Caleb James

Last week was quite eventful for us! I went in for my prenatal appointment last Monday to find that I was suddenly measuring 4 centimeters smaller than I should have been, especially since I had been on track up until that point. My ob/gyn was also concerned about the estimated small size of Caleb compared to what the other two were. I also was dilated 3.5 centimeters (I had dilated 1.5 cm in a week) and having no contractions yet. Due to his concern, he wanted us to consider inducing and because we didn't want to risk the safety of our baby, we agreed. Dr. Vanwingen said he wanted to break my water on Wednesday morning and the only times the hospital had open were 3:00 am and 5:00 am. We chose the 5:00 am.
Needless to say, I barely slept Tuesday night. We actually spent the night with some friends in GR since they would be watching the kids the next day and we were going to be delivering at Spectrum so it put us closer on the actual day, or should I have spontaneously gone into labor on my own the night before.
The day went nothing like we thought it would.
We arrived at the hospital and pulled up to the ER entrance, which is where we were told to go. Apparently I must have looked too calm to be having a baby because they asked if I was being induced and then said we had to park, walk in ourselves and then ask what floor to go to. So we did. They told us the second floor. We walked to the second floor and announced what we were there for. They told us to go to the third floor. Well, for crying out loud. I just wanted to settle in and have a baby and already I felt confused.
Once on the correct floor, they hooked me up to be monitored for a little bit. A young looking resident came in and said that he was going to check me and break my bag of waters. After a quite painful examination to which he said I was 3 - 4 cm dilated, 30% effaced, with a cervix that was extremely posterior (huh??) and no bulging bag of waters, he declared that he was going to call my doctor and probably start me on pitocin because there was no way he could break a bag that wasn't bulging or couldn't even be felt. He and the nurse left and I turned to Tim and started to cry.
I really wanted to labor without an epidural and to do that, I really wanted to be able to stay away from pitocin, too. All I ever heard about with pitocin was that it goes hand-in-hand with the epidural.
The nurse and resident came back in and said that Dr. Vanwingen was on his way into the hospital to break my water himself. I was so happy. To kill time and try to help get things moving, Tim and I walked the halls for a bit. We returned about 6:30 and a few minutes later Dr. Vanwingen walked through the door. He sat down on the bed, examined me and told the nurse I was 4 cm dilated. He explained to me that there are hospitals that teach their residents how to break the bag of waters and there were others who pushed the pitocin. While talking, he took a hook that resembled one you would crochet with and broke my water. No problem for him. I always joke with Tim that this doctor has magic hands because his exams barely hurt, too.
We waited as Dr. Vanwingen talked some more and watched me. He mentioned his concern that I didn't seem to be losing much fluid from the bag breaking and that it might be low and he wanted things monitored more closely. They put a pressure catheter - I think it was called that - in to my uterus to monitor my contractions more precisely and see how they correlated with Caleb's heart rate. It also was meant to irritate the uterus and cause it to contract. Thankfully, by the time Dr. Vanwingen left a short time later, I was starting to lose more fluid and he left feeling better about the situation. We decided he would call around lunchtime to see what progress there was and go from there.
We spent the next five hours walking halls (not comfortable with the catheter and gushing fluid), sitting on the labor ball and resting in the bed. My parents joined us mid-morning and visited a bit. By lunchtime we had had no progress and no contractions, besides the occasional one or two. We decided that when Dr. Vanwingen called, we would tell him we were ready to try something different. At this point, I was starting to think things were going to end in a c-section because apparently Caleb was not willing to leave the womb.
Dr. Vanwingen talked to Tim and then called down to the nurse's station to start us on pitocin. I was not thrilled, but was still holding to the possibility of having it without an epidural. (If you haven't been reading my blog long and are curious as to why I was so anti-epidural, read this post about Ellie's birth experience along with the bad epidural experience resulting in a spinal headache.)
We started the pitocin low, .5 ml/hour. I asked how high it went and the nurse said most women respond at a 4 or 6, but some make it to 20. We all figured I would be one of the lower numbers since I was dilated as far as I was and my water wasn't intact anymore. Well nothing happened over the next couple hours as they increased it to 1, 2, 4, 6, or 8. By this point, my sister had made her husband cancel and reschedule his dermatologist appointment so they could get over to GR since she was so worried I was going to end up in a c-section as well. When they upped me to 10, things started rolling and then she upped it again to 12. At this point, the labor ball, which had been nice in the beginning, was starting to annoy me and I needed something different. I moved to the bed and continued with the breathing. The contractions came closer and stronger and I got to a breaking point. Tim had been doing an awesome job coaching me on breathing but I screwed up once and then got thrown off.
