Tuesday, September 18, 2012

My Dreams as a Mama

I've been in baby world for the past weeks, soaking up my son. I've also been soaking up sleep and showers and any type of food I can get my hands on. All in all, these weeks have been great. (There were a few days when we had no home due to a power outage, and those days were less than great, but I really don't want to dwell on them because I'll get mad all over again.)

But my son? Oh my, he's the best. I don't think you'll believe me until you spend a day with him, but he has my husband's easy-going nature, and we're both so grateful for that. He sleeps well, he eats well, he cries only when appropriate. I'm not sure how long these traits will last, but for now, I am grateful for them.

As we think about parenting him, Josh and I are pretty open minded. We don't have very many specific dreams for his career, his interests, or his personality. But I do have some broad dreams for him.

Today, I've been thinking a lot about how I want him to be a man of vision, to see beyond what most people see. I want him to serve our King, the true King, but I don't want him to just do it out of duty; I want August to be driven by something bigger and better. 

This is the song that's been stuck in my head all day:

I've occasionally been playing music while August nurses. Often I play (via iTunes) hymns. Today, Gungor came on and it was perfect.

I want August to value life on earth just as Jesus did. I want him to eat good food, dance with abandon, travel the world, and fall in love. But, I want him to know that this is only the beginning, that food and dance and travel and beautiful women are only foretastes of what he was truly made for.

How can I raise a son with vision for things he won't be able to see with his eyes? I don't know. Help us as we figure it out?

And for now, prayers for everything that accompany the first months of parenthood are appreciated.

Tuesday, September 11, 2012

August's Birth Story, Told Twice

Josh and I have decided that August's birth story probably needs to be remembered from both of our perspectives, so he has written his version and I have written mine. Enjoy.

Our first family photo, the day after August's birth.
From Laura

Since Thursday, I had been having more frequent Braxton Hicks, especially in the evening or following any of a variety of induction attempts. I could bring on these BH contractions fairly easily, but once I fell asleep each night, they disappeared by morning. I was encouraged, however, that my body seemed to be preparing.

Tuesday (EDD): I got a call from the OB's office that they needed to move my "Past EDD" appointment from Friday to Wednesday because of a conflict in the doc's schedule. I agreed heartily because Josh was going to be at work on Friday and was sad to be missing the appointment, especially because it included an ultrasound to do some screenings. 

Wednesday: A Twist in the Road

10:30am Ultrasound and exam at the doc.

The ultrasound tech inquired as to if there were plans to induce me, and I said no, and she got pretty quiet after that. That's when I started to suspect that the appointment might not be as uneventful as we had thought it would be. Once we saw the doc, he did not like a very prominent arrhythmia he was seeing on the fetal heart monitor. (I had heard this arrhythmia at previous appointments, but the doc had not been at the room at the time, so it was his first time hearing it.) The u/s also indicated that August was close to 9 lbs, so he didn't feel that letting me go further in the pregnancy would be very wise.

He said, "So we should get this baby out soon" and left the room for a few minutes to give me additional time to sit with the monitors on. I thought he meant, "Well, this means going to 42 weeks would be unwise. We'll schedule an induction for next week if things haven't progressed." Instead, he came back in the room and said, "So why don't you head on over to Foothill [the hospital] and I'll let them know you're coming?"

My eyes about popped out of my head. Josh and I looked at each other.

He continued, "We'll do some more extended monitoring of the baby, and then we'll probably schedule a two-part induction after that. Since your cervix isn't fully effaced, I'll give you some Cervidil, and then some Pitocin after that."

"Um," I stammered, "This can't wait 'til next week? We have to go today?"

He said something about feeling very uncomfortable leaving the baby unmonitored over the long weekend with such a prominent arrhythmia, especially considering it would only grow larger while we waited.

I was still in shock and he could tell, so he continued to explain that we could take our time getting to the hospital. He suggested we go out to lunch, go home and pack up our stuff, and then head over in the early afternoon, planning on staying.


Josh and I head home and debrief. Things were tense. We didn't know how to process or proceed. We had a lot to get together for taking time off from our various responsibilities, so went sent emails and laid plans for not being available for the next week. We emailed family to update them. We packed our bags, did the dishes, and took out the trash. In the midst of doing all of these things, we tried discussing the situation, but it was hard. We decided we'd proceed to the hospital and talk things out as they developed.


We went out to lunch at our local Thai place. We were able to talk a bit more over food. We decided that while we're uncomfortable with induction, especially with its increased risk of c-section, we did trust our doc. He had always been SUPER laid back, never expressing any concern when he could have been a bit of an alarmist about little things here and there. Even during our SUA "scare," he was super laid back and told us that he wasn't concerned. In context, we realized that he probably was sincere in his concern, and that we should trust him.


