Bionic Mamas

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


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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.


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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.


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CD 1 Eve

Hi, internets. You awake? I am, and I’m blaming my new, thrilling PMS symptom of intractable insomnia on the day prior to my period’s arrival. I could be wrong: I’ve been thinking my period imminent for several days, what with cramping and spotting and weeping on the floor at the end of our final (I promise, Starrhillgirl) attempt at toddler yoga, about which more another time. (WTF, spotting? Granted, the volume in question is probably <1% of the pre-hysteroscopy volume, but I thought I was supposed to be done with this, Oh, uterus, you old tease.) This could be just the prednisone, I suppose.

Yes, prednisone again. I returned to the ENT this Thursday, having finished a fourteen-day course of augmentin (which began with six days of prednisone), feeling very, very much improved, expecting to be declared well and sent on my way. 'twas not to be, alas. One aerosolized cocktail of novocaine and decongestant and a scope up the nose later, the doctor declared himself pleased but not pleased enough. So. Ten more days of augmentin, four more of prednisone, come back in a week. I'm beginning to feel I'm getting to know that office too well, rather as one does with the baby factory. And I definitely prefer a dildocam to a nostrilscope.

Still, I am much, much better — practically human now! Thank you for your sympathy on my last post.

The prednisone means no drinking or NSAIDs, still. Clean living! You can imagine, I'm sure, how pleased I was to hear that, given the cyclical date and all. Part of why I am hoping tomorrow is indeed CD 1 is that it's the weekend, which means Sugar can watch the Bean if I need to take Percocet in the daytime as well as at night.

CD 1, those of you following along at home may remember, also means Return to Dildocam Island, aka Baby Factory: The Musical: The Sequel. About this I feel…strangely cold-blooded. Every new stage of TTC the first time around, from deciding to begin, to making appointments with new doctors, even upping the treatment ante, felt exciting (among other things). Just starting the process, let alone having the actual baby, felt like the realization of close to a lifetime's worth of dreaming about having a baby, dreaming that, what with the endometriosis and the relative poverty and the lesbianism, often felt very unlikely to come true. Trying again just doesn't feel like that.

For one thing, those lifelong dreams always included at least one child, but the number was sometimes only one. I spent an enormous amount of time imagining what it would feel like to hold a child of mine on my chest (and feeling the terrible lightness of that child's absence), but I don't have a similarly visceral sense of what holding two children of mine might feel like.

More to the point, I think, is the fact that I am straight-up terrified of going through infancy again. I am just so very much better at this toddler gig, and I don't think it's only a case of being a more experienced mother now, in which case the second iteration of the larval need-bag stage could be reasonably expected to go better than the last. I think it's more to do with coping very poorly with serious sleep deprivation, not being particularly well-treated by breastfeeding hormones (Do I have a mild case of Dysphoric Milk Ejection Reflex? Maybe.), and, well, being the kind of person who would even think of calling a gurgling bundle of sour-milk-scented joy a larva.

You, of course, know the other thing I’m afraid of: birth, and that whole nightmare roller coaster again. See: everything tagged Dr. Russian. It is entirely possible that much of my feeling distant about the whole TTC business is just protecting myself from thinking seriously about the prospect of facing all that beyond the safe confines of this space. That I started weeping while looking at positive reviews from women who had delivered with my new doctor suggests there could be something to that notion. Throw in a soupçon’s fear of TTC not working, and you have a fine recipe for an aloof Bionic.

It isn’t, I am almost certain, that I don’t want to have another child. I keep asking myself if that’s it, of course, because we are still at a stage where backing out is possible. But no, it’s not that. I do want a sibling for the Bean — and another one of these critters for my own, selfish reasons. I wish I could capture in writing the wry smile the Bean had tonight when Sugar asked if he’d like a fish stick and, champion re-director that he is, he laced his fingers together, leaned across the table like a talkshow host, and said, “ooooor, maybe chocolate?” And did I tell you about the “turtle” he “drew” this week? What’s the turtle’s name, I asked. The Bean uses a kind of movie-Italian speech pattern sometimes now. “It’s-a called Penis,” he said, “It’s a big one.” I think Penis is a weird name for a turtle (maybe it was a skinny baby?), but the point is, this is a pretty great gig.

Last time around, every move we made to get to the Bean was driven by passion, and it’s just different this time. It’s less like I need to have a baby NOW, and more like, I know what I’d like our lives to look like in several years, and this is the time it makes sense to start building that future. I gather more rational people have experiences like this a lot, you know, and plan their lives in an orderly fashion and so on. But it’s a disorienting sensation for an impulsive creature like me. So. Off I go to the clinic, faking it ’til I make it.


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News From the Front

The bottom of the front, specifically. The front bottom, if you will.

The appointment went well. Dr. Baby Factory did not, after all, yell at me, you will be relieved to hear, though as always, he had that sad look that Sugar reminds me is mostly just how his eyebrows are shaped. His hair’s gotten a bit shaggy, as if the four years since we’ve met (is that all?) have taken him from being the 11-year-old star of the piano recital (as I always thought of him after seeing the picture in his office of him sitting ramrod straight up on one of the Today Show’s couches) to a 15-year-old with a garage band and a penchant for eschaton.

Dr. BF is who first suggested I go to Dr. Russian’s practice for OB, although in fairness he specifically recommended Dr. Robot, who left the practice in my first trimester.  Nevertheless, I decided I would tell him to rethink recommending them, if not for Dr. Russian’s appalling manner (which I know you all believe me about, but which could sound like the whining of a delicate flower) then for the way Dr. Skinny, the head of the practice, dismissed out of hand my was-that-an-abruption bleeding in the days before labor.  It is with deep pleasure that I report to you that he already has a call into Dr. Skinny, because he keeps having her patients come to him, get pregnant, and then refuse to return to her practice.  (Smart women!) So I guess it’s not just me.

While we’re on the subject of Dr. BF, can I just say what an absolute artist that man is at a pelvic exam? Seriously, he is the only person ever whose haven’t hurt; even his double pap smears don’t hurt. (Yes, I am a special snowflake and regularly cry over medical messing about in my lady business(es).  My cervices are on the inside for a reason.) I have to say that here because, 1) it is worthy of praise, and 2) there is no non-creepy way to express this sentiment in the moment.

So, the various bottom lines:

  • I will be making a lot more “bottom” jokes around here in the coming months.  Enjoy.
  • My CD 2 numbers are, I think without digging for my old notebook of data, the best they have ever been.  (FSH 5.6, E2 a shockingly low-for-me 39.)
  • My famous endometriomas (aka, “chocolate cycts,” if you are into ruining your ability to enjoy chocolate forever, which I am not) have apparently disappeared (?) (!).  Is this even possible?  I have noticed less back pain in the past few months, but I certainly felt plenty in cycles since being pregnant.  I am befuddled.  I’ll work on being glad, but right now I’m too confused.  At any rate, the dildo-camming didn’t give me the usual sensation that a smoldering rat is trying to scramble out of my lower back, which was a nice change.
  • We have lots of embryos, and Dr. BF seems optimistic about our chances, or as optimistic as his eyebrows will allow.

