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First prenatal appointment

Johnny and I went to see the midwives today for my first prenatal appointment. It went well!

I think he was convinced he would be getting a shot that day. Fortunately for him, it was an appointment for me.

Just your standard appointment — pee in a cup, get your blood pressure (112/80, and that was immediately after carrying J into the exam room), weight (eh, who really cares?), and the sort. Tried to use the Doppler to listen for a heartbeat, but it’s way too early for that and we didn’t hear one. I didn’t expect to.

I will have an ultrasound on May 11 to help pinpoint a due date. I don’t really like “due dates.” For one thing, it’s not an expiration date like on a gallon of milk. It’s just when they think you’ll be 40 weeks. And most people don’t give birth right at 40w on their own! It’s a crapshoot.

So unless they tell me otherwise, I’m just going to go with “mid-December.” Probably the later part. Possibly after Johnny’s birthday (Dec. 20). But I do believe it will be 2010. Does that narrow it down enough? K.

The appointment was actually pretty long, and most of it was updating my medical history, talking about birth and a few questions.

The nurse told me she was really impressed with me going without pain meds last time, because she said magnesium sulfate (the anti-seizure meds they give pre-ecclamptic mamas) causes your muscles to relax. She said that would make laboring harder.

Plus, the Cervidil can cause stronger contractions.

So heck yes, if I can get through that, then hopefully this time I won’t even need those meds and maybe it’ll be even easier on me. I’m hopeful.

The midwife told me that the hospital’s epidural rate is around 98%. Well good grief. The nursing staff is hospital-wide — as in the midwifery practice use the same nurses at the hospital. So no wonder my labor nurse had only attended a handful of unmedicated births.

Can’t fault them for not having a ton of experience.

Maybe I’ll help give some of the staff a little more experience in that regard.

The midwife also told me that the heplock wasn’t mandatory — as long as I was having a normal labor that started on its own and that I didn’t require any medication. I’ll probably need the midwife to communicate that to the nursing staff because IVs are so routine.

I think I will stick with this practice. It seems to be my best bet, given my pickiness and insurance coverage.

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Have you ever noticed that when you’re pregnant, you suddenly see pregnant women or newborns everywhere?

Well, now I’m seeing moms who are pregnant and have a little toddler, or who have a toddler and a baby. It’s really nice to know that there are plenty of people who have kids close in age!

I have several friends who were pregnant around the time I was with Johnny, and are now expecting their second child — there’s Susan, Stacy, Jess (ok, so she has two daughters already, but Caylee is around Johnny’s age), and some more who haven’t announced it publicly yet. And then some first-time mamas. You know who you are.

I chatted up a mom who is due in August, and her son is 18 months. He was really cute and very talkative (and always darting off!). Johnny tends to stay near me and is really quiet when we’re in unfamiliar surroundings. I like that. Stay with mama, baby!

(More) thoughts on natural childbirth

If you’ve been reading this blog awhile, then you may remember these two posts where I mention some of my thoughts on unmedicated childbirth.

I’m going to go for it again.

This time, I sort of know what to expect. I know what birthing a human feels like. I know what the adrenaline and endorphins during my recovery will feel like.

I know that Johnny was ready (and able) to nurse in his first few minutes of life. He was alert and checking out the world.

I know that the pain of labor did hurt like nothing I’ve ever gone through — but it was not a constant pain. It went away after each contraction to give me a break. When I tell you I was in active labor for oh, 9 hours or so, it was not 9 hours of agony. Not even close.

It was hard work for the first half of it. And then there was maybe two hours of contractions that were super hard and frequent — probably intensified by the Cervadil and me being unable to move around to get to a more comfy position.

And then transition — I can’t remember how long that was. It wasn’t fun. I was talking epidurals at that point, but I wasn’t really serious — I just wanted to know that it was an option if I wanted it.

Pushing was 45 minutes but it felt like 10. The contractions spaced out a great deal and I had a ton of rest between each one. It was extremely intense but I did not consider it painful. Some women do have pain for the pushing part. I think it depends on how the baby is positioned.

Anyway, once Johnny was born, I was good to go. I actually said “I could do that again” while I was still on the delivery bed. And I meant it.

