Tuesday, November 29, 2011

Full term!

I forgot to say that today I am officially* full-term at 37 weeks*!! Yay! That means if I go into labor today I can go to the birth center as baby boy is, medically-speaking, already all set for life outside the womb.

Did you hear that baby boy? You're officially fully developed and ready to meet us! It's your cue to arrive.... we're waiting patiently...

Because my pelvic pain is getting worse by the day, I don't think I'll be waiting as patiently in a weeks' time. Then it will be the hour for please-tell-me-every-single-old-wives-tale-about-inducing-labor-pretty-please-I'll-try-anything. Eating entire pineapples & mouth-searing curries, drinking raspberry-leaf tea, even watching The Bourne Identity (really?! something about the camera shaking...) will all be commenced shortly if baby boy hasn't come by next week. (Which, er, I don't think he will. I don't feel any special premonitions about the next week or two... Are you supposed to?)

Me and my basketball belly above. Apologies for my disheveled appearance. My wardrobe is seriously limited these days and always includes the stylish white pelvic-support belt you can see at the bottom of the picture - so fashionable, I know!

*My EDD based on the first day of my last period is December 18th - I like the sound of this date a lot better than my revised, official EDD (based on my 12 week ultrasound) which is December 20th, so I've been saying the 18th is my due date whenever anyone who isn't a medical professional asks. So unofficially I was full-term two days ago...

** I'm 37 weeks pregnant, which means I'm in my 38th week of pregnancy.

birth plans

I went to the water birth workshop at my hospital's birthing centre yesterday. It was - to employ local parlance - absolutely brillant!!! So informative - and whereas before I thought I would only want to labor in the pool but not give birth in it - now I 100% want to give birth in water. I think it will be especially helpful for me to be in the water to take weight off my poor dysfunctioning pelvis, I just need to be careful about getting in and out of the pool. It also is no problem that I have GBS and will need to have intravenous antibiotics every four hours throughout labor - they just put a rubber glove over the hand that has the cannula... still not sure how that keeps the water out, but if I have to just keep one hand out of the water I think I can deal with that. They also addressed all my other worries about water births. They have telemetric fetal monitoring which is waterproof and thus can be used to continuously monitor baby's heart-beat if need be. (Although I would prefer that, if everything is going normally, that they only monitor baby's heart-beat every 15 minutes. Intermittent monitoring is just as effective and results in fewer false alarms of fetal distress.) Some more embarrassing aspects of giving birth were also addressed. (Er, you know, contact me if you want to know more.) You don't have to get out of the pool at all. They examine you with a flashlight and a mirror while you're in the pool. You can also use gas & air while in the pool, and there is a shower head for some water massage! All in all it sounds just exactly how I want to go through this powerful, painful, wonderful, empowering, life-changing, life-giving experience.

I am so lucky to be giving birth in the UK where birthing centers and water births are integral, accepted and encouraged within the medical establishment. Where midwives run the show, view birth as a natural process, and have experience and enthusiasm for natural, non-medicated births. I don't belittle or begrudge those who have a medicalized birth - I think that it is much safer for a woman to have an epidural if her experience of birth pain is excruciating and she is unable to cope. There are also many things that can go wrong in labor that require immediate medical intervention. There is a reason why getting pregnant used to be the most dangerous thing a woman could do!  Before modern medicine your chances of dying in labor were quite high. However, the medicalization of birth has been taken to an extreme in the US and I really dread having to give birth back home next time, unless I can find a birthing center! (I would have a home-birth next time, but our insurance wouldn't cover that.) I am also so lucky to be giving birth in the UK because all my care is completely 100% free. Even though our US insurance covers 100% of "wellness visits" - it only covers 80% of pregnancy and delivery related visits. Because apparently pregnancy is a "condition" and not a natural, normal part of life. So we are saving a lot of money by having this little guy in London at an NHS (National Health Service) hospital.

