At 32 weeks, I expected to be getting “big and pregnant” and to be nesting, preparing for the arrival of our little one in two months. Baby Hartman had other plans in mind.
On Sunday, December 9th we were to celebrate the arrival of 32 weeks. We had been counting down to this date for two reasons. First, 32 weeks marks an important level of fetal lung maturity and two, it would be the half way point in the hospital stay (we were anticipating delivering at 36 weeks).
However, on the evening of December 8th, Baby Hartman’s heart rate dropped for a scary period of 8 minutes. One of my favorite nurses, Tammy was on that night. As usual, she rushed in as the alarms were going off. She moved me to the right, to the left, to the right again. This time changing positions did not help Baby Hartman’s heart rate return to normal. She pulled the alarm behind the bed (which Neal and I had accidentally pulled early in the admission). Within seconds many nurses from the maternity ward rushed in to her aid. Finally, after eight, very long minutes, Baby Hartman’s heart rate returned to baseline. That evening, she continued to have dips in her heart rate with contractions, which for the first time felt like true, painful labor contractions becoming 3-4 minutes apart.
During the admission, the OB had ordered Terbutiline injections (fast-acting bronchodilator) every several days to control contractions. Traditionally this medication has been used to control asthma. Currently, the medication is used to prevent preterm labor 48-72 hours. It has a painful burn and causes shaking and a very high heart rate–feelings which I will never forget. Even though I have an incredible fear of needles, this medication worked wonders for me and provided amazing relief from contractions and the feeling of the baby’s head pushing down. I almost started to welcome them. During this evening and the frequency of terbutiline injections increased to every few hours.
The morning of December 9th, my OB came to visit and told us that she did not like what Baby Hartman’s heart rate had done over the past 24 hours. She wanted to deliver her because she thought Baby Hartman was in distress. It was decided that the C-section would be scheduled for 4 pm on December 10th. This would allow for maximal effects of the second round of steroid injections. Because my cervix was still progressing (I believe I was 4 cm? at this point), the OB started me on Magnesium sulfate, also traditionally used to prevent preterm labor. While studies show it doesn’t successfully prevent preterm labor, it does help to reduce contractions by relaxing all of the muscles in your body. It also shows some neuroprotection, primarily from cerebral palsy (more common in premies).
The magnesium sulfate burned (pharmacy’s can no longer prepare it with lidocaine because of accidental toxicity). It made my body feel like it was under a broiler. I felt flushed and very warm. The worse part was the incredible, insatiable thirst. I was receiving fluids through the IV and also drinking 5 liters of water per day. Luckily, I was still able to sit up and walk (because of the muscle relaxing effects, some people can’t even hold their head up). At midnight, the OB made me NPO (no food by mouth) to prepare for surgery the following day. This wouldn’t have been bad expect for that crazy thirst (Neal sneaked me a few ice chips). The nurse brought me some fruity swabs that are supposed to increase saliva production (which almost made it worse…).
On the day of Baby Hartman’s scheduled entrance into the world, I felt relatively calm (aside from the crazy thirst). For years I had envisioned how I wanted the birth of my children to go. If I was to have had a “Birth Plan” it would have been to experience the delivery as “naturally” and “drug-free” as possible. I wanted to experience all of the aches, pains, and joys that pregnancy and delivery is said to offer. However, with the experiences of the last few months and the blessings of medical interventions, I had already had to throw all expectations out the window. Like pregnancy, birth was going to be dictated by the needs of our unborn child and we were going to do everything in our power to have the best, safest birth outcome. In order to achieve this outcome, a c-section was necessary. The main concern was that Baby Hartman’s head was compressing the cord under her head, which was far into the birth canal. Throughout the past month+ she had demonstrated poor tolerance to contractions (which hadn’t even been as intense as labor contractions are) and additionally the position of the cord put her at risk for cord prolapse. After I accepted that a c-section was necessary, then I had to accept what I had feared the most, a spinal. Because of the fear of needles and the fear of what we might experience in the delivery room with our premie, I seriously considered being put to sleep for the surgery. After much discussion with Neal and family, I eventually accepted that the spinal was the best option and that i would regret not experiencing Baby Hartman’s birth.
About an hour before delivery my Mom, Neal’s mom, and my sister arrived to show their support. I had begged for a shower prior to delivery (I wanted to look pretty in those classic post delivery pictures–and I figured I might not be up for showering for a few days). After convincing the doctor (who was concerned because my contractions continued to pick up in frequency the morning of delivery, even with the Magnesium), I showered but didn’t know that I had to be reconnected with my monitors right away. As a result, my mom was going to try to style my hair for me.
As my mom began to style my hair, I quickly became overwhelmed with emotion and fear. My body began to shake uncontrollably and I felt panic set in. At that point, our family left and it was just Neal and I. Neal cuddled with me for a little to try and help me calm down. One of my amazing antepartum nurses was able to be with me during the surgical prep and delivery. The anesthesiologist was the first to come in the room, he went and gathered the rest of the medical team (OB, neonatologist, nurses, etc). Within minutes we were rolling out of my “home” and into the surgical area of the maternity ward. The scariest part was when they have you walk yourself from the hallway into the room and climb up onto the table yourself. The table is really skinny with two extensions for your arms that stick straight out, making you feel very vulnerable.
First, they administered the spinal. They asked me to curve my back as much as possible to expose the region for the injection. Because of fear, I curved my back as much as possible, but heard my OB demanding I push back harder. I was still shaking uncontrollably and so scared. The spinal was not nearly as bad as I had imagined. The worst part was the burn of the lidocaine injection prior to the spinal itself. The spinal sent the most bizarre, intense tingly feeling down my legs. After that everything went extremely quickly. There were so many people doing different things. The neonatologist was setting up with his team for the baby, the medical assistant was getting the tools ready for the OB, my amazing nurse was finishing my prep and then came to support me during the procedure. Neal was there on my left, holding my hand. Within minutes I felt pressure, even some pinching as the doctor was making sure the spinal was effective. Then there was intense pressure and tugging and at this point I knew Baby Hartman was being born, but my memory is not as clear. Neal will have to fill this part of the story in for me.
Nora Emerie Hartman was born at 4:06 pm weight 4 lb 11.8 ounces and was 17.7 inches long. The next thing I remember was the neonatologist holding Nora in front of me to see her. The emotion was overwhelming. There she was, who we had been waiting for for months and really our whole lives. She was perfect, I didn’t know how to respond. I reached out and touched her. She was soft and warm and I couldn’t wait to hold her, to get to know her.
Then they were rushing Nora out of the delivery room to the NICU and Neal was asking if I was okay if he went with them. I was scared for him to leave, but immediately I couldn’t imagine our baby being alone without us. She had been a constant presence for the past 7 months. I had felt her move, held her (always rubbing and hugging my belly) talked to her, cared for her, watch her grow, and had made important decisions for her well-being. We had been active parents for months before she arrived. An amazing realization. Life hadn’t been the same since we found out we were pregnant-but we had really actively embraced and thrived in our roles as parents during the time in the hospital.
Nora Emerie was officially here, tiny, perfect and healthy, and she was forever ours.
WELCOME TO THE WORLD NORA EMERIE!
XO!
Caity
