If a woman has enough difficulties with breastfeeding, sometimes it makes sense (depending on her and her situation) to consider bottle-feeding a baby instead. I realize that in saying that, I'm totally defying many authorities. Breastmilk is definitely best for babies, and if you have breastmilk to give, the thought of actually choosing another feeding method floods you instantly with tremendous guilt. But having milk (whether or not it is enough can be debatable) is not the only issue at hand. Sometimes other things need to be taken into consideration.
Anyway, if you are considering weaning, maybe you shouldn't read this. I would recommend that you call a lactation consultant or a La Leche Leader. Call a friend who has been successful with breastfeeding. Pray. Keep nursing until you know that you could not take it anymore. That's the only advice I could ever give on the subject, because anyone can tell that I'm no expert on breast-feeding.
But I am an expert on struggling with breastfeeding. I'm an expert at calling lactation consultants, reading websites, pouring through The Womanly Art of Breastfeeding, watching videos of the right way to latch your baby, buying herbs to naturally but gently battle intraductal yeast, weighing your baby way too much before, after, and between feedings, looking at dairy with fear after a tough night of frequent wakings and green mucousy poopy diapers the next day, stepping on the scale and weighing 1/2 pound less than the day before (day after day) because you couldn't get enough to eat for another day, spending 40+ minutes per feeding stripping, changing, switch feeding, and working to wake your baby to make sure they feed better and get enough. I'm an expert at crying. Oh, I'm a bonafide guru at turning on the waterworks.
I could write a book about laying in bed in the morning after an exhausting night of feedings with your sweet baby tucked in next to you and thinking about the day ahead of trying to be a mother to four children in a house that's piling higher and higher with dishes and laundry. And while you have images of 40 minute feedings with your seemingly perpetually exposed breasts hanging out while your toddler is coming at you and the baby with large toys, you just think, "Please, let my heart stop beating right now."
But that's pretty unhealthy, isn't it? If you're like me, you might know what post-partum depression sounds like, and when you're wishing for a cardiac arrest it can be pretty alarming to you let alone to your husband and others. So, you might find yourself searching for something that can make the load you're carrying a little more managable.
And let's talk about breasts. Actually, let's not. I'm not a fan of mine. They've let me down way too many times with their lopsidedness and slow letdown and watery milk and sore, tender nipples and shooting pains during yeast infections that feel like a string is tied from your nipple to a place in your left shoulder blade and the baby is tugging on that string as they nurse. I've had enough of my breasts, and if I thought for a second that they'd do some good for someone else I would definitely post them on e-bay or something. Alas, this is only disturbing and is completely impossible.
A woman who weans earlier than she originally expected is on a horrible roller-coaster for at least a while. Hopefully, if she can have a healthy outlook on it, it can be a short while. But the mourning is there, because when the milk is gone, it's pretty much gone (unless you have the time, energy, and resources to invest in relactation - something I would have seriously considered with my first baby, but could not possibly now that I have four kids).
I would like to respectfully point out that most women I know who wean early (and earlier than planned) have really tried to explore all of their options. To say, "Exhaustion won over" is an oversimplification. Indeed, most have exhausted certain options, or at least, as we've accessed all of the solutions necessary (when there is more than one problem), we've concluded that the battle was more than we could manage with the other factors in our life. For some of us, weaning was the more sane option for us and our families.
I would like to humbly request that no one offer me advice on how to fix my breastfeeding challenges. If a woman says, "Breastfeeding didn't work out," please don't recommend that she rent a hospital grade pump. The use of past tense will likely indicate that the milk is gone already. Now if she says, "I don't think breastfeeding is working out," that's another story. If I were still nursing and reaching out (as I was last week when I blogged, called a ton of people, read a ton of literature, bought of ton of herbs, did a ton of nursing, etc), advice would be welcomed and appreciated. But now that I've decided to bottle feed and made that transition, it doesn't help me to look back and question my decision again and again.
The truth is, I don't even need help to question my decision. That's the toughest part of premature weaning - you question your decision for awhile. I've often found myself looking back for at least a few weeks thinking, "Maybe I could've pumped my milk? Why didn't I just do that? What a selfish person I am!" But then my mind plays through the scenario and I remember that part of the problem was the yeast, the fatigue brought on by continued lactation and food sensitivities, and I already had too many things on my plate as it was. So where was the time to pump?
Maybe just a few more weeks of switch-nursing, I've wondered? Maybe I just needed to wait it out, and then she'd wake up and start nursing better. But the baby had become such a weak nurser by the end, and again there were the other children to care for.
"Sooner or later it would've gotten better. She would've nursed better. My milk would've come back better. We could've beat the yeast. Or I could've breast and bottle fed." Unless the doctor declared the weight-gain was too slow, and do I think I could've handled several more weeks (or 60 minute feedings instead of 40 minute feedings)? (My 3rd baby was a very sleepy, slow nurser all the way through 2 months when I fell apart for all of the same reasons).
I don't even ask how will I bond with my baby, because the fact is, I didn't enjoy the nursing experience very much. I love holding and snuggling my baby, but I don't have to be topless to do that. And I'm such a stress case that every time my baby fussed for any reason, I was flooded with guilt and anxiety that she wasn't getting enough, it was something I ate, or a fear of, "Do I have to nurse again now?"
Please believe me, this is not meant persuade other women to wean or even to defend my choice to others. On the contrary, it's a heads-up that any woman who chooses too wean early (unless your own health issues make that decision for you or something) will be facing some more big emotions. So hang in there and give it your all.
