Wednesday, November 30, 2011

Getting Fired...

It's true, I got fired by my doctor today. Boy, that came out of no where! This was my second prenatal visit, the first had been highly encouraging 4 weeks ago...

At the practice I'm currently seeing, you see one of the 4 doctors each time you go for a visit since they have a call schedule for delivery and you never know who you will get the day you labor. Doc #1 was very laid back about the "dia-bets", he even went as far as to say, I would most likely do better than most "normal" pregnant women. I was thinking, alright! I've lucked up, this practice might be ok.

Then I went for my 14 week appointment today. Thankfully, I didn't have much to report to doc, my nausea subsided around 10 weeks and hasn't bothered me too much since. The fatigue diminished around the same time and other than some evening heart burn I'm feeling pretty good for a pregnant lady these days.

I reported about my visit with the endocrinologist this past Monday... My A1C continues to trend down (it was 7.3 when I conceived, then was 6.5 around 10 weeks and is now down to 6.3). My endocrinologist is seeing me every two weeks, for which I am VERY grateful because since we are new to one another, we still have so kinks to work out in how he will manage me and our communication, etc.

We didn't even talk about my thyroid, although I did have some questions about that because things went south pretty quickly after I told him that I had a few questions about labor and delivery since I was new to this hospital and practice with baby #3.

I began with the simple question first (now remember, this is the FIRST time I've gotten to ask questions of this practice, my first visit lasted 2 hours and was all THEM talking at me really- maybe this should have caught my attention).... do you only deliver at "Hospital X"? I asked because "Hospital Y" is 2 minutes from my home and a smaller hospital that I do not think has a NICU, but Hospital X is a good 30 minutes from my home. The doctor smiled, laughed and said, yes, only Hospital X.

Ok, now what sort of expectations do you have about diabetic births, I asked. Doctor responded: "we induce between 38 and 39 weeks, But given your history of the tear with your first baby, I don't think you need to be delivering a baby that is larger than 8lbs, so we will take that into consideration, also, a scheduled c-section may be the best option."

I think I wanted to scream at him, but despite my usual lack of calm in these situations, I was able to remain very calm and ask him my questions that followed that absurd statement. "Now, I've had 2 vaginal births, one without any interventions, why do think I should have a c-section. And also, I'm not willing to induce before 40 weeks unless there is some good indication."

Doctor didn't say anything. So I continued, "ok, lets say I'm in labor and the physician on call orders my water to be broken or pitocin, and I decline what would happen in a situation like this?"

Doctor says " I think you need to find a practice where they will let you call the shots, this is not a practice like that, and it sounds like you can't trust us."

I back peddle...." I didn't say I needed to call the shots, but I am the one having the baby, right?"

Doc says something along the lines of we will deal with this later and says he will see me in 4 weeks and quickly leaves the room.

I was stunned and angry now, I made my way through check out quickly before the tears started... stupid pregnancy tears, they just come whenever they want, it's like there's no way NOT to cry when you're pregnant. :) I called the hubs and relayed the story, he was so kind and encouraging. He said we would find another doctor, not to worry, I of course can't NOT worry because this is "the" practice that everyone in town goes to and expects me to go to, especially my mother in law, super.

I came home and immediately called the Midwifery practice to see who they would recommend. The gave me the number to their overseeing physician who also has a new partner, I haven't heard back from them yet, but they are my best hope at this point.

It seems after making some more calls to local OB offices that "in town transfers" are not accepted per many offices policy. Grrr. So, I'm praying I'm not stuck, although, worried that I may be.

I promise to write about bloodsugars this pregnancy soon, baby is nudging me right now!!! YAY :) that can always make you smile when things seem crazy. Praying that the Lord lead me to the right Doctor soon! jenn

Sunday, November 27, 2011

Thursday, November 24, 2011

Happy Thanksgiving!

Happy Thanksgiving, everyone!

This year, I am grateful for my own health and that of my children. I will be celebrating with my gigantic extended family (40 people...and those are only the local relatives!). I will be making stuffed mushrooms for the first time. I will probably try to avoid watching football, but may get sucked in anyway. I will try to put a larger portion turkey on my plate and a smaller helping of mashed potatoes. I will remember that everything that I have is from God, and holidays are no excuse to stop playing by the rules (particularly the ones about temperance. You know, the ones that tell you it really is unreasonable to have three slices of pie). I will do my best to teach my children about gratitude and to keep them from a love of material possessions, and maybe we'll all sing a song of thanks to our gracious Lord.

Thanks be to God!

Friday, November 18, 2011

Guest Contributor: Blood Sugar Management During Labor

Thanks again to Amy for sharing her stories with us over the last week!

One of our regular visitors commented that Amy's birth stories didn't include a lot of information about blood sugar management during delivery. In response, Amy had the following thoughts to share about her blood sugars during labor and birth.


I did want to say something about the comment that these don't seem like natural birth stories from a woman with type 1 diabetes just because I didn't mention my blood sugar in them. Beth was right in saying that when I wrote these it was just for friends and family and they either wouldn't care about what my blood sugar was and/or wouldn't even know what the numbers meant :) Also, my labors have all been extremely fast and there just wasn't time to check my blood sugar multiple times. Of course I don't think it is unimportant, but I honestly just don't have the time to do it. Plus, as Beth mentioned, for type 1's with good blood sugar control our births don't really look much different than "normal" anyway.

Thinking back to when I did check my blood sugar while in labor:

With #1 I know I checked once during labor at home (probably actually around 9-10 or so because I had eaten dinner and wanted to get an after meal check), it was around 100. I checked again before we left for the hospital and it was 86. I did not check any more after that since I arrived at the hospital fully dilated and my son was born about 45 minutes after we arrived.

With #2 I woke up and my water broke at 6am, I took a shower, finished packing my hospital bag and we were out the door by 6:35am. I checked my blood sugar before leaving and it was in the 150's, I didn't do anything about it because I was afraid of dropping too low if labor happened to bring it down low as well. We arrived at the hospital a little after 7am, put in a room around 7:10/7:15, and he was born at 7:25. There was simply no time to check my blood sugar again.

With #3 I remember checking it once while we were sitting around in triage (when I "wasn't really in labor") and it was in the 80's. Once I was actually in active labor- for a whole 27 minutes- there wasn't time to check my blood sugar, I was just concerned with pushing my baby out. Besides, I'm not exactly sure what the recommendation is for how often to check your blood sugar during labor, but even if it were hourly or every 30 minutes I wasn't even in labor for that long.

I always resume checking my blood sugar soon after the birth and it is always climbing in the 200's. I don't really know how to prevent that, it is difficult to maintain good control when there are so many hormones going crazy at the same time.

All that to say, YES these are natural birth stories of a type 1 diabetic! But I don't think my labors would be a very good example of what your blood sugar does during labor and how to manage it because I have extremely fast labors and there simply isn't time to track my blood sugar every hour throughout labor or to see what it is doing during different stages of labor (like early labor, hard labor, transition, pushing). All my stages of labor pretty much happen all at once. :)

Thursday, November 17, 2011

Guest Contributor: My Third Son's Birth

Over the next week, we welcome some posts from a guest contributor. Amy contacted me a few weeks ago to share her birth stories. She has Type I diabetes and three sons, all born vaginally and with minimal intervention. Her stories have been a real encouragement to us, and we hope you enjoy reading about her journey!

First of all, when we found out that we were expecting a baby at the end of March we always joked about the baby being born on my husband's birthday, April 2nd. Sharing birthdays is kind of a trademark of my family. I share a birthday with my dad and my brother. But we didn’t actually think that would happen! I was pretty sure he would be a March baby. According to my due dates my first son was born at 39 weeks 5 days and my second son was born at 37 weeks 6 days. I didn’t imagine that I would go past my due date this time.

What I did expect was to have several episodes of contractions before the actual birth, and my third son certainly didn’t disappoint in that regard. With my first son, I experienced four different episodes of contractions on different days within the two weeks leading up to his birth. With my second, I had 10 consecutive days of contractions, several hours every night. They are not Braxton-Hicks, mind you. They are regular, timeable, painful contractions of varying intensities. I’ve just resigned myself to the reality that this is how I labor.

On Sunday March 20th I had a few hours of contractions in the evening after the boys had gone to bed. Nothing really alarming about that, as I assumed I would have several days or even weeks of these, but it was exciting because I knew we were getting closer to the birth! From Monday through Wednesday of that week I had sporadic contractions.

On Thursday the 24th things changed. I thought something might be happening because these contractions lasted all throughout the day, about 10 minutes apart, and they were intense. I needed to focus on breathing through them and even get down on my hands and knees sometimes. I didn’t want my husband to go back to work, because I wanted him to stay with me. I needed him for support and I didn’t want him to have to drive back home from work if I truly was in labor. He was only be a few minutes away, but if you’ve never experienced a fast labor you have no idea how insane they can be. Sometimes you don’t even have a few minutes to spare.

