I was in my call room at 3:45am. I had been asleep for a few hours during the tail end of a heinous 24 hour call shift and woke up to more contractions. I better use the restroom, I thought. I stood up and my water broke. In retrospect, I should have expected this. For the last few days I had been experiencing painful contractions. I timed them the evening before and they were occurring at 7-8 minute intervals. I was only 36 weeks, so I shrugged it off. This could not possibly be labor. But there was no denying what had just happened. I generally am in control and have a plan, but this situation caught me off guard. I called for a second opinion on the matter. Adam was sleeping with his phone at bedside these days. His years of EMS had been good training for a panicked phone call at 4am.
"My water just broke. What should I do?" The answer should have been obvious. Before he could respond, I was telling him to meet me in the call room. "No, no, just meet me in the birthing pavilion. No, actually, just meet me here." He told me to get a grip and call my attending, then head to the birthing pavilion. Of course, I had not packed a bag yet since I knew I would not deliver this early. He assured me that he would pack some belongings and food and be there in 30 minutes.
Next, I made the phone call no attending physician wants to get in the pre-dawn hours. "Um, hi, my membranes just ruptured and I'm heading to the birthing pavilion." My attending was very nice and offered to come in. We negotiated that I would take phone calls and he would come in if there was an emergency. It was only a few hours until my colleagues arrived.
At the birthing pavilion, I was met with suprise. I was ushered into triage and the resident came to examine me. She told me we needed to do a pelvic exam to assess for membrane rupture but changed her mind as she saw the puddle of fluid I was sitting in on the stretcher. I was placed in a birthing room and given a few hours to see if labor would commence on its own. I was only one centimeter dilated. Pitocin was started when this failed to occur. I was consented by anesthesia "just in case" but was convinced that I wanted a natural birth. Adam came but I sent him off to retrieve our camera and more supplies. I started having painful contractions but was so exhausted I just laid in bed, resting with my eyes closed in between. The nurse took this as a signal that the pitocin was under-dosed. By the time Adam returned I was cowering in pain, crying and begging for an epidural. After the epidural I was comfortable, and by afternoon I was fully dilated and ready to push. This was fortunate because I was having late decelerations, a sign that the umbilical cord was wrapped around baby's neck, cutting off oxygen. Any longer and I would have been taken to the OR suite. Ryland was born at 5:16pm. He weighed 5lbs 2oz. He did well for the first hour or two, but then I noticed his hands and feet were cyanotic. His body temperature had dropped to 35C (95F). He was rushed to the NICU for warming. In the midst of this situation, I got more shocking news. My mother was en route to New Hampshire. I had spoken with her earlier and we decided it was best for her to wait two weeks to visit. She told me she respected that and understood. I got the phone call asking for directions, and telling me she would be at the hospital at 2am. I told her this was unacceptable and gave her directions to my house.
The NICU team placed Ryland on IV fluids for the night so that I could get some sleep. I had gained infamy during the day as "the resident who's water broke on call". He did well overnight and was released from intensive care the next day.
We made it home and my mother left.
The birth was far from the controlled, natural experience I envisioned. But I have no complaints and I'm happy to have Ryland here, safe and sound.
