Thursday, August 24, 2017

Some Victories are Sweeter When the Battle is More Arduous

I finally get why my 4th grade teacher gave the coveted Spelling prize, a 101 Dalmatians kite, to my best friend and not to me.  I had the highest grade in the class and while she had an A, it was a lower percentage for sure.  Was it favoritism?  Why had she chosen her over me?  It was something that baffled my 10 year old self. While I understood it eventually, I didn't really, truly get it.  Not like I do today at least.

My son is almost 19 months old and today he said the word "ball."  I know that sounds like an unimpressive reason to write a blog post.  I know because he is my third child.  My other two said the same word as one of their first few.  Those moments passed with little or no fanfare.  We were happy but really it was just another word added to a growing vocabulary.  It was great but expected...unimpressive.

This time was different.  My baby has a speech delay.  A few months ago his test results ranked him at an 8 month old level for communication skills. He didn't respond to his name and we quite frankly (along with his speech therapist) weren't convinced he could even hear us talking to him.

I've waited so long to hear his sweet voice form words.

Today, he said "ball"!  It's the first object he's named.   I'll never forget watching him work so hard to mimic his therapist's "bah...bah...bah" sounds and his determination in getting his little mouth to form that word after many failed attempts... How he clapped for himself when he finally got it right... the huge grin on his face... I can't even express how proud and excited I felt.

It's so different watching your little one learn something when he or she has to work harder than peers to get it.  The victory is so much sweeter.

That's what my 4th grade teacher already knew all those years ago.  Getting the highest grade in Spelling was great but something else was even more exciting.  Watching a student who was struggling and getting Cs at the beginning of the year fight her way firmly into straight As...that's an amazing accomplishment. A huge victory worthy of a prize.

Sunday, August 7, 2016

When Bottle Fed Became My Best

This picture is from March but still very special to me. Here are my almost Irish twins coming as close to tandem nursing as we will ever get.


I've always been all about scientific facts. I'm pretty much the biggest breastfeeding advocate there is. The science supports that breast is best, so I had every intention of feeding all of my babies exclusively breastmilk. I spent my last year of medical school pumping despite lack of sleep and an insane work schedule to make that happen for my firstborn.

But I bottle fed my second baby. 

became pregnant when he was less than 6 months old. While exclusively breastfeeding around the clock. By 9 months, he self-weaned.

Despite the scientific fact that breastfeeding is perfectly safe during pregnancy. Despite the many articles I read stating that self-weaning would not happen before a year. Despite the countless women I read about who nursed through their pregnancies and then tandem nursed for months afterward. Despite my envy for them. But most importantly, despite anything I did. 

I nursed around the clock. When my baby began to refuse the breast, I pumped. And I pumped. And pumped. 

Increased demand will increase supply!! My brain yelled the scientific facts.

I nursed and pumped until my nipples were cracked and bleeding. I continued pumping even when my baby refused my breast completely. I pumped as the hormones and guilt raged and countless tears fell. I pumped even when I was down to an ounce from a 20 minute session.  Even when I was so strung out from caring for two littles 2 and under all day while being pregnant that I wanted nothing more than to curl into the fetal position and sleep for 14 hours straight.

I pumped until my husband finally helped me see that it was time to let go. That I was causing more harm than good. That sometimes, breast is not best. And it was no longer my best.

I had to re-define. Change. Realign my expectations with reality. My reality. 

But isn't that the beautiful surprise essence of motherhood? We go into it imaging what we will impart on the lives of our babies only to find out that it is we who are most deeply changed. Endless learning, shifting, stretching, re-thinking, re-discovering.... It is true that the day a baby is born, so is a mother. 

My precious boys have changed me into who I am today. Changed me for the better. Changed me from knowing endless scientific facts about parenting to being one.

Not that change is easy. And comparison with a hefty dose of guilt is hard to let go of. I'll always marvel at the beauty of tandem breastfeeding photos and feel a tiny twinge of envy, but that doesn't change my reality. My body cannot sustain breast milk production and a pregnancy at once. I lost a baby while nursing my oldest then could not conceive again until I weaned him a half a year later. This time, my milk dried up as my pregnancy progressed.

But my reality is beautiful too. I have 3 growing boys that my body has cumulatively nurtured for 27 months inside and 30 months (so far) outside. I'm grateful for each of those days and the special bonds of pregnancy and breastfeeding I was able to experience.

