Maura Elizabeth Smalley joined us on Thursday, August 21 at 1:35 p.m. She was 4 lbs. 15 oz. and 18 inches long. Sorry it has taken me so long to update! Here's the birth story:
On Wednesday the 20th I headed to the hospital for a repeat ultrasound to see if the girl had grown any from the previous week's ultrasound. Before I left the house, I thought, "This could be it. Shave your legs and pluck your eyebrows, do your hair and bring your bag." I didn't really believe it though, as they said I would get at least two days notice if I was going to be induced.
I arrived for the ultrasound and the tech immediately said, "She hasn't grown." I had gotten an official diagnosis of IUGR (interuterine growth retardation) earlier in the week, which basically means that my placenta just gave up around 34 weeks, and she was unable to gain any nutrients from my body from that point forward, which caused her to stop growing. It was a dangerous condition, particularly if the ultrasound proved that things had not improved over the course of a week.
The tech searched around looking at her blood and oxygen supply and went to go report to the doctor on call. 10 minutes later they came in and said that the baby was in distress and they were going to move me to labor and delivery. I got up in a daze and they said, "We're starting the induction." I was like, "Now??? Can I call my husband? What's going to happen?" A very nice doctor put his arm around me and said, "Your baby needs to be born. This is a great time to deliver, and you'll be just fine. 38 weeks is a perfect time to have a baby." They felt that she would not need NICU care once she was born and that it was safe to deliver at the hospital there instead of one in the city, so they brought me into a room and had me change into a gown. I called Jay and told him it was a go, which induced a bit of panic. He left work right away and was by my side within an hour.
It took a few hours, but they came in and set me up with pitocin, which is an artificial hormone that stimulates the uterus to contract. They told me the induction could take three days because they had to go slow because of her size and state. This was around 1:30 p.m. We sat and waited for the pitocin to take effect, but by 7 p.m., I hadn't really dilated any further and they wanted me to be able to eat and sleep before they kept up with everything any longer. The doctor came in and said that while the baby was OK, no matter what she needed to be born the next day, at the latest. So they turned off the pitocin, let me have a cheeseburger, and gave me orders to sleep, as the pitocin would be starting up again the next morning at 4 a.m. They were going to let it "saturate" in my body overnight.
We were too excited to sleep, and with all the goings on and checking in with the nurses, we didn't fall asleep until about midnight. At 4 a.m. as promised they came in with the pitocin. By the time I was checked again at 7 a.m., I had dilated only another half-centimeter, and while I was feeling contractions, they were only mildly uncomfortable and not very frequent, even though I was on the highest level of pitocin. At this point, they decided to break my water to get things moving. And move they did . . .
The contractions kicked in majorly, which as I imagined, were quite painful. I was breathing through them and Jay was calming me down, but when they came in at 10 a.m. after three hours of it, I was ready for the epidural. The epidural was finished by 11:30 a.m. and was a god-send; it didn't hurt AT ALL going in (no more than an IV prick) and the relief was almost instant. They checked me again to get a baseline and I was 4 cm. Everyone took bets on her birth time; everyone said no earlier than 10 p.m. We hunkered down for the long haul.
About an hour later, I started to get very cold, teeth-chattering and all. They checked me again and I was 6 cm. They came back 20 minutes later to adjust the pitocin, took one look at me, checked me again, and I was a full 10 cm. The doctor was like, "Ummm, call the pediatrician and let them know they need to be here for a birth immediately." She looked at me and said, "ready to push? You better get ready, we're starting in a few minutes and this baby needs to get out." She was struggling, and they had to insert an internal fetal monitor to the top of her head since the monitor on my belly wasn't able to keep track of her well enough. It all happened so fast, and next thing I knew, my legs were up and I was pushing.
