Two Months: A Letter

Dear Nicholas,

You turned two months old last Friday, the 23rd, and it seems like you have grown by leaps and bounds. You had your two month doctor appointment on the 26th and you are officially weighing in at 11 pounds 7 ounces (50th percentile). You are 23 inches long (also 50th percentile) and your big noggin is 41 1/2 cm around (75th percentile). You've finally put on some weight--apparently you were in just the 10th percentile for weight when we brought you in for your 2 day appointment-- and you are starting to show off some adorable little rolls on your thighs and some chubby little cheeks. You are also finally able to fit into a bunch of your 0-3 month clothing and it has been so much to dress you up!

This month also brought lots of visitors and lots of first experiences. You met your Grandmama and Dzia Dzia when they came to visit for a week. You loved getting to know them, and we appreciated all their help around the house. They also babysat you for the first time, and we had our first date night alone. Don't worry-- we hurried home to see you after about two and a half hours.

You also saw your Aunt Kristin again when she was in town for SXSW. We took you up to her super cool hotel room at the W and you got to test out her big bed. I think you liked it.

We also took you to the Austin Kite Festival, walks around the neighborhood and Town Lake, and meals out at a bunch of restaurants. You are so great when we take you out for meals-- particularly if it's a noisy place. The sound puts you right to sleep. I know it will become tougher to get out with you when you're older and more active, but we're enjoying this phase.

Most notably, you really started showing off your little personality this month. You started smiling pretty regularly around 5 weeks and we can't get enough of it. You have adorable dimples and a huge open mouth grin. When you're in a good mood (especially after you eat), you will coo to us, and we have fascinating conversations back and forth.

You love the outdoors, and when you're fussy your dad can instantly calm you down by taking you outside to look at the trees and listen to the birds. You also love the bird mobile hanging from your bouncy chair, bath time, and staring at ceiling fans. You do not love getting strapped into your car seat (although you always relax once the car starts moving) or waiting more than about 30 seconds to eat when you're hungry.

We moved you out of our room and into your crib at 8 weeks, and you've done great in your own room. You immediately starting sleeping for an initial stretch of 5-6 hours when we first put you down at night (between 7-8pm), and then after that you wake up to eat every 3 hours until about 9am. Both your dad and I are loving the increase in nighttime sleep!

Nicholas, you have brought so much joy to our lives. Everyday with you has become more and more fun, and I love seeing you grow and develop before my eyes-- just don't do it too fast! Part of me wishes you could stay like this forever, but I also can't wait to see what comes next.

I love you buddy.

Mommy

Nicholas' Birth Story, Part II

Once my new nurse sent for the anesthesiologist, my memory becomes a bit fuzzy. I know it was a full hour from when my doctor broke my water until the epidural was administered, but I don't really recall much of what went on in my hospital room aside from my excruciatingly intense contractions. I know they were about 3 minutes apart, and so by doing the math I know I must have had about 20. I was hooked up to several monitors and had an IV in place, so I was confined to the bed. Unfortunately, lying down was the worst possible position and only amplified the pain. I wanted to be able to get up to walk or sway through the contractions, but that wasn't a possibility. I remember telling the nurse I had to sit up and I remember leaning over with my feet dangling off the bed. Jason tried rubbing my back and the nurse told me to grip her hands during a contraction, but I didn't want anyone touching me. At one point, I became very nauseous and felt like I might vomit, so they got me a bucket. I may be slightly overstating the obvious, but childbirth is not glamorous.

Finally, the anesthesiologist arrived and after some prep work, she administered a shot to numb my back. While the idea of having an epidural inserted had made me slightly queasy during my pregnancy, had the anesthesiologist not shown up, I honestly felt like I would have inserted it myself. There was a little bit of stinging pain and a weird cold sensation, but it was absolutely nothing compared to the contractions. The worst part was that I had to lie back down in order to get the medicine flowing down my spine and it took about 30 minutes before I was fully numbed, so there were a bunch of contractions I had to endure while lying flat on my back. Gradually the contractions became less and less intense, and finally I was numb from the bottom of my rib cage down to my feet. Sweet relief. While pregnant I had contemplated the idea of a natural childbirth, but by the time epidural kicked in I was fully satisfied that I had experienced enough unmedicated labor. My husband insists I said something like, "Screw this natural childbirth crap." I don't remember it, but it's definitely possible.

