Sunday, April 15, 2012
Saturday, April 14, 2012
38 Week Appointments
Thursday I met with Katherine and Alison at Andaluz for my 38 week visit. All of the usual tests were fine (urine, BP, pulse) and my weight was even up to 152. They were so proud.
Our main topic of conversation at this visit was getting a plan in place for me to hopefully ward off any possible postpartum depression that may be looming on the horizon. As I have a history of depression and a current anxiety disorder that has been in full swing during the entire pregnancy, I have been concerned lately about how I will cope with the demands of a newborn, little sleep, etc. In fact, at my 37 week visit with Dr. Stempel, I asked him to write me a preemptive antidepressant prescription--just in case. He thought it was an excellent idea and wrote me one for 50 mg Zoloft tablets, advising to cut them in half and start taking one on the day the baby is born. His thought was to take 25 mg for one week and then at that point see if I needed to take the whole 50 mg pill. My experience in the past with antidepressants has been that they take 2-3 weeks to "kick in," so if I choose to go that route, I'll probably just go ahead and up the dose to 50 mg after the first week.
Of course I don't want to take them . . . there aren't any antidepressants that don't pass through breastmilk although Stempel said only 1-2% gets through as opposed to something like 25% passing through the placenta when taken during pregnancy. And I haven't taken anything in about seven years now, so if I was to go back on them I think I would feel as if I have failed. But on the other hand, I sure don't want my emotions and thoughts to spiral out of control so that I can't take care of my baby the way he deserves. And I want to enjoy being a mama!
Katherine understood my concern about the Zoloft and looked up some information on the Internet about a study on that drug in particular and its presence in breastmilk. The findings were that zero to very minimal amounts had been found in breastmilk. That made me feel a bit better.
Katherine also told me about a practice that oddly enough, I had just read about for the first time in a People magazine earlier in the week. It's called placental encapsulation and apparently is very very good for women to take postpartum. The baby's placenta is made into capsules after birth (takes 3-5 days) and then the mama takes them in order to help her body recover and get extra nutrients that she would otherwise not get. It's supposed to help very much with postpartum depression symptoms. There are a couple of local women who prepare these capsules and I have their information. It's pretty likely that I will go ahead and have it done because honestly, I'd much rather take those (even though at first it does sound a little bit gross), than the Zoloft if I can at all help it. Tinctures can also be made from the placenta but it takes much longer--weeks--that I just don't feel I have.
Katherine also suggested contacting Baby Blues Connection for information on attending a local support group. I told her that I picked up their information months ago during an appointment at Dr. Stempel's office, but I felt like I wouldn't fit in well since I already have depression / anxiety. My thought was that the group would be full of women who only experienced those symptoms during pregnancy or postpartum. Katherine assured me that there would more than likely be many women in attendance with histories similar to mine and encouraged me to get in touch with them. I called them when I got home that day and left a message. A really sweet volunteer emailed me that evening and said that I was so smart to reach out for help now instead of waiting until it gets really bad. That made me feel better. We emailed a couple of times that night and she let me know about a support group that meets on Mondays in my general area. My plan is to check it out next week and see how it goes. Generally I find I do better one-on-one as opposed to being in a group (I really dread having to go around the circle and talk about myself), but I'll give it a shot. Maybe I can just listen during my first few meetings.
Friday (yesterday), I saw Dr. Stempel and had a fairly uneventful visit. I weighed 153 by his scale so have now gained a total of nineteen pounds during the pregnancy. I'm hoping to reach twenty-five pounds by the time our little guy is born, but we shall see. I guess all the whole milk, cheese, almond butter and ice cream I've been eating is paying off! ;)
I let Dr. Stempel know that the midwives are planning to call him soon to discuss the birth plan and get any input he may have. Katherine said they will write up an actual plan and have me sign it on my next visit so that everyone is on the same page. As far as I know, the plan is that the midwives will check the baby's heart tones every 20 minutes during active labor and if there are any signs of a problem, we will transport to Emanuel where Dr. Stempel will take over. I am comfortable with this as the hospital is only about four miles from the birth center and we should know far in advance of any trouble brewing. But I feel in my heart that all will go well and smoothly, and that this little boy will make his way into the world in exactly the way that works best for him.
