2

Misplaced Attention

During pregnancy, I loved reading weekly updates on fetal development. I also researched labor in an attempt to prepare and mitigate the pain. I did read about infant care and parenting strategies, but babies aren’t textbook and I don’t think I read enough or concentrated on the right things. Our first few nights home involved frantically researching baby topics on my phone while trying to nurse or get the baby to sleep. These topics included milk supply, gas, colic, reflux, bedtime routines, how much formula to feed by weight and age, bottle warmers, formulas indicated when there’s a family history of type 1 diabetes (alimentum and nutramigen), etc. I didn’t research bottles, formula, or much about nursing before because I took it for granted that breast feeding would just work. It may be natural but it does not come naturally for lots of people!

Similarly, I felt like I focused on buying cute yet often unnecessary baby items and then had to scramble in the first few weeks. I didn’t buy bottles because a) I didn’t think I’d need them and b) a friend had bought a bunch and then her daughter refused to drink out of that kind. I didn’t buy a pump because a) I didn’t know if I’d need one and b) if I needed one I didn’t know if I’d be better off renting a medical grade one or buying a single electric for the occasional break from nursing. With the trouble with breast feeding we had, our house quickly filled with bottles, a rented Medela Symphony pump, formula, and a steam sterilizer. We also bought a few pacifiers, which I had originally planned to avoid out of fear of nipple confusion, but they calm her. I had thought we were well prepared and had bought everything we’d need for the first few months, minus more diapers and wipes, but those first few weeks proved expensive (especially since we first bought Medela Calma bottles to help with nursing and they are $22 each and once we gave up on nursing, we made things easier for L by going with Playtex Ventair). Definitely a better investment than all the headbands (albeit those are still cute)!

Although I had previously told J that we’d have to rely a lot on trial and error, I underestimated how much. I have definitely wished that babies came with manuals since becoming a mom, but we are getting to know each other and starting to develop a routine.

3

Postpartum Body

The first time I looked in the mirror after giving birth I thought I still looked 7 months pregnant. I expected that to be the way my body would stay until I hit the gym, hard. Considering that I got in the shower during early labor and laid down on wet hair, I also looked like a hot mess. My feet and ankles were very swollen and my face also seemed extra puffy. In those first few days in the hospital, I found myself worrying that J would never find me attractive again.

I stepped on the scale the day we got home because I was curious to see how much weight I lost just from giving birth. 17 pounds. Pretty surreal to see a sudden drop like that on the scale. I’ve continued to lose weight as my uterus continued to shrink and I lost more fluid. I think I’m plateauing now and will have to work for the rest, but so far I have lost 36 pounds, 16 pounds away from my per-pregnancy weight. I’m pretty happy with that as I was worried I’d keep on the majority of the 52 pounds I gained. However, my body may forever be different. My stomach is riddled with stretch marks and far softer than it has ever been. They aren’t all that dark so I am hoping they fade well. I have some varicose veins along my side too. And although I didn’t think it was possible with my smaller boobs, they are now saggy. I feel that they lost volume from before. All of these changes, yet I don’t overly care. Sure I hope to get back in shape and if the stretch marks don’t fade considerably, I will never sport a bikini again, but it’s not worth stressing over and my body went through something pretty incredible that is so much more important than my vanity.

11

Birth Story

At around 1:15 am on October 31, 2013, I heard/felt a tiny pop and then what felt like a little bubble of water flow out of me. I jumped up and ran to the bathroom as more fluid rushed out. My underwear were soaked and once I sat on the toilet, I found I also had to pee. The sensation of peeing was entirely different from the feeling of the fluid that just flowed with no muscle control. I woke J and told him my water broke. Because of our false alarm and first trip to labor and delivery, J asked if I was sure. I told him I was sure my water broke. About 15 minutes later I started getting contractions. They were definitely more painful than what I had previously mistaken for early labor contractions. We drove to the hospital and contacted our doula who came to meet us. At L&D, they did a test and told me it was negative for amniotic fluid. I was like “you’ve got to be kidding me; this cannot be another false alarm.” While in triage, my contractions really kicked in and they were strong enough to make me vomit once. The doctor offered me morphine and gravol. I turned it down saying I didn’t want it to affect my baby. He told me I likely had a long road ahead of me and it would wear off by the time of delivery. He also said it would help take the edge off so hopefully I could sleep and conserve the energy I’d need later. I still said no. He said that it seemed like I was in early labor but I was only 1cm dilated and 90-100% effaced. It was also possible that the contractions would just stop. I was feeling pretty frustrated and defeated, as well as in pain. I was about to ask the next nurse/doctor I saw for the morphine when someone came in and said, “Are you sure you don’t want the morphine?!” So I jumped at the chance – strike one against my birth plan.

