Wednesday, April 06, 2011

Emma's So-Called Birth

*Disclaimers: Blogger makes adding pictures incredibly difficult. Sorry there are so few. Also, this post is very long. Its for my memory's sake, so please forgive all the details you don't care about!*
My pregnancy with Emma went as well as my pregnancy with Megan did (well, until her actual birth day)...up until the end. No issues, perfect blood pressure, etc. Like with Megan, I didn't even get any stretch marks. Until 36 weeks. And then all of a sudden, my whole body was one big stretch mark, practically. Lovely. (I mean, who gets stretch marks on their calves?)

We had been told that I could definitely try for a VBAC, as long as everything went ok. No pitocin to induce, close monitoring because of the risk of uterine rupture, and at least an epidural catheter so that if I had to have an emergency c-section while in labor they wouldn't have to put me under general anesthetic. I was ok with all of that...especially if they let me do the catheter with no actual drug in it. I wanted to go all natural to hopefully help labor and pushing go as quickly as possible and to help breast feeding happen as easily as it possibly could (because Megan had such a hard time gaining weight at first).

At 36 weeks I had an ultrasound. The doctor who did it said that everything looked great. The baby was head down, the placenta was far away from my incision and high up in the uterus, and the incision area looked good.

At 37 weeks I was seeing the doctor who did the emergency c-section when Megan was born. I had been in awful traffic on the way to the appointment and was concerned I wouldn't get there in time. On top of that, I hadn't had anything to drink yet for the day. (I had some water with me but, with the traffic, didn't have the chance to drink it while driving in.) So, I went through my appointment. Baby's heart rate was fine. My belly was measuring fine. But my blood pressure was slightly elevated...for me. The bottom number was 80 rather than my normal 60. I also told her that my heartburn had been a bit worse. Like, I had woken up twice almost throwing up from it. (Yuck. I hate pregnancy heart burn.) Apparently that raised red flags because she decided to send me over to the hospital for possible preeclampsia.

So, we called in the troops. I walked over to the hospital (the dr's office is attached - its not as bad as it seems!) while Jamie waited impatiently for his mom to come from work to watch Megan for us. (The dr said that today could be the day if preeclampsia was an issue.) Once I got to Labor and Delivery, they had me sit down while they filled out paperwork. It made me feel kind of funny - especially because I was actually feeling pretty good except being thirsty. Anyway, they put me in a room and hooked me up to the baby heart rate monitor and the contraction monitor. I laid there and slept and read a book on the kindle app on my phone and generally relaxed. Oh, and texted everyone who had demanded to know when it was baby time to let them know where we were. The nurse kept telling me that I definitely didn't have preeclampsia symptoms that she could see. Then she asked about Megan's birth and when I told her about it she was like, "oh yeah, I think I remember that." Wow, I guess that was an eventful birth if an L&D nurse (who didn't actually work on me) remembers it from almost 18 months ago!

Jamie got there after an hour or so and we both just sat and waited and gave thanks for the iPhone. Finally after several hours the doctor came by for a long chat and then to release me. They were concerned even with a slightly high blood pressure because of my history. Apparently what happened to me (spontaneous placenta abruption) just does NOT happen to people unless they are using cocaine. (And I wasn't!) It does sometimes happen with severe preeclampsia. And, one of the symptoms of sudden preeclampsia is a very bad heartburn type feeling.

She was pretty concerned and almost didn't let me leave, but I told her that I had had pretty severe cramping before the big event last time, so she gave me a long list of preeclampsia symptoms, made me promise to come to the hospital and call on my way in (no calling first) if I experienced any of them, and sent me home. Ha. Nothing like being told to look for headaches and cramping when you're 38 weeks pregnant to make you paranoid! Oh yeah, and they told me that I had to rest and definitely not pick Megan up because she was too heavy.

Starting that night we had to figure out a way for someone to be with me all the time because Megan was little enough that she still needed to be held quite a bit (and lifted into her high chair and her crib and out of both, etc.) Poor Jamie ended up missing a lot of work...or working from home as much as possible.

