Middle Weeks of August

Visitors 

Mom and I were joined by quite a few visitors in the past few weeks. We've been doing really well with our routines - hospital visits, evening walks in the park, visits to the farmer's market - and we have tried to incorporate our visitors into our calm routines here in Houston. Other than the semi-stressful drives to the airport (Houston traffic is very congested and unpredictable), we have been able to keep ourselves relaxed and in the mindset to to welcome baby Autumn in the next few weeks.

Dad arrived on Thursday evening and we were able to show him some of our favorite walking spots. This is a picture outside of Rice University. The Rice community is pretty close to the hospital district and mom and I have spent a lot of time walking around during the afternoons. Dad finally got to experience the Houston heat and humidity - we've been carrying water everywhere to stay hydrated when we walk around. 

We were able to take advantage of a lot of the free events in the community while dad was here - a tribute to David Bowie and a bluegrass concert in the park. It was wonderful to have him here for the weekend while he's waiting for a place to stay back home :)

Andre arrived late Saturday to spend the weekend with us. We made sure to stop by his new favorite spot in Houston - the chocolate bar. They've got an excellent truffle cake and milkshake. We are making sure that Autumn has a taste for chocolate... something she and her dad and grandpa can share.

We had a few appointments on Monday that Andre was able to attend. Autumn is growing well - almost 5 lbs now!! At the moment, the doctors feel comfortable with her size, but it will be better if she continues to grow. If she's bigger when she's born, the surgeons can replace her valve with a bigger valve that will last longer for her - meaning she won't need a second surgery for longer. The cardiologists like to try and stretch the valve usage as long as possible.

Andre returned back to El Paso for the next 10 days and we are reminding Autumn to wait for her dad to get back to Houston before she decides to come. It was tough to say good-bye but the 10 days have been going by pretty quickly.

Diaper Project
Much of my time has been consumed with diaper-making. Thanks to my friend Judith, I have the pattern to make diapers for Autumn and it's been a little bit of a learning curve, but I'm making it through the diapers with less and less mistakes. The goal is to have about 10 baby diapers (0-4 mos) and 25 baby/toddler diapers (4 mos - 2 years). So far it's going well, but I'm starting to feel the pressure of the clock... I've only got a little more time to get them done!!

With our guests and diapers and routines, we've been busy but doing very well. Houston does not feel exactly like "home" but it's been treating us well during this period of waiting.

Week 2-3 - Hospital/Birth Updates

Appointments at the Hospital
For the past two weeks, we have had about 5-6 appointments at the hospital. We have appointments that check how I am doing, appointments to check how baby Autumn is doing, hospital tours of the delivery room and the NICU, and some studies that we've agreed to support. 


Monday appointments 
Autumn gets weekly checks for her biophysical profile - usually in the form of a Non-Stress Test (NST) and an ultrasound. She has been measuring very small (between 2.3 - 5%) from about 20 weeks. Although this can be a sign of problems with the placenta or nourishment she's receiving, the doctors have seemed to feel comfortable with her growth as she is continuing to grow equally at a steady rate - meaning she's small all over (her head, abdomen, legs, arms) and she's growing every time at the same pace. 

As of now all of her biophysical profiles have looked really good - passing 8 out of 8 of the signs to make sure she's safe and healthy. She sometimes needs a bit of cran-apple juice to make her move during the NST... she may be a bit of a sugar junkie because it only takes about 30 to 60 seconds for juice to wake her up and make her kick and wiggle. Other than her hesitancy to wiggle sometimes, her fluids, heart-beat, practice-breathing, nutrition, and overall development looks really good.

The nurses and technicians have been wonderful across the board... answering all of our questions and narrating the tests so we understand what we are seeing. The whole process here has felt more inclusive and I feel very informed about knowing how she is doing. 

After our last appointment Autumn was approximately 4 lbs and 13 oz. I am hoping that she gains at least a pound or more before she comes. The doctors/neonatalogists/cardiologists seem comfortable with her weight now if she comes early, but everything is a little easier for the cardiologists if she's bigger. I was having pretty consistent 'practice contractions' Braxton Hicks during the NST, but I still feel like she's got at least two more weeks of growing. I keep reminding Autumn that she needs to wait at least 10 more days for Andre to get back to Houston.

The nurse noted that she has pouty lips :)

She likes to lay against the placenta with her hand in front of her face, so it's been difficult to get a picture of her face - this is a pretty good view for what we've seen so far.

Baby feet! She likes to kick so maybe she'll be a soccer fan like her parents.

OB Appointments and Study
We've had pretty standard weekly OB appointments and are coming to really like our doctor. We've been on the same page for many birthing choices. Because I had switched to midwifery care, I've had a lot of tests to complete over the past few weeks - lots of blood draws... but all is looking good. 

We agreed to participate in a study that Baylor Medicine is conducting for children with congenital heart disease. The study is looking for affects on brain development for children with different heart conditions. The study included an ultrasound and my first MRI.

The ultrasound tech was really excited about the pictures they were able to get of the synapses in Autumn's brain... mentioning that they might even use her pictures in the journal when they complete the study. It was nice to get to see her again in the ultrasound... still kicking moving and most importantly GROWING. 

