Tuesday, October 30, 2007

New baby, unexpected circumstances

There is a woman in my life - I can't even quite call her a friend, as we weren't quite there yet - who needs your thoughts and prayers today.

Melissa and I have been through a lot of drama and bullshit in the past, but in the last six months or so we've started emailing again, brought together by a mutual friend and the fact that we had something in common; we'd both miscarried our first pregnancies.

Through the past few months we lay our history aside in favour of being able to share the loss and pain of a miscarriage, and the difficulties of learning to trust and try again. There was a brief blip in our correspondence when she got pregnant again and didn't know how I'd react, but after a month or so she wrote to apologize, something she'd never done throughout our previous relationship. I forgave her, and was soon able to share the news that I was expecting again as well.

We were on our way to building a friendship, and emailed every few weeks or so about what kind of pregnancy symptoms we were having, how these things affected our relationships, work, and social lives, and what kind of choices we were making for our pregnancies, our births, and our lives with a newborn. We weren't quite ready to meet in person yet, but I knew the time would come. I looked forward to the upcoming births of our babies - hers in January, mine in May - not only for the events themselves, but as a way to transition into both motherhood and a true friendship.

I just found out - through that same mutual friend - that Melissa's baby was delivered on Saturday via emergency C-section. At only 27 weeks gestation, there must have been some very dramatic reason to get the baby out so fast, and the friend, justifiably so, feels it's not his story to tell. I sent a quick email to Melissa letting her know that I was thinking of her, and now all I can do is hope she'll email back when she has a moment to spare. But with a 2.5-pound baby in preemie care, and family members across the country to fill in, I'm sure I'm low on her list.

But I can pray for her, for her husband, and for their new son. So I will, and I hope you'll do the same.

Friday, October 26, 2007

Baby Catcher by Peggy Vincent

I just finished reading this book and figured it was a good time to add a list of all the [pregnancy, labour] books I've read so far to the sidebar of the blog. I wish I knew how to make them appear with pretty pictures of the covers, but then again we're not supposed to be judging books by their covers, right? (Speaking of which, I'd also love to know how to make the NaBloPoMo badge actually link to the the NaBloPoMo page. Typically I would ask my husband to help me but he doesn't know about this blog and I'm not ready to tell him, so unlinked it remains).

Anyway, Peggy Vincent's book was amazing. I devoured it in less than a day - it was full of birth stories, which I find fascinating under any circumstance, but it was even more fascinating to read them from the midwife's point of view instead of the mother's. Naturally, Peggy has a more objective point of view, and is able to tell the stories in a way that gives the facts and context but somehow doesn't take away from the magic of birth - the moment when "one person becomes two". (That phrase brought me to tears the first time I read it; pregnancy hormones plus my upcoming 1-year wedding anniversary, when "two people became one".)

It was also enlightening to read about Peggy's journey to midwifery. The book opens with her as a student nurse, pleading with a labouring woman to lie down in the bed like the rules say. The woman wants to walk, sway, and dance instead to deal with the pains of labour. As young Peggy learns more about labouring women and the obstacles put in their way by obstetrical management, she decides to take a different route and turns to midwifery. The pivotal moment in the book, one that defines for her (and for me) the difference between midwifery care and obstetrical care, comes when an (older, male) doctor insists that "every birth is complicated until proven otherwise." Peggy, like most midwives - and, I would think, most educated mothers - believes the opposite: every birth is normal until proven otherwise. If you also believe, like I do, that looking for trouble is the best way to find it, the superiority of the midwifery mindset is crystal clear.

Wednesday, October 24, 2007

Huge Improvement.

After Monday's horrible experience (migraine + more vomiting than previous 12 weeks combined), yesterday was quite a welcome switch. I woke up in the morning after sleeping for nearly ten hours and Chris asked me, "How do you feel?" I said, "I don't know yet, I'm afraid to move." I sat up slowly, gradually, and it was okay. The headache was there, but it was subdued - a 3 on the pain scale instead of a 9, and I consider anything below a 5 to be livable without medication.

