Post disclaimer: this is going to be long, detailed, photo-filled, and from the heart.
Baby is here! She made a sort of dramatic entrance into the world and I'm going to try to sum up the events of the week of her birth.
My due date was Sun., April 13th. At my doctor's appointment on Monday the 7th, my doctor asked if I wanted to be induced on Sat. the 12th. I agreed to that. I had 2 successful inductions before, and was ready for this baby to be born. I was concerned she was getting big, despite the doctor's estimate that the baby appeared to be average size. I was induced with Adelaide 5 days early and she was 8 lb. 8 oz. I didn't want to give birth to a 9+ pound baby, so I was ok with the Saturday deadline. I was also still only 1 cm on Monday so it didn't look like it was coming any time soon.
On Tues. April 8th, Oliver and I had a parent orientation for Sofia's kindergarten at St. Gabriel's. I didn't expect making it to the event, so I asked for the paperwork to be mailed. But, as it turns out, I was still pregnant on Tues. so we asked my parents to babysit and planned on attending the orientation. They were going to come to our house to babysit, but at the last minute we drove them out to their house because we also got a showing request for our house, which is still on the market. Literally, as I was leaving their house, I stumbled out the front door, twisted my ankle and kind of fell on my right side. I knew I hadn't hurt myself, but I called the doctor and she said I should come in to the hospital and be monitored to make sure there wasn't any damage to the placenta. So no kindergarten orientation after all. Instead we spent an uneventful few hours at Lake West being monitored. I was hoping maybe a little that she ould just tell me to stay because I was in labor or they'd induce me, but I left knowing I'd be back on Saturday for my scheduled induction.
Well, I didn't even make it a few more days without another visit to the hospital. On Thursday at work I had contractions all day and they were about 8 minutes apart. I had planned to make Friday my last day of work. The contractions weren't painful, so I knew it wasn't anything exciting yet. On Thurs. night we went to my friend Jessica's house, for a final visit before she moved to Columbus on Saturday. Oliver and the girls came and a few other friends and we ate pizza and hung out. I was starting to have contractions more frequently, and at Jess's urging. timed them for an hour. They were about every 5 minutes now, but still not painful. I called the doctor when got home at about 8:30 and talked to Dr. Boes, who said that it sounded like I should come in.
So my mom packed her bags and came over to watch the girls while Oliver and I went up to Lake West again. I was still only 1-2 cms. Dr. Boes suggested I get up and walk around a bit and see if anything was going to pick up. After walking the halls and hanging out for awhile, we were given the choice of being induced or going home and coming back on Saturday and having my scheduled induction with my doctor. I was having contractions every 3 minutes, they just weren't really doing anything yet. We decided to go home because I was still only 1-2cms after a few hours. The thought of starting Pitocin at midnight and a night of labor with a baby arriving in the early hours of the next morning didn't sound like what I wanted to do. So we went home and I was able to sleep a few hours that night.
I called in to work and said I was starting my leave as of Friday and on Friday morning, Oliver took the girls to preschool and I pretty much hung out on the couch. My sister Kate had come up from Columbus, so she and Emily came over to keep me company. I just felt bad on Friday. Every time I got up and moved around, my stomach hurt. I was able to nap a little, but in the evening things started to pick up. My mother-in-law arrived from Toronto at about 4ish and that seems to have been the turning point. I was more uncomfortable and the contractions seemed to be a little stronger, although it was hard to tell. We ate dinner at around 7. My brother Chris stopped over to pick up something at about 9 and by then I had pretty much resigned myself to going back to the hospital. Oliver and I kissed the girls goodnight and drove to Lake West at about 9:30. By the time we were driving it, they were definitely getting painful. We were admitted through the ER for the second time in 2 nights and wheeled to the labor and delivery floor.
Dr. Boes was still the doctor on call and she checked me and I was about 2-3 cms and 90% effaced. I thought for sure all those contractions all day would have done something more, but I was still convinced this was it and was not going anywhere this time. I begged for my epidural at around 11 because the pain was getting intolerable, but had to wait almost to midnight to get it because they wanted to get some IV fluids in me. I was about 5 cms when I got the epidural. I never had any Pitocin, and this is the first time I went into labor on my own. They didn't let Oliver stay during the epidural. I felt much better after I got it and the doctor said I could probably get a few hours of rest in now that I was more comfortable.
After about 15 or 20 minutes after getting the epidural, the nurses came back in and said the baby's heart rate was decelerating after my contractions and they wanted me to change positions. This was definitely the strongest of the 3 epidurals I've had and couldn't feel my legs much at all. They rolled me from side to side to get the best position. They gave me some oxygen. Oliver was still gone from being kicked out during the epidural. I started to feel a littl
e
nauseous, also something I've never experienced during labor. I thought maybe we could call Oliver to see where he was, but he had left his phone in the room. Dr. Boes came in and watched what was going on. She put on a fetal scalp monitor to watch the heart rate better. There was also talk about my blood pressure being low, also a side effect of an epidural. I think one of the nurses mentioned epinephrine
at one point, but was never given any. It did make me worried about what was going on though. After a little while, they seemed to be satisfied that the baby was now cooperating, and left me alone again.
