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Friday Update: Week 36

Uploaded from the Photobucket iPhone AppThey say baby is about 18-1/2 inches long this week – the width of the lid on my washing machine!

This week we’ve really been cleaning up on the to-do list and I’m starting to feel ready. I’ve crossed a whole bunch of items off my to-do list (which I’ll post tomorrow). The nursery is all finished, although my mind is still obsessing over ways to improve my giant mobile (I’m sure some things will happen to it with it in the next couple weeks. I can’t let this stuff go!).

We have acquired all the essential baby gear: the car seat and a Moby wrap carrier from my transportation gear post, a breast pump and pillow from my feeding gear post and a crib, dresser, play mat and some blankets from my home gear post.

We’ve taken our waterbirth class, taken a tour of the hospital birth center (enlightening! The recovery rooms are so much bigger than they were nine years ago!), I’ve read seven books about birth and I’ve written down a bunch of birth plan thoughts that Mr. Handsome and I will go over this weekend. We’ve talked about it on and off but it’s time to really get down to business about it!

Despite all this work that has been done and as ready things seem, every time I look at the calendar and realize how close we are I am both excited and freaked out at the same time. I’m pretty sure Mr. Handsome feels the same way. When I remind him how many weeks are left he just kind of repeats the number I quoted and gets quiet. It’s just like, whoa! We’re super close to being a family of four instead of three! Three is all we’ve known for nine whole years!

Still super excited more than freaked out, though. I’ve started to think about upcoming events with this new little one in mind. We’ll have a little bundle in tow everywhere we go! So awesome to think about!

Other awesomeness of the week:

  • Total weight gain: 30 pounds. An unfortunate combination of not meeting my exercise goals (for several weeks in a row), relaxing my diet (damn you Snickers Blizzards!) and Baby2’s own half-pound-per-week gain is wreaking havoc on my pound-a-week goal! The pregnant part of my brain is totally okay with this but the non-pregnant part is a little in shock when the number comes up on the scale.
  • Cravings: A whole bunch of sweet stuff that I’m trying not to pay attention to. I’ve been sticking to my daily salad but ice cream is just so fantasically amazing. It’s not fair that there are so many forms of chocolate in the world.
  • Coolest symptom: She’s moving around super low and I can feel her push against my cervix, especially when I’m walking around. I remember these senstations becoming more and more frequent leading up to the day Kiddo1 was born. Although this “pinching” of my cervix is slightly uncomfortable, it makes me feel like things are starting to happen. I can’t get too ahead of myself though! She hasn’t dropped or anything, though. Her kicks still push up my boobs when I’m sitting!
  • Lamest symptom: A byproduct of the super low movement is that I have to pee all the time. ALL the time. At work, I swear I’m in the bathroom 20 times a day at least. At night I’m up three or four times at least. I am trying to stay extra hydrated lately so I’m sure that doesn’t help but STILL. It’s a lot of bathroom time.
  • Exercise this week (the goal is 210 minutes 180 minutes): I’m dropping the goal down a bit since I suppose I should be taking it easy — no, that’s just a excuse to drop my goal because I haven’t made it the last four or five weeks so might as well right?! This week I did pretty well but mostly because we were out and about around town most of Sunday. I’m going to count 60 minutes of walking for that (even though we did way more, but it was intermittent). Plus 60 minutes of water aerobics and 75 of yoga means I made the goal this week with 195 minutes!

Here’s what’s new with Baby2, courtesy babycenter.com:

Your baby is still packing on the pounds – at the rate of about an ounce a day. He or she now weighs almost 6 pounds (like a crenshaw melon) and is more than 18 1/2 inches long. Your baby is shedding most of the downy hair that covered his or her body, as well as the vernix caseosa – a waxy substance that protects the skin during its nine-month bath in amniotic fluid. Your baby swallows these substances, along with other secretions, and they form a tar-like black substance called meconium which your baby passes in his or her first bowel movements. At the end of this week, your baby will be considered full term. (Full term is 37 to 42 weeks; babies born before 37 weeks are preterm and those born after 42 are post term.) Most likely he or she is in a head-down position. But if not, your practitioner may suggest scheduling an external cephalic version. (This is a fancy way of saying that your caregiver will try to coax your baby into a head-down position by manipulating him or her from the outside of your belly.)

