38 Weeks: The Waiting Game and the Myth of the Due Date
I haven’t been working at work (working at home instead) since about 35 weeks, and look what it’s gotten me! No September posts on my blog. Oh well. This will be the first.
What have I been up to? Let me see … working from home with HGTV in the background, watching old movies (I can highly recommend The Apartment with Shirley MacLaine and Jack Lemmon), doing load after load of baby clothing and cloth diaper laundry (you’ve gotta wash everything for your baby before it touches his or her body …), reading Diaper Swappers, and working on a complicated sewing pattern for a large diaper bag (so far, I’ve only cut out the pieces). A lot of the time, I’m going slightly crazy wondering when Baby Sam will make his appearance. My husband is also getting anxious, and I believe even the dog knows something is up.
Eric and I were both born around 38 weeks, so, for nine months, I’ve thought that I’d deliver at 38 weeks. I always felt that Sam was ahead in his development — I could feel him moving early on, and at his 20 week scan, the doctor changed my due date from 9/22 to 9/17. Well, folks, week 38 is drawing to a close, and I’m beginning to accept that this little guy is NOT going to be early. I wish I’d come to this conclusion earlier on, but I just kept thinking he’d be here by Labor Day. No such luck.
This whole cycle of thought makes me somewhat ashamed. I’ve fallen prey to the Due Date. I’ve designed my pattern of thought around September 17th, when in fact, there’s really no such thing as a due date. Sure, you can call it Your Due Date because your doctor wrote it down in your chart, and you can drive yourself completely insane if you go “past” your due date. The reality is that the doctor doesn’t know any more than to get the day your last period started, and then add forty weeks and seven days. Really, it’s as simple as that. It’s a (very) rough guess.
This article actually gives a really good idea of why this guess is terribly rough. This whole system was thought of in 1850 (!!!) and hasn’t been altered since. Recent studies have shown that you should add 15 days instead of seven to the formula for white women who are first time moms. That puts me at … September 25th. Oh my heavens.
If you calculate with my original due date of September 22nd in mind, it takes me right on to September 30th.
When you couple this tremendous disparity in due dates with everyone EXPECTING your child on a Certain Day, it can drive you insane. You get impatient and tired. You resort to evening primrose oil, black cohosh tea, squats and stretches, and scrubbing down the whole bathroom in an attempt to Make It Happen.
And what do you think I’m going to mention, folks? Something about the medical industry perhaps? Something about the medical industry pushing the Due Date on you and scheduling, scheduling, scheduling around it? Yes — because that is what happens.
“Wow, it’s September 17th, we better start scheduling an induction… What’s that the cervidil suppository didn’t work? Let’s get you started on Pitocin. What, the pitocin is giving you terrible pain? Time for an epidural. What? The epidural slowed your labor? I’ve gotta go after this shift. Let’s get you to the operating room for a c-section.”
Believe it or not, there are a ton of docs out there who will start scheduling you as soon as 40 weeks hit — some start asking you about dates at week 38. I was lucky enough to find a reputable OBGYN who will let me roll on towards 42 weeks. But you better bet, come September 30th, he’s going to have me on a drip. I might have some wiggle room in there by one or two days, but most doctors are simply not going to stand for that. How unfortunate that I might deliver naturally on October 2nd, but that I may be sitting in a hospital with an IV full of fake oxytocin in my arm on September 30th.
Again, as I always say, you better bet I’ll do what’s best for my son, and if I fail my non-stress test at week 41, or if there is evidence that my placenta has started to calcify, I’ll do what Doc says. But there are a lot of women out there who stress over the Due Date, and a lot of doctors who take it as gospel and start to schedule around it. My wish for you, reader, is to be informed of your actual due date and construct a “due date window” for yourself. Your baby will likely not be born on that one date (only 4% of women deliver on their Due Date), so it’s good to say, to yourself, and everyone … “Sometime between September 10th and 30th.”
That way, you’re not getting those phone calls on that One Day, wondering why your child isn’t here, why you haven’t performed, why your body is defective. Because you are not defective, nor is your birth a performance for the benefit of others. It is a singular experience between you and your baby — and your body, and your baby, will more often than not know exactly what date is truly best.
“Nothing, my dear, you’re not qualified!”: Sexism and Heteronormativity in Pregnancy and Birth
A lot of things have been brewing to inspire this post. And there’s a lot to go into it, so hopefully I don’t get too off topic. I’ll sum up my inspirations here and use them as a framework for what I have to say:
- The prevalence of the words “husband” and “father” in pregnancy literature, medical settings, and birth classes (and indeed, the insistence that there be a birth partner to begin with).
- The expectation of the pregnant woman to be submissive and frightened when it comes to choices concerning her pregnancy and birth and the history that led to this.
Since I’m not writing a paper, I’m not sure if these points are in any sort of logical order, but I’m pretty sure they all make sense together, so I’m going to roll with it.
I’ll start off by saying that I’m pretty up in arms about this kind of thing, and always have been. I come from an interesting family (which is where my views start); I was raised by a traditional, conservative, Southern man and woman who both have very feminist ideals. It seems like a contradiction, but for my parents, it’s just who they are. I was always told that I could do anything that a man could do (save, perhaps, playing sports — none of us were ever good at that), and that I should never listen to anyone who tried to control me or tell me what I could NOT do. So I’m very much that way, and I sought out a life partner who believes in my ideals and does not look down on me because of my biological sex. (The whole other story is that my parents taught me to be so independent that they are upset with some of the choices I’ve made, but I am quick to point out that it’s all their fault.) As a woman, I’ve always been proud of who I am, where I come from, and what I can become. (Thanks Mom and Dad.)
