Sunday, December 12, 2010

First Snow

Okay, it's not technically our first snow of the season, but it's the first we've had that amounted to more than an inch or two. And it was M's first trip outside to see it.

She thought snow sounded pretty cool.

Until she had to get bundled...

And go out in the cold...

Yeah...maybe she'll wait 'til next year to make snow angels.

But Duke liked it!

Come play, Mom!

Wednesday, December 8, 2010

Why I stopped worrying about growth charts...

I started this post assuming that a number of my mommy friends who want to exclusively breastfeed their babes are getting inaccurate information from their pediatrician's office. I'm told that they are by reports in the media and in casual conversation. All over the net, there are moms encouraged to head to the 6-month check-up with the WHO breastfed baby growth charts in-hand. However, what I've read on the CDC website and in medical journals doesn't seem to support that assumption. Even the CDC acknowledges that the WHO growth charts should be used for children up to 2 years. This is a more recent development (as in, within the past 4 years), but most doctor's offices should be in the loop on that by now.

"In April 2006, the World Health Organization (WHO) released new international growth charts for children aged 0–59 months. Similar to the 2000 CDC growth charts, these charts describe weight for age, length (or stature) for age, weight for length (or stature), and body mass index for age. Whereas the WHO charts are growth standards, describing the growth of healthy children in optimal conditions, the CDC charts are a growth reference, describing how certain children grew in a particular place and time. However, in practice, clinicians use growth charts as standards rather than references.

"In 2006, CDC, the National Institutes of Health, and the American Academy of Pediatrics convened an expert panel to review scientific evidence and discuss the potential use of the new WHO growth charts in clinical settings in the United States. On the basis of input from this expert panel, CDC recommends that clinicians in the United States use the 2006 WHO international growth charts, rather than the CDC growth charts, for children aged <24 months (available at CDC growth charts should continue to be used for the assessment of growth in persons aged 2–19 years.

"The recommendation to use the 2006 WHO international growth charts for children aged <24 months is based on several considerations, including the recognition that breastfeeding is the recommended standard for infant feeding. In the WHO charts, the healthy breastfed infant is intended to be the standard against which all other infants are compared; 100% of the reference population of infants were breastfed for 12 months and were predominantly breastfed for at least 4 months. When using the WHO growth charts to screen for possible abnormal or unhealthy growth, use of the 2.3rd and 97.7th percentiles (or ±2 standard deviations) are recommended, rather than the 5th and 95th percentiles. Clinicians should be aware that fewer U.S. children will be identified as underweight using the WHO charts, slower growth among breastfed infants during ages 3–18 months is normal, and gaining weight more rapidly than is indicated on the WHO charts might signal early signs of overweight." (Grummer-Strawn LM, Reinold C, Krebs NF, Centers for Disease Control and Prevention (CDC), MMWR. Recommendations And Reports: Morbidity And Mortality Weekly Report. Recommendations And Reports / Centers For Disease Control [MMWR Recomm Rep], ISSN: 1545-8601, 2010 Sep 10; Vol. 59 (RR-9), pp 1)

M at birth
 They key here is that pediatricians are trained to look at overall growth trends of the individual infant, not to fixate on a goal number. The environment in which the child is raised, the method of nourishment, other health conditions, and gestational age at birth are all factors that contribute to the growth and development of a baby. As a mother, I know it's easy for me to fret when folks tell me how tiny my girl is, and I confess that yes, she's in the 25th percentile for her age. As if I have been deficient as a mother because my kid is small and not yet crawling at nearly 9 months. But those are my issues and have nothing to do with the CDC or WHO.

This is significant to me because my healthy girl, who was 9 1/2 pounds at birth, quickly fell in the percentages (97th percentile to 25th percentile on the WHO charts in the first 4 months), and I was sent home with samples of formula and instructions to see an LC with the assumption that my supply was not sufficient to nourish her. After feeling like a failure as a woman because I couldn't have my homebirth, I needed to know I could at least succeed as a nursing mom. Don't get me wrong, I was ready to supplement if I truly had a supply issue, but I was going to take the appropriate steps first.
    M at 10 days
  1. Determine if I really had a supply issue by either exclusively pumping for 4 consecutive feedings or weighing M before and after each feeding, as recommended in the La Leche League publication, Making More Milk
  2. If I did have a supply issue, I'd meet with a lactation consultant, nurse frequently, and drink mother's milk tea to help build my supply
  3. If I still had supply issues or needed to supplement in the mean time, I would contact the Mother's Milk Bank or another milk-sharing organization

