Approaching 31

In two weeks I will be turning 31. I must confess that I'm not where I thought I would be at this point. I don't have a clear picture of exactly what I thought (maybe that's part of the problem), but I can say for sure that this isn't it.  For one thing, I expected to have a Master's degree by now.  I don't regret not finishing my MA because of the circumstances that led to my dropping out of that program, but, still, it was part of the plan at one point.  It was the plan for quite a while, really.  But, I am unwilling to return to the program I left, and I'm also unwilling to move somewhere in order to pursue that degree.  An online program is out of the question, because music performance programs can't be done that way.  So, that's out.

I also thought I would be playing for a symphony that paid by now.  But, I'm still playing in a volunteer community orchestra. On the one hand, I'm sad that I haven't accomplished that goal, while on the other hand, the freedom to not worry too much about it is nice at this juncture.

I suppose a fair amount of the tension I feel about where I am versus where I thought I would be is due to the expectation that all the important things must be done, or at least started, before 30.  The currently famous concertising violinists are not much older than me, but they've been performing publicly (and getting paid for it), for at least a decade, if not more.  That means they started in their early to mid 20s.  And I am 31, playing for an unpaid community orchestra and on the verge of shutting down my teaching studio.  I barely play outside of rehearsals.  I could play more if I put forth the effort, but finding the motivation is difficult, and having a 17 month old who cries when I practice doesn't help.

And that brings me to my next point.  Nearly everyone my age has multiple children by now and they're all older than mine.  You see, you're supposed to start a family in your early 20s, too.  Or, if you don't, at least have a career to show for it.  And me?  I'm 31 and have barely started.  My friends with children the same age as my daughter are several years younger than me and have been married for less than 5 years (put together).  I will be celebrating my 10th anniversary in July.  It's a bit strange to be the oldest (or one of the oldest), when I've nearly always been one of the youngest.

This has all been on my mind lately as I approach my 31st birthday. I don't regret my choices along the way.  I am happy, though it may sound a bit like I'm complaining.  I suppose I'm in a transitional season righ now.  Maybe I will still complete my Master's in Music or win a position with a professional symphony.  At the moment I'm not even pursuing either goal. It's strange because I've been doing one or the other until about a year and a half ago.  Maybe in a few years I will resume the pursuit.  And maybe I won't.  For now I'm focusing on raising my daughter, growing Riverview Naturals, and writing again.  I guess the important takeaway is that plans change. Sometimes it's because of your own decisions or because of things that happen to you. Sometimes you let go of long held goals and pick up new ones. Sometimes you can even pick up a goal you had put down a long time ago.  And putting down a goal now, doesn't mean it can never be picked up again.

Too Much TV

Sometimes I watch TV shows and think that I should get into the same line of work as the character or characters on the show, particularly if they're making a lot of money. And then I realize that I've been binge watching Leverage and that what they do is illegal. Being a con artist might sound like fun in my head, but the illegal activity is a bit of a hitch, even if it does pay well. Oh, well. I guess I'll have to figure something else out. 

Shrinking Women

A couple days ago I was reading The Bloggess and she linked to this post on Momastery.  I actually watched the video (the one posted above), which is a bit rare for me. I tend not to watch the videos people post, but this one I did.  You should watch it, too.

I posted it on Facebook, hoping that it would spark some conversation.  One person liked the post and one of my uncles commented, and that was it.  I was a bit disappointed that more of my female friends didn't say anything, particularly the more feminist leaning ones.

I think the point here is important and timely.  The ways in which we as women feed ourselves and treat our bodies profoundly affects our daughters.  Our obsession with dieting and weight loss teaches our daughters to shrink, to absorb, to make space around them, and to apologize for any space they take up, especially if that space is any more than another girl or woman occupies.  This not only affects their eating habits, but their relationships with themselves and everyone around them.  This reinforces the holdover belief that women are inherently less valuable, less worthy, and only valued for their appearance.

Is this the message we want to send and reinforce with our daughters?  I don't. It is this message that leads to disordered eating, disordered thinking, pregnant women who feel guilty for gaining weight, and breastfeeding women who think they should be able to survive on 1500 calories per day.  Do you realize that the weight gain recommendations really only take into account the extra weight from the baby, the placenta, the amniotic fluid, and the additional blood volume?  It doesn't account for the additional fat stores that women's bodies are designed to lay down in pregnancy to prepare for breastfeeding. Did you know that a toddler is supposed to consume a minimum of 1300 calories per day?  It seems to me that a full grown adult woman who just grew another person inside her body and is now nourishing that person with milk produced by her body needs more food than a 1 year old.

