Gwen's Birth

I haven't blogged in a suuuuper long time. We've moved (yet again) and now live in California, where Jay and I first met. And we had our fourth girl! I want to post her birth story before I forget the details. It's already been 3.5 months, so I've probably forgotten some small details.

My pregnancy with Gwen was very difficult. I got pregnant right smack in the middle of our move from Colorado to California. We did a DITY move (do-it-yourself), so Jay and I had to load and unload every one of our possessions by ourselves, when I was only a few weeks pregnant. I ended up with a subchorionic hemorrhage that I'm convinced was a result of all that physical labor. I had to go on "light duty" until the bleeding stopped, which didn't happen until 16 weeks. Also during that first trimester, I suffered from severe stomach pain. I had to go to the emergency room twice for the bleeding and stomach pain. The pain eventually stopped around 14 weeks, thank goodness, but it was a very dark time for me.

Right around the time the bleeding stopped, I started having pubic symphysis issues. I had it during my previous pregnancy as well, but it started earlier and was more severe this time. Walking for any distance was excruciatingly painful. Stairs were nearly impossible. Even getting out of bed was quite an endeavor. So I basically sat around around throughout my entire pregnancy. I was already in a mild state of depression because that's just what happens to me when I'm pregnant, but not being able to do anything made it that much more difficult.

After A's birth, I wasn't sure what I wanted to do for this birth. Jay and I interviewed some homebirth midwives, and Jay was 100% supportive of another homebirth if I wanted to go that route. I was scared. I decided not to. I decided to go with a group of certified nurse-midwives who do hospital deliveries instead. In a strange twist of events, one of the homebirth midwives we had interviewed had a child in Mae's school, so I ran into her when I was 33 weeks pregnant. Jay and I had some intense discussions, and again, he was 100% supportive of me no matter what I chose. So I decided that I did want a homebirth after all.

That week, at my 34 week appointment with the CNMs, I ended up having high blood pressure. This was not in our plans! For the next week, I saw both the CNMs and the homebirth midwives. I had yet another high blood pressure reading, so that ended up risking me out of a homebirth after all. I was sorely disappointed. I had felt excited about the impending birth for the first time during my pregnancy, and now it was completely taken away from me. It was hard.

Because of the high blood pressure, I had to start seeing my midwives and the OB in the practice 1-2 times a week. Every one of my lab tests, AFIs, and NSTs came back normal. My blood pressure was borderline high the rest of the time, except once when I had dealt with some bad traffic on the way to my appointment (these California drivers!). I was trying to be positive about everything, reminding myself that God had a plan, and for whatever reason, it seemed that I was supposed to give birth in the hospital this time.

At my 38 week appointment, on Monday, December 1, I had another AFI. My baby was vertex by that point, so when the sonographer put the transducer on my lower abdomen, right about my pubic bone, I was shocked and dismayed to see...not a head. Oh no. 38 weeks, and I was already being pressured to induce because of my borderline blood pressure (the OB and I had tentatively agreed on inducing at 40 weeks if the baby hadn't come, and I had never had a baby before my due date, so this scared me). The midwife immediately informed me that if I wanted a vaginal birth, I would have to schedule a version and immediate induction for the next day. My baby was transverse, which significantly increased the odds of a cord prolapse if my water broke. It wasn't worth it to risk it. I called Jay while the midwife called in the OB who would be doing the version. He came in the exam room about 20 minutes later, and I mentioned that I had felt the baby move. He decided to check her position before scheduling the version, and voila! Baby was vertex once again. The midwife still wasn't terribly pleased that my baby had an "unstable lie" which meant that she could flip-flop around easily. They wanted to schedule me for an induction sooner rather than later so that I could avoid a cesarean due to a breech or transverse baby. I was really confused about what to do.

I had another appointment scheduled for Dec. 4, so I decided to wait until then to see my baby's position before making any decisions. I prayed a lot about the situation. I was 38 weeks and 1 day, and I was just praying that I would go into labor spontaneously with a vertex baby.

On Tuesday, Dec. 2, I was hanging out with Jay after the girls went to bed, when I started having bloody show. I know that it doesn't mean labor is imminent, but I felt very encouraged! That night, while I was in bed, I started having irregular contractions. Definitely more than Braxton Hicks but not quite labor contractions. I timed them, and they were sporadic, but they were strong. I spent the whole day Wednesday having contractions off-and-on. I packed the girls' overnight bags and discussed our plans with them and with our friend who was going to watch them for us. I didn't know when I'd actually go into labor, but I wanted to be prepared, especially after how quickly things moved along with A's birth.

