Monday, October 10, 2011

A Last Minute Change

This might sound crazy, but I've had a last minute change of mind about my birth plan! I'm just about 36 weeks pregnant and about to embark upon a new phase of my pregnancy. It feels like a phase of confidence in my mothering, intuition, and my ability to chose what is right for me. I am leaving my passive phase of fear and the feeling that I want someone else to choose for me and tell me what is right to a phase of taking charge and putting myself right in the middle of this birthing experience.

I'm leaving my OB and original plans to have a hospital birth at Overlake, and am instead switching to midwifery care and having a birth (anticipating a water birth) at a birth center!

Now let me start off by saying I liked my OB and had no problems with Overlake as a potential place to give birth. I looked forward to every one of my prenatal appointments, appreciated the quick responses to all of my worries and calls, and felt well-taken care of in terms of getting all the testing and screening I needed, getting answers to medical questions, and addressing potential issues. My tour of Overlake's Birth Center was impressive. Compared to traditional creepy hospital settings, Overlake presented a much more comfortable environment in terms of hospital birth. It wasn't exactly warm and cuddly, but the lighting was dim, the rooms streamlined and modern, and the scary-looking equipment was either hidden behind sleek doors or easy to overlook. Of course, there was a slightly cold and 'sterile' feeling to the place, which I'm sure is impossible to avoid in a hospital.

So if things were going so well, why change now?

When our first little 'surprise' came about and I began to accept that we were having a baby, I was scared and passive. I hadn't done a lick of research about pregnancy, labor, or delivery. I had no idea what to expect, what was routine, what was best. I just wanted someone to tell me what I should do, where I should go, what tests I should take, where and how I should give birth. Of course, being the bookworm and organized planner that I am, I quickly started reading and learning about what I was about to embark on. I slowly became more and more comfortable about what was ahead for me, yet I remained passive. I've had the tendency to do this in the past- freeze up in fear and ask someone else to tell me what the right decision is. In fact, I do this when choosing ice cream or when buying a new jacket. Or picking out the best cracker for a certain cheese. Just ask anyone I know...seriously!

If you've read my last post, you'll remember I mentioned having to take charge and choose a day to take maternity leave on my own. This is when I was the most afraid and uncertain, yet it led me to become empowered.

It began with the rib pain, sluggishness and 'run down' feeling that began as I approached my 7th month. I was starting to feel like it was time to take it easy, work less, and really prepare for the upcoming change. I remembered the 7th month was about the same time that two other women from my work had quit working and took leave, so I felt like my feelings were spot on. When I came to my OB and asked her when I should take leave due to my difficulties at work, she had no answer for me. She couldn't gauge my physical pain, she could only see if my pregnancy had complications or was causing harm to the baby. Not having a plan stressed me out. I wanted her to give me an estimate, a suggestion. I ended up talking to one of the women from my work who had her baby last year. She encouraged me to choose for myself. It was a mother's decision; my OB was only there to back me up. Her midwife had been more than supportive of her decision to take leave when the time had come. And I remembered the other woman from my work saying the same thing of her midwife.

So October 7th I chose. I toughed it out to my last month. I was almost in tears from my rib pain many days, but I held out as long as I could, iced my rib, thought positive thoughts, and (almost) made it to my anticipated day. I had told my OB a couple weeks before this that I had chosen a day to take leave, and she made no comment opposing it. Around this time, my OB measured me and found that I had measured a little on the big side. She sent me in for an ultrasound to check baby's growth, and the next day I was told to go to the Overlake birth center for a non-stress test. Of course, upon hearing I needed a NST, I became stressed! No one told us why we needed one, only that the baby had measured large. During the test, the baby's heart rate and movement looked great. But they discovered I was contracting!

It was just a day or two before when I first started noticing the difference between baby's movement and my braxton hick's contractions. I wasn't paying much attention to which I was feeling during the test, so I was a bit surprised to learn I had been contracting regularly, about every 10 minutes. I thought that since they didn't hurt, and I was having no other labor signs, that the contractions were fine. But the nurse told me my OB wanted me given a shot of Terbutaline to stop them. I was so overwhelmed, I didn't ask why or what would happen if I said no, or what we could try instead. I took the shot, felt like I was incredibly high on caffeine after a night of binge drinking, was told my contractions had stopped, and then sent home. I was so confused. No precautions? No rest? Nothing? I was good to go home and back to my everyday life without any change? If I needed a shot to stop contractions, shouldn't I be taking precautions so I don't get them again? And if not, then obviously it wasn't a big enough deal to warrant the shot in the first place! And I was still contracting later that day, and the next!

I was so stressed and confused I had my OB call me on her day off to clarify what was going on. It turns out the NST was ordered because the ultrasound didn't provide solid results and she wanted to make sure the baby was fine. The contractions were just a coincidence, not the reason they sent me in. The shot was given more for peace of mind than for real necessity. She had no reason to believe I was in danger of preterm labor, and didn't exactly need to STOP me from having contractions, just needed to make sure they weren't real labor contractions. I was deemed fine. I felt a lot less stressed and worried after that, but I realized my OB and I didn't really see eye-to-eye about a few things. I didn't agree that I didn't need to be careful after this. I had a feeling that my body needed rest. Also, I didn't know what my stand on drugs during labor was until after that shot. I hated it. I hated the side effects. I hated feeling loopy and shaky. I was sort of depressed afterward. I felt slightly betrayed, for some reason. I realized then that I wanted a natural birth for sure.