We returned home and the doula went to her house to await our call that we needed her. I labored on the floor, leaning over a yoga ball and on the bed for a bit, then on the toilet and in the shower. Time had no meaning to me during labor. Hours passed without me having any understanding of it. So eventually (no idea how long it was), we went to the living room where I continued to kneel over the ball. I was laboring in just my bathrobe because I had been in the shower, but when Jeff called the doula to come, he suggested I put on some underwear. So I switched to a bra and underwear. Definitely less modest than I expected to be in front of the doula who I still didn’t know well.

I alternated between the living room and the toilet while laboring at home. Pressure on my lower back and massage were definitely my friends. I can’t remember the specifics of how the pain felt, but I remember feeling the need to push during contractions and constantly being reminded to breathe deeply. Finally, our doula suggested we get going to the hospital. J got me some clothes and helped me put them on. I was dreading the car ride because I had heard and figured it would be toughest being locked into one position with less access to my support people and massage. However, I actually found I calmed down in the car. When we got to the hospital, the main parking lot was full, so J dropped me and the doula off and went to find a spot. I remember having 3 contractions along the length of a bench, needing to stop to grip it each time. Then we waited in the hospital lobby for J and I’m pretty sure my guttural, primal moans were frightening a child nearby (sorry little girl). When J came in, they got me a wheelchair and we headed up to L&D. This time my trip to triage was very short! I was asked by the nurse if I had the urge to push. When I said yes, she gave a little laugh and said that’s because I was 9.5 cm dilated and they might even be able to just push the little lip that remained aside while I pushed. I was so excited because for once I was further along than I had expected. When we got to the hospital I told myself that if I was less than 7-8 cm, I’d ask for an epidural. I feared they’d say I was only 4 cm (or maybe even less). So here I was, almost past transition, without realizing I was even in it!

I expected that stage 2 (pushing) would be over in as little as 20-30 minutes since the average is apparently 30 mins-2 hours. At one point, oxytocin was recommended to increase the frequency of my contractions because throughout my entire labor I had clusters of very close together intense contractions and then nothing for awhile (strike 2 – I didn’t want IV fluids). I also needed continuous fetal monitoring because of meconium in my mucus (strike 3). There were two in and out catheters as well. Again, I didn’t feel like as much time had passed as it had, but 4.5 hours later, the doctor advised forceps and if I was going to go that route, he strongly suggested an epidural. I looked at J, feeling so exhausted, and said, “I just can’t do it anymore.” I think I was looking for permission to consent to it all and he more than freely gave it. He later told me he wanted me to take the epidural and wiped tears away while I pushed because he hated seeing me in so much pain. Again, I don’t really remember what the pain felt like (a blessing I’m sure).

So I had a one shot epidural, which I do remember hurting as it went in. Well a combination of pain and pressure. I could still wiggle my toes, but everything felt numb. After apparently 18 hours of going without, I had committed strike 4 for the purposes of strike 5 (forceps). During the forceps delivery, strike 6 happened – episiotomy (2 little snips that happened so fast because her heart rate started to drop and I heard the doctor say he wanted the baby out now). As a result, I ended up with a third degree tear (for those who are new to tear degrees as I was, it goes up to 4 – my anal muscles were spared).

When Lyla was pulled from my body, it was so surreal. I didn’t cry at first because I couldn’t fully process that she was real and she was mine. I looked at her and then J and he was crying. Just picturing his face when he saw her is enough to make me cry tears of joy now. Then I looked back at her and burst into sobs. They were sobs of joy and relief. I even saw our doula crying. She later said the doctors probably thought she was nuts.

