almost there

We had a great and uneventful 39 week appointment with my midwife group yesterday. Baby is holding his/her vertex (head down) position beautifully, and I'm so thankful.

Medical stuff: baby's position is Right Occiput Anterior, heartbeat is in the 130's, my blood pressure is nice and low (no signs of preeclampsia), uterine (or fundus) measurements are now shrinking instead of increasing because the baby's head is moving down into my pelvis...and I've gained 28 lbs. Jeepers.
I kept going back and forth on whether or not I wanted a dilatation check at this appointment, but in the end my midwife never even brought it up, and I left thankful that I didn't have either the disappointment of no progress or the fixation on labor that progress would have brought.

After the version 10 days ago, I had a few days where I felt much fewer Braxton-Hicks in the evenings and thought this meant I might be settling into "nothing is happening towards labor" territory for a while and I'd go overdue. I'm not feeling that way at all anymore. Every night I go to sleep with false labor and wake up with it in the morning. Contractions are coming so easily all day, I need only lean forward or even just yawn to make one start up. Sometimes the contractions get painful, come regularly and close together before eventually fading off. I've started getting sharp, surprising "corkscrew pains" (my own created term) where suddenly it feels like the baby's head is pushing and turning its way down farther than it has room to go. I used to get those only while standing but last night they started coming as I was sitting and even laying down.

So I don't know if all that means I'm headed into labor soon or if it's just regular stuff that many pregnant women experience and I'll be living with it for another three weeks. Either way, we're back to spending our evenings hunkered down at home, and whenever we do go out I have to take it really slow through all the contractions and unexpected corkscrew pains that come up (and can make me gasp and lean over...it's a little awkward to have those in the grocery store). My mom arrives in 2 days and I was really hoping to show her Chicago since she's never been here before, but I'm feeling less and less like I can trek all over town on foot. Maybe a Segway tour...just kidding.

Even though we're in the holding tank of "any moment" (and moments could take weeks), I have a lot of peace. Tim is tearing through his last pile of editing before all the work of 2012 is done, and once it is--save for a couple of shoots--he will be free to do nothing but care for me and bond with the baby for all of January! The greatest gift! I'm looking forward to having my mom and my sister here with us for a couple of weeks, and even the thought of being up all night for the coming months isn't too daunting since I've been doing that for most of my pregnancy anyway.

Christmas in Chicago

This is our first Christmas "on our own", where we start our own traditions and make Christmas happen for ourselves here in Chicago. I'm really hoping for snow.

I am so pregnant. So heavily pregnant. We will hit 39 weeks in 2 days, so the baby can really come at any time. Tim and I are savoring these sweet festive moments and last days as just the two of us.

We really loved our church's Christmas service. It's so sweet to sing carols in the community of friends. Candlelight is a plus too. 

I love Chicago's Christkindlmarket, and I'll tell you why: when I was a kid and we lived in France, one Christmas we went to Köln, Germany to see the cathedral there, and they had a Christmas market on the plaza out front. We ate bratwursts with sauerkraut and mustard and my dad got a gluhwein that he let me take a sip from. My mom got some pretty handmade Christmas decorations that she still uses. For some reason I've always remembered that day in Germany, and the Christkindlmarket offers pretty much the same experience. 

This year I got a paper star light and a candle holder that depicts the actual Köln Christmas Market I visited when I was a kid.

 

And Tim got some gluhwein that he let me sip :)

rejoice

I ordered these Christmas cards before all the ups and downs of the last few weeks, and they arrived just in time to give me a project when I really needed one. Addressing and stamping 100 of these, while listening to Christmas carols, I was constantly reminded that this is to be a season of joy. Rejoice! Rejoice! Fear not. Emmanuel has come. A thrill of hope, the weary rejoice. Soon a new and glorious morning will break. 

Today I was hit with how very much we have to be grateful for. Our bell rang four times with packages being delivered. Our refrigerator is full of festive holiday food. We have plans to celebrate Christmas Eve with dear family members. Tim and I are convinced we've found the perfect gifts for each other and we can't wait to see each other's reactions on Christmas morning. We have a healthy baby coming to join our lives any day now. We have plenty of work to provide for our little family. There is nothing to do but to rejoice. 

External Version Day

At my 37 week midwife appointment, I was still breech. So, after much research and discussion between ourselves and with our midwives, Tim and I decided to schedule an external cephalic version at the hospital for Tuesday morning. We knew the risks. I read all the statistics and studied the drug that would be involved. I watched videos of the procedure being done on other women, and we felt confident that we were making the right decision, especially for the long-term of our family, this baby, and our future babies. 

