Sunday, July 15, 2012

holly hobby

This is the first maternity leave where I haven't had a big heavy To Do list hanging over my head like the sword of Damocles.  And it feels fine, friends.

My first maternity leave with Cal, you'll remember, was three weeks into my Anesthesia residency.  So I spent much of that five weeks off from work trying to memorize Baby Miller, or at least, you know, sitting at a desk with Baby Miller open in front of me.  That

With Mack, I had the second round edits due on my book--and this was a big edit, since the first round manuscript had the chapters arranged by theme instead of chronologically; it was basically akin to dismantling your entire house and then building it again but with the rooms all in different places, with, uh, new doors and hallways connecting them (that creaking sound is that of a metaphor becoming overly labored)--so that leave was also spent marinating in a stew of low-grade obligation and stress.

But this maternity leave, I think I pretty much cleared the deck.  I'm not even doing those speaking engagements anymore, so there's no more of that "I gotta do my slides, I gotta review my slides, I gotta practice running through my slides" that has catagorized most of last year up until the Spring when I quit traveling.

So I'm doing some sewing is what I'm saying.

Some functional stuff I made for the baby.  That blanket, based on the tutorial here, and that crib sheet, based on the tutorial here.  Both were actually really easy, so fellow novice sewers, have at it, you will be surprised and pleased.

Then I modified the measurements on the fitted mattress sheet tutorial to make a cover for the diaper changing pad here.  This was especially pleasing because I got this piece of red striped cotton fabric from the "scraps" bin at the fabric store for 99 cents.  It was just big enough for the project, which was a happy coincidence.  (Joe also thought it was a coincidence that the cover matched the alphabet print hanging over the changing table, but I disabused him of that notion quickly--THE COLOR COORDINATION WAS PLANNED, DAMMIT.)

Speaking of salvage, my new thing is sewing with knit fabrics from thrift store finds.  Woven fabrics are nice and of course come in gorgeous prints, but in making things for kids, knit fabrics (think T-shirts, stretchy pants, etcetera) are much softer and more comfortable, especially for a baby.  Even for older kids--Cal complained endlessly when he had to wear this button-down shirt for school picture day, but he will wear any T-shirt or polo shirt until it basically disintegrates.  So anyway, I found this soft cotton sweater at the thrift store--not my style, and also not my size, but appealing in its oatmeal and grey stripes.  As you will soon see, I love stripes.  So I hacked off the bottom part and hacked off the sleeves, and made these two new items, respectively.

The internet is full of variations on how to make a dress from a onesie, so I'll just point you to this one here and say that I just sawed off a tube of fabric from the bottom of an adult T-shirt just to make it that much easier.  For comfort I decided to place the skirt part up higher, like an empire waist, so that the inflexible part of the stitching wouldn't be over the baby's stomach, where her width is the widest.

The pants I made out of the sweater sleeves, which was great because I basically had only had to sew the crotch seam and the casing.  (Tutorial for that little project here--but again, the internet is full of similar tutorials and variations therein, just look around.)  The onesies I got from Rock Bottom T-shirts, who I've mentioned before and with whom I have no relationship, but boy do I love them.  (Another plug: I also ordered some polo shirts from them for Mack's school uniforms--they are of surprisingly good quality.)

Using the bottom part of a T-shirt to make a dress was so easy that I just went ahead and made a couple more for the fall.  MORE STRIPES, PLEASE.  (No pants out of the navy and grey striped T-shirt, unfortunately--I would have loved to make them, but unfortunately that T-shirt was short-sleeved.)

And just so you don't think I am totally anti-pink, this last one here, which I'm hoping will fit by around Thanksgiving.

Just an observation--your local Goodwill is where all Gap, Old Navy and Target-branded shirts (your Merona, your Cherokee, your Massimo for Target, what have you) go to die.  It's like the elephant graveyard of soft T-shirts.

