Sunday, March 20, 2011

"Every Pregnancy is Different..."

This is one of those things that women say: "Every pregnancy is different..." This comment can be a catch-all for whatever may ail you - or bring you joy and pleasure - as a pregnant woman.  The Runner and I have been blessed with three gorgeous, perfect children - and yes, each one of my pregnancies was different.  But really, not THAT different! I was still me carrying a baby each time.  I still gained about 35 pounds with each child, and I always ended up with a giant, scary belly that contained either a 9+ or 10+ pound person.

What was profoundly different for each of my pregnancies was the way they ended. The way each child arrived was unique and deeply meaningful in very different ways.

Our oldest, the Talker (and sometimes the Reader), was born via c-section after a long labor. My cervix had "failed to progress" in its dilation. I had every intervention in the book: internal fetal monitoring, pitocin, epidural, spinal block...oh, what an overwhelming way to learn about maternal/fetal care in a top-notch teaching hospital.
He was BIG. Nine pounds, five ounces. He had a gigantic head. My recovery was challenging: my incision leaked, I developed mastitis, and I was almost readmitted to the hospital after a week at home due to a very high fever. I struggled emotionally - often feeling confused about why I was disappointed in the birth process. It was difficult, and I didn't really have anyone to relate to, since most of my friends were still single at the time, and pretty much no one I knew, aside from my new neighbor, had a baby or had a c-section.  The Talker was - and still is! - a delight.  Without him, I think I would've become truly confused about how to be a mother. He was a gentle, easy baby who allowed me the space to process what needed processing. And what a joy to have a son!

Our second baby, Miss Rosie, was my first VBAC. I cross-posted an article I wrote for the Chicago Moms Blog in 2010 about my experience preparing for her birth. It was an uphill battle - challenging for me and for the Runner, who wanted, undoubtedly, to protect me from any more emotional or physical pain. Miss Rosie was a long labor, too - and though I'd planned to birth naturally, the labor was irregular and long, and I was getting so tired. To regulate my coupling contractions, my midwife suggested a very low pitocin augmentation, which I agreed to. I also suggested an epidural at that point in order to conserve energy for what I anticipated would be a longer pushing phase. This series of decisions turned out to be perfect. I DID push for two and a half hours, but I requested that the epidural be turned down low enough that I could squat and move around as I needed to. The acute burning sensations of birth were numbed by the epidural, but I could still feel her descending and could direct my pushing effectively. Miss Rosie was 9 lbs, 12 oz. Even bigger than the Talker! We couldn't believe it.  I had quite a bit of bleeding after her birth - I could have received a transfusion, but our midwife preferred that I take iron supplements for a month and rest, rest, rest.  Still - with the complication of heavy bleeding, I felt tremendously more whole following Rosie's birth.

Last and certainly not least, the Bruiser's birth was notable. I went into labor a mere 20 hours after the conclusion of a terrible snow storm in Chicagoland, and though we could get out of the neighborhood, the roads were still quite slippery. My contractions went from 20 minutes apart to 5 minutes apart within and hour and a half, and we left for the hospital at my midwife's urging. I knew from past experiences to expect that my labor would slow significantly once we pulled into the hospital parking lot.  I was right!  As I stuffed the last of my granola bars down my throat (they won't let you eat any food in most hospitals during labor - which makes me really cranky!), I could feel my adrenaline surge. Adrenaline is not labor's friend. Once we checked in, my midwife checked my progress. I was at 8cm!!!  Wow. That was really something, since labor had been quite manageable up through that point. But...then things slowed down. About five different people swarmed the room as I was getting settled in, taking my blood, putting a fetal monitor on my belly (which would need readjusting every 4-7 minutes because it would not stay put), bringing in the baby warmer and all the supplies they would need once the baby arrived. It was overwhelming, and I started to feel frazzled and distracted from the work that I needed to do. As a people pleaser, I felt that I needed to be smiley and chatty with every nurse or tech that came through the room. This is also bad for labor. The Runner is also a people pleaser, so the two of us were chatting it up with the staff, and my labor took a hike.

One other piece to note: I have performance anxiety when it comes to labor. With each baby, checking in at the hospital virtually halted my labors. I seem to be one of these people who would prefer to give birth like your house cat: get comfortable in a dark place where I can do what I need to do without being bothered, and all moves along effectively. In a hospital setting, I tend to feel watched and judged - even if I am in the room with people I trust, like the Runner and my midwives! The constant monitoring makes me anxious and frazzled, and the implicit lack of trust in my body to do what it knows how to do makes me angry. That is a BAD cocktail of emotions that presents serious roadblocks to the "love hormone," oxytocin, which is integral for beginning and maintaining labor.

