Adalyn's Arrival July 16th, 2017 at 5:32 am

Photo Credit Monet Moutrie.

Below are the nitty gritty details on Adalyn's arrival.  She took her sweet time coming, finally arriving on July 16th, 12 days past her July 4th due date, at 41 weeks 5 days beating Keegan's tardy arrival at 41 weeks 4 days.  She weighed 9 pounds even and was 21.5 inches long! As usual, I required some nudging by my wonderful midwives at Baby + Co to get me into actual labor.  My labor was great once it got going, the birth was in the water like my other two, but immediately after being delivered Adalyn's oxygenation wasn't where we wanted it to be and so she was transferred to Lutheran Medical Center across the street from Baby + Co to help her get started with this whole breathing thing.  In the end, I do believe this was the right call to transfer even though all her stats were much improved even on the ambulance ride over.  Better safe than sorry.  You don't mess around with oxygenation!  She was admitted for about 30 hours and we were home the next day. She's perfect as can be and we are so happy she's here.  A really cool thing that Baby + Co has is an electronic medical record that me as a patient has access to so the times and details are what was charted by my midwives!

Here's the longer version:

41 weeks 0 days with Midwife Erin.
Visit to birth center for a non-stress test to check on baby's well-being.  The mucus plug was lost 5 days prior and there had been some bloody show.  Baby did great at for the NST and then we went to the OB office across the street to check the amniotic fluid index.  It was 18.6 cm! Normal, but on the high end of normal.  Because of this we got some great pictures of baby sucking on it's fingers and moving their tongue.  Return to office in three days if no labor.  I was about 2 cm dilated, 75% effaced and baby at about -2 station and got my second membrane sweep.  This very similar to what I was at 40 weeks which was 1.5 cm dilated, 60 % effaced, and about -2 station when I had my first membrane sweep.

41 weeks 3 days with Midwife Ellen.
Visit to birth center to have another NST to check on baby before starting to try different things to get me into labor.  Baby passed the NST again! We opted to get a cervical balloon dilation done because I was still just about the same as I was a few days prior, about 2.5 cm dilated, 50% effaced and baby at about -2 station.  Ellen placed the balloon.  The procedure wasn't bad.  My instructions were to either see if it falls out on its own, which happens when the cervix is dilated to the size of the balloon which is about 4 or 5 cm, or to cut the tube and let the water out of the balloons in 12 hours.  After leaving the birth center I was getting mild contractions that were much more noticeable than all the Braxton Hicks I had been having for weeks.  About 2.5 hours later the balloon fell out on its own!  But, all the contractions stopped. The plan was to wait and see if labor started that night and if not I'd return the next day for some more interventions to get labor started.  Labor did not start and so I had a good night of sleep.

Baby dropped after the balloon dilation!

41 weeks 4 days with Midwife Gaither
We touched base with Gaither and decided to come into the birth center around 10 to try doing the breast pump and cotton root bark.  This is what had worked for me when I was in early labor with Keegan.  I was checked and was indeed at about 5 cm dilated, 60% effaced and now at -1 station.  We did the pump/herb protocol for 5 rounds.  Contractions were about 10 minuets apart and it was lunch time.  We decided to take a break and walk to a lunch place nearby.  Jeremy and I walked to Colorado Plus and had a lovely lunch.

Upon returning to the birth center  after lunch we discussed breaking my water but decided to wait because there was still a sizeable amount of fluid between baby's head and the cervix and the risk of cord prolapse outweighed waiting to see what my body could do over the afternoon/evening.  We also discussed doing Castor oil.  This was the only thing I was really dead set against doing since I had done it with Keegan and it didn't work, I ended up being dehydrated, and I think it contributed to us dealing with thrush those first few weeks.  After talking it over and learning it tends to be much more effective with second/third time moms I agreed to do it.  Yuck.  I mixed it with a smoothie from McDonald's.  Since Jeremy and I had some hours to burn we decided to go to REI and either get or order the Bob stroller we'd been wanting.  I was getting mild contractions about every 5 minutes for the remainder of the afternoon.

