I always like to write down the birth story but I haven't made time to write down Caleb's until now, probably because I am usually holding our dear boy, and I don't want to let him go. It's been six weeks, though, and I'm not sure even now how much I remember, so I should write it down.
Caleb's birth was different from our other children's births in several ways. Different enough that I have been thinking I should write a blog post titled something like "Homebirth Mama Gives Birth in Hospital, Has Surprisingly Good Experience" or something like that. Our eldest three children were born out of hospital, all in Idaho, all through Dayspring Midwifery. Caleb's birth story is quite a bit different... and yet not all that different, because once again, I had excellent care, again had a lot of labor pain (because labor hurts), again had a long labor, again delivered a healthy baby.
We started out our prenatal care with a midwife named Margaret. She is a Certified Nurse Midwife with three decades (I think?) of doula experience and two decades (I think?) of midwife experience. We liked that she seemed to know the area hospitals and doctors well enough that she would know where to take us in case of a transfer. I didn't interview other midwives, I just went with Margaret because our insurance paid for us to have a homebirth with her, and she was recommended both by a friend and one of my former midwives.
My plan up until 38 weeks was to have a waterbirth at home. I had planned to have our children be present, because they wanted to be there, and I had a good vision for it being peaceful. I assumed it would be a long labor (although I so hoped that it wouldn't!) and I assumed that it would happen at about 40.5 weeks like my other labors. So I cleaned and tidied the house, bought our homebirth supplies, and had my home visit with Margaret at 37 weeks.
At 38 weeks, I went in for my routine prenatal visit, and my fundal height measurement had jumped significantly from my last prenatal visit, which was five days before. I had been measuring a few weeks ahead through most of the pregnancy, which I chalked up to having a disproportionately large belly even when I'm not pregnant, as well as weak stomach muscles and diastasis recti. I think my measurement at 38 weeks had jumped to 42, although I can't remember for sure. Margaret was pretty sure that I had polyhydramnios - too much amniotic fluid - and so I had an ultrasound at the end of that week.
The ultrasound showed that I did indeed have polyhydramnios, significantly more amniotic fluid than normal, so that meant that I needed to transfer care to a physician and be able to be induced in a hospital. The reason for the induction would be to be able to break my amniotic sac and control the flow. The danger with having polyhydramnios is that if my amniotic sac were to break and all the fluid gush out quickly, it could cause a prolapsed cord. The other, even more dangerous possibility would be that the quick gush could trigger the placenta to detach. So, both bad possibilities. Unlikely, but bad.
On the day that I was 39 weeks pregnant, I went to a new hospital and met a new doctor. And thus began a week of firsts. Dr. Brasch was great, and I was so thankful for Margaret's recommendation to this practice that he shared with two other Christian doctors. Dr. Brash was so respectful about my having had previous out-of-hospital births that I was tremendously surprised. He was almost fully in agreement with my birth plan and was most definitely not stressed out about my risks. (Which was a huge relief, because I'd felt like my midwife was rather stressed out about it all!) He decided not to bother with trying to figure out why I had polyhydramnios, which I appreciated, and we went ahead with the plan to induce me on Saturday, February 6th.
On Friday night, we took our kids to Reuben & Josie's house, where Keith's mom then picked them up to take them to their place for a few days. Keith and I went out to dinner, then went home. One thing I was super happy about was being able to make sure that our whole house was all neat and tidy before going to the hospital the next day! I was pretty happy about the idea of starting out the postpartum period with a perfectly clean house. It was also really nice to be deliberate about getting a good hearty steak for dinner and a good night's sleep.
I was supposed to call in on Saturday morning at 6:30 am to see when would be a good time to come into the hospital. Keith was going to let me sleep and call for me, but I woke up at 6:00 on my own, so I laid awake and then called. The nurse in charge said they were super busy, and to call back at 9:00. I had an egg and toast, took a shower, and had a quiet time, then went back to sleep until 9:30. I called again, and they said to call back at 12:00. So Keith and I got up and made some elk backstrap steak with pasture butter for breakfast (yum!!!), talked, and really just hung out. I was nearly twiddling my thumbs... I mean really, there was nothing left to do. I was nearly bored, which is not a feeling that I have very often!
I called at 12:00, and they had just called me but had apparently called the wrong number. They said to come on in. In retrospect, I wonder if I should have gone forward with the induction that day, knowing how long my labors go. But we went with it, and that's fine. One thing I should say is that as I write all this down and reflect on how this or that went, there's not really anything I'm disappointed about or regret in this labor. I can look at it logically and go, yeah, it might have gone differently if we'd done this or that. But I'm fine with how it went.
We got to Holy Family Hospital at 1:00 and got checked in. We hadn't been to the maternity center at all before this, since I'd just transferred care to Dr. Brasch four days previously, and the nurses were really sweet about introducing themselves and being so helpful and explanatory about everything. Our first two nurses were Hope and Shawna, and they were great! We had several sweet, lovely nurses during our stay there. I was really surprised by how young and kind and sweet they all were. Somehow I suppose I'd been expecting old, cranky nurses, like the ones who were there when my mom had my baby brother. These ladies were my age, and I felt like we could be friends. That was pretty great.
Dr. Brasch came in at about 1:30 pm and broke the amniotic sac. He held the baby's head in place while the fluid gushed out, so that the baby wouldn't turn, and also to avoid allowing the umbilical cord to come out with all the amniotic fluid. There was so much fluid! So I sat for quite a while, being monitored and resting while the fluid continued to seep out. After an hour or so they said that I could get up to use the restroom. It was amazing how small my belly was by this point. It was like half the size it had been! I had really had a crazy amount of fluid!
When I got back to the bed, Dr. Brasch realized that the baby had turned, and his head was way up under my ribs. Agh! So I laid down and Dr. Brasch did an aversion, turning baby so that he was head-down again. Shawna bound my belly and then I stayed in bed for quite a while, sitting in my favorite labor position (with my legs out like a butterfly) as contractions began to get going. I wasn't supposed to eat at this point, but I knew I'd likely be in labor for a long time, so I ate a few protein bars when the nurses were out of the room. I was drinking a ton of water, too, and at some point Dr. Brasch came in and mentioned that I should keep my bladder as empty as possible during labor so as to make contractions more effective. What!? How had I never heard that before? There were some things like this that happened during my labor with Caleb that made me feel like I had forgotten a ton, or had never known, about giving birth. I wouldn't say that it made me feel insecure, but it sure made me realize that there was so, so much I didn't/don't know about labor and delivery.