Another thing that they have at thrift stores is old sweaters.  Many of them are hideous, but some of them are decent, or, barring that, made of very soft wools or cotton (sometimes even cashmere) that you can rescue and turn into something else.  I found this grey angora turtleneck sweater that I was able to turn into two things for the winter.  (I kind of wish I had taken I picture of the sweater before I started, but this was my first time doing some of this stuff so in the event that it turned out crappy you understand I wanted to hide the evidence.)  First, these pants:

Again, from the sleeves of the sweater.  The angora is really pretty soft, but wool always has the potential to be scratchy so I decided to line the inside of the pants with the remnants of another thrifted T-shirt.  I actually had used that T- shirt to make another pair of soft pants, but I screwed that pair up in that I wasn't playing close attention and ended up sewing half the seams on the outside, half on the inside.  However, all was not lost--I just slipped that whole pair of pants inside the sweater pants, sewed them together and folded up the cuffs, and behold.  Mistake rectified.

The rest of the sweater (meaning the body part) I used to make this little cardigan, and let me just tell you, I AM SO PROUD OF THIS CARDIGAN.  I'd never sewn sleeves before, you see (something about the three-dimensionality of it seemed overwhelming to me) and I'd never drafted my own pattern before (I used a 6 month-sized onesie to approximate the size and dimensions), and while keen observation would undoubtedly reveal the amateur nature of this project, it actually turned out pretty well, and, I hope, very wearable.  (I would have liked buttons ideally, but I haven't figured out how to do that yet, and I didn't want to screw up the sweater with my first attempts.)

I mentioned this was a turtleneck sweater, right?  Well, there wasn't quite enough fabric to make the sleeves long enough, so I used the ribbing from the turtleneck to extend the sleeve length and make cuffs.  YOU'RE GOD DAMN RIGHT I DID.

I also used some of the leftover ribbing from the turtleneck to bind off the collar.  My stitching has its lumpy bits, but it won't be spotted from a trotting horse.  (Remember how Ramona's dad said that about her lamb costume?  I still think about that sometimes.  That and how the older girls colored her nose with mascara.)

And this was what was left of the sweater after I was done.  Every part of the buffalo, baby.

Now you'll have to remember that I only started sewing stuff like, what, a few months ago?  So I'm fairly new at this game.  However, as hobbies go, it's pretty fun.  Someone in the last entry asked me what I thought people would need to get started, and I have a few things that I would suggest.

First: a sewing machine.  I use this one, the Brother CS6000i, because while I didn't want to get the most expensive sewing machine in the universe, I also didn't want to get one that didn't have a good range of functions.  This one is nice because it's computerized (meaning you can change the type of stiches by pushing a few buttons), has a lot of nice convenience features, is really easy to use, and most importantly comes loaded up with basically every accessory that you could possibly need.  So I would recommend it, but it's also the only one I've really ever tried--there are cheaper models out there too, but I can't attest to their user-friendliness.

I'm going to assume you have scissors in your house if you're, you know, a human being, but I would also recommend (because I use it all the time) getting a rotary cutter (basically like a pizza cutter but for fabric and paper) and a cutting mat, unless you want to be like me with gouges all over one end of the table.  Sure, you can use the scissors for cutting too, but for long, straight cuts, the rotary cutter is easier.

You can get thread basically anywhere, and if you're starting out, I wouldn't go nuts--just go to any kind of craft store and get the handful of colors that you need.  But if you're looking for more colors to match your projects, this company called Threadsrus (I keep reading that as "thesaurus" but I think it's supposed to be Threads R Us--whether the R is written backwards is unclear) offers good quality thread at a very reasonable deal.  I am not at the point yet where I am ordering 200 spools of thread, mind you, but I did order a smaller aliquot from them in an assortment of colors, and I've been pretty pleased.

