Bionic Mamas

you're not losing a vagina, you're gaining a son


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39w 1d: Reports of My Early Labor Greatly Exaggerated

Happy Monday, internets. The Bean and I are lolling around the apartment, while the fire alarm I can’t knock down even with a broom beeps intermittently, in its death throes but far beyond my reach. Heavy snow outside, the wet kind people carry umbrellas against. I’m in the leggings that always fall down, because the others need washing and I can’t stand pants anymore. The Bean is in monster underpants, which is more than he usually has on these days.

Jackalope remains fashionably clad in an amniotic sac and my uterus.

Sugar has gone to work today, for the first time since Thursday. I made her stay home on Friday, because I was so sure I was going into labor. Oops.

In my defense, I had a rough day Thursday and woke up several times on Thursday night with what were clearly labor-type contractions, not the long, strange ones I’ve been having for ages. These were relatively short (1-2 minutes? I didn’t time them), repeating, and felt like the books say they do, starting in my back and wrapping around to the front. (I never felt anything like that when the Bean was born, only back and later back/hip/leg pain. Possibly there was some abdominal action that I just couldn’t discern because the other parts hurt so much.) Meanwhile, Jackalope seems to have suddenly figured out that the way out is down. Lots more pressure and cervical stabbing, accompanied by some relief at the thought that s/he’s not going to try to actually crawl through the fundus, as previous behavior has suggested.

Childcare connections were alerted. I wrote to our doula and my father. I felt justified in having told the food coop that I needed to start my maternity leave early. We all waited for the contractions to ramp up and find a rhythm.

Ah, waiting. The through-line to the whole TTC experience, from Two Week Waits to this. Well, one of the through-lines, if you count obsessive monitoring of mucous. Or maybe that’s more of a goopy set of bookends.

We are still waiting. No contractions to speak of since Friday. Did more walking this weekend than I have in a while (though essentially none by my usual standard), which might count as a burst of energy or maybe just cabin fever finally overpowering me. Meanwhile, apparently 38.5 weeks was some kind of towel-throwing moment as far as my abdominal skin’s resisting stretch marks. Oh, well. Guess I won’t be able to hawk my Think Method alongside the more traditional snake oils advertised in the parenting magazines after all.

I gather this experience — thinking one is in labor only to be sheepishly still pregnant several days later — is a common one. It is, however, the opposite of my experience with the Bean, when I was in labor for at least 24 hours (maybe more like 36) before my denial broke. File under “each pregnancy is different,” I guess. I thought I was supposed to be more savvy now that I’m what Penny Simkin calls an “experienced mother.”

File under: “things I would only tell the internet” my adventures in, erm, self-exploration last night. Although I feel confident that refusing cervix checks at the OB office has been the right decision, given that there’s nothing to do with any result (since the follow up to any finding in that setting is, “normal, could mean anything”), I admit I am curious. So in the tub last night, I made a good attempt at finding my own cervix, something I can usually manage when not pregnant. (I use the singular here because the medical consensus is that the other has wriggled up somewhere out of the way as my uterus has stretched, for which I am grateful.) No luck; I blame short arms/big belly syndrome, though possibly it’s also that it hasn’t shifted forward yet. What I did feel, however, was a head. Sort of through the, as it were, roof of my vagina, as if it had acquired a hard-top. Like I’d grown a bone there, which I suppose, in a sense, I have.

So. That’s something.

I don’t mind still being pregnant, for the record. Yes, I am uncomfortable and can’t sleep for beans, even with unisom, my constant companion. But I am happy to have made it to ACOG’s revised version of full term. I’ve had a 38 week baby, and find the new “early term” definition (37w – 38w6d) a sensible distinction; yes, he was healthy and basically fine, but I am hopeful that a slightly more cooked baby may have an easier time nursing and just generally adjusting to the world. (But please still be small enough that I can get you out, okay, Jackalope?)

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Items Gestational, For The Nonce

Dateline: 38 weeks, 4 days.

Item: I am still pregnant.

Item: I wonder if that will be true for much longer.

PicsArt.com
The view from now

Item: Had a nice visit at the OB’s yesterday. Sweetly enthusiastic u/s tech kept enthusing during my BPP, making me feel a bit jaded in comparison. (Partly, I’ve been spoiled by the image quality at the high-risk place I go for growth scans.). She really was adorable, taking care to point out specific bones, to enthuse over how Jackalope was practicing breathing, “which they don’t do all the time so we don’t always get to see it!” Apparently both placenta and fluid levels are fantastic, or words to that effect.

After a rather too-lengthy wait for the OB portion of the visit (not because anyone was late but because there are few slots for BPPs, and this was the best we could do), a punchy and overtired Bean accompanied me back to the exam rooms, where he roll on the floor. Blood pressure up a bit, which I suspected as I’ve been having these darling little panic attacks, but not enough to worry anyone; weight down a bit. “Undress from the waist down,” said the nurse, and I said no, I’d wait to talk to the doctor before setting myself up for cervix rummaging, thank you. I do not remember that fondly at all, and have decided I am not submitting myself to painful procedures without good reason.

This, it transpired, was perfectly fine with Dr. White*, who came in wearing yet another pair of hip glasses. (Between my previous visit with her, this one, and my doula’s report of meeting her at a delivery, no repeat frames yet.) She agreed that there wasn’t much to do with the information except satisfy general curiosity and encourage me to go to the hospital quickly when labor starts if it happens that I am secretly already fairly dilated. “But,” she said, “that is already what you are planning to do, so it doesn’t matter.”

