The First of Many Weekly Updates...

From here on out, I intend on updating Billy's blog once a week on the weekends. As you've noticed, I won't be sending out email updates as reminders that the blog is being updated. You'll just have to check in from time to time.

Antoinette is coming along nicely. She's had little trouble feeding the little guy and has battled some routine soreness. All in all, its back to the same old Antoinette where we practically need to tie her to a chair to make sure that she's not trying to do laundry, vacuum floors, or spit shine tile or something. Sometimes I think we need to keep a closer eye on her than we do the little guy. Antoinette is quickly learning that it is in her best interest to take advantage of the time her Mother is in town to catch up on as much sleep as possible, as well as to make sure she's sleeping when the baby is.

Billy has had plenty of new experiences since coming home. He spends about 95% of his time eating and sleeping and then maybe we get a little 5% window where we can play with him. As you can imagine, he is infatuated with his Mother and you'll often catch him just gazing into her eyes after a good feeding.

We've been experimenting with the little guy to see what he likes and what he doesn't. We found out that he doesn't fit in the vibrating seat just yet, but that he loves his swing. We rotated the swing around into a side to side cradle mode and its been pretty effective at putting him to sleep and keeping him that way. We also tested him out in the stroller for an afternoon walk, but we were afraid it might have been too warm outside for him, so we brought him back to the house. We'll test that out again tomorrow morning if the weather cooperates and the sun isn't quite so high in the sky. Temps are in the low 80's in the afternoon here.

Billy has also been introduced to Hunter, our Weimaraner, and the two of them seem to get along just fine. For all of the concern Antoinette had about their first meeting, Hunter basically gave him a sniff and went about his business. He perks up every now and then when he hears the baby crying and throws the occasional sniff and awkward glance at the baby in the swing, but for the most part, he's pretty indifferent to the baby's presence.

When it comes to Billy's development, he's been staring at his Mother and Father a lot, almost like he's trying to figure out who we are and why we're always around. His vision is limited to about 8-10 inches in front of his face, but that should improve over the coming weeks. He's begun to shed weight since birth, which is quite common. A baby can lose up to 10% of their birth weight in the first week or so of life, which is basically the baby losing excess water weight. For Billy, who weighed 6 lbs. and 13 oz. at birth (109 oz.), he can be expected to drop down to a bit over 6 lbs. before he begins to put the weight back on. As his Mother's milk comes in, he should begin to pack it back on, with most babies regaining their birth weight within two weeks.

Finally, his two major battle scars include his umbilical and his other one (a bit lower), both of which are healing on pace. The latter should be sufficiently healed within 3-5 days of birth, and the umbilical is expected to fall off within 7-10 days. Both are cared for with each diaper change. Speaking of which, the little guy is right on schedule with his digestive track, which is another good sign that all of the plumbing is working just fine.

On Monday, we visit the Pediatrician for the first time to make sure the little guy remains in good health and that he doesn't have jaundice. We are going to attempt to get him a little sunlight each day to help balance out those billirueben levels and prevent the little guy from turning a lighter shade of yellow.

Lastly, sorry the update is a little blurred...

William Arthur Douglas Lionhood II, Born 4/22/09, 11:52 PM...

At approximately 6 AM, Antoinette and I arrived at the hospital to begin the process of inducing labor. She was checked in, stepped into her hospital gown, got as comfortable as she possible could, and then the doctor came in. At about 8:15 AM, the Doctor broker her water and began her on an Pitosin drip. Within an hour or so, her contractions had begun to increase although Antoinette could still not feel them. The plan was to increase her drip from 2 ml/hr to 20 ml/hr in 2 ml/hr increments ever 20 minutes.

Before long, Antoinette had begun to show signs of progress and she began to feel the brunt of the contractions. At that point, she requested the epidural be started and within an hour, Antoinette had been hooked up and the pain reliever had begun to flow. Shortly after, the pain faded until it was non-existent and Antoinette rode out the bulk of her 16 hour labor relatively pain free.

She began to move slowly from 2 cms dilated to 3 cms dilated. Then from 3 to 4 and from 4 she jumped to 6 cms dilated. By 7 cms dilated, about 14 hours into labor, she had begun to feel the pain of contractions over and above the relief that the epidural was capable of providing. The good news was that within an hour and a half, she shot forward to 9.5 cms dilated and 100% effaced which is great because as a husband, you can imagine no more helpless a feeling than to watch your wife in pain without anything you can do.

