sisters

A comparison-shot of Leona and Eliana from their first days:

 

It is so exciting to see the daily changes in newborns!

Not sure if these shots really capture it, but both girls, after the first day or two, have started to resemble Judge a lot from when he was a little baby...and thus they both resemble each other as well.

[Still pains this mama's heart seeing pictures of Leona from her first week - what a different start these two girls are getting! One abandoned in NICU for the majority of the hours in the day due to visiting restrictions, one nare left our sides except for maybe twice for a few minutes each time. Not that I'm not grateful for NICU (!!), and not that Leona bears any (or many) scars from that time anymore, I believe, but still.]


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The 'not exactly as planned' birth story

First off: Be warned - this is a semi-(?)-long one. May want to make sure you have a cuppa if you're planning on reading it all. Or, jump to the bottom for the CliffsNotes version.

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I had a couple titles for this one up my sleeve, in expectation:

Conceived under the northern lights, born under the midnight sun
Little miss Eleventh Hour

But alas, neither of them came to fruition.

The first would have been a stretch anyhow, because there's so much light pollution where we currently live that I can't be certain she was conceived under the northern lights. Then there's the fact she was born in the afternoon - but it would've been a romantic title in any event, no?

The second title is one that emerged towards the very end of the pregnancy. I figured maybe since she was already an eleventh hour child, that it was just 'her thing', and that she would decide to come naturally the night before our scheduled induction.

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After all the preparations for a homebirth, coming up on 41 weeks was a slight disappointment, but not fatal as we still had a week to get going. We ended up going to two overtime-checks (and a third unofficial one with my homebirth midwife who was on shift the Sunday evening after our second OT-check...she had wanted me to come in just to be safe, as she felt going 4 days without a check so late in the pregnancy was too long), where the second one was on Thursday June 13th. Since we were under 'threat' of induction the next day I was all game for an internal check and stripping of my membranes, two things I had politely declined when offered the Monday before.

The doctor was SUPER surprised when she found I was about 3cm dialated and practically fully effaced, and was sure I would go into labor naturally that day or at least over the weekend, and so without me even having to ask for an extension, she scheduled me for induction on Monday the 17th, completely going against hospital procedures of 'baby must be out by 42+2' (based on their calculations Monday put me at 42+3). Yay for experienced and optimistic doctors!

I myself was quite happy to hear there was dilation and effacement, but sat thinking to myself later that I could have been this dilated and effaced for the past few weeks for all we know, because these stats don't say much about when labor will actually start in the least. But hey, an extension is an extension, and perhaps exactly what we needed to get our natural homebirth.

[Judge and I had also discussed with the homebirth midwives our options if we really decided we didn't want to get an induction, and knew that if we so chose, we could request to come in for ultrasounds and CTGs daily until labor started naturally or until there was a problem, but knowing what and how the risks increase the longer you go past 42 weeks, we felt comfortable with a scheduled induction at 42+3].

With a heavy heart I woke on Monday morning, with no contractions and a super disappointed feeling deep in the pit of my heart. My dream of a homebirth, and more importantly a natural birth, were gone. And I have to admit, I have some fears when it comes to induction...you know, the whole downward spiral where one intervention leads to the next. Though I know some inductions go great and smoothly and you just need a small nudge, the interventions still scare me.

I took some time to try to really get back in the mindframe of my body just needing that little nudge of the waters being broken manually and that then everything would be kick-started and continue as though it was all natural, and off we headed to the hospital.

Thankfully one of our homebirth midwives is also the one who schedules the midwives' shifts at the hospital, and so she had arranged for us to have the most perfect midwife - one that had planned to have a homebirth last year, but had ended up having to come in to the hospital for an induction, and ended up with a great waterbirth instead. AND this midwife is planning on joining the team of homebirth midwives, so really she has the mindframe and heart for knowing where we're coming from and what is important to us.

A small summary:

10:30 arrive, talk to assigned midwife, do CTG check (all is well)
11:30 manual rupture of the membranes (no meconium to be seen - thank goodness!)
... while waiting for some action Judge and I discuss breaking and other life passions, and take a few Pictures

[Last belly shot before she's born...and a view of the room - see why a hospital birth wasn't far off our comfort-radar?]