In my years on this earth, I have experienced sexism in its subtle forms, particularly in the medical business (it is a business; let it be said). That’s part of the reason I started this uppity, opinionated blog — it’s always been a goal of mine to educate and inform women about their rights, particularly the rights they have to their OWN bodies. Let me rewind a bit — in 2003, I was diagnosed with vulvodynia, a pain condition that affects 20% of women in their lifetime, but for which the cause is not known, the cure has not been properly explored, and is drastically under-reported (mainly due to embarrassment and reluctance to talk about sexual issues). This is what kinda really got me going on the feminist view of the medical industry — I don’t trust what a lot of doctors tell me, because a lot of doctors (and I’ve seen a lot) are driven by the desire for a paycheck rather than the desire to connect with a patient and provide a logical cure. Don’t get me wrong — I’ve had a LOT of amazing doctors, including the dermatologist and gynecologist who treated my condition, and the OB I have now who knows more about vulvodynia and natural birth than I thought possible. (And yeah, I’m like, REALLY not embarrassed talking about this stuff — I wrote an article about it for a magazine and read it aloud to a room full of people. It was hardcore.)
I can’t say it’s surprised me to make the observations that I have during my pregnant journey. It has somewhat disheartened me, as a pregnant woman in 2010, but no, it’s not surprising. My conclusion is that the medical industry is necessarily patriarchal — for a long time, women were excluded from being doctors, and that sentiment has kind of stuck over time. Now, there are lots of women doctors, but they came to work for a patriarchal business, and so hey, they follow the rules that were already set up for them (now, that’s a big generalization, and certainly it doesn’t always hold true).
Because medicine has been established as a patriarchy, it is also heteronormative and managed as both a sexist and heteronormative institution. (I’m starting with this point since it’s the most readily visible — on medical and insurance forms, in books, on brochures and from the voices of many.)
Big claims, right? Well I’m making them. It even spills over into the world of natural childbirth, like the Bradley Method:
Husband-coached? What if I don’t have a husband? What if, say, I married a lovely lady in California (hooray for no more Prop 8!) and decided to artificially inseminate? What if I were a single mom, with no husband, but an amazing pregnant belly and an awesome best friend, mom, or doula as my birth partner? What if I simply decided that I didn’t want to get married, and I brought my boyfriend to Bradley class instead of my husband?
What then?
What about the forms for the hospital that say “husband/father”? What do I do then? Do I make a stink of it and write down my situation and my choices?
Probably not. And I can tell you, I’d probably get pissed and not take a Bradley class because of its title. (I took it anyway, but kind of wish I’d taken Birthworks.)
What happened to me that made me all kinds of pissed is about insurance. My doctor’s office(s) by default assume that I have my husband’s insurance. At my current doctor, I was even pushed on the issue when I filled out the form. “Does your husband have insurance? Are you sure you are the primary insured?” Why yes, he has my insurance. And why yes, I am indeed the primary insured. Why wouldn’t I be? I work, he works, and my insurance is way better.
This seems like a simple thing, but it is indicative of so much more. If we as women are viewed as the lesser party — the one not able to pay insurance for instance, or the one not even able to birth without a male partner — then we can take on some of the feeling of BEING lesser and relying on others’ opinions. (In my estimate, heteronormativity always ties back to a basic sexist point of view.)
So many pregnant women I’ve spoken with have come off as afraid or upset about their pregnancy and their birth. I’ve come to the conclusion that this is because we are told about so many things we CANNOT do. We are told over and over that women make sacrifices, that labor is the curse of Eve, that it’s so painful, and we should give our trust over to the doctors because we cannot control our own bodies or our own life-giving process. I was even told by a lab tech, taking my blood for my gestational diabetes test, that he “would never want to be a woman because of all that they go through,” and that “women should be viewed as sacred for all the sacrifices they make.” Call me crazy, but that point of view puts me DOWN. I can’t imagine being luckier than to be a woman. I can’t imagine being luckier than to bring my son into this world.
A lot of women buy into this point of view because it’s what they know, it’s what they’re told, and there’s a lot of comfort in being told what to do, especially during a time that is unusual and emotional.
This whole system was set up because of a shift away from midwives performing births, a distrust of the birth process, and an emphasis on actively managing a mother’s pregnancy. This really started in America during the early 1900s, with the introduction of lovely pain relief techniques like twilight sleep. Jennifer Block, author of Pushed, talks a lot about how birth has been “pathologized” in this country as a result of moving away from midwives and home births (the woman’s realm) to hospitals (the man’s realm). Indeed, birth has become a scary illness in the minds of many, rather than a very natural process by which all men and women come into this world. My doula and Bradley instructor have both pointed out that many OBs become OBs because they “enjoy doing surgery.” And because of the fear of malpractice, many doctors (and even midwives who deliver at hospitals or centers), encourage women to receive interventions such as episiotomies or c-sections in order to avoid lawsuits. Why wouldn’t this create a culture of frightened women? We’re even encouraged to labor and give birth lying down — an inherently submissive position, and one that doesn’t work nearly as well as standing, squatting, or staying on all fours. (I won’t get into more of the history here, since I’ve already cut down this post significantly and I could keep going for hours, but I would suggest the documentary The Business of Being Born, Ricki Lake’s Your Best Birth and Jennifer Block’s Pushed if you’re interested.)
I think Monty Python sums it up rather well in their hospital sketch.
Laboring Mother: “What do I do?”
Doctor: “Nothing my dear! You’re not qualified!”