So I am so thankful to be giving birth here. So thankful that the following birth plan will raise ZERO eyebrows in the hospital birth center.

I AM SO EXCITED TO GIVE BIRTH. I know that sentiment makes many people cringe and innerly (or directly) call me crazy. Fine, think that I am crazy! But I just cannot wait for this empowering, emotional, most uplifting and dramatic moment of my life. Every time I watch a video of a baby being born I tear up. I just cannot wait to meet our baby boy.

Oh, and please excuse the British spelling in the following...

ta-da! here is my...

Birth Plan

Mother: Olivia Stevens
Birth Partner: husband, Chris Stevens

Key points:
-     natural birth, gas & air only
-     water birth
-     GBS positive, wants antibiotics asap
-     SPD
-     Spontaneous pushing
-     No episiotomy
-     delayed cord cutting
-     physiological third stage
-     immediate skin to skin contact
-     immediate breast-feeding

I am GBS positive – I would like antibiotics as soon as possible in labour.

I have SPD and am limited in the movements I can make. I would like to deliver in the water, or on all fours or on my side. If in case of an emergency I need to have an epidural, great care needs to be taken to ensure my legs are moved in parallel and not moved too far apart (my partner has a ribbon marked to how far I can move my legs without pain).

I do not want any medical pain relief, except gas & air. I plan on managing the pain through breathing, visualization, vocalization, massage, and water.

I want to push spontaneously – no directed pushing please.

Crowning – please remind me not to push through crowning. I want to avoid tearing and do not want an episiotomy.

I would like immediate skin to skin contact with my baby immediately after birth.

We want a delayed cord cutting, please wait until the cord has stopped pulsing before cutting the cord.

Physiological third stage of labour – I want to deliver the placenta naturally, please do not give any drugs, and do not use controlled cord traction. If the bleeding has become excessive or the placenta does not deliver naturally within 30 minutes, then we would like to re-evaluate.

I plan on breastfeeding immediately after birth.

Tuesday, November 22, 2011

Time to start packing...

One of the girls in my NCT class (remember we all have due-dates within 15 days of each other, all in December) gave birth on Sunday. Sunday, November 27th - 3 and a half weeks before her due date!! A due date which is only four days before my own!

This slap in the face of reality reminded me that, hm, yes, my hospital bag is still not completely packed. If I went into labor today I would arrive at the hospital with half the allotted crap I wanted to have. Which would probably not have been the end of the world given my tendency to over-pack and all - but I most certainly would be laboring in the clothes I arrived at the hospital in. Which is not cool according to me, because I want to be laboring in clothes I can throw away afterwards if necessary. (Given the amounts of blood involved in delivery I'm banking on the, yes, it will be necessary. And no, hospitals in England don't give you disposable gowns like they do in fancy American hospitals.) I do already have disposable underwear in there. But I wanted some pairs of cheap black panties too, in case the thought of wearing plastic becomes untenable (it already is somewhat so.) I have straws for drinking, but no tennis balls for massage. I have slippers (cheap hotel ones I can throw out) and flip-flops for the shower, but no towel. I could go on and on. Basically I am unprepared. Except for the baby's bag. The baby's bag is completely set to go! Because his was the most fun to pack, obviously. All those cute little onesies and receiving blankets and hats - oh my! Can I un-pack and re-pack for the fifth time just to ooggle again?

My hospital bags 

*UK edition (in the US you wouldn't need clothes to labor in, or maternity pads, or diapers, because you pay your private hospital bill which includes all those freebies!)

