A Baby Monster Attacks!

A Tongue-in-cheek Account of our Ariel’s Harrowing Birth | Download the Print Version Here

9:30am on a Monday – Thursday January 29th.

Amy Beth Saurer, now 9 days overdue with child arrives to her regular fetal heart monitoring appointment at San Diego’s Scripps Hospital in Hillcrest with her usual friendly smile and optimism. She quite enjoys these appointments which usually take a full hour and are quite nice since she gets to chat with the nurse she is seeing that day. Conversation is stimulating and all three nurses are great. Her unborn baby, Ariel Rain Leppla, affectionately known as Baby Monster or BM, has always instantly passed all her wellness tests, be it movement, heart rate, or amniotic fluid levels.

Ariel doesn’t pass today

Amy talks to the nurse and chats a bit as they prepare her to be connected to the monitoring devices. The nurse today is one of her favorites and they have a natural congruent banter as they go through the steps. However once the nurse connects her to the fetal heart monitor, that friendly banter ends and nurse Dana’s face goes slack. Dana takes a breath and then moves Amy slightly to reposition her, to get another connection on Amy’s ample belly. The original location reads that the heart rate is only around 90 bpm instead of its usual 140bpm. They reposition her again, try again, fail, fail, fail and time… time is passing. This baby is showing a dangerously low heart rate. Right when Amy was connected, she had a low bad reading, and it continues, 4 minutes pass, then 5, 6, 7 and finally 8. Ariel still hasn’t recovered. She is in danger…

Nurse Marylin calls it | 9:45

The full team rushes in. Three or four nurses and the head doctor all storm into the room. Amy, going through this is in emotional shock. She is scared and terrified for her baby, have to have a C Section, will she suffer damage? She begins to tear up, but relinquishes control to the staff. They quickly move her onto a gurney and begin to whisk her out of the room and to emergency. Dana grabs Amy’s hand, she quite likes the gutsy young woman, and whispers, “Your going to be okay.. but you’re not leaving this hospital today. Call your husband now!” Amy fumbles for her phone, holding back the tears and dials.

The time is now. Get over here.

Amy’s fiancé, Brian, a tall gorgeous ripped man with long flowing locks and bright intelligent hazel eyes is just finishing cleaning the guns when he answers the phone. Amy’s voice comes across the line in a series of gurgles and babbles. “What is wrong?” he asks calmly and softly. Amy, in the midst of all this, bravely gains composure and let him know that the time to get there is now and to grab the pre-packed luggage for a hospital stay. Brian adeptly gathers everything together and loads it into the back of their powered up G35 coupe. The G35, barely a visible blue streak of speed as it dances between the traffic safely delivering him to his love in record time. “Thank God we kept that car!” he thinks to himself.

Destination Purgatory | 10:30

Amy’s gurney flies down the hall carried like an ancient princess on the arms of her team. Dana has to let Amy go, her duty for now is elsewhere. Having seen a couple cases like these, she wishes her the best. Amy arrives at her destination- a small narrow room, roughly 10’ x 15’. This room is a monitoring room that also doubles as a birthing room when the hospital is slammed and the hospital is slammed. A day like this day is becoming scarcer here in southern California for it is at the end of a full moon and true to Ariel’s middle name, it is raining. Those in the hospital business know that it is always busy when moon and rain align and today is not an exception.

Amy is moved out of her gurney into a proper hospital bed. She has now completely left the antenatal unit to the full labor and delivery wing of the hospital. Hooked quickly into monitors and with anticipation and if not a little bit of anxiety, they go to get an updated look at Ariel’s progress. Is her heart rate still low? Is she starving for oxygen? Is she there? Fortunately, she is there, and better than that, she is stable.

