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The birth of Joshua James


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  #1  
October 13th, 2005, 06:01 PM
~Trina~'s Avatar Platinum Supermommy
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Joshua’s Birth Story

On Sunday, I woke up and noticed that I really didn’t feel very well even though I had felt great the day before I and had a lot of things that I wanted to accomplish for the day. I hadn’t slept real well and was just a wee bit crabby. I spent most of the day lying on the couch watching TV or taking cat naps. About 4 pm I decided to eat something and went and fixed myself a bowl of cereal and a bagel. As soon as I was done eating, I was quite nauseous and regretted eating. I noticed that I was having some contractions and timed them to be about 7 or 8 minutes apart. I also noticed that I had a lot of pressure down below. It was hurting when I had to use the bathroom so I decided that it was probable that I had another urinary tract infection (I’d had numerous throughout my pregnancy) and decided that I would come up to labor and delivery to be evaluated so that James wouldn’t have to miss work to come with me on Monday.

I arrived at L & D at 9:30 pm, changed into a gown, got comfy in the bed and they hooked me up to the monitors. Baby’s heart rate was looking really good and strong. As the nurse was asking me questions about symptoms and why I was there, they monitored contractions. I told the nurse that the contractions were about 7 minutes apart and she said… “Well, they are showing up here on the monitors at about 2-3 minutes apart and pretty strong.” I was shocked! Since I wasn’t 37 weeks yet, she had to get the doctors permission to check my cervix. She went to call the on-call doctor and get the permission. She came back in and we found out that I was a good 2 centimeters dilated. At my last appointment at 34 weeks, I was about a fingertip dilated and they thought baby was possibly butt down. She did another check to see if she would figure out if it was the head or the butt down. She said she was sure the head was down so we were good to go. She also did a Group B Strep test since mine was scheduled to be done this Tuesday. They figured they wouldn’t have the results back in time if I was really in labor but if there was any question later…they would know. They wanted to put in an IV and start antibiotics right away but I requested that no IV be placed until we knew for sure if I was in labor or if I was going to be admitted because I seriously hate IV’s and have a history of long labors so there would be ample time to run 4 hours of IV later.

The doctor decided to keep me for 2 hours and check me again to see if my cervix made any change before deciding whether or not to admit me. I stayed on the monitors for about an hour so they could get a good tracing of baby’s heart rate and contractions and then I got up and walked for an hour. At midnight, the nurse checked my cervix again and I was 3 centimeters. The doc said that he wanted to wait another 2 hours to see if I continued to progress but he was planning to admit me because I had a very steady and active labor pattern according to the monitors (he can watch them from home). I spent the next hour and a half walking in my room or leaning against the counter. My back was killing me with each contraction and figured baby was posterior. James was a good boy and stood behind me and rubbed my lower back as I continued to have contractions. Neither of us was actually convinced that this was “it” yet. I’ve had several false alarms in past pregnancies like that, so we weren’t about to start holding our breath! It 1:45 am the nurse came in and said that the doc had told her that we needed to start that IV so that they could run the antibiotics. I argued a bit but in the end gave in and let them try to start one. The nurse failed at the first attempt and decided to call the anesthesiologist on duty to come put it in. He came in and got it started on the first try…and rather painlessly! I was impressed.

At 2 am, the doctor came in to see me and said that he was about to go do a c-section and wouldn’t be able to check on me for at least another hour and a half and he thought it was about time to commit to the delivery. He asked if I wanted him to break my water. Baby’s head was still pretty high up and he thought that if my water was broken he would be able to drop down quicker and get the show on the road. I agreed to let him break my water because I could feel it bulging and I figured it was going to break soon anyways and at least this way I didn’t have to worry about it catching me off guard. He broke my water and said he’d be back to check on me after he was done with the c-section. The anesthesiologist came back and asked me if I wanted an ISN or an epidural before he went in to assist with the c-section. I told him that I wanted to wait awhile yet and so to check with me after the c-section.

The contractions didn’t get TOO bad until about 4 am. By then, I was having to breathe through them pretty intently. I could no longer speak through them. James fell asleep shortly after they broke my water and slept until about 7 am. With the exception of the nurse coming in every so often to check on me, I labored by myself and tried to focus on the TV show that was on. I was actually pretty content and rather liked the quietness of it all. At 6 am, they checked my cervix again and I was only at 5 centimeters. This of course was incredibly frustrating, but then again I had no idea what was in store for me yet! At 7 am, I asked for them to call the anesthesiologist to administer my ISN.