We arrive at the hospital and check in for prolonged monitoring and another ultrasound. Our nurses are immediately AWESOME. As in, they wanted to know how we felt about everything, how they could be advocates for us, etc. As soon as we dropped the Bradley Birthing name, they knew what we wanted and that this wasn't it. They only showed the utmost respect for our wishes, helping us to feel empowered to bargain with the doctor for some compromises.


After the extended monitoring and bargaining with the doc, we leave the hospital to grab some more things at home and have dinner. We agree that we'll be back by 6pm, at which time we'll check in and begin the induction. The planned timeline for the induction was this:

6:30pm Receive the Cervidil
Sleep through the night as my cervix ripened
3:30am Cessation of Cervidil
4am Start Pitocin at a very, very low dose
Sometime during the afternoon/evening we'd have a baby.

BUT, things didn't quite work out this way. Here's what did happen:

6:30pm Received the Cervidil. Am about 1.5cm dilated and 75% effaced.

8:30pm Start having regular contractions at about 4 minutes apart. They weren't super strong, but they slowly grew in intensity. It was mildly exciting that my body was laboring on its own without the Pit.

11pm Things ramp up. Contractions are steadily about 3 minutes apart. I start getting the shakes and can no longer do anything during the worst part of a contraction, even talk. We make sure to move a lot to encourage the baby to move down and be in a good position. The L&D ward was small, but we walked, used the ball, tried various positions on the bed, standing, squatting, etc. The nurse mentions that I can take the Cervidil out if things get "unbearable." I respond by saying something like, "Well, I like what the Cervidil is accomplishing, so I doubt I'll want to take it out."

Thursday: August's Birthday!

12:30am Contractions are 2 minutes apart. Josh is pretty concerned at this point because I am mentally in and out and still getting the shakes. The nurse notices my quick progression. She mentions a bit more authoritatively that it would be a good idea to take the Cervidil out. I agree quickly.

She also checks me. Guess what? No change. 1.5 cm, 75% effaced.

NOT HAPPY. Um, from everything I read, 2 minute contractions should not be happening at 1.5 cm.

She sees my frustration and tells me that she's seen this before, and often times the cervix will catch up to the uterus in a matter of hours. I think, "Okay, I can keep at this."

12:30-6am This is kind of where things get blurry. Josh's account might be better.

I remember: Super intense contractions 2 minutes apart all morning long, sometimes right on top of one another or multi-peaking. Labor was now in my back most of the time. We walked. We used the labor ball, tennis balls, massage, the shower, heat packs, counter pressure, anything. The most lucid moments for me were the 2 stints in the shower. I would've stayed in longer, but the heat was making me realize how darn tired I was (I did have a chair in there). Immediately after each stint in the shower, I would want to lie down on the bed to go to sleep, but that wasn't possible at all.

I also remember that around 4am, the nurses decided that they'd let me labor on my own without the Pit because I was doing so well. I'll admit, I was pretty proud of my body for not needing it.

Also, sometime before 6am, I'm not sure when, the nurse hooks me back up for extended monitoring. The baby's arrhythmia is quite pronounced, and she begins to talk about Pitocin again to speed things up.

6am She checks me again because of how rapidly things are progressing. I have the shakes again, and we pretty much all think I'm in transition based on the super low pressure I'm feeling. I think, "I can totally do this."

And then, it basically all came crashing down with a few words: 3.5-4cm.


I don't think I did any cursing at the time, but I wanted to. I wasn't anywhere near transition and I was exhausted. I knew I could push through it for a few more hours, but as soon as I realized that my cervix and my uterus were not in sync, I felt pretty defeated. The nurse said that the Pit was probably going to have to happen. I knew that the Pit would only make my pain ratchet up to new levels, and that my contractions would probably come even more quickly.

This is when the epidural enters my mind. No one mentioned pain meds to me at all, for which I am very grateful. All of the nurses and Josh were amazingly supportive of laboring through the pain without meds. I inquire about the epidural to the nurse. She looks surprised but understanding. I feel a little bit like a failure for even mentioning it. All of the nurses felt like my big natural-birth cheerleaders, and I felt a bit like I was letting them down.

6:30am After Josh tries his best to assess my mental state and my sincerity in wanting the epidural, I insist that I am lucid, thinking clearly, and that I want the epidural. Josh reminds me of all of the reasons I had told him to tell me that I didn't want it. I say something like, "I know, but something's not working and I'm exhausted." We order the epidural just as the first drop of Pit is administered.

