Fifth midwife visit/second childbirth class.

[rivka]

Scariest words spoken by the midwife last night: "Before you leave, go ahead and schedule the rest of your visits up through your due date." Up. Through. My. Due date. That's how close it is.

I've hit the rapidly increasing stage of pregnancy - not just baby and belly size, but also number of appointments. I have been going in every five weeks. The next visit is in four weeks, then three weeks after that, then two weeks, then one week, and weekly after that. Two visits from now we need to have our birth plan and hospital admissions paperwork complete, and the midwife will start checking my cervix to see if I'm getting ready to deliver.

Yikes.

For the most part, everything looks great. I'm finally over my prepregnancy weight and gaining at a reasonable rate (six pounds in the last five weeks). The bloodwork I had taken last week is normal. There's no sugar or protein in my urine. My blood pressure is great. My hands and feet aren't swelling. The baby has a strong, steady heartbeat. She's lying on the right side of my belly, with her head down and her feet up by my diaphragm. (This is a refreshing change from the week she spent with her feet firmly planted on my bladder.)

What they never tell you about pregnancy, no matter how forthcoming they're being: The further along you are, the harder it is to pee in a cup.

Today's geeky pregnancy factoid: The distance in centimeters between the pubic bone and the top of the uterus is equal to the number of weeks pregnant you are. (I'm actually one centimeter off. But how cool a correspondence is that, anyway?)

New baby trick: Now that her feet are in a leaner part of my belly, I can see her kick. Not just feel, but see. I first noticed it in the bathtub, but when she's being particularly vigorous I can also sometimes see her through my clothes. That's just weird. And cool, mind you - but weird.

Second childbirth class:
I continue to love this class. Tuesday night we spent the whole evening discussing prelabor and the first stage of labor, which, for those of you not immersed in a home study obstetrics course, covers everything up to the point at which the cervix is 10cm dilated and the mother is ready to start pushing the baby out.

Michele (our instructor) did a nice job of reframing a lot of the uncomfortable and whine-inducing ninth-month symptoms as signs that the body is preparing for labor. I don't know if that will be enough to convince me that peeing every ten minutes, sitting uncomfortably, and backaches are good symptoms rather than bad - but I suspect that it will be helpful to at least know that they can be interpreted that way.

We spent a lot of time dividing up late pregnancy symptoms into "preliminary," "possible," and "definite" signs of labor, and talking about how those symptoms feel and how you know things are starting to get moving. We also took a brief detour into "call your midwife immediately" territory, some of which I didn't know. (For example, it wouldn't occur to me to call the midwife if I didn't feel the baby move for an hour.) We covered, extensively, what it's like when your water breaks and how to be sure that's really what happened. We learned how to time contractions.

Then we got into real labor - early labor ("try to sleep, try to let your husband sleep"), active labor (complete with a vivid dramatization of the difference between an early labor contraction and an active labor contraction), and transition ("Most of you wrote on your registration forms that you wanted to have an unmedicated labor. Transition is when you'll want to change your mind."). She described how the contractions change from phase to phase and what comfort measures might help in different stages - next week we'll apparently spend the whole class practicing comfort measures. She introduced us to the "Three R's" of coping with labor - relaxation, rhythm, and ritual - and we talked about what each one is for, what it might look like, and why it's helpful.

We watched a video of a single couple going through labor and delivery with a midwife. She encouraged us to keep track of all the different things they used as comfort measures (heat, massage, showers, rocking, changing positions, encouragement, walking...), and also emphasized the mother's emotional state - how she got the most discouraged and wanted to give up just as she was getting very close to the end. The video made me cry, but I also found it tremendously helpful to actually watch someone in labor. I feel as though I'm getting a much better sense of what to expect, and that always makes me feel more in control.

We finished up the class with a mini-seminar on breathing - practicing "deep cleansing breaths" and "light breaths," which it turns out is what I know as diaphragmatic breathing and chest breathing - and a relaxation exercise. I had trouble with the relaxation exercise because I kept going into professional-critique mode and analyzing what she was doing. I've got to find a way to turn that off.

Homework this week: find out about our own birth if possible, figure out who's going to be at the birth and what their roles will be, start choosing music, schedule a hospital tour, and repeat last week's massage trade if desired.