But aren’t we as women qualified? I say nothing to negate the expertise of doctors, especially those who necessarily save the lives of women and children. But really, shouldn’t we as women be given the autonomy to guide our own pregnancy and birth our babies — instead of having them delivered? Why do we submit when our bodies are doing the work, making the magic, and pushing out the babies? Why can’t doctors be more like guides and less like micro-managers?
I can’t totally answer, but I know that shutting off, not doing research, and not being aware are the things that put us down even further, when we need to lift ourselves up.
Orientation at the Hospital
Eric and I attended an orientation at the hospital yesterday — the hospital being Virginia Hospital Center. This is where I’ve been going to see my doc since about week 14, when I decided to switch from the local baby factory, Fairfax Inova (the hospital that delivers 11,000 babies a year compared to Virginia Hospital Center’s 3000). My doctor told me early on that Fairfax Inova is a great place to go if you have a high risk pregnancy — they’ve got all the gear to take care of your little one — but that at Virginia Hospital Center, you’ll get more personalized care.
This seems to be the case. As for a more natural birth experience? The word on the street is that you’ll get a better chance at a natural birth at VHC, but the c-section rates are actually pretty comparable — 37% of women end up with c-sections at Fairfax Inova, as apposed to 34% at VHC. It’s probably most dependent on the doctor or midwife you select, and we feel we selected one of the best of the bunch. We’ll see what happens of course … but on to the tour …
The tour started at the Women and Infant Health Center. We saw a bunch of other pregnant ladies waiting around when we came in, and eventually an RN from the education center came around to show us the place. The Women and Infant Health Center was clean, decorated nicely, and had a good feel to it. The nurse led us up to the labor and delivery area, and then showed us the mom and baby rooms where you stay after you deliver.
Overall assessment? It’s nothing to write home about in the long run, but it’s a clean, nice hospital with a guaranteed private room and heck — good doctors. Other pros include a complimentary gourmet breakfast (nice), snacks provided, and a flexibility on when you can leave (24 or 48 hours after a natural birth). The nurse also let her tour group know that VHC supports birth plans (though they might not always go as planned, she pointedly pointed out), and she also mentioned that immediate placement of the baby on the mother is just quite fine. (It was interesting to me that she referred to epidurals, APGAR tests, shots and vaccines, and the immediate bath as the “traditional” method of birth, whereas placing the baby on the mother’s chest and laboring unmedicated is “non-traditional.” Traditional since when? Traditional since … 1920? What about before that? Anyway …)
Cons include that it’s a sterilized, non-homey environment. You have nurses making you get on the monitor and stay still every forty minutes (sounds just like what a laboring woman needs), and they’re more than a bit suspicious of you wearing your own clothes, or bringing in your own food and drink. There’s always someone checking on you, and when it comes time to deliver, they hoist you into the bed, put your feet into stirrup like things and have a doctor or resident catch your little baby. Admittedly, it’s not ideal, but it’s pretty much what all hospitals are like.
And honestly? If you tell me not to do something, I’m going to do it. It’s the reason why I doodle during meetings, speak up when I’m not supposed to, leave products in random places in the grocery store, and it’s part of the reason why I’m planning a natural birth and why I’m intending to cloth diaper (everyone keeps telling me I’m crazy, so the more assured I become). So believe me — I’m rolling with bringing my own clothes to wear and totally eating and drinking when the nurses can’t see me. I can’t do those things because I’m in a pre-operative state? Oh yeah? I’ve been in a pre-operative state right now and have been all my life. A meteor could fall on me right now, and someone would have to operate on me, clothes on and with partially digested carrots and hummus inside! BS on your rules.
At least I can’t get risked out and sent to a doctor I’ve never seen. I’m glad of that. But next time? If all goes well, we’re gearing up the hose for the giant inflatable pool, and getting an awesome home birth midwife. Color me disenchanted with the away-from-home birth options — we’re going in for the big crazy next time, no matter what people tell us.
What’s a Birth Plan? Why Should You Have One?
What’s a birth plan?
A birth plan is what it sounds like — a plan for how your childbirth should go in the hospital. Mostly natural birthing mamas tend to write birth plans. Why’s that? Medicated birth is the norm in America, and so natural birth (while it is the most natural, physiological process a woman’s body is meant to go through) is something that requires a plan.
Why should I have a plan?
Well, why on earth would it require a plan? I mean, really? A woman is a customer at a hospital, and the hospital is providing a service. Why can’t they listen to the mother and her significant other in the moment? Well, because of the nature of the service that the hospital provides, doctors and nurses are generally given the ownership of all decisions and as such, frequently perform routine procedures without a mother’s knowledge — or even her consent (i.e. performing an episotomy or using forceps to deliver the baby). A woman can also be pressured to use pain medications such as an epidural or stadol, or to have a c-section even when labor is progressing at a normal (if slow) pace. Given these pressures of a “routine” hospital birth, it becomes essential for a woman who wants something outside of the norm to take control of her autonomy and make a detailed plan that outlines her wishes.
How do I craft a plan?
1. First, thou shalt do research.
I’ve just finished working on the second draft of my birth plan. I’m currently 33 weeks pregnant, and I’ve done a shitload of research, reading, thinking, asking questions, talking to experts, and listening to my birth instructor. I would contend that you shouldn’t go into a hospital wanting a natural birth without strong, self-propelled research and a strong outline of your wishes. I can’t even fathom setting foot into a hospital without knowing how labor progresses, what interventions are necessary and when, and what happens after delivery. I would strongly suggest a good birth class (we’ll discuss those on A Savvy Mom soon!) so that you can get a grip on these things, supplemented by reading at least one book on natural birth. (Your Best Birth would be my top recommendation for an easy, informative read — and it talks about birth plans at the end!)
