The Story of Catie

After losing Grace in December, we were told to wait at least 2 months before trying again. Month 3 was a disappointment: no baby. I was very discouraged. My doctor was recommending surgery because my endo pain had gotten so severe (Sweetie was another Vicodin conception), but I was determined to try one more month.

At the end of month 4, I started getting PMS cramps 5 days ahead of my expected period, which was typical for me at the time. I knew I couldn’t be pregnant, so called the doctor to schedule surgery. I went in two days later for pre-surgery testing and paperwork, giving the test samples first. As I was working on the forms, a nurse called me back to see Dr. D. When I walked into her office, the first thing I noticed was that she was looking at one of those circular due-date-finders. I nearly fainted! Surgery was cancelled.

Despite the rough start, my pregnancy progressed really well through the first 2 trimesters much like Smartie’s had. I knew my chances of recurrent pre-eclampsia were 40% and was very vigilant about my symptoms. This time, I started swelling and having breathing troubles at 33 weeks. My doctor (a new one since Smartie’s birth) was very good about taking this seriously. We started doing weekly 24-hour urine checks for protein and weekly blood pressure checks in the office, plus I had a BP cuff at home for daily checks.

We had a scare at 35 weeks—I woke early one morning with a terrible headache that Tylenol couldn’t touch. I took my BP, and it was 165/110. Wouldn’t you know, there was a blizzard outside. It took Papa Runner 3 hours to dig us out, and by the time we got to L&D, my BP was back down to 110/70. The nurses just rolled their eyes and sent me home, but my doctor increased the in-office BP checks to twice a week.

At 36+5 weeks, I finally became diagnostic for PE—two BPs above 140/90 six hours apart plus a 24-hr protein measurement over 300. Since we were so close to term, my doctor put me on strict bedrest for 24 hours and brought me in for an overnight induction the next evening. The plan, like with Smartie, was cervix softener for 12 hours followed by Pitocin, with baby expected the following afternoon. We knew this drill, so Papa dropped me off and went home to get some sleep before the big day.

The first problem was that my new doctor preferred Cytotec to Cervadil as a cervix softener. Cytotec is much more likely to cause hyper-contractions. (And, incidentally, it is not approved for this use. The manufacturer has put all kinds of warnings out that it is not to be used to induce labor, because an overdose can lead to uterine rupture.) I had a dose at 6:00 and another at 10:00. By midnight, I was having regular contractions. I told the nurse I was in early labor. She just laughed at me, “Honey, I’ve seen this a thousand times. You’re not in labor.”

I had the third dose at 2:00, and this is my biggest regret. I knew I was in labor and there was no more need of medicine. I should have refused the dose. It put my contractions WAY out of control. The contraction belt was not set right, because the monitor was not picking up anything. Then, when my contractions finally got intense enough to show up, the nurse ran in…and zeroed out the monitor at the peak. She just plain didn’t believe I could be in labor yet and thought the monitor was picking up random movements. I told her it really was a contraction, but again she just laughed. She did this a couple times as my contractions got more and more intense.

At 4:30, I called Papa, waking him from a dead sleep, and told him he needed to come RIGHT NOW or he was going to miss it. He didn’t believe me either! He took a shower, ate breakfast, read the paper, finally showed up at 5:30 to find me ready to kill someone. He ran out to get the nurse, and it was finally at this point that she realized I had been right all along and things were moving fast.

The nurse gave me a shot of Nubain, which did nothing. She paged the anesthetist, who was at home, to come in for an epidural. By 6:30, I was dilated to 10 and pushing. The nurse started yelling that I couldn’t push because the doctor wasn’t there yet! “Honey,” I said, “I lost control of this thing a looooong time ago!” The delivery tech, who was much calmer, told me she couldn’t see the head yet so I should just go ahead and push if I needed to. The anesthetist finally showed up at 6:45.

(Another aside—the ACOG recommends that any hospital handling deliveries have an OB, a pediatrician, and an anesthetist on staff at all times in case of an emergency c-section. You should be able to have the surgery within 30 minutes of the decision being made. It took the anesthetist close to an hour to show up, and the OB was 15 minutes after that. Thank God I didn’t need a c-section! We go to the hospital because we’re told it’s safer, but if they don’t have the staff on hand to handle emergencies, we might as well have our babies at home!)

The poor anesthetist came in to do my epidural, and the response he got was, “Screw you! I’m already to 10, the hard part’s done!” I really had not wanted an epidural to begin with, only asking for it after the Cytotec overdose gave me hyper-contractions, and figured if I was this close to delivery I could tough it out. It’s amazing the change in attitude you get when you know it’s time to push; it no longer seemed that bad even though the pain hadn’t lessened.

The anesthetist said that was fine and left. The nurse stopped him in the hallway. We could hear her screaming at him, “YOU HAVE TO MAKE HER TAKE SOMETHING SHE’S PUSHING AND THE DOCTOR’S NOT HERE!” They argued for a few minutes, and he finally came back in to offer me a spinal. It goes a layer deeper than an epidural and takes effect instantly. I refused again. Then the nurse started screaming at Papa, which made him panicky, and he joined in trying to convince me to take it. I didn’t have the strength to fight everyone, so I gave in.

Within seconds of finishing up the spinal, the doctor walked in. I was furious: if I had known she was that close, I would never have agreed to the meds. Now I was completely numb and unable to push effectively. And to make matters worse, Sweetie was stuck! I had a strong instinct to get onto my hands and knees. A change in position would have helped her to turn enough to be born. But how can you kneel when you can’t feel your legs? Stupid meds, and shame on the nurse for bullying me into it! I pushed for 20 more minutes, and the doctor had the vacuum extractor all set up and ready to go because this baby was not coming! She did an episiotomy, and suddenly Sweetie turned and pretty much fell out in one swoop without help. So Sweetie was born at 7:20 am on December 8, weighing 5lb 2oz and measuring 18 inches long. She has been another delight to our family.

Smartie's birth was not the natural experience I had hoped for, but knowing how sick I was I look back with no regrets. Sweetie’s birth, on the other hand, makes me furious to this day! I was not nearly as sick, and the mismanagement of the nurse caused so many problems. The overdose leading to hyper-contractions, failing to believe me when I reported contractions, panicking and screaming at everyone…I swear, if I go in to deliver the twins this summer and see the same nurse, I will turn around and head back out. I will deliver the babies myself before I let that woman near me again. I also have switched doctors again, hoping for a more natural experience. But I’m being realistic, too; I’m considered very high risk with my PE history and twins to boot.