Less than 6 weeks to go, only 2 more pants-on checkups left at my OB office and then we start the Great Contraction Watch of 2010. I was going to say Cervix Watch but that seemed too…graphic. You’re welcome.

(Also, in case you’ve been holding your breath, I’ll put up a “guess the birth date” post right after Thanksgiving and offer some sort of prize for the person who gets it right. Nothing fancy – probably a knitting project, but better than last time when no one got anything. I may do a sub category for birth weight/length but that seems like a lot to keep track of and as far as I know WordPress doesn’t have a plug-in to do it for me yet.)

I went to my appointment today expecting a lecture on my weight and had already planned out my whiny blog post in advance…but instead I got a doctor who looked at my chart, did the math and said “35 pounds! Right on target.”

Which one is the blank-stare-blinky emoticon? I need about two dozen of those.

Honestly, 35 pounds SOUNDS like a lot. I was hoping to keep it closer to 25 this time. It also feels like a lot – just ask my pelvis and my sciatic nerve, which cry a little every time I have to trek down to the basement for yet another half-gallon of milk for the thirstiest toddler on the planet. But despite once again being on the high end of the suggested weight gain scale, I am still having an extremely healthy pregnancy. Excellent blood pressure, no gestational diabetes, no preeclampsia, no warnings about gigantic babies that cannot possibly fit through my tiny delicate lady parts. And for the record, all my pre-pregnancy underwear still fits, as do my pre-pregnancy pants – if I don’t try to zip them. I’m still going to Stroller Strides at least twice a week, I am capable of buying ice cream/candy/cookies and not eating ALL OF IT within seconds, and I haven’t scarfed down more than 1 cheeseburger in a sitting the whole 8 months. MY WILLPOWER, LET ME SHOW YOU IT.

So why have I gained just as many pounds as last time, when I DID eat ice cream and cheeseburgers like they were the last food on the planet and barely moved from the couch after my 4th month? Is this just how much fat my body needs to grow a baby? Is this one going to be bigger? Is this weight going to be just as hard to lose or will it magically burn away with the breastfeeding like so many people claim? That last one would be AWESOME. The potentially larger baby, not so much (my lady parts might be made for birthin’ the babies but I’d like it if they weren’t torn to shreds in the process)(You’re welcome again).

Tell me mamas, am I fooling myself? Is my butt really that much bigger than I’m seeing in my mirror?

This is sort of rambling and vague so I apologize in advance.

Baby Evan’s birth was just the way I wanted it. It was fast and uneventful and pain-free. I went to the hospital without a formal birth plan (although I joked I was going to print out a dozen pieces of paper that just said “GET THE BABY OUT” in giant letters) since my requests were already written in my chart. I liked and trusted the OB practice I was seeing and with my totally normal, low risk pregnancy I was confident I could avoid the only two things I was horribly afraid of: a c-section and an episiotomy. And I did, thanks to a doctor who let me go home to labor, a very well placed epidural, some of the strongest pelvic muscles in the Western hemisphere and a lot of luck. I have absolutely zero regrets regarding my choices, especially since I ended up with the healthy baby every mom wants after 40 weeks of pregnancy.

But sometimes I feel that because I didn’t give birth squatting in a meadow surrounded by bluebirds and fawns and harp music and 100 of my closest friends chanting ancient birth rituals I have somehow failed. Because I don’t have regrets about trusting modern medicine and taking advantage of pain medication I am betraying womankind. Because I didn’t even try to do it naturally I am less worthy to call myself a mother.

Which is all ridiculous.

I think I just spend too much time on the internet, where the only two stories seem to be horrible traumatic c-sections no one wanted and all-natural wheat field births where Jesus himself was the midwife. If I had never heard a birth story other than my own I wouldn’t feel this way at all. Which is probably an indication I need to get away from the computer more often. But with every joyful, triumphant, glowing story about a natural childbirth I wonder…could I do that? Do I even care if I do that or is it a weird form of social peer-pressure and misplaced guilt?

This pregnancy is clearly to blame for all my thoughts about my last birth, since I hope to experience another one in the not too distant future. But do I want the same one?

(Sidenote: E thinks I’m a crazy person for even considering doing things differently. What kind of person decides their birth was too easy and too painless? A crazy one, that’s who. Which means any of the husband-coached pain management techniques are probably out – my coach is too skeptical to be truly helpful.)

p.s. As silly as this sounds, one of the reasons I feel I have to give this birth so much more thought is my day after Christmas due date. I have horrible fantasies of a doctor who doesn’t want to miss his kids opening presents and insists I get a c-section so he can be home in time for dinner. Not that I think that would ACTUALLY happen. Probably not. Right?

p.p.s. And THEN I start thinking of the mothers who didn’t end up with a healthy baby in the end and think I’m being totally selfish for spending so much time thinking about trivial details. I imagine those mothers would sign up for unmedicated c-sections if it meant they could have their babies back.