2. Second, thou shalt look at sample birth plans.
When it comes to birth plans, plagiarize freely (something I get really pissed at my students for doing). But trust me, natural mamas everywhere post their plans online, and most of them are nice friendly ladies who want to share. I found a pretty awesome birth plan on Diaper Swappers (I’ve turned into a forum dork), and I also took bits from my doula’s birth instruction book. If you don’t look at any birth plans, you won’t know what to include!
3. Third, thou shalt keep it totally simple.
Nurses and docs don’t want to read a tome when they are trying to get you prepped for labor. It must be no more than one page typed! Use bullets, make sure it’s written as simply as possible, and don’t over-word or over-include! My doula suggests printing several copies on florescent paper so that the medical folks can easily find it in your chart.
For your perusing pleasure, here’s a solid draft of my birth plan, liberally plagiarized from multiple sources, and inspired by my birth instructor, doula, husband, self, books, other ladies … (Some of it might be Greek to the non-birthing ladies, but if it is, frickin’ do some research if you get knocked up and make sure you know what all of it means! The knowledgeable woman is the empowered one!)
——-
We are so excited to have our child at Virginia Hospital Center. Our goal is to have a natural, intervention-free birth, and we respectfully submit the following requests as our preferred options for labor and delivery. We ask for your consideration of these requests as long as the health of both mother and baby permit. We trust that you will inform us in the event that any problems arise so that we may make a responsible decision together.
For labor and delivery, we request …
- Limited fetal monitoring after initial 20 minutes
- No IV (Heplock if necessary)
- Dimmed lights, as much privacy as possible, and a closed door
- Alternative methods of induction besides Pitocin
- Internal exams limited to one upon admission and one at transition
- Choice of positions for labor—shower, walking, squatting, etc.
- Ability to drink fluids and eat light foods during labor
- Gentle, guided pushing with warm compresses on the perineum
- Limited interventions (no episiotomy, vacuum or forceps unless necessary)
- Positive encouragement instead of pain medication
After delivery, we request that you …
- Place the baby on the mother’s chest immediately after birth
- Do APGAR tests there and place warming blanket over both of us if needed
- Delay cutting the umbilical cord until after it has stopped pulsing and turns white
- Delay routine procedures until two hours after birth to allow time for bonding
For baby care, we request that …
- The baby room in with the mother during her stay in the hospital
- The mother breastfeed immediately
- Our male child not be circumcised
- No Hepatitis B vaccine or eye medications be given
- The baby not be bathed until we request it
- The baby not be given any supplements, formula, pacifiers or glucose
———–
Anyone reading the above could totally agree with me or think I’m totally crazy! That’s why it’s up to you to complete your own plan — be prepared, know what you want, and get it down on paper.
The Bras You’ll Need for Pregnancy
Yes, this is a post about bras. It’s not going to be provocative or salacious, because maternity and nursing bras are none of those things. They can be reasonably pretty, but you won’t be left feeling terribly randy after putting one on.
First of all, as a pregnant lady, you’re going to have to accept that you’ll have to spend a little money on bras. And, if you’re like me, a chick who places a high premium on extreme comfort in the breast-y area, you’ll want to lay down a bit of change on a FEW very nice brassieres.
I said a FEW. I said NEED.
How many bras do you wear regularly? Before I got knocked up, I probably wore about three or four in a rotating basis, with a nice sports bra on the side. Vicki’s was my brand of choice, and I got a lot of those off Ebay (big shocker). At $20-$30 a bra, that totals $80-$120 in all. Not so bad. And since Vicki’s holds up so well, I don’t really buy bras but every two years or so. Right now, I’ve got all of those lovely ladies stashed away for thinner, less chesty times.
So how many maternity and nursing bras do you REALLY need? My answer: four is all you need, and a sports bra on the side. Seriously. Let’s see how we can do that for less than $120, since that totals my bra stash in “real” life.
1. You’ll need a sports bra. I did have one preggo friend who didn’t want to wear one, because you know, they don’t separate and lift. But trust me, there are some days when you’ll be all like, this is the only thing I can wear. At all. Seriously. (Seriously, ladies, your boobs will hurt at various stages in pregnancy.) Buy one in a couple of sizes larger than your favorite work out bra. I got mine at Target so I could try it on. I would suggest you do the same. I tend to like Champion — this looks like a good one, especially since it goes up to XXL. ($24 on Amazon.)
