Birth Story: Harper Lyn Gummersall

Where do I even begin?

Tender Mercies:

I've found that as I've told people Harper's birth story their initial reaction is shock that so many "bad" things have happened to our family and what a trial this is.  Don't get me wrong, this pregnancy, delivery, and aftermath has been an absolute roller coaster, but I can't help but find so many tender mercies and blessings from it all.

- To have an amazing OBGYN (and her partners).  She/they have been such an incredible blessing to both Harper and I.  To be so diligent in the tests/monitoring/ultra sounds, to think about giving me betamethasone to mature her lungs the WEEK before I actually delivered her (it is most effective if you deliver within a week of getting it).

- To have an echocardiogram done with abnormal results that had us concerned I could potentially have a blood clot in my lungs (pulmonary embolism)... to be honest, when I woke up at 1:30am with shortness of breath if I would have taken my blood pressure myself I would have thought the cuff was broken and ignored the insanely high readings.  I wouldn't have gone into the emergency room, I wouldn't have been on the track to catch my preeclampsia as early as I did.

- The Monday and Tuesday before her birth we had two amazing friends who were certainly prompted by the spirit to offer to bring us dinner.  Both of those days I was exhausted, and not feeling "up" to cooking and they stepped up without Lance or I saying anything.

- Thursday night to have Lance's sister and her family staying at our house for the weekend while they picked up their new puppy.  They allowed for Lance and I to be at the hospital all weekend and have comfort knowing our kids were in good hands.

- To have the relationship I have with IMC Labor and Delivery.  Because I worked there for 2 1/2 years I felt completely comforted their skill and knew that we were going to be in great hands. To have them there as I quickly transitioned and to calm me when I was about to lose my s*** from the painful contractions.

- To one of my favorite anesthesiologists who was so worried my epidural had gone bad that he was frantically trying to give me a spinal block to make me comfortable.

- To finding comfort in my delivery doctor as she encouraged me that I was capable of delivering Harper while feeling it all....

- To whatever prompting I had to just be brave and deliver her since I had abrupted and every second counted to get her out quickly.

- To the amazing NICU team who continues to care for her each and every day.  Who include me on the plan and her current status.

- To the amazing neighbors/ward/friends/family who have extended their kind service to my family in the form of meals and babysitting without hesitation. Who have reached out to make sure we have all that we need, that we are coping well, and to be listening ears.

- To whatever prompted me to get an insurance plan with a max family out of pocket of $3500..... seriously.... such a blessing.

- To my kids both being sick... sounds like a weird tender mercy, but I'd much much rather them be sick now and on antibiotics while Harper is in the NICU then when she gets home.

- To how sweet my Bennett boy became since I was discharged from the hospital.  He was a sweet boy before, but the comments he has made have literally melted my heart.  He is so excited for his baby Harper to come home.  We were walking into the doctor on Monday and he said "mom, do you miss Harper?" and I immediately started to cry and said "of course I do Bennett" and he said "its okay mom, the doctors are gonna make her all better and bring her home so you won't be sad anymore."  He's been my #1 helper when it comes to pumping.  Every couple of hours he asks if its time to pump, he turns it on for me (well.. my kids fight over who gets to turn it on) and then Bennett says "you are pumping milk for baby harper. She is gonna love it mom just love it."

- Harpers daily progression towards discharge.  She has seriously done   S O   W E L L.  Each day we go in to visit her and she has more thing disconnected from her little body.

- To an amazing husband who is constantly making sure that I have whatever I need, a hug, the kids bathed, a listening ear, or even someone just to sit with me as my hormonal self just cries... He is literally the best thing that has ever happened to me.

Thursday, July 6th: blood pressures were elevated in the morning ranging from 140's/100-105.  I went in for my routine NST and baby looked great.  I had my blood labs drawn and they came back normal.  Still feeling very tired, short of breath, and lethargic I took a nap that afternoon then started getting the kids ready for a wedding reception.  I huffed and puffed around the house getting everyone dressed and just as we were about to walk out the door I had the impression to take my blood pressure.  For 40 minutes they ranged from 140-160 / 108-112.  I called the on call dr (Dr. Parrett) and she had me come to labor and delivery to be triaged.

We watched my blood pressures for a few hours, decided to start an oral blood pressure medication, Labetalol 100mg three times a day, and just as a precaution we did betamethasone steroids injections to protect the babies lungs in case I needed to be delivered early... but in all actuality I don't think any of us thought I would deliver a week later. 

-the next week-

Wednesday, July 12th: I woke up at 4:45am with shortness of breath and just a heavy feeling like I couldn't take in a full breath.  I couldn't fall back asleep feeling so "off" so I journeyed downstairs and started taking my blood pressures.  For over an hour they were elevated.  I then felt prompted to go upstairs and start packing my hospital bag (the bag was packed at 25 weeks.... but I through in the last minute necessities: makeup, blow dryer, straightener, phone charger).  I cried a little and then mentally prepared myself for the possibility of delivering my baby at 32.0 weeks gestation.  When Lance woke up I told him I was going to labor and delivery and I would update him.  Of course upon getting there my blood pressures trended back down to a high, but safe range.  We did a chest X-ray that basically showed my pneumonia was getting better and I was sent home around 11am with an incentive spirometer to help my lungs get strong again. 

