Down syndrome is focus of new blood test for pregnant women

I thought this was a good, balanced article.

Down syndrome is focus of new blood test for pregnant women

The test (from a competing company) was supposed to be ready before I became pregnant with Teddy but was delayed. I understand and sympathize with the concerns many have about the non-invasive diagnostic test but am glad it's available, would have used it with my last two pregnancies (I had the far more painful, dangerous, and scary CVS instead) and would definitely use it if I became pregnant again. With my first pregnancy, I had amniocentesis.

Choosing to have Ellie was one of the most intense and defining moments of my life. In that moment - though I had already been pregnant and excited and preparing for months - in that moment I became a parent. I became an adult. Being Ellie's mom fills me with intense joy and devastating pain.

Similar states, of course, are common when loving and parenting any other child.

Announcing . . .

Theodore James
Born 3/25/11
Weight: 7 pounds, 13 ounces
Length: 22 inches

Mom and baby are doing great.

Ready To Go

The house is relatively tidy.
The bathrooms are clean.
The nursery is ready (and stocked with clothing).
The place the baby will sleep at first is also ready.
Oh, and I'm ready, too.
Except for . . . (is one ever fully ready for anything?)

You know you're in your ninth month of pregnancy when . . .

1. It's easier to get out of bed and lie down again than to "simply" roll over.
   
2. People point and laugh at your belly.
   
3. Other people express disbelief that you're not either overdue or carrying sextuplets.
   
4. Even your closest loved one deems your swollen extremities "unattractive." (Redemption comes in the form of foot rubs!)
   
5. Someone else's child tells you that you look "sorta fat."
   
6. Sleep with a newborn in the house seems more likely than sleeping through the night right now.

But I know that soon enough I'll be nostalgic for this time. Let this post serve as a lighthearted reminder to me of the good ole' days of pregnancy! And now I'm off to bed - just kidding, a lot of good that would do. I'm off to do a little yoga in hopes of restoring some circulation. Then bed!

Professional Model

A couple of weeks ago a friend emailed me asking if I'd like to participate in a photoshoot for a massage therapy textbook. She was in need of a pregnant model for the maternity chapter.

I agreed and we went back and forth a little bit. I was thinking: I like this friend, I want to help out, I like to maintain connections with my former employer (the textbook publisher), photoshoots are fun and it would be neat to be on the other side of one (rather than as the organizer), I like being pregnant, and, hey, cool, someone wants to take pictures of me! Plus, it was a paid gig.

Then I got a follow-up email that included information for all the models, including instructions on attire. "Female: Dark colored sports tank or bra and fitted shorts, or Tankini, without huge logos." Hah hah hah, she obviously didn't mean me; that's for the other (non-maternity) models. I emailed to verify, then packed an assortment of clothes. I figured I'd be in yoga pants or leggings with a tank top.

All those seasons I've watched of America's Next Top Model really came in handy. I knew what to expect and was prepared. I was on time, I had a variety of clothing options in various colors, I had a ponytail holder and comb in case those were needed (and they were). I enjoyed hanging out in the back of the room chatting with the other models, editors, massage therapists, and the author's son. I enjoyed the craft table. I liked the green room just fine. And I certainly didn't mind watching the model ahead of me as he worked (he was a very very fit young man).

The photoshoot was in a professional studio. We were set up in a large, concrete room, dimly lit with tables and cords stretched out all over the place, people clustered around the outside edges (mostly at the back near the door). One corner of the room contained a raised wooden floor with a massage table, a folding screen, and lots of bright lights. The photographer stood nearby, perched on a ladder overlooking the set.

All too soon, it was my turn to model. The author (and massage therapist) scanned through my clothing and then selected a plain black sports bra and maternity swim suit bottoms (basically, large shiny underpants). !!!

!!!

I changed in the green room, wrapped myself in a tablecloth, and headed out to the stage, still thinking that I'd mainly be on the table, "draped modestly."

Not so much. The author wanted a series of shots of the massage therapist greeting the pregnant lady then helping her up onto the massage table. Without the wrap. Are you imagining this scene?!

!!!