When I got back to the bed, Dr. Brasch realized that the baby had turned, and his head was way up under my ribs. Agh! So I laid down and Dr. Brasch did an aversion, turning baby so that he was head-down again. Shawna bound my belly and then I stayed in bed for quite a while, sitting in my favorite labor position (with my legs out like a butterfly) as contractions began to get going. I wasn't supposed to eat at this point, but I knew I'd likely be in labor for a long time, so I ate a few protein bars when the nurses were out of the room. I was drinking a ton of water, too, and at some point Dr. Brasch came in and mentioned that I should keep my bladder as empty as possible during labor so as to make contractions more effective. What!? How had I never heard that before? There were some things like this that happened during my labor with Caleb that made me feel like I had forgotten a ton, or had never known, about giving birth. I wouldn't say that it made me feel insecure, but it sure made me realize that there was so, so much I didn't/don't know about labor and delivery.
My notes about labor and progression get more few and far between at this point, so I don't really remember what happened the rest of the afternoon. Contractions picked up, I was monitored often, and Keith and I talked and visited. We talked with the kids at one point, and I was missing them. I was also getting hungrier, so I think I had part of a Bolthouse Farms smoothie then. Oh, and I ordered several chicken broths from the cafeteria, which were brought up by room service. I could drink juice and eat a bit of sherbet as well.
We had brought an entire gallon of homemade red raspberry leaf tea with us, so I worked on drinking as much of that as I could. I think I drank about half the gallon. I am sure that helped with getting my contractions going!
We had brought an entire gallon of homemade red raspberry leaf tea with us, so I worked on drinking as much of that as I could. I think I drank about half the gallon. I am sure that helped with getting my contractions going!
monitoring from my perspective
monitoring from Keith's perspective
sitting on the birth ball
At 10:00 pm, I was 80% effaced, 4-5 cm dilated, and baby was at -1 station. Things were beginning to progress more and I felt like if I were to get up and really move around, I could get the labor going more. But by 11:00 or so, I was just feeling tired. Not drained from labor tired, but tired because it was night. Keith was tired too, the lights were dimmed, and he fell asleep in the chair next to me. I began dozing off and on. I woke up at around 12:00 midnight and looked around and thought about how if I had a midwife or doula on hand, they would probably have me get up and get moving. But I was tired, and contractions calmed down enough when I was sitting that I thought maybe I would just sit, in my favorite sitting position, and kinda drift until morning without having to really move and engage and make things more painful.
I really dislike pain, and although I don't think I was fearful about it, I chose not to muster up the courage to get up and press into it while I was tired and hungry. We had chosen not to have a doula there because we couldn't afford it, and in many ways it really was nice to have it just be Keith and me there, with a gentle nurse coming in every now and then to check on us! But this is one of those points where having a doula would have likely been a good thing. The nurses and doctors were very kind, but it took me most of the labor to realize that one of the key differences between their bedside manners and that of a doula or midwife is that they don't push a mama - or at least they didn't push this mama - to get up and get things going. I was totally free to labor however I wanted to; they would only intervene if they needed to.
Keith noted down here in my phone notes that at 2:15 am, I woke up after a particularly good contraction saying, "Man, swear words on that one!!" But I think we mostly drifted in and out of sleep through the night. I was tired... I really just don't remember it that well.
Dr. Brasch's shift was ending in the morning, so he came in and checked me. I was 90% effaced, dilated to 5 cm, and baby was at -1 or -2. So, not much progress through the night, but I had rested some and would be able to get going again, I thought.
This is when the monitoring began to really interfere with labor progression, in my opinion. Baby was having dips... I forget the name... heart rate dips when I had contractions. But only very occasionally. So they would monitor me, and get one dip over twenty minutes, and then just before it was time to get off the monitor, there would be another dip, so I'd have to stay on again. So my labor just wasn't moving forward, because I couldn't move around! I wasn't irritated about it at first, but I do think it slowed things up a little.
At 11:00 am, the new doctor who was on call that day, Dr. Fine (another very kind doctor), checked me. I was at 90% effaced, baby was at -1 station, and I was 8 cm dilated. Great! I knew I should get up and get things going, but MAN, the pain was incredible! So terrible. I would get up and get the courage to move around some, but then it would be time to be monitored again, and so I gradually... okay, quickly... lost the courage to get up and move around. My midwives in the past had been so good about encouraging me to get up and get moving. I think it was disheartening to have someone come in continually and ask me to sit back down to be monitored. Yes, the baby was showing a dip in heartrate now and then, but everything I could remember from all my past research about labor and about what my midwives had said was that yes, that happens, because yes, it's stressful for the baby to have his head squeezed as he lowers more into the birth canal! But instead of the focus being, let's go ahead and get him out of there, it was more like, hmm, let's slow things down so it isn't stressful for baby.
This was really hard. I reached that point where I was sure I couldn't keep going. I complained. I puked. I swore. I began talking to Keith - privately, while the nurses weren't there - about wanting to have an epidural. He was shocked. Of course, I have always asked for an epidural while in transition, so the logical part of me knew that I was in transition. I knew that logically, it would only be another hour or two until the baby was out. Maybe less, if only I could keep moving. But it HURT. SO MUCH.
Keith encouraged me to keep going. He was a great doulos for me. He heated my rice packs, encouraged me to drink water, and kept lavendar essential oils rolling out of my diffuser. He played worship music softly on a CD player. He read the Bible to me.
By early afternoon, it had been a full day since we'd begun this thing, and I was getting tired. I was weak from not eating anything that day. And the pain hurt so much. I couldn't stomach any chicken broth and I didn't want to try eating or drinking anything, lest my nurse come back in while I was puking it up. I couldn't handle the red raspberry leaf tea anymore. I decided to take a tincture that I'd brought along, something that I hadn't researched at all but had been on my midwife's list of suggested items to buy for my homebirth. It was a Wishgarden tincture for transition. I knew as I took it that I really shouldn't take it unless I had a midwife advising me to... but I didn't have one. And the transition pains had been going on for long enough... two hours, maybe?... that I was sure I couldn't keep going with that much pain.
