Where the Willinghams Are: 2017

Amelia Josephine Willingham born 10-18-16 at 6:27 am weighing 6lbs 6oz and measuring 19 inches long with a head and chest circumference of 13 inches respectively.

I was scheduled for induction at 5pm on Monday October 16^th at exactly 40 weeks gestation due to gestational diabetes. Her growth was always in the 30^th percentile at my scans and my glucose levels were in normal range with diet, but my fasting numbers were elevated and only controlled by insulin use at bedtime. The use of insulin during pregnancy can cause higher risk for baby and mom and it’s not recommended to go beyond 40 weeks.

I started my maternity leave on the 16^th tried to relax the day of while Josh went to work. We got in the car and had just left when the hospital called to tell us that they were experiencing a high volume of births and didn’t have a bed available for me, so they would call when one became available. We decided to have dinner and watch some television while we waited for them to call.

Around 9pm they called to tell us that they needed to reschedule my induction for the next day and asked us to come in at 5 am. I called my doula and let her know the new plan and went to bed. I’m thankful I was able to get a full night’s sleep.

Josh and I woke up around 4:30, showered and got ready to go. We arrived a little after 5 and went through the last-minute registration process. I was given room 16 and around 7:30 my Certified Nurse Midwife, Yvonne came in and placed a cook catheter, which is a device that is inserted into the cervix that has two balloons that filled with saline and sandwiches the cervix causing it to dilate. It typically dilates the cervix to 5 cm before falling out. Yvonne said that I was a fingertip dilated, but very soft and stretchy, and Amelia was at a -3 station. I was nervous that the catheter would not insert easily, but it slipped in with no problem. I was able to order breakfast and eat before Pitocin was started. They don’t like you to eat solids after starting pit, so they wanted to make sure I had a good meal before starting. Around 10:30 they started a low dose of Pitocin.

During the use of Pitocin I labored on the birthing ball, watched tv, napped and took a long hot bath. Every hour Tanya, my fantastic day nurse, would check the catheter and up the pit by one unit. The latent part of labor is long and having lots of distractions is important. For me it was Facebook, Episodes of Riverdale on Netflix, and reading.

At around 3:30 my dad called Josh, which is abnormal because he typically calls me. I had a feeling it was not good news and I was right. My dad and told him that he had some upsetting news and that it was up to Josh if he wanted to tell me. I could hear him on the phone and knew it was about my grandpa Dave. He passed about half an hour before and my dad wasn’t sure if the news would be good for me or my labor. Of course, Josh and I don’t keep things like that from one another, but I knew before he hung up the phone. My granddad had been diagnosed with stage 4 lung cancer in the summer and it had progressed to his brain. I knew we might not have him through the year, but I had hoped he’d be able to meet his newest great granddaughter. He had been admitted to the hospital last week and as of Monday he had stopped eating, had become combative with staff, and was having conversations with people who had already died. My dad wasn’t sure when they would be leaving, but I knew it would be soon. I cried with Josh and we both agreed that I needed to put my focus on my labor.

My poor nurse was in constantly because my contraction monitor wouldn’t read contractions accurately. She was so kind and I really appreciated her kindness.

At around 4:30 the catheter came out and Tanya checked me and I had dilated to a 7 and Amelia was at -2 station.. The pressure relief was amazing. I was really crampy and the contractions were uncomfortable, though tolerable, but I didn’t realize it was because of the catheter. I was on an adrenaline high, because I only got to a 6 with Silas and a 7 with Declan before having their cesarean sections. I called my Doula, Jenni, and she headed down to the hospital. At that time I was on 8 units of Pitocin. Jenni came in and started some aroma therapy and provided some massage and counter pressure on my lower back as I transitioned into active labor.

My contractions had started coming every 2-3 minutes and lasting almost a minute long. Jenni suggested the bath, but I really didn’t want to sit in water at that point. She raised the bed up so I could lean over the bed and sway and rotate my hips. At 6:00 Amanda, one of the other Certified Nurse Midwives came in to check on me. She asked if she could check me and possibly break my water, but I asked her to give me another hour and explained my reluctance for ruptured waters because of the infection I developed while in labor with Silas. She agreed and let me continue to labor. She came back in right before shift change and I was dilated to 8 but still at -2. Because I had progressed to 8, I agreed to breaking the waters. There was a LOT of fluid. And the intensity of the contractions increased afterwards.

At shift change I said goodnight to my day nurse Tanya and hello to my night nurse Cindi. Cindi was so encouraging. She and Jenni worked together to get me through transition. Jenni suggested hands and knees so we got a bean bag and positioned it on the bed so I could lean against it. I labored there for about an hour and then we tried a sheet to pull my belly up in a rebozo sling. Amelia did not care for that and her deceleration caused Amanda to come in to check. We all agreed not to do that anymore and instead I pulled my belly up with my hands instead and there were no more decelerations at that point.

