Nicholas is here!

Nicholas, just a few minutes after birth.

We are happy to report that Nicholas has arrived!

He was born at 9:36am, weighing 5 pounds and measuring 17 inches.

Kat is now recovering and Grandma Sofya and I are by the bedside. We just completed our first trip down to the NICU where we visited Nicholas as he was peacefully sleeping.

Nicholas, reunited as Kat makes her way up to the recovery room.

Nicholas, holding his daddy's finger.

The Last Day of Pregnancy

We’ve made it to 34 weeks! Today is our last day of pregnancy!  We are ready to say goodbye to the belly, and meet the baby.

Goodbye, Belly!

This baby has been a part of me for almost 8 months, and I’ve enjoyed sharing my body, blood, nutrients, oxygen with him.  At this point, there is not much benefit for him to stay inside me for much longer, because the risks of infection are high.  Now it’s time for him to face the world on his own.  I hope that he’s going to be a tough little guy and adapt well.

Razvan and I are super excited for tomorrow!  We are also a little nervous and anxious about it all, but we are trying to stay positive and focus on meeting the baby.

Baby, we are ready for you!

We had a nice and relaxing day today.  We got to spend some quiet time together, and get out into the NICU garden to take some last pictures of the belly.  It’s amazing how big my belly got!

Wow! I never thought my belly would get this big!

Our dog Kona helped to distract us and keep our spirits up today by appearing as “puppy of the day” on dailypuppy.com.  It was fun to read all the cute comments from her admirers.  This definitely helped us pass the time while waiting around for the big day.

Well, hopefully in about 12 hours from now Razvan will be posting some cute baby pictures on this blog.  I’m going to pop a sleeping pill shortly and try to get some sleep before the big day.  Until later!

"Space Race"

33 weeks and 5 days

Only a couple of days left until we get to meet our baby boy!  It seems that my condition is becoming somewhat unstable.  I’ve been a lot more uncomfortable and experienced a lot more uterine irritability and contractions in the past few days.  This is to be expected as my internal organs are becoming more and more compressed by the growing baby, and there is a fight for space between various organs.  Now that it’s bigger, the uterus gets easily aggravated and starts contracting for all kinds of reasons, like baby’s movement, dehydration, full bladder, full intestines, full stomach, and who knows what else.  These contractions don’t progress to active labor and seem to go away on their own when the underlying issues irritating the uterus are resolved.  I’m definitely ready to meet the baby on Friday, and hope I can last until then without spontaneously going into labor.

We had another ultrasound today to make sure the baby is growing and to look at his position.  The baby is still breech, so C-section is still the plan for delivery.  His estimated weight today was 4 lbs 3 oz, which is within the normal range for his gestational age.  Yay!  Maybe I can still fatten him up by a few ounces before Friday…

The Home Stretch

I am filling in for Kat today. The last few days have been a little crazy. hence the lack of posts. Kat has been experiencing some cramping and a few contractions. That has bought us a trip to the labor floor Saturday evening that lasted until the wee hours on Sunday. For me that meant lack of sleep. For Kat it meant being strapped to the monitor belts for a few hours to check the baby’s heart and her contractions. It also meant Kat getting an IV hooked up after getting poked for a bit and having to give up drinking fluids (one of her favorite things), while being limited to ice chips. After all both Kat and I were happy to be back in our room on the 8^th floor with the baby still put.

After making up for some of the lost sleep the night before, Sunday started out with a late breakfast followed by visits from dear friends and family. Not to trigger any more trips down to the labor floor, Kat decided to take a break from our usual late afternoon wheelchair stroll down to the NICU floor terrace, and instead concentrate on relaxing.

Thus our weekend came to a close and we entered the final week of pregnancy. We are full of hope and excitement and are counting the days until we get to finally meet Nicholas.

Monday is almost at a close and yet another uneventful day is behind us. We just finished watching the 1989 movie “Look who’s talking” and decided it’s time to update the blog, but given Kat has not been in the right mental and physical condition to do it (not wanting to cause any unnecessary contractions) we decided I would take on the task. While I know my writing does not compare to Kat’s scientific narration style, I agreed to do it. I thought this would be my warm up for the days to follow our Friday scheduled c-section. Hope you can all check in sometime on Friday afternoon for some updates and pictures.