It won't be long now. :)
Our main topic of conversation at this visit was getting a plan in place for me to hopefully ward off any possible postpartum depression that may be looming on the horizon. As I have a history of depression and a current anxiety disorder that has been in full swing during the entire pregnancy, I have been concerned lately about how I will cope with the demands of a newborn, little sleep, etc. In fact, at my 37 week visit with Dr. Stempel, I asked him to write me a preemptive antidepressant prescription--just in case. He thought it was an excellent idea and wrote me one for 50 mg Zoloft tablets, advising to cut them in half and start taking one on the day the baby is born. His thought was to take 25 mg for one week and then at that point see if I needed to take the whole 50 mg pill. My experience in the past with antidepressants has been that they take 2-3 weeks to "kick in," so if I choose to go that route, I'll probably just go ahead and up the dose to 50 mg after the first week.
Of course I don't want to take them . . . there aren't any antidepressants that don't pass through breastmilk although Stempel said only 1-2% gets through as opposed to something like 25% passing through the placenta when taken during pregnancy. And I haven't taken anything in about seven years now, so if I was to go back on them I think I would feel as if I have failed. But on the other hand, I sure don't want my emotions and thoughts to spiral out of control so that I can't take care of my baby the way he deserves. And I want to enjoy being a mama!
Katherine understood my concern about the Zoloft and looked up some information on the Internet about a study on that drug in particular and its presence in breastmilk. The findings were that zero to very minimal amounts had been found in breastmilk. That made me feel a bit better.
Katherine also told me about a practice that oddly enough, I had just read about for the first time in a People magazine earlier in the week. It's called placental encapsulation and apparently is very very good for women to take postpartum. The baby's placenta is made into capsules after birth (takes 3-5 days) and then the mama takes them in order to help her body recover and get extra nutrients that she would otherwise not get. It's supposed to help very much with postpartum depression symptoms. There are a couple of local women who prepare these capsules and I have their information. It's pretty likely that I will go ahead and have it done because honestly, I'd much rather take those (even though at first it does sound a little bit gross), than the Zoloft if I can at all help it. Tinctures can also be made from the placenta but it takes much longer--weeks--that I just don't feel I have.
Katherine also suggested contacting Baby Blues Connection for information on attending a local support group. I told her that I picked up their information months ago during an appointment at Dr. Stempel's office, but I felt like I wouldn't fit in well since I already have depression / anxiety. My thought was that the group would be full of women who only experienced those symptoms during pregnancy or postpartum. Katherine assured me that there would more than likely be many women in attendance with histories similar to mine and encouraged me to get in touch with them. I called them when I got home that day and left a message. A really sweet volunteer emailed me that evening and said that I was so smart to reach out for help now instead of waiting until it gets really bad. That made me feel better. We emailed a couple of times that night and she let me know about a support group that meets on Mondays in my general area. My plan is to check it out next week and see how it goes. Generally I find I do better one-on-one as opposed to being in a group (I really dread having to go around the circle and talk about myself), but I'll give it a shot. Maybe I can just listen during my first few meetings.
Friday (yesterday), I saw Dr. Stempel and had a fairly uneventful visit. I weighed 153 by his scale so have now gained a total of nineteen pounds during the pregnancy. I'm hoping to reach twenty-five pounds by the time our little guy is born, but we shall see. I guess all the whole milk, cheese, almond butter and ice cream I've been eating is paying off! ;)
I let Dr. Stempel know that the midwives are planning to call him soon to discuss the birth plan and get any input he may have. Katherine said they will write up an actual plan and have me sign it on my next visit so that everyone is on the same page. As far as I know, the plan is that the midwives will check the baby's heart tones every 20 minutes during active labor and if there are any signs of a problem, we will transport to Emanuel where Dr. Stempel will take over. I am comfortable with this as the hospital is only about four miles from the birth center and we should know far in advance of any trouble brewing. But I feel in my heart that all will go well and smoothly, and that this little boy will make his way into the world in exactly the way that works best for him.
