Posts Tagged ‘birth’

My Pregnancy: Week 38

Tuesday, May 3rd, 2016

Screen Shot 2016-05-02 at 9.09.08 AMI’m done. So done. It started with some minor itching, enough that I asked my doctor about it at my weekly visit at week 37. He suggested the itching was likely hormones and stretched, dry skin. Two days later arrived the weekend and a buzz to my doctor on-call. He ordered blood tests to check my liver without offering much detail. Thus began a very long, stressful week. In the end I learned to feel more empathy for the mamas that have odd symptoms, call the doctor’s office more than they’d like to admit, and get a little grumpy or inexplicably tearful amidst their pregnancy hormones and discomfort. I’ve now been there. I’ve so been there.

I’ll cut to the chase—the lab work came back normal, but based on symptoms my doctor said I developed cholestasis. The trouble rested on the timing of it all. Test results took over a week and there wasn’t really time to do more testing before baby was due to arrive, in 3 days. In my 38th week I called my doctor more than all the other days of my three pregnancies combined. Every day they said to try again tomorrow, surely tomorrow the labs will be in or—worse—I left a message and received no response. Dr. Google provided scary information. For example, the suggested treatment for cholestasis potentially includes having baby at the 37/38 week mark… which I was in the midst of.

Add to the unknowing and impatience my 38th week discomfort and hormones along with my previous work in hospitals, often spending time with families who were in the midst of tragedy. Worried and itchy to the point of breaking my skin was not how I wanted to spend my last full week pregnant. I felt crazy at my 38 week appointment when the doctor seemed nonchalant yet he also said we’d do the C-section the next day if the test results came back by then. They didn’t. Mixed signals left me feeling like a crazy ticking time bomb over the weekend.

I would say I wanted to spend this last, final week of pregnancy ever focusing on last minute details and relaxing, eating up our final times as a family of four. I mostly spent many late, sleepless nights bleary-eyed between bathroom breaks, glaring at the computer screen and inputting very odd questions to Google. I imagine the waiting seemed all the worse because my eyes were so directly focused on the prize, our soon-to-arrive babe and, hopefully, her healthy delivery. As I reflect on the situation, in a way I did focus on last minute details. I also focused on cherishing our family, but instead of the four we were already a family of five in my heart.

PS—She arrives just fine, just a couple of days from this post. She’s perfect.

My Pregnancy: Week 36

Tuesday, April 19th, 2016

Week 36We’re nearing go-time. What was once abstract in our mind—a baby on the way—becomes more real every single day. Our two-year-old lives in the nebulous, aware that baby is coming but not significantly understanding how his life is about to change. Our four-year-old shows far greater awareness, interest, and understanding about the baby situation. We introduced baby toward the end of the first trimester. We’ve continued talking about my growing belly; going to the doctor and hearing the heartbeat has proven particularly significant and concrete for him.

In the last few weeks we’ve gotten close enough to birth to integrate a variety of tools to understand baby sister’s quickly approaching arrival. Every kiddo is different, both in how they best understand things and of what developmental capability they are at. We’ve found several tools useful in preparing our children for baby #3.

Books.
Depending on your children’s specific needs you can find books on a wide variety of topics. Our sons needed help understanding why I could not do everything I used to as pregnancy progressed. Our 4-year old was also interested in what baby looks like and how she was developing in my belly. There are stories about becoming a big sibling and bringing a new sibling into the house, giving birth at home, what newborns are like, and how babies are made. If characters are helpful, everyone from Arthur and Daniel Tiger to Olivia, The Berenstain Bears, Little Critters, and others have books on the subject.

Videos.
Among others, Daniel Tiger spends the first few episodes of the second season introducing little sister. You Tube also has a diverse array of clips about babies. One of my favorites includes Big Bird learning about breastfeeding.

Baby photos.
Our sons like to look back on their own baby pictures. They provide opportunities not only to see a baby but also see babies in their development and surroundings. I was able to explain aspects of the hospital by looking at pictures of the first few days of life. I could show how my belly gets bigger, baby eats milk from my breast and that babies sleep a lot and need to be held often simply through our family photos.

Conversation and Integration.
Just talking about the baby and including our children in our conversations about the baby help to make her more real. As we bought clothing, set up baby’s things, and packed my hospital bag, we presented the baby as part of our family long before she ever arrived. We pulled our swing out so our sons can practice being gentle as they pushed our Hulk, who stands in as proxy until baby arrives.

