hello, little man!!

welcome to the world, George Nicholas! our fifth baby was born two weeks early, completely upending my previous delivery pattern -- all of his sisters were born just before or up to 10 days after their due dates, except for Victoria with a scheduled induction at 39 weeks. a 39 week induction was the plan for baby boy too, and our dear friend Amy had requested the day off work to come doula for us again, bless her! my coworkers kept telling me I was going to go early with him and I kept confidently responding, "oh no, my babies like to stay cozy in here!" as I left the office on Friday (at 37 weeks 2 days pregnant), I told them, "see you Monday!" they all looked at me and said, "well... maybe!" and I reassured them that I would be there. 

the last "bump" photo I have, on July 4, just 9 days before baby would make his appearance! 

Amy texted me that weekend to see how I was feeling. baby boy was definitely sitting lower and I was having some intermittent cramping. no sign of imminent labor, I told her, but since I was already dilated to 1 cm at my 36 week appointment, things were looking favorable for the induction. all our ducks were in a row: Mom was scheduled to fly in the next Friday, so she'd arrive in plenty of time to stay with the other kids during the induction the following Wednesday. our amazing neighbor Kim had also told us that if anything happened before Mom arrived, she'd be happy to help. 

the only outstanding project was moving from our upstairs master bedroom to the downstairs bedroom, our previous guest room (with plans to convert the master bedroom to a kid room). I had my doubts that everything would be in place by induction day, but also, Nick was doing 99% of the work (replacing a light fixture and fan, painting, moving furniture, etc) and the 1% of work I was physically capable of at this point I was feeling very unmotivated to do. my motto at that point was que sera, sera. I did have the cosleeper all set up, baby's clothes washed and stored in a rolling cart for portability, the changing station set up in the bathroom, the car seat and swing inserts freshly washed, my hospital bag packed, and five or six meals stashed in the freezer so, technically, we were ready! 

that Sunday afternoon, when I was 37 weeks 4 days along, I drove Greta and my friend's daughter ninety minutes north to sleepaway camp for the week, with plans for my friend to do the pickup run the next weekend (my idea, so it wouldn't be too close to my due date). I felt completely fine on the drive up. for some reason, throughout the second and third trimesters, I had been having frequent Braxton Hicks while driving (although not when riding in the car as a passenger), and this time there were only a few. by 6 PM, the girls were settled and I headed back.

Greta had lots of "help" making her bed

on the way home, I picked up pizza to share with a few of Nick's friends who had come over to help him get his Galaxie back up and running. that steak ranchero really hit the spot! around 8:30 PM, my office manager texted to confirm if I was still coming into the office the next day -- I planned to work my usual Monday/Wednesday/Friday schedule until baby's arrival, but starting that week we were blocking the schedule until the night before to minimize rescheduling patients if I went into labor or wasn't feeling well. I told her we were on for tomorrow, and eventually went to bed. 

around 1:30 AM, Elizabeth woke up asking for a drink of water. after I got it for her, I just couldn't get comfortable in bed. I was having a lot more cramping and general discomfort very similar to the prodromal labor I had with Greta. I kept dozing off and then waking again to shift position and go to the bathroom. eventually I took a Tylenol and was able to sleep a bit. then I woke up at 3:45 with a distinct contraction. I thought, ugh, work is really going to be miserable today without getting much sleep. ten minutes later, there was another contraction. hmm. I wonder how dilated I'll be at my 37+6 week appointment on Tuesday. seven minutes later, another contraction. I re-downloaded my contraction timer app and just laid there, trying to get back to sleep. five minutes later, another contraction, and a notification popped up on the app: "we recommend gathering your bags and going to the hospital". that's ridiculous. they should be five minutes apart for an hour before going to the hospital. then, three minutes later, another one, and another one. it was 4:30 AM and I was still in denial. with Greta at camp for the week, and my mom not arriving until Friday, we would need to contact someone else to watch the kids and I hated to wake anyone that early in the morning. but I also did not want to chance another sidewalk baby, and I didn't want to get to the hospital too late for an epidural -- after four unmedicated births, I had decided to opt for the drugs this time for a few reasons. the first was genuine curiosity about what the experience would be like! the second was that I'm old and tired and had a fair amount of back pain and general discomfort with this pregnancy, so the idea of pain relief in labor was quite appealing.    

so, I reluctantly woke up Nick and told him I was in labor. he shot up out of bed faster than I have ever seen him move, which was particularly amusing because he's usually slow to wake up. I tried to convince him to wait until 6 AM to contact our neighbor, but he wisely refused and she came over within ten minutes, God bless her! I told her she could sleep in Greta's bed until the kids woke up and she said, "oh, I'm too excited to sleep!". 

