Monday, December 17, 2007

Birth Story

Thursday the 13th we were scheduled for a routine 41w non-stress test. I had agreed to it reluctantly in order to hold off on induction pressure. However, it snowed and the city came to a standstill, so we rescheduled for Monday. A. and I stayed up until 3am Thursday night playing World of Warcraft together (his 70 druid ran my 50 priest through Sunken Temple).

7am Friday I woke up with contractions. They were regular and somewhat painful, but all less than a minute long (usually 30-45 secs) so I didn't time their spacing. I tried to go back to sleep but they hurt, so by 9am I was up and having breakfast. They hurt less when I was upright. I started timing them using Contraction Master and they were 5-7 minutes apart, but usually less than a minute long. I read a pile of blogs and the archives of xkcd. I got into the bath around 11 or so. It spaced out my contractions a little, but it didn't make them hurt any less, so I got out after a while.

Around noonish A. got up. I let him know I was having contractions and that I thought it might be the real thing. He went online for a little bit and did his regular slow getting-out-of-grumpy-morning-state thing. The contractions were getting harder and were starting to really hurt my back. Around 2pm I got back into the bath. A. went for a quick trip to the grocery store; he bought me strawberries, juice, and candy to help get me through labour. I got out of the bath again when he was gone; again, it was spacing out my contractions, but I needed to be upright to handle them better. A. came back and started really helping me through the contractions. He also started being a little vain: shaving, trimming his hair, etc. He also had a strange little cleaning jag. Around 3 we started timing the contractions using Contraction Master again. They were 2-3 minutes apart, but still usually less than a minute long. I was making a lot of noise during contractions and A. was coaching my breathing. We decided to call the midwife. A. talked to her for a minute, then she wanted to talk to me. She asked me how I was coping with the contractions and I remember saying "They hurt, but I'm handling them ok... and here's one now... uhhh, ummm... A.!" and A. came running to take the phone away. He actually put the phone down and coached me through the contraction. When it was over he talked to the midwife and she didn't really give a lot of guidance. She said it was probably still pretty early, it was my first baby, it was up to us whether we came in or not. I found this a little disconcerting because I didn't know what we were supposed to use to make that decision. She suggested we pack our bags.

A. started packing but I needed him for every contraction and they were very close. I was losing the pace of my breathing and having a really hard time staying relaxed through the pain. So he'd put one thing in the bag and then come running to slow dance with me and coach my breathing. I tried sitting, kneeling, hands and knees, but only standing and swaying while leaning on A. really worked for me. A. asked me a few questions about what to put in the bags and I snapped at him; I didn't want to make any decisions or have to think about anything but getting through the contractions. When he was done packing he decided we had to get to the hospital. He tried to dress me between contractions; it was really slow as I would only put on one item of clothing (and sometimes only halfway) per contraction. He called the midwife back and told her we were on our way in.

I went to the bathroom and A. started calling cabs. He called every cab company he could find listed. He was getting increasingly frustrated as none of them would come right away. Some of them didn't answer; some of them directed him to other, busy numbers; some of them told him they could get us a cab in two hours. I don't know if it was the snow, the fact it was Friday evening, or if taxi service to our town is really that bad (we usually take transit). I laboured alone on the toilet for probably half an hour while he made calls. We tried to contact a friend but she's out of town at a conference. Almost no one we know owns a car. Finally I got off the toilet, came to the phone, and called my postdoctoral advisor on her cellphone. I told her quickly we needed a ride then passed the phone off to A.. She called her husband then called us back and said she'd come pick us up. A. coached me through a few more contractions while he got us into our coats. My advisor got to our place and after I had a contraction in the doorway we got into the car. I was still making a lot of noise, even though I was a little self-conscious about my advisor being there. She was freaking out a little (had never seen a woman in labour before) and kept asking if we should pull over and call an ambulance instead. She and A. made small talk between contractions, and it annoyed me but I participated a little anyway. She said seeing me in pain was really cementing her decision not to have kids and her husband was going to be upset with us. She sped and yelled at other drivers.

We got to the hospital around 6:30. At first I said I didn't need a wheelchair but then relented and took one. They're really comfortable! We went to admitting. They suggested we go right up to L&D and then send A. back down to do the admitting but we didn't want to be separated. I stood up from the wheelchair while A. coached me through at least two contractions while we got admitted. I threw up on the floor and then in the garbage can they quickly gave us.

We took the the elevator to L&D and met our nurse. I immediately didn't like her very much. We went to a triage room and she put me on the monitor. She spent a lot of time explaining how important it was that we get a good tracing and how I'd have to stay still etc. She told me that I was taking the contractions too hard and that I should save my energy for when I really needed it in later labour. A. told her I threw up and maybe I was approaching transition and she said "oh, is that what you think." She asked how much water I had been drinking and A. said I had been drinking juice. She said that's why I had been throwing up and I needed to drink water. She put her hand on my belly, said she was feeling a lot of "uterine irritability" and that I needed to drink as much water as possible. I didn't really object to drinking, so I drank quite a bit between contractions. I was taking the contractions very hard lying on the exam table, and was still making a lot of noise and arching my back between contractions. The midwife wasn't there yet because it was 15 minutes before the midwife shift change. The nurse left us alone and we checked the monitor for reactivity ourselves between contractions and decided everything was fine.

The midwife got there shortly after 7. I had met her once before during the hospital tour and gotten a good first impression, and her husband had been a student in our department at the same time I was and worked with a friend of mine. We talked about having a cervical check and decided to have one. She checked me and I was 5cm and fully effaced, baby at -2 station. She also noticed that I was very wet and confirmed that my water was leaking but I still had an intact forebag and they wanted to leave that to help cushion contractions. She got me off my back and onto my side. The nurse wanted one more contraction on the monitor so we waited for that. Then we were taken to a labour room.

