Friday, November 17, 2006

Isaac's Birth





On the day before my due date(Wednesday, Aug 23), I had an appointment with a midwife (not my primary one) and everything was good. The baby's heartrate was good, my blood pressure was good, I was 3 cm dilated and 80% effaced (woohoo!) The midwife offered to do an induction, which to this day I am not happy about. The thing is, both midwives were going to be out of town during the weekend and there was a chance that I would go into labor while they were gone. I didn't want to be at the mercy of just any obstetrician with a hobby for unnecessary surgery. As rumor has it, there are several OBs with a penchant for surgery. Yikes! The induction was scheduled for my due date and I had a favorable Bishop's score. At any rate, I decided to go forward with the induction. The next morning, we made a few phone calls and lined up Nana to take care of Caroline. Todd drove me to the hospital at 7 AM and I headed up to Labor and Delivery. Todd took Caroline back home and waited for Nana to arrive (she had just returned from a vacation at that morning at 3 AM).

Once I was admitted to the hospital, I really started to panic. I was at a hospital and I was a PATIENT! Not just any old, run of the mill patient. I was considered Pre-OP. That is, being in labor means that you are considered to be on the verge of surgery at a moments notice. I was very concerned by this turn of events. I considered going home, but I feared going into labor over the weekend and getting stuck with surgeon (I mean Obstetrician, but OBs are surgeons...) The nurse went over lists and lists of complications (informed consent) of the different procedures thaat they do. For example, epidurals carry certain risks, like a precipitous drop in blood pressure, followed by drop in fetal heart rates, necessitating a cesarian section and so on. I didn't really need or want to hear about the risks. I knew what they were. What concerned me most was being in the hospital to give birth. Caroline was born in a free standing birth center. There was no patient bed, like you are used to seeing at a hospital, but a regular bed. There was some medical equipment and such, but it was out of the way. This hospital room was a high-tech operating room. Okay, I know it wasn't an operating room, but it is how I felt.

The delivery room had its own mini-NICU off to the side, which also scared me. Seeing the NICU bed scared me into thinking that they would take my soon to be born baby away from me. Of course, I knew that there was always the chance of something going wrong necessitating a quick delivery and newborn resuscitation. However, such an event is unusual, but more likely if you deliver in a hospital. Outside a hospital setting, the interventions are fewer and I think in most cases babies are born in better condition. There are situations which need careful monitoring in a hospital. And if problems arise in a birth center, it is always advisable to transport to a hospital. At any rate, here I was, in a HOSPITAL as a PATIENT and I was really uncomfortable with that. I don't recall ever truly being a patient, and the lack of control as a patient really bothers me.

My midwife came in to talk to me and I relayed my concerns to her. She said that once the pitocin induction was started, I would need to be on a fetal heart rate monitor. However, if my labor picked up on its own, they could stop the pitocin and I could walk around without the monitor and such. I agreed to begin the induction and an IV was inserted (ouch!) and the pitocin drip was started. The nurse started the pitocin very slowly, up the amount by a little every half hour. The contractions started within 10 minutes. They were wimpy contractions. I kept trying to tell my body to pick it up! These contractions are going to get us nowhere fast! The contractions were regular and annoying because they hurt, but they didn't hurt enough to push a baby out. Todd arrived shortly after the induction was started. It was really strange laying there in the hospital bed waiting for labor to really start. We talked about mundane things. "Did you call so and so?" "Did I put that load of clothes in the laundry?" And so on. I told Todd to go an get me some food, because I was starving. Of course, since I was a pre-surgical patient, I was NPO, as in nil per os or nothing by mouth. The whole NPO business during labor is quite controversial, because you are essentially stop intake (food and water) during a very physically taxing event. I've heard labor compared to running a marathon in terms of the energy required. Just try telling a runner that he can't eat or drink during a marathon. Such advice would be considered laughable. Go into a hospital and you will see that this is required of ALL women in labor. I think that not eating during labor increases your chances of having a c-section, because maternal exhaustion is one of the reasons c-sections are done. The reason for NPO is aspiration pneumonia brought on by emergency surgery. This is, however, extremely rare and I have yet to see where its incidence necessitates NPO for everyone. But I digress. Todd went and found some snacks for me. Everytime the nurse left the room, he would slip me some M&Ms or peanutbutter crackers. Then, rumor came back that the hospital provides free jello (okay, I know its not free, but I'm trying to stay on point here). I asked for some jello and scarfed it down like I had never seen food before. Man I was STARVING! I think that the being NPO made me even more hungry. While in labor with Caroline, I snacked as neccesary, first on chinese food (which wasn't appetizing at all) and then on some granola bars and yogurt. Food wasn't a huge deal to me when I was allowed to have it. At this point the contractions were picking up such that I had to stop and concentrate on my breathing to get through them. They hurt, but I knew they weren't doing much.

