Tuesday, June 29, 2010

AF you're LATE!

I am on cycle day 40! This is a record for me. I didn't want to test because a negative is disappointing even when/if I really don't want a positive. In those 3 minutes you wait before viewing the result, I completely convince myself that I want a baby. Just for those 3 minutes. I know that emotionally, financially, and physically I am not quite ready, but I still find myself wanting another baby so badly in those 3 long minutes that when the test shows only 1 line, I feel devastated.

I finally broke down and tested and of coarse it was negative. DH was really sad, which made it even harder. My LMP was May 21st. We are on July's doorstep and I still haven't seen AF. I am seriously annoyed. Since I haven't been temp charting, I have no idea when or if I even ovulated. This will be the last cycle where I am in the dark about my own body. I don't want to go through this kind of stress each month. I am going to start charting so I can avoid all this stress. If I knew that I ovulated late or even just how many days past ovulation I was, I wouldn't be stressed at all.

I know the tests are pretty accurate, but I always wonder if I will be one of the few people who get false negatives. I never have gotten a false negative, so I should just quit worrying and know that AF will be here soon enough. I will be wondering why I was ever excited for her visit once the cramps and bleeding start. I wish I could quit wondering about it. I wish I could shut my mind off, but no. I am literally losing sleep over this. I can't seem to snap out of it. I worry about what I would do if I was pregnant (like I mentioned before, not emotionally, physically or financially ready for another kid yet). I worry about how I will feel when I know for certain that I am not. I don't feel pregnant, but maybe I subconsciously want to?

I'm a mess.

Sunday, June 27, 2010

Getting closer to a decision

I have had so much stress and anxiety about making a decision about what I want for my next birth. I don't want an overly medicalized birth that generally happens in the hospital, but I don't feel comfortable enough to birth at home. I kept looking for a happy medium. I needed the right mix of comfortable personalized and unmedicated care and the safety-net of the hospital for that dreaded "what-if" factor. (I know there are lots of people who believe that it is more dangerous to give birth in a hospital, and to them I say, you're right. I have read the research and I believe that to be true, but I still feel more comfortable in a hospital. Who knows? Maybe I will change my mind by the time I am actually pregnant.)

I have been hoping that going to a Certified Nurse Midwife (CNM or hospital midwife) would be the middle ground I was looking for. I was told not to expect much. I was told they are only as good as the OB's that control them and that they have to transfer patients to the OB's for nearly everything. I started to doubt that a middle ground even existed. Then, after lots of phone calls I realized that much of what I had been told was true, but not all of it. I realized that, just like any medical professional there are good and bad providers. I felt like I just needed to find the right CNM, and I think I did. :)

Today I met with a CNM named Lindsay. The clinic where she works is in a large hospital. This clinic says (on their website and reitorated in person) they are intentionally small in order to provide personalized care. They have only 1 OB and 2 midwives, including Lindsay. The OB is the doctor who delivered all 3 of my boss' children. She wanted an unmedicalized birth with her second and third children and he was very supportive of that. I considered going to him, but I really just don't like the idea of choosing a surgeon to help me with something that doesn't and should only in rare instances require surgery. I was thrilled to hear he had CNM's working in his office.

I talked to Lindsay for over an hour! She never seemed rushed or irritated by the questions I had. She asked me a lot of questions too. She wanted to hear about my husband and family and how long we had been married. She asked me to tell her about my first birth and my experience with the OB and the hospital and nursing staff. We talked as though we were friends instead of a doctor-patient relationship. I felt so comfortable with her.

I told her about my episiotomy and she told me that she never does those. (Exactly what I wanted to hear!) I told her about how I was induced because my baby was big. She told me that big babies are not an medical reason for induction and she doesn't do elective induction. (Exactly what I was hoping she would say.) I asked her about which circumstances required her to transfer my care to an OB and she told me only if I have gestational diabetes that requires insulin, or severe preeclampsia. I asked her if I had to transfer to an OB if I was overdue and she told me only if I was 43 weeks. She could deliver my baby up til 42 weeks 6 days. I was concerned about that so I felt relieved. I asked her about autonomy during labor and she told me she encourages intermittant fetal monitoring and no iv. She said her patients usually labor in the jacuzzi or walk around. She told me she delivered a baby yesterday while mom was standing up. (Awesome!)