Comments

[wiredferret.livejournal.com]

Transition is not only the loss-of-intent part, it is the part where I swear. Not coincidentally, it's right around there that I completely lose memory. Well, not completely. But enough so that things happen that I don't at all recall. The mental sensation is very similar (for me) to coming out of a sedative. Also, I am scared before transition (first time because I didn't know what was coming, second time because I did ;>), but during, I am just angry at everyone, because it is someone else's fault that I feel like this. That was my big PPD symptom -- guilt about that.

Anyway, in encouraging news, I never had to pee that often, I decided that 7+ months entitled me to use the handicap bathroom, and this is also the stage where people take care of you. I liked that part a lot.

Did you talk about how, if you don't feel the baby moving, you can also get some sugar and lie down on your back? (in addition to the midwife) That always got my kids going. Clementines and being on my back.

[sashajwolf.livejournal.com]

Another trick to get the baby moving: drink an ice-cold glass of water, followed immediately by a hot cup of tea, both down in one. I learned that one from the midwife who looked after me when I had to go into hospital for them to check whether my waters were leaking during my third pregnancy, and my daughter wasn't co-operating with the exam ;-)

[rivka.livejournal.com]

That sounds like a great combination: cold, heat, and stimulants. That would get my baby going, especially if the tea were sweet.

[rivka.livejournal.com]

Did you talk about how, if you don't feel the baby moving, you can also get some sugar and lie down on your back? (in addition to the midwife) That always got my kids going. Clementines and being on my back.

Yes. She said, "eat something sweet, or something cold, or something sweet and cold. Then lie down and wait. If you've done both of those things, and you still haven't felt any movement after 30-45 minutes, call the midwife."

My mother's advice last night, should I not feel the baby move: put a cold pack on your belly. She says that most people who go to the ER for lack of fetal movement feel the baby move when the cold ultrasound gel goes on the belly.

I bet that would work for Li'l Critter. She always responds to cold.

Transition is not only the loss-of-intent part, it is the part where I swear.

I hope you don't mind that I used you as an example, in class. The instructor was talking about how sometimes women get absolutely furious during transition, and I said, "Our friend said that her husband didn't even know she knew those words." It seemed like a good illustration of the point. :-)

I do remember your guilt about it afterwards, though. I am worried that I will be difficult to deal with during labor, and a burden on Michael. My mother reminds me that I was always relatively easy to take care of after surgery, so hopefully some of that will carry over.

[mactavish.livejournal.com]

My sister used to watch her baby turn over, because the kid always had an elbow out. It'd crawl across her belly like a little live . . . bump.

I'm very excited for you.

[jonquil.livejournal.com]

I've never forgotten watching the little pointy bit slide across my belly.

Of course, after the kid was born, I realized that was her little pointy tailbone... (lack of body fat gives you a pointed ass. It gets buried soon enough.)

[therealjae.livejournal.com]

complete with a vivid dramatization of the difference between an early labor contraction and an active labor contraction

Do tell.

-J

P.S. Homework. *snicker*

[rivka.livejournal.com]

Do tell.

"An early labor contraction, she might say..." She stood with her hands rubbing her belly, looked up, and said conversationally (as if to her birth partner), "Oh, yeah, I'm really feeling this one... it's mostly in my stomach, but it's sort of speading around to my back, yeah, this one is definitely stronger... okay, there it goes."

"And then there will be an active labor contraction." She stood stock still, hunched over a bit, hands holding her belly, and moaned (with her face sort of closed and inward) "Ohhhhhhh... Ohhhhhhh... Ohhhhhh... okay, that one was different."

(And in fact, one of the signs that it's time to call the midwife and/or go to the hospital is when you can't talk through a contraction.)

P.S. Homework. *snicker*

I've already done part of it! I am amazed at how much my mother remembers about my birth, given that I was the fourth child, born 31 years ago.

[ailbhe]

Baby playing plate tectonics! Whee! Before you know it, you'll be playing Feet!

[wild-irises.livejournal.com]

For what it's worth (I may have mentioned this here before), I have a very close friend who loves transition and laughs through it. And she's not kinky ...