Getting stitched up was really unpleasant, and I didn’t like the feeling of delivering the placenta, but at least it didn’t hurt.

What did hurt was my poor, swollen, achy bottom. That hurt in the hours and days ahead, and it was because I had an unusual tear.

I have a theory.

I think I tore for two reasons. First, I ended up pushing on my back. I was partially sitting up, but I was nowhere near the squatting position. Pushing on your back means your pelvis isn’t opened up as much as it could be. (Pushing while on hands & knees or in a full squat can open the pelvis by 20% or more!) It puts pressure on your tailbone. It’s a convenient position to catch a baby in, but not always the best for the mama.

I think being in that position contributed to my tearing.

The next factor: The midwife directed me to push out Johnny’s body the moment after his head was out. Normally, you can birth the head and then push out the body with the next contraction — way easier because your body is helping you push.

Instead, she told me to keep pushing to get him out.

Now, I do know that the cord was around his neck at least one time, which is fairly common. Perhaps it was too tight for her to slip over his head. Perhaps that was a factor in why she needed Johnny out right then, since the cord was exposed and possibly there was pressure on it, restricting his oxygen supply. Or who knows.

I have a midwife appointment tomorrow and if there’s time, I will ask for some clarification for what might have happened.

If Johnny did indeed need to be born at that moment then I am a-ok with the tear and the subsequent surgery I needed to repair the botched tear repair.

But if it *wasn’t* necessary that I pushed him out right then, then that’s annoying.

I do think that being able to feel my pushing effort since I didn’t have an epidural, it made my pushing really effective.

She told me to push the rest of him out, and I could summon all my strength and give it a good effort. Maybe I would have needed assistance if I had an epidural. Hard to say.

So for baby #2, here are my reasons for wanting to go med-free:

- No drugs have been proven totally safe for an unborn baby. The epidural meds (narcotics!) do indeed reach the baby. They can have an effect on the baby. We can’t be completely certain of long-term effects. Many babies appear totally fine after a medicated delivery. But there are some babies who are not fine, and who go into distress just minutes after the epidural is placed, and a c-section is needed to potentially save their life.

The long-term effects of Pitocin isn’t certain. One study found differences in three-year-olds whose moms had been given Pit. Some people have speculated that the rise in Pit use in labor matches up with the rise in Autism rates, but that link hasn’t been nailed down.

- I am scared of epidurals. I just don’t trust them to work. Sure, plenty of moms have great experiences with them. But I do not trust that I’ll be able to hold perfectly still during its placement. I don’t trust that the needle will stop at the correct point. I don’t trust that I won’t have long-term pain because of it. I don’t like the idea of not feeling parts of my body. And I don’t want to shut down the natural birthing hormones that are sending good things to my body and baby. I don’t want to have a catheter. I want to be able to move around and pee if I have to pee.

- I don’t want an IV while in labor. It hurts, it’s annoying, and it really restricted my movement. I had a heplock placed almost as soon as I showed up to the birth room. I didn’t need anything in the IV until 1 a.m. when my pre-e was diagnosed.

Now, I’m not going to refuse an IV if there’s a legitimate medical reason for giving me some sort of IV drug. But placed ‘just in case’? Not if I have a say in it, thanks.

Do they think I’m getting dehydrated? Give me some water or juice then, please. By mouth. It’s safe, seriously.

If I accept an epidural or any sort of labor augmentation, I’ll need an IV. So that’s one more reason for me to just do it without those things.

- I’m not afraid of the pain. As I said before, most of my labor was just plain hard work, but it was manageable. Moving around, using the shower sprayer on my belly, and having Shane help me through it was extremely effective for me. Yes, there was a good portion of it that hurt in ways that still sorta blow my mind. But the most painful parts, I was confined to the bed. I don’t know how it would have felt if I could have flipped into a different position or moved in some way.

And really, I got through it. It wasn’t that bad. I mean, if it was, I wouldn’t be planning to do it again, right?

The pain is temporary. It’s humbling. And it’s not a pain that causes injury. I can handle it.

- I don’t want a c-section. With every bit of pain med or labor augmentation/induction that I accept, I put the baby at increased risk for distress. Not all babies tolerate narcotics (or any drugs) well. Plus, drugs can stall labor if it isn’t already scooting along at a steady clip. That means that more Pitocin is needed or whatnot, and that can just add extra stress to the mom and baby.