At lunchtime, when everyone left to go eat, my midwife came back in to visit with me and she check me to find that I was 4 cm dilated. Not bad for 3 hours into an induction. Though considering that I had come to the hospital dilated to three, I was hoping for some more progress. She talked to us about breaking my bag of water. At first I said "no" because I felt it was an unneccesary intervention. The midwife said that it would be fine either way, but I might be in labor a lot longer if she didn't break my water. Plus, since my contractions were pretty strong and regular at that point, she could break my water and take me off the pitocin and I could move around more and walk the halls. I agreed to it. The baby's head was really low at this point, so there was not a big gush of fluid or anything. It was more like a steady trickle. Once my water bag was broken, the contractions became much more intense. The nurse took me off the pitocin drip and I started to walk the halls with Todd. We walked by the nursery and saw all the freshly birthed little babies. They were so cute screaming in their own little plastic boxes. Wait a second... did I miss something? Why weren't these babies with mom, since they had clearly just been born? I asked Todd about it and he went and talked to our L&D nurse. He found out that rooming in is only allowed if the pediatrician okays it. WHAT? We aren't allowed to keep babies we birth with us? Yep. It was hospital policy. Babies stay in the nursery where they belong. The nurses bring them around every few hours so that mom can nurse. If babies get hungry while the nurses are busy then they get a bottle (if you formula feed) or a pacifier if you breastfeed. And if they don't take a pacifier (Isaac doesn't, even though I want him to), then they just cry. It's soo sad. Todd phoned our pediatric practice about faxing us permission to keep our baby after the birth and they gave him the run around. Eventually, he spoke with the someone who said they would fax the form, etc. So, while we were walking the halls, my contractions were picking up in intensity and slowing down in frequency. We tried everything to get them going again. I sat on the birth ball, walked around stayed upright as much as possible. Eventually, my contractions completely stopped. At around 4 pm, we told the nurse to start the pitocin again and so there I was back in the bed, on the monitors, attached to different machines, measuring my blood pressure, providing fluids, and detecting the baby's heartrate. As soon as the pitocin was started, my contractions started back. They were coming every three minutes and they hurt. I had to breathe through each of them. I started joking about getting some drugs to help me out and at this point, I knew I was in the thick of active labor.

I told Todd I wanted to watch something on TV, because we don't have cable at home, and when it is available to me, I like to watch it. We flipped through a few of the channels and found nothing but Jerry Springer and a murder mystery (something like American Justice) where a really creepy guy killed 10 people or something. So, I sent Todd went to blockbuster where he bought a few of their previously viewed DVDs and while he was gone, he ate some lunch. I endured contractions by myself for close to an hour. I knew that I was approaching transition and that it was going to get worse before it gets better. I kept hoping that Todd would get there soon, because I didn't want him to miss his son's birth. Eventually, he came back and showed me the DVDs he bought. I remember one of them being "The Wedding Crashers" and he put the movie in so that we could watch it. My contractions were too bad at this point for me to even notice the television. I told Todd to turn it off and he did and we focused on my 1-2 minutes apart contractions. I started telling him that I needed an epidural NOW! Drugs! Anything! I wanted all the drugs in the hospital. Todd and the nurse ignored my requests for drugs, because they knew that the baby would be born soon. The contractions were so bad that I was yelling through them. Todd started talking about the baby. Big mistake. I told him and everyone else I saw that did not want a baby. Nope. I was done with this whole "labor thing" and I was ready to go home. So Todd told me that it was okay, I didn't have to have a baby, but I needed to breathe with him during the contractions. The nurse checked me and announced that I was 6 cm dilated. Oh no. Last time, it took several more hours to approach full dilation. The nurse asked if I felt like pushing, I nodded. A few minutes later, the midwife checked me and announced that I was in fact 8 cm dilated. I could feel the baby moving down and I knew it would be over soon. My midwife told me to try pushing. I said "Are you sure?" and she said that since I had given birth recently, there was a good chance that my cervix would stretch the last 2 cm during pushing. I started pushing and pushing and within a few minutes, the baby crowned and he was born very quickly. My midwife handed him to me and I laid him on belly because the cord was quite short. As soon as the cord was cut I brought him up to my breast so he could nurse. He cried as he took his first breath and then he nursed for at least 10 minutes. The placenta came out fairly quickly and an my perineum was intact, so no stitches. Once the placenta came out, the nurses took Isaac to the mini-NICU and weighed him (8lbs 5 oz) and put erythromycin in his eyes.