On this last day of world breastfeeding week, while we celebrate the beauty of a mother's body continuing to sustain her infant outside of her body, remember to be kind because motherhood is hard enough without criticizing each other. Let's support each other instead. And remember that not everyone's reality is the same as yours. 

And truly, fed, nurtured, and loved is best. The face of best looks different because our stories are different. 

Tuesday, February 9, 2016

The Birth of Oliver

This pregnancy was tumultuous for me. I had a 2 year old in the throes of terrible two-ness and a 6 month old who was up many times at night and very clingy during the day. I felt overwhelmed often. Then one night my husband suggested I take a pregnancy test. I was defensive. I told him that there's no way I could be pregnant.  But he gently explained that he felt I had been hormonal and my craving Mexican food for dinner had him concerned. To indulge him, I rummaged around in my drawer and found an expired dollar tree test. It came up as a bright, bold, immediate positive. 

I panicked. I couldn't be pregnant. I didn't want to be. Sometimes I felt that I couldn't handle the 2 children I had and to add a pregnancy on top of it all...

This panic merged into fear and then, of course, a fair helping of guilt, the emotions mixing and rolling together for most of my pregnancy. I felt like I wasn't bonding well with this baby like I had with my other 2. I had less time to dream about him, doubted my ability to mother 3 littles so close together well, and on top of it all, feared labor and delivery. 

My last birth was a long mix of fighting the hospital staff on having interventions I didn't want and defending myself from assumptions they made about me as a result.  It was exhausting and unpleasant. While my OB is amazing and did come in a few times when she could, she didn't know the full story and could only do so much in the brief snippets she was able to be there. 

A few months before my due date, my sister, Emily, passed away.  We had planned for her to visit us the week after the baby was born.  Sadness, regret, and the many other things that come with grief compounded my already stormy feelings.

When my labor began at midnight on February 5th my emotions were at full tilt. I was determined to stay home about 5 hours. Apparently 12 hours without intervention is the hospital cut-off and my previous labors had both been a solid 17. My husband and I had agreed...less time there gave them less incentive to rush my labor.

In significant pain, we arrived at the hospital at 5 AM.  In triage, I was checked and excited to find out I was already 5 cm and 75% effaced, in -3 station. They monitored me as I expected for 2 hours. What I didn't expect was for my contractions to slowly become less painful then pretty much stop.  I figured it was lying in bed so I tried to move, sway, and walk as best I could with monitors attached. Nothing seemed to help pick up the contractions. Feeling defeated, I decided to rest.  I had been awake the entire night and knew that if labor did start back that day, I would need all of my strength. 

Ironically, my contractions picked up a little when I attempted to sleep (they had at home too). So, unable to sleep,  I spent some time on my phone looking for something to explain my labor stopping in the middle of active labor.  I found a reassuring article about labor patterns on spinning babies that said some labors can have a start and stop pattern. It encouraged Moms not to view this stop as "stalled labor" but as a natural rest for the uterus. 
 Progress had not necessarily stopped during this rest but some birth task that was not dilation-related such as engagement or fetal rotation may be occurring. It promised that the contractions should return strongly (kind of like picking up where we left off) and labor was likely to advance faster once they did. 

Waiting and keeping a positive attitude was hard as neither of my previous labors had followed the “start and stop” pattern but fit more under the “long and steady” category.  I wasn't surprised when I was rechecked and there was no change other than baby moving down a station. Of course the attending recommended pitocin. This is an intervention I am not interested in unless used as a last resort, so I refused.  I did agree to have my membranes stripped before going home. My husband and I left the hospital at 9 AM. 

We went to the mall to walk around to see if we could get labor moving again. We started looking for some shoes for my oldest son just so we had something to do. A few laps around the mall and my contractions picked up quite a bit. They came back in the manner the article I read had promised--as strong, if not stronger than before. The pain picked up quickly. I usually like walking through contractions but I found myself unable to do that after a while. I had to sit down during the peak of each of the contractions. My earlier intestinal upset came back along with intense nausea. I decided to cut the shopping trip short.

In the car, my contractions continued to become more and more painful. My husband was incredibly supportive and flexible. He went with whatever I said though my decisions were hardly clear.  In between contractions I would say that I was OK with going to a hotel or the house like we'd previously decided. However, during a contraction I would beg to go back to the hospital. In the end, we made a quick detour by the house for him to pick up a few things then we went straight to the hospital. I vomited three times by the time we got there. I was in a great deal of pain and vocalizing loudly in the privacy of our vehicle. I was already begging for an epidural. My husband was incredibly supportive, even while driving, finding bags and napkins when I threw up, rubbing my back, holding my hand and reminding me to breathe through the pain.