Oh, one last thing.  If you are prone to jabbing yourself with pins while you work (and I don't know how I am so injury-prone when sewing but I am--if I had as many needle sticks at work as I've had at home I would live at employee health permanently) might I recommend these?  They are these little fabric clips that hold your cloth together in lieu of pins in most situations, and they work great.  Don't bother with the small pack, get the big pack of 50, you will definitely not regret it.  They are super useful, and, you know, not so pointy.

Of course there's a ton of other stuff that you can get if you're in the market and have money to burn, but for a start, that's what I would recommend.  Anyway, sewing is fun, cutting up old busted clothes to make new cute clothes is fun, so let's all do it and humiliate our children by forcing them to wear our lumpy, ill-shaped handiwork into school!  It'll be awesome!

Feel free to discuss other sewing recommendations--either for projects or tools--in the comments section, and we will all share in the goodness.  And just so we don't get too far off course into turning this into a total other species of blog, my next entry will be the oft-requested "Day in the Life" post about private practice anesthesiology, or at least my experiences in that realm.  It'll be a real humdinger!

Hope you had a good weekend.

Friday, July 13, 2012

party of five

Hey everyone.  I meant to update sooner, but you know, NEW BABY.  Always needing stuff, they are.

Nina's been doing really well.  I was afraid, after having two pretty easy babies with Cal and Mack, that we were going to strike out with Thing 3 and be granted some kind of hellion.  But Nina's much like her brothers were, in that she's a good, sweet baby who is easy to please and whose cuteness makes up for the rest.

I do think that some of it is due to her innate good nature, but I also think that our easy time of things is framed by expectation.  With a new baby, people mostly complain about the lack of sleep, and the constant neediness of the newborn--so much feeding! so much holding and rocking! where one diaper change ends, the next one begins!  And so forth.  The thing is--that's what babies are supposed to do.  And what I'm doing on my end--holding her basically all the time when she's awake, feeding her on demand, changing many many teeny little poo diapers and scanning her pee diapers with almost clinical intensity to assess her degree of urobilinogen excretion (though now, linking to Wikipedia, I am realizing for the first time that urobilinogen is colorless--all that wasted observation!)--that's what I'm supposed to do.  So I don't really think I'm having an appreciably easier or harder time than anyone else with a new baby, we're just all doing what we're supposed to be doing, and everybody's happy.

Anyway, I'm pretty firmly of the belief that if you want to sleep all night, you probably shouldn't have a baby, much the way that if you want to be well-rested, ever, you probably shouldn't go into medicine.  See, it's all about framing your expectations.

Hey, wanna see some pictures?  Most of these are on my Tumblr already, but I know not everyone is my buddy on the twitters et al.  It's fine, little technophobe, we'll just churn some butter and make some corn husk dolls right here by the flickering light of this here computer screen.

I knew that Cal would do well with a new baby (little old man that he is, I knew he would relish the expertise conferred by being not only seven years her senior but also a veteran older sibling) but I'll admit that I was a little concerned that Mack, who has spent the last three and a half years marinating in his baby-of-the-family status, would be jealous.  And I'm not saying that he's not ever going to be jealous or competitive (just wait until she starts getting mobile and his slavishly guarded collection of superhero action figures comes under siege) but so far, he is in love with his baby.

"Mom, I love baby Nina," he'll say unprompted.

"Baby Nina is so pretty."

"Can I kiss her?"

"Can I rub her and smell her?"  (He means rub her head.  We talked about the fontanelles and the importance of using his flat palm instead of poking her brain with his fingers, but then Cal was like, "She has a HOLE in her HEAD?" and then we had to kind of soft-pedal the anatomy lesson lest everyone freak out.  Mack also particularly likes smelling the baby.  I understand the appeal of smelling a new baby and much as the next weirdo, but the way Mack goes after her, you'd think she's one of those really fascinating second generation scratch 'n' sniff stickers that really really for real OMG smell like food.  Like the buttered popcorn one.  Or that one that smelled like pepperoni pizza that I was fascinated with as a child because wow, they made a sticker smell like pizza?  THE FUTURE IS HERE.)