I had a moment to decide. I could walk out and leave them without a model. I could be a prima donna and argue for more clothing. Or I could just go with it and be a good sport. Again America's Next Top Model came to my rescue and that's exactly what I did. I dropped my drape, apologized for my cellulite, and cracked wise as I posed in front of friends and strangers in little more than my underwear.

The shoot went well, I think. I hope. And then . . .

"OK, we're ready for the husband, now."

Say what?

My "husband" came out of the green room, took off his boots, and climbed up onto the massage table behind me. The author placed a pillow between us to support my back (loved her a little bit right then) and asked me to lean back against him, relaxing. He reached around to rest his hands on my belly and both of our shiny silver "wedding bands" shone in the floodlights. The baby kicked at him and probably freaked the guy out.

We practiced relaxing and he "learned" how to position his hands to help me with backache in labor. Very soon, it was all over.

I never did catch his name.

One Born Every Minute

So there's a new Lifetime show called "One Born Every Minute" in which Labor-Delivery-Recovery (LDR) rooms at Riverside Methodist Hospital in Columbus, Ohio are fitted with fancy cameras to catch every moment and film is edited to fit specific episodes. There's no camera crew in the room, just the family and hospital staff plus a ceiling-mounted camera. I watched an episode entitled "To Medicate or Not? That Is the Question." The episode follows 3 patients from admission through delivery.

1) Woman comes into the hospital in early labor. Nurse hangs an IV of pitocin and promises an epidural when the pain kicks in. All just a matter of course, no requests from the patient for anything and no discussion of why pitocin might be needed for someone already in labor with unbroken waters and no apparent fetal distress. This is a medically managed birth.

But you know what? Pitocin is a serious drug. It can be seriously helpful at times. But it also has serious risks and potential side effects. It's really strange to me to see it just given routinely, without specific indication.

The nurse says, "Not that many women want to have a natural birth anymore, about 90% choose an epidural. It's a choice between feeling the worst pain of your entire life and not feeling anything, so it's pretty obvious what most women are going to choose . . . I guess it's just a personal preference."

Oh, sure, when you put it like that . . .

With the rest of this case, it's obvious that the mom is very comfortable with a managed birth experience. She wants IV narcotics and an epidural. She does not want to hold the baby until after she's been cleaned up. Her nurse asks her preferences and is supportive of the mother's requests. Healthy 9 pounds, 2 ounces baby girl.

2) Woman comes in who has had a previous large baby and is being induced because her physician is worried the second will be large, too. The (different) nurse questions the mother's decision not to have an elective cesarean section! But the mother does not want to have a surgical birth. The nurse says they'll break her bag of waters right away (this increases the pain of contractions and has other risks as well - including infection - but might speed labor) and asks about an epidural. The mother says she'd prefer to try to go without and expresses concerns about the drug's known side effects ("last time it really slowed down my labor"). The nurse replies, "Really?! Alright..." to the woman's request for no needle into the spine and says there's no problem with slowing down labor "if you time it right."

No implied judgment there . . .

The nurse continues to cast doubt on the mother's ability to birth this baby, saying things like, "unless he's too big..." and threatening that if her contractions stall out she'll have a c-section. I was happy when the second shift nurse came in; she was much more supportive.

But after a narcotics shot mom doesn't feel like she can do it without an epidural (no shame in that but it's too bad there was no one there reassuring her and telling her what a great job she's doing, etc.).

Unfortunately, after narcotics + epidural and lying flat on her back the baby's heart rate slows. Mom is too drugged and out of it to move over onto her side. She is freezing cold with chattering teeth and it is nearly time to push but she's pretty out of it. The doctor calls in for a c-section, saying, "I know it's scary and it's not what you want but I think it's probably safer for the baby." Healthy 9 pounds, 12 ounces baby boy.

3) Finally we have the "deliberate" couple who bring their birth plan (and a doula) and want a natural child birth. They sound really prepared, talking about cascading interventions, what's best for the baby, and mom wanting to challenge herself to see what she can do. (The parents met doing endurance sports.)

The nurses and admins at the main desk share many raised eyebrows and smirks at the mom and dad with their birth plan and shared moaning. "Oooopen..." The LDR nurse really wants to run the show and the couple (along with their doula) want time to make their own decisions. The nurse does push quite a bit, saying things like, "the longer you labor, the harder this is going to be," which probably puts unnecessary stress on the mother. The nurse wants continuous fetal monitoring and an internal contractions monitor (the former does not prove advantageous over intermittent monitoring and the latter increases risk of infection).