Doctor appointments.
Certainly, bringing my children to appointments did not make the visit go more smoothly. It was a challenge worth the effort because our four-year-old was especially moved by hearing the heartbeat each visit. Every visit I also made sure to see if he had any questions for the doctor about the baby. Our doctor humored this and built relationships with all of us.

Notice babies.
They are all around us. Point out babies, newborns, and pregnant women to your children and liken them to your experience. This brings a sense of normalcy to childbirth, seeing that our baby is special but at the same time babies are just a part of life.

Annie is a mom of two boys, ages two and four. She enjoys the finer things in life, like compression socks and a full night’s rest.

My Pregnancy: Week 34

Wednesday, April 6th, 2016

My Pregnancy Week 34I would have never thought of myself as a C-section advocate. Now having had two, with a third scheduled for just five short weeks away, I do consider myself an advocate for the C-section experience. My first cesarean was not planned; it was after 19 hours of hard labor. I spiked a fever, heartbeats were slowed, baby was angled and never coming out (we would later see at birth). My C-section was not necessarily a statistical risk of induction but rather a life-saving procedure I’m thankful for every single day.

It was still an experience I had to “heal” from though. Some of the healing came from processing my own expectations. I planned for and deeply wanted that natural childbirth. That was what I focused on, and I gave little attention to the idea of a cesarean. I now give the (when asked for) advice to learn about and think through a cesarean birth plan as well as talk to mamas who have had positive C-section experiences. It’s not to scare her, test fate, or downplay the seriousness of deciding on a C-section. Instead, many of my feelings that I processed after the first birth had to do with the fear of not knowing, the lack of control, and general sense of a C-section as bad.

Healing and peace about my subsequent cesareans came from filtering out other people’s views on the method of delivery. For example, everyone focuses on the pain and recovery involved with cesareans. We often down-play the pain and recovery involved with vaginal birth. While “natural,” vaginal childbirth is generally a beautiful and wonderful process, it also brings months and even years of pain to some women. It inhibits their sexual interactions and bladder functions among other things. I’m not denying the seriousness of cesarean birth complications; I’m also not trying to compare vaginal birth to cesarean. I’m simply using this as an example of how our mommy culture downplays some of the difficulties of vaginal birth and plays up the horror stories of cesareans to the detriment of the women.

This culture of seeing vaginal birth as the “best” way to go can limit conversation for women who are struggling with healing from vaginal births. The culture of seeing cesarean birth as secondary status dampens the beauty of what can be a wonderful birth experience. It took about two years to come to terms with my first child’s birth story. My second child’s cesarean was a healing and empowering experience for me as I became more aware of the derogatory ways we culturally refer to C-section births.

As I think through what my hopes are for our third child’s birth, I see the sterile operating room as the place where we will warmly welcome our third baby into this world. It’s not a place to fear but rather the place where our world will change and never be the same again.

Annie is a mom of two boys, ages two and four. She enjoys the finer things in life, like compression socks and a full night’s rest.

My Pregnancy: Week 33

Thursday, March 31st, 2016

Week 33Birth plans often conjure up images of doulas and skin-to-skin contact and other simple hopes of families-to-be. After a C-section, birth plans often point to VBACs with undertones of hoping to be redeemed from the original cesarean never wanted. I have nothing against VBACs and all the beautiful ways a baby can be birthed. I am here to include in that list of beauty the planned cesarean. For all first-time moms to be, I always encourage learning about a C-section and planning what one wants from that experience. My first birth cesarean experience was less ideal than my second, and I attribute partly to the hospital and also not being prepared for the possibility of a C-section with my first.

A cesarean often seems defined as something to come back from as opposed to something that simply is. My first was an emergency, and the remaining two are medically necessary. Many C-section moms feel need to give reason for another “medical birth,” as if they need to justify the wonderful entrance of their children into the world. Some mamas still feel the wounds related to what brought about that first cesarean. I hope that in thinking about a birth plan for a planned C-section mothers and families can feel joy, excitement, and peace with having a voice in the details of their child’s arrival.

