Tuesday, February 13, 2007

Out on the town

Yesterday I had my first successful solo outing with Adriana. (Actually, the first time wasn't completely unsuccessful. I was just too nervous to even go into Target to buy one thing without panicking.) I packed Adriana and the stroller into the car and headed to the mall, where I had scheduled an appointment at the salon to have my brows done. The only crisis was a small one: once I was in the parking garage, I couldn't figure out to unfold the stroller, even though I'd practiced before we'd left the house. Reasoning that not using the stroller, which is just a frame that holds thecarseat, meant that I didn't have to worry about whether I got the carseat back into the car properly at the end of the trip, I tucked Adriana into her pouch and went on my way. She lay quietly on my chest while Jasmine did my brows, and slept while I visited a couple of other stores in the mall. When she started to stir, about an hour after I'd figured she would want to eat, I headed to the mothers lounge inNordstrom . By the time I got there she was asleep again, but I needed to adjust her in the pouch anyhow and I thought that would wake her up. No luck: she slept solidly when I took her out and put her back in. An hour later, as I was waiting in line at the bookstore, she woke up angry that it had been four hours since her last meal. Deciding that carrying a screaming infant all the way back toNordstrom was more frightening that trying to nurse in public, I found an armchair in the store and fed her there. The man in the chair beside mine looked up and nodded at me, but went back to his book, and I think I managed to be pretty discreet (although Adriana is a noisy eater and I am not yet a graceful nurser, so even if you couldn't see any skin, it was quiet obvious what we were doing). Who needs a mothers lounge?

But I'm glad I went into the lounge that first time anyhow. It gave me a chance to sip the cold drink that I bought on my way in, and to talk with another young mom who was there. Her son was seven months old, and it was nice to chat with someone who was relatively new at this mom business but still more experienced than I am. Throughout the trip I discovered that Adriana is a better conversation piece than Zorro (although I haven't tried that on the Metro). Whenever I went into a store the salespeople would talk to me about her, several people stopped to ask me about the carrier I was using, and other moms would gush over her hair and her size (they all thought she was so tiny, until they knew that she was only a month old). I, however, refrained from chasing after a woman I saw heading into the Gap with a stroller identical to mine to ask her how the hell to open the damn thing.

Sunday, February 11, 2007

One month

Adriana Ruth is one month old. It's amazing to me how much she has changed in the past four weeks. Although I know that most people would just look at her and see a helpless infant, I keep noticing how much she has grown since we first laid eyes on her.

Only a parent would marvel at her accomplishments I suppose: at how she can hold her head up a little bit longer every day; at how she can now focus on us and follow us with her eyes; at how she can (sometimes) get her hand to her mouth. She has outgrown her newborn-sized clothes (including the outfit she came home from the hospital in) and is on her way out of some of the 0-3 month-sized sleepers in certain brands. She spends a little more time awake and alert.

Some days this is so hard, harder than I imagined it would be. I think she is developing some sort of routine, and then she changes it. Or she cries, and I don't know why. I try everything in my small bag of tricks: nursing, changing, swaddling, walking. I get worried about how we will ever manage and wonder what on earth I was thinking. But then there are times when everything works. She cries, and is comforted when I pick her up. She wakes up to nurse as Brian is leaving for work, and when she finishes, she and I snuggle back down into the bed to sleep for another hour. She fusses and I pop her into the sling and dance around the house to Paul Simon as she makes funny baby faces up at me.

There was one evening a few days after we came home from the hospital when I nursed her and then handed her to Brian to rock. I walked into the next room and watched the sky get dark as I cried, completely sure that I was never going to bond with the baby. In spite of the overwhelming love I felt when I looked at her, I thought there was something missing, because I didn't know what to do with the baby besides feed her and change her and hope she would fall asleep. I have to confess that I still have those moods on occasion, moods that leave me in helpless tears, but they are fewer and further between. I find that mostly she just needs me to feed her and change her and snuggle her, and I am capable of all of those things.

And the love just gets more overwhelming.

baby on a blanket

Wednesday, February 07, 2007

Every time I check on the baby in the bassinet, I have to look at this. I've never taken a French class in my life, but I still know it's wrong, and it's driving me nuts.

Arm's Reach Co-sleeper safety warnings label

The funny thing is that we had the co-sleeper set up for two months before Adriana was born (in a futile attempt to train the cat to stay the hell out), and I didn't notice the typo until the day after we got home from the hospital.

