Friday, March 25, 2011

Joy's one month check-up appointment

Today Joy went in to see the pediatrician for her one month check-up. Her previous appointment was when she was 2 weeks old, and she weighed 6 pounds 14 ounces. She'd been gaining one ounce a day. I'd supplemented her for a few days after her very first pediatrician's appointment, and then I stopped. I thought she was getting enough breast milk because the pediatrician was satisfied with her weight gain. So I didn't do anything different.

And then I got something in the mail from Similac earlier this week. It talked about how frequently and how much milk babies should eat at each feeding. That's when I got concerned. I thought it was weird that some of her newborn clothes are still too big, but other people were saying she was getting bigger, so I figured maybe I just didn't notice it as much because I was spending all day every day with her.

When I was asked today if I had any questions or concerns by the nurse at today's appointment, I brought up my concern about whether or not she was getting enough food, especially when I heard her weight... she is only at 7 pounds 4 ounces, meaning she only gained 6 ounces since her last appointment 2 weeks ago! The nurse didn't say anything. But when the doctor came in, I talked to him about my concern, and he said she is definitely not eating enough. He told me she's not "malnourished," but she is "undernourished." And he said I need to supplement. But it's not something he wants me to do just for a period of time but rather for good.

I have been doing several things to try to increase my milk supply since learning she lost 11% of her birth weight between her birth and when she met the pediatrician 2 days later. I will keep doing them. But they just aren't really working enough. And now I feel like a terrible mother and a failure since I can't provide enough milk to give my baby all the nourishment she needs and I didn't recognize there was a problem and contact the pediatrician earlier to correct it earlier.

My poor baby! I feel so guilty and terrible!

Wednesday, March 23, 2011

Joy's birth story

I finally took some time to get Joy's birth story written down, which I figured I should before I forget any more details. I wanted to do it earlier, but I just never had the opportunity. I know that what I’ve written all happened, but I may have the timing of a few details mixed up. I really didn’t have much of a concept of time as things were going on. Since giving birth, I have learned the truth to the statement that new moms can’t always find time to fit in a shower, and if a new mom gets one or two things accomplished during the early days of a baby’s life, that’s a lot.

I woke up sometime around 11:30 pm on the 21st to my first real contraction. There was no doubt in my mind that was what was going on. I had a lot of back pain with it too and was pretty sure that I was having back labor, despite not ever learning much about it or anything about how to deal with it. I had heard that first time moms were normally in labor close to twenty-four hours, so I figured if I was actually in labor and not just having contractions, it would last quite a while. Because of that, I didn’t bother timing my contractions, but the next one came about three to five minutes later, which surprised me. I also had to go to the bathroom and didn’t want to wake up Joe, so I used our upstairs bathroom outside the master bedroom.

I had another contraction while I was on the toilet, but noticed that in that position I got a little relief from the back pain. I went back to bed and noticed it was around 11:45 at that time. I had another contraction or two and then decided I was going to go back to the bathroom where I could be a little more comfortable anyway. It dawned on me while I sat there contracting that I was definitely in labor. And with the amount of pain I was already feeling, I wanted medication stronger than anything I had at home. So I was more than ready to get to the hospital to get pain relief and because things were progressing faster than I had been told they would.

I walked back to the bedroom, opened the door, turned on the light, and woke Joe up, telling him it was time to go to the hospital. It took him a little while to wake up and grasp what I was saying, as neither of us was expecting anything like this to happen that night. My contractions continued at regular intervals, and the back pain continued along with them. So I had to have Joe help me get
dressed and finish packing the hospital bag. We left the house around 12:30 and got to the hospital around 1:00.

Joe drove the car up to the emergency room entrance and went inside the ER to get a wheelchair.  A security guard came out with a wheelchair, helped me get from the car into the chair, and wheeled me in to the check-in desk while Joe parked the car. Joe met me inside, and we were taken to a room where I had to sign papers. Then we were sent to the hallway to wait for someone to come and get us from labor and delivery.  We waited and waited and waited.  The woman that helped us with the paperwork came out and apologized that it was taking so long (she said it’d been 30 minutes, but with all the contractions and pain, I didn’t really have any concept of time). She said she would call up there to see what was taking so long and if somebody didn’t come in a few minutes, she would have someone take us up to labor and delivery. More time and contractions passed, and so she grabbed somebody to take us up. When we were almost to the elevators we intercepted two women from labor and delivery who had brought a wheelchair for me, not realizing I was already in one. They tried to ask me questions on the way up to labor and delivery, and I had to wait until I was between contractions before I was able to answer them. All I could think of was how much I wanted pain medication.

I was taken to triage and measured and was told I was at four centimeters. While I was in the bed, I heard an anesthesiologist outside the room saying he’d heard there was an epidural. And I heard the nurse tell him that they were doing blood work first. I was given fluids via an IV and had blood drawn for testing. I told the nurse about my DVT, bilateral pulmonary embolisms, and my blood thinner medication. This information was passed to the anesthesiologist, who then came into the room to tell me I would NOT be getting an epidural or spinal. He said he was concerned about the Heparin I was on increasing the risk of me bleeding into my spine. And then he said that most people who bleed into their spines end up paralyzed. At this point in time, I said I just wanted SOMETHING and asked if that was possible. I was told that I could get something. Finally, I was given an injection into my hip that took the edge off, but it only lasted for about 1 ½ hours.