“ISN” stands for intra-spinal narcotic. Basically, its very similar to an epidural with a couple major differences. First, the medication is a different formula…. my mixture was a mixture of morphine and fentonal (spelling?). Second, there is no catheter inserted in the back with an ISN. The medication is injected directly into the spinal cavity. There is usually no need for a bladder catheter either. You don’t lose all functions below the ribs like an epidural…..you just lose the ability to feel pain. You keep the ability to get up and go to the bathroom on your own, you can get up and walk or stand, the whole nine yards. Sometimes you are still able to feel the contractions but they don’t hurt but rather feel like pressure.

My ISN was administered just before 8 am. It took total effect within 10 minutes. I was suddenly VERY comfortable  and able to relax. Soon though, one of the more rare side effects of getting an ISN kicked in for me …..intensely! I itched…everywhere! My arms, my legs, my back, my stomach, my butt, and my face, you name it. Usually when people do have that side effect, its just mild and tolerable. However, I got a particularly intense case of the itchies. I chalk this up to the strange reactions I’ve had to other medications in recent times. They gave me 2 doses of Benedryl through my IV but it didn’t help. Then the doc had them give me a dose of Nubain through my IV. That helped and made things tolerable for short periods of time … but my face continued to itch. I was using a dry washcloth to rub my face because it scratched better than I could. They kept giving me doses of Nubain when they could to help control the itching but there were always periods when the Nubain wore off but it was too soon for another dose. It was VERY miserable but at least the contractions didn’t hurt right?

At 4 am, I was still 5 cm and they decided to add pitocin to my IV because although I was having a good contraction pattern, the baby wasn’t dropping further down in the birth canal to cause further dilation. They wanted to make the contractions even stronger. I stayed 5 cm dilated until about 11 am. At my 11 am check, I was 6 cm. I kept laboring at 6 cm until about 2 pm. At this point, I was getting very frustrated at the fact that baby wasn’t dropping down properly. I tried the birthing ball, I tried standing, I tried walking, just about anything I could think of to use gravity to bring him down so that I would dilate further. Finally I was exhausted and laid down for awhile and tried to just focus and mentally picture him moving down. The well-meaning nurses kept saying “Just as soon as he drops down, you’ll go very quickly and it’ll be over.” I, however, was getting very cranky and was tired of hearing that and told them to STOP saying that. There was obviously some reason that he wasn’t dropping.

At 5 pm, I was 7 cm dilated but baby was still only as low as a -2 station. The nurses contacted my doctor and he decided that if I hadn’t made any more progress in 1 hour, we would be doing a c-section. I was one VERY unhappy camper and told them to tell my doc that I had no intention of having a c-section and that there was no clear reason at that point to push one just yet. My water had been broken for 15 hours and I knew that I had until about 24 hours after it broke to deliver. As tired, frustrated, and impatient that I was, I did NOT want to have a c-section. Luckily for me, at a few minutes to 6 pm a different doctor came in to check me, not realizing that MY doc was planning to come in for my case. She heard the “plan” and asked me if I was ok with that. I told her that I wasn’t and that I really wanted to keep attempting the vaginal delivery. She said she would check me and informed me that she is more “aggressive” than the nurses with her internals and maybe she could help get me moving. She did a check and tried to stretch my cervix to get it to dilate further. By this time, my ISN had long worn off. It quit working about 3-4 pm. Her internal was quite painful, but was worth it to me to avoid a c-section. She managed to get me to 8 cm.

