Saturday, December 15, 2012

The Arrival of London Antoinette Okray

The past 12 days have been a whirlwind in the Okray household.  We appreciate all the love, support and friendship that we've received from each and every one of you and now that we're all safely snuggled in at home we are finally able to share London's birth story with you all.

The whole ordeal started on Tuesday December 4th, 2012 around 11:30am.  Amber was at work and started to feel very minor contractions.  She made it through the afternoon at school and through that evening things started to progress even more.  After dinner on Tuesday night Amber and John started to time the contractions which were lasting for 1 to 2 minutes and were about 10 minutes apart.  That night they continued about every 10 minutes at 1 to 2 minutes long and also got more intense.  About 4:30am Amber called her long-term substitute and the substitute co-ordinator at work because she was sure that within the next 24 hours London would be born.

On Wednesday morning the contractions got even more intense and John and Amber headed to the Madison Birth Center (the non-intervention birthing location that we had been going for our prenatal care since early October) and we made all the necessary calls to immediate family that we were on our way to give birth so that there would be a baby born very soon.  Once at the birth center it was confirmed that Amber was not as far along as we thought.  The pain was very intense, however, Amber was not dilated very much so we were told that we'd have to go home and labor some more at home.  This is very typically done at the Madison Birth Center so we didn't think anything of it.

We didn't want to go all the way home to Janesville (being that it's about 45 minutes one way from the Madison Birth Center) so we made arrangements to go to John's sister's house in Verona, WI (about 15 minutes from the Madison Birth Center) to labor for the day and then head back to the birth center when things progressed later on.  By this time Amber's mom, Diane, had made her way down from Appleton and spent the day with us at Michelle's.  As the day went on Amber continued to labor, but it became very irregular without much of a pattern.  We were in touch with our midwife throughout the day and evening and once the pain got so intense that Amber thought it was time (about 4am on Thursday) we were about to pack up and leave when Amber just stopped having contractions.  All that labor and just like that nothing!

At 9:00am on Thursday Amber still had not had a contraction since about 4:00am so we decided to head home to Janesville.  It isn't incredibly common, but it does happen that your body just needs a break from labor so that's what we figured was happening.  Around dinner time that night (Thursday) Amber started contractions again, but this time the pain was all in her lower back and again the labor had no consistent pattern.  Sometimes they would be 20 minutes apart and 5 minutes long and other times they were 7 minutes apart and 1 minute long.  The contractions lasted like this throughout Thursday night and when we called our midwife the next morning she suggested seeing our chiropractor to see if baby would move to a better position so that regular labor (labor with contractions in Amber's uterus) would start back up.  After the chiropractor we headed up to the Madison Birth Center to see if Amber had progressed any further.  When it showed that she had not dilated anymore than she had on Tuesday morning our midwife got out the fetal-scope to monitor Amber's contractions. Each time Amber had a contraction the baby's heart rate would drop and it took a long time for the heart rate to get back up.  Also, the fetal-scope showed that Amber's contractions were only in her lower back and not spreading to the uterus which is not a good thing.  Our midwife referred us to Meriter Hospital in Madison to see what other information we could find out from this odd labor process.  John, Amber, Diane and our doula Margaret (who is also studying to be a midwife at the Madison Birth Center) headed to Meriter Hospital.

Once there the fetal-scope showed the same drop in the baby's heart rate that we saw at the Madison Birth Center and it also showed that the contractions were all in Amber's back and not spreading to her uterus.  They decided that an ultrasound was in order.  The ultrasound found that London was transverse breech (meaning her head was on Amber's right side and her feet were on Amber's left side).  Being in this position there is almost no way to have a vaginal delivery.  This was the time for modern medicine to kick in and for us to have an emergency cesarian section.  With tears and frustration and a lot of fear we knew that have the emergency c-section was our only option and both John and Amber got prepped for surgery.  We had to have the OB Surgeon (who was wonderful) come in and discuss the risks of the surgery, we had to have the Anesthesiologist (who was also wonderful) come in and discuss the risks of anesthesia and John had to get into a surgical outfit.  Once we were all ready Amber was wheeled into the operating room and John had to wait outside until Amber was prepped (the longest 20 minutes of his life).  Once everything was ready to go John was able to hold Amber's hand and be with her during the surgery.  Amber was able to stay awake and alert throughout the surgery although she or John were not able to see anything as there was a sheet separating the surgeon and his work from Amber and John.

