Friday, August 1, 2014

3 a.m. Feedings

Sometimes 3 a.m. feedings aren't that bad--at least when you're breastfeeding. As your baby grows, you can even do it in bed and fall asleep during it. My baby still isn't great at latching in bed, so I get up and sit in a chair with a dim light on. Both baby and I stay sleepy so it's easy to go back to sleep when he's done eating. Most of the time.

And then there are 3 a.m. feedings that go like this:

Baby eats. 
Baby throws up everything he's eaten all over both of you.
Husband changes baby while you change. 
Husband goes to bed.
You sit down with the baby and the baby poops.
You change the poopy diaper.
While you're wiping the baby's bum, baby poops right into your hand (thankfully the wipe catches it all).
Once baby finishes pooping all over, you put a fresh diaper on him.
You sit down with the baby and the baby poops again.
You change the baby again and finish feeding him.
You finally get him asleep, but you're wide awake.

But you know, at least he didn't pee on me. It could have been worse.

Friday, July 25, 2014

Book Review and Thoughts on Grief

Having a Kindle Paperwhite has allowed me to read many books in just the past month that I've been breastfeeding. It's a lot easier to hold than a print book, the baby is not distracted by the noise of turning pages, and I can easily read books at 3 a.m. without turning on any lights.

One book I recently read (and finished at 3 a.m. as often seems to be the case) is Wave by Sonali Deraniyagala. It is a memoir of a woman who lost her husband, both her sons, and her parents when the tsunami hit Sri Lanka where they were vacationing on December 26, 2004.

I vaguely remember hearing about this tsunami that killed more than 200,000 people across many countries in the Indian Ocean. But as sad as such a news story is, if it doesn't directly effect you, you quickly forget it. As Annie Dillard said, "It hurts more to break a leg."

Wave tells the story of what happened to her family, and of the grief that followed. She is brutally honest about her feelings and her actions in the years following her loss. She doesn't sugarcoat the crazy things she did or the angry thoughts she had about other people. And she addresses things that made her feel guilty--like the fact that she didn't grieve for her parents' loss for a few years because she was so caught up in grieving for her sons and her husband. Something that most people grieving for the death of a loved one don't have to deal with because we usually face them one at a time.




This book made me think about grief and how we all deal with it. A couple of weeks ago marked the 4th year anniversary of my father's death from lung cancer. Two days before that an old acquaintance who touched hundreds of lives died. One day before that my great-uncle died. It was a tough week.

But I have something that Deraniyagala doesn't seem to--a belief in God and faith that we will one day be reunited with our lost loved ones. Knowing that doesn't mean you don't miss them or think it's unfair that they are gone. But when Deraniyagala spoke of her lost family, she kept stating that they were gone and she had to remember that. No hopes or thoughts of a future reunion. No comfort in knowing her family is together. How terribly bleak death must be without that faith.

I do not mean this next comment to make light of what Deraniyagala went through, but her apparent wealth made the process of dealing with what her family left behind different than what my family experienced at my father's death. Just the fact that her family traveled back and forth between different countries often shows she had a lot more than most. And this fact made it so that she didn't return to her London home until almost four years after her family's death--and it was still her home. My family had to leave the home they shared with my father just weeks after he died. Meaning we, and especially my mother, had to deal with the material things left behind right away rather than waiting years. I can't even begin to say what might be better or worse. She also traveled to new places she'd never been with her family to deal with the emotions she faced at each of her children's birthdays.

Birthdays. My family and I try to take my dad's birthday as a time to celebrate his life and remember him. The family that lives close get together and have a dinner of his favorite things and talk about him. I only rarely think about how old my father would have been. I might reflect on it more on the years he would have been 60 or 70. But losing a child fills each passing birthday with thoughts of how old they would have been, how much they would have grown, and what they would have been doing if only they had lived. I cannot even imagine that pain--especially in losing all your children.

