Farewell, Winnie

Last night was an unexpectedly terrible night.  As we sat down to eat dinner and watch the Tiger game, we heard Winnie making some unusual sounds, and they continued to get louder and we realized something was wrong.  Matt got up to check on her and offered some treats, which she never refuses, and she wouldn't get up to touch them.  Then, she tried to get up and it seemed that she could not use her back legs.  She continued to squawk and we knew that she was either hurt or very sick, and quickly looked up the number for the 24-hour emergency vet.  While we rushed around to get Norah dressed and grab a few things before running out the door, Winnie crawled into our room and hid under the bed.  We were very worried that she knew something was wrong, too, and we didn't want her to be scared or in pain.  Matt coaxed her out and wrapped her in a towel, and we got in the car to rush to Ann Arbor.  Despite getting behind two trucks with horse trailers and one very slow elderly driver, we got her there pretty quickly.  

Once the vet was able to examine her, she determined that it was probably a blood clot which had moved to somewhere in her spine, causing the sudden onset of paralysis.  They gave her a sedative and some pain medication, but ultimately we decided that the treatment for something like this would be too risky, not likely to succeed, too painful for Winnie to endure, and too costly for us to afford.  We had to put sweet Winnie to sleep to end her pain, just a few hours after realizing something was even wrong.  As terribly hard as it is to have to make a decision to do that, we talked about it on the way in and knew that if she was in pain it would be the right thing to do.  I said goodbye to her, and then took Norah out of the room to feed her, and Matt stayed with Winnie until the end.  I'm so proud of him for being there with her and comforting her, because I think if I had stayed I would have been sad and made her more anxious rather than calm.  It was quick, and the staff was considerate and kind.  Today we took her over to Mark's and buried her next to her best buddy, Willie.  I hope that they are already together at the "Rainbow Bridge"...eating and lolling about and generally being fat, happy, lazy cats together like they used to.    

Winnie meets Lainey...little did she know she would soon be outmatched in size

Such pretty markings

Always loved to burrow and snuggle somewhere cozy

Watching prey through the window...a fearless hunter indeed :) 

Claiming the baby's items as your own - you spent your last night in her pack and play downstairs, and I hope it was cozy at least!

Thank you for being by my side through the end of my pregnancy and for being a good kittie to your human sister, Norah.  She won't remember you, but we'll show her pictures!  We miss you already, sweet Winnie.  I hope you are no longer in pain and you know that you were loved by this family.  Sleep peacefully now, and eat lots of chicken! 

Norah Grows: 4 Weeks Old

Oh Norah, 4 Weeks...One month...Where has the time gone?  My once tiny (ha!) newborn baby is already filling out into a chubby infant.  What looked like almost disproportionately long, slender fingers at birth are now pudgy adorable digits on pudgy cabbage patch kid hands.  

Your little torso is now topped off with rolls and a perfectly round little baby belly. 

We noticed just yesterday that you are getting more expressive and it seems to be intentional.  When you're happy, you most often look like this: 

We are seeing more and more of those sweet dimples, and your eyes seem way more focused and track us as we move in front of you.  You seem genuinely interested to engage with us, and although you haven't directly smiled in response to a smiling face yet, I think it's not far away.  I don't want to wish the moments away, but it is exciting to have you respond to us in a positive way.  You have also started cooing and making content little sounds and at times it even seems like you're laughing when you are happy.  It's really just a joy to watch you become a happy baby and start to develop your own personality.  I'm so lucky to be your Mama.

You are so strong, and you can sit leaning up against something for quite a while when you want to...even when you're tired! You can stand up on our laps and stretch your legs while holding onto us...which, not to boast or anything but that is a 2 month milestone and you are ahead of the curve!

We are trying some "tummy time" here and there, but you're not always the biggest fan yet.  We can usually get a few minutes before you full on start to scream, but we don't push it! You also really like to have those hands in your mouth whenever you find them.

You are a great sleeper - you still sleep much of the time during the day in short spurts and are sleeping for 3-hour stretches at night.  Consequently, most of the pictures I get look like this: 

You are one month old and you are so amazing!  We love you, little girl. 

