Monday, April 7, 2014

Baby Rose is Here

Our baby girl is finally here! She's sleeping in my lap as I'm typing this. I'm sleep deprived, have seen more poop in the last week than I have in my previous 24 years of life, and I could not be happier.

Rosalind Elizabeth was born on Monday, March 31st, 2014 at 8:53 PM. She was 5lbs 13oz and 18" long.

I wanted to write my birth story because I had a lot of people asking to hear it, and because I wanted to have it for the future, when details may get a bit fuzzy.

During my last trimester we started to see baby's size start falling behind, according to the fundal height measurement. She had always been a bit small during the whole pregnancy, but had grown at a good rate until about week 34. At one of my later appointments, I saw the nurse practitioner, who wanted to send me for an ultrasound to get a more accurate picture of baby's size.

So, a few days later, John and I went to the hospital for one more ultrasound, where they took measurements of her whole anatomy. After, the radiologist/OB came in to tell us that she was in the 7th percentile in weight. Anything below the 10th percentile was cause for some concern. She explained that ultrasound measurements have a large range for error, and that 7th percentile is a bit of a gray area because she could be small, or she could be a bit bigger than measured and be above that 10th percentile mark. She explained a bit about intrauterine growth restriction (IUGR), and said that it's possible that is the reason for baby's small size. With IUGR comes a big risk of placenta failure, which goes up a lot at 39 weeks, and a risk of baby's heart rate dropping suddenly. She then instructed for us to go back to our OB, who knows me and my history better, to talk about it more and discuss options.

I went home and did more research and talked with some trusted friends in the medical field about the situation. They all told me the same information that the radiologist had told me, and agreed that a 39 week induction was the best course of action. We went back to my OB at 38 weeks and 5 days, and she gave us the option of inducing two days later on Sunday, or waiting a couple of days to see if my cervix would be more ready, and inducing on Wednesday. After reading about the risks and talking to educated people on the matter, John and I had decided that we'd rather not take the risk of waiting, and decided to induce on my 39 week date. My doctor told me labor would be longer and harder, since my cervix was only a fingertip dilated, but we thought it was worth it.

On Sunday evening, we went to the hospital, ready to meet our baby girl. We checked in at 5:30, and they did a couple of checks, hooked me up to the IV, and got the monitors on. I was disappointed that I wasn't able to do the first half of my labor at home like I wanted to, but was really grateful that baby would be monitored the whole time in case the IUGR caused her heart rate to drop.

At 7:00, the OB on shift placed Cervidil, and my long night began.

I was told that the Cervidil would cause a bit of cramping as my cervix would start to open. The OB mentioned that it occasionally starts labor for some women. The Cervidil definitely started labor for me! A half an hour in, I started feeling crampy, but it just felt like bad period cramps. An hour later, I started having irregular contractions. At around 10 PM, I was having true, hard contractions that were picking up on the monitor. There wasn't a clear pattern, but almost all were never more than 20 seconds apart. Most ran right into each other, with just a couple of seconds between them. Occasionally I'd get a break for a few minutes, but the ones after the breaks were the most painful of all.

I used my birth ball and all the different labor positions I learned, along with breathing. John helped tremendously by rubbing my back and helping me move and adjust. The non-stop labor without breaks between the contractions was really wearing me down fast. I'm sure they weren't the super hard ones experienced in later labor, but not having any time between them made the night almost unbearable. By 4 AM, I was ready to give up and had no idea how I was supposed to keep going. At 5 AM, I asked about my epidural. Unfortunately, shift change was coming up, and I'd have to wait for the next anesthesiologist to come on shift, and my OB wanted to check my progress before having it placed.

At 8 AM, 13 hours in, my OB came on shift! I was so happy to see her. She checked me and I was at 3 cm. She was happy with that, so she removed the Cervidil string and put in the order for my epidural. She also told me that I was laboring on my own (no, really??) and didn't need the Pitocin. I continued to labor for over an hour until the anesthesiologist resident came in. After seeing my scoliosis, she left to get the attending to help her place it.

It took them quite a while to get the epidural in, due to my crooked spine. The whole process was miserable. The anesthetic injection burned more than any shot I'd ever felt, but the worst of it was baby up in my ribs. For the epidural, I had to bend over as much as I could to make my spine stick out. It wouldn't have been so bad, except that baby was kicking me right in the ribs the whole time! She did not like being squished in there. I know another reason the anesthesiologists had a hard time getting it in was because they were trying to work between contractions, but only had about 20 seconds between them. They finally gave up and just worked through them, and I did my very best to hold still.

