Resurrection

I've decided I need a life reset. I may resurrect this blog to chronicle it. I wonder if I still have any readers from back in 2007 when I guest-posted on Feministe? We shall see. Now: I will do some work, since that is part of the life reset. When I get a moment, I will write a post summarising what's gone on in my life in the last 3-and-a-half years.

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.

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.

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?

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!)

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

"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.