I went back to work this week. In some ways, it went fantastic: I wasn't late to work any day, pumping went great, I'm really happy with the day care arrangement we all worked out. In other ways, it didn't: It looks like I may have to use bottles even on days I telework because Jesse still likes cluster feeding at the breast, and that just doesn't work when I'm working; I found myself distracted by habits I'd gotten into while on leave that can't continue while I'm working (oh hai @moshermama twitter stream); and getting back into the groove of a job I used to do seamlessly is proving to be paved with all manner of speed bumps that didn't used to apply to me.
Jesse shocked me by sleeping through the night for the first time Sunday night, going down about 10:30 and waking up about 5:30. I was so expecting the 2-3 feeding that I was shocked when I found that I had slept nearly til the alarm, which was going off at 6. He's doing this regularly, too, although Thursday and Friday he enacted some weird timeshift and woke us up at 4:30 both mornings. Ugh.
He doesn't have his checkup until next week, but I think he weighs about 13 pounds already. Size 3 months is a wash; I'm glad they lasted 2, honestly.
Ok, that's the Jesse update. Next up is another of my birth rant posts!
Sunday, January 17, 2010
Wednesday, January 6, 2010
The doctor isn't always right
Not long ago, I wrote my birth story up, and I got a lot of web traffic from it because I turned down pitocin four times, believing it to be an intervention that wasn't indicated for my labor and that having my labor medically managed would increase the bottom line cost of my birth and increase the chances that I would have a cesarean section.
A couple of weeks ago, I had my 6-week followup with the woman who _should_ have delivered my baby. She often shares anonymized birth stories with me, almost like case studies that help me better understand what is rapidly becoming my vocation. She told me about a recent night on call, when she had a woman with a scheduled cesarean successfully VBAC because she arrived at the hospital fully dilated and ready to push, and a woman having her fourth vaginal delivery go wrong because she had insisted on getting the epidural at two centimeters, well before the baby was engaged; when the baby finally did descend, it did so in a brow presentation, and got hung up, and she wound up having a c-section.
In other words, it's not as important to have a birth plan as it is to be fully prepared. A birth _plan_, especially if you've never given birth before, quickly goes out the window when things don't go to plan--and they usually don't.
But by being prepared, you can spare yourself a lot of agony. One tip I don't hear mentioned much, but one that helped me when I was fighting the OB for a natural birth, is to talk to other women in your family, if possible, about their birth experiences. One of the objections my OB had to allowing me to progress naturally was that I was clearly carrying a big baby. My retort was to list off the birth weights of my aunts and uncles, my own and my brother's and several of my cousins. It hadn't helped that K had showed up at a funny angle and gotten his shoulder hung up on my pelvis back in 1992--but not seriously so. Another objection she had was that if something *did* go wrong, she wanted it to happen during daytime hours when there were "a lot more people here." Staffing issues on the late shift?
But as I continued to talk to my midwife at my 6-week checkup, she explained to me that the doctor--new to the practice--had never had a patient question her judgment. Remember her comment during my birth story, that she was accustomed to a certain process? During her medical school and internships in India, and her residency in an inner-city hospital, she had never faced a strong-willed, well-informed patient who was prepared to advocate on her own behalf.
So here's where my birth "plan" went wrong. Not only did I get a stranger delivering my baby--I got a stranger who had never encountered a birth she hadn't medically managed. Had I put blind trust in this woman, it was possible I'd have wound up with a c-section.
Now, for the post-script. It turned out that the OB called the senior doctor in the practice, the one that I thought would deliver me if my midwife wasn't available, and asked her what to do with this stubborn patient who kept refusing treatment. The senior doctor responded, "Get used to it." As my midwife explained, our community has a lot of intelligent, strong women who don't want to be treated under an assembly-line process. By fighting the new doctor, I taught her something new about the kind of doctor she could be--one that listens to her patients, one that resists a rote process, one that doesn't hunt down a pathology or use fear tactics to bully her patients into interventions they don't need.
What of all the doctors who never get this lesson?
