Monday, July 30, 2007
Sunday, July 29, 2007
My problem is that I have an over-active let down. The milk flows out too fast for the baby to handle, and he has taken to clamping down on my nipples (often times not letting go even with my finger totally inserted into his mouth), fighting me when feeding, and has a serious amount of gas. The large amount of foremilk that he is forced to ingest has a lot of lactose, that his system has difficulty digesting effectively. He is spitting up often and fussing due to the substantial amount of gas and intestinal discomfort caused by the over abundance of lactose.
I feel horrible for him, and want to comfort him. But, it seems the very thing that would give him comfort (the breast) is the thing that is causing him (and me) the most grief. This hurts my heart to no end, and the guilt associated with not being able to give him what he needs is eating away at my innards.
I went to a breastfeeding support group last week. I called La Leche League twice and didn't get a call back (and their schedule is posted on-line but with no address or email address), I called UCSD to speak with someone and didn't get a return call. I am thinking about contacting a lactation consultant. But, at $60/hour...it seems a little pricey. But, I am desperate. I don't want to sabotage our breastfeeding relationship.
The best website and info I found so far was below and on the WIC site. I bought some contraption to help heal my nipples. I am going to try nursing on one side for several feedings and try the modified feeding position as well. If all else fails, I am going to contact a lactation consultant. I promise not to give up at least for another couple of weeks.
Summary of Strategies to Reduce Rate of Milk Production and Force of Milk Ejection:
Nurse on one side for a each feeding, continuing to offer that same side for at least two hours until the next full feeding
Gradually increase the length of time feeding from one breast if necessary
If this strategy is not effective, try the method of thoroughly pumping breasts and then feeding on one breast until unbearably full (described in detail above)
If the other breast feels unbearably full before you are ready to nurse on it, pump or hand express for a few moments to relieve some of the pressure
Use cold raw green cabbage leaves or a bag of frozen peas to reduce discomfort and swelling
Feed baby before he becomes overly hungry to minimize aggressive sucking
Try alternate nursing positions
Mother leaning far back
Side-lying (letting milk dribble out)
Use scissors hold or the side of your hand to compress ducts to reduce the force of the milk ejection
If baby chokes or sputters, unlatch him and let the excess milk spray into a towel or cloth
Allow baby to come on and off the breast at will
Burp frequently if baby is gassy
Certain herbs and drugs, used judiciously, may be helpful in reducing milk production
Thursday, July 26, 2007
2. Nursing/Breastfeeding is not intuitive (more on this later)
3. Motherhood is awesome (and trying)
4. Babies generate a TON of laundry
5. Everyday I learn something new about parenting, about myself and about Elliott
6. When Elliott cries, the dog looks stressed out
7. Healing from a C-Section is difficult, in ways that Mom's don't have time to talk about
8. I always wondered why Mom's, after they gave birth, didn't talk about their recovery and their personal struggles. It is because they don't have time to worry about it, and even less time to blog about it
9. Everyone thinks their opinion is right
10. One yawn means-I need a nap RIGHT NOW (or else)
Tuesday, July 24, 2007
Sunday, July 22, 2007
So, I spoke with a girlfriend, and did some searching on the WWW, and discovered what appears to be my problem. I have an Over Active Let Down... We fit all of the criteria.
So, tomorrow I am going to call UCSD and make an appointment with a lactation consultant. I may also consider attending a La Leche League meeting or a breastfeeding support group. They meet on Tuesday and Thursday in my hood. I didn't think that breastfeeding would be so difficult...
It seems like it should be intuitive, and a natural organic process. But, there is a big learning curve that I was completely oblivious to. Which is a theme that I am encountering often these days. I discovered a little nub of info about myself lately. In the past, when it came to other people and their kids...I always turned a blind eye, and tuned all things kid and parent out.
To all my friends who I didn't pay attention to when you were pregnant, nursing, struggling, parenting...I am sorry. This is hard work and I should have been a better friend.
Saturday, July 21, 2007
Hubby and I in the course of my pregnancy, and even more so now (since Elliott's been born) are reminded about how lucky we are. Lucky to be a married couple with a new baby, and not single. Lucky to work so well together as a team, lucky that we both welcome the changes and the challenges.
We are grateful not to be single parents. We often talk about how difficult it must be for single parents to cope, to get anything and everything done, and to be good parents on top of it. I personally can not even imagine one day as a single parent (or pregnant person).
