Monday, September 13, 2010

Natalie's Birth and Beyond

Monday, Sept. 28th, I had a doctor's appointment and ultrasound since Natalie was two days late. I had the ultrasound done first, then went upstairs to see my doctor. She did an exam and we made a plan to induce in case labor hadn't started in the next week. She got the results from the ultrasound; everything looked good, except that the technician hadn't observed practice breathing. So, I was sent up to maternity for a non-stress test. (This is where the monitor the baby for an hour to make sure that the womb hasn't become a stressful environment).

I laid back on one of the birthing room beds with a monitor attached to my belly. I was a little nervous, scared that something could be wrong. I had brought a new books with me, The Girl with the Pearl Earring, and I tried to read some of it while I waited out the hour. The results weren't conclusive, so the nurse scheduled for me to come back the next day at 1PM for another test.

In hind sight, I believe it was during this test that I started labor. A slight menstrual cramp feeling had started, but I figured it was just a normal pregnancy discomfort and wasn't concerned since I was in the process of being checked out by a nurse. As the evening went on, the feeling got stronger. I called my mother to ask her about it, but she said she never had menstrual cramps, so she couldn't compare. However, a friend's mom said that was what the start of labor felt like. I was excited, but still not confident. I knew it could be a long time before it was time to go to the hospital and I didn't want a false alarm. I was also comforted knowing that no matter what, I had a 1PM appointment the next day.

By bed time around 10PM, the feeling was coming in more like waves. It was uncomfortable, but by no means unbearable. Mike and I went to bed and I managed to get some sleep, but got up at 4AM, which wasn't that out of the ordinary anyway, since I often moved to the couch in the early hour of the morning late in the pregnancy. After a little while, I started writing down the time of the contractions; they varied from 3 to 10 minutes. By 7 AM, I was pretty uncomfortable and decided we should call the hospital. The doctor on call (who I believe wound up being the one who delivered Natalie) said to come on in and get checked out, which was both expected and very anti-climatic. Getting ready and getting over there took about an hour. It was very much NOT like how the situation is depicted in movies and TV. There was no rushing around at all. Mike wasn't that least bit frantic. In fact, I wished that he would hurry up as he was going through his regular routine of showering and flossing and all. Looking back, he had probably expected me to make it more clear if I needed him to do something, but I really didn't ask much from him at all.

When we arrived in maternity, I was given a non-stress test again, which meant sitting and waiting for another hour. We were in a tiny room that felt like a closet compared to the big birthing room I'd been in the day before. Also unlike the day before, I was far more nervous and excited. Mike and I talked to pass the time, but it was slow going. At the end of the hour, the nurse returned to check my dilation. She said I wasn't dilated at all, which was very upsetting and I started crying, not sobbing, just crying. I really hadn't wanted to come all the way to the hospital to be told to go home and wait some more. I would have much rather just stayed at home with some comforts. Also, with the amount of discomfort and no dilation, I was worried about the long haul. We had planned to try without pain medicine, but that wasn't looking like a possibility anymore.

They decided to monitor me for a little longer. I'm not sure if the reason they didn't send me right home was because of my discomfort, my crying, or my past due date. I'm not sure how much time went by, but my doctor came and checked me. She said I was 2cm dilated. This was a huge relief. I still feel like the first nurse might have miss measured me due to how low everyone said Natalie was. Throughout the day, pretty much everyone who checked me had a hard time and I was often asked to make fists and place them under my hips to help out.

My doctor decided to admit me as well, which was a surprise since we were told in birthing class that dilation needed to 3 - 5cm to stay. I'm fairly certain she made this choice because we were past due.

We figure this was at about nine. The next few hours went by slowly for me. We had to wait to be brought to birthing room, wait for a nurse to be called in on her day off to help, and go over a lot of information on forms for her to put into the computer. I had hoped to walk and move around more in labor, but these things really got in the way of me doing that on top of being hooked up to monitor for the baby and the contractions. I just didn't feel comfortable trying any of the things we had learned about with a nurse asking me questions.