Anyway, sibling rivalry averted for now.  Cal and Mack seem to have reserved all their petty animus for each other ("MOM! Cal looked at me!") but Nina, so far as they're concerned, is a princess.

I'd meant to post this up earlier today (because I'm pretty sure no one's going to read this now when I'm posting it, almost 11:00pm on a Friday night), but see above: baby, comma, care of.  There are a couple of other posts that I'm working on in my head to post hopefully in the next week or two when I have a free moment, including but not limited to:

  • Private practice anesthesiology: a day in the life
  • Breastfeeding and pumping after returning to work, my experience and strategies (warning: boobs will be alluded to though not depicted)
  • More sewing projects that I done did, culled of the more embarrassing mishaps (like the time I got confused while making a pair of leggings and sewed half the seams on the outside, half the seams on the inside)

Any other post topics you guys interested in hearing about while I'm on maternity leave and have some time for such extracurricular pursuits?  Aside from wanting to see more pictures of Cooper to prove that she didn't die a year ago and I just somehow never mentioned it here?  I'm working on that post too--I'll get her to hold a copy of today's Wall Street Journal in the pictures, you know, as a proof of life.  (Not to joke about our dog dying or anything--obviously we care deeply about our dog.  But we're just no longer in the phase of life where we treat her as a child by proxy.  Rest assured that she is well loved and taken care of and just got a new memory foam dog bed that she is very pleased with.)

Anyway.  Have a good weekend, everyone.

Monday, July 09, 2012

make your own baby video monitor

Hey all.  Forgive me if this is too "uh...duh" for some of you, but I promised I would share the execution of this idea with someone at work who was having her first grandchild (hi Maree!) and am actually quite pleased at how well this is working.

Like most people, we had a baby monitor.  Actually, we only had one for Mack--when we lived in New York, I think we were actually able to hear Cal in the next room because that's apartment living for you--but it was just an audio monitor, really nothing but a glorified one-way walkie-talkie.  But it worked OK and Mack is still alive, so...monitoring success, I guess.  We still have the audio monitor, I just kind of stopped using it when I got sick of it basically being a broadcast of the kids arguing with each other in the basement of our old house.  Just share the damn toys guys, dag.

With a fresh baby though, everyone gets a little more vigilant (read: paranoid), and though I like to think of myself as laid back, it crossed my mind that a video monitor might be nice for peace of mind, to be able to see the things that don't make any noise that a monitor can pick up (blanket over face, malevolent stuffed animals come to life, what have you).  The only thing is, I can be kind of a skinflint about certain things, and it just seemed to me to be an awful lot of money to spend for something with somewhat limited lifespan and utility.  And then I had an idea.

(Again, forgive me if this is too obvious, but I was proud of thinking of it, especially since it used equipment that I had already.)

What you will need:

- A transmitter (I used an old iPhone that I saved--I was on AT&T originally but reception was crap at my hospital and I was continually paranoid about missing calls, since that's that primary way we communicate between ORs and such.  Anyway, my point being that when the new iPhone came out I upgraded and switched to Verizon--therefore I have a phone-plan-less iPhone kind of lying around that still works on our home WiFi.  But really you can use anything with a wireless connection and a camera.)

- A receiver (you can use your phone, a 2nd or 3rd generation iPad, your desktop or laptop computer, whatever.  I've been using my iPad because it's light and easy to carry from room to room, but again, it can be pretty much anything, it just has to have wireless connectivity and a camera.)

- Two Skype accounts (I just use mine and Joe's--the accounts are free to sign up for, and at bare bones, calls made over WiFi are free and unlimited so far as I can ascertain)

- Optional but helpful, depending on what you're using for your transmitter: a tripod, some creative velcro strapping, etcetera.

OK, so here's what you do.

STEP 1: Get a baby that you want to stare at.