Of course he did go back to work, my contractions continued, and I called our doula later that evening to see what she thought. I’m used to having bouts of contractions before the actual birth day, but I’ve never had them all throughout the day like this, so I thought perhaps this would turn into the real thing very soon. Amanda suggested that I take a shower and then lay down for about an hour, timing the contractions and noting any changes. Taking a shower would hopefully relax me enough to get everything going if it was for real, or to calm the contractions if it wasn’t. After my shower the contractions didn’t exactly go away, but they didn’t get closer together or more intense. When my husband got home we went to bed.

The next morning everything started up again. Contractions 10 minutes apart pretty much all day long, sometimes longer depending on what I was doing. This lasted for the next week. I will admit that I was miserable. My husband will admit that too, because he was home with me on vacation all week! I spent a lot of time emailing/texting/calling Amanda. We decided not to go to church on Sunday the 27th, partly because I felt terrible and partly because I didn’t want to kick into active labor while I was an hour away from my planned place of birth.

Late Monday night (March 28th), I felt like something was different. My contractions were different, sometimes they were closer together or sometimes very intense. I did not want to go to the hospital if it wasn’t the real thing, but we thought that we might as well go in and see what would happen. We called Amanda and met up at the hospital. I hadn’t had any exams up until this point. I always decline them late in pregnancy because honestly there really is no point to them and they can introduce bacteria to the area. The exam found that I was 4cm dilated, 90% effaced, and the baby was -2. That wasn't bad, but it didn’t mean I was in labor either.

I was on the monitors for a little while and then I was free to walk the halls or do whatever I wanted. We walked around the halls for awhile, contractions were sometimes every few minutes, sometimes much farther apart. My husband and Amanda helped me through every contraction and we all just enjoyed one another's company. I was in some pain and decided to take a shower to get relaxed and relieve some of my aches and pains. It had been a few hours after I got out of the shower so Laura came in to check me again and nothing had changed. It was a huge letdown. Reluctantly we packed up and headed home. It was really early on Tuesday morning and I didn’t sleep at all the rest of the night because my contractions and general discomfort kept me awake.

Tuesday, Wednesday and Thursday, I had the same contractions and pain. I did decide to go to the chiropractor twice. I thought that the baby might be a funky position, still head down but maybe positioned in a strange way. My regular chiropractor’s sister is also a chiropractor who is trained in the Webster technique (most often used to turn breech babies), so I went to her and had a few adjustments.

These 10 days wore me down and caused a lot of anxiety within me about how we would know when to go to the hospital or if we would even make it. I had also had a feeling all along that this baby was of a similar build to my second son, who weighed a large 8lbs. 14oz. at just shy of 38 weeks. Now I was 40 weeks, so this baby could be a pound or more heavier than that. That was making me nervous too. Even though I know of plenty of women who have given birth to larger babies vaginally with no problems (in fact, my second son's birth was easy), I sometimes still let the whole “big baby” scare tactics get to me. I know that fear and anxiety can inhibit labor so I tried to let go of the fears I had and also prayed for God to take them away and replace my thoughts with truth and peace. I’ll be honest, that didn’t really ever happen, because I was holding on too tight.

My due date, March 31, came and went. I was proud of myself for successfully avoiding an induction and standing up for myself to a doctor I barely knew. Most doctors would recommend induction at 38 weeks, but I made it clear that we would NOT agree to an induction unless there was something wrong with the baby or myself. Fortunately, there wasn't.

By now it was April - April Fool’s Day to be exact. The day started out like every day had throughout the past week. Contractions were 10 minutes apart for the most part. I sat around being a bum, complaining about my circumstances, while my husband pretty much ran the house and gracefully dealt with me :) In the afternoon my contractions started to get a little closer together, about 6-8 minutes apart. They still felt the same but we thought that we should really keep an eye on them. Later on in the evening they were about 4-5 minutes apart and I started to wonder if this could be it. Maybe I was actually going to have a more normal labor this time and this was my early labor!

I still wasn’t sure if we should go to the hospital or not, and after what happened earlier in the week I did not want to go back to the hospital unless I was REALLY sure. I wasn't convinced yet. But the thought didn’t leave my mind all day. Looking back I think it was God prompting me to go in to the hospital even though it seemed different than my other births. He knew we would actually need to be at the hospital right when active labor kicked in if we had any hope of actually birthing the baby there!

About 9:45pm we decided that we should go to the hospital. We called my husband’s dad to come over and stay at our house, and we called Amanda to meet us at the hospital. I was having consistent, intense contractions but it still felt strange to be driving to the hospital when I could still think straight and things really didn’t feel *that* bad. My husband called my mom to let her know that we thought this might be the real thing, and she began to six hour drive to meet us. He also called Amelia to ask her to pray for me. We called our doctor as well, but he was out of town as we thought he would be. He had told us to call anyway. I liked the doctor on call more than any of the other doctors in the practice, aside from my own, so I felt alright with our doctor being out of town.

We arrived at the hospital around 10:30pm, and Amanda was there waiting for us. We entered through the ER and then we escorted up to L&D. I can’t even explain how strange this all felt to me compared to my other births. This was downright weird! No urge to push, and no "can't-think-straight" or "can't-do-this-anymore" feeling at the hospital entrance. And I was a little excited, thinking that I would have at least progressed a little bit from earlier in the week and would truly be in labor this time.

The nurse examined me and found me to be exactly the same as earlier in the week. How could that even be possible?! I was so discouraged. I felt like maybe we had made the wrong decision about when to come in. As we all sat around in the room while I was on the monitors I expressed my discouragement and fears to my husband and Amanda. I was in so much pain, I was afraid we would be sent back home, and I didn’t think I could take this any longer. At one point I said, “I am in so much pain. You have to tell me I can do this!” I needed support and encouragement from my husband and Amanda and of course they did not disappoint. I can’t tell you how much it meant to even just have their encouraging words. Of course they did so much more as well. I can’t imagine birthing without them. I didn’t even know what to do, I was pretty distraught at this point.

We decided to walk the halls in hopes that my labor would progress. Sometime before midnight we started walking. I remember walking past the clock right at 12am and telling my husband, “Happy Birthday!" Maybe the baby and his father would share a birthday after all. I was still having contractions of course, every few minutes. They were bad and whenever one hit we stopped and I leaned against the wall. I swayed either side to side or back and forth while Amanda squeezed my hips together or put pressure on my back or whatever it is that she does that is seriously amazing.

[If you’ve read through all my birth stories and still haven’t considered finding a doula for your next birth (or recommending it to others), what are you waiting for?! A doula’s support is absolutely invaluable no matter what kind of birth you are planning.]

At 12:37am we went back to our room. I went to the bathroom and then sat in a chair and leaned over the bed during contractions. I was still struggling with the pain and my fears. Sometime around 1am the nurse came back to check me again. I tried to be optimistic, and hoped that I had progressed and we could all consider me "in labor." Thinking back on this, I realize how silly it was for me to be waiting for the nurse to declare that I was in labor based on a vaginal exam! I WAS in labor, whether a vaginal exam proved that or not, according to all other emotional and physical indicators. After the exam Laura said I was still (still….STILL!!) at 4cm, and everything was the same.

AAAAAAAAAAAAHHHHHHH!

OK, I didn’t really scream, but probably just because I was so despondent at this point. I was so overwhelmed. I had already been at the hospital longer than I had been first and second births combined, I was having contractions every few minutes, I was in pain, and I was confused at what was going on.

Having been our nurse earlier in the week, Laura knew my birth history and knew that we were a little nervous to go home in case we wouldn’t have enough time to get back. She told us that she could feel my bag of waters and thought that if my water broke then things would probably start progressing pretty quickly. She said we could stay at the hospital a few more hours if we wanted to. Maybe my water would break in that time, or things would otherwise progress, and we could talk to the doctor in the morning to see what she thought.

Laura left the room and we just sat around. I was so disappointed and confused about what to do. No one was pressuring us to do anything, so that was good. I just felt like I couldn’t take it any longer. I think one reason that I was in so much pain and feeling so terribly was because I was only thinking about my labor based on how far dilated I was. The mind/body connection is very strong, and what you think about something or how you perceive it can affect your pain level and how you feel physically.

With my first son, I never had any exam until I arrived at the hospital and I was fully dilated. With my second, because of the pre-term labor incident, I knew that I was at least 5cm dilated throughout the last four weeks of my pregnancy. When I got to the hospital I’m not even sure that they had to check to see how far dilated I was. They just looked and saw that he was coming! So I didn’t have any point of reference to think, “I’m 4cm right now, but that means that soon my labor will be over because I usually progress quickly from here” or anything like that. I thought, if I can’t even handle myself at 4cm then I’m certainly not going to be able to do this once I start progressing. I thought I had hours ahead of me - hours of much more intense contractions and pain. And those thoughts I had affected the way I felt things physically. As with my labor with my first , I should have paid more attention to my emotional sign posts. If I feel like I just can’t do it anymore then I am VERY close to the end no matter what anyone else is telling me or how far dilated I am! If I can’t even think straight, I am VERY close to the end. If I had realized those things then I think I would have handled everything better.

By then it was around 1:15am. We were sitting around discussing things and probably all praying that something would happen. I was lying in bed on my side because lying on my back was extremely uncomfortable during contractions.

