Birth story, part 3- the happy ending

As I mentioned, I was heartened by the fact that I heard a brief cry from Maggie before she and C left for the nursery. I was also encouraged when the nurse brought her over to me before taking her away. That would not have happened if Maggie had been in any real danger. I only wish C were a better photographer. The two pictures we have now of Maggie and me in her first few hours are horrible- I look like hell, and the pics are not well composed so we're not sharing them.


Once C left, I felt like I was essentially on my own in the OR. No one was talking to me, and it was only after repeating "I'm going to throw up" a few times that the anesthesiologist put a puke-bucket near enough that I could almost reach it (then he told me "Try not to miss next time" when I missed with the first round). I was tremendously uncomfortable, and time was still a blur even though I knew Maggie had arrived at 1:32. I could have been in there for 20 minutes or 3 hours as far as I knew. I was still freezing and shivering pretty violently so when a nurse replaced the anesthesiologist, I was wrapped in warm blankets from the arms up. It helped a little, but I was still mostly exposed and mostly frozen while the surgeon stitched me up. Regardless of how long it really took, it felt like I was there for an eternity- still trying not to move so I'd be an easy sew-up, but shivering uncontrollably. I suspect the table was tilted so my head was lower than my feet because I felt pretty upside-down, adding to the awkward uncomfortable-ness. It also felt like a 40-pound brick was on my breastbone- I had a hard time taking more than a very shallow breath and I worried I might pass out, further delaying my chance to hold Maggie for the first time.

After an eternity (where was my baby? where was my husband? was everyone OK? was someone holding my baby or was she untouched and neglected?), the sewing was done and I met the "bear hug," greatest OR invntion I've heard of- a blanket of sorts that hooked up to a low-powered hair dryer which filled the blanket with warm air that was gently pushed out onto my body through a network of tiny vents. Pure heaven, but it still took a good half-hour or so for the shivering to stop. C commented later that he'd never seen anyone shiver as violently as I did in the OR. Unbeknownst to me, I was hooked up to a pitocin IV- I found that out pretty quickly, though, when "after pains" carried on for nearly 18 hours, and not just when I was nursing as I'd read to expect. For that, not for the incision or anything else, I needed pain meds. Seriously, it was worse than labor with Charlotte had been. Morphine was connected to my IV, too, and I actually pressed the dose button 5 times in the first 12 hours or so. The pit was done (three bags, I think) by the next morning, and then Motrin was enough to manage the pain, which was mostly due to a gassy-inflated abdomen once the pit was over. Having a nurse come in every few hours to check on my uterus and do "uterine massage" was pretty painful, too, but that pain ended as soon as the nurse's hands stopped touching my belly.

In addition to the pitocin, I received several bags of IV fluids before the line was removed at about 11 am on Wednesday. I did not count how many bags, but it seemes excessive. Someone said something about making up for all the fluid I lost (blood, amniotic fluid, anythng else?), but that doesn't make any sense to me since you're supposed to lose the amniotic fluid and I didn't have any bleeding issues. In the aftermath, when my legs were painfully swollen from knees to toes, it felt like a sadistic joke to have been pumped so full just so it could puddle in my lower extremeties. If anyone cares to explain that rationale for all those fluids, I'm all ears. But since I will never be pregnant again, it's not something I can improve on "next time."

Once my shivering had quieted a bit and the nurses weren't afraid I'd drop little Maggie, she was brought into my room. She looked exactly like Charlotte to me at first, but with so much more and darker hair than Charlotte was born with. I don't know if there was an issue with her blood sugar at birth, but they were concerned that if she did not feed fairly soon then her blood sugar would drop lower than they were comfortable with. One nurse told me I'd be given a chance to nurse, and then we would give Maggie some formula to make sure she'd gotten enough. The another nurse came in and said it was time to give Maggie a bottle- she was ready to take her away for the feeding. I got mad, really mad. For two reasons- first, I'd been told I'd have the chance to feed her before any supplementation and I was concerned about both nipple confusion and a negative affect on my milk coming in; second, Charlotte had been given her first bottle by a student nurse without my consent on our discharge day, which upset me in so many ways. So, with Maggie, I first expressed my confusion over not being allowed to attempt nursing before the bottle was introduced and then demanded that either C or I feed her. The staff did not cave in to my request to breastfeed, but C was able to give Maggie the bottle. And based on how much she took, I guess she needed it. I think she drank 2oz or something like that, which seemed like quite a bit for a brand-new newborn. The next feeding was entirely mine, and Maggie was given only one additional bottle (also by C) in the 4 days we spent in the hospital. And that bottle was in response to a borderline low blood sugar after I allowed her to sleep a little too long (I was asleep too, and therefore did not wake her when I should have). My milk came in late on day 3, catching Maggie by surprise as she gagged and choked a little when her mouth was unexpectedly filled. To this day, I feel like I'm producing enough to feed 2 or 3 Maggies. Maggie has nursed like a champ since her first time at the boob. All the breastfeeding woes I went through with Charlotte are a distant memory, and my biggest concern now is keeping Maggie's razor-like fingernails away from my very tenderest bits. Mittens or socks on her little hands do the trick, but I sometimes forget at 3 am.

