Month: August 2014

To close out this blog, I want to share some first impressions of my experience as a mother.

The short answer is that I’m infatuated and tired.

Of course, I don’t have much experience yet — just over seven weeks — and my child isn’t that challenging yet, in the big scheme of things. She eats. She sleeps. She poops. But already, my life has changed to orient around her.

She’s the most wonderful little person in the world. Every movement and every sound is fascinating. Some of them are worrisome or annoying too, but still worthwhile. She’s growing and changing so quickly. She has slowed me down. I am paying attention to the tiniest things and living life on her schedule.

I have a much greater respect for other parents. I’ve always thought parents are doing wonderful work, but as everyone tells you, it’s not until you have a baby that you really know. I really appreciate the advice given and the advice not given by other parents I know. It’s been a whole new learning experience.

Of course, not everything is good. She can be fussy — everyone tells us that we’re currently at peak fussiness. Fortunately, bouncing and walking a baby is good exercise (and baby wearing is a life saver). We’re sleep deprived. Recently things have “improved” to where we often get a three hour chunk of sleep. Before that, the longest stretch was 1-1.5 hours.

But overall, our baby is healthy and generally pretty chill. I am excited about my new role as her caretaker, protector, teacher, safe harbor — in short, her mommy.

Here’s your unsurprising fact of the day: birth is a medical event.

It takes time for the body to heal. Recovery may range from an easy recovery for a birth without complications to a difficult recovery from a C-section (which is a major abdominal surgery). I can only speak to my own recovery which, fortunately, was on the easy end of the spectrum.

Oh, and be warned, while there’s nothing too graphic here, this is, in large part, a post about pain along and around the birth canal[1].

In the first couple days after birth, I was dealing with

• a leg I couldn’t stand on because I had strained it during birth
• copious amounts of blood — enough that I was soaking a super large thick pad every 4 – 6 hours
• slight soreness which made sitting and pooping uncomfortable
• pain when I urinated due to the stitches I had for a small tear in my perineum
• painful “massages” to help shrink my uterus

Over the next couple weeks, there was

• a continuation of general soreness
• more bleeding — quite heavy for about a week, period like for another couple weeks after that, and finally fading a way over another week. (In reality, the decrease wasn’t quite so linear.)
• a huge appetite (and I didn’t even have to spend a long time without food during labor). The second day we were home, we ordered in from Goldberg’s Deli, and I was still hungry after finishing a serving of french toast that has defeated some of my heartier friends. 
• low physical endurance. After a few weeks of not even counting, I struggled to get 15,000 steps in a week. I’m up to about 30,000 now, but I still need to rest frequently[2].

That’s just the physical side of recovery. Just as important is the emotional side. It’s normal for new mothers to have some amount of baby blues[3]. After birth, the hormonal makeup inside a woman’s body changes dramatically. The hormones from the placenta are gone, other hormones are kicking in for milk production and recovery, and the normal hormonal activity is just completely out of whack.

I experienced a fair amount of emotional variance after birth, some good and some bad. On the good side was the intense rush of love I felt for my baby whenever I held her (or saw her or heard her or thought about her). There was one moment where I was holding Sylvia and looking at her and it just struck me how precious that moment was and how it and many others like it would soon be gone and forgotten. I started to cry (and I tear up a bit just remembering it).

On the bad side, there were several times I cried in frustration because of some small difficulty taking care of Sylvia (and because of some large frustrations, but those seemed more reasonable). One day I stayed in bed all afternoon I felt like I was nothing more than a milk machine, and not a very good one at that. I think that Jeff was a large part of the reason my blues didn’t turn into depression. He was there to support me and to make sure that I asked for support when I needed it.

At this point, I still tear up fairly easily, especially for anything that has to do with having difficulties with babies (e.g., reading a friend’s birth story or talking to a coworker about breastfeeding difficulties). I also still get intense rushes of joy. But it’s moderating back toward my normal emotional keel. I still experience both the love and the frustration, but they aren’t overwhelming emotions.

I am so grateful for the support that I had during my recovery period. The nurses at Evergreen Health were kind and capable. Jeff has been wonderful. The family and friends who have visited have been a huge help. Without the help of my community, even my easy recovery would have been much more difficult.

[1] No, I’m not just trying to avoid using the word vagina—just after birth, my birth canal didn’t really resemble anything I’d recognize as my vagina.
[2]  My step goal until about 6 months into the pregnancy was 80,000 a week.
[3] It’s also fairly common for that to turn into full blown postpartum depression, a serious condition which needs to be treated.

This is a guest post from my wonderful husband, Jeff Scherpelz 

Sylvia was born, but I’m not quite done with this blog yet. This is the first of about four more posts I have planned—although this one was supposed to be posted before the birth.

Families have a lot of options for a birth setting and support team these days. Everything from a completely unmedicated home birth with a team that only supports home births to a planned cesarean section in a hospital. All of these birth choices are valid as long as the mother is educated about the choice she is making mother and her medical provider agree the setting and support matches the mother’s risk profile.

