Cankles

I was chastened by Nephi this morning.

1 Nephi 18:15-16
"...and also mine ankles were much swollen, and great was the soreness thereof...Nevertheless...I did not murmur...because of mine afflictions."

So I guess I should stop complaining that I can't tell where my calves stop and my toes begin. ::sigh::

Should I be angry or amused? I'll take amused.

At first when people started noticing my belly and taking the liberty of asking me all sorts of personal questions and scrutinizing my figure in usually inappropriate ways I was a little self-conscious. My child’s gender has been predicted based on the size and shape of my abdomen more times than I can remember (according to most people it’s a boy because I’ve expanded up more than out; one woman told me that if it were a girl my butt would be bigger.) But now I’ve come to appreciate these little comments as other people’s excitement and desire to share in the joy of new life and so I just roll with it.

Yesterday was a little different.

I was washing my hands in the bathroom at WalMart. There was another lady in there -- about 50ish, small, and witch-like -- who seemed to be adjusting the back of her dress, so she was looking into the sink as she reached behind her head. Lifting only her eyes, she said to me, “Is this your first baby?”

Me, smiling, anticipating her excitement for me: “Yes.”

Then, in a tone of neither curiosity nor cluelessness about the socially acceptable but rather a flat tone of accusation and still without lifting her head she said, “How old are you.”

I was so taken aback that I wasn’t quick enough to say, “How old are you? And how much do you weigh?” Or even, “Excuse me?” Instead I just said, “Twenty-four.”

Her tone didn’t change, and she replied, “You look very young.”

I laughed and said, “Yeah. But I’m married.” And then left the bathroom.

Maybe you had to be there, but I was blown away by the gall of the whole thing. I know I look like a pregnant teenager, but to indict me for it…come on!

Follow-up

I just wanted to say that if I came across anti-hospital in my last post, I didn't mean to. Hospitals are great places to have babies (my friend Melanie that I referenced had hers in a hospital in Utah County). My intended point was just that I was exposed to information that both surprised me and challenged a lot of my assumptions about birth. So that post was partly to explain myself (since what I'm doing is outside the norm) and partly to pass along some things that I found helpful -- since this info wasn't offered by either of the OBs I had seen (one great, one not-so-great) -- in case there's another "me" out there who will appreciate it.

Why I’m choosing to “go natural”

As you may or may not know, I’m planning a non-hospital, drug-free waterbirth attended by a midwife. I get varied reactions from people when they find this out – mostly polite surprise, but also the occasional “Hoo boy, you’re brave” (Mark’s grandma) and, among the brutally honest (my father), overt initial skepticism. Curiosity is one consistent aspect of nearly everyone’s reaction.

And as a disclaimer, I’m not trying to convince anyone that they should do the same thing, but I am glad that I was exposed to this birth information when I was, so if I can increase exposure to this way of having a baby, then great. If I help someone else find a better birth for herself, then hey, pay it forward.

I always assumed I would give birth in a hospital, in a bed with a hospital gown, just like everyone else I knew. My exposure to birth was limited to postpartum visits to friends and family, one visit to a friend who was actually in labor in the hospital, and television portrayals (which, it turns out, are a wild misrepresentation). In other words, my exposure was (and still is) very limited. But I assumed I would go to the hospital like everyone else. I wanted to “see if I could do it” without an epidural – partly to see if I was “tough enough,” and partly because I wanted to connect with this rite of passage for women through history. But, if I couldn’t hash it, I thought, I’ll get an epidural.

This was my plan – or rather, this was the default option. Then I read the birth story of my friend Melanie. She talked about laboring in a tub, using a birth ball, walking around, and her doctor massaging the perineum as the baby crowned (!) – I thought it was all quite strange but thought hey, to each her own. Then, in a later post, she referenced an article called “The Purpose of Pain in Labor” (which unfortunately is no longer available on the website – Mel, if you have a copy would you email it to me?). The gist of the article (as I remember it) was that pain in labor, like in any aspect of life, is your body’s way of communicating with you, and that naturally responding to that pain allows your body to be most effective in getting the baby out with the least damage to everyone involved.

I had a major “Huh.” moment reading that article. It just made so much sense. One reference led to another, and by the end of the day I was researching birth centers and midwifery and waterbirths, and I was just about sold.

Coincidentally (actually, I don’t think it was a coincidence, I think it was divine providence), that same day Mark attended a presentation on various community service opportunities he would have this year, and one of them was at the only birth center in the Valley. He took the time to talk to the nurse afterward and get some additional information, thinking it sounded like something I would be interested in. When he came home that day, we both, independent of each other, had a lot to say about birth centers. This was the first of many little confirmations that this was the right direction for me to take.

I must pause to tell you why Mark thought this would appeal to me. My biggest fear about giving birth was not the pain, not that something would go wrong with me or my baby, nothing like that. My biggest fear was that I would have people telling me what I could and could not do. It was that I would be in a hospital where people would be telling me that I couldn’t even get a drink of water if I was thirsty. I had this vision of being so thirsty and being told all I could have was ice chips, and grabbing some medical individual by their white lapels in raging agony and yelling, “Get me a damn drink of water NOW!”

So, naturally, learning about a place where you’re “allowed” to labor as you want – eating and drinking as much or as little as you want, moving around, and just generally trusting your body and your own intuition – was very, very appealing to me. And the more I learned, the more it appealed to me on just about every level.

The more I’ve read, the more I’ve learned about some of the problems with the obstetrical model of maternity care, and how most women (like me) are just not familiar with the other options. I won’t try to regurgitate everything I’ve read over the last five months, but I’ll give a few examples of what I mean. And I mention these because they were huge wake-up calls to me.

