Saturday, December 29, 2012

He's here!

Baby C was born Tuesday, December 18, at 9:54pm about 48 hours after we started the induction process. He weighed 8lbs 5oz, 20.75 inches long. He's perfect and even the doctors and nurses admitted he's an incredibly cute baby.

The birth story (lots of detail to help me remember! And written over a few sessions, so possibly a bit repetitive):

Sunday night we arrived at the hospital at 7pm to be induced. Got our bags unloaded and settled into the room. Our hospital usually has patients stay in the same private room for labor, delivery and recovery, unless things get really busy.

Around 8pm, I went on monitors (for me and baby), and around 8:40pm the nurse inserted Cervidil to ripen my cervix. (I'd been 70% effaced and about 1cm dilated for roughly 2 weeks.) The nurse was nice but not super competent - she botched a blood draw and ended up calling a lab tech to come do it, and the Cervidil insertion was extremely uncomfortable. At 9:30 I felt crampy, and at 11:30 I was feeling contractions - not super strong, but by 2am they were about 5 minutes apart. I wasn't really able to sleep much - the hospital environment isn't conducive to it, and at 2am the contractions were distracting enough that I gave up trying. At 6am we started doing laps around the hallways and the contractions continued to get stronger.

At 7am Monday I got an awesome new nurse, and at 7:30am my doctor visited and check my progress. Of which there was none - still 70% effaced, and about a cm dilated. Ugh. He decided to leave the Cervidil in until noon when he would return to check me again.

We did laps all morning, I took a shower, and rested (but didn't sleep). I noticed a rash on the inside of my thighs - maybe from the Cervidil? or the lubricant the nurse used to insert it? The shower helped clear away whatever was causing it, but it was sensitive for about a day. I also had some vaginal pain, which may have been a internal version of the external rash. Never figured it out.

I wasn't hungry, but had some fruit and drank a protein juice drink and had a cookie. I'd baked cookies all weekend and we doled out plates of cookies throughout out stay which the nurses loved.

More laps, more time in room. Baby was doing great on monitors the whole time. My doctor showed up around 2:30 instead of noon, which was annoying. He checked me again, and I was 1.5cm dilated, and my cervix was still posterior. Ugh.

The doctor inserted a foley balloon, which threads through the cervix and has balloons on either side of the cervix that are inflated with saline to encourage the cervix to open (mimicking the pressure of the baby's head). It was very uncomfortable going in, and started stronger contractions.

I was monitored for 20 minutes in the room afterwards, and then allowed to walk around again. Contractions were definitely stronger (I called them a 5 on the 0-10 scale) and I got a little teary because they were coming fast. I took a 20 minute shower which felt great.

My fabulous nurse left (sob) at the end of her shift at 4:30.

My contractions were easier to handle after the shower. I was sitting on the side of the bed for a vitals check with the new nurse, and all of a sudden was sitting in a puddle. I thought my water had broken! But when the nurse checked it with a pH strip, it wasn't amniotic fluid. Turns out I had sprung a leak in one of the balloons! (Quite unusual.)

My doula arrived around 7pm - my contractions had gotten strong enough with the foley balloon that I knew I'd need her help during the night.

My doctor came back at 7:30pm and removed the foley (no discomfort), confirmed it had been the source of the leak, and broke the amniotic sac (also no discomfort).

My doula suggested trying some new positions - she'd brought a birthing ball, so I sat on the ball and leaned on the side of the bed. The first contraction was... dramatic. While I'd felt some water leak after my doctor broke the sac, it was nothing like this - I gushed hot fluid all over the ball and the floor. It was really funny, and I got a big case of the giggles. I had bloody show at this point (never saw a mucus plug at any point, though).

Contractions started getting stronger, and more sudden. I leaked fluid here and there all night long.

9pm-10pm I tried a lot of different positions. Contractions were now a 6 out of 10 in intensity. They weren't painful, just intense and uncomfortable.

Midnight check by a new nurse showed I was still 3cm, and maybe a little more effaced. Monitoring overnight was terrible (baby and I were doing fine - the wireless monitors kept getting out of position and the nurse wouldn't notice). We got good at fixing and resetting the monitor ourselves.

