The Aftermath

*Disclaimer: This is rather long.  It also might have a couple TMI moments for some people if you're uncomfortable with baby poop and/or breastfeeding.

Despite all the issues Kaylin had during her birth, she hasn't had a problem really since.  They had me make her cry for a little bit right after they gave her to me to help clear her lungs, but she's had a clean bill of health ever since.  I, on the other hand, wasn't so fortunate.

We were discharged on Saturday, June 23.  My blood pressure was still elevated and the minor swelling in my ankles hadn't gone away, though it's not unusual for that to take a week or so to go away.  The first 48 hours after the birth are the most crucial when dealing with preeclampsia, but I seemed to be stable.  When they discharged me I was on bed rest and they told me to limit visitors and take my blood pressure two or three times a day.  My doula, Liz, had a blood pressure cuff that I could borrow so that I could do that.  I was told to call the doctor if my blood pressure went above a certain threshold, or if I experienced headaches, blurry vision, or epigastric pain.

On Monday I started having headaches.  I am prone to sinus headaches, so I did my usual things to relieve a sinus headache, and it didn't work, so I called the doctor and went in that afternoon.  I had a slight fever from my milk coming in, which we decided was the likely culprit for the headaches.  My blood pressure was still holding steady in its elevated, but not dangerous range.  So, he sent me home and had me make an appointment to check up on me on Thursday.

Tuesday evening I started having blurry vision.  Michael had a job interview the next morning that he was already not wanting to go to, so I elected not to say anything and see if it was better in the morning.  My blood pressure was still where it had been, so I figured I was safe to wait.  After he left for his interview I called the doctor's office again and they scheduled me to come in that afternoon.  When Michael called on his way home from the interview I told him what was going on.  He wasn't very happy when he found out it had started the night before.  Also, my blood pressure had started creeping higher.  When they took it at the doctor's office it was 178/110.  They had me relax in a recliner in a dimly lit room for 20-30 minutes and took it again.  It was 150-something/102.  The doctors decided that I should go to the hospital and start magnesium sulfate, Lasix (a diuretic), and Labetalol (a blood pressure medication).  I was allowed to go home and pack a bag, and we got to the hospital around 5:30.

I was admitted to Labor and Delivery, as they are the ones familiar with the preeclampsia protocols.  This also made it easy for Kaylin to stay with me since they have bassinets and diapers and such.  (We cloth diaper at home, but used disposables in the hospital since it was just easier.)  They started me on a 24 hour drip of magnesium sulfate at about 7:00 pm.  The nurses emphasized that Michael would be responsible for Kaylin and I would basically only be able to feed her.  Magnesium sulfate is an anticonvulsant, so it dampens the central nervous system.  I was allowed to sit up and go to the bathroom per doctors orders, but I was encouraged to lay down as much as possible, even when nursing.  One of the nurses offered to put in a catheter so I wouldn't have to get up and use the bathroom so much (because of the diuretic), but I declined.  I already was essentially confined to bed with the iv hooked up to a pump in one arm, a blood pressure cuff on the other (my blood pressure was being taken every 15 minutes at that point from an automated thing, so the cuff stayed on), and an oxygen saturation monitor on my toe.  While getting up to use the bathroom was a bit of an ordeal (I had to be unhooked from the blood pressure and oxygen saturation monitors and have help with the iv pump) I wasn't about to fully live my worst nightmare by having a catheter as well (plus, my lady bits had been traumatized quite enough at that point, thank you).

At first I was doing okay with the medicine (lying in my padded bed in case of seizure or stroke), but by about midnight the magnesium had reached therapeutic levels and I needed help walking to the bathroom, not just with the pump.  Throughout that night and the next day my hands and feet were hot, I felt like I had a heating pad along my spine, and I was tired and wanted to sleep all the time.  Michael stayed all night the first night, but barely got any sleep.  He's used to being the one in the hospital, not the one watching the person in the hospital (he's been hospitalized twice since we've been married - this was the first time for me).  Apparently I looked pretty badly, too, so I'm sure that was hard to watch.  Thursday morning he was so exhausted that he asked if I minded if he called my mom to come sit with me so he could go home to take a shower and get some rest.  I said that I didn't mind at all and that I understood.  (When we were in the hospital following the birth I made him go home on Friday night for that reason.  I knew what it was like to sit with someone in the hospital and we didn't have a newborn to care for when his stuff was going on.  Sitting with someone you love in the hospital is exhausting on many levels - add a baby into the mix and it's even more so.)  My mom came for a while that morning and part of the afternoon.  The doctor came in at some point and said that I wouldn't possibly be going home that day (I had been hoping it would just be a one night stay until then) and we devised a schedule for people to be with Kaylin and me.  My mom did the first night shift from 8 pm to 2 am, my mother-in-law did the shift from 2 am to 8 pm, and Michael was with me during the day from 8 am to 8 pm.  They held Kaylin while she slept, gave her to me when she got hungry, changed her diapers when she needed that, and kept me company while I was awake.  I was taken off the magnesium around 7 pm on Thursday evening.  My vision had still not returned to normal at that point and I was beginning to worry that it might be permanent.  I was very, very near sighted.  I could only see clearly about 12 inches in front of my face, beyond that everything was really blurry.  I could tell time from the clock on the wall because I could see the black blotches for the numbers on the white face and could make out the black blurs that were the hands and I know where the numbers go.  If it had been a digital clock, I would've had no idea what time it was.

While I was on the magnesium sulfate and Labetalol my blood pressure was under control.  Once the magnesium left my system, my blood pressure started spiking again.  So, they upped my dosage of Labetalol from 100 mg twice a day to 200 mg twice a day.  By Friday evening I was still not responding well to the medication, so the OB brought in a Hospitalist to consult on what to do about my blood pressure.  She wrote orders to increase the Labetalol to 300 mg twice a day and added Procardia with orders for an iv push of Enalapril if my systolic blood pressure went above 175.  The next morning it spiked to 179, so they gave me the Enalapril, which brought things back to normal rather quickly.  That evening they decided to add an oral dose of Enalapril and add a third dose of 300 mg of Labetalol (plus the Lasix and potassium that I was still on).  That combo brought things under control, and I was finally discharged on Sunday evening.  I was so glad to finally be home.  My parents brought over a pizza from Papa Murphy's for us to have dinner and I finally got to hold my little girl as much as I wanted.  By the end of the hospital stay, as I was feeling more like myself, I was able to hold her more.  But it wasn't the same as being home with just her and Michael.

