August Kamanakai Koessler
Born Tuesday June 24th, 2008, 10:35 pm
Weight: 7lbs 9oz
Length: 19 inches
Now that we are home and settled I will attempt to record the events that led up to August's birth. I was warned to write it down quickly as the details rapidly start to fade, and I already find that to be true only four days after his birth. Overall, it was a long journey, full of ups and downs, but one that I savor every minute of.
Monday, June 23rd: Phil and I went to bed Sunday night around 10:30 after attending the lovely wedding and reception of our friends Cam and Lisa. I woke up around midnight with sore hips as usual, and as I tried to work it out in bed I felt the overwhelming urge to pee. By the time I got to the toilet I had water streaming down my legs. " Oh my gosh!" I thought, "its happening,my water broke." As soon I thought it was safe I went to the bedroom to tell Phil, but barely made it there before I had to turn around again as more liquid spilled out of me. We were so excited. Phil, still in a sleep stooper was understandably confused about what the he should then do. After a cleansing breath, he hopped into action calling our midwife, the top of our phone tree, tidying up the apartment and beginning to set up the birthing tub. Once I stopped gushing I started to pack a "just in case" hospital bag. In retrospect, it is humorous at how fast we got everything together and ready for something that was still almost two days away. Around 1am my contractions began. This was exciting because they were the first real contractions I had felt. They started about 10minutes apart and progressed to about 5 min apart by 6am. After we got the through the business of preparation, we were able to get a few hours of sleep before morning.
Our midwife came over around 8am after delivering another baby in Waimea. Upon examination she determined that I was only 60% effaced and about 2cm dilated. The baby was still sitting pretty high, and we were told to hunker down for a long day.
So Phil and I did our best to stay positive and active. Phil made a nutritious breakfast, we walked the driveway, watched a few movies, and played cribbage. My contractions were definitely present, but manageable, and had slowed to between 8 and 10 minutes apart. We were certainly waiting for something to happen but were enjoying the time together. Around 5pm that afternoon, our midwife came back to check on us. Examination indicated that not much progress had been made during the day. This was definitely frustrating news, but we were not discouraged. We were told that because the membranes had ruptured, we were concerned about possible infection, but as we had been monitoring baby's heart rate all day, and my temperature as well, nothing was indicating signs of stress. She left telling us to get as much rest as possible and we she would be back in the morning.
Monday night, early Tuesday morning was perhaps the most challenging night I have ever had. I went to bed that night with contractions coming about every 8 minutes. I wasn't able to sleep through them, but rather I would wake as they were coming on, move through them, and then doze in the space between. Because Phil had been at my side through almost every contraction during the day, in addition to getting me water, reminding me to do things, making food, etc. I really wanted to allow him as much sleep as possible, because I knew he would have another big day on Tuesday. I wanted to only wake him if I really needed him, and thus get through the night on my own. It was challenging because laying on my side allowed me a certain degree of sleep, but the contractions were much more intense. Sitting up felt better, but was tiring on my sacrum and pelvis. Contractions certainly strengthened during the night and I had to go deep into myself to stay focused and accept the pain as progress. I visualized the contractions as waves rolling over my body, I welcomed the contractions on a deep inhale, and released the pain on each exhale, I imagined my mind separated from my body, and I talked my body through the progress it was sure to be making. I got out of bed several times to walk around, use the bathroom, and eat. The hours between midnight and 5am were the longest and hardest. I thought I had done alright until Phil woke up in the morning and I lost it. I cried harder that morning than I have all pregnancy. I was surprised too, because I had worked so hard to stay strong during the night, but sometimes I think you don't realize how lonely and dark a situation is until its not anymore. Phil did a wonderful job consoling me and working through the next set of contractions together. Leaning against his chest I was again able to melt into the rhythmic patterns of his breathing, and sensations of his touch.