C-section Scheduled for 10/29/2010

My C-section is scheduled for Friday, October 29, 2010 8:30am.  It will be performed by Dr. David Olson, and will take about an hour.  The baby should be out within the first 5 minutes of surgery.  The rest of the time will be used to clean up the uterus and stitch me up.  Razvan will be with me in the OR the entire time to support me and meet the baby!

Here’s the plan.  Around 7am, I will be transferred to the pre-operating room to prepare for surgery.  I’ll be given an IV, and a shot of anesthesia into my spine (spinal block), which will numb everything below my rib cage, but allow me to remain awake through the entire surgery and see my baby when he is born.  I have to fast (no eating or drinking) starting at midnight the night before to reduce the risk of aspirating the contents of my stomach into my lungs during surgery.

Once in the OR, the doc will perform the first incision on my skin around the bikini line.  He will then separate my abs, and perform a second incision on my uterus.  Then he’ll pull the baby out, remove the placenta, and clean up my uterus, and stitch me back up.  The NICU team will be in the OR to take care of and stabilize the baby immediately.  Once the baby has been cleaned up and stabilized, we should be allowed to touch him and take pictures.  The NICU team will then transfer the baby to the NICU.  The length of baby’s stay in the NICU will totally depend on how mature the baby is, and how well he’s doing.

I am both scared and excited!!!  10/29/10 will actually mark one month since my hospitalization.  I’m glad that we were able to buy this much more time for the baby inside me.  I’m really looking forward to meeting the little guy!!!

Wish us luck!!!

Maternity Leave

In the United States, “The Family Medical Leave Act” (FMLA) allows a person to take up to 12 weeks of unpaid leave with job protection for family-related medical reasons.  These reasons can include the birth and care of the employee’s child, adoption of a child, or care for health of a family member.  This act, however, does not apply to those who have been at their job for less than a year before taking their leave, to those working in a small company (less than 50 employees), and to those who are not considered to be “official employees” (e.g., graduate students at a private university in MA). FMLA also does not provide any guarantee for paid leave, although many employers may choose to provide paid leave as part of employee’s benefits package. 

Most other industrialized countries have a different view of maternity leave than the United States.  Check out these pictures to learn more:

Length of maternity leave around the world.

Percent of wages paid to employees on maternity leave around the world.

In case you are not familiar with lives of Ph.D. students in science, we typically receive a monthly stipend for research/teaching assistantship and health insurance.  The exact source of income varies, but typically comes from federal grants, private grants or fellowships, the department, or some combination of the above.

Harvard University has NO maternity leave policy for graduate students.  At Harvard, graduate students are not considered to be university employees.

In my department, each student basically negotiates the arrangements for her maternity leave individually with her advisor.  How much leverage does a student have in that negation?  Whichever way you spin it, I think it’s hard to make a convincing case against the fact that your advisor has no obligation to pay you your stipend or make accommodations for you to maintain your active student status while you are consumed by taking care of yourself and the baby immediately after giving birth.  This lack of policy essentially leaves the student at complete mercy of the Ph.D. supervisor.  

It is understandable that the university and the department would want to avoid implementing an official maternity leave policy for graduate students.  Who wants to be financially liable for something that they are not mandated to be liable for by any law?  From a student’s perspective, this is not helpful at all. 

I think the situation is exacerbated by the fact that, if your advisor does indeed choose to pay you while you are on leave, the source of income for graduate students on maternity leave is not supposed to come from federal grants (because certification of effort is requires).  In this case, the income is supposed to come from a non-sponsored fund (What’s that? Who has that kind of money?).

Pregnant graduate students are a fairly rare occurrence in the Department of Chemistry and Chemical Biology at Harvard, but I’m told that in recent cases graduate students who had babies and took some time off for maternity leave continued to receive a stipend and remain in active status while on this “unofficial” leave.  I’m curious if their stipend actually came from those non-sponsored funds.

