William Thomas Garner - Birth Story

October 27th, 2009
3:00PM
Matt is able to come home from work early. We were both sitting on the couch watching TV, when Kim starts having more and more discomfort. We time how frequently the contractions are coming, and they are every 5-8 minutes and stronger than ever.

We call the nurse's line at the Dr's office - we told them she was 41 weeks and 2 days and they called back before even finding her chart. They told us it would be a good idea to come into the hospital for evaluation.

Kim proceeds to shower, put on makeup, and fix her hair; even though she was having to stop what she was doing and bend over in pain every few minutes. Without Kim knowing, I called both sets of grandparents to let them know that things were speeding up and that labor was likely imminent. After finishing up, she was ready for her close-up, Mr Deville. She looked great! We made the trip in the nasty weather to the hospital.

6:00PM
We finally arrive at at St. Mary's Hospital in St Louis. Kim is taken to the maternity triage area and put on the monitor. We waited there for about an hour while being examined by nurses, students, residents and finally the attending. He said that everything looked good and that we could either go home or stay at the hospital. Her contractions were becoming more intense, and we all agreed it would be best to stay and keep a close eye on things overnight. William (although not yet officially named at this point) was having mild deceleration, or a decreasing of his heart rate, after every few contractions. At this point everything looked normal, but it justified our staying. Kim was wheeled over to the Labor and Delivery room around 8:00 PM. We were hesitant to induce labor, so they agreed to just observe us for a while before starting any labor inducing medicines.

10:00PM
Overall, everything looked good, but we couldn't just use the hospital as a hotel. They would give us a few hours to push on our own, but Pitocin would have to be started eventually. By this time, all of the admission paperwork had been completed, evaluations were done and an IV line had been placed. The Pitocin (which stimulates STRONG contractions) was started and the pain with each contraction increased significantly. Kim suffered through that for about 30 minutes when she decided that an Epidural would be a great idea. Having both worked in hospitals, we knew how long things could sometimes take. We let the nurse know, and a quick 2 hours later it was in, and she could finally get some rest. By 12:30AM the line was in, Kim was back in bed and everything seemed to be going pretty smoothly.

October 28th
12:45AM
While Kim was finally getting some well-deserved rest, Matt was warming up to his roll of "spousal observation", rather than his usual "health care provider". Responsibilities of this new roll included staring at the monitor keeping track of contractions and the baby's heart rate, especially looking out for these decelerations as noted earlier.

About 15 minutes after the business of the epidural settled down, there was another deceleration; this time the baby's heart rate dropped to around 60 bpm for about a minute, rather than just 10-20 seconds like before. We called the nurse and moments later the room was filled with about 10 residents and nurses. It wasn't clear if the monitor was getting the baby's heart rate, or if he moved and it was getting Kim's pulse. They decided to artificially rupture her fetal membranes (break her water) and place a pulse monitor on little Will's scalp, which is more accurate than the abdominal monitor. They also informed us that if these decelerations were real and they continued, a Cesarean section might have to be performed. While we wanted to do anything to avoid placing our tiny guy at risk, it was frustrating that we had gone the entire 9+ months without any real problems, and now were being told we might have to get a c-section.

Until about 06:00 AM we were in a constant state of anxiety about what would happen, how the baby was doing and whether or not Kim would need this abdominal surgery. Four more times we had decelerations that morning, and each time they lasted for about one excruciatingly long minute. But each time his little pulse came back up to the normal range between the little red lines. We prayed that God would keep the three of us safe, and that he would give wisdom to the doctors taking care of us.

6:00AM (24 hours after waking up)
We waited for labor to progress throughout the night. Kim was able to get some rest, but Matt was forced to rest on a reclining chair and stare at and listen to the heart monitor. Every couple of hours they check Kim's cervix for progress and also her vital signs for any changes.

Over the course of the morning Kim would have about 4 more decelerations, each lasting almost a minute and down in the 60-70 bpm range. The residents started making preparations for a possible c-section including going over risks and benefits. Something we had both done for our patients, but was quite different from this perspective. Because it wasn't an emergency, we requested the attending Ob/Gyn give us his opinion; this may have been annoying and/or overstepping our boundaries somewhat, but I felt that if I could ever take advantage of what "pull" I had as a medical resident, this was the time, the birth of my son.

Dr X (I can't remember his name, but it really did start with an X) reviewed all of the monitor strips from the evening and told us that what had been going on were perfectly normal decelerations, which were probably caused by some kind of compression of the umbilical cord with Kim's contractions. Unless they started lasting 4-5 minutes, or began occurring with every contraction, a c-section would not be needed. Needless to say we felt relieved by his reassurances and we also felt that our prayers had been heard, especially since the rest of the delivery went so well.

At one point Kim developed a fever. Since her fetal membranes had been ruptured for some time she was a risk for developing choreoamnionitis since the inside of her uterus was now exposed to the environment. Left untreated, an infection could cause lots of problems for both her and the baby, so antibiotics had to be started. This would also later mean that William would need antibiotics until he was ruled out for infection as well. At first he had an IV in his leg, but after a day he kicked it out and another one had to be placed in his head! :( Poor little guy went through so much those first few days, then he had get what looked like a little antennae. Her fever actually raised the baby's pulse to upper limits of normal (160-170's) which was still safe and actually helped avoid the decelerations, which had been an ongoing problem.

Nurses continued to check her progress and she slowly dilated to that 10cm goal. Dr Dubas, Kim's Ob/Gyn, who was a wonderful doctor, arrived around 9:00AM just to check on Kim and her progress. She came up to the hospital specifically for Kim's delivery, even though it wasn't her day to be at the hospital. She confirmed what we had been told by the nighttime attending that we wouldn't need a c-section and that everything looked good.

