Welcome Audrey Elizabeth born 11/24/21; A Cervadil/Cytotec/Pitocin induction birth story

Audrey Elizabeth Burns

11/25/2021, 10:35am, 39+0 weeks

6lb, 5oz; 19.5 in long

"Throughout my third trimester I had been battling low growth measurements (9th percentile at 33 weeks, but 20th at 38 weeks) & blood pressure (I was put on meds at 36 weeks, but no signs of pre-eclampsia). We had thought I would need to be induced at 37 or 38 weeks, but everything was looking good, so we kept with weekly MFM (Maternal-Fetal Medicine) & OB appointments for monitoring & scheduled induction for 39 weeks.

Due to COVID restrictions, a 3 year old at home, and no family/support in the area, my husband & I made the decision that he would stay home with the 3 year old & I would have a doula for support at the hospital. It worked well for our family.

We did not find out gender before delivery & none of the care team knew either!

Audrey's Birth Story

I went to my MFM appointment Tuesday afternoon (11/23). I was 38+5. Baby looked great on ultrasound, but my blood pressure was elevated 150s-160s/90s. We were already scheduled for an induction Friday, but the doctor wanted me to go over to be induced right then. He didn’t want me getting pre-e over the holiday & getting really sick. He wanted me to go straight there, but I really wanted to go home & get my bags. So, the clinic nurse & I talked (I’m an RN as well) and I decided I was safe to go home & get my stuff, since L&D was full & I would be waiting anyway (I was going to anyway but at least she agreed).

So, went home, got my stuff and my husband & son took me to the hospital. I got to say bye to my son & husband & eat some food. When I got to L&D I didn’t have to wait long at all. I got checked in (pre-e labs were all negative, as they have been this entire pregnancy) & they gave me some IV BP meds & started Cervadil. I tried to sleep.

About 2:30 I woke up with contractions about every 2-3 minutes but mild intensity. They picked up in intensity through the early morning until I went to the bathroom & had a bowel movement & then they dropped back to mild. After 12 hours of Cervadil (Wednesday morning) they took it out & checked me- I wasn’t dilated or effaced really at all but cervix was making changes.

They started oral Cytotec. I got 2 doses & was still having regular contractions. Finally I had a little ripening of the cervix after 2 doses so we started Pitocin & Emily (my doula) came (Wednesday evening). I labored throughout the night with Pitocin going up from 2 to 22. I went from 4cm to 6cm. It was rough but I was managing, thinking I was progressing.

Then the day shift nurse came on & checked me about 8:30am. She felt I was only 4cm dilated & 60% effaced- that was where the other nurse said I started the night before! (Nurses can vary in their assessment). I was so upset. I had worked hard all night to be no where. I know I was making progress, but it was more of a mental thing where I thought I was over halfway & close to transition, but now I wasn’t. I wasn’t sure I could do another 12 hours of labor to go from 4 to 6 again.

At that point, I had been awake & contracting every 2-3 (max 5) minutes for over 24 hours. I was soooo tired. I discussed with Emily & we decided I would get an epidural, sleep for a few hours, allow them to crank up the pitocin & hopefully have the baby by evening.

So, my nurse called anesthesia. The CRNA had one patient in front of me.

8:45am- I decided on the epidural; Continued to labor with good strong contractions while waiting.

9:40-9:55am- Epidural placement

9:58am- As they were laying me flat after placement baby kicked hard & my water broke! The nurse checked me: 6cm.

I was having really strong contractions, but the epidural hadn’t kicked in yet. I was lying flat & water was broken, so they were extremely painful, but the only thing I could do was breathe & try to tolerate them. After a few of those (maybe 5-10), I started to feel a ton of pressure in my vagina. I was in tears saying “so much pressure.” The nurse, being wise & experienced, checked me & baby’s head was right there!!! It was go time.

The doctor wasn’t there yet!!! So, I kept laboring with the contractions. The nurse wasn’t stopping delivery if it happened, but I wasn’t actively pushing (she was standing there with her hand on my baby’s head the whole time). The doctor arrived & I started pushing. I wasn’t doing a very good job (I think I was very tired & just enough effect of the epidural to make bad pushing), but then baby’s heart rate really dropped, the doctor suspected cord around the neck. So he quickly grabbed the forceps- I pushed, he pulled & out came baby!

As soon as the head came out, the doctor removed the cord & we were able to slow down a bit. Baby had good tone & they immediately placed baby on me & I was able to look and see that it was a girl!

10:35am- less than an hour after the epidural was placed she arrived. It didn’t even fully kick in (I only got the push bolus dose, nothing else)- I could move my legs the whole time, but it was just enough to push me over the edge & make the forceps & repair manageable.

So, she was taking her sweet time, until she wasn’t. The worst part was I was hoping to get some sleep & then I didn’t & was immediately in post-partum/newborn care stage, but I was happy she was here.

We had talked about breaking my water manually before the epidural, so maybe that would have done the same without the epidural, but I’m not sure I would have gone that fast & it would have been intense…hind sight is 20/20 & we’re both healthy & that’s all that matters.

Wasn’t the exact birth I planned, but it worked & I’m proud of myself, my body, & my baby. We’re both healthy, which was my ultimate goal!"

- Authored by Kelli, mother of 2