2. Next, you’ll need a nice maternity bra that lifts and separates. I tried A LOT of different kinds of brassiere — cheapies from Target, Playtex, Bali, Haynes, Barely There … but DANGIT, the absolute best thing ever was from A Pea in the Pod. I’m sorry to say it, I know it ain’t cheap, but that sucker is comfortable and it makes my bosoms look sexy. Here it is. I LOVE it. I wear it with all of my nicer dresses and work clothes, and the ladies at APIP helped me pick out the best size. It’s super supportive, very soft, and has a big supportive band in the back. I can’t recommend it enough. ($36 on apeainthepod.com)
3. For later pregnancy, you’ll want to start buying nursing bras, which let you nurse your kiddo in comfort. You might not start wearing them, but I sure started wearing this one when I found it. I love love love it. For later pregnancy, your bubbies will start growing a second time (they start growing for reals in the later part of your first trimester), and they’ll be a bit sore. Get this lovely brassiere, and you’ll want to wear it all day long, and it will hold over into your nursing stage. Fabulous. It doesn’t LOOK like it has a tremendous amount of support, but it does, and the it has … how can I put this delicately … it has … nipple pads … that keep your ladies looking … smooth. (Yeah that’s a problem in pregnancy you might not expect, but there it is, in heat and in the AC.) Those pads will come in handy when your milk comes in as well. So, hooray for this extremely comfortable purchase. Worth every penny. ($38 on apeainthepod.com)
4. And for those days at home, in pregnancy and in breastfeeding, you’ll need a lovely inexpensive sleep bra. This is comfortable, soft, doesn’t give a lot of support, but is essential for supporting when you’re chilling. And during breastfeeding times, you’ll need one of these to sleep in since you’re boobs will be all over the place and producing some unpredictable fluids at unpredictable times. I got the Medela Sleep Bra, and I enjoy chilling in it. It’s not fabulous for going out out, but it’s fine for the grocery, or Babies R Us, or a walk in the park. ($17 on Amazon)
Hey yo! That’s $115. I did pretty good. And remember, you’ll get some use out of these for a year or so, and if you have a second bambino, two years. Can’t argue with that!
Tips:
If your budget is tight and you don’t want to spend all at once, then don’t! I lived on the APIP maternity bra, the sports bra and a couple of my old Vicki’s for months, until the Vicki’s weren’t cutting it any more.
Do splurge. I swear. Just splurge on those two bras, and you’ll be set. Honest.
I don’t recommend going on the cheap, particularly for nursing bras. I did buy a couple of Playtex nursers at the Leggs Haynes Bali Playtex outlet (of which there are many in the world), and after wearing them a few times, I can attest that they dig into my skin and leave red marks on me at the end of the day. Those clips that let your boob free? On the cheap bras, they’re ugly, crappy plastic and poorly placed. They HURT. Like heck. Not cool. When you’re nursing and want a really nice bra, get this one instead of a cheap two or three.
Get measured! Don’t GUESS what to get. And go in the store and try them on! The only one I ordered from the online was the sleep bra.
Sorry, I don’t recommend the Bravado line. I find that they have stiff feeling material, and they dig in the skin. Not cool. And they are more expensive than APIP bras, believe it or not.
I won’t comment one way or another on Motherhood Maternity bras. Try them on, but see if they are comfortable. Walk around in one for a day with the tag on so you can return it if you need to. I really don’t like any of their other stuff though, since it has poor fit.
Don’t overbuy! You don’t need more than four. Wash often, hang to dry, and keep them nice.
Buy them in nude. Nude works with everything. Don’t bother with white or black. Nude it is.
And that’s it … I’m going to try to roll with what I’ve got for nursing, so we’ll see how that works out. I might have to get maybe one more, but that’s all. And I’m done.
Orientation at the Birth Center
After six months on the waiting list, I finally got a call from the only freestanding birth center in Northern Virginia. (For those of you who aren’t yet birth geeks like I am, a freestanding birth center is a building not connected to a hospital, where you can give birth, attended by only nurse midwives. There are birth centers connected to hospitals as well … but anyway, this is not that.) They told me that I would soon move off the waiting list. The lady on the phone hesitated when I asked if I could come to the next orientation, acting as if I might not want to do that since I could remain on the waiting list. I said I’d come anyway, and so the husband and I went this past Tuesday evening.
It turns out I’m glad we did. Because it turns out it wasn’t all that we expected.
When you first walk into the freestanding birth center in Northern Virginia (I won’t name names, but it’s easy peasy to find on the online), you realize it’s like a lot of other businesses in the Old Town Alexandria area: it’s a converted older townhouse or office building that was probably first built sometime way back in the day. The air conditioning was not fully suitable for the hot, hot day, and my belly started to tighten in Braxton-Hicks contractions some time after we sat down. The furniture was older and dingy, and it didn’t quite seem clean in the downstairs area — not that it wasn’t, it’s just that older buildings give you that sense sometimes.
Everyone who came in was given a folder with brochures about the center, and a long list of medical reasons that can “risk you out” of giving birth at the center. First red flag. These factors include, but are not limited to: breech presentation, carrying multiples, anemia, previous stillbirth or missed miscarriage, previous c-section, being older than 40, post date pregnancy (after 42 weeks), decreased fetal movement, or “any other significant condition which exposes the client or the baby to increased risk,” which really, could be … anything. Most likely a prolonged labor. Risking out? What does that mean? That means at week 36 or whatever, or during your labor, they send you on to a major hospital down the street to be handled by a doctor you’ve never met. How often does this happen? 10% of the time during labor (!!!), and the midwife was majorly vague about telling us how often it happens BEFORE you go into labor. Probably a lot given the list of things that could risk you out, or automatically risk you out.
When the orientation started, there were 20-25 people, mostly well-dressed Nova couples, one hippie couple in homemade clothes, and a couple of single ladies. The range of pregnancy was from just found out, to totally about to bust (me). The midwife who led the orientation gave a brief overview of the center, conveniently skipping over review of the risking out business. But a lot of us had already noticed. The presenter went through a lot of the advantages of birthing at the center, heavily relying on all the things that are great about natural birth to carry her point. (It’s empowering, you can breastfeed immediately, you get an endorphin high, it’s awesome, la la la.) The actual advantages of giving birth at the center seemed to be that you get a midwife and a birth assistant rather than a doctor and nurse. And your appointments last 20-30 minutes instead of 5-10.