Tuesday, June 24th: After the hard night, I was hopeful that some progress had been made. Our midwife came over that morning and reported that indeed progress had been made, but nowhere near what we needed. At 7am , I was 3cm dilated and fully effaced, and baby had dropped into my pelvis. We had been checking baby's heartrate regularly, as well as my temperature to make sure there was no infection or stress, and since all signs seemed positive we hunkered down for another day of laboring and hoped things would start to happen. So Tuesday happened much like Monday. Throughout the night my contractions had become a steady 5minutes apart and continued at this frequency throughout the day. The intensity however, certainly increased.It was like the volume being turned up.
I have to give Phil much thanks and praise here. He was the jack of all labor-coaching trades. When he wasn't getting me something to eat or drink, making me more comfortable, distracting me with games, walking the driveway with me, reminding me to pee- he was breathing through each and every contraction with me, offering new positions, and stroking my hair, neck and back. Without him, my laboring at home would have been drastically shorter in duration.
Around 5pm, our midwife returned. Despite all the hard work we had done throughout the day, no further progress had been made. We were told that we clearly had a case of
'failure to progress", and it might be time to consider utilizing tools that the hospital could provide. Phil and I took some time to come to terms with this reality. We knew that once we got to the hospital, our peaceful atmosphere would change, so we took our time preparing to leave. At this point, my contractions were strong and I was both physically and emotionally tired. I was sad to leave home, and give up the idea of a home birth, but I was also ready to move more definitively toward the finish line. So, after 44 hours of laboring at home, we headed to Hilo Medical Center.
We walked through the doors of Hilo Medical Center at 8pm. By 8:30 we were up in our room. As anticipated, things started moving really fast. I was put in a bed and strapped down with fetal monitors. They wanted to do a stress test on the baby to see where he was at. Phil and I elected to fudge the time of my water breaking to hopefully keep us in a mode of investigation and decision making, versus an emergent mode. We said that the water had broken that morning and we had been laboring at home. They were not thrilled with this news to say the least. They became very concerned with infection and started me on an IV. Then, when the baby's heart rate was in the higher ranges of their comfort zone they gave me an oxygen mask. So much for birth plan or discussing options, it was apparently go time. By 9:15 the OBGYN on call was up in our room assessing the data. He immediately advocated for a cesarean section in light of the the baby's heart rate patterns, and the duration in which the bag of waters had been broken. When we asked when he thought this might happen, he informed us that we should waste no time and he would assemble the team immediately.
Phil and I were floored. We knew this could be a possibility, but we could have never imagined that it could become a reality so soon after arriving. We asked for a moment alone to discuss our options, which they were reluctant to give us , but they did leave the room for all of 3 minutes. We looked at each other with expressions that could only be interpreted as "What the hell is going on here?" It was intense to say the least. We realized that this might be the end of the road; if 44 hours wasn't enough to do it, then perhaps more time at the hospital would accomplish anything more. We were also under the influence of phrases such as " brain damage" and "infection", and certainly we did not want to do any harm. So, after our allowed 3 minutes of conversation, we conceded to the surgery. At least, we knew, we would be meeting our little one very shortly.
When we arrived at the hospital they had given us a Power of Medical Attorney form which we were thankful for since it was one of the details we just hadn't covered, but wanted to. Now that surgery was imminent, we wanted to make sure that Phil could make decisions on my behalf in case of any complications with surgery. Phil jumped into action and called our friends JP and Mike, who flew down to the hospital to bear witness to the document. As that was happening, I was being prepped for surgery. All of a sudden there were 6 people in the room, all poking and prodding me and asking me questions. I was still having contractions, just as strong, and at frequent intervals, but at this point no one would pause to let me work through them. These were by far the most difficult contractions of the whole experience. I was so scared, and uncomfortable, and out of control of what was happening to me that much of the experience seems lost in a fog - as though not happening to me at all. They wheeled me into the operating room which was so bright and cold. I started to shiver almost uncontrollably. They brought me warm blankets to put around my shoulders as they inserted the epidural into my lower back. Within minutes I couldn't feel anything from my diaphragm down. My legs felt like dead tree stumps that were only peripherally apart of my body. Phil was watching all of this through the operating door window, trying not to lose it, as he was prepped in gown, mask, and hat. The surgical sheet was lifted so I could no longer see below my chest. Phil came in and sat directly to my left, held and kissed my hand and kept eye contact with me. The surgeons discussed where to get the best pizza on island as they began the surgery. Phil and I felt the table shake and doctors say "Wow, he is really wedged in here!" and then a loud, long, boisterous roar rang out as August was delivered from the womb at 10:35pm! Phil left me to go over to where they were assessing him, and soon he was at my side again holding our son. As happy and excited as I was, it was one of the most surreal experiences of my life. I couldn't quite hold on the what was happening or who that was in front of me. Soon Phil and the baby left for the nursery as I got sewn up and sent down to recovery. I got so shaky from the cold, or the experience, or the meds that they gave me Demerol which made me sleepy. I was in recovery for about an hour while feeling came back to my lower body.