I took the tincture, and it eased up the pains. I took a little more. Finally, finally, finally! I could handle this now.
My contractions eased up, and slowed way down. After an hour or so of that (that's a rough guess... time wasn't running normally at this point), Keith went out to get something to eat. I walked around the hallways with my nurse Shawna, but my contractions had slowed to about once every 8-10 minutes. I got tired of walking, but when I would go back to the room to sit on the birth ball, my nurse would want to monitor me. Honestly, that part was getting pretty irritating. I'm a perfectionist, so seeing the numbers not be "just right" on the screen bothered me. I started to figure out which positions made the baby not seem stressed and which did. When I was sitting on the birth ball and leaned forward, I could feel that my contractions were much stronger. But that is also when the baby's heartrate would dip. So, wanting to not be monitored, I'd sit up on the bed in the butterfly position. But then I'd get sleepy, so that even when I wasn't being monitored anymore, I didn't feel like getting up. I knew I'd just have to sit down to be monitored again soon anyway.
This all got pretty discouraging. Dr. Fine checked me at some point and I was at a -2, and 90% effaced. So baby had slid back up. I had almost felt the desire to push earlier in the afternoon, when I'd felt more like I was in transition. Almost meaning that I had just barely begun to feel it... and then it would slip away. I hadn't done any test pushing because I didn't want to push before I was fully effaced and risk causing the lip of the cervix to swell.
Anyway, by about 5:00 or 6:00, I was mentally, physically, and emotionally spent. The terrible pain was back again, I felt again like I was in transition but never quite to the pushing stage, and I told Keith that I was going to need to have an epidural. This was very, very hard for him. Not that he said that, but I could see it. He didn't know what to do. I'd been in labor for about 28 hours, but I'd had long, hard labors before, too. And I'd asked for epidurals during those labors, but of course I'd been out of the hospital. I'd always wondered if I would really ask for drugs if I was in the hospital, and now I knew. Yes, yes I would absolutely ask for drugs, because labor hurts, and it keeps hurting, and it keeps hurting for way, way, way too long.
I talked with my doctor and nurse. They were carefully supportive, but definitely didn't push me to get an epidural. Neither of them had suggested it, which seemed odd to me. My contractions were painful, but not consistent enough that I would really be getting this baby out anytime soon, so I was thinking that pitocin was going to be a necessity... and I just didn't think I could handle pitocin without an epidural!
The anesthesiologist was great. We asked him a lot of questions and he was very helpful. I got the epidural at around 7:00 pm. And oh, I was so relieved! I kept trying to encourage Keith, to tell him that it was really okay. I knew he wasn't sure whether I was thinking rationally or not, but I was. It had been a long labor, my water had been broken for a long time, and I was pretty sure that I would be looking at a c-section if the baby didn't come out soon. I needed to have pitocin, and I needed a rest. I do think that the epidural was a good choice.
My new nurse, Heidi, came on in the evening. She is a very sweet Christian and she talked with us a lot, about a lot of things. I rested for a few hours, then we started the pitocin. My temperature also began to climb. Just a little bit every hour, but I would have to begin taking antibiotics if it got to a certain level... 100.8, I think.
My contractions kept coming. I had a very good epidural, meaning that I could still feel the contractions, but only a little bit. I could also move my legs (even though they were numb), so I made the hospital bed go up in the back and then maneuvered myself so that I was on my knees, leaning against the back of the bed. I tried to labor through the contractions as if I could feel them: really bearing into them, breathing down into them, and trying to make the most of each one. I did this for an hour or so... time is funny in labor though... and then, because my temperature had risen high enough, I was given the first dose of a round of antibiotics. Baby still wasn't all that happy through the contractions, and I was constantly being monitored. I think it was about 10:30 pm when there begain to be talk of turning off the epidural. Boy, did I start pressing into contractions then! I was determined to get that baby out before I had to start feeling those horrible, terrible, miserable, wretched contractions again.
Dr. Fine checked me and baby was still at a -2. Still 90% effaced. I was so frustrated and discouraged by this point. I think if I'd been able to feel the contractions, I would have just been a big weepy mess at this point. But I was increasingly certain that I was looking at a c-section in the near future, even though nobody had mentioned it. The fear of our baby not getting the good bacteria from the birth canal, the fear of the long recovery time and increased recovery risks with the c-section (and knowing Keith would be going back to work in just a few days), and the fear of having to feel the pain of having the epidural turned off all motivated me to keep going. I kept pressing into the contractions as best I could. My nurse was coaching me to breathe differently than I'd breathed through other labors, though, and that threw me off. She seemed to know what she was talking about, but I'd been through enough labors that I really felt that I knew how to breathe through the contractions. She and Keith kept pushing me (nicely) to do it her way, so I kept trying. It was difficult to be in that moment and wanting more than anything in the world, and wanting it more than anybody in the world, for this labor to be over, and yet to sort of get the impression that I wasn't doing something right.
At last, Dr. Fine suggested that I try pushing. My cervix was still at 90%, but it was soft. I knew this was probably a last resort kind of thing before going to have a c-section. So I laid on my back, and Keith and Heidi held my legs back, and I tried pushing with each contraction. It didn't quite feel right, because baby was still up at that -2 and I still had the epidural going. But pushing, at least, is something I can do. So I pushed as hard as I could, but it felt sorta weird, like when your arm is really, really asleep and you are telling your brain to move it, but your arm doesn't want to move.
The idea with trying to push was just to see if I could get the baby to move down. It seemed to be a surprise to everyone that he actually did move down. I was sleepy... keep in mind that I was on my back, with a blissful epidural, and I'd been in labor for 32 hours... and it was hard for me to keep focused. I pushed because they told me to, but it took all my powers of concentration now to keep myself semi-awake and disciplined enough to push with the contractions. I would fall solidly asleep between them, despite all my best efforts to stay awake.
But the baby moved down, and the voices of Keith, Heidi, and Dr. Fine grew more excited and constant. I kept pushing and I knew I was making some progress. The baby was coming out!
