ramona & her mother, part two

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

the nurse practitioner went ahead & ordered another round of bloodwork & another 24-hour catch. i would have to take some time out of thanksgiving preparations to go to the lab & get everything done, & i wouldn’t be getting results until the following monday because the office was closed for the thanksgiving holiday, but i figured things would come back clear or not clinically concerning because that’s what had happened before. so i didn’t sweat it too hard.

jared & i had a very nice thanksgiving dinner & i spent the next few days just laying around reading, eating leftovers, & hanging out with him. i had my first prenatal massage on sunday afternoon (november 25th), which was very pleasant. i made a lasagna for dinner that night to satisfy a craving.

just as i was pulling my lasagna out of the oven, my phone rang with a private number. it was dr. mercado. immediately, my heart sank. i knew she wasn’t the doctor on call that weekend, & it can’t possibly be a good thing when you’re 32 weeks pregnant & your obstetrician calls you at home on a sunday night & asks, “hey, girl. i was just wondering how you’re feeling?” i mean, there’s compassionate, involved medical care & then there’s a pretty obvious medical emergency.

she told me that she’d finally had a chance to look at the thanksgiving labwork & my protein was up to 595–more than double the october labs. & although my platelet counts were normal & good, i was starting to show elevated liver enzymes, which is a symptom that my liver was in distress & is considered a major indicator of actual pre-eclampsia (not just pregnancy-induced hypertension). she asked me to go to labor & delivery at the hospital ASAP “for some repeat labwork”.

jared & i ate dinner first, but we were both pretty quiet because the whole situation was a little scary. we drove over to the hospital & i realized that i hadn’t had my hospital pre-registration appointment yet so i didn’t actually know where labor & delivery was. & there were no elderly docents around to tell us because it was a sunday night. i got directions from a hospital operator & then had another scare when the nurses immediately hustled me into a fully-appointed delivery room the second i walked up the hall. they made me change into a hospital gown & they hooked me up to a fetal monitor for a non-stress test. that’s just where they make you lay around & do nothing & they see how the baby is doing. as always, the baby was doing just great. i expected them to unhook me & send me down to the lab for the repeat bloodwork, so i was pretty surprised when a phlebotomist suddenly materialized at my bedside. if they were sending techs to me, that indicated that they were actually pretty concerned & didn’t want me up & moving around. & that was scary.

the on-call obstetrician, dr. durland, showed up a short while later with the lab results. she talked a mile a minute & i really wich i just had a transcript of what she said because it was all a blur. the main points were that the labwork indicated even higher liver enzyme levels, & that wasn’t a good thing at all. then she said (i remember this part word for word), “i’m not saying that you won’t still be pregnant by the end of the week, but it doesn’t seem at all likely, so i need to know whether you want to be transferred to kansas city or topeka. you’re going to be making the drive a lot while the baby is in the NICU, so it’s really up to you. both have great facilities for premature babies.”

& that is when i burst into tears.

obviously we didn’t know anything about the NICU facilities or labor & delivery protocols at any hospitals in topeka or kansas city. i had been on the fence about even having the baby at lawrence memorial (as opposed to at home), but was at least comforted by the fact that lawrence released moms & babies very quickly when there are no complications, & their labor & delivery facilities are very similar to what one might find in a birth center as far as their standards pertaining to continuous fetal monitoring, food & drink during labor, episiotomy, moving & vocalizing during labor, etc. they even have birth tubs! i hadn’t considered for a second that i wouldn’t get to term, & obviously i hadn’t thought about having a premature baby. especially such a premature baby that it might need the care of a level-three NICU. lawrence memorial can handle preemies born after 34 weeks, but this doctor was saying that it would be a stretch to get to 33.

she came back in about fifteen minutes later & told me that there was a chance i wouldn’t even make it through the night. she said that the transfer hospital (we chose overland park medical center in kansas city because we are more comfortable driving to kansas city, & because the nurse on my case told me that they offer more private care–they aren’t a teaching hospital, & although i’m a big advocate of women’s health education & have even considered volunteering as a pelvic model so new doctors can learn how to do pap smears, i really did not want to be an educational tool with all of this crazy shit going on) would do more labs on me when i arrived, & that if they continued to show progressively more liver dysfunction, i might be delivered that night. via emergency cesarean. so that i didn’t have start having seizures or even strokes. the nurse inserted a heplock into my hand, which is a long-term IV that can be used to administer numerous different medications over a matter of days. they gave me a steroid shot in my right hip to help force the baby to produce surfactant & lung maturation. they ordered an ambulance & informed jared that he wouldn’t be able to ride with me due to the IV. some guys showed up & actually strapped me on to a gurney. jared & i cobbled together a list of stuff he should bring to me at overland park medical center, since all i had with me were the clothes i’d worn in, my pocketbook, my cell phone, & my keys. he took off to pack me a bag & start driving to the hospital & i was loaded into the ambulance.

through all of this, i was crying off & on. i cried more when it was just jared & me in the room. i was kind of embarrassed to cry in front of the nurses & doctors & ambulance dudes. the nurse noticed that i have a speculum tattooed on my arm & showed dr. durland. she asked why i’d gotten it done & i explained that i had gone to midwifery school & am just really into reproductive health stuff. she slowed way down & was like, “oh my god, this must be even worse for you then. because you must have been planning on a full-term pregnancy & maybe even an unmedicated delivery. i am so, so sorry. this must be really scary for you.” that was a really sweet little moment.

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