Baby's Birthday

Thank you all for the notes and congratulations. Charlotte is 1 week old today and she is wrapped up in a baby sling on my chest. She is beautiful and we are so in love with her. I'm amazed that this all happened so fast and we actually have a real live baby in the world. I'm anxious to get the story down so that we can remember everything that happened, so here it goes.

This is the story of Charlotte's birth.

On Thursday evening, I went out with my friends for some Mediterranean food at Alladin's. It was a nice distraction from being enormously pregnant. We hung out until about 9pm chatting and I eventually waddled myself back to the car and drove home around 9pm. I remember saying that I was really hoping that labor would start that night (haha). I found Chris at home reading up on the new camera that we bought specifically for taking baby pictures. He insisted on teaching me the basics of how to use it, but I was sort of feeling strangely emotional and weird and crampy. In hindsight, I was definitely in early labor. We watched the daily show and went to bed at around 11:30pm.  

At about 1am I woke up to go to the bathroom and my water broke on the way down the hall. At first I was confused and upset about being all wet, but when I realized what was happening I was super excited. I cleaned up and put on new pajama pants (big mistake, by the way, because there were 3 more gushes that followed in the next few hours, and lots more amniotic-fluid-soaked pajama pants strewn throughout the house. I thought that the "water" only happened once!). I came back to the room and told Chris that my water broke. We were both very excited, but a little dismayed that we had only gotten an hour of sleep. I was worried I wouldn't make it the 24-36 hours that labor would take. Good thing for us, the whole event only lasted about 11 hours.

Our birth class teacher had told us that the most important thing to remember was that if you thought you were going into labor, you should go to sleep. So Chris dutifully told me that I should go to sleep so that I wouldn't be too tired when it got really intense. Good advice, but this was totally impossible for me, because I had already launched into active labor. Contractions were coming every 4-5 minutes and lasting for about 30 seconds. I wandered around the house moaning through contractions and rocking back and forth on my hands and knees. Chris kept telling me to try and sleep. As the contractions got longer and more intense I needed help to get through each one. Chris was really good at pushing down on my lower back to take the pressure off my hips. He was still telling me that I should try and sleep, but by this point, I was ready to murder him if he looked like he was trying to sleep and I insisted that I couldn't sleep and he had to stay awake with me.

I got Chris to call the Doula at about 7am. He told her something along the lines of, "Whenever you get a chance, you can make your way over." I was in the background saying, "No, tell her to get here NOW! We need to go the hospital SOON!!!". He was ignoring me... which I guess was the best thing to do with a crazy laboring person, but it annoyed me at the time. Jessica arrived about an hour later and seemed surprised that I was in such active labor. She checked me and I was already 6cm dilated! Our plan was to head to the hospital when I was at about 5-6 cm dilated so that was great news.

Chris started running around the house gathering our bags and just generally having a panic attack. I, on the other hand, had started to go into "labor land". I was rocking back and forth with my eyes closed and really focusing on my body. I was heavily under the influence of crazy endorphins and other hormones getting me ready for the main event. The contractions were feeling a lot stronger, but they weren't quite as raw as before. I felt like I was in a trance. It was almost impossible for me to communicate because all I could think about was working on my labor. Jessica helped me through contractions while Chris packed the car. When it was time to go, I wandered out of the house to the car moaning and, in general, looking like an escaped schizophrenic patient.

The car ride and our arrival at the hospital is all a blur in my mind. Chris probably remembers it better. He looked over at me and said, "Jessica could feel the baby's head! We're so close!". I managed to nod and smile. Next thing I remember we were in the elevator going up to the labor and delivery floor. They were going to get me a wheel chair, but they were taking too long and I just marched in the direction of the elevators. I was furious at everyone in the elevator for making it go slower. Totally irrational. Next thing, they had us in the triage room and it was a blur of random nurses. They hooked me up to a fetal monitor and they checked my cervix. I was at 8cm dilated and 100% effaced. At this point they asked me to rate my pain level on a scale of 1 to 10. This question makes absolutely no sense. They could have been asking me what the square root of 569 was. All I knew was that if I said anything higher than 4, the nurses would be obligated to offer me pain medication, and I didn't want anyone saying the word "epidural" to me.... so I said 4.... then another contraction hit and I said, "It's a ten! I want an epidural!". Chris and Jessica calmly reminded me that I didn't want an epidural and I was already at 8 cm and it would be time to push very soon. I probably had a bit of mental deliberation, but thinking was so difficult that I just went back to laboring.

