Postpartum Diary: Pamela & Simon @ 6 weeks

Simon is six weeks old. Not sure how that happened, but we’ve been taking it one day at a time.

Postpartum care has been more difficult this time for me, maybe because I have two kids already or maybe because it was a birth followed directly by the holidays with family in town. It’s been difficult to keep track of everything.

The first week or two after Simon was born I kept myself to the couch and spent all my time nursing, sleeping, and taking my regimen of postpartum supplements.  As difficult as it is to sit still for me, my midwife reminded me that I am working on life-long health and healing so she told me to work hard at being “the most bored I’ve ever been in my life.”

As far as my gestational diabetes, Simon’s blood sugar was fine at birth, and I’m finding as long as I eat a diet similar to what I ate while I was pregnant, I feel great. I have a follow up glucose screen scheduled in March.

The uterine contractions while nursing were the most intense cramps I have ever had, worse so this time as it was my third, and I alternated ibuprofen, Tylenol, arnica (for bruising), and After-Ease tincture. Even though I had no tearing or abrasions, the internal bruising from delivering a posterior baby was severe, so the morning after Simon’s birth Thad drove us to Dr. Michelle, the amazing chiropractor, for adjustments.  It took about three weeks for my sacrum to stop throbbing. With regular adjustments and careful sitting positions, I did my best to keep myself comfortable, especially with all the nursing.

At her postpartum visit, my doula checked me for diastasis recti, something no one has ever done for me before. It was very weird. I lay down flat on the couch, she put her fingers across my belly, and had me lift only my head to look at my feet. As I did that, she could feel where my abdominal muscles separated – luckily it was only about three fingers wide. She recommended looking up Julie Tupler and her famous Tupler Technique ™ to learn more. After reading their website, I found that the abdominal problems I had after Dash were due to this separation, and I had never known. I bought the DVD, booklet, and splint and started the program this past Sunday. Hopefully, this will encourage healing and prevent any further injury. This is really important for mothers to look for and fix – the separation can cause so many problems with your back and your core, especially if you have had multiple pregnancies. This isn’t generally an area of focus in postpartum care, so it’s extra important for you to educate yourself. In fact, no one has ever brought this up to me before my trainer, with whom I worked during my pregnancy with Simon.

Simon is doing great. He is growing like a weed and by his 11th day had already surpassed his birth weight. Nursing has been the area in which I’ve felt the most comfortable, and I feel that we had a very good rhythm from the get go. Luckily, my milk came in on day 2, and we’ve been going strong ever since.

We decided to do vitamin K drops with Simon, as opposed to our first two where we did the shot. After researching our options this time around we felt the drops would be sufficient. I’m also taking alfalfa, which increases the amount of Vitamin K in my milk which he then gets.   The state of Virginia required blood screenings – we never received any results, but from what we’ve been told, no news is good news.

At six weeks, physically I feel pretty good. My bleeding has stopped, started, and stopped again, and I’ve been using it as my measurement for how much I should be doing. With three kids and a household to run, needless to say, there is plenty to do, but luckily my husband has been on paternity leave up to now (yes, I know how lucky I am), so he has been helping tremendously with the older boys and general house chores. In fact, he is transcribing this entry for me as I nurse Simon.

Emotionally, for the first two weeks of Simon’s life I had more intense baby blues than I have had in either of the prior births. I have had an unexpected experience this time, however, with a lot of irrational anxieties and uncontrollable weepiness. At about four weeks postpartum, it occurred to me that I may be experiencing some symptoms of postpartum depression, such as lack of desire to do things that used to make me happy, being anxious and worrisome, trouble sleeping, wanting to be alone, withdrawing from friends, and feeling guilty. Normally, I’m a very social person, but these past few weeks, I’ve found it difficult to see anyone outside my nuclear family, but have been ‘forcing it’ to make sure the boys get some social time.   Thad’s sister and her husband were visiting for five weeks throughout this time and I don’t know if that had an impact on me, but I am grateful that they were here to spend time with the boys while I was recovering.

Last year, I attended a conference thrown by Postpartum Virginia on perinatal anxiety disorders at INOVA Fairfax Hospital. I went wearing my hat as the founder of Mothers Healing Together to find ways to help my mothers better, and I never thought I would be sitting here using the things I learned there to help myself instead.

I’ve been trying to do all of the things the experts say to do when battling postpartum depression – extra rest, eating a healthy diet, taking breaks from Simon when needed (his presence, luckily, is not difficult for me like it is for some moms), and frankly, giving myself a break. It’s too easy in these postpartum days to let your hormones drive your thoughts, and I’ve been trying hard to stay rational and objective.

I am planning on going to a Postpartum Virginia support group tomorrow at the hospital to listen to other women’s stories and hopefully better understand what is going on. I had no idea this affects more than 20% of mothers and I hope they are finding the help they need too.  Having never battled clinical depression before, this is uncharted territory for me and I keep getting frustrated that I can’t ‘turn off my brain’. Self-talk doesn’t necessarily help, and talking to friends who know me doesn’t help, but hopefully hearing the stories of women who have been in my shoes will. I’ll report back.

So this is where we are.  Thad goes back to work full-time on Monday and I am looking forward to getting into a routine with the boys.  We are enjoying these last few days of his paternity leave together and hopefully we’ll slide into a nice family routine as we navigate these crazy days with a newborn.