At noon, back at the hospital, they took one look at me and immediately admitted me to a room this time. On recheck I was 75% effaced but a loose 6 cm dilated and -1 station. The next few hours are a blur of trying to delay the epidural as long as possible, something I had previously planned.  I tried to make use of this time when I was completely mobile by rocking or getting on the floor, whatever my body compelled me to do during a contraction. My nurse had a completely natural delivery with her baby and she was very supportive of all of the things I asked for in my birth plan.  I remember when she read my plan, her only comment was “no problem… we can do all that. Easy.

I got my epidural around 2:30 PM.  I wanted to still be able to move my legs so that I could change positions on my own and to be able to feel my contractions.  It was perfect. The anesthesia only extended through my pelvis and quickly took the edge off of the maddening pain.  I was able to relax and enjoy the rest of the birth.  My contractions immediately picked up and by 3:30 PM, I was 8 cm and completely effaced.

My OB/GYN was not on call until the next morning but she came in for my delivery anyway. By 4:30 PM, when she checked me again, I was fully dilated with a little cervical lip. She said it was stretchy so I could do a few test pushes to see if his head would slide past.  I was a little nervous that my mom would miss the birth. She had been watching my older two boys and hadn't arrived yet. The test pushes didn’t work to move the lip though so we decided to wait in order to avoid potential tearing of my cervix. I moved onto my stomach to help the baby descend.  It was wonderful to be able to control my body’s position, something I was not able to do to this extent at my previous deliveries.

In less than 30 minutes, I started feeling the head move into the birth canal and called for my doctor. My mom arrived then, just in time. My OB asked again if I could feel my contractions and I reassured her that I could. She told me that timing would be up to me then and to let her know when I was having a contraction and was ready to push.  It felt good to have the lead and not have to be told what my body was doing or when to push.  Three contractions with about 3 pushes each and his head was born.

My doctor asked me if I wanted to catch the baby.  Of course I did! I'll never forget the feeling pulling him out of myself, feeling the pressure release and his body twist slightly as he slid out.  I lifted his slippery, bluish, screaming self to my chest, the grand finale of this birth changing and healing me. I wish I had a picture but I will never forget this moment, regardless.  I felt a rush of positive emotions replacing the swirl of negative ones I’d been feeling for months.

All the anxiety over him being unplanned and my being unable to handle it all or love him enough…fearing the birth and worrying about fighting the system along the way…it was all undone somehow and I just felt…empowered. My body felt strong and capable. I felt in control. My nurses, doctor and husband had been nothing but supportive.  It was the beginning of a new chapter and I knew somehow I could do it all because I loved this little wailing being with my whole heart, just like I loved his brothers.

Oliver Emil came earthside at 5:10 PM, squalling loudly, born into his mother's eager arms, the namesake of his aunt who had passed from this earth a few months too early to meet him.  His name symbolizes peace and healing.

Sunday, December 28, 2014

On Sleep Deprivation as a New Mommy of Two

Big brother loved his baby brother from the moment they met.
What were my first few weeks as a Mommy of two like? Well, they involved permanently bloodshot eyes, wild hair, and an inability to make coherent sentences. I feel like people passing me on my rare trips out of the house probably thought I looked like a druggie. These trips were very rare considering the fact that lifting the stroller or wearing my then 6-7 something pounder actually made my belly ache. It didn't help that it is flu season and my pediatrician mother and Facebook feed bombarded me with seemingly endless stories of sick babies.  I would wince every time I heard a sniffle or a sneeze, ready to bolt back home. (Speaking of which, is my throat a little sore or am I imagining it??)  Most times I was too tired to feel the need to leave the house anyway.

On our way home from the hospital.
My little one seemed intent on only sleeping during the day and my two year old refused to nap, making their schedules perfectly opposite (coincidence?  I think not ;). And in the middle of that somewhere my body was trying to recover from pregnancy and giving birth, not to mention spending an immense amount of energy on breastfeeding.  My emotions were spinning from shifting hormones combined with feeling an enormous amount of pressure to learn how to fill my new role as Mommy to two.  I was trying my best to ignore the fact that our house was in shambles around me.  I mostly just felt like there wasn't enough of me to go around in general. 

Adjusting to life with two littles is not easy. Sleep deprivation with one baby was hard but a newborn combined with a possibly jealous toddler who seemed to decide to become as difficult as possible the day you came home from the hospital? It was rough. 

