Thursday, June 30, 2011

Maia's birth story

Maia's birth was much faster and less annoying than Chloë's. As the attending midwife said, "First babies don't just fall out." It had a bit of a run-up in medical advice and family politics, but otherwise was nice and uneventful.

At my 39-week appointment, the midwife, Amy, who had delivered Chloë, talked to me about being GPS positive, which you'll remember from last time meant I would need antibiotics during delivery to prevent possible serious infection in the baby. She checked me and found that I was 3 cm dilated, 80% effaced. "Your body's ready to have this baby," she said. She went on to say that since I was clearly on the cusp of active labor, it might start at any time and things were likely to happen very fast, and in that case the baby was at more risk of infection if I didn't get at least four hours' worth of antibiotics before she was born, and controlling the start of labor might be the best thing. She concluded, "So, should we strip your membranes?"

I was nonplussed, and wasn't excited about being induced before my due date. (I looked up stripping membranes later and it's not exactly induction, more encouragement, but I didn't know that at the time and she didn't explain.) Amy said that my next appointment should be scheduled for my due date and we'd talk more about induction then, if I actually made it to the appointment. It was clear she didn't think I would.

But I did; five days later, on April 26, I went in and talked to a different midwife, Heather. She, too, was concerned about GBS, though she wasn't as strongly in favor of induction as Amy had been. She said, "At this point I could go either way. In a week, we'll draw the line and say 'You have to have this baby now,' because outcomes get worse after 41 weeks. Right now, it's your decision." Eric and I discussed it and decided to schedule an induction for the next day.

I was ambivalent about this decision, since I've been inculcated in the natural-childbirth school of thought and also wasn't sure whether insurance would cover the induction itself (they did). Also nearly changed my mind when told we should be at the hospital at 6 AM. But we showed up almost on time, after having sent Chloë to spend the night with the mothers, and got checked in.

Getting registered and set up and settled in took some time (especially since the first nurse couldn't get an IV in me, instead "blowing up" my vein which gave me a horrible bruise for three weeks afterward) and I didn't see the midwife on duty, Sue, for an hour or more. She told my nurse, Midge, to get me started on antibiotics and then an hour after that I'd get Pitocin. "We'll increase it a little bit every half-hour until you're at about two to three minutes between contractions," she told me. "And in a while we'll break your water, and that should help get things going too."

So they started the IV at around 8, added the antibiotics at 9, and started Pitocin at 10. "How long was your first delivery?" Sue asked. I told her 20.5 hours. "Oh," she said. "Well, this will be much faster. We're aiming for before 6."

After that, there wasn't much to do for a while. We looked at the readout of my contractions, which were unnoticeable. Upon first getting hooked up, it turned out I was in fact having contractions at ten or twelve minutes apart already, but I wasn't feeling them, and didn't for a few hours. I shifted positions every so often and read or knitted. Eric played on his phone. We talked. We got me to the bathroom regularly, which was an ordeal since I had to bring the monitors and the IV stand with me. Midge came in to check on us a few times. "Is there anything I can get you?" she said. "Most of my patients are more needy than this; I feel like I'm neglecting you." I asked for some juice to make her feel useful.

Somewhere around 11, Sue came in to break my water. "I thought we wanted to avoid that because of GBS," I objected. I was also kind of creeped out by the whole idea, though I didn't say that part.

"You need at least four hours of antibiotics, and you've had two," she said. "I'm watching your progress, and I don't see you having this baby before one." She got out the water-breaking tool, saying ,"Some women don't like this because it makes the contractions come. But they have to come."

*WARNING: GRAPHIC GIRL CONTENT* The water-breaking tool was basically a long crochet hook, and she inserted it into me and started sawing back and forth, which really creeped me out. After what I thought must be longer than necessary, there was a little trickle between my legs, and she removed it, saying, "Fluid nice and clear. Good. It's just trickling now, but in a while you'll get up and there will be a gush," she told me. *END WARNING*

She left, and I started crying a bit because the procedure had made me feel awfully vulnerable and I was still ambivalent about all this intervention. On the other hand, delivery before dinnertime was a happy thought, and I recovered quickly and had lunch, such as it was. Since I had said I might think about an epidural, Sue had put me on a clear-liquids diet plan, so I had some juice and some sorbet and nothing else. (They provided broth and gelatin as well, but the broth was chicken and the gelatin was "varied flavors" flavored, so I passed on both.)