* Who is, point of order, not white. But I am into using fairly obvious nicknames this time around (why have I been protecting Dr. Russian and pals?) and the other obvious ways to alter her name are not nice.

I really like her. She was so encouraging about everything, saying she really thought everything was going to go well and I would do great and my birth plan looks good, too. She talked to me for a long time, wanting to hear again a bunch of details from my labor with the Bean, and here, gentle reader, is where she really won me over. I was describing the Horrible Cab Ride, and how even though it was Horrible, I was apparently at 4 cm both before and afterwards (leading to my point about how much better and faster everything went after the epidural, not matter what the books say). “It sounds like you were in transition,” she said.

Internets, I was floored. YES, that is exactly what I thought at the time. Everything about how I was feeling and acting was exactly how transition is described, except supposedly I wasn’t because transition is said to happen from 8-10cm. (This led to some real shock at the hospital when the resident said, brightly, “you’re at 4 cm!” not realizing I had been told the same four hours of agony previously. “WHAT??” I said, or perhaps roared. “Um, maybe four and a half,” she said, in a frankly adorable attempt to mollify me.)

When I told my mother about the transition confusion, she said the same thing (minus the cab) had happened to her when I was born, and that moreover, when she was in med school, they were taught that transition was a kind of labor, not a particular point in dilation. (In other words, maybe many people experience transitional labor in the 8-10 cm range, but that doesn’t mean the two are synonymous). Until Dr. White’s comment, I have never heard anyone with more recent training agree with that concept, and I can’t tell you how relieving it was to hear that maybe I am not crazy, and that did happen. Redeeming, that’s the word.

Anyway, yay, Dr. White. On the basis of nothing except our chat (which included how I’d thought I was going into labor last Thursday and then not and then that being able to walk to a restaurant two blocks away for my date (!) with Sugar on Monday made me think I was having a pre-labor burst of energy and then how I could barely sleep that night from pain because in fact I was not up to that walk and how I’ve been having these panic attacks, sometimes without even consciously thinking about anything that worries me), anyway, on the basis of that long parenthetical, she mentioned cheerfully several times how if I happened to go into labor in the next couple days, she would be on call. “Go ahead and make an appointment for next week, just in case,” she said. She almost rolled her eyes when I asked about their induction date policy. (It’s 41 weeks. I never bothered to ask before because I never expected this pregnancy to last longer than the Bean’s. But here I am, still knocked up.)

And then I went home. And then I lay on the bed in various kinds of back pain and contraction exhaustion for several hours, while the Bean covered me with stuffed animals and trucks. And then I lost a great deal of sleep last night in the same way, unisom notwithstanding, and had a pretty rough morning, to boot. And I am starting to wonder if she might be onto something.

At least we have made it to the lunar new year. The Bean and Sugar are both rabbits, you see, and I have been secretly hoping for a little horse, like me.

Oh, and post-scriptural Item: Thank you for your many kind and encouraging comments on the birth plan. I do want to clarify that many of the things you thought it was horrible to have to request are, in fact, standard at this hospital. I know from being there all but plan-less with the Bean that they always hurl the newborn onto your chest and assume you will all room together. (In fact, the dumb tour guide we had last time said that was mandatory, which sounded intimidating. That was only one of many things she was wrong about. The LCs at that place…I don’t have much good to say about the two I encountered last time. I plan to skip the whole business this time and just see the good one I eventually found in Brooklyn if needed. And my insurance will pay! Thanks, Obama!) As far as I know, non-gestational parents can hang with the baby post-caesarean. Nor do I think anyone’s penis gets automatically docked in the absence of a specified desired to leave the thing alone.

The yelling and so on — well, I certainly hope none of my providers would do such a thing. It’s just that I’ve been so wrong on that count before, and felt so helpless to do anything about it (or even, for a long time, to admit it had happened). Really, putting all that in was mostly an exercise in showing myself I could be an advocate for myself, taking control and all that.

I really do like and trust the OBs in this practice, as much as my twice-shy self can trust anyone. Even Dr. Smarm I think is probably okay, despite not being my favorite: she gets very good reviews online, and Dr. Ready seemed genuine when she assured me that, weird appointment or no, she would not do the things I fear. I feel a bit defensive on this point, partly because of my own history, but also because I often feel sort of demographically pressured to believe I should see midwives instead of OBs. I like midwives, in the abstract, but sometimes the praise of them necessitates a villain in a way I find problematic. Point of order, I have good reason to have chosen OB care, both times. I really like this hospital, and no midwives deliver there. The local midwifery practice everyone loves delivers at a hospital I do not love. The hospital with the fancy birth center and therefore more midwives is farther from our house, and the present cab ride is sufficiently long. In particular during my last pregnancy, I was thought to be at increased risk of needing a c-section, and I thought on the whole I preferred to know the person performing it.

This is part of a longer rant on the problems of birth activism’s concerning itself with abandoning medical systems in favor of options (midwives, home births) that may be great for many people but require, among other things, “good” health. Midwifery has a problem, in my ever humble etc., if hospital-based practices risk out patients for things like gestational diabetes. More to my point, it is not ultimately appropriate to advocate that “healthy” people abandon hospital care en mass as a primary response to problems in that care, inasmuch as removing the most privileged (in health but also, statistically, in race, class, and education) from the system, leaving those less well positioned to advocate for themselves stuck in a system activists would do better to improve. (Mind you, I am talking about activist rhetoric here; a given individual’s decision to have a home birth I have no ideological argument against.)

