Welcoming Sully

Sullivan’s birth story:

There is some back story to Sullivan’s arrival into the world.  Around 20 weeks of pregnancy I switched to a new care provider, opting for a nurse midwife.  Not long after I felt like Sullivan’s movements were somewhat erratic and the flip-flopping was continuous.  I also wasn’t getting as big as I usually would by this stage of pregnancy.  I dismissed the concern as unfounded fear but a gut feeling that something wasn’t right kept creeping up.  About 6 months along I mentioned it to my midwife and asked if she would do an ultrasound to verify all was well.  We scheduled the ultrasound for around 28 weeks.  At the ultrasound they were surprised at how tiny my baby was…he was significantly underweight for his gestational age.  We were referred to a perinatologist for follow-up.   This was on a Friday which, of course, gave me all weekend to practice being anxious for nothing J.  We visited with the next doc on Monday who said Sullivan was bigger than they had originally estimated and on the low side of normal but still very tiny for my babies so we would plan to do a follow up in a month.  We left feeling relieved but I still wasn’t convinced all was well.  Time passed and our next ultrasound showed consistent growth.  We scheduled a final follow up ultrasound at 36 weeks as a triple check. 

                The morning of the ultrasound I scheduled an appointment for as early as possible so Eric could just go into work late but not interrupt the entire flow of his work day.  I thought before leaving about whether I should pack a bag and shower, etc. just in case but I was running a bit behind (story of my life these days) and opted for a pony tail and a deep breath.  The ultrasound lasted forever…they kept waiting for him to take practice breaths and he wasn’t taking them.  He was still quite small. I drank cold water, we prodded my belly to encourage him to wake up since he seemed to be sleeping.  Nada.  This is where that knotted feeling in the pit of your stomach enters the picture…why isn’t he moving?? I knew something wasn’t right.  Maybe I’m concerned for nothing…what will the doctor say?  Enter Dr. B who I LOVE.  He was kind and supportive and so willing to discuss options with me without just handing over a prescription or diagnosis.  He had been very liberal to this point, preferring to let nature take its course.  This day he walked into the room and said “we need to meet your baby today…I think you should walk right over to labor and delivery”. He simply wasn’t moving enough, wasn’t taking the minimum amount of practice breaths, etc. and was not growing adequately since his last visit. 

                Of course it would happen this way…the one time I am unprepared, haven’t done my hair, my husband hasn’t planned to be here and we have no where to take our children.  I told the doc I had to go home and get my things and my husband and drop off our children…somewhere.  So he asked me to be expeditious…I headed toward home a little shaky and a little frustrated and unprepared.  Grabbed my things, my husband and phoned some friends to find a solution.  My Dad had emergency surgery the day prior so mom was quite busy as he was in the hospital and she works full time…that option was out.  Thankfully we have a dear friend who our eldest carpooled to kindergarten with who cared for our little ones all day at the last minute.  All 3 of them! I cried in her front yard and she prayed for me….I took a deep breath and we headed to the hospital. 

                I preferred to not use Pitocin if I could avoid it.  I have had a cesarean (with my first) and while pitocin has been used in labors past and I’ve done fine, I prefer to avoid it if at all possible.  We used a foley catheter. Typically these are used in the bladder but for purposes of labor induction they can be inserted into a partly dilated cervix and inflated with saline then taped to the leg.  This provides pressure which encourages the cervix to thin and open.  Once the cervix opens beyond the size of the inflated catheter, it simply falls out and often times this is all that’s needed to start labor. In my case, I dilated quickly to a 4 but labor wasn’t going…it was just too early for my body to jump on board.  So we started Pitocin.  For many hours not much happened.  Sullivan looked fine on the monitors as far as his heart rate went so I was allowed to labor…a few hours later his heart rate was taking big dives and not coming back up quickly enough and it wasn’t only going down with contractions.  The contractions went from nothing to painful very quickly which has been my experience with Pitocin every time…nothing…nothing…nothing…then bam – it his me.   My hope was to use a narcotic in order to get dilated enough that my body would continue to labor and then back off the pit and avoid an epidural.  I tried Fentanyl and I regret it.  I have never used a narcotic in labor but the stress and overwhelm and uncertainty of this situation after a full day of waiting weighed heavily enough on me that I thought “why not?” I felt completely loopy and still couldn’t rest.  Bad choice for me.  An hour or so later the contractions were intense but I was only a 6.  I asked for an epidural and everyone said for sure I was in transition because the contractions were so intense and I was shaking so much.  I thought otherwise…I know my body and I remember this happening the last time pit was used in labor.  I couldn’t feel the baby low enough and I knew.  They checked me talking about how it might be time…nada…6. 

