Sunday, February 10, 2008

Leah Amira Imran

Sorry it's been so long since I've posted. For a few days there wasn't anything new to share. And then, as you know, life got very exciting! So here's a really long one. If you are only interested in the pictures, here's my Picasa site - please check back often, as we'll be posting regularly.

Wednesday evening at my 39 week check-up, my blood pressure was up and Dr. Ho was concerned that it, along with a couple other things, were early signs of pre-eclampsia. She consulted with Dr. Markoff, who also came in to talk to and look at me. Thankfully Shafi was able to join me for the appointment, as it was of course a bit stressful to hear that things were not going along as perfectly as they had been.

The docs decided that since my due date was so close, we would be safest to go ahead and induce labor. They asked if we had a preference for Thursday or Friday and we decided to go with Thursday to get it over with, rather than sit and worry for the next day and a half. Dr. Ho was on hospital duty for Thursday, so she told us to come in to NYU at 7 a.m. the next morning and she'd see us there.

We decided to tell only immediate family what was going on - and a couple key work people - as my maternity leave would officially begin the next day and Shafi would be taking off a week and a half or so.

Of course we got little sleep that night, but got up at 6 a.m. and took a cab to NYU Medical Center. We were right on time at 7 a.m. and were already in a room in the Labor & Delivery ward by 7:10. Shafi then went down to Admitting to take care of paperwork while they got me into a gown and bed and started an IV. We then had an hour or so to wait for the doctor to come and check me and order the pitocin drip - the drug that induces labor. I was about 3 cm dilated and still 70% effaced - so only a slight change from the day before. My blood pressure was fine, but we weren't going to call off the induction at that point.

They started the pitocin around 9 a.m. The anesthesiology resident stopped in and I filled out the consent form so that if I decided I wanted an epidural, I would be able to call for it. I decided to play it by ear and see if I needed it rather, than starting the epidural at the same time as the pitocin.

We then pretty much just sat around for a few hours watching television and reading. I was having very mild contractions and wasn't really having any pain. They gradually increased the pitocin every 20 minutes or so. And all of a sudden around noon I started to feel the contractions. They came on very quickly and were only about a minute and a half apart. That's when I asked for the epidural. Shortly thereafter my water broke - but just a little - giving me a trickle every couple minutes. Dr. Ho came in and checked me and I was around 6 cm and 80% effaced and she went ahead and further broke my water. I had a couple big gushes and then continued to leak fluid - which was normal.

I was on a fetal heartrate monitor and contraction monitor the entire time, and the baby's heartrate stayed within the normal range - so none of this was bothering her. I also had a blood pressure cuff on that activated a few times an hour - and my blood pressure and heartrate stayed normal. They came in to do the epidural around 12:30. There was an anesthesiologist with the resident, but he was the one doing it. I guess I should have objected, but it seemed fair that residents have to learn and NYU is a teaching hospital.

They had me sit on the side of the bed with Shafi in front of me in a chair. I leaned forward on him and he helped support my shoulders and head while I curved my back out so that they could put the epidural in. Every time I had a contraction they would wait until it was over to proceed. The numbing shot was a bit of a sting, but not too bad. Then they told me I'd feel pressure but not pain as they inserted the very large needle into the epidural space. I thought I was feeling pain, but with everything that was going on, it was hard to tell. Then I suddenly had a shooting tingly feeling down my left leg. I told them immediately. It happened about 3 more times and they decided they needed to start over. This time it was the anesthesiologist putting it in. She was much faster and more proficient than the resident of course, and all went well.

As I had feared, they told me that they had accidentally gone past the epidural space and into the spinal space - one of the risks of getting an epidural. They went over with me what some of the risks are - the main one being a "spinal headache." They said they'd check on me later and the next day but to let someone know if I had any problems. Luckily - I did not.

They started me off on a low dose and said we'd know after about 5 contractions whether it was enough. It wasn't. They came back and added more and waited with me for it to take effect. It took quite awhile until I had relief. Then my right leg was getting numb while I was still feeling contractions on the left. Eventually it evened out and by 2:30 I was no longer in any pain but was pretty much completely numb from about the waist down.

