A Labor Nurse's Birth Plan - revisited

Ah, my "birth plan". I was laughing to myself (yes, I'm easily entertained) about the birth plan I had come up with when compared it to what actually happened with Caleb's birth. It is a good idea to have an idea of what you want and don't want, but once again it shows that even with the best laid plans, things may not go your way, even if you write a kind of "anti" birth plan, to ward of any unfavorable vibes for the labor/birth. Guess the labor gods decided to take me seriously and grant me some of the items on my birth plan. Figures, right?


Just for fun, let's look at my "birth" plan:


1. I want lots and lots of Magnesium Sulfate. Gee, I guess I got that, didn't I?!? My whole sense of time the day leading up to Caleb's birth is a bit of a blur, but I got a nice hefty 6g bolus and was on Mag, I believe, about 18 hours, and a nice big maintenance rate of 3g an hour the majority of that time. Good times, good times.



2. I'd like to have an emergency c-section without anesthesia due to a uterine rupture at my old incision site. (yes, unfortunately, we have done c/s sans anesthesia, luckily not often) - Thankfully, I did not have to have this. No emergency, no uterine rupture. And Doc told me after the c/s that my uterus did not look like a uterus that had 2 prior c/s. Nice to know the ole' girl healed well after c/s 1 & 2.



3. If I don't get a emergency c/s and can VBAC, I'd like an episiotomy with a 4th degree extension, please. Wasn't given a chance at a VBAC, heck, it seemed like it was a huge deal that I wanted to wait until Husband was there before I was taken back to the OR. When one of the other docs I work with heard I delivered, (according to a coworker/friend) by c/s, and had a vaginal delivery with my first baby (perhaps a breech in HIPAA, but I don't mind) he said he would have let me VBAC. Go figure. But, in reality, I would have been too nervous to VBAC after 2 c-sections.


4. I also would like to be tethered to the bed for the duration of labor with internal monitoring. No internal monitoring, but I was, in fact, in bed from the time I changed out of my scrubs and into a hospital gown right before they started Mag. However, I wasn't in any shape to stand after a certain amount of time, remembering how weak my muscles were just trying to move in bed and when I tried to get to the wheelchair for my ride to the OR.


5. I desire lots and lots of cervical checks - I did have several exams, but I realize they were all necessary to make sure I wasn't changing my cervix.


6. I also would like my baby taken from me straight away for at least an hour so it interrupts with breastfeeding and bonding. I had wanted Caleb to stay in the OR with me...but that was on the condition he was term and healthy. My coworkers tried their best to keep him in the OR, but I told them to take him to the nursery, make sure he's just fine. I did get to see and touch him before they took him to the nursery, so that was nice. Thankfully he was fine and it had no effect on bonding or breastfeeding. That boy latched easily while I was on the recovery room cart.


So, like I said in the original post, be flexible with your birth plans. You just never know what labor and delivery will bring.

A little daily ritual

Someday, I will not have to change the sheets on my bed everyday. Why, you may ask, do I change the sheets everyday? Is it because I am a clean freak? Clearly not if you saw my house. Do I just like to do laundry? No, not really, and even if I did really like laundry, I have plenty without my bed sheets to satisfy my craving. And no, Husband does not wet the bed, neither do I for that matter, and believe it or not, the baby isn't the reason for the daily bed change. My friends, let me tell you why I do this daily ritual. Husband gets up out of bed to go to work around 4:30am. I fall back to sleep after feeding Caleb about that time and when I wake up, Isaiah has crawled in bed with me. When we get up for the day, Isaiah is soaked. Not just full diaper soaked, but wet pants and shirt. He leaves a huge wet pee soaked spot on Husband's side of the bed, wet pj's, saturated diaper. You may think "Well, get him potty trained". If only it were that easy!! Or "Why doesn't Husband change his diaper when he gets up for work?" Well, that's because Isaiah is still sleeping when Husband leaves...and I don't wake up when he crawls up in bed because, well, I'm tired from the nighttime feedings. I suppose we could wake him up in the middle of the night and change him, I have considered that, but with as horrible of a sleeper that Isaiah is, I changed my mind. You wouldn't wake him up in the middle of the night to change him either, trust me. Bedtime is a huge battle we've been fighting with him for a long, long time so once he finally goes to sleep, we don't want to wake him up. We've tried limiting drinks, and he goes to bed with a fresh clean diaper every night. Sometimes he will sit and use the potty before bed...other times he just plain refuses to sit and try. We've tried so many things (that have failed), every old wives tale, every trick others have used, all have failed. I've decided Isaiah has a bladder the size of the water tower, and can store fluid like a camel. I've even gone so far to do a little dance around a fire and gave a sacrifice of a pack of diapers, hoping to appeal to the dry diaper gods, or at least to the not-saturated-and-overflowing, diaper gods. They haven't heard me. I may need to go buy a few more sets of sheets, maybe a set for each day of the week. I guess I could look at the bright side - if Husband irritates me, I could always NOT change the sheets!