We checked into the hospital at 8am. I tried to push down negative feelings about the intimidation of the triage room and the mystery stains on the hospital gown I had to wear. 

Being in a hospital is kind of like landing on a foreign planet. Everything is unfamiliar and so many factors remain unexplained because the staff is just too busy to help you understand. I had to get a blood typing test even though my blood type was written on my chart. I couldn't drink water but had to get an IV put in my arm just for fluids. I brought my own tank top that covered much less surface area than the baggy hospital gown but couldn't wear it...not sure why. And all of this comes under the bigger umbrella of the thought: "what are they really going to do to me?"

I knew that for this particular procedure to actually work, I was going to have to relax my mind and muscles and be as docile and compliant as possible to let the powers that be put their hands on me and move my baby within me. Oh, the tug of war in my mind as we waited. I got hooked up to a fetal heart monitor and we started the mandatory two hours of monitoring before the procedure.

Thankfully, I had Tim with me. I held onto his arm and his good-natured optimism and light heart. We drew on what we learned in our birth class about deep breathing and relaxation techniques. He talked to me about happier things and the beach and made me laugh so hard I gave myself contractions that went off the grid of the monitor (exhibit A right above). 

Eventually our Obstetrician came in and we got some real human interaction with her, which was awesome. She did an ultrasound and together we learned some good details: no part of the baby was engaged in my pelvis, and I still had pockets of amniotic fluid to give them some free room in maneuvering the baby around. I knew these factors contributed significantly to the success rate of the external version, so knowing this really helped me feel better.

Our doctor had to rush off but we soon got a visit from a kindred soul. Gayle, one of my midwives, was having a crazy morning delivering babies too but she came to check on us and talk to us about what was going to happen. She let me know that they were going to give me an injection of Terbutaline, a drug to relax my uterus, immediately before they started the procedure. It would make me shaky and anxious and increase mine and the baby's heart rates and I might find it hard to breathe...yikes. Since I was going to have three people working on my stomach, the only place for Tim was at my feet and he could give me a foot massage to try to help me stay relaxed throughout the version.

Suddenly, the tiny room was full of people. Gayle, our obstetrician, a nurse, and a new male doctor I had never met before. And another unidentified woman who came and left a few times. I quickly figured out that the man in the room was a medical student who was learning this procedure from our OB. Deep breath...I so didn't want me and my baby to be a practice subject under these circumstances, but there was no time to talk about it and I really do value the education process that doctors have to go through. We need good, experienced doctors so badly in this country. So I forced a smile and shook his hand. He took my left side, and the women stood on my right. They lowered the head of the bed until I was totally flat and gave me the shot of Terbutaline in my thigh.

I've wondered how much to share about what happened next. It was very difficult for me to endure, and it's a painful memory now. Suffice it to say that I had three people pushing down, pulling, fisting, and wrenching on my abdomen and my baby with all their might for about six minutes. It was much more painful than I expected and very frightening, and it just felt wrong for them to be handling my baby like that. I didn't make it to the end without breaking down into big embarrassing sobs. It was so hard to stay relaxed for them, to even stay still on the table for them, but I knew it was so important to try to breathe deeply for me and the baby until it was over. I was aware that it was working, the direction of their hands on the baby told me that. I felt so bad for Tim having to watch it all happen, because if it had been me at the end of the table I wouldn't have been able to hold myself together while watching him go through that.

Finally, they let up and confirmed with ultrasound that the baby was head down, but the baby's heart rate was not good. I heard little snippets like "he's not happy", "put her on her side", "get the oxygen" and I just knew we were headed next door to the operating room for an emergency c-section. But we didn't. Within seconds (that felt more like minutes) of me taking long deep breaths into the oxygen mask, the baby's heart rate was back to normal and everyone relaxed and started celebrating the success of the version. There were high fives with the staff as a nurse wrapped my torso with a corset-style velcro binder to keep the baby in place. I tried to be happy, but in the moments after the procedure I just kept thinking "I made the wrong decision. I shouldn't have put my baby through that. A c-section would have been easier for him or her."

Gayle stayed back for a while to comfort me and outwardly validate what I had been thinking. "It's so hard...I know you're normally so gentle with your baby...it just seems wrong...I know...but your baby is already fine, look at this awesome heart rate...you're going to have bruises..." I appreciated her care more than I can say. As soon as she left and it was just me and Tim again, I fell apart in his arms and just wept. Why couldn't I feel happy that we got exactly what we hoped for? I started to realize that I was trembling all over and I couldn't catch my breath through all the crying. It was the Terbutaline. I was anxious, my heart was racing, I was having every side effect that Gayle had prepared me for. It helped a little bit to know that I was feeling the effects of a drug, not necessarily all of my own faculties. So I just laid there and cried it out and waited for the tremors to pass. They let me drink water so I tried to flood and flush out the Terbutaline.

