Alyssa’s Birth Story

February 25, 2013

Originally posted on Alyssa’s blog.

The crisp mornings and early sunsets that make September different from August in the Northeast are such instinctual reminders of Virginia’s month long birth story. It was in that month before her birth that I realized how precious life is, how important faith is, what a truly amazing husband I have, and what an incredible support system of friends and family we have.

Until 20 weeks I had a perfectly normal pregnancy. I had been working out 5-6 days a week, eating (mostly) healthy, and had perfect checkups and ultrasounds. Around 20 weeks I started to notice my tummy occasionally getting hard while I was working out or sitting for a long period of time. Initially I thought it was the baby rolling, but then realized that it was likely Braxton Hicks contractions. Dr. Google told me that it was normal to have them that early but it still made me nervous. I had previously had a uterine surgery (septoplasty) that I knew put me a slightly higher risk for pre-term labor and cervical issues. Because of my history I had made a plan with my OB at the first appointment to have monthly ultrasounds to monitor for any cervical changes. Once I started noticing sporadic Braxton Hicks contractions I called my OB and asked that we move up my scheduled ultrasound from 23 weeks to 21 weeks. He agreed and also eased my concerns stating that serious complications would be rare even with my history, but it was worth being cautious.

I was convinced that everything was fine, but was glad that I would have piece of mind after the ultrasound. Unfortunately I knew something was definitely wrong as soon as I saw the ultrasound image on the screen mounted to the wall in front of me… the baby’s tiny feet were slipped down into what looked like a funnel. This is definitely not what my weekly “your baby is this big” email from Babycenter looked like. In an instant my heart sank, my hands shook, and my mind went blank. My cervix was funneling and measuring 2.2 cm. A full 1 cm shorter than the measurement at my ultrasound 3 weeks prior. Again, my doctor put me at ease. He explained that while my cervix was effacing much earlier than normal it did not mean that I couldn’t continue to have a healthy pregnancy, albeit one spent on bedrest. I felt better, composed myself and left the office determined to do everything I could do to keep the baby cooking. We canceled all of our plans for traveling to our niece’s baptism and babymoon in Montauk and set up a new routine at home. I was ready to spend the next 4-ish months alternating between my bed and the couch. My first week of bedrest went really well. I hardly had any Braxton Hicks contractions, I was able to get quite a bit of work done from home, my spirits were high, and we already had so much support. It was a week later and a week closer to a healthy baby.

Again, I walked into my OB’s office pretty confident that things would be ok. I thought for sure that the measurements would either be the same or maybe even better. Afterall I had gone from being very active (including long runs and workouts) to laying around and doing nothing for a week. This time I had no idea what I was looking at when the image came up on the screen. I didn’t need to though, the look on the ultrasound technician’s face was an unmistakable look of sympathy. There was basically nothing left to measure and they sent me right over to the hospital for observation, testing and a possible cerclage the next morning.

The two days that followed were the hardest of our lives. We had consultations with many doctors. We were hopeful that a cerclage to stitch my cervix shut could be done, but didn’t meet a single doctor willing to recommend the procedure because of the risk of sending me into immediate labor. Even the doctors that suggested that our baby had very little chance of making it to viability were unwilling to perform a cerclage. It was unbelievably confusing, scary and heartbreaking. Over those 2 days, My Husband and I talked about things that no expectant parents should have to discuss. Would we name the baby? Would we baptize the baby? Would we want to be alone? It was a relief to discuss and decide on the unimaginable and move on so we wouldn’t have to make these decisions at even more emotional and stressful moments. From then on we only accepted hope and despite all the grim statistics we decided to believe that we would be okay.

We counted days, days that felt like years. Somehow days turned into a week and then another week and suddenly we had reached viability. I received steroids to help the baby’s lungs mature and was moved from the general gynecology floor to the antepartum maternity floor where they were better equipped to monitor my condition. We went from desperation veiled as hope to so much hope. My first ultrasound in 2 weeks revealed that everything was the same. I was still fully effaced but was not dilated. It seemed like I had stabilized! My doctors were equally surprised and confident that it meant that I could remain pregnant for much longer than anyone expected. I was even given a discharge date of December 10th (32 weeks).

