Halloween

Today I had a follow-up appointment with my midwife. This was the first time I've seen her since the delivery. Being in her office brought back my memories of being pregnant & my dreams for perfect birth. I promised myself not to get emotional, but when Sally asked me how I was doing after everything that was done to me, I couldn't hold back tears. I still felt sad & disappointed by not being able to deliver Gerritt vaginally. I had hoped for a natural, unmedicated birth & ended up experiencing almost every medical intervention out there (except forceps & vacuum extraction since baby was too high up in the pelvis for those to be useful, thank goodness!). The good news is that Sally thought I was a good candidate for trying a VBAC (vaginal birth after Cesarean) with my next baby. Sally could be my midwife again; only I would deliver at Groop Health instead of Swedish Ballard. I will definitely try VBAC. The next baby may be smaller & positioned differently. Who knows?

Gerritt & Charlie

Our dog Charlie has adjusted to Gerritt's birth better than we expected. He is so sensitive & nurturing, we call him nurse Charlie now. :-) He doesn't like hearing Gerritt cry & attempts to comfort him by licking. He has also been sleeping by my side every night even though it means waking up frequently. We found Charlie to be as tired & sleepy during the day as we were. ;-) Also on occassion, Charlie has been known to sniff out a dirty diaper & to alert us by tugging at baby's blanket. Since I used to hold Charlie so much, he still wants his Mommy time regularly even if it means sharing a Boppy pillow with nursing Gerritt. Charlie loves to snuggle next to Gerritt with our supervision, of course, & has accepted him as a new addition to our family. Charlie has turned 3 last September, so he'll be around when Gerritt is in his teens. Hard to imagine now...