The nurse had filled the jacuzzi tub for me so A. helped me get undressed and I got straight in. The midwife told me to keep drinking water and left us alone. It was really nice to have a tub deep enough that it covered my whole belly, but like the previous baths, it gave me some space between contractions to breathe but didn't help with the actual contractions. A. told me I was handling contractions standing up much better than in any other position so he got me out of the tub. I got onto the toilet and started shaking like crazy. It was really bizarre. I told A. I was cold and he dried me off, brought me a gown and a blanket, and I was suddenly not at all cold.

I was being extremely loud through contractions and sometimes swearing at the top of my lungs. I'm sure everyone heard me all through L&D and postpartum. Every contraction I swayed with A. and yelled to him how much it hurt. One contraction I felt the tiniest bit pushy, did a little poop-push, and my water broke all over the floor. Then I threw up about four times, all the water that the nurse had pressured me to drink (about a litre or so). There was water all over the floor, either amniotic fluid or vomit everywhere. I thought I needed to pee so I went to the toilet. A. was cleaning up some of the mess and I snapped at him to leave it but he wanted there to be a path for us to walk through from the bathroom. We just kept dancing through the contractions and I just kept yelling.

The midwife came back into the room and checked the baby's heartrate. She could only find it in one spot down low on my left side. Not long after that, I was really feeling like I needed to poop at the peak of my contractions. She noticed this and I asked if I was feeling pushy. We decided to do a cervical check. It took a few contractions just to get me over to the bed so she could check me. She said I was about 9.5 centimetres, or fully dilated except for a tiny rim on either side. I asked about the baby's station and she estimated +2 station. She told me to grunt and breathe down my baby during the pushy parts instead of pushing. I tried that for a few contractions but it was hard not to push instead. I was labouring standing up with one leg on the bed, leaning on A.. The midwife said I was probably complete and wanted to check me again. When she went to do it I started having another contraction and started screaming. She thought she had hurt me. After the contraction she checked me and said I was complete.

I found the pushing stage very challenging. I had heard that most people find it a relief, but I didn't. The pushing contractions hurt. Pushing felt awful, though I also absolutely had to push. The contractions were very close together, and I was screaming through all of them. I started pushing standing up next to the bed. The nurse was checking baby's heartrate during and between contractions. At one point she found a heartrate in the 80s and completely freaked out. She told me I had to get into the bed on my right side and have oxygen. Then she told the midwife she wanted a fetal scalp electrode. The midwife said it was probably just an artifact, but wasn't really standing up to the nurse. A. then had a little freak out of his own. He objected both to the oxygen mask and to the proposed internal monitor. I told him I didn't mind the oxygen, but I did not want an internal monitor. So he dropped the oxygen objection and flat out informed the nurse we did not need internal monitoring and would not have it. She got really huffy and told him he was endangering our baby and said something about how she was going to have to call a doctor in. He stood his ground and we did not get an internal monitor. I was kind of out of it and I'm not sure how it happened that the nurse wasn't in the room anymore but the midwife still was. Anyway, he told the midwife that the relationship with the nurse was not working and we would be needing a new nurse. The midwife quietly said she would see what she could do. She left the room for a bit, we got a new nurse, and we never saw the first nurse again. That was awesome and I'm really proud of A. for recognizing what we needed and firing our nurse.

I pushed for a little less than an hour, I think. It felt so weird. At first it was just like a really big, really painful, horrible poop, but then it just felt strange. The contractions were right on top of each other sometimes, and I screamed during some of them. The midwife held hot compresses to my perineum. At some point I made small talk with her about her husband between contractions; I'm not really sure why I felt the need to do that. I kept telling everyone how much it hurt, that I didn't want to push, and that I did not want a baby at all. But at least I kept pushing. I reached down and felt my baby's head at one point and it was much squishier than I thought it would be. The ring of fire was absolutely horrible and I screamed really loudly. The midwife gave me some sort of topical anesthetic. When her head was out I figured I was pretty much done, but I apparently still had to push out the shoulders. Then I thought I was definitely done, but it took another push to get out the body. She came out crying and cried for the first few hours of her life. They put her right on my belly and I held her for a while. I put her to the breast but she wasn't really interested. When I got a little grunty again the midwife had A. cut the cord. She said she wanted to give me Pitocin to help with bleeding but I declined, saying I'd only take it if I needed it. A while later she said she thought I was really bleeding heavily and she'd like me to take the Pitocin so I did. The nurse kept telling me that the placenta had no bones, which I think is an odd thing to say. A. told the midwife I would not be wanting to see the placenta at all.

I had two tears, one just a little superficial thing in the skin, one more serious but still first degree. The midwife gave me a local and sewed them up very slowly. At some point during that, A. took the baby to be weighed. After about 45 minutes the midwife showed me how to get her latched on. We refused bathing, vitamin K, and the hepatitis B vaccine, so all she has had is the PKU and the hearing test. We got released the next afternoon, after less than a day in the hospital.

The first day home was a lot of crying, but my milk is coming in and baby is much happier and sleepier now. I have her sleeping in her Maya Wrap right now, so I can type with both hands.

Friday, October 12, 2007

The "ick" factor

Last night, our Bradley instructor showed us a video of several births, some of which included episiotomies. A. had to turn away, while I could mostly watch it. I found that interesting, since I am extremely sensitive to gore and therefore refuse to watch many movies that A. would like to see. Afterwards he said he distinguishes clearly in his mind between real and fictional gore, and is only sensitive to the real. I guess I didn't learn that skill.

Thinking about it, I've decided that the Bradley instructor showing us a graphic episiotomy, blood and all, is not qualitatively different from the forced-birthers waving their bloody fetus pictures. Surgery is gross. I wouldn't want to watch an appendectomy, but that doesn't mean I would decline one if it were indicated.

I will still be doing what I can to avoid an episiotomy. On the basis of its merits, not its ick factor.