I started noticing the contractions, first more as involuntary motion in my muscles than anything else. Midge felt at the top of my bump and explained that she was feeling for the strength of the contraction. "Press your nose," she said. "That's a soft contraction. Your chin is a medium, and your forehead is a strong one." Then I started feeling a bit of pain. Then I started staring at the clock during them--ostensibly to time them, but really because the staring helped steady me. Midge asked how my pain level was. We'd discussed this at length when she first came in, and she made it clear that she was in favor of drugs but could happily help me do natural techniques if I wanted. We'd also discussed her pain scale, in the first actually helpful description of the 0-10 scale I've heard. "0 means no pain," she told me. "1 means it's there, but it's no big deal. 5 means you're antsy in your seat, starting to think you can't tolerate it. 10 is your arm being torn off. 5 is when we'll start talking about pain meds. But we can get something for you anytime you want it. Just tell me."

As I got up the scale from 0 to 3 and 4, I started, as I told Eric, thinking about the breathing techniques we'd learned in our birth education class last time--not necessarily relying on them, but thinking about them to distract myself. Then I started actually using them. Midge watched me through one and counseled me for the next-- "Slow, deep breath in for the count of five," she said, and counted for me. "Then slow breath out."

I was still going back and forth on the pain meds issue, but I was also starting to have trouble keeping control during contractions and wanting to vocalize--which is not the same thing as needing to scream, but is the step before it, and I remembered how awful it was with Chloë. So at this point, around 2:15, we asked Midge to call Sue to check my progress and help advise me. Sue came in and checked. "You're at about six centimeters, and your cervix is tissue-thin," she said. "I'm actually not going to leave the floor until your baby is born, just in case. But this is the perfect time for some medication if you want it." When I still couldn't decide, she suggested that I try some Nubain, "To get you through the worst of it," since I was coming up on transition (seven to ten centimeters), and I finally said yes.

Midge left with the order to get the Nubain, and so did Sue, after telling another nurse or technician (I don't remember) to get the delivery cart into the room, just in case. I lay in the bed, on my side, through another contraction or two, squeezing Eric's hand, and started vocalizing--an "Aaaaaaaah" sort of sound, fairly controlled, though it was getting more difficult. Now that I'd made the decision to get some pain relief, I was happy I'd done it, and complained about why Midge was taking so long.

Then, in the middle of another contraction, the pain turned into a sudden stuttering urgent need to push, and my focused vocalization turned into a wild uncontrollable wail that I probably couldn't reproduce now if I tried. Eric says when he heard it, he thought, "Okay: now an hour of the hard stuff." I was pushing, though I knew I probably shouldn't since no one else was in the room, and just as the contraction ended Sue and Midge and a couple of other people burst in.

"What changed?" Sue demanded.

"I'm actually feeling the need to push," I said, apologetically, because I knew I was supposed to have gone through transition first and what had happened to it?

"That’s what I thought," she said in satisfaction, as people started scurrying around. "We were at the end of the corridor, and I heard you and said, 'That's a baby coming.' Nothing else sounds like that. Let's get you on your back and into the stirrups."

"Nooooo," I said, because another contraction was starting and the idea of rolling over and putting my legs up was totally ridiculous. But Midge and whoever else was in the room--I totally don't remember--started moving me, getting me and the bed set up quickly and smoothly, and I cooperated because I knew dimly that they were right and I couldn't possibly deliver a baby with my legs shut tight like they were. *WARNING: GRAPHIC GIRL CONTENT* Also, I had had the classic I-need-to-poop feeling during the previous contraction and wasn't convinced I hadn't, and figured that if I had and I moved they could remove the pad from under me and clean it up. (They didn't.) *END WARNING*

"Remember, use the cries for efficient pushing," Eric said, remembering last time when I'd been told I was spending too much energy screaming and not enough pushing. I did my best, though it felt like everything was so urgent and happening so fast that I wasn't able to focus and figure out how.

