Little Bit's Birth Story.

On Sunday 10/1, dh and I went to bed around midnight. My mom had come the week before to help me with the boys since I was on modified bedrest due to complete placenta previa. When she realized that they didn't have school on Monday for Yom Kippur, she agreed to stay until Tuesday. I fell asleep with my head filled with ideas of what mom and I would do with the boys the next day. I was also thinking of all we might do to prepare for baby while mom was here.

90 minutes later, I woke up to use the bathroom and thought something felt weird. When I got in the bathroom, I saw blood covering my underwear and realized there was a puddle on the bed. I called the doc, woke up dh, and headed to the hospital. I was admitted to L&D at 2AM on Monday, 10/2 for observation and monitoring. Soon after being admitted, the contractions started about 4 minutes apart. I was told that blood irritates the uterus and so I was likely to contract, so I wasn't too worried. I got the first of two steroid shots to mature baby's lungs "just in case" and was started on magnesium sulfate to stop the contractions. I knew from friends that mag "is evil", but wasn't sure what to expect. The nurse told me it would make me feel hot, might give me a head ache etc. She also told me they would be checking my reflexes, breathing, vitals etc every hour while I was on it, so it was obvious this was a heavy duty drug. For the first several hours, I was surprised to feel pretty OK. The worst was that the L&D bed was so uncomfortable and was killing my back. The monitor also kept losing Nathaniel's h/b. I thought this was because I was fidgeting so much trying to get comfortable. The nurse reassured me it was because Little Bit was moving so much.
At one point she had me roll back and forth on the bed for something (steroid shot maybe?) and then was pushing on my belly with the monitor trying to find him. My blood pressure had dropped to 82/43. The drop in bp, the rolling, the belly pressing and the mag all combined to make me sick. I lay there vomiting wondering why I had sent my husband home and feeling very alone. Luckily the nurse picked up on it right away, pumped fluids in my IV, and I felt better within the hour. I stayed in L&D until Tuesday morning when the mag was stopped and I as transferred to regular room on the antepartum unit. I was so happy to be in a regular hospital bed in a room with a window that I actually cried. (TheL&D room was a little used, tiny box with no window that felt like a prison cell). Oh, I was also finally allowed to eat for the first time since I had been admitted. Chicken broth has never tasted so good! They told me I would be going home sometime on Friday assuming I didn't bleed again. Those were the prophetic words.

On Weds, I was finally allowed to shower for the first time since I had been admitted, dh brought my 5 year old in to visit and I went down to radiology for an MRI. I was at risk for placenta accreta which is when the placenta embeds too deeply in the uterine muscle. This can make the placenta very difficult to remove at delivery and can lead to hemorraging. I was anxious for these results since having an accreta was likely to keep me in the hospital until delivery. By the time dh and ds left, I was feeling pretty tired and crampy. That night the contractions and bleeding started again, so it was back to L&D and magnesium for me. This time they took me to L&D in my regular bed which helped me be much more comfortable. The mag really wasn't that bad and I was only on it about 12 hours. The resident finally convinced the peri to try me on procardia to control the contractions which would allow me to go back to the antepartum unit. My nurse and the ob in my ob group that I liked and I all agreed it probably made sense for me to stay in the hospital. My mom and I were very worried about what would happen if I went home.

Friday, I was in shock when the peri came in and told me I was going home that day. I was very scared to leave, but he said he couldn't justify keeping me. He also told me the MRI was inconclusive, so they still didn't know if I had an accreta or not. As he left I asked what would bring me back to the hospital. He said "red blood". An hour later, I used the bathroom, wiped, and found red blood on the TP. Gross as it is, I saved the TP to show the nurse when she came in after shift change. Before the nurse came in, one of the OBs came in. I said, "this is gross, but I need your opinion on what color this blood is. Dr. Smith said I should come back if I had red blood". She agreed with me that it looked red and looked concerned. Needless to say, I didn't go home that day.