The things I wanted to try that I got to included different pushing and labor positions, showering, massage, warmed compresses to prevent tearing, delaying the routine tests and medications (eye drops and vitamin K), and, most importantly to me, immediate skin to skin and breastfeeding as early as possible.

As a bit of an aside, I LOVED our nurse but when she went on break, the replacement drove me nuts. I have to say, I think I was a very polite laboring woman. I said please and thank you when asking for water or ice chips, I didn’t swear, and I consciously held back from snapping a couple times when people were not there to massage as quickly as I wanted or were annoying me with the way they were telling me to breathe. My doula later said she thought I might have been in transition at home but normally women are much more vocal at that point. The one time I snapped was at this nurse. She asked me a question, I think about if I wanted to change positions while I was in the middle of pushing and totally in my zone. When I didn’t answer her, she moved around to my head, got right in my face and asked me again. So I yelled, “No!” J and the doula thought she was annoying too.

I feel like our birth story is a positive one, despite it not following the preferences I had laid out. I was definitely sore after from the tear and I remember the pain of the first bowel movement (cried so loud my roommate called the nurse) more vividly than the pain of labor and delivery. The tear means I need a referral to the pelvic floor clinic and I was super afraid of what it looked like (I pictured ground beef all sewn together haphazardly). But it’s healing and hopefully my new hemorrhoids will soon too! Regardless of the recovery, everything was and is worth it!

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3

My Due Date Came and Went

Yesterday was my due date and nothing yet. I had a prenatal appointment today and I was measuring between 1-2 cm and about 70% effaced. The baby is lower in my pelvis now and my cervix is a bit softer and further forward. All of that really means nothing though since things could progress very rapidly or slowly.

At this point, the plan is that if I’m still pregnant at 41 weeks, I’ll be booked for an ultrasound to check on the baby and then meet with the doctor to discuss the results and our options. The general rule is that I’d be induced at 41 weeks + 3 days (November 7). I am afraid of being induced because it’s supposed to make contractions more intense and it will increase the likelihood that I’ll get an epidural and/or need forceps, vacuum, and/or a c-section. There is another part of me that fears waiting, as our little one is already on the larger size (75th percentile) and growing by the day. And I just learned that J had extra large shoulders at birth. Ultimately, the safe arrival of our little girl is what really matters.

1

False Alarm

I thought I was going to have my baby yesterday and I was crushed when I realized that wasn’t going to happen. At 2 am, I woke up with contractions that were painful enough to get my attention. I think I was actually waking up every 20-30 minutes for a couple hours before with them, but from 2 am on they were frequent enough that I couldn’t sleep and I started wondering, “Is this it?!” and I was hoping it was. A stark contrast to the nerves and, I’ll admit, full on fear I was experiencing in the last week or so. The contractions quickly went from every 12 minutes, to every 6-7 minutes, to every 2-4 minutes. I still wasn’t in that much pain. I could breathe through them and even talk through most. I knew that was not the norm for active labor, but having just read several birth stories, I also knew that everyone is different and some people said that labor didn’t feel like anything other than bad menstrual cramps and they were able to joke with their husbands in between contractions all the way through. I have always had bad cramps and these contractions just felt like the worst of them, so I thought just maybe. And the frequency of them, plus the fact that they were lasting 60-90 seconds and had done so for over an hour, made me think we might need to get to the hospital (I was keeping the 5-1-1 rule we learned at prenatal class in mind). We have this service here called HealthLink where you can call and speak to a nurse at any time to get some basic health advice. I find they air on the side of caution and more often than not advise you to see the doctor. Keep in mind I’ve only called twice now, but I expect this is the norm because they can only do so much over the phone and they would never want to advise someone against medical care when they might need it. Anyway, I called and the nurse told me that my contractions met the criteria for going to the hospital, even though there wasn’t much pain. Off we went, at about 5 am, into the very foggy morning. For once, the roads were almost empty (seems they never are regardless of the hour here). We made our way to Labor and Delivery and were put in triage so baby could have a non-stress test (NST) and I could have a cervical check.