But meanwhile, my back hurts. I am going to take a bath.


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Items, Glorious Items

Were you in Oliver! ever? I was. Eight grade. I do not love that show. Sorry if this song is now in your head for the rest of the day, too. I don’t know what gets into me. We were instructed to wear our fathers’ old shirts for that scene, so while the rest of the orphans (whose fathers were bigger than mine, I gather) looked waif-ish, I looked like a blue, permanent-press sausage. At least I got to sing the pretty rose seller bit later, in a peasant blouse.

Sorry, as ever, for the silence. I’d say it has been difficult to find time, but the real issue is energy. I am just so beat these days. I feel fine in the morning, but by evening, forget it. Makes me rather nervous about what’s coming next.

Meanwhile! Pease porridge and items:

  • Thank you for your many thoughtful, um, thoughts, about the doula situation. I/we have not decided what to do, but your comments have been very helpful. After meeting with friend-doula, I feel about the same as I did before: I think she is a good personality match for me, but I am worried about the experience issue. On the other hand, it is very, very valuable to me to know her personality well enough to trust that she won’t be crazy at me during labor. The doctors I have met at my new OB place all seem very nice and swear they aren’t insane, yet I find I am having enormous difficulty believing that. Just having that concern out of the way about a doula might be valuable enough to make up for a lot. As for the “morning-after” problem, I never saw my last doula after delivery, and I think that on balance that hasn’t been so great for my mental health. I do plan to have some pretty clear guidelines for anyone in this role, namely: pay more attention to me than the baby; tell me what a great job I did more times than anyone could possibly need to hear. Especially if this isn’t the kind of birth people carry on about the beauty of.
  • Speaking of mental health, I did go see that therapist last week, and I have an appointment for next week. She seems good, I think. She said several good things, things many of you have said, but it is different to hear them from someone who doesn’t like me, you know? (Wait, maybe you don’t like me, either? Someone who I’m not trying to have a friend-style relationship with, anyway.) I chose her because she has training in CBT and EMDR; a cognitive approach to this situation feels much more to the point than still more mucking about in my feeeeelings. Of course, what did I do? I talked about my feelings for a fifty-minute hour, that’s what. But I am a narrative gal, and I did need to tell her the story.
  • I only cried once! Rather suddenly, at the point where I said the thing about how, when I imagine things going well this time, I imagine myself surrounded by warriors. That was surprising timing, to me. The therapist — she might need a bovine name, not because she herself seems at all cow-like, but because the waiting room of her otherwise very midtown office (converted apartment, doorman, and so on) is entirely decorated in strangely urbane cow art. Let’s call her Caroline, as long as we’re on a musical kick, for the new, blue, true, moo cow in Gypsy, the one who is willing to moooove to the city with Baby June. Anyway, Caroline stopped me and asked me to dwell on the feeling that brought up, and woman, I wanted to shout, all I DO is dwell! But anyway, I think that went about as well as expected.

how bovine is thy dwelling place
How…bovine is thy dwelling place

  • I paid another visit to the high-risk place with the fancy u/s machines, for part two of the anatomy scan. It was…a bit of an ordeal, frankly. (With the obvious caveat that I mean “ordeal” in the limited way the word can apply to a situation with a good outcome.) Sugar had an important work meeting, so it was just me; God bless my friend the Dane for taking the Bean in addition to her own kids for the afternoon.
  • First, there was the Great Cervix Search, the longest stretch (as it were) of dildo-camming I have as yet experienced. My cervices, you may recall, are of particular interest because having the two of ’em means I am at increased risk of cervical incompetence, number two on my list of most-despised obstetric terms. (Number one is “habitual aborter.”) On the MRI I had prior to ever being pregnant, the two of them are smack next to each other; before the Bean removed my septum with his head, they were fairly easy to find on physical exam, since each had its own little vagina. How cute. Post-Bean, one — the one he used — has been easy to find by hand, as it were, one much more difficult. When I was in labor, they only found one, so my hunch is that the other made itself scarce in late pregnancy, and many thanks I send it.
  • So, back in the stirrups: the tech spent a while poking around with the ultrasound wand, pursing her lips and printing pictures and, as they all do in these moments, interrogating me about how I knew there were two, anyway. (MRI, plus I used to bleed out of the un-tamponned side, plus the other tech found it a month ago.) This is a slightly annoying conversation to have while being dildo-graphed. After a while, she stopped but told me to stay put while she found a doctor to decide if her pictures were satisfactory. Enter doctor. “I’ve never done this before,” she says, and off to the races we go, complete with the same interrogation. Eventually, she gives up, too, and in comes the senior doc on duty, who is very luckily the southern one I like so much. “How does it feel to be a medical marvel?” He has a firmer hand with the whole business (GOD, I do not like being able to compare technique in this way, but there’s only so long I can stare at the ceiling and think of England.) After quite a hunt, at least punctuated with jovial asides and no dubious eyebrow twitches, he declares himself defeated by my marvelous anatomy, too, but willing to assume things are okay in the absence of symptoms, given the fine state of the less shy cervix and the full-term status of the Bean.
  • Now is the part where I insert a little prayer that Jackalope doesn’t get any funny ideas about using the untested one. Do you hear me, young…person?
  • Jackalope, who has been kicking up a storm through all this, has fallen asleep, and in a position not conducive to measuring anything relevant. Now we see what fun toys the fancy place has at its disposal, like the tilt-a-whirl electric bed I am soon sliding off of, head first. (Seriously, I braced myself only by putting a hand on the wall behind me.) I am basted with more and more gel and rotated like a rotisserie chicken. The paper under me tears into little, goopy pieces. Just…yuck. Eventually the creature shifts enough to show off everything except what the tech keeps calling “the gender.” I resist the urge to parrot a women’s studies lecture at her. Jackalope has her feet between his legs, or the other way around. As I am instructed to roll over again, I mention that they did, after all, get a look last time, but apparently they have to look again. Lord knows why — is it all that likely to have changed? I guess that would be noteworthy.
  • Eventually, the tech’s rolling and prodding and jiggling pay off. She releases me to attempt to squeegie some gel off of myself, though it is clear this is more a job for a pressure washer than a paper towel. Dr. Southern returns to say everything is fine, Jackalope is a good size, the cord, which they couldn’t see well last time, is inserted in the expected manner, and while the placenta is still marginally previa, it’s only by 2 mm, which even I can’t manage to fret over. And no cervix searches again until the third trimester, though I’m back for another growth scan in a month. Phew.
  • Because she is an angel, the Dane has not only kept the Bean all this time but has also made enough quiche that I can inhale half a pie-plate’s worth upon my return to Brooklyn.
  • I did at least get lots of pictures to show to Sugar and the Bean, who respectively described the Jackalope as “a barracuda” and “scawy.” So now you have to look at them.