That night, Jay and I went to bed at 10:30 pm. My contractions had kind of tapered off, but I was still having bloody show, and I had a feeling that this was going to be the night. We fell asleep, and I woke up at 11:45 with some VERY strong contractions. I shifted positions and felt like maybe my water was leaking. The only time my water broke spontaneously was with M's birth, and it was just a leak, not a huge gush, and that's what I thought was happening. After the third strong contraction in a 15 minute period, I got up to go to the bathroom to check if it was my water leaking. As soon as I stood up, though, I knew immediately that my water was indeed breaking, and it wasn't just a leak. I RAN to the bathroom like I've never run before, and I didn't quite make it to the toilet. As I was going to sit down on the toilet, my water broke in a huge gush all over the floor in front of the toilet, and another strong contraction hit right away.

I yelled for Jay to come, and I let him know that my water had broken and that things were moving quickly. We both hopped in the shower. I wasn't happy that Jay wanted to take a shower, but I needed to because I was covered in amniotic fluid, so it ended up being no big deal. The warm water felt good anyway. We got out, got dressed, and woke up the girls to take them to the car. Z and M had wanted to come to the hospital with us to witness the birth, so that had been our original plan. But once they saw me in labor, they both decided they wanted to go to our friend's house with A instead. So we packed them in the car and headed out to our friend's house. While on our way, I called our birth center (a free-standing birth center/surgical suite) to let them know we were on our way. It was a 45 minute drive, and I was already vocalizing through my contractions, so I wanted them to be prepared for us.

And that's when they informed us that they were booked and had no beds available for me.

What to do?!

I was very unhappy. I could go to the hospital where my midwives were on call, but that was an hour away, and I wasn't even sure if I'd have one of my midwives or the OB I was seeing there. Or I could go to our local hospital, 15 minutes away, where I'd have to use the on-call OB. As soon as we dropped off the girls, I knew things were moving quickly, so I told Jay just to go to the local hospital. I was sad that I wasn't going to the birth center with my midwives, but I was too focused on my contractions to be too upset.

We got to the hospital at nearly 1 am. The security guard helped Jay and me to the maternity ward, where it seemed like it was a slow night. The nurses jumped into action and immediately got me to a room. They were amazing, considering the fact that I wasn't registered at that hospital, nor was I seeing any of the OBs that worked there. My nurse, Danielle, was great! As soon as we got to our room, she asked me what my plans were regarding pain management. After my plans to have a homebirth fell through, I had decided to really take my labor as it came, making no decisions about pain management until I was in labor. If I had another long labor with a build-up to transition, I was thinking I would try for another unmedicated childbirth. If it was going to be like A's birth, then I wanted pain meds. And it was much like A's birth. Labor had started with a vengeance, and I was having transition-like contractions from the start. I was only 3 cm (and vertex!) when I got to the hospital, but I was most definitely in transition with back-to-back contractions. I let the nurse know that I wanted to get an epidural.

That's when she informed me that they would have to call in the anesthesiologist, so I would have to wait about an hour for him to get there. That was a tough pill to swallow! I had finally agreed to an epidural early in labor, and I couldn't have it, go figure. The nurse decided to give me fentanyl. She asked if I wanted it, but I wasn't sure because of all the horror stories I've heard of narcotics. How they make you feel drunk but do nothing at all for the pain. How they cause the baby to be sleepy. She ended up giving me the meds despite my reluctance to try them, and wow! I've never been drunk before, but that stuff felt GOOD. It definitely took the edge off the contractions, and I was able to sleep a bit between contractions. It was definitely helpful while I was waiting for the anesthesiologist to arrive.

He did finally arrive, and I got my epidural around 1:45 am. It didn't work evenly, so I could still feel some pain in a small window near my left hip bone. It wasn't horrible, but I definitely felt it. They gave me more meds and put me on my side to try to get the pain to go away, but it only worked to dull the pain. It was fine though, and I was able to sleep for a bit while Jay slept on the little couch.

At 4:30 am, I woke up suddenly feeling a lot of pain in that little window near my hip. I called the nurse about it, and she decided to check my cervix before pressing the button to give me more pain meds. I was 9 cm! She pushed the button once and told me to rest while she called the doctor. I tried to rest, but the pain kept getting worse and worse. It ended up going up and down my whole left side, almost feeling like a really bad backache along my whole spine. I started quietly vocalizing through the contractions, and I let the nurse know that the pain was much worse. She checked me again, and I was fully dilated!

At that point, she checked the chux pad underneath me, and we discovered that the baby had passed meconium. Go figure. That makes three out of my four. I was really disappointed because I knew it meant I wouldn't be able to hold my baby right away.

The doctor then came in, all gowned up. They fixed the bed, had me pull up my legs (well, they pulled them up for me because the epidural was so strong that I couldn't move my right leg for anything). The doctor asked me to push, and I pushed. Everyone was so quiet, so I asked if the baby was coming, and the doctor announced that her head was already out! I was quite surprised! With another push, my baby was earthside, and to my great surprise, the doctor placed her on my belly! I didn't expect that since she had passed meconium. Her umbilical cord was very short, so she was only able to go on my belly, not my chest, but the moment they handed her to me, it was love. Looking back, I am amazed at how much more present I felt for my birth when I chose the epidural and was able to rest before having the baby! I know it's not for everyone, but I was able to focus on my baby and how happy I was to finally meet her rather than being so tired and disoriented from the pain of giving birth.