A little after 11 PM, Antoinette began pushing and by 11:52 AM, she had given birth to our son, William Arthur Douglas Lionhood II. The odd part was that the final hour of labor prior to pushing was the worst part for her. The actual act of pushing went by much easier, with Antoinette smiling, laughing, and even telling the occasional joke in between contractions.

The baby emerged a little messy and after being cleaned off a bit, was immediately given to his Mother. I quickly cut the cord and the doctor's proceeded with the act of Antoinette passing the placenta while the baby was taken across the room for his APGAR testing (which he scored a solid 8-9 on), a routine physical and reflex test, and for the doctor to clean out a bit of meconium that had been swallowed (which is typical of a 41 week pregnancy). After a bit, he was placed under the warmer and spent the better part of the next hour being poked and prodded, weighed and measured, and most of it screaming his little lungs out (he was crying from the minute his head popped out without assistance).

Antoinette and I had an opportunity to spend the night with the little guy in our room and she recovered remarkably well. She was a bit sore and uncomfortable, but was in remarkably good spirits. The little guy took immediately regarding feeding sessions with Mom and has been doing very well since birth. Antoinette was feeling so well this morning that she actually cleaned the suite, took a shower, and was generally good and able to see any and all visitors.

This morning, Billy had his hearing test, which he passed, and had his circumcision, which as you can imagine, he did not particularly enjoy. Since that time though, he has basically been sound asleep, as he is in this picture with his Mother. Now, I am home to shower, change, pack some things, eat, and then head back to the hospital for our 2nd night. We hope to have the little guy home sometime tomorrow, just in time for the NFL Draft on Saturday.

I hope you enjoy this picture and some of the others I'll be floating around in email... The next update will be in about a week and will not be emailed out as a reminder, so remember to tune in periodically if you want updates on how he's doing and the milestones he's reaching.

12 Hours and Counting...

We are under 12 hours from the time we are scheduled to arrive at the hospital. In just over 24 hours, little Billy should have officially arrived. No more grainy ultrasound photos, pictures of other people's kids, weekly belly shots of his Mother carrying him, or computer images of his likely position. In about 24 hours, we'll get our first glimpse of the real thing.

The last doctor visit was on Monday and at that appointment, we learned that Antoinette has remained at just 1 cm dilated. She has, however, progressed to 50% effaced. Also, the baby has finally engaged, even though he is just at -3 station (0 station being the goal). He's locked into place now. He's head down and the doctor can no longer move his head up and down. The doctor believes the baby is going to be closer to the 7.5 lb. range rather than the 8 to 8.5 lb. range the tech was predicting. We'll see what actually happens. Average for 42 weeks and 1 day is about 8 lbs.

The process for the morning is interesting. We will arrive at the hospital at 6 AM. At that point, we will get checked in, get our room, get comfortable and situated, and then Antoinette will have her first exam. After that exam, they will begin hooking up her IV and her Pitosin drip. At 8 AM, they will break her water and start the drip and contractions should begin soon after that. Shortly after, they will start Antoinette on an Epidural and then we just start waiting. According to the doctor's estimate of labor, it sounds like we should be expecting little Billy sometime between 6 PM and 10 PM.

Antoinette will then stay in the hospital through Thursday and we should be able to bring the little guy home for the first time on Friday. I will try and get some pictures of him on the blog first thing on Friday after we get somewhat situated. No promise as to what "somewhat situated" means, because I have no idea.

On a final, pre-birth note, the picture this week is a reminder of what little Billy began as just 9 months ago. On this journey of his, he began as a combination of the largest cell in the human body (egg) and the smallest cell in the human body (sperm). Within four days of conception, this fertilized egg has turned into a blastocyst, consisting of a hundred or so cells. It is the size of a pinhead, at just 0.006 inches long. At 22 inches in length at birth, Billy will have grown nearly 370,000 times his original size as a fertilized egg, all in less than 300 days. At this time, all of his genetic information was present. His hair color, eye color, skin color, height, weight, gender, etc.

The bottom line is that we are almost at the finish line. Both Antoinette and I are glad we had the opportunity to share this with you all. The next update will be one of little Billy safely in the arms of his loving Mother...

4 Days and Counting...

One way or another, little Billy is arriving no later than the early morning hours of Thursday, 4/23, although I think he'll actually be arriving the night of 4/22. At this point, Antoinette is still very much on track to make it all the way to her inducement date, which is Wednesday, 4/22. She will be induced at 8 AM in the morning, although we have to arrive by 6 AM. And with the change of her flight schedule, Antoinette's Mother will get to be there for the birth of her first grandchild if she holds out that long. The clock is definitely ticking.

