Crazy Pregnancy with Pancake #2

The summer of 2013 through the summer of 2014 was a mostly wonderful adventure for our family, including our move from Florida to California. The summer of 2014, however, brought some unexpected chaos. As most of you know, we were expecting Pancake #2 in early September. From the very beginning this pregnancy had felt different from my first -- much more nausea, exhaustion, headaches, general feelings of blah, more weight gain, etc. I also began noticing around 20 weeks that I was feeling lots of pressure and thought I was carrying the baby pretty low. Additionally, I felt tightness in my uterus, but knew it was normal to have Braxton Hicks contractions, especially with a second pregnancy.

28 Weeks at Laguna Beach

As we did with Silas, we sought the care of midwives when we learned we were pregnant and planned to birth at a local birthing center. Considering Silas was born very quickly, we were thrilled to find a wonderful birth center only a five-minute drive from our apartment. (Interesting side note and a very "Orange County" tidbit, this midwifery group was featured on an episode of Keeping Up With the Kardashians when Kourtney was considering and attended one of their homebirths... #iamnotinflorida. Not that this influenced our decision at all.)

I have a hereditary blood clotting disorder called Leiden Factor V. Although I have never had any complications with blood clots, I have a strong family history of them, and pregnancy increases your risk even further. Thus as a precaution the midwives asked me to consult with a perinatologist (high risk OB) during my pregnancy, and I agreed to do so. This is background as to how I found myself in my perinatologist's office for a precautionary ultrasound on June 24, 2014. I was 29 weeks into my pregnancy.

Our first good look at Baby Nathan!

I'm very thankful Bob had been able to join me for this appointment and my friend Andria had agreed to keep Silas for us. We had the ultrasound and the technician said everything was looking good. Baby was still a boy (always a relief), his size looked good, placenta and fluid looked fine, etc. We also got a really beautiful 4D image of his sweet face. Later we decided he looks quite a bit like a Silas who hadn't chubbed up yet.

Toward the end of the ultrasound the technician mentioned she was having trouble seeing my cervix and asked me to go empty my bladder. We waited a long time once I got back to the exam room, and when she came back the doctor was with her. In retrospect this was a clue that something was off, but I was oblivious to it at the time. The doctor switched from an abdominal ultrasound to a vaginal one and immediately sighed and told the tech she was correct. He then explained to Bob and me that my cervix was very short. At 29 weeks a normal length was around 3.5 centimeters, and I was measuring between 1.3 and 1.6. He then checked to see if it was also dilated and found it was close to two centimeters dilated. During that exam, he also noted that he was feeling my uterus contract. He asked if I had been feeling contractions, and I reported that I had noticed tightness but nothing especially strong or unusual.

At this point he decided to connect me to a contraction monitor and call my midwife to discuss, but he told us we would likely be sent to the hospital for at least a couple days. Wow. That was totally not what we were expecting to hear. (NOTE: I was very, very pleased with the cooperation between my doctor and midwives. Far too often this respectful relationship doesn't exist, which is a huge hindrance to midwifery being a viable option for care for many women in the United States.) Also of note...this was a Tuesday and I had been planning to fly that coming Saturday alone with Silas for a two-week trip to visit our family and friends in South Carolina and Florida. At this point I didn't feel overly vulnerable or fearful about the pregnancy, but I did feel extremely disappointed when I realized this meant I had to cancel my trip. Anyways, after being on the contraction monitor for 20 minutes, it showed I had four contractions about five minutes apart; and although they were mild, this sealed my fate of being sent to the hospital.

Best part of those first two days was this visit from Silas.

We were directed to go check-in at OB triage at Hoag Newport Beach, where I would be admitted under the care of my midwives' back-up OB (a different physician than the perinatologist I saw that morning). The initial plan was to monitor me for a couple days and administer two corticosteroid injections to help the baby's lungs develop in case he was born early. I was also started on procardia/nifedipine to relax my uterus and stop contractions. If things stabilized, I would likely be discharged and then on bed rest at home for the remainder of the pregnancy. Wow, again, this was nothing like we had planned!

Perhaps stemming from my father being hospitalized frequently for blood clots throughout my life, or perhaps for some unrelated reason, I have a strong dislike and almost phobia of hospitals. Truthfully, this is one of the biggest reasons I initially sought options for out-of-hospital births. So spending my first night ever in a hospital was a very strange experience. However, I must admit, the nursing staff at Hoag was fantastic and the facility itself was superior to any other hospital I had experienced. For this I will always be grateful. So those first two days went by quickly as I actually enjoyed resting and relaxing, and also stayed busy with canceling my trip and arranging both immediate and long-term care for Silas. I also, of course, spent time researching pre-term labor and short cervixes and such. I'm reluctant to admit I didn't even know cervixes had particular lengths during pregnancy.

Thursday morning we were scheduled to have another ultrasound to make sure I had stabilized and then the doctor planned to discharge me. I had continued to have mild and occasional contractions, but the doctor felt confident we were controlling them sufficiently (irritable uterus, they called it). That morning a transport guy (what are they actually called? Orderlies?) brought a wheelchair to my room and took me down to radiology for the ultrasound. As the technician was checking me, she asked me how long my cervix was at last check, and I told her 1.3 to 1.6. She seemed perplexed. Then she told me she needed to go speak to the doctor and gave me firm instructions not to get up for any reason. Okay. She came back a few minutes later and told me they were going to take me back upstairs lying flat on the gurney instead of in the wheelchair. I asked her directly how my cervix looked, and she reluctantly told me it had shortened to 0.6. Apparently this is dangerously short for 29 weeks pregnant.

