39w6d...Maely's Arrival!

Maelyn Grace made her appearance in the world at 10:41pm on January 24, 2013. She weighs 8lb 9oz and is 20 1/2 in long. I had the birth experience that I fought so hard for, and since I have shared so much about the last weeks of my pregnancy, I want to share my birth story to show that despite the heavily medical atmosphere that surrounds labor and delivery today it is still possible to have a wonderful, natural birth experience.

Wednesday night, I was so starving that no amount of food was satiating me. I ate until I was too full to eat anything else and went to bed. Around 2:30am, I woke up with a contraction. I laid in bed for a few minutes and felt another. I felt a little glimmer of hope that this might be the real deal since these contractions felt different than any I had experienced before. I timed my first one at 2:45 and got up to try to relax and watch tv. Contractions came steadily, about 7-8 minutes apart. At 4:00 I felt confident that today was going to be the day, and I started freaking out a little! The house was a mess so I started cleaning up to distract from the contractions. At 4:30, I woke up Seth and said "I think something is happening!" I told him to go back to sleep, but by 6 I couldn't stand it anymore, I wanted to get everything ready to go because I was pretty sure by then that this was it.

I took a shower and curled my hair so that it would stay out of my face during labor since my straight hair ponytails constantly fall down. Also, I had been telling Seth I was going to do this and he didn't believe me, so of course I had to prove myself!

I was so hesitant to call my parents or Charlotte, our doula, because I part of me kept thinking that this may not be the real thing, and I didn't want to be chastised for the rest of my life about a false alarm!

Around 11, the contractions started getting intense to the point that I had to stop and breathe through them, but could still function pretty well in between them. Seth finally made me call Charlotte and decided to have her go ahead and come over. Charlotte helped me better assess my progress, helped me get into the mindset to work through my contractions. Since it was so nice outside, Seth, Charlotte, and I walked around our property to get gravity working in my favor. 

I realized it was pot roast Thursday at Reid's, which I was not missing! Seth went and got me pot roast with lots of carrots, and I tailor sat on the floor watching Maury, stopping for contractions. I am so glad I ate this meal, I really feel like it gave me the strength to power through. I also think it gave my body the fuel it needed to really kick labor into high gear.

After eating, we did some work with the birthing ball to stay loose and stretched out, I took a "nap" to get a little rest before the hospital, and Charlotte gave me an awesome massage that allowed me to sleep between contractions for about an hour. I highly recommend having a doula who is also a licensed massage therapist to rub your back throughout your labor. So worth it!

By 5pm contractions were less than 4 minutes apart lasting consistently for a minute, so we decided it was time to load up and head to the hospital. Seth got the back of the truck ready - plastic drape over the entire backseat, towels, and blankets, just in case my water broke and/or we had to deliver on the way. I loaded up in the truck, and about 5 minutes on the road I realized we forgot the birthing ball so we had to turn around and get it, I could not be without it! The ball really did provide a lot of relief and helped me stay in a positive position.

I have always heard that riding in the car with the contractions is horrible, and while I agree that it wasn't the best thing I've ever experienced, I can remember laying there thinking "it's supposed to be so much worse than this, it doesn't hurt enough!". I actually thought this a lot throughout my labor. Not sure if this was because of all the mental prep work I had done, or just sheer disbelief that I was finally in labor.

Seth tried to drop me off at the front of the hospital so I wouldn't have to walk so far, but I refused. I did not want to be by myself. So I walked across the entire length of the parking lot, through two contractions, and finally made it to labor and delivery. Our sweet friends at L&D were getting a nice, big delivery room ready for us, which was awesome except that it meant I had to stand out in a packed waiting room, working through contractions while everyone was staring at me! By far, the worst part of my labor experience.

We got into triage finally, and I my progress was checked. I was at 4cm, which was not horrible but we were really hoping to be at a 7 by the time we got to the hospital. This is where Seth and I had to start being adamant about what I wanted, such as not wearing a hospital gown. These things may seem small, but it is all part of a bigger picture of being comfortable. Also, during the triage part, the Seth noticed that the nurse checked off a whole list of items that we did not want for the baby without even asking us. Luckily Seth was paying attention and was able to tell her to correct the form to reflect that we did not want Vitamin K, Hep B, etc.

When we got back to the delivery room, I got settled in. After Seth loaded all our bags in, I decided to get into the jetted tub to try and soothe some contractions. Well, that tub is way too small to get into any decent positions to work through contractions! However, I think the position I chose to sit in really helped open me up a lot, because I could not tolerate not being able to move through the contractions pretty quickly, and when I got out of the bath I was checked for progress and was at 7cm after an hour and half.

At that point, Charlotte had me get on all fours propped up over the back of the bed. This position totally prepared my body to push Maely Grace right out. I am not sure how long I was able to stay in this position, but it didn't feel like it was very long before I could not tolerate any position other than laying down. I so badly wanted to lay on my right side, but Charlotte just kept saying "left side, left side!", so I got as comfortable as I could on my left side.

