Saturday, October 27, 2007

The baby story--the long version

We're finally home, Sophia's sleeping on Tim's chest, and I have a few minutes to play on the computer. So, I figured I better write the story before I forget!

(Editor's note: this is the long version, intended for my personal record and people who have trouble with insomnia. Feel free to check out the bulleted version for the highlights.)

I had intended to post another "still pregnant" post on Tuesday, focusing on some of the things I've learned instead of being all "I'm so uncomfortable, blah blah" again. But when I woke up Tuesday morning, things didn't feel right. I was up when Tim left for work about 7:30, and from then until about 10:30, I didn't feel the baby move. She's usually very active in the morning. Sometimes she would wake me up from a sound sleep with her kicking! When I couldn't get her to move with all of the tricks the books tell you to use (eat something then lie down, get up and walk around, shift positions, etc), I called the doctor's office about 11 AM. After I left a message, I emailed Tim as calmly as I could that I couldn't feel the baby, I called the doc, and they may want me to come in. I didn't feel calm, but I didn't want us both to panic.

He came home about 12, and the nurse called backed back just before he got home. They told me to come in for a non-stress test. I grabbed a quick shower and grabbed anything we'd need for the hospital just in case they wanted to get the baby out immediately. We headed up to the hospital, went to labor and delivery, and got hooked up on the fetal monitors. They instantly found her heartbeat. I was so relieved (and feeling kind of stupid at the same time). She was moving like crazy and doing well, but I couldn't feel her, so she must have moved around a bit. They didn't do an ultrasound, so I didn't know how she was laying, but I could tell it was different.

My doctor came up to check on me. She said to come to my regular appointment the next day (Wednesday at 9:30) and we'd make a plan. She had a look on her face when the topic of induction came up that both Tim and I thought looked like she was really thinking if she wanted to do it right then. But, since the NST was ok, she decided that we'd wait. She was talking about not inducing me until next week, but we both agreed to talk about it the next day. She also stripped my membranes for a third time, since she was there.

We also found out that one of Tim's friends that he's known since high school is a labor and delivery nurse at the hospital. She was great about explaining things and offered to be our nurse when we delivered. The catch was she was going on vacation for her birthday, and she was only working Tuesday (when we had the NST) and Wednesday. So we'd have to deliver soon or hang out for a while :)

After we got home from the hospital, we had just enough time to stop home, let the dog out, and then leave again. Tim took me down to my parent's house to be baby-sat while he went to class. I had dinner there and hung out until he got back from class about 7:15. We then headed over to his parent's house to say hi (we hadn't seen them in a few weeks because they had been in New England), and we left there about 9:30 or so. By the time we got home at 10, we were exhausted.

I had a few contractions right after the doctor had stripped my membranes, but they had fizzled out around dinner time. I tried a few more of the old wive's tales Tuesday night to try and get labor started, but nothing really seemed to work.

Then, about 11:30, I was lying in bed when I started having some contractions. I think they were real--they were definitely uncomfortable--and they seemed strong. I paid attention to them for a while. I tried timing them, but they were still pretty irregular. They were painful enough that I couldn't sleep (plus I was excited at the thought that maybe we were headed for labor). So, about 2:30 AM, I decided to test them and see if they got stronger with walking. I got out of bed and headed downstairs to walk around. And of course, they went away. Even just sitting and watching TV led to no contractions. But, as soon as I would lay down, they'd be back. Final answer: they weren't regular enough to be labor, but they were painful enough to prevent me from sleeping.

So I got basically no sleep Tuesday night. I went back upstairs about 7:30 to shower, and Tim went to work. He asked me if he should come to my appointment that morning. I told him no, we'd just talk induction and I'd fill him in. As I was getting ready to shower, I had a moment of vanity. I had planned to do my hair, shave my legs, put on makeup, and generally try to look nice before I went into labor, figuring there'd be pictures and whatnot. But, since I was so tired Wednesday morning, and I was convinced this baby wasn't coming anytime soon, I just got a quick shower and threw on some crappy clothes, pulled my hair back, and skipped the makeup entirely. Figures, right?

