The birth of my sweet baby girl!

We arrived at the hospital around 7:30 Tuesday morning. I was nervous but had done my best to put my relaxation practice to work. We filled out a lot of paperwork and then were taken to our room. We waited an hour before anyone arrived. It seems there were some emergencies and our Cesarean was being moved to after 10:00. That meant more sitting and waiting, ugh!
Finally they started to prep me for the Cesarean. I met with my nurse and the anesthesiologist. He was a very nice man and explained everything as he went along and answered all of my questions. Oddly enough, the hardest part for me was the epidural. I'm not sure what the reason for it was, but I became faint and had to ask to lay down during the middle of the procedure. I felt nauseous and anxious, I desperately wanted this just to be over with. My husband was there with me, all dressed in scrubs. After the epidural was in place and started taking effect we were wheeled into the operating room.
The atmosphere in the waiting room was very happy go lucky. The lights were very bright and the nurses were making jokes and teasing one another. We were asked for permission to allow students to watch the birth of our baby girl. Since she had severe hydrocephalus it was something that drew a crowd. We gave permission, and as a result we had over a dozen people watching the birth.
As the operation started the anesthesiologist stayed right close my head and whispered to me at different points during the surgery to let me know what was going on. My hands were shaking terribly and I could only get the shaking under control for brief moments, it was a very odd feeling. My arms were pulled out to my sides and strapped down, my husband was to my right sitting on a stool holding my hand. As the Cesarean started my husband peeked up over the large blue drape they had in front of me, he would tell me what he could see. I felt nothing as they sliced open my abdomen and uterus. It was quite hard to believe it when in a few short minutes my husband told me I was cut open and they were getting ready to pull our baby girl out. It went by so quickly, I heard a weak, faint cry as they peaked my daughters head over the drape for me to see her. I was thrilled to see her small little face. I was also thrilled that I heard her cry even though it was small and faint.
At that point I was asking my husband on the condition of our daughter, I wanted whatever information I could get. A slew of nurses and doctors from Children's Hospital were now in control of her care. She was put on a ventilator because her head was so large that it closed her breathing passages when she was laid down.
I was sewed up in a few quick minutes then wheeled back to the room to wait. Later they brought our newborn daughter in for a few quick minutes in an incubator. Her big sister got to take her first peek and say a quick hello.She was then whisked away to Children's Hospital where she would begin her long journey in the NICU. I honestly don't remember too much after that.
Later that evening I was taken to a different room for recovery. I remember this point, I was extremely nauseous and continued to vomit for the next several hours. I was completely miserable. I was given anti-nausea medication, but I wasn't able to keep it down. Later I had a shot that helped. It was so painful to be wretching and vomiting when you just had your stomach muscles and uterus cut open. My husband went to check on our baby girl at Children's Hospital. I had a close friend there with me to give me a cool washcloth on my forehead and to set with me. I was glad for the day to be over, I wanted to rest. I felt I couldn't even keep my thoughts straight. After many long and worrisome months, our baby girl was finally here!

Tomorrow?!

I woke up yesterday, Sunday morning feeling crampy and decided to take it easy all day. The pains didn't follow any sort of pattern and I just stayed achey for most of the day. I had already packed my suitcase a few weeks back and was prepared to go to the hospital at any time. I even had rented my breastpump ahead of time and felt I was prepared. I knew I had an appointment with the doctors early the next day, so I didn't worry too much about it.
Monday morning I was still feeling achey, but no hard pain. I went through the normal routine. We had a Biophysical Profile done, but they didn't take any new head measurements at this appointment. From our previous appointment we knew the head was measuring around 52 weeks. Everything else was fine, I had plenty of amniotic fluid, the cord blood flow was good and I was still gaining weight.
When I first visited with the doctors they told us they had set up the C-section for Monday, January 30th at 6:00 in the morning. By the end of the appointment they moved the C-section to the next day. I was 4cms dilated and they could feel the baby's head actively pushing down. I was excited that my baby was showing signs of being in labor, it made me feel like maybe she was ready to be born. I was also very nervous that TOMORROW my pregnancy was going to be over and a whole new adventure beginning.