We had to do two more hours of monitoring to make sure the baby held on to his/her good heart rate. It was really comforting to hear the steady beat through the monitor. Slowly, I started to feel better and come back to being my real self. Our nurse brought me some food and encouraged me to eat, and I did. 

By the time we were ready to leave, I was able to smile again and sincerely thank Gayle and our nurse (the doctors were long gone) for everything. I could walk, get myself dressed, leave the hospital, and climb the three flights of stairs back up to our apartment all on my own strength. By the evening, I was feeling the positive effects of having the baby in the right position. I could breathe easier since the baby's head wasn't pushing up on my lungs. I was feeling kicks and little feet poking into my side, which was so welcome. I started to think again about how we could have a natural birth.

I'm still very sore from the actual procedure, but the all-day every-day Braxton Hicks I've been having since 34 weeks are basically gone. Last night Tim and I went out to dinner and then Christmas shopping until 10pm, something I haven't felt like doing for the last month because the contractions were so strong at night that sometimes I couldn't stand up straight. I'm glad now that we did the external version and I can stay pregnant as long as the baby needs me to (we would have been scheduled for a c-section at 39 weeks). I don't feel like Tim, me, or the baby is ready for birth before my due date and I even hope we go a little over. I'm not sure why, it's just the general sense I have about it.

If you or someone you love is considering doing an external version, I have some really useless advice: if it works, it's totally worth it, and if it doesn't work, it's not worth it at all. On the day it happened, I told my sister that I wasn't sure I would recommend this procedure to her if she was in my position, just because I wouldn't want her to go through the fear and pain of the procedure, but the farther away I get from the experience, the happier I feel about the outcome...it was just really hard while we were going through it.

breech week

This week has been rough; a constant pendulum swing between doing everything in my power to fix our breech situation, and trying to let go of all my long-time natural birth hopes and expectations and graciously receive whatever comes in the next two weeks. 

I've had a LOT of appointments. Every day this week I've either had the round ligaments in my pelvis "loosened" (read: pushed on REALLY hard for an extended period of time), or had a set of needles stuck in my feet...or heard my midwives tell me that despite everything I'm doing, my baby is still breech.

Thankfully, when I come home from all the difficulty, I find a safe place in the ready arms of my husband. I've wet many of his shirts with frustrated tears since last Friday, and he hasn't yet grown tired of consoling me. This hard time has also been the best time for us together.

We've gone on a couple of dates but I've mostly tried to work out my negative energy in the kitchen making us candlelight dinners every night...just to have something pretty to look at and give us something to look forward to in the evenings.

I haven't been sleeping very well, but the light of the Christmas tree has been comforting in the early mornings, and I've gotten really good at drawing a killer mineral and bubble bath. 

One bright spot has been all the Christmas cards and packages arriving at our apartment every day. Tim and I have all but ruined our surprises for each other because our credits cards are tied to the same email account that we both check...so when the boxes come from Amazon we have no idea what's inside or what goes to who...so we just wrap the box and I guess we'll open them together on Christmas morning. This is also the week we get new business equipment for next year, and watching Tim get excited over his tax deductible toys is really fun. I love that his favorite things are also his work tools.

Tomorrow morning, I'll go back to the chiropractor and he'll confirm the baby's position. Then in the afternoon I'll see my midwives and we'll plan whatever next steps we need to according to their care limitations and the best judgement of our OBGYN. I really don't expect to hear that there's been a change, and it's not because I'm being pessimistic. I'm trying to be reasonable and prepared for the most likely scenario, especially after everything we've tried. I'm ready to move passed all the craziness of this week and know for sure how we're going to bring our baby into the world, whether that be through surgery or the non-interventive route we've hoped for since we got married.
Either way, I'm still working hard to keep the perspective that this is all minor in the grand scheme. A bumpy road filled with detours that I'd rather not take but with an unchanged destination ahead. And each detour has its little surprises and joys.

*malpositioned* at 36 weeks

It was just over a week ago at my 35 week prenatal appointment that I learned that New Tab was still breech and we had to start getting serious about changing his/her position. The baby spinning positions and techniques I'd been doing on my own for three weeks weren't working. One of my midwives set me up with a list of referrals to chiropractors and acupuncturists and gently reminded me that their practice could not deliver breech babies. If the situation didn't get resolved I would be transferred to our back-up Ob-Gyn (a wonderful doctor whom I really like) for an external cephalic version procedure, and if that didn't work, a C-section.