I then chose to have her take over my case from my doctor because he still wanted to do a c-section. She said she thought she could make it so I could go vaginally. I still struggled to dilate until about 7 pm when I was still only at 9 cm. She then used her hands to reach up and feel baby and found out that the reason that he wouldn’t drop was because he was turned SIDEWAYS in the birth canal. Instead of being face up to the sky or face down to the floor … he was looking at my HIP! His shoulders couldn’t get past the top of the birth canal, preventing him from dropping down. She had me get on my hands and knees again and push with a couple contractions to try and get him to turn either anterior or posterior. I could deliver in one of those two positions but if he didn’t turn, I would have no choice but to do a c-section. Meanwhile they had the pitocin maxed out and the contractions were HORRIBLY intense. I was starting to lose control due to the pain. I was starting to scream with the contractions rather than breathing threw them. She again used her hands while I contracted and twisted baby to where he was face up (that was the only way she could get him to turn….ideally she would have gotten him to face down). She then had me start pushing even though I was only 9 cm. As he crowned, he flipped to face down and he was born in about 3 pushes. He was whisked away to the warmer because he was 4 weeks early and they wanted to make sure he was ok and we were going to be donating his cord blood and they needed to do the collection right away.

The doc examined my cervix to make sure that it hadn’t torn during the pushing and it was perfect. I also had no other tears or abrasions so I didn’t need any stitches.

Joshua James was born at 7:23 pm on October 10, 2005. He weighed in at 7 pounds and 9.6 ounces…not bad for being 4 weeks early! He was 20 ¾ inches long. He swallowed some amniotic fluid at some point in the delivery and so they had to suction him and he required oxygen for a little while as he worked on being able to cry. His face was pretty badly bruised from being smushed up against my pelvic bones for so long during so many contractions. His face was actually one large black and blue bruise. After a few minutes, his body pinked up and after they had all their cord blood collected, they wrapped him up and brought him to me. I was glad to see him and his head full of dark hair after 22 hours of labor!

Joshua’s blood sugar was pretty low after birth so they made sure I nursed him and they re-tested his blood sugar 20 min after eating. It was normal and to be safe they checked it about every 3 hours until about 9 am the next morning. All the subsequent tests came back normal as well.

Joshua was very lazy about eating that first night and we struggled to wake him enough to eat. On Tuesday morning they weighed him and he had lost several ounces already so we tried to wake and feed him about every hour. His pediatrician examined him late morning and decided to run a CBC blood test just to be safe and make sure nothing was going on. It was found that his white blood count was significantly high and they ordered an IV be started and a course of antibiotics. My GBS test had come back negative, but they wanted to make sure he didn’t have any other infections. They also ordered a blood culture to find out for SURE if he had an infection. The doc came in to talk to us and told us that they would be watching him pretty close since he was so early and that he was at high risk for jaundice because of that and because of the bruising on his face.

Throughout Tuesday, Joshua got much better at eating. He was waking a bit easier but needed to be stimulated throughout the feedings to keep him awake. He even woke himself up a couple times to ask to eat!! That was a very good sign. However as the day went on, you could tell that he was already becoming yellowish in color. The bruising on his face was clearing rapidly but his chest and abdomen was yellow as were the whites of his eyes.

Wednesday morning they tested his billirubin and found his levels to be just under 13. Anything over 14 is considered too high and requires treatment. However, most babies don’t reach that high until 4-6 days old and Joshua was less than 48 hours old. They determined that they needed to start him immediately with phototherapy. They came down and explained it all to me as well as that he would need to stay in the hospital until Friday most likely. Since he was being breastfed, they were going to allow me to stay as well. He is on a strict schedule at the moment. He lays under the lights in the nursery for 3 hours and then he comes to my room for 45 minutes to eat. After 45 minutes, he has to return to the nursery to resume phototherapy. Also, they brought me a breast pump and have me pumping after each feeding because my milk is already in and they would like to be able to have some breast milk to feed him in the nursery if he gets cranky before his 3 hours are up. They will be feeding him with a syringe if that happens to avoid giving him a bottle and risking nipple preference/confusion. Pumping has not worked very well for me yet, I’m unable to reach “let down” with the pump and I’m becoming badly engorged which is quite painful. I’ve been working with hot and cold packs to try and reduce swelling and start the release of milk. I’ve stood in hot showers and tried to get it started there as well but the boobs just aren’t cooperating! This morning I will be getting together with a lactation consultant again to see if we can’t find a better way to reduce the engorgement and make feeding him at the breast easier (his mouth is struggling to be able to latch on because my breasts are so full).

So, we’ve had a rough ride so far. I’m actually no longer a patient at the hospital. I’ve been officially discharged but am classified as a “house guest”. This means that I am still in my room, still have access to meals, but am completely on my own. Kind of like a REALLY expensive hotel room. But, it keeps me close to my son and makes it so that we can continue to try and breastfeed.

