Get Out While You Can

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Update – Several of you have inquired about the outcome of my OB visit.  First off, thank you for your concern.  A few of you had ideas, suggestions, etc. as to what may be causing my problem.  I appreciate the support, and am once again reminded that yes, I should be as open and honest as possible in my little corner here. 

The good news is that my ultrasound came back normal.  If “things” don’t completely stop soon (I’m attempting not to gross anyone out this post), then I will be put on the pill for a couple months to force my body into a cycle.  It was a huge relief to know there is no need for some kind of procedure, which would only further prolong my already slow recovery.

Enough about that…

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So in the last two weeks I have been able to go out with my husband not once, but twice for dinner.  No, don’t rush over that sentence.  Okay, in case you missed it, I have spent time alone with my husband outside of our home TWO times in the last TWO weeks.  Prior to this, the last time we’d spent any time together sans child was way back in November 2010. 

There are several reasons for this, the main one being we were living on location while Vinny worked, away from family and friends, and I am paranoid beyond belief about having someone I do not personally know well watch our child (now children).

And now, as I continue to breastfeed our second child and avoid my breast pump as much as possible (I can’t help it, I know it “buys” me freedom, but I hate pumping), we are once again reduced to life revolving around my boobs and Sophie’s feeding schedule.  Mind you, I say this with no irritation or ill-will.  It’s my choice to do this, my preference, and in the grand scheme of things, committing a year of my life to feeding her is a blip on the radar.  It flies by. 

All this being said, would I like to “get away?”  Would I like to spend time just with Vinny on occasion?  Hell yes.

Thankfully, this is starting to happen (a rather huge perk to our cross-country move).  We enjoyed an evening out courtesy of my parents, and then a little more than a week later (and 200+ miles away) an evening out with Vinny’s sisters and their husbands, courtesy of his parents.

You’d think I would be totally and completely thrilled to have this time away.  And mostly, I am.  But I do find myself lingering between wanting the time away and then feeling like I am going to miss something while I’m gone.  Evenings are toughest.  Although it is the most draining part of the day, it is also my favorite time of day with the kids.  I love the last bit of cuddling in the evenings: rocking Sophie to sleep, reading Eli a couple bedtime stories. 

Knowing that Sophie is our last, there is part of me that doesn’t want to miss a moment.  She is growing and changing so quickly.  Then there is Eli.  He is so much fun each and every day.  I love this age with him, and know that I will look back on this period with longing when he is older.

Of course we all need a break from the wee ones now and again.  But I never anticipated leaving them with so much reluctance, even for a short two-hour break. 

In the end, the time away always does me good.  I feel recharged, refreshed, and thankful for adult conversation.  The car ride to and from is always quiet, and man, does it ever feel peaceful.  It reminds me of how much I love (and miss) spending time just with Vinny. 

Now that we know we have occasional babysitters, we are plotting for the days when Sophie is off the boob and we could escape, er, leave for an entire day (or more? Dare we wish for such a thing?). 

As good as it feels to get away and spend some quality time together, there is always such a rush of happiness when I see the kids upon our return.  Cliches tend to originate in some grain of truth, and as much as they tend to annoy me I have to admit some of them have taken on more depth for me as time passes.  What is that saying?  Absence make the heart…?  Just kidding, I know how it goes, and so do you.

To Doula or Not To Doula?

If you’re like most people, your first thought is probably: what is a doula?  A doula (pronounced doo-luh) is, in the most basic sense, a labor assistant (read more here).  I had never heard the term until a friend of mine used a doula nearly six years ago for her first labor and delivery.  I thought it a strange word at a time, and the concept itself seemed rather foreign as well.

When I was pregnant with Eli it didn’t occur to me to hire a doula.  A couple friends recommended it, but I figured, “well, my body is going to do this the way it’s going to do this, how would having someone I barely know there with me be of any help?”  Again, a naïve sentiment, but only in hindsight.  And only because my labor and delivery with Eli didn’t go well.  Had it gone well I probably wouldn’t have considered the idea this time around, either.

But here we are.

Initially I had an interest in hiring a doula because I knew I was going to be delivering at a hospital that is: 1) not very labor friendly in general, and 2) was not going to be supportive in the least of my attempt at having a VBAC.  I felt like having a doula on my side, helping to coach me along, would help to offset some of the anxiety I was feeling about my less-than-ideal birth location.