As a contrast, I am weight stable and have been for about a year (prior to that I was still experiencing postpartum weight loss) and I consume at least 3000 calories per day.  I am still breastfeeding a few times per day, and that is the amount it takes for me to not feel hungry.  Either, breastfeeding uses a lot more than 500 calories per day (the usual amount cited), or I have a high metabolism.  While I have been working to improve my metabolic function for the last several months and have been seeing improvements, I can guarantee that my metabolism is average at best.  I don't think any adult should restrict themselves to 1500 calories per day.  Even if you're trying to lose weight, that is just not enough fuel for an adult body.  You might lose weight quickly at first, but you will also cause your metabolism to significantly down regulate, which will cause a whole host of other problems.

I wish that we were not so culturally obsessed with weight loss to the exclusion of all other pursuits.  I wish that this video would have been in my Facebook feed multiple times over.  Holly McNish's video of her performing her poem Embarrassed was all over my news feed for days.  It's an awesome poem and an important issue, and I'm glad she had such a profound impact on so many.  I think this poem deserves equal exposure.  This issue is more pervasive, more insidious, and lifelong.

Women, do not shrink yourselves as though you are unworthy of taking up space.  Fill up your space.  Fill it with laughter and joy and compassion and love.

(Im)Patience

Michael is out of town this week for work.  This is the first time he's been away since our daughter was born, the first time in several years he's been away at all, and the longest we've been apart since we were married. When he worked for the state he occasionally went to Boise, but that was just for a couple days.  He left early Sunday morning and won't be back until Saturday evening. Hopefully he'll be back home before Kaylin needs to go to bed, but, depending on delays and such, it could go either way.  I realize that I don't have a lot of room to complain.  Many people are, or function as, single parents due to employment situations, military deployments, divorce, and whatnot.  They go for weeks, months, years on end without steady backup.  But, I'm used to having an extra pair of hands, another lap for the toddler to climb on, another set of eyes to watch her and make sure she doesn't get into anything she shouldn't, someone to talk to so it's less boring around here.  By nighttime my patience has worn pretty thin.  Sleep has never come particularly easily to my daughter.  She is her mother's daughter, after all.  She still needs to be nursed and/or rocked to sleep.  Usually lying down with her and nursing her does the trick.  The last couple days, not so much.  And I get rather unreasonably frustrated that she's not just falling asleep in 5 minutes or less, as I would so dearly love. She nurses for a while, then she squirms and rolls over and climbs on me and flails and kicks and I start to get angry.  This happens sometimes in general, and I do find it frustrating normally.  But the level of frustration is elevated this week while I'm on my own. Not because Michael helps with bed time, because he doesn't. That sounds terrible, but she finds Daddy far too exciting and won't settle down for him at all. The only way he can get her to sleep is to drive her around in the car, and then he just has to drive around until she wakes up, or I have to make the transfer to the bed.  She won't stay asleep for him.  The only other option for him to get her to sleep is to wait until she's so utterly exhausted that she is incapable of staying awake any longer.  Then she'll crawl into his lap and fall asleep.  These are both less than ideal situations, so nap time and bed time both fall to me still.  But, the lack of pre-bed time assistance takes its toll on me.  Getting crawled on all day makes getting crawled on in bed at night far less cute and far more irritating.  Tonight did go a bit better than last night, though.  She was in bed and asleep before 10:00, so I'm calling it a win.

Revival

I've decided it's time to revive this space. I started it as a repository of my random thoughts. I made some half hearted attempts to narrow the focus, but my interests are rather varied, so narrowly focused blogs feel too restrictive. So, I'm returning to my random thought repository.

I've actually been meaning to start writing here again for a little while. I compose posts in my head while I'm doing other things, but forget about them when I move on to something else. I had a baby, and everyone knows that babies eat your brain. That's my excuse.

Don't get me wrong. I'm not complaining. I actually have enjoyed my journey into motherhood so far. But, I'm finally starting to find more of myself again. The first year, while gratifying, is also a bit all consuming. Now that my daughter is exerting more independence and learning new things, I'm able to reclaim more of my time and things I enjoy. One of those things is writing. I used to write often. Mostly in notebooks. Sometimes poems. I haven't written poetry in a very long time. Well, I did write one poem a couple months ago, but that was the first in years. I suppose that's not necessarily a bad thing, though, because most of my poetry was written as a vehicle to express to strong emotions, usually of the less pleasant variety. So, my lack of poetry would be indicative of a sense of general happiness with life. I can't see that as a bad thing. (Yes, I did spend a portion of my teenage years writing angsty, and likely bad, poems. It is what it is.)

I used to write stories, too. Those were usually for school assignments, but I never had difficulty finding things to write about. By high school, though, they want analytical essays on other people's stories or research papers, so the creative story telling gets pushed aside. I guess that's partly why I went with poetry. It's short and compact in comparison to writing fiction. Anyway, I've missed writing, so I'm starting again.

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.