STEP 2: Figure out where you want the monitor to be.  You're somewhat limited by the fact that streaming a video call over Skype used a lot of juice, so I would choose a place near an outlet, but more importantly, find a place where you can fixate your transmitter, be it over a crib rail or on a nightstand or what have you.  I apologize for the noise in these photos, but I was under low-light conditions for what I assume are obvious reasons.

(Here you see I have my old hobbled iPhone on a tripod and then Velcro-ed the tripod to the corner of the crib.  I don't think you absolutely need a tripod, but I had one from a lens kit that I got for iPhone photography that I rarely use and it's pretty handy in general--it also allows you to put the transmitter on a flat surface instead if that's your preference.  Just make modifications as you see fit--for example, if your baby is old enough to pull up and grab things, you probably don't want to have that phone just dangling there on the edge of the crib rail, but in that case, you know, put a table next to the crib out of reach or put the camera on a shelf, whatever.)

STEP 3: Make sure you have Skype downloaded on both transmitter and receiver devices.  There's a free Skype app for iPhone/iPad/iPod on iTunes (iKnow, this is starting to seem like I work for Apple but I swear I don't, it's just what iHave in my house.)  Log in with one account on the transmitter and the other account on the receiver.  (I use Joe's account as the receiver, and my account is the transmitter.)

STEP 4: Use one end to call the other end.  Doesn't matter which one initiates the call, just make sure you're placing a video call because that's the whole point.  Accept the call on the other end.

STEP 5: If you're using something like an iPhone for your transmitter that has two cameras, make sure that you change the preferences such that you're using the "back facing camera" or whatever they call it--that's the higher quality camera anyway, it'll probably give you a better image, and that way you're not shining that screen in the baby's face.  

STEP 6: And there's your call on the other end.  Now continue to silently and creepily spy on your offspring.

Saturday, July 07, 2012

in which I either save you money or get you to spend more of it

Hey, can I give you a completely unsolicited, unsponsored product recommendation, if for no other reason than to get that gory cord photo down below the fold?   OK then.

Like many people, I like the aesthetic of American Apparel clothes for kids--for babies in particular, it seems like the only place to get plain, bold-colored (meaning non-pastel) clothes not cluttered with pictures and logos for various things.  The only problem is the price.  I mean, $11.50 for a onesie?  Are you shitting me?  I love my kid, and you know, it's nice that they're American made and everything,

Then, when I was tooling around the internet looking for some plain T-shirts for our freezer paper stencil projects, I found this company called Rock Bottom T-shirts, and among many other things (I think they mostly deal in plain T-shirts and sweatshirts and things of that ilk) I noticed that they sell, huh, what do you know, plain, bright-colored onesies not cluttered with pictures or logos.  I thought there was a pretty good chance that they would be made of that really rough, scratchy cotton, but I ordered a few to check them out and no, the cotton is nice and soft, good construction, washes up well, and the colors really are very bright.  I would compare them favorably to those Gerber onesies that you can buy in a big five-pack.  These shrink up the same way, but to my hand, they are softer.  And the colors!  Love the colors, want to lick them.  For the price, I could not say no.  At the time I ordered the onesies, they were actually having a sale, so they were even a full dollar cheaper than they are listed for now (and if you don't need a snap-bottom onesie, these short sleeved lap tees are a good alternative and also at a full dollar cheaper) which means I was able to get this big, admittedly indulgent pile for the price of two American Apparel onesies.

Will they hold up?  The real question is, do they need to hold up?  We're talking about baby clothes, after all.  It's a race to the Goodwill bin anyway, so who cares?

(And yes, when I have things in different colors, I need to order them all ROY G. BIV--I can't help it, it's a disease.)

At Nina's third bili check in as many days, she's down to 13.8, and an ounce shy of her birth weight. We're going to keep letting her get some sun (our house is unfortunately a low-ceilinged ranch devoid of natural light in most rooms, but the kids' playroom was a sunroom in its former incarnatiom so we'll just hang out there as much as possible for the weekend. One more weight and bili check on Monday, after which poit, hopefully, we'll be released on our own recognizance.