Great Expectations: Pamela’s Birth Story

39 weeks and 4 days.  I had what I think was my first contraction around 7:15am while I was cuddling in bed with my boys.  I didn’t necessarily believe it was a contraction since up to this point I had had three nights of contractions that went from about 2am until 3am and then stopped.  The day before I went into labor I felt terrible; my body ached, I was in a tough place emotionally, and I truly thought I was going to be pregnant forever.  After I got out of bed I went about my morning trying to keep time on my contractions.  I called Thad around 8am and told him I had a few contractions but I couldn’t keep track of their pattern; they were somewhere between 10-15 minutes apart but not consistent.  He said he was going to leave the office right away but I told him I wasn’t sure if this was it.  He said he’d rather be home than miss anything so he came home.  I was standing in my kitchen trying to keep track of my contractions by my last made calls/texts to my husband, doula, and midwife.  By 8:45am my husband came home and he asked his mom to stay home in case she needed to take the boys out of the house.  I remember walking to the bathroom (I was making very frequent trips to the bathroom that morning which was a good indicator that I was truly in labor) around 9am and had to hang on to my dresser to get through a contraction.  My midwife, Marilee, called to check on me and said she was on her way and my doula texted me to tell her when we needed her help.  Around 9:30am my friend, Amanda, came by to pick up the cookies for our cookie exchange that morning and my mother-in-law was getting the boys and dog into the car and I had a long, intense contraction that had me on my knees hanging on to the banister with tears in my eyes.  Active labor began!  Dash, my younger son, was very concerned seeing me in pain and I was grateful that they would not be there for labor despite my initial wants of having them in the house for labor and/or the birth.  I wouldn’t have been able to concentrate on labor if they were there.  I remember Marilee walking into the house while I was groaning through a contraction and I heard her say, “Those are good sounds,” and it finally occurred to me that this kid was going to be born that day.  It was around 9:45am.

I made it downstairs in between contractions to see Thad busy at work filling the aqua doula (birth pool), Marilee setting up supplies, and I helped by setting up my iPod for music (I will post my labor/birth playlist soon) and setting up my diffuser (I used doTerra’s Balance blend for grounding).  I was having a hard time getting comfortable through contractions because I couldn’t quite tell where I was having pressure.  Was the pressure on my bottom or my perineum or my back? I couldn’t tell, so I couldn’t figure out what position to be in for maximum comfort as I worked through my contractions.  All I knew was that I did not want to be standing up, so I tried being on all fours (which was tolerable) or sitting on the toilet and/or the birthing stool (which was more tolerable but not perfect).  I even tried hanging off the corner of my sectional but it was not quite right.  My doula, Mary Beth, arrived around 10:15am and she jumped right in and helped ground me through my contractions.  She helped me relax and used essential oils (we used Iris Oils 4 pack for childbirth) for scent and massage.  Thad sat behind me to hold my shoulders down during contractions (so I wouldn’t tense up) and Mary Beth sat in front of me between my legs.  They took turns feeding me pineapple and/or pomegranate seeds and giving me sips of water to keep me hydrated.  I felt encapsulated in love.

Around 10:45am after I went to the bathroom I stood there crying.  In pain, I cried worrying about whether or not my son would love me.  In retrospect, I realize this irrational worry was a sign of transition, and apparently so did everyone in the room because Marilee, Thad, and Mary Beth held me in the bathroom as I cried.  When I got out of the bathroom I complained that I couldn’t get into a comfortable position and Marilee wisely suggested the aqua doula.

Once I lowered myself into the pool I had instant relief.  I can’t believe I didn’t have a pool with all my babies!  The water was warm, soothing, and I instantly felt like it lifted everywhere I was feeling pressure. The counter-pressure was so helpful in managing the pain, it was just amazing. We labored in the pool as the contractions became stronger – at this point I was still able to talk or joke a bit between them; I distinctly remember joking with the birth team over my husband’s dismay when Celine Dion came on the playlist.

The period for talking soon ended – the break between contractions was shortening and the contractions themselves were getting much stronger. I remember asking Marilee why I wasn’t getting a break, and what I should be doing, and she kept saying, “You’re doing it.” Sometime around noon I was really working hard – I remember feeling tired for the first time, and concerned about how long the labor would take – would I still have the energy to push effectively at the end? Mary Beth kept me hydrated with water and Gatorade, and I continually sought positions that would relieve pressure from my back. I remember leaning back with my husband’s hand supporting my back, leaning back in an almost hurdler pose with one leg extended, squatting upright and swirling my hips, and finally shifting to all fours in the pool, which would become my final birthing position.

At one point well into active labor, I asked if there was anything for pain relief, and after a brief silence, Marilee replied “You’re sitting in it.”

In retrospect, now I know the various positions and movements were all what Simon needed me to do to safely enter the world. While I was deep in active labor, I had to release the negative thoughts that spun through my head. I questioned whether I had done enough. I had thoughts of being ill prepared, of his size, of my abilities to actually get him out, of possible rupture, and I realized I was at a point of no return, and in releasing those thoughts, I started to unintentionally push. My midwife does not normally dictate pushing; she allows the body to do what it needs to do. With Dash’s birth, she told me when to push because she saw that I was getting tired and needed to help me focus. This time, my body just did what it needed to do, and unbeknownst to both my husband and me, I was pushing.

I noticed Marilee was behind me by the pool, and Leigh Ann (her assistant) was holding tools of some sort. I had no concept of time at this point – I don’t know exactly when I began to push, or for how long I pushed. I don’t know if it’s because I was in the water, or because the bag of waters was intact, but I had no idea how close he was to being born. I remember Mary Beth asking my midwife if she “catches in the water,” (she does) and it hit me that we were going to meet him soon. It’s a crime that in some places women have to get out of the tub to deliver – I can’t imagine how hard that must be.

My groans became grunts, and bearing down with each contraction became instinctive. Whatever people say, you truly poop a baby out. The sensation is low and deep, and no other sensation can be compared to it other than pooping.