I have a tremendous amount of respect and new found understanding for folks that go at it alone. I wonder how my Mom did it with 2 girls. She was married off and on, but spent a while being single, or in between marriages. Power to the single peeps.
Thursday, July 19, 2007
Wednesday, July 18, 2007
In a moment of frustration and bitterness at my husbands freedom to do whatever he wanted (he spent the majority of the day on the computer working, and the evening watching baseball--although in all fairness he did take the dog to get washed), but get nothing done (I asked for a couple of simple tasks-my honey-do list was small and had carried over from several days ago). I asked him for one day to sit with me, and not move every time I had to breastfeed. I wanted him to know what it felt like to be constrained (perhaps he would be less frustrated when I asked him for something). He basically laughed in my face, and said no. Just as well. Who would get me water if he was tied to the couch too. But, then again who is going to get me water come Monday when he is back at work?
I do not want to imply that I these things aren't done willingly or with love for my son. I just want to bring to light the great amount of sacrifice and selflessness that it takes to be a good mother. I wonder with all that we give up, why it is also accompanied by such vast amounts of guilt and grief.
Are we giving enough time to our child, did we handle that situation correctly, could I have done something different, given more, shown more patience, love, or guidance...The list is endless and the guilt never ending for some. It is a tight rope to walk, and unless we all find balance both in parenting and in our marriages, we are bound to fall.
Who gives to Mom's? Who makes sure we are alright? Who nurtures us? Who takes care of us when we are sick, or sad, or lonely? I am working the details out now, and hopefully will be able to find my balance soon.
Tuesday, July 17, 2007
I am going stir crazy. I need a car, and I need to get out of the house. Now that I have the all clear to drive, I cant afford to. Hopefully I will be able to lift the car seat out of the car. The nurse came to the house yesterday and Elliott now weighs 9 lbs and 14 ounces. All he wants to do is eat. Is it possible he just wants/likes to suck? Can I give him a pacifier? Or will that cause nipple confusion? He will stay on the boob for an hour each side if I let him...and, boy my nipples are sore!
Last night we were so desperate to get some sleep that I took him out of his sleeper and let him sleep directly in the bed with us. I have been reluctant to bed share because I am a pretty hard sleeper by nature, and initially was taking pain meds post-surgery. But I might have to try it out for a while as I think he slept better and more soundly next to me.
Monday, July 16, 2007
Saturday, July 14, 2007
I am very much looking forward to the next week. We have had visitors at our house almost every day since I went out on leave. The first week my girlfriend from home stayed in our Airstream while attending a conference. Then I went into Labor, and had visitors almost every day in hospital. Then we came home and had people who stopped by daily. Then on Sunday hubby's family arrived for a long planned SD vacation. The SIL and BIL et. al stayed in a hotel, while the MIL stayed here. Initially it was a bit overwhelming. Mostly because we weren't aware of the sleeping arrangements, or what the weeks plan was. Plus, we weren't expecting to have Elliott during their visit. But, all in all it worked out. They left yesterday. Now, today we have another friend from back home who wants to travel down here to visit for the day. I must say Elliott is one popular kiddo.
Wednesday, July 11, 2007
Rilo Kiley - Live at Fingerprints
Feist - Let it Die
Iron & Wine - The Creek Drank the Cradle
Gipsy Kings - The Best of...
Christopher O-Riley - Home to Oblivion / Elliott Smith Piano Tribute
Mishupishu - Best New Music, disk 1
Tuesday, July 10, 2007
I wanted to labor and birth naturally, the way my body intended. I also wanted to ensure that my son's arrival into this world was not traumatic or medicalized. It was important to me that I wasn't restrained while I was in labor. I was adamant about the need to be free to move around, and not be limited to a hospital bed. I didn't want to be hooked up to an IV, or any monitors. I also didn't want people to treat me like I was sick.
From 8:30am on Saturday to 2:30pm on Sunday things went exactly as I had planned. Then, the intervention happened. Beginning at around 3:00 pm on Sunday, it was clear that I wasn't progressing, was suffering from exhaustion and my contractions had slowed to a grinding halt. The pitocin suggestion was offered, and we realized that something else needed to occur in order for us to move forward successfully.
