Peter Kenneth's homebirth and NICU stay

The Birth Story of Peter Kenneth Fisher

My estimated due weekend, February 21-22, came and went with absolutely no signs of a baby's imminent arrival. I was still working, we had workers banging away in our kitchen-I was glad to see the days go by without a baby. In my mind, I'd envisioned a Leap Day or March 1st baby. When THAT weekend flew by, the impatience and hormones began mounting. On Monday the first, my 41 week prenatal showed that the baby had dropped and seemed to be in a good position, which gave us hope that we might be parents before the week was out. It wasn't until Wednesday that my Braxton-Hicks turned into something more exciting.

Wednesday afternoon I was feeling good enough that Dan and I went to 5pm Mass together. I realized afterwards that I'd felt at least two contractions during the 35 minute service, but didn't think much of it at the time. We went out to a family restaurant after Mass to enjoy what we thought might be our last dinner out for quite awhile. I commented to Dan as I experienced a couple Braxton-Hicks and he decided to time them for practice. Over the course of dinner, we realized that these practice contractions were coming fairly consistently ten minutes apart. My B-H had been fairly frequent for a week or two, but rarely had I felt more than two in an hour. Dan convinced me to come walking with him once I talked him into doing a little shopping simultaneously. We headed to the nearest mall and I browsed through bookshelves while feeling contractions every nine minutes. At first I tried to ignore the times and just tell Dan when they started, but after over an hour of regular contractions, I couldn't help but check the times. The contractions made my belly harden enough that they were impossible to miss and they made my lower back ache a bit, too. The backache was the key to my determining that these were no longer Braxton-Hicks. We stayed at the mall nearly two hours, walking and hoping the contractions would get stronger.

We got home that night and watched "The Princess Bride" and I got online and wrote to everyone I knew that I might be in early labor. We called the midwives to let them know that something was happening. They repeated the instructions I'd heard over and over again-get as much rest as possible. They said that I might sleep through the night and have things start up again in the morning, or they might get stronger as the night went on. I went to bed at 11:30 figuring that either I'd be well-rested or in active labor by morning.

I spent my first three hours Wednesday night dozing for a few minutes and waking for contractions. My body did such a good job sleeping between them that it felt like they were coming without breaks in between. I tossed and turned trying to find the most comfortable way to get through them and becoming increasingly miserable. Seeing Dan asleep beside me made them worse somehow. The night dragged on and on-every time I woke up I looked at the clock hoping that more time would have passed. Around 2am, I couldn't stand lying in bed any longer and went into the baby's room. I surrounded myself with pillows and leaned back in our IKEA semi-rocking chair. I was able to wedge things behind my back so that as the contractions came, I would rock and put enough pressure on my back to get through them. Sitting like this, I was able to go longer stretches without waking-maybe 20 or 30 minutes at once. It felt heavenly after being in bed. I began writing down the times and realized the contractions were about seven minutes apart for most of the night. Around 5, I decided that I'd dealt with this alone long enough and it was time for Dan to share the pain. I couldn't force myself to sleep any longer. He came into the nursery with me and spent an hour or two timing contractions and rubbing my back when I asked. We may have both dozed a bit after awhile.

Thursday morning, March 4th, as the sun came up I had high hopes of delivering a baby that day. I'd had about 6 hours of every-10-minute contractions and another 6 to 8 hours where they came every 7 to 10 minutes. It seemed like asking a lot to imagine a baby by lunchtime, but dinner or midnight did not seem out of the question. I was about on track to follow my mom's 48 hour delivery with me, her firstborn, or maybe somewhat faster.

We called the midwives and told them how my contractions had gotten closer together overnight and that I'd rested as much as I could. We'd planned on having Dan's sister Kara (a student nurse who plans to become a nurse-midwife) with us for at least my early labor. She was scheduled to be nearby for her clinicals starting at 8am, so we figured it would be better to catch her before she arrived than for her to potentially miss most of my labor. Dan picked her up from the hospital once she arrived and they were back before 9am.

I was in a good mood when they came back. The contractions slowed me down, but I could talk through them without too much trouble. Kara made herself some eggs, I had a bowl of oatmeal, and the three of us settled in to watch "Oh Brother Where Art Thou". During the movie, I played around on the computer, mostly replying to messages inquiring as to whether anything was happening.

By lunchtime Thursday, the contractions had clearly spread out-they were coming every 15 minutes at the most. We decided it was safe to keep our appointment with our tax preparer across town. I noticed a few contractions while we were there-I would stop talking and quietly breathe through them, but I doubt Dan or the tax guy even realized I was having them.

Later that afternoon, we tried to walk the baby out. The three of us walked down to the river at a pretty good pace-especially for a 42 week pregnant woman. I kept walking through some of the contractions and stopped to support my back through a couple. A few times, I needed to stop and rest, but it was mostly to give my legs a break. We detoured to Dairy Queen on the way back despite the fact that it wasn't really a warm enough day to walk outside eating ice cream. We were out more than an hour by the time we got home.

I went back on the computer and had enough messages that I decided I couldn't keep up with them anymore and it was time to stop replying. I didn't want to stress myself out thinking that I needed to get back to the computer. I did keep reading my usual sites until Friday afternoon when the messages started expressing worry about my safety and then I ignored the computer altogether until after the birth.

By 5pm Thursday, the contractions were back to ten minutes apart, after having 20 to 30 minute spacing for most of the day. I was able to nap for awhile at that point, waking only for the contractions. Around 9 or 10, it was clear that the birth wasn't going to happen immediately, and Kara went to her parents' house for the night to sleep. I felt bad that she'd missed class and Dan had missed work and we were back at the same place I'd been 24 hours before, but there'd been no way to know that the contractions would slow down like that.

Thursday night, I started off in the IKEA chair since lying in bed had been so horrible the night before. Dan made a bed of blankets on the floor next to me. It seemed like I was only in active labor when the sun went down because I had contractions every 5 to 7 minutes for the second night in a row. My back bothered me more than anything else, and during contractions I would have Dan push on my lower back when I indicated that another contraction had begun. They were lasting 45-60 seconds each. I never really had contractions shorter than 45 seconds, even at the beginning. I was able to rest more in the chair than I had in bed, but I didn't have more than a few 20-30 minutes stretches of sleep throughout the night.

Friday morning I was tempted to send Dan to work so he could have more time off once the baby arrived, but I was glad he was with me later, even though the contractions slowed to every 10-20 minutes during the day. Again. I talked to Jeanette (of MT) and she recommended a number of baby-turning techniques like side-stepping down stairs and doing lunges since the baby had been in some awkward positions at various points during my pregnancy. She highly recommended seeing a chiropractor. I sort of pooh-poohed her ideas because I was tired and grouchy, but tried the side-stepping thing and seemed to twist my hip or something painful, and that was the end of that.

Around lunch, we called the midwives to check in and ask if they had any suggestions. We also found out that my back-up doctor wasn't going to be at work on Monday, but that she was fine with waiting until Tuesday before an induction would be deemed necessary. Earlier, we'd thought that I'd have to go in for a bio-physical profile and ultrasound on Friday if the baby hadn't arrived. Since labor had begun, even half-heartedly, I was able to avoid those procedures.

Essentially, the midwives wanted the labor to either slow down so I could rest or speed up so it would end. I might have been able to slow it down by taking calcium, but purposely doing something that did not get the baby out as soon as possible didn't sound like a good plan to me. Instead, Dan went to the store and bought bottles of blue and black cohosh, which I proceeded to take all afternoon. I'd heard of people taking them to help induce labor, but the midwives said that they didn't find that the cohoshes made much of a difference unless the woman was in labor already. They suggested taking a dropperful of one cohosh diluted in a glass of juice every fifteen minutes, switching between them each time. The liquid tasted terrible-it made the juice taste rancid, and I quickly tired of the whole thing. I took the first dose at 12:45 and the last at 4:20, with nine more in between. The timing got thrown off depending on when contractions came. I went through a LOT of juice during my labor, all of it apple, grape, cranberry-not the acidic kinds. After the cohoshes, I forgot how sweet juice normally tastes.

The midwives said that the cohoshes would take up to an hour to take effect and that they wouldn't want me to keep taking them indefinitely. The contractions did pick up some after beginning the cohoshes-about every ten minutes, rather than 15-20-but not to the rate we'd hoped.

