The rest of the story

I know it's no longer live-blogging -- however, I think a number of folks wanted to hear how we got from the Doctor's musings about breaking the water & cords to an emergency c-section. Thanks, everyone, for all the kind wishes and support; they really make a huge difference.

So, after I wrote that penultimate blog post last night, we went from progressing well on the vaginal delivery to an emergency C-section. It was hectic, hairy, and one the things I'm proudest of us as parents of Josie so far -- as well as grateful for the top-notch team here at UCSF. Turns out that the cord was around Josie's head; when contractions happened, her heart rate would drop in what's known as a late deceleration (a "late decell"). Of course, we just saw the late decells, and didn't know why. These became more and more frequent in the half-hour between 11:18 and 11:50. After each of these, they would have Ilsa change sides; usually this would jostle things enough that the heart rate would climb back into the normal range (120-170). These changes of position, however, were lasting less and less long -- and each contraction seemed to cause them. They turned off the pitocin; contractions were happening naturally. As we got closer to an acute situation, they gave her a drug to cause her to stop contacting. Around 12:05 or so, no position for Ilsa would revive the heart rate, and the decision was made to go to OR immediately. The baby recovered as part of this process, and we had a decision to make. The attending doc said she said it was just as safe either way (either elect a c-section or do an emergency one if the baby failed to tolerate contractions during the labor). Ilsa was 7cm dilated at this point and very shaky due to the contraction stopping meds they'd given her. We decided very quickly that the baby's failure to tolerate contractions meant that we wanted a planned c-section; they started prepping her, asked me to step out, then, about 2 minutes later, ran to get me as they'd started already b/c the baby's HR had crashed again. I ran back in there and got to Ilsa's head, said it would be ok, and within about 30 seconds, we heard a baby's cry. As soon as they'd disengaged her head from Ilsa's pelvis, Josie started to wail out, and Josephine Helena Andre was born. She was in great shape; 9s on her apgars.

Turns out that Josie's cord had been wrapped around her neck and head and this was the reason for all the issues. Somehow she also had switched from facing posterior to facing anterior between last Thursday and Monday night. I suspect it might have been when the water broke; however, who knows. The back labor was a big part of Ilsa's pain. In any case, the call to do the c-section was perfect, given what we later learned.

Josie is great; very strong (trying to get her hands to stay in the swaddle is tough), opinionated, and full of energy. Most babies sleep a lot on the first day (say all the books); Josie slept some -- she just insisted on doing a lot of it in our arms. Ilsa's ok and in pain from the c-section, which, because of the epidural, was done transverse instead of longitudinal which is good on a number of fronts. We're learning to be parents and are largely in disbelief that such a cute, loud, and tiny human could be ours.

Josephine Helena is born

12:20 AM, 7 lbs 4 oz

Mommy and baby are great; Josephine is breastfeeding.

Yay!

Sleeping mom2be & grandmom

Dad2be and possum seem awake.

Side note: the folks here at UCSF are great. A few minutes ago, the baby's HR dropped a bit, and I was just getting concerned. The nurse was here about 10 seconds after I made a plan about when to press the button for her: "wait 30 seconds and see if the baby's HR came back up". They are on top of it.

Second side note: the baby's HR drops more when the bag of waters is broken; apparently this is normal due to the fact that the cord no longer has a bag of cushion around it. Thus, positioning matters more, and the baby tolerates positions differently. In the scenario above, they rearranged Ilsa and everything was fine.

9:22pm Lots of news

Lots of news since the last update. Ilsa's on an epidural and has 10 wires coming off of her (pulse ox, bladder catheter, contraction monitor, blood pressure, fluid, sugared fluid, insulin, epidural medicine, pitocin, and an internal heart meter attached (gently) to the baby's scalp). The last was a bit scary; however, everything now seems fine and the baby's heart rate is steady around 150. Contractions are still happening and, with the epidural, Ilsa is even smiling a bit at my lame jokes.

Occasional regular contraction cycles

7:17pm: Ilsa's getting more of a break between them; still too consistently sinusoidal. Pitocin is being amped up. BP is also staying a bit high. Possum is sleeping. Ilsa's mom is here.

Upping the pitocin to "break through" the 75-85s sine wave pattern

The title says it; that's what we're trying now. Ilsa's having a bite to eat.

Fetanyl: better living through chemistry

4:51pm Ilsa just had a 100 microgram dose of fentanyl and is resting much better, contractions are still about 75 secs apart. We'd wanted them to be regular; they're now regular. Now they will probably slow down a bit and then get more intense again, apparently. Possum appears to be sleeping.