Family Celebration

The family came together for a few days to celebrate Ariana's birth.

It was pretty neat, for the last time we were all together

was 12 years ago when we were married.

I hope it doesn't take that long to bring both sets of grandparents together the next time.

We enjoyed each other's company and lots of great food

served on tables set both inside and out.

We enjoyed the littlest member of the family.

And as you would expect, we took a few pictures.

Introducing Ariana Thalia

Ariana Thalia

Born: July 6, 2009 at 10:48 a.m.

Weight: 8 lb 11 ounces

Length: 20.5 inches

This child has a mind of her own.

She sent me into labor the day before her scheduled delivery date.

I suppose, she felt it was more her right to decide the day of her entry into the world

than anyone else's.

I suppose that she is right.

A birthday, a diagnosis, and a mother's musings on it all

In 4 short weeks, our daughter will be here. We have been scheduled for a C-section for July 7th. Our Summer Baby's birthday will be July 7, 2009 - if all goes as planned.

I am the most unlikely candidate to schedule a surgery for one of the most natural processes of life - childbirth. It's not who I am - at all. Yet I who don't even use medicine, not even a painkiller in the past 5 years (except for IV drugs for 2 days after my first C-section), have scheduled a surgery to deliver my second child.

I've made the decision with the knowledge of several things. One of these things I haven't talked about yet - our baby has what's called a Single Umbilical Artery, also called a two-vein chord. Basically, there are 2 arteries and 1 vein in the umbilical chord (one vein carrying nutrients/oxygen in, two arteries carrying waste out) and the baby's chord is missing one of the arteries that carries the waste out. This condition presents in approximately 1-2% of all births, its cause is unknown, though more common in older mothers, and it is considered a fairly common occurrence by obstetricians, but it can signal several problems. In most (about 70%) of cases, the baby is perfectly fine, the SUA being an isolated condition, which is the case with our baby. In a lesser number of cases, it can be a soft marker for other health problems, most commonly heart and kidney problems.

We've known about this since the 20th week ultrasound scan, when we were told that everything looks healthy, but that there seems to be a two-vein chord. We were then referred to a perinatologist for a Level II ultrasound to make sure they didn't miss anything and he confirmed that all the organs look healthy; the two-vein chord is just an isolated condition.

Of course, you know me, I research everything, so between the first diagnosis and the perinatologist's visit 3 days later, I became an expert on the condition and was able to have an intelligent discussion about it with him (surprising him a little, to say the least).

Since the SUA is an isolated condition, basically at this point, we just need to monitor the amniotic fluid level and the size of the baby, as one of the risk factors is IUGR (intra-uterine growth restriction) due to the single outgoing artery putting extra stress on the placenta. If the placenta is not able to supply enough nutrients/oxygen to the baby, the baby uses what is supplied for the most vital of functions (heart, brain) and slows down kidney function, i.e. not putting out the needed urine, which is what makes up most of the amniotic fluid at the end of the pregnancy. Low amniotic fluid, of course is not safe, especially when the chord only has two veins running through it (thus less Wharton's jelly surrounding it) and isn't as sturdy as a three-vein chord. So the amniotic fluid level and the size of the baby need to be monitored in late pregnancy - those are the two main concerns. If the fluid level and baby's size look good at 32 weeks, it is very unlikely to become a problem in the upcoming weeks.

We found out at the 32 week ultrasound that not only is the amniotic fluid level better than average, but that our baby is already a whopping 5 pounds! Estimated to reach 9 pounds and 4 ounces if carried to 40 weeks! I was watching her head size measurement come up on the screen (and remember, I was exactly 32 weeks along) - the head size came up measuring 35 weeks and 6 days, almost 4 weeks larger! What can I say, I have big-headed babies. From good German stock, I suppose. :)

So the good news is that my placenta is still rocking it, despite the disadvantage of the dysfunctional chord, and I'm still making just as large a baby as ever. Woo-hoo! No growth restriction!