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Book Review: Birthing From Within

PhotobucketBirthing From Within is the lucky number seventh book about birth that I’ve read during this pregnancy.

It took me awhile to get through this book, for two reasons. One, being that this is the seventh birth book I’ve read, I’m getting a little restless with birthing so I took my time reading. Two, this isn’t a book you can just whip right through – it requires you to stop and think, reflect, visualize, etc. This latter reason for delay is also what makes this book so great.

I almost felt like I went through a little workshop in the experience of this book. Ms. England speaks of her experiences with leading childbirth classes. One of her favorite ways to help women and couples cope with fears about childbirth and all related things is to make art. She recommends all kinds of subjects for art but mostly about perceptions and expectations of birth. While I didn’t actually make any art, I did take the time to visualize what my art would be like and envision what I thought this birth would be like. I think that alone has helped in working through some of my fears for this birth.

One of my favorite tid-bits from this book was the concept of having a labor project. If you’ve been a reader of my blog you’d know that I love to have a project! Well, Ms. England describes this great birth story of an Amish couple. The Mrs. is basically going about her daily tasks, plus refinishing a rocking chair, while she’s in labor. I love the idea of immersing yourself in some distracting project while allowing your labor to just do its thing. Sure, this isn’t possible in all labors, but I’m willing to give it a try. I need to come up with something to do as a labor project now!

I also like that the benefits of active birth are discussed; very similar concepts that I read in the book Active Birth. I love when a concept shows up in more than one of the books that I read. It gives me the sense that the point is something to really pay attention to, that it has real value.

The section about pain management is great, including the chapter about “surrendering to pain” which kind of sounds easy but, of course, isn’t. It is not about forgetting about the pain or making it go away but rather about working with the pain, being part of it, giving up control and surrendering to what the body needs to do to make it through. Other chapters in this section explain practical techniques such as “Non-Focused Awareness,” breathing exercises, vocalizing, etc.

Honestly, if this book wasn’t good I wouldn’t have made it through because, like I said, I’m tired of reading birthing books! It took me awhile to get into the book but I’m really glad I read it all. I think it helped me to really think about some of my fears, think about letting go of my control issues and giving me productive things to do and think during labor.

Next review: The Everything Breastfeeding Book by Suzanne Fredregill and Ray Fredregill

Group Appointments and Interventions

Mr. Handsome and I have taken the group appointments route for maternity care. We see a midwife along with five to seven other couples in one visit. It sounds a little strange, and we had some reservations at first, but now that we’ve had three appointments I’ve started to really enjoy and even look forward to them.

There are pros and cons to this style of care, of course. The biggest con is that the appointments take two hours (or more) where regular non-group appointments can be as short as 20 minutes. We can’t bring Kiddo1 with us so we have to ask someone to watch him for about three hours (with travel time).

However, a lot gets discussed during those two hours. Every session has had a focus. During the second session we focused a lot on nutrition. I learned a little too much about how many calories and carbs are in my favorite foods. We were all advised to keep our carbs to 30 grams per meal (three meals a day) and 15 per snack (two snacks a day) – that’s only 120 grams of carbs per day which may sound like a lot but when you realize your favorite bagel has 65 grams of carbs… it’s sobering. Even to a person who is stone-cold sober, like the pregnant.

Another con would be that there isn’t a lot of privacy when it comes to discussions (the part during which the belly is measured, heart rate monitored, etc is done in privacy). But, honestly, the fact is that we (the couples) don’t know each other and don’t know each others’ friends so what are we going to say about each other? We might as well commiserate on the what’s what. Plus, once we get going, things start to come out and we begin identifying with each other really well. It just takes a bit to get comfortable and get things rolling.