So I went to work, and work was pretty good, fairly low-key, and by the time I got home I was in no pain at all. I wasn't really focussing on that, wasn't thinking about it or talking about it, but Chris could tell when he got home that the headache was absent - he said I was nearly giddy in my joy at not being in pain.

That's what I'm like when I'm in pain - I just can't conceptualize that it's ever going to end. I think, Sure, I can get through a Monday night with a debilitating migraine, it'll suck, but I can do it. But what about Tuesday, when I have to go back to work? What about Thursday, when I have to go practice with my vocal group for an upcoming performance? What about the rest of the second trimester, because obviously the entire next twelve weeks is going to be as awful as this night, and how am I supposed to retain my will to live? How about that?

I really did have reason to wonder what was up, though, because I had a headache just as nasty last week, and it lasted three straight days. After one headache, you know, you eat some ice cream and move on. After two in a row, you start to question the point of continuing your life. At least, if you're me that's how you react. That's just how I roll.

So, this headache only lasted a day, and I'm really grateful for that, and I've been in a really good mood since yesterday afternoon and starting to ponder the good stuff about the second trimester. A girlfriend of mine said that during the second trimester she would wake up and think, "Am I even pregnant?" It's true, a lot of the physical inconveniences and annoyances that keep pregnancy constantly on your mind through the first twelve weeks - nausea, sore breasts, mood swings, exhaustion, and pregnancy brain - are fading now. Quite a relief.

Now the only thing keeping me from a terrifically happy second trimester is the possibility of the headache appearing a THIRD time, in which case I will morph immediately from the happy little cheerblossom I am now into a shaking, weeping, pessimistic blob. So let's just hope it doesn't come to that.

Tuesday, October 23, 2007

Yesterday was not a good day

Last week I went to a special yoga class, a one-off fundraiser for the local Child Development Centre. I was really happy to be back at yoga after a whole summer of not being able to find a class to attend. The session was really challenging after such a long break - not just for me, either.

Near the end of class as we lay prone in the Savasana pose, I heard strange noises coming from the woman next to me. It sounded like she was having difficulty breathing; the noises were like soft whimpers, without much breath to support them. I was getting really worried and starting to wonder if she needed help, when it finally dawned on me what the noises were. She'd fallen asleep on her mat. I immediately stopped being worried for her safety and instead felt completely mortified on her behalf.

As impossible as this story may seem to top, I've topped it - in less than a week.

Last night, I went to the first session of the new yoga class I joined. It's held in a lovely home-based studio, with a bathroom/changeroom right next door. And how is it relevant to the story that the bathroom is located so close? Well, because if someone were to use the bathroom for any purpose during a yoga session - you know, while the soft music is playing and the lights are dimmed and everyone's quietly breathing and focussing on their bodies - everyone in the studio would be able to hear you.

And if, say, you were 12 weeks pregnant and your body suddenly decided to make up for 12 weeks practically vomit-free, and make you void the entire contents of your stomach right next to 8 people who are trying to relax to the soothing sounds of your guts heaving, I'd say you topped the "falling asleep at yoga class" story quite definitively.

Sigh.

Monday, October 22, 2007

Conversations with Sara

My younger sister Sara and I have always been close, and over the past year we've become closer than ever before. She's been an incredible friend to me as I coped with my parents' bizarre behaviour around the wedding, and a wonderful shoulder to lean on as I went through miscarriage - since she's been through two of them. I find that I am able to talk to her about things that I wouldn't share with many other people, and even more interesting to me, she is recently beginning to share things with me - since my pregnancies - that she's never told me before.

For example, last Tuesday night she and I talked for over two hours. Our conversation touched on a great many subjects, but by far the most in-depth portion was to do with pregnancy, labour, and birth. She told me the following story about her youngest son's birth last June.

Sara's husband, Dave, drives a Canada Bread truck for a living. He is an incredibly hard worker and must put in long days in order to make his business a success. He gets up around 2am, heads out to meet the barge at the dock at 3:30am and pick up his deliveries for the day. Then he finishes work sometime between 2 and 4pm, heads home and makes dinner for his family before going to bed at 8pm.