After breaking my bag of waters and waiting for a long while, the OB on call came in to check on how we were all doing. My midwife reported that I was dialated to 9 on one side of my cervix, but I had a "lip" that made the other side of my cervix feel more like 6 or 7 cm. Knowing of this cervical lip scared me - that was one of the reasons I had a c-section with the Talker.  I was instantly afraid of the same outcome, but my midwife assured me that we were not anywhere near discussing a c-section.  After a sigh of relief, the OB and midwife suggested that I try to push away the lip.  "You can DO that?!" I asked.  This might sound completely nuts, but being able to try that made me feel incredibly empowered - like I was able to work with my body to muscle through what some OBs would label as a major setback in labor.

So we pushed.  I pushed from the inside, and my gentle and kind midwife pushed, too.  I will spare you, dear Reader, the gory details, but let's just say that while I pushed, she used her hands to push my cervix back over the baby's head.  Ouch, right?!  You bet.  But, all things considered, it wasn't that miserable. I pushed, she pushed, and within 5 or 6 contractions the lip was gone. Then it was time to push the Bruiser out, which was remarkably different from my experience pushing with Miss Rosie.

Clearly I felt a lot more without the epidural.  The sensations were overwhelming at first - burning and stretching sorts of pain, mostly - and it was difficult to focus on the task of pushing. Honestly, I began this phase terrified of the process of pushing. The other sensations were intense and distracting. I know I whined to everyone in the room that I couldn't do it - that I didn't want to.  But really, there was no other alternative. Once I steeled myself and got down to business, the pain stopped hijacking my attention. I was able to focus on moving the baby down and out.

And out he came. All 10 pounds, 3 ounces, and 22 inches of him. Remarkably, I only tore a tiny bit - 5 or 6 stitches worth. My midwife laid him on my chest immediately, completely perfect and new. And then the afterglow of birth began. For about 90 minutes the Runner and I stared at our newest child, marveling over his beauty and sharing the joy of parenthood together.

The recovery from the Bruiser's birth has been the easiest of the three. The two main differences from the other births are: 1. I skipped the epidural (and any other pain meds) and 2. As soon as I got home, I put on a postpartum compression garment (like a girdle!) that helped me regain proper posture more quickly. I'll be writing more on the benefits of compression later this week.

I am blessed to have carried three beautiful babies to term (and then some!), and I am proud to have brought them forth into this world in three very different, very special ways. The journey of childbirth has been, for me, a process of profound growth and empowerment. I hope all mothers can identify with birth as a special expression of womanhood.

Thursday, March 17, 2011

Happy Saint Patrick's Day!

I have two wishes for this St. Patrick's Day:

1. To make a batch of scones to have with tea this afternoon.
2. To bring my little Irish laddie home from the hospital.

Beannachtai na Feile Padraig!

Monday, March 7, 2011

Motherhood Makes You Powerful

NOTE:  This original post first appeared on May 9, 2010 on the Chicago Moms Blog.

0708margaretbreeze-h 432 Motherhood has made me bolder than I ever thought possible. Perhaps it just comes with the territory, but 3 years of caring for my son has created a defensive/offensive place inside me: For him, yes, but also for myself. About a year ago I put this defense-offense strategy into play at a critical time in my life. After a long year and a half of trying, I became pregnant with our second baby. I was determined to give myself a truly fair chance at having a vaginal birth. Our son was delivered by c-section, and my recovery was extremely uncomfortable, both physically and emotionally. I know many, many women who have recovered easily from c-sections and would choose that birthing method again. In fact, 6 of the ten women in my playgroup gave birth to their first child by c-section. That’s sixty percent! YIKES!

I was about 22 weeks along when I started feeling antsy about the OB/GYN practice I was seeing. My son was 9lbs, 6oz at birth. When I met the head OB in the practice, he read my chart, shook my hand, and exclaimed, “Wow! Nine pounds! That’s a big baby boy!” The underlying message I received, whether he intended it or not, was “If you have another big baby there’s no chance you’ll have a vaginal delivery, lady.” I had shared my desire for a low-intervention, natural childbirth over and over again with the various doctors in the practice. They responded that I could certainly attempt a VBAC (vaginal birth after cesarean) if that’s what I wanted. I left that appointment so frustrated and angry. I felt like I had to defend my choices over and over again to doctors and nurses who were paying me lip service while being wary of me trusting my body to do the job it was meant to do.