Once they had him dried off and weighed, they wanted to take him to the nursery. What???!!! So, Todd inquired about the fax that was sent authorizing us, the parents, to keep our child with us. "What fax?" Apparently, the fax was not sent. Todd called the pediatricians' office and of course, they are closed. Todd got the rounding pediatrician at the hospital on the phone and asked about rooming in with Isaac. The pediatrician said "no." I don't know much about what else happened, but at that point we severed our relationship with this particular pediatric office. The nurses worked on finding us a new pediatrician that would allow the rooming in. Within an hour, we found a new pediatrician that allowed us to keep our son with us. I had no idea that rooming in was a special request that needed formal approval from a pediatrician. Why was it such a big deal? Once we had authorization to keep our son, I handed him to Todd and got up and walked to the shower, so that could clean up and feel refreshed. After birth, I always have natural "high" that gives me all the energy in the world to do things. Yes, I showered within an hour of Isaac's birth. I shocked all the nurses with my insistence on the shower. They didn't resist much and they helped me cover up my IV site with a glove. After the shower, I went back to the bed which had gotten some new linens and laid down. I told Todd that I was hungry and he said that he would get me whatever I wanted. I distinctly recall saying "one of everything, please." The nurses gave him some vouchers to use in the cafeteria and he brought back a tray full of food. Fries. Cheeseburger. Some chicken thing. Chocolate. A soda. And so on. I took one bite of each thing and just could not stomach any of it. I was STARVING but nothing looked good to me.

Soon after that, we moved to the postpartum part of the floor. I had a private room, but it was much smaller. It was still very nice. I received an itemized copy of the hospital bill and my insurance was charged $750 a night for this room. Wow. I could get a suite at the Ritz with an ocean view for that much. Oh well. The first night Todd was walking the halls near the nursery and he said that it was full of babies screaming. Why, again, did the hospital make such a big deal about us keeping Isaac? After 2 nights, we went home. My dad and stepmother helped us get everything home and we arrived to a very clean house and dinner prepared by Caroline's Nana. It was great. Caroline ignored me for a while, because I'm sure the separation stressed her out. Within a few days, things were back to normal.

Saturday, November 11, 2006

Thursday, November 09, 2006

Birth Stories



I realized recently that I've never really shared 2 birth experiences with my blog readers. Well I've decided to forever give them up to cyberspace and post them on my blog. For whatever reason, I am having trouble publishing the photos. Just click on the boxes and they will come up in a new window.

Caroline's birth

On my due date (12/01/04) with Caroline, my amniotic fluid started leaking. Although I wasn't aware of it at the time, it was definitly leaking. The next day, I phoned my midwife and mentioned that I thought my amniotic fluid was leaking. She told me to come in so she could check. At the midwife's office, she did a nitrazine test, which is basically litmus paper that measures the pH of fluid. I think the test is usually inconclusive, so I'm not sure why it is even used, but I digress. The midwife did another test which required that she dry the fluid out and check for ferning. The second test showed positive signs of amniotic fluid, though the membranes were intact at the cervix, so it had to be a high leak. My midwife told me to go home and go to sleep, because I would probably be in labor very soon.

The next morning I woke up and Todd was busy in the kitchen making me a castor oil milkshake. Yum! Okay, it was really, really disgusting. My midwife recommended it in the morning if labor had not started, and indeed, it had not. So I downed the milkshake, gagging the whole time. It was NASTY! I still cannot eat vanilla ice cream. We waited for contractions to start. Around noon on December 2nd, we talked with the midwife and she told us that I would need to go in for an induction if labor didn't start on its own soon. At 3pm, we headed for the hospital for an induction. While I was packing my bag (yeah, I hadn't done that yet)my contractions started. I didn't want to get too excited, so I didn't tell Todd. Todd dragged me to the car and we headed for a Brooklyn hospital. I called my doula and apprised her of the plans. She planned to come to the hospital, once labor was underway. At the hospital, I went to check in at the L&D desk. They were asking me lots of questions even though they had my file. I thought it was very annoying. I finally said "look, I having a contraction! stop!" The nurse said "so you don't need an induction?" Ugh. I couldn't think through anything, because my contractions were 6 minutes apart and I had just spent the last HOUR in the car enduring them. Finally, a midwife at the hospital recommended that I go to the birth center(our original plan). She said that I would almost certainly have a better birth experience. At that moment, Todd, having finally found parking, came in with our various bags. I told him to pack up, we're going to the Brooklyn Birthing Center.

