How Baby Ess got here

A few of you have asked for the story of how Ess came to join us three weeks ago today. Since we're at the halfway point between her birthday and her due date (which was June 21), it seems like an appropriate time to tell the tale... that is, if she cooperates and continues to snooze blissfully on her father's chest.

So, three-and-a-half weeks ago, on Saturday the 7th, I started feeling funky in the afternoon, with a constant dull pain in my lower left abdomen. I didn't think much of it, especially since digestive issues were the bane of my pregnancy. But it was irritating enough that I sent D down to the corner bakery for some ginger beer -- and when he returned with that and a chocolate chip cookie, I turned down the cookie(!). I continued to feel crummy that afternoon and evening, but we went ahead with our plans -- dinner out with friends, and then a stop at another friends birthday party. I was achy and uncomfortable, but never thought it was anything important.

Then the pain woke me up in the middle of the night. At 1:30 am, I was at the computer, Googling "third trimester abdominal pain" and not getting much in the way of useful answers. I spent the rest of the night tossing and turning in the guest room. By Sunday morning, the discomfort had turned to pain, and it was starting to occur in surges. But it still never occurred to me that it was contractions, largely because the pain was so localized; I was sure that contractions would be broader, across my whole belly.

At some point that morning, I called my doctor's answering service. The midwife on call thought the baby might be in a funny position, that I might be feeling her head, and advised me to spend some time on my hands and knees, and on my side, to encourage her to move. That didn't help, and the surges of pain got worse. Somewhere in there D and a friend went off to run the course of the road race they'll be doing later this summer; I said I'd be fine while they were gone. When D returned, and I was still having some moments of pretty powerful pain, he and my sister, who had come over to keep me company, convinced me to call the doctor again. This time, the midwife consulted with my doctor, and together they decided that I should go to the hospital to get checked out. The assumption at this point was that I had a urinary tract infection, that they'd treat it and send me home.

That, of course, is not what happened.

I was admitted to the Birth Center, where they tested me for a UTI (negative) and hooked me up to a fetal heart monitor and a contraction monitor. Lo and behold, I was having steady, minor contractions. And when they examined me, they determined that I was one centimeter dilated. At this point, things started to speed up. The resident mentioned, in the midst of a flurry of information about how they were going to treat me, that I'd be in the hospital for at least a few days. D and I were in a bit of shock at that point -- we thought the options were (a) get antibiotics and come home; or (b) have an emergency c-section on the spot. Option (c), stay in the hospital for a while, never occurred to us.

So we settled in. Luckily I had a private room, with a great view of The Big Mountain in the State West of Us, so we could be at least a little comfortable. I was confined to bed, with an IV pumping both fluids and magnesium, to stop the contractions, into me. The side effects of magnesium can be miserable, but I was lucky enough not to feel much more than exhaustion.

At some point -- and this is where the details of time and date start to get fuzzy, but I think it was Monday evening -- the nurse was in checking things out. I took the opportunity to unplug from the monitors and go to the bathroom. When I came back and plugged back in, the nurse became very attentive and even more calm than she already was. The baby's heartrate, it turned out, had dipped very low -- usually in the 130-150 range, it was down below 90. In a matter of seconds, other nurses showed up at the door, I had an oxygen mask on my face and was told to lay down on my side immediately. The heartrate recovered, but not as fast or as well as the nurses would have liked.

Then, later that night, the contractions came back. None of this was very much fun.

Overnight, the baby's heartrate decelerated a few more times when I'd get up to go to the bathroom. I was sent for an ultrasound on Tuesday to check out the position and health of the umbilical cord -- the theory being that me standing up caused the baby to crimp the cord or something. All was well, and by Wednesday morning I'd gone more than 24 hours without a deceleration. D was hanging out with me, waiting for my doctor to come in and discharge me; the plan was that I'd be on bed rest at home until I hit 36 weeks (which would have been last Thursday).

But Ess had other ideas. In mid-morning, her heartrate slowed one more time. "You've just bought yourself another night in the hospital," my nurse said. But she also wondered if my doctor would just send me home, since it's possible that the decelerations had been happening throughout the pregnancy and we just didn't know it.

