Tuesday, April 12, 2011

Our little miracle - Hyrum Jacob

Hyrum Jacob was born Sunday, April 10th, 2011 at 6:32 AM at a home water birth. He was 9 lbs even and 22.5 inches long.

I could always get a sense of my kids personalities while they were still in utero. Mostly just based on how they moved or the way they responded to outside stimulus. But there was something about Hyrum's pregnancy that was stopping me from feeling like I could get a good sense of who he was. I knew he never stopped moving. When he was smaller, I could literally feel him bouncing from one side of my uterus to the other. During my midterm ultrasound, the ultrasound tech was annoyed at being unable to get good shots because he would not hold still. Even when he was filling every possible space inside me, it was like he was one of those people who always tap their foot or shake their leg when they're holding still. It was rare for him to hold still.

But I was having a hard time imagining a child more hyper than Gabe. Gabe was a mover and a shaker and he still is, but he didn't have this constant hyper activity level that Hyrum did. For some reason, I just couldn't imagine Hyrum as a kid that was going to give Gabe a run for his money. It just didn't feel like that's who Hyrum was. So why did he move all.the.time?

Then there came a day a few weeks ago when Hyrum got really, really quiet. He was giving me courtesy nudges. Like "hey, mom..still here" but it was't his normal movement and I got paranoid. I had been worried for a long time about Hyrums birth. I had a feeling it was going to be harder than my other kids but I didn't know why. I came up with all sorts of possible scenarios that I didn't want. Everything from emergency c-section to still birth to back labor to induction, etc, etc. So this day that he got really quiet I asked Dave for another blessing. In the blessing I was assured that Hyrum was okay and would be okay and the birth would go well. I was reminded that we'd been praying daily since I got pregnant that he would be born healthy and strong and the birth would go smoothly. Every prayer the kids said ended with "and bless Hyrum to grow healthy and strong." Every single one. I was reminded to continue to pray and read my scriptures for guidance and stay close to the spirit and I'd know what to do. After the blessing Hyrum perked up and was back to his state of constant motion.

So I tried to follow that counsel. One thing that came from this was the birth pool. I had planned a water birth with Clara but her labor went so quickly that we never even got around to filling the pool. So with Hyrum I wasn't originally going to do a water birth. My midwife even asked and I said no. But over the next couple weeks I thought about it a lot and felt prompted to prepare for a water birth after all. I knew my placenta was anterior and I knew this could cause the baby to be posterior which meant back labor and I figured if nothing else the pool would help with that. So with only a few weeks til my due date I went ahead and got the necessary things for the water birth.

Then it was countdown time. All my other 4 kids were born early and although I know that every pregnancy is different, I didn't really expect to make it to my due date so when I not only was pregnant until my due date but past it, I got pretty discouraged. My blood pressure was a little high and I was having this constant inner battle of wanting to rest to keep my blood pressure down vs wanting to keep moving to try and get the oxytocin flowing for contractions.

I was also terribly worried about going so far past due that I'd be forced into an unwanted induction and I knew that just didn't feel right. Dave and I were arguing back and forth over the safety level of going way overdue vs the safety level of induction and interventions.

I still walked to the park, swung on swings, bounced on the birth ball, ate spicy food, took my evening primrose oil (and other prostiglandins *wink* *wink*), and one of my friends even called this bakery in Virginia that supposedly makes a lemon cupcake that induces labor. They didn't have a delivery service though.

Anyway...my point is I was a little stressed. And I knew Hyrum needed to get out but my only real recourse to get him out was prayer. So I prayed and I waited.

We decided to have Mom go ahead and come up even though we had no idea when I'd have the baby. But it was spring break and I was spending all my time in bed and my poor kids were being neglected. So Mom came and made their last couple days of spring break special.