The situation is completely different for postdocs.  Postdocs are considered to be university employees, and their maternity leave policies are clearly outlined, and mandated by state and federal laws.  Postdocs get 13 weeks of paid maternity leave.  This is paid for by 8 weeks short term disability, 4 weeks parental leave, and 1 week from vacation time (if any). Otherwise, the 13th week is unpaid.  Why can’t it be the same for graduate students?

When I learned about all of this, a part of me wanted to fight the system, speak up, and do something about changing the policy for graduate students.  Another part of me just wanted to defend my thesis and get out.

My major comfort in all of this is that I have a supportive husband with a source of income.  My original plan (fully supported by my advisor) was to defend my thesis before the baby comes.  That way I would exit “the system” before the spring semester starts, my ties with Harvard would be severed, and I would take some time off, free from work-related responsibilities, to be with the baby until I start my next job (September 2011).  That plan is no longer feasible.  My thesis is still not finished, and I’ll need to come up with a new plan at some point…

33 Weeks!

After 3 weeks of hospitalization, the baby and I made it to 33 weeks together!  We are going strong and are hoping to make it to 34 weeks!

The baby has been wiggling a lot last night, so I was hoping that maybe he would turn around from breech (butt down) to vertex (head down).  I woke up in the middle of the night, and saw the whole circumference of his head poking at the top of my belly, right above the belly button!  Unless he has buns of steel, he’s definitely still breech.

Despite feeling the baby move and seeing imprints of various body parts through my belly, I still have a difficult time believing that there is a ~4-lb baby inside me who is going to have to face the world on his own in about a week.  I know he has a beautiful spine, brain, and lungs based on the ultrasound, but I still can’t even imagine what he really looks like.  Last night I had a little meltdown about the prospect of having this little human surgically extracted from me before his due date.  Luckily, Razvan was here to comfort me and calm me down.  The prospect of C-section no longer scares me as much as it did 3 weeks ago, my main source of fear now is well-being of my baby.  I really hope the little guy makes it out healthy.

For some reason, every time I try to work on my thesis, my uterus decides to practice contracting.  This is a normal occurrence this late in pregnancy, and usually these types of contractions are painless, irregular, and are not supposed to lead to the dilation of the cervix.  Once I lie down and relax the contractions go away.  Perhaps it’s a sign that I should take it easy.  I’m kind of stubborn though, and would like to get a revised draft of my thesis to my advisor before heading off to the operating room.  So I periodically keep trying to get the thesis in order.  The uterus is the boss, though.  She has total control over my body right now, and she is the one who ultimately decides whether or not that thesis draft will make it in.


Here are some pictures we took in the garden outside the NICU today:

33 weeks!  Front view.

33 weeks! Side view.

Food

The food at BWH is not too bad.  I’ve lasted about two weeks before I started craving more variety than the “room service menu” had to offer.  Thank you to everyone who came by and brought me yummy food from the outside world!  It’s been such a treat!

Still, the hospital food is my primary diet these days.  The other day a hospital nutritionist stopped by to check on how I was doing.  She asked me about my appetite and if I was bored with the “room service menu” yet.  Of course I was!  The nutritionist had a chat with the “menu fairy” on my behalf and upgraded me to the “cafeteria menu”.  Yay!  The “cafeteria menu” is still hospital food, but it has a lot more variety than the “room service menu”.  That should help vary things up. 

I also mentioned to the nutritionist that the mild nausea I had during the first trimester came back to haunt me again.  Her solution to the problem was to prescribe me milkshakes.  Now I get milkshakes delivered to my room three times a day, and the nausea is under control.  Not bad.  I kind of like it here.