I was feeling occasional pressure from contractions and pressure as the baby continued to descend. They had me sit straight up with my knees out the sides - almost indian style - to help encourage the baby to continue to drop. The doctor came back to check me about 4:00 and said she was surprised I wasn't feeling the urge to push - the head was "right there" and I was ready to go. I guess the numbness had stopped me from feeling the pressure enough to know it was time to push, but no problem, I did have enough feeling to be able to push.

The nurse then told me when each contraction was starting and she and Shafi stood on either side to help hold my legs as I pushed. 3 times for 10 seconds with each contraction. It took 7 sets of pushes and just under 30 minutes and Leah was born at 4:41 p.m.

First her head came out and they told me to pause as they suctioned her nose and mouth. Then they told me to push gently and she came flying out. Dr. Ho clamped the cord and Shafi cut it between the clamps. And they put Leah right onto my chest. I definitely didn't know how great it would feel until it happened - and I was not at all bothered by her not having been cleaned off yet. She was perfect. She was alert right away but didn't cry much. She just looked up at me and at Shafi. We put her to the breast just to get her familiar, but she wasn't really ready to feed yet.

While this was going on I delivered the placenta. It seemed to come on its own - I didn't have to push. I really wouldn't have known it was happening if they hadn't told me.

Then they took Leah to the warmer just a couple feet away - still in the room - to weigh her and clean her up a bit while the doctor cleaned me up. I had a 2nd degree tear that she sewed up, as well as a couple of "bleeders" that she had to tend to first. I was starting to get feeling back at this point and it was a pretty uncomfortable half an hour or so. But having just had a beautiful healthy baby, I wasn't complaining too much.

We got to spend a couple hours in the room before being moved up to the Post Natal ward. We made a few phone calls to let immediate family know and we both got to spend quite awhile holding Leah. I tried to feed her but she wasn't latching on well. They told me not to stress about it too much - we'd keep trying and I could meet with the lactation consultant the next morning.

Shafi took to fatherhood like a pro. He held Leah and talked to her. He tried to help as much as he could when I tried to feed her. And of course he was a great labor and delivery coach all day - bringing me ice chips and hard candy, holding my hand, helping me breath through the contractions, and counting through the pushes.

Leah's first night was a bit rough on me. We got moved into a shared room in the Post Natal ward, but we lucked out and got the window side and no roommate for awhile. Shafi was able to stay until after 11, even though technically fathers are supposed to leave by 10:30 p.m. I continued to try breastfeeding, which continued to be a challenge. And we made lots of phone calls, took pictures, and sent some emails.

Of course Leah is perfect...but she seems to have a need to be held while she sleeps. Even when she seems sound asleep, she wakes up when we put her down. (Even right now, she is sleeping across my lap as I write this - it's Shafi's turn to get a few hours of sleep.) So the first night I only slept about an hour and a half plus a little dozing with Leah in my arms. She wasn't eating enough, so they told me that if I sent her to the nursery and they thought she was hungry I could either let them give her formula or they could bring her back to breastfeed. Since breastfeeding wasn't going too well and I didn't want her to have formula, I had to keep her with me. Finally around 6 a.m. I got her to sleep in the bassinet and I was able to sleep for about an hour and a half before the normal morning commotion started - announcements being made, breakfast being served, etc.

I did get a roommate around 1 a.m. Luckily she was very nice and fairly quiet - so we had no problems sharing the room for a couple days. I was luckier than she, as her baby was very sleepy and quiet. Leah has a good set of lungs I guess, as she's got a pretty loud cry for a newborn. And since we kept trying to get her to sleep in the bassinet, there were quite a few long crying episodes.

Friday morning Shafi came back around 9:30 and took Leah so that I could shower. I felt quite a bit better after that, despite my exhaustion. I then went to the breastfeeding class at 10:30. All mothers and babies are invited to attend the daily class (well, daily except Saturdays). They have you sit in a chair and feed your baby while the lactation consultant goes around to each mom/baby. If you're having problems, she spends time helping you. And if not, she just gives feedback on form and such. She also gave some general information and tips - nothing I hadn't learned in the class we took or read in a book.

