One month old: Meeting the family

Month 2 – July 11- August 11

The first week of Aisling's second month began with a Week of Adventure!

Meeting GeeGee

We left for Oregon on Friday July 12. It was about 3 hours from San Francisco to Doug’s grandmother Webster’s (“GeeGee”) home in Ukiah, CA. She loved meeting her great-grand daughter Aisling, and we had a good long visit with her and Aunt Myrna, and an overnight stay and breakfast. We drove about 5 hours to Medford the next day, Saturday. We’d decided to take it slow in case Aisling had a car seat meltdown (which she never did, praise the Heavens), and to allow time to stop and feed/change her. She did great, but we could tell that she’d reached her limit at 5 hours on the road. On Sunday we made it to Portland where we had a nice visit with Doug’s long-time friends, Ian and Cynda, and their sweet family. It was quite an experience watching the non-stop action of their three boys (ages 5, 2 ½, and 9 mos). I will always admire Cynda’s prowess as a mother.

Meeting Grandma, and Uncle Phil

The next day (Monday) we spent some time exploring Portland (food trucks! Powell’s books!) before meeting Aisling’s Grandma Elizabeth and Uncle Phil. We had a lovely dinner and then walked to a park for a nice family photo shoot. Tuesday we spent the day with Grandma and explored some of Oregon's great wine country! We just love Oregon Pinot Noir. 

Meeting Great-Grandpa Puett

On Wednesday we were back on the road to Bend, OR to meet Doug’s Puett grandparents, and Aunt and Uncle Smith and the cousins. It was a nice drive over the mountain and through the desert.

Meeting Great Grammie

The fourth generation at Paulina Lake, OR!

We enjoyed a nice dinner with the family, and on Thursday Doug and I had a little baby-free excursion all by ourselves to Deschutes Brewery for lunch while Great Grammie Puett cuddled with Aisling. Yumm. That afternoon we went to a music festival on the lawn of the park by the Deschutes river. It was nice to be out in the open at a relaxed event with family. Before we hit the road home, we drove to Paulina Lake, where Aisling's great-great-great grandfather lived for a while, and which has become a traditional Puett family destination.

On Aisling’s official due date (July 19) we were driving home from our week-long road trip to see family. Aisling slept in the carseat, cuddled with us, and continued to eat like a champ. Her head control was improving, and she was beginning to focus on peoples’ faces. She loved to look at contrasting colors and patterns.

Meeting Aunt Laurie

The next Monday Doug went back to work, and my sister Laurie came to visit us for the whole week! Laurie is my earth-mama sister: she's laid-back and philosophical. We had lots of fun exploring San Francisco, the beach, and Muir Woods. She loved meeting baby Aisling, took care of her while I had doctor and dentist appointments, cleaned the apartment, played board games with us, and helped us cook a yummy dinner! It was a great visit. Aisling was making eye contact, noticing faces and voices, and just starting to think about smiling. I was homesick when I left Laurie at the airport, but I knew it would just be another few days before I'd see my other sister!

The last week in July was my first week home alone with Aisling. I quickly developed a whole new respect for stay-at-home mommies! Aisling wasn’t a particularly difficult baby, but she was very time- and energy-consuming to me, especially by myself. I found myself looking forward every day to Doug’s return so that I could have some relief and alone-time. I just don't think I'll be a mom who can stay at home and administer my daughter's entire childhood. I'm absolutely certain that there are women (and men!) who are specially gifted with a talent for doing just that, and I can't wait to enlist their help! But I have committed to being home for her first few months, at least, because it's best for her, and because I can! I am completely grateful for the ability to witness her changes and growth, and the ability to continue breastfeeding. Also it's wonderful to be able to respond to her needs instead of setting a "schedule" that's artificially dictated by my need to work or a daycare's need to have everything on a timeline.

Our first anniversary was August 3 (yay!). It was a fairly uneventful day – we went to the toystore to get Aisling an activity gym for her to practice tummy time and start to interact with toys. It was an overwhelming experience for Mommy and Daddy! She loved the gym we ended up choosing, which is made by Skip Hop.

Her 2-month pediatrician appointment was on August 6^th. It was a big day, because this was the day she got her first set of vaccinations. It was also a big deal because her weight was higher than the 60^th percentile for full-term babies in height, weight, and head circumference! She also impressed the doctor by pushing her chest up off the table with her arms and holding her head up high. That was a big developmental milestone! As a preemie we've been told to expect her to lag developmentally behind other babies of her same chronological age, but she seems to be catching up fast.

Meeting Aunt Tracie

My other sister Tracie came to visit August 7-11. She got to see more of Aisling’s smiles and cuddles. Aisling was getting much stronger, smiling pretty consistently, and starting to have good head control, but she still hated tummy time. Tracie is incredibly positive and cheerful and energetic, and a natural homemaker; she helped so much to make our apartment feel more homey, and impressed upon me the desire to hire a personal organizer for our next apartment. Although she was only there for a few days, she was so much help to us.

Overall, Aisling's second month was great! Her third month was a blur, and I'll post about that next.

Wearing Grandma Elizabeth's baby bonnet

Aisling's first month! NICU and coming home

It's been so long since I blogged! We've just moved to a new apartment and I decided to sit down and get it all out. I'll go month-by-month. Enjoy!

Month 1 – June 11-July 11

Week 1: NICU Stay
Aisling was in the UCSF NICU for about 6 days. She was only 34 ½ weeks along when I delivered, and many babies that young have trouble breathing, maintaining their body temperature, and eating. Aisling was a big strong preemie, though: they took her off of support step-by-step just to make sure her body's systems could handle independence, and each step took at least 12 hours because that was the timing of shift changes when the doctors came around and did evaluations.

They had her on a CPAP unit (not oxygen, just gentle air pressure through a face mask) for her first 12 hours(Weds morning) just to make sure her lungs got fully expanded, since many babies haven’t yet produced the surfactant that keeps the walls of our lungs' alveoli from sticking together when we exhale. I started latching her onto the breast just after they took her off of CPAP (early Weds afternoon). She liked to suck but she wasn’t very hungry because they had her on IV nutrients and hydration. They did not give her any fluids, sugar-water, or formula by mouth, so her “virgin gut” remained intact, which was very important to me. If you wonder what the heck a virgin gut is, click here.

UCSF has a great NICU which includes the parents in all aspects of the baby’s care. They allow parents to be in the NICU 24 hours a day, except for 30 min blocks at 7 am and pm for shift changes. We stayed in the hospital and visited Aisling to feed her every 3 hours, with one of us usually staying with her for most of the time between daytime feedings.