As sad as the story is, I highly recommend the book. It is a very human story and I enjoyed her writing. It's one of those rare occasions when something extraordinary happens to someone and their memoir doesn't need to include the name of the person who actually wrote it. Fair warning, she uses the F word about half a dozen times. I can't say I necessarily blame her based on what she was going through, but I know some people would like to avoid it in the books they read.

Tuesday, July 8, 2014

Baby #3 Birth Story

The birth of my third baby is the reason for my long absence here. As I've said in the past baby #1 was an in hospital birth with an epidural. Baby #2 was a home waterbirth. With baby #3, I was lucky enough to live in a place that offered every option for birthing that I could hope for. (Florida is not a good place for a VBAC though. But that wasn't something I needed to worry about.) I chose another home waterbirth. Here's the short version of birth #3.

****

I had a midwife appointment at 40 weeks and 4 days. I had been losing my mucus plug for a few days and had been having harder contractions on and off, though they never lasted for more than an hour or two. When the midwife checked me for progress, I was dilated to a little more than a 3. Since I was past my due date, she offered to strip my membranes if I wanted. That is supposed to help get labor going in a few days if you’re close anyway. I felt I really was close to labor this time. After she stripped the membranes, I was dilated to 4 cm. 

At 4:00 p.m. I started having contractions that slowly built in frequency and intensity—until about 9:00 at night. Then they slowed down. I went to bed at 10:00 knowing that if real labor was going to happen, it would happen even if I was sleeping. I was woken up with a few sharp contractions, but fell asleep after them. At 1:00 a.m. they were frequent and strong enough that I couldn’t go back to sleep, so I got up and walked around and bounced on the birth ball. I woke my husband up a little after 3:00 and had him stay up with me and watch the contraction tracker. He was worried about calling the midwife too early (a mistake we made in the past), but I was ready. He called her a little after 4:30 and she headed here.

I got into the bathtub to help me relax through the contractions as they were getting much more intense. I was handling my contractions better than my past labors. The key for me this time was using the time between contractions to relax and enjoy the break instead of spending the time between contractions being tense and fearing the next contraction. This worked so well, especially early on that when the midwife got here (a little after 5:00 a.m.) my blood pressure and pulse were really low and made it seem as if I were relaxed instead of in labor. When the midwife first checked my progress, I was hoping to be dilated to a 6 (that’s a number that indicates real labor—you can walk around for days at a 3 or a 4). I was an 8!

I definitely wanted to labor and birth in the birthtub and since contractions were getting more difficult, I was hoping to get in soon. But the midwife said his head was a little to one side and it would help if I labored while lying on the opposite side for a while. So I did. It was nice to labor in a resting position, but hard to do it without warm water or movement to help. Eventually I moved to the birth tub. 

I’m not sure of the timeline from that point. But the contractions continued to get harder to get through, though I kept telling myself that they were good because each one got me closer to baby. 
I remember being tired and wanting a nap (I’d been awake since 1 a.m. after all). I asked the midwife how much longer it would be so she checked me and said I was dilated enough, but that the amniotic sac hadn’t broken yet. It was bulging with his head right behind it so she asked if I wanted her to break it and speed things up or if I wanted to try some pushes during contractions to see if I could get it to break. I pushed through three contractions. When the midwife checked, my water still hadn’t broken, so she broke it for me. Thankfully, it was bulging enough that she could do it between contractions instead of during one.

Things definitely sped up after that. I can’t remember if I threw up before or after she broke my water. But I knew it was a good sign when I did throw up because I had thrown up during transition with both my girls, so I was kind of waiting for it. I was upset that I did it during a contraction though—it just seemed unfair to have to deal with both. And not really possible to relax through a contraction while you’re throwing up bile.

I moved into a kneeling position with my husband kneeling outside the tub to support me. I won’t sugarcoat it—pushing a baby out without any pain relief is excruciating. I did notice with some curiosity that once the burning pain of the head crowning begins, the band of pain around my lower abdomen (which is where the pain of most my contractions are felt) was gone. Just replaced by the horrible burning sting that they call the ring of fire. My legs also felt like they were burning.