Thursday, October 11, 2007

Fetuses as victims of violence

I didn't used to think much of Antonia Zerbisias. She started out as the Toronto Star's television reviewer. I'm not usually a television fan, so much of her work was uninteresting to me. And frankly, I thought of her as a bit of a lightweight. Then she started writing about weight loss, and women's relationships with their bodies. She was still relegated to what might be considered "fluffy" topics, but her analysis was good and often insightful. Now she's doing some serious opinion writing: Killings reopen debate on rights of fetuses. It's still, for some odd reason, in the Living section (if it were Rosie DiManno it would be in Opinion). The Star has been missing a strong feminist voice since the departure of Michele Landsberg (a product of her era, that is, great on everything except transgender issues). I hope they continue to give Zerbisias more weighty assignments.

Yesterday's topic was proposed legislation in Canada to make the killing of a fetus during a violent attack on a woman a separate crime. Zerbisias gets it right:
To me it's clear: When a pregnant woman is killed by her partner, that's murder. Isn't that enough to lock up a killer for life? No separate charges should be laid. Our uteruses are not public property.
As someone who is currently 7 months pregnant, the same gestation as Aysun Sesen, the woman whose murder triggered this debate, you might expect my feelings about this issue to be more complex. They're not. If I were to be violently attacked and my fetus killed, that would be assault. On me. If I were to be killed, along with my fetus, that would be murder. One murder, of me. This creature may be keeping me up at night by increasing my appetite, it may be kicking me hard and hiccuping at all hours, but neither on an emotional nor a rational level do I consider my seventh-month-gestation fetus a separate person. It feels like a part of me, though a rather strange and uncontrollable part.

Another argument for providing a separate penalty for the "murder" of a fetus is that pregnant women are exceptionally vulnerable. While it's true that domestic violence tends to be initiated or increased during a woman's pregnancy, and that homicide is the number one killer of pregnant women, I'm not sure what the effect of extra criminal penalties are. That is, a woman is valuable, and doesn't deserve to be battered, whether she is pregnant or not. I don't deserve to be hit, now, at seven months pregnant, but I don't see how it's any worse than if I were hit a year ago, or a few months from now. Much more effective would be the consistent enforcement of existing domestic violence laws, more resources to help victims of domestic violence, etc.

Creating a special class of pregnant victims won't help anybody. Madonna=protected, whore=deserves to be beaten? And it comes from the same place that led my labmate to tell me today that I can't move furniture into my new office (with windows!). I'm in a "delicate condition." So delicate, I'm worth more than other women?

Tuesday, September 25, 2007

Viable

I'm at 29 weeks, five days. This is exactly the gestational age at which Charlie, of a Little Pregnant fame, was born. This comforts me. The data I've read say that 30-weekers have about a 95% chance of survival, with about a 2% chance of major disability. Statistics are helpful (especially to a math geek and research-addict like me) but knowing of an adorable little boy who loves Friendly's milkshakes, silver dollar pancakes, and imitating the cat, is reassuring. Even if I only know him through the computer.

Being beyond the "limit of viability" range relieves me beyond measure. Premature birth freaks the hell out of me. After reading The Preemie Experiment, other blogs, and tons of medical literature, A. and I had a long talk about our wishes if we were to have a "micro-preemie." We decided that at less than 25 weeks, we would want to the medical team to provide comfort care only. Between 25 and 26 weeks, we would look at the individual situation, talk with a neonatologist, and make a decision based on individual factors and the neo's expert opinion. Past 26 weeks, we would "allow" aggressive resuscitation measures. But then I found out that it's not that simple; it's apparently not really up to us. The Baby Doe Law and the Born-Alive Infants Protection Act tie the hands of parents and healthcare providers, and require them to give care, even if it is painful, near futile, and likely to result in a severely degraded quality of life. The former law is designed to protect the rights of the disabled, and the latter is an anti-choice stunt law that has ramifications beyond the reproductive fascism envisioned by its writers.

But now that we're getting to 30 weeks, there's really no question about the provision of medical care. Nobody will ask my opinion, and everyone will agree on the right course of treatment.

The next big milestone is 34 weeks, after which a birth would result in a "near-term infant." Not a big change, just terminology, but I think it corresponds to needing the NICU significantly less, or maybe not at all.

I'm finally starting to show. The Dunkin' Donuts guy let us in 15 minutes after the store closed, and gave us four doughnuts (we asked for 2) for the price of 1. I think it might have been because he noticed my belly.

And since I'm not allowed to announce it to anyone who actually knows him, I will say it here. My beloved A. has been a non-smoker for two and a half weeks now, after a 20-year habit. I'm very proud of him. And he's barely been an asshole at all during that time. (Thank you Zyban!)

Sunday, August 19, 2007

Call for help from the blogosphere: Help a 17-year-old girl in Kansas City get medical care

UPDATE

She's acquired transportation on her own, it seems. All it took was a few hours of A. on the phone brainstorming her options with her, as well as stressing the importance of getting medical care. She's perfectly internet savvy, but he needed to get her step-by-step directions from her school to the closest Planned Parenthood, for instance. She needed to get her priorities straight. It also seems that he's convinced her she should be on contraception longer-term, which while I know doesn't solve all problems (e.g. STDs) but should help prevent future scares to some degree.

=====================================
This request is urgent as time is of the essence.

My husband, A., is an avid player of MMPORGs. He is also an excellent listener, and people, especially teenagers, seem to really open up to him. He has become good friends with one particular 17-year-old girl who lives in Kansas City, Missouri.

She had unprotected sex last night. A. has spent some time talking to her over the last few hours. He's managed to get the conversation moving from self-slut-shaming to the need to do something.

She needs to get appropriate medical care. But she needs non-judgemental support and a ride to the clinic.
The only time she can make it is tomorrow (Monday) after school. Her school ends at 3pm. It's about a 20-minute drive from her school to the local Planned Parenthood clinic.

Also helpful would be someone willing to buy Plan B and drop it off at her house tonight.

Anyone who can help us with this situation would be greatly appreciated. You can leave a comment here or email me: doctorconfused@gmail.com

Friday, July 27, 2007

"Lesion" update

I had a midwife's appointment yesterday so I asked her to look at my cervix. Yes, I specifically said "please take a look at my cervix." She waaay over-apologized and over-warned as she greased up her speculum and inserted it, leading A. to believe that pelvic exams are painful (which, for me at least, they are not). And she saw... nothing. Nada. Zip. No "lesions." Well, she did see a Nabothian cyst, which she described as like a whitehead on my cervix.