I then asked her about hospital policy on several things. Since she was a labor and delivery nurse at that hospital she was familiar with the staff and policies. I wanted skin to skin and to breastfeed immediately after birth. I also felt strongly about delayed cord clamping and waiting for established breastfeeding and bonding before bathing the baby. She told me all these things were no problem at the hospital so long as baby was breathing. Baby always rooms in (unless medically required to be elsewhere but I don't even want to think about NICU) and won't come in to weigh or check baby until an hour or more after birth. They encourage bonding and breastfeeding. I am sure I will have to make a request for these things, as I doubt that is standard procedure, but I am glad my CNM will back me up. She told me I wouldn't need an iv unless I tested positive for group b and even then it would be a hep lock that could be removed so I could walk around and not be stuck to the pole.

Anyway, I felt really comfortable with Lindsay and I feel comfortable with my decision to have a hospital birth with a CNM. I am open to change and will continue exploring other options, but I feel relieved to have made some progress. I still need to get pregnant first! I am still open to other options, so it's likely I could change my mind and skip the hospital altogether. My next plan is to gather the required paperwork from the hospital and go over the details. That may help me decide if a hospital is really where I'd like to give birth.

Monday, June 7, 2010

Fence sitting is frustrating

I have been thinking a lot about what I want for my next birth and I felt I should start writing a birth plan to get a clear idea. That got me thinking about who reads the birth plan and if it will even matter whether or not I have one. If the doctor or nurse will just ignore it, why go to the trouble?

I think maybe I will write one out to get a better idea of my own wishes for birth. Then I can work on choosing a health care provider that will support my wishes. I am still leaning toward a drug free hospital birth, but that could easily change. I really like the idea of  homebirth but I still don't feel comfortable enough to plan for it. I know that it is safer and that I will get the birth I want at home, but I still don't feel comfortable with it. I want a homebirth, but I am scared. Why does a hospital that has more germs, more unnecessary interventions, and less freedom feel more comfortable?! Maybe because I have been a sheep for too long. It shouldn't feel more comfortable, but it does.

I have a long road ahead of me.

Revised Birth Story

After rereading my birth story from a year ago, I decided to write a revision. No longer do I feel the need to be defensive or afraid to admit any negative feelings about the birth of my son. I know it was a happy day and I will remember it as such. But that doesn't mean nothing negative happened. This is a pretty straight-forward account of my birth. Not overly happy, not overly sad. Just a normal, routine unnecessary induction.

Toward the end of my pregnancy I went to the OB for weekly visits. Dr. Hansen checked my cervix each time and would tell me how far I was dilated (or rather that I wasn't.) My baby was still really high, I had absolutely no braxton hicks contractions, I was dilated to a 2 and labor seemed weeks away. My body wasn't ready to give birth yet. My doctor asked how I felt about induction and I immediately jumped at the chance to not be pregnant anymore. (How foolish of me.) He told me I would have to wait until my due date. He wouldn't induce any earlier than that. We scheduled my induction at 6:00 a.m. the day I was due.

I arrived at the hospital right on time and checked in at the nurses desk. They took me too my "birthing suite" and gave me a hospital gown to change into. I did as I was told despite the fact that I felt very uncomfortable in the hospital gown. (Anyone who knows me well, knows how insanely modest I am, especially around strangers. I love to be covered up and cozy. No wonder I love the winter.) Then I was given a stack of forms to read and sign. I was informed that if I had any questions about the forms, to ask a nurse and they would happily explain. I did have questions. I was given a short response that included little to no relevant detail about my questions. Basically, when I brought up a concern, I was told not to worry. Forms were signed and I was asked if I wanted an epidural. I hadn't even had pitocin to start my labor yet! I told them I planned on getting one, but that I wanted to hold out as long as I could so it wouldn't slow down my labor.

