Joshua’s Arrival

I wrote this about a month ago when memories were fresh but kept forgetting to get Jacob’s approval before posting, since it is a bit more intimate.

For my memory’s sake, I like to write down the story of each of my boys’ arrival.  For the sake of not repetitively telling the story to the many who have asked, I do it here.  Since it serves both purposes, you’ll have to excuse (or enjoy) the length and detail in which I record it for my personal purposes.  The morning of Joshua’s birth is a bit fuzzy for me as far as timeline goes, so Jacob tried to help me piece it together.

I guess to adequately tell the story, I have to go back to pre-labor for explanation.  For this pregnancy, I was Group B Strep positive (GBS), which was not the case for the previous two.  Now, before you think I have some disease, it’s just a bacteria that a fair percentage of women are naturally colonized with.   It is generally harmless, except to babies that are born to these women, a certain percentage of which can develop life threatening infection as a result.  To prevent this, antibiotics are given via IV for 4 hours during labor and it’s no big deal.  Knowing that my labors don’t even last 4 hours I started asking questions of my OB and pediatrician early on about what to do.  We kicked around the idea of induction (I loath inductions because Josiah’s was not an experience I want to repeat) but ultimately decided that the risk was low and serious infection could be prevented or treated just with close monitoring and quick action, if needed.  So, we sat back and waited.

Well, my due date came and went.  Another visit to my OB brought the idea of induction back up more because she was concerned about me making to the hospital in time for delivery than because of the GBS factor, but it prompted me to call my pediatrician who seemed to be a bit more careful this time by saying it was of “utmost importance to get 4 hours of antibiotics”.  So, now we started to stress a little about making the right choice for Joshua regardless of what it meant for me in delivery and recovery.  Ultimately, with a lot of prayer and uncertainty about our choice, we opted to stick with the original plan of letting my body do its thing in its own time, though we did tentatively plan an induction for 3 days later (5 days post due date) if I happened to make it that long, though we didn’t think we’d follow through.

Induction day arrived with still no baby, but at 2:30 AM I woke to a mild, sudden, and very brief pain in my lower abdomen and a mild contraction followed.  It didn’t feel any different than the countless Braxton Hicks contractions I’d had in the many previous weeks, so it was no big deal to me, though the initial pain was odd.  I continued to have these contractions every 9 minutes for the next 4 hours with no change, during which time I tried to sleep and even got up for a snack and reading.  The duration and regularity was a little odd for false labor, but there was only discomfort, no pain, and no progression.  I laid back down at 5:00 or so, but by 6:00 some started to come closer together, but were more variable in time.  I had one mildly intense contraction and told Jacob maybe we should head to the hospital in case it was real so that we could start antibiotics.  Given that the first contraction I had with Elijah was so strong that it made me drop to my knees, this seemed very odd and unconvincing to me, but we figured we may just have to follow through with that induction, after all, and at least we wouldn’t have to question Joshua’s health.

As we headed to the hospital, the contractions grew farther apart and I only had one on the way, but it was stronger than a typical Braxton Hicks, so we kept going.  We got there around 8:30 AM.  I made Jacob wait with me in the lobby for one more contraction, which took almost 15 minutes to come, but was strong, before I was convinced we should go up.  I felt like a fool standing there checking in telling them I was in labor when I didn’t even have a contraction while going through that process and when I did, I was easily able to hide the discomfort.  Obviously there was no pattern to this labor.  They put us in triage with nurse Francis.  She got me set up with monitors and asked me all the questions about which symptoms of early labor I was experiencing.  I had none of them except mild contractions that hardly fit the description of labor.  I warned her that I believed I was in labor and that I deliver fast.  Jacob and I expressed our concerns over Joshua’s health risks and that we were only there this early for that intervention, but during this whole conversation I hadn’t yet had a contraction.  She wasn’t buying it.  Jacob had mentioned to her that I hung out for 3 weeks dilated to 5-6cm with Elijah (which is what I was in triage), so she really wasn’t convinced.  Finally I had a few contractions, 10 minutes apart, so she said she’d monitor for an hour, then recheck. 

An hour later they were 4 minutes apart and I was having to deal with a bit of pain, but it was nothing like what the poor girl across the curtain had going on.  She was highly vocal and I had to feel sorry for her when she measured at only a 2.  It made me feel blessed to have felt absolutely nothing whenever I must have been a 2…or 5, for that matter!  When the nurse walked back in to recheck me I felt for sure she’d recognize it as labor and stated the obvious that they were closer now and more intense, but the first words out of her mouth were to ask how I felt about going home.  Now, let me clarify that Jacob and I actually really liked this nurse, but neither of us could believe she just asked that!  I think she saw our surprise, so she said she’d just check me before we decided.  At that point I asked what had to happen before I was considered to be in active labor and she answered that there had to be changes on exam.  My exam revealed not quite a centimeter of change (but remember this is to nearly a 6) so she said it was borderline.  We reiterated our wishes and she decided to admit us.