Scheduling is a bit of a annoyance, more so than I had anticipated.  I have the good insurance for six months, March-August.  I naively assumed this meant time for several cycles, but I had forgotten that the Baby Factory closes for IVF and like matters three months of the year, and two of those months are April and August.  When the scheduler explained that an April cycle, which was what I had begun to imagine, wasn’t going to happen, I felt bathed in adrenaline.  March?  March?!?  That’s so soon! But waiting doesn’t make a lot of sense, under the circumstances, so March it is.  Then I drank the warm apple juice she’d brought when I got woozy missing the half-gallon of blood they’d siphoned off for still more tests.  When a few molecules of sugar reached my brain, I remembered that I can’t do March, because Dr. BF wants me to come back early next cycle to see if a polyp is what’s making me spot so much before my period or if it’s just my good buddy endometriosis.

So May it is.  I am not entirely sorry to wait, though I had gotten myself slightly excited about Just Doing It.  I am worried that between the possible polyp and the closures, my six months of insurance just became three (and that’s assuming there’s no polyp or that it can come out quick-like in April).  However, billing had a surprise for us: the less-good insurance (under whose begrudging, code-careful auspices we had this consult) actually covers quite a bit more than we had thought.  Doing a cycle with them would still be more expensive than with the good insurance, but it sounds at the moment like it wouldn’t be impossible, especially if we planned ahead and got the drugs while I’m still on the good plan.

May gives me time for a few more visits to the favorite cocktail bar I am just now falling back in love with.  It also gives me some time to get worked up about various parts of this whole gig I wasn’t expecting.

For instance: more shots.  When I was first contemplating IVF, I decided I could deal with the little needles for stims but not the big ones for progesterone-in-oil, and Dr. BF agreed that I could use coochie bullets — excuse me, vaginal suppositories; excuse me, non-American readers, pessaries — instead.  They were messy and sort of annoying, but I was never sorry to be missing the intra-muscular missile to the butt I’d read about on other blogs, still less the bruises and lumps and lingering scar tissue.  But I guess now I get to learn for myself what all the fuss is about, because Dr. BF says (and, I regret to say, that the study I found on the topic agrees) that the delivery method really does make a difference in FET cycles.  Dr. BF says that during my IVF cycle, I was making some progesterone on my own, but that during a medicated FET, I won’t, which means that small differences in efficacy can mean big differences in results.

So one thing I guess I could use about now is some PIO pep-talking, should you have any on hand.  I’m not upset by needles per se, but I am no great fan of personal pain, especially deliberately inflicted, in my own home, every day for three months.  Call me crazy.  However, I also realize that a miscarriage I would always fear I could have prevented is worse.  Great choices, these are.

Okay, I know there are worse choices, I KNOW.  I know that, as subfertile lesbians go, I am sitting very pretty, what with the good clinic and the good insurance and the bewildering array of embryos.  It’s just…I had forgotten what this part, when fear and uncertainty loom so very large, feels like.  Frankly, I thought I got to skip it this time.

Mel asked the other day, after my first return to the Baby Factory for CD 2 blood work, whether I found that some of being back was much easier and some was ten times harder.  Yes.  That is exactly how I found it.  At first, I was giddy, almost, being back in such a powerful place without the dread and exhaustion I remember from the last time around.  This is a cinch, I thought, walking right up to the check-in computer to type my name.  The first time I came in, I stood awkwardly in front of the receptionist’s desk for some time before a woman in a pompadour, whom I did not yet know was nosy as the day is long and none too quick on the uptake, informed me in one of those New York lady klaxon voices that still startle me that I was doing everything wrong, as though it weren’t understandable that a person might imagine their office worked like every other office on Earth.  This time, the receptionists were new and muscle memory guided my hands through the menus as surely as if they were ticket machines at Grand Central.  Bam! I thought, jabbing the CD2 bloodwork button, my doctor’s name, my insurance carrier.  I got this.  I even made a self-deprecating joke about sperm to the guy ahead of me in line.  (Sorry, sir.  I should probably not be allowed in public alone, at least not while giddy.)

As I waited for my name to be called, a strange nausea crept over me.  I hadn’t, I realized, been comparing my present-day self with the me who had first come to the Baby Factory at all; I’d been comparing myself to my memory of that person, a memory colored by knowing that my first visit was only the beginning, that there were miles to go, disappointments and fears and more than a few crying jags.  In fact, that very first me, the one the receptionist startled, was a lot like this me: happy, excited, hopeful.  I had mainly wanted to go to an RE because of my mysterious lady-part arrangement and because my insurance covered it and the Gyn I’d gone to was a dick, so why not?  I imagined we’d leave with a plan, buy some sperm for home use, and have a baby in less than a year. Although our story ended happily, that original me sure had another think coming.

The PIO surprise was like a bucket of cold water to the face in part because I thought this time was going to be so easy.  Aren’t FETs supposed to be so simple compared to a fresh cycle?  I suppose it is simpler, in that I don’t have to come to the office much and won’t get OHSS this time, but I had forgotten that simpler isn’t the same as easy.  I know what to expect from an IVF cycle, but an FET is nevertheless new to me, bringing with it all the anxiety that attends medical novelty.  That I know how to get to the clinic and where to buy a coke after they exsanguinate me for science does not mean I know anything about what’s going to happen, and worse, it doesn’t mean I have any control over the results. I know I’m a lucky subfertile lesbian, but dammit, why can’t I just be a fertile one?  I thought skipping the rounds of IUI this time would make me feel fertile, but that fantasy is crumbling now that I remember that this “fertility” still involves doctors and needles and tenacula and fear.  I never really believed this when we were trying to conceive the first time, but it turns out this secondary infertility jazz is, to paraphrase Smarshy’s memorable image, just a different bag of ass.


7 Comments

I Figured It Out

OH!

The reason I am a staticky ball of anxiety — like, if you turned off the light, I’m sure you could see little lightning flashes around me — isn’t that I am having cold feet about returning to the Baby Factory, per se.

It’s PTSD from that horrible postpartum appointment with Dr. Russian. I was just like this before my last lady-parts doctor’s visit too, even though nothing terrible was on the agenda. Maybe I will always be like this from now on. Fun times for my lucky readers!

I realized talking to Sugar just now that the reason I wasn’t worried about my bloodwork visit the other day but I am scared to see Dr. Baby Factory himself is that I have in my mind that he will somehow yell at me about something. What he’d have to yell at me about, I don’t know, but then, I wouldn’t have thought there was a lot it made sense to ream out a limping, anemic mother of a six-week-old for, either.

In my actual brain, I know that Dr. BF is a kind, gentle man who will may even be happy to see us and want to see a picture or two of the Bean, seeing as how he was rather small last time they were in a room together. We’ll see if I can get my viciously tense body to listen to reason, but at least my brain feels better.


16 Comments

Back In The Saddle

…or the stirrups, anyway.

No, no, not in the TTC sort of way, not yet anyway. I won’t spring that on you without some high-octane angst first, promise.

But I did go to the OB/Gyn, for the first time since my postpartum appointment, which some of you may recall ended with me wandering the avenues of Midtown, weeping so hard people were forced to break the NYC taboo on talking to crying people and the one on stopping strangers in the street. (In case you’re wondering, it does take some doing, especially in the blocks around Grand Central.) I was, erm, a little nervous. Related: what is it about filling out those medical history forms that makes me afraid I’ve forgotten my own name, let alone whether I have kidney disease?

