Tuesday, July 21, 2009

She Turned Our World Upside-Down

Jersey #4 does not have a pregnancy & childbirth STORY....she has an ADVENTURE!

The largest age gap between our children is this one between Jersey #3 and Jersey #4. This is because Jersey #3 was a high maintenance baby! His demands left us drained, exhausted, and barely able to function for nearly his entire first year (but that would be another post entirely)! When I finally reached a point where I felt brave enough to desire another baby, The Referee offered a mathematical solution...."We've already got 2 girls and 1 boy, so let's have another boy and make it even!" (Sure enough, Jersey #4 is a girl.)

Pregnancy arrived easily and we were excited to share our big news that our family was growing! Unfortunately, our extended families reacted poorly. We heard a lot of "With all that you have been through, are you sure you want to try to have more kids?" and "I thought you were done"..."I thought your husband was done".....or the ever-popular "I thought you would stop once you got your boy." My husband and I were both a little shocked by such negativity. I was more shocked that anyone who knew me would dare think I was done having kids, since I have always expressed a desire for a large family. My husband was shocked that folks even had strong opinions about the size of OUR family, as if that was any of their business. He went so far as to react to his Mom with, "Well, it is not like I am asking you to pay for them or take care of them." In some ways, the negative reactions from others were a blessing to us, as we were able to turn towards each other for support at the start of this pregnancy, acting as a team.

Once again, the first trimester was filled with morning sickness and exhaustion. Blah. And, once again there was a big bleeding scare. This time, I was just past 13 weeks. Thinking we knew the routine, we went to the hospital to see what we might be dealing with. With Jersey #3, Dr S said placenta issues were usually to blame, so that is what we were expecting again. There were a few major differences this time around. First, it was A LOT of bleeding. A lot. Second, the resident doctor in charge that day has no business working in the field of prenatal health. I do not know her story, but I do know she really should pick a different career. The intern was awesome, and he was able to find the baby's heartbeat. That was a huge relief, because at least we knew the baby was still alive. He also came to my defense when the Resident doctor continued to suggest that bleeding in pregnancy can be caused by many things, including sexually transmitted diseases, especially if I had any new sexual partners recently. I stared at her---completely jaw dropped open---wondering what in the world she was talking about! Apparently, she didn't bother to read anything in my chart before entering the room. The intern actually told her that all of my children also belonged to my husband (not that he even asked me that question), but I am guessing even he thought his superior was on the wrong tangent. I finally interrupted her and gave her a brief run-down of my previous pregnancy, where a bleeding scare like this was caused by placenta previa. She brushed off the idea of placenta issues, and said she had no need to check on things via ultrasound. By that point, I had enough of her, and just replied that since we heard the heartbeat and knew the baby was alive, I was content with that, and I would just follow up with Dr. S when he returned from vacation the following week. The Resident Doctor then offered the "comfort" of telling me that IF this pregnancy was even wanted, that I MIGHT have some grief if I miscarried! What? I informed her that I completely understood the grieving cycle, as I had already had a stillborn baby and a baby I miscarried. I assured her that women DO grieve the loss of their babies. I waited around for the nurse to give me yet another RhoGam shot (due to RH incompatibility), and went home to rest.

I saw Dr. S the first business day he was back in town, and he immediately ordered an ultrasound to see what we were dealing with. He could not find the baby's heartbeat with the Doppler that morning, and I was not feeling movement, so I was secretly in a state of panic. It did not take the ultrasound tech long to figure out that my panic was not a secret, because as soon as she placed the transducer on my abdomen and started to search for the baby, I stopped breathing completely and was trembling so hard that she reached out her other hand and held my arm down against the table to hold me still. She captured an image of the baby--with a beating heart--immediately! She then took a pause to let me catch my breath, calm down, and wipe the tears of relief from my face. She did not say a word about my reaction, but her entire posture was filled with compassion. Instead of starting with crown-to-rump measurements, she stayed right there on the heart, and played the recording of the heartbeat 3 times in a row (probably because I relaxed more and more each time it played).