I see terms like “family-centered” or “gentle” birth in reference to C-section births. Some hospitals and doctors do a better job than others. First, simply speak with your doctor (and possibly hospital) about what a cesarean birth can look like. In all honesty, most of mine isn’t written but communicated with my doctor in the weeks leading up to birth and in discussion with the nurses in the couple hours before I enter the operating room. In case of an emergency hospital staff likely aren’t reading paperwork, but having thought through these things allows my husband and me to advocate for our family.

Before birth and during surgery

Spell out your preference for drugs that won’t hinder breastfeeding (if you plan to nurse). For me this included explicitly saying I did not want a sedative as they gave me during the first birth. I was very drowsy and hazy in many memories after the birth of babe. I spoke with my doctor and anesthesiologist beforehand to let them know I wanted conversation about what they were doing. Some moms may prefer staying in the dark about all that “medical” stuff, but I found comfort in having that open line of communication during the procedure. You may want silence so baby only hears you and hubby, as far as possible. The ambiance of the room may include lighting and music, so let your preferences be known in your birth plan and with the medical staff beforehand. My hands were restrained for my first birth but I requested them not for my second.

You may even want to research types of stitching and other details of your cesarean related to your health and safety. The placement of your IV (hand or arm, left or right) might be of concern to you as you plan to nurse and hold your babe in the coming day(s). For this third and final birth, my plan also includes plans on tubal ligation and circumstances in which I would not want that to occur.

Baby-focused

Many of these things may be the same as a vaginal birth, like keeping the cord attached for a longer period, no K or Hep related medicines administered, delayed bath, and more. Skin-to-skin allowances will vary by hospital, but consider if it can occur immediately with you, with daddy, in the operating room or as soon as in recovery. Make note for dad to cut cord if interested. For me, the biggest hope in my plan (aside from the “healthy birth” we all hope for) is to see my baby in all its gooey glory. First babe was taken immediately to the NICU and second came out a concerning shade of blue so I didn’t see him for several minutes.

Lowering the screen just before delivery is what I’ve most strongly discussed with my doctor. Remember to know what is allowed in terms of photography and ask if anyone is the room is able to assist with taking photos of baby and family immediately after birth.

Recovery

We wanted baby with me or hubby at all times and wanted left alone as much as possible in those first few hours after birth for nursing and bonding without family, friends, or unnecessary medical interruption. Others may want to have a mother, sister, friend, or other significant person visit during this recovery time as only one person is usually allowed in surgery. I immediately wanted warm blankets as I uncomfortably shivered with both recoveries. After the immediate recovery and into the first full day, I also consider keeping the catheter in for the first night a big convenience and safety reassurance (we had evening births), but then I wanted to move forward in recovery to have it removed early so I could begin getting up and around in the light with assistance. Your plans for feeding, from formula to nursing on demand, can be outlined as well.

Consider scenarios that could occur, like baby in NICU for a short or extended stay, and how you will respond to meet your plan. For example, immediate access to pumping might help should baby be moved to the NICU. If baby is separated, consider outlining your stance on the use of pacifiers, other people holding baby, and other preferences you may have.

Annie is a mom of two boys, ages two and four. She enjoys the finer things in life, like compression socks and a full night’s rest.

My Birth Story: 41 Weeks

Thursday, August 20th, 2015

IMG_20120531_113708My pregnancy with my daughter was blissful. Honestly. I never had any morning sickness. I was comfortable for most of my pregnancy, my energy levels (after the first few exhausting weeks) were great, and I generally just enjoyed every minute of it. I planned on a natural childbirth in my local hospital and had every reason to think I’d get it…until I began to show signs of pre-eclampsia. Around my thirty-seventh week my blood pressure began to climb and my feet looked like tree trunks. I underwent a Non-Stress Test (NST) and a urine analysis for protein. Both tests went well and my blood pressure dropped a bit, so I was placed on reduced activity and a plan to continue NSTs every other day or so. I knew this could completely change my plans, but the fact that I was already 3cm dilated and 50 percent effaced at 37 weeks helped ease my mind.

At 38 weeks, knowing that I was growing tired of the NSTs, my OB recommended an induction. We scheduled it for the next day (Wednesday). Then I went home, spoke with my husband, listened to my heart, and canceled the induction. By then I was 80 to 90 percent effaced, walking around at 4cm dilated, and not feeling a single contraction (although the NSTs showed that I was having them). Instead of induction, I agreed to continue the NSTs every other day and they moved the induction to the end of the week, just in case any issues popped up.

