Random question

Hi everyone!

I have been commenting on blog posts for the last two days but they are not registering. I see them posted after I hit reply but once I go back in the app the comment is not there. I tried to reinstall the app on my phone, and also tried the app on my iPad, in addition to going on the regular internet (gasp) and nothing worked. Any suggestions? Or can you see my comments? MPB and Nara, I’ve definitely commented on your blogs over the past couple days. Can you see them?

Help!! Thanks 


A Cause for the IUGR

I had my 6 week postpartum appointment yesterday. Baby A came with me and screamed a lot. I ended up breastfeeding her while walking into the appointment room and during my pelvic exam…surreal. Everything looks good on my end!

We discussed several things throughout the appointment. 

•I expressed to her that I do not wish to be on birth control. Firstly, I am not convinced that it didn’t contribute to our difficulties TTC. Secondly, we plan to try again (although I cannot imagine that right now…more on that in another post). Lastly, I have switched to all natural products and I am not interested in introducing hormones into my body at this point. 

•She said that since I had an uncomplicated vaginal delivery we could try again as early as 6 months (I think that’s crazy).

•When my cycle returns and is regular, she can order a follow up FSH, AMH, and E2 so I don’t have to go back to my HMO fertility clinic right away. I am relieved about that (even though I had a pretty great experience with our RE). I’m wondering how those numbers will have changed a year or so after having them drawn. I also hope it will give us an idea of what to expect. 

•And now the main point of this post. The results of my placental pathology. It was small (as we already knew from looking at it after delivery). This could have been due to the UU (meaning the smaller size of my uterus) or uteroplacental insufficiency. The placenta showed signs of chronic uteroplacental insufficiency. Basically this means that the blood flow from my uterus to the placenta was insufficient for a good chunk of the pregnancy. Thus the IUGR diagnosis. I have lots of thoughts about this. 

Firstly, the baby was in the 38th percentile at the 20 week anatomy scan. That is normal. Then, right before 30 weeks at our growth scan, she was less than 3rd percentile. So things went wrong somewhere between 20-30 weeks. I stopped taking the baby aspirin at 28 weeks (which I was taking to hypothetically increase blood flow to my uterus…who knows if it helped. I feel it did help). I don’t think that would have affected growth that drastically in 2 weeks but I can’t help but wonder if I had stayed on it (or restarted it) if her growth would have been less restricted. 

Secondly, I wonder if the less than ideal blood flow had anything to do with my 3 miscarriages. I did not take aspirin until before the 4th pregnancy (which actually worked). I do have signs of poor egg quality with high FSH and boarderline AMH. All the miscarriages were missed, with no growth each time past 6-6.5 weeks. Could that have been due to poor blood flow and not egg quality? My gut says its egg quality. I guess we will never know but I wish we could. Too bad we were unable to test the embryos that miscarried.  

Thirdly, I wonder if the pregnancy being successful is because the embryo implanted in an area of the uterus that had better blood flow and the majority of my uterus has poorer blood flow. Those with a unicornuate uterus can have poor blood flow due to the abnormal formation of the uterus. Am I doomed to have tons of miscarriages? That remains to be seen.

Lastly, I wonder if I am lucky enough to get pregnant for a second time (and not miscarry) if this will happen again. And if not, how much more will my uterus grow? Can I make a bigger baby in my half uterus? It obviously stretched a ton this time but not like a normal sized uterus did. 

I made my OB cookies and wrote her a thank you note because she was so incredibly kind and supportive throughout the entire pregnancy. I know I was a high needs patient (for good reasons I think) and I wanted to let her know how thankful I am for her care. I ended the card saying “I am so thankful for my beautiful baby”, and I teared up as I wrote that. The gratitude I feel toward having her is immense and I don’t think I could put it into words. 

Our First Week Home

We had a lactation appointment and weight check the day after discharge. I was again in tears as I could not get her to latch once we got home. The lactation nurse weighed her, and she was 4lb 10oz, so gaining quite well and almost back to her birthweight. Then we tried to latch her. She was so frustrated and just wouldn’t latch. So the lactation RN gave me a nipple shield and baby A latched on immediately and transferred just under an ounce! I was so happy. 