Soon to be reunited

Dear running shoes,

Oh, how I have missed you so these last several months. I can tell you I longed for our long outings together...cruising the streets of town, running through the countryside. Oh, the times we had! We made quite the pair, you and I! What a great fit and the comfort I felt when we were together was better than any other running shoe I had ever been with. We were on a roll, spending more and more time together when suddenly we had to stop these rendezvous. I remember our last run together. I missed you, but it was more important that I grew this baby and kept him safe and sound until he was ready to live in this world. Our parting was sorrowful, but for great cause and I knew in good time we'd be together again. Our time is near! I anticipated our reunion in December, but as fate would have it, in November, we will be able to once again start our relationship anew. When we slipped out last night on a walk, those same feelings came back and my anticipation is growing. In a few weeks, we will once again become inseparable.

All my love,
Nurse Lochia

4 Weeks

I saw this on a few other blogs, and I thought I'd do the same.

How far along were you when you had your baby? 34 5/7

How long was labor? Hmm, true labor, probably only 2 hours until the c/s. My cervix hadn't changed during the day and I wasn't checked after my water broke around 2 a.m. But I was on Magnesium Sulfate for about 15 hours to slow the contractions and I doubt there was much change.

Total weight gain: 26 pounds

Total weight loss since: 13 lbs. 13 more lbs to go until my pre-pregnant weight, but I had put on a few pounds after the miscarriage last year while we were trying to conceive.

Back into your own clothes yet? Mostly...still wearing the black stretch pants I always wore and the one pair of jeans that are my "post-c/s" pants. I doubt my other jeans would fit and if they did they wouldn't be comfortable thanks to the incision.

Did you get stretch marks? Nope, I'm very thankful for the good genes! But I do have that darn skin flap that a lot of c/s moms complain about and my extra "padding" on my stomach appears to be misshapen. There is more on one side right above my scar than on the other. Looks a bit strange.

Did you deliver vaginally or by c-section? C-section

Best moment this week: 5 hours of sleep between two feedings one night

What I miss about being pregnant: The movement, the big belly and the fact that I was growing a life, but I DON'T miss being uncomfortable!.

How big is baby: I'm guessing he's about 7lbs now. He was 6lb4oz at his 2 week appointment, up from birth weight of 6lb1oz and from his lowest of 5lb9oz.

Breastfeeding? Still going great. He nurses about 1.5-3 hours during the day and will go about 4 hours between feedings at nights. I'm working on building up a nice freezer full of bmilk for when I go back to work.

Baby's temperament? He's still pretty laid back. We've not had any crying fits where we have done everything and he's still crying. He'll fuss with a diaper change and make some noise when he's hungry but he's so easy going. He loves to snuggle, too!

What I am looking forward to: Hmm, ready to exercise again and lose the baby weight, but I'm just trying to enjoy each day as they come.

"The drama of birth is over. The cord is cut, the first cry heard: A new life begun....The mother - seeing, hearing, perhaps touching her baby - scarcely notices the world around her, let alone how much her body aches. She just participated in a miracle."

Carrol Dunham


I found this quote in a book I was reading last night while enjoying a quiet bath. It brought tears to my eyes (although that's not hard, especially these days!) and it is now in the ranks of my favorite quotes ever. When Jacob was born, all I remember is seeing him - not other people around me, and when I was holding him in my arms, he was all I was seeing. Clara I didn't hold right away but I was no longer aware that I was on the OR table after seeing her face and when I held her for the first time in the nursery, again, she was the only thing I noticed. Likewise with Isaiah and Caleb. Holding, seeing my children, and hearing their first cries, I noticed only their sweet faces and delicate features and marveled at these perfect little creatures that Husband and I brought into this world. All I felt was love and awe of them, I didn't notice the staff, the exhaustion, the line of fire across my lower abdomen , or anything else other than the fact that I had indeed just participated in a miracle.

Pregnancy and Infant Loss Day

Today I'll be remembering all the babies that left this earth too soon. I'll think about those babies who's parents never got to hold them, those who were born sleeping and those who left after a short time. Personally, I will be holding my niece Mirabel in my thoughts...gone at 39weeks. Also I will remembering my own little angel, gone but not forgotten. I am forever changed with a life that was only here for such a short time. Because that life existed, I now hold my sleeping newborn son Caleb in my arms, but I will always wonder who that little life was that occupied my womb for such a short time. May God hold all these angels in His hands, and give peace to those left here with just memories.