At 1:20am, I had a contraction that was way different than the others. I was clenching the handrail of the bed, I couldn’t even get my thoughts together enough to remember to relax, and I weakly told them that I thought that contraction was different.

A few minutes later, BAM! another one and now I am quite sure that something has changed! I started crying and they encouraged me to get out of bed in order to handle everything better. Someone pushed the call button for the nurse. I tried to move over to the chair and sit down but then said that I did NOT want to sit down. Instead I just leaned onto the bed while standing. The nurse was not responding to the call button but I did not want either my husband or Amanda to go get her because I needed them with me.

I tried to relax and sway during contractions while Amanda applied pressure to my back and my husband was right there next to me. I felt like I couldn’t do it (and that thought completely freaked me out since I was only 4cm dilated), but my husband kept telling me that I was doing great. With the few contractions I had while leaning on the bed I felt just the slightest urge to push at the peak of them, which also freaked me out because I was only 4cm and thought that couldn’t possibly be right. So I didn’t say anything about that at the time. I reluctantly let my husband run to get the nurse while Amanda stayed with me.

Laura came in around 1:35am and didn’t hesitate to examine me while I was standing up. I told her there was no way I was getting back into the bed, and some nurses won’t do that, but Laura was great! She said I was 5-6cm with a bulging bag of waters. On the one hand that was good since it meant that things were progressing (not that we didn’t realize that already), but on the other hand I thought, “5-6cm, you have got to be kidding me. I really cannot do this for much longer, let alone HOURS." I was still mistakenly thinking that I had hours to go based on the faulty idea that all women dilate 1cm per hour. At some point I think I tried to breathlessly say between the contractions that I felt like I needed to push. We quickly got ready to move to a birthing room and Laura went to call the doctor.

We moved to the birthing room around 1:40am. The bed was still raised pretty high and I begged them to lower it as quickly as possible because I knew I needed to get up onto that bed immediately. Another contraction would be coming soon and I needed something to lean on. I climbed up onto the bed and knelt down leaning myself up against the head of the bed, which was raised.

I was moaning and saying I needed to push, but of course the nurses did not want me pushing until the doctor arrived. Everyone tried to encourage me to breathe lightly through my contractions but there is just no way to do that when your body is pushing the baby out anyway. Amanda calmly told me to just do my best and that I was doing a good job. They asked me if I wanted antibiotics (I was GBS+ this time) and I declined. I had planned to decline anyway, and I knew they wouldn’t have had time to get them in me even if I had wanted them! They asked me if they could put in an IV and I said no. Hello! Can you not see that I am about to push a baby out here? There is no time for that! I told them that I could not hold back from pushing, whether they were prepared or not.

I pushed a few times? I’m not exactly sure how long it lasted, but it couldn’t have been long since he was born seven minutes after we got to the birthing room. At 1:47am our son was born. The nurses caught him and his waters broke as he came out. Since his waters broke when his head came out, it took me a second to realize that his head was actually out. I thought it might have just been the waters breaking. His body did not come out right away on the same contraction as his head did, most likely due to the fact that one of his arms had come out with his head. The nurses were very concerned about that and wanted me to turn over so that they could “help” get him out. I did not want to turn over onto my back, but when I heard them say he was “stuck,” I immediately thought they meant his shoulders were stuck (which is a very serious situation!) so I turned over. His shoulders were not stuck and I think the rest of his body would have come without their help within the next contraction or two, but they were not willing to wait and I wasn’t in the right mind to be able to argue with them. We talked with my doctor about this later, and he agreed that the shoulders were not stuck.

My baby was handed to me and I held him on my chest. I was relieved that he was here, yet stunned after what I had just been through. It’s hard to explain, but I felt like something happened *to* me as opposed to me being an active participant in my labor and birth. It was terrifying! Not because of the pain, but because of the quickness and my own mental state at that point. I was paying too close attention to my dilation as opposed to other labor markers. I immediately thought, “I am NEVER doing this again, that was ridiculous!” I seriously felt like I was in shock, it was so incredibly crazy.

But now that I am three months out from the birth I think the emotions I had at the time have died down a bit. I think it’s true when people say that you don’t remember the pain after it is all said and done. Besides, it is up to God whether we have more children anyway. Most likely we will, and I will be glad to go through it all again if that is the case (although I certainly won't complain if my next labor happens to be just a little bit more “normal”).

My husband and I both thought that he looked exactly like our second son, and in fact for the first week of his life I think I called him by our second son's name more often than not! When he was first born he was bluish, but nothing to be very concerned about as he pinked up quickly while I held him. After a few minutes he started turning blue again so they decided to cut the umbilical cord. It was much sooner than we wanted it to be cut. They took him over to the warmer, where my husband tells me that he pinked back up right away.

Soon after this the nurses weighed him. We all discussed how much we thought he weighed and we all (even the nurses) guessed somewhere around 8 ½ pounds from just looking at him. Then one of the nurses picked him up to carry him to the scale and she said she thought he must weigh more because he felt heavy. We were shocked when he weighed 9lbs. 11.6oz! I knew he was going to have our second son's build :) I was glad that I chose to decline the growth ultrasounds in my third trimester because if they had thought that he would be larger than normal I am sure it could have been used as another “reason” that I needed to be induced. But it’s amazing what our bodies are capable of when we let them do what God designed them to do, unhindered by unnecessary interventions and negative (and untrue) thoughts such as “this baby is going to be too big to deliver." His birth was not difficult at all and recovery was easy (aside from the afterbirth pains - those are seriously killer!).

My son began nursing and the doctor arrived around 2:10am. The doctor was there for the delivery of the placenta and to put in some stitches. It doesn’t seem to matter what I do, or how big or small the baby is, I always tear.

So we’re now 2 for 3 on the nurses catching our babies. Although I do hope that our doctor will actually be there next time! Our first son’s birth was the only one he was there for and it was the least hectic. The baby's blood sugar was checked at 2:45am and it was 67, which is just right for a newborn! Around 3:45am Amanda left and we got ready to move to our postpartum room.

So, was my third birth as quick as my others? Well it all depends on how long you consider me to have been in labor:

Do I count from when I started having regular contractions? Then that would be over a week.
Do I count from when my contractions seemed to be getting closer together? Then that would be around 12 hours, even though I didn’t progress dilation wise for 11 ½ hours of that.
Do I count from when I went into active labor? Then that would be 27 minutes.

So I just say it was long and short.

April 2nd will always be a special day in our home and I’m expecting a great gift on my next birthday since I've set the bar pretty high.

Wednesday, November 16, 2011

Guest Contributor: Baby's Low Blood Sugar

Over the next week, we welcome some posts from a guest contributor. Amy contacted me a few weeks ago to share her birth stories. She has Type I diabetes and three sons, all born vaginally and with minimal intervention. Her stories have been a real encouragement to us, and we hope you enjoy reading about her journey!

About one hour after my second son was born (you can read his birth story here), his blood sugar was checked and it was 22, which is quite low. It should be above 40 to be considered normal for infants. I had been nursing him off and on, but when it was checked again it was down to 16. His body temperature was also not registering on the thermometer. It was quite low as well. We tried lots of skin-to-skin contact and covering ourselves with warm blankets. We hoped to bring his temperature up just by doing that, but we also needed to give him something for his blood sugar.

The nurse offered for us to use either sugar water or formula, and we chose the sugar water. We really did not want him having any formula at all. Then she said he really needed to have the formula since the sugar water would not keep his blood sugar up. This situation started to become really frustrating. We had not adequately prepared ourselves for something like this. It was frustrating to have choices offered to us that suddenly became unavailable after we chose them.

Amanda suggested that we give him formula through a dropper instead of a bottle since we didn't want him to have any nipple confusion. I am so glad she was still there because I would not have thought of that in the moment! For a little while we tried to give him the formula through a dropper while I was holding him. He was not taking it very well. We were told that if his blood sugar did not go up after having the formula, he would have to be have an IV put in. We wanted to avoid that, so I am sure we were all quietly praying that his blood sugar would go up.

We started giving the formula a little before 10am. Eventually my husband and Amanda took our baby over to the warmer and helped him take in more formula over there. He had about one ounce by 10:34am. At 10:37am his blood sugar was rechecked and it was 34. We all breathed a sigh of relief and thought it was great to see that his blood sugar was on the way up!

Even though his blood sugar was going up (which was the only requirement we thought there was) we were told he still needed to have an IV. What?! Why did they even offer the formula? My husband went with our baby to the nursery and Amanda stayed with me. I was talking with her about how upsetting this all was to me and how I didn't understand why he still needed an IV since his blood sugar was obviously going up. I knew it would most likely continue to go up since it was checked right after he finished the one ounce of formula . Your blood sugar does not even peak until 1-2 hours after eating. She thought maybe we could call my husband and have him ask the doctor if they could check his blood sugar once more before inserting the IV to see if it had gone up anymore. Perhaps he wouldn't need an IV after all.