She rolled her eyes at the emergency doctors, their diagnosis of lesions, and their insistence on me making sure I got follow-up care. I don't know; I really liked the doctors, though since they have to be such generalists I don't expect them to be particular experts on cervical changes in pregnancy. So it turns out all my extensive googling into possible causes of cervical lesions, and endometriosis, was for nought. At least if I had had endo, I would have been in good company.

We did some quick follow-up on my quad screen (screen negative for everything), and my ultrasound. The only thing she noted about the ultrasound was that it shows I have an anterior placenta. An anterior placenta is totally normal, though it can make fetal movement a little less noticeable, and there is a very small amount of evidence indicating that an anterior placenta may be associated with a posterior presentation. I guess I'll have to be pretty vigilant about following the posture recommendations at Spinning Babies.

I asked her if the ultrasound said anything about dates. She told me, but didn't seem happy about telling me. I found that slightly annoying. It turns out the ultrasound would recommend a due date six days before the one I have according to LMP. So, of course, I (and she) are choosing to ignore this. However, if it had recommended a later date, even by a few days, I would have asked the official EDD to be changed. It annoyed me that she seemed to think I didn't have the knowledge to interpret this data, and so didn't want to tell me at all.

She also recommended that we try to make appointments with other midwives in the practice. I thought I was seeing the same person (for every appointment but my first) on purpose. Apparently not. I'm glad she made that recommendation since I'm beginning to get frustrated with her. If there is anything I hate, it is being condescended to. Not that she's so bad I wouldn't trust her to help me birth a baby; she seems very hands off and relaxed, which I like.

Monday, July 23, 2007

Not as upbeat as it should be

Friday was 20 weeks. I had a post planned; it was going to marvel at how normally everything has been going this pregnancy. It was going to go into some detail on the screening ultrasound: the two kidneys, the heart with four chambers, A. getting teary, etc. It was going to discuss how in my opinion 20 weeks is not halfway through the pregnancy, since 1. Most first-time mothers go well after their "due dates" and 2. The pregnancy didn't really start at the beginning of my last menstrual period.

Instead of posting, I spent five hours in an emergency room on the other side of the country.

I was on a two-week long trip visiting a distant university. I helped run a workshop in my field for a few days and then was working with some colleagues on the project that's funding my postdoc position.

Two days before I was to fly home, I had a lovely dinner out at an Indian restaurant with my ex-boyfriend and his newly pregnant wife. I adore Indian food, but it makes me gassy. While waking the next morning, I had a ginormous fart. Really, an excellent fart. But during the fart, I also felt some liquid moving through my vagina. I'm not sure if my readers are familiar with this phenomenon; I certainly am. Whenever I get my period my farts do a lot of the work of getting the blood moving downwards.

Anyway, I figured it was just that extra cervical fluid so helpfully provided by pregnancy. But I'm your standard paranoid pregnant person, so without opening my eyes, I slipped a finger inside my vagina to gather some liquid and wiped it off on the white motel sheet next to me (oh yes, housekeeping loves me). I half-lifted my sleep mask and opened one eye.

Brown. What? Mask comes off, other eye opens, and I stare at the sheet. There's a clear brown fingerprint. I'm immediately up and into the bathroom, wiping myself vigorously and checking the colour and origin. There is no doubt that my vagina is leaking dark brown liquid.

I called my midwife's office back home and the nurse told me to go to the E.R.

They saw me very quickly, but then they wanted to monitor me for my initially high blood pressure (See the previous post, re white-coat hypertension) and then the OB/GYN department took 3 hours responding to a request for a consult.

Also there was a bit of confusion over my dates. I told them I was exactly twenty weeks. Twenty weeks is the borderline for whether they'll see you in the E.R. or send you to L & D for continuous fetal monitoring. Then the nurse brought out one of those wheels and told me I was nineteen weeks. I told her I was pretty sure I was twenty, but I wasn't going to argue with her when she decided she knew better. I spent the time waiting for the doctor double-checking my math (March 2+140 days=March 142=April 111=May 81=June 50=July 20. See? 20 weeks). Then the doctor came and did it on his PDA, and got the same answer I had. But they decided to see me in the E.R. anyway since I was there and right on the border.

They did an ultrasound and everything was fine, which I already mostly knew because I can feel fetal movement pretty frequently. Then they did a pelvic exam. The doctor saw two lesions on my cervix. To me, lesion is a somewhat frightening word. I associate it with bad things, like AIDS and cancer. However, it appears that it's medical speak for "damage" or "something looks a little funny." He asked about a pap smear: I had one in February and it was normal. He also asked about STDs; I was checked for all the common ones at the beginning of the pregnancy and they were all negative.

When the OB/GYN consult came back, it was suggested I might have endometriosis on my cervix. I have no idea how they came up with that; my googling indicates that cervical endometriosis is relatively uncommon. I haven't really had any symptoms of endo, although in retrospect I do have somewhat painful periods.

I didn't get a definitive diagnosis; they told me to follow up with my own care providers. I called my midwife's office today and lengthened my appointment; they gave me the last appointment of the day this Thursday. I'm worried that I should have instead gotten an appointment with the OB, since I'm not sure if midwives are trained to look at abnormal cervices.

The worst part was sitting there for 5 hours without food. I left as soon as I got up; I didn't have breakfast. I was smart enough to grab an apple on the way out and ate that in the waiting room. They asked me early on if I was lightheaded; good thing they didn't ask later. You don't leave pregnant women for 5 hours without food! The other bad part was poor A. back home. I sent him a quick e-mail (followed by a brief msn conversation) telling him I was going to the E.R. for vaginal bleeding; he didn't hear from me until almost 6 hours later.