You will not be surprised to hear that I did not return to Dr. Russian, as punching her in the face would open me up to more court and jail time than fits my schedule. I stacked the deck a bit by going to Sugar’s doctor, whom I have met before. (In fact, I tried to go to her practice when I got knocked up, but they weren’t taking new OB patients.) Nevertheless, I was feeling pretty shaky as I sat there on the table waiting, gripping my notebook of questions. I fetched my journal out of my purse, for the sense of enhanced safety only another book can provide.

And…she was wonderful. She listened to my slightly quavery explanation of why I was switching practices and said it all sounded pretty traumatic. She said that lots of women push for four hours with a first baby and that it doesn’t mean they aren’t trying, and that they give nifedipine if they even suspect Reynaud’s in the nipples of a breastfeeding mother, because Reynaud’s is so awful and nifedipine is so safe. (See here and here for contrast.)

I haven’t written about this, but one part of labor that I have felt increasingly upset about in recent months is the part where I was bleeding heavily for days at home and Dr. Skinny said it was nothing and then was such a bitch about my calling back when it hadn’t stopped, twelve hours or more after my first call. I’ve talked to many, many women since then about their experiences of labor, and I have yet to hear anything that reassures me it was normal. I suppose it’s possible that it really was just a particularly determined (and large — this was a lot of blood) broken vessel in my cervix, but it’s also possible it was a placental abruption, and there is no way Dr. Skinny could have known it wasn’t via phone. I didn’t think it seemed normal at the time, and I shouldn’t have let her intimidate me out of that. Things turned out okay for me and the Bean, of course, but it’s not a comfortable feeling, thinking that I could have let my baby die — oh, and potentially died myself — because I was too chicken to argue with a doctor. I told the new doctor that, and she looked very serious. That does not sound normal, she said, and no one at this practice would have let you stay at home if you called bleeding that much. That will not happen to you here.

Ultimately, she said that while she couldn’t ethically say things about Dr. Russian to a patient, she was — I think the word was “horrified” — by what I had told her. Then she said so again.

So. Maybe it wasn’t just me.

If this doctor has a fault I am aware of, it is that I find her a little happy to cut, as surgeons tend to be. On the other hand, as much as I don’t want to have surgery for the endometriosis I’ve thus far fail to cure with denial or pregnancy, I’m not sure she’s wrong that I should have it. Things are getting worse, and most months I now spend three out of ever four or five weeks in some amount of pain. In particular, pain in the week before my period is getting out of hand, such that I’ve been dipping into my hoarded Percocet stash to sleep. Nothing else does a thing. The question in my mind is whether surgery is worth the pain of recovery, given that it doesn’t always help with endo. Somehow I didn’t get that question in, but I am being sent back to Dr. Demure, the man who did a transvaginal ultrasound without so much as seeing my legs, to see how my garden of ovarian cysts grows. Well, I imagine, from the way my back feels half the month. I’m also to see a rehab specialist about the way my hip joints fall to pieces and leave me so weak once a month, though she seems unconvinced that isn’t somehow also endo.

If I am going to try to get pregnant again in the spring or summer, I’m not keen to have surgery first. I’m hard-pressed to come up with a rational excuse for that — besides that I have no idea what I would do with the Bean for two weeks if my recovery were anything like Sugar’s — but she said it did not sound crazy. Should have asked her why not. In the meantime, I have a legitimate prescription for Percocet now, though she said several times that we couldn’t just carry on like this until menopause. Other than pain medication and surgery that might not help, there is no treatment. Birth control pills help some people, but are a bad idea for people like me, who get migraine with aura and don’t like the idea of having a stroke.

The pelvic exam itself was not much fun, though I think she was as gentle as possible while hunting around for cervix number two. Righty seems to have done the job at delivery, for those who were wondering. The worst part, though, was the groping around for uterus and ovaries and such like. I was doubled-over after and am still in a fair bit of pain, though some sangria left over from our party on Sunday did take the edge off last night. She may have a point about this situation not being tenable.

So! On balance, a win yesterday, I think. Let us hope for another one tomorrow, when I have a job interview at a college in Staten Island. I am hoping that my scanty publication record’s including a book about a forgotten corner of our most ignored borough will give me an edge.


8 Comments

What Was That All About?

Hey, y’all.  Thank you again and a hundred more times for your comment on my sad post the other day.  One of my blog goals is to start replying to more comments [sidebar: I’ve finally learned that if I reply using WP’s email system, I can also cc the email you used when you left the comment, which means you might actually see my reply, assuming you left a working email]; I’m not sure I’ll manage replies to these ones, only because I feel them very deeply and am having trouble finding words, even after looking under the couch cushions.  But truly, deeply, thank you all.

I’ve been doing some thinking about what made me fall apart so very much just then.  Certainly, the things I mentioned in the post itself — sick, sad Bean; lack of sun and exercise; insomnia (WTF?); cetera — are part of the answer, but a few other things have come to mind, to whit:

  • That pesky anniversary thing.  Several of you have mentioned bad stuff coming up around a year after birth.  For that matter, many of you (too many) have talked about renewed sadness and upset around the anniversaries of losses.  How that part of my mind knows what time of year it is, I don’t know, but I think maybe this is part of what’s going on.  Here’s hoping the outburst at 11 months is somehow protective and that the Bean’s birthday will be only joy.
  • PMS — Okay, I did mention this one, but it makes the list anyway because I’m curious to know whether any of you who have had babies think your PMS has changed.  I think mine has, and I’m hoping it’s partly because of the nursing-related hormone roller coaster and will therefore GTFH eventually.  I’ve always…felt intensely about PMS.  Feeling fat and moaning about same was, given the uncertainties of my cycle, pretty much how I knew it was time to buy pads; some light crying on the last day inevitable; weeping not wholly out of the question.  But it did not used to ravage me so thoroughly.  Crying, yes; sobbing, not so much until now.  (And just in time to try not to scare another creature with unpredictable behavior!)  These days…damn.  Anyone else?
  • Another thing that’s new is the kind and character of my period pain.  It’s been creeping back.  Every month I nurse a little less and I bleed a lot more and things hurt.  I didn’t expect being pregnant to cure my endometriosis any more than it cured my mother’s or than adulthood cured the asthma of anyone in my family, but I can’t help having hoped a little.  At least so far there have been no visitations of the dreaded GI/endo horrors which I positively cannot take care of a child during.  (I remember thinking on the infamous cab ride to the hospital that, while what was happening was very painful, I had been in worse pain many times and survived.  It’s like that.)  I’m not surprised that the pain is coming back, but what I am surprised about is how it has changed.  I’ve always been in pretty bad shape from the sternum down during my period, with belly, hips, back, and legs all hurting in one way or another, but the hip pain in particular has shifted from being something that I mostly noticed when trying to sleep on my side to being constant, beginning even before my period.  It also feels different, like someone is standing behind me, digging curled fingers around the front of my hip bones and then pulling out and back.  My hips and legs also get strangely tired and loose-feeling walking long distances during my period, the way they did at the end of pregnancy and especially after birth. It and the back pain are all-too reminiscent of giving birth, which I think makes me a little panicky and upset even before it’s strong enough that I’m thinking about it consciously.  I’m curious to know whether any of you who’ve given birth and/or been pregnant have noticed anything similar.  (I’m trying not to exclude anyone who’d like to answer but also trying not to be all trigger-y; please forgive inability to find a better way to ask.)  And, you know, whether it ever went away.  Also, pain med suggestions happily accepted.  I was so happy, post the cervix-puncturing HSG, that my pain had gone down so much that I could use Advil instead of Aleve, as Advil takes a week to really tear up my stomach while Aleve only needs two days, but this month I found myself taking half a percocet one night, and taking the other half an hour later.

