Kelten's Birth Story

First of all, Kelten's birth story goes back to June when Martin and I attended our Planned Parenting classes.  We really enjoyed the class and loved our teacher.  It was so informative and helped us both get used to the idea of what was going to happen.  We learned quite a few relaxation techniques, which was my favorite part.  Even though I had participated in births during school, I did not know that there were so many different ways to prepare for delivery, labor, and give birth.  We were excited to have our baby boy "naturally".  We chose to deliver with the UNC Midwives, which was a decision we never regretted.    
At the end of June, I developed some severe itching all over.  It precluded me from sleeping well at night.  I thought at first it was normal, but mentioned it to my midwife just in case.  She decided to run some tests on my liver because there is a rare disease in pregnancy that causes ithcing called cholestasis.  Apparently it happens in about 2% of pregancies.  It occurs when pregnancy hormones cause over-production of bile acids in the gallbladder.  These bile acids spill over into the skin and placenta causing itching.  Because it is a chemical in the skin causing the itching, it is not relieved by benedryl or lotions.  Well, turns out I had it.  My liver enzymes and bile acids were elevated.  They gave me some medication to try and relieve the itching.  It only worked some.  Unfortunately, Cholestasis can also cause problems with the fetus.  Studies show that women who have Cholestasis have a higher chance of having a still-birth if the pregnancy continues to full term.  We met with our midwives as well as the Maternal Fetal Medicine doctors (for high risk pregancies), and they all concluded that I should be induced to deliver at 37 weeks.  So our due date went from September 16 to August 26th.

On August 26th we had a crazy day getting last minute things done and we had a really nice dinner with Daniel and Mandi.  We went to the hospital around 8:00 pm. They got me settled in and inserted a folley bulb to dilate my cervix. We sort of slept...

 In the morning they started Pitocin through an IV, and  around 9:30 am the folley bulb came out which meant that I was 3-4 cm dilated.  Then we waited, and walked, and waited.  Luckily UNC has wireless monitors so I was able to walk around in my room and out in the hallway some. 

This was the weekend that Hurricane Irene hit our area.  Although there wasn't any damage, it did rain and was pretty windy that we could tell from our window.  Apparently it brought everyone who was pregnant and close to delivering into the hospital to deliver.  The midwives were very busy that weekend with everyone, but me.  We ended up naming my IV pole Irene maybe to give us some luck.

Around noon on Saturday, I reached the maximum amount of pitocin without so much as a contraction.  They brought the dose back down and re-titrated up again.  In the evening, I did feel some discomfort, but no contractions.  The midwife checked me around 1:00 am, I was still 4 cm dilated, and the baby was still high.  She said that she could break my water or I could come off the pitocin, get some rest and try again tomorrow.  Since we were concerned about infection as well as the baby already coming early, we opted not to have my water broken that night.  We got a few hours of sleep and the started the whole thing again.

Sunday morning my midwife changed and she again suggested that we continue with the Pitocin starting at the low dose and increasing it every 30 minutes.  Again, today we walked, waited, played games, slept a little, and wathced a movie.  By the way, through all of this Martin and my mom were wonderful support people.  On Sunday evening they gave me a foot massage and a hand massage!  They were great!  Mid-afternoon I reached max dose, they dropped the pitocin back to 0 and restarted again.  All of this time, I had not felt much at all. 

Daniel and Mandi visited Saturday and Sunday evenings.  It was fun to see them! 

I will add that usually, when a pregnant woman is given pitocin to induce labor, they do not feed her.  Luckily because I was with the midwives they let me eat.  All of them told me that I would know when I shouldn't eat anymore.

Around 10 pm, the midwife came in to check me and I was stll 3.5-4 cm and the baby had not dropped.  She had discussed my case with the MFM doctor who recommended that if nothing happened that day that the midwife should break my water the next morning.  She offered to break my water then and she also suggested that I get some sleep and we could do it in the morning when I had more energy.  It was a hard decision because we had already been there over 48 hours with no progress.  I think I was nervous about having a c-section if they broke my water and nothing happened, or if I developed an infection.  Finally, we decided to wait till the morning and have the midwife break the water.  She also recommended that we take a more aggressive approach with titrating the pitocin.  So, again, I was unhooked from the IV and I had some rest.  My mom had to leave that night to get back to work the next morning.  She had spent the whole weekend in the hospital with me and we were pretty disappointed that she would not be there on when hopefully we would have the baby.   

