Bobby, Shanna and Carter Kirkpatrick

It has been one week since sweet Carter was born. It seems like the craziness was just yesterday yet it seems miles and miles away now that we are experiencing the joy that has come out of the labor God delivered Bobby and I from. The story is long and I don't remember some things but we felt is was important to document the whole thing so to remember God's amazing grace at the end. So, here is how it went down from a very PROUD and RELEAVED father...

Ok, here’s how we had Carter. We did not plan things this way; I think that in the middle of the process we looked back, and everything that happened had been unplanned or contrary to what we had wanted to happen. Shanna’s mom, Karen, had a “road map” for labor that she uses sometimes at the birthing center where she works. During labor I looked at the map and looked all the way to step 1, and realized that NOTHING had gone the way that we had wanted it to so far, from the very beginning! However, looking back at things now I am so happy that we have Carter here and healthy. And perhaps God had a good lesson for us in trusting Him and letting go of our own sense of “control” over life and its creation.

We left home by 9:10 am Friday morning, October 8th. Shanna felt fine; she later commented that had we not had a doctor’s appointment, she probably would have been working out again at the gym (like she had all week!). We got into the doctor’s office a few minutes before our 10 am appointment, and waited. Then we were called to the back, and waited some more. Dr. Boswell, our OB, was in surgery. We ended up seeing Dr. Boswell around 11:45 am, and she looked at the blood pressure reading from that morning and asked to have Shanna’s BP tested again. It came back as something around 138/78, which was a little high. We didn’t think anything of it, because Shanna had periodically had high blood pressures throughout the pregnancy, but Dr. Boswell then said something we weren’t expecting: “I’m going to send you straight over to Labor and Delivery for further monitoring.”

By noon, we were in the triage section of L&D, in a curtained-off area where we sat for 4 hours. Shanna’s blood was taken to the labs for testing, and blood pressure readings were taken every 15 minutes. Apparently, they were worried that she was showing signs of preeclampsia, which is a condition that can eventually lead to organ failure. One of the symptoms is high blood pressure, but the lab work was to check her liver enzyme levels, blood platelet counts, and other symptoms. After four hours, her blood pressures had been fine; she never had a reading near what she read at the doctor’s office. The nurse at 4 pm came over and was explaining to us that the lab work came back fine, and we were going back home!

At that moment, the doctor on-call for our OB offices, Dr. Ortique, came over and stopped the nurse, saying to us that she took a second look at our lab work (and was glad she did) because Shanna’s platelet counts had dropped from her normal of around 160 down to 135, which was below the normal for a healthy person of 150-450. Even though they were below normal, they weren’t too far below what Shanna’s normal counts were; nevertheless, we were told to stay overnight for 24hrs of monitoring.

Seeing the possibility of us potentially going into labor this weekend, I went home and grabbed all the things that we had left behind, and grabbed dinner. Shanna was not allowed to eat (in case of an emergency surgery), and she stayed behind at the hospital for more blood work and 24 hours of urine monitoring (every time she went, they measured the amount). When I came back to the hospital around 7:15, she was still in the room that they had moved us to in the antepartum section of L&D, and had an IV in her and a blood pressure machine taking BP readings every 15 minutes. She also had cotton on the other arm now—she had given more blood for testing.

At 8 pm, October 8th, Dr. Ortique came into the room with the nurse and told us that Shanna’s platelet counts had dropped again (down to 108), and her blood pressures had been within the high range of normal except for a few spikes into the 130-140s. Because of these symptoms, even though her liver enzymes had all been normal and her urine output was good, we were told that her plan of action was to induce labor, starting that night. The standard line we were told (by everyone) to assure us is that “the only cure for preeclampsia is delivery”. Basically, we had to get the baby out.

So we were on a course for induced labor, moving to Labor and Delivery room 2 and started at 11 pm with a dose of Cytotec (not sure on the spelling here). It’s a cervix softener, and it gave contractions to Shanna all night long. In addition, Shanna was also put on Magnesium Sulfate, which is a muscle relaxant that helps to control high blood pressure. We were also informed that because of the magnesium (muscle relaxant) and a need to measure urine output, Dr. Ortique required a catheter to be inserted so that Shanna could be on complete bedrest from this point forward (also thinking that we would probably be going into a c-section soon, although we weren’t informed of that at the time).

So for the first night, Shanna battled through induced contractions all night, had 2 different lines fed into her (magnesium sulfate and IV fluids) and a catheter coming out. The catheter was the MOST uncomfortable part; it gave Shanna pain all night. She continues to say that she would much rather have dealt with the pain of the contractions than the pain of the catheter.