So D and I were more than a little stunned when my doctor showed up at about 12:15 and told us that, after conferring with the head of the maternal/fetal high risk team, she'd decided that they needed to deliver me -- that day. I'd been given a steroid injection on Sunday, to help the baby's lungs mature in case of just this circumstance, and their feeling was that she was far enough along that it was riskier to keep her in the womb, and risk further decelerations, than to bring her out early. Since I'd just eaten something, she figured they'd do the c-section at about 5 or 6 that night.

D started making calls -- to his parents, my parents, and my sister. And while he was on the phone, the room filled up with people. The anesthesiologist had decided it was ok to go ahead and do the surgery now; with an OR free, and all the necessary staff available, they thought it was better to just do it under non-emergency circumstances than to wait for the afternoon, possibly have me experience another deceleration and do it on an emergency basis. Still, the rapidity with which it occurred made it feel like an emergency to us.

Within 45 minutes, I was in the yellow operating room, crying as a team of women -- doctors, nurses, the anesthesiologist -- prepped me for surgery. D wasn't allowed to come in until I'd been given the spinal and was lying down on the table; those 15 minutes or so of being apart were the worst part for both of us. But then he came in, wrapped in scrubs, and sat by my head. The surgery itself was surreal -- D and I just chatted; I think at one point we talked about the dogs, because what the heck are you supposed to talk about in the 20 minutes while your belly is being cut open so your daughter can be pulled out? My doctor complimented me on the muscle tone in my abs as she sliced through them(!), and at some point Darren brought up the idea of using the name of our friend who died in December as Ess' middle name. I loved it immediately.

And then there was the warning that I'd feel a lot of pressure, and then the squawk of Ess as she emerged at 1:43 pm -- just 90 minutes after we learned she'd be arriving that day. The doc dangled her over the screen so I could see her for a brief moment, then she was whisked off to be evaluated by the neonatologists. D went over to cut the cord, and I waited for what seemed like the interminable end of the surgery. At some point, one of the nurses brought her over, all swaddled and warm, so I could see her. She held Ess to my cheek; I kissed her and cried. Then she was whisked away again, this time to the Neonatal Intensive Care Unit, where she'd stay for the next three-and-a-half days.

I spent an hour in recovery back in my nice private room, then was moved to a smaller, shared room in the Family Center, in an older wing of the hospital. Later that evening, I slowly and painfully got into a wheelchair and D brought me to the NICU to see her.

Astonishingly, that all seems like it happened a long time ago. Ess has been home for 10 days now, and we are starting to establish a routine -- at least, as much of a routine as you can have with a three-week-old baby. Her arrival was certainly not how we'd expected it to be -- in fact, once I came home from the hospital, I had my mom go to the bookstore to exchange the natural childbirth book I'd bought the day before I went into the hospital for one on breastfeeding -- but it all turned out ok. The theory about the decelerations is that they were due to her short umbilical cord; there was no other explanation for it. So she's here, much earlier than we expected, but fortunately healthy and, as far as we can tell, happy. As are we. Exhausted, but happy.

Today's accomplishment...

...I shaved my legs for the first time in weeks. This proud moment brought to you by D, who took little Ess from 11 pm to 5:30 am (one of the advantages of her early introduction to bottles). Apparently she was miserable for about two hours (a big, messy poo turned out to be what made her happy), then went back to her normal, everyday eating-and-sleeping routine. I loved every moment of sleep I got, including the two hours this morning when D and Ess came upstairs. I nursed her for a while, and we all went to sleep in the big bed. Bliss.

Today, we're headed off to my in-laws' for the baby shower that we foolishly thought was planned for far enough ahead of my due date for there not to be a problem. (Thus the leg-shaving.) I was dismayed to find that very little in my closet actually fits my bizarre post-partum body, but I think I'll live. I'm just glad that my brilliant sister decided to move the shower from our house, where it was originally scheduled to be held, to D's parents', who were thrilled to take over. The thought of having 30 people here, plus lots of kids, made me want to weep.

Oh, and I wanted to say a big congratulations to Halloweenlover, who is expecting her very own bambina later this year. Hang in there through the "morning" sickness, HL; I promise it gets better (and five months ago, who'da thought I'd be the one uttering those sage words?).