Thursday, July 13th: I went in for my regularly scheduled OBGYN 32 week appointment.  During that appointment we discussed my shortness of breath and decided that it would be a good idea to get an echocardiogram on my heart just to make sure we weren't missing anything "big and scary."  I went in that afternoon for the echo and that evening I got a call saying the echo came back abnormal (pulmonary artery reverse flow during diastole)... basically this could be a few different things, #1 residual pneumonia, #2 a blood clot in my lungs, #3 pulmonary hypertension or some other scary cardiac issue.  Of course our minds were freaking out due to the fact that Lance's mom's one year of her passing was the day before and it was due to a blood clot.  I went to sleep that night at 11:30 and at 1:30am woke up to the same shortness of breath feeling.

Friday, July 14th: 

I laid in bed for almost an hour praying that I could either fall back asleep, the shortness of breath would go away, or that I would know I should go to the hospital.  Pondering and worrying over it potentially being a blood clot got me out of bed and I drove over to Riverton hospital's ER in hopes they would do the VQ scan that would show if it was a clot and then I could go back home and get some sleep.

About 45 minutes after I had been checked into the ER, IV place, labs drawn, vital checked... the labor and delivery nurses came in to put Harper on the monitor.  They then said "so I know you have gestational hypertension, but what are your normal blood pressures?" I said "140's/90's why is it higher?" and then turned around to see my crazy 160-170's/110-126.

I was in disbelief.  The monitor must be broken.  There's no way, NO WAY my blood pressures could be that high and I not feel symptomatic.  But it was true.  (I even checked my blood pressure a few times on the L&D monitor to verify).  The reality that I would have a baby today suddenly became a lot more realistic.  It took a couple of hours before I was given hydralazine IV to lower my blood pressure and then around 5am the technician was there for my VQ scan (to rule out a blood clot).  

The VQ scan was literally the worst thing I think I've ever experienced.  They place you on the machine similar to a CT/MRI.  Place a mask on your face and tell you that it'll be difficult to breathe for the next 4 minutes.  For 4 whole minutes I literally felt like I was suffocating.  Half way through I started panicking, flailing my arms, crying, and thought I was going to pass out from lack of oxygen.  It.  was.   so.   scary.    

Luckily the results came back as negative and I was soon after discharged from Riverton's ER with instructions to immediately drive over to IMC Labor and Delivery to have my blood pressures monitored.  Of course it was 6:30 am as I left Riverton, so I called L&D and gave them a heads up that I would be there all day on the unit and to save me a nurse.

Upon my arrival I ran into Angie, who was my nurse, in the parking lot and told her to be excited to have me as a patient.  I got settled into my room and we redrew labs and this time my protein to creatinine ratio was 0.2 which means I have proteinuria (protein in the urine) which in combination with my high blood pressures and elevated liver enzymes meant that I had preeclampsia.  Dr. Brown came into see me around 8am, and the shortness of breath feeling and the PTSD from the VQ scan had me a sobbing mess.  We started a nasal cannula of oxygen just to help me feel like I was breathing.  Around 9:30am we journeyed up to MFM (maternal fetal medicine) for my growth ultrasound that showed Harper was in the 24% for growth and was close to being IUGR (intrauterine growth restricted aka my placenta wasn't giving her what she needed to grow).  Just 4 weeks prior at my 28 week ultrasound her growth was completely normal so obviously my preeclampsia had set in and was causing her stress. After the ultrasound was over Dr. Porter MFM and Dr. Brown, my OB came in to conference with me that it was indeed delivery day. 

swollen feet

 (magnesium makes you extremely hot and flushed so Angie brought in this fan to help cool me down.  Little did we know the lowest setting was going to be like a huge wind gust.  Made us laugh). 

So we started the long grueling process of a cytotec induction since my cervix was fgt/40%... Magnesium was started at 11:36am with cytotec started at 12:45pm.  It was a long day and just as I would finally be comfortable enough to fall asleep my bladder had me getting up to pee literally every hour on the hour.  The magnesium didn’t make me feel as terrible as I thought it was going to, just gave me the inability to focus on anything and made everything pretty foggy if I attempted to open my eyes.  At 7pm Dr. Brown came in and ordered some benedryl/compazine IV for my headache.  Little did I know how crazy this was going to make me feel for the rest of my labor.  The benadryl made me extremely drowsy, but the compazine made me extremely restless and fidgety and couldn't get comfortable.  About 20 minutes after getting the medicine my arm started to burn like crazy and I couldn’t sit still or do anything.  My call button on my bed wasn’t working and I had this panic moment of helplessness until Lance walked in and got my nurse.  The most frustrating part of the medication was I could think clearly, but for some reason I wasn’t able to verbalize anything I wanted. 