Amniocentesis- The Pros and Cons

Since our first appointment at the high risk prenatal center we were asked to have an Amniocentesis. This is a test where the doctor inserts a needle down through the stomach using the ultrasound as a guide to remove some amniotic fluid. The fluid is then tested for chromosomal abnormalities or genetic birth defects. It takes several weeks to get the results of the Amniocentesis.
We have declined the Amniocentesis, up to this point, for many reasons. From the beginning it was not an option for us to "choose" not to have the baby because of her diagnosis. Often people choose to have an ultrasound to find out what issues the child will have and then may decide not to have the child. We knew whatever her issues we were going to do our best to provide for her so it wasn't of any benefit to us to do the procedure early in the pregnancy. The doctor reminded us that if we learned our daughter was diagnosed with a chromosomal abnormality that was incompatible with life than they would be able to perform a procedure where they could drain the fluid from her brain in utero, and then have her born vaginally. There was little chance she would ever survive the procedure. While a vaginal birth would mean a lot to me, that was not an option for us to consider! We were fine with waiting to find out exactly what chromosomal issues we may be dealing with down the line.
There are also many risks associated with having an Amniocentesis performed early in the pregnancy. These risks include infection, miscarriage and possible club foot. The risk for miscarriage lowers the later in the pregnancy the procedure is performed. It is also best to find a provider that has a lot of experience in performing an Amnio. Most Amniocentesis are performed in the second trimester. Finally, the day came when it was decided we would do an Amniocentesis to check the lung maturity of our daughter. We had put it off as long as we could, we were now 36 weeks pregnant and hoped her lungs were developed. Her head was growing so large and we were hoping to get the fluid drained quickly after birth, hopefully as soon as possible. After the fluid was removed, the baby's heart rate was monitored for about an hour.
There was quite a delay with us getting our results. The machine malfunctioned several times and then they decided to send it to UT medical center to have them test it. We waited several hours at the doctors office, then we left and waited for them to call us and let us know the results. We were hoping to get a surfactant level of 55 or close, this would mean her lungs were developed. Surfactant is the lung coating, it's excreted into the amniotic fluid. The doctors seemed to think she'd be ready, then we'd proceed with making plans for her birth and shunt surgery. We finally received the call only to find out that the surfactant level was 19! Needless to say we were quite disappointed. This number was a lot lower than anyone expected. This brought on a lot more anxiety, now we were worrying she'd be born to early and would have lung issues to deal with. We certainly didn't want that on top of everything else. So now we wait and hope I don't go into labor on my own. My first daughter was born at 36 weeks naturally, so this makes me very nervous.

Celebrating Pregnancy

I enjoy being pregnant. I get excited to watch my belly enlarge each week, I get excited to wear maternity clothes and I love to feel the little life inside of me kicking and moving around. A lot of the joy has been sucked out of this pregnancy due to the complications of Hydrocephalus and Dandy Walker to our unborn daughter. Instead of joy and excitement we are often left feeling anxious and depressed.
I really wanted to do something that would help me have some joy and celebrate this pregnancy. We decided to have some pregnancy photos taken. It was a great experience for our entire family. My husband was hesitant at first, but after some thought he agreed. He has a photographer friend at his work that was willing to come to our house to take the photos. We spent the evening posing individually and together as a family with my bare belly. The pictures turned out wonderfully and have brought me a lot of joy just to look at them. I'm so glad we did it!
I hope others take the time to do something to celebrate their pregnancy. Having maternity photos are only one way of doing this. You can use paper mache and make a mold of your belly to remember your pregnancy, you can do this yourself or buy a kit to make it easier. Other moms have had henna tattoos or some sort of art work painted on the canvas of their tummies. Whether you are having a low or high risk pregnancy I encourage every mom to be to take the time to really enjoy and celebrate their pregnancy.
At our appointment this week I had to abandon all possibilities of a vaginal birth. Our daughter's head circumference is now 370.80mms, or the equivalent of approximately 44 weeks. Her abdominal cavity measures around 246.80mms or about 29 weeks. The right lateral ventrical is measuring about 67mms and the left ventricle measures at 23mms. This was a tough appointment, I went by myself. My husband has always been with me up to this point. They needed three technicians to come in to do the measurements. I was more than happy to leave when this appointment was over! They have scheduled a lung maturity amniocentesis for this next week.