Around 4:30, Jeanne came over to check me. I peed on a stick that declared me to not be exhausted-I wasn't spilling ketones into my urine. I think that if I hadn't passed that 'test', they might have considered transferring me to a hospital, or at the least, kept a very close eye on me after that. We decided against an internal exam that day. I'd had one at 37 weeks (a month before!) showing me to be 80% effaced and a fingertip dilated, but that was all. My blood pressure and the baby's heartrate were both fine. So everything looked good except that I was at 42 weeks and seemed like I'd be laboring forever! Jeanne believed that the baby was in a position that wasn't allowing him or her to properly dilate my cervix and that my contractions were working to turn the baby. She advised stopping the cohoshes since they weren't doing much. She suggested having a chiropractor work on me to help things along. Of course, it's now 5pm on a Friday, which wasn't the best time to find someone. She said she'd try making a few calls. Perhaps if I'd listened to Jeanette, I would have been able to see someone that day, but I figured that the midwives knew what they were doing and they'd tell me if I should see a chiropractor. Jeanne also showed me how to do lunges during contractions to get the baby turning. Doing anything other than leaning over and getting my back rubbed during a contraction wasn't that fun, but I tried a few lunges now and then.

For dinner that night we decided to make veggie lasagna. We were short of ingredients and decided to make a field trip of going to the grocery store and picking up a video. I was cranky and moved very slowly through the store-I knew walking was good for me, but my pelvis was driving me crazy. If it hadn't been obvious before, it was clear now that something was wedging its way through that space! I was in my own world as I wandered through the store-it seemed so odd to be having contractions, experiencing labor as the rest of the world bought groceries as usual. At the video store, we went with "Pirates of the Caribbean"-we'd both seen and enjoyed it and a comedy seemed like a good idea. I was just glad to get home again. Having contractions while out of the house made me grateful once again that we were planning a homebirth. Returning to the familiar rooms was very comforting.

Around 7, my friend Adam was scheduled to arrive at the airport for a 24 hour layover. We had planned for him to come visit a bit, then stay overnight with my parents. Of course, we'd expected a baby to be in the house by then. When he found out Friday afternoon that I was still in labor, he tried to get a flight out to L.A. Friday night, but couldn't. As it turned out, by 7, I was looking for some distraction, and an hour-long visit by Adam and my mom was fun. He brought a baby gift, checked out our house, chatted awhile, then left for my parents' house. The contractions then were strong enough for me to stop and breathe through them, but I was cheery and chatty otherwise.

Friday night, I went back to sleeping propped on the chair, since it seemed to work better than the bed. That was my best night's sleep in three days-I'd wake up every 30 to 45 minutes. Anything was better than waking up every 10 minutes all night.

Saturday morning, Kim came to check on me. Again, my urine showed that I wasn't leaking ketones, my blood pressure was fine, and the baby's heartrate was great. We decided it was time to see what an internal exam would tell us. I figured that even if I wasn't dilating, the baby might have done lots of turning and I wouldn't be too disappointed no matter what she felt. It turned out that my cervix was paper-thin and dilated to 3cm! It was a little thicker in the back, which Kim thought indicated that the baby's head wasn't pressing evenly on my cervix. The baby was at zero station, so he/she had dropped quite a bit. It now seemed very likely that the baby was positioned poorly and that all my contracting was working him/her into a good anterior position. She got serious about finding a chiropractor and left messages for a few she liked who might be willing to make a Saturday house call. The confusing thing was that the baby's body felt anterior-it was just the head that seemed crooked. It was also possible that he or she was holding his/her hands up to his/her chin and preventing the head from fitting well.

We considered going back to the cohoshes, but never summoned the willpower to do that again. The potential risks of taking them outweighed the benefits now that we'd tried them without success the day before.

Saturday afternoon, Dan's mom came over. Since the visit with my mom and Adam had gone well, we figured the distraction wouldn't hurt anything. She's a licensed massage therapist, and making use of her skills certainly sounded good to me. She'd just started working on me when the chiropractor arrived. Lucia, the chiropractor, turned out to be someone I knew from my parents' church ten years ago. She had me lie on the couch, which was surprisingly comfortable. She worked with my pelvis, which was out of whack in some way, then did muscle work on my belly. I did feel some changes, but it wasn't the miracle baby-turning cure that I'd convinced myself would occur with her arrival. She showed Dan's mom some techniques that would help me before she left.

That evening, we went back to the mall where my contractions had got going three days before and walked and walked and walked. I was moving faster than I had for weeks. Most of the stores were closed, so we just walked the halls from one end to the other, stopping at most of the bathrooms along the way. We met my mom there so she could loan us some videos, and she walked with us for awhile. I think she felt better seeing me and knowing I was okay. For Dan and I, going from one day to the next was hard, but our families were going buggy wondering what was going on. Everybody was afraid to call us because they didn't want to intrude.

Saturday night, we propped me up on the couch with pillows everywhere. Dan made a little mattress of blankets on the floor next to me and we prepared for another long night. Going by our contraction notes, it looks like they came every 8-10 minutes between 10 and 11, then we slept until midnight and they came every 6-10 minutes. The next notation is at 3am-I can't remember whether I was sleeping during these gaps too, or if I just didn't wake up Dan for support (he was the contraction tracker). I did have my first blob of mucus plug around 2:30. Every time I'd talked to the midwives for WEEKS, they'd asked if I had any unusual discharge. Nope, nothing ever. Until then. It was clear and looked like lots of egg-white, fertile cervical mucus to me. Just lots and lots of it. Dan got me through a couple contractions around 3am, then must have slept until 5. At 4am, more of my mucus plug came out.

At 5am, we were both awake for the day. Between 5 and 7, the contractions came every 7 to 15 minutes. At 6:45, I saw more of my plug-this time tinged with some blood. Starting at 7, the contractions became more frequent-they were suddenly only 3 to 5 minutes apart (lasting about a minute each). We'd been watching "An Affair to Remember", and halfway through, I realized that I was missing more than I was watching and turned it off. By 9am, some contractions were lasting up to 90 seconds and were still coming steadily every 4 minutes. Finally, we were getting somewhere!

We called the midwives and Kara and told them all to come over. I was beginning to feel like I needed the midwives' support to know how to cope. If nothing else, the change in frequency made me feel like the baby could potentially come anytime and I didn't want him/her to come before the midwives did-no unassisted birth for me, thanks! I spent the contractions pacing back and forth in our living room and entryway, hoping to see someone's car pull up. During a contraction, I could feel my uterus tightening, but the real pain came in my back. My lower back ached throughout each contraction, building then waning after the tightness released, cutting down my rest time between them considerably. I tried to remember that I would get a break each time but it got harder to avoid thinking about that next inevitable contraction.

Kara arrived before the midwives and set up camp in the dining room and kitchen. She and Dan probably gave me something to eat. At lunchtime, I had toast with peanut butter and some juice. Throughout the day, they force-fed me an energy bar-it took me hours to get through that thing with the tiny bites I took between contractions. I was scared to death that a contraction would come while I still had something in my mouth. I was a little better about fluids-I could take a few sips at a time. I had no desire to eat, but I knew that if I didn't keep up my strength, I'd be in trouble. If I couldn't be rested, I needed to at least have food in my belly. I'd expected to be a puker, but at no point did I get nauseous. By the time that the midwives came around 10 (and we stopped writing down contraction times), the contractions were 2 to 4 minutes apart and lasting 75 seconds.

The midwives stayed out of our (Dan and my) way for the most part. Every hour, they checked the baby's heart tones, which were generally between 120 and 144 beats per minute with good variability. In the early afternoon, my tailbone began to hurt during contractions and that quickly became the worst pain to manage. Kim got ahold of Lucia, the chiropractor, and she agreed to return. It appeared that the baby was having a hard time getting past my tailbone and in my mind, as soon as that obstacle was accomplished, the baby would fly right out. We waited and waited for Lucia, who finally arrived at 4:45. Once again, she was able to work on me, but the pain didn't magically disappear. Shortly after she worked on one area, she came back and discovered that as the baby shifted, the problem immediately returned.

