Kieran's Home Birth

My estimated due date was December 2nd. I fully expected Kieran to come late, and did everything I could to prepare myself emotionally for that eventuality. After all, Joel was 7 days late and Xander was 12 days late. I knew it was practically inevitable. But despite all my mental prep, it was still really rough, especially the last five days or so.

On Thursday morning (41 weeks + 4 days), my midwife Karla had me come for a non-stress test. At this stage of lateness, they start to get concerned about the placenta shutting down. The NST was okay, but not great. Kieran's heart didn't have any decelerations, which was good, but he didn't have great accelerations in response to stimuli, which is less good. At that point, Karla gave me a concoction of castor oil, juice, almond butter, and lemon verbena.

I had taken castor oil with Joel, and I had been pretty reluctant to try it again. Online forums are rife with warnings about the risks. But there comes a desperation, and with my midwife's encouragement, I went ahead and gave it a try.

About three hours later, I began having contractions. They were not super intense, but they quickly grew regular and stayed that way through the afternoon. I began to be hopeful! We had dinner, went to the store, inflated the birth tub, and around 8pm took the boys over to my parents for the night.

However, my contractions were not progressing. Karla checked me that evening, and I was only dilated to 3cm. It was devastating to have made so little progress after contracting all day. The problem was that Kieran was still posterior and his head wasn't engaged in my cervix. Karla gave me some exercises to do that would encourage him to turn around. I worked at them through the evening and into the small hours of the morning, and my contractions did grow more intense...until I fell asleep. When I woke up early the next morning, labor had stopped entirely. It was sooooo discouraging!

So now Friday the 14th had arrived (41+5), and I felt like we were back at square one. James and I went to Karla's house at 10am. She checked me again, and to our surprise and relief she announced that I was dilated to 7cm and 70% effaced! But Kieran's head still wasn't engaged. Karla gave me another dose of the castor oil concoction and sent me home to work on moving this baby around.

At about 11am, contractions started up again, as intense as they'd left off the night before. I moved between exercises, working to get Kieran to turn around. My mom brought the kids home for a bit, so we hung out before putting Xander down for a nap, then put a show on for Joel. The intensity of my contractions increased, but the interval stayed irregular, between 6-9 minutes apart.

Just before 2pm, Karla texted to see how things were going. When I told her what was happening, she asked if I was ready for her to come over. I told her I wanted to wait until my contractions were closer together. She warned me not to wait too long.

Then all the sudden, my contractions jumped to 3 minutes apart. After a few of these in a row, I decided that maybe things were moving faster than I'd thought. I texted Karla at 2:20pm and told her yes, I did want her to come over. She headed our way. I called my mom and asked her to come pick up the boys. So in the midst of stronger and stronger contractions, James and I packed up the boys and their overnight things. My mom and Karla arrived within minutes of each other. We said goodbye to the children, and my mom left with them around 2:45pm. It was a bit chaotic there for a bit!

Once they were gone, Karla checked me. I was dilated to 9cm and pretty close to complete. Ahh! So I called the photographer. I think I gave her a mini heart attack when I told her I was already at 9cm. Fortunately she made it over in time! (Unlike Karla's assistant, who arrived about 5 minutes after Kieran did.)

I labored for a little while longer before I got in the birth pool.We had the tub set up next to our Christmas tree. With the lights down low and "Ever After" playing quietly in the background, it felt like it was going to be peaceful and amazing.

But I only got to labor in the tub for about 20 minutes. Karla was monitoring Kieran's heart during contractions, and she grew concerned about the drop in his heart rate. Ultimately she asked me to get out of the tub so that she could control things better. Getting out of the tub was not very fun. We moved me to the floor; I ended up in this weird half-squat position. After another contraction, Karla told me that we needed to get the baby out, now.

There's nothing like the urgency of a midwife in a moment like that. On my next contraction, she told me to push and to keep pushing. In the background, I could hear Karla asking James to call 911, in case we needed help getting the baby to breathe. Now feeling frightened for Kieran, I kept pushing, certain that I was tearing as I did so.