They put in my I.V. and my contractions started. I was hooked up to an external fetal monitor and a contraction monitor and I was stuck in bed from 7:00 a.m. til 2:00 am the next morning.

At about 10:00 a.m. a doctor that I had never met came in and broke my water. It hurt pretty badly and it was very uncomfortable to be stuck in a wet bed. I asked the nurse to change the linens and I was told that I would continue to leak so there was no point. They did change the linens right after they broke my water (the ones that were completely soaked) but after that I was stuck in a damp bed the rest of the time.

My contractions became more intense, but I didn't focus on them. I was enjoying my time with my husband. We played backgammon and listened to an audio book. We actually had a good time. It was wonderful being with him in anticipation of our baby's arrival. We had some great moments together just the two of us before adding to the family. The nurse came in periodically to check my cervix and ask if I was ready for my epidural yet. I held out pretty long. I was feeling ok and didn't want the epidural to slow down my labor. Little did I know that as soon as they give you an epi, they crank up the pit to keep you progressing on schedule.

The nurse came in and said my contractions were pretty intense and were happening one right on top of another and my baby's oxygen level was low. I was given oxygen and shortly after, the nurse assured me everything was ok. (Hello?! Maybe the pitocin? Thankfully I avoided the fetal distress that would have gotten me wheeled into the operating room.)

Mid-afternoon (around 3 or 4 p.m.) the nurse came in and said my contractions were about as bad as they would get and if I wanted the epidural I needed to get it now or never. I thought about not getting it and felt like I could do it, but I really felt compelled to just get it. I kept having this nagging feeling like I should just get it. The anesthesiologist came in and gave me the epidural. I felt numb almost immediately. I remember feeling really numb on my left side and not so much on my right.

Shortly after my epidural I was told that my doctor was stuck in a snow storm and wouldn't be able to get to the hospital for a while. I was asked if I wanted to have a different doctor deliver or if I wanted to wait. I felt so relieved that I had gotten the epidural because I didn't feel pain or pressure and I was able to wait for my doctor.

About 2 hours later, my doctor arrived and I was told to push. I pushed and instantly felt sick. I turned my head to the side and ended up puking in my hair instead of that bean shaped hospital puke dish. I was so nauseous that I wasn't able to push. The doctor told me to just catch my breath and keep pushing. With difficulty, I managed to calm my stomach and concentrate on pushing. I started to tear and the doctor gave me a 3rd degree episiotomy. I still remember the look on my husband's face when the doctor did that. I wish I had gotten a picture. I didn't have to push long once they cut me. My son was born and I could hear his scream the second he was born. He came out screaming. The doctor asked the nurse for the suction and she dropped it. I remember my heart skipping a beat and worrying that my son would suffocate because they didn't suction him fast enough. The nurse quickly grabbed a new one and I calmed down. (Now I know that I didn't need to worry. Babies don't need to be suctioned at all.)

My husband cut the cord and the doctor put my baby on my belly and he was bright purple screaming his head off. I thought right in that instant, "Whoa! He looks like my sister!"  That is still a funny memory. Before there was room in my head for another thought, the nurses took my baby to the table next to my bed and washed him and weighed him. My husband was there taking pictures and watching the nurses at work. We were going to wait to see what he looked like before naming him and DH looked at him and decided on a name. For blog purposes I use my nickname for him. He is my little lovey-Lou and I call him that all the time, so on this blog is he Lou :)

The nurse increased my pitocin and in a matter of about 3 minutes my placenta was born. The doctor inspected it and held it up for me to see. I immediately turned my head away. "Gross!" I couldn't look at that red mass of yucky. (I'm gonna look next time.) He said everything looked healthy and he started sewing me back up. It took nearly 45 minutes to sew me back together! I just sat there bored since my baby was over on a table being weighed, cleaned and checked. (At least he was still in the same room.) I ended up calling my family on my cell phone while the doctor was still sewing. (Rude, I know.)

He finally finished and my husband and I had time with our son before the onslaught of family showed up. I have a big family and they all showed up within an hour it got crowded fast :) Dh's family lives farther away and they came the next day.