USWeek20001

I think all that dust is on the scanner and not in my uterus, but who knows?

USWeek20003

USWeek20004

Clearly, my mind is going, because I even thought the creepy 3-D ones were cute.
USWeek20005

…But maybe I also see where the “barracuda” idea comes from. Still not half as scary as the dragon-lizard the Bean appeared to be at a similar age.

 

  • Speaking of the Bean, he is charming, obsessed with street sweepers and the alphabet, awfully tall all of a sudden (36″), and still not much of a sleeper, very much to my consternation, though it is Sugar who gets the brunt of the night work, since he refuses to let me be the one to come in when he wakes. He mostly still naps (and is a holy terror if he doesn’t), but he rarely falls asleep before 10 pm. This would be annoying enough if he could be allowed to just stay up, but he really cannot function that way. So we start bedtime at 8 or 8:30, read books, brush teeth, all that, and then one of us sits in the dark for an hour or so. Every night. Thank God for iPads. (If he does not nap, he falls asleep much more quickly, but you will have to take my word for it that his mood and behavior for the last several hours of the day in that case are such that, NO. Artificially shortening his nap does not speed up bedtime.)
  • I did not answer the cat-torture question because I kept hoping I would find an answer or at least discover that his current delight in pestering the household felines was a short-lived phase. Ha. I don’t know what brought this on, but I know I want it to stop, pronto. Also a thing that could stop any time: “knocking” (read: hitting) his mothers.
  • He’s down to refusing all food except smoothies for dinner. (At lunch he will usually eat a peanut butter sandwich.) I don’t know anymore. He loves to cook and talk about food, just not so much to eat it.
  • He is very sweet about the baby, though, hugging and kissing my stomach and whispering, I love you, baby, in that not-very-whispery two-year-old way. This is very clever, as it is impossible to remain annoyed with whatever shenanigans he has been pulling when he does that.
  • Potty training is under way, in the most lazy way possible. His little butt is extremely cute in underpants. It is extremely hilarious when nude, as it often is, especially when he starts practicing being an acrobat.
  • This post is even more scattered than usual. Winning!
  • Sugar did come with me to today’s OB appointment, with the original doctor I know in the practice, the one who dealt with my Return To Stirrups last summer and also with Sugar’s menacing ovarian cysts, back in the day. She is very nice. She says no one at that practice is going to yell at me in labor. I have some trouble believing she can really know that about her colleagues, but I at least think she would not, so that’s a start. She did say, however, that she favors having women hold their breath while pushing, which I found ridiculous and panic-inducing. But we will work on that next visit, I guess. Time for another lit-review….
  • In the meantime, I am to acquire a blood sugar monitor in preparation for testing four times a day for two weeks, starting around week 26. This strikes me as overkill, but still better than having my brains scrambled the way they were by the glucola last time.
  • I asked whether it was really okay to be taking unisom every night, because if I don’t the first time I get up to pee is the end of sleep for me. “It’s not a great idea to take anything every night,” she started, but when I asked what I should do instead about being up for the day at 2am, it turns out she didn’t think half a tab was such a big deal, after all.

THE END.

  • (Don’t you always stick around, just to see if something comes after the credits?)
  • I’m going to DC for the weekend, for a baby shower. This is emphatically not the kind of thing I usually travel for, but the gravid friend in question organized my shower from DC, so it seems the least I can do. I will be there Saturday and Sunday, basking in the glory of the closed museums and terminally borked transit system, and while this was supposed to be sort of a treat, it isn’t feeling like much of one. So let me know if you are around or have great ideas for something nice to do that doesn’t involve alcohol or the federal government.