Once inside they found the uterus stained with meconium (baby poop) and they were worried that London may have ingested some.  This could cause a lot of harm to a baby.  Once London was out of Amber they immediately took London and tried to suck as much of the meconium out of her nose and mouth as they could.  When they thought they had everything out they finally allowed London to cry.  It seemed like hours before Amber and John were able to hear her cry (although it was probably only a matter of a minute).  Then John was able to go over and see her and after they cleaned her up a bit more they brought London over to see Amber too.  London's official time of birth was Friday December 7th, 2012 at 5:45pm and she was 6 pounds 12 ounces and 19 inches long.

First family photo with London, Amber and John.

Amber meeting London for the first time.

After a brief meet and greet they took John and London off to the NICU so that they could monitor London for possible meconium aspiration (ingestion of meconium).  Amber stayed in the OR until she was all stitched back up and then she spent about an hour in post-op and was given a review from the nurses and OB Surgeon on what happend during the surgery.  The surgeon said that London was one of the hardest breech surgeries that he had done in quite awhile and because she was so wedged in there that he had to make two incisions (called a t-incision) which would mean that Amber will not be able to have a VBAC (vaginal birth after cesarian).  That was very disheartening news to both Amber and John because we had wanted to have a very natural, non-intervention birth for all our kids down the road and now we know that will not happen.

John and Amber in post-op

After post-op Amber was wheeled up to the NICU to see London for another brief moment and then we were brought to her room for recovery.  Amber was put on some strong pain medication that basically "knocked her out" until about 3:00am when she woke and wanted to see London.  The nurses and John wheeled Amber up to the NICU where she was able to hold London for the very first time.

Amber holding London for the first time (3:30am)

Another family photo.

London once she was all settled in the NICU.

You may notice that London was hooked up to a few things.  Let me explain those as best I can.  The "cast-looking" thing on her arm (eventually moved to her head because she scratched the one on her arm off) is an IV because they did give her antibiotics because if she ingested any meconium that could be toxic to her and the cultures that they give to check if she has an infection take 24 and 48 hours to come back so they decide to be "better safe than sorry" and give her an IV of antibiotics right away after birth if there is an meconium present in the womb.  She also has a breathing tube by her nose.  This IS NOT oxygen.  It's also a precautionary measure to insure that air (the regular air that we're breathing) can get to her quicker if she does have breathing problems from ingesting meconium.  Also, there is a tiny tube coming from her mouth (later they move this to her nose because she kept pulling it out of her mouth).  That is a feeding tube which they put in as a precautionary measure just incase she will not eat or is not able to eat because of the ingestion of the meconium, however, this was never needed or used!

Over the next four days they continued to monitor London for meconium ingestion (all the cultures came back negative) which means that as far as they know she never ingested any meconium.  After that scare was over they also monitored London to make sure she was feeding correctly which she was able to do just fine because Amber's milk came in very quickly and she was able to pump enough colostrum before that to keep London satisfied.  We are proud to say that London did not need any formula supplements although we did need to have some donor milk from the Madison Birth Center just to be safe.

Amber and London were released on Tuesday December 11th, 2012 around 3:00pm and we were all very excited to go home as a three-person-one-cat-family for the very first time!  London continues to feed very well and as of today (Saturday December 15th, 2012) she is 7 pounds 7 ounces so she is growing fast!

John loading London into the car to head home from the hospital.

London's first car ride.

Amber, John and London are home for the first time!

Stay tuned for more updates on London's first week at home as well as information on our move to our new house.  Until then Go Pack Go!

Some other pictures from London's stay in the NICU:

London's NICU Room Sign

London meeting Grandma Diane.

Mommy and London Koala time

London's first feeding by bottle.

London meeting Great-Grandpa Norb and Great-Grandma Betty

London getting kisses and snuggles from Mom

London being held by Daddy for the first time

London meeting Uncle Adam

Okray Family Photo

London meeting Auntie Michelle

Auntie Michelle, Daddy and London

Auntie Michelle, Mommy and London