By about 8 pm the contractions had spaced out a bit and were milder.  I decided to try to rest.  But after I was laying down for about an hour or so they picked back up again.  I waited to call Gaither until I was sure they were getting longer, stronger, and closer together.  And the lovely castor oil started working at about 10:30 pm. Eventually contractions were convincing enough and I called her about about 11:45 pm and we decided to go in.  We put Keegan and Ryleigh in the Jetta with Tracy and Jeremy and I went in the Suburban.  We arrive around 12:30 am and the kids stayed asleep and transferred nicely to the couches in the lobby of the birth center.  They had a blow up bed for Tracy and she tried to rest out there as well.

Early labor! Still smiling! Photo credit to Jeremy.

At this point I was about 6 cm dilated, 70% effaced but still at -1 station.  We wanted baby to be at 0 station to break the water if it didn't break on its own.  We decided to do more cotton root bark and pumping.  After one round of pumping I was really noticing some soreness, we think the flanges were a size too small, so we decided to not do any more pump and just continue with the cotton root bark.  Contractions were about every 3-5 minutes and lasting 45 to 60 seconds.  At about 1:30 they had be eat something and I picked applesauce.  Then I threw it all up about 10 minutes later along with the cotton root bark I had been given earlier.  In the time between contractions I was able to talk and relax completely.  We were listening to XM radio and having a nice time getting to know Gaither a bit more.

Gaither was checking baby's heart rate.  Big belly!! Photo credit to Jeremy.

By 2:30 am contractions were stronger, still 3-4 minutes apart and lasting about a minute.  I tried sitting backwards on the toilet and leaning against the wall through a few contractions and then I threw up again and had a good amount of bloody show.  Then we tried the sling attached to the bars with some pillows because I was preferring to stand leaning forward and swaying during the contractions.  This was comfortable and Jeremy was rubbing my back.

Around 3:00 am she checked me again and I was 7 cm dilated and 90 % effaced and at 0 station! Progress!! We decided to wait and see if I could progress further on my own versus breaking my water.   Gaither said wouldn't it be cool if my water broke on its own?!?  Yes.  It would be.  But apparently I grow babies with sacs of steel.  Also, the major drawback to breaking the water artificially is that if there is meconium in the water we are supposed to transfer to the hospital. Into the birth tub I went! It was so warm and so much more comfortable than being "on land". I preferred to lean over the edge or be on hands and knees for contractions in the tub. At this point we texted Monet so she could come to Baby + Co to start documenting our labor.  Before Monet arrived Jeremy took a few more pictures.

Chit chatting between contractions.

Concentrating during contractions.

Around 4:15 I felt the contractions were getting stronger and I started to have to hum and moan through them.  Prior to this I was just able to breath through them.  This continued until about 5 am when I got out the tub to get checked.  I was still at 7 cm and 90 % effaced and 0 station.  Given there had been no great progress over the past two hours we decided to try breaking the water since I was getting somewhat tired.  Jeremy went and woke up Tracy and the kids.  They joined us in the birth room and little bleary eyed but excited.

Jeremy giving me great support during contractions.  Photo credit to Monet Moutrie.

At 5:09 Gaither broke the water which was nice and clear and guided baby's head down and it gushed and gushed.  We had to wait until the uterus contracted to really settle down. After breaking the water I was 7 cm, 90% effaced and baby was at +1 station. Once the head was engaged I got back into the tub and resumed by learning forward positing on hands and knees.  Thanks to all that cat/cow yoga I did!  Amy the assistant CNM arrived at 5:25. At 5:26 I could feel my body spontaneously start to bear down and I alerted everyone to this. AT 5:28 there was a quarter sized crown, at 5:29 there was a small crown, at 5:31 there was a large crown and she was born at 5:32!! This crowning felt different from Ryleigh and more like Keegan's  I definitely felt the "ring of fire" and grunted loudly with each contraction and was doing my best to following the coaching from Gaither and Amy trying to push and breathe and keep my bottom under the water.  Gaither provided great perineal support and I didn't tear at all!

What I didn't see at this point in the process was that baby had a very tight nuchal cord (cord wrapped around the neck) and the cord was also wrapped around baby's body and it had to be untangled.  But more importantly it was amazing that she had come so FAST!  From 5:09 at 0 station to born at 5:32.  Adalyn didn't get the benefit of being squeezed for very long in the birth canal.  More on that later.

Someone behind be said baby need to turn and then baby was passed under my legs and I helped lift baby up out of the water! I cupped baby's bottom and was absolutely SHOCKED to not feel boy parts and I said "It's a GIRL!!!".

