After having my temperature taken and attaching a “Screened 04/08/2020” sticker to the front of my sweater, I made my way up to the third floor. The elevator doors opened and I stepped into a dark hallway. The sign said Labor and Delivery was to the left. I made my way to the end of a shadowy corridor, past silent and empty waiting rooms, and through a door where there was a phone on the wall. I decided to text Micah the directions I had just taken, so he didn’t get lost in the unfamiliar building, then I picked up the phone to ring the nurse on the other side of the door. She buzzed me into Labor and Delivery suite and asked me a few questions before checking me into triage. Not being a rookie, I went to the bathroom first, because the worst thing about triage is being stuck in a hospital gown in labor with no access to the bathroom without going into the hallway. I made my way into my triage room to strip down and wait for my nurse. I made note of a baby warmer sitting in the corner and thought about all the women who had probably accidentally given birth in triage. With subtle contractions every four or five minutes, I patiently waited for my nurse.
The next two hours were the worst part of the entire labor process. The nurse came in and decided to do a strip test for amniotic fluid to ensure my water had truly broken. Even though the test came back positive, she decided it could be bloody show and not amniotic fluid, so she decided to wait for an OB to double-check the test. Then began the long wait. First, I was told the OB had just gone in with a patient but would see me next. After ten minutes, I was informed I was actually third in line. When the OB finally came in, she did another strip test (which came back positive for amniotic fluid) but decided she couldn’t see enough fluid in the birth canal to be sure. Then she did an ultrasound and said there was still a lot of fluid in the uterus (which was not surprising since my broken water was just a slow leak). Finally, she took a sample of fluids on a slide to look at under the microscope. I was told it would be 15 minutes before the slides were dry enough to examine.
Meanwhile, Micah had ventured into the lobby. When he received my text directions on how to get into Labor and Delivery, he thought that meant it was time to come in. He passed the temperature screening to get in the door, but was informed that I hadn’t been admitted yet, so he couldn’t go upstairs. He already had all our bags with him, so he hid in a corner of the lobby seating area and took a short nap.
The doctor came back in and told me the slides were “inconclusive” so they were finally going to do a real swab test and send it to main hospital lab downstairs. As this point, I had been in triage for almost two hours and was getting irritated. I could feel amniotic fluid dripping out of me and was having fairly intense contractions every four minutes. When she noticed the look on my face, the doctor casually asked what was wrong, as if there was no reason for me to be annoyed at this point. I told her point blank, “I have been in here for nearly two hours. My husband has been waiting in the lobby for almost that long, and even if my water hasn’t broken (which it has), I am dilated to a four and having contractions every four minutes. Clearly, I am in labor.” She looked at me nonchalantly and replied, “Well, we wouldn’t admit you until you were a six anyway,” and then she left the room.
At this point, I was in pain and beginning to wonder if the warmer in the corner was going to be used for my own baby. I began whispering Psalm 23 to myself during every contraction as I laid there alone in the windowless room. At one point, I finally had to venture into the hallway to use the bathroom. Even though the floor was silent and almost-empty, I emerged from my room right as a dad was walking down the hallway. He might have seen my exposed backside but I was in too much pain to care. Thankfully, my nurse was compassionate. While we were waiting for the official lab results, she came back in and said, “I am going to assume you are getting admitted, so let’s fill out your check-in questions now.” One of them was, “Do you have any fears or anxieties?” I responded with, “Yes! That I am going to have my baby in triage and my husband is not going to be here.”
After about two hours and 15 minutes in triage, the heartless OB walked in and said, “The results are in. Your water is broken.” I texted Micah and said he could finally come upstairs, which happened to be perfect timing, because security had just approached him and told him he needed to go back out the car to wait.
By the time I got into my room, it was about 6:30 or 6:45 in the morning. We had been at the hospital for over two hours, and I had dilated from a 4 to a 6 in triage. I had vowed not to take any medications of any sort or even get an IV until we ensured that both Micah and I were past all the screenings and in the same room together. When Micah finally got to the room, I decided I would get an epidural. I was in so much pain at this point (probably heightened by my annoyance and anxiety at being trapped in triage), that my nurse wondered if I was already in transition. I wasn’t. They started me on fluids, had someone come in to draw my blood, and said the anesthesiologist could come in about 30 minutes after my bloodwork came back.
After what seemed like ages, the nurse, who was standing next to me on the computer, said, “Oh good, your blood results are in!” And then her tone changed, “Oh, but bad news, your platelets are low.”
I knew instantly what she indicating. I couldn’t get an epidural. The first time I learned about low platelets was from a friend who had her first baby a few weeks before Zianne was born. She went in for an induction and when the contractions got too painful she learned her platelets were low and an epidural was not an option. This friend happens to be very petite and her delivery ended up being a c-section while she under general anesthesia. Her husband couldn’t even be in the room. Ever since I heard her birth story, I have literally prayed for my platelet levels during pregnancy, but this 4th time around I had forgotten to pray that specific prayer. My levels were at 96 (technically 96,000) and the hospital cutoff for an epidural was 100. My mind wavered between, “Okay, you are going to have a birth with no interventions. You probably only have an hour or two to go. You can do this!” and “You are going to die. You are going to get the c-section you were trying to avoid.” I asked them to put some meds in my IV. I instantly felt loopy but was still in great pain.
Thankfully, the nurse took pity on me and called the anesthesiologist. Since my numbers were right below the threshold, she thought it was worth having a conversation with him. My numbers in my previous blood tests had always been around 150 (which I have since learned is still a bit on the low side of normal), but I have no idea why they dipped so low during labor. At the time, I told myself it was probably due to the stress of being in triage for so long and if they had taken my blood right when I had arrived at the hospital, my numbers would have been normal. In reality, I think my low platelets was due to my anemia. I always have low-iron during pregnancy, but I think it was extra low this time around.
After reviewing my bloodwork with the anesthesiologist, the nurse said he was going to come talk to me. While they were on the phone, I had a contraction and I made sure he could tell how much pain I was in on the other end of the call.
The anesthesiologist, Dan, walked in about 15 minutes later. He told me my platelet levels were in a “gray area.” Some hospital choose 100 as the cutoff; other hospitals choose 90. After confirming that I’ve had uncomplicated epidurals during my other deliveries, he said he would be willing to give me one, but that the risk of adverse events, while still extremely low, was slightly elevated with platelets at 96,000. “Yes, I want it.” I quickly replied. At that point, Micah intervened. He asked Dan for a few minutes to speak with me.
“You can choose to get an epidural if you want, but I want you to think through this rationally. He just said ‘paralysis’ is a risk. Do you really want to trade one day of pain for 40 years of not being able to walk?”
“I understand your concern, but that’s not going to happen,” I responded. “I know my body is fine.” Maybe this seems crazy, but I knew everything was going to be okay. If you’ve ever had a doctor warn you about a health concern that you know deep within is not actually a problem for you or, conversely, have had a doctor ignore you when you know something is wrong with your body — it was that kind of intuition.
Right after my receiving my epidural, my midwife came in to introduce herself and told me I could take off my face mask. I had been wearing the thing for about an hour and felt like I was suffocating. Once I was admitted, Micah and I had been told we had to wear masks anytime a medical staff person was in our room, but the midwife pointed to herself and the nurses and said, “Since we are all wearing masks; you don’t need to.” I never wore mine again for the rest of our time at the hospital. The mask is now hanging in our minivan to wear into stores and restaurants — a new Costa Mesa city policy. Who knew a birth souvenir in 2020 would be a medical face mask?
