The Reynolds Report: Our First Born: Evelynne Gabourey

So, since I have failed to update the blog in a while (surprise surprise right?), it seems appropriate that my next post be of Evelynne's birth story. I will try to give a complete account of what happened for those of you who are interested while trying hard not to over share. This is probably going to be my longest post (two days of labor and a total of 4 days in the hospital will make any story lengthy) so you may want to get comfortable.

The morning of Saturday the 2nd I woke up around 4:30 to use the bathroom. I tried for about an hour and a half to get comfortable after getting up and since I was sleeping on our air mattress at the time it could take a while. A little after 6am I went to roll over to readjust and my water broke. I was a little shocked and it took me a while to convince myself that that was what actually had happened since I wasn't feeling any contractions. I went into our bedroom and woke Drew up who was just as shocked as I was. Since I wasn't feeling any contractions I knew we could take a little time getting to the hospital. And good thing we had some time because we, well I, didn't have much packed except the diaper bag. So I was able to shower (there was a lot of fluid and I continued to leak during a lot of labor) and get my things together while Drew did a few things around the house. He also had to get the car seat in the truck since we had been holding off because we're in the process of trying to sell the Tacoma and get a bigger, more family appropriate vehicle. Once we were finished we left the house about an hour after my water broke and arrived at the hospital around 7:30.

When we got to the hospital we checked in and were taken to a delivery room so I could be placed on a monitor and be checked out to verify that in fact I had broke my water. They ran an analysis of the fluid and sure enough at around 9am the test confirmed that it was amniotic fluid. I was barely dilated so there was no other option but to induce me since they begin to worry about infection after a while so my nurse placed an IV (first try too which was way better than the five attempts it took the last time I needed an IV) and got the Pitocin going at around 10:30. When we arrived I was having contractions according to the monitor, but little ones and I couldn't feel them, and obviously they weren't doing anything.

So as Drew said the hurry up and wait began. Probably about an hour and a half to two hours after they started the Pitocin I started to notice the contractions. They started off being tolerable and I was managing pretty well through them. And since E and I were doing well my doctor let me eat in the early afternoon. I hadn't eaten since Friday evening and was hungry and starting to not feel well due to that. He also let me have dinner which was wonderful. My day nurse Liz said I was really lucky cause usually when you've been started on Pitocin the doctors don't let you eat.

But before I continue, let me just say that all of my nurses were awesome. I had three L&D nurses and three postpartum nurses as well. All of them were great, really helpful and supportive but my favorite was Hilary. She was my overnight nurse in L&D both nights and was there for my delivery and the beginning stages of postpartum. She helped me through the most challenging thing I've ever done and I will always be grateful for her.

Unfortunately though I didn't progress much during the day or through the night. At around 2am Sunday morning (about 20 hours after my water broke) I decided to try a little pain medication to take the edge off. I was only dilated between 3-4cm and was beginning to realize that this was going to take a while. I was given some Fentanyl which lasted maybe 40 minutes. It made me groggy and did help take the edge off but I could still feel the contractions. The doctor said I could have a dose every hour but Hilary explained that usually the effects are only felt for the first two to three doses and then they became less and less effective. After the effects wore off I knew that if my labor continued to progress as slowly as it was I was going to be exhausted during delivery. So even though I had every intention of going through labor and delivery naturally with minimal pain medication I decided around 3:30am to get an epidural. At this time they also started me on antibiotics since the chance of infection was higher since my water had broke over 18 hours prior.

After getting a bolus of fluids and notifying the anesthesiologist, he came in a little after 4am to place the epidural. I wasn't exactly thrilled with the idea of someone sticking a needle in my spine but it was better than doing nothing. Overall the epidural placement wasn't too bad except having contractions during the placement and the initial stick for the local. And it was a really odd feeling having the catheter placed, it was like someone was repeatedly popping and manipulating my spine. He told me it would take about 10-15 minutes to start to feel the effects. And I did, but only in my right thigh. Both Hilary and he did a couple of cold tests to determine what I could and couldn't feel. He then tried giving me a bolus of the meds, waited another 15 minutes and I still could feel everything but my right thigh so he placed another epidural. The second time it finally took effect around 5am. Its the strangest sensation to not be able to feel anything from the waist down. My legs were so heavy and tingly and I wasn't much a fan of not being able to move around on my own but it was better than the alternative.

At this point I had been awake for over 24 hours and was exhausted but with the epidural I was finally able to get some rest. I slept from about 5 to 8 and during this time both the doctors and the nurses had a shift change. My new doctor for the next 24 hours was Dr. Santa Maria, an associate for my ob, just like my doctor from the previous day. And my day nurse was Maria. They came in and did a check a little after 8am and I was still only dilated 3-4cm. At this point since I wasn't progressing they had to put a plan in place. They decided to start repositioning me every 30-45 minutes in hopes to get E to drop and then to recheck me in about 4 hours. If at that point I didn't start to progress we would start having a discussion about a c-section. So, no more sleep for me. Also around this time I started to notice that my epidural was wearing off. After a little bit of investigation Maria noticed that my IV line had been pulled and since they didn't know how long it had been (they worried about contamination) they needed to replace my epidural... again. At least this time I couldn't really feel it. After the epidural was replaced they started me on fluids with Dextrose (sugar) because with the epidural I really couldn't eat and I was feeling nauseous. They also gave me some Zofran for the nausea. I started to feel a lot better once these were administered.