Bringing baby up out of the water!  Nothing better than this! Photo credit to Monet Moutrie.

Looking at our GIRL! Photo credit to Monet Moutrie.

She was making little yelps and not screaming or crying much.  I clutched her to my chest and we were encouraging her to scream.  She wasn't doing it a lot so they had me stand up and go to the bed a few steps away.  They gave her three breaths and she started to cry a bit more.  We continued to  try to get her to cough and scream and either Amy or Gaither held belly down and there was a lot of mucous drainage coming from her mouth and nose.  What seemed like only a few moments later they had oxygen going and a pulse ox meter on her and were suctioning her mouth and nose.  Almost instantly Gaither and Amy decided to go ahead and transfer.  Amy made the phone call to get an ambulance. Meanwhile a few minutes before it was apparent to Jeremy what was going on Keegan and Ryleigh said they needed to potty so he had stepped out with them and when he returned they were on the phone with 911 dispatch.   She was doing sort of okay enough for us to cuddle on the bed for a few minuets before the paramedics came and Monet got a few more great pictures despite the surrounding chaos.

Getting in a snuggle.  Notice how the her forehead looks a little purple.  Poor thing came out so fast and that combined with her oxygen issue gave her an interesting color. Photo credit to Monet Moutrie.

Saying hello and goodbye. Photo credit to Monet Moutrie.

The worst part was when Amy said "Say goodbye to your baby, Kate".  The cord was cut and they put Adalyn in a big zip-loc bag.  I wasn't surprised at this because I had heard a few stories on the Birth Hour podcast where other mamas described their babies being put into gallon sized bags when they were transfered, but this did surprise Jeremy.  Whenever a baby is transferred the dad goes with the baby so Jeremy went with Adalyn and Gaither in the ambulance.  At some point during all of this the placenta came out and I also got a shot of pitocin in my leg to help stop my bleeding.

During the ride over to Lutheran her stats were in the 90'sand she was doing well.  When she arrived and looked her over they said she was doing well but sounded "wet" in her lungs.  She was in a room called the transitional NICU and they had this little helmet thing over her head providing her with blended oxygen/air.  The plan was to wean her down from 35% to room air levels of 21% gradually and watch her stats.  She completed this process over the course of a few hours.  During this time she was weighed and measured and had her Vitamin K and Hep B shots.

In the transitional NICU getting mixed air. Photo credit Jeremy.

Our little astronaut. Photo credit Jeremy.

Meanwhile I was still at Baby + Co for my postpartum recovery and observation time of 4 to 5 hours.  Tracy eventually left with the kids.  Monet was there with me for the first part and was so sweet and brought me my first snack of cheese, crackers, and apples and ADVIL! Hooray for Advil!  Jeremy called and we face timed  while Adalyn was getting weighed and checked out.  It was really surreal watching this on my phone.  After we hung up Monet and I said our goodbyes.  At some point Gaither returned, she must have walked back from Lutheran, and gave me the update which was the same as what Jeremy had just told me on the phone.  After having been sitting up in the bed with Monet for about 20 minutes I laid back down and had a gush and passed a clot.  Amy gave me another shot in my leg of a different drug called Methergine to make the uterus contract.  I said how that shot hurt a lot worse than the pitocin and Amy remarked I was more than a little distracted when I got the first shot.  Which was true and funny in an odd sort of way. 

Around 7 am Amy switched with the postpartum CNM Everly who would take care of me until I was ready to go.  I thanked Amy for being there and really was so glad to have had both her and Gaither through that process.  Amy offered some words of wisdom about being a mama of transferred baby and reminded me to take it easy and baby was doing well.  I explained how I really felt that it I was okay with the transfer because oxygen isn't something you mess around with.  Also, that was why I decided to give birth at the birth center so that if anything like this did happen the hospital was right there, just like it should be, for extra support when needed.

Everly offered to draw me up the herbal bath and I agreed to it.  I thought it would be good to try to relax.  At some point I was talking to Jeremy on the phone and asked him to ask my very good friend Kelsey to come to the birth center and help me get ready to go and  to drive me to Lutheran.  Kelsey got there around 8:15 while I was in the bath.  Kelsey was actually there for Ryleigh's birth because she was in charge of Keegan 4 years ago and had since delivered her own baby at a birth center so she knew exactly what to expect.   Kelsey and I chatted for a while and then she helped me get from the tub to the shower and cleaned up and got dressed.  I threw my hair up in a pony tail at this point and put on the clothes I had worn into the birth center the night before.  I laid on the bed and Everly went over all my discharge instructions around 9:20.  At 9:30 Kelsey and I left Baby and Co for very short drive across the street to Lutheran.

