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Saturday, June 25, 2016

pippa's birth story

**Warning - This post is extremely long and extremely detailed.  If you want to know the ins and outs of my experience with Pippa's birth and pre-eclampsia, keep reading.  If you'd rather not, just pass on by.

Pippa turns one tomorrow.  And I'm just now sitting down to write out her birth story.  Oh well, better late than never!

In order to fully capture her birth, I have to back up a little.  A few months before her birth, my feet, ankles, and lower legs began to get extremely swollen.  I had swollen feet and ankles at the end of Scout's pregnancy, but nothing like this!  Apparently, with Pippa, my hands were swollen too, because the tips of my fingers were tingly and numb all the time.  Even my face was swollen!  

And the weight gain.  Oh, the weight gain.  I didn't have to eat anything to gain weight, and the amount in one month caused comments from one midwife.  But there was nothing I could do to stop it.  I'm not the type of pregnant woman that eats ice cream every night and indulges in everything.  I eat normally and healthily and stay active with my kiddos as much as possible. 

I made a comment to my husband during these weeks, that I KNEW that I was going to have pre-eclampsia with this pregnancy.  He laughed it off, but I just knew. 

Three weeks before my due date, I had a midwife appointment, and the nurse commented that my blood pressure was a bit high.  130 over something is all I remember.  She had me sit still for a few moments and then took it again.  She said they'd keep a watch on it, but didn't seem overly concerned.

The following week, I had another appointment.  The nurse checked my blood pressure, but didn't comment.  I asked her what it was, and she said 116/70, which was typically a normal reading for me.  I couldn't shake the feeling though that wasn't right.  I had watched the blood pressure tick down on the old-school monitor, and thankful for my medical knowledge from college, I swear it was 140 something for the top number.  I didn't, however, call it out and ask her to recheck it.  

The next day, I wasn't feeling so great.  Just super tired, splitting headache, and not myself.  I took the kids to a massive indoor play space so that I could sit and put my feet up while they ran.  My intuition kept nudging me and wouldn't leave me alone.  I knew something wasn't right.  

When we left the play space, I needed to pick up a prescription for one of the kids, and while I was at the drug store, checked my blood pressure on one of the machines by the pharmacy.  The machine started flashing red and gave me a reading of 147/94.  I called my midwife upon leaving there, and she urged me to come directly into the hospital to get checked out.

When you have two other kids in tow, this is no small feat. Thankfully, though, their bags for going to a friend's house during the delivery were already packed, as was my hospital bag.  I didn't know what was going to happen, but I swung by home and picked up those bags and called my friend, Kara, who at the time lived close to the hospital, to ask if I could drop off the kids for a few hours.  I think I might have shocked her when I also left their overnight bags!!

I headed to the hospital not sure what was going to happen.  I don't remember my blood pressure reading when I got there, but it was cause for alarm.  They then did some blood work which showed protein in my urine and decreased platelets in my blood.  These three things combined with all the swelling I was having brought about a diagnosis of pre-eclampsia.  

I remember the midwife coming in and saying, "I'm so glad you came in.  You very much need to be here.  The only cure for pre-eclampsia is delivering the baby and placenta, and we are going to deliver this baby tonight!"  

Tonight?!?!  Let's not forget that we were in the throes of a kitchen renovation and had just gotten a working sink two days before after 77 days of no running water in the kitchen.  Everything else in our kitchen was still in boxes.  Cabinets didn't have doors.  Every part of my house was in construction shambles.  I hadn't even gotten to washing and putting away baby clothes yet.  My other two kids had been 10 and 11 days late, and therefore in my mind, I had 3 weeks longer to get ready.

This was Wednesday, June 24th.  Pippa's due date had originally been July 10th, then changed to July 4th due to an early ultrasound.  We aren't really sure which one was correct, but either way, she was early.  

My brain had trouble wrapping around the idea of not leaving the hospital until our baby was born.  Reeling.  I called my friend, Lindsey, told her the news and asked if she could go pick up my kids from Kara and have them spend the night with her.  As I hadn't yet gotten to those baby clothes, I also had to ask Lindsey if she could bring me something for the baby to wear home. Ack!  She was so sweet and took the kids shopping for an outfit for their little sister.  

Shortly, after the news that the baby needed to come out, they started me on a pitocin drip to get labor started.  I walked the halls to encourage labor as well, but was forced to sit down by the nurse because my BP kept spiking in dangerous levels.  

With pre-eclampia, there are a few major risk factors.  Seizure is the biggest one, so normally women are treated with magnesium sulfate.  My midwives wanted to hold off on treating me with it if possible because it makes you feel pretty horrible, and labor is hard enough when you feel good.

That first night, nurses continually upped my pitocin drip each hour.  I was up to 16 mU/min and only having mild contractions.  To put it in perspective 6 mU/min gives the same oxytocin levels found in spontaneous labor.  So, the midwives decided to back off since that didn't seem to be working and try some other methods.  I had two doses of misoprostal over the course of several hours, but still not too much progression.  By late afternoon, I think I had finally dilated to maybe a 5 and they decided to break my water to see if that would get things going.

The midwife on call that day was Mary Lou.  She told me I could have a few hours for that to work, but we would need to start pitocin again if things didn't get going.  I did some walking and labor would progress, but I had to lie down every 30 minutes for a stress test on the baby and to check my BP and labor would once again slow down.

At 10pm on Thursday, June 25th another pitocin drip was started.  Around 11pm, a very kurt and efficient nurse came in and told Ryan and I that we were going to bed.  She turned the lights out and tucked us in and told us to get some rest.