I called my husband, but the doctor said it didn't matter if his blood sugar had gone up since we last checked it. He would be getting the IV no matter what. It was really frustrating to me because if he was going to need an IV anyway, then why didn't they just tell us that in the first place? It would have made it a lot easier to accept and I probably would have asked to just skip over giving him the formula (which I never wanted to give in the first place) since an IV would bring his blood sugar up anyway. I started to get all emotional. First, my son had been born into a room of people who were all shouting and frantic (I would have liked a more peaceful birth), he had already been poked several times for blood sugar checks and had blood drawn once (to check his blood sugar in a different way), and now was having an IV inserted into his tiny little body. It was too much to think about at the time. I am sure my hormones were all whacky from just giving birth anyway. I know that many other parents have had to deal with situations much more serious with their little babies, so it might sound silly to get all worked up over this, but it's just what I felt at the time. It didn't help that one of the nurses said, “he could die from this!” as if I didn't care about the life of my baby just because I was asking questions about what was happening.

A nurse or nurse's aide came back into my room and asked if I was ready to get up, use the bathroom, and then go to the nursery to be with my son. I told her no. I was still trying to process everything. A little while later I told Amanda I was finally ready for those things. One of the best things about our hospital is that because it is small, they let us stay in the nursery the entire time our baby was in there. I held him and nursed him and we all touched him and talked to him. He didn't have to lie there by himself without his family around. Amanda stayed with us for a while, and at some point we went to my postpartum room so that I could eat breakfast.

I know I've said it before, but I am so glad that we had Amanda to be our doula and that she stayed there with us for several hours after our baby was born. We never had to decide if my husband should stay with the baby or go with me because Amanda was there to stay with me. She provided support and a listening ear and advice when it was hard for us to think straight. I highly recommend having a doula for your birth, because I know we would have been a lot more stressed out had she not been there.

Our son's blood sugar was stabilized but his temperature was still so low that he had to stay in the nursery for several hours. He was there until the mid-afternoon. Eventually my husband's mom came to stay with us and Amanda went home. Once our son's temperature was stabilized, we all went to our postpartum room and the baby was allowed to room-in with us the entire time. That was a real blessing since he still had his IV in and I am sure some hospitals would want an infant with an IV to stay in the nursery.

My husband didn't seem to want to hold our son very much during his first day and I wondered what was wrong. He told me later that he was nervous because of the IV and didn't want to mess anything up. But from that afternoon on everything was just fine, our son's IV was removed the next morning, and we were even able to go home that night.

Tuesday, November 15, 2011

Guest Contributor: My Second Son's Birth

Over the next week, we welcome some posts from a guest contributor. Amy contacted me a few weeks ago to share her birth stories. She has Type I diabetes and three sons, all born vaginally and with minimal intervention. Her stories have been a real encouragement to us, and we hope you enjoy reading about her journey!

This birth story really begins with my "premature labor" and hospital stay. I came home on October 9th, at 35 1/2 weeks.

On the evening of October 14th, I had a few hours of contractions, but of course they didn't go anywhere. My mom and brother came to town for my son's birthday party and the night of October 15th, I remember telling my mom before she went to bed that she shouldn't be surprised if we left for the hospital in the middle of the night to have the baby. I wondered every night if this was “it,” but they always stopped and didn't seem to follow a consistent pattern when they were happening. If my husband was at home I wanted him to be with me during the contractions. I don't even remember what I did for the nights he was at work. I have contraction timings scrawled down on the bottom of my daily planning notebook so I guess I must have kept myself occupied doing that! I was beginning to wonder when this baby would arrive and what kind of cervical changes these contractions were causing. We began to pray that God would give us a definite sign when I was in “real” labor so that we would be able to make it to the hospital on time. The hospital we use is 30 minutes away, so I was concerned that we would not be able to make it there.

This continued almost every single night up until October 24th. I don't know what exactly to consider these contractions. I don't think they were Braxton-Hicks, because they were not painless. They were real and painful. I figured that the same thing was going to happen as it did with my first son: several nights of contractions followed by a quick labor and birth. The nurses at the hospital told me to rush to the hospital the moment my contractions started back up again. They expected the baby would be born any minute. In light of the end of this story, that's pretty ironic! Apparently that's just not how my body works.

It didn't take long for me to get really fed up with these nightly contractions. I told our doctor at my 37 week appointment that I did not want to be induced, but I didn't know how much longer I could handle this. On top of all the contractions, I felt horrible and got exhausted easily. I had no energy, probably at least in part due to sitting around the hospital for so long and not engaging in my normal activity levels. I had also decided that the baby had to be really long because I could not get comfortable AT ALL. He was either up in my rib cage or pressing on my pelvic bones or really doing both at the same time and I felt like I couldn't even sit down. On October 22nd I went in for a non stress test. Thankfully, our doctor was on call that night and told the nurse to send me home even though I was having contractions during the test. When I was on my way out of the hospital I stopped to chat with the lady at the front desk and she asked when I was due. I told her I was due in about 2 weeks and she said, “it looks like the baby hasn't even dropped yet." Gee, thanks, actually the baby HAS dropped already, and now I know that my perceived hugeness is not just a figment of my imagination.

On October 24th my son and I ran to the grocery store to pick up a few things and I immediately regretted it. It took every ounce of strength I had to walk around the store. After I put my son to bed my contractions started up again and I felt like I could really not deal with this for much longer. I felt horrible and it was hard to deal with the contractions. My husband was at work. I thought about emailing or calling Amanda to ask her to pray for my stamina, but I didn't even have the strength to do that. When my husband got home I took a warm bath, my contractions let up, and I was finally able to get comfortable enough to fall asleep around 2am.

The next morning I woke up a few minutes after 6am to use the bathroom and while I was walking to the bathroom my water broke. It wasn't a lot, since the baby was so well engaged already, so I was unsure. Once I decided that this really was my water breaking, I called out to my husband from the bathroom and he immediately called his parents to come over and watch our son. I also called my mom to let her know what was going on.

I called Amanda to discuss our options. I was not having any contractions yet. We had planned a few weeks ago for Amanda to just meet us at the hospital this time, as opposed to our house, but I didn't really want to go in yet since nothing else was happening. I know it sounds funny with how fast things usually go for me in the end, but I am always nervous about getting to the hospital too soon. I do not want to be there any longer than I have to. I would prefer to arrive already well-advanced and in hard labor. She told me that my contractions would probably start once I was able to relax and I did want to take a shower before going in.

I decided to call my doctor to see what he thought. When I told him that my water broke he said, “Great! Now I have something to look forward to today!” Have I mentioned how much I really like my doctor and how grateful I am that we found him?! He said that medically and legally he had to tell me to come in right away, but really I could do whatever I wanted to. He also mentioned that he was actually on call that day so we would not need to call him when we decided to go.

When I got off the phone with the doctor, my husband and I discussed what we should do. He really wanted to get on our way to the hospital even if I wasn't having contractions yet since once they started it would probably all happen pretty fast. But I did convince him to let me take a shower first. So I showered and he put some last minute things into our hospital bag. We also got our son up since we heard him moving around even though it was earlier than than his normal waking time. Because of a hospital policy that had just been put into place a few days before (something about swine flu), he would not be able to come visit us at the hospital so it was nice to see him before we left.

At 6:25, my husband called Amanda again to let her know we were leaving soon for the hospital. By this time my contractions had started and we were loading up the car. I briefly considered grabbing something to eat but I started to feel sick so decided against it. The first few contractions were probably a couple of minutes apart, but they were quite intense and I could barely talk or walk or think through them. We got into the car and left for the hospital. This time we had two car seats in the back, so I had to sit in the front seat.

A few minutes after we left our house (6:38) I called a friend from church to let her know that I was in labor and to ask for prayer from her and the other ladies at our church. I had to hang up with her suddenly because I felt a contraction coming on. The rest of the ride to the hospital was absolutely horrible! My contractions were very close together, I'm guessing probably 2 minutes apart and lasting for around 90 seconds so I felt like I hardly had any break in between them. It is so hard when your labor starts and you are suddenly in transition! I can't think clearly, I can't relax...I don't even know how to describe it. Looking back on a short labor I can think, “wasn't it nice to have a short labor?”, but in the midst of it, it's terrifying. A short labor doesn't mean it was easy or less painful, it just means it was short.

Anyway, we're on our way to the hospital and I am wishing to be basically anywhere other than buckled into a car. I had been planning on having a natural birth anyway, but just sitting there in a car is certainly not the ideal place to be dealing with contractions. I wanted to move and try different positions to see what was most comfortable, but I couldn't. I knew that I was in transition at this point. I kept telling my husband that I could not do this, it was so painful and I was scared. He is always so very calm and just kept reassuring me that I could do it – that I WAS doing it. I really don't know anyone else who could be so calm and encouraging when in this same situation, and he's dealt with it twice! I asked him to turn the radio on at some point, thinking that might help me to focus on something else. But I think I mostly just kept asking him to drive faster.

We made it to the hospital a little after 7am and had to use the ER entrance. A contraction started right when we walked in the door so I dropped to the floor on all fours to attempt to deal with it and my husband went to get a wheelchair. A woman arrived with the wheelchair and then proceeded to give me the slowest ride EVER up to the 4th floor. I’m guessing that she just didn’t want to jostle me around too much, but I was about ready to jump out of the wheelchair in between contractions and run up to labor and delivery myself! It was really ridiculous. Even my husband thought so. It was so difficult to just sit still and by this time I was feeling a lot of pressure and knew that I was probably fully dilated or somewhere close.