So other than great discussion and comradery, the main pro is that you don’t have to go through the same crap that you do during an OB appointment. I hear ladies in my mom’s group complain about how their OBs spend more time reading their chart than listening to them, that there isn’t time to bring up their questions or really get to the root of their concerns, that they analyze their urine sample more than their simple “symptoms” like leg cramps, indigestion, etc, which I’ve learned in my group appointments can be indicative of or adjusted by diet, exercise or vitamins. Simple fixes to annoying problems, which an OB usually doesn’t bring up.

I don’t mean to bad-mouth OBs at all. There are a lot of good ones out there. I’m simply reacting to feedback from fellow pregnants. The OB I had with my first pregnancy was great and a good listener, but this experience with the midwives is SO much more fulfilling.

I wanted to write about these group appointments today because during last night’s session we talked a little about our fears about childbirth (which I’ll write about more specifically in a later post). Our questions, however, led to a much larger discussion/overview of hospital policies.

I admit, after reading Natural Hospital Birth I started to focus my fears a lot on how the hospital could screw up my birth experience… After last night’s appointment I feel a lot better. The policies of the midwives very much align with my expectations and desires for this birth. This is why I chose this hospital and group of midwives, after all, so I shouldn’t be surprised!

The “24-hour countdown” of labor-to-delivery isn’t nearly as rigid with the midwives. They’ll pretty much let you take your time, but they say do yourself a favor and labor as much as you can at home (which won’t count on the clock). They only want to see you if your water breaks early AND there’s a risk factor (such as colored fluid or you tested positive for Group B Strep, the latter will cause a need for antibiotics via IV). Also, eating and drinking during labor is encouraged by the midwives but the OB-side of the hospital strictly prohibits it (the midwives will cut you off if you have Pitocin or an Epidural, though). Speaking of Pitocin, the midwives discourage it, which I am delighted to hear! Fetal monitoring is done via a doppler-like device and it is not constant, so it’s as non-invasive as possible. It still has to be done, but intermittently. As soon as you arrive at the hospital you are monitored for 30 minutes continuously so they can get a good idea of how the baby is doing. Then doppler monitoring will occur for about a minute every 30 minutes or so. For a hospital, that’s really not so bad.

We also talked about all the post-birth procedures that are generally required at most hospitals but are elective at the university. First off, as soon as baby is born she is placed on your chest and you are encouraged to breast feed within the first hour. All baby check-ups can take place right there on your chest. They even prefer to administer the vitamin K shot while you’re breast feeding (it distracts the baby from the shot). You can forgo the baby’s vitamin K if you want, or choose a gradual method instead of the shot (I think we’ll just get it over with with the shot though). You can decline the eye ointment if there’s no risk of infection. If your pediatrician is not affiliated with the hospital you can choose from a pediatric or family practice consult – the midwives recommend the family practice because they are “a lot more flexible” than the peds and will require a lot less monitoring if the birth was healthy and there’s no risk of infection. All this sounds great to me!

I got some great news on my stats, too:

  • I only gained three pounds since the last visit, which is consistent with my home-based weight check-ins. The midwife is happy with my weight gain, diet and exercise.
  • My fundal height (uterus size) is 32 cm which is also right on target. Baby’s heartbeat is an excellent 140 bpm.
  • My blood pressure is 118/70, most excellent. Apparently I am quite calm.
  • My glucose test (which I really tried to reject but apparently this midwife’s study focus is gestational diabetes so there was no getting out of it) showed my blood sugar level at 53 which the student midwife said is the lowest she’s ever seen. Not dangerously low, but low enough that – get this, GET THIS – the midwife says I have (basically) free reign on eating carbs and sugar. I CAN EAT CARBS AND SUGAR! I will still keep this manageable but I won’t be as restrictive as I have been. For example, that night I ate a sensible chicken dinner. And a cheese roll. … And some ice cream.
  • Baby is positioned the same as our last appointment – head down, butt on the right and feet to the left. She is awesome. Stay in that position baby! The midwife says it’s the best position for an easy, quick birth. Fingers crossed!