So why would I choose to give birth without pain relief? Without getting into benefits vs. risks of medical intervention, I have two main reasons. 1) With my first I couldn’t feel what was going on—which meant I couldn’t work with my body to push the baby out. Feeling pain meant I could also feel what I needed to do and when my body needed to push. 2) Relief and happy hormones come once you push a baby out without pain medication. When I couldn’t feel pain, I couldn’t feel any of the good hormones either. I still felt numb, both emotionally and physically, after my medicated birth.

I remember them telling me to try to relax in between contractions. But here’s the thing for me with pushing—there is no in between. There are waves of more and less pain, but they crash into each other relentlessly without giving you a break. The only way they end is to get the baby out. Which was motivation for me. Since I was more in control this time around, I was able to actually bear down and push with my body. I also had a chance to reach down and feel his head when it was partially out, which helped me realize how close I was to being done.

His head was out but his shoulders were stuck so the midwife told me to put one of my legs up. In the moment I couldn’t comprehend what that meant so she grabbed my leg and set my foot down so I was only on one knee to try to open my hips and help him out. This didn’t work so she told me I needed to lay back. I understood what that meant, but couldn’t comprehend how I could possibly change position in the moment. Somehow they moved me so my other leg was up and I was laying back. As I pushed I felt a definite tug as the midwife pulled and helped me get his shoulders through. The cord was wrapped around his neck a few times so it took a moment before he could be brought up to my chest.

When he was brought up, he was blue. Which is scary, but I could feel his heart beating and I knew it was common for babies to need help getting that first breath. The midwife and I rubbed him for a bit, then she took him and laid him face down while she rubbed his back. That still didn’t work so she got the bag and mask and gave him a few pumps of air. She asked the assistant what time he had been born and realized that only two minutes had passed even though it seems like an eternity when your baby’s not breathing. After the bag and mask he started coughing stuff up and breathing.

I held him and the family gathered around to see him. The placenta came out soon after and a little while later, Daddy cut the cord and baby got out of the water. Daddy and big sisters cuddled the baby in bed while the midwife and her assistant helped me out of the birth tub and to the bedroom. I had only a superficial tear and I was allowed to decide whether I wanted stitches or not. I chose not to and had to be really careful the first few days, but the recovery has been so much better without stitches.


Baby #3 was born at 8:55 a.m. after 6 or 7 hours of labor and only 14 minutes of pushing. He was my biggest baby weighing in at 9 lbs. 7 oz., 22 inches long, and a 14.75 inch head.

I absolutely do not want to do it again--I'm content with #3 and neither my husband or I feel that we'll have anymore. But if I did, I would still choose a natural birth again.




Friday, June 13, 2014

My Nonspecific Childbirth Advice

I try to not feel guilty about things I did or didn't do during the birth of my children. And I know that there will be things that I wish I had or hadn't done when all is said and done with baby #3. But as I've reflected on my past birth experiences as I look forward to this one, there are a few things I wish I had known or remembered--and that I'm trying to remember for this one.

1) Educate yourself. You can't make a choice if you don't know your choices. And yes, doctors and nurses and midwives have seen more births than you, but they haven't seen the one you're about to have. Many institutions have a way that they normally do things. That doesn't mean that way is right for you.

2) Speak up. This is my #1 regret with baby #1. I ignorantly thought that people had read my birth plan or cared. Some things happened in the hospital both during and after labor that I did not agree to. And I wish I'd spoken up. I wish I'd told that night nurse to leave my room and get someone else. I'm  not great at speaking up for myself. And I don't think either my husband or I realized that we could and should speak up. This is where a doula could really help.

3) Rest and enjoy the moments between contractions. With baby #1 I was so anxious to go into labor that I didn't sleep in very early labor, which was a Thursday night. Then I spent all of Friday and Friday night in labor and didn't deliver until Saturday morning. Exhaustion did not help the challenges I faced in labor or the recovery period at all. With both births, I spent the moments between contractions in fear of the next one. And that got me nowhere. Labor is not nonstop pain. One of the main things I want to do differently this time is to try to remember to use the moments in between to relax, to renew, and to enjoy not having a contraction.