The baby nurse decided to take my baby because her breathing wasn't the best due to the meconium. They suctioned her then wrapped her up and gave her back to me. I decided to try nursing her, and she latched on right away. I was so happy about that, thinking that all would be well with our nursing relationship. Everyone left for awhile so Jay and I could revel in our new baby during her Golden Hour. My mother was scheduled to go in for surgery that morning, so we called her to let her know that she had a new granddaughter. We also called a few other family members to let them know, but we really wanted to wait to share the news. I just wanted it to be Jay, the baby, and me for a bit. I loved having that time to ourselves.

The rest of the hospital stay was very quiet for us. Jay brought in the older girls to meet their baby sister, and they were all beyond ecstatic. I decided to leave the hospital the following day because it just wasn't comfortable there. I wanted to get home and relax with all of my girls and with Jay.

Things seemed to be going well for the first few days, but after that, I noticed that the baby (who still didn't have a name at this point) wasn't swallowing much while nursing. At her four day weight check, she hadn't gained back any of the weight she had lost in the hospital. M and A had both gained back their weight quite quickly, so this made me nervous, coupled with the fact that she didn't seem to be swallowing much. The pediatrician mentioned that I was eligible to see the lactation consultants at the hospital where I had given birth, so I called them and made an appointment.

Also during this week, we had to come up with a name for our baby. It took six days to finally decide, and at this point I'm still having some naming regrets. I love her name, and it fits her, but I feel like the other name was the name I wanted but that I was too afraid to use. That name is now her middle name, so we did use it in a sense, but maybe I just need to let her first name grow on me more.

By the time I saw the lactation consultant, Gwen was 8 days old, and she still hadn't gained back ANY weight. Not even an ounce. That's when my fears were confirmed. She wasn't nursing effectively. I spent the next couple of weeks in a whirlwind of pumping, nursing, pumping, supplementing with expressed breast milk, wash, rinse, repeat. It was beyond exhausting, both physically and emotionally. I was a basket case, bursting into tears, yelling at Jay over stupid stuff, afraid to leave the house. I tried special bottles, a supplemental nursing system, cup feeding, everything. I would fix her latch over and over again. More pumping, waking up every couple of hours to pump. It was so much work. If I hadn't had my previous nursing experiences with my girls, I don't think I would have made it through this with Gwen. I knew from previous experience how much nursing meant to me, both practically and emotionally. I would burst into tears thinking that I might not be able to nurse Gwen in the middle of the night, that I would have to get up to warm her a bottle of pumped milk. Or thinking about any and every outing...how would I manage that? Pumping and bottle-feeding with four children always on the go. I just couldn't imagine it. So I continued to push through until Gwen almost miraculously got the hang of nursing. I remember it so clearly, it was just a couple of days before Christmas, and she finally, FINALLY started nursing. Then I couldn't stop crying tears of joy.

Even after she finally started nursing and gaining weight, I couldn't stop worrying obsessively about it. I was obsessive about counting her diaper output, about not leaving the house in case she ended up having a bad day. Even after she started nursing, she would have some difficult days where I would have to pump and supplement again, which would send me in a tailspin of despair, thinking it was all coming to an end. I eventually asked my midwife for some anti-anxiety medication because I realized that it was beyond my capabilities to fix it on my own. I started a very low dose of meds, and it has been immensely helpful in overcoming my anxiety. Gwen has been nursing well and gaining weight since our rough start, and while I do still worry about it, I feel a lot better about the fact that she has had 3.5 months of exclusive breastfeeding. I'm still taking it a day at a time.

As for my older girls, they are all adjusting to having a baby in the house. Z and M are extremely helpful, and they both love Gwen so much. A loves Gwen so much too. It's been sweet to see them so eager to help and to love on their baby sister. We did go through some growing pains, but that's normal with any new addition.

As for me, my blood pressure was still on the higher side, so I started taking blood pressure medication. It's now pretty low, and I'll be seeing my doctor next week about going off of my meds. I lost so much muscle from my sedentary pregnancy, so I'm also slowly working on gaining back the muscle I lost. The blood pressure issue has really pushed me to become healthier. I want to set a good example for all four of my girls, since they will have the same genetic predisposition for high blood pressure that I have. I don't know if my blood pressure issues during pregnancy were pregnancy-induced or not (I'm inclined to believe that it was essential hypertension, not pregnancy-induced), but I do know that I want the girls to learn to make healthy choices so that if they ever do end up with hypertension, they'll know they did everything they could to prevent it.

Anyway, it's a super long birth story again, but this is mainly so I can come back to read it someday when the details start leaving me.