Sunday, July 1, 2007

Pregnancy update

  • I'm still pregnant. 17 weeks now. I had a midwife appointment the other day, and there is still a heartbeat present. I used to scoff at people who bought home doppler ultrasounds. I know the American Institute of Ultrasound in Medicine is not a big fan of ultrasounds for other than indicated medical reasons, and I thought that people who disregarded such advice for their own reassurance were foolhardy at worst, merely silly at best. I'm not running out to buy a Doppler, but I now have much more sympathy for the people who do. Four weeks is a long time to wait between live-fetus checks. Especially when one is a big research-slut, aware of many of the things that can go wrong in a pregnancy at any point. But next week is the screening ultrasound, and fairly soon I expect to start feeling fetal movement on a regular basis. So this four weeks might just be the longest period I've had to go not being quite sure if there's a real live fetus in there.
  • I'm not showing. I bought my first baby item last week: a Maya Wrap sling. I found it on craigslist. Plain black, my size (but not A.'s), with instructional DVD, and within short biking distance. Perfect. The couple I bought it from have a six-week old daughter who hates the sling. The father said to me "I hope... whoever you're buying this for... enjoys it!" So I guess, even when my behaviour indicates I could be pregnant, I don't look it. The midwife also mentioned me not showing. I told her A. can tell, when I'm naked. Apparently having one's husband think one looks pregnant while naked does not officially count as "showing."
  • I have a definite case of white coat syndrome. Except that it's not doctors (or midwives) who necessarily freak me out. It's receptionists and nurses. I've always had a pretty significant social anxiety disorder (yes, professionally diagnosed), and it tends to be worse with "counter people" (retail workers, receptionists) and low-level authorities like nurses. I breathe deeply in the elevator while A. pats my arm, check in with the receptionists (whom I hate, for a combination of rational and irrational reasons), fiddle clumsily with the label for the urine sample I brought along, try to calm myself while flipping through a magazine in the waiting room, quickly get called by a nurse (since my midwife seems to do her appointments on time, and I refuse to show up any time either than exactly 5 minutes before my appointment), follow the (feared, but not hated) nurse into the exam room, and immediately get my blood pressure taken. High, of course. This time I got the midwife to take it at the end of the exam as well, at which point it was comfortably in the normal range. I'm worried that they'll want to induce me later for PIH, which will really just be social anxiety. Maybe I can convince them to let me take my own readings over 24 hours before they make any decisions.
  • I'm gaining weight like crazy. It worries me. If I continue gaining at this rate, I will gain 50 lbs over the course of the pregnancy.
  • We asked the midwife if she knew any Bradley instructors. She mentioned a couple of names, that A. had already found in his research. She also said that she liked them because they didn't make their clients "hostile." She described the "hostility" as "vestigial." A. was impressed with her choice of vocabulary. I was slightly disturbed by her dismissal of the consumer-education portion of the classes. It seems she measures an instructor by their tendency to have complacent students. I guess I shouldn't expect any differently, since she would be on the receiving end of the "hostility." I think she thinks it's no longer needed since she and her colleagues no longer routinely shave their patients, give enemas, separate the parents, etc. But I'm still worried about other decisions: to not have an IV, to eat and drink, to delay cord cutting, and to have the baby never ever leave the room.
  • A. finds me extra-sexy when I'm pregnant. He told me he's even finding himself attracted to other pregnant women, which hasn't been a factor for him before. I'm enjoying the attention, since I have the typical worries about how pregnancy is changing my body.
  • I still haven't told my boss I'm pregnant, and only one labmate knows. I figure the boss should be first. She's been out of town for a few weeks. I may have to tell her at a workshop we have out-of-town in about a week. I'm nervous. She does not like children. She's always felt, I think, that I've been one of the few people she can confide in about her dislike of children, and her annoyance when events she has to attend turn out to be child-centred. On the other hand, I know she strongly identifies as a feminist, and I don't think she's going to try to make my life hell for choosing motherhood. She knows that it's much easier for men to choose fatherhood at this stage (or any) in their careers, and I know that her sense of fairness will win out in the end.

Monday, June 18, 2007

Why I chose marriage, and am glad I did

Jill Filipovic is not getting married. Neither is Amanda Marcotte. I admire and respect these two women. I think their reasons are sound. I made a different choice.

For a very long time, I thought I would never get married. I just didn't picture myself in that role of "wife." Some of Jill's commenters talk about that: about how the social expectations, especially those based on gender, change when moving from girlfriend to wife. Anyone who knows me knows I could never fit neatly into any such category. And my dreams as a child were always about what I would do with my life and my career: fly airplanes, write books, travel the world. I don't remember ever dressing up in a white pillowcase and pretending to be a bride. My parents emphasized my education over all else. My father, in fact, specifically advised me against marriage. He sees it as career suicide for a woman. It probably doesn't help that his own marriage failed spectacularly.

When A. and I stumbled into each other's lives (or, more accurately, beds) we were both in open relationships, mine of 4.5 years. And then we fell hard in ways that would be saccharin if I tried to explain them here. After only 2 months, A. proposed. And I reacted with panic. I didn't want to be married, didn't feel ready to make a big commitment, was too familiar with divorce statistics and the consequences of divorce, felt that if I announced an engagement people around me would ridicule me. We put off announcing it for six months, during which A. worked hard to assuage my various fears. Our relationship calmed down over that period, as we worked on our conflict resolution skills and learned to be less sensitive to one another's tendencies to wild emotion. Then we announced the engagement and spent the next year working even harder on our relationship and planning a wedding.

After reading Jill's piece, I asked A. if he had wanted to get married before meeting me. He said yes; he had pictured himself, eventually, as a husband and father. I suppose that makes the narrative clear: man with marital ambitions meets woman without, they fall in love, he convinces her to marry. While there may be some of that; I think that's missing a crucial element. I wasn't just convinced, I was converted. I was enthused and committed. He didn't have my grudging consent, I was an enthusiastic participant.