Why didn’t I just switch care providers/hospitals?  Long story short my husband, son and I had temporarily re-located to Michigan for seven months as my husband had work there.  I knew we’d be returning late in my pregnancy (34 weeks) and I love my OB in L.A., who had said from the get-go he would be supportive of my VBAC attempt.

Well, we’d barely been back in L.A. two weeks when our well-laid plans began to crumble.  My OB started telling me that I couldn’t say VBAC at the hospital and that we were at least going to have to schedule my c-section to make it look like we were “playing by the rules” (the hospital, for reasons I do not understand, had deemed me a mandatory repeat c-section). 

Then the avalanche of negative feedback kicked in.  How reviled is this hospital?  The first doula we interviewed refuses to attend births there because they are so labor unfriendly, but was willing to make an exception as a favor to a good friend of mine.  Then, three days later, at my first chiropractic appointment here in L.A., the chiropractor asked me why I decided to deliver at that hospital. 

“I really like my OB, and it’s where our insurance covers us,” was my reply.

“Well, your insurance also covers you delivering at X, Y, and Z hospitals,” he responded.  “How badly do you want a VBAC?”

I didn’t have to think long.  “Very badly.”

“I hate to tell you this, but you’re at the worst hospital in L.A. for what you’re trying to do.”

I couldn’t ignore the growing pit of anxiety in my stomach.  It felt so late in the game to make a switch this major.

Two days later I switched OBs and hospitals.  The following day I learned that my original OB threw out his hip and was going to require surgery and would be out for 6-8 weeks, minimum.  In other words, I would have had to switch OBs anyways.

The decision felt right.

The hospital I am now delivering at has midwives on staff 24-hours a day.  I decided this would suffice as support, that I would simply call a midwife in if I was struggling, or if this baby happened to be asynclitic as well. 

The reassurance that the hospital was now behind my decision to attempt a VBAC meant my anxiety levels came down, a lot.

I decided I didn’t need a doula anymore.

Well, for about a week.  Then I began to realize that while yes, my anxiety levels had dropped and I felt better about the environment I would be delivering in, I still was having some serious self-doubt about my ability to deliver this baby without medication (not an absolute requirement, but strongly recommended when attempting a VBAC). 

I wanted someone there with me that had been through this before, that could suggest techniques, reassure me in my moments of waning confidence, and generally offer guidance.

Doulas are a varied bunch.  There is a wide range of experience.  Some doulas specialize in massage or hypnobirthing or acupressure or… 

After speaking with a couple doulas, I found one close to my age, Gracie Davis.  She isn’t the most experienced doula I spoke with, but she had a c-section with her first and a VBAC with her second.  She immediately understood where my self-doubts were coming from, and having someone that “got it” suddenly became the most crucial form of “experience” in my book.  Her demeanor is so calming.  She has already worked hard to familiarize herself with my previous birth experience, my concerns, and my hopes for this upcoming birth.  We’ve talked about how she’ll communicate with me, what she’ll suggest, and how she should interpret my responses to her. 

I never imagined I would “need” so much extra assistance to get through this process.  Sometimes I feel like I should be able to buck up and just do the damn thing.  But knowing that had I been better educated AND had a doula last time that my labor and delivery experience may have gone differently … well, I want to know I did everything this time around, for the baby and for myself.

To VBAC Or Not To VBAC

Sometimes it can't be avoided: serious topics. And I'm struggling to find much humor in this one.

At my last OB visit, my OB-of-the-day (there are four in the practice) wanted to talk about my upcoming labor and delivery.

An aside: this is my temporary OB as we have re-located for my husband's job … we are supposed to be back in L.A. before babe #2 makes her appearance. And a little refresher: Eli was born via c-section due to an abruption. There was also an issue of my pelvis "not opening," or so I was told, so I was also labeled as “failure to progress.”

At the visit, my OB told me that since my pelvis didn't "open" last time there isn't much chance of it doing so this go-round, and that I should seriously consider having a scheduled c-section.

I listened to her reasons and came home. My OB back in L.A. has told me I'm not the best candidate for a VBAC (vaginal birth after cesarean), but in previous visits, told me he would at least let me try.