While offering his wife a drink of water the dad asks the nurse to be more positive (rather than saying things like, "well, she's probably dehydrated, which could be part of the problem"). (My question: what problem?!) The specially trained and very professional nurse midwife (which this couple has instead of an OB/GYN) is very supportive (though she's not in the room most of the time) even as the LDR nurse is pushy. "I'm really glad this shift is over," she says as she walks out, frustrated that the couple did not want her to "teach" them.

A little pitocin after 23 hours of natural labor to push the baby down the rest of the way work wonders and mom quickly delivers a healthy 9 pounds 2 ounces baby girl. She gleefully holds her baby right away and both parents clearly feel great about having the birth experience they wanted (annoying passive aggressive LDR nurse aside).

Disclosures. I've had two babies. My first birth experience was pretty natural in that my water broke in early labor, I labored at home all night, and went to the hospital less than two hours before giving birth. I was not given any pitocin, narcotics, local anesthetia, or an epidural. I did not have an episiotomy, forceps, or vacuum extraction. On the other hand, despite being completely healthy, hydrated, and in transition (almost ready to push) by the time I was admitted, by the time I started pushing I had an IV in my hand (just fluids, no meds), an oxygen mask over my face, a pulse oximeter clipped to my finger, and an internal fetal monitor in Ellie's scalp. It was a low-risk, routine delivery; neither of us had any complications or problems before, during, or after the birth.

My second baby was almost two weeks "late" so I was induced (at a different hospital, one closer to home). The pitocin contractions were indeed very different from the natural contractions I experienced with my first labor. I fought them for hours before asking for an epidural. (By that point I didn't care about ANY side effects, I just needed a break from the pain that never really went away, even during the "rest" period between contractions.) The epidural was awesome and I enjoyed the birth of my second child despite lying flat on my back with my legs strapped into stirrups. I had an IV, etc. etc. and the side effects of that were easily my least favorite parts of the experience. It was a low-risk, routine delivery; neither of us had any complications or problems before, during, or after the birth.

Both of my birth experiences were positive and had happy outcomes. But evidence does not support improved outcomes from so many of the routinely administered medical interventions in hospital labor and delivery. In Missouri there is only one free-standing birth center and it's across the state from me. (A local center is said to be coming soon.) Evidence supports the fact that freestanding birth centers are safe and have outcomes for mother and baby that are at least as good as births in hospitals (with much lower intervention rates). They're close to hospitals and can get patients in for surgery very quickly in the rare case of true emergency.

The U.S. has unusually high intervention rates and is behind 29 other countries in infant mortality. I feel so fortunate that the nurses I had at both of the hospitals where I delivered my first two babies were supportive of me and all my choices, unlike some of the clearly judgmental and prejudicial nurses I saw on One Born Every Minute.

Other quotes from the episode:

"You wouldn't go to the dentist to have a tooth pulled without being numb; why would you go and have a baby without an epidural?" (from a mom)

"No point in being miserable." (from a nurse)

Well, labor feels different for every woman (and every birth experience). For me, the natural contractions (as opposed to the pitocin ones) were hard work but far from the "worst pain I've ever felt in my life." Working with and through them was enormously rewarding and the endorphin rush afterward was incredible. Why do people run marathons? Why do people do anything that's challenging but also rewarding? It really is a "personal preference."

And - even more importantly - epidurals are also serious drugs (and a serious procedure) with risks and side effects for both mom and baby.

The show's editing and voice over (Sigourney Weaver) make the first labor - the most medically managed one - seem like the smoothest, quickest choice. (Obviously this is not always the case.) The tone with the "natural child birth couple" suggests that showering in labor is weird (no way; it's great!) and that thirteen hours of labor for a first child is crazy long. (Nope, not even average.)

But in the end - all happy parents, all healthy babies. So hooray for that. I've got lots more to say, but good grief I've been typing forever and I can't imagine anyone actually read this whole piece!

33 Weeks

In lieu of the post I was planning to write tonight about parenting a child with a disability, I will instead post an excuse.

