Friday, January 29, 2010

More Yuck Than You Ever Thought Possible

Okay, pregnancy is weird. I get it. In fact, I embrace it. Theoretically.

After I peed today there was a gob of yuck in the toilet. A thumb-sized tannish-shredded-something-with-dark-reddish-brown-spots in it. Now, I never lost my mucus plug before my daughter was born, but the phrase "mucus plug" is so yucky that this seemed like it might fit the description.

I called the nurse. She seemed perplexed by the whole description and had me fish it out of the toilet (note - use slotted or perfed pasta spoon, not ladle, to get anything out of the toilet, otherwise you just have to chase it all over the place and it tries to go down the plumbing) and bring it in.

And you know what that means - another hour of toco/fetal monitoring, an ultrasound and a speculum check. Yay! But it's nice to know that things look good in there, even if nobody's quite sure what the yucky thing was.

People actually kept coming into the room to look at the yucky thing. It was like an obstetrical roadside attraction.

I probably should have charged admission.

Wednesday, January 27, 2010


First off, I hate that the word "natural" is used to describe a non-medicated birth. It just seems like it's co-opting a universal but often vague word to describe something that is actually very specific. Plus, as someone who had anything but a "natural" conception, it seems silly to start assigning words like that to any part of the process. So, I'll work on a better semantic descriptor, but in the meanwhile, let me tell you about the apprentice doula who was better than drugs.

I had a doula for the birth of my daughter. That was back in the dark ages of the 90s, when it was harder to find people on the internet. I wanted a doula because my husband gets nauseous at the sight of blood - I knew he would be of no use to me. I didn't want my mother there, because, well - I've written about my mother before. I wanted to have someone supportive and knowledgeable and calm by my side, and I figured I'd have to hire someone. But it was hard to find a recommendation - there were some lists at the hospital and a national organization that gave our names in the area. Finally I decided to use the woman that also taught a pre-natal class at the hospital - I figured that at least she had some relationship with the staff.

She was fine. I think she knew what she was doing and her class was informative. I didn't feel an instant connection with her, but I respected her level of experience and she seemed like a caring person. After we hired her, she asked if she could bring a doula trainee with her to my birth. The trainees had to attend a certain number of births as part of their program, and she said it would be to my benefit to have an extra person helping me. I figured it would be to my benefit to have an extra person helping her, so that she could concentrate on me, so I said sure.

It was the best decision I could possibly have made. The apprentice was exactly what I would have wanted in a doula if I could have figured out exactly what all the options were. She was calm, she knew when to distract me from a mild contraction, she knew when to do accupressure massage for a stronger one. She would tell me stories about being a new mother (she had two young children) while we were in the early phase, and then later she would rub my feet while the nurses watched my contractions on the monitor and made a big fuss over how intense they were. Honestly, all I could feel was the best foot rub I had ever had.

I had a long early labor - almost 24 hours at home (easy, very mild contractions - not even as bad as a period) and then about 12 hours at the hospital. The doulas were there for maybe ten hours. I think the first part of the day was fairly easy, some contractions and a lot of walking around the courtyards. I have low blood pressure normally, and lying down for a long time tends to make it even lower so we tried to keep moving. Plus, walking is supposed to help move labor along, and I was obviously on the long, slow plan. After a while the nurses had me stay on the L&D floor because I was so dilated. I remember suddenly feeling like I had to lie down, and the apprentice doula put me on my side and began doing counter-pressure massage on my lower back.

Just as I was thinking, hmmm, this labor thing isn't so bad, the other doula came back with a nurse and said she thought I was ready. The nurse checked, and suddenly there were people flying in and carts being pushed around and they were telling me that the doctor wasn't there yet and I needed to wait. I was fully dilated. The apprentice doula kept rubbing my back and then she whispered that I had gone through "transtition" - the worst part of labor - in 8 minutes, and that if I wanted to push I shouldn't worry about the doctor. She told me that my nurse had been a midwife for 20 years in Australia, and that she was perfectly capable of delivering a baby.