At 6pm, I continued to have bloody show as I'd had since the night before-there was more blood in it as the day went on. Whenever I saw more show, it gave me hope that I was dilating more and was encouraged, no matter how odd it was to have this goo coming out whenever I peed. At that point, I ate some soup and, in their notes, the midwives said I was coping well. Sometime around then, the tailbone pain lessened and I returned to my previous back pain. I never did feel menstrual cramp-ish pain-my uterus would tighten and my back would hurt.

Around 7, I thought I overheard one midwife telling someone that I was probably 6 or 7 cm dilated and entering transition. This gave me a lot of confidence because I felt like I could handle labor as it was, and transition was known to be the hardest phase to tolerate, particularly in drug-free labors. I headed upstairs then and only briefly came back down to the living room later before delivering. Somehow, thinking I was in transition meant that I should stay in the bedroom and bathroom. It was easier to avoid using the stairs.

At first I stayed in bed in the side-lying position. After awhile, I went back to standing during contractions and walking in between them or slow dancing. Throughout all of them, I needed Dan to push and rub my back during each contraction. I vocalized some, mostly a low moan. Every once in a while, I had the chiropractor (who'd never left) work on my back or just help rub. I could hear Kara and the midwives talking downstairs, but the house seemed muffled-the sounds, the lights, everything was dim to me. Dan says that the entire day I was in my own world and acted like someone who woke up in the middle of the night and was trying to find my way to the bathroom. It wasn't possible to talk with me, but every few minutes, I needed him there to help me through the next painful minute. When the midwives would come to check on the baby, I'd have to lie down for the fetoscope, which was never pleasant. I knew they had to check him/her, but I dreaded hearing them come in the room to do it.

By 10pm, I was tired. When I'd gone upstairs as the sun set, supposedly in transition, I'd expected to have the baby by midnight. There's a history of babies born on the seventh of the month in my mom's family, and March 7th seemed like a great birthday. (Heck, March 1st would have been fine, or the 2nd, or 3rd&#8230 But by 10pm, I was convinced that the baby wasn't ever coming out. Despite the midwives' warning that it might not be good news, I decided to have my first internal since active labor began. The result-7 cm dilated, zero station. I was crushed. I really, really wanted to hear that I was 8 or 9 cm along. But still at 7, I couldn't see how I'd ever progress any more. That was the only point in my labor when I would have requested an epidural, had it been an option. I could cope with the contractions, but the unknown labor to come was more than I thought I could handle. I'm pretty sure I cried. I asked the midwives what my options were, part of me wanting to know what a hospital transfer might bring. They convinced me that what I needed was rest. Later, I recognized my hopelessness as a clear sign of being in transition, but at the time, it didn't seem possible that just because the Bradley book says women want to give up at transition, that I would experience that. I then spent 20 or 30 minutes in the bathtub. I'd expected to use the tub more during labor, and possibly deliver there, but I couldn't get my belly underwater or be in any position other than leaning back, and it just wasn't as comfortable as I'd expected. The warm water did relax me enough that I was able to curl up on the bed next to Dan and rest in the dark for about half an hour. It seemed like I was just having one contraction after another and I finally gave up and got up around midnight, but I must have been sleeping between contractions. The time I spent in the bath, then napping, must have given me the strength I would need to get through the pushing phase. I woke with a new energy-the hopelessness had passed.

At 12:15am, I realized that the end of each contraction felt different-I thought they were urging me to push. I didn't think I could have gotten fully dilated already, but with each contraction I was more convinced that my second stage was beginning. We got the midwives back upstairs and they checked me again-10 cm with a lip, +1 station. By golly, I'd arrived at my pushing stage after all!

I think the midwives were dozing for most of the time between my 10pm check and 1:30am because one of them came upstairs at that point and was surprised to hear that I'd been pushing. I varied between sitting in bed, squatting with Dan and Kara's help, and side-lying. Early on, I remembered pooping onto a chux pad and being glad about it because at least I was pushing SOMETHING out! Ever since I'd gotten out of the bath, I was wearing just a nightgown, but eventually I took it off-I remember being concerned that it was going to get messy and not wanting to bother with it anymore. So much for modesty! My thigh muscles grew sore and squatting became more of a challenge. I would moan through each contraction, giving a number of short push attempts. I have stronger memories of my thighs being sore and not being able to hold myself up than I have of the contractions themselves. Finding positions that didn't make my muscles ache was a priority.

Between 2:30 and 3:45, a midwife came to check the baby's heart rate four times and he/she seemed to be coping well. At 3:45, they did another internal. The lip was gone and the baby was still at +1 station. My contractions' intensity had dropped somewhat. Someone asked when I'd last peed and I realized it had been a few hours since I'd seen anything other than bloody show. Apparently, my bladder was visibly distended and my perineum was beginning to swell from the extended pushing. I could tell that the midwives were concerned that things were taking too long. When questioned, I also realized that I didn't feel the baby descending when I pushed. Jeanne suggested that potentially, with some Pitocin, the contractions might be strong enough to get the baby out sooner. They gave us two options-transfer to the hospital for Pitocin and possible pain relief, or stay at home, take a break from pushing, and then give it another try. Either way, they recommended being catheterized to relieve the bladder pressure I didn't even feel. We decided things had gone on long enough and it was time to transfer.

In my mind, I was pretty sure that going to the hospital would mean a C-section. It would also mean 15 minutes of contractions in the car, plus maybe up to an hour while the details of transferring a fully-dilated woman to the hospital got sorted out. Dan and Kara ran around gathering clothes for the baby and me. It was a crazy whirlwind, trying to think through where we'd stored baby things in the midst of the still-present contractions.

As Dan and Kara prepared for the transfer, Kim and Jeanne were working on the catheter. I don't know how often my midwives insert catheters, but I doubt it's very often. Add to the challenge a swollen perineum, and it took them a few tries to get it in. Instantly, I felt immensely better. Kim's notes indicate I released a cup of urine. It felt like I peed for a very long time.

They wanted me to refrain from pushing for awhile to help relieve the swelling, but that was nearly impossible. The best I could do was to breathe through the beginning of the contraction, and once it got really intense, I'd push. That didn't last too long before I returned to full-fledged pushing around 5am. Jeanne encouraged me to really push, just for awhile, to see if the baby would descent. She later said that she knew my pelvis was large enough and with enough time, the baby would turn him/herself into position and find his/her way out. "One more try" turned into pushing for however long it would take. After 20 hours of laboring at home, I couldn't quite give it all up yet.

The midwives seemed to think that the pushing I had been doing was ineffective and I needed to change my approach. Dan and I were confused because their instructions were to do exactly what our Bradley classes told us to avoid-holding my breath and pushing as hard and long as I could. Nevertheless, we figured the midwives knew what they were doing and I did as they said. I tried a number of positions-side-lying, semi-reclining, hands and knees (which I'd expected to like, but didn't), and squatting while being held under my armpits are the ones I remember. By 5:30, I had found the position where I would remain-semi-sitting on my bedroom floor, leaning against my dresser. I was so worn out that all the upright positions made my legs shake, no matter how much support I had. In the semi-sitting position, I was able to pull back on my own legs as I pushed.

A strange thing began to occur with this second round of pushing. In all that time, my bag of waters had not yet broken. As I pushed, the midwives could see a silver of amniotic sac get wider. They held up a mirror so I could see too and be encouraged by my progress. I could feel the baby descending now. The sliver grew and the midwives were convinced that my water would break at any second. By now, the chiropractor had left, but Kara sat in the corner of the room and each midwife sat on one side of me. The last of Dan's adrenaline had been spent gathering clothes for the cancelled hospital transport and throughout the second round of pushing, he would doing anything someone asked, but he was clearly emotionally and physically exhausted and left the support for the midwives. Mostly, he sat and watched. He later said that he'd been nervous when we decided not to transport and he had just enough confidence in the midwives to follow their instincts throughout that last part of my labor.

By now, Kim listened to the baby during each contraction and often did internals too. The baby's position was a bit mysterious-they couldn't feel his/her fontanels, so it appeared that the head was still askew. At first, they were careful not to break the water bag in order to give the baby as much space as possible to turn. As time went on and the water bag emerged, I would have welcomed its accidental pop since it seemed like the baby might just come out with the amniotic fluid. For two midwives who are generally opposed to internals, I ended up with more than I can count, mostly in that last couple hours. The knowledge they hoped to gain regarding the baby's position was more important than avoiding potential infection by doing internal exams. For awhile, they were even checking during contractions.

