It was so special to help Cassie and Jarod welcome their 5th baby. They had originally planned a birth center birth, but after preeclampsia setting in baby had to come early, at only 35 weeks in the hospital rather than the birth center as they had planned. I was so amazed at how calm this family was even with all the obstacles they faced. Here is little Henry Killian’s full birth story told by his mama:
“Once again- things went exactly opposite of how I had planned them. I should know by now how life works, yet I’m still surprised. I was pretty set on having a birth center birth with Henry at the Dar a Luz birth center and its amazing CNMs. I did everything in my power to make this happen. It was easily the healthiest pregnancy I have ever had (in spite of going in at my heaviest, due to having just been pregnant). I walked constantly and stayed very active. I practiced the gestational diabetes diet after that diagnosis and kept it diet controlled. I attended all my BPPs and NSTs and urine checks. And I still developed preeclampsia. My blood pressure was borderline for a few checks, but the urine in my protein was rising. I had an appointment at DAL for Monday, 1/1/18, and jokingly told my husband that they were going to tell me that they had to transfer my care that day because my body was “breaking down.” Well. When I started out my day on New Year’s Eve 2017, I knew it was going to be a rough day. I woke up with a splitting headache and my foot swelling was there in the morning, which was abnormal for me. By 5pm, my blood pressure had taken a huge spike. I actually ended up calling the on call Midwife as she was on her way to a birth. she asked if she could call back and I said yes, but she then quickly asked if it was my pressure. I told her yes, she asked what the numbers were and told me, “I’m so sorry, but you need to go to UNM OB triage right now. I’ll find a way to find time to let them know you’re coming.”
Jarrod and I kind of bitched and groaned because we have a long history of showing up at a hospital, sitting for 12 hours, and then going home. But. We went. The resident and attending who initially saw us were AMAZING. They had concerns and told me with my high numbers (I was 165/105 at admittance), my protein & headache – I was going to be admitted to special care.
So we went to special care, where I got labs drawn as the clock struck midnight.
My entire time at special care was a back and forth teetering act. Sometimes my pressures were lower and my labs were improving, sometimes they were high and so was my protein. Because I was only 35 weeks, their goal was to keep me pregnant for as long as possible. Dr. Eric, one of the dozens of OB residents/fellows/attendings that I saw came in and told me that my numbers were good and they were just going to monitor me. A few hours and massive BP spikes later, Dr Eric came back and told me that he thought the best course of action would be to induce me. He gave me the decision, but after hearing the risks vs benefits – we agreed with him.
I called Jarrod and Lori (my birth photographer) and updated them. Jarrod dropped the kids off with friends and made it back before they transferred me to L&D. I was in such a state of shock. I was happy to know there was a plan, excited to meet my baby, and terrified that my baby was coming so early.
We got settled in L&D and I got the best nurse. She was pregnant herself and really went to bat for me any time that I needed her too. (Not that the staff was combative or anything, she just went above and beyond). I got set up in L&D and was met by an entire team of OBs again (the benefit of a teaching hospital) & one of my Midwives from Dar a Luz showed up, so I had a bunch of people present. The OBs explained the plan- 1. get all the steroid shots in me to help baby’s lungs, 2. Get started on my Penicillin since I wasn’t far enough along to take the GBS test 3. Start my magnesium drip 4. Check my cervix and determine what to do for step 5. Start cervadil or insert a Foley catheter.
The Midwife was reassuring any concerns I had. It was a a lot of intervention and I think they’re used to having to calm mothers who had not planned on anything like what i was about to go through. I was surprisingly calm with the plan, though. I knew that we were trying to do this in the safest way possible. And the staff at UNM has been amazing.