It won't be long now. :)
Wednesday, April 11, 2012
38 Weeks & No More Jeans or Undies
This is kind of a humorous note to the tail end of my pregnancy . . . I have officially gotten so big that I can no longer wear either of the two pairs of maternity jeans I have or the bigger undies that I bought only about a month or two ago . . . I started out with some really cute dark blue denim jeans from The Gap that I wore from about 3 months to 6 months. Then those got too tight when I sat so I switched to some "hippie" flared jeans in a lighter denim wash for the next couple of months. Two weeks ago now (so 36 weeks), I went to put them on after washing them and discovered that they too had become too tight and uncomfortable. The midwives at Andaluz had suggested bringing comfy clothes for labor and I figured I should just bite the bullet and buy myself some maternity yoga pants. I also figured it was time because I had begun going pantless around the house since it wasn't comfortable to sit or lie on the couch in my jeans anymore. Michael thought this was a funny turn of events, but I really wanted to be wearing some pants! I found some great black ones at Macy's that weren't too spendy and have been practically living in them for the past two weeks. The only other thing I can wear is the very cute black dress that Eileen loaned me . . . the equally cute leggings she loaned me are now too tight as well.
And as for the undies . . . here's something I think is pretty darn hilarious in terms of maternity sizing. I have been buying the "Motherhood Maternity" brand of undies since about my third month of pregnancy, and the tag said to "buy your pre-pregnancy size." For me this was medium, so back when my baby bump was still pretty petite I bought a bunch of packages of three pairs. Eventually I noticed that they were too tight (this was while I was still working), and I thought I could be thrifty and just snip the elastic around the legs here and there to make more room. Let me just say that this did not work well. I ended up with undies that were hanging on by inches of material but those inches were still too tight. So I bought a few packages of size "large" undies thinking they would last me until the end of my pregnancy. But I was a little confused about the sizing . . . I mean, if my pre-pregnancy size was supposed to work, how come I was buying the next size up?
Well, this past week even those large size undies became too tight while I was sitting. I just can't bring myself to buy more undies in a bigger size for only a few more weeks of pregnancy, so have now decided to spend the rest of the time "going commando." Hope that's not TMI, everyone.
I think it's pretty funny how it all worked out and that I am now down to one pair of pants. I was thinking the other day that I sure hope my water doesn't break while I am wearing them because then--what will I be laboring in? Maybe I will be going commando. I know the midwives won't mind. :)
And as for the undies . . . here's something I think is pretty darn hilarious in terms of maternity sizing. I have been buying the "Motherhood Maternity" brand of undies since about my third month of pregnancy, and the tag said to "buy your pre-pregnancy size." For me this was medium, so back when my baby bump was still pretty petite I bought a bunch of packages of three pairs. Eventually I noticed that they were too tight (this was while I was still working), and I thought I could be thrifty and just snip the elastic around the legs here and there to make more room. Let me just say that this did not work well. I ended up with undies that were hanging on by inches of material but those inches were still too tight. So I bought a few packages of size "large" undies thinking they would last me until the end of my pregnancy. But I was a little confused about the sizing . . . I mean, if my pre-pregnancy size was supposed to work, how come I was buying the next size up?
Well, this past week even those large size undies became too tight while I was sitting. I just can't bring myself to buy more undies in a bigger size for only a few more weeks of pregnancy, so have now decided to spend the rest of the time "going commando." Hope that's not TMI, everyone.
I think it's pretty funny how it all worked out and that I am now down to one pair of pants. I was thinking the other day that I sure hope my water doesn't break while I am wearing them because then--what will I be laboring in? Maybe I will be going commando. I know the midwives won't mind. :)
Tuesday, April 10, 2012
38 Weeks!!
Whew! We're at 38 weeks now and my belly has officially become what you would call "big." :) Even Michael says so! My belly button is hanging tough, though, and has so far refused to pop out. I keep thinking that my skin cannot possibly stretch any more . . . and then it does! Bodies are truly amazing.
At the risk of sounding like I am complaining (because believe me, pre-pregnancy I promised myself if I ever got pregnant I would bear every ache and pain in silence), I'm going to tell you the truth about how I've been feeling . . . I honestly think that if I don't write it down, my "pregnancy brain" will forget all about it once I see that sweet little boy's face.
