ToBP

Toward the end of the pregnancy, moms-in-waiting are encouraged to make more frequent visits to the OB/GYN or midwife.  During one such visit, the midwife I saw indicated that she wrote in my file that I was suffering from ToBP.

ToBP (or TBP) is a very common condition and nothing too serious--or at least, nothing anyone else takes seriously.  It's an acronym for Tired of Being Pregnant.

And she was right.  I was very tired of being pregnant.  I was also just very tired.  And sore.  And constantly having heartburn.  People kept telling me I would have relief once the baby "dropped".  Not so.  He was so large that it was almost indistinguishable when he did hang a little lower inside my belly.  And he kept kicking me.  Hard.

It's not unusual, therefore, for women to start feeling a little resentful of their wee one.  I began asking the little dear to hurry up and come on out, as I was sure he was sufficiently done cooking in the oven.

About a week before my due date, I wrote a diatribe denouncing all the "evils" of pregnancy that a woman experiences, even when things go perfectly well.  For example, the worse a woman's morning sickness, the better, they say.   (I kept track on a calendar of every time my nausea turned productive.  Jackson was VERY healthy.)

My conclusions then were somewhat superficial, though I still support them more than a year since:

1. Women deserve to be thanked for enduring an entire pregnancy, regardless of whether or not they were good parents afterward
2. The only reasons women willingly get impregnated subsequent to the first time are either induced by alcohol or the result of some form of amnesia, possibly both
3. The first child was probably the result of alcohol or amnesia, too

Sure, there are couples out there who naively seek to deliberately create their own temporary opaque human aquariums.  These people are also usually the ones who have a difficult time conceiving.  Coincidence?  I think not.  These types remind me of the beer called Celebration, put out by Sierra Nevada.

The back story:  A completely awesome group of people gathers each Saturday night at a house in Tampa.  One night, while I was a regular attendee, an unsuspecting member of our group purchased a 6-pack of Celebration.  He took a sip of his bottle and pronounced it foul and undrinkable.  Of the 10 or so of us there that night, nearly every one proceeded to then attempt to try a taste of something so putrid it needed to be experienced first hand.  A final assessment of Celebration deemed the flavor reminiscent of beer that had been regurgitated and strained through dirty pantyhose before being rebottled.  

"Oh, it's terrible!" 

"Let me try!"

Now, I'm not essaying to tell people not to have children.  Far from it!  But it's not all roses and sunshine.  For a year and a half, I never once slept a full night through.  For the first 6 months of Jackson's life, I spent a great deal of time wearing clothing covered in spit up, since he had reflux issues.  Conception, pregnancy, birth, and infancy are not for the delicate of manners.  They are gross.  Period.

And then...well, I have historically been a typical Floridian, feeling chill at 72F.  I used to keep my thermostat set to about 80F or 82F in the summer, and was quite fine with it.  However, the last month of my pregnancy was spent burning hot.  In December.  With the air conditioning running.  Poor Andrew, my darling husband, suffered manfully while I pushed the thermostat down to 62F at night, kicking off the blankets because it was sooo hot.

We were ready for Jackson to find the light at the end of the tunnel and venture forth into a brave new world.

Useful Prenatal/Post Partum Literature (A Serious Post)

Living as we do in the so-called Age of Information, those with unfiltered access to the Internet no longer have any excuse not to know or be able to discover just about any piece of knowledge we desire.  There are some who take this to extreme and insist on knowing the ins and outs of the anatomy of every person willing to provide a visual demonstration.  Others prefer a more cloistered lifestyle, sequestered from carnal knowledge until marital vows are pronounced.  Still others are generously populating the Internet with all kinds of useful, useless, or incorrect information, so the seeker of wisdom may have to rely on his best judgment to determine what advice or principles to follow.

Good friends to those making a quest for details on pregnancy, labor and delivery, and child rearing are the well-matched pair of Google and Amazon.  I scarcely need inform my visitors of the existence of the magical realm Google has invented, infecting the world wide web with a notion of purifying websites and webtools down to their clearest and most efficient forms, and providing a search engine unparalleled by any guru or librarian in the history of the world.  Amazon long ago learned to be molded by the will of the people and has become a reference tool with a variety of measuring sticks on hand for evaluating as well as purchasing literature, among its many other traits.