So I started hyperventilating. This led to a lack of oxygen getting to my feet and hands, which made me freak out even more, since I felt like I was slowly being paralyzed. My legs were tingly and my hands felt swollen and I couldn't bend my fingers. I kept obsessing and asking why I couldn't bend my fingers to curl around Tim's hand during contractions. My blood pressure and vitals were great and even Tim told me later that he thought I was just freaking out and overreacting. He said it finally got to the point where he realized I was telling the truth when he saw the veins in my hands bulge out every time I tried to move my fingers, but they wouldn't move. The nurse gave me the oxygen mask and after lots of deep breaths, feeling returned.
Can I just say I really hate that oxygen mask? Oh, it was so annoying to feel it over my mouth and because I had hyperventilated once, they wanted it on me when I started pushing later.
Anyways, during all that chaos, I asked for a dose of Stadol. Stadol has become my best friend in labor, besides Tim. It took the edge off the contractions. I still felt them very strongly and clearly and Tim still had to coach me through each one because it hurt like crazy, but I just didn't care. It was such a bizarre feeling, like how I guess I would imagine being high on something. They told me the Stadol would last about an hour or two and then I could get another dose if I wanted. I didn't need one because by the time it wore off, Dr. Vanwingen was walking back through the door. He checked me and declared I was at a nine and that after I went to the bathroom (I had to pee so bad), I could start pushing to move the baby down because he was still a bit high up.
Now, at this point I just want to say that it really stinks to feel like you become bi-polar while you're delivering a baby. Especially when you can feel everything. I would push and yell because my doctor would be stretching my cervix out at the same time and it hurt like crazy. Then I would apologize between contractions. Tim kept a cold washcloth on my head - that was amazing - and a nurse eventually put warm washcloths down in the delivery area, which also felt great, and I believe helped me to avoid a bad tear. So on and on we went for an hour, pushing/yelling, changing positions, re-wetting cold
washcloths, etc. Dr. Vanwingen checked me again and said Caleb's head was not turned the way it should be and the position-changing had helped it move a bit further, but still not where it should be yet. He also had been watching the monitor for the past few contractions and noticed that with each contraction, Caleb's heart rate would drop and then take a long time to pick back up. He said we were going to have to look at the possibility of using the vacuum. I asked him if he wanted to use it them or still have me push longer and he said it was up to me. I was so concerned about Caleb at this point: the small size of everything, the meconium-stained fluid from my water breaking, the dropping heart rate and fact he seemed stuck in there that I said, "Let's just do it now."
I guess I never realized that when they referred to using a vacuum, they actually mean a little suction cup that they insert inside the mother to attach to the baby's head. I didn't realize this device was headed inside me. More pain. After my delivery, I heard Dr. Vanwingen tell the resident that had stepped in to help with the delivery that most women take another 3-5 contractions of pushing/suctioning combo to deliver the baby.
We got him out on the first contraction.
I described it to Tim like this, the pain was so much that I either had to keep pushing during the contraction and get him out, or I was going to give up and die because I couldn't do it any more. So I pushed like I never had, while yelling at Dr. Vanwingen to "get this kid out of me" and "Stop hurting me." I looked down as Dr. Vanwingen pulled Caleb up and the first words out of my mouth were:
"He has dark hair!!" (You don't know how I have longed for a child that actually looked like me at birth; I was born with a mass of dark hair and kept hoping he would have it, too.) I looked at Tim who was laughing and, of course, crying. They put Caleb on my chest and we just kept laughing in amazement at (a) the hair and (b) we really did it without the epidural!
And then I started to apologize over and over and over to everyone in the room that had to endure my yelling at them. I said, "I'm really not a mean person. I am so sorry." They said, "No, you're a woman who didn't have an epidural! You reacted like they do. We expect it." That made me feel a little better. I will say this, too - this is my first labor in which I never swore once. I said at least one word with the other two at some point during the process, but not this one. So I yelled, but at least I didn't cuss anyone out. I would feel even worse.
So there is our story behind Caleb's birth (Lacey asked and as a result you all get to read it.)
The stats:
Caleb James Ross
3/31/10
6:27 pm
6 lbs. 9 oz.
19 1/2 in. long
And everything turned out healthy and great! He is considered SGA (small for gestational age) but at his pediatrician's appointment this morning (he is 6 days old today) he has grown an inch and not only regained his birth weight from his discharge weight, but put on a couple ounces as well and is now 6 lbs. 11 oz. His pediatrician is impressed because he said most breastfed babies take 2 weeks to regain their birth weight, so whatever I'm doing for nursing, keep on doing it.
Caleb is a blessing to our home. An unexpected one, but one we can't imagine our life without now. He is absolutely handsome with great coloring and a face like Noah's when he was a baby.