Postpartum Part 1: Jaundice

Albert and I tried to exclusively breastfeed in the hospital until he lost greater than 10% of his body weight and started showing signs of jaundice. This made me sad, but the lactation consultants said it's likely the size and shape of Albert's lips and mouth that are giving us difficulty maintaining a good latch. He struggled with a bottle too. 

On a positive note, bottle feeding has been a good way to observe and correct his latch and I am pumping to help encourage my milk production. We were doing breast, formula and then pumping at each feeding (every 3 hours) and now we're alternating pumped breastmilk and formula at each feeding (every 3 hours).

Photo credit: Armando from Bella Baby Photography

The Birth

We experienced a few contractions, early labor. It was confirmed on a monitor so it was real. We got a peek at the amniotic fluid index (AFI), it was 9.6 cm on Saturday night (3/7). This was a little low compared to Thursday (3/5) when it was 13.1 cm. Values between 8 and 25 are considered normal, so we were sent home. Two cervical checks indicated that I was 60% effaced, 1.5 cm dilated and baby was at -3 station. She could touch baby's head.

Symptoms from week 39 include contractions and soreness in the pelvic area, including groin muscles and lower back. I felt like I could do more walking, but I was so sleepy. Naps were my jam.

The feeling I had in my body was similar to food poisoning. There were waves of nausea, trembling, weakness, shortness of breath. But then things went back to normal, my appetite returned and the contractions stopped. My body was gearing up gradually to active labor.

Thursday (3/12) at my OB appt, we scheduled the induction. At 1pm on Friday (3/13) oral Cytotec (misoprostol aka miso) was used to ripen the cervix. I tested positive for GBS so the IV was placed immediately. Dilated 1 cm. Bishop score = 3

4pm Fri (3/13) On an ultrasound, they saw a problem with Albert's abdominal wall. They told us that his intestines might be spilling out of his body cavity. It was so frightening to think he might be born and then sent for immediate surgery.

6pm Pitocin, 7pm second ultrasound, 8pm balloon in, 9pm Epidural, 11:30pm balloon fell out. Dilation 5 cm. Bishop score 8. They broke my water and it was full of meconium. I knew this meant bad news, which stressed me out more.

"Baby Bath" After the amniotic fluid came out dirty, they set up some pump that sent fluid up into my uterus to clean the baby and then back out into a bucket. It was absolutely disgusting and distressing to see the nurses take that bucket to empty it out. Also, the catheter fluid they collected was an alarming shade of brown and they said that means I have a baby pushing on my kidneys/bladder and pushing blood into my urine. Who knows? It was gross. There were so many things hanging out of my vagina (1) catheter (2) baby bath (3) sensor for baby, it was really awkward to change positions in bed. Plus there was an IV attached to my arm. It felt very unnatural.

3am serious pain, tremors, 6am oxygen. In order to get all the pictures they needed on the ultrasound (earlier), they ended up rotating baby into a bad birthing position, and we could never get him back to a good position. I got stuck at 8 cm dilated. 7am Sat (3/14) My cervix was ripe in a manner which was uneven (asymmetrical) which my OB thought was due to a LEEP surgery that I had in 2003 (causing some scar tissue that wouldn't ripen). Every cervical check was extremely painful because they kept trying to manually stretch it out.

At this point I had some visitors and listened to some music, it was really nice to have a break from the pain and pass some hours singing (and crying). 10am Sat (3/14) Eventually, I did have a bloody show. But never got to 10 cm. Baby never dropped past -2 station. I was on oxygen due to baby's heart rate dropping during contractions. We tried laboring in a few key positions. Side laying with peanut ball, in a sort of child's pose, in a "throne" position, nothing would get the cervix to dilate further than 8 cm. It was really discouraging. I had my mom timing the 18 minutes between doses of pain medication so that I could push the button only when it would actually deliver the drugs, instead of pushing it like a maniac at every moment when I was in pain. Unfortunately, it took until this point to learn that that's how it worked.

1pm Sat (3/14) c-section. Couldn't stop shaking during surgery. They thought it was because I was scared or cold. I was mentally resigned and at peace with the decision, but my body wasn't cooperating. Albert is filling diapers but he has an inguinal hernia. His intestines are in his scrotum. It's considered 'elective' surgery to fix. If poop gets trapped in there, it could go from fine to NOT FINE so it's better to fix it. It's possible now to gently massage the intestines back up into his abdomen like squeezing a tube of toothpaste. Lots of hospitals will not do this surgery so it is causing more stress. Some of this drama is caused by COVID-19 overwhelming the health care system. We are in process of getting it done though, with the help of lots of doctors.

Pregnancy Part 30

This week we have our biophysical profile (BPP) ultrasound. I guess they will be looking at the baby's size and movements. I wonder if they will be able to see where the umbilical cord is and how the placenta looks. The technician will be checking Albert's muscle tone and if there is an adequate amount of amniotic fluid there for him. Also, how his heart rate changes over time.