Held in captivity by a 5 lb, 6 oz. tyrant

I am still here. Alive, even, if you consider someone who hasn't had more than two hours of sleep in a row in almost a week to be living. I've written a bunch of posts in my head -- good ones, too, though I have no idea at the moment what each one was supposed to be about.

The quick update: Things are proceeding really well. Ess is gaining an ounce a day, and her pediatrician pronounced her perfect in every way yesterday (I may be paraphrasing there). We've quit the supplemental bottle feedings, though we've kept the option open for D to give her a full bottle instead of me nursing her, in the off chance that I might like to, you know, sleep. Due to the nipple shield, I am still pumping seven -- count 'em, seven -- times a day, but at least we're down to two steps per feeding instead of three.

And at my post-op appointment today, my doctor said they'd found no problems with the placenta or the cord that would indicate why I went into pre-term labor (or why Ess' heartrate was decelerating, the event that ultimately caused the c-section). So it remains a mystery, which isn't great, but it doesn't seem to have implications for any (highly, highly theoretical) future pregnancies. And, finally, she cleared me to lift up to 25 pounds, which means that now when D leaves Jelly on the couch, I can do more than just glance apologetically at her when she wants to get down.

More posts, including the birth story, to come at some indeterminate point in the future when I have time and brain cells. Or at least one of the above.

She's home!

I've now entered the world of one-handed blogging on very little sleep. But all is well, and we are thrilled. Here's a picture -- from the hospital, but cute nonetheless, if you ask me -- of our girl.

All hail the nipple shield!

I can only imagine the Google searchers who will head my way as a result of this title, but it's absolutely true. The nipple shield has been our salvation in the last few days. Suggested by one of the hospital lactation consultants, it has made breastfeeding an entirely different -- and much more successful -- experience.

How successful, you ask? Well, that little piece of silicon is responsible for the fact that, barring any unforseen events in the next 12 hours, sweet Ess will be coming home tomorrow. I am hesitant about even typing those words for fear of a jinx, but we just got back from the hospital and all is well. Ess is nursing like a champ, curling her little hand around my breast and grunting in contentment as she eats. When she's done nursing, she gets a bit more breastmilk in a bottle, and when I'm not at the hospital, she gets her whole meal from the bottle.

I was wary of going the bottle route for fear of nipple confusion (may as well get all these hot-button phrases in one post), but everyone from the pediatrician to the lactation consultants to our friend the doula said that preemies just aren't strong enough to get all their food via nursing. I doubted much of the advice because it was coming from people with agendas, most of which revolved around getting us out of the hospital as soon as possible -- a goal I appreciated, but not if it meant a lifetime of pumping. But a long conversation with our friend J., a doula who has worked with tons of families with multiples, meaning lots of small, early babies, convinced me that we could do a combination of breast and bottle.

And she was right. Since we introduced the bottle a few days ago, we haven't looked back. Ess is over her birth weight today, and she seems to have no problem going back and forth between the Avent bottles and the breast -- wherever there's food, she's happy to be there. This morning when we got to the hospital, they'd removed her feeding tube, and at her next diaper change we were able to take off the remaining wires that were monitoring her heartrate and respiration. She nursed for 20-30 minutes each time we fed her today, and followed that with a tiny bit of breastmilk from a bottle each time.

This evening, we gave her a bath. And when we left an hour ago, she was strapped into her brand new carseat for the 90-minute test all preemies get to make sure they can breathe when they're in the seat. We'd been hoping that she would get to come home in the next few days, but were surprised this morning to hear that it'd be tomorrow as long as nothing surprising happened between now and then. So my sister and brother-in-law made a run to the Evil Baby Superstore and Tarjay to stock us up on diapers, wipes and other essentials. Armed with our debit card and a brochure from the hospital, they also had to select a carseat; they ended up getting what the car-seat-expert nurse said was her favorite seat. And during the afternoon, D and his parents headed over to the unfinished furniture store to buy a dresser for Ess's room.