Recovering from a c-section doesn’t sound pleasant. How would I be able to take good care of myself, plus a newborn, plus a toddler? That sounds just plain yucky.

- I want breastfeeding to start well. Some babies born with drugs in their system go on to be perfectly strong nursers without any troubles. And some babies born to med-free moms have trouble with nursing at the beginning. But generally speaking, it seems that breastfeeding does come easiest to a med-free duo.

- I want a good recovery. I don’t have time to feel really lousy while all those drugs are being flushed out of my system. I don’t want anything to stand in the way of those happy hormones.

- I want to keep some sort of control over what’s happening. Yes, I totally get that things don’t go as planned. I had weird things happen in my labor that I certainly didn’t prepare for. I get it.

I get that even the best intentions for a med-free birth can end up in a c-section, or an epidural or the sort. And I like to think that I will be fine with that outcome, if that’s how it plays out.

But I don’t like laying in a bed, unable to really get up and move around, with wires hooked up to me and being told how and when to push and all that. That sounds like a passive delivery more than an active birth and I don’t like it.

I want to be left alone. My body knows how to do this. I know how to do this.

—-

So why not a homebirth or delivery at a free-standing birth center? Money. My insurance doesn’t cover the birth center. I can’t justify paying out of pocket for it.

And the homebirth, I just don’t feel like that’s something I want.

I like being at a hospital in case something random really does go wrong (especially since I’m due in winter–an ambulance transport might be scary because of icy roads or heavy snow, or something like last winter).

So since I will be in a hospital, and one with a pretty high epidural rate (I will need to find out the midwife practice’s rate, but they use the regular hospital labor nurses)…I will hire a doula.

The doula will be my talking birth plan, able to communicate my wishes to the nursing staff and to help me figure out what to do when random things come up and the ‘plan’ goes flying out the window.

I’m hiring my former Bradley childbirth educator who is also a doula, and I think she will be a huge asset.

Before I let this post sound like I am anti-hospital, I should clarify that I’m not. I am thankful for the medical advances that are able to save babies and moms. I do believe that labor nurses are compassionate people who genuinely do care about the moms and babies in their care.

It was just my experience that the nursing staff I encountered had extremely limited experience with med-free moms and they didn’t quite know how to handle me.

So in the most non-confrontational way that I can muster, I’m going to give birth my way. I hope that between my doula, Shane and I, we can communicate to the staff that I’m not trying to go against every bit of hospital protocol they have just to make them mad.

I’m just trying to give birth. Ya know?

And I will let it be known that if there are any medical students or residents or nurses or OBs hanging out in the labor ward, that they are welcome to observe me in labor and while delivering if they don’t have anything else to do and are interested. Some OBs seriously have never seen an unmedicated birth.

I am looking forward to labor and I am not afraid.

One final note: Please do not take this post as judgement about you or your choices. Selfish as this is going to sound, it was about me and my choices. If you know and understand the risks of a medicated delivery and still think that is the best option for you and your baby, then that is your choice. You’ve gotta do what you’ve gotta do.

And heck, I’m not saying that I won’t end up with an epidural or a c-section. God only knows. I’m just saying I’m going to do all that I can to avoid those things.

Shane’s first marathon

My husband, Shane, completed his first marathon yesterday. I am just amazed at him! He only started running for the first time in his life in September 2009 thereabouts. He has a few coworkers who like to run during their lunch break and on weekends and such, and he thought it would be a good way for him to get in shape.

One of his coworkers is an elite athlete. I’m talking elite. Sponsored by Brooks. So he got Shane a really good deal on some shoes.

After just a few weeks of running or so, he decided he’d enter the Pittsburgh Marathon on May 2, 2010.

As a training exercise and to show him how road races operated, he completed a half-marathon (his first race) toward the end of March.

A half-marathon as training. What a crazy. He completed it in something like 2:02 or so.

Training over the winter was rough, especially since we had such a snowy February. But Shane knew that he needed to get his miles in, so as soon as the snow stopped falling and there was sort of a path down the middle of roads (though most roads weren’t even drivable) he did go for a run. A lady took his picture.