This tech did a great ultrasound evaluation. She was able to get a great view of the problem....a subchorionic hematoma. This is a blood clot between the layers of the amniotic sac. It looks like a big bubble on ultrasound....



The cause is unknown. These are often discovered during the first trimester, during routine ultrasounds. They sometimes bleed, but sometimes not. They usually resolve themselves by the 2nd trimester. Of course, since this is me we are talking about, the subchorionic hematoma I had was huge. It was causing so much bleeding that when I returned to the hospital later in the pregnancy for another RhoGam shot, the nurse remembered me from "that miscarriage that had so much blood." (She was shocked to learn I was actually still pregnant, and the baby was still alive). And, I was in the 2nd trimester when it was discovered...so no one knew if it would actually resolve by delivery, since I was not following the textbook.

So, once again, I spent the second trimester resting as much as I could, praying constantly, and worrying way too much about something that was out of my control. And, once again, my husband decided he could not handle the emotional strain of a risk to the life of our child, so he threw himself into his work and avoided home as much as possible. Thankfully, the bleeding did eventually stop after a couple weeks. We monitored the size of the hematoma with ultrasounds every 3-4 weeks, and it eventually started to shrink. By the time I was in the 3rd trimester, we knew we were having a baby GIRL, and the doctors were confident that the hematoma was not affecting the growth of the baby, and it would be dissolved completely by the time of delivery. Praise the Lord!

And then, the other shoe dropped.....

The company that my husband was working for announced they needed to lay-off about 10% of their employees, due to major financial woes. My husband received 60 days advanced notice that he was going to be laid-off from his job. Jersey #4 was due in 58 days!

There was no time to cry or lament. We took one evening to face the emotional impact of this disappointment. Then, he got busy! He updated his resume, attended the career counseling seminar the company offered, and started job hunting with great passion. We also took charge of trying to get out of a rental property mess we were dealing with, and evicted the non-paying renters, and put the property on the market to be sold (at a loss). I prayed constantly, and asked for prayers from our family and friends, repeatedly. We decided to aim for local jobs first, but opened ourselves up to the possibility of moving out of state.

Thankfully, my husband received 2 job offers within a month. My husband was excited about the "really cool" start-up opportunity, so he chose that job. We were so thankful he found another job so quickly. Praise the Lord! The additional blessing was that the transition between jobs would occur right around the time of our daughter's birth, giving my husband at least a week or two to be home to help. How nice that things are working out so well for us!

And then a 3rd shoe drops....(aren't there usually only 2 shoes?)....

At my 37 week prenatal appointment, I commented to Dr. S that I was not convinced that Jersey #4 was in the proper head-down position. Usually, Dr. S has great skill at determining the position of the baby, just by pressing on my abdomen. He palpated to check, and was a little unsure. So, he called a colleague and sent me over to that clinic for a quick ultrasound peek at the baby's position. That doctor was busy when I arrived, so he had one of his Resident Doctors meet with me first and run the ultrasound. Sure enough, Jersey #4 was breech. She was determined to be a "Footling Breech," because she was standing on one foot in the womb. Her foot was down, her head was up. She was not in the proper labor-ready position for birth. I had already research some of the options, so I knew that a breech baby would encourage a c-section delivery. I had also read about the procedure to attempt to externally turn a breech baby, known as a version. I had many questions and concerns.

