Day 28: The Finale of The Prolonged-Early Arrival of Quinn Collins, Part 3

Finally, let's see if we can get this series wrapped up! Click on the links to read Part 1 and Part 2.

Sept 5, 2013

I got up around 4:45am in the morning to make sure I got a complete shower and shave in, along with a touch of make up before giving birth… you never know how long the labor process is going to take and how you will be feeling afters, or what state you will be in. I can probably count on one hand the number of times I have not gotten to shower in a day, in the last 5 years. Yes, even when I have the flu or am newborn-baby-sleep-deprived, I shower. Showering daily is basically in my DNA. Besides, labor makes you not only feel awful, but look terrible! A little mascara can go a long way to helping a girl feel a tad better about herself.

As I was getting dressed, I told Jared I was really glad today was the day, as I didn't feel like Quinn was being active enough for my liking. Again, she was reactive, but her own independent motions seemed dramatically diminished. And again, I felt like my abdomen was tiny in comparison to what it had been before.

Oddly, I was not have experiencing any pain contractions. I remember thinking great, I have been miserable all week with contractions, and now that I really need them to work for me, they quit.

Just my luck.

By 6:30 am, I was in a hospital gown, hooked up to a fetal monitor, and having my IV placed. It felt so different from the last time, when it was all new and unknown. Instead, it felt like just yesterday that we had been here for Ellie Faith's birth.

Some of the same nursing staff were there from last time, and remembered us. Everyone seemed to think this labor would progress much like Ellie's, and that Quinn would be in our arms between 12-2pm. I continued to prepare myself for something different, like a marathon of a long labor.

The monitor showed mild, but consistent contractions, and Quinn's heart rate was holding rock solid steady at 145. Exactly were she had hung out the entire pregnancy.

Good, she is just fine. Probably just a little tired, like her mom, from all this stupid prodromal labor nonsense. 

This greatly relaxed me. Once I could hear my baby second by second, I had the constant reassurance she was ok. Now, I just started to prepare for, and dread, the labor aspect.

I had made a  Labor Playlist, much like I had prior to Ellie's birth, but I opted for a quiet room for now, in hopes of getting some rest.

Side note: when I had been making this playlist Jared thought he would be sooooo witty by saying he knew what my labor theme song would be this time: Roar by Katy Perry. The glare I gave him nearly made myself a widow. Needless to say, that song did not make the cut.

Jared and I tried to catch a few minutes of sleep during the nurses shift change, before the pitocin got started, and the "real" fun began.

My day shift nurse was Rose, and she was about to become my new BFF, ally, and advocate. She was pure Bostonian - thick accent, catholic, and cussed like a sailor. But kind of grandmother-ish too. She was awesome! The nurse in me could tell instantly this woman knew what she was doing, and she did a good job doing it.

Sometimes when I am in a medical setting I don't tell people about my own nursing background. Just depends on the situation. In this situation, I wanted everyone to know, in case Quinn got compromised, something went wrong, etc… I wanted the real facts, and I wanted them quickly and succinctly. I didn't need much in way of wordy explanations. I also wanted them to realize I was capable of making informed decisions. This ended up really paying off in the end.

Rose and I chit-chatted about all things of the nursing profession, while Jared sat back and made of us and rolled his eyes.  I gave a pretty short but detailed description of my labor with Ellie, so Rose understood what my goals and expectations were this go around… and that I wasn't the quietest of laboring patients.  (Hence the Roar theme song suggestion.)

One of the main things I wanted really wanted to be different with this labor was to keep my bag of water intact as long as possible.

"So when are you going to start my pitocin?" I finally asked.

This was when Rose told me that she had decided to wait until the midwife arrived on the floor to start pitocin, even though she already had the orders in hand.

Apparently, I had been listening to Quinn's heart beat with my mommy ears and not my nurse's ears. While Quinn's heart rate was holding steady at 145, she was not having any accelerations after my contractions. In fact, she had had a few decelerations already. For the lay person, late decelerations tend to indicate placental insufficiency, and poor blood flow.

I wasn't too concerned when I heard this. If anything it just reassured me that I was right in noticing that Quinn's movements and actions had changed and that is was definitely time for her to come out.

By the time my midwife arrived, there had been a few more decelerations on the monitor. After talking through it, we decided we would in fact go ahead and break my water, while holding off on the pitocin. The thought being that breaking the water might self induce my labor/speed up and intensify my contractions more naturally then pitocin, which can be hard on the placenta. Also, my OB-GYN was in surgery, so on the off chance something went wrong, we wanted him as readily available as possible.

Because of the decelerations, they wanted me to stay in bed to keep a close eye on Quinn, so no walking around.