Doug spent lots of “skin-to-skin” time with her lying on his chest, and she got to cuddle with me during and after nursing sessions. Doug got to sleep all night, but I got up religiously and shuffled sleepily to the NICU at 11, 2, and 5 to feed and hold her. She didn’t particularly care about eating because of her IV, but she needed the “first milk” (colostrum) to get her gut moving, so I was pumping like crazy and feeding her with a syringe and my finger to suck on at first. Colostrum is transparent yellowish sticky fluid. In the first day I was lucky to get a total of 3 ml every 3 hours. By the second day I was getting up to 10 ml, which seemed like a lot at the time! By 72 hours I was starting to get real milk at about 2 oz (40 ml) every 3 hours. This is normal, because babies’ stomachs are just the size of a marble when they’re born, and expand very slowly over the first week.

At 24 hours old they turned off the heat in her isolette, and she maintained her own body temp just fine. At about 36 hours, her nurse noticed that she was starting to look orange, and predicted that Aisling would need the “bilibed” treatment soon, for jaundice. Sure enough, her bilirubin levels shot up between 36-48 hours and they put her under lights. Jaundice is the accumulation of a substance called bilirubin in an infant’s blood, which makes their skin look yellow or orange-ish. The worst part of this time was that we couldn’t hold her constantly, because she needed to be under the lights so the UV could break down the bilirubin. I still came religiously to feed her every 3 hours but I had to put her right back in bed after about 30 mins. The best part of this time was that Doug and I got to have some alone time, and had time to walk to a restaurant where I had my first postpartum beer! It was delicious.

After 24 hours under lights, she came out and we could hold her all we wanted again. Yay! Going home seemed imminent. But then after a day her bilirubin level rose again, and back came the lights. Boo. This meant at least another 2 days in the NICU – one for lights, and one to make sure her bilirubin stayed down once she was out of the lights. We were exhausted. Since I was breastfeeding and the delivery rooms weren’t full they let us stay in my postpartum care room for an extra day after I was discharged. But then the rooms filled up and they kicked us out to a tiny little room that had been re-purposed from an infant isolation room by sticking a mattress on the floor. They gave Doug a vinyl mattress-y thing so he could stay, too – I was so thankful for that! By day 5, running on very little sleep and still recovering from delivery, my feet had swollen into shoe-sausages. I would lay on the bed with my feet propped up on the wall while I made phone calls to relatives with status updates. We wanted our own bed so badly.

On Monday morning, June 18, while Aisling was under lights, we were banking on the likelihood of her coming home the next day, so we came back to the apartment to get everything set up and ready. Since I delivered 5 weeks early we weren’t entirely prepared, but at least we actually owned all of the necessities. We took a nap in our bed and I remember it being the sweetest possible experience I could imagine at that moment.

Sure enough, Aisling was cleared to come home the next morning. We tucked her tiny body into her car seat at around noon, and headed home. We stopped at REI on the way home to get her a smartwool hat and fuzzy socks because it was very chilly and windy, and our apartment would be colder than the NICU.

Once we got home, we snuggled into bed. Doug put baby onto his chest and read her some of Beowulf, which he’d been dreaming of doing for my entire pregnancy. The recovery napping began. Aisling was home.

Weeks 2-4
The rest of the first month was fairly easy and uneventful. Aisling’s first pediatrician appointment was the day after we brought her home, and she was doing great and back up to her birth weight. Even though she was a preemie, she was already on the full-term charts (albeit in low percentiles) for weight, height, and head circumference. Compared to other preemies her age, she was huge and healthy.

During this month, she spent most of her time sleeping and eating. She was latching on great, nursing for a long time, and I was changing lots of wet and dirty diapers and pumping extra milk, so I wasn’t worried at all about her getting enough to eat. She woke herself to eat at night, which is a big deal for preemies. I never put her on any kind of schedule, but let her lead with her own rhythms. She slept in the play-yard bassinet right next to me, where I could hear her wake up and feed her right away. We didn’t really have any issues with colic or reflux... she rarely cried and never spit up (which was weird!). I know how blessed we were, and am so thankful!!

We were also truly blessed that Doug got 6 weeks of paid paternity leave. This was a wonderful time for us to bond as a family and establish our own rhythms without the stress of work and commute for either of us. We’d decided to get in the habit of being active with Aisling right away. We carried her in a soft sling when we’d go out walking, and we took her all over the neighborhood with us. Since we don’t own (or particularly want) a stroller or an infant seat with a handle, we got used to holding her all the time. We generally took it easy in those first few weeks.

At her 1-month pediatrician appointment, Aisling had gained an impressive 22 oz in 2 weeks and was now close to 9 lbs. Her head circumference and length were on similar growth trajectories, putting her squarely in the middle of full-term baby growth charts and completely off the chart for a preemie. She was still not due for another 8 days, and I was very thankful that I’d been spared that last month of bladder-torture.
We’d been waiting for this appointment to make the final decision about taking a week-long road trip to Oregon for Aisling to meet Doug’s family. Since the results were so good and she was a trooper in the car seat, we decided to make the trip.

We had a baby! Our birth story part 3 - Baby Aisling arrives!

Late afternoon and evening June 11, 2013

Before I begin, let me just say that I am very happy with the staff at UCSF, even though I didn't follow their advice in every case and actively resisted additional augmentation of my labor. They were extremely polite and professional even as I politely rebelled, and for this I am very thankful. I trusted my own body in balance with standards of care, and because of this I believe that I had a great experience with a very healthy, though premature, baby. I should also say that the epidural I received, with the exception of a short time when I screwed it up, was better than I ever imagined, because I could still feel everything, and I could move around easily. I could stand up unsupported, I could turn over in bed, and my skin had sensation. If I give into another epidural in the future, which I hope I don't, I hope it's exactly the same as this one.

Ok, now for the rest of the story.

During the 30-45 minutes of peaceful rest after I received my epidural, I was still conscious of my contractions, but the sharp peaks of pain were gone. Instead I felt dull cramps where the peaks had been and an increasing pressure low in my pelvis. The pressure built as I rested until it became quite uncomfortable even through the epidural. It felt somewhat like needing to poop but with an unfamiliar sharpness that felt “wrong” somehow (can’t explain how) and a full feeling between and below the lowest part of my front hipbones. About 2 hours after the last check, an hour after my epidural, and as the discomfort was building, I asked to be checked again.

This time when the midwife checked me I was 4 cm dilated and almost 100% effaced, but the midwife felt a small “lip” where my cervix was resisting, and also said that the baby was presenting “sunny side up” or "posterior" with her nose facing my front. Ideally the baby should be facing my tailbone when she was delivered because of the way her neck, shoulders, and body could bend more easily as she passed through the pelvis. I figured that the way she was facing was probably also what was causing the “wrong” feeling as the back of her head mashed against my rectum and sacrum, and her face began to encounter my pubic bone. The midwife said that babies were born that way all the time, but I’d read about the pain, trauma, and difficulty during the pushing phase of a “posterior” presentation.

