9.20.19 The Labor & Delivery Blog

Isla’s birthday was delightfully unremarkable in the all the best ways. Of course the day of her birth will always be unique and special to us, but from a medical perspective it was as unremarkable as they come. And in the OBGYN world and to a laboring mom who has to birth a baby from her body, unremarkable is actually #goals. Nevertheless, it was one of the best days our family has had in a long time and a day I am more than happy to relive via this blog and photos.

Why Elective Induction?

Many people have asked me why we chose to pursue elective induction for both of my deliveries. The decision was two fold. Firstly, medical evidence from the ARRIVE trial, a large scale study comparing elective induction in healthy first time moms to expectant management (meaning left to spontaneously go into labor), showed that elective induction is not only safe but may be beneficial. The second part of our decision was based on planning around my husband’s schedule. His job as a physician anesthesiologist would likely not allow him to leave if I were to spontaneously go into labor while he is caring for a patient in the operating room. So for these reasons we opted for an elective induction.

By the time my 39 week induction day rolled around on September 20, 2019, my cervix was ready to go (this is great news for an induced labor!) If you follow me on instagram, you know via my instastories that I wasn’t sure I’d even make it to induction day. My husband happened to be working long hours and overnight shifts the last week of my pregnancy so, we crossed our fingers that I wouldn’t spontaneously go into labor and my mom came to stay with me just in case I did. And in the meantime, I continued to chase my toddler around while 5cm dilated and 90% effaced because #MomLife.

My induction was scheduled for 9/20/19 at 8 am, and the plan was that my husband would meet me there directly following his 17 hour overnight shift.

The Last Bedtime Routine.

At around 7 pm on 9/19/19, Everett and I ascended the stairs toward his bedroom for one last bedtime routine as my only baby. I had been feeling pretty nostalgic and melancholy about the whole “last night as my only baby” thing for the preceding weeks. As fate would have it, Everett was a much grumpier and overly tired version of his usual self that night. He wanted no part of playing with glow sticks in tub so we cut “the last bath” short. And after a poorly tolerated tooth brushing, we read a couple of “last bedtime stories” before he began some martial arts type maneuvers indicative of him being really done with the whole routine. I hoisted his flailing little body into the crib one last “only child” time and said, “Well, there will be other times, Everett. Good night. Mommy loves you.” And that was that.

I went to bed that night feeling at peace with welcoming a second baby. I was thankful that Everett’s crankiness lightened the mood and stopped me from lingering with the “last night, only child” thoughts.

No Room at the Inn.

The next morning I woke up at 5 am to shower and glamorize my look for the labor festivities. At 6 am, I called Labor & Delivery to ensure there was room on the unit. September is a notoriously busy time for L&D (the busiest, actually) and sure enough, this September morning was no exception. The charge nurse informed me that all the rooms were occupied by laboring moms, and they’d call me when/if something became available that day.

I thought that I’d be feeling way more stressed about this but I think God knew I needed a little more quality time with family.

The best day ever.

Instead of meeting me at the hospital, my husband came home after work. I read Everett a bunch of books that morning and sipped luxurious lattes with my mom from my beloved Espresso machine.

Everett and I did a little photoshoot with the tripod, and looking back now at these photos makes me so happy.

My whole family went out to breakfast that morning. My mom then took Everett back home for a nap while Jason and I strolled around downtown.

We got coffee at our favorite coffee shop, one of the places where we had engagement photos taken.

My husband upped his instagram-husband game and snapped a hot fire “pregnant lady in front of a bright door” pic. Wow…just wow!

We managed to pick up our car, that had been involved in an accident the week prior, from the body shop; and just as we were dropping off the rental car, Labor & Delivery called that a room was available. The car rental place was only 10 minutes from the hospital and boom, off we went.

It was pretty much a flawless morning.

The Delivery.

We arrived at Labor & Delivery at approximately 3 pm and I changed into my boujee gown and propped up my matching pillow case. The nurse placed the IV and I requested the epidural with anesthesia prior to beginning the induction.

In my prior delivery, I went from 5cm to 10 cm in 45 minutes, after my water broke; and I wanted to make absolutely certain that I had the epidural in place AND FUNCTIONING prior to active labor. So, at around 5 pm, my husband’s colleague (and the same doctor who placed my epidural the first time around) placed my second epidural.

And let me tell you, it was a pretty flawless epidural.

Minutes later, the urinary catheter was in place and FINALLY after months and months of getting up to pee every 20 minutes, I could lay back and relax. The pitocin was started a few minutes later.

Just before transitional labor began!

Jason and I settled in with some Great British Baking Show and watched the contractions become strong and regular on the monitor. At around 8 pm, my doctor performed an amniotomy (A.K.A – broke my water). I knew that our baby would be here really soon as I was fully dilated within 45 minutes of my water breaking with Everett.

Sure enough, transitional labor began and I complained to my husband that I could feel contractions and pain in my very lower belly. This is when it is super handy to be married to an anesthesiologist. He used an ice cube to determine if I had an area where the epidural wasn’t reaching.

He asked me to compare the sensation of the ice cube on my arm (full sensation) to areas on my stomach, thighs and then bottom of my feet. He determined there was an area on the bottom of my foot with sensation of cold and wet. By now though, I was fully dilated and it was time to push.

Naturally, a piece of unsolicited mommy advice. This IS a mom blog, after-all.

Request anesthesia (specifically) if your pain is not adequately controlled.

Labor & Delivery nurses are amazing – many are actual angels on earth but no matter how many years they’ve been a L & D nurse – they are not anesthesia experts and neither is your OBGYN (for the most part).

