Posts tagged ‘organism repair and maintenance’

On Breastfeeding

I was lucky to have a book on breastfeeding on loan from the midwives when J happened to be born, and it was awfully handy as a reference during those first few difficult days. My midwives are very well informed on lactation, and the hospital where J was born is “baby friendly”, meaning all the nurses have basic training on feeding babies.

It took till the fourth day after J’s birth for my milk to really come in, and he was pretty dehydrated and down 9.5% of his body weight at that time. He ate pretty much continuously for about 36 hours, and was obviously getting more and more dehydrated, as his wet diapers were increasingly pitiful. I was pretty much convinced he wasn’t getting anything at all and was pretty worried. Z thought I was insane. J finally spat up some colostrum which made me very happy; if he spat something up that meant he was eating something! And then my milk showed up and everything got so much better – immediately, and over the next days.

If we hadn’t had such great information and caregivers, the first few days would have been much harder.  Even though my milk showed up a little later than average, I think our experience was about as stressful as average, because J was a pretty skilled and enthusiastic eater from day 1 and lots of babies aren’t. Thank goodness my kid loves to eat.

J asleep in his favourite spot in the whole world - draped over my boob and using it as a pillow.

We still have ongoing challenges of supply and demand, which I might get into another day (stay tuned for a fascinating potential post about green poop and sleeping on towels) but things are so much better. J is thriving, and I benefit from the inspiration of friends with older babies who breastfeed them effortlessly, often while multitasking. One day, I hope to be able to feed J in the carrier while also doing laundry. But for now, I’m getting to watch a lot of TV, and J is getting nice and plump, and my boobs don’t hurt (much anymore) so all is well.

So come all ye pregnant ladies: take out a book on breastfeeding from the library, read some stuff online, or talk to someone about their experience.  There was about 10 minutes about breastfeeding in my prenatal class, which is not nearly enough. Also, get a spill-proof cup with a built-in straw so you can drink water with one or no hands while nursing a little tiny baby. And maybe some trail mix which you can eat with one or no hands…

That part where you first learn to feed the baby is really hard! Then it gets easier.

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Braindump: 36 Weeks, Homebirth and Potential Restrictions

Today was my 36-week midwife appointment (2 days early), and it seemed like all the restrictions came out of the shadows.

I’m most disappointed to learn that provincial policy applies an arbitrary time limit to cervical dilation. Once 3 cm dilation is reached, after 4 hours with no further progress, “consultation with a physician” (i.e. hospital transfer) is mandatory. Having read about homebirth (in the US context) as having the advantage of avoiding arbitrary hospital time limits, I am pretty disappointed to that this rule will be applied to me labouring at home, however unlikely the scenario.

The midwife’s response to my dismay was basically that if I had been labouring for 4 hours with no progress, I’d be asking to go to the hospital anyways. In certain contexts, that makes good sense. However, I can think of 3 births during which the mom’s body took a several-hour break at 6-8cm dilation to allow her to have a rest or nap before transition and pushing. So a pause in dilation isn’t necessarily pathological or even uncomfortable! The midwife also mentioned the purpose of this policy in limiting professional liability. Anyways, there is no point in arguing about it, because midwives are bound by these rules too. I’m still thinking about whether there’s anything I can do to try and protect myself, such as declining frequent cervical checks.

Image

St. Anne, a Catholic version of the crone goddess, and patron saint of childbirth. I love the idea of her, but do wonder why she is always so creepy looking in paintings. Also, why does the baby Jesus look like a balding miniature bodybuilder?

I also have an exciting new documented risk factor to contend with, because our baby is presumed giant. Oh, didn’t I tell you? Our last ultrasound at 34 weeks – which showed his kidneys are PERFECTLY FINE, fuck yeah – also resulted in a new diagnosis of “fetal macrosomia”. This means the kid is expected to be really big. Although guesses of fetal size are notoriously inaccurate, his head was estimated in the 99th percentile. Just what every mother wants to hear! We were offered another ultrasound to reassess his size, but have decided against it. Ultrasound exams look for trouble, and every ultrasound so far has brought a new diagnosis to cause stress and threaten required interventions. No, thank you.

Fetal macrosomia is a contra-indication for homebirth. It means that medical care providers will be extra vigilant about the speed of my progress, on the theory that big babies are at risk of cephalo-pelvic disproportion, meaning the head might not fit into the pelvis and therefore couldn’t apply proper dialating pressure to ye olde cervix. According to “Ina May’s Guide to Childbirth”, true cephalo-pelvic disproportion is pretty darn rare, but the concern is often raised with big babies, small women, and small women with big babies. (Hi!)

