Monday, July 30, 2012

Birth in Monterey County

I thought it would be fun, and perhaps helpful, to have women in Monterey County share their birth stories on here. The words will be 100% theirs. I put this out to facebook already I have some rolling in to my inbox! I'm hoping to be able to share a broad spectrum of experiences with you, help moms to know what to expect in the area, and just clear some of the mystery that surrounds birth, especially in our area. I plan on posting one a week over the next few months, so watch for them!

If you birthed in Monterey County and would like to share your story, please email me at Every story is welcome and we love pictures!

Baby III Week 12: Pressure Cooker

12 Weeks

I'm finally not feeling so gross, I think I'm coming out of the first trimester yuckies and might get to enjoy the downhill coast of the second trimester now. I've been running more (23 miles since my last post), made it to kickboxing and boot camp this week, and while I'm stoked to be getting more active, it's coming just a week before the Salinas Valley Half Marathon and I did not reach the level of fitness I expected to achieve... but I also didn't expect to be pregnant. Right now I feel like I can run the whole thing, based purely on how pumped I am and not at all on a realistic evaluation of my abilities.

So the tummy is poking out a bit more, but I'm wondering how much of it is baby related and how much is out of control appetite and slightly reduced activity level... and cherrios... related. Despite working out almost every day this week I'm up another pound, and lived in leggings and yoga pants all week. I did get brave and put on jeans this weekend. They fit, but they weren't happy about it.

I know I said I'm eating better and working out more, I totally am, but my diet is still far from the pristine, perfectly planned out menu it was before. Facebook has been my worst accomplice when it comes to cheating. A friend posts about grilled peanut butter and banana sandwich and I'm making it immediately.  I've made mac & cheese 4 times in the last 2 weeks... I think that's more than I did in the last year, all become someone's pic reminded me that it existed. On Friday someone posted about KFC (which would normally make me gag!) and I'm sending Eric out at 10pm. All I could think was that this fetus is a fat 40 year old bachelor sitting on a couch scratching his hairy belly and he just thought "mmmm chicken." I'm sure I just simultaneously ruined chicken and pregnancy for myself and everyone... but it just had to be said. This is my least health conscious baby yet, I take zero responsibility.

Keeping an eye on my blood pressure still, and I'm still having those heart palpitations... which coming off my food confessions I'm sure makes it seem like it's all my fault, but I get them and the high bp readings even when my diet/hydration is perfect. I'm still using these high readings to extra motivate myself to keep my diet under control, I started using again to track my food. My high readings have been like, 149/98 (one from last night) but then today I was 125/82 and 117/62... so I think I'm going to have to just keep monitoring it to see if I pick up a pattern. It's so early, I don't like seeing most of my readings over 130/80, and esp not so close to the 150/100!

Oh and cutest thing ever? Both Milo (2 years 9 months) and Ash (16 months) say "baby" when I ask what is in my tummy, and Ash is obsessed with lifting my shirt and poking "baby." Love it.

Getting round, having the round ligament pains to prove it!

Apricot bebe.

Saturday, July 21, 2012

Baby III Week 11: No Tequila With This Lime!

11 Weeks

I swear I can feel this baby. Honestly, I thought I could at 9 weeks but knowing that I shouldn't be able to I told my self it was a gas bubble or something, and with my intestines blown up like balloon animals that seemed like a likely answer. With Ash I thought I felt him at 11 weeks, but decided that I couldn't have. Well, last night I was laying in bed and felt a little swish and poke on my very lower left side of my abdomen, which is where I've felt all my babies first. I laid there holding my breath forever (probably made the fetus faint) telling myself if I felt something twice, then that would make it real. I didn't so I'm not going to make it official and whip out the baby book (ha like I have one), but something to note. We had just gotten home from a wedding, maybe baby was all energized from all the dancing mama did on the dance floor!