7am Epidural time. It doesn't take full effect until 8am, but as it takes the edge off of the pain, I slowly drift off to sleep. I think I'm asleep around 8ish. The Pit dosage is now increased every 30 minutes to speed things up.

9am I'm asleep and vaguely remember the doc rupturing my membranes. He also says that I'm about 6cm at this point. He maybe said something about being at a -2 station. I'm not sure. I see the contractions on my belly and on the monitor; they are fast and furious. I go back to sleep. Glorious, painless sleep.

11am (or somewhere around there) The nurse checks me again, 9.5-10 cm! I was half asleep until she said that, and then I woke up heartily. She says that she needs to start prepping the room for delivery. My hearts skips a beat. I let Josh sleep for a bit longer before I wake him.

11:45am The nurse calls for the doc as I'm ready to push. The doc was in surgery. We all agree that we're fine with waiting until he's done. After all, I'm not in pain and I thought that pushing would be difficult since I had no sensation below the bump. I was fine with August moving down on his own so that I had to push less.

1pm The doc is on his way up. After two little practice pushes with the nurse, she tells me that I'm doing great but need to stop and wait. The baby is crowning. Josh, who we all thought would freak out a little watching me give birth, is the exact opposite. He was so excited and enthusiastic, especially once he saw a full head of hair. I ask for a mirror so that I can see too. I was curious. I see August's little head and then promptly ask for the mirror to be removed. Curiosity = sated. Haha.

Doc arrives.

Three sets of pushes with everyone in the room cheering me on.

1:09pm August is on my chest!

Elated, relieved, overwhelmed.

That's the story. On this side of things, I really have no regrets. My biggest fear with induction was the increased risk of c-section, so I am relieved to have avoided that.

In terms of the arrhythmia that prompted the eviction notice: After his birth, August's EKG was "extremely unusual," so we've been paying some visits to the pediatric cardiologist. As of now, his heart structure looks good, but his EKG is still reading a bit weird. The doc thinks the strange readings will resolve with time, so we go back in a few weeks for more tests. I am strangely not anxious at all. Even if August's heart isn't 100% perfect, I still wouldn't trade him for the world. He doesn't seem to be in any distress, and I guess that's what this mama cares about most right now.

From Josh

On August’s official due date, Laura got a call that our doctor would be unavailable for our routine OB appointment on that Friday. Laura was able to reschedule the appointment for Wednesday, and we were both really excited about the change because I was going to miss the appointment on Friday but I would be able to accompany her to the appointment on Wednesday.  It was especially exciting because the appointment included a sonogram, which we hadn’t had since August’s Single Umbilical Artery scare back at 21.5 weeks.
The next day we arrived at our appointment, which started with the sonogram.  The sonogram took a long time, and the technician was obviously measuring a lot of different things without really explaining what she was doing.  She casually asked if the doctor was going to be inducing Laura, which seemed a bit strange at the time, and we told her that we didn’t think that was the case. After the sonogram, we were waiting in the reception area to see the doctor, and the sonogram technician walked a piece of paper over to the nurse’s station and was intentionally not making eye contact with us.  That was when I started to wonder if something was wrong.
Soon after being taken to the appointment room, our doctor came in with a concerned look on his face.  Now you have to understand that our doctor had been incredibly laid-back the entire pregnancy, so seeing him act so concerned was a bit alarming.  He told us that the sonogram had detected an arrhythmia in August’s little heart and had also indicated that he had macrosomia (i.e. he was really big, especially his head).  Since the doctor knew we wanted a vaginal birth, he told us that Laura needed to be induced.  He stepped out for a few minutes, and Laura and I had a few minutes to process this new information.  We discussed the possibility of trying to induce naturally over the weekend if the doctor was amenable to the idea, but when he came back in he said that we needed to go home, eat lunch, and get our hospital bag to go to the hospital immediately.
To say that we were shocked is a bit of an understatement.  I was supposed to go to my practicum in just a few hours, and we had a new tenant in our building that we were handing the keys to in a few hours as well.  All of sudden all of our plans had to change.  So we went home, packed our bags, made some calls, and went out for some Thai food before arriving at the hospital around 2pm.
When we got there, the nurses put us in a room for an extended sonogram and additional monitoring.  We were able to hear the arrhythmia (which was not fun) and meet the staff that would be taking care of us (which was pretty awesome).  The charge nurse that performed the sonogram spent a lot of time talking to us about our expectations and wishes for the birth process, and she informed us right off the bat that she was a patient advocate.  In fact, when she called our doctor to let him know the results of our sonogram, she helped us convince the doctor to let us leave the hospital to grab dinner before beginning the induction process. 
We went to Petrillo’s for dinner and then checked in to the hospital to begin the induction.  Around 6:30, the nurse inserted the Cervidil, which was supposed to “ripen” Laura’s cervix to prepare for the “real” induction at 4am the next day.  They told us that Laura would likely get to sleep through the night and that the real work would begin the next day.  We actually talked about me possibly coming home to sleep that night so I’d be fully rested for the hard labor the next day.
Haha.  Yeah right.  I’m SO glad I’d pretty much decided to stay at the hospital (thanks, in part, to a text from a good friend suggesting that I stay).  Around 7:30 or 8:00, Laura started experiencing very mild contractions every 4-5 minutes.  We were excited that something was happening, and we spent the next couple of hours talking and watching TV.  We decided to play a card game around 9:00, but Laura had a hard time concentrating because the contractions were slowly but surely getting more painful.
By 11pm, Laura’s contractions had gotten significantly stronger.  They were happening just about every two to three minutes, so she just was not getting a break between contractions.  By 12:30am she was shaking violently and the nurse finally removed the Cervidil because it appeared that she was in full-blown, active labor.  (Side note: I just looked up the side effects of Cervidil, and it appears that the most common side effect, which occurs in about 1 in 20 women, is “uterine hyperstimulation”, or contractions occurring at a faster rate than normal.  Yup, that about sums it up!) Unfortunately, Laura had not dilated at all, which was a bit discouraging.
At this point, we realized that we probably weren’t going to be getting any sleep, and we focused on helping Laura manage her pain.  We tried just about everything: walking, massage, counterpressure, shower.  These things definitely helped manage the pain, but it was clear that it was only getting worse.  Around 4:30am, our nurse performed another exam and put Laura on the fetal heart monitor.  By this time Laura had only dilated to 4cm and August’s arrhythmia was very prominent and concerning to hear.  The nurse said she really needed to start the Pitocin since August’s heart sounded so alarming, but after half an hour the nurse stated that she was going to let us try to progress naturally.  We were really excited about this at the time, but by the 6:15am exam Laura was still at 4cm. 