My husband and I were confused as to why that wasn’t offered in the hospital. Well I researched nipple shields and realized that they are very controversial. If you don’t use the right brand, size, and place it correctly, you can actually decrease your milk supply. Also, babies can have a hard time weaning off of it. Still, it allowed me to breastfeed. Our schedule once she was nursing was for me to feed her every 3 hours (at least) and them pump after the feed to make sure she “emptied” my breast. She was also allowed to be supplemented with formula or expressed breast milk afterward. But she seemed satisfied after breastfeeding so we didn’t bother with supplementing. 

We went to the doctor for some discoloration around her lips and eyes. She looked blueish there and I was pretty sure she was ok, but I was so scared I had to get her checked out. Apparently it is normal in newborns due to thin skin and increased vasculature in those areas. She was weighed again and was 5lb 1oz! Passed birthweight at 1 week. I was very relieved. 

We had a follow up lactation appointment at the end of that week and she was 5lb 5oz! We were also able to latch her without the nipple shield, although it was a shallow latch and caused me some pain and nipple compression. The plan was to do some feedings without the nipple shield (as much as I could tolerate) and cut the pumping from after every feed down to 4 times a day. What a relief!

My husband also though it would be a brilliant idea to have his wisdom teeth removed in the 3 weeks he took off from work to be with me and our baby. Not the smartest decision we’ve ever made as he was in a lot of pain! And he refused to take the narcotic pain meds because he was getting a drug test the next week before he started a new job. Yup, that’s right, let’s make 2 huge life changes at one time…have a baby and make a career change! But his new job is way better, closer to home, better pay, better benefits, better hours, so it was the right move.  

Our Postpartum Stay

I’ve been wanting to write about what’s been going on but I have not made an effort! Here is an attempt to update on the last 5 weeks. The post was so long that I am going to break it up into several posts. This is probably fairly boring to anyone who is not me! But I would like this to remember the early days!

After baby A’s delivery we were transferred over to the mother/baby unit to work on breastfeeding and recover. Because of her low birthweight (4lb 13oz) she needed frequent temperature checks and blood sugar checks. Her sugars were on the low side of normal. The nurses said that my colostrum would be enough to sustain her sugars. Well, breastfeeding was a different story. Since she was 3 weeks early and quite small, she could not latch on effectively to transfer the colostrum, and she was jus biting my nipples. Ouch!! She had a sugar of 37 in the early evening. I nursed her and also expressed some colostrum (like 0.3ml) and fed that to her. Then nighttime came. Baby A screamed and screamed throughout the night. The kind of scream that hunger brings about. Now I know colostrum is suppose to sustain babies through the first days of life. The nurses tried to reaffirm that. But I truly believe our baby was starving. Remember, she was IUGR. She had not met her growth potential in the womb. She was ready to grow and to do that, she needed to eat. It was so difficult to listen to her scream and for me to be unable to sustain her. I was in tears for a large part of the night.

The icing on the cake was when they checked her sugar around 4am and it was 28. That is a scary low blood sugar. I know what happens to babies and kids when they blood sugar is low, that’s part of my job. I demanded formula to feed my screaming, starving child and the nurses were so hesitant to provide it. They took awhile to bring it which only made me more upset. It was incredibly frustrating to be made to feel bad for doing what was medically necessary for my baby. Hindsight tells me I should have demanded to speak with the pediatrician but I was so upset and sleep deprived that I wasn’t thinking straight. 

After feeding the formula she slept. It was such a relief. But then she woke up screaming again in a couple of hours. That was when I lost it and was just continuously crying. When the nurses came in for change of shift, they told me I would be the first patient to be seen by lactation that morning.

The visit from the lactation nurse was just what we needed. She watch baby A try to latch and agreed that she was too little and bite-y (is that a word?) to latch properly. So we developed s plan. I would try to latch her 2-3 times a day to practice. Then I would use hand expression to get out as much colostrum as possible. My husband would then finger feed her the colostrum and give her about a half ounce of formula while I double pumped to help bring in my milk supply. I was given a hospital grade pump to take home for 2 months. I was so incredibly thankful that we had a plan that my husband and I could agree with. I felt like my concerns were heard. The pediatric nurse practitioner was on board with us as well. 

We ended up staying an extra night to make sure she gained weight, as on the morning of our original discharge she weighed 4lb 7oz. We continued our feeding plan, and the next day she was 4lb 10oz and we were free to go. 

Overall the nurses were fantastic and I feel like we got great care, aside from the formula issue. 

My Marathon Induction

I’m finally feeling up to writing this story down before I forget everything!