by this point the contractions were coming every 2-3 minutes. I couldn't talk through them but, as I reassured Nick, "I'm not making noise yet". my hospital bag was already packed so once he threw his things in, we were on our way at just after 5 AM. as we drove, he called his parents to let them know, and I texted my manager: "just kidding ... we're on our way to the hospital!" I was bummed that Amy would miss this birth since she was working, and was even more determined to get that epidural knowing that we wouldn't have her support.  

in triage, I couldn't sit down through the contractions, which made me nervous about how far along I was (even though active labor had started less than two hours prior). I felt like it took forever for them to call me back to a room, and then even longer for the resident to come in to check me. with every passing moment I was more and more worried that I'd miss my window of opportunity for the epidural. finally the resident came in and said my bag of waters was bulging but she couldn't reliably tell how dilated I was, so they paged the attending to come check. I had to lie flat back on the bed for the cervical exam and absolutely could not tolerate being in that position during contractions so they had to wait for the narrow window of opportunity in between to check. I remember feeling bad about keeping them waiting but they were all so encouraging and kind! Nick was great with counterpressure on my hips and back too. but mostly, I just wanted the drugs! 

finally the attending checked me and said I was 9 cm. the resident cheerfully announced, "okay! so we're definitely keeping you then" and I wanted to yell at her, "this is my fifth baby and I have a history of fast labors -- you are definitely keeping me and you'd better get me upstairs before I have this baby in triage!" in retrospect as I type this out, I must have been in transition at this point :D 

the nurse paged anesthesiology to meet us in the L&D room upstairs and then set to work getting IV access. she stuck me twice in the left arm and couldn't get it (she did one stick during a contraction which at first I thought was kind of cruel, but then realized made a ton of sense from a distraction perspective!). they decided to hustle me upstairs and try again for the IV up there. I told Nick (with, ahem, slightly more colorful language), "I'm going to be so mad if I don't get this epidural!". one nurse paged anesthesia again while another one finally got IV access in my right hand. then the anesthesiologist, looking like a redheaded goddess, walked in and explained the procedure, risks, benefits, and had me sign the consent form. she said as long as I wasn't actively pushing and as long as I could hold still for the epidural placement, they could still do it.

as she was setting up her sterile field, I had one contraction where I felt slightly pushy, but told myself "ABSOLUTELY NOT". I'm sure Nick could hear the change in my vocalization but he didn't say anything about it, and I had a few more contractions that didn't feel pushy at all. then she asked if I understood everything. "yes!" "do you want me to talk anymore about the procedure?" "NO!!" to her credit she was not offended by my terse responses! but when she wanted me to sit on the edge of the bed with legs in butterfly position, I just could not possibly do it -- it put way too much pressure on my pelvis to draw my legs up like that. she said it was okay if my legs were down normally as long as they were at symmetric angles to each other and the nurse helped me position and curl over a pillow. once I was in that position, I just willed every muscle in my body to stay completely still. first there was a little pinch and burn from the local anesthetic, then a few seconds later she said, "I'm in!" and a few seconds after that, a blessedly warm numb feeling cascaded down my back into my bottom and legs.

I had another contraction that I could still feel in my lower abdomen, but that intense pain and pressure that had had me scrabbling at the bedrails was gone. and in another few minutes, the abdominal pain was gone too. I could still feel the contractions but they were completely painless, just a sensation of tightening and relaxing. even more amazing was the fact that I could still move my legs! they felt pleasantly tingly and warm (as if I was sitting in a hot tub at the perfect temperature), but I was still able to shift positions independently. there was such an exquisite reprieve, both physically and mentally, that I asked Nick why I hadn't ever done this before?! I thought about stories I had read of women napping until it was time to push, but I felt way too excited to sleep. I just wanted to revel in the warmth and relief!

6:30 AM. we can call this photo Portrait of an Epidural. God bless that anesthesiologist! also, the crazy amount of tape on my hand was on purpose to make sure that pesky, third-time's-the-charm IV didn't go anywhere. after delivery, a different nurse was appalled by the tape job and while I understood it didn't look pretty, I told her I would happily have had my whole arm duct taped up to preserve that IV access.

about fifteen minutes later, the nurses were back. baby's heart rate was dropping during contractions. they had me lie on my left side, then my right, then flip onto all fours. no matter what position they had me in, his heart rate was still dropping, although it recovered well immediately after the contraction stopped. I remembered that they had had trouble picking up Elizabeth's heart rate with the monitors right before I started pushing with her, so I thought maybe it was a similar issue with baby boy and said "that's probably not a real heart rate, right?" when the nurse told me they were accurate heart tone readings, I started to worry. maybe this was all a result of getting the epidural and I was about to experience the notorious "cascade of interventions". but my own vital signs including blood pressure, heart rate, and oxygen saturation were all normal, which argued against the epidural as the cause. the nurses hypothesized that the umbilical cord was getting compressed, either from a knot in the cord or a short cord.

