Wednesday, August 30, 2006

It's a BOY!!!!!!

Antony Joseph was born at 8:22 this morning. 7lbs 2oz, 20 inches. He is so sweet and adorable. (I adore him, anyway!) We've had a full day with relatives visiting, so this will be short, but I have lots to say about the c-section (I wouldn't choose it over a vaginal delivery if the choice were to be made, I just got up out of bed for the first time, and OH MY GOD it was painful. But the operation itself was totally cool!) so I will be writing that over the next few days.

He's basically been sleeping since 1pm this afternoon, so I'm going to go now and get some z's while I can. Take advantage of the honeymoon period!

Tuesday, August 29, 2006

Wow

We get to meet Phred in approximately 18 hours. AAAAAAAHHHHHHHHHHHH! I still can't wrap my mind around that idea. Feels very surreal. I assume it will feel more real when we're actually in the hospital!

Thursday, August 24, 2006

Random thoughts

M was doing some internet research on what to expect with a c-section, and came across this gem, from WebMD, no less:

"What else do you need to think about before surgery?
Questions to consider include:
Do you need to finish any heavy work, such as laundry, shopping, or cutting wood, before your delivery? You will not be able to do any heavy lifting for 6 to 8 weeks."

Cutting wood? Is that really a common household chore, like laundry and shopping??? It's almost as if this came from a different century!

****************************

I'm finding myself less and less sanguine about the idea of having a c-section with every passing day. I wish I didn't have two weeks notice, I feel like it's just given me too much time to think about all the bad things that could happen, how much worse recovery is going to be, all that kind of stuff. I really am excited to meet Phred, but at the moment the excitement is being overwhelmed with dread. Which I don't think is really a good way to be heading into this. It's gotten to the point where thinking about having my baby is bringing me to tears, which in turn makes me feel even worse. Yet another time where I wish life had a fast forward button!

I was just emailing with my sis about this, and I think she had some really good advice. Now I just have to follow it! "Forget about the natural birth. Forget that you are not getting to do this the way you want to, and have expected to. Put aside your previous expectations and come up with a whole new scenario. Plan Phred’s birth, and your birth experience around the knowledge that you are having a C, not that you are not delivering naturally. Get excited about the anticipation of knowing exactly when Phred is coming, and just focus on that moment and on the pure joy you will feel at that second. Your birth experience may not be the one you were looking forward to all these months, but it is going to be your birth experience forever. Make it special and look forward to it. Put everything else behind you and make what is going to happen what you want. You do not want to look back at this day for the rest of your life and wish for something different. Make it a day you can look back at with no regrets."

**********************************

I spoke with my MIL last night - she mentioned at one point that she purchased two really cute outfits for Phred to wear home from the hospital, one if it's a boy, one if a girl. It actually seemed like a really good opportunity to me to at least begin addressing some of my concerns. So I tried to be very gentle, and said that we really appreciated her doing things like this, and that I totally understand how excited she is about her first grandchild, but that we're excited about our first *child*, and WE want to be able to buy the cute outfits. She actually took it really well, and said that with anything she gets that we don't want for any reason, she's more than happy to return them. She said she would absolutely return these outfits, she just wants me to see them first, because they're so cute. So we'll see if she actually means it. But on the surface at least, I think I got that part of my point across.

Of course, I am a totally unsentimental person, and as I mentioned quite frugal - some might even say "cheap". I don't see the point for us to spend money on a cutesy outfit to come home from the hospital in, when all it's going to be is hospital, car, house (I totally understand that some people DO want a cute outfit, and I think that's totally cool. It's just not for me). A onesie or sleeper seems perfectly adequate to me. Of course, I won't tell HER that!

**********************************
GandKsmom asked for some belly pics. Here's one of me with the obviously unfinished baby's room. And here are a couple of the belly.

Tuesday, August 22, 2006

In-law dilemma

My in-laws are really nice people. I truly believe that they have the best of intentions, they love their three sons dearly, and are really happy with their daughters-in-law. They are absolutely thrilled about Phred, who will be their first grandchild.

