The Day We Went Into Labor & Met Our Little Leaf

It's helpful for me to just tell this whole segment of birth & being with Leaf together, in one fail swoop, even though it's a bit longer. We'll talk about the losing Leaf in the next post... So sorry if you've been in this situation. Please be advised it may be triggering for some.

Tuesday morning we drove down to Denver for our weekly OB appointment in Denver, and brought Cord with us so he could meet with the child-life specialist. It was fun having him there, with so many child-friendly displays on the hospital floor we were on. He loved it! And we loved having him at the appointment with us, being a part of the process. We had been leaving him with family, mostly so we could be present for Leaf and our special time with her.

At this visit, they did all the normal things, and Leaf's heart was still beating. That's always a bit of a breath- holder for us (they repeatedly told us she might not make it to birth... that meant we wouldn't be able to meet her alive). She had been kicking, and I could feel it, which was reassuring, however I couldn't feel the kicks as well since there was so much fluid in my belly. I'd been having stronger contractions, so they also checked my cervix to see if I was dilating, but first checked to see if I was leaking amniotic fluid (I had a hunch it was not just discharge). It tested positive. Yay! ... quickly followed by fear filled my body. And my cervix was thinning out, so it was decided we'd be admitted to the hospital that day.

It was noon-ish by the time my sister Leah came and picked up Cord, and Brian and I made our way over to the delivery floor. It felt so weird to not have Cord with us, but knew we needed to be present during this time. It was starting to blizzard outside.

I was filled with so many feelings, excitement to meet Leaf, but also to finally have some forward movement in this journey of ours. Equally being held in the other side of my heart, was this sense of dread, the dread of not knowing if we'd have her for moments, or a year+. I see these rare cases of Trisomy babies living years, and while I hold hope for that, I also think those babies are probably getting surgeries. So many unknowns lie ahead of us, and I sort of felt eager to finally be knowing what our reality would be. I was terrified of not having my baby in my arms... at least right now I had her in my belly, and there was nothing anyone could do to take that away from me. I could not even make space in my brain to conceptualize what it might feel like to say good-bye to Leaf. There was only so far into the future I could go.

Journal entry from 11/11/2014

"Ok team. We went in for our weekly OB visit today and found out that we are dilating a little (cervix opening), effaced (thinned) to 80%, and leaking amniotic fluid. So they admitted us to the hospital PSL. My water broke at 1:30, and we are having some contractions to write home about.

Those big question marks about whether baby Leaf will survive birth, whether her brain will tell her lungs to breath, and whether she will have an esophageal atresia (a disconnect in the tube from her mouth to her stomach) will soon be answered. Then we will go from there, I suppose. We'll probably not update this for a while, unless Micah and Lindsey or my sister do. We just will want to be as present as possible through this time.

Love each of you so much, and appreciate your prayers, grounding, and truths through this time."

In the Hospital Room

Brian and I got settled into the labor & delivery room at the hospital- so much stuff. We had all our clothes, but also all the memory-making things we were given for birth. Being in the hospital for a birth was a little awkward for us since our original intention was to have this baby at home. Being a nurse, I was very familiar with what hospital birth looks like. And I know my husband. I love him dearly, but his gifting is not advocacy, especially in an intimidating environment (staff, doctors, nurses, etc.), so I was a little nervous to be in a vulnerable

(labor/birth) situation and also have to stand up for our preferences and the way we'd like this birth to look... I gave the nurse my birth plan, and she looked it over at the nursing station. In our room, I menitoned quietly to her that we'd originally been intending on a home birth, and were feeling a little out of place with the change of plans and situation. She was reassuring and seemed sweet. She had a nurse in training working with her. Both their names were Jenna. Unfortunately, the unpleasant MD from the prior week's visit was on tonight... ugh.

Brian and I walked the halls of the hospital to see if my contractions would get a bit more regular. My water officially broke, and contractions got as close as every 7-8 min apart (good, but still early labor). We did this for hours, then stopped and took a break. Things slowed down. We missed Cord so much, and asked my sister to bring him back over to the hospital (in the middle of a blizzard). She said he napped on the way, sweet little guy, he'd had a long day too. They hung out with us, I sat on the birth ball, and then Leah rubbed pressure points on my feet. Cord helped. Then Cord got on the birth ball, and used it as a trampoline. I got in the tub... Cord got in the tub. Cord told Leaf hi, and kissed her (my belly :). Brian took a much needed nap. It was such a sweet time for us all.

