Special delivery

Welcome to the world, James William Phillips! (First off, I must make a confession — our son went a full week without a name. But for the sake of readability, I’m going to insert the name we eventually gave him into the posts I wrote during the time he went by “Baby Boy Phillips.”)

James made his grand entrance five weeks ahead of schedule Tuesday, Nov. 28. After getting off bedrest, I won’t say I overdid it, but I had definitely been taking advantage of the relaxed rules on housework and childcare. However, Monday was my “lazy day.” Dr. Goncalves had said I could go to the gym and use the elliptical machine if I wanted to, but after a full weekend, I wasn’t feeling up to much of anything. On Monday, I lay about the house playing with Maddi, watching TV and generally doing nothing at all. Although there was an impressive amount of snow on the ground, I didn’t even take Maddi out to play. It was my day of rest, and I figured I’d pack her into her snowsuit tomorrow and we’d make snowballs. Monday night, Chris and I watched a DVD and then I listened to my hypnobirthing CD and flipped on an episode of “Beverly Hills, 90210” (you’re not supposed to fall directly asleep after practicing your hypnobirthing). It was to be a relaxing end to a relaxing day.

As Brenda made yet another bad decision and Brandon’s eyebrows chewed up ever more scenery, I had a contraction or two, but nothing outside what I’d been experiencing for the past few weeks. Braxton Hicks contractions are typically more noticeable in second and subsequent pregnancies, and while there was a good amount of pressure, my contractions hadn’t been painful or regular. Then, around 1 a.m. Tuesday, as I lay there relaxing in bed after my “lazy day,” not contracting at all and mentally preparing myself for a full night of sleep, I felt a big, warm gush.

I had been to the bathroom shortly before, so I was certain I hadn’t wet my pants. The other options were amniotic fluid or blood, and after my abruption 18 days earlier, I wasn’t ruling out blood. Before the gush had finished, my feet had hit the floor and I was making tracks for the bathroom. Although the last thing a mother usually wants is for her water to break at 35 weeks, I was relieved when I saw that my pajamas were saturated with clear fluid rather than blood. This meant that, while I would be going to the hospital as soon as I had dressed and packed, I would not be lying on the floor and waiting for an ambulance, pondering the fate of my baby.

Chris was in bed but not asleep. I told him my water had broken, and we started packing and preparing and making calls. We had already lined up three potential babysitters for Maddi, but our first line of defense, Aunt Kathy, was an hour away before factoring the ice on the roads. I called Maddi’s daycare operator, who had volunteered her services day or night when baby came, but there was no answer. Ditto for my playgroup friend, Krista, who babysat Maddi during my previous hospital stay. Since I wasn’t having contractions or bleeding, though, I figured we’d have plenty of time to call them later in the morning.

At the hospital, everything was normal. My water had broken, but I wasn’t in labor and the baby was doing fine. The on-call OB told me that I could expect to go into labor within the next day. About 3:30 a.m., Chris took Maddi home for some sleep before our busy day.

After he left, I had some bloodwork done and lay down to get some sleep of my own about 4 o’clock. Breakfast is served at 8, and I figured four hours was better than nothing. But as I lay there, sleep was hard to find. I’d relax and start drifting off, only to have a contraction. The contractions were mild, but distracting. I practiced my hypnobirthing technique during contractions, hoping that I’d be relaxed enough to fall asleep before the next one. But pretty soon, the contractions were coming very close together and were too intense to relax through — especially since I’d only begun practicing three days earlier!

At 5, I rang for the nurse, who determined that my contractions were two to three minutes apart. I was about 3 cm dilated and 80 percent effaced (I’d been high and thick just two hours earlier). At this point, my hypnobirthing techniques and breathing weren’t working at all, and I was annoyed but not surprised when I heard the nurse tell the OB that the baby was still OP (occiput posterior, or facing outward rather than toward my spine). That meant I was having back labor. Again. Considering that I hadn’t yet woken up the entire hospital with my agonized screams as I had with Maddi, I reckoned the hypnobirthing had been some help, after all. However, it wasn’t exactly a walk in the park, so I asked for an epidural. The anesthetist was summoned, and then the nurse called Chris. It was about 5:30. The epidural was in around 5:40 and another cervical check showed I was dilated 6-7 cm. After a few contractions, we realized the epidural hadn’t made it to my left side so well, and the nurse helped me roll onto that side to get the anesthesia working.