If you end up where I've found myself, though, I pray you can forgive yourself quicker than I am. I hope you can quickly find a formula that your baby loves and thrives on. (Thank goodness, we've had some good, healthy, regular stools since we switched!) I hope that you can enjoy the benefits of bottle-feeding without guilt while rejoicing that you genuinely gave it your best effort and gave them the best start you could. Hold your baby close and snuggle them a lot while feeding them. Look into their eyes, and be sure to burp them well. :)
A good friend of mine (who loves nursing and does with little or no struggle at all) asked why I was afraid to quit nursing. She repeatedly said, "Enjoy your baby. If that means you can fix the nursing problems and enjoy it, do that. If it means bottle-feed, do that. Enjoy your baby."
It seems too simple, but since my breasts are mostly back to normal and the baby is content with the bottle, it's the advice I have to take now.
I can cheekily say this - if she follows suit like her siblings and is sleeping 12 hours straight at 4 months (or is down to one feeding that her wonderful father does), I will not be mourning anymore. ;)
Tuesday, March 9, 2010
Friday, March 5, 2010
The Last Great Marathon
I guess now is as good a time as any to describe my labor with this last baby, my 4th child and 2nd daughter.
First of all, I think that I should share my birth plan with you. Well, I won't share it word for word, but here are some of the requests I made in my plan (which I respectfully entitled my "Birth Requests" just to show I was level-headed):
-No IV or heplock unless medically necessary
-A quiet, peaceful atmosphere in which to labor with my husband
-Please don't offer medication. I will request it if I need it
-Only intermittent fetal monitoring unless continuous monitoring proves necessary
-No episiotomy unless there are signs of fetal distress during stage 2, and please allow me to try pushing harder if needed
Well, you get the picture. I wanted the most natural, lowest intervention birth necessary. I was convinced that the less intervention I had, the more I could relax and enjoy my labor.
The funny thing is, I'm not a very relaxed person. :) But seriously, I had never labored before without an IV and continuous fetal monitoring, and I was surprised at how much I'd come to depend on having a machine count my contractions and track my baby's heartbeat for me. It was so strange to have all of that freedom.
I guess I should backtrack and just describe what happened. As I stated a few posts ago, I was scheduled for induction on Wednesday, February 17. I was not excited about this. I knew that an induction would be a final farewell forever to my "dream birth." (Well, actually, my dream birth is a home tub birth, but oh well...) Anyway, I called the midwife on call on Tuesday the 16th and asked her what would really be the safest option for me. Should I a) just keep waiting to see if I start naturally soon and potentially go over a week past the due date, b) see if getting my cervix stripped could start me into labor so I wouldn't need a Pitocin induction, or c) just face the induction. Both she, the midwife on call (I'll call her Midwife C, my favorite in the practice) and the midwife scheduled for Wednesday were absolutely wonderful. I knew that with either one of them I could trust that I'd have their full support to labor as I wanted to. I knew that I wouldn't need to feel like I was auditioning - they wouldn't panic, even if I did. I was straight-forward with Midwife C about this, that I wanted either her or Midwife R (scheduled for Wednesday) to deliver my baby. I let her know that my comfort level dropped on Thursday with JB was back on call.
And frankly I was in pain. During those final weeks of pregnancy, my daughter's stretches and kicks weren't just uncomfortable - they were frighteningly painful. Her head was so low and hitting a nerve, and at times I would completely lose my footing and almost fall to the floor. It was sudden, sharp, and frustrating. I swore a lot in those weeks. Also, I felt a deep burning pain just behind my pubic bone (sorry to be graphic, but hey, it's pregnancy). I could tell that her head was right behind it, and walking was terribly comfortable.
I was ready to be done with my pregnancy, and I was willing to be induced on Wednesday if it meant a sooner birth and a better provider. Still, I wanted one last shot at a natural, low-intervention birth. So we agreed to have my cervix stripped. I hurried to the office, underwent the very uncomfortable procedure, and found out that I was dilated to about 5 centimeters. Midwife C was pretty hopeful that she'd see me later to have a baby. I was pretty hopeful too, but I had waited so long and had started losing faith in my body. So it was hard to relax or get excited (which I wanted to avoid anyway, because I feared that adrenaline would undermine any contractions that might start).
During the hours that followed, I experienced occasional, mild to moderate contractions. I'm not very good at timing contractions, though, so I couldn't tell you how far about they were. Besides, I was too busy doing other things. My sweet husband, hoping that we were set for a labor and feeling antsy about being at work when I might start quickly, opted to work from home that day. He helped out with the boys while I nested lightly and tried to stay mildly active without wearing myself out.
By dinner-time the contractions were stronger and a bit steadier, but I still hadn't gotten around to really timing them. They seemed inconsistent. I did start to feel, however, that I wanted to rest and relax through them instead of being on my feet. My husband cleared the table, called his parents to let them know that we thought we were probably starting, and worked on putting the children down for the night. At around 8ish, the contractions reached a new level, and I needed to use the bathroom. As I sat on the toilet, I noticed the faint smell of blood and looked down see a bloody show. It wasn't scary, but it was something new. I decided to step into the shower. This was probably it. Now I needed to focus on relaxing.
My husband checked on me in the shower, and I said that it was a good time to call his parents. He picked up the phone and found a voice message from his mother saying that his dad was on the way in case he was needed. He called her and let her know that the timing was perfect.
Now we packed the car and waited for my father in law, and suddenly the contractions started to slow down, though they didn't weaken at all. As I feared, excitement (even my mild, apprehensive excitement) was slowing the labor down. I shared with my husband that felt silly and wondered if we were moving too quickly. He said that he felt that it was the right time. We had prayed that we'd know when to go to the hospital, and he felt confident that now was the time. So we moved on.