What went into my decision about birth setting and support team?

Interventions

I knew I wanted to try for an unmedicated birth. Part of this was pragmatic. The medical interventions associated with birth are not, despite the rhetoric on both sides, associated with significantly different birth outcomes for the mother or the baby for low risk pregnancies. However, they do tend to be chained to each other. Pitocin induced labor tends to cause more painful contractions which can lead to earlier epidurals which reduces the mother’s ability to move which can prolong labor (but remember these are tendencies, not absolutes). Given how I tend to cope with stress and discomfort, I knew that movement would be important to me during my labor. Thus, my desire to avoid medication. (I didn’t have time for any interventions anyway.)

I also wanted to try to go for an unmedicated birth just to see if I could. While I certainly am not an advocate of pain for its own sake, I also believe that pain is not necessarily bad. It’s part of the experience of an embodied being. The pain of birth has been part of the human experience since before we were human, and I wanted to be a part of that. Obviously, this is a very personal decision. We have the tools to make birth much less painful, and if pain turns to suffering, those tools can be wonderful.

All that said, I was not absolutely committed an unmedicated birth. If an intervention became medically necessary or if I just couldn’t handle the pain, I wanted those interventions to be available.

Support team


I wanted a support team that I felt would not only allow for my preferences but would also help make them a reality. Every provider has different preferences. The more that my preferences were aligned with those of the provider, the less I would need to worry about having to struggle to have things done to my preferences, whether before or during the birth.

I also knew that I wanted my support team to be small. Some people want their birth to be attended by family or friends. I didn’t want that. Birth, to me, is too intensely personal an experience for me to want to share it with anyone other than my husband.

The result


Given these preferences, I knew I wanted to give birth with a midwife. Midwives tend to be more aligned with my preference for minimal interventions. They also tend to be in the room for more of the birth process which was especially important if I wasn’t going to have other family or friends there for additional support.

I had a hard time deciding between a hospital or birth center birth. Some hospitals have default policies that would not align with my preferences (e.g., around insertion of IVs). The nurses may not be as supportive of forgoing interventions. Plus, a hospital has a certain atmosphere that is inherently medical.

On the other hand, birth centers support few to no interventions. If I was having a difficult birth or just wanted an epidural to cope with the pain, I would need to be transferred after I was already in labor. Plus, if I ended up having an unexpected complication, there was a slightly greater chance that the baby or I would end up harmed.

Ultimately, two factors made me decide on a hospital birth at Evergreen Health in Kirkland, WA. First, the birth centers I was considering only transferred to Evergreen for emergency transfers, even though they were right near the hospital. For non-emergency transfers, I would have had to be transported to a hospital in Seattle (and that was even more risky with the 520 bridge closed most weekends around Sylvia’s due date). One source I remember reading indicated that about a third of first time mothers giving birth at a birth center end up transferred at some point, so there was a reasonable risk of having to do an uncomfortable and stressful transfer while I was in labor.

Second, Evergreen is awesome. Evergreen Health Midwifery is a practice of midwives who work exclusively in the hospital and so know the hospital policies and are known by the hospital staff. The labor and delivery nurses are known for their high quality of care and their support for whatever birth preferences a woman may have. The labor nurses work with a single mother at a time, and so are there for support the whole time. Evergreen is also a certified Baby Friendly hospital—in fact, they were the first certified Baby Friendly hospital in the U.S. They are strong advocates of breast feeding and have good support both immediately after birth and after mom and baby go home.

To round out our support team, we decided to hire a doula. Sometimes people wonder if a doula is worth having if you’re working with a midwife. The one-on-one nursing support at Evergreen may make a doula seem even more redundant. But a doula provided us with a number of benefits.

A doula would support us before we went to the hospital, and staying home longer is associated with lower rates of interventions. Another benefit of a doula is they provide support for the partner (or can take on some of the support role of the partner for a woman giving birth without one). The midwife and the nurse would be there to support me. The doula would support Jeff by helping him remember coping and comfort techniques that he could use with me, by providing support to me when he needed a break, and by freeing him from small errands like getting bags from the car or finding snacks.

After looking at the profiles of local DONA certified doulas, we interviewed a couple and chose to work with Tiffany Guenther. We would have felt comfortable with either of the doulas we chose to interview, but we just clicked really well with Tiffany. Plus, in what ended up being a nice benefit given how quickly my birth went, she lives a lot closer to us than the other doula we were considering.

The judgment

So the upside of writing this post late is that I can tell you that I am quite happy with the decisions I made. Of course, I have to add the caveat that a lot of what went into my decision making process was not relevant. There was neither time nor need for interventions (there wasn’t even time to get all of my vital signs). We didn’t have much time with any of the support team. But knowing that I would give birth in a setting that supported my goals with people that supported my goals reduced the stress before hand, and they supported me just as well as I hoped during the birth.