The other, happier realization I’ve had about all this mess is that it is not strictly true that, as I had been thinking, I’m stuck on this.  It seems that way, but I think what’s really going on is that I’m slow, not stuck.  I wish I were done turning this over in my head, that I had successfully turned the whole story into an empowering narrative of personal triumph and joy and unicorn poop

[pause for unicorn poop cookies.  These Exist.]

…but the fact that I haven’t been able to do that yet, it has finally occurred to me, doesn’t mean I’ve been doing nothing.

It took me six weeks to even begin to accept that I was upset at all; that’s what the hysterical crying that began after Dr. Russian told me off in my post partum visit and continued for another day and a half was all about.  (And that there was some Crying, let me tell you.  People in midtown Manhattan do not stop crying people walking down the street to tell them it will be okay; it is just not done.  But they did me. And then this weird subway con-artist regular manhandled my baby on the 42nd Street shuttle.  Great day.)  Until then, I was fumbling around, wondering why I felt ashamed of myself, assuming who suggested that I had Encountered Assholes was just misunderstanding the situation.  I think that’s called denial.

Since then, I’ve gone through some valleys of despair, it’s true, but I’m starting to look around and think that maybe it’s not all the same valley.  They tend to look the same — being so shadowy and all — but maybe I’m not going in circles but just on a very long walk, one that ends somewhere with unicorn poop cookies.

(Okay, probably not.  But the disco dust part of those cookies isn’t really for eating, and I’d be much happier with a nice red wine and chocolate.)


27 Comments

Birth Story Part Five

Back to our story, already in progress. (See parts 1, 2, 3, and 4.)

As you’ve probably gathered, Dr. Jerkwad did not paralyze me. Thank you, Hippocratic oath. Or self-interest — my mother pointed out later that any misstep after I’d called him an asshole would have looked very bad in court. Also: I’m pretty sure you’re supposed to have the patient sign the consent before the procedure, not after.

For anyone reading this while considering options for her own delivery: getting the epidural was not a big deal. It did not hurt or even feel especially strange, and while the thought of a needle in the spine is a bit creepy, at that moment, the finer distinctions of human experience were not exactly at the forefront of my mind. There was no “creepy,” only “good” (a highly theoretical construct, belonging to the world that existed before the cab ride) and “bad” (everything I am feeling right now and for as long as I can remember). I, who am nervous about practically everything, felt no anxiety, only impatience. In terms of physical sensation, it was as I was told it would be: cold skin from the alcohol, very slight stinging from the local anesthetic, then a spreading coolness in my back. It hurt less than the IV. If you don’t want one, don’t get one, but if you think you might, don’t let fear of the procedure itself scare you off.

What can I say about epidurals that hasn’t already been said in a thousand love songs? Whoever invented those things should get the Nobel Prize for Medicine and no, I am not joking. I said some time ago that post-delivery, my anger at people (like that patronizing dick, Dr. Sears) who would try to scare women out of having epidurals had hardened to a murderous rage, and I meant it. (And again, this is not at all to say that those of you who didn’t or don’t want them shouldn’t have the choice, even if you do make me feel like a bit of a wimp.) I’ve had occasion recently to reflect on the unusual level of privilege I enjoy when it comes to medicine. Not only do I have access to good health care (insurance, good local doctors, all that), but I have a unusually (another rant for another day) good science education for someone who didn’t get a science degree, access to library databases and knowledge of how to use them, and an appropriately massive sense of entitlement regarding my medical care. So while I may have my own psychological demons about wanting/needing pain relief, at least I am more able than average to sort through the immense amount of crap out there about the supposed medical reasons to avoid epidurals. It pisses me off to no end that a whole parade of well-meaning nitwits and genuine jackasses would lie to women with fewer resources rather than risk letting women decide for themselves what ideologies to sign up with and what medicine to accept.

Back in the prenatal day, when I was confessing my epidural neuroses, wise Sara said:

The thing that nobody tells you about giving birth with an epidural (or, in my case, being denied an epidural, so giving birth without one after begging for one), is that in addition to dulling the pain, the epidural also totally erases any weird psychological hangups that one might have about epidurals. They actually rock, as it turns out. It’s just a well-kept secret.

And she’s right. I have a lot of strange feelings about how birth went, but not about the epidural. It just rocked, full stop.

Epidurals work very, very fast, but it does take a few contractions. The first contraction after it went in is as painful as the ones before, but somewhat more emotionally difficult for me, since I had been looking forward to being saved, and now I am not saved after all. I feel a sickening fear that it won’t work, but then it starts to. The next two contractions are maybe 85% of what I’ve been feeling, and after that they become manageable. I can sit up and turn around on the bed; I can listen to the nurses again. Kips Bay Mega Hospital uses low-dose, patient-controlled epidurals, which is part of why I wanted to come here: light epidurals compare favorably to traditional ones in studies of practically everything you can think of. Someone shows me the button I can use to boost the dose if I need to. The world begins to reassemble itself.

Despite my stabbing at the button, the low-dose epi is ultimately not enough, so after 45 minutes, a different anesthesiologist — who manages not to be an asshole, imagine that — comes in and gives me a bigger dose. After that, I can still feel the contractions, but they aren’t so bad. (I am glad I got to try the low-dose, though, and I think more hospitals should have that option.)

Unfortunately, what can’t feel my contractions is the contraction monitor. It picks up maybe one in three or four. The nurse keeps moving the sensor around, asking me to tell her when they come, and feeling all over my belly with her hands, but she can’t find them, either. At this point, I don’t think much of that. Who cares? I am having contractions — I can feel them — and it doesn’t seem surprising in the least that some contraption doesn’t register them. Contraptions! Of course they are prone to failure! Yes, I am the girl who thought for nearly 20 years that tampons didn’t work for me because they just don’t work all that well.

What does need to be registering those contractions is at least one — ideally only one — cervix. (So far, there is no hint of my didelphic nature causing a problem: everyone who sticks a hand in my business agrees with Dr. Skinny that one has obviously taken over.) In the “natural” childbirth literature, there is a lot about how labor pain is not something women have justifiably dreaded for all of recorded history but is actually fantastic because unlike kinds of pain men experience every other kind of pain, labor pain is “productive.” Allow me to add that to the list of things Dr. Sears can shove up his urethra. Frankly, so what? Passing a kidney stone is a thing that happens, too; does that make that pain “productive”and therefore worth having?

