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Labor and delivery (notes for new moms: birth stories, the fourth trimester and nursing)


Birth Stories

Moms need to tell their delivery stories.  At baby showers, that's mainly what happens. Have you ever noticed that anytime a pregnant lady asks for stories, women always tell their traumatic ones?  The women who had easy deliveries never weigh in, because they don't have time to retell a story they've already processed.  But the woman with the agonizing delivery is still waiting for somebody to validate her experience. 

If you're at a baby shower, just wait for it.  The cute mother-to-be starts doing a little research and timidly asks something about childbirth.  Here's my two cents:  if you're the pregnant lady, gently redirect that other lady and say something like, "may I pass?  It won't help me to hear your story, and I won't be able to help you."  Then look around the room for a kindred spirit, a lady with 2-3 kids of her own and a kind face, and say, "but maybe she'd be willing to listen."

The moms who struggled and suffered and had a horrible experience, who never had a friend or therapist validate what happened, are still looking for a listening ear.  They hope that the pregnant friend can offer support or empathy, but she can't.  She's only terrified and it perpetuates a cycle of fear before childbirth.

So before I go any further:  here are my four delivery stories.

Baby #1
Norm and I were students and we picked an excellent OB. 

I'd had some ideas about how childbirth should go, I wanted to walk around during labor, I wanted to do it naturally, etc.  We got to the hospital early in the morning, inducing labor one day after my due date, and by 10 am I realized I was in trouble.  They wouldn't let me walk around since the pitocin IV was hooked up.  By 2pm the nurse convinced me to have an epidural.  I was in pain, didn't have the tools necessary, and I felt like Norm, the doctor and the nurse were calling all the shots.

The epidural helped and I was able to take a nap, let my body relax and do its thing, and by dinnertime things were getting pretty intense.  Around 6pm I thought for sure we'd be done soon.  But when 9pm rolled around and my baby was still crowning, the doctor said something like, "sorry, but if he's not out in the next half hour, we're doing a C section."  Okay, that made me mad.  I didn't do all that labor all afternoon for nothing.

They'd redosed the epidural by that point and I couldn't feel my legs, just an enormous pressure.  Somewhere between the nurse standing by my head and pushing down with all her might, the doctor with forceps and a vacuum pulling the baby out on the other end, me pushing with all my might, eventually baby boy emerged around 9:30 pm.  I was exhausted, numb, elated, etc.  I later learned that his head circumference was roughly the size of a pumpkin.  Seriously.  Most normal babies measure 34-36 cm.  Cade was 37 cm.  No wonder he was crowning for forever.  He weighed 8 lbs 13 oz.

A word about music:  I think we brought an old-school ghetto-blaster, and a bunch of CD's for entertainment. I swear we were listening to Bon Jovi and ironically enough, a song from the musical Prince of Egypt called "deliver us."  I wish somebody would have told me to pick really boring, slow elevator music.  But whatever.

Details that went unnoticed at the time:  the doctor was an expert with stitches.  The recovery season was difficult.  If any of my friends' husbands are reading, sorry.  Suffice it to say that I couldn't sit on a hard chair for months.  When you go to church and the women get the padded chairs, now you know why.

The other complication from the epidural:  it completely shut down my digestive system.  Even though I was eating All-Bran for fun, drinking prune juice and having fiber all day long, it still took my body TEN DAYS before things returned to normal. Not fun.

I vowed a few things in those early weeks:
* I would not deliver with an OB again.  Midwives must know something.
* I would research childbirth and pain control techniques.
* I would wait until the baby wanted to come out, and never induce early.

When Cade was a newborn, he was a good eater.  I'm sure at least one person (including my father in law) commented that I was probably feeding him too much, but since I was the mom I knew better.  In hindsight, they were right and I was probably feeding him too much.  When a newborn wakes up every two hours in the night, they don't need to be fed.  I didn't realize that, and so every time he cried in the night (EVERY TWO HOURS) I fed him.  Needless to say, I was sleep deprived and desperate.

photo credit Kiddie Kandids 

One more side note.  If you have a great grandma, take a photo! In the next few years before I had baby #2, all of my grandparents had passed away.  So remember life is short.


Baby #2
Some of our friends recommended hypnobirthing and we decided to try it.  We'd chosen a group of midwives for prenatal care, and our teacher was in that group. She also happened to be on call when our son was born. Safety tip here: Pick a hospital where the midwives have a good relationship with the staff.  If they are respected, they will be able to help you get the delivery you want.  When you're shopping for a hospital, ask questions like:  "If I need to have an IV during labor, will you still let me walk around?"  Yes it's possible. They have portable units.