Again we were confident. No contractions, the baby was growing well, I felt good, I had a steady stream of visitors, and we were prepared to spend the next 8 weeks in the hospital. Just a few days later, late in the night on a Tuesday things deteriorated, I felt different and knew something was wrong. I will never forget the fear as I waited for the chief resident to come to my room. I shook like a leaf; fear and disbelief once again took over. The resident determined that I was 3cm dilated and my membranes were in the birth canal. In a matter of minutes they were inserting IVs into my arm and wheeling me to the labor and delivery floor. I called my Husband, who didn’t hear any of the phone calls. We have no family and the area, so I ultimately had to call the police to go knock on our door to awake my husband. It must have been the scariest night of his life too, he walked into the hospital not knowing if I had already delivered. During the wee hours of the night, while in the haze and overwhelming heat of magnesium, there were ultrasounds showing that the baby was in the least favorable position of feet down, we met with anesthesiologists, met with my on call OB, met with the on-call Maternal Fetal Medicine (MFM) doctor and most sobering of all we met with the neonatologist. We were once again given the statistics; survival statistics and disability statistics for a baby born at 24.5 weeks. She also attempted to prepare us for what we would see and how they would attempt to help our baby. Hours turned into shifts and then days and somehow things stabilized again. I desperately wanted to get back to my room on the antepartum floor and desperately wanted to be able eat again (I was nil per os (NPO) for several days while on magnesium). I felt like a ticking time bomb on the labor and delivery floor (I was), and wanted to go back to “my” room where I hoped to turn days into weeks again.

After 3.5 days in a labor and delivery room on strict bedrest (otherwise known as the the 7th level of bedrest hell where catheters, bedpans and sponge baths are very much a reality) my doctor agreed to let me go back to “my” room on strict bedrest. I told him I was ready to last another few weeks and for the first time he didn’t share the same optimism. He gave it to us real. It was Friday afternoon. He was on-call all weekend and said he wouldn’t be going home all weekend. He didn’t think I would still be pregnant when he signed off to the next OB on Sunday night and wanted to be sure he was “in house” for what would likely be an emergency situation. He anticipated that my water would break and had us prepared for a crash c-section and a very frantic but well rehearsed series of events.

By dinnertime on Friday the 21st I was back in “my” room and more importantly back in “my” bed which was far more comfortable than the beds on labor and delivery which were very clearly made for birthing babies and not for sleeping. In hindsight, I was very much preparing for Virginia’s imminent birth while putting on a face of strength and hope. We narrowed down names to 2 boys names and 2 girls names, something that we hadn’t discussed since the series of unfathomable conversations that Heath and I had during those first 2 days in the hospital. By the next morning I knew I was going to give birth that day. I tried to convince myself otherwise, but even my favorite Resident’s prediction that I would prove my OB wrong and make it to Thanksgiving was not enough to distract me from what I already knew. I called my nurse a few times and she said they weren’t picking up any contractions on the monitor belts that had been strapped to my belly for the last few weeks. I called her again and asked her to page my doctor. I was right. I was 7cm dilated, as scary thought since she was still breech and a baby so small can be delivered before being the full 10cm dilated. I thankfully skipped my breakfast knowing that I would need a c-section and was soon back down in the same Labor and Delivery room.

If you have to give birth to a baby 15 weeks early, you want it to be under the most controlled and ideal circumstances. Somehow I had avoided infection and somehow my water had not broken. We were down in Labor and Delivery under fairly calm conditions. There was definite tension in the air as micropreemie births are not an every day occurrence even in the best of hospitals. The calm erupted into controlled chaos when they thought the baby was going into distress. Suddenly seconds felt like hours until I was in the OR and they confirmed that the baby was fine. Things calmed down and instead of being put under general anesthesia I held my OB’s hand as they tried and tried and tried and finally succeeded at giving me a spinal. It was all so surreal – it still is. My most distinct memory of that day is laying flat on the cold operating table and looking down at my bare belly before they put up the blue screen. I could see the tips of my toes, the little pregnant belly I had in the days prior was mostly gone because the baby was so far down in my pelvis. It was so unsettling, so surreal. Heath joined me in the OR as they started the operation. He sat on the left side of my head and held my hand. Within minutes the baby was out. 11:11am. Absent was a cry that we wouldn’t hear for another 8 weeks. Ten or fifteen minutes later they announced it was a girl and let us know that she was successfully intubated.

The rest was hazy and none of it mattered. It was a new fight, a fight that I unfortunately could no longer fight for Virginia. We could only hope, pray and BELIEVE that she would fight. This is the end of this story and the beginning of the most amazing story I have ever known.

You can read more of Virginia’s story here.