The Grays

Lillian was born on July 15th and is the most loveable little human ever. She was in the breech position all along and when it came time for her to make an appearance we had some decisions to make. Kristy and I chose to attempt an ECV, which is an external maneuver to rotate the baby out of the breech position and thus allow for a vaginal delivery. This procedure was scheduled for 8:00am on July 15th, with a cesarean scheduled for immediately afterward in case the rotation was unsuccessful.

We learned about the breech position on a Monday afternoon and by Tuesday morning had the ECV scheduled for the following day. The doctors and midwives estimated our chance of a successful rotation at roughly 20%, so we spent the rest of the day Tuesday preparing for a cesarean and predicting if the ECV would work by checking in with our gut feelings. We also spent quite a bit of time packing for the potential hospital stay.

On Wednesday we woke up to our alarms at 4:30am and made it out the door by 5:30. While driving to the hospital I noticed that the sky was covered with a layer of clouds that abruptly cleared in the direction we were driving (towards the hospital). I interpreted this as a sign that we had some work ahead of us before everything would clear and Lilly would be born. I also saw a deer on the way to the hospital which was incredibly calming. Kristy and I also found some significance in the baby chipmunks and squirrels we had first seen feeding on our deck the evening before.

When we arrived at the hospital at 6:00am, both our moms and Aunt Terry were in the waiting room. We said hello, told them we would keep them posted, and then checked in with the nursing station. Our first nurse was April and she explained what would happen over the next two hours. There was some confusion as to if Kristy would be getting an epidural. When our midwife described the procedure at our last appointment she explained that anesthesia would not be used. Somewhere along the way the doctors and midwives had decided that it made sense to use an epidural, and this hadn’t been communicated back to us. April paged the doctor so he could share his plans for the procedure and so that we could meet him before the procedure began.

Our initial impression of Dr. Valice was not great. I was confident that he would do a good job in the OR and just didn’t care much for the way he ‘handled’ our questions and concerns. At that point we needed some gentle hand holding more than anything else.

Around 7:30am the nurses changed shifts and Chris took over for April. About this time they moved us down to a labor and delivery room to finish the preparations. I took a moment to duck out and tell the moms that we would be starting the ECV procedure soon.

Once we were in the L&D room things started to get a little chaotic. The anesthesiologists’ assistant showed up and seemed to think we were getting an epidural and inducing labor. Chris wasn’t 100% sure we were even getting an epidural because it wasn’t standard practice at Beaumont for an ECV and there was no order from the doctor. Just before we reached our wits end, one of our midwives, Danette Lee, came in and immediately set everything straight and did an awesome job of calming us back down.

Our anesthesiologist’s name was Craig and he seemed very in tune and started the epidural with the proficiency of someone who had already performed 100 epidurals that morning. After the epidural was working they gave Kristy a drug to make her uterus relax. One side effect of the drug was that it made her very jittery to the point that her teeth chattered. At this point I focused entirely on Kristy, held her hand, and looked in her eyes so that she would stay as calm as possible.

Dr. Valice came in about when Kristy got the drug to relax her uterus. He took a quick look with the ultrasound and it was clear from his demeanor that there wasn’t a great chance of success with the procedure. He explained that there wasn’t much fluid and the baby had descended into the pelvis. And so we proceeded with diminished hopes. A second doctor came in to assist with the procedure and didn’t seem to have any idea how he could help. I thought about telling him that he needed to push the baby up out of the pelvis while Dr. Valice works to rotate the head down. Thankfully, Dr. Valice explained how the procedure is performed to the other doctor before I opened my big mouth.

Once the procedure started the manipulations were aggressive and I concentrated on helping Kristy stay calm. Out of the corner of my eye I could see Dr. Valice grab the baby’s head and try to rotate it clockwise towards Kristy’s pelvis. On his second attempt he was successful in moving the baby’s head a few inches. After making no progress on the third attempt he threw in the towel and in a very make lemons out of lemonade way told us the rotation wasn’t going to work out and baby was going to have a birthday.

That was an emotional moment for both of us. We were very disappointed not to have a vaginal delivery and at the same time excited that we would meet our daughter in just a few minutes. With a cesarean being major surgery, we were also a little scared.

The nurses had to make a couple preparations for the cesarean and I needed to change into scrubs. One of the nurses said there was enough time for our moms to poke their heads in before the operation so I went to retrieve them from the waiting area before changing into scrubs. After showing the moms into our L&D room I ducked into the bathroom to change into scrubs. After I finished our midwife explained that Kristy would be taken into the OR first and once the sterile field was setup she would bring me into the OR. I asked if there was any chance I could take a small camera into the OR and she said it was fine to take our big SLR. A couple minutes later it was time and I followed Kristy as they wheeled her down the hall and then waived a goodbye as she went through the OR doors.