I was clipping along through this pregnancy, measuring right on dates until 31 weeks when, bam! my belly suddenly measured in at 34 weeks. (This wasn't a huge surprise, I was well aware of my growth spurt.)

This week I'm at 33 weeks and am curious to hear what the doctor says.

Also, hooray for prenatal yoga!

You Can't Fight Gravidity

In July I could walk out my front door and run five miles without stopping. Today I walked two miles and think I might have overdone it a little.

You can't really complain about being pregnant. Heck, I practically apologize for it when I'm talking to a friend who's struggled with infertility or miscarriage. There are so many women who'd love to be where I am now, either because they can't get pregnant, have lost a pregnancy, or miss the days when they were pregnant. I absolutely get all that.

But pregnancy's not all wine and roses, either. (Actually, it's not wine and roses at all. Because people look at you with loud disapproval if you drink wine while visibly pregnant. And roses smell pretty strong. I can't handle scents like that in my current state.) Let's take a moment to contemplate the use of senses in that parenthetical and consider how I could have gracefully included "touch" to hit all five.

I've mentioned that I knew I was pregnant almost immediately due to nausea, exhaustion, intolerance for altitude (and onion rings) and intense craving for protein every couple of hours.

From there I moved on into worse nausea and exhaustion and protein cravings plus some fun bleeding issues. I gave up all types of exercise for napping and snacking . . . and still managed to lose nine pounds in just a couple of months.

I've since gained them back with interest and am fully enjoying my elastic waistband pants. But there are new joys for the third trimester.

Skin. Holy cow. Didn't I get large enough the first two times I did this? Heck, my belly's so striped I already look like a zebra (a really, really sexy zebra, obviously). But some days I feel the baby pressing off my spine and push-push-pushing against my abdomen. The skin stretches and burns and there's nothing I can do to soothe it.

"Round ligaments." I don't even know what that really means. I thought ligaments generally connected bones to bones. But I know what I feel and let me try to explain that. It's the middle of the night and I'm fast asleep. Then maybe my husband shifts on the bed or I take a deep breath or the baby rolls over or who knows what but my uterus gently begins to pull to one side. I wake up and I know what's coming. OH MY GOD SOMEONE'S STABBING ME IN THE SIDE WITH A STEAK KNIFE PLEASE GOD MAKE IT STOP MAKE IT STOP MAKE IT STOP. Nothing makes it stop until I find a neutral position - which varies, incidentally - and sit/stand/lie there shaking and whimpering for a several minutes as the pain gradually subsides to manageable levels. I also experience "round ligament pain" if I shift direction too quickly or do something unwise during the day like sneezing without getting into the proper position. These are modifications I've quickly made to my motor plans. But I can't figure out how to stop my uterus from shifting around inside me while I sleep. (No, the maternity pillow prop doesn't help.)

Heartburn. But only when I eat or drink anything I enjoy.

Extra body hair and skin pigmentation. But how much do you really want to know about me, anyway? Surely not nearly this much. So I'll leave out everything to do with the lower end of the digestive track and won't go anywhere near the "h" word for now.

Congestion. At the moment I'm recovering from a nasty cold. But I've felt stuffy since August. I wake up in the morning, eager to relieve the pressure in my clogged sinuses, but nothing comes out when I blow my nose. This is because of edema in so many of my tender tissues and is unrelated to bacteria, viruses, or allergies. It's all hormones, baby. My husband would say that I snore when I'm pregnant, too, but we don't believe him.

Edited to add: Relaxin. (Not to be confused with "relaxing.") My most pressing complaint at the moment has to do with the fact that my pelvis is spreading to allow the baby more room to escape. Have you ever slipped and fallen into the splits, straining your groin? I've felt that same sort of pain with every step I've taken for the past week or so. It's increasingly difficult to walk normally without devolving into a splayed-legs waddling but I will persevere!

Blah blah blah contractions, blah blah blah nothing fits anymore, blah blah blah I need to pee whenever I stand up or cough or have a funny thought, blah blah blah what's happening to my dainty little ankles, blah blah blah did my eyesight really just get worse blah blah blah is that my cervix attempting to communicate with me, blah blah blah those are tender, dadgummit, blah blah blah and so forth.