That contraction ended and another started. "This is it!" Sue said encouragingly. "This is your baby coming!" I was panting and feeling a wild need to push with all my might. "Here it is!" Sue said. "Push!" I pushed, a long, long push, and felt a sort of weird scrambled feeling down there, and wasn't totally sure whether I had just delivered a baby or not, but was still feeling an adrenaline-fueled need to do something, sort of a panic but without the actual panic--"Keep pushing!" she said again, and I pushed, and felt the "ring of fire" start and expand, and then, all at once, Maia was born.

Sue held her up, limbs sprawling, weakly mewling. "Do you want her?" Midge said. I was still panting, my heart racing, feeling like I couldn't get a grasp on what had just happened to my body, and didn't answer right away, so she said again, "Do you want her?" I gasped, "Give me a minute." So Eric got to hold her first. In a bit, when I was enough calmer that I thought I could hold her without dropping her, she came to me, the umbilical cord slapping cold against my lower belly. She had a funny ridge on her head, sort of Klingon-like, and a burst blood vessel in her left eye. Sue said the ridge was normal, from pressures in the birth canal, and the blood vessel wasn't surprising. "She'll probably have a bruise later on because she went through so fast," she said. "It's a good thing I ordered the delivery cart just in case."

Maia was pretty alert, so we tried nursing right away. When she was done, the nurses/technicians took her and started doing the usual procedures--cleaning, weighing, administering medicines, and so on. Sue pulled on the cord, cut now, to get the placenta out. I could feel it and pushed to help get it out, though she hadn't asked me to. In the meantime, Midge was throwing away the Nubain, which she'd had in her hand when she ran in. "That was what we call a slam-dunk baby," Sue said, partly to us and partly to the nurses, as she was sewing me up (I got a second-degree tear, same as last time). "I've got two more births today and they're both going to be just like that!" It was less than half an hour after she'd pronounced me six centimeters.

One of the technicians helping take care of Maia turned out to be the same one who'd wanted to watch while I had Chloë. Her name is Monica, not Martha. Eric mentioned it, and she remembered us, and was pleased he remembered her. She and Midge went to help me out of the stirrups and sit up. "Chin to your chest," Monica instructed me. I obeyed, though I thought that was kind of odd, and Midge said, "No, no--no epidural. She can move."

"Oh, that's right!" Monica said, as they helped me up. "I always forget that about natural births."

Before long, Maia was measured and cleaned and wrapped up, and I begged for food (should I have another baby, I must remember to pack some snacks), and we all started feeling life slow down a little, though we weren't over the speed of the birth. Or at least Eric and I weren't. Maia was pretty nonchalant about the whole thing. "Here I am," she seemed to be saying. "You'll have to deal with me on my terms." She's still saying it, and we still are.

Tuesday, June 28, 2011

Words...

Chloë: "Koë need more surp for pa-cake dipping."
Eric: "That's a big sentence."
Jenny: "I think that's seven."
Chloë: "Eight, nine, ten!"

Monday, June 27, 2011

The trouble with lipase

I've been pumping milk for the past several weeks, here and there, to build up a back stock for when I go back to work. The midwife at my six-week appointment pointed out that all I really need is enough for the first day, but it was very nice last time being able to send frozen packets along to the mothers' or aunt's with Chloë at will without having to pump extra, so I pumped enough for a decent bagful in the freezer and was quite pleased.

Then, when we realized we needed to reintroduce bottles to Maia and figure out what size meal she needed, I pumped a test bottle in the wee hours and we tried it that night. Maia refused it, howling and shrieking. After a couple of attempts, Eric noticed the milk smelled a little off. I pumped a completely fresh bottle and she still refused to take it, so that didn't explain the bottle troubles, but it did present a concern of its own. Milk usually stays good around forty-eight hours, at least twenty-four, and this had been twelve. We tried it again the next day, and again the early morning milk smelled and tasted off.