Anyway, we got through the weekend with me reassuring myself the whole time, "No, that headache is tiredness, its not in the right spot....no, that's the baby moving, not cramps...etc." Then Megan and Jamie came down with the stomach flu. And it was bad. Poor Jamie was up all night Sunday night throwing up and then on Monday I started having stomach cramps....but I had promised to go to the hospital if I had cramps. Arg. So, I went. They monitored me. I walked around. All of a sudden I had to throw up so one of the nurses aides gave me an ice cup to throw up into. My cramps went away. I walked back to my room. The doctor finally came and released me. Hospital visit number two done. (After more time off for Patti while she watched Megan and for Jamie while he stayed with me.)

We had a monitoring doctor's visit scheduled for that Thursday, so there we went. I had been feeling itchy all over the night before so I told the doctor about it. She told me to get some blood work and schedule an induction for the following Monday. Then she looked at my blood pressure and had me go back to the hospital. I hung out at the hospital; was monitored. Jamie left Megan with his mom and came to be with me. Blood pressure and baby were fine at the hospital. They never took my blood. I never scheduled an induction. And the doctor sent me home. False alarm #3.

After the third false alarm and with my due date coming the next Tuesday, my mom decided to fly out to be with us on Saturday. Oh how wonderful it was to have her here for a few days before Emma was born. I got to see her delight in getting reacquainted with Megan. Emma was super active, but no cramps, no preecclampsia. I was feeling relatively good.

Finally on Monday, I thought for sure that would be the day. I had another monitoring appointment with the nurse practitioner. We brought our bags because I figured they would probably send me over to the hospital to be induced. I hadn't felt any contractions that I knew of, but the monitors had picked up contractions that I wasn't feeling before, so I was hoping I was progressed enough for them to induce without the use of pitocin (which they - and I - were reluctant to use.)

But the monitoring seemed to go well. My blood pressure was low. The nurse practitioner who was seeing us had the nurse come in and send us home. As we left, we caught our regular (paranoid) doctor in the hall and she told us to schedule an induction as soon as possible because of my history.

We left feeling weird. We were relieved on the one hand because I wanted to go natural and my body wasn't ready to be induced, but we felt weird because we were both sure today was going to be the day.

Then, as we drove out of the parking garage, we got a call from the doctor's office. In checking the records from the monitoring that morning, they had some concerns. The baby's heart beat wasn't as fluctuating as it should be. Normally a baby's heart beat accelerates and decelerates a lot within a certain range. Emma's was just staying steady. So, they sent us to another doctor's office in the same building for a kind of ultrasound that would check on her health. We were honestly quite relieved because we had both felt so weird about leaving.

The new doctor's office sent us out to get lunch and walk around. We got back at 1 and were immediately taken in for our ultrasound. The first thing the technician said was, "You know she's breach right?" Um, no. Last time anyone checked, she was head down. I guess all that movement over the weekend was actually her turning over. Other than that, though, she looked great. But then the doctor came in and kept going over a certain section of my uterus again and again. Finally she told us that it was thin which meant I was in labor and, since Emma was breach, we would need to have a c-section that day. Then she walked us out to the waiting room and told us to wait there. "Don't go anywhere." We weren't planning on going anywhere, but she was just kind of weird about it. Seemed more urgent than was warranted by a breach baby. I mean, I wasn't even feeling contractions. Labor obviously wasn't progressing very fast.

Anyway, we sat there for a while until they finally brought a wheel chair to wheel me over to labor and delivery. They assured me it was just protocol. Hmmm. It wasn't protocol the last 2 times I was sent from a doctor's office over to the hospital. I wasn't worried though. Just interested.

Finally, we were all settled in my labor and delivery room and hooked up to the monitors and my doctor came in (the one on call at the hospital for the day) and, yay!, it was my favorite one at the practice. She explained that it wasn't just that the baby was breach, but that the ultrasound doctor had seen some concerning things on the ultrasound. Apparently she couldn't see the wall of my uterus near my bladder on the ultrasound. That could just mean that it was really thin...or it could mean that my incision had opened up and the only thing holding me together was the pressure of the amniotic sac on my bladder. Not good! Plus, if the baby kicked or was distressed, or my water broke, she could do real damage to the bladder.