Thad was in front of me, supporting my weight and helping me focus. His strength and faith in me took away any fear I had in pushing. It started to burn up towards my clitoris, and I still had no idea where he was. My midwife never told me how much she could see, but in watching the birth video, he was beginning to crown. My midwife put her hands on me to help guide him out, and when she touched me, I was afraid that I was going to suck him back up into my body. When I watched the video and saw the moment she touched me, I didn’t realize just how close he was to being born.

I was pushing and Marilee told me that my bag of waters was intact, that there was a lot of vernix in there, and that his head was almost out. Thad told me that the time to slow down (to prevent tearing) was coming, but all I could feel was pressure and stretching – I didn’t realize his head was already out. It took my doula and husband telling me that his head was out before I grasped, emotionally and physically, that he was about to be born. My sac was still intact at this point and Marilee asked if I wanted her to puncture it – I told her to do whatever would relieve some pressure. On his way out, she made a small puncture to help him glide out.  I don’t know if other women who birth in water have felt the same way, but I truly had no idea how much he was out at each contraction.

While waiting for the next contraction, I felt stretched to the absolute max, and Thad and I maintained steady eye contact to help me stay open. It was during the next contraction that he was born – I was still bearing down and pushing when I heard Marilee say, “He’s out – reach down and take your baby – be careful, his cord is short.” I couldn’t believe that I was actually pulling him to my chest. I rested him on my breast, he let out a cry, and the flood of emotions completely overwhelmed me. What broke my trance was Marilee saying to me, “You just birthed a direct OP baby.” For those of you who don’t know what that means, he was posterior, sunny side up, and he came out gently, which is extremely unusual for babies in that position. In fact, part of the reason why Julian was born by cesarean is because he was posterior.  Despite all the work I was doing to get him into optimum birthing position, I think his short cord was the reason he kept spinning into posterior. It just goes to show you, babies have their own plans.

Once he was born, we completed all the particulars – getting out of the pool, cutting the cord, prenatal exam, passing the placenta (which took about 45-50 minutes), and of course ordering some pizza. The entire birth team was in high spirits, the sun was still up, and they would be home in time to have dinner with their families – Simon Edgar Winston Lurie was born at 1:06pm. He was 7 lbs. 5 oz. and 21 inches long.  ”Edgar” is for my father.  Simon was born on the 11th anniversary of his passing, which was also our original due date.  I couldn’t think of a better way to honor my father.  ”Winston” is our street name since he was born in our family room. 

We had the obligatory family text and Facebook post, and by 4pm it was just the three of us, snuggling on the couch and soaking up every moment of our perfect birth and perfect son.  By 4:30pm the boys came bounding into the house to meet their new brother.  The postpartum period has been an emotional roller coaster and I will use my next post to talk more to postpartum care and healing.  For now, I will return my arms to my little 3-week old babe waiting for mama’s milk and snuggles.  Life is good.

Great Expectations: Pamela @ 38 weeks

Words to describe this stage in pregnancy:  Uncomfortable. Waddle. Sleepless. Cranky. Blessed.

Being 38 weeks pregnant with two little children to care for as well as the holidays to deal with has been overwhelming, but at the same time it’s a blessing to make it this far into a pregnancy when I know a lot of women who were unable to make it this far for a variety of reasons. Despite the sleepless nights (which I truly believe are preparing me for newborn hours) and a very sore body, I am trying my hardest to enjoy these final days of pregnancy.  At this point in our lives and our family, we are not planning on having any more children so the thought of these being my final days of ever being pregnant, of feeling a life inside me and knowing the miracle it has been to get him here, are important for me to cherish.

I am less fearful of the process of childbirth after meditating on my last birth and watching some beautiful natural births online through the Peaceful Birth Project.  Today I met a woman who was served by my same midwife for both of her births.  In her second birth, her labor started and stopped multiple times, enough that my midwife had come and set up her supplies each time.  When her daughter was finally born she was born with her cord wrapped around her neck, arm, and torso.  My midwife’s response to the birth was that the baby was just doing what she had to do to come out safely.   This phrase is so profound because my midwife truly believes in the power of a woman’s body as well as trusts in the process of birth and babies.  While she monitors and makes sure everyone is safe and healthy, she does so without undermining the power of a woman’s body.  Knowing my midwife has my back makes a world of difference for me and feeling prepared to go into labor.  I only wish that all pregnant women can feel this supported.

Most recent family picture, all 4.9 of us.

Selfishly, today I got excited thinking that within weeks I’ll hopefully be able to fit into something non-maternity, even if it may not be pretty.  I also got excited about not having to track everything I eat, even though I plan on maintaining my similar diet post-pregnancy because of how good it has made me feel.  What are another two to four weeks of pregnant bliss after 38 weeks?  It is funny, too, seeing the look on people’s faces when they ask when I’m due and I say, “any time now,” and they don’t know how to respond to me.  Some people back away, some people want to offer me a chair.  Often times lately I’ve been getting the empathizing look from other women who know just how uncomfortable it is to be 38 weeks pregnant.

Birth supplies are stacked in boxes in my living room, essential oils for birth and postpartum are ordered, and my birth pool is literally in front of me waiting to be assembled.  After this, almost everything on my to-do list is done and we will be on cruise control waiting for this little peanut to make his grand entrance.  With any luck, my 40 week update will be an announcement of his arrival.  To everyone also in their final weeks of pregnancy, how are you keeping distracted from the biggest test of patience of your life?

Great Expectations: Pamela @ 36 weeks

9 months!!  As my midwife told me during our Wednesday appointment, I just have to get through November 30th and then I will be in my ‘safe window of birth.’  I hope we can hang in there because at this point, I really don’t think the baby can get any lower without falling as the downward pressure is quite intense.  My midwife was having a hard time measuring my fundal height because his head is already tucked so nicely into my pubic bone.   In the past ten days I have had two separate episodes of strong contractions (three in an hour) that were strong enough to stop me in my tracks and force me to lay down and see if they would stop.  They obviously did but the episodes were enough to remind me that I can’t keep going at the pace I’ve been going if I want to keep this baby cooking for a little bit longer.  I’ve returned to napping when the boys nap in the afternoons and have slowly cleared my calendar so we can slide into these final weeks with less stress and activity.