My contractions still weren't regular, so when my doctor returned, she wanted to break my water. We did this and discovered that the baby had had her first bowel movement inside the womb, most likely because she was a couple days overdue. This meant that they would have to keep me hooked up the monitor and that the pediatrician must be present at the birth in case Natalie had inhaled any of the waste. My doctor and I also talked about pain medicine. Since my dilation was progressing so slowly and I was very uncomfortable and not able to move all that much, I knew that going the long haul like it looked like it would be, would be very difficult. Originally, we had planned on trying a drug called Nubain, but it was more of a relaxing drug than a pain killer. I felt pretty relaxed already, so we decided to go for the epidural even though that hadn't been part of our plan.

Around here I lose track of what time. The epidural was ordered, but we had a wait a while because there were only two anesthesiologist at the hospital that day. I really don't know how we passed the time until the anesthesiologist arrived. When he showed up, of course he had a bunch of procedural stuff to do first. He got to the point where he was numbing the site, but he was beeped on an serious emergency and had to leave! This was extremely frustrating, but understandable. The nurse felt that we should give the Nubain a try while waiting for him to return, so we did. This was a very good idea. Even though I felt relaxed, the drug really helped me mentally deal with the pain. I think it was about an hour later that he returned and I got the epidural. It took affect quickly and the rest of the labor up until the end was very easy because of this. I could barely even feel the exams to check dilation. Of course, I couldn't get up, but that was okay because Mike was there to keep me company and right around that time Mike's mom arrived. Because of Mike's mom's arrival, we figure this had to be around 3PM.

The next several hours went by more quickly. We turned on the TV to pass the time. I remember Law and Order, Rocky III, and Dancing with the Stars. I dozed a little bit, but I don't think I was every fully asleep for long. Also, shortly after the epidural, the doctor put me on potocin to regulate my contractions so that they would make me dilate more. There were a couple glitches with this because it lowered Natalie's heart rate a few times, but when I moved on to my side that seemed to solve the problem. I wasn't worried because I trusted the doctor to tell me if there was something to worry about. They also had me breath oxygen a few times, too. I counted at some point that there were like 6 or 7 things attached to my body (IV, epidural, catherder, baby monitor, heart rate monitor, oxygen, and I feel I'm forgetting something else).

The nurse who had been with us all day left around 6 PM and my doctor left some time later too because she had been at the hospital working longer than us at that point. When the second doctor came in to check me, I was up to 8cm dilated, which was very pleasing information. Before that, I was at about 5cm and my doctor was beginning to think about talking about a C-section. At about 10PM, I was ready to start getting ready to push. I couldn't feel much of anything, so the doctor had the nurse lower the epidural. I started pushing sometime after that, maybe 1030PM.

Time is hazy here, but I'm pretty sure I pushed for close to two hours and know it was at least an hour because she came after midnight, and we really thought she'd make it before midnight. At first, the pushing wasn't that bad because the epidural was still going strong, but as it wore off the pain increased. It wasn't so much her crowning that hurt, but the contractions. I also had trouble with the breathing. They wanted me to hold my breath while I pushed and then take another breath quickly and push again. That was far more difficult for me than the act of pushing, even though I did get tired. I wanted to make noise as a pushed, but they kept saying to hold my breath. It felt like I was going to break blood vessels in my face, and I didn't understand how it helped. I remember being frustrated that the nurse wanted me to push when I felt a contraction coming on, but in all honesty, it just hurt consistently and I couldn't tell very clearly when I was supposed to push. It was definitely hard to remember all the instructions for pushing each time while I was actually doing it. (Hold your breath, push a certain way, keep your legs a certain way, etc). The breathing, knowing when to push, and remembering everything was a lot of what slowed it down. Also, at some point I threw up due to acid / heart burn. What sucked was that I didn't have time to warn anyone one it was coming. Dealing with that broke us out of the rhythm a little bit. After at least an hour, I said to Mike that I couldn't do this for another hour, and someone said that I wouldn't have to, she would be born before then.