This is important because, in the days leading up to Scotty's birth, Sara knew she would have to have a contingency plan in place if Dave wasn't home when she went into labour. She had her friend Louise "on call" for when she needed company, care for her older son Andrew, and/or a ride to the hospital. Sara also spoke of a mixture of determination and worry that Scotty would be born a few days after his due date: he was due on a Tuesday, which is Dave's longest day of work, and Sara hoped he would be a few days late, as his older brother was, so that there would be less difficulty for Dave to be in attendance.

However, it was not to be. Dave got up that Tuesday morning around 2am and Sara woke up slightly, feeling something that she knew she couldn't deny. She tried, though, telling herself it would go away, telling herself "this baby isn't coming till the weekend." Dave went off to work, and Sara went back to sleep for a few hours. By 5am, she couldn't sleep anymore and called Louise, who came over to get Andrew out of bed and keep Sara company. Sara called her doctor, and Dave, to let them know that she was in labour.

At 7am, it was time to go to the hospital. Sara labours very quickly, and both her sons were born within 12 hours of the beginning of labour. Louise drove Sara and Andrew to the hospital and called Dave to let him know they had arrived. After this, Sara said, things were very blurry to her. She broke down in tears at one point, crying to Louise that she couldn't do this, she wanted it to stop, someone had to make it stop, she just couldn't handle it. She also remembers telling Louise, "Right now, I need you. But when Andrew needs you, I need you to go be with him, make sure he's okay, take him out if that's what he needs."

Soon after, Dave arrived at the hospital, and Andrew told Louise that he didn't like the noises his mommy was making. Louise took Andrew out of the room. Moments later, Scotty was born.

Sara then talked to me about things that she wasn't aware of during her labour, but that only fell into place for her later. "When I broke down crying, it was Louise who told me why I'd done that - it was because Dave wasn't there. It wasn't the pain, I'd handled that before. It was that I couldn't have the baby unless Dave was there with me. I just needed him there." Makes perfect sense. She talked about how she'd already begun pushing before Dave arrived, but that "as soon as he walked in the room, my pushes became 100% more committed, more intense. It was like I was finally ready to get on with it." Sara's doctor also mentioned later that when she called him from home, she spoke in a very calm and detached way. "I thought you were way earlier in your labour than you were," he told her later, because of the way she was speaking. It was as if she wasn't truly commited to labour - in fact, a part of her was in denial about it - until the plans she'd lined up for her family fell into place: Dave in attendance, Andrew being taken care of by Louise so Sara could labour freely without worrying about his reaction.

I knew bits and pieces of this story before, but Sara has never shared so completely her thoughts and feelings at the time of Scotty's birth. I hear this story and I get a very powerful message about the importance of respecting and honouring women's feelings around labour and birth.

Sara simply was not ready - you could say, was not able to have that baby until her husband arrived. Sara had never created anything like a formal "birth plan", but nevertheless, she had one critical factor that needed to be in place in order for her to commit to labour and birth, and that was it. Look at the incredible power she exerted over her body's labour to hold it back until he was there - and she wasn't even consciously aware of it. This is a real-life example of what midwives and doulas are talking about when they say that the mother will have better outcomes when she feels empowered, respected, and confident during labour and birth.

This story shows me that it's worth it to keep fighting for what I feel is important during my own labour and birth: who's there with me (and who's not), where the birth takes place, and what kind of care we receive throughout the experience.

Friday, October 19, 2007

Midwife Appointment

I was so wrapped up in the anticipation of hearing the heartbeat (and the incredible migraine that I was suffering from) that I forgot about the other aspect of our visit: the attendance of my mother-in-law and her inquisition of the midwife.

That ... was something else.

I warned Lillian (the midwife) ahead of time, and she was quite prepared, even happy, to answer all of Karen's questions. It was even somewhat amusing to see Karen's inner struggle between her desire to be polite and make a good impression, and her desire to ask any ugly question she has to in order to feel heard.

