The birth story

Little man is 3 weeks old today.  Seems like if I don't get this birth story written soon, it may never happen.

Read at your own risk (menfolk).  As with any birth story, there is talk of potentially icky things.

Prologue
For those of you what may not know my back story, this was my third birth.  My first birth, 4 years ago, ended in an emergency c-section after 2.5 hours of pushing.  The OB who performed the c-section later referred to it as "Vaginal birth with C-section".  You can read about it here and here.  I spent the next 3 years blaming myself for the c-section, thinking I wasn't pushing effectively because I got an epidural.

So for my next birth, 1.5 years ago, I planned very carefully.  I decided I wanted a VBAC, and was told I was a good candidate for it.  I switched to a small practice with an exceptionally good VBAC success rate.  I hired a doula.  I had the birth I wanted in the beginning, arriving at the hospital 8 cm dilated.  I didn't get an epidural.  At first.  But after an hour-and-a-half of pushing, I was shaking so badly I knew I wasn't effectively pushing, and ended up with an epidural.  This was ultimately a good decision.  After 2 more hours of pushing, she was born.  But not without a lot of drama that very nearly resulted in a repeat c-section.  It was almost exactly like my first birth.  With that experience, I forgave myself for my first birth and moved on.  Recovery was better than the first birth, but a VBAC was not the magic bullet I had hoped for.  The full story of Greta's birth can be found here.

And then this guy.  I spent the last few months of pregnancy facing great indecision on whether or not to have a scheduled c-section.  Although a lot of the midwives were fond of telling me this birth would be totally different because I'd done it once, what they did not seem to recall is that they'd told me the same thing last time.  I was so very close to a c-section last time.  If this guy was a bit bigger?  Or later term and under greater distress?  I knew my chance of a c-section was fairly high, despite what many of the midwives told me.  I did have one who had a frank discussion with me, and said "It's clear you don't have easy births, and whatever you decide is entirely understandable."  It was so nice to have someone acknowledge that (and she ended up being the midwife who was at Teddy's birth).

I ended up deciding to go for the VBAC, because I just couldn't bring myself to not even try.  I knew I'd jump to a c-section fairly quickly if it looked like I was heading that way, though I also knew it'd be a hard labor no matter what.  I don't have easy labors.  That's how it is.

I stumbled on this article a few days before my due date.  I have a tendency to search the scholarly literature when I'm in late pregnancy.  It is a nice review of the VBAC research, and points out the interesting statistic that women who have an emergency c-section after they have fully dilated have only a 13% VBAC success rate in a subsequent pregnancy.  Seriously.  This made me feel like a little bit of a rock star for Greta's birth, but also made me wonder why I was told I was an "excellent candidate" for a VBAC.

That's quite a prologue.  Now for the actual story.

Chapter 1
(Don't worry, there's only one chapter.)

With my first two births, I felt totally euphoric before birth began.  So of course I expected the same sensation to precede my third birth.  There were a couple times, in the weeks leading up to my due date, that I was convinced I was about to go into labor.  I did not.

The night before I actually went into labor I was feeling anything but euphoric.  We had some friends over for dinner and I was feeling borderline antisocial.  Perhaps it's because I had such a rough late pregnancy this time.  I thought I had a rough time the last two times, but it was nothing compared to this.  I was tired, I was sore, I was very, very over it.   As everyone is at 40 weeks & 1 day.  But still.

Hubs and I crawled into bed at a very reasonable 10 p.m on December 27th, the day after my due date.  He often works nights and weekends but had had a very normal schedule since early December, and it was nice to have him home.  My mom had arrived a week earlier, so everything was in place.  But I felt that all eyes were on me, waiting for something to happen.  This was the very reason I had not had any family in town for earlier births, but this time we really needed someone to watch the girls when I went to the hospital.

Anyway.  I couldn't sleep.  I had been having trouble sleeping in general, but this time I really couldn't sleep.  I tossed and turned until 2 a.m., trying to not wake up hubs.  I played Candy Crush on my phone, which has been very good at putting me to sleep.  For that matter, I finally beat Candy Crush. I also read the entire internet.  All of it.  At 2 a.m., after beating Candy Crush, I finally got out of bed.  I felt very hot so I took my temperature. 99 degrees.  I googled whether a slight fever is an indicator of impending labor.  It is, along with every other symptom known to man.  I went downstairs and got an apple and some juice.

I sat on the couch and stared at the Christmas tree.  I was glad I had not had him before Christmas, because I got to enjoy a wonderful Christmas with the girls.  But now I was ready.  I wondered if I felt a contraction, but I had wondered that many times over the past couple days.  The day before, at my midwife appointment, I had been 1.5 cm dilated.  I got back in bed at 2:15 or 2:30 and finally fell asleep.

At 3:00 a.m. I was woken up by a contraction.  With my previous births I'd woken up after a night of sleep with contractions, so I always wondered if they came on gradually.  This time, they clearly came on pretty suddenly.  I timed the next several; 5 to 7 minutes apart, about a minute long.  The pain brought back memories of labor.  When I'd gone into labor before I'd felt energized and excited.  Yes, they hurt, but things were happening!  Baby was almost here!  This time, I felt very much that I didn't want to do this.  I wanted to quit.  This was going to be hard.

By 3:30 I gave up on sleep and got out of bed.  I finished packing my hospital bag, and put absurd things like makeup in there.  Hubs woke up and asked me what I was doing, and I explained I was in labor.  I don't think he believed me at first.  My contractions had gotten rather weird; 2-5 minutes apart but very short.  After everything was packed hubs convinced me to get back in bed and try to sleep.  He was being remarkably sweet, not at all annoyed by being woken up.  He watched me for a bit, and when I had a contraction he smiled "Ahhh.... that looks like a real contraction."  I was glad at that moment that he'd been through this before and he knew what we were in for.  He held my hand and half-dozed while I laid there.  The contractions returned to normal, about 7-8 minutes apart, 1 minute long.

At 4:45 I got out of bed.  I had some peanut butter toast and at some point decided they were getting worse.  I did not want to wait so long this time to go to the hospital.  I knew my labors progress fairly quickly (apart from the pushing part) and I wanted to be settled into our room before things got too rough.  So I called the midwife at 5:30.  She had just gotten back from the hospital and I felt bad waking her up, since her shift was done at 8:00.  She encouraged me to labor at home for a bit, but I decided to head in at 6:00.  It was time.  I did not want to do this, and I just wanted to check things off the list that had to get done.  The biggest hurdle in front of me was transitioning into the hospital.  On the drive to the hospital hubs was jazzed.  Cracking jokes.  I tried to play along.  I informed him I fully planned to get an epidural.  My head was not in this.  I was tired.  I just wanted to be done.