Over at Feministe, commenter Nita writes:
And finally, it has always seemed weird to me to talk of wanting to get married or not wanting to get married as a theoretical construct separate from the “getting married TO X”–the desire to get married seems so contingent on the person or people you have relationships with, that it just doesn’t even make sense to talk of my general desire for (or lack of desire for) marriage. I may want to get married if I find a particular person who is so amazingly awesom that I simply can’t imagine NOT being with them for the rest of my life, but may emphatically NOT want to get married if I had to choose between George Bush, Rick Santorum, and James Dobson.
I agree strongly with this sentiment. Marriage was not something I wanted to do until I met A., and to talk about "marriage" without talking about "marriage to X" seems very odd to me. Nonetheless, I know people do that, such as the women who did the pillowcase thing as girls, and, it turns out, A. Problematically, the point of Nita's statement is often used as a means of dismissing those who state their choice not to be married. I hope you understand that when I'm saying "I didn't want to marry until I met A., and then I changed my mind" I'm not saying "oh dearie, you're saying that now, but you'll change your tune when you meet the right man!" I'm not so self-centred or condescending as to believe that my narrative is universal. Jill may get married one day and may not. Her choices and her relationships are legitimate either way. While my narrative is not uncommon, and I don't think hypocritical, there are also many people with committed, long-term unmarried relationships, people who are happily in serial relationships (monogamous or not), and people who are happily unpartnered.

And since getting married? I have to say, I love it. It's far better than I thought it would be. We get all the social benefits of marriage, with very little of the social expectations. Only my mother-in-law is under the impression that marriage should have changed us to fit neatly into our gender roles. Everyone else knows us too well, expects strangeness of us, and leaves us alone. I have serious social anxiety issues around, for example, medical personnel. Doctors used to look at me strangely when I asked to bring my boyfriend into the exam room, and a nurse even tried to kick him out once. But no one bats an eye when I bring my husband in, although the gynecologist did say "you know, most men don't stay for this part" as she performed the Pap smear. The legal benefits are wonderful as well. I just added A. to my health insurance. I think it would have been possible if we were just living together, but it would have been a hell of a lot more paperwork. I am very comforted by the idea that if I couldn't make my own medical decisions, the first person they'd turn to is A., someone who knows me well and shares my values, instead of my parents, who don't.

The legal benefits for A. are even more important. He doesn't get paid directly for any work he does; not the housework, not the sortof-secretarial work he does for me, not the academic job-seeking, not the hand-holding through the hard parts of my job. When this kid comes out, he'll be doing childcare without payment, while I benefit, earning experience, credentials, and pay. If, FSM-forbid, the marriage were to end, he deserves every legal right he has to our assets and my future earnings. And I benefit from this security. If he couldn't count on my perpetual financial support, he would most likely be much less willing to follow me from city to city, doing my laundry.

This last part may be part of the reason women have often been more eager for marriage than men. A. is playing the stereotypically female role in our division of labour. The unpaid, not-publicly-acknowledged role. Marriage provides important legal protection to the person playing that role. In relationships without children, in which both partners work and make near-equivalent contributions to the running of the household, marriage is not as important. I imagine Jill and Amanda picture themselves in those kinds of relationships. (I know Amanda is sure she doesn't want kids, I don't remember if Jill's ever said anything either way). But I'm an academic, and I plan on being peripatetic, and A. and I have decided my career always comes first. It only makes sense for A. to protect himself legally and financially.

All this, and I've said very little about the emotional benefits of marriage. Those are much harder to enumerate or quantify. Most of these benefits are benefits of any relationship. Would A. be any worse at holding me and reassuring me when the world is a scary place, if we didn't have a legal contract? Probably not. But marriage has an important symbolic value, at least to us. I know he's committed to me, and vice versa. We were able to live in different cities for three years while still being sure of our commitment. I see our marriage as permanent, and I'm willing to work hard to make it fulfilling for both of us. In previous relationships, and even earlier in this one, I was timid, and didn't always make my needs clear. But now, I know that I can't live my whole life with these needs unmet, and so I'm more willing to speak up. I'm willing to invest time and effort into my marriage, because I know it will pay off over the long run. I'm less scared of an argument, because I know it will always end, and that neither of us is going to walk away.

I imagine there are many people who have this sense of permanence in non-married relationships. But for me and for A., the marriage is a good way of cementing it, reminding us of the commitments we've made.

So yes, for me, and I'm sure for many others, marriage is the right choice. It hurts me that this institution, which has done so much for us, isn't available to everyone. While I will note that I married in a jurisdiction that allows same-sex-marriage, and live in another, I still know that my marriage benefits from extreme heterosexual privilege. My marriage is valid no matter where I live and under all legal definitions; Pam (of Pam's house blend) and Kate's is not recognized in their own state. The unvailability of SSM is one of the best arguments I've heard against marriage; it's unfair to take advantage of a system that is inherently unequal. To this I can only say, yes, and I'm sorry. I will work hard for my gay and lesbian friends to be able to have all the advantages I have. But I don't think giving up my own legal, social, and emotional benefits will be of any help to them.

Sunday, June 3, 2007

Obligatory heartbeat post

I recently had an appointment with the midwife. I was a little worried that she would be flaky. Her bio states that she used to run a health-food store and is an "unlimited body practitioner." Um, what? Google led me to this page, which is absolutely full of pseudoscience.
They are advised beginning in the First Healing Gift - the Safe Touch - "that the less you do, the more you get done." This paradox causes more than a little mental gymnastics for students. It challenges truths' that they have accepted without question for their entire lives. The Safe Touch is a hands-on technique that consists of allowing the tissue to move as it wants, which leads to trust. This in turn leads to surrender and natural healing.
Right... whatever that means. Anthropomorphized tissue, which needs to trust before it heals. So yeah, I expected some flakiness. Maybe an attempt to lay on hands. Maybe some crystals, or some herb recommendations.