"He's coming, Jamie, he's coming! Keep pushing!"
There were no specifics said to me about how far out he was, so I wasn't sure if this meant he was moving down the birth canal, or if he was crowning, or if his head was out and his shoulders were stuck like Ezekiel had been. I just kept pushing for all I was worth. I wasn't emotionally scared, just logically desperate to make sure that he got out, and wasn't stuck with his head out.
At last he was out! He was born at 12:31 am on Monday, February 8th. He had moved from being at a -2 to fully out in less than twenty minutes. They put him on my chest and I could see that he was limp, but with his eyes open and looking brightly all around. I couldn't hold him very well... honestly, I had only fully woken up as the baby actually came out of the birth canal, I was that drowsy... and he was purplish-blue, covered with gray-white vernix.
The cord pulsed for 30-60 seconds and then Dr. Fine had Keith cut the cord. Keith was confused because this wasn't very long to let the cord blood pulse, and it was hard to cut the cord. Several people had bustled into the room just as the baby was born - Heidi having called them at the last minute, as it became apparent that the baby was actually, finally coming out - and now one of them worked feverishly over me to wipe the baby and prod him to cry.
At some point in all of this... probably while he was still on my chest... Keith announced the name and gender of our baby.
"It's a boy! This is my son. His name is Caleb James Lorenz!"
The cord was cut and they whisked him over to the warming station across the room. Keith looked desperately lost and confused. He didn't know what was wrong. I was sure (whether this was blind confidence or genuine insight, I don't know) that the baby would be fine, and I was blissfully relieved and overflowing with happiness that he was born. I knew that the team of nurses would now work on him, and I was so, so wonderfully thankful that my part of the labor was done!! I leaned back on the bed in shaky relief, and told Keith to go over to the baby, that I was okay. Dr. Fine and Heidi and I stayed clustered at my bed... all of us resting with thankfulness, I think... while we watched the team of three people work on Caleb.
His Apgar score was a 2 at one minute, meaning he wasn't breathing yet or doing very well at all. One of the nurses was moving him all around... this, Keith found out, to keep the amniotic fluid from going into his lungs... and they put a tube into his stomach to suck out the amniotic fluid, and Keith saw his chest inflate with air. Poor Keith was so worked up, and didn't know what to do, and I just sat back on the bed and rested. I don't know what Caleb's Apgar score was at five minutes, but he was very soon doing much better.
Oh, and I delivered the placenta during all of this. Heidi began to pump the rest of the bag of pitocin into my system to begin helping my hugely overextended uterus to contract. And I began to appreciate having my nurse still being fresh to the scene, something I would continue to appreciate for the rest of the night!
There began to be talk of taking Caleb to the nursery. I asked to hold him, and everyone clustered around me. I began to nurse him, and the leader of the group of the new nurses who had come in to help Caleb now pushed over and began critiquing the way I was holding him and nursing him. It wasn't a perfect latch, but I was leaning at an awkward angle and holding him up without support, and he was on, and I was really just concerned about getting him started breastfeeding, not so much concerned about doing it perfectly. I was surprised by this sudden intrusion and felt rather embarrassed. I told her I was a La Leche League leader, and she backed off for a while, but this began a rather awkward series of exchanges that was quite different from our experiences with the other doctors and nurses at this hospital.
I nursed Caleb for about an hour. Of course, it only felt like five minutes, because we were in that beautiful afterwards time. It was so good to rest and hold him and be done with that crazy long 32-hour labor.
The nursery nurse (probably not her official title) came into the room again after I'd started nursing him and began lambasting me for bad birth decisions. This really surprised me. It surprised my nurse too, who came in just afterwards and stood behind her looking somewhat horrified (though trying to hide it) as this nursery nurse gave me a piece of her mind. She accused me of dangerous birth practices with my out-of-hospital birth, saying I should have come into the hospital sooner (what?) and that I'd been endangering my baby's life by not having an epidural sooner (what?) and that my doctor had been recommending I have a c-section sooner (what? he never even suggested it) and that my baby could have died (yeah, I got that, thanks).
I didn't really take it lying down. I mean, I was reclining and nursing my baby, having just given birth in the last 20-30 minutes, but I was quite cognitive and feeling quite level-headed enough to respond to her. I don't remember really what I said, but we ended up arguing because she wanted to take the baby right to the nursery to put an IV in and monitor him for three hours. She said we couldn't come along. You'd better believe I was up in arms about this! Like hell she was going to take my baby away for three hours! She went on and on about how she'd been in nursing for 25 years and how she knew what she was doing.
It was all just so unexpected and so awkward. In a way, it was more what I had expected to experience with a hospital birth... people set in their ways of doing things and not open to my more natural (but well-researched and well-proved) ways of doing things. And it was all the more awkward because this woman had just resuscitated my baby! Maybe even saved his life. I understood that she was worked up, and maybe it was because she was still experiencing a lot of adrenaline too, but it really surprised me, and made me wonder what kind of misinformation was floating around at the nurse's station about me! I wasn't risking my baby's life; that's why I transferred care at 39 weeks to a doctor and agreed to be induced in the hospital. I do think I could have given birth at home and everything could have been fine... many midwives don't risk out clients because of polyhydramnios... but I had decided to take the risk of having a hospital birth with all the possibilities of slowed labor, increased c-section rates, increased infection rate, etc rather than risk the more dangerous possibilities of having my water break and gush out on its own at home. She acted as though I had transferred care during labor and had been some crazy outspoken hippie mama who refused reasonable medical care. It really irritated me. And on top of all that, she wanted to take away my newborn baby, who was needing to nurse and have skin-to-skin with his mama more than anything.
I don't remember quite how she left the room, but she may have been ushered out by my nurse. Oooh, I was so mad. My nurse apologized afterward and said that the nursery nurse wasn't supposed to come back into our room. Keith asked me to let him handle it, so I agreed, because he's actually pretty awesome at handling unreasonable older women... it's one of his gifts. So it turned out that the nursery nurse was (apparently!) saying that we couldn't be in the room while she put the IV in Caleb's arm, but we could come in and be with him after that. They had to do blood draws and whatever to see if he was running an infection. They expected that he was, since I'd had a high fever.