So that was disappointing.

I went home and dealt with this new and stressful situation the way I deal with all new and stressful situations: Google. Research just helps me. It was a real mystery to me how chiropractics or acupuncture could possible help turn my baby. I learned that moxibustion can increase fetal activity in hopes the baby will turn its head down. The Chiropractic Webster Technique is used to give the baby more space within the uterus to move around by loosening up tight round ligaments, and I've had some pain in those ligaments, so I decided to start by seeing a Chiropractor. The earliest appointment I could get was an hour before my 36 week visit with my midwife.

So Friday came and I had a great first visit with the Chiropractor. Having those ligaments relaxed through sustained pressure was uncomfortable but nothing I couldn't handle. He explained that he saw the majority of breech babies turn down into a favorable position between the third and sixth appointment to administer the Webster Technique. That sounded fine to me because I figured I still had about two to three weeks before I would have to get transferred out of the midwives' care to more invasive procedures, so there was plenty of time to fit in 3-6 visits.

Unfortunately, my bubble was burst an hour later when I explained to my midwife that my baby was still breech but I felt optimistic that we could resolve this in the next four weeks before I hit my due date. She informed me that my doctor likes to do external versions by 37 weeks, before the babies have a chance to grow so big they can't be moved out of their position. Instead of having three weeks to work on the situation with non-invasive care, I have barely 7 days. We talked more and reached a compromise: if I am still breech by the day I hit 37 weeks, we will schedule an external version for 3 days later.

I've cried many tears this weekend, mostly over fear of having to undergo the extremes of obstetric care. External versions are painful. It requires that I take a powerful muscle relaxer  when I haven't so much as taken tylenol my whole pregnancy. It carries the risk of placental abruption and cord entanglement, and it only has a 50% success rate. I've wondered more than once if it might be worth it to skip that procedure and move straight to the cesarean section...another intervention I desperately hope to avoid. I've never had surgery before, let alone a surgery where I would be awake the entire time. What's worse is that I know vaginal breech births are not only possible, but they're even common in other countries. Tim's cousin (in France) had one just a few months ago. My mother in law had one with Tim's brother. The cultural norm of suing doctors for malpractice has driven up insurance costs and decreased the various possibilities that doctors have in caring for patients in America to the point that they have to rule out many practices, including vaginal breech birth. We've gotten to the point now where cesarean delivery of breech babies is the preferred method of delivery because of the lack of education and training available to doctors on how to birth breech babies vaginally. It's a rather maddening situation to be in; faced with surgery that isn't entirely necessary. A study by the American Congress of Ob-Gyn's showed that in 95% of vaginal breech births, mother and baby came out fine.

So we're down to ultimatums. I have my next chiropractic appointment tomorrow morning, and I'll keep going back as often as he can fit me in. I'm going to try to get in to see my midwives again for a quick check tomorrow because I've noticed the baby shifting and I want to stay updated on any position changes. Anyhow...we have until Friday to get our wee babe pointing the right direction.

It's not lost on me that in the grand scheme of things, this is a minor problem. Ultimately, the baby and I are both healthy and strong and we'll probably come out of this situation with nothing more than a few scars. We'll be okay. And even though I'm frustrated with the medical system, I am very grateful for it. I actually have choices when it comes to my prenatal care. Heck, even the fact that I have prenatal care is more than what most women of the world can say.

So we will be grateful and hopeful.

life before baby

It's so easy for photography to feel like work that we don't often use more than our iPhones to document our life together, so we asked our good friend Sean Dorgan to come over for breakfast and do the picture-taking work for us.

I really wanted a reminder of how sweet this season has been, just me and Tim in our apartment where we love to live and do our work. For now it's just us, and it's quiet and we sleep in a lot and work very late most nights. I know it's all going to change soon, and I'm sure that these rooms will feel empty and blank without the sounds of a baby crying or the site of baby things or the smell of baby soap. Who is this person who's going to join our family, anyway? I'm dying to know.

So this is us, one month before we find out what we'd be missing if we hadn't decided to have kids.

And if you're wondering if I only have one outfit because you keep seeing pictures of it on this blog; the answer is yes. I only have one outfit. One pair of maternity jeans (I refuse to buy more), two of those white maternity tanks, and my go-to fall cardigan. When I'm not getting my picture taken I may or may not be wearing yoga pants and Tim's undershirts at all times. It's just too late in the game to justify buying more clothes that I'll only wear for a few weeks. And now I've said my peace and we can continue on with the pictures: