Luke Perie Bigler: Oligohydramnios

Well, after having the easiest and (almost most) uneventful pregnancy ever, things got a little complicated at the end of 36 weeks. But let me back up a little further.

Kimmy got engaged to Bud and set their wedding date for October 22 in St. George. I wanted to fly on Allegiant (a short one our flight) but after consulting with my doctor, she said she couldn't give me permission past 36 weeks, and I would be in my 37th week. Therefore I would have to drive, but they gave me strict orders to get out and stretch every hour, in order to prevent blood clots from forming. This meant that the 7 hour drive, which usually takes us 9-10 hours with kids, would now take us 12 hours. Because of Sam's work schedule, we had to drive all day on Wednesday the 21^st. On Monday the 19th at about midnight I started having strong Braxton Hicks contractions, very regularly (about every 8-9 minutes). This went on for about 5 hours, This is exactly how Ella’s labor started, so I was very concerned that the baby was coming early and we were going to miss the wedding. (This would be unprecedented though, as I have never gone into labor early, it's always been 2-3 days before my due date). The contractions did end up stopping, and luckily I had scheduled my 37 week OB check-up for Tuesday the 20^th, and I asked for an ultrasound to check for size and to make sure everything looked okay before we made that long drive. At the appointment, I had the nurse practitioner check me for dilation, and she said I was at a 1 and 50% effaced (actually, I was that at 36 weeks and hadn’t changed at 36 weeks 6 days). They did the ultrasound and estimated that baby boy weighed about 7 lbs. They did note that the amniotic fluid was getting low (total of about 8 cm) and they said that while it was still within normal range, it was on the low side, with 5-25 considered normal. They gave me the green light to go, but warned me that I needed to be drink a ton of water, and “listen to my body.” We did manage to leave by noon on Wednesday, and it took us 12 hours, exactly what we had planned on. The girls were so good, and there was no screaming or crying or whining. Traveling with older kids is so much easier. I laid down on the floor of the van (on pillows and blankets) for about 2 hours of the drive and it was so comfortable, my favorite way to travel! My belly BARELY fit in the space between front seats and the back seats, with me laying on my side. The only thing hiccup on the drive was that Ella started reacting to some Italian sausage that she had eaten on pizza in Wickenburg. Her airway was swelling up, something we thought she had outgrown- it hasn't happened for at least a year. She was coughing a ton and hoarse and by Vegas we had to get her some Benadryl, and by St. George she was so bad, we were seriously worried about her breathing and considered taking her to the ER. Luckily I found my mom’s inhaler (albuterol) and gave her a few puffs of that, and then put breathing essential oils on her alllllll night, every time she had her coughing fits. The oils almost seemed to help more than the albuterol, and I was so glad that I had them with me. She ended up being okay (she coughed excessively for 3-4 days). While I was in St. George, I started feeling concern that the baby wasn’t moving as much or as vigorously as I had been used to for the last few months. Sam told me I was probably worried over nothing, but on Saturday night I started doing kick counts to make sure he was passing the test for “not stressed or in trouble.” He did pass the kick count test, but I decided to bring it up at my next appointment. Another thing was that I had a few trickles of fluid that seemed like water, but they didn’t seem like urine. They weren’t happening when I had a full bladder. I did get a blessing from my dad before we left St. George, and I was so comforted by it- I was told I would make it home without incident and would soon have a good delivery and would have my beautiful baby boy.