In what felt like an instant, (and was only about 20 minutes), out came Maura screaming her little head off. They plopped her on my chest, and time stood still. I couldn't believe she was here and I was touching her. They had told me to expect that she would be moved right away to an isolette and that I wouldn't likely get to hold her right away, but because she was crying, they felt it was safe to let me hold her for a minute. Too soon they moved her to the warmer, and Jay got to cut the cord. I kept asking if she was OK as a team from the pediatrician's office were conducting her Apgar tests and checking her lungs and heart. I was so preoccupied with her that I don't remember delivering the placenta or getting stitched up. They concluded that although she was fine, she was in fact a preemie at just under 5 lbs., and they believe that I was not in fact 38 weeks, but more like 36, which is pre-term. We're still not sure if we believe that--it means that every ultrasound we'd had to date was incorrect in assessing her size and my due date, which is highly unlikely. But the pediatrician was convinced she was no older than 36 weeks, and so they were going to treat her as such in the nursery.
They cleaned everything up and decided that we could hold her for a while until it was time to move me to a new room and give her a bath. We were ecstatic -- again, we had been told not to expect this, that we would likely have to watch her being wheeled off to the nursery immediately. I couldn't stop crying at how much I loved her, and Jay was in heaven, holding his daughter like a natural. I'd never loved him so much as in that moment.
About an hour later they came back to move me and took her off to her bath. We were told they would come get us in about an hour or so once they were finished to show us a few things about feeding before we got settled in our room. They asked if it was OK to have a group of nurses and interns with her in the nursery as they got her cleaned up and ran some final tests on her muscular development, reflexes, etc. Of course, we said yes, and as they wheeled me to my new room past the nursery they held her up in the window to wave to me.
We got into our new room and I said I wanted to go check on her. We got half-way down the hall and the nurses stopped us and told us there were some problems. Her breathing was very labored, and she turned "dusty" during the tests. They had to abandon the bathing and put her in a warmer and run some tests. They let us go in as they were hooking her up to some makeshift oxygen tubes, and calling for more support from the pediatrician. They did a chest x-ray and determined she had something called TTN, which basically is a condition in preemies that causes fluid in the lungs. After much trial and error and us in tears, they decided to put her in a "hood" which is basically an upside-down bowl over her head that was going to feed in oxygen through some tubes filtered by a dehumidifier. And they hooked her up to an IV, which they wouldn't let us witness.
I have never been so terrified in my life. They let us come to look at her and touch her and talk to her whenever we wanted, but we had to spend the first night without her in our room. I barely slept, and went and sat with her a few times through the night. I felt terrible -- people came to visit, but no one got to hold her. And watching her on the monitors and stuck with an IV and not in my arms, I couldn't keep it together.
By noon the next morning she was doing better and they were slowly weaning her off the hood. By 4 p.m., she was breathing room air on her own, and they let me go in and feed her. It was exhilarating. Finally, after my body had failed to feed her for her last few weeks inside me, and after I was unable to do anything for her in her first day of life, getting to feed her gave me a purpose I could hold on to, something I could do for her that would do some good.
The next two days in the hospital were perfect--we got to have her in our room that night, learned to feed her and take care of her, bonded as a new family, got to know each other. I have many of my life's best moments that took place in those days--holding my sleeping daughter to my chest, laying in the hospital bed in the middle of the night with my husband curled up behind me, holding me as I cried at all of the love I felt for him and her, watching Jay lay with her on the silly fold out bed at 3 a.m. as we got ready to feed her. I still cry every day at those memories, knowing I will never get them back. As exhausted and out of sorts as I was, it was when I was at my best.
The decided to keep her another day to monitor her, and they let us stay on as boarding parents so we didn't have to leave her. We were so excited when we got the word we could take her home. The nurses and doctors were wonderful and wished us well, and then we were on our way to our new life.
The past two weeks have been like nothing else in my life. We love Maura so much it hurts sometimes to look at her because I have to hold back from sobbing. We can't imagine our world without her. It's the hardest thing we've ever had to do, but we're getting better at it by the day. I've never been so in love with Jay, and although I sometimes feel like we are two ships passing in the night, I couldn't be the mother I aspire to be without him by my side, and I want to do it again as soon as possible so we can keep building on the love we have for each other. I finally feel complete!
She is growing well, and as of her two week appointment yesterday she is up to 6 lbs. and 19 inches. Small, but growing like a champ!
Thank you to everyone for your love and support. Thanks to your generosity, we re the most well-fed new parents and she is the best dressed girl on the block. I'm going to try to update here as frequently as she allows, hopefully at least once a week.
XOXO,
Emily, Jay and Maura
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