Saturday, February 03, 2007

Question for Polonius

If brevity is the soul of wit, does that make me witless? Or simply soulless?

Friday, February 02, 2007

Adriana's birth story, part 5: Reflections

Or, What the hell, let's just go for a nice round 10,000 words

Why does it matter to me so much that I ended up with a hospital birth and a c-section? It wasn't what I'd wanted or planned for, but in the end I have my baby. I wish I weren't so upset by it. I wish I didn't need to write an 8,000-word birth story to help me process what happened. I wish I understood why after 8,000 words I still can't articulate what it is that's bothering me.

I have spent a lot of time over the past three weeks thinking about Adriana's birth, about how it all went. The experience of her birth was not what we had planned for at all. I know that the end results--a healthy mom and a healthy baby--are what really matter, but the experience of getting to that end was important to me too, and I didn't get what I wanted, what I had planned for so carefully for so long.

Sometime in the week before she was born, I came across the expression "People make plans, and God laughs." I don't remember where I read it, or what context it was used in, but the line has certainly replayed itself over and over in my mind since January 11. I had planned so much. We didn't just have plans, we had contingency plans as well. I had written not one but THREE birth plans (one for the birth center, one for a hospital transfer, and one for a hospital induction). It's funny to look at my hospital transfer plan now. My expectations for that were perhaps a bit high. I think it was good to have, though; anyone at the hospital who might have read it would have known what our ideal birth would have been and realized our mental and emotional states given what was actually happening.

Looking back, I don't think I could have planned any better for what happened. I didn't know what labor was really like, and I didn't know what our particular circumstances would be.

But I keep wondering about everything that happened. If there was a way to avoid the c-section. There are so many what-ifs:

  • What if I hadn't had the stretch and sweep? Maybe I wouldn't have gone into labor that night. Perhaps when I finally went into labor, the baby would have been in a better position.
  • What if I hadn't tried the evening primrose oil? I wonder sometimes if that contributed to my upset stomach, which led me to have so little fuel for labor.
  • What if I had gone in earlier for the Ambien so I could get some rest? Would that have given me the energy I needed?
  • What if I had been willing to try the Nubain to get some rest at the birth center?
  • What if I had gone for the IV fluids at the birth center? Would I have moved further along on my own?
  • What if I hadn't gone to the hospital? Could I have gotten the baby out on my own at the birth center, given enough time?
  • What if I had fought the Pitocin at the hospital? Perhaps that moved the labor along too quickly, so that the baby didn't have time to turn. Or at least I might have avoided the internal fetal monitor.

What if, what if, what if....

The day after we were discharged from the hospital, Marsha came to our house to check on us. Toward the end of the visit she asked me how I felt about the way the birth had gone. I began to cry, and told her some of my what-ifs. She stopped me eventually. "Posterior baby. Bad positioning of the head. Nine pounds, eleven ounces. She was not an easy baby to get out." She assured me that she thought I had done all I could. She reassured me again yesterday at a post partum check-up, as I continued to express my doubts and regrets.

I still have my doubts and still regret that I wasn't more alert for some of my choices, but it is nice to have Marsha's reassurance.


Pam, our birth assistant, visited us in the hospital the day after Adriana was born. She had stayed behind to clean up at the birth center on Wednesday night, and I spoke with her briefly on Marsha's cell phone on Thursday when I was in the recovery room (I remember that I had the conversation, but I don't actually remember the conversation). We talked with her a little bit about how things had gone. She told us that after we left the birth center, she and Regina were talking. They knew then that one of two things would happen: either the car ride to the hospital would somehow jar the baby into a better position and I would get to the hospital and have the baby, or I would have a c-section. I found that strangely reassuring. As with what Marsha said to me, it helps me realize that there was only so much I could do. The choices I made were mine. I don't give up responsibility for them. But there are only so many choices out there.

Still, I wonder what would have happened if Pam and Regina had said those things to me before I made my decision to go to the hospital. Would I have made the same decision? I just don't know.