On Saturday the 9th, another friend, Tiffany, decided to make homemade lemon cupcakes for me since nothing else was working. She brought them over and I had two. They were delicious but I really didn't think they'd do anything. Later that night, I was reading my scriptures and I came across a phrase like "the hour is at hand" in the Doctrine and Covenants. I asked Dave for a blessing again that night and I was told again that he would be born at home and everything would be okay.

I'd been resting a lot. Taking a couple naps a day and sleeping quite well for 9 months pregnant. I went to bed that night around midnight and woke up to use the bathroom at about 1:30. I laid back down and realized I was having contractions that hurt more than usual. I stayed in bed til about 2:15 just timing the contractions and waiting for them to go away because they always did. But this time they didn't and I realized I was already starting to breathe through them. I went ahead and got out of bed and wandered around the room timing and breathing. I woke Dave up and called Margaret at 2:30.

Contractions were anywhere from 4-6 minutes apart by now and I was starting to moan through them. I was sitting on the birth ball and could feel the pressure from the bag of waters. We started filling the birth tub.

Margaret showed up a little after 3 and Violet (her assistant/apprentice) was not far behind her. They pretty much left Dave and I alone while I labored, alternating between the ball and the tub. My mom heard them and came upstairs to join us and take some pictures (we were about to go get her anyway). The birth pool was wonderful. I was having back labor but the breaks between contractions were pretty lengthy still. Anywhere from 2-5 minutes apart. (Dave could tell you, he timed them continuously until I was pushing, lol).

At this point I didn't think things were moving very quickly. Dave kept telling me to get checked and I kept saying no because I didn't want to find out I was only 4 or 5 cms along. This labor was weird. It felt different than my other ones. Contractions were harder to get through and I continued to hurt between them unless I was in the pool. The water really helped between contractions though. But during...I was fighting to focus and breathe. I was trying to recall everything I've ever read about keeping my jaw relaxed in order to allow my cervix to open more easily. I was making low noises and blowing raspberries with my lips and getting counter pressure on my back and hips, rocking my hips, staying on my knees in the pool, etc. But I was still struggling. I went ahead and got checked and found out I was at 9 cms. This was encouraging but still I didn't feel like I normally do in transition. The sensations were different than I remembered. The pain more intense, the breaks between contractions still fairly longish.

In fact Dave was counting down (out loud) and trying to predict when my next contraction would start. This was...irritating...to say the least. He'd get to one and look at me all expectantly. I'd say something like "you lose" and roll my eyes. It wouldn't take long though before I was trying to get through another contraction. Trying to will Hyrum down the birth canal.

Margaret suggested I sit on the toilet for a contraction and my water broke there. The fluid was clear and I got back in the pool to push. Finally I could feel the baby coming down and I had the strongest sensation that I must NOT let him descend and then go back up and try again. I needed to get him out and now. So I did. I remember screaming and pushing and trying not to scream and just focus on pushing but holy cow did it hurt. Margaret said to stop pushing but I didn't. I couldn't. I had to get him out with that push so I did.

I heard him cry out right away but I was still in a strange combination of relief and pain. I turned over and was able to relax a bit. Somebody handed Hyrum to me but he had stopped crying. He was turning blue and my midwives were getting anxious. One was examining the cord and found a true knot twisted inside what looked like a telephone cord. They were stimulating Hyrum and flicking his feet and trying to get him to cry but he wasn't really. I heard Margaret say "Praise God" when she found the knot in the cord (because he was alive) and she had Violet go get the oxygen for Hyrum.

During all of this I think I was being protected because although I could see the activity and worry around me, I wasn't feeling it myself. Physically, I was still feeling pain, but mentally, I was calm. I felt like Hyrum would be okay. I could see that he was blue and that they were quickly cutting the cord and that they were giving him oxygen and trying to get his heart rate up but I wasn't feeling the panic myself.

