Birth and Lupus: Baby Meena’s Birth Story.

Today Baby Meena is one year old.  Yes, it has taken me a year to finish writing his birth story.  I wrote down many details in the first two weeks, intending to get the story out much sooner, but I was somewhat traumatized from giving birth and had to stop reliving it in my mind for a while.

Life was also really hard with a newborn as a parent with lupus.  I have struggled mightily in all areas of my life over the past year, including working on this blog.  Thankfully, things did begin to get significantly easier at about 10 months (which I look forward to discussing in postpartum posts).  Also, I knew that if I didn’t get this post out within one year then I’d never write it.

Baby Meena has come so far since his first day on this earth and it’s been an amazing journey.  The change from helpless newborn to toddling, spunky one year old is astounding.  As you might imagine, it’s been the most difficult and most rewarding year of my life.  In this post, I’m going to take you back to the very beginning.  I read tons of birth stories during my pregnancy and I was thankful for other women who shared their experiences so that I had an idea of what to expect.  While this is a typical birth story in many ways, I will also share how my lupus impacted my birth experience.

 

Baby Meena’s Birth Story.

 

 

Due to my lupus and chronic high blood pressure (hypertension), my high risk OB team and maternal fetal medicine doctor strongly recommended that I have an induction at 39 weeks.  This is because after 39 weeks the risk of lupus and/or hypertension causing harm to the baby is greater than the risk of being born at 39 weeks.  In other words, he was fully cooked and no longer needed to be exposed to any potential harm.

I had mixed feelings about having an induction.  I wanted my birth experience be as natural as possible and I had read that inductions caused labor to be quite painful and increased the likelihood of other interventions.  However, I could not imagine having something terrible happen to my baby during the final week or two of pregnancy and I was so absolutely miserable at the end of my third trimester that I was afraid of a massive lupus flare if things kept on.

So on my 28^th birthday, which was also Mother’s Day, we took a few last photos of my belly, packed up the bags, had a nice dinner as a family of two, and then headed to the hospital for our 7:30pm check-in.

 

 

I have to admit, it was very nice to have everything planned out and not be rushed or flustered on our way to the hospital.  I was surprised, but thankful, when my doctors had recommended a natural birth (as opposed to a C-section) because of the stress it would put on my body, but they assured me this was always the preference when possible.

Some doctors have you show up on the morning of the induction, but my team of doctors prefer to have you come in the night before.  When you stay overnight they can help your body prepare more slowly and be more ready for giving birth.

I had read from other blogs to take a quick shower as soon as you get in the hospital room as you might not get another chance.  It had been a hot sweaty day and I was glad to wash off.  I was barely out of the bathroom and dressed in my gown when the doctor showed up.

This first doctor was my least favorite of the whole bunch throughout my stay, unfortunately.  Since my OB clinic rotates through a team of a dozen doctors I hadn’t had the chance to meet a few of them, including this one.  He got right down to business inserting a prostaglandin suppository.  This is used for cervical ripening – the process of softening and widening the cervix.  From what I understand, it’s a simple and easy way of beginning an induction.  It was just a small pill and, after the first ten minutes, I could move around freely and it didn’t bother me.

He then inserted a balloon catheter, also called a Foley catheter, into my cervix.  This type of catheter encourages dilation and will fall out before you reach four centimeters.  The end was taped to my leg and I could still use the bathroom normally.  Using a balloon catheter seems to be much less common than the suppository medication, but my doctors have had a lot of success using it with inductions.  I’m really glad they did it, even though it was hugely uncomfortable.  Occasionally, the suppository and the catheter combined is enough to induce labor.

All of this was completed by 8:30pm and the doctor was ready to rush off.  I asked about taking my nightly blood pressure medication and said he wanted to hold off on it.  I was irritated and considered taking it from my own medication bag that I had brought with me (despite the fact that you are only supposed to take medication administered to you directly while in hospital) but I dislike going against doctors orders.  Skipping the medication ended up causing problems later on, which I’ll talk about, and is the main reason why I didn’t like that doctor.