I'm experiencing some pretty intense insomnia. I get to bed fine, then from 2-4am I wake up and can't get back to sleep for another 2-3 hours. I'm not uncomfortable, the reason often given for pregnancy induced insomnia, I think it's hormone related. I feel like my adrenaline is up and I can't calm down. I'm not upset about everything, it's just my body malfunctioning or something. Babies should not be allowed to keep you up at all hours before they born, cruelest part of pregnancy for sure.

I had heart palpitations most of the week, I ended up calling my family practitioner to get my blood pressure checked and it was a little high, 132/78. I like to be around 114/60. Considering how much I'm running I felt my heart should be in better shape, though my diet has not been fantastic. I also know that I'm not drinking as much water as I normally do, and I have a cold, so my doctor said it could be dehydration. I'm trying to drink more, if they keep up, I'll have to get a blood test to check my sodium and potassium levels.

So pregnancy first. I've never gained weight in my first trimester, usually not until 18-20 weeks. Well I gained 2 pounds over the last 2 weeks. I'm not super freaking out, I did start this pregnancy weight 10 pounds less than my last and 20 pounds less than my first, but because of my blood pressure and blood sugar issues keeping my gains in check is important. Gaining around 4 pounds in the first trimester is normal, so if I don't gain more than that by 14 weeks (shouldn't!) then I will be ok.

Oh and nausea is subsiding! Yay! I've only thrown up twice but the constant queasiness is no fun.

Here's our 11 week pics! Baby is a lime, mommy is a watermelon.

Baby's first wedding!

Mmm margarita... or pie... or both...

Thursday, July 12, 2012

Baby III Week 10: Quarter Way!

Week 10

Yay! This is the first time that I've realized 10 weeks is the quarter way point, I always celebrate double digits and not how far I am, I feel like I've accomplished more! The other day Eric asked how far along I was, I said almost 10 weeks, quarter there. Some color drained from the small amount of skin between his eyes and beard and said "great, this is going to totally be a 'omg a positive pregnancy test, omg there's another baby here' thing huh." Yeah, pretty much. PS... on the topic of beards... if you ask Milo where his beard is, he will be concerned for a moment, then assure you it's in a box in the car. HAHA love him.

This month we got our good insurance back, the one that covers pregnancy, the other one didn't, super awesome. This one costs about $500 more a month. I love insurance. So since we have our fancy insurance now, yesterday I decided to go ahead and make a 3 month prenatal appointment with one of my midwives. The receptionist responded to my request with sheer panic over the fact that I had not been receiving care, I swear I could hear papers flying and filing cabinets falling over. She said I would be 10 weeks tomorrow, they needed to see me between 7-10 weeks for a confirmation of pregnancy, they needed to see me immediately. I felt like I had disturbed her sense of reality.

I calmly told her my pregnancy has been uncomplicated, this is my third baby, I've never had a loss, I know I'm pregnant, I know when I conceived, I shouldn't need a confirmation of pregnancy ultrasound since I know my exact conception date, something at the end of the month is fine.

Not fine.

There was then a flurry of words about having to have an ultrasound and seeing an OB before seeing a midwife and that they could not give me care without an ultrasound to confirm the pregnancy. She needed permission from the owners of the practice to do anything different and she said she would have one call me.

No call.

I called this afternoon and got a receptionist that sounded a little more like she belonged there, everyone in the office has always been It's A Small World cheery with me. I explained what happened yesterday and she wanted to know who I had talked to because she was confused by the whole scenario. Me too. We went on to make an appointment with one of the midwives, Meredith, second week in August. She said she needed to schedule an ultrasound too and I again asked if I had to have one. She said yes, there is a 20% increase in viable pregnancy after ultrasound at 7-10 weeks gestation.

*confused silence*

Anyone catch why this makes zero sense? I asked how that could be and she didn't know, and I certainly didn't know, and I said I'd like to know what they are basing that off of and she said so would she... There is an increase in viability after a heartbeat has been seen, but it's not because we've seen it! Ultrasound or not viability increases. I was so stunned that I forgot to push the issue on the ultrasound and a referral into Healthcare for Women was put in for me to get an ultrasound there. That appointment hasn't been made so I might ask some more questions because it sounds like there is really no reason for me to be getting an ultrasound, likely just policy to protect the practice but does not benefit mom or baby. We all know how I feel about that.