What I got was a rather sweet, matter-of-fact older woman. She gelled me up, used the doppler to check the heartbeat, and estimated it to be in the 130s. She gave me a couple interesting pieces of information, such as how high the top of my uterus should be by the next appointment, and that I might get some round ligament pain. She told me that if I need a break from the nausea (which I still have, past 13 weeks now) I should take Benadryl. She urged me to get the AFP test and scheduled that and the routine screening/dating ultrasound.

No crystals, no weirdness. Then again, it was a very short appointment.

Some people get very verklempt about the first time they hear the heartbeat. Apparently there's a sudden realization that the fetus in there is going to develop into a real, honest-to-goodness person, or something. Didn't do much for me. Yep, it's a heartbeat.

On the way home I started telling my husband, A, what we learned from the existence of the heartbeat. It rules out a complete molar pregnancy, but not a partial molar pregnancy. It rules out a fetus that has already died, and since I'm past the 12 week mark significantly reduces the chances of a miscarriage. It doesn't rule out many of the other problems that can occur, like anencephaly (warning, scary pictures) and other problems incompatible with life.

A interrupted me. "Yes," he said, "I get it. Heartbeat good!"

Yes, I suppose. Heartbeat good.

Wednesday, May 30, 2007

Pressured to consider female candidates

I applied for a tenure-track academic job at the university where I got my bachelor's and master's degrees. The current department head there knows me fairly well. He taught me both undergraduate and graduate classes, in which I did very well. He also supervised my undergraduate thesis, and gave me an excellent grade. When the faculty position opened up, he wrote me personally and asked me to apply.

All this to say, I thought I might have a reasonable shot at this job.

My PhD co-advisor (the one who didn't really do the major advising work) just came in to talk to me. He had gotten a request for a letter of recommendation, and had called this department head to ask for details about what he should put in the letter, and what exactly they were looking for in a candidate. What he learned from the conversation does not look good for me.

I'm not being seriously considered for the job. Apparently the department head felt "pressured to consider female candidates." This is somewhat understandable. The department has never had a female faculty member. Seriously. Did you even know there are departments in the world that don't have even one woman? They have once made an offer to a woman; she chose to work at another university, which also had a faculty opening for her husband.

While I understand to some degree the politics that force search committees to put a token woman on their shortlist, it also pisses me off. They're wasting my time and the time of my recommenders, and they have no intentions whatsoever of actually hiring me. And now that I've been fit into this token-woman spot, I doubt I'll be able to get out of it. Even stunning recommendations are unlikely to change the minds of the search committee, now that they've been biased against me.

The truth is, I know I'm not that great a candidate. I have a single publication in review right now, and this is a Research I school. Yeah, I need to publish more. I also need to learn to write grant proposals. Other than that I'm pretty good (growing subfield, good school, teaching experience with positive evaluations, can make an excellent presentation) but not quite good enough, yet. So if my publication record wasn't good enough, they should have just not considered me. Also, there's a relatively young faculty member there whose research overlaps significantly with my own, so I can see them thinking they don't need to expand that subfield.

I'm disappointed. I had problems with this school anyway: the unsupportive administrative staff; the long public-transit commute to anywhere I'd want to live; and I didn't actually want to take on all the burdens of being the first woman professor. But as I started to think I had a shot, I was coming up with positives: the friends I have in the city; the excellent quality of the students; the opportunity to be a sorely-needed female role model for the women students.

There's no reason for them to mess with me like this, and to waste their time and mine.

Sunday, May 27, 2007

Marital fraud

"Most women I know commit fraud on their wedding days--they weigh-in for the walk down the aisle with no expectation of maintaining that weight year after year," said anti-obesity advocate, MeMe Roth.

-- from Roth's blog, Wedding Gown Challenge, in which she liberally quotes herself.
I found MeMe Roth's blog through the comments to zuzu's post about Roth's insulting, misogynist, body-dysmorphic (is the woman blind!?) rant on Fox news about Jordin Sparks, an American Idol contestant. The above quote is a lot more mainstream than Roth's bizarre attacks on Girl Scouts and reading programs, and her vandalism of a YMCA sundae stand. And that's what makes it scary, and worthy of attention.

A woman whose weight varies from her weight at her wedding is committing fraud. Other similar sentiments have used the term false advertising. I'm not a lawyer, but I know that the basic concept behind fraud and false advertising are the same: gaining something, usually financial, through deceptive means.

What are these "deceptive" women gaining, in addition to weight? Maybe Ms. Roth and others mean that women are falsely getting the emotional benefits of marriage, like love and support. I doubt it though. I think they mean the most direct definitions of fraud and false advertising: financial gain.

And now the argument starts to make sense. It fits nicely in a worldview that sees marriage as a straightforward, gender-based financial contract. A man gives his money; in return, a woman gives her body.
What would be the equivalent "false advertising" on the part of a man? Roth's site doesn't mention a "wedding tux" challenge for men. They're allowed to change their bodies. No, I think the equivalent situation is a groom in medical school at the time of his wedding, who later chooses to drop out of residency and become an artist. He wouldn't be holding up the financial side of the bargain; the male side.

None of this is new; marriage has been seen as the sale of a woman's body to a man for centuries. But silly, optimistic me. I thought things were changing. I thought marriage was transforming, becoming more egalitatrian. What frightens me the most is that people are still saying these things, now, in 2007. And both Ms. Roth and MorphingIntoMama are young.

I'd better ask my husband if he's getting his money's worth.

Is this your first pregnancy?

A few days after I peed on a stick and got that second line (known in baby dust circles as a BFP) I called my school's medical centre to get a prenatal appointment. They made me one for a few weeks later. In a few days, I was woken up by a phone call (people! mornings are not for the use of the telephone!) from a nurse.

She wanted to confirm my address so she could mail me some forms and information, see if I needed a prescription for prenatal vitamins, and ask a small number of questions. Fine. And then she asked, "is this your first pregnancy?"

I paused. For a long time, as conversational pauses go. Maybe a second or two. Then I answered "no."