Needing an IV to battle dehydration becomes the first battle in our purgatory. The nurse fumbles the process, stabbing Amy’s arm repeatedly and painfully multiple times, finally and with great relief the IV takes and Amy begins to receive the liquid nourishment. Another nurse remarks later that they all have their bad days and sometimes something that goes quickly normally becomes a nightmare every once and a while – such is life, Amy comments. Either way the IV is working. Amy is hooked up with an oxygen mask as well to get more oxygen in her blood stream and help Ariel. Ariel further stabilizes. And finally like a beautiful, powerful and omnipotent golden god Brian arrives to her arms.

Nurse Jackie and the Path of Deceleration | 11:00

After meeting the head Nurse Focker for that shift and being reassured they were doing all they could, Amy was pretty well set up and ready to go. The question now becomes is it best to take Ariel by force immediately due to that severe dip or was that just some odd anomaly. If not had that happened all night before even arriving to the hospital – what then was the cause? The hospital slammed as they were got us our own nurse, on call and here to help out what was more so becoming a complicated and dangerous case.

Understanding the cause and what was happening to baby Ariel fell firmly to Nurse Jackie, a spirited, fun, mid-30s woman (the type you might play volleyball with) and thus we entered the concept of deceleration. One of the tools off to Amy’s side was the fetal heart rate monitor. On the screen existed two bars or sections – the top monitored the heart rate of Ariel whereas the bottom monitored Amy’s contractions. Within the top bar there is an acceptable range of escalation or deceleration – Ariel had deeply decelerated, the danger of her heart stopping or loss of oxygen lingered in the air. At the bottom bar one could see the waves of Amy’s contractions and though at the time she did not feel them one could match the contraction with Ariel’s decelerating heart rate. Upon Amy’s arrival she had a particular long contraction which dragged Ariel down and from which she had difficulty recovering and a slow long recovery. It was the contractions that were crushing Ariel.

Nurse Jackie described it this way. It is very similar to being in a pool with someone above you. When a contraction comes that someone dips you under water, if the contraction is short you are release and arise to gather breath. You breathe a few in and then the next contraction hits and pushes you under water again. Up down again and again until a long contraction hits you and you are held under for a couple of minutes, you struggle for breath, you panic, your heart rate drops. Your heart rate decelerates, and you are in danger. Then you are up, you are pretty resilient, but how much longer can you last.., you are getting tired… This is where Ariel lived.

Two blessings came along to assist Amy and Ariel in the battle – first the oxygen mask. Ariel would gain power by being completely oxygenated from Amy’s oxygen rich blood stream and could potentially persevere. The second was the actual monitoring process. Nurse Jackie’s gift was the spirit of knowing everything would be alright and her confidence made our team confident. You see her daughter had gone through a terrible c-section and pregnancy resulting in 3 weeks in the nicu (baby emergency room) and had survived to be a flourishing powerful woman. Jackie new we could do it.

Though now the dream of spending labor running through the fields, smelling flowers, meditating happily and enjoying the coming birth was now absolutely gone. There would be no walking down the hallways, no doing various stretches and positions in fact that was all gone. Amy had envisioned, nay prepared for this beautiful early stage experience of health and fitness and one of the key ideas she had learned was not to be tethered to a monitor. She was tethered to a monitor and could move maybe three feet in any direction. Being tethered is Amy’s idea of misery.

Induction

Thus came the choice. Ariel, outside of that initial heart deceleration, looked amazing on the monitor. Still we knew we had to get her out as soon as possible. Should we do the c-section or should we induce? Generally, if able, a vaginal birth is considered the desired outcome and we were unsure that we may have that option if her heart rate does not dip again. So we decide to induce. The first action is a strip that is inserted in Amy to further dilate her to the necessary 9 or 10cm which will make the passage large enough for Ariel to come through. This, of course, is an 8-12 hour process and at Amy’s last pelvic exam she was only at 1cm of dilation. So are we delaying the inevitable? Should we just go ahead and get the c-section and skip the tough labor and the whole nine yards, yet deal with what can be a trickier recovery? We decide to induce.