Yesterday, we were at the doctor for her second to last appointment. We learned a lot at this appointment. Namely, that the BPP test I elaborated on in the previous blog update was actually far less complicated than I had thought. Turns out, the majority of the BPP's are done prior to the due date for women who have suspected complications, which is why the intense detail is needed. Those that are performed after the due date have minimal goals in mind. While they still take a measure of the heartbeat, the breathing, and the movement, they do so quickly and from visual observation. Detailed observation is not necessary.

As far as some of the results we did measure, the first is the width of the head. As you can imagine, this was considered a very important measurement by Antoinette. It looked like the width was approximately 9.62 cm if I was reading the screen right, which is just under 4 inches, which the tech told Antoinette was an average sized head. She estimated (reluctantly) that the baby would be approximately 8 to 8.5 lbs. That would be slightly larger than average. The average 41 week birth coming in at 7.93 lbs. They also measured his amniotic fluid levels, which were the primary goal of the test and they came in perfect. Billy has plenty of amniotic fluid to allow him to make it all the way to the day Antoinette is induced, which the tech felt Antoinette would make it to since according to her, the baby had still not "engaged" yet from what she could see.

As far as the baby fully engaging, this is not a factor in being able to deliver a baby. For some women, the baby doesn't engage until active labor. The negative aspect though is that according to a couple studies, if the baby is not engaged, the risk of the birth needing to progress from vaginal delivery to cesarean doubles or triples. We are hoping the baby engages because generally speaking, some believe that having one cesarean could lead to always having cesareans. Thinking this is always the case is an untruth. The danger lies with uterine rupture of the scar tissue during future labors. The numbers indicate that for women who have had a previous cesarean, those who have a cesarean the second time around, the incidence of uterine rupture is 1.6 in every 1,000 births. For those who attempt vaginal birth the second time around, the incidence of uterine rupture increases to 5.6 out of a 1,000. Still pretty low, but also still triple the previous second time cesarean figures. Anyway, one in four pregnancies are delivered by cesarean in the United States, so we figure, if it happens, it happens. Antoinette's doctor does not believe in cesareans unless its medically necessary, so that's good enough for us. By the way, that brings me to an interesting story. One of my roomates in College has a sister who believed up until her High School years that a "C-Section" was so called because the scar was cut in the shape of the letter "C". Needless to say, she drew quite a few blank stares.

The final note on this test is that we did get to watch the ultrasound, which is the image you are seeing in this picture. Hopefully it is apparent to you that you are seeing his head. If not, look at it from a distance or try tilting your head to the right. If you do, you will be lined up with his face. Two thirds of the image is head, so you really can't miss it once you realize what you're looking at. The top of his head is the right side of the image, which then moves down to his chin toward the bottom left. From the top of his head moving left, you'll see his forehead, his two eyes, his nose, his mouth (which the tech said appeared quite large), and his chin. To the left of his head is a hand, which is tougher to make out in this picture, but easier in some of the others. Those others have a blurrier face though. When you are seeing the image move, it is much easier to understand what you are looking at and looks a little less like a Jason mask, but what the hell. For now, these are the best photos we've got of the little guy. Remember when he was just a tiny little oval shape with arm and leg buds? I believe he had a tail back then, too. Those kids grow up so fast, don't they? We could see how cramped he looks in the live feed, watch his head move back and forth, watch his mouth open and close, see his hands and arms move over his head, see his heart beating in his chest, check out his spinal cord, see the top of his head and the two hemispheres of his brain, and see some images briefly of his legs and arms.

Antoinette has her final doctor visit on Monday (I thought this one was the last, but they figure they want two per week and since the last one was on Tuesday, another was in order before she is induced). At that visit, we will check dilation, the baby's engagement level (what station the baby is at on a scale of zero, which is fully engaged, to -5, which is 5 cms from fully engaged), heart rate, position, and any other Q&A's we need to get out of the way before Wednesday's big show. If we're lucky, we'll get Antoinette to get us one final belly picture for the Monday update and then you won't see an update again until after he arrives. Quite the journey, but its almost over.

Handmade for Billy...

The picture this week is of a blanket that was handmade by a fellow co-worker of Antoinette's named Nikki. This was the first blanket that Nikki has ever made and she has spent months working on it. For a first attempt at blanket making, this looks fantastic. Looks like Nikki knows exactly what little Billy's Dad wants his little boy wrapped up in. Footballs, baseballs, and basketballs, right? What Father would complain about that? Anyway, you can look at this blanket and know how much care went into its creation and for that, I want to take a minute to thank Nikki for all of her hard work. Thank you. Little Billy will love it, I'm sure.