Once again, and to my dismay, the midwife strongly urged me to let them give me Pitocin. She said it would “organize” my contractions and get things moving faster. It seemed to me that having gone from 2 to 4 cm in 2 hours indicated sufficient “organization,” and that any additional stimulation of my uterus would just keep squeezing my baby’s face into my pubic bone, and possibly lead to trauma to my nether regions during delivery. I wanted time to turn my baby, and I was sure that I could do it.

The midwife settled herself comfortably into a chair to argue with me. I don’t remember what all was said, but I do remember that she calmly repeated herself many times. I’m thankful that my family has always said that I’m so stubborn I’d argue with a fence post, because that’s what it felt like. Mainly she repeated that my contractions needed to be more organized and regular. I observed that my contractions were far more regular than the monitor showed, because I’d watched it many times when it hadn't picked up a contraction I could clearly feel. She even hinted at the “dead baby card” by saying that my baby’s vitals might be concerning because the highs and lows were different than earlier in the morning and last night, which could indicate distress. She didn't push very hard on this one, and I was thankful for my business brain, because I’d been tracking the numbers and there was no difference, and also why would no one have said anything to me about it until the heat of this debate? As far as I was concerned, we were making great progress, baby and I, and I thought I might be able to deliver before midnight without any additional augmentation if the midwife would leave me alone.

Again, I know the midwife was doing her job, and I can see how scared or less argumentative women would just give in and let the staff follow standards of care to chemically augment their labor to get things "back on schedule." As the clock ticked, I found myself getting more and more impatient for her to just go away and let me turn my baby. Finally I just started to politely ignore her (still responding to her questions but not giving into her pressure), and turned over onto my hands and knees. I think the only reason she finally left was because her shift change was approaching and it was clear I wasn't going to give in anytime soon.

When she finally left I was swaying, arching my back, and twisting my hips aggressively to let my baby fall back out of my pelvis, into my belly, so that maybe she could re-enter my pelvis at a different angle. I pictured her slipping slowly back towards my ribcage as I arched my back, pushing my belly toward the bed with my hips and head up. I pictured pulling a cork (her head) from a bottle (my pelvis) as I twisted and rocked my hips with my shoulders and head on the bed and my hips in the air. Every now and then I’d arch my back like a cat and tuck my hips under, picturing her sliding back into my pelvis, hopefully in a new position, then start the process over again. The movement was exhausting, and I’d lie down every now and then on my side, almost on my belly, with the top leg pulled forward, picturing her back sliding around towards my belly button. I could feel her kicking and squirming about as usual, as I worked. My doula Heather was wonderful, rubbing my back, playing white noise sounds like ocean and rainfall on the iPod, and encouraging me.

Over the next hour, the pain in my pelvis started to feel “right.” Again, it’s hard to explain why…but it did. It was almost a pleasurable sensation – almost – or at least in the general direction of pleasure relative to how it felt before. I could feel tingles in my pelvic floor and I remembered the perineal massage that Doug and I had practiced. If I hadn't known how it felt to actually relax the muscles in my pelvic floor because of having done perineal massage, I would never have known that what I was feeling was sensation in the same nerves. Again I was thankful that my epidural wasn't the awful kind where I couldn't feel my legs or move freely, or this story might end differently.

Things get fuzzy here. Time passed quickly as I worked to turn my baby, the hospital staff shift change happened, and I had Janice back as my labor nurse with a new attending doctor and other staff. I was beginning to feel more intense peaks of discomfort as though my contractions were intensifying (though they still weren't showing up regularly on the monitor), and growing pressure in my pelvic floor. I wanted to be checked but for some reason they wouldn't check me. I was beginning to feel an urgency along with the pain. I asked if they weren't going to check me, could they perhaps augment the epidural a teeny bit (I freely admit that I was a wimp about the pain at this point, which was a mistake).

For some reason, they augmented the epidural immediately even though they wouldn't check me. They gave me a bolus and turned up the base level of the drug. Suddenly, I could no longer feel my legs. I couldn't move anymore. I couldn't turn over, I felt like I was sliding off the bed and couldn't stop myself. It was awful, and exactly what I’d heard about the 'usual" epidurals. Several doctors and staff members came in during this time to introduce themselves but didn't acknowledge my gentle suggestions that perhaps the epidural was too strong? I must have shown increasing distress about the fact that I couldn't feel or move my legs, because finally Doug asked me, “would you rather have the pain back?” and I said “YES.” Then he went out into the hall and worked some kind of magic, because they turned the base level of drug down, but it would take at least another hour for the bolus to wear off.

Again, the blessing of a time with no pain (or sensation at all) was that I could rest, and this time I got some actual sleep for about an hour until returning feeling in my legs and body woke me up. This time I was serious, almost frantic, when I spoke up about the pressure in my pelvis, but even Janice didn't believe me! I think at some point she even said, “You don’t act like a woman who needs to push.” I wondered what the hell those women acted like, so I could pull the moves! Instead, staff continued to leisurely introduce themselves to me and ask me questions.

At some point during this time, before or after I rested, I let Janice start me on a Pitocin drip at the very lowest level. I thought I was close to delivering anyway and I couldn't feel a damn thing, plus I knew that Pitocin can be helpful after the baby is delivered to get the uterus to shrink back down and not hemorrhage. So I did finally get a little Pitocin right before I actually delivered.

Finally, after 10:15 p.m. or so, I was almost freaking out about how I felt between my legs. I insisted that I be checked. It took forever for one of the doctors to come in and check me, maybe another 20 or 30 minutes. It was all I could do to hold myself together while she took her everloving time getting her gloves on, etc. When she finally checked me it took about 5 seconds for her to say, “Oh! Well you’re fully dilated and ready to go!”

Probably because my daughter’s head was RIGHT THERE and had been for at least the last hour. Sigh. I was thankful, in the end, that I'd "labored down" and didn't have to push her all the way from my cervix to the real world.

Commotion immediately ensued as the delivery team rushed in and began turning things on, laying out frightening shiny implements on the table nearby, and getting my bed ready for the delivery. I had been laying on my side for some time, and it felt right to me that I deliver that way, so I asked if I could and they said of course.

So they had me slide down to the edge of the bed where they had pulled out a table-like extension. I laid on my right side with my left knee up in the air. They assigned Doug to hold my knee up and steady, where he could see everything and do a job, too. Janice and Heather stood at my other knee, helping to hold it up perpendicular to my body.

When everything seemed ready they asked me to push once, gently, and the top of my daughter’s head appeared. I asked if I could reach down and feel her and they said of course (I had washed and sanitized my hands while they were preparing everything). I could feel a tiny bit of her head right there peeking out, and I asked if I could leave my hand there while I pushed so I could feel how much my pushes were doing. Again, no problem.

This is where the fact that I could feel my own hand touching myself was so important, both because the epidural wasn't too strong anymore, and because they let me touch myself as I labored. If I hadn't been able to, I wouldn't have known the difference between my own body and my daughter’s head and might not have been able to push as effectively.

