Elias' arrival

The social revolution that is Twitter and Facebook means that this blog is no longer the go-to place for up-to-the-minute news about things like births and Iranian politics. If you don't know the essentials about the birth last week, then you need to "plug in" dude.

Jaime describes this birthing experience as the perfect end to a miserable pregnancy. Smooth, easy, enjoyable. Boring, almost.

But let's back up to the point where we were sure all of this was going to kill her. Let's back up to Wednesday . . . was it Thursday? . . . I don't really remember at this point and Jaime is sleeping--as she should be--so I can't ask. Jaime was in the hospital for the the third time in the last trimester getting IV fluids and anti-nausea meds. She had hardly gained any weight during the entire big-weight-gain weeks at the end of the pregnancy. Her due date based on her cycle was the 22nd. Based on sonograms, it was the 15th. Calling Monday, the 15, her 39-week point, Denise, her nurse-midwife, had said that Friday night, the 12th was the earliest she would consider inducing. Jaime wanted to set that as the "GO" date. She made this decision with great reluctance. Both David and Simon were induced prior to their due date and Jaime was looking forward to a natural labor experience. But the inability to eat anything was more than she could take. So she asked to begin inducing on the 12th.

And her doctor said "no."

I was not present for this, but I heard the wailing and gnashing of teeth. Apparently there was a miscommunication or reconsideration, but her OB-GYN partners were not willing to allow this baby to arrive a minute before the 39-week point. Which means she could begin as early as Sunday night for a Monday birthday. I was not present or my suggestion would have been that we would agree to that as long as the Doctors making this decision agreed to eat no more than Jaime was able to eat for the following three days. Turns out, they would have come of OK in that deal. We went home, mom watched the boys, and Jaime slept. When she awoke (with fresh meds) she felt much better and was able to eat properly most of the weekend. Sunday night we went in as scheduled.

I'll spare you the details, but various treatments over night into Monday morning brought on spontaneous labor without Pitocen. Around 1:30, her contractions were so intense, she reluctantly decided she would need an epidural. This was the moment we had been waiting for. With her priors, the epidural was the event that moved her to the final stages and babies arrived shortly thereafter. I called my sister to come on up and mused that were going to be able to take the baby's first pictures with daylight. The anesthesiologist arrived and put in the epi.

And labor stopped.

So we had to start the Pitocen and waited around for the rest of the afternoon.

At this point I need stop and mention the nurses. One of the advantages of birthing in the hospital where you work is that you can know the nurses and can request your pick of the shift ahead of time. Jaime had requested Rita for when we went in Sunday night. Rita had taken care of her when were there three day prior and we thought she was wonderful. When Rita's shift ended at 6:00am Monday, we got Amy, whom we really didn't know, but there was no one scheduled for that shift she did know. Turns out a friend of Jaime's--Karen--was filling in on that shift unexpectedly, but Amy had already been assigned to us so that is who we got. Over the course of the next twelve hours, we came to love Amy. But the shift was ending. Both Amy and Karen would be going home. Amy had put in all this work taking care of Jaime all day and Jaime was sad she would not be able to be present at the birth. Jaime was equally sad that Karen, her friend, would not be present since she was also going off shift. But Rita was coming back on, so that was good at least. But wouldn't it be perfect if all three of them could be present? What is the solution? Full-on pushing right at shift change! They all got to be there. Along with a student nurse who has been following Jaime for a couple weeks, the nurse-midwife, my sister, two nurses from the nursery who would take over postpartum care, me, and Jaime--that was 10 people attending to this birth. It was like a knitting club. At one point I almost asked for all the sisterly chit chat and "go girl" encouragement to just stop already, but I was outnumbered.

Here is how Jaime has been describing the experience: the amount of pain-control meds were exactly right. She was able to feel the labor--even the pain of it, without being debilitated by pain. She was neither numb nor in a fog. It was perfect.

Elias came almost without complications. His umbilical cord was wrapped around his neck tightly enough that Denise could not slide it off over his head or push it back over his shoulders. This caused a momentary pause as his shoulder emerged. Denise was able to cut the cord at this point to allow him to come the rest of the way out. They are so strange when the emerge, like inanimate objects: purple and still. Then they transform like time-lapse films of a pupating moth. They wake up, change color, begin to move and cry. The child you see an hour after birth is completely unrecognizable as the one that emerged during labor.

APGAR at birth:8. After five minutes: 9
Weight: 8 lbs
Length 21 inches.

Since the birth, Jaime has had no problem keeping food down. Thanks to God and the women at church, she has no shortage of food to keep down. Both are feeling good, eating well, thriving. Sleeping? Not so much. But I have been here all week to take care of the older brothers, so mother and baby have had plenty of naps. Jaime is tired, but not miserably so.