The first month

Gerritt is going to be 1 month old in 1 day! And we've managed to keep him alive! People say to enjoy every moment since children grow up so fast, however, the past month seemed really long to us. Maybe it is due to the fact that our lives were turned upside down since the birth of our little bundle of joy. We knew having children would not be easy, but we were still shocked by the overwhelming responsibilities & demands of early parenthood. Now I know pregnancy was the easy part... We have never been so tired & sleep-deprived before. Also it was hard to adjust from having active social & professional lives to staying home all day & realizing that every day would be the same: change diaper, feed, burp, play a little, put baby to sleep, then repeat every 2.5-3 hours! :-) Add the fact that newborns don't interact very much and you have a severe case of boredom on your hands. My husband would find me in a rocking chair with a dazed blank look on my face at least once a day & say, "Sweetie, you look really bored... Poor thing!" Some days it is noon time & you realize you haven't showered yet & you are starving because you forgot to eat breakfast. The good news is that it gets better over time. As you get to know your baby & recover from childbirth, you find joy in little things - the way Gerritt smiles when sleeping, the way he draws his hands to his face every time he eats, all the different facial expressions he makes, the way he yawns, the long stretches he does when unwrapped for a diaper change, & even the "golden shower" (the joys of having a boy!).
The first month was spent getting to know Gerritt & adjusting our parenting style. I was set on practicing the attachment style of parenting, however, found I couldn't follow all of its aspects. Gerritt slept in bed with me for the first 2.5 weeks & the quality of my sleep was poor. I was awakening every hour due to all the little noises he made & to make sure his face was not accidently covered with a blanket. I also couldn't turn in bed freely. Things have improved tremendously with Gerritt sleeping in his crib & me sleeping in bed next to him. I am still open to the idea of co-sleeping, however, with an older child. Also I couldn't carry Gerritt in a sling all day due to pain in my abdominal incision, so that had to be replaced with lots of holding & rocking. One thing I was able to practice was to respond to Gerritt's cries right away. I am not a believer in letting a baby cry it out to soothe himself. We are also feeding Gerritt on demand & not on a schedule.
We had a few sleepless nights & even thought Gerritt was colicky for a while. We've tried such anti-gas/anti-colick remedies as Mylicon drops & Gripe water. Then we found out we were underfeeding him (2 oz. of breast milk or formula that satisfied him as a newborn were not enough at 3 weeks of age) & that he was a bit cold. Gerritt kept waking up frequently & crying & it took Shon's Mom taking care of him for one night to figure things out. He started sleeping for 3-3.5-hour stretches as soon as the room's temperature was increased to 71-72 degrees & he was wrapped in two (instead of one) blankets. We've also had a couple of nerve-wrackig days when Gerritt did not have a bowel movement for 2 days. We were frantic with worry & called the Ballard Pediatrics office & the Nurse Consulting phone line (free service provided to Microsoft employees). We've learned Gerritt's pattern was normal since he was receiving both formula & breastmilk. Becoming a parent sure involves a steep learning curve!
When Gerritt was 2 weeks old we had our first outing. We all went to the grocery store, Costco & then Tully's for some coffee. I just remember everything around me feeling surreal. I couldn't believe I was sitting in a chair by the fireplace drinking tea - a resemblance of my old life! We were able to stay at Tully's for only 20 minutes since Gerritt started crying & everyone was looking at us, however, that little outing gave us hope that life would some day be normal again. :-) Also around that time I spend some time running errands by myself. Driving for the first time after surgery was an experience & I got tired fairly quickly. Still it was good for my spirit to get out of the house.
The first month was filled with Gerritt's pediatric appointments, my follow-ups with the surgeon who did my C-section (Dr. White) as well as my midwife, a trip to the lab for a repeat PKU test for Gerritt, visits from our doula and multiple friends. We learned how much work it is to get out of the house on time when you have a little one. It has been wonderful to experience the support of our friends & family. It really does take a village to raise a child. My husband's Mom has been a lifesaver! It is great to have her come & take care of Gerritt once a week while we have a few hours to ourselves. Thanks to her we were able to go out as a couple a few times & take naps. Now we have a newfound respect for all of the parents out there including our own. I vowed to never criticize anyone's parenting style again.
Physically, it took me about 3 weeks to feel somewhat like my old self again. My C-section scar still aches once in a while & a few areas around it continue to stay numb. It is quite unpleasant to brush against it accidently & not have previous level of sensation. Some days I feel like one giant breast. I am pumping milk about every 3 hours. A couple of times I got a bad case of a plugged milk duct (when one of the ducts gets clogged, does not drain & gets inflamed). I think those were the times I was so tired I didn't hear the alarm & slept for 5-6 hours straight instead of waking up & pumping. Thanks to hot packs, increased frequency of pumping, Ibuprofen & rest, the plugged ducts didn't turn into mastitis. I have joined a New Mom's support group at my church, however, missed the first meeting. It was just too much trying to get out of house by myself with a 2-week-old baby.
We are gradually transitioning to being parents. We are taking it one day at a time. I am counting the days until Gerritt will be able to interact with us more. My husband's paternity leave ends on December 10th. I don't know what I would have done without his help. My love for him has grown since Gerritt's birth. The baby brought out a different side of him - such tenderness & nurturing. My husband who could sleep through everything now wakes up at Gerritt's first cry. We feel really blessed with a healthy pregnancy & baby. We have reconsidered our thought of having 4 children though. :-)