One of the hardest things about being in the hospital (besides it being one of my worst nightmares) was not being able to hold Kaylin.  From the time they gave her to me after she was born, the longest I'd gone without holding her was when they weighed and measured her and got us ready to go to our Postpartum room a couple hours after she was born.  She slept on me in the hospital then and at home before I got readmitted.  While I was in the hospital for the postpartum preeclampsia, I couldn't sleep with her.  I couldn't be trusted to even hold her for very long for the first 36 hours or so (because of the magnesium sulfate).  Even after the magnesium wore off, because of the blood pressure spikes it was safer for others to be in charge of her care for the most part until my blood pressure was back under control.  At one point, while I was still on the magnesium, I had been nursing her side-lying, she had fallen asleep, and I was nearly asleep myself.  My mom was there at that point and I had her take her so that I could go to sleep.  Since I was not very awake at that point, I dreamed that Kaylin was still lying next to me.  When I woke up it was only a pillow, and I started crying.  I so wanted to just hold my baby.  The only time we slept together in the hospital was a short nap that I took on Saturday or Sunday before I got discharged.  I had my bed so I was more reclined than lying down and Kaylin had fallen asleep on my chest.  I turned my head to the side and fell asleep as well, and my mother-in-law just let us sleep there like that.  She knew I needed my rest since I barely slept in the hospital once I was off the magnesium.  Between feeding Kaylin, the nurses coming in to administer medications and/or check my vitals, and the doctors coming in to check on me, I was lucky if I got four hours of sleep a day, and that wasn't all at once.

After I finally got discharged I was on three different blood pressure medications, a diuretic, and potassium (lots of it) to replace what was being flushed out by the other drugs.  Monday morning I woke up and took one of my blood pressure drugs.  Within a half hour I started feeling dizzy and light headed.  We still had Liz's blood pressure cuff, so we were taking my blood pressure before I took each medication and again about an hour later.  I took it a half hour after my first pill and my diastolic pressure had dropped like 12-15 points.  But, they'd only given me instructions for what to do if my systolic was below 100 (skip the next pill, but resume after that), so I called the doctor's office to figure out what I should do.  (There was also some confusion over how much potassium I should be taking.  The amount they gave me in the hospital and the amount the instructions on the pill bottle were for were very different, so I needed to ask about that as well.)  While waiting for the nurse to call me back so I could ask my questions, it was time to take another medication, so I did.  Michael had a Cisco certification test, so he wasn't home, but his mom was with me.  We also still needed to go pick up a couple of prescriptions because the pharmacy that was open Sunday evening didn't have them.  The hospital had given me enough of the blood pressure medication that I needed to get through Sunday night, but I needed to pick up that one and the diuretic (which I only took once a day).  I spoke to the nurse and she told me not to take my next pill (which it was time for while we were on the phone) and that she would talk to the doctor and call me back.  While we were getting ready to go to the pharmacy to pick up my other prescriptions (we were literally in the car putting Kaylin in the car seat) the nurse called back and said the doctor had said to stop taking everything except the Labetalol and the potassium (and told me how much of that to take, which was less than either the pill bottle said or I had been given in the hospital).  So, we got back out of the car and didn't go pick up the prescriptions because I didn't need them anymore.  Tuesday morning I woke up and took my one medication and potassium and a half hour later my blood pressure had tanked from 120/70 something to 98/58.  I called the doctor's office again and they told me to just stop taking everything because I obviously didn't need it anymore (this time my mom was with me because Michael had a second interview for the company he'd interviewed with the week before).  So, within 48 hours of being discharged from the hospital I was off all my medications.  I think a lot of that had to do with the fact that I was able to sleep more and be in my own space.  I understand why they kept me as long as they did - they couldn't very well send me home with such high blood pressure spikes because of the risk of stroke.  And they couldn't know that just being home and getting more sleep would definitely get my blood pressure back under control that quickly.  So, we still monitored my blood pressure a couple times a day for the rest of the week until my follow up appointment the following Monday.  My blood pressure had been somewhat elevated again, but not in the danger zone or in need of medication, and it was on its way down.  My vision slowly started clearing up on Saturday and Sunday, and was completely back to normal within a day or two of coming home.  It was so nice to be able to see people's faces again.

The other really crappy thing that happened because of this was that the diuretic I was on affected my milk supply without me really realizing it.  When I first got readmitted I was leaking milk everywhere (at one point, I was lying down nursing Kaylin and milk was leaking out and pooling on my neck - fun times).  By the time I was discharged, I was no longer leaking.  Having never done this before, I just thought my supply had regulated (I didn't know that it doesn't happen that quickly).  It turns out that Kaylin wasn't getting enough to eat.  The last two or three days in the hospital she was really fussy and wanting to nurse constantly.  I thought she was going through a growth spurt (one often happens around 10 days, and that's where we were).  Sometime Monday after we got home I realized that she hadn't pooped all day and I was pretty sure she hadn't the day before either.  In fact, I wasn't really sure when she had last and neither was Michael (that's what happens when three different people change her diapers - no one really keeps track and they didn't always tell me what was in her diaper when they changed it, especially if I were asleep).  At first I thought maybe she was constipated, but her tummy was soft and according to everyone on the internet breastfed babies very rarely get constipated.  Everything said that you know your newborn baby's getting enough to eat if they have at least four poopy diapers per day and 6-8 wet ones.  She had plenty of wet ones (at that point), but no poopy ones.  At that point I decided that she hadn't been getting enough to eat (that was sometime Tuesday), but my supply was starting to come back because I'd been off the diuretic for a couple days.  She did finally poop once a tiny bit on Wednesday.  We had her two week well check on Thursday and she was five ounces under her birth weight (she weighed 7 lbs 8 oz at birth and only 7 lbs 3 oz that day) and they like them to be at or above birth weight by the two week mark. I'm fairly confident that she had actually started to regain a bit of weight by then and was probably even lower at the worst point.  We explained to the pediatrician what had been going on and she was sympathetic.  She told me to nurse Kaylin every two hours minimum, that they wanted to her gain at least an ounce a day, and that we were to come back on Monday for a weight check.  I had my mom make me some lactation cookies (cookies full of ingredients that help increase supply).  She brought them to me on Friday and on Saturday there was a noticeable increase (I was leaking again and spraying Kaylin in the face when she popped off).  By Monday she weighed 7 lbs 9.5 oz, so she was given a clean bill of health and hasn't had a problem since.  I felt really awful though when I finally realized why she'd been so fussy.  It was because she was hungry and I wasn't giving her enough to eat.  It still makes me sad when I think about it.