They asked me to push with the next contraction. As I did, I could feel her moving down in my pelvis and also feel with my hand how much her head was progressing, which wasn't much. So with the next contraction I knew I had to push harder and longer. There was a place in my mind that was terrified of tearing or being cut, but because I could keep my hand on my daughter’s head and push my own perineal tissue back myself, it was easy to calm the fear. At one point I took my hand away to brace myself and really push hard. While I pushed I felt something start to pinch or just feel wrong, and I reached back down. The doctor had been pushing my skin back to help my daughter to crown, but because the doctor wasn't me and couldn't feel what she was doing, she was pushing too much at the top, toward my pubic bone. I remember pushing her hand away and holding that area, then actually pushing my daughter’s head back away from it and holding it there for a few seconds. Then I reached back to the perineum and pushed the skin really hard, harder than the doctor had been, because I could feel that it was fine and not close to tearing. At the same time I pushed with my whole body while relaxing my pelvic floor, and felt my baby's head move a LOT while everybody cheered and encouraged me.

As she crowned, I felt incredibly full and uncomfortable but not in pain. There was an edge of sensation that told me to be careful, but also gave me confidence that I could push harder without tearing. I pushed HARD, pausing a couple of times to catch my breath while trying not to let up the tension in my abdominal muscles and keep my pelvic floor relaxed. It was a weird combination of moves! One more push and her head was born (facing the correct way!). A pause and then another big push delivered the rest of her, which was such a feeling of physical and emotional relief. I did it!

I looked down at Aisling (ASH-ling) for the first time at 11:10 PM after just 10 minutes of pushing. Throughout my labor I had been confident that she was fine, and hoped that she was going to beat all expectations for a 35-week preemie (she did!). Even though she was 5 weeks early, she was not tiny and frail! She was 6 1/2 pounds, bright pinkish purple with lots of vernix, the cheesy looking protective coating. She had an incredibly cone-shaped head where she'd been sitting parked in my birth canal just waiting for me to start pushing while I freaked out and begged to be checked.

The doctors held her up by her middle with her head and limbs hanging down, while stimulating her back, and she gave her first squalls. They weren't super-loud and aggressive, but they were strong and they were there!

They laid my daughter on my belly with the cord still attached so that it could finish delivering the rest of her blood to her body from the placenta. They covered her with a blanket and one of the pediatric nurses was rubbing her vigorously to stimulate her. I remember that I kept lifting the edge of the blanket to look at her face and the nurse kept pushing it back down saying that she needed to keep warm. I couldn't understand how she could lose that much heat out of her face, which I very much wanted to see. I put my finger in Aisling’s fist and felt her squeeze it as she breathed and squalled on my belly.

After about 4 minutes, her cord was finished pulsing. Doug cut the cord and they whisked her over to the incubator area in the room to work on her. Doug followed with his camera, and stayed with her for the rest of the night while they worked on me. I delivered the placenta easily, and the doctors looked hard for any tearing. There was none. The only abrasion they could find was at the front where I had felt something pinching and pushed the doctor’s hand away.

I kept looking wistfully over to the team in the corner working with my baby. Tears were streaming down my face because I wanted to be with her so badly. Heather stood by me and rubbed my neck and said the kindest things. I was so thankful to have her there. They wheeled Aisling by my bed in the incubator – she needed to go to the NICU for some time with the CPAP machine to help her lungs inflate fully. Lungs are the last thing to develop and she needed some support, which was to be expected. I was heartbroken though, because I wanted to spend a little more time with her, and because I was so full of birth hormones!

Heather stayed with me after they took her away. The next hour is pretty fuzzy in my head but I wasn't sleepy; I was desperate to see my baby and know how she was doing. I said goodbye to Heather as Janice got ready to wheel me to the NICU to see my baby.

Aisling Jane was 6 lb 9 oz and 19 ½ inches long. She spent 6 full days in the NICU, mainly due to jaundice that kept her under lights on two separate days. I’ll tell that story in the next post, and hopefully get back to blogging more regularly soon!

Thank you for following our story! I’d love to hear your birth stories, too.

We had a baby! Our birth story Part 2

Tuesday morning and early afternoon, June 11

After walking the halls for a short while, I realized how tired I was. I hadn’t slept well the night before and I was certain that I wouldn’t be delivering anytime soon. So we returned to our room to rest. While Doug slept soundly on the pull-out chair/bed beside my bed, I tried unsuccessfully to get some rest. I’d agreed to revisit the idea of induction at 3am. Until then, I alternated lying quietly trying to sleep with doing deep lunges and squats and moving my hips to stimulate contractions.

My contractions had returned: they were steadily getting more regular and stronger, but they were still completely painless, so I knew I wasn’t making much real progress. I decided to go ahead and take the first dose of Misoprostol at 3am, knowing it would take a while to have its effect. The second dose would be scheduled for 7a.m., and a possible third dose at 11a.m. I could refuse any of the doses if I chose.

Between 3 and 7 a.m. I felt the contractions continue to get stronger and more regular but they were just barely crampy and I still couldn’t feel anything at all happening in my pelvis, where things were supposed to be moving as the contractions pulled my cervix open.

The hospital shift changed at 7a.m. so there was a whole new set of faces to meet, and they moved us into an actual Labor and Delivery room. It was so spacious and comfortable, with an incredible view of the whole city, a larger bathroom with a tub, an area full of equipment for the baby when it was delivered, and a large area for me to labor. It also had a “birthing ball” which is just a large exercise ball to sit on and rock and help me open my pelvis during contractions, and other amenities. Doug set up our music player and got himself settled in the corner by the window. I took my second dose of Misoprostol – my contractions were about 5 minutes apart, about a minute long, and felt like menstrual cramps with a purpose, which was nice. I was still chatty, texting my family, talking to the various new staff who introduced themselves, and I ate breakfast (because eating is no longer prohibited during labor at UCSF, thank God) – eggs, sausage, and a bit of toast.

When 11a.m. rolled around the nurse decided not to give me my third dose of Misoprostol because my contractions were closer together than the recommendations for continuing the dose of that drug. At this point they wanted to start me on Pitocin but I refused. I was listening carefully to my body and could now feel the contractions getting harder and stronger, more intense and closer together. There was also beginning to be some good pressure and pain in my pelvis and cervix. To add Pitocin, I felt, would take me too quickly into unbearable pain and I still wanted to try for a totally natural birth.

The midwife on duty was rather pushy in her way about this; her style of being pushy meant that she would stay in the room and calmly explain (over and over again) why they wanted to give me Pitocin (“risk of infection,” “we need to make your contractions regular and stronger,” “the baby could go into distress if labor goes on too long”) without truly listening to any of the reasons I gave for wanting to hold off (I am not afraid of infection, my contractions are getting stronger and more regular, the baby’s vitals have been perfectly regular, and I don’t want an epidural but I know I’ll need one with Pitocin). Just as with the doctor the night before, I finally had to look her in the eye and say something like, “You have informed me, and I am choosing not to proceed with your recommendation. Thank you.” It was stressful to have to object so strongly and directly, even though I have a pretty strong personality and she was being very polite, and I can see why women frequently don’t feel able to stand up for themselves and instead just go along. So she finally left and let me labor.