I don't feel like writing more today, but I haven't said much about the recovery. I'll address that in another post. For now, I'd like to annouce that the swelling is nearly gone. There's just a trace left in my ankles and upper feet, but everything looks perfectly normal now. The swelling started to noticeably diminish on day 13. I still had a hard time squeezing into shoes as late as day 18. But things are nearly back to normal now. After the gas, the swollen legs/feet were the worst part of recovering.

Birth Story, part 2

OK, so the midwives broke my water and copious amounts cascaded out while one of them kept her finger on Maggie's head- a very uncomfortable position to be in (for me. I don't know how it was for the m/w). When the fluid eased to a trickle, we all turned our attention to the monitor and saw that Maggie's heart rate was plummeting from 140-ish to 45-ish with every contraction. Contractions also started coming more frequently, although I couldn't tell you how often since this is when everything started to blur for me. The midwives had me roll onto my left side, then my hands-and-knees, hoping a new position would relieve pressure on the cord and prevent additional decelerations. Nothing worked.

C was still standing off to the side, near the door. He heard one of the midwives call down the hall, "All hands in 209!" The room was suddenly full of people. An internal fetal monitor was inserted. An anesthesiologist came in and said to me, "So, we're having a c-section. Why doesn't she have an IV?" He was the first to mention c-section, and the midwives and doctor quickly shushed him (he was unanimously labelled an a$$hole and pretty much everyone apologized for his crude insensitivity afterwards) then turned to me to explain what was happening- each contraction was putting pressure on the cord, blocking the flow of oxygen to Maggie and causing her heart rate to decelerate. She could not tolerate the decels for long, and since no position appeared to alleviate the pressure, the safest course of action would be a quick c-section. A nurse started an IV in my arm (not an easy task while I was on hands-and-knees). I rolled onto my right side and signed the consent for surgery, then was whisked away to the OR.

It was freezing in the OR. Why is it always so darned cold in operating rooms? I sat on the edge of the table while the anesthesiologist administered a spinal. He told me to hunch over and push my lower back toward him. Obviously, he'd never been 9-months pregnant with a big baby who was entirely out front. There was no way I could "hunch." I could slump, but I could not "curl around the baby" or do anything else he was asking me to do. He seemed frustrated with me and kept jabbing me in the back, all while I was trying very hard not to move. I was afraid to flinch as he kept hitting nerves, for fear that he'd hit something even worse and do some damage, or that my movements would somehow harm Maggie. People were talking, but I couldn't tell if they were talking to me. I had tunnel-vision, and the only person I could really understand or pay attention to was the midwife who calmly put her face in front of mine and explained all that was going on. If not for her, I would have been even more lost and scared in the frigid, glaring room full of distant voices.

I kept asking the midwife if Maggie's heart rate was OK. I was afraid that my inability to curl my back would mean general anesthesia for me or serious permanent damage to Maggie. I'm not a crier, especially in front of people I don't know *very* well, but I know I was in tears at this point- frustrated with myself for not being able to comply, and terrified that something awful was happening to my baby. And I wanted to punch the anesthesiologist, who kept right on poking and stabbing, muttering about my not doing as I was told, not warning me before hitting nerve after nerve in my spine. For some reason, he was also harping on getting my tubes tied (not part of my plan, and obviously unnecessary)- like that was his business and something I'd be thinking about at a time when my baby's life was in jeopardy.

Finally, I felt a warm, tingling sensation (thank goodness for the warmth of it!) in my right foot. Then in my left. As it crept upward, I swung around to lie on the table and felt an overwhelming sense of relief- the spinal had finally worked and I would not need to be knocked out, and we could finally get to work on saving Maggie.

Time was still a complete blur to me. When C received his scrubs so he could join me in the OR, the nurse told him it would only be about 5 more minutes until he'd be escorted in. Half an hour later, he was still waiting, worrying that something unthinkable had happened or that I'd needed general anesthesia to speed things up (in which case, he would not be allowed in the OR). When he did finally walk in, C was told not to look at anything but my face because the surgery had already begun.

I remember asking C what time it was just before Maggie emerged. Charlotte was born at 1:25 AM, and I knew we were close to 1:25 PM. I thought it would be interesting for both girls to have the same birth time, 12-hours apart. It was 1:30 by then, and Maggie was out two minutes later. C's first words on seeing his second daughter were, "God- she's BIG!" Then I heard someone comment that she wasn't pinking up and was a little limp. I heard her cry and that gave me hope that she would be OK. A nurse brought her over and C snapped a quick photo of my first sight of Maggie, then he and our daughter quickly left for the nursery while the doctor closed me up.