(Gorgeous quilt a gift from the lovely and talented Ramona Bates, a plastic surgeon, prominent medical blogger, and quilt-maker extraordinaire.  It must have taken a lot of hard work, thank you so much again!)

Thursday, July 05, 2012

glow worm

Hey, thanks for those in the comments who helped me convert the RAW files to JPGs.  Insert Eddie Murphy's "Raw" joke here!  (I don't even know what that joke would be, I just like to say "Eddie Murphy's 'Raw'".)  A few more pics from Nina's birthday.


Big ups to Dr. Moore.

And now, Deep Thoughts.

I had lying-down-for-too-many-hours hair.

So today we brought in Nina for her first Peds check after being discharged from the hospital.  We didn't have any real concerns--she's been doing all the things that she's supposed to do, she's less than an ounce shy of her birth weight (my milk came in yesterday afternoon--we'd been doing some supplementing with formula up until then to avoid dehydration and jaundice) and she's just been generally delightful.  So we were a little surprised when a quasi-routine heel stick for bilirubin turned up levels in the high-risk range.  (She was about 82 hours old when the blood was checked, and her level was 16 point something.)  Honestly, she doesn't look that yellow to me, I almost wonder if hemolysis from heel-stick sampling plays a role in the number being high (does it do that?) but whatever, better safe than sorry.


Apparently we have this really shit health insurance that doesn't cover bili blankets via home health nursing--the nurse says in the past when they've had patients with our insurance needing phototherapy the only thing that has been covered has been those baby tanning beds in the isolettes, which would be TERRIBLE, since you're supposed to just leave the baby in there all the time, by themselves, for 24 hours or more, only taking them out for feeds and diaper changes.  Boo-urns to that.  

However, the Peds group that we're with has a bili blanket system that they loan out for just this kind of situation--thankfully no one else was using it.  (Actually, from the equipment log, it looks like no one has needed to borrow it since February, which either means no babies need phototherapy or everyone has better health insurance than us.)  NO MATTER.  We were so very grateful to have this option, and to be with a Peds group that has a loaner unit because they know that babies need to be held and touched even if they are busy isomerizing the double bonds in their excess bilirubin.  Two thumbs up for the Children's Medical Group of Atlanta.

We're going to go back in tomorrow afternoon for another bili check, aiming for at least a two point drop in her level after about 24 hours on the lights.  Let's hope we're already moving in the right direction.

Wednesday, July 04, 2012

independence day

I did want to put the birth announcement up here first, as this is something of my Primary Address when it comes to the internet, but something was weird with the wireless network at the hospital and my computer couldn't connect, blah blah blah (now I'm just boring myself) and besides, everyone is on Facebook and Twitter anyway, right?  But just because I'm a completist when it comes to documentation:


Nina Qiao-Ying Walrath
Born July 2nd, 2012 at 12:05am
6lbs, 13oz
19 inches long

(Her Chinese middle name, picked out by my dad, means "witty" and "intelligent." We figured she'd have a lifetime of people telling her that she was "pretty"--I mean, not that we knew she would be pretty, though she is, but you know what I mean, people always tell little girls that--and we wanted to pick a middle name that would emphasize that there are more important things.  When it comes to first names, we don't make a big thing about choosing first names that have a lot of symbolism, we just go by the "like the way it sounds" school of baby naming, but so far as I can tell, Nina means "girl." So, you know, story checks out.)

Nina came into the world in her own way, which I am coming to understand is determinedly unique and certainly on her own timetable.  You remember I was admitted to the hospital for about 12 hours in what was first deemed to be active and then downgraded to a sort of meandering prodromal labor last week--and I spent the time since then doing exactly what I didn't want to do with the final stages of my pregnancy, which was puttering around, hyperaware of my body, and sort of obsessively cataloguing every squeeze and twinge and thump.  This is so annoying, I thought to myself.  If I was at work, I'd be busy, I'd have more to do than naval-gazing, and I wouldn't be so focused on every little thing going on all up in my junk.  This is a waste of time.