As the hours after my appointment passed I found myself becoming more upset and emotional. I do not want another c-section if it can at all be avoided. I realize if it's scheduled, meaning: if I don't have the 20+ hours of labor, the abruption and THEN the c-section that my recovery will, in fact, be better. But it will still involve a surgical procedure and me being stuck in bed the first day attached to a catheter and those funky inflating leg warmers to ward off blood clots. I won't be able to immediately bond with or breastfeed my baby. I won't be able to hold her. This is devastating to me, again. Then there are the risks of having a c-section in the first place, and those do not diminish for repeat c-sections.

What I kept wondering was: Why are my healthcare providers so convinced my body isn't capable of doing this?

I went online and decided to do some research.

I posted a thread on Mothering.com (home of Mothering magazine). I know this particular crowd is pro-VBAC, homebirth, midwife, natural birth, etc., and I figured if there was an audience that would encourage and support me in my endeavor to have a VBAC this would be the place.

I laid out my birth experience and asked if any women had had a similar pelvis issue and gone on to have a successful VBAC.

It's worth noting that Eli was asynclitic before I went into labor, meaning he was head down, but slanted off to the side a bit. He was like that for several weeks before he was born, didn't flip for the longest time and was actually quite lodged in there. It was for this reason he was born with torticollis and plagiocephally (an issue with neck muscles; he also had a flat spot on his head). Well, come to find out his position was most likely responsible for my unyielding pelvis, as this is a common “side effect” of having an asynclitic baby. It's amazing what you can learn in an afternoon.

I dilated to a nine during my labor. Were it not for the abruption and had I been handling the sciatic pain (due to his asynclitic position) better, basically, if I had had more time (and no epidural), it's tough to say whether or not he could have been born naturally.

What I do know, after my frenzied research period, is that there are things I can do before I go into labor and even after I do, to encourage an optimal birth position for the baby and to prep my pelvic floor. I can visit a chiropractor, continue my yoga, hire a doula to assist me during labor with stretches and positioning to encourage the baby to move into a good position. Most of all, I will do whatever I can to avoid getting an epidural, as that hindered my ability to move around, thus ending any hope of assisting the opening of my pelvis.

These are all things I didn't know during my first labor, but none of them are absolutes. This baby may not be asynclitic. My pelvis may open if she is in the proper position. Will I have another abruption? There is no way to know. It is the one factor I cannot prepare for and the one big risk I will be taking in attempting a VBAC. Because I have already had one, statistically I am at greater risk of having another. That is frightening. Will it keep me from attempting a VBAC? I don't think so.

The point I’m trying to get at here is that if I only listened to my healthcare providers I would continue to believe that my body isn't "right," that it isn't capable of delivering a baby without surgery. In my heart I do not believe this. I was almost there last time. Had I been better educated (and supported) perhaps things could have turned out differently. That's the beauty of hindsight, and it means I will be better prepared this time.

I would like to think I've moved past my c-section. In most ways I have. All I have to do is look at Eli, at what a beautiful, smart, sweet boy he is, and I know the c-section, in that instance, was the right thing to do, it is what needed to be done to insure the safety of both of us. My problem is that without getting into the next labor, seeing how the conditions play out, I can't say with any certainty it would be the way to go next time.

Sure, if we get a few hours in and some of the same hurdles present themselves and we are not getting around them, well, I wouldn't hesitate to get the c-section. But if I can try and birth my daughter naturally, hold her, feed her, walk around with her on the same day she is born, well, that makes me tear up just thinking about it.

All I can say is be your own advocate. If you don't like what you're being told, do your own research and seek out the experiences of other women. Obtain and read your medical records. I guarantee they will tell you things about your medical history you did not know.

Ultimately, as was the case during my first labor, some conditions and issues cannot be prepared for and if that is the case, I will do what is best for the health of the baby. At the end of the day that is all that matters. But it doesn’t mean I don’t deserve a choice or a say in how my next birthing experience unfolds. I will prepare myself and hope for the best. It is all I can do; it is what I have to do.

An End, And Beginning

It's been exactly four weeks since I stopped breastfeeding Eli. I was hoping some distance from the event would give me some shiny conclusion, a pearl of wisdom to share, something meaningful to say.

That hasn't happened, exactly. We stopped and there hasn't been much looking back. Between my participation in National Novel Writing Month during November, which took every spare second I had (and yes, I made my 50,000 word goal and will continue to work on this novel), and Eli's seemingly-daily-increase of energy, well, there hasn't been much time for reflection. What I do have is my experience on that final day.