Once I was all set up with the epidural, it was about 1pm and there wasn't much to do but sit back and relax. Jason went to get lunch and finally Ed returned. At 3:30, my doctor came back to check my progress again. I could tell everyone thought I must be about ready to start pushing, so when my doctor announced I was only 5.5 cm, everyone seemed disappointed. My contractions had slowed down to 4-5 minutes apart, so they decided to start a very light pitocin drip. Thanks to the glorious epidural I couldn't feel anything, but I could see the contractions pick back up again on the monitor. However, as my contractions picked up, Nicholas' heart rate started dropping after each contraction. Apparently it's normal for the baby's heart rate to drop during a contraction, but if it drops after a contraction it's a sign that the baby may be going into distress. Due to his two vessel cord, Nicholas was already getting less oxygen than he would otherwise, and Ed warned me that if Nicholas' heart rate didn't stabilize, there was a good chance I would need a c-section. He gave me an oxygen mask and told me to start verbally encouraging Nicholas through each contraction. Apparently babies can really sense and respond to their mother's state of mind. I don't know if it was the oxygen, my encouragement, or both, but after a about a half hour, his heart rate picked up and he seemed to be tolerating the contractions better. Ed thought he had most likely just passed through the narrowest part of my pelvis.

Around 4:15pm, I started to feel a lot of pressure. I told Ed and asked if he should check my progress, but he said that my doctor would be back at 5:30 and we should just wait until then to minimize the risk of infection since my water was already broken. By 4:45pm the pressure was intense and I could feel it mounting with each contraction. This time, I told Ed I thought he should really check my progress. He agreed and then said, "Hey Jason, do you want to see your son?" I was fully dilated to 10cm and Nicholas was about to crown.

Ed started gathering supplies, called my doctor, and told me I could just start pushing on my own each time I felt a contraction. I didn't feel any pain, but I could feel strong pressure as each contraction built. My doctor arrived around 5:30, along with a team of about 8 other nurses and doctors. My doctor wasn't on call that night, but was surprised to see how close Nicholas was to arriving and decided to just stay to deliver him.

Throughout the pushing stage, I felt great and it felt so much easier than I had expected. I felt like I could just push continuously from one contraction to the next, but they wanted me to rest in between to give Nicholas a break. The funny part was that my contractions had slowed to about 5 minutes apart at that point, so I would push for a minute and then we would all just hang out while waiting for the next one. My feet were in the stirrups, his head was partway out, and my doctor was chit chatting with one of the nurses about his yoga class. Slightly awkward. After a few pushes, they wheeled over a mirror to help me concentrate. It seemed like wasn't moving much for the last half hour or so, but everyone kept telling me he was just moments from his big debut. I glanced up at the second clock to help me focus on a contraction and then, suddenly, with one final burst of pressure, he was here. They handed him to me and I just remember looking at Jason and being shocked at how adorable he was. I kept saying, "He's so cute!" It was 6:26pm.

Jason cut the cord and then they whisked him away to weigh and measure him. We stayed in the same labor and delivery room for about two hours as they bathed Nicholas, administered some tests, and I recovered. We called our families, I ate a bad hospital dinner (later Jason went to get me the Chick-Fil-A sandwich and chocolate shake I had been craving all day), and we marveled at our son. The next two days in the hospital, as well as the following weeks, would be full of ups and downs as we got to know our little man, but the labor and delivery experience was amazing. I was so grateful to have had such a great nurse and I was thrilled that my doctor was able to stay and deliver Nicholas despite not being on call that evening. During the pregnancy I had a lot of anxieties, and later I would encounter challenges with breastfeeding and acclimating to life with a newborn, but I would honestly do labor and delivery again in a heart beat. Best day of my life.

Welcome to the world, buddy.