I remember thinking that I was glad for the nurse-midwife, but that I really wasn't worried about waiting for the doctor anyway. I mean, L&D nurses knew what to do, right? I was in this perfect zone from the counter-pressure massage, and I was going to just stay there. Suddenly the nurses were yelling for a resident. I just decided to go with the pushing feeling, and the apprentice was guiding me into a better position and then my doctor showed up and before she could get her gloves on my daughter was born. We have photos of Dr. D waving at the camera with her hands all bloody.

Afterwards, things were so easy. We just got wheeled to our room (now that hospital has labor-delivery-postpartum rooms, but at the time there were separate areas for the before and after). I had never gotten to a point where I desperately needed an epidural. I had felt like I was in charge of my own experience. I could tell that everything was fine. I was so glad that I had the chance to feel what childbirth was like without being in terrifying pain. And I don't know if any of that would have happened without the apprentice doula.

So, that's my experience with "natural" (substitute your own phrase here) childbirth. I would sum it up by saying it's really not bad if you have the right kind of labor - and don't rely on your husband to get you through it, of course.

Afterwards I found out that long slow labors almost always slow down with an epidural, and then need pitocin to pick back up again. Labors that are naturally long and slow suffer the most complications from pitocin, with decreased fetal heartrate, retained placenta and maternal hemorrhage topping the list. Um, yikes!

Some people have drastic, incredibly painful labors and can't imagine going through the whole thing without an epidural. My most "all-natural" friend went into the hospital swearing she would never stoop to anesthesia, and was screaming for medication after a few hours. She had a hard fast labor and it was just too much for her. So, I get it. And if I have a different kind of labor this time I am totally open to needing the drugs. After all, it was less than a month ago that I was willing to kiss the nurse who put morphine into my IV.

Anyway, I figured it would be easier to find a doula today. Anybody who wants to be found has a good internet footprint, and it only makes sense that doulas would make sure they can be googled. So, I typed the name of the apprentice doula into the search bar and - voila! She's a midwife now, but she will work as a hospital doula in high-risk cases. I have high hopes for another great experience with her, and if I have the same kind of labor I'll be glad to go through a little pain to avoid more serious complications. (If I have the hard, fast, incredibly painful kind of labor, I'll be glad that I'm in a hospital with an anesthesiologist right there.)

And, in case you were wondering, I don't think I'll be going in for an emergency low-fluid C-section any time soon. Since I've been on bedrest my AFI has gone up to 14. I saw my OB this morning and she said that as long as I keep resting and glugging liquids she doesn't think I have any more risk than anybody else of an early birth. So, yay! I am allowed to do a little bit of light activity, but other than that I have to stay horizontal as much as possible. As long as it's working, I won't complain too much!

Saturday, January 23, 2010

Kick in the (Maternity) Pants

I had another round of non-stress test and ultrasound yesterday, which showed that nothing has really changed. My fluid is still hovering just above 10, but the little guy seems to be growing well and doing fine. My official diagnosis is "borderline fluid." All of this leaking and low fluid and bedrest at least gave me a much-needed jump-start as far as getting some of the baby-stuff figured out.

I am basically torn between wanting to just get it all done now and knowing that I don't really need much in those first few weeks anyway. Since I am trapped on the couch, I have been doing oodles of research about every baby product I can find. And it's been interesting - there are so many new baby-contraptions out there! For instance, I had never heard of a Tummy Tub before, and now I simply must have one. Even though it's $40.

Yep, it's a giant expensive bucket. But there are hundreds of reviews raving about how fantastic it is, that bathtime isn't the screaming disaster that it is with the lounger tubs, that babies love to stay in the water when they are upright and mostly submerged. Okay, I guess you could just get a bucket at the hardware store, but this one is phthalate and bisphenol free, blah blah blah. Of course, I'll save my final opinion for after I've actually used it.

I did order a car seat and a stroller chassis, thanks to Gwynn's recommendations. I have my eye on a "light-jogging" (i.e, brisk walking, which is all I'll do anyway) stroller which won't be available until March, but really I doubt I'll have the gumption to do any actual brisk walking in those first few weeks. I still need to get a crib mattress (gah! latex vs. coconut vs. the pristine wool of hand-fed mongolian goats...) and some kind of Other Thing that can be the thing the baby sleeps in next to our bed for a while.