We arrived at the hospital and I was thankful to be able to walk myself.  To not be screaming in pain in the entry way.  I was also thankful that I had some tough contractions on the way so that I didn't look like a faker.  I got settled in my room.  Answered their questions.  Abided by their poking and prodding, which I would not have been able to do if I'd waited.  When they finally checked me I was 4 cm.  That seemed like a good number, and I was glad we had come when we did.

I was finally able to get in the tub.  The midwife arrived.  She was one of my favorites, very kind and patient.  After watching me for a while she agreed I had come at the right time.  Everyone was encouraging me to get up and move.  I couldn't help feeling they just didn't get it.  I'm fine right where I am. I am enduring, I want to be left to endure.  Getting up and moving requires energy I just don't have.  They seemed to think that I was stalling, but when they finally convinced me to get out of the tub and check me at 8:00, I was dilated to 6 "stretchy to 7".  It was then that I decided I needed an epidural.  I had already decided it, really, but that was the time.

The midwife clearly felt I was making a bad decision.  She was borderline pushy in trying to dissuade me from getting an epidural.  In my first two births I would have appreciated this.  This time, though, I knew something she did not seem to remember.  I knew I still had a long haul in front of me.  I knew that early labor goes fast but pushing does not.  I was nowhere near the end.  I was exhausted.  An epidural would allow me to rest and save my energy for the pushing phase.  At 9:00 the epidural was in and the new midwife had come on.  When they checked me right after, I was 9.5 cm dilated.  So I had sat still during transition while they inserted a giant needle in my back.  Go me.  The anesthesiologist was a borderline D-bag, but he did a superb job.  It took away the pain but I could still move my legs.  It was exactly what I needed.

I was finally able to get some rest.  I was feeling absolutely delirious from exhaustion.   At 11:00 Teddy was still rather high up, and they made the decision to break my water (something that had happened spontaneously in my first two births.)  He immediately started having some heart rate issues, so they had me turn on my side until his heart rate returned to normal.  This was bringing back memories of my past two births.  The midwife made the decision to allow me to "labor down", since his heart rate was good and the epidural was in, which means that I just laid there and allowed my body to do the work.  I didn't push to try to speed things along.  At noon they had me try pushing, because he was coming down so slowly, but not much came of it and his heart rate dipped down again.  So I laid there and napped some more.  I don't remember what station I was at what time, but I slowly made progress.  The midwife suspected, as did I, that once pushing really began his heart rate would suffer, just like my last births, so she let him get as far as possible before I had to start pushing.  Sometime around 2:30 I mentioned that I was starting to feel the urge to push.  I could feel the contractions, they just weren't particularly painful.  I could also feel all my pelvic muscles.  Like I said, the ideal epidural.

By 3:00 everything was in place.  I started to push, and he made some progress.  At some point, he got rather stuck, and the midwife later told me that she watched as his head slowly turned with each contraction, until he was finally able to push past a bone.  She said it was very weird to see.  I wore out pretty quickly and his heart rate was really suffering, dipping down very low.  The midwife decided to call in the NICU team, "just in case", as well as the on-call OB.  Luckily for me, the OB in the hospital that day happened to be the OB from the clinic I go to, and the same one who was at Greta's birth.  She remembered Greta's birth and this was following suit.  I started to wonder if I was close to a c-section, but they didn't seem to think so.  Finally, the OB told me I had one more chance to push him out or she'd try the vacuum.  He came out on that push.

But of course, the drama wasn't over.  He was very blue.  I'm not sure if I'll ever forget the mental image of how blue he was, and he wasn't crying.  Hubs didn't even cut the cord, they just snipped it and moved him to the warming table.  It seemed like forever until he cried, and I was sobbing, very scared.  The midwife was working on getting the placenta out, and massaging my uterus, and she seemed to think I was in pain while in fact I was just listening for crying.  His birth hadn't been nearly as scary as MJ and Greta's, and yet here he was not breathing.  Finally, I heard him cry.  Hubs later told me it was about 80 seconds before he took a breath.

And then he was fine.  He "pinked right up" and nursed pretty well.  He was 9 lb 5 oz, with a 15" noggin (that puts him in the 93rd percentile).  I had a second-degree tear but apparently not very deep.  Although I was sore, I was able to get up and walk right after (the epidural had apparently worn out).  I made the mistake of feeling "down there" and it all felt like I would imagine someone's face would after getting beaten up.  But by the next morning everything felt pretty normal.

Three days later I was walking around the Mall of America like a normal person (except that I was at the Mall of America 3 days post-partum, making me definitely not normal).  It was a phenomenally easy recovery compared to my other two.  It dawned on me, for the first time, how much of a woman's first couple months can be dictated by the birth itself.  That women who have an easy birth are not even in the same hemisphere when discussing those first weeks (or even months) with a new baby.  Because the way I felt, and my capabilities, were worlds away from my first birth experience, and probably still a world away from my second birth experience.  I was so thankful for my midwife, and for her appreciation for how my body worked, and how I birth.  She read my chart and knew what to expect, and she wasn't impatient.  She later told me she had to keep catching herself when she felt like maybe I should start pushing, and remind herself to let me go as long as possible before pushing.  And she was right.

All in all, I'm really glad this was my last birth.  Pregnancy and birth is not a magical time for me.  I love newborns, I do fine as a postpartum gal, but the precursor is only something to be endured.  I'm so thankful for modern medicine, and for this beautiful, healthy baby boy.

The first week down

(I started this post when he really was just a week old.  But, as with everything, I am behind.  So now he's 11 days old... practically an old man in newborn terms.)

First off, welcome back folks.  Nothing like having a baby to make you reassess your blog priorities.  (What?!  Really? I don't know).  I moved my blog to Tumblr in August, because I found that Blogger didn't allow me to do a few of the things I wanted to do.  While it did many things well, ultimately I was very frustrated with the platform, so I'm back!  Good old blogger.  I think I'm just not young and hip enough to really get Tumblr.  All the cool kids are doing it, I know, but I'm no longer cool and no longer a kid.  If you have any questions about that transition feel free to ask, but I'll leave it at that.