Who Let the Dogs Out? PUPPs made their way baaaaack :(

Well, as heartbreaking as it is to write this, the PUPPs hives are back.  And they are more widespread than they were before, although not yet as horrible in terms of redness or inflammation.  I know it's PUPPs because they are exactly the same as they were when they started spreading initially, and the ones in the belly area are still contained to just within the stretch marks...weird and fascinating and hellishly maddening at the same time.  I called Holly's office yesterday and she said she hasn't heard of PUPPs coming back this far out from delivery, although she has heard of it taking a while to go away. I suspect that despite the fact that mine went away almost immediately it never really cleared systemically, and it has just crept back up to the pronounced state it's in again.  Nonetheless, she said this far out from delivery I should run it by my PCP and possibly see Derm...so that's what I'm doing today.  Hopefully someone can give me something to try to make it go away for good - I'm open to a course of oral steroids or different topical steroids or whatever at this point as long as it's safe while breastfeeding, just whatever will make these hives GO AWAY.

I have had emotional and tearful moments on and off since Norah was born on account of post-partum hormone levels I'm sure, but last night I really was just devastated that this seems to be coming back.  For whatever reason, the flare-ups are worse at night, and it also happens that Norah's fussy time is 9:30-12:00
PM.  I just couldn't handle not really being able to discern what she needed to calm down and cope with my insane itching on my legs simultaneously and I just melted down.  Poor Matt has been so strong for me when I have these moments of feeling helpless and pitiful, and he just reminded me that we're doing everything we can for Norah and we won't always be able to help her stop crying right away, but it doesn't mean we are not good parents.  He also calmly reminded me as he did before to stop scratching and put something on my skin before I made a mess of my legs again.  I don't know what I'd do without his calm, steady demeanor and his loving support.  He has been just what I needed throughout the end of the pregnancy and these early weeks as parents, and I'm so grateful that he's so committed and involved and devoted to making our family happy and successful.

We will figure out what to do about this PUPPs sooner or later...I just hope it's the former! Until then, I just keep reminding myself to look at Norah and remember that she's perfect and it gets me through :) I mean, look at that face!

3 Whole Weeks

Amazing how time goes by when your are counting the days of a brand new life...our baby is already 3 weeks old today! I was looking at her sleep last night and realized that 3 weeks ago on Sunday night we didn't know her yet.  In some ways it feels like she's been here forever with us, and maybe that's because so many characteristics of hers are recognizable from her behaviors in utero, but other times I cannot believe it's already been three quarters of a month since she lived inside of me and we didn't know what she would look or sound like, how big she would be, or what life with her would be like.  Every day she seems to develop a more solid appearance that is uniquely hers, rather than the nebulous puffy "newborn" face.  She spends her waking time mostly alert and looking around, although she has had a few seriously fussy hours in the past week when she would just not be soothed.  I know it's par for the course with a newborn, but I feel so helpless when she gets so worked up and has this full body cry that just about breaks your heart to listen to.  In general though, when she cries she really just wants to eat...and she has figured out that there is a 24-hr all you can eat buffet just waiting for her! According to our bathroom scale, she is 10.5 lbs already! 

Her next doctor's visit won't be until she is 2 months old, and we're scheduled to start her childhood vaccines at that visit.  I'll be honest, I've always, always been a pro-vaccine individual, and I think I still am 99%, but now that I'm considering blindly trusting the manufacturers of chemicals that will be injected into my perfect little child, I'm a little bit shaken by the fact that I have the option to choose not to do so.  I've been spending some time perusing the CDC website and reading reports on various vaccines, and trying to weigh my options about what I think is best for her.  Every parent makes decisions on behalf of their children in what they believe are their best interests, but I'm finding already at 3 weeks just how difficult that responsibility is! Anyway...not to start a pro-vax or anti-vax dialogue or anything...but just throwing it out there that it's on my mind! 

Here she is at 3 weeks (and already a Wee-Wolverine at that!): 

