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Tuesday, February 02, 2010

The Best-Laid Plans – Labor & Delivery

By my 40th week, stubbornness was no longer an option. My blood pressure, which had averaged 116/64 during my pregnancy, had begun to climb. It was 134/84 at 38 weeks and 140/90 at 39 weeks. Showing no signs of protein in my urine or blood, I didn’t have pre-eclampsia but it seemed like that was the next logical step. The day before I was admitted to the hospital, my blood pressure was 150/94 and I was showing trace amounts of protein in my urine. Official diagnosis: Pregnancy-induced hypertension, referred to by some doctors as “pre-pre-eclampsia.” I wonder if those doctors also work for the Department of Redundancy Department.

Humor aside, my need to compromise wasn’t over. My doctor explained that being induced while still relatively healthy increased my chances of a somewhat natural delivery and reduced my chances of requiring a Caesarean section. Though I come from the school of thought where “natural childbirth” is defined as allowing your body to naturally do its own thing (no induction, no painkillers, no medical intervention, etc.), I found myself compromising yet again.

Hurry up and Wait
I admitted myself into the hospital at 8 a.m. Jan. 21. Since my body was showing all the signs of being ready to deliver on its own, the doctor agreed to be less aggressive and start with prostaglandin gel. The baby’s head was right on the cervix so there was no need for pitocin-induced contractions to bring the baby lower into the pelvic outlet. We just needed to get the cervix opened up so the baby could come out.

The gel did its work on my cervix, and regular contractions began shortly thereafter. The doctor visited me around dinnertime and said that we’d most likely have a baby Friday afternoon. My night-shift nurse decided to administer another dose of gel around 8 p.m., figuring it would cause my cervix to soften overnight while I slept. We called the doula and told her that we wouldn’t need her services until the next day. None of us knew at the time what lie ahead of us.

They Don’t Call it ‘Labor’ for Nothin’
The second dose of gel threw labor into overdrive for me with intense contractions starting at 11 p.m. The most intense contractions alternated between belly and back, indicating the baby was most likely sideways with its shoulder and elbow digging into my spine.

This is when I should have called the doula, but I still believed “hard labor” wouldn’t begin until the following morning and didn’t want to disturb her. Only now do I realize that was the wrong move.

Thinking I should conserve my energy for the hard work ahead the next day, I agreed to the nurse’s offer of a small dose of Stadol to help me sleep. Bad idea. The drug hit me hard and fast, making me just this side of crazy. I swear, I haven’t felt that intoxicated since taking up the challenge of drinking 21 shots on my 21st birthday. I was out of my mind but aware enough to realize I couldn’t articulate a complete sentence and should just stay quiet.

Fear Sets In
Here is where things got a bit hairy. Brian, the doula and I were all prepared for the signs of transition, which has symptoms that mirror severe hypoglycemia. We were also prepared for the possibility that I might have a hypoglycemic episode (blood sugar dipping below 50) during labor. What we didn’t prepare for is that both could occur at the same time, and that none of us would figure it out.

Between the hypoglycemia and the Stadol, I was incoherent. I couldn’t follow simple instructions and kept having flashbacks to my bowel obstruction three years ago. I had a hard time differentiating between past and present. I was terrified and couldn’t effectively communicate.

My blood pressure was escalating, giving readings of 150/99 up to 165/ 104. The nurse suggested an epidural. I fought the idea. I had already compromised my ideal natural birth experience; I didn’t want to compromise further. Yet I couldn’t figure out how I would deliver my baby when I couldn’t even figure out where I was or speak a complete sentence to anyone around me.

Seeking a way to clear my head, I agreed to the epidural. The anesthesiologist arrived at the same time as our doula. But by that point, there was little she could do for me. Instead of giving me a full epidural, the doctor administered a bolus – a temporary dose of medication – with the intention of returning to give me more later. Once the epidural kicked in and the doula began feeding me diluted juice, the fog in my head began to clear. I wasn’t numb from the epidural – just a little tingly. I could feel my contractions but I was no longer in fear. I knew where I was and what I was doing. I was able to put the terror of the bowel obstruction behind me and focus on the task at hand. Once I had enough juice in me, I realized the uncontrollable jitters, nausea and mental fog were due to low blood sugar.

I had a moment of feeling like an epic failure at the birth process since I caved to offers of drugs, but that gave way to excited anticipation that I would soon hold my baby in my arms. The bolus began wearing off after a couple of hours and my contractions got more intense. I felt the full force of each, most concentrated in my back, and my doula and Brian coached me through relaxing as each one came and went.

Getting Down to Business
It soon became apparent that the baby would arrive quickly. The nurse called our doctor and said she was on her way, but the baby had no intention of waiting. The urge to push was overwhelming, and the nurse led me through a practice push to see how effective I would be at it. Apparently, I did a great job because her next instructions were to avoid pushing and to breathe through the contractions. Fat chance, I told her. Her response: “Tonya, I cannot deliver your baby. We have to wait for a doctor.” Then she started paging residents.