Speaking of the little guy, he's kicking up a storm. Clearly, he's reached his limit in terms of being smashed in there. The question is when Antoinette will feel its the right time to let him out. He's kicking and rolling and punching and really just going crazy in there. Tonight's little episode looked like a scene out of the movie Alien and Antoinette and I just sat back and enjoyed it, knowing that we only have a few more days of experiencing this part of parenthood for a few years. Plus, he can do everything that a real baby can do except scream, so that part is enjoyable, too.

Tomorrow is the next step in the process. We should know a whole lot more about what's going on and what's likely to happen on our next visit to the doctor. On this visit, Antoinette will have a procedure known as a Biophysical Profile completed. This is routinely done in pregnant women who have passed their due date. It is essentially a test that consists of a non-stress test and an ultrasound procedure designed to measure fetal health. The test measures heart rate, muscle tone, movement, breathing, and the amniotic fluid level around the baby. This test will detect normal ranges for these categories using a scoring system to determine overall baby health.

During a BPP (Biophysical Profile), the non-stress test is typically done first. During this test, the baby's heart rate is tracked by an external fetal heart monitor during periods of rest and periods of increased activity. Two flat devices are held in place by elastic bands around the belly. Antoinette had this done when she fell down a couple weeks ago. One uses reflected sound waves (ultrasound) to measure the heart rate and the other measures the frequency and intensity of Antoinette's contractions. This part of the test takes about 30 minutes.

The next portion of the exam is the ultrasound. This part uses a gel which is spread over the abdomen and then a transducer is drawn across the belly to peek inside. This ultrasound can take anywhere from 30-60 minutes. While the ultrasound tech (if one performs the ultrasound) can gather images from the ultrasound, they cannot answer questions about the test. Only the doctor can after they review the images.

This five component test is scored on a two point per component system. For a completely healthy baby, you are looking for a score of 8-10 points. So how do you earn these points? During the heart rate test, you are looking for two or more instances of heart rate increases of 15 beats per minute over resting heart rate when the baby is moving. For breathing, they are looking for one or more "breathing movements" lasting 30 seconds or longer. On the baby movement category, we are looking for three or more movements of the arms, legs, or body (based on tonight, he should get extra credit on that one). On muscle tone, we want to see a head resting on the chest, arms and legs flexed, and at least one hand movement (opening and closing). For amniotic fluid, we are looking for at least one pocket of 2 cms or more of amniotic fluid in the uterus. On Saturday's update (which hopefully includes a belly pic), I will get out the results of the BPP. I also anticipate that Antoinette may have another check done to determine the dilation of the cervix and we should be briefed in detail on the process for preparing her to be induced on Wednesday, should the need arise.

On a final note, we were able to swap out Antoinette's Mom's visit to coincide with a potential inducing of the baby on Wednesday. Now she will be arriving on Tuesday morning so that she can be here for the birth of her first grandchild if Antoinette holds out that long. We're both very excited to have her down here. Antoinette was all smiles talking about how excited her Mom was when she told her she wanted her here for the birth. I can only imagine how exciting it will be for her.

April 14th, 2009...

Today is little Billy's due date. And in one hour, it will have come and gone. In the past 24 hours since the last blog update, there has been quite a bit of action. Antoinette's discomfort that prevented the belly blog update turned into several shooting pains, one of which was centered slightly to the right of her belly button. While a pain of this type is not unusual, an abdominal pain that does not subside after 11 hours despite a full night's sleep is. So early this morning, Antoinette and I placed a call to the on call physician. She told us that it was more than likely nothing, but any persistent abdominal pain this late in the game needs to be checked out. With Antoinette having an appointment scheduled for Thursday, she decided that Antoinette should come in as soon as possible.

So this morning, Antoinette and I took an unscheduled trip to the doctor's office in what amounted to 40 mph wind gusts and sideways rain. Oh joy!!! After hanging out in the waiting room for about 45 minutes (which will happen when you're unscheduled and your doctor is trying to fight a sizable storm to get in to see you), they booked us with the on call doctor that Antoinette had talked to a few hours earlier. She came in and basically gave Antoinette a Q & A about the pain, the symptoms, etc. She told her that the good news is that there is nothing vitally important in that area of the belly that would typically be cause for concern. Had the problem been the worst case scenario, namely a placental separation, then Antoinette's pain would've had her doubled over on the floor, there would've been bleeding, and water breaking and labor would soon follow.

