5 weeks before my due date I was put on bedrest because I was exhibiting signs of preeclamsia, aka. pregnancy induced hypertension (PIH) &/or toxemia (I was so healthy before that, I even did a triathlon to mark the start of my third trimester). This is a mysterious disease; no one knows what causes it or why it develops most often in first-time moms-to-be, but it is theorized that toxic substances are produced by the body as an immune/defensive reaction to a foreign intruder (in this case the baby) when the mechanism that's supposed to work to suppress such a reaction during pregnancy is absent or fails. It is marked by high blood pressure, protein in the urine, a high liver enzyme count, and a low blood platelet count. My blood pressure had held steady at 130/80 for sometime (I'm normally something like 110/64), but was showing an increase each week, even with bedrest. My baseline bloodwork and tests showed PIH, but not serious enough to require anything more than continued bedrest and twice-weekly assessment. OK, that brings us to our OB appointment on Wednesday, 9 October...
Well, actually, on Tuesday night, I was experiencing severe abdominal pain, especially on the right side. The baby was kicking a lot, so I assumed I was just bloated or something. I did call the hospital and they said I was welcome to come in, but I did have my OB appointment first thing Wednesday morning, so I just toughed it out. Turns out, that was a red flag and the right side is where my liver is. So, we go to the OB and have an ultrasound; baby looks great and the estimated weight was 6 pounds, 5 ounces. They drew six (!) tubes of blood, plus checked my urine and blood pressure. I was already showing 2++ protein in my urine (previously it was a trace) and my blood pressure climbed up to 180/105. I went home and then had my afternoon appointment at thehospital's Mother-Fetal Biophysical Profile Monitoring Unit, where the baby was very active and had plenty of amniotic fluid - we scored another 10/10. Kent and I got home and then Kent took off for his cyclocross training at a park not too far away...
Perhaps 10 minutes after Kent left, the phone rang, but I was in the bathroom. One of my OBs called to say that they got my morning's bloodwork results back and to call her immediately (it's just after 5pm now). I called and left a message with the service and she called back within two minutes. She told me my liver enzymes had quadrupled from the previous baseline number and that I had "severe preeclamsia." She then told me I was in the HELLP syndrome form of the disease, but I didn't know what she meant. All I know is she was trying to break things to me gently, but made it very clear that I had to get to the hospital now. I asked her if I could page Kent and she asked how far away he was; I got permission to page him, which gave me a chance to feed the animals and gather my bag and things. Kent called and hauled ass home and off we were to the hospital. I know the doctor also mentioned some things that would be done, such as an IV with a drug that would prevent me from having seizures.
We got to the hospital and a team of nurses were already waiting for me. I got changed and put into a room, where I was hooked up to magnesium sulfate, the aforementioned anti-convulsant. This drug rendered me bed-ridden and gave me double vision. Nonetheless, I tried to stick to our all-natural birth plan and refused a foley catheter, so I got to hover over a bedpan every hour. My blood pressure remained high throughout the night. Kent slept in a fold-out bed next to mine and kept a log/journal of what was going on. I had continuous external fetal monitoring and was already 1.5 cm dilated when we checked into the hospital at 6pm. To induce labor, they used a synthetic prostaglandin pill called Cytotec; the way this works is 1/4 of the pill is inserted into my vagina every 3 hours. At approximately 6:30am the next morning (Thursday the 10th), after the 12 hours of Cytotec, I had only dilated another 1/2 cm to 2cm!
At 8am, my OB (the one on call that day) said it was time to get busy. He had a good line for me when he said: "severe preeclampsia trumps the birth plan." My bag of waters was then broken and I was started on pitocin. I got a Foley catheter placed. Pitocin induces labor, but the downside is you don't get a break between contractions to catch your breath and recover; with the magnesium sulfate and Foley confining me to the bed in a loopy state, I realized that I did not have the coping skills I planned on utilizing for my natural childbirth plan (thinking I could walk around and use the birthing ball, etc.). The contractions got stronger and stronger and after three hours I broke down and asked for an epidural. At 11am, I got the epidural and the pain just magically went away. The doctor came in and checked me around noon; I was at 0 station, 4 cm, and 80% effaced. He went back to the office.
I was checked again at approximately 12:15pm and was 6cm. My blood pressure was very high still and they were talking about the baby being in possible distress. I really didn't want to do it, but the baby was then monitored internally. Then, just about 12:45pm, I felt the most intense pain and mentioned to Kent that the epidural was wearing off. Two nurses came in and were confused; they were about to call the anesthesiologist, but checked me first. It was go time - I had dilated from 6 to 10 and was 100% effaced in less than 1/2 hour! They called the doctor at 12:50pm (18 minutes before the birth; he made it just in time). We got into position, with Kent holding my left leg and a nurse holding my right. For some reason, the pushing for me was very easy; three pushes and out he came! I did not have an episiotomy and I did not tear. Of course, I stretched and there was a potential suspect area, so the doctor put in one preventive token suture. Logan got Apgar scores of 7 and 9 and started feeding within the hour. He was 5lbs, 8oz, and 18 1/2 inches. Small, but full term (38 weeks).
We were moved to the mother-baby floor, where we roomed in with Logan and had a room all to ourselves. They kept me on the magnesium sulfate for another 24 hours, so I had to contend with double vision and being bedridden until Friday afternoon. Kent and Logan were never apart and Kent changed all his diapers. I was pretty much just a lump of flesh who fed him every 2 hours. Once I got off the mag sulfate (and Foley), I was pretty much loving life. They still came in to monitor me every 4 hours (taking blood, checking urine output, and getting vitals). Magically, once that placenta came out (about 5 minutes after Logan), my liver enzymes and platelets returned to normal. The protein eventually left my urine and my blood pressure slowly but steadily came down. It was amazing. We were both discharged from the hospital Saturday afternoon, 48 hours after he was born.
Well, that is my labor story. It wasn't what we planned, but it was an amazing birth experience. The nurses kept saying how shocked they were that we didn't have a c-section. I have no complaints. We are all happy and healthy and are getting the hang of things. Kent has been particularly amazing. To date, I have changed a total of only 8 diapers; Kent has changed the other 100+. He gives Logan his baths and likes to pick out the outfits. He's also better at swaddling than I am. Guess I'm pretty much just the feed bags! I've started pumping so Kent could feed him a bottle. We each get a good stretch of 3-4 hours straight sleep per night, which really makes a difference.
Oh, that HELLP syndrome I had stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. That's not good, but it is now a distant memory. I'd better go feed the little one; he loves a good feast!
D.M., Colorado Springs