Nicholas' Birth Story, Part I

Nicholas is eight weeks old today and he'll officially reach the two month mark later this week, so I think it's time to finally share his birth story before I start forgetting details. The story really begins at my 20th week of pregnancy when we learned that he had a somewhat rare umbilical cord abnormality. Instead of having two arteries and one vein, as umbilical cords typically do, he had just one artery and one vein-- or a two vessel cord as it's known. This occurs in about 1% of babies and usually poses no serious problems. In fact, it wasn't even something doctors could diagnose until the mid-90s when ultrasounds became strong enough to see that the cord was missing one of its three vessels. Still, there are some rare but serious risks, including complications with the heart and kidneys, significant growth restriction, or, at the end of pregnancy, cord accidents that can result in a stillbirth. A visit to the perinatologist at 20 weeks helped assure us that his heart and kidneys were just fine, but I had to undergo weekly ultrasounds and biophysical profiles beginning at 32 weeks to make sure Nicholas' growth was on track. And, I couldn't quite shake my nagging fears about a cord accident.

During my third trimester, the perinatologist advised us that I should be induced early at 38 or 39 weeks to reduce the risk of a cord accident. My doctor was less concerned, and I had initially wanted as natural of a birth as possible, so I wasn't thrilled with the idea of an induction. But, as I grew bigger and I started feeling fewer of Nicholas' movements (a normal occurrence considering he was pretty squished in there), I became increasingly nervous about letting the pregnancy go to 40 weeks or beyond. After one evening of feeling no activity whatsoever at 36 weeks that landed us in the maternity ward for an evening of fetal monitoring (a fun Friday night), I started leaning towards the idea of an induction. I went back and forth with Jason and with my doctor. Both were supportive of whatever decision I made, but my doctor wanted to minimize the risk of a c-section that might result from an induction when my body just wasn't ready. Finally, we decided to do the induction at 39 and a half weeks. My doctor said he would give me a very light dose of medication to try to induce labor, but if, after 18 hours or so, I just wasn't progressing, he said he would send me home and we would try again at 40 weeks. I agreed, but was really hoping I wouldn't get sent home from the hospital.

On Sunday January 22nd, at 7pm, we checked into our maternity suite. They got me all hooked up to all the monitors, inserted my saline lock (ouch!), and asked me about a million questions to complete my registration. Then the nurses gave me a small dose of medication to help soften my cervix. The drug typically doesn't induce labor on its own-- although it can in some women-- but it makes for a more favorable outcome when labor is later induced with pitocin. At first I felt nothing, and Jason and I killed time watching an NFL playoff game (the Giants vs. the 49ers) and whatever random sitcoms we could find on TV. I had brought a bag full of entertainment, including some magazines, a novel, and a sewing project for Nicholas' nursery, but I didn't read more than a few pages of my book. Between my excitement, nerves, and the still sore IV site, I couldn't concentrate on much.

Eventually, I started feeling some light contractions. Around 10 or 11pm, my nurse gave me a sleeping pill. It worked only slightly. I tossed and turned most of the night as the contractions grew stronger. However, they were still very irregular, and I could tell they weren't quite enough to send me into full-fledged labor.

At 7am on January 23rd, my doctor came by to check my progress. I hadn't dilated any further (I had been at 1cm for about two weeks), but I was now 70% effaced. My doctor decided to give me another dose of the softening medication instead of starting the pitocin, and within an hour or so, I was feeling stronger contractions that were coming every 3 minutes. For about two hours I was managing to breathe through them pretty well, but around 10am they picked up in intensity and I really had to focus on breathing strong through each contraction. I could tell I was starting to make some real progress and began to suspect an epidural was in my future at some point. Throughout the morning, both Jason and my nurse, Ed, were amazingly supportive and encouraging. Yes, I had a male L&D nurse and I loved him. He was fantastic.

At 11am, my doctor came back to check my progress again. This time, we were all pleased to discover I was dilated to 4cm. At this point, my doctor declared he would not be sending me home and I would be having this baby today. He informed me that he was going to break my water, and before I even had time to process this information, it was done. In retrospect, I would have asked him to wait until later. Lesson learned for next time. Within about 30 seconds another contraction hit, and instead of managing it with some heavy breathing, I could barely manage to stay on the bed. The pain had jumped from marginally tolerable to absolutely excruciating. My goal of holding out on the epidural for a bit longer went out the window and I loudly informed the whole room that I wanted one immediately. At this point Ed had to leave for a few hours to conduct a tour for visiting state inspectors, and the new nurse informed me it would be at least 45 minutes before the anesthesiologist would arrive. I knew I was in for a very long 45 minutes.