Two issues. First, they do tend to be somewhat overbearing. I'm not sure whether overbearing is exactly the right description. In some ways I think it's because they're lonely - they will often call us (or M's middle brother a lot more), with nothing really to say. Recently they've been calling on an almost daily basis asking "So how's my grandchild?" Ummmmm..... fine as far as I know. I've heard them say, as well, that once Phred is born, they plan on spending two days a week with us. Ack. Again, they're really very nice people, but they're not family to me in the same way that my mom and sister are - I feel like I need to entertain them and keep them busy where with my mom and sis I know that I don't. So that's issue number one.

Issue number two is going to be even harder to deal with. It has to do with gift giving, for birthdays, but way more so, for Christmas. My MIL is a shopaholic. Which is a really bad thing when you are planning on retiring in about six months, have your house fully mortgaged, and over $30K in credit card debt. Christmas at their house is a truly disgusting event, in my mind. Each person gets a stack of presents about three feet high. The first few years we estimated that the total value of gifts amongst the three sons and their spouses was in excess of $2K. It's gotten better since then, but still completely and thoroughly over the top. So much waste, excess, spending for the sake of spending.

A prime example was my baby showers. I had two - one organized by my MIL for her friends and relatives, and another organized by my sis, for our family friends. Similar to my bridal shower, I felt completely embarassed by opening the huge stack of gifts all from my MIL. To me, a single gift would have been more than sufficient, given that she spent all the time and energy to throw the shower. But no. She got us (brace yourself!) 1. the bedding set we had registered for, 2. along with the matching diaper stacker and 3. sheet. 4. A box full of about fifteen different bibs for all sorts of occasions, all individually wrapped in the appropriate paper (e.g. heart paper for "baby's first valentine"). 5. Another pair of sheets. 6. Waterproof bed cover. 7. Two sleep sacks. 8. Hangars. I don't know about you all, but spending fifteen minutes opening presents from one person was a bit much for me - again, I know it's well intentioned... The real kicker for me was at the baby shower thrown by my sis. I was completely and totally taken aback when I was handed a SECOND stack of presents from her! More bibs (we have 29 in total, thank you very much), more hangers, more sleep sacks, another sheet, another set of waterproof sheet covers, three or four sleepers of different sizes, and the Graco stroller we had registered for. All told, around $600 worth of stuff.

After this, M tried very gently to tell her that although it was much appreciated, it was way more than they should have done... and that Christmas is going to have to be *very* toned down, i.e. only one or two gifts. And nothing for Phred (in my mind, it is worthless to give gifts to a child before they're old enough to grasp what's going on, and at 4 months, I can pretty much guarantee that even if Phred is a super genius, that's unlikely). She told him that she has already purchased a bunch of outfits for next summer! Argh!

So that's issue number two.

I feel like I need to address these things with them now. Set expectations up front so that we don't have to battle every Christmas and birthday, and so that they don't expect to be living part-time with us! The rules that I would like to set are one toy and one outfit for Christmas and birthdays. If nothing else, I feel like it's unfair to us for them to do more than that - this may be their first grandchild, but it's our first child, and *I* want to have the enjoyment of picking out toys and clothes! If they're buying dozens of outfits, on top of all the hand-me downs I'm probably getting from various friends and relatives, I feel like I won't be able to have that fun (I am extremely frugal and thrifty, and aside from my car, really don't buy things that I don't *need*. Which makes their excess even worse in my eyes!). And we'll need to figure out how much we actually want them to visit, but I think weekly visits should be more than enough. I don't want to have to plan our lives around them, and also want to have time to spend with OTHER people.

My dilemma is how best to address these so that I can get my point across without getting their backs up and making them all defensive. I thought of a few options - 1) writing a letter, 2) inviting both of them over to dinner this weekend, along with my mom and her husband, and laying this out for all of them, so that my in-laws don't feel as targeted, or 3) taking my MIL out to lunch, just the two of us, and trying to get the point across to her on our own.

Which option do you think is most likely to work (feel free to make other suggestions too!)? Am I completely deluding myself in thinking that there is anything I can do about this?

Sunday, August 20, 2006

If you can't laugh at yourself...

Thursday morning I was heading to the gym, to do my usual routine of light weight lifting, a few minutes on the elliptical, and some swimming (well, my usual routine since I was allowed to start exercising again at 34 weeks). I grabbed a yellow floral tank top, some pants, and the bella band I had picked up over the weekend, just in case.

