Before we knew, Lin and Li are almost 2 weeks old. Lin weighs over 8lbs already, and Li is almost 8 lbs (their birth weight were 7lbs 2oz and 6lbs 15oz respectively). We are working out the milk problem and currently supplementing donor’s milk for them. Overall, the boys are doing great, it’s been almost a week that we only need to get up once during the night to feed and change them, they don’t seem to wake each other up yet (we are lucky on that one) and for the most part, they are not fussy at all if they are fed and changed. They start to smile, and show interests of being entertained, and the cutest of all, if we place them far apart, somehow they always manage to get closer to each other.
It’s been a while since we had the time to even think about writing the blog…but I am glad we waited, time was needed to think through the birth experience, and in a way, to come to terms of what happened with our own observation and analysis.
To describe our birth story in a nutshell, the whole pregnancy was a victory, we were under excellent care of Dr. Gil and it wasn’t surprising to us that we made it almost full 41 weeks and had two 7lbs babies, healthy, alert and beautiful – both of them were born with Apgar score of 8 at 1 minute, and 9 at 5 minutes, no jaundice, not even a birth mark. Even though the first couple of days were extremely difficult and challenging, we can’t take our eyes off of them. Holding, nursing, talking to them becomes such joyful moments of our life and they almost seem to understand what we are saying, being parents is indeed the most amazing feeling in the world, and somehow, getting 2 or 3 hours of sleep everyday doesn’t seem to stop us from functioning at all.
On the other hand, the labor and delivery part was something that we don’t want to look back too often, we had a lot of things going for us, babies were doing great, both head down, none of the routine tests was alarming, we hired an excellent midwife as our doula, a practice we thought who supports natural birth, and a hospital that’s close by and has all the things we were looking for to facilitate a birth that we desire. But we were very disappointed, and I, still ended up with a C-section after a long, difficult labor for almost 24 hours without Pitocin and Epidural. As a result, Baby A Lin has a little cone-shaped head while his brother Li doesn’t.
To fully understand what happened is really difficult, since every birth is different, and there’s no way to know how the birth would have turned out to be if any of the decisions we made were slightly different, but it doesn’t take long for us to figure out what could have been done to improve the birth experience, a series of unnecessary medical intervention (some were forced on us) lead to a chain of events that worked against us. Let’s start with a few days before I went into the labor.
The Thursday of the the 40th week, I had an OB appointment, since Dr. V, our preferred doctor was out of town, Dr. Grana checked me, and the result was still the same – 50% effacement, and half centimeter dilated. We only saw her once and we didn’t quite agree with her opinion of having ultrasound every four weeks, we ended up having 4 in total, at 11th, 21st, 31st, and 38th week. This was the third cervix check I had done, I had waited till late 39th week because the results are not the indicators of when the onset of labor would be, but sometimes it poses risks for infection and it can cause the rupture of the membrane. The following (Friday) night, I woke up noticing there’s leaking of a size of a quarter on the sheet, and I wasn’t sure if it was urine or amniotic fluid. Since the amount was so small, we waited till the following Monday and told the CNM Kim about the leaking, she tested the fluid and said it’s amniotic fluid (at the time we didn’t know if she did a nitrazine test or a fern test), so we were told to go to the hospital right away and get induced. We were very surprised to hear that from a nurse-midwife, we came home, and got second and third opinion from Audrey and Dr. Gil, did some research online, and found out that it could be just condensation of the fluid, and sometimes even a small rupture of the membrane does seal up (in our case, it did after a day or my water was never broken!) and we decided to wait for a few days since we think the labor will start on its own very soon anyway, plus other than the cervix check, there’s no activity that we had done to cause upward infection. So we called back the office and left a message for Dr. Grana and let her know that we wanted to wait, if nothing happens, we will go to the hospital first thing Friday morning.
The following day, a CNM called us again, her name is Luci who we have never met, she talked to us about the risk of infection, we asked her if the test they did was nitrazine or fern test (fern test is the one that confirms that sac has broken), she didn’t answer directly but said, if it weren’t positive, we wouldn’t be having this conversation, so we still had no idea whether my sac really broke or not (until during the birth)! She also said that I don’t have enough amniotic fluid, Michael and I asked her if we can go into the office and have the fluid level checked, which was what Kim wanted to do the previous week. If there’s not enough fluid we would go into the hospital immediately.. Luci said no, we were very surprised, Michael asked her again, “are you willing to provide the service that we requested?” Luci refused, and said they won’t see us in the office but the hospital. So we stated that we understand their concerns but as patients, we have decided to wait just a few more days, in the mean time, carefully monitoring my temperature. Wed night we had dinner with Audrey and just went over our game plan, since my mucous plug came out already, we knew soon I would be in labor.
