When you’re the .1%
On Tuesday June 6 I went for a routine OB appointment and growth check ultrasound. A couple things happened that day that later became very significant.
First, my OB was concerned that I was still having fairly regular contractions despite being on partial bedrest. So she decided to check my cervix and swab for fetal fibronectin. Fetal fibronectin, if negative, assures there is over a 99.9% chance you will not go into labor for the next two weeks. I’d had the test done a couple weeks previous at the ER, which had come back negative.
My cervix was softened, but not open. My OB put me on the fetal moniters and I had no contractions while I was there. The fetal fibronectin test came back negative. So there was over a 99.9% chance baby girl was staying inside me for at least another 2 weeks. My OB instructed to continue the bedrest and go to the ER if the contractions became severe. She said only 30% of women who have early regular contractions actually go into pre term labor, so we’d be careful but with the negative test result she didn’t see a need for preventative medications or the steroid shots.
The second significant news of the day was that the ultrasound showed baby girl had gained an abnormal amount of weight in a very short period of time. Despite having passed my glucose test, my OB decided to have me test my blood sugar after every meal for two weeks to determine if insulin resistance was the cause of baby’s sudden weight gain.
As the week progressed I was confused by the low blood sugar levels I consistently had. So far, there was no indication of insulin resistance. So I wondered why baby girl was so big. I had only gained 5 lb in the pregnancy so far, so it didn’t seem to add up.
Fast forward to Sunday, June 11. I went to half of church before returning home to rest. Later that afternoon, my husband and I attended a local theatre production that someone had gifted us tickets for. During the show, I had some more intense contractions, but that wasn’t unusual for me at this point.
Upon returning home, my husband and I prepared my usual spot on our recliner to take it easy the rest of the evening.
While Max was preparing something for dinner, I used the restroom. And I lost my mucus plug.
The stupid thing about pregnancy is that almost everything that can be a sign of complication can also be totally normal. Losing a mucus plug at 32 weeks isn’t unheard of. And usually a new one will form in the next couple weeks after losing it early.
But I called the night nurse just to be safe. After explaining that my fetal fibronectin just 5 days earlier had been negative, she said she didn’t think it was too worrisome, so to just call my OB the next morning to her them know. Or, if my contractions (which had been unusually painful) became regular, to go to labor and delivery.
So I opened up my contraction timer app and Max and I settled in for pizza and some Doctor Who.
And the pain got worse. And worse. And the contractions got closer and closer together. After about an hour of contractions 2-3 minutes apart I finally agreed to go to the hospital. So we drug our poor son out of bed and drove the short distance across the street to the hospital. Handy huh?
Well, despite the short travel, by time we got there things had escalated quite a bit.
Max said, “what if we have the baby tonight?”
And I rolled my eyes and said, “we’re not having the baby tonight,” with a don’t be silly kind of attitude.
I walked in the ER entrance and got maybe two words out before I was hunched over on the floor unable to speak or move. So they wheeled me up to labor and delivery while Max explained to the nurses the events of the evening and how far along I was in the pregnancy.
Despite knowing what labor feels like and knowing what I was experiencing couldn’t be anything but the real deal, I was still convinced they’d just give me preventative meds, a steroid shot, and send me home. Worst case scenario in my mind was that they would make me spend the rest of my pregnancy on full bed rest –maybe even in the hospital.
They checked my cervix and told me I was 5 cm dilated. At this point I was starting to realize that maybe Max was right. But I still fought against the idea. After all, the fetal fibronectin had been negative not even a week earlier. There was less than a .1% chance I could be going into real labor.
I wasn’t thinking clearly enough to realize that 5 cm dilated is already definitely real labor. I was in pretty strong denial.
Finally the on call OB showed up and I waited to hear the words, “let’s get you some medicine to stop the labor,” but instead he said, “we’re delivering this baby tonight, and then she will have to be airlifted to the NICU in Iowa City. You’re too unstable to go with her, so we’ll do the surgery here and have her airlifted.”
The instant anxiety, pain, shock, and waves of intense grief pummeled me. I remember gasping as tears came a split second after hearing “baby tonight” and the nurse reminding me to breath deeply and not hyperventilate.
The next thing out of my mouth was a request for the anesthesiologist who we were friends with and had already agreed to do the pain relief for my scheduled c section. He wasn’t on call, but he came. Because he is that type of person. The anxiety about my anesthesia was intense (yay PTSD), and I needed someone I knew and trusted.
Between contractions I was emotionally numb, the shock of it all not quite sinking in.
A phlebotomist came up to take my blood. She was a mature woman, with slightly greying hair and smile lines around her eyes and mouth. It’s funny the things I remember. Before doing anything else, she leaned over, took my hand in hers, stared into my eyes, and said, “it’s going to be ok. You’re going to be ok. You’re baby will be ok.” I looked back at her and the numbness finally faded away as I let the tears return. They poured, and managed to choke out a feeble thank you.
I was approaching transition by time they wheeled me to the OR. I was thinking, “is this what normal labors feel like? It’s not so bad…” as I remembered the pain that felt like my body was dying from the delivery of my first child. Sure this time was still intensely painful, but not even close to what I had experienced almost exactly two years earlier, and I was comforted by the fact that it was unlikely I would feel that same pain again this time around.
In the OR, our trusted friend prepared me for the spinal block, and during the administering of the medicine my contractions grew to just seconds apart. The OR nurse who supported me as I hunched over for the spinal block wrapped her arms around me and asked if it was okay if we said a prayer together. I nodded, and she whispered in my ear one of the most sincere prayers I’ve ever heard, and as I sat there wishing my mom was with me, I felt this nurse provide me with the maternal comfort I needed in that moment.
The doctor checked my cervix and announced I was at 7 cm. I had been in the hospital not much more than an hour at this point. As numbness traveled down my legs the OR team started to strap my arms down and steralize the surgical area. When my arms were restrained and I realized I could not move any of my limbs, panic rushed through me –I had flashbacks of my epidural not working, and the idea of not being able to move if my spinal block stopped working mid operation filled me with some of the most intense fear I’ve experienced.
Finally I was fully prepped and Max was allowed in the room. He gently stroked my head and some of my panic was able to subside. I looked in his eyes and let my fear melt into them.
After a few minutes I began to wonder when they were going to make the first cut. I wasn’t sure what was taking so long. Then our anesthesiologist said, “baby’s almost out,” and I realized they had made the first cut almost 10 minutes ago and I simply could not feel a thing. At that point, I was able to better relax, knowing the spinal block was working better than I had hoped. I could not even feel the tugging and pulling I had been warned I may feel.
A couple minutes later I heard the quietest little cry, and strained to see tiny feet kicking the air from behind nurses’ arms. Moments later the little legs were whisked away, and my husband followed them.
Thankfully that was the point I was given the anesthesia that made me sleepy, and I could slip into a drug induced rest that became an escape from the things going on around me.
Soon I was in a recovery room, and given updates about the transfer team arriving from Iowa City. Finally someone came I’m who knew my baby had weighed in at 5 lb.
That extra weight she had packed on those last few weeks revealed itself as a miracle.
Eventually they wheeled in a giant machine. Inside the machine was a clear box, and inside the box was a tiny head I could barely see. Then faster than it had came, the giant machine left and a few minutes later I heard the whir of the hospital helicopter. A sound I had heard many times before (since we live across the street) but would never sound quite the same to me again.