We got back on Sunday night, and on Tuesday the 27^th , I left my girls with Sam’s parents and went to my appointment. I was still measuring small (by about 2 cm, barely within normal range, by 3 cm they would be concerned.) I mentioned the possible slowing down of movement and possible leaking fluid. This was enough for them to do another ultrasound, and they found that my amniotic fluid had dropped out of normal range- it was down to 4 cm. There was no MD/doctor there that day, but the nurse practitioner told me to head over to the hospital because it wasn’t safe for the baby anymore and he needed to come out. I was barely 38 weeks along, and not at all prepared to have a baby that day. I don’t have my babies early! I hadn’t packed a hospital bag, Sam was at work in Florence, 55 minutes away, and I still had a ton of stuff on my “get ready for baby” to-do list. They said I had enough time to go home and get some stuff and get Sam home from work, so that’s what I did. Then we headed to the hospital. I was feeling so sad because I wanted to have a VBAC again so bad, and I knew that if I was induced, they would use Pitocin, my epidural would wear off like it always does, and I could very well end up with a c-section like I did with Kalia- and the recovery on that was awful. (Later I found out that because of my low fluid, my chances of c-section had gone up to 68% if I was induced. Not good odds.) Going through labor and then a c-section on top of it is just brutal on the body. I wondered if it would be easier to just skip the induction and labor and go right for the c-section. It just sounded easier. But we decided to see what the doctor on call at the hospital thought we should do. 99% of doctors will just induce or recommend c-section. But there was something unexpected waiting for me. It was such an amazing blessing- the doctor that day was a young doctor named Grayson Guzman. I had heard of Dr. Guzman, and everybody just raves about how great he was. Little did I know that he was a huge fan of women who can do a VBAC, he works with midwives, and he had a plan for me. He was NOT going to induce me, but instead was going to try everything in his power to help me keep my baby healthy and in more fluids, for as long as possible, to try to get me to go into labor on my own. I did not know there was anything we could do about the low fluid, but it turned out that by giving me 2-3 bags of IV fluid, my amniotic fluid levels were raised. They were actually raised enormously. The first time we did it, it raised the levels from 4 cm to 12 cm! That was huge. Baby boy started moving around vigorously again, and the whole time I was getting the fluids he was monitored, and his stats were so strong! His heartrate was awesome and never ever dropped, besides lots of Braxton hicks contractions while I was there, and his movement was exceptional. Dr. Guzman said he was the “best looking baby on the whole floor.” He was not in distress and did not not to be forced out. He said that it just wasn't a good idea because my cervix was not yet "favorable." (Favorable would be dilated to 3 cm and 70%, and chances of successful induction is much higher.) That was cool. Guzman and Sam really hit it off, and Guzman said that he knew other doctors would just be ready to induce me or c-section me without trying anything else. That’s just how doctors are these days. Dr. Guzman is a rare gem indeed. Dr. Guzman also told me that I switch over to his care so that he could make the decisions on how to handle my care and I knew that he would do everything he could to help me have a VBAC. He really wouldn’t benefit from this switch, as he already worked under the same umbrella practice as the group I was already seeing- they just transferred my records over to him. I felt like it really was just for my own benefit and I was so grateful and touched that a brand new doctor would care that much about this outcome that I wanted so much. Doctors who make you feel like they really care about you are hard to find! He told me to follow up in a week, and so I did. I went back to his practice at 39 weeks and they did another ultrasound. Unfortunately, the fluid had dropped back down to 5. Dr, Guzman checked me again, still not "favorable", so he sent me the hospital AGAIN to get more fluids. This time I went on my own and just stayed in triage, and after a few hours, they did another ultrasound, and I was back up to 9. Not as good as 12, but good enough. He wanted me to come back in two days to see how well I was doing, and again, another ultrasound (this was on November 5) and I was back down to 6. So we made up a plan: On Saturday I would go to the hospital one more time for fluids. Then Sunday night I would go back and get admitted, and be under the care of a midwife in his practice, and maybe have them put in a foley catheter to dilate me further (the water balloon thing that can get you dilated to a 4 or 5, no pitocin needed.) Then, he would be back on call Monday and delivering patients that day, and could hopefully finish off my VBAC for me. I felt good about this plan- Annie's birthday party was Saturday, my mom had just gotten into town for 11 days, and Sunday the 8th was when I had always guessed I would have him anyway, based on my history of going into labor on it's own 2-3 days before the due date. So I was still hoping to avoid an induction. Part of me really just wanted to have an all-natural birth, like I did with Ella. You really need the stars to align for that, so I was prepared to get an epidural, but ideally I wanted to get to the hospital, dilated so far that there wouldn't be time for an epidural and I would be forced to do it naturally. It was my last time, and I thought I could experience the full pain and experience of childbirth one more time, and then enjoy the super fast recovery afterwards.

The plan almost didn't work out when I got to the hospital Saturday morning. I woke up at 4 a.m. and couldn't fall back to sleep. I was feeling pretty anxious about how low the fluid might be. So I drove myself to the hospital at 5 a.m. and went to triage. I was hoping to sleep through the I.V. bags but I couldn't fall asleep. The ultrasound showed that my fluid was down to 3.4! Holy cow- the lowest yet. They gave me two bags and took me back to ultrasound pretty quickly. Unfortunately I was only back up to 4.3 and that's not even a safe level to let me leave at. I was shocked that it wasn't working very well, but Annie's ice skating birthday party was starting at 1, Samuel was at work, Floy and Perie were busy with some church stuff, and the whole party would get cancelled and have to be rescheduled if I didn't get home. I begged the doctor to let me try one more bag and one more ultrasound. I was sure that it would work if I could just get one more bag of fluid (I'd always gotten three) and then I just needed a little more time for it to get into my belly! Sure enough, it did the trick,My fluid was up to 6.7, but they made me schedule my induction time for the next day at 4:00 before they let me leave at noon. They also checked me one more time and my cervix had FINALLY gotten to favorable status. 3 cm and 70% effaced! Things were happening! As I was leaving, I ran into Tiffany, the midwife who was on call for the weekend. She told me that she probably wouldn't even need to put in a balloon the next day, because I was already to a 3, and it wouldn't make that big of a difference. That put a little more pressure on me to go into labor on my own, and she recommended I get Sam involved when he got home with some nipple stimulation. (lol. But she really did tell me to do that.) I got home just in time for the party, my mom had made the cake, bless her heart, and had the house clean and everything ready. I'm SO glad she came a little earlier than usual to help make this happen. We drove up to Phoenix and she ice skated with the girls while I watched Aria and froze. (Should have dressed warmer!)