Silas had a blast with Uncle Craig and others in SC.

So that's how my two-day hospital stay turned into a full month. Although I was sad on many levels to remain in the hospital, a part of me was also quite relieved to know I was in the safest place should this baby be born soon. Even at 29 weeks the chances for survival were very high, and the risk of long-term complications was only 20 percent. However, our apartment was about 15 miles away from the hospital, and in high-traffic times that was often a 45-60 minute drive. Also, knowing that Silas's labor and birth were only 3 hours, and second babies are generally about half the length of first babies, I had a real fear of something happening and me giving birth somewhere other than the hospital with a preemie baby who was unable to breathe on his own.

Bob took Silas to SC to spend 3 weeks with my Mom and family. 

Surprisingly, the next five weeks in the hospital passed rather quickly, and very uneventfully. I was on pretty strict bed rest to keep as much pressure as possible off my cervix. I was directed to stay flat except when eating, and I was allowed up to use the restroom and to shower every other day. The nights were long but the days got into a manageable rhythm for me. Bob has asked me several times, "What did you do all day?" so here is my best answer.

My doctor usually rounded about 6:00 each morning, which is also about the time a nurse came in to administer my meds (every four hours around the clock). I'd watch the morning news and Today Show while browsing Facebook and Twitter and Zulily and whatever else interested me online. You know when you're on the internet and see articles that peak your interest but you browse past because who has time to read them? Hey, I actually clicked on them and read them!

I wore compression socks to decrease my risk
for blood clots. I also wore electronic
compression sleeves on my legs overnight.

Breakfast would arrive around 8:00-8:30, so I'd sit up to eat and also browse the menu to make my food selections for the next day. Around 9:00 my day nurse would come in to check my vitals and do our daily non-stress test, which put the baby on the monitor for 30 minutes to check his heart rate. He always looked perfect, and my vitals were never bad either. At 10:00 I'd get my next round of pills, and then I would get up and either shower or just get dressed and brush my teeth if it was an off day. I was very, very happy that I was able to wear my own clothes and was not attached to an IV ever during my stay. Getting dressed each day seemed important to my sanity and giving some structure to my day.

I was usually exhausted after my shower (crazy I know, but I'd lost all stamina), so I'd eagerly crawl back in bed for some rest. I might read or answer emails or needlepoint until lunchtime. I did a good bit of internet shopping during this time, too, mostly ordering diapers and figuring out what other supplies we still needed for the baby and spending ridiculous amounts of time reading reviews and comparing prices because...hey...I could. I was also getting lots of texts and phone calls and skype calls, and it is surprising how much of your day can be spent responding to those things. I'd also sometimes have visitors, which was always a nice treat.

The food was surprisingly decent for
hospital food. Although I was very glad to
have new options when I was discharged! 

Lunch usually came around 12:30, and after that I'd continue doing whatever until my 2:00 dose of meds. Then I usually took a nap or, on days I wasn't sleepy, would watch old episodes of Parenthood. Dinner arrived around 5:30 and then, most days, Bob would come visit me after work in the evenings, usually arriving around 7:00. I learned to save my cookie from dinner for him and be sure to order some milk. After Bob left around 8:00 or so, I'd veg out watching TV or Parenthood or reading or internet-playing or needlepointing until bedtime. My night nurse usually came in to do my assessment around 9:00, and then she'd come back at 10:00 for my nightly cocktail of pills. After that I'd do my best to get some sleep, being woken up at 2:00 am for another pill, then at 6:00 am the whole routine began again.

Medically, my month in the hospital was very uneventful, which my nurses assured me was good. After my cervix shortened even more those first few days, my dosage of medication was increased and it never got any shorter. My contractions were significantly reduced as well; I occasionally felt one, and the monitor strapped to my belly would show mild ones periodically, but my doctor was pleased with where we were. Early on we targeted 34 weeks as my discharge, and of course the daily goal was simply to stay pregnant. Since my uterus had calmed down, everyone was confident that I should make it to term. The nurses even told me some stories about women they had cared for similar to me who then came back to be induced when they went past their due date. Not so funny. See the next post about the next few weeks and actual birth...

Here are some more photos.

My room had a great 4th floor view with huge windows.
The ocean was just to the right out of my view from bed. 

On average, for each day I stayed pregnant my baby would spend 3 fewer days in the NICU.

One of my baby supply purchases. Bob texted me this picture when
Nathan's bag arrived and it made me so happy!

After Silas spent 3 weeks in South Carolina, my mom flew back with him to California.  

First day home. Oh how we missed our buddy! 

This was Silas's favorite place in my hospital room...inside the cabinet.

Reading books and playing on my phone or kindle were about the only way he would sit still with me.
I turned upside down on my bed this time but complied with staying flat. 

We celebrated Silas's 2nd birthday in my hospital room, complete with a cupcake! 

Some friends from my home church in Aiken, South Carolina, were visiting the LA area and came to visit me. What fun! This was about a week before my discharge (and I was down to no clean clothes, thus the PJ's). 

34 Weeks on July 25, 2014. Discharge! 

I saw the outdoors for the first time in a month. Going home!

My mom was able to stay a few more days after I got home. We were sad to say goodbye. Then Bob's parents arrived two days after she left to help get us through the rest of my bed rest and recovery.