4) Remember the baby. I know this sounds weird, and hopefully I won't be judged too harshly for it, but at many points during both my previous labors, I was so wrapped up in the work and the pain and the exhaustion that I didn't think about the coming baby much. I'm not saying I didn't care, but I didn't take advantage of the coping technique of imagining the baby in my arms--the whole point of what I was going through. This is my favorite picture from the birth of baby #2. I have it framed and I recently got it down to look at to remind myself that this is what it's all for:


I've also gathered some quotes from my readings that I review and want to remember. Here are just a few:

“Don’t let your over-busy mind interfere with the ancient wisdom of your body.” – Ina May Gaskin

“To diminish the suffering of pain, we need to make a crucial distinction between the pain of pain and the pain we create by our thoughts about the pain. Fear, anger, guilt, loneliness, and helplessness are all mental and emotional responses that can intensify pain.” – The Dalai Lama

“Knowing unshakably that everything is in constant transformation can be extremely helpful in childbirth. No matter how long your labor takes—hours or days—or how challenging or easy the experience is, it will end. Each labor lasts only a certain number of breaths. Then it’s over. We don’t know how many breaths we will take in and release during labor or many intense physical sensations we call contraction-expansions will arise and pass, but however it goes, it goes. That much we do know.” - Nancy Bardacke

Sunday, June 8, 2014

What Do Homebirth Midwives Do?

As homebirth is becoming more common, I'm finding that more people are enthusiastic (or at least not panicking) when I tell them I'm doing a homebirth. Even if "there's no way I ever would/could do a homebirth," many people of my generation have at least heard of someone else who did it.

There are still a few people who ask if I'm going to have a midwife come. Umm, yes. I may be a bit outside of normal, but not that much. I appreciate having the expertise of a licensed midwife combined with the comforts and freedoms of home. There are extremists out there who choose an unattended birth or want to give birth in the ocean with dolphins (I seriously remember a news story about that from a few years ago, I'm not making it up). But even back when homebirth was the norm, women usually had midwives and other women attend them.

Since we moved, I'm experiencing my second homebirth midwife. Though their personalities are wildly different, as Licensed Midwives their education, training, and abilities are the same. My current midwife's practice is called Sweet Baby Midwifery. I was going to write my own explanation of what a homebirth midwife does, but she writes it so well on her website that I'm going to borrow some of her words (and you can check out her site if you want more detailed information).

Prenatal Care

I offer complete prenatal care during your pregnancy. Visits are scheduled at standard intervals: Once a  month until 28 weeks, every two weeks until 36 weeks and once a week until the baby is born. All visits are done in the comfort of your own home.

All prenatal care covers the exact same care you would get from an OB or a hospital based midwife. They check the same things and do the same lab tests at the same times.

Labor and Birth

When your body goes into labor, my birth assistant and I will come to your home. I bring with me everything needed for the labor, birth and immediate postpartum. This includes my birth kit of instruments, bulb syringe, oxygen, IV supplies, emergency equipment and medications to stop postpartum bleeding. I am fully prepared and trained should the birth or postpartum move outside of normal.  

While in labor, you have complete freedom of movement. You are encouraged to eat and drink. I have the ability to give you an IV, but it is not standard and only given if needed. I will monitor your blood pressure, pulse and temperature. I will listen to the baby's heart beat with my handheld Doppler in increasing intervals as labor progresses. 

Baby comes right to your chest after birth. Anything that I need to do for baby, I can do right on your chest.

Once you and baby are medically stable, comfortable breastfeeding and ready to sleep, my birth assistant and I will leave you to enjoy your new family addition.

Should a situation arise that requires transferring to the hospital, I will accompany you. I will call ahead to the hospital to let them know what is happening and what is needed. We will go either via ambulance or personal vehicle depending on the situation. Although, I don't have hospital privileges, I will be able to communicate with the hospital staff to insure a smooth transition.

Homebirth midwives come with all the equipment and medication (and training to use them!) that would be needed in an emergency. Without interventions, birth usually goes just fine. But a homebirth midwife is trained to face any emergency and to know when it's wise to transfer to a hospital.