Did you know, for example, that lying on your back – the standard hospital position – is probably the worst position to deliver a baby? You don’t have gravity working for you, it’s generally more painful, and you’re more likely to tear or end up with an episiotomy. Most women who choose their own position end up squatting, sitting slightly reclined, lying on their side, or even being on all fours.

To me this was a revelation. I thought women everywhere, throughout the ages, had given birth on their backs. Not so – the US is one of the few countries where this is standard procedure, and only since the last century.

I had always thought that giving birth in a tub was something that crazy hippie home birth people did. (I had even been known to make jokes along the lines of “Are you going to be one of those crazy people who give birth in a tub?” followed by a superior chuckle.) In fact, I have read that water is the best non-pharmaceutical pain killer for labor. Some women even describe it as relaxing. (I’m not holding out for that, by the way, but if it happens – woohoo!) You’re also less likely to tear under water.

Another thing I had never before considered was how a birth could be affected by a woman’s environment and her emotions. Being able to let go and surrender to the birth process is key, and tension, fear, and anxiety can impede and even halt labor. One article talked about how a doe in labor finds herself a dark, secluded spot to give birth. If anything happens where she feels threatened, the adrenaline rush will actually stop her labor so she can get up and run. The same is true for humans – how you’re feeling emotionally has a huge effect on labor.

If you have the same, trusted person with you for the duration of your labor (which is what a midwife or doula would do), if the lights are low, if you’re comfortable in your environment (if it’s as home-like as possible), that fight-or-flight reflex is much less likely to be triggered. It can be very hard to really relax with various nurses, students, residents, and so forth, coming in and out of the room, checking your cervix, changing shifts, etc. At the hospital, you don’t get to choose who ends up spending most of your labor with you, and you might get stuck with an ornery nurse (I know I’ve heard several of those stories).

Anyway, those are just a few of the things that I had never before considered, but once I started learning more about them it just made so much sense. And the list goes on, from the effects of various interventions (pitocin, pain medication, fetal monitoring, etc.) to the obstetrical philosophy (seeing birth as a potential emergency and over-treating for fear of litigation) to cesarean rates (way too high) to hospital policies (often not mom- or baby-friendly, and surprisingly often not evidence-based) to VBACs (unfortunately discouraged) and so forth.

So that’s a little bit of why I’ve chosen to go the way I have. And to follow up on my disclaimer at the beginning of this post, I’d just like to say that I don’t think that every woman should necessarily say adios to her OB and have her baby at home. Unfortunately, some natural birth advocates are a little too aggressively evangelical and they end up vilifying all doctors and hospitals and it can be a real turn-off.

But I do think that every woman should try to become as informed as possible and make her own decision, one that she’s happy with. Personality is a huge factor that I think rarely gets addressed. You may be like me and want to make all your own decisions regarding your care, or you may feel much more at ease knowing that you’re in the hands of a highly trained professional who is going to make the decisions for you. Your biggest fear may be similar to mine, or you may be afraid of something going wrong with your child. Either way, my hope is that everyone can at least know the truth about all her options. And OBs, as good as they may be, are likely to give a one-sided representation of reality. I’m a skeptic by nature and I don’t like to take any one person’s word for it, especially when it comes to something as important as my body and my child.

One more thing. Reading and hearing birth stories is very interesting (and often inspiring). When it comes to hospital births, I haven’t really read or heard a woman rave about how wonderful her experience was. Mostly they seem neutral, mediocre, or sometimes even really bad. And though there are certainly the rare scary birth center and home births, as a general rule women who have chosen to go that route tend to rave about their experience. Not that it was easy, but that it was empowering, beautiful, spiritual, and even life changing. I hope to have one like that.

If I don’t have one like that, if I end up in the hospital or with a c-section, that will certainly be disappointing, but I think I’ll be okay with it – because I know I won’t be railroaded into it and ultimately it will be my decision. I’m not holding out for any ideal birth because I know that labor is a poker hand and you get what you get – long or short, hard or easy, emergency or not. But I’m happy knowing that I’ve done everything I can to plan for the kind of experience I hope to have.

For some good, middle-of-the-road resources, I recommend Your Best Birth as a nice introduction to the various birth options (it does lean natural-birth but was neutral enough for me) and The Birth Partner as a great resource for preparing for birth no matter where or how you’re going to do it. And this is a blog mostly about birthing that I follow regularly now, because its author is educated, smart, and objective. (Her two birth stories, which are linked in the "About Dr. Freeze" sidebar, are amazing by the way.) There’s too much polemic and divisive stuff out there on both sides, from blogs and books that make you see every man with a stethoscope as a misogynist to simply false doctrine on the Today Show about the “Perils of Midwifery.” So I recommend steering clear of both extremes, and don't believe anyone who uses fear as a tactic to get you to believe their side (whether that's "Your doctor will disregard your wishes and cut you a huge episiotomy for his own convenience" or "If you don't do x, y, or z, procedure, your baby might die"), because unfortunately there's too much fear mongering out there. So these three resources, I think, are good objective places to start.

By the way, feel free to disagree with anything here. You may even extol the virtues of the epidural! You won't hurt my feelings. In fact I’ll respect you for voicing a contrary opinion. And soon I’ll have my own birth story to share (I was 38 weeks on Sunday), ready or not…

Eew

Gross: Finding a dead spider in your bedside Vaseline. Deciding to deal with it tomorrow.

Grosser: Applying Vaseline to your lips in the dark the next night and wondering what that crusty thing was. Realizing what that crusty thing was.