In the car, I tried timing contractions (I'd done a little bit while resting - they were somewhere around 4-5 minutes apart). This time the contractions were stronger, but the position I was sitting in made them seem more mild. I can't explain, but I can tell you that I like to labor sitting up. :) I called the midwife, and the next contraction came about 3 minutes after the previous one had. She said that was timing she could work with and said that she looked forward to seeing us. (As I turned out, she delivered at least 3 or 4 babies that day!)
We arrived at the hospital and rode the elevator up to the labor and delivery unit. I was brought in to triage for 10 minutes of monitoring and a cervical check. I was hoping for 7 centimeters, but I was only at 6. Still, that was something. They don't usually send you home at 6 centimeters. While I was trying to find a comfortable position during the monitoring, the probe kept getting off track. (This should be a good reminder of why continuous monitoring can be such a pain. Too much movement makes for messy readings, and that can make people anxious). My husband and I were joyfully marveling at the steady chug of our daughter's heartbeat, which sounded like horses' hooves on a race-track. My husband made a joke and asked whether I was ready to deliver the race-horse that was with the baby, and I couldn't stop laughing. The monitor contractions showed some pretty spiky readings for the next few minutes from my belly shaking. Finally I was released from the monitor and brought to my room. I quickly used the bathroom, changed clothing, and started moving around. Then I decided to fill up the tub while my husband got our stuff from the car. I enjoyed sitting in the tub for awhile, where I noticed that the backpain which came with each strong contraction seemed to be muted somewhat.
It might have been wise for me to stay in the tub, but when my midwife visited and checked on me, I realized that I had no idea how far apart my contractions were and it was hard to tell how strong they were in the tub too. She suggested that I turn on the jets and see if the bubbles could stimulate the nipples and make my contractions get stronger. It worked like a charm. In fact, the contractions that came with the jets on were intense and almost scarily close. I went from what I am sure was 3-4 minutes apart to maybe 90 seconds to 2 minutes apart. It was erratic. I started to think that it would be wiser to get out soon.
I toweled off and proposed that we go for a walk. I was given a second robe to cover my backside, but after taking about 4 steps into the hallway, I realized that I was in no condition to walk. My contractions required rest.
I came back in and sat on the bed. I admitted that I was frustrated about keeping track of my contractions. The uncertainty was getting to me - I was so used to a machine doing the work and letting me know how far along I was. My midwife offered to check me and I accepted. I was now at an 8. The contractions, though somewhat inconsistent, were very strong. In fact, right after the tub, I had a couple of contractions that literally came immediately one after the other.
As I expected, the deep back pain which came with my previous labors was there again. This time it seemed stronger and more intense, and the fact was I was finding it very hard to really relax. I mean, ideally I should be on my side or slightly reclined and letting my whole body go. But the backpain seemed to intensify beyond anything I could handle when I was on my side. The only thing that I felt that I could handle was being upright. I was focusing on relaxing my lower body while I was propping myself up with my arms. It was crazy, I could tell. But at this point the contractions were too strong and too frequent to request a birthing ball or something.
Midwife C was so awesome. She just supported me through it and told me what a great job I was doing. I didn't feel judged for not being more relaxed or better prepared. I just worked through each contraction sitting up with her directly in front of me encouraging me. My husband gently massaged my back between contractions and pushed hard on my lower back during contractions. The burning was so intense. I focused on deep breathing and visualizing my uterus and my cervix. I could feel and see the muscles doing their work.
It was very painful. So painful. Painfully humbling, and yet I knew that I was in transition and that I was a matter of minutes before I'd be pushing out my daughter. I started to feel pressure and an urge to push even though my water hadn't yet broken. The midwife said that I could grunt a bit with the next contraction, so I did, and I was convinced that my water broke when liquid started gushing out. She looked and said that it was just urine, but then she reached in to check the bag of waters, and it burst immediately. I just started pushing at that point.
Now, for some reason I remember that when I was pushing my boys, I didn't feel a whole lot of pain between contractions. Something about the way my daughter was positioned made this much more painful, and I didn't really feel like I could or should rest and only push with contractions. There was intense pressure and that continued burning pain in my abdomen. Unfortunately, I was sitting so far forward that the baby wasn't going to progress in that position. She they got me slightly reclined back at a 45 degree angle, and I pulled me legs back and pushed with all that I had. I wasn't screaming, but I was moaning and wailing the whole time. It was a whole new experience.
The baby had really worked herself up into an interesting place. As I had suspected, her head was right behind my pubic bone, and the midwife was literally reaching up and pulling her head down (almost digging her out) to where she could be birthed. I just kept pushing, and thank goodness people reminded me to take some breaths and pace myself. As the baby started to crown, I felt that familiar sting and pull. But I had not opted for a mirror this time, and I'm glad I didn't. They announced that the baby was crowning, and I continued to push hard. Then my midwife yelled at me to slow down a bit. :) She want to save me from crowning. She told me to gently grunt the baby out, and I could hear here announce that the head was born.
Then I did something naughty. I pushed again. I could feel the rest of the baby's body still inside me, and the pressure was so strong and the burning so intense that I didn't wait for coaching. I just pushed, and her body slid out. I immediately felt a stinging sensation, though, that was too familiar - the feeling of a perineal tear. I knew it, but it was okay. The midwife had tried, and I was the one who didn't wait for coaching. Happily it was just a 1st degree tear again.
And there was this lovely little person on belly at that point. The fluid had actually been a bit yellow, showing slight signs of her having passed mechonium. But they examined her on my chest and suctioned her out a bit, and she was fine. She had ingested a bit, but not much. And she was pink.
And then she pooped on me. What a funny thing to have happen to you! Though, after having pushed a baby out, you really don't care that someone has pooped on you, especially when they are small and beautiful.
