Let’s make an attempt to work out exactly what happened on our little excursion to the hospital. I’ve been processing it for a couple of days now, but I’d like to get some of the details down “on paper” before they start to get too fuzzy.
It was Wednesday morning, and I was taking a shower. When I went to turn off the water, I noticed blood (the bright red kind doctors and pregnancy books get really excited about) in the tub, and tried to call Craig. He thought I wanted him to get the biscuits out of the oven, so he didn’t come and I had to call again. We called the midwife, but she didn’t pick up, so we called the office of our back-up doctor, and they told us to come in to the labor and delivery floor.
At any rate, I got cleaned up and dressed, and went to lay down. The bleeding seemed to have stopped, but we knew we should still go have it checked out. Craig got the girls dressed and packed some biscuits for their breakfast, and called Theresa to watch them until his mom could come in from Baton Rouge. I failed to eat, which was a mistake, except to snatch a couple of small biscuits from the girls’ bag before they left.
Theresa is, after all, a saint. We dropped the girls off at her house on the way to the hospital (and forgot to leave the car seats and had to circle back) even though she was getting on an airplane in a few hours. She and Craig’s mom worked out what to do with the girls, and they spent the afternoon at our house then went to BR for the night.
Craig and I made our way to Touro uptown and found a parking place near the entrance. (He had to renew that meter I think five times over the course of the day!) We went upstairs, checked in, got a room, changed clothes, and started waiting. I can’t remember exactly what order things happened at this point. I thought there would be tests – pelvic exam, ultrasound, and whatever else, and then we would either know something was really wrong or we would go home. We were told my back-up doctor was in surgery or something like that, and would be in a little later to see me. In the meantime, they put me on a fetal monitor, and then the nurse came in with an IV bag. We had been there an hour or two at this point.
I started to cry, which confused the nurse a great deal. Why wouldn’t I want an IV? I think it was that what I had hoped would be a battery of tests and home in time for lunch was suddenly looking like a much longer stay. I think I made our doctor mad, because I asked the nurse to ask if I could do oral fluids instead of the IV. What no one had explained to us, I figured out the next day, was that the fetal monitor was showing weak but semi-regular contractions (which I could not feel at all) and so they thought I was starting pre-term labor. IV fluids are a really good way to stop that, so that’s what they wanted to do. I might have been less upset by it if anyone had bothered to tell us what was going on.
They did blood work at some point (and I would have had it done again later if I hadn’t asked what they were checking for now – the tech left to check her orders and never came back!) and the speculum exam showed nothing of interest except that my cervix was still closed. They rolled in an ultrasound, and it looked like my placenta was low, so they wanted to use the better ultrasound. So we waited for someone to come from that office across the street to do that. And we waited.
Meanwhile, lunchtime had come and gone, and I wasn’t being allowed to eat, which really just made me grumpy. Our nurse finally sneaked me some crackers, and when Craig went home later in the evening he brought back almonds so I’d have a little something at least. Again, apparently they were thinking I was in labor, so I shouldn’t eat, as is the usual policy, but no one was telling us that.
What are the chances of a woman who is fairly well in touch with her body and in her third pregnancy going into labor and having no idea that it’s happening at all?
We did eventually see a doctor (ours was not able to make it after all) and he wanted to keep up the IV, keep us overnight, and give me shots to slow down labor (labor!?) and speed up the baby’s lung development in case it was born early. Not what we were expecting. We still didn’t really know what the doctors were seeing or what was going on.
Finally it was decided that we would have to go across the street to do the next ultrasound, they wouldn’t be coming to us after all. This was somewhere around 3PM if I remember right.
So we loaded up a wheel chair and headed out. The first ultrasound showed a very healthy baby and everything looked pretty good. Then they did a transvaginal ultrasound so they could see just how low the placenta actually came, and found that it is covering about 1.5 cm of my cervix.
So here is the trouble. If it doesn’t move off of the cervix, the bleeding risk during labor is too great to make a vaginal delivery a good idea. Contractions, particularly strong ones, have the potential to move the cervix (which is what they’re supposed to do), and if the cervix pulls away from the placenta when the placenta isn’t ready, the placenta could bleed. It could be a lot or a little, there’s no way to know. If it’s a whole lot, it could be very bad for me and the baby.
So what they usually do is prescribe bed rest and schedule a c-section for 36 weeks or so.
So we rolled back to the L&D floor after another chat with the doctor on call and discussed our options. We decided that since there were almost no risks associated with it, we would do the steroid injections to help Oscar’s lungs develop faster, just in case something did cause a very early birth. But we wanted to go home for the night and come back for the second injection. The doctor didn’t like that idea, but told us we could do that if it was really what we wanted.
Craig renewed the parking meter again and made some phone calls (our cell didn’t work in the hospital room) including to the midwife, who told me to “trust my gut.” Of course, I never felt bad at all except for the things the hospital did to me, so my gut was saying, “Let’s go home and sleep this off. I want to see my girls. I don’t want to stay here.”