Eventually, a 'forebag' of amniotic sac came out of my body-it looked like a two or three inch water balloon, partially filled, was hanging there. It was so strange. Finally, a midwife said that she could see the baby's head through the bag and he/she had hair! Hearing about my baby's hair was astonishing to me-after 9 ½ months of pregnancy and four days of labor, realizing how close I was to birthing a real, live baby was crazy. I had envisioned a bald baby and hearing that he/she had hair made it even stranger.

We never had the bursting bag that I expected-from what we could tell, my bag of waters was still intact until the birth. I wasn't able to see the baby's head emerging and sinking back in like in the videos because of the bag being there. I did feel (with my hand) the bag and the head behind it, but it was such a foreign feeling that it was hard to comprehend what was happening.

Once the head was close, everyone kept telling me that the baby would be there soon, to just push a little longer, a little harder. My contractions didn't feel as strong as they once were, but I would push even when the sensation was dying away, doing all I could to bring that baby out into the world.

I looked down at one point and saw blood on Jeanne's hands and knew I'd torn something, even before the head was out. Then I felt the baby crown and I knew I was tearing as I pushed the baby's head out. I'd been told that tears and even episiotomies can't be felt at the time because of all the pressure, but I could feel it. There was something horrible in knowing I was doing damage to my own body, but the labor had gone on so long that the midwives weren't able to take the time to keep my perineum intact. They'd emphasized during our prenatals that preventing tearing was one of their primary goals. It's not that they didn't try, or didn't care, but we all just knew that this child needed to come out, the sooner, the better.

Dan says he saw the baby's head turn to align with the body, just like the books say. I looked down at the baby's head between my legs and simply said "Youch." I never reached a point in labor where I was screaming or swearing. Frustrated, crabby, quiet-sure, but never loud and obnoxious.

A number of things happened once the head was out that felt like a flurry of activity at the time, but I wasn't aware of all that occurred until later. Kim reached up to pull the amniotic sac off the baby's head and discovered a hole in it near the baby's neck. Apparently, my water had broken after all, but too high up for the fluid to come out. Once the head was cleared, the midwives went to wipe off his/her nose and mouth and found both blood and meconium, so they used the bulb syringe to try to clear it. In addition, the baby's umbilical cord was tight over his/her shoulder, acting as a harness. One of them pushed it down over the baby's arm to allow the body to come out.

I have no memory of birthing the baby's body. I remember pushing out his/her head, and then they put the baby on my chest, still suctioning him/her, and rubbing him/her with blanket after blanket. For two women who emphasize the extreme importance of immediately nursing and mom/baby bonding I knew something was wrong. I was trying to hold onto the baby, but all these hands were in my way, vigorously rubbing, while the baby made these small grunting, coughing sounds. I felt completely helpless-I was sitting on the floor, holding a slippery baby covered in bloody blankets and I had no idea what I should do. I tried to hold him/her to my breast, but someone advised me not to since they were still helping the baby breathe.

Once things calmed down a bit, we decided it was time to discover whether we had a boy or a girl. For nine months, we'd avoided ultrasounds and I'd gone back and forth with my guesses as to the sex. Then suddenly, I had a son. Dan's immediately said, "Amy, we have a little boy!" The midwives immediately said, "He's not so little!" It was the weirdest feeling for his sex to be determined at last. Part of me thought that I could wrap him back up, and maybe he would be a girl when I checked again. I couldn't believe that after all the waiting, we actually knew. I suddenly imagined a future with Legos and soccer and splashing in the mud and years as the mother of a boy. What was I supposed to do with a boy? It's not that I was hoping for a daughter, but I grew up with a sister, Dan only has sisters, I don't know how to live with a little boy!

We realized that no one had checked the clock as he was born, but guessed it had been five minutes or so and we declared his birth to be at 6:35am, Monday March 8th, 2004. The sun was coming up as we all sat on the floor. A couple weeks earlier, I'd told someone that I liked the idea of laboring through the night and giving birth at sunrise. I hadn't expected days of labor to precede it, but that's exactly what happened.

Then I started worrying about the third stage and how that would go. The thought of pushing anything else through there was not remotely appealing. Before I could get too caught up in fear, I found myself pushing out the placenta and hardly realizing it (It was 6:44, I found out later). I hadn't been given anything, it just came on its own. Soon after, Dan cut the umbilical cord, which turned out to be fairly short.

After Dan had a chance to hold the baby (he was even more awkward than me), the midwives took him away to give him oxygen and deep-suction him. He was making grunting sounds-a sign, they said, that he had something in his lungs that he needed to cough up. Jeanne held him for quite awhile, giving "blow-by" oxygen-Dan called it the Jeanne isolette monitoring system.

Kara, who'd been in the background throughout the whole second stage, had broken down sobbing after the baby was born. Dan and I were on the floor still in shock over everything. Eventually, I asked someone if I was bleeding too much and was told that I was fine. Since Jeanette, the homebirther I was most familiar with, had problems with bleeding afterwards, it was a relief to know I wasn't having similar trouble. Kara and the midwives massaged my uterus a bit, but nothing like I'd heard other people experience. Apparently, it firmed up quickly and wasn't cause for concern.

At 7:30, they helped me get up and make my way to the shower. Although I didn't mind the blood and goo I was covered with at the time, it felt really good to be rid of it! While I was there, Dan and I discussed the name we'd been considered and decided that our son would be forever known as Peter Kenneth. I'd waited to make a final naming decision until after the birth in case it didn't feel right. But when it came down to it, I had no better idea than I'd had before. In the end, I couldn't think of any reasons not to use our first choice name.

They helped me into bed and I was immediately hungry and thirsty-I ate an entire energy bar and gulped a glass of water, after taking 12 hours to consume the previous bar. I rested until they brought the baby back at 9am for his newborn exam. His APGAR scores, at 1, 5, and 10 minutes had been 7, 8, and 10, losing points for respirations, tone, and color. Even during the exam, his hands and feet still looked slightly blue. Dan and Kara picked out a sleeper and diaper for him to wear. For some reason, we hadn't thought to choose anything earlier. It seemed weird for all those little clothes we'd carefully washed and folded away to be used on an actual baby! We finally got to find out just how big he was. Kim guessed that he was at least nine pounds. He didn't seem that big to me, but I haven't seen many newborns to compare. Jeanne put him in her fish scale and determined him to be 9 pounds exactly. He was 22" long, with a 14.5" head and a 14.5" chest. Apparently, I'd birthed a fully-grown football player! Peter's breathing had improved over the previous hours with the help of the oxygen, and they gave him back to me to try nursing after the exam. He was clearly rooting and trying to suck-he'd suck my finger-but he wouldn't latch on. His breathing was labored enough that nursing was still too much effort.

As they held him up to me, my eyes were drooping-I could hardly stay awake even while holding the baby. Meanwhile, I was getting instructions about keeping watch on his breathing and making sure that he latched on by the end of the day. I just kept thinking that I couldn't take care of a baby! Wasn't somebody going to be around to make sure I didn't screw everything up? Suddenly, the midwives' questions during our prenatals about who we'd lined up to help us came back to me. We were going to need a lot more help than I'd thought. Why exactly hadn't I studied the chapters on baby care?

Kara took Peter, since I was clearly going to fall asleep no matter what, and the next thing I knew, the midwives were back trying to wake Dan and I up. It was 10:30, and Peter's breathing had gotten worse instead of better. They were almost through the entire oxygen tank, and after consulting with the backup doctor, they decided that Peter needed to get to a hospital. The doctor had lined things up at Children's, the best hospital in the area for very sick babies. They said that he might be gone for 24 hours to be observed. I felt like this mysterious baby I must have given birth to was being taken away before I'd come to grips with being his mother, but I knew it was the safest thing to do.

I fell back asleep and only woke for lunch and dinner when Kara brought me food. The eight hours of sleep I got that day were more than I'd had in nearly a week. By sunset, I felt better than I had in a long time.

While I was sleeping, more things happened than I could possibly have guessed.

-----

The Week at the Hospital--this section is different because it's a combination of entries Dan made at our hospital web site, entries from my journal at the time, and comments I added months after-the-fact. I'll try to keep it all clear.