Here is what I wrote in my journal the day the milk ran dry…


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11/8/10
Today has been an emotional day. First off, it was Eli's final day of breastfeeding. He has been down to one feeding, first thing in the morning, and it is the one feeding he has been resistant to give up so I've been taking my time with him. But today there was nothing left. The boob juice was gone. He sat up and looked at me, confused. When I realized what was happening and what it meant I felt conflicted. Was I really done breastfeeding? I had made it just over a year, a huge accomplishment for me. But was this it?

It was a bittersweet moment. When I look at Eli I know I will miss the connection we've shared for so long, but at the same time I swell with pride when I see what a little man he is becoming, how much he has grown and changed, how he is becoming more independent each day.

The combination of this event, coupled with all these disparate thoughts and feelings, started me off on shaky ground for the day. Barely an hour later we were at my OB's office for our "big ultrasound," where we also opted to find out the sex of the baby. I initially thought girl when I first became pregnant, but then for several weeks had no inkling one way or the other. Then in the last week or two my husband and I had convinced ourselves this babe was a boy.

There was an immediate crotch shot during the ultrasound and I swear I saw some junk floating around in there. The tech didn't say anything but in my head I thought I knew. So it was a rather big shock to hear her announce a couple minutes later: "It's a girl!"

My response? I asked in disbelief, "Really?" Then my eyes filled with tears.

Of course the tech thought I was moved because I was going to have a little girl to buy frilly dresses for and to take doll shopping. She immediately started telling us about taking her daughter to the American Girl doll store. This is not my idea of a good time, by the way.

No, I'm not sure where the tears came from, other than the joy of feeling like I now knew my baby just a little better, felt a greater connection to this little person squirming around in there. Perhaps it was the knowledge that while one connection was ending on this day, another was beginning.

It was strange for me to feel so emotional over this news. The circumstances had been different with Eli. I was going to acupuncture during my first pregnancy and ten weeks in my acupuncturist asked if we were planning on finding out the sex of the baby. I said yes. "Well," she said, "I can tell you right now if you want to know."

Well of course I wanted to know so I found out. No one believed she could know such things, but my husband and I had already suspected we were having a boy, and Cristina only confirmed it. So while we were excited for our "big ultrasound" for Eli, it was really just a safety check, and then a confirmation of something we already knew.

This time around it was a true surprise.

I spent the rest of today wearing a silly grin one minute and then teary-eyed the next. I would look at Eli, imagine him with his baby sister, and feel my heart swell. In many ways, it is probably the best possible day for us to stop breastfeeding, a day when there is other happy news to focus on, to distract us from what could otherwise be a sad and/or traumatic day.

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Four weeks later we all move forward, Eli drinking whole milk like a monster (he loves it, thank goodness). I am thankful for a smooth transition, not one clouded with doubt about whether I did things the right way. Eli never seemed upset that he was no longer breastfeeding, never tugged at me. It's like we both knew: This time is over. It's time to move on.

Mostly, I am thankful that we made it. Breastfeeding for one full year was always my goal and so many times, especially in the early days, it seemed unattainable. By the time we finished it felt second nature, natural, like there couldn't be anything more normal in the entire world. I never thought any of these statements would come out of my mouth (or fingers) so that feels like true progress. It also feels like a wonderful way to move forward in preparation for our next babe, who will have a much more assured mother waiting for her.

This Milk Machine is closed, for a little while ;)

The No-Plan Plan

(or, why things got off to such a rough start)

I'll be the first to admit that I was (and still am) anti-birth plan. I downloaded a copy of a birth plan template from thebump.com, and was rather overwhelmed to see it was six pages long. This isn't to say you shouldn't give your upcoming birth some time and consideration. It's crucial to educate yourself and know what could/should & likely will happen.

However, my experience in life is that any time you try to plan for an event, and put all of your hopes into the said event going a very specific way, your plans will be foiled. I have never known any major life event to go perfectly, ever.

I figured birth would fall into this category as well. Why force parameters onto something you have no control over? So instead of compiling a birth plan, I put together a brief list of "preferences" for my OB. Such as: I would prefer not to have any pain relief. I would prefer to move about as needed/possible. The list was brief: eight preferences. When I showed it to my OB, he pulled out a ruler and measured the page. "What is this?" he exclaimed. "Four inches? It's the shortest birth plan ever!"

It felt good to not expect my birth to go a particular way.