She checked her out a bit, felt for the baby, and determined that Antoinette's pain was likely caused by more ligament stretching, straining, or possibly even some small ligament tearing, all of which are very common during this stage of pregnancy. She then listened to Billy's heartbeat, and while I don't have a number for you, rest assured that she said it was right on target. She then felt around a bit and thought she felt the baby's head in the correct lower pelvic position, but wanted to make absolutely sure.

When she came back in, she was dragging a monitor on a cart with a long staff looking thing. Turns out it is an internal ultrasound probe, but it can generically be used externally for basic information, such as the position of the head. She started poking around Antoinette's lower abdomen and was able to locate the head, which we could clearly see as two hemispheres of his brain. She then moved it around her belly and we could see general views of a spine, ribs, hips, a rear end, and even an arm. This all went by very fast, as she was basically just confirming his general positioning.

When this was complete, and she had confirmed the baby was head down, she then performed an internal. This determined that Antoinette appears to be dilated to 1 cm (we've heard this before, right?), but that while the baby is indeed positioned correctly in a head down position, he has also not engaged. This means that his head is down, but it has not yet lodged itself into the birth canal. The baby seems to have partially dropped, but not quite all the way just yet. She was also able to determine that there is a significant enough distance between the opening of the cervix and the baby's head, meaning that if the water breaks soon, since the baby's head is not acting like a cork, we'll definitely know when it happens.

Now for the bad news, because Antoinette is now past her due date, on Friday she is scheduled for a special ultrasound. This test will determine the baby's heartbeat, position, approximate weight/size, and the level of amniotic fluid inside of her uterus. This isn't the bad news just yet, in case you were wondering what's so bad about that. The bad news is that at that visit, we will begin the discussion about when we will be inducing the labor if it has not occurred by then. At this point, Antoinette will have to choose a day between one and three days past the marked completion of her 41st week. Antoinette has already decided to induce no later than April 22nd, which is a week from tomorrow. So one way or another, little Billy will be arriving at about that point.

Why is this bad news? Well, there are pros and cons to the inducement of labor. On the pros side, there is a convenience factor. Inducing labor means it is easier to plan for the baby and allows for you to prepare your birthing environment in the hospital room to make the most relaxing and comfortable situation for Antoinette to have the baby in. It also means there is no rush to the hospital and that proper planning for everything else you will need after the baby is born. On the cons side, the American College of Obstetricians and Gynecologists does not recommend inducing labor unless it is medically necessary for the Mother. In Antoinette's case, it would be creeping into that range due to some of the negatives to carrying beyond your due date such as insignificant oxygen and nutrients from the placenta. Pitocin can also cause labor to speed up too rapidly which can make it a pinch more difficult for some Mom's. That's not such a major issue if you are getting the epidural, which Antoinette is. There are also some additional potential complications to the intentional manual rupture of the membranes (breaking your water).

All of that being said, it is a relief to both Antoinette and I to finally have a ceiling date beginning to take shape. At the moment, it looks like one way or another, Antoinette will be in labor by April 22nd and little Billy should be born by no later than the early morning hours of Thursday, April 23rd. With all of these new revelations, Antoinette's Mom has rescheduled her visit down to April 28th, allowing Antoinette to be able to have two weeks in a row with somebody helping her. It will be her and I the first week or week and a half, followed by her and her Mother the second week (while I'm at work, because I'll be back in the mix the minute I walk in the door)... Long blog update, but there was a lot to cover. I'll get back with you all on Friday.

Oh, and one last thing. I'm not sure if I mentioned it or not in a previous blog update, but once Billy is born, I will send out a final Baby Blog email letting you know that I have pictures and info about him. But after that final email, I will stop sending out the blog update reminders. I will continue to update the blog, but it will be every week or two. If you want to continue to follow along, just save it to your favorites and check in with us every now and then.

Contracting Through Week 40...

Well, sorry to say, there may be no more belly pics. That shouldn't be that disappointing since Antoinette's belly has all but stopped growing (although little Billy has not). The primary factor in this decision is Antoinette not really feeling up to getting ready for a photo. She's been having some contractions the last couple of night that have included some random shooting pains here and there. All are perfectly normal as the baby begins to press harder on the cervix and Antoinette's body begins what could be the preliminary signs of the start of labor. In place of the belly pic, I have put a very nice black and white photo taken by Antoinette's Mother of Antoinette and I's hands on her belly. I thought it was nice, but you be the judge.

