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Amber Smith

Critical Essay Draft

I got the phone call. Today is the day! Today is the first day to the rest of my life. It is

happening now, well for the second time, but right now! These are the thoughts that were racing

through my mind during the seconds I got off the phone with my OB/GYN. Forty-one weeks

pregnant, it was MY turn to begin an induction. There was no way I thought I would have made

it to forty-one weeks.

I had a complicated pregnancy with my son three years prior, which automatically put me

at high-risk of having a repeat C-section. When you are pregnant there are so many decisions

to make about your care, how you want your delivery to go and where to have your baby. I

chose the wonderful team at St. Joseph Mercy Hospital to assist me in this journey of delivery.

There are many factors to consider when choosing a hospital to deliver your baby at. A

great hospital must have an appropriate amount of staff and that staff must be well trained,

experts in their department, caring, reliable, and nice to their patients. The hospital must be

equipped with proper resources from imaging devices to pillows. It is also very important that

the hospital is clean, inviting, and comfortable. Based on my personal experience, I have found

St. Joes hospital to be great.

My doctor works out of St. Joes, which has an amazing, (increasingly popular) birthing

center. In a birthing center you have access to doctors and nurses, a private room, some even

have hot tubs in them, you are given birthing balls, you have a TV, movies, you can set the

lighting how you prefer, and the best part each room is designed so you can deliver your baby,
and the baby never has to leave the room after birth, assuming he or she is healthy, and if there is

an emergency, the state of the art NICU is right down the hall.

In the weeks before delivery my doctor weighed the risks and benefits with me about all

the different options; Scheduled C-section vs natural delivery, medicated vs nonmedicated

delivery, what I should do if I go into labor at home, etc. Since I was at high risk for having a

repeat C-section, this also was a critical detail as to which hospital I chose because some

hospitals require you to have a repeat C-section if you had already had one.

Induction day! In case you are unfamiliar with what an induction is, it is when you go to

a hospital to have your labor medically started. This is usually done by physical means (using a

catheter with a balloon to manually open your cervix), medication, or both. My induction began

in the early afternoon, by physical means. The Residents and nurses came into my private room

to explain the procedure and check my vitals. The doctor on staff placed a Foley bulb, that is a

balloon catheter which sits between the babys head and cervix to enhance dilation. To attempt to

deliver a baby, one must be dilated to 10 centimeters. Within an hour of having the bulb placed I

began to have contractions and was beginning labor.

Over the next twelve hours, my labor was not progressing, I was still having contractions,

however there was no more dilation after the Foley catheter was removed. I was dilated to four

centimeters, almost half way. The incredible nursing staff made me comfortable, encouraged me

to eat and get some rest before the second phase of induction was by infusing Pitocin into my IV.

Pitocin is synthetic oxytocin to mimic the natural hormones a womans body releases during

delivery to increase rate and effectiveness of contractions.


Before I continue, I had my son at St. Joes hospital three years prior. I was sent directly

from my doctors office to the Labor and Delivery unit because my blood pressure had

skyrocketed. When this happens during pregnancy, it is called Preeclampsia. This could be a

potentially fatal problem for the mother and baby. If your blood pressure gets too high the

mother could stroke and or have seizures, which could stop blood carrying oxygen to the unborn

baby. Once I arrived to the hospital they immediately started my induction with the same steps I

listed above, the Foley bulb, then Pitocin. After a few hours they broke my water, and I ended up

with a C-section because my water had been broken for too long, they didnt want to risk

infection.

During my stay, the doctors and nurses were very nice, competent, I felt they did their

job well. I would have a nurse come check on me every twenty minutes or so to take vitals,

check my IVs and my overall wellbeing. I didnt feel the need for any medication until after they

broke my water. Once I got my epidural I felt I was just waiting for the baby to come out. No big

deal. When the decision had been made that I had needed a C-section, I agreed, signed what felt

like a hundred forms, they began to give me medication through my epidural site to prepare for

surgery. I was taken into an operating room, it was bright and cold. The medication and

hormones which were surging through my body were making me feel very sick, I was shaking

uncontrollably and felt like I had to vomit. I remember thinking, dont do it! They might mess

up! After surgery I was taken into ICU where I got to hold my baby for a few minutes before

they made me rest. Once I was in the mother baby unit I was able to see and hold my baby

more once the medication from surgery wore off a bit. I stayed in the hospital an additional three

days, then was discharged home.


After my first birth, Ive been there, done that. I was dreading having a C-section for the

second time because of how sick I felt during and the few hours after surgery. The second

pregnancy was much different too, I only gained about twelve pounds, instead of nearly sixty, I

was much more active, and in general healthier. I was convinced I had done everything right this

time to avoid a C-section, even though I was given 60/40 odds against me.

So the Foley bulb part went fine, then, they started the Pitocin. I was on an IV drip for

about fifteen minutes when the nurse noticed the baby wasnt responding well to the medication.

She called the doctor on staff and immediately took me off the Pitocin drip. This was just enough

Pitocin to jumpstart my labor, and boy! I didnt know what I was in for!

I was offered IV pain medications, however I did not want to be loopy when my baby

was born, so I denied this opportunity. I however was in so much pain, I felt as if I was being

exercised. In my birth plan I stated to not ask me if I wanted any pain medication, and that I

would ask. My nurse was very respectful of this. When I could no longer take the pain, I asked

for my options, which were; morphine and nitrous gas. I chose the nitrous gas because the effects

of the medication are short lived compared to the morphine. After an hour or so, my water finally

broke! This was a huge moment after being in so much pain I really couldnt wait to get an

epidural! Within minutes my nurse had gotten the anesthesiologist to give me the epidural.

Unfortunately, the epidural only had helped my pain slightly this time around.

It was now shift change, the morning nurse introduced me to the night nurse, gave a

detailed report about the progress of my labor. I was dilated to six centimeters. Slow progress,

but progress. As the night nurse is looking over my report, I had mentioned to her that I was

starting to feel ill, like I had a fever. She took my temperature, and I did indeed have a fever. She

paged the on-call resident. They noticed I had no urine output for a few hours and decided to
catharize me, to see if I was producing any urine. I wasnt. I knew this was not good. Being a

pre-nursing student at the time, I knew that no urine means no kidney function. The resident and

nurse were now monitoring me very closely, without making us feel stressed.

Within the next hour my heart rate spiked over 200, my blood pressure was increasing, I

was in agonizing pain, and the babys heart rate was dropping. I was in an emergency state. I

knew I would not be able to deliver my baby naturally at this point. Within seconds of my heart

rate spiking there were five or more nurses, two or three residents, the anthologist in my room

prepping me to go to the operating room. The doctor on staff came in, told us it was time and

they took me off to surgery. The C-section this time around was much easier to handle then the

first time around. They held my daughter on my chest while they finished surgery and she didnt

leave me until she had to go to the NICU for some medication, which was brief and her father

was able to go with her.

I chose a hospital I felt could handle all the what if scenarios of having a baby. I chose

the right hospital. They were properly staffed, highly trained, and had every resource they

needed to keep myself and my baby safe during and after delivery. My nurse didnt leave my

room one time in 12 hours, not even to use the restroom, and when my situation became

emergent there was enough staff to handle the situation so I didnt have to wait for surgery. If I

were to have gone to a hospital which was understaffed or under trained, the outcome could have

been devastating.