[T-shirt chosen with care for this special occasion :D]

 

... absolutely nothing happens in the birthing department

1:40 get some acupuncture to try and get things started (nothing happens)
2:00 baby girl gets an electrode stuck to her scalp and I get a belt to monitor contractions strapped on me. You got it folks - continuous fetal monitoring on the go, because:
2:40 we got a hep-lock and oxytocin drip - contractions started but not 'up to par'

The oxytocin is subsequently increased from 30 to 40, and after a while our midwife suggests we should maybe increase again. At this point I said lets go with the internal check first (doctor's orders) and then take it from there, as I had no interest in getting it increased and rather wanted it decreased because though the contractions weren't painful per se (it's all in how you perceive them...I went for intense, no pain, and used hypnobabies' anesthesia and relaxation to brainwash myself), I wasn't ready to have them stronger and closer together...felt like they were already strong enough, like the ones that measured up to 130 and more during Leona's birth, though thes were only showing as at about 50-60 on the monitor.

The internal revealed that I was already 8 cm and (still?) fully effaced, which totally aligned with me being in transition and my feeling of actually wanting to give up.

Thankfully the oxytocin was downgraded, and on the next contraction I was surprised I felt the urge to push. After moving into various positions that I felt were right for us, angling myself just a little over here, just a little over there, kneeling in the bed, then going into a more sitting position, I could feel she was heading past my talebone and then was almost right on the perinium. Felt her head with my hand...something she totally didn't like, making me totally not like it either :P

Unfortunately after a few more pushes her heart rate dropped to 70-80 and then didn't pick back up again, so the oxytocin was increased to 60 then 100 and I was guided in pushing her out on the next contraction.

And there she was, our Eliana, at 5:40pm, all 4348g and 50cm of her little beautiful self. Though basically a kilo bigger than Leona, and the oxytocin-enhanced push at the end, I ended up with just a tiny little rift, thanks to the helpful guidance of my midwife. Seriously. Love her.

A while after the umbilical cord stopped pulsing I cut it (while Judge looked away - he is seriously squeemish about this stuff), and we continued our cuddles.

Unfortunately my uterus went on strike after she was out, and no matter how high the oxytocin was set to, there were no contractions. To make it a pressing issue I had a bit of bleeding (total of 1.2 liters I believe), and so had to have concentrated pitocin that shot in the leg that I hadn't wanted to have unless medically required...and then I had to have an other shot of the stuff directly into my hep-lock. Still no contractions and continued sporadic bleeding, and by now an hour had passed since Eliana was born.

Two doctors came in to try and see if they could manually shake it loose (NOT comfortable, at all, but thankfully I had my hypnoanesthesia on full blast so was 'ok' through it). No success.

So, I was rushed up to a team of 10 or so green-clad-and-masked persons who bustled around me, but at the same time were all very communicative with me and concerned about my well-being. I was quickly put to sleep, and woke up groggy and oh-so happy I hadn't had to be awake through whatever it was they did.

Then Judge and Eliana, having completed some checks and measurements, came up to me and I was able to hold and nurse her and talk with Judge until we were taken back down to the birthing ward, where Eliana and I stayed the night. Next day I was fine as could be, and we were allowed to head home, after a visit with Leona and Judge - our first four-person-family encounter(and my first co-nurse of the girls), and a visit from my mom as well.

Needless to say the whole birthing experience wasn't what we were planning for and not at all what I had wanted, but I have to say it wasn't bad, at all, either. I am so thankful we had the midwives we had, because I know that each step along the way was the right one for us, and I can therefore not feel any regret over losing the birth we had hoped for.

[Eliana aprox 18 hours after her birth]

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CliffsNotes Version:

Eliana Owen was born 5:40pm on June 17, 2013, weighing in at 4348g and 50cm long.

The birth went fenomenally, despite it being an induced labor, with contraction-start to birth being three hours.

Only a minor complication at the end where I had to have the placenta manually removed, but after a night in the hospital so I could be under observation we were good to go home.


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going into OT in the pregnancy department

So far we've had four midwife homevisits (not counting the first 'orientation' one before we had made up our mind).

Last one, a few days ago, I asked the visiting midwife for more details regarding going overtime (past 42 weeks) here in Tromsø. I am fascinated with 'standard procedures' here, loving that I get to compare them to those in Taiwan, not to see which ones are better, but just getting a deeper understanding of the similarities and differences in what I now consider my two home countries.

A little run-down/back-ground:

Last Tuesday I went on my final midwife check in town - I have continued to go to these even after deciding on a home birth because these checks are 'in the system' and the homebirth midwives prefer you continue to do them - the home visits are more us getting to know eachother and discuss birth-stuff. I was 40+4 at that visit, and so two days post EDD, so an overtime-control was scheduled for Monday (41+3).

[Sidenote: A difference between here and Taiwan is that at first the checks are every 4 weeks, and then towards the end of pregnancy the checks become first bi-weekly then weekly in Taiwan, whereas here because of my midwife's schedule and some double-bookings, I've gone 6 weeks between a check, and now towards the end the last three checks were 3 weeks apart, not weekly...no complaints on my end!]