I was so amazed that she was there, and I tried to cuddle her. I was humbled by my pain, though. It wasn't in a way that made me feel cold toward the baby. It was just a deep, humbling ache in my body. And it was such a relief to have her outside of me for a change.
My husband and I were overjoyed. We were also tired. After the placenta was delivered (again, I was a little hasty and pushed it out before the cord even stopped pulsing - I just wanted to get everything out of my body!) and my tear was stitched up, the room started clearing out. My midwife had another labor to attend in the same hospital. My husband and I were left with our little one, and I offered her the breast. She latched on well (though I didn't do an amazing job making it a painless latch for her). She nursed both sides for awhile, and I immediately met a new pain - nipple soreness.
We really enjoyed our bonding time with her, but I have to admit that my husband and I hadn't realized until then how tired we were. I nursed her again, and eventually they took the baby down to the nursery where my husband assisted in and recorded the baby's first bath.
I was a bloody mess, though I did enjoy using the bathroom. It really is a great feeling to relieve your own bladder after a birth. I was transferred to our room, and soon my husband arrived with our cute little one with the round head and the slightly large ears. She's beautiful and sweet, and she's has a sensitive little soul. I can tell. I don't know if she'll eventually become as rowdy as her siblings are.
About the hospital stay: The staff was great, but hospital stays are so not restful. It seemed that every time I dozed off after awhile, someone came in for a blood-pressure check or to change the garbage. Some nurses were nice enough to turn off the computer monitor, but most forgot. I was glad to have three pillows from home to stack up around my head and block out the light.
So that was it. No painless birth for me, but that's okay. I didn't expect it. In fact, I think there was a part of me that wasn't willing to trust and give in to the labor until I felt that the contractions were truly painful. Then I could work at relaxing against them to minimize the pain. It might not be the smartest way to have a baby, but it worked for me.
And I'm so grateful to be done. No, I haven't had surgery. We don't yet know that it would prove necessary. Hopefully other reliable forms of birth control will be...well, reliable (and not detrimental to my physical or emotional health). Still, we feel that our family is complete.
And now we are in the throws of chaotic life with a newborn. She's lovely, but someday I want my bed back. And my breasts, and some sleep. :)
(Again, I think I'll post this unedited for now in case a curious friend is anxious to get the scoop. Thanks for reading!)
First of all, I think that I should share my birth plan with you. Well, I won't share it word for word, but here are some of the requests I made in my plan (which I respectfully entitled my "Birth Requests" just to show I was level-headed):
-No IV or heplock unless medically necessary
-A quiet, peaceful atmosphere in which to labor with my husband
-Please don't offer medication. I will request it if I need it
-Only intermittent fetal monitoring unless continuous monitoring proves necessary
-No episiotomy unless there are signs of fetal distress during stage 2, and please allow me to try pushing harder if needed
Well, you get the picture. I wanted the most natural, lowest intervention birth necessary. I was convinced that the less intervention I had, the more I could relax and enjoy my labor.
The funny thing is, I'm not a very relaxed person. :) But seriously, I had never labored before without an IV and continuous fetal monitoring, and I was surprised at how much I'd come to depend on having a machine count my contractions and track my baby's heartbeat for me. It was so strange to have all of that freedom.
I guess I should backtrack and just describe what happened. As I stated a few posts ago, I was scheduled for induction on Wednesday, February 17. I was not excited about this. I knew that an induction would be a final farewell forever to my "dream birth." (Well, actually, my dream birth is a home tub birth, but oh well...) Anyway, I called the midwife on call on Tuesday the 16th and asked her what would really be the safest option for me. Should I a) just keep waiting to see if I start naturally soon and potentially go over a week past the due date, b) see if getting my cervix stripped could start me into labor so I wouldn't need a Pitocin induction, or c) just face the induction. Both she, the midwife on call (I'll call her Midwife C, my favorite in the practice) and the midwife scheduled for Wednesday were absolutely wonderful. I knew that with either one of them I could trust that I'd have their full support to labor as I wanted to. I knew that I wouldn't need to feel like I was auditioning - they wouldn't panic, even if I did. I was straight-forward with Midwife C about this, that I wanted either her or Midwife R (scheduled for Wednesday) to deliver my baby. I let her know that my comfort level dropped on Thursday with JB was back on call.
And frankly I was in pain. During those final weeks of pregnancy, my daughter's stretches and kicks weren't just uncomfortable - they were frighteningly painful. Her head was so low and hitting a nerve, and at times I would completely lose my footing and almost fall to the floor. It was sudden, sharp, and frustrating. I swore a lot in those weeks. Also, I felt a deep burning pain just behind my pubic bone (sorry to be graphic, but hey, it's pregnancy). I could tell that her head was right behind it, and walking was terribly comfortable.
I was ready to be done with my pregnancy, and I was willing to be induced on Wednesday if it meant a sooner birth and a better provider. Still, I wanted one last shot at a natural, low-intervention birth. So we agreed to have my cervix stripped. I hurried to the office, underwent the very uncomfortable procedure, and found out that I was dilated to about 5 centimeters. Midwife C was pretty hopeful that she'd see me later to have a baby. I was pretty hopeful too, but I had waited so long and had started losing faith in my body. So it was hard to relax or get excited (which I wanted to avoid anyway, because I feared that adrenaline would undermine any contractions that might start).
During the hours that followed, I experienced occasional, mild to moderate contractions. I'm not very good at timing contractions, though, so I couldn't tell you how far about they were. Besides, I was too busy doing other things. My sweet husband, hoping that we were set for a labor and feeling antsy about being at work when I might start quickly, opted to work from home that day. He helped out with the boys while I nested lightly and tried to stay mildly active without wearing myself out.