Eric did some research and found out that some women produce milk with too much lipase in it. Lipase breaks down fats and causes rancidity, and an excess makes that happen much more quickly than normal. It doesn't technically spoil the milk, but it makes it taste nasty enough that no baby will drink it anyway. He also read that scalding the milk, on the stove or in a bottle warmer, will deactivate the lipase and save the milk, without causing quite as much destruction as microwaving it would do.

I was somewhat skeptical that this was what was going on, since I didn't have this problem last time and felt vaguely that I was being criticized. But it made most sense to proceed as if this were true, so we bought a bottle warmer and I started scalding all my pumped milk. Then I thawed one of the stashed aliquots to verify, since lipase will continue to work when frozen, if more slowly. It smelled and tasted awful.

So, we're throwing out the entire back stock. Luckily we--Eric--caught this in enough time that I'll have just about enough time to pump enough for my first day back at work without being crazy about it. I'm also going to have to bring the bottle warmer to work with me, which will be a pain (and too bad for Eric, since it would be very useful for him--I don't know why we didn't think of buying one last time; they're pretty inexpensive and very fast). But it's better than the alternative. I do wonder what's causing it, though. One possible cause is diet. It better not be the chocolate.

Status report: Month 2 (Maia)

Two months? Really? No wonder the 0-3 month clothes are fitting so much better. Maia's' two-month (really eight-week) checkup last week went very well; she was 11 lb, 3 oz, which is perfect, 50th percentile. She's also 50th percentile for weight, and 95th for head size. I guess our kids are just that way.

She was furious about her shots and let us know, and then slept. A lot. Which was a change. Like Chloë, she hasn't been doing as much sleeping as the books say she should. She also gets very cranky at night and usually about half an hour after feeding, though that half-hour is usually pretty pleasant these days. She looks around, smiles, follows faces with her eyes, puts up with her sister's kisses and prods.


But the crankiness, oh, the crankiness. Nights have been especially bad, high-pitched screaming that usually only gets stopped by a cork (i.e., the R.I.N.D.S.). It's bad enough and inconsolable enough that we're considering it night colic. The pediatrician suggested that reflux might be causing it, as she also much prefers being upright and in motion, never, ever refuses a R.I.N.D.S., and I have my suspicions that she doesn't actually need to eat every two hours so much as she needs to suck on something, and she won't take a pacifier. Or a finger. Or a bottle, we've discovered. (More on that later.) We got a prescription for baby Zantac; we'll see whether it works.

We're having no issues with the R.I.N.D.S. this time around, at least as far as the direct interface goes. We have discovered, though, that she won't take a bottle. She did a few weeks ago, when we left her with the mothers for a few hours for our anniversary dinner; but Eric's been trying to get her to take a bottle for several days now in preparation for my return to work, and no dice. Our parents and the doctors say that when she's hungry enough, she will; which seems heartless but there's really not much we can do, since I must return to work and it's not close enough to come home every two hours, and I doubt they'd let me bring her to work with me. She'd bring down productivity too much.


(That's Chloë's doll. She'll get her own, but it'll have to be when I've got time to make one, which is not going to happen while we're nursing every two hours and walking the halls with her at night until bed.) My plans for a summer quilt for Chloë are also scrapped for now. I'm pleased I finished Maia's before she was born. Maia's slept under it a few times and seems to approve.


She goes to bed with me around 10-11, usually nursed down. The bassinet has been much emptier during her first two months than with Chloë's. She's still waking up mostly every three hours, though we've had a couple of four-hour stretches. I'm wondering if nursing her in bed is part of the problem, but she's still awfully little, so I'm not sure. She sleeps when she sleeps. And usually with her hands in the air, for some reason.