Thursday morning around 2:30, I started feeling the discomfort in the stomach. It lasted for couple of hours, but it’s nothing like I thought for labor, it felt more like I had a stomach virus, so even through next morning, when Michael decided to call Audrey, I still wasn’t sure if I were in labor. She came around 11:30am, and checked me, telling me that I was 6cm dilated already! I couldn’t believe my ears and we were all excited and right away we started getting things ready, after a quick lunch, we were on the way, the ride was only 5 minutes to WakeMed Cary, we checked in at 12:30pm, everything was fine. And I was put in a labor and delivery room. Dr. Grana showed up, first thing she said, “you are famous in town with the broken water!” Then a nurse came in, and checked my temperature, 100.5 degrees (100.4 being the normal temperature), we were all surprised, since just before we left home, we checked the temperature couple of times, it was between 98.2 and 98.6 degrees. So we asked the nurse to check my temperature again, she did it this time under my armpit, and she said it was 99 degrees, and she needed to add 2 degrees to get the internal temperature (???). Dr. Grana then said, it doesn’t matter if I had a fever or not, she will put me on antibiotics, since I’ve been carrying a broken sac for days. The nurse tried to put the hep-lock in my arm as I requested, instead of my hand, and she blew my vein on both sides, and had to call another nurse to come in and put it in my hand! So two antibiotic and IV fluid were on. Later on, they added one more antibiotic to cover more types of potential infection. Audrey asked about the catheter to drain the urine, Grana’s reply was it’s not a routine so there’s no need for it. She quickly did an ultrasound to confirm that I can try to deliver vaginally and left.
The whole labor was a blur, I don’t really remembered too much of it but I do remember throughout the labor, my back ached a lot (later on it turned out Lin was in OP position) so it wasn’t like what people described that between the contractions there’s a break, my back was aching all the time, and the contractions were closer to each other for sure, we were determined not to use Pitocin and Epidural so I did feel every bit of it, I remember it was difficult but it was still manageable (I do remember thinking there’s a reason people want Epidural though). Michael, Audrey, Mom were with me, along with two excellent nurses Anne and Aimee, the only problem was that since I got to the hospital my labor has slowed down tremendously, and the transition felt like never-ending, it lasted for 4~5 hours! After 5pm, Dr. V took over the shift but apparently he was under the assumption that I am having a fever and had an infection, since the progress was so slow, after 10 hours in the hospital, I still wasn’t fully dilated. In the evening, Dr. V broke the sac of Baby A, and there was pretty dark maconium in it, at that point, I think we all knew that my water wasn’t broken to begin with since there would be maconium leaking if that was the case.
The biggest problem now is that I have been drinking so much water, I was so thirsty ever since I got to the hospital, each contraction, I would drink a lot of water, and I would have the sensation all the time to urinate but couldn’t. However, there’s a lot of BM, poor Mom and Michael, they were cleaning up my mess throughout labor. Because of the antibiotics and IV fluid, I was confined to bed all the time, couldn’t use the Jacuzzi, not to mention that I was on continuous EFM at all time – all these things were the opposite of what we desired and were clearly stated in our birth plan.
Finally at 11:30pm, I was fully dilated! Then a nurse came in, and told Michael that we have to go into the operating room, we were shocked, since Dr. V agreed with us to deliver in the labor and delivery room and that’s what he signed off. Michael explained the situation but I was too tired to fight it at that point, all I wanted is to get the babies out. So they wheeled me into the OR, only two support people were allowed, so Audrey and Michael stayed with me in the OR, and Mom waited in the LDR. I suddenly realized it was not a good place to be, the temperature there was 50 degrees, my body was shivering, and it was really really bright with the surgical lights, my labor stalled again from contractions on top of each other to about 7 minutes apart. It was freezing that the nurse brought me socks but just like what I read, a cold environment is damaging to the labor. Under the light, Audrey saw my bladder was bloated (the nurse thought it was the baby) and asked to drain my bladder again, at this point, I had been in labor for almost 23 hours, and THEY TOOK OUT 1500CC URINE OUT OF ME!!! No wonder Baby A couldn’t come out, there’s a huge water bag in the way blocking him from the birth canal. We were furious, even though the bladder wasn’t an issue at that point, my body was just not working well any more, after two hours of pushing, Baby A moved from +1 station to +2 station, Dr. V said my infected uterus wasn’t strong enough to contract at that point (which of course I do not agree that was the reason). During the two hours in the OR, Audrey helped me try various positions, and the nurses were cheering for me at each push. They were all very kind. Baby A turned out to be in posterior position, and we tried vacuum extraction (only after Baby A was at least at 2+ station) and he tried to turn him into anterior position but Baby B’s head was in the way so that didn’t work. It was too late in the game to turn. Audrey later told me with an OP baby, it takes at least 4 to 5 hours to push him out. Dr. V also tried forceps but I am glad that he didn’t force it, it was nice of him to say no after a quick attempt. By 2:30am, 24 hours almost to the minute since the labor started, we went for the next option – Cesarean. Michael held my hand, and both of us had tears in our eyes after such a long and difficult labor. Since the boys’ heart rate has been so stable all through labor other than at 1:30pm when the antibiotics were put in, I had plenty of time to get a spinal. Michael and Audrey had to leave the room while the anesthesiologist did his part, then Michael was let in, everything went on pretty quickly but I felt even colder, my hands were uncontrollably shaking, before we knew, we heard the baby screaming, they told Michael, “Daddy look up!”, then Michael said, “they are beautiful!”. The boys were sent in after they were cleaned up, and we took our first family picture.