Postpartum Care

I will return to your home 24-48 hrs after the birth. I will check on you and the baby. I provide breastfeeding help. Overall, I make sure you and baby are happy and healthy. I will then return at 2 weeks and 6 weeks postpartum.

This care is significantly better than what I received from the hospital. If I have problems with breastfeeding, I have someone's personal cell I can call to get that help as soon as I need it.

*****

When I was pregnant with baby #2, I was in a car accident. I called my midwife and she came to check on me and the baby at home right away. It was a Sunday and I didn't have to decide between waiting to make an appointment the next day or going to the ER to make sure my baby was safe.

Homebirth is definitely not for everyone or even for every birth. But true choice in childbirth includes knowing your choices. And I can attest that anyone making a different choice than what you're accustomed to will appreciate you learning a little bit about their choice before passing judgment.

Friday, June 6, 2014

Birth Books

Going on baby #3, I've read lots of pregnancy and birth books. The list tends to be heavy on natural birthing because that it is what I have chosen when possible, but I've read a variety. Though I certainly advocate natural birth, I also know that it's not the right choice for everyone or a possibility for every pregnancy. But I firmly believe that you can't truly make a choice unless you actually know what your choices are. And just as it's important for someone like me planning a home birth to know about and be prepared for any possibility, including a c-section if it is truly needed, I believe it's important for someone planning a hospital birth with pain medications to have some knowledge of how to get through an unmedicated birth. I know plenty of women who planned a hospital birth with medications who had a baby too quickly to take anything--even one who gave birth in her car on the way to the hospital.

Since I keep a list of books I've read (yes, I'm a nerd like that), I can look back and know exactly what books I've read before each child.

Before Baby #1 (who I wanted to have naturally but being in a hospital setting contributed to me needing an epidural--one that didn't work like they're supposed to):

1) Having a Baby, Naturally by Peggy O'Mara
Written by the editor of Mothering Magazine, it's a good overview of natural childbirth.
2) Birthing from Within by Pam England
I don't remember a lot of details from this book, but I remember that it covers lots of methods for coping with the pain of childbirth, not just one like most books do.
3) Birth: The Surprising History of How We are Born by Tina Cassidy
Talks about the history of childbirth through the years. Interesting to see how much things change and how certain beliefs came to be.
4) Belly Laughs by Jenny McCarthy
Not an education book, but she does give some funny insight into a first time mom's experience. She can be a little crude, and I didn't like the follow up Baby Laughs nearly as much.
5) The Girlfriend's Guide to Pregnancy by Vicki Iovine
Written by a normal woman. It talks about some of the weird, embarrassing things that women in experience during pregnancy and childbirth that we don't talk about with everyone.
6) Hypnobirthing by Marie F. Mongan
I've known this method to work great for many people. It simply didn't for me. I don't think I'm the right personality for it. But if you are planning a natural birth, it's a good one to look into.
7) What to Expect When You're Expecting
This is the only book I wish I hadn't read. It should only be used as a reference book (but you can easily search the same information on childbirth websites like babycenter.com). Read from cover to cover it brings up too many scary what ifs that are rarely an issue.

Before Baby #2 (who I gave birth to in a tub at home):

1) Better Birth by Denise Spatafora
My take on it after reading it was: "Pretty good, a little too touchy feely, repetitive and there are lots of others like it."
2) Your Best Birth by Ricki Lake and Abby Epstein
This is a good one with lots of information and fairly unbiased. They also have two documentaries: The Business of Being Born and More Business of Being Born which are usually available n Netflix Streaming. The first one set out to explore natural birth, but in an unexpected turn of events also follows a birth that ends up taking place in a hospital. Which reinforces my feelings that it's important to know all aspects of birth.
3) Birth Matters: A Midwife's Manifesta by Ina May Gaskin
Ina May is the most well-known midwife in America, and is also known throughout the world. She definitely advocates natural birth. But if you want to learn about it, she is the one to read.
4) Gentle Birth Choices by Barbara Harper, RN
This one was long, but had a good coverage of lots of issues surrounding childbirth.
5) The Official Lamaze Guide by Lothian and DeVries
Another method of childbirth pain management. I've never stuck to one method, but was glad that I read a variety so I had different methods to call on at the time.
6) Ina May's Guide to Childbirth by Ina May Gaskin
The book to read on natural childbirth.
7) Ina May's Guide to Breastfeeding by Ina May Gaskin
A good guide to breastfeeding no matter what your childbirth choices or realities are.

