Thursday, October 12, 2023

Riley June Dwight

 We are a family of three! Welcome to the world, Riley June Dwight! We welcomed our adorable baby girl on September 24th, 2023 at 8:24 in the morning. I had just reached 37 weeks, 1 day and she weighed in at a whopping 5 lb 6 oz and 18" long. I will go much more into detail on the birth a little later, but first I have to backtrack from where we left off on our last post! 

If you read my last post, you'll remember that I had been going to the "high risk" OB due to my gestational diabetes and they confirmed via ultrasound that this baby was "intrauterine growth restricted" as well but likely just because I am a small person. However, the day after I published that last blog post I went in for my weekly follow-up to assess bloodflow to baby from all of the major arteries and they observed something on ultrasound where the blood vessels to baby's brain were dilated indicating to them that she was compensating in order to continue getting enough bloodflow to her brain. While the bloodflow through the umbilical artery and everywhere else looked good, this was still an indication that somehow the placental bloodflow was lacking. I was at this appointment by myself as I assumed it would be quick and not much to report on, but miraculously I maintained my composure long enough to ask pertinent questions before promptly leaving the appointment and breaking down. I was obviously very scared of what this could mean and whether our baby would continue to be safe. The doctor assured me that the baby was compensating well and that there was no reason to be concerned for brain damage at this point, however she determined that it would be safest to be induced at 37 weeks. From my understanding, this would be the earliest they wanted to go for the development of other systems but not any longer in order to ensure the bloodflow not get any worse. It was pretty awful just hoping from week to week at this point that nothing was going to get worse, but obviously in the doctor's minds it wasn't so urgent that I needed to be induced right away which was comforting. So I had a couple more of these blood flow ultrasounds leading up to the 37 week mark and everything continued to look stable, but between the high risk OB and my regular OB they determined we should move forward with the induction at 37 weeks. And they took this very literally, as we showed up at midnight of September 22nd into 23rd, on my exact 37 week mark! 

A few days before we went to the hospital I had an appointment with our midwife to do all of the regular checks and discuss the induction plan. She also performed my first cervical exam and actually found out I was 1 cm dilated and 70% effaced! We were expecting absolutely nothing since it was still so far from my due date, so that was really exciting and made me hopeful that the induction would go a little more smoothly than it might have otherwise. 

My parents flew into town a few days before we went to the hospital and were staying with us. We were supposed to be going to Breckenridge with them this weekend, but it worked out nicely for them to be here! The day before we went to the hospital, we had a little day of fun - we ate breakfast in bed, went bowling, and had a nice lunch and dinner out! A mini "celebration" of our last day without kids!  Jeremiah's family flew in that weekend as well as my sister, so we had a little crew of family waiting to hear of baby's arrival and come visit in the hospital! 

Final bump photo! 

Bowling with my personal bowling ball!

Headed in to the hospital! 

Our welcoming crew!

