It's a Girl!

Wow, I can’t believe after nine months of delight, worry, anticipation and wonder that my baby is finally here, and that she is a girl! All the old wives tales were wrong, but apparently my two baby dreams of having a girl were right. Looking back on the pregnancy, I am thankful for how uneventful it was, for the lack of morning sickness and for the ability to enjoy being pregnant. Now, with our baby girl born and on the outside, I do miss some of the joys of being pregnant. I miss feeling her at all times and knowing that she is safely tucked away inside me. I miss that bond that is felt between mother and baby. But, that is all insignificant in light of the love and joy I have to hold her in my arms, snuggle her, feed her and see her beautiful face.

Introducing Elena Elizabeth Brokmeier, born March 12, 2011 at 8:50 pm, weighing 6 lbs 15 oz and 20 inches long. (far less than the growth ultrasound estimate of 7 lbs 11 oz).

Disclaimer: I had quite the eventful labor, delivery and post-partum process and wanted to capture it, so I could remember it always. I know the important parts will always remain fresh in my mind, but as the days pass and I can’t even recall the pain I want to be able to look back on the events of the labor. (so there may be some TMI type info below, consider yourself warned, also this is kind of freeform/therapeutic writing style as I am really recording events for me, so it is REALLY long).

EARLY LABOR

I was finishing up my second week of maternity leave and had embraced the “walk the baby out mantra” around the streets and shopping areas of Chicago. On Friday March 11, 6 days past my due date, I began to feel contractions unlike any other Braxton Hicks contractions that I had ever felt. Much more intense and much more regular, they were about 15-20 minutes apart. I reached out to a friend to see what she thought and after going home, drinking water and resting, the contractions were still there! For me, the contractions started as very intense lower back pain and then wrapped around the front to my lower abdomen. It was a throbbing and tightening sensation much different than anything I have ever felt before. I was so excited that something was beginning and was ever hopeful that I would not have to go through an induction (was going to be induced March 15th). After two hours, so around 5 pm, I headed to the bathroom and was so excited to see my mucus plug. Now, this is such a gross thing, but for me, and from hearing about my mom’s labor experience I definitely knew that this was likely going to be it! The contractions continued to progress and so I took a bath and had a glass of wine and tried to relax.

When it came time for bed, I knew I likely wasn’t going to be able to sleep through the contractions and so I resorted to the family room, surrounding myself with pillows and alternating between side lying and all fours to work through the contractions. I took a few more showers and tried to stay hydrated. The contractions became more intense and the 7-10 minute intervals that I experienced through most of the night shortened to around 5 minutes. At this point it was about 5 am and I woke Chris and told him it was time to get ready. I had envisioned him jolting out of bed, running to get the bags and being in the car before realizing that I was still upstairs. Instead, he was very calm, finished putting the last minute items in the hospital bag and stayed close to me while I labored. I called the doctor around 6 am, when my contractions had been 5 minutes apart, 1 minute long, for over an hour only to find out that the on-call doc was not my primary care doctor. He was still very nice and helpful and agreed, after listening to me breathe through a contraction, that I was likely beyond early labor and should head to triage.

I honestly must say that the car ride to the hospital was one of the more painful experiences. Having to sit upright, with a seatbelt on, unable to move while driving down the minefield of potholes that is Lakeshore Drive, while in labor, is not something that I would wish on anyone. Chris decided to valet park the car at Prentice Hospital, so that he wouldn’t have to leave me. As soon as we stopped in front of the door, I got out and waddled my way into triage. It was about 7 am at this point. I remember breathing through the contractions and waving off the guy with the wheel chair. It felt good to walk after sitting in the car and I just wanted to get myself admitted. I glanced back and Chris came up behind me, bags in tow like a Sherpa, and we walked into triage together. Thankfully I had preregistered and didn’t have to wait long at all. After clothing myself in the ever fashionable hospital gown and getting attached to all the monitors, I was checked and was almost 4 cm and fully effaced. I had gotten through early labor and was well on my way. They had us walk the halls for about 10 minutes before my first labor and delivery nurse, Peggy, came down to get us.

LABOR

After getting my vitals taken, we made some calls to let loved ones know that the process was starting. Shortly thereafter, I was delighted when my OBGYN, Gil Weiss, walked in. He had switched on call shifts with the other doctor and was going to be there to deliver our baby. As he was the only one that I had seen throughout the pregnancy and we had discussed birth plans, etc. in detail, I was very happy and more at ease knowing that he would be there for the delivery. When he checked me I was still around 4 cm and had a bulging bag of water, as it was close to 9 am at this point we decided to break my bag of waters since it was bulging and likely slowing down both my contractions and labor. Getting your water broken is the strangest feeling ever, it is a warm gush of fluid that seems to keep coming. As amniotic fluid replenishes itself every hour or so, it never really stops gushing and with every contraction, you can feel more and more of it coming out of your body. Thankfully, the fluid was clear, so the baby wasn’t at risk of aspirating meconium.