We have only two more appointments left until the due date! One in late June and one in early July. Unless a complication arises that’s all we’ll have to do! No weekly appointments, no constant check-ins. I’m loving the midwives at my hospital!

Book Review: Natural Hospital Birth

PhotobucketThis book was recommended to me by a member of my Moms Group. When I heard the title I knew I had to read it, as I am planning a natural hospital birth myself.

I was a little afraid the book would make me start to feel really combative about how we would have to deal with the hospital in order to get our natural birth. Over the last few weeks, I have identified that my biggest fear about birth isn’t that I can’t do it, it’s that hospital staff will somehow mess it up for me by not following my wishes.

Much to my surprise, though, this book doesn’t encourage confrontation with staff. Ms. Gabriel emphasizes a calm but firm approach, one that allows the staff to see your confidence in and commitment to natural birth.

One of her biggest strategies for avoiding interventions is using the phrase, “I think we’ll wait an hour.” It isn’t rejecting the staff’s ideas or being combative, rather it’s a keen delay mechanism that often allows time for whatever they feel needs resolution to resolve itself. For example, if the staff is pushing Pitocin because of an inactive labor, one hour could be all you need to really get in the groove of things. And if one hour doesn’t work, ask for another. Staff may try to guilt-trip you into seeing things their way, but hold your ground and they’ll see your commitment to natural birth.

One of the great things about this book is the assistance in writing one’s birth plan. I had no idea that birth plans can be controversial: apparently some practitioners discourage them because they don’t want their patients to get “too attached” to a specific plan. Ms. Gabriel is a big advocate of plans, though, as long as you understand that plans change and you keep your “hospital version” short and sweet.

Ms. Gabriel recommends three versions of your plan: a dream version, a realistic version and a hospital version. The hospital version should basically say, “I want the most natural birth possible.” I’ve been inspired to finally start to writing down elements of my ideal plan and get working with Mr. Handsome, too, to make sure we’re on the same page.

Plus, I’m asking Mr. Handsome to read this book, too. It’s great that I have all the information about obtaining a natural birth in a hospital, but there’s only so much I’ll be able to do during “the throws” of labor. Mr. Handsome is my advocate so he not only needs to live and breathe our birth plan as much as me (maybe even more so!) but he needs to know the strategies presented in this book in order to get what we want out of this birth. Poor guy, his prescribed reading list is getting longer and longer!

I’m not as nervous about the hospital staff failing me after reading this book. I think there are things we need to do to prepare ourselves for trying to achieve a natural birth in a hospital setting. I have confidence in myself and in Mr. Handsome that we can convey our commitment to natural birth and have things the way we want them. I know circumstances can change and some things are just out of our control, but I feel like we will have a handle on ensuring that we have the most natural (and enjoyable!) birth possible.

Book Review: The Waterbirth Book

As you may know, I’m very interested in pursuing a waterbirth so, naturally, I’m reading up about it in order to prepare myself and Mr. Handsome.

The first book I read, Choosing Waterbirth, was a great primer and helped prepare the emotional side of my brain for this experience. This next book, however, took my preparation to a whole new level.

PhotobucketMuch like her book Active Birth, The Waterbirth Book, by Janet Balaskas, is a comprehensive account of every detail of waterbirth that I could possible thing of, and then some.

Ms. Balaskas not only goes over a brief history of waterbirth, cultural uses of water during birth and pain management using water, but she also walks the reader through every stage of water labor and delivery. Any question that was lingering in my mind after reading Choosing Waterbirth has now been answered. Now I’m only left with a list of questions for the hospital about their policies. And an incredible excitement for what we could experience with this birth plan!

