rivka: (pseudoscience)
"[Rh incompatibility] wasn't an issue for all of human history until interventions were performed, like episiotomy and early cord cutting or Cesarians. Again, what gives?"

Okay, I have to get this off my chest here, because if I say it in response to the actual post I'm quoting I'll probably be banned: medical model espoused below )
rivka: (her majesty)
A month after I miscarried, I felt mostly okay. I'd read things that would refer to months and years of post-miscarriage grief and think "wow, I'm glad that my reaction has been milder." I was aware of potential future roadblocks - the due date from that pregnancy, the anniversary of the miscarriage - but for the most part I thought I was adjusting and moving on.

As we cleaned the old house, all last week, I became increasingly anxious about the prospect of doing a final walk-through with our landlords. I realized that, of all the people I know, they were the only ones who still thought I was pregnant. I made Michael promise to do the walk-through by himself so that I wouldn't have to see them. Or, more specifically, so I wouldn't have to see them see my regular-sized belly and my pronounced lack of glow.

I don't think there's anything unusual about that, but the amount of time I spent thinking about it and being anxious about it was kind of excessive.

The dolphin show on Saturday was about play - how dolphins play, why animals play, how play is used in dolphin training. There was a video montage of mammals playing. It included a few brief images of human infants. Boom: tears. I cried at a dolphin show. From, like, three seconds' worth of baby exposure.

Sunday, at church, out of nowhere: uncontrollable, but mercifully silent, crying. Not related to the service content.

The only thing I can think of that might behind the suddenly increased grief is that we are gearing up to try to conceive again. (I need to buy an ovulation predictor kit on my way home from work.) That has always been a fraught and anxious process for me, and it seems about ten thousand times more so now. What if we can't? What if it takes a long time? What if it's hard to even bring ourselves to try, and the whole... process... is overshadowed with grimness?

I shouldn't have to do this. I should be about halfway through my pregnancy. I should be wearing maternity clothes. I should have had my high-level ultrasound, and watched blood pumping through the tiny channels of a tiny fetal heart. I should know the sex. I should be making plans for who will take care of Alex during childbirth, and checking out new-baby preparation books from the library for her. I should be pushing to get my grant up and running before my maternity leave. I should be pregnant.

This really sucks.
rivka: (her majesty)
For the last several months, I've been having more pain than I'm used to in my right hip. I did remarkably well with that hip during my pregnancy - better than I'd expected; I had anticipated needing a cane and had considered the possibility that I would need crutches or even a wheelchair during pregnancy because of the extra weight centered over my hips. We had also considered the possibility that I would have excruciating hip pain during delivery, because of my pelvic abnormality. That didn't happen either.

But after Alex was born, and I regained my strength, my hip didn't bounce back. I have a lot of stiffness in the joint, so much so that I can barely walk when I first get up from sitting or lying down. It hurts more than it used to, including sometimes when I'm lying down in bed. My limp is more pronounced. It aches after exercise. I have some referred pain to my knee.

It could be a lot of things. It could just be that I'm deconditioned. Lord knows that I haven't been getting anywhere near an optimal amount of exercise. It could be that my artificial hip is beginning to fail - I was told to expect it to last about fifteen years, and it's been nine. I'm not sure what the experience of having an artificial joint wear out is supposed to be like, but if it feels like developing arthritis in the first place did, then this could be that. It could be that the pelvic changes that happen during pregnancy and delivery caused some sort of damage to my artificial hip or to the plastered-together old surgical breaks in my pelvis. It could be a lot of things.

In a couple of minutes I'm going to leave the house for an appointment with an orthopedist. No, not the asshole I saw when I saw pregnant. I'm not even seeing anyone in the same practice as him, ever again, ever. It's someone my primary care doc thinks is wonderful. But I'm still nervous.

One of the things she said when she referred me to this guy was, "and he specializes in minimally invasive surgery!" Please don't let it come to that.
rivka: (Default)
Gentle folk, please welcome Miss Alexandra, born on April 11, 2005 at 6:21 P.M.

Arriving whole and sound following a labor described by a staff member as " a beautiful experience", weighing (drum roll, please) 8 pounds 4.8 ounces and measuring 21 inches long.