I was able to practice some of my hynobirthing strategies during the MRI. They seemed to work really well for helping me relax during the loud and slight uncomfortable MRI. Mom was able to sit in for the MRI and said I looked like I was sleeping. I will continue to practice in hopes that I can relax and have a gentle calm birth. 

Doula and Natural Health
We had our 3 hour prenatal doula appointment and learned a lot about exercises to practice in anticipation for the birth. We also learned about the process of birth - with detailed descriptions of what my body will be doing at each stage. Our doula is really wonderful and had many suggestions and answered all of our questions about what to expect with this hospital and the typical strategies she uses to help mothers with their birth. Mom and I had to go out and buy a different birthing ball because mine was way too small to practice the exercises. I am now sitting almost exclusively on the birthing ball and following pelvic floor exercises - squatting and stretching to help with birth and recovery. 

My sad birthing ball next to the recommended ball from the doula.

We are continuing to walk everyday - between 4 and 8 miles and trying to swim a few times during the week. Even though the transition was difficult, we have been able to start a lot of routines to help prepare for the big day :)

Coming up in the next week:
We have our first appointment with the cardiologist who will be performing the surgery. We will be able to ask about the projected treatment and his/her thoughts about cord blood/tissue banking - something that may be helpful for Autumn as they are researching the ability to create a value out of the baby's own stem cells. 

Love from Family and Friends - Week 1

People are amazing. 

This journey is not a journey that Andre and I are making alone. From the moment we knew we were expecting, we have felt love and support from our family and friends.  And now that we are facing this detour, we have never felt alone. From little messages to phone calls to card to gifts to prayers, we have felt surrounded by love (even though our family and friends are scattered throughout the country and world).

Some highlights and shout-outs:

- A heart-felt send-off from my co-workers at United Way. I will be missing my parent educators while I am here in Houston

- Lots of calls from friends and family - Mom and I have been pacing the halls of the apartment talking to our friends

- We were touched to receive an unprompted call from the cardiologist in El Paso - just checking in to see how "princess" is doing. He was incredibly compassionate and patient with us as the first person to explain her condition.

- A box of super cute gifts - books, nail polish, chocolate, journals... all detailed with messages from Mom's good friend Amy. Truly touched by all the detail and love :)


- A delicious edible arrangement from Mom's friend Martha... we've been picking at it all afternoon.

- A beautiful prayer blankey from Cindy with a prayer rock. (I don't know if Cindy knows but my childhood stuffed animal was a lamb... I had a super creative name... Lamby) . It'll be perfect for Autumn's bed at the NICU 


Thank you for all your support and love :)

Week 1 - Hospital/Birth Updates

A little bit of background...
One of the most difficult transitions for me has been the transition from the birth center in El Paso back to the traditional hospital setting. We began our prenatal care at the baby-friendly hospital in El Paso. Although I know the doctors and staff were kind and capable, I just did not feel comfortable with the philosophy and practices that have become standard in a traditional hospital birth. I am coming into my experience with doctors from my childhood with my dad - who has always been very didactic... taking the time to teach and explain what was happening. The environment in the hospital in El Paso did not support this climate... seeming to prefer patients as compliant recipients of care and expertise of the doctors. I have respect for the knowledge and experience of doctors, but I have always preferred feeling like my thoughts and preferences were valued and considered instead of being brushed aside. 

Around four months into the pregnancy, I began to seek other options and found a fantastic birthing center with a midwife I loved. Every appointment was life-giving and confidence-building. I felt like I was part of the team and my decisions were considered and valued. With my appointments at the birth center and our weekly Hypnobirthing Class, Andre and I were feeling really comfortable and excited about our calm birth and Autumn's gentle entry into the world. 

That, of course, all had to be altered after our last ultrasound in El Paso that altered us to the issues in her heart. (If you haven't read the Autumn's Heart page and are interested in understanding exactly what the cardiologists are seeing, please check out the page on the right of the blog or click here ... I did my best to explain what we understand as of now ). We are at the second best hospital in the country for pediatric cardiology and I know that Autumn's heart will be in some of the best hands in the world.

My initial fears about coming to Houston were mostly linked with the uncertainty of the birthing climate in the hospital. I knew that the Women's Pavilion had the label of being baby-friendly, but I know that a calm/gentle/unmedicated/natural birth is not always received well by doctors and nurses who are coming from a different philosophy of care. In some ways, I feel unsure about my goal to go through this birth using the hypnobirthing/gentle techniques because I know that she will need immediate medical interventions that will not be gentle and calm, but something continues to motivate me to give her this calm time as an entrance into a world that will be stressful and hectic for the first few weeks. I believe in the practices of natural birth and I think it most closely aligns with the type of entrance I want for Autumn in the world.