The only good thing about postpartum preeclampsia was that it was postpartum.  We were really worried about me (I did wonder at one point if I might die - my doctor has a tendency to understate the severity of a situation, so I really didn't know how bad off I was.  On the other side of things, I think it was bad, but not that dire, or I wouldn't have been allowed to sit or have bathroom privileges, and I might've been in the ICU), but we didn't have to worry about the baby, really.  Preeclampsia often severely restricts the growth of the fetus, but since I was no longer pregnant, that wasn't an issue for us.

A couple of lighthearted moments from the hospital, and then I'll wrap this up.  At one point a nurse walked into my room while I was feeding Kaylin and said, "Well, since you're nursing, you obviously don't have a baby on the inside anymore.  I'm in the wrong room."  All of the nurses also commented on how big/mature Kaylin was.  At 6-10 days old, she was the oldest baby on the floor.  They're all used to dealing with moms with babies that are 0-2 days old.  I thought it was funny that they kept telling me my tiny baby was so big.

Also, Michael got the job and passed his certification test.

Kaylin Michelle

Kaylin Michelle was born at 11:00 pm on Thursday, June 21, 2012.  She was 7 lbs, 8 ounces and 20 inches long.

*Warning - this is a birth story.  If you think that's icky, read no further*

I was remiss in documenting the last few months of my pregnancy. Allow me to sum up. Mostly it wasn't too bad. I was tired a lot (no surprise - that was the overarching theme of my pregnancy), but otherwise okay. Due to some unfortunate incidents with one of our neighbors, we no longer felt safe living in our home and put our house on the market and moved out to house sit for some family friends.  This happened in late April.

In May my blood pressure started creeping up, which we initially attributed to the stress of our living situation. I also started having some swelling and eventually protein started to appear in my urine samples at my prenatal appointments. My midwife had me increase my protein intake to 100 grams per day minimum. This successfully brought my blood pressure down and reduced the protein levels to trace amounts until the week that Kaylin was born.

That Tuesday my blood pressure was high and I was +4 for protein (that's bad). Margaret, my midwife, sent me in for lab work and she called me the next day with the results. The labs indicated that I was in the early stages of preeclampsia. My official due date was that Sunday, June 24, so she wanted me to come in again so she could see if I was close to going into labor. I went to the chiropractor first (I'd been going for several weeks because of pubic symphysis pain) and had him do his thing to try to push me into full on labor. I'd been having mild contractions off and on since Saturday. Well, I'd been having contractions any time I got up or walked upstairs or got in and out of the car for weeks, but that Saturday they started being regular for several hours regardless of my activity. After the chiropractor, Michael and I went to see Margaret and I was already three centimeters dilated. She was happy about that because she wanted me to have the baby sooner than later so as to resolve the burgeoning preeclampsia as soon as possible before it could get worse. She stripped my membranes and sent me home and told me to relax and get as much rest as I could.

That evening I started having regular contractions again. Nothing terribly strong - they felt like Braxton-Hicks contractions. We went to bed around 9 or 10, but I couldn't sleep at all. The contractions kept pushing the baby into my bladder, so I had to get up to use the bathroom every 10 or 15 minutes. I really wanted to sleep, but couldn't because of the frequent bathroom trips. The contractions were stronger than any I'd had so far, but weren't terribly intense. I timed them from 12:30 to 1:30 am and they were 3-4 minutes apart that whole time. I called my doula and told her I wanted her to come over because I thought this was the real thing. My doula, Liz, often works with Margaret, so she was aware of everything that had been going on from both of our perspectives. She came over and told me to call Margaret as well. Liz sat up with me until morning and let Michael get some sleep.

After it was light out she had me relax in the hot tub for a little while and eat breakfast, then told Michael and I to go for a walk. While walking my contractions were more intense and closer together. They were uncomfortable, but not painful. Putting pressure on my belly made the contractions less uncomfortable. We walked for quite a while with occasional bathroom breaks. After an hour or two of that (I have no idea how long it really was), Liz said that Margaret wanted me to eat something and rest for a bit. The walking made the contractions intensify, but when I stopped they were less intense and further apart. I was able to sleep for a couple hours, and when I woke up Margaret had arrived. She checked me again, but I hadn't made much progress from the evening before. I was a bit disappointed by that. She was concerned by the fact that my labor pattern seemed to be slowing down and recommended that we go have an ultrasound to see what was going on. She was afraid that the baby was in distress, which was why labor was stalling. I wasn't excited by the idea of an ultrasound because that, to me, was the first step away from my planned and desired home birth. She gave Michael and I time alone to discuss it and we agreed that it was a good idea and that we should trust Margaret's judgement (that was why we hired her, after all). She called the OB's office that I had used previously (prior to the pregnancy) and discussed her concerns and plan of action in case she was right and we ended up needing to transfer care. The doctor agreed with her plan and gave her his cell phone number so that she could keep him updated. We then got ready for the appointment at the imaging center for the ultrasound and left. My doula had us get some things together in case we did end up in the hospital so that we were prepared for the worst, but still hoping to be able to come back home for the birth.

I think at that point that both Margaret and Liz knew we weren't coming home for the birth. They didn't ever say so to me or Michael, I think mostly because they were trying to keep me as relaxed and positive as possible.