She started off with:
How many babies have you delivered?
How long have you been a midwife?
How long have you been a midwife in Nanaimo, and how many babies have you delivered here?Then came the first tricky one: being aware of people's privacy issues, can you get one of your clients to call me and talk about their experiences with you? Basically asking for a reference. This is *so* the way Karen thinks - I think Chris was a little surprised that his mom actually went that far, but I could see where she was going as she led up to that!

The next round of questions got a little tougher, and they weren't really 'questions' so much as, I guess, 'discussion points'. For example, after telling me she hoped I wouldn't get offended - which I didn't - she asked Lillian how my advanced age (32) affected her expectation and care surrounding my pregnancy and birth. She also asked about Lillian's preference for home or hospital births, which I thought was a little beside the point, since Lillian will catch the baby wherever we decide to do it, it's not really up to her. But it was really just a way for Lillian to open the discussion about home births, what they're like compared to hospital births, and what her rules are - both those governed by the college of midwives, and her own personal guidelines - for turning a home birth into a hospital one. I really felt that we were having this whole discussion about 5 months too early, but at the same time it was really interesting to have a passionate, well-informed discussion about all the aspects of home/hospital birth. It was at this stage of conversation that Chris and I really started to get involved and ask some of our own questions surrounding the issue, and that was great.

For example, I was reassured that many of the worries I had about hospital births - primarily, the "cascade of interventions" - is much less likely to take place when you are there under midwifery care instead of obstetrical management. "Midwives just aren't trained that way," Lillian assured me. "We aren't going to turn on all the machines just because they're there." I also commented on what I'd learned from Rhea about the hospitals having certain rules and guidelines that *any* caregiver has to abide by when attending a birth. "The way I understand it, as soon as we enter the hospital, even though I am under your care, you and I are no longer the bottom-line in decision making: there are certain rules we have to obey, simply because we are in their hospital." Lillian agreed that this was true, but commented that there weren't any rules at NRGH that she personally disagreed with. "One of their rules states that if the meconium is really thick and the baby's heartrate is going down, that a pediatrician gets called in." She raised her hands in the air in a "hands off" gesture. "That's something I'd do anyway, so it doesn't bother me that they have that rule."

In any case, I was really happy with the way Lillian handled Karen's questions, and I hope Karen was too. I don't really know if anything got put to rest - I think we have a ways to go before we get to that point - but I can honestly say that I think we're on the right track.
As for home birth vs. hospital birth, Karen is sure selling hard on the hospital birth, and I am wavering a bit. One sentence I read in "The Midwifery Option" has stuck with me: [paraphrased] "The fact is that if anything goes wrong with your baby during or after birth, those around you will find it easier to accept if the baby was in a hospital, regardless of the outcome." That is to say, the baby may have died no matter where it was, but family and friends will feel more at peace about that death if it took place in a hospital. Fair or not, it rings true to me - and obviously I don't expect our baby to die (nobody does, I guess), but this holds true for a million other things as well. The baby gets sick, the baby's lung collapses, the baby's at a low birth weight, the baby has a heart murmur, whatever. Everyone's going to feel better about that baby's chances if s/he was born in a hospital. It's not necessarily accurate, but it's true.

So hospital birth feels to me like a good way to compromise. If I could extract a tacit agreement that everyone would get off my back about having a midwife if only I'd agree to have a hospital birth, well, that sounds okay to me. Especially now that the new maternity wing is built and it sounds absolutely awesome: a pullout bed for Dad, great deep tubs for labouring in the water, and each private, family-oriented room is self-contained, that is, the room where you labour is the room where you deliver is the room where you recover.

On the other hand, there's this niggling doubt in the back of my mind that asks what will happen if I prove this much of a pushover, right at the start of my parenting journey - will The Grandparents think they can push me around on everything? So I think the best route to take would be for Chris and I to truly find peace and acceptance in our decision, and make it clear that it was OUR decision. The thing is, it's way too early to make that decision now, so I'm kind of aggravated that we're all fighting - or at least, "passionately discussing" - five months early. I've never said to either set of grandparents "I want a home birth." All I've said is "I haven't decided yet." And I think I have a long time until I have to decide.

