Sunday, November 30, 2008

Harper. The first week and a bit.

Harper is a lovely baby. She loves her sleep, which is wonderful, because so do I!

Harper is a snacker, so only takes about 60ish mls before falling asleep, then will sleep for an hour and a half before wanting another 60mls. We've been working on keeping her awake, or at least waking her up when she first nods off and getting her to take more.

She hasn't been weighed since we've been home, I think I'm meant to take her to the Baby Health Clinic sometime this week, although I really don't want to. I remember seeing them when Isla was a newborn, and I expressed my concerns to them about Isla's legs always being stiff, and the nurse told me that it was a "sign that she wants to walk" and that she'll walk early - when in fact, it was her Cerebral Palsy, which could have been picked up a LOT earlier had the nurse not dismissed my concerns. Maybe I'll just take her to the GP instead?

Harper doesn't like to be wrapped, she loves sleeping with her arms raised above her head, but I wrapped her up again yesterday when she wouldn't settle and she had a really, really good sleep, so we continued it last night and this morning too and she seems a but more settled.

Hmm, I have no new photos, these are from a few days ago, I will endeavour to take more today :)

Isla is a really wonderful big sister and has adjusted really well to Harper coming home (thankfully). She's scared of her pooey nappies though, but apart from that hasn't complained at all. The 2nd day we were home together she asked to have a sleep over at my Mum's place though!

She officially has middle names now, Miss Harper Joni Kate :)

Sunday, November 23, 2008

Meet Harper.

So, we’re home. Well we were, Ian has already packed up Isla and Harper and has taken them to visit his parents – he’s such a proud Dad. So, I should be relaxing on the lounge, but I just wanted to come in here and jot everything down before I am completely rushed off my feet!

I’d really like to thank everyone for their well wishes, texts, emails etc, it’s meant a lot to me to feel so supported through the pregnancy and birth of Harper. Thursday was both the most wonderful and terrifying experience in my entire life all rolled into one moment.

The birth

My sister and I arrived at the hospital at 7am while Ian took Isla to kindy for the day. We went up to the Birthing Unit and sat in the triage room until theatre called for me. A little while after 8 Ian arrived, and I was sitting on the bed absolutely crapping myself, I was so scared. Just as I said to Ian and Kate, “I don’t think having a baby was a good idea” the midwife came in to say theatre were ready.

I was told I’d get the spinal in the anaesthetic bay but they wanted to do it in theatre – and even though this was my 4th operation, I’d always been too scared to open my eyes inside the operating room. It wasn’t as bad as I thought, although I did have to try really hard not to think about what all the equipment is for. I had to sit on the edge of the table with my feet hanging over, while another anaesthetist held onto my shoulders. They washed my back down with something absolutely freezing, then they gave me the local. It took a long time to do the spinal though, the anaesthetist was training someone on how to insert it, and kept saying things like "No! No! Don't bend it! No not like that!" Far out! So, it took a few attempts to get everything positioned right, and once it was in I couldn’t believe how bizarre it felt - at first it went down my bum and legs, they felt all warm, fuzzy and heavy.

Once that happened, they got me to lay down and they put the sheet up and tested me to see how well the spinal was working. They rubbed an ice-cube on my forehead then on my stomach to see whether I could feel the cold or just the sensation. After a few goes, I couldn't feel the cold from the boobs down.

Kate was then let in, armed with her iPod to distract me, as soon as she came in I started shaking uncontrollably. Kate put the earplugs in and I didn’t even know that they’d started, I thought they were still getting everything set up. I could feel a bit of pressing on my tummy, and I just assumed they were feeling the position of the baby, so I was surprised that when the first song finished and I heard Kate saying, “she’s almost here!”. I felt a big push on my tummy, then I felt a lot lighter, then I heard her little screams!

