What a Difference a Year Makes

Many of you know that I had a miscarriage about this time last year. It was a painful emotional experience, and one that is unfortunately incredibly common (based on statistics and from several women I know, especially among women over 30 who have been on hormonal birth control for a long period of time). One of the things that got Jason and I through that tough time was the knowledge that we could have a baby in our arms in a year. Little did we know that would be such a literal prediction!

I’ve been doing some processing of the pregnancy and birth experience, and wanted to share some thoughts, answer some “FAQs,” and offer some advice for those of you who are embarking upon the same journey. Fair warning: if you know me you know that I either go all out or don't do it at all. This is a long post.

Be positive. Our OB was unfailingly confident that we would be able to conceive again and have a normal pregnancy, and she was right. Miscarriages are common, but conceiving and having a normal pregnancy is even more common. Same goes for all those screens once you’re pregnant – they can be nerve wracking but freaking yourself out in advance isn’t going to help.

Get in touch with your body. I think Taking Charge of Your Fertility by Toni Weschler should be required reading for all women, whether you are trying to get pregnant or not. You don’t actually have to do all the temperature recording and stretchy mucous stuff, but it’s good to know how your body works all the same.

Be true to yourself and what you want for your pregnancy, birth, and afterwards. If you don’t know what your preferences are (I sure didn't at first), do some research. Talk to other moms about their childbirth experiences. Read. Surf the web. Take childbirth classes – perhaps more than one. Here are some references that we used:

General Pregnancy:

• www.babycenter.com - great weekly email updates that compare your baby’s size to various fruits and vegetables (“your baby is the size of a large rutabaga this week!”)
• Mayo Clinic Guide to a Healthy Pregnancy – good all-around pregnancy reference. I heard too many bad reviews of “What to Expect” so I never touched it.
• 40 Weeks +: The Essential Pregnancy Organizer – we took this to all of our prenatal appointments to record questions, notes in classes, etc.
• Baby Bargains, 8th Edition: Secrets to Saving 20% to 50% on Baby Furniture, Gear, Clothes, Toys, Maternity Wear and Much, Much More! by Denise Fields – this is a fantastic reference once you venture into the completely overwhelming world of baby stuff

Birth Preparation:

• Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block – excellent journalistic account of the modern birth “industry”
• Bountiful, Beautiful, Blissful: Experience the Natural Power of Pregnancy and Birth with Kundalini Yoga and Meditation by Gurmukh Kaur Khalsa. Gurmukh is a yoga celebrity yoga guru, but this book is actually quite nice. Quick digestible tidbits for throughout pregnancy and labor. And Cindy Crawford did the introduction!
• Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation by Pam England and Rob Horowitz. A little goofy, but it did have some good visualization tips and pain management planning for natural childbirth.
• The Birth Partner, Third Edition: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions by Penny Simkin. This was Jason’s reference, he read it on subsequent trips to DC for work. I personally think he did it to be a chick magnet on the plane…
• The Business of Being Born – documentary about natural childbirth/home births. Not for the squeamish. Kudos to Jason for watching Ricki Lake give birth in a tub…

Work/Life Balance:

• Creating a Life: Professional Women and the Quest for Children by Sylvia Ann Hewlett – insightful research about women with high-powered careers and how their plans for having a family are often sacrificed along the way

Baby books:

• Baby 411, 4th Edition: Clear Answers & Smart Advice For Your Baby's First Year by Denise Fields and Ari Brown – awesome reference for all things baby. We have pretty much read this constantly since Grace was born. And Ari Brown is a practicing pediatrician in Austin!
• The Baby Book: Everything You Need to Know About Your Baby from Birth to Age Two by William and Martha Sears – the attachment parenting bible. Probably more complete but not as user-friendly as Baby 411.
• Touchpoints: Birth to 3: Your Child’s Emotional and Behavioral Development by T. Berry Brazelton. Brazelton is a famous child name in child development – if you want to read up on the developmental milestones this is a good reference.
• Operating Instructions: A Journal of My Son's First Year by Anne Lamott. Lamott is a terrific writer of all sorts of nonfiction. This is a narrative account of her first year as a single parent of a demanding baby with colic – I thought it was a terrific introduction to how hard, crazy and wonderful parenting can be.

Classes: we probably overdid it, but I did appreciate attending classes that had different angles and perspectives. We took:

• Childbirth classes (“Lamaze”) through our OB office: 6 hours. Surprisingly good – helpful overview of birth process and pros/cons of various medical interventions
• Yoga for Labor and Delivery workshop at YogaYoga with Alice Duffy: 3 hours. Highly recommend to anyone who lives in Austin. Alice is a great teacher and this class gives you tangible skills/poses for labor.
• Childbirth preparation with our doula, Summer Greenlees: 8 hours. More on the benefits of a doula below.
• Breastfeeding class: 3 hours. Arguably the most useful class we took. As Jason remarked, “learning how to feed your baby is pretty important.”
• Baby care basics class: 2 hours. Overview of diaper changing/swaddling/bathing/etc. OK, but you could probably find UTube videos that would provide you with the same information. As Jason scrawled on a note during this class: “$40 for a video and to practice putting a diaper on a doll?!”

Find a health care provider who is a good fit for your preferences. Once you know what you want for your birth, make sure that your health care provider will honor and respect those preferences. I really can’t stress this enough. Ask them open-ended questions at your appointments (e.g. “Under what circumstances do you induce first-time moms? What positions can I give birth in? How often will the fetal monitoring occur and can I walk around during it?”). If you don’t like the answers to the questions you’re asking, shop around.