So yay, I'd done my homework, prepared and I had a midwife that I knew and liked.  A word on hypnobirthing:  you are preparing your body and mind to deliver your baby without fear.  The affirmations allow you to relax and let your body do what it's made to do. Nature works great when anxiety doesn't get in the way.

Recommended reading:
Baby Catcher, by Peggy Vincent  (This one is not G-rated.  The language and the delivery stories might offend some of my friends.  But a sweet mentor gave me her copy of this book, and I've since passed it down to another mom-to-be.  It's one of the best things I read to help me anticipate a normal delivery.)
Hypnobirthing, by Marie Mongan
The Good Earth, by Pearl Buck  (The lead female character Olan is a Chinese peasant lady in the 1800's.  She works in the rice paddie all morning, goes inside, delivers the baby by herself, and returns to help her husband in the fields later that day.  This is not my ideal birth, but it illustrates the cultural things at play.)
I thought it was just me by Brene Brown.  For a quick insight into expectations and how they impact your delivery, check out p. 209 where she talks about the Life Shuffle.  In a nutshell, let's say you get 5/10 things you're hoping for in a delivery.  Can you be okay with that?

Baby boy was due in the springtime.  Since I'd vowed to never induce early, I made it a whole NINE days past the due date.  At that point I started getting scared that he'd be too big to come out.  So we induced labor again.  Same as before, we went to the hospital early in the morning, said something like, "I'd like to have a baby please," and off we went to Labor and Delivery.  This time we brought movies to watch, I had a walking IV so I could cruise the halls in my sweet nightgown, and things were going well.  Halfway into our chick flick, I had a total meltdown.  (I later learned that when they crank the pitocin up, sometimes the emotional fallout happens about two hours later.)  So they turned off the pitocin, we turned off the movie, and that's when the midwife and her awesome tricks helped.  We did a hot water bath, we did all sorts of stuff I've forgotten.

The most helpful thing we did was to have my husband record his voice reading all the scripts.  That way I could push a button and he'd be saying all the helpful stuff I needed to hear.  But then if I wanted quiet, I could just turn it off.

Also we brought really soothing, calm music this time.  I think it was an ocean CD with really pretty instrumental stuff.

Baby boy was born by lunchtime.  The labor was fast and furious, but I didn't have any of the horrendous after-effects of the epidural.  He weighed 8lbs 11oz.  I can't remember the head circumference because it was probably normal.  The midwife wasn't quite as good at stitches as the doctor was with Cade.  But she used lidocaine and got the job done.  A word about tearing:  don't worry about it too much.  Sure it's a bummer, but if you accept that fact that it might happen and your body will heal, it's better.


Baby #3
I remember it was snowing during her delivery, and I'd had to do all my Christmas preparations before she was born. Six days after her due date,  Same as baby 2, we got to the hospital early in the morning, pitocin meltdown halfway into the chick flick, the midwife was great, baby was born by lunchtime.  Hurray!  I'd reviewed all the hypnobirthing scripts again, but we didn't take the class.  Karly weighed in at 7lbs 12 oz, a full pound lighter than her brothers.  I'd say that's probably because I spent my pregnancy chasing two little boys around.


best Christmas present ever


sisters
Baby #4
At this point we had two boys and a girl, so we were open to the old-school idea of waiting to find out baby's gender.  One of Norm's cousins talked about this idea and it made me think.  How often in life are you truly surprised and amazed and thrilled at something genuine?  Often there are difficult, painful surprise (ie car wreck, bad grade on a test, etc.) But how many opportunities do you have in your lifetime, for a miracle and a good surprise to happen simultaneously?

When we did the ultrasound at 20 weeks, we asked the technician not to tell us the gender.  So she wrote it on a piece of paper, and the midwives knew.  But we never asked to open the envelope. I spent the entire pregnancy thinking I'd have another boy, and then towards the end I changed my mind.  It occurred to me that this might, in fact, be a girl. Karly had been praying for a sister all along, and she'd been saying that this new baby was a girl. When I made the baby quilt, I chose lots of yellow fabric, lots of dragonflies, and also lots of pink, red, orange, blue, green, etc.  Babies really don't care if they're gifted with yellow or green or pink or blue.

I can't remember what day I was due, but this time my body actually went into labor on its own.  Miracle of miracles!  It was a Saturday morning right after sunrise, about the time I'd be going for an early morning walk. I felt some cramps, and decided that doing the hula upstairs in my room was my best way to manage.  Norm and I had to make a decision as to whether or not I was actually in labor, since that had never happened before.  He was supposed to drive a handful of Scouts to a merit badge pow-wow, and I almost sent him.  But then I thought, "I might be in labor, let's get somebody else to drive..."  After we got to the hospital, we hung out for an hour and when the midwife came back to chat, she said I could stay.  I'd been sure they'd send me home because there were so many other moms delivering that day, or that she'd say, "no you're not really in labor."  But my body was progressing and she said I'd have a baby that day!  Happy day!  I didn't have to get induced.  I had an IV because I was group B positive, or something like that.