I did shower and have my 3 year old come visit, both of which wore me out. The bleeding pretty much stopped by mid afternoon though which was a relief. Or so I thought. Then, around 5pm, I went to use the bathroom and realized I was bleeding again. I told the nurse, she called the resident, but nothing happened. I also told the nurse I was feeling crampy, but she did not put me on the monitor. I had to pee every 30 minutes for the next 2 hours and every time I did the bleeding was worse. WARNING: TMI - at one point I passed about a dozen small clots. I called the nurse again after that one and told her about the clots and that I thought I was contracting. She put me on the monitor and called the resident again. He finally came and seemed really grumpy. He was not one I had met before and I didn't like him. He did a speculum exam which hurt like the dickens and decided to send me back to L&D. I had to have another IV put in which took the nurses 3 tries to get in and was not fun! While I was waiting to be transferred, I had a mega big contraction, the monitor alarmed and I thought it was just because it was showing the contraction as being twice as strong as any I had had so far. The nurse and resident came running in, the nurse had me roll onto my left side and they started rolling me to L&D, I thought. I was rubbing my belly, talking to Little Bit and praying for God to give him strength and to give the doctors skill and help them make the right decisions. Then, I heard the nurse say "oh, open up" in a really worried voice when we got to some locked double doors. I saw the resident on the phone and heard "2 minute decel" as we were rolling by the nurses station, but didn't put it all together. Then the next thing I saw was people grabbing surgical caps as we went through another set of doors. I freaked out. "Where are you taking me? is this the OR?" I was so afraid they were going to put me under and do the section without my husband or any of the experienced docs who were familiar with my history and my case.

The anesthesiologist was peppering me with questions, but he was not a native English speaker and didn't understand my replies. I was sooooo scared. Finally, God answered my prayers by sending an angel to me in the form of a resident who was so calm and cool and kind. She came over and introduced herself, held my hand and told me what was going on. The monitor had gone off because Nathaniel had a decel in his heart rate. She thought the best course of action was to monitor me in the OR for about an hour to make sure he was stable. If he was stable, I would go back to L&D to start magnesium again as originally planned. Thank goodness Little Bit cooperated. As I was lying there, they called Craig, so by the time I got to L&D, he was there and he spent the night with me. It was one of the most miserable nights of my life. I don't know if they were giving me more mag than I had the first 2 times or if it was just because I was on it longer, but I was miserable. And because of the race to the ER, they weren't even letting me have ice chips. By the next morning, I couldn't even move in the bed and felt like I couldn't breathe. I found out later that magnesium is a central nervous system suppressant which is why they regularly check your reflexes, breathing, blood pressure etc.

The chief resident, who is a total sweetheart, came in early in the morning and couldn't believe what was going on. He was very low key but seemed pretty concerned. He told me he would be back with the peri in 1/2 hour. In the meantime, the OB came in, I had an biophysical profile of baby and was checked a million times. I finally sent my husband home to take our boys to soccer class and told him I would call him if he was needed. Finally around noon, the peri made it in. He told me "you are a time bomb. You are having this baby today. How's 1:30 sound?" Then things started moving. They shut off the mag, the nurse called my husband, and the anesthesiologist's Physicians Assistant came in to talk with me. I was really worried about delivering so early - 32w5d, but was also relieved. I didn't know how much longer I could do the mag or how many more of these bleeding episodes I could handle. I was also scared for myself. The docs had seemed so concerned about my past history and we still didn't know if I had an accreta, so I was concerned about how the surgery would go. Then, the gynecologic oncologist came in to talk to me. He exuded such confidence and didn't seem concerned at all about what he would find when he opened me up. He answered my questions and spoke to me like I am an intelligent human being. He even appreciated my more obscure question about using methotrexate to shrink a placenta when it is left in the uterus, and understood my desire to avoid this so I could breastfeed. He also made it clear that no matter what we discussed now, he would do what was necessary in the moment to keep my baby and I safe.

Craig arrived and we finally headed for the OR. At one point, they had me sitting alone on the skinny little OR table all alone while everyone scurried around. I was so dizzy and light headed it took all my willpower to stay up right. It didn't help when the anesthesiologist peppered me with questions and repeatedly jabbed his fingers in my back with no warning. Finally I was laying down and happy to see them use my gown as the screen rather than a huge sheet. I could actually see the surgeons working above me. I was asking lots of questions etc which made the anesthesiologist think I was too anxious. So, he got me really stoned. In some ways it was good, and in others it was really irritating. For example, I know Craig finally was allowed in the room and was really, really sweet to me, but I couldn't really focus on him. I also know Little Bit cried in the OR, but wasn't sure when it happened. Craig has since told me he cried as soon as he was out. I have never been so happy to hear a baby cry in my life. Then Craig told me "they are taking out the placenta". He says the docs were really tugging and yanking away. I remember asking if it was an accreta and the resident shaking his head, but later the OB told me it was embedded deeply.

