Thursday, March 12, 2015

Madelyn Brianne's birth part 1

Some of you asked about a birth story so I thought I would attempt it.  If birth stories are not your thing feel free to skip this post.  ;)  I don't think I wrote one for Isaiah so this is new for me but here goes.

As most of you know I had a complication free pregnancy and a home water birth with Isaiah.  I was so pleased with the experience I very much wanted to repeat it when I found out Madelyn was on the way.  We began making plans for that and signed up with a midwife.  At my first prenatal labwork she noted that my platelets were a little on the low side (120,000 with normal range being 140,000-400,000) and the lab noted the presence of an antibody.  She wasn't terribly concerned but commented that since it was low she wanted to check it again in 4 weeks to see if it came back low again.  After the 4 weeks they had dropped to about 113,000 but there were no antibodies present.  This was puzzling because I had no other symptoms or indication of any problems so we decided to just recheck the platelets again in a few weeks.  I honestly gave it next to no thought after the first discussions because it didn't really seem like a big deal.  My midwife researched and I did some googling and we came up with a few supplements to try and see if we could bring the platelets up.  However as we watched and my due date got closer they continued to drop.  At 36 weeks they were down to 97,000 at which point my midwife recommended we consult with her backup OB on what his opinion was on the matter and whether a home birth was potentially unsafe.

Since Isaiah was born at 37 weeks exactly all on his own timing we weren't sure how much longer I would actually be pregnant as it was.  I called and set the appointment with the OB for the middle of my 37th week and half hoped I would just have a baby before then and we wouldn't have to deal with anything.  We were all in agreement that at 97,000 we would be okay proceeding with the home birth until we had talked to the doctor.  Meanwhile I began taking even more supplements to try to bring the levels up some.  Two days before the doctor's appointment I had my 37 week appointment with my midwife and we ran another platelet check so we would have fresh numbers to take with us and also know where I stood for the next week.  The lab was annoyingly slow and I did not hear the results (which I expected to be around the low 90s) until my midwife met us at the doctor's office.  The lab had sent back they were down to 67,000.  This really shocked me and was a huge game changer.  For them to have fallen so dramatically in a week's time I knew was a bad thing and I was very apprehensive about a hospital birth that I had not been able to prepare myself for mentally and that we knew would be very expensive as we do not have insurance.  We went into the appointment and the doctor was definitely concerned.  There were two likelihoods he felt like, one that I had gestational thrombocytopenia which is basically an autoimmune reaction from my body to the pregnancy and resolves after delivery (and may or may not come back with subsequent pregnancies) or ITP which he felt like was less likely and would be something I had all the time and could potentially cause platelet issues in my baby.  He wanted to send me to L&D for a check of the platelets at his lab (he was concerned about the accuracy of the one we had used), a full ultrasound, and some fetal monitoring to see how things were looking.  He mentioned a possible induction if things were really that bad.  After spending the morning and afternoon in an observation room the results came back that my platelets were actually 87,000 and all I got from the nurses was that the doctor said I should go home and follow up the next Monday or Tuesday.  Talk about a roller coaster of emotions!  My mother in law gave me a beautiful baby shower that Saturday and I just decided that Maddie was waiting for me to be able to have that before she came.

We set up my 38 week appointment with my midwife for Monday to check platelet levels again.  My midwife had read online that some people have trouble with their platelets clumping and that in these cases a special type of tube should be used to prevent that.  She ordered that test instead and this time they came back up to 100,000!  This was a miracle I felt like and absolutely direction from God that a home birth was still okay because many people had suggested that as the cut off.  To be sure though I made an appointment with the OB for that week and asked his opinion.  He said that he would be okay with a home birth at 100 and suggested we do what we could to encourage baby girl to be born that week.  He recommended some things (some I had already been trying like evening primrose oil, and some I had not considered like stripping my membranes) and sent me on my way.  My midwife stripped my membranes for me a couple of days after that and I waited with baited breath.  The evening after this I began having regular contractions and feeling lightly crampy.  I was very excited that maybe this was it, I was going to have this baby at home!  The contractions continued into the night even when I tried to go to bed.  At 4 AM I suddenly felt like I needed to throw up.  I thought that was strange because I hadn't felt nauseous at all but a quick google check seemed to indicate some women did this during labor so I was encouraged.  About an hour later I thought I could feel pressure much lower during a contraction so I woke Jonathan up and said I really wanted to go ahead and call the midwife and my mom.  They both headed out and Jonathan set up the birth pool in anticipation.  After everyone arrived I began throwing up more and my contractions spaced themselves out even though they were fairly painful.  My midwife at some point recommended I try to get some rest and that I wasn't far enough into labor for her to be there, she felt like I would feel like a watched pot.  So she left with instructions to call her if things changed.  The only change that happened was that I quit throwing up around noon and my contractions began to lighten around 3 PM.  This was terribly disappointing to me, but I knew I had my church baby shower that Sunday so I thought maybe after that I would go into labor.  The birth pool stayed up, the midwife's bags were all lined out on the dining table as well as my birth kit because everyone just knew I would have her any day.  But still she didn't come.

We had my 39 week appointment and checked platelets again.  The doctor had requested that I come in again each week with my platelet levels so they could help monitor.  The lab came back two hours before my appointment at 59,000.  I was stunned.  I was so tired of the up and down from one week to the next (and sometimes from one day to the next).  I felt like I knew what was going to happen so I threw my emergency hospital bag in the car, kissed my baby boy good and long before I left him at his grandmother's, and mentally prepared myself for a hospital delivery that night.  Thankfully Jonathan was able to meet me at my appointment (it was for 4 PM) so he could be there with me for whatever happened.  I assumed at the least I would have to go in for another check of my levels but I was fairly sure I knew the doctor would push an induction since I was over 39 weeks and at this point dilated to about 5 cm and 50% effaced.  The doctor came in and said pretty much what I thought he might.  He wanted to send me straight over to L&D to have a baby.  I was still not sure what to make of the idea of a hospital birth since that had not been my plan but I was also relieved to end the constant seesaw of emotions and to finally have my baby in my hands.  The CNM who worked with the OB came in and checked me.  She was surprised to find I was dilated to 6 cm and 80% effaced.  She couldn't believe I was walking around like that with no regular contractions.  She also said she would be the one delivering the baby (this was super important to me as I had been disappointed thinking I would have a male OB when I knew I would be more comfortable with a female) and helped talk me through some of the things she wanted to try--some herbal tinctures and oils while they got me going on a steroid to temporarily boost platelets and some IV antibiotics because I was GBS+.  She felt like doing the herbs first might work and if not they would give me some pitocin but she wanted to avoid breaking my water because Maddie was so high up and she didn't want to risk a prolapsed cord.  I felt somewhat better about the birth after discussing things with her but this was still new and different and I had not heard many good things about pitocin inductions and was a bit nervous about that.  Jonathan and I called and texted our moms and my midwife to let them know we were going to have a baby soon and prayed before walking out of the office.  I wish I could tell you I had a wonderful spiritual moment in which suddenly I was perfectly happy about the whole deal but I did have a peace that this was what we needed to do for some reason.  And yet I was mourning the loss of my ideal delivery and had to choke back tears a few times.  I'm sure hormones had NOTHING to do with that.  ;)

So this is what led up to my walking into Conroe Regional on a Wednesday evening to have a baby.  It was a crazy ride (and continued to be) and made little sense to me but I was confident God had clearly directed through circumstances and the doctor that we needed to be there.  My midwife met us there to act as my doula and we all settled in for what we hoped would be a short evening before baby girl joined us.

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