After such a miserable pregnancy, we could not have asked for a better labor and postpartum week. We thank God. We also thank my mom for older-brother duty while we were in the hospital, Skylar for being present at the birth again, Denise, our super nurse mid-wife, the great nurses at St. Francis, our family's and our friends for love, encouragement, food, and baby supplies.

Jaime just put him in my arm, so I am typing single-handedly while he stares at me and I stare back at him. Jaime voices his thoughts: "Dad, how can you write about me when I am right here in your arm?"

I have no reply.

Squirmies

It actually bothers me a bit how much the new one moves around inside his poor ailing mother. He'll have these bouts of squirmies (to use the technical term) that feel like he is a couple of wrestling puppies egged on by toddler swinging a kitten. It makes Jaime miserable. But, by all other accounts, he is healthy and growing so I have to feel gratitude while I sympathize with Jaime, who feels like she is having her life essence sucked out of her. This has been a more difficult pregnancy than the previous ones. But we have friends who have been so sick as to be bed-ridden for their entire pregnancy, so I am grateful that it is not worse.

In unrelated news, please take the Nook off of your Christmas list for me.

Beat

So I took the whole morning off yesterday to spend 30 minutes in a doctor's office to hear 30-seconds of sound--the sound of the heartbeat of an 11-week-old. It was totally worth it.

It was Jaime's first with the nurse/midwife who will be our captain of baby birthin' for number three.

This is a pregnancy blog again.

ready to roll

Well, in spite of some days with long periods of regular, but light contractions, and some days with heavy, but irregular, contractions, no baby has arrived.

sigh

So, tomorrow morning we are off for an inducin'. We'll arrive to the hospital around 7:00 and start things going. So, I don't expect to sleep a lot tonight, which is why I am blogging at 11:00.

The feeling is somewhere between the excitement you feel the night before going to Disney World and the foreboding you feel the night before . . . well, before you'll submit your wife to one of the most physically painful experiences she'll ever have.

Grandma Suzie is here and pretty excited to be able to participate this time. Everyone is on high alert, waiting for the phone call, which you already know, because you are pretty much everyone.

So, here we go, perched at the top of the roller coaster after a long nerve-wracking tug up the hill. Ready to roll.

later, Disney fans

our best-laid plan

OK, we have a plan, which is a great relief.

Jaime and I have been torn between waiting until spontaneous labor and going completely batso insane. The litany of fears basically boils down to "in another week, this child will spring, fully grown (and armored) from my forehead." You may recall that David got stuck and we had a few scary moments because of that. This is not an indicator that the same thing could happen again, but the specter is ever-present cloud over our desire for a natural childbirth.

We met with the OB today to discuss the issue in a more rational, less metaphorically soupy way. On one hand, he is willing to induce Jaime when ever she feels like it at this point. On the other, both she and the baby are healthy and he is happy to let the pregnancy go until September 7. He has very little advice to offer otherwise. I wish I could get paid so much for so little.

But he did have this: in a study, 328 near-term pregnant women who have previously had a child were asked to guess the weight of their baby. Then, the OB did his exam and made a guess as to the weight and the women were given a sonogram and the weight was determined from that. On average, the doctors' guesses were off by 1.5 pounds plus/minus, the sonograms were off by 1 pound, and the mothers' guesses off by .5 pounds. Our doctor used this to illustrate where the decision for the next step ultimately lies. He could examine and guess and make a recommendation, but it is less likely to be as accurate as what Jaime thinks. If she thinks it is getting too big and wants to go ahead an induce, then that is what he'll do.

Another fact I didn't know: inducing doesn't always work. They'll give it a try for about a day--less, if the weather is good for golfing--but if the mother and baby are honestly not ready, then it won't work and the woman will go home as pregnant as when she arrived--but more batso insane. That helped me. David was induced because Jaime's water broke. It was an unpleasant and drawn-out process. But in that case, they wanted the baby to come before the risk of infection developed from the ruptured membranes. So they were much more aggressive than they are with a voluntary induction. I am relieved to know that induction is actually a good try to get things started--not an attempt to artificially force the issue.

Lastly, Grandma Susie is coming next week. She'll be here for several weeks.

So, this is the "plan." Our OB is on call for deliveries tomorrow, this weekend, and next Wednesday. The plan is that we'll wait one more week. If we don't have spontaneous labor or a nervous breakdown by Wednesday--which is the day before the "due date," then we'll induce and Grandma Susie will get to be there, which wasn't possible with David.

Why are we relieved to have a plan? Because it allows us to stop thinking about it and relax. That, combined with our decision to wait until Grandma Susie can be with us, will cause the immediate onset of labor, which is what we are counting on.