Labor comes in all shapes and sizes. Some women have experienced the beginning of labor with contractions as far apart as 20 minutes that very gradually begin to narrow the time between them. Antoinette is not in that range yet, but her contractions have definitely increased in intensity a bit. The specific pains she is having now have often been attributed to dilation of the cervix, but sometimes they are just caused by a shifting baby. Only time will tell. Even if they are caused by dilation of the cervix or contractions of the uterine wall, those symptoms can indicate the immediate onset of labor or a labor that will begin in weeks. There's really no way to tell. All we know is that it could be another symptom to check off the list on the way to the big dance.

As you all know, tomorrow is little Billy's official due date. April 14th is the day we've all been waiting for and it could possibly be all for not as we could very easily see it come and go. Who knows? She could go all the way to April 24th, which is the Doctor's Day of Inducement. What we do know is that this time is a very trying time on your nerves. You spend 13 weeks just hoping he makes it through the first trimester. Then you spend another 24 weeks hoping he passes any of a dozen major milestones making his arrival seem more and more certain with each passing week. Then you wait 4 more weeks so he can hit 40 weeks and full term. And then...you wonder where your kid is at? 40 weeks of wanting him to stay in there and in seconds, your brain shifts gears to not being able to wait for him to come out. But trying as it may be, Antoinette's body knows better than the rest of us what is in the best interest of the little guy, so I reluctantly defer (not that I really have much of a choice).

The Case of the Incredibly Shrinking Cervix...

Antoinette had her most recent visit to the doctor today. As far as the baby and his Mother's health is concerned, everything was outstanding. Antoinette's belly measurement was right on target. The baby's heartbeat was perfect. Antoinette feels great. Her weight is perfect as she has added just a pound in the past two weeks. Even his head is lined up in the perfect position. Then the real shocker. After an internal, it was determined that Antoinette had gone from the 1 cm dilated that she was last week to 0 cm dilated this week. That's right, folks. She appears to have a cervix that has either sealed shut or that wasn't open 1 cm to begin with. There are several explanations for this. One, which is most likely NOT the case, is backward dilation. This process involves the baby pressing less on the cervical opening and therefore causing the cervix to tighten back up. The most likely scenario is that Antoinette simply had a different doctor checking her. It is quite common for one doctor's "1 cm" measurement to be another doctor's "closed" measurement. Since we will be discussing cervical dilation over the next week or two, here is a visual guide for you to follow along. Remember, the cervix is the opening between the uterus (which is where the baby is) and the birth canal.

That being said, without specifically venturing a guess, the doctor seemed to be hinting that it was more likely that she would be giving birth later rather than sooner, which to me seems like 5-7 days is more realistic than 1-3 days. Even so, the doctor also said that this is really anybody's guess. Plenty of women go from 0 cm to 10 cm in 24 hours, although it is not particularly common. The most likely scenario is that he'll be arriving closer to his due date, which is Tuesday, April 14th. The doctor also said that they would allow Antoinette to go a full 10 days past her due date. The previous doctor had said that a week was about as far as they would go. If he goes 10 days past, then the baby is coming no later than 4/24 or 4/25. Basically, we're guaranteed an April baby at this point.

So what is a due date? Well, a due date is actually a day which is centered on a full four week window of time when a baby is likely to come. It should more accurately be described as a due month than a due date. The window is two weeks before and two weeks after the actual "due date", which means weeks 38-42. Since Antoinette is just 39.5 weeks, she realistically has plenty of time in her natural window. A full 1/3 of pregnancies venture past the due date and on average, first time Mothers, in one survey, averaged 8 days past their due date, which would put us at 4/22.

There are two major issues with induction of labor after a due date has been passed. The first is the possibility that a baby is outgrowing his placenta. While a baby continues to grow at 1/3 to 1/2 a pound a week, the placenta will eventually achieve a maximum size. If the doctor feels that the baby may be approaching this equilibrium point, they could recommend that a new Mom be induced. The second issue with induction of labor is that many new Mom's request induction when the due date has passed, with the reason being nothing more than nervous anticipation. The result is that labor begins, but in many cases, the cervix does not properly open since you are bypassing the natural labor process. This results in an increase in Cesarean Sections for this reason.

All of this being said, we are getting way ahead of ourselves. In a quick survey of stories on the Internet, there are plenty of women who go from 0 to 10 cm in hours or days. At this point, we are preparing to sit and wait this guy out. Since this could go another full two weeks and we feel adequately prepared for his arrival, its time to just enjoy the quiet and the last few full nights of sleep we are likely to get for the next 3-4 months.