I apologize for cluttering your feed, that will stop now, too.

And if you haven't already heard through some other social media outlet, I had a boy!  Theodore.  We're still thinking about nicknames... Teddy?  Theo?  TJ?  They're all in rotation.

I'll get to the birth story... sometime.  It was far and away my easiest birth, which is lucky because adding a third kid... is no joke.  I already feel Mama guilt because he's already not getting the attention the others had.  The first few days home I kept forgetting about him, that he was part of our family.  One day I almost walked out of the house without him.  Maybe part of this is having an easy birth, because I often forget I just gave birth.  With the others it was ever-present in my mind.

There are many moments that I feel like "what did we do..."   But there are also many moments when I'm so glad that he's here.  So glad that he's ours.  I look at his sisters, swarming around him, and am so glad he's part of our chaos.

He is, by and large, a very easy baby.  When he was first born, he took about 80 seconds before he breathed.  It was terrifying.  And he finally cried after a couple minutes, but apart from that nothing much could make him cry.  His first couple days he made barely a peep.

But then he got home.  And he got loud.  He's usually happy, but if he gets hungry he screams so loud.  It wakes up every other child in the house.  So we aim to not let him get hungry.

He nursed well the first day, then not well at all.  Nothing would wake him up.  In the hospital they weren't too concerned, but it continued and when we had our first doctor's visit he was down 11% for weight.  So we tried a couple other things.  I tried a nipple shield one time and he has never latched well since.  I had needed a nipple shield with my girls due to trouble latching, and it was never so addictive.  But then he continued to drop, down 14% for weight, so we had to start the complicated pump-and-supplement routine.  Given our experience with the nipple shield, I knew it was dangerous, but felt it was unavoidable.  Since having a bottle, he has only latched and nursed well twice. Ugh.

So now, I am basically exclusively pumping.  Which is terrible.  I continue to try to get him to latch, and he sort of does but then just stops nursing.  Greta was the same, and then one day she just figured it out, though my supply tanked after a couple months and the lactation consultant thinks she was just never very good at nursing.  So maybe I'll be able to provide milk longer this way?  I just don't understand how it is that three children have had such nursing issues. Is it my anatomy?  Am I doing something wrong early on?  Is our lactation consultant offering bad advice?  All of them have lost a ton of weight, all of them have had to be supplemented from early on (with pumped milk) and none of them have ever been great in the long term.  Why?  These boobs have served me well enough in life, but they seem to struggle when it comes to the little ones.  But this is the first time I've been exclusively  pumping.  I just don't have the time for breastfeeding drama.  I can't sit and work on it for 2 hours or feed every 40 minutes when there are two other kids to tend to.  So maybe this will be better in the long run?  My supply is already way up from what it was, maybe this is sustainable... maybe....  though relying on a pump seems like a terrible way to function.

But apart from that, super easy baby.  Sleeps well.  Falls asleep easily.  We haven't had to use any device, such as a swing or bouncy seat, to keep him happy.  I just set him down, and he stares around and if he's tired he's goes to sleep.  No drama, no fuss.  Our pediatrician today commented "So... this isn't your first baby... so I assume you guys know that's not predictive of anything?"  Yes, I suppose we do, but it does give us hope... we keep saying we need a calm one....

The girls have adjusted well.  MJ is happy about having him here but otherwise unfazed.  He basically impacts her not at all, especially because she is such a Daddy's girl these days.  Greta is doing better.  The first day was a little confusing, I think.  But she is generally not jealous, unless she is tired and wants to sit in my lap while I am holding him.  She doesn't have a general jealousy, wherein she is upset whenever I hold him.  She has very specific jealousy, when I would have been holding her and am instead holding him and she wants her place back.  Even that, though, is getting better and she is often satisfied to sit next to me.  She brings him toys and pacifiers (if she can get her mitts on one) and is always concerned when he cries.  In fact, it is just about the only thing that wakes her up at night these days, and if she hears him crying she is wide awake.  Her concern for him is endearing, and I am hopeful they will become good pals over the next year.  Their closeness in age is overwhelming at times, and she can't be left with him for even an instant because she just doesn't understand all the ways she can hurt him.  But she seems to really like him, and likes having him here.

My Mom has been here for the past 3 weeks.  She will be here for about another week and a half (if she can stand us that long), and I am terrified for her departure.  The hubs will be back at work and real life will be... real.  As easy a baby boy as he has been, the reality of tending to three kids needs is daunting.  I have narrowed it down to this: it will mean no break at all during the day and an 8 or 8:30 bedtime.  Which means there will just be no time in the day for anything other than the children.  I know that's sort of what I asked for, but it is still hard to adjust to.  Especially with no family around and therefore no real breaks.  Come February I think I will be looking for a babysitter for help one day a week.

This post is getting long... I feel that Blogger better enables the rambling that I am so very fond of.  So look forward to more of that.

Here's a photo of the 5 of us:

It's unflattering to pretty much everyone other than the menfolk.  But that's okay, because it's real.  My friend Erin took it last week, 4 days post-partum, and looking at it brings the reality of it all back to me, again and again.  There are 5 of us now.  And this is it, this will be our family forever.  It's so very exciting to me.  It's like that moment you finally meet all your teammates and you start to feel each other out.  Start to envision your future together.  Try to picture what obstacles you'll overcome and whether you'll win the championship.  This is my team, and I couldn't be happier about it.

Greta's Birth Story

One of the more frustrating things in life is a peacefully sleeping baby, coupled with the inability to fall asleep myself.  DH kindly took Greta this morning so I could get some extra sleep, but I didn't realize he'd let me sleep as long as I wanted!  I slept until noon, and now can't fall asleep for anything.

So I'm trying to get some things done.  And drinking a beer in the hopes it will help me fall asleep.

Let's go back a month.  On Saturday, July 28th, we went to a going away party for some dear friends of ours.  They were our first friends in Minnesota and are greatly missed.  At the time, I thought we would see them again before their departure, so it didn't really feel like a goodbye.  That, and I hate goodbyes, so I usually just avoid them.  It was a wonderful party.  MJ was up late that night, probably not getting to bed until about 10 o'clock.  I felt completely blissed out.  It was an absolutely phenomenal evening.  I'm not sure quite how to describe it, but the feeling was one of elation, intoxication (and no, nothing was imbibed).  At first I felt like it was due to it being a wonderful party, which it was, but as DH and I were crawling into bed I realized that the feeling was the exact same as I had had the evening before I went into labor with MJ (which was at a Regina Spektor concert).  I made a comment to DH that if I was a betting person, I would bet that I would go into labor with MJ that night.