Got a new nurse at 7:30am who was also great - took me a bit to get used to her style, but she was awesome. She checked my progress as my doctor was in surgery, and I was STILL 3cm and about 90% effaced. I was so worn out after a hard 12 hours of contractions that I decided it was time to get an epidural. Amazingly the anesthesiologist was right outside (probably the nurse had anticipated me) and I got an epidural about 10 minutes after deciding to. It felt weird going in. After it took effect, it was amazing - I could feel a contraction but they didn't hurt. And it was a very precise epidural - I was numb from the bottom of my breasts to the bottom of the belly. My thighs were sorta numb, but I could move my legs (and by the time I was pushing my legs weren't numb at all).  It was apparently a pretty low dose epidural, and I had a button to top it off which I could use every 10 minutes.

I got about 90 minutes of napping before they started the Pitocin. I started feeling pressure against my cervix, but not the contractions. I got itchy and had some shakes. By early afternoon I was 7cm dilated and 90% effaced and around 3pm was 9cm and 100% effaced. The nurse guessed it would be at least two hours for the baby to descend.

I napped a little more - eyelids felt heavy. We increased the epidural strength a little in the early evening.

New nurse at 7:30pm. I didn't have great chemistry with her (this was consistently true of the night nurses - some were more competent than others, but none were great). At this point I was fully dilated and she told me I could push a little but that it would take awhile for the baby to descend - he was still at about -1 station. About 15 minutes later, she went to call my doctor as she was seeing his head everytime I pushed. Finally something went more quickly than expected!

The doctor arrived which started two hours of pushing. He did a lot of perineal massage during pushes which I hadn't anticipated and was often uncomfortable. The took out the cathether that I'd had in all day post-epidural. I popped capillaries in my eyes, and left finger bruises in my legs while pushing. Initially my doctor thought it would be pretty fast, and the pediatrician arrived maybe an hour in, and my husband got gown and gloves (he wanted to 'catch the baby').  I pushed hard for pretty much the whole two hours. And when his head finally came out, it wasn't particularly noticeable - I think because he'd been so close for so long. (I did want to kill the nurse earlier when she talked about the ring of fire about 15 minutes into pushing... I think I said 'this is NOT the ring of fire' and later said 'THIS is the ring of fire', though honestly it was all hard and no single part stands out in my memory. At some point in the pushing I was given an oxygen mask - I assume because the baby was getting a little stressed.

My husband did deliver the baby - after the head came out, the doctor instructed him on how to move the baby so the shoulders popped out one at a time, and then the body. I had sort of expected the body to be an easy push after the head, but it was still a big effort.

My husband put the baby on my mid-section, and I reached down to get him. We waited for the cord to stop pulsing before the cord got cut (which my husband had no interest in doing). And then we had about 20 minutes of the three of us meeting each other. We let the baby root around on my chest to find my breast, which was pretty amazing. He was really alert, and I have a fantastic photo my doula took of me and the baby looking at each other.

While we were bonding, the doctor and nurses were massaging my abdomen pretty hard. I got a few stitches for a first degree tear. And after about 25 minutes, my doctor realized my placenta wasn't detaching. So the pediatrician took the baby to get cleaned up, and my doctor started working on me. Initially it was heavy massage and some gentle tugs on the cord, but pretty soon I got a dose of fentanyl, and lots of doctors and nurses started showing up. The fentanyl made me pretty out of it, though I was still feeling really uncomfortable, and I was (in my head) annoyed at how many nurses seemed to be in the room. (My husband says it was something like 3 doctors and 4 nurses.) I eventually got another dose of fentanyl, and after about 90 minutes, my placenta was finally out (in two pieces). Apparently it was pretty messy, and I lost a bunch of blood. My poor husband was really freaked out - he was sitting on the daybed with the baby watching them work on me.

They wanted to put my catheter back in afterwards but I really wanted to avoid it  so the nurse said if I could get to the bathroom and pee and not pass out, they could skip the pacifier. Well I got to the bathroom with their help, couldn't make my body pee, but didn't pass out, so they let me be.