Thank goodness I grabbed that band! When I put the shirt on, it was WAY too short in the front. I would have been embarrased to show my face if I hadn't had the band to cover the large expanse of belly that was hanging out. As it was, I think the fashion police would definitely have had shots of me in the "what not to wear" category. Can you buy one of those black bands to wear over your eyes when something like that happens?

The next day I was going swimming again, and this time picked out a button down tank top and a skirt. I thought back to my experience of the day before, and also snagged one of the t-shirts I had just bought at Tarjhay. What a sight when I tried to put on the button down - there was NO WAY the button and button-hole were meeting. There was a good one-ince gap there. Score one more for my forethought in bringing the t-shirt!

Later that afternoon I was having lunch with a friend whom I haven't seen since late last year. Burger and fries. Have I mentioned that I have been eating like crap for the past month? Anyway, I decided I wanted some ketchup on my fries, picked up the bottle, and began shaking. Didn't realize that she hadn't screwed the top back on after using it... shake, shake, then in slow motion the cap dislodged itself, and there was a spray of ketchup twisting through the air... At which point I thankfully managed to arrest my motion. But I got ketchup on my wrist, my knee, and two big globs on my stomach. Looked like an idiot, but I couldn't stop laughing at myself. Typical!

Thursday, August 17, 2006

Houston, we have a schedule...

After reading a bunch more, thinking a lot, taking all your comments into consideration (I cannot tell you how much hearing all your thoughts really helped! I'm a little too emotionally invested.), we decided that going ahead with the scheduled c-section really is the best course of action.

So, unless I happen to go into labor beforehand, or Phred magically gets the right idea and turns head down, he/she will be joining us on 8/30, at around 8:30. How cool is that? We have to arrive at 6am, so I'm going to ask them if it's at all possible to go up to the OR slightly early so that Phred really can be born at 8:30. If you're going to schedule, you might as well go all out, right? ;-)

It's really bizarre, for me, to know that 8/30 is Phred's likely birthday. Not something I ever thought I would know in advance. I'm going to take a couple of days off work before the birth-day, so my last day will be next Friday. It's funny, I really feel like this has just snuck up on me. I only have six working days left! I okayed all of that with my boss, so we're good to go.

You know what really irks me though? A couple of women at work decided to organize a baby shower (on 8/27) for three of us who are due between now and mid-October. They sent out an evite to everyone. My boss replied that she wouldn't be able to make it, and perhaps since I'm scheduled for a c-section on 8/30, they should make the date earlier. You could have bowled me over with a feather. Am I wrong in finding it completely and totally inappropriate for her to put that on a website for... oh... 20 of my 'closest' coworkers to find out?

Wednesday, August 16, 2006

This is one stubborn kid!

No luck with the flipping today.

We started with another u/s to do a biophysical profile, as well as confirm Phred's position. I was thinking after the last u/s that calling Phred "complete breech" wasn't quite right, because all the pics you can find by googling show that as the head towards the top of the uterus, the spine basically lined up with your spine, then the baby in a cross-legged position. Phred is in a much more transverse like position, with the head over on my right, spine along the top of my uterus, then feet down near my cervix. Although all the websites seem to say that a transverse baby has their back / shoulder against the cervix. So Phred is upside down transverse. M was joking that it's because I was born in the Southern hemisphere, so all we would need to do is go back there to get our phlip.

I was really hopeful - the u/s tech said that there's plenty of fluid, and Phred is nowhere near engaged, so I figured it would be a snap to get a nice big phlip. Well, not so much. There were two docs there, one pushing up and out of the cervix on Phred's bum, and the other pushing down on the head/back. After the first attempt, although they were pushing down, somehow Phred ended up more like a complete breech. Then back to transverse, complete breech, and back to transverse again. Which was when they decided enough was enough, and it wasn't going to work.

They told me I was a real trooper, and took it much better than most. I figured if I couldn't stand this for 10 minutes, there was no way I could manage labor! As others have said, it wasn't exactly painful, but it was also next to impossible to relax. I did find that concentrating on my breathing helped a lot. But yes, it was mighty uncomfortable. I am definitely glad that we at least gave it a shot!

