Genes and Jeans

So this week I took advice from rookiemoms and went to go buy myself a pair of normal jeans. It does feel really nice to wear a pair of pants that is neither stretchy yoga pants nor maternity wear. Wearing them makes me feel more like I’ve begun to re-enter “normal”, non-pregnant life again. On the other hand, they were a somewhat horrifyingly large size. I’ve decided not to stress about it now at the one-month-mark but I really hope that breastfeeding and daily walks will help me not to still be wearing these jeans six months from now. I think I actually went a little too big, as they are jeans with a bit of stretch to them and after a few hours of wear, they start to fall down. I vaguely remember this being the norm for this type of jean from way back in my pre-pregnancy past. Just imagine; it’s been so long since I’ve worn regular jeans that I can’t remember how to go about it!

Another significant, more serious happening this week was a call we got from Grace’s pediatrician. They did the state-mandated tests and screenings in the hospital after she was born, and it turns out that Grace is a carrier for cystic fibrosis. This was quite a surprise to Rob and me because there is no history of CF in either of our families. (For anybody who is a little rusty on your Mendelian genetics, Grace will never get the disease but if she has a child with another carrier, their child could have CF.) My first response was really overwhelming thankfulness that Grace is OK. Rob and I turned down pretty much all the prenatal testing offered to us and talked then in an abstract way about the possibility of having a child with a serious disease or birth defect. This revelation now felt so much more real and immediate, though, and really brought me up short with the realization that Grace’s health is such a blessing.

So Grace’s status as a carrier means that either one or both of Robert and I are carriers. The vastly more likely case is that one of us is a carrier and thus statistically half of our children will be carriers. However, it is a slight possibility that we’re both carriers, which would mean that a child of ours would have a 50% chance of being a carrier, a 25% chance of being “normal”, and a 25% chance of having CF. A rather important item has just been added to both of our to-do lists; I think I’ll be able to be tested at my 6-week post-partum checkup. It feels sort of surreal to be thinking about all these genetic possibilities, especially as it could affect Grace’s future. Unlike whichever (or both) of us is a carrier, Grace will have this bit of information when she gets to her childbearing years. It’s crazy to think about how that could affect her decisions decades from now about children and relationships. It reminds me of quantum mechanics and Schroedinger’s cat and all that about how having information changes reality. Rob and I have started joking that we are going to subtly encourage her to date only non-white boys. We would love to extend the cultural depth of our family regardless, but CF is most common in the Caucasian gene pool and much more rare in other ethnic groups. Maybe we can have a nice Asian or black son-in-law? Shall we arrange the marriage now? Any takers?

Boobalicious

Hmmm, this entry might need some kind of disclaimer as well. Don’t read further if you are not comfortable with discussions of breastfeeding.

We are exclusively breastfeeding Grace. I think we kind of had to, or else Rob would lose his pediatrician street cred. And even if we weren’t the kind of people who try to do what the AAP tells us to, there sure is an overwhelming amount of evidence that it is good for babies. One does tend to hear the mantra “breast is best” in general life, but it is pretty amazing when you look a little deeper into it that this choice can reduce the risk for everything from SIDS to diabetes to allergies to ear infections. Being able to have something as necessary as feeding also become an opportunity for such intense bonding and comfort and all is also a lovely idea. Both my sister and I were exclusively breastfed (in fact, my hard-core mother didn’t ever give us a bottle, EVER) so I was comfortable with the idea and don’t view it as weird or abnormal. Robert and I were very committed to breastfeeding before Grace arrived. In our childbirth class, the instructor asked who was planning on giving breastfeeding a try and pretty much everyone raised their hands. She then asked who was going to breastfeed come hell or high water, and although the number of raised hands greatly diminished, Rob’s and mine were still there.

Our experience with breastfeeding has made me so glad that we took classes, read books, and decided we were committed to this ahead of time because it turns out that it is hard! These first weeks have been pretty challenging in the breastfeeding department. As we approach the one-month mark of Grace’s life, I am finally starting to feel like we know what we’re doing and it isn’t so difficult.

