Wednesday, December 17, 2008

The rest of the story

I know it's no longer live-blogging -- however, I think a number of folks wanted to hear how we got from the Doctor's musings about breaking the water & cords to an emergency c-section. Thanks, everyone, for all the kind wishes and support; they really make a huge difference.

So, after I wrote that penultimate blog post last night, we went from progressing well on the vaginal delivery to an emergency C-section. It was hectic, hairy, and one the things I'm proudest of us as parents of Josie so far -- as well as grateful for the top-notch team here at UCSF. Turns out that the cord was around Josie's head; when contractions happened, her heart rate would drop in what's known as a late deceleration (a "late decell"). Of course, we just saw the late decells, and didn't know why. These became more and more frequent in the half-hour between 11:18 and 11:50. After each of these, they would have Ilsa change sides; usually this would jostle things enough that the heart rate would climb back into the normal range (120-170). These changes of position, however, were lasting less and less long -- and each contraction seemed to cause them. They turned off the pitocin; contractions were happening naturally. As we got closer to an acute situation, they gave her a drug to cause her to stop contacting. Around 12:05 or so, no position for Ilsa would revive the heart rate, and the decision was made to go to OR immediately. The baby recovered as part of this process, and we had a decision to make. The attending doc said she said it was just as safe either way (either elect a c-section or do an emergency one if the baby failed to tolerate contractions during the labor). Ilsa was 7cm dilated at this point and very shaky due to the contraction stopping meds they'd given her. We decided very quickly that the baby's failure to tolerate contractions meant that we wanted a planned c-section; they started prepping her, asked me to step out, then, about 2 minutes later, ran to get me as they'd started already b/c the baby's HR had crashed again. I ran back in there and got to Ilsa's head, said it would be ok, and within about 30 seconds, we heard a baby's cry. As soon as they'd disengaged her head from Ilsa's pelvis, Josie started to wail out, and Josephine Helena Andre was born. She was in great shape; 9s on her apgars.

Turns out that Josie's cord had been wrapped around her neck and head and this was the reason for all the issues. Somehow she also had switched from facing posterior to facing anterior between last Thursday and Monday night. I suspect it might have been when the water broke; however, who knows. The back labor was a big part of Ilsa's pain. In any case, the call to do the c-section was perfect, given what we later learned.

Josie is great; very strong (trying to get her hands to stay in the swaddle is tough), opinionated, and full of energy. Most babies sleep a lot on the first day (say all the books); Josie slept some -- she just insisted on doing a lot of it in our arms. Ilsa's ok and in pain from the c-section, which, because of the epidural, was done transverse instead of longitudinal which is good on a number of fronts. We're learning to be parents and are largely in disbelief that such a cute, loud, and tiny human could be ours.

4 comments:

Heidi said...

So glad you got really good medical advice and that everyone's happy and healthy. But you're being a little stingy with the photos, mister. We need more! ;-)

lornadoone1972 said...

Thanks for the update, glad to know how things turned out and that all is well and you are all healthy and happy... can't wait for more pics - Alex and I think she is just gorgeous (Tadpole agrees)! Love to you all!

sheryl said...

I'm pleased as punch that you both can make quick decisions in stressful times. Gives you confidence for next time you might need to make a quick choice.

Smiles on the strong and opinionated comment. That is just a taste of things to come.

Panthergirl said...

So glad everything turned out well...but where are the photos?? Am I just dense? I'm not seeing any!! Waaah!!! (sorry, I know you're hearing plenty of those)