Saturday, December 24, 2011

Holiday lessons learned, 2011.

Today was interesting. We took the boy to grandma's house for the holiday gathering today after only a 50 minute nap. On a typical day he requires two to three hours for a full recharge- especially when he has had a rough night for sleep. But we did it. He was mellow/whiny in the typical dr Jekyll manner of a toddler.

Then upon arrival he was immersed in a total sensory experience. People, things, lights, noise, food, motion activated decor... and meltdowns began. Oh, boy.

"Eat? Mama, eat? Eat now?"

"ham. Ham! HAM!! Eggs. Egg peeeeeese! Want pineapple."

"my car. That's my car! Mines!!"

That's the first ten minutes.

Three separate occasions I had to pull him to a quiet room to reset him, and once I had to break out my Mandt Training moves... then gifts were opened.

Everyone who brought a gift for him brought toys. Most had lights and sounds. All the kids were overstimulated by the time all the gifts were opened. They began to feed off each other's energy, and it was like a demonstration of atoms being heated.

We came home and found more toys with lights and sounds had come by mail. The thought I appreciate, but now we are all overwhelmed! When I become sensorily over-tapped, I get irritable and emotional. When my husband gets to that point, he gets jittery and needs to be doing something-anything with his hands. The boy gets hyper-happy and tries to bite folks. This is bad, by the way. It's like we all three go offline.

So. Here we are with a mountain of toys for one child, many of which are noisy and large. My common sense mama brain says we need to give goodwill a donation of all his old stuff. My sentimental mama brain says we need more storage bins.

Next year we are determined to just hand out a booklist and a list of clothing needs/likes/dislikes to make sure we aren't overly 'blessed' with so many toys.

Our boy does not handle abundance well. He sort of short circuits, pulls every toy out, then wanders around touching every toy. So, less is more. We will ask that everyone understand that about him and to only get him something meaningful (books, specific toys) and I'm fairly certain we're going to freak them out with this.

Another lesson learned: mandatory potty trip before looking at Christmas lights. The kid is a trooper. He made it through 45 minutes of Christmas lights (we couldn't escape the neighborhood) albeit uncomfortably while holding back full bowels and bladder. Unfortunately, his daddy was super stressed by the whimpering from the back, "potty! Gas station? Home? Potty!!"

Tuesday, December 20, 2011

Putting down the pump

Monday, December 19 (which was my EDD two years ago!) was my first day at work in two years without a breastpump.  It was odd.  Over the weekend I decided to pack it up for good (or at least until we start working on Offspring v2.0) since my body has stopped responding well to the pump and my production has dropped to less than three ounces take-home milk per day.  I had a love-hate relationship with that pump.  In the early days I virtually measured my abilities as a working mother by how many ounces I brought home.  Less than twelve ounces back then led to severe self-worth issues.  Twelve ounces now would be a freaking miracle!

But, I made it.  When I started, I figured I'd give up at a year like everyone else I knew.  But then a year came, and I was still making good milk.  And it was winter.  I just kept going because that's what I knew the little guy needed.  I hated that I missed out on good sunlight during the spring and summer, but loved that he was getting my absolute best every day.  I hated how uncomfortable my pump was.  But the milk kept coming and coming!

I sit here now and look back at the hours logged with that small yellow device perched upon my lap as I ate lunches, read books, read articles online, and wrote letters to my son.  I know it's a little thing, and at times I hated it, but damn am I ever proud of myself for keeping at it for so long.  I did something that everyone told me couldn't be done.  And I did that thing for a very long time, openly and honestly.  Educating and sharing along the way in hopes that other mothers will have the confidence and support they need to do this, too.

So, Saturday night as I packed away that pump for the last time, I found myself weeping a little.  That pump was ugly and uncomfortable, but it was a huge part of my life and my early mothering.  I should have the darned thing bronzed or something!

Thursday, December 8, 2011

Milestones: nearly two years of breastfeeding and pumping.

In a little less than a week I will celebrate little guy's second birthday. I am amazed by the fact that we have made it this far with breastfeeding, but despite the naysayers and those questioning continuing into toddlerhood, we're still going strong. He will get to choose when we stop as long as it works for both of us... though the pumping ends next week. I'm down to one session a day (my lunch hour) of pumping, and anywhere from one ounce to three ounces to bring home after an intense hour of ten minutes on/off/on pumping. My body simply isn't responding to the pump anymore. I can't say that I will miss the act of pumping, but I am a little sad that we are winding down. Time passes so quickly!

In 100 weeks of pumping breast milk at work, I have produced gallons of goodness for my son. I have watched him grow and thrive, even in my absence, on my milk. It makes me feel pretty awesome.

He has yet to encounter more than a small cold and a tiny run-in with Roseola (all in the last month) since birth.

