Baby Blog Part I

WARNING
Well as my last blog entry was about starting my maternity leave as you can imagine this blog entry will have nothing to do with my career—at least my career in public education. This blog entry will be all about the baby. If you do not want to read about the baby, then DO NOT READ THIS BLOG ENTRY! Also, please excuse any typos or misspelled words as I am extremely tired and that makes me more prone to mistakes.

James "Jake" William Carr was born on November 25th, 2005 at 4:30 PM. He was 21 inches long and weighed 8lbs 9.5oz. He was a week early! He was a lot smaller than the doctors thought, but he through off their estimated with his big head, hands and feet! After over 18 hours of labor he was delivered by a c-section and spent a week in the Neonatal Intensive Care Unit. We brought him home Friday afternoon. He weighed 8lbs 15oz when they discharged him and we are both doing great. He was in the NICU for a suspected infection of the amniotic fluid, and although his blood work never actually showed an infection, they kept him on antibiotics for seven days just to be sure. Apart from that he was completely healthy. As it is a very long story today I will post the story of his birth and some time in the next week I will post entries about his week in the NICU and his homecoming.

Me+Baby=Drama Squared
The doctor had warned us the baby could come as early as the last week of October, but he thought the baby would definitely be here no later than the second week of November. Our 35 week ultrasound on October 24th placed the baby around 7lbs. Around 5 pm on October 29th (while visiting James’s parents in Water Valley, after my last class in Oxford) I started having back pains and contractions. When we went to our doctor’s appointment that Monday (Halloween) the baby had dropped, I had started dilating, and the contractions were showing up on the Fetal Monitor. I had also gained 8lbs in one week (fluid) and the skin on my legs was so tight that you couldn’t pinch them and I was starting to have numbness. The doctor could not figure out what was behind the fluid, but suggested that I start my maternity leave, stay off my feet and drink as much water as possible. My blood pressure had already started to rise, although it wasn’t at a dangerous level, and the doctor was worried the fluid gain would adversely affect my blood pressure. I didn’t really relish the idea of sitting around the house and waiting on the baby, but I was having pretty painful contractions (they would wake me up at night because of the intensity, but they were very irregular) and because of the pressure of the baby’s head, it was pretty painful to move or make any transition from position to position—standing to sitting, sitting to standing, lying down to standing up, walking to stopping, etc. It felt like I had a bowling ball inside my hips and when I moved or stopped moving I could feel it bump up against my pelvis. Once I sat down too quickly and I promise it felt like his head hit the seat. So I started my maternity leave with the doctor’s promise that the baby should come any day and that if he hadn’t by the second week we would look at inducing. The next week I had gained about 8 more lbs of fluid, my blood pressure had risen a little bit more, I was still having contractions, but I had only dilated to 2 cm. The doctor said it should be any day (It is lucky James was there because by now I had this strange urge to slap the doctor when he said things like, "Your back this week?", "You still haven’t had that baby", and "It will be any day now."), he said he wished me pains and that he hoped he wouldn’t see me next week. I was really frustrated by the next Monday’s appointment, especially when the receptionist had a hard time booking my appointment because the doctor was going to be on vacation until the next week. I didn’t really want to be induced, just because I felt like I would rather the baby choose his own birth date than some doctor. Also I was really starting to loose faith in my doctor, and I was hoping that I would luck up and go into labor on a day when my doctor was not on call. My doctor told me to limit my walking (even around the house) to try and control the fluid retention. James and I asked about inducing (since he had promised us we would have a baby by now and because we were worried about ending up with a 10 lb baby) and the doctor said that inducement carried a high risk of a c-section and that it was possible that I could handle delivering a large baby. He even mentioned that since my blood pressure had not climbed over into dangerous levels, since the baby’s heart rate and movements were great and since I was not having any problems with my blood sugar or protein levels (a sign of kidney complications) that me might not induce on the 29th as planned, but he might let us go until the Tuesday after that. So to sum it up I was anxious, miserable and pretty much housebound most of the last month. The fluid retention got so bad that I bumped my leg on the dish washer and the cut didn’t bleed until that night when the swelling went down a little bit (when the swelling started going down a week later after delivery, it bled again).