Thankfully, I did not have a supply issue at all. M was getting plenty of milk. To confirm all was well, our pediatrician had M come in for weight checks every couple of weeks, and she could see that M's weight gain was healthy and within normal paramaters. Breastfed babies put on weight slower than formula fed babies, in general, and our pediatrician took that into account. M was born at 41 weeks, 4 days gestation which really started her out in the 90th percentile for gestational age. Factor in that M dropped to 8 pounds 13 oz before we left the hospital and was down to 8 1/2 pounds before she started gaining within her first week, and that huge percentage change doesn't seem so drastic.

Yes, our ped used the charts as a guideline, but she didn't insist I start supplementing immediately or panic that our child was malnourished. She casually mentioned that our girl was 'a little smaller' than she'd like and wanted to keep tabs on her growth for a while. I was the one who focussed on the charts and the numbers and printed out charts. Turns out, she's doing just fine. So, I put all of that away for now, and we'll just enjoy watching M grow at whatever pace is right for her.  
M at 8 months

Friday, December 3, 2010

Fun With Friends

While we were back east, we enjoyed a lovely afternoon with dear friends.

We played on the swings

And the slides

We watched the ferry return from Block Island

Our little family (M is tucked in my coat...brrrrr)

Wednesday, December 1, 2010

Travel With Our Girl (And Our Experience Opting-Out)

M playing with her Irish lamb on the trip home
We just spent a lovely long weekend with my parents and friends. Thanksgiving was our first plane trip, and I was a little nervous about taking two flights each way with a baby. When M was 3 months old, I attempted a trip back east, but she was colicky. At that time, we waited to board the plane for two hours while it was delayed. And she screamed. For 2 hours. I gave up and went back home.

This was our second attempt at 8 months, and it was much smoother. Miss M coasted through security, happy as a clam. Daddy was the one who had trouble. We had read about the back-scatter machines and decided to opt-out. Despite claims in the press that the radiation was equal to about 10 minutes on the airplane, a letter from scientists at UCSF had me concerned that even the small amount of radiation on the skin would be a risk to all of us. And we didn't object to the enhanced pat-downs. B agreed with the concerns and decided to opt-out with me. While we were waiting in the security line at our home airport, we kept our eyes peeled for those new devices, and sure enough, there was the bulky machine with illustrations of the appropriate posture on the outside.

M and I were only sent through the metal detector, but B was pegged for the special screening. I waited and watched while B talked with the TSA agent and was sent to a designated area. Another agent donned fresh gloves and proceded to pat-down my hubby. No big deal. Definitely thorough, but it appeared friendly. It was clear that B was the only passenger 'opting-out,' and we were getting a lot of funny looks. Thinking to myself that we all must be sheep if this is the first guy to refuse the radiation, I was proud of B for making an informed choice.

After we were given the all-clear, we gathered our things and assessed the situation. Apparently, when B told the agent he was opting-out, the security guy clarified that it wasn't the x-ray machine he was being asked to stand in. Assuming the agent was just poo-pooing his concerns, B quickly retorted, "No. I'm opting out." As I observed, he went through the pat-down, and B said the second agent was clearly uncomfortable about touching my husband in his special places. B tried to joke about the gloves making him nervous (a la cavity search), but it didn't bother him as much as the poor TSA agent. After all that hoopla, we was the trace explosives detector. No radiation. A puff of air. Oops. I'm pretty sure we were the subject of a few funny stories over turkey that night. We didn't see a single back-scatter machine the entire trip. What a bunch of fuss over nothing.

M was great. She nursed on take-off and landing to prevent any ear aches from the pressure change, and it worked like a charm. I've read that any kind of sucking on a bottle or pacifier works, too. Nursing is what was easiest for us. She played or napped during each flight and only fussed a little when her diaper was wet. Only one of the 4 planes we took had a changing station in the bathroom, so B sat on the toilet lid and changed her on his lap. Not ideal, but it worked. Thankfully, there were no poopy diapers in-flight. (Before children, I once watched a woman change a very stinky, poopy diaper on the airplane seat. No blanket or any kind of barrier. Gross!!!)

When she's older and not guaranteed to nurse every time she's presented with a boob, we're going to invest in some EarPlanes. They come in children's and adult sizes. My cousins used these for years, and I even used adult ones when flying with a sinus infection. They work wonders!

