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My son Francis was born December 28, his due date. I had been feeling pretty done with everything, and was just ready to meet my baby of course, but mainly to not be pregnant anymore!

I went on maternity leave at 36 weeks, and was relieved to finally be off my feet, as I am a nurse on a busy pediatric hospital. The next few weeks dragged by. My last day at work was thanksgiving, and I cooked an entire traditional meal the next day. Up until this point, my main complaints had been moderate nausea first trimester and hip/pelvis pain in the first and third. Everything was "normal" at every appointment. That night after preparing all that food, I became pretty swollen, but assumed it was due to being on my feet all day in the kitchen and eating a feast. I was very swollen from then on, but it was only in my ankles and so my doctor wasn't concerned. It was a pain because my feet were almost 2 sizes bigger than normal! I spent everyday in a pair of toms that started out big and sort of stretched and grew with me.

My last appointment was on the Monday before my due date. Everything checked out, as every previous appointment, and my swelling was even a little down. I was discouraged as they made me my next appointments "just in case". The next couple of days were each more miserable than the last. I had 3 sleepless nights, ending in my crankiest Christmas so far. My family came to us to make it easier on me, but I felt so crappy I could barely eat. I had suddenly developed horrible heartburn, I had back pain, Braxton hicks on and off, and cramps similar to a period, but never any true contractions. My entire upper abdomen ached with the heartburn.

One of my biggest worries was going to the hospital too early and being sent home with an eye roll at yet another first time mom thinking she's in labor. I was hoping my water would break to send a clear signal that labor was truly beginning, as I knew they'd want me in to start the GBS prophylactic antibiotics. Finally, Friday night came, and I started having some blood and mucous. I was so excited to see some sort of positive change! Contractions started soon after, and before bed, regular enough to time. But I could tell I was a long way off from the speed and strength needed to head into the hospital. They varied greatly from 30 seconds to a minute long, and were coming longer than 5 minutes apart. I was surprised after all the different type of cramping Id experienced to find that they were yet another type of sensation. Each contraction would start in my back, on both sides of my sacrum, with strong painful pressure that radiated to my upper thighs. My partner and I got little sleep that night, him because he thought we might need to run to the hospital at any minute. The night went by so slowly. And I was so relieved when it was officially morning.

I moved to the couch, and tried to eat breakfast but could only stomach a few bites of oatmeal. I was disappointed, because all week, the only thing that distracted me somewhat from my discomforts was watching cooking shows on PBS (especially Julia Child and Jacque Pepin), but the only thing that was on was This Old House! We waited as long as possible, and then I called the advice line as I was starting to fall within the suggested guidelines of frequency and length of contractions. I thought she would say to wait it out, but she said I was welcome to come get checked and possibly get something for pain.

I had my heart set on a natural birth, but at this point I was doubting my abilities after experiencing early labor. I had done a half ass job at hypnobabies home study, which mainly just caused me feelings of guilt throughout my pregnancy as I failed to practice even half of the recommended amounts. I like to think I still had some benefits from the little I did. I was furious during labor when my partner suggested I do my hypnosis meditation, even though that was the planned idea!

We finally headed to the hospital at around noon. I felt pretty miserable but I just knew my contractions weren't frequent/intense enough and I was dreading them sending me home. The triage nurse checked us in, and my blood pressure was pretty high, maybe 160/100 or so. I wasn't worried though because I was so stressed and in pain, and it had been perfect just the past Monday. Then she checked my urine and I had 2+ protein. That one took me by surprise, no easy explanation I could think of. I thought maybe my water was leaking and I didn't realize, as I had mucous and some mild bleeding with contractions. She drew some labs, and said it was possible I was developing preeclampsia.

The resident doctor came in and I wasn't very fond of her personality. She had this irritating (more so at the time, I know) way of patting my leg to show her support if I had a contraction while she was there. She did my cervical exam and her technique was clearly to go quick, but I found it so painful compared to my previous exams. And then she said I wasn't dilated at all, which worsened my impression of her since I hated that news! Especially since at my last few appointments my OB told me I was at least 1 cm. She checked if my water had broken. It hadn't. So she said, assuming my labs were ok, I'd go home with some urine test strips and go see my doctor later that week. As soon as she left the room, I burst into tears. I couldn't imagine more days of all this discomfort. But then, not much later, the nurse came in and told me some results of my labs. My liver function was off and my platelets were 48 (should be above 150). She told me I was definitely staying and that not only did I have preeclampsia, but I had HELLP syndrome. I had to rack my brain back to nursing school to remember what it was, basically a more dangerous variation on preeclampsia. And it made sense why I had suddenly developed the severe abdominal pain and heartburn and just felt generally lousy all week.