Right off the bat, I was having to let go of any ounce of control I had hoped to maintain.

They had a much harder time breaking my water this go around, because apparently there wasn't much amniotic fluid left, as it pretty much just trickled out, as opposed to the typical gush. I was 4 cm dilated and 90% effaced. It was around 7:45ish.

I don't really remember the exact times of things after this point. My mom showed up at some point, but I don't remember exactly when.:)

Around 9:30-45, decels were still happening, and my contractions hadn't picked up a whole lot. They decided to do an amnio-infusion (place a catheter between the baby and my uterus to infuse warm liquid to help ease the strain of labor on Quinn) as well as place a scalp monitor just to make sure the decels were in fact decels. I was around 5 cm.

FYI scalp monitors hurt like crazy!!!! My advice, do everything possible to avoid them unless you have an epidural. Good Gosh, it was awful. I am sure the addition of the catheter through  my cervix to my uterus wasn't helping either. In addition to natural labor. Just a few too many things going on down there for my liking!

As luck would have it the infuser they needed for the amnio-infusion was in use in surgery, the second floor set up was no where to be found, and central supply in the main hospital was "coming with it" for over 1.5 hrs.:) So the infusion never got started. Those who have worked in a hospital setting understand this scenario with all too much familiarity.

Around 10:30, my OB-GYN came in to check on us. He hemmed and hawed with Rose and the midwife looking over my contraction and Quinn's heart rate graphs. He felt confident that Quinn was fine now, and that it was more an issue of my placental blood flow. The big question was, how long could we go on like this, and how would my placenta and Quinn react to transition.

After the doctor left, Jared did what he always does when we find ourselves in these medical situations - he asked me, "so what do you think?" My answer was short and to the point, "Probably a c-section."

About this time my contractions kicked it up many notches. I was having to close my eyes and breathe through them. They were coming every 5-7 minutes and lasting for 45-90 secs. I could not move comfortably with those dang chords and wires hanging out of my crotch, so I couldn't rock, which is the motion I prefer during contractions. But I was somehow able to go completely limp, and just breathe extremely deep with each wave of contractions. I was willing those babies to work for all they were worth with every cell in my body.

In spite of all the in and outs of medical staff, changing of plans, and beeping of monitors, the room was extremely calm. The lights were low, people spoke quietly, and it was just pretty chill. No panic. We hadn't turned on my Labor Playlist. Instead I think Jared and were just both continually praying silently for peace, safety, and wisdom.

Even as Jared and I began to discuss, what I figured was a rapidly approaching c-section, we both were completely matter of fact and unemotional (in the way of negative emotion). I decided that even if they decided to continue to let me labor, especially with pitocin, that I was going to get an epidural.

My thought process was that if I ended up needing an emergency c-section, an epidural already in place was my best chance of avoiding general anesthesia. Plus, I know how important it is to relax in order for labor to progress. Even though I was overall calm, I was worried about my baby, and knew that worry would only increase the longer she was inside me, and that labor can make you loose all rationale.

It was after 11 when my midwife and OB came back in on things. The amnio-infusion equipment was still unavailable. My ob decided to do an exam to see if I had progressed at all.

Let's take a moment here to note that I have never had a cervical exam done by a man. Let's also point out the fact that every time my midwife did my exam, she made sure she waited until my contractions were over. I should also note that I love my OB, and think he is the best at what he does! However…

This is how that exam went:

OB: oh I see you are having an contraction, a good one too…..
        WONK - up to his elbow in my va-jay-jay!

I am quite sure a levitated off the bed. Good news, I was 7.5 cm and completely effaced. Bad news, I am quite sure I will never let a man give me cervical exam every again… unless he has hands the size of a 12 year old, below average sized boy.

By now my contractions really hurt. Fun fact, once you decide you are going to get an epidural, you loose the ability to mentally go the place you need to go to handle the pain of contractions leaves, like it was never there at all.

My OB said he was willing to let me attempt to labor for an hour with a low dose of pitocin, with close monitoring. He thought I could potentially deliver in an hour or two, since I had already progressed so quickly, and reacted so favorably to pitocin with Ellie. As he was saying this, Quinn had one of longest decels yet, and I looked at him and said, "I think she needs to get out, now."

What transpired next is a blur. I stayed curled up on my side with my eyes closed breathing through contractions.

Surgical apparel was thrown at Jared and mom helped him garb up.

Nurses were in and out of my room, taking things out of me, putting in new things, prepping, etc… then I was being wheeled into the OR. And that's when I finally started to cry. Not sob or boo-hoo. I just had a continuous flood of tears pouring down my cheeks.