We were told to call the hospital at 4pm on Oct. 1st to see if they had room to admit us. They told us to call back at 8pm, so we watched “Meet Joe Black”. At 8 pm, they told us they would have a bed ready at 10:30pm. We ate Chipotle, packed up the car, and headed up to the hospital. 

Upon arrival, we were checked in and the doctor checked my cervix. I was 1cm dilated and 80% effaced. She recommended we use the foley balloon to dilate my cervix as far as it would go before falling out and she said we didn’t have to use misoprostal to soften the cervix since I was already 80% effaced. (I was so relieved to hear this as all three of my miscarriages were induced with misoprostal and I really didn’t want to use it during my birth. It just has such a bad connotation for me). The foley balloon was inserted and blown up at 12:30am, I was placed on the continuous fetal monitor, and the induction timer was started!

The nurse then attempted to put in a massive 18 gauge IV in my hand and she missed. It hurt, and I was surprised she missed as I have great veins. She called for back up. The next nurse had no problems. They drew labs and then my husband slept. I tried to sleep, but having a huge balloon in your vagina is quite uncomfortable and I was crampy. I was reassured that my baby sounded great on the fetal monitor throughout the night. 

They checked my cervix again around 8am, and I think I was at 3cm, so it was doing its job. I had breakfast, and then we were moved over to an actual labor room. It was a huge room with a beautiful view of San Francisco, which shocked me because the room we saw on our tour was tiny and had a view of a roof. Such an amazing surprise. The doctor can back to check me again and the balloon had fallen out meaning my cervix was dilated to 5cm! They cut the balloon and a bunch of water poured out. I asked how much water they filled it with and they said 50ml!!! I’m so glad I didn’t ask that when they put it in. A foley balloon in the bladder is only filled with 10mls, for comparison. 

I was allowed to have lunch and then they started the pitocin at 2pm. They started it off at the lowest rate and were suppose to increase it every 30 minutes to get the contractions about 1 min in length and 2-3 min apart. Well then change of shift happened and they didn’t go up for over an hour. The baby was tolerating labor very well thus far. I was also given the first dose of penicillin since I was GBS positive. The dose was to be every 4 hours until I delivered. 

I think the next nurse made it to 4 before I was checked again around 5:30pm. Still at 5cm, ugh! And I was starting to feel quite a bit of pain with the contractions. Because of the IUGR and now the pitocin, I had to stay on the fetal monitor, so I could not move very far from bed. This made it quite difficult to move around during contractions. At this point I kept wavering between wanting an epidural to just wanting some IV fentanyl to take the edge off. But I was scared to do the IV meds because I was scared it would affect the baby, who had been handling labor like a champ so far. 

Then my nurse came in and gave me the second dose of penicillin around 5:45pm. I have never felt so much pain in my life as she ran the medication in my IV. It was way worse than my contractions and I was crying so hard. I managed to look up at the IV pole and I realized she ran the medication “wide open”, which means as fast as it would go. It was suppose to be run over 1 hour. I was incredible angry she did that. This was the point I decided to get the epidural after a dose of fentanyl to take the edge off of the labor pains. 

After the fentanyl around 6pm, I felt loopy but so much better! However, the pitocin was making me contract every 30sec-1min so they turned it back down to 1, and there it stayed for several hours. So there were several hours before they turned it back up and things started happening again. My husband feels like this contributed to the extra long induction. 

Then the nurses changed again and I had a male nurse and his male student. I always thought this (male nurse and a student of either sex) would bother me but I actually thought it was so awesome to have a student. He was so excited and kind. They assisted the nurse anesthetist in the epidural placement and then put in my foley. This was done between 7-8pm. The two of them were fantastic and I was so grateful for their wonderful care. 

The epidural was incredible and I was finally able to doze in and out of sleep. Funny how I always thought I would labor naturally, but this entire process of getting pregnant, staying pregnant, and making it through the pregnancy complications has taught me to just go with the flow. I cannot control everything, as much as I would like to. 

I was checked again at 10pm, and STILL at 5cm. At this point, the resident decided to break my water to see if that helped move things along. Finally they got the pitocin back to 4. My husband then slept again and I dozed in and out of sleep for several hours. The night nurse was the one who successfully placed my IV and she was great! Around 12:30am, I heard the baby’s heart rate drop for the first time. She recovered on her own but it was super scary. Luckily she didn’t do it again. 

