Friday, August 28, 2009

Forking Peas

Violet has had considerably more success of late with using utensils during meals. She's moved on from the shoveling motion of the spoon to the more intricate stabbing of a fork. Not quite chopsticks, but still.

The dulled tines of her toddler fork were no match for the peas, however.

Tuesday, August 25, 2009

Fool Me Once...

Almost every woman loves to tell her birth story. Whether her labor began during American Idol and ended before the evening news or lasted for days on end, it is a story worth telling. The end result--a precious, hopefully healthy, baby--makes it instant family lore and a tale that will be repeated as long as women gather and share their experiences. So having a birth that was a bummer, is, well, a bummer.

Before I get reprimanded, let me emphasize that I know the point of pregnancy and birth is a HEALTHY CHILD and god strike me down if I fail to be grateful for the soft, glorious, human that is Violet. I would have squeezed her out of my nostril if that was what was asked of me and would sleep in a box of live mice every night if it would keep her out of harm's way. She is my blood, my life, my sweet child, and she is far more of a blessing than I have ever earned.

That being said...

Violet's birth was, in hindsight, far from my ideal. My labor was induced at 40 weeks even and ended in a cesarean section. If I had had any idea what kind of parent I'd become prior to V's arrival, I might have done a little more planning, a little more reading, really brushed up on what kind of care and medical advice is being doled out in OBs offices and delivery rooms in the US these days. Had I known that my blind trust, my desire to meet my baby NOW, would have left a permanent mark on my body as well as severely limited my available choices for the rest of my childbearing years, perhaps I'd have thought more seriously about my decision.

And maybe that is why I feel cheated. It is not that I had some grand plan for natural childbirth when I went into this and maybe that is where I went wrong. I wanted an epidural if the pain became overwhelming. I got one long before the pain was too much; the nurse anethstitist must have been a GM dealer in a past life because he convinced me if I didn't have the epidural NOWNOWNOW he may be tied up with other patients and THEN WHAT?? It should have tipped me off when I got the feeling that the hospital was trying to sell me something. That's not why they're there, is it??? If I'd had that plan, if I'd researched my options independently, if I had felt that I'd given Violet's impending birth the study it deserved, maybe ending up with a C-section wouldn't have been such a kick in the ass.

The induction--yep--I wanted that, too. I was over 200 pounds, constipated, weepy, scared, eager, had hemorrhoids, couldn't breath, couldn't sleep, and had no realistic concept of time. The possibility of going 3, 7, 10 days beyond my "due" date was inconceivable. So when my OB offered to bring me in on May 12, the day that had been circled in red on the Pierce calendar for 40 weeks, I agreed and thanked her. And when she ducked out of the exam room leaving Shawn and I to schedule the induction for Monday morning, she even implored us, "If anyone tries to tell you anything bad about being induced, call me. It is perfectly safe."

And I trusted. And we induced. And I lay on my back or side for 15 hours, wearing a fetal monitor (external til noon, internal after doc broke my water), hooked to an IV releasing Pitocin into my bloodstream causing my uterus to contract, not that my cervix ever took note. So after a long day of fake labor, and a measly 3 cm of dilation, my Doc called the game on account of darkness, and wheeled me into the surgical delivery room, where I had the most miraculous experience of my life. Or at least Shawn did.

So, that's my story...and if it ended with that story, maybe it wouldn't be such a sore spot. But Violet's birth story is, I have every reason to believe, going to be only the beginning of my Cesarean saga. Since her birth, (I sure wish this sentence began "Before her birth"), I have read oodles more literature about birth in this country and seen how Violet and I were a part of that machine. ( I'll add some links to some of my favorite sites at the end of this post for those of you who are riveted.) I've realized that the medicalization of a wholly natural human process is taking us further away from our parenting instincts instead of empowering mothers to trust their bodies and listen to their babies. Since Violet was born I have realized how often I act on my instincts and her cues as I mother her and how that rhythm was disrupted when she was born. I've seen how far removed from natural human behavior so many of us are when it comes to our babies; whether it is the mother who lets her tiny baby "cry it out" despite her heart that aches at doing so; or the mother who had every intention of breast feeding her child but convinced herself that her body wasn't making enough milk because the babe wanted to nurse more frequently than the every 3 hours her pediatrician told her to expect.