One of the theatre staff took my camera and took some photo’s of her arrival, but she flicked the setting to video camera, so I have some pretty gory footage of the inside of me, but the audio is good, all I can hear is Harper crying, Kate crying and me crying and asking “is she okay?”, "Is it a girl" and "She's really big!". The moment I laid eyes on her, the iPod played “Beautiful Girl” by INXS although technically, she was born while I listened to Fall Out Boy!

Kate was able to trim the cord and took lots of photos for me. The baby was all wrapped up and I was able to give her a few kisses and strokes on the forehead before she went off to be weighed and measured. I wished she had stayed in there with me a little longer. I also wish I was able to move my right arm to be able to see her properly.

After she was taken, Kate was supposed to go with her, but she refused and stayed with me for the rest of the operation, and I'm so glad that she did. One of the theatre staff was insisting that she leave, but we'd already asked someone else who said it was okay, so Ian waited in the nursery with her. I was still shaking uncontrollably and when I could sense that they had a tray on my tummy that they were putting their clamps etc into I started to feel really sick, but one quick injection and I was okay. The worst part of it all was I had the worst case of dry mouth of my entire life, I couldn't swallow anything and it was making me feel awful!

It wasn't long until everything was finished and I went to recovery for what was meant to be 30 minutes. They had to get me off the operating table (obviously!) and they had to roll me from one side to the other and I was convinced that I was going to fall on the floor, I kept pleading with them, "Please don't let me fall!". So, off to recovery, I couldn’t stop shaking, so I stayed there for over 2 hours. It was really awful, all I wanted was to see Ian and the baby, but I had to stay until the shakes had gone. They loaded me up with heated blankets (I think I had 5 in the end) and made me do deep breathing exercises, but nothing worked. All my obs were normal, so after about 2 hours I was allowed to go but I still had the shakes when I got to my room. I had to wait about 20 minutes before the nurse went to find Ian and Harper, then I was allowed to have all the cuddles I could!

Harper Joni Kate

Born at 9.34am

Weight: 8lb

Length: 53cm

HC: 36cms

Wednesday, November 19, 2008

39 weeks.

Starting to freak out slightly!

I don't remember if I posted an update after my last Resident appointment on Friday (38+3wks) so I'll give you a rundown on that.

:: Appointment was for 9.15. I got there at 9, i left just after 12. Thank god Isla was a good girl.

I saw the same idiotic Dr as last time. She checked the swelling in my feet but said it was okay, they only worry if you can leave an indentation in your legs/feet which I can of an evening. She said as long as the swelling goes away when I put my feet up then not to worry about it, and it will continue (probably get worse) until little sister gets here. Have only put on 550g since last week, although I really should weigh myself after I go to the toilet and not before!!

I told her that I tried to book into the anaesthetic clinic last week but I didn't have the right forms, so she gave me the forms for my GP to fill in and told me to see the ladies at the desk and they'll book me in. I go and see the ladies, the woman takes one look at the forms the Dr just gave me and said, "you have to go back and get these filled out by the doctor before I can book you in, you don't even have a booking date for the c-section". So, I told her that I was booked for the 20th and she said to get the Dr to write it in.

So, after waiting over an hour to see the Dr, I then had to go back and wait to see her again (it was now 11.15) she filled in the forms, then said that she couldn't fill them in because she's a resident, I had to have a registrar or LMO to sign/fill them in. BLOODY HELL. I got moved to another clinic room to wait for another Dr to come in and fill out all the forms. In the meantime, Jane, the nice midwife saw me in the corridor looking less than impressed, so she called the theatre rooms and double checked my booking for Thursday - and it's all in there - 8am.
The next Dr came and filled in the forms, she was the Dr who booked me in again for the 20th anyway, as soon as she saw my name she knew all about what had happened, although still couldn't explain why I'd been taken off in the first place.
I'm booked in to the Pre-admission Anaesthetic Review Clinic for Tuesday the 18th at 2.30pm. I have no idea how long it takes or what's involved, but we'll find out on Tuesday.