To be continued...

Birth Story, part 1

I don't have time to write a whole lot now. Charlotte is at a swim class with grandma and daddy, and Maggie is asleep... probably for another half-hour or so. And I hope to take a shower before everyone is back and awake. But, if I don't start writing this now, I'm afraid I'll lose all the details to the haze of time. So here's a start...

My doc (I alternated appointments between a midwife and a DO- love both of them, and trust them both with Maggie's life and mine) had asked that we arrive at the hospital between 6 and 6:30 on the morning of the AROM. In spite of our best efforts, we were running about 10 minutes late, but figured that didn't really matter since nothing runs on-time in a birth center. Babies are not born on a schedule, right? Anyhow, my parents arrived to spend the day with Charlotte, and C and I left for the hospital. The nurses told us when we got there that we weren't expected until 9, but since we were there we might as well get the early monitoring done. I just wanted to go out to breakfast, but they convinced us to stay. 30-minutes later, all was measuring well- small contractions every 8 minutes or so, a steady fetal heart rate with appropriate accelerations when she moved around, no suggestion of an IV or other "invasive" paraphenalia.

The midwives (not my usual one... two others in the same association, but who work exclusively at the hospital) came in shortly after 8 to assess and found that I was essentially unchanged since my last appointment- 4cm, -1-station, and maybe 90-percent effaced. "Walk" they told me. I suggested I get dressed and walk down to the donut shop in the lobby for breakfast, but they asked me to stick to the halls of the birth center. C went out and picked up a breakfast sandwich for me, a muffin for himself. I walked. And walked.

The birth center is one not-very-long hall in the rambling hospital, so walking was extremely dull. I'd met one of the nurses (K) when she popped into my room to make sure the birthing cart was stocked with everything it should contain, and I joked with her that if she needed anything from the supply room down the hall she should just let me know and I'd pick it up for her on my next trip by. I don't know how many times I paced the hall, but eventually the midwives decided I should try somthing a little different and offered me a birthing ball to rock on. The checked me again at 9:30, and nothing had changed. More monitoring, all was well, but no progress toward a natural labor. One midwife said she wasn't comfortable breaking waters with the baby as high as she was, but the other insisted it was OK. I was told to walk some more, rock on the ball a bit longer, and they'd break my water at 11:30 even if nothing had changed. So I walked. The nurses changed shifts and the one who'd done several of my NSTs (and discharged us after Charlotte was born) was "mine" for the next 8 hours. I liked her a lot- warm and friendly, sincere, and chatty where I am quiet so I never felt like I had to make up conversation or entertain her.

11:30 rolled around, and I'd put miles of wear on my slippers and the hallway. More monitoring, another check, and no change whatsoever. Surely AROM would get things going. So, the midwives finally agreed with each other that I'd gone as far as I would without interference, and that as long as they kept a finger on Maggie's head to prevent the cord from whooshing out with the fluid it was safe to rupture the membranes. C ducked out of the room for a moment as he didn't want to see exactly how the membranes would be ruptured (it sounded worse to him that the reality of a "crochet" hook).

Pop.

Whoosh.

Whoooooosh.

Gush.

Waterfall from between my legs.

C came back in and stood off to the side, not sure of what to do.

It went on...
and on...
and on.

All while a midwife kept her finger on Maggie's head to keep the cord from slipping down.

Finally, the waterfall tapered to a trickle and the midwives told me there had been 5-6 times the normal amount of amniotic fluid they expected. Polyamnio-something. Not a problem, just an indication that Maggie's kidneys were working VERY well.

Maggie's waking up. Got to go...

no worries

Things are going well, but with obvious room for improvement. The c-section incision continues to be the least of my worries. The bloat has eased a bit, or maybe I just got used to it. Now, my attention has shifted to my incredibly swollen lower extremeties. If I sit with my feet up, way up, for an hour or so, I can then walk comfortably for about 10 minutes before my feet and ankles return to elephantine proportions. I was walking down some stairs yesterday when I felt a popping sensation and then saw one of my toes visibly swell before my eyes. Until then, the swelling stopped at the base of my toes, but now everything from the knees down is fair game. My calves are rock hard and I can't imagine squeezing into a pair of shoes right now. We'll start all the doctors' appointments next week, so I still have some time before I need to wear shoes or venture outside. But tomorrow is supposed to be warm and glorious, so I will try to rig something tonight so I sleep with my legs elevated in the hope that will kick the day off with minimal swelling.