Mother, father and infant are all well and happy.

Details to follow as mother feels inclined.

This announcement brought to you by [livejournal.com profile] saoba.
rivka: (family)
Yesterday evening I went in for a nonstress test, because I'm now officially a week past my due date. They did the test on the L&D floor of the hospital. My midwife didn't show up until the end - it looked like she was having a pretty hectic weekend - so one of the hospital midwives did the actual test. (Wow, do I prefer my own midwives to the hospital version. But the L&D nurse was nice.)

They hooked me to an electronic fetal monitor for about an hour. This involved two flat disks about the size of coasters, but thicker and heavier, held on to my stomach by big elastic bands. Not very conducive to freedom of movement. After about half an hour, the hospital midwife decided that she didn't want me on my back in bed, even with the head of the bed elevated somewhat, so she rolled up a towel and wedged it under my right side to tilt me a little. (As you might imagine, that was even more comfortable.) Intellectually, I already knew that I didn't want continuous fetal monitoring during labor and I didn't want to have to stay in bed. Now that I've actually experienced what it's like to mostly hold one position in bed for fetal monitoring for an hour, while heavily pregnant... yikes. I can't believe it's standard procedure at many hospitals.

But anyway: for an hour, we listened to the Li'l Critter's heartbeat. They wanted to see periods of appropriate acceleration with movement - an increase of at least 15 beats per minute for at least 15 seconds. For the first half of the test, she apparently slumbered peacefully. Finally she woke up and obliged them with lots of movement and beautiful heart accelerations, winning her much praise from our own midwife, who had arrived by that time.

Then we worked out our game plan. We're ready to try Cervidil, which is a prostaglandin - usually used to ripen the cervix, but also highly likely to cause labor if the cervix is already ripe. (As mine is. Ripe, thinning, and dilating. Why aren't I in labor?) The midwife thinks this is an eminently sensible plan. So tonight, at 8:30, we'll meet her at the hospital and get checked in to L&D. She'll insert a little packet of Cervidil right next to my cervix. (It's on a string, so it can be pulled out again if contractions get too intense.) They'll monitor me for an hour or two to make sure that I'm not having any kind of an adverse reaction, and then they'll take off the monitors and let me try to get some sleep. At some point - Cervidil can take up to 12 hours to work - I should wake up in labor.

My mother is coming down on the bus this afternoon. I'm going to take it easy and do some cooking. When Mom gets here, we'll have a celebration dinner (including a birthday cake, I have decided) and then I will head off to the hospital. Hopefully (probably?) to come home with a baby!
rivka: (her majesty)
I can't believe that I'm still pregnant after 10 days of prelabor.

Yesterday the cramping and the sharp pains around my cervix were so uncomfortable that they almost had me crying. Today I'm feeling a bit better, physically - well enough that I took a walk around the block - but I'm very discouraged.

At today's visit I was 3.5cm dilated and 60% effaced - barely changed from a week ago. She stripped the membranes, with my permission. It really didn't hurt any more than a regular pelvic exam. Hopefully that will do something, but I'm not feeling especially optimistic right now.

We talked about things I could do to speed labor along. My midwives really don't recommend castor oil, but she did suggest that I start black & blue cohosh - 10-15 drops each in a little water, every 30 minutes until contractions are regular (or for four hours, if contractions don't start). I'll try that in the morning. I'm also going to continue with the evening primrose oil. She recommended sex, spicy food, nipple stimulation, crying, and yelling at [livejournal.com profile] curiousangel. (I'm pretty sure the last two were jokes.)

At 41 weeks - so, this weekend - they want me to go in for a nonstress test. She told me to bring my suitcase, because if the baby's in distress I won't be going home again, but also said that there's no reason to believe that the baby will be in trouble. Because of the situation with my hip, after 41 weeks they're willing to go any direction I want to go - waiting, or induction, or scheduling a C-section. If I wait, they'll do a biophysical profile between 41 and 42 weeks, and then after 42 weeks they would want to see me three times a week to monitor the baby's condition.