I left about 8:30 to head to my doctor's appointment (rush hour sucks, so I figured I'd need an hour or so). It was crappy outside, and I half debated using the valet parking for labor and delivery, but I decided to be honest and just pay to park in the garage.

Right as I was pulling into the garage, I felt a little pop. It was strange, but I didn't feel any fluid, so I just ignored it. It took me another five minutes to find a spot. I parked, stood up to get out of the car, and felt a huge gush. I had a feeling it was my water breaking, but I also had the thought that maybe my bladder had decided to empty on its own. As discreetly as I could, I grabbed the stack of McDonald's napkins I keep in the car, plugged myself up, and walked to my appointment (about a five minute walk). I didn't think my pants were soaked too obviously, but I wrapped my jacket around my waist and waddled to the hospital as best I could.

I got there right at 9:30 (I try to be a little early, but the waddling was especially slow with the napkins). I signed in, and I leaned into the window and told the secretary, "I have a weird situation. I think my water just broke, but I'm not sure."

She went back and told the nurse, who came out and said that I'm going right out to labor and delivery. She also said that she had told my doctor that my water just broke, and she said my doctor just laughed and laughed.

I was hoping to get a chance to head to the bathroom and see if this was really my water or pee, but I didn't get the chance. I did call Tim and tell him we may be having this baby today, but it depended on the water breaking situation. I told him to wait until I called him back (because that's so easy to do when you think your wife's in labor), but I was really worried it was just pee and they'd send me home.

Well, when I got up there and changed into a gown, I knew instantly it was my water (no need for details). They checked me out, agreed, admitted me, and I called Tim a little after ten to tell him we'd be having a baby today. I was four centimeters dilated, 70% effaced, and -1 station. They said that things should be pretty quick because I was already progressed, so I called my family and Tim called his. I told them we might not have the baby until a few hours later, so no big rush (but again, like I could convince them to wait).

My doctor stopped up about 12:30 or so to check me out and chat. The contractions were pretty regular, but they weren't pushing the baby down. She said we'd start pitocin maybe 3-3:30 if the contractions didn't start things on their own. By this time Tim and my mom were in the room with me, so they kept an eye on the monitors and kept me company. The contractions were strong, but I could breathe through them, so I wouldn't call them painful.

About 2:30 or so a resident came in to check me. She thought she felt a forebag, which I guess is another part of the amniotic sac, so she got the amniohook (with Tim assisting) and re-broke my water. If what I had before was a gush of fluid, this was a waterfall. So again I was told things should start moving quickly now.

Do you see a pattern developing?

We were lucky enough to have Tim's friend come into work from 3-7, and she volunteered to be our nurse. I was way past having any personal boundaries at that point--we even had a student nurse stay with us from 2-11:30 PM so she could see the labor and delivery process--so who cares if someone I know gets to see my cash and prizes? It meant she gave us a lot of personal attention. And she's got a good sense of humor too, which is always helpful.

At 3:30, I was checked and was 4-5 centimeters, 90% effaced, and -1 station. Things were moving, but very slowly, and the baby wasn't coming down. We talked about starting pitocin, but I asked that we place the epidural before the pitocin. I didn't think we wanted to try and insert a spinal catheter while I was having strong contractions. Or worse yet, things would move as quickly as they kept saying, and I'd be pushing with no epidural.

They placed the epidural at 4 (piece of cake), and it was probably what they call a "walking epidural". I had no pain, diminished abdominal sensation, but I could feel my feet and legs (although they still don't let you walk because they worry things could chance any time). They started the pitocin at 4:30. They started me at 2 mu/min and said they could go up every half hour if need be, with the max dose at 20 mu/min. The pitocin got the contractions stronger, and with the epidural, all I felt was pressure and no pain. Totally awesome. Ask anyone in the room at that time, and they'd tell you I was like a public service announcement for epidurals at that time.