As for me, I had my 2 week post-partum visit with Holly last week, and overall things seem to be going as well as could be expected at this point in recovery.  We talked about the pathology report of the placenta and possible causes for the post-partum hemorrhage.  She said there was nothing remarkable in the pathology that seems to be something we would have been able to identify via ultrasound or anything before delivery, but the fact that I have had one serious hemorrhage means I am at an increased risk for a repeat scenario in future deliveries.  The succenturiate lobe of the placenta was just a random occurrence in my case, although it can be associated with serious complications like Vasa Previa and velamentous cord insertion (neither of which I had, and both can usually be seen on ultrasound).  That being said, she explained that I would still be able to have normal midwifery care throughout the prenatal period and plan for a typical delivery, but we would definitely do "Active Management" of the third stage of delivery next time, and they would have certain medications ready in the room in case I started bleeding again (Pitocin, methergine, cytotec, hemabate - all meds I received in major doses in the OR to contract the uterus and/or stop bleeding).  We also talked about the fact that an experience like this can cause PTSD type reactions in people, and those may not arise immediately but may come about when planning a future pregnancy or when approaching the next delivery.  Right now I'm doing well, and although in the first week I did have "flashbacks" to the hemorrhage and being in the OR, those seem to have subsided and I'm able to relax and just enjoy my family.  Holly was wonderfully caring and supportive when discussing all of this, and we are again so thankful for the support and care and really professional medical treatment we received from the midwives, OB team and nurses.  In our case, we truly couldn't have been in a better place, and I will forever feel that way.  

Norah is 2 Weeks Old!

I can't believe two weeks have passed since Norah was born...so begins a lifetime of wondering where time has gone as we watch our beautiful child grow.  She is doing wonderfully! We had her 2 week check up with the pediatrician today, and had nothing but good news.  Dr. GreenLee is very sweet, and she was so great with Norah.  I'm happy with our choice and I think Child Health Associates will be a great place for us to get her care over the years.




At 2 weeks, Norah now weighs 9 lbs 5.6 oz, and is 22" long - 82nd percentile for weight and 95th percentile for length! She met the goal of regaining her birth weight by two weeks, and then some! She has  pretty much outgrown newborn clothing and just fits into her 0-3 month clothes at this point, and she's busting out of the newborn size diapers! Can't wait to try out some of her cutie cloth diapers soon since they ought to fit :)  She also has rolled from her back up to her side a few times when I lay her down to sleep, and her neck muscles are so strong because she is always holding her head up and looking around!

Sunday was my first Mother's Day, and I have to say it was overwhelming to look into her sweet face and realize that I am her mother...forever.  She will call me Mama, Mom, Mommy, or something of her own choosing, but I whatever she decides to call me I will forever be the woman in her life that she looks to for guidance and support and unconditional love.  Matt said to me today that he's happy she's a girl, and I have to say I agree.  There is something about the connection between mothers and daughters (of course, mothers and sons have this too...) and I just feel lucky to have the opportunity to experience that in my life. Already in these 2 weeks, I have been overcome with emotions about how much I love her and just how much I would do for her. There aren't really words to describe the instant connection I have felt at being her mother, but I know looking into her eyes that it's here to stay.  And, spending my first Mother's Day as a mama in the company of my own mother was also really special - to know that her love as a mother is now multiplied as she watches her daughter go through the experience of becoming one too...it's pretty wonderful, and I'm glad we're here with her so that I get to witness her love for Norah every day too.

Adjusting

Norah is 12 days old today, and we are all settling into a groove at home as we approach two weeks as her parents.  It's hard to believe how much can change in just 12 days, and how someone so tiny can hold so much of your heart.  I feel like she's already changing so fast, and I want to capture the nuances of her features every day so that I never forget them, but I know no matter how hard I try, some of these details will still probably fade over time.  We had newborn photos taken when she was 8 days old, and I can't believe it but I think she already looks bigger and older since then!

Here's the link to the full gallery of photos, too: http://lmd-photography.smugmug.com/Other/Norah-Newborn/16917397_LgSrP5#1278522283_Mtmsvg5

Daddy loves her so much...

My little coccoon

Tiny fingers

Sweet sleeping angel

Cradled in my hands

We got lucky that we got this shot on the white chair...and she saved the explosion for the next shot!

Daddy took one for the team! 

Sweet little pink baby

She has been such a good baby and we are really lucky that everything seems to be going smoothly at this point.  She's healthy, she's nursing like a champ, and I think she's gained back the weight she lost after birth and then some! She's not really chunky, but she's so long! I love when she stretches out her legs and curls her toes when she's waking up - gives me a glimpse of ballet classes in our future ;) She generally gives us at least a 2-3 hour stretch of sleep in between feedings and waking at night, and even though it's an adjustment to get our sleep in chunks instead of one long stretch we're really doing OK.  She isn't very fussy, other than her "witching hour" which seems to be from about 9:30-11:00 PM or so, and it's funny because that's totally the time of night she would get very active when I was pregnant.  We'd lay down for bed and she'd start kicking and moving and tumbling...guess girlfriend is still on the same schedule!