Our first interactions with the docs...
Andre and I were very impressed and thankful for the excellent care and compassion we felt at our initial appointments with the doctors. Our nurse case manager booked our Monday and Tuesday with appointments all day long - meeting the neonatalogists, obstetricians, cardiologists and counselors. We repeated all of the test from El Paso - a full anatomy screening, echocardiogram on Autumn's heart, and blood draws for gestational diabetes and test for 22q.112 (a genetic condition that can be associated with Tetrology of Fallot). 

Details make an impression on me... for example, all the ultrasound docs and techs made sure to make physical contact with me and speak with me before proceeding with a test. All docs always ask the sex of baby and refer to her as her during procedures - making the experience feel like an authentic human interaction instead of just a procedure. They have spent time to explain and let us ask as many questions as we need. I never feel like I am being rushed out of the room. And most importantly for me, these experts in their field seem to encourage patient investment and participation. They seem to prefer having the patients as part of the team - taking my thoughts and preferences as valid within the context of the team.

Some wins for our gentle/natural birth:
- Unless there is danger for me or baby...
- It looks like they will respect my wishes to not be induced (the docs in El Paso gave me the impression that I wouldn't have the choice).
- I will be able to drink and eat clear liquids during labor. 
- Varied positions and even hydrotherapy will be allowed.
- The doula (recommended by the midwives in El Paso) is excellent and will be an amazing support during the birth...she's participated in over 400 births and specializes in hospital births
- The neonatalogists seem to truly prefer breast milk - when possible for her digestive system and will exclusively feed her breast milk with supplements of IV fluid when needed 


Some compromises:
- Skin to skin contact will probably not be possible. The neonatalogists will need to check her for 30 minutes and start administering prostaglandins right away. I may get the chance to see her for a few minutes before they take her to the NICU (Mom will be following Autumn while Andre waits with me to be cleared to go see her)
- IV - I will definitely need the IV lock placed in my arm, even though I will not necessarily be receiving fluids unless they think it's necessary
- Limited flexibility for final pushing position - it looks like the standard is the back position and no flexibility for squatting or side.


Overall feelings..
I am thankful that we are here so early so I have had the opportunity to meet the docs and feel comfortable with the environment at the hospital. I feel so secure after meeting the doula and feeling her support already with more support to come during the birth. I am comforted to know that Women's Pavilion truly deserves its mother/baby-friendly distinction and that the doctors and staff are compassionate and willing to see me as a part of the team. I am thankful that our OB is flexible and kind - taking seriously my plans and hopes while also concerned about our experience in Houston (He recommended at least 20 restaurants and museum/events we should visit while we are here).

I am able to start picturing the experience and feeling at peace with some of the compromises to my plan of a birth center labor and delivery. One of my favorite affirmations from hypnobirthing is:

"I am prepared to calmly meet whatever turn my birthing journey takes." 

This affirmation has become more important in the light of this detour and any mini-detours that will come up as we continue along this journey.

Moving in to Houston and Adventures in Austin 

Mom and I have settled into a routine in Houston. We were able to find a fully furnished apartment less than 10 minutes from the hospital. The location has been so convenient for the multiple weekly check-ins, and having our own space has allowed us both to work on projects while we are preparing for Autumn's arrival. Mom has been busy working on reports for work and the final paperwork for moving out of her house back in Ohio while I've been trying to finish sewing 25 reusable diapers with snaps before she arrives. My friend Judith (who made all of her diapers for her son) has inspired/taught me how to make them and I am working hard to finish them before baby Autumn arrives-...more to come with diaper updates... I've been able to add all the snaps and will start sewing today (I hope)

We are very close to a beautiful park in the museum district of Houston and started taking walks in the evenings. The park is full of families going to the zoo and even has a theater with free events during the evenings. We checked our a modern adaptation of Much Ado About Nothing last week. The actors were excellent and we were close enough to the stage to get periodic waves of air conditioning when the breeze blew the right way.  We look forward to checking out more plays that are offered during this free outdoor summer series... maybe even an Elton John/Billy Joel tribute band when Dad comes next week.

Last week, we were even able to travel a bit. (Probably our last big trip because we are getting closer to go time). We drove 3 hours to Austin and stayed the night with my great friend Kristen. She introduced us to Dominion - and mom was very impressive with her gaming skills winning the first game. We met up with my cousin Daly at one of his favorite coffee spots in Austin - it was great to hear about his first year of college and the fantastic music scene in Austin. Mom got the chance to experience an amazing black bean avocado taco at a food truck and even has started to like Kombucha (there's an excellent Austin brand - Budha's Brew). It was a nice break in the middle of the week to get out of the humidity and busyness of Houston.

Now that the weekend has arrived, Mom and I have caught up on grocery shopping (Saturday farmer's market is very nice here). We've visited St. Paul's Methodist church (only about 10 minutes from our place) twice now. The services are beautiful and the choir is fantastic. We both thought Grandma would have loved the organist - who makes great use of the massive pipes especially during the last verse of the hymns. I'm glad Autumn is getting exposed to some traditional organ music before she's born... Grandma would definitely be proud. The oppressive Houston heat and humidity has chilled out a bit with a rain system that passed through Saturday night and we are preparing for the upcoming week - full of appointments and some very welcome visitors (Andre and Dad will be here this weekend)