At 8 am, our doctor, Dr. Boswell, came in to check on us, as she was on call for the next 24 hours (which was great, as she is our doctor, and we like her!). She said that the lab work from overnight had gone well, and Shanna’s platelet counts for the last 2 readings were holding steady and slightly improving (108 to 111, then 117). Also, after not-much-convincing, she let us take the catheter out and move to a bedside potty, where her urine would also be monitored. Her reasoning was that “I wouldn’t have REQUIRED a catheter in this situation”; it was a difference of opinion, apparently (thanks, Dr. Ortique). This helped Shanna GREATLY. Also something that helped Shanna: we got a new nurse, the aptly-named Hope. She was very helpful (not that the others weren’t), and made a good connection with Shanna.
Dr. Boswell did say, however, that due to the nature of the muscle relaxant (stupid magnesium), her contractions were spacing out and growing inconsistent, and we still needed to deliver Carter. So she put Shanna on Pitocin to help produce contractions. At this point, we lost the catheter (GREAT) but gained Pitocin (meh), and as a result Shanna had 3 lines feeding into her now (magnesium, pitocin, IV fluids).

At this 8 am meeting, Dr. Boswell also checked Shanna’s progress. She had dilated from the 1 cm she had been at for 2 weeks to 2 cm overnight from the Cytotec. Great progress, we were told! We had high hopes now for a day of laboring with Pitocin. However, the baby was still VERY high in the uterus, and she didn’t even give a number, saying that his head was “floating” a little above the cervix.

So Shanna had contractions with the Pitocin for 8 hours, until 4 pm. This is how her contractions were with Pitocin, and this remained true when she went back on it later that night: she would contract, then as she was “coming down” from the contraction, would contract again…and again…and again. Her contractions would pile on top of each other, and last for 5-6 minutes. Then she would get a 5-6 minute reprieve, and start again. They were very irregular, and so would tire her quickly and cause a lot of pain due to their length and relentless timing.

At 4 pm, Dr. Boswell came in and checked Shanna again. Her dilation was the same (2 cm), and the baby’s head was still high. She said he was “maybe” at a minus-3 (or plus-3, we can’t remember). The point is that she had made no progress, and was getting tired. So we took her off the pitocin and let her rest for 8 hours and perform more lab work on her blood, which all came back normal. She was finally able to eat something (which she hadn’t since the night before) and was allowed to take a bath, preparing for “Round 2”.

At 8 pm, Hope was off but promised to come back in the morning for her next 12-hour shift. At midnight, Shanna’s blood work was reviewed again and she prepared for more pitocin, which came at 2 am. She had more of the very irregular, long, painful contractions until 7 am when Dr. Boswell came in to check her. Boswell reviewed the blood work, looked at Shanna, and found that no real progress had been made. The baby’s head was still very high, and she had “maybe” dilated to 3 cm. So Dr Boswell broke Shanna’s water to speed things along. Immediately after, Dr. Boswell left and Dr. Ortique took over again for her on-call rotation.

This was the turning point for Shanna; for the next hour and 45 minutes, Shanna’s contractions were VERY strong and painful. She began to “check out” mentally, especially between contractions; the nurse and her mother said that she looked as if she was experiencing contractions that women normally experience in transitional labor, as they prepare to push. She was “climbing the rails” during contractions, and having a really hard time maintaining composure. But when she was examined later, she hadn’t made any progress and the baby was very high.

So at the end of that time, just under 2 hours, we had a discussion about an epidural with our nurse, Hope. Shanna felt like she could not continue in this manner for another 6-8 hours minimum, which is what we were estimating we would be spending in more labor at this rate. Also, if her blood pressures (which had risen) continued to go in a bad direction, this would prepare her more quickly for the caesarean section. So she got the epidural with the help of Hope and an anesthesiologist, and immediately felt the pain go away. At this time, she also had a catheter reinserted. She was now working with a lot of different lines running in and out of her: IV fluids, Magnesium Sulfate, Petocin, an Epidural, a catheter going out, and a blood pressure machine that was still taking steady readings every 15 minutes. And little did she know, she was about to have some more monitoring equipment attached in preparation for surgery! She really did have a lot of different things plugging in and out of her.

Her contractions continued (induced by the pitocin), and they also became more regular. Unfortunately, we received some bad news about 30 minutes later. Dr. Ortique came into the room, and showed us how Carter’s heart rate had been dropping after Shanna’s contractions. It was happening consistently for the past 15-20 minutes, and the drop-off was significant; this was a sign that Carter was wearing out, and going into distress. The result was that we needed to get the baby out. She checked Shanna to make sure, and said that the baby STILL, after all this laboring, had not dropped down, and her cervix was “maybe” at 4 cm.