I got up many times that night to pee, and as the early morning hours started to roll around I began to despair.  Like, really despair.  I had been really, really certain that I was going to go into labor.  And now it looked like I was wrong.  But about 6 am I woke up with very mild cramping.  I thought it was wishful thinking, but (of course) hoped it was the real thing.  By 7 they were real enough that I began to wonder if I wasn't imagining it.  I decided to get things ready, just in case.  I got out of bed and made some cinnamon rolls.  I packed up the last of the things that needed to come to the hospital with us.  At 7:45 I had some bloody show, and I started to become convinced this was it.  I was nervous to notify anyone, because I didn't want to be wrong.  But the show convinced me to contact our doula.  Just a head's up, in case she was trying to plan her day.

MJ woke up about 8 and was ecstatic to see cinnamon rolls waiting for her.  We ate some together then woke up Dad.  I told him I thought I was in labor and he should get up and get things together.  He was totally skeptical but I ignored him.

Apparently at 8:45 I started sending out emails to people (because I have a record of this).  My contractions were 7 to 9 minutes apart.  I asked our friends if they could watch MJ for the day.  I told my work that I would not be coming in and sent them my timesheet info.  I was pretty convinced, apparently.  I still was afraid that things would totally stall but didn't want to be caught in a panic situation.  I also lost my mucous plug at 10 am.  So by about 10ish (10:30?) MJ was at our friends house with enough stuff to stay the night if needed.  She was excited for it and completely oblivious when contractionts hit, but I was relieved when she was gone. I knew she was in safe hands and I didn't have to worry about anything other than getting the baby out. 

After DH came home from dropping MJ off we sat and watched some olympics.  I had some strong contractions and called the oncall midwife.  Contractions were 5-7 minutes apart.  She seemed subdued, unconvinced this was anything serious yet, but I was convinced.  I took some Zofran at 11, because I was starting to feel nauseous and wanted to head off the extreme nausea that had gotten me last time.  I ate part of a sandwich, largely because I was told to.  Our doula showed up about 11 to see how things were going.  We chatted for a while, and my contractions lessened.  We went for a walk and things seemed to have totally slowed down.  This was exactly what I was scared of: putting everyone on alert for nothing.  After our walk, about 12:30, when it seemed nothing was happening, our doula went home for a while.  We sat and watched some more olympics, me feeling totally discouraged.  But by 1:30 things had picked up again.  I took some more Zofran.  DH called our doula again about 1:45, and when she showed up at the house 15 minutes later things were intense.  While we were chatting, I had an absurdly painful contraction that made me convinced it was time to go to the hospital.  I remember Rebecca asking what it felt like and responding that it felt like someone was stabbing me.  It wasn't until then that I realized my water had broken during that contraction.  So we threw everything in the car and left, about 2:15.

I sat in the back seat of our virtually brand new minivan.  I didn't think to bring a towel.  With every contraction fluid went everywhere.  I remember just sitting in a puddle of warm fluid thinking how gross this was going to be.  I also remember driving by the hospital we had MJ at, which is about 5 minutes from our house, thinking "Why did we decide to go somewhere so much further?  Maybe it's not too late to just go to the closer hospital."  I was yelling through each contraction at this point. 

At some point, I realized we were nowhere we were supposed to be.  I asked DH "Where the fuck are we?"  I took joy in swearing, knowing MJ was nowhere around and therefore it was okay.  All in all, I think I took the fact that DH got lost on the way to the hospital very well.  I was really in too much pain to worry too much about it, and by the time I realized it we were almost there. 

He dropped me at the door to the ER so he could park.  I was not in a cooperative mood.  I spoke to the receptionist, and she asked me to sit down while she contacted maternity.  I told her no.  I need to go now.  I am not sitting down.  I wasn't angry or anything, I just felt like there was no way I could do these things they were asking me to do.  They wheeled me to maternity (I was still leaking fluid, afterall) and asked me questions on the way.  They called my midwife, got me into a room and told me I'd have to wait to be checked and monitored.  Again, I couldn't do this.  I wanted to get in the bathtub.  I remember them telling me I'd have to wait, and then leaving.  They didn't come back!  So I did it myself (with help from Rebecca and DH once they realized I was not going to abide by what I was told). 

When they came back and checked me at 3 o'clock I was 8 cm.  This made me feel better, knowing that I had every right to be having a tough time at that point.  I almost wish I'd arrived earlier, because at that point I had a really hard time complying with their requests.  They wanted to monitor the baby for 15 minutes before letting me labor freely.  A reasonable request, but it was torture to not move.  Things went so fast from there that I never really felt like I got my feet beneath me.  I wish I'd had a little more time to settle in before labor picked up so much.

By 3:20 there was only a tiny lip of cervix left.  But we were having problems with Greta's heart rate.  It kept dropping to uncomfortably low levels, so they put an internal fetal scalp monitor on her.  I was having the urge to push, but the lip of cervix wasn't gone until ~4 pm.  After about an hour and a half of pushing, Greta was not really descending.  She was somewhat twisted, and we continued to have problems with her heart rate.  I felt like this was becoming a mirror of MJ's birth.  The difference was that with MJ, I had an epidural at this point and felt like I just wasn't pushing effectively because of it.  This time I could feel everything and was pushing, but just didn't feel her get anywhere.  She was stuck at +1 or +2, I think.  I was starting to shake really badly with each contraction and became convinced I needed an epidural.  Largely, I felt like I had to do something to change what was happening.  Because we'd tried lots of positions, etc., and all that was happening is that I was getting exhausted and she wasn't moving.  I was starting to become so convinced this would end in c-section that I wanted to change something.  I also found myself making peace with MJ's birth, because I started to think that it was my anatomy and not anything I did. I knew that the epidural might lead to a c-section, but I felt like I was already heading that way and maybe it would help me rest.