Regarding comments: Please feel free to share your experiences and birth stories. I love reading them, especially the good kind – and by good kind I mean any that you were happy with. But if you use the phrase “women have been giving birth for thousands of years” or “your body was designed for birth so of COURSE you can do it naturally” you’re going to get some epic eye rolling on my part. I’m not looking for a bunch of “you go gurl!!!” support. If I DO decide to do things differently this time I will let you know I am open to all the womanly power affirmations you can think of.

I was going to write a whole big joke post today (I’m pregnant! AHAHAHAHA HILARIOUS!) but I don’t really like April Fools jokes. I’m not very good at pulling them and have pretty much no sense of humor when they’re pulled on me. It’s like pinching people for not wearing green on St. Patrick’s Day – the only person laughing is the one doing the pinching.

Besides, announcing I’m pregnant a year after having my last baby isn’t really that shocking or funny.  And I kind of hope it’s true.

April 1st 2009 was my due date. I had been counting down every day, every hour, every second until the morning I woke up on the first of April and thought TODAY. Today, I will meet my baby.

Except that I didn’t. Baby Evan didn’t read the memo about due dates and how important they are to pregnant women (I mean, I tried showing it to him but I think the paper got too soggy to be legible). I tried sending him gentle hints.

I tried the whole list of things that are supposed to induce labor, including eating a very questionable can of pineapple rings I found in the back of the pantry. I walked my way through a brand new pair of running shoes. But the first rule of babies is you can’t make them do anything they aren’t ready for and Baby Evan clearly wasn’t ready to join us in the non-amniotic world. (Second rule of babies: Don’t talk about babies. Well, ok, talk about them sometimes. A few times a day. All day. Every second of every day. Forever.)

The five more days it took Baby Evan to make his appearance were some of the longest and most strenuous of my life. I tried to will myself into labor and then take it back as soon as the doctor suggested actually doing something to induce me. There’s just no way to explain those last few days of pregnancy when you go from totally eager and prepared to meet your child one minute to scared shitless and hoping the baby stays inside forever the next. Let’s just say if you find yourself researching adoption laws at 41 weeks you wouldn’t be the first person.

But I promise you’ll be OK. And it is so worth it.

2 more days until Baby Evan’s First Birthday Party.

4 more days until my baby is officially one year old.

I am not a particularly political person (besides that one time my boss ran for mayor and I was his technology campaign manager – Hi Mayor Allyn!) so I try to stay out of the angry online discussions. I try even harder to stay out of angry IN PERSON discussions, because never in the history of the world has yelling ever changed anyone’s mind about politics. There is zero chance that just because I can give my opinion LOUDER THAN YOU CAN you will suddenly realize your belief system for the last 30 years is wrong and happily sign up for mine.

But after watching my Facebook feed split straight down the middle on health care reform, I wanted to share my thoughts. And since this is my blog and I have 100% control over what gets published here and what doesn’t, please believe I will DELETE any impolite or combative comments, although feel free to disagree nicely.

As a military dependent I enjoy a number of benefits, from discounts on clothes, tickets to Disney World and food to tax-free shopping on base. But in my opinion the absolute best part of my dependent status is my Tricare insurance coverage. 99% of the time I pay nothing (zero, nada, the opposite of some) to see a doctor, fill a prescription, get a referral, or have a baby. That’s right, although prenatal care and a hospital birth can cost tens of thousands of dollars (see this post over on His Boys Can Swim for their breakdown) the entire cost of my pregnancy was $14 for a giant bottle of Tums and a tube of Preparation H. Which I’m pretty sure I could have gotten a prescription for if I had asked. Which I then could have gotten filled at the base pharmacy for free.

I get most of my medical care on base from a combination of corpsmen, active duty doctors, and civilians contracted through the military – although I did get to see a local civilian provider for my OB care. I’m not saying Tricare  gets everything right.  Getting a same day appointment at the Navy Ambulatory Care Clinic means waking up at 6 am to talk to the regional call center and agreeing to see whatever doctor is on call instead my primary care provider. Sometimes the doctor on call talks on his cell phone through my whole appointment and then tells me I might have strep but he’s not going to order a test for it or write me a prescription so have a nice day! Then there was the bureaucratic hell that was trying to get my 4 day old jaundiced son in to see a pediatrician who was retiring in two days even though the baby wasn’t yet in the Navy’s computer system because HE WAS 4 DAMN DAYS OLD. But besides the totally free health care for myself, Tricare offers a very low cost (yearly cap for out-of-pocket/co-pay spending before they cover everything: $1000)  plan that lets us see the pediatrician right down the street any time Baby Evan falls on his face. Our total bill for the OMG EMERGENCY trip to the Children’s Hospital in Hartford? Less than $40. My complaints about one lousy doctor, a lot of paperwork and a long wait at the pharmacy pale in comparison to people who have gone bankrupt (or worse) over health care.

