Friday, November 9, 2007

Hannah and Isabelle's birth story, Part I

By way of introduction to our story and some historical background, I'm going to post Hannah and Isabelle's birth story, which I finally got around to writing after almost two years.
On a Wednesday in my 27th week, I noticed some very light spotting.
I went to the doctor and got checked: I was not dilated or effaced, and I was not having regular contractions. Everything was fine, but the doctor told me it was time to think about quitting work and going on modified bedrest. I agreed to make Friday my last day, and started making plans for finishing up any last projects and ensuring my maternity leave replacement was ready to assume my responsibilities.

On Thursday, I woke up feeling like I was coming down with something. I had a slight temperature and my stomach was upset beyond the regular indigestion that had been plaguing me for weeks. I put in a few hours at work, went home to rest, and then met my husband(B) for dinner before we went to our birthing class. I was increasingly uncomfortable throughout the day and could barely sit through class, constantly shifting positions and trying to find ways to take the pressure off of my stomach and back.

When we finally got home, around 9pm, I noticed more, heavier spotting. We called the doctor on call and explained that I hadn’t been feeling well and was spotting again. He said that if I wasn’t cramping, I should just come in first thing in the morning to be checked, since I had been in to the office the day before and everything was fine. I went to bed and slept fitfully, slightly aware of some minor cramping but not enough to wake me fully. When I woke at 6:30am, I called the doctor again to report that I was starting to cramp, and he said I should meet him at the hospital.

B had already left for work so he planned to meet me there. As I drove the 30 minutes to the hospital, I felt waves of low-intensity cramps pass through me. I can remember thinking, “this can’t be good,” and just tried to stay focused on getting myself there as fast and as safely as I could.

I got to the hospital at around 8:30am and B met me at the entrance and helped me inside. Several people smiled at us, seeing my huge size and assuming I was a full-term mama in labor and that this was a happy occasion. The receptionist asked, “Are you in labor?” and I said, “I hope not!” They whisked us through the admitting process and directed us to the 7th floor, where the birthing center is.

The birthing center is a new, bright, airy facility that’s just past the NICU on the 7th floor. I paid no attention to the NICU as we walked by, not realizing that would be my second home for the next two months. A nurse met us at the door, took us to a room and had me get undressed and put on a gown. She hooked me up to a fetal heartrate monitor and spent a good bit of time trying to make sure she had both babies’ hearts being measured separately, and not just one baby being heard twice. I was also hooked up to something that kept track of my contractions.

Soon after, the OB came in and did a quick exam: I was 1-2cm dilated and 90% effaced, so he was going to have me started on magnesium to stop the contractions and prevent labor from progressing. He also ordered a steroid shot to help speed up the development of the babies’ lungs. My mind raced as I tried to remember from birthing class and my books what 90% effaced meant. I didn’t think it was good, but I felt confident that the meds he was going to give me would do the trick since I was just barely dilated. At one point, he said to me, “Well, you’re officially on bed rest now!” and I smiled weakly, assuming it would happen at some point but not quite ready to be bedridden so soon. I was also glad that I had gotten the steroids, thinking that was a good precaution so that the babies’ lungs could go on hyper-development-drive, should I deliver early.

B started making phone calls to family and we waited for the meds to kick in. The nurse told me I would start to feel very hot from the magnesium, and soon a slow, tingling heat crept across my face and chest, inching its way through my body and down to my toes. I’m not sure how much time passed, and this is where details start to get fuzzy. I think this is partly from the medication and partly from the trauma of what was happening.

The OB checked in on me again and said it looked like I was still having regular contractions so he was going to increase the dose of magnesium and add something else as well, something stronger. He told us that he was going to have the anesthesiologist and neonatologist come in to speak with us, so we knew what to expect if I did in fact deliver in the next 24-48 hours. At that point I felt the first flicker of fear and shock: “What do you mean? Won’t these meds stop labor and then I can just go on bedrest?” I remember asking, panicked. I think the doctor said something like, “Well, we hope so, but we like to just be prepared.”

While we waited for the docs to come by, the nurse asked if I felt contractions. I wasn’t sure: I felt cramps ripple across me periodically, but was that a contraction? I had no idea, I’d never been in labor before and was praying that this was not it. She looked at the monitor and said that it seemed I still was contracting fairly regularly.

At some point the anesthesiologist came by and explained the process for getting a spinal in case I needed to have a C-section. I don’t remember anything he said except for this: “I’m telling you this in case you do deliver in the next 24-48 hours, but hopefully that doesn’t happen and we won’t meet again until much later in your pregnancy.” Soon after, a neonatology fellow, a young guy who looked to be about our age came in. I don’t remember much at all of what he said. A few phrases floated by me: “27-weekers…vision and hearing problems…learning disabilities…breathing problems…developmental delays.”

About an hour later, the OB examined me again and said I was now 5-6cm dilated. I was amazed: “How can I be 5-6 and barely feel anything more than some cramps? Are you sure?” He said that often with twin pregnancies, the uterus is so stretched and the mother already so uncomfortable that she can go pretty far into active labor before she really starts to feel a lot of pain.

The next thing I remember is that I started to feel like I was leaking. I told the nurse and she had me roll onto my side, and just as I did, a huge gush of fluid came out of me. I started to groan, a deep, primal groan. I knew that my water just broke and I felt myself begin to fade away, deep inside myself, into my core. The OB and a resident were there, trying to find the babies on an ultrasound. They said something about one of the babies being in some distress, and that it looked like they were going to be born today.

At that point, things started to move very fast. The neonatologist fellow was back, telling us that once we got in the delivery room, we would see a lot of people in there, shouting instructions to each other, but not to freak out because that didn’t mean things were bad, it was just the way that they ensured they could hear one another through all the chaos of an emergency C-section. The anesthesiologist came back and I don’t remember what he said, I just remember his demeanor was very gentle, and calm, and kind. The nurse told B he would have to leave while I got prepped and then he would meet me in the OR. The next thing I remember is a sharp sting and then a lot of pressure as I got the spinal.

Once I was wheeled into the OR, the anesthesiologist set up camp next to me and kept up a steady stream of dialogue about a variety of topics, some related and some unrelated to what was happening to the lower half of my body. He was my link to consciousness; I listened fiercely to his voice, for fear that I would slip away otherwise into some remote place. B made his way back into the OR and stood by my side, squeezing my hand.

I felt a lot of pressure and tugging, and then someone cried out, “It’s a girl!” Hannah. Our Hannah Kate was born. 12:49pm, only 4 hours after I arrived at the hospital. I listened intently for what every mother listens for after she gives birth: the sound of her baby crying. But it was silent. And then, moments later, I heard the faintest of sounds, a soft whimper of a cry. Three minutes later, 12:52pm: “It’s another girl!” Oh my. Two girls. We don’t have another girl’s name. We hadn’t gotten that far. We had only chosen a girl and a boys’ name. And no middle names.

They wheeled the girls by us as they raced them off to the NICU and I caught a fleeting glimpse of an isolette and a tiny bundle in the center. The next thing I remember was many hours later, as I recovered in the maternity ward. B had already been up to see the babies while I slept on and off. When he came back, he reported that they were doing okay, but were very, very small. He said this several times: “They’re very, very small.” He handed me a picture of each of them, taken by one of the delivery nurses, which I studied intently. These are my children; my girls. Hannah, and “Baby B.” My two pound, two ounce little girls. How incredibly surreal.

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