I am so thankful that we do not live during a time when death was a common result of childbirth and I cannot say enough positive things about all the medical advances that have saved lives, both of mother and baby. But I do think that there is truth in getting too much of a good thing and that, while miraculous when necessary, medical intervention in the birthing process is detrimental when overused. And it is being overused.

Long story longer, I have been corresponding with my OBGYN (actually with her office manager), about the potential for a VBAC (vaginal birth after cesarean) when and if Shawn and I are lucky enough to get pregnant again. My OB is a young, hip, lovely, fashion forward, woman so, despite what I'd heard about most obstetrician's aversion to VBAC, somehow I thought she would be on board. Turns out, not so much. Below is her response to my inquiries:
Dear Jillian,

Office Manager passed your email on to me and I thought it would be easier to communicate directly with you about your desire to VBAC.

VBAC is becoming an increasingly difficult situation in my practice and I think for many Ob/Gyns in general. There is significant risk to the baby and the mother in the event that the uterine incision opens or ruptures during labor. Because of the poor outcomes in cases of uterine rupture, 50% mortality for mother and/or baby, many Ob/Gyn's do not do VBACs in their practice. In fact, of the seven physicians in my current call group, Dr. X and I are the only physicians who will do a VBAC in the right patient. For the other physicians, they are not willing to take on the increase risk of allowing VBACs to labor, or they have seen the dangers of uterine rupture firsthand and are apprehensive about the potential liability with such clearly documented risks. They have even refused to cover any patient that she or I believe are good candidates. While I understand the serious risks associated with VBAC, I do think that some patients are good candidates and I am willing to be available for those few patients 24 hours a day should they go into labor. Ultimately, I want to do what I feel is the best for the patient and her baby regardless of mode of delivery. I don't do C-sections out of convenience. I perform C-sections when I honestly think it is best and to do otherwise would compromise care. Furthermore, while having a C-section is not without risk, neither is a vaginal delivery (esp. VBAC). Patients who have significant pelvic floor dysfunction, injury to their infant secondary to a difficult vaginal delivery, or chronic pain following a vaginal delivery often feel that a C-section is a much better and safer option for subsequent pregnancies. Again, my focus, and I think your focus should be less on mode of delivery but what is the safest for you and your baby.

To answer your questions, induction can increase the risk of C-section in some patients remote from term or inductions done electively without a clear medical indication. I do not believe that your induction was the reason you needed a C-section. Many of my patients are induced, largely for medical reasons or postdates and the vast majority of my patients still deliver vaginally. You were induced at 40 weeks which would not have been considered elective or premature. In addition, despite adequate contractions and a significant amount of waiting for further cervical dilation your cervix stopped dilating. In my opinion, this suggests that Violet was too big for your pelvis or your pelvis was too small for her, depending on how you want to look at it. In general, subsequent babies are larger and the idea is if a patient either fails to progress in labor despite adequate contractions or is unable to push out a baby, odds are that the next baby will be larger and thus even less likely to deliver vaginally. Patients that have a C-section for breech presentation, fetal distress, placenta previa, and/or multiple gestation have not had an opportunity to labor and therefore are better VBAC candidates than a woman who had a trial of labor prior to their C-section.

Going into labor spontaneously does not guarantee a vaginal delivery, although certainly spontaneous labor in a patient without a medical indication for induction is optimal. I generally induce my patients between 40 and 41 weeks because after 41 weeks there is an increased risk of stillbirth, meconium stained fluid, large babies, and low amnionic fluid. In addition, of those patients who have not gone into labor at 41 weeks I do find that my C-section rate is higher because the increased incidence of large babies, fetal distress, and meconium fluid. I also think that if labor has not happened by 41 weeks that may also suggest that there is an underlying reason why labor did not occur spontaneously (i.e. large baby, inadequate pelvis, etc.) thus leading more often to C-section...this is based solely on my personal experience in practice.