Thanks to my parents, who left this morning, any number of household chores have been completed. My mom finished altering the curtains I started when, unbeknownst to me, I was in pre-term labor two weeks ago, cleaned our bathroom, cooked for us every night and provided a shoulder on which I cried many a hormonal tear. And my dad not only hung shades in Ess' room, installed a phone jack to take care of the protruding wires and replaced our crappy back door, but he and my brother-in-law also quickly and efficiently replaced the porcelain bathroom sink I managed to shatter a few hours after being discharged from the hospital (word to the wise: do not use a glass bowl to wash your pumping supplies in a porcelain sink, especially when you are doped up on oxycodone).

So all we have left to do tomorrow morning is do a quick run to the grocery store, throw some laundry in and put together the co-sleeper. This evening, we sat on the couch with the pooches and shared a toast to what is potentially the last child-free night in our home (D had a glass of wine, and I had a thimbleful). We can not wait to bring little Ess home; it's amazing to think she's spent her entire life thus far -- all 10 days of it -- in the hospital. Now we get to show her the wide, amazing world, and begin our lives together beyond the watchful eyes of her nurses and the tyranny of the hospital schedule. We can. not. wait.

**********

I will try to put up a quick post tomorrow with an update, but I can't make any promises... And I also want to say a hearty THANK YOU to all of you who commented about the difficulty of breastfeeding. It's one of those things ahout which I had absolutely no idea before the last 10 days, and your support and words of encouragement (and shared misery!) were really helpful.

Breastfeeding is hard

That pretty much sums it up. It's tough getting little miss Ess to latch on for long, but I think we're making some progress... we're weighing her before and after each attempt, so the nurses can subtract whatever she gets straight from me from what they give her in the feeding tube. So far the maximum we've gotten in her from the breast is 4 ccs (for the sake of comparison, she gets 40 ccs each time she eats).

The nurses are very supportive, but with varying degrees of (literally) hands-on help. The one nurse who's been the most helpful also stresses me out the most; she pinches my nipple in her hands -- oh, shoot, I should have saved this for Wednesday Whining! -- and shoves it in Ess' mouth, giving me constant and sometimes contradictory instruction. But at least she's letting me know what's working. The nurse who was on this evening was really kind and supportive, but offered no practical advice.

I know this is going to take time -- the kid is only six days old, and just 4 lbs 13 oz (she's on her way back up after the normal post-birth weight loss). But it feels so incredibly difficult at times. I spent much of this afternoon teary-eyed and feeling sorry for myself, and for Ess. Part of the problem is that the every-three-hours breastfeeding attempts make so much of the time I spend with her feel like work. So I made sure to spend some time just snuggling her while she slept. That -- and a vanilla milkshake on the way home from the hospital -- did wonders for my mood, which I'm sure wasn't helped by the crazy postpartum hormones. Tomorrow, I'm going to call a friend who was able to breastfeed her twins, who were born at 35 weeks, and pick her brain.

I know we'll get there, but the process ain't easy, that's for sure.

Out of the NICU!

One of these days I will write a proper post, I promise, but for now I just wanted to pass on today's fantastic news: Little miss Ess, our precious daughter, is graduating from the NICU to the continuing care nursery today. Her health is great -- the wires are incredibly minimal now; just a few leads to monitor heart rate and respiration, as well as a feeding tube in her nose -- and she's very, very stable. We're lucky: she's not sick, just early.

I started working on breastfeeding with her yesterday; at the moment, we're trying that at least twice a day, with the frequency to increase as she and I get stronger. She knows how to latch on, though, so it's just a matter of getting her used to staying there. I'm headed over to the hospital in a few minutes to see her in her new digs and try feeding once again. To get her home, she'll have to be getting 100% of her food either from a bottle or from me directly, so at some point it looks like I will be camping out in the hospital to try nursing around the clock; I'd love to get breastfeeding really well established before we introduce the bottle. But that whole process will likely take a couple weeks.

As for me, I am tired and sore -- I can't imagine the ordeal it must be to come home from a c-section with a baby that needs taking care of. As lousy as it is to have Ess in the hospital, it does give me time to recover. Kate, you are my hero!

Also, many, many thanks to the wonderful Songbird, who visited me twice in the hospital and brought me a gorgeous, soft prayer shawl that was of great comfort on those lonely nights (not to mention the fact that it helped me pump discreetly when my dad was in the room...). I was really touched by her thoughtfulness, and that shawl will be a reminder for years to come of the crazy, chaotic, ultimately wonderful days that brought us sweet Ess.