10:30AM
By this time I had finally gotten a second wind and was getting ready to get some caffeine. I was headed out the door when the nurse came in to check Kim again, and I decided to wait to see if there had been any change. She announced that Kim was fully dilated, and we needed to start getting ready to push. I remember saying "OK! I'm going to get a mountain dew then". After chugging some sugar and caffeine, I returned to our room to find our nurse, Helen and the residents prepping the room for delivery. The nursery nurses were staring to arrive as well as the OB nursing students, the residents and Dr Dubas. At 11:10 Kim started pushing and by 11:30 little William had been born.

The doctors put me at Kim's left side, and I was to help hold her leg and let her squeeze my hand. The routine was: for every contraction, Kim had to give three, 10-second pushes before taking a break until the next contraction. Kim only had to go through 5-6 cycles total. She had been working out through her pregnancy and Dr Dubas was bragging that Kim would be a good pusher because of it. Because of the buildup and Kim wanting to impress the audience now staring at her, she took a deep breath gave a BIG first push... Maybe too big. Kim just remembers not being able to hear what Dr Dubas and I had been saying to her. Apparently she felt like she had almost passed out!

Fortunately that feeling got better right away and never returned. The rest of the pushing went great and moved really fast. Before you knew it, his little head had popped out. Part of the cord was wrapped around his shoulder and they had to lift the cord around a little bit quickly. This was probably the reason that Will had been having the decelerations throughout the night. Everything was happening real fast, and before you knew it he had been born.

11:30AM
William Thomas Garner entered the world!
Although not yet named (we would officially name him the day we left the hospital) he looked and sounded wonderful. Matt was able to cut the umbilical cord and the baby was passed off to the pediatric nurses. Since Will had passed meconium while in utero they were aggressive with his initial suctioning. For the first 10-15 seconds he didn't cry right away. I told Kim "I'm sure he will be alright" and we both teared up a little. Dr Dubas agreed that it is common for babies to not cry right away. Almost immediately after that little William began hollering! Wonderful little cries and gulps of air that sounded incredible.

Instead of calling grandparents to tell them he had been born, I thought it would be a good idea to let the baby tell them. Both sets of grandparents were on I-44 driving to Saint Louis from Tulsa. I called and let them listen to his crying and both grandma's started laughing and crying right away! After his APGAR evaluations they wrapped him up and let his Daddy hold him for the first time. I took him over to his Mommy and we both agreed that he was the best little baby ever!

We were exhausted from the long night, happy that he was healthy and amazed about the whole event. In one wonderful moment we realized that our lives were changed forever and we both felt so incredibly blessed. The next hour or so was over in a moment. The doctors finished up with Kim and Matt kept a close eye on little William.

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They then had us change rooms from labor and delivery to the postpartum area. Our best friends Brandi and Tory showed up to meet Will and to bring us sandwiches and beautiful flowers. They also arrived just in time to help us move all our stuff to the new room. As they wheeled Kim and the crib William was in, they played a lullaby over the hospital intercom so the whole hospital knew he had been born. They initially moved us to a double room, but when they realized that we had so many visitors they thankfully moved us to a private room. Next the Burns grandparents arrived - you have never seen such a happy grandpa and grandma! William was in the nursery at that time getting his first bath and shots so we walked down to the nursery to look at him. Kim couldn't yet walk by herself because the epidural hadn't fully worn off, but they brought him back in the room so we could all be together.

Next the Garner family arrived, Grandma Tracy, Grandpa John and Uncle Michael. Grandpa Garner wore a special baby blue shirt. Everyone was so excited to meet little Will. We told them everything that had happened and showed everyone all the pictures and videos we had taken, and we took plenty more.

It was amazing how fast everything happened that first day. I didn't end up getting sleep until 40 hours after I had woken up the day before, which is about 10 hours longer than even my post-call days at the hospital. Needless to day I was tired. That evening I didn't even get up when Kim started feeding Will. I slept through tons of checks the nurses made on Kim and Will that night, and the next morning the Fire Marshall came into the room to check the fire alarms/sensors and I didn't even wake up for that. When I did finally wake up, I found that the grandparents had brought breakfast and mom and baby were doing really good.

Will had been latching on pretty good for his first day, but the lactation consultant noticed that he seemed to be a little tongue-tied. His frenulum (that little piece of tissue underneath your tongue that connects it to the bottom of your mouth) would need to be clipped. Our resident said that she hadn't ever done one, and didn't want to try it by herself. I agreed, and asked that the attending do it, and if I could watch it done. A while later, our nurse ran in and said that she had to take Will to the nursery right NOW. The attending physician in the NICU had come down to the general nursery, JUST to perform the procedure on our baby. This was kind of a big deal, in that the NICU attending hardly ever came down for this sort of thing.

I had never seen one before and didn't really know what to expect. I walked out the the nurses station and casually watched the activity inside the nursery, and tried to keep an eye on William. All of a sudden two residents popped out and said that it was done. The doctor had just slipped her fingers under his tongue and popped the little membrane - she didn't even use any instruments. Will didn't cry at all until afterwards when they wiped away a small drop of blood a few minutes later. The attending came out and shook my hand and told me everything looked great. There were no problems she could already tell he had better tongue movement, which would help with his latching and breastfeeding. And it really did help. Afterwards he did great with all of his feedings, even if daddy slept through some of them. :)

We were there for almost three full days. It was great having friends and family there for such an important event. The whole thing is kind of a blur, and even now some of the details are a little hazy. It was great having a private room, so that I could stay the night with Kim. Things were made a little difficult because of a new policy the hospital had established. Since H1N1 flu has been going around, only two visitors at a time could be in the hospital room. So we had to spend a lot of time shuffling people between our room, and the open-use family room. Even with five famly members visiting Me and Kim plus baby, everything worked out pretty well.