A couple of weeks ago, I had my 6-week followup with the woman who _should_ have delivered my baby. She often shares anonymized birth stories with me, almost like case studies that help me better understand what is rapidly becoming my vocation. She told me about a recent night on call, when she had a woman with a scheduled cesarean successfully VBAC because she arrived at the hospital fully dilated and ready to push, and a woman having her fourth vaginal delivery go wrong because she had insisted on getting the epidural at two centimeters, well before the baby was engaged; when the baby finally did descend, it did so in a brow presentation, and got hung up, and she wound up having a c-section.
In other words, it's not as important to have a birth plan as it is to be fully prepared. A birth _plan_, especially if you've never given birth before, quickly goes out the window when things don't go to plan--and they usually don't.
But by being prepared, you can spare yourself a lot of agony. One tip I don't hear mentioned much, but one that helped me when I was fighting the OB for a natural birth, is to talk to other women in your family, if possible, about their birth experiences. One of the objections my OB had to allowing me to progress naturally was that I was clearly carrying a big baby. My retort was to list off the birth weights of my aunts and uncles, my own and my brother's and several of my cousins. It hadn't helped that K had showed up at a funny angle and gotten his shoulder hung up on my pelvis back in 1992--but not seriously so. Another objection she had was that if something *did* go wrong, she wanted it to happen during daytime hours when there were "a lot more people here." Staffing issues on the late shift?
But as I continued to talk to my midwife at my 6-week checkup, she explained to me that the doctor--new to the practice--had never had a patient question her judgment. Remember her comment during my birth story, that she was accustomed to a certain process? During her medical school and internships in India, and her residency in an inner-city hospital, she had never faced a strong-willed, well-informed patient who was prepared to advocate on her own behalf.
So here's where my birth "plan" went wrong. Not only did I get a stranger delivering my baby--I got a stranger who had never encountered a birth she hadn't medically managed. Had I put blind trust in this woman, it was possible I'd have wound up with a c-section.
Now, for the post-script. It turned out that the OB called the senior doctor in the practice, the one that I thought would deliver me if my midwife wasn't available, and asked her what to do with this stubborn patient who kept refusing treatment. The senior doctor responded, "Get used to it." As my midwife explained, our community has a lot of intelligent, strong women who don't want to be treated under an assembly-line process. By fighting the new doctor, I taught her something new about the kind of doctor she could be--one that listens to her patients, one that resists a rote process, one that doesn't hunt down a pathology or use fear tactics to bully her patients into interventions they don't need.
What of all the doctors who never get this lesson?
Thursday, December 17, 2009
Thursday, December 10, 2009
Four weeks and counting, and #Cora
I was going to do my first wordless Wednesday post yesterday but couldn't get my camera, a charged battery, and a download cord or card reader in the same place for some reason. I've been distracted all week, actually, trying to secure a caregiver for Jesse as Dean got himself ready to go back to work, and we picked up Dean's new car, a 2000 Subaru Outback.
Dean's going back to work has been a stress point for me, because he works two hours away, and as such, tends to stay in Northern Virginia at his dad's old house during the week. We used to jokingly call this our commuter marriage, which worked fine prior to my late pregnancy and Jesse's arrival. I don't see it working so well anymore; I can't even run to the corner to pick up a newspaper without it turning into a production. I don't know how single moms do it, and I say this having been a single mom--just of a tween, not of an infant.
In the meantime, said former tween turned 17 last week. Where does the time go? And Jesse hit four weeks yesterday. The days are a blur, honestly, partly because I haven't slept more than 3.5 hours at a time since he was born. But that's ok, too, because a half-hour feeding in between two such sleeping jags translates into 7 hours of mostly uninterrupted sleep.
Today, the breast pump arrived. Dean will likely be able to feed Jesse by this weekend. That will be nice, although I'm a bit stressed about how the damned thing works! I didn't use a pump with Elder Son, per se--just the occasional portable one-side kind, battery operated. Didn't need it too much because I worked nights and Kieran slept through the night by that point.
Jesse's also really starting to make eye contact with me in a way that he hasn't before--I can tell he recognizes me, and he smiles a lot more often.