Monday, March 8th:

Dan:

Peter was born this morning at home at 6:35 am after a LONG labor…

The fluid was terminally meconium-stained (baby pooped inside during the last bit of labor), probably due to the cord over his shoulder that was pulled tight before final escape. This was remedied as his head came out, he was thoroughly suctioned, and the rest of him slid out. It took some more coughing (him) and suctioning (the midwives) to get him crying, but he did and perked up well. The lungs sounded wet, so he was "cried" to get the gunk out and watched, and given some blow-by oxygen (a tube blowing into his face). After a bunch of checking, he was deemed to be healthy and we began the cleanup.

The midwives did a full newborn exam which looked good. We were told to watch him closely for about 24 hours to make sure his color remained pink. My sister Kara stayed with us to watch the baby while Amy and Dan (now Mom and Dad) slept. However, we were woken at 10:30 to be told that his grunting wasn't going away (a sign of labored breathing) and that we'd need to take him to the NICU for monitoring. One midwife led the way to Children's Hospital in her car, while the other followed with Peter and Dan. It was a bit scary, since a snowstorm had quickly erupted outside making travel difficult. I kept stimulating the baby to keep him moving and making sounds in the back as the midwife drove. We made a wrong turn in the snow, and had difficulty parking, but were led right into the NICU (our backup doctor had set it up).

The crew here is really great. They were all very kind and informative to me (Dad), as well as respectful of the fact that we had the baby at home. Peter wasn't in immediate, emergency danger, but his breathing was grunty and very labored. An x-ray identified pneumonia in both lungs (the wet fluid we had heard) as well as 2 - 3 small pockets of air that had poked through his lung walls. Both are caused by meconium, blood, or amniotic fluid that enters and irritates the lungs during labor. Also, blood tests found that his blood was a bit too acidic from his labored breathing. The oxygen mask wasn't getting his blood O2 up high enough so they tried a little dome over his head with 100% oxygen. That still didn't have the desired effect, so they intubated him. This is how he is tonight, and his blood O2 is now very good and his lungs sound much better (still a bit of raspiness, but filling well). He is also being given two kinds of antibiotics to prevent any potential infections from the pneumonia. The air bubbles are too small to take out with a needle, so the will be left alone and will hopefully reabsorb on their own.

Amy is doing very well after the birth, and Peter is expected to make a full recovery. He will only be left on the ventilator until he can breathe on his own without much difficulty. He will remain here for at least 5 - 7 days to watch for infection and to check on his pneumonia. There were no emergency procedures done, but Peter is now getting the help he needs to breathe after an unlucky birth. We will keep this journal updated (hopefully daily) with how he is doing.

Your prayers for patience, courage and health are welcomed. Amy and I are so glad to see our wonderful baby boy, despite the unexpected circumstances!

Me, now:

Three hours post-partum, it looked as though Peter's lungs were clearing and we'd just need to keep an eye on him, so Dan and I both got some much-needed rest while Kara and the midwives watched Peter. I am so grateful they didn't leave him with us because we probably would have been too tired to see that his breathing was getting worse instead of better. Kim (one of the midwives) tried to wake Dan up but couldn't rouse him until she woke me and I told him he needed to get up.

At first, the midwives thought Peter just needed to be seen by the back-up doctor in her clinic, but the doctor told them to go to the hospital instead. She (Dr. B, the one I'd seen at 37 weeks) called St. Joe's, her preferred hospital, but they told her to bring Peter somewhere with a higher-level NICU. So she called Regions, but they were full and told her to call Children's. Dr. B didn't have privileges there, but was able to arrange for Peter's arrival anyway.

We hadn't paid much attention, but shortly after Peter was born, it began snowing. By 10:30 when Dan and the midwives left the house, there were white-out conditions. Kim drove her car and Jeanne drove my car, with Dan watching Peter in the back seat. The drive is usually just under 15 minutes, but in the snow it took them over 45, even in mid-day. The freeway barely moved and later we learned that a 20-car pileup had occurred in that stretch of road going the other direction right at that time. Everywhere they looked, cars were sliding off the road.

After a few minutes without extra oxygen, Peter's grunting got so labored that Jeanne counseled Dan to take him out of his car seat in order to rub and stimulate him more. Those few minutes holding Peter in the midst of the sudden blizzard were the most contact Dan was to have with Peter for many days and he later said that he was happy he was able to help him in some way in the midst of a very scary time.

Dr. B had cleared Peter's arrival with the NICU staff and at the front desk, Dan was told to bring the baby straight up. I am so grateful they did not need to sit in the ER or fill out any paperwork-they were given a NICU room immediately and seen by the perinatologists who'd already been briefed on the situation. Throughout the day, Kim and Jeanne stayed with Dan, answering questions if Dan asked them, but generally staying in the background. The NICU staff was aware that we'd had a homebirth and must have realized that they were the midwives, but just directed everything to Dan and let them stay to support him. Occasionally they were asked information such as APGAR scores. Not once was our decision to homebirth blamed for Peter's health.

As Dan's journal states, Peter was x-rayed-right there in the room while Dan stood by. Only the eventual MRI required leaving the room. The hospital contained nearly 50 NICU beds, with separate rooms for each family (multiples had bigger rooms). The rooms had a pull-out couch, a storage locker, and privacy curtains in addition to all necessary medical equipment. The department was just renovated a year ago. For the families of preemies, the additional privacy must make the long stays so much more bearable. In addition to the babies' rooms, there was a family room with comfy chairs and a TV, plus two computers and a kitchen where we could keep food. The only computer time I had that week was while I ate meals in that kitchen.

A variety of techniques were attempted to get Peter's oxygen level up to normal. When they put an oxygen helmet on him, he rolled onto his side and grabbed at his face, trying to get it off. The nurses were amazed by how powerful our newborn was. Granted, they're used to 3 lb babies, but still. Eventually, he had to be intubated when the less invasive procedures weren't helping him enough.

A number of routine procedures occurred upon Peter's admittance-they took his height and weight (22.4" and 9 lbs 7 oz) and gave him the PKU test, the eye ointment, and the Vitamin K shot. Although I'd hoped to avoid the eye goop and shot, even the midwives said that if he was going to spend his fragile first days in the NICU environment, it was probably best to have them.

Meanwhile at home, Kara was staying with me. She woke me up to eat around lunchtime and again in the late afternoon. She then drove me to the hospital that evening. Just as we left, Kim dropped Jeanne off since her car was still at our house. Getting into the car was no easy feat and I began a habit of using a wheelchair in the hospital to avoid aggravating my tearing any more than necessary and avoid any extra work. The woman at the NICU front desk asked if I was Peter's mom and led us to his room.

After eight hours being away from my baby, it was very strange to see this little guy wrapped up in an incubator, under a heat lamp, with a tube down his throat and taped to his face, covered with wires. All sorts of machines were blinking and buzzing and the baby looked so small and strange surrounded by all of that. I didn't know if I could touch him. He looked so different than he had in the morning, wires and gadgets notwithstanding, due to the IV fluids and lack of clothes or birth goo. It was hard to believe that I'd actually given birth to this child and he was mine. I had a BABY? A son?

Peter was either sleeping or sedated, it was hard to tell which, but the nurse said it was okay for me to touch him. I began to stroke his head and arm until she said that stroking was too much stimulation and I should just hold onto him. We stayed for an hour, maybe two. The resident came by to talk to us, and I talked to someone about pumping my milk. I had originally hoped to begin pumping that night, but I realized how much I needed a full night's sleep and decided to wait until the morning when a lactation consultant would be available. After staring at Peter for awhile and praying over him, we went home around 10.

It felt very odd to be back at home, the two of us, with all these reminders of my labor, but no baby. Dan was stressed out to be back in the house where every corner reminded him of somewhere he rubbed and rubbed and rubbed my back some more. I didn't realize until then how hard it had been for him to watch me labor. He didn't complain once as I woke him up or motioned for him to come RIGHT AWAY. Even though he was exhausted that night, he sat in front of the TV for awhile to escape everything that had happened. I tried to use the computer and quickly realized that it would be a long time before I comfortably sat on that chair.

We slept our first and last full night's sleep for a long time.

Tuesday:

Dan:

Peter's second day of life in the hospital was both encouraging and a cause for concern. The encouraging sign was that Peter came off his ventilator at about 3:45 pm. Monday night they began reducing the percent of oxygen in the air they were giving him, and that continued overnight until he was breathing regular air from the vent. When Peter was given the opportunity, he began to breathe faster than the ventilator and was successfully taken off of it. He now looks much more comfortable without the tube and calming drugs. They supplemented his breathing with oxygen through his nose until Tuesday night when even that came off. As of this morning, he is breathing all on his own! This is a very positive step.