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Items From Our Catalog

Hi, Internets.  I wrote you such a post yesterday!  Well, we can all believe it was wonderful, because the WP iPad app ate it, and only the good die young, right?  In the interest of posting something, anything, here are some items:

Current Events

  • Sugar did not get the promotion/new job she has been waiting to hear about since, oh, February-ish.  (The actual interview was in August, but that’s around when she started the application process.)  Waiting to hear has been a stressful situation for our family, and this news is, of course, even more stressful.  The job would have meant more money and the kind of title and responsibilities that make it easier to move to another good job elsewhere, so that sucks.  Then there’s the part where she is a great employee who has been in this small department for eight years, doing the work of this better job for most of a year, and generally feels pretty damn shafted right now.  “We sure hope you won’t take this as a reflection on how much we value your [tireless, underpaid-even-for-this-department, grant-money-attracting] work in your current position,” says her boss, who can eat ALL THE BAGS OF DICKS, as far as I am concerned.
  • Her boss gave her this news following a big meeting about how there would be a lot of work for the department in February.  She stayed after to tell him that he might need to assign extra staff to those projects, since we are expecting a baby at that time.  Nothing like getting additional rejection immediately after saying things like “I might need to take time off if it’s like last time, because my wife almost died.”
  • No, I don’t think that influenced his decision.  He is not a quick decider, just an asshole.
  • She isn’t getting fired, but it feels a little like that, because if they aren’t willing to promote her to management after eight years, yeah, it’s time to move on.
  • There has literally never been a better time to convince us to come be your neighbors!  Seriously, if you have connections in educational technology and/or public health, be in touch, huh?  We are open to leaving the city.  Probably not — full disclosure — for Indiana.
  • Sugar left early this morning to visit her parents for the weekend, so we get to be apart while processing all this.  Whee.

Democracy In Action

  • We voted in the NYC primary this week.  Sugar tried to weasel out of it by saying she wasn’t registered to a political party (required for primaries in this state), but ha ha, turns out there’s a website to check that kind of thing.  The Bean was putting up a fuss about going, but the return of the old voting machines (with LEVERS!) and the advent of never-seen-here-before STICKERS may have won him over for life.
  • I kind of can’t believe that in a field that included a lesbian and black man, I checked the box by yet another straight white guy’s name.  But, hey, at least he’s married to a lesbian.  And I’m married to a lesbian, myself!

Obstetrics and Midwifery

  • My appointment last week went well.  I saw the midwife again, and I wish she were an OB.  This practice has two CNMs who work with OB patients, but only the OBs deliver.  I’m not sure why this is the system, but I wish I could see this MW more often.  If nothing else, it was a nice break from grilling everyone about whether they are competent/emotionally stable, since I’ve already told her my deal.
  • I had told her about the postpartum anemia last time I saw her, but I hadn’t known for sure it was because of hemorrhage (as opposed to general pregnancy anemia).  I told her the numbers from the hospital records, and she said they would definitely have offered a transfusion.  That is reassuring, vis-a-vis hoping to not be that sick again.
  • She noted in my chart that I had had a postpartum hemorrhage, but said she thinks it is unlikely to recur, since it was probably mostly the septum doing the bleeding.  If a septum includes an artery, she says, “those things can really pump.”  I guess that explains why the doctors used up all the gauze in the room and the supply closet both, stuffing my vagina full of it and pulling it out again.  (Which hurt a surprising amount.)
  • I made a supposedly off-hand comment about how maybe none of this will matter anyway, if the placenta doesn’t move, since I’d end up with an automatic c-section.  She waved her hand, as if dismissing a joke.  “Please.  It’s marginal at sixteen weeks.  It will move.”  I think she is likely to be right, but this was still a nice antidote to my mother’s gloom on the subject.  (My mother generally seems to think I don’t take bad news sufficiently seriously, and so takes pains to impress upon me that bad news is bad.  I’m not sure where she got the impression that I am an optimist.)
  • The most surprising aspect of the appointment is that we did not have a fight or even a lengthy discussion about my plan to refuse the glucose tolerance screening this time around.  I told her how sick I had gotten last time, confirmed that I had eaten beforehand and still was neurologically wrecked for three days, and mentioned my low risk factors for gestational diabetes.  (I restrained myself from opening with what BS I think most of the things written about GD are, at least when it comes to bad outcomes among patients without pre-existing insulin resistance.  And since when is an episiotomy in the same category of outcome as a c-section, anyway?)  I was all set to argue, with data and citations and everything (thanks to Dr. J. F. Scientist and my mother), but she said, “We had a patient like you really recently.  Are you willing to do some monitoring at home?” I am — what’s a few more self-inflicted stab wounds for a fertility clinic veteran, am I right?  “I’ll bring it up at the OB meeting this week, but I’m sure it’s fine.  You’ll have to get a meter.”  And then she got out the doppler and we listened to Jackalope’s galloping heart.
  • I feel surprised, relieved, and perversely thwarted.  I have data, damn it!  Don’t you want to even look at it?  Please?
  • In general, the visit was reassuring on the “have I once again chosen insane care providers” front.