We talked the most about a Cervidil induction. She said that even though it's primarily a cervical ripening agent, when the cervix is already ripe it usually brings on contractions. (She said it works that way for about 75% of the women in their practice.) The big advantage of Cervidil would be that it could be removed if the contractions got strong, and that it wouldn't necessarily lead to the cascade of interventions you can get with a Pitocin induction. I would have to stay in bed and not eat anything for the first two hours, but after that I could move around, get in the tub, go home if it doesn't work, etc. I wouldn't need an IV or continuous fetal monitoring.

I don't think we're willing to try a Pitocin induction unless the baby is in distress. It just seems like there are too many downsides.

A friend recommended that, if I turn out to need a Pitocin induction, I consider just scheduling a C-section instead. She pointed out that the only thing worse than a C-section is a long hard labor ending with a C-section, and that I've already been told I have a greater than 50% risk of section anyway. I am not convinced, but I'm sitting with the idea to kind of get used to it.

I'm having some cramping now from the internal exam. I wish that at this point I believed that cramping *meant* anything.
rivka: (Default)
[livejournal.com profile] saoba and I went to see Bride and Prejudice, which I absolutely adored. It's an extraordinarily silly Bollywood rendition of Pride and Prejudice - every ten minutes or so the story grinds to a halt for an elaborately costumed and choreographed musical number. I was disposed to like it from the beginning, but from the moment the troupe of Indian transvestites showed up to waggle their hips at a young bride-to-be, I was lost. I stayed lost right up through the triumphant conclusion with the painted elephants. For frivolous eye candy - which was exactly what I was in the mood for today - Bride and Prejudice can't be beat.

This evening, as we settled down to watch the pregame show (Opening Day!!!), I started having contractions. Every seven minutes. For more than an hour. "If it goes on like this until nine, I'll call the midwife," I told [livejournal.com profile] saoba, who allowed as how that was a sensible plan. At eight-thirty, the contractions stopped. At least this time wasn't like Friday night, when the hour's worth of every-seven-minutes contractions was painful enough - and unresponsive enough to attempts to stop them, such as a half-glass of wine and a warm bath - that [livejournal.com profile] curiousangel ran around putting our toothbrushes and things into the hospital bag.

I begin to doubt that I will ever have this baby.
rivka: (her majesty)
I'm starting to feel kind of dragged down.

I've been in prelabor for a solid week now - a week of intermittent abdominal cramps, back pain, trouble sleeping, flurries of contractions that dwindle away into nothing, and the occasional spot of blood. I don't feel miserable, and I should be grateful to have progressed this far (3cm!) without significant pain. But day after day, I don't feel well. Prelabor is uncomfortable and tiring, and it seems to have no end in sight.

It's hard for me to stay in any one position for very long, and sitting at my computer is one of the worst and hardest to maintain. So I'm mostly camped on the couch, reading, doing embroidery, watching TV, doing minute quantities of housework, chatting a little with [livejournal.com profile] saoba, and waiting. Earlier in the week, I was determined to get a reasonable amount of exercise every day, but by now I'm finding that I get worn out too quickly. A short stroll to the store is about enough.

Patience has never been one of my best qualities, but I really am trying. At this point it's not so much that I'm impatient for the baby to come (although of course I am), as it is that I just can't imagine how I could manage to go on feeling this way for very much longer. But I am trying to be patient, and take it one day at a time. I really am.
rivka: (family)
Despite my frustration, there has indeed been progress: I'm 3cm dilated (!!!) and 60% effaced, and the baby has moved down even yet still further, to -1 station (only 1 cm above the ischial spines of the pelvis). The size of my belly has shrunk since last week, even though the baby has grown - further evidence that she's way down in the pelvis, getting ready to be born. For perspective: a lot of women don't get to 3cm dilated until they've been in labor for a few hours.

Everything else looks fine: good blood pressure, good fetal movement and fetal heart rate, minimal swelling.

The midwife encouraged me to pay a little less attention to early contractions. If I start having contractions, she wants me to try lying down or taking a bath to see if they go away. If it's really labor, she explained, I won't be able to stop it. That was helpful advice, because I've tended to hyperfocus on anything that might be a sign of labor, and I've worried about not doing anything to slow down contractions. The result is that I get (a) hyped up, and (b) worn out. I'm going to try to be a little more Zen about it.