Possibly the biggest difficulty was trusting the nurse, Mike, and his mom (Mike and his mom each held one of my legs for most of the pushing) that each push was making progress because it didn't feel all that different to me until the end. There was a moment in there when the pediatrician walked in to the full view of everything, but I could have carried less at that time. I kept talking to Natalie in between pushes telling encouraging her to come out. The nurse had me reach down and feel her head when she was crowning, which I wasn't sure ahead of time if I wanted to do, but at that point it was very reassuring. At some point, I realized that the doctor would be staying in the room if we were really that close, so when he got suited up and stuck around, I knew we were truly getting close to the moment.

I don't remember much about the actual moment she was born. Mike tells me that he was surprised that suddenly he could see her face. I remember the feeling of the rest of her body being born (an easy warm rush), but not her head.

Right after her head was out, the doctor had me stop pushing because they were a little worried the cord was around her neck (because of the drops in her heart rate earlier), but there was no problem. They moved her quickly over to the cradle where the pediatrician could look her over. Mike says she cried about half way across the room.

I didn't get to see her for a couple minutes because the pediatrician was looking her over and because the doctor was working on getting my afterbirth out. Then, Mike brought her over to me. She had such adorable checks! The contractions began to hurt again after the relief of the birth, but the nurse turned the epidural back up a bit because the doctor had to fix some tearing. I couldn't feel most of this, but it prevented me from holding Natalie for a little bit. It seemed like he was stitching forever, but I never found out exactly how many stitches I had like some women know. I found out when he was basically done that I could have held Natalie while he doing the stitches. As time has gone by, this fact has bothered me more and more. I was very jealous of Mike and his mom holding Natalie during this time, and I am annoyed that I was expected to ask to hold my baby in a hospital whose birth class emphasized the importance of immediate skin-to-skin contact. Anyway, Mike and his mom spent time inspecting her and telling me about her.

When the doctor was done, I got to hold her. After just holding her for a minute, we laid her tummy to tummy me and she worked her way up to my breast with very little help. She latched on and suckled some. I was amazed with how so soon after birth an infant so otherwise defenseless could manage to do this.

After that little bit of snuggle time, Mike's mom left and the nurse started getting us ready for bed. We were both exhausted. She gave Natalie her shots, pricked her heel for her blood type, gave her a bath, and put on her ankle bands. Since the birth, the nurse had slowly removed all the things attached to me. Once Natalie was all set, the nurse helped me get cleaned up for bed, but that didn't consist of much since when I stood up I immediately felt incredibly dizzy, as in a few second from fainting, and had to sit back down. We finally got to bed at about 4:30, and Natalie spent her first night in the nursery so we could sleep.

The rest of our hospital stay is mostly a blur. I have some very clear memories, but it doesn't make up for most of the time there and some of the ordering is hazy.

I slept alright that night, but did sweat a ton like I had read about in What to Expect. Mike slept on a fold out cot. I think that a nurse brought Natalie into us in the morning, probably around 8am. At this time, our regular duties as parents started. At first, Mike did all the diapers since it was so hard for me to get up and down. He would bring Natalie over to me to nurse.

The first day, we were left alone for the majority if the day. Mike's mom visited us in the morning for a little bit. Otherwise, the biggest thing that happened to us was switching rooms. This was to our advantage since we got the big water birthing room I had my first non-stress test in which also had the double bed. It was more spacious and no cot for Mike. We thought the lack of contact was normal, but found out it was because they were understaffed. The only reason this really bothered us at this point was because I was asking for pain medication because it didn't seem important enough to use the buzzer. I had just given birth, I figured it was going to hurt. But, I found later that a nurse could come in when it was time to give me the medicine instead of me having to ask.

The second day, I felt good enough to get out of the hospital johnny and get dressed in my pjs. I had a much easier time getting up and down, probably a lot dealing with more pain medication. It was probably this day that I was taught how to use the football hold and side laying position for nursing. We had a friend come to visit us in the evening. We continued to be very impressed with the food that I was given, but I found the contact with the doctor that delivered Natalie rushed. He came first thing in the morning, waking me up, and asked if I had any questions about my health, not the baby, and said it in a tone that just rubbed me wrong way. Of course, at that time, I didn't, and later had to ask the nurses questions.

