Happy Birth Day Ande Joy...and Reese!

Documenting this third labor and delivery experience has been challenging because I'm not quite sure how to give it usual markers of time compared to my first two. For nearly 3 weeks before Ande was born, I had been experiencing prodromal labor. This isn't braxton hicks where you have 'fake' contractions, these are real contractions that hurt and feel exactly like labor, but then they die off. There were 3 different evenings where I woke up in the middle of the night because of the strength of the contractions, looked at the clock and noticed the intervals of 5-10minutes apart, and then after a couple hours I would get up and they just stopped. The first time that happened it was pretty disappointing because you mentally prepare yourself for the whole labor and deliver experience to be coming that day, and then nothing happens.

I've learned that this is a fairly common experience with third babies. They don't have as clear of an onset of labor marker. So after the first go-round of thinking I was going to deliver a baby that day, I decided to reset my mind to 42 weeks of gestation and ignore any labor signs until I couldn't. So Ande's 40 week prenatal check up came and went and everything continued to report back healthy for her and me. My mom had flown into town that day- February 2nd, and 6 days later we were wondering if she would have to fly back to California before Ande was even born. Plenty of people around me felt restless about this idea of a 'past due' baby, but I remained steadfast in my belief that babies come when they are ready and the longest record of pregnancy is in fact, not forever!

So Reese's birthday, Thursday February 8th came and we were thankful to have Oma here to help celebrate! We opened some gifts that morning at breakfast. Jonathan, Oma and I were able to join her at preschool that morning to share a special birthday snack that she and Oma had made together that week, crafting the flower spoons and making the pudding and crushing cookies for dirt cake. Reese really enjoyed being the helper at snack time and getting to pass out her creations to her friends.

That afternoon I continued to have contractions, nothing new from the previous month, so I generally ignored them until 3pm. I called J and asked if he could work from home for the rest of the day so I didn't have to factor in when I needed to call him home IF this did turn into labor moving to delivery of baby. When he came home at 3:15p we went for a walk in the neighborhood and the contractions remained strong. Our plan was to take Reese out to a birthday dinner- her request was spaghetti and broccoli! By 5pm I thought sitting at a restaurant sounded like a terrible idea so we made a plan B for Oma to take the kids to a special dinner and we would do birthday cake together at home when they got back. I didn't get a slice of birthday cake until 2 days later.

J went and picked up some Thai takeout for us to eat at home. I went to the bathroom about 6pm and my water broke- a first experience for me to have that come 'early' (but not really, because, prodromal labor for a month). The contractions after that definitely stepped up in their intensity and by the time I finished my chicken pad Thai I knew we needed to head to the hospital. I had the midwife on call paged and Sharon called me back quickly. I was in between contractions and was able to talk to her cheerfully about my day and the progress. I was grateful that she said she would meet us at the hospital and believed me since I hung up after only talking for 3 minutes and probably didn't 'sound like I was in labor.'

We arrived to the hospital at 7pm and had to check in through the Emergency Room since it was after hours. They said we were the 3rd patient for labor and delivery in the past hour. I went from talking easily between contractions, to not communicating much at all. The check in process was relatively quick, but we had to wait for someone from LandD to come down and get us and that was another 20 minutes. I went from standing in front of the window rocking as I stood, to sitting down on a chair and crossing my legs wishing labor to slow down. By the time a nurse came down, it took another couple of contractions for us to walk a short distance then pause to eventually get through the elevator and up to a room.

~7:30pm
When we got to LandD my midwife Sharon was there and asked about my thoughts on the plan. I told her I really wanted to get into the tub, but wasn't sure that I would last long enough for it to be set up and filled with water. She said lets just start getting it ready and if we make it, we make it and if not, we will adjust. I asked for an exercise ball and stayed sitting on that until the tub was ready, about 8pm.

Getting into the warm water felt good. Ande's heart rate had been monitored on the ball and was handling contractions well. In the water they intermittently checked on her and it continued to hold strong. Pretty quickly after getting into the water I felt a shift in labor pains that I recognized as transition. I felt hot and overwhelmed and complained of not wanting to do this anymore. I knew this was a sign that she was coming soon. Sharon asked me if I felt like pushing and I said not yet. The on call nurse helped tie my hair up out of my face with a rubber glove. Sharon offered some hip squeezes as counter pressure, but after a couple it didn't feel good to me.

Then I knew it was time to push. I told Sharon 'little push, little push' and noted how I had so many thoughts in my mind but could barely get out that little phrase to tell anyone else what was going on. She nodded and said something encouraging like 'you've got this.' I pushed with the next two contractions and they monitored Ande's heart. After the second push, Sharon said we are going to push this baby out on the next contraction ok? I thought, that's quick- but great if I don't have to push for much longer. The third contraction felt like a dud, it wasn't as strong and did not help me bear down much to get a strong push. After it let up, Sharon said ok I need you to push again, we aren't waiting for another contraction. So I pushed and she told me to stand up, I did, and felt Ande come the rest of the way out, caught by Sharon and handed directly to my chest back in the water. 8:47pm Ande cried and cried. I cried. Jonathan held us from the outside of the tub. After soaking each other in for a bit, I birthed the placenta in the tub. After a little bit longer, Sharon asked if I felt comfortable to get out and onto the bed so they could check my bleeding, she was concerned about how much blood I was loosing but it was harder to tell in the water. So Jonathan had skin to skin time with Ande (he quickly obliged when I directed him to take his shirt off before I handed her over) and I was helped out and onto the bed.

I did have a lot of blood loss and was given some options of how to approach with a mouth dissolving dose of Cytotec, a shot of pitocin in my leg, or a manual sweep for blood clots. We started with the Cytotec and when  I continued to loose blood we did the sweep for clots. Painful. The nurse held my hand. It was the right decision as there were a lot of blood clots Sharon was able to get out and that ultimately slowed the bleeding down. She told me I had lost enough that she was categorizing it as a postpartum hemorrhage. She explained to me that her urgency for having me push Ande out quickly was because her heart rate dropped and was not rebounding. She was concerned that the cord was likely wrapped and if it was short, she wouldn't be able to untangle it in the water and still hand her to me, so that's why she asked me to stand up. What she discovered was that Ande had a double nuchal (the umbilical cord was wrapped twice around her neck), but that it was also very long and she had no trouble unwrapping her and then handing her to me. I told her I trusted what she was telling me in the moment because she got her 'midwife voice' on and I just followed. (Sidenote- Sharon is the senior member of the 4 CNM team and she founded the practice alongside the OBs two decades ago).

Our first picture 9:08pm

9:27pm

Ande came back to my chest and snuggled more, latched again and we all had some very sweet time together. Probably an hour had passed since she came out and the nursing staff was doing a great job of giving us space- something I had concerns about after the beauty of Reese's home birth experience. We asked if we could have her weighed now because we were kind of curious how big she was. I knew she was larger than Heath (8, 4o) and Reese (8, 14o). I guessed closer to 9 and a half, and she came in on the scale at 9lbs 10 ounces. She measured 21", same as her sister.

I am so grateful that we were with a competent provider who knew exactly how to respond to Ande's drop in heart rate as well as my postpartum hemorrhaging. There were some things to navigate with a hospital stay this time that were a little challenging, but overall we soaked in the pampering provisions of having extra help and our big kids safely cared for at home with Oma. They all came to visit us the next morning and meet Ande.