Once we moved downstairs to labor and delivery, it was a whole new world. As soon as I was moved, I had an IV inserted. I was so out of it, I didn't realize that she couldn't find my vein, had made several attempts before finding it and I was bleeding all over the place (UCSD is a teaching hospital, and the nurse was obviously learning). I have a loose memory of seeing blood on my wedding ring.
Next came the fetal heart monitors, and my heart monitor. Then the epidural. I was pretty scared to get an epidural, as I have needle phobia and all in all phobia about things being inserted into my spinal cord. But, this was probably the least painful thing about the whole process. It didn't hurt at all, and the most uncomfortable part of the process what having to curl up and apply pressure to my very full bladder. It was done before I knew it, and my doula said it was the fastest epidural procedure she had witnessed. I was still having strong contractions at this point, and the need to push was still there. It was an odd sensation for the epidural to kick in, and be able to move my feet and legs, but to not feel pain. I still had the massive urge to push and bear down, but it was remarkably painless.
After that we needed to decide on the type of catheter I was going to receive. This is where the key decision needed to be made. If I opted for the pitocin then one type of catheter was required, but if we went straight for the c-section then a foley catheter was required. So, hubby and I consulted everyone, weighed all the options and decided for the c-section.
It was about 4:30pm by now, and the frenzy had begun. Since moving down to L&D, I had been surrounded by at least 5 people, and at any given time, at least 2 or 3 were doing some sort of procedure on me. The surgical nurses were now involved, and they took over for the birth center gals and the L&D gals. I had the foley inserted, I was partially shaved, and my husband was prepped for the OR.
It didn't take long for them to wheel me in, swab me with betadine, lock my legs down, give me a stronger dose of the epidural, test me to be sure it was working, hook me up to oxygen, and prepare to cut me open. To say I was nervous is an understatement. I was shaking like crazy, even before the epidural kicked in from nerves. My husband finally was brought in. I think they almost forgot him, as the anesthesiologist had to say several times, "Are you going to bring the husband in?". I was relived to see him. He stood by my head during the procedure.
It felt like it took forever! I could see Elliott being brought over to the table where he was examined and cleaned, Hubby cut his cord after it had finished pulsing. He was then brought over to me. He was placed on my chest for a moment (we got a photo), but the surgical team needed the space, so he was taken back over to the table, swaddled and his Dad got to hold him while they took some additional pictures.
They finished up the procedure, and placed Elliott on my chest while we were wheeled out to recovery. While we were in recovery we made our first skin to skin breastfeeding attempt. We weren't very successful for several reasons, the first being my complete lack of coordination due to the drugs and anesthesia. And the second being my utter lack of experience. Elliott on the other hand was rooting around looking to latch on. He is a champ at that. My doula was there luckily to help me keep a hold of him, and comfort him and me in our first attempts.
We stayed in recovery for a couple of hours and then moved back up to the 4th floor. We stayed in the hospital for 3 more sleepless nights before we came home. Nothing but vital signs, liquid meals, and measured urine. Elliott did great on all his tests-apgars were 8 and 9, his weight was good and he didn't lose too much over the first few days, he hearing test was fine. All pediatrician visits were positive. I was up and around after the first day, and have been pretty mobile since.
So in summary, I am still processing my feelings about the birth and the entire event. I feel deeply saddened that I wasn't able to birth my son vaginally. I feel a little like I let him (and myself) down. Personally, I feel that I missed out on a rite of passage as a woman and a mother. I am still mourning the loss. But, in the same breath I feel that I did the very best I could, and could not have labored any longer without assistance. Not to mention the health risks that were at hand. What I need to remember is that Elliott is here, he is safe, he is perfect in every way possible. I wouldn't change a thing about that.
I am head over heals in love with my boy. No amount of sadness about the way he came into this world will ever change that.
Sunday, July 8, 2007
The contractions felt like menstrual cramps (I only infrequently get cramps during my period, but imagine that this must be what they feel like when they are more pronounced) and they were in my lower belly. I continued cramping lightly throughout the morning, and with more intensity as the day wore on. The key for me was monitoring the time and continuous rhythm. Since I still wasn’t sure that real labor had actually begun, or for how long these contractions were going to last, I was intent on making the best of it.