At this point, we got a new Labor and Deliver nurse, Veronica. She was truly my advocate throughout the labor process and I am so very thankful for all of her efforts in trying to help me have as much of an intervention free labor as I could and also working to help me avoid a C-Section. Shortly after getting my water broken, I was at 5 cm and the contractions were increasing in intensity and coming at irregular intervals, but the time between contractions wasn't decreasing at all, this was at about 10:30 am. Considering that my contractions had been occurring at the same intervals and weren't shortening, we started talking pitocin. Pitocin had been something that I wanted to avoid, as I knew it made for a much more painful labor, but I also realized that I wasn’t progressing and had already been in some phase of labor for 19 hours or so at this point. With much trepidation I agreed to the pitocin as it seemed to be the best option for baby and me.

Since I was getting the pitocin, the conversation moved towards an epidural. I was proud of myself for getting to 5 cm without the epidural, but also recognized that my strength was waning, that pitocin would intensify things, that an epidural could help me relax and would help with dilation, and finally that I needed the strength to push later. All things considered, I agreed to the epidural. Chris was asked to leave the room and I was administered the epidural around 11 am. The anesthesiologist cleansed and disinfected my back with a very cold orange liquid, and then gave me a numbing shot which hurt a bit upon insertion and then there was a slight burning, but for me it was nothing more intense than getting a tetanus shot. I didn’t feel the actual epidural thread go in. I felt almost immediate relief and overall the process was fairly simple and other than the cold/shot I didn’t feel any pain. The epidural was interesting, I could move around and feel my legs as well as tell when I was having a contraction, but there was no pain associated with it. They commenced the pitocin at this point at a level 2 (levels go up to 40, although for me we were primarily between a 2 and a 5). After having my catheter inserted, required with an epidural, I started to feel even more relaxed and admittedly felt like I was kind of fading out a bit.

At this point it was just the nurse and I in the room. Chris still wasn’t in the room, he had gone to get an early lunch while they administered the epidural. After feeling very cloudy, all of a sudden there was a beeping on the monitors and Veronica was trying to push around my stomach and then all of a sudden there were a number of nurses and doctors that rushed in. Before I knew it, I was flipped over on my stomach and on all fours being told to breathe deeply. I vaguely remember getting a shot in my back and saw them putting meds into my IV. As the monitors continued to go crazy, more doctors and nurses were in the room. Someone put an oxygen mask on my face. I tried to focus on what they were saying, and on my breathing, but was terrified by the fact that there were what seemed like 20 people in the room. I made eye contact with my doctor and finally had the courage to ask him “Is the baby ok? Is it me?”. I had no idea if they were worried about me or my baby. Dr. Weiss let me know that the babies heart rate had dropped very low after I had a drop in blood pressure and they were just trying to get everything stabilized. After what seemed like hours, but was actually only probably a few minutes, the monitors resumed their normal rhythmic beeping, the doctors and nurses slowly left the room and I was allowed to turn back on my side. I was very hesitant at first and said I would stay on all fours until the baby came, but Veronica coaxed me into getting into a more comfortable position.

Dr. Weiss and Veronica explained to me that the babies heart rate and my blood pressure had gone drastically below where they wanted to see it and not to be alarmed if everyone rushes in again as they typically have an all hands on deck philosophy when people start to have problems. Apparently the epidural had gotten me too relaxed and baby didn’t like the more intense contractions with the pitocin. They had given me something to bring my blood pressure back up and also some nitrate to slow down the contractions. I was told I needed to wait an hour and then we would see where we were at before starting up the pitocin again. Meanwhile, I realized that Chris was back in the room. It must have been terrifying for him to walk in and see me in obvious distress. Not to mention for him, and the rest of the staff, they must have gotten an eyeful when they walked in the room to me on all fours with my butt in the air and my hospital gown wide open, LOL. I was feeling less cloudy and began to watch the monitors like a hawk through the contractions. My goal from then on became to keep the babies heart rate above 100. Chris or I would keep an eye on it and I would focus on breathing through contractions to make sure we were helping baby with as much oxygen as possible. I became obsessed with this and am convinced that I will forever hate heart rate monitors. By now it is about noon.

Since I was relaxed and resting, I was able to have my mom and step-dad come in. They had recently arrived and had been waiting in the visitors lounge through all of this. It was strengthening to have them there and to know that I was surrounded by love and support. I continued to watch the heart rate monitors while we had lighthearted conversation. Around 1 pm the doctor came to check me, and my parents departed. I was around a 6 and the doctor said that the baby was very low and appeared to me sunnyside up so with the help of the Chief Resident they performed an external/internal version. They were only able to turn the baby halfway, but were hopeful that the little one would rotate the rest of the way on its own.

Over the course of the next two hours, baby had two more episodes of a dropping heart rate, but they were much less traumatic and never got into the 60s like the first episode. During each episode I focused on my breathing, watched the monitor and talked to the baby (aka Monkey). We had a number of these pep talks as the hours passed. Not surprisingly all of this was taking its toll on me and around 2 or 3 I was told that I was starting to run a fever. My temp was 99.4 and I was informed that if it went above 100.4 that meant that since my bag of waters was broken both baby and I were at risk of an infection. That meant antibiotics for me and a 48 hour NICU stay for observation as well as antibiotics for baby. So I had another number that I was targeting – below 100.4. Given this risk of infection, Dr Weiss didn’t want to check me and gave me anymore and gave me until 6 pm and said he wanted me to be at 8 cm at that time or we would have to talk about a C-Section because he was worried about the risk of infection and the health of the baby. I totally understood where he was coming from and appreciated knowing the next steps, and having time to let my body get where it needed to be, but I really wanted to avoid a C-Section.