Our little girl is often quite active, but she tends to be resting whenever we start an NST (we’ve done 2 now) and the nurses seem worried as they ask if she’s been moving ok. The first time they gave me juice and she turned into a ninja and this time the nurse shook my belly and either got what she wanted (I didn’t feel much movement) or took my word for it that she has been making at least the requisite 6 movements per 2 hours.

Then the nurse did a cervical check. This was my third because my curiosity got to me at my last prenatal and I hoped I’d handle it better than the first one I had. Checks 2 and 3 were both uncomfortable, but not nearly as painful or traumatizing as the first. At check 2, I was told my cervix is still high, but lower than it was, and I was a fingertip dilated. I did a google search and apparently that’s about .75 cm. In the hospital, I was measuring 1.5 cm and 50% effaced. Unfortunately this means nothing in terms of being able to predict when I’ll be in active labor or ready to deliver.

I was disappointed to find out I wasn’t anywhere near active labor, but not surprised. The lack of intense pain was too good to be true. So we were sent home and told to come back if I had much more painful contractions that followed the 5-1-1 rule of thumb. We tried to confirm that I was in fact in early labor. The nurse said likely, but it was possible that the contractions would stop.

We went back home and got there around 6:30. I was exhausted and I’m sure J was too, so I suggested we try to get some sleep, reserve our energy. Even though the contractions continued, I managed to fall asleep for a few hours. When we woke up, J and I decided to watch some movies to relax and wait, hoping the contractions would get stronger. We watched Knocked Up, which definitely made me laugh but when the baby was born, I sobbed because I was thinking about how we’d get to meet our little girl soon. I was so very excited!

As the day wore on, the intensity didn’t really increase. There were a handful of contractions that made me stop in my tracks, moan, and cry out, but they were in no way regular and several happen after I got up from sitting, which probably had something to do with round ligament pain. Eventually even the milder contractions became irregular. I was afraid to admit to myself and J that I think it was a false alarm, but as time wore on (over 12 hours now) I couldn’t really deny it anymore. I sobbed again, but this time it was out of disappointment. I was so upset that we weren’t going to get to meet her as soon as I had expected. J reminded me that we would get to meet her soon. I also felt bad that he had used up a vacation day essentially for nothing, so I felt like I had taken a day away from his time with Lyla once she’s born. I just felt like I had gotten people’s hopes up – mine, J’s, and our doula’s (she kept texting periodically to see how I was doing and if there was any progress, and I had woken her in the middle of the night for nothing) – and now I (my body) was letting us all down. I think my fatigue was adding to the disappointment. I broke into tears a few times until my mom called and I filled her in. I sobbed on the phone but afterward I felt so much better. I spent the rest of the evening having accepted the fact that it wasn’t happening and I slept through the night (with several trips to the bathroom of course) without contractions. Today feels like a normal, very pregnant day. So, we wait and hopefully the next time won’t be a false alarm and things will progress as they should.

 

1

Daddy’s Ready. Am I?

This morning when I was in the shower, J came upstairs to brush his teeth. He said hello to “his girls” and, completely out of the blue, asked if I was in labor. He is definitely excited for the baby to get here and I think he’s hoping I’ll go into labor ASAP. I am more patient than he is at the moment because tomorrow is my last day of work and I am hoping to enjoy a couple days to a week of mat leave before she makes her big debut. Of course, if she comes before then, I will welcome her with open arms and just be happy if she has a safe arrival. However, a bit of relaxation (luckily I prepped the meals I had planned for freezing already) and getting a couple errands done sounds great! I’m also a wee bit scared of labor. I thought I might have been going into labor on Monday because of some persistent back pain, intense cramping, and nausea, but I was wrong. During that time though, I became a bit nervous because I was really uncomfortable but expected it was pre-labor or really early labor and I wondered just how much worse it was going to feel. I could definitely handle the discomfort I was experiencing, but the unknown of just how much the increase in intensity from early labor to active labor will be is what is anxiety-provoking for me.