I don’t know if I said it out loud, but I didn’t care if she wanted to deliver the baby or not. As far as I was concerned, she could step aside and let Brian and the doula take over. One thing was certain, the baby was coming, and I wasn’t holding back. My doula whispered to me that I could push if I wanted. So I did.

Lily Ann was born in the next push. Her cord was around her neck but the nurse calmly took care of that without much distress. She was in my arms as the OB residents entered the room in time to clamp the cord for Brian to cut. My doctor arrived just in time to handle the cleanup, which was pretty extensive given the speed at which Lily was born. But by that point, I had Lily on my chest and I didn’t care. Brian and I were in awe of her. Such a perfect little being that we created, and I birthed into the world. The achievement -- even though it required compromises on my part -- still boggles my mind.

Monday, February 01, 2010

The Best-Laid Plans

I have waited my entire life to become a mother. Seriously, having children is something I can vividly recall looking forward to from the time I was about 6 years old. Raised as an only child, I also wanted a really big family, often telling people that I wanted 25 children. I was about 13 before I realized that it would take me about 40 years to reach that goal unless I had a string of multiple births. By the time I was in high school, I had settled on a much more manageable number: 6, and had a plan to start my family at 25.

But as we all know, planning and doing are two entirely separate things. I never planned to have trouble getting pregnant, I never planned to get divorced and I definitely didn’t plan on getting remarried in my early 30s – yet that’s what happened, and what led to me having my very first baby on Jan. 22.

Lily Ann has 10 fingers, 10 toes, and all the necessary parts to connect them. She’s practically perfect in every way. Yet her debut into this world did not come as I had planned.
Having spent my childhood, teens and early 20s as a paid caregiver for other people’s children, I had plenty of time to plan how I would raise my own. I babysat and nannied for a variety of individuals – granola-munching ex-hippies, modern yuppies, welfare moms struggling to get by, military personnel, etc. – and each experience taught me a little about what I did and didn’t want for my own children.

I knew I wanted to exclusively breastfeed, use cloth diapers and wear my baby 24/7. I also wanted natural birth, with my preference being an unassisted home birth but willing to compromise by having a midwife present.

My pre-existing health conditions – gastric bypass, bowel obstruction, abdominal hernia, anemia, reactive hypoglycemia – caused me to “risk out” when it came to a home birth, meaning that no midwife was willing to take on the risk of assisting me with a home delivery.

Thus began my first compromise as an expectant mom: I would give birth in a hospital, attended by a family practitioner and assisted by my husband and a doula (labor assistant) to serve as my advocate.

Then my health conditions took their toll on my body and on my pregnancy, leading me to more compromises: Ultrasounds and fetal monitoring multiple times per week and early maternity leave.

When it came to my 38th week and my doctor began discussing the possibility of induction, I was a bit like a spoiled child and dug in my heels. I felt that I had compromised enough during my pregnancy, and I didn’t want to budge one inch further. I wanted the natural delivery of my dreams, and I was determined to get it. But sometimes, fate forces our hand even when we want to be stubborn.

Saturday, January 23, 2010

Lily Ann Makes Her Debut

Lily Ann was born at 5:12 a.m. Jan. 22, 2010. She weighed 6 pounds, 7 ounces; and measured 18.5 inches. Details to come...

Wednesday, January 20, 2010

40-Week Update

As my 40th week of pregnancy winds down, reality and excited anticipation are ramping up. I've been having strong contractions since last night in what seems to be proof that Skipolini's Prego Pizza really does what it promises to do. We'll see how the rest of the day goes.

Speaking of rest, that's tops on my agenda for today. They say it's important to reserve energy as much as possible during the first stage of labor to ensure you have the stamina to make it through to the end. I alternate cat naps with birthing exercises on my yoga ball. I've even managed to do a load of laundry here and there. Both Brian and I are eager to meet our little one and I have to admit that I'm eager to experience childbirth.

Though both Brian and I are techno-savvy folks, we are not planning Twitter or FB play-by-plays in the delivery room. Once we get there, we're on a mission and plan to focus on the serious work ahead of us. But until then, it's fun to text friends back and forth with our progress thus far.

I can't wait to hold our little bundle of joy in my arms!

Tuesday, January 19, 2010

The Final Countdown

The last few weeks have been a whirlwind of activity in our home as we make final preparations for Baby Kubo’s welcome into the world. We’ve washed loads and loads of diapers, blankets and other baby-related laundry, taking special care not to go overboard in case we have a closet full of clothes that the baby will never have a chance to wear.

I have completed my newborn diaper stash with a selection of fitteds, diaper wraps, some homemade soakers from a local woman and a variety of cloth diaper wipes. We also have some prefolds and all-in-ones for future use. I’m still waiting on some custom-made pail deodorizer and wipe solution/bum cleaner to arrive in the mail. My rapid research and foray into the world of cloth diapering is worthy of its own post one day, but today isn’t that day.