Addled Brain, My

  • I am somewhat bemused to report that the one thing that would have irritated me about that appointment, in other times, namely the MW referring to the amount of weight I’ve gained as “not bad,” didn’t bother me at all, except in an impersonal, cultural-political kind of way.  Huh.  I realized that I never gave them the “please don’t bug me about eating/my weight” talk that led Dr. Russian’s practice to label me as an active anorexic (and therefore interrogate me about my diet at every opportunity, FAIL), partly because they have never told me anything dumb like some imaginary, ideal amount of weight to program my animatronic body to gain without exceeding.  Funny, how not setting a person up to think her weight in under surveilance is helpful in the not-feeling-under-surveillance department.
  • However.
  • I am not doing so very well in the “putting that birth behind me” category (the one comment from my last appointment with this MW that, while meant kindly, did in fact rub me the wrong way).
  • And so.
  • I have decided to look for a therapist.
  • I have very mixed feelings about that.
  • Bunny mentioned in a comment a few posts ago that she wasn’t sure of my feelings about therapy except that I had been utterly enraged by the Baby Factory’s requirement that we see their counselor.  For the sake of clarity, my feelings about Our Dumb Appointment are not my feelings about therapy in general, but are more to do with the screening-for-parental-fitness nature of that requirement.  Eugenics is so pre-war, darling.
  • That’s not to say I have no issues with the idea of going into therapy, many of which are conveniently wrapped up in my feelings about my mother, who is a psychiatrist.
  1. I prefer the convenience of boring and annoying my family, friends, and readership.
  2. My previous experience with therapy (in college) was deeply pointless.  I now realize that might have had more to do with my therapist being a 22-year-old intern from Alma Mater’s social work school than with therapy as a whole.
  3. A lot of therapists, however, are tremendous flakes.  I imagine it’s not a majority, but admit it: it’s a visible group.
  4. Therapy is the town pastime here, in a way that makes me feel ooky.  Woody Allen is much closer to a documentarian than I had realized when living elsewhere.  I am not interested in a lifetime commitment, let alone such an expensive one.
  5. While I think SSRIs and the like are very useful in some cases, I am unconvinced they are all they are cracked up to be for many people.  No, I don’t think you should stop taking yours, but I don’t want to start taking them, either.
  • However, I have to admit that while all the processing I’ve done here and elsewhere has been tremendously helpful (and you have been, you really, really have), I’m getting to a point where I could use some more help.  As much as it feels like heresy to claim this about a vaginal birth that brought me a healthy baby, I am beginning to think that the initials P, T, S, and D are not entirely inappropriate here.  I look at diagnostic checklists, and it’s increasingly difficult to deny that a lot of those boxes have x’s.
  • Thinking of this as PTSD and therefore a cognitive issue rather than only my special snowflake feeeelings makes me think that maybe I should talk to someone who has actually studied this stuff. Which brings me to more sub-bullets!  Criteria:
  1. No generalized wading into my feelings in a global sense.  I am not interested in analyzing my whole life and my relationship to food and my mother and the military-industrial complex.  I have a goal (not completely losing my shit as I approach my due date) and a deadline (my due date).  No quagmires.
  2. No support groups.  I have those, in a virtual sense (Hi!), and in-person ones I think will only feed my sense that what happened to me was not bad enough to feel bad about.
  3. No well-meaning idiots.  Or, as a friend put it, “you mean you don’t think talking to someone with no idea about how birth works and what you were going through will help you deal with feeling traumatized be being surrounded by people who seemed to have no idea how birth works and what was going on for you?”
  4. No “natural”-birth fanatics.  None of what happened was the fault of the epidural or modern obstetrics as a whole, and furthermore, I am planning to go back to the hospital, so I will thank you not to freak me out about that.
  5. Here’s the deal-breaker: takes my insurance.  This is hard enough without feeling I am spending money we don’t have on such a self-indulgent project.
  • So far, I’ve called one person, who has an opening at a difficult time for childcare.  Contrary to my desire, I did not spend the rest of the day hiding under the covers, but lordy, this is harder than I thought.  I can’t believe so many people do it.

And now it is past time to run off to the hippie food coop and cut the cheese for a few hours.  I’m going to publish this anyway.  Verisimilitude, all that.  Links later.


24 Comments

Bloody Business

Before I begin, I want to just say, in a small voice, how crushed I feel by May’s latest news, by the utter un-rightness of it, by how badly the universe is flubbing its lines. This is not how the story is supposed to go, dammit. I know we talk a lot about how unfair all of this business is, but sometimes the unfairness is just so fucking unfair. It is not the only thing that has been Not Right lately; that doesn’t make it any less wrong.

I am wondering if any of you happens to know what counts as a normal postpartum drop in hemoglobin and what doesn’t. Imagine you have this patient who, after two days of fairly heavy vaginal bleeding, arrives at a hospital in labor. Her hemoglobin at that point is 13; her hematocrit is 37.8. Following a vaginal delivery, her numbers are 7.3 and 21.7, a drop in the neighborhood of 44%.

Question one: Is that normal? If not, how abnormal?

Question two: Are there causes of postpartum decreases in hemoglobin other than blood loss? Does the placenta itself (or the baby) in some way count towards the starting number?

Question three: Do you do anything about those numbers, beyond suggesting an iron supplement? Do you do anything if the patient calls three weeks later complaining of continued extreme fatigue, dizziness, breathlessness, etc.?

Question four: Supposing a patient with this history is pregnant again. One likely source of postpartum bleeding (vaginal septum) is gone, though possibly the vaginal wall where it attached has scar tissue. Is postpartum hemorrhage in such a case likely to recur? Do you do anything in particular to lessen the chances of her feeling terrible for months again? Is there anything you can say to her to help her feel less frightened?

Question five: Is this patient a good home birth candidate? Just kidding.