One recurring issue I’ve had throughout this pregnancy are my hips and muscles and the thought of being able to roll over without fear of tweaking my hip sounds divine.  My trainer and I have been working together each week to strengthen my supportive muscles without straining my abdominals, but unfortunately I can’t say that we’ve been totally successful.  Between the exercises both my trainer and my chiropractor give me to help with hip and lower back pain, I’m uncomfortable probably 50-75% of the time, especially after sitting on a hard surface.  Even though I have very minimal abdominal separation, or diastasis recti, I am not doing any direct abdominal strengthening and focusing on my back, glutes, and legs for strengthening.  As a former triathlete, I know the importance of a strong core and where I always thought I needed strong abdominals, the further along in my pregnancy shows me how important strong gluteus muscles are for support and balance.  So ladies, work on those buns of steel BEFORE you get pregnant if it means being more comfortable the bigger you get!

An impromptu tummy pic taken by my hubby

Each chiropractic adjustment I have my right hip is way higher than my left and the mobility of my right leg is quite limited.  I’ve been working on keeping my hips loose (through pelvic tilts, pelvic rolls on a yoga ball, and squatting) but what I keep thinking is my hips that hurt are actually my gluteus muscles!  Here’s what’s happening:  my sacrum is tilted due to the weight of my belly.  Due to my sacrum’s tilt, the nerves for my gluteus Maximus muscles are not firing thus preventing my gluteus Maximus muscles from doing their job of stabilizing me the larger I get.  Instead, my gluteus medius muscles (which are meant for more lateral movement stability rather than forward/backward stabilization) are overworked and sore.  When my massage therapist or chiropractor gets their hands on my gluteus muscles, a light rub down makes me sweat with pain but it is SO relieving!  On the front side of my body, because my abdominal muscles are compromised and stretched, my psoas muscles are overcompensating and also getting sore.  I thought I was in tune with my body before I had children through sports training and yoga, but pregnancy has certainly given me more knowledge of my body than I ever thought was possible.

Tied in with being hyper aware of my body, the other thing that’s been on my mind is postpartum recovery.  Seeing all these babies being born around me these past few months and seeing the mothers’ recoveries continues to remind me that there is indeed life postpartum, no matter how far away it feels right now.  As my friend reminded me recently, a big part of why we choose unmedicated, natural childbirth is that recovery is supposed to be much easier on the body.  My recovery plan right now includes a hefty box of perineal ice packs, postpartum herbal supplements to manage uterine contractions and pain, abdominal wrapping, and placental encapsulation.  I am also tapping an army of people to help with house duties and childcare so I can spend at least my first two weeks postpartum literally sitting on my bum and bonding with my new baby.  I did not ingest my placenta after either of my boys but this time around I’ve heard so many wonderful things about the benefits of placenta encapsulation, I figured I might as well try it.  I also love the idea of saving some capsules for menopause to use them for my own hormonal replacement if I need it.  I’ll let you know how that experiment goes.

My next prenatal appointment is set for my 37 week mark this coming Friday, the 30th.  Each day seems like an eternity until I will meet our baby but at the same time as I reflect upon the past 8 months, it only feels like yesterday when we discovered our little bundle.  All the body pains, blood sugar drama, and emotional downs will all be worth it when we have our baby in our arms.  I’d like to thank Giving Birth with Confidence for allowing me to share my journey with you.  Only a few more weeks to go!!

Great Expectations: Pamela @ 34 weeks

A quick picture with our very own super heroes before trick or treating. My waddle could barely keep up with my 4 year old’s sprinting between houses.

Since my last entry, three of my friends have had babies.  My first friend was 41 weeks and 1 day pregnant with her third child.  From first contraction to birth of her daughter was 30 minutes.  All of her labor and deliveries were super-fast, so this was not totally unexpected for her and her husband, but wow.  Baby came fast!!   My second friend was 38 weeks and 5 days pregnant with her third child.  Her birth began with trickling amniotic fluid and ended almost 21 hours later with the birth of her son with a little hand up next to his cheek.  All her births lasted varying lengths of time but each was entirely memorable in their own way.  As impatient as she seemed when she was hours into her labor, she remained strong and positive and once her little dude got into position, it wasn’t long until he was in her arms.  My third friend was 39 weeks and 1 day pregnant with her first child.   She was induced due to a genetic issue and from what I’ve heard the induction went smoothly and her little girl was born a little bit before noon yesterday.  I’d like to give these brave, strong mamas a HUGE hug for all their strength and patience to grow a baby over 9 months, prepare for his or her arrival, and then labor them into their arms.  Despite being pregnant with my third, I am still in awe in the power of our bodies and what we can accomplish.  These women give me power and inspiration as I prepare for our own arrival in a few weeks.

I’ve been chugging along over here pretty well, I suppose.  The hurricane brought historically low pressure and an emotional downslide that lasted until I saw the sun again.  I have been on insulin now for a week and haven’t seen a huge impact on my blood sugar numbers but at the same time, it *was* just Halloween and I may have taken some candy from my kids’ buckets.  I am feeling confident that I can do what I need to do for the next 4-8 weeks to have a healthy me and a healthy baby, but it’s not easy.  When I first started the insulin I felt like I had failed in my care; how could I become dependent on this outside “thing” to be healthy?  The more I’ve read, though, and the more I learn about diabetes in general, I know that what I am doing is best for me and baby so I am at peace with it now.