At this point, we were forced into an emergency c-section. The pitocin stopped, and Shanna’s contractions stopped. This confirmed several things for us: 1) that Shanna was not having natural contractions on her own, and her body was not ready to go into labor, and 2) Carter was not low enough to put pressure on her cervix and help dilate her, as he was not ready to go into labor, either. All the contracting for the past 30-something hours that Shanna had done had been simply “squeezing” Carter; they had not managed to help him descend or to dilate her cervix. The pitocin and Cytotec had done most of that, artificially. And now, Carter was wearing out.
Shanna was then prepped, and we went into surgery. I was called back later, and Shanna was awake, a curtain in between her and the surgery that was happening on the lower part of her body. She said repeatedly that she could feel “tugging and pulling”, and was grimacing in pain most of the time. Finally, after a few minutes, out came Carter! They showed him to us over the curtain, and then whisked him off to the neonatal team right outside the surgery room to get cleaned up and checked out. I followed.

Carter was born on October 10th, 2010 (10-10-10!), at 12:12 pm, after 37 hours and 37 minutes of labor! Hope informed me of this, as we were measuring and weighing Carter. She was there during the surgery as well, watching over Shanna. Carter weighed in at 7 lbs 3.7 oz (7 lbs 4 oz, officially), and 19 ½ inches long! He was pretty much on the smaller side of normal, so his size wasn’t the issue. I heard them comment several times during the surgery, among their talk, that he was “very high” inside of Shanna. So high, in fact, that they had a little trouble grabbing him and pulling him out by c-section!

(Our nurse Hope, a true gift from God during our two days of labor!)

Outside, I watched as they cleaned and examined Carter, and as I spoke he distinctly looked my direction, which was noticeable (all the nurses made a big deal out of this!). I blame it on the low voice, as opposed to all the chirping that the nurses were doing about how cute he was. Then they bundled him up, gave him to me and we went back into the surgery room and put him near mom’s head. Shanna was barely coherent at this point, and still complaining about pain. I saw the nurse who was monitoring her anesthetic look at me, then half-smile and dial something else into the epidural. In about 10 seconds, Shanna was out.

It took about 30 minutes for them to finish the surgery, and then they carted Shanna out to a different L&D room for recovery, L&D room 8. Because of the blood pressure, they wanted her to be on 24-hour watch again down in L&D rather than migrating upstairs to floor 25 for postpartum, and they wanted her to continue on the IV, Petocin (to help her uterus shrink back), and on Magnesium Sulfate for her blood pressure (which is really just a fancy word for epsom salt, by the way!). In the L&D recovery room, I laid Carter next to Shanna, then in a few minutes when she was more coherent laid him on top of her for the first time, which was highly emotional. Then, after a few minutes together, we allowed our family members to come back and look at them, two at a time. First, Kelly and Karen Hartman, then Bob & Karen Kirkpatrick, then Kenton & Lindsay Kirkpatrick, then Halie and Katherine Hartman begin_of_the_skype_highlighting end_of_the_skype_highlighting, and last Allen Kirkpatrick and Kirsten Hartman. All were excited to see Carter, and everything went well.

In our L&D room, we practiced trying to feed and monitored Shanna’s blood pressures, which were high but slowly overnight came down (consistently in the 150s, dropping down to 130s by morning). By afternoon, the blood pressures were down into the 110s and it was time to get off the magnesium and head upstairs!

We spent the next 2 nights in postpartum, upstairs in room 2511. Here, we had lots of visitors, attempts at feeding, circumcision, doctors checking out Carter and Shanna (including our pediatrician, Dr. Matt Wilber, and our OB, Dr. Hilary Boswell), and good bonding time together as a family. Wednesday morning, they informed us that as soon as the circumcision was done and we waited 2 hours to monitor it, we were free to go! Shanna finally got her heparin lock out of her hand, and we packed things up, waiting in anticipation. We came home, and were home around 4:30 on Wednesday, October 13th.

This was a long process with a lot to it, so we wanted to write it down to make sure we remembered everything. We thank God for Carter, for good health, and for teaching us a valuable lesson in humility and control—we trust God more for finding His way to bring Carter to us, and to use good doctors to help navigate the tricky waters that Shanna’s health became at the end of her pregnancy! Praise God for healthy baby and mom! Amen!