At this point Dave and Violet took Hyrum over to a heating pad and continued to work on him and Margaret helped me out of the tub so I could deliver the placenta. But the pain was still intense, contractions were ineffective and the placenta wasn't coming out. Margaret could feel it but I couldn't seem to do anything about it. I was leaning against the wall and breathing through the pain and she gave me a shot of pitocin and led me to my bed. She helped me down and I was still pretty caught up in the pain. She told me later that she said a prayer right then, put gloves on and checked to see what was going on with the placenta. It was caught up half way through my cervix, hence the pain. With the next contraction, and a little help from Margaret (and more pain for me) it finally came out.

Hyrum was doing better by now. He had pinked up a bit but his temp and blood sugar were low. I still couldn't move so they brought him to me to try and nurse but I couldn't yet. All this is a little fuzzy in my mind. I don't really remember getting from flat on my back to being propped up in bed but it happened. I was skin to skin with Hyrum, and a heating pad was over us. We gave him a bit of sugar water (which he did not want) and I nursed him (which he was great at). We called my kids' pediatrician (who is freaking awesome and does home visits exclusively) and she headed over to check him out.

His temp was rising, albeit slowly, but she felt that he'd be okay with skin to skin contact and lots of nursing and checking his temp every hour. So I spent the next 6 hours or so lying with Hyrum and a heating pad to warm him up. His temp was slowly rising but I was still concerned so Dave called our home teacher and him and Dave gave Hyrum a blessing just before church. In it he was told he'd pull through just fine and after that his temp rose really quickly. It took 6 hours to get fromm 92-94 and then after the blessing it was up to 97.5 in an hour and up to 98.5 an hour after that and stayed there.

In the meantime my midwife was examining the cord and placenta. She said the cord was the longest cord she's ever seen. (46 inches). She said the top 6 inches or so that connect to the placenta was thin and brittle looking and had partially detached from the placenta. She said the placenta itself had kinda folded on top of itself instead of spreading out like it should have and the area where it connected to my uterus was much smaller than it should have been. She said it had weird, hard deposits or something in it.

She said that usually a cord knot like that causes still birth.

She went home later and read pathology reports and found out something interesting.

Cord knots often cause lack of movement and lack of growth in utero. But sometimes, there's only one indication of a cord knot and it's hyperactivity. And that's what Hyrum was doing. Hyrum grew on schedule for 9 months and he grew well. His heart rate was always great, even during labor. But he moved. Constantly. He literally fought for 9 months to get the oxygen he needed to grow and survive the pregnancy and birth. By moving constantly, he kept oxygen and nutrients going through the knotted cord so he could use them. The cord continued to grow and twist on itself to compensate for the knot.

Oh, and my midwife explained that there's a bounce back effect during birth. The baby goes through the birth canal, which pushes blood into the placenta. The placenta is then supposed to shoot it back to the baby once he's out but in Hyrum's case the knot stopped that oxygen bounce back. That's why he came out crying and pink but then crashed right afterwards. He didn't get his bounce back.

Our prayers were answered. For 9 months, Hyrum fought constantly and he did grow healthy and strong like his brothers and sisters prayed for. I'm convinced that had I been in the hospital for induction, the harder and more frequent contractions from pitocin would have caused a very different outcome. I think that the pain was from my screwed up placenta and that the longer breaks between contractions were for Hyrums benefit. I think we both knew he needed to get through the birth canal quickly hence my inability to stop pushing and just get him out.

I think we were all greatly blessed through the entire process. I think Hyrum has a special job here on earth and was watched over to get him here safely. I think I'm blessed to be his mom.

Now for lots of pictures. These are from the birth. They're all perfectly modest, but just wanted to warn you before you start looking. There are also a few at the bottom of Hyrum today.

Dave doing his all important timing job.

Sumo mama. lol. This was early labor.

Things are getting harder.

Still timing.

Counter pressure


He's here!

My friend Lee Ann took the next three when she was visiting on Monday. He's 1 day old here.

And I took these today (2 days old). April (my sister) knitted the awesome hat!