Jenni and Amanda thought it would be a good idea to do a “princess sit” and Jenni transformed the bed into a chair and with each contraction I would have more fluid expel. I had no idea Amelia was surrounded by that much fluid. I don’t recall either of the boys having that much. While I labored like that Amanda had gone home and Dr. Newman, one of the obgyns at the practice, started his shift. I was also surprised by a visit from my mom and dad. They came to see me before they left for Montana to help my aunts with arrangements for my grandpa. I think they both had hoped she would be born before they left, but no such luck, however, labor was really starting to pick up at this point and I couldn’t stand sitting anymore so I moved off the bed and had Jenni raise it so I could lean and sway.

Dr. Newman did decide he was tired of the external monitor being so inconsistent so I didn’t get to labor upright for very long before he came in and place the internal monitor. I’m not sure if it’s because he is a male and unfamiliar with what having a vagina is like, but I felt he was extremely rough with the placement of the monitor and I cried and honestly felt very violated. Both Cindi and Jenni had to calm me down and remind me that the internal monitor was what was best for the baby and that if he needed to check me again that we could request he be a little gentler and that he didn’t mean to be so rough, but the monitor has to be placed just right. He did mention I was still at an 8 and -2 station, which was discouraging.

Since I had the internal monitor I wasn’t able to disconnect to use the bathroom so Cindi had to place a urine catheter and I was basically confined to around the bed. At this time we decided to try the bean bag again and do the hands and knees position. The pain from the contractions were so intense by this point that I just wanted her to be born and I couldn’t control the pain. Jenni would tell me that I was very close and nearly there and it would give me the motivation to get through the next contraction. Josh was rubbing my shoulders and telling me how proud he was of me and how strong I was. The contractions were roughly one and a half to two minutes apart. I didn’t last on hands and knees long because my legs were shaking and I couldn’t handle the position without wanting to collapse so we attempted the peanut ball. The contractions felt right on top of one another in rapid succession and Cindi asked to check me. I was so discouraged when she said I was still an 8, almost a 9 and no change in station. We started having issues with the internal monitor so she ran out to see what suggestions her coworkers had.

While she left the room Jenni and Josh both told me how great I had been doing. When Cindi came back she brought a new cable in and that fixed the monitor, I was relieved it wasn’t the actual monitor because I did not want Dr. Newman to place it again after how rough it had been. Jenni asked Cindi if she would help her with the “dead bug” labor position which would require me to hang off the end of the bed with my legs dangling for three contractions and then have my legs held above with knees close to my chest for three contractions in order to get Amelia to rotate. After this placement we attempted the “princess throne” again. Jenni kept reminding me to melt into the bed with each contraction and I honestly felt like I couldn’t keep going.

It was around 1:30 and Cindi asked another nurse to come in. I can’t recall her name off top of my head, but she asked if she could check the monitor placement. Cindi also wanted her to check me to see what she thought because after her last check she said she wasn’t quite sure what she felt, but she needed confirmation before mentioning it to the doctor. The other nurse told her that it was the strangest thing but it felt like my cervix was thick on top, thin on bottom and that Amelia was transverse face presentation. Cindi confirmed she felt the same thing and that was the moment I felt most defeated and wanted to just give up and do a section. I figured Dr. Newman would be all for the idea, but it was Dr. Newman who insisted I give it a few more hours, but to have an epidural and increase the Pitocin, which was at 10 units at that time.

The anesthesiologist, Jose, was an amazing man and placed the epidural quickly and the pain relief was immediately worth it. He walked me through the process and made sure I didn’t feel any more discomfort from the contractions. I was able to use the peanut ball again on a different side and get some sleep. While I was resting my Pitocin was gradually increased from 10 to 16.

I woke up around 4 am and Cindi checked me again and there were no changes to Amelia’s position or station, which was concerning since the Pitocin was so high. At that point I knew we would be doing the cesarean. Cindi went to speak with Dr. Newman and I talked and cried with Josh and Jenni. I knew I was not a failure and that we tried everything in our power, but that doesn’t hurt any less knowing that I would never have a vaginal birth. Cindi came back in and confirmed that Dr. Newman wanted to do the cesarean then left again to help prep.

I asked Jenni to walk me through Premier Care’s protocol for gentle/family centered cesarean so I would know what to expect then Amanda came back in at that time and she also walked me through what would happen. She would be assisting Dr. Newman in the OR during the surgery and she also told me how well I had done and that this was the next step because we had covered all the bases before this decision. Dr. Jose, the anesthesiologist, introduced his CRNA, Jack. He reminded me of a kind grandfather and he held my hand as he described his role for me and we discussed how I responded to anesthesia with my last two cesareans and what to expect with this one.

Everything happened so smoothly afterwards. I was wheeled back into the OR, said a prayer with Jenni then was transferred from my bed to the OR table. Then Jack got me prepped with anesthesia while Amanda, Dr. Newman, and the OR team prepared the area below the drapes. I asked for Josh and they let him in and I was talking to him about being excited to meet our daughter when I heard a baby cry. I had no idea they had worked that fast! They allowed her blood to pulse from the placenta and milked it into her before clamping then slid her through the two drapes and placed her on my chest. She was very dark, like purple, but she was calm and settled on my chest with eyes wide open as I cried tears of joy. I had vernix all over my hands and chest. I had never experienced holding my child after delivery and had no idea she would be so cheesy! One of the nurses rubbed her down with a towel so she wouldn’t be so slippery and they did her assessment right on my chest. Her one and five-minute Apgar tests were both 9.