So, mark your calendars. Sometime in the next eight days we are goin' to the hospital to have a baby or give it our best effort.

Later, batso insane fans.

37-weeks

Jaime emailed me.

Well the good news is that I am dilated to a 2 and Simon is head down.

The bad news is that Wiley said he would not let me go past my due date of "September 7th". I almost wanted to die.

In a passive-aggressive attempt to get him to think about going earlier, I asked him to compare my current size to that of David at 36 weeks.

I am dilated which I don't think I was at that time, I weigh almost 10 pounds more, and Simon measures 3cm bigger than David did. And after all that he still won't let me go past September, oh lucky me.

Wiley asked if he was moving ok and I said the movements have seemed to slow down a bit so he ordered a stress test. Simon is fine and moves like a champ, I even had two mild contractions during the test. The nurse was really nice and talked to me for a bit after it was done. She said the August 31st (according to the sono) was probably the most accurate date and to give it until this weekend when I hit 38 weeks.

I still feel like crying, which I am getting sick of but I will try to remain patient.

david & the tummy

david & the tummy, originally uploaded by jandjgilbert.

restin

restin, originally uploaded by jandjgilbert.

david & the tummy 2

david & the tummy 2, originally uploaded by jandjgilbert.

hurrying up, waiting

Well, we are disappointed to have no real news yet. When Jaime lost her plug Monday, we were pretty excited. Yes, one can unplug as much as three weeks prior to the birth, but with David that was only five days and the second is supposed to come faster, right? Additionally, Jaime was showing several other signs of a pending birth. So, we have been preparing for a birthin' this weekend. Alas, no. Not only is there baby yet, but most of the symptoms have subsided.

We went to the mall today for a long walk--because that is supposed to help. Sure enough, while walking through Dillards, Jaime had a pretty significant contraction--the first in 24 hours. It maintained while walking and while not walking whereas false labor generally subsides when you change modes. So, we were stoked. But it subsided and nothing followed. Jaime is convinced that it has something to do with Dillards.

We were trying to remember details from David, but are not recalling much. I didn't record enough information. For instance, there is a scale from -5 to +5 that tracks the baby's progress. -5 is just starting, not even in the birth canal yet, and +5 is crowning. The baby is -2. I don't remember where David was when, so I can't compare. Jaime is partially, but not fully, effaced. Again, I don't remember when David met this milestone.

I do, however, remember that, when Jaime's water broke with David, I was surprised--even a little incredulous. I recall thinking that there had been no accompanying signs, perhaps she is mistaken. I was prepared to take Jaime to the hospital in labor, but that didn't happen, we had to induce the actual labor. So, this one could take us by surprise as well.

Nevertheless, we wait. It is hard, especially for Jaime. I am trying to get us in the mindset of abandoning the idea that it will come this week. Let's just assume that it will come next week. That way, if it comes earlier, great. But, if it does not, then we'll at least get out of this craziness of planning to be at the hospital sometime in the next 24 hours. It is an impossible level of hyper-readiness. I am cramming as much work in to every day in preparation for leaving at a moment's notice and I am putting off any project that will take more than 24 hours to execute.

So, we hope it will come sooner, but are trying to resign ourselves to it coming later. Or later still.

Later, fans.

perhaps on the mtv blog

--I've gone acoustic [giggle].
--huh?
--I'm unplugged.
--oh. Ha! That's pretty good
--You should blog it.

labor: true or false?

For the time being, false.

faq

Has Jaime birthed that baby yet?

No.

The OB, Dr. Wiley, has the due date set at August 31 (cute story, David has a baby cousin named "Riley." When they were introduced on Saturday, David called him "Dr. Riley"). Jaime's calculations, based on being present at certain stepping-stones in the process, put her at August 11. However, Dr. Wiley trusts her instincts. If labor has not begun by the weekend, he is willing to order sonograms or measurements or whatever it takes to determine how big the baby is and induce if necessary. The goal is to avoid a baby bigger than about eight pounds--one that raises the possibility of needing an emergency c-section.

So, there are two issues at work here--uncertainty about the due date, and concern about the size of the baby. It is common knowledge that due dates are highly unreliable and nearly arbitrary. People often say to us that baby will come when it is ready to come, regardless of an established date. That may be true, but having a due date helps with addressing the size problem. If the due date comes and goes, then that will trigger doctors to monitor the size to be sure that the extra time is not causing problem. Having such a wide discrepancy as we makes it difficult to address this issue.

You may have noticed that white American people are having larger and larger babies these days. While certainly not a health crisis, it does pose interesting issues. We have gotten very good at promoting prenatal health to middle-class women--maximizing every opportunity for the fetus to develop as much as possible. They are so healthy that they are reaching birthing weight and beyond just a little quicker than they should.