I enjoy being pregnant, I really do. And I am so fortunate to have experienced three healthy pregnancies. But I can't say I'm really sad (yet) that this is my last time.

Mom Jeans

I'm thinking of a new book idea along the lines of "You Might Be a Redneck." Mine would be You Might Be a Mom and would have sections like, "You Know You're an At-Home Mom When..." "You Know You're a Work-at-Home Mom When..." and "You Know You're a Mom of Multiples When..."

Today's entry:

You know you're a stay-at-home mom when you save getting "dressed up" in blue jeans for special occasions like going out for coffee with girlfriends.

The leggings I wore all day today (before shimmying into sexy maternity jeans) are very comfortable and would have been just fine . . . if they weren't simultaneously too baggy everywhere and yet too short to meet up with my socks. Alas. None of those features (the fact that they're leggings and I no longer have "long" shirts, the fact that they're too big, the fact that they're too short) disqualifies them from being part of my regular pants rotation.

In fact, I put them right back on when I returned home from book club.

Another Snow Day - No Hair Cuts, Please!

A snow day is not the end of the world, especially not on a day when only Ellie was going to be in school and we didn't have anything significant planned, anyway. The girls and I will stay home, bake something yummy, maybe go outside and shovel a little or build tiny snowmen. I plan to use my gravid state as an excuse not to pull children around on a sled.

One nice thing about (yet another) snow day is an excuse not to shower. Showering is dangerous! Children can leave the house, let other people into the house, join me in the shower, or cut off their hair. They are excellent at foiling "child-proofing" attempts. Fortunately I'm relatively clean already and I just had my hair done so none of me really needs washing.

The worst thing about a snow day is the lack of guaranteed nap. I know, all you working people are really feeling for me right about now. But by this point in my pregnancy, knowing that I get to lie down for 30 minutes in the afternoon really helps me muster the energy to get through the day. Everyone should be allowed to take a brief siesta, but for me it's nearly a necessity right now.

(When I was working throughout pregnancies and unable to nap in the afternoons, I'd come home from work, collapse on the couch, and be no good at all in the evenings. Once I even stopped a few blocks from home. I was too tired to drive the rest of the way without passing out on my steering wheel.)

I still think it's a little crazy to cancel school when a few inches of snow is forecast. Unless there's been half a foot of fresh snow since midnight and the roads are dangerously impassable - or unless you live in the deep South where there's inadequate snow removal equipment - I think a few inches of snow falling gradually throughout the night merits at most a few hours snow delay. I blame this trend on the litigious nature of our society. Why not?

Uncomfortable Dinner

Last weekend, after Paul ran a very cold 12.5 mile race, we treated ourselves to a nice pasta dinner out. Our neighbors at the next table were two elderly people and two middle aged people, one of whom was in a motorized chair and, apparently, wearing an adult diaper.

I was sympathetic, imagining this scenario: a middle aged person with a disability who perhaps couldn't completely care for himself, and older parents who could no longer care for him, either.

But on the other hand, my dinner was pretty miserable because the stench of bodily uncleanliness and an adult diaper that needed to be changed overwhelmed my sensitive pregnant nose. It wasn't just me being hypersensitive; Paul admitted later that he noticed the situation, too. (He was seated across the table and does not have a particularly sensitive nose.)

The party next to us were already seated when we arrived at the restaurant and sat to enjoy conversation after eating. We ate our dinner and skipped dessert while I took the kids to the car and Paul waited to pay.

I am sympathetic (and empathetic and concerned about the future of my own family). And certainly this family deserved an evening out at least as much as any other family. But at the same time I had a very uncomfortable time at a nice meal out that I, too, was looking forward to.

I'm comfortable with the way we handled the situation. The girls (thankfully!) did not complain or draw attention to the problem. I buried my nose in Paul's wine glass when necessary (after smearing a bit of menthol chapstick under my nose) and I did not need to excuse myself from the table. Perhaps we should have asked our server if we could move, but that would have felt really rude to me (in fact, writing this now feels rude to me).

But I'm wondering about the ethics of this situation. When we eat out is this sort of situation just a possibility of being out in public? Or do we as individuals have a responsibility to keep our aromas to ourselves? Certainly I've experienced uncomfortably strong perfume, smoke, and bodily aromas in public before (as well as parents who are none too prompt about changing their child's diapers). But there really is a difference, at least for me, between other strong aromas and those associated with bodily waste, at least when it comes to mealtimes.