The doctor came back to check me at 2am and I had finally progressed to 8cm! I was so excited! Unfortunately, at this point, I realized the epidural was working too well on the right side of my body. I literally had a right dead leg. I could kind of feel and kind of move. My husband woke up (really I woke him up) to massage the leg and try to get feeling back in it. We were not very successful. 

I had another cervix check at 4am and I was at 10cm! But the baby was still at -1 station so the decision was made to turn up the pitocin to 6 and see if the baby would come down any further before pushing. With the pitocin increased again, I could actually feel my contractions on the right side, since my epidural was pretty one sided. It hurt but only like strong period cramps. 

The doctor came back at 6am and re-checked to find that the baby was at 0 station. It was time to push. Her and the nurse coached me through some practice pushes. And then we got to work. Side note…right after the practice pushes, I got super nauseated and I threw up. This was my first and only barf the entire pregnancy. 

Once again the doctors and nurses changes shifts and the new doctor wanted to get a quick ultrasound to check the position of the baby. It was then confirmed that she was “sunny side up”. Normally babies present with their face toward the mom’s behind. My little girl had her face toward my front. This causes it to be much harder to push the baby out as she will basically take two steps forward and one step back with each push. The resident who ordered the ultrasound wanted to try and turn her around. Apparently this can be quite painful. Thank goodness for great nurses as my nurse says no because I was doing a great job effectively pushing her down, it was just taking longer.

Honestly at this point the whole labor becomes a blur. I remember being able to feel each contraction start on my right side, and then I could palpate it on the left so I knew when to start pushing. I remember pushing in clusters of 4 (10 seconds each) instead of in clusters of 3. I remember there was another male nursing student who was in change of holding my dead right leg during pushing and my husband held the left one. 

(An interesting aside: it was the nursing student’s first time witnessing a birth and he was so excited. I distinctly remember the first brith I saw when I was a nursing student and that beautiful memory is still with my today. So that was pretty cool.)

I remember running out of steam and my husband encouraging me to keep pushing because she was almost out. I also remember hearing the doctors saying they needed to call pediatrics for fetal heart rate in the 80’s. They gave me oxygen. At this point I started freaking out because I was so scared something bad was happening to her. I started crying and asking if she was ok, I vaguely remember more doctors and nurses coming in as I sat up to watch myself push her out. 

She was a bluish color and then I started hysterically crying. And then she started screaming and they placed her on my stomach. My hysterics turned into repeating “my baby my baby” over and over again as I finally got to snuggle her as she kept crying. It was the most beautiful cry I’ve ever heard. I looked up at my husband, who was also crying. He got to cut the cord and we all just marveled at each other while the doctors finished up what they needed to do with me. 

Toward the end of our skin-to-skin, she was able to latch for a short period of time before they weighed her and did her shots/meds. Then my husband snuggled her so I could eat! 

All in all it was an extremely difficult labor for me as it was not how I imagined labor to proceed. However, I am so thankful to have had the experience of carrying my beautiful daughter and then giving birth to her. I wouldn’t change anything about the experience, as it is a wonderful part of our lives. I have never felt such love for anything in my entire life as I love my baby, and I didn’t think I could love my husband any more than I already did. 

Today I Remember…

Today I remember…

My excitement at each positive pregnancy test. 

How I told my husband I was pregnant. 

All of the plans I made for each baby who was never meant to walk the earth. 

The anticipation of the first appointment, and then the nerves for the following pregnancy’s appointments. 

The incredibly heartbreaking power of the sentence “I’m sorry, there’s no heartbeat”.

The look on my husband’s face the first time we heard that sentence. 

The physical pain of each miscarriage, followed by the emotional turmoil. 

The thought that I may never become a mother to a living child. 

The fear of trying again only to face the same fate. 

That if I had never lost my three babies, baby A would not be in my arms today. 

Today, and every day, I remember my three angel babies, and I am grateful and thankful that I carried them for their short lives. I also remember all of the beautiful babies who were taken from our arms too soon. 

Baby A is Here!

Baby A was born Oct. 3 at 9:01am. She weighed 4lb 13oz and came out screaming. It was a successful vaginal delivery from a 44 hour marathon induction.

I’m emotionally and physically exhausted but my husband and I are so in love with our precious, tiny baby. We’re having some blood sugar and breastfeeding issues that are keeping us in the hospital, but doing ok so far. My husband has been incredible. 

Thank you everyone for all your support and well wishes. I will write a birth story when I’m more with it. I’m also very behind on everyone’s blogs so I will catch up when things settle down. Hope everyone is well!