At 5:30 they gave me some fentanyl, which I don't recall provided any relief.  At 6:10 the epidural was in.  Having to sit still through those contractions was absolute torture, but it went in without a problem.  It started to take effect soon after and they let me rest until about 8:00.  During that time, I had my right leg resting on a peanut (which looks like a large, peanut shaped birth ball) with the hope that my contractions would turn her into a better position.  At 8 I started pushing again, but there were two issues.  Her heart rate kept dropping unless I was in one particular position (which was not the position I needed to push from).  So every time I pushed I had to rearrange myself, then go back to another position so her heartrate returned to normal.  Furthermore, I couldn't feel when the contraction was coming so the timing was problematic.  They were concerned enough about Greta's heartrate section that they called the OB in from home.

 This looked even more like it was heading towards a C-section.  If I had gone with any other OB practice I still think it would have.  Between the time the OB was called and the time she arrived, we figured some things out.  We were able to turn the epidural down to the point that I could feel the contractions well enough to know when to push.  This also helped Greta's heart rate; it still fell a bit when I was pushing, but wasn't as dramatic or prolonged.  When the OB arrived, rather than suggesting a C-section, she labored with me for a while, then went into the other room and let my midwife take over again.  I was very impressed (in retrospect) at the way she dealt with everything.

By 8:45 I was into active pushing.  I recall at 9:30 asking how much longer they felt it would take, because I needed to mentally gear myself up if we were looking at hours still.  I could feel myself wearing out again.  But they told me no, we were close.  We were not talking about hours still.  Shortly thereafter I remember feeling her hairy little head with my hand; one of the oddest feeling things I've ever experienced.  And at 10:08 she was born!

The activity immediately after she was born was frenzied.  There was a lot of meconium, so they had a whole team in place in case she was in bad shape.  The cord was around her neck, which was what was causing the heart rate drops.  They let DH cut the cord then rushed her to the little NICU table (not sure what the real name for it is) to suction her; she took a breath before being suctioned, but didn't show any detrimental effects from it.

It was all pretty awesome.  I felt pretty ecstatic it had worked out.  I didn't feel the rush of "I can do anything" that so many women talk about.  I mainly just felt really freaking lucky that this didn't end in a c-section.

In retrospect, if we have another kid, I'm not sure if I would try for another VBAC.  I felt like we so narrowly squeaked by that I'm not confident another birth wouldn't end in C-section.  Last time, I attributed all of my recovery to the C-section, but this birth showed me there was still quite a bit from a vaginal birth.  Much more than I expected.  Yes, the recovery was easier than with a C-section, but if I had to put a number on it the recovery was still about half as bad, maybe a little more.  My greatest fear is pushing for a long time and still getting a C-section, and I'm not convinced that wouldn't happen again.  Only time will tell, and only if we decide to have another kid. 

The rest of our stay in the hospital was pretty uneventful.  She nursed pretty well, we got some rest.  MJ loved meeting her for the first time, and you can see in the picture below she was already stealing her things.  There is, of course, always more to say.  But this post has been a week and a half in the works, so time to just hit "Publish" already...

Working? (aka full term)

I had my performance review yesterday.  It was mediocre.  I have been mediocre.  It was also a probationary review, because I started here just over 6 months ago and that's how long my probationary period lasts.  After that I'm fully unionized and, you know, unions.  Love them or hate them, it is true that it's harder to fire a union employee.  So they make sure they like you before it's too hard to fire you.  

So, despite the fact that I’m mediocre and very pregnant and about to leave for several months, they are keeping me.  There was a small part of me that almost wanted them to let me go so that I have an excuse to not be here.  This is probably part of what makes me mediocre.  Also, I’m only here 75% of the time, so I simply don’t get as much done as other folks.  And I’m just not that excited about this job.  It’s good but not great.  I still see the potential for it to get a lot better, and part of the reason it hasn’t been great is just circumstances beyond anyone’s control.  Projects that haven’t gone as planned.  What is great is the hours.  And the flexibility.  It fits in so well with our family.  I feel like I still get to see my daughter a ton, and yet it keeps me sane and keeps my skills up.  Even though I don’t love it, I never dread it, so that’s something.  And, like I said, I keep hoping it will get better. 

It is a new thing to me, though, to be mediocre and be 100% fine with that.  While I’ve been okay with not being the best, I like to do good work and earn awards and accolades.  Now?  I just don’t care.  Does that do a disservice to women in the workplace?  I don’t really know, but it’s something I think about.  I hate to fit the stereotype, but here I am, fitting the stereotype.  Does that bother anyone else?

The other reason I’m mediocre right now, is that I’m just very pregnant.  I’m uncomfortable.  I’m distracted.  I don’t want to start new projects.  I hope that each day at the office will be my last for a long while. 

Things are starting to feel very close.  As I may have mentioned, I have it firmly lodged in my head that I will go early.  I wish I didn’t have this in my head, because I may still have a month (or a little more!) left.  This is, I think, the hardest part of pregnancy.  The discomfort isn’t great, but it doesn’t mess with my head.  The waiting messes with my head.  Each day could be like any other, or could be completely life changing.  If you walked out of your house in the morning and had a 0.5% chance (my current odds of going into labor on any given day) of your life changing in a dramatic, important and permanent way, wouldn’t that be hard to live with?  And what about when it becomes a 5% chance, the odds once I get closer to 40 weeks?  It’s not enough of a chance to plan for, and not enough of a chance to ignore.  That’s where my head’s at. 

I recently found this awesome website:

http://spacefem.com/pregnant/charts/duedate0.php

If you are as obsessed with labor statistics as I am at this moment, check it out.  This woman has a simple survey to compile statistics, and currently has over 2300 respondents.  Although there are some statistical issues with this method, there are with any method, and as her number of respondents goes up I think it becomes a more and more powerful tool.  Among the more interesting parts is her finding that second time moms actually go into labor, on average, later than they did with their first.  This means I would go into labor close to 41 weeks, not early. 

I pulled out my birth books the other day.  I read through MJ’s birth story.  That’s the first time I’ve read it in a long, long time and I came away feeling a lot more upbeat about the whole thing.  I forgot how low her heartrate got.  I forgot how much distress she was in.  One thing I have decided is that puking was the worst part of labor, not pain.  I avoided anti-nausea medications last time, because I didn’t want meds, and this time I’ve decided I’ll do whatever I can to avoid the nausea, because that’s what put me over the edge. 

