After some research, I realized even if I saw a fertility specialist that my BMI was too high for treatment if we needed help. With this knowledge, I underwent Gastric Sleeve Surgery in October 2019 (this becomes relevant later on!) in the hopes that it would help me fall pregnant. 12 months later, we started trying, and I almost immediately fell pregnant and finally got a positive pregnancy test.
I was told I would have additional growth scans due to my Gastric Sleeve. Everything in the pregnancy went smoothly up until 20 and then 24 weeks, where our growth scans showed our little girl was slowly dropping percentiles (not growing how she should). She dropped from the 24th centile down to the 20th and then eventually, at 30 weeks pregnant down to the 11th centile.
At 33 weeks, I presented to our local hospital to be checked for reduced movements (she decided to have a dance party once they attached me to the CTG), and due to bubs small size, they gave me steroid shots over 2 days to help mature her lungs. A couple of days later, I saw an OB at the hospital who reviewed all of our scans, and I was scheduled to be induced at 37 weeks due to IUGR (Intrauterine Growth Restriction) and told I would be monitored closely with 2x weekly CTGs and weekly ultrasounds.
The next ultrasound at 34 weeks showed that bub was growing but extremely slowly, and her abdominal measurement was now less than the 2nd Percentile. The OB reviewed again and informed me we would now be induced at 36 weeks – this caused me A LOT of anxiety as it felt too early, and I was considering declining induction or asking to stretch it to 37 weeks (and I mean, everyone always says how inaccurate the scans can be!). In the end, I discussed it with my husband, and together we spoke with my midwife and made the decision to proceed with the induction at 36 weeks.
The last weeks of my pregnancy did not go as planned with relaxing and calmly preparing for our baby girls arrival. Instead, it was an exhausting whirlwind of my baby shower and frantically preparing the house and endless hospital visits – these were increased to daily for the last week due to an elevated Doppler on one of our weekly scans.
The day of our induction arrived, and we headed to the hospital at 2pm on June 7th.
Our girl was estimated to be 1975g, and it was explained to me that using gel (cervadril) was not an option because it might not be removed quickly enough if bub went into distress and so we went with the Cooks Catheter (Balloon Induction)
This was extremely unpleasant, even with gas and air. While the nurse and midwife with us were incredible, the doctor present used the speculum or inserted instruments (I am not sure exactly which as I couldn't see in the stirrups) 3 times without warning. I had to ask her to warn me before touching me as the previous three examinations came with no warning, which made each of those moments more painful due to the surprise.
Due to the length of my cervix, the team was only able to inflate 1 side of the balloon. After that, I went back to my room and thought to myself, "this is a cakewalk" I had honestly had worse periods. My hubby went and got us dinner and then left for the night to get some sleep in preparation for the next day.
At about 9pm, I was seen by the next OB on shift, and he advised he would like to attempt to inflate the other side of the balloon as he didn't think only having 1 side would work adequately for the induction.
I consented but advised he could try once and that I didn't want to spend ages trying to get it inflated (the 1st time was painful enough, and this time would be without hubby as support. I didn't want to wake him from what would be the last decent sleep he would have in a while).
The new OB got the other side of the balloon inflated on the 1st try, and from there, it was probably the most unpleasant night of my life. The cramps the balloon caused were constant and severe, and I couldn't find any relief. I tried walking, laying and sitting in different positions, heat packs, a peanut ball and kept on top of my Panadol. At about 4am I gave up on sleep altogether and got in the shower, where I sat with hot water on my back, and the midwife was an absolute trooper doing all my checks and administering my antibiotics while I was butt naked under the hot water. In hindsight wish I had done this earlier as it was the only thing that provided any type of relief, and I would have also requested stronger pain killers as I got zero sleep which was not ideal.
At about 5.30am on June 8th, I was transferred to the labour ward where my husband met me and then together, we met the Midwife and Student midwife who would be with us for the day.
I told them my only plan for the birth was drugs !! ALL OF THE DRUGS (epidural), and that I really did not want an episiotomy unless the baby or I were in distress/danger - otherwise, I was happy to go with the flow and just see what happens.