Next we were in the labor and delivery room and I was leaning in the shower with my hands on the wall and Chris was pushing on my back. I was in transition and completely in the midst of labor land. Chris was with me the whole time and he kept telling me he was so proud of me. They made me get out of the shower and the nurses checked me again and it was time to start pushing. They called in my Obstetrician, who arrived with a table full of scary looking metal instruments and she was donning what appeared to be a hazmat suit, complete with a face shield. They set me up with a squatting bar and put the bed low to the ground and threw a huge plastic tarp under me. With each contraction my body was involuntarily pushing down hard. As soon as I started pushing I felt so much better. The pain was gone. The contractions slowed down so I had 5 minutes between each one, but they were super strong. When I felt a contraction coming Chris and Jessica helped me pull myself up into a deep squat and I pushed as hard as I could. Chris started counting to 10 with me and reminding me to breathe in. The Ob was stretching my vagina and putting some sort of lubricating stuff around it. The baby's head started crowning and I reached down and touched the top of her head. I was so excited she was so close and I started roaring with each push. Her head was out and then her shoulders and at 12:04 pm on September 23rd, the Ob put a tiny, lavender, slimy, squirming Charlotte on my chest! The room filled with butterflies and rainbows and unicorns and Charlotte took her first breath and let out a big wail. She was breathing really well and turning nice and pink and she was wide awake. I looked up at Chris and he had tears coming down his face. The nurses cleared out and left us alone with her for more than an hour. She was so perfect.

Looking back, there is not a single thing I would have changed. Jessica was amazing with helping Chris and I stay calm and with the plan. The nurses and the Ob respected my wishes and really paid attention to my birth plan. I'm so happy that everything was going so smoothly that I was able to birth my baby with no drugs and minimal interventions. I was able to get up and walk around just a few minutes after having the baby. Within a few hours I took a shower, had an enormous dinner, and Chris and I napped with our new baby in the hospital room.

The past week has been amazing and exhausting. Expect more posts and pictures. There's lots of pictures on Chris's facebook page if you'd like to check that out. Thanks for reading!

Any day now...

Here is a picture of what the baby should look like in there right now. I really liked this one, because Charlotte seems to be in this exact position. I can feel two little feet kicking around in the top right quadrant of my tummy and a mound that moves around occasionally that is most likely her butt.

Right now I'm 40 weeks pregnant according to the date of my last period, but 39 weeks according to the sonogram I had at ~20 weeks. Not sure which is correct, it's all a big guessing game anyway. Regardless, I'm going NUTS waiting. It doesn't seem like anything is happening, and I feel totally normal most of the time. I've been having period-like cramps every now and then during the day, but nothing that sounds like what I've heard about labor.

Anyway, that's the super boring update. Come on, Charlotte!

The 15 most awkward and creepy pregnancy portraits

Many couples choose to commemorate their pregnancy by having some artistic photos taken of this special time in their lives. Although a good idea in theory, sometimes this goes alllllllll wrong. Check out the top 15 here.

In case you don't feel like going to the link, this is my absolute favorite.

There are no words. 

My friend sent me this link at a really good time too, because Chris and I just did a little DIY pregnancy photo shoot. I was afraid our pictures were a little cheesy, but I have no fears now!  At least I opted to not wear sequined bunny ears while aiming my crotch at my husband's face. 

Bacteria in the Vag! Oh my!

One of the standard tests during pregnancy is for colonization of Group B Streptococcus (GBS) in your vagina. This is a common bacteria that colonizes the colon and vagina in about 25% of all women (and men also, for that matter, minus the vagina part). GBS does not make adults sick, but can be harmful to a baby. A woman who is positive for GBS has about a 1/200 chance of passing the bacteria on to her baby. The risk is very, very low, that the bacteria will affect the baby. However, the risks of GBS infection in the infant are scary enough that it is something to be worried about. There is a good chance of sepsis, pneumonia or meningitis if the baby does become infected and GBS remains a leading cause of infant mortality. The baby is especially at risk if it is born premature. Thus, all pregnant women are tested for GBS colonization between 35 and 37 weeks of gestastion and if a woman turns out to be positive, it is recommended that she be treated with intravenous antibiotics (usually penicillin) at the very start of her labor and every 4 hours following, until the baby is delivered. (This basic info can be found at the American Pregnancy Association website and the American Congress of Obstetricians and Gynecologists (AGOG) website)

