we made it

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.

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:

written resources

I've been reading a lot of books this past year that have really helped me get informed and prepared for childbearing and rearing. I've also read a few that freaked me out and didn't help at all, but I'm not sharing those. These are the good ones:

This book taught me more about how my body works than I ever could have figured out on my own (or from a health class, or from a doctor's visit). I wish I had read it long before I got married. Plus, I couldn't do synthetic hormone birth control, so the information in here was a lifesaver for staying not pregnant as long as I wanted to and then achieving pregnancy when we were ready.

I think all women should read this book, if only to really appreciate how amazing and fully capable our bodies are of birthing babies. It was fascinating and gave me so much confidence in approaching birth. I've already surrendered my copy to a pregnant friend and I think I need to buy another just to give away again. 

I found this book on the required reading list for Doulas. It's pretty old, and I was continually surprised at how much it emphasizes positive thinking and visualization as a vital tool in childbirth. But everything I've learned since then about birth from my healthcare providers has followed along pretty well with everything I read in this here. So great. 

Once I have this baby, I sincerely hope that we can get sleep under control during the first year. I think Tim and I will be better parents if we can get good rest. I've talked to lots of moms who used the information in this book to sleep train their babies into sleeping all night by 7-8 weeks. My hopes are high!

As much as I observe from other people and hear advice like "girl, your life is gonna CHANGE!", living with a newborn is still a great mystery to me. What do babies do all day? What will I be doing all day? This book simply told the story of days with a baby, and how a parent's life changes and characters develop through the struggle and triumph of the first year. I love Anne Lamott. She reminds me that it's okay to be human and fragile and make mistakes without living in guilt, a skill that I think will be really important in early motherhood. This is a non-fiction memoir from a grandmother's perspective. 

The vaccine question. It's such a loaded gun these days, and had me really stressed at the beginning of my pregnancy. My advice is just to do as much of your own research as possible--in books AND current events, because this developing issue is in the news pretty regularly--and go with whatever solution fits your family's needs. Remember that air travel with a baby is a huge factor to consider when deciding if you're going to vaccinate. This book helped me a lot.

[one resource that I would highly recommend NOT using is the documentary on this subject called the Vaccine Wars. My personal opinion is that it does not present well-balanced or well-researched information.]

Personally, I loved this book because it shed light on my own experience of growing up in France with American parents, but I think it could be beneficial for all-American families too just because most cultures can learn so much from each other if we're willing to pay attention to another way of doing most anything, including parenting. I wouldn't say France does all things well in raising children, but I wouldn't say America does either. There's a lot of fascinating information in this book. And it's an entertaining read.

Okay, I haven't read this book yet, but it's been recommended to me by so many parents I admire that I will definitely be reading it in the future.

the labor scare that almost stole Thanksgiving

We had an eventful Monday in the Tab home. 

On Sunday night, I started having some lengthy bouts of Braxton Hicks contractions. It seemed like every time I stood up or walked around the apartment, I would get a contraction. So over the course of the evening I tried to stay as still and relaxed as possible to keep them away, but then they started coming back to back. I wasn't too worried because they weren't painful and even though they were frequent, they weren't growing in intensity. Tim had been out of town and I was anxious to pick him up from the airport when he arrived at midnight and have him back home.

The next morning they started coming again--before I had even gotten out of bed. I decided to start timing them to see what the pattern was and I was surprised that the first one I timed lasted over 5 minutes, with only a 30 second break before another one came. Thankfully, I already had a regularly scheduled appointment for that afternoon, so I knew I could get some advice on how to handle all this false labor. I went about my morning, but got a little alarmed when one contraction started as I got in the shower and didn't end until after I had finished showering, gotten dressed, and blow-dried my hair. It had lasted at least 15 minutes. But still, they didn't hurt, so it still really seemed like those "practice" contractions I had read about that don't lead to real labor.

Tim and I went to the Starbucks next door to the midwive's office to kill some time before my appointment, and while I was sipping my chai, I got hit with a really painful contraction that slowly grew in intensity so much that I couldn't respond to what Tim was saying to me until it was over. Then right away another one came and again I couldn't talk through it and had to really focus on breathing through the pain. I got scared.