Anyway, after all that I lay down on the bed and we tried to hear the heartbeat. We didn't find it, but we did hear kicking, which was amusing: the kicks were very distinct "click" noises, much more satisfying than the "whooshing" sounds we heard last time. After a few minutes and a few kicks, Lillian concluded that the baby's feet must be up against my belly, rather than his/her torso, so we wouldn't get to hear the heart. Too bad, but there's always next time.

Thursday, October 18, 2007

Proof of Life

No audible heartbeat at the midwife's this week. But we are only 11.5 weeks along, so that's still a bit early. We did get to hear distinct "clicking" noises which the midwife said were kicks. So, there is something in there! Pretty cool.

Overall, things are improving. I'm not feeling as miserable as I was a couple weeks ago, or even one week ago - knock on wood! My pregnancy brain seems to be dissipating, as evidenced by the fact that twice in the past week I have found something long missing, not by looking everywhere for it, but by actually thinking and remembering where I'd left it. Miracle! The Diclectin prescribed by the midwife has helped the nausea get under control, and even my energy levels are improving. This must be that "second trimester" thing that everyone always raves about.

Another great improvement is that we have now passed the day when I miscarried last pregnancy - 11 weeks, 1 day. As that day drew closer and closer I felt myself becoming wound more and more tightly, and a lot of stupid fights with Chris were due primarily to that tension. The day came and went with no blood, no pain, no nothing - and the next day, off we went to the midwife and heard the baby kicking. I'm now at 11 weeks 5 days and starting to feel a real sense of relief, as well as the sense of awe and wonder that I've been waiting for so long to experience - at last, we are in new territory and I find myself able to really imagine that there's a baby at the end of this journey.

What I really need to focus on now, I think, is shedding the crappy habits I picked up during the first trimester. For the past 9 weeks I've been eating so much junk food I can hardly look at myself. My nausea wouldn't stand for the fruit smoothies and green salads that I usually eat; it wanted starches, breads, potatoes, hash browns. And I was way too tired to exercise. This has resulted in a gain of TWELVE POUNDS in the first trimester - I am not impressed. I already gained 10 pounds with the first pregnancy and didn't manage to lose it. So my new comittment to myself is more exercise, more fruits and vegetables, and less crap. If my energy is coming back and my nausea is fading away, I've got no excuse, right? I can't hope to lose any weight, I know, but perhaps I can slow down the gain enough to feel healthy.

Thursday, October 11, 2007

A Scary Decision

Last night, I had a terrible fight with my husband. For the first time in our 4 years together, we voluntarily slept apart - he on the couch, me in the bed.

Details don't matter. What matters is that this fight wouldn't have happened if I wasn't pregnant. It wasn't about being pregnant, but it started because I was in pain, and that pain was due to pregnancy. It ramped up because when I'm in pain I'm incapable (or unwilling) to use tact and diplomacy, instead working to make the world outside resemble the world inside, where everything is secondary to the sheer head-splitting agony I'm experiencing. Nothing in the world is more important to me at that moment than making the pain go away, and I'm desperate to make you feel the same sense of priority. If that means omitting the word "please" or letting loose a torrent of curse-words of which a future mother shouldn't be capable, fine. Whatever it takes.

So yes, the fight was my fault. I started it. And as I lay in the dark, alone in our queen-sized bed, I came to a scary realization. I don't like myself very much right now. I don't like myself very much when I'm pregnant. I'm not a nice person, or even a good person. I'm so enormously self-involved that I hardly even remember the existence of other people, except as receptacles for my own complaining, or potential solvers of my myriad problems. There's pain, and there's hormones, and there's inability to exercise and eat properly, and there's nausea and fatigue and a constant feeling of malaise, and somehow that becomes an excuse for me to become an utter, complete asshole.

I can't do this again. I hope the next few weeks go well, and that we hear the heartbeat and the little bugger actually survives the first trimester and that the hormones back off and I start to feel better like everyone's been promising for the past two months and in seven more months I'll give birth to a healthy baby and then I will never do this again. Please God.

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