High Expectations

Since my condition has been stable, and I’ve lasted through almost three weeks of hospitalization, my doc has high hopes for me making it to 34 weeks (which will be on 10/28/10).  What happens at 34 weeks seems to be all about risk management.  At that point the risks of infection outweigh the risks of prematurity, so the standard of care is to deliver the baby.  Since my baby is still breech, the doc started to talk about scheduling a C-section at the end of this month.  He’ll do another ultrasound to confirm the baby’s position before C-section (and if the baby turned around attempt vaginal delivery), but he thinks it would be extremely difficult for the baby to change position because there is so little fluid around him.  Nothing is scheduled yet, but it’s hard to believe that I’m going to be a mommy in less than two weeks!!!  It seems weird to be able to schedule the date of birth of your child.  I wonder how much flexibility I’ll have in choosing a date.  Of course, everything may change really fast, and the baby may decide to come earlier…

Until then, I’m continuing to play the waiting game.  The nurses come to check on me every 4 hours, get my vital signs, and listen to the baby’s heart beat.  Every time they come in, they ask if I feel the baby moving.  I am supposed to let them know if the baby’s pattern of activity changes, since that may signal that the baby is under some kind of stress.  Because of this, I’ve become extremely obsessed with tracking baby’s activity patterns.  I even have an app on my cellphone to help me keep track of his movements.  This morning I was concerned that the baby was moving less, so the nurses put me on a monitor, and luckily everything turned out to be okay.  It is nice that I’m getting to know my baby through his activity patterns, but it’s sometimes tough to make the judgment call on whether he’s moving more or less than usual because every day is a little bit different.  I think my expectations on the regularity of these patterns may be a bit too high.

Parakeets Looking for a Home

Razvan and I are starting to realize that we may need to give up our parakeets when the baby comes.  It breaks my heart to even think about giving them up, and I hope that we can find a nice home for them.

Their names are Woody and Happy.  Woody is a green-yellow colored female and Happy is a blue-white colored male.  Happy is chill and laid back and Woody is anxious and moody.  They love each other and never seem to run out of things to “talk” about.  We adopted them when they were about 1 year old (they are now about 3 years old) from our friends who decided to leave the country.  The reason we’ll have to give them up is because they are loud and high energy pets, and are going to be too much for us to handle with the new baby in our small one bedroom apartment.  Please let us know if you might be interested in giving Woody and Happy a new home by adopting these cheerful and energetic birds!

The Zoo

Our home is a zoo.  We have plants, fish, two parakeets, and a dog.  When Razvan and I moved in together, we decided to test our ability to cultivated life by starting with one plant.  We did well with that plant, and have been continuously upgrading ever since to more complex forms of life.

I miss our zoo.  Especially the dog!  She is a 1.5 year-old 8-pound bundle of joy named Kona.  She is the perfect dog for us at this point in our life, and we can’t imagine our life without her!!!  She may be tiny, but she is fast, adventurous, and super friendly.  She likes swimming, hiking, playing fetch, and being petted.  I haven’t seen her since I got hospitalized and I miss her so much.  She stayed with Sarah V. (thanks Sarah!) during the very uncertain time of the first week of my hospitalization.  She is now with Razvan’s dad in RI, and will probably stay there until the baby is born.  Can’t wait to be reunited with Kona!

Kona.  October 2009.  Photo by Kate Duval

Kona.  March 2010. Photo by Razvan Mirica.

Quiet Weekend

We made it through another weekend!  It was a quiet and uneventful—exactly the kind of weekend that the nurses and doctors like to have around here.  We had some visitors who brought us some yummy food.  Thank you! 

As usual, Razvan took me outside to the little garden today to catch some sunshine.  I can’t explain how nice it is to be able to get out of bed and get some fresh air!  On the way back from the garden, before getting back to my room, I like to stop by the newborn nursery on our floor and look at babies.  In the absence of any complications, BWH encourages parents to keep their babies in the rooms with them in a little bassinet, but I guess the nursery is always there if you need it.  The nursery has the feel of a fishbowl; it has a huge glass window, and you can just sit and stare at the babies through it.  There are usually one to three babies in there.  Today there were two.  They looked so cute and peaceful sleeping in their bassinets all swaddled up in blankets… 

This weekend Razvan finally decided to leave the car at home to avoid paying parking fees (the parking fees around here are pretty expensive and really add up after a few weeks)!  I know my husband is tough and fearless and all, but I was kind of surprised when he chose to commute here from home by running.  I was also a little concerned because I asked him to bring a bunch of stuff from home, and I wasn’t sure how he would carry it all on the run.  Well, he ran with a little backpack on and his door-to-door commute was 32 minutes!  That’s pretty much the same amount of time it takes him to get here by car and find parking.  I am impressed!