The Finish Line Nears...

Antoinette has finally made it. The final week of pregnancy. Billy's due date is in exactly one week. Its been a long road, but Antoinette has been amazing throughout. Hardly a peep out of her in the form of a complaint for 40 weeks, other than after she cracked a couple ribs. But who can blame her for that? Who busts ribs from coughing?!?!? The last few weeks have had their difficulties for her, as they do for all pregnant women at this stage. She often finds it difficult to get comfortable doing just about anything, but still, you hardly get a cross word. A truly amazing woman. Congratulations to you, Antoinette. We're almost there, Sweetheart.

Billy has probably reached his maximum size at this point. If the doctor's prediction holds true, he should be about 22 inches long and weigh about 7.5 lbs this week. Antoinette will have another doctor visit in the next couple days to check on where we're at in terms of the final Act. She's begun having contractions, but they are very infrequent and very spread out. Often times they come at night, which makes me wonder if I will be awoken any day from a deep sleep with word that its time. Bags are packed, final arrangements have been made, and we believe we are ready to go. I'm sure we'll forget something, but as long as its not Antoinette that I realize I'm forgetting as I'm cruising down the street to the hospital, oh well.

As false labor contractions begin to pop up more and more, Antoinette will begin to use them as practice for the big day. She can practice her breathing and her relaxation methods now to see what works the best for her when the big moment arrives. The doctor visit could include Antoinette's first station measurement, which determines the distance of Billy's head from the "exit". The bony structure of the pelvis is considered the "0" station. If his head is lower and closer to coming out, he'll be measured in the negatives, such as -1, -2, etc. If his head is higher and therefore farther from coming out, he'll be measured in the positives, or +1, +2, etc.

When Billy is born, he will be immediately weighed and measured. He may begin to cry loudly or he could be out of it from the meds. He will be quickly aspirated early on in the process to clear his mouth and nose. He will be dried off and a hat will be placed on his head to prevent him from losing too much body heat from that rapid energy consuming brain of his. Then, security tags will be placed around his wrists and ankles to prevent baby thievery. That's probably unnecessary because I'll likely be following everyone who tries to move farther than three feet away from me with my kid, but why not? He will then be swaddled snugly into a blanket and then handed to his Mother to hold for the very first time. Afterward, he will get a bath and some other routine procedures under the watchful eye of his Father.

In the middle of all of this action, the baby will be given Apgar tests at the 1 and 5 minute mark. The high score on an Apgar is a 10, which is rare. Typically, babies score a 7, 8, or 9. Many babies have low 1 minute scores which are quickly improved upon by the 5 minute test, once their little bodies have had time to adjust to life outside of the womb. The Apgar is broken into 5 components. The first is heart rate. If the baby's heart rate is 0, that's obviously bad and he gets 0 points. A heart rate under 100 beats per minute earns you 1 point (also not great) and over 100 is worth 2 points. The next category is breathing. No breathing earns you 0 points, while short and irregular breaths earn you 1 point. To get the full 2 points, you need crying, screaming, or generally breathing well. The third component is movement. No movement earns you 0 points, some movement 1 point, and an active kicking and punching baby earns you 2 points. The fourth part of the test is reflex testing with no reflexes earning a 0, while the varying levels of reflexes earning a 1 or 2 point total. Baby coloring is the final part. A blue or pale baby is worth 0 points, pink bodied baby with blue arms and legs worth 1 point, and a totally pink baby worth 2 points.

And to wrap up this entry, a fun fact. Babies are born with 300 bones in their body. As they get older, the bones begin to fuse together, eventually resulting in the adult total of 206 bones in the body.

Tick, tock...7 days and counting...

Last Belly Pic?...

Antoinette was closing out Week 39 last night with a bang. That bang consisted of several major contractions in the wee hours of the morning, followed by what is being described to me as "a pressure". Tick, tock. My prediction of 4/7/09 means that this kid needs to be born tomorrow and I'm not sure that its going to happen at this rate. 4/14/09 is looking much more realistic. As you can see by Antoinette's picture, she still looks pretty damn good for being 9 months pregnant. She's all belly.

We continue to find ways to prepare for Billy's arrival. Most recently, we replaced all of the tires on Antoinette's car and bought a camcorder. The tires were definitely overdue and the camcorder seemed like a necessity considering we will only ever bring him home from the hospital once. It hits you hard when you realize that a lifetime of firsts is about to begin all over again.