If you are still reading this, WOW! Thanks for coming on this journey with me! I appreciate it. I’m doing ok but am of course sad that we can’t be at home yet. It’s frustrating when there is nothing that you can do, but I’m also very aware at how much worse it could be. A little infection and some jaundice are very manageable. We are very blessed that these are the only complications because some babies have more serious problems when born at 36 weeks. Others have none…and that is what I’m used to. My two previous 36 week babies were free of all complications and so we’ve been spoiled in the past. But this just goes to show how important it is to keep these babies in for as long as possible and not to get too impatient for our babies to be born. At this point, its possible that he will be discharged on Thursday but it is not likely. We are aiming for Friday sometime….but it could be as late as sometime this weekend.

*UPDATE* Joshua was released this afternoon He has to go back to the hospital for an appointment to check his weight and bilirubin on Saturday morning!!


Welcome to the world my sweet baby boy. We waited a long time to meet you but I wish we would have had to wait just a couple weeks longer! We love you and we’ll wait as long as we have to so that you can come home as healthy as possible.
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  #2  
October 13th, 2005, 07:50 PM
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Congratulations Trina! I'm so glad you and JJ are home now. Keep us updated on his progress. I can't wait to see pictures of him. We've really missed you around here, so welcome back!
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  #3  
October 14th, 2005, 05:36 AM
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Wow-- that really was a long story! It was really great to hear all about it though. I am sorry your little man was so stubborn-- but I am also glad to hear he is home now and doing so much better! I am going to check now to see if there are any pics of him yet! We're glad to have you back, we missed you!
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  #4  
October 14th, 2005, 07:42 AM
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CONGRATULATIONS TRINA & FAMILY

I hope that I have the brain and strength to ask for what I want like you did. I don't want to just comply with the doctors, and if you had, you would have had a c-section!

I'm glad that everything is okay, and I can't wait to see pics!
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  #5  
October 14th, 2005, 07:44 AM
-Shannon-'s Avatar Platinum Supermommy
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Congratulations Trina! I hope you are recovering well and that Joshua has a better week next week. I am so happy for you! Joshua James!
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  #6  
October 14th, 2005, 07:52 AM
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<span style="colorurple">Congratulations Trina! Welcome to the world little JJ. </span>
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  #7  
October 14th, 2005, 06:31 PM
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Is that the longest birth story of all 4 of your kids? I can't believe all you went through! You must have a good hospital, or insurance or something for them to let you stay like that! Thanks for the sharing your story and CONGRATULATIONS!!! You did it!
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  #8  
October 15th, 2005, 09:25 AM
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Now I can say Ive read a novel today!

Wonderful birth story...you're so descriptive! Glad JJ is well and momma too
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  #9  
October 17th, 2005, 10:32 AM
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Thanks Trina for sharing your birth story. I found it very interesting. I hope you and JJ have a speedy recovery. Take Care
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  #10  
October 24th, 2005, 03:47 PM
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I Loved reading your story Trina... I was SOO excited when I read about the ISN and went right in and asked my dr about it... wouldn't you know NO ONE in the area does them... not at either hospital!! I'm so bummed...

I'm glad that it all went well for you... Little JJ is ADORABLE!
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  #11  
October 24th, 2005, 08:04 PM
~Trina~'s Avatar Platinum Supermommy
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Yeah... the ISN is pretty hard to find....I'm very lucky that my hospital does them!
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  #12  
October 24th, 2005, 10:49 PM
Sarahmom's Avatar Mega Super Mommy
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Trina, after reading your birth story again after having mine, you and I had very similar experiences. Jacob was actually stuck transversly as well. Dr. thought he was face up but turns out after the c-section, they found out he was looking at my hip too. I wish I could have avoided the section.
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  #13  
October 25th, 2005, 09:50 AM
~Trina~'s Avatar Platinum Supermommy
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Aww I'm sorry hun .... in reality ...I probably SHOULD have had the c-section but I'm wayyyy too darn stubborn and had been through such long labors in the past that I just told myself that I had to hang tough .... thankfully the one doc believed I could do it or else I would be in your shoes now!
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