The Dr asked whether I wanted a General, Epidural or Spinal, and I said Spinal. She thinks that will be the best option, even though I really have no idea, I just prefer 2 injections (a local, then the spinal) to having the epidural catheter inserted. Someone remind me to speak to the anaesthetist about that ::

So that was a massive pain in the arse. I went to the GP on Monday to have the forms filled out, but after sitting for nearly 2 hours in their waiting room, I couldn't be bothered going to the hospital to hand in the forms and took them with me yesterday when I had the anaesthetic clinic.
Pre-Admission Clinic: Was really good. Kate came with me, bless her cotton socks, I'd be lost without her! We had a lengthy wait again, but at least they warned us about it this time. We got there around 2.30 for the appointment and left after 5 - again! The anaesthetist was SO lovely, I am so bummed that she's not working TOMORROW (OMG tomorrow!) but she assured me that the man who will be there with me is lovely too!

I am allowed to take in an iPod - Yippee! The more distractions the better! She agreed that a spinal is the way to go, but did warn me about a) shaking b) nausea and vomiting and c) headaches. She also said that once you've decided to go for a spinal you are completely awake, they can't give me any of those magical drugs that take you away to la-la land because they'll affect the baby - but if I feel like I'm not coping I can have a General at any stage (unless of course there is only about 5 minutes left). She said that I'll have the spinal put in in the anaesthetic bay not in the theatre which is a MASSIVE relief to me, even though this will be my fourth surgery I've never seen the inside of an operating room, so the prospect of having to sit on an operating table while they did the spinal has been something I have been dreading. Unfortunately, she doesn't think that Kate will be able to be with me while that's being inserted, but fingers crossed I'll be a.o.k.
She said that the Dr's are really quite fast at c-sections at this hospital and it would probably be all over and done with in about 30-45 minutes. Wow. She said that once the baby is out, she'll be wrapped up and given to me for cuddles, then while I'm being stitched etc she'll go to the birthing unit to be weighed and cleaned up properly and given the vitamin K shot etc. They said Kate will go with her to have all that done and I'll meet them back in the BU after I've spent about 30 minutes in recovery - BUT, Ian will be waiting out in the waiting room while we're in theatre, so hopefully he'll go with the baby to get weighed etc and Kate can stay with me for a while longer, I think the longer I'm left on my own, the more likely I am to freak out. We'll see anyway.
As we were leaving the pre-admission clinic, I thought I probably should hand in my admission papers, given that the actual birth would be less than 48 hours away. Imagine our surprise when I hand the forms to the lady at the desk and she tells me that there are "lots of pages missing". GAH! I explained that the Dr's in the antenatal clinc filled some forms out, ripped them out and told me to get the rest filled in by the GP. The lady told me to take the forms to the antenatal clinic because they needed them not her, and they were closed! I may never have this baby!

Isla is getting super excited about her baby sister arriving. We told her that she'll be here on Thursday but she doesn't really get what Thursday is unless we say today is Thursday, so she'll be off to kindy first thing in the morning and Ian will collect her in the afternoon and bring her in to meet her little sister! I can't wait for that moment, I get all teary just thinking about it. Isla keeps telling me how much she loves her baby sister already, I just hope the love continues when we come home.

I'm sad that I'll be in hospital away from Isla for so long, somewhere between 3-5 days. I want to stay as long as possible so that I have the help of the midwives etc, I don't want to over-do anything by coming home early, I just hope I can cope being away from Isla for so long - even though she'll spend lots of time visiting, it just wont be the same :(
I have really no clothes for this little girl if she's less than a 000! Isla's 00000's absolutely swam on her when she was born, although she was 5 weeks early, so that makes sense. I have a box in the garage of her little stuff but I can't find it anywhere and haven't really been bothered going to the shops to buy little things for her, so Ian may be forced to go clothes shopping - I shudder to think what he'll come home with, although I really should just tell him wondersuits, how wrong can he go??
Starting to crap myself, I was awake from 5am this morning thinking, "this time tomorrow..." Cross your fingers that I get some rest tonight (doubtful after I fell asleep for 3 hours this afternoon) and I can relax and enjoy this experience...