My recovery is going very well, also.  I'm still tired, but at this point I think it's just par for the course with a newborn, rather than compounded by blood-loss induced fatigue.  I'm sure there's still a component of that lingering and it will take a while for me to regain my full strength and color, but really overall I feel about as good as I would have anticipated following a normal delivery at 2 weeks post-partum.  I think I'm bouncing back to my normal weight and shape at a reasonable pace, although I'd certainly like it to speed up a little bit! The stretch marks are pretty wicked, but I'm told they will fade so I will just have to trust that they will.  By lower belly is pretty pouchy and resembles a lump of bread dough at the moment, but I'm also told that will get better too! But really, what matters most is that I'm well, Norah's healthy, and we're home enjoying each other, and I can't ask for a whole lot more than that.

It's sunny and mild outside, and leaves and plants have finally caught up with the season.  I'm hoping to get out and walk with her today and enjoy the sunshine and warmer temps.  We discovered that she likes being carried in the Moby wrap the other day, so that's good! She's like a little papoose all cozied up in there - we will have to get some pics if we venture out this weekend.

Matt and I are so grateful for all the support, love, and well wishes we've received from friends, family and coworkers.  I know we haven't had a chance to thank you all personally or even catch up individually by phone yet, but we are always thinking of you and your support really does help us get through these early days as parents.  We are just trying to cherish the moments because if there is one thing we've heard at least 100 times since she was born, it's "Just enjoy her now...it goes so fast" and as cliche as it sounded before she was born, people are right.  So, that's what we're up to - enjoying our precious new teeny and soaking up her littleness as much as we can.

Norah Annabel Smith's Birth: Part Two

I've decided to divide these posts into two parts, because Norah's birth itself was so perfect and went just as we could have hoped and planned for.  I made it through without medication or intervention, and she was delivered safely and healthy.  The aftermath is a completely different story, and I want to separate the fear and negative emotions from this part in their own right.  I wish I didn't have to write this part at all, because it really changes how I look back on part of my daughter's birth day, but I have to process what happened here just as much as how amazing her birth was.

Part Two: Third Stage of Delivery; Post-Partum Hemorrhage
After she was out, we had opted for "expectant management" of the third stage of labor; delivery of the placenta.  Basically that means we were going to wait for my body to do what it was supposed to do, and let my uterus contract on its own to expel the placenta, rather than jump start this with a dose of Pitocin injected in my thigh. This is something that usually happens within 30 minutes of birth.  So while Norah and I were being cleaned up and checked out, we waited.  My Mom had come down and was there with us at this point, and Matt's Dad and the kids came by to meet Norah, but they didn't stay very long, which ended up being a really good thing.  However, after waiting 30 minutes, I'd really had no more contractions, and when Kathy gave a little tug on the cord, the placenta was definitely still attached.  They gave me a shot of Pitocin in the leg at this point to encourage contractions, but after maybe another 15 minutes nothing was happening.  Kathy started to get a little worried and they decided to start an IV and hang a bag of Pitocin pretty much wide open to have one last ditch attempt at delivering the placenta normally.   This didn't have any effect, and we were now getting to point where the placenta needed to come out.  Kathy paged OB, and an OB resident named Samar came down to consult on what to do.  They said they could go in and remove it with manual traction, but most women find this way too painful to undergo without pain medication or anesthesia.  After some brief discussion, we opted to have a spinal or epidural placed and even though I'd made it through the birth without this, I really didn't want to go through any more pain unnecessarily. *

*Somewhere in the midst of this time, I guess Holly had been called in on her day off to come see me.  She was wonderful - she came up to me and told me how beautiful Norah was and how great of a job I was doing.  She was so positive and calming, and I know she helped both Matt and my Mom get through the next few hours too.

Anesthesia was paged, but they were in the OR working on a case, and while we waited for them to come down, Kathy realized that the Pitocin was working to some extent and the placenta seemed to have loosened and she thought she could manually remove it quickly.  She asked me to push, while she pulled on the cord and massaged (FIRMLY. Read, PAINFULLY) from the outside.  This was probably as painful the actual delivery, and when the placenta came out Kathy realized it was coming apart in pieces.  Immediately after that, a HUGE gush of blood came pouring out, and she felt that part of the placenta was retained.  She began trying to remove the pieces by hand, which was horrible, but necessary.  I was bleeding heavily, and we couldn't wait for anesthesia to come to the bedside.  Samar was paged again, and she came right down to check with an ultrasound what it looked like inside.  There was definitely a large part of placenta and lots of blood clots retained, and they felt I needed to go to the OR immediately to stop the bleeding.  It turns out I had a succenturiate ("extra") placental lobe, and this was the main part that was retained.  I was scared, and I knew the situation was serious.  I looked at Matt, and I know he was terrified too, but neither of us knew how bad it was going to get.  They pretty much packed up the bed and ran down the hall with me at this point.