By dinner-time the contractions were stronger and a bit steadier, but I still hadn't gotten around to really timing them. They seemed inconsistent. I did start to feel, however, that I wanted to rest and relax through them instead of being on my feet. My husband cleared the table, called his parents to let them know that we thought we were probably starting, and worked on putting the children down for the night. At around 8ish, the contractions reached a new level, and I needed to use the bathroom. As I sat on the toilet, I noticed the faint smell of blood and looked down see a bloody show. It wasn't scary, but it was something new. I decided to step into the shower. This was probably it. Now I needed to focus on relaxing.
My husband checked on me in the shower, and I said that it was a good time to call his parents. He picked up the phone and found a voice message from his mother saying that his dad was on the way in case he was needed. He called her and let her know that the timing was perfect.
Now we packed the car and waited for my father in law, and suddenly the contractions started to slow down, though they didn't weaken at all. As I feared, excitement (even my mild, apprehensive excitement) was slowing the labor down. I shared with my husband that felt silly and wondered if we were moving too quickly. He said that he felt that it was the right time. We had prayed that we'd know when to go to the hospital, and he felt confident that now was the time. So we moved on.
In the car, I tried timing contractions (I'd done a little bit while resting - they were somewhere around 4-5 minutes apart). This time the contractions were stronger, but the position I was sitting in made them seem more mild. I can't explain, but I can tell you that I like to labor sitting up. :) I called the midwife, and the next contraction came about 3 minutes after the previous one had. She said that was timing she could work with and said that she looked forward to seeing us. (As I turned out, she delivered at least 3 or 4 babies that day!)
We arrived at the hospital and rode the elevator up to the labor and delivery unit. I was brought in to triage for 10 minutes of monitoring and a cervical check. I was hoping for 7 centimeters, but I was only at 6. Still, that was something. They don't usually send you home at 6 centimeters. While I was trying to find a comfortable position during the monitoring, the probe kept getting off track. (This should be a good reminder of why continuous monitoring can be such a pain. Too much movement makes for messy readings, and that can make people anxious). My husband and I were joyfully marveling at the steady chug of our daughter's heartbeat, which sounded like horses' hooves on a race-track. My husband made a joke and asked whether I was ready to deliver the race-horse that was with the baby, and I couldn't stop laughing. The monitor contractions showed some pretty spiky readings for the next few minutes from my belly shaking. Finally I was released from the monitor and brought to my room. I quickly used the bathroom, changed clothing, and started moving around. Then I decided to fill up the tub while my husband got our stuff from the car. I enjoyed sitting in the tub for awhile, where I noticed that the backpain which came with each strong contraction seemed to be muted somewhat.
It might have been wise for me to stay in the tub, but when my midwife visited and checked on me, I realized that I had no idea how far apart my contractions were and it was hard to tell how strong they were in the tub too. She suggested that I turn on the jets and see if the bubbles could stimulate the nipples and make my contractions get stronger. It worked like a charm. In fact, the contractions that came with the jets on were intense and almost scarily close. I went from what I am sure was 3-4 minutes apart to maybe 90 seconds to 2 minutes apart. It was erratic. I started to think that it would be wiser to get out soon.
I toweled off and proposed that we go for a walk. I was given a second robe to cover my backside, but after taking about 4 steps into the hallway, I realized that I was in no condition to walk. My contractions required rest.
I came back in and sat on the bed. I admitted that I was frustrated about keeping track of my contractions. The uncertainty was getting to me - I was so used to a machine doing the work and letting me know how far along I was. My midwife offered to check me and I accepted. I was now at an 8. The contractions, though somewhat inconsistent, were very strong. In fact, right after the tub, I had a couple of contractions that literally came immediately one after the other.
As I expected, the deep back pain which came with my previous labors was there again. This time it seemed stronger and more intense, and the fact was I was finding it very hard to really relax. I mean, ideally I should be on my side or slightly reclined and letting my whole body go. But the backpain seemed to intensify beyond anything I could handle when I was on my side. The only thing that I felt that I could handle was being upright. I was focusing on relaxing my lower body while I was propping myself up with my arms. It was crazy, I could tell. But at this point the contractions were too strong and too frequent to request a birthing ball or something.
Midwife C was so awesome. She just supported me through it and told me what a great job I was doing. I didn't feel judged for not being more relaxed or better prepared. I just worked through each contraction sitting up with her directly in front of me encouraging me. My husband gently massaged my back between contractions and pushed hard on my lower back during contractions. The burning was so intense. I focused on deep breathing and visualizing my uterus and my cervix. I could feel and see the muscles doing their work.
It was very painful. So painful. Painfully humbling, and yet I knew that I was in transition and that I was a matter of minutes before I'd be pushing out my daughter. I started to feel pressure and an urge to push even though my water hadn't yet broken. The midwife said that I could grunt a bit with the next contraction, so I did, and I was convinced that my water broke when liquid started gushing out. She looked and said that it was just urine, but then she reached in to check the bag of waters, and it burst immediately. I just started pushing at that point.
Now, for some reason I remember that when I was pushing my boys, I didn't feel a whole lot of pain between contractions. Something about the way my daughter was positioned made this much more painful, and I didn't really feel like I could or should rest and only push with contractions. There was intense pressure and that continued burning pain in my abdomen. Unfortunately, I was sitting so far forward that the baby wasn't going to progress in that position. She they got me slightly reclined back at a 45 degree angle, and I pulled me legs back and pushed with all that I had. I wasn't screaming, but I was moaning and wailing the whole time. It was a whole new experience.
