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I was due with my baby on August 19, 1995, and I was planning a homebirth with a DEM (direct-entry midwife) who has 20 years experience, first as a L&D nurse in a hospital then as a midwife for the last 13 years. She has attended over 1000 deliveries. When I got to 38 weeks, she did a VE (vaginal exam) and told me she thought that the baby was presenting breech. I went home and did the different exercises recommended for turning breech babies, and sure enough, one evening a few days later, I felt the baby turn (amazing!). At my next appointment (a week later) the midwife confirmed that the baby was vertex (head down). However, a few days later I felt the baby turn again (!) so I went to the midwife who confirmed it. Then, I felt him turn again (!!), so he was once again vertex. Just when we were getting comfortable, as it was now 40 weeks, he turned again (!!!). At this point, we called in OB backups. They had me in their office the next Tuesday, which put me at 41 weeks and 3 days. US (ultrasound) revealed a frank breech presentation...and the US tech told us she estimated baby to be between 7.5 and 8.5 pounds. The OB sent me to the hospital for a pelvimetry (measure the space in my pelvis) and told me that I measured adequate to try a vaginal delivery. I was very glad to hear that, because I did not want a c-section. The OB asked me to come in the next day at 5:00 pm to attempt an external version. (The previous Friday I had told my midwife that I thought I was leaking fluid, and she told the OB, and they both told me I was just having a discharge, not amniotic fluid, but they didn't test it.) The OB met me at the Birthing Center in the hospital on Wednesday afternoon. I was 41 weeks, 4 days. They gave me MagSulfate IM (a shot), and then, using US to guide him, the OB and his partner attempted to turn the baby manually. It was not particularly comfortable, but I didn't find it painful. I *did* have to use my breathing from my childbirth classes, though. External Version is successful in about 66% of trials at 38 weeks, and there is a 33% chance that the attempt will start labor. Neither of these things happened to us; the baby stayed breech, and labor was not forthcoming. The OB told me he'd wait until Monday to induce me. On Friday afternoon, I was driving past the football stadium to which I lived adjacent, and I noticed the groundskeepers were setting up port-a-potties. I remembered that the next day was the first football game of the season, and thinking of Murphy's law, I commented to my mother-in-law, "Gee, I bet the baby is born at halftime!" Saturday morning I woke up feeling crampy, so I told my husband and mother-in-law (who was staying with us to help take care of my 23 month old). MIL decided to take us out to breakfast, so that if I *were* in labor, I would have plenty of energy! Throughout breakfast I was having crampiness about 3 times an hour. MIL and I went grocery shopping, still having crampiness about 3 times/hour. Went home and ate a plain baked potato for lunch and sat down to watch "Little Women." Still having cramps about 3 times an hour. I was on the phone with my grandmother at about 3:00 when it felt as if someone reached up from between my legs and grabbed me by the throat...*this* was a contraction!!! I had to stop and concentrate on it, even. I got off the phone when it happened again only 5 minutes later. I called my midwife, and she said she'd come right over. BUT, guess what? The football game was over about 4 minutes later, and the midwife had to swim against the current of 26,000 fans going home. It took her 45 minutes to drive the 2 miles to my house. By the time she arrived, I was having contractions every 3 minutes that lasted 90 to 120 seconds each. I was laying on my bed in the fetal position when she got there, my knees drawn up to my belly as tight as they could. She took one look at me and said "Time to go to the hospital!" She did a VE real quick, and I was at 7 cm. By the time we got up to the Birthing Center, it was about 5:15 and I was still at 7 cm. Since this was going to be a vaginal breech delivery, there were many people around to check it out. My midwife, her apprentice, my OB, 2 residents, my L/D nurse, a student nurse, my MIL, my SIL with my 2 year old, and my husband. (When the baby "crowned" we were joined by the pediatric nurse... the pediatrician had gone on break). I didn't stay in bed much, just 20 minutes each hour to do Fetal Monitoring. The rest of the time I paced around the room, stood in the shower, and leaned on my husband or my midwife. The OB came in every 30 minutes or so to ask how we were doing. Finally, at about 8, I felt like pushing, so I got into a supported squat and within 15 or 20 minutes, the butt was "crowning." At this point the OB had me get onto the birthing bed, and somehow he got me into stirrups...even though in my birth plan I had indicated I wanted to use other positions, like squatting. The OB helped to deliver the legs, which took 2 contractions and *really purple* pushing. Then, it took a few minutes for the OB to figure out which arm should come first. After the shoulders were delivered, he tells