Phone and charger
iPad + charger 
camera + charger
power convertor

Maternity notes
Many copies of birth plan
One (or two?) pillow(s) from home with not-so-great pillowcase w/ waterproof cover
Small coin purse for vending machines
Hairbands and headband
Back massager (tennis balls!, rolling pin?)
Chewing gum
Warm, comfortable socks that can be thrown out
Very old nightgown or t-shirt & shorts that can be thrown out
Bikini top for birthing pool
Big water bottle
Juice packs and snacks for hubby
Labor massage oil (rose, lavender)
Lavender essence (to dap on tissue)

Breast pads/ nursing pads
Nursing bras / tanks
Towel and washcloth
Toiletries (shampoo, conditioner, bodywash, body lotion, toothbrush, toothpaste, floss, face moisturizer)
Flip-flops for shower
Contact lenses and eyedrops
Sleeping mask
Zip-up fleece
Old PJ pants and button up shirt
Maternity pads
Disposable underwear AND cheap cotton underwear that can be thrown away if nec.
Baby book to record baby’s footprint and vital stats
Going home outfit for me

Receiving & swaddling blankets
Cotton wool (aka jumbo sized cotton balls, for cleaning baby's bum)
Going home outfit (a baseball sleeper! so cute, must assert American-ness from day 1)
Baby onesies and sleepers (3 of each)
Scratch mitts
Burp cloths
Snowsuit (one fleece for a warmer winter day, one intense fluffiness for a colder day)
Infant sleeping bag

Wasn't that a fun list?? Now I get to go finish packing... because seriously... in one week EXACTLY I will be full-term. FULL TERM! DO YOU KNOW WHAT THAT MEANS? THAT MEANS I COULD GO INTO LABOR ANY DAY! ANY. DAY. Phew. Fun, scary, exciting times. 

I can't wait to meet baby boy.

Monday, November 14, 2011

All About the Boobs... what I've learned about feeding my baby

This past month Chris and I have been taking a great antenatal class in our local neighborhood. (Antenatal is apparently a very British term, I'm thinking the American term equivalent would be birth class?) The classes are run by a national charity called the National Childbirth Trust, and though the classes were not free, or cheap, they were pretty informative, helpful, and most importantly, we met some great other new parents. There were eight other couples, all of us have due dates within 15 days of each other, and we all live within 1/2 hour of each other. (One of the couples lives literally right around the corner!) Class was also like a mini UN - Greek, Australian, Portuguese, New Zealander, Iranian, American, and only half British. And although I felt the coverage of labour and delivery was scanty and repetitive (there was no discussion of the third stage of delivery or perineal massage, much to my dismay), the information on breast-feeding was VERY helpful. This makes sense because our instructor - a middle-aged bourgeoise hippie who lay on the floor moaning in fake-labour pain at least once a class - is a lactation consultant.

Useful facts about breast-feeding:

 - Newborn babies need to feed at least once every three hours. You shouldn't try to schedule the baby's feedings, except you should set an alarm to go off every three hours in the night so that if your baby doesn't wake on his or her own to feed you can wake them.

- After baby is done feeding on one breast you should always offer the other. Then start with that breast the next feeding.

- A baby doesn't need to feed for a certain amount of time. But if your baby is at your breast for 45- 1 hour, he probably isn't latched properly. When babies don't latch properly they don't get as much milk, and your boobs get unnecessarily sore.

- Your nipples shouldn't hurt when baby is breast-feeding. If they do, he isn't latched on properly.

- Baby's head should always be tilted BACK when feeding. (Do this now. Put your chin to your chest and try to open your mouth and swallow. Go ahead, do it! How does that feel?)

- Don't support baby's head when feeding either, just hold them very snug and firm against your body.

- It is really important that baby's first experience with feeding be positive. Right after birth, let them lay against your chest and find your nipple on their own - don't force them on or let a midwife/nurse force them on. We watched a video of a newborn lying on his mom's chest immediately after birth and he just instinctively crawled his little head towards her nipple - it is amazing!

- If feeding your newborn every two hours (or more) seems excessive, think of it this way.... When was the last time you put anything in your mouth today? Even a sip of water? Because breast-milk is baby's everything... and with a stomach the size of a walnut in the first weeks, it makes sense they get hungry and thirsty at least every two hours!

- Crying is a last resort for hunger. Look for rooting with the mouth, putting hands in mouth, general restlessness - and try to feed before he cries.