My hospital records — the short version only — from the Bean’s birth arrived this week. I’d put off ordering them for a couple of years, which I guess is good, considering that I find myself a little taken aback anyway. This is just the abstract — test results and some nonsense from the lactation consultant, an extremely silly person. There are errors: I am listed as having a didelphic uterus (nope, not that normal), and hemoglobin and hematocrit are reversed in one place. (I flatter myself that a hematocrit of seven might have been more worthy of note.)

Also this week, I finally tracked down a picture I didn’t know existed until recently, of Sugar cutting the Bean’s umbilical cord. That is to say, it’s a picture of my crotch, post delivery but prior to the arrival of the placenta. I thought it might feel sort of empowering to see that, since I was scared to look at that part of my body for weeks after birth, not wanting to see all the stitches. Maybe it would have been, but I found it hard to pay much attention to my flesh, finding the pool of blood I was apparently lying in rather visually distracting. When I say pool, understand, I mean pool. I don’t mean the bed was a mess. I mean liquid. I mean depth. I mean volume.

I thought I was done finding new things to feel angry and scared about, regarding the Bean’s birth, but I guess I was wrong.

I haven’t written in much detail about how sick I was after the Bean was born, partly because at the time, I was filled with confusing hormones, alternately elated and distraught, and, well, sick. I’d been pretty thoroughly conditioned to believe that only people with (unplanned) c-sections were allowed to feel sick or sad after birth, anyway; the websites said I should be exulting in my all-powerful womynhood and resuming my exercise routine while teaching the baby French. All that matters, as you know, is that the baby is healthy. The vessel has done its job.

So, here: I was pretty sick after the Bean was born. For the first week or so, I had an annoying tendency to black out every time I tried to nurse him. The nurse I asked about it told me that was “oxytocin, filling your body with feelings of well being.” Later I realized that was the only time I wasn’t lying flat. I couldn’t hold him during the lactation class and was grateful that lesbian privilege meant I alone among the women there had someone to help. (Men weren’t allowed.) We left early because I couldn’t sit up anymore.

For the endless rounds of pediatrician visits for weight checks in the first few weeks, I took cabs. One day Sugar had a work meeting, and I couldn’t carry the Bean in his carseat. I could barely carry the car seat. We tried to take the subway once. Sugar carried the baby while I shuffled behind her, hips still entirely disconnected, like a troll aunt of some kind. (Sugar got lots of congratulations for her new baby in those days. She deserved them, but my own invisibility beside this gorgeous, healthy, thin woman and her perfect baby was sometimes hard to take. “Don’t worry, honey,” one woman said, “you’re next!”) Sugar went to the store for a different kind of iron supplement for me while I took the dwindling Bean to a lactation group. I remember feeling such utter hatred for the other woman there, so pink and healthy with her fat, pink baby, who was younger than the Bean. While Sugar was gone, I started shaking convulsively. I was losing my vision, trying to figure out how I was going to get myself onto the floor without dropping the baby, who was so, so heavy. Sugar arrived just in time, and held him while I lay my head on the desk and shook. No one asked if I was okay. I took a cab home.

It’s hard to write this without feeling I am exaggerating things, but this happened. Other things happened, too, many of them good. I stayed conscious for the ride home from the hospital, even if I did have to go immediately to bed and so missed the cats greeting the Bean. Friends came over, and I sat and talked with them. But it was months before I could walk around the neighborhood normally. Going up the gentle incline of the train station left me breathless, my vision blotchy. I feel existentially queasy looking at pictures of me with the Bean in the early weeks, because I am so very grey.

I got better. The human body really does have amazing powers of restoration. But does the patient’s recovery mean the treatment regime was wisely chosen? The heroic medicine doctors, the bleeders and purgers and givers of mercury, thought their treatments worked because their patients often survived, when the truth is those patients recovered in spite of the medicine. Regardless of whether I should have had different treatment in objective terms — and I gather from google that sources differ on the guidelines for iron infusions and blood transfusions and so on — I feel sure the other aspects of treatment could have been better. Only one nurse, when I was already in the process of being discharged, mentioned my hematocrit drop and asked if I really felt okay. (Desperate to leave, I said yes.) The nurse practitioner at my OB office told me I should expect to feel tired when I described my trouble breathing while walking. At the infamous postpartum appointment, Dr. Russian didn’t know my hematocrit levels and dismissed my questions on the topic. None of that was helpful, even if it was the case that the best course of action was waiting for my body to rebuild itself. It’s a kind of gaslighting, I think, not to tell a patient that how she feels is not in her head or her weak moral constitution.

Besides angry, I feel a bit scared by these new documents, in particular the picture. My septum is gone and presumably won’t break and bleed again. I expect it caused some of the trouble, in addition to other tears. The midwife at my new clinic says that didelphic cervices can bleed a lot, and suggested they might try rectal cytotec in addition to pitocin if it seems necessary. (I haven’t talked numbers with her, just my experience of being anemic.) If the pre-labor bleeding was a placental abruption — and we’ll never know, since the head of the OB practice didn’t see fit to take it seriously — there’s a chance that won’t happen again, and a 100% chance I won’t let it be ignored this time. I have the reassurance that I did survive, however sick I got. But there is still that nauseating feeling of almost having been run down by a bus, not realizing it was even there until it passed.


17 Comments

Happy Hour Items

Greetings, internets, from a local trendy bar that turns out to be more than capable of turning out something “fun and non-alcoholic,” if requested. I thought this order might reassure the woman giving me side-eye as I, well, bellied up to the bar, but it turns out that is just how she holds her face.