Oliver returned and had told me that he had tried to come back a few times, but the door was closed so he didn't think that things were done with the epidural. After probably another 15 minutes, the nurses were back in with talk again about the baby's heart rate. Things happened very quickly from this point. It was about 1 AM at this point. The nurses were all busy looking, asked the doctor to be paged, and Dr. Boes was back in quickly. She was very calm, but by the way the nurses were rushing around I knew that this wasn't really the way things should be going. The one nurse had mentioned that maybe the cord was wrapped around the baby. I realized they were setting up all things for the baby - the little isolette and warmer, the tray of instruments, and I was getting increasingly nervous. I was 7-8 cms, so I wasn't ready to have this baby yet, but I could tell something was going on. Dr. Boes then said she could stretch my cervix to 9 cms and I would have to push over the remaining cervix. She started asking me questions like how big my girls were and did they think this baby was big and how long it took to push out the girls. At this point I remember thinking that she's probably trying to figure out how much time is needed to get the baby out and all I kept thinking is that if I was going to end up in a C-section that I hoped they had time to numb me more than the epidural. Once I started pushing, it was very nerve wracking because I could hear the beeping of the heart rate and after the pushing you could hear it slow down. I looked at one point and saw that it was in the 80s where it had been in the 130s. Thankfully, it took 20 minutes to push her out and she was born at 1:47 AM. She was posterior ("sunnyside up" face up instead of face down) just like Sofia and Adelaide were. They declared, "it's a girl!" and then quickly placed her on me and then scooped her right up and had her checked out. Her APGARs were good and she wasn't in distress. I wanted to see her as the nurses were talking about strawberry blond hair!
It was exhausting and definitely the most dramatic of the 3 deliveries, but everything turned out well and she is a perfect little baby. At 7 lb. and 11 oz. and 20.5 in. she was the littlest of my 3. She was not going to wait until her induction to be born. Sofia and Adelaide were the first family to see her. They got there at 9 in the morning on Sunday and the took on their faces when they saw her and learned she was a girl were ones I'll always remember. They loved her instantly. So much love that I fear for her safety on a daily basis! - they want to hug and kiss her all the time.
It took us a day to come up with a middle name, but knew from birth that her name is Evelyn, Hebrew for "life."
Welcome, Evelyn Audrey! You are definitely an amazing addition to our lives.
She had a heart murmur for the 3 days we were in the hospital and at discharge the pediatrician said we could do an echo because of Sofia's history, but he believed it just to be a PDA (the vessel that is supposed to close off after birth was probably still open). Her pulse ox and blood pressure we both normal. We chose to have the echo done at the Cleveland Clinic on Monday when she was discharged. Dr. Edwards, Sofia's cardiologist, squeezed us in and we went right from Lake West to Hillcrest. After examining her and her vitals, he didn't think she really needed an echo but left it up to us. We decided to have one done for peace of mind.
After the echo, Dr. Edwards explained that she does have a PDA and FPO (not really uncommon for infants), but that she has a little narrowing of her pulmonary valve. Pulmonary valve stenosis is when the valve is a little thicker than normal. If very thick, the blood flow across the valve can be obstructed and cause insufficient blood delivery from the right ventricle to the pulmonary artery. The resistance of blood across the valve is measured in an echo and the gradient is in units mmHG. Up to 10 mmHG is within a normal range, and Evelyn's was 12-14, and categorized as trivial. Mild is about 30 mmHG and can range up to critical of 70 or 80 mmHG, which would require intervention. Dr. Edwards said worst case scenario is a balloon valvuloplasty through a cath. He doesn't think she will progress to that though. He said that he used to not believe this early in his career, but he has seen kids with gradients of 40s or 50s that have gone back into normal range and that is definitely possible for Evelyn. From talking with him and doing some reading on my own, it seems that once she is about 6 months old or so her numbers will level off. Cases that are mild at that point tend to stay mild and usually don't progress. She probably will not need any intervention. Of course, we were pretty shocked by all this and I spent a day or so being pretty upset about it. Thank goodness I have best friends and best friend sisters that let me cry it out and talk it out until it's ok. I was reeled back in and realized we have a healthy, perfect baby. She will be fine. We will hope that her gradient goes back into normal range, but if not hope that it stays mild. Problems with the pulmonary valve can be hereditary I also read, which could explain why Sofia and Evelyn both have issues with the pulmonary valve, however, we don't know where it came from. Sofia's heart problems aren't genetic, meaning she doesn't have a genetic disorder with known heart-related problems, but that doesn't mean the two aren't related. It is also impossible to say that they are definitely connected. Dr. Edwards is always good with us, spelling things out and answering questions, emailing us and calling us to see how things are going. This man is not allowed to retire! He will see her in June to follow up with her and see how's she's doing.
We love this little baby so much and are settling into a routine here. Of course, the nights are difficult. She's pretty much up every 2 hours to eat and she doesn't like to settle down before 1 AM or so. Breastfeeding is never a walk in the park for me, so it's been difficult. I know that if I hang on, it'll get easier. She is so sweet. She is a perfect mix of Sofia's delicate features and Adelaide's coloring. It's heart warming that one minute she's crying and frantic and I can pick her up and she lays her head down on my chest and will settle down. I am glad to be adjusting to life with 3 girls and we have kept busy. She will be two weeks old tomorrow. Welcome to the world, Evelyn! You complete our family.
We even had time to get some professional pictures taken this week by my talented friend Lorelei. She did an amazing job and I love how the weather cooperated!