Tuesday, November 11, 2008

38 weeks.

I am REALLY feeling it now. Last night it was well after 3am by the time I got to sleep. Swollen feet, sore back and awfully painful (but irregular) Braxton Hicks had me on the lounge watching bloody infomercials for hours on end, and now, I want the Windsor Pilates Circle thing and Pro-active!!

I tried to be organised this morning and put on a load of washing as soon as I woke up, it's still sitting in the washing machine some 5 hours later, and the clothes I hung out on Sunday are still on the line too. I really do have good intentions on getting it all done, it's just the following though that I struggle with LOL.

Isla has been really good, I am really very lucky that she's been so sweet and lovely and not a complete and utter feral. ian goes on holidays at the end of this week, with the baby scheduled to come on the 20th, although I will be calling the hospital tonight just to confirm and see if someone can give me a straight answer on the anaesthesia clinic/pre-admission clinic and paperwork. I just want to have everything sorted out ASAP so I can relax a little.

I've spent the morning searching on various childbirth things, not sure why, I've made up my mind, but I'm just so curious to know more, but I don't want to know too much! It's so hard to be one of those people who freaks out at the mere mention of anything medical, yet being faced with being awake for a major surgery - I'm trying to find a balance between knowing enough and knowing too much. Easier said than done.

I have lots of questions to ask, but I don't know if a) I'll get the chance to actually ask them (will I go into labour before my appointments?) and b) whether anyone will be able to answer them for me, or will it simply be a case of passing the buck a-la last Friday's appointment.

Things I want to know:

:: Can I have music/ipod in with me so I don't hear all that surgical stuff?

:: Can the baby stay with me (along with my husband) in recovery?

:: Can the baby have all the health checks/weighing etc done with me there rather than while I'm in recovery?

:: What's the difference between a spinal block and an epidural, and which one would be best for me?

:: What sort of pain relief will I be offered after the birth?

:: What happens if I have a MAJOR freak out in the theatre? - a very real possibility!

:: Can someone PLEASE look at my wobbly tummy and ensure that I don't have some feral skin apron after the birth - something I am very worried about.

That's all I can think of for now, I know my lovely sister Kate (who will be accompanying me for the birth) has some questions too, I should really call her and see what they are so I can ask on her behalf.

Just before I go to lay on the lounge for the umpteenth time today, I want to say a very, very BIG thank-you to my wonderful girls for all their support and understanding of my decision for an elective c-section. You girls are my rock!

Friday, November 7, 2008

Registrar Visit.

The Dr I saw was terrible, it seemed like she had absolutely no idea what she was doing, which was a bit un-nerving. She pumped up my BP thing 3 times, then seemed to make up the actual BP that she wrote on my card. So once we'd finished there, Kate and I went to the medical centre that has an automated one and it was pretty close to what she'd written on my card.
I tested positive to Strep B, so it's a good thing I'm having a c-section. She said it doesn't mean I have it, I could just be a carrier, but it can be passed on to the baby through a vaginal delivery, so c-section it is.
BUT there was nothing written in my notes about a c-section on the 20th, and I saw the note where my c-section was canned for the 19th. It said, "No c-section booked for 19th therefore c-section not needed". Pretty interesting. I told her I was booked in for a c-section on the 20th and that they said that I would have to go to an anaesthesia clinic the week before-hand. She said that they usually make the bookings at the same time, so they should have told me when I had to go to the clinic, just to ask the midwives at the front desk - she really had no clue what was going on.
So, I asked the midwife out the front and she asked me for my admission papers - which I don't have. She said that I need to have the admission papers and have them signed by a GP and returned before I could go to the anaesthesia clinic or the pre-admission clinic. I told her I don't have them, and she told me to ask them for them at next weeks weekly visit, which is on next Friday - talk about cutting it fine. The Dr said that the anaesthesia clinic would probably be on the 18th! Bloody hell.
I think I might just call them in tears next week and ask someone to sort it all out for me - no one seems willing to help me get everything organised at all - it's very stressful.