Contractions were continuing to ramp quickly in intensity, and I texted Heather, my Doula, that she should probably head over soon because I would need her help soon in managing the pain. I had a deep inner worry that I didn’t express to Doug or Heather, and that I barely admitted to myself. I’d read about Misoprostol before and I knew that it could make contractions unbearable all by itself, because it interferes with a woman’s own balance of hormonal signals that are controlling labor. I had refused Pitocin because I knew it would make me progress faster than I could handle – because now I was actually worried, deep inside my mind, that I was already progressing faster than I could handle. Had my water broken 4 weeks further along, I would have been laboring naturally at home all this time; I probably would have slept all night, and my own hormones would be in control and gradually working me toward birth slowly and naturally. But instead I now hadn’t slept at all in 36 hours, and I was feeling it. The contractions were now like Charlie horses in my belly and steadily intensifying.

By the time Heather arrived, I was having Doug help me to get through each contraction by pressing strongly on my hips from behind while I sat and bounced on a birthing ball. I could now feel every contraction deep in my pelvis and sacrum, as well as my belly. When I’d stand up off the birthing ball, I could feel where my pelvis was flexing and opening and creaking. During contractions I could feel a tingle, like electricity, deep inside me that would radiate up my back. Occasionally I’d feel a snapping or popping feeling deep inside, too, like the feeling when a stretch goes deep and pulls a muscle. These feelings were almost certainly my cervix beginning to dilate and efface and the ligaments in my pelvis relaxing, but I could tell that it wasn’t happening fast.

I don’t remember everything that Heather did, because by the time she arrived I was very focused inward during contractions, but everything she did helped. She had essential oils and helped to direct Doug and give me ideas for different positions.

I labored for about an hour after Heather arrived when we decided I should get into the tub for a while. The pain was now quite intense with contractions coming faster than every three minutes. I was officially at the point when I thought, “why do women do this?!” and “I don’t think I will ever do this again,” but I was still handling it well.

The tub felt so nice. I was sweating and they’d made the tub tepid. Heather put a cool rag on my forehead and there was a lovely mint smell from her essential oils. She and Doug lowered the lights and turned on a hypnosis track and sat with me in the bathroom while I breathed through each contraction. The waves were so intense. I fell asleep between them but they were coming very close together so I wasn’t getting any real respite. Somewhere deep inside me, my devious conscious mind raised the niggling thought that some women went for pain relief right about now, and I could, too. But I pushed that thought back down without letting it be more than a fleeting image. I probably had 15-20 contractions in the hour I was in the tub. Suddenly I became aware that I was getting very cold. I remember Heather saying that they could add some warm water but all I could think of was how comfortable it would be to get dry and warm and wrapped in blankets and lay on the bed.

Getting out of the tub, dried off, and dressed was complicated by my contractions, the IV lock in my hand, and the monitor I was wearing (I had to wear a monitor once they induced me, which restricted my mobility somewhat). Just as I’d get going on action like putting underwear on, a contraction wave would come and require me to focus. This was somewhat distressing…I was so sleepy…and that inner part of my mind raised the image of rest and pain relief once again. But again I pushed past it.

At last I was dressed in dry underwear, gown, and bathrobe with a new dry elastic band for the monitor, and I could climb into the dry warm bed with blankets piled on top of me. But the comfort of warmth was ruined by the contraction waves that were continuing to get more and more intense, along with growing pressure in my pelvis as my cervix continued to change. I changed positions several times to try to find the best way to bear them, with no real difference. A third time, I thought about the potential for pain relief. I was dreading each new contraction and not getting much rest between them. I decided to ask for nitrous oxide, which is an option that only a few US hospitals provide.

It took a couple of contractions before they could set up the nitrous oxide mask. The peaks were rising very quickly and approaching my pain threshold, and I had begun to vocalize and moan loudly during each one. Then they gave me the mask and told me to start breathing into it before each contraction and to stop once it had peaked. Almost immediately I realized that I couldn’t use the gas. It smelled sickly sweet and warm and it made me nauseous almost immediately. The warmth and closeness of the mask also made me feel suffocated and claustrophobic somehow, which was unbearable when added to the pain of each contraction. The polite part of me felt so bad that I’d asked them to set up the gas and then couldn’t use it.

About this time Heather offered to let me use her TENS unit. She placed electrodes on my lower back and gave me the controller, which let me apply a distracting electrical current to my back muscles during contractions. The purpose is to supply a sensation and stimulate nerves to reduce local pain. It was actually helpful, and I wished I’d begun to use it sooner. I sat thru a few more strong contractions, moaning loudly which also seemed to help, as I could feel things changing inside me. I suddenly had to go to the bathroom, where I found blood on the toilet paper. Hurrah! I announced it to the room: this meant changes were really happening!

But when I sat back down on the toilet, I experienced two intense waves right on top of each other before I could even pee. I turned my mind inward again and did an assessment of my body. I somehow knew that things were not very far along, and I estimated that there would be at least another 5-7 hours of this crushing, aching, piercing pain, and then I would transition, which would be even worse, and then I would labor down and push my daughter out, which could possibly be awful too, especially if I was even more exhausted. I realized that I was fighting the contractions, dreading them, and that my exhaustion was undermining my determination.

I came out of the bathroom, had another 2-3 awful contractions while leaning on Doug, and then I just broke down. It seemed very sudden to Doug and Heather because up until then I’d apparently not shown much of my inner struggle on the surface. I was so tired and rather upset with myself, but most of all I was in pain and I was crying as I asked for an epidural. They wanted to check my cervix first, which was more agony as I waited through another couple of contractions. When they checked me at about 2:30 p.m. I was 90% effaced (cervix thinned out) but only 2 cm dilated. I was not at all surprised, having assessed my own body and knowing that it had much more work to do. The team tried to get me to consider narcotics, but I was done messing around and I firmly requested an epidural.

In retrospect, thinking about how quickly my contractions went from cramps to Charlie horses to crushing stabbing pain, I’m even more assured that refusing Pitocin was the right call for me. Later in the evening it proved completely unnecessary. I’m also certain that the Misoprostol that started my labor is what caused the pain to escalate quickly beyond my ability to bear it. My contractions were coming very fast and hard for having made so little progress in my cervix, and the pain was just draining my energy even more. Baby’s vitals were still trucking right along, though, and I was assured that she was holding up well.