From this point forward I truly don't remember much. I remember American Idol and Glee being on. I remember thinking that I was probably going to miss Scandal. I remember constantly reaching for Seth and freaking out if I couldn't hang on to him. Seth was so my comfort. I remember playing with his hair through a contraction. Like many women before me, I was not exempt from the self doubt that kind of pain will make you feel. I finally hit my wall and starting asking for the medicine. I know this was partially because I remember people talking around me about how I would probably not deliver until after midnight, and I can remember seeing the clock and it only being 9 something. All I could think was that I could not go on for several more hours at this level.

Charlotte and Seth held me off, reminding me that I didn't need it, that I had already made it this far and that I was doing it all by myself just fine. I do remember clearly crying for "the medicine" three times, and on the third time, our midwife, Suzanne, checked me around 10pm and I was at a 10! I think everyone was shocked that it was time to start pushing. Even then, Suzanne left to go check on another patient because she believed I would be pushing for a while based on the size of the baby.

All the things I have read and heard is that pushing is a relief, and that you can feel the urge to push down. I really couldn't feel the urge to push down until I started consciously pushing, and that's when the pressure came. This was really no relief to me, but Seth told me afterwards that I was much calming during this phase than the transition phase.
 
I feel like I didn't push for very long, and I know that my pushing was much more effective than anyone anticipated because our nurse got on the phone and frantically said "get Suzanne back in here NOW!". Suzanne came back in and at that point didn't leave my side. She started helping me through each contraction, and pushed with her finger the area that I needed to concentrate my pushing in. This is where I was so happy that I did not have an epidural. With an epidural, there would have been no way for me to feel this and to push so effectively.

I do remember thinking "this baby is not even close to coming out, it doesn't hurt bad enough, I don't feel the burning 'ring of fire'"! What I felt most was pressure, unbelievable, indescribable pressure.

I will that when I first started pushing, I tried to breathe through my pushes and I could not get a strong enough force between my pushes that way. Until I held my breath and pushed very hard, I wasn't make much headway. It took Maely 41 minutes to make her descension into this world.

I thought I made it out scot-free without any tearing, but I wasn't so lucky! Maely came with her elbow cocked out and tore the top side of my labia. No perineal tearing though, which was my major concern!

Maely came out perfect as she could be. She latched on like a pro 15 minutes or so after she was born, and we have been a nursing superpower duo ever since, which I fully credit to her being fully lucid when she was born, and unadulterated by bright lights, baths, shots, and eye goop as soon as she came out. She had no distractions and was able to focus on her goal of getting the best food nature could provide. I've had no supply issues as of 14 weeks postpartum.

The journey that Maely and I went on was magical, and I will cherish it for the rest of my life.

39w Update

At my perinatologist appointment last Friday, blood pressure was 120/78, BPP was perfect. No push for an induction at this point. I honestly get the feeling that the perinatologist is slightly annoyed that I am still a patient taking up his time, I am not an interesting case and will need no special procedures to give birth. I mean, I get it. In the medical world, boring cases are, well, boring.

Sunday night I got very sick, vomiting and diarrhea for most of the night. Blood pressure at the OB Monday morning was 130/90, not great but not bad considering I was likely a bit dehydrated despite my best attempt to stay hydrated through the vomiting. NST still looked good and the OB I saw was very reasonable. He moved my due date back to the date of my LMP which essentially buys me 4 more days before I know they will start pushing hard for an induction.

As my due date draws closer, I am excited but increasingly more anxious about going into labor. I am confident I will be able to buy time until 41 weeks, and as long as the baby looks good, my placenta is still functioning optimally, and my blood pressure is stable, I would be fine to continue on past the 41 week mark. However, I cannot say the same for my husband, and I do believe he does have some say. He is pretty easily scared into "well, there's a chance..."

At the end of the day, we both want the same thing, a healthy baby. I just hope she cooperates and decides she's done cooking before the OB team does!

38w0d Update

BP this morning was 118/86. No protein. NST was perfect. As expected, the OB was pushing for a 39w induction and essentially dismissed my desire for a natural birthing experience. However, since my perinatologist is supportive, I am not concerned since he is the decision maker at the end of the day. I am also not concerned because I really have no markers that put me at high risk for developing pre-eclampsia, but am unfortunately being lumped into that category due to a few isolated incidents that could have been the onset of pre-eclampsia, but has become clear that it is not.

This is the problem with the modern obstetrics system. While there are undoubtedly women that do have markers and should be delivered to prevent obstetric emergencies, there are many, many more women who are bullied into falling in line just because they have a few mild markers for a problem, and even if those markers dissipate, it is often too late because they've already been put on the induction train.