(Those of you who know me well can stop laughing any time now.)
rivka: (family)
Still waiting for the baby. There's been no progress that I can see, although [livejournal.com profile] saoba thinks the Li'l Critter has dropped even further just since last week. I'm still having some intermittent abdominal cramps and some painless or slightly uncomfortable contractions, but nothing laboresque.

I really got my hopes up too much when the symptoms seemed so promising, over the weekend. It shifted me away from thinking of my due date as the goal, and I started attending too much to every little twinge and ache. It's actually getting a little easier to deal with, now that I'm no longer expecting to go into labor.

Tomorrow we go back to the midwife in the evening. I'm going to ask her about stripping the membranes. It might help, and it's unlikely to cause harm.

I'm not doing much. I brought work home with me, but there have been obstacles - I can't sit for very long at my desktop computer, and until this evening I didn't have the adapter to use the work laptop in our living room. (No three-pronged electrical sockets. We live in an elderly house.) Tomorrow I'll try to knock out a presentation for my boss, and at least I'll feel like I'm accomplishing something. Otherwise I am mostly reading novels, doing needlework, cooking tasty dinners, resting, and waiting for the baby.

I am getting out every day for exercise, at least. Today the sun came out for the first time in days and days, and [livejournal.com profile] saoba and I fled the house for the Inner Harbor. We had lunch, toured the USS Constellation (I had never been aboard before), and finished the afternoon with ice cream. I exhausted myself completely - as soon as we got home, I fell asleep sitting upright on the couch. But it was good to get out.
rivka: (her majesty)
I woke up this morning, and everything seemed to be progressing nicely. I had five contractions in a row that were uncomfortable and regular, fifteen minutes apart.

Then they stopped.

For the entire afternoon, I didn't even have the cramping feelings from Friday and Saturday. I felt totally normal. I felt like I could go on being pregnant for weeks. (Seriously. I went out for a brisk twelve-block walk, without difficulty.)

Some minor cramping again this evening, but I don't trust it. More than 48 hours after the bloody show, I have to concede that it doesn't seem to have been the harbinger of anything at all.

So we can all stop holding our breath.
rivka: (family)
...I'm still not in labor.

Preliminary signs of labor continue to be encouraging: more cramps, more show, a restless and backachy night. No contractions.

I went to the library and picked up a stack of frivolous reading material: five Georgette Heyers, four YA fantasies, and the lastest Jasper Fforde. We did a dry run of the drive to the hospital. (Yes, it's only five minutes away. Yes, we drive past it frequently. Yes, [livejournal.com profile] curiousangel insisted anyway.) Now [livejournal.com profile] curiousangel and [livejournal.com profile] saoba are out buying the last couple of things we need. I've got a load of baby clothes in the dryer. Hospital bag is mostly packed, except for my snacks and drinks. (Yay for midwives who let you eat and drink during labor.)

Other things left to do:
- Burn two remaining "labor" playlists to disc.
- Make out an on-paper list of people to call when the baby is born, and retrieve their numbers from the various places I have them stored.
- Set up an e-mail group for people who will be receiving the announcement that way.
- Leave my LJ password for [livejournal.com profile] saoba, who will be coming back to the house after the birth to notify you all. ([livejournal.com profile] curiousangel will be staying at the hospital.)

I am feeling good: happy and excited. I'm hoping that labor starts in the next couple of days, and from my symptoms I kind of expect that it will, but I'm not desperate.
rivka: (family)
And it looks like I stopped working just in time, because TMI alert )
rivka: (family)
...and so tired of it.

I have reconsidered my plan to work right up until my water breaks. Instead, tomorrow will be my last day in the office. I'll take some things home with me and work on them next week if I'm, you know, still pregnant, but it's just gotten too hard to drag myself into the office and sit at my desk all day. (If I'm lucky. Today I've walked sixteen blocks in the course of the workday.)

How it feels to be me these days:
- The baby is very, very low in my pelvis, leading to uncomfortable grinding feelings as her bony little head juts up against my cervix and my pelvic bone and so forth.