On my third big push, his head was delivered. His body followed easily, and then to all our relief, he let out an enormous cry! James was able to hang up with 911 as we welcomed little Kieran into the world at 3:55pm.

I remember feeling immediately euphoric after the birth of my other children. Unfortunately it took a few minutes to get to that point this time--I'm pretty sure that Kieran bruised my tailbone with his little posterior self. It made it really hard to get into a comfortable position so that I could hold him. Ultimately James and Karla cobbled together some cushions for me to recline on there on the floor so that I could finally hold my baby. (Part of the adventure of birthing at home!) What a joy he was to hold at last!!

Not too long after birth, I called my parents and had them bring the boys over to meet their new little brother. They were all pretty delighted.

After my parents took the boys back to their house for the night, there was much settling in. Karla got Kieran's measurements: 8lbs 2oz, 20 inches long, and 14.5 head circumference. (And no tearing for me, huzzah!)

Karla finished examining Kieran and filling out paperwork. She and her assistant got all the birth supplies cleaned up, got me cleaned up, made sure Kieran was nursing well, started the laundry, then departed, leaving James and I at home with our snuggly little boy.

All in all it was a wonderful birth experience. Giving birth at home is awesome. It's empowering, it's peaceful, and it's sooooo nice to be able to sleep in my own bed afterward. James is the best partner; he was there every step of the way encouraging, comforting, and supporting me. This was our third delivery together, and he knew just what to do - applying pressure to my back, setting up things I would need, and caring for me and the baby afterward. I am more in love with James than ever, and we are both so in love with our sweet Kieran.

Our weekend in Pediatrics

On Friday, our sons met for the first time.

Honestly, Joel was not super interested in the baby. He looked him over briefly, then proceeded to explore every cabinet and drawer in the room. He was also very interested in the play area down the hall. They have balls and cars. Much more interesting than that squishy thing Mama's holding. :)

The weekend was pretty quiet, medically speaking. Xander's oxygen needs went up and down several times, and late Saturday night he seemed to be struggling a bit more to breathe. But that resolved on its own, thankfully, though it was very worrying at the time.

I have to make a note here about engorgement: It sucks. My milk came in hardcore on Thursday, and by Friday morning I was referring to my breasts as rocks. I got to visit with a lactation consultant on Friday morning, and she gave me several things to help ease the discomfort. She did tell me that this was probably something that I would just have to suffer through--albeit not so bad--for a few days before my body settled. Not going to lie, it was pretty amusing to have an entire head of cabbage delivered to our room shortly after the consult. I got some funny comments from nurses and others who visited. But I think the cabbage leaves actually did help!

Anyway, our days took on something of a routine. James and I spent the nights at the hospital. After spending the mornings with Xander--snuggling, nursing, pumping--we headed home in the afternoons to refresh and spend time with Joel. Then we returned in the late afternoon to the hospital.

It was hard. When I was with Xander, I missed Joel. When I was with Joel, I missed Xander. When I was with Xander, at least I knew that Joel had Grandma to take care of him. But leaving Xander was hard, all alone in that big hospital room. I know the nurses enjoyed snuggling him. But I still felt guilty, especially because breastfeeding is so important to me. Even with pumped milk, I felt guilty for leaving him with a bottle. It was awful to feel so torn between my babies.

We're hoping to be released Monday evening after Xander's last dose of antibiotics. I cannot wait to be done with this particular trial, and be able to be home as a family.

NICU Day 3 / Transition

To my surprise and delight, when I went into the NICU at 8am on Thursday morning, I found Xander off oxygen and IV fluids. The nurse had taken him off about an hour before, and he was doing great!

James came to the hospital shortly thereafter. We were told that if Xander continued to do well off oxygen and IV fluids, that he would probably be transferred out of the NICU and into the regular pediatrics unit, where he could finish his 7-day course of antibiotics. After visiting with Xander for awhile that morning, James took me home for a few hours to refresh and spend some time with Joel.