At 5:15, I was 5 cm dilated, 100% effaced, but still -1 station. They kept upping the pitocin, and again all I heard was that things would take off soon. At 8:55, I was "complete": 9-10 cm dilated, 100% effaced, and +1 station. They thought maybe the baby was held up on my bladder (I had been getting fluids IV for hours because of the epidural), so they sent all the family members out. They straight catheterized me to drain my bladder, and they warned everyone that the baby could basically slide right out if that was the hold up.

Umm, yeah. That was 8:55 PM. I had already been there for almost 12 hours, and I was constantly being told how quickly things were going to happen. Still no baby.

And the straight cath didn't produce a baby either. They had me just labor on pitocin for another two hours, hoping she'd move down. Not so much. And by now, the pitocin was at 16 mu/min. I didn't have much more room to go--if the contractions wouldn't do it at 20 mu/min, we'd be thinking about other ways of getting the baby out.

Finally, at 10:45 PM, we decided to start pushing. We sent all the family downstairs for real this time. It was showtime. Again, I was told that things should move fast once we started pushing.

Umm, not so much. I started pushing. And then I realized I could feel the head. In the birth canal. And it was not fun. I pushed the epidural button to up the pain meds, but it didn't work. It was then that I realized things could get interesting.

I pushed for what seemed like ages. Tim would hold one leg up, and the student nurse would hold the other. And I'd push. I could feel pain and stretching, but I just tried to breathe through it.

So we started at 10:45 PM. And at 1 AM, the baby crowned. Yes, more than two hours later. No one thought it would take that long. They kept saying, "Maybe the shoulders are stuck in pelvis" and things like that. So I tried pushing in other positions, like pulling on a sheet wrapped around a squat bar with my feet on the bar. That had to be quite a sight, I'm sure. The cool thing about that was that they put a mirror at the foot of the bed, and I could see the top of the baby's head at the end of each push. I couldn't see much of it, and it would disappear at the end of each push, but I knew she was coming.

At 1 AM, the on call doctor came in, and she decided to move things along. (Warning: talk of girl parts). She decided to stretch the opening of the birth canal with mineral oil and her hands during each contraction. That should stretch things enough that the baby should come down faster and without an episiotomy.

Let me explain the pain. During contractions, pre-epidural: uncomfortable, like cramping, but it doesn't last long. During contractions, post-epidural (including transition, the tough part): I could feel a little pressure in my abdomen, but no pain whatsoever. I could talk through contractions, and everyone kept commenting on how I was smiling and laughing. Pushing, pre-crowning: a sharp pain in the birth canal (I kept saying that I could feel her nose or something on the right side jabbing me). Lots of pressure and stretching/burning during the push. But it felt more relieving to push during the contraction than to let it happen without pushing. And in between contractions, I could rest.

And then there was pushing once the doctor got there. The worst pain. Of. My. Life. I felt like I was going to black out from the pain. And there was no rest from the pain. And pushing wasn't relief. I was screaming, and I couldn't help it. Tim kept telling me to open my eyes and see the baby's head. I physically couldn't open my eyes because of the pain. I was drenched in sweat. And all I could say was, "Oh my God, it hurts!" I tried breathing and all the other things they tell you, but the pain level was like nothing I've ever even heard of. Each time the doctor would stretch me, it just multiplied the pain by ten. And I did this non-stop for almost half an hour.

Now, let me take a detour for a minute. To amuse ourselves during labor, everyone in the room was guessing the baby's weight. She had been 6 pounds, 7 ounces by ultrasound estimate at the end of September. She was also smack on for the earlier due date of Oct. 16. Overall, that meant she was 55th percentile for both weight and head circumference.

They say babies can gain an ounce a day or more at the end of pregnancy. So, I estimated she was over 8 lbs 7 ounces a month post-ultrasound, and since she was also overdue for both the earlier and the later due date, I said she'd be over 8.5 pounds.

