Emmett Thomas Strong is officially 2 months old! It’s so cliché, but I feel like he’s already been with us forever. He was born 3.5 weeks before his due date on August 1, 2017 at 9:23 PM in Chicago, IL. When he was born, he weighed 6 lbs 13.5 oz and was 19.8 inches long. His head circumference was 14.1 inches--ouchie.
This is going to be a birth story, which is possibly the longest and most boring type of story there is for anyone except the parents and the child (and very graphic, as well), so please don’t feel obligated to read any of this. My dad was so kind as to give a play-by-play account of my labor and delivery in our family group text. So most of this is from what he put down in the texts and what little parts I can remember. Please also bear in mind that I’m running off of 2 hour spurts of sleep here and there, so this writing will definitely not be my best work.
A few weeks before Emmett was born, I was diagnosed with intrahepatic cholestasis of pregnancy, which means that my liver is not filtering the bile in my body the way it should be. There is no risk to me with this diagnosis—just really bad itchiness all over my body. However, it can result in stillbirth for the baby, so with a diagnosis, they typically induce labor at 37 weeks. I started undergoing bi-weekly non stress tests to monitor Emmett’s heart rate and movement. If anything changed during one of these tests, they would consider inducing labor even earlier. They took my blood weekly to see if my bile acid levels were rising.
My initial diagnosis was tentative because my bile acid levels had not elevated above the normal level and the only symptom was the itchiness (which is also a normal pregnancy symptom, so it’s hard to really know). I also had upper right quadrant pain (where my gallbladder has moved to) and I had been nauseous during the whole pregnancy, which are other symptoms that not all people get with cholestasis. But they are also considered symptoms that happen during pregnancy anyway. Everyone that I told I had constant pain in my gallbladder area just explained it by saying his feet were up there and digging in. So, basically, I was diagnosed based on very subjective symptoms—just the fact that I told the doctor my itching had spread to my hands and it had gotten worse. One of Billy’s friends had lost her first baby due to cholestasis, and I think that Billy thought that her story was making me a hypochondriac. And I wondered that myself.
My doctor decided to induce me on Sunday, August 6th at 37 weeks and 1 day, based on what I told him about my itchiness getting worse. This gave me such anxiety and made me feel like it was my decision. What if I didn’t have cholestasis and we induced that early and he had major problems because of it? What if I did have cholestasis and I played down my itchiness and then he died because we left him in there too long? Ultimately, his life compared to some medical problems isn’t a real comparison, but I wanted more definitive proof. I met with a maternal fetal medicine specialist and she didn’t seem to think I had cholestasis at all, but luckily my OB didn’t want to take this lightly. After I met with the MFM specialist, my bile acid levels came back the next day and they saw that one of the levels was elevated, but typically they look at the combination of all the levels to diagnose, and the combination was still in the normal range. The problem with relying on the bile acid levels are that there are only a few labs throughout the whole country that test these bile acid levels and so the results take one week to come back. With cholestasis, your levels can triple over 24 hours, so it’s not smart to go completely off of that. Things can change so quickly and by the time you realize it, it may be too late. The MFM specialist quickly changed her tune after seeing the elevated levels and so I felt a little better about inducing early.
Anyway, my last bile acid level results were extremely elevated, and my OB got those results back on Sunday, July 30. Based on these results, and the fact that the Urodial medication he had given me relieved my itchiness, he even more vehemently diagnosed me with cholestasis. He was a little concerned with how quickly the levels had risen, so on our appointment on Monday, he told us that most experts recommend induction at 37 weeks, while some actually recommend induction at 36 weeks. So he gave us the option of inducing TOMORROW(?!?!?!) or Thursday, August 3rd because those were the days he was on call at the hospital. We decided we would wait until Thursday to let him cook a little bit longer and to get everything ready (and golf one more time) and then we went home. We started talking about it at home and changed our minds. 2 extra days in the womb is not going to make that much of a difference in his development. Plus, I knew that I would be a crazy person the next 2 days, counting his kicks and freaking out if I didn’t feel him move constantly. He was already measuring at 6.5 pounds, so low birth weight was not a worry (and as it turns out, he weighed even more than that!) I was mostly worried about his lungs not being fully developed. But, they can do so much nowadays with premature babies and when you measure the risk of treatable medical problems to the small but real risk of stillbirth, it wasn’t even a question in this anxious momma’s eyes. So, on Monday afternoon, we cleaned our house as clean as it has ever been and tried to get everything ready that we thought we had a whole other week to do. During this time, Billy confessed to me that the first thought he had when my OBGYN said we could induce TOMORROW, was that he was planning on golfing tomorrow. I’ve heard that dads take a little longer to realize that their world is about to be rocked, and Billy proved it beautifully.