me, "Ok now it's time to really work." After one contraction and no progress, OB decides to use forceps, the nurse wrapped a towel around Mark's waist, and together they pulled while I pushed...we were all starting to get a little scared, because you could see his body go from purple to ashen gray to *white*. Mark's head finally popped out at 8:46 pm, Saturday, September 2, 1995. You know the APGAR scores? At one minute, Mark's APGAR was 1...the one point was for a very faint heartbeat, 42 bpm. (Normal is over 120's.) The pediatrician, who had been in the cafeteria, walked in just as the OB was handing Mark to the ped. nurse. She performed artificial respiration and instructed the nurse to inject one full cc of epinephrine. Mark started pinking up within 5 minutes or so, his 5 minute APGAR was a 4. He started breathing on his own at 20 minutes. We have him on video at around 11:00 pm, and he's pink and screaming lustily, using supplemental oxygen but breathing on his own. His arms and legs are tethered to the bed to keep him from pulling off his monitors and IV. Meanwhile, back at the ranch, I was hemmorhaging from a retained placenta. I lost 1000cc's of blood (one liter), but the nurses were telling me that Mark was doing just fine as I drifted off to sleep. When I woke up at around 9:00 Sunday morning, my husband was there telling me that they were about to transport Mark to NICU at Children's Hospital, about 60 miles away. Apparently at about 3 a.m. his left lobe of his lungs had collapsed, filled with pus from aspirating amniotic fluid, which had turned to pus because he had the Group B Strep infection (I had not been cultured for it, so we had no idea). Suddenly, I was alone in the Women's Care Unit, with no baby or husband and not enough strength to lift my head from my pillow. I had tried to get up to go to the bathroom and had passed out on the nurse! Mark's transport to Children's was delayed by several hours, because they were having a hard time stabilizing his condition enough to move him. Of course, no one told me about that until weeks later. I called my OB and asked him to discharge me so that I could go to my baby. He told me that I couldn't go because I'd lost too much blood and was too weak. My MIL came to get me, and she pushed me in a wheelchair out to the car and drove me to Children's anyway. For 3 days, Mark's life hung on the edge, and I could not hold him. He had to take medicine to keep his blood pressure from plummeting, and if you so much as breathed on the tubing, his bp would drop. On Tuesday, the doctors sent a social worker to me, and they told me that if Mark were to live, he appeared to be blind and deaf and they expected him to have severe mental disabilities. That night we left my mom at the hospital, and we went home. We met with some men from our church, and they prayed that if nothing else, that Mark could get off that medication that was keeping me from holding him, so that I could at least hold him before he died. Wednesday morning the phone rang as I was walking out the door to go to the hospital. It was my mom, and she said, "Get here as fast as you can! They weaned him off the medicine and you can hold him now!!" Wow! Hallelujah! I got to the hospital, and the first thing I took my baby and held him close...he was still hooked up to all kinds of wires and tubing, including a mainline for meds, an IV for fluids and nutrition, oxygen thru a nasal cannula, heart and respiration monitors, and pulse oximeter. The doctor came over and explained to me that Mark still wasn't showing any reflex response, so it was probably useless to try to breastfeed him, but I was welcome to try if I wanted. I put him to the breast, and can you believe it? He latched on and sucked for 5 minutes! The rest of the day I held him and sang to him, and from then on I stayed at the hospital so that I could nurse him every 3 hours. The next day was Thursday, and a neonatal audiologist came and tested Mark and proclaimed his hearing to be normal. Every time I got near him, he followed me with his eyes, so the doctors told me that his vision seemed to be perfect, after all! The more I held him, the more normal he seemed. Two days prior, the doctors had told me he might not live; today he was telling me that we could go home on Saturday! I took Mark home on Saturday, on oxygen...getting him into the carseat with a nasal cannula and an oxygen tank was a learning experience! They told us they had no idea how long he'd be on oxygen; he was off of it by Sept. 28. Mark is now 20 months old. He's normal in every aspect but one: he has been diagnosed by a physical therapist as having "congenital hypotonia" which means he has a lack of muscle tone in his trunk and arms. It doesn't slow him down much, though...he can pretty much almost keep up with his 3.5 year old brother. Even though he weighed 9 lbs 8 oz at birth, he only weighs 21 lbs now at 20 months. Went from the 95th percentile to less than the 5th percentile...no matter, though. Every kid has his own rate of growth. He's my miracle baby, a joyful addition to our family. He's even a big brother already! But, that's another story, altogether.
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