The cause for concern is one that is unrelated to his pneumonia. Monday afternoon and night they noticed some seizure-like activity, occurring 4 - 5 times total (hiccup-like rhythmic gasps and some tight fist clenching). They gave him a loading dose of an anti-seizing drug (Phenobarbital) and they haven't reoccurred. Seizures occurring within the first day or so after birth are consistent with a period of decreased blood oxygenation during delivery. A head ultrasound also showed some brain swelling that would also be a sign of that. Since Amy's pushing stage was indeed very long (~5 hrs), this is a possibility. After a preliminary talk with the neurologist, she was still not quite sure about the cause. An MRI scan to image the physical structure of the brain (done Wednesday morning) and an EEG to look at his brain patterns (done later Wednesday) will give more information, such as locking down the probable cause of the seizures and identifying the severity of any future problems that may or may not occur. There is a good chance that none will (the neurologist was optimistic after his exam and no other organs have been effected), but even if the tests all come back normal the seizures have warranted follow-up meetings and testing over the next year to track Peter's development.

So, his breathing is back to normal but we're waiting for more information about his brain. He looks very cute. Amy was able to pump for the first time Tuesday and has continued periodically through the night. Her supply is responding well and anything she stores will be given to Peter first when they start feedings. Amy is hoping that they won't be necessary and that she'll be able to stay with him for nursing instead of using a bottle when the time comes. We'll also get to hold him when we go into the hospital today (Wednesday). Yay!

Thanks to much help from both our families and midwives, and all of your kind words and prayers, Amy and I are doing well. The unusual has become our normal since we have no other situation with which to compare it.

Me, now:

I wanted to arrive as early as possible at the hospital on Tuesday, but I ended up not arriving until mid-afternoon. Dan left earlier and I stayed home and my mom helped me out. Jeanne came to check on me at 1:30. That was the first time anyone took a good look at me, since the baby had required more urgent attention. She said I had a couple first degree tears, which didn't sound too bad, but that I needed to be incredibly diligent over the next few weeks as they healed since I didn't have the luxury of lying in bed all day recuperating. She said that she usually tells new moms to avoid all stairs for a week and I should only go down once and up again each day. I also was instructed to take 3-4 baths a day and to "air dry" on chux pads as much as possible. I had no idea how to pull this off while at the hospital, but she said to do all I could, coming home to bathe if necessary. We quickly realized that so long as Peter was sedated, it made more sense for me to be home most of the time.

As soon as I got to the hospital, a lactation consultant came by with the NICU's pump and a set of parts for me to keep. I didn't expect to see results that first time pumping, but after less than a minute, colostrum began dripping out! It had been almost 36 hours since I'd given birth with no stimulation at all and bam, I'm producing milk. Amazing. I didn't leak at all during pregnancy and all the women in my family had trouble breastfeeding due to low supply, so I was incredibly happy to succeed at pumping.

Soon after, a pump I could bring home arrived and I was told to pump 8-12 times a day-preferably every 2 hours while awake and every 3 at night. My second pumping attempt only produced a few drops, but by the end of the day, I produced 30 ml (1 oz) of yellow fluid each time I pumped.

The news that Peter had experienced seizures was confusing. By the time I arrived on Tuesday, he was no longer intubated and looked healthier. His oxygen levels were improving quickly and he appeared to be recovering. It seemed like the doctors weren't completely sure he had seized at all-the signs are so slight in small babies. But they'd given him the Phenobarb that I came to despise later. They gave him a head ultrasound through his soft spot while we were there-after all those months avoiding them, he got one at two days old! This time, I'll gladly admit there was a good reason for it.

We went home that evening and began setting an alarm to pump. We got into a routine that let me avoid getting out of bed. Dan would turn off the alarm and I'd pump while he dozed. When I was done, I'd wake him up and he'd go wash the pump parts. The next time I woke, I'd find clean parts waiting next to me.

Wednesday:

Dan:

Peter had his MRI and EEG in the morning before Amy and I came to the hospital in the early afternoon (we just can't seem to get here before 12:00!). We met with the neurologist at about 3:00 pm, a different woman than before but also very nice. The MRI was completely normal, showing no signs of injury from lack of oxygen. This was very good! The head ultrasound the day before had indicated possible slight brain swelling, but the MRI didn't confirm it. While the MRI can sometimes give false negatives, the doctor seemed to indicate that the normal result was very good.

The EEG scan revealed a few things out of the ordinary, causing the neurologists to classify Peter's brain activity as moderately abnormal. The scale goes from mild (95% of children have no future problems), moderate (50% have no future problems), to severe. After the examinations and the trend in Peter's progress, the doctors are optimistic that Peter is in the good 50% of moderate cases. Also done yesterday was a spinal tap that came back clear indicating no infection.

So, two out of three tests were completely normal and the Peter's trend suggests that the abnormal EEG will effect him minimally. At this time we're continuing to watch him to see if any further seizures occur and that he "perks up" as he clears the drugs out of his system (the anti-seizure dose from two days ago and the sedation from the MRI yesterday). Last night and today Peter did very well with no observed seizures. (The nurse on the phone Thursday morning mentioned a possible one overnight, but she was apparently mistaken and nothing was recorded in Peter's record. Boo her for scaring Mommy and Daddy!

Me, now:

When we arrived on Wednesday, Peter looked really good. He'd just finished the EEG and had tape marks on his face, but was free from breathing tubes. He wasn't yet receiving nourishment from anything but IV's, so that was the only day for awhile without any tubes connected to his face. Right away, the nurse encouraged us to hold him. She wrapped him up and found a way to swing all the wires to one side and I sat near his crib and held him. We tried to see if he would nurse, but he was too sleepy.

The news that Peter was classified as having "moderately abnormal" brain activity was scary, but it was so overwhelming that it was hard to think through all that might entail. The abnormal EEG was due to his not going into deep sleep during the hour-long scan and a few strange patterns. They also brought up the fact that his sodium had been incredibly low when he arrived. I hadn't shown signs of low sodium levels and there was no way to test after-the-fact if he'd just carried over the low level from me. The neurologist's hope was that the seizures had been caused by temporarily low sodium instead of decreased oxygen during his birth. I never quite figured out why one was better than the other, and the neurologists were never able to definitively tell us which caused the seizures. We just prayed that they wouldn't return.

Jeanne came to visit us at the hospital that afternoon and it was suddenly obvious that they needed to check on Peter and I as much as I needed to hear from them. Both Kim and Jeanne called every day and one of them came to see us every day that week. I showed Jeanne the handicapped shower I'd found and begun using as a way to keep up my baths even at the hospital. She was relieved to see Peter looking better.

Thursday:

Dan:

Peter has indeed perked up today. They began giving him a bit of pumped breast milk through a gastro tube in his nose last night, and today upped that to a full feeding every three hours. Amy tried feeding him yesterday, but Peter was too sleepy and nuzzled contentedly at her breast. This afternoon we tried again but he was full from the tube feeding. Today he has found his cry when it's time to eat, and right now Mom is trying to get Baby to latch on. It's amazing, after all his drugs and sleepiness the novelty of his cry is wearing off already! Truthfully, the sound is a joy to hear despite the stress of trying to satisfy him.

Amy stopped by to see her doctor today to check on her birth wounds. While our midwife was concerned of possible infection, the doctor thought Amy is healing well. She now has a prescription for antibiotics just in case.

While today was a bit tiring (coming here, trying to feed, pumping, eating, sending Amy to doctor's via her father, soothing Peter, trying to feed again), we are happy to hold our son - trailing wires et al.

Thanks you all for your prayers, visits, messages and kind thoughts. The Lord has allowed Amy to keep our heads enough to get done what needs doing. Keep 'em coming!

Me, Thursday morning:

My tears are looking sort of iffy and might get infected because I can't lie down all the time due to going back and forth to the hospital. If Peter gets the hang of feeding, I will likely start staying at the hospital 24/7 until he comes home. The earliest he'd come home would be Friday afternoon, but Saturday looks more likely, if not later.