I might have slept a little, but remember waking up a lot.  Around 2am, contractions were kicking in to high gear and things were getting serious.  My pitocin drip was only at 6 mU/min at this point, far less than the night before but my body was responding this time.

I asked the nurse to fill the tub, because I knew I wanted to do most of my laboring in the water.  Ryan was still asleep and since I had a nurse and Mary Lou there, I decided to let him sleep and not wake him at this point.  Hoping that after I had the baby, he would be better rested and I could have a nap!

I labored in tub for a few hours, with contractions getting stronger and stronger.  I remember Mary Lou pouring water on my back during contractions and I remember her saying she could tell I was a good mom.  Labor was getting hard, but I was much more relaxed than with my other two births.  And then around 5 something, I started transitioning and had a super strong contraction during which I totally felt Pippa's head shift downward in the birth canal a couple of times.  Mid-contration I said, "She's moving down!"

Mary Lou then said to let her know when I felt like I wanted to start pushing because I would need to get out of the tub.  I told her that I needed to get out RIGHT NOW!  I made it to standing beside the bed and had another strong contraction.  That one woke Ryan up.  He was stunned that I was already that far along, and he'd slept through most of it, but I really felt like it was better for him sleep during that.  I had enough support and seriously, how many people can you fit in a tiny bathroom anyways?

I got on the bed and the very next contraction, Pippa was crowning.  And one more contration, and I was able to push her out.  When they handed her to me, the first thing I said was, "She's so small!"  My other kids had been 10 and 11 pounds, and she was only 6 pounds 4 ounces.  Compared to the other labors and deliveries, she was a piece of cake.  So much easier to push out a baby half the size.  She was born at 5:42 am on Friday, June 26th and was 19 inches long.

Since I had hemorrhaged with the other two births, we just assumed I would with this one.  We had a doctor on standby and I was given a shot of pitocin immediately to try to get my uterus contracting and closing up blood vessels.  As with Leif's birth, my placenta wasn't delivering, so they decided that they would have to remove it manually.  The midwife tried, but then passed me over to the OB.  They gave me some pain meds to help, but it didn't do much besides make me feel a bit lightheaded.

I had to pass the baby to Ryan, because I was feeling a little woozy, and as a big proponent of skin to skin, I asked him to remove his shirt to hold the baby.  He looked at me like I had three heads, but he did it.  I later heard she was totally suckling his chest.  Ha!

Once they finally got my placenta out (apparently, mine grow really strongly into my uterine wall), I, as expected, started hemorrhaging.  I don't really know what they were doing or how they were trying to stop the bleeding.  I think more pitocin and uterine massage.  Ryan said that at one point he looked around and counted and there were 15 medical staff in my room.

I lost close to 2 liters of blood, but thankfully they were able to get it under control without having to do anything drastic.  My hematocrit was down to 21.  At 20, we're talking blood transfusion, but I was doing well enough that we decided against it.  I don't know what it's like to have a baby and not lose a ton of blood and be totally wiped out by that.  It's just what my body does.

Things are a bit of a blur after that.  I think I slept a lot that day since I'd been up for two nights in a row.  I know I had a catheter, so I wouldn't have to get up to go to the bathroom.  I think they took that out the next morning and I was able to take a shower and get cleaned up.

We were discharged on Saturday evening.  On Sunday evening, I had a terrible headache, and I had noticed that my swelling wasn't really going down.  So, at midnight or some ridiculous hour, we headed up to QFC for me to check my blood pressure at their pharmacy machine.  It was 173/102.  Crap.  Called the midwife and headed back to the hospital.  My blood pressure was even higher when we got there.

In the ER, they explained that normally in most cases pre-eclampsia is cured with the delivery, but not in all cases.  I was one of the few.  They put me on magnesium sulfate for 24 hours.  I don't think I've ever felt so bad in my entire life as I did on that drug.  My nurse kept my room dark and basically told me to stay lying down.  My liquids were rationed.  I could only have a certain amount of water each hour...and it wasn't enough.  I was so thirsty and my head hurt so badly.  And all the while, I'm trying to be mom to a teeny newborn.  She was a champ and we learned early how to nurse side lying because it was all I could do right then.

I was so thankful when I was finished with that 24 hours.  I felt like I was really missing my baby's first days of life.  We stayed on at the hospital as we watched my blood pressure which remained elevated.  As doctors would change shifts, I would get a new recommendation with each one.  One was really pushing a blood transfusion, but they decided to try an iron drip instead which made me feel a lot better.  They had stopped really monitoring my BP after the magnsium, but as they were trying to discharge me, I told one doctor I still had a massive headache.  They checked my BP and found it was still really high, so they decided to put me on BP meds to lower it.  Some docs were saying I needed to go and others would say I needed to stay.  It was ridiculous and confusing.

I finally was discharged on Tuesday late afternoon, I believe.  So relieved to go home and be in our own space and finally get to relax with that sweet baby.  Scout and Leif came home on Wednesday.  We were so thankful to have them taken care of for a whole week by various friends and family.

I was on blood pressure meds for about two weeks, but have been totally fine since then.

I'm sorry that I waited so long to write this.  I've lost so many of the details over the course of the last twelve months of sleep deprivation and life.   I want to remember it all.

Welcome to the world, Pippa Rose!  Welcome to our family.  We love you and you were worth it!

**these beautiful photos taken by the amazing Tatiana Skye Photography


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