I’m also starting to worry a bit more about adjusting to the demands of motherhood. Not a minute goes by that I’m not 100% certain that this is a dream come true, but it doesn’t mean it will be easy or that I’ll be blissful all the time. Fatigue and hormones are bound to cause some meltdowns and feelings of being overwhelmed. Because I’m at higher risk for postpartum depression (PPD), I’m worried about how I’ll react to all the change and new demands. I know that mommy blues are very common, so I also wonder if I’ll attribute normal feelings and reactions to PPD and rush to the doctor to increase my meds. I consider myself proactive in treating my depression (which is extremely well-managed now), which is good, but I don’t want to over-medicate or pathologize what is normal. I’m hoping that self-reflection and open communication with my doctor (and my doctor parents) will help me determine what is and is not normal.

3

Third Trimester

As a follow up to Lest I Forget, I thought I would recap my third trimester experiences and symptoms.

  • Aches have continued. My tailbone sometimes downright hurts when I get out of my office chair. My feet are pretty much a constant. Prenatal massages every 3-4 weeks helps though.
  • Heartburn – it woke me up a few times
  • Harder to sleep, definitely feeling really fatigued again
  • Woke up with dried colostrum on my nipple a couple times
  • Harder to move around, hurts to bend at the waist, and to pick anything small up off the ground, I need to take a knee  – resulted in strained ACL
  • I felt so hot during the summer and most of September, and not in a sexy way. We turned the fan on full blast at night and while J covered up and shivered, I couldn’t get the blankets far enough away from me. For once, I was wishing for colder weather to return.
  • I developed carpal tunnel syndrome. I started wearing a wrist brace, but it makes it harder to fall asleep on the nights when I’m feeling particularly uncomfortable.
  • Lots more pelvic pressure – sometimes it feels like my groin is ripping apart and every little movement is painful. I wonder if it might be Symphysis Pubis Dysfunction.
  • Night sweats – maybe they’ve been around for awhile but now that the weather is cooler, I can recognize them for what they are and not just because I’m always hot!
  • Super stuffed up which leads to frequent, loud snoring. J has considered sleeping in the spare room more than once.
  • The days of little, almost imperceptible kicks are gone. I can now feel the baby moving often and sometimes I can feel  poking out the side of my stomach. If I put my hand on top, I can even feel her “slither” down the side of my uterus. Also, her kicks and rolls are large enough that I can often see them. It’s my mission to get J to see them too since he is either out of the room or looking away whenever it happens!

In my second trimester, once my bump was clearly showing, but I was still quite mobile, I said that I couldn’t imagine not being pregnant. I was loving the freedom to eat what I want (and I definitely over indulged) and my new belly was a source of pride. Now that I’m into my third trimester, I can see why people want to give the baby an eviction notice and why people lament to have their old bodies back.

0

How am I feeling? Huge!

My husband is 6’4″. I am 5’2″ (and a half). We now weigh the same.

I have said before that I definitely indulged during this pregnancy. Basically every craving for fast food, chocolate, cake, and chips was satiated. So I’ve totally done it to myself. But knowing that I’ve actually managed to put on so much weight that I have caught up to (and might even surpass) J is a little disconcerting. I also thought that I was avoiding stretch marks, but I was wrong. My mom didn’t have any with me and she gained 40 lbs, so genetics was on my side. I’ve gained 46 lbs as of the last time I checked and although I feel like a beached whale, I didn’t see any stretch marks so I was happy. However, I decided to look at my underbelly with a mirror and there they were. Definitely worth it and again, likely my own doing by gaining so much weight so fast, but I couldn’t help but think that I might become a one-piece wearer for life. Small price to pay though and only a little while to go.

2

Doulas, Birth Plans, and Perceptions of Labor

I’m 3 days away from being full-term (well more accurately, baby is) and my due date is fast approaching. We’ve also been taking a childbirth class that has us actively thinking about our wishes, goals, and strategies for labor and delivery. During our very first class, the instructor informed us that we’re allowed 2 support people at the hospital and that she strongly encourages it. She also mentioned doulas. I was familiar with what doulas are and what they offer, but I had thought of it as an unnecessary expense, a luxury. When I started thinking about how J will have to leave on occasion to tend to his diabetic needs, the idea of a second support person started to sound much more important. Because we don’t have family here and my closest friends live far, far away, a doula seemed like the best and most realistic option. Also, the fact that she’d be trained in how to help women (and their partners) through labor is a bonus because we are newbies to this whole experience and it may not go down how we’re anticipating it will.