What this Other Thing is, though, is unknown. I am intrigued by the idea of the co-sleeper, but our bed is this upholstered platform thing with wide edges. The mattress sits about five inches in from the edge of the upholstered platform. I think that the edge of the co-sleeper won't be able to scoot all the way over to my mattress, so it's whole raison d'etre will be irrelevant. Other than that, a moses basket on a stand? They are really little, though, so probably only good for a few months. Bassinet? I can't cope with one of those poofy things that looks like a miniature coffin inside Scarlett O'Hara's petticoat. There is one intriguing option, but I have found two reviews of it: one person loved it more than anything, one person thought it was a death trap. Hmmm.

See? It could go either way - organic cotton and FSC wood, all very green and fabulous and yay. Or, flimsy and collapses on your baby. Although I am always suspicious that the person who thinks it's dangerous just put it together backwards. I did find one blogger who got it for her nursery back in November - I emailed her to find out what she thinks, and if the blogosphere is all it's cracked up to be she'll write back with the real scoop.

So, that's it so far. Next time - "natural" childbirth!

Monday, January 18, 2010

Ongoing Whatever

So, I am still low on fluid, but not super-low. My averaged fluid measurement is 10.4 - they like to see at least 11. I mean, it's close. It's not drastic. The little guy is banging away in there and it seems like he doesn't have any trouble moving around.

But maybe the bumping is just really dramatic because he isn't cushioned by a vat of fluid? I've had two ultrasounds since I left the hospital and I go back on Friday for prolonged monitoring and another scan. I'm at 31 weeks now, and I know that every week until 36 is important, so I'm just hoping to keep things going for a while with bedrest and liquids. I'm not having any contractions, so if my doc decides that this guy would be better off out in the world, I'm guessing that means the dreaded C.

My husband is going out of town for ten days at the end of the week. I think I can pull off the bedrest with the help of friends and carpoolers and delivery guys, but I can't pull off another late-night trip to L&D by myself. I semi-wish he would cancel, but it's a big deal thing that he's doing and he might never get a chance to do it again. I hate to take away something that means so much to him, especially since I have been so demanding in the past few years - IVF, private school for my daughter, a new house. (Sheesh, I'm like a Real Housewife of Somewhere!) So, he's been working more (which for a freelancer sometimes means taking dumb jobs with idiots he can't stand, or not getting any time off after a grueling project) and now FINALLY he gets to do something prestigious and meaningful and important to him.

I'm gonna try to make it work, but I hope he can get back here fast even if he might have to hijack a snowmobile if he ever hopes to make it to an actual airport in an emergency. My little guy better just hang in there until his dad gets back...

Thursday, January 14, 2010

Taking It Easy...

I'm trying not to really do much of anything, but I'm not sure how long I can keep that up. I am just not very good at lounging, unless I am under a pine tree on Kailua beach, and there's not much chance of that for a while.

I have decided that going through boxes while lying on my side on the couch can count as resting. Today I sorted through letter and photos and travel souvenirs, the junk that accumulates while you try to decide if you are sentimental enough to save any of it. I love the idea of keeping these things as a record of our experiences, but the truth is I'm just not very scrapbooky. Still, packing everything and moving makes you think about your stuff in a way that doesn't usually come up. A sense of minimalism is definitely driving me to get rid of anything that seems superfluous in any way, but there is still some sentimental attachment to all these things I know I don't really need.

And at the same time that I am trying to figure out what to get rid of, I am also researching all the stuff I am thinking about accumulating. I've registered, although my list is on the odd side. I have enjoyed finding a kind of scheme for the baby's room, although I'm still not sure how it will work out in the long run. Let's just call it modern and graphic for now - I'll post some pictures if it seems to work out. My registry has pillows from Bodalee and wall art from Bookhou on it.

I love these things, but they are definitely not necessities. It's been hard for me to figure out what I might really need - when my daughter was born I didn't know anyone with a baby, and learning as I went was a hit and miss process. By the time I found things that might work for us she would be on to a new phase, and we tended to try to make due without things that might have been really helpful. So, if anyone has knows or has heard that such-and-such is absolutely essential, let me know!

I guess I should get up the gumption to read some actual parenting blogs. I have been so amazed at how much it has helped me to find other people going through infertility and the fear of loss - it should be the same for infancy, right? It's just that after years of IF, those parenting sites have always been risky territory. It's not as easy to just jump right in as I thought it would be.

