We arrived for ultrasound and NST [non-stress test] on Monday, March 20th, at 9am. Yuli had the non-stress test first and it went very well. Then we had the ultrasound and the tech seemed a bit concerned and said she needed to show it to the doctor (which no one said at the ultrasound on Friday), which was concerning. We then overheard doctor Ashford telling Jo that fluid is low and it's an issue. Then he came in and nicely, but frighteningly, told us directly we should go now to triage and get ready to have an induction. Noah asked if we could speak to our midwife first. He said that’s fine, can I trust you to go upstairs after?
Instead of going upstairs we called Jo (our midwife) and Cara (our doula), and gave them each the update. Jo said she already knew and was able to get us to buy some time so we could go home first and have a meal (and Noah could change out of his suit) and come back at 2. Cara said to call her back when got back to the hospital. Both were very reassuring that this was the best course of action and that he was more than ready to come out. Cara was very helpful in calming Yuli down. At this point Yuli was nervous about the idea of an induction and the fact that labor was going to start for sure sometime that afternoon. Of course, she knew that it was going to happen at some point but knowing exactly when was anxiety-provoking instead of exciting. We also called Yuli’s mom and told her what was happening and she and her dad headed home from work to drive us back to the hospital later that afternoon.
We took an Uber home. Yuli and Noah were very anxious as they tried to process what just happened and Yuli was processing that today she would be going into labor, something she hadn’t expected this morning. We ordered a pepperoni pizza and garlic knots. They were delicious and a good idea given it would end up being Yuli’s last meal until Tuesday at 5pm. We packed out bags and headed back to the hospital with Yuli’s parents driving us.
We arrived at the hospital at 2:20pm and headed to triage where we met Jo. We sent Yuli’s parents home because we didn’t want them waiting around and Yuli did not want them to see her in the hospital bed and in labor. Since we didn’t know what was happening or how long it would take it made her less anxious to know that they were not waiting around outside or downstairs. Yuli got hooked up to the baby monitor at 3:00pm and had an IV port put in at 3:10pm. The first IV into her arm above wrist was realllly painful (and still was at least 6-days out [postpartum]). Perhaps he hit a nerve. The nurse then was able to insert the IV into her hand right at the wrist, which worked but unfortunately would limit her ability to use that had to support her weight during pushing
At 4:00pm, Jo examined Yuli and found she was at 1.5-2cm and [baby] at -3 station. This was upsetting considering she already had two sweeps and the bloody show, random contractions for days, and was at the exact same measurements on Friday.
Jo decided to start Yuli with Cytotec to soften her cervix and a Foley balloon to help her dilate to 3-4cm. They were inserted at 4:20pm. Contractions started to become regular and intensify around 5:15pm. Yuli hated the Foley balloon. It was really uncomfortable being strapped to her thigh. On top of that, she was required to be 100% monitored, meaning she couldn’t get up to walk around or use the shower or get up to go to the bathroom and had to use a bedpan. On a chair. In front of people. It was the worst! They also said she was not to eat ANYTHING. This was all really disappointing because Yuli was expecting to be active and have free movement to help her cope during labor. It seemed that all of her options to deal with the pain were very quickly taken away from her.
Cara arrived at 8pm and helped to darken the room and set up LED lights. We also watched, for the first time, Dancing with the Stars. The music helped Yuli get through the early contractions. Contractions were regular and Yuli was able to breathe through them. By 10:00pm, contractions started becoming more regular (every 5-7 minutes) and were taking much more attention. From 11pm-12am we all tried to get some sleep (while Yuli rested through contractions on her side). She side-lied at Jo’s recommendation to make them stronger, which worked, as contractions became continuous around 12:15am.
At 1am, a magical thing happened. The Foley balloon came out! This explained why for the last two hours Yuli couldn’t pee. This really improved everyone’s spirits and showed some clear progress. It also meant Yuli would not longer have to be under constant monitoring and could walk around and pee. At 1:15am Jo examined Yuli again, and found she was 70% effaced, 3-4cms and at -2 station, and the IV was removed and a hep-lock was inserted. Yuli had lost all sense of time by this point.
Around 1:30am, as the hormones began raging through Yuli’s body, her whole body began to shake uncontrollably. This was celebrated by Cara as most uncomfortable things were. Cara asked her to try and do a contractions or two on the toilet, but Yuli couldn’t because she was shaking too much. It was really scary. Cara massaged Yuli’s legs because they were so swollen and in pain.
Yuli focused a lot on her breathing. We tried using the rebozo scarf but that didn’t help. We tried using counterpressure but that didn’t help. The only measure that sort of worked was a neck massage somewhere throughout this process.