We had a bar mitzvah’s temple services to attend and a birthday party gift that needed to be dropped off. So, we dropped off the party gift and joked with our friends that our son might be born today, and headed up to the temple for Saturday Services. We arrived a few minutes late, but stayed the 2 hour service and for the kiddish, and then went back to our friend’s hotel to hang out for a bit. At around 3:00 pm, I suggested that we go home, and get changed for the party. It was again a joke that I was in labor, and everyone kept telling me to sit on a towel for fear that my water was going to break. I reminded them that often times a woman’s water doesn’t break, and that wasn’t always the next step in the labor progression. I didn’t want anyone to panic, or get all freaked out and start worrying.
I had expressed my desire for a particular bottle of pink champagne that I wanted to open after Elliott was born, in the hospital. Hubby hadn’t purchased it yet, so on our way home we stopped by BevMo and bought a bottle of pink champagne (although not the one I wanted…).
The whole day I vacillated on if this was it or not. I knew in the back of my mind that this was it, but I didn’t want to say it out loud for fear of freaking myself out. I was handling everything calmly, taking it one step at a time, and up to this point wasn’t making any assumptions. When we arrived at home I had decided that I was likely in early labor and should let my doula know so she can possibly begin planning, just in case something else happened. We agreed to keep one another posted if anything progressed, and hung up. I suggested to my hubby that he set his out of office assistant and tie up his loose work ends, and gather his things together so when I give the high sign, he is all ready. I also started to gather and pack up the last few things that I needed to take with me to the hospital. I was pretty much ready for whatever came next. Hubby was working on the computer, apparently putting the finishing touches on a few last things (though not with any sense of urgency).
I went to use the restroom. After emptying my bladder, I was just about ready to finish up, and a flow of liquid was released. I immediately knew what had happened, and there was no doubt in my mind that my water had indeed just broken!
I told my hubby what had happened, and in typical hubby style, I had to offer up all the reasons why I think that it happened, walk him through the details, and practically convince him that it was in fact true. (This is an ongoing conversation with hubby-ever since the positive pregnancy test-more on that later). I had to make a solitary decision, since it didn’t seem like I was going to get his buy in that my water had in fact broke. So, I called the Midwife hotline from our kitchen phone, which BTW is the only phone in the house. As soon as the answering service gal answers-my water really breaks. This was a main line fracture, just like every woman fears will happen while they are out in public. I start gushing amniotic fluid, and it is pouring out of me. I can’t stop laughing (I often laugh when I am nervous or don’t know exactly how to handle a situation), as I try to explain who I was and why I was calling the Midwife Hotline. I hang up the phone and turn around to a look on hubby’s face that I only wish I could have captured on camera. He looked totally freaked out-a combination of terror, shock and total disbelief (now maybe he will believe me is what I was thinking!).
In the meantime, he doesn’t know what to do, and is just standing there. What does he do first? No, not get me a towel or ask how he can help, or if I am OK. No, he gets the camera, and wants to start snapping photo’s to document the event. We are both hysterical and can’t stop laughing at the sheer amount of fluid that is freely flowing from my vagina. Once we got some sort of control over the flood gates, hubby realizes this if for real, and starts running around frantically to finish up what he needs to get ready. In the meantime, I am calmly waiting for him on the couch to leave for this hospital.
We pack up and go, and arrive at the hospital (5:30 pm). After we check in, we are notified that there isn’t a nurse available in the birth center, so they have to temporarily triage us in Labor and Delivery (bummer). We are laboring there (the 2nd floor of the hospital) for a while, and the midwife on call-Jasmine checks in on us periodically. But, we hadn’t officially checking in to the hospital yet.
Around 9 or 10pm, we are notified that a nurse has arrived and we can be moved to the birth center (4th floor of the hospital). While we are being transferred, they are filling up the tub with warm water for me to labor in. The birth center was nice, the room was big and private, and most important to me it was relatively uninterrupted. Things seemed to be moving along well, and looking back it was really all a blur to me now. We tried different positions on the ball, in the rocking chair, laying down, squatting, sitting in the bed, walking the halls, the tub, and anything else you can think of to ease the pain. I felt ultra focused and introspective. I felt very much inside of my head. I didn’t have much to say, and was really trying to concentrate on the contractions, not think about their length or time, or look at the clock. My Doula kept me hydrated and using the bathroom and she kept me active and calm.
My husband told me later that he and the Doula spoke around 3am, and consulted the midwife and guessed that based on my progress I would have the baby some time in the AM hours (9am was the estimate). Up until this point I had not had a vaginal exam (the midwives feel that exams are disruptive to labor, and are often counter productive to a laboring woman's progress. I too was worried about having an exam, for fear that if I hadn’t progressed far enough that I would be disappointed by my own progress). Around 4:30am the Midwife comes in to check on me and see how I am feeling, and offers me an exam.