The nurse asked me if we had a birth plan, and I realized she was talking about that letter.  "uh, get the baby out...?"  I said.  She smiled and I knew we were good.  We spent a few minutes chatting and then we were on the same page.

Some of the cool things I remember from this labor:  no pitocin, no epidural, I loved the lemon popsicle thing.  Hot water bath when things got kind of intense, same hypnobirthing scripts from before.  This time after the baby was crowning, the heart rate dropped and both Jessica (my midwife) and the nurse started getting kind of worried.  This was a difficult moment, and Norm knew how serious it was, more than I did.  All I remember hearing Jessica say is, "we need to get the baby here safely."  She said it at least five times.  I had to push harder, and ultimately I had to grab my heels and push for all I was worth.

In the concern for baby's dropping heart rate, they'd forgotten that we didn't know if we were having a boy or a girl.  So to hear Norm say, "we have a girl," was probably one of the most amazing moments of my life.  The midwife and nurses looked over and realized they'd just seen a tender moment. Norm doesn't cry much, maybe less than a dozen times in the twenty years I've known him.  But this was a big deal.  Somewhere between relief that the delivery was over, relief that his wife was okay, and wonder at a little girl...  Baby girl was purple, but after a few minutes she was fine.  She cried right away, and weighed in at 8 lbs 12 oz.  And she had the chubbiest cheeks, even on day 1.

Okay, this is a great time to go listen to this song:  Peter Hollens Ashland's song

Recovery/Newborn phase:  the fourth trimester
Our American culture is not great at supporting new moms.  We often expect them to look and act normal right away.  Some of my friends can do the newborn phase effortlessly.  That was not the case for me.

When Cade was a newborn, the insomnia thing was brutal.  I remember praying for sleep, just begging God to let the baby start sleeping through the night.  God hears and answers prayers, but sometimes He says no.  That season was exhausting for me.  But I learned some pretty important lessons.

Stuff to read while you're pregnant (when you still have free time!):
Secrets of the Baby Whisperer by Tracy Hogg.  I love this book so much.  Written by an English lady, reading it is like listening to a friend talking to you.  She has great advice and great ideas, especially on training newborns to follow a rhythm so you can identify their needs.
Healthy Sleep Habits Happy Child by Marc Weissbluth
Babywise is another great system for training newborns.

When Shad was a newborn, the postpartum depression was worse.  And because his delivery was so easy, my body felt great.  I started doing too much too soon.  When he was just a few weeks old, I hurt my knee getting out of bed.  It was an old skiing injury, but at least I had crutches to help me get around.  I quickly realized that my split level house was not going to work, I couldn't carry the baby and crutch around.  (I didn't have the skills to ask my husband, "hey will you please make me a sandwich?"  without whining or complaining, and this was back when I still expected him to read my mind.)  And I certainly couldn't chase around my toddler.  So I drove to visit my parents with my two boys and hung out with them for a week or two.  Norm stayed behind to work, and my mom helped play with Cade while I figured out the newborn thing all over again.  I saw a doctor for my knee, and a psychiatrist for the depression.  He warned that PPD will get worse with each successive baby.  Great.  He prescribed an antidepressant and I thought, "I've been fighting this depression monster my whole life, why not let some medicine help?"  And so began a dark chapter.

I wrote about depression over here and I wrote about having a two year old over here.  For the sake of brevity, all I will say is this:  whenever I see a mom with a two year old and a newborn, I wonder if she's going through the same thing.  I wonder if she's okay, or if she's at the low point of her career as well.  But here's the good news:  every phase eventually works itself out.  I finally figured out the mental health issues.

When Karly was a newborn, I knew that I had to do things differently.  This time I asked for help.  This time I knew that depression would come, and I knew we'd need to hibernate all winter because of flu season and the cold weather.  And I knew more about self-care, and I realized that I have to take care of me first.

When Amber was a newborn, I basically cancelled all my commitments.  I knew that having a newborn would be a kick in the butt, and that I needed a season to just take care of me and the baby.  My marriage was in a better place, and Norm pretty much took care of the three big kids.  I told the Bishop that I wouldn't be available to play the organ again for a while.  So they found another organist.  I had tons of friends in our neighborhood.  They brought dinners for weeks, and I will always be grateful.

Moms:  you don't have to be wonder woman.  It's okay to cry and fall apart.  The hormones are all over the place anyway.  It's okay to ask for help.  You can't do it all.  The myth that you can have everything is absolutely not true.  You can't have everything.  So pick what you want the most and be happy with your choice.

