Surprise! Part I (the story, with some semi-gory details)

In my last post, I asked if I could possibly get any bigger. Whether I could or not, I won't. Julie decided to surprise us this week, and come early! Let me explain...

Friday night while I was making dinner, I felt three contractions within about 20 minutes that were all noticeably stronger than any I'd had up to that point. I didn't have any more that evening, but I decided it was definitely time to start paying attention to the timing of my contractions. A little later that evening, I start leaking a little bit of clear fluid. Not enough to be concerned, but enough that I noticed it. I figured it was part of normal late-pregnancy changes. I continued to leak all day Saturday and Sunday, but everything was the same -- my contractions weren't any stronger or more frequent than previously (or less so, either), I wasn't cramping or bleeding at all, either. I didn't call the doctor on call for the weekend because I didn't want to automatically be sent to the hospital. I was supposed to see my doctor on Tuesday, and figured I could probably wait until then.

By Sunday night, I decided to call the doctor's office Monday morning, and hope that they would have my come in to the office to be checked. By this time I was leaking enough that it took me over 2 hours to make a dinner that normally takes me about 40 minutes to make. I was running to the bathroom every 10-15 minutes (and staying for 10 minutes each time). I slept with a towel under me that night. Otherwise, still no changes. I got up the next morning, and started paying attention again to my body -- what it was doing. The leakage seemed to have slowed down some, so I decided I could wait until the next day when I was going to see the doctor. I didn't do much for most of the morning, but I had lunch around noon and got in the shower around 1:00 that day. Once I was out of the shower and moving around with more activity, the leaking started back up again. I decided to call the doctor's office before I went out to Target (where I was going to start buying some baby stuff that we much needed).

When I talked to the nurse, I told her everything that had happened, but that I didn't think my water had broke, because labor wasn't otherwise progressing. She said it still could have been, and ended up sending me to the hospital anyway. I didn't want to go. I called Ben at work to tell him, and I was crying. I was just a little freaked out, because if it really was my water, that meant it had been broken for two and a half days at that point (sometime around dinner on Friday is when it happened). He came home from work to take me. I packed "the bag" while I waited for him (I hadn't even done that much yet). When he got home, I asked him to give me a blessing of comfort before we left. That really helped settle my nerves.

We went to the hospital, hoping that we were right and the nurse was just being overcautious. I was only 36 weeks after all, and hadn't even had an internal exam yet. I didn't know if I was group B strep positive, because I hadn't had that test done yet, either. It was supposed to happen on Tuesday. In the triage unit, they did an internal exam, swabbed the fluid I was leaking, and did the group B strep test. The doctor said I was "fingertip" (less than 1 cm dilated), 20% effaced, and at a -2/-3 station (the baby's head was fairly high in the canal still).

While I went to the bathroom, they tested the fluid, which turned out to be amniotic fluid. My water had in fact broken. I was admitted to the hospital and put on an IV and an antibiotic, since I had been ruptured for nearly 3 days at that point. They also started me on Pitocen, to induce labor and get my uterus contracting. I was hooked up to fetal monitors to monitor the baby's heartbeat and my contractions. I had three tubes going into my IV, two monitors strapped around my belly, and a blood pressure cuff on my other arm, checking me every half hour. I looked like a science project, and getting up to go to the bathroom was like an act of Congress trying to get me undone and re-hooked up again. A friend of ours came by later that evening to help Ben give me a blessing of health, and more comfort, since we now knew what was going on a little more.

They started the Pitocen around 5:00ish on Monday evening. By 10:30 on Tuesday morning, I was having contractions strong enough that I had asked for Nubain to "take the edge off" but not enough to ask for an epidural yet. I also was still only dilated "fingertip" although by then I was almost 70% effaced. The baby still hadn't dropped any further, though. The nurse taking care of me told me that with a first pregnancy that they like to see effacement before dilation, but that I should still be dilating by then.

They decided to stop the Pitocen and gave me two options. One, we could stop it and do a C-section. Two, they could stop it and give me something call Cytatek (I'm not sure of the spelling) to soften and relax my cervix. It might help me dilate some, but it might not be effective fast enough, and we might end up doing a C-section anyway. Ben and I talked about it, and decided to give the Cytatek a try. It's actually a capsule that is inserted into the vagina where it dissolves on/near the cervix, so it's right at the site.