The nurse came in and told me Lou needed to be fed. I asked if I could nurse him (Why am I asking if I can feed my own child?!) and the nurse told me his blood sugar was too low and that I needed to give him just half to one ounce of formula. That was the very first thing he had outside the womb. FORMULA!! No wonder he had a hard time nursing afterward. He got a bottle first.

After my family left, I got settled into a recovery room. I had to be wheeled in there because my left leg was still numb. The numbness didn't wear off for hours and hours after Lou was born. That was really annoying.

Lou was able to room in with me and he didn't leave my side the entire time I was there. I was able to breastfeed and Lou didn't get any formula at all besides the very first time. I was able to work with a lactation consultant and felt more confident each time. Besides that one incident, I was surprised at how breastfeeding friendly the hospital staff was. I was never offered formula again. I was also not even sent home with any! That was actually a surprise.

I grew tired of the hospital very quickly and convinced my doctor to release Lou and me a day early. The doctor actually had no problem with it. I was glad. It made me wonder how much sooner I could have left.

I have learned and grown so much since the birth of my son. I am so happy things turned out the way they did. I am so grateful for the experience I had. I am also grateful for the knowledge I have now. I am grateful for the options that now know I have. I am grateful for the person who opened this door for me. She is the one helping me transition from ignorance to empowerment. I owe her a lot. I am excited to write my next birth story. I know it will be another happy one, but a different one too. Just need to get pregnant first ;)

Sunday, June 6, 2010

Is ignorance really bliss?

I LOVED my first birth. I don't really have anything that I would change about it. Sure my episiotomy sucked, but it wasn't bad considering what could have happened. My  incredible SIL started a "doula blog" (wow. She has come a long way since then.) and asked me to share my birth story. Being a bit (yes I'll admit it) ignorant and defensive, and knowing this was going on a "hippy birth" blog, I wrote everything as though I knew exactly what was going on in my birth and was in complete control the whole time. It's defensive and a bit self righteous but if you must, you can read my birth story here.

Having reread my birth story over a year later (Lou is 2 &1/2 but my birth story was only written a year ago), I realize that there are a lot of things I wasn't in control of. It was the perfect birth because I was the perfect patient. I wasn't an active part in it at all. Yes. Technically I was the one who approved the decisions that were made. I certainly felt I was informed in those decisions and I honestly feel that my doctor and nurses didn't intentionally hold anything back. I think they really felt all the interventions were safe and that I knew what I needed to know before proceeding. I don't have any negative feelings about the doctor or nurses. I think they are a bit ignorant themselves, but I don't believe they meant any harm. I am still glad I was able to have Dr. Hansen deliver my baby. Like I said before, I wouldn't change anything. But I also wouldn't repeat it.

Sure. I was happy in my ignorance. Yes. I was lucky everything went smoothly. But what if it hadn't? Would my ignorance be bliss if it involved sitting next to an incubator watching my child have tubes and monitors put all over him? Would it be bliss if I had a scar on my abdomen where they had to cut my baby out? Would it be bliss not being able to hold my child, or breastfeed him? This sounds like more like a nightmare; one that many people I care about have had to experience. This the bliss that comes with being ignorant of your choices in birth. This is reality slapping you in the face. Forcing you to live with consequences of some choices that you may not have had control over; choices that doctors may have made for you. (Understand that I am not judging anyone over their choices and I am certainly not referring to a specific event. I am just talking about how I feel about potential outcomes from medical interventions.) The only thing blissful about ignorance is when things turn out well despite your poor choices. When out of sheer luck, you manage to walk into a dangerous scenario and come out unscathed.

So is knowledge what brings about bliss? I wish. Now that I know more about my choices and what could have gone wrong in my birth, I am more terrified than ever. I know I have reached the point of no return. I can't go back to the blind faith in doctors who may not have my best interest at heart. I can't go back to the hospital where medical interventions were routine and where the epidural was constantly mentioned. I can't go back to the ignorance that once held me back.

I can't go back, but I am not ready to go forward.