The ultrasound didn't go quite as swimmingly as we had hoped. The baby wasn't moving and wasn't practice breathing. We technically passed the biophysical profile with a 4/8. However, my fluid levels were just barely passing (and the tech rounded up). The only good thing was the strong heartbeat. Honestly, the most painful contractions I experienced were during the ultrasound. I was lying on my back and she was pushing the probe thingy into my belly and it hurt.  I suppose I could have said something, but everyone was so focused on the screen that no one even noticed I was having contractions.  No one except Michael, whose hand I was squeezing every time I had one.  Toward the end of the 30 minutes, Margaret must've looked down and saw me grimacing because she asked if I was having a contraction.  I said yes, and the tech stopped pushing so hard with the probe.  

After the ultrasound, since it wasn't so great, we went across the street to the hospital to have a non-stress test.  Even then they kept acting like there was a chance that I could go back home, but, really, Margaret had decided that she was transferring care.  I cried.  I cried on the way to the ultrasound.  And I cried on the way to the NST.  I was trying really hard not to cry when they wheeled me up to Labor and Delivery.  One of the nurses said hi to me and asked how I was in a really friendly, cheerful way.  I choked back tears and said, "I've been better."  We did actually pass the NST (the baby started moving for that and had two spontaneous heart rate accelerations within 10 minutes), but by then it had been decided that we needed to be in the hospital.  I knew that by being in the hospital they were going to do something to speed up my labor.  My biggest concern was how hard and fast that was going to happen.  The doctor said he wanted to break my water and would give me a few hours to see if I went into active labor on my own before giving me pitocin.  I was glad of that much, as I really wanted to avoid pitocin.  I didn't want an epidural and I have heard that pitocin makes contractions much harder to handle.  I wanted to avoid those things.

Michael went back home to feed our goats while I changed into a hospital gown and got the IV port placed.  The doctor came in to check me before Michael got back and asked if I wanted him to go ahead and break my water then or wait for Michael.  Since Michael had been present for the conversation about the plan of action, I had him go ahead and do it, since I didn't really think that Michael would be too upset about missing that part.  When he broke my water there was thick meconium.  If that had happened at home we would have transferred to the hospital, so it was a good thing that we were already there.

My water was broken at about 7:30 pm and I was at 4 centimeters dilated at that point.  When Michael got back we had to choose a pediatrician.  We hadn't really worried about that before because Margaret takes care of the well checks for the baby during the first six weeks along with the postpartum care.  Now we had to choose one within an hour.  So, I asked Liz who she uses and how she likes them and we went with her recommendation, which we've been quite happy with.

Liz had told me to order dinner before the cafeteria closed at 7:00, but I hadn't gotten to eat it yet because of all the activity going on, so I ate some while we waited for things to get started.  Breaking my water put me into active labor pretty much immediately.  My next contraction was significantly stronger than any prior to my water breaking and they started getting closer together right away.  I was managing fine in the bed while I was eating, but as things progressed I noticed that I was starting to tense up during the contractions instead of relaxing into them.  So, I decided that I wanted to get into the bath tub.  I was on constant monitoring because of the meconium, so the nurse got the portable telemetry unit so that I could use the bath tub.  The warm water helped with the contractions quite a bit until I started having back labor.  At that point I was trying to find a comfortable position to be in during the contractions in a narrow tub.  I ended up on hands and knees, swaying my hips or rocking forward and back.  Liz started massaging my low back and providing counter pressure during the contractions.  Shortly after that I decided I wanted to go back to the bed.  I was really tired and needed to lay down.  I was operating on two hours of sleep in over 24 hours.

At one point while I was still in the bath (before the back labor really got started), Liz kept telling me to stay as much on my left side as possible.  The baby was having heart rate decelerations after my contractions.  Not badly enough that they wanted to do a c-section, but still a beginning sign of concern.  I remember silently telling the baby that I needed her to work with me and that we were in this together.  I would do my part and she needed to do hers.  A c-section was not what either of us wanted.

Before I got out of the bath, they checked me and I was 6 centimeters dilated.  It was about 9:30.  Liz told me that I was right on track, that they liked to see one centimeter dilation progress per hour.  I remember thinking, "I have to do four more hours of this?"  As I got out of the tub and walked to the bed, I thought, "I totally get why women get epidurals."  The whole giant needle in the spine thing still freaks me out, but I do totally get why women get epidurals.

I labored for an unknown amount of time on my side in the bed.  I don't think it was really that long, though, maybe a half hour or so.  They checked me again and I was at 8 cm.  A few contractions later I was starting to push.  Liz noticed and mentioned it to the nurse.  The nurse told her to tell me not to push because I was only at 8 and it might cause my cervix to swell, which would make things take longer and to have me breathe in some particular way through the next contractions.  Liz started to tell me how to breathe through the next contractions and my response was, "I can't do anything except what I'm doing.  I'm not in charge of this."  Liz told the nurse to check me again because she thought I was complete.  The nurse did so and, lo and behold, I was at 10 cm and had permission to push.  I remember thinking something along the lines of, "Oh, thank you so much.  I was just waiting for your permission."

At some point during transition they sent in the pediatrician to talk to us.  We had wanted delayed cord clamping so that the baby could get as much blood from the placenta as possible.  When Liz mentioned it to the nurse earlier in the labor, the nurse said we couldn't do that because of the meconium.  So, they had the pediatrician come in to talk to us about that.  When they said she was coming in, I was thinking, "Are you kidding me?  You expect me to talk to someone now?"  Fortunately, Michael knew enough to talk to the pediatrician, because I was too busy dealing with contractions to speak much to anyone.  She explained that the risk of waiting far outweighed any benefit due to the increased risk of respiratory distress and that waiting a minute could make the difference between a healthy baby and one who was on a respirator in the NICU.  Michael said something to the effect that we wanted what was best for the baby and wanted as much of our original plan as possible, but realized that things had changed and so we were okay with them doing what was necessary.  Liz then asked if the doctor would milk the umbilical cord, which means that he would push blood down the cord to the baby immediately after delivery to get her as much of the blood from the placenta as possible without waiting so long as to compromise the baby.

Apparently, I make a lot of noise during labor (I was moaning through every contraction from about 7/8 cm on), but I don't communicate verbally much during labor.  I think I only said a handful of things during late stage labor.  When my doula was adjusting the monitors on my belly to try to get the baby's heartbeat, I told her that she couldn't do that anymore, at which point she stopped immediately.  I told them I couldn't help but push when I had started pushing.  At one point between contractions Liz was talking to fill the silence and I preferred the silence, so I said, "Shhh."  Michael, who was in front of me, heard it and said that I wanted everyone to be quiet.  I also recall saying that I wanted labor to be over a few times.  I was exhausted by that point and my contractions were one right after the other without much space between them.  I was having trouble staying on top of them.