Leah and Cord ended up leaving and Brian and I walked a bit more. At 6:30 we walked the halls for almost an hour and had measurable contractions 4-6 min apart. Brian and I looked at the beautiful pictures on the walls, talked to the nurses along our many laps, many of which we’d become close with over the previous visits (what a beautiful little community of people between that OB floor, the OB office (same doctors), and the office that helps coordinate special circumstances (genetic specialist, nurse coordinator, child life specialist, NICU MD, etc).

Excerpt from a journal entry at this time

"Many of the people we've met along the way came specially by our room to give us hugs and cry with us. Really? It felt like our little Pagosa family, but in the big city… God’s beauty shines through AGAIN. In the midst of this challenging situation, there is comfort & friendship… "

After walking for an hour, we took a break and ate some dinner, thinking maybe we had started something. We were starting to feel the weight of the day at this point. “We” ;) watched a baseball movie for a bit and I laid down to close my eyes at 9pm. At 10, I noticed my contractions were waking me up between resting. Eventually my contractions required a little more presence from me, and at 11:45 I got up and ran another bath. Brian was resting,

and I let him be. I thought maybe I could labor in the tub, in the bathroom and relax for a bit. A few minutes later Brian joined me in the bathroom, and sat on the birthing ball beside the tub.

We weren’t timing contractions, but after about an hour we noticed there were 3 in a row...

Geez! Not my favorite. And such a sweet thing, that I could be in a hospital setting and still

setting and still have my uninterrupted quiet laboring time in the tub. I felt so blessed-God knowing my heart and caring about the tiny details of my preferences. At 1:00 am my nurse came in and checked by cervix. I was 80% effaced (same as when I was admitted), dilated to a 3 :( , and -1 station (baby was starting to engage). That wasn't great news, but now at least we knew where we were at. I was not very excited, and imagined many more hours of this.

The nurse left, and Brian went back to bed. I had the nurse turn the lights down in the bathroom and I rested my head back between contractions.10 minutes later I felt the need to go to the bathroom. I awkwardly got up and out of the tub. I got a contraction between the tub & the toilet... I squatted through a contraction, or 3, and then sat down on the toilet. Moments later I realized I was having another contraction. I quickly met the contraction where it was, squatted by the tub, deep breathing through it. I sat back on the toilet, and still felt like I needed to go to the bathroom. Then my legs started to shake. I was getting a sensation that baby Leaf was “right there”. Not possible, the nurse JUST checked me. I asked Jenna to come in the bathroom. She read my body language and eyes… she was visibly assessing the situation, with me on the toilet. Then the words all came out, from us both, at the same time! She very quickly helped me to the edge of the bed, hollered for help, and calmly helped me lift my legs up. As the undeniable feeling to push came, she hollered again, that we were “having a baby NOW”. Brian jumped up, met me at the bedside, held my hand, and encouraged me. Nurses filled the room, questions rambled as I closed my eyes, still trying to “meet” my contractions.

“Where’s the doctor?!”

“He’s on his way!”

“This baby is coming NOW!”

“It’s ok…” my nurse said calmly... “If you need to push you can. She’s ok, she’s ready, and you are too.”

“Do we need to call the NICU nurse?!” Another person shouted.

Then the wave that couldn’t be stopped, overcame me. She was coming… the nurse encouraged me, Brian held me, and Leaf joined this world. I couldn’t see anything because I was barely on the edge of the bed. The nurse asked, “Can you push?” I tried, but no more contractions came for what seemed like an eternity, just a couple deep breaths before the shoulder push. Then came the rest of the body.

1:14am 11/12/14

Leaf was born. I was crying, Brian was crying, and because I was lying on my back, I couldn’t see if she was alive. I found myself repeatedly asking/sobbing if she was alive…begging to have her on my skin, on my chest. The umbilical cord wasn’t long enough… Daddy cut the cord. I heard Leaf start crying. We cried. I held her on my chest. The whole room was crying.

Leaf had black hair on her little head, where that came from, I have no idea. I didn’t have hair till I was 2, and Cord still hardly had peach fuzz at 2 years old. Her skin was covered with vernix (white cream) & lenugo (thin hair covering the body), both signs of a premature baby. She barely opened her right eye, then gently peering up at Brian & I. I held her precious tiny little body against mine. I had on a swim suit top, and had the nurse untie the back so it could be just she and I, reunited body against body again… It was still not enough. She was sadly separated from me, and the only environment she would be able to thrive in.