At 4:30 am I was dialed to between 5 and 6 centimeters. It was kind of disappointed that I wasn't farther along, but I was still in good spirits and felt strong. By 9am, there was a shift change and a new midwife came on staff (the new midwife was my favorite one, so I was happy about that). Rebecca did another exam and I was dialed to 8.5 centimeters. She noted that my posterior cervix was still thick and wanted to help me loosen it. So, over the next hour or so, during a contraction she manually attempted and succeeded in bringing me to 10 centimeters. It was about 11:30 am and I was fully dilated. I didn't feel the immediate urge to push, perhaps because she had manually manipulated my cervix, or perhaps because the babies head was only at a 0 station. During the exam she noted that the babies head was not facing the correct direction, but that it might shift during the next stage.
I began pushing to try to get the babies head to come down a few stations. So from 11:30 to 2:30pm I pushed, and pushed with each contraction trying to birth my son. However, in that time he only moved 1 station.
This is where my troubles began. I hadn't be able to urinate for a few hours, and they had to insert a catheter to temporally assist with that. My bladder was FULL. By 2:30pm my contractions had slowed down dramatically, and I was exhausted. I hadn't eaten since lunch time Saturday, and couldn't eat while I was in labor as I was nauseous the entire time. The Midwife, then based on the length of time I had been pushing, the fact that I had only moved 1 station, the time that had lapsed since my water had broken, and the fact that my contractions were now 5 minutes apart--she suggested we move downstairs, and they administer pitocin (an epidural was implied as well, since I was already at 10 centimeters and pushing).
I broke down and cried for a long time, I realized then and there that my hopes of an unmedicated vaginal birth were not going to play out the way I had intended. I was grieving the loss. I thought for an even longer time about what that meant to me, what I was willing to do, and what I felt I was capable of. I had been in labor for more than 28 hours with no drugs and had gotten so far, but from the looks of it the babies head was not descending.
I agreed to go down stairs and be assessed. The labor and delivery doctor came in and performed an ultrasound, they did a blood draw and an exam. She spoke with the Midwife and then presented me with my options. They went like this:
Based on the ultrasound the babies head was crooked in the birth canal and that was why he wasn't descending.
My white blood cell count was high, which meant that an infection could be brewing (it had been almost 24 hours since my water had broken).
I still couldn't urinate, and my full bladder might be in the way of my progress.
They estimated the babies size at around 9 pounds. Because of his size and head position they didn't feel that an assisted birth using forceps or a vacuum were recommended. They felt he was too high in the birth canal and assisting could cause him to get further loged as well as cause me vaginal and possibly cervical trauma (not to mention all the risks to my baby).
I would therefore have to push the baby out and they would only allow me to push for another 30 or so minutes, even with the epidural and pitocin.
If I couldnt push the baby out in that time frame, I would have to have a c-section anyway (and I increased the risk of the c-section depending on how far I was able to push him down the birth canal).
So, after I shed another 20 plus minutes of tears, and talked out every option and risk with the doctor, midwife, my doula and most importantly my husband...we opted to skip the pitocin and have a C-section. After more than 30 hours of natural, wonderful, unmedicated labor, pushing for 3 hours, and wanting more than anything to have a vaginal childbirth...I was going under the knife.
I was trying to remember and be able to articulate what a contraction felt like and couldn't. I also wanted to remember what I was thinking or doing to deal with them. I want to be able to describe details...but I cant remember many of them.
Today, while I was breastfeeding Elliott I opened up a book I was reading to prepare for childbirth, called Birthing from Within. I flipped to the chapter on endorphins. It basically summed up what I was feeling, by saying that during a natural childbirth, your body produces endorphins as a natural response to pain. The endorphins cause a haze that soften your memories and protect you from lasting trauma. It goes on to say that endorphins cause amnesia about pain and allow for a misty magical memory of your labor. In opposition, it says that when you get an epidural that the natural endorphin haze is lifted and you have a more acute memory of details, which often when retrieved are more traumatic and vivid.
After reading this I felt better about not being able to remember. I felt very at peace during the labor process, and 'inside my own head'. It felt natural and I felt in control of my body.