ramona & her mother, part one

(this is essentially ramona’s birth story, but because her birth was so crazy, there’s a lot going into it. this is part one of ten, & all are tagged “birth story,” in order to help you the reader navigate from one part of the story to the next.)

full disclosure: i am mainly writing this series of posts for myself, because i know the details will fade with time & i want to make sure i have as much of the story written up somewhere as i can remember. parts will probably be pretty personal, in terms of medical detail, & maybe not that interesting. but hopefully some of what i write here will make for good reading, & maybe some will even be useful to other women who wind up with gestational hypertension/pre-eclampsia, or give birth prematurely or to babies who spend time in the NICU for other reasons.

so, after returning home to lawrence after our boston babymoon in late october, my 28-week prenatal appointment didn’t go so well. i had some major edema in my legs & ankles–so much so, i couldn’t fit into my own socks, let alone my shoes. i had to wear a pair of jared’s socks to the appointments, along with slippers. i felt okay physically–no headaches or anything. but my blood pressure was fairly high & protein was detected in the office urinalysis. my doctor prescribed blood pressure medication, at-home blood pressure monitoring twice a day, bloodwork, & a 24-hour urine catch. at this point, i knew that maybe things weren’t going great, but i assumed that my doctor was basically just ruling out pre-eclampsia & that most of my problems were probably being caused by nothing more than the physical stress of having been traveling & socializing way more than usual for the last week & a half.

my bloodwork came back perfect, which reinforced my belief that any protein spillage (i scored 280 on that first catch–20 points below the clinical standard for freaking out) was just the result of some minor dehydration & that i’d be fixed up in no time by just putting my feet up more & increasing fluids. i figured the blood pressure medication would do the rest, but that even that was probably unnecessary. to be extra safe, the doctor also ordered weekly biophysical profiles for the remainder of my pregnancy. every wednesday, i was scheduled to go in for an ultrasound where the baby’s heart rate, amniotic fluid levels, & breathing reflexes would be measured. then i would have a regular prenatal, with fundal measurements, blood pressure check, & urinalysis. even though the doctor told me, “my goal is to see you through to 34 weeks,” i was still banking on making it to my due date.

the doctor scotched that a week later when she confirmed that both baby & i were doing great (my blood pressure was just a touch high but not in the real danger zone, & my urine was clear of all protein), but that she was not going to allow me to go all the way to 40 weeks. “if you make it to 34 weeks, then we’ll try to get to 36 weeks,” she said. if you make it to 36, we’ll try to get you to 39, but i’m not letting you go further than that. if you don’t get into labor on your own before then, we’ll induce.” this made me really sad because i know that induction is a major pregnancy intervention & it sets the stage for further interventions as labor progresses (or doesn’t), & that cascading interventions so often result in “emergency” cesareans. i use quotes because so often, the “emergency” at hand (becoming too physically exhausted to continue with labor, stressing the baby to the point of decelerations & potential distress, etc) could have been avoided by just waiting for labor to start naturally. i hadn’t even considered the possibility that i would have a cesarean. i was terrified by the idea. i knew that spinal anesthesia is a big part of getting a cesarean–i mean, obviously they pump you full of drugs so you don’t feel the doctors slicing you open. the idea of someone sticking a huge needle into my spine…i don’t even have the words to explain how much that scared me, even though it happens to women every single day & they recover just fine. i also knew that a cesarean, as common as it may be, is major abdominal surgery. the prospect of recovering from that while caring for a helpless infant also terrified me.

i felt better after i talked it over with my doula, stefanie. she has worked with my obstetrician, dr. mercado, a lot & knew that dr. mercado prefers to induce without drugs if possible. she said something about some tube or something attached to a balloon being inserted into my cervix to hasten dilation, etc etc, which sounds scary in its own way (especially because i still have a lot of “things being jammed through my cervix” trauma after having an abortion without anesthesia), but better than being stuck in bed on a pitocin drip.

after a couple of perfect appointments where the baby scored full marks on the biophysicals, my blood pressure was reasonably controlled, & there was no sign of any protein spillage, i decided to just worry about the birth/induction part of things later. i felt really confident about making it to 37 weeks–maybe even 39. my leg edema went way down when i increased my fluids, i still wasn’t having any headaches, & although i had one scary night of complete night blindness in my left eye (after which dr. mercado doubled my blood pressure meds), i wasn’t having weird vision changes. i felt that i was pretty asymptomatic. not that i am a medical professional who really had any clear idea of what could be considered “symptoms” or what were regular pregnancy discomforts compared to physical manifestations of hypertension/pre-eclampsia. for example, i routinely had sharp chest pains around my sternum that i never mentioned to dr. mercado, mainly because they came & went & never bothered me when i happened to be in the office, so i just forgot about them. but i also chalked them up to maybe some weird form of heartburn, or just normal heart/lung stresses from having the baby take up more & more space in my abdomen.

jared came home from his research trip on sunday, november 18th, & we spent the next few days just enjoying each other’s company & getting ready for our big thanksgiving meal. he went to my weekly prenatal with me that week, but after the biophysical (another perfect score for baby), i realized i’d forgotten my blood pressure log at home so he went back to get it. i was called back by the nurse while he was gone so i had the medical part of the appointment without him. my blood pressure was showing a major spike–something like 160/110. it had dropped a little but was still worryingly high ten minutes later. & there was protein in my urine. jared & i had both noticed that my legs were kind of puffy again, but it was so minor compared to the swelling i’d experienced after boston, i didn’t really think much of it. after all, swelling can be a perfectly normal symptom of late pregnancy, & i was nearly 32 weeks along by this point.

to be continued…

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s