Once we finally got to the car (another 30 minutes), I told him I was in labor. Definitely in labor. We timed my contractions and they were 8 minutes apart. I called the midwife and my doula and told them about the change in plans. No induction! I arrived at the birthing center and the midwife checked me and said that I was 1 cm dilated and 10% effaced. I was very disappointed with the news. She told us to go outside and walk around for a few hours. The doula had joined us by that point. Once we got outside, I realized that this was going to be a long night. It was approximately -20 degrees with the windchill. Todd gave me his coat, since I didn't have one that fit me. Of course, he was very very sick for the next weeks, so I don't recommend this course of action. Todd and my doula kept walking for at least a half hour, before I told them that I NEEDED to go back to the birthing center. No deal. We have to keep walking, they said. I kept trying to find excuses (I'm cold, I need my Mylanta, etc.) that would allow me to go back inside where it was warm. Nothing worked. Finally, I told them that I had to go to the bathroom. Bingo! We went back inside and the midwife looked at us like "what are you doing here?" I went to the bathroom and delayed as much as possible. It was really, really cold outside. We went back out into the freezing cold December-in-New York-weather. We walked through the streets of Brooklyn. I kept stopping at the various stores, so I could go inside. At some point, we found a Rite Aid that was well lit and spacious and HEATED. We went inside and stayed there for several hours. I bought some random stuff (camera batteries, chap stick, a candle) and I walked around enduring my contractions by holding onto the shelves.

When we got back to the birthing center, Todd ordered some chinese food. We all ate the food, and I had maybe a few bites. The contractions were much more intense at this point. After dinner, Todd took a nap. I still give him grief about the 6 hours he slept during my labor, but I did labor for 24 hours, so I can't blame him too much. The midwife checked me again and said that I was almost fully effaced and 2 cm dilated. Not much progress, I thought, but she said that since my cervix was completely effaced, it was easier for it to dilate. I went into the birthing suite and sat on my birthing ball. My doula was talking me through the contractions, since this is what seemed to work. I don't remember much about the next several hours, except that we tried everything to get labor to speed up. (Herbs, using a breast pump...) My labor was really, really slow. Once I dilated to 3 cm, the midwife had me get into a tub of warm water. It was wonderful. I stayed in there as long as she would let me (an hour or two). Laboring in a tub is really good pain relief. I was able to relax in the tub and even sleep a little between contractions, which were about 4 minutes apart. Once I got out of the tub, I really starting complaining that I was tired and I wanted to sleep. Everyone else was taking turns napping, why couldn't I nap??? (remember that it is impossible to reason with a woman in labor) Finally after some discussion, the midwife decided to give me a shot of stadol for a little pain relief and because it would allow me to sleep between contractions. I happily agreed to the shot and Todd (he was up at this point)coached me through contractions for next 2 hours.

At this point my contractions were 2 minutes apart, but I was still sleeping between them because of the stadol. Once the stadol wore off, I BEGGED for more. Pleaded and begged. I mean, the stadol wasn't great. I felt every contraction, but it made me not care so much. The midwife said (and I paraphrase) "you're not getting anymore drugs, so stop asking!" I was in going through transition at this point and was in aboslute misery. I got back in the tub and argued with the midwife for the next hour. Telling her that the baby was coming and I couldn't stop it. When the midwife told me I couldn't push yet, I tried this line out on her apprentices, but to no avail. I was crying and holding my breath during contractions because the pain was so bad. The midwife, my doula, and Todd were all telling me to breathe. I tried hard to breathe, but then I wasn't doing it right. No, you have to breathe THIS way. Sheesh. I'm breathing aren't I? Truly, rhythmic breathing does help take your focus off the contractions and breathing is better for the baby. I got into a good pattern of breathing and I was 9 1/2 cm dilated and my body was starting to push on its own. The midwife wanted me to wait to push and it was the hardest thing I have ever done in my life. For about 30 minutes, we played the game of "can I push?" "no, not yet" "Well the baby is coming, so I NEED to push." The midwife wanted me to empty my bladder before starting to push, but I couldn't. The baby was too low. I had to be catheterized, which was no fun. When the midwife finally said I could push, I was flabbergasted. I mean, I had been begging to push for probably 2 hours. I was completely exhausted. I looked around at the 10 people in the room (most of them were midwives in training) and asked if was really okay. After about 15-20 minutes of intense pushing, the baby's head crowned. The midwife had been doing perineal massage to protect my perineum and I could definitely feel the difference. She told me to stop pushing for a minute so that the tissue could stretch naturally. When she told me to start pushing again, I delivered the baby's head. One more push later, the body was out and our daughter was being handed to me.