Postpartum/recovery

Immediately after the C-section I returned to my room, the same room I was laboring in. Since I was still numb from the chest down, I was turned to my side so that I could breastfeed Gerritt. My doula kept helping Gerritt to stay latched on. He was alert & eager to nurse. I wanted to elevate my head to hold the baby in my arms, however, I was advised against doing so for at least 3 hours to prevent spinal-induced hypotension. So I stayed laying flat until about 2100. I was happy the surgery was over and I had a healthy beautiful baby in my arms. It was strange not to be able to feel and move my legs. I was relieved when the anesthesia started to slowly wear off & I could turn myself in bed within 3 hours after surgery. I continued to feel comfortable even after spinal anesthesia wore off due to the Duramorph injected earlier. It provided pain relief for about 18 hours and after that time I started taking oxycodone & Tylenol. One of the best advices I received was not to eat or drink large amounts of fluid for 12 hours after surgery to prevent postoperative nausea and vomiting. So I felt great postpartum with the only medication side effect experienced being generalized itching (thanks to Duramorph).
We didn't get much sleep that night since Gerritt kept waking up every 2-3 hours & crying. I ended up rocking him all night long. The mother-baby unit was short of nurses that day (due to a large number of laboring women - the result of last winter's power outage & wind storm), so my husband & I did all of the diaper duties.
The next day, I took my 1st walk & ate regular food. I found myself being constantly hungry and thirsty. Much of the day was spent learning to breastfeed & keeping our baby warm & dry. The urinary catheter was discontinued later that evening & I was relieved to be able to urinate on my own. It was difficult to get in and out of bed & to walk standing up straight due to the pain in my abdominal incision. I kept taking oxycodone & Tylenol on schedule, every 3 hours, which allowed me to do my motherly duties. That night we didn't get much sleep either since Gerritt kept waking up about every hour & crying from hunger. Newborns are born with good fluid & fat reserves, which should allow them to survive on a few drops of colostrum (fluid produced in the breasts until the breast milk becomes available), however, Gerritt was not satisfied with colostrum alone. Since my milk hasn't come in yet, I ended up asking a nurse for SNS (Supplemental Nursing System, which allows the baby to breastfeed while being supplemented with formula via a tube attached to the nipple). Gerritt still continued to fuss & wake up often. We finally learned that we were not feeding him enough (we were giving him 10-15 cc of formula instead of at least 30 cc every 3 hours). Needless to say, I was in no shape to go home on our third day in the hospital. My husband & I were like walking zombies. We were very fatigued & kept falling asleep in mid-sentence. Since I had a long labor which ended in a C-section & was still in considerable pain, my surgeon thought it was a good idea for us to spend a 3rd night at the hospital. I was so relieved! We took our evening nurse's advice & let her watch the baby & feed him formula while we slept from 1:30 to 7 am. That was the longest stretch of sleep we got since Gerritt's birth & we felt like new people in the morning.
On October 4th (Thursday) we were discharged around 5 pm. It was a beautiful sunny fall day & I remember thinking how the world would never be the same. I was a changed person & as we were driving home with Gerritt in his car seat, everything looked different. The next few days were filled with Gerritt's mother/baby visit on October 6th (where he got weighed & checked for jaundice), his 1st pediatric appointment on October 8th, & learning to breastfeed. I ended up having a home visit with a lactation consultant due to my condition of flat nipples. Breastfeeding did not come naturally & was quite a time-consuming process with application of a nipple shield, correct positioning, trying to keep baby awake during feedings & pumping afterwords to stimulate more milk production. My milk has come in on the 4th day after the delivery & I've experienced swollen & tender breasts. As I continued to breastfeed & pump, take hot showers & apply heat packs, the tenderness subsided within a couple of days. It was such a miracle to observe my body's capability to produce what baby needed most - breast milk! Since I wasn't producing enough milk to keep Gerritt comfortably full, we ended up supplementing his diet with formula after each feeding. Our efforts paid off since he surpassed his birth weight at his 2-week check up. Gerritt weighed 8 lbs 1 oz at 1 week of age & 8 lbs 11 oz at 2 weeks!
It was wonderful to have my American Mom Chris here with us for about 10 days after Gerritt's birth! Her delicious meals kept us nourished & her emotional support was invaluable. I found myself experiencing baby blues soon after coming home. A combination of fatigue, surgical pain, changing hormone levels & a huge change in our lifestyle made me feel deliriously happy some times ("This baby is such a God's miracle & I can't believe he is my son!") and unable to control crying spells at other times ("I am a failure since I wasn't able to deliver vaginally."). I quickly found out that my day as a new Mom went a lot better if I was able to start it with a hot shower (which felt like a luxury) and a good breakfast.
I was amazed at how quickly my abdomen flattened out after baby was out as well as such a rapid weight loss. I weighed 145 lbs on the day of returning home from the hospital (18 lb weight loss in a 4-day period from pre-delivery weight of 163 lbs!). No stretch marks, varicose veins or hemorrhoids - not bad for a 1st baby! :-) Some major physiological shifts took place within a few days after delivery: my swollen feet & ankles disappeared allowing me to fit into my old shoes again; so did my nasal congestion & frequent sneezing (I was able to sleep using only 1 instead of 3 pillows); no more heartburn & frequent urination; & my wedding ring was not tight any more. However, I continued to be constantly hungry & thirsty. 500 extra calories per day are needed to produce breast milk, so no wonder I continued my pregnancy eating habits post-partum! Also it is amazing how quickly I started to forget all of the unpleasant details associated with pregnancy & childbirth. Must be nature's way to ensure I do this again some day! :-)