If my insurance coverage sounds sort of like – GASP – socialized medicine, that’s because it pretty much is. I hope one day everyone gets to enjoy what I take for granted. I’m shocked to see opposition to the health care bill among my peers who I know enjoy the same Tricare coverage I do. I’m pained that anyone would try to take the restrictions on unfair insurance practices away from people who desperately need them because of a misconception of a single line item or bit of wording. I’m thrilled my elected representatives managed to get something so huge accomplished and proud it happened during my lifetime.

And that’s all I’m going to say about that.

Suzanne asked me a couple of weeks ago if I could write about my experience with breastfeeding so that she could share a different experience from her own. Initially I was really excited about it, but then I found myself putting it off.  I had really thought that I had come to terms with my decision, to give up on nursing and feed from a bottle, and was surprised at how emotional I still was about it. Apparently I had just been trying not to think about. Having to sum it up just seemed like trying to make excuses for my failures.  I’m really not trying to be melodramatic or go fishing for sympathy; I just wish I had known how emotional this was going to be. That someone had been able to warn me that so much of my confidence as a mother would be wrapped up in this experience. So here is what happened to me…..

I had my first baby in July. I had made the decision to breastfeed without giving any thought to anything else. I wanted to breastfeed exclusively for the first six months. I wasn’t sure about a whole year, wanted to wait and see. I had read all the books and taken breastfeeding classes. I had told my friend when she asked that I wouldn’t need to buy more than a couple of bottles because my baby would be breastfed. I was committed.

When Reid was born he breathed in too hard and punctured a tiny hole in his lung. He spent the first 3 days of his life in the NICU. The first day we were not even allowed to hold him. He had to stay on his right side with a big oxygen bubble over his head and a feeding tube.  The separation and that feed tube were our first set back. Sure I had the pump, but I was no part of his feeding and he was no part of mine. By the second day, Reid was out of the woods and doing much better. They let me try to nurse him, since they knew that I was planning to breastfeed and they told me not to be discouraged that my milk hadn’t come in. They gave me a nipple shield and told me to use it help him because he would not open his mouth wide enough to latch. Then they would take the baby and feed him whatever I had been able to pump with a little syringe.

Then the nurse actually said to me “How stuck are you on breastfeeding?” I didn’t really even get what she was asking. I just said “What?” And she said “If you let us give him a bottle now, then he will be able to get out of here faster.” …..and of course I said yes. That’s right, she asked a mother with no milk; who had just held her two-day-old baby for the first time; whose baby had to get off the feeding tube to be discharged and hadn’t eaten yet, if she could give him a bottle. If any of you think that you would have said no, then you are sorely mistaken. It was nothing short of emotional blackmail. Plus, she wasn’t going to sit there and feed him a whole bottle using a syringe and I wasn’t allowed to stay there with him.

He really liked the bottle. We left the hospital with a baby who had never nursed and who had a strong preference for the bottle. We were assured by the doctor that it was normal that my milk hadn’t come in yet since he hadn’t been with me and that there was no such thing as nipple confusion. He assured us that as soon as my milk came in he would take the breast. Oh, and give him 20mls of formula with each feeding. Two days after we got home I realized that we would have to go cold turkey on the bottle. My milk was coming in and he still wasn’t nursing. At that point I don’t think he even knew how. I was bitterly disappointed about everything that had happened (and that I had let happen) at the NICU. I felt robbed. I hadn’t even realized how badly I wanted to breast feed until then, when it looked like we wouldn’t be able to. We decided to ignore the doctor’s order for a supplement (a really hard decision for a baby with jaundice). I nursed and pumped and nursed and we gave him breast milk with a syringe and things started to turn around. I started to feel like you could fix any breastfeeding problem if you researched it and then you worked at it, CONSTANTLY.

Over the next couple of weeks I worked and fought to improve things. Getting him off the nipple shield was really hard, and it made our nursing sessions so much longer. But I was afraid that it was affecting my supply. I had to get him to take my nipple. He was a lazy nurser. He would fall asleep most of the time, or he would only suck just a little bit, only when my breast was really full. He had his two week appointment and he had only gained two ounces. I researched. I read. I used sucking exercises. I let him nurse for two hours. I did latching exercises. I re-latched and re-latched and re-latched. I let him nurse all day. I used compressions. I researched and I worked and I fought with him and I worked at it some more. He was gaining weight but it was only on the minimum side of normal. About the time he was a month old I felt like we finally had it down. He definitely had a good latch even if he was a lazy nurser. And the articles I read said that that should get better real soon.