Matt was given Norah and told he would have to wait with her in newborn recovery because her newborn screening wasn't quite complete.  They did follow our wishes though, and delayed the eye ointment and Vit K injection during the time between delivery and when I left for the OR, so I had nearly an hour with her without any extra interventions.  Matt and my Mom went to wait with her, and I was wheeled into the OR.

I was starting to get incredibly shaky, and by the time I got to OR I was in so much pain I was becoming delirious and just wanted them to do whatever they needed to in order to stop the pain.  They asked me to sit up and try to transfer to the OR table, and when I pushed up to sit, I nearly passed out, so they laid me back down and had several people help slide me over onto my side.  My legs were cramping, my abdomen was cramping, and I was freezing cold.  They were still planning to do a spinal for anesthesia, but they had to get extra IV lines in first.  I'd already lost about 600 cc's of blood at the bedside, and my veins were  nearly impossible to start a line in.  The anesthesia resident ended up getting one started, but before they could run the fluids they needed through it to get prepped for the spinal, I began gushing blood again.  I ended up losing 2100 cc's total (just over 2 liters) and my blood pressure dropped to 50's/40's.  I remember at this point through the pain, someone said "She's going to crash if we do the spinal..." and they began rushing around to start general anesthesia.

I was flipped over from my side to my back by about 10 people, and suddenly the OR filled up with 20-30 people rushing around.  Someone tipped my head back and checked my throat size for intubation, and I started to get really scared.  I was afraid of being intubated while I was awake, and I also asked the attending anesthesiologist (Dr. Greene) if I was going to lose my uterus.   She told me if anyone was going to have their uterus out any time soon it was going to be her! I was shaking uncontrollably and moaning that I just wanted something to stop the pain, and the next thing I knew they had a mask on me with oxygen and something else to put me to sleep before they intubated me.  It probably only took 15 seconds before I was out, but I was gasping on that oxygen and just hoping to be knocked out ASAP.  It took effect, and I don't remember anything after that until I went to to recovery, which ended up being a really good thing.  I am actually grateful that I didn't have the spinal, because I would have been awake and scared throughout the whole procedure.

I was in the OR for about an hour and a half, and they ended up doing an emergency D&C to clean all the retained placental pieces and blood clots from my uterus.  During this time, they also gave me 2 units of blood and several bags of IV fluids, plus a barrage of medications to make my uterus contract to stop the bleeding.  Because my blood pressure was dangerously low, they also gave me "pressers" to keep me stable.  This information was all relayed to my Mom and Matt, and at this point I think Matt realized how serious the situation was.  I will never know exactly what was going through his head while he was holding his hours old daughter and hearing the information from the OR, but I know that it was a really scary time for him.

After I was stabilized and the procedures were completed, they took me to recovery.  It took a while to wake up, and I remember catching a glimpse of myself in a mirror at some point.  I was a color of gray-white I had never seen a person before from all the blood loss.  I felt pretty terrible, but once I was awake enough, Matt and Norah were able to come back and that helped so much to see them.  The staff watched me closely for another few hours, and it wasn't until about 10:30 PM that we were finally taken to a recovery room.  The nurses got me all situated and then around midnight Matt asked if I was hungry and I was! We ordered from Pizza House and I got mac and cheese - the GD diagnosis was clear and I was given the go-ahead for a normal diet!

The first night was rough and I barely slept, even after the general anesthesia (not to mention the 14 hour labor).  Norah was by my side and even though she was a wonderful tiny brand new thing, she sure didn't sleep long either! Tuesday I was feeling slightly better, although by then all the IV fluids that had been pushed through my system were settling in and I was swollen everywhere - my eyelids, fingers, toes, legs...I looked pretty rough.  Every time I sat up or stood to walk to the bathroom, I was getting a bit dizzy and could hear my heart pounding in my ears, and that combined with my blood work that said my hematocrit and hemoglobin levels were still quite low, we decided I would get another transfusion with 2 more units of blood.  This helped so much, and by Tuesday evening I was moved out of the high-risk recovery and over to general recovery.  Tuesday night I finally was able to shower and felt much more human after that, and Tuesday night went pretty well.  By Wednesday I was feeling much, much better, and we were given the all-clear that we could go home.  We were packed up and ready to go by about 6:00 PM, and it felt so wonderful to finally be able to bring our daughter home.