The day the baby should have been born.
After my appointment on the 14th I experienced a gush of fluid when getting into my car, followed by bleeding and cramping. I went home (where I discovered the bleeding) and called the doctor’s office (I had just left there), he and his nurse were both at lunch and the only nurse left up there told me to wait about an hour and see if the bleeding stopped. By this time James had came home for lunch to check on me (it was the only doctors appointment that I made by myself—James had been to all the rest) and see how things had gone. When the hour had passed the bleeding was worse and my contractions (the ones that I had been having for two weeks) had picked up. I didn’t think I was in labor but I have always heard bleeding at anytime in pregnancy is a concern and this was definitely bleeding, not spotting. I called the doctor’s office back and he still was unavailable, as was his nurse, so they urged me to go on to the hospital. James and I went to hospital and explained what happened. They put me on the fetal monitor and said there were several possibilities—early separation of the placenta (because of the pain and bleeding) and rupture of membrane (possibility that my water had broken). The fetal monitor showed that I was having contractions 3 minutes apart and that the baby was doing really well so they ruled out separation of placenta after a few hours of observation. They then decided to swab me for leakage of the amniotic fluid, which came back negative. By this time (some 5 hours later) the contractions were starting to slow down and the bleeding had stopped. They discharged me and said that something the doctor had done during the exam—possibly attempting to strip my membranes to bring on labor (without telling me of course)—had just irritated my cervix and uterus causing both the bleeding and the contractions. The contractions actually went away for a few days and even when they came back they were generally only at night and not nearly as bad as they had been the two weeks previous. When James and I went to my appointment on the 21st I was still only dilated to 2cm and he set up a tentative inducement on the 29th (the day before the baby’s official due date). I was beginning to think I would never have this baby!

Depression sets in
The 21st came and went. At one point the doctor had told us he would induce if we had not had the baby by this date (because of the baby’s size). Thanksgiving Day came and I got really depressed. From the moment we had discovered we were pregnant, James and I always really thought we would have a baby before Thanksgiving. Early afternoon on Thanksgiving I started having a lot of back pain and by early evening the contractions had started again. I didn’t get excited because I was afraid of getting every ones hopes up and I had been having contractions for over three weeks now! Plus, like I said, I had started to really believe that I would never have this baby on my own and that we would have to just evict him on the 29th (with the doctors help, of course). Around 10:30 that night it became obvious that I was probably really in labor and that they were not going to stop, they kept getting stronger, closer and more regular. I told James that we probably need to try and get some sleep because we were both exhausted—I hadn’t slept well in days. I couldn’t sleep because the pain was so bad and poor James tried (I still was trying not to get him to excited because I was still afraid they would stop) to write down when I had one and how long it lasted but I felt so guilty waking him up. Finally, around 1 or 2 in the morning I knew that it was probably time to go to the hospital. When I woke James up and he started timing them he got a little frantic because they were five minutes apart. He wanted to go to the hospital then, but I told him to sit up with me and time them for at least an hour, because I didn’t want to go up there only to be sent home again or have the contractions stop. Over the next hour they were consistently three to five minutes apart so we headed on to the hospital. The pain was so intense some times that my teeth would start chattering and I would shake/shiver uncontrollably. When they admitted us, I was running a fever and so they decided to start me on an antibiotic intravenously. They monitored my contractions for a little over an hour and then told me congratulations I was in labor. The doctor on call for that day was scheduled to go off call at 5:30 AM and since he wasn’t already at the hospital, they decided to wait until 5:30 and call the doctor who was on call for the next day. Two hours passed and he still hadn’t shown up and my contractions were so close together James and I were having trouble telling them apart. The nurse checked me and we were dilated to 4cm, but the doctor had still not arrived. I knew I could start the epidural at 4 cm, and I knew James needed a food break and that I was exhausted and the hard part was yet to come. I thought if I went ahead and got the epidural that I could relax a little bit—maybe even catch a few minutes rest—and that James could go get some breakfast and call our parents to let them know what was going on. The nurse said she could not order anesthesia, only the doctor could and he wasn’t there yet (this is not the way they presented it in my birthing classes that we took at the hospital—I though all I had to do was ask). After seeing how strong and close my contractions were, she agreed to call him back and get authorization for an analgesic, but she said he couldn’t order the epidural without examining me. I wasn’t too sure about taking an analgesic because I was worried about it getting passed on to the baby, but I knew I needed a break and I was starting to get frustrated about the doctor not being there yet. She warned me that I would feel drunk and dizzy and the pain must have been pretty bad by that point because I remember telling her that I would just shut my eyes if I felt dizzy. She didn’t give me much because we both assumed the doctor would show up any minute. Wrong! The doctor did not show up until about 10 o’clock AM and by then the analgesic had worn off and I was feeling worse than before. He examined me and I had only progressed to 5cm, but even more troublesome he could not detect the bag of waters. He asked me when my water had broken and James and I were shocked, because as far as we knew it hadn’t. He insisted that it had and then it dawned on me to tell him about what happened on the 14th when they sent me home. At this point they officially admitted me and put me in a room (we were in the observation area prior to this, just curtained off from the other women. The woman across from us came in at three cm with broken water and she sounded like she was dying, cussing, crying, screaming, etc. I remember being scared (at the time I didn’t know that my water had already broken and that I was at 5 cm) and that is shortly before I asked about pain meds! He still had not ordered an epidural, but I guess it slipped his mind as he left me to perform a c-section on another woman. An hour later after he came out of the operating room with her, they managed to track him down and get my epidural (by then I was at 6 or 7 cm). When the doctor checked me again, he remarked that this was going to be a big baby. He sounded surprised and so I asked what constituted big, he said anything over 9lbs (this scared me). The epidural didn’t take all they way, but I wouldn’t learn that until later. All I knew was that I finally had some relief and although I could still tell when I was having contractions there was no real pain for the first time in over 12 hours! Because I had been in labor so long and my water had already broken, they decided to give me pitocin to help speed things along and the doctor said he thought we would have a baby in two more hours! For some reason my labor started stalling, even with the pitocin, I took a long time to dilate from 7 to 8 and my fever kept getting higher. The doctor came in and told us that although the baby seemed fine, he was worried that my fever and stalled labor could mean that the amniotic fluid or uterus could have become infected (especially since they weren’t sure how long my water had been broken—you are not supposed to go over 24 hours after your water breaks). He was worried that this could result in a much longer and more stressful delivery and with the size of the baby he didn’t want to risk it. He advised me to consent to a c-section and we did. The anesthesiologist came in and discussed options with us and we decided to up the epidural and attempt the c-section with me awake (which I was really feeling squeamish about). While they were prepping me, I said something to the nurse about it hurting when she shaved me and she ran and got the anesthesiologist. He kept asking me what made me think the epidural had not taken and I didn’t understand—I thought it had taken—I didn’t realize I wasn’t supposed to be feeling what I felt. They had James changing into scrubs at this point, so he had no clue that anything was wrong. They upped the epidural meds as much as they could, and while I was completely numb on my left side, I could feel him pinching my skin on the right side and my back never went completely numb. They decided last minute to put me completely under. James was not allowed in. I remember being scared and trying to relax. Right before I went completely under I heard a female voice ask someone if I was having my tubes tied. I heard a male voice—not the doctors—answer back that he didn’t think so. I remember wanting to scream NO!, but not being able to speak and thinking, "please check my chart" and that is the last thing I remember.