Nurse Hathaway and The Drop | 1pm

Nurse Hathaway was an older woman, slightly eccentric, with a bit of a tick – she might of remind you of an aunt, you know the one who has a lot of cats. Our initial impression after Nurse Jackie is that Hathaway might be minorly incompetent. However this proved to be wrong, her abilities were quite adept but hidden. She proved to be a master of the monitor and after moving and rearranging Amy we were able to see the contractions very clearly and see Ariel’s reaction to them. Thus we saw what was next.

A couple hours went by and then Ariel dropped the second time for 5 minutes.

The Doctors

We have three doctors, any of which could possibly be the one that was there for the delivery. The lottery began.

Our primary doctor – Dr. Lommis, a small very friendly blond woman whom might be the type you would see at a Dave Mathews concern with a book in hand initially we had liked very much. However over time that relationship had soured a bit. We felt she had become short tempered and rushed, almost as if she had a chip on her shoulder or maybe felt like she had to prove herself. Perhaps it was that she didn’t have any kids and was getting to the point where the clock might be ticking a bit or maybe she just was simply rushed, one can never know for sure. One thing we did know is that it couldn’t be us that she was annoyed with. We were always quite charming, weren’t we? Of course we were. For example, when we brought her the birth plan she was just kind of like “uhhh whatevs”. I could see her tossing it right over her shoulder in my mind’s eye.

Dr. Stone – Dr. Stone was a tall thin Asian woman that just had her second child (I hate to stereotype but a doctor whom had directly gone through the birth experience seemed like a plus to us) and we had only met her twice when Dr. Lommis was out delivering a child or sharpening her smile, we had this great chemistry with. The nurses Amy saw in Antenatal just glowed over her as well. Yes this is the one we want.

Dr. Huxtable – A tall quick and funny Indian man whom was the doctor we meet first right when we found out we were pregnant had turned us off from the get go. That initial visit he informs us that we are indeed pregnant, does the first sonogram but does it with no fanfare at all. With a joking attitude but a bit indifferent, “Yea you all are pregnant *yawn*, the baby is there…, okay see you later”. Just didn’t do it for us. The second visit with him (Lommis was out on a ‘score’) was better more attentive but still a too relaxed and whatevs. Yep, we still want option Dr. Stone.

Dr. Lommis | 2pm

Dr. Lommis was on campus delivering for another patient came and saw us. She was leading us towards c-section even though Ariel at this point was very stable and strong. One indicator on the monitor is if the baby is moving about and the needle dashes up and down but not out of range – this means the baby looks good, is alert, active and strong. What you don’t want is to have a dip and recovery where the baby monitor line is on the flat side. This indicates a baby that has given up. Not Ariel though! She was pumping! Of course I asked if she thought there might be brain damage and to this she was not very reassuring, which I naturally read to mean – “Oh yea that child has brain damage”…

This feeds into the c-section concept because after all Ariel had dipped twice now – wasn’t it inevitable that another big dip would come? Why go through all the labor if you know the c-section is the answer for you? Yet we felt strong that we had a chance – so we made a deal. Third drop = c-section, no question.

Time passed – our Dr. Stone whom we hoped for was at the hospital a couple hours and then gone. This left Dr. Huxtable for the night shift…

Nurse Betty – The Final Nurse | 7pm

Nurse Betty was an assertive nurse with a fast tongue, youth on her side and a protégé of our earlier favorite, Nurse Jackie, who had apparently given her confidence and a can- do attitude. Ariel had gone a few more hours now and was looking strong. The induction medicine was making its effects known and Amy was starting to feel the actual contractions something furious, rather than just see them on the monitor. Still it was early in the game and so she was still considered to be in early labor. Lots has to happen to get her ready to go – it was on its way though. The hospital itself had slowed down at this point so we were free to banter with Nurse Betty and go over things.

Ariel and The Contraction Intolerant | 8pm

How’s that for your first label in the world? Ariel was “Contraction Intolerant.” It was explained to us that when Amy had these little contraction earlier and the second one, stronger now that Amy felt had caused Ariel to dip, this was evidence that she couldn’t handle them. What then would happen when actual third level contraction occurred or the real pushing happened if Ariel couldn’t handle these minor ones? Surely she would not make it through those. Still we all agreed that we would try to make it.