The nurse strapped a contraction monitor and a fetal heartrate monitor around my belly, which I could disconnect to walk over to the bathroom.  I started to have painful cramps pretty much right after this was all completed.  Baby Meena also become feisty and began kicking violently, perhaps because he didn’t like the catheter or because the cramps were starting.  Mr. Meena took a walk around the hospital and captured the nice sunset view of Charlotte before taking up his spot on the couch for the night.

 

 

Between the cramping, the catheter, the baby kicks, and my regular chronic pain, I was pretty uncomfortable.  I kept twisting in the bed and the nurse would have to come in and reposition the heart rate monitor as it had slid out of place.  She was nice about it but I’m sure it must have been frustrating.  By 10pm she offered me an Ambien as it was clear that I wasn’t settling down, which I gratefully accepted.  Unfortunately this had no real effect and I was still restless.

I tried getting into the rocking chair in the room and reading but I was still moving around too much for the fetal monitor to stay in place.  I was getting overwhelmed by it all so at 1am they gave me a dose of morphine.  This helped me relax a lot, but I still couldn’t sleep much.  I dozed off and on until 6am, when the suppository was removed and I jumped at the chance to take another quick shower.

The nurses and doctors changed shifts and I met the next doctor, who I also had not met previously in the clinic.  This doctor was irritated that the previous one hadn’t administered my blood pressure medication the night before and told the nurses to give it now.  She was brief but kind – she was very busy that day, later she told me she had delivered five babies during that shift.  She rushed off, for a delivery I believe, and little did I know I wouldn’t be seeing her again until my own delivery.

My dreaded IV pitocin drip was started at 7:30am with an increase every half hour.  I’m not sure of the dosage units, but by 9am it was running at a painful six and it could go up to 20 (although I think that’s rarely required).

 

 

I wasn’t allowed to eat real food, but I had to eat something in order to take my morning medications (plaquenil and imuran).  The nurse ended up bringing several jello cups and a popsicle.  It was enough to keep me from having a stomachache.

My contractions started abruptly around 9:30am.  There was no gradual build up – I went from having painful cramps to quick, intense contractions.  They were coming every two or three minutes.  I tried getting up and walking around, which was hard to do with two monitors on my belly, a catheter strapped to my leg, and an IV pole to pull along (not to mention having to be careful of the blood running down my legs – in small, normal, yet messy amounts).  I had planned to cope with labor pains by sitting on a birthing ball, stretching, or dancing, but it became too difficult for me to stand up during a contraction.

I tried sitting in the hospital bed and watching a movie with my husband to distract myself.  I think we made it about 15 minutes into the movie before the contractions changed.  One minute I was sitting up talking to Mr. Meena and the next I was lying on my side in the bed gripping the rail, unable to talk from the pain.  I think it was around 10:30am at this point.  My nurse had been checking in pretty frequently and the next time she came in I asked for a shot of morphine.

The morphine didn’t hit me the way it did the night before, in fact I could barely tell a difference.  By 11am I was starting to feel like I was nearly passing out in between the contractions.  They would grip me and I would come awake and beat my hands on the rail to cope with the pain, and when they passed I would collapse and barely be able to open my eyes or speak.  I managed to ask the nurse if I could have more morphine but she said it was too soon.  I was terrified of an epidural, especially the complications they can cause, but I was only able to hold out another 15 minutes before asking for one.

 

Me before the pain started in earnest.

 

Around 11:45am the nurse told me the anesthesiologist was on his way and someone started lying out his needed equipment on a table behind me.  I was just barely aware of what was happening and I was starting to cry out during each contraction.  I remember wailing the word ‘no’ over and over again because I was unable to accept the pain.