I was wheeled up to my room to find Phil holding a beautiful baby boy in his arms. His mouth was moving
rapidly in a sucking/feeding motion and Phil said "Its about time, Mom, there is someone here who wants to see you". Phil handed him off to me and I put him to my breast where he immediately and effortlessly latched on and went to town. I was grateful that the hospital staff has abstained from giving him a bottle while I was in recovery so we could have that bonding experience together. At this time, it was a little after 12:30 in the morning. We spent the rest of the night in each others arms, I don't think baby spent one minute in the bassinet until well into the next day.

We spent the next 48 hours in the hospital, recovering, relaxing, and getting to know each other in our new role as family. Phil was happy when we were assigned a second night in the hospital because he said that would ensure that I relax and recover. After the surgery I was sore, but not in as much pain as expected. The nursing staff was so nice and ac
commodating, we were very pleased with our care after the surgery. Although a cesarean was the last thing that Phil or I envisioned for ourselves, we have no regrets because we were able to labor at home together for as long was safe. We did our best, and we did it together, and at the end of the day, we have a beautiful little boy staring up at us who is all kinds of wonderful.
Born Tuesday June 24th, 2008, 10:35 pm
Weight: 7lbs 9oz
Length: 19 inches
Now that we are home and settled I will attempt to record the events that led up to August's birth. I was warned to write it down quickly as the details rapidly start to fade, and I already find that to be true only four days after his birth. Overall, it was a long journey, full of ups and downs, but one that I savor every minute of.
Monday, June 23rd: Phil and I went to bed Sunday night around 10:30 after attending the lovely wedding and reception of our friends Cam and Lisa. I woke up around midnight with sore hips as usual, and as I tried to work it out in bed I felt the overwhelming urge to pee. By the time I got to the toilet I had water streaming down my legs. " Oh my gosh!" I thought, "its happening,my water broke." As soon I thought it was safe I went to the bedroom to tell Phil, but barely made it there before I had to turn around again as more liquid spilled out of me. We were so excited. Phil, still in a sleep stooper was understandably confused about what the he should then do. After a cleansing breath, he hopped into action calling our midwife, the top of our phone tree, tidying up the apartment and beginning to set up the birthing tub. Once I stopped gushing I started to pack a "just in case" hospital bag. In retrospect, it is humorous at how fast we got everything together and ready for something that was still almost two days away. Around 1am my contractions began. This was exciting because they were the first real contractions I had felt. They started about 10minutes apart and progressed to about 5 min apart by 6am. After we got the through the business of preparation, we were able to get a few hours of sleep before morning.
Our midwife came over around 8am after delivering another baby in Waimea. Upon examination she determined that I was only 60% effaced and about 2cm dilated. The baby was still sitting pretty high, and we were told to hunker down for a long day.
So Phil and I did our best to stay positive and active. Phil made a nutritious breakfast, we walked the driveway, watched a few movies, and played cribbage. My contractions were definitely present, but manageable, and had slowed to between 8 and 10 minutes apart. We were certainly waiting for something to happen but were enjoying the time together. Around 5pm that afternoon, our midwife came back to check on us. Examination indicated that not much progress had been made during the day. This was definitely frustrating news, but we were not discouraged. We were told that because the membranes had ruptured, we were concerned about possible infection, but as we had been monitoring baby's heart rate all day, and my temperature as well, nothing was indicating signs of stress. She left telling us to get as much rest as possible and we she would be back in the morning.