It doesn't help that my OB and perinatologist both seemed shocked I am not in a rush to get this baby delivered, as I've been told multiple times that I am not the norm, most women want to be induced ASAP. Sad to me. So, while I would hope that this would make me stand out and easy to remember, unfortunately I just seem to be forgotten because I'm not jumping on anyone's induction schedule.

Next appointment is Friday, and hopefully everything will still be looking great and I will get another go ahead to keep trucking on until I go into labor naturally.

37w3d Update

My 24hr protein analysis came back, my protein level dropped to 315. While this is still slightly over the threshold of 300, the most important thing is that over the course of 3 weeks, the protein level DROPPED, which reinforces that this is not pre-eclampsia. In pre-e cases, protein levels steadily increase. Crisis numbers are 700-800+.

Had it not been for my perinatologist really listening to me and not jumping to quick conclusions the way the midwife in the OB office did, I would have already been induced by now, and unnecessarily so. 

My NST from Monday, 12/31 was reactive. My blood pressure that day was 144/82. Happy with that diastolic number for sure, as diastolic is what is really considered the "important" number in pregnancy/delivery.

Going for a Biophysical Profile (BPP) tomorrow with my perinatologist. Expecting nothing but a blessing to carry on until this baby decides she is ready!

36w4d Update

I had a midwife/NST appointment on Wednesday. My blood pressure that day was 135/91. Protein was negative. The midwife (who I had never seen before) wanted to run a full pre-eclampsia panel, which I declined at that time based on my blood pressure being no different than the Friday before at the Perinatologist, and the fact that there was no protein in my urine. Also, she really irritated me by threatening "well then we may have to induce". Our conversation ended there, as I am not getting bullied into anything. Also, I am not longer seeing the midwives at this practice starting Monday. I requested to see an OB from this point forward because I feel like the midwives are extremely self-righteous and overly afraid of being wrong to the point of being test happy. I may not have better luck with an OB, but we shall see.

Today at the Perinatologist, my BP was 143/92. Cord blood flow and placenta function was excellent and has not declined in the 4 weeks I have been having the biophysical profiles. The perinatologist recanted the previous diagnosis of pre-eclampsia and says he feels confident this is not a pre-e case. He did not seem concerned about my BP at all and told me he'd see me next Friday.

Not thrilled about my BP but also excited that I have escaped the Pre-e diagnosis, which means I will not have to be forced into an induction at 37 weeks, which will be New Years Eve.

Week 36 Update

So, not much news. My blood pressure at my appointment on Thursday was 118/72 (awesome). However, my blood pressure Friday was 147/95, then 130/82 a couple minutes later, which, I'm sure, is due in part to in-law drama immediately preceding my appointment.

No protein.

I feel like the providers don't recognize me from week to week, and they still make passing comments like "if it continues like this, we'll keep you pregnant until 39 weeks", which yesterday, I was so worked up and upset about other issues, I was afraid I would burst into uncontrollable tears if I tried to go up against them and say "no, if everything keeps going like this, I'll go into labor spontaneously". My plan is to start really emphasizing this at my appointment next week.

Pre-eclampsia or Pregnancy-induced Hypertension?

To begin, this has been the history of my blood pressure before getting pregnant and throughout my pregnancy:
10/18/11 - 138/82
12/12/11 - 138/96
3/7/12 - 126/83

16w - 134/76           Protein in Urine 220mg/dl (24hr)
20w - 144/90
24w - 118/80
28w - 120/78
30w - 125/80
32w - 155/88
33w - 136/85          Protein in Urine 304mg/dl (24hr)
34w - 126/85          Protein in Urine 400mg/dl (24hr)

So, by and large, my blood pressure measurements are in the "pre-hypertension" category with a couple of exceptions. The perinatologist said that if my blood pressure remained stable, that I could go to 40 weeks, with each day I am able to remain pregnant obviously lowering the possibility of having to be induced. This was before my protein came back high for a second week in a row. If my protein continues to increase, I know that they will push to induce me at 37 weeks.

However, I feel as though these numbers could be indicative of other issues besides pre-eclampsia, such as external stress and dehydration, both of which I experienced while taking my 34 week urine sample. When I am doing my 35 week sample, I am going to make a huge effort to avoid all outside stress, stay extremely hydrated, and increase the amount of fruits and vegetables I'm eating while decreasing protein intake. If I can show even a one week decrease in my protein levels, then that will help substantiate my case that I do not have pre-eclampsia, thus helping me avoid an induction. Because if I had true pre-eclampsia, environmental factors would not influence a 24hr urine test.

On 12/11/12, I had my first non-stress test and the baby was perfect. Her heart rate accellerations were on point and she had lots of movement.

So to recap, as of 12/11/12, the cord blood flow is perfect, non-stress test is perfect, baby's growth is in the 60th percentile (pretty much perfect), and my blood pressure is slightly high but is stable. The only issue we have now is protein in the urine. I go back to the perinatologist on Friday.