I certainly value you as a patient and would hate to have to transfer your care with your next pregnancy. On the other hand, I do want you to have a positive experience and if that means pursuing a VBAC I respect that as well. After reviewing your labor course, I am not comfortable with the significant risk to you and your baby associated with managing you as a VBAC patient. Although I cannot say with 100% certainty that you would not deliver vaginally, as I have said before, I don't feel you are the best VBAC candidate. As such, I am uncomfortable with the associated risk of VBAC in your particular case. I am happy to discuss this further with you or meet with you in the office if you have any other questions.

Dr. NoChanceInHell

I forwarded this email to my mom, a fellow C-section survivor, looking for the wisdom only your mom can give. Her response?

"How does that make you feel?"

Well, Mom, it makes me feel like she is so entrenched in the medical establishment that she is blind to how birth works.

It makes me feel like a subversive for wanting to see if my body can deliver a baby.

It makes me feel scared that she may be right and I may end up with another cesarean, or worse, a death.

I feel grateful that she took the time to answer my questions herself but I feel belittled for asking: see the part where she says: "my focus, and I think your focus should be less on mode of delivery but what is the safest for you and your baby." As if I would be selfishly endangering my baby's life by attempting a normal birth. It makes me feel like a birth is a birth so what's my hang up?

It makes me feel like she believes she is on the cutting edge of medicine for attending any VBACs and there would be no way I would ever find an OB flippant enough to take me on. I worry that she may be right.

I feel that she is selective with her invocation of statistics. 50% mortality rate in the case of uterine rupture is a scary thought but what is the rate of uterine rupture during VBAC? I've read as little as 1%...Isn't that a tiny risk as far as risks go?

It makes me feel that my due date with Violet was miscalculated. Maybe only miscalculated by a week, but enough that it could have made a huge difference.

I feel that there must be a very real risk of a malpractice lawsuit for an OB who has a VBAC go wrong.

Most of all, I feel powerless. And that sucks.

Here are some of the links that I have been digging on this topic:

Wednesday, August 19, 2009

Panty Party

While I was rearranging my dresser drawers, Violet got into my underwear drawer and re-defined the panty raid...

Shawn and I counted 19 pairs of undies and one bra around her neck as we untangled the web!

Sunday, August 16, 2009

Sugar Cubes and Cupcake Batter

A few hours ago we rolled in from Chicago and Violet's first summertime trip to the Windy City. After getting off to a sloooow start, as in a 2.5 hour traffic jam south of Valpo, the rest of the weekend was a whirlwind.

Due to the time we spent parked, literally with the car turned off, on I-65, we arrived much later on Friday than we'd anticipated. Violet and I spent a little time playing with Jack and having a glass of wine with Aly (respectively), while Shawn and Andy hit the town with a friend and former co-worker to celebrate his bachelor party. I have no idea what time the men returned as everyone in our room was sawing logs by the time Shawn rolled in.

Our hotel was right downtown and we convenient to everything. A short cab ride (with babies on laps!!) got us to our first stop. The Shedd Aquarium was the #1 thing on our list for Saturday and we got there early enough to find the crowds only tedious and maddening but not quite at the suffocation level yet. The line forming outside as we left looked like a rowdy bunch, eager to see some fish and willing to body slam or trample any kid in the way. Probably best we left when we did. Two hours of aquarium is plenty for a 31 year old, so I think the three toddlers had probably gotten their fill as well.

After lunch, we schnarffed down hotdogs and cones in the park while we watched the pigeons and gulls fight for our crumbs. Then, we walked to Buckingham Fountain, in hopes of using it as the background for a family photo. The heat and the excitement of the "'Quarium" had overtaken the smaller members of our group by the time we got to the fountain so our family shot shows three crashed out babies and 4 sweaty adults in from of the gorgeous Chicago skyline.

We met a family friend for dinner at an Italian place near the hotel. The food was great and the kids were decent. A two+ hour dinner is hard to sit through and they did pretty well. Violet is such a night owl so she was hitting her stride around 9 p.m., right when Charlie was losing it because he was so tired. They are soo different already. Aly and Andy do a great job of respecting Charlie's need for zzz's and Aly headed back to the room before dessert so he could zonk out.