I just want him to wake up and eat so we can bring him home and lie in bed with him all day.

Me, Thursday evening:

Peter is acting like a normal little boy! We got to the hospital and he was having his first full feeding (through a nose tube). He was sucking a pacifier while being fed, which was encouraging since he was associating sucking with feeding. He didn't seem all that active, but it was more than yesterday. I tried to feed him after 40ml, but he'd already eaten 4 times as much as he ever had before and didn't have much reason to do more than lick me

I left to go get checked by the backup doctor. There was a lot of waiting around involved, but most of that was lying on the examining table, which was rather restful The doctor (who has been amazing with getting Peter speed-admitted when he arrived) determined that I definitely had a second degree tear (no WONDER I'm so sore!), but the potential infection Kim had seen this morning was more likely just healing tissue. She also said I was keeping the area clean. Since I hadn't been home in hours, I didn't expect her to be too impressed. She gave me an antibiotic script, but advised I not fill it unless things look worse in the upcoming days. Even though I had thought it would be a relief to take the antibiotics and not worry so much, knowing that I was raising my chances at yeast infections and thrush--especially since Peter's on antibiotics, too--is actually less to worry about. Kim and Jeanne will be checking me every day in the near future, so they'll let me know if things look worse down there. The doc thinks the bad tear will heal fine--it's this goofy skin tag that might need to be repaired later.

When I got back to the hospital, Peter was WAILING and they had me try feeding him, but this time he was too pissed to suck. He'd suck on my finger, or anything else, but noooo, not my nipples. After awhile, they turned on the feeding tube again and had me try simultaneously. He was calmer, but still mostly just licked. They'd drop a few drops on my nipple and he'd root around to find them, lick them off, then just sit there. He's way too smart! Eventually, I just held him. He's such a sweetie. It was great to hear him being cranky and making all these sounds. They even disconnected all the wires so I could feed him on the couch.

I really wanted feeding to happen instantly so SOMETHING would go smoothly, but apparently that's too much to ask. I'm going to try once again tonight--hopefully before he's so hungry and upset--then go home and rest up for tomorrow. The lactation folks will all be here then and darn it, we WILL get this figured out! I pumped 75ml (still colostrum) after holding/feeding him a couple hours ago, which means I'm only one feeding ahead of him for the moment. So if he doesn't take the breast at 9 tonight, then he'll have my milk at 9 and 12, then formula at 3, 6, and 9 before I'm back with pumped stuff in the morning. Hopefully, he'll just feed from me tomorrow. I'll stay tomorrow night if we've got it figured out, and I think he'd be discharged Saturday.

It feels like we're normal parents with normal problems all of a sudden!

It seems that the nurse who told us about the seizure overnight was mistaken because none of today's nurses or the neurologist knew anything about it. Yay! We didn't get that straight until tonight.

So--his IV's are out, he's taking food well, he sucks (on everything but my nipples), and he's alert. I have worse tearing than we thought, but it's in better shape than expected. C'mon Peter, figure out how to latch on!!

Me, now:

Thursday was such an up and down day. We woke up and were told by one nurse that the previous nurse had observed a possible seizure. Then Kim came to check me and was worried enough that she arranged for me to go to the backup doc's clinic. We were at the hospital for only a couple hours before my dad brought me to the clinic. I didn't have an appointment and the front desk clerks weren't quite sure what to do with me, but told me to take a seat. After maybe 20 minutes, they called me back. My dad was stuck in the waiting area for the next hour, but I was pretty comfortable on the reclining exam table. I would have turned the lights off and REALLY slept if I hadn't been afraid that they'd forget I was there. A nurse came by to apologize every once in awhile, but so long as I could lie down, I was fine. Eventually, Dr B came to check me. I couldn't thank her enough for her expediting Peter's admittance. It was also a relief to hear that my tears were both worse than expected and not infected. I had thought that if the discomfort I felt was first degree tearing, that third and fourth degree tears must be truly horrific.

My attempts at breastfeeding are pretty well recorded above, so I won't explain again. Peter didn't nurse at 9pm either and it didn't look like he'd be nursing full-time anytime soon. We left that night somewhat discouraged, but heartened that we were leaving the world of seizures and dealing with more standard issues.

Friday:

Dan:

The main task at hand is to get Peter eating from Mommy. Friday consisted mainly of Peter waking up, screaming as Amy tried to nurse him, then calming down as the nurse started his gastro tube feeding, then Amy pumped. This took about an hour from start to finish, and then we got a two hour break before trying again. As you can imagine, it was not soothing for Amy to have a baby screaming on her breast. The lactation consultant here was helpful, and gave us some options for over the weekend. We tried a supplemental nursing system where the pumped milk is held in a little cylinder clipped to Amy's shoulder and run through a tube that is taped on her nipple. As baby sucks, he gets milk a little easier. It didn't work, and since we didn't want one more thing to wash along with the pumping kit we haven't tried it again. Peter finally latched on at the 6:00 feeding for at least five minutes, which means he only needed half of his normal milk through the nose.

Me, now:

I had hoped that Friday I'd be able to consistently nurse and stay overnight for a possible Saturday release, but we soon realized it wouldn't be that simple. The loading dose of phenobarb that Peter received three days earlier was clearly still affecting him. He had been so strong and feisty on Monday, then sleepy and calm ever since. The lactation consultant was helpful, but she didn't give off a "any second now, this will work" vibe. Neither she nor anyone else in the NICU ever suggested we give him a bottle, and for that I am so grateful. I was bound and determined to do everything I could to avoid bottles and they were supportive of that. We also had one of the nurses attach a "No pacifiers for Peter" sign when it became clear that he could suck, but only wanted to suck on items bigger and easier to grasp than my nipples.

Friday afternoon, my favorite nurse introduced herself as Peter's nurse for the evening. She had two kids of her own that she'd nursed and had taken extra training in lactation guidance. She happened to be the one in the room when Peter successfully latched on for the first time at 6pm Friday and I associated happy nursing with her ever after. When that success was deemed to be more of a fluke than the first of many consecutive nursing sessions, I decided to go home Friday night and rest.

Saturday

Dan:

Peter was very alert in the morning and had apparently been awake most of the night. We had a good visit with my aunt and Amy's mom in the morning, ending with a good 10 minute latch with intermittent swallowing. The neonatologist stopped by and said we could take out his IV (the antibiotics finished the previous night), gastro tube and all his monitoring. So we had a normal baby again! He was very fun, then got cranky. He got into the habit of being at the breast for a long time but not sucking very much. Finally after a cup feeding to top him off, he went to sleep... and kept sleeping for 4 hours! As you can tell, his schedule is not a normal one, probably due to the drugs still clearing from his little body. Amy stayed the night while I went home to sleep, which was hard for us. The night was especially hard for Amy as she tried to nurse an uncooperative child. The screaming was gone, and he appeared happy at the breast, but apparently doesn't get much food. He hasn't been peeing much, so we're working with cup feedings as well, which he downs no problem. We really need to get him eating before we can go home. Amy has been a bit down as Peter hasn't taken to nursing yet. I will stay with Amy here tonight (Sunday) to make things easier. Since Peter is now happy munching on mommy but doesn't seem to get the eating part, we're going to try the SNS again to see if getting the milk at her breast will give him the right idea.

Me, Saturday:

I stayed overnight at the hospital for the first time Saturday (without Dan) and it was pretty rough. Peter had been disconnected from all wires around lunchtime (yaaay!!) after a successful cup feeding that morning and we were allowed to feed him on demand without threat of the dreaded nose tube being plugged in. He ate happily right away, and again every hour and a half or so until about 3pm. At that point, he became Mr. Crankypants and wouldn't stop screaming for anything (he'd been VERY alert since noon). We tried cup feeding him a little, but he wasn't too hungry. I couldn't take the crying and took a nap while Dan walked him and rocked him until he conked out. He didn't wake up until almost 8 pm! He fed enough from the breast that we didn't have to use the cup and he slept again until 11. Then Dan left and he munched at my breasts until 2:15. He didn't swallow much, but he didn't scream with the breast in his face, so I didn't want to mess with him. He hadn't peed since noon though, so the nurse gave him a cup feeding at that point and he ate 90cc's. I was so upset that he was that hungry after feeding so much that I could barely watch him eat. He slurps it down and it rips my heart into a million tiny pieces to see it. Meanwhile, I'm feeling engorged for the first time and my breasts are throbbing while he refuses to eat from them. I hadn't pumped all day (ahh, free from the tubes) so I could see whether Peter and I could regulate each other, but I pumped for 5 minutes at that point. He didn't fall asleep, even after eating the 90cc's, but didn't fuss until 3am. I picked him up and he nuzzled at my breast for 5 minutes before falling asleep. I love holding him--his little face is so cute and he makes such fun faces, but I just dread feeding him for fear of how he'll react. And knowing he's not peeing isn't helping. He did produce a number of poopy diapers (no more antibiotic diarhhea either), but never a wet one. At 4am, he woke up again, and he fed well for 5 minutes, then just snuggled for another 5 before falling asleep. I pumped for 10 minutes after that. The nurses were great about doing all they could for me--I wasn't sure if they'd wash pump parts and whatnot beforehand (since that's usually Dan's responsibility), but it wasn't a problem. Heck, he's probably one of the few kids without monitors to watch and all the extra paraphernalia--it's the least they can do to change his diapers and wash the pump.