Without going into much detail, I signed the release forms and got my epidural between 3 and 4 p.m. It took the anesthesiology team a long time to place it, which meant I was sitting on the edge of the bed, bent over leaning on Doug and moaning, through 10-15 intense contractions. Sitting bent over is a terrible position and made the pain even more intense. I remember looking up at Doug and seeing tears streaming down his face. He just couldn’t bear to see me in this much pain. Somewhere deep inside me, his tears of empathy made me love him even more, which may not be something many women feel during the peak intense pain of their labors. He was and is a wonderful partner in the worst of times.

Finally the tubes were placed and I felt my feet getting warm, then my legs began to tingle, and finally the intensity of each contraction began to subside as the drug took effect. As the pain receded, the tidal wave of exhaustion rushed past it and washed over me. I was so sleepy. They dimmed the lights to let me get some rest, and I closed my eyes.  

We had a baby! Our birth story Part 1

We delivered our daughter, Aisling Jane, 4-5 weeks early on June 11, 2013. She was 6 lb 9 oz and 19 1/2 inches long. She stayed in the NICU for 7 days, mainly due to Jaundice that kept her under UV light therapy on 2 separate days.

It's taken me a couple of weeks to get to where I can write out our birth story. I'm very happy with how it all went, though I didn't have a "natural birth" because I was early, the hospital staff were amazing to work with and the meds I received were as close to perfect as I can imagine -- I could feel everything but without the intense crushing, piercing pain of my induced contractions.

Here is our birth story, Part 1.

Disclaimer: There are references to bodily fluids and parts in this story. I am very comfortable with all aspects of my body and its functions, and I hope you are, too. If not, read with caution. :)

Prelude: leading up to Monday afternoon, June 10

The weekend before my delivery was very relaxed without as much exercise as usual because I was generally feeling lazy and under the weather. I attributed my somewhat icky feeling to having gotten the TDaP vaccine on the previous Thursday, which made my shoulder sore. But overall I just felt very generally lazy and sleepy and never had a fever, so I just laid around reading a book all weekend. I do remember laying in bed on Sunday night having a hard time getting comfy, and feeling a strange sharpish pain as I turned over to go to the bathroom, but it went away quickly and I didn’t think much more of it. In retrospect it could have been significant.

Monday morning June 10 was a fairly ordinary morning. I remember getting up and feeling good, and looking in the mirror and thinking I must not have eaten much all weekend, because I looked less full under my ribs and felt less pregnant somehow. I had an 8:30 meeting to rush off to, and the morning was very normal. Baby was moving around and squirming as she usually did each morning, and I even commented to a coworker that it was more fun to feel her movements now that I knew which way she was oriented after my 32-week ultrasound.

Just after I ate lunch, sometime close to noon, I was sitting comfortably at my desk working. I moved to cross my legs, which required some effort as it lifted my belly a little, and suddenly I felt a tiny bit of warm fluid moving where it shouldn’t be. I froze. It did not feel like pee; I had not had a problem with incontinence and I had recently been to the bathroom, so I immediately got suspicious. It was not a gush, it was maybe a few drops; enough to feel but not enough to even get my clothes damp. I went straight to the bathroom and when I sat down on the toilet I heard a little faint trickling sound that I knew wasn’t pee because it took me a while to “let go” when I peed. I looked down and saw clear liquid of different consistency from the toilet water slowly diffusing out. I felt myself and there was thick clear fluid and a little bit of mucous on my fingers.

Now she had my full attention.

I went home (which is literally right across the street from work) and caught some of the trickle in a clean glass to see if it looked like amniotic fluid. It did: it was perfectly clear with tiny particles floating in it which were bits of the vernix that coats the baby and protects her skin. Totally odorless. I decided to call my doctor. I’d been texting Doug all along to let him know what was happening but I told him not to come home, that if anything was happening it would still be a long time before he’d need to be home.

My midwife scheduled me to come in at 4:00pm for an evaluation. I scooted back to the office, finished what I was working on, and sent an email to my boss and coworkers that I needed to head home, but not to be alarmed. When I got home I decided to take a shower before heading to the midwife. BEST DECISION of the week. I couldn’t feel any contractions, the baby was moving around normally, and the tiny trickle of fluid continued.

I drove over to the Dr. at 4:00pm where it was immediately obvious to my midwife Brooke that I was, in fact, leaking amniotic fluid. I had put a washcloth in my underwear, which turned a PH strip blue as soon as she touched it to the damp area. She listened to Baby’s heartbeat, took my blood pressure and temperature (both normal). While I was on the table I had my first little contraction, and soon had a couple more. Brooke said that I needed to go ahead to the hospital (I planned to deliver at UCSF). She wanted me to go straight from her office, but I wanted to run home and pack a bag and meet Doug. While I’d been waiting for 4:00 to roll around I’d read up on “PPROM” (preterm premature rupture of membranes) and learned that if the baby was <34 weeks gestational age, they would try to stop labor; but if it was >34 weeks, they’d let it progress or try to augment it because the risk of infection outweighed the risk of baby not being ready to come into the world. I figured that when I went to the hospital, I wouldn’t be coming out again without having delivered, and I wanted to get my stuff together. Second best decision of the week!

So I texted Doug to get home (he’s about an hour commute away), drove home, and started to pack. The best possible items I packed were a bathrobe, my own pillow, my toothbrush, and a change of clothes with nursing in mind. My little contractions were getting close together, about 5 minutes apart and about a minute long, but they were painless other than being tight and pressing on my bladder. Baby was still squirming as usual and I laid down to wait for Doug. When he got home he threw together a ton of camera stuff, his portable ipod speaker, and a few things to keep him entertained and comfy. We bundled down to the car and off we went.

The drive across town to the hospital was excruciating, and not because of labor. I suddenly had to pee, which was exacerbated by my frequent contractions, and the San Francisco streets are so roughly paved that it felt like we were off-roading. By this time it was 6:30 and traffic was heavy, so we caught every red light and got behind slow turning people, buses, and delivery trucks way too frequently. By the time we got to the hospital I was in urinary agony. Doug let me off at the front entrance while he went to go park. I waddled to the nearest restroom (waddling to keep from peeing and because I could feel the leaking getting worse). As soon as I peed, which was a tremendous relief, everything stopped completely. No more contractions, nothing, nada.

I headed up to the 15^th floor where UCSF Labor & Delivery is located, and was directed straight to the nurse’s station where they were expecting me because my midwife had called. They got me set up in a room, Doug arrived, and the wait began. I was very nervous about how the PPROM would alter my birth plan, which was for as natural a birth as possible, and I was extremely resistant to the thought of induction. I called our Doula, Heather, who we had not even finalized our contract with yet, and she was on her way. We had everything we needed for Baby, but so much logistical work was as yet undone, because we expected at least another 3-4 weeks before delivery. But ‘twas not to be.