The benefits of a vaginal birth

Time is marching on, and it seems like we'll have a good day then we'll have a bad day. I guess that's just how the body and mind help us cope. One day I feel like I can handle anything that we are presented with, then I'll feel completely overwhelmed the next day and struggle to get out of bed. I'm thankful for my faith that helps me have hope, I"m also thankful that I have such a supportive group of family and friends that are always checking in on us.
I'm really struggling with the idea of having a Cesarean. I believe so strongly that there are so many advantages of having a baby vaginally. I also believe that Cesareans are often over used in our country. I do realize that our situation, as with many Hydrocephalus infants, will more than likely require a Cesarean for the safety of myself and my baby. I do, however, continue to keep the possibility of a vaginal birth before the eyes of my doctor.
I think I am all too familiar with the increased risks of a birth by Cesarean Section. There is a highter death rate associated with cesareans, also their is a higher rate of injury and risks to the baby in most situations. Simply because of the nature of the invasive process you have a higher risk of infection, a higher risk of complications due to anesthesia and a higher rate of post-partum pain, not to mention any emotional reactions of a negative birth experience. One of the major factors that concerned me was the lack of stimulation my baby would recieve by being born through Cesarean. I wanted her to benefit from the process of labor and birth in regards to her breathing and alertness. Labor is important to both mother and baby. Another benefit of a vagainal birth is the baby's lungs are squeezed as the baby passes through the birth canal and removes any fluid from the lungs, this obviously doesn't happen in a Cesarean birth. I know some doctors are open to massaging the baby afterwards, and this has been of some benefit. My doctors have not been open to the idea so far, but I'll continue to bring it up just in case.
I do need to say that I had a wonderful birth experience with my first daughter. I found it very empowering and the most wonderful day of my life. I was only hoping to share the same experience with my second daughter. I now need to change my focus on move past my hopes of a vaginal birth, and focus on enjoying the birth of my second daughter now matter how she is born.
Here's what we learned at our appointment this week: I am almost 33 weeks pregnant at this point. Her head Circumference is 316.20mm, or measuring a little over 35 weeks. Her abdominal cavity is still behind, measuring 240.7mm or the equivalent of 28 weeks. I"m still gaining weight with normal cord dopplers and amniotic fluid. Her right lateral ventricle measures 58mms and the left ventricle measures 21mms.

What's a big sister to do?

Throughout the pregnancy we have been very open with our oldest daughter that is three and half. While we were planning our birth at the Birthing Center she was went with us to all of our appointments. She has watched numerous birthing videos with me, real birthing videos, not ones that have been edited for TV. She knew about normal birth, and how the baby grows inside her mommy. She had been planning on cutting the cord of her younger sister and was telling everyone about it. Now plans had changed a bit due to the diagnoses of Hydrocephalus and Dandy Walker with our unborn baby girl.
We now keep her involved in the pregnancy, but she doesn't go with us to our appointments at the Perinatal Center. She was with us for the original ultrasound where we learned of the Hydrocephalus. The appointments are quite stressful, so we make the day fun for her by taking her to spend the day with my parents. This gives my husband and I the time to go to the appointments together, and then regroup deal with the latest news before going back to pick her up. It works well for all of us.
We still keep our daughter informed on the pregnancy, but on her level. She knows she is going to be a big sister, but now we're not going to have a water birth. She also knows the baby is a bit sick and will need to be in the hospital. We try not to focus so much on the negative, but also want her to be aware of the changes that we're all going to experience in the upcoming months.
At this weeks appointment we were hoping to still have stable measurements, but we had no such luck. So that was quite disappointing. We're about 31 weeks pregnant and her head circumference is 311mm, or about 35 weeks. Her body is only measuring at about 26 weeks. At this point I'm still hoping for a vaginal delivery, though it is looking less and less likely.

Touring the NICU

Again it has been a tough three weeks. We are doing all we can to learn about Hydrocephalus and Dandy Walker. The yahoo groups have been the most helpful. It is a great resource to be able to find other parents and families that have gone through what you are experiencing now. Their support and information has been invaluable so far, and I"m sure it will continue to be so.
I've been pleased that I've been able to keep my appointment at three week intervals. I know they wanted to see me every 2 weeks, that was a bit more often that I felt comfortable with. Up until now they were ok with every three weeks. I had some pre-labor, braxton hicks contractions this week. So now I do need to come back every 2 weeks, ugh!
So we had a bit of good news this week, her ventricles remained stable at 17mm and 37 mms. We are almost 29 weeks, her body is still measuring about 4 weeks behind. We hope that her ventricles will remain stable through the rest of the pregnancy.
We had an appointment with the NICU social worker after our appointment at the Perinatal Center. Jill Edds is the social worker at the East TN Children's Hospital. She was a very pleasant and mild mannered woman. I can see how she could be very calming to grieving parents. She showed us the procedure for entering the NICU, including how to buzz entry and how to scrub up before entering the NICU. So once we were inside it was very hard to see all of the fragile baby's and know that we were going have our daughter here connected to all of these machines. We learned about the different kinds of beds for the baby's to lie in. We also learned about a few of the monitors and equipment. About half way through the tour I couldn't handle it anymore despite how hard I was trying. I burst into tears, which didn't help my husband keep it together. It was all very overwhelming. After a few minutes I was able to gain my composure. We met with one of the doctors that rotates care in the NICU. We sat down and spoke with him for a few minutes, he was very nice and comforting. He was the most positive doctor we've met so far. He explained that if there aren't other complications, that a baby with shunt surgery for Hydrocephalus may only need to stay in the NICU for 5-7 days. We left on that positive note.
I highly suggest touring the NICU ahead of time if you have a baby that is prenatally diagnosed with Hydrocephalus. It definitely will help lessen some of the shock that you'll be dealing with later.