At 6am, the midwife removed the balloon (finally, the cramps went away) and checked my cervix, which she advised was nice and soft and great for induction!
The drip was started, contractions began, and I quickly asked for the gas and air as things ramped up fast. Bubs heart rate dropped a couple times during contractions, and I was quickly flipped to the side, which helped bring it back up again. I wasn't concerned as I had been warned this could happen with small babies.
4 hours passed extremely quickly. It felt like 1 or 2 at most -and then it was time for another examination, and when the midwife checked, she was happy to report I was 3cm dilated but could easily stretch to 4-5cm. I thought to myself, "Yes, this I what we want, we got this!!!" And then promptly asked for my epidural as the contractions were pretty intense by this stage.
My epidural went in, and I had sweet relief.... for all of about 20 mins then I could feel the contractions becoming more and more painful to the point I requested gas and air again. Of course, the only plan I had for the birth went a bit pear-shaped, and it became clear my epidural was not fully effective!!!
Each top-up (I believe these were in 20-minute intervals) would assist for a couple of contractions (I could still feel them but was able to talk through them), but by 4 or 5 contractions, I could feel them really strongly again - I ended up on the gas and air between doses to manage the pain.
During this time bubs, heart rate also began to drop more frequently, and I was constantly being moved from side to side or onto my back to manage bubs heart decelerations. But I still wasn't discouraged as I was so sure I would be 7-8cm and progressing at the next check, and we would be getting close to the end. The pressure felt different now, and it really felt like pressure and pushing down, and this reassured me further.
As it turned out, the next time the midwife examined me, she explained I was still only 3cm ☹ and this was due to the baby being in an acynclitic position (her head was on an angle, and instead of pushing down on the cervix to dilate she was only pushing down on half of it) she even drew a little picture for us to explain what this meant. We flipped to my left side to try and help bub get into a better position, but she wasn't happy there, and her heart rate dropped again. This time it took longer to come up, and my midwife was concerned. She called for the doctor to come down and see us and turned the drip right down.
The doctor arrived, and he advised he that while he wasn't concerned with bubs trace, he was concerned about my lack of progress and offered us the option of a C section however said it was 100% our choice.
We talked it over for a few minutes.
We considered that it could still be another 7-8+ hours to get to 10cm, and that was if we could get bub on the right angle. I was running on no sleep and had been contracting and on the drip for 8 hours already.
We considered that bubs heart rate kept on dropping – and was beginning to do so more frequently and not returning to normal as quickly as liked - I looked over at my midwife, and I could just tell even without words that she was unsure of proceeding with the induction and that she was not comfortable with bubs decelerations and that gave me all the information I needed.
We made the decision to go for a C Section in order to avoid bub going into distress.
I had a huge flood of emotions at this point and cried - I can't say exactly why as I was 100% ok with whatever way bub needed to arrive.
They turned off the drip completely and stopped the epidural medication.
At this point, my body had taken over, and I was contracting every 3-5 minutes while trying to sign paperwork for consent and be prepped to move.
While getting wheeled to the OR, the contractions worsened, and they were deep and radiating right down into my lower back (previously, I had only felt them in my abdomen. I was gripping the bed and close to tears while hubby couldn't do anything but walk alongside me with words of support. I found I dealt with the pain best by myself and disliked being touched or spoken to during the contractions.
When I spoke to the anesthetist, we decided to remove the epidural and go to a spinal block to give me the best chance of being awake during the birth (thanks to a kickass midwife who told him in no uncertain terms that my epidural was not effective).
They wheeled me into the OR, where a midwife held my hand and cleaned my face up as I bawled through contractions which had gotten beyond what I was prepared to experience (naive me thought my epidural would work wonders and I wouldn't feel full contractions at any stage.... I should have really known better)
Having the spinal block inserted was not painful; however, once it was in, the anesthetist tried to lay me down mid contraction, and it felt like my body was tearing in half. The midwife told him I was mid contraction and that I couldn't lay down right now.
I heard him say that it might not work if I didn't lay down, so I pushed through and forced myself onto my back as I didn't want to risk having to be put under and missing my girl coming into the world.