When we got up to labor and delivery a nurse was getting a bed ready for me in the room where they take women to monitor them and determine if they are really in labor. I figured they probably didn't want a baby to actually be born in there so I said something to the effect of “No, I need to be in a real labor room, I am really in labor. My water broke, and I think the baby is coming soon." The one nurse flashed a questioning look to the other nurse who was there and they reluctantly took us to a birthing room. I climbed up into the bed, which was upright, and was on my knees, basically kneeling, and started to undress. I was SO relieved to not have to be sitting down.

The nurses were slowly getting things ready, trying to register me in the system, trying to monitor the baby’s heart rate, and so forth. This was about 7:10/7:15ish. I definitely needed to push now and I kept saying that, but the nurses just told me not to. I don't believe they had called our doctor yet and they had not checked to see how far dilated I was. I was getting really nervous because I could not hold back from pushing. Finally a nurse decided to check me.

I wish someone had recorded the mad scramble that ensued when she found that I was fully dilated. An ER doctor was called up, the nurses continued to tell me to stop pushing and I continued to tell them that I COULD NOT stop. I managed to hold back for maybe one contraction but I just had to push, so I did. Well it didn’t take them long to realize that I was not going to be able to stop pushing so then they began to try and get me to assume the “normal” pushing position of laying down with your feet in stirrups. I did not want to do that because 1) I knew how uncomfortable I would be, 2) even though this position is very commonly used in hospital, it is pretty much the worst position to birth a baby in (you're not even working with gravity!), and 3) being upright is a much better position since it would allow my body to open up even more to let the baby pass through. My husband argued with them for a minute or two, all in vain. I wish Amanda or our doctor (or really BOTH of them!) had been there. I know my doctor would have been fine with me pushing in any position I felt comfortable in.

But the nurses were extremely insistent and were practically yelling about it and saying “what if the baby gets stuck," which is a ridiculous thing to even say since there wasn't any indication that the baby was at risk for getting “stuck." Besides, being in an upright position actually opens up your pelvis MORE than if you are just laying there, which means that would actually allow more room for a baby to come through, lowering the chances of the baby getting stuck...but I digress. I finally had enough of people yelling at me about when to push/not to push/what position to get into that I just told my husband: “It's ok, I'll just do what they're asking. Everyone is acting like they don't know what they're doing and that's making me really nervous." I regret giving in and wish I had continued how I was.

In the midst of turning myself around another contraction began and I pushed the baby's head out before I could even get into their preferred position. I felt so relieved after his head was out that I wasn't even thinking about how I needed to push the rest of him out as well- cue the shouting from the nurses to PUSH!- but a few more pushes and out he came. I asked what time it was because I was pretty sure that no one was paying attention to that. The birth certificate does have the wrong time of birth on it. It was 7:25am. Since of course no one had any time to read our birth plan, I might have been a little snappy when asking them to please NOT clamp and cut the cord and to just let it go until it stopped pulsing.

We had already chosen a name for this guy, or rather, we felt that God had given us a name for him. He was handed to me right away, we covered up with lots of blankets, and I tried to nurse him. I was surprised that he had dark hair since I assumed he would look more like our first son did, with the red hair and dark blue eyes. His whole face was purple and bruised from coming out so quickly! Our doctor arrived a few minutes later, and at 7:32 my husband called Amanda to tell her that our son had been born. She was only just walking into labor and delivery area! A little while after that I pushed out the placenta and was inspected for any tearing. I only had some superficial tearing this time, which I attribute, at least in part, to the fact that I was trying to turn over when he came out. It was MUCH easier to recover from than the tear I had with my first, and I only needed a few stitches.

I had been holding our newborn son all this time and at that point I still figured that he would weigh less than my first son did, since he was born at 38 weeks and our first son was born a few days before his due date. I about fell off the bed when he was taken to be weighed and measured and he was 8 pounds 14 ounces and 22 inches long! He was actually quite proportional. You can tell he's just meant to be a big boy. His weight and length have always been off the charts. But I really could not believe it. Our doctor joked, “I guess we didn't have to worry about growth restriction with this guy!”

Our second son certainly has an interesting story and we want to thank everyone again who prayed for us and helped us in any way during our rough time with me in the hospital and throughout my entire pregnancy. Just like with our first, we saw God working in many ways and answering the many prayers that were prayed by us and you for our entire family.

Monday, November 14, 2011

Guest Contributor: Pre-Term Labor

Over the next week, we welcome some posts from a guest contributor. Amy contacted me a few weeks ago to share her birth stories. She has Type I diabetes and three sons, all born vaginally and with minimal intervention. Her stories have been a real encouragement to us, and we hope you enjoy reading about her journey!

We had an interesting journey with our second son and we are so thankful for everyone who was a part of his story: the friends who brought us food while I was in the hospital on bed rest, who prayed for us, visited me, talked with me about preterm birth and premature babies, encouraged us, kept others updated on our situation, my in-laws who took care of our toddler when I couldn't be there, the people who helped us move to a new home, and our doula who really went above and beyond. The list is pretty much endless.

I suppose our son's birth story starts back in September. Beginning at 32 weeks I had to go to the hospital twice a week for a non stress test, standard testing for Type I diabetics. These tests monitor the baby's heartbeat and the mother's contractions. This could take anywhere from 20 minutes if the baby is active or hours if the baby happens to be sleeping. I had my first test on September 14th and all was well. Then on September 17th I went in for my test in the afternoon. I was hoping to be done quickly since we were leaving the weekend as soon as my husband got home from work. The baby looked great, but the nurse was concerned because the monitors were picking up regular contractions. I wasn’t really worried since I couldn’t feel them, but the doctor who was on call insisted that she do an exam to see if I was dilated. I didn’t think it was necessary but complied anyway. I was not dilated, so I went home.

Fast forward to September 28th. That night I was scheduled to go in for another NST. I put my older son to bed and was getting ready to head out the door around 7pm. I told my husband that I wanted him to go with me, because he always came with me whenever he could when I was pregnant with our first son. We knew his parents would have come over while our son was sleeping, but we just decided I would go ahead and go on my own. It wouldn’t take too long and then I’d be back home. As I was walking out the door my husband said, “call me if you’re having the baby." He is NEVER allowed to joke about that ever again.

I arrived at the hospital and found that a nurse I knew from my first pregnancy, Megan, was going to be taking care of me during my test. She usually works in the day (she said it’s terrible that I know what nurses work what shifts, I’ve been there so many times over the past year!), but she had been called in to work that night. Usually I am the only one being monitored when I am there because it’s a small hospital, but that night there was another woman being monitored as well. She was 26 weeks pregnant and had had a pretty hard fall so they were just checking up on the baby and making sure that her water was not broken or leaking. She had a friend with her whose daughter was born at 31 weeks due to placental abruption and followed by a life-saving emergency c-section, so the conversation revolved around their families and premature babies.

Everything seemed to be going fine with my test. After two pregnancies, I know exactly what they are looking for so I always turn the computer towards me try to guess when I’ll be done. It may sound kind of silly, but there really isn’t anything else interesting to do! I think it was somewhere around 8:30pm and Megan came in to tell me that the baby looked wonderful, but I was having regular contractions. She wondered if I could feel them. I couldn’t. She told me that the doctor on call wanted her to check to see if I was dilating, then monitor me for an hour and check again. If everything was fine, I would be allowed to go home. I complained to Megan that I did not want to be checked. Didn’t I just go through this a few weeks ago? I didn’t want to be a difficult patient, but vaginal exams carry the risk of introducing bacteria and accidentally breaking the bag of waters, so I did not want any done unless it was absolutely necessary.

She went back to discuss it with the doctor and came back to tell me that the doctor was really insisting that she check me at least once. Megan told me that sometimes with pre-term labor you can’t feel the contractions but you may still be dilating. They just wanted to be certain I was not dilating before they sent me home, so I decided to let her check me. She said I was at least 4cm dilated but she was trying to be very careful not to disrupt my bag of waters (which I appreciated), so she wasn't sure how accurate that was. She called in another nurse to confirm my dilation, and the second nurse agreed. They also said that my bag of waters was bulging out.

I called my husband again to let him know what was going on and he called his parents to come over immediately. He also pulled up our church directory on the computer and started calling people in alphabetical order until someone answered. He finally got a hold of one friend, and she let everyone at our church know what was going on. They prayed for us, and continued to keep everyone updated throughout my time spent in the hospital. She also called and emailed me frequently to check up on me. I really appreciated that.

From here everything is kind of a blur, so I'm not sure if it will all come out in the right order or not.

I was told that I needed to undress and put a gown on. That was difficult, because they also instructed me not to get up. I was just in shock, lying there on the bed, and a friend of the patient being monitored next to me peeked around the curtain to ask if she could help me. I gladly accepted her offer. She helped me into my gown and also went to get a bag to put all of my clothes and other things in to make sure they would go wherever I went. She told me about her daughter born at 31 weeks and encouraged me that everything was going to be alright. My nurses came back in and hooked me up to an IV of magnesium to stop contractions and put in a catheter. They also gave me a steroid shot for the baby’s lungs, which I have since found out have not even been proven to help a baby (at 34 weeks). This was around 9pm.