But all of this is hollow, this week, because one of my bump buddies from Twitter, Kristine, lost her daughter, born Nov. 30, to an undetected heart defect earlier this week. Cora was breastfeeding in her mother's arms one minute, and the next.. Kristine was racing to the hospital, where Cora died. My heart goes out to Kristine and her family, and in Cora's honor, many of us in the Twittersphere are wearing pink. I'm wearing the pink maternity tee that I loved so much while pregnant, and wrapped in the pink prayer shawl that my friend Audra sent me: it was knit for her during her pregnancy, and she passed it along to me, and now I wear it in honor of Cora.
Every day, I'm grateful that I have a healthy little boy. He was a surprise for us, but a blessing we never could have anticipated.
Kristine, my prayers are with you this week. Much love to you and Ben.
Dean's going back to work has been a stress point for me, because he works two hours away, and as such, tends to stay in Northern Virginia at his dad's old house during the week. We used to jokingly call this our commuter marriage, which worked fine prior to my late pregnancy and Jesse's arrival. I don't see it working so well anymore; I can't even run to the corner to pick up a newspaper without it turning into a production. I don't know how single moms do it, and I say this having been a single mom--just of a tween, not of an infant.
In the meantime, said former tween turned 17 last week. Where does the time go? And Jesse hit four weeks yesterday. The days are a blur, honestly, partly because I haven't slept more than 3.5 hours at a time since he was born. But that's ok, too, because a half-hour feeding in between two such sleeping jags translates into 7 hours of mostly uninterrupted sleep.
Today, the breast pump arrived. Dean will likely be able to feed Jesse by this weekend. That will be nice, although I'm a bit stressed about how the damned thing works! I didn't use a pump with Elder Son, per se--just the occasional portable one-side kind, battery operated. Didn't need it too much because I worked nights and Kieran slept through the night by that point.
Jesse's also really starting to make eye contact with me in a way that he hasn't before--I can tell he recognizes me, and he smiles a lot more often.
But all of this is hollow, this week, because one of my bump buddies from Twitter, Kristine, lost her daughter, born Nov. 30, to an undetected heart defect earlier this week. Cora was breastfeeding in her mother's arms one minute, and the next.. Kristine was racing to the hospital, where Cora died. My heart goes out to Kristine and her family, and in Cora's honor, many of us in the Twittersphere are wearing pink. I'm wearing the pink maternity tee that I loved so much while pregnant, and wrapped in the pink prayer shawl that my friend Audra sent me: it was knit for her during her pregnancy, and she passed it along to me, and now I wear it in honor of Cora.
Every day, I'm grateful that I have a healthy little boy. He was a surprise for us, but a blessing we never could have anticipated.
Kristine, my prayers are with you this week. Much love to you and Ben.
Tuesday, December 1, 2009
First smile!
Now posting in real time, although there will be some backstory to fill in since the 13th, including our vacation to Hatteras! Yay. But anyhow, Jesse gave us our first authentic smile this morning. There've been plenty of hints at smiles, especially when he's asleep and dreaming and his face goes through an entire gamut of expressions he doesn't make when he's awake. But this was the real thing. Dean and I had our heads together, beaming down at him, and he beamed right back, and when we laughed at this he smiled even wider.
But of course we didn't have a camera handy. So instead I'll just amuse you with this picture of father and son making strange faces at each other.
But of course we didn't have a camera handy. So instead I'll just amuse you with this picture of father and son making strange faces at each other.
Saturday, November 28, 2009
Calling all hands--it's a staph meeting
After our long nap that Friday the 13th, I was relieved that no calamity had befallen us, but the day wasn't over yet. As I was nursing Jesse contentedly in my newly put-together, extremely comfortable rocker-glider, Dean bounded up the stairs and announced, with his usual humorous aplomb, that our baby had been recalled. We had been summoned back to the hospital for some antibiotics because one of the lab cultures had come back positive for a strain of unidentified bacteria, and because they weren't certain whether the bacteria had come from his skin (where it's--believe it or not--normally present) or from an internal infection. But his previous low-grade fever and high-ish white blood cell count meant that something was tasking his newborn system, and so he was re-admitted as a pediatric patient.
