Thursday, August 03, 2006

I’ve been reading a couple of home-birth midwife blogs lately and enjoying hearing the birth stories. I love the idea of a birth without interventions, although I don’t know if I could do a homebirth (I’m too chicken), and with Peanut it wouldn’t have been an option. I considered using a birthing center, but Hubby and I were concerned about what would happen in the event that Peanut or I needed transport to the hospital, so we opted to go with the OB a good friend highly recommended. I had full confidence in my OB, but she didn’t have much bedside manner, was not gentle with her internal exams (my former gyn, a man, was much, much gentler), and she pissed me off during labor. If we ever have another child, I’m pretty certain I’ll use the midwives in my OB’s practice or further research the birthing center.

Even though I’m a homebirth isn’t for me, I love hearing the stories of women who are confident enough in their bodies to deviate from the current “norm” and allow their pregnancies & births to progress as something natural, rather than as a medical condition.

All this has brought about some introspection on my part about Peanut’s delivery and our unsuccessful battle at breastfeeding, which still bothers me, a good 7 months after weaning off the pump.

I took Bradley Method classes while pregnant, in hopes of an intervention-free labor and delivery. The class instructor was also a doula and I considered hiring her, but something just didn’t click. I’m almost certain Hubby felt the same. She flaked out on us at the beginning of class, so we missed the first two (she knew we were going on vacation and scheduled the first class to start while we were away, then didn’t let us know that the 2nd class was moved to earlier in the day, so we showed up after it ended – a good hour’s drive away). It was awkward to join in when we finally made it to class 3, since the other couples had gotten to know each other and had already bonded. On some level, I was afraid if we did hire her, she’d flake out on us at delivery time.

I wonder, though, how things would have differed if I had a midwife and/or a doula. Would I have made it through without an epidural? I don’t regret having one, but it probably would have made for less pushing – I was still very numb, even after the anesthesiologist stopped medicating me, and it took nearly 2 ½ hours to push Peanut out. The nurse even had me wait while after I was fully dilated to let some of the numbness wear off. I loved the L&D nurse, she was awesome. She was supposed to stay in triage, but wound up staying with me instead. I’m so glad she had me wait for some of the anesthetic to wear of before pushing, because I would have just worn myself out otherwise - I was sapped when Peanut finally slid out. I honestly don’t think I could’ve given one more push. I don’t know if they doctor threatening me with a C-section was what did it (like I said, great bedside manner), or the episiotomy (eek) she cut, or if he finally decided to budge. I do know that the horrible nausea and vomiting stopped with the epidural, and there’s no way I would’ve made it puking throughout labor. Were there other anti-vomiting meds available? The nurse gave me something that wore off quickly, but maybe I could’ve gotten something else. I wasn’t with it enough to even think of asking for something else. My thinking was along the lines of “Oh shit, I’m puking again. Guess the meds don’t work. I’m so glad the anesthesiologist is here.” (I had another round of puking just before he put the epidural in). But if I had a doula, maybe she would’ve suggested something else to manage the puking and maybe she could have helped me work through the pain.

The doctor’s c-section comment angered me. I understand she wanted me to get the baby out and she wanted to avoid surgery, since vacuum or forceps (eek again) weren’t an option, but she could have been kinder. You know why I wasn’t “pushing effectively”? Because I COULD HARDLY FEEL.. Peanut came out with big bruising and a lump on one side of his head, so I wonder if his head was at an odd angle and he needed to align correctly before making his grand entrance.

The continuous monitoring also bothered me. Peanut was too jumpy for the external monitor to get a good read. Every time the nurse would finally get it in a good place, he would move. She finally resorted to internal monitoring and we went through 3 leads – they kept falling out. (Internal monitors poke into the baby’s scalp – so that also contributed to the bruising and lacerations on his head. The NICU was worried about infection, so Peanut constantly had antibiotic goop on his head.)

On to the breastfeeding thing. I realize Peanut may never have gotten the hang of it, being a preemie and being bottle fed in the NICU, but I’ve learned so many things since his birth and early days. When looking back at our home videos, I realized he was smacking his lips when given to me after his delivery. I would’ve put him to the breast had I known, and had I known the doctors were going to give us a few minutes with him before whisking him off to the NICU.

The lactation consultants (all 3 that I saw) were of little help. All I heard was “Keep trying. You’re doing everything right. He’ll catch on.” I should’ve been more aggressive in calling and visiting them, but some sort of follow-ups on their part would have been welcome. Preemie, with trouble latching/staying latched, hmmmm, maybe a follow-up or 5 is in order.

No one gave me information on exclusively pumping. The LLL leader mentioned a friend of hers had done it for 2 years (that’s where I learned it could be done*), but her comment was something along the lines of “I don’t think *I* could do that.” She could offer little help with preemies, but did give me LLL’s pamphlet on breastfeeding preemies – it was all old news to me – I had already read everything I could get my hands on. She did put me in touch with the one LC who had good suggestions, but I was only able to get phone consultations with her. Nursing in the tub was one – unfortunately Peanut generally pooped during or just after eating. He latched on great, but we ended up with a floating Baby Ruth.

*After several online searches, I came across a couple of good support communities for exclusive pumpers (listed on the side bar). Without those, I’m positive I would have given it up. No one discouraged me from pumping or told me it was impossible (as some doctors falsely think), but no one offered any real support, either. Yes, pumping is less efficient than a baby, but it can be done with little or no supplementation. I did have to supplement during a few spells when Peanut was in growth spurts, or when I was sick, but I was able to do it until he was a year old and decided I had enough.

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