The doctor arrived to check me as well and she thought that I was 5 or 6cm dilated, and by this time I could feel the contractions. She told me I would have to be transferred to a different hospital because I needed to be somewhere that had a NICU. My hospital did not have one and could not care for babies born at 34 weeks. If the baby was born at this hospital, he would have to be transferred to Children's and we would be separated. They felt that everything was progressing so rapidly that they considered med-flighting me to another hospital by helicopter, which is funny to think of now. It was too windy for a helicopter ride, so we waited for an ambulance. They also ordered an ultrasound to confirm that the baby was head down, and we are SO thankful that he was.

Everyone was acting like the baby would be born that night and I don’t even know what I was thinking. It’s hard to think straight when everything is happening so quickly, I was extremely stressed out, and very uncomfortable from just lying there on my back hooked up to everything, and having multiple vaginal exams. I had been calling my husband every few minutes to let him know what was going on. His parents had arrived at our house and we were trying to decide whether he should come out to where I was (30 minute drive) or just head over to the hospital where I was being transferred (about 10/15 minute drive). The ambulance had not even arrived to pick me up yet, so he and his mom decided to drive to me.

I just lay in bed waiting for the ambulance and feeling terrible. The magnesium made me feel like I was burning up inside and I was starting to get nauseated. I was also extremely uncomfortable because I had been laying flat on my back this whole time. I have no idea how often I was having contractions, but they were very bearable. I just closed my eyes, breathed deeply, and tried to relax and not think about having a premature baby who I would have to leave at the hospital once I was able to go home. I would also not be under the care of my doctor anymore, who is frankly the only doctor in the area that we trust. We go to see him even though he is 30 minutes away.

The ambulance transfer team arrived and the doctor checked me one more time to be sure I was not close to delivering, since they did not want to risk that happening in the ambulance. I was still 5 or 6cm dilated and fully effaced. My husband and his mom also arrived about this time but I only got to see them for a minute. They were not allowed to go in the ambulance with me so they just drove to the other hospital themselves. They got a speeding ticket on the way!

When I got outside to get in the ambulance the cold air felt SO good since I had been burning up before. The ambulance ride was really uncomfortable because I was still lying flat on my back. My back was killing me, and that is also not really the best position to be in while dealing with contractions, which I was still having. I can’t say this for sure, but I am fairly certain that the magnesium was not hooked up to me or going at all during the ambulance ride because I did not feel like I was burning up inside anymore, but as soon as we arrived and I was hooked up to everything at the new hospital, I began to feel that burning sensation again. It is really a horrible medication to take.

I think we arrived sometime around 11pm. The transfer team wasn’t sure where to take me so we had to stand around in the ER for a little bit. Quite an emergency, huh? I was finally taken to a room in labor and delivery and met my nurse, Audrey. My husband wasn’t there yet and I did not like being there alone. The nurse began the registration process, and I was still having contractions regularly, though they were not that intense. They were nothing like what I experienced when I was in labor with my first son. I don’t think the magnesium was doing anything at all to stop or slow them.

A resident doctor came in to see me and got set up to do another ultrasound to make sure the baby's head was down. I told her that I already had an ultrasound and they confirmed the baby was head down, but she didn’t seem to care and went right ahead. I am really not comfortable with having that many ultrasounds, but when everything is happening in such frenzy it’s hard to make your desires heard. My mother-in-law left the room for the ultrasound. My husband and I knew the sex, but we were keeping it a secret from everyone else. It ended up that it didn’t really matter since 3 different people came into our room over the course of the night saying, “so I hear you’re having another boy!” I would always say, “It’s a surprise,” but it was kind of hard to act like that many people were mistaken! So my mother-in-law did unintentionally find out that we were having a boy.

For the next 2-ish hours I just lay in bed, completely uncomfortable, attached to monitors and an IV. No one really seemed to be very concerned about me. I guess they were just waiting for my contractions to stop. At some point I thought that we should call our doula, Amanda, to let her know what was going on, because I knew she would at least pray for us. She wasn't even on call for us yet since I was only 34 weeks, but she answered that 1am phone call anyway. While my husband was discussing things with her, the doctor came back in to see if we would be okay with just stopping all the medication and letting labor progress to have the baby. It had become obvious at that point that the medication they were giving me was not stopping my contractions at all. We agreed to that and Amanda also agreed to come be with us at the hospital.

Amanda arrived at 1:25am and for a few more hours she and my husband helped me through the contractions and we talked about the events of the evening. My contractions really weren't that bad, and I don't think they ever really increased in intensity or frequency. But I was so uncomfortable from having to lay flat in bed for so long, and I felt really sick from the magnesium.

I threw up a few times between 3:30 and 4:30am, and I thought maybe that meant I was in transition or nearing the time to push. I asked to be checked again, but everything was the same: 6cm dilated, fully effaced, baby at zero station. There had been no changes even though I had been contracting for hours by this point. I was able to sit up and move around the bed more since they weren't trying to stop my labor anymore. That felt good.

By early morning (maybe 5am?) my contractions had completely died down. Amanda continued to stay with us until the high-risk doctor came to see me late that morning. We showed her pictures of our first son. I think we all tried to sleep a little bit. My husband's mom stayed with us throughout the night as well. The doctor arrived around 9:50am to discuss what was going on. He said he expected the baby to come in the next day or two, so I would not be allowed to leave. I was allowed to eat, for which I was grateful. Amanda then left at 10:30am. We kept in touch with her through phone calls and email, and she also came to check in on me a few more times.

My son came to visit me that afternoon and my heart just about shattered into a million pieces when he acted like he didn't know who I was and didn't really want me to hold him. I understand he must have been really confused and I probably didn't really look like myself anyway, but still, it was awful. I had never been away from him overnight before and I hadn't even had any time to prepare for this excursion.

For two days I stayed in an L&D room, waiting for something to happen, which it never did. I still had an IV in which ran antibiotics into me every 4 hours. It was SO painful! Everyone was expecting me to just go into labor any second and my GBS status was unknown. I had to get a new IV the next day since my IV had been originally put in at a different hospital. I know, I don't get that either. I convinced them to take out my catheter and let me go to the bathroom on my own (and shower!). Once I was moved to a different room I pleaded with the nurse to take out my IV, which she did. I was also allowed to wear regular clothes so I had a little bit of a sense of normalcy. My son came to visit me every afternoon. My husband's parents took care of him while my husband was at work and overnight. My husband stayed with me through the night at the hospital. I saw a high-risk doctor every morning where I basically got the runaround about how long I would have to stay at the hospital. It ranged from until 36 weeks to until the baby's born to “well, if you're still here at 38 weeks we can just do an amniocentesis and then induce you" (um, no thank you!). My husband and I decided I would leave at 36 weeks, against medical advice if we had to.

I'll spare you all the other boring details about my hospital stay, but fortunately we didn't even have to leave AMA because one of the high-risk doctors decided to let me go home on October 9th. I was 35 weeks and 4 days. I don't know why he finally decided that. Maybe it was because I begged every day to be able to go home or because he got fed up with me not doing what he wanted me to. For whatever reason I was discharged and I was SO happy! I was 5cm dilated upon discharge, according to the OB resident who checked me.

I couldn't wait to get home to my family and to a new home. We had moved to a new house a few days after I was admitted to the hospital! I was so glad to see my son, and when he went down for his nap I wasted no time in cleaning the kitchen. Ah, now I felt like I was back to real life! That night a family from church came down to visit with us and bring us dinner, and it was the most delicious meal I had eaten in so long. We spent the next few weeks getting the house in good order for a new baby to arrive.

Friday, November 11, 2011

Guest Contributor: My First Son's Birth

Over the next week, we welcome some posts from a guest contributor. Amy contacted me a few weeks ago to share her birth stories. She has Type I diabetes and three sons, all born vaginally and with minimal intervention. Her stories have been a real encouragement to us, and we hope you enjoy reading about her journey!

This being my first pregnancy, I spent a long time choosing the right doctor. You can read about that adventure here.

By now it is late September and everything seems to be in place. We attended our weekly Bradley classes, and had a few home visits with Amanda, our doula. We continued to have appointments with our doctor, and by this time we were driving to the hospital twice each week for non-stress tests. The tests always showed that our baby was healthy and wonderful.

When I was 37 weeks pregnant an ultrasound showed that our little baby was posterior (facing my belly instead of facing my back), and we knew that was not the ideal position for a baby to be in for birth. We didn’t think much of it, but I did try doing some exercises to encourage the baby to turn around. As it got closer to my due date of October 22nd, our doctor started to give us the option of inducing me early, which is standard procedure for diabetic women. He never pressured us to do this and we always politely declined. We believe that it is best for babies to come when they are ready, not to mention the many risks that come with induction. We thought that being induced could really lower the chance of having the natural childbirth that we knew was best for me and our baby under normal circumstances. Besides, there was no medical indication for an induction (I do not believe that simply having diabetes qualifies as a medical indication for induction). The baby and I were both doing well. Now we were all just in a waiting game!