(She said with great PORTENT.)

Sunday morning--the day I turned 38 weeks--I woke up, and Nina, intrauterine, was still asleep.  I had gotten pretty accustomed to her sleep/wake patterns by this time, and usually she would perk up and start kicking around pretty soon after I got up myself, but this morning, she was a little slow to get going.  So I did the usual things they tell you to do.  I had some breakfast.  I had some coffee.  I started counting her kicks.  It wasn't that she wasn't moving around AT ALL--obviously that would have been very worrisome--she was meeting her minimum kick count, which I believe is 10 movements in 2 hours, but it was just different from usual.  She was just kind of pokey in there.

I know that decreased movement at term can be normal--there's just less room in there, after all, and who knows, maybe they sense when birth is imminent and quiet down to save energy for getting borned and all that.  But it was still a change, and though I considered long and hard just going about my day (see above: with the lack of my usual daily runaround, maybe I was just being too obsessive about what was going on inside) but in the end decided to just call my OB and get his opinion.

Sidebar: I cannot recommend my OB highly enough, by the way.  I can talk about it more with anyone who wants a recommendation, but his name is Dr. Brad Moore, here is the website for his office, and he is truly an excellent clinician and bedside doctor--and this is from someone who is well aware of the Pressures of Modern Medicine and therefore very forgiving when it comes to how other clinicians practice.  He is quite simply and unequivocally excellent, so get thee to his practice, pregnant ladies of Atlanta.  End sidebar.

Anyway, I called my OB, kind of apologizing for calling on the weekend about something that could be nothing, I'm not a hysteric, I swear, but he listened and he did take it seriously.  "Come on in," he told me, "we'll check you and check the baby.  You're 38 weeks, contracting, with advanced dilation, GBS positive and a history of fast labors.  If things are in line, maybe we'll just get in your antibiotics, augment you with a whiff of Pitocin, and have this baby tonight."

I think his intent had been for me to check into L&D right from the beginning (since he was on call that weekend he was already in the hospital, puttering around) but because my chief complaint was "decreased fetal movement at term" they sent me to triage first, where the nurse was very clearly of the opinion that I was a hysteric and should be sent home.  "The best outcome here would be to send you home," she told me brightly with one of those tight, forced smiles as she was doing the admissions paperwork, and after she got the phone orders from my OB that I should indeed be admitted to L&D, she made it clear that she disagreed in the way that people do without coming out and saying so outright.  "Well, you're getting admitted.  It's what your doctor wants, I guess..."  I don't begrudge her the sentiment--I don't like being on call for the weekend either, I guess--but I was also glad that I'd called my OB first and that the decision was not up to her.

The actual lead up to delivery was completely uneventful, much with with Cal and Mack.  I got my antibiotics, started some low-dose Pitocin, got my epidural (great stuff, by the way, though it's not an entirely pleasant process getting it placed, and fact that I'm pleased to be reminded of every 3.5 years just for the purposes of patient empathy) and then had my membranes ruptured with my second dose of penicillin hanging.  We were on our way.  At 11:56, the baby's head was at +2, all the players were in the room, and we were ready to push.

"We've still got four minutes to make a July 1st birthday!" Joe kidded, and my OB made a little jokey show of putting on his glove and gowns real fast.  Then we started pushing.

I should mention that up until this point, for the hours we'd been there, the fetal heartbeat monitor was looking really good.  Lots of good variability, perky, with a rate right in the normal range.  When the head was all the way down and we started getting ready to push however, the tracing looked a little more flat, meaning that the rate was still normal, but it wasn't quite as variable as it had been.  I assumed she just didn't like getting squashed.  But then after the first two rounds of pushing, it all kind of fell off a cliff.