The bambina is here!!

Sorry for the last few days of silence -- it's been crazy 'round here. The short version: The bambina arrived by not-quite-emergency C-section at 1:43 pm on Wednesday, May 10, weighing in at 5 lbs, 1 oz -- not bad at all, considering she showed up six weeks early. We are absolutely in love with her (though she does show signs of being a very stubborn, single-minded little girl... perhaps like someone else we know...)

She's in the neonatal unit here at the hospital, and doing very, very well, all things considered. She's already off supplemental oxygen; if we can get her digestive system to get going, she'll be able to head to the continuing care nursery pretty shortly. No word yet on how long she'll have to stay, but she's one of the biggest kids in the NICU, and everyone seems very happy with her progress.

I'm doing well (although I guess I can return that natural childbirth book I bought on Saturday); looks like I'll get to go home tomorrow. I'll tell y'all the whole story once I get settled. In the meantime, thanks again for all the thoughts and prayers.

Update

This is mc's friend Sarah. mc is still in the hospital. Because of some episodes with the baby's heart rate dropping, she is going to be there at least until tomorrow and then on bed rest for two weeks. But the baby's heart rate is fine now and ultrasounds look good, so the doctors are just monitoring her to make sure everything is OK. She thanks people for their well wishes and is looking forward to having internet access so that she can tell the whole story herself, hopefully in the next day or two.

Hello -- this is Darren, mc's husband. mc went in to the hospital today and is having pre-term contractions. She will be there for 3 days or so, and the medication seems to be slowing the contractions down. She asked me to update people here.

I am a wimp

Well, last night got a lot better after I headed to the guest room. I was sufficiently uncomfortable that I made it three-quarters of the way through a lengthy New Yorker article about Libya before I fell asleep. I slept decently until 7 or so, at which point I was up for the day.

That's the part that hasn't gone particularly well -- the daylight hours. I was still achy and uncomfortable this morning, so I paged the midwives who cover the on-call hours for my docs. D and I sat around waiting for the return call. And then we waited some more. I struggled to straighten myself in my chair without straining the sore spots, and then we waited some more. Finally, after more than an hour had passed, I called the answering service again. This time, I got a call back almost immediately.

The upshot is that the midwife wasn't overly concerned, calling this a "watch and wait" situation. She advised me to spend some time on my hands and knees, and then to lay on my right side (the pain has been on the left) to see if I can get the bambina to move and stop pressing on whatever she's been pressing on. I'm supposed to call back if there is any bleeding or fluid leaking, or if the pain becomes rhythmic and I feel more than four contractions in an hour.

It's that last one that worries me a bit... the pain has spread out across my lower abdomen in the last hour or so. While the hands and knees bit helped a little, laying on my right side did absolutely nothing to improve the situation. So I've now begun writing down the time at which the pain increases, and hoping that it doesn't happen three more times between now and 1 pm (not least because D is out on a 7-mile run with a friend -- something I encouraged him to do).
I have (ridiculously melodramatic) visions of bedrest and emergency C-sections, of a baby in the NICU and a house that is completely unprepared... none of which is helping me relax and try to get through whatever my body is doing today.

So, any of you experienced moms out there, I'd be more than happy to hear your stories of bizarre mid-third-trimester pains that resolved uneventfully. You know where to find me -- I'll be on the couch.

Awake

Ugh, this is crummy. I went to bed two hours ago after an evening out -- not one, but two birthday gatherings for friends. Late this afternoon, I started feeling uncomfortable, with a dull ache in my lower left abdomen that would occasionally radiate around to my back, then subside. It's very, very localized -- definitely not a contraction of any kind. And perhaps this is too much information (but I am too groggy to care): I've had achiness before in this spot when I've had the joy of experiencing pregnancy-related constipation, though that would not seem to be the problem right now. So when D asked me if I wanted to stay home tonight, I said yes -- but that I wasn't going to.

Sure enough, going out distracted me from the discomfort. We got home about 10, and I was in bed reading by 10:30. And the pain, she is back. I slept for a while, then woke up about half an hour ago, uncomfortable but not in agony. Going to the bathroom does not help. But going back upstairs, far from the bathroom in a queen-sized bed that seems far too small, is not an option.