Three hours later, at 5:30am, the boys were in our postpartum room, I was pretty alert, and we were glad that we finally got to hold them before the 4-hour window goes away, they latched on immediately with no problem. Although it broke our heart to see them having hep-lock and bandages already. They were put on three different kinds of antibiotics and apparently blood was drawn as well, we had to wait 48 hours for the blood culture being tested before they stop giving them antibiotics.
The hospital stay was okay, we didn’t quite like the fact that there’s no chance we would get any rest, people come and go so frequently, even at 2pm in the morning, while we were trying to get some sleep, they still came in even though we had a sign on the door. The first couple of days of recovery was very painful, so I took the pain killer, and as soon as we are cleared of all potential problems, we decided to go home right away. All the blood culture test of three of us came back negative, like we thought, my water never broke, neither did I have any infection.
We are struggling now with the milk production now, my milk didn’t come in as expected – one of the main reasons we wanted to wait for the onset of labor rather than getting induced was to be able to breastfeed – I couldn’t understand why my milk didn’t come in on time, after a lot of research, we believe the answer lies again, in the IV fluid – it causes the imbalance of the body fluid, see the following link, we talked to some friends who had milk problem, almost all of them received fluids. See this article:
We looked back and thought about what went wrong during the labor:
– The IV fluid was totally not necessary. It didn’t solve the thirst problem, I was constantly drinking water; it dilutes the oxytocin, and probably weakened the contraction; It filled up my bladder and prevents the baby to descend; It confines me to the bed, and limits the mobility; It delays the milk production by diluting the hormone (Endocrine Control System) and causing imbalance of the fluid.
– Change of location definitely slowed down the labor, I wasn’t even sure that I was in labor or not when Audrey came, but once I got into the hospital, then the OR, it was apparent that the labor slowed down or stalled. Also being put on antibiotics and IV fluids, many labor options were taken away, such as walking. I still don’t know how anyone can push the baby out in the OR- it was freezing in there.
– Not getting support from the doctors, we felt that we were being “punished” for not going into the hospital as they requested. When we were at the hospital, all the nurses knew I was the one with the broken water for 8 days, my water wasn’t broken, and it was the fifth day my labor started on its own since I noticed the leak.
– The antibiotics may be the reason Baby A had maconium, their heart rate shot up at 1:30pm, when I was put on antibiotics, they also received the antibiotics for 2 full days unnecessarily, days after they came home, their hands and heels were still black and blue.
For the above reasons, the labor and delivery left us with the feeling of being defeated vs. a sense of accomplishment during pregnancy, and it was not a good memory to share with our kids in the future. However, we are proud of ourselves for doing all the learning, researches (unfortunately what happened to us could have been predicted and prevented, but there’s very little control once we were admitted to the hospital), and we were able to at least try our best for a non-medicated birth (Dr. Gil said we got an A+ for it). With this experience, we will definitely go for a VBAC home birth if we ever decide to have another child.
The boys are growing fast once Dr. Gil put them on the probiotics to counteract the antibiotics they received at the hospital, they are truly precious and even though the birth experience was not great, we will get over it soon watching them thrive everyday. After all, the delivery is still a small part of a healthy head start, we’ve given them the best insurance of good nutrition and no-stress pregnancy, which will benefit them throughout their lives. And we are so appreciative of our friends: Dr. Gil, Audrey, David and Johanna, Welkin, Nora and Joe, Michele and Kim, who have been giving us unconditional support and great advice to make the pregnancy a great success. Also our gratitude goes to some excellent childbirth educators like Kathy, Bonny and Elissa. Michael made a video that recorded the precious moments of our pregnancy, something we will cherish forever.
Here are the pictures of the boys!