However, when the resident comes in and asks to do a cervix check, I am a little excited. If I was four centimeters five hours ago and spent most of those hours having strong, frequent contractions, surely things must be getting close. And my water broke, too. Maybe I really was in transition in the cab. Maybe the resident will look shocked and say, “No wonder you felt bad! It’s almost time!”

Instead, she feels around for a minute and says, “Great, you’re at four centimeters.”

WHAT? All that for NOTHING? Are you kidding me? I am ready to hit the ceiling. She looks like she knows she’s said the wrong thing. “Um, maybe four and a half?”

Oh, and my water hasn’t broken after all, so, um, sorry I peed in your car, cabbie.

While all this is going on, Sugar goes back downstairs to reclaim our luggage, which the man at the information desk let her leave there when it became obvious that she couldn’t carry it and push my wheelchair at the same time, formally checks me in, and gets a health care proxy. At some point, she calls the doulas — we have two, since neither is a full-time doula. It turns out the one we liked can’t come tonight, but the other one shows up a little while later and sits with me while Sugar gets dinner somewhere I don’t have to watch her eat and brings me back some cranberry juice. My main concern with this doula has been that I will find her happy but frantic energy upsetting in labor, but I manage to find the spine to tell her that I don’t want to talk, and to her credit, she listens.

This part, from when Sugar gets back in the room until it’s time to push, I look back on fondly, all thanks to the epidural. Sugar dozes on the fold-out chair/bed in the corner, the doula reads, and I just rest. I am freezing cold, but the nurse brings piles of warmed blankets and bundles me up. The lights are turned down low, and the fetal heart monitor fills the room with the Bean’s steady, reassuring heartbeat. I love the thought that we spent those last hours together that way, he listening to my heartbeat all around him while I heard his all around me. I feel safe and calm.

I’ve read quite a few stories that include praise for being at home or at a birth center; let me throw in some praise for being at the hospital. Because of my father’s devotion to his job, I spent quite a lot of night time at the hospital as a child, waiting for him to visit just one more set of patients on the way home from a piano concert; perhaps my experience is unrepeatably idiosyncratic. I remember the quiet of the wards at night as my father walked from room to room, silently watching his patients, stepping into the hall to ask a resident for details. Of course I like the epidural and feel reassured by the knowledge that there are pediatricians and a NICU right here if the Bean needs them, but I also like feeling that my room is a quiet part of an active hive. By now it is dark out, and my window is filled with a grid of windows from the wing of the hospital across the courtyard, some lit, some dark, some in between. I think I might have felt alone and isolated at home; here I feel watched but not bothered. Like I am in the right place, safe.

At some point, Dr. Russian turns up, seeming cheerful. She checks my cervix now and again, and there’s another thing to love about the epidural: now I am dilating smoothly and rapidly. I can’t remember exactly when I heard each number, but I remember thinking at one point it was two centimeters per hour. The Bean’s head is dropping nicely, too. Everything is fine, except that I am supposedly not contracting enough. At eight centimeters, Dr. Russian wants to break my water to speed things up, which I don’t mind and don’t even really feel. It certainly doesn’t hurt.

Contrary to what you may have read about epidurals, mine in no way leaves me paralyzed or numb-feeling. I can and do move my legs, and when the nurse starts talking about catheters, it’s not because she won’t let me try walking to the bathroom. However, even though she says my bladder is very full, I do not feel any urge to pee, so after a few minutes of focusing on finding that sensation, I agree that the catheter is a good idea. I had really wanted to avoid that, but it isn’t a big deal. Getting cleaned for it hurts in a “clitoral exfoliation” kind of way, but the catheter itself doesn’t. She takes it out as soon as it’s done its job.

The only negative side-effect I have from the epidural is that my belly itches. A lot. And all that moving around the monitor in search of my contractions isn’t helping. Of all the things we threw in the hospital bag, the only one I really want is the washcloth we’ve forgotten. Sugar gets paper towels wet to distract me with cold. It only sort of works, but boy howdy, I will take itching like this any day of the week over the pain I was having.

The nurse who is mostly taking care of me is sweet and young. She thinks the baby will be a girl because it is being so good; Dr. Russian says that surely means boy. The nurse asks about names. We had wanted to give the baby a name from each family, and while the girl names were easy to choose (we have 3 names we like, in four possible combinations), finding a male name from Sugar’s family has not been not easy. There are plenty of men on her dad’s side, but not many names at all. My pick is Sugar’s father’s middle name, which lots of the men have, but she is having none of it.

No one ever says I’m completely dilated, but I gather that I must be at about 10 o’clock, when Dr. Russian tells me I have an hour to develop an urge to push before she wants to turn off the epidural. How about down rather than off, I ask, terrified. She agrees and leaves me with the nurse again.

So for an hour, I try to push. The nurse tries to find my contractions; Sugar and the doula try to help me. I can feel the muscles just fine. I know what to do and I feel a slightly constipated feeling, but never anything more. I roll over a few times, which I don’t like and doesn’t help. The nurse coaches me through pushing anyway, but the resident says I’m not doing it right. I convince the nurse to let me breathe out as through a straw while pushing, because holding my breath makes me feel terrible. I do three 10-count pushes per contraction.

After 45 minutes, Dr. Russian returns, and I agree that it’s time to turn down the epidural. I’m not too worried, since I figure the pain will just return to where it was before the extra dose. And they say epidurals do slow down pushing, so maybe this won’t even last long. Maybe I’ll have a February baby, just like BFF predicted back in October! The anesthesiologist (another one) comes in and lowers the dose; Dr. Russian says, “Don’t you DARE touch that button,” and leaves again.

And here, Gentle Internets, is where the horror movie starts. I can’t tell this part of the story neatly, because I wasn’t in my right mind for it. I often wish I didn’t remember it at all.

Without the epidural, the pain rapidly goes past what I can stand. Now my bones are being broken again, but only after being set on fire. There’s still nothing in my belly at all, just back and hips and especially my thighs. God, my thighs. I feel sick now just thinking about it. Between contractions, I can hear that I’m making those terrible dry sobbing sounds again. At some point, Dr. Russian speaks with scorn about my crying, but I’m not crying in any normal sense. My face is dry. This noise is coming from some dying animal part of me, utterly beyond my control.

I’m on my back still — I know, I KNOW; I “should” be in some other position. I didn’t even want to tell you all this now, because I am afraid someone will come tearing in to lecture me on Best Practices for Back Labor and tell me it’s all my fault. But I can’t stand the thought of any other position. I know I’ll fall apart if anyone tries to move me, and I mean fall apart physically.

At each contraction, Sugar and the doula hold my legs up while I push. At various points, I try holding the bar or my own legs; eventually I settle on holding a sheet-rope tied to the bar. I push for a count of ten, three times per contraction, while someone — usually the resident, sometimes Dr. Russian — tells me I’m not doing it right. I am doing exactly what they describe. A few times, I am told that I have finally done the right thing, that I should keep doing that. I am always doing exactly the same thing, every time. The scolding and praise come at arbitrary intervals, heavy with emotional freight. It’s very like a nightmare.

Dr. Russian is horrified that the nurse has let me hiss breath out during pushing, so it’s back to holding my breath. Which is stupid, by the way. And, as far as I can remember, not supported in the literature. Up until this point in our relationship, Dr. Russian has been so medically rational that I blithely ignored the advice to talk to my OB about her views on coached pushing, a grave mistake.