Grace nursed just minutes after being born; it was amazing to see her quiet and alert and ready to start her life like that. After that initial feeding, however, we got off to a bit of a slow start. Grace was very sleepy in the hospital and did not really get the hang of breastfeeding in our couple of days there. She dropped from 7 lbs even at birth to 6 lbs 9 oz when we left two days later, which is a little bit high for the post-birth weight loss. By the time we got home, I was feeling slightly panicky and desperate for her to start eating. She did, of course, as my milk increased in volume and changed to transitional milk and she started to be more awake. Those were such a challenging couple of days, though, as she learned how to latch on and actually eat. She would get so frustrated by her intense desire to gain sustenance from a certain part of my anatomy usually modestly ensconced in clothing, and her inability to gain said sustenance. There was much screaming and angry-baby face and whatnot. It really felt pretty awful at the time; emotionally, it felt like Grace was profoundly hungry and I did not have what she needed, that I could not meet her needs. And what arrived in the mail that day? A “welcome kit” or some such thing from Enfamil or Similac or whoever filled with samples and pictures of fat smiling babies. Evil, evil formula companies...

Those first days home from the hospital did pass, though, and Grace and I learned a lot of what we needed. However, I had gotten into the habit of tolerating uncomfortable latches when I was in the stage of being desperate for her to have any success at all, and I started to have a lot of pain around Day 4 or 5. I tried to correct the latch myself and spent a lot of time perusing the books I have and the materials from our class, but it didn’t seem to be getting better. On Day 7, I was in tears in the shower from the pain; afterwards, I marched in to where Rob was holding Grace and said that I needed help. A few days later we found ourselves at the office of the local lactation consultant. Ironically, I was actually starting to feel better by the time we saw the lactation consultant (the therapeutic power of making an appointment with a healthcare provider) but the appointment was still so helpful. I highly recommend getting help if you are having trouble with breastfeeding; having someone help me in person was so much better than trying to do it on my own with books.

My little bit of breastfeeding drama does make me realize that I am a 21st-century, upper-middle-class crybaby. I mean, human babies have been fed this way for millennia without a shelf full of books or people with IBCLC after their names. I am so glad that we have worked through our issues, though. This week I am practically pain-free, as my latch issues have been dealt with and I’ve had time to heal. I had one of my first beautiful breastfeeding moments last week. On the first day of March, we had a significant snowfall and I sat nursing this quiet, happy, stunningly beautiful baby (who amazingly enough is mine), watching big fluffy flakes fall outside our windows. I felt so calm and happy and so profoundly grateful to be one-half of such a unique and amazing relationship. Hooray for boobs!

An Ode to Robert

This week has marked the end of Rob’s two-week paternity leave and his return to doctoring. It’s been quite an adjustment to move from the two of us caring for Grace to all Julia, all the time during his working hours. Grace is still a very new baby and wants to be held all the time; I am very accepting of this and want to meet her needs for physical closeness and show her that she can trust us and be secure. However, it does present a challenge when it is time for me to, you know, take a shower or eat some lunch. She has cried more this week, as her retinue has decreased in size by half. The week has felt somewhat draining but has gone well, and Grace is slowly gaining the security and confidence to sleep for little stretches with a little more distance between her and us.

The week has made me realize anew how glad I am that Rob is my partner in this crazy endeavor called parenthood. He was really available and proactive during his weeks at home, even taking care of things he wouldn’t normally care about, like making sure the house is neat and the dishes done and all that. I guess he realizes that things like that could knock out my equilibrium being that I’m already stretched thin. Rob’s been really great this week as well. A few evenings, I was feeling quite fragile by the time he got home after a day spent meeting Grace’s intense, immediate needs and not doing a good job meeting my own less-immediate needs (food, sleep, etc). He made me dinner and told me I was doing a good job being a mother and packed me off to bed; what a huge relief to have someone do that for me...

I think the moments that make me the most glad that I’m doing this parenthood thing with Rob are seeing him with Grace, though. I am still pretty overwhelmed by my own love for Grace and how I feel connected to her down in the very core of who I am. In some ways, it is even cooler still to see Rob love her and think she’s amazing and want to be with her. The mysterious tangle of relationships that is “family” looks pretty beautiful to me right now, and I am so happy that it’s Rob here with me.