At the OT-control we will get a high level ultrasound done by a doctor that specializes in this, rather than an ultrasound technician, because he is going to have to check some aspects that need special training and practice: Amniotic fluid levels, health of the placenta, and blood flow in the umbilical cord being the most important ones - and of course general stress levels of the baby (based on heart-rate I believe). I will also be discussing with the doctor our plan for home-birth, and asking when the deadline is for it being advisable from the hospital's perspective.

With 'advisable' or perhaps allowable or preferred, I mean is that during the first homebirth orientation meeting the midwife had mentioned that if I go past 42 weeks the hospital wants me to give birth there, and the homebirth midwives prefer this as well. If I did decide I still wanted to have a home birth they would come of course, but because home births are no longer the 'norm' here in Norway, it is important to uphold good relations with 'the system' in order to ensure continued support for it, and that is something I am fully on board with. So if we do reach the deadline I get from the doctor, we will go on to plan B - a hospital birth. Not a bad alternative due to the SOPs here being pretty darn good imo - and flexible enough to accomodate my wished alterations to the SOP, plus there is the possibility for a water birth.

Tomorrow (OT-control) I will also have to tell the doctor I do not wish to have an internal exam (I am so of the school-of-thought that internal exams just give you info on where you are right now, and say nothing about when or how soon you will give birth), and definitely no stripping of the membrains (which would require an internal exam anyways). My midwife mentioned it was important I explicitly state this, as the doctor very well could just strip the membrains during an internal exam, without discussing/asking first. This I am not a fan of, obviously, and so am very happy to have midwives that understand - and fully agree with - my thoughts around birth, so they know what kind of information to arm me with when I head into The System.

Anyhow, if at the first OT-control all seems well, another OT-control will be scheduled for a few days later (before 42w roll around) to check the same stats. At that control I believe is when a potential date for induction will be set. Potential date means potential in two forms, one of course being I could give birth spontaneously before it, another being if they end up being too busy in the birth-floor that day, I would just get checked once more and then asked to come back the next day or two when they had better time.

I will be discussing with the doctor this whole induction-after-42-weeks issue as well. I prefer, if everything looks ok in the OT-controls, to rather wait until birth starts naturally...but at the same time I don't have a strong need to go too far over 42 weeks. It's not that I have a strong faith in my estimated due date (EDD) actually being 'accurate', because it was set with the ultrasound done in week 18 which means it could be measured off by about a week, based on my own calculations I believe it ended up being a bit earlier than it should be. PLUS EDDs don't mean that if even accurate, babies would be born that day, as all babies have different needs and schedules in the tummy. I fully believe a baby will come when she is ready...and am against interventions or inductions that are not medically necessary, but at the same time...I don't know, risks do increase by 42-43 weeks.

Anyhow, I am hoping we just won't have to face that issue.

In Taiwan it was very different. After my 40w check-up I went down to the front desk and asked her to schedule my next check-up, and she was super surprised because there are basically no more check-ups after that, just scheduled inductions/c-sections.

Speaking of inductions and c-sections, out of curiosity I asked about how they approach requests, and was pretty happy about the answer. Basically, I cannot get a c-section or be induced just because I want to, there does actually have to be a medical reason for it. If I am insistant, I would have to talk with the doctors several times, and they would see if, for example, it is because of a mental reason (i.e., if I had had a very traumatic last birth and am now terrified, etc.) they would try to first address these mentally through therapy/talking. So basically, being induced or c-sectioned for 'social' reasons doesn't happen often or easily.

Of course, the whole 'going over 42 weeks' being a medical reason can be debated, I'll give you that.

Another interesting tidbit is that many midwives here are trained in accupuncture - accupuncture is in fact considered mainstream in Norway, not alternative medicine. So one can ask for 'maturation' accupuncture (not considered a form of induction, but to help your body move towards birth, encouraging thinning of the cervix type of stuff), and can ask for accupuncture during the birthing process as well.

One of my homebirth midwives does it, but...I'm fully aware of certain dangers with accupuncture as well - not saying I doubt her skills in it, but just...yeah, if it isn't necessary then I am of the stance that one shouldn't mess with things. So, I think I may not end up taking advantage of the opportunity. However, last visit she showed me some points I could do self-accupressure, which I am down with. One for mental stimulation (help with when I'm not as chipper as I'd like) on the top of the head, and then also a few for uterus strengthening/stimulation.

So now we are just playing the waiting game.

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