Then I felt a warm, slow bursting of fluid that flowed for a long time.  I had to try several times before I was able to tell my husband that I thought my water had broken.  He called the nurse back and she pulled my catheter out – it was completely full and would have fallen out if I had been standing.  She said I was around four centimeters dilated and was quite happy about it.

A few minutes later I felt a great urge to push down with my entire body, which alarmed the nurse.  It was noon and apparently I had gone from four to nearly 10 centimeters rapidly.  The nurse realized the baby was coming, asked me to refrain from pushing, and ran to get my doctor.  There was no way I could stop the pushing.  My entire body squeezed itself without much effort required on my part.  I heard people running down the hallway and yelling.

Suddenly my doctor was there, along with several other staff pushing in carts.  They had to turn me from my side to my back as I was incapable of doing it myself.  They turned on the birth lights, adjusted the bed for giving birth, and gave me another shot of morphine.  I wasn’t going to get the epidural after all, which made me feel both relieved and terrified.  The doctor tried to help me stay calm while they rushed to set up but I couldn’t stay calm and I couldn’t stop pushing.

Finally they were ready and they started to help me.  They pulled my legs up along my side, which I had seen in the birth videos, and instructed me to hold them.  This made me quite angry; in the videos it always looked to me like the nurses were holding the woman’s legs while she focused on pushing, and I didn’t have any energy to hold onto my legs.  But the nurses and the doctor told me that I had to hold my legs because it was essential to helping me push.  I managed to grab them, but I was also mad because I had wanted to try giving birth in a squatting position and I knew there was no way I’d be able to do that in the state I was in.

With each contraction they told me to push, but I didn’t need to actively do it – all I had to do was lean into the urges.  It was so hard and absolutely terrifying.  Despite everything I had read about giving birth, nothing can actually prepare you for having to push a baby out of your body.  I felt out of my mind with the pain and the effort of it.  I didn’t understand how this could be happening – it felt wild and I hardly had any control over my body.  A few minutes in I told the doctor I couldn’t do it.  I was too afraid, too tired, and too intimidated by what was happening to my body.  She and all the nurses encouraged me and told me I could do it, and then she also firmly told me that I had to do it.

I got angry again and decided that this had to be over, now.  The anger helped me, because otherwise I probably wouldn’t have had the strength to do it.  I screamed, a lot, as I put an intense amount of effort into two long pushes.  My abdomen ached, and I felt a terrible burning sensation, and I hated everything I was feeling.  The nurses were very enthusiastic and encouraging; I was later told that 95% of the births at that hospital were done with epidurals and they enjoyed helping someone go through labor in this way.

Finally, my long push ended and I felt relief.  The doctor pulled Baby Meena up and laid him on my belly immediately.  I remember being absolutely stunned.  I looked down and could only see the top of his head, covered in dark hair with stringy blood all over it.  I gingerly touched his head as the doctor had Mr. Meena come around and cut the cord.  We all smiled for a moment before the nurses took him over to be checked out and cleaned up.  After all that I had just gone through, he was an amazing reward.

 

 

He was born at 12:15pm.  He weighed 6 lbs. 8 oz. and he was 19 inches long.  He didn’t really make any noises, there was no typical baby screaming, but he was just fine.  Before long he was swaddled and observing the world quietly in his Dad’s arms.  Mr. Meena came and held him right next to me, but after a while he stepped away because the doctor was concerned that my placenta hadn’t passed.

She started pressing down on my stomach to try and get it out.  She pushed so hard on my stomach that it felt like her hand had gone all the way through my body.  I had no idea it could hurt that much to have someone press on your abdomen.  I couldn’t believe that after all I had gone through I was having to go through even more pain.

Once she finally got the placenta and all the broken pieces out, she informed me I had a small upper tear and a second degree lower tear.  At this point I was getting frantic – I wanted to hold my baby and I wanted the pain to end.  She had to stitch me up though, and I was completely freaked out about having to be stitched in that spot.  They numbed me and it didn’t hurt much, it was more uncomfortable than painful, but I kept flinching every time she touched me with the needle.