I told my parents at 1 PM that I was being induced TOMORROW and they packed their bags and were on the road to Chicago by 6 PM. Oh and it was also their 41st wedding anniversary. They celebrated by eating at Roy Rogers in a gas station. I’m nominating them for the best parents award. They spent the night in Cleveland and then got to the hospital at 12:30 PM, right as my contractions were getting stronger.
Billy and I went into the hospital at 6:30 AM on Tuesday, August 1st. My doctor warned me that the induction could take a couple days if my body wasn’t ready to get going, so we were prepared for the long haul. They admitted me and got everything ready. They asked me if I was an organ donor, which is always really comforting right before you’re about to do something that many women have died from. I told my family this piece of news, and my dad called dibs on my eyes since he has cataracts.
My doctor explained to me the pros and cons of getting a steroid injection to help Emmett develop his lungs—the worry was that his lungs weren’t fully developed since he was only 36 weeks and 3 days gestational age. There was a slight risk that he would need some extra help. So, we decided to get the steroid, which they gave to me at about 7:30 AM. They then placed a small dose of misoprostol up my lady parts at 8 AM and waited a few hours to see what it did. Dr. Izbicki warned me that I probably wouldn’t notice anything until 9 AM and it may not do anything at all, especially since I was not effaced at all and only 1 cm dilated. He just wanted to ease my body into it. I bragged to him that I always respond really well to medications. At 8:30 AM I started having contractions 5 minutes apart. He checked my cervix at 11 AM and I was still only dilated to a 1, but I was about 40% effaced. Since I wasn’t dilating, he said we would try putting a balloon up me to help stretch it out, but I didn’t need any more medication. They put the balloon in around 1:00 PM. My contractions at this point were about 3 minutes apart and that balloon really aggravated my uterus. I was writhing in pain, and my mom told me that I was definitely in hard labor—she’d recognize that level of pain anywhere. At 1:30, my doctor said I could have the epidural whenever, and I immediately asked for it. I thought I could maybe one day have a birth that is natural, but no thank you. Give me all the drugs. The anesthesiologist took her sweet time in getting there, and the epidural took 20 minutes before it numbed the balloon area. But once it kicked in, holy heaven! At one point I rested my hand on my belly and thought there was something on top of my belly—but nope, it was just part of my body that couldn’t even feel my hand touching it. I highly recommend an epidural. It felt awesome. Billy was making fun of me because I totally got caught giving myself some more once I had started pushing and the nurse called me out. I just wanted to be prepared in case it started wearing off!
At around 3 PM, Dr. Izbicki checked me again and I was dilated to a 4 and 80% effaced. At this point, my contractions were so strong and frequent that they didn’t think I’d need any Pitocin unless they started getting weaker. The doc put a catheter in me so I didn’t have to get up to pee. I wish I had one of those all during my pregnancy—it would have solved all of my insomnia problems!
The doctor then broke my water. For the last few weeks of my pregnancy, I was also being monitored for having a lot of amniotic fluid. When he broke that water, it gushed everywhere! And it was kind of gross how warm it felt.
Emmett’s heart rate started to get too low during some of my contractions, so they put an oxygen mask on me to make sure we were both getting enough oxygen. My parents were there in the room and I think it really freaked them out to see me like that. Actually, I think a lot about the birth really freaked them out. The mask was annoying because I was trying to laugh and talk to my parents and Billy, but they couldn’t understand me. And the nurse thought Emmett’s heart rate was better when I was on my right side, so I had my back to them all. The oxygen helped his heart rate even out, but then they took it off and it wigged out again, so I kept it on for the remainder of the delivery. At this point, my contractions were three minutes apart and extremely strong. They were going literally off the chart—we couldn’t see the peak of them on the monitor. But I couldn’t feel a thing. I think I even took a little nap at the time. At one point, we heard a girl in another room SCREAMING in agony. It sounded like she was getting tortured. Meanwhile, my contractions were through the roof and I was contently sipping my jello. Again, I cannot emphasize enough the beauty of epidurals.
At about 4:30 PM, the nurse informed us that first time moms usually dilate about 1 cm every 1.5 hours, so at that rate I would start pushing around 11 PM. At 5 PM, they checked me again and I was dilated to a 5. The doctor could feel Emmett’s head and remarked on how much hair he has. Which I already knew, because my heartburn was ridiculous from 18 weeks on. Then, they got a more accurate fetal heart rate monitor by attaching little hooks into Emmett’s scalp. Now that he’s out, I can actually see the tiny scratches from the monitor on his head. The poor little guy has all sorts of wounds from that traumatic day.
The doctor came in to check me at 6:15 PM and said I was 100% effaced and 9 cm dilated. Then he checked again just to be sure and decided that I was actually at 10 cm! He asked me to start doing some practice pushes to see what would happen. I have no idea how my cervix dilated 5 cm in 1 hour, but I think Emmett just really wanted to get out. Emmett was below 0 station, so at 6:30 PM, it was go time.