Poor Amy – she was really feeling the crazy contractions now! Happy we were that the initial induction drug was having the desired affect, still a bit hesitant for her to feel so much pain before the next drug Pitocin would be administered. So we appeared to be getting results and it was really on Amy because the road ahead was long and hard. Once the initial drug passed, there was a chance if Amy hadn’t dilated enough that she would have to go through a second dose of that, plus the Pitocin so time- wise we could be looking at a long delivery, and by that I mean three days.

Amy and The Contraction Intolerant | 8pm

In fact Amy was really feeling them. Feeling them pretty strong for this early labor – so bad that she was clenching her jaw and crying out a bit. She kept apologizing for making such a big scene when she should be strong and for such low level contractions. We decided to try one of the lesser meds and an epidural was certainly not out of the question. We had always been open to that – screw the natural birth kids and their go natural or fail condemnation and attitude! Don’t forget the goal is a healthy baby and mother at the end and you go to that by any means available. So epidural or any other tool to our disposal was considered and if good then welcomed.

This meant as Amy was really struggling and getting hard to watch that Nurse Betty slipped a little something into her drip. Just a little.., you know. Then the withering, frantic and painful world of Amy stopped.., euphoria appeared. Not high, mind you, as she could still feel it more like the anxiety was released and she came back to earth. She was relaxed. She could talk again. 10 minutes passed and then, as quickly as it came, it went. Bliss was gone and the storm was back this time with a vengeance. A vengeance so strong that despite this being “early” in the labor we were going for the epidural – we didn’t want to do it this early but now was the time. Amy was truly in agony. The worst pain she ever felt, it made that Chinese torture camp she always talks about seem like child’s play.

Amy was not allowed to and had not eaten in over 12 hours.

Amy could barely keep it together. Nurse Betty singled to her crew “haaay!”, to get the drug guy down and the party started. Amy limped and almost crawled to the bathroom just a few feet away moaning and threatening to push the entire way. The urge to push was creeping in even at this early stage and it was quite powerful. The nurse offered to do a pelvic exam, which was not one of our favorite events and previous procedures had left Amy uncomfortable and pretty much ruin the day. This plus all the intense pain led to a clear “no” from Amy. Not going to do it. She managed to get back on the bed, sweating, moaning and shivering the whole time. Brian’s smooth, silky confident voice was the only thing that could give her comfort at all. Thank God for Brian.

Finally the drug doc arrives and we were able to get Amy over on her side. The whole process took about 20 minutes. Amy was keeping control well enough until a contraction came which would then cause her to move and shake. You don’t want that when administering an epidural in to the back by the spine. Stillness is key, precision is key. So he prepped her and then bided his time and finally made the insertion. Was able to load up the drug into her and…

Sweet Relief | 9

The epidural took effect quickly enough. Mounting really at first just minor relief and then more followed until Amy was numb. She sensed the pain but didn’t feel it yet she felt the contractions well enough and could call them out as they came.

Ariel and the Final Descent

Amy finally felt relief and then Ariel decelerates dangerously for the final and third time… Dr. Huxtable is alerted and on his way.

The Call is Made – C-Section

Nurse Betty and crew makes the call and it is time for the C-Section. The staff is alert. The operating room is prepared and staffed. Brian is brought scrubs and nimbly gets dressed. They gurney is lifted and right outside the room people are rushing around and preparing just like your favorite hospital drama. Off we go to the knife. Ariel must get out now – she is fully Contraction Intolerant and might not survive when real labor sets in… Brian prepares to go down the hall with Amy to the or where he will wait outside while the prep her and be only allowed inside right before the cut.

The Audible | 9:30

Amy much much calmer now – still is feeling a lot of pressure down there. Some serious action and movement generate by those contractions. The induction medicine is starting to work everyone agrees. Too late of course – the blade awaits.