As we get closer to delivery time, there are some common features of a newborn infant to point out. Most babies have big heads, short necks, and distended abdomens. Quite a large number of infants are born with a conical shaped head caused by the flexing of the bony plates in the head as the baby works its way through the birth canal. Babies can have swollen areas of the body which are typically caused by last minute surges in female hormones provided by the Mother. This swelling tends to disappear soon after delivery.

Baby skin can be very smooth or can be covered in baby acne or red spots. Some are born with a condition called pustular melanosis where the skin can be covered in tiny little pus filled spots. In those cases, the condition clears up soon after birth. Birthmarks are another unique condition for infants, as they can come in various sizes and shapes which change quickly, getting both larger and smaller, as the child ages.

Hair color is another interesting issue. I often wonder what color hair he will have or if he will have hair at all. Hair color in infants can be all over the map. Often times, the offspring of a pair of dark haired parents, like Antoinette and I, will be born with red or blonde hair. That hair can stay that color or, as is most often the case, turn to a darker shade of brown over time. For example, all four of the children in my family (both sisters, a brother, and I) were all born blonde. Yet both of our parents are dark haired and dark eyed. Three of us had brown eyes and one of us had a green/blue/hazel eye color. Both Antoinette and I have blue eyes in our family, but the calculated odds of that occurring are about 11%. That being said, Billy is likely to have deep baby blue eyes at birth, which gradually turn brown over time. Also, my brother and I, and most of his children, were all born bald. Both he and I stayed bald well past our 1st birthday. Makes you wonder...

Tick tock...8 days and counting...

Doctor's Visit & a Fall...

We'll start with the Doctor's visit as Week 39 continues on. On Thursday, Antoinette had her weekly checkup. They weighed her and tested her urine for bladder and kidney infections, diabetes, dehydration, and preeclampsia. She passed all tests with flying colors. The next step was to have her in for her measurements and checking the baby's heartbeat. Antoinette's belly measured 37.5 inches, which is right on schedule. The baby's heartbeat was in the 155 beats per minute range, also right on target. The last part of the visit was a physical exam in which the doctor determined several things. For one, Antoinette has begun to dilate. She's now at 1 cm. This is a sign that the process has begun, but not a good indicator of how much time is left. She could also tell that Antoinette's cervix had not begun to thin out, which is generally a prerequisite to full blown labor. The baby is in the proper head down position still and Antoinette has space between her cervix and the baby's head, indicating that water breakage could result in a bit of a flood, since Billy's head is not blocking the opening. Finally, she made a prediction based on Antoinette's physical test, her lack of contractions, and this being her first full pregnancy, and decided that Antoinette probably would go to full term, which is in 11 days.

All in all, great news on this doctor visit. But then the action started. On her way back to work, Antoinette got out of her car and turned to walk toward the sidewalk when she lost her balance, tripped, and ultimately fell on her belly. Obviously in total shock, she sat on the ground and became pretty emotional. After calling the doctor, she was advised to head to the birthing center of our local hospital to make sure everything is OK. Then she called me and and I met her at the hospital. As a precautionary measure, they hooked Antoinette up to a fetal monitor and some other monitor that detected uterine wall contraction. Antoinette stayed on this machine for about an hour and then was released. Prior to release, the staff explained the charts we were seeing. Billy's heart rate was fluctuating from 125-175 beats per minute, which is perfectly healthy. The doctor likes to see that sort of peaking, as it is a sign of a Baby that is reacting to its environment and while Antoinette had a couple minor contractions which showed up on the machine, she was unable to feel them. Overall, the doc said that if they could draw a graph of what this would ideally look like, they could've used Billy's on the computer screen. See that? He's tough already...

Turns out that pregnant women falling is a very common thing. Especially in late term pregnancy when the center of gravity moves forward of the typical center, causing instability. There is also a hormonal imbalance that can effect reflexes for the worse. For women, their pregnant bellies are like giant shock absorbers. A thick uterine muscular wall, a belly full of shock absorbing amniotic fluid, and the baby's own skeletal system all act in unison to immediately reduce the impact of any falls. As a general rule of thumb, a woman should have major concern if a fall results in her being significantly injured, if there is bleeding, or if the baby stops moving. Otherwise, they are common place and not a major concern, although you should visit the hospital as a precaution.

Long story short, Antoinette's belly is a little sore today, but she's none the worse for wear. The baby is healthy, she is healthy, and I can breath easier.

This weekend, we'll wrap up the final preparations. We'll prepare the dog related items on our list and produce a sort of delivery checklist to run through when Antoinette's contractions begin so that after one hour of timing them up, I just need to load her into the car in order to split.