It’s 5:30 a.m. on Tuesday August 8, 2017. I’d showered, dressed, done my hair, make-up and was in a car, drinking my morning protein shake while I drove to my weekly appointment in Seattle at Swedish Maternal Fetal Medicine. Today was different though, I was scheduled to see Dr. Krabill prior to my slew of appointments at Swedish; I was to have the much needed echocardiogram on Arrow’s heart. As I drove to Seattle I worked hard to settle my nerves. I was afraid that after being admitted just a few days prior due to Arrow’s NST test being less than ideal, that today’s appointment may also not be positive. I blasted worship music and sang along, praising God for the works He has done and is doing; choosing to instead focus my heart on Him rather than on my fears.
I arrived to Seattle with time to take a small walk down the block to Starbucks, treating myself to a Vanilla Soy Chai Latte (my favorite) and a slice of warm pumpkin bread. I sat in the lobby of the medical building for Dr. Krabill, savoring the amazing flavors of my drink and treat while I read my book, with no knowledge of what my day would hold. Soon it was time to check in for my appointment, and I took my relaxing moment to the waiting room of Dr. Krabill’s office. Upon arrival to check-in, I was informed the clinic still had not received my referral from my health insurance. I contacted my health insurance to inquire on the status, explaining to them the urgency and requesting a stat approval. The insurance company said they would place an urgent request to my authorization that was in nurse review for medical necessity, and would call me back. 45 long minutes later insurance contacted me, notifying me the authorization had been approved for one echocardiogram. Unfortunately, it was already too late for me to have my appointment at my originally scheduled time; thankfully the office was lovely and rescheduled my appointment to occur after my tests down at Maternal Fetal Medicine.
I took a deep breath as I walked down to the elevators. I felt frustrated by the delay of my insurance company; I felt frustrated that today was already going to be a long, stressful day and now it was going to be longer. The benefit of the echocardiogram prior to my appointments was the providers I was to be seeing would have been able to also review the results to aid in their decision making with next steps if necessary. Now I would simply have my usual slew of appointments and then find out how the echocardiogram results may change their course of care either via phone call or at my Friday appointment.
I laid on the exam bed, listening to Arrow’s heartbeat - the twice a week NST. The sound of her heart was so lovely to me; it’s amazing how a sound so beautiful was also the major piece of concern for her health. I laid there, listening, praying. Thankfully the NST Tech was able to tell me the NST looked good; Arrow was moving much more how they like to see. The Tech then unhooked me, walked me down the hall to the ultrasound room for the ultrasound to check Arrow’s dopplers (blood flow). I took a deep breath as I crawled up on the exam table in the ultrasound room and said another prayer. The Ultrasound Tech began checking all the dopplers, checking Arrow’s heart and taking her measurements. As usual the Tech left the room to review the images with the provider to ensure they had all the images they needed, only this time she said to me “There is an increased restriction so I need to ensure the doctor doesn’t want additional images.” My heart sank - another restriction. I laid in the dark room, hand on my belly, numb.
The Tech returned letting me know no additional images were needed and she could walk me to the next exam room where I would meet with the provider. I entered the exam room, sat in my seat under the window and stared blankly at the door waiting for the provider. I didn’t have to wait long when Carolyn Ward, ARNP entered my room.
“Tiani, I know you weren’t scheduled to see me, but the other provider is behind schedule so I said I could see you.”
She pulled up a stool, sitting it directly in front of me, looked me in the eyes, and said “there have been some changes with the baby.”
“I know. The tech told me there was an additional restriction.”
“That’s kind of correct. The restriction is actually a reversal of her blood flow. She also hasn’t grown like we like. She is now in the one percentile with only a growth of four ounces in two weeks.”
“Okay.” I didn’t know what else to say. My eyes were welling with tears as much as I was trying to remain strong.
“Tiani, we need to deliver her. Let me step out and see if we are going to have you stay tonight on antepartum with an induction tomorrow, or if we are going to take you to labor and delivery with an induction today.”
I sat in the exam room, phone in my hand, ready to text Aaron when Carolyn returned to my room. She had left and returned in such a quick manner I didn’t even have time to unlock my phone to message Aaron.
“Tiani a nurse will walk you over to labor and delivery now and we will begin your induction and you will be having your baby.”