He typically can only fit in a 3-mile run during his lunch break, but lately he hasn’t even been able to do that. Work has just been so busy for him lately.

So some days, he’d get up really early and run beforehand.

The weekends were reserved for his super long runs.

He put in the miles and prepared as best as he could for the race.

Sunday morning, we got up at 5:30 to head to the starting line. My parents are in town right now and they were able to take care of Johnny.

We took the trolley downtown to avoid the road closures and parking headaches, and that was a good move.

About 16,000 runners participated in the half-marathon, marathon and the relay. Took Shane something like 8 minutes just to get to the starting line, and a big longer to really start running at his desired pace.

I saw him off a little bit ahead of the start, and then headed a few blocks over to take my spot around the three-mile mark. I was on the corner of Penn and the 16th Street Bridge, for you Pittsburgh locals.

It started raining around the time the first runners rounded that corner, and didn’t let up for several hours.

The front-runners were flying. I spotted Shane’s speedy coworker and hollered out his name, but I dunno if he heard me. Anyway, he was in the top 30 at that point but it doesn’t look like he finished the race. We think he had an injury of some sort.

I saw Shane a little bit later in a big herd of people. I hollered as loud as I could and he turned and waved.

The route took him across the Allegheny River and into the North Shore, passing by the stadiums. Shane ran past his boss, whom I found later and tagged around with his family a little. Thousands of people downtown, and you run into someone ya know. I also saw my dentist.

After seeing him run by the 3-mile mark, I made my way to Carson Street near Station Square. It was 1.6 miles away according to Google Maps, and though I was walking fast, the elite runners had already passed by the time I made it to the 10-mile mark.

I hung around there for awhile.

Some of the runners’ bibs had their names on it — it was a special thing for early registrants (Shane included). I hollered out to anyone whose name I could read and gave ‘em a thumbs-up or shook my fist or some other bit of encouragement.

They all looked my way to see if they knew me (they didn’t) and to smile or say thanks or run just a little quicker. SO fun to yell at people!

Shane later told me that more than a dozen people called out his name or said “go Hoosiers” or “Go Indiana” or “Go IUP!” because he had “Indiana” on his shirt. IUP is Indiana University of Pennsylvania which is NOT affiliated with our Indiana University of Bloomington. Oh well.

He loved the extra encouragement. Who wouldn’t?

I was busy hollering at Elizabeth when Shane ran up and gave me a high-five. Didn’t even see him coming! Glad he spotted me.

After that, it was time for me to head back toward the Strip District. There wasn’t another location that I could quickly get to to holler at Shane, so I planned to get something to eat and holler at more people.

The male winner had completed the marathon by that point. He was in a hurry.

I was trying to make my way over to a good spot around the finish, and then the Army and some police officers were clearing the area.

Runners were being re-routed and they were so confused — “Where’s the finish line!?” Uh, good question.

I was not far from where a suspicious microwave was blown up by the bomb squad. What in the world? A microwave was on a sidewalk and remnants of ravioli was spotted nearby. Lovely.

Whatever it was, it screwed up the half-marathon for quite a few runners. They had to walk through the Amtrak station to get around the microwave and back on the course, wherever it was.

The finish line was moved.

The last mile or so of the marathon was rerouted, too. Shane said he kept weaving in and out of city blocks, when it was supposed to be a straight-shot. So know knows if it was an exact 26.2.

I took a spot around the new 26-mile-mark (I saw the old 26-mile designation and runners weren’t on that route anymore). I had a long view of the runners coming toward us.

I spotted Shane from way back and he looked great! I took a quick video and offered him some water but he didn’t want it.

He just wanted to finish and be done with it.

His final time was 5:17. Wow! He wasn’t sure of what his final time would be and just wanted to keep a steady pace. He was averaging 11-minute miles.

He went through the corral and got some snacks and water and I met him just outside that. His legs were really sore and he was slow-moving, but happy that he finished in the time he did.

We made our way to the train station and headed home.

I’m so proud of him! He really did a fantastic job.

He thinks he’ll do another marathon someday, but probably will focus on half-marathons and maybe some 10ks to work on his speed.

As for me — I just enjoy being a spectator.