Wednesday, February 22, 2012

Gabrielle Susanne Romo is here!

She's really really here!  It's so surreal to have her actually on the outside.  I keep looking at her and trying to reconcile the baby I see with the one that was growing inside of me for 9 months.  She's so perfect that I just don't know what to do :)

Birth story time!  I'm not pulling any punches here, so if you're squeamish, you may want to not read all the way through.  I'll try to indicate when it's going to get real.

I had been feeling pretty much the same since my 39 week appointment--tired, bored, ready to be done--that I did on the day of my 40 week appointment.  I'd had some contractions off and on all week, generally starting around 2 am and lasting until 4 (fantastic for my sleep), so I figured there had been some progress down in that area beyond the 1 cm and very soft cervix I'd had on Feb. 2.  So I went into my appointment on Feb. 9 at 3:45 pm, 2 days overdue according to my OB, secure in the knowledge that they wouldn't let me get beyond 10 days post due date, and thinking that we'd be setting up an induction for the following week.

I was seeing one of my favorites in the practice, and feeling pretty good.  I was put in a room without an ultrasound machine, but moved since they like to do quick ultrasounds on women who are overdue.  She told me before we started that if everything looked OK, then we would schedule an induction for the following week, but if there were problems, we'd try to get me in sooner.  She fired up the machine and started the scan.  Jacquizza was moving all around, but was clearly very cramped.  The OB started to measure amniotic fluid levels around the baby, and found that my AFI (the fluid level) was around 3.  They like to keep the levels above 5, and anything lower could stress the baby out too much.  She just looked at me and asked "what do you need to do--do you need to go home and pack a bag?"  I told her I at least needed to get my husband home from work, so she asked how much time I needed for that.  I told her probably a couple of hours would do just fine, so we could come back that evening or the following morning if that was better.  She looked at me and said "when we see fluid levels this low, we induce right away--you need to get admitted tonight".  That really impressed upon me how serious this was!  I knew the fluid levels being low was bad, but I guess I was just blocking out how bad it actually was.  I said we'd be at the hospital by 6:00.

I called Brian from the parking lot and told him that the amniotic fluids were low and we needed to be at the hospital by 6:00.  He told me later that he was in the middle of a conversation and just stopped talking and walked out the door.  I drove back to our house, met him there where we finished packing and headed to the hospital.  We got there around 5:45, got checked in downstairs, and then sent up to labor and delivery.  I was in the labor room by 7:00 on an IV and as comfortable as I could be.  I met my nurse for the evening, Becky, who was absolutely wonderful about answering questions and making sure I had what I needed.  We had to wait a few hours to get the pitocin on board, since my doctor was delivering another baby, but we started the pitocin drip at about 9:00.

Becky made it clear that they were calling it an induction since we were using drugs to make me go into active labor, but it actually wasn't a classical induction, since my cervix was already at about 80% effacement, I was 1-2 cm dilated and Jacquizza's head was fully locked at 0 station in my pelvis.  So basically, I had to have less pitocin for a shorter period of time since my body was already on the cusp of labor as it was.  Additionally, the I was hooked up to a monitor from 7-9 and it was showing that I was already contracting fairly regularly, even if I couldn't really feel them.  So things were happening even before the drugs were on board.  The monitors in the Mercy labor and delivery rooms were super cool--they actually showed not just my contractions and baby's heartbeat, but everyone else's who was in labor at the time.  It was really fun to watch them all and compare my progress to theirs.  Kind of like a race that we were all running separately.

Anyway, the pitocin started to kick in and my contractions were getting stronger and somewhat closer together.  Thanks to the yoga DVDs, I was able to breath through them fairly well.  I was actually pretty surprised at how effective just deep breathing was at keeping the pain tolerable.  I quickly developed a routine that seemed to work best for me--I would lie on one side (Becky told me lying on my side would help the pitocin work better, and I couldn't actually leave the room, since once you're on pitocin they monitor you and the baby very carefully, effectively tethering me to the bed) for about half an hour, then roll myself to the other.  They were taking my blood pressure remotely once an hour, so when the blood pressure cuff went off, I would get up and use the restroom.  This lasted until around 2:00 am, when the nurse checked me again and told me I was at 4 cm.  She suggested I try sitting up for a while to change up the position.  Becky got me a chair and I sat down.  It was wicked obvious with the first contraction that sitting upright was not going to work for me at all.  That was the first time I realized that I was not doing this naturally.  I stood, and that really helped a ton, but the contractions were really starting to pick up by then.

