Mr. & Mrs. Gubbins & Sons: Theodore's Birth & Hospital Stay

Well, I've told the story in email and in person to some of you, but it seems some version of it ought to go on the blog too! The story of Theodore's birth...

Theodore was born early, at 36 weeks, 1 day gestation. His was a non-emergency, but unplanned C-section. That is, we were planning to have a C-section when he reached full-term the following week, but my bleeding (due to the low-lying placenta) got worse, so I checked into the hospital on May 2nd, my birthday. Everything was calm bleeding-wise during the day, so I went to bed expecting to be kept for observation for the week, and to have the C-section on May 10th, as planned. However, the bleeding picked up overnight, and the doctors decided I couldn't lose blood at that rate for a whole week, and that at this late in the pregnancy it was probably safer for baby to be out than in. Mostly, they said, they wanted to avoid having to do a true emergency C-section. Better to do it now than to wait and suddenly things could get out of hand. So at around 3:15 am on May 3rd I called Andy (who was home with Simon, and who I'd been updating from the hospital) and told him to come in. He dropped Simon off with our daycare provider and tucked him in to bed there, then hurried over to the hospital. I was getting my spinal put in when I saw through the operating room window that he had arrived and was in scrubs, ready to come in...but they sent him back to the room to wait, and said he could come in in a little while.

Unfortunately, while the spinal mostly worked, it didn't quite work well enough--the numbness wasn't spreading high enough on my abdomen. They kept angling the operating table to lower my head and get it to spread "up" but it just didn't get far enough. It seemed like forever that they tried and waited--I kept asking when Andy could come in. There I was, laid out on the table, under anesthesia, all covered in surgical drapes just like in the little video they show you--once you get covered in sterile drapes, that's when they let the birth partner in (or so I thought!). But they wouldn't let him in, not yet :-(. Finally they gave up on the spinal and said they needed to use general anesthesia, so I would be unconscious for the whole thing...no feeling weird tugging and pulling sensations (okay with me), but also no hearing my baby's first cry, learning with Andy whether it was a boy or a girl, or getting to hold and start nursing in the recovery room (NOT okay with me!). I started crying...and still they wouldn't let Andy in. Not until they made the first incision, they said...which meant not until I was unconscious...so under I went.

When I woke up a few hours later in the recovery room, Andy was there with our little boy. The first hours are sort of a blur as I was very groggy. Eventually I heard the story of how little Theodore's was a difficult birth, because of how he was lodged in there and kept trying to exit arm-first! The doctor had to shove his arm back in several times (in some photos you'll notice his left arm is blue--it is bruised from the manipulating), and tried to get him to turn head down--eventually they were able to pull him out feet first, instead. Andy caught a little video clip including the actual exit on our camera--poor little babe was totally limp coming out. His one-minute Apgar score was only 2! But, they cleared his lungs, puffed a little oxygen in, and he came to right away--his five-minute score was a healthy 8. All fingers, toes, and a penis were present--he was declared a boy and then whisked away to be checked out.

Because I was unconscious anyway, Andy didn't have to choose between staying to comfort me and going with Theodore--so off he went, and took photos for me to see later. They did all the usual things, footprints, measurements, etc., but also hooked him up to heart rate, breathing, and oxygen monitors, and put him in a cozy little incubator (above) for a little while. He weighed in at a healthy 6 lbs 14 oz--rather hefty for being born a month preterm.

Theodore was born at 4:40 am...it wasn't until around noon that I finally got to hold him, try nursing, and do a little kangaroo care with him. I had seen him for just a few seconds in a very groggy state of mind in the recovery room as Andy held him down to my face and told me it was a boy, and then they whisked him away. I have to say the whole thing felt quite surreal until I finally got to hold him myself.

Because he was "late preterm" or "near term," Theodore was automatically sent to the Intermediate Special Care Nursery, or ISCN. We had been told by the doctor earlier that it would be a mandatory 12-24 hour stay there, but that if he was doing fine they would probably let him come room in with us after that. Unfortunately, that doctor (on the OB staff, not the neonatology staff) was not the best informed, as they had just recently changed their policy, and any preterm baby was now to stay in the ISCN until discharge. Luckily, because I was wanting to breastfeed and couldn't yet get out of bed, this meant that a nurse would bring Theodore down to my room every three hours to try nursing--so I did get to see and hold him every three hours, day and night--and Andy could go down to him room anytime. They also had a camera on him that showed on a private channel in my room, so he was constantly on the tv as well, and we could see when he was sleeping, being changed, etc. Andy went back and forth between our rooms, and between home and work as well, as we hadn't exactly planned for the birth to happen when it did and he couldn't quite drop everything to just stay with me 24/7.

Because he is preterm, we had a little less say in some things than we did with Simon's birth. He was not in our room, for one thing. They also started topping him off with formula (special preemie blend) right from the beginning--they would bring him in to try nursing, and then give him a bottle. They also had me pumping from the start--every 2 hours they wanted me to pump, plus try and feed him. They still have me pumping every time after he eats, despite the fact that he is nursing quite well, to make sure my milk supply stays up...if our freezer is any indication, there is currently NO problem with my milk supply! He was down to 6 lbs 4.5 oz upon discharge Thursday evening, and when we returned for a check-up on Monday, he was up to 6 lbs 8.4 oz, right on track for reaching his birth weight by two weeks, as they hoped. We have another check-up scheduled for about two weeks from now, and if all is well then, we can stop doing some of these preemie-precautionary measures (like pumping like mad!) and start treating him more like a normal newborn, nursing on demand, etc.

Theodore had only a few minor hiccups in his time in the ISCN. The first day, he had a brief apnic episode--that is, he stopped breathing briefly, as people do who have sleep apnea. But he recovered himself, without intervention, and never had another episode. He also had some jaundice, but his highest bilirubin levels weren't enough to require phototherapy, so all was well with that as long as he kept eating. Turns out his biggest hurdle was the car seat! Preemies and small babies have to take what they call an "angle test" where basically they have to sit, strapped into their car seat, for 90 minutes, without having any problems--steady heartrate, oxygen saturation, breathing, etc. I guess the angle of the seat can cause them to slump a bit, which can cut off the airways. Theodore failed his test twice, before finally passing the third time--we waited half a day after I was discharged for him to retake it, hoping he would get to go home with us (and eventually, he did!). Both times he failed his oxygen saturation levels dropped below 90--both times he recovered on his own, without intervention, so they weren't terribly worried (the nurses were quick to point out that its entirely possible full-term healthy babies do the same thing all the time, we just don't know because they aren't hooked up to monitors--same with the earlier apnic episode that resolved itself)...still, they wouldn't let him go until he passed. And, finally, he did :-).

Well, it is much later than I planned to be awake tonight--if I don't get to bed soon, it will just be time to feed Theodore again before I even fall asleep! What remains are some photos from our time in the hospital--visitors and the like. Enjoy!

Aunt Karlie giving Theodore a kiss

Grandma Phyllis came down Monday night and stayed to take care of Simon while I was in the hospital

The whole family!

Simon got to peek at Theodore in his bassinet the evening after he was born, and the next day got to see him in our room--here he is "holding" him...he wasn't quite sure what to think, but was very good at being gentle