Additionally, Andrew and I made use of our spare time during my pregnancy at local bookstores.  We felt then and maintain now, with our son currently 14 months old, that for us to be successful parents and maintain positive relations with one another, we needed not only to comprehend the imminent future but to have some glimpse of further horizons.

For a relationship to survive the strains of the first year with a child, both partners must be committed.  As much as possible, they need to agree in advance as to how to handle given situations that might arise.  They need a plan:  Who will care for the child?  Breastfeed or bottle feed?  Who will handle night wakings?  How will chores be divided in the new regime?  What sort of allowances will be deemed acceptable?  What behaviors are deal breakers?

Yet in order to know what things to discuss and attempt to resolve as best as possible in advance, it helps to have a guide (or several) indicating what issues you are most likely to encounter.  This is where the Age of Information becomes your friend.  Andrew and I were fortunate in that the literature we selected to aid us in our pre-parenting and early parenting processes were all very helpful in their own regards:

• What to Expect When You're Expecting by Heidi Murkoff is the more modern equivalent of Dr. Spock a generation or so back.  One of the greatest aspects of this book is that it is frequently updated to include newer information and insights into the experience of pregnancy.  A wealth of knowledge pervades the text, derived from reputable sources and even including an acknowledgement that pregnant women are not always occupying the status of married or even necessarily heterosexual.
  

• Great Expectations by Sandy & Marcie Jones provide a weekly update on what experiences to expect throughout pregnancy.  Each week is numbered in several ways including fetal age and number of days remaining until your due date.  Each also indicates the size of your baby, the stage of development achieved, what is happening to you as the mother, and some basic tips for the general time period.  The book is very clearly arrayed with lots of graphics that include periodic glimpses at the changing shape of the mother's belly and the growing and changing shape of the uterus and its bundle of joy.  Great Expectations also shares a good deal of information and planning help for the birthing side of things as well as that often ignored post partum period.
  

• The Modern Girl's Guide to Motherhood by Jane Buckingham is a much better guide than the cover leads one to believe.  She uses a lot of straight talk that is great for those who really want to know what to expect.  An excerpt:  

  I don't know if it's some unspoken mother's code, or if mommy veterans are simply trying to protect us delivery virgins from the inevitable, but for some reason, no one--and none of the books for that matter--told me how downright painful recovery is. ... Everyone tells you about labor.  Somehow they forget about recovery.

  The bulk of the material, though, is best directed toward offering suggestions for how and when to do things.  The timelines for what to expect with your child were GREAT.  I still use this book to help keep track of what vaccines Jackson will be getting and for what milestones he should be expected to achieve at each stage.
  

• Be Prepared, A Practical Handbook for New Dads by Gary Greenberg and Jeannie Hayden is an excellent primer for parenthood--and it's hilarious!  The drawings are wonderful and the diction is well directed at the male brain.  This book has some great and innovative ideas for those "Now what?" moments.  One section provides a breakdown of the distinctions in infant cries for hunger, fatigue, colic, etc. while another gives useful suggestions for remaining upright at work.  For each age bracket of infancy, the text offers ways to entertain a child that cost little or no money, as well as ways to use your child as a source of (deliberate) exercise.

These are just a few of the resources you can use to help prepare for a wee one.  But if you lack the funds to buy anything but the barest of essentials, consider that most of the information provided in any book is derived from publications by the American Academy of Pediatrics.  The AAP is considered the authority by most Western pediatricians and prints a large number of books for helping parents do their job.  Many places offer their books for free.  The most common publication of use is Your Baby's First Year (available for purchase here).  If you live in the southern United States, you can apply for the Publix baby club, which is free through the grocery store chain.  Publix will then send you an expanded version of this book, entitled Caring for Your Baby and Young Child for free (USD$20 value), in addition to a bunch of great coupons and a wonderful regular newsletter with tips for your child's current age group.  This expanded volume contains helpful information from the AAP for children through age 5 years.