At 10 AM, they finally got it placed, and life was bliss. I couldn't feel anything from the ribs below. I had labored for about 14 hours on my own before getting the epidural, so I felt like I had earned it!

At about 2:00 PM, my OB came in to do another check, and we learned I was at 4 cm. At this point, to try to progress things, she broke my water and told me to get more rest.

A bit later, the nurse came in to tell me that my contractions had started to slow down, so they started me on a pitocin drip. I didn't care, since I was flying high on my epidural and just wanted to get the labor going. At one point, they turned off the drip for about 30 minutes, and then turned it back on, because my body wasn't responding to it and they were trying to give my body a break so I'd respond to it again.

At 6:00 PM, the OB came to do another check, and I still hadn't progressed at all, and was at 4 cm. I was getting nervous at that point that they'd have to do a c-section, and expressed that concern with my doctor. She told me that she'd never give up yet, and still had some tricks up her sleeve. She wanted to do everything possible, and wouldn't resort to that unless she'd done everything else possible, or the baby was in danger. At this point, she opted to place an internal contraction monitor that would help us know the strength of the contractions, and they could control how much pitocin I'd need. At 6:30, they increased the dose and then came in a few more times after that to adjust it.

The increased dose of pitocin made the contractions a lot stronger, and I started to feel them. I called in the anesthesiologist, who gave me another bolus to keep me happy. I then fell asleep for a while, not knowing how much longer it'd take.

I woke up somewhere around 8:20 PM with a very odd feeling. It was a strong pressure down south, and I felt like I needed to take a bowel movement. The nurse came in, and I told her that I felt like I needed to push. She took a look and said, "Well, I think it's time for the doctor to check you. Also, DON'T PUSH." My doctor came in immediately and told me that I was fully dilated and the baby was at +2! I couldn't believe it, since I was only at 4 cm and 80% effaced just an hour and a half before! The nurse told me not to push until they were ready. She then helped me push through two contractions, and baby had crowned. The team quickly made it in the room, and the resident and my OB were there and ready. I pushed through 4 more contractions, and baby girl was here! I only pushed for about 20 minutes. There was all kinds of fluid everywhere, but I didn't care. I could see her, and that's all I cared about. John got to help out the whole time, holding one of my legs and giving me encouragement. He then got to cut the cord after she was born.

They immediately passed her to the NICU team and they did a very quick assessment. They were there in case her small size had caused problems. She looked good, so they gave her to me for some skin to skin. I only had a small, 1st degree internal tear, so there wasn't much that needed to be done on me. I delivered the placenta, and my OB said baby was all wrapped up in the umbilical cord, and that it was unusually long. She thinks being wrapped and tangled up in the cord so much caused the growth restriction.

It's amazing that babies can find the breast and start feeding all on their own. I was given instruction to let her lay there and squirm her way to the breast herself. She found it, latched, and started eating all on her own! That survival instinct was really amazing to watch. After my hour with her, they weighed her and then gave her over to John for his skin to skin time while the nurse helped me get cleaned up a bit, removed my epidural, and helped me to go the bathroom.

It was a great night from there. I couldn't sleep, and I didn't want to. I was up all night with her and loved it.

The rest of the story is pretty boring- lots of hospital staff coming in every 15 minutes to do checks and give me paperwork, spending time with my baby, learning to breastfeed, and eating icky hospital food. Tuesday night was very hard because Baby would not sleep in her bassinet. She wanted to be held, and would only sleep if we were holding her, and would only stop crying if she was on the boob. It made me very tired, since I was the only one that could fulfill that for her. My mom and the nurse both tried to help find a solution, but in the end, I had to stay up all night with her to keep her calm and stop her screaming.

We were very happy when we were able to go home Wednesday at lunchtime. Things settled down a lot more, and both Rosie and I were calmer and had better nights. She still refused to sleep unless she was being cuddled (can you blame her?) but we all took turns and worked out a system. Finally, John used his magic daddy touch, and got her to sleep in her bassinet, and that's where she's been sleeping since. Well, unless I decide to cuddle her, which is almost all day long. At least she sleeps there at night!

To reward you for getting this far, here are some pictures of Baby! They take forever to load on here, so check out my Facebook profile for a more complete album. I'll try to include different pictures here.