I pushed on my side for a while - I have no idea really how long.  It was at that point that they were getting concerned for the baby because the monitor had moved off her and they hadn't had a good heartbeat reading on her in a while.  When I wouldn't let Liz adjust the monitors she called and talked to Margaret, who had gone to be with her daughter in law who was in the hospital in Spokane with preeclampsia (she hadn't expected me to labor so quickly and was planning on being back in time for late labor and the birth).  I believe Liz had called to see if she was on her way since I was already pushing and informed her of the lack of monitoring ability.  She recommended putting in a fetal scalp monitor, which Liz communicated to the nurse and was done pretty quickly after that.  I didn't object because I knew they needed to find her heartbeat and I wouldn't let them push those monitors into my belly during contractions again.  Normally, if she'd been doing fine all along, I wouldn't have agreed to the scalp monitor.  They referred to it as an internal monitor, and Michael didn't know what that really meant until sometime the next day when I told him.  He was rather horrified, so I think it was a good thing he didn't realize what it was until later.  The wound in her scalp healed pretty quickly.

Shortly after that, they decided that I needed to be in a more upright position to facilitate getting the baby out more quickly.  They were getting a squat bar for me and had Michael getting up in bed behind me to help support me when the doctor came in and told them he didn't want that (or something of the sort - I don't really know, I just know they didn't get the squat bar, Michael got down and I leaned back against the bed, which was put into a more upright position).  I was so tired, that I was glad I didn't have to squat.  Around then they tried to cut off the belly band that had been holding the external monitors in place, but for some reason couldn't get it to cut through all the way.  They gave up because there was too much else going on that was more important.  They also put on the blood pressure cuff to get a blood pressure reading and told me they'd take it off soon.  They never did, so I ended up giving birth with a belly band hanging off me and a blood pressure cuff on my arm.

I was given an oxygen mask and told to breathe really deeply and hold it in.  I tried, but holding my breath between contractions wasn't really happening because I was trying to breathe.  Then they were telling me to hold my breath and push hard with the contractions.  I just pushed as hard as I could and largely ignored what they were telling me to do because it seemed to be self-contradictory.  I had long since surrendered to what was going on in my body and couldn't really do much about it.  Liz was holding the oxygen mask on my face and it was sort of poking me in the left eye.  I reached up to pull it down slightly so it wasn't in my eye anymore and she thought I was trying to pull it away and pushed it in harder and told me I needed it.  At that point I said probably the last thing I said in labor, which was, "You're poking me in the eye!"  She said, "Oh!  Sorry!" and allowed me to put it where I wanted it.  Near the end, the baby's heartbeat was in the 60's and she needed to come out quickly.  The doctor told me he might need to use the vacuum to assist because of the dips in her heart rate, but in the end didn't need to do that.  I was able to push her down far enough that it wasn't necessary.  She was crowning, but I wasn't able to push her out fast enough, so the doctor cut an episiotomy and dragged her out.  The cord was loosely wrapped around her neck, which he undid after her head was out, then pulled her the rest of the way out on the next contraction.  I could see him holding her in his hand and she was just draped there, motionless and not crying.  It didn't really register with me that that was not really a good thing.  I was just staring at her as he milked the cord, then clamped and cut it and handed her over to the pediatrics team.  At that point I laid back on the bed and Michael followed her over to the corner of the room where they were working on her while the doctor stitched me up.  She cried, and I heard the pediatrician say, "She cried on her own.  That's good."  They told Michael she was a girl and he turned and said, "You were right, it's a girl.  You get to say, 'Burn,'" to which I replied, "Burn."  (While I was pregnant we kept arguing over whether it was a girl or a boy and Michael said that if it was a boy he was going to look at me and say, "Burn!"  So, since I was right, I got to say it.)  They suctioned out all the meconium and wiped her off. Michael cut the cord shorter and the pediatrician brought her over to me and put her on my chest and the nurse covered us with a warm blanket.  She said something to me, but I have no idea what she said. I was too busy staring at my beautiful little girl.  Her face was all scrunched up like she had a bad taste in her mouth (which she probably did) and it took her a while to open her eyes.  At about that point, Margaret came in.  She had missed the birth by about five minutes.  I was glad she was there afterward, though.  I think having my husband, midwife, and doula all there helped the nursing staff to not rush me too much.  It took a little while for Kaylin's temperature to get up to 98 degrees, which I think was another reason they didn't rush us.  Who knows - maybe they would've been quicker to put her under the warmer if I didn't have so many people there looking out for us who weren't employed by the hospital.  Either way, I was allowed to hold onto her for as long as I wanted before she was weighed and measured.  I told them not to bathe her because she'd been under enough stress already and it had taken so long to get her temperature up, I didn't want them to make her cold again and stress her out more.  She did latch on a little bit while we were still in the Labor and Delivery room before they weighed her and everything.

My parents and Michael's parents had come to the hospital and waited in the waiting area while I was in labor.  The dads had gone home before Kaylin was born because everyone thought it would be such a long time.  Her official birth time was 11:00 pm, putting my active labor at right about three and a half hours.  When Liz went out to tell the moms that she was born, they were both really surprised.  When I gave her back to the nurse to weigh and measure, Liz went and got the moms so they could come in and see their new granddaughter.  After that the nurse got me up and cleaned up and ready to go to my Postpartum room.  By the time I got over there it was about 1:40 am.  The nurse helped me get started with breastfeeding to facilitate the uterine contractions necessary for proper involution and to prevent hemorrhage.  They had started me on pitocin after the delivery for the placenta, but I hadn't finished it, so things weren't as firm as they wanted when the nurse checked me in the Postpartum room.  Twenty minutes of breastfeeding later, everything was on track.

