Rick & Angi's Page

Reese Catherine Hotz was born at Sharp Mary Birch Hospital for Women on Thursday May 14, 2009 at 1:03 am. As was true for the rest of her life from the time of her conception, her entrance into the world did not lack for drama.

Our doctor, Dr. Colleen McNally, offered to strip my membranes on Reese’s due date (May 12, 2009). I eagerly accepted this offer, as I was extremely uncomfortable in the final weeks of pregnancy. I had gained 50 lbs and had been at home for 2 months awaiting Reese’s arrival. This was way too much time to think and to wallow!

After the membrane strip, Rick and I returned home and the evening was business as usual. I awoke to fairly unpleasant contractions at about 4:00 am. They felt different than any of the million I had had previously and I definitely could not sleep through them. I laid there in bed for an hour before waking Rick up. We began timing contractions and they were about 5 minutes apart. They stayed 5 minutes apart for several hours, and also increased in intensity – again, this was the first time that I had any lasting changes in intensity, so I hoped this was finally the real deal. At about 11:00 am we decided it was time to go to the hospital. Nothing had changed for several hours, but the fact that the whole process was still continuing made me think it was labor (the longest any patterned contractions had lasted previously was 3 hours). I did think it might be too early to go based on the level of pain I was experiencing, but since this was our first baby I really didn’t know what to expect. I was also GBS positive, so wanted to get there in plenty of time to receive the necessary antibiotics prior to delivery. We were also supposed to be continuously monitored during labor because of Reese’s velamentous cord insertion (i.e., umbilical cord abnormality that could lead to stress during labor and delivery). So off we went!

We got checked in and hooked up to the monitors. It was then the moment of truth – cervical check. Unfortunately my cervix was still at 3 cm, which is what it had been at our doctor’s appointment the day before. I was pretty disappointed, but rather than send us home, the nurse ordered us to go walk the hospital campus for 2 hours and then come back. So, Rick ran me ragged all over the Sharp campus. Contractions definitely became more intense during the walk, which made me hopeful that I would make some progress in those 2 hours and be admitted. This was the case (I made it to 4 cm!) and we were admitted to the hospital at about 3:00 pm after meeting with the doctor on call from our doctor’s office, Dr. Binno. We let our families know that Reese was on the way.

We got up to our room and met our first nurse. We let her know that my hope was to get through the delivery without pain medication. She said that was great, but to let her know if I changed my mind at any time. She was awesome about checking with me about how I was doing and watching my demeanor through contractions. I was able to breath through them for a couple hours, but the continuous monitoring made this more difficult than I expected. My ability to change positions to make myself more comfortable was limited because if I moved too much, Reese would go off the monitor. So, after a couple hours of laboring in our room, I requested fentanyl (narcotic pain killer, level below epidural in the pain relief world) to give me a little relief. This helped immensely and I continued to labor.

The doctor came in to see us at about 6:00 pm to see how we were doing. There had been a shift change at 5:00 pm and Rick and I were happy to see that the doctor on call for the night was Dr. Brambhatt – we had seen her many times in the office and were happy that she would be the one to deliver our baby. At this point were both sure she’d be born on the 13^th considering labor had started at 4:00 am that day!

When she checked my cervix, I was a lousy 4.5 cm! Ugh!!! Despite contractions getting much more intense, virtually no progress was made. Dr. Brambhatt offered to break my water or give me pitocin to speed things along if I wanted to. I declined both. I knew I didn’t want pitocin because I thought that would mean the end of my epidural-free delivery. I should have let her break my water, but I was secretly hoping it would go on its own. So, she said she’d be back at 8:00 pm to check me again.

Over the next couple hours, the contraction pattern went a little haywire. I’d have sets of contractions a couple minutes apart and then none for 7-8 minutes. Intensity stayed about the same. We got a new nurse at 7:00 pm and she got pretty aggressive with having me shift positions to try to get contractions back into a good pattern. By the time Dr. Brambhatt came back at 8:00 pm, my contractions were 2-3 minutes apart. She checked me and she said I was still 4.5 cm. When she looked at my face, she said “maybe 5.” I opted for her to break my water to get things going. So, break my water she did!