Since Tuesday of that week I’d been doing all the things they say to try for natural induction of labor, hoping to avoid being induced. I ate spicy things, walked, did bedroom activities, ate Chinese food. My NSTs on Wednesday and Friday went well, showing that baby was healthy, but didn’t indicate impending labor. Since the NST on Friday morning looked so good, my Dr. felt comfortable enough with my slightly increased BP to cancel the Saturday induction and allow me to continue on with monitoring. I left the clinic and treated myself to a large iced chai tea, feeling happy and very indulgent. I then decided to treat myself to a pedicure, since I really needed one and since massaging the feet was also one of those things that might help bring on labor. My nurses later commented on my cute toenails!

Unfortunately, my parents mistakenly had taken the Saturday induction for a sure thing, so they bought plane tickets and were due to arrive Sunday. All I could do was hope that my girl would show up at some point during the week they’d be there. That morning I had posted what was to be my last pregnancy photo on Facebook, with the caption “39 weeks! You can come out now baby!” Little did I know how well she would listen.

pizza before laborMy husband got home from work that afternoon and we intended to pick up the house, mow the lawn, and finish some other chores before my mom and dad arrived. We were going to do inside house things that evening, so we ordered a pizza and were goofing around. At 6:45 I performed a ridiculous “Come out baby” dance (which my husband caught on video). At 7pm we decided to hang the curtains in the nursery. I got up off the couch, walked 10 steps to the nursery door, and felt a small “pop” followed by a release of some warm fluid. It wasn’t much, but we were certain that my water had broken. The dance worked! We called the hospital, let our parents know, put the few lingering things into the hospital bag and waited for the pizza guy. My mother was adamant that I not eat, since I could get sick during labor, but I wanted that pizza!

By 8pm we were at the hospital and that’s when the fun began. While checking in I began to really feel contractions and thought I needed to use the bathroom. They let me, and although it helped a bit, the feeling that I needed to go “#2” got stronger and stronger, which was initially mortifying. The strength of the contractions also went from 0-60, pretty much instantly. For a split second, I contemplated asking for an epidural. Looking back, I only did that because I had skipped the easier contractions and went straight to strong ones, so I was scared about how much stronger they had the potential to get. Both my husband and my nurse urged me to stick to my birth plan, which set my head back into a better place.

_DSC0544

The urge to push was so strong that I begged to be checked. My first check showed 7-8cm dilated and 100 percent effaced. One more contraction, and I was up to 8-9cm, and just one more brought me to 9.5. My fantastic nurse was making sure I didn’t push, to make sure I didn’t cause swelling that would slow the process. With her on one side and my husband with oxygen for me (the most wonderful thing they gave me!!) at the other, my doctor arrived and helped me gently push past the 9.5cm lip. Once we’d done that, it was go time. They gave me full permission to push and the urge pretty much overwhelmed me. I had my eyes closed through most of the process, lost in the crazy sensations and lost in my own head. I very much remember wondering how in the world people go through labor again and again. My daughter tended to yo-yo, so I’d push, my husband would see her and encourage me that she was coming, and then she’d slip back into her cozy world. Frustrating child, I just wanted to meet you!

Ready to leave the hospital-2

After an hour or two of pushing, my daughter was ready to join us. My amazing doctor brought me through the final pushes and then she was here. The whole process was incredible and overwhelming and I was shocked at how fast labor amnesia set in! Just minutes before I was willing her backwards, and then she was there on my chest and the memories of the pain were already hazy! She weighed 7 lbs 9 oz., was 19.5 inches long, and arrived at 11:32pm. From water break to birth, I was in labor for just 4.5 hours. In the end, I had the unmedicated labor that I had hoped for, along with fairly uninterrupted bonding time immediately following delivery.

While the day after her birth was a crazy one in its own right (a story for another time!), I honestly look back on theday my daughter was born with such love and happiness. With all of that uncertainty, all of the stress in the two weeks before her arrival, she chose to arrive on a sunny day when her momma was happy, daddy was close at hand, and family were soon to arrive to celebrate her. She chose a good day.

Kate Cunha lives in the Pacific NW with her husband and daughter. She is a strong believer in birthing without fear and hopes every woman can have a positive and supported labor experience.