At around 3:15 am, I looked at Brian and said, I really need an epidural now.  He found Becky, and she said that she would page the anesthesiologist on call.  The good thing about laboring in the early am is that there are no scheduled procedures, so Dr. Young was able to get there by 3:30.  He asked me if I was sure (I think he's required to), and I said "yes, please!".  He said he usually hears more profanity-laden requests :)  He started prepping the area, and I had the needle in by 4:00.  It actually wasn't as bad getting it as I thought--there was a small burning when he put in the local, but I didn't feel the catheter at all.  I went through the trial dosage just fine, and he started the main drip.  Brian was in the room the whole time, but sat in a chair in front of me.  Dr. Young actually insisted on it--he said he had fathers that were super curious about the procedure and want to watch, but he just refuses to put in the epi until they decide to sit down.  He said the mothers then yell at the fathers and tell them to sit the heck down!

I actually made it to 5 cm without the epidural, which was what my unstated goal was.  I wanted to labor as long as possible on my own, so that I wasn't confined to the bed for the entire labor.  Plus, if I got it too early, I was worried about the epi wearing off before I had to push.  Overall, I managed to achieve the unspoken goal I set for myself, and I'm pretty proud of that!

After the epi was in, obviously I couldn't move around at all on my own.  It actually took about 15 minutes to fully kick in, but each contractions was less and less painful until I didn't feel them at all.  The nurse said I needed to be switched from side to side every 2 hours or so, which is what we did.  It was the weirdest feeling, sending commands to my feet to move and just having them sit there!  I lost all feeling in my right leg, but was able to move my left toes the entire time.  Everything else on the left was blessedly numb.  It made me feel very much better to be able to move something!

After the epi was in, I was able to get some rest.  I never actually slept, but I was able to relax and save my energy.  Becky brought in a sleep chair for Brian, and he was able to catch some catnaps.  We stayed resting/sleeping until about 7 when the nursing shift changed.  My new nurse was named Margaret, and she was also amazing.  She was from England, and had trained under the old-school midwives who she said could tell the amount of dilation based just on looking at how the woman was acting.  I had the epi, so she couldn't do that to me, but she had a ton of fascinating stories!  At about 9:45 am, Margaret came in and declared that I was fully dilated.  She told me it was almost time to push!  I admit that I freaked out a bit, since now it seemed so real!

Gross alert!!!  I'd been having a lot of bloody show (my bed was looking like a field hospital during WWII), but my water actually hadn't broken yet.  Margaret did a cervical check and only then did my water break (all on its own--that's our story and we're sticking to it!).  Unfortunately, the waters contained quite a bit of meconium, which is baby's first poo.  Normally, babies don't do this until they are out of the womb, and it's actually a really bad sign when it happens in utero.  Generally, it means the baby is in distress, and it also means that there's a good chance the baby will aspirate it and inhale it into the lungs with the first breath, which can cause some pretty bad breathing problems.  I was pretty freaked out, but Margaret was great about calming me down, telling me that in her experience, it just means a mature bowel.  It was still pretty vital to get Jacquizza out quickly, though.  So Margaret paged the doctor and the respiratory team and we settled me in to start pushing around 10:00.

Margaret had one leg pulled up, and Brian had the other (which surprised me, since I don't think he really wanted to be that close).  I hooked my hands behind my knees and bent forward to push.  Margaret and Brian were both so encouraging, and I really appreciated having them both there in the room with me.  Although the nurse seemed under the impression that I wanted to know what was going on--she asked if I wanted to feel, and then asked if I wanted a mirror.  Um, not so much!  Brian did watch a push, but I really just wanted to focus on pushing, and not be distracted by thoughts of what was coming out down there!  I pushed for about 15 minutes, and the respiratory team came in to get the warmer set up for their checks after Jacquizza was out.  Shortly after that, the doctor came in (there was a shift change there too, so it wasn't the same one who originally admitted me) and started to get herself settled in.  I kept pushing for another few minutes when the doc said that Jacquizza's head was stuck and not coming out.  Apparently, my perineum is really thick and wasn't thinning out at the rate it needed to.  So the doctor said she wanted to do an episiotomy (basically cutting the perineum instead of letting it tear).  She basically looked at me like I was going to object, but at that point, I knew the baby was in distress and was willing to do anything to get her out quickly and safely.  So she did the procedure (Brian at this point retreated to near my head so he didn't have to watch, although the doctor assured him that I had 7-8 liters of blood, and I could stand to lose a bit), and I started to push again.  After another few minutes, at 10:42 am on Feb. 10, Gabrielle made her entrance to the world.

Unfortunately, she started crying immediately (they were hoping to get her aspirated before she had a chance to inhale the meconium).  The respiratory therapist took her over to the warmer, and she and the nursery staff got her aspirated and checked her over thoroughly.  Brian was splitting his time between me and Gabby.  After a couple of minutes, they determined that she was all right, and moved her back over to me for the hospital's mandated skin-to-skin time.  The doctor in the meantime had delivered the placenta and gotten me stitched back up (and was very proud of her stitching job--she told the nurse that it was some of her best work, then told me a story of a colleague who took out his own appendix).  Everyone left the room except for Brian and we got to spend about 2 hours bonding as a new family.