Around 4am contractions started slowing down and coming less frequently, although Yuli complained about a lot of pressure/pain in the front/bottom of her pelvis, which is where Henry likely was. At 4:45am, Yuli received her first [dose of antibiotics due to] strep B and was hooked back up to the IV. At 6am, Yuli had another exam from Jo and saw she was at 4.5-5cm, but wanted to monitor contractions for a bit given how they were not progressing.
Due to lack of progression, Jo decided to start Yuli on 2ccs of Pitocin at 6:30am. She said they usually would first try to break Yuli’s water, but because fluid was low, it was better to start Pitocin first. Yuli was really nervous and scared about this, and whether she would be able to cope with the Pitocin contractions. She really did not want to use medicine, so this was another disappointment.
Right as the Pitocin was administered, Henry’s heart rate dropped to 110 [beats per minute]. It was unlikely this was directly related to the Pitocin because how soon the drop occurred after the Pitocin line was hooked up. However by 7am Henry’s heart rate got back into the 120s after some close monitoring. Also contractions started to strengthen and get closer together again. At 7:25am, unbeknownst to Yuli, Pitocin was increased to 4ccs, and was slowing increased to 6 and then 8ccs over the next few hours.
At 9:00am, [midwife] Elaine came to take over for Jo. Elaine gave her an exam at 10:15am, showing Yuli at 7-8cm, 80% effaced, and at -1 station. By this point, it was getting more and more difficult for Yuli to cope. It was also especially clear to Noah at this point that the contractions monitor wasn’t working well at all and not capturing the intensity of each contraction. The baby’s head was sitting very low in her pelvis, so she had a constant feeling of pressure down there even when she wasn’t having a contraction. Furthermore, the nurse for this shift was being very intrusive and kept talking and asking Yuli questions about the pain during her contractions. She also kept offering to do counterpressure, even through we realized early on it wasn’t helping. Henry was likely in a good position and so back pain was never really an issue throughout labor (fortunately!) It was also really annoying to have to keep moving around the contraction monitor during contractions.
By 11:00am, Yuli started feeling the urge to push. At noon, Elaine broke Yuli’s water. Only a small trickle of fluid came out, confirming the earlier diagnosis that her fluids were indeed low and it was time for the baby to come out! Yuli kept wanting to start pushing, but still wasn’t 100% effaced, so Elaine coached her to still try and breath through the contractions and not push. The whole mantra was to keep chin down, voice low, and keep everything focused downward. It was not always fully successful, and there were some (ok, a lot of!) loud yelps by Yuli. Yuli kept hoping that she was really close to done, and kept asking if this was the case, but unfortunately wasn’t there yet. Elaine kept coaching her to take it contraction by contraction. She also kept using her iPhone flashlight to check on the progress. Yuli asked for nitrous oxide to help with the pain, but at this point it was already too late!
By 1:20pm, it was finally time for Yuli to start pushing. Yuli tried to sit on the stool, but it was really uncomfortable. She resisted getting on all fours as well. So she went to the reclined position on the hospital bed with her legs up. Cara was on one leg and Noah was on the other leg. Noah was hoping to stay closer to the head to avoid seeing the action, but given his positioning, was in full view of the final sequence.
Yuli really let it out during the pushes, as she was reminded to keep everything down and to not raise her voice too loudly. She exclaimed she wanted to die, and Elaine said no, and then Yuli agreed to stay alive. Once the overhead lights came on, Yuli knew she was getting close. Also, once Noah saw all the tools get laid out for Elaine to use bedside, he knew things were very close too. As Noah witnessed, Elaine tried everything to soften/stretch the perenium, using hot compresses, lubricant, and then her fingers to stretch everything around. Baby’s head started to show, and each contraction more and more started to come out. It felt like a poop that was there but unable to get fully pushed out.
As things progressed, Elaine became concerned that the baby’s was too big and might do too much damage to the perineum and other parts if it tore while the baby was being pushed out, so she decided, and we agreed, it made sense to cut the perineum ["episiotomy"]. Yuli even exclaimed “just cut me already!” Elaine cut the perineum and with that final push the baby’s head came out. The cord was loosely wrapped around his neck and Elaine was able to maneuver it out. She told Yuli to keep pushing and Yuli complied and out come his shoulder and Elaine was able to slip the rest of him right out! At 2:18pm, baby was born. After he came out, a big whoosh of [fluid with] meconium followed, but it didn’t seem to touch the baby. In fact he came out looking incredibly clean! The baby went straight to Yuli’s chest where she and Noah saw him for the first time. Henry screamed and cried and cried, but came out OK, weighing 8 pounds and 5 ounces. Soon after Yuli birthed the placenta, which weighed another 3.5 pounds. Elaine said it looked fine and we reluctantly looked at it as well. Elaine then patched Yuli up for quite a while during which time Yuli made small talk with Elaine. What else are you going to do at that point? At 4pm, following Elaine’s recommendation, Noah wandered outside to get some burritos. They were delicious!