Sunday, November 21, 2010

Breastfeeding Challenges- Recurring Mastitis

M having a snack

For some nursing pairs, breastfeeding comes easily and has few challenges. For M and me, it's been a bit more difficult. While the benefits still far outweigh those challenges, some days I just want to give up. But that time is fleeting. There are so many great reasons to continue to breastfeed that I just look for solutions to our struggles.

I have had mastitis 4 or 5 times in the eight months since M's birth. I've lost count. Each experience has been different. Sometimes, it's accompanied with a very high fever and delerium, sometimes not much worse than a cold and some soreness. My most recent bout of mastitis started yesterday morning around 4 when I noticed that it hurt while M was nursing. At 4 a.m., that didn't matter too much. We went right back to sleep. By the time we woke for the day, it hurt an awful lot, I was swollen and red, and I knew it was mastitis. Some resources recommend homeopathic treatments as the first course of action when symptoms occur, but since my case is recurring, I go straight to the doc. (I don't want it to become an abscess.)

One of our awesome La Leche League (LLL) leaders sent me a ton  of information on mastitis, potential causes, and repeat infections. Most or all of the information is available on KellyMom and on the LLL site. Some things that may be causing my troubles are the following:

1. Failure to fully recover from a previous case of mastitis
2. Anemia (I've been anemic my whole adult life, but with no menstruation I'm not sure if it's an issue currently.)
3. Sore and cracked nipples
4. Use of a nipple shield (She was off the shield until she got teeth recently. Now, she's back on because it dulls the impact of the bite.Ouch!)
5. Sleeping position- I sleep on my right side most of the night, snuggled up to M

I'm treating this current case with allopathic and homeopathic remedies. So far, this is what I've tried:

A. I'm on day two of a 10-day course of antibiotics
B. Hot compresses on the clogged duct- I use a sock filled with rice and warmed in the microwave
C. Fresh cabbage leaves applied directly to the breast to draw out infection (It sounds wacky, but even the doc at the walk-in clinic suggested this approach)
D. Ibuprofen- OTC dose whenever I have a fever- So far, 6 doses in 36 hours
E. Tablespoon of soy lecithin- I mix it in with applesauce or oatmeal
F. Lots of vitamin C- I've been drinking EmergenC
G. Most important- Nursing frequently on the infected side with M's chin in the direction of the clogged duct

Usually, that all works, but I'm still feeling pretty crummy and having difficulty clearing out the clogged duct. This evening (Sunday), I called my family doctor to make an appointment for tomorrow morning. I'm hoping I'm better by then, but just in case, I want to nip this in the bud.


I never was able to get into my doctor's office. When I called for an appointment, the nurse called back saying to use a hot compress and take tylenol. :/ I don't think she gave the doctor all of the information I shared, but ultimately it worked out fine. It took the full course of antibiotics to get rid of the infection. And despite taking a probiotic and eating plenty of greek yogurt, I now have thrush. More on treating thrush later...


Thursday, November 18, 2010

Affordable Cat Maintenance

Johann and Wolfgang

In addition to Miss M, we have 3 furry kids: Wolfgang, Johann, and Duke. They're two big fat cats and a huge puppy. I adopted the kitties 6 years ago, when they were rowdy kittens. In six years, those poor cats have moved 3 times, got an annoying big brother (Duke), and now have a very curious 8-month-old who has discovered how to pull fur out by the fistfull.

Although they put up with all of this change without much fuss, we did develop a litter box problem. Their restroom was relegated to the basement last January, in preparation for the new babe. Ventilation is poor down there, and while I was pregnant, B was in charge of the litter changes. (Risk of toxoplasmosis.) B, ever interested in minimizing the workload and shrinking the budget, cut some corners that led to an odor problem. Then a marking problem. Now, they regularly poop outside the box. I can't begin to express how this grosses me out.

Last night, I got into my hazmat gear (read: grungy pajama bottoms and handkerchief over my face) and reclaimed my role as germ eliminator. While B was in charge of things, I let him make the decisions about what to buy, how frequently to clean, etc. But I think I have a cheaper and more effective method.