Cool enough. I like to chat about my pregnancy. But did it sell me? Not quite. What’s wrong with that equation? Well, you see one of each of six midwives when you go, and you give birth with whomever is on call when you get there. Doesn’t matter if you don’t like her, or she doesn’t remember your name, or you wanted someone else. Sounds an awful lot like my first doctor’s office, where you see one of six docs or a midwife, and you give birth with whomever is on call.
Then there were questions. And continued dissatisfaction. (Note: responses were edited in my own brain’s sarcastic tone of voice.)
- Are most women risked out because of prolonged labor? Yes.
- That’s one in ten women? Yes.
- What are the stats on women who get risked out before labor? I don’t really know. Next question.
- What are the statistics for maternal and infant mortality? About the same as the hospital, but not quite. I won’t really tell you.
- I see you only have two beds. What if three women show up at the same time? Well that doesn’t really happen that often.
- But what if it does? Well there’s a futon in the office. You can hang out on the futon. But it doesn’t happen very often.
- What if two women want to use the jacuzzi? One of them just has to wait. But it’s very rare that two women would be here at the same time. (My mathy husband figured out that the chances are 1 in 6 that two women would go into labor on the same day.)
- Why can’t you give birth in the tub? Is it illegal in Virginia? Um, I don’t think it’s illegal in Virginia. But it’s not safe since the baby could drown.
- It’s legal in Tennessee. Don’t they do it at the birth center in DC? Um, I don’t know. Next question.
- Are the birth assistants all doulas? No, but they have doula-like experience. (WTF does that mean?)
- MY question: So do I have to use one of your birth assistants? Or can I use my own doula? We’ve already paid her. I’m sorry, no, you have to use one of ours. The birth assistants here are trained to clean up. And your doula wouldn’t know how.
- MY follow up comment: But no one told me that when I first got on the waiting list. I paid my doula at 20 weeks. Sorry, no exceptions.
- MY follow up comment, as I walked out of the door: We’ll be going with Virginia Hospital Center. I have some feedback for you. In the future, please tell clients to come to orientation when they get on the waiting list, or tell them not to hire a doula before they come here. Hmm that’s interesting.
We did take a tour. And the jacuzzi is super nice. I mean, really primo. But the bedrooms look like “the motel of your dreams” (quote: Eric), and they don’t really look big enough for a laboring woman, midwife, birth assistant, and significant other. Not to mention parents or friends if you want them there.
Why is it like this?
Oh! I can answer. It’s because of this wonderful thing called malpractice insurance. The midwives have to pay it out of the wazoo to keep their birth center alive. So, new furniture and more beds take a backseat to packing in as many clients as they can manage (up from 20 to 30 women a month), and malpractice insurance stays a whole hell of a lot cheaper when you risk women out to the hospital for any variation of a normal pregnancy. I mean, you don’t get sued and lose your license for being too cautious (which is why c-sections run rampant in this country to begin with). If there’s any risk, you get sent to the big hospital. Sorry, see ya.
Why did I decide to peace out?
Well, besides the fact that our doula is selected and paid for (and we love her), I figure it’s just as, if not MORE likely, that I’ll have a natural birth at Virginia Hospital Center than at the birth center. Why? I’ve done a lot of research and picked out a doc who is friendly to natural childbirth. Besides that, he’s the head OB at that hospital, and works only with other docs whose kids he’s delivered, all of whom are friendly to natural childbirth. He strongly recommends a birth class, reviews your birth plan with you, and talks through your plans in the five minutes he spends with you. Besides that? I’ve been seeing him for most of my pregnancy. He knows my medical history. And? And? He delivers twins and breech births naturally. He once let a woman push for nine hours. He tolerates prolonged labor. And when she said she couldn’t do it anymore? She got an expert c-section, immediately. And? He’s been doing this for 35 years.
There might be disadvantages to going to a hospital. But I’ll have my doula. The one I chose. And I’ll have a doctor who knows his stuff and is a good guy. His office is filled with pictures of him holding babies. My favorite pic is of him holding triplets.
I’m sure I’d get excellent care with a midwife. But better? Debatable.
The jacuzzi can wait. I’ll hang out in the shower. I’ll tolerate the fetal monitoring. I’ll risk getting a nurse who is not natural-friendly. And next time, we’ll probably do it at home — forget the center.
I got a call yesterday telling me I’m off the waiting list, and the birth center would love to see me for my first appointment. Too bad. I like to do things on my own terms, and it seems like the hospital is a better choice for that right now.
The Essential Pregnancy Library
As a pregnant lady, you may be interested in getting some good books. I mean, the internet just doesn’t cut it. And as I said, a lot of those sites end up with a bunch of scary comments about miscarriages and illness. I have known of pregnant ladies who stay away from reading any books or sites, but as you might have guessed, I’m not really that type of person. In fact, I highly recommend reading a good selection of books — but you don’t need to go overboard.
You’ll need …
A great reference book. I totally do NOT recommend What to Expect When You’re Expecting. It’s not written by doctors, and it just kinda tells moms to avoid every little thing possible. It’s information light, and condescension heavy. Instead, I highly recommend the Mayo Clinic Guide to a Healthy Pregnancy. This book is a true treasure — if you only buy ONE book for your pregnancy, this is really the one you need. It is divided into three sections — pregnancy, childbirth, and your newborn. It’s written by health care professionals, and has a non-conversational this-is-what-you-need-to-know kind of tone. It provides information on every option for pregnancy and labor, has charts for when you should call the doctor according to the week of pregnancy, and it tells you what to do with your newborn once you get it home. It’s well organized, well laid out, has lots of great information, and it will help you chill out when you perceive a potential problem.