Thoughts? Or am I just an insensitive jerk for asking?

Edited to add a link to Changing Places. If I can't walk - or stand - on my own, should I not go out in public? That sounds ridiculous, right? But when was the last time you saw a public restroom equipped with a hoist to handle lifting someone who can't lift him or herself? I don't think I have ever seen one.

My Costume

I already posted pictures of the girls in costume from last week's Boo at the Zoo, so today I'll share my own Halloween costume. Many thanks to Paul who handled the rather tricky iron-on portion of construction.



Ada is fond of putting her hand on the baby skeleton and introducing her little brother to all we meet. Ellie prefers pointing to individual bones and naming them. "And this is the collar bone . . . "

Handsome Is as Handsome Does

I've had some problems with this pregnancy.  I've been sick and I've had complications and it's just not been easy.  But I am feeling better this week.  Still, every time I think I can finally relax and just enjoy the second trimester, something alarming comes up.  And yesterday I spent a couple hours in the doctor's office getting checked out.  (Everything is fine. But notice how obscure I'm being just to avoid saying "blood" or "bleeding." Oops, messed that one up.)

I left messages for Paul and my mom after my appointment and ultrasound yesterday, letting them know that I'm back to "taking it easy" (which means avoiding many fun things) but that the baby looks great and I check out OK, too.

My mom texted back asking if her grandson is adorable or handsome.  I think it's a little early to tell, but you be the judge.  (For the record, he's right on schedule for four months along at a grand total of 8 inches long and 8 ounces heavy. And he waves at the camera.)

Announcement

"Sarahlynn, it's great to see you. You have a certain glow about you!"

This is how my OB/GYN greeted me at my annual visit this summer and is how I learned I am pregnant for the third - and, presumably, final - time.

Officially.

Because I'd sort of known for a couple of weeks already. I got suspicious when my period was late. But I was having fun on vacation. Until one day I ate some onion rings and my body revolted.

Then the altitude in Wyoming started really bothering me.

I tired quickly.

I grew nauseous if I went more than two hours without eating something protein-rich.

Then I was just exhausted and nauseous all the time, period, even after we returned to sea level.  The heat made me whimper and cower indoors.

And then I went in for my annual well woman visit and learned that I am a very well woman, indeed. And hopefully I will remain so until about . . .

April Fool's!

Jumping Through Hoops Sucks

"OK, fine, I'll have my baby at Big, Urban, Major University-Affiliated Hospital, rather than Closer-to-Home Extension Hospital within the same system. But only if I won't have medical students or residents poking at me."

"Oh, you won't be a teaching case. You have good insurance."

This is a representation of an actual exchange I had with my doctor while I was pregnant with Ellie. Because of her known and unknown medical conditions, the doctor wanted me to deliver in a hospital that had more support for higher-risk births. It was the right decision and I had a good experience with the hospital, although I did choose to have Ada at Closer-to-Home Extension Hospital, where I also had a good experience.

I've never had a problem getting the health care I need - with the singular exception of the short period between when I expired from my parents' insurance and the corporate coverage from my first job kicked in, during which time a UTI became a kidney infection. Nonetheless, one of the issues I've been watching this election year is health care. I think it's horrifying that so many Americans do not have sufficient health insurance, and I think it's exciting that there's a real possibility of addressing that issue in the near future.

Today, however, I had an experience that shook my faith in the prospect of the single-payer system, just a little bit. The story surrounding this experience is not mine to tell, so I will be a little vague.

A good friend of mine is a little bit pregnant. Today, she started cramping and bleeding, and she just knew that she was miscarrying. She was understandably distraught. Not knowing what else to do, but unable to sit around doing nothing but freaking out, she hurried over to her doctor's office.

Where we waited, and waited, and waited. The clinical medical assistants and nurses were wonderful, offering hugs and support but no false comfort. Eventually, an administrative medical assistant with, er, somewhat less bedside manner came in to explain that with my friend's government-sponsored health insurance - a plan she had no role in choosing as her government employer chose for her - she couldn't be seen as an obstetrical patient, let alone given an ultrasound or exam, without a referral from her primary care doctor. It's worth noting that she sees her OB/GYN at least annually for an exam and other gynecological care, but hadn't seen her primary care doctor in quite some time.