In Austin, there are basically three options for giving birth: 1) hospital, 2) birthing center, and 3) home birth. While hospital births are overwhelmingly the most common option (something like 95% of all births), many people have strong preferences for the other two options. You can do a tub birth at the birthing center or at home (hospitals rarely allow this), and midwives are in general more supportive and comfortable with natural birth. On the downside, if you or the baby has any serious complications you would have to be transferred to a hospital. Also, you only stay at the birthing center for 4-5 hours after the birth compared to a couple nights at the hospital with lots of people to ask questions of. Some hospitals do allow midwives to attend hospital births.

If you’re the type of person who is uncomfortable in hospitals in general, you might want to consider other options. I, on the other hand, have always been pretty at ease in the hospital setting (dating back to volunteering in the ER during high school, I guess?). And maybe I just like being taken care of, but I really appreciated the few days of room service and tlc in the hospital afterwards.

Stay active. Other than genetics, which you don’t have any control over, I think this is probably the way in which you most influence your birth outcome. I highly, highly, highly recommend finding a prenatal yoga class, even if you haven’t done yoga beforehand. It really helps with all the aches and pains, and can be a great way to connect with other pregnant mamas. Shiva Rea’s Prenatal Yoga video is also good. My main cardiovascular exercise during pregnancy was swimming and walking (lucky for me Austin’s climate allows for year-round outdoor swimming). Do your Kegels religiously. And get an exercise ball. It was the only thing I was comfortable watching tv on during the last month. I also used it a fair amount during labor.

Have fun and pamper yourself. We did “Monday Movie Nights” during my first trimester in the summer when it was too hot to do much else. Regular massage therapy (with someone trained in prenatal massage) really helped keep my sciatic and back pain at bay during pregnancy. And at the end of the pregnancy (especially during those last two excruciating weeks), I did whatever I could to relieve boredom and anxiety and to try to get the baby moving. This included two sessions of acupuncture (interesting and relaxing, but can’t say it worked for induction purposes), getting a pedicure, eating out at any restaurant I was having a craving for that day, watching Olympic curling, catching up on Oscar nominated movies, and reading Twilight and New Moon (which I loved... I’m currently waiting on a 10-year old to finish Eclipse so I can read that next). OK, so I’m good at pampering myself!!!

Write a birth plan. This is the next step to complete after you’ve figured out all of your preferences. Keep it short and simple. Although I had heard stories that birth plans don’t always get read by the hospital staff, I was pleasantly surprised that our doctor and the nurses were in tune with our preferences and stuck to our plan during and after birth.

Don’t have any expectations that your labor will go according to your birth plan. The above being said, I think the danger of creating a birth plan is that you rigidly set in your mind a vision of how your birth will occur. And if there’s one thing I’ve learned through our experience as well as several other women I know who gave birth around the same time, it’s that there is definitely a Murphy’s law of labor and delivery – whatever you plan for won’t be what will happen. I was progressing a month before my due date and my doctor thought for certain that I would go into labor early, but I ended up being two weeks late. Other babies come much earlier than expected. Planned inductions can fail. Emergency c-sections happen. So know what you want, but also be prepared to be flexible and to weigh your options when things don’t turn out the way you expected.

If you want to go natural, hire a doula. I could not have made it through a natural birth without a doula (birth coach/assistant), especially as a first-time mom. Let me repeat with emphasis. There is no way in hell that I could have had a natural birth without a doula. Doulas aren’t medically trained, they serve as support for both the mom and dad during birth. We hired Summer Greenlees as our doula and she was exceptional. Different doulas have different strengths. Summer is a licensed massage therapist (the one I went to for prenatal massage) and quite frankly the best massage therapist I’ve ever been to. She’s also a trained yoga instructor and infant massage teacher and in general just knows a ton about natural childbirth, “somatic” childbirth preparation and attachment parenting. It wasn’t just her presence at our birth, which was incredible (she earned her fee just by knowing how to operate the hospital barf bags), but I have to say all of the preparation and visualization we did with her before the birth was invaluable to prepare me for the actual experience.

Other random questions:

• Did it hurt? Yes. Although it is the most productive pain possible. I mean, after you pass a kidney stone they don't hand you a baby. So the memory of the pain is totally different than anything else. I think maybe all those mommy hormones have something to do with this, too...
• How long was your labor? It depends on what you mean by labor. Looking back I was experiencing signs of early labor for a month or so. But in terms of active labor (e.g. painful contractions), really only about 4 hours after they broke my water in the hospital. I attribute this solely to genetics as both my mom and sister also had relatively quick labors. But I have to say, 4 weeks of early labor and 4 hours of active labor is not such a bad deal…
• Did you yell at Jason? Not really. I did ask him to stop breathing on me once. I also told him to change the music when a super cheerful old timey bluegrass song came on. I also may have muttered a few choice expletives during the worst of the contractions, but they weren’t directed at Jason (e.g. I never said “You did this to me, you @#$#%$!" Really! I didn’t.).
• Are you going back to work? Yes. I am on maternity leave through the end of April. I will go back full-time the first week in May and Jason is going to take part-time leave starting then. Nana Grace (bless her heart) will be helping out with child care during that time, so luckily we won’t have to worry about day care for at least 6 months.
• Any other advice? Take as many of those mesh panties home from the hospital as you can.
  

And for those of you who actually made it to the end of this post, here is a reward (we know what you really want, after all...)