The baby had really worked herself up into an interesting place. As I had suspected, her head was right behind my pubic bone, and the midwife was literally reaching up and pulling her head down (almost digging her out) to where she could be birthed. I just kept pushing, and thank goodness people reminded me to take some breaths and pace myself. As the baby started to crown, I felt that familiar sting and pull. But I had not opted for a mirror this time, and I'm glad I didn't. They announced that the baby was crowning, and I continued to push hard. Then my midwife yelled at me to slow down a bit. :) She want to save me from crowning. She told me to gently grunt the baby out, and I could hear here announce that the head was born.
Then I did something naughty. I pushed again. I could feel the rest of the baby's body still inside me, and the pressure was so strong and the burning so intense that I didn't wait for coaching. I just pushed, and her body slid out. I immediately felt a stinging sensation, though, that was too familiar - the feeling of a perineal tear. I knew it, but it was okay. The midwife had tried, and I was the one who didn't wait for coaching. Happily it was just a 1st degree tear again.
And there was this lovely little person on belly at that point. The fluid had actually been a bit yellow, showing slight signs of her having passed mechonium. But they examined her on my chest and suctioned her out a bit, and she was fine. She had ingested a bit, but not much. And she was pink.
And then she pooped on me. What a funny thing to have happen to you! Though, after having pushed a baby out, you really don't care that someone has pooped on you, especially when they are small and beautiful.
I was so amazed that she was there, and I tried to cuddle her. I was humbled by my pain, though. It wasn't in a way that made me feel cold toward the baby. It was just a deep, humbling ache in my body. And it was such a relief to have her outside of me for a change.
My husband and I were overjoyed. We were also tired. After the placenta was delivered (again, I was a little hasty and pushed it out before the cord even stopped pulsing - I just wanted to get everything out of my body!) and my tear was stitched up, the room started clearing out. My midwife had another labor to attend in the same hospital. My husband and I were left with our little one, and I offered her the breast. She latched on well (though I didn't do an amazing job making it a painless latch for her). She nursed both sides for awhile, and I immediately met a new pain - nipple soreness.
We really enjoyed our bonding time with her, but I have to admit that my husband and I hadn't realized until then how tired we were. I nursed her again, and eventually they took the baby down to the nursery where my husband assisted in and recorded the baby's first bath.
I was a bloody mess, though I did enjoy using the bathroom. It really is a great feeling to relieve your own bladder after a birth. I was transferred to our room, and soon my husband arrived with our cute little one with the round head and the slightly large ears. She's beautiful and sweet, and she's has a sensitive little soul. I can tell. I don't know if she'll eventually become as rowdy as her siblings are.
About the hospital stay: The staff was great, but hospital stays are so not restful. It seemed that every time I dozed off after awhile, someone came in for a blood-pressure check or to change the garbage. Some nurses were nice enough to turn off the computer monitor, but most forgot. I was glad to have three pillows from home to stack up around my head and block out the light.
So that was it. No painless birth for me, but that's okay. I didn't expect it. In fact, I think there was a part of me that wasn't willing to trust and give in to the labor until I felt that the contractions were truly painful. Then I could work at relaxing against them to minimize the pain. It might not be the smartest way to have a baby, but it worked for me.
And I'm so grateful to be done. No, I haven't had surgery. We don't yet know that it would prove necessary. Hopefully other reliable forms of birth control will be...well, reliable (and not detrimental to my physical or emotional health). Still, we feel that our family is complete.
And now we are in the throws of chaotic life with a newborn. She's lovely, but someday I want my bed back. And my breasts, and some sleep. :)
(Again, I think I'll post this unedited for now in case a curious friend is anxious to get the scoop. Thanks for reading!)
Wednesday, March 3, 2010
Breastfeeding Blues
Breastfeeding is so hard for me. It just is.
This might sound surprising, since I'm such an advocate for natural childbirth. It would usually follow that I have a very optimistic outlook on breastfeeding. Indeed, I think that breastfeeding is a wonderful thing and something that every mom should give a concerted effort toward (or at least consider trying). That doesn't mean that I think it's easy.
When my daughter was born, I had two big challenges that arose in connection to my birth experience and breastfeeding: placental remains and having received antibiotics during labor. Actually, a third challenge that I attributed for years to the epidural was a sleep baby. Alas, I've had three unmedicated births now (yes, my 4th birth, which I promise to describe soon, was also a natural birth), and all of my babies have been somewhat sleepy eaters (though one was less than the others).
Anyway, after the baby came, I was very stressed, had inadequate (and pretty starchy and sugary) nutrition, and I quickly started to experience symptoms of yeast, though I was undiagnosed until the baby was 4 weeks old.
Wait. There is one more challenge which I've not admitted yet - I was extremely uneducated about breastfeeding. Even after having 4 children, I still feel like a novice. But I digress...
Anyway, I came down with yeast in my milk, and that made my already sore nipples even more painful. My daughter didn't actually latch on until day 2, and I didn't realize that it would have been wise to pump a lot in the first day. So I only pumped a few times. Then I didn't bring a pump home, which would have been wise as well, as my sleepy eater of a daughter wasn't so hot at stimulating my breasts to produce milk.
So the milk came in - not a ton, I'm sure, but a start. I nursed my daughter until she fell asleep, called it a feeding, and when she would quickly fuss for more, I would hesitate to feed her again. It was hurting.