So, that was why this was such an emergency. We had to wait until 7 pm because we had eaten lunch at 1 (at the ultrasound doctor's request - it helps to see baby movement if blood sugar is up). So, we sat around and waited and watched the monitoring equipment.

Finally it was time and they had me walk to the OR. (That's a weird experience.) Once they were ready they had me sit on the operating table (much skinnier than I would have thought) and lean forward while the anesthesiologist stuck the needle in my back and asked me if it was in the center or to the left or the right. Ugh. Yucko. Finally he got it in the middle and then had me lay down quickly before my legs got numb.

What a weird experience a spinal block is. You can't feel pain, but you can feel pressure. You have awareness of where your limbs are but you can't move them. Ha ha. All I wanted was for my knees to point up to the ceiling so my legs were straight. The nurses moved them a little for me, but not quite enough and it drove me nuts! Plus, the medication made me dizzy and nauseous so the anesthesiologist had to give me some anti-nausea medication. And then I started panicking. I JUST wanted to be able to MOVE MY LEGS!!! I wanted it over. I couldn't reason myself out of it. I was freaked out. (Later my mom explained that the anti-nausea medication was probably epinephrine and it probably gave me a medically induced panic attack. No wonder I couldn't control my emotions in the moment!)

Anyway, it seemed like it took forever. Jamie came in and sat by my head stroking my hair and trying to help me calm down. I could feel them pushing aside muscle (not sure they found much!) to avoid cutting it. Then, after what seemed like 30-40 minutes to me, but was probably not more than 15 minutes, they pushed down hard on my belly and out came Emma. She screamed and everyone was happy. They whisked her away to be suctioned and weighed and cleaned and then brought her for Jamie and me to see. Honestly and sadly, I was still freaking out on the inside and it was hard for me to focus on her.
But she was so sweet and one of my prayers was definitely answered. Even from that first moment they put her next to me, she started rooting and licking my cheek. Unlike Megan, she came out wanting to eat!
Another anesthesiologist had taken over and she kept making us do stupid poses for the camera and kept wiping Emma's spit bubbles away from her mouth for the pictures, which made me mad. If Emma has spit bubbles, I want to see them in the pictures! I just wanted to tell her that I love my baby the way she is, spit bubbles and all!

After the pictures, they took Emma away and Jamie went with her. And, to my relief, they gave me some more medication to put me to sleep (not like unconscious, just asleep.)

I vaguely remember having to scoot onto another bed to be wheeled back to the room and then being able to use my legs well enough to be able to help as they scooted me into the bed in the post partum ward.

Then, almost immediately, I was able to hold Emma and try to nurse and she really got it! I mean, not that we never had any feedings where she wouldn't latch or never had moments of frustration, but THANKS BE TO GOD she really knew what she was doing from the start!

Honestly, most of those first couple days are a blur.
I was amazed at how quickly I recovered. By the next morning I could stand up.

And it was wonderful getting to know this precious baby girl without any monitors or really even much help. When Jamie had to be gone with Megan I would just hold her and if she needed her diaper changed, I would lay her down between my legs and change her on the bed. What a difference from Megan, who I didn't even see naked for the first couple days of her life!

On Emma's second night of life Jamie had to go home to be with poor little Megan, who was pretty unsettled by not having mommy or daddy home with her. (Although Grammy and Mia made good substitutes.) It seemed like as soon as Jamie left Emma started screaming. And she just kept screaming. I tried nursing her but that didn't comfort her for long. I tried holding her close. Nothing. I tried changing her diaper, swaddling her, unswaddling her, swaddling her again, singing to her, feeding her...I mean, how much can you really do less than 36 hours after abdominal surgery? After hours of this, a nurse came in to give me more meds or something. I told her that Emma was just screaming and screaming. She said, "yeah, its the second night syndrome." I looked it up on my iphone and, sure enough, it pretty much described Emma. Here is my facebook status update from 2:50 am that night:"Apparently there's a thing called the second night syndrome where the baby wants to nurse constantly, won't sleep especially in bassinet, and cries a LOT. Well, at least we're text book. Poor Emma is not very happy tonight. :-(" It did make me feel better though, just knowing that there wasn't something wrong with her! Finally, after a long night of crying, Emma fell asleep snuggled inside my hospital gown with me with her head against my heart. So sweet! I loved the thought that she was finally comfortable being as close to inside me as she could get.