Here are some of my questions for the hospital after reading this book:

  • When do you fill up the pool? When we call to say we’re coming in (based on our assumed progress/timing of contractions)? When we get there and progress has been assessed?
  • How long does it take to fill the pool? How is water temperature regulated?
  • What does the pool look like/what is it made of? (Based on photos I’ve seen, our hospital uses inflatable pools that look about 5-6′ in diameter and maybe 2-1/3′ tall.)
  • At what point during labor is the appropriate time to get in the pool? (The book says 5-6 cm dilated, before transition.) Is there a point at which “the window closes” and it’s too late to get in?
  • What things would cause you to ask a woman to leave the pool?
  • How do you manage fetal monitoring? How often do you monitor?
  • Are partners allowed in the pool? During all stages?
  • Is there a time limit for being in the pool? (This book states most births occur within 3-4 hours of getting in the pool.)
  • Can the entire third stage (birth of the placenta) be done in the water or is it preferable that this is done on dry land? Will cord blood banking be effected? (We’re donating to a public bank.)
  • Finally, the big one, will you let Mr. Handsome “catch” and bring our baby up to the surface?!

See, Ms. Balaskas gives you a whole lot of ammo to make sure you’re fully comfortable with hospital policies regarding waterbirth. I’m totally going to rock our class (coming up in June).

There’s also some great tidbits in here from Active Birth; not so much from a physioloical perspective, more like the reiteration that movement and staying upright is helpful whether on “dry land” or in the water. She also points out that the pool actually facilitates movement as you’re less inclined to get into bed and have greater freedom of motion (one of the birth story quotes talked about being able to move quickly from an all-fours position to a squat which is quite a feat on dry land). Plus you’re in your own little bubble where you can be free to concentrate inward which is a major bonus for me.

Choosing Waterbirth was a great book but there’s nothing in it that The Waterbirth Book doesn’t have, plus it has a whole lot more. If you can only read one book about waterbirth, make it this one by Janet Balaskas!

Book Review: Active Birth

This book is so great I literally read it twice. I finished the book and just flipped it right back to the first chapter and starting reading it again. I checked the book out from the library but I’m even thinking about buying it because it is that good. I want Mr. Handsome to read it to so he can help me keep its principles during my labor.

PhotobucketActive Birth: The New Approach to Giving Birth Naturally by Janet Balaskas is all about moving around and basically getting off your butt (literally) during labor and delivery.

Let me back up: a lot of books about labor talk about listening to your body and doing what comes natural. They talk about moving around to facilitate labor and encourage you not to be embarrassed about assuming (for lack of a better work) “primitive” positions for delivery, such as squatting. They talk about labor in a very touchy-feely way which really, is all fine and good, you should listen to your body, but it gives a sort of flighty vibe to the whole thing.

This book is not like the others. For one, it is very much grounded in science (I like science). Ms. Balaskas proves that labor is much more easy if you move around and assist your body during contractions rather than lying back on a table as in most hospital labors. Did you know that the uterus actually tips forward during a contraction? So if you’re lying on your back the muscle has to work even harder to do what it has to do. But if you’re upright you can bend yourself forward a bit and help yourself out. You can even slow down your labor a bit if needed by coming all the way forward, like an all-fours position.

Uploaded from the Photobucket iPhone AppScience is in delivery, too. Ms. Balaskas clearly shows how the bones and muscles of the pelvis just open right up when you’re upright or bending over. But if you’re lying on your back the sactococcygeal joint slips the coccyx (science talk!) forward, narrowing the pelvic opening (the bones push together creating less space for baby to pass through).

This info about helpful positioning for labor and delivery is enough to make this book great. But wait – there’s more!