I expected the next question to be "and how many children do you have?" but the question never came, so I didn't get a chance to explain my answer. Apparently she interpreted the pause as full of meaning. Maybe tragedy. Really, it could have been anything: an ectopic, a miscarriage, a stillbirth, a live baby since passed on. Apparently she took my pause to mean I wasn't up for discussing it. And considering the harrowing experiences so many women have had, and how much it upsets many of them when they have to explain yet again what happened in their previous pregnancy or pregnancies, her choice not to continue down that line of questioning was probably one of compassion. But in my particular case, that was misplaced.

The pause was simply because for a second I wasn't sure about the answer. No, it wasn't my first pregnancy. Yes, it was my first "real" pregnancy; the first pregnancy I was allowed to speak to others about. My early-morning-brain took a moment to figure out which answer was the correct one in this situation.

Had I been given the opportunity, I would have continued: "I had an elective abortion at ten weeks." That's what I put on the history form I brought to my first appointment with the midwife. I chose the word "elective" with some care. With no adjective, abortion can be a synonym for miscarriage (but one a woman would rarely use to describe her own history). "Induced abortion" is more clear, but could be due to threats to my health, genetic testing of the embryo giving a poor prognosis, or other "good, compelling, patriarchy-approved" reasons. My own medical records call it a "therapeutic abortion," which I presume stems from the time when an abortion was allowed only "when the health of the woman was in danger as determined by a three-doctor hospital committee." My abortion was not "therapeutic;" neither my physical nor my mental health were in imminent danger. It was elective. It was my exercise of autonomy over my own body, and the rational decision that at that point in my life I preferred not to carry a pregnancy to term.

Perhaps in a future post I'll tell the story of my abortion, including the reasons at the time, and my own continued belief that it was the right decision for me. That's not what this post is about, though.

What I'd like to discuss is how an aborted pregnancy is not a "real" pregnancy. It is not socially acceptable for me to mention it. It's supposed to be a shameful thing, something I would never mention in public. But to me, it's not a shameful thing. And after the beginning of my second pregnancy, I started feeling it was relevant, and wanted to mention it. But every time, I chose not to do so.

I'll admit that due to some misplaced search for community, I spent a little time on forums populated by the above-mentioned "baby dust" people. There's a lot of women just looking for tidbits of information. Typical post title: when does morning sickness usually start? The answer I wanted to give: In my first pregnancy, morning sickness started very suddenly at six weeks. It was accompanied and triggered by an insanely perceptive sense of smell. There was a lot of vomiting. However, in this pregnancy, I'm finding it very different. It came on a little later, around 8 weeks. I feel nauseated all day, but rarely throw up. Answer I did give: none. With no comparison to make between pregnancies, I really had no point. And if I mentioned the first pregnancy, I'd have to answer the questions: how old is your kid? No, no kid. Oh! That must be horrible for you, what happened? I chose to end the pregnancy at 10 weeks. And then silence. Or castigation. Social exclusion. A forum full of pregnant women tends to be a good place to find virulent, uninformed anti-choice opinion. And it comes up again and again. How's your libido? Ravenous when I was 19 and pregnant. Existing now, but tempered by nausea.

The doctor who performed my abortion told me my cervix was very difficult to dilate. They used the 8-week tube instead of the correct 10-week one. She mentioned that this could "cause some problems later when [I] have children." I didn't ask for more details. At the time, I didn't picture myself ever having children. However, now I think this is something I think my health-care practitioners should know. But again, they don't want to discuss my abortion. The couple of times I've mentioned it, the doctors have moved away from the subject as quickly as possible. I haven't mentioned it to any midwives yet; I will if I get a chance. And I expect, again, that they won't want to try to interpret this piece of information. They won't want to talk about it.

My desire to discuss my first pregnancy is waning now that I'm further along in my second pregnancy than I was in that one. This part is new to me, and I don't make comparisons as often, or marvel at how different the two pregnancies are. But that pregnancy existed, it was legitimate, and I learned from it. It's too bad others can't.

Introduction

Two days ago, on Friday, I achieved two major milestones. First, I handed in a completed PhD thesis. It was on special magic thesis paper and was even signed by my committee. This means that, when the university gets around to planning a big ceremony, I'll be getting a PhD.

I'm trying to protect my pseudonymity here, so I won't tell you exactly what it is I study, or where. It's in a technical field. Take the most impressive field of study you can think of. No, that's not what I study. Think of another. That's the one. I study the second-most-cool-sounding technical field. Now think of the most "prestigious" school in the United States where a random layperson thinks one would go to study that field. Yes, that's where I am.

I'm not saying those things to brag, just to give you some idea of where I'm coming from. I will tell you that the field, while interesting to me, isn't nearly as cool or as difficult as most people think it is. And my narrow specialty sounds much less cool than the field as a whole. And the school? Yeah, it's a good school. It has a lot of money, and that makes a big difference. My department in particular is awesome, with, on average, very good faculty, and administrative staff who are actually helpful, rather than obstacles to getting work done.

Second, I passed the twelve-week mark in my pregnancy. Some sources claim that after 12 weeks, the risk of miscarriage decreases substantially. I've also heard the same happens at 8 weeks, 10 weeks, and 14 weeks, so I don't have huge confidence in 12 being some kind of magic number. Most likely the odds decrease exponentially with time, and experts just simplify it for the laywoman by giving these arbitrary dates. Numbers I've heard, for the odds past 12 weeks, are 3% and 5%, so the odds of miscarriage aren't even that low. And I've read enough about all the various things that can go wrong, even late, in a pregnancy, that I'm not overly cavalier. But yeah, it's looking like the best prediction is that sometime in December a mewling, slimy mini-person will emerge from my vagina. How very, very, odd.

And thus, after passing those two milestones, I decided to start a blog. I made an attempt once before, but overreached a little and got frustrated with myself. This one will be about my experiences as a post-doc, my search for a job as a professor, and my pregnancy. I presume the intersection of the last two may provide some entertainment. I make no promises about the frequency or quality of my posts.

As for my handle, I prefer to pronounce it in three syllables: "con-FOO-zed", but that's up to you.