The surreal life
About an hour later I woke up in the recovery room. I was the only one in there except the nurse. No one said anything to me about the baby and I was so out of it I temporarily forgot why I was there. The anesthesiologist came in and asked me to move my feet. I could move my left foot and knee, but I couldn’t even wiggle my toe (no matter how hard I tried) on my right side. I heard the nurse on the phone complaining to someone that she couldn’t get off early to go shopping because I wouldn’t hurry up and move my leg. I don’t think she realized I could hear her phone conversation. I remember getting upset, because I didn’t want to be there either. I wanted to go see my baby. I was really upset (and still am) about not getting to see him, hold him or hear him cry. I was in the recovery room for over two hours and they didn’t explain anything to James or my parents. One of the nurses that had assisted me during labor came in with our camara to show me a picture (on the digital screen) of the baby, but I didn’t have my contacts in and I couldn’t see it. She didn’t know anything about the baby. James had just asked her to show me the picture and try and find out how I was doing because he was really worried about me and hadn’t been able to find out anything any other way. Finally, I could get my right foot to wiggle and even though I couldn’t move my right knee yet. They decided to move me back to a room. Finally I was able to see James and our parents, but still no baby. They told me that their had been some meconium staining of the amniotic fluid and that they had taken him to the Neonatal Intensive Care Unit (NICU) for observation, but that he seemed fine. They didn’t know how long it would be before I could see him as I would have to be able to get up and walk down there to the NICU to see him and I had just had a c-section (plus the general anesthesia to recover from) and was still receiving pain meds and the antibiotic through the IV. The doctor did not want me getting out of bed that night, but with the help of a nurse who had delivered three of her four babies with meconium staining (Jake never aspirated it and it never made it down his throat) and knew how I felt; I managed to go see him (IV and all) early in the AM of the 26th. He was sound asleep at the time and they had an IV going into his umbilical cord stump so we were not allowed to hold him and it just all felt so strange. Well I guess this is where I will stop for now as I am still exhausted and it has taken me several days to write this. I just wanted everyone to know what was going on and that everything is okay.