A trip to the hospital.

I woke up on Tuesday morning with some pretty feral looking bright green discharge in my undies. Charming.

In a panic (anything green has to be bad - right?) I called Ian and asked him to come home from work and take me to the hospital. I then called the Birthing Unit and explained to them the green stuff, they told me to "pop on a pad and come on in!". She said it could be meconium in my amniotic fluid (insert freak out here) or it could be some sort of infection. Best to go in and be checked out for certain.

So, Mum came over to mind Isla and Ian and I went off to the Birthing Unit. Turns out what I consider to be green (we're talking the colour of green cordial here) isn't what they consider to be green, so there was no need to worry at all. Phew!

They put me on the CTG for a while, which brought back lots of memories from being in hospital with Isla, I would spend half an hour two or three times a day strapped to a CTG checking out my little munchkin. Thankfully the trace was fine, one very happy baby in there :)

The Dr, who was SO lovely, wanted to do a speculum (ugh!) but couldn't. I just couldn't relax enough for it to happen, so after a few attempts, he said not to worry, that he couldn't see any obvious amniotic fluid leaking, and that he thinks it could just be an infection. Midwife did the swab for Strep B and I was allowed to go home.

BUT, the Dr made a comment before we left, "I see you canceled your c-section on the 19th" and asked if I had decided on a VBAC. I couldn't believe it! I told them that I had definitely NOT canceled and that I will be having the c-section as planned, thank-you-very-much. I was so upset, it had taken quite a lot for me to a) reach the decision of having the c-section, and b) being at peace with it, so the fact I'd been taken off the list (after being on it for 3 weeks, I might add!) really pissed me off!

The midwife ducked out to check the list, and surprise!! They'd completely booked out my day!! And the days either side of it! I asked what was going to happen, they said that they'd have to either "see if they can fit me in or bump someone from the list". Honestly. The midwife said to call her back the next day and see what she could work out for me in the meantime, or I could wait until Friday and discuss it with the Registrar.

I called on Wednesday, and they said that I was booked in for the 20th - a Thursday, which is significant because they only do elective c-sections on Wednesdays and Fridays. They said to be at the hospital at 7am, I'm first on the list and barring any emergencies, I will be in theatre at 8am.

Sunday, November 2, 2008

37 weeks.

37 weeks!!!!

A baby is considered full-term if born any time after 37 weeks!


There are no midwife appointments this week, so I will be seeing a Registrar on Friday morning with Kate. I'll be informing them of my decision to go with an elective c-section.

It's something I've thought long and hard about and I'm glad to say that so far, the people I've told have been supportive. I composed an email to send to family & friends about my reasons etc, I'll post it at the end here too.

My feet swell every day. Saturday I had to ask my Mum to go to the shops and buy me some new slippers because I couldn't get my feet into any shoes! My lovely inlaws are also going to put some Xmas presents on layby for me today because it's all too hard for me to get to the shops these days (particularly with Isla in tow) so I only have 1 person to buy for now (and the IL's too, but I think I know exactly what I'm getting them). Feels good to know Xmas is sorted!

It's 9.39am and I've already been up for 5 hours and I'd really like to go back to bed, but Isla has only been awake for about an hour or so, so the chances of her going back to sleep are non-existant!

Anyway, this is my lengthy email:

I've made up my mind what I'm planning on doing with the birth of this baby. I'm just letting you know so that we're all on the same page.

I've decided to go ahead and have the elective c-section. There's a few reasons why I'm choosing to have this, and I'll share them with you so that you can understand and hopefully support my decision.