First, we were getting a 40 lb container of clumping cat litter at the local wholesale club for about $21. It's dusty, has a perfume odor, and after the cats use it, leaves an ammonia smell behind. Ick! When the fluff balls were kittens, I used Feline Pine, but that was before all of the other expenses associated with home ownership, having a child, and only one income. I did some digging and found something that looks and smells a lot like the Feline Pine: Equine Fresh. I don't know how similar the products are in reality, but I wouldn't know the difference if it weren't for the label. Here's the great news: Equine Fresh is $5 for a 40 lb bag at the local Tractor Supply! Woo-hoo!

After doing a massive clean-up downstairs, I filled the litter box with some of the pellets. I also bought a second litter box and placed it across the room and filled it with the new litter. So far, the basement is back to smelling like basement and a little like woodshop. Not great, but a vast improvement over the ammonia odor. However, I did get the daily poop gift just outside the box. I'm hoping it's just that one of the cats got used to the space and will learn to go back to the box. (B was not diligent about keeping things clean, and the poop surprises started as the result of unclean litter.)

If you have tips to help, I'd appreciate it!

This appeals to the nerd in me: Good Radiation (public radio rap)

Sunday, November 14, 2010

Bath Time

M does not like baths. She never has. I've tried the sink, the little bucket, with a sponge pad, without a sponge pad, in the tub with me...I don't know if it's sliding around and getting all slippery that bugs her. Maybe we keep our house too cool. Who knows? If you have tips to help an 8 month old enjoy bath time, please share!

Getting ready for bath

In the mean time, M gets a sponge bath for her clean-up routine. I sit her on a diaper on her changing pad, and she gets all lathered up. I keep a cup of warm water beside me and rinse with a different warm, wet cloth. For now, it works.

Speaking of bath time, there is a great resource available online for folks who like to know what is in the typical baby shampoo and other products. It's called the Cosmetics Database, and you can type in specific searches or just browse products. By law, companies are not required to disclose certain ingredients (like what makes up the generic label, 'fragrance'). But they do have to disclose some ingredients that aren't considered trade secrets. This website offers a database compiling information about known effects of each individual ingredient since the product testing results are confidential.

The reason I found it handy was because I discovered that the high end 'natural' diaper cream I was buying at the local health food store was no better than regular old Desitin. And that the soap I was using for the baby was worse than my own body soap. Having shunned vaseline because it was a petroleum product, I realized it was one of the safest items out there to act as a barrier cream. Of course, it's still a petroleum product... Look for a post soon with homemade soap, shampoo, lotions, and even diaper cream! (All 100% natural and safe)

Saturday, November 13, 2010

Cloth Diapers and Homemade Detergent

Lately, I've had a number of friends ask about M's cloth diapers and our homemade laundry detergent. Despite making me sound like a tree-hugging nut (I am) with too much time on my hands (maybe), it's actually very easy and wicked cheap. It works well for anyone interested in saving a ton of money on baby items. We have spent less than $200 on diapers, and M is equipped through next year. The cost of laundering the pre-folds is about $4/month. Did I mention that we have had 3 poop explosions in 8 months? And that was only because we accidentally left a gap in the leg. Otherwise, our poop explosion count would be zero. What's not to love?

Laundry Detergent: I'll start here because our laundry detergent can be used on all laundry and costs less than one cent per load. It takes about 15 minutes to put together and lasts a couple of months (laundry for three people plus diapers).

1 bar of soap- I use ivory because it's easy to find at the grocery
1 cup washing soda- this is different from baking soda
1/2 cup borax
5 gallon bucket- we use an empty cat-litter bucket

1. Boil four cups of water on the stove
2. Grate bar of soap into boiling water and stir, while boiling, until soap has dissolved
3. Pour 3 gallons of hot water from that tap into a 5 gallon container. Add the boiled soap solution to the hot water.
4. Pour in washing soda and stir until dissolved.
5. Pour in borax and stir until dissolved.
6. Set container aside and let sit overnight.
7. The next morning, stir mixture again. A thick gel will have formed at the top; just stir to break up gel.

You can keep the detergent in the 5 gallon container or reuse old detergent bottles. I prefer the latter because the mixture needs to be shaken or stirred (ha-ha) before each use, and the cup is already there to measure the detergent.

This formula works with high-efficiency washers because it is low-sudsing, naturally. (Suds are an added gimmick. Don't take my word for it; Google it and you'll see what I mean.)

Diapers: There are a million options out there for cloth diapers. I'm just going to plug what we prefer for our kiddo based on quality and cost-effectiveness. Pre-folds, in my opinion, are the best in terms of ease-of-use and budget-friendliness.