After admission, which was around 10 AM, we spoke with Dr. Chamberlain (who we really liked!) and she told us the plan that she’d see us again in 4 hours for induction.  I just said ok and laughed inwardly.  At this point contractions were still 4 minutes apart and were intense enough that I was closing my eyes and breathing through them, but still they were not too much to easily handle.  Francis started the loading dose of antibiotics which she said would take 20 minutes to run, then left the room.

Well…when Francis came back, I was standing, leaning on Jacob in a tough contraction, and had just told him I felt the urge to push!  I think he had a short moment of panic until he saw the nurse :)  I got back in bed for another check, and sure enough everything was a go.  The four hour plan turned into 20 minutes!

I didn’t have an epidural with Josiah or Elijah, but this time I had told Jacob ahead of time that I was open to it if the timing worked out and if I wanted it.  I had withstood the previous two ok, but clearly remembered crowning and wasn’t looking forward to it again.  This go round I was physically tired for much of the pregnancy and I just didn’t know if I had the mental or physical stamina to do it epidural-free with the attitude that I felt I needed.  So, at this point, I was finally in enough pain to be thinking of the epidural, though I wasn’t convinced I wanted it.  I asked the nurse about it and she gave me a blank stare, stumbled on her words a bit and I knew it was too late.  She said that I would have to sit still for 20 more minutes or else risk it not being effective.  I told her never mind and that I’d tough it out.

Francis called Dr. Chamberlain back in, who said she couldn’t believe that 45 minutes ago she was talking to me about induction in 4 hours.  I wanted to say I told you so, but pain kept me quiet.   We discussed whether or not to break my water and I asked about not breaking my water to help slow delivery thus allowing more time for antibiotics.  She said that unless I could wait 3 more hours then there was no point.  That wasn’t going to happen!  Being unable to face the fact that it would bring more pain, I declined breaking my water anyway, though I knew it was inevitable.  She came back shortly afterwards and I told them I was ready to stop avoiding it :)

After Dr. Chamberlain broke my water the pain decreased significantly and it didn’t seem like much was happening.  Joshua just wasn’t making much downward progress.  I said something about this time being different and that because of all the variability I felt like I didn’t know what was happening or what to do and Dr. Chamberlain said it was ok and that they were just there to help me do what I felt my body needed me to do.  I liked that.  No pressure.  She said she’d give me some time to let things progress and left the room.  As soon as she left, the next contraction came on strong and left me, Jacob, and Francis trying to call her back, but she was already gone.  At this point Jacob and I were both so thankful for our nurse.  I think she’s the best we’ve had.  We (I) spent the next several contractions working hard to get Joshua to move, but he just wasn’t making progress, so Francis had me assume a new, awkward position that required leg support from Jacob and the nurse.  It worked and Francis had to call for the doctor over the intercom to come NOW.  She did and before I knew it Joshua was on his way. 

As was true with my other deliveries, I had that moment of involuntary reaction at the moment of arrival and I gave Jacob a run for his money in his job of helping support one of my legs and left Francis calling for backup from another nurse.  The moment was brief before I reminded myself it would only be over if I could control myself long enough to push (and push again).  Then it was, in fact, over and I was holding my sweet, wet little man at 11:59 AM.  My first impression was that he looked like a cross between Josiah and Elijah, though seemed to favor Josiah more initially.  He cried and coughed a bit, but was mostly calm.  He was beautiful!

I always feel guilty about what follows, but it has happened with each delivery.  At this point, I have found myself to be exhausted and overwhelmed and hardly even able to lift my head enough to  look at my new son in my arms, much less do anything more.  I can’t even cry like a decent mother should :)  It doesn’t mean it isn’t a special moment for me.  It just means that outwardly I come up dry.  Dr. Chamberlain must have been watching me and after awhile said that I looked like I needed a minute.  I agreed and they had Jacob cut the cord then took him to do measurements and such while she tended to me.

My regular OB, Dr. Million, came to see me later that night and said she heard I had had to push for a long time.  She had called during my labor to set up plans for me for later in the day, only to find out I was there and actively pushing.  After she said that, I remembered being frustrated that Joshua seemed to be coming along slowly and that the nurse and doctor kept saying he wasn’t moving, but I hadn’t thought of it in terms of having to push for a long time, but I guess I had.  No wonder I was tired!

As with Elijah, I had a quick recovery from this delivery and was doing well enough to go home in no time.  The question was with Joshua.  We had already been warned that we’d have to have a 48 hour monitoring period and bloodwork since we didn’t get the 4 hours of antibiotics.  We also had some nursing troubles early on because he was full of amniotic fluid that he kept spitting up and that seemed to steal his appetite, but that resolved in 24 hours or so.  His bloodwork was fine though he was jaundiced, and the pediatrician decided that since we were “experienced parents” (ha ha!) we could go home at the routine 24 hour mark as long as we’d contact her the next day with an update with a follow up visit with our normal pediatrician on Monday.  Itching to get home, we agreed, and he did well.

It’s amazing to me how different each of my pregnancies and deliveries have been.  Each has had it’s own challenges and positives.  Similarly, both of the older boys look so different and have opposite personalities.  We’re waiting to see just who exactly little Joshua will be and to see what he looks like when the “newborn look” is lost and his features take shape.  We are excited about our newest family member!