Feeling ok, craving a new food everyday still. Today I ate 4 nectarines, if we had more I probably would eat them. Here's my 10 week pics!

Ten down, thirty to go!

Baby should be the size of a kumquat, but we couldn't find
one so we found a really small plum that should be about the
same size. You get the idea, it's amazing how fast they grow!

Wednesday, July 11, 2012

Dumb Models & Drugged Babies

My mom called me yesterday to ask if I had seen anything about Victoria Secret model/Orlando Bloom's wife, Miranda Kerr's comments on not wanting an epidural because they can affect the baby and breastfeeding, and then the news anchor said something like "I'm not taking my medical advice from a model." I hadn't, so I looked up her birth comments and found an article on her interview with Harper's Bazaar. The interview seemed fine to me, maybe because I'm aware of the facts about possible epidural complications and effects. However... from what I read in the comments not only were other mothers not aware of the effects, they lashed out at Miranda as if she had personally accused each one of them of shooting their babies up with heroine.

 Here is what Miranda said:
"I had been watching all these baby bonding videos and [without an epidural], when the baby comes out it goes straight onto the breast." When the mom had an epidural: "The baby was a little bit drugged up and I was like, well, I don’t want that, I wanted to give him the best possible start in life I could." 
Here are how some mothers responded:
"Another idiot telling the masses what she thinks is best. This is misinformation. Read the literature, sweetie, and stop going on anecdotal 'evidence!'"  
"I am sick of these judgmental women that think they ‘know better’ and ‘do better’ then anyone else. Do you really think that every woman that has an epidural is DRUGGING her baby?? Get a grip, Miranda. Mothering is not a competition. I don’t know what it is with models."  
"Um… that’s not how epidurals work + it’s only to help the mother get through child birth. Why torment yourself with agonizing pain when you don’t have to? – that’s just stupid and selfish."  
"Holy misinformation! I had an epidural and my baby came out looking for my breast. It’s going to depend on the baby. If you want a natural birth that’s fine but don’t assume you know what you’re talking about when you don’t."  
"It’s not as if the epidural is inserted into the baby’s arm. Let’s get a little bit of perspective people. I had three children, all with epidurals, and I was able to nurse all of them almost immediately. The only reason I couldn’t nurse them immediately was because they had to be cleaned first….as with all babies that are not born under a tree." 
If someone shared that they lost 50 pounds because they were concerned about heart disease, consider how unreasonable it would be if other people who were 50 pounds over weight responded in outrage because they did not have heart disease. Fine, you don't, but studies show that if you are over weight you increase your chances of health complications. The decision to lose 50 pounds for your health is an evidence based decision and arguing against that decision is ridiculous, as is arguing against epidural anesthesia having any affects on a baby.