The main reason I was originally swayed by a c-section was because of Isla's special needs. I am particularly terrified of something/anything going wrong with a natural delivery, specifically, foetal distress, the cord being wrapped around the baby's neck etc. For me, the choice to have a c-section was set in stone last night when I found this piece of information, which was published in the New England Journal of Medicine in December 2004. It's the results of 46000 women attempting a VBAC (vaginal birth after caesarean section)

Among infants whose mothers chose this "trial of labour," the frequency of hypoxic ischemic encephalopathy (HIE) - another serious complication-was increased. While only 12 cases of HIE occurred with "trial of labour" cases, there were no cases among women who had elected to have a repeat caesarean delivery. Seven of 12 cases of HIE, including two neonatal deaths, followed uterine rupture. Maternal morbidity, endometritis and blood transfusion were all more likely among women who chose VBAC than among those who chose repeat caesarean delivery”

HIE = newborn brain injury due to lack of oxygen

The specific risk is 1 in 2000, which I know is a slight risk, but given that I already have a child that has HIE (specifically Periventricular Leukomalacia) the risk is just too great for me to willingly take just so I can have a particular kind of birth. Part of me is sad that I won’t be able to experience a “natural” birth, but I have to put the well-being of the baby before my needs. I know that if there’s a 1 in 2000 chance that something will go wrong, then there’s a 1999 in 2000 chance that everything will be fine but still, I am confident in my choice. I also know that any birth resulting in a healthy baby is successful and that’s what my focus will be.

I spoke about this with the Dr at the High Risk Clinic, and she is happy to support my choice and while Bankstown Hospital actually has the lowest c-section rate of any hospital in NSW, she said, it’s not up to her to single-handedly lower the Country's c-section rate, so if I want one, I can have one. I know that the Birthing Unit is co-located with the operating theatres (I studied the floor map on Tuesday night) it is literally across the corridor, but, what if something goes wrong and all the theatres are booked? I would never be able to forgive myself. The Dr did say that they could get me into theatre within 5 minutes and have the baby out within 1 minute - assuming that there’s a free theatre. I also know that if the brain becomes compromised if it is starved of oxygen for more than 11 minutes.

There are also other limitations surrounding attempting a VBAC that have influenced my decision.

:: I would need to go into spontaneous labour by 41+3wks otherwise I’d have to have a c/s.

:: I would have to make very specific progress in labour, ie I would have to dilate 1cm per hour, they aren’t keen on giving syntocin to help speed things up, so failure to progress would mean a c/s.

:: If there’s staining in the amniotic fluid , I will be taken for a c/s straight away.

:: If there’s any sign of foetal distress, I will have a c/s straight away.

So, that’s where we are at. Should I go into labour on my own, I need to ring the birthing unit and tell them I’m scheduled and they’ll ask me to come in and I’ll be slotted into that day’s Caesars. I am hoping that I will be able to have the c-section before going in to labour as I will have enough recovering to do from the surgery, but we'll wait and see what happens.

I am hoping to have either a epidural or spinal block, but I will discuss that with the Anaesthetist at the clinic in the coming weeks. Kate will be coming with me for the c-section because Ian doesn't feel he'll be able to cope inside the operating theatre, and I respect his decision. He will spend time one-on-one with the baby when I am in recovery.

A few people said to me the other day “you’re mad for having a c-section” and you may feel that way too, but I ask that nobody judge my decision, because it ultimately is my decision, which I have made based on a lot of research. If you feel the same as the people above, I ask that you do not bring it up with me, I’m not interested in being converted to the natural birth camp or being judged, I would prefer to have the support of family and friends.

I also ask that you are patient with us after the birth, in terms of visiting us and us visiting other people. We’ll contact you when we’re ready for visitors as we want to spend some family time together when the baby arrives, so we can all adjust to our new arrival, Isla particularly. Similarly, with visiting people so they can meet the baby, we would like to take our time to settle in to home life, especially as I will be in hospital for 5 days.


Al & Ian