Nicholas' Birth Story, Part I

Nicholas is eight weeks old today and he'll officially reach the two month mark later this week, so I think it's time to finally share his birth story before I start forgetting details. The story really begins at my 20th week of pregnancy when we learned that he had a somewhat rare umbilical cord abnormality. Instead of having two arteries and one vein, as umbilical cords typically do, he had just one artery and one vein-- or a two vessel cord as it's known. This occurs in about 1% of babies and usually poses no serious problems. In fact, it wasn't even something doctors could diagnose until the mid-90s when ultrasounds became strong enough to see that the cord was missing one of its three vessels. Still, there are some rare but serious risks, including complications with the heart and kidneys, significant growth restriction, or, at the end of pregnancy, cord accidents that can result in a stillbirth. A visit to the perinatologist at 20 weeks helped assure us that his heart and kidneys were just fine, but I had to undergo weekly ultrasounds and biophysical profiles beginning at 32 weeks to make sure Nicholas' growth was on track. And, I couldn't quite shake my nagging fears about a cord accident.

During my third trimester, the perinatologist advised us that I should be induced early at 38 or 39 weeks to reduce the risk of a cord accident. My doctor was less concerned, and I had initially wanted as natural of a birth as possible, so I wasn't thrilled with the idea of an induction. But, as I grew bigger and I started feeling fewer of Nicholas' movements (a normal occurrence considering he was pretty squished in there), I became increasingly nervous about letting the pregnancy go to 40 weeks or beyond. After one evening of feeling no activity whatsoever at 36 weeks that landed us in the maternity ward for an evening of fetal monitoring (a fun Friday night), I started leaning towards the idea of an induction. I went back and forth with Jason and with my doctor. Both were supportive of whatever decision I made, but my doctor wanted to minimize the risk of a c-section that might result from an induction when my body just wasn't ready. Finally, we decided to do the induction at 39 and a half weeks. My doctor said he would give me a very light dose of medication to try to induce labor, but if, after 18 hours or so, I just wasn't progressing, he said he would send me home and we would try again at 40 weeks. I agreed, but was really hoping I wouldn't get sent home from the hospital.

On Sunday January 22nd, at 7pm, we checked into our maternity suite. They got me all hooked up to all the monitors, inserted my saline lock (ouch!), and asked me about a million questions to complete my registration. Then the nurses gave me a small dose of medication to help soften my cervix. The drug typically doesn't induce labor on its own-- although it can in some women-- but it makes for a more favorable outcome when labor is later induced with pitocin. At first I felt nothing, and Jason and I killed time watching an NFL playoff game (the Giants vs. the 49ers) and whatever random sitcoms we could find on TV. I had brought a bag full of entertainment, including some magazines, a novel, and a sewing project for Nicholas' nursery, but I didn't read more than a few pages of my book. Between my excitement, nerves, and the still sore IV site, I couldn't concentrate on much.

Eventually, I started feeling some light contractions. Around 10 or 11pm, my nurse gave me a sleeping pill. It worked only slightly. I tossed and turned most of the night as the contractions grew stronger. However, they were still very irregular, and I could tell they weren't quite enough to send me into full-fledged labor.

At 7am on January 23rd, my doctor came by to check my progress. I hadn't dilated any further (I had been at 1cm for about two weeks), but I was now 70% effaced. My doctor decided to give me another dose of the softening medication instead of starting the pitocin, and within an hour or so, I was feeling stronger contractions that were coming every 3 minutes. For about two hours I was managing to breathe through them pretty well, but around 10am they picked up in intensity and I really had to focus on breathing strong through each contraction. I could tell I was starting to make some real progress and began to suspect an epidural was in my future at some point. Throughout the morning, both Jason and my nurse, Ed, were amazingly supportive and encouraging. Yes, I had a male L&D nurse and I loved him. He was fantastic.

At 11am, my doctor came back to check my progress again. This time, we were all pleased to discover I was dilated to 4cm. At this point, my doctor declared he would not be sending me home and I would be having this baby today. He informed me that he was going to break my water, and before I even had time to process this information, it was done. In retrospect, I would have asked him to wait until later. Lesson learned for next time. Within about 30 seconds another contraction hit, and instead of managing it with some heavy breathing, I could barely manage to stay on the bed. The pain had jumped from marginally tolerable to absolutely excruciating. My goal of holding out on the epidural for a bit longer went out the window and I loudly informed the whole room that I wanted one immediately. At this point Ed had to leave for a few hours to conduct a tour for visiting state inspectors, and the new nurse informed me it would be at least 45 minutes before the anesthesiologist would arrive. I knew I was in for a very long 45 minutes.