Grateful

Thank you, everyone, for visiting this blog and for all your words of encouragement through mail, email, phone, and comments on the blog.  It really helps to know that you care, and that you are there for us.

I am especially thankful to Razvan for being there for me.  I know I’ve been moody, emotional, and demanding over these last few weeks (well, he may argue that it’s always been that way…), and I really appreciate his patience through all of this.  I appreciate him putting up with sleeping on an uncomfortable bed to keep me company here every night, getting up at the crack of dawn to satisfy my cravings for blueberry bagels with cream cheese, taking me for a ride in a wheelchair to a little outdoor garden every day, and leaving me this really nice note on the shower door :-)

32 Weeks!

We’ve made it to 32 weeks!  Yay!

The baby was super active today.  Maybe due to this crazy activity (my whole belly was deformed and moving!) or something else, I started feeling some mild irregular contractions and abdominal cramping this morning and early afternoon.  The nurse hooked me up to a monitor and said that the baby looked fine, and that I probably had some uterine irritability because of baby’s movement.  I laid low for most of the afternoon today because of this.  The cramping seems to come and go, but with no regular pattern to it.

Two weeks of bed rest are taking their toll.  I’m loosing muscle mass and feel myself getting weaker.  My joints are a little sore from lack of use.  A physical therapist came by the other day and gave me some moves that I can do while on bed rest to prevent myself from turning into a jelly fish. The moves are really easy, but are better then nothing. 

I really do miss moving around.  Last night I dreamt that I was no longer pregnant and ran 18 miles barefoot along Charles River!  It felt great! Around this time last year I actually did a couple of 18 mile runs along Charles River in preparation for the Dublin marathon.  I never did them barefoot though.  Anyway, those 18 milers were not as fun in reality as they were in this dream last night.

Despite the slight physical discomforts of my current situation, I’ve actually managed to enjoy bed rest so far.  Some sort of maternal instincts (and/or maybe hormones) kicked in, and my body peacefully went into “incubator mode”, a mode I did not know I had.  I am happy to report that I am all caught up with the Kardashians, and have watched wayyyyy too much TV.  I also spent a lot of time in the blogosphere, reading several blogs written by female scientists and by parents of premature babies.

To me, two of the most difficult aspects of my current situation are: i) impaired ability to focus, and ii) not having a plan.  A lot of what’s happening with my body right now is beyond my control, and it makes it tough to focus and make plans.  In general, I think it’s difficult to focus while laying or sitting in bed.  At least for me, a bed would not be a place of choice for solving complex problems and getting work done.  With some effort, I found that I can stay focused maybe for an hour or two, and then I have to take a break.  I also read somewhere (it might have been one of those blogs by female scientists) that the ability to be productive and get work done 1-2 hour increments is an acquired skill.  So I’m working on that.

As far as planning goes, making and executing plans with some reliable certainty was central to my existence before I got hospitalized.  I realize now that I can’t quite plan things, and may not be able to for a while, like I used to.  This whole “one day at a time” philosophy does not come natural to me, but I’m working on it :-)  Yesterday was my first attempt at planning my day since I got hospitalized.  I made a small "to do" list, I was able to do a little bit of work, and get a few things done.  Today, I thought I might try the same strategy.  I had a small plan in mind, but then my baby decided to practice some kickboxing, and my uterus decided to practice contracting.  So I spent most of the day laying in bed so far, focusing on breathing and staying relaxed.  Oh well, I guess today is the day to roll with the punches.  Let’s just hope those mild sporadic cramps and contractions don’t progress to active labor.  And if they do, it’s good to know that, unlike me, the doctors DO have a plan for what happens next. I’ll keep you posted.

Belly

This is a note to my pregnant belly… I hope he reads this blog (yes, "belly" is masculine... in Russian).

Dear Belly,

I love you!  I think you are so beautiful!  And functional!  You’ve been such a nice home for our growing baby.  I’m proud of your amazing ability to expand so much without causing me any major discomfort or leaving behind any stretchmarks.  Razvan nicknamed you “ovo”, after the Cirque du Soleil show that we saw together.