It was definitely odd driving to the hospital that night, knowing we wouldn't be going home until we were parents! We drove to Swedish Medical Center (also where I work) at midnight and actually just walked in through the staff entrance and up to the labor and delivery floor! We got our room, filled out some paperwork, and were started on the induction process. Everything was slow to start so I didn't really get anything going until about 3 am. Though before that, I had to have an IV placed in order to get an antibiotic during labor since I tested positive for something called Group B Strep (very common). I don't have a problem with needles, but have never had an IV before. After she placed it I started to feel lightheaded, so I told her what I was feeling as I started to lower the head of my bed to lay flat. She took my blood pressure and it was 80/44! I have low blood pressure to begin with, but that is low even for me. She promptly started IV fluids and I quickly started feeling better and BP started coming up a bit. All I could think though was, wow, great start Hannah! Not really sure what happened there, but I was glad it was resolved quickly! I have to mention here that we went into the hospital with a "birth plan" or perhaps I should say "birth desires" regarding things that we were hoping to have done or avoid, and all of the staff was so great about going over those things with me when they changed shifts or were about to start something. So the first step in the induction was a medication called Cervidil. Basically we start with this medication and wait for 12 hours to do a cervical exam or until contractions begin. We did our best to get some sleep that night, though I had to be continuously monitored from this point on to ensure the baby continued to be safe, and the two monitors on my belly were slipping off all the time when I shifted in the bed, so that meant many interruptions for the nurse to come fix the monitors! We then spent the morning of 9/23 until about 3 pm playing cards, watching Survivor, walking loops around the unit, and spending some time with family. By the time 3:00 rolled around, the cervical exam revealed... absolutely no progress! We were pretty disheartened because it felt like so much wasted time, but we also had nowhere else to be at this point! They reached out to my OB, Dr Sander, to see how we wanted to move forward and started the next step of a different medication called Cytotec. By the way, I keep switching back and forth between "OB" and "midwife" because my practice, Bella Health & Wellness, has mostly midwives and one OBGYN. Throughout my pregnancy I was meeting with the midwives, but the OB was who was on call the weekend I went in for induction. Anyway, we started on a low dose of Cytotec (25 mcg) to ensure baby and I were safe and not in distress. This medication I swallowed, so there was no going back once it was started and then after 4 hours we assess progress. However, after 4 hours (roughly 8:00 pm) I was still only feeling extremely mild discomfort, sort of a very mild cramping feeling, so rather than doing a cervical exam I was just given another dose at about 8:30 pm and continued to feel barely anything. During the early evening we had more family visits from both my parents and Jeremiah's family, napped, more loops around the unit, and also changed rooms to one with a full bathtub that they reserve for people trying to go through labor without an epidural. That room wasn't available when we first arrived, but was by the afternoon the next day (9/23). By the time I received the second dose of Cytotec we settled in for another choppy night of sleep, frustrated by going a whole day without anything to show for. At about 1 am, since there was still no change in my symptoms, we again just went ahead with a third low-dose of  Cytotec without a cervical exam. I continued to sleep for a little while, but around 2 am started to feel some contractions! Pretty mild still at first, but enough that I was having a hard time sleeping and staying comfortable. Around 3 am I got up to the bathroom and noticed a lot of bleeding. It really scared me because I didn't know if this was normal before labor was really in progress. I immediately woke Jeremiah up and called our nurse in. She encouraged me that it was probably just because things were starting to progress, but did double check with the OB who encouraged us that things were still looking normal, no reason to be concerned. Also, I was comforted by the monitor of baby's heartbeat indicating no change and no distress. I tried to go back to sleep for a little while unsuccessfully after that so Jeremiah and I continued watching Survivor while sitting on the yoga ball until I couldn't focus on the show anymore and laid down on my side in bed. My sacrum was really feeling it at this point and was definitely the most significant pain point through contractions. It was about 5:30 when the nurses had shift change and things were starting to really be uncomfortable. I was talking less and less, really focusing on my breathing, etc and still feeling somewhat anxious about all of the bleeding since I had no idea where we were in the process. Shortly after, our new nurse for the day Elizabeth completed a cervical exam. She literally said, "well that was a very interesting exam." She said that because I was only 3 cm dilated, but at a "zero station." This means that basically the head was engaged, but dilation-wise I was not ready! That was simultaneously discouraging and encouraging because I had no idea how long it would take to get to 10 cm and I was really feeling uncomfortable at this point, but baby was ready to be here! Our nurse never left the room from this point on and basically served as a doula to us. She was SO helpful, assisting Jeremiah with some counter-pressure techniques, recommending various position changes, reminding me to lower my pitch with my "moaning." Jeremiah and I had both read a very helpful book, "Ina May's Guide to Childbirth" to prepare for birth as well as taken a birth class, but it was very helpful to have someone to remind us in the thick of things what could be helpful! I spent most of my time enduring contractions with my upper body draped over the top of the bed and propped on my knees, but also labored in standing, sitting on the toilet (really didn't like this position), and upper body draped over a peanut ball - kind of a modified hands and knees position (I'm writing all of this detail for myself to look back on too, by the way - I know this is a lot of detail!). I was also very shaky through a lot of labor, which I was not expecting, but probably because of adrenaline! At one point, I said to Jeremiah "I don't know if I can do this" and starting to get a little panicky that I wouldn't be able to see it through without an epidural. Jeremiah sweetly said "we can definitely ask about getting an epidural" and I said back "I think it's too late." And reflecting back, we're both pretty sure it was indeed too late at this point. I have no idea how long it was before I asked our nurse to check where I was at, but she reported back that I was 7 cm so I continued through contractions steadily, at this point I was actually getting a little more relief between them where I could just breathe and relax from the intense tension during contractions. Earlier on the contractions, I think due to the Cytotec, were coming very quickly with little relief between them, so I was glad for a little more rest time! Though I was also a little concerned this meant things were slowing down, but evidently they were not because not much later, just after I asked our nurse "will it be obvious when I need to push?" That I quickly realized "I need to push!" She quickly checked me again and said it looked like I was close to 10, but not quite there. She called in our OB, Dr Sander, who came in I think quite soon after and I started pushing! I started the pushing from the hands and knees over the peanut ball position but actually did end up in the classic on-your-back position where Dr. Sander was able to manually assist with the last little bit of cervix that was in the way allowing me to push. I held my own legs throughout and pushed with some serious intensity! They propped my left hip up on a bolster at some point in here as well and I would guess about halfway through pushing they had Jeremiah, who was standing on my right side, hold supplemental oxygen up to my face between contractions, which I was actually very grateful for because I was having a hard time breathing through the pushes and feeling a little lightheaded. Throughout this time they were also monitoring baby of course, and I was trying to ignore the rather scary couple of comments where I could tell they were getting a little bit worried about her oxygen and heart rate. I did hear at one point someone express concern that they were picking up my heartbeat, not the baby's. Though I really think that was only for a couple of pushes, fortunately. We were getting extremely close and Dr Sander asked if I wanted to feel the baby's head, which I did and which was very nice motivation for the last couple of pushes! Also right before the last couple pushes, Dr Sander asked if Jeremiah wanted to pray for us which was a really sweet moment. I could hear the emotion in Jeremiah's voice and it just felt very surreal that we were about to meet our daughter! The baby we tried for for months, prayed hard for, and desperately wanted! This was absolutely an answered prayer. After about 30 minutes of pushing (this is per Jeremiah - I had no concept of time through any of this!) Riley June was here and placed right into my arms. It was once again very surreal, emotional, and just a really happy moment - to put it simply. I just stared at her and at Jeremiah, back and forth, and was overcome by this moment I had visualized for so long! Our hospital was great about protecting the "golden hour" so for the next hour I held her to my chest and Jeremiah and I just continued to stare at her and each other! Our daughter had arrived! It was so special to hold her to me, to hear her cry, and just to take it all in, even while people were still moving all around us! Of course during this time, Dr Sander was delivering my placenta - goodbye gestational diabetes, and pressing very uncomfortably on my uterus to reduce chance for hemorrhaging and start the process of it shrinking back down. Jeremiah also cut the umbilical cord at some point in there. Dr Sander reported that I had a first degree tear, but after monitoring it for a bit determined I wouldn't need stitches. I was grateful for that because funnily enough, even after the pain of labor and delivery getting stitches sounded horrible! All in all, it was about 5 hours of active labor and pushing and we met Riley at 8:24 am on September 24th! It sure felt like 0 to 60 for us with the labor process! A whole day of waiting and then contractions kicked into high gear and then she was in our arms! 

