Have you heard the lullaby that goes, "All night, all day angels watching over me, my Lord. All night, all day, angels watching over me"? We sing this song at the end of Godly Play class, but I've never really sung it at home with my babies.
That is about to change.
Logan's birth story actually begins almost a month ago. Right after the Cub Scout camping trip, I started having preterm labor. I was 33 weeks at the time and the working theory is that the camping trip, followed by 2 days in the 90s without air conditioning, caused significant enough dehydration to cause contractions. I had 1 trip to labor & delivery for a shot of terbutaline and 2 days later, I was back in the clinic and ended up on oral terbutaline.
For those of you who have never taken this drug, it is awful! It makes your heart feel like its beating out of your chest. If you've ever had a panic attack or anxiety, that pretty much describes the feeling. I didn't really want to take it, but my OB and I agreed that I would take it until 35 weeks and then I could stop. I was 35 weeks on a Tuesday, saw him on Wednesday, and we agreed that if baby decided he really wanted to be born then we would let him. His exact words were, "At this point, sometimes babies know better than we do that something is wrong and its time to be born."
That Friday I had irregular contractions all day, but they never developed into any sort of pattern. Towards the end of the day, however, I noticed that Logan was moving less and less as the day went on. I called the clinic and went in for a non-stress test, which Logan passed without any trouble. I left feeling tired, but reassured.
Over the course of the weekend, Logan's movement continued to be decreased. I grew more and more anxious and almost went in several times, but decided to wait until Monday when I could see my OB again.
Monday morning I went in around 9:00 AM and waiting for quite awhile while they figured out where to squeeze me in to the schedule. Fortunately, I was able to see my OB, who was great about listening to my concerns and ordered another NST and a BioPhysical Profile (U/S). 25 minutes into the NST, Logan still had not moved or had any accellerations. My OB came in and buzzed him and he had a quick acceleration and then settled back into a non reactive pattern. After 5 more minutes, Logan had moved 1 more time with a small accelleration and my OB came in and told me that Logan had "technically" passed the NST (a pass only requires 2 accels), but he wanted me to go downstairs right away for my U/S and then come back upstairs.
Previously, he had told me I could go home after the U/S and he would call me later in the day, so I knew his concerns had increased quite a bit already.
While I was sitting waiting for my U/S I got a text from one of my friends who happens to be a nurse in the Family Birth Center and also helps facilitate the Little One's Remembered Infant Loss Rememberence group. Talk about divine timing. I filled her in briefly on what was going on and she let me know she would be working that night if anything ended up happening.
Interestingly, at this point I was still not convinced that I could really be meeting my baby. I wasn't even 36 weeks yet... it just didn't seem possible!
The short version of the BPP is that it didn't go well. Out of 8 possible points, Logan only scored 4. Two of those were because I had adequate amniotic fluid! Despite repeated buzzing and shaking he would not take a practice breath and his movements were low in frequency and tone. As soon as it was finished, I headed back upstairs where my OB let me know that we would be having a birthday.
I was told to take an hour, gather my things (and my husband!), and to report back to the hospital. After literally picking Tim up on the side of the road (he was on an end of year field trip that the class had walked to, so he didn't have a car), we headed upstairs and got hooked up to the monitors and an IV (I was GBS+) and waited for my OB to come break my water.
Because Kylee was born via C-section, I was planning on having a VBAC for this delivery. As soon as I knew Logan wasn't thriving I began to have doubts about if I even wanted to try. My OB admitted that he also had some reservations, but he felt that it was worth it to try. Logan was looking a little better on the monitors than he had earlier in the day and I felt that a vaginal delivery would be better at his young gestational age.
Part of the VBAC agreement was that I would have an epidural in the event that quick action was needed later. I could have waited a little bit or only had the catheter placed, but I decided I felt better having it right away. I also knew that they would be using Pitocin, and I didn't have a good labor experience with Aidan with Pit so I wanted the epidural anyways. I knew also knew my movement was going to be limited by the continual monitoring they were going to need to do.