I think her birth hair is starting to fall out; I've been seeing fine strands here and there. Her eyes are still blue, but very dark; I suspect they're at least going to be like Chloë's changeable eyes, if not fully brown. She's mostly able to keep her head up now, and has kind of rolled over--not true rolls, I think, but it indicates some trunk strength, which is good. She is a sweet little girl.


Thank you. Thank you very much.

Friday, June 24, 2011

Status report: Month 23 (Chloë)

Chloë the almost-two-year-old! Eric says, "Where did the time go?" I'd say mostly into diaper changes, but Maia's got her beat.

But Chloë is a happy, running, talkative--oh, so talkative--girl, big and adorable and getting ever more clever and funny. Yesterday morning she was watching my morning ablutions and said casually, "Lotion on mouth no?" (her syntax for "no lotion on mouth," an injunction we've drilled into her since she frequently asks for lotion because she likes to spread it on her face and hands). "No," I agreed. "Lotion on forehead? Lotion on cheeks?" she went on. I concurred that these were okay. "Have lotion? Please?" she concluded, and I, having seen the general drift of this conversation, dispensed some from the bottle I'd already picked up.

She hardly ever asks to be picked up anymore, but she's done it several times lately I was holding Maia. But mostly, she's been a great big sister, wanting to see her and kiss her and know where she is. I'm afraid I've been so focused on the jealousy aspect that I've been overlooking her love for her sister. Recently she wanted to see the pictures on my phone, and when I set the slideshow to run drove me crazy with her refrain of "No, no, no!" After I yelled at her about it and drove her to tears, we worked out what she was no-ing, and it turned out she wanted to see only the pictures that had Maia in them.


She's still a good eater, but becoming more picky--no, that's not the right word. Lunches are in fact usually pretty small, but then she often eats whatever's left over as an afternoon snack. She simply has definite opinions about what she wants now. That's really what's characterized the last month or two, I think. She knows what she wants, and she can tell us (mostly), and if she doesn't get it she gets mad. No huge tantrums, but plenty of small ones--but mostly, she's still a happy girl.

The water park was a huge, huge hit. She still talks about it constantly, and mentions the slide she went down with Mimi or the sunscreen she had to put on or that she went in the wave pool with Omi and Mimaw or the closet she and Addie played in. It also cured her hesitation on her slide at home--we got it out the other day and she went up and slid down, up and slid down, endlessly. It didn't cure her of being a water baby, though. We went to the farmer's market the other day, which is located right by the river, and spent more time stopping along the walkway looking at the river than actually at the market.


Playing hard at Kalahari unfortunately didn't cure her of waking up at 6 AM, but it did help her sleep hard. She's still a somewhat restless sleeper, and unfortunately a frequent nighttime nose-bleeder. She can't seem to keep blankets or sheets on at night, but she sleeps so hot it doesn't seem to matter.



Her vocabulary and usage, and understanding, continue to amaze us. Her record sentence so far is six words: "Milk fall down on blue pants." Then there was the following conversation the other day, while Eric was combing Chloë's hair (yes, he's the one who does it; I used to but he decided to be all smart about breaking out his own comb instead of the baby ones we had and she likes his better):

Eric: Your hair is getting so long now.
Chloë: Koë hair get long?
Eric: That's right.
Chloë: Koë get big?
Eric: Yes, you are.
Chloë: Koë huge!

She has a shape-sorter, has had for a while, that she wasn't interested in. But recently she started playing with it, and now she can easily fit and name all four shapes--circle, square, triangle, and star. She's working on non-rainbow colors, and adoring her Potty Elmo video--I'm starting to suspect for the music, though she's interested in Curly Bear, who's just learning to use the potty, too. "Koë baby nope?" she just said. "Koë big burl?" And yes, she certainly is.

Sunday, June 19, 2011

Kalahari

And we're back from Kalahari, the water park, where we stayed for three-ish days with the mothers and Eric's sister's family. Chloe had a fabulous time, in the kiddie area or the wave pool with Daddy or me or Mimaw or Omi or Michelle. She started out timid, but by the end was going down the slides by herself, slipping down on her back and lying there in her life jacket waiting for a hand up so she could go again. Whenever we took a break, she'd willingly accept a drink or a snack or a diaper change, but pretty soon she was tugging at somebody's arm to go back into the water.