Side bar: Last Saturday, partially as a diversion from STILL being pregnant, and partially as something we'd already been planning to do, we went to For Garden's Sake (a charming nursery that we fell in love with this summer) to pick out a shade tree for our yard. We fell in love with this Shumard Oak, which James planted on Thursday afternoon.

While at home, we got the call we'd been hoping for--Xander had been moved to pediatrics! Yay! We finished with the tree, then returned to the hospital.

Unfortunately, it seemed that the move had upset the stability Xander had achieved in the NICU. We were pretty disappointed to find him back on oxygen support by the time we arrived.

Still, the children's unit was a HUGE improvement, especially when it came to OUR comfort. Xander had a large private room, with a bathroom and shower, and a pull-out couch. Also, the policy for visitors was much more relaxed. In the NICU, only 2 visitors were allowed at a time, which had made it virtually impossible for Joel to come. So we planned for Joel to visit the next day.

James had planned on sleeping at our house that night, while I spent the night with Xander. But I'll be honest, I had a total emotional breakdown that night. I think the weight of everything happening, plus the postpartum hormones hitting me, contributed to me becoming a weepy mess. So James ended up driving all the way back to spend the night with me. I have the best husband in the world!

NICU Day 2

Wednesday morning James and I went to the hospital. To our relief and joy, Xander was no longer under the oxy hood. It had been replaced by a nose cannula for his oxygen. But this meant we could hold him, and I was able to breastfeed. It was such a relief to snuggle with our chunky monkey!

Unfortunately, because of his continuing need for oxygen support, we learned that he would indeed be staying for at least a week. The main purpose of the week was to run a full course of antibiotics. It was disheartening to hear Xander would be staying so long, when we'd hoped to take him home the next day. But of course his health was most important!

Wednesday afternoon I brought my mother to the hospital to visit. She was sure a happy grandma! I have to say, my mother has been our saving grace this week. With her here to watch Joel, James and I have been able to spend most of our time at the hospital with Xander. While it's certainly been hard to be away from Joel so much, at least he's got Grandma doting on him at home, which I think has mitigated some of the hardship for him.

That night was an adventure. I was given a sleeping room in the NICU. I had made a feeding plan with the nurses, to breastfeed Xander every three hours. So I set alarms on my phone, and every three hours that night, I got up, shuffled through the hallways to Xander's pod, and fed my baby. I wouldn't have had it any other way, though by the 5am feeding, I definitely felt like a zombie. I continued to pump periodically, so that Xander would have milk for when I wasn't there.

NICU Day 1 (Part 2)

In retrospect, I have to be glad that Xander came late. Last week, James happened to be on fall break. Of course, this time was supposed to be spent on his major writing assignment. Fortunately, his professor was very generous and gave him a week extension. Because not a lot of schoolwork happened during the first week of Xander's life. And I don't know what I would have done if James had not been there with me.

It was determined on Tuesday that he had indeed aspirated meconium, and based off his chest x-ray, the doctors were fairly certain that he had developed pneumonia, which is a common result. We were told that he was definitely going to be there for two days, but might end up staying a week, depending on his response to the treatment.

Xander spent all of Tuesday under the oxy hood. I asked, mid-morning, if there was any possibility of holding and maybe nursing him. At that point, I was told, it was important to maintain his "oxygen environment" under the hood, which meant no.

We were given a boarder room--basically somewhere we could crash and keep our stuff while at the hospital. This was helpful, as there is basically no free space in the NICU. There's barely room to pull a couple of chairs up to his little bedside.

The lactation consultant visited; she showed me how to use the hospital breast pump, and advised me on hand expressing my colostrum, since the pump isn't super effective at getting the thicker colostrum out. Although, it's been fantastic to use since my milk came in. SO much nicer than the little manual pump I have at home.