Josh and I reveled in her perfection when I heard Dr. Newman say something about no more babies. Josh and I laughed and Dr. Newman said, “No, I mean it. No more babies.” He went on to say that the scar tissue was extensive and that my uterus was wrapped over my bladder. I mentioned that I signed the consent for a tubal in the office and if he felt I wasn’t able or shouldn’t have any more children that we should progress, so he went ahead and performed the tubal.

While Dr. Newman and Amanda worked at cleaning up my scar tissue and doing the tubal the nurses took Amelia to the warmer to do her measurements. Jenni recorded everything with photos. Amelia’s official stats were 6lbs, 6oz and 19 inches long. She had a chest and head circumference of 13 inches.

Soon after we all taken back to the labor and delivery room to recover and wait for a couplet care room. My new day nurse, Christina, told me how well the surgery went on her end and reassured me that Amelia and I had done a great job with the TOLAC and she helped us get comfortable. Jenni helped me establish breast feeding with Amelia, took some more photos and said her goodbyes.

Amanda came in and confirmed that the reason Amelia couldn’t descend and I wouldn’t dilate completely had everything to do with the amount of scar tissue obstructing my uterus and mentioned that my uterus looked like it was draping over and hugging my bladder. It could also be why I couldn’t drain my bladder completely until I had the catheter in.

This information made it a lot easier to understand why none of the laboring techniques worked and made me feel like less of a failure. She also said they were not able to use my lower incision from Declan’s birth because of the positioning of my pelvis, so they had to use the one from Silas’ birth.

Recovery this time around had been interesting. I was worried with using the higher incision it would be more difficult, but actually the incision isn’t bothering me at all. While in recovery I called family and shared pictures of our newest addition. I had some ice chips and spent a lot of time holding, cuddling and breast-feeding Amelia. We were moved up to couplet care midafternoon and got settled. I napped a lot between the different nurses and doctors coming in. We finally got to see our boys and see them interact with their new sister.

Declan looked at Amelia, declared her cute, and then asked if he could cuddle with me. I had ordered a clear diet meal with broth, Italian ice and jello. Declan looked at it and wanted to know if he could share my Italian ice and we did. He asked about my belly and how long it would be until I could lay down in his bed and scratch his back. I know where his priorities lie! He did hold her for a few minutes, but then he laid down and fell asleep on the couch bed.

Silas of course was over the moon. He chatted with me about how I was feeling and how scared he was that I was going to die. We assured him that I was okay and asked if he had questions, which he did! He asked about how long I was in labor for, what kind of birth I had, how I felt during the surgery, why I needed the surgery, how long it would take me to heal and if I hurt. Silas told me he loved his sister and couldn’t wait to hold her whenever he wanted.

Josh ran the boys home to him mom while I rested. While Josh was at home for a bit I was able to get up with my wonderful evening nurse Janene and I walked the hallway, but then I started feeling really sore and shaky again. I have been very light headed, and feeling fuzzy around the edges. Any time I move suddenly I feel woozy. Come to find out I lost a lot of blood. I had already been identified as anemic and between the cesarean, the adhesions and the tubal I lost a fair amount of blood. They ordered some labs and wanted to take time to see if the iron supplements would help. Between the wooziness and the pain, it made for a rough night.

The following day I had more lightheadedness, fuzziness, and in general felt really off. I did walk a couple of times, but spent most of the day in bed cuddling Amelia and working on breast feeding. I also got to take that first shower after baby. It was so nice to feel clean and just sit under the running water. It improved my spirits ten fold.

The lactation consultant came in to see us and agreed that Amelia has a very small mouth and that her bottom lip kept slipping up and compressing the nipple. She brought me a pump to stimulate after feeding as well as an SNS, nipple shield, and I went ahead and did the rental for three months as well as bought some nursing bras.

My good friend Liz came to visit as did my sister, Andi. I loved being able to talk about my birth with them and know that I really did everything I could for my tolac/vbac. Between visitors and the lactation consultant I tried walking again and resting, but I just wasn’t feeling any better.

By the time my night team came on I had expressed how strange I was feeling and learned that my blood volume had dropped to 6.4. Due to the other symptoms they wanted to do a blood transfusion. I was really fortunate to have Janene again as well as Michelle. They were fantastic and once the first unit of blood had finished I could already feel a difference. I had a second unit before the night was done and there was such a night and day difference by time I was up in the morning.

My blood volume had gone back up to 9.7 and given how easily I was moving around and that my pain was being controlled there was talk of letting me go home. While we waited to hear back about discharge the hospital photographer came in and took pictures of Amelia. My brother and sister in law came to meet Amelia as well. We had a good visit and then Amanda came in and took a look at my incision. I would have to have the staples removed in office on Monday, but they didn’t see any reason to keep me at the hospital, so we got all ready to go and came home.

We’ve been adjusting to home life the last two days and trying to take one thing at a time. I’m tired, sore, and having some difficulty managing the pain, but one thing is for sure, I love this little girl with my whole heart just as I do her brothers!