She was a lifesaver. Not to provide too much detail about my breasts, but basically every time I would try to get the baby to latch on, my nipples would flatten out. The lactation consultant was able to help me get a hold in such a way that Leah was able to latch. I sat there for almost 2 hours trying to feed her. She was finally able to latch, but she would only stay on for a few seconds at a time and then I'd have to get her on again. It was painful and exhausting. But the lactation consultant said not to give up. Leah is a natural - definitely trying hard and sucking hard - so it would all work out soon. She said she'd come see me in the afternoon to see if I needed more help.

She was right - each time I nursed her, she latched on faster and for longer. By the time the lactation consultant came back to see me around 4:30, I felt like things were working well enough that she couldn't do much else for me yet. She had already told me my form was good and all of that, so it was just a matter of practice for both me and Leah.

Shafi and I spent the day trading off holding Leah and napping - and of course making lots of phone calls and sending emails. He left around 10:00 to head home for the night and get some sleep, as he'd be returning with the car seat in the morning.

The night nurse suggested that I send the baby to the nursery since I obviously needed to get some sleep. By this point, Leah was nursing well enough that I was able to do "baby on demand." Basically they took her to the nursery and whenever she showed signs of wanting to eat or no less than every 4 hours, they would bring her back in for me to feed her.

I was worried that she'd just cry all night in the nursery, but they assured me that if she was inconsolable they would bring her back to me. About 15 minutes after they took her, I went to see for myself. Sure enough she was sound asleep in the bassinet. Not sure what it was about being there versus being in my room, but she was fine. I was then able to sleep for about 3 hours before they brought her in for a feeding. The feeding went pretty well and when she fell asleep I called the nurse to come back and take her back to the nursery. They brought her back to me about 4 hours later and I fed her again.

Saturday morning was spent getting everyone checked - Dr. Shweizer came in to see me around 11 a.m. and said everything seemed fine and I should make an appointment to see Dr. Markoff in 6 weeks. And he signed for me to be discharged. The NYU affiliated pediatrician we picked - Dr. Rossi - had seen Leah Friday morning and said she was fine, so they checked with him that she didn't need to be seen again and he signed for her to be discharged.

We finally got all of our paperwork by about 1 p.m. and were able to leave. We dressed Leah in an adorable newborn outfit - lavendar velour overalls with a long sleeve T with flowers on it (thanks Kristen) and some newborn maryjane sock-booties in pink (thanks Paul & Jill). The snowsuit we had brought was definitely too big for her, but it wasn't a problem. We put her in the car seat with a blanket over her and the boot on the car seat and she was nice and cozy.

We had no trouble getting her buckled into the middle of the back seat in the cab with Shafi and I on either side - worrying about every little thing. But she was very happy in the car seat and had fallen asleep as soon as we started carrying her down the hall to leave and stayed asleep for the entire ride home.

Once we got home, we unpacked and ordered some lunch and did Leah's first at-home diaper change and feeding. All went well. We then spent the day trading off. I'd feed her and then Shafi would handle the diaper change and hold her while I took a nap or ate. Then Shafi would eat or nap while I fed her again. On and on. I sent him to get some sleep around midnight while I fed her and now she's sleeping happily in my lap as I check email and write this. In a little while I'll feed her again and then maybe attempt to get her to sleep in the crib so that I can get a little sleep too. And if not, I'll doze with her on my lap or chest until the next feeding and let Shafi sleep for a few more hours. Since she's supposed to be fed every 2-3 hours from beginning to beginning of the feeding, I'll need him a bit rested so that I can get some good day time naps in today (Sunday).

I think that's all the news for now.

In short - Leah Amira Imran was born on February 7, 2008 (the Chinese New Year - Year of the Rat) at 4:41 p.m. She weighed 6 pounds 10 ounces and measured 19 inches long. Her head circumference is 34 cm - normal for her size. I'd say she's tall and skinny - in a cute baby way. She definitely got Shafi's round face and his eyes and nose. Beyond that I think we'll have to wait to see what other traits she's gotten from the two of us.

Almost time for the 3 a.m. feeding.

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