So this long detour brings me back to the week before October 7th. I called my OB requesting the doctor's note I would need to officially go on leave, and met another conflict of opinion. She didn't see any reason why I should take leave. She said there would need to be complications with my pregnancy in order to recommend such a thing. This is not the way I operate! I would much rather take preventative steps according to what I feel is right for my body, then to wait until some harm to the baby became apparent! I did, however, realize I probably needed to be more clear about how my rib pain (among other daily complications) was negatively effecting my job, and explain WHY I felt like I needed to take leave. So my OB offered to check me at my next appointment and see if there was something she could find to write a note about. This made me feel criminal! I wasn't trying to fight the system. I wasn't trying to con her into doing something inappropriate. I felt so bad about myself. Was I just being weak?

While I still felt like my OB could help me effectively after some better communication from me, and Overlake could still be a wonderful place for a natural birth, I started researching midwives and birth centers. I was drawn to Puget Sound Midwives and Birth Center. The website provided a lot of info about their philosophy with beautiful pictures of their birthing suites. And they allowed water birth! I had been really interested in a water birth until I found out Overlake didn't allow it. They allow and promote many natural pain coping techniques, including laboring in the Jacuzzi tub, just not birthing in it. After a consultation at the Birth Center a couple days later, I was sold. I immediately felt at peace. I told the midwife my story and I felt like she really listened, understood, and cared. She couldn't believe I was having so much trouble getting a note from my OB to take leave! I have my first offical appointment tomorrow, where she will more than happily write me a note supporting me taking leave.

I'm really excited about this. I'm actually EXCITED to go into labor and give birth! It helps that I'm reading Ina May's Guide to Childbirth, full of inspiring stories about the hardships and rewards of natural childbirth. Of course, I am still fully aware and accepting that something could occur, and I could have need of a hospital birth, and maybe even medical interventions. There's always a chance. But I feel like I'm in good hands. I feel like I'm a participant in this birth, not just a passive vessel. I feel empowered to make decisions, and I feel supported in following my intuition and my body's signals.

I also feel huge and like I can't possibly get bigger or carry this weight on my squished bladder much longer. But at least I'm at home resting where I know I belong!

Friday, October 7, 2011

Thrid Trimester!

So far I feel like this trimester has flown by! And I feel like I grow bigger and bigger every day, so fast I don't think I can even keep up with picture evidence! The above picture was taken over a month ago. I'm currently 35 weeks pregnant! The picture below was taken a week or two ago, but I feel like I've already grown since then!
So what are my new developments this trimester?

As the second trimester turned into the third, I slowly started noticing more fatigue, low energy, and more frequent days feeling 'run down.' I finally was able to quit my cleaning job and go back to Trader Joe's full time. However, I don't think I've been able to complete a single full week because there's always been something popping up- feeling unwell here and there and needing to come in late or go home early or stay home all day, coming in late for upset stomach, dizziness, or even because of restlessness the night before, leaving early for appointments, or (most frequently, irritatingly, and painfully) leaving early due to intense back pain.

I started feeling lower and middle back pain pretty early on in my pregnancy and corrected it by adding extra pillows here and there at night. But a couple months ago, I started getting this pain in the middle of my back to the right of my spine. The best way to correct it was to lie down with my growing belly propped up with a small pillow, or with a small portion of my Boppy pregnancy body pillow. But this pain didn't only occur at night. It started happening more and more frequently and growing more intense. I started noticing the many things that triggered the pain- lifting, bending, carrying anything (especially in my right hand), walking my dog, standing or sitting too long, writing (and doing any artwork at work, especially since I usually bend forward when creating signs) and driving. I finally went to a physical therapist who discovered it was actually my rib! This boosted my confidence in my intuition, because I had initially thought it could be my rib!

It turns out the rib just under my breast was loose, and putting pressure on the back of the rib. He explained how the hormones meant to relax a pregnant mother's joints and ligaments in order to loosen up for birth were causing my rib to easily pop out of alignment, especially as I grow bigger. He was able to put the rib back in place, and sent me home with some cautionary measures- I have to ice my rib once a day when the pain acts up, I have to wear a stretchy belt around my ribs, just under my breasts (especially at work) to help keep them properly in place, I have to be careful about lifting or carrying anything, especially when using my right arm, I have to walk my dog with my left arm, I have to squat instead of bend to pick things up, and I have to get up and walk around or lie on my side if I start hurting after sitting too long. Despite these precautions, I still have had the rib come loose, and have had to re-visit him a couple of times. He also says the farther along I go, the harder it will be to keep that rib in place!