I called and pestered and cajoled, to little avail. Despite the insurance company's assurances to the contrary, and the primary care doctor's immediate action to call in a referral to the insurance company, no referral had been received by the OB's office when we left a couple of hours later.

Fortunately, they were eventually willing to proceed without the formal referral, after receiving a verbal referral from the primary care physician's office. An assistant had been on hold for hours with the insurance company by that point, trying to complete the process.

What if I hadn't been there to be the assertive bully? I have no doubt that my friend's medical office would be eventually taken care of her, but the whole process was horrible and excruciating and unnecessary.

The end result was good. The referral will come through, and my friend's insurance will pay for the medical care she needs. And she did not miscarry today. (I too had threatened miscarriages with both of my pregnancies. They're not uncommon, but that doesn't make them less scary.)

But we need to make sure that we fix a lot of the kinks in the current systems before we adopt them on a larger scale.

Still Growing Up

When I turned 32 last September, I liked vanilla and I had straight hair. I didn't believe in therapy.

When I turned 33 this September, I liked chocolate and I had curly hair. I think everyone could probably use a little therapy.

I wonder what changes this year will bring!

2006 hair


2007 hair

Afterward

They don't tell you . . .

They don't tell you that the weight you gain during pregnancy won't disappear immediately. They don't tell you that all the edema/swelling might take 2 weeks or more to subside, and that you'll sweat it out in bed at night.

They don't tell you about the hemorrhoids, except perhaps as a brief aside like this one.

They don't tell you about how your organs feel like they're sloshing around and banging into each other for a while. How you feel like you should hold your abdomen when you move, or perhaps invest in a snug girdle.

They don't tell you about the bleeding. Oh, you might hear mention of "the lochia." But they don't tell you that you could bleed through diaper-like giganta-pads hourly the first couple of days. They certainly don't say that you could still be bleeding 6 weeks later - 6 weeks! - and pads only, ladies. No tampons or anything else inside your vagina for those first 6 weeks. That includes bathwater, for those who like to bath and swim: you must wait.

No sex, either. But do you really want it?

Lack of sleep, bleeding, and hormonal vaginal dryness aside, at 6 weeks even relatively minor tearing will only be "about 80% healed." The stitching material won't fully dissolve for another month or so.

And your wonderfully sensitive doctor will give you the OK to resume "all normal activity," including exercise, tampon wearing, baths, and sex. If you're ready. Unless you'd like to wait some more. But it's OK with him - as long as it's OK with you.

So many disclaimers! Perhaps he's had patients laugh at the very suggestion. Or throw things at him.

Pregnancy is not for the faint of heart and neither is what comes afterward.

Senioritis

Remember that end-of-semester feeling, that just-before-break feeling, the way it felt the last weeks of high school after you'd been accepted into college?

I've been feeling that way for weeks. It was hard to concentrate - or care - at work. Lately, it's been hard at home too.

Paul has been feeling less motivated at work too. Every day, he thinks he's about to be called home to rush to the hospital, which keeps him from caring quite as much as usual about his work. He's ready for a 2-week "vacation."

My mom - expecting 2 grandbabies weeks ago - is feeling much the same way.

And now me . . . I've been impatient with Ellie's increased demands on me. I've been short with her. I've been trying to think about why, and this is what I've come up with.

I love her. I appreciate her need for cuddles and snuggles and reassurances, knowing that it won't be too long before I'll long for these days again. But this has been my life, unremittingly, for over 3 years. I'm actually looking forward to 2 days in the hospital, for labor, for time with a new baby, for family being here and taking over Ellie care - for a break from my life.

Well, all that plus I'm tired and sore and uncomfortable.

I have it much better than my sister, though. She's a week overdue herself, and has suffered for the last couple of months. She's got horrible edema - she's so swollen that she can barely operate her cell phone with her clumsy fingers. And her blood pressure is way high, causing vision issues and general fear and discomfort. She's showing no signs of being ready for labor (I'm talking about her cervix here, for those who care) so her doctor is reluctant to induce. She has regular blood work to check for pre-eclampsia and is on bedrest until she either goes into labor on her own or a c-section becomes much safer than waiting any longer.