Before Baby #3 (who is due in a couple of weeks and I'm planning a home waterbirth, though I have back up plans for if something goes wrong):

1) A Good Birth by Anne Drapkin Lyerly
I highly recommend this book to anyone who has given birth, especially if things didn't go as hoped. It helped me process both of my previous births and come to terms with some regrets I had.
2) The Homebirth Guide by some doctors
This one was okay. As someone who had already given birth at home, it was mostly reminders.
3) Ina May's Guide to Childbirth by Ina May Gaskin
A good reread and reminder.
4) Ina May's Guide to Breastfeeding by Ina May Gaskin
Another good reread. I'm really hoping to avoid the same early breastfeeding issues I encountered with my first two (who had different issues). What I've probably learned the most is to get professional intervention right away if I'm having any difficulties.
5) Mindful Birthing by Nancy Bardacke
The method in this one is mostly meditation, but I've found good information in it even without doing the meditation practices. Even with all the other childbirth books I've read, I'm glad that I picked up this one.

So there you have it. I believe that knowledge is power--but too much knowledge can stress you out. What I really wish I'd known the first time around (both in reading about birthing and parenting) was to gather knowledge but to trust in myself, to not become too attached to any one method or idea, and to speak up for myself.

For Baby #3, I have plans for how I want things to go, contingency plans for if something goes wrong, and trying to have more trust in my body's ability to birth, and since I'm religious, a little more faith in God and a little less need to try and control things out of my control.

Tuesday, May 20, 2014

Top 10 Signs You’re at the End of Your Pregnancy

Granted, a lot of people think I’m near the end of pregnancy long before I am. But I think that people don’t realize, or forget, what an 8 – 9 month pregnant belly really looks like because you see them so rarely. My nesting instinct is kicking in—not the cleaning kind, but the hurry up and run all the errands and buy all the things kind. Mostly because it’s getting harder and harder to go out and I’m looking forward to sitting around the house for the last few weeks. Which brings me to #1 on my list (this might only apply to women with short legs as it’s apparently not an issue for everyone).

1. The steering wheel hits your belly. Your driving days are numbered. (A short legs with big belly problem.)

2. Reaching things in general is more difficult. (A short arms with big belly problem. Cooking dinner is getting hard. Forget about being tired and food only sometimes sounding good. If I lean against the counter, the baby kicks back in protest and pushes me away from it.)

3. Your pregnant belly is not always round. It’s often misshapen and skewed in one direction or another as baby snuggles into one side.

4. Turning over in bed is a major production.

5. If you need to pick up more than one thing off the floor, you crawl rather than getting up and down and up again. Too much work.

6. It’s hard to see your own feet. Or if you have a small child who is shorter than your belly, she can hide underneath it.

7. Your maternity shirts are getting too small. Your limited wardrobe is limited further as you slowly have to put aside maternity shirts that no longer cover your belly.

8. Almost everyone opens doors for you. People even rush to offer to help you if you’re carrying something. (This same politeness doesn’t apply to all people driving through a parking lot. But let me tell you, if you’re not stopping for this pregnant lady carrying her toddler, you’re going to get a dirty look. Because come on, who doesn’t stop for that?)

9. You use the bathroom before you leave for the store. After the 15 minute drive to the store, you have to use the bathroom again before you dare start shopping. (A change of position can make you need to pee.)

10. Your four year old tells you that she’s walking slower for you because “pregnant ladies walk really slow.”


And every time you’re certain your belly can’t get any bigger—it does.