I couldn't have done this without the support of my wonderful supervisors who let me have the freedom to run down the hall every couple hours to pump, a husband who was willing to learn about breastfeeding and it's importance to my health as well as our son's health, and a supportive online community of moms and dads who have been here before and were able to help me navigate.

Friday, December 2, 2011

When options aren't options.

I have lots of friends and acquaintances who have scars from bringing their children into the world. Some are physical, some are mental. In our society no one wants to hear it if a mother has a healthy baby, but doesn't feel so hot herself... unless she contracted some horrible infection, in which case people want details. Nobody wants to hear about a woman's post-partum depression if she was otherwise okay and her baby is in great shape. After all, she exercised her right to choose how that baby was going to get here, right? She made that choice from a list of options available to her with modern medicine's greatest achievements. She had access to information about those choices and she made her decision. Right? That's how it went, and she should just be happy with that healthy baby and stop moping. Right? Wrong. She may not have had that access. And here's what I think about it.

I'm a firm believer in the idea that all options must exist if any options are to exist. That means I have to concede that it truly is better for some women to elect for a fully surgical, clinical birth if I am to have my choice of a home birth available. I can't fight for one type and one type alone. Unfortunately, I'm seeing more and more that women aren't really choosing some of these options as a choice, they're badgered into it or they're shown by the media that this is really the modern way to go. Why do things 'the old fashioned way' as that heifer on 'The Doctors' said a few weeks back, when you have doctors and drugs and scalpels to ease your way into motherhood. Why would you *POSSIBLY* want to be inconvenienced by the baby choosing a day that doesn't work for you? That's the message that's all around us in these modern times. Unfortunately, the message doesn't bear the weight of the risks and consequences. If you know the benefits but not the risks, you don't have the full information required to make a decision... so in effect, you don't *really* know your options.

When we don't know our options, we don't have any options. So, I'm going to clarify my position on options. You must do the research before you sign up for an elective induction, caesarean section, home birth, or natural hospital birth. You need to know what each of these will entail, what the risk is to you and to your baby, and to your body. It's not just about a healthy baby and it's not just about fitting into a busy schedule. You both need to come out healthy, because ultimately, your healthy body will be the one responsible for keeping that baby's body healthy for the next eighteen years.

So, If you're picking induction, bear in mind that this is not a simple process. You're changing the path that millenia of our women ancestors' bodies have perfected. When baby is done baking, baby sends a hormonal signal to your brain that essentially says "Hey, you! I can not only survive the outside world, I can breathe air on my own without assistance. Prepare for launch!" This causes a delicate balance in hormones to be released to soften your cervix and begin to efface and dilate more effectively. Contractions begin in earnest. Your body's own pain management system begins to kick up the oxytocin (which makes you feel better and makes you contract more), and eventually your body even begins to push the baby down and out. This is an ideal situation. I realize that the world is full of non-ideal situations and anyone planning to just let things happen on their own could need help at any time. I also realize that we live in a busy world and it's hard to wait out those last amazing weeks and some folks just get tired of answering the age-old question, "have you had that baby yet?", plus all their friends are doing it and they're *fine*.

Induction is not simple. A Caesarean is not simple. Sure, the mechanics are simple. You pick a date, your doctor agrees. You show up at the appointed time, get checked in, hooked up to monitors and IVs, things are inserted in places. When things get too hairy, you just get a needle in the spine and drift away on happy thoughts until the doctor tells you it's time to push... which of course you'll not feel because the epidural will be pumping happy juice right into your spine until they hand you your clean and shiny baby burrito. It sounds almost like you don't have to do any work in those terms.

Here's the deal. Induction is forcing the baby to leave before he or she has finished whatever project he or she is working on. This means you are asking your child to stop building brain mass, fat stores, iron stores, or polishing up those shiny new lungs for their first breath without a medical reason to do so. If you have a medical reason, then sure, this is a great idea. Same with the Caesarean. I'm not against these things if you fully understand what you're asking for. If you're doing it because of peer or family pressure, or just something that the doctor tosses out as a way to fit it into your week, this is not you making a choice. If you have chosen this after weighing your options and understanding the risks, then go for it.

For those who haven't been reading about birth, talking to women who have given birth, and researching birth for three years, here's the lowdown. Birth cannot be trusted, but it must be respected. An unmedicated birth is great, but challenging and the timing is unpredictable. Usual outcome is a healthy mom and a healthy baby, especially in a place where both mom and baby are treated with respect and kindness. That's kind of the goal of all birth methods- birth equals healthy mom and healthy baby.

Induction is usually the addition of a chemical cocktail to get things started. If your body is ready, it'll take fewer interventions to get labor started and usher that baby earthside. If your body is not ready (get to know your Bishop Score to determine whether this has a good chance of working or not), no amount of chemicals will help make this happen, and you will likely end up on an operating table.