They kept telling me that the cure was delivering the baby, and I was lucky to be full term. The resident came back in and told me the plan. I would stay and be induced. I was immediately worried about getting Pitocin, but she said I was contracting well enough for now, and they would start by dilating me with the foley bulb. I decided that regardless of my previous hopes, with all these changes to what I expected, I wanted an epidural. I knew it was important for me to stay calm.

We got settled into the delivery room and met our nurse. It took some time to draw a lot more labs, have two IVs placed, be started on a loading dose and then continuous drip of magnesium sulfate, and be placed on the monitors. Everything was going fairly well and my nurse was awesome. The mag felt pretty crappy at first, but I got used to it quickly.

Then the anesthesiologist came in. He was the head of anesthesia for the whole hospital and oversaw the nurse anesthetists that covered OB, and he made sure to point that out. He said they had been "discussing my case", which is a bit of a freaky thing to hear. He said that unfortunately they would not be able to offer me an epidural due to the risk of bleeding. The nurse had told me I might need a platelet transfusion before they did an epidural but he said that would not be a safe option.

Then he said the worst part. If I need a c section, I had no option for spinal anesthesia at all and would have to be totally out, under general. This meant that the baby would be
born sedated and potentially have respiratory problems at birth. He also told us a bunch of worst case scenarios of other complications that can happen with c section and hellp syndrome (uterus may not contract down after, risk for hemorrhage, all these blood products on hold for me).

I found out later my husband thought I was going to die from all these warnings. It was so scary for him, especially because he has no medical background. I suppose it could have been even scarier for me with a medical background, but I was sort of in shock. The nurses kept telling me it was the "nurse curse". Plus, it's hard to process news when you keep having painful contractions in your back every 5-7 minutes.

The resident asked the nurse to let her know when she gave the premedication of fentanyl so she could place the bulb. But there were some emergencies, and that didn't happen until around 4 pm. She gave me the medication and I felt briefly very out of it, but the contractions were still painful. The nurse had warned me that fentanyl works best the first dose, and the effect lessens with subsequent doses. The resident got ready to place the bulb, but I was already 4 cms! That was a pleasant surprise and I felt vindicated to know I was definitely in real labor.

More time passed and the back labor continued. One thing that both surprised and irritated me was everyone kept saying "oh, maybe he's posterior". I assumed they would be able to check and tell me for sure, but no one ever did.

My partner was so amazing with the contractions. I would squeeze his hand really hard, and it was very difficult to not hold my breath. I felt like each contraction seized me and I couldn't move. They kept telling me to try to melt into the bed. I had read to make your mouth loose, like horse lips, but somehow for me in trying to do that, I started blowing air through my lips pressed together in a ridiculous sound. Sometimes it helped me relax and sometimes I just used it to escalate my tension.

I felt like I was a horrible patient. Nurses often are. I felt babyish and weak. The nurses and my partner told me I was very strong but I wasn't convinced! The next time she checked me, I was I think 6 cm. I ended up dilating right around 1 cm per hour. I don't remember when, but at some point as I was lying there in bed, my water spontaneously broke. It continued to flow out a little bit with each contraction. I spent almost the entire time lying down, despite my plans to walk and move about. With all the monitors and iv lines, plus blood pressure every 15 min, it was impractical anyways. I always dropped my monitors when I got up to the toilet (one time actually in the toilet!)

We were planning to give minimal updates to family throughout labor, but it seemed that we should tell my parents about the complications that had unfolded. My mom wanted to come, but I kept telling my husband to tell her no way. She said she would have waited in waiting room if that's what we wanted but the thought would have just irritated me. They drove up an hour to bring my sister to stay with the dogs.