[saoba.livejournal.com]

For extra fun, try wearing a tshirt with thin horizontal black and white stripes. When the Lil Critter does a Pointy Bit push across your belly you become a mobile Op Art Installation. Plus, it amuses/freaks people out. (It's one of those 50% universal things.)

Transition? Here's something to I found it helped to keep in mind, it's a natural stage in labor and once it's done you have this nifty new baby to stare at. The physical components of transition seem to be amplified by the absolute cocktail of biochemistry flooding your system.


Now, be a good girl and do your homework.

[papersky.livejournal.com]

And they say the metric system isn't a natural form of measurement. Imperial may be based on thumbs and feet, metric is clearly based on the cervix.

On the medication issue, find out what possible things they might give you if you change your mind and which you might accept. You're probably thinking it's only pain, and you're familiar with pain. They changed my mind before transition by telling me that I was tensing against the pain and the contractions weren't doing as much good as if I was relaxed... and promptly injected me with something that wasn't in my book (I kept saying "no pethedine") and which made me feel stoned. The really weird thing was that it made Ken feel stoned as well, and he didn't even get any, and it made the midwife tell us her hippy childbirth story, about a home birth where they were all passing around joints, including the mother-to-be...

[rivka.livejournal.com]

On the medication issue, find out what possible things they might give you if you change your mind and which you might accept.

The thorny issue is that my spinal fusion probably rules out an epidural, and that means that my remaining choices are narcotic. (Nitrous oxide is not used for American births, although I know it's quite common in the UK.)

One of the interesting things my mother told me tonight is that, when she was a student nurse, she observed births medicated with scopolamine. She said the women screamed and cried continuously throughout labor, and afterward they didn't remember anything at all about having the baby. It horrified my mother so much, she resolved that she just wouldn't need pain medication during childbirth. And she didn't.

You're probably thinking it's only pain, and you're familiar with pain.

Heh. You read my mind. I'm hoping, though, that I'll find it useful to remember that hip pain accomplishes nothing, whereas labor pain accomplishes a baby. (My mother, again (she gave me quite the labor pep talk, tonight): "The other difference from your hip pain is that when you're in labor, between contractions, you feel pretty darn good. Even when the contractions are very close together, you can still regroup between them.")

[metacara.livejournal.com]

I don't know if I am a total freak or if people just don't talk about this, but when I was in labor, of course it was agonizing, but then during active labor (I guess it was active)I felt "the urge to push", which is actually more like "waves of exquisite pleasure caused by bearing down". At this point I had been begging piteously for drugs, any drugs, and then I got an interthecal injection and suddenly both the pain and the pleasure went away, which I had mixed feelings about. I am thinking that for this delivery I might go drug-free just to get that "urge to push" again. I just wanted to mention this because it was my experience and although I read birth books voraciously, no one seemed to mention this wonderful feeling. Just to be clear, the rest of labor felt like I was being torn in half, though, and there was a lot of screaming from me. But if you do go drug free there is a distinct possibility that the end stage of labor will feel really good, and that's something to look forward to. (to which to look forward?)

[filkerdave.livejournal.com]

Wow, this brings back memories! Have I mentioned yet that when you pack your hospital bag (assuming you're delivering in the hospital) that you pack one for him, too?

For YEAR and YEARS I was saying "deep cleansing breath" to my (now ex) wife when she was getting all het up about something.

[zencuppa.livejournal.com]

I still use the breathing exercises to keep myself calm and I am starting to teach Nick to use them too :-)

[zencuppa.livejournal.com]

"We covered, extensively, what it's like when your water breaks and how to be sure that's really what happened."

-- My water broke at home with Matthew (second child). When I went into the hospital and they wanted to examine me to *make sure* my water had broken, I said "I don't need an exam, I was *standing* in the fluid in a plastic container." The nurse replied "Oh, no exam for you, you passed the 'puddle test'" *wry grin.*

From the first real contraction to delivery, my first child took seven hours. From breaking my water to delivery of the second child, five hours. Lamaze breathing, lots and lots of walking, an excellent birth plan and doctor and a great husband . . But more than anything else . ..walking and the realization that I am finally going to meet my baby!!

I am excited and happy for you :-)

[ruth-lawrence.livejournal.com]

Extraodinarily exciting and always amazing!