- I'm having intermittent menstrual-cramp feelings, which are probably prelabor. Sometimes they are very clearly associated with contractions; other times it's hard to be sure. I get excited about it when they are, but I am mostly deluding myself - prelabor can go on for weeks.

- My back hurts, pretty much most of the time. I'm also having some pain in my hip. I think the hip pain is because I lean forward in my chair to take some of the strain off my back, and that just transfers the strain to my hip.

- I am feeling antisocial. I seem to want to spend much more of my time being quiet. This is particularly true when I'm at work, probably because I'm in more pain there - but it's awkward, because I have to force myself not to snap at my research assistants or avoid them. They have a right to talk to me during the workday.

- I have to pee every ten minutes. If I don't drink gallons and gallons of water, I still have to pee every ten minutes, plus I get painful spasms in my bladder. I begin to suspect that this enormous swollen belly of mine is not so much a baby as it is a vast and inexhaustible reservoir of pee.

- I am so unbelievably tired by the end of the day.

- I am relatively over my panic about having a baby to take home, and am mostly looking forward to holding the Li'l Critter in my arms at last.

The latest midwife news:
We went in on Tuesday. Everything looked good for me - blood pressure, swelling, urine, weight - and for the baby - size, heartbeat, response to activity. The baby has moved way down into the pelvis since last week. My cervix is soft and 1.5cm dilated, but still less than 50% effaced. She offered to strip my membranes, but Michael and I hadn't had a chance to talk it over beforehand and wound up putting it off. (He was afraid that it would be very painful for me. Opinions?) We might do it at our next visit on Wednesday, if I'm, you know, still pregnant.
rivka: (family)
Saw the midwife again today - it'll be weekly from now on. Everything still looks great - good blood pressure for me, strong heartbeat for the baby, good weight gain for both of us (I gained a pound and a half in the last ten days, and she gained an estimated half-pound). I'm one centimeter dilated but still only 25% effaced.

The midwife quizzed us on our baby readiness and reminded us of labor signs. She wants us to call if my water breaks or if I have more than four contractions an hour for more than one hour. I am to continue my current practice of drinking everything in sight, and... that's about it.

We're at full term, so as far as I'm concerned the Li'l Critter can show up any day now.

(Well, I suppose it would be best for her to wait for [livejournal.com profile] saoba. And also, we could finish putting her things away. And we still need to buy diapers. Okay, maybe she shouldn't come today.)
rivka: (family)
Wow, [livejournal.com profile] tammylc wasn't kidding when she said that there wasn't much out there on the web for women having Cesarean births.

Not much you'd want to read, anyway, if you think you're going to have one.

The first hit on Google for "cesarean section" is at childbirth.org, usually a good general information site. But their C-section page starts with a link to "Books on Labor, Birth, Cesarean and VBAC [vaginal birth after cesarean]" in which only one book about C-sections is recommended. It's called The Silent Knife: Cesarean Prevention and VBAC. The other books with "Cesarean" in the title are all about VBAC. The childbirth.org list of links continues: How to avoid an unnecessary section, risks of Cesarean section, Cesarean fact sheet (which contains not one piece of positive information about the procedure), VBAC checklist... halfway down the page there's a link to a short FAQ on planning your Cesarean, something about "family-centered Cesareans," and a link that doesn't work but claims to be about breastfeeding after C-section. But to get there, if you're reading down the list, you go through a poem about being DISEMBOWELLED ALIVE (emphasis theirs) and literally more than a dozen articles about C-sections being bad and unnecessary and dangerous.

Yes, I know that there are too many C-sections performed in the United States. But the World Health Organization estimates that the rate should be around 10-15%. That's still one in ten births. Shouldn't there be at least a little bit of positive information out there for those women?

My midwife recommended a twenty-year-old book called The Cesarean Birth Experience. The physical stuff is probably somewhat out of date - although from the other reading I've done, it doesn't seem that much has changed. The sections on emotional and family aspects, and the advice about making your Cesarean as birthlike as possible, are wonderfully helpful and reassuring. But the book's out of print. (I found it on Amazon - it wasn't at my library.)

The single most breathtakingly hurtful thing that I have seen: an offhand comment on a message board, one woman talking about another. "Both of her kids were C-sections, so she's never given birth."