As I mentioned, the hospital usually keeps patients in one room, but my room was so messy after the placenta extraction that they wanted to move me. However there were 5 babies born that night, and they didn't end up having a different room for me. Someone came to clean up but didn't do a very complete job...

I was woozy and managed to sleep a bit. Bringing me up to something like 6-7 hours total sleep since arriving at the hospital on Sunday night.

In the morning, all the grandparents showed up to meet the baby. I breastfed throughout the day, and ohmygod was it painful. The nurses and lactation consultants who checked the baby used words like piranha and barracuda. I called him Shark Boy. (A week later I had an appointment with a lactation consultant who helped me improve the latch, so I'm no longer in tears every time I breastfeed.)

Wednesday night he was weighed, and was down to 7 lbs 12 oz which was an entirely normal 7% weight loss. The night nurse, however, was telling me I should pump and supplement, which was crazy. And my doctor stopped by to say hello and confirmed she was crazy.

The hospitalist pediatrician, who was amazing (we checked to see if she also had office hours for patients, but alas she's only in the hospital), said he was doing fine, but when we checked his bilirubin levels they were elevated.  We'd also checked for infection since my waters had been broken more than 24 hours before I gave birth - all good there.

We went home on Thursday night, after Baby C spent the afternoon under bili lights for the elevated bilirubin levels. That was really hard, because he was under the lights in goggles, which he hated, and just a diaper, and we couldn't really comfort him. I could only breastfeed him 30 minutes every 3 hours. And he was so upset by the goggles he'd scoot his way up in the bassinet until he could rub his head and dislodge the goggles, which would then smush his nose. We'd fix it, reset him, and it would start over.

Friday we had a pediatrician appointment to recheck bilirubin levels. His weight was up to 7 lbs 15 oz, and thankfully his bilirubin ended up being stable (which is great since the risk is based on level vs. hours since birth, so he was becoming lower risk as time passed. She asked us to schedule another appointment on Sunday to get him weighed and to make sure the jaundice hadn't gotten worse.

Sunday the jaundice was fine - but his weight was down to 7 lbs 2 oz. Which wasn't good. Apart from the weight, he was doing well - no personality shifts, breastfeeding regularly (although my milk had only come in about 2 hours before the appointment), having wet and dirty diapers. So the doctor told us to supplement 0.5oz with every breastfeeding session, and to have another appointment on Monday to see if he'd gained.

We supplemented two feedings with formula, and I started pumping after breastfeeding so we could supplement with breastmilk after that. Monday he'd gained more than 2 ounces! So we were able to stop supplementing. And Wednesday, when I had the lactation consult, he'd gained another 3 ounces, so our next appointment isn't until his regular 2 week appointment.

I'm not pumping now, since I'm trying to let my nipples recover, but will probably start up again in a week or so since I want my husband to be able to bottlefeed expressed milk starting at 4 weeks.

So we're home and settling into our new life as a family of 3! My husband has been great with the baby - even in the hospital he was really good at soothing and handling the baby. I didn't change a diaper until day 4 or 5!

A few observations about the hospital experience:

  • The day nurses were universally better than the night nurses.
  • Birth is a lot gooey-er than I expected.
  • Bring your own toilet paper and Kleenex to the hospital - single-ply is not your friend.
  • Sleeping in the hospital is nearly impossible.
  • Nursing in the hospital is really uncomfortable - hospital beds aren't good ergonomically, and you don't really want to be sitting in a hard chair right after giving birth. I wish I'd brought my nursing pillow.

Thanks to everyone for their support along the way - it's been a long journey - more than 5 and a half years since we started trying to have a child, and it's amazing and surreal that he's finally here.

Monday, December 10, 2012

38 weeks plus

Neglected to post on Saturday, when I actually hit 38 weeks...

So a few exciting things happened since my 37 week post.

I had an ob appointment last Wednesday for monitoring. The non-stress test went fine, as always, but my blood pressure was elevated (something like 118/86). And my feet are really puffy. They really want the lower number to stay below 90, and my doctor was worried I might be developing preeclampsia. So he asked me to go in on Saturday morning for another round of monitoring, and we'd make a decision about inducing earlier at that point.