Monday Night

The “risk of infection” would become the top term of my labor, as far as the doctors were concerned. Many women whose membrane ruptures prematurely have some sort of infection which causes the rupture, and as soon as the membrane ruptures, that infection can pass to the baby and create complications in labor and afterwards. Therefore, the standard of care for PPROM after 34 weeks is to induce labor and get the baby out as quickly as possible. However, I was quite certain that I did NOT have an infection (a certainty later borne out in the results of all of the tests they performed on me and my baby), and I was absolutely determined to wait for my body to get started naturally even though it certainly meant a long labor.

Once a woman is induced, the clock starts ticking for the baby, because a woman’s own hormones are no longer in control. Far too many inductions end in C-Section, especially in the US, because induction can make a woman’s labor progress very rapidly and put the baby into distress. Inductions also start a “cascade of interventions” which are basically more unnatural actions done to counteract the effects of unnatural practices that began the labor. I knew that I was going to have to balance the “risk of infection” with my own confidence in my body’s ability to give birth to my daughter. I also had no idea how the USCF staff would handle my resistance to what I knew they would recommend, but I’d heard great things about UCSF so I just went ahead with confidence.

As soon as we were settled in our room, the endless parade of new faces began. UCSF is a teaching hospital, so at each 12-hour shift there is one attending M.D. OB, two resident M.D.’s, at least one med student, one nurse who’s assigned to you, and several other nurses who rotate in for your nurse’s breaks. During the day there are midwives on duty, and there are also other doctors who may come introduce themselves, like anesthesiologists, neonatologists, pediatric specialists, etc. Since I met at least 25 new people at each shift change, eventually I stopped trying to remember names and just remembered faces so I’d know whether I’d met someone or not.

Our antenatal (pre-labor) nurse was named Janice, and she would eventually be my labor nurse. She quickly endeared herself to me. Her job was to monitor my vitals and generally take care of me and make sure I was comfortable. She also proved to be a reliable foil for some overly-cautious doctor speculation -- though in no way did she ever contradict a doctor’s advice, her expressions and body language were extremely communicative.

Our team of doctors, residents, med students, etc. for the current shift came and introduced themselves, performed a visual cervical check with a sterile speculum, and also took a few culture swabs to check for infection. I’d never had so many people looking at my crotch at once; suddenly I realized there would probably be even more later when things got serious. Modesty was already out the window, and I decided to let it go completely.

My cervix was still closed and long, as I expected having just started leaking that afternoon with no other symptoms and no time to start labor at all. With PPROM, they try to limit the number of cervical checks to reduce the potential exposure to infection, and this first one was the only “visual” check. I wouldn’t have another check until things really got going, which turned out to be after noon the next day.

The attending OB came in to make some recommendations. She wanted to induce me with Misoprostol right away to get things moving, since it had already been about 8 hours since I started leaking, and standards of care recommended delivery less than 24 hours after membranes rupture. I was VERY resistant to this idea, because our bodies can react very strongly to induction drugs and I wanted my body to at least start to labor on its own without adding drugs just yet. I was also hoping for a natural delivery and drugs would almost certainly bring the pain on to strongly, too fast for me to be able to handle it.

I had to push back very hard on her and tell her that we’d been expecting an early labor (though not quite this early), I’d had an uncomplicated pregnancy up until now, I was having steady contractions before I came into L&D, but I’d now been in my room for several hours being checked in and “informed,” and how was I supposed to walk around and get labor started if people wouldn’t get out of my room, leave me alone, and let me get up and walk. If I’d been 37 weeks instead of 34 I’d still be at home. I did agree to let them give me Penicillin IV since I couldn’t be absolutely certain that there wasn’t an infection, and I am a reasonable person. My doctor agreed to come back in a couple of hours to talk about induction again.

No sooner had she gone than the Neonatologist came in to introduce herself, and then promptly told us that they expected to keep our daughter in the NICU for at least three or four weeks. I almost lost it. I re-stated to this new doctor that our daughter had measured ahead on every ultrasound, I’d had an incredibly uncomplicated pregnancy, and for all we knew our daughter was just ready to be born. Doug came around and sat next to me on the bed like a hero. After some conversation I got the doctor to admit that if our daughter was an absolute preemie superstar, she might get to go home by the following Monday, still almost a week away. This still seemed like an awfully long time, but WAY shorter than three to four weeks.

And now, my adrenaline pumping, there was no way in Hell my labor was going to get started anytime soon. Doug and I got up and started walking the halls.

Our doula Heather arrived and we debriefed her about what was happening. It was so wonderful to see her, a familiar face and calming presence. She was very reassuring and helped me to think thru some of the emotional responses I was having so that the next time the OB came in, I was able to calmly ask for the evidence (research) that warranted inducing me for a 24-hour delivery. She looked it up and came back, saying that honestly there wasn’t much research, the evidence was weak, and the strongest negative outcome (still VERY weak in probability) was cerebral palsey due to fetal distress and infection.

I decided that the likelihood of fetal (and maternal!) distress from a rushed labor and delivery outweighed my fear of the risk of not inducing. I was confident in my body’s ability to at least start contracting by itself again, and decided to wait 4-5 more hours for my own labor to start back up before taking any drugs. Contractions were showing up, faintly, on the monitor, and I wanted to let my body strengthen them.

And with that decision, we let Heather go home to get some sleep and settled in for a long, sleepless night.

Last pregnant belly selfie

Belly update ~ 34 weeks

Six weeks left to go to full-term!

Here's the latest on my baby belly progress. Very few clothes fit anymore and I'm loathe to spend money on any new ones, so I'm the frumpiest frump who ever frumped. I'm feeling big and heavy, especially in bed. Turning over is an effort that requires waking up completely, which also usually means getting up to pee. I'm so tired of laying on my sides; I'm normally a back-sleeper. I've also been appreciating the support of a pillow under my belly when I'm laying on my side, to keep my belly from pulling on my back too much.

I've been able to be very active over these last few weeks -- the weather has been great, beautiful and sunny and breezy in the 60's and 70's. I try to walk at least 3 miles a day along the Embarcadero which passes right behind out building, and throw in some stretching and strength moves in the park nearby. I walked a total of about 30 miles last week, and I've averaged 15-20 miles per week since the first trimester ended and I got some energy back. I'd like to start some prenatal yoga in the next couple of weeks to help keep me flexible and prepare for labor. Thankfully my activity seems to be keeping the leg-swelling that affects many women at bay, though I'm getting a teeny bit swollen in my feet and ankles during work so I try to take a walk after lunch to get the blood flowing.

The view from the inside

Baby is definitely starting to think her world is closing in on her. Her movements are much slower, stronger, and more deliberate. I can distinctly feel the bump of her bottom at the top of my belly and she likes to brace her feet against my sides and push. She also sometimes sways her bottom from side to side slowly, especially when we're leaning back on the couch at night. The lump of her bottom moves from one side of my belly button to the other and then back, and I can feel her feet pressing on my sides and her hands fluttering down low near my hipbones.