An hour after getting the benedryl/compazine we had the NICU doctor in the room telling us what to expect from our 32 weeker.  I tried SO HARD to keep my eyes open, but at one point I just said, “I’m sorry, I’m listening to you, but I just can’t keep my eyes open.”  Around 7-8pm the cytotec started to kick in and things went from cramping to contractions.  At 8pm I was so tired of getting up to pee every time I was almost asleep that I caved and got my epidural.  By 9:30pm I was 2/50/-3 and by 11:30pm we finally started pitocin.  From initiating pitocin I started having variable decelerations and once we were up to 6 on pitocin was having tachysystole and we decreased it to 3.  By 1:47am I was a 3+/80%/-3 with a bulging bag.  I told the nurses to tell the doctors that in both of my deliveries I have gone from 4cm to completely dilated in an hour.  

At 2:00am I went from 1 nurse to 3 nurses as the entire hospital changed computer charting programs.  I had one nurse performing all of my cares, another nurse charting my cares, and a third helping the charting nurse know how to chart.  Occasionally I even had a 4th nurse in the room to help with charting and other tasks.  Things. Happened.  Quickly.  I felt so bad as I transitioned through labor and remember for the next few hours hearing my nurse, Renee, repeat over and over again…. “she feels _____________, how do I chart that?”  As a fellow nurse understanding the frustrations of how much needed to be charted, and not having a clue how to go about it, I felt real bad about the timing of me delivering this sweet girl.  

At 2:15 am my bag of water was broken and things progressed extremely fast (as I knew they would). My contractions quickly became very uncomfortable so I pushed my epidural button and had zero relief,  I called the anesthesiologist and he came in to redose my epidural, but once again I had no relief.  He came in again 10 minutes later and redosed me while checking my back to make sure my epidural was indeed in the right place and working correctly.  Meanwhile I was huffing and puffing in pain and things were progressing fast.  At one point Dee Dee checked me and I was 4cm, and 2 or so contractions later I was complete.  I even had to have Dee Dee start coaching me through the contractions as she performed counter pressure.  I snapped Lance awake on the couch and told him to get dressed and that we were going back to the operating room. 

transition labor, things are getting real REAL quick... about to go back to the operating room. 

 Within a few minutes we were wheeling down the hall.  My hands were clenching the bed in pain and as we pulled my bed into the OR.  The anesthesiologist ripped my epidural from my back and said “lets just do a spinal” and started setting things up.  I yelled back, “Mike! How long is it gonna take?”  He said two minutes and I said, nope, lets just have a baby.  Dr. Parrett quickly set up her stuff and within 30 seconds another contraction came and she was out a push and a half later.  Covered in blood because my placenta has abrupted, Dr. Parrett quickly adjusted her hands around the very floppy and still Harper to discover she was indeed a little girl!  We quickly passed her through the window to the NICU and were out of the operating room within a couple of minutes.  

We delivered in the operating room (vaginally, not c-section) because theres a pass through window to the NICU for Harper and a whole team of nurses and doctors waiting on the other side to take care of her. 

Dr. Parrett came back to my delivery room to tell me Harper was on CPAP with apgars of 6 and 8 and doing well! What. a. relief.  I went in and out of sleep as we pressed through my recovery.  At 4am Shauna, the L&D manager comes in to congratulate me on having the first iCentra baby!  

When my recovery was over we wheeled down to the NICU and into sweet Harpers room.  My old manager took a picture of Harper and I together to put in the Intermountain Stories as the first baby born on the new charting system.  It was so amazing to hold my three pound perfect baby in my arms.  The thickest dark hair, long skinny feet and super long fingers on her huge hands.  Her body super long amidst her skinniness.  She was just perfect.  

 As I look back on my labor experience I can’t help but have so much gratitude for “everything going wrong, but with a perfect outcome.”  I went from having high blood pressure, to developing pneumonia, to possibly having a blood clot or some other heart problem, to several trips to the hospital for monitoring, preeclampsia checks, a week of insomnia from the steroid shots, to severe preeclampsia, delivering my baby on a hectic day where they changed charting systems, placental abruption, epidural not catching up to my pain and essentially delivering unmedicated, headaches galore, continued high blood pressure after delivery, pneumonia coming back after delivery, two sick toddlers at home, spitting my time between my kids at home to give them consistency and the NICU, and the emotional rollercoaster of hormone fluctuations that had me crying every time I was in the car by myself or with Harper.  I continue to thank my amazing team of doctors and nurses for their amazing care.  My sweet doctor who knew was so on top of my care through each step I am forever grateful.  I am also so grateful to my Father in Heaven for keeping my mind positive throughout this crazy process.  I never once had feelings of hopelessness that I was going to lose this sweet girl, and while I probably should have been a little more scared than I was, this coping strategy pulled my family through one of the best and worst experiences of our lives.  I am so grateful to have Harper as the newest addition to our sweet family.  She is small, but absolutely perfect. 

 

first colostrum pumping session