So here’s to you, Rob; thanks for being who you are. Let’s see how your first night of call goes next week...

Grace's Birth Story

Disclaimer: The following contains references to medical procedures, bodily fluids, and general ickiness which may not be appropriate for those squeamish about such things.

Several people have told me that I should be sure to write out the story of Grace’s birth now while the memories are fresh in my mind, so here I go. Hopefully it won’t give our family and friends the heebie jeebies or anything...

Grace was due on February 7 and on February 11, things finally got going. My waters broke about 6am Saturday morning. My OB practice gives you 24 hours after your membranes rupture to go into labor on your own (waiting longer than that increases risks for infections and complications and things), so we went up to the hospital that afternoon just to get checked and to confirm that the amniotic membranes were ruptured. Rob and I spent the day around the house, and although the intermittent contractions I’d been having for weeks did intensify over the course of the day, they were way too far apart to be called labor.

Sunday morning found us at the hospital bright and early, ready to start our induction. They hooked me up to the external fetal heart monitor and contraction monitor (the kind they strap around your belly), along with the IV for the fluids and pitocin. We started out with a teeny tiny dose of pitocin and over the course of the day, slowly increased it. The contractions gradually became more intense; by early afternoon, I was having to really concentrate on coping with the pain of each contraction. The contractions didn’t seem to go through the phases of labor we learned about in our childbirth classes, no doubt because it wasn’t my own body guiding the labor. I haven’t experienced any other labor (obviously) but I would certainly not contradict the people who say that pitocin makes labor more intense and difficult.

By early evening, I wasn’t coping well with the pain and decided to ask for pain relief. They checked the progress of my cervix’s dilation, and I was at 4cm. (They hadn’t checked earlier because of the increased risk of infection from the ruptured membranes.) Since I was that far along, we decided to go with an epidural. Having the epidural placed was a weird experience but I was sure it was the right decision for me in that situation. And talk about a difference! I really am amazed at modern medicine. Once the epidural was in full effect, I could feel each contraction but I perceived them as pressure, not pain. I could still feel and move my legs and abdomen and did not feel at all numb. Unfortunately, I was no longer allowed to get up out of bed because my legs would be too weak. I had found things like the birthing ball and changing positions really helpful earlier in labor, but exchanging those coping mechanisms for the epidural was definitely worth it in this case.

A few hours later, we started to run into some trouble. Grace had been tolerating labor well through the day, but about 12 hours into it, the heart monitor showed that she was not responding well to each contraction. They eventually turned the pitocin totally off to give her time to recover and placed a different, more accurate kind of heart monitor on her (the kind that goes up through the birth canal and attaches to her scalp). With the pitocin off, Grace did much better but unfortunately my contractions became really weak and infrequent. They turned the pitocin back on at the teeny tiny low level where we started the morning, and my next contraction was this really intense long one that caused Grace’s heart rate to plummet. No good, no good at all.

At this stage, it looked we were headed for a C-section-- troubled baby on pitocin, no contractions off pitocin. They checked me again and I was only at 5cm, so there was still a lot of labor to go. Rob and I asked if we could take an hour to see if labor might pick up on its own before we headed into a C-section; the doctor said he didn’t feel comfortable with that much time but would wait 30 minutes. I signed the consent form for the surgery and Rob got his funny OR jumpsuit and we adjusted to the idea of a surgical birth; we were feeling disappointed about it but felt convinced that it was the right decision. In the meantime, the OR got backed up (divine intervention!) and it turned out that we waited about an hour anyway. In this hour, my contractions started up at a respectable rate of every three minutes and Grace looked like she was doing great on the monitors. Rob was watching the monitors saying, “OK, this kid is just messing with our minds now.” The doctor came back in to check me one more time before going into surgery. He found that I’d progressed 1.5cm and since the monitors looked so good, the C-section was put on hold. Hooray!

In another hour I was fully dilated and Grace continued to do well. My epidural had started to wear off, which is what they intend so that you can feel to push effectively, so I was experiencing pain again but not nearly as badly as on the pitocin pre-epidural. We pushed for 2 hours; it was really hard work and hurt but in a different way than the contractions. It was exhausting, actually, and near the end I was really starting to run out of energy to push effectively. We ran into another little hurdle as I struggled to finish pushing, and the OB suggested an episiotomy. I said I would try a few more pushes on my own but when those didn’t work, I happily acquiesced to a medium episiotomy. Grace came out quickly after that, and was born at 2:24am on Monday, February 13.