And now it is too late. For two hours, this goes on. I try to push, despite the fact that I am now in so much pain that some primitive part of my brain simply won’t let my legs spread enough, won’t let my back muscles let go at all. My body is trying to save itself, and I can’t override it. I can’t open more, I can’t relax, I can’t push harder; wanting to doesn’t enter into it, and neither does any conscious idea of fear. I am trying my best with every part of myself still under the control of my brain, but it’s not enough.

Complicating matters, no one can find my contractions on the monitor or by feeling my belly, so they often don’t believe I’m having contractions, just that I’m carrying on, I guess. I have to tell them when one is starting or stopping, which pleases no one. I have since learned (thanks, HFF) that this happens to bionic folks like us reasonably often; I didn’t make the connection until recently, but I was told early on that no matter the normal size and shape of my uterus, there would likely be differences in the muscle tissue at a microscopic level, which is why they wouldn’t have attempted an external version in case of breech presentation. I can only assume that no one at the hospital ever put those ideas together at all.

And then there was Dr. Russian. It’s Dr. Russian who has kept me from writing this down for all these months. It was two months before I could begin to be honest with myself that she was not, in fact, consciously using “tough love” in a misguided attempt to motivate me but is, in fact, the kind of smart, funny, emotionally unstable maniac that I Always Fucking Fall For. (That I have managed to marry someone smart, funny, and also compassionate and gentle is a miracle of the first order.) Four months out, I can confidently say that her behavior was assholic and frankly cruel, but it’s taken some time to get here.

Dr. Russian, as far as I can remember, spends the remainder of labor yelling at me for pushing wrong, for making noise, for holding my face wrong, for not wanting to push the baby out, for not trying.

That last one, that’s the one I can’t shut out, then or now. It cuts to the bone of my childhood insecurities. Recently, a friend whose pregnancy overlapped mine asked why I had liked being pregnant. From her perspective, pregnancy had been a somewhat uncomfortable, often inconvenient means to an end, not something she enjoyed for its own sake. But I did love it, and talking to her made me realize that a big part of why is that for the first time, after a lifetime of being told I was failing at gym and the like because I wasn’t trying (not, say, because I had untreated asthma), I felt physically competent at something important. I was doing it right, and until the last day, no one said otherwise.

Over the course of two hours, everyone in the room realizes that however typically helpful it is to turn down the epidural at this stage, in my case it is a rank disaster. When Dr. Russian leaves the room, the nurse starts asking if maybe, really I do want to push that button. I refuse. Things are bad enough; I am terrified of what Dr. Russian will say if I do that.

Dr. Russian comes and goes. At some point she threatens me with a c-section if I don’t start trying, which, despite the high rate of sections at this hospital, is curiously the only thing she says that doesn’t frighten me. I know I’ve dilated smoothly, I know The Bean is very far down, I know my water hasn’t been broken for long. The Bean’s heartbeat is steady and strong, no distress there. For the first time since I googled “double vagina,” I know I’m not having a c-section. I am sure of that, and the threat doesn’t touch me.

Eventually, the mood in the room changes enough that I can say, yes, I give up, I need the epidural back. Sugar tells me later that the resident and a collection of nurses bundled Dr. Russian off to the hallway to convince her it was not working. The anesthesiologist who had turned it down comes and turns it back up, without comment. I rest a little while. It starts to work, and while I’m never out of pain again, I stop sobbing.

Dr. Russian spends the rest of labor sulking. At some point, when I say how much better I think things are going with the epidural back on, she rolls her eyes at the ceiling.

Pushing continues. I’m exhausted and shaking all over. In between contractions, when my legs are released to the bed, I have to tell myself, out loud, over and over, that the bed will hold me up. Again and again, I’m told I’m not pushing hard enough or long enough or right. They say I’m not having enough contractions. I am. I’m tempted to lie sometimes, to not mention one is starting, just so I can get a break, but I don’t. They give me pitocin — or maybe that was before the epidural was turned down; I can’t remember now because I didn’t care at the time.

At some point, Dr. Russian asks whether the heart rate on the monitor is mine or the baby’s. “The baby’s, I think,” says the resident.

“No. About this I am very particular. Find out for sure.” I am grateful for Dr. Russian in that moment, glad she is watching out for The Bean.

There is a small flurry of activity as the resident and nurse try to figure out what to do, how to move the monitor, how to be sure, but then Nurse Ringer, an older Latina says calmly, “Why not take mom’s pulse and see if it matches?” They do and it doesn’t. Thanks, Nurse Ringer, for saving me from internal monitoring with the power of logic.

The Bean’s heart keeps steady on, steady on through all of this. At one point, I hear Dr. Russian remark to a nurse that he has an “enviable trace.” I glow with pride and silently thank the Bean for being so strong, for causing no worry.

Eventually, it is Nurse RInger who saves the contraction-monitoring day, too, as she finds a magic spot, very low on my belly, where she can feel them. Everyone is gathered around the bed at this point. The doula reminds me at every contraction to keep my face relaxed and my chin down; I am grateful that she can say that gently, since it saves me from being yelled at by Dr. Russian. They keep saying I’m pushing wrong. Someone gets a mirror, tells me I can see the head, but I never do, just my swollen lady bits and blood. (They had tried to clean the blood away before bringing the mirror, for fear of upsetting me, but I’m not bothered.) I carry on. Nurse Ringer is yelling that she wants to meet this baby; she reminds me of the baby-crazy secretary at Sugar’s office, and I don’t mind her yelling.

And here is what happens, after four hours of pushing three times per contraction, exactly the same way every time: I have another contraction, just like the others. I push twice, and am told I’m not doing it right. I push one more time — exactly the same way I’ve done it before, except maybe for two seconds longer — and out comes the Bean, all at once. Dr. Russian is across the room. The resident catches him, and “catch” is no metaphor here: he was flying.

* * *

And everything is happening at once again, only now it’s in a good way. Someone says he’s a boy. Someone puts him on my chest. The placenta comes out, and he’s passed back down so Sugar can cut the cord. Someone asks if we have a name. We have a first name…. Everyone else has to wear gloves to touch him, but we don’t, because we belong to each other.  We talk gently to him and are awed.

His initial Apgar is 9, with a point off for not crying much. (A very polite way to lose a point, in my opinion.) After a few minutes, Nurse Ringer takes him to the bassinet and warming station in the corner to suction him and clean him up a bit. Sugar goes with him, and I’m so glad she can. Holding him was one kind of amazing, but watching her with him is another kind altogether. I hope she’ll tell you about it herself.

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Meanwhile, I am getting stitched up. Dr. Russian is giddy now, and she and the resident are working together, stitching and pulling and filling me up with gauze and pulling it back out again. I ask to see the placenta, and the resident shows me, after asking if I want to go skin to skin with it.  It’s smaller than I had expected.  They can’t get the bleeding to stop. The epidural is turned up higher and they’re using lidocaine, but it hurts. This indicates to me that I had plenty of sensation in my vagina all along and that the woman who told me tearing wouldn’t really hurt in the moment was right, because I certainly didn’t notice it happening. Mr. Hyde Dr. Russian had said when the epidural was tuned back up that it wouldn’t stop me feeling pain as he came through my vagina and that I had to not “freak out,” but really, it was nothing compared to everything else.