I was checked by the resident and she said I was 0cm dilated, 0% effaced, Long, hard and baby was a -3. Basically, the least labor ready that a cervix could be. They inserted the cervadil and told me to prepare for a long night and a long induction. Shortly after that, I got another steroid shot to the bum. I psyched myself out about the steroid shots and they were honestly not that bad. The nurse then went to start the magnesium, but she began to explain how I would need a catheter because I would be on bedrest & unable to move once I had it. This made me extremely uncomfortable and I said I did not want the magnesium. The resident came back in to talk to me about why the magnesium was necessary, while I explained how badly I wanted to have freedom of movement. I asked to wait on the drip. I was crying and upset at this moment because it finally hit me that this was not going to be the birth that I had envisioned. The amazing awesome nurse came over and told me that she could talk to the doctor & maybe we could compromise. She wanted to know how I felt about having freedom of movement to be on my hands and knees on the bed and a birth ball besides the bed and standing with my husband next to the bed, etc. I was so grateful to her for that, because the doctors and I agreed that was a win/win situation.
However. Holy crap. Then initial bolus of magnesium is awful. The nurse kept preparing me for it, telling me that it was literally the worst thing she does in her job. She prepared cool rags and told me she’d do a countdown because it only lasts 10 minutes. It was the worst 10 minutes of my life. I felt like I was burning from the inside out. Literal burning. I was nauseous and dizzy and on fire and kind of drunk-like. After the initial bolus, it wasn’t terrible but magnesium was still not fun. I felt icky the entire time that I was on it and it made me dizzy and gross. But nothing was as bad as those first 10 minutes.
Then the catheter debacle started. And then my labor basically became about my urine. I insisted I did not want a catheter. However, the nurse convinced me to try. I tried it for 90 minutes before I begged her to take it out. I don’t know what it is with me and catheters – but I hate the sensation of always feeling like I have to pee. The nurse told me that because of the magnesium, they had to monitor my urine output and I would have to use a bed pan every hour. I said I’d rather do that. I think I peed every 20 minutes from that point forward. And every time I had to pee, it was a thing because I couldn’t use the bathroom. I talked about my peeing SO much during my labor. It was the labor of all things PeeTalk.
Anyway. After that, I asked for a medication to knock me out and help me sleep. It allowed me to get as much sleep as possible in a hospital room. I was checked again at some point in the night and was still 0/0, so I was given Cervadil by mouth. I went back to sleep and woke up to contractions. And shift change. I started to develop this really good pattern of contractions and at 5:20am, I was checked and found to be 1cm dilated and 25% and -3. Because my contractions started to form a good pattern, they decided to hold off on any more meds and the Foley bulb.
My labor really started to pick up from that point. I sat on the ball for awhile, but it was hard for the nurse to find the baby so I ended up back on the bed. I remember having to breathe through them and I told Jarrod that he should call Lori and let her know that things were picking up. the contractions weren’t crazy bad or anything, I just know I tend to progress quickly and that I knew labor was getting going.
Lori arrived shortly before 9am. They checked me again so they could start the Foley catheter, but I was found to be 2.5cm, 75% effaced and -2. Dr Eric said that the Foley catheter wouldn’t do much and that I had a great labor pattern and he didn’t even think we needed Pitocin. However, I was feeling the intensity of my contractions decrease- so I asked if we could do a low dose Pitocin. He agreed that we could do a “baby” dose to keep the contractions regular.
Things really picked up after that. I ended up in all sorts of positions around the bed. I was given a bedside commode which completely improved my pee situation, and I labored on that. I labored on my side. I labored standing up (and spent most of my time like that). I began to vocalize. I needed Jarrod to put pressure on my back because I had SO much pressure in my tailbone. They were intense. I started to say that I did not want to be checked because I did not want to be a 4. I felt like I was a 6-7. And I said that if I was only a 4, I was getting an epidural.
They checked me at noon. I was 4cm. 4 measly centimeters. Still 75%, still -2 station. I was so defeated. They did not feel like 4cm contractions. I think I stated that he had to be wrong. I do remember being a little grateful that I still had time to labor for the videographer, who had just gotten in.
I decided that I must be dilating rapidly and therefore, the doctors knew nothing. I needed to be on my side for awhile to help them find the baby, so I asked for gas (nitrous). WHY DO MOST HOSPITALS NOT NORMALLY OFFER THIS? What a great form of pain management. It forced me to breathe through contractions, it calmed me down, and the effects lasted only as long as you had the mask on. The gas became my best friend through contractions. It also muffled my vocalizations.