I used some passages from Henci Goer's The Thinking Woman's Guide to a Better Birth because the number of studies she has compiled is just amazing and makes for an excellent one stop shop for birth research.
"Studies have shown that bupivavaine, the anesthetic most used in epidural, crosses the placenta and is absorbed into the fetal tissues and that fetal dose rises with epidural duration. Researchers have measured umbilical vein levels at bupivavaine one-third that of maternal levels." 
And also from the official FDA information on Bupivacaine
"Bupivacaine hydrochloride should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. This does not exclude the use of Bupivacaine Hydrochloride at term for obstetrical anesthesia or analgesia... Local anesthetics rapidly cross the placenta, and when used for epidural, caudal, or pudendal block anesthesia, can cause varying degrees of maternal, fetal, and neonatal toxicity."
I saw one woman post that where the epidural is injected is nowhere near the baby... well where you inhale the smoke from a cigarette is also nowhere near the baby. The injection takes place in the spinal cord, but it does enter the mother's bloodstream and therefore the baby's. It lowers the mother's blood pressure (that is why you are given IV fluids before, to keep your BP stable) and therefore potentially decreases oxygen to the baby, leading to fetal distress and a possible c-section. Until the cord is cut, what affects mom affects the baby, can we please stop arguing this fact? Now whether it is safe or not all depends upon who you ask.
"Doctors often feel unconcerned about the side effects, even life-threatening side effects, provided they know what they will do to treat them and that the life-threatening ones occur reasonably rarely. So, two doctors writing for their colleagues can say reassuringly: 'These [epidural] complications should not cause fatalities if trained personnel and adequate resuscitation facilities are available.'"
The medical community is aware of the risks because there are procedures in place to minimize the effects. A local labor and delivery nurse I know said she chose natural childbirth because of the effects of epidurals on babies. Some of my friend's OB's have joked that "so baby will be a little sleepy, who doesn't like a sleepy baby?" My OB told me that Milo's breathing problems were likely due to having the epidural (which was in place for 12 hours). A nurse also made a "sleepy epidural baby" comment, but no one was concerned because Milo was easily resuscitated. If that does not bother you (it was a risk I was aware of and chose to take) then that's fine, you are making an informed choice, but don't deny that it's even true!

Some physicians will deny risks associated with many interventions, but that is not because there is debate over whether the risks are real. I don't know many teachers that take the time to read up on the latest teaching approaches in their spare time once they are out of college and in the workforce. Same is true for many obstetricians and nurses. They may be completely unaware of newly published data, not want to change their good enough practices, or be bound by hospital policy/peer's expectations to play down the risks.

I don't think women who get an epidural don't care about their babies. I don't think women who don't know about the adverse effects are stupid. There are times where an epidural can even be beneficial to the mother and baby. Every intervention has its place. However, an epidural does have very real risks to both the mother and baby and refusing to consider what they might be just because you feel defensive in your decision and you want to be right at all costs is obnoxious.

Friday, July 6, 2012

Baby III Week 9: Amnesia, Will Smith, & Carbs

Week 9

A big reason I blog my pregnancies is because I forget almost everything about them as soon they end. I do have an excuse, in addition to brain cells losing mass during pregnancy, the hormone oxytocin, which is at it's highest levels during labor, has shown to have amnesiac properties. If someone told me that Will Smith showed up with one of these flashy things after all my births, I would not be surprised. Though that's more of an excuse for not remembering one's labor, but it must apply somewhat to pregnancy because I'm honestly shocked by every new symptom... aaaaand... as I read through the posts in my due date group I see moms of three, four, even more asking "hey, is this normal?" "I dont remember this!" So, if I'm posting seemingly unimportant details, like what I'm eating or my weight gaining/losing patterns, it's not because I think you are all that fascinated, it's because I know I'll want to look back on that information during my next pregnancy.

So... what AM I eating, how am I gaining and how do I feel. I'm eating bland carbs and I feel like this:

I could eat cheerios for three meals a day, and I'm pretty sure I have at least once this week. I'm eating zero vegetables, I have a hard time even watering the vegetables in the garden. I have a bunch of zucchini that really needs to be picked but just smelling them makes me gag. I had to spit out sweet potatoes yesterday and who knows what's rotting in the fridge right now. I know my nutrition was right on with Ash, but I was also sick so I'm not sure what is up. I'm sure part of it may be that I'm less determined because even though I worked so hard during my last pregnancy, I still had gestational diabetes. I know there's a little voice in my head saying "what's the point." Hopefully when the nausea subsides my normal healthy eating habits will return. I haven't really gained, I seem to fluctuate a pound of so, nothing to panic over.

Here are my 9 week pictures! Sure is a cute bump until you consider that is really just bloated intestines due to the digestive system slowing down during pregnancy so you can suck every last bit of nutrients out of you food. But hey, it's still pregnancy related growth so I will take pictures of it. I can't feel my uterus yet, this time last pregnancy it was the size of a small squash according the ultrasound tech, so it should be at least that size now since you are supposed to stretch out quicker with each pregnancy.

Our little grape baby.