Monday night, early Tuesday morning was perhaps the most challenging night I have ever had. I went to bed that night with contractions coming about every 8 minutes. I wasn't able to sleep through them, but rather I would wake as they were coming on, move through them, and then doze in the space between. Because Phil had been at my side through almost every contraction during the day, in addition to getting me water, reminding me to do things, making food, etc. I really wanted to allow him as much sleep as possible, because I knew he would have another big day on Tuesday. I wanted to only wake him if I really needed him, and thus get through the night on my own. It was challenging because laying on my side allowed me a certain degree of sleep, but the contractions were much more intense. Sitting up felt better, but was tiring on my sacrum and pelvis. Contractions certainly strengthened during the night and I had to go deep into myself to stay focused and accept the pain as progress. I visualized the contractions as waves rolling over my body, I welcomed the contractions on a deep inhale, and released the pain on each exhale, I imagined my mind separated from my body, and I talked my body through the progress it was sure to be making. I got out of bed several times to walk around, use the bathroom, and eat. The hours between midnight and 5am were the longest and hardest. I thought I had done alright until Phil woke up in the morning and I lost it. I cried harder that morning than I have all pregnancy. I was surprised too, because I had worked so hard to stay strong during the night, but sometimes I think you don't realize how lonely and dark a situation is until its not anymore. Phil did a wonderful job consoling me and working through the next set of contractions together. Leaning against his chest I was again able to melt into the rhythmic patterns of his breathing, and sensations of his touch.
Tuesday, June 24th: After the hard night, I was hopeful that some progress had been made. Our midwife came over that morning and reported that indeed progress had been made, but nowhere near what we needed. At 7am , I was 3cm dilated and fully effaced, and baby had dropped into my pelvis. We had been checking baby's heartrate regularly, as well as my temperature to make sure there was no infection or stress, and since all signs seemed positive we hunkered down for another day of laboring and hoped things would start to happen. So Tuesday happened much like Monday. Throughout the night my contractions had become a steady 5minutes apart and continued at this frequency throughout the day. The intensity however, certainly increased.It was like the volume being turned up.
I have to give Phil much thanks and praise here. He was the jack of all labor-coaching trades. When he wasn't getting me something to eat or drink, making me more comfortable, distracting me with games, walking the driveway with me, reminding me to pee- he was breathing through each and every contraction with me, offering new positions, and stroking my hair, neck and back. Without him, my laboring at home would have been drastically shorter in duration.
Around 5pm, our midwife returned. Despite all the hard work we had done throughout the day, no further progress had been made. We were told that we clearly had a case of
'failure to progress", and it might be time to consider utilizing tools that the hospital could provide. Phil and I took some time to come to terms with this reality. We knew that once we got to the hospital, our peaceful atmosphere would change, so we took our time preparing to leave. At this point, my contractions were strong and I was both physically and emotionally tired. I was sad to leave home, and give up the idea of a home birth, but I was also ready to move more definitively toward the finish line. So, after 44 hours of laboring at home, we headed to Hilo Medical Center.
We walked through the doors of Hilo Medical Center at 8pm. By 8:30 we were up in our room. As anticipated, things started moving really fast. I was put in a bed and strapped down with fetal monitors. They wanted to do a stress test on the baby to see where he was at. Phil and I elected to fudge the time of my water breaking to hopefully keep us in a mode of investigation and decision making, versus an emergent mode. We said that the water had broken that morning and we had been laboring at home. They were not thrilled with this news to say the least. They became very concerned with infection and started me on an IV. Then, when the baby's heart rate was in the higher ranges of their comfort zone they gave me an oxygen mask. So much for birth plan or discussing options, it was apparently go time. By 9:15 the OBGYN on call was up in our room assessing the data. He immediately advocated for a cesarean section in light of the the baby's heart rate patterns, and the duration in which the bag of waters had been broken. When we asked when he thought this might happen, he informed us that we should waste no time and he would assemble the team immediately.