Day 1 - not much happening! 

Day 2  - early AM, smile fading, things were kicking into gear!

After our "golden hour" they took Riley to the scale and to complete various vaccines and tests including glucose test because of my GDM. She unfortunately failed her first glucose test which I was very upset by because I had worked so hard to manage the GDM, but the nurse encouraged me that it was likely because she was a little bit cold and that it's very common to fail the first one, but we had three more tests to complete before there was real reason to be concerned. They did give her an initial dose of a glucose gel and we worked on breastfeeding again and keeping her warm and she did pass the remaining three tests! We were very relieved! After these tests Jeremiah finally got to hold her as well! It was so special to see him holding her for the first time. My two favorite people together! 

First family photo! 

Covered in vernix! Common for early babies! 





At some point in here our families trickled in and out to see her - originally just to see her as there was still a lot of staff trickling in and out, but we ended up being in a holding pattern waiting for our recovery room to be cleaned, so they got to cycle back through to hold her too! More special moments getting to introduce her to family! My parents 8th grandchild, and Jeremiah's parents' 1st! She'll get two totally different experiences on each side of the family! 





One good thing about not having an epidural was that I was able to be mobile pretty immediately after delivery. Not that I had a whole lot of energy stores leftover! But I was able to get myself to the bathroom and could move around in the bed freely which was very nice! After a few hours we transferred over to "The Family Place" for recovery! We were so grateful for all of the staff in "The Birth Place" especially our nurse Elizabeth and Dr Sander. They were both so calm, helpful, encouraging, knowledgeable, and ultimately helped deliver a healthy, albeit tiny, baby! 