The Bean was born at 3:06 am, after four and a half hours of pushing. I hear Dr. Russian declare to the resident that it was really only two hours, since I apparently wasn’t trying the rest of the time. She has very sharp things in my crotch.  I don’t kick her.

Meanwhile, Sugar is still with the Bean. Suddenly she looks up at me, teary-eyed, and cries out, “I want to give him my dad’s middle name!”  I agree, and he has a name.

Eventually, the stitching and gauze-stuffing stops, my legs are released to the bed, and Sugar brings The Bean back to nurse. And he does, or at least makes a good effort. The doula swoops in to give me confusing advice, but mostly we just lie there together.

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(What ever did happen to my vagina, anyway? Stay tuned for the Recovery Epilogue.)


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Birth Story, Part Three

Well, it’s happened. One of those overdue babies has gone and gotten herself born! Congratulations, Ms. Debbie G! And your lovely wusband, too! Biggest congratulations of all to that lucky, lucky baby girl, who is going to grow up in a super-awesome family.

In other news, while I was spacing out again, another due date I told myself I’d beat has gone and passed. I’d better get on this, eh?

(Parts 1 and 2, in case you’re just joining us.)

Sunday night: Home from dinner, cranky and crampy. Am starting to wonder just how normal it can be to still be bleeding so very, very much. And why hasn’t there been any mucous? All the books and websites say that bloody show is maybe “tinged” with blood. I start googling pictures and find nothing that looks like what I’m seeing. I figure better to call the doctor at 9:30 than wait until the middle of the night and wake her up. So I do.

The answering service takes my message and, as always, says to call back if I haven’t heard anything within 15 minutes. I wait 45, then try again. A while later, Dr. Skinny calls, sounding pissed. Which is weird, because hello, it’s not late by OB time, and anyway, I’m bleeding here. She couldn’t call sooner because she was delivering a baby (which I should have known via the Pregnant Lady Alert Network, I guess) and says she doesn’t understand why I’m calling. Um, because I’ve been bleeding like a stuck pig for nigh on 13 hours? (And must have been for quite a while before getting out of bed in the morning, to judge by the enormous clots. Which she had said weren’t big, but you know what? They were.) And all this “is it heavier than a period” business is confusing since A) I haven’t had a period in a while, actually; B) Heavier at any given moment? Or greater volume of blood overall? Because: no and yes; C) this blood is nothing like period blood; and D) WTF does that have to do with the price of milk? I’m not so much supposed to be having a period, right? And where’s that mucous I ordered?

For the record, I am not hysterical (bad pun; enjoy!) on the phone. [That came later, with the vasospasms. Apparently nipple pain trumps fear of bleeding to death.] I am calm and polite, express my hope that the birth went well, all that. Southern as all get.

Eventually, Dr. Skinny says — as if I should have known this — that I will be like this until I give birth. Pro tip: mentioning that in the morning would have saved you this phone call, Dr. Skinny. Also, how about you take a look some time at pregnancy books your patients are likely to have. You might be surprised how little information is in there. But they all say in no uncertain terms that heavy bleeding means time to pick up the phone.

She agrees with me that waiting until my next appointment on Thursday is not a good idea and says I should call in the morning for an appointment.

At nearly 38 weeks’ wide, I am a difficult party to share a bed with, so after a little while tossing and turning, Sugar goes to sleep on the chaise in the other room. I have no choice but to sleep with myself, which isn’t going well. I drift off but wake up every half an hour or so in bad pain. Still only in my back and legs. I start to wonder at all the advice I’ve heard about trying to sleep through early labor. How the hell do people do that? I try more alcohol, which just makes me feel gross.

Monday: By 4 a.m., even pretending to sleep is ridiculous. The contractions are coming about every ten minutes and lasting a minute or more each time. The pain is worst in my back but now seems to wrap around to my belly some of the time before shooting down my legs, right on the bone. I still don’t think it’s likely that I’ll be in real labor any time soon, but just in case, I decide not to wake up Sugar; I’ll want her rested for labor more than I need her help now. I spend some time in the tub until that starts to make things worse. I try to read a book. I bend over the couch, like they said in birth class. That is the only thing that feels even a little better, but I’m too tired to keep it up. Mostly, I lie on my side in bed and squeeze the cat, who is an absolute prince about the whole thing. I do some groaning and a whole lot of counting.

The pain is worse in the morning. Sugar gets up and complains about how lousy she feels, that she didn’t sleep well. I proceed to have a contraction, and she doesn’t complain anymore. Heh. We do some counting and breathing and all that jazz. The contractions hurt more, and I’m glad she’s there to help me through them. Counter-pressure on my back helps some; the birth ball seems like the worst idea ever. I get an OB appointment for 1:15 that afternoon. We decide to pack a hospital bag, just in case, even though I don’t have half of the things I meant to get. Between contractions, we write — and I mean “write, on yellow lined paper;” remember that the printer has croaked — a very minimal birth plan. (“Epidural, yes. You get to come to the OR for a section. You wanna cut the cord? Put something in there about circumcision.”) At some point I write to the doulas.

Things go on in this vein until it is time to leave for the doctor. We really do take a cab this time. As is the way of these things, my contractions, which have been steady on all this time, all but stop on the drive in. I think I had three in the hour it took to get there. We feel a little foolish dragging our luggage into the waiting room, I tell you.

I pee in a cup (like you do) and some blood drips in; I’m still bleeding, though less than on Sunday. The nurse seems a bit horrified, all the same. I ask Dr. Russian whether she thinks they’ll manage to find protein in that sample. She laughs [See! This is why I liked her!], hooks me up to contraction and fetal heart rate monitors, and leaves for twenty minutes.

While she’s gone, I have only one contraction, but Lordy, it hurts. I’m sure people in the hall can hear me, as my counting is getting a little…emphatic. It’s over by the time Dr. Russian returns, though. She declares the Bean’s heart rate perfect and says there’s no evidence of a contraction on the tape. I about hit the ceiling. I had a contraction, dammit. I believe you, she says, it just didn’t show up here. As long as you’re here, let’s check your cervix.

This time, I do start to crabwalk off the back of the exam table. There has got to be a less painful way to do that. Dr. Russian is visibly shocked as she reports that I am 4 cm dilated and completely effaced.

What do you want to do, she asks.

What? Aren’t you supposed to tell me?

Well, she says, you can go to the hospital if you want, but you aren’t contracting, so they’re going to give you pitocin. I know you want to avoid that, so why don’t you go have lunch, walk around, and I’ll probably hear from you tonight.

I can’t tell you how happy I am to hear that Dr. Russian is on call. I don’t like the other OBs at all. [And even after everything that came later, I’m still glad it was her. I didn’t rate my chances of a vaginal birth with Dr. Skinny too highly, and Dr. Sympathetic Noises said when I first met her that I’d likely need a c-section. Only Dr. Russian ever seemed to think things might work on their own.]