On the other hand, I am making a very large baby here. With Caleb, we had no idea of his size, as there was no reason for any ultrasounds past the one at 20 weeks. It was the one thing I hadn't considered at the time - that the baby may be too big for me to give birth to -although I diligently studied every aspect of natural childbirth, and then some: from the most advantegous position in which to give birth (it's not flat on your back, but the squatting position, which opens up the pelvis by 1/3 more) to the various ways epidurals and other drugs can disrupt the physicological process of birth, delayed chord cutting, coached pushing vs. physiologic pushing, the precise way the uterine muscles move during labor and what wonders breathing and relaxed muscles in the rest of the body can do to facilitate its contraction almost painlessly (worked exactly like I read it), etc., etc.

Caleb was 9 pounds 2 ounces with a huge head and apparently too big for my body to pass through. My cervix stayed at 8 cm for about ten hours, then started to swell, and towards the end Caleb was not tolerating the marathon-length labor (I'm sure butting his head up against something that didn't give for 2 whole days wasn't fun) - he had to be delivered through a C-section.

I had been planning a VBAC (vaginal birth after Cesarean) throughout this pregnancy, thinking I already know what to expect in labor, it isn't bad, and worse comes to worse if my cervix stops dilating, we'll just end up with a C-section again. There's no harm in trying, the risks of uterine rupture during a VBAC are only slightly higher than they are with a C-section, but the C-section of course has its own risks, being major abdominal surgery (which trump the uterine rupture risks).

However, the SUA diagnosis has added a different twist to things, and after much research, I've come to the conclusion that it is safer for the baby to be born by C-section if she is just as large as Caleb was (we'll get the final word at 37 weeks) - considering my C-section history, narrow subpubic arch, which is strongly associated with prolonged labor and forcep or vacuum assistance at the end, coupled with the less sturdy two-vein chord, which is more easily compressed than a normal chord, especially during a lengthy labor/pushing phase. Compression of the chord during birth is very serious and it requires an emergency C-section, and even then, sometimes they cannot save the baby. Of course, it is possible to give birth to an SUA baby without any problems at all, but with everything considered in my specific case, I think the C-section is the safer option for this baby. Which means, I will never push a baby out of my body and experience the joy of natural childbirth (just the joy of post-childbirth -THE BABY) or put to practice most of the things I learned about childbirth in my first pregnancy. They do not allow VBAC after having had two C-sections. This was my one chance.

With all that said, I feel at peace with my decision. The health and safety of the baby is what's most important, not my experience.

We've believed, almost immediately after the initial shock that there could be anything wrong at all, that we had a healthy baby. Fear and worry have not crept into this pregnancy due to this diagnosis; I did not allow it. I prayed to God that first night and concluded right then and there that I was not going to worry about this situation, because worry is not from God, that I choose to have faith instead. God has blessed me with such peace during my first pregnancy and He has done the same during this second.

As I now prepare for the impending birth on July 7th, I trust that God will continue to keep me in His care - even as I put my care into frail human hands, as well.

BIRTH STORY

The last couple of weeks have been a whirlwind! I cannot believe that Caleb is already 2.5 weeks old! He is the most precious, beautiful, sweet little boy and we are so blessed to have him in our lives!

I promised to give an account of his birth, so before I forget all the details, here it is. I started getting mild contractions on the morning of the 22nd around 3 am. They came about every 10-15 minutes for about 8 hours. Totally manageable, but nevertheless, I could not go back to sleep. (First sleepless night.) During the day, the contractions eased up and went away all together for about 6 hours. At 6 pm they started back up again and this time, they were coming about every 6-8 minutes. Ron went to sleep, but I could not. (Second sleepless night.) I kept breathing through them and timing them on a website that times your contractions called www.contractionmaster.com.

By 3 am, they were coming every 3-5 minutes, so I woke up Ron, who was surprised that I hadn’t gone to sleep. The doula had said that when the contractions are 5 minutes apart lasting more than a minute, we should call her. So we did and she came out to the house. The early morning hours found us all sitting in our dark living room with only the lights of the Christmas tree, me breathing through contractions with some relaxation music playing. It was a very peaceful scene and I was able to completely relax. This went on until about 10-11 am, when we decided to head to the Birthing Center. I had no idea how far along I was, but the contractions were coming about 2-4 minutes apart and they were a few minutes long. I wanted to get there and settle in, so I didn’t have to bother with being transported during more advanced labor. So we went in and were admitted. I was dilated to 3 cm (I thought it would be more).