Sunday

Me, Sunday:

Peter and I both slept until close to 8am. I was pretty zonked, if he wasn't. At that point, the nurse took his vitals and it looked like he was going to wake up. We brought him to my chest, and he'd take 3 swigs and fall asleep. She'd put him back in his bassinet and he'd wake up. We repeated that 3 times before I had her give him a cup feeding. I slept again until 10 when Dan returned. I pumped then (producing 130cc's) and on both Dan and the nurse's advice, left the room. Right before we left, the doctor came by and said that due to his lack of peeing (he did finally produce a wet diaper early this morning) and loss of weight (he's down to 8 lbs 12 oz), he won't be going home today. Even though I knew it wasn't a guarantee, I thought that if he could cup feed, they'd let us go. I can't deal with being in the hospital much longer. His long stretches of waking and sleeping are due to a combination of the drugs still leaving his system and the funkiness of living in a world where the lights are always slightly dimmed. I want him in bed next to me, with the curtains up when it's light out. Without a steady stream of nurses who change every 8 hours and doctors who nonchalantly tell us that he's not quite doing well enough yet. I feel like he's never going to have the chance to get the hang of breastfeeding until we get him OUT OF HERE.

A nurse yesterday asked if we were mourning the birth we'd hoped for. That's not it at all--it's the babymoon I'm missing. While I would have preferred a 12 hour labor that didn't leave me with tears I need to bathe 3 times a day, I'm happy with my birth experience. After I'd showered and they had him breathing, we tried nursing at home on Monday. He wouldn't latch on, but he would suck our fingers really vigorously. At the time, breathing and nursing seemed too much for him. But I can't help but think that if he had been able to spend the following days home with me, we would have figured it out during the colostrum time instead of him being fed through an IV then, and a nose tube later.

I never did figure out when exactly my milk came in. I didn't get hugely engorged or anything. Tuesday, I pumped about 15cc's each pumping, Wednesday it went up to 30, and by Thursday I was at 60 or 70. I didn't see the color change either. Apparently, it was just a subtle thing for me. I was worried that I wouldn't produce enough milk for him before the birth, and that's one of the few things I haven't had to worry about. How odd.

My bleeding has gone down a lot. I've become a fan of Depends--they're just easier than pads. I have an herb wash in a peri bottle that I use. The midwives are pretty concerned that I'm not able to rest enough for "my bottom" to heal. I don't think they usually deal with this much tearing. They knew he needed to come out when he did, and there wasn't any talk of slowing down to get his 14 1/2" head out gently. Once I get home with Peter, I'm just not going to wear underwear for a week =) I have been able to use a handicapped-accessible shower here at the hospital with a handheld nozzle--if that wasn't available, the midwives would have had me go home for baths multiple times a day.

I've been using a wheelchair around the hospital so I don't wear myself out any more than necessary. I feel a little lame, especially since a lot of the NICU moms are wearing robes and still have IV's attached. But I get worn out enough by the end of the day.

I've been sobbing a good portion of the morning, but life always looks better when Dan's around. He brought me up to the family resource room and has been checking out LLL's breastfeeding book for advice. I guess the plan is to try feeding him every 2 hours, whether he wants to or not, just to get in the extra practice. Hopefully that'll keep me from getting engorged and will let him trying feeding before he's starving. I think we're going to give the SNS another try, too. We tried it Friday afternoon, but he was too pissed to latch on at all then, so it didn't work. If we can convince him that mommy's nipples are for eating, we might be set. My right nipple is sore from some of his chomping overnight, but I hope that won't get worse.

I think I'm sane enough to go back to my boy now. He really is the most adorable precious little thing. I just can't stand him when the feeding doesn't work. He can pull his head from side to side and his eyes are amazing when he gazes at me. He'll turn to look at me when I talk to him. And he has my crooked toes =)

Monday, March 15th - Wednesday, March 17th

Dan:

Successful nursing continued the Monday morning and the doctors gave the ok for getting discharged. This involved some baby lessons from the nurse and an exam from our resident, which went well. We needed a cart to get all of our stuff to the car. I went out first, and then returned for my wife and son.

It was so nice to leave! When we got home I could feel 100 lbs lift off my shoulders. While the care we received at Children's was wonderful, the pressure of "get baby eating or else" was happily left behind. Our life has slowed to the normal new-baby pace of nurse, poop, change, sleep. The last two nights have gone well, and Peter is doing wonderful. We even are using and washing our cloth diapers successfully! Our midwife Kim came by Tuesday morning and said Amy was healing nicely, even giving her the cleanliness award for avoiding infection despite all the stress and hospital time. Amy's parents stopped by yesterday evening to look after her while I went to class at Hamline (I already had missed a class last week). My mom was here this afternoon comforting the baby while Amy checked email and I showered and shaved (hadn't shaved since labor began!). Peter had a good dose of his cousins during a brief visit this evening.

Both a homecare nurse and our midwife Jeanne will stop by at different times tomorrow for a checkup. Peter will see his primary physician for the first time on Friday. The NICU clinic will see him at 4, 12, 24 months, and 4.5 years old to track his development. We will also check back with the neurology center at 3 months. Basically, Peter's breathing cleared up fairly quickly after only a few days. The seizures did not reoccur, and the neurologist thinks that it was probably due to his low blood sodium since his brain scans were fairly normal. However, we don't know why his sodium was so low. The rule of thumb is that if a baby looks normal a week after birth, he probably is. Peter is indeed looking normal, and our family is settling into the new "normal" of life.

We are so thankful to our Heavenly Father for his strenth and healing grace throughout this ordeal. Thank you all for your prayers. Among other things, the Lord has taught us to trust him, for he is really the only one who has any idea where our lives are headed. And we are safe in his hands.

Come now, you who say, 'Today or tomorrow we will go into such and such a town and spend a year there and trade and get gain'; whereas you do not know about tomorrow. What is your life? For you are a mist that appears for a little time and then vanishes. Instead you ought to say, 'If the Lord wills, we shall live and we shall do this or that.'" Jas 4:13-15

Me, Mon. March 15th:

We got through Sunday night pretty well--Peter was up feeding from 11 to 12 and 4 to 5, but otherwise slept from 12 to 7:30. My nipples are sore from his munching Saturday night, but for the most part, he seems to have figured out what to do. During one feeding yesterday, he slurped so much milk that we could hear it pouring down his throat! That was an awesome sound. He's peeing well enough that they aren't even weighing his diapers anymore. We met with the discharge nurse this morning; his nurse went over how to use the bulb-sucker, give him a bath, and wipe the goop out of his eyes. I've been concentrating so hard at getting from one feeding to the next that I'm at a bit of a loss when he's awake and not hungry, but I figure that will come with time. It's so fun to watch Dan interact with him! He's got a Peter-voice and he's been reading him The Hobbit, which we never did finish during the pregnancy. Dan's got the diaper-changing figured out, but we'll have to get used to cloth once we leave. This isn't the way I expected to skip the meconium stage!

They're expecting to discharge him around 3. I think I'm going to sob when we get to the house--it'll be amazing to have him there with us! I haven't been home myself since Saturday morning. I've started walking around the NICU a bit more instead of using the chair. My bleeding has really gone down. Kim will come over for our one week home visit later today.

It's a happy, happy day