Diapers

Just when I thought I had it all together...this am, after getting the big kids off to school, I get the two little guys home and Isaiah promptly needs a diaper change. I go to our usual downstairs spot for diapers and no diapers. I knew we were out of diapers upstairs because I had put him in the last one that morning when I got him dressed, but I assumed we had some downstairs. But no diapers there. I wasn't too worried at that point because there is usually a diaper in my purse, in my van and in his daycare backpack. Wouldn't you know it but not a diaper in any of those places? I curse a bit under my breath because I realized I had to go to the store...and I didn't have a diaper to put on him to even go to the store. Great. And he's been refusing to sit on the potty for the last month, even though he was doing great for awhile. So I put him in underwear, tell him he has to use the potty if he has to go. Now what do you suppose happens? As I'm feeding Caleb because he, of course, decided that now is the time to eat, Isaiah looks at me and tells me he's wet. He emptied his bladder while sitting on my living room rug and is saturated. Fabulous. So once again, I clean him up and I do finally get to the store to get diapers and thankfully he didn't have an accident while we were in the store or van. He did promptly poop in his underwear as we walked in the house, but at least we were home. I can not wait until he's potty trained. I actually thought a couple months ago that maybe he would be out of diapers by now because he was doing so well. But he was just messing with my mind, giving me false hope! Someday though, someday he'll be out of diapers and I won't have pee soaked pants to wash. Ah, the joys of motherhood!

Randomness that is my mind

Today Husband went back to work. It was really nice having him around as we adjust from being a family of 5 to a family of 6. "We are a 6-pack now" he says. But as nice as it was to have an extra set of hands, it was time for him to go back. Don't get me wrong, I love the guy, but I have my routine, my way of doing things and, well, we were getting in each other's way. Plus eventually we'll both have to go back to work and we'll have to see how our routine will be. So today, it was just me and the 4 kids and really, it went pretty well. We'll see how it is when Caleb is a bit older and not so laid back, but for now it wasn't too bad.
Yesterday we had newborn pictures taken with Caleb. We go to this friend/coworker of mine who does photography and has always done a great job. So I'm excited to see the pictures because he cooperated pretty well. We had been working on a pregnancy progression project and while we anticipated taking one about this time, right before I delivered at term, we took the final picture with me in the nude wrap and a newborn. It promises to be pretty cool, so that was fun.
I also had a quick doctor appointment to check on my incision. It's healing pretty well. I had managed to not get that flap of skin moms with c-sections always talk about having...until this delivery. It was inevitable I guess, but the scar itself looks pretty good I will say. A nice thin line that I imagine will fade quite a bit just like it did after my last 2 c-sections. I have to go back in another 3 weeks for the whole 6 week post-partum exam and to be released to go back to work. My plan is to talk to doc about some of my frustration at that point, just so I can see her perspective. I don't blame her for what happened, even though it may sound like it from Caleb's birth story, but I do have a few questions I would like answered. Plus I want to make sure that she knows I wasn't hoping for a preterm delivery to get out of the misery of pregnancy. I've been feeling a bit better with the "blues" lately. I think just getting out of the house and going for a quick walk, or even just sitting outside helps. So fewer sessions of tears for no reason has been nice.
I realized today that while I am enjoying being home, and I don't miss all the politics that swirl around a hospital, I miss working a little. Weird, huh? I miss laboring with the patients, circulating deliveries, and helping moms with their newborns. I know soon enough I'll be returning to the land of labor and delivery so I'm trying to savor my time away.

2 Weeks Already

It's hard to believe that just over 2 weeks ago, I was still pregnant. And strange that I expected to be pregnant right now...and for the next couple weeks. Caleb is doing great. He continues to sleep most of the time, eats about every 2-3 hours and generally is an easy baby for now. He has been awake a bit more the last few days so that's been fun to watch him taking in the world. Yesterday he had an appointment and he is up to 6lbs 4oz. So he's eating well and has surpassed his birth weight! I'm healing well. My incision appears to be healing nicely but my abdominal muscles are pretty tender still, tender well up to almost my belly button. But I figure that was the extra manipulation for the tubal ligation. These crazy post-partum hormones though are the devil. With my 2nd and 3rd babies, I didn't have post-partum blues, but I did with Jacob. And again this time. Nothing serious enough to warrant concern of post-partum depression, but I am pretty irritable, teary, sad at times, emotional, etc. I think part of it is because it is an end - an end of my childbearing years. And while I have no desire for more children, it is an end to that part of my life, and being a labor and delivery nurse, I love the whole pregnancy/childbirth/newborn stuff. This is the time in recovery that I remember why it is so much easier to deliver vaginally. I want to be doing more and my body just isn't ready, and that drives me crazy! I'm also still trying to reconcile the delivery I had to what I wanted, and I'm trying to quit looking back over the last weeks of my pregnancy and wondering "What if I had done this differently, would I have still delivered preterm?" I understand 34w5d isn't so bad, but at the same time, I wanted more time. I had plans, man! I had more maternity pics to have taken and I was going to let the kids finger paint my belly like a pumpkin closer to Halloween! Oh well, now we get to dress up little Caleb for Halloween, won't be taking him out anywhere, but we can still dress him up. That's also an issue - not going anywhere with the baby. Our pediatrician recommended we not take him out in public places for 6-8 weeks...hard to do with 3 older kids, and with errands to run, etc. It's just not realistic but at the same time, I don't want to take him out in a germy store and run the risk of him getting sick. But, other than that, we're doing well. I'm still getting about as much sleep now with a newborn as I did while pregnant, breastfeeding is going great, my breast aren't even all that tender, the kids are doing well and Caleb is such a sweet little baby who loves to cuddle but will also actually sleep in his bed!