Even in an adult, a heart rate of 50 in an adult is slow.  That's what Joe's heart rate is, and he's on beta blockers, for chrissake.  A heartrate of 50 in a neonate is...well.  Let's just say that if I was in the NICU and there was a baby with a heart rate of 50, I would be doing chest compressions on that baby.  After the first two pushes, that's what our baby's heart rate did on the monitor.  The nurse adjusted the Doppler, thinking maybe that the baby was so low down that it wasn't picking up, but no, it was picking up, and it was 50.  So my OB--in a way that was very calm but also very quick and decisive, and I'm convinced that it was this quick response that really saved us from those things we don't like to think about--busted out the obstetric vacuum, applied it to the baby's head, told me to push one more time quick, and pulled that puppy out of there.

Nina was born vigorous, with good tone, and she cried right away.  Her Apgars were 8 and 9.  As they were warming her up and drying her off, I heard my OB, from the region I like to call Down There, say, "Oh my gosh, look at this."  Which is not a thing that I like to hear from Down There.  Because when he delivered the rest of the placenta and cord, it looked like this:

(Let me just insert here that this is not a picture of our umbilical cord, it's a picture I got off Ye Internet, though ours looked remarkably similar, only tighter.  That is not to say that we didn't take pictures of this phenomenon, because WE TOTALLY DID, once the placenta and associated works were safely and discreetly deposited in the specimen basin, but they're on our "real" camera and I can't figure out how to get them off, because someone switched the settings so that all our photos from that day are in RAW format.  If someone knows a good strategy to batch convert them in Photoshop so we don't have to do them one by one, let me know in the comments section, thanks--I'll update with those photos once I'm able to extract them.)

In case you can't see for yourself, it was a knot.  What they call a true knot in the umbilical cord, which is pretty rare, and even rarer for it to actually get pulled tight enough to manifest with fetal distress.  The knot had probably already been there for months--Nina had probably tied it earlier in gestation when she was much smaller and there was more room to maneuver, and if you don't read about all the terrible things that can happen with a true knot in the umbilical cord, it's actually a little amusing to thing about her doing the loop-de-loop, then threading the needle while swinging her cord around like a lariat.  A little amusing, until she started to pull down on the cord on her way out and tightened that knot up but good.  Obviously we had no idea until after, it's not exactly something you screen for routinely without lack of other indicators for risk, and there's nothing you can really do to cause or prevent it.  We were incredibly lucky, and we know it.

I also do have to say this here, because these days, what my friend Veronica (also an OB-Gyn) has called "the fetishization of the natural" goes hand in hand with the demonization of the medical.  By no means am I saying that everyone should have the maximal interventions possible (Pitocin and epidurals and C-sections for everyone!) or that people's hearts aren't in the right places when they choose to have births outside of the hospital.  But if I were of the type to elect for a home birth (and let's be clear: I'M TOTALLY NOT) I would have, on paper, been the perfect candidate.  Multiparous with two prior uncomplicated vaginal deliveries, full-term with normal-sized fetus and an uncomplicated gestation.  But if this pregnancy experience has taught me anything, it's that you can't plan for everything, and there's always going to be things you can't expect.  And maybe because it's the anesthesiologist's credo (aside from vigilance), but I live by the idea of hoping for the best and planning for the worst.

This could have been bad.  It could have been catastrophic.  But it was not, and for that, and for our sweet baby Nina, we could not be more grateful.

Cal, upon meeting Nina for the first time in the hospital the next day, gave this assessment.  (Cal's demeanor is often overly serious--we keep telling him to lighten up, kid, for god's sake--and while we mentioned to him about the interesting little finding on Nina's umbilical cord we didn't really go into detail about what it could have meant; Cal's grave little pronouncements just happen on their own.)

"She's perfect." he told me.  "She's the perfect baby and we get to take her home with us."

Yes she is, and yes we do.  And we love her so much already.

Welcome to the family, Nina.  Now get ready to have some fun.