Our daughter has arrived!

Gabriela Anna’s Birth Story

Friday, January 27, 2012

So Gaby’s birth story is similar to Santi’s in the way it began…I went in on a Friday for a routine OB appointment, hoping the doctor would check me and say that I was 3 cm dilated and contracting regularly. Instead, I had high blood pressure (hypertension) and was admitted up to Labor and Delivery to have her.  I was only 1cm dilated and my cervix wasn’t effaced enough so my OB decided to do a c-section rather than inducing since it could be too dangerous for my heart.

I was placed on a magnesium drip which has side effects of burning where it goes into the body at the IV site and also making you feel hot and flushed, especially during the first hour of infusion. It can also make you have a headache and feel nauseous. I felt all of these. So I was given an ice pack to wear on my IV and suffered through the first hour and then had the amount backed off so I just had a low grade headache. I also got Heparin through IV to thin my blood and prevent clots.



We were told that they could possibly deliver the baby that evening or the next morning, depending on what my Heparin levels were. I’d been taking Heparin injections on my own at home and hadn’t taken one since that morning and also hadn’t eaten since lunch time (which was in my favor at that point) so they decided that they would head towards trying to do a c-section that evening.

A couple of hours later, the doctors came in and said my Heparin levels were continuing to rise, so the anesthesiologists didn’t feel comfortable with my levels at what they were doing a spinal block for the surgery. So they suggested waiting until the early morning and delivering then. So we were set up for the night and spent our last evening as the parents of just one baby.





Saturday, January 28, 2012

We were woken up throughout the night by nurses coming in to take my vital signs and check on my IV’s. At about 5am, the OB doctors on call and a couple of residents (since my OB was out of the country) came in to talk to me about the procedure. The anesthesiologist came in again and got some info from me for the surgery. My nurse came in at 6am and said that they wanted me back in the OR by 7am to get me set up with the spinal block, and set for the surgery.  So at this point we knew that January 28^th would be our little girls birthday! At 7am, they got me out of bed, put some footie socks on me, and a hair net as well, and I kissed Tito goodbye. They wheeled me into the OR and got me up on the table. Those rooms are always freezing, so I was shivering while on the table waiting for my spinal block. Back in the room, Tito was getting ready putting on scrubs and a mask and his own hair net.

Since the UW is a teaching hospital, the anesthesiologist had a student there with him to do my spinal. This wasn’t concerning to me, but it was slightly distracting while I was trying to focus on being quiet in my head and thinking the pain away and all I could hear was the one doctor giving instructions to the student. They managed to get the spinal in and laid me down and then gave me the Foley catheter, and the pressure socks. They draped me up and the anesthesiologist proceeded to put the blood pressure cuff on me and also tried to get an “art lock” which is basically an IV that goes into the artery in your wrist, right where your pulse point is. They said the reason for having it was because in case I was having a heart attack on the table they’d be able to tell quicker with that and deliver meds that way than waiting for the blood pressure cuff to go off every three minutes to tell them something was wrong. I’d argued against having it since I’d never had one before, particularly for the last c-section with Santi, but they argued for it and I said ok. But I mentioned how sensitive the veins I had were in my wrists and how they had a tendency to always blow when IV’s were placed there. But they assured me they’d give me numbing meds via needle ahead of time and it would be ok. So they tried to get the first art lock in and the vein went out. Since I’d been nervous about it I was super tense while they were doing the procedure and wasn’t happy when they said it hadn’t gone in. The anesthesiologist took over for his student and he tried in a different spot and the same thing happened.

At this point, the doctors were there and were feeling for how high my block had gone by pinching my skin on my abdomen. When they got to this one spot high up on my abdomen on my left side I felt it every time they poked me. I mentioned this and was a little nervous the block wasn’t set in yet. So it was decided that they would undrape me and put in an epidural catheter where they could administer medicine right away. So all of the doctors and nurses left the room aside from one and the anesthesiologists and they worked on the epidural. Tito was able to stay in the room as well even though I couldn’t see him. After they administered the epidural and the meds, I started to feel really lightheaded and like I was going to pass out. So they moved the table so I was placed more head down, and gave me more fluids to counteract the feeling. My blood pressure got really low as did my pulse and I felt like I was going to throw up. Finally I felt better but not before I thought I would really pass out on the table. They said it was common to have this happen but it still scared me a little bit.
After they had gotten me back to feeling better, the docs came in and they re-draped me and decided to start the surgery again. They started pinching me again and I wasn’t able to feel them thankfully so they started.  Tito came to sit by me and I started feeling a lot of tugging and pulling. A lot more than I’d remembered feeling with Santi’s surgery. At one point it felt like they were lifting me up by my stomach, similar to how you’d lift a puppy up by the scruff of its neck.

After about 30 minutes, the anesthesiologist came over and said that they were getting ready to pull the baby out and prepared me for how it would feel. LOTS of pressure and pushing later, she was here! Tito stood up and snapped a photo and they lifted her over the drape so I could see her (something I’d requested.) All I could think was how tiny she was!



I started crying but had no tears so it was an odd sobbing feeling without tears. I could see her in the bed being examined by the pediatricians, and then Tito cutting her cord. They weighed her and brought her over to me so I could fully see her all bundled up. They then gave her to Tito to hold. I asked how much she’d weighed and they said 5lbs, 12oz. I was shocked at how  little she weighed!





They tried to put her on my chest skin to skin right away but while it was a good idea in theory, I was still angled head down, so it was hard without her falling off! So they gave her back to Tito as they were finishing closing me up.



They took a long time since the last c-section I’d had an arterial bleed so they were extra careful making sure nothing was bleeding before closing me up. After they were done, they brought me back to my room holding her and Tito followed closely behind.  While in the room we did some skin to skin, she tried to nurse and was able to latch on right away, and then the nurse took her vitals and bathed her. She mentioned her body temp was a little low so she suggested putting her under the warming lights and then talking to the pediatricians, especially given the history of what Santi went through.





The pediatricians came in and said it was normal and they’d just monitor her and recommended more skin on skin time. We started with that, but pretty soon after I started feeling lightheaded again and so they took her from me and laid me down and checked my vitals. The doctors came in again and said since my oxygen sats were ok that they weren’t going to give me oxygen. My blood pressure dropped again and my pulse got into the low 40’s. Finally things came back up when they pushed more fluids. They ran some blood tests and said that they would wait to see what was going on.

That afternoon, Tito decided to go home and check on Santi and make sure things were ok with my parents and the house. While he was gone and the nurse was in the room, she checked my incision and was massaging my stomach to get my uterus to contract. This was really painful, and I started feeling dizzy and lightheaded again. At this point the docs came in but so did the anesthesiologist who thought I might be having a heart attack. I said that it didn’t feel that way to me and just felt like almost passing out due to the pain I was feeling. They decided to do an EKG and I called Tito and told him to come back as soon as he could.

The docs decided I probably wasn’t having a heart attack but instead ran more blood tests. After a bit they came in and said that my blood levels were rising and it looked like I had some internal bleeding somewhere. They did an ultrasound to figure out if it was a small bleed or something large like with Santi. The found a few small areas with blood pooling but no major visible bleeds. So they decided to hold off on putting me back on the blood thinning medications and instead to transfuse me with a couple units of blood in the hopes that the extra blood would replace what I’d lost and my blood would clot on its own. They decided to start that right away and do that through the morning.

More later...