No sooner had I rolled onto my side than I had another contraction, and this time, I felt the urge to push. I told the doctor, who examined me and found I was at 8-9 cm — I’d progressed two centimeters in fewer than 10 minutes. Delivery was imminent and since the baby was to be five weeks early, the pediatrician was called in. In another two contractions, I was 10 cm dilated and began pushing about 6 a.m. Having been called just 30 minutes earlier, Chris was still on his way. The roads were covered in snow and Maddi had to be dropped at the sitter, whose house is about a half-hour roundtrip detour off the 20-minute drive to the hospital. I asked if we could wait, but the baby’s heart rate was dropping and he needed to come out soon. Our little boy was tiny and began crowning on the second push, but we had to wait through another contraction for the pediatrician to arrive before I could continue pushing him out. Meanwhile, nurses were readying the incubator, oxygen and other equipment for the baby.

The doctor instructed me not to push too strenuously, because our little boy was premature and could fly across the room with a good, hard push. However, since the epidural had only been administered 20-odd minutes before, I was feeling very numb on one side and still in intense pain on the other side, so it was hard to gauge what my muscles were doing. I pushed for two more contractions without much progress, and the doctor was practically yelling at me at this point because the baby’s heart rate was dipping dangerously low. An episiotomy was performed and I pushed as hard as I could despite my worry about shooting my baby against the wall. Finally, just as the contraction was about to end, his head popped out. One more push and the rest of the baby came out easily, instantly relieving the excruciating pain on the un-epiduraled left side of my body. At 6:16 a.m. PST, our little son entered the world wiggling and squeaking.

Little James was much less little than I thought he’d be. He was big and pink and beautiful, the best-looking newborn I’d ever seen. His delivery had been so rapid — just a little more than two hours between the first contraction and the last push — that he hadn’t had time to get all squashed and stressed out like most newborns. He let out a few kittenlike cries as they suctioned him, and scored a 9 on both the 1-minute and 5-minute APGARs. At 5 pounds, 12 ounces, he was big and healthy-looking for a 35-weeker, especially a boy. The nurses cooed over his round little head and his handsome features.

Unfortunately, as healthy as he was for a 35-weeker, he was still a month premature. Instead of snuggling and feeding my baby as I’d outlined in my birth plan (a plan I’d optimistically written for a baby born closer to term), I was allowed to hold him for about 15-30 seconds, then kissed him goodbye before he was whisked off to the nursery for assessment and treatment. The placenta was delivered shortly thereafter, and sure enough, when the doctor held it up for me, I noticed several large clots toward one edge of the organ, confirming that I’d had an abruption. Luckily, it looked as if less than a quarter of the placenta had been involved, which means that the baby had plenty of oxygen and nutrition — hence his relatively impressive birthweight.

Speeding down snowy streets after dropping off Maddi, Chris arrived within 30 minutes of the birth, and was heartbroken to discover that he’d missed the big event. However, the health of the baby comes first and we were happy when the pediatrician told us James was doing very well. He was breathing well but staff placed him under an oxygen hood to make it easier on him, and he was receiving IV fluids. The pediatrician warned us that at his age, James could face several common problems, including temperature regulation, breathing issues, feeding difficulties and jaundice. Chris went to the nursery to visit our handsome little son, and, as I was not allowed to get up yet, I laid back and enjoyed not being in back labor.

Chris’ mother showed up about a half-hour after he did, and while I waited for an assessment and transfer to the postpartum wing, they visited the baby and showed me the pictures they’d taken of James on their cameras. He had looked so big when the doctor held him up, but in the photographs, he looked so tiny lying there in the incubator, tiny legs poking out of a preemie diaper and wires and tubes coming out everywhere. Despite all that, he was still pink and perfect and other than the oxygen seemed to be doing very well. However, the pediatrician warned us that our little preterm baby wouldn’t be able to leave the nursery for at least 24 to 48 hours and would not be leaving the hospital for five or six days at best. I would probably be pumping rather than breastfeeding until he’d been deemed well enough to feed.

After I’d been moved to my new room, Chris and Nana headed home. In the afternoon, after my nap, the pediatrician stopped by to let me know that James was off the oxygen and doing very well — so well, in fact, that I could go in and breastfeed him after all. He’d been moved into a new, less-intimidating incubator and was resting comfortably between two babies who were receiving phototherapy. James latched on instantly and it was immediately clear that, early bird though he was, he had a strong sucking reflex. He nursed for about an hour before going back in his incubator, dozing on and off all the while. As early, rapid and unexpected as his birth was, our little baby looks like he’s going to be just fine.

And — you knew it was coming — here’s the very final belly pic, taken at 35 weeks (and just three or four hours before baby arrived!).

And we can’t forget the birthday boy himself — here’s James about an hour after his birth:

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