Before we left the city this morning, we headed to Wrigleyville to the Southport Grocery for brunch. A friend had mentioned their pancakes made out of CUPCAKE BATTER, so, obviously, I had to get some. There was a Cubs game this afternoon, so the area was busy and we had a 40 minute wait to be seated. Again, the kiddos were being asked to draw on their patience reserves as we waited and waited to eat. The wait was manageable (I really couldn't imagine NOT waiting in Chicago) but we definitely pulled out all the stops to keep everyone chillin' til the food came out. At one point, after sucking on a handful of Splenda packets, Violet joined Jack in eating the sugar cubes on the table. Jack kept saying things like, "Aunt Jilly, this sugar cube is actually delicious." Vi agreed and had downed two by the time our food came out.

The drive home was fairly uneventful and we all are bedding down early. Shawn's first day back at school is tomorrow and I think we all have a case of the Sundays. Hopefully the sugar buzz will wear off slowly!

Wednesday, August 12, 2009

Fair Time

Say what you want about how hillbilly Indiana is, the one time it is good to live in a hillbilly state is when it is time for your state fair. The Indiana State Fair is probably one of the top 2 state fairs (I hear Iowa's is pretty awesome) in the country and it really is worth a trip. For those of you who live in cool states, (you know if you live in a cool state if your state is worth visiting year round because there is always something to do, be it hike, swim, shop, eat, view art, go to museums, etc.) this is the one time a year you should be jealous of us Hoosiers. Because we are milking goats and eating deep fried oreos. We use hand sanitizer between the two activities.

Shawn and I took Violet over to the Fairgrounds tonight and met my Mom for dinner. We strolled though the crowds on what might have been the nicest evening of the summer and took in all the manurey goodness that the fair offers. We drank lemon shake-ups while we watched horses and ponies riding in the practice arena.

We looked at the beautiful cows that the 4-H kids from all over the state have been caring for so diligently. Violet got to pet a freshly shorn sheep. For a few hours tonight, we felt really proud of our state. It is hard to see all the livestock and the kids who are learning the art of farming and not get a little Charlotte's Web about it. It's hard to overlook the pride on the parent's faces as they watch their kids learning about agriculture and competition and not feel a little pride for them. I dare you to watch the looks on the city kid's faces the first time they see "The World's Largest Sow" and all her little piglets and not be a little bit amused.

Violet had a great time wiggling to the beat of the band and eating ice cream and learning a little about being born a Hoosier.

Sunday, August 9, 2009

Baby Gloton: The Breast-Feeding Doll Who Will Scar Your Daughter For Life

So, last week I'm diddling around on Facebook, reading the updates from every person I've ever shared a zip code with, paying little attention to "Judy McCullen Walsh is ready for the pool!!!" and "Alex Sanchez can't believe it's August already," and checking to see if anyone has a baby that rivals mine in cuteness when I see a post that actually interests me. A girl I went to high school with wrote something about a new breast feeding doll and leaving motherhood to mommies while letting kids be kids. Well, y'all know I am pretty much a shoe-in for Breast Feeder of the Year (very prestigious) and couldn't believe more in this particular cause (is breast feeding even a cause?) so I have to check out the comments, and, naturally, put in my two cents. Well, all the women that have commented up to this point, probably 5 or so, are all in agreement that this doll is "disturbing" and "goes too far."

Since I haven't seen the doll, I Googled it to see why this particular toy is so creepy. This is what all the fuss is about:

Wow--scandalous, huh? I mean, the way that little girl is pretending to nourish that doll, what is the world coming to? A bunch of sickos, I tell you. What I'd really like Violet to have is yet another baby doll that comes with a bottle to shove in her mouth. I mean, that is wholesome pretend fun for a kid. Playing Mommy crosses the line from sweet and innocent to deviant when you bring nursing into it. Breasts are for sex, kiddies, don't you forget it!

Seriously, though, the reaction of the public to this doll makes me realize that breastfeeding is still a cause that needs to be supported because there is such an incredible slew of misinformation out there. Just look at what the DOCTOR (he's an MD for Crissakes!) who acts as managing health editor for Fox says about what trauma could be unleashed on a child who plays with this toy:

Dr. Manny Alvarez, said although he supports the idea of breast-feeding, he sees how his own daughter plays with dolls and wonders if Bebe Gloton might speed up maternal urges in the little girls who play it.