Nevertheless, I am looking rather fecund at present, even in the tent-dresses that are all I can tolerate wearing at present. I haven’t had much of the stretching and cramping and so on I had in early Bean-pregnancy since the first couple of weeks, but lately anything putting even nominal pressure on my uterus makes me sore and dizzy and nauseated. An ultrasound probe, for instance. I tried a belt for twenty seconds this week and was off all afternoon, and even my maternity jeans, which felt fine at first, caused trouble after an hour. Sure hope this sorts itself out before the weather turns.

The nuchal scan went well, I’m into the lowest risk zone for miscarriage, and my body is rapidly outing itself, but Sugar is interviewing for a new position at work, so we are in the odd position of telling people in real life but not on Facebook, where Sugar’s colleagues will see it, lest the idea of her taking time off in, say, February, make another candidate look more appealing. (Her job does not give “paternity” leave — or indeed maternity leave beyond six weeks of disability (stay classy, academia) — but she took unpaid FMLA leave when the Bean was born. Besides giving them invaluable bonding time, the leave was frankly necessary for my health, as I was in no condition to be left alone with an infant, being among other things rather deficient in the hemoglobin department.)

The not-telling has me a little blue, it turns out. I don’t mind waiting a little longer, but I sure hope they hire somebody before February. That concern would not seem silly if you knew how long it’s taken them to schedule interviews. Meanwhile, why does a group email seem so much more intrusive than a social media announcement? Thank heavens for you all.

(Speaking of, have I mentioned how over the moon I am to be pregnant at the same time as our beloved May? I am in danger of leaving orbit.)

Meanwhile, the nuchal. It went well! Despite my anxiety-fueled delusions of intuition, risks of trisomy 13, 18, and 21 are as low as the statisticians are willing to concede. (I gather that in some circles it is poor form to admit happiness at this news, but I am not in those circles. I would not bear a grudge against anyone happy to find she didn’t have the diseases I have, for one thing. For another, my father’s line of work leaves me without certain protective illusions.) Because I was too deep in denial to schedule childcare and because the timing of the appointment interfered with prime toddler napping hours, the Bean joined us. He was not exactly an advertisement for bringing a toddler to such an event, but with Sugar there to wrangle his truck beads, he did okay. We have not, to answer gwinne’s long-ago question, told him the score, but he clearly suspects something, though I don’t know what. There have been several pointed questions lately along the lines of, “What’s in YOUR belly?” (I equivocate. “Lots of amazing things, just like in your belly.” “My belly!!!” Fin.)

We had the same super-nice doctor go over the results as last time. His southernness relaxes me. I find myself stifling the thought that if only I did have a high-risk pregnancy, I could see him. We talked for a while about my peculiar mix of normal and anomalous reproductive anatomy, and get this, he actually apologized at one point for asking too many personal questions! I told him that particular bar had been set rather low by the doctor who invited his receptionist in to see my vaginal septum, and he appreciated my stories about the look on the same doctor’s face when, after he told a fully-clothed me he was sure I didn’t have a septum, I replied, “I can put two fingers inside and they don’t touch.” (This diagnosis is not rocket science. Necessary equipment is two fingers and a functioning brain.)

ANYWAY, this doctor, who is not a condescending nitwit, delivered the happy news that not only were the ultrasound findings good, but this time, in contrast to last time, my blood count numbers were also all good. I find it cheering that my body or the placenta or whatever is in charge of whatever PAPP-A even is, is doing so much better this time (to the tune of about 85 percentiles higher than last time). Low PAPP-A is associated with a host of unpleasantries I was watched closely for last time, including pre-eclampsia and also IUGR, pre-term labor, and placental insufficiency, all of which also go along with mullerian anomalies.

I asked whether I should still be considered at increased risk for the MA complications, or whether my delivery of a normal-weight, full-term baby (albeit one at the low end of normal on both counts) meant my future risk was lower than MA baseline. I was pleased by the caution of his answer, which amounts to that it would mean that, if I had a more typical MA combination, but that my rara avis status means that there are no relevant statistics. (I found one case report of someone like me in the journals I searched, and the dominant theory of fetal development says I am impossible.). He is therefore recommending to my OB practice that I still have cervix-length checks and regular growth scans. I know some people find that sort of thing intrusive, but I find it very reassuring. Meanwhile, in a surprisingly decent move on my psyche’s part, I simultaneously feel much more confident than last time that things will work out, because they did once.

Yeah, I don’t know who I am anymore, either.

I am supposed to be using my time away from the house to work on another writing project, so I will have to tell you about the midwife at the OB office another time. Meanwhile, a picture, because pictures!

12 weeks 1 day

ETA: I just realized these aren’t even items. You must feel so cheated!


9 Comments

Oh, FFS

I have a lot of things to tell you, internets, about our week in the north woods and the wonders of unisom for nausea and so on, but it is late and I am tired.

And spotting. I’m also spotting.

And I know, it’s pale pink and almost nothing and I scraped myself a little with the crinone applicator this morning and I maybe shouldn’t have carried a backpack while climbing that (very small) mountain yesterday and that this is exactly (to the day; I just checked) when I started a month of spotting with the Bean and all that. And I really am going to try to sleep, despite the fact that just thinking about my uterus always makes me feel like maybe it’s cramping.

But this is not what I want to be lying awake thinking about at my in-laws’ house, hundreds of miles from my bed and my cats and my doctors (who I know couldn’t do a thing even if I were there, but still).