Well, the resident (intern? something like that…) came back a little later and told us that the doctor was going to sign a “left against medical advice” paper which meant that our insurance would pay for nothing that had happened on our whole visit. As we are not independently wealthy, that was clearly not a option. So we felt totally trapped, and spent the night in the hospital.
It turns out, after Craig talked to the insurance, that she was totally wrong about this in our case. We could have left at any point as long as I wasn’t in the ER or mentally unsound. But we didn’t know any better!
So I didn’t get to eat dinner, either, and after we got back to the room they wouldn’t let me go to the bathroom, I had to use the bed pan. I tried to consider it a lesson in humility. But with the amount of IV fluids in my system, I had to be humble fairly often.
I had the first of the steroid shots (the needle didn’t work right and it had to be done twice) and then Craig went home for a little while to see the girls and gather things for the night. He slept in the arm chair with the extendable foot rest. I refused the sleeping pills until around 11, and then it took an hour for them to come over and I had dozed off anyway.
The real problem with the night was that my nurse was apparently very busy and I had to keep calling twice to get anything – bed pan, new IV bag (and the beeping that goes with an empty IV is horrendous), more paper for the fetal monitor, which also beeps until someone pays attention to it. Once my nurse came to put me on the bedpan, and then left the room. I had to wake Craig up to help me because the thing made my legs fall asleep. Even with the sleeping pills I woke up around 7.
I had to wonder several times just how worried they really were about me, since I tended to knock one or both of the fetal monitor probes loose and the baby’s heart rate would go off record for half an hour or more at a time.
The morning brought no breakfast, even though the doctor the night before had promised that I could have some juice before bed (which I declined as I didn’t think it would help me sleep) and something to eat in the morning. The morning shift nurse was nice enough to go on a crusade for me and find out if I could at least get some lunch, which I finally did. We spent the day waiting around, mostly, until 24 hours had passed since the last steroid shot, so I could get the next one and go home.
But in the afternoon the new doctor on call came in to visit, and he wanted us to stay another 12 hours. I balked. I had been told I could eat, then I couldn’t eat; I could leave, then I couldn’t leave; I could walk around, then I had to stay in the bed; I had had enough of these changing orders. So I explained this to the doctor, who admitted he was of a “conservative” mind frame and followed ACOG’s guidelines closely, but would yield if we really wanted to go home. He, too, would sign the “against medical advice” paper, but we knew now that that only meant we couldn’t sue him for letting us go, so that was no big deal. We were much less interested in suing than in sleeping.
The highlight of the whole visit was that a friend of ours from the Catholic Worker was also there having her baby, and she was able to walk over and visit us before we left. (Craig got to go see little Micah Francis, lucky thing!) She had a wonderful birth experience with one of the midwives who works in the hospital, and looked great and was a true blessing for us at that time. I don’t think she’ll ever be able to know how much good that little visit did me.
So I got dinner, Craig gathered things up, and a little after 6:30 we had steroid shot #2. Then it was remove all the various medical devices, get dressed, sign the release paper, and roll out to the car. My mom had picked the girls up in Baton Rouge and brought them home, so they greeted us at the door, which was wonderful. It was a long two days without them. And then I went to bed and had Craig try to rub some circulation into my legs. I’ve had no swelling this whole pregnancy, but they had pumped so much fluid into me that I could barely squeeze my sandals on to come home because my feet were so swollen.
And here we are, two days out now, and so far so good. It’s hard to turn over my carefully systematized (ha!) house to other hands, but I’m working on it. I am highly motivated not to go back to the hospital any sooner than I have to. Tomorrow morning we have an appointment with our own doctor, so we’ll see what things look like from her perspective, and what our course of action will be. Pray hard around 9AM! (Or later – it took us 3 hours to get in for the last visit!)
Postscript, if you’re still reading: some things that didn’t fit into the storyline, but that I hate to leave out.
- What is bed rest anyway? Nurse #1 said it means only getting out of bed for the toilet, but on-call-doctor #1 said it meant staying home and taking it easy – he mentioned walking around the house and doing light activity.
- Shouldn’t another nurse cover a call for a bedpan if the nurse in charge of that room is busy? That seems like common courtesy.
- Where are they writing down things like “she can eat now” that no one can find them???
- Does it make sense to make a woman 31 weeks pregnant fast for over 30 hours when you don’t want her to start labor? Or ever, unless there is a really, really good reason? I don’t think the possibility of starting early labor sometime in the next few days a very good reason, personally.
- What do hospitals have against fresh food? The food wasn’t terrible, but you there was definitely a disproportionate amount of starch and dessert. I devoured the cooked squash. (The real problem is that we have been doing way too much research into nutrition lately, and the hospital food I got equals not nutrition.)
- Again, where are they writing stuff down that I almost had my blood work done twice? And with experiences like that, why wouldn’t I question everything that is being done to me?
- After four nurses, three doctors, and one intern-type-person, I didn’t know which way was up or who to listen to. I know the circumstances were a little strange, but still. My vote will forever be for a midwifery model of care.