I’ve also started to become a bit nervous about my water breaking unexpectedly.  It’s fairly rare (~10%) for your water to break before labor begins, but that’s what actually started my labor last time.  It may have been a random occurrence, or it may be how I labor.  I won’t know until it happens, and I’m hoping it won’t happen in public.  In addition, once my water broke, my labor was on.  So I’m nervous that I’ll get stuck somewhere, with hubs working an hour away in the middle of a long shift he can’t just leave, me with MJ and in so much pain I can’t drive.  These are the things I fret about. 

My mom visited for the past week and left yesterday.  It was so nice to have her here.  The help and the distraction were much appreciated.  We got the nursery ~85% complete; I’m excited to post pictures but want to wait until it’s done.  So you may have to wait for some finishing touches. 

And now that my Mom has left MJ must just deal with me.  I’m just a lump these days, and I feel bad for her.  Yesterday I tried to take MJ and Vito for a walk.  I seriously made it two blocks and nearly cried in pain.  Round ligament pain, I think.  I had to sit down on some random guy’s lawn to collect myself, then hobbled back home with dog and toddler, barely containing myself.  I’m sure that most people who saw me thought I was having contractions, because I am that pregnant and was clearly in that much pain.  But what kind of crazy person would take their toddler and dog for a walk while having contractions?  So my abilities are severely limited right now.  My legs feel restless from lack of activity, but the rest of my body just can’t handle it. 

Also, lots of cramping this week, but no real contractions.  At my midwife appointment yesterday I was 4-5 cm dilated at the outside and 1-2 on the inside (so essentially 1-2 cm).  It’s nice to know that all this pain is at least getting me somewhere and accomplishing something.  Up 43 pounds.  Down a lot of sleep.  It happened suddenly, but starting about 5 days ago sleep got really, really crappy.  I have discovered, though, that since the weather cooled down I can deal with this pregnancy thing a lot better.  Just trying to take it one day at a time.  One week at a time.  One midwife appointment at a time.  Trying very hard not to wish this time away, because I know full well how precious it is.  Like I said, it’s just the not knowing.  It’s not that I don’t appreciate this time, but the suspense is sometimes too much.  Coupled with the discomfort. 

36 weeks.

I should start this post by saying that I won't be offended if you want to step away from my blog for the next few weeks.  I know I'm being whiny.  I know deep down that I'm lucky and my discomforts are minor and temporary.  But this is my blog, and therefore this is where I whine.

Today's appointment was an odd one, mostly because it was the first one I've taken MJ to.  And because I had an internal exam that I forgot about.  I always try to shower for those.  Oops.

The appointment started with me peeing in a cup.  I find it odd that my midwife practice makes me do this at every appointment.  Is this normal for other folks?  During MJ's pregnancy (in a completely different office) I remember maybe once or twice being checked for protein.  I can't help but think this is just a ratcheting up of health care costs with unnecessary tests.

MJ was pretty fascinated by the concept of peeing in a cup.  She was only willing to go potty afterwards if I promised her that she did not have to pee in a cup.

The exam was fine, and thankfully MJ listened and sat in the chair (next to my head) for the actual exam.  I'm not too worried about traumatizing her, but I'm certain she would share whatever she learned with anyone who will listen at the 4th of July party, thus traumatizing me.  Mostly she just liked that it was an actual doctor's office, with an examining table, stethoscope, etc., just like in her books.

I'm up 41.5 pounds, which is half a pound in the last two weeks.  A much more respectable weight gain than the rest of my pregnancy, thankfully.  Furthermore, I'm 75% effaced and "baby is really low".  The midwife didn't use any words like engaged, etc., but kept reiterating that she was really low, asking if I felt like she was low.  I have been wondering this, given the random (and crippling) shooting pains in my pelvis.  It doesn't really feel like she dropped, because my belly seems to be in the same place.  But hearing this makes me at least feel like I'm not crazy for feeling like I'm so close.  I realize that these numbers don't really mean anything, I could still deliver at 42 weeks, but that's progress I don't have to worry about making later.

I am entering the bitching stage of pregnancy (I may have been in it for a while).  I am not a glowing pregnant lady.  Until recently I've at least been a happy pregnant lady, but I'm past that, too.  I've been whining a lot.  And grumbling a lot.  About the heat.  About pelvic pain.  About peeing ALLTHETIME.  About round ligament pain, which is much worse than last time around.  Probably because I had so much back and hip pain I was largely immobile (in that I simply didn't move) and didn't have the opportunity for the weight of my belly to be a problem.

I know this is nature's way of making us glad for the approaching discomfort that is labor and having a newborn.  When labor was done last time, I recall thinking how much better that was than pregnancy.  Having a newborn seemed so much more pleasant than being pregnant.  But labor and newbornhood is tough, so late pregnancy HAS to suck this much or we wouldn't feel this way.

I've discussed this theory of mine with other women.  I don't think most of them agree.

In other news, our mice are back.  Aren't they supposed to be living outside in the Minnesota summer while they can?  Also, our dining room lights no longer work and our third floor shower leaks into my daughter's bedroom.  I love having a 109 year old house.

Round Two

Today I am 34 weeks.  That sounds unbelievably close to the end.  It doesn't feel that close, but it sounds like it.  Time has slowed down.  Up until about 32 weeks, this pregnancy sped by.  I felt wonderful, I enjoyed being pregnant and I looked forward to what was to come.

Now I'm starting to feel some dread.  I'm starting to feel uncomfortable.  The heat is largely responsible.  And not being able to bend over.  Those two characteristics are responsible for most of the negative feelings I'm currently having towards being pregnant.  Last night, with the thermometer still hovering at ~90 degrees, I left the comfort of our air conditioned family room to the non-air conditioned kitchen.  I made myself a rootbeer float, the entire time thinking

"I am dying.  I am dying.  I am dying."

I knew, somewhere deep down, that this wasn't true.  But the heat seems to take away any capacity I have for rational thought.  Our 109 year old house has radiator heat, so there is no easy way to install central air.  We have a little room unit for MJ's room, my room, and our family room.  If MJ was content to stay in one of these areas my job would be easier, but she is not.  So I try to play along and be a rational human being, but it seems I am unable.

The other dread I'm starting to feel is about having a newborn.   If you've read this blog for a while, you'll know that this is a very wanted baby.  A very longed for baby.  A very tried for baby.  But I still feel a little dread.  Last time around, I felt much more dread.  I didn't like babies.  I didn't even like little kids, and figured they'd be pretty uninteresting until they were about 10.  In reality, I really enjoyed having a newborn; MJ was an easy newborn, it's just the other 2.5 years that she's been not so easy, but totally interesting.  So while I have a more firm understanding of the upsides, I also have a more firm understanding of the downsides.