For some reason, I interpret Dr. Russian’s words, which now seem to pretty obviously suggest that she thinks I am in labor, as, “Go home. Maybe you’ll have the baby later this week. Like Thursday, say.”

So here it is, the hands-down dumbest thing I did in the whole pregnancy. The one thing I can definitively look back on about labor and say, I sure as hell won’t do THAT again.

We go home.

On the subway.


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Easing Back In

Hello, internets. Miss me?The radio silence you’ve been enjoying has been made possible by:

  • a Bean who is getting smilier and more fun every day
  • a Mama who is way less depressed now that she isn’t in pain all the time*
  • more weather worth walking around in [Ha! Except then it rained all week and I still didn’t get this post done!]*only…I seem to have injured myself with only a little pumping, and the weather got chillier, and…the vasospasms are back. I have stopped pumping and they seem to be fading. I figure I’ll try pumping again when I’m healed up, but if that’s how it’s gonna be, then I guess it will be formula when there comes a time that I can’t always be nursing him. ‘Cause I ain’t going down that road again.

But I miss you, and it’s raining, and the Bean is asleep in the ergo, so I thought I’d tiptoe back by accepting these nice awards from Kaitake:


The rules:

1. Link back to the person who bestowed the awards on you (yup).


2. Tell us 7 things about yourself, for each of the awards (total 14 things):

Good heavens. Fourteen things. But I do so want to be both stylish and versatile…. I may have to draw from current events.

1. I’m from North Carolina. My accent was never terribly strong, and what I had of it was beaten out of me in college, where almost the only thing left to give someone trouble over was the region of the country she came from. I regret its loss very, very much. I get very pissed off when people say stupid things about the South, especially when it’s that smarmy aren’t-we-all-so-awesome-because-we’re-liberal-Northeasterners B.S. that some folks will try on me because I don’t have an accent and because all Southerners are bigoted and backward, right?

2. My first year out of college, I worked for City Year, part of Americorps. At our national conference that spring, I shook Bill Clinton’s hand after he gave us the most generous and moving speech; was deeply disappointed by John McCain, who phoned in his appearance in a way I found very disrespectful; and went to hear a state senator give a surprisingly good talk to in a small classroom. Although I agreed with what he had to say and thought he’d said it well, I was bothered by a lazy rhetorical flourish that relied on the expectation that rural people are backward, and, as I try to when possible, I came up to him afterwards to tell him so. We had a good talk, I thought, and he seemed to see my point. …which is why I was so disappointed when, years later, this happened. Barack, we talkedabout this!


[Whoa. It’s days later; I have no idea what bee was in my bonnet when I started that. Someone must have crossed me, and now you bear the brunt of my irritation. I won’t delete, as the tirade above certainly tells you more about me than whatever cutesy facts I’d come up with to replace it. Ahem.]

3. In case the above cast any doubt, I loved and continue to love my college. Sugar and I met there, when she was a sexy senior and I was a bright-eyed first-year with waist-length braids. (I shaved my head second semester. As you do.)

4. Lists apparently give me thinking-block. My preferred form of OCD is categorizing.

5. …which is why my “favorite” household chore is laundry. Secretly, I even love that our wee-tiny, totally not-allowed-in-our-building, hooks-to-sink/drains-to-tub washing machine is so small that I have to subdivide my normal categories into smaller loads. (Hot pinks only! Lights/cold! Blue things with buttons!)

6. I am not a good housekeeper. At all. But I am a good cook. If you were coming to dinner for the first time, I’d probably make a lamb tagine and Lebanese couscous, unless I was in the mood for chicken and biscuit. If you are a vegetarian, we’d probably have pasta alla norma. If you are a vegan, well, you probably aren’t friends with me, on the grounds of my terrible boorishness.

7. I have a degree in writing and even a little book-ella, with photographs by Sugar. (Please don’t give away our secret spidey-identities.) I found pregnancy profoundly mentally debilitating but am now starting to feel like thinking again, which might turn into writing again. Last time the ol’ noggin was functional, I was reading Illness as Metaphor and thinking about infertility in literature. I got as far as checking Hedda Gabbler out of the library and carting both around for months. Then I lost both of them. The library has now been paid and I’m ready to start again. If you think of other examples of infertility — at least strongly implied — in literature, especially canon-stuff, please tell me.

Okay, that took almost a week. On to current events.

8. Can I say again how much more fun I am having with the Bean these days? He smiles, he laughs, he shows a marked delight in Evita and Patti Lupone in general. I’m starting to figure out the napping situation, thanks to some good advice about putting him down earlier and some accidental discoveries about the wisdom of letting him fuss a little. It helps that he can see his mobiles now, so I don’t feel quite as guilty putting him down when awake.

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Not the world’s greatest pictures, but I love this thing.
9. The Bean’s room is still very much a work in progress, particularly when it comes to decoration. Why, yes, the man in that print is smoking a cigarette. Positively wholesome compared to most of what’s on the walls in there. That room has been the repository for art that I like but either don’t want our guests staring at during dinner or don’t want to see when I’m trying to go to sleep. Which is to say, it’s mostly me naked and/or work that is overtly about death. Cheerful!
10. We’re having a lot more fun doing tummy time these days, thanks to the Bean’s greater head control (which he developed despite having virtually no tummy time until recently, which makes me wonder just how necessary it is, but anyway) and my giving up on forcing him to face-plant on the floor, which seemed cruel, boring, and a guarantee of a crabby baby. Now I lie most of the way down and put him on my stomach. Cute! (And I don’t have to lie on the floor, staring at the herd of dust buffalos under the furniture, which is kind of a drag — see #6.)

tummy time

The mobile Sugar made, which hangs over his bassinet, is fuzzily visible in the upper right.
11. We have rain-sound white noise on so much of the time now that I’ve started dreaming of monsoons. Think Apocalypse Now. Also, I have to pee. All the time. The continual actual rain outside is more of a problem, not least because I suspect that the Bean has inherited my (and my mother’s) air-pressure-related migraines. There have been at least two days when a blistering headache on my part has coincided with strangely pained, inconsolable wailing on his, much improved by a dose of infant Advil. Poor critter. I was so happy knowing he couldn’t have endometriosis and so naggingly worried about the likelihood of asthma, but I never thought about this one. At least he’s also got my ability to move his eyebrows individually. That’s some compensation.
12. He also has my (and my father’s) simian crease on his left hand. I get strange looks when I glow with pride over this point of resemblance, but I have always loved sharing this with my dad. It’s like we’re part of a secret club most people don’t even know exists. My father, who is a geneticist, used to show his students pictures of our hands — a good reminder that soft-markers are not diagnoses.
Left Hands
13. I keep meaning to write my birth story for y’all; I don’t know if there’s a statute of limitations on that sort of thing. Even though I basically got the story I wanted — healthy baby, vaginal birth, an epidural that was nothing but wonderful — I spent a long time feeling really messed up about parts of it. Ashamed is the closest word, I think. In a way, Dr. Russian’s later display of bitchery was a relief in that it suggested that maybe her behavior during labor wasn’t my fault, per se.
14. The one I’ve been keeping from you: I need to change the subtitle of this blog, as I’m now down to just the one vagina.

I nominate the following bloggers for these awards: You. You Over There. You There. And You, Ya Lurker.