Oh, I could go on and on, but it's a really depressing story, and I don't need depressing right now. Suffice it to say, I knew little, made a lot of mistakes, learned more, made fewer mistakes, and by the time I really understood what it would take to get my milk supply where it needed to be and to get my daughter nursing well enough to be nourished by me, it was too late. Having tried a supplemental nursing system for several days and ending up with my daughter and me in tears each time, I finally began to offer my daughter supplemental bottles to keep her gaining well. When she was six weeks old, she realized that she could be nourished by a bottle and no longer needed to latch on. At 8 weeks postpartum, my bleeding had continued, and it was discovered that, in delivering my placenta for me, the doctor had left some placental remains in my uterus. My body had never fully figured out that it wasn't pregnant anymore, and the prolactin levels had been insufficient for me to produce an adequate supply. Ironically, I still got a little bit of satisfaction in pumping what milk I until my daughter was 3 months old and adding it to her formula bottles. At 3 months, we had a family gathering that threw off my pumping schedule, and my milk never came out again. I had about a half a day of engorgement.
That first experience was painful, so when my second baby came and needed a quick transfer to the NICU, I immediately requested a pump. Until I was allowed to put my son on the breast, I pumped at least every two hours with one 4 hour stretch at night, and I gave myself an incredible start with a milk supply. Happily, my son was less sleepy than his siblings have all turned out to be, and he nursed pretty well. I still had soreness, but I passed quicker. We did have yeast, but it was quickly taken care of.
The hardest challenges I faced with my handsome son was that 1) he was very sensitive to any dairy I ate - so much so that his stools literally had blood in them, and 2) he was not a great sleeper. I was so determined to nurse him that I kept him in a swing for months to make his sleep schedule "bareable" for me, and by 4 months had never exceeded a 5 or 6 hour stretch of sleep in a night. He also usually followed a good night with two or three rough nights of nursing every two hours. It seemed that my body was so time sensitive that getting extra sleep and going too long was poison to my supply. But I could be wrong. It might just have been that his sleep quality in the swing was very poor, and he was accustomed to frequent night-time nursings.
Anyway, at 4 months I reluctantly weaned my boy, and my emotional and physical health changed literally overnight. It was a sad choice, but it was a blessing to my family.
With our third child, I had a sleepy eater on my hands. And though I had nursed frequently in the beginning, I had forgotten to do breast compressions and work hard to wake my son to feed well enough. My right breast immediately shrunk to half-sized as soon as engorement ended - the letdown was too slow for my little guy, so he hadn't drained the breast well. We eventually showed strong signs of yeast again, and this time I found it more difficult to erradicate (having 3 kids is really hard, by the way). Happily, or unhappily, he was a great sleeper, and I was so anxious at all times about my milk just going away, that I was wearing myself out with nighttime feedings (I would literally go in and feed my son in his sleep just to keep my milk up).
At about 8 weeks, my husband had a three day business trip. Right around that time, my son stopped napping well during the day and was demanding feedings every 90 minutes during the day. By the second day, I started offering him supplemental bottles. He loved it. Then I panicked and wanted to go back to just the breast again. So I tried to pump after each feeding to stimulate my supply back up. After less than a day of pumping, I was exhausted. My husband came home, and after some prayer and consideration (I was still fighting yeast, by the way), we decided to fully wean him to a bottle. He was happy, slept like a dream, and fussed very little. It took a few tries of formula (we didn't just start with the normal stuff, which turned out to be the best for him) to keep him regular. But - viola - he was a happy formula fed baby.
Here we are now with our 4th and final baby. I have milk for her, and I think she's doing alright. But I'm a little discouraged. Well, a lot discouraged, actually. I have cried me a river already. Her output has been great - at least 8 or more wets and 4-6 messy diapers a day. She lost at least 9 or 10 ounces (so many poopy diapers) in the hospital, and her weight gain quota was pretty big - at least 9 or 10 ounces in 12 days. Well, she hasn't hit her birth-weight yet, and she's 2 weeks old today. Sometimes I weigh her, and it looks like she's almost there, but then she'll have a wet diaper or a big bowel movement, or it'll be a couple of hours after a feeding, and she'll be a few ounces behind again. (I have a scale - I don't know that it's amazing, but it seems to work).
So, my point to all of this is, even if you've had a successful nursing experience before (I consider my handsome son's experience to be the most successful, and I attribute it largely to the great milk supply and his active nursing from the beginning), there is a lot to know.
So here's a link I found to a very helpful website. The information is so much better than that idiotic little booklet they give you at the hospital. I would encourage all to not make the mistake I made this time - which was to wait until after the baby came - to educate or reeducate myself on the breastfeeding. Read up on things now and learn how to get the best start you can so that you don't have to "fix" problems later on. If you can get your baby gaining and nursing well in those first few weeks, you have such a great start.
I haven't given up. She's gaining - more slowly than I'd like, but still gaining I think. We'll have to see what her doctor says. I believe we can do it (if I can just get enough calories and not DIE of stress!!). I wish you the best!!
P.S. I'll have to skip editing and let this be it's grammatically messy self. Must rest (or pick up a crying toddler).
This might sound surprising, since I'm such an advocate for natural childbirth. It would usually follow that I have a very optimistic outlook on breastfeeding. Indeed, I think that breastfeeding is a wonderful thing and something that every mom should give a concerted effort toward (or at least consider trying). That doesn't mean that I think it's easy.
When my daughter was born, I had two big challenges that arose in connection to my birth experience and breastfeeding: placental remains and having received antibiotics during labor. Actually, a third challenge that I attributed for years to the epidural was a sleep baby. Alas, I've had three unmedicated births now (yes, my 4th birth, which I promise to describe soon, was also a natural birth), and all of my babies have been somewhat sleepy eaters (though one was less than the others).
Anyway, after the baby came, I was very stressed, had inadequate (and pretty starchy and sugary) nutrition, and I quickly started to experience symptoms of yeast, though I was undiagnosed until the baby was 4 weeks old.
Wait. There is one more challenge which I've not admitted yet - I was extremely uneducated about breastfeeding. Even after having 4 children, I still feel like a novice. But I digress...