I got out of the car and went to the bench outside the main entrance while Kelsey parked the car.  Then Kelsey came with a few bags of our things and we went inside and found a wheelchair for me.  We found out where to go and after a small detour we finally got to the transitional NICU room where Jeremy was standing and holding Adalyn who was breathing room air by this point.  I sat in a chair and held Adalyn and got to feed her for the first time!   Kelsey snapped a few pictures for us.

First feed.  She was a natural.  Photo credit Kelsey Etchison.

I'm getting to hold my baby.  Finally! Photo credit Kelsey Etchison.

Maybe 10 or 15 minutes later we were transferred up to the third floor to the room we'd spend the night in.  Kelsey helped up get upstairs and get settled.  Jeremy and I spent the new few hours staring at our new baby and resting as much as we could.

Getting in some much need (for both of us!) skin to skin time.

Monet offered to meet us over at Lutheran when we were all settled in and Tracy, my mom Donna, and Keegan and Ryleigh were coming over to really meet baby Adalyn.  Monet came around 3:30 and everyone else arrived around 4.  We spent some time taking pictures.  Keegan fell absolutely in love with his new baby sister.  Ryleigh was curious but seemed really unsure what to think.  Eventually Monet took off and then everyone else.

Photo credit to Monet Moutrie.

Photo credit to Monet Moutrie.

Photo credit to Monet Moutrie.

Photo credit to Monet Moutrie.

Photo credit to Monet Moutrie.

Photo credit to Monet Moutrie.

Ryleigh being spunky and talking to Monet! Photo credit Jeremy.

Jeremy and I tried to rest but it was difficult with the people coming in and out of the room so often.  They were checking Adalyn's stats often and she was always well saturated, a good temperature and good vitals.  Also, because she was 9 pounds she was considered LGA, which is "large for gestational age".  Because of this they  had to check her blood sugar levels often to make sure they didn't fall too low, especially since I wasn't able to feed her for the first 4 and half hours of her life.   I didn't have gestational diabetes or anything during the pregnancy so she was just big because I make big babies! Keegan was 8 pounds 9.5 ounces and Ryleigh was 8 pounds 4 ounces. She also passed all these blood tests with flying colors so gratefully they stopped doing them after 12 hours or so.

More snuggles. Photo credit Jeremy.

Our little hospital burrito baby in her plastic box. Photo credit Jeremy.

We didn't sleep great at the hospital and it was just so different form what we had experienced with Keegan and Ryleigh where we were able to go back to our home and be cozy and snuggle in our own bed. They had also started testing her bilirubin levels and they were going up a bit.  By the morning they were borderline high and they suggested giving her about 10 to 20 mL donor milk to help her clear it out before my milk came in.  I agreed to this and they gave us two 40 mL bottles of donor milk to go home with.  The discharge process took forever and we were finally able to leave around 12:30 the next day and we agreed to follow up with our pediatrician the following day to have her bilirubin checked again (which we did and she was fine!).

Finally going home!!  We were so excited to use this outfit!

It was a long process getting this little girl to join us earth-side but totally worth.  I'm still mourning the loss of all those special moments you typically get to have at the birth center in those first postpartum hours and that first 24 hours at home.  I'm so grateful for the kindness and expertise of my entire labor team from Erin and Ellen to Gaither, Amy and Evelyn to Jeremy, Monet, and Kelsey!  Adalyn is totally worth and I wouldn't have had her any other way, except for skipping the whole cord and subsequent oxygen issues.

Home!!!

Edited to add:
On August 1st we had a short 2 week postpartum visit with Gaither to help process the whole transfer experience.  It was really good and we got to ask a lot of questions and talk over what happened and specculate as to why.  Gaither believes Adalyn had such a hard time transferring not because of the nuchal cord but because of her extremely fast birth.  She spent so little time in the birth canal after we broke my water she didn't get a chance to clear her lungs in the process.  This makes me so sad.  I'm a trooper.  I could have stuck it out for a few more hours and it would have totally been worth it to avoid the transfer.