When we heard that Laura had just gone through almost two hours of the most painful contractions yet and had not progressed at all, I could see the light go out of Laura’s eyes.  I remember trying to console her as she told me that she didn’t think she could do it anymore and wanted the Pitocin and epidural.  This was the hypothetical moment I was most nervous about when thinking about the labor, and now it was happening.  I was in the position of having to decide if Laura really wanted the Pitocin/epidural or if she was just exhausted and just saying that because she was tired and would wind up regretting the decision.  So I had to play the uncomfortable role of really challenging her decision.  Even though I knew wanted her to just have the epidural because it SUCKED seeing her in so much pain, I just wasn’t confident that she was thinking clearly.  So we went back and forth for about 10 minutes, and I tried to do everything I could to convince her not to take the epidural (which sounded so stupid coming out of my mouth, but whatever… I did what I had to do).  I remember finally accepting the decision when she just looked at me calmly, with tears in her eyes, saying that she couldn’t go on like this, that she wasn’t even halfway to 10cm and couldn’t imagine experiencing hours more of these intense contractions.  Yes, she wanted to go medication free, but that just wasn’t going to be possible at this point.  (Another side note: I truly think this decision would have been a LOT easier to make if we had known about the side effects of Cervidil.  I guess that’s the one way that the hospital dropped the ball in this process.  I thought the whole time that these contractions were just a natural by-product of the drug, but I didn’t realize that the drug was making the contractions worse/more frequent.)

So we called in the nurse and said that we wanted the Pitocin and the epidural.  It took a while to get the doctor called in, but after about 45 minutes Laura had the epidural and we were both finally able to sleep.  I slept from about 8:15-11:00, and when I woke up Laura was fully dilated and we were ready to push.  The only problem was that our doctor was in surgery, so we had to wait about an hour for the doctor to finally arrive so that Laura could begin pushing.  In that time I was able to see August’s hair, which for some reason made the whole process become real in that moment.  I was really afraid of the whole pushing process before that moment, but immediately I became extremely excited about August’s imminent arrival.  It really was a blur after that; the doctor arrived and Laura pushed and before I knew it August was born!  I even wound up cutting the umbilical cord, which I had not planned on.

Although August’s birth did not go quite as planned, I know that it happened the way it was meant to.  We have a beautiful young boy, and I can’t wait to see him grow up!

Our heartbreaker. Yesterday, 9/10/12.

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