Overall, I feel good about the way things went with the birth.  There were more interventions than I would've chosen if we'd both been healthy, but I feel the ones we had were necessary and I wasn't bullied into anything.  I was informed of the plans and given the time to consent or refuse.  Because I trusted that my birth team wasn't recommending anything that wasn't necessary and I was included in the decision making process.  I do wish I could've had my home birth.  I think the immediate postpartum period would've been more restful if I'd been able to be at home in my own bed.  But with the distress Kaylin was experiencing, I'm glad we were where that could be dealt with quickly and appropriately.  I honestly attribute our good outcome largely to my planned home birth and my excellent midwife.  If I'd been planning a hospital birth I wouldn't have recognized my stalling labor for what it was - I would've thought it was just another bout of prodromal labor that I'd been experiencing all week.  I would've waited until I grew concerned by the baby's lack of movement, at which point I most likely would've had a c-section.  Because of Margaret's experience and instincts, we transferred care before things got really scary and we both came out healthy and intact.

Growth Spurt?

I've been feeling really run down this week. I've been tired a lot and getting light headed with any increase in activity. I didn't do my workout today because showering made me light headed. I figured squats and pushups and the like probably wouldn't help anything. I'm not sure if I'm fighting something off or if we're in the middle of a growth spurt or both. I'm inclined to think both. My ligaments have been hurting lately and my abdominal muscles have been a bit sore. Also, it seems like my belly got bigger between Tuesday and Wednesday. I haven't been measuring it or anything, so I have no definitive proof, but when I looked in the mirror after I got dressed on Wednesday I thought, "Man, my belly looks bigger today." Plus, my sinuses have been a bit unhappy and my head's been feeling weird, so I think I might be fighting something off as well. I've also been neglecting taking my vitamins lately. No real reason why, just forgetting. But, pregnancy suppresses the immune system and so does forgetting to take vitamins, so germy invaders have more room to horn in. I've been better about taking the vitamins since I started not feeling well. I just hope it's not too little, too late. I napped today for the first time in a while. So, lots of rest, lots of fluid, hopefully I'll start feeling better soon. And by soon I mean tomorrow. I have a gig on Saturday, so I need to not feel like crap and get dizzy after playing for five minutes.

Saturday Night

I'm feeling restless and I want to do something, but I don't know what. I was going to write some posts for this week for the SMFarms blog, but I'm a bit stymied there at the moment. I also need to write a reference letter for one of my violin students by Tuesday. So, I started on that and I have one sentence. And I'm stuck. Even now, I have only a few sentences and can think of nothing interesting to write. This is potentially the most boring blog post in the history of blogging.

So, we'll recap today's activities. I know you're all fascinated by the mundane details of my life, so here you go. I actually got more than six hours of sleep last night. That's the first time in several days, so that was nice. I went to bed a little after midnight and slept until 10:00 am. We had our appointment to go over our taxes this afternoon, which took about an hour and a half. After that we went grocery shopping and ran a couple other errands in town. Then we came home and Michael fed the goats and put them in for the night while I made dinner. I made some more moisturizer and shampoo and we played with labels. If I know you in person you might get conscripted to try some of my soaps and lotions in the near future. I'm experimenting with different things and I will need other people's opinions. We're considering having a booth at the Rathdrum Farmer's Market this summer, and, since our farm will not be producing enough to sell yet, it'll be my craft products. But, I need testers to tell me if they like things. Also, any input on scents would be nice, specifically scents that can be created with essential oils. I'm trying to make things that are non-toxic and fragrance oils are synthetic and synthetic fragrances tend to have known and unknown chemicals that are or could be toxic. I feel better about scenting a product with essential oils rather than fragrance oils. So, feel free to leave me a comment with your favorite scents and I'll see what I can do.

21 Weeks

As of today I am at 21 weeks.  The baby's moving more.  It still feels weird to me, especially when it's moving against the inside.  I prefer the outward movements much more.  Michael hasn't felt it yet.  Mostly from bad timing.  Every time the baby moves where it can be felt from the outside, he's asleep or somewhere else.  Everything else is going fine, though.  I'm starting to research childbirth classes and whatnot.  The available ones around here seem to be Bradley, Hypnobirthing, and Hypnobabies.  They all seem interesting, I'm just not sure which one will be best for me.  I think I'm going to see if I can get the books from the library that go with each one and read through them to see which one resonates the most.  I've read good things about all of them, so it seems like whichever seems like it fits best with the way my brain works would be the one to do. 

I haven't been good about the belly picture/pregnancy documenting things.  When I found out I was pregnant I intended to keep a journal and everything, but that totally didn't happen.  So, I don't remember the date that I first felt the baby move or anything.  I think it was around 16 weeks, but I'm not completely sure.  I'm not really sure what else I would write about in a pregnancy update thing.  Most of my pregnancy has been quite uneventful.  I've been tired for most of it, but that's gotten a lot better lately.  I'm still a bit more tired than normal, but I'm also growing a person, so I think that's to be expected.  It's not the bone deep exhaustion that it was for so long. 


In other news, I've started regular updates on our farm blog.  You can check it out at smfarms.wordpress.com.   That's where I'll be writing about all the happenings on the farm.  It'll probably be updated more than here because this is where I post all my random ramblings and personal things.  There may be some overlapping content, but the thrust of both blogs are fairly different.  If you'd like regular updates from that one you can become a follower, or you can like the Sláinte Mhaith Farms page on Facebook, where I'll post when a new blog post comes out. 

Confessions

I think a lot about things.  Lately I think a lot about pregnancy related stuff (who would've guessed?), but I think about other things, too.  Mostly when I post about my thoughts I try to stick to the more normal things and stuff people expect you to talk about.  But, tonight I feel the need to put out there the weird stuff and the stuff I feel weird about.  Enjoy.