So anyway, now they want to schedule a c-section for 39.5 weeks (8/30 or 31). In a way, at least, I'm glad that Phred is transverse, because even the anti c-section books say that one cannot deliver a transverse baby vaginally, so I don't have to wonder if I should go out and try and find a practitioner who would let me deliver a breech baby.

I'm really torn as to what to do. Go ahead and schedule? Or tell them that I'm not going to, and wait until I go into labor on my own? I know that I had said in my earlier post that I would wait... but honestly I really thought that something would work, at least the version, and I wouldn't be faced with that choice. (Kinda like how I said before IF that if it didn't happen naturally that was the way it was supposed to be. HAHAHA)

Here are the pros and cons of a scheduled c-section as I see them:
Pro #1: Doctor feels it's safer than going into labor, as (especially given I've been contracting for so long) I may not recognize the labor until I'm well into it. Pro #2: Phred is born in August, which means we get a choice of which year to send him/her to school. Pro #3: Easier c-section when I'm not in labor? (must research this one a bit). Pro #4: Labor with a transverse baby can cause cord prolapse if the waters break, and uterine rupture if the labor lasts for a while. Con #1: I don't get to experience any true labor, which you may call me crazy for, but I was actually looking forward to. But then again they probably wouldn't want me to get far enough into it that I'd feel much anyway. Con #2: Phred may want to cook for longer - who am I to say that he/she is ready now? Especially as I was two weeks late myself, and refused to be induced 10 days before that. However, with basically zero pressure on my cervix, chances are that I'd go late just because of that and nothing really to do with how ready Phred is. Con #3: Less time for Phred to flip naturally, as slim as that chance may be, it's zero once I've had the section. Just found an abstract from 1990 that stated that 24/29 patients with a transverse lie at 37 weeks spontaneously converted by the time they went into labor, with 15 of those vertex. That's actually better odds than I was expecting. But the same paper says to perform version at 39 weeks and if not successful, c-section based on "major morbidity associated with expectant management of these patients".

Is there anything I'm not thinking of, either pro or con? What would you do? Yes, I am soliciting advice, opinions, and anything in between. I really can't make up my mind one way or the other at the moment. It probably doesn't help that I feel somewhat gypped by all this. As I said, I really was looking forward to labor and delivery, and I'm sad that I'm most likely not going to experience much if any of it. I know that once Phred is born I probably won't care one bit, but right now I'm a bit down in the dumps.

Version, fliperoo, whatever - let's just hope it works!

No dice with the acupuncture / moxibustion. (Supposed to heat up the "line" going through my uterus, causing the baby to be agitated and move more... one of the possible results of which is flipping over, and such effects have actually been documented in the medical literature). So I'm headed over to the hospital in about 15 minutes to try the ECV.

I really, really REALLY want it to work! Any turning over, somersaulting, flipping thoughts that you can send our way in the next couple of hours will be much appreciated.

Of course, one of the possibilities is that if something goes wrong (e.g. placental abruption, 0.5% chance) I may have an emergency c-section, and Phred's birthday could be today. That thought is a little overwhelming!

Monday, August 14, 2006

Phlipping? Not so much.

Our first attempt at moxibustion was on Saturday. It was interesting, basically my acu lit a coal of some kind of herb, and burned it next to my pinky toes for 15 min each. It wasn't painful at all, somewhat to my surprise. And it did do something - almost as soon as she brought it close to my toe, my face got really warm. But as far as encouraging Phred to be more active and/or flip, I'm dubious on the first, and the second certainly did not occur.

We're going to try again this evening, this time I'm going to ask her to use needles as well, based on a couple of papers that I found that used both. She wouldn't do it until I was 37 weeks, though, and most of the papers about it seem to suggest that it be done between 33 and 35 weeks, so it may be too late. (Which really irks me because I had an appointment with her where I was expecting her to try it, at 35 weeks, but she said she wanted to wait because "it could induce labor".) There's also another paper that I found that suggested doing it every day for two whole weeks! Why can't people just agree on a procedure, instead of there being umpteen variations so you can never be sure that your practitioner is doing it "right"?

Speaking of doing it right, I'm not seeing the chiro anymore - when I originally mentioned that I was going to try someone versed in the "Webster technique" for turning babies, one of the commenters mentioned that she had it done, and that the chiro didn't need to touch her belly for it. And then I read the same thing somewhere else. Well this chiro, although she was listed as a chiropractor trained in the technique WAS using her hands on my belly, and it just made me uncomfortable. Although not enough that I didn't go a few times, but it just seems like she wasn't following the technique properly either. GAH!