I would like to say I was reciting long portions of scripture at this time to calm my nerves, but all I could do was silently beg God to, "hold my baby for me, protect her."

I remember thinking it was really warm in the OR. It was bizarre being the patient and not the medical staff. Before I knew it, I was sitting on the side of surgical table, socked feet dangling like I was 5 year old (and silently shedding tears just like one too), having my back prepped for the spinal block. Sweet Rose, made me lay my head on her shoulder and wiped my tears, and kept telling me it was ok, and not to to cry, because then she would have to cry too.

I felt something less then a pinch with the spinal. NO pressure, no pain. Just a tiny pinch!

As soon as I laid down, my feet started to feel like they were falling asleep, but just for a a few seconds. After that the most incredible warmth just spread up my body, as I went numb.

About this time Jared was brought back to the room, and informed me he had been taking selfies of himself in the surgical attire ( ha ha!) and texting an update to my friends.

And to think that whole time we had been separated I was so worried that he was freaking out without me there to tell him what was going on and assure him I was fine! He held my left hand, that was strapped down, and my anesthesiologist held my right hand, and kept my right arm unstrapped.

The only moment of panic I felt was when they started prepping my abdomen for the incision, and I could feel it! I quickly let them know! I was then informed I would in fact feels somethings, nothing sharp thought "just" dull. Um… excuse me what!?!? They asked me if what I was feeling was in the prep work felt wet or dry.

It felt like a dry cotton ball was being rubbed over my abdomen. And apparently that means you are numb enough for surgery. Who knew!?!?

I couldn't feel the incisional cut, but I could feel just about everything else, but it was not painful at all. I was aware of clamps and retractors being placed, hands inside me, pulling and tugging, but it was not painful in the slightest. Most bizarre sensation ever!

Because we knew Quinn was going to be pretty small, my OB cut a much smaller incision then usual. Lucky me! Even though she was so small, she was very low in the birth canal, and they nearly had to use forceps to get her out! Jared and I were both surprised with the aggression used to get her out. I could feel my body being rocked back and forth, side to side. You could also see the force/strain my OB was using in all his movements.

And then, the tiniest little purple baby was held up over the drape and my OB said,"Hi mom!"

"She is TINY!" 

And off she was wisked to the warmer and NICU staff. I sent Jared over to her immediately.

She let out a few little cries but was silent after that. I kept asking if she was ok.

Apparently, she was just looking around, taking in her new surroundings. Just like her sister did. And just like with her sister, as soon as she was out, my tears stopped. She was fine. My baby was finally outside of me, and she was ok.

size comparison to daddy's hand

newborn diapers swallowed her, but check out the size of those feet!

And she was 4lb 11oz, and 18 inches. The baby doll we had bough Ellie as a big sister present was bigger then that!

I asked my OB to give me a six pack since he had me sliced open already. He laughed and said he would do what he could, but that I should be thankful for my small incision. The c-section he had done before me was for a 9 lb 11 oz baby. Bless its mother, y'all!

When I had been moved from the hospital bed to the surgical table, some meconium had been noted on the sheets, but thankfully there was no sign of Quinn aspirating any of it. Her apgars were 8 and 9.

The decision to have the c-section was made around 11:30. I was wheeled to the OR at 12 o'clock, and by 12:40 I was back in my room, holding Quinn. The nursing staff had been right - she was in our arms between 12-2 pm.:)

My parents and sister in were the room waiting for us. Quinn was so little, even all bundled up, they didn't notice that she was in my arms until I held her up for them to see.

Ok, so I thought this was going to be the final installment, and technically it is. However, there is still quite a bit I want to document about how Rose was the best postpartum nurse ever, how we managed to keep our 4lb-er out of the NICU, c-section recovery, post-spinal headaches, etc… Looks like I will be doing a Postpartum post in the near future.

I've been asked a lot if I was/am ok with the way everything happened. Yes, over all I am. We got a healthy baby at the end of the day. Am I disappointed that I wasn't able to give birth naturally, a little. But mainly only because I now have mildly increased my risk of needing a c-section in the future. Immediately after delivery, the nurse in me was worried about wound dehiscence and infection, and worst case scenario (because nurse know too much sometimes) uterine rupture.:) Recovery was no where near as bad as I thought it would be. But still way worse then a vaginal delivery! I don't mind my scar. It is rapidly diminishing in size, and looks neat and straight.

While I will always be a huge proponent and supporter of natural labor and childbirth, I am beyond thankful for the advances in modern medicine. Without them, I probably wouldn't have two healthy girls. 50 years ago, I could have been one of those women who always delivered a still born, for unknown reasons.

So there you have it! How our teeny-tiny, little rockstar finally made her early appearance, in style and fashion.