I was afraid of c-sections, and of surgery in general. There was an exercise during one of our childbirth classes where we all given slips of paper with goals on them to rank. We were told that the ones that said "healthy mom" and "healthy baby" were our top goals, but it was up to us to arrange the rest of them: "avoid internal fetal monitoring," "avoid c-section," "avoid episiotomy," "wear my own clothes"--there were probably two dozen different things. "Avoid c-section" was one of my top goals. When the instructor asked what I was doing toward that goal, my only answer was that I was receiving care from midwives and planning an out-of-hospital birth.

In the end, though, the rough part wasn't the c-section itself. I was nervous during it, but I managed okay. The worst part was the recovery. It wasn't until two days after Adriana was born that I was able to go to her bassinet and pick her up, rather than asking Brian or a nurse to bring her to me. We got home on Sunday afternoon, and I went upstairs to bed. It wasn't until Tuesday that I came back down the stairs, and even then I was still too shaky to carry the baby down with me. I had to have Brian do it for me. I felt guilty for the Percoset I had to take in order to cope with the pain for over a week, as I wondered how much of the drug was making its way into my milk and if that's why Adriana was such a sleepy baby. A nurse friend reminded me that if I was in too much pain it would interfere with my milk production and reassured me that it was fine to take the meds as long as I needed them. Still it was a relief when I felt well enough to switch to regular Tylenol.

I still don't feel 100% myself, and that's the most frustrating thing. I know I would have had to recover from a normal birth as well, but I don't think it would have taken this long.


The other night Brian asked whether I'd rather have a three-day labor or have a c-section. In spite of the fact that after 24 hours of labor I opted to go to the hospital for pain relief, I told him I'd take the three-day labor.

"You're a bad-ass," he said.

"No, recovering from surgery just sucks that much," I told him


When we took Adriana for her first pediatrician visit, we briefly outlined how the birth had gone for the doctor. "C-section, failure to progress," she murmured to herself, as she made a note in the medical record.

Failure to progress. Somehow just hearing those words depressed me.


Brian asked me the other day if I thought that our experience was an argument for or against out-of-hospital births. Without having to think I told him that it was an argument for the care we received. My experience at the birth center was wonderful. I look back at laboring in the bedroom at the birth center, surrounded by people who were focused on me and supported me completely, with nothing but awe. Up until the point where I couldn't handle the pain anymore, my birth experience was nearly exactly what I'd wanted. When I came to the realization that I couldn't go on any longer without some rest from the pain, I had the support I needed to make that decision without fear. It was my choice to make, and once I made it, everyone did what they needed to do to support me. If I were to do it all over again, I would do that much the same way. Just without the back labor. Especially 24 hours of it.

One of the more disappointing aspects of how everything turned out is that now I am unlikely to ever have a birth the way I imagined. If Brian and I ever decide to have another baby, a midwifery practice like the one we used for this pregnancy is unlikely to accept us as clients. VBACs are becoming more and more common and accepted, but they are done in hospital settings, not by midwives at birthing centers. That's disappointing to me not only because of the birth experience I would love to have, but because of the prenatal care I received from my midwives.

During my first pregnancy, before we had completely made up our minds about whether to use an OB or a midwife, we scheduled prenatal visits with both a doctor and with a midwife. Our first visit was with Regina, who spent an hour with us and answered all of our questions. Our second visit was with an OB, who rushed through the appointment and hardly gave us time to get a word in edgewise. Our minds were made up then, but the midwives did nothing except continue to reassure us about our choice by their actions. When I miscarried the first pregnancy, Regina was on the phone with me as it happened, talking me through the pain. When I was pregnant again, she and her colleagues were just as supportive. Around the time I was reaching the second trimester, we heard about a birth that had gone badly from a friend (baby was fine, but mom had a rough time of it). I was less concerned than Brian, and at our next appointment, which was supposed to last about 20 minutes, he spent a lot of time questioning the midwife about our friend's story and how the practice would handle it. Erin patiently answered his questions, explaining the practice's protocols in various circumstances. The visit lasted over an hour and we never felt hurried. I truly believe that I received the most outstanding prenatal care possible, and I hate that in the future that exact same care won't be available to me.


I know someone who had an unplanned c-section a few years ago. She regrets how long she labored before having the c-section. She wonders what was the point of that long labor, if she was just going to have surgery in the end. I find myself having the opposite reaction to my own experience: I'm glad I labored as long as I did. I tried as hard as I could, and I know that.