When it was finally time to push, I got really nervous. Was he gonna be okay? Would I really be meeting my baby boy within an hour? Would I feel it? Was I about to die in childbirth? Was I even pushing the right way? So much anxiety!
Emmett was face up, or sunny-side up, as they call it--which is not ideal for pushing. They prefer the babies to be face down, so their face doesn’t get caught on the pubic bone. I pushed for an hour and a half, and some progress was made, but then the contractions started getting more spread out. My arms and legs were so shaky, that if I had had Emmett then, I may have dropped him. My mom and sisters warned me that they got super shaky during the transition part of labor, so I assumed that’s what it was. Thank goodness for mothers and sisters who can somewhat prep you for childbirth.
The doctor gave me a break at 8:00 PM. I started pushing again at 8:30 PM, but stopped after a few minutes because the contractions weren’t strong enough to do anything. They finally gave me some Pitocin to make my contractions stronger to help me push. At 8:50 PM, I started getting super nauseous and threw up a few times and then Dr. Izbicki came in and said “Let’s deliver this baby!” He checked and said Emmett hadn’t come down very much since he last checked. I started pushing again and made some good progress.
At 9 PM, the doctor decided we needed to use the suction cup to get him out, because he just wasn’t coming out quickly enough. I didn’t see any of this, but Billy and my parents said it looked like Dr. Izbicki was trying to reel in a 500 lb tuna out of my vagina. The suction popped off 3 different times. The first time, there was a loud popping noise, and I honestly thought that the baby had come out and that’s the noise that my body made when he came out. Billy and I looked at each other, both bewildered. But no such luck. Emmett started moving down without the suction, thanks to my amazing pushing (or so the doctor said to encourage me). Dr. Izbicki said if I pushed like that again, we wouldn’t need the suction.
Pushing is so freaking hard though. Not only is it tiring (especially after 3 hours), but it’s hard to really know if you’re pushing with the right muscles. Luckily, my friends all told me to push as if you are pooping, so that’s what I did. Sometimes I’d be pushing and out of breath, and I thought “was I even pushing, or was I just holding my breath and gritting my teeth?” No one told me if I did or not, but I’m sure I pooped all over that table.
At 9:15, the doctors and nurses all put on their delivery gowns. I bore down while the doctor used the suction cup. He warned that if it didn’t work during these next couple contractions, we would need to do a C-section for the baby’s safety. That may have been the biggest motivator for me to push as hard as I could. I did not just push 3 hours so that I could have a C-section. I had always thought that a C-section would be easier and less dangerous for the baby. Even though the recovery is hard, I was mostly concerned about Emmett’s safety. But then Billy told me how going through the birth canal is really beneficial for the baby—it helps his lungs to develop, which I had been really worried about with him being so early. So, I really wanted to avoid a C-section, especially since I had already worked so hard.
At 9:23 PM, with the help of a quick episiotomy (that I didn’t even feel, thanks to that glorious epidural), he finally came out. Billy said that the sound of the doctor cutting me was like ripping carpet. So gross. Dr. Izbicki announced that he hadn’t wanted to say anything earlier so as not to worry me, but the cord was wrapped tightly around Emmett’s neck, which is why it took so long for him to come. I was fighting against the cord the whole time. I actually had noticed in our last ultrasound that it looked like the cord was wrapped around his neck and asked the doctor about it. He assured me in my next doctor’s appointment that it definitely could have been the cord, but not to worry, because 1 in 3 babies are born with the cord wrapped around their neck. The doctor calmly and quickly unwrapped the cord from his neck and then plopped him on my chest. Then Billy cut his cord--all right on top of my belly.
I’ll be honest, I have no recollection of any of this—except for the first time I saw Emmett. I didn’t know the cord was wrapped around his neck or that I got an episiotomy until Billy told me 10 minutes later. I was so focused on pushing, that I didn’t hear anything until I heard the room start saying, “Congratulations!” When the doctor plopped bloody little Emmett on my chest, I think I was even still pushing. It took me a few minutes to come back to reality and realize that this was my baby I was holding! I don’t think it really registered until I looked up to see Billy wiping away his tears. I can count on one hand the times that I’ve ever seen Billy cry. For the first time in our lives together, he was crying about something and I wasn’t, because I was so in shock. Don’t worry, the tears eventually came—especially when they took him away to the nursery because they were a little worried about his breathing. I think I was expecting this dramatic “love at first sight” moment, but it definitely wasn’t that way for me. This baby that I had been carrying and growing for 9 months was suddenly here and I felt like I didn’t know him at all. I definitely had the motherly instinct to protect him, but I mostly just wanted to get to know him more. I felt the need to learn everything about him and just spend as much time as I possibly could with him. Every day I fall more and more in love with him.
|Last bump shot. 36 weeks 3 days.|
|Stoked on the jello|
|Contractions off the charts|
|Epidurals are heavenly|
|Best parents around|
|Sara was my favorite nurse during my NSTs and she got to help me through labor.|