thekurths.com

Labor Day

Kaeta Bernice Kurth was born on October 16 (just barely) at 12:33am. She was 8 lbs. even and 21 inches long. She looked like this:

So, for those interested, here's how that all went down. It starts with a whole lot of scratching.

Starting around October 8, a Saturday, Karianne started to itch. Not just "Honey, scratch my back" itching that goes away -- this was some serious itching. Her belly itched, which I guess is normal, but her feet and palms also itched. And her thighs, back, arms, and pretty much everywhere else.

It was pretty ridiculous. I suggested putting some lotion on. This did not help. She tried some Benadryl. Also didn't help much. By Thursday, the itching was keeping her up all night and bringing her to tears.

So on Friday she called the doctor's office to see if they had any suggestions about what might relieve this. Surprisingly, they told her to come in for an examination. It turns out that extreme itching is pretty much the symptom of a condition called cholestasis of pregnancy. This is rare, affecting only one or two women in a thousand, and it basically means that bile was not properly flowing from her gallbladder, probably in reaction to certain pregnancy hormones. So, bile acids built up in her liver, then spilled over into her bloodstream, causing the itching. So I guess you could say that her blood was itching. Crazy.

This was fairly serious for another reason. According to this article (and several others on the internet):

The risk of having a stillborn baby is 15 per cent greater for women who have OC [obstetric cholestasis] than for other women. Nobody is quite sure why. The baby may die because of the bile acids, which are known to cross the placenta, or as a result of being suddenly deprived of oxygen, perhaps because of placental problems.

Also,

As far as the baby is concerned, the principal aim of treatment is to eliminate the risk of stillbirth by delivering him as soon as his lungs are mature enough for him to survive outside the womb. At present, doctors think it best to deliver the baby at about 35 to 38 weeks. If women with OC have their labours induced at this time, their babies are very likely to survive, while if pregnancy is allowed to continue to 40 weeks, the risk of stillbirth increases.

We were well into our 39th week when we found this out, so obviously we chose to induce labor. We had planned to have the baby naturally, but a better than 15% chance of stillbirth pretty much ruled that out completely. It wasn't the way we planned for things to go, but as you will see, a lot of things didn't go as planned over the next week. Well, we'll get to that (probably in a later post).

So anyway, we checked into the hospital Friday night. Karianne was not a great candidate for induction at that point, so she was given some medicine to "help ripen her cervix" and we tried to get some sleep. Anyone who's ever tried to sleep in a hospital knows this is more or less impossible. Karianne was receiving some antibiotics through an IV and was on a baby monitor (two monitors strapped to her belly to track the baby's heartbeat and her contractions). Just going to the bathroom required unplugging the monitors, managing the cables, and rolling the IV stand.

Karianne had some contractions, albeit erratically, throughout Friday night. At 6:00am on Saturday morning she was given pitocin to induce labor. Pitocin is a synthetic equivalent to a hormone called oxytocin that your body produces naturally during labor. A main difference is that pitocin often produces much stronger contractions than oxytocin.

At this point, Karianne's cervix was dilated to about 2cm. (You are fully dilated at 10cm, which is when you begin pushing.) We were still committed to doing things as naturally as possible, so Karianne requested not to be offered any pain medication. We practiced our Bradley relaxation techniques, and they worked really well for a long time.

It's hard to convey the sluglike passage of time over the next ten and a half hours. Contractions became more and more intense. We had written some Bible verses on index cards to pray during labor, and we really tried to focus on relaxing Karianne's body. Every couple of hours, the doctor would come in and check our progress. We slowly got to 2.5cm. A couple more hours passed. 2.75cm. The contractions were getting pretty strong now. Another hour: 3cm.

It was very disheartening, after struggling for two hours, to find that so little progress had been made. At around 4:30 in the afternoon, Karianne was exhausted and had still not quite reached 4cm. We decided at this point that she'd better get some pain medicine: an epidural.

An epidural catheter is a tube inserted into your spine via a long scary needle. The anesthesiologist told me not to watch it be inserted and that I should sit down -- a lot of husbands faint. Anyway, once you are getting pain medicine through this catheter, you don't feel much of anything from the belly down.