I also have some fear about some of the things I feel committed to.  Last time I was committed to natural birth and breastfeeding.  I didn't do real great at either of them.  So this time around, I find myself even more committed.  From reading other mom blogs, I feel like a bit of a rarity on those fronts.  It seems like those moms who had c-sections last time had a scheduled c-section this time.  Those who had trouble breast feeding seem to not be doing it at all this time, or to be not as insistent that it will work. Instead, I find myself thinking I've learned from my mistakes and will definitely do better this time.  Am I setting myself up for even more failure and disappointment?  Having committed to a VBAC, I'm slightly terrified of failing at it.

The saving grace through all of this, is a better understanding that none of it matters as much as it seems to at the time.  MJ's birth experience and my breast feeding prowess don't define our relationship.  Despite what brochures at the pediatricians office tell you, there are other, far more important, aspects to the person she is becoming.  Do they play a role?  Probably.  I don't want to fully downplay their significance, but I think that part of the reason women play up their significance so much is that they are so damn hard.  So if they're that hard, they must matter a lot, right?  Otherwise, why bother?

To me, the reason they matter has more to do with insurance purposes.  We all pay a lot for insurance, but how often do we really use it?  How often does it matter?  For most people, not much, but if you need it you're sure glad you have it.  Similarly, the reason to avoid a c-section is not so much about the birth experience but about those rare bad outcomes.  The reason to breastfeed is that the antibodies might save your kid from a life threatening illness.  There are other, touchy feely reasons, but it's not like those touchy feely moments don't exist if you give your kid a bottle.  It's not like you're not ecstatic to meet your baby even if they don't come through your vagina.

So anyway, yes, I'm committed, but no, in the end it probably won't matter that much.  Ask me in two months time how that's working out for me.

Birth Story, Part II

Madeline has been doing great. We're starting to get the breast feeding thing down (had I written this post a few days ago I would not have felt so encouraged). We still have some issues, but they seem to slowly be getting better. I think she's hit her first growth spurt; she's hungry constantly and constantly awake. Makes for tiring days, but I'm glad she's doing well. So on to part deux.

I got the epidural. I remember saying to A "this is the best decision I ever made". I felt very good about it. I figured this would let me rest for pushing, and, at least at first, it wasn't complete numbness. It was about 10:30 am and I slept for a couple hours. Now time actually seemed to slow down. Two hours later they checked me again and I had not progressed, however. I was so disappointed. The staff even seemed surprised, because I had been going so fast and I was still having consistent contractions. We discussed and decided on Pitocin.

I realized this was becoming the birth I did NOT want. Everything I had hoped to avoid. I never felt like things were being pushed on me, but there was the meconium issue, which was getting worse. And by this time there were dips in her heart rate, too. It was unclear how much of it was the monitor and how much was her. They discussed a scalp monitor until her heart rate came back up. I was too out of it to really protest. I had agreed to the epidural, knowing it ties me to all these other things. I remember being frustrated but still feeling like everything was progressing well and it would all end well. I didn't really feel like anything was wrong with her.

After a couple hours of pitocin it was time to push. Everything seemed to be going well, at least to me. I had sensation in half my body, so I could feel well enough to push. There was pain but it wasn't intolerable, which I was okay with. She was descending, a little slowly, but I felt okay. I think everyone thought I was more tired than I was because my eyes were closed. But it felt more meditative than anything. The lights were bright, there was too much commotion so I just closed my eyes and focused. Then I started to realize they were concerned. She wasn't descending. Her heart rate kept dipping. They thought I was tired, though I didn't feel that tired, my pushes just weren't doing anything. Mostly I just felt like I was pushing wrong.

The OB team showed up in the room, the midwife must have called them. I remember the midwife saying she was getting stuck on a bone; she asked if I'd ever damaged my tailbone, which I had. I broke it ~8 years ago while snowboarding. It had never occurred to me this could be a problem. Anyway, they discussed. They agreed to let me continue pushing as long as I felt up to it. But they were concerned that her heart rate kept dipping, sometimes down to a sustained 60 or 90 bpm. There was meconium. If I didn't progress, they would try the vacuum.

If that didn't work they said c-section might be my best option. This was the first time c-section was mentioned and I think I cried. I was so determined to get her out, but I just remember being disbelieving. How could she get stuck? Everything had been going so well. It just didn't seem like a real possibility.

So when the OB team left I suggested I push on hands and knees; I had pretty good sensation and felt certain this could work. I pushed this way for a while. Her heart rate was much better, but eventually I got tired and she had essentially not moved at all. We tried again on my back; her heart rate dropped again. No progress. Then I suggested the toilet; they suggest the squat bar instead which I was fine with. Her heart rate was fine again, but I was getting nowhere. The midwife was trying to turn her, but I guess her head was transverse (so that her ear was facing out) and there was not much success. Eventually I agreed to try the vacuum; they told me I had about 3 tries and then it was a c-section. I pushed as hard as I knew how. In total, I pushed for over 2.5 hours, but I think all of her progress was in the first 45 minutes or so.

I couldn't believe it was going to be a c-section. It seemed so unreal. I felt like I had more pushing left in me. But I could tell A was very worried. And I didn't know what else to suggest. I felt like I had to. Like to not get a c-section would have been irresponsible. And so we did. I remember A talking to the doctor about using double layer sutures, about how I wanted to try a VBAC in the future, and she was on board. It made me feel slightly better to know how supportive of vaginal birth she was, it was one small concession. My epidural was completely ineffective at this point, I remember still trying to push even while they were getting things ready for a c-section, hoping I could get somewhere. That they were just giving up on me too soon. But I got nowhere. I was sobbing as they wheeled me in. As they were performing it. I couldn't stop crying. For that matter, I can't not cry as I write this.

They gave me a spinal. All the nurses and techs were trying to console me as I sobbed. When they began the operation A began telling me everything they were doing, and I looked at him horrified and told him to stop. It took a little longer than I expected to get her out, and once she was out there was just quiet. I started bawling, not knowing what was going on. Then she started to cry and I immediately felt like it was all worth it. I had asked A to stay with her, but it felt like an eternity before I knew what was going on. It was probably only a couple minutes, but it seemed much longer. A brought her over to me and she was fine. No problems. Scored 8 and 9 on her apgars. This, in spite of the fact that she had been severely wedged in my pelvis and took them quite a while to get her out. And A said there was more meconium than he'd ever seen (he's probably been at ~20 c-section births).