On the evening of Sunday, October 5th, I began to have contractions that were 3 minutes apart and painful. Almost everyone had told us that with first time mothers, the first contractions usually mean the real thing so I was excited, yet nervous, and kind of confused. I kept thinking, “is this really a contraction?” I thought I would feel a tightening around my entire belly, but the sensation I was feeling was only in my lower abdomen, similar to the monthly cramping I was used to. All I could think about was that I did not want the baby to be born the next day (October 6th) because that was our wedding anniversary! My husband was sleeping and would have to be up for work very early, so I tried not to bother him. I wondered if I should call our doula, but I decided instead to try some of the things we learned in our Bradley classes to determine if I was experiencing was real labor. I drank a glass of water and I walked around our house. They had gone on for four hours, but they eventually stopped. I told our doctor about it the next day and at the end of my appointment he implied that I should schedule an appointment for the next week like usual, but he didn’t think I would make it that long. Nothing exciting happened during the following week and I went to my next appointment as planned.

Then, on the evening of Wednesday, October 15th, contractions began again, very similar to before. They stopped after 2 hours. A few days later on the morning of Friday October 17th contractions picked back up again (several minutes apart) and continued for four hours. Conveniently, they stopped immediately after I talked to our doula on the phone informing her that this may be “the real thing”!

By this time I was getting a little frustrated and I wondered how I would ever know when I was really in labor. Now I laugh thinking about how I ever wondered such a thing! Amanda encouraged me that these contractions could be helping the baby turn from being posterior into a better birthing position, so I just tried to go about my day without spending too much time wondering when the baby would come. The next morning, Saturday the 18th, my contractions began again and ran the same course as the day before: painful contractions several minutes apart. I could not go about my day normally, and during each contraction I tried to put into practice all of the techniques we had learned in our classes: relaxation, breathing, trying different positions and moving around, and so on. Again these contractions lasted for about 4 hours.

Right after my last contraction I felt a sharp pain in my back, and it was pretty much continuous if I was moving around. I was starting to get worried about what it could be from. We called our doctor and he told us not to worry about it, but to come in if I began having a lot of bleeding or could not control the pain with Tylenol. I did take some Tylenol and used a heating pad on my back, but I still felt terrible! Up until this point in my pregnancy I had felt pretty good and even had quite a bit of energy, so this was a new experience for me.

The next morning, Sunday the 19th, I continued my bit of sitting around with the heating pad and my husband helped me with anything I needed. I still wasn’t feeling so well. I sent an email to Rachel, explaining about the pain and asking her to pray for me, and she called later that afternoon and we chatted for a little while. I remember telling her, “wouldn’t it be nice if the baby was born by the end of the day...ha-ha, it’s already 4pm, so I guess that won’t be happening." Rachel told me that Amy, who had helped connect us with our doula, was now a midwife-in-training, and had offered to have me come over the next morning before my appointment and check me. I also spoke to my sister on the phone that afternoon and told her how I hoped the baby would be born soon. That evening at 7:08pm I felt a contraction, and thought about just brushing it off (I mean, how many times has THIS happened already!), but decided instead to write the time down on the dry-erase board in our kitchen.

In the meantime, my husband had just put a caramel apple pie in the oven (which we now refer to as our son's "birthday pie”) and I made myself a sandwich to eat for dinner. My next contraction came 20 minutes later and I thought how odd this was compared to the other times. The contractions were intense and I had to focus and relax through them, but in between I was checking my email and chatting with my husband. Then a few more contractions came, now 12 minutes apart. They were still intense enough that I did not want to talk during them. I called Amanda to let her know what was going on and promised to call back with updates. I also talked to my friend on the phone and told her that I was having contractions again and it might be the real thing. She said to keep her updated and feel free to call her at any time of the day. While talking with Rachel my contractions began coming every 8 minutes and I really felt like I needed to get off the phone and concentrate. They were becoming very intense.

For about an hour my contractions were about 6-8 minutes apart and very strong. I also went to the bathroom at some point and saw bloody show. At that point I really began to believe that this was going to be the real thing! I decided to try and lie down, relax, and try my favorite relaxing position that we had practiced. Our doctor was in agreement with us that we should labor at home for a while before coming in to the hospital. Labor usually takes a long time and I would be more comfortable at home. I wouldn't have to worry about fending off unnecessary interventions at the hospital, so I figured that we would be hanging out at home for some time and I had better get comfortable. But I just couldn’t! I tried a few positions before finally deciding to take a warm bath. The bath was nice in between contractions, but during them I found it very hard to relax. By this time I had told my husband that he needed to stay with me at all times!

I got out of the bathtub and felt like I was doing a terrible job handling the contractions. They were still about 5-7 minutes apart, but they were extremely intense and I just could not relax. I began to wonder how I would do this for so many more hours. I felt like such a wimp. Why did I think that I could have a natural birth? I thought that my husband and my doula would think I was the wimpiest person ever since I couldn't even handle what I assumed then to be early labor. I started to cry and I couldn’t think straight. I kept telling Adam “I can’t do this...this is too hard...this is too painful...it’s just too much...I think I really need some medication or better yet just take me to the hospital, put me under, and get the baby out!”

This was around 9:30pm, and looking back, based on my emotional signs, we believe that I was already in transition. At the time, because I had only been in labor for a little over 2 hours we didn’t think I could be in transition so quickly. We had been told that my labor would most likely take many hours, so I thought I was in early labor. I couldn’t imagine going on for hours or the intensity increasing (which it didn't after that point!). In fact, I was in hard labor. I was also feeling very nauseated so I decided that it would be a good idea to stay in the bathroom. I got down on my hands and knees, which seemed to be the best position for me, so I stayed that way and leaned over the toilet.

My husband called Amanda to give her an update and she asked what we wanted her to do. I couldn’t think and so I just kept telling him, “I don’t know what I want her to do!" My husband asked her to come over. In between contractions he ran downstairs to unlock the door for her, and then came back upstairs to be with me.

Around 9:50pm contractions were coming every 3-4 minutes and I felt like I couldn’t handle it anymore. I was still on my hands and knees over the toilet and with each contraction I focused on breathing normally, deeply and it felt natural and somewhat more comfortable to sway my hips. My husband rubbed my back, encouraged me, and tried to do what he could to comfort and support me, though I was quite out of sorts by that time! I thought that maybe we should go to the hospital, but then I also thought about how I did not want to ride in a car for 30 minutes feeling like THIS. I also still thought that my labor would last many more hours and I did not want to get to the hospital too soon.

Amanda arrived around 10:15 and just observed us in the bathroom for a few minutes. My contractions were close together and very intense. I still doubted myself, told them that I was scared and that I thought I could not do this. Amanda suggested that I try some different positions. We moved out of the bathroom and I tried standing with my arms around my husband, being on my hands and knees on the floor, and also having Amanda apply counter pressure to my back. I was still very uncomfortable and didn’t know what to do. Soon after that, I threw up.

We decided to call our doctor and let him know that we were coming to the hospital. It was about 11:00pm. As soon as my husband got off the phone with Dr. Hammett I felt tremendous pressure and said that I needed to push. I stayed down on the floor on my hands and knees and Amanda showed me how to breathe through my contractions and not push myself, although my body was. I began to get nervous at this point because the drive to the hospital was quite the drive. My husband took all of our things out to the car and covered the back seat with towels as my water had not yet broken. Amanda helped me get dressed and get down the stairs, then left to get into her car and follow us. Before my husband and I could get out the door I had another contraction and once again needed to get down on my hands and knees and focus on breathing through it. We grabbed a blanket before we walked out because I told him that I was cold. I got onto my hands and knees in the back seat of the car, with half of my body up on the seat and one knee placed on the floor. I found that I was no longer cold so I balled up the blanket, placed it up against the inside of the door and laid my head into it. We left our house around 11:20pm.

During the car ride my contractions began to space out a little bit, but with each one I called out to my husband, “I need to push, the baby is coming right now!” My husband, being ever calm as he is, just kept telling me, “no, you don’t have to push...just breathe, you’re doing great." With every contraction I swayed back and forth, tried to breathe, and continued to pray, “Lord please help me." I was not buckled in as there was absolutely no way I would be even close to comfortable that way. With every turn I had to brace myself. It didn't help that I had driven to the hospital multiple times for my non stress tests and I knew exactly where we were on the route without even seeing out the window. I felt like we would never get there. I kept asking my husband what time it was to see if it was still Sunday or if it was Monday.

My husband called the doctor when we were very close to the hospital to let him know that I was fighting the urge to push. When we parked, Amanda told him to go in and get a wheelchair. She helped me out of the car. As Amanda and I were walking in I felt another contraction coming on and dropped down onto my hands and knees in the parking lot. My husband and a man from the ER came out with a wheelchair during my contraction and the man said, “I don’t think you should be doing this out here." Of course, I had no intention of standing up and walking into the hospital at that moment! When the contraction was over I sat down in the wheelchair and was wheeled up to labor and delivery.