Mommy and Gabby skin-to-skin in the recovery room

Here are some pictures from her first week of life.  I'm going to do my best to keep updating the blog (my goal is once a month), but I'm really not making any promises at this point!  Gabby's been great, and we've had a wonderful first week and a half (with plenty of help from Grandma and Grandpa Romo and Aunt Jennifer), but I know things will only get harder!

With Grandma and Grandpa Romo at the hospital

The 3 Romos

Mommy and Gabby

Monday, February 6, 2012

Oh waiting is the hardest part

Week: 39. 

Baby Size: Anywhere from 6-9 pounds (I don't plan on changing this until we announce an actual birth weight--provided she decides to come out at some point).  I actually lost 2 pounds at my appointment this week, giving me now 31 lbs total gain.  Weight stabilization/loss is actually really common at the end--the amniotic fluid gets reabsorbed to make more room for baby, which drops the fluid and hence the weight.  Jacquizza's heart rate was 156, and sounded nice and regular.  My blood pressure was much higher this week (134/84--I think I was nervous about getting an internal check), but still no protein in the urine.   

Sleep: Aches and pains and general worries about giving birth/taking care of a baby keep me up a lot.  And now we've added the fun of having actual contractions that last from about 1-4 am, and then taper off until they stop all together.  Just a little preview of what my sleep is going to be like once she's actually here?   

Diet and Exercise:  Still hanging in there with the yoga.  It'll be weird
not doing yoga every morning if and when she's here! 
Movement: Jacquizza still has her nightly dance party from 8-10.  I've also been noticing contractions (real ones, with pelvic and back pain, not the Braxton-Hicks fakey ones), and when they let up, she really starts to move a ton!  I think she hates the feeling of being compressed, and is trying to push everything away from her.  It's pretty amusing assigning dialog to it ("Like I wasn't already cramped enough in here--what the hell does the incubator think it's doing now??")! 

What I Miss: And, again, normal movement, coupled with sleep! 

What I'm Looking Forward to: Super Bowl party!  I love our annual gathering with its overabundance of food and laughing!     

Best Moment this Week: Having the doctor tell me she doesn't think I'll go past my due date.  It would be great to not be induced.  Although as my due date on Thursday approaches, I have less and less faith that the doctor is right!  If I make it to my Thursday appointment, the doctor said we'd start talking induction.

Pregnancy Body-New and Exciting!..maybe:
  I am definitely having "real" contractions!  At the internal check on Thursday, I was 1 cm dilated, my cervix was very soft, and Jacquizza's head was in position!  The doctor said it looks like she's ready to go, she just needs things to open up and let her out!   

Baby Milestones: Pretty much all weight gain until she decides she's done--apparently it's 0.5-0.75 pounds per week!  She's also in there practicing the skills she needs on the outside (breathing, swallowing, sucking)!    

Food Cravings: Had my sushi, had some chocolate chip cookies (slice and bake, but still tasty)--I'm good to go :) 

How's Dad?:
Very happy to have made it through Super Bowl without a baby!  We kept joking that she was going to wait until he put the ribs on the smoker, and then my water would break.  Well, we made it through the game with Jacquizza still in her parasite phase.  We had around 15 people over, including 2 very active 2.5 year-olds, and Brian as usual outdid himself with the babyback ribs, marinated flank steak, homemade BBQ sauce, and some seriously good guac.  Everyone else brought the sides and some desserts, and we ate so much!  Not everyone was a football fan (at some points, Brian was the only one in the room watching the game), but everyone seemed to really enjoy some aspect of the day--be it the commercials, the half time show or just the socializing.  Brian and I would have been happier with a different winner, but we did have a great time hanging out with everyone and eating a ton of food!    
Tid Bits:  I am so ready to be done.  I think I've handing the various ups and downs of being pregnant fairly well, until yesterday.  I think I hit that stage that all pregnant women hit where the fear of delivery is overshadowed by the feeling of just wanting this thing out now!  It would be nice one night to have those contractions last beyond the 3 hour mark (although the internal check did assure me that they are doing something besides annoying me).  I'm getting really short and irritable with everyone and everything--Beau peed on Brian's bathmat, and I went on a tirade about how I can't have a cat who can't even manage to find the litter box with a newborn in the house.  I love Beau, and it was totally the hormones talking, but that's just some of the craziness that's going through my head right now!

Here's hoping this is my last entry before Jacquizza graces us with her presence.  I have a feeling the entries are going to get much less happy and upbeat from here on out if she decides to stay put :S