this all coincided with shift change. the nurses grabbed the OB coming on service, who just happens to be one of my favourite doctors in the group, to come look at the monitors. she also did not like what she saw, and when she checked me and I was fully dilated, she had me start pushing right away. "we need this baby to be born!" she said. 

now here was the one downside to the epidural: I couldn't feel a darn thing. even with all my muscle memory, my best efforts at pushing weren't moving baby down one iota. his heart rate did seem to stabilize for a little bit, so the OB recommended waiting for a bit to let my contractions work him further down naturally, but she stayed in the room to watch closely. (this was such a different experience than my previous births where the OB pops their head in, checks me, and doesn't return until it's baby time!) 

then he had a few decelerations in a row, and she calmly explained that we absolutely needed to get this baby out soon. she recommended turning down the epidural so I'd have a bit more feeling and using a vacuum assist once baby crowned to make sure he was delivered quickly. if we weren't able to get baby moving, we'd need to consider a C-section. let it be known that my two wishes for birth have always been, in order: 1) healthy baby and healthy mom, and 2) not to end up with a C-section after already going through a full blown labor experience. since this labor had been so quick and I had the epidural already, I wasn't so devastated by the idea of a section, but I obviously would prefer not to have major surgery if avoidable.

so, they turned down the epidural, and I was able to feel a more distinct pressure sensation so I could direct my pushes. and oh, my goodness, did I ever push. I thought blood vessels were going to pop in my face (they didn't). if it was going to come to a section, I wanted to feel confident that I had done everything in my power to avoid it (solely because of the prolonged recovery with a C-section, including the fact that it would mean taking blood thinner injections postpartum since I have factor V Leiden, a genetic condition that predisposes to blood clots). and also, I felt so incredibly grateful to be in a hospital setting with an experienced OB whom I trusted to make the right call if the time came.

after just a few minutes of pushing, she said, "stop! hold it right there!" she applied the vacuum and then said, "okay, now just a whisper of a push" and announced that his head was born. usually delivering the baby's head is the most intense moment of childbirth -- it was absolutely surreal not to be able to sense it at all! and a few seconds later, after some maneuvering, he was born at 7:40 AM. 

that moment of seeing your newborn for the first time never gets old. as I snuggled his slippery body up to my chest, I was overwhelmed with gratitude for his safe arrival. and then, for the first time ever, I was able to cut my own child's umbilical cord! the OB offered for Nick to do it but he was feeling a bit overwhelmed in the moment so I gladly did the honors. the OB then announced that baby's head was at angle and his left hand and arm were over his face when he was delivered, known as a compound presentation. this was why the umbilical cord had been getting compressed with each contraction, and also why baby hadn't been descending well with my initial pushes. there were no knots in the cord and his Apgars were 8 and 9 (normal). so not only was the epidural not to blame for the heart rate problems, it was an absolute blessing to have it on board -- an unmedicated delivery of a head and an arm simultaneously did not sound like a good time. 

I could just look into his eyes forever!

the pediatric team was in the room to check him over given the heart rate issues as well as his known urinary tract dilation (diagnosed in utero, currently being treated with a low dose of antibiotics once daily to prevent UTIs with plans to follow up with pediatric urology at 6 weeks). they said everything looked great and he snuggled back up with me. 

a good set of lungs and lots of vernix! baby weighed 6 lb 14 oz and was 19 3/4 inches long, at 37 weeks 5 days. if he had stayed in until 39 weeks, I'm sure he would have been our biggest baby (Cece and Greta still hold the tie for "biggest" at 7 lb 5 oz at 41 weeks 3 days and 40 weeks 3 days respectively; Elizabeth was 7 lb 2 oz at 39 weeks 6 days, and Victoria was 6 lb 3 oz at 39 weeks). 

the classic Simba pose

during all of this, I was blissfully unaware of whatever the OB was doing down below, if you will, until she asked me if I had ever had a retained placenta with previous deliveries. um, no. we were approaching the hour mark after delivery, when the risk of postpartum hemorrhage increases if the placenta has not delivered. unbeknownst to me (thank God for that epidural!), she had been attempting a manual extraction, gently sweeping between the placenta and the uterus to encourage the placenta to detach. she said if she couldn't get it to release within the next 15 minutes, we would likely need to go to the OR for extraction. she ended up paging anesthesia to come back up and administer nitroglycerin to allow the uterus to relax because it kept contracting hard down around her hand and preventing the placenta from detaching. the postpartum hemorrhage cart was on standby, which was simultaneously terrifying and also reassuring. once again I was so grateful to be in the hospital setting! 