I say this not to brag on my own, personal, awesome-anesthesia-expert husband but to encourage you to be your own advocate. My husband is happy to troubleshoot epidurals for his patients, time permitting. He does not want women to unnecessarily be in pain if they don’t want to be and he does not want a patient to be told that nothing can be done if anesthesia hasn’t been consulted. This is not to say that epidurals always remove ALL pain but at least give your anesthesiologist the chance to evaluate you.

But, back to me, this is my labor & delivery blog, after-all. My husband insisted that we wait for anesthesia in spite of my (otherwise) wonderful nurse encouraging me to just push and deal with the pain. Given that the baby was doing fine on the monitor and there was no reason to start pushing just yet, I opted to go with my husband’s expert opinion and requested to wait for the anesthesia doctor to evaluate and manage my epidural. I’d had a second degree tear with my first delivery and wanted to make sure I felt as little of that as possible if I had one again. And I did.

Unfortunately as sometimes happens with anesthesia, the doctor & CRNAs were dealing with several emergencies and little old me fell a lot lower on the priority list. My husband knew what needed to be done, but was not there as my doctor. Luck was on my side that day, however, and just as the OB hoisted my legs into stirrups and cranked up those “show time” theater lights, the anesthesiologist came to the rescue!

I was given an extra dose of some medicine through the epidural, and sat upright for another 5-6 minutes to let it settle into the right spots. It was heaven. I could no longer feel any contractions in that specific area of my lower uterus, no perineal pressure and yeah, could no longer fully control my legs. But guess what? I could still push like a champ. I needed help holding my legs up to push but by looking at the monitor I could time my pushing just fine.

Approximately 9 pushes and 3-4 minutes later, Isla Mae was born at 9:12 pm, exactly 4 hours and 12 minutes after the start of the induction.

We had that beautiful golden hour of skin to skin, and she latched right away!

Our hospital automatically does delayed cord clamping, which has benefits of increasing iron and hemoglobin; along with skin to skin, which promotes breastfeeding and regulation of body temperature in the newborn. We requested to delay the bath as this helps baby to regulate their body temperature more easily, and the vernix caseosa (cheesy, waxy substance on baby skin) is beneficial in promoting breastfeeding along with reducing risk of infection.

After my legs finally worked again, my awesome, angel nurse helped me to the bathroom and into my beautiful, blush colored depends. She asked if I liked them better than the mesh underwear provided by the hospital and that she’d noted many women bringing their own depends. I put on my comfy Amazon button-up pajamas and settled into bed.

I was starving and so my husband decided to scour the physician lounge for snacks because by that time of the night, food wasn’t available. I NEEDED food. In hindsight, I’m not really sure why I was so famished. We ate a huge brunch before I arrived at the hospital so really, I only skipped dinner, and I can hardly even call my 4 hours of labor, “labor”.

My husband returned with a smorgasbord of sandwiches, Lorna Doone cookies, Oreos, granola bars and of course, the infamous peanut butter and graham crackers all hospital workers are very familiar with. I happily inhaled a bit of everything and guess what, no acid reflux for the first time in months! What joy.

This is why I recommend bringing snacks! If you deliver your baby after hours, you’ll be left to whatever the hospital vending machines offer.

The next day, my mom brought Everett to visit us in the hospital and he wasn’t too sure what to make of his little sister. In fact, he didn’t even really want to come near me or Jason, he mostly clung to my mom.

We didn’t push it and really haven’t pushed it since being home – we know he’ll come around on his own. I’m thankful my mom brought him up to the hospital because we were able to get a few family photos.

I decided to test the waters of “no reflux” a little more and we ordered sushi and pad thai to the hospital. Isn’t it amazing how so many pregnancy ailments just go away immediately with delivery?

Later that evening we ramped up the acidity level and ordered Chipotle, guac and all! No reflux. #LIVING

Early Checkout

If you’re anything like me you strongly dislike staying in the hospital. Even with my own pillow, sound machine and own pajamas I struggle to get any sleep whatsoever while in the hospital. So, if you want to get out of the hospital ASAP I strongly suggest requesting early checkout immediately upon arriving. There are a lot of moving parts to discharge both you and the baby – remember that you’ll have doctors and nurses along with the baby so everyone needs to be informed of your desire to check out early. We learned this the hard way with Everett and found that notifying people early in your hospital stay provides the best opportunity for leaving quickly, assuming both mom and baby are doing well.

The earliest checkout allowed at our hospital is 24 hours after the baby is born and I believe this is fairly standard. A 24 hour interval is required between time of birth and newborn screening. Isla passed her newborn screening with the exception of her bilirubin level which was moderate to high risk for jaundice. However, the hospital pediatrician was comfortable with discharging her under the condition that we take Isla to the pediatrician first thing Monday morning and with clear guidance for monitoring her condition.

The following morning we introduced Isla to Everett once again. He was a bit more comfortable getting close to her but naturally was more interested in her knot baby turban. He personally thinks she looks better without it.

I’m finishing up this blog as Isla turns two weeks old, and as cliche as it sounds, she was a missing piece to our family that we didn’t even realize we needed. Everett taught me how to be a mom. With him I learned about a love so intense that my heart could actually burst. That love brought on profound worries and anxiety about doing everything right, protecting him, ensuring his safety and scarier thoughts like how would I ever go on if anything happened to him. Isla has taught me to relax those feelings of worry and anxiety a little bit, to let go and trust that I know what I’m doing now. I’m learning that I can’t always respond immediately to every whimper and cry, Everett has to wait for books or one-on-one time as I tend to Isla and sometimes both kids sit in a dirty diaper longer than 12 seconds these days.

We’re all still adjusting but so far so good.

Now if only I could get her to sleep for longer than 2 hour blocks… but, hey no colic so there’s that! I’ll take sleepless nights over colic any day!

Thanks for reading!

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