In spite of all my worries and doubts about the way things happened, there is one thing that stands out in my mind about the entire birth experience, from the time I spent at home, denying I was in labor, to the birth center part of my labor, to laboring at the hospital, and then dealing with the c-section and recovery: how essential Brian was to me throughout all of it.

We took a twelve-week Bradley course to prepare us for natural childbirth. Bradley called his method "husband-coached childbirth." To people of our generation, I think the idea of the father not being at the birth is somewhat foreign; of course Brian was going to attend the birth of our daughter. But the classes taught him about birth and about what kind of support he could provide for me during the birth.

Still, I don't think it was the classes that did it. It was Brian just being there, being himself, loving me, that made everything better. He pushed on my back, helped me in and out of the shower, reassured me when strong contractions made me start to panic. Mostly, though, he was just there, looking into my face, holding my hand, giving me whatever I needed. I needed Pam and Marsha and Marisa, as well, but not the way I needed Brian.

One week of our birth class was devoted to hearing the birth stories of students from the instructor's most recent group of students. Several of the couples noted how much closer labor and birth had brought them. I believed them, but I didn't understand, not really. I needed to see how much harder contractions were to deal with without Brian, to cope with pain by tuning out everything but the sound of his voice, to lean into his arms during a contraction as we paced the birth center hallway, to have him beside me through the surgery.

I needed to cry with him once he and Adriana and I were all back together in the maternity ward, to see the way he holds her, to have him take her from me in the night after I've fed her, so he can walk her to sleep. I needed all of these things in order to understand what they meant. And I know that no matter how much I write, or how I try to describe it, I can't make anyone else understand this new closeness.

Thursday, February 01, 2007

Adriana's birth story, part 4: Recovery

I was being wheeled back into the labor and delivery room where I'd spent the night when I woke up. Marsha was there, but Brian wasn't back from the nursery with the baby yet. Marsha and Barbara began getting me settled. I couldn't stop shaking and they wrapped me in heated towels while I faded in and out.

I was a little more alert when Brian returned with Adriana, or maybe it was their return that woke me up a bit. He placed her beside me on the bed. Marsha used our camera to take a few photos, and Brian said that the baby's blood sugar was low, something common in large babies, and they had wanted to give her something in the nursery, but he had convinced them to let him bring her to me to try to nurse. Marsha was also encouraging me to try to nurse, which I wanted more than anything, but Barbara was reluctant. She wanted to make sure I was okay first. But when it neared eleven, she let us try, because that was when Brian had promised to have the baby back in the nursery. They helped me turn to my side, and Marsha tried to help the baby latch. We were fairly unsuccessful, but we'd at least tried. And when Brian got back to the nursery and they checked Adriana's blood sugar again, it was well within normal range, and he brought her back again soon.

At some point, my friend Becca called from London, checking on me because I hadn't answered email in a couple of days. Marsha answered my phone and let me speak to her for a couple of minutes. I told her briefly what had happened and how big Adriana was. Becca exclaimed over the size of the baby--only three ounces less than her daughter had weighed at her six-week check up the week before. I was hurried off the phone, but it was good to have announced the baby's birth to someone.

There was talk of something being wrong with one of my ureters, a tube that connects the kidney to the bladder. The doctor wanted to make sure that it hadn't been damaged during the surgery and wanted me sent down to x-ray for an intravenous polygram: they would run some sort of dye through my system and take x-rays to make sure everything was all right. When it was time to go, Brian and the baby were sent to our room in the maternity ward, and Barbara accompanied me down to x-ray.

As we waited for the radiologist, I asked Barbara about VBACs. I think she was amused that three hours after a c-section I was already wondering about the possibility of having a normal birth in the future. She advised me to find a good, open-minded OB well in advance of getting pregnant again, as many midwives, including the ones I had been seeing throughout my pregnancy, wouldn't do VBACs.

The radiologist finally joined us and while the technician was asking me various health history questions (I was of the mind that if I had no idea what the condition was that he mentioned, it was safe to say that I'd never had it), I heard the radiologist telling Barbara that the dye they were going to use would get into my breastmilk and I would be unable to nurse for 48 hours. I tuned out the technician's next question and stared at the doctor.

"What?" he said, looking surprised.