Late that evening, our home teacher came to the hospital to help James give Xander a priesthood blessing. To be honest, I'd never met our home teacher before, and James had only met him this past Sunday while in nursery with Joel. But I think it stands as a testament to the wonderful community of the church. We were so grateful that he came. The blessing brought James and I a great deal of comfort, and I felt that Xander's breathing seemed less labored afterward.

We decided to check out of the boarder room and go home that night. I knew that I needed rest, which I wasn't going to get much of there. Between waking Monday morning and that point Tuesday evening, I had only had about three hours of sleep, and had delivered a baby in the midst. But it was seriously one of the hardest things I have ever done, leaving my baby at the hospital and going home without him. It just broke my heart.

NICU Day 1

Xander was born at 9:28pm Monday night. It took a couple of hours for us to get settled in. By midnight, James and I had finally laid down with the baby to attempt some sleep.

It's impossible to rest, however, when you've got a little baby between you who can't sleep. Xander's breathing was rapid, and as time passed, it grew more and more labored. The nurse had checked him before leaving us for the night, but we finally brought her back in around 3:30am. She didn't seem very concerned, but acknowledged that he was breathing too fast, and called in the midwife. After her examination, they decided to deep suction him, supported with oxygen.

He did have a lot of amniotic fluid in him. But even after the deep suction and a good bit of time on oxygen, his breathing had not improved. It was such a struggle for him. Our midwife decided to call UNC hospital, who sent over a team to examine him. We were warned at that point that it was likely we'd be going to the hospital.

The UNC team arrived shortly and spent a few minutes examining the baby. They decided to take him to the NICU. James and I rapidly threw our things together. I was given this whole new reason to be grateful for not tearing. After Joel was born, I could barely walk to the bathroom for the first couple of days. There's no way I could have gotten up, dressed, and climbed into an ambulance mere hours after delivery.

At the hospital, we were shown to a waiting room while Xander was assessed and set up in the NICU. I just wept. The doctor eventually came to us there. She talked us through everything that might be going on, the most likely being meconium aspiration--that Xander had breathed in his first poop during his birth. They were going to start him on antibiotics, get a chest x-ray, start him on IV fluids, and keep him under an oxygen hood to stabilize his breathing. She advised us that Xander's condition was not overly serious, and simply would take time to assess and treat.

We were soon taken in to see him. We had been warned that the NICU can be overwhelming, which was absolutely the case. The room is full of equipment and sounds, and there is a constant air of worry from the parents and visitors. It's impossible to fully relax there, with the incessant barrage of beeping, bubbling, hisses and whispers.

Xander was in a warmer, under the oxygen hood, with an IV and a bunch of other wires. The oxy hood looked like an astronaut helmet. The hardest part that first day, besides the uncertainty, was not being able to hold him or breastfeed. We could touch him, but not being able to hold him was awful. I felt totally bereft of this little life that so shortly before had been safe in my womb.

And so the waiting began. Or rather, changed. We'd been waiting for his arrival. Now we were waiting to know what was wrong, waiting to know what would happen, waiting to know when our sweet baby could come home.

Birth story: Baby X

I thought I had it bad with Joel, who was born a week late. I tried to prepare myself for Baby X to come late. I had my mother schedule her flight out six days after his due date, knowing it was likely. But in spite of all my "preparations," I grew more and more disheartened as I passed 40 weeks. My mother arrived, and still no baby. 41 weeks, still no baby, and no signs of labor. My midwives started preparing me for a possible induction at 42 weeks, which was NOT what I wanted. Needless to say, there were many prayers and tears over the past few weeks!

After nothing and more nothing, I finally started having some contractions on Sunday evening. They were sporadic and light, but they were something. Monday morning, October 12th, the contractions started to seem a bit more promising. I had a non-stress test scheduled at noon, to check the baby's heartrate and make sure he was doing well. I figured if my contractions progressed, I'd get checked while we were there. When it came time to go, James and I went ahead and packed up the bag with my labor supplies and the infant car seat--just in case.