Another contra-indication for homebirth is my pet fibroid, which was also diagnosed during the last ultrasound. I couldn’t handle a discussion with the midwife today about how much it increases my risk of  postpartum hemmorhage, but will start researching.

Going post-dates would be another risk factor, and while there doesn’t appear to be a hard cut-off at three strikes, it’s clear that the more risk factors I have, the less support there will be for birthing with limited interventions. At an early appointment with a different midwife, I had already raised the question of going post-dates. At that point, with no other apparent risk factors, she had assured me there is no policy on induction or “risking out” of homebirth, but I could merrily go to 43 or 44 weeks. Because of the suspected big baby, however, I am finding myself encouraged to try and have this kid earlier, depending on which midwife at the practice I talk to about it. Hence, starting this weekend, I get more accupuncture, to try and line everything up for delivery. At 38 weeks, the midwives will offer stretch and sweeps, which I haven’t decided yet whether to accept.

The opportunity to birth at home (in the absence of good reasons to go to the hospital) is pretty important to me. The biggest reason is that I feel safer at home, with the fewest strangers around possible, and feeling safe helps mammals give birth. Mostly, that’s psychological, but it’s also partly based on a risk assessment. Despite my documented “risk factors”, I believe this is a low-risk pregnancy and birth, and going to a hospital (again, in the absence of a good medical reason) would actually increase our risk of infection and unnecessary interventions.

Overall, I am feeling relieved to still be clear for a homebirth, although wary and a little defensive about losing the opportunity. I’m also very glad to have an awesome doula lined up to provide non-medical support. I’m fortunate that Z is pretty sensible about all this stuff, although he does think I’m nuts to be upset about being on the clock for cervical dilation. Thank goodness we took a comprehensive childbirth class together, so he is reasonably well informed about best practices and options. One of the lessons from our childbirth classes were that the birth partner is the best advocate and spokesperson for the family. (I’ll be busy, and it’s not the doula’s role.) I still need to think about how to best prepare him to speak on my behalf about issues that might come up.

At 37 weeks (8 days and one midwife appointment from now) I will theoretically be clear for a homebirth at any time this baby feels like showing up. First babies do not tend to be early, and this one has shown absolutely no signs of being in a hurry to arrive, but he may find himself encouraged to depart earlier than he otherwise would have liked by evening primrose oil, acupuncture, and stretch and sweeps. As a general principle, I would prefer to leave my baby alone until he’s ready to be born, or at least until 42 weeks. However, given the risks presented either by actual macrosomia or by decreased support for a low-intervention birth due to presumed macrosomia (I don’t know which stresses me out more) I am feeling conflicted about hurrying him out. Baby, it would be really helpful if you could just be ready to be born on your own steam around 38.5 weeks, OK?

TL:DR – It’s very nearly time to start collecting waterproof sheets, Gravol and secondhand towels. Yay?

33 weeks: Nesting, Exhaustion, All is Well

I have been such a naughty blogger. Haven’t been writing, haven’t been taking belly pictures. Naughty!

Alas, I’ve been kind of knackered. I had three (count’em) colds, one after another, stretching out over two snot-encrusted months. It would appear that I have no immune system at all. I’m also just plain tired. Walking is far, stairs are tall, bags are heavy. One theory is that I may have developed anemia: the midwives have me taking iron supplements for the next few weeks, then a blood test will reveal how I’m doing.

But, really, in the realm of important things, all is well. The kid is enormous (or feels that way to me) and is vigourous, flippy and full of kicks and pokes. He is positioned incorrectly (as indicated by the bony skull pushing into my ribs), but at 33 weeks tomorrow he still has lots of time to turn. I’m going to see an acupuncturist tomorrow to see if she can convince him to get head down. I wonder if that might be more comfortable as well as more conducive to easy birthing, but won’t get my hopes up about comfort.

A random image from Christmas day by the ocean.

After the Christmas holidays, I’m back to work until 39 weeks (or that’s the plan). The very thought of going downtown and working 8.5 hours every day for 6 more weeks is so exhausting that I’m trying to get lots of nesting done in the next few days here. Z is painting the kid’s room, because it had lots of holes in the walls. Today, we did a big shop, picking up all kinds of baby miscellany like a change table topper, diaper bag and swaddling blankets.

