Philip Newton (pne) wrote,
Philip Newton
pne

Details on the child's birth

Amy Nadine Newton was born at 2004-09-06T23:36+0200 (just after half past eleven at night on Monday, Central European Summer Time). She weighed 3340 g (7 lb 6 oz) and was 49 cm (19¼ in) long; her head had a circumference of 35.5 cm (14 in). She has dark brown hair on her head. I haven't checked her eye colour yet.

Around half-past ten at night on Sunday, Stella's waters broke. We called Bettina, a friend of ours who had offered to drive Stella to the hospital, and asked her whether we could take her up on the offer despite the time. She agreed and came over shortly afterwards. I posted two LiveJournal entries in the short time she was here.

At the hospital, Stella got put on the CTG machine (aka Electronic Fetal Monitoring; it records the heart rate of the unborn baby [cardio-] as well as how contractions are progressing [toco-]). Then we were assigned a room (together).

Her contractions started to get painful pretty much as soon as she got to the room and lay down, which was about 1:15 in the morning on Monday. I managed to get some sleep until half-past six, but Stella just lay there.

In the morning, we went down to the midwives again, she got put on the CTG machine, and they examined her. We went back up to our room and came back down around 10-ish.

At some point around then, we started the process of giving birth "for real"; we went into the section marked "delivery rooms—no entry". Stella spent a lot of time in the bathtub; this got her cervix dilated from 2 cm (nearly an inch) to 7 cm (nearly three inches) by two o'clock.

I spent a fair bit of time on the toilet—well, not so long each time, but I must have gone up to the toilet (since all the ones on the delivery room floor were off-limits to men) a dozen times or more during the course of the birth.

The midwife was encouraged by this and said that the baby might be there by three (she wouldn't see it since there was a shift change at two).

Stella was really good about "breathing away" the contractions; she later told me that it helped that I breathed hard along with her to kind of act as a reminder to breathe properly and deeply, and to help set the rate a bit. The warm water also helped make them more bearable. During the whole experience, she was very quiet; several doctors, midwives, and interns/trainees remarked on this. She never once screamed or shouted.

However, things didn't go so well from there: she was still under contractions but they were a bit irregular and not as strong; she was starting to get exhausted.

Around five-thirty in the afternoon, she got to the point where she said "I don't want to go through with this any longer", and two contractions later, "I can't go through with this any longer".

Since her contractions weren't effective enough in opening the cervix and preparing for birth, the midwife contemplated putting her on a trip containing oxytocin(?). However, Stella was in no state to handle this additional load in the condition she was in, and she asked for epidural anæsthesia (or, in German, peridural anæsthesia: Periduralanästhesie, or usually PDA for short; strictly speaking, this is actually epidural analgesia rather than anæsthesia since pain, rather than all sensation, is removed): a form of regional anæsthesia that numbs the lower body. This would enable her to continue having contractions, but they would no longer be painful, and she would be able to relax more.

An anæthesiologist came down with his assistant to lay the catheter and administer the anæsthesia; the assistant remained for half an hour to monitor blood pressure and some other vital signs, then left when she was satisfied that she was stable. She was also hooked up to two drips: one with a solution containing electrolytes such as salt and lactates (to bolster the blood volume and help her circulation from collapsing), and another with the same solution but some oxytocin added to help the contractions along (since one of the side effects of the PDA is to reduce the strength of contractions). This second drip was attached to a pump which could be set to administer the fluid at a set rate.

The midwife hoped that she could have the baby there by nine, the time of the next shift change (partly so she could show the two trainees with her a birth), but it didn't work out: the contractions were still not good enough, and the cervix was only dilated to about 9 cm and there was a "neck" remaining: it still had about another centimetre to go. So she went on into another shift.

Around half-past ten or eleven, she started getting "pressing contractions"(?), where the main focus changes from dilating the cervix to actually pressing the child out through the birth canal. The midwife encouraged Stella to press, but this was hard because it was hard to tell when a contraction began; since they were no longer painful, Stella could not always sense them properly, and they also sometimes went away before you could tell that a proper contraction had begun. Pressing without the aid of a contraction was really hard work. (Once the child was partway down the birth canal, this was even more difficult, since the pressure its head exerted was easy for Stella to mistake with a real contraction.)

After eleven, they got the doctor, who had arrived in the mean time and was watching, to help; he grabbed a bit of the sheet underneath Stella and pressed down on her stomach each time Stella pressed, to help the child out. This took a while as well, but the little girl finally came out just after half-past eleven. The midwife cut Stella's perineum to help the child come out more quickly.

They laid her on Stella's breast to rest, but she looked a bit odd; Stella said she thought there was something strange about the way her eyes moved, and she was oddly quiet.

The midwife also noticed that, and was rather quick about blocking off the umbilical cord and cutting it apart (a job traditionally reserved for the father if he is present), then she was taken away into a neighbouring room and a children's specialist was called from a nearby hospital.

This was a really hard time. We were there, after a long ordeal, and had no child to show for it: it was in the other room, waiting for a doctor who would do who knows what. The local doctor was performing some basic tests such as blood oxygen in the mean time. And Stella was crying and feeling guilty about how everything had gone, saying that "I did the best I could!".

When the specialist arrived, I went over to see what was happening. They had given her a bit of oxygen and sucked out the contents of her repiratory tract: fortunately, only clear amniotic fluid. He checked her a little bit (getting annoyed at the blood oxygen sensor, which kept giving nonsense readings), and I went back to say that I'd seen her and she appeared to be all right.