I will be transparent with everyone. The sleep deprivation was real. Real to the point that I sometimes worried it was dangerous. Falling asleep holding the baby was my greatest fear. One that fed endless nightmares. Perhaps hormone changes and new mother protectiveness fed the nightmares too, but extreme sleep deprivation was the major culprit in my opinion. Exhaustion seems to lengthen that space in time between sleeping and waking. A space in which my body is awake but my brain is still dreaming. A hypnopompic state is the official term.

A rare moment of sleep... I can't help but stare.
In this state, nightmares become real. And I hallucinated.  My recurring hallucination in the weeks after we brought my youngest home centered around my recurring nightmare in which I fell asleep holding him. I woke up terrified that he had suffocated in my arms or next to me in the bed.  I have a stuffed dog I sleep with and I would wake up cradling him, terrified and frantic. I was convinced he was the baby and I would attempt to arouse him (unsuccessfully of course).  One night, my husband awoke too and heard me freaking out. He told me the baby was fine and that what I was holding wasn't the baby.  My nightmare felt so real that I argued back, angrily since he never even checked to see. "How do you know?!" I insisted before my brain slowly shook off the fog of sleep and I found my crying infant (which is what had awakened me in the first place) safe in his bassinet.

I love walks with my boys!
Thankfully, this low point passed as Coen's sleep stretched out from one hour (yes, he only slept an hour at a time many nights!) to now sometimes as much as 3 and a half hour windows.  The holidays were also nice because having family here meant naps for me and help with the kids and daily tasks.  My body has healed a lot in the past month as well.  But, most importantly, my toddler seems to have adjusted back to his normal sweet self that sleeps and eats and isn't a holy terror all day.  

My precious angel.  
Don't get me wrong though! I'm so grateful for my beautiful healthy children and supportive family. I don't know how I'd have survived without my husband giving me naps and pep talks those early weeks. I've done a lot of cuddling and breathing in that precious newborn scent. I know that these days of tinyhood are all too few and I'm soaking them up much more intensely this time around.

We are finding our balance and a new normal now. And, today, after snuggling down with my 2 year old for his bedtime song and cuddling my almost 5 week old who passed out at my breast, I breathe in his sweet milky scent and can't help but think, "this is heaven."

There is no one I would rather be than these boys' Mommy. I'm blessed beyond words. Now, it's off to bed before my sleep window closes and the fun/chaos starts all over again!

Friday, December 19, 2014

My Second Birth Story

Let me start by saying, I'm pretty much as unlikely a candidate to choose a home birth as they come but after my delivery this time and fighting pushy nurses and doctors for hours while in labor, I can see why some mothers choose that route. I had the delivery I wanted but it took a lot of standing up for myself and my (reasonable and educated) desires.  If it weren't for my medical training, I might have given into some of the bullying and had a very different outcome.

So to my story... The Tuesday before Thanksgiving was my ideal day for our second little guy to arrive. My doctor was on call and my best friend was staying with us so she could to watch my 2 year old son.  In hopes of convincing the little guy to come that day, I had my membranes stripped Monday afternoon.  My husband was able to be there and took me walking afterward.  (I am convinced this is key for stripping to work.)  My Captain husband went Army on me and we walked a lot.  First all around the hospital (about 2 miles) then, after dinner, every inch of our neighborhood.  My back and pelvis ached by the end of it (not unusual at this point in my pregnancy).

39 weeks and after a lot of walking
My best friend and her husband came over that night and we stayed up until about midnight. I never went to bed because I began having contractions 2-3 minutes apart. I was excited that they were so close together since I'd heard that second babies come faster. Thankfully, I had no idea this statistic did not apply to me. 

I told the hubby to sleep a little.  I laid down for maybe 2 minutes then paced and packed.  I woke him up at 1:30AM. We walked some more but the contractions were getting more intense so, for fear of waiting too long (my OB had strongly recommended I not stay at home as long as I did with my first delivery if I wanted an epidural), we headed to the hospital around 3AM, leaving my son asleep in his bed with my friends watching the monitor. (Best scenario ever! I had spent so much time worrying over having to drop him off somewhere in the middle of the night.)

On the drive is when it got a little weird. Walking kept my contractions at 2-3 minutes; sitting they slipped to 4-6. Still hospital worthy according to my OB but I worried about them spacing out more and stopping.  I was ready at this point and my mom was already on her way. We stopped and walked two more times in random parking lots just in case.  Besides, I like to walk when I'm in labor. Everything inside me is antsy and pushes me to keep moving.