The Resident Doctor was a big fan of the version, and very against c-sections. She started to explain the version, and completely ignored my concerns. I refused to be dismissed, so I continued to ask questions and express my concerns. I told her that I was not certain I was even a good candidate for the version, considering the subchorionic hematoma I had. If the amniotic sac was weakened in some way that it had a bleed, then was it even wise to go adding external pressure like that? She brushed off my question with the reply that most of those hematomas resolve themselves by the 2nd trimester. Yes, that is true, but mine did not. I then explained to her that I was suffering from torn abdominal muscles, (due to a big coughing illness I had during that pregnancy), so I wasn't even sure my abdomen would handle the procedure very well. She brushed that off and said it wasn't a problem. I then explained my BIG concern which was that the version has a chance at causing the umbilical cord to wrap around the baby's neck. And, this doctor lost her case when she casually shrugged and told me that cords around the neck were not usually a problem either. I sternly informed her that my first baby arrived stillborn due to the umbilical cord being around her neck, and what was "not usually a problem" for her, was a BIG problem for me! When the statistical risks are quoted as only being around 1%, I AM THAT 1%!!! Those rare problems always seem to happen to ME! And, when it is happening to ME, it is 100% for ME!!! She then argued back at me that since I had already had 4 successful vaginal deliveries, I did not want a C-section. I informed her that of course I did not want a C-section delivery...no one wants a C-section...I wanted my baby to be born ALIVE! I was choosing the delivery option that was the safest for my baby, because I was not going to risk burying a child just to bring down the c-section statistical rates! She had the nerve to hand me an appointment card, with the version scheduled for the next morning, and assured me that I could talk to the surgeon then and opt out of the procedure.

I left that clinic and called my husband. He listened to the information and said that if the version only had a 70% success rate at turning the baby, but also ran a risk of harm to the baby....and a c-section was safe for the baby, but added risks to me of infection and a longer recovery time...then it sounded like a no-brainer to him to schedule a c-section. After all, our top priority is a living baby. Infections and recovery complications we could handle. Keeping everyone alive was the priority. I totally agreed.

I called Dr. S and gave him a run-down of the appointment, the advice I was given, and our decision to refuse the version and go with a c-section. He assured me that we were making a wise decision, and he would call the surgeon and inform him. I was worried that the surgeon was going to be mad that I didn't let him try the version. I had nothing to worry about, though, because the surgeon was totally understanding and respectful of our decision. He apologized for being too busy that day I arrived in his clinic, saying he wished he had the chance to talk to me himself instead. He was also completely understanding of my history of complications, and even offered to schedule the c-section 3 days before my due date, to follow along with Dr. S's pattern of "mercy."

I assured the surgeon that I had never gone into labor early before, and I felt comfortable waiting until the date he originally proposed for the c-section (which happened to be 2 days before my due date). He had explained to me from the beginning that he did not want me to go into labor on my own, because with the baby's foot on my cervix, and not her head, there was great risk of the cord swooshing out of my body, if my water broke, because nothing would be there to stop it (and that is an emergency situation). He did not want to do the surgery too early, because he wanted the baby to have as much time to grow and develop as possible. Balancing those priorities was very important. He gave me his pager number and told me to page him at the first sign of labor, or he would otherwise see me the morning the c-section was scheduled.

In the days that followed, I read all I could to learn about c-sections, so that I would be prepared for the procedure, what to expect with it, what could go wrong, how it would be different, and how to best heal while also taking care of a newborn. I received a lot of encouragement from 3 older women, who all told me their breech baby vaginal delivery stories (or nightmares, as the case may be). One lady put it best when she said that breech babies come out looking like they were in a fight. I also paid attention to all the c-section stories I could gather from the moms I knew who had experienced them. I was ready. I buried my fears of the unknown and tried to focus on the positive...getting to "schedule" the birth day....what a cool thing for a planning person like me.

...and then shoes started dropping all over the place.....