The verdict at the end was that she had been stressed—possibly from the long drawn-out labour or perhaps from the fact that the actual birth bit at the end was very quick compared to the labour, and she had difficulty adjusting. This was reflected in her bad APGAR scores; I believe the doctor said they were 4-6-8 (1/5/10 minutes). However, half an hour after birth, after the doctors had looked over her, they said she could come back to us, making us all very relieved.

Now it was time to turn to Stella: her episiotomy had to be sewn shut, which the local doctor did.

After this, she was in quite a bit of pain, and asked for pain medicine (very unusual for her). She got a Paracetamol (Tylenol), but it didn't do much for her; a bit later, she got a suppository, which helped a little.

I was really shaken by the whole birth and the having my child taken away from us, and didn't know what to do for Stella any longer, so I decided I'd go to bed, which I did with her blessing.

I later heard that the midwife thought Stella was complaining an awful lot about the pain after the episiotomy and the sewing, but she finally got the doctor to have a look at it and it turned out that a blood vessel somewhere inside had burst and caused a big hæmatoma inside, which was pressing on the wound and causing her pain. So he opened her up again, let the blood out, closed the burst vessel, and sewed her up again; this immediately made her feel better. She was still in pain, but it was just ordinary wound pain, not what she had previously felt.

She had lost quite a bit of blood in the process, so they stuck her on a drip to replace the volume, and they decided to keep her there for observation until morning.

So I didn't see her again until about 9:30; the advantage was that I could get a bit of sleep, though not that much since it had already been 2 when I went up and it was 7:30 when I awoke.

Today (Tuesday) was a comparatively easy day: except for having another pædiatrician have a routine look at the little girl (along with other newborn babies) during his daily visit from 10–12, nothing much happened in the morning. I took the afternoon off to go home and fetch some things and wash underwear which had piled up in the mean time.

Before the baby was born, I didn't want to commit to a name in case it didn't "fit" the way the child looked when she was born; however, after toying around with several names, we eventually arrived at a shortlist of three names: Amy Nadine, Emma Victoria, and Lea Tamara. Since we hadn't decided yet, I wouldn't tell anyone else what name we planned to use—if I did give a name at all, I'd say "Hildegard" (a name which is about as modern as, say, "Mildred" in English): a kind of a joke. Or perhaps a code name like the ones software releases or hardware sometimes get (e.g. "Sarge" or "Cairo" or "Klamath").

Stella didn't want to give the child a name which was already "taken" by a child in our ward at church, which meant that our favourite name during much of our married life, Rebecca, was out due to Rebecca Goerke, who's about three now. This also counted out Hannah, which I liked quite a bit, but there's Hannah Leah Emma Fischer who is also not that old.

I also liked her other names, Leah and Emma, and occasionally suggested "Emma Leah Hannah", but Stella nixed that idea completely as it would be too derivative. Also, she said she'd spell Lea without an -h, which seems to be more common in Germany. However, I don't much like that spelling. And since I'd ideally like something that works in English and in Germany and didn't want her to be called "Lee" in English, I wasn't too big a fan of "Lea". "Lea Tamara" was more one of Stella's suggestions.

We didn't have a good second name to go with Emma at first, but I asked emmavescence once whether she had a middle name and she told me it was Victoria. When I suggested "Emma Victoria" to Stella, she was immediately very taken by the name and liked it a lot. So that was settled fairly firmly.

We had been toying with "Amy Elisabeth" for a while, due to someone I know called Amy Elizabeth, and due to a book Stella likes called "Amy und die Wildgänse" (Amy and the Wild Geese). We later changed this to Amy Nadine, since Stella likes the name Nadine, and this would make her initials ANN—also a name. Stella also liked the meaning of the names: Amy is from french aimée "loved", and Nadine is from Russian надежда "hope".

When the baby arrived, I still didn't know which name to give her; none of our prepared names really suggested itself. (Of course, in the state I was in, I wasn't really able to give the matter much thought anyway.)

In the morning, I thought about it a bit more, and though I had been inclined more to Emma Victoria the past couple of weeks (with Stella favouring Amy Nadine—but both of us were willing to go with the respective other name), the more I thought about it, the more I felt that Amy might be more appropriate.

It may be a bit difficult for Germans to pronounce or to spell (I had a bit of a job getting Stella's pronunciation to something I considered acceptable; she started out as [e:mi], not surprising given that [Ej] is not a sequence common in German words, but got around to [Ejmi] in the end), but I guess that with the average knowledge of English names and phonology, the problem might not be so bad. And if it does turn out to be, she has a middle name that should work well in Germany.

We tried to get the baby to nurse on Stella's belly in the delivery room, but weren't very successful—partly because Stella's nipples are fairly flat, partly because the baby was exhausted and also didn't have very good sucking technique (her tongue tended to move forwards, pushing the nipple out of the mouth, rather than backwards, "milking" the ducts and getting the milk into her mouth).

This continued through the morning, with Stella trying it out occasionally, sometimes with the help of a midwife, but not getting very far. This evening, when I phoned Stella, she said that she had expressed some milk with a pump and fed it to Amy from a little beaker, so at least she has some milk inside her now. She'll still have to work on the sucking technique, though; I'd hate to have nursing fail because of something like that. Though in the end, even if we have to pump milk, it's probably better for the child to get mother's milk regardless of the method of delivery, even if you can't have all of the benefits of "real" breast-to-mouth nursing.

We'll have to see how she'll do later.

There, it's getting late. I'll have to get back to Stella in the hospital. Goodbye!

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