• I'm finally at the point where I don't have to remind myself that I'm pregnant all the time.  I guess I've told myself that I am often enough since October that it's finally sunk in.  It's been about a week since I thought, "Oh, yeah!  I'm pregnant."  It only took 4 1/2 months.
• I'm starting to feel the baby move.  Not very much yet.  More in the last day or two, but still not a lot.  I have to say, though, that the idea of another being inside me moving around and poking me from the inside kinda freaks me out.  Does anyone else find it slightly freaky?  I've never heard anyone else talk about that.  So, either it's one of those things that everyone thinks at some point and just won't admit it, or I'm in the minority and I'm the weirdo.  Both seem equally viable to me.
• In my last post I said that I was excited about being able to do fun things with my child.  This is true.  I'm also a little sad that it won't just be Michael and me anymore.  We've been just us for 8 years.  Part of it's the fear of change and the unknown.  But with any major change, even good ones, there's always a part of me that's sad about leaving behind what was before.  This is no different.  I'm probably not supposed to say that, though.
• Even though I tell people I'm excited, I haven't really been super excited yet.  As I said, I kept having to remind myself about the pregnancy, plus, with the exhaustion, it was all I could do just to get through the day and get the bare minimum done.  Excitement?  Who has energy for that?  That's not to say there haven't been cool things.  Getting to hear the baby's heartbeat is pretty cool.  Part of it, too, is that I don't get excited in the way other people do very often or very easily.  And major changes always seem really unreal to me until they've actually happened.  Even when I'm preparing for them, it seems like a weird dream.  It takes a bit for the new way of life to sink in and not seem so unreal anymore.  Maybe I'll be more excited in a month or so or when I actually start getting things ready for the baby.
• I don't plan on finding out the gender of my baby until it's born.  I also don't plan on having an ultrasound.  ACOG doesn't recommend ultrasounds unless medically necessary.  As long as things continue in the normal, non-concerning way that they have been, I don't feel an ultrasound is indicated.  Determining the gender is not a medical necessity.  Plus, surprises are fun.  Feel free to guess the gender.  Guessing is half the fun in my opinion.  And, in this case, you'll have a 50/50 chance of being right.  Personally, I think it's a girl.  Or a boy.
• I break "pregnancy rules."  I go tanning.  I lay on my back more than just at my prenatal appointments.  I find it uncomfortable after a bit, though, so I don't do it for very long.  I take a regular multivitamin not a specific prenatal (my regular multivitamin meets the recommendation for prenatals, except it's a bit lower in iron, so I take an iron supplement, too.)  I drink raw milk.  I've been doing so for almost two years and suffered no ill effects, so I'm not worried about it.  I occasionally have steak and I don't cook it well-done.  I don't eat deli meat from the grocery store, though.  But, I generally don't eat deli meat anyway whether I'm pregnant or not.  Except the occasional Jimmy John's sandwich.  
• I'm planning on a home birth.  I know many people freak out about home birth.  I have done a lot of reading and research on the subject and looked at both sides of the issue.  I did most of this reading when we were first talking about having kids in the near future.  I have a midwife that has a high success rate and a low incidence of problems.  I feel confident that she will recommend a hospital birth if she feels it's necessary, and I trust that she's neither overly alarmist nor overly cavalier in her attitude toward labor, birth, and the safety of the mothers and babies in her care.  She has lots of experience in hospitals and at home.  The woman knows her stuff.

Eleven

My friend Katrina tagged me in her post, so here goes.

First Things First… The Rules:

• You must post the rules.
• Post eleven fun facts about yourself on the blog post.
• Answer the questions the tagger set for you in their post, and then create eleven new questions to ask the people you’ve tagged.
• Tag eleven people and link them on your post
• Let them know you’ve tagged them!

Eleven Fun Facts:

 

1. I'm learning to sew.  I got a sewing machine for Christmas and I've been playing with it ever since.  I've wanted to learn to sew for a while, and since I'm now pregnant I figured I better get started.  In my world, moms should know how to sew.  

2. My first instrument was the piano.  I started when I was 5 at the beginning of kindergarten.  I decided I wanted to play the piano the Christmas prior to that when we were at my grandparents' house and most of my cousins could play the piano.  I wanted to play, too.  So, several months later, my parents procured a piano and found me a teacher.  Thus began my musical career. 

3. I make my own yogurt.

4. I often wish I had the ability to teleport.  I don't think I'd like to be able to read people's minds, but teleportation would be an extremely handy skill.  I used to think the Star Trek method of beaming people would be nice, but after reading The Hitchhiker's Guide trilogy (in 5 books), I'm not so sure that would be such a nice way to travel after all. 

5. I like seeing new places, but I don't really like the actual traveling part.  Whether it's flying or driving, it's just not that much fun.  With flying you have all the airport security silliness and you're at the mercy of the airline for the entire time.  With driving it takes longer and I can't read because I get carsick.  I suppose that's why I fantasize about #4.

6. I make my own soap and lotion bars.  I'm trying to find a good shampoo bar recipe, but I haven't found one yet.

7. I'm a hermit.  I don't leave my property very often.  I go outside pretty much everyday because I have animals to take care of, but I can go for days without getting in a car and going anywhere.  If my students didn't come to my house, I'd also go for long periods of time without seeing anyone except Michael.  Probably once the baby comes that will happen, since I will be taking time off from teaching.

8. I'm excited about having a kid to do all the things that are fun to do, but not so much fun as a childless adult.  Like going to the pumpkin patch, trick-or-treating, sledding, building forts, and so many other things.  It's difficult for me to imagine what life will really be like, and it's strange to think it won't just be Michael and me in a few more months, but I think there will be a lot of fun stuff.  I know it's not all rainbows and unicorns, but I'm excited about the fun stuff to come.

9. I still like peanut butter and jelly sandwiches.  And I still eat them sometimes.

10. My favorite part about college was finding people who got me.  I never tried to be anyone other than who I am, but I didn't really fit in very well growing up.  I had some friends, but even they didn't always really get my sense of humor a lot of the time.  It was nice to find people who I could be goofy and quirky with and they didn't give me weird looks because they were the same way. 

11. I'm a voracious reader.  Sometimes I go through spells where I don't read very much, but then a switch flips somewhere and I can't stop reading.  I'll easily read entire novels in a day or two (of the 300-500 page variety) and just keep going until I've fulfilled my need for books.  I'm in the middle of one such spell right now.  Though it has calmed down the last couple of days.  I'm currently finishing Mostly Harmless by Douglas Adams.  It's the 5th book in the aforementioned Hitchhiker's Guide trilogy.  And, for the record, if you've seen the movie and haven't read the books, you should read the books, they're way better. 