Here's my only regret about labor: the anesthesiologist had come up with a plan for me of a fentanyl pca (patient controlled pain medication you push the button for). After the first dose didn't do much, I should have known that smaller doses would have been pretty useless. Although my husband thinks it made a difference from his perspective. The thing I regretted though was it made me stress mostly, because of a chance for it affecting the baby's breathing. It wears off fairly quickly but can depress both mom and baby's drive to breathe, and there was a chance he might need medication to reverse that at birth. Because of that (and maybe because of the other issues?) a NICU team would be there at birth. And, if he had needed the medication, he would have needed to spend 6 hours minimum in the NICU. I know in the grand scheme of things, it would have been fine, but at the time it was one more worst case scenario for me to stress about.

I couldn't turn off my nurse brain about it and kept asking questions when the baby's nurse came in to set up her resuscitation area. My nurse told me "look. Usually the mom is the one we worry about with hellp syndrome. The babies are fine. We need to take care of you in this situation!" But my main concern remained my baby. I was stressing about if he needed help breathing, how I would miss out on skin to skin, because they basically implied that wouldn't be an option right away. I ended up pressing my pain medication button only about 4-5 times and stopping when I got to 8 cm. It wasn't a normal practice for them to set the pain medication up this way, so it took a while, and honestly I wish I just skipped it. It just wasted time and stressed me out. And ruined my chance to say I had a natural birth !

At this point we had already had nurses change shift at 7 and 11. Each time I was annoyed but had an equally great nurse come on. They were so supportive but gave me space. I loved them all in L&D.

I don't remember exactly but assume I was fully dilated at around 1am. It was a huge learning curve for me to figure out the pushing technique. They had me hold my breath, which felt terrible. It was so frustrating, it felt very much like he kept almost coming out only to go back in! In fact I think I kept exclaiming that ("did he go back in???!!!"). The nurse had a very calm yet supportive way about her. We had pushed 3-4 times when she left to go on break! I was very irritated that this extremely tall and brusque lady with an Australian accent had needed to relieve her at exactly that minute, but it ended up being the best thing for us. She was an amazing pushing coach. I pushed for about 2 hours, and then, she called everyone in. Suddenly, everything moved so fast and the room filled with people. They ended up giving me some pitocin because my contractions wanted to remain a little too far apart. Which made it difficult to build on each one when you had to wait so long in between. There were so many people, I had no idea who they were. In particular, one older woman stayed on the side and occasionally offered an encouraging word or moved the bars I was holding. I was thinking, "is that a student or something? She looks too old though!" It turns out she was the attending OB physician, and her name is on the birth certificate as delivering Francis! She never even introduced herself. The same resident who I didn't love was front and center. She had this totally irritating phrase with the pushing "ok, give a little more" over and over. My husband likes to say it to drive me crazy now. But finally, the baby slid right out! He was born at 3:40 AM. And once he came out, everything moved so fast. He was not in any distress in the least and they suctioned his mouth and nose right on my stomach. My husband cut the cord and all the people filed out (I think). They wiped him off a little and suctioned his mouth, but mainly kept him as is and delayed all the tasks for well over an hour. When he was born, I frantically asked over and over "is he ok? Is he breathing???"
And he was. He was perfect!

I had a grade 2 tear which she sewed up quickly. And, Apparently when I delivered the placenta, there was a lot of bleeding. I found out a few hours later when listening to the nurses give bedside report that they assumed I had a placental abruption! No one mentioned this directly to me, I wouldn't have even known if it weren't for my eavesdropping. I didn't actually see an OB doctor again until the next morning, although I assume they were monitoring my chart.

I ended up staying in bed for almost the whole day. I got the Foley catheter out the following morning when the magnesium infusion was finally finished (they placed the catheter in the morning when I almost passed out trying to go pee). It felt amazing to be off all the lines and tubes! I always thought I would want lots of visitors, but I was so physically exhausted and a little shell shocked, and my family was plenty. I didn't really sleep at all until Monday night, as Frankie skipped the "sleepy newborn" except for briefly when my milk came in Wednesday. The nurses still switched a lot but both Sunday and Monday nights in postpartum, I had angel nurses come on at midnight when I was totally desperate for help and support.

We didn't get to leave until Tuesday evening, and we had to come back Wednesday and Thursday (New Years eve and day) for weight checks as little Frankie lost almost 11% of his 7 lbs 9 oz birth weight before my milk came in. Since then, he's been doing amazing and weighed 15 lbs at his 2 month appointment! I feel so lucky to have ended up with an overall positive experience and to have given birth to such a spunky strong little guy. Things didn't go as I planned, but of course they never really do!