The big day - October 1st

On Sunday evening, September 30, I started to feel a bit restless. I felt I really needed to get out and exercise. Since it was raining, my husband and I went to the Alderwood Mall & did a few loops inside. I had to stop a few times & do deep breathing exercises due to intermittent sharp lower abdominal pains. It was hard to walk being so big, however, exercise helped me to go to sleep that night. At 1:11 am on Monday, October 1st, my water broke as I attempted to get out of bed to use the restroom. A large gush of warm fluid running down my legs & rapidly covering the bedroom floor was an unmistakable sign of early labor. I started to shake with excitement knowing my big day has arrived at last. I woke up my husband. I knew I had to conserve my energy and try going back to sleep, however, it was nearly impossible. The contractions started a couple of minutes after my water breaking. They were mild in intensity lasting about 20-30 seconds each & coming 10 minutes apart. I was re-reading Penny Simkin's Pregnancy, Childbirth & the Newborn book trying to anticipate what's ahead. It stated that rupture of membranes before labor occurs in about 10% of women, & in most pregnancies the membranes do not rupture until the active phase of labor or later. My husband's Mom was spending the night at our house since we were supposed to take her for her swearing-in ceremony on Monday. Once she found out why we were up, she wanted us to go to the hospital immediately, however, we have told her that in order to be admitted we had to meet the 4-1-1 criteria (contractions lasting 1 minute each 4 minutes apart for at least 1 hour). She could not go back to sleep either & spent the rest of the morning praying for a safe delivery & a healthy baby in her bedroom. I have realized that I was in such denial I have not packed my hospital bag, so at 2:30 am I've started packing it at last. At 3 am I have called my midwife Sally to inform her of the recent developments. After asking a few questions, she suggested I stay home for as long as I was comfortable. After eating some macaroni & cheese, I went back to bed. My husband & I kept track of the contraction intensity using his stop watch. I was doing deep breathing & relaxation. At 6 am I called Chris & Gerry & told them I was in labor. I have also called my doula Audra & told her I may need her in a couple of hours.

I spent much of the morning walking around the house, packing last-minute items, eating light easily-digestible foods, rotating my pelvis on a birth ball & listening to my hypnobirthing CD. I was able to relax to the point of almost falling asleep for about an hour while listening to my one of my CDs. I've started to get more uncomfortable at around 1030 am. The contractions were longer & coming every 2-3 minutes apart. It took much breathing to get through each one. I've phoned Sally & informed her that we were going to the hospital. She said she would inform the hospital unit I was on my way. We have also called my doula Audra & told her to meet us at the hospital.

The drive to the hospital was challenging. I could feel every bump. Thanks to the timing of the day, there was no rush hour traffic. We arrived to the hospital at about 11 am. After arrival to the maternity unit at Swedish Ballard, we were greeted by a nurse who escorted us to our room. We have asked her for a cart so that my husband could unload all of our bags from the car. She suggested we wait until she assessed my contraction pattern. After helping me to change into a gown, the nurse applied electronic monitor to my abdomen. I focused my energy on staying relaxed, closing my eyes & deep breathing through each contraction. After confirming that my contractions were frequent & intense enough, the nurse phoned Sally who suggested I have a vaginal exam to assess my dilation. After checking me, the nurse praised me & told me what a brave woman I was since I was 9 cm dilated! She said she did not see this very often & that I must have very high pain tolerance. She initially thought I would probably need to return home since I looked too calm & relaxed to be in active labor. She stated that I am less than an hour away from having my baby born & my midwife needed to be there ASAP & ran out of the room.