Here is where the problem is. The recommendation to flood a pregnant women with antibiotics during labor is controversial, even among ACOG members. The high doses of penicillin necessary to kill the GBS has the effect of killing off all of the gut flora in the mother and in the newborn infant. Much of the infant's immune system is mediated by the gut flora that he/she is inocculated with during the descent through the birth canal. If this immune system is destroyed by high doses of antibiotics, it leaves the infant susceptible to antibiotic resistant strains of E. Coli and other nasty things. A recent study in one hospital noted that between 2004 and 2008 the screening of GBS colonization increased from ~10% to 65% and the use of intravenous antibiotic treatment increased from 40% to 90%. Although the rates of early-onset sepsis because of GBS decreased from 45.4% to 20%, the rates of sepsis caused by antibiotic resistant E. Coli increased from 40.9% to 70% (Lin et al., Pediatrics and Neonatology, 2011). The incidence of infant mortality due to early onset infections remained the same, even though antibiotic prophylaxis increased dramatically. 

There are also problems with the overuse of antibiotics not just with pregnant women, but with society in general. In a recent commentary in Nature (Antibiotic overuse: Stop the killing of beneficial bacteria. August 24, 2011), the author wrote that,  

The average child in the United States and other developed countries has received 10–20 courses of antibiotics by the time he or she is 18 years old¹. In many respects, this is a life-saving development. The average US citizen born in 1940 was expected to live to the age of 63; a baby born today should reach 78, in part because of antibiotics. But the assumption that antibiotics are generally safe has fostered overuse and led to an increase in bacterial resistance to treatments.

Other, equally serious, long-term consequences of our love of antibiotics have received far less attention. Antibiotics kill the bacteria we do want, as well as those we don't. Early evidence from my lab and others hints that, sometimes, our friendly flora never fully recover. These long-term changes to the beneficial bacteria within people's bodies may even increase our susceptibility to infections and disease. Overuse of antibiotics could be fuelling the dramatic increase in conditions such as obesity, type 1 diabetes, inflammatory bowel disease, allergies and asthma, which have more than doubled in many populations

The blanket recommendation to treat 30% of all pregnant women with penicillin during labor could be causing permanent changes in gut flora, leading to problems we don't yet fully understand. Not to mention that if a baby is born by C-section, they are not exposed to the vaginal flora and miss out on this important step in the development of their immune systems. The author continues,

Consequently, we should reduce the use of antibiotics during pregnancy and childhood. Antibiotics — particularly penicillins — are now given routinely to between one-third and one-half of all women during pregnancy or nearing childbirth in the United States and other developed countries. Babies acquire their founding bacterial populations from their mothers while passing through the vagina at birth. So each generation — particularly the 30% or so of infants born via Caesarian⁹ — could be beginning life with a smaller endowment of ancient microbes than the last⁵.

I just had the results of my GBS test come back and I am negative! This is good because it means that I don't need to fight with my Obstetrician about hospital policies, and because my baby is lower risk for a scary infection. I believe that if I had turned out to be positive, I would have declined to receive the IV antibiotics.  The antibiotics may decrease the spread of GBS, but at what cost? These practices are currently being reviewed and researchers are working on developing a vaccine for GBS that would eliminate the need for mass antibiotic treatments. Until better treatments are found, I would encourage other pregnant ladies to read the literature and make their own informed decision on this issue.

I love Rachel Zoe

This post is dedicated to Rachel Zoe and how much I love her. The new season of the Rachel Zoe project just started last night and I LOVE that Rachel Zoe is pregnant. OK, she's not pregnant anymore, she had her baby boy, Skyler, on March 23rd of this year. But the show is obviously a few months delayed, and I'm happy to continue pretending that Rachel and I are pregnant together and are best friends.

Even though being a professional scientist is a very different compared to being a stylist/designer, I still feel like I have a lot to learn from her. I greatly admire RZ's dedication to her career and her workaholic tendencies. She also is really confidently irrational about half the time, but is always dead-on with her decisions and constantly hilarious. It also helps that she gets to wear amazing clothes all the time, and spent close to $100,000 on her baby's nursery.... I can dream.