Well, readers, let me tell you that while in some ways I had amply prepared myself for the process of birth (and in my mind, by extension, breastfeeding), in a few key ways I did not.

MISTAKE #1
I assumed I wouldn't have a c-section.

Why did I do this? Well, my pregnancy was "normal," and up until days before Eli's birth there were no inclinations that I would have any complications. Even then, the issue at hand was that my pelvis was not opening. My OB assured me that in most instances this became a non-issue once the woman began to dilate. A tiny red flag went up somewhere in the deep recesses of my mind, but I chose to ignore it. I shouldn't have.

You see, in the few pregnancy books I did read, I always skipped over the c-section chapters. I wasn't going to have one, they freaked me out, why scare myself even more by reading about them?

MISTAKE #2
I assumed that breastfeeding would proceed without a hitch (yes, I can be a naïve idiot).

How the scenario played out in my mind: I would naturally birth my son, he would be placed onto my stomach, and minutes later he would breastfeed for the first time, thus completing one of the oldest, most natural scenes in all of history.

Remember Mistake #1?

I ended up having an emergency c-section after twenty hours of labor. When I emerged from recovery I found myself in a drugged-up, stupefied state. By the time Eli was wheeled in for our first true introduction, he'd already been introduced to the bottle and formula. This hadn't been my "preference," but I hardly felt in a state to disagree. I could barely move, how was I supposed to breastfeed?

MISTAKE #3
Not having a breastfeeding plan.

Sure, there's tons of talk about birth plans and what will happen during delivery given factors A, B, or C. But I had given no thought about what I would do, what support systems I would lean on, if and when breastfeeding became a harrowing challenge, which it did almost immediately.

On day three post-partum, after asking the nurses several times, the hospital's lactation consultant finally paid me a visit. At this point I was becoming discouraged from the entire enterprise, and the blisters on my right nipple had me wincing each time Eli was forced onto my breast to "try again." Maybe this wasn't going to work?

Thankfully, the LC had a soothing demeanor, and offered some useful tips and suggestions. Of course, one of those suggestions was that we not feed the baby any more formula. At all. Considering all the problems I was having getting the baby to latch on, this didn't seem realistic, but I became determined that dammit, the baby wasn't going to have any more supplemental formula.

MISTAKE #4
Failing to be flexible.

Once I decided Eli wasn't going to have any more formula, I became hell-bent on that goal. And for nearly two days (the last day at the hospital and the first day home) he was an entirely breastfed baby and I felt like I had somehow overcome the worst of it. I was doing this!

That is, until I wasn't. Until Eli wouldn't latch on, again. Until he wasn't eating sufficiently. Until I was so sleep-deprived that I caved in, sobbing to my husband, "Just give him some formula." I felt so defeated. I felt like I had failed. I felt like a terrible mother, poorly equipped to nourish my son.

In reality, I had underestimated the toll labor and delivery would take, as well as the effects of ping-ponging hormones raging through my body. In the days after birth the highs and lows came with alarming force and with small passages of time between each extreme.

I needed to cut myself some slack.

I made a couple calls to close friends and to my acupuncturist (who had recently given birth to her second child & is always a source of wisdom for me). It was from these conversations that I began to learn that breastfeeding rarely comes "naturally" to anyone. It's a taxing process, one that takes practice, patience, and gentleness towards oneself. Having a meltdown each time we needed to supplement with formula, until we could get things on track, wasn't going to do anyone any good whatsoever.

I began to wonder why, in all the excitement of pregnancy, in all the talks with friends about pregnancy-related ailments, discomforts, joys, and fears, we had never talked about breastfeeding?

That's why I’m here. I'm here to share my challenges, my triumphs, my frustrations, and perhaps most importantly, my mis-steps. I find myself struggling, at odds with what I think is best for Eli, and what is best for me. There are feelings of guilt and selfishness. So far, I have managed to persevere. I am ten weeks in and still breastfeeding. For me, this is an enormous victory.

I want to talk about breastfeeding (and motherhood) with openness and honesty, and because it is in my nature, with humor. This is a place for sharing, with no judgments handed out when the goals, tactics, and ideas of others differ from my own.

My one breastfeeding goal from the earliest stages of pregnancy was to breastfeed Eli for a year. We'll see if I get there, but if I don't, I will back up and remind myself of that "gentleness towards oneself" bit.