She got to spend a lot of time with her cousin Addie, which I think both of them enjoyed. Addie tends to be a bit bossy, as befits her role as eldest cousin and four-year-old, but they played in the water and at the kids' playground, and in our room in the mornings, and giggled together a lot.


Maia continues her schedule of feeding every two hours, but with a ratio of seven adults/teens to four kids, I got to spend a good amount of time away from her (which sounds terrible, but hey, I like being in the water too). She seemed to like the humidity and warmth and white noise while we were there.


Hey, how come I don't get to go on the water slides?

This was our first real Snyder family vacation with the girls, and I think it was a success--we all had a good time, and the community of extended family is always nice, and the scramble of coordinating schedules and preferences wasn't too bad. I was happy we went, for all of us but particularly for Chloë. We played hard, which I think is how this sort of vacation should be, and spent today recovering--after a disagreement on whether the concept of "having a bath in the morning" exists, Chloë's hair finally no longer smells like chlorine. Hooray!

Wednesday, June 15, 2011

I gave my love a cherry

Man, only two weeks left of maternity leave. This last week we've been trying to get a few things done, plus getting ready for the water park trip. In the meantime, the girls continue to grow up.

Chloë talks herself to sleep these days. It's hilarious to listen to her. "Mama Daddy Chloë Maia. Monkey jump. Dolly baby jump. Dolly baby sleep. Pooh bear sleep. Wait a minute! See you in the morning? Bye-bye Mama, bye-bye Daddy, bye-bye Maia, bye-bye Chloë. Bye-bye milk." She announces whatever happens to her and whatever she sees, and apparently whatever crosses her mind: "Someone coming downstairs." "Mama go potty now." "Go see Mimaw Omi Addie Raegan? Aunt Angie? Grandpa Halmoni? Grandpa Nana?" "Chloë watch Potty Elmo other day." (It is amazing how serious the actors sound on that show.)

One of her favorite words lately is "give." Our friend Nancy came by a few weeks ago to meet Maia and brought a present for each of them; Chloë's was a fuzzy duck with accompanying blanket. She picks up the duck and announces, "Incy gave ducky." (She can't do Ns to start with but seems to be okay with them in the middle of words.) When I let her have her favorite snacks, blueberries or fruit strips, she invariably walks out and tells Eric, "Mama gave blueberry/fruit snack." It's a good thing I hadn't given her anything I didn't want him to know.

Maia, in the meantime, has discovered the baby in the mirror and is starting to spend more time alert and not crying, which is nice. She's spending almost no time in the bassinet at no time, which drives me crazy, but I think the same thing happened with Chloë. I don't know if that's a result of my lack of patience or their habits. Ah well. I'll take the quiet time, and the solitary sleep will come eventually.

Thursday, June 9, 2011

Where have all the cowgirls gone?

Where did my chicken-legged little baby go? Sometime while I wasn't looking, Maia has started packing on the weight, especially in her thighs, and gotten bigger all around. Even though she's six weeks (and a day) old, I've been thinking of her as newborn, "0 months," because all of her 0-3 months clothes were so gapingly huge. Not so anymore. They're hardly tight, but she no longer swims in them, and she's moved up to size 1 diapers. And her legs and arms are no longer scrawny. It's good progress, but it startles me.

And where did my Kayyee go? Because that's how Chloë was pronouncing her name up until, I think, yesterday. Suddenly, today, she's Koë. (Ls are still on our wish list, along with Ss, Fs, and THs.) Was it because her Aunt Karolyn was here for a visit, and Chloë called her "Aun' Kayyo"? Sometime soon she's going to stop referring to herself in third person, and Eric will be relieved, and my heart will twist because it will mean she's really truly her own person, and not just mine. Is that selfish? I wish I had more time with her. Jealousy cuts both ways.