Gestational Hypertension Emergency Induction + NYC Birth During Covid
Ashley’s First Birth
During her first pregnancy, Ashley planned for an unmedicated hospital birth at her hospital’s natural birthing center. Ashley only has one kidney as a result of a Wilms tumor at birth and received close monitoring for pre-eclampsia due to gestational hypertension. She was induced at 39 weeks, 5 days due to consistently high blood pressure readings. She was induced with Pitocin and labored well for 15 hours with the support of her husband and doula. Her water broke on its own around hour 8. She didn’t know her son was posterior, which caused the nurses to be unable to successfully monitor his heart rate with the traditional monitor. After 3 failed attempts to place an internal monitor, the OB on call required Ashley to labor in the hospital bed. At that point, she requested an epidural after learning she was only 4-5cm.
Labor progressed fairly quickly at that point and she was ready to push around 3pm. During this time, the OB on call was rushing back and forth between Ashley’s room and the ER. Another patient of the practice had come in with an ectopic pregnancy and needed emergency surgery. This was rather chaotic and most of the 2.5 hours spent pushing was with the nurses and her doula. Due to his posterior position and the epidural wearing off, Ashley experienced excruciating pain during transition and pushing.
Because the OB on call ended up in emergency surgery, her OB rushed in from her home an hour away to come deliver her baby. The nurses didn’t think her OB would make it in time, so they called an attending and resident in to deliver Ben. They attending didn’t think Ashley could deliver the baby without help, so she received an episiotomy without her consent from the attending as her OB ran into the room. The baby was crowning at that point and he was delivered quite quickly. The resident nearly dropped her son as he was delivered. Ben was born at 8 lbs 4oz. Ashley lost as significant amount of blood and had to have retained placenta extracted manually. She also tore in addition to the episiotomy.
Ashley had a pretty rough recovery from the episiotomy and tears. Benjamin struggled to gain weight in the first few weeks home from the hospital. He was diagnosed with a lip and tongue tie when he was 2.5 weeks old. Ashley struggled with breastfeeding throughout the first year. We were blessed by donor milk and nursed until Ben was 14 months old. Between his traumatic birth and their breastfeeding struggles, Ashley waited until Ben was almost 4 to get pregnant again.
Ashley’s Second Birth
Ashley got pregnant with Cara in September 2019. The pregnancy was pretty similar to Ben’s with blood pressure issues, but nothing terribly concerning. We went into quarantine as Ashley neared the 3rd trimester. She feared her husband and doula wouldn’t be able to join her for delivery as many hospitals restricted visitors. She shared her concerns on Bryn’s zoom calls and received immense support from the Birth Hour community. Protocols changed regularly, but she was able to have her husband and doula attend Cara’s birth due to executive orders signed by New York’s governor. Ashley was induced again at 38 weeks 2 days for high blood pressure.
Labor went much quicker this time and lasted exactly 6 hours from the start of pitocin to Cara’s arrival. Pitocin began at 6:30am and her doula arrived at 9am. Her OB broke her water at 9:30am at 4cm and her husband arrived shortly thereafter. She asked for an epidural around 11am and it was placed by 1130am. Her OB checked her once the epidural was place and she was already 8cm. By noon Ashley was feeling intense pressure and thought her catheter wasn’t inserted properly. Her doula went to look for the nurse and her OB came running in and told her to stop pushing. It turns out the baby already was crowning. Cara was delivered in a few pushes and no tearing. Ashley hardly pushed and felt her body did nearly all of the work on its own. Cara was 8 lbs and 6oz.
Ashley had an easy recovery and felt amazing postpartum. They were discharged at 24 hours post-delivery as a result of Covid protocol. Cara ended up having jaundice and being admitted to the NICU for two days to get her bilirubin levels back to normal. Between Cara’s lip and tongue tie and the unexpected NICU stay, Ashley struggled again with breastfeeding. Thanks to the support of her amazing IBCLC and donor milk, they’re still nursing two weeks before Cara’s first birthday.
Ashley Espejo Bio
Ashley lives on Long Island, NY with her husband, five year old, Ben and almost one year old Cara. She also has a 19 year old stepdaughter, Darlene. She is a tax manager at a private equity fund in New York City. Ashley loves hanging out with her family, going to the beach, coffee and riding her peloton. You can connect with her on Instagram at @Mrs_espejo and on Facebook.
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