They had me sit on a chair about 20 feet down the hall from the OR while they setup the sterile field. During our childbirth classes in Virginia we were told that I could be with Kristy the whole time in the event of a cesarean, so I didn’t understand why I couldn’t enter the OR with Kristy. Since our midwife said she would get me in ten to fifteen minutes I didn’t press the issue. After what seemed like too long I started getting impatient, stood up, and starting pacing. Luckily our midwife retrieved me before I got too agitated from waiting.

Once in the OR there was a feeling of calm. There were four people gathered around Kristy’s abdomen (2 docs and 2 assistants) who were working in a very focused and relaxed manner. I knew right away everything was going fine because this team was talking about some intramural basketball game. There was an anesthesiologist and his assistant by Kristy’s head and a pediatrician and her assistant off to the side.

Our midwife led me through the sterile field and had me sit down on a stool by the most important person in the room – Kristy. I asked how she was doing and Kristy said there was lots of pressure and pain in the back of her head. I immediately looked to the anesthesiologist who said without missing a beat that her blood pressure had gone high and they had already given her something to bring it back down and the pressure should be subsiding now. Kristy replied that the pain was now subsiding. This focused and on-the-ball exchange gave me the feeling that Kristy was in good hands.

What happened next seemed like the longest part of the whole day. I had to wait several minutes to meet our daughter. The expectation was that it would take ten to fifteen minutes for our daughter to be delivered, and it may not have been any longer. I was really excited and didn’t want to wait.

One of Kristy’s friends who had a cesarean mentioned regretting not seeing her baby delivered. We had time to think about it before hand and had requested to see the delivery. When the time came, the anesthesiologist assistant (Magda) held up a mirror. There wasn’t much we could see with everyone working around Kristy, and then in the blink of an eye our daughter appeared. It couldn’t have taken more then another five or ten seconds for the umbilical cord to be cut and then we were blessed with her first cry. When the nurse asked for her name, in a chocked up voice I said Lillian Grace Gray.

When we found out that Lillian was in the breech position and could not be delivered vaginally, Bill and I were disappointed and scared.  We had planned for a natural birth with a midwifery practice and were excited to share the experience together.  This last-minute information was hard to digest (we found out on Monday at 39 weeks).

I was initially concerned that Lilly and I would not share the same experience when we saw each other for the first time because we did not go through the hormonal process, etc.   I spoke with other women who had c-sections, including my mom, and heard mixed stories.  I can say with absolute certainty that the moment I saw Lilly for the first time was the most amazing moment of my entire life.  I was overwhelmed with happiness and cannot imagine that I would have felt any differently if she were delivered vaginally.  Bill and I shared in this amazing experience and grew even closer together as a result.

I am VERY glad that we knew about the c-section early and had time to prepare.  I like to say that it was the worst-case scenario of the best-case scenarios, with the end result being a beautiful, healthy baby girl.  🙂

Yesterday during our weekly appointment we learned that our little girl is in a breech position. This news came as a surprise as we have been under the impression for the last several weeks that she was in a head down position (as assessed by two different midwifes and two different doctors). We think she was probably breech all along as the ‘bumps’ in Kristy’s abdomen have stayed in the same place. What we thought was our little girl’s boney butt all along is actually her head.

Kristy and both of her brothers were all in the breech position and our midwife thinks Kristy must be shaped like her mother.  Mark was delivered vaginally (breech) and Todd & Kristy were scheduled c-sections.  Our midwife was very surprised to hear this – only 4% of pregnancies are breech and it is extremely rare to have a breech baby on more than one occasion.  Apparently Kristy is built more like her mom than we previously thought!

We have a couple options moving forward. Since breech delivers are risky (and illegal in 49 states) and there is little chance of the baby rotating on her own this late in the pregnancy, we need to take some action. One option is to try to rotate our baby into a head down position with an External Cephalic Version (ECV) procedure. This procedure if fairly successful around 36 or 37 weeks and is a little more difficult at full term. The doctors think that our chance of successfully rotating the baby at this point in the pregnancy is around 20%. Our other option is to schedule a cesarean. Since Kristy is now 39 weeks and 4 days, we could do a cesarean at any time, and the doctors would prefer sooner rather than later as it becomes more difficult once labor starts.

We have chosen something of a middle ground. Tomorrow morning at 6:00 am we are going to attempt the ECV. We have also scheduled a cesarean for 8:00am so that if we are unable to rotate the baby we will go right into the cesarean. Our intention is to give the ECV an honest try and not make any heroic efforts. If it doesn’t seem like the baby is going to turn without a whole lot of manipulation, then we will move forward with the cesarean.