Sure enough, apart from the placenta, she was not happy (while connected to the placenta, she had all the oxygen and food she needed. Her lungs and heart didn't need to work as hard). Her profusion was very poor from the start. Her body was pink, but all her extremities were cool and purple, a sign her heart was not ready life on this side of my body. Brian noted that she briefly had a less purple time just after she was born.

Not long after Leaf joined us, the nurse gave me a large dose of Pitocin, all at once (to help the uterus contract & help the placenta out). The concern was that my uterus would not contract correctly since it had been overtly distended for so many weeks & that the placenta wouldn't come out as quickly as it needed to, which could lead me to bleed too much (hemorrhage). This was the main reason I was told I needed to be in the high risk hospital in the first place (now that I'm a midwife, I know you can get Pitocin & other antihemorrhagic

drugs in both the birth center & home birth settings) . My legs started shaking uncontrollably. The unbearably strong cramping started. The nurse handed Leaf to Brian. I tried to breath through the intense contractions. The placenta came out. The doctor came in, checked the placenta, checked to make sure I didn’t need any stitches, told me congratulations, said all looked good to him, and that he would check in on me later. I love how God orchestrated my hospital birth that had many parts of what a home-birth would've looked like (middle of the night, laboring in water, private & nobody in the room, limited doctors, etc). I felt like he was shining down on us even though the situation was not ideal.

After the dust settled and the nurses left the room...

We had some sweet moments with Leaf. It felt surreal to meet her, to hold her & to watch her be alive and breathing... It felt a little like the balance between enjoying her and memorizing her little face, but also waiting to see how long she'd live. We didn't want her to die, we wanted to pretend like she was our new baby, and we were going to take her home. We wanted to talk to her like any parent talked to their newborn, cooing and adoringly. And deep inside we both knew she would not last very long. So we held her close, loved on her constantly, took too many videos and pictures, and cried when we remembered she wasn't going to stay with us.

As Leaf was breathing, we kept noticing a wheeze with every exhaled. At first it sounded like a sweet baby noise, but we realized as time went on, that it was her struggling with every breath. She also had flared ribs and retractions along her collar bone. Her whole body, tiny as it was, moved with each breath, all signs she was having a hard time breathing. She kept gurgling her spit, and we kept using a suction bulb to get all her spit out, a sign her esophagus wasn’t connected properly to her stomach. When she first was born & laying on my chest, she let out some strong cries and raised her head, but as a short amount of time went by, she became more and more limp. Not anything like when my son was born, who had the opposite progression. There was an awareness that Cord had that Leaf did not. She was struggling so hard just to spend time with us, just to take the next breath… In some parts of our time with her, it hurt us to know that she was struggling, and that her tiny body was having to work so hard. It was heartbreaking. It was hard for me to see her purple… In some ways I couldn’t even really enjoy my time with her because I wanted so desperately to help her. We were entering the "comfort care" part of this journey. We were offered, and did give her morphine to help her breathe with more ease, as she progressed towards saying goodbye.

Brian and I had Leaf all to ourselves until the wee hours of the morning. We both cuddled up facing each other in the hospital bed, my legs bent over his, holding Leaf between us. The sweetness of these moments, at 3 & 4 in the morning... what a true blessing that was. I will forever remember (hopefully) those precious moments. Brian took a ton of videos, never enough though, now that we’re on the other side.

I keep looking back at our birth experience with such appreciation. If we'd had Leaf In the middle of the day, we would've been bombarded by people, company, food trays... but instead we had the coziest, quietest, most private time to cherish with our little one. We'd only have her a short time, but it was perfectly perfect.

After a few hours, we felt really drawn to have our whole family together, including Cord. Leaf was starting to go downhill, and around 5:30, through my tears and sobbing, I asked my sister to bring Cord down to the hospital as soon as possible. It had started snowing on Tuesday when we checked in, and had progressively worsened. By Wednesday it was full blown terrible weather, and it was effecting travel times for everyone, but we were desperate for Cord to meet Leaf while she was still alive.

Next up, Cord meeting Leaf, saying good-bye to Leaf, family pictures and the memory making we'd cherish forever.