Baby notes and fifth childbirth class.
Feb. 8th, 2005 05:40 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
rivkaI never got around to writing up the fifth childbirth class, and tonight is the sixth and last. So this is a catch-up post.
It was also supposed to include an account of my 32-week midwife visit, but we got to the office this morning to discover that four of their clients were in labor and one of the midwives was out with strep throat. Unsurprisingly, office visits were canceled for the day. (Apparently, they tried to call and tell us so while we were in the shower.) So, alas, no midwife update.
Just in the last week, the third trimester has hit me like the proverbial ton of bricks. After three days in a row of thinking, "wow, I'm having a rough day today - I must have overdone it somehow," I realized that the unnaturally charmed portion of my pregnancy is probably over. I felt fantastic right up through the end of the seventh month, so I don't have anything to complain about - but now it's different. I'm tired. By the end of the day, I'm exhausted. My pubic bone hurts when I get up from sitting or lying down. It's gotten harder and less comfortable to move around. And did I mention that I'm tired?
But I'm trying not to whine too much.![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
curiousangel is being a saint, but I don't want to tax his patience.
Yesterday afternoon, the Li'l Critter managed to wedge herself into a transverse (crossways) position, with her hard little skull digging into my ribs. She stayed that way all afternoon and evening, despite the obvious fact that there's not room for her to lie in that position. Honestly, it can't have been any more comfortable for her than it was for me. I woke up at 5am to feel kicks on the normal vertical axis, and I was so. Pathetically. Grateful.
Okay, and one final digression: how did I not know about Luna bars until now? They're so tasty, and they have so much calcium, and they do such a good job of stopping the pre-lunch shakes.
But anyway, back to the fifth childbirth class. It focused on what the instructor euphemistically referred to as "unexpected events," but despite that, I came out feeling reassured.
We started with a brief recap on episiotomies, and how to avoid them. Apparently we have all already done the main thing that needs to be done to avoid an episiotomy: hiring a practitioner who isn't epi-happy. We did some pelvic floor exercises. Michele told us she'd distributed perineal massage instructions in our binders, and that it was worth trying but might or might not make a difference.
Then we moved on to a discussion of birth plans - not in all their minutia, but in terms of "what is the most important thing to me about this birth?" She used that framework to structure her presentation of things that can go wrong during birth, and how to keep your focus on the most-important aspects. (For our group, those things were: healthy baby, healthy mother, no separation from the baby, being alert during delivery, and feeling empowered. A pretty sensible list. Actually, Michele had to elicit "healthy mother" after "healthy baby" was mentioned - she pointed out that mothers tend to think exclusively about the baby's health, whereas fathers are more concerned about both. The men in the room all nodded; the women all got "Oh! Yeah, I guess I should think about that" expressions.
We talked briefly about forceps deliveries ("it's like a big set of salad tongs") and vacuum extractions. She had a vacuum extractor on hand - it's almost comically cheesy-looking. The up side to vacuum extraction is that, compared to forceps, it's less likely to tear up the mother. The down side is that the baby is likely to have a big blister/bruise on the top of the head, for weeks. Our midwives don't do forceps or vacuum deliveries, so if we need them done an OB will be called in.
Caesarian sections. This was the section of the presentation I found the most reassuring, mostly because I had been imagining it as worse than it apparently is. (I'm not afraid of surgery, because I've been through it a lot. I'm not afraid of post-surgical pain. I'm afraid of (a) missing the birth because I'm under general anesthesia, (b) being separated from my baby for a long time, and (c) having trouble nursing because of the effects of separated and medication.)
She described the experience of C-section, step by step: how you're prepped, who is present, what the room looks and feels like, etc. Reassuring fact #1: most C-sections are not true emergencies - they're done because of failure to progress or positioning or cephalo-pelvic disproportion (translation: the baby's head is too big to fit), and so there's plenty of time to see it coming. That's especially reassuring to me because more time to plan probably means a greater chance that the anesthesiologist will be willing to try spinal anesthesia despite my history of spine surgery. Before I got pregnant, I never would've imagined wanting to be conscious for a surgical procedure, but now I really really want to be awake and aware for my baby's birth.