Saturday morning went in and my blood pressure was normal. Like, pre-pregnancy normal. And the baby passed the non-stress test with flying colors (as always - he's a super wiggler). So no reason to speed up the induction, but my doctor asked me to come in Monday morning for another round.

Went in this morning, and NST was fine and blood pressure is fine (not as low as Saturday, but normal for pregnancy).  Still about 70% effaced, maybe slightly more dilated than last Wednesday, and soft cervix.

Last Wednesday my doctor was pretty sure we'd end up inducing by now, and now he thinks we may make it to this weekend as originally planned. I go back in on Wednesday for my regular appointment, and if all still looks good, we'd likely induce Sunday night.

The uncertainty has been challenging, particularly for my husband who's trying to get work stuff wrapped up before paternity leave, but despite not having a solid date, it's all for good reasons - baby is doing well and I'm doing well. And if we can keep him in until 39w (which we'll hit on Saturday), his risk outcomes are the same as for a 40w baby.

That said, since the version, I am dramatically less comfortable. The puffy feet mean I can only wear flip-flops or my Mephisto sandals (and I really wanted to not be the pregnant woman in flip flops...), and the baby's movements, which have always been vigorous, sometimes take my breath away. We took a (probably too long) walk on Sunday morning, and I'm super sore from it - ankles and shins are hurting (damn flip flops). On the plus side, I had a fantastic prenatal massage this morning which hopefully helped work some of it out. My massage therapist thinks my body is ready, and guesses I'll go into labor pre-induction (hope she's right!)

Had another acupuncture appointment today to try to get labor started. I ended up queasy afterward, which is not a usual acupuncture reaction for me. Hoping it's an early labor signal.

One thing that's really been annoying me is that when we've told family about the pregnancy-induced hypertension (PIH), the reaction is 'eat less/no salt'. Not only does that not affect PIH, it implicitly blames me for it, which I resent. I am eating extra protein, and trying to stay well hydrated (snagged the giant mug from the hospital when we had our version - I try to drink 3 of them a day), but it's a placenta/immune system thing, not a salt thing. Grr.

The nursery is all set up except for a bookcase that's arriving this week and will go under the window. Photos, as promised!

I made caramels to bring to the nurses at the hospital (if we have advance warning, I'll bake cookies instead and keep the caramels for us. :) All our Christmas presents (that have arrived, at least) are wrapped and under the tree. (My husband and I aren't exchanging presents this year, but we're still doing big presents (as opposed to stocking presents) for immediate family.)

Less than a week to go, and could be any day now! A friend of mine had a baby 10 days ago and I met him last Friday when he was a week old. Crazy that I'll be there so soon!

Saturday, December 1, 2012

37 weeks!

What a huge milestone! Officially full term. And only 2 weeks to go until we're at least being induced - crazy!

Today was the last day I had something scheduled that I really wanted to get done before the baby comes. I've been telling my little guy that he's welcome to come anytime starting tomorrow (Dec. 2).

**pregnancy complaints coming up**

I'm remarkably less comfortable now that he's head down. I mean, I'm completely relieved that he turned in Thursday's version, but now when he moves it's his whole body moving around, and it's often uncomfortable. And my feet/ankles are consistently swollen (and uncomfortable at night), and my hands continue to be quite painful. But my energy level continues to be good despite getting pretty poor sleep (I can't remember the last time I felt like I had a good night's sleep... I joked today that I'm about to go from good quantity/bad quality to bad quantity/good quality sleep.

I've gained about 30 pounds at this point - I'm sure some of it is water looking at my lower legs/ankles/feet, but otherwise it's all in my belly/chest. People are saying I look much bigger all of a sudden, though I don't have that self image. I do feel more awkward, and it's harder to do things.

**pregnancy complaints over**

The nursery furniture is set up, and the wall decal and mobile are up. (I promise I'll post pictures soon!) Now I'm doing loads of laundry with tiny clothes - incredible and emotional. Hospital bag is in progress.

Our lives are going to completely change so soon! We can't wait!