Carolyn hugged me as she handed me over to the nurse who would walk me to labor and delivery. I was numb as we walked the five minute walk through the building from Maternal Fetal Medicine to Labor and Delivery. My mind was racing… I needed to get a hold of Aaron to get kids and get down here. I needed to contact mom and dad to have them come now since they are in Seattle so I am not alone. I needed to get ahold of work to notify them I will be out on maternity leave effective now. The list of what I needed to do kept me from fully feeling my fear of delivering my daughter at 35 weeks.
As I entered the Labor and Delivery wing of Swedish Medical Center, a nurse, Alix, poked her head out of a room and said “You must be the one I’m getting the room ready for. Come on in.” I entered the room, noticing the gown on the bed as the nurse told me to to change my clothes, get the gown on and she will then begin my vitals while we wait for the doctors to come speak with me about how they will begin the induction. I changed my clothes, got into my gown, laid in the hospital bed and then inquired if I would be able to take a few moments to message my family to get them en route to the hospital. I messaged Aaron, my parents, work and my brothers between Alix taking my vitals, starting my iv and the providers coming into the room to speak with me about the course of the induction. It was chaotic and everything was moving so fast; I had no time to fully process what was happening and within 45 minutes of being told I would be delivering my baby, I was in the hospital room, changed and beginning the induction while Aaron was still two hours north and my parents 45 minutes from being with me. I was going to begin the induction alone, contractions could start and I would be alone… in this moment I chose to not be afraid, I chose to trust, after all what other choice did I have? Being afraid would change the situation or make any of it better. Trusting was about hope, and the whole journey with Arrow had been about trust and hope. There was a reason the providers were moving quickly on starting the induction. They wanted the best outcome for my baby; this meant me being alone for the start of the induction. I needed to find peace with this, for waiting to have my family with me but risk a less than desired outcome would not be worth it. I had to be strong, stand in faith and know my family would be there as soon as they could join.
Strength and standing in faith sounded great in my head while I listened to the provider tell me how they decided to induce my labor - a cervical balloon dilator. She explained a catheter would be inserted up to my cervix where it would be placed and the balloon filled to keep it in place. The pressure of the catheter balloon against the cervix would cause contractions to begin, and the catheter would fall out once the cervix was dilated to 3 cm. If no progress of dilating after 12 hours, pitocin would then be given to assist in contractions.
This all sounded reasonable, until the provider asked me if I needed pain medication prior to them inserting the cervical dilator. The provider asked me how my exam upstairs went to determine if I needed pain medication. I explained it was like every other time I had to be checked to see if I was dialated or effaced (for the record I was not dilated or effaced and baby was -3 at this point). We agreed then I should be alright with no pain medication would begin the insertion. The provider reclined the bed so I was slighting my head slightly upside down; the nurse took my head saying “I will be your nurse and your mom right now.”
I tried to be strong. I tried to breath deep and relax while they inserted the cervical dilator, but I have never felt such intense pain. Tears streamed down my cheeks, I told them it was hurting. They agreed to stop, apologized but said they have to ensure it’s right up against the cervix, so maybe pain medication would be beneficial after all. I agreed. They gave me a pain medication in my iv and then resumed the insertion. This time, I still had to breath deep, focus on a spot on the ceiling and tears still fell, as the pain medication alleviated the intensity of the pain, but didn’t remove the pain.
Once completed, the bed was raised back up, I was covered up with blankets, informed I could feel crampy, and contractions could take a bit of time to start. The provider said she would monitor contractions from the nurses station and will check in on me later. The nurse completed hooking up the fetal monitors while I laid in bed, wiping my tears and feeling the contractions begin all while waiting for my family.
Strength and standing in faith… the induction hurt, my strength felt weak but I continued to hold on to my faith. I kept reminding myself “faith over fear” even in this moment. I chose not to fear the upcoming process, fear if Aaron would make it, fear if Arrow would be able to handle the stress of labor and delivery or any other fear that could surface. Instead, I would have faith… Aaron would arrive with the kids in time, my parents would be there soon, Arrow would arrive safely into my arms, healthy and strong.
I'm a single mom of four radiant kids who believes in relationship with Jesus over religion. I'm trying not to battle with fear anymore - instead I am choosing to follow what God has called me to do. With that you'll find me here, trying to be brave, with the goal of being authentic and honest about God, single parenting and the beauty in the mess of my joyful chaos. It's sure to be a journey... and I am blessed to share it with you!