If memory serves me right, it wasn't long after taking our favorite hospital pictures of Natale swaddled that we noticed she looked a bit yellow. It was late at night. So, we buzzed the nurse. She agreed and took Natalie away to test her. It turned out that she had jaundice. This changed things greatly. We were supposed to leave in the morning, but now we could not. Also, the suggested treatment was to give her formula to help work the biliruben out of her system, but I was very worried this would interfere with her learning to nurse. I wound up sobbing. I wasn't that upset in actuality. I knew that she wasn't in danger of dying. I also was understanding that if nursing didn't work for us, then it wasn't the end of the world. But, once I started crying, I couldn't stop. I couldn't see because of the amount of tears. I remember there being a lot of nurses there talking to us trying to comfort us and me saying "I'm really not that upset, I just can't stop crying."

Here is a hazy patch. I know that we had to put Natalie in an incubator under blue lights as much as possible. I know that we also agreed to give her some formula, which Mike fed to her. Since we weren't going home, Mike had to make a trip home for us. We needed more clothes, better snacks, and a couple other items. This was my first time totally alone with Natalie. I was still very nervous about picking her up, afraid I would hurt or drop her. While Mike was gone, I did buzz the nurse because I was supposed to leave Natalie under the lights, but I couldn't get her to stop crying, even though we had fed her, changed her, and offered a paci. No one came to help me. I wound up deciding to wrap her up and hold her, but was still upset no one came to help at all. At some point, Mike's mom and his brother and his wife visited for an hour or so, but Natalie stayed under the lights the whole time.

We continued to have trouble getting Natalie to stay asleep in the incubator and were still worried about the formula. So, we talked to the pediatrician on call. For some reason, I again think this took place at the night. We decided that we would nurse every hour and use the small device called a Wallaby which wrapped Natalie in blue light so she could be held. I spent most of the night awake holding Natalie and watching TV. I remember a horror movie documentary.

Natalie was tested again. We had really hoped that we had done enough to get her levels down enough to go home. But, the pediatrician on call was very cautious. Even though it was clear to us that all the nurses disagreed, he wouldn't sign off on us leaving. We had another discussion that I feel was at night (maybe it was because we kept that lights so low in the room?). The nurse we were working with said that she could call the head of pediatrics and discuss our leaving with her. After a long talk with the nurse and then talking alone together, we decided to not have her do that. But, we didn't want a repeat of the night before since we didn't want to leave for home already exhausted. So, the nurse said that they could take Natalie in the nursery for the night and make sure that she was happy in the incubator with the lights. Even though it was hard to trust the nurses to do this, we decided it was the best option.

We kept Natalie until almost midnight. My sister and her husband came to visit us and helped us pass the time while Natalie was in the blue lights. We had worried that it would be rough going like the day before, but she slept pretty soundly the whole time. We watched The Longest Yard on TV. We slept alright without her with us. But, I woke up around 5 or 6 hearing a baby crying. I didn't know when Natalie was coming back to us. I was worried that it was her crying. So, Mike brought me out to the nursery. (Until that point, I had not left out room aside from the walk where we switched rooms. Mike had dutifully gotten me anything I needed outside of the room) Turns out, that Natalie was fine and had slept well and had a bottle without a problem. So, we head back to our room since she was sleeping.

She was tested again in the morning and the doctor agreed that her levels were low enough for us to go home. My sister and her husband returned that morning. The checking out process took a while. There were a lot of papers to sign about knowledge that had been shared with us. It seemed to take forever to get our things ready, get through the technicalities, get Natalie ready, and finally make it to the car.

We finally head home after five and half days in the hospital.

