital (Jason had left her a note at home). She wanted to make sure that I was okay and I said I was doing fine and that she should go down to the NICU and see her beautiful new babies.

At about 1 a.m. ( I delivered them at 9:08 p.m. and 9:42 p.m.), I returned to my room on the ward and went to the NICU to see the babies. I held Jake while Susan held Lia. The nurses kept saying how great they looked and how wonderfully they were doing on their own.


2007 OPTS - The Organization of Parents Through Surrogacy