Anyway, I came down with yeast in my milk, and that made my already sore nipples even more painful. My daughter didn't actually latch on until day 2, and I didn't realize that it would have been wise to pump a lot in the first day. So I only pumped a few times. Then I didn't bring a pump home, which would have been wise as well, as my sleepy eater of a daughter wasn't so hot at stimulating my breasts to produce milk.
So the milk came in - not a ton, I'm sure, but a start. I nursed my daughter until she fell asleep, called it a feeding, and when she would quickly fuss for more, I would hesitate to feed her again. It was hurting.
Oh, I could go on and on, but it's a really depressing story, and I don't need depressing right now. Suffice it to say, I knew little, made a lot of mistakes, learned more, made fewer mistakes, and by the time I really understood what it would take to get my milk supply where it needed to be and to get my daughter nursing well enough to be nourished by me, it was too late. Having tried a supplemental nursing system for several days and ending up with my daughter and me in tears each time, I finally began to offer my daughter supplemental bottles to keep her gaining well. When she was six weeks old, she realized that she could be nourished by a bottle and no longer needed to latch on. At 8 weeks postpartum, my bleeding had continued, and it was discovered that, in delivering my placenta for me, the doctor had left some placental remains in my uterus. My body had never fully figured out that it wasn't pregnant anymore, and the prolactin levels had been insufficient for me to produce an adequate supply. Ironically, I still got a little bit of satisfaction in pumping what milk I until my daughter was 3 months old and adding it to her formula bottles. At 3 months, we had a family gathering that threw off my pumping schedule, and my milk never came out again. I had about a half a day of engorgement.
That first experience was painful, so when my second baby came and needed a quick transfer to the NICU, I immediately requested a pump. Until I was allowed to put my son on the breast, I pumped at least every two hours with one 4 hour stretch at night, and I gave myself an incredible start with a milk supply. Happily, my son was less sleepy than his siblings have all turned out to be, and he nursed pretty well. I still had soreness, but I passed quicker. We did have yeast, but it was quickly taken care of.
The hardest challenges I faced with my handsome son was that 1) he was very sensitive to any dairy I ate - so much so that his stools literally had blood in them, and 2) he was not a great sleeper. I was so determined to nurse him that I kept him in a swing for months to make his sleep schedule "bareable" for me, and by 4 months had never exceeded a 5 or 6 hour stretch of sleep in a night. He also usually followed a good night with two or three rough nights of nursing every two hours. It seemed that my body was so time sensitive that getting extra sleep and going too long was poison to my supply. But I could be wrong. It might just have been that his sleep quality in the swing was very poor, and he was accustomed to frequent night-time nursings.
Anyway, at 4 months I reluctantly weaned my boy, and my emotional and physical health changed literally overnight. It was a sad choice, but it was a blessing to my family.
With our third child, I had a sleepy eater on my hands. And though I had nursed frequently in the beginning, I had forgotten to do breast compressions and work hard to wake my son to feed well enough. My right breast immediately shrunk to half-sized as soon as engorement ended - the letdown was too slow for my little guy, so he hadn't drained the breast well. We eventually showed strong signs of yeast again, and this time I found it more difficult to erradicate (having 3 kids is really hard, by the way). Happily, or unhappily, he was a great sleeper, and I was so anxious at all times about my milk just going away, that I was wearing myself out with nighttime feedings (I would literally go in and feed my son in his sleep just to keep my milk up).
At about 8 weeks, my husband had a three day business trip. Right around that time, my son stopped napping well during the day and was demanding feedings every 90 minutes during the day. By the second day, I started offering him supplemental bottles. He loved it. Then I panicked and wanted to go back to just the breast again. So I tried to pump after each feeding to stimulate my supply back up. After less than a day of pumping, I was exhausted. My husband came home, and after some prayer and consideration (I was still fighting yeast, by the way), we decided to fully wean him to a bottle. He was happy, slept like a dream, and fussed very little. It took a few tries of formula (we didn't just start with the normal stuff, which turned out to be the best for him) to keep him regular. But - viola - he was a happy formula fed baby.
Here we are now with our 4th and final baby. I have milk for her, and I think she's doing alright. But I'm a little discouraged. Well, a lot discouraged, actually. I have cried me a river already. Her output has been great - at least 8 or more wets and 4-6 messy diapers a day. She lost at least 9 or 10 ounces (so many poopy diapers) in the hospital, and her weight gain quota was pretty big - at least 9 or 10 ounces in 12 days. Well, she hasn't hit her birth-weight yet, and she's 2 weeks old today. Sometimes I weigh her, and it looks like she's almost there, but then she'll have a wet diaper or a big bowel movement, or it'll be a couple of hours after a feeding, and she'll be a few ounces behind again. (I have a scale - I don't know that it's amazing, but it seems to work).
So, my point to all of this is, even if you've had a successful nursing experience before (I consider my handsome son's experience to be the most successful, and I attribute it largely to the great milk supply and his active nursing from the beginning), there is a lot to know.
So here's a link I found to a very helpful website. The information is so much better than that idiotic little booklet they give you at the hospital. I would encourage all to not make the mistake I made this time - which was to wait until after the baby came - to educate or reeducate myself on the breastfeeding. Read up on things now and learn how to get the best start you can so that you don't have to "fix" problems later on. If you can get your baby gaining and nursing well in those first few weeks, you have such a great start.
I haven't given up. She's gaining - more slowly than I'd like, but still gaining I think. We'll have to see what her doctor says. I believe we can do it (if I can just get enough calories and not DIE of stress!!). I wish you the best!!
P.S. I'll have to skip editing and let this be it's grammatically messy self. Must rest (or pick up a crying toddler).
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