I feel pretty miserable these days. Like not depression, just physical pain. It's hard to get in and out of chairs and beds. Pretty much all positions are uncomfortable. My wrists hurt. When Albert is active, it causes me to exclaim because he has run out of room. The heartburn is pretty much around the clock. I say that we collaborate on pooping because it feels like he has to help massage the turds out and make room to let them pass. His foot keeps sticking out under my right rib. When I push it back in, he kicks me. Ouch!

During breakfast, I had a bit of a crying session, then I got up and danced a bit to LCD Soundsystem. We reminisced about what was going on in our lives in 2010. It was really great to see how far we've come since those dark days.

When we went to our appointment for the BPP, the whole building had no power so we were told that we would be getting a call from the office to reschedule.  I sat in stunned silence for about 5 minutes before deciding that it probably wasn't a good idea to wait around in an area with poor air circulation with other potentially sick people. We have a NST on Thursday anyway, so I hope they get the power issue sorted out by then.

On a happy note, we went for a 45 minute walk in the park I love by our hospital. Did some birdwatching and enjoyed the hints of spring in wildflower-covered hills and fresh air. Went home and husband caught an afternoon nap while I did a bit more work on baby's quilt. Then dear husband finally agreed to go with me to a restorative yoga class and he admitted that it was nice! I feel so grateful for this day, even though it didn't go as planned.

Over the weekend, we washed the washable parts of the breastpump and the bottles that we have. It was overwhelming getting used to the idea that this new equipment will soon be a large part of daily life, but my sore breasts are a constant reminder that avoidance is a bad idea. Better to just face it and get ready. We had another visit from mother-in-law on Sunday and it was nice to chat and have lunch with them. We broke the news that my mom will be here in less than a week and MIL seemed relieved. I was worried that she would feel like we're pushing her out, but she was happy to "come visit later" and not be the primary person to help me while in labor.

We also booked our hotel for the summer trip to Nebraska. We found a "king suite" at a La Quinta that has an outdoor pool. I think it will be an ideal base of operations for us to host guests and relax. It felt strange to be planning for something that is only 3 months away because in my mind it's like the timeline of my whole life is on hold until the baby is born. Dear husband keeps reminding me that one way or another, this baby will be born soon, there's no way around it. Our regular OB is out of town this week, so Thursday's appointment is with a different doc. Hoping it goes smoothly!

I really thought I couldn't track one more thing. I never expected to be this number-obsessed during pregnancy. I count and track so many damn things. How many hours of sleep, steps in a day, days per week of exercise, calories per day eaten & burned, grams of protein, mg of calcium, is baby kicking, when did I eat last, when will I eat next, what to buy at the store, how much salt have I eaten, how many glasses of water have I drank, when is next doctor appt, when is next birth class, what is my blood pressure, what is baby's heart rate, what is my fundal height, am I gaining weight at the appropriate rate... I was looking forward to stopping all this tracking nonsense when baby is born, but maybe it will continue to escalate. There are apps and devices for tracking baby's breastfeeding and sleeping habits. And also, it will be important to have good nutrition to sustain my milk supply. My expectation was a blissful pregnancy. my reality has been a blur of numbers. and a constant fear of "doing it wrong." But I must admit, having a blood pressure cuff at home has put my mind at ease.

At 38 weeks + 5 days (based on LMP) I feel like cooking in the kitchen just isn't going to happen. I'm so tired. I have a few things I would like to make, but when I weigh the pros and cons of it, it's really hard to motivate myself to do it. It's tiring being on my feet and with this pain in my wrists, it's hard to chop veggies and to lift heavy bowls and pots and pans. I feel like I'm kind of giving up on my diet plan, and I also feel like that's kind of OK at this point. I've been following it for 27 weeks now (6.2 months) and I would say it "worked." My Fitbit says I've gained 27.3 pounds. The suggestion for healthy women is to gain 25 to 35 pounds during pregnancy, while women who start off as obese should aim for 15 to 25 pounds. So overall I feel pretty good about this. It's not like I'm about to start gorging myself on anything I want, I'm still logging macros in MyFitnessPal, but as it's getting harder to eat due to constant heartburn, I'm kind of going back to my first trimester habits of just doing what I can even if it doesn't perfectly follow the diet plan.

Week 12 - 49%
Week 13 - 26% (one fast food)

Second Trimester
Week 14 - 28% (four fast food)
Week 15 - 28% (four fast food)

Week 16 - 26% (three fast food)

Week 17 - 31% (three fast food)
Week 18 - 37% (three fast food)

Week 19 - 31% (seven fast food)
Week 20 - 43% (four fast food)
Week 21 - 37% (five fast food)
Week 22 - 46% (five fast food)

Week 23 - 34% (seven fast food)

Week 24 - 40% (five fast food)
Week 25 - 34% (two fast food)
Week 26 - 29% (six fast food)

Third Trimester

Week 27 - 26% (seven fast food)
Week 28 - 51% (four fast food)
Week 29 - 37% (four fast food)

Week 30 - 54% (three fast food)
Week 31 - 60% (three fast food)
Week 32 - 54% (six fast food)

Week 33 - 50% (five fast food)
Week 34 - 43% (five fast food)
Week 35 - 63% (three fast food)
Week 36 - 43% (six fast food)
Week 37 - 69% (four fast food)
Week 38 - 51% (three fast food)