Thankfully the epidural had gotten her to a point where she could feel and think and not be just entirely consumed by pain. She mentions this pressure again and again. Then she feels a leak of water that indicates her water had broken. Also, she felt something down there- had they given her a catheter? No, it was something else!

Brian looks into the fury of bodies preparing outside and catch the nurse’s eye. He waves her over and Amy now numb and strong agrees to the pelvic exam. The pelvic exam is done quickly and Nurse Betty looks puzzled – she then rushes off with out a word, only to return a second later and do a second exam. Breaking the lip she explains it as she pulls a piece of soft flesh out of Amy.

Amy is dilated! She has gone from 1 to 10 seemingly suddenly. Dr. Huxtable arrives and we all confer. This clearly is one of the weirdest cases that they have ever had comments Huxtable and Betty and the both laugh and further comment that anytime they work together there is something odd. The worst of course being a pair of baby twins with legs that had the strength and definition of a nine year old that manage to run out of the hospital only to be found asleep on the swings at Balboa park hours later.

The question came up. Could the crazy and now called bossy baby whom was formally contraction intolerant actually be born the old fashion way? We agreed we wanted to try it – we also agreed to allow for suction devices to assist in the delivery if necessary. Thus the audible was called and the plan was changed – we are having her vaginally. Somewhere off in the distant a scalpel returned to its tray.

The Setup

One of the powers of Nurse Betty was her assertive take charge attitude. Like the team leader she rallied all the troops, got them to bring in new equipment and switch out old to the hallway – she really called the shot. You go here, you.. move this, get us this and so on. The plans where adjust quickly.

The plan for a C-Section was still on the plate as back up so our heroes were still going to the Operating Room, which turned out to be a blessing. The room was huge with those massive lights and a table with plenty of space right in the center. Of course we were greatly pleased to see light, fluffy clouds amidst a blue sky had been painted on the ceiling. Surely to ease those under duress or perhaps to encourage those who wanted to go to heaven now to go there, well, perhaps not the latter. The room itself was actually beautiful.

Thankfully it was so large because there was a cast of characters. Those you have already met, our doctor, nurse and drug guy had added two technicians that would clean and weight Ariel after her escape, and then finally another woman on the corner whom we didn’t really know whose purpose wasn’t clear though she ironically introduced herself as the nurse you would forget.

Amy was positioned directly in the middle of the room in stirrups and on her back, comfortable enough and clear with the help of the epidural. The drug guy was above her head. Nurse Betty was by her right leg though she would move around on occasion. The Doctor was in the catching position and the rest of the team was off in the sidelines. There was a fetal monitor to back right which would be useful to track the contractions. Brian was down at Jack in the Box for their late night snack pack. Wait.., he returned quickly (he is a wonderful and elegant runner – something to behold), washed hands and set himself up. There is always a question for the dad in a case like this – downtown where the father would view the birth in all it glory (not for the squeemish) or uptown where one could be by his loves head and encourage her directly from there. Since we were in a large operating room Brian ended up mid-town where he was both close to Amy and could be involved in the birth.

Transcendence

Everything was prepared. It was time. The Doctor made a couple final checks and then we began. Looking between Brian and Amy he could see the monitor and the first contraction started growing. Amy was instructed that she would ride the contractions and when they peaked she would take a deep breath in and then push with all her might, take a deep breath in again, push and do this three times per contraction. Then she would get a break gather forces and prepare for the next contraction.

So it started – Amy took a deep breath in… The Power Went Out…

The room went black and the Doctor produced from his coat pocket a white emerald the size of a man’s fist – his face had turned absurdly white and slacked. The emerald ominously throbbed with Amy’s contractions. In a deep dark voice he began to incant the sacred ancient words of the Behoven…

Brian blinked and Amy pushed as she was told. Push, breath, 1, 2, 3 times. She rested. Nurse Betty coached her on pushing techniques. Rushing here had prevented coaching. Contraction rose. Amy pushed. Brian held her leg up and back in the stirrup to help. 1,2,3. Push. Rest. The doctors bantered calmly. Contraction. 1,2,3. Push. More productive this time.