“Pregnancy has to entail maturity and understanding,” Alvarez said. “It’s like introducing sex education in first grade instead of seventh or eighth grade. Or, it could inadvertently lead little girls to become traumatized. You never know the effects this could have until she’s older.”

WTF? WTF? WTF? Pardon my eloquence, but did I mention WTF? Did Dr. Manny really use the word TRAUMATIZED? Oh, yes, this is a direct quote and he really did use the word TRAUMATIZED to describe what might happen to a child who PRETENDS TO NURSE A BABY DOLL. Now, I can't help but wonder if Manny's daughter has a dolly that came with a bottle, or a doll who has a diaper to change or maybe a doll who even has a lifelike cry? I certainly hope not because surely, these dolls, too, would "speed up her maternal urges" and lead to a knocked-up 3rd grader. I bet Manny buys his daughter dolls that serve as role models, like those sweet Bratz girls or, of course, all-American Barbie dolls. You know, the dolls that can show her what tits are really for!

The crying shame in all of this, though, is how far away we have gotten from what is natural human behavior. Teaching young girls that breast feeding is a shameful act, an act that they need neither knowledge of nor exposure to, is, I believe a grave mistake. All the lip service that the medical community gives to breast feeding is for naught if kids grow up believing that the nice way to give a baby milk is through a bottle and that nursing a child is somehow dirty.

Now, where do I go to order me a Baby Gloton? Violet's first Christmas gift is coming early this year!

So what do you think? Is Baby Gloton going to give kids the wrong sort of ideas or is she a good toy to promote breast feeding? This blog really upset Megan, my Facebook friend who started the thread that got me thinking about this, which was absolutely never my intention. (I'm sorry you felt attacked, Megan!!) But, it is obviously a controversial topic and I'd love to hear your comments!

Monday, August 3, 2009

Away I Go

After luxuriating at home for the last month, I am headed back to work this morning. It's funny how quickly I got used to having all 3 members of our little family unit at home everyday. I think we would have eventually gotten bored, but 30 some days was not enough to do it. Waking up at 9 or 9:30--yes, Violet sleeps that late!--eating breakfast together Leave-It-To-Beaver-style, and then tackling our house chores for the day--it was a pretty nice little bubble we were living in. We made some progress on the house, not as much as I'd hoped, but not totally worthless, either. We took some bike rides, got to the pool a few times, walked around the new 'hood and met some neighbors, visited with family, and generally enjoyed life. The rigorous exercise regimen that I was going to follow EVERYDAY never materialized, but fortunately I was able to stick to my Twice Daily Dessert program which I'm sure will offset any workouts I missed. Yum pie...

Shawn has another 2 weeks off before school begins again for him so my two partners in crime will be ending the summer the same way they began it, with some quality Daddy-Daughter time. Having this extended chunk of time off has done wonders for Violet's relationship with Shawn. She still has her moments when no one but Mommy will do, but she is becoming far less discriminating when it comes to whose leg she'll nuzzle into to hide from strangers. They have developed their own games to play together and Daddy is the only one thus far who has been able to elicit a certain high pitched shriek of pleasure from Violet during rumpus time. I'll miss them today!

Next weekend is going to bring about another Violet and Shawn milestone: their first solo overnight together. I'll be heading to Nashville, TN for my future sister in law Steph's bachelorette party so the other two Pierces will be holding down the fort. I am excited, but a bit apprehensive about leaving Vi overnight. She sleeps like a champ for us, but when she does wake up, she usually nurses for a minute or two to drift back off. The night nursing doesn't bother me a bit; quite the opposite actually. It's such a snugly time and has become so instinctual for both of us, I frequently don't even fully wake up to do it. I know that Daddy's loving arms are just as capable as mine, and I also know that if I never give them a chance, then Shawn won't ever be on call at night. I'm sure they'll be fine, they always are. And, after a few gin and tonics in Nashville, I'll be fine too! Who knows, maybe I'll even enjoy my ME time...