After that, the days went by relatively fast. Mostly we had to wait for me to be ready to go home and as soon as they let me go, Jamie and I wanted to get home. It was hard being away from Megan for so long. She was a trooper and had a great time with Grammy and Mia at home...and she did come in to meet Emma, but at night she would get unsettled and it was breaking our hearts to be away for so long. I think it was especially hard on Jamie. I was still in that new mom stage where everything revolves (rightly) around the baby. I missed Megan like crazy, but I had to focus on Emma and couldn't focus on how Megan was doing as much.

So, after a second night where Jamie had to go home to be with Megan around 2 am, we packed up and left.

As much as it was great to be home, being home was another kind of torture. Emma was so good. She ate and slept and was as easy as a newborn baby could be, but I was hating the recovery. For some reason, this time around, recovery (after the first couple days) seemed much worse than it did last time. Maybe last time there was just too much going on to be able to focus on my recovery. I had to worry about how to get Megan to eat, where everything was from the move, etc. This time, Emma was eating and gaining so well that, after her 1st day home appointment, we didn't have to go back until she was one month old. Crazy!

But my incision was sore. Nursing was at that painful stage where you dread every feeding and just want it to be over. Megan just wanted me to hold her and I couldn't even have her on my lap for fear that she would kick the incision. Megan was also having a lot of trouble sleeping at night and would call for me (who had always been the one to get up with her at night), but I couldn't even lift her out of her crib. I would lay in bed and cry while Jamie went for her and she cried for me. I had just been told that I would never be able to have children naturally...any further kids would have to be by c-section too. And I was remembering the awful panic that I experienced during Emma's "birth". I was thinking a lot about how I really didn't ever want to go through that again, which meant that I never wanted to have more kids. But I've always wanted more than 2. But I didn't ever want to go through a c-section again. (Actually, if I think about it too hard, it makes me feel slightly panicky even now!) Those baby blues kicked in and kicked in hard. I tried to remember that it was hormonal. That it was temporary. That recovery would be over in 6 weeks. That the hormones would calm down. That nursing would become enjoyable in a few weeks. And that the memory of the c-section would fade. But it all seemed like it would take SO long.

And then I felt better. I'm not sure when. Ha. I just know the depression ended, as I knew it would. The pain (except the back pain that is my constant companion from carrying babies) went away. And I can now carry Megan around to my heart's content. (And Emma, of course, but that was never an issue...although she did weigh over the 10 lb limit before I got to my 6 week "recovered" date.)

I had help from my mom, then my brother James, then my Dad, then James again...and from Jamie's mom...for the entire first 6 weeks of Emma's life. What a blessing! What would I have done if they hadn't been there?

But I have to admit that, although I was sad to see them go because I would miss them, it was such a relief to get to that 6 week mark and finally be able to take over being a mom again! It didn't take long to adjust to being home with the two girls. And it was wonderful to be solely responsible for them during the day.
To start to be able to pay attention to Emma's eating and sleeping patterns instead of relying on whoever has been holding her to know when she's tired. To get into a routine and figure out how to get both girls dressed in the morning...and, more difficultly, how to get ME dressed in the morning!

We've had plenty of crazy days, plenty of times where one or both girls are screaming as I try to get two poopy diapers changed, spit up mopped up, and pee cleaned off of the couch or our bed, but those times are not often (thankfully!) and we're all pretty contented most of the time. Megan is such a fantastic big sister and Emma is such a sweet, good little sister that now, at three months, I can't imagine life without two!



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