For natural birth planners, you’ll need: Your Best Birth by Ricki Lake and Abby Epstein. Ricki Lake — she’s at her least ridiculous in this book — and Abby Epstein are the minds behind the eye-opening documentary, The Business of Being Born (available on Netflix instant). (I recommend this for natural birthers as well.) This is the companion book, which details why pregnancy and childbirth are treated differently in the U.S. than in other countries, and it tells American mothers about all of their options when it comes to their own births. Ricki and Abby both tell their own birth stories in Your Best Birth, all of which are vastly different experiences (hospital birth with an epidural, home birth with no medication, and an emergency c-section). The best part about this book to me was the lists of questions to ask your doctor, midwife, hospital, and doula. They also go over how to write a birth plan and the things you may want to include. A quick, easy, fun and thoroughly informative read!
For the natural birth planner, you’ll also want to read … Ina May’s Guide to Childbirth. I’ve already written a full review of this fabulous classic, and yeah, I still think it’s pretty much the best thing ever. Ina May Gaskin is a total badass — a rogue, self-trained midwife who started her own birthing center at a commune in Tennessee. This book is her guide, her philosophy, and her experience. The best thing? The first third of the book is written by her patients, giving glimpses of their positive, natural birth experiences. Then, Ina May details all of the different ways and methods to cope with labor — particularly the more difficult labors. She is unflappably calm and amazingly creative, and gives you a lot of ideas to hold in your personal labor arsenal. For example, if you open your mouth during pushing, you’re less likely to tear. If you’re muscles are tight, and someone rocks you back and forth, you’re more likely to relax and have it easier. And you get to read Ina May’s amazing statistics for her commune birthing center at the end. Also, it’s well written and has a good sense of humor!
For coping with labor pain in a natural way, check out: Birthing from Within by Pam England and Rob Horowitz and Hypnobirthing by Marie Mongan. Both of these books are designed around a “method” to deal with labor, so you may want to choose one ore the other. However, I think checking out a little of both is important because it gives you a chance to gather more tools for your labor arsenal. Birthing from Within does have some wacky stuff about creating birth art to express your fear, which I’m not really into, but some people might find cool. What I really liked about Birthing from Within is the varied methods of coping with pain and the suggestions for how to cope with post-partum stress. Hypnobirthing has a lot about the history of childbirth, and it explains the self-hypnosis methods for dealing with labor. It has a great deal of wonderful information about pregnancy, and it explains meditation you can practice and use during childbirth. Also very well written and engaging. Highly recommended!
Breastfeeders will need … A good breastfeeding book. The Womanly Art of Breastfeeding By La Leche League International comes highly recommended. It’s the one I have, and there’s a ton of great information in it … but … it gets a bit preachy. If you are someone who knows you’ll get cranky at super preachy breastfeeding dogma (i.e. “There’s no such thing as not producing enough milk. If you’re not producing enough milk, there’s something wrong with you.”), then don’t get this one. I haven’t checked any other ones, but The Nursing Mother’s Companion comes highly recommended as well, and I would definitely give Ina May’s Guide to Breastfeeding a good try since Ina May pretty much rules.
Everyone needs … Baby Bargains! As you know, I totally support Baby Bargains. The authors claim they’ll save you lots of dough when buying your baby gear, but I’m not sure if that’s the main benefit of this tome. The main benefit? I found out about everything available on the market, got familiar with brands, and got good ideas for what I needed and didn’t need. From this book, I got the crib recommendation that led me to choose Westwood, the idea to purchase the Arm’s Reach Mini Co-Sleeper, and the suggestions as to what brands to include on my registry. That said, the authors, Denise and Alan Fields, are parents and not consumer reports experts. It’s also good to get opinions from other sources — I choose friends and family, and Amazon reviews!
And if you’re interested in a book for your partner … Get The Birth Partner by Penny Simkin. This is the to-go reference for the person in your life who will be supporting you through labor — significant other, friend, mom and dad … etc. This has all the information that that person can tell you throughout your pregnancy — exercises, health, nutrition, and all the stuff they can tell you about labor while you’re in it — medical interventions, options, and positions, and what you can expect after the birth — how to identify postpartum depression, how you can be supported in breastfeeding, and how to clean your baby. It’s good for that person in your life to have all the info. As much as you can cram in your brain, you won’t remember all of it, and it’s good to have someone there to remind you and make sure you’ve got what you need.
I’ll have another addition after Sam is born — the best books for having a baby!
Things You May Not Have Heard about Pregnancy and Childbirth
The media portrays pregnancy (and childbirth, for that matter) in a very particular way. My advice is to trust none, or quite little, of what you see on television or in the movies. There are a lot of things that are partially accurate (you may puke in your first trimester, you may swell in your third), but there’s a lot you don’t see.
There’s a lot about pregnancy that you will not expect. I can by no means cover all of it here, but these are just a few of my experiences …
1. Nausea, food aversions, and strong reactions to smells may bug you throughout your entire pregnancy. Though I am not as ill at the thought of food as I was during the first thirteen weeks of my pregnancy, I often catch myself getting nauseous at the thought of certain foods, and I find myself very particular about what I eat. Don’t get me started on smells … that has stuck with me throughout the entire pregnancy. I can’t handle the smell of someone chewing minty gum, and I almost upchucked at the waft of a banana a couple of weeks ago. Of course, it’s not nearly as bad as it once was, but my system is still very different than it was before I got pregnant. As you may have expected, heartburn runs rampant any time it wants to.