Reassuring fact #2: "Your midwives are the most patient people on the planet." They don't rush into C-sections. If you have a fighting chance of a vaginal birth, they'll wait as long as it takes to make it happen.
Reassuring fact #3: After the baby is out, the pediatricians take over for about five minutes to check her over, suction her little lungs, etc. If nothing is dramatically wrong, she then gets handed to her father, who keeps her for the entire rest of the time. In other words, they don't routinely whisk C-section babies off to the nursery.curiousangel would be able to bring her over right next to me, where I could see and touch her while I was still being stitched up. If I were conscious.
I feel much, much better about the possibility of a C-section knowing that the baby won't be separated from both of her parents. Research has proven that, at birth, she'll already recognizecuriousangel's voice as well as mine. So she'll have a comforting, familiar presence even if I can't hold her right away.
Reassuring fact #4: "How long after a C-section before you can attempt to breastfeed?" "About an hour." (Attempting to nurse in the first hour is associated with better breastfeeding outcomes.)
The last unexpected event we talked about was induced labor. Michele said, "one of the things I like about having everyone in the class be clients of your midwife practice is that I don't even have to get into a discussion of how to refuse induction." That's because our midwives don't suggest inducing labor a few days past the due date, or because the cervix isn't dilating at the rate of a centimeter per hour, or for any of the other stupid reasons why one in five American labors are now induced. Reassuring fact #5: "Reasons why your midwives might induce labor… well, for example, if you were to develop pregnancy-induced hypertension." (That's a life-threatening complication for which the only cure is birth. I'm okay with that as a reason for induction.)
We finished up the class with an incredibly positive and affirming birth video which left bothcuriousangel and me teary, and a guided imagery exercise focused on relaxation and letting go of fears. I got a lovely mental image of standing on the shores of a lake holding the Li'l Critter in my arms, watching a sailboat full of my birth fears disappear into the distance. It's definitely time for me to start practicing imagery at home, in preparation for birth.
It was also supposed to include an account of my 32-week midwife visit, but we got to the office this morning to discover that four of their clients were in labor and one of the midwives was out with strep throat. Unsurprisingly, office visits were canceled for the day. (Apparently, they tried to call and tell us so while we were in the shower.) So, alas, no midwife update.
Just in the last week, the third trimester has hit me like the proverbial ton of bricks. After three days in a row of thinking, "wow, I'm having a rough day today - I must have overdone it somehow," I realized that the unnaturally charmed portion of my pregnancy is probably over. I felt fantastic right up through the end of the seventh month, so I don't have anything to complain about - but now it's different. I'm tired. By the end of the day, I'm exhausted. My pubic bone hurts when I get up from sitting or lying down. It's gotten harder and less comfortable to move around. And did I mention that I'm tired?
But I'm trying not to whine too much.
curiousangel is being a saint, but I don't want to tax his patience.Yesterday afternoon, the Li'l Critter managed to wedge herself into a transverse (crossways) position, with her hard little skull digging into my ribs. She stayed that way all afternoon and evening, despite the obvious fact that there's not room for her to lie in that position. Honestly, it can't have been any more comfortable for her than it was for me. I woke up at 5am to feel kicks on the normal vertical axis, and I was so. Pathetically. Grateful.
Okay, and one final digression: how did I not know about Luna bars until now? They're so tasty, and they have so much calcium, and they do such a good job of stopping the pre-lunch shakes.
But anyway, back to the fifth childbirth class. It focused on what the instructor euphemistically referred to as "unexpected events," but despite that, I came out feeling reassured.
We started with a brief recap on episiotomies, and how to avoid them. Apparently we have all already done the main thing that needs to be done to avoid an episiotomy: hiring a practitioner who isn't epi-happy. We did some pelvic floor exercises. Michele told us she'd distributed perineal massage instructions in our binders, and that it was worth trying but might or might not make a difference.