It was nearly impossible for me to remain still – no matter how hard I focused on calming down I couldn’t stop my body from jerking.  I think I was in a state of panic from giving birth and everything after.  I was actually embarrassed that I couldn’t make myself lie still and let her finish quickly – I must have apologized two dozen times.  Once the bottom tear was stitched she decided that we could give the upper one a chance to heal on its own since I was so upset.

I had missed the first hour, the golden hour, of my son’s life, but I finally got to hold him at this point.  And I didn’t ever want to let go of him.

 

 

The lactation consult came in and I discovered just how much it hurt to have someone press really hard on your breasts for a long time.  Baby Meena had no interest in breastfeeding, but we managed to spoon feed him small amounts of colostrum.  This was partially just his demeanor – he never took to breastfeeding – but it was also because my blood pressure medication had caused him to have low blood sugar and be lethargic.  This is a common side effect and I was very upset that no one had told me beforehand.  I should have either skipped it for one day or taken it the night before – taking it four hours before giving birth ended up in a larger concentration in him when he was born.  We ended up having a lot of issues trying to get his blood sugar back to normal levels.

Around 2pm my lunch arrived from the cafeteria and it was delicious (food usually is when you’re that hungry).  After eating the nurses told me I had to go to the bathroom.  Apparently this is a pretty big deal.  Two nurses got on either side of me and helped me walk to the bathroom and get situated.  They said that I had to go on my own or they would likely have to put a catheter in.  Talk about pressure.  I did finally manage to go after I convinced them to leave me alone in the bathroom.

The nurses told me that my delivery had only lasted eight minutes; they were calling it the “fastest delivery in the west”.  I couldn’t imagine if it had lasted longer, though I suppose that without an induction it might not have been so intense.  My labor lasted for just under three hours.  It’s hard for me to imagine how other women have gone through hours of labor and delivery.  There was a woman who was checking into the hospital at the same time as me the night before, and she ended up being in labor for 48 hours.  We were preparing to leave the hospital when she was being brought to the postpartum area.  In the end, I was happy that everything happened quickly, despite the pain, and ecstatic to have a healthy little boy.

It was time to leave the birthing suite and go to a postpartum room.  We got all packed up and a nurse put me into a wheelchair with Baby Meena in my lap.  I don’t know if it was the exhaustion, the endorphins from giving birth, or the remnant of morphine, but that was the most exhilarating wheelchair ride.  I was sitting comfortably, with my precious baby in my lap, and I felt like I was flying down the hospital hallways.  I don’t know if the nurse was actually going that fast or if my perception was off, but it felt like standing on a hill with wind blowing my hair on a cool fall day.  It was a great transition into the postpartum area.

 

 

While giving birth was traumatizing for me, I don’t regret my decision to do as the doctors recommended and have an induction.  At the time I was just happy that we had made it to 39 weeks – preterm birth and growth restriction are the biggest risk factors for women with lupus.  But I do wonder what it would have been like to let Baby Meena come on his own schedule instead of serving him an eviction notice.  I wonder if my labor would have been easier without an induction.  I don’t plan on having another baby, but if we do then I may ask for extra monitoring instead of an early birth.

Oh, and fun fact – I was born at the same hospital that I gave birth at (28 years and one day later!) and they even had my information in the system from when I was a child.

I will talk about the rest of my hospital stay in my postpartum blog post (which I will hopefully write before Baby Meena turns two).  I hope this birth story has provided some value to you, and as a reward for making it this far I’ve put a bunch of Baby Meena’s newborn photos at the end of the post – which were taken when he was 10 days old by Leslie Mason Photography.

 

 

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If you enjoyed this post, you may also enjoy these:
My Lupus Pregnancy: The First Trimester.
The Second Trimester of Being Pregnant with Lupus.
Lupus and Pregnancy in the Third Trimester.

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