As we round our final weeks as a family of four, we decided to take the boys out of preschool and spend the time together enjoying the holidays before the chaos of a newborn.  Thad’s family is arriving for the holidays, too, so I am hoping to spend the next week or so getting the baby’s room ready so I can focus the rest of my time until the birth on my boys and nurturing our relationship.   Tomorrow my husband and mother in law are painting the baby’s room so I can finally start bringing up the baby stuff from storage and prepare his things.

A big part of our preparation has been to talk with the boys about baby brother’s arrival and how things will change around here.  Our favorite books are We’re Having a Home Birth by Kelly Mochel, and Baby on the Way by Dr. Sears.  We tailor the stories to our family and our plans and the boys love reading them.  It has made Julian very excited about Baby-San’s arrival and he has told me that he wants to rub my back when I am in labor and he hopes I ‘squat and make sounds like an elephant’ when he is born.  Dash is looking forward to making the birthday cake with the grandmothers.  Preparing the boys for the birth and seeing their excitement about our growing family makes me excited to see how these brothers will grow up together.  I’ve deliberately been telling the boys that after baby brother is born mommy is going to need to rest and recover.  When Dash was born we didn’t quite know how recovery was going to be since it was my first vaginal birth and I wish I had prepared Julian more for how my recovery was going to be.

I was telling my trainer today that I’m at a point now where my focus has shifted to the postpartum period.  Sure, I am doing everything I can to be healthy but I have my routine now with my care and whether I’m ready or not, eventually I will go into labor.  After the birth, however it may be, we will have a little helpless baby to care for.   All I’ve been able to think about this week are the first few weeks of life with a newborn.  For those of preparing for a baby, regardless of how far along you are, where is your brain?  I’d love to hear where you are right now.

Great Expectations: Pamela @ 32 weeks

What a change these past two weeks have been from the previous two.  After an upsetting prenatal appointment at 29 weeks I had a lot of homework to do which did a LOT of good both emotionally and physically.  I went to see a certified dietician and she gave me a breakdown of how much I should be eating per day. It was an excellent reminder of ways I could make my diet friendly again.  I was so anxious about what I could eat that food became stressful and my dietician helped put food in perspective.  I have been staying as active as possible, walking and seeing my trainer, as well as chasing the boys around umpteen pumpkin patches.  I also started taking a Vitamin D supplement, and between that and everything else I’ve been doing, my blood sugar numbers have been outstanding.  I hope that my endocrinologist will agree at my follow-up appointment tomorrow.

Physically, I was really sore after an ambitious workout with my trainer as I am dealing with a recurring issue with my hip flexors and psoas.  After an amazing massage with my therapist, nightly stretching, and a very kind husband giving me massages, I am feeling MUCH better.  I also am enjoying the cooler weather so I can get out more often for walks without melting.

Since I feel as though I have a much better handle on my blood sugar issues, I’ve been spending more time thinking about optimum fetal positioning.  With about eight weeks to go, I still have time to help encourage this kid to be in good position for birth.  I started going back to ICAN (International Cesarean Awareness Network) meetings as I did after Julian’s birth so to remind me from where I came and how I can avoid a repeat cesarean.  Despite having had a successful home birth after cesarean (HBAC), I will always be considered a VBAC mother with subsequent births and the fear and anxiety over having a repeat cesarean will always be there for me.  With Julian, our birth was induced due to preeclampsia one day before my due date.  They ‘started’ labor for me by breaking my bag of waters and looking back, I would have asked for any other way to induce labor other than this way because I believe it was one of the major reasons why I ended up with a cesarean section.  Once your water is broken the baby is much less likely to get into a better position and in our case, Julian was posterior as well as asynclitic.  With the amniotic fluid leaking out, he couldn’t get into a better position.  If you are unfamiliar with the website Spinning Babies, I highly recommend it.  It is an amazing reference for all things regarding baby positioning, which is one of the major causes for cesarean sections. 

Julian’s labor was one of the toughest things I’ve ever had to do.  I’ve climbed fourteen-thousand foot mountains and completed half-iron distance triathlons and those physical feats were nothing compared to what labor demanded from me.  Anyone who has experienced back labor due to a posterior baby will tell you just how excruciating it is.  When they broke my meconium-stained water nothing happened (common for a posterior baby) and my labor was eventually augmented through Pitocin.  Let me tell you, Pitocin-induced contractions without an epidural is the worst pain I’ve ever experienced.   After hours of erratic contractions (almost 15 hours total) I relented and got the epidural that I never wanted to get in the first place.

For the record, I do not have anything against epidurals and cesarean sections because they do have a place in childbirth.  I do believe, however, that they are often used unnecessarily in what could be seemingly normal labors and births.

By the time we got to full dilation (almost 28 hours after my water was broken) the anterior lip of my cervix would not retract.  The nurse was trying to hold it out of the way while I pushed but he still would not come down.  Looking back, we know that his head was holding my cervix in place because of his position.  When we went to the cesarean (33 hours after my water was broken) and they discovered not only his poor positioning but also that his cord was wrapped twice around his neck, I had mixed emotions. Cord wrapping is actually very common in babies but in our case could have been part of why he would not descend.  Incidentally, Dash’s cord was wrapped around his neck when he came out but my midwife was able to unwrap it as he slid out and it was not an issue.

If I could go back in time, what would I change about my birth experience with Julian?  I would start by not letting them break my water.  I also would have tried harder before his birth to help encourage him into a better position.  Would those changes have helped me avoid a c-section?  I don’t know, but at least I could have done more to encourage him.   Having learned many lessons from Julian’s birth, as my pregnancy with Dash progressed I was obsessed with encouraging optimal fetal positioning.  I saw my chiropractor more often, I almost never reclined or sat back, and I used my exercise ball daily, among many other things.  I wholeheartedly believe that if Julian had been in a better position, I would have been able to birth him vaginally.  I do not feel as though his size (8 lbs 13 oz) was the reason he could not get into a better position, although having a smaller baby with Dash certainly helped (6 lbs 11 oz).  This time around, with my blood sugar under more control and my growth slowing down in general, I feel confident that this baby is going to be a good size for me to push out.  It’s all about his positioning now.