Phil and I were floored. We knew this could be a possibility, but we could have never imagined that it could become a reality so soon after arriving. We asked for a moment alone to discuss our options, which they were reluctant to give us , but they did leave the room for all of 3 minutes. We looked at each other with expressions that could only be interpreted as "What the hell is going on here?" It was intense to say the least. We realized that this might be the end of the road; if 44 hours wasn't enough to do it, then perhaps more time at the hospital would accomplish anything more. We were also under the influence of phrases such as " brain damage" and "infection", and certainly we did not want to do any harm. So, after our allowed 3 minutes of conversation, we conceded to the surgery. At least, we knew, we would be meeting our little one very shortly.
When we arrived at the hospital they had given us a Power of Medical Attorney form which we were thankful for since it was one of the details we just hadn't covered, but wanted to. Now that surgery was imminent, we wanted to make sure that Phil could make decisions on my behalf in case of any complications with surgery. Phil jumped into action and called our friends JP and Mike, who flew down to the hospital to bear witness to the document. As that was happening, I was being prepped for surgery. All of a sudden there were 6 people in the room, all poking and prodding me and asking me questions. I was still having contractions, just as strong, and at frequent intervals, but at this point no one would pause to let me work through them. These were by far the most difficult contractions of the whole experience. I was so scared, and uncomfortable, and out of control of what was happening to me that much of the experience seems lost in a fog - as though not happening to me at all. They wheeled me into the operating room which was so bright and cold. I started to shiver almost uncontrollably. They brought me warm blankets to put around my shoulders as they inserted the epidural into my lower back. Within minutes I couldn't feel anything from my diaphragm down. My legs felt like dead tree stumps that were only peripherally apart of my body. Phil was watching all of this through the operating door window, trying not to lose it, as he was prepped in gown, mask, and hat. The surgical sheet was lifted so I could no longer see below my chest. Phil came in and sat directly to my left, held and kissed my hand and kept eye contact with me. The surgeons discussed where to get the best pizza on island as they began the surgery. Phil and I felt the table shake and doctors say "Wow, he is really wedged in here!" and then a loud, long, boisterous roar rang out as August was delivered from the womb at 10:35pm! Phil left me to go over to where they were assessing him, and soon he was at my side again holding our son. As happy and excited as I was, it was one of the most surreal experiences of my life. I couldn't quite hold on the what was happening or who that was in front of me. Soon Phil and the baby left for the nursery as I got sewn up and sent down to recovery. I got so shaky from the cold, or the experience, or the meds that they gave me Demerol which made me sleepy. I was in recovery for about an hour while feeling came back to my lower body.
I was wheeled up to my room to find Phil holding a beautiful baby boy in his arms. His mouth was moving
We spent the next 48 hours in the hospital, recovering, relaxing, and getting to know each other in our new role as family. Phil was happy when we were assigned a second night in the hospital because he said that would ensure that I relax and recover. After the surgery I was sore, but not in as much pain as expected. The nursing staff was so nice and ac

3 comments:
congratulations phil and katie! what a beautiful baby boy. I cant wait to meet him.
Wow, you guys are amazing, I am so impressed at how strong you both are. What a miracle of an event, and I am glad to be able to read about it. Take care, I can't wait to meet the little guy.
Becky Olson
wow...i a want to ay congratrulations...i read he was born a while ago but wanted to really read your entry.
yay. i am all teary eyed...moving really. i am so glad you oculd breast feed right away and that he latched on so effortlessly, so beauytiful i still remmeber her first time going to town nursing and while they nurse a zillion times, that first time is so amazing and beautiful and just...connecting and bonding and natural and just wow. the way you wrote about it moved me.
i am so happy you have a bueaitiufl boy home and with you guys. may your recovery me smooth.
aloha
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