It was one of the most amazing experiences of my life. I did it. I gave birth to her. She was perfect. She was gorgeous and I felt like we had really, finally become a family. I tried to nurse her, but she was very sleepy, probably from the shot of stadol. I delivered the placenta and it was quite a relief. I bled quite a bit after the birth, so once I delivered the placenta, the bleeding mostly stopped. The midwife checked my perineum and it was intact. No stitches! I had a few abrasions, but they were very minor and they heal on their own. I didn't have an epidural. I didn't give birth in a hospital. It was what I wanted. When we finally got the baby (she hadn't been named at this point)on the scale, she weighed 9lbs. Wow. Everyone thought she was a big baby, but I had no idea. She probably weighed more at birth, but she passed meconium before she was weighed. Everyone at the birth center was impressed that I birthed such a big baby so quickly and without needing any stitches. At this point, the baby was being taken care of by the midwives-to-be, getting her first bath, and shots and stuff like that. I got up to go to the bathroom, because, well, I needed to go. Once I got to the bathroom, I hear the midwife ask "where'd she go??" Someone found me sitting on the toilet about to pass out. Apparently, after experiencing a hemmorrage, it is not a good idea to get up and go to the bathroom. I held onto consciousness with all that I had, and fortunately, I did not pass out. I was carried back to the bed with strict instructions to "stay there!" After a bit, I convinced the midwife that I needed to take a shower. I felt pretty gross after the whole experience. She agreed and we went back to the bathroom where she and and the midwife apprentices all helped me take a shower. Looking back, it's hard to understand how a normally modest person like a myself didn't mind having 2 people holding me up so I could shower, but labor and birth really change the perception of yourself. After the shower, I went back to the bed and slept for several hours. I woke up to find the baby laying next to , swaddled. She still didn't have a name and Todd was no where to be found. The midwife told me I needed to name her, but I couldn't do that with Todd around. Turns out, I sent him out to get me a steak! Go figure. I'm always insanely hungry after I give birth, but I can never really eat anything. Once he got back to the birth center, we discussed our naming options. We had a list of a few choices that we liked. Caroline was my favorite. I just love the name. We picked Ruth for a middle name, because we wanted her to have a biblical name, and Ruth is not commonly used. So, in the end we decided on Caroline Ruth. In the end, about 10 hours after her birth, we went home.

Saturday, November 04, 2006

oops!

I told Caroline to go get her shoes because we were going outside for a walk. By walk, I mean she and Isaac sit in the stroller while I push them. Caroline is just too eager to run wild on the street so actually walking is out of the question. Anyway, as I am putting my own shoes on, I look over to the spot in the living room where I store the double stroller and it is, sadly, not there. I went to the mall yesterday, and the dear old double is still in the trunk of the car, which also happens to be at work with dad. Caroline cried and screamed when I tried to explain the situation. I promised her that we would go later. It is going to be a long day, indeed.

Friday, November 03, 2006

Caroline is going through a phase where she says "no" all the time. It's not a defiant or angry "no" but the sweetest "no" you have ever heard. It's so sweet that it's difficult to get upset with her,even when I have told her 10 times to (fill in the blank). She is starting to count, knows "up" and "down" and can do puzzles like nobody's business. Isaac is smiling and laughing a lot. ( Isaac means laughter, by the way)

Everything is going well in the Lewis household, but we are really starting to be constrained by our car. It is too small for 2 carseats and a double stroller. The big problem is that we can't take the stroller and go shopping. It's either the stroller or buying groceries. Quite a pain actually. We may be getting that minivan soon.

Thursday, November 02, 2006

Adventures in the kitchen, part 1


I baked some bread today. It was my first try at something other than banana bread and it went pretty well. I bought Beth Hensperger's Bread Made Easy book and made the first recipe. It was a batter bread that didn't need to be kneaded or anything. My first attempt activating the yeast turned out poorly. The recipe called for the yeast to be dissolved in warm water with a little sugar and ginger. I dissolved the yeast, but waited and waited and it never activated. I tried it again, raising the temperature of the water and it worked! I then put the batter into a fluted tube pan and waited for the yeast to work its magic. The dough was supposed to double in size after an hour. The hour came and went and the dough did not look much different. After 3 or 4 hours, the dough had risen to the top of the pan. I put the soon-to-be-delicious-bread in the oven. After 40 minutes at 350 degrees, the bread was done. I checked the temperature (205 degrees) and knew that it was finished. After waiting for the bread to cool for a few minutes, I turned it onto a plate. It looked delightful for a first bread making attempt. I later served the bread with my butternut squash soup and it was a hit (with Caroline, at least). I am still enjoying the bread. I just hope that Todd gets home soon, because it may disappear.

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