If there is anything that I’ve learned since Julian’s birth it’s that we have the power to influence our births, especially if we take the time to learn about potential issues beforehand.  Do I know for sure the work that I am doing to encourage this kid to get into a good head-down position is going to work?  I don’t but at least I know that I am doing everything possible to help.  As of right now, he is head-down and anterior…let’s hope he stays that way!!

Great Expectations: Pamela @ 30 weeks

We went to the cabin this weekend with friends. Me and my hubs having a snuggly moment on the porch while the kids ran amok through the leaves.

My disclaimer for this post is that these may sound like the rants of a woman who is 30 weeks pregnant and is ready to be done now.  It just feels like I’ve been pregnant FOREVER and I still have 10 or so weeks to go.  At my 27 week appointment I was measuring exactly 27 so I felt like all this work of eating well and taking my blood sugars was paying off.  Unfortunately, at my 29 week appointment this past Friday it was a different story.  I measured at 32 and I had had a string of days of poor blood sugar readings.  My midwife was being supportive and helping me put together solutions for my care but I really broke down at the end of the appointment.
I was bitter.  I felt like I’ve had to fight for something every pregnancy and  I didn’t think it was fair.  I’m not trying to make myself a martyr here because honestly, we went into all of these pregnancies willingly and of course the result (our children) makes it all worth it.  The toll, however, on my emotions and my body has been difficult.  Since I got pregnant in September of 2007 with Julian, my body hasn’t really had a “break” and between pregnancies and nursing, it’s a wonder how this big ball of hormones sitting here typing right now hasn’t exploded.  During my appointment on Friday when I felt like everything I’ve been trying to do to have a healthy birth and a healthy baby were NOT working, I really lost it.  Pregnancy is hard enough but to add in feeling like my BODY wasn’t cooperating despite my attempts is so hard.
With Julian, I felt like we were fighting for a natural childbirth experience that just wasn’t in the cards.  Between having providers that weren’t entirely supportive of our birth plan, an induction due to pre-eclampsia, something over which I had no control, and ending in a surgical birth, it all took away the experience we dreamt of for 9 months.  With Dash, I fought for a vaginal birth after cesarean, almost every step of the way.  Between non-supportive providers and OBs who did not believe in my ability to birth vaginally, and all the work in getting him in a good position and growing him a healthy size, it was a lot of hard work that, fortunately, resulted in a birth experience that was healing and life-changing.  Now here we are again, fighting for a healthy baby and healthy mama after an official diagnosis this Tuesday of gestational diabetes.
For the women who have had easy pregnancies with no complications and for the women who have had easy labor and deliveries where your baby and body did everything they were supposed to do, I hope you know how easy you had it.  For those of us who have to work extra hard to have healthy babies and healthy births, all I can say is that I understand what you are going through or what you have gone through and I am giving you a virtual hug.  This pregnancy thing is not easy for everyone.
After my appointment on Friday my midwife and I made a plan together.  I would start chromium supplements daily and I would see a specialist to see if there is anything else I could do with my blood sugar issue.  Luckily I was able to get into an appointment with an endocrinologist this Tuesday and she gave me a very objective look at what’s going on with my body and where we can go from here.  Basically, I have to keep my blood sugars down.  I have to take my ketones every morning with a pee stick and this will measure if I am eating enough.  After looking at my food journal since August, my doctor did not feel that I am eating enough and that may be why it’s difficult to get good readings.  She could have fooled me with this revelation since I have gained 22 pounds since getting pregnant (which I feel is a lot but it’s still in a healthy range), but she’s the expert.  I have to take my blood sugar every morning fasting and then after every meal.  I have to walk everyday.  I have to see a Certified Diabetic Nutritionist to go through my food journal closer and see how I can tweak what I am eating to help my blood sugar readings.  After two weeks I am seeing them again and if I am keeping my numbers low enough, then we’ll go another two weeks.  If I have erratic and high readings then we may need to look at medication, which for pregnant women it means insulin.  Despite all this information being thrown at me on Tuesday, I actually feel better about things.  On Friday I felt like my body was failing me but now that I have met with my doctor and had things explained to me, at least I understand now what is going on and exactly what I need to do to help the situation.
My appointment with my doctor reminded me that there is life after birth.  In fact, birth is just the beginning and with a diagnosis like this for me AND for him, how I treat my body over the next 10 weeks can have a major impact not only on myself for the rest of my life, but also for him and his health.  This is MAJOR.  This is no longer about having ‘the perfect baby and perfect birth’ because truly, what does ‘perfect’ mean anyways?  What I am dealing with is a potentially life long struggle with diabetes for the both of us and I am going to do everything in my power to set both of us up for a healthy life after birth.
Last night I was a part of a panel to speak about natural childbirth and beyond for a local mother’s group.  I was there in the capacity of my birth trauma support group but since I was having a trying weekend in general it was really helpful to be there as a pregnant mama too.  It was helpful to hear stories and tips for other expectant mamas in how to have the pregnancy and birth they want.  Everything we talked about last night resonated with me and reminded me of why we (birth educators/doulas/activists) are all here.  One of the doulas on the panel ended the meeting with a most perfect phrase: it’s all about empowering women to make decisions they feel good about.  So that’s where I am.  As I sit here I feel empowered.  Before I was able to gather the appropriate information, I felt like I had a vague idea of what I was doing but now that I understand what is going on inside my body I feel more prepared to deal with this issue.  Together with my provider and my endocrinologist we have a plan of care in place that I feel very comfortable executing.  I feel armed with knowledge and support to be as healthy as I can be.