Before long, it became apparent that the bacteria was a staphylococcus, or staph, strain. What blew my mind was the number of times I was asked if I had tested positive for Group B Strep, which I hadn't. Last I checked, Strep and Staph were totally different strains of bacteria. I was also asked repeatedly if there had been anything unusual about my pregnancy. Well, aside from my tongue possibly being a map to buried treasure, no. I had to fight the urge to be smart-alecky ("At his second ultrasound, Jesse flipped us off..."), actually. I thought we'd be there for a while for them to draw new blood samples and be sent home with antibiotics, but then I found out we'd be there overnight for several courses of IV antibiotics.
I was devastated and nonplussed. We hadn't been told to pack for an overnight stay, for one--and this meant that I hadn't brought any of my postpartum supplies other than a change of pads, much less any food or drink. What was worse was that we were now in the pediatric unit, so I didn't have access to the mother-baby unit refreshment stand. I'd discover the following day that I was to be fed, being the breastfeeding mother of the patient, but in the meantime we were in for the most harrowing night I can ever remember. Dean went with the nurses while Jesse got his IV, and I meanwhile sat wringing my hands in Jesse's room, freaking out and thinking, "If I'd had him at home this never would have happened." When Dean brought Jesse back--his hand immobilized by the complicated heplock they had created--Dean said to me, "He is so brave, Helen." This struck me as a strange thing to hear Dean say, but then I realized that he was bonding with the baby too.
This being the same man who didn't speak to me for a half hour when I told him I was pregnant.
But the doctor--a very nice woman--came in and explained that we should have results of the additional tests by 3 p.m. the next day, and that they should reveal the course of treatment from that point forward. By this point, it was nearly 10 p.m. I thought I could tough it out, and Dean said he'd stay with us. Jesse cried through most of the night, and I found myself in meltdown mode shortly after 3 a.m., sobbing hysterically with my newborn, wanting nothing other than to go home. My milk was starting to come in; Dean was holding me and the night nurse was comforting me. I remember blubbering out all of my fears as I tried to nurse Jesse and he'd find no solace there because latching on was so difficult. Finally, Jesse and I fell asleep--with him in my lap in the hospital bed.
The following morning, a shift change brought us a new nurse that we didn't really see all that much of. Another doctor--different from the one we'd seen the previous night-- came in, did an exam, and explained brusquely that Jesse might be sick and might not be but we needed to err on the safe side, and left. We sat and waited, and sat and waited, and sat and waited. Jesse had two normal temperatures in a row. I got breakfast, and lunch, and was asked to place an order for dinner. That's when I started to get suspicious, and summoned the nurse to find out what was going on. It was now nearly 3. She explained that usually these infections meant a 48-hour stay in the hospital. I nearly lost it all over again. "I was told we'd have test results by this time!" I said, insistently. The nurse cocked her head. "Well, the doctor won't be back in until this evening."
ARGH! I nearly burst into tears again, but put my adamant hat on and told her what last night's doctor had said. The nurse said she'd try and find out the results of the additional testing and call today's doctor for more instructions.
An hour later she came back in and said we could go home; the tests showed he'd cleared whatever it was. Dean made the observation that I had been giving Jesse my antibodies since shortly after he was born, amniotic fluid in his tummy notwithstanding. (And I have the immune system of a tank, really. I don't get sick often, although I'm apt to get run-down often enough because I'm Type A that way.)
The nurse ran down our discharge instructions and then went on to add a bit of unsolicited advice. "And don't put your baby in the bed with you!" she said, firmly. Did we look suspiciously like co-sleepers to her? Or was she concerned about the fact that when she'd come in this morning, Jesse had been asleep in my lap? "They can suffocate," she continued, "and when you go into a deep sleep, you can roll over on top of the baby."
Yeah, like I roll over on top of my husband on a regular basis, right? I co-slept with my first son without ever having heard of attachment parenting (or co-sleeping, for that matter. It just made sense, and made him a better sleeper; he slept through the night at 6 weeks and slept in his bassinet or crib from that point onward, with the occasional exception for rough nights.
So we just smiled and nodded and took our little boy home--for good, this time.