Today Norah is one week old - in 20 minutes actually - and I can't believe how my life has changed in 7 short days.  I am so thankful for an amazing team of caregivers who brought my daughter into the world safely, and then in a matter of minutes snapped into action and saved my life.  Had we not been in the hospital, the outcome might not have been the same.  I will never question our choice of care providers or our decision to have a hospital birth - it was the beautiful, unmedicated, intervention free experience I had hoped for all the way up to her birth, but when it quickly became a life and death emergency for me, I was right where I needed to be.  I'll probably never know many of the 20-30 people who were in the OR with me doing their jobs on 4/25, but I know that they saved my life and even if I could tell them all in person how grateful I am, I don't think words will ever be enough.  I'm sitting here holding my perfect daughter and able to see her grow up with my amazing husband because of a team of people were at UM doing their jobs flawlessly and caringly when I needed them.  Thank you, thank you, thank you.

Coming Home

3 days old

3 days old

The Arrival of Norah Annabel Smith: Part One

*Of course this is the post the blog has been leading up to for 9 months, and I wanted to make sure that I wrote the story of her birth in a way that helps me remember the details.  That being said, it's likely that portions will be fairly descriptive and possibly graphic due to some of the circumstances that occurred.  I know that most friends and family reading this have already heard many of the details, but for others checking in I just wanted to clarify that I'm writing this as much for myself as for the blog so that I can process the event. It will be long, and hopefully not TMI for most of you :) *

Part 1 - Labor and Norah's Birth
April 25, 2:12 AM:

I woke from a sound sleep to the sensation that my water had broken, and got up to check and be sure...there was no doubt about it and I came back to bed to tell Matt that we're going to meet our daughter soon! I started timing contractions which began immediately after, and they ranged from 4-7 min apart and  lasted about 1:00 for a while.  Winnie (our cat) was up with me and totally knew something was going on, while Lainey (the dog) casually glanced at me on my way past her to the bathroom as if to say "I'm sleeping right here, please don't step on me" and promptly went back to sleep.  I told Matt to try and get some rest, as he had literally just turned out the light and gone to sleep just about 2!  

5:19 AM: Labor has definitely started! Nothing serious yet, but contractions are consistently about 5 min apart and getting slowly stronger.  I think we're going to have a birthday today (well...I hope it's today and not tomorrow!!)  I am able to manage the contractions mostly by sitting on an exercise ball and rocking side to side. I've had to have Matt help me focus on a few of them and he's a great support! 

7:41 AM: Called OB Triage as contractions are now about 3 min apart and have been for the past hour. I have had a few contractions that dropped me to my hands and knees and definitely feel the need to start making some noise to get through them.  There is no real way to be distracted through them at this point, and just have to focus on coping with each one.  Because my water had broken they asked me to come in and be checked and hopefully be admitted.  We scurried around and packed the last minute items we could think of, and we headed off to UM around 9:00.

At this point my times get a little less specific, but around 9:30 we got to the hospital and went up to triage. They got me hooked up to a fetal monitor to watch baby's heart rate and to follow my contractions, and paged the midwife on-call to come down and check me for a starting point.  A midwife student named Anouk was here studying from the Netherlands, and she was with us pretty much from triage through delivery.  I can't say enough how special it was to have her support throughout the process - she was truly wonderful and helped both Matt and myself tremendously.  It was like having a doula we hadn't planned for, and I seriously don't know how we would have made it through without her!  Kathy Bedikian was the CMN on-call for the day, and would be the one who delivered Norah.  She came down to triage, checked my cervix (was at a 4 cm dilation and 100% effaced) and confirmed that my water had broken.  I was set to be admitted!