We headed to the birth center--the Women's Birth and Wellness Center in Chapel Hill. The NST took FOREVER. I was hooked up to the monitors for nearly two hours. (The test is supposed to be 20 minutes.) First of all, Xander was a wiggly monster. Secondly the nurse couldn't get him to react well to stimuli, which is one of the major things that determines his well being. I know it was necessary, but it was still majorly frustrating! Especially because I was having contractions the entire time.

We visited briefly with the on call midwife, who gave us some options. We decided to go get some lunch--we were starving!--and then come back to get checked. It was about 2:30pm when we got back to the birth center. The midwife, Allison, checked my cervix. To my utter astonishment, she announced that I was dilated to 7-8cm and had bulging waters! James and I were totally stunned, but elated that I was having a baby at last. I was admitted and we got settled into our birthing suite.

We went for a couple of walks around the grounds, then labored in the tub for awhile. The contractions stayed pretty consistent, getting a bit stronger. It was about 5pm when I requested another cervical check. It's not routine for them to check, but I wanted to know if I was progressing, to be able to pace myself. Allison determined that the baby's head had dropped a fair bit, but I was still at about 8cm. That was a little disheartening. She suggested changing positions--all fours, or on my knees over the edge of the tub--to help him move into position.

So we kept working. James and I were left mostly to our devices, except for a nurse coming in every half hour to check the baby's heartbeat. It was not quite what I had expected, but I actually rather liked it. It might have been different if this was my first delivery. But James and I knew what to do, and it was nice to just do it, the two of us. I labored all over the place--multiple positions in the tub, leaning on James, standing and bracing on the sink, and later others. I loved the freedom to do what my body wanted to do.

I think it was just before 8pm when I had James bring Allison in. She watched me through a contraction standing, then suggested I try the birthing stool. I had never used one before. It really increased the sense of pressure. I labored there for awhile. When things got more intense, Allison suggested moving to either the pool or the bed--she wanted a gravity-neutral position for the next part of my labor, in the hope of avoiding tearing like I had done previously. So I moved back to the tub.

Contractions got much more intense. I didn't actually feel the urge to push. I felt pressure, but nothing like the urge to bear down like I remember feeling with Joel. But it felt like time, so I just started trying to push, to see what happened. And it was definitely time!

Pushing took what felt like ages. Xander was positioned at an odd angle, so I had to change my position several times. My water broke there in the tub. Shifting during that part was agonizing. The worst was when Allison said she wanted me to get out of the tub and move to all fours on the bed. At several points along the way to the bed, that seemed like an impossible request. For several contractions I stood at the edge of the bed. I thought my legs were going to give out! He crowned there; Allison suggested lying on the edge of the bed, saying that movement would probably pop him out. She wasn't far off. I lurched rather awkwardly onto my side. Lying on the corner of the bed with one leg up in the air, I gave two more pushes and out he came!

His cord was very short--they could only get him to my tummy, I could only see the top of his head. They ended up having James cut his cord right away so we could move. But while still in my awkward edge-of-the-bed position, I suddenly expelled about a pint of blood. James was a bit alarmed! Apparently it was just the result of my placenta shedding, and the placenta itself soon followed. But I hardly noticed most of that, because I was enraptured by my beautiful baby!

That full head of dark hair makes me so happy. He's got long Holley fingers and toes. Of course his size was immediately noticeable--a little while after the birth, they took his measurements, which were astonishing--9lbs 15oz, 22 inches long, 15.75" head circumference. The best part was hearing that I pushed out a baby just shy of 10 pounds with NO TEARING. Hallelujah! And I can tell you, there is a world of difference in how I feel postpartum.

We got settled in. James went and got us a pizza. Xander nursed for the first time. Once we were all cleaned up, measured, fed and squared away, we attempted to get some sleep.

Unfortunately, that's where things went downhill. But that story shall continue in another post. I would like to remember my triumphant delivery of Alexander Lee Holley independently of what followed. It was a wonderful, empowering birth.

To be continued...