2. You may not have a natural “glow” during pregnancy. At least I haven’t noticed any. In fact, my skin has gone oily and sticky, and my high school acne has returned. I definitely have to wash my face twice a day. Oh, and my hair looks exactly the same as it ever did.
3. Not all ladies vomit during the first trimester. According to Women’s Healthcare Topics, 75% of women experience nausea or vomiting. See the “or” in there? Not everyone hurls. I never did until I got a stomach virus in my second trimester. I got quite nauseous and even lost weight because of it in my first trimester, but the content of my stomach never expelled itself. So please, don’t worry if you don’t have vomiting. Don’t even worry if you don’t have nausea — you may be in the lucky 25% (hey, that’s like a lot of people) that never experiences it to begin with.
4. You might grow OUT of some of your maternity clothes. Now this one … this really gets to me. I haven’t gained all that much weight, but I swear to you I can’t fit a couple of the things I bought at the end of my first trimester. Remedy? Think about HOW you gain weight. If you gain it through your hips and legs as I am wont to do, you might want to purchase a size up from what the size charts say you should buy. Be wise about what you buy, and don’t buy too much when you’re not all that big.
5. Your “water” most likely won’t “break” in one big rush. Your bag of waters, or amniotic sac, is the thing that holds your baby during pregnancy. It provides a safe, warm place for him or her to swish around. It’s like a saline solution in there, and when the sac breaks, it can drip out slowly, or come in several larger gushes. As in, it probably won’t all gush out on your shoes in the middle of the street.
6. Your water can break at any time during your labor — even during the stage when you’re actually pushing. Your water can break right as you start having a few contractions here and there — when the hospital is a long, long way off. It can break a good couple of days before you really go into labor. Or, it can break when the baby is on its way out. In the TV and in the movies, we see the water break just as the woman heads off to the hospital to start her labor in earnest. Which is really just not the way things work.
7. You don’t have to give birth lying down. Actually, you can push in a whole lotta different positions — hands and knees, lying on your side, or squatting. You can even do these things when you’ve got an epidural going on — you just have to be careful and get some support. If you’re interested in an epidural, but don’t want to push lying down, you can request a “walking epidural” from the doctor. This may not let you fully walk, but you can get some more mobility in order to move around some. What’s the advantage of trying different positions to push? Well, think about it. A baby can be lodged or stuck in lots of ways, and the natural way to get him to move around and get on out of there is to move around yourself. The lying down position can actually be counterproductive since you’re not using gravity to your advantage. Take note and take charge!
There are a ton of other stuff as well, I’m quite and very sure! Anything you didn’t hear about pregnancy or childbirth that you’d like to share?
Best Paint for Pregnant Ladies
Hey everyone! I was just looking at my blog stats and saw that one of the more common searches that led people to my page was “best paint for pregnant ladies,” so hey, I give the people what they want.
The best paint for pregnant ladies is, of course, the lowest of the low-VOC, the paints that are qualified as no-VOC.
The paints that I have used are:
1. Benjamin Moore Natura — I got this guy mixed to match Glidden’s Fresh Guacamole for the nursery. The big advantage here is that you can get Natura mixed to match just about ANYTHING. Another advantage is that it has very little smell at all. Any paint sample you find anywhere? You can get it in Natura. The disadvantages are that you have to go to a Benjamin Moore store to get it, and it’s hella expensive at about 60 bucks a gallon.
2. C2 Lovo (available at Benjamin Moore Stores) — I used this for the master bedroom (in Potato Leek) and the nursery closet (in Chelsea). The advantages are that it comes in lovely colors and that it has very little smell. Again, you have to get it at Benjamin Moore stores, and it runs 55 bucks a gallon. And it’s low-VOC, not no-VOC. But it’s worked well for us in a couple of places.
3. Freshaire — Now, this is the best paint of the lot, I do believe. Major advantages include: you can get it at your local Home Depot, it has a small but very nice selection of colors, and it’s way cheaper at 30 bucks a gallon. It’s not going to be your cheapest option (you have to buy higher VOC paint options for that), but it’s probably down there with the cheapest of the cheap no-VOC options. Oh yeah, and for a cheaper paint, it’s super high quality, thick, and goes on smooth. And with absolutely no odor that we can detect! The only disadvantage I can see is that the color options are limited and somewhat muted. As in, you probably won’t be able to find a bright, charming nursery color — but if your tendency is toward the more subdued, you may be in luck.
A paint I’ve heard about a lot but have not used is Mythic Paint, found at Lowe’s. Check it out! I think it may have more color options than Freshaire, so it’s worth a look.
Of course, many of you pregnant ladies won’t have occasion to paint, or may be totally freaked out by the idea altogether. I will say that the no-VOC is just that. It has no volatile organic compounds, which is the nasty stuff that can give you headaches (and if you drink it, it probably won’t be good for your baby). But there’s no reason to shy away from using the no-VOC paint. It’s an excuse to exercise your nesting instinct in your baby’s room, and perhaps in other areas of your home. It’s water based, green, and non-toxic. As for painting, go for it! Get someone else to get up on the step stool, and take care of your back since you’re up and down a lot during the painting process. And enjoy!
Welcome to the Savvy Mom Space
I’m a liberal feminist that believes that liberal, feminist ideals should gel with embracing your gender and motherhood (if that’s what you feel like doing). I support all kinds of moms and dads and parents. Oh and, although I totally love that natural vibe and not harming the environment, I supplement my organic milk and fresh fruits and veggies with the occasional Twix, the frequent Oreo, and the daily Coke Zero. I’m opinionated, not easily offended, and a loudmouth in person and on the internet. I am what I am. Welcome.
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