Then he started to cry between feedings. I let him eat whenever he wanted but he was getting fussier and fussier. At six weeks old, after nothing but the breast for five weeks, we took him to someone’s house for dinner and I broke down and gave him a bottle. He was screaming even as we were putting him into the car and I had just nursed him FOREVER. He drank the whole thing and finally had his first awake and content moments in two weeks. I was horrified! I had read a million times that there is no such thing (or very rarely!) as not being able to produce enough milk. I had been thinking that he was gassy (since his poops were green). I beat myself up imagining how hungry he must have been all that time. Then when we got home I pumped for the first time in a long time and I got less than 2 ounces!!! From both breasts!

I decided to start supplementing. He was dropping drastically in weight percentile and I was starting to worry about him developmentally since all he had been doing was crying. I pumped and nursed constantly for a whole week, literally doing nothing else. I followed all the advice from the breastfeeding experts. I drank the tea and took the supplements. I was able to improve my supply but only to about 3 to 4 ounces every three hours. But now that Reid was getting the bottle again he started to refuse the breast. I tried to get back to the breast and away from the bottle but it just brought increases in crying and decreases in milk. In the end I was just tired of fighting with him. I felt like breastfeeding was not a bonding experience for us and I had started to crave the peaceful easy feedings we had with the bottle. It was the first time I was able to look into my baby’s eyes while he ate.

I decided to give up on nursing and just pump because I could not keep trying to nurse, then pump, then bottle feed. There just wasn’t enough hours in the day. But I beat myself up about it. I felt like I was quitting. That I wasn’t dedicated enough to pump AS MUCH AS IT TAKES to get to where I should be. I felt like I was sabotaging the breastfeeding by enjoying the peace of the bottle. I felt like people would judge me. When I heard other woman say that they went to formula because they weren’t making enough milk I judged them— They must have been doing it wrong and they weren’t dedicated enough to fix it.

I still feel guilty that I didn’t try harder and ashamed when I give him a bottle in front of someone who breastfeeds.  I miss that connection and that he had to be with me all the time. I miss the exclusivity, since now anyone can feed him. I get defensive now when people talk about “Breast is Best”. It feels like salt in the wound. I read the quote above the breastfeeding art that Suzanne linked in her blog yesterday that said “Natural feeding is the duty of every mother and the birthright of every child” and cried.

Pumping may sound like an okay alternative, but it has a lot of issues. It doesn’t stimulate milk like the baby does so you have to work a lot harder. My supply doesn’t maintain itself. When you are nursing your baby it is socially expectable to nurse him wherever you are, especially under a cover. But you can’t pump in a restaurant or in some one’s living room. You have to give your baby to someone else to hold and enjoy and go take care of it in the bathroom. Even when you are home, you can’t pump until after your baby is fed and happy and doesn’t need you, which makes it very hard to get all the pumping sessions crammed into your day.

I know I’ve said a lot here, and I don’t really know how to end it. Just that I wish they had prepared me for this when I took the breastfeeding classes. Instead of just saying how great it is when it goes right, I wish someone had warned me about when it doesn’t. Then maybe I wouldn’t be so hard on myself.

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

I think Erin’s story identifies two really big stumbling blocks in the road to breastfeeding success. First, her trouble in the NICU and the emotional blackmail that horrible nurse used make her agree to a bottle. I cannot believe how many nurses undermine a new mother’s attempts to breastfeed. Even my own non-NICU baby was given a bottle because “his blood sugar was low”, despite having APGARs at 8 and 9 and no medical issues, EVEN THOUGH I specifically asked that he not be given any formula. I can’t imagine how much greater the fear is when your baby is hooked up to machines.

Second, Erin’s experience with pumping brings up a great point. Although I wouldn’t agree that breastfeeding in public is “socially acceptable” (anyone who’s ever gotten a dirty look for nursing can attest to that), pumping in public isn’t even discussed. No one campaigns for a woman’s right to be hooked to their Medela at the park or the mall or in restaurants. When moms pump at work they fight for quite rooms with locks on their doors, not the right to pump at their desks. Once you add that extra step between baby and boob, you lose the right to call it “natural” and thus the protection from society’s disapproval.

Even though Erin is my best friend and I talk to her all the time, I didn’t know just how much she struggled with breastfeeding until she wrote this. I probably wasn’t “helping” at all when I emailed her links to lactivist sites or complained about my overproduction or spouted off the advice from my lactation consultant.  And for that Erin, I’m really sorry. You’re doing a great job with Baby Reid, please don’t beat yourself up. I love you!