Then, the day after tomorrow, we’re going on a road trip to collect hand-me-down clothes from some friends in another city. I’m hopeful that between the clothes their little girls have outgrown, and the stuff we already have, we can be officially set for clothes for the first six months. Then, we just have a few more things to fix and organize in the kid’s room, and we need to put together a functional guest room space in the basement or attic for when grandma comes to visit after he is born.

Just twoish months left! When I feel like an old, old woman huffing and puffing my way down the sidewalk, I remember that one day I will go running again, sleep on my stomach and be strong enough to carry this little kid around all over town.

Fingers Crossed

Stick, baby, stick!

 

 

 

 

 

 

 

 

 

 

 

 

 

(cramp, cramp, cramp.)

“Preconception” Doctor’s Appointment

My “pre-conception” doctor’s appointment was on Saturday, and I’m so glad I went! First of all, the doctor was awesome, and now I have a real “family doctor”, hopefully for many years to come.

The doctor ordered a ton of “preconception” tests, including tests for anaemia, thyroid function, UTIs and a host of STIs. Apparently it’s much easier to test and treat a these things if you’re not already pregnant when you first go see the doctor.

Then she gave me an extremely low-quality photocopy of an information sheet about pregnancy and babies. It’s everything you need to know about conception, pregnancy, childbirth and breastfeeding on one side of a piece of paper that has been faxed and photocopied about a million times. A quarter of the paper deals with nausea and vomiting. It also includes a fuzzy drawing of an enormous pregnant woman doing water aerobics. You can tell right away that this journey is going to be a lot of fun.

The doctor also told me sternly that 30 was good time to be trying (subtext: you’re getting kind of old) and to switch to prenatal vitamins right away, on my third-last cycle before we start trying.

Internet, I am so excited to be taking prenatal vitamins, even though they taste like a blend of rotting fish and potpourri. It’s like we’re actually almost there.

Body and Soul

We need to work our muscles over here. Days filled with blogging, studying and riding the bus (in my case) or working at a desk, reading books and playing video games (in Z’s case) don’t seem to be maximizing our physical fitness. Who knew? Without putting too fine a point on it, we could both stand to sweat more.

My favourite way to get exercise is as a side effect of daily life. Using a bicycle for transportation is the optimal solution- taking the stairs and walking to get groceries also do the trick. But in the neverending rain it’s harder to get excited about an hour-long bike ride to school and last winter sometimes weeks went by where I take the bus to school. For Z it’s even harder to incorporate physical activity into his day – he works from home, so there’s nowhere to walk to on a daily basis.

So! There’s this beginners’ triathlon in a small town a few hours from here that happens every summer. Z signed up to do it with a group of friends one year, and ended up wanking on it for one reason or another. (Haha, spell-check doesn’t recognize “wanking.” Or wank, for that matter. Wanky!)

Ahem.

Then, this past summer, he and a friend decided to do it together. His friend bailed after a few months of training, and he sort of gave up.

Right now, my boy is in probably the worst shape of his life and feels bad about himself. I would dearly love to help him out. Partly self interest, of course – he is beautiful now, but damn, he’d be hot if he lost a few pounds. We could eat better, of course, but I think the big ticket for him is more exercise. He’s built to climb mountains and lift heavy things, not sit and type all day.

As for me – I’m lucky enough to be a tense little person with a high metabolism. I’m not overweight. But I do have a soft little belly and I should have way more strength and stamina for things like biking up big hills. My doctor, in one of her moments of actually discussing my health with me, mentioned that physical exercise would be really good for my anxiety, which can get pretty crippling. Finally, as I keep relentlessly mentioning in this blog, we hope to have a baybee in the next few years, and if all goes well, I will be needing to push said human being *out of my hoohaw*. I understand that being in shape is a good idea for that sort of endeavour.

So – should I tell him I want to do this triathlon with him next summer? It’s not a real triathlon, but a shorter version for beginners. As part of our training, Z would have to teach me to swim pretty much from scratch – no way in hell I could swim 500 meters or whatever it is at the present, even to save my life. We’d need to set up a training schedule and be committed about it – limited flexibility.

If I mention it, I’m 90% sure he’ll be in. I’ll also have to be 100% committed myself, and can be pretty sure that at some point I will wish I’d never even thought of it. He’s bailed and been bailed on in the past – so if I so much as say I’m interested to him, I have to mean it. Even though next summer is going to be when my final project for school is wrapping up, and HELLO ANXIETY!

I’m going to think about this for a week or two, then once classes are underway for the winter and I’m good and stressed out, I’ll check if the idea is still palatable. Helping Z get in shape is a noble goal, but for this to be a success, I’d have to want it for myself.