At 5 am on Monday morning, the nurse came in a started pitocin at 6ml/hr.  I ate some yogurt to tide me over.  At 6, the midwife came in and got set up to break the water.  She also checked me, and there was no change from the night before.  She broke my water which did have meconium in the fluid.  This meant that the NICU team had to be in the room when I delivered to check the baby's lungs.  6:30, the nurse increased the pitocin to 12 ml/hr. After that...contractions started!!! At first it was painful, then it got really painful!! I don't know what the time table was like after that.  The next midwife came on at 7am.  At UNC, there are 6 midwives, and up until a week before my induction date I had seen 4 of them.  That last week, I had insisted on seeing a new one even though I knew that she was not going to be on call the weekend that I was supposed to deliver.  I had no idea that I would be in the hospital till Monday and she was the one on call that day.  Good thing I had seen her because she delivered my baby!

So, contractions continued to get worse.  I had previously thought that I would be able to give birth without the assistance of pain medication; however with pitocin causing my uterus to contract, it was pretty painful.  I decided to have an epidural.  This was around 9:00 am.  The aneasthesiologist resident came in and talked to me about the procedure.  I only remember her talking to me while I was having contractions and not really wanting to talk at all.  Martin left the room as they got things set up to put the medicine in.  Luckily, while they were doing this procedure, the nurse stopped the pitocin, so the contractions were not as close together.  My midwife was with me while I got the epidural, helping me breath through contractions and sitting very still.  Unfortunately, the resident missed...twice.  Finally the attending physician was able to get the epidural in the right place.  Martin came back 2 times while they were trying to get it in.  He even had time to go over to his lab and chat with his co-workers while I was getting it done.  It didn't start to work very quickly.  They had to give me several bolus doses to help it kick in.  In the mean-time the nurse had restarted the pitocin and I was in lots of pain.  I did get a very small dose of pain medication through the IV to help with the pain while the epidural was working.  Once they gave me the medicine, the midwife checked my cervix and said I was an 8!  It was 9:00 am.  Martin called my mom who was actually already on her way back to Chapel Hill!  She had a 2 hour drive still.  I still had what was called a "window" where the epidural wasn't working.  I rotated laying on the other side and was able to get some relief.  I was pretty loopy by this point as the pain medication took hold. 

As the medication was working, I felt relief from the pain and began to experience other discomforts that signified that the baby was coming.  The midwife checked me again at 11:00 and said that I was ready to push.  I decided to deliver while laying on my right side. They kept the monitor on the baby and attempted to keep a toco monitor to monitor the contractions, but this one didn't work very well. As a result, it was hard to know when I was having a contraction because I couldn't feel it with the medication. I didn't really get that sensation or urge to push even with the epidural. Just as I was starting to push, my mom walked in the door! She held my leg, Martin was behind me giving me encouragement, the nurse was following the baby with the monitor, and the midwife was doing her thing. It all happened pretty fast after that. I just pushed and rested and pushed again. The NICU team came in and got set up during all of this. I was pretty frustrated that I couldn't really feel when I was having contractions and wasn't sure if I was pushing at the right time to work with my body to get the baby out. At some point I didn't pay attention to that, and just kept pushing. Luckily, that little guy was pretty small and came out quickly. He was born at 11:55 am.



Kelten James Buchkovich

5 lbs 15 oz

19 inches long

 Happy Family!

We were so excited he was finally here!  He was healthy according to the NCCC team and perfect according to us!  His dad was exstatic as was his Nanna.  I was tired, but happy.  Just after he was born, my dad called from India and we got to tell him the great news.  I was so happy that he had called, and so happy, and so overwhelmed that I became very emotional.  We had waited to tell everyone our baby's name because we wanted it to be a suprise.  Martin announced it to my parents and the staff in the room.  We then let Martin's parents know.  It was a very surreal experience and we were very happy to finally have him in our arms.  We were moved up to the Mother-Baby unit and were able to get some rest and enjoy yummy food.  We had a great experience and were very happy how things went.  We were so grateful for the 9 nurses and 5 midwives that were very patient and kind to us during our marathon stay.  They were wonderful!  Now we have the wonderful gift of our little son to enjoy!