Thursday, March 18, 2010

The backstory - Kieran's birth

I thought I should probably post a back story on Kieran's situation so you can see where it all started. In the interest of time, here is the note I posted on Facebook on March 13th, 2010, about my first pre-eclampsia issues with Kieran's pregnancy.

Kieran's birth story
After my initial pre-e diagnosis, I was discharged Saturday evening the 13th, to bedrest at home. The goal was to keep Kieran in as long as possible and as close to term as possible. I was 29.5 weeks along and wasn't due until May 28th. I thought "Sure, I can make it until 32 weeks, then we'll try for 34 weeks, and maybe we can make it to 36!" But of course, my body had to cooperate with that goal. Sunday and Monday went off without a hitch symptom-wise. At 3:30 AM Tuesday morning I woke up with extreme abdominal/gastric pain. This was something they warned me about on my discharge papers, but I wanted to see if it was heartburn first so I took some Maalox - those didn't help at all! I tried sleeping in some different positions, and eventually Josh woke up to help me try to figure out what was wrong. By 7AM I was writhing around, barely able to breathe so I called the hospital, who told me to come in right away. Josh and Maia quickly gathered things up and we headed out. I could barely walk in to the hospital so I went to the emergency room to get wheeled in. Once they put me in bed, they took my BP a few times - the highest they got was 194/90. They had my labs drawn to check my liver function and checked kidney function with a urine test as well, and discovered that my liver enzymes were up (a non-issue the weekend before) and my blood platelets were even lower than weekend levels. Protein in my urine was also up, and they started to suspect it could be HELLP syndrome on top of the pre-eclampsia. They quickly started me on a magnesium sulfate drip to help prevent seizures and started to talk about inducing.

I think we had a slight advantage to Kieran's preterm birth by being in the hospital over the weekend. Josh and I knew that this was a possibility; that I may have to deliver. When they started to talk about inducing I wasn't as nervous as I thought I would be, except for the fact that I had no idea induction could be successful at 29.5 weeks gestation. The nurses assured me that sometimes the body and baby just knows something's not right and the induction can end in a successful vaginal delivery - an optimal goal and a much gentler birth for both mom and baby. I was found to be a fingertip dilated, so they opted to start Cervadil, a drug used to ripen and prepare the cervix, and then later move on to a Pitocin drip to push the uterus to contract. Cervadil was started at about 1PM, and I finally got some relief from gastric pain, so I was able to relax and breathe and start focusing on the first task ahead: giving birth to my 29.5 weeker.

I had planned on learning Hypnobirthing techniques with this pregnancy to help me cope with labor pains, and had just started reading about the method, thinking I had weeks to prepare. Luckily I had read enough and started to visualize my cervix opening up (I used an opening flower visualization) and sure enough, it started to do just that. I spent some time going inside myself - closing my eyes, talking to Kieran and encouraging him to come out, explaining to him about what was going on with his mama. I tried to focus only the birth, something I could sort of control, and not worry about the tough road that lied ahead with a NICU stay. I was able to stay focused and I knew I was progressing. At 7PM, I was 3 cm dilated and 70% effaced, so they stopped the Cervadil. I continued to labor until it was decided to start Pitocin - that was hooked up at 12AM. My mom arrived shortly after that to help support Josh and I. After that, contractions started to get slightly more intense, and I started to visualize being on waves to help me get through those contractions. At about 1AM, the RN who was staying with me noticed they started to get more intense and said she wanted to check me. I told her that I felt pressure - sure enough, his head was RIGHT there and my bag of waters was bulging. Since the NICU had to be on-call for Kieran and be at the birth, she started calling over the intercom to get help - the doctor was not in the room at this time, either! I told them I needed to push - the RN said "don't push!", but that wasn't going to happen, I couldn't stop! My water broke, and then another push or two later, Kieran was born. There was another flurry of activity with more nurses coming in, prepping to care for him right away, but I was able to see what was going on at the end of the bed and watch them work. He was SO tiny, but he seemed long. Josh accompanied him over to the isolette to peek at what the nurses were doing but mostly had to stay back so they could focus on getting him hooked up to the various machines. Once he was swaddled and prepared to go to the NICU I was able to hold him for a few moments to take pictures with him and then he was whisked away. Josh was able to see him an hour after birth in the NICU while I stayed back to get cleaned up, rest and focus on the next task at hand for me - getting better.

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I was still quite sick post-birth; I required a lot of BP checks & lab level checks to make sure my levels were coming down - thankfully they were, and my blood pressure has finally returned to normal as of this evening. I had to stay on the magnesium sulfate another 24 hours. Delivery is the only cure for pre-eclampsia and HELLP syndrome, and unfortunately it resulted in the preterm birth of our beautiful little son.

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Kieran Michael was born on March 17th, 2010, at 1:05AM. 2lb, 10 ounces & 15 inches long. It was St. Patrick's Day - and the Irish name we had picked out for him before he was born seemed all the more fitting that day. He is going to need the luck of the Irish, and all the prayers and love he can get, too. He was born at 29.5 weeks and has a bit of a tough road ahead of him, but we are confident that he's getting great care in the NICU and that our little guy is a fighter. He is our beautiful little lucky charm!

3 comments:

  1. wow!! you got to hold him right after he was born! I'm so glad, I wasn't able to hold or see Olivia for more then about 10 seconds after she was first born. ::hugs::

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  2. Brittany,
    Thanks for sharing your whole story. I can relate in a lot of ways. With Matthew I suffered through a whole week of that epigastric pain that you talked about (I thought it was just REALLY bad heartburn) and I was super itchy from liver enzymes that were in the 1100s (normal 20-60)! Unfortunately - when I went in to the doctor the day the symptoms started I was kind of blown off- and even though they did labs, no one followed up with me to tell me they were bad.

    I'm so glad your induction went well. I think it's pretty traumatic to have pre-e/HELLP and then a preemie on top of that. But you sound so positive. I pray that there are few challenges during this and that you are able to make it through the emotional stuff ok.

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  3. Aw its great to hear you got to have a vaginal birth. I never hear of a preterm birth going natural. He was surely big for being 29weeks! Found ya on twitter :D Hope all is well!

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