Honestly, VBAC is not as scary or dangerous as many obstetricians would lead women to believe. Yes, there is a risk of uterine rupture. It’s very small. Statistically, a rupture will occur in about 1 in 180 VBACs. And if a rupture does occur and you are birthing in a hospital with a surgical team present, the rupture is highly unlikely to cause harm to the mother or baby. This is the one of the many things obstetricians are highly trained to deal with: obstetric surgeries and emergencies.

Doctors are likely to tell you that the risk of uterine rupture doubles with a VBAC. That is true. What they are not telling you is that the risk increases from 0.3%-0.5% to 0.6%-1.0%. In fact, it’s more dangerous for mom and baby to undergo a repeat cesarean than it is to attempt a VBAC (ICAN).

But I digress. For another week or so I stressed. Big Time. I wondered if I was being selfish for wanting a vaginal delivery. I worried that my uterus would rupture and kill my baby. I worried that my husband and my friends thought I was crazy. I worried that I would be absolutely alone in my decision. That worry came true. I was alone in the decision. But, ultimately, that was okay. After about a week of agonizing I called West Suburban Women’s Health in Willowbrook and made an appointment to meet with one of the midwives.

I switched practices. That decision came easily. Though I fought away feelings of guilt for “abandoning” my previous OBs, I eventually understood that childbirth is not about pleasing people, it’s about getting a job done. And I wanted to participate fully in accomplishing that task. I knew there was a chance that my VBAC would result in another c-section. I tried to prepare myself for that possibility by talking about how to make the surgery as birth-like as possible. I explained to my midwives how I desperately wanted to nurse the baby within an hour of the birth, and I wanted to use a mirror to see the baby being born, since I wouldn’t be able to feel it with a spinal. They supported me beautifully as I worked through the complex emotions I carried around after my c-section. They eased my anxieties when I was still pregnant on my due date, and even met us at the hospital on the Fourth of July because we thought my water had broken. It hadn’t. Days later they cheered me on for over 12 hours of labor - and insisted that I collaborate with them on every single decision in that delivery room.

Our baby girl was born after two and a half hours of pushing, and she was 9lbs, 12oz. Six ounces heavier than my big baby boy! My recovery was so completely different from after my c-section. I couldn’t believe how much better I felt - and looked - this time. I am still shocked at the differences between the two experiences. Ultimately, however, I am overwhelmingly grateful for my c-section. The joy of having a son, our first child, was perfect. There is nothing like seeing and touching your baby for the first time - not to mention sharing that moment with your partner. But on another level, I am grateful for the experience because it led me to a deeper understanding of myself. I am proud to say that I used my c-section to learn about the situation many OB/GYNs face at their hospitals and through their insurance carriers when they consider allowing VBACs. I learned that midwives are some of the coolest, kindest, most patient, and most empowering women I know. And perhaps most importantly, I re-learned how to trust my body and revel in the miraculous things it can do.

I wouldn’t change a thing. Motherhood has made me powerful.

Friday, March 4, 2011

Welcome to the Bruiser!

On February 3rd, we joyfully welcomed our third baby.  Around here, we'll call him the Bruiser. He weighed in at 10 pounds, 3 ounces and was 22 inches long.  We've been recovering well at home, and life is returning rapidly to a new form of normal.  In fact, my own recovery has been the easiest, despite the Bruiser's heft.

As I've reflected on my recovery, I've wondered what has made this go around easier than the others.  There are many thoughts running around in my mind, most of them related to the simple fact that I've done this before.  But in talking with friends, I've realized that over the years I've amassed quite of bit of information about labor, birth, and postpartum recovery.  So I've planned a series of posts about it all.  My guess is that there will be at least six of them, two each for pregnancy, labor & birth, and postpartum recovery.  It's likely that once I get going, that will be expanded, but for now, that's the plan.

Blogging took a long hiatus during the last months before the Bruiser's arrival. Between the holidays and ample contract work, I barely had time to wash the baby clothes so the new one would have something to wear home from the hospital!  Additionally, a lot has been going on with the Reader and Miss Rosie. The Reader will be officially tested for a variety of intellectual competencies next week. We discovered, with the help of his amazing preschool teacher, that he's reading at a 5th grade level. More on that later, but I've been investigating giftedness in relation to parenting - though that investigation is on hiatus with the arrival of the Bruiser. We've also been watching Miss Rosie turn into a true toddler. She has full-on tantrums like we've never seen before! But she remains our sweetest darling, too.