I'm still keeping hope that tonight's acu/moxi will work, but if not, I have a version scheduled for Wednesday afternoon. If THAT doesn't work either, I'll see if I can find another chiro around here who's Webster certified... and actually spend a little more time talking to him/her to ensure that they'll be doing what I expect they should, instead of blindly going along with it.

Friday, August 11, 2006

Update on the u/s journal article

Despite USA today saying that the article regarding the effects of prenatal u/s on brain architecture was published on Tuesday, it wasn't available to us peons until yesterday. Here's the link, if you're interested.

Reading through the original article I had found, they don't misrepresent anything, but I do feel much better after having read the source document.

For one thing, the mice were exposed to the u/s for a much longer percentage of developing brain time than any of our babies are. Plus, no effect was seen until 30+ minutes of exposure to a stationary u/s beam. Our u/s don't take nearly that long, nor is the beam stationary. Even if cumulative exposure is > 30 minutes, I think there's long enough between exposures that different cells would be "affected" with each scan, not enough to cause the kinds of changes seen in this study.

That said, I still think it's worth considering the value of each u/s before having it.

37 weeks tomorrow. Mind boggling, as many of you commented on my previous posts. And acupuncture / moxybustion scheduled for tomorrow as well to try and get Phred to "assume the position". I'm really hoping that it works!!!

Tuesday, August 08, 2006

Ironic timing...

For this article about the potential effects of ultrasound on the development of the fetal brain (of mice) to come out. The natural birth books I've been reading suggest that one should decline "unnecessary" ultrasounds and fetal heartbeat monitoring with a Doppler. So I was thinking this morning at my u/s when the tech was showing me Phred's brain, whether it was a good idea to be doing so or not. And then I read this article! Argh!

The caveats of the article definitely hold true, I think - the study was conducted in mice, so there are a lot of factors that make the relevance to humans questionable. And, I tried to look up the original article in PNAS, and was unable to find it (please drop me a comment if you do find it and I'm just being an idiot). I generally don't like to take what the media write about science as gospel without going to check on the source myself, as it is often sensationalized.

But, the article does make me wonder a bit about the utility of some of the early scans I had done (6wks and 8 wks) - yes, it was nice to see the embryo, and to see the heartbeat, but really, were they both necessary? I can see that an early u/s is good for diagnosis of a possible ectopic pg, or multiples, but most women who aren't with an RE don't get these early scans.

There was another article that I found while looking for this one mentioning that in a study of men born from 1973-78 when ultrasounds first started to be used, there was a statistically significant increase in the number who were left-handed. I kind of laughed at that - who really cares? But at the same time, one has to question what other effects there might be.

I guess that the point is that like just about everything else in life, there are pros and cons. It's a question of weighing between the two. Having read this article I might make a different decision on my early scans than I did - but what's done is done. I think the lesson that I will draw from this is that it is worthwhile to consider, even if there don't seem to be any drawbacks to a particular procedure, how necessary it truly is. There is nothing in life that I can think of that is 100% guaranteed safe. But having considered this and then decided to do something rather than just doing it on the assumption that it's safe would make me feel better, I think.

On the other hand, my u/s today was so totally cool! I could see Phred breathing, eyelids opening and closing, the fuzzy hair on the head, heart going pitter-patter, little tongue sticking in and out of the mouth... incredible.

Phred's personality - stubborn already!

Well, I had my 36 week appointment this morning, with an ultrasound to see exactly how Phred is lying in there. The verdict? "Complete breech". If you google it you can find some pictures, although none of them are exactly right. Phred's head is over on my right side, with the back pointing more towards the top of my uterus, and feet right down by my cervix. So maybe a combo of transverse and complete breech? I had been thinking that Phred's head was over at the top left of my uterus, but I was wrong about that - although exactly right about where the feet are!

The u/s tech also did measurements to figure out how big Phred is, and came up with 5lb 14oz, in the 25th percentile. Which is good, as it gives the external version (which will be scheduled for next Weds or Thurs, assuming that acupuncture / chiropracty / lying with my butt in the air haven't worked by then) a better chance of working than if he/she were oversized.