All I really cared about was the warmer where they were working on Little Bit. I was so hopeful that the crying meant he was breathing ok and wouldn't need a respirator etc. He was doing so well that they brought him to me all swaddled and told me to touch him. Then the nurse held him right up to my face so I could kiss him. I was so grateful to her for that. It is one of my most cherished memories. I sent dh off to the NICU with Little Bit and just kinda zoned out while they were working on me. I had wanted them to tie my tubes, but they said they could not accept my consent while I was spaced out on Mag. (I was supposed to sign the consent at my next prenatal appointment 3days later) I felt alot more with this section than I have in the past. It felt at one point like I was a drawstring bag that they were tugging closed. Not painful at all, but very strange. Finally it was time to go to recovery where dh brought me the digital camera filled with pictures of him.

From recovery, I had to go to L&D for more monitoring for a couple of hours. On the way to a regular room, they wheeled me on the stretcher to the NICU. Miraculously, I didn't get sick on this trip. I usually throw up after surgery especially when being transported afterwards. Maybe it was just willpower. I was not going to let anything get in the way of my seeing my little man. Little Bit was on the warmer and looked absolutely perfect. He was like a tiny perfect little doll. In fact he was half the size of his older brother at birth. Maestro was 8lbs 6oz. Little Bit was 4lbs. The nurse gave me lots of info and told me how well he was doing. He was on room air cpap. He didn't need any extra oxygen, but did need just a little pressure to force the air in his lungs. This was given through a nasal canula. She warned me that he would probably be in an isolette in the AM when I came to see him and that he would eventually graduate to an open crib when he could regulate his own temperature. Soon I was very tired and they wheeled me to my room where I got sick several times. BUT it just didn't matter. May baby boy was here and he was OK! I was ecstatic.

My recovery has been fairly easy. I swear the vertical incision is less painful than the horizontal ones I had for my 2 previous sections were. Every time the docs came to check on me, I told them I felt great and it was true. I was just so happy to not be pregnant anymore and after months of worry was so glad that everything turned out ok. I found out the next day just how lucky I was. This has been repeated by every doc that was in the OR that day including the neonatologist. Apparently as soon as they opened me up, they could see Little Bit. My uterine wall had an area about 6 inches in diameter that was paper thin. The neonatologist described it as "barely a membrane covering the baby" and said she had never seen anything like it. The gynecologic oncologist also told me about it and warned me that getting pg again would be really dangerous. In the end, the bleeding and the contractions turned out to be a good thing. If the pregnancy had gone on much longer the uterus could have ruptured which could have been fatal for baby and I both. I just feel so thankful to be alive and thankful to have my 3 beautiful boys. I'm not a very religous person, but I had a lot of people praying for us, and I think that had to have helped! To all of those doing the praying thank you!

Best of all, Little Bit is supposed to come home tomorrow! 2 weeks after birth at 34w6d gestation.

Little Bit Has Arrived

This is an email that dh sent out:

"FYI -
Carol and I are happy to announce that "Little Bit" was born Saturday at 2:29pm . He was only at 33 weeks (gestational age), and we weren't expecting a scheduled C-section until early November. His "official" due date was Nov 27th.

I took Carol to the hospital last Sunday night, after midnight,
with early bleeding. This was expected given her existing complications with this pregnancy. As a precaution they gave her steroids to trigger the early maturation of Little Bit's lungs, in case they had to deliver within a couple of days. They kept her in Labor & Delivery throughout
the week, trying to get contractions and bleeding under control. She was back-and-forth between the Ante-Partum wing and the labor and delivery room, as her status fluxuated. I spent all of Friday night in L&D with her. I came home at 9am to take the kids to Soccer, but
by 11:30am the Perinatologist had decided that there was a greater risk in delaying the birth. It is good that he did, because of what they found in doing the C-Section, but I will let Carol post about that when she is back home.

Fortunately, everyone is doing well. Little Bit was just about 4lbs even, and cried immediately upon birth (so lungs were mature). He's in really good shape, nice pink color, but will probably spend the next 2 to 3 weeks in the NICU. His facial features, from his
picture on the warmer, looks remarkably like Maestro's picture when
he was born. It will be interesting to see if this holds true. I'll
post a picture later. Carol will probably come home on Wednesday.

- Craig"