Too bad you got deflated a little bit after loosing all that water.  Sorry that you had to go through that, poor Belly, but you seem to have recovered nicely.  The doctors say that it’s not your fault.  It could have happened to any belly.  There were no warning signs.  You thought you were the happiest Belly on the face of the earth, and that you were going to have it easy (and you did, for the first 30 weeks!).  Life is full of surprises, Belly. Don’t blame yourself, and be strong.  It’s not yet time to think about getting into that pre-pregnancy shape (I promise, we’ll work on that later). We need you a little longer.  Hang in there, Belly. 

XOXO

Kat

Ultrasound

We just came back from our ultrasound and non-stress test (NST) on the third floor.  As usual, my stretch limo (i.e., my stretcher) arrived at my door and took me down to the third floor for testing.  I always feel like an Egyptian royalty gliding down the hallways of Brigham in my stretcher.

The baby did well on his NST, and the ultrasound looked good… for the most part.  This was not like the “cute” ultrasounds I got early on in pregnancy, where I saw my entire baby, distinct body parts, and even him waving at me when I said “hi baby”.  This time, I didn’t even see “the baby”.  First of all, at this point he is pretty tightly curled up in there, so it’s hard to tell what’s what with an untrained eye.  And second, there is not much fluid there surrounding him, so the contrast is pretty horrible. The sonographer mostly poked around *inside the baby* making sure his heart, brain, and lungs were developing properly. 

The good news.  The baby looks normal, and I’m told that he is “practicing breathing like crazy”.  The baby is gaining weight: he gained 6 oz based on his estimated weight from ~2 weeks ago.  He is now 3 lbs and 14 oz (+/- 10 oz), which puts him in the 67th percentile by weight (he is bigger than 67 percent of fetuses of his gestational age).  Look at the margin of error on this measurement though (+/- 10 oz)!  That’s a big uncertainty!  I guess that’s the reason they don’t do these measurements less than two weeks apart.  The margin of error still exceeds the weight gain this case…

The not so good news.  The baby is still breech.  His butt sits right at the cervix, his head is at the top of my uterus, and his feet are by his head. There are several negative consequences of this position.  The first one is the high likelihood of C-section for me (unless he turns).  Vaginal birth is particularly risky for a premature baby in a breech position (the negative consequences of which are much worse than those of a C-section for me).  The second one is the inability to build up the level of amniotic fluid. It’s true that the baby continuously produces more fluid (by urination). But, if his butt sits at the cervix, right where the rupture of the amniotic sac occurred, the fluid that he produces can’t really accumulate and leaks out.  Also, the fact that the level of amniotic fluid is low makes it hard for him to turn and get out of the breech position.  Oh well.  I still have faith and hope that he might turn around.

I guess the most important thing is that both the baby and I are healthy, and my uterus is still better for him than NICU!

Using "Wheelchair Privileges"

I got to use my “wheelchair privileges” today! Razvan rolled me out into a little outdoor garden located on the 6th floor next to the NICU.  I got to feel the sun on my skin and breathe in some fresh air for the first time since I got to the hospital.  I also got to hang out with my mom who came to visit from RI today.  So nice!

I’m very excited about tomorrow because I’m scheduled to get an ultrasound!  I haven’t had one since I checked into the hospital two weeks ago.  Can’t wait to *see* how my baby is doing!

Participating in a Sleep Study

I participated in a sleep study last night!  Some docs were looking for volunteers to participate in a study that compares sleep cycles and breathing patterns of pregnant women with various medical conditions.  I decided to volunteer.  Why?  I like research. I figured that if I couldn’t be in the lab generating some cool results myself, I might as well help someone else learn something.

The doc doing the study came by last night to hook me up to some fancy equipment that monitored my heart rate, oxygen level, breathing patterns, among other things.  The most uncomfortable gadgets were the oxygen sensor on my finger and the nasal cannula. These discomforts were nothing compared to sleeping with a pregnant belly, and enduring fetal movement with occasional kicks to the bladder, so they didn’t bother me at all.  I slept as usual.