At this point, I calmed down. The pain was easing by the second until I realized I could see my abdomen in a reflection on the metal of the OR lights while being prepped. I panicked and yelled at anyone who was listening that I could see !! Luckily someone was listening, and it got moved straight away, so I didn't have to see myself be cut open.
Hubby came in and sat by my side, and I asked if they would warn me when they were starting and was told they already had (great news, the spinal block was working wonders - though a little warning would have been nice). We sat holding hands while the doctors did their thing. I am not sure how long it took.
At 4.18pm 08.06.2021 (the day before my birthday), my beautiful little Ella Bree was brought into the world at 36w2d.
She reassured us straight away with strong cries – honestly the most beautiful sound I've ever heard and instantly brought tears of joy to my eyes.
Hubby went over while they cleaned her up, and he got to cut the cord, A nurse told me to look across to the left where her weight would be shown on screen, and up it popped a tiny 1950g (just 25g different to her estimated weight from the scans).
A few moments later, A nurse told me that Ella would need to go to the neonatal unit. I asked if she was well enough for me to meet her quickly first, which thankfully she was. My little girl was bundled up and brought over, I touched her little face and said hello - she locked her eyes on me, and I could tell she recognized her mama's voice and those little dark eyes honestly just pierced my soul. I spoke to her, and I told her how much I loved her and that her Daddy was going to go with her to look after her and that I would see her soon. While I talked to her, a nurse took some photos of us and as a family (not that I looked at the camera – I only had eyes for my baby girl) then about a minute later, they took her away, and hubby went with her to be looked after in special care.
I remember my body shaking uncontrollably and getting given another warm blanket while on the table. At this point, sheer exhaustion caught up with me, and I had a nap while they sewed me up. After that, it was up to recovery and then back to the maternity ward, where I got to wheel past the neonatal unit and see Ella from my bed. I was told she was doing exceptionally well breathing on her own she had just needed a little suction - but she was on a drip as she was having some trouble regulating her blood sugars. The doctors told me a lot of other information, but all I could focus on was my baby girl.
I wasn't actually allowed to see her in the unit until I could move my legs again to get in a wheelchair. I must have asked the nursed every 10 minutes and willed my legs to move (the stupid things would not cooperate). Eventually, after about 2 hours after Ella had arrived, my legs moved enough that I was able to flop into a chair and was wheeled to the nursery where I was finally able to hold my baby girl on my chest, and it was the most perfect moment.
I didn't ever want to let her go. I had worried that not getting to hold her immediately would impact bonding with her, but it was honestly still so magical the moment I got her in my arms. I stayed with her until the nurses kicked me out so I would get some sleep (about 10.30pm from memory) and then went back to her at 5am the next morning, where I was able to try breastfeeding and was filled in more on her status.
For her size and gestation, she was doing exceptionally well, she was super alert, and there were no major concerns other than making sure she continued to maintain her breathing and temperature on her own and getting her blood sugars stabilized.
After that, we spent a week in the hospital. The c section recovery was easier than I expected as the nurses kept on top of my pain management while I focused on my baby girl. I was up and walking the next day!!
We had a few small bumps in the road, weight loss after cluster feeding (due to her size, the feeding caused her to burn more calories than she was taking in), and so we were put on capped feeding with bottle top-ups I pumped for every 3 hours, and she was only to feed for a total of 30 minutes.
2 rounds under the lights in the incubator for Jaundice (she was VERY yellow) – these I found really difficult not being able to cuddle and settle her, which also made me feel I wasn't bonding well).
7 days later, we got to take our tiny trooper home – weighing 1910g and absolutely SWIMMING in all of her clothes.
My placenta was sent for testing to see if there was any cause for the IUGR – the results of the testing did not find any cause for her reduced growth, and so it could be due to my gastric sleeve, or it could just be unexplained, which the case is sometimes. I know many people that have the gastric sleeve and go on to have healthy average size babies, so it's unclear if it was the cause for us or not.
Though the end of my pregnancy and my birth didn't quite go the way I had imagined and had its ups and downs, I don't feel it was traumatic at all, and I am thankful for the team we had around us throughout the experience.