that darn placenta still would not come out. she kept working and actually paged the other attending OB on call to help her because her hands and forearms were starting to cramp up. shortly after the other OB arrived, all of a sudden, the placenta finally detached and thank goodness it was intact! no postpartum hemorrhage. I was incredibly grateful for the epidural anesthesia during all of that mucking around. I told the OB that we both needed a drink! 

after staying in my room for almost two hours (40 minutes from the start of her shift until delivery, monitoring baby's heart rate and performing a vacuum assisted delivery, and then another hour dealing with that pesky placenta), the OB finally said goodbye and we thanked her profusely. the concept of an OB delivering my baby had rung a bit hollow for me in the past -- my labors are so fast and furious that I always felt that I was the one delivering the baby (which, in a sense, is always true). with this birth, I truly feel that she worked harder than I did! I am so thankful that she was able to avert taking me to the OR not just once, but twice, and beyond that I was grateful that she was the one on call that day because I knew she would do everything in her power to facilitate a vaginal delivery as long as it was safe for baby and me; if she had said we needed to move to the OR, I would have trusted her clinical judgment completely. 

over the next few hours, we snuggled baby, I nursed him a few times, and we continued to deliberate over his name. throughout the pregnancy, I really loved the name Peter Leo, but he just did not look like a Peter to me. the boy name we'd planned to use from the time we got married was George (a family name on Nick's side), but we hadn't settled on a middle name. with a one-syllable first name and last name, I felt strongly about a three- or four-syllable middle name. we discussed various options (Benedict? Frederick? Christopher?). finally, Nick suggested Nicholas. I immediately loved it -- it continues a naming pattern in his family (giving a son the father's first name as a middle name), plus St. Nicholas is a wonderful patron, plus the wonderful OB's last name just happens to be Nicholas. as I write this three weeks later, his name continues to suit him perfectly!  

I watched him make this duck lips face in several of the third trimester growth scan ultrasounds!

such a little old man with those big ears, and all that hair ... no wonder I had to take Pepcid Complete every day

proud Daddy!

all three of us took naps that afternoon

after all of that craziness, recovery was about as easy as recoveries go! Nick's parents drove out to stay with the kids and then Nick went back to the house and they traded places, coming to the hospital with Cece to meet the baby. I called Greta at camp to tell her the news and she was so excited (but perfectly content to stay at camp for the week instead of coming home early!). 

she said, "I GUESS I'll forgive you for not naming him Peter"

George screamed through his first sponge bath that night and then gave me this reproachful look when he was finally swaddled back up. it's so hard to be a baby (but just look at that fuzzy little duckling head!).

the adorable flower arrangement Nick's aunt sent 

we came home from the hospital the next day and Elizabeth and Victoria were so excited to meet their baby brother! Kim continued to help with the kids and also spent a few afternoons painting the downstairs bedroom to expedite our move (she's truly the best).

my coworker's wife made this blanket, which I foresee becoming his lovey!

riding home in style

please note Elizabeth pouting when it was Victoria's turn to hold him

so proud to finally be a big sister!

first snuggles with Miss Kim

the painting queen in action. we truly can't thank her enough!

on Friday, Mom arrived and it was great to have her here! she snuggled George, played with the older kids, decluttered and organized our toy shelves (which was a truly herculean task), and sent me upstairs for a cry and a nap at 5 days postpartum when allllll of the hormonal weepiness hit full force. 

Mom also bought us a new set of nonstick pans which was desperately needed. my omelettes have never looked better!

meeting Aunt Becca

"he must grow up to be a reader!" Cece declared

little yogi

nursing snuggles. his latch has been good but he doesn't transfer milk well. after a nutso week of triple feeding (nursing, then pumping, then bottle feeding) I decided to exclusively pump. he occasionally still nurses for comfort in the evening, but it's a relief to know that he's getting enough milk! 

Greta arrived home from camp on Saturday and was smitten with him too. both Greta and Cece have been such big helpers, snuggling him, feeding him bottles, and even making dinner! they both draw the line at changing diapers, however, and I can't say I blame them. 

Greta's contribution: pesto pasta with sausage and roasted broccoli

Cece made tacos. (the beer is courtesy of my dear friend Autumn, who brought us dinner and included a few beers just for me! she knows me so well)

sweet baby George, we can't imagine our family without you!!