Great Expectations: Pamela @ 28 weeks

Third trimester!!  How quickly this pregnancy has gone…yeah right.  I had the sad realization the other day that I still have 12 weeks to go and I got very sad.  As much as I love the miracle of pregnancy and the arrival of a new baby at the end, I’m very ready to meet this little baby.

Update from my prenatal appointment last week:  I’m doing alright.  My blood pressure is normal and healthy.  I’ve gained four lbs in the last four weeks which my midwife assured me is very healthy at this point in my pregnancy.  With the blood sugar monitoring I am already doing, I decided to forgo the glucose tolerance test and am continuing with my diet and tracking.  So far, so good, although it has been interesting to see what kind of foods spike my blood sugar and what doesn’t.  What I’ve found is that if I eat a lot of protein with my carbs, my blood sugar tends to be in a safe and healthy range.  Unfortunately, though, I haven’t been able to keep my blood sugar consistently under my maximum number so tomorrow I am going to start taking chromium to help out.  I am hoping it makes a difference.

Family picture at a recent trip downtown

Over the past couple of weeks I have been a part of two situations that really bothered me and I want to get this off my chest.

Situation One:  There was another pregnant mama working out with a trainer at the same time as me up until a couple of weeks ago.  I hadn’t seen her so I asked her trainer about her to make sure she was okay.  She stopped working with the trainer about a week before her due date and up until that point she was doing really well just waiting for baby.  This was her first child.  Last week she was still pregnant and her OB wanted to induce her at about one week overdue but she declined because she didn’t feel it was necessary yet.  The trainers were discussing this with me and they couldn’t believe this mom wouldn’t take the induction because, really, who wants to be pregnant any longer than they should have.  Their reason she didn’t want to be induced – “she’s a first time mom, she doesn’t know any better.”  This week I found out that she *just* had her baby at almost two full weeks overdue and her baby was just barely over seven pounds.

Situation Two:  A friend of mine from my pre-baby life of racing triathlons asked me to join a Facebook group for women who used to race but now have babies or are pregnant and somehow trying to get racing back into our lives.  Fun premise for  a group but the execution of it, for me, was poor and I have since left the group.  This week a woman posted about how pro-induction (early) she is and how important medical interventions are to birth.  Other women started responding to this post about how grateful they were to be induced and they can’t imagine doing it another way, etc.  One woman went so far as to say that before we had OB-assisted births the death rate for newborns was 9 out of 10!
Here’s my beef.  It saddens me that women can look so disdainfully upon another woman’s birthing choices (in the first situation the mom’s decision not to be induced and in the second situation the audacity of women to choose differently from them).  We are so lucky to have the choices that we have as birthing women in this country and we are lucky to have the option of medical intervention if its necessary, or if a woman chooses it.  For the women on the FB group, I’m glad that their inductions and medical interventions worked out in their favor, but for anyone who has worked with healing women, this isn’t always the case.

Three years ago when I was pregnant with my second and people found out I was choosing an out of hospital birth for us, I had a lot of people question my sanity and the safety of our family.  I realized that people may not be informed of the birthing options that we have, so I educated as much as I could.  After everything went smoothly with our birth, the naysayers around me became believers.  It’s sad to me that it took a ‘perfect birth’ to prove that non-OB care can be safe as there are plenty of hospital births that aren’t so perfect.

This time around, maybe it’s because of the people around us, I do not feel that I have to defend my decision for another home birth.  When I am around women, though, who feel that their experiences were the ‘correct’ ones and anyone who choose differently were ‘incorrect’ I get very frustrated at the lack of support women are getting, especially if it is a difficult time for them.

As I’m writing this I didn’t mean for this post to become an ‘us-versus-them’ post.  I get so annoyed that despite that a woman has the right to choose her care, her choice is judged.  Ultimately, it is OUR choice to how we birth.  We should honor each other and that choice because this is the community – the women community – above all others that should stick together.

Great Expectations: Pamela @ 26 weeks

These past two weeks have been low for me.  Last week I was working with my trainer and I felt….big.  I felt bigger than big, actually, and after seeing a couple friends who are also pregnant and further along than me and I felt gargantuan next to them, I was concerned.  Rationally, I know that everyone carries babies differently, person to person and pregnancy to pregnancy, so it’s useless comparing tummy size during pregnancies because truly, we’re all different.  But something was nagging at the back of my mind so I decided to call my midwife to voice my concerns.

Leading up to my phone call, I had also been feeling out of breath.  Not just “winded” in an out-of-shape kind of way, but winded when I was reading books with the boys.  Winded from reading a book?  Come on, body, I’ve done a lot more strenuous things in my life and reading a book is far from the worst I’ve done.  I had also been feeling really crummy.  Not just “crummy” in a left-of-center-maybe-I-need-more-caffeine kind of way, but crummy enough to want to crawl into a hole and just sit there.  Alone.  A cold hole, hopefully somewhere in the Arctic Circle because I’m so tired of being hot.  Between feeling heavy and big and out of breath, I decided I had to talk to my midwife about all this to see what she thought.

The first question she asked me was, “are you taking your blood sugar?”  Backstory:  I did not have diagnosed gestational diabetes with either child however everyone in my family is diabetic so my potential to develop diabetes during pregnancy is higher than people without a family history.  Julian was a larger baby (8 lbs 13 oz) and with the difficulties I had with him during childirth, I knew the key to my vaginal birth after cesarean was to have a smaller baby.  With Daschel I did not have gestational diabetes despite having “failed” my two glucose tests because my blood sugar was completely controllable by diet.  With Daschel I took my blood sugar fasting as well as an hour after each meal, kept a food journal to see what spiked my blood sugar, cut out all carbs and refined sugars, as well as took chromium to improve my insulin action.  In the end, Daschel ended up being two pounds smaller than Julian (6 lbs 11 oz) and recovery was a million times easier after Daschel than it was with Julian on so many levels.  With this history, I know that I have to take care of my diet, resist the doughy carbs and ice cream, and be keenly aware of my blood sugar levels.