So after all that, was a C-section necessary? A week out I can think about this a little bit more objectively, but not much. Yes, I'm happy I have a beautiful, healthy girl. She's perfect. So if the C-section was truly necessary, it was totally worth it. No hesitation. But could it have been avoided? Do I have an inadequate pelvis? I recall reading that only ~5% of women do, and I find it hard to believe that I'm one of them. I don't have a small frame, I have no reason to believe that a baby can't fit. How much of a role did my broken tail bone play? I don't know, but I have an appointment to meet with both the midwife and the OB to ask them their opinion of my likelihood of having a VBAC in the future.

There you go. Not the birth I had hoped and planned for. But a healthy girl nonetheless, the consolation I have to focus on. I found stories such as mine discouraging when I was pregnant, but I guess I wrote this all out more for myself than other people (because who really reads all this, anyway!) It's healing I find to think through and write out everything that happened. And now I can focus on MJ, the cutest baby ever.

Birth Story, Part I

I've been working on this for days, and it's so long (and still unfinished) I think it best to post it in installments. Hey, if it was good enough for Dickens, who am I to shun my noise at a serialized version?

i sit here typing one handed, abandoning all attempts at capitalization for the time being. i am unpregnant. and, more importantly, we are a family. i guess we were before, but now we're a family like we've never been before. she's beautiful. perfect. everything i could have hoped for, and the only thing that makes this rough week worthwhile.

so i'll start with the birth story, because i was obsessed with reading these while pregnant and feel the need to write it all out. i'll warn any family or friends reading this there will be extensive discussion of my girly bits, mention of poop, mucus, and a lot of other things you may just not want to think about. so be forewarned.

i was very frustrated last week. i didn't think i'd be one of those people who got all frustrated about going past their due date, but i most certainly was. i was despairing, and largely tried to avoid contact with family and friends so as not to be asked questions or listen to jokes. on thursday night of last week i had contractions all night long, ~10 minutes apart, but even getting down to 7 minutes apart. i was sure this was labor. i wasn't excited about having her on the 11th, but i was excited that this was finally it. but by friday morning they had completely stopped.

(Return of capitalization means Madeline is down for a nap). All of Friday I was rather crampy, though not having contractions and generally just frustrated. That evening I had a few, though not regular and not strong. I talked A into going to a Regina Spektor concert with me (which was, by the way, absolutely amazing.) He was not excited about it, but he went (and later admitted he had a great time). If you haven't heard of her I highly recommend checking her out.

Anyway, I went to bed that night thinking about induction options, c-section risks and generally nothing good. At 3:45 am on Saturday I woke up to a slight contraction and then a gush; I immediately knew my water had broken. I called to A from the bathroom, telling him to wake up, we're going to need to head to the hospital. His immediate response - "Are you sure you didn't just piss yourself?" "No, A, I did not piss myself." I don't think he believed me. But then the contractions really started kicking in and he realized that either way we needed to get going. They were about 7 minutes apart and strong. We took showers, put the bags in the car and headed out.

By the time I got to the hospital they were ~5 minutes apart. We checked into labor and delivery, they took us to our room. We got one of the rooms that had the mobile fetal monitors, which I am so glad for. By the time I got into the gown and they checked me it was ~4:45 and I was 4 cm dilated. I was a little under 3 cm at my last appt., so a little over a cm progress in a few days. Not bad. The contractions were strong and the midwife told me that if I was thinking of pain meds I could have them at any time; I said I was hoping to go natural and she was fully supportive.

Although the fluid had looked clear to me when my water broke, when they did the exam they noticed some meconium. Not a ton, but some. I was a bit disappointed, knowing that that means an automatically slightly higher risk birth. But we carried on.

I recall laboring on the toilet for a while when they were getting everything ready. They put the fetal monitor on me, with the plan to take it off after a while. The nurse drew a bath, and although I had no desire to move they talked me into getting in. Best. Thing. Ever. I hadn't realized how many tense muscles I had until I felt them all relax in the hot water. It made all the difference. A was being great. Supportive, encouraging, everything I needed. I labored for I don't know how long... I had no sense of time, and I think it actually passed quicker than it felt. I was assuming it was at least ~5 minutes between contractions, but they were actually much closer together so time was actually moving quicker than I realized. With each contraction I thought "maybe I should get an epidural". Then between contractions I thought "I can do this". Once I realized this was the pattern I was settling into, it gave me strength to know that the relief between contractions was sufficient to give me the strength to keep going. The midwife was fantastic and her encouraging words made a huge difference. Furthermore, they offered to take the monitor off and I found I actually liked having it on. Hearing her heartbeat was wonderful... I would just listen to the galloping horses and continue to remember what this was all for.

Then the pain intensified. Exponentially. I felt like I was getting no break between contractions. I was having nausea throughout, but now it was much worse. I suddenly decided I had to have an epidural. I couldn't tolerate it. I figured I had to have progressed far enough that it wouldn't be so bad. The midwife guessed 7 cm, I got out of the tub and she checked me. I was at 6. At this point, it was essentially contraction, puke, contraction, puke. No rest whatsoever and knowing that I hadn't even hit transition I was losing my mind. They called the anesthesiologist who said he'd be a while; I think it was about 9:30 am at this point. They offered me fentinol in the interim, which I agreed to, and it did help.

I started to think maybe this is all I would need. However, when she checked me there was much more meconium than before. And the problem is that things were moving so fast that I was afraid she would be born with fentinol still in her system. The anesthesiologist arrived much quicker than he had said he would, about 10 am I think. But because the fentinol seemed to be working the midwife asked if I still wanted an epidural. She was gently trying to talk me out of it, which I appreciated. She checked me again and I was 8.5 cm (in only about an hour or hour and a half I'd gone another 1.5 cm.) I was so torn. The anesthesiologist was standing there. I knew this was probably my only chance, but I was also so close. I remember looking at A, wanting him to decide for me. I think he was in favor of the epidural. He later told me how much he hated seeing me in that much pain, and he also felt than another dose of fentinol, if needed later, would not be a good option. I decided to get the epidural. I also remember thinking that I had enough "momentum" that everything would continue to progress. In retrospect, that was foolish, that's not how things work. But anyway.