What facts am I citing to support this supposition? You are clearly not familiar with the way blogging works. I'm just typing to kill some time. If you want facts, go watch Fox News.

It just seems to me like babies are getting bigger, that's all. I would be curious to know how many women of my grandmother's generation had to worry about an emergency c-section because the baby would be too big at the onset of labor.

later, big baby fans

She's come unplugged

One of the more awkward aspects of discussing the progress of a pregancy is the frank discussion of physical processes that are normally very private. This is especially awkward on the World Wide Web. So I am not going to elaborate on the title of this post. If it makes sense to you, great. If it doesn't, then suffice to say that Jaime is progressing normally towards the Big Day.

We read through the list of "Prelabor Symptoms" in What to Expect When You Are Expecting this morning. We were able to check off eight of the nine prelabor symptoms as well as several of the false labor symptoms that women often experience in the weeks prior to real labor. What does this tell us? In fact, nothing new. Jaime is progressing normally for someone that is expecting in the next two or three weeks. However, there is a great deal of comfort in reading about what is normal and comparing that to what she is going through. It is just further reasurance that mother and child are healthy.

Engaged

We went to the doctor today. Baby is still upside down, which is good. His little heart is 150 beats per minute, also good. Jaime's cervix is dilated 1.5 cm. For you non-experts, that is not much, it could stay that way for quite awhile (10 cm is the final goal). In childbirth class, we learned that the cervix is about the size and shape of a stack of three lifesavers. It eventually thins and stretches to let the baby through. Jaime's is still about 2 or three lifesavers thick, so it has a ways to go.

The most interesting news is that he has dropped into position in the pelvis. This is interesting on two points. Firstly, all of the hobbyist-OB/Gyns in our life have assured us that he is still quite high and will not be here for many many more months. Heck, we can barely call Jaime pregnant yet at this point, she has soooo far to go. Well, he is there, in position, presenting. Secondly, I expected his move into the pelvis to be a bit more dramatic. I figured there would be some sort of "plop" and the sound of Jaime's bladder being schmushed. Not so. While this is all good news, it is really no indicator. He could be ready in three days or three weeks. We counted from the presumed point of conception and that puts forty weeks at April eighth. However, the doctor will not let this go more than ten days past the due date of March 25.

Stay tuned

other baby news

In other news from the baby world. Congratulations to our friends Justin and Jody Mathews of Kansas City for their new arrival--Asher John Mathews! A healthy baby boy. May God grant him many many years!

Also, Jaime's cousin, Michelle, who is due in early April is progressing well, we hear. She has passed a mile-marker and could be here very soon.

bladder biter

Ok everyone, we are going to play a roll-playing game! This requires the participation of both the husband and the wife so if you don't have one of those, go get someone to play along. The wife is going to lay on the bed and be the pregnant lady with the breech baby. The husband will be the doctor doing an external version. If you like, you can prop up a stuffed animal at the bedside to be the pregnant lady's speechless, horrified husband. Now the one playing doctor is going to place one hand on either side of the patient's tummy. Ready? Now push your hands together squeezing just as much of the tummy just as hard as you can. Are you pushing! Hard?! Com'on, I don't hear any groaning--PUSH!! You may need to work out a bit if you don't think that you are really putting vice-like pressure on that tummy. Wasn't that fun? That is what we call an External Version!

Fortunately, I think it was worse for the horrified, stuffed animal husband than for the pregnant lady. It went exceptionally well. This procedure can take ten to twenty-five minutes. Our baby flipped in about 90 seconds--a record for our doctor. Jaime felt discomfort and is a bit bruised. She is having pains in her back that seem to be showing up in the monitor as contractions--but not real ones. She describes the change as feeling distinctly different and very weird. Now the baby's head is on her bladder. At one point her bladder was full and the head was on it and the discomfort was acute. Jaime described it as feeling like he was biting her bladder.

The whole thing was monitored with a sonogram with which we were able to see the baby again. Good strong heartbeat, lots of activity, definitely a boy.

One of the nicest things about this was the enormous amount of prayer and encouragement we got from everyone. We were inundated with emails and phone calls expressing love and support. It felt great. Thank you to everyone.

Bottoms up, not

As of this evening, the baby is breech--head up and bottom down. With only two and a half weeks to go, this is cause for mild concern. Tomorrow, we will go to the hospital and Dr. Wiley, our OB will attempt an external version. This is latin for "pushing against Jaime's abdomen in such a way as to try to get the baby to turn over." Dr. Wiley guestimates that about 25% of first-pregnancy breeches flip over with this proceedure and stay that way. We have been told by other sources that he is very good at this. In thirteen years, he has never had a complication.

I will let you know how things turn out (no pun intended).