Sally arrived to the hospital within next half an hour. She checked my cervical dilation which invited a strong urge to push. I've started pushing at around noon time gently rocking my hips as I was leaning over a hospital bed. Pretty soon the intense back labor set in & I switched my position to being on my hands and knees. My doula kept massaging my back with lavender massage oil & applying pressure to tense areas which helped tremendously. She also made sure I stayed hydrated offering me water to drink every hour or so. Soon I had an IV put in & blood drawn to check my latest platelet count. At around 1400 Sally decided to get more aggressive about pushing. It turned out the baby was in occiput posterior position (back of the baby's head facing toward my back or a "sunny side up") which is considered to be an unfavorable fetal position. I was having considerable back pain due to the hard round part of the baby's head (the occiput) pressing on my sacrum, straining the sacroiliac joints & causing pain in the entire lower back area. I kept changing positions every 30 minutes while pushing: leaning over the bed, doing the lunge (lunging one of my legs while staying upright), side-lying with my right leg elevated, semi-prone, sitting on a toilet, & "water skiing" (squatting while pulling on a sheet wrapped around a squatting bar in front of you). Sally thought one of the reasons the baby wasn't descending during pushing urges was because I was afraid of letting go & truly bearing down due to severe back labor. So she suggested I try sterile water block (back acupressure point saline injections). The injections were one of my most painful things I have experienced, much worse than the labor itself, however, they did provide good back pain relief for about an hour. Due to the baby's position, I found out I couldn't urinate, so a catheter was used twice to drain my bladder during labor. After a couple of hours of bearing down with no results, my labor started to slow down. Nipple stimulation brought my contractions back, however, they were not intense or long enough for the pushing stage. Sally suggested I try Pitocin drip to make my contractions more effective. I was very nervous about trying it since I've heard it was often difficult to tolerate the intensity of Pitocin-induced contractions without an epidural. However, Sally reassured me that Pitocin would be started at a slow rate & that it takes a while to come into full effect. She was right, Pitocin worked slowly, however, once it reached its full effect, my contractions were very intense & coming every 2-3 minutes apart. I experienced an uncontrollable urge to push with each contraction. I was pushing for over 3 hours & no progress has been made. The baby did not come down even an inch. Sally has even tried to turn the baby's head to facilitate his better descend, however, he flipped right back to his old position as soon as she was done rotating him. I was getting to the point of exhaustion & falling asleep between my contractions.

At around 1700, Sally stated that she wasn't comfortable with me pushing any longer since no progress has been made & with my history of ITP (idiopathic thrombocytopenia purpura, or low platelet count) the baby was at a higher risk of intracranial hemorrhage. She stated that she thought C-section was the best option for me at that time. I was shocked & reluctant initially, however, once another contraction came I changed my mind. The contractions without any progress took everything I had & I was more exhausted by the minute. Once the decision about C-section was made the nurse anesthetist arrived pretty quickly & went through the list of standard medical history questions & obtaining informed consent. I just remember thinking, "I can't make it through another contraction. Stop all of this questioning & let's get on with the business." A few minutes later I was wheeled into the OR downstairs & was sitting on an operating table hugging my knees awaiting my spinal block. After everything I've been through that day my mind barely registered the pain of the needle being inserted between my vertebrae. The bliss of numbness set in from my nipple line down to my toes in a matter of minutes & was positioned for the surgery. The most uncomfortable thing about the surgery was laying with my head lower than my legs with big belly pushing on my diaphragm & making it harder for me to breathe. The smell of burning flesh as my vessels were cauterized was not pleasant either. However, the surgery itself was conducted quickly. My hubby & my doula were at my side the whole time. After several strong pulls (I felt my whole body lifted off the operating table 3 times) to get the baby's head out which was wedged deeply in the pelvis, Gerritt was born at 1747!

It was amazing to hear Gerritt's first cry! There is really nothing like it. I've started crying the minute I heard it. What a miracle it is to create another human being! Gerritt Jinwon Hong weighed 8 lbs 8 oz. and was 21 inches long. My husband was a proud Dad at last & brought the baby over to me as soon as Gerritt was measured, weighed & wrapped. The baby was born at 39 weeks & 3 days of gestation, or 4 days before the due date. So much for our expectations of overdue baby!

"A child is such a precious gift, a seed destined to grow and blossom forth in all the ways that parents choose to sow. Hug that child, love that child and when the time has come, set that perfect being free, and be glad you were the one, to have a chance to share this dance, with a flame of the golden sun." ~ Sri Gawn Tu Fahr