Dr. Google has little to say, although I'm certainly glad I'm not in the first trimester, when lower left abdominal pain would be a sign of an ectopic pregnancy, which is clearly not the issue now. I am debating calling my doctor, which would involve waking the midwife on call... which seems silly for something that is probably just intestinal. I can feel the baby moving (another factor making it difficult to sleep) so I think everything is fine.

So I think I am headed to the guest bed, with a glass of water and the latest New Yorker. I would really like the discomfort to ease so I can get some sleep....

A new post is brewing, I swear

I've been pondering a post about prenatal bonding (or not) with the bambina, but have had absolutely no time to write it. But it's coming, I promise. In the meantime, I will attempt to tide you over with this picture of the bambina's furry stunt double, testing out the crib. We're hoping the bambina will be slightly more pleased with the accomodations than the stuntdog was.















And here's another, of the swanky glider (for which we owe a debt of gratitude to my parents and grandparents) and ottoman (for which we thank ourselves), which arrived yesterday. The colors aren't very true-to-life; the photos were taken after dark with a crappy overhead light and the flash. The arms on the glider seem low to me, but I'm sure it will be fine. I sat in it for a lengthy phone conversation with my parents last night, and it was incredibly comfortable. Oh, and you can get a glimpse of our swanky new carpet, too, which is about the most boring pattern ever.















Lastly, on the wall is a framed poster from Manhattan, the Woody Allen movie. It was our wedding present to each other, and we have no idea where to put it and D's 600+ DVDs, which used to reside on the built-in shelves on the other side of the room. If only Ikea were closer...

PS: Yes, that is a bare wire of some sort sticking out of the wall. We have no idea what it is -- the raw materials for a phone jack, maybe? -- but we've got to figure out how to get rid of it/patch over it in the next few weeks. Any suggestions on that one would be much appreciated.

Daycare ponderings

Just got back from our second daycare tour, this one at a locally owned chain about 10 minutes from the house (and between here and D's work). We didn't expect to like it, but figured we'd check it out just to have another basis of comparison. And our expectations were correct: This place is like the WalMart of daycare.

Well, that's not quite fair. It's very clean and seems well run. It's a new facility, much nicer than the highly accredited YMCA daycare we visited a few weeks ago. But there's something about it that seems a little creepy. Perhaps it was the reaction of the manager/tour guide when I asked about their policy on dropping in for breastfeeding. "Well, you could," she says. "We have one mom who does. But we don't have any special place for it; sometimes she goes to use the utility closet."

Yeah, I don't think so. I'm also not a big fan of the fact that they have Gymboree come in every week to do activities with the kids; of course, this isn't included in the tuition, and the parent handbook strongarms you into participating: "Gymboree is an optional program at [daycare] but most choose to participate. Our goal is that the entire class participate in the weekly Gymboree class."

And then there was the answer to D's question about whether this place is pursuing accreditation. "Not at this time," the manager said. "The owner is really focusing on franchising right now -- she's got a lot on her plate."

So they're too busy finding ways to make more money to focus on getting accredited. That is not music to my ears. Another warning sign: There's no waiting list at all. Another issue I have here is that I have met the owner of this place, in circumstances I wish I could share, and just wasn't very impressed with her. And on this one I am going to trust my gut.

We still have to visit the home-based daycare in our neighborhood; it only accepts kids up to 2 1/2, and the woman who runs it prefers to have kids part-time. She's also flexible about adding extra days here and there. A neighbor of ours -- who happens to work for a child welfare research institute affiliated with the local university -- takes his daughter there and raves about it. It's not any cheaper than either of the centers we've toured, but I like the sound of it already.

And then there's the latest option: D arrived at work today to find an email from a friend and former coworker of his, who is planning to start a small, home-based daycare of her own in the fall. She is offering us the first spot, which is fantastic. It'd be convenient, and we absolutely trust her. My only concern is starting a business relationship, on such a sensitive area as the care of our daughter, with a friend; I'm not sure how it would go if we had issues with something our friend was doing. And, on a less significant but still important note, I need to find out whether money paid to an unlicensed home daycare is still eligible for the child care tax credit.

So there's a lot to think about here. But at least we have some options.