Then we moved on to a discussion of birth plans - not in all their minutia, but in terms of "what is the most important thing to me about this birth?" She used that framework to structure her presentation of things that can go wrong during birth, and how to keep your focus on the most-important aspects. (For our group, those things were: healthy baby, healthy mother, no separation from the baby, being alert during delivery, and feeling empowered. A pretty sensible list. Actually, Michele had to elicit "healthy mother" after "healthy baby" was mentioned - she pointed out that mothers tend to think exclusively about the baby's health, whereas fathers are more concerned about both. The men in the room all nodded; the women all got "Oh! Yeah, I guess I should think about that" expressions.
We talked briefly about forceps deliveries ("it's like a big set of salad tongs") and vacuum extractions. She had a vacuum extractor on hand - it's almost comically cheesy-looking. The up side to vacuum extraction is that, compared to forceps, it's less likely to tear up the mother. The down side is that the baby is likely to have a big blister/bruise on the top of the head, for weeks. Our midwives don't do forceps or vacuum deliveries, so if we need them done an OB will be called in.
Caesarian sections. This was the section of the presentation I found the most reassuring, mostly because I had been imagining it as worse than it apparently is. (I'm not afraid of surgery, because I've been through it a lot. I'm not afraid of post-surgical pain. I'm afraid of (a) missing the birth because I'm under general anesthesia, (b) being separated from my baby for a long time, and (c) having trouble nursing because of the effects of separated and medication.)
She described the experience of C-section, step by step: how you're prepped, who is present, what the room looks and feels like, etc. Reassuring fact #1: most C-sections are not true emergencies - they're done because of failure to progress or positioning or cephalo-pelvic disproportion (translation: the baby's head is too big to fit), and so there's plenty of time to see it coming. That's especially reassuring to me because more time to plan probably means a greater chance that the anesthesiologist will be willing to try spinal anesthesia despite my history of spine surgery. Before I got pregnant, I never would've imagined wanting to be conscious for a surgical procedure, but now I really really want to be awake and aware for my baby's birth.
Reassuring fact #2: "Your midwives are the most patient people on the planet." They don't rush into C-sections. If you have a fighting chance of a vaginal birth, they'll wait as long as it takes to make it happen.
Reassuring fact #3: After the baby is out, the pediatricians take over for about five minutes to check her over, suction her little lungs, etc. If nothing is dramatically wrong, she then gets handed to her father, who keeps her for the entire rest of the time. In other words, they don't routinely whisk C-section babies off to the nursery.
curiousangel would be able to bring her over right next to me, where I could see and touch her while I was still being stitched up. If I were conscious. I feel much, much better about the possibility of a C-section knowing that the baby won't be separated from both of her parents. Research has proven that, at birth, she'll already recognize
curiousangel's voice as well as mine. So she'll have a comforting, familiar presence even if I can't hold her right away.Reassuring fact #4: "How long after a C-section before you can attempt to breastfeed?" "About an hour." (Attempting to nurse in the first hour is associated with better breastfeeding outcomes.)
The last unexpected event we talked about was induced labor. Michele said, "one of the things I like about having everyone in the class be clients of your midwife practice is that I don't even have to get into a discussion of how to refuse induction." That's because our midwives don't suggest inducing labor a few days past the due date, or because the cervix isn't dilating at the rate of a centimeter per hour, or for any of the other stupid reasons why one in five American labors are now induced. Reassuring fact #5: "Reasons why your midwives might induce labor… well, for example, if you were to develop pregnancy-induced hypertension." (That's a life-threatening complication for which the only cure is birth. I'm okay with that as a reason for induction.)
We finished up the class with an incredibly positive and affirming birth video which left both
curiousangel and me teary, and a guided imagery exercise focused on relaxation and letting go of fears. I got a lovely mental image of standing on the shores of a lake holding the Li'l Critter in my arms, watching a sailboat full of my birth fears disappear into the distance. It's definitely time for me to start practicing imagery at home, in preparation for birth.