You can get cheaper pre-folds, but we buy ours from Green Mountain Diapers (GMD). I buy the unbleached organic cotton, but they have cheaper options. I prefer this style because they are wider and shorter for each size. This seems to fit our girl better. She's a skinny-mini, so I don't know how the typical, narrow pre-fold suits the chunky babes. In addition to great diapers, their washing instructions are my diapering bible. They have a solution for every issue. GMD is also a great, small-business. I love to support small businesses!

We use Imse Vimse covers because they are soft, quiet, don't allow leaks, and each size seems to fit for a long time. My only complaint is that the elastic wears easily. (We dry them in the dryer, which is against the manufacturer's recommendation.) We'll have to buy new covers for the next baby.

M in her Imse Vimse
Photo by Shawn Pierce

Laundering the Diapers: We use about a cap full of detergent for each load of diapers (24 prefolds and a cover or two). We also use 2 tablespoons of oxygen bleach. Because we have soft water and a high-efficiency washer, this helps brighten the diapers and completely eliminates urine odors. I equate diaper laundry with Barry's smelly soccer clothes. They need something a little extra. It amounts to $0.25 per load ($4/month). We prefer pure oxygen bleach. The only option we've found that you can buy without being a wholesaler is Ecover. It's non-chlorine and 100% natural. Not all families need this addition, but we do best with it.

We dry our pre-folds and covers in the dryer despite recommendations against it. We just don't have a good space in the yard for hanging laundry because our great dane eats fabric. And, being a great dane, there's no space out of his reach. ;)

Friday, November 12, 2010

Building a bond

Many mothers form an instant bond with their babies. One look, one snuggle, and that bond is formed. It took M and me a little longer. Don't get me wrong, I loved her before she was born...the solid mommy/daughter connection took a while longer.

I have a few guesses as to why it took us a while, based on attachment studies. We were separated for a couple of hours at birth, and it took M 3 1/2 weeks to latch. In addition, she was colicky (Dietary intolerances and reflux), and I had pretty significant PPD. The early weeks were rough. I told B that I wanted to give away the cats, the dog, and the baby. I frequently daydreamed about moving to Fiji. Looking back, I feel horrible. But, that's the truth, and I think the only way to move forward from that space is to recognize it and leave it in the past.

Over time, you can't help but bond with a child who nurses at your breast and snuggles much of the day against your skin. It happened slowly, but at about 4 months, it hit me. This is my sweet little girl. I would do absolutely anything for her. We had a special connection and rhythm. I could read her cues for hunger or boredom without so much as a fuss. I knew just when she was ready for a nap or the broccoli I ate was giving her gas. I'm sure all moms develop that skill, but it held so much meaning for me. I didn't feel like a failure anymore. We were going to be just fine. :)

Now, we're compadres. Caring for M has become a joy instead of a burden. We wake up smiling at each other. Even daddy has benefitted from this bond. She's more secure with him, too. And while she's waking, she reaches for his arm and looks for his smiles. Words cannot express the joy we experience with our little family.

Thursday, November 11, 2010

Learning how to nurse

When M was born, we were immediately separated for two hours, while we were each 'under observation.' Our full term, 9 1/2 lb, healthy girl was carted off to the NICU because there was meconium in the amniotic fluid. This is common in an infant born after 40 weeks. When M was born, her breathing and heart rate were normal, and her apgar scores were high. She had no signs of Meconium Aspiration Syndrome, yet she was whisked away.

My parents got a good look at M before I did. I was vomiting when they tried to show her to me, an effect of the anesthesia. Mom said M looked like a giant baby compared to all the preemies in the NICU. When they finally brought our baby to me, I was relieved. But somehow, it was like being handed a stranger. I didn't feel her come out; I didn't hold her while she was gray and squishy; I didn't even have a chance to offer her milk. When she was finally in my arms, she was dressed in baby clothes from the hospital, wearing a diaper and swaddled in a blanket.

Months before her birth, I watched this great video illustrating how babies will crawl to the breast and latch. Nursing our children is the most natural part of life. It's instinctual.

According to the World Health Organization (WHO), it is recommended that breastfeeding is initiated within 60 minutes of birth. Infants also shouldn't be offered any artificial nipples or pacifiers. Because of our unnecessary separation, we didn't have that opportunity. When the time came to nurse M, the hospital lactation consultant (LC) told me my nipples were flat and handed me a plastic nipple shield. M latched a few times that day, but because of the plastic device, never got much colostrum. I was exhausted, and while B was on baby duty for 2 hours the first night, he found a pacifier gifted by a well-meaning relative. When I woke to see the device, I let B know we would not be using that. But it was too late. M wouldn't latch again. And to this day, M uses a pacifier at night.