Before long, it became apparent that the bacteria was a staphylococcus, or staph, strain. What blew my mind was the number of times I was asked if I had tested positive for Group B Strep, which I hadn't. Last I checked, Strep and Staph were totally different strains of bacteria. I was also asked repeatedly if there had been anything unusual about my pregnancy. Well, aside from my tongue possibly being a map to buried treasure, no. I had to fight the urge to be smart-alecky ("At his second ultrasound, Jesse flipped us off..."), actually. I thought we'd be there for a while for them to draw new blood samples and be sent home with antibiotics, but then I found out we'd be there overnight for several courses of IV antibiotics.
I was devastated and nonplussed. We hadn't been told to pack for an overnight stay, for one--and this meant that I hadn't brought any of my postpartum supplies other than a change of pads, much less any food or drink. What was worse was that we were now in the pediatric unit, so I didn't have access to the mother-baby unit refreshment stand. I'd discover the following day that I was to be fed, being the breastfeeding mother of the patient, but in the meantime we were in for the most harrowing night I can ever remember. Dean went with the nurses while Jesse got his IV, and I meanwhile sat wringing my hands in Jesse's room, freaking out and thinking, "If I'd had him at home this never would have happened." When Dean brought Jesse back--his hand immobilized by the complicated heplock they had created--Dean said to me, "He is so brave, Helen." This struck me as a strange thing to hear Dean say, but then I realized that he was bonding with the baby too.
This being the same man who didn't speak to me for a half hour when I told him I was pregnant.
But the doctor--a very nice woman--came in and explained that we should have results of the additional tests by 3 p.m. the next day, and that they should reveal the course of treatment from that point forward. By this point, it was nearly 10 p.m. I thought I could tough it out, and Dean said he'd stay with us. Jesse cried through most of the night, and I found myself in meltdown mode shortly after 3 a.m., sobbing hysterically with my newborn, wanting nothing other than to go home. My milk was starting to come in; Dean was holding me and the night nurse was comforting me. I remember blubbering out all of my fears as I tried to nurse Jesse and he'd find no solace there because latching on was so difficult. Finally, Jesse and I fell asleep--with him in my lap in the hospital bed.
The following morning, a shift change brought us a new nurse that we didn't really see all that much of. Another doctor--different from the one we'd seen the previous night-- came in, did an exam, and explained brusquely that Jesse might be sick and might not be but we needed to err on the safe side, and left. We sat and waited, and sat and waited, and sat and waited. Jesse had two normal temperatures in a row. I got breakfast, and lunch, and was asked to place an order for dinner. That's when I started to get suspicious, and summoned the nurse to find out what was going on. It was now nearly 3. She explained that usually these infections meant a 48-hour stay in the hospital. I nearly lost it all over again. "I was told we'd have test results by this time!" I said, insistently. The nurse cocked her head. "Well, the doctor won't be back in until this evening." ARGH! I nearly burst into tears again, but put my adamant hat on and told her what last night's doctor had said. The nurse said she'd try and find out the results of the additional testing and call today's doctor for more instructions.
An hour later she came back in and said we could go home; the tests showed he'd cleared whatever it was. Dean made the observation that I had been giving Jesse my antibodies since shortly after he was born, amniotic fluid in his tummy notwithstanding. (And I have the immune system of a tank, really. I don't get sick often, although I'm apt to get run-down often enough because I'm Type A that way.)
The nurse ran down our discharge instructions and then went on to add a bit of unsolicited advice. "And don't put your baby in the bed with you!" she said, firmly. Did we look suspiciously like co-sleepers to her? Or was she concerned about the fact that when she'd come in this morning, Jesse had been asleep in my lap? "They can suffocate," she continued, "and when you go into a deep sleep, you can roll over on top of the baby."
Yeah, like I roll over on top of my husband on a regular basis, right? I co-slept with my first son without ever having heard of attachment parenting (or co-sleeping, for that matter. It just made sense, and made him a better sleeper; he slept through the night at 6 weeks and slept in his bassinet or crib from that point onward, with the occasional exception for rough nights.
So we just smiled and nodded and took our little boy home--for good, this time.
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