This has been a real struggle while at work! Everything I do is with my right arm! I quickly discontinued work at the register (no standing too long or lifting those heavy milk gallons!), started asking for help when I drop something, need to reach something, lift something, or assist a customer in a way that requires lifting or moving heavy boxes. I took up my fellow sign artist Sharon's offer to push my cart and load my groceries into my car after work when I need to buy some things, which was a real life saver! But even so, I still can't avoid irritating my rib completely, especially since I use my right arm to make signs at my desk, which is all I have left to my abilities, and even that hurts after too long!

I started to realize I needed to set a date for my last day, sooner rather than later. I was happy that I had managed to stay as long as I had, and since my OB wasn't giving me any recommendations on when to take leave, I decided upon October 7th...well, that's today! It's just about a month before my due date, and the next two days I'll be at a childbirth education class, so it seemed like the perfect time to take leave. Unfortunately, I wasn't even able to make it to my last day of work! This morning, while I was walking my dog, I suddenly got this sharp pain in the left middle of my back, which grew more intense upon inhalation. It was hard to make it back home, and continued to be painful during inhalation, even after lying on my side for awhile. I remember a similar occurrence just before my right side back pain started acting up, so I wonder if that was the feeling of the rib on the other side coming loose, and my lungs pushing it out and causing the pain! After going back to bed for a couple hours, and then taking it easy throughout today, my back pain has subsided. The pain with breathing has subsided as well, although it lasted quite a bit longer than it did when this occurred on my right side. Strange!

So enough about my rib and pains, what else is new?

Well, I have retried my 'fort' oddly enough (if you remember from this post) and am now sleeping on a folded up comforter on top of the mattress with just my boppy body pillow that I take with me as I roll from one side to the other throughout the night (my hips still hurt regularly each night) and my memory foam pillow under my head, propped up by a small pillow. The 'fort' was the only thing making me comfortable during my second trimester, but as I've gotten bigger over the past couple months, it's become more difficult to get in and out of bed when surrounded by a mountain of pillows. This new set up is also easier on my rib when I get in and out of bed, and when I roll over.

I got my first stretch marks this trimester! Can you see them in the picture below?
More and more appear every day, I swear! And my tattoo on the other side of my stomach looks really funny now, too! It'll be interesting to see how it will look after I give birth and start to deflate. Luckily I'm not too fond of my stomach tattoo, so if it gets damaged, I'll just think of an awesome new tattoo to cover it with!

And speaking of growing and stretching, I find that I fit into less and less of my clothing every day. Oddly enough, I still fit into a few larger non-pregnancy shirts, stretch pants, and pajamas, but have had to retire two of my three maternity jeans! In the warmer weather, it was easy to wear flowy dresses. But now that it's fall and getting quite chilly, my clothing of choice is stretchy jammies while I'm at home, or stretchy pull-on (non-maternity) jeggings, t-shirt, and sweater on the rare occasion that I go out somewhere. I have to admit, as an over-heated pregnant lady, I'm really happy to see fall! I usually despise cold weather, but I'm running much warmer than ever before, and the idea of bundling up all snug sounds wonderful!

I've become a lot more emotional this trimester. I don't think I did much crying during the first two. I had dips in my mood, and felt bummed out or just low on emotional energy, but this trimester I've had full-on crying spells! I was so stressed out and in pain one day when I first started getting that rib pain. It was the day after my OB told me physical pain was no means for her to recommend me a day in the future to take leave, and I came in to work and was inconsolable after only an hour! I called it an emotional breakdown, and went home for the day to relax, breathe, meditate, journal, and work out my fears, anxieties, and angers. That was when I made my decision to select a day to take leave myself. I felt a lot better about work after this, and much more in control of my situation. However, since then I've been easily upset and cry when I'm under a lot of stress or start feeling anxious. But I guess that's normal! I'm a pregnant, hormonal lady, I guess I shouldn't expect much else!

Baby is still just as squirmy as ever! She's no longer doing flips and somersaults, but she still squirms, kicks, and even hiccups! The bigger she gets, the crazier her movements feel! She gets hiccups about 4 times a day, and must not like them because that is when she squirms around the most! I can always feel the weight of her little body just under my skin, and can even feel her tiny foot kick out (and yes, into my ribs on occasion!). Good news: according to our last ultrasound about a week ago, she is head-down and in position for birth!

And I've recently started feeling Braxton Hicks contractions. They were hard for me to notice at first, because I just thought it was the baby moving. But as they've grown stronger (and after a recent non-stress test confirmed that I am indeed having contractions) I've been able to tell the difference. They feel like a sudden weight and pressure growing stronger and stronger in my lower uterus, and then the rest of my belly gets really hard. They don't happen too regularly, except for when I'm in the car. For some reason being in the car makes me contract about every 10 minutes! My OB assured me that's ok, since my non-stress test had very healthy results, and the contractions don't hurt and do eventually stop.

I do feel much better about them now that I'm actually on leave! Now if I am worried about contracting too much, or if they seem to be getting too strong, I can lie on my side whenever I need to. And if that horrible rib pain acts up, I can lie down for that as well! I have a lot I want to get done during my month of leave before baby arrives- lots of books to read, lots of 'nesting' to do (I've already been participating in quite a bit of nesting already!), and lots of preparing and relaxing. It's hard to believe that in just 2 more weeks, baby will be full term! And in just over 4 weeks, we will be at her due date!