For most of Sunday it was just a matter of repositioning me and trying to get E to descend. I was checked again around 1pm and I had started to make some progress, I think I was dilated to 5cm at this time. The doctor said she would check me again in a couple of hours and at around 3pm I had dilated further to about 6cm and since E and I were both doing well a c-section was no longer warranted. For the most part I was pretty comfortable except for when they had me in a sitting position. I'm not sure if the IV line or the catheter would kink in this position or what, but no amount of drugs could block out that pain. They only put me in this position twice and both times they gave me a bolus of pain meds and readjusted me. So after being turned and rotated all day, at around 8pm (38 hours after my water broke) they checked me again and I was finally dilated to 10cm. Time to start pushing.

For a little while it was just Hilary helping me as you don't really need the doctor until you're about to deliver. At first she thought it wasn't going to take me long to deliver because I had made some good progress but about an hour later E wasn't really moving much. I took a break and during that time noticed that I had at some point kinked my IV and it had blown so Hilary took the opportunity to replace it. Once that was finished I tried pushing again. Around 9:30 since I hadn't made much more progress, we decided to taper down my epidural in hopes that I could feel the contractions better. After another hour and a half of pushing with no progress the doctor said she would try an assisted delivery with the vacuum. She said she would give it 3 tries without the vacuum suction coming off and if E still made no progress then I would have to have a c-section.

At this point my epidural was completely turned off. The goal by having it turned off was so I could be more effective at pushing while the doctor was manipulating E to be able to get her head to pass. To be perfectly honest I'm not exactly sure how long the assisted delivery took, I want to say at least an hour but I'm pretty sure it took longer than that. I was able to take a break while they got set-up and good thing too. At first it was somewhat tolerable but the longer it went on the harder and harder it became for me to hold my composure as the pain was becoming pretty unbearable. I've never experienced anything like that in my life and never want to again. I almost gave up a couple of times but Drew and Hilary along with the other L&D nurse who came to help with the delivery and the nurses from the nursery helped to keep me as focused as possible. I'm just thankful that E tolerated the delivery well and that the doctor felt comfortable continuing with a vaginal delivery. And finally at 2:33am on Monday the 4th, about 44 hours after my water broke and 4 hours after I started pushing, Evelynne was born.

The nursery nurses immediately took her from the doctor as there was a possibility that she had aspirated her meconium. They intubated her immediately and suctioned her lungs to make sure they were clear. However, I couldn't see what was going on nor did I understand why I couldn't hear her cry. Drew kept telling me that she was moving around and that she was pink but the nurses were focused on her and didn't actually say what had happened until a couple of minutes after they had her. While that was going on, the doctor and Hilary were working on me. They immediately gave me pain medication and started me on a couple of different medications to keep me from hemorrhaging. I was unaware until after delivery that the doctor had to do an episiotomy so she began to do the repair. Hilary later informed me that since she began working in L&D a few months ago this was the first time she'd seen any of the doctors do one as they like to avoid it but in my case there was no way E was going to deliver without it. So once I had my sutures and the nurses had finished checking E out, I was finally able to see and hold her about 20 minutes or so after delivery.

Once we got to spend some time with her, they needed to take her and monitor her in the nursery. She had some swelling on her head from where the vacuum was and they needed to do their newborn check up. I sent Drew to the nursery with her while I recovered. The one advantage of having the epidural turned off was that I could get up soon after delivery. Hilary helped me to get up so I could get cleaned up and so she could change my bedding. Drew came back with a report an hour or so later. E was doing fine, they gave her a bath and she was checked out by the NICU nurses. She had a hematoma and some swelling over the area where the vacuum had been placed for delivery. They were a bit concerned because the hematoma was over a suture line on her skull and they wanted to monitor her to make sure the blood wasn't going to migrate under her skull to her brain. She was neurologically appropriate and doing well.

Later in the morning Maria was my nurse again and she moved us to a larger room on the L&D floor until a room opened up on the postpartum floor. Apparently there was an influx of deliveries over the course of the previous couple of days and there weren't any rooms available. After being monitored for a few hours, they brought E back to our room after she was seen by our pediatrician. She confirmed what the NICU nurses had told Drew earlier that she would need to be monitored but that she should be fine. We were moved to the postpartum floor later in the afternoon and luckily since Drew is an employee were we able to get one of the suites (work perk!!).

We ended up staying in the hospital for another two nights. With needing to be on antibiotics, the nature of the delivery and with E needing to be monitored they wanted to keep us an extra night. During our stay E was able to stay in the room with us which was wonderful. The only time we were separated was when she needed to go to the nursery for daily check ups and for blood work. My overnight postpartum nurse Kathryn was great and she was the first one to notice that E was looking jaundice. Luckily, even though her T Bili levels were rising, she didn't need the light therapy and we were able to go home as scheduled on Wednesday.

So far we are doing well at home. Her jaundice is much better and she looks less orange everyday. Her swelling has pretty much resolved and her sores from where the vacuum was are healing up well. The main issue now is that she is very reluctant to breast feed. The lactation consultants, nurses and pediatrician suspect that with her head swelling, jaundice and the fact that we were separated for the first few hours all attribute to why she is having trouble. I'm still hopeful that eventually she'll start nursing but we'll have to see as she prefers a bottle. And I'm not producing much milk which isn't helping the situation either. With the blood loss and the amount of fluids they pushed during and after delivery its not necessarily a surprise that I'm having trouble producing. As for me, I'm recovering slowly but overall doing well. I'm incredibly sore and have edema in my feet, legs and hands. It gets a little better everyday but I'm still not able to wear normal clothes, not even my maternity jeans because of the swelling in my legs, and none of my shoes really fit, even sandals. The doctors all say it should be better over the next couple of weeks but its still irritating. And the dogs have adjusted well. They are both very concerned about her and love to just sit and watch her. And sneak a puppy kiss or two if possible.

So now we're all just adjusting to life as a family of 5 (including the dogs). It's still surreal that she's here and that she's ours but she is such a blessing to our entire family. And this is just the start of our next adventure: parenthood.