We have the co-sleeper set up in our room, and the crib was picked up and assembled today. Brian is a great expectant dad, knowing exactly what to do and when. He even made sure the car seat was properly installed today, which is not nearly as easy as it sounds. Luckily, our brother-in-law is a firefighter and father, and therefore, well educated and experienced in that sort of thing.

There’s a misconception among some couples that it’s better to be the parents of the first grandchild, but I have to say that we have benefitted greatly from the fact that Brian’s sister was the first on his side to have children. We’ve been so blessed to learn from them and their experiences over the past few months. We’ve not had to reinvent the wheel, and that’s made for a stress-free pregnancy in so many ways.

I’ve enjoyed practicing swaddle and babywearing techniques on the stuffed animals I’ve kept since childhood. Brian says I’m getting pretty good at it. Of course, we’re both aware that it’s easy to be good on inanimate objects. But at least I’m getting the basics mastered. Next step: Add squirmy newborn.

I’m just beginning my 40th week of pregnancy and am eagerly anticipating signs of labor. As I’ve said before, I’m in no rush to end the experience but I am ready to meet the baby now. We’ve waited a long time to get to this point and it’s exciting to see the end in sight, even if that end is merely the beginning to a whole new experience.

Sunday, January 10, 2010

38-Week Update

It’s official, I am almost 10 months pregnant. It’s not until you’re pregnant that you realize it’s not a nine-month experience. I’m surprised more people don’t do the math and realize that 40 weeks equals 10 months. Then again, it’s not uncommon to deliver a baby between 36 weeks and 41 weeks so everyone’s journey really is relative.

For me, it’s been a fast few months. Even planning our wedding didn’t go this quickly in my mind.

It’s hard to believe that just a few weeks ago, I was at risk of pre-term labor and had to make some major adjustments in that arena. Now it appears, it’s all smooth sailing. My belly has grown. The baby has grown. And I have learned the art of taking it easy, which I would have previously told you was impossible.

As of our latest ultrasound, the baby is over 6 lbs and appears to be in position to make his/her debut. We have gotten some fun photos, thanks to a very patient ultrasound technician. Baby Kubo has never felt photogenic and has made most techs go insane as they attempt in vain to capture cutesy keepsake photos. My favorite photo from our last appointment is that of the baby's foot, which at 3 inches long, looks a lot like Brian's.

I’m not in a rush to end my pregnancy. I really enjoy being pregnant and having this little person moving and growing inside of me. At the same time, I look forward to meeting him or her, learning the baby’s personality and seeing how Brian’s and my genes have meshed. We hope the baby gets the best of both of us instead of the worst, but I imagine he/she will have a little of both. I'm also interested to see how accurate the ultrasounds have been. Does the baby have as much hair as it seems? Are the size estimates true or is that "plus/minus 1 pound" margin of error more true to form?

As I look over the photos I’ve been posting, I’m glad we took the time to document the past few months. It’s hard for me right now to remember life before I had a rotund belly. It’s hard to picture my pre-pregnancy life at all. It feels as if I’ve always been carrying around this little being who has required me to alter my eating and lifestyle habits. I’m going to miss this feeling when it’s gone.

Monday, January 04, 2010

Happy New Year!

2010 is officially in full swing, and I am in awe of what's ahead of me this year. I know 2009 was a downer for many. The economy affected many I know through the loss of jobs, loss of homes, loss of credit and loss of loved ones.

A good friend of mine who had a pretty rotten 2009 admitted that she had a rough time when writing out her Christmas cards last year, because the only thing that went well for her family that year was in the area of finances.

"Given what's happened to everyone else in 2009, that's just not the sort of thing you can brag about," she said. So her Christmas cards were general and basic with hopes for 2010 to be better all around.

Brian and I were discussing 2009 over the weekend. We know it was a tough year for the nation in general. But even though we faced our own challenges over the year, it's hard for us to deny the incredible blessings we experienced throughout the year:
  • We were married in a fairytale ceremony in the company of our dearest friends and relatives.
  • I had the once-in-a-lifetime experience of coordinating media when First Lady Michelle Obama visited UC Merced.
  • We discovered I was pregnant, despite being told such a feat was impossible without medical intervention.
  • Brian was cast as Cogsworth in Playhouse Merced's production of "Beauty and the Beast," one of the best shows he's been in.
The year was far from perfect, but we really can't complain. We survived it relatively unscathed. And now we're looking ahead to 2010. This is going to be an equally big year for us, with a baby coming, increased involvement in our church and our first wedding anniversary all in the next few months.

I'm not doing resolutions this year but I do have goals. My primary goal is to enjoy life and my family. I love leading a busy life, but priorities are the key to harmony. When everything is urgent, nothing is important. I want to make sure I spend this year putting first things first. Everything else will fall into place after that.