Like Choosing Waterbirth, there are whole chapters devoted to yoga and breathing exercises for pregnancy (one chapter for each). I felt like the poses in this book were a bit more basic than in Choosing Waterbirth, but I don’t think that’s a bad thing. They’re perfect for later on in pregnancy when you don’t feel like contorting your body too much at all. Nice and simple. (To be fair, I don’t have Choosing Waterbirth at my side for a direct comparison. I’ve already returned it to the library.)

I love when I book has a chapter about the three stages of labor and delivery because I learn something from every explanation. This one is quite extensive and one of the main reasons why I chose to read the whole book all over again. Not only does it contain insights about what is happening to you and the baby during each stage, it reiterates helpful positions based on stage and situation (like squatting to help move the baby down and open the cervix if things are moving slowly).

There’s a small section about pain-reducing drugs but it isn’t scary – some books present this information in a way that you sort of think they almost want to scare you out of using it. (Hey! Who’s Having This Baby Anyway? was kind of like that. Although it was a very thorough account of each drug and its pros and cons.) This book is more like, “here are the drugs that are available, but you won’t need them because you’ll be such an awesome active birther.” I like that it’s pumping me up for success rather than scaring me into success.

I could go on and on about  the things I love about this book, really. There’s a chapter on waterbirth that is great so I can’t wait to read Ms. Balaskas’ next book, The Waterbirth Book.

If you can’t tell, I highly recommend this book. It’s for sure in my top three pregnancy books that I’ve read so far, it’s actually probably number one. Read it!

Next review:

Book Review: Choosing Waterbirth

A few years ago, a friend of Mr. Handsome and mine told us her waterbirth story (over beers you tend to talk about anything after awhile!). It was such an amazing story that I swore right then and there that I would pursue the waterbirth option in the future if given the chance.

Now that I have been given the chance, ie we are pregnant, have a healthy pregnancy, are seeing the hospital midwives, etc, I’m totally taking the opportunity to birth this way.

Naturally, I’ve been looking for books on waterbirth to supplement the class we’ll be taking in June, however these books are a bit few and far between. Waterbirth isn’t anything new but it has been somewhat slow to gain frequency, especially in this country. I’ve been cruising the local library looking for books on waterbirth. So far I’ve found two so I’ll be reviewing those over the next week or so.

PhotobucketThe first book I found is Choosing Waterbirth: Reclaiming the Sacred Power of Birth by Lakshmi Bertram.

This was a good book for not just an overview and testimony of waterbirth but also preparation for birth and some postpartum tips as well. It has a very “free spirit” sort of vibe – this is good for natural childbirth, of course, but it is very noticible in this book!

The author very much emphasizes natural methods of relaxation not only during birth but as preparation for birth and dealing with day-to-day life in general. There’s a whole chapter on yoga poses which are illustrated and explained well. Plus, it made me feel good that most of the poses I already incorporate in my yoga routine. She also gives a couple great birthing exercises that I’ve been using. They are great!

The chapters on waterbirth helped to answer a lot of the questions I’ve had about this method, such as how big the tub should be, how high the water level should be, when to get in the tub, when to get out, etc. There’s information on some of the perceived risks and how the mother’s body and the baby’s instincts mitigate these risks (such as how babies won’t try to breath in the water and how low the risk of infection is). The chapter on the three stages of labor and delivery was also excellent.

The author publishes six waterbirth stories – all five of her own children’s births plus her sister’s waterbirth. I love reading birth stories. It’s great to hear a first-hand experience. For me, I can’t imagine a better way to prepare than by learning from others’ stories.

This book is a great overview of waterbirth. It helped to answer some of my questions and it gave me enough knowledge to think of more questions, which I think is great. I hope the next waterbirth book helps to give me even more knowledge about what I’m wanting to get myself into. By the time our class roles around in June (and our birth in July!) I think I will be a well-prepared student.

Next Review: Active Birth: The New Approach to Giving Birth Naturally by Janet Balaskas