Charlotte hasn't shown any signs of what I'd call jealousy, but she's incredibly needy and breaks into tears at the drop of a hat. She likes to hold Maggie on her lap and give her kisses. She points out Maggie's "little baby eyes and nose and ears and hands and fingers and baby toes." She cries in the morning because I won't lift her out of bed, and C's nerves and patience are wearing thin. I got a little daring yesterday and held Charlotte, picking her up from her changing table. No actual lifting involed, and I didn't walk while holding her, but it sure felt good to give her a big hug. Today, I had her climb onto a chair and then I helped her "jump" into her high chair from there for breakfast. I think I should be OK picking her up from the floor in a few more days. Once I can do that, and the swelling goes down, and I'll be self-sufficient enough to give C a break when he needs one.

He's not used to dealing with a toddler all the time, and I'm afraid this situation isn't the beautiful bonding experience he was hoping to share with Charlotte. My patience with his parenting is wearing thin too. I don't want to pull the old "my way is better" argument, and I want him to develop his own parenting style, but I also don't want to see it all go horribly wrong. The thing that gets me most is that he never tells Charlotte to do anything. He always asks... "Do you want to brush your teeth now? Are you ready for jammies? Will you go bye-bye with Daddy?" My style is more like, "It's time to brush your teeth now. Would you like to use the green toothbrush or the pink one tonight?" I give her choices, but they both accomplish what needs to be done, while C's "choice" is simply yes or no when a no is not really an option.

Anyhow, they're out on errands now, and I suggested he could stop somewhere for lunch if they wanted to since they won't be back until a few minutes after lunch time at the earliest. I suspect Charlotte will fall asleep on the way home and her afternoon nap will be completely messed up. They could have left 45 minutes earlier except that C kept asking Charlotte if she was ready to get dressed, ready to brush her teeth, if she wanted to put on her shoes, if she wanted to go bye-bye...

Maggie, on the other hand, is amazing. She sleeps. She eats. She poops and pees. Then she sleeps some more. She does not object to sleeping alone in her bassinet, although I've only put her in it when she's already asleep. She was awake most of last night, nursing every 90 minutes or so. She only cries when she's hungry or has a soiled diaper. When she's awake and not eating (a rarity), she looks around with her big midnight eyes and makes little smacking noises with her lips. She's in the bassinet right now, and has been sleeping peacefully since I put her there more than an hour ago.

I need to go put my feet up before she wakes up and I need to walk around the house again.

recovering & learning Maggie

We're still in the hospital. After a c-section, insurance will cover 4 days' stay and I am still quite hobbled so I'm going to take whatever is available. The incision itself isn't too bad, except when I cough, laugh, or sneeze. My back aches from sitting around too much in unsupportive chairs, and possibly from the spinal too, so I have a hard time standing upright. I'm also ridiculously inflated. My belly is so full of air that it resonates like a drum when tapped on. I try to spend a decent amount of time walking around to help move the air out, but it's difficult and a bit painful. I have yet to see the incision- it's well below the inflated belly which blocks my view.

Maggie is turning out to be a fantastic nursling. She had no trouble latching from day one, even though we were advised to supplement a couple of times in her first 24 hours to keep her blood sugar from plummeting. C really liked having the chance to feed her the two bottles that she had, but I was a little disappointed and worried about the problems that could have resulted. But, everything is fine now. I think my milk is starting to come in already. Maggie wakes on her own every 2-3 hours to nurse, and manages to continue sucking even when she falls asleep mid-meal.

I'll write a bit about her birth story later, but want to mention now that the c-section was not the result of induction. My first thought when the midwives starting breaking the news to me that a c-section was be necessary was that I had fallen into the cascade of interventions that I've read so much about. In fact, being induced and having my water broken under controlled and closely monitored conditions may have saved Maggie's life. I cringe and cry when I think of what could have happened if my water had broken at home and I'd waited for labor to "start" before seeking medical care. Tuesday was a frightening and emotional day that I will never forget. I've experienced the two extremes of childbirth, and I'm glad this one didn't come first or there may not have been a second.

well, there was no pitocin...

Margaret Frances was born via c-section at 1:32 this afternoon after some serious decels that followed the AROM. The cord was wrapped twice around her neck and up under her arm. She's perfectly healthy and sleeping beside me. She's 22 inches tall and weighed 9 pounds 6 ounces. We can't believe how much she looks like Charlotte, but with more and darker hair.

nothing naturally

We're off to the hospital for as non-intrusive an induction as I could dream up. They'll break my water this morning and see what happens. I hope that's all it takes. We'll have a laptop at the hospital, but I don't know if they have WiFi so I'm not sure I'll be able to post. I'm not sure I'll be in a blog-posting frame of mind either, honestly. In any case, the clock will start ticking in an hour or two, and as soon as I am up to it, I'll let you know how it went. I'm about to have my biggest Valentine's Day ever!