In the end, you as the parent are the one who has to make all of the decisions.  Being informed can help you make better decisions:  To breastfeed or bottle feed?  Natural childbirth or epidural?  Co-sleep or crib sleep?

I hereby give you permission to make your own (informed) decisions, regardless of societal or familial pressures.  As a parent and caregiver you are in a position to know and understand your child's (and your own!) personality, preferences, and abilities better than anyone else.  Raising a child is tough enough, just trying to keep the little things alive and healthy despite their best attempts to the contrary.  If you can learn to trust your own instincts for what is best for your baby, then you are well ahead of the curve.

Doula Selection

After reading about doulas in our prenatal books, Andrew and I decided that a labor doula would be very helpful to have.  Our reasoning was that:

1. We could afford one (in the end, we paid about $575)
2. Outside of ourselves and hospital staff, we had no local network of support during labor
3. With my hip malfunctions (from that cruel hormone relaxin) and my cervical disc herniation (from a pre-conception car accident), we wanted someone who could help me be as comfortable as possible
4. Andrew's general level of sympathy is not very, shall we say, "developed" and he was honest about that upfront -- he wanted me to have the best possible experience.  (n.b. Andrew entered this one; it does not mean he was wanting to shirk his responsibilities as a father at the birth--just wanted help!)
5. Given the stress of labor and delivery, it made sense to want someone a bit emotionally removed who could remain clearheaded and help to enforce our preferences and rights as parents-to-be

So, I queried my midwife for suggestions for a doula.  At first she was reluctant to offer any, stating that whichever midwife from the practice was on call would stay with me during my labor.  (Ironically, she turned out to be the midwife on duty, and perhaps it was because I had a doula and perhaps not, but she was NOT around much at all until close to pushing time!)  Eventually she surrendered the name of a local midwife named Daniela.

I called Daniela and scheduled an informal interview with her at our home.  Andrew researched online for appropriate questions to ask her, and we added a few of our own:  just what exactly is it that a doula does?  After we had a chance to interrogate our prospective doula (who turned out to be a midwife as well, specializing in home births) about any manner of things, including the name and number of her hairdresser (her hair was fabulous!), my husband and I conferred.

While Daniela was perfectly agreeable, she was also somewhat mousy.  She seemed affronted by our unusual questions (which were likely the result of a certain amount of anxiety on our part) but tried to hide it while remaining reasonably cheerful.  Then we struck gold:  she had a back-up doula!

As Daniela was both doula and midwife, she seemed overly qualified to the point where it was practically insulting for us to hire her as "only" a doula.  Her back-up doula, however, was a doula AND a massage therapist, which was exactly what we had hoped to find.  We politely requested Sabrina's contact information so that we might interview her as well, and in the process I fear we may have offended Daniela--though I suspect she was secretly glad not to have further dealings with us, the "crazy" couple with the odd sense of humor!

Andrew and I were nervous about a second interview, but we were better prepared this time around.  Still, we felt little need to pretend to be people we were not since our true personalities were likely to resurface in the excitement of labor and delivery.

Sabrina was a godsend!  From the moment she arrived I felt very comfortable with her, almost as though she were my own sister.  She even bears a strong resemblance to my actual sister!  While at first she was rather uncertain of how to interpret our strangeness, Sabrina quickly warmed to us and seemed to even enjoy our often unexpected injections of humor into the whole process.

One thing that was very impressive to us was her apparent level of organization.  She had paperwork for us to complete with basic information about ourselves and what restrictions and allowances we wanted to have in place at Jackson's evacuation from my uterus.  Her payment plan was very straightforward and reasonable--and it included a free prenatal massage!  For control freaks such as ourselves, Sabrina was the ideal candidate.

As we only met her a month before my due date, she returned on only 2 or 3 other occasions before the birth itself for training sessions.  Sabrina had recently learned some new techniques for helping laboring moms to cope with the pain.  Andrew and I accepted our tutorials, which included an emphasis on changing focus.