The next few hours, the contractions seemed to slow down again, coming only every 6-7 minutes (they say it is not unusual for labor to slow down upon arrival at the hospital, because of the disruption). We walked around the labor & delivery halls; I sat on the birthing ball, and got in the Aqua Doula tub. My room was private and dark (blinds shut, lights off) and we put in a music CD. I was able to relax. By early afternoon, I was dilated to 5-6 cm. That made me very happy, as I felt that the contractions have not been bad at all. The deep breathing I learned really helped and that’s what I concentrated on while relaxing my whole body. The only thing that was bothersome was that I kept throwing up (now this was not surprising to me, because during my teenage years, I used to throw up from cramps). Thus, I had to keep drinking huge amounts of liquids to hydrate myself. By evening, I was dilated to 8 cm. I was happy to hear of the progress and thought that we would have a baby by midnight. I was checked again around midnight, but no progression. Strange, we thought, as the last couple of centimeters usually go the quickest.

Early Sunday morning I was still at 8 cm dilation. I stayed at 8 cm dilation for about 6 hours (doula thinks it was even longer) and after walking some, we decided to break my water and try some Pitocin to encourage my body to finish dilating (not something I wanted to do, but figuring since it was late labor, it would be okay). I was pretty exhausted by now (third sleepless night), but was still breathing through my contractions and didn’t feel like they were unmanageable. Well, a few hours of this later, I was checked and I had apparently regressed to a 6-7 cm dilation, which meant that my cervix was swelling. I had begun to feel incredible pushing urges, which I could not control; my body just wanted to bear down and push this baby out, while my cervix was not fully dilated. This was the hardest part of the whole experience, because unlike the contractions, this was completely unmanageable. I knew I wasn’t supposed to push yet, because I could hurt my baby or my cervix, but I couldn’t stop my body from bearing down. Meanwhile, the baby’s heart rate had slowly gone from a baseline of 150 bpm to 110. Which meant he was still okay, but was not as happy as a day ago and he wasn’t going to take much more of this.

Around 8 am, the midwife said that we had waited much longer than they were comfortable with, there had been no progress for many hours, and we should go ahead with a C-section. Reluctantly, we agreed. They prepped me and took me into the operating room. We passed the anesthesiologist, who was drinking his morning coffee, and I heard someone say to him that I’d been in the labor ward since yesterday morning and will need to have anesthesia for surgery. The anesthesiologist looked up with a shocked expression and said, “She hasn’t had an epidural?” Even in my exhausted state, I got a kick out of the surprised look on his face, that someone would choose to do this thing naturally. He asked me if I wanted to be awake for the procedure. I said yes. I was given a spinal, which is basically a one-time shot of anesthesia in the back with no tubes attached (except that I felt 2-3 pinches with blood pouring down; he may have missed the first time). My legs started getting numb, they laid me on the table, put in a catheter, prepped my lower stomach for the bikini cut, and the doctor came in. I hadn’t seen any of the 3 doctors at the practice, since I was seeing the midwives, but I had heard about this doctor, who was Jewish. Well, we exchanged a couple of sentences and he says, “Is your accent Hungarian?” I answered, “Yes, and that is really good how you were able to pick that out.” He says, “One of my ex-girlfriends was Hungarian.”

They started the operation and Ron was able to come in and sit by my head. They had the baby out in less than 5 minutes (I didn’t feel too much tugging) and lifted him up for me to see. The first thing I noticed was his dark, wet hair – and that he was a big baby! The doctor says, “No wonder he wasn’t coming out, look at that head!” His head apparently had started to mold. They whisked him off and Ron went to see him. He peed all over the nurse as soon as he was out. Ron came back and they brought the baby to me, all wrapped up. I was able to greet him and kiss him for a couple of minutes. He was so cute! Then they took him away and I told Ron to go with him. It took about another 15 minutes to close me up and I was wheeled into Recovery, where a nurse sat with me for about an hour. Ron came in after a while and said that the nurse wouldn’t let him stay with the baby in the nursery, because another baby was being circumcised. That did not make me very happy, that our child has to spend the first hour of his life separated from both of us. This is not how I had planned it! The doula thought this was strange too, because they advocate how the dad can go with the baby to the nursery.