We walked down with our nurse to our labor and delivery room - we got a room with a tub just like we wanted which was a godsend - and got settled in.    Because I was still sort of in between early and active labor, they let me order a breakfast tray and try to eat a little since I'd been up since 2:00 without much to eat.  I got Fruit Loops, some yogurt and fruit, but by the time it arrived I didn't end up eating much of it because I started throwing up - this was probably  about 11:00.  Matt helped me labor through contractions by putting counter pressure on my back.  Things started to pick up, and looking back I think this is when transition really began - I did put together that throwing up is usually a good sign that the cervix is dilating quickly.  I was starting to have difficulty finding anything that would work to help me cope, and Matt asked if it was time to get in the tub. I said yes! Matt ran water in the tub and I think I was in the water by 11:30 or so. I won't say laboring in the water took the pain away, by any means, but it was more manageable and I spent probably close to the next 4 hours in the tub.  

Transition contractions were SO much more intense than I could have imagined.  They would peak and barely come down before another one would start, and I really had a hard time catching my breath at this point.  I was trying to breathe in my nose and out my mouth, but I needed pretty much constant breathing support from Matt and Anouk to help me through.  Probably about 1:15 I realized that my body was starting to push at the top of the contractions, whether I intended it to or not.  Anouk called Kathy to come down and check me, and although it probably only took her 5 minutes to get there it felt like forever! She checked me and said I was a 9.5 - I remember asking her if she could please, please make it 10? And she must have been able to stretch the last tiny bit, because she said I could just go ahead and push.  This was such relief for a while, because my contractions spaced out and I actually had a break in between them again.  Pushing was really hard work, but for the first hour or so it was actually a nice change from transition.  By the end of the second hour of pushing in the tub though, I was getting really, really tired and discouraged and felt that I wasn't making any progress.  They all assured me I was, but I just needed a change and so we got out of the tub and moved to the bed.  I was disappointed because I had wanted to have a water birth and didn't think I wanted to be on the bed, and I cried while walking over.  Didn't have time to think about it for long, and got busy pushing again right away!  I tried several different positions to push on the bed, and finally started to feel like I was doing something each time.  They asked if I wanted a mirror, which I swore beforehand I would not want, but it actually helped a ton for me to see what was going on.  

This last stage of pushing was probably the second worst part of labor along with transition.  Kathy felt that her head was slightly turned to the side, and she used her hands to slowly rotate with each push for a while.  Once Norah's head clicked into position, she really moved down and started crowning.  Once she started crowning, it took about 20-25 minutes more before she was born...and without any pain medication or numbing...that's a really long time to crown! I had the nurses and midwives laughing at one point because I kept saying "This.Is.BEASTLY"!  I could clearly see that she was so close to being born, and yet no matter how hard I tried she just moved so slowly each time.  It ended up being a good thing, because when she was finally born at 4:22, I really had no tearing and no need for an episiotomy.  Kathy handed her to me once her shoulders were out, and I pulled her up onto my chest.  She was perfect, and from the second I had her she was holding her head up looking around the room.  Matt was amazing, and he was right there by my side every minute.  We let her rest on my chest skin to skin and waited for her cord to stop pulsing before Matt cut it.  He didn't think he'd want to, but when it was time he was ready!  Her Apgar scores were 9 and 9, and she weighed in at 9 lbs 1.9 oz, and 21 1/4" long!  Matt asked Kathy and the nurses if they played a little guessing game for how big the babies would be and they said they totally do! When I checked in at triage, Kathy thought Norah would be about 7.5 lbs, and after a long while of pushing she said she was going to have to change her guess, but even then she couldn't have predicted how big she was! She laughed that they were all off by 2 lbs!!

Our care team was incredible - Kathy was absolutely wonderful and even though I had never met her she was exactly the kind of midwife we ended up needing.  She was supportive when I would get discouraged, and reminded me that what I was doing was hard work but totally within the normal range for a first baby.  When I was really in pain, she would stroke my hair or rub my leg, and remind me that it was all helping me get closer to meeting my baby.  And Anouk, who was there by our sides the whole way...she got us through the toughest part of transition and was a tremendous support to both of us when we needed it the most.  Right after the birth, she brought us a baby hat that the students from the Netherlands had purchased as a fundraiser for supporting healthy babies in Sierra Leone - it was really special to have that from her.  The day we were going home, she also came by and brought us a pair of knitted booties that her grandmother made for her to give to all the babies she helped deliver...it brought tears to my eyes and those will always be a special reminder to us of the care and support we received that day.

Relief, Amazement, Bliss

Our first family photo

Sweetest moment

How on Earth did I have a 9 lb baby? 

(Photo taken on 4/27 before going home)