Ow.

My midwife says: "This is still your birth." I'm trying to have that be my mantra.

Since I saw the midwife last week, there is new news. )
rivka: (Default)
Vignette 1: I am sitting on a bench along the sidewalk, eating a sandwich. At the other end of the bench, a middle-aged man is talking quietly on his cell phone. I catch phrases here and there - benign ones, at first, but then he starts repeating, "Why you got to say that? Why you got to talk like that?" His tone remains mild.

Suddenly, he gets up from the bench and walks over to stand about ten feet away from me, still talking into the cell phone. It's still close enough for me to hear him, because he's gotten much louder: "Listen, bitch, you better remember who you're talking to!"

I was a bit taken aback, but pleased that he was considerate enough not to disrupt my lunch or make me nervous by shouting obscenities right next to me.

Vignette 2: I get onto a very crowded bus. There are no seats at all, even in the front section that's reserved for the elderly and people with disabilities, so I brace myself to stand. A frail older woman who looks to be about seventy catches my eye and starts to rise.

"Miss, would you like to sit down?"

"Oh no, ma'am, you don't have to get up."

Immediately, two middle-aged, apparently able-bodied men fall all over themselves to get up and offer me their seats. They'd be the right age to be sons of the older woman, although they obviously don't know her. "Here you go, miss, my stop's about to come up." "You can sit right here."

I thank them as I sit down, and then thank the older woman - who seems quite satisfied with the response to her etiquette lesson.
rivka: (family)
I'm about ready to stop being pregnant. I am not going to go into a protracted litany of complaints here, but the shorthand version is that I am large, awkward, tired, and sore.

We went out yesterday and bought the remaining things we definitely need to have on hand before the baby is born. (Except diapers, because we are still comparison shopping for the best place to buy.) So we now have an infant-size carseat, and someplace for the baby to sleep, and a playpen/bassinet/changing table for the living room, and a breast pump, and a nursing pillow, and of course piles of cute tiny outfits and little cardboard books and so forth. [livejournal.com profile] curiousangel is out installing the carseat right now. So if she's born soon, we will make it. Physically, at least.

We still don't have much more news on the delivery front. I talked to an anesthesiologist over the phone, and he said that my spinal fusion was high enough that "probably" I could have a spinal or epidural anesthesia below it. I'll be taking my X-rays by the hospital on Tuesday for a consultation, but I am feeling somewhat encouraged. I really think I will be fine with a C-section if I can be conscious for it - although of course I'm still hoping that she'll be able to squeeze out without surgical help. That means hoping that I'll go into labor sooner rather than later, so any "hurry up and dilate" vibes you want to send my way would be welcome. (Although [livejournal.com profile] kcobweb probably thinks you should send them to her.)

Thanks, everyone, for your support and encouragement this week. I've definitely needed it.

(A few people have asked where we're registered, and the answer is here. No begging or even hinting should be implied from the provision of this information.)

pictures: 36 weeks and huuuuge )
rivka: (family)
35-week midwife appointment this evening. Briefly, everything is swell for me and the baby, but my chances of having the kind of birth I want are not looking great.

Let's start with the good news: the L'il Critter is doing so well. She has indeed dropped, and has her head pressed against my cervix. She has a strong heartbeat which speeds up appropriately when she moves, as the midwife determined by poking her little hands and feet. Estimated weight: five pounds, which would put her at about seven pounds on her due date. And of course, she's nicely active - which I knew already, thank you very much.

I'm doing well, too. I'm gaining about a pound a week. My blood pressure is a beautiful 110/68. I have a tiny bit of swelling in my calves and ankles, but nothing to worry about - especially considering that it was an evening appointment. I'm not spilling any protein or sugar. My miscellaneous symptoms are all normal for the third trimester. My cervix is still closed, but it's about 25% effaced (which means that it's starting to shorten and thin for delivery). The baby's head pressing against my cervix should help that process along.

The main event for this visit was the pelvic exam. The senior midwife wanted to examine my pelvic architecture (which is abnormal because of my hip surgeries) to see if I had enough room in there to deliver vaginally. This is the part that didn't go so well.
Read more... )

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