At the hospital, they hooked me up to the monitors and confirmed that my contractions were strong and regular.  They insisted I lay in bed to be monitored for 2 hours before I could follow the "intermittent monitoring" order my OB had written on the chart.  (This was her promise that I would be allowed to walk so that I wouldn't wait so long to come to the hospital.)

Things went a little differently after those two hours than I had pictured.  Two different residents checked me 2 hours apart and both said I was 3cm dilated (one told us "3, almost 4" but must have reported 3 to the attending).  First, I was disappointed that I was only 3 or 4cm dilated because I had been 5cm with my first son at this level of pain and intensity of contractions (which is when I decided to go to the hospital with him too), but the biggest disappointment came from the medical team.  Based on "no change" in my cervix, it was decided somehow that I wasn't in labor (huh?!) and that they would send me home.  Now here's the kicker... a nurse told me that I would be sent home unless I agreed to have them start a Pitocin drip.

(I need to take a moment to say that Pitocin is a topic I will blog about one of these days because I feel very strongly about it.  Studies are there saying that Pitocin is very overused and associated with significant risk and that it should only be used when medically necessary. Yet the overuse continues and I've heard so many stories of less than ideal outcomes... But this is too big a topic to do justice to it here, so stay tuned for more on this later.)

I refused both the Pitocin and going home after listening to the attending physician monologue about how cervical checks are very subjective (he actually compared it to reaching into a wet sock) but never once checked me himself.  He also based his reasoning that I wasn't in active labor on the fact that I was talking to him (between contractions, hello!) and that I didn't "look in pain enough."  He never addressed our concerns about the obvious contractions on the monitor (that had been at less than 5 minutes apart for 5 hours at this point) or listened to my husband and mom say that I am in pain even if I don't fit his stereotype of pain reactions.  Nor did he give any credence to the fact that I had been in labor before and knew what it felt like (and he hadn't and couldn't! though I held back from saying this to him).

You can imagine how furious that man made me.

Perhaps I would have believed him that I wasn't in labor if this was my first child.  And perhaps I would've agreed to Pitocin if I was post-term or if I had much less knowledge on the subject but to me, his approach was all wrong.  If I wasn't in labor (which I knew I was), starting Pitocin = induction, something I didn't want unless absolutely necessary (because of the risks).  And if I was in labor, the monitor clearly showed strong, regular contractions and I didn't need a drug meant to induce contractions.  As long as the baby is happy, there is no time table, within reason and when membranes are intact, for the baby to be born once contractions start.

My doctor came and saved the day (thank goodness!) not too long afterward.  She checked me and declared that I was 4cm dilated and had been 2cm the evening before in her office and that although slow that was progress.  She stripped my membranes again and things really took off.  I was ready for an epidural (because of how much my pain increased) at 5cm not too long after that.

My nurse (a new one and a great one!) was surprised when I asked for the epidural.  Somehow, without ever being asked, it was decided that I didn't want an epidural.  In fact, she seemed concerned that I wanted to go home (what?! They were the ones trying to send me away! Hand-over between the night nurse and day nurse obviously failed).  She also thought I had not had regular prenatal care and was therefore missing lab work that was required in order to receive an epidural.  Thankfully, all of that was cleared up fairly quickly and after a quick refusal of the resident anesthesiologist, the attending gave me a perfect epidural.

Interestingly, the epidural revved up my contractions even more (the opposite of my last delivery).  Eventually, my doctor said I was completely dilated, and my nurse told me to let her know when it was "baby time."  I did and she called for my doctor and told me she'd be there in 5 minutes.  I remember saying "that is way too long! It's baby time!"  He was about to be born.  I convinced the nurse to check me just in case and after that, she somehow quickly procured my doctor.  I have video after my son was born and you can hear the nurse telling my OB "I didn't know she was THAT close." ;)

 And, long story short, after nearly 18 hours of labor (more than with my first son!), my healthy, squalling, beautiful 6lb 13oz son was born with just 2 pushes and no tears. The bed was never disassembled into stirrups (there wasn't time) so he was within my reach (and view) the whole time and came straight to my arms.  He nursed a few minutes later and I held him skin to skin until I couldn't handle not knowing his weight any longer.

The beginning was long but the ending was perfect.

 I could've done without the battling in between but otherwise, I wouldn't have had it any other way.