One way or another, there should be two new babies in the family this week!

I was a little hopeful . . .

First, let me say that I acknowledge all the literature suggesting that we can't exactly determine due dates, and inducing for being post-dates is therefore problematic, etc. But in my case, I know when my last period was, I know the first day I got a positive test result, and I know when my first ultrasound was. I'm pretty sure about the due date of this baby, and I'm pretty sure that she's "late." Also, I'm pretty sure that she's physically mature enough to be born! Since Paul's sister was "two weeks late" and suffering from serious post-maturity syndrome, that's something that I'm watchful of.

I didn't start trying to have this baby until the day after my due date. Here's what didn't work last week/end:

• an "internal exam" by my large-handed OB
  
• spicy Mexican food
  
• ice cream with Splenda
  
• regular (like, nearly daily!) sex
  
• raspberry leaf tea
  
• milkshake with chocolate and Splenda (I think Splenda's lost its "magic" with me)

Yesterday, I was 41 weeks pregnant. I had another appointment, this time for a non-stress test, which I found quite stressful, ultrasound, and visit with the OB. The ultrasound tech kept commenting on the extreme chubbiness of my baby's cheeks. And how hard it was to get a measurement around her belly. Seriously! Come on out, big healthy baby! Her verdict? 9+ pounds. We'll see.

The OB gave me a slightly "vigorous" internal exam, which he says can help start things off. And he scheduled me for an induction at midnight next Monday night/Tuesday morning. Not for size, for post-maturity concerns. But he did wonder aloud if I'd be able to deliver a 9-pound baby (for the record, he thinks 9 pounds is the high end of the range, bless his heart). I think I can. My pelvis was made for this.

Right. So I came home, where Paul was putting Ellie down for her nap after working at home all morning so that he could be here to meet her when she got off the school bus (!!). And we had some really good sex, hoping that that, in conjunction with the internal exam, might move some things along. (Aren't you just thrilled to know this about us? Lucky you!) Then he went to work and I, blessedly, took a nap.

After nap, I played with Ellie and took her to music class, where I popped up and down like everyone else. Before dinner, I walked around the block. Later last evening, I did 50 jumping jacks, which really freaked Paul out. Then we walked around the block again. Before bed, I spent 30 minutes hooked up to my fancy electric breast pump. In bed, we tried some relaxation and visualization exercises.

"Imagine that big bag of muscles working . . . "

All evening, I was having contractions about 15 minutes apart. I was getting hopeful . . .

And then I slept. Alas. Now I'm off for a longer walk.

Shiver

Did you think my weekend silence might have indicated labor and delivery? Wrong!

It hasn't been all thumb twiddling, though. We did have an ice storm on Friday night. Ellie and I went to lunch with Paul at his office's cafeteria (they make individual pizzas on Fridays) and during the 45 minutes we were inside, the temperature fell from 60 to about 40. Overnight it continued to rain and get colder, so we awoke on Saturday to a fantastic wonderland, all the trees perfectly encased in gleaming ice, all the flags frozen stiffly in place.

Ellie enjoyed throwing the ice to watch it shatter on the driveway, brushing her unmittened hand against the frozen evergreens, and splashing in the puddles. It's been especially lovely because the ground hasn't frozen so it's not treacherous to get around. Branches and entire trees are falling everywhere, though. We've lost several branches from our trees, and lost power for a few hours yesterday. We are among the lucky ones; 60% of our suburb was without power this morning.

Paul and I often claim that there's not enough cold and snow around here, but it's also true that the beautiful ice storm we get nearly every January is a stunningly impressive part of the weather here that's much less common where we're each from.

So. Under 13 hours until my doctor comes back on duty. I'm thinking I can make it, given my lack of progress over the weekend.

At church this morning, everyone was surprised to see me. The woman who usually sits in the pew behind us has been asking me "how many weeks do you have left?" since my 20th week. Last week she commented on my plaid jumper, and this week she just looked at me and threw up her hands. I used to be annoyed by this; now I think it's funny. Really, without a sense of humor, what do I have?

I'll be laughing especially hard when I deliver a 7 pound baby instead of the 10 pounder that everyone seems to be expecting.