While the house doctor was inserting the capsule, the doctor who was rounding for my obstetrician was getting the results of my group B strep test. It turns out it was positive. VERY positive, apparently. Between the high levels of positivity of that test, and the length of time I'd been ruptured at that point, they decided to do the C-section. The doctor tried to remove the capsule, but it had already dissolved. She tried very hard to find it with her fingertips, though...OUCH! Very uncomfortable. Then they began prepping me for surgery. I was surprised at this point how not freaked out I was. I was surprisingly calm. It may have been because I was so tired and the Nubain was still wearing off. I also had been pretty calm since I got the blessing the night before. Concerned and a little scared still, but not so much freaked out.

By this time it was about 11:30, maybe even later. They unhooked me, took me to an operating room, and started to prep me. Everything was a whirlwind. They had Ben put on scrubs, a mask, and a hair net. They went so quickly...Julie's time of birth was 12:08pm. When they finally wheeled me out of the OR and into recovery, it was almost 1:00, though, with stitching me up and everything. Ben got to hold her in the OR for a few minutes, but they took her to the nursery pretty quickly. I slept for an hour or so in the recovery room, and finally got to hold her (see her, really) for the first time just before getting wheeled into my post-partum room. I had barely seen her in the OR, and it was upside down from my point of view.

Julie Joyce Nutter was 5 lbs, 4 oz, 17 3/4 inches long. She was born at 12:08pm on Tuesday, April 22, 2008. She was four weeks early, and there had been a high risk of infection due to the combination of the positive group B strep and the length of time I'd been ruptured. We were concerned that her lungs might not be fully developed, that she might not be able to breastfeed, or any other number of things that could be "wrong." Gratefully, her Apgars were both at 9, and she never even went to the NICU. She went directly to the newborn nursery, and she's been there or in my hospital room ever since. She's had a tough time nursing, which is partly due to being new and just not knowing what she's doing, and partly due to the fact that she has a hard time getting her little mouth open far enough. She's starting to get a little jaundiced, but isn't too bad yet. I've got her laying in her bassinet by the window today, and we've started supplementing her with formula, to make sure she's getting enough nutrition. Otherwise, she's doing great.

I am also doing pretty well. I was kept on a clear liquid diet the rest of Tuesday. By Wednesday morning, I was moved up to a "full liquid diet" (it included milk, pudding, oatmeal, and some other mushy stuff). By lunch I could eat soft solids, and by this morning I was able to eat anything. They took me off the IV around 1:00 yesterday, and pulled the catheter out of my bladder at 2:00. I was finally a free woman! I'm taking pain medicines and am told I'm doing remarkably well. I'm comfortable walking around, up and down the hallways or in my room. I took a shower this morning for the first time since Monday (oh, it felt great!!). My incision hurts, especially when I cough, laugh, stand up, or sit down, but it's not unbearable (except that I've had a frog in my throat all day today that I've been trying to get rid of). I haven't sneezed yet (knock on wood), and hope not to for several days still. I keep saying that while it does hurt, it mostly feels like a productive hurt, like I've just done a few too many situps or something like that. I'm getting the hang of breast-feeding, except that I feel like I need three or four hands to do everything they tell me to...hold her head up, keep her lip down, squeeze the milk down my ducts toward the nipple, stimulate her jaw to get her to suck, tickle her feet to get her to suck (my mom's suggestion), and everything else.

I am loving "kangaroo care" though. So is Julie. The breast-feeding is a little tough to figure out, but I'm enjoying the bonding, and it's very relaxing for me.

It looks like I will be discharged tomorrow morning. Unless something really funky and scary happens this afternoon or tonight, I don't see any reason I won't be. I'm reaching all the milestones they want me to be. I'm still very pale (even for me), but I'm drinking a lot of water and things look good. At this point, it looks like they will also discharge Julie tomorrow morning. If her bilirubin levels keep going up though (the jaundice gets worse), that may change. I'm hoping that we'll be able to bring her home with us, though.

Well, it's time for Julie to eat again. I will post part 2 (pictures) a little later.