Everyone in the room, including the doctor, nurses, and every other random person coming through, said there was no way. Just the day before, where I was in for the non-stress test, I had asked my doctor about size, and she said she wasn't concerned. I had measured 42 cm to the top of the fundus the week before (and since I had a little extra padding around the middle from before I was pregnant, I measured 1-2 cm ahead every week). So 42 cm is within normal range for a full term pregnancy (the estimate is 1 cm=1 week gestational age). And even though we only had the month old estimate of weight by ultrasound, they didn't want to check again.

Want to guess how big she was?

Nine pounds, one ounce. 21 inches long. Head circumference of 37 cm.

She was HUGE! As the doctor stretched me right at the end, she could finally feel around the head, and she said I'd need an episiotomy anyway, despite all the stretching. But even when Sophia was born, the doctor guessed her to be about 8 pounds before she was weighed.

Not so much. 9 lbs, 1 oz. They weighed her twice, because neither the nurses or the doctor could believe she was really that big.

And all of a sudden, it was clear why I labored for 16 hours and pushed for three. Her head was gigantic. And my body just had a hard time pushing it out.
Now, a caveat. I don't think she looks like a basketball or anything. She looks two weeks older than every other newborn. She does have round, full cheeks, but she's proportional. Her measurements, for a 40 week baby, put her at the 90th percentile or so for height, weight, and head size. But for a 42 week baby (2 weeks overdue), she'd be about 50th percentile. And her newborn maturity score put her at 42 weeks.

So basically, she was two weeks overdue by her physiology. Which is what I had been trying to tell people. By the end, I knew she was ready, but I also realized that my body couldn't get labor started. If my water hadn't broken, I still probably wouldn't have had contractions, wouldn't have gone into labor, and would still be pregnant. And she'd be even bigger!!!!

Anyway, once she was out, I had something else to think about besides the pain. They put her on my chest right away. I still had pain (especially after the placenta was out--I had a lot of uterine bleeding with clots, and the way they get those out is gross and painful). But I also had a beautiful baby (who I affectionately called "my little porker" for most of the morning). The family came back in three at a time at about 2:30, and they all left about 3:30 AM when we were headed to postpartum. Unfortunately, things were busy, and we were stuck in labor and delivery until 5:15 AM. I hadn't slept since Monday night (it's now Thursday morning), I had eaten one turkey sandwich in a day and a half (and that's only because my doctor overrode the no eating during labor rule and had them get me something about 2 PM Wednesday), and I had just labored for 16 hours and pushed for three. I was beyond exhausted, and so was Tim.

We finally got upstairs about 5:15 AM. By the time they checked us in, did what they needed with the baby, and took her to the nursery, it was 7 AM. We got about 2.5 hours of constantly interrupted sleep, and at 9:30 they brought her in to eat. Surprisingly, the 2.5 hours was enough to at least make me functional again. The rest of Thursday was spent feeding the baby, having family come by, and just recovering. I was in a lot of lower abdominal pain, especially externally, and I was still losing a lot of blood. At one point the clots were big enough that they were talking about starting an IV in case I needed fluid/blood, but things leveled off after that.

Sophia was a doll all day Thursday. We definitely had a learning curve with the breastfeeding, but the nurses were super helpful. And when she wasn't eating, she was a peaceful little angel.

Once all the family left again at about 9:30 PM, Tim and I chilled. He went home a little after 11 to sleep. Sophie had been so calm all day, I planned to have her room in with me overnight (she rooms in full time unless you want the nursery to take her). Not twenty minutes after Tim leaves, she starts screaming bloody murder. I tried to soothe her, and I fed her again. She went back to sleep, but she woke up again a few minutes later and screamed. I tried feeding her again. Just as I was finishing, the nurse came in to take her to the nursery to be weighed. She asked me if I wanted her back in my room afterwards, or if I wanted Sophie to stay in the nursery. I thought about it for a minute, and I felt really guilty, but I told her to keep the baby in the nursery.