Nothing much else of note to report... I'm finding it harder to move around - sitting down and standing up require a bit more work these days. I also managed to acquire some hemmorhoids over the last few days, and the doc said that I can't expect that to clear up before delivery. Lovely. Ankle swelling isn't quite as bad now that it's cooler outside, but my ankle bones are still a bit hard to find. But all in all, that's not too much to whinge about.

Wednesday, August 02, 2006

Birth plan

As I mentioned, since reading "Natural birth the bradley way", I've also read a couple of other books on the topic of delivery, and more specifically, the things that your doctors don't necessarily tell you ("The thinking woman's guide to a better birth", and "The silent knife" about C-sections and VBAC. I wouldn't say that reading these has scared me, but they have definitely raised some questions in my mind about standard obstetrical practice that have made me realize that M and I are going to need to be more proactive in our management of Phred's delivery that I would have anticipated had I not read these books, and learned about the possible negative effects of standard care. So, here's what I'm thinking (assuming, of course, that I don't have to have a c-section because Phred is still breech).

Please note that these are my opinions, based on what I've read. I'm not criticizing anyone else's choices!

1. Eating and drinking during active labor. Strongly discouraged by the hospital, in case you need general anesthesia for an emergency c-section. Problem is that it can cause dehydration (leading to the need for IV fluids, see #2), and lack of energy for the second stage of labor. Which can lead to an extended pushing phase, and c-section for "failure to progress". They claim that if you are put under with food in your stomach, you might throw up and aspirate the contents of your stomach = bad. But, if you haven't been eating or drinking, you throw up gastric juices, which to me seems a lot worse. At my hospital, the rate of c-sections is 30%, the rate of general anesthesia is 5%, which means that absolute max, 1.5% of people are having GA with a c-section. And as the 30% rate includes planned c-sections as well, it's actually a lot less than that. AND, if someone's been in a car accident or the like, they almost certainly don't have an empty stomach. So I think that the prohibition on eating / drinking is bogus, and don't plan to follow it. (Which I will let them know if I do end up needing GA).

2. No IV fluids for hydration. The rate of IV's is quite astonishing - 94%! Are that many of us really dehydrated? When I was in for my contractions they stuck an IV in me 2/3 times - the first I managed to convince them that I really was not having the contractions because of dehydration (I had had over 100oz of fluid during the day). The second time they wanted to try it anyway, despite my saying the same thing. And it made no difference to the contractions whatsoever. And then the third was when I was having the magnesium, which needed to go in through an IV. But, our hormones are fairly delicately balanced, and getting more fluid than needed can screw with that balance. Perhaps leading to a slowdown in labor, so pitocin to help... blah blah blah. Slippery slope.

3. No induction. If Phred isn't ready to come out yet, I don't see any reason to force it. Plus, it seems like very few people who are induced end up with a normal, natural labor. I'd rather be pregnant for a few more days.

4. No breaking of waters to speed up labor. The amniotic sac can A) help with opennig the cervix more gently, B) cushion the baby's head, and C) equalize the pressure the baby feels with contractions - less fetal distress.

5. Minimal external fetal monitoring. The standard is to throw those suckers on you as soon as you arrive in the hospital, and keep them on the entire time. However, they definitely seem to lead to a higher c-section rate, because as soon as any kind of issue is seen, the doctors feel like they have to fix it right away. There has been a fair amount of research into this topic, and almost every article says that "intermittent auscultation" is just as effective at catching real problems as the continuous monitoring is, while lessening the c-section rate.

6. No time limits on labor (within reason). First, there seems to be a "you have to deliver within 24 hours of your water breaking" paradigm in place these days. Because of threat of infection. But studies have shown that there is no increased risk of infection just because of broken waters, especially if no internal exams are performed. So I'm thinking that if this happens and I don't start having contractions right away, I'm not even going to bother calling the hospital at that point. I also do not want a c-section just because I've been in phase 1 for X number of hours, or phase 2 for 2 hours. The time limits used seem to be actually quite fast, so I'm not going to let them pressure me into having a c-section just because of those.

7. No scheduled c-section, even if Phred does seem to want to stay breech. I figure the longer he/she is in there, the more chance there is of turning over, however remote it may be.

I think that about covers it!