I scoured the internet for local doulas and contacted a bunch to see if they are available (I was cutting it quite close to the due date so I was just hoping somebody would be). Five women responded saying they are available and, based on what I had read, we interviewed the first 3 who had responded (they were 3 that appealed to me most from their websites as well). We just had our last interview last night and now I’m trying to decide. J said the decision is completely up to me because he wants me to be as comfortable as possible and he doesn’t want to sway me. Of the 3, I’m really trying to decide between 2 and ironically they are each other’s primary back up doula in the event that they couldn’t attend the birth for some reason. It’s hard to decide though and the thought of “rejecting” the other 2 is also hard. They assured us that they are a close knit community of friends really and there’s no competition or hard feelings among them, but it’s still hard to explain to someone why you didn’t pick them, especially if the reason is that you just clicked with someone else (by default it sounds like you’re saying that the “rejectee’s” personality just wasn’t good enough). I personally clicked the best with Doula A. She was outgoing, friendly, and kind of bubbly. I could see her being really hands-on, positive, and vocal, but she is going on vacation 12 days after my due date so she wouldn’t actually be around for the typical promised 2 weeks on either side of the due date. At the same time, it’s customary to induce if a woman is 10 days late here. Doula B didn’t immediately stand out but I quickly warmed to the idea of her a few minutes after she left. She was the most professional of all 3, as she brought a folder with some general pamphlets on doula services, as well as samples of her contract and confidentiality agreement. The folders were printed with her logo, which was a nice touch. I definitely appreciate professionalism. She was very kind, but more soft-spoken. So I was a bit concerned that she might not be as assertive in suggesting new strategies or changes to what we were trying. I emailed her with follow-up questions though and she seems willing and able to change up her approach based on our preferences and she stated that her approach might even change throughout labor depending on what I need from her at a given stage. That seems reasonable. So now I’m a bit torn, but I’m leaning toward Doula B. She also has a TENS unit, which keeps being brought up when I read about natural labor comfort measures and, as a physiatrist, it’s something my dad recommends to patients dealing with pain from their injuries. Doula C who I have 99.9% ruled out (not because there was anything wrong with her, but she just didn’t stick out to me and I felt much more reserved with her) has the most experience (34 births attended compared to 6 and 7), but as the doula isn’t the one delivering the baby, I’m not really fussed about that. Also, Doula C is certified whereas Doulas A and B are in the process of getting their certification (although it’s just a matter of paper work for them both). As a result, Doula C costs as much as Doulas A and B combined. Although it’s not the deciding factor, it definitely plays a role when I’m just not feeling Doula C as much.

Part of having a doula is discussing your birth preferences. I wasn’t originally planning to make a Birth Plan because unlike my typical type A approach, I was comfortable with the fact that you just can’t control birth. But, a friend mentioned her Birth Plan, which she called Birth Preferences, and offered to share it with me. I figured it couldn’t hurt to look at it and then I realized the value in specifying our preferences but also recognizing that everything might go out the window if there is an emergency. I modeled my preferences off my friend’s. My main goal, aside from a safe and healthy delivery, is to do skin-to-skin immediately and breastfeed as soon as possible after delivery. Anything that helps that is a pro and anything that hinders it is a con. I would like to try natural labor, but having NO clue what it will actually feel like, I might ask for an epidural fairly quickly. I’m not going to beat myself up if I do, but I want to see if I can cope by other means first. There are a few risks and downsides to the epidural that it would be nice to avoid, but they are pretty mild or extremely rare. I always thought I would jump right on the epidural train, but when we were TTC, I watched The Business of Being Born and it made me think of labor and delivery as an experience rather than something to endure, so it got me re-thinking what I would want from the birth process. I guess that’s why I want to see what it’s like without the epidural first. I also try to remind myself that many women all over the world have no choice but to deliver without medication or other modern supports and they survive. I remember this book I had to read for an anthropology course (Nisa: The Life and Words of a !Kung Woman) and the woman quietly went away from her tribe, leaned against a tree, and delivered her baby on her own, before carrying her baby back to her people like it was no big deal. I certainly won’t be taking that approach, but it helps calm my fears and restore faith in my body’s ability when I think about it. In the moment though I might tell Nisa to go f*ck herself!