For as hard as it was to send Sophia out of the room, it gave me five hours of sleep. They didn't bring her back in to feed until 7 AM. And that five hours made me feel like a new person. I fed her and got her situated, and then I had the nursery take her again for 20 minutes so I could shower. Of course, just as I finish the shower, I hear noise in my room. It turns out my doctor had stopped by to say hi, and they had brought Sophia back. So I threw on my gown and didn't even take my hair out of the towel. I was trying to talk to my doc about things, but Sophie was screaming because she was hungry. That turned out to be the theme of the day.

Tim came back about 11 AM, which was a nice relief. One of my friends who works at the children's hospital pharmacy (attached to the same hospital) stopped by, and Ming and Kim from the lab came by, but each time Sophie would only give me about ten minute's peace between feedings (and I'm still a little weird about flashing boob randomly). Due to car issues, my parents couldn't visit Friday, and Tim's didn't come up till about 8 and stayed till 9:30. And you know what? It was actually really nice to just have it be me and Tim most of the day. I thought I'd be stir crazy or lonely, but once Tim got there, we were our own little family.

He went back home again last night, and I didn't feel bad about sending Sophie to the nursery. Kim from lab, who's a pediatrician, said not to feel bad at all about using the nursery option while I had it. I didn't get quite the sleep last night that I got the night before, but it was still better than nothing. I do have to say--I hope the night sweats end sometime soon. The nurse said they can last a while, but it makes sleeping tough.

Tim came back about 9 AM this morning. Sophie was eating again like crazy, and my milk came in sometime overnight, so now she's getting the real thing. Let me tell you--I knew my chest would get bigger, but I'm about 5 times the size I was when I was pregnant, which was twice as big as I am normally. It's insane!!

We got everything squared away for the discharge, and at 1:30 PM, we left the hospital and headed home. Sophia did well with the ride home, and she didn't seem to mind the change of scenery once we got home either. Macgyver was a little wound up, but I came in the house first, got reaquainted with him, and let him smell Sophie's hat. He was still hyper when she came in, but not aggressive. I had to feed her again almost as soon as we got home. The dog sniffed her the whole time, but no other trouble. I think they'll get along fine.

It's amazing the difference in feeding from even yesterday to today. Yesterday, with just colostrum, she would feed up to 30 minutes on one side, switch and do the same on the other, and then she's hungry again half an hour later. I felt like she never left my chest. Today, she eats for 10-15 minutes on one side and is totally full. She'll sleep for about two hours between feedings and then only spend another 10-15 minutes eating. And we've already had two pee and two poopy diapers since we've been home! Just unreal.

So that's been the experience. She's totally gorgeous. Tim's been absolutely amazing with her, and both of our families have been great and super supportive. Really, other than the tough delivery (and the after effects that go along with it), it's been great. Now, the delivery was tough enough that I'm not real anxious to do this again anytime in the near future. Sophia will definitely be an only child for a while.

Tim and I both look at each other on occasion and think, "They let us take her home?" We're still learning a lot--like how she can pee while you are changing her, soaking her sleeper and the changing pad cover underneath. But, that's what the washing machine is for.

I think we'll be learning for a while. But we do a lot together--change her together, do diapers together, he'll take her when I'm done feeding, etc. It's been wonderful. I know he'll have to go back to work next week, but I'm so glad we'll have at least one more day to learn together.

Tonight is our first night with Sophie full time. I'm scared to death that she'll be too hot or too cold in her crib, or that she'll cry all night and I won't know what she needs. It's terrifying, but it's something we've got to get through. We'll survive it, but I'm not counting on getting a lot of sleep.

But it's all worth it to be able to have Sophia in our lives. She's a little angel.

1 comment:

  1. Okay, I should be fired from my job. I read both the short and long entry! I'm so excited for you guys! I can't wait to meet her! You are going to be such a great mommy!