Friday, July 13, 2012

Birth Story Part 1: Deviation from the plan

I had a smooth pregnancy. I was active walking and doing yoga up until my 40th week. I did not have back pain or morning sickness. My mood was steady and I gained appropriate weight per my midwife. I planned to give birth at a birthing center with a midwife and my doula. Only catch was I needed to remain in the category of non-high risk pregnancy, which I was up until the 40th week...

At my 39 weeks the concern was raised about my elevating blood pressure. I started pregnancy at 102/68 and never had a history of high blood pressure. Today my blood pressure is 128/90, but went down to a bottom number of 86 as the doctor appointment went on. While the concern was raised we were just watching it as it started to creep the last 3 routine weekly appointments. I was to take calcium magnesium and return in a week, or have a baby by then. I felt fine. I was told to let them know if I experienced headache, abdominal pain, sudden increase in swelling, visual changes, or changes in baby's movement. I never felt any of those warning signs of pre-eclampsia, so I returned at 40 weeks. 

At this appointment my blood pressure rose to 138/92 and discussions around me potentially moving into the high risk category. The conversation became elevated when my reflex test came back abnormal, with what I call a double kick - instead of moving out smoothly it felt like I had a twitch or a double movement of my leg as it extended. From there out I was counseled on hypertension and what my next steps would be. We had a phone conference to include my husband, and my midwife went through the effects and complications of hypertension including decreased blood flow to the baby, intrauterine growth restriction, fetal distress during labor, maternal strokes and placental eruption. At this point, I had blood drawn to retest for pre-eclampsia and Group B Strep (Group B Strep was a routine retest at 40 weeks and not too much of a concern for how to proceed with pregnancy, just an issue when delivering vaginal whether to give antibiotics). The concern was the hypertension or high blood pressure, not pre-eclamsia. My midwife consulted an OB and within a matter of hours I was put on a waiting list for a hospital bed at University of Washington Medical Center (UWMC) labor and delivery unit specializing in hypertension. My blood tests had come back as showing the first signs of pre-eclampsia, which the only way to cure is to deliver the placenta, ie the baby. With hypertension and now the elevated concern of pre-eclampsia, 

The first thing I did upon meeting my nurse, was to hand her my hard copy of my birth plan and start discussing which parts of it could be met in a hospital setting. I was happy to learn that all of it could be met! The highlights of what I wanted: I had a tub to labor in (not give birth in), cloth diapers were available, skin-to-skin is encouraged, baby can room in, there was a long, soft window seat that doubled as a bed for my husband and a pull-out cot for my doula, formula is looked at as medicine, delayed cord clamping could happen and placenta was able to come home with me. The hard copy was placed in my file and was read by each nurse and doctor as they started their shift.  

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