Mike had to leave that first day though for his father's memorial, which was why his brother was up from Texas. My sister and her husband stayed with at the house with me. I didn't feel comfortable asking too much of them because I was feeling alright and we didn't have any trouble managing Natalie. After Mike got home, they left. Mike made me dinner, which he continued to do for many nights. (In fact, since Natalie's birth, we have cooked dinner to have together at least 80% of the time, which was not the case previously for various reasons including his bi-weekly visits to his mom's, my allergies, and lack of ambition). We tried to settle in for the night, but Natalie wasn't having it. Even though she had eaten, she didn't want to sleep. We tried playing a babies lullaby CD I bought and playing her mobile. We tried giving her some formula. We tried putting her in the swing in the living room. Nothing helped. We tried letting her cry it out a bit thinking she might just need to get it out of her system. In the end, we nursed again and let Natalie sleep on the bed in her room with us instead of the crib. This worked, and this is how we continued to do things most of the time for the next week or so.

That night was the worse night we had with newborn Natalie. In the morning, she had a huge dark chocolate poop. We couldn't help but think that if we'd had that inside us, we'd be crabby, too. This poop was a huge deal to us because we were watching for a good poop to further show she was over her jaundice since biliruben exits the body through stool.

That morning, my milk finally came in, which was another huge relief. We also took Natalie back to the hospital for our meeting with the lactation consultant, who was also our birth class instructor. I had a long list of questions for her and felt very comfortable just going right on down the list. I was very happy that while we were nursing in her office, she said Natalie's latch was fine except for a little bit her bottom lip being curled in. Also, I got to see my milk for the first time as it dripped out as Natalie drank on the other side. This did a lot to help calm my anxieties.

The next few days went by pretty smoothly. I did feel rather anxious in general. Looking back, I know it was the hormone changes and the newness of it all. I was just concerned that we would suddenly have an inconsolable Natalie screaming at us for hours and hours. But this never happened. Even though she cried and we had some struggles, we were never over our heads. Over the next couple of weeks, Mike's mom visited again, my family came for the day, and my sister came back again to help out for a few days, including taking going to Natalie's 2 week check up and helping me shop at Walmart.

Mike was able to stay home from work for about three weeks, which was longer than originally planned since we were in the hospital longer than planned. He did leave me alone a couple times; once to go shopping at Babies R Us, which was when we got out sling, and the other time I think was for a car appointment. I was very anxious about being alone with her at the time, but knew that soon we'd be alone all the time. The day Mike went back to work, was also a day that the hospital was supposed to have a breast feeding support group. I decided that since I was feeling that I could use some support, we'd go. But when we got there, no one was there! We were having a shed built in the back yard, so I felt stupid coming back so soon when I said I'd be gone for a while, so Natalie and I went shopping instead. This trip really let me see that I could handle bring her out by myself, and that Friday we went to story time at the library for the first time.

I remember these early weeks mostly in terms of senses. I remember the engorged feeling of my breasts, the pain in my tailbone, and the pinching of Natalie latching on. I remember the darkness in the house as it became rainy fall, with its earlier night time darkness and cloudy days. I remember the dim lighting of her bedroom as we'd put her down to sleep. I remember trying to drink 8 glasses of water a day and the glass always on the night stand. I remember eating applesauce in the middle of the night. I'd often sleep with my glasses on to see her through the crib slats, and we always slept with the light on dim so I wouldn't have to turn it on and off. I remember walking around the house at 2am with Natalie almost every night. She would be in the sling after I nursed her and I would walk the same circuit around the house five or six times before sitting down in the living room and turning on Adult Swim. I'd often dozy off a bit, too. I often would rock back and forth with her as I checked my Facebook. I'd then move Natalie out of the sling into her bed. If she was thoroughly asleep, the jostling wouldn't wake her, but more than once, I'd be frustrated at having to start over. I remember putting the nursing pillows on the floor with my slippers and some other items overflowing off the end table, then crawling into bed with my hood up and the blanket pulled up close. I was cold a lot in the beginning. It felt like I was always making cups of tea, even in the middle of the night.

By Christmas, life with Natalie was much easier. We moved back into our bed room and soon Natalie was sleeping through the night. She was smiling, sitting in a Bumbo, and playing with toys. Already, the experience of having a newborn was transitioning into something else. Now, almost a year later, it is hard for me to remember Natalie at only 8lbs, Natalie not being able to "talk," Natalie not being able to ravenously latch on, Natalie not being able to even hold her head up, let alone sit, crawl, or walk!

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