Over the next few hours Veronica never left the room, she was awesome watching my temp and helping me through the contractions, and working with the pitocin to come up with a balance that would both promote dilation and not interfere too much with the baby’s heart rate. As the hours passed, I stayed in a zone. I really don’t remember much other than my family coming in to say hello, breathing through the contractions and asking Chris what the heart rate monitor said. Chris was a great coach and was always there when I needed him. For the most part, conversation was at a minimum, the lights were dim and I focused on keeping things as serene as possible. Unfortunately, during this time my fever went above 100.4 to 100.8 so I knew that Monkey would be heading to the NICU after delivery. I was very upset by this, but kept my emotions under control as I knew it wouldn’t help matters any and certainly couldn’t be good for Monkey’s heart rate, or my blood pressure.

6 pm came and went, and then at 6:45 Dr Weiss came in. He had given me a little bit of extra time. Of course, when he came back in little Monkey’s heartrate dropped a bit, probably because of my anxiety, but it came back up and Dr Weiss gave me a pass. As he went to check me, I said a little prayer and hoped that my body had done what it needed to do. As he examined me, Dr Weiss looked up, smiled and said that I was 10 cm dilated, fully effaced and complete. Even better, Monkey was no longer facing sideways and was face down, in an ideal position for labor. I couldn’t believe it. I was so happy with my body at that moment and so thankful. Dr Weiss decided it would be a good idea for me to wait a bit to let Monkey descend further into the birth canal, so he left and said he would return at 8 pm.


DELIVERY

At 8 pm, Dr Weiss walked back into the room and I knew it was my turn to finish this process. I finally felt like something was in my control, and that I could finally do something to make sure that Monkey was safe. We all discussed that Monkey would likely not like me pushing as I would have to be on my back (I had been rotating between my left and my right side depending on Monkey’s heartbeat for the entire labor). Dr Weiss decided that he would let me decide when to push based on feeling a contraction (the epidural had worn off a decent amount at this point). I would push three times per contraction and then roll back on my right side and work through two contractions before trying again. Pushing was both amazing and terrifying, with my first set of pushes Dr Weiss stood up to go and get his scrubs on. He said I was a great pusher and that Monkey would be here in no time. Pushing felt like such a relief and I felt so empowered to finally be able to do something for my child. During the fourth set of pushes I was crowning and I knew baby was close. I knew I would probably tear and I knew it would hurt, but as Monkey’s heart beat faltered during each time pushing I was determined to push the baby out during the next contraction. I pushed with all of my might and she was born (after 15 minutes and 5 sets of of active pushing) at 8:50 pm. Hearing her cry was the most wonderful thing in the entire world, I barely remember anything else other than asking if she was ok and hearing that she had a 9 on her APGAR scores. Somewhere in there the Doctor said that it was a girl and I was surprised and elated. She did have the cord around her neck once, which is what we believe caused all the issues during her labor.


POST-PARTUM

I don’t remember delivering the placenta, I don’t remember them stitching me up, all I remember is gazing into my daughter’s eyes and feeling the most amazing sense of love, wonder and adoration that I have experienced in my entire life. I couldn’t believe the journey we had been through the last 30 hours and was so thankful for every minute of it as it brought her to me. I knew I had a limited amount of time with her before the NICU team would take her for evaluation and admission so I wanted to soak in every minute. We immediately did skin to skin time and I was able to breastfeed her. Since we hadn’t known what we were having we had to decide on her name. Chris’ choice had been Kayla and mine was Elena. As I held her in my arms I asked her, “So is your name Kayla?” to which she responded with a disgruntled, yet very cute, cry. So I then asked her “Is your name Elena?” and she opened her eyes and gazed at me, thus Elena Elizabeth was born and named.

NICU

The next 48 hours were spent with me waddling from my post partum room to the NICU. I really didn’t spend much time in post partum as I wanted to be with Elena as much as possible. It was really hard to not be sleeping in the same room at night, but I was still able to go down and breastfeed her whenever I wanted. We spent a lot of time doing Kangaroo care and just talking to her. She did very well in the NICU, but it was so hard to see her connected to the NICU monitors and to have an IV. In the end, she passed all of her tests so we were told we were going to be able to take her home once the 48 hour time period was up.

DEPARTURE

Waiting in the NICU room for 9 pm on March 14 to roll around was filled with about as much anticipation as the labor and delivery itself. We were those parents that were bugging the NICU staff about when we could go. “Is it time, Is it time?”. As we waited Chris read Elena the book “On the Night you were Born”. I didn’t make it beyond the first page before I started to cry. A good cry, a healthy cry, we were finally taking our baby girl home and she was happy and healthy and she was all ours.