Sleeping has been a bit of a bear for about the past three weeks. My tummy is so big that it's pretty uncomfortable when I'm on my side--even with a pillow under my belly and one tucked between my legs to help keep my spine aligned. And if I'm on my left side (which is the side that is supposed to be the best to be on because it allows for the most circulation to the baby), I feel like he gets squished, since his torso and bottom are on that side. A few times I've woken up early to take my thyroid pill and not been able to go back to sleep so have watched some really early morning t.v., read my book (currently The Girl With the Dragon Tattoo) or just tried sleeping with pillows behind my back on the couch.
I've discovered too, just within the last week or so, that I generally can't walk far or be out of the house for longer than a few hours or my back aches like crazy. All I want to do is go home and sit or lie down. Michael and I went for a walk last Saturday because the weather was just beautiful (one of the first really spring-like days we've had this year), and halfway through the walk I wasn't sure I could make it back to the house. :) It took a couple of short rest breaks, but I did in fact make it home. Being this far in my pregnancy has definitely made me pay more attention to my body and the messages it sends.
I'm also quite short of breath lately . . . my diaphragm is being compressed by my massive womb, which, by the way, can grow up to 1000x its non-pregnant size. Isn't that amazing? I read that in a book at the library yesterday, and saw pictures of what my insides look like at this stage: my stomach and intestines are all shoved up against my diaphragm and my glorious womb with baby inside has first dibs on the available room in my abdominal and pelvic cavities right now.
The late pregnancy symptom that I am enjoying the least is hands-down the return of morningsickness. The past few days it has been my companion for most of the day, every day. Sparkling mineral water seems to be the only thing that really helps. Earlier on in my pregnancy I found that lollipops from YummyEarth did the trick, but I'm trying to cut out extra sugar where I can (so I can get it from fruit and the occasional ice cream), and am back to the sparkling water, which I love. It helps, but dang, it certainly cuts down on my motivation to get things done around the house or in preparation for Baby's arrival. I am just so, so thankful that I don't have to work . . . I really don't know how I would make it at this point.
So that is the nitty gritty of Amy's pregnancy at 38 weeks. If nothing happens by the end of this week, I'm going to make an appointment with Jelena to get some "jump start" acupuncture next Friday. We'll be just a couple of days before the 40 week milestone and I don't want to go too far past our due date or I know Stempel will want to induce.
At the risk of sounding like I am complaining (because believe me, pre-pregnancy I promised myself if I ever got pregnant I would bear every ache and pain in silence), I'm going to tell you the truth about how I've been feeling . . . I honestly think that if I don't write it down, my "pregnancy brain" will forget all about it once I see that sweet little boy's face.
Sleeping has been a bit of a bear for about the past three weeks. My tummy is so big that it's pretty uncomfortable when I'm on my side--even with a pillow under my belly and one tucked between my legs to help keep my spine aligned. And if I'm on my left side (which is the side that is supposed to be the best to be on because it allows for the most circulation to the baby), I feel like he gets squished, since his torso and bottom are on that side. A few times I've woken up early to take my thyroid pill and not been able to go back to sleep so have watched some really early morning t.v., read my book (currently The Girl With the Dragon Tattoo) or just tried sleeping with pillows behind my back on the couch.
I've discovered too, just within the last week or so, that I generally can't walk far or be out of the house for longer than a few hours or my back aches like crazy. All I want to do is go home and sit or lie down. Michael and I went for a walk last Saturday because the weather was just beautiful (one of the first really spring-like days we've had this year), and halfway through the walk I wasn't sure I could make it back to the house. :) It took a couple of short rest breaks, but I did in fact make it home. Being this far in my pregnancy has definitely made me pay more attention to my body and the messages it sends.
I'm also quite short of breath lately . . . my diaphragm is being compressed by my massive womb, which, by the way, can grow up to 1000x its non-pregnant size. Isn't that amazing? I read that in a book at the library yesterday, and saw pictures of what my insides look like at this stage: my stomach and intestines are all shoved up against my diaphragm and my glorious womb with baby inside has first dibs on the available room in my abdominal and pelvic cavities right now.