So, for the first time ever, I had to be separated from my newborn baby after birth. It must be the grace of God, but I was okay with it. I was scared that he would cry and I wouldn't be there to nurse him, but I was also very worn-out. So Keith went with baby Caleb to the nursery, and I stayed in the room. That was hard, but I trusted that he was okay. And then followed probably the best part of being in the hospital: my nurse took care of me. In my other births, my midwives have been pretty worn out by this point, after such long labors. They looked after me too, but having my nurse still be fresh and attentive to me was super awesome. She emptied the bag of pitocin into my IV to contract, and she checked how I was doing in every way. I ate a sandwich (oh, glorious delicious sandwich!! Keith had ordered one from the cafeteria and it was beyond delicious) and I drank a smoothie and oh, it was just so good to have some food. It probably took another hour for me to regain most of the feeling in my legs and get past my wooziness enough for it to be okay for me to go to the nursery. I sat in a wheelchair and she wheeled me down to the nursery.
I had never needed to be in a wheelchair before. Actually, I'd never even been checked into a hospital that I can remember, except briefly after a car accident when I was a teenager. So here I was with my IV bags, hospital gown, woozily sitting in a wheelchair... it was all pretty different.
Caleb and Keith were sitting peacefully in the nursery when I arrived. Keith was holding him and I was so, so happy that the two of them got to have this special time together. Keith said that Caleb hadn't cried at all, even when he had the IV put in. His oxygen saturation was at like 99%, and all his numbers looked fantastic. The news came back then or maybe later that his bloodwork looked great and he wasn't running a fever of his own; he had just been hot because he'd been inside me and I'd been running a fever. This was great news because I'd just found out from my nurse that if Caleb did have an infection, we'd be looking at staying in the hospital for 7-10 days. So, what a relief! I sat with them there in the nursery for probably 20 minutes or so and then went back to my room. I honestly just couldn't stay longer, I was so worn out.
My nurse Heidi took care of me some more, and I just kept marveling at this. Having someone give me the right pain medicines at the right times for the remainder of my stay there was just so awesome. She tidied up my room, put things in the right places for me, and kept giving me fresh ice water and checking on how I was feeling. I felt so cared for. I do love having a homebirth but the afterward had been so brutal before, with me always forgetting to take Tylenol and whatnot for the afterbirth contractions, and really just feeling like I was on my own. After this birth, I didn't even feel the afterbirth pains, and I know they were there! Yay for strong medication!
I was still so relieved and thankful through all of this time to be done with labor. I think I was still awake when Keith came back. We swaddled Caleb up and placed him in the bassinet next to me. That was hard, because I would have liked to sleep with him, but it wasn't safe in that hospital bed or with me so exhausted. We all got some good hours of rest and woke up around 8:00 am or so when the stream of nurses started up again.
The thing I really loved now was the room service. Ah, glorious food! It was Monday morning now and I had delicious meals for breakfast, lunch, and dinner. I was so hungry and I enjoyed the food so much.
The thing that started to get annoying was the rigamarole of being in the hospital. We'd fall asleep, and someone would come in for some thing or another: to check my temperature, to check Caleb's temperature, to ask how often he was nursing, to do the heel poke (although I did delay that for 24 hours), and so on.
He started to get a yellow tinge on that first day and I could tell his bilirubin was rising. I did NOT want to have to stay in the hospital to sit under the lights with him! Providentially, our third floor window faced south, and it was a sunny day! I stripped him down and had skin-to-skin time in the window with him for probably 2-3 hours, just letting the light shine on us and break up the bilirubin count. It helped tremendously and my nurses never seemed to notice... because of the times when they'd checked him... that he was actually a little jaundiced. It rose a bit more after we went home, but not dangerously so, and I was relieved that we made it out of there without having to sit under the UV lights! I kept sitting in the sun with him as much as I could for the rest of that week.
We stayed all that Monday in the hospital. We called the kids at some point and told them about their baby brother and told them his name. They were staying with Reuben and Josie at this point - they'd stayed with Grandpa and Grandma for two nights, and now they were with the Arts family for two nights - so it didn't work out for them to come to the hospital. Which was really just fine, because it was so nice for Keith and I to hang out together with our new baby, with no interruptions... EXCEPT for the constant interruptions of nurses and room service and all that every hour or so. By Monday night, as I tried to sleep with my baby, that got really annoying. Caleb and I ended up sleeping in a chair that night as I nursed him, and I was so stiff and sore! And nurses kept popping in through the night, and there were so many annoying lights in our room from all the little machines. I'm used to blackout curtains and no lights at night, so it really bothered me. One nurse gave me a sheet to fill out and carefully instructed me to write down the times that I nursed the baby. I wanted to be compliant, but I had no energy, and who keeps track of that stuff? Not me. So I didn't fill it out at all. Sorry, no time for that. I fed him all night. He's fine.
We ended up staying at the hospital until about 2:00 or 3:00 on Tuesday. My sweet nurse Hope, who'd been my nurse on Saturday, walked us out to the car. She'd been praying for us and had just been so sweet. I loved having her be the one to walk us out. I was so nervous that Caleb would cry on our 25-minute trip home but he didn't. Yay! He went right to sleep. I sat in the back seat and gazed at him the whole way.
Keith stayed home on Wednesday, but went back to work on Thursday. I wish he could have stayed home longer! The first few weeks were really challenging... the kids were loud and somewhat hard to handle after having been basically partying with their grandparents and then their cousins for four days! I had mastitis twice... once really, really bad, and Keith providentially didn't have to go to work that day, which was great, because I couldn't even walk... and I had some other after-baby complications that made the first weeks really overwhelming. But Caleb has been utterly delightful, and we have all been enjoying him so much. I relaxed any plans for doing anything but taking care of the baby, and I think that has helped the recovery time to be less exhausting for me.
Here are Caleb's birth details!