All I have to say is, oh my god. As soon as she broke the water, labor was a whole new animal. I have never felt such horrible pain in my whole life – the increase in intensity was absolutely instantaneous and I could not believe the difference. Reese had been well-engaged before the water was broken, but man, what a difference a few mm makes! When her head was in direct contact with my cervix, the intensity of the pain blew my mind. The other very important note at this point was that there was blood present when the waters broke. There was no way to tell whether the blood was from the cervix or the placenta, but apparently it was not an amount that we needed to be concerned about yet. But I digress…

Three contractions passed and I asked for the epidural. I knew there was no way I could make it to 10 cm without relief considering it had taken 16 hours to get from 3 cm to “maybe 5" cm. So, the anesthesiologist came in at about 9:00 pm. By this time, I was crying through each contraction and had gotten the shakes. My entire body was shivering uncontrollably. Apparently this is a “normal” occurrence during labor. It sucked. It made it very difficult to hold still to get the epidural, but it was a success and by 10:00 pm I was feeling much better. I could still move my legs and easily change position in the bed. I also could still feel all the pressure and a little discomfort down south. Before the epidural, everything hurt. After the epidural, I noticed that most of what I felt was coming from my back and butt. I told the nurse, and she did a very thorough check of the baby’s position. She told us that Reese was right occiput posterior (ROP) also known as sunny side up. This explained the length and intensity of my labor – Reese was facing my stomach rather than my back making the passage of her head through my pelvis extremely difficult – makes it feel like it’s twice the size that it really is. I was pretty bummed, but determined to continue. Also at this point, Reese’s heart rate began to deviate from the ideal pattern; nothing to be alarmed about yet, but required attention. We went back to frequently shifting positions to see how she was affected.

Dr. Brambhatt came back in at 11:30 pm to check on us. She reviewed all the heart rate data, talked to the nurse about the bleeding that was still occurring, and then checked my cervix (now 6 cm). She said it was time for us to talk. She told us that the bleeding coupled with the heart rate had her a bit concerned. She said one or the other on its own would not worry her, but the two together made her lean toward placental rather than cervical bleeding. She also said there was absolutely no way to confirm it and if I continued to labor, one of two situations would result. One – I could end up with a perfectly normal vaginal delivery or two – Reese could crash and we’d end up with an emergency c-section. She offered an immediate c-section as an alternative to continuing with labor and then left us alone to discuss it and decide what to do.

As scared as I was about having a c-section and as much as I wanted to deliver vaginally, Rick and I decided fairly quickly to have the c-section right away. We were now 20 hours into labor and had only gotten from 3-6 cm so who knew how much longer it could take to get to 10 cm considering her position. They could not give me pitocin to speed things along at this point because of the bleeding; the risk of hemorrhage was too high. That being the case, we thought it unlikely we’d make it to 10 cm before something went wrong if the placenta was the source of the bleeding. After everything we’d been through to have Reese, one mode of delivery versus another was not worth an ounce of risk that anything would happen to her. We let Dr. Brambhatt know we were ready to meet our daughter.

Everything went pretty quickly from then on. The anesthesiologist came back and numbed me up the rest of the way, I signed my consent, Rick got geared up for the OR and we were on our way. The OR staff got me prepped while Rick waited outside. Couple things I will never forget about getting prepped… First is the sensation of falling while being moved from the bed to the OR table. They tip you onto your side so they can slip a sheet underneath to slide you with. Being numb and having no control of your body makes it feel like you are going to crash to the floor. This was a very strange feeling and you can’t help but try to catch yourself despite the staff saying you will feel this way and that they will not drop you. The second had nothing to do with the procedure, but was quite funny! Dr. Brambhatt asked what she could do to help get me ready and one of the nurses said she could strap my legs down. One of the straps was stuck underneath the bed and as she tugged on it to get it loose, Dr. Brambhatt lost her balance and fell down. She didn’t fall hard, and everyone had a good laugh.

Once Rick came in, they got started quickly. I was grateful that things were moving along, as I was anxious about the whole process. I was also still suffering from the shakes and was looking forward to getting some medicine that would stop the shaking after the surgery was done. Rick and I remained focused on one another through the procedure. I was really surprised at how much tugging and pulling I could feel. They really had to work to get her out of there! I have no idea how long that took, but it felt like an eternity to me. None of it mattered though when Rick looked at me and said “She’s out! She’s here babe!” I began crying immediately, especially when I saw Rick tear up too. Reese took her first breath a few seconds later and we got to hear her voice for the first time. Let me tell you – this child has a good set of lungs!

Rick was able to watch the nurses clean her up and within just a couple of minutes, they brought her over to me. It was amazing looking at her, I couldn’t believe she was really there and safe. She was so beautiful and had quieted down as soon as she was wrapped up. The anesthesiologist took several pictures of her and of us with her. At that point, Rick and Reese left the OR so I could get stitched up. It felt like an eternity that I was away from them, and I was glad to see them when I got into the recovery room.

Unfortunately, it took a little while for the anti-shaking medicine took effect and I could hold my baby. Rick was a very proud papa and was clearly in love with his daughter, so watching him with her took away some of the sadness at not being able to hold her myself. I can’t describe the feeling when I finally did get to hold her. Anyone who is a parent knows that moment changes your life forever. Along with sheer joy, the next strongest feeling I had was relief; relief that our very long journey toward parenthood was finally over. We had done it, we had made it through, and we had our baby girl.