Usually chemical induction starts with a cervical 'ripening' agent, such as cervidil, to soften your cervix and make it more favorable to begin to dilate. After hours of 'ripening', usually a drip of pitocin is added to the regimen to get contractions fired up. Some doctors prefer cytotec, also known as misopristone... if this is your doctor, run. After a little time on the Pit or Miso, the bag of waters is usually broken by a nurse or doctor to 'really get things going'. Monitors are hooked up, the mom is unable to leave the bed. The extra monitoring is generally needed because contractions caused by these drugs are longer, harder, and closer together than ones your body creates without help. This puts extra stress on your baby, who needs breaks between contractions to get more oxygen and to relax, too. If baby isn't getting enough oxygen, he or she could go into distress, which means that mom gets wheeled away for emergency surgery.

Pitocin is a synthetic version of the chemical your brain produces, called oxytocin. It stimulates the uterus to contract, which can start labor. It's great for using after birth if a mom can't stop bleeding, but using it to create labor can also lead to a post-partum hemorrhage or an overstimulated uterus. As hard as it is on the body, Pitocin is better than misopristone/cytotec because it can be dialed down if your body responds too aggressively to it. The cytotec is a pill, and once you ring that bell, you can't un-ring it. Aside from not being approved for use on pregnant women, being known as an abortion pill, and being clearly indicated on the package as unsafe for pregnant women, this stomach drug for ulcers can start some serious contractions. It has caused in the past severe enough contractions to rupture the uterus and endanger both mother and baby. Again, cytotec is great for post-partum hemorrhage since it can make the uterus contract, but can also cause post-partum hemorrhage because of how it acts on the uterus.

As long as your bag of waters is intact, baby has a cushion around his or her body that makes it easier for baby to move into a good position, keeps the contractions from squeezing baby directly, and protects baby from infections. Breaking the water can speed up labor a little by taking the cushion off baby and putting his or her head closer to the cervical os. That head pressure helps dilation, and the contractions generally help move the baby down if he or she is actually in a good position. Sometimes though, breaking the water before baby does it can cause baby to hit the birth canal at a funny angle, which can make labor even harder on mom. Breaking the water also makes both mom and baby more susceptible to infections since the amniotic sac is a germ-proof barrier for the most part. It's almost like your baby is vacuum sealed for the duration of the stay in the womb. Generally you are put on the clock once your water is broken, and the more vaginal exams you have once your water is broken, the higher your odds of having an infection. You'll be monitored more closely for signs of fever or fetal distress.

With luck, a few of these things or all of these things will come together to make a beautiful moment in which your baby will come sliding right down the birth canal and into the waiting arms of some lucky doctor or nurse with nary a scratch. Sometimes though, that baby won't want to come down. Then you may experience vacuum-assisted or forceps-assisted birth, which generally also means an episiotomy since we weren't designed to have tools crammed up our vaggies along with the heads of our offspring.

Some doctors will cut an episiotomy anyway, even if they don't need to insert tools to remove your child... but that's a topic for a different day.

If all of these things didn't work, then the odds are good that for some reason during your induction, you will find yourself in an operating room numb to the gills and divided from the view of your child by a big blue surgical drape. Of course, some of you will choose to skip everything and just head here. That's fine if it is indeed an informed choice.

Surgical birth is major abdominal surgery. Organs will leave your abdominal cavity. You could have up to six weeks of recovery. You could have issues after the healing such as a numbness where nerves have been cut, or damage to internal organs. You will now have a little scar on the outside, and a little scar on the inside... and that little scar can cause big problems down the road if you have more pregnancies.

Caesarean scars can cause problems if future pregnancies occur because the placenta can grow into or through the scar, a condition that makes it very difficult or impossible for the placenta to detach on its own after birth the way it is supposed to, and can be fatal. The risk of rupture can go up, though the rise isn't huge, the limitations in your options is. The old saying was 'once a caesarean, always a caesarean', and if you'd like to try a VBAC you may have to fight harder for it than you have fought for anything in your life. Many doctors do not want to take on the increased risk and will only do repeat caesareans. Each surgery increases the risk to the mother's health.

So, please ladies. I beg you to dig deeply and read everything you can before you make up your mind. This is more important than picking out the perfect nursery furniture and registering for all those tiny clothes and gadgets. This is more important than your stroller or diaper bag choices. This is a life choice for two people, and it can't be taken lightly.

For those who have weighed the risks with the benefits and chosen to still move ahead with your plans, I wish you a safe, peaceful, and respected birth. As a mom, all you can do is the best you can with the knowledge you have available, and I just gave you some. There's more out there. Keep searching. Be sure that what people are pushing at you is what YOU want, not just something to make someone else's life easier.

And for the friends and family members who chose to do it this way, that doesn't mean that it's the right choice for everyone. Maybe the woman you're leaning on to 'get that baby out here' because you'd like some cuddle time wants to let the baby finish baking.