Me and the boys posing for an after-dinner picture

I wasn’t surprised that Marilee asked me about my blood sugar.  Truth be told, I hadn’t taken it as much as I should have and I was a bit too lax with my diet than I should have been.  After I told her my symptoms, she told me to do two things.  One, take chlorophyll supplementation to help possible anemia.  Being at about 25 weeks my blood volume is almost at its maximum for pregnancy (almost 50% more than a normal woman’s) so this is the point at which women start to show symptoms of anemia.  In case you’re wondering about the chlorophyll, it has very similar molecular structure to red blood cells so this can support blood oxygen levels as well as iron, if I’m not mistaken.  (Someone please check me on that).  Two, Marilee told me to take my blood sugar after every meal, keep a journal again, and take random fasting reads to make sure my fasting number is still in a safe range.

Wouldn’t you know it, within a week of doing all these things, as well as increasing my protein intake and removing the carbs and refined sugars, I am feeling AMAZING.  I feel like I can breathe again (well, as best as I can with a baby riding high in my belly), I feel more energetic, and best of all that weird crummy haze that has been over me has lifted.

What is empowering about everything that has happened over the past week or so is to know that I am in complete control over SOMETHING.  I may not have control over what color this baby’s hair is, or when he’ll actually be born, but I have complete control over how I care for my body.  Sure, it sucks not to be able to eat pizza or ice cream, but truthfully, I have the rest of my life to eat the bad stuff and only one shot to grow a healthy baby.  What makes me angry is when women are told that they have gestational diabetes and then doctors start scaring them with stories of large babies and c-sections.  If you have ever wondered about what you can do to take care of your diabetes and avoid possible interventions, ASK SOMEONE.  Ask your doctor if there is something you can do to take better care of yourself because the power may lie with YOU, not them.

True, if you’ve had gestational diabetes before the likelihood of you getting it with subsequent pregnancies is high.  But what is a few weeks of being hyper-vigilant about your care and diet if it means having a successful and happy birth resulting in a healthy baby?  I haven’t even taken my official glucose intolerance test yet but I’m not as worried about it anymore because I know what I have to do to have a healthy pregnancy and a healthy me.

I’ll worry about baby positioning next week…..

Great Expectations: Pamela @ 24 weeks

My brain is on overdrive from a crazy week and Thursday snuck up on me!   My oldest is attending a rock and roll camp all week so we’ve had to get out of the door every day by 8:30am.  It has killed naps and basically thrown our entire routine out the window and my husband is home sick to top it off.  It has not been a week where I’ve been able to focus much on my pregnancy but I’m trying.  I’ve been napping when the boys do, even if it’s very late in the day, and I got to the gym twice this week despite being extremely tired and hot.  My chicken wings and bubbly drink cravings haven’t been as strong and are slowly being replaced with a desire instead to eat a lot of protein.  Chicken, tuna, sausage, whatever I can get my hands on, really.  I don’t have as much of a craving for cheese and milk the way I did with Julian, but I wouldn’t mind a glass of chocolate milk now and then.  During my pregnancy with Dash all I can remember wanting is watermelon.  But then again, find me a woman pregnant in the summer who won’t eat an entire watermelon in one sitting and I’ll be impressed.  Really, I’m just glad not to crave bread anymore because I was very nervous I was going to go 40 weeks and eat nothing but bread, rolls, or pizza.  I know my midwife wouldn’t like that.

The boys start outside preschool for the first time next week and as nervous as I am about the whole transition, I am looking forward to having a day each week to focus on this baby and preparing for his arrival.  I’ve been trying to envision the birth, how it will look, who will be there, the environment, and how it will feel.  My birth team is pretty much assembled but my doula (who was at both Julian and Dash’s births) may be out of town for the holidays so that is a gap in my mental images.  Even if the birth doesn’t go exactly how I’ve imagined, I think it’s important to have these images reeling beforehand so I have something positive on which to meditate.

I am lucky to know at least five women who had babies this month of August.  None of them were first time mothers;  for some this was their second, for some this was their third.  Each birth was unique in their own right; one woman was induced, two of the women had planned c-sections due to their own physical situations.  One woman had planned a home birth with a midwife but due to unforeseen circumstances they transfered to a hospital and she had her vaginal birth after cesarean in a room filled with her husband, a doctor, a nurse, her midwife, the midwife’s assistant, and her friend/doula/photographer.  One woman had very long prodromal labor, which lasted over days, so that by the time true labor began her baby was born within an hour of arriving at the birthing center.  All of these women are recovering beautifully from their births and babies are settling in nicely with their siblings.

The reason I am listing these births is because it’s important, one, to honor these mothers and their births this month, and two, to remember that regardless of being a first time mom or a sixth time mom, each birth is unique.  The success of birth can be measured by so many variables that are, again, unique to the mother who prepared for that birth and ultimately it’s up to that mother to decide whether or not her birth was a ‘success’ or not.  Sure, there is a beautiful baby at the end of labor and all the work, but the whole birth experience belongs to the mother and her transformation into being a mother.   Our experiences add up, the pregnancies, the nausea, the bonds we form with the women and other mothers around us, and climactically with the births we have. These shared experiences become the glue that holds our mothering community together and I am grateful to have this community to share this pregnancy with me.
Next stop?  The big glucose test.  Will report back next time.