When your baby hits about three months old, you're kind of at the new normal.  Congratulations on surviving a phase that you probably won't remember.

Nursing

Okay, here's my notes on breastfeeding.  Again, if any of my friends' husbands are reading, just stop! Or proceed with caution.  Once upon a time, my mom made a comment about boobs.  She said something like, "well, you might be too big to breastfeed."  And I remember thinking, "oh, these had better be useful as well as decorative."  So I went to La Leche League.  I asked for advice and the moms were nice, but they're kind of nuts about milk and rules and never using formula.  So I didn't stay there for long, but they pointed me towards the nursing bible:  The womanly art of breastfeeding  If you ever have a question about anything related to nipples or milk, latching on, or mastitis or whatever, this is a great reference.

After your baby is born, he/she won't be hungry.  But the rooting reflex is real and that's your chance to teach them (and yourself) how to latch on.  Colostrum is amazing stuff.  They call it liquid gold for a reason.  Don't let anybody talk you out of nursing your baby in the hospital. Your baby needs the tiny amount of liquid, and the miraculous stuff in it. It sets the stage for establishing a proper milk supply later. Your milk comes in somewhere between day 3-5.  You'll know it because all of a sudden your breasts are heavy and swollen.  You can stuff your bra with cabbage leaves, that helps a little.  Or take a hot shower.

Nursing a baby is amazing.  It's the coolest thing ever, but it's not free of charge. You pay your dues at the beginning. You have to eat extra calories to keep up your milk supply. That's not all bad. PS if your milk supply is low: add more soy.  Soy is super high in estrogen, so try edamame and soy juice, etc.

Those first weeks and months are really hard.  If I had a penny for every time a baby latched on to a cracked nipple and I had to grit my teeth to keep from crying, yeah. Even with my fourth baby, I'd already nursed three other kids for a year each.  But getting her to latch on properly, and working through cracked nipples and blood in the milk, it was not a picnic.  I remember bringing Amber with me to one of the midwives, planning the visit when I knew she'd be hungry and ready to nurse, and asking the midwife to tell me what was wrong. So she watched me get Amber started and said that baby was fine, but I needed to let all the cracks heal. My solution was to pump milk right before she started nursing, so that the milk would already be there and she wouldn't have to suck as hard at the beginning.

I loved having two different kind of pumps.  The hand pump was small and I used it sometimes.  The one I had looked like this:  hand pump
The electric pump was great because you can do two bottles at once, and it's faster.  I bought a gently used Medela one from my friend A.  It was a great investment!  However much we spent on it, it was worth it.  Having bottles of milk and bags in the freezer means freedom.  It means that a nursing mom can leave the house, leave hubby home with baby and he's not helpless. It was also fun for the big kids to feed Amber bottles of milk.

Nursing is worth it: there's bonding between mom and baby. Oxytocin makes everybody happy. The milk itself is miraculous. After your nursing pattern is established, consider doing single side feedings.  Here's why: the milk that comes out first is watery, made to quench thirst.  After the first few minutes, the milk gets fattier. It's called hindmilk, and your baby's brain needs fat. Their brain is growing at an amazing rate, and all the good fat takes time to develop between feedings. If you pump a bottle of milk and stick it in the fridge, notice what it looks like the next day.  The cream will rise to the top.  Your baby needs that cream, and it only comes at the end of the feeding.

Some moms like to nurse when they're out and about. I remember nursing babies in the car, at the park, in the dressing room at the mall, at church. That said, my preference was to be at home. Usually baby ends up sticking their head out of the blanket and then mom is flashing everybody around her. So that's where having a pump is really helpful. Then I could wear a regular bra with an underwire and not worry about a hungry baby ruining a trip to Costco or needing to eat in an inconvenient place.

Once again, if you didn't already read "Secrets of the Baby Whisperer," by Tracy Hogg, this is the synopsis: Establish a routine where you feed the baby, then let them be awake and alert and content looking around, and then set them down to sleep. Repeat this every four hours during the newborn phase. A four hour rhythm will help you and baby get started. Babies don't know how to structure their day, so you need to help them. This helps you understand the different kinds of crying.  I've read and re-read this book a bunch of times.

So to sum up:  if you're pregnant with your first baby, try to enjoy being pregnant. Even at the very end when you think you're miserable, be patient and wait. My mom once said something like, "At the end of the pregnancy, you feel so heavy you'd do absolutely anything (meaning childbirth) just so that you don't have to be pregnant any longer." Babies are demanding, and your life will change dramatically when you become a parent. I wish you a sweet baby and a decent delivery. I hope you have friends and grandmas and people who love you and help you through this season. Reach out to them and ask for help.




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