Caleb James Lorenz
We named him after Caleb from the Bible and my dad, whose name is James. Caleb means "whole-hearted" and James means "follower," so we thought that was pretty cool too. Caleb James has been one of our favorite baby names since before we even had kids. It is fun to finally have our own little Caleb James to love and cherish! I'm so glad he's here with us. We've always wanted to have at least four children... so our family feels much closer to complete, now that he is a part of it. And having the other kids be so much older makes taking care of this little guy pretty great. I love snuggling him as much as I possibly can. I have spent many days in the rocking chair, just holding him all day long. He is really a sweet little guy and we love him so much.
My contractions eased up, and slowed way down. After an hour or so of that (that's a rough guess... time wasn't running normally at this point), Keith went out to get something to eat. I walked around the hallways with my nurse Shawna, but my contractions had slowed to about once every 8-10 minutes. I got tired of walking, but when I would go back to the room to sit on the birth ball, my nurse would want to monitor me. Honestly, that part was getting pretty irritating. I'm a perfectionist, so seeing the numbers not be "just right" on the screen bothered me. I started to figure out which positions made the baby not seem stressed and which did. When I was sitting on the birth ball and leaned forward, I could feel that my contractions were much stronger. But that is also when the baby's heartrate would dip. So, wanting to not be monitored, I'd sit up on the bed in the butterfly position. But then I'd get sleepy, so that even when I wasn't being monitored anymore, I didn't feel like getting up. I knew I'd just have to sit down to be monitored again soon anyway.
This all got pretty discouraging. Dr. Fine checked me at some point and I was at a -2, and 90% effaced. So baby had slid back up. I had almost felt the desire to push earlier in the afternoon, when I'd felt more like I was in transition. Almost meaning that I had just barely begun to feel it... and then it would slip away. I hadn't done any test pushing because I didn't want to push before I was fully effaced and risk causing the lip of the cervix to swell.
Anyway, by about 5:00 or 6:00, I was mentally, physically, and emotionally spent. The terrible pain was back again, I felt again like I was in transition but never quite to the pushing stage, and I told Keith that I was going to need to have an epidural. This was very, very hard for him. Not that he said that, but I could see it. He didn't know what to do. I'd been in labor for about 28 hours, but I'd had long, hard labors before, too. And I'd asked for epidurals during those labors, but of course I'd been out of the hospital. I'd always wondered if I would really ask for drugs if I was in the hospital, and now I knew. Yes, yes I would absolutely ask for drugs, because labor hurts, and it keeps hurting, and it keeps hurting for way, way, way too long.
I talked with my doctor and nurse. They were carefully supportive, but definitely didn't push me to get an epidural. Neither of them had suggested it, which seemed odd to me. My contractions were painful, but not consistent enough that I would really be getting this baby out anytime soon, so I was thinking that pitocin was going to be a necessity... and I just didn't think I could handle pitocin without an epidural!
The anesthesiologist was great. We asked him a lot of questions and he was very helpful. I got the epidural at around 7:00 pm. And oh, I was so relieved! I kept trying to encourage Keith, to tell him that it was really okay. I knew he wasn't sure whether I was thinking rationally or not, but I was. It had been a long labor, my water had been broken for a long time, and I was pretty sure that I would be looking at a c-section if the baby didn't come out soon. I needed to have pitocin, and I needed a rest. I do think that the epidural was a good choice.
My new nurse, Heidi, came on in the evening. She is a very sweet Christian and she talked with us a lot, about a lot of things. I rested for a few hours, then we started the pitocin. My temperature also began to climb. Just a little bit every hour, but I would have to begin taking antibiotics if it got to a certain level... 100.8, I think.
My contractions kept coming. I had a very good epidural, meaning that I could still feel the contractions, but only a little bit. I could also move my legs (even though they were numb), so I made the hospital bed go up in the back and then maneuvered myself so that I was on my knees, leaning against the back of the bed. I tried to labor through the contractions as if I could feel them: really bearing into them, breathing down into them, and trying to make the most of each one. I did this for an hour or so... time is funny in labor though... and then, because my temperature had risen high enough, I was given the first dose of a round of antibiotics. Baby still wasn't all that happy through the contractions, and I was constantly being monitored. I think it was about 10:30 pm when there begain to be talk of turning off the epidural. Boy, did I start pressing into contractions then! I was determined to get that baby out before I had to start feeling those horrible, terrible, miserable, wretched contractions again.
Dr. Fine checked me and baby was still at a -2. Still 90% effaced. I was so frustrated and discouraged by this point. I think if I'd been able to feel the contractions, I would have just been a big weepy mess at this point. But I was increasingly certain that I was looking at a c-section in the near future, even though nobody had mentioned it. The fear of our baby not getting the good bacteria from the birth canal, the fear of the long recovery time and increased recovery risks with the c-section (and knowing Keith would be going back to work in just a few days), and the fear of having to feel the pain of having the epidural turned off all motivated me to keep going. I kept pressing into the contractions as best I could. My nurse was coaching me to breathe differently than I'd breathed through other labors, though, and that threw me off. She seemed to know what she was talking about, but I'd been through enough labors that I really felt that I knew how to breathe through the contractions. She and Keith kept pushing me (nicely) to do it her way, so I kept trying. It was difficult to be in that moment and wanting more than anything in the world, and wanting it more than anybody in the world, for this labor to be over, and yet to sort of get the impression that I wasn't doing something right.
At last, Dr. Fine suggested that I try pushing. My cervix was still at 90%, but it was soft. I knew this was probably a last resort kind of thing before going to have a c-section. So I laid on my back, and Keith and Heidi held my legs back, and I tried pushing with each contraction. It didn't quite feel right, because baby was still up at that -2 and I still had the epidural going. But pushing, at least, is something I can do. So I pushed as hard as I could, but it felt sorta weird, like when your arm is really, really asleep and you are telling your brain to move it, but your arm doesn't want to move.
The idea with trying to push was just to see if I could get the baby to move down. It seemed to be a surprise to everyone that he actually did move down. I was sleepy... keep in mind that I was on my back, with a blissful epidural, and I'd been in labor for 32 hours... and it was hard for me to keep focused. I pushed because they told me to, but it took all my powers of concentration now to keep myself semi-awake and disciplined enough to push with the contractions. I would fall solidly asleep between them, despite all my best efforts to stay awake.
But the baby moved down, and the voices of Keith, Heidi, and Dr. Fine grew more excited and constant. I kept pushing and I knew I was making some progress. The baby was coming out!
