Friday, November 2, 2012

Shelby Hope's Dramatic Birth - The Decision



Sometime during the night Friday, my nose started bleeding. I’ve never had a nosebleed, so that was weird. I didn’t really think anything of it at the time … even though Tim held my nose for 20 minutes and it wouldn’t stop. “It’s pretty dry in here” I told myself. The fact that platelet levels were part of HELLP didn’t cross my mind – which is just as well. The only way Shelby was going to know anything was wrong would be if I started to get upset. Staying calm was the best thing I could do for her.

Saturday – the day we were supposed to be moving from our 2nd floor apartment to a cute house in the country. Saturday morning the Pitocin did not get started at 6am as planned. I don’t remember what time it was, but one of the doctors from the practice I go to came in (I think our wonderful nurse was there too) and told me I had a choice. My platelet levels were basically in the toilet – there was blood in my catheter, and last night’s nosebleeding episodes, as evidence. I was losing the ability to clot my own blood. I was given a choice.

I could try the Pitocin until 4pm, at which time a C-section would be performed. I could not have an epidural even if I decided I wanted one because of the risk of hemorrhaging into my spine.

Or we could do a C-section under general anesthesia. Tim could not be in the room (in our Bradley birth classes we had to say what we were most afraid of, and I was most afraid of being separated from Tim).

Not a choice I was excited to make. No one said anything at the time, but my family all thought the choice was pretty clear and were surprised I was even being given a choice given my deteriorating condition and the risks involved.

Still not realizing exactly how sick I was, I asked a few questions:
  • Could my condition worsen between now and 4pm? It most assuredly would.
  • Could my deteriorating condition affect Shelby? Yes.
  • Did I progress any yesterday on the Pitocin? At this point they obliged me and did a pelvic exam. Now, I knew this can mean nothing – but this was never a naturally progressing birth. I felt like if I had made a good bit of progress there was a chance I could deliver her by 4pm on the Pitocin. I was at 1.5cm and 50% effaced. In over 48 hours, I had only progressed less than 1cm and an extra 10% engagement of her head. To me that didn’t point to her suddenly exiting quickly and safely.

The fact that Shelby could begin being affected sealed it for me, and I haven’t looked back at our decision. She would be here very shortly via C-section and I would not be awake.

Things began moving very quickly at this point. My Dr, who was working on his racing trailer, came in even though it was a Saturday and he was not on call. I can’t tell you how much I appreciated this! He is an excellent surgeon and has pretty much been my OB/GYN for about a decade now. I would be going back to surgery at 11:30am. Shelby was about to have her birthday!

I remember the moments before the surgery surprisingly well. At first I was numb, in a whirlwind of information about what was about to happen, friends and family coming to excitedly but nervously tell me goodbye and that they can’t wait to meet Shelby, and my own emotions about having a C-section after so many months of practicing for a natural birth. Tim and my Mom’s tearful goodbyes began to give gravity to the situation … I was going to be undergoing major abdominal surgery, with donated platelets being quickly eaten up in my arteries, under general anesthesia where I wouldn’t hear Shelby’s first cries and Tim couldn’t join me. And I might wake up in the ICU?

Once I was wheeled out of the room that had been my home for three days, I paid close attention to the fluorescent lights passing by overhead until it made me dizzy. Tears were forming in my eyes, but not falling … I was calm, practicing my abdominal breathing.

Then we burst into the surgery suite and a controlled chaos enveloped me. I saw the bags of blood clearly labeled “O-neg” waiting for me if I began to hemorrhage. With assistance I moved to the table, where I was shocked to find I was asked to spread my arms as if on a cross. The anesthesiologist’s assistant was immediately by my head, telling me what was going on … and I saw Carrie, the nurse from my room. I truly believe these two comforters kept me from panicking as my arms were tied to the table.

Various nurses swirled around the room preparing for the surgery and the assistant told me who they were and what they were there for. An oxygen mask was lowered over my face, and he reminded me to breathe deep. A drape was spread over me and stuck to my stomach, but then a discussion over a hole ensued and eventually it was taken up and a new one found.

A sharpie was drawn over the area that was to be cut. Instead of thinking “My stomach is going to be cut open!” I told myself “This is where Shelby will be coming into the world!” I heard my doctor’s voice as they joked about finding sterile scrubs his size (he’s tall) and the assistant told me that as soon as I was out they would be taking her as quickly as they could to have as little of the anesthetics in her system as possible. Suddenly I smelled the gas …

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