                When the anesthesiologist came in to give me the epidural I was more than ready and very frustrated.  When he inserted it I told him it felt very high to me and I could feel it only on one side of my body.  He said all looked fine and proceeded. It took a while for the medication to numb me so he kept upping it to the point that my blood pressure dropped and I was shaking and had tunnel vision, ringing in the ears, I etc. and got very scared.  After a few doses of epinephrine and turning down the epidural things seemed to calm a bit. My poor husband was terrified after watching that whole ordeal which lasted better than an hour. I wanted to sit up to put the pressure of baby’s head on the cervix to help things along if at all possible.  When I went to sit up, I fell over…the epidural was so high I was numb from my shoulder blades down but not my left side from my hips down initially.  I knew in my mind that if I did not turn over and get on all 4’s so the babe could get into a good position it might be long and I was hoping a change of position would help his heart rate as well.  I couldn’t move my right side but maneuvered myself over on the bed.  Within about 20 seconds I could not breathe…my entire front side went numb and I was panicky.  I flipped over and tried to breathe…of course all my vital signs were off so the nurse came in and put the oxygen mask on me.  I just cried…feeling overwhelmed, out of control, afraid for my baby and scared of having to have surgery.  My midwife was scheduled to have her own surgery that day and tagged teamed with the OB in her practice who happened to be just awesome.  Supportive, kind, and not in a rush to do anything unnecessary.  She broke my water to see if we might be able to help the process along and avoid surgery.  I was about 8 cm now so I called my mom and texted my best friend. My first cesarean was at 8 ½ cm…so I wasn’t fully convinced we were done yet.  Not long thereafter she checked me and I was 9 ½…she waited for a contraction and the cervix was gone.  I didn’t feel like pushing, I was tired and didn’t have the urge and I was afraid about whether the baby was ok.  I woke up Eric who had finally just fallen to sleep about 4AM.  I pushed on my side to avoid tearing which has worked well for me.  One push and the baby was almost there so the doc suited up as quickly as possible…one more push and he was born.  The first thing the doc said was “look….a true knot” – He had a tight knot in his cord.  I felt my gut feeling was confirmed and also shuddered at the thought of not having had that final ultrasound.  True knots are a known cause of death in utero and cannot usually be seen on ultrasound.  What if we would have waited, I wondered?  That carried me through the next few weeks.

                He was SO tiny…I mean just as itty bitty as I could imagine.  His cry was there which reassured me and he was placed immediately on my chest but he couldn’t breathe.  I could see the intense retractions all throughout his ribs and beneath and I knew they would take him quickly.  They did…his oxygen sats were in the 70’s.  Over 90 is normal.  They didn’t have to intubate since he responded to oxygen support. They whisked him away to the NICU along with my husband and I was left alone…with my mom… in a very quiet labor and delivery room.  I heard the baby crying next door and my heart ached.  I sobbed and sobbed.  I felt so scared for our baby and so robbed of what should have been a joyous welcoming.

The nurse practitioner assured me I could hold him just as soon as I was considered stable and moved into a postpartum room.  I decided to just look forward to that.  I just wanted to see his little face and nurse him.  We moved to another room, mom had to go to work, Eric met me and I got up and walked to the nursery…I didn’t want help or a wheelchair, I just wanted my baby.  The nurse quickly informed me that the baby wasn’t well enough for me to hold him and that maybe in a few hours I could hold him when she had a minute to assist me.  I was angry…and my heart ached to hold my baby.  He had cpap, an IV and an NG tube as well as all the probes and monitors that come with the NICU.  Compared to other babies he looked really wonderful and I knew he would recover and come home with us while others there may not.  He had already had his first set of xrays— without me.  He appeared to have aspirated during delivery or perhaps had some sort of pneumonia or other fluid in his lungs.  Finally later that day I held him…and cried…and wished I had photos but it was just he and I.  I wanted so badly to nurse him but he could not with the cpap on. I only got to hold him for a half hour.  Which made me more angry and more upset.  Many hours were spent sitting and staring at him with my hands on his tiny feet, legs and body.  My parents visited as dad recovered from surgery but only one friend came...I’d be lying if I didn’t say it made the time there harder.  I received lots of emails and facebook messages…not sure if people felt uncertain whether to come or what.  We had a lot of love when we came home and so many families and friends brought meals.  That was so precious to me and such a life saver.

For the next few days I ventured back and forth between my room and his…showing up every 4 hours on the hour asking if I could nurse him or hold him.  I was so angry when a nurse changed his diaper without asking me first…without calling me to do it.  It was the only thing I could do for him…check his temp and change his diaper.  I LONGED to change them.   So I spent more time in the nursery. Crying, staring at the baby, staring at the monitors…knotted up stomach wondering if it would be annoying for me to ask again when I could hold him.  Wondering if they would feed him a bottle or give me the chance to nurse. When I did nurse the first time he latched on rather quickly…I felt so under the gun…if his oxygen levels went too low, if he did not gain weight by nursing, if he struggled at all...it would be over.  Each nursing session took a long time and I was excited to nurse and also scared that he wouldn’t get what he needed from me.  Over time, he improved.  I would wait each morning for the doctor to come and discuss with him what was going on with our baby.  One day he asked the team accompanying him when they thought Sullivan would head home…up until day 4 he was “Baby Smith” and then we finally agreed on a name J.  He had been in the NICU just about a week and I piped up and said “how about today?” and while the doc seemed shocked that I volunteered I explained I was comfortable with what he needed and could take oxygen with us.  He agreed to let us take him provided we scheduled a surgery he needed within 2 weeks or so.  We agreed and brought him home.  I cried in the van leaving and cannot tell you the relief…I held him and held him and held him and did not put him down and would not stop snuggling and smelling and staring at him.  While our journey was not as tough as some, for me it was very difficult…and for our family.  Our children cried when they left the hospital each night without us and still talk about how they don’t want me to be at the hospital again. When we packed up to leave I asked the Lord why things went this way…I did not get an answer but He did speak very clearly to me that while this cannot be changed, it will be redeemed.  My heart is content with that answer and so grateful for His providence in the midst of my obvious struggles during this time.

                The following week, at 2 weeks old, we went to Denver for surgery which was another heartache all its own.  All things considered we received such wonderful care from all the doctors and nurses we worked with.  I wish I could have changed the process but had I waited and Sullivan may not be here. That makes it all worthwhile.  While many moms and babies are healthy, some mommies and babies need additional care.  I’m so grateful that was available to us when we needed it.          

                Sullivan is 8 months old now…he has fat rolls all over and is still a breast fed baby.  He is happy and content and continues to grow and develop perfectly J He’s in the 6^th percentile so still itty bitty but he’s catching up!! J He is a joy to my heart and I’m so glad the Lord gave him to us.