I never did get to experience the benefit of scheduling Jersey #4's delivery. No, my body decided to go into labor on its own. Early. For the first time ever. Two days before the scheduled c-section (4 days before my due date), our Realtor called me to tell me that she had received a cash offer on the property we were trying to sell. Two hours later, my water broke! (our Realtor takes credit for sending me into labor with her awesome news). My husband was at work at the time, attempting to out-process from his job. He had already turned in his pager, and was in an area where he could not take his cell phone. I could not reach him. My Mom was planning to visit and stay with the kids during the delivery, but she was not set to arrive until the next day. I paged the surgeon and got his voicemail message that said he was out of town for the day and to not leave a message! I started to panic. I called Dr. S (who enjoyed a chuckle at my predicament) and he advised me to go to the hospital immediately, before I risked delivering on the interstate! I sat frozen in the chair, so that I did not move and encourage the cord to move anywhere it shouldn't be, and started to make a series of phone calls to our church family. I called our babysitters, who gladly came over to watch the kids. I called my friend (who is a trained nurse), who gladly came over to drive me to the hospital...and was even ready to deliver the baby on the way, if necessary! I called my Mom, who jumped into her truck and started the drive to my house.

My sister called me as I was on the way to the hospital. She told me she was busy calling and emailing my husband, so that when he returned to the world of technology, he would know the news and could meet me at the hospital. She was also very curious to know if my water broke first, before contractions began. Yes. This is a funny thing to us, because it supposedly only happens about 10% of the time, yet it has happened to me and both of my sisters, and our Mom!

We made it to the hospital in plenty of time. Contractions had not started yet. The cord was not swooshing out. All was well. My husband made it to the hospital shortly after, thanks to my sisters' messages. Since I had eaten a hamburger for lunch, they wanted to delay the surgery for as long as possible, to allow me time to digest. The surgeon made it back to town, and to the hospital while I was waiting and digesting. The baby was being monitored, and she was doing great. My Mom arrived to stay with the kids. Contractions did not start for 4 hours after my water broke. Things were running fairly smoothly, under the circumstances, until a series of emergency c-sections bumped my name down the list and required further waiting. I was dilated to 4 cm and it was 11pm, by the time it was my turn in the delivery room.

The C-section delivery was really, really cool! I don't know if we were open to adventure, or if we were just that elated that our daughter was being born, but my husband and I had a blast with the surgical birth experience! My husband dressed up in the surgery room scrubs and proudly modeled his new look for me. I strained my head to try to capture any glimpses of the surgery in the reflections off the metal equipment around my head. (There was a sheet blocking us from the surgical site). I enjoyed resting on a bed while the surgeon did all the work to remove the baby from my body. My husband and I chatted and joked with each other and the anasthesiologist. Here is a picture of us, while the surgery was in the early stage.....


I was numb from the waist down, and could not feel anything. The surgeon explained to us that Jersey #4 would be born feet first....he would reach in and grab hold of her feet and pull her out. She did not appreciate his services, and came out screaming! We were so thankful to know she was alive! She was healthy and alive! And screaming! Lots of screaming. She calmed down when her Daddy held her. He brought her for me to see. I asked what color was her hair, and my husband replied that she did not have any. She was so blonde that she was bald. She was also demanding to nurse. She was not real patient with the surgeon trying to close up shop. She screamed in the operating room. She screamed in the hallway as we were rolling to the recovery room. The assistant wanted to do an assessment of the baby while she had a chance as soon as we arrived at the recovery room, but Jersey #4 refused. She screamed to nurse. So, the doctor gave in and handed her to me and suggested I nurse her first, before they attempted anything else. Jersey #4 nursed well, snuggled in my arms, and fell asleep on my chest. Thankfully, I was recovering very well from the surgery, so the nurses were able to let me just lay there undisturbed for a while, and hold my baby girl. As my husband dosed, sitting in the chair beside us, I reflected on the implications of this child and her adventurous life thus far. We just might have our hands full with this one. She refused to turn head down to be born the regular way. She refused to wait for her scheduled delivery. And...I had just witnessed a doctor give in to a newborn baby and quit an assessment because she was demanding her Mama and would not settle for anything else. For some reason, when I was dreaming about the arrival of a 4th child into our family, I was expecting her to be calm and easy-going. Instead, Jersey #4 completely turned our world upside-down!

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