We had plans to fly down to Georgia and Alabama today to celebrate two separate Thanksgivings with my all of my extended family over the course of the week, and by the time we walked over to the midwive's office, I was nearly sure we couldn't go. The rest of the week was starting to look like bedrest and a Thanksgiving TV dinner for us...or something. I am 33 and a half weeks pregnant, so a pre-term labor at this point would be serious, fearful business. I tried not to think about it and just prayed prayers of thankfulness that I already had an appointment to get help before all of this happened. I was just worried that when we got to the office, I wouldn't be able to accurately explain all that was happening or I wouldn't be taken seriously. 

None of those fears materialized. As soon as I got to talk with one of my midwives, I was presented with options: she could do a cervix check, an ultrasound, a fetal fibronectin test, and a non-stress test on the baby that would also monitor the intensity of my contractions. "I'll take one of each, please!". It took over two and a half hours of testing, but we all learned for absolute certain that I wasn't in trouble, despite the painful contractions I had felt earlier. No other signs pointed to real labor. The baby's position was high up and breech, nowhere near ready to come out. By the time I sat back in the recliner to get hooked up to the fetal monitor to gage the contractions, I was so relaxed and relieved that I didn't have a single one for the thirty minute monitoring session. The baby's heart-rate was perfect.We were highly encouraged to go on with our travel plans.

As we were on our way out, one of the midwives asked me: "Have you been drinking at least 80 ounces of water every day?" No. Definitely not. Not even close. "Have you been under any additional stress?" Maybe that time earlier in the weekend when Tim had to fly to California to do a shoot and I disintegrated into the likes of a pitiful pup with separation anxiety over him being so far away? I was hoping to keep that whole incident private...but my body eventually told on me. So I went out and bought an adult sippy cup a Camelbak water bottle to keep full and nearby for the next 7 weeks, and I'm making big efforts to not stress about the next big thing that I could be stressing about: a breech baby.

I'm happy to report that we made it to Atlanta tonight to start the grand week of quality family time that I so look forward to every year. I'm still getting contractions, but they're painless (if not tiring) and I'm so glad to know they're harmless. My fetal fibronectin test came back negative this morning so I know for sure my body isn't remotely ready to have this baby yet, which is the greatest relief, because we both need at LEAST 4 more weeks of this pregnancy to have a healthy baby.

Happy Thanksgiving!

showered! again!

Tim and I were insanely blessed last weekend to have another shower thrown for us by dear family and friends. Paul and Amanda really outdid themselves with the planning, decor, food, games, and so many much needed gifts.

It was such a sweet time of fellowship with our closest friends in Wheaton. We almost forgot to stop partying to open presents.  

I'm not usually one for shower games (I probably made one too many toilet paper wedding dresses in my time), but these games were cool. The top photo is the baby picture game. Every attendee brought a baby picture of themselves and we had to guess who was who, with the help of a name bank. The below photo is The Price is Right, where everyone had to guess how much all the combined items cost. I probably loved this game because I got to take home all the items at the end :) They were mostly things that I didn't know I needed (butt paste? portable diaper trash bags? special baby Q-tips?) or didn't know which brand to buy (diapers and pacifiers: I had no idea where to even start), so walking out of there with it all bagged up for me was really helpful. 

Amazing cake, no? You should make friends with your local Whole Foods Cake Decorator and invite him to your parties. That's what we do.

Fall wardrobe tip: these cardigans are at Target and they're like $22. All your friends are wearing them...or maybe that's just me.

Really, it was such a swell time. Tim and I walked away that night feeling our first sense of "readiness" for New Tab to arrive. Between our own purchases, the two showers, and some early Christmas presents, we have all the must-haves: crib, stroller, car-seat, rocking chair, a few gender neutral outfits to get us started, some nursing and diapering essentials...that's all you need to bring home a baby, right? I hope so.

A word about the registry process: it was so overwhelming for me! And as I got started with some  early research on products I had a sneaking suspicion that the baby industry was out to try to fool me into thinking I had to have all their stuff just as like the wedding industry tried to do. Sneaky advertising campaigns. Plus, I just didn't have the time to tackle it during wedding season. My solution was to hand the bar-code scanner to my mother. I figured; she raised three babies, she knows what I need better than I do. We chose a nationwide chain store (Target) because she's in Florida and I'm in Illinois, and she picked out all of the things she knew I would really need. It turned out to be a great experience for her to get into the groove of grandmotherhood and it helped me so much. Then I went online and made the changes I wanted to the registry that she started for me. I also paid attention to what my friends use the most with their babies, asked them lots of questions, and even looked up their still-active registries online for specific product information when I needed it.