The doctors bantered, we joined them. It was actually very comical and very relaxed. Huxtable’s nonchalant attitude was actually fun and worked well to lessen and lighten the event. What we initially despised had become a blessing and something to be embraced.

Eyes back on the monitor. Contraction rise. 1,2,3. Push. Rest. 1,2,3. Push. Rest. 1,2,3. Push. Rest. Ariel’s head crowning. 1,2,3. Push. Rest. 1,2,3. Push. Rest. Suction device appears. Suction cup placed on Ariel’s head. Devices pumped. Latch made. Amy instructed big push. Do it. Contraction. Amy encouraged and pushes with all her might. 1,2, and 3!

Ariel is lifted out in to the world! She tries to run but is cradled by the doctor. The umbilical cord is produce and Brian is given hospital scissors. A clamp holds the cord in place with a “V” cut into it to guide the scissors. Brian guides the scissors and cuts. Ariel, purple and covered in mucus, is released to the cleaning team behind her. They whisk her over and suction out her throat a couple times.

A Beautiful Cry

Ariel lets out her first cry and it sounds as if angels had descended from above. Everyone in the room experiences a lasting feeling of peace and harmony immediately. Ariel is safe. Ariel is being cleaned. Amy herself, exhausted, hungry but blissful and wonderful is being put together and cleaned herself. She is gorgeous, brave and noble. The placenta slips away and is put into a container. Everyone congratulates each other, talks, pictures are taken and smiles abound. This crazy birth that started off with the potential of a still birth, then evolved to a cut and finally a full release, was over. The child was born at 10:31pm January 29th 2015 weighing 7.3 pounds and dubbed Ariel Rain Reign Leppla.

The birth is a success.

Closing Notes.

You All – We are deeply grateful and blessed, blessed, blessed. Gratitude to God, The Universe, Universal Intelligence, Jesus, Buddha, Nanak, Gurus, Tao, and all those wonderful paths. Here on Earth gratitude to all our amazing friends and family whom we look to for support and have granted that and continue to grant it and be in our lives. We love you all so so much.

Path of Deceleration – The cause of Ariel’s sketchy heart rate drops is unclear and is one of the things that made this case interesting to the staff. The best reason I heard was that the placenta had grown tired, and also the umbilical cord was narrow, which prevented it from performing as well as it could during those random contractions it didn’t like.

The Contraction Intolerant Diagnosis – Ariel was not actually contraction intolerant. Rather Amy’s labor had actually gone through all stages but no one had caught that and misdiagnosed it going off an earlier pelvic exam the day before. So, what she went through was pretty natural. It was just scary to us because we believed otherwise at the time.

Placenta – we intended to get the placenta and bury it in the backyard to grow a pear on top. Alas you have to fill out the form very early and we missed that part. Don’t miss it yourself if you have the opportunity – in most cultures around the world this is a very sacred and loved item that supported your baby.

Cord Blood – We donated the cord blood after much debate and the woman who we did not know whose purpose it was in the delivery was actual the cord blood collector. Donate or bank if you can. Sign up early.

Initial Skin to Skin Contact – Normally the baby is brought to the mother immediately after birth to establish the important event of initial skin to skin bonding and contact. Due to the first drug – the euphoric one Ariel was not able to do that and had to be cleaned first. She was brought over to mommy right after the cleaning within 3 minutes.

Epidural – In our case, without the Epidural, a vaginal birth would not have been possible. Amy simply would have not relaxed enough. The negative rumors of not being able to feel and have intelligent labor just did not appear for us. Our doctor when visiting us in post-natal told us to recommend the epidural and tell our friends (something she would never had said before). So we are recommending it and telling you – get the epidural if you need it. It saved our asses.

The Birth – Later we would hear comments and murmurs of the whole labor wing and post natal wing commenting about what amazing and bizarre birth process this was, only to be topped by a couple of twins with legs.