Less than 24 hours after M's arrival, another LC insisted our healthy, 9 1/2 lb, full term baby needed to supplement since she hadn't latched again. So, I sat with a breast pump attached to my boobs, trying to get my milk to come in. Across the room, B gave M a bottle of formula. We were able to order donor mother's milk, but not 'in time' for M's feeding. The next three days in the hospital, M had donor milk from a bottle provided by dad while I cried and tried to get my milk to come in. I also continued to try to get M interested in getting milk from me instead of the bottle, but to no avail.

My milk came in on the fourth day, but it took M 3 1/2 weeks to latch. That may not seem like much time, but to a new mom, that is an eternity. And it took even longer for us to bond...but that's a topic for another post. We read books upon books about childbirth and breastfeeding before M arrived. We knew the WHO guidelines, and we hired a post-partum doula to come to our house. But being medicated and exhausted in an environment with 'experts' telling us what to do, we just didn't have the presence of mind or strength to fight it. As first time parents, who were we to argue with the pediatrician insisting M needed formula within her first 24 hours of life? And when the LC was attaching bizarre devices to my breast, like the SNS (a complicated feeding tube), I trusted that it was a necessary evil.

Thankfully, we have a secure, attached relationship, and our little one, now 8 months old, nurses like a champ. With the support of our post-partum doula, local La Leche League chapter, and midwife and family who believe in breastfeeding, we were able to jump those initial hurdles. We spent three and a half weeks enjoying skin-to-skin contact and frequently offering the breast. M rooted instinctually, but a nipple is so different from the plastic substitutes that it took time for her to figure out the real thing. A visit to a recommended LC in town finally ended in a successful latch. M was exclusively breastfed for 6 months, and she still only gets tastes of whole foods.

La Leche League has excellent resources for mothers planning to breastfeed:

Attending meetings before and after M was born ensured our success.

Wednesday, November 10, 2010

Birth Day

M started her journey to the other side of the womb around 6 p.m. on March 15th. My cousin K, on spring break, had come down for the afternoon. We stopped at Starbucks (tall peppermint hot chocolate- yum!), wandered around Kroger, and hung out at the house watching Fight Club and eating pizza. As soon as K left, I regretted the pizza. I had gas pains. Every five minutes. For about 30 seconds. Uh-oh.

I was 41 weeks, 4 days pregnant, so this was no surprise. I had spent the past few weeks reading birth stories and hanging out in the birth tub. I knew how early labor for a first-time mom should be. It would progress slowly, be easy. I was going to watch a movie and hang out in the tub.

Just to be sure these were real contractions, I got in the tub and had my husband, B, time contractions with my iPhone app (yes, they have an app for that!) for about 30 minutes. It was about 9:30, and I suggested we call our midwife to give her a heads up. I knew we wouldn't need her 'til morning, but maybe she should try to get to sleep early.

Our midwife (I'll call her L) suggested I try to get some rest, so I got a little nest assembled on the couch. I went to lay down, and my water broke. It was only 9:45. B called L again to report, and I got in the birth tub. Contractions were still about 5 minutes apart, so I couldn't rest. I suggested we watch something funny on t.v. to distract me. We got about 20 minutes into Tosh.0 before I had B turn it off. This was getting hard! Already?

By 11, I had to vocalize through contractions, and they were about 2 minutes in length. B called L and had her come over. Time is a bit fuzzy through all this. I know I was 2 centimeters at midnight and the next few hours were pure hell. I screamed through every contraction. It was very painful, and the hypnobabies practice didn't do a thing except help me breathe.

Between midnight and 4 a.m., I labored in the tub, leaning on a bar stool, and on my hands and knees. It was intense and painful. I know some women experience labor as 'pressure' or 'hard work.' I felt sharp pain, like knives stabbing me from inside, on the underside of my belly. Contractions were very close together for a while, and I remember wishing for a break.

At one point, I remember leaning on the edge of the tub and thinking that I'd rather die than continue with the pain. Later, B said my pupils were very dilated, and he knew I was on another planet. It reminded him of this scene from Family Guy:

That's also about the time L swooped in with rescue remedy and offered to check me again. I was 9 centimeters! Just a small lip on the cervix to go, and I could start to push!