I had a fever by the end of labor which could indicate an infection so Grace had to be checked out immediately after birth by the pediatricians (and I had to have a bunch of IV antibiotics). She looked great (which you can see for yourself in the video) and they brought her back to me as I was being stitched up and put back together. Rob bringing her over to me and holding her for the first time was, as cliched as it may be, a fundamentally life-altering and wonderful moment.

Things that surprised me about labor

• Ahead of time, Rob and I did not have a specific agenda for labor but thought that we wanted to minimize interventions, stay at home for a long time during early labor, maybe avoid pain medications, etc. This is definitely not what happened, so that was a surprise.
  
• I am surprised by how little this fact bothered me at the time, or bothers me now. The fact that we have our daughter safe and sound really is what matters, just like they tell you.
  
• I am surprised how great an epidural is.
  
• I am surprised how little the annoying requirements of getting an epidural (catheter, only ice chips, no getting out of bed) bothered me.
  
• I am surprised I ended up with an episiotomy. I was all for just letting nature take its course and tearing a bit if necessary. I just didn’t have the energy at that point, so another preconceived notion out the window!
  
• I was really surprised by a couple of the effects of our long pushing stage; my face was super puffy for a couple of days and I strained an eye muscle so badly that I couldn’t focus my eyes for about a day.
  

To sum up this very long account, I’ll just say that the rest of our hospital stay was smooth and uneventful. Both Grace and I did splendidly and the three of us are glad that the experience of labor had such a wonderful outcome and that we are enjoying being a family now.

Babymoon

A honeymoon is that first bit of time in a new marriage when the new couple adjusts to life together. Rob and I are about a week into our babymoon now; everything is so new and different and changed forever. This time is so unique in its place in the course of our lives. Most of it is spent wrapped up in the details of taking care of a new baby. Grace needs to eat again! Time for a new, non-poop-covered outfit! Going to the bathroom or eating lunch now involves logistical decisions! However, I continue to have moments when the fog of details lift and I am overwhelmed with the realization of how utterly wonderful this all this. No exaggerating-- I cannot believe how happy I am and how much this tiny individual makes us stop in our tracks with joy.

One thing that has amazed me is how tiny Grace is. She isn’t actually that small for a newborn; she weighed 7 pounds at birth and probably is on her way to gaining back her birth weight by now. Part of the reason for my surprise is that we were actually expecting a bigger baby. Grace came into the world about a week past her due date, and several of the OBs kept estimating her size at over 8 pounds. (What does that tell you about how much weight I gained? I’m sure there will be more on that in some future entry...) More than her actual physical weight, though, I think it has surprised me how tiny that 7 pounds feels. The metaphorical heft of her entry into our lives seems so huge that her tiny physical self seems impossible.

Her clothing situation only exacerbates my perceptions, I think. This has come as a shock to me, but her clothes are all huge on her! Even the newborn size clothes! Every item of clothing she has must have its sleeves rolled back if there is any hope of finding her tiny hands. The bodies are so big that she pulls her little arms inside her clothing, leaving us with an apparently armless baby. Our first experience with this came the first time we dressed her in her own clothes in preparation for our trip home from the hospital. Grace’s outerwear is a lovely fleece hooded bunting, and I am now pretty darn confident there is no danger of her outgrowing it before spring has unequivocally sprung. When we put it on her in the hospital, her entire body fit into the torso section, leaving the bunting arms and legs pretty much empty. I find this whole thing puzzling because the newborn size is supposedly the appropriate one for her current weight. Perhaps this is her introduction to the mysterious world of women’s sizing where the numbers don’t really mean anything?

I know this will be a fleeting time and soon she will be growing gangbusters. I’ll have that experience common to motherkind of picking up an outgrown article of clothing and being struck by the lightning fast changes in who my daughter is and who she is growing to be. For now, I’ll keep dressing her in these giant onesies and kissing the soft warm curve of her skull as it is today, right here in the now during our babymoon.