"He's coming, Jamie, he's coming! Keep pushing!"
There were no specifics said to me about how far out he was, so I wasn't sure if this meant he was moving down the birth canal, or if he was crowning, or if his head was out and his shoulders were stuck like Ezekiel had been. I just kept pushing for all I was worth. I wasn't emotionally scared, just logically desperate to make sure that he got out, and wasn't stuck with his head out.
At last he was out! He was born at 12:31 am on Monday, February 8th. He had moved from being at a -2 to fully out in less than twenty minutes. They put him on my chest and I could see that he was limp, but with his eyes open and looking brightly all around. I couldn't hold him very well... honestly, I had only fully woken up as the baby actually came out of the birth canal, I was that drowsy... and he was purplish-blue, covered with gray-white vernix.
The cord pulsed for 30-60 seconds and then Dr. Fine had Keith cut the cord. Keith was confused because this wasn't very long to let the cord blood pulse, and it was hard to cut the cord. Several people had bustled into the room just as the baby was born - Heidi having called them at the last minute, as it became apparent that the baby was actually, finally coming out - and now one of them worked feverishly over me to wipe the baby and prod him to cry.
At some point in all of this... probably while he was still on my chest... Keith announced the name and gender of our baby.
"It's a boy! This is my son. His name is Caleb James Lorenz!"
The cord was cut and they whisked him over to the warming station across the room. Keith looked desperately lost and confused. He didn't know what was wrong. I was sure (whether this was blind confidence or genuine insight, I don't know) that the baby would be fine, and I was blissfully relieved and overflowing with happiness that he was born. I knew that the team of nurses would now work on him, and I was so, so wonderfully thankful that my part of the labor was done!! I leaned back on the bed in shaky relief, and told Keith to go over to the baby, that I was okay. Dr. Fine and Heidi and I stayed clustered at my bed... all of us resting with thankfulness, I think... while we watched the team of three people work on Caleb.
His Apgar score was a 2 at one minute, meaning he wasn't breathing yet or doing very well at all. One of the nurses was moving him all around... this, Keith found out, to keep the amniotic fluid from going into his lungs... and they put a tube into his stomach to suck out the amniotic fluid, and Keith saw his chest inflate with air. Poor Keith was so worked up, and didn't know what to do, and I just sat back on the bed and rested. I don't know what Caleb's Apgar score was at five minutes, but he was very soon doing much better.
our first picture of baby Caleb
Oh, and I delivered the placenta during all of this. Heidi began to pump the rest of the bag of pitocin into my system to begin helping my hugely overextended uterus to contract. And I began to appreciate having my nurse still being fresh to the scene, something I would continue to appreciate for the rest of the night!
There began to be talk of taking Caleb to the nursery. I asked to hold him, and everyone clustered around me. I began to nurse him, and the leader of the group of the new nurses who had come in to help Caleb now pushed over and began critiquing the way I was holding him and nursing him. It wasn't a perfect latch, but I was leaning at an awkward angle and holding him up without support, and he was on, and I was really just concerned about getting him started breastfeeding, not so much concerned about doing it perfectly. I was surprised by this sudden intrusion and felt rather embarrassed. I told her I was a La Leche League leader, and she backed off for a while, but this began a rather awkward series of exchanges that was quite different from our experiences with the other doctors and nurses at this hospital.
I nursed Caleb for about an hour. Of course, it only felt like five minutes, because we were in that beautiful afterwards time. It was so good to rest and hold him and be done with that crazy long 32-hour labor.
The nursery nurse (probably not her official title) came into the room again after I'd started nursing him and began lambasting me for bad birth decisions. This really surprised me. It surprised my nurse too, who came in just afterwards and stood behind her looking somewhat horrified (though trying to hide it) as this nursery nurse gave me a piece of her mind. She accused me of dangerous birth practices with my out-of-hospital birth, saying I should have come into the hospital sooner (what?) and that I'd been endangering my baby's life by not having an epidural sooner (what?) and that my doctor had been recommending I have a c-section sooner (what? he never even suggested it) and that my baby could have died (yeah, I got that, thanks).
I didn't really take it lying down. I mean, I was reclining and nursing my baby, having just given birth in the last 20-30 minutes, but I was quite cognitive and feeling quite level-headed enough to respond to her. I don't remember really what I said, but we ended up arguing because she wanted to take the baby right to the nursery to put an IV in and monitor him for three hours. She said we couldn't come along. You'd better believe I was up in arms about this! Like hell she was going to take my baby away for three hours! She went on and on about how she'd been in nursing for 25 years and how she knew what she was doing.
It was all just so unexpected and so awkward. In a way, it was more what I had expected to experience with a hospital birth... people set in their ways of doing things and not open to my more natural (but well-researched and well-proved) ways of doing things. And it was all the more awkward because this woman had just resuscitated my baby! Maybe even saved his life. I understood that she was worked up, and maybe it was because she was still experiencing a lot of adrenaline too, but it really surprised me, and made me wonder what kind of misinformation was floating around at the nurse's station about me! I wasn't risking my baby's life; that's why I transferred care at 39 weeks to a doctor and agreed to be induced in the hospital. I do think I could have given birth at home and everything could have been fine... many midwives don't risk out clients because of polyhydramnios... but I had decided to take the risk of having a hospital birth with all the possibilities of slowed labor, increased c-section rates, increased infection rate, etc rather than risk the more dangerous possibilities of having my water break and gush out on its own at home. She acted as though I had transferred care during labor and had been some crazy outspoken hippie mama who refused reasonable medical care. It really irritated me. And on top of all that, she wanted to take away my newborn baby, who was needing to nurse and have skin-to-skin with his mama more than anything.
I don't remember quite how she left the room, but she may have been ushered out by my nurse. Oooh, I was so mad. My nurse apologized afterward and said that the nursery nurse wasn't supposed to come back into our room. Keith asked me to let him handle it, so I agreed, because he's actually pretty awesome at handling unreasonable older women... it's one of his gifts. So it turned out that the nursery nurse was (apparently!) saying that we couldn't be in the room while she put the IV in Caleb's arm, but we could come in and be with him after that. They had to do blood draws and whatever to see if he was running an infection. They expected that he was, since I'd had a high fever.