Our perferred plan was for a natural delivery and Kristy and I had been looking forward to the labor process. So, yesterday’s news was a little disappointing. The important thing is that everyone is very healthy and there is a good chance we will meet our daughter tomorrow!

A few months back Kristy and I watched The Business of Being Born (preview), which is a documentary on the US birthing practice. The overall argument of the movie is that the US medical industry had drifted away from a philosophy that childbirth is a natural process towards an attitude that childbirth is dangerous and requires significant medical intervention to make it safe. The documentary then proceeded to show a couple assembly line type birthing wings where almost all the women received Pitocin to control the birth process (I have vivid memories of the nurses calling out ‘up the pit’). There were also several interviews with practicing obstetricians who claimed they had never seen a natural child birth. One point of discussion was the rapidly changing graph of cesarean rates. It does make you wonder what has changed over the last few years that has caused the cesarean rate to spike (currently around 30%). While the need for a cesarean is often clear in a particular instance, the overall trend is hard to understand.

The documentary then followed several women through natural childbirths that were assisted by midwives. In contrast to the almost 1 in 3 cesarean rate of doctors, one midwife claimed that she delivered over 300 children naturally before requiring a doctor’s assistance to perform a cesarean. Granted, some of this discrepancy could be explained by the difference in populations between the midwife patients and the obstetrician patients. I think the more important distinction to make here is the underlying difference in birthing philosophy between midwives and doctors that leads to such startling different numbers.

We loved our doctor in Charlottesville and would be delivering with him had we not moved back to Michigan. Basically, we liked his philosophy for birthing. Once we decided to move back to Michigan we started looking for a midwife to help deliver our little girl. We would still be fine with having an obstetrician deliver our child, providing they shared our philosophy. Our thinking was that we might have to interview several obstetricians to find one we liked whereas finding a midwife would be much quicker. In fact, Kristy met with three midwives when visiting Michigan and liked them all. In contrast, we meet with a couple obstetricians and were fairly turned off by their attitudes.

Not too much news here.  I’m getting a little bigger every day (this week I am the length of a stalk of leeks – un puerro) but for the most part I’m ready to make my appearance!

Mom is still feeling good and energized.  Some days she is more tired than others, but she is sleeping well and continues to exercise 4-5 days a week.  She isn’t seeing any obvious signs of labor but feels more and more ready each day for things to get started!

Getting Ready for Baby

With the due date in just accouple of weeks we have been brushing up on ‘what to expect’ during labor & delivery, breastfeeding, and the initial weeks with a newborn.  Here I am in the middle of a study session – surrounded by our Martha Jefferson class materials and books that I read recently.  We finished the last of the classes – child and infant CPR (30 compressions to 2 breaths!) – last week.  Now that the house and the nursery are done it has been nice to spend time relaxing together and preparing for the baby.  Bill has also been really involved in this process and is currently reading ‘Heading Home With Your Newborn’.

Most of the couples in our labor & delivery class, as well as our friends Dean & Melissa and Todd’s friend Erin,  have had their babies recently.  We have enjoyed hearing their stories – one woman delivered in 4 hours and, most recently, a friend who planned for a natural birth at home had a 47 hour labor with two surgeries that ended in a C-section.  We are prepared (well, sort of…) for anything!

Over the past few weeks we have taken several classes to prepare for the arrival of Baby Gray.  These classes are all offered through Martha Jefferson Hospital.  Monday evenings we attend a 2-hour preparation for childbirth class that meets over a period of 6 weeks. This class details the stages of labor, how to be a helpful birthing partner, breathing techniques, complications, etc.

On the first day of class the ‘birthing partners’ were asked to get into their favorite birthing position.  I’m pretty sure the instructor had every intention of embarrassing the guys and making the women feel more at ease.  Bill immediately went into a squatting position with his butt in the air – it was rather amusing.  Since then we have learned many birthing positions for early labor and later stages.  Our favorite is the ‘8th grade prom’ (I lean on Bill and wrap my arms around his neck while swaying) and using the exercise ball.  We have both been doing yoga 2 times a week and hope that some of these positions are helpful during labor as well.

Last week we were given two ice cubes and asked to squeeze them as hard as we could for two minutes and pretend it was a contraction.  Bill and I liked this exercise and coached each other through breathing to cope with the discomfort.  I will never think of an ice cube in the same way again…

Today we went to the basics in baby care class and we have yet to complete breastfeeding (Bill is really excited about that one) and infant CPR classes.  The classes have definitely been helpful but we’ve also just about reached the threshold of information that we can handle for now.  Bill is complaining about the lecture format of the classes – the Darden case method has spoiled him forever!