That news, combined with slowing contractions, made the next stage of labor more tolerable. I had been in transition when I was in that dark place, but given how quicly I had progressed, I knew we'd have a baby by 7 or 8 a.m.! Throughout labor, B stood by me, holding my hands and offering encouragement.

L had another client in labor and saw that my contractions were coming further apart (I was falling asleep between them now). She decided to have a back-up midwife come over, and she headed to her other client's house.

By 5 or 6 a.m., the other midwife gave me permission to start pushing with contractions. She and the birth assistant had to coach me on how to push and how to relax. I was fighting the contractions instead of pushing through the pain. I thought pushing would be a relief, but it hurt more!

Note: I spent months talking about 'pressure waves' and 'hypnotic anesthesia.' I read all of the lovely birth stories from Ina May Gaskin. For me, it hurt like hell! Intense, mind-numbing, loss-of-control pain. If I had been in a hospital and strapped to a bed, I'd have been screaming for an epidural at midnight (2 centimeters).

Once I figured out how to push, we tried in every position. In the tub, on the birth stool, on the toilet, on hands and knees, on my back (with the midwife's hands inside me, trying to turn the baby's head). M's head was turned to the side. While we made progress during a contraction, as soon as it passed, she slipped right back up with her head turned to the side.

At about 10:30 a.m., I declared I was done. We had pushed for so long. I was tired of the pain and getting scared. The backup called L who confirmed we had tried everything. L coordinated our transfer to the baby-friendly hospital. We left for the hospital at 11:30. It was a shock to see what a sunny and warm spring day it was. We had kept the blinds closed and lights dim in the house. I realized what a beautiful day it was to be born!

One of the funniest memories of that day is riding down to the hospital and getting stuck at traffic lights. I kept wondering what the people in the car next to us thought as I was screaming and hanging from the panic bar. I couldn't sit because M's head was so low.

L called ahead at the hospital and coordinated the transfer. We skipped triage and went straight to L & D. The nurses were very patient while it took 2 or 3 contractions for me to do what was asked. The OB took a quick look and decided a c-section was necessary. B, my sweet advocate, asked the questions I didn't have the presence of mind to ask: Is there an alternative? Could we try a bit longer? I heard her say something about concern the baby could be in distress. (To be clear, M never actually was in distress) I felt at that moment that I didn't have a choice. As soon as that word 'distress' popped up, I agreed to whatever was necessary. There was an emergency c-section ahead of me, and then we'd be next.

The anesthesiologist came in and gave me an epidural since they thought it would be some time before the surgery. It took effect immediately. I felt nothing. No pain, no pressure. Sweet, sweet relief. They got us in with another OB very quickly, so the epi ultimately wasn't necessary.

I was so tired during the surgery that I slept through most of it. It did occur to me at one point to give Barry instructions about what shots and procedures we would/would not allow. I put him in charge of making sure they didn't do anything we didn't approve. The anesthesiologist talked and joked with my husband. He was curious about the homebirth and asked a lot of questions about it. I was amazed by how cool all of the medical professionals were about the whole thing. They treated us with kindness and respect, despite choices they might not have made for themselves.

When they pulled the baby out, it took a few seconds to hear cries. Longest few seconds of my life. But there they were. I was certain we were having a boy, and when they said girl, B and I both started crying. M pooped all over the table where they were cleaning her (hee-hee). She was 9 lbs, 8 oz and 20 1/2 inches long. Born at 1:36 p.m. on March 16th. There was meconium in the womb, so they whisked her away for observation. I tried to get a good look at her, but I was vomiting and couldn't really see her.

When the OB stitched me up, she promised me a VBAC and confirmed she was stitching me up for the best possible outcome next time.

M and I were separated for 2 hours while we were each under observation. I still don't understand why we couldn't be observed together, but that's a different topic for another day. M was perfectly healthy, and although I did get an infection while in the hospital, I healed just fine.

Sometimes, I look back and feel like I failed because I gave up. Maybe if I had just tried a little longer or a little harder. Or maybe I'm just a big whimp. Then I remember: I recovered from the c-section by alternating Tylenol and Naproxen for three days. That's it. Over-the-counter medicine for three days, then absolutely nothing. Definitely not a whimp. And it took M 3 1/2 weeks to latch, but I never gave up. In baby time, that felt like an eternity. Definitely not a quitter, either. ;)