We were then off to our next room where we settled in for the next couple of days! We had to be monitored for an extra day because the labor process was faster than everyone expected I ended up only getting one dose of IV antibiotics, and was supposed to receive two, so they wanted to monitor Riley to make sure she didn't show any signs of Group B strep. It was also actually very helpful to us to be there a little extra time for some breastfeeding support, glucose monitoring, and to be able to ask a bunch of questions to the various staff that was in and out! Our nurse Lindsay here we had both days and she was also SO helpful! She happened to be a certified lactation consultant as well so she was a great support in that regard and just overall in making us feel comfortable, getting used to being in charge of this new baby! While in our recovery we had more family visits and I invited my boss, Courtney, up as well as one of my favorite coworkers, Kelley! Since I was at my workplace and we had time, I figured why not, and it was fun to have Jeremiah meet them as well! Family brought us some delicious meals. My main request after labor was a Jimmy John's Italian sandwich as well as Andy's Frozen custard and they did not disappoint! We slept as much as we could with so many staff coming in and out, and worked a lot on feeding! One thing I was surprised by was how sore my whole body was the next day! That may sound silly but I mean even my biceps and shoulders were sore from some of the tension I was holding in certain laboring positions! I also had a very raspy voice from the moaning through contractions! 

While in the hospital, one of the lactation consultants suggested that Riley might have a posterior tongue tie. I was aware this might be an issue as I had a tongue tie as an infant and two of my sister's four kids had one as well. So she gave us some recommendations for who to go to and we actually got in with a dentist right by us who specializes in frenectomies (the tongue tie release procedure),  the following day, Wednesday. Never thought I would take our infant to the dentist before the pediatrician! It was a quick appointment and he did the revision right then and there. It was very hard for me to see her so upset by the stretches that he had to perform on her tongue and that we were now performing 3 times per day for 4 weeks! Also while in the hospital, Riley's weight dropped a little bit more than they were hoping for so it was recommended that we "triple feed." This means breastfeed, pump, and bottle supplement. Goodbye sleep! In the hospital they had donor breastmilk for us to use for the supplement and then we ordered from a donor "milk bank" for home, and now I have been pumping enough we can use my breastmilk for supplementation which is nice! But that has by far been the biggest challenge. She is so sleepy that it is a struggle to get her to complete the triple feed in a timely manner, which means less time between feedings. At our initial peds appointment she was still weighing fairly low so they then wanted us to do regular weight check-ins. Unfortunately at the first weight check-in she had dropped to 4 lb 15 oz, which was an 8.5% drop from birth weight. At 10th percent they readmit to the hospital and we'd already been struggling to get her to participate and eat enough, but the NP we met with was adamant that we really get the full supplementation in, so we worked very hard over the next few days to get her to eat. We obviously, absolutely did not want her back in the hospital! I was a bit emotional over all of this as you might imagine. But we were so relieved that her weight at the next check-in was 5 lb 2 oz, then 5 lb 9 oz at the next one, and most recently 6 lb 1 oz at her 2 week check-up! Quickly headed in the right direction with the hard work from all parties paying off! My mom was also instrumental in helping with bottle feeds to allow us to get a little bit more sleep! Now we have a 2 week old already who has been to the dentist, the pediatrician 5 times, had 3 lactation consultations/support groups, and an OT appointment! We had OT to work on the coordination for feeding and bring everything together after the frenectomy. It has been a whirlwind and harder than both of us expected, but we are getting through! And as I said, the help of my mom was tremendous! It was actually a good lesson in learning to accept help, which it turns out is not natural for either of us! Jeremiah just went back to work this week as well so we are going to be settling into a new normal there and Jeremiah's mom just switched off with my mom to provide us help this week! 



Jeremiah's coworker bought him "dad shoes!"







Where we spend majority of our time these days!




Don't mind the hanger, we were trying the hat on and I captured a smile! I think I spy dimples?

She loves having her hands at her face!

Overall, we are loving this new phase of life so far. We spend a lot of time just staring at Riley and admiring the fact that she's ours! We've been loving neighborhood walks, Disney dance parties, football Sunday snuggles on the couch, and laughing at her little smiles and noises when she's dreaming. Also, in case you are wondering how we picked out her name or if there is any significance, the answer is - we both just liked the name! We looked at the list of top 100 baby names and read through all of them, and Riley stood out to us with Jeremiah being the first to really highlight this name. We both took to it very quickly actually and once we started calling her that it felt right! The harder part was the middle name, we were between June and Ruth and spent some time calling her by each one. At the end of a period of time calling her each one of those, we both preferred Riley June and that was it! We love our little Riley June! We can't wait to watch her grow up, reach new milestones and explore her world, to introduce her to traditions, discover her personality, introduce her to all of her cousins and extended family, and to show her so much love! She hasn't yet reached her due date, but we are so happy to have our unexpected September baby here already! We love you, Riley! 

Maternity photos we had done only 1 week before we got induced! Didn't realize how close we would be cutting it!