It's medical procedures like this that really make me wonder: whose idea was this?? And what patient was so desperate that he said, sure doc, poke around in my spine and see what happens, it couldn't hurt! I'm really thankful for doctors, but sometimes they make me wonder... :-)

Much as we had not wanted to get one, the epidural really saved us. We were able to sleep for a few hours, which we desperately needed, and Karianne was able to relax, so she began dilating faster. At 9pm she was ready to start pushing.

Now, if you noted the first line of this post, you saw that Kaeta was born at 12:33am. That's right, three and a half hours of pushing. Karianne was incredibly tough through all of this. I kept wondering how much longer she could handle having to push, but she just kept doing it. It was amazing.

Kaeta took a long time to come out because her head was stuck behind the pelvic bone. We tried a few different pushing positions, and ultimately alternating between two positions seemed to do the trick. Normally they don't let a woman push more than two or maybe three hours, but in our case, she was making steady (if agonizingly slow) progress, so we just pressed on. At around the 3 hour mark, Karianne asked what our options were (Kaeta's head was still behind that pelvic bone), and the doctor said we could try forceps, and if that didn't work, the only other option was a C-section. I think Karianne thought, "I did not go through all of this to end up having a C-section!", because she pushed even harder after that, and a half hour later our little girl was born.

A baby's head crowning looks kind of like a hairy meatball; I thought this exact thing as I was watching it happen. That being said, I have never seen anything so utterly astonishing as when she was born. She was covered in goo, with a weird greenish-white cord coming out of her belly, but she was absolutely beautiful.

Several books I've read have warned new fathers: You may feel nothing for your child at first. You may not feel terribly attached to her, and you may even resent her. I had mentally prepared myself for those feelings, and I really expected them. They may yet come, but I was surprised to realize that night that I love her very much, and I feel incredibly attached to her!

So there's an account of our labor and delivery. Not 15 hours later she was taken to the NICU for observation, but I'll save that story for another post.

I must be huge!

I know people mean well, and most are just trying to make conversation, but we as a society have got to come up with more tactful things to say to a very pregnant woman. Why every person I pass in the hall feels obligated to make comments such as, "Wow, you're huge!", "You look like you're about to pop!", and "You still haven't had that baby yet?!" is beyond me. To be fair, I DO look like I'm about to pop. Thirty-nine weeks is VERY pregnant. But on the other hand, I have been getting some of these comments since I was a good 6 weeks or more away from my due date. There are not many things more disheartening than to hear, "So, any day now?" when you are only 7 months pregnant.

Now, I probably was guilty of these types of borderline insults in the past, but now that they are directed toward me at 39 weeks gestation (or earlier), I know that they for the most part do NOT make a pregnant woman feel good about herself. More often than not, they just make her feel fat. And for a society that tip-toes so carefully around saying anything that might make anyone feel bad about themselves, why do we make this exception for pregnant women? As I am finding out from personal experience, pregnant women do not like to be told they are fat more than all the other women. Maybe we should try more flattering comments such as, "My, you are looking great today. I can't believe your due date is coming up so fast!" You just might get a real smile out of her, rather than the stiffening of her upper lip as she braces herself against the onslaught.

I can't help but notice that many of the birth weight guesses in our baby pool are over 9 lbs, and at least half the guesses are over 8 lbs. How am I to interpret this, especially when I notice that the same people are guessing that the baby will come about on time, if not a few days early?... I must be huge! Okay, so it's a just a fun game, and we definitely have friends who like to be extreme. But what about the prediction for a 10 lb 3 oz baby to be born tomorrow? Or the 15 lb 9 oz baby to come next week??? Do these friends of ours wish me harm? Of course not, I try to tell myself, they are only being silly. *Sigh* I don't know... maybe it's just hard to have a sense of humor about things at 39 weeks.

So the moral is, next time you see a very pregnant woman waddling along, minding her own business (probably heading toward the bathroom for the fifth time in 45 minutes), try not to verbally assault her. Just be nice.