Tuesday, January 12, 2010

Home For Now

I'm sprung, at least for a while. My amniotic fluid seems to be increasing a little bit, and there is now a new theory about what may have happened.

My placenta isn't a perfect disc shape - it has a comet tail that wraps around towards the back. It looks like the tail may have separated a bit, which led to some bleeding. That blood formed the giant clot, which passed through the cervix - taking with it the chorionic fluid.

Yep, there is also the lesser-considered second sac of fluid around the amniotic sac. The second sac has it's own thin layer of fluid. It's not something that usually ruptures, but it can happen. And it is just a theory - my amniotic fluid measurements are low, but they were never huge anyway. As long as the baby seems to be doing well we are going to just hope for the best.

Meanwhile, I am exhausted. A hospital is no place for sleep, what with the IV fluids being changed at all hours and the monitors going off for the tiniest reasons. I had to have the IV in the back of my hand since it was so freezing when we got there that all my other veins were shrunken. My fingers are now stiff and swollen and my hand is giant and sore. I can't really type with only one good hand, but I just wanted to post an update.

Tomorrow: why to pack a "just in case" bag, even if you think you have lots of time left...

Sunday, January 10, 2010

The Crib Curse

I have been too exhausted to post lately. Having finally begun to think that I might actually really have a viable baby going on in there somewhere I realized that I should probably get all the baby stuff together. Not just a cute outfit and some burp cloths, but all the stuff that normal pregnant people have so much fun buying. So, I went on a spree.

We wanted to be sustainable reusers of whatever baby things we had left from eleven years ago. Really we did. But when we unpacked it all we saw how it hadn't fared so well through several lendings, so we decided to put what we had on Craig's List and start over. My friend L, due 5 weeks after I am, went on an all day research excursion with me to all kinds of shops, fancy and basic. We loaded both of our bags into countless strollers and car seats to find out how heavy they might be with 10 lbs of baby to schlep around in them. We debated zippers vs. snaps. We rocked and glided, with and without ottomans. We wondered why it is that crib bedding sets always seem to include one component that you really don't like.

The I did a lot of internet research for pricing and scheduling and reviews and even made a universal wish list on Amazon so that I could combine items from other vendors in one place. I figured that the discount some stores offer for registering barely covers tax in Los Angeles (9.25%), so getting a no-tax deal on low-cost internet shopping usually turns out to be better anyway. I bought a few items to have on hand and was really congratulating myself on catching up so quickly, and having over two months left to take care of whatever is left.

Then I woke up in a puddle of wetness.

I've been in L&D since last night, had lots of tests, seen my OB. We still don't know exactly what is going on. When I woke up with a soaked pajama seat I was too woozy to panic immediately. I went to the loo and saw pink and red. I thought, hmm, not so good. Then I felt a whoosh and a giant (maybe like the diameter of a soda can) dark clot came out. I vaguely realized that panic might be appropriate, but all I could do was start saying "oh, no!" over and over again until my husband woke up and took over.

Clearly I had a leak. But the nitrizine test was inconclusive by the time they did it, so the leak had stopped. The ferning test was also hard to read. There is still some fluid around the baby, but not as much as they like to see. It's rare but not unheard of that a partial leak will seal over and the fluid will be replenished. I was started on betamethasone injections to mature the baby's lungs, and antibiotics to ward off infection, which is what usually happens when the waters rupture.

But so far, no more leaks and only a very few minor contractions - just the BHs I've been having for a few weeks now. Yesterday we figured it was our son's birthday, but now I may actually be able to go home (on bedrest, of course). Perinatologist tomorrow - I saw her Friday and she got fluid measurements then, so we'll have something fairly recent to compare with.

The thing is, I never thought I'd have this kind of problem. I assumed that my troubles were at the front end - once I had made it this far I thought it was just a matter of waiting it out. I have low blood pressure, no GD, my asthma hasn't acted up, my cervix is like a vault, my placenta is in a good place, my blood flow and clotting times are perfect...

Nobody knows what happened. The little guy looks good on the monitors, so it's just a wait and see at this point. Either I'm glad I got most of that ordering and shopping done, or I am really terribly cursed with the infertility jinx.