A room was ready for me, and our nurse was waiting. I felt another contraction coming on so I climbed up into the bed and got onto my hands and knees. My husband and Amanda helped to take off my clothes and soon after that my water broke all over the bed. The nurse wanted to check me and asked me to roll over and lay on my back, but I said that I couldn’t, so she just waited for our doctor to come and found the baby’s heartbeat with the monitor. Baby was doing great! Our doctor came into the room, checked me, and found that I was completely dilated. He left the room to change his clothes and when he came back it was about 12am. I was finally able to push. Our nurse moved the head of the bed up. That put me in a kneeling position and I was holding onto the top of the bed. My husband was right next to me and Amanda and the doctor were behind me.

I began to push whenever I had a contraction, though not very effectively at first! I was relieved to be able to push, but still a little scared. I wasn’t concentrating very well. Someone reminded me of what to do while pushing and then I think I was much more effective. I was making a lot of noise during contractions and pushing, but I actually felt so much better than when I was going through hard labor at home. Between contractions I asked how the baby was doing, and the doctor kept telling me that the baby was doing great. Amanda kept on encouraging me, though now I can’t remember exactly what she said. After I had pushed for a few contractions, our doctor said that if I turned around into a squatting position he thought that the baby would come very soon. I slowly turned around and grabbed onto my husband’s arms and the side of the bed to steady myself. I held myself up this way while I pushed, and my arms hurt SO bad for the next few days!

At some point when the baby was close to crowning, our doctor took my hand and let me touch my baby’s head for the first time. I could hardly believe it - my baby was almost here! After a few more pushes the baby’s head was out, and then the rest of his body! The official time was 12:33am. He had been presenting with both of his hands up by his head and the doctor was able to move one out of the way. I did suffer a tear, probably from a combination of things, including how fast the baby came out. I felt such a sense of relief that the baby was finally born and I couldn’t believe that I had just done that! I heard the nurse say, “we have a boy!” and I saw him laying on the bed below me. I had almost forgotten that we didn’t know the sex until that moment. I hadn’t even asked!

He was a bit blue and his face was a little bruised, but he pinked up quickly and he was handed to me immediately. Our nurse wrapped a blanket around the two of us and I just held him and looked at him, with my husband standing right next to us. He had a scratch on his face already from his long fingernails, he had a lot of hair and it was much lighter than I thought it would be. He had little blonde sideburns and I could barely make out his eyebrows. His eyes were tightly closed and he wasn’t crying at all. He was so tiny, and he was ours!

After the umbilical cord stopped pulsing my husband went over to cut it and my placenta came out soon after that. Then our doctor checked to make sure everything was okay with me and put in my stitches. He thought it would be best for me to have a shot of pitocin because I was bleeding more than normal, so I agreed. I was able to hold our son, who was yet to be named, the whole time.

After my stitches were in and our doctor left, our nurse took the baby to the other side of our room to weigh him (7lbs. 12oz.), measure him (19 inches) check his blood sugar (95!), bathe him (he loved getting his hair washed), diaper him, and put his wristband on. She explained everything as she was doing it and was very gentle with the baby. My husband stayed by his side the whole time.

When she was finished he was handed to my husband and he held his son for the first time. Amanda was able to get several great pictures of us during this time. We are so grateful to her for supporting us throughout everything. Around 1:30am I began to nurse our son, though he didn’t seem too interested, he was very sleepy. Amanda made sure that everything was going well and that we were okay with her leaving, we thanked her for everything and she left a little after 1:30am.

After Amanda left I sat in bed holding our son, with my husband right next to me, and our nurse went through all the registration questions that they usually ask right when you come in. After they were all answered, she helped me get ready to move to our room and explained to me how to take care of myself postpartum. When I was ready I got into the wheelchair and she wheeled me to our room while my husband pushed the baby in his bassinet. We got settled into our new room and the nurse took care of a few more things. When we were finally alone (sometime around 4am), we texted our family’s a picture of the baby and said “call for details." No one had even known that I was in labor the night before! I also called Rachel to tell her our good news and that we had a little boy. Hey, she told me to call her anytime day or night!

We give all the glory to God for the things we saw that only He could do and the way that He answered our specific prayers that we had been bringing before Him for months regarding myself and the baby during pregnancy and the birth. Doctors say that diabetic women must be induced, but I wasn’t. One doctor told me that I FOR SURE would develop problems with this pregnancy, but I didn’t. People say that babies of diabetic mothers don’t handle labor well, but my son did. Most babies of diabetic mothers have low blood sugar after birth, but my son never did in all the three times they checked. My husband and I did everything in our power to ensure that I continued to be healthy and that my blood sugar was well-controlled throughout the pregnancy. We did all that we could to give our son a healthy beginning to his life, and we prepared ourselves in every way we could for a natural birth. But we know that beyond all our good efforts, God was continually extending His grace to our family and we will forever be grateful for all He has given to us.

Thursday, November 10, 2011

Guest Contributor: Choosing a Doctor and a Doula

Over the next week, we welcome some posts from a guest contributor. Amy contacted me a few weeks ago to share her birth stories. She has Type I diabetes and three sons, all born vaginally and with minimal intervention. Her stories have been a real encouragement to us, and we hope you enjoy reading about her journey!

Our first son's birth story really began before he was even conceived, because we believe that God knew him before then and in His sovereignty chose to give him to our family at just the time that He did. But, on our end, his story began on February 19, 2008. That evening we found out that we were expecting him and we were thrilled! I wrote this story down because I wanted to remember everything about my first son's birth and what led up to it, including finding our doctor and being connected with our doula.

I began my hunt for a doctor right away and I knew that I would need to find a doctor who was willing to work with “high-risk” pregnancies, since I have type 1 diabetes. Being new to the area, all I had to go on was a recommendation from a woman at church. In all my excitement, I didn’t really ask this doctor any important questions until my third visit. My husband and I were planning for a natural childbirth, so at this appointment we finally asked questions about how I would be allowed to labor and birth. We left this appointment completely appalled at the doctor’s answers! I would HAVE TO be induced, all sorts of interventions would be used as a matter of standard procedure at the hospital, and to top it all off, he told us that our baby would not be able to room-in with us for the first 24 hours, but would HAVE TO stay in the nursery during that time (even if the baby was fine and stable). He also had the audacity to tell me that I had a 50% chance of having a c-section. Looking back I realize that would have been true had I let him “care” for me and followed all of his instructions. I knew we would not be returning. So the search began for a different doctor, and I didn’t even know where to start!

I belong to a somewhat large yahoo group for Christian women (Above Rubies) and I know there are a lot of women from all over the world on the group. I thought there might be someone in my area who could help me. I asked if anyone had any ideas or advice for me and a woman who is now a good friend, Leah, responded. She encouraged me to contact the midwife, Kathy, that assisted at her home birth the previous year. Also, through searching on the internet I came across an organization called Center for Humane Options in Childbirth Experiences (CHOICE). They offered many programs and services, including pairing mothers with midwives and doulas, and assisting in home births. I knew that I would not be able to receive pregnancy care from a midwife, but I thought they may be of help so I called and set up a consultation. In the meantime I also contacted Kathy. Both Kathy and the ladies I met with at CHOICE recommended the same doctor. Another doctor/midwife practice nearby was also recommended.

I chose to look into the doctor/midwife team first since they were closer and I liked that it was a solo practice that included a midwife. We loved the midwife, but the doctor was not a good fit for us. I left his office in tears because he basically told me the same things my previous doctor had. He also told me I WOULD have problems at the end of my pregnancy, no matter what. I was so devastated and having that experience made me really nervous to try out another doctor. I didn't want to be told the same things all over again and I felt like I had no options.

Finally, when I was about 21 weeks along, I decided to set up an appointment with the last recommended doctor. To my surprise, he was wonderful! He was immediately supportive of our preferences of how the baby and I would be treated during pregnancy, birth, and after the birth. He actually treated me like a normal person and not a worst-case scenario waiting to happen. He informed me of the possible complications of pregnancy when the mother is diabetic, but said that as long as none of these things were happening that our plans were acceptable. He continued to care for me for the rest of my pregnancy, and I was even able to request to see him specifically for all my appointments. He gave us his phone number so that we could be sure he would be the one caring for us during the birth, even if he was not on call.

A few weeks later my husband and I started our The Bradley Method® childbirth classes. Everything was going great. I was able to keep my blood sugar under control (as usual), we were learning and preparing all we could for having a natural childbirth, and the baby was as active as ever. Several weeks before my due date we were discussing our birth with our Bradley instructor, Rachel, who was quickly becoming a good friend as well. She recommended that we have a doula with us for labor and birth. My husband and I had thought about this before, but knew that if we had a doula, we wanted her to be a Christian. We saw the benefit of having a doula there to support us,and thought it would work out best if our doula also shared our faith and could encourage and pray for us. Not knowing how to find a Christian doula, we set that idea aside. But with our due date drawing close, Rachel gave us the phone number for the doula who assisted at her home birth, Amy. Amy said she would be happy to help us find a Christian doula. Amy connected us with Amanda, who we eventually chose to assist at our birth.

For more information on what a doula is and how they can help you during pregnancy, labor, and birth I would recommend looking at this website: www.dona.org. Their quick explanation of a doula: “The word 'doula' comes from the ancient Greek meaning 'a woman who serves' and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.”