After an hour, I started feeling my legs again and they wheeled me out, passing the nursery, where we stopped to look at the baby. He was naked under the warmer, crying. (When he should have been on my stomach nursing.) We got in our room and Ron went to get the baby. He was wheeled into our room in his little bassinet and we finally had our little bundle with us. He was 9 pounds and 2 ounces (4.17 kg) and 21.5 inches (54.61 cm) long. (I grew a linebacker!) I was shocked that I had gained 20 pounds and had a 9 pound baby!

The next couple of days were pleasant; the nurses were very nice and helpful. We spent Christmas Eve and Christmas Day in the hospital; Ron stayed with us on the cot that they have in the room. It was nice that we were all together, our new little family. I of course could not sleep all day (and only a few hours at night) from the excitement of having our baby. He slept on my chest for part of each night; he seemed most content when he could be near me. I felt great and asked to be released a day early, so we came home on the 26th, 48 hours after the birth of our baby.

Looking back at the whole experience, things went a lot differently in the end than what I had expected (the C-section was the LAST thing I expected), but I had a tremendous peace through the whole process. Managing the contractions through breathing and relaxation went better than I expected. I never felt like it was too much and I was never afraid. Even when it came time for the C-section, there was a peace that was with me and I felt that God was with me, protecting me. I wondered why my body didn’t finish dilating and I got some more answers just yesterday, when I met with the doula for the 2 week visit. She said that she asked the midwife after the surgery what they had found when they went in. The midwife said that they found the baby’s head presenting the wrong way; not at the crown like it should have, but at the forehead. He was caught the wrong way and they had to work to wedge him out of my pelvis. So, it may not have been the size of the head (although it was big), but that it was coming down in a way that didn’t fit. Which would explain the tremendous pressure and some of the back pain I was feeling towards the end. He was butting his head up against my bony structure, the poor little guy! The doula thinks it was a fluke thing that happened and that it should not affect future deliveries. I am of course disappointed that after laboring so easily, I couldn’t also deliver him naturally. But I realize that I did all I knew to do to have a natural delivery and there’s nothing more I could have done. I’m glad to have had the experience of a labor without any drugs; I liked being alert (though exhausted) through the whole thing and using natural means to relieve discomfort. I now know what to expect, at least up to 8 cm!

More important than my birth experience, I am so grateful that we have a healthy baby boy and a healthy mom in the end. Caleb had Apgar scores of 8 and 9 at birth and I came through major abdominal surgery safe and sound. I felt great from the first day, with minimal pain and hardly feeling like I had surgery at all. I’ve been able to take care of Caleb from the beginning without any difficulties. Two weeks later, my body feels almost like it did before the pregnancy; amazingly I am just 5 pounds over my pre-pregnancy weight. We had Ron home with us for 2 and a half weeks; he took over the kitchen and housework, cooking wonderful meals, so that I could just concentrate on the baby and rest. (I have not yet had a full night’s sleep; 4-5 hours is about as much as I get, but a few daytime naps have helped.) We are slowly settling into a routine and I’ve even managed to complete a mid-sized project in one day with baby Caleb camping out on my lap (on the Boppy pillow) the entire time!

We are so happy to finally have our sweet baby boy with us. We love cuddling with him and watching his many cute expressions, seeing his little personality come through already, and we can’t wait to see him grow, see him laugh (his smiles are a preview). I can’t believe that something so perfect grew in my body (and I can’t imagine how he fit); it is just an awesome thing to comprehend that he grew from two cells into this beautiful little person and that he is part of me and part of my husband. I love to study his little face, hands, ear, feet to see whose resemblance I can find in him.

I will now keep updating on this new site, so that all of you who live far and away can hear about our days with Caleb and view pictures of him to see how he is growing.