So, for the first time ever, I had to be separated from my newborn baby after birth. It must be the grace of God, but I was okay with it. I was scared that he would cry and I wouldn't be there to nurse him, but I was also very worn-out. So Keith went with baby Caleb to the nursery, and I stayed in the room. That was hard, but I trusted that he was okay. And then followed probably the best part of being in the hospital: my nurse took care of me. In my other births, my midwives have been pretty worn out by this point, after such long labors. They looked after me too, but having my nurse still be fresh and attentive to me was super awesome. She emptied the bag of pitocin into my IV to contract, and she checked how I was doing in every way. I ate a sandwich (oh, glorious delicious sandwich!! Keith had ordered one from the cafeteria and it was beyond delicious) and I drank a smoothie and oh, it was just so good to have some food. It probably took another hour for me to regain most of the feeling in my legs and get past my wooziness enough for it to be okay for me to go to the nursery. I sat in a wheelchair and she wheeled me down to the nursery.
I had never needed to be in a wheelchair before. Actually, I'd never even been checked into a hospital that I can remember, except briefly after a car accident when I was a teenager. So here I was with my IV bags, hospital gown, woozily sitting in a wheelchair... it was all pretty different.
Caleb and Keith were sitting peacefully in the nursery when I arrived. Keith was holding him and I was so, so happy that the two of them got to have this special time together. Keith said that Caleb hadn't cried at all, even when he had the IV put in. His oxygen saturation was at like 99%, and all his numbers looked fantastic. The news came back then or maybe later that his bloodwork looked great and he wasn't running a fever of his own; he had just been hot because he'd been inside me and I'd been running a fever. This was great news because I'd just found out from my nurse that if Caleb did have an infection, we'd be looking at staying in the hospital for 7-10 days. So, what a relief! I sat with them there in the nursery for probably 20 minutes or so and then went back to my room. I honestly just couldn't stay longer, I was so worn out.
Keith's picture of Caleb in the nursery
Keith holding Caleb while he was monitored
my visit to see Caleb in the nursery
Keith and Caleb
Caleb with all his monitoring stuff
My nurse Heidi took care of me some more, and I just kept marveling at this. Having someone give me the right pain medicines at the right times for the remainder of my stay there was just so awesome. She tidied up my room, put things in the right places for me, and kept giving me fresh ice water and checking on how I was feeling. I felt so cared for. I do love having a homebirth but the afterward had been so brutal before, with me always forgetting to take Tylenol and whatnot for the afterbirth contractions, and really just feeling like I was on my own. After this birth, I didn't even feel the afterbirth pains, and I know they were there! Yay for strong medication!
I was still so relieved and thankful through all of this time to be done with labor. I think I was still awake when Keith came back. We swaddled Caleb up and placed him in the bassinet next to me. That was hard, because I would have liked to sleep with him, but it wasn't safe in that hospital bed or with me so exhausted. We all got some good hours of rest and woke up around 8:00 am or so when the stream of nurses started up again.
The thing I really loved now was the room service. Ah, glorious food! It was Monday morning now and I had delicious meals for breakfast, lunch, and dinner. I was so hungry and I enjoyed the food so much.
The thing that started to get annoying was the rigamarole of being in the hospital. We'd fall asleep, and someone would come in for some thing or another: to check my temperature, to check Caleb's temperature, to ask how often he was nursing, to do the heel poke (although I did delay that for 24 hours), and so on.
He started to get a yellow tinge on that first day and I could tell his bilirubin was rising. I did NOT want to have to stay in the hospital to sit under the lights with him! Providentially, our third floor window faced south, and it was a sunny day! I stripped him down and had skin-to-skin time in the window with him for probably 2-3 hours, just letting the light shine on us and break up the bilirubin count. It helped tremendously and my nurses never seemed to notice... because of the times when they'd checked him... that he was actually a little jaundiced. It rose a bit more after we went home, but not dangerously so, and I was relieved that we made it out of there without having to sit under the UV lights! I kept sitting in the sun with him as much as I could for the rest of that week.
soaking up the sunshine
sunshine to break up the bilirubin
Caleb at about fourteen hours after birth
beautiful little boy
We stayed all that Monday in the hospital. We called the kids at some point and told them about their baby brother and told them his name. They were staying with Reuben and Josie at this point - they'd stayed with Grandpa and Grandma for two nights, and now they were with the Arts family for two nights - so it didn't work out for them to come to the hospital. Which was really just fine, because it was so nice for Keith and I to hang out together with our new baby, with no interruptions... EXCEPT for the constant interruptions of nurses and room service and all that every hour or so. By Monday night, as I tried to sleep with my baby, that got really annoying. Caleb and I ended up sleeping in a chair that night as I nursed him, and I was so stiff and sore! And nurses kept popping in through the night, and there were so many annoying lights in our room from all the little machines. I'm used to blackout curtains and no lights at night, so it really bothered me. One nurse gave me a sheet to fill out and carefully instructed me to write down the times that I nursed the baby. I wanted to be compliant, but I had no energy, and who keeps track of that stuff? Not me. So I didn't fill it out at all. Sorry, no time for that. I fed him all night. He's fine.
Keith got us home and settled in. I think we took a nap, or maybe I talked to someone on the phone. Then he went to pick up the kids, and when they got home on Tuesday evening, we introduced them to their new brother! It was very special. They were all so delighted to meet him.
Here are Caleb's birth details!
Caleb James Lorenz
born on February 8th 2016
weighing 8 pounds, 4 ounces
measuring 22 inches long
15 inch head circumference
We named him after Caleb from the Bible and my dad, whose name is James. Caleb means "whole-hearted" and James means "follower," so we thought that was pretty cool too. Caleb James has been one of our favorite baby names since before we even had kids. It is fun to finally have our own little Caleb James to love and cherish! I'm so glad he's here with us. We've always wanted to have at least four children... so our family feels much closer to complete, now that he is a part of it. And having the other kids be so much older makes taking care of this little guy pretty great. I love snuggling him as much as I possibly can. I have spent many days in the rocking chair, just holding him all day long. He is really a sweet little guy and we love him so much.
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