One lesson in particular involved us holding a piece of ice inside a closed fist for a given duration.  We had to look around at various objects and focus on basic concepts about them:  green couch, wood chair, the feel of carpet on bare feet, etc. while trying to maintain steady breathing and minimal awareness of the ice.

Any laboring mother can tell you that ice is no substitute for the real deal, but for learning a basic trick to use in labor, ice sufficed quite well.  [Please, if you try this yourself, exercise caution as prolonged exposure to ice can severely damage your skin!]

Everyone has their own individual preferences and comfort levels.  When it came down to it, Sabrina was chosen by us because not only did she exude confidence, but she also helped us to feel relaxed and comfortable.  Giving birth is stressful enough an experience that anything that can be done to mitigate that stress rather than exacerbate it is much appreciated by all those involved.  Andrew and I knew that we could rely on Sabrina to help serve as an ambassador to hospital staff, someone who would state and reaffirm and enforce our individual preferences in dealing with both medical professionals--and ourselves!

Learning to be Natural

Bill Cosby famously joked (see video below) about how he and his wife went to classes to learn how to have natural childbirth.  Andrew and I experienced a journey somewhat similar to Bill Cosby and his wife--conceivably because we are also "intellectuals."  

One of the main reasons we wanted a midwife was because we didn't want a hospital experience similar to the example shown in Monty Python's The Meaning of Life:  

When I delivered, I wanted it to be a personal event, not a personnel event.  I wanted things to be calm and focused and as uncomplicated as possible.  After taking our classes on how to have children (after the conception bit; we had figured that part out just fine), I had determined I wanted to deliver naturally:  no drugs at all.

This came about as a result in large part of learning about the distinctions between natural vaginal childbirth and medicated vaginal childbirth.  Our instructor, Tina, was a mom 3 times over.  She had been present at many more births beyond those of her own children.  She also knew a fair amount of statistics, which are about on equal footing with anecdotal information to any mom looking at squeezing out a kid for the first time.

In birth, Tina said, any medical intervention tends to lead to further medical interventions.  For example, if a woman were to receive an epidural dose of pain medication, she might potentially have difficulty knowing how to maneuver in order to expedite delivery.  She is also confined to the hospital bed and cannot move around very freely to even be able to attempt such maneuvers.  She may have, therefore, a longer labor.  

Additionally, it may be difficult for her to know how to push or even to be able to push, thereby increasing the likelihood of a Caesarean birth.  However should she still manage to try vaginal delivery, she will have a far greater chance of needing help to get the baby out via 

the "salad spoons" or the suction cup or an episiotomy.  Vain as I was for my unborn child, I wanted him to have a well-shaped head, so a quick delivery with no use of forceps or suction was optimal to me.  (Image above obtained here.)

Another issue with medication was plain and simple fear.  I've known enough kids born when their mothers used drugs to make them comfortable in labor to recognize that any effects are inconsequential in the long run.  My sister and I were both born Caesarean (bless you, Mom, you were a trooper!) just 18 months apart, and we are perfectly fine.  At least, any defects we have we can't blame on the birth medicines, anyway!

No, my fear wasn't for Jackson so much as for me.  In our childbirth class, Tina showed us a video of an epidural injection.  In order to get the most common method of pain relief in labor, the mom-to-be has to be turned onto her side and made to hug her knees.  Then, despite being continually wracked with pain, she has to hold very still as an anaesthesiologist spends about 15 minutes putting things in and out of her spine.

Needle in the spine?  Wasn't going to be mine.

We learned all the techniques for breathing and noise-making.  (Came in VERY handy!)  We learned about how the baby might be oriented at the time of departure.  (Also very handy.)  We learned distraction methods so that I might have a focus other than OH MY GOD THIS HURTS WHAT THE (BLEEP) DID YOU DO TO ME?!? (Which would have come out as "Omgrrdfkdym!?!!")

We also learned about this mysterious doula concept that had been floating throughout some of our literature of pregnancy and labor.  And the search began for a person to substitute for the drugs I would not be taking!