After triage, I was moved into the room where I would deliver. Joe was given two small mats so he could lie down and get some rest. Unfortunately for him, he really didn’t get the chance. I needed him to help me get through the contractions. He made sure I had water when I asked for it and gave me my iPod to listen to. He also put pressure on my lower back, which seemed to help alleviate the pain slightly. The nurse strapped a heating pad to my back once the injection wore off, so the combination of the heat and the pressure helped a teeny bit. I’d asked for more of the narcotic injection as soon as it wore off, but the nurse said it was too early to get more, so this was her solution for pain relief. She’d also suggested a bath, but I could barely get out of bed to go to the bathroom and give a urine sample as they’d requested, so taking a bath didn’t sound feasible at all.
After some time, I realized I had the urge to push, but I fought it, since it was only Joe and I in the room. Not only that, but I was in enough pain as it was, and I didn’t want to push until I was able to get more pain medication (which I was certain would happen any minute, especially if I kept bugging the nurse about it). Eventually I made Joe go get the nurse (even though he’d placed the call button right next to my head; I apparently refused to use it). I told her about my urges and she told me not to fight them and to go ahead and push. She had checked me a while before and I was at a 7. As the urges to push hit me, I went ahead and did it, despite the pain. Soon I was checked again and was told I was at a 9. I was also told my bag of waters was in the way, preventing me from being fully dilated, but I was told that when I pushed and it broke, that would fully dilate me. The on-call doctor was called into the room.
I pushed and my water broke. I heard them say there was meconium in the amniotic fluid, and I started to worry about what that would mean for Joy’s health. I was told not to push anymore and listened as people from the NICU were called into the room so they could suction off the baby before she breathed in anything she shouldn’t. Once they were in the room I was given the go-ahead. I pushed and the baby must’ve crowned. Joe said that the OB had to hurry and put her gloves on, like she thought that the baby wasn’t going to be coming that quickly.
I’m a verbal person and was in pain. While I pushed, I made some noises, and one of the nurses told me more than once not to make any noises. I wanted to punch her in the face! A nurse (not sure if it was the same one or a different nurse) also told me to hold my breath after I had already been pushing and holding my breath for several seconds while I was pushing, making me want to punch her. How long did they think I could or should be able to hold my breath anyway? Anyway, during one of the pushes, I felt some terrible pain. I saw the OB and thought she had given me an episiotomy and wanted to (and almost did) yell at her, “What did you just do?” But then the more rational part of me figured that I must have just torn. I continued pushing through the pain. As the baby’s head started to emerge, they asked me if I wanted to touch it. I was using my hands to push down on the bed and didn’t want to move them. I was shocked by the question and let out a surprised, “No!” But I pushed a few more times, and the baby’s head was eventually fully out.
Then everyone told me to stop pushing as a handful of people swarmed on the baby to suction her face off. I remember thinking that I had absolutely no control over my body at that time, and if it was determined to keep pushing, it probably would. But I apparently managed not to push until it was okay to do so, and getting the rest of her out was much easier. They didn’t ask Joe if he’d wanted to cut the umbilical cord, which he had said he'd like to do when I asked him about it in our birth planning. Instead, they just did it, right away. I’d wanted to delay the clamping and cutting of the cord, but with all the pain I’d been in, thinking about going over my birth plan with this group of
strangers never even entered my mind.

Basically NOTHING happened as I’d thought it would. Things progressed much more quickly. It was very stressful on my body to go through so much in such a short period of time. The tips I’d learned in my childbirth education class weren’t really helpful, and the things that everyone told me I’d experience didn’t happen. Regardless, Joy Alexis was born at 5:52 am weighing 6 pounds 15 ounces and measuring 19 ¾ inches long after approximately 6 hours of labor.
Joy was whisked away to be cleaned off, weighed, etc. Joe had the camera to take pictures. Meanwhile, I was stuck on the bed, in pain, while the OB stitched up my tears. I asked her what degree my tearing was, and she said it was second degree. I don’t know how many stitches she put in, but I do know that it seemed to take quite some time. I was told that in addition to my second degree tear, my labia tore. And I think that is where a lot of the pain came from. I also had to have a local anesthetic injection before the OB was able to stitch up that tear, and the pain from the injection was comparable to the pain of giving birth, even though it didn’t take all that long to inject the anesthetic.
Before too long, we were moved into our recovery room on a different floor. Joy stayed with us the whole time we were in there. Joe was able to eventually get some sleep on a cot in the room. I was also able to eventually get some sleep. The whole pregnancy and birth process was a big physical and emotional challenge for me, but I was so happy to welcome my beautiful, healthy baby girl!