- The WHO and all other major health groups recommend exclusive breast-feeding (no formula!) for 6 months. Only 1-2% of British women do this.

- Frequent feeding through the night is really important for establishing a good milk supply so that you can successfully feed for those six months (and beyond.)

- At six months, solids can start to be introduced but you should still be breast-feeding too.

I feel very lucky to be able to be unemployed through the first year of little boy's life. I don't know how I would cope with leaving him after 3 months' (or even 6 months!) maternity leave. I also don't know how I could possibly exclusively breast-feed if I had to go back to work after 3 months! I don't think it's possible, unless you pump and store your milk every couple of hours while at work. My mom swears she exclusively breast feed me when she started going back to work when I was 3 months old, but then I asked her, well didn't you supplement with formula? and she said she couldn't really remember. She didn't pump at work, but would run home during her lunch break to feed me, and then would race home every evening early. Sounds too hard! I'm so lucky, this I know.

Thursday, November 3, 2011

Chipmunk cheeks (aka weight gain during this pregnancy)

In the past two weeks I baked the following:

chocolate-chip sour-cream coffee cake (it's amazing!! - go bake it right now!)
pumpkin cookies
whole-wheat apple muffins
mango banana muffins
black-bottom cupcakes***

Now, remember that a) I naturally gain weight easily b) I live in a two-person household c) I am home all day long unable to move and d) I am pregnant and naturally craving sweets.

Should it be any surprise to me that I've gained 5 lbs in the past week and a half then?

Hm. No. It shouldn't.

I am currently on a full-stop baking hiatus.

(But I really want to make these.)

Anyways, I really have gained so much weight during this pregnancy. Now, I'll let you know that I have nothing but scorn for those women who care about their figure during pregnancy. I mean - HELLO! - you're PREGNANT! Your growing baby needs good food and your body needs some stored fat to make breast-milk after birth! (The making of which - btw - uses more energy than growing baby does.) But I really haven't been helping myself out by eating so many sweets while being unable to exercise.

Don't be misled by this picture of my ginaaarmous belly - that belly is ALL baby! (He is so squished in there, I feel his protest kicks and squiggles all day - and night - long.... he is one strong baby!) My fat deposits are pretty much all in my butt. The best was when my grandmother told me (repeatedly) that I was "carrying all in the back." Okay, thanks grandma! You know that's not physically possible right? Why don't you just call me fat and get it over with?? She regaled me with stories of her two pregnancies the whole visit - "I didn't go one pound over the 12 pound weight gain my doctor recommended!" Well... gee.... that sounds.... healthy?

My recommended weight gain (based on this calculator) was 25 lbs, given that I'm 5'4" and started at 120 lbs. Right now I weigh 160. Yes, you read that right! I've gained 40 lbs!

When thinking about that number my first reaction is utter revulsion and a steel-will resolution not to consume any baked product ever again. But the fact of the matter is, I don't sit at home stuffing my face with cake all day. I just can't MOVE, so that one piece of cake, or one cookie, does not get burned off, at. all. So unless I want to completely deprive myself of one of the only joys left to me in this pregnancy, then I'm going to gain more weight before this little guy's appearance.

Right now I'm leading towards the yes, you must deprive yourself of this last joy side of things. I can go four more weeks** without baking... right? right? 

* for the record, DH's co-workers have been benefiting from this baking spree and my freezer overfloweth with muffins!

** my NCT instructor last night told me she thinks I will deliver early, "there's not much room left in there!" were her exact words! As someone who has been seeing 8-month pregnant women every week for 30 years I think I can safely put some hope in her opinion. Because seriously, giving birth at 38 weeks (in one month's time) sounds so infinitely preferably to the dreaded 1-2 week's over-due that is common with many first births! (38-42 weeks is all within full-term. Doesn't that make the phrase "due-date" rather funny?) Here's for a birthday in the single digits of December!!!!