Her rhythms tend to match ours -- she's usually active most of the day while I'm at work, and she likes to push and brace herself while I'm walking, though this morning she took a nap where I couldn't get her to move at all no matter how much I poked and prodded her. Hopefully this napping habit will last after birth, but it was disconcerting at first until she suddenly punched my bladder and recommenced squirming as usual. She's still very active while we eat dinner and wind down for the night, and then she seems to stay blessedly quiet all night while we sleep. Doug usually puts his hand around my belly as we fall asleep and he can feel her squirming and trying to get comfy for the night. My bladder gets me out of bed 6-10 times per night and I can feel Baby move when I lay back down, but she settles down fast so I can get back to sleep.

I think it's so sweet how she seems to wake up when we do. Doug and I usually cuddle for a while as we wake up. As we start talking and moving around more, she begins to stir and stretch and start bouncing just a little. And by the time I get to work she's in full squirmy mode.

Doug has started kissing my belly after he kisses me when we wake up. He says he has to say good morning to his girls. Heart. Melting.

Breast is (obviously?) best

I've found something new to be thankful for: that it never occurred to me that breastfeeding is a "choice" to agonize or beat myself (or anyone else) up over.

If you read this blog and think me ignorant, innocent, or a typical self-centered and idealistic new parent, I won't mind...and if you think I'm judging any woman who makes a different decision than me, you certainly don't know me. I've been relatively oblivious to the power of "what other people think about me" and "what other people want me to think" and "what other people should think with their own minds" since I was a very little girl (and my mom and sisters have stories to  support me in that assertion). This hasn't always led to the best outcomes, and so I have learned to be more sensitive, but it's still reflexive for me to "follow my own drummer" before listening for anyone else's.

So it's been interesting for me to learn about the perspectives of women who DO care what other people think about them, especially when it comes to child care. And boy, do "other people" seem to care about what women do with their breasts!

There's a breast AND a nipple
in this photo.
Are you excited? Or offended?
Or oblivious?

It seems that, according to American popular culture, breasts are first and foremost sexual objects, and any use of them is, therefore, sexual. Apparently breastfeeding initially fell "out of fashion" in the early part of the last century, and once the corporate marketing engines got going in the 1950's, it was widely considered to be a "lower-class" way to provide for children's nutritional needs. Simultaneously, societal thoughts about breasts were warped by the explosion of objectification of women in the popular media, and our society felt a kind of twisted shame about this explosion. I say twisted because today, instead of thinking "objectification of women and their component parts is shameful," or, "people who can't control/politely suppress their sexual thoughts are acting shamefully" the societal mind says, "visible pieces of women's component parts which might incite sexual thoughts are shameful," and, therefore, so are the women "exposing themselves" by feeding their children using the parts they were born with exclusively for that very function. See? Twisted. I have a brain cramp now.

Seriously, should the fact that you might have a foot fetish make me feel ashamed about exposing my feet to walk with them?

So it never really occurred to me, even long before I got pregnant, that I would do anything other than breastfeed my child/children. I was rather surprised to be asked at my very first prenatal appointment whether I plan to breastfeed (I apparently have VERY pro-breastfeeding doctors and midwives), because, I thought, why would I do anything else? Only physical problems or severe (probably job-related) logistical factors would cause me to consider anything different. And I've been quite surprised to learn that apparently my attitude is rare, compared with many American women who feel the need to seriously deliberate, research, justify, and enforce their choice to feed their children using the glands nature provides all mammals with to nourish our offspring.

May 2012 Cover of TIME.
The article was about "Attachment Parenting"
but the cover got the most attention.

For example, this cultural condemnation is apparently bad enough for some that entire blogs like the Badass Breastfeeder dedicate their existence to promoting breastfeeding and nursing in public (the Facebook page for the Badass Breastfeeder has 25,000 likes!), and fundraising is underway to produce a video which publicizes the struggle faced by women who haven't yet made a choice. Some women feel enough anti-breastfeeding social pressure that they feel the need to fight for their right to nurse in public places. Read the comments on photos of women nursing in public and you'll see dozens of stories about bystanders who stare in disgust, who tell them that their actions are obscene or inappropriate, who tell them to go to the restroom to feed the child. The restroom? Do YOU eat in the restroom? Some commenters go so far as to say that breastfeeding in public is the same as masturbating or defecating in public (seriously?!).  The comments that strangers AND family/friends make to these women are often hateful and generally just sad.

Now, despite learning about all of this pressure, I still don't feel weird for just always knowing and planning to breastfeed...but perhaps my personal percussion section is just too loud. When I think about every mother I'm related to (2 sisters, 3 cousins, mom, aunt) and all of the children they've mothered (somewhere upwards of 15), I'm almost positive that all of them breastfed for at least some portion of every child's life. And I guess the most influential people to a woman's "instinctive" mothering choices would usually be the mothers she actually knows. So I can see how my influencers might be different, and that helps me to come closer to relating to why other women might not find the choice as natural as I do. 

I'm also aware that, although it's completely natural, breastfeeding is not "easy" or "painless." But neither is childbirth or parenting, for that matter. I'm thankful that, should something happen that makes it impossible for me to nurse my child, there are alternatives available, including "breastmilk banks" where women donate their extra milk (after testing and pasteurization) to support women who can't make their own!

A huge problem as far as "choosing" to breastfeed goes seems to be that women who don't naturally choose to breastfeed are absolutely bombarded by marketing and cultural messages about what they should be doing, instead. Even the medical industry is sucked into providing free formula to new parents, and standards of care can be in many ways less-than-supportive of the conditions that foster breastfeeding immediately after childbirth.

Did you know that the World Health Organization recommends breastfeeding exclusively (no water, no juice, no rice cereal) for 6 months? And that they recommend that breastfeeding continue for two years and beyond? But social pressure in the US is so strong that even women who DO breastfeed are pressured to wean early, introduce solid foods faster than medically recommended, and generally to STOP breastfeeding ASAP. What gives?!

I won't even go into the nutritional and biological factors that make breastmilk superior to anything that we are capable of manufacturing ourselves, which is merely sufficient for meeting basic needs. But if you don't know, you can Google it.

Anyway, our plan is to breastfeed exclusively for six months and to introduce solid foods as Baby indicates she's ready, which is normally after 6 months for most babies. We'll only give her solid foods that she can eat and handle herself, so no spoon-feeding of prepared baby foods. I'll pump as much as I can and let Doug feed her once our nursing pattern is fully established. And if, God forbid, something prevents me from being able to nurse or pump, then we'll look into breastmilk banks and formula. We'd like to continue nursing and/or providing pumped breastmilk until she's at least 18 months old, and possibly longer depending on logistical factors of our lives at that time.

Because breast is, obviously, best.

Incidentally, we got our nursing pillow in the mail yesterday, which just about completes our most necessary supplies! Hurrah!

We'd love to read your thoughts in the comments below. They should be open to everyone now, and we won't close them unless SPAMmers get out of control. What do you think about breastfeeding?