"I heard what you said." He looked at me blankly. "About breastfeeding." He seemed unconcerned, but I could tell Barbara understood. She came over to me as I asked the doctor if there was a different dye they could use. He said there wasn't another dye, wasn't another test. I had a feeling there were other questions I was meant to ask when faced with the need to consent to medical procedures, but I couldn't come up with them. I thought about declining the test, but then I wondered what would happen to me if something really was wrong. I talked with Barbara for a few minutes, and we decided that we could syringe-feed the baby formula for two days while I used a breast pump to get my milk to come in. I hated the idea, but I didn't know what else to do. I dreaded telling Brian--I knew he would be as disappointed as I was.

It took about ten minutes for the dye to run through my system, and then they began taking x-rays. The x-rays seemed to go on forever, with long pauses in between, but my concept of time was fuzzy, and I kept dozing off. I was there long enough that there was a shift change and a new technician took over toward the end. It was a relief to finally be wheeled back up to the room where Brian and Adriana were waiting for me. I was right about Brian being disappointed, but we had the nurse bring us a syringe and some formula, and he got to feed Adriana for the first time, while I sipped some cranberry juice, relieved to finally be allowed to have something other than ice chips.

Various people were in and our of our room, including the attending physician and a resident and medical student that he works with. The resident found out the name of the dye that was used during the IVP, so that I could ask the lactation consultant when she came in the next morning. They brought me a breast pump to use during the night while Brian continued with the syringe feedings. I was given antibiotics because I was running a fever, and two units of blood because I'd lost so much during the operation. I did try pumping once, and I intended to do so throughout the night, whenever Brian was feeding the baby, but he let me sleep for six hours straight, which I probably needed to do after the long couple of days I'd just had.

In the morning they removed my epidural. It wasn't until afternoon that I'd regained all the feeling in my legs, at which point the nurse came to help me to the bathroom, I was shaky but okay, and spent some time sitting up in a chair. That afternoon the lactation consultant came rushing into my room, declaring that the dye used during the IVP hadn't entered my GI tract and had a short half-life, so breastfeeding was fine. It was fine all along, which made Brian and me mad--we felt that we'd lost valuable time establishing nursing. But I realized that there wasn't really time to be mad, I just had to start now. The lactation consultant helped get Adriana latched for the first time, which was a relief.

The next couple of days were a long blend of people coming in and out of the room, taking my blood pressure and temperature, checking the baby, giving me more pills to take. Adriana and I struggled to figure out nursing, and I dealt with getting my body back to normal. The first night after the epidural was out, Brian headed home to pick up a few things, and I had to call a nurse to help me get to the bathroom while he was gone. It wasn't that I couldn't walk okay on my own; I just couldn't figure out how to sit myself up and get out of bed, given the pain in my abdomen from the surgery. The nurse showed me how to pull myself up to a seated position and then turn my body to get my legs on the floor. After that I was fine on my own. On Saturday, I even felt confident enough to pick Adriana up out of her bassinet on my own a couple of times, rather than asking Brian to bring her to me.

We'd been told we would be discharged on Monday, but on Sunday someone said to us, "So, you're going home today?" Confused, we corrected her, but the nurse checked our chart and the doctor had written the day before that we could be discharged on Sunday. Nervously, we decided that was a good thing, and got ready to go home.

My real frustration with recovering from a c-section began once we were home. In the hospital it was easy to let Brian and the nurses do things for me, but once I was back in my own house, I hated feeling like an invalid. If I wanted something and Brian wasn't in the room, I talked to him through the baby monitor. At first I couldn't manage the stairs, so we ate our meals upstairs in our bedroom. It wasn't until two days after we came home that I went down the stairs for the first time. I made Brian carry the baby, but it wasn't as hard as I thought it would be. I took prescription pain relievers for the next week, feeling guilty as I wondered how much codeine was getting into my milk, but accepting a reminder from a nurse friend that pain would interfere with my milk production. Nursing was slow and frustrating at first, but Adriana and I were learning, and now she eats like a champ.

I'm still tired a lot of the time, but that's the normal tiredness of caring for a newborn, I think. I still think a lot about how the labor and delivery went. Recovering from surgery is something I wish I weren't dealing with at the same time as dealing with a new baby, but I try not to dwell too much on it. I know, after 8,000 words you don't really believe that I'm not dwelling on it, do you? It's actually easy not to focus on all of that too much, as I'm awfully busy dwelling on how overwhelming my love of Brian and Adriana is.