 

Here are the questions Katrina posted for me:

1. If you won a gift certificate good for a year’s service from either a maid or a private chef, which one would you choose?  I would get a maid.  I hate cleaning.  I can deal with cooking, but cleaning is awful.  What would be better though is if I got both, even if it were only for 6 months.

2. Name something you’ve done that was totally out of character for you. 

3. Imagine we discovered a life-sustaining planet and a way to get there in a five year space journey. If invited to go, would you be willing to leave behind your life on Earth to explore a new world? (Your family can go with you, of course.)  It depends, really.  What's the condition of the Earth at the time of discovery?  I'd say probably not.  Mostly because I'm a hermit and don't like to go anywhere.  And 5 years is a long time to travel to get somewhere.

4. If someone gave you $500 on the condition that you somehow use it to help someone in need, how would you spend it?  I'd probably sit on it for quite a while looking for someone specific to help.  While I think charitable organizations are great and serve a definite need, I would want to find a person or family that I could specifically help.

5. What’s the worst movie you’ve ever seen?  The Ninth Gate.  It started out interesting and about halfway through it starts going downhill fast.

6. If you lost your U.S. citizenship and had to relocate permanently to another country, where would you go? Why?  I've actually thought about where I would go if for some reason we felt the need to leave the country.  The United Kingdom is appealing because they speak English and I've always wanted to spend a lot of time there.  Chile is an option because I've actually spent a fair amount of time there and would be happy to go back.  If we had to flee or leave quickly, we'd probably go to Canada first, then decide on where we really wanted to be after that.

7. What’s your guilty pleasure?  The book equivalent to chick flicks.  They're like candy for your brain.

8. Who would win in a street fight between the Black Eyed Peas and the Fugees?  Umm...your mom?  I have no idea. 

9. If you could go back in time and change just ONE decision that you’ve made, what would it be? (I’m not talking about mistakes, but about a time you had to choose between two or more paths.)  I honestly can't think of anything.  I'm pretty happy with my life and where it's going.

10. What superpower would you like to have?  Teleportation.

11. Do you have a weird body quirk? What is it?  I have a birthmark on my right knee.  It's actually darker now than it was when I was little.  When I was a kid and played in the dirt a lot, my mom used to try to scrub it off in the bath because it was light enough to pass for dirt.  It never did come off.

Since the very few people that I might tag have already been tagged, I will not participate in that aspect of this.  You're welcome.


 

 

Pregnancy Update

So, I'm now 17 weeks and 3 days.  I have felt the baby move twice now.  It's certainly not a regular occurrence at this point.  In a few more weeks I'm sure it will be. 

I'm starting to have more energy again.  I've made it through several days in a row without taking a nap.  In fact, I haven't taken a nap since last Thursday.  I think that's the longest I've gone without a nap this pregnancy.  I thought about taking one today, but decided I felt tired from staring at a computer screen for too long and decided to go for a walk instead.  It wasn't a very long walk (just around the back of our property), but that's the first time since October that the thought of doing something requiring physical activity didn't make me want to curl under a blanket and go to sleep.  Not only did I not want to crawl into bed and go to sleep at the mere thought of physical activity, but I actually got all bundled up and went out.  And I felt better for having done it.  I enjoy walking in the snow and I haven't really gotten to do it this winter.  Since we have snow now and I have a bit more energy, it looks like we'll even get to try out our new snowshoes this weekend.

It really helps that we've discovered the culprit for my extreme, bone deep weariness.  My blood test results came back and my midwife called me last week to let me know what they said.  Most things were pretty normal, but my Vitamin D level was at 13.  For some perspective, people develop rickets at 10 or below.  The bare minimum for recommended Vitamin D levels is 30 and 50-70 is considered optimal.  I was at 13.  So, I started taking 4,000IU of Vitamin D supplements daily.  And I've started going to a tanning salon. 

I know, I know.  Before everyone freaks out about me cooking my baby or how tanning gives you cancer, let me say that I put a lot of thought and research into this and my midwife is totally on board, as is my husband.  Tanning beds will not cook a person or their unborn baby.  The salon I'm going to uses electronic beds (rather than the older style magnetic beds).  The electronic beds don't get terribly hot, so the risk of overheating (which, as far as I can tell, is the only real concern) is minimal.  So far, they're just pleasantly warm.  Plus, if I feel too hot, I can turn off the bed and get out, simple as that. The electronic beds have a ratio of UVA/UVB light that more closely approximates natural sunlight (the magnetic ones tend to have a higher UVA output.)  UVB light is what causes your skin to produce Vitamin D.  UVA light is what oxidizes your skin pigment and potentially causes damage.  Having a balanced ratio is important.  Also, sun exposure is not what causes skin cancer.  Overexposure, i.e. sunburn, eventually can cause skin cancer.  The more frequent and the worse the burns, the greater your chances of developing skin cancer.  In a good tanning salon, they will set your tanning times so that you don't risk getting burned and will slowly work you up to optimal exposure levels for your skin type, Vitamin D production, and tanning preferences.  I'm not so much worried about the actual tan (I don't really change colors anyway), but UVB exposure produces far more Vitamin D than a supplement or food source can possibly supply, and it's in a form that the body uses much more readily than that of an oral supplement.  Altogether, the supplements and the tanning, are making me feel much more like myself.  I'm not completely back to my normal feeling self, but I'm well on my way.  And for that, I'm quite thankful. 

To My Unborn Child

Dear Baby,

I know you like our midnight snacks.  I'm not entirely opposed to them myself, especially when they include hot chocolate (which is fairly frequently).  However, this whole keeping me up all night thing has got to stop.  I can't even feel you yet and you're already wreaking havoc with my sleep schedule.  That's just not fair.  And sometimes you just mess with me.  Like tonight.  You let me fall asleep at a reasonable hour (9:00 pm or so), but then decided I needed to get up at 11:30 pm.  It's now 3:45 am and I'm still awake.  That's just not right.  We're going back to bed now, and we'll stay there for quite a while, okay?  We have things to do tomorrow (well, today, I suppose) and Mama needs more than two hours of sleep for that to happen.  And let's try not to repeat this tomorrow night.  I'm okay with staying up until midnight or a bit later to give you your midnight snack (you seem very insistent on that point), but I'd like to go to bed by 1:00 so we can get our beauty rest. 

Love,

Mom