Over the next 12 hours, I had a steady stream of fake hormones and I sat in bed and did nothing. It was kind of a boring labor to be honest with you. If it weren't for the fact we were all nervously watching the monitor to see how Logan was doing, we probably could have come up with something fun to do. Much to Tim's chagrin, there wasn't even a TWINS game on! We did have some great company, however, because not only was my friend Jenny (who texted while I was waiting for my U/S) work the overnight shift another good friend (and the nurse who was with us when we found out Kenna died and was at her memorial service) worked the evening shift. They were the right people to have with us during the emotionally draining experience. I also had a visit from a fellow homeschooling mom (another nurse who works in another area of the hospital), who's friendly face kept my spirits up for some time after her visit.
All night I kept waiting for my OB to pull the plug on the VBAC. In fact, anytime after about 3:00 AM I probably would have agreed to it fully. Logan had a few strange decellerations, but nothing consistent enough to raise serious concerns until I was already pushing. My dilation was extremely slow all night long. Somewhere in the area of 1 cm every 2-3 hours. Just like Kylee, I never had a true transition.
Finally, at about 8:30 on Tuesday morning (when I was officially 36 weeks) I was ready to push. As soon as I started pushing, Logan started having scary low decels that lasted long after the contractions stopped. They put my on oxygen and I had to push kind of like crazy, even between a few contractions to get him out quickly. I think my OB put quite a bit of faith in my ability to push effectively, being a many times experienced mom!
After he was born, they put Logan on oxygen almost immediately. He was retracting quite severely and if they tried to stop the oxygen he got worse. In the picture below, you can see the blueness in his face and hand. They used blowby oxygen for a while and then switched to an oxygen hood on 100%. They explained that if he didn't settle down soon that they would bring him to the nursery where they could have more control over the setting. Our hospital does not have a NICU and my OB had talked to us beforehand about the possibility of needing a transfer, but thankfully it never came to that.
After an hour or two (I'm honestly not sure), Logan started trying to latch on to the oxygen hood. They moved him back down to blowby and he started trying to latch on to that to! Thank goodness for brave nurses who believe in the importance of breastfeeding and could recognize what he was trying to do. She called up the respitory therapist who brought a teeny tiny o2 moniter that he could move around on and then brought him over to me.
Much to my surprise he latched right on! He suckled for 45 minutes on one side, during which his o2 sats went up to 100% and stayed there. He never needed another drop of oxygen. Isn't that amazing?
He had a few other minor temperature and blood sugar issues over the rest of the day, but he was able to stay with us. Due to the business of everything, we didn't end up weighing him and doing the normal newborn things until several hours into his life. In fact our original phone calls to friends and family, after things had settled down, didn't include any vital statistics other than a name!
I'm so grateful to have delivered in a hospital that didn't rush him off to the NICU. At many hospitals, the o2, especially combined with the temperature and blood sugar issues would have led to a mandatory NICU stay. Which probably would have led to a longer NICU stay when he had a harder time establishing breastfeeding and then had more trouble with jaundice (he had some but we were able to avoid lights). I truly believe the fact that he was with us made all the difference in the world to his adjustment to the outside world. He was able to come home with us after only 48 hours.
So what caused him to be doing so poorly in the days before he was born? Well, officially we don't know. He had a nuchal cord and his cord was also wrapped tighly around one of his legs (he had a bruise/mark at birth). My OB doesn't think this was the cause, but quite frankly he's the only one. Everyone else I've talked to (including medical minded people) is sure that was the problem. The cord was either restricting his movement, restricting circulation, or a combination of both. My immobile labor probably kept the cord from causing more issues than it did. My placenta was sent for testing to see if it was aging prematurely, but I don't expect to see anything come back from that.
If you've gotten to know me at all, you know I am a person who tries hard not to think too much about the what if's in life or to have regret about choices that I make. There is a what if I can't get out of my head, however. What if I hadn't gone back in on Monday? What if I had trusted the Friday NST to assure me that everything was fine?
We learn a lot from our past experiences, even the negative ones. In the days before Kenna died, she had been moving less and less and I didn't go in. In her case, with her age and her specific cord deformity, it is unlikely that going in would have changed the outcome. Everything I have learned since her death, however, made sure that I went in when I was concerned about Logan's movement patterns. There is really only one thing to be said about it-
All night, all day, angels watching over Logan.....