I remember getting quiet and breathing better because I began to tell myself, “it’s only 1 minute. You can do anything for 1 minute. It’s just 1 minute.” I remember bursting into tears for no reason and stating, “this feels like transition!” I know I felt the baby moving down and I know that I had immense pressure in my tailbone. I started to lose my cool and nothing felt comfortable and I just wanted to be in a tub somewhere. I kept feeling pressure, so they checked me at 1:30pm.
5cm. I pretty much decided that I was getting an epidural. 5cm. 5cm and I could have sworn that I was in transition. I decided to just give up at this point and just wait for the nurse to come back so i could ask for an epidural. I laid down with my gas mask in 1 hand, gripping on to Jarrod with the other. I slept tiny little cat naps between contractions and just breathed through them with the help of nitrous. Then I had 1 contraction that felt really, really different. I had to pee and had no shame left and asked Jarrod to grab a bed pan. I peed. He removed it.
And then I went, “oh no!” And Jarrod went, “oh no!” As I peed myself. And peed myself. And peed myself. And then it clicked and I just shouted, “it’s my water!!” And Jarrod went, “is it?” And Stacey went, “oh yeah! That’s her water!” And nurse buttons were hit and staff were assembled and I started to holler because whoa, contractions. I was found to be 7cm, 75%, -2. But based on my past labors and this being my 5th, and the fact that they wanted me to deliver in the OR (so that we’d have quick access to the NICU team’s room), they decided to get us ready for transport.
This is when everything changed. This is when all I knew was pain and pressure. I remember seeing Jarrod and Lori put on their OR scrubs and thinking it was adorable. I remember feeling bad as they wheeled me down the hallway because I was so vocal, I didn’t want to scare the other moms. I remember being scared they wanted me to move on to the OR table, but they didn’t. I remember thinking there were a billion people in the OR, and I remember the attending physician telling me that she liked my Serenity tattoo as she explained Firefly to the nearby staff.
I was talking & joking in between my long breaks between contractions at first, but then everything changed again. I was so mad when the doctor told me I was still 7 and couldn’t push yet. I knew a contraction was coming because a bunch of water would gush out first. In spite of making sure they brought it, I was so frustrated the gas wasn’t working.
Then instinct took over. I cried and yelled and screamed. I asked for an epidural. I told Jarrod that I could not do this. He told me I was. He told me that I always say that and then I do. He comforted me. For a moment. Before I started screaming and moaning. I started pushing involuntarily and they found a cervical lip. They told me they could move it out of the way, but- again- my labor changed into PURE instinct. I screamed at them not to touch me, crawled up the bed trying to escape my own body, ended up gripping on to the side rail on my own side and yelling at everybody that I couldn’t be in that position. They recommended hands and knees and I wanted to so badly, but I could not move. I begged them to give me a Cesarean. All I remember is feeling the head & the resident saying, “are you pushing? Let me check for the lip.” I wanted to scream, “ITS THE FREAKING HEAD” but I could only muster out grunts and screams. Then I heard her go, “woah! Oh. Okay!” Dr Eric took over, I yelled about the burning, someone told me not to fear it, and I somehow found the power to push past the ring of fire and then. There he was.
They held him up to me and I heard Jarrod go, “holy shit!” And I said, “it’s a boy?” And he said, “it’s a boy!”
I can’t describe that birth euphoria. I just can’t. I wish I could bottle it up and sell it and make millions. I know everyone around me was talking about how well he looked, but everything seems blurry except for that baby and me. I was so grateful for how long I had with him before they took him to NICU. I’m also grateful that I did it the way I wanted to! A natural birth in the OR is not easy and all the doctors came up to tell me how cool it was to see, and that I didn’t have to keep apologizing for yelling at them �
So, no. Definitely did not plan to birth a 35 weeker. But I am really happy with how the birth turned out given the circumstances. I’m also really happy with how Jarrod, Henry and I were treated. UNMH’s staff went above and beyond and I’ll recommend them until I’m blue in the face! It was a beautiful experience and I’m so grateful that we are healthy and safe and have been so respected.
Henry Killian James January 2nd, 2018 @ 2:54pm 35w4d, UNMH 6lbs8oz 18.5in