The late pregnancy symptom that I am enjoying the least is hands-down the return of morningsickness. The past few days it has been my companion for most of the day, every day. Sparkling mineral water seems to be the only thing that really helps. Earlier on in my pregnancy I found that lollipops from YummyEarth did the trick, but I'm trying to cut out extra sugar where I can (so I can get it from fruit and the occasional ice cream), and am back to the sparkling water, which I love. It helps, but dang, it certainly cuts down on my motivation to get things done around the house or in preparation for Baby's arrival. I am just so, so thankful that I don't have to work . . . I really don't know how I would make it at this point.
So that is the nitty gritty of Amy's pregnancy at 38 weeks. If nothing happens by the end of this week, I'm going to make an appointment with Jelena to get some "jump start" acupuncture next Friday. We'll be just a couple of days before the 40 week milestone and I don't want to go too far past our due date or I know Stempel will want to induce.
 |
| Sorry these pics are sideways--will try to flip them later. :) |
Thursday, April 5, 2012
37 Week Prenatal at Andaluz
Tuesday I had my 37 week appointment with Dana (back from her month off), her apprentice, Isabelle, and Jennifer, who will be my doula and assistant midwife at the birth. The very cool thing about this appointment is that Michael was able to go with me. I think the last appointment he went to was the 20 week ultrasound. It's not that he doesn't want to be there; it's just really tough for him to get away from work. And not much usually happens at the appointments anyway: I get weighed, my BP gets taken,, I pee in a cup, etc. The best part is always hearing the baby's heart beat.
But this appointment was different because Dana was back and he hadn't seen or spoken with her since the childbirth class we took back in January. Even more importantly, it was the last time before the baby's birth that he would have a chance to meet Jennifer, as she lives on the coast and doesn't get to Portland all that often. I thought the appointment went really well. The five of us sat in a circle and talked a lot about the birth plan that Michael and I put together, and also about some of my fears surrounding labor and birth.
These last two and half weeks that I have been free from work, I have been trying to prepare myself mentally for our big day. I've been reading from Birthing from Within, by Pam England, which I've found to be a great resource. There are numerous exercises to choose from that help a woman and her partner explore their thoughts and feelings around birth, tips on what one might expect during a hospital birth versus a home birth and many, many suggestions on pain coping techniques for labor.
I've also read birth stories in Ina May Gaskin's book, Ina May's Guide to Childbirth, (thanks, Christi!) and have likewise found it to be an invaluable resource. One of my biggest fears around labor has been that the baby might get stuck on his way out. The other day I read story after story of babies who had gotten temporarily stuck due to shoulder dystocia (where the head is born, but then the shoulders have trouble coming through), and Ina May and the other midwives would simply have the woman move to a hands and knees position. In every case, the baby's shoulders had no problem slipping through once this change in position had occurred. It was very comforting to know that a simple change in a laboring woman's position could shift her pelvic bones enough to open up even more space for her baby.
I'm not going to lie . . . I've been nervous about the pain of labor and of how I will handle it. My biggest concern is that it will be like the menstrual pain I've had with endometriosis--awful, awful, awful. I've had a few twinges of that pain here and there lately. At times I think it could be from the baby inadvertently bumping one of my cysts, but I notice it most when I am having a strong Braxton-Hicks contraction. I've read stories of other women with endo who have said that labor pain was nothing compared with the pain they'd had for years with their monthly cycles, and I am hoping very much that that will prove true for me too. And if it doesn't . . . well, I tell myself at least there will be spaces between the pain where I can rest. When I've had endo pain with its accompanying symptoms (nausea, vomiting, diarrhea), there has been no break for the duration of the "attack." Granted, in my experience endo pain attacks never lasted as long as labor will, but I think having at least a minute of rest between contractions /rushes will help a great deal.
My hugest, biggest fear around labor and birth has always been for the baby. It's the unknown and for someone (me) who feels most comfortable around things she can control, having to surrender to the process and trust that what she wants most (safe birth of healthy baby), will take place. I found some great affirmations from a doula service website in South Africa: http://www.birthbuddy.wordpress.com/, and have written down my favorites. My plan is to read them aloud at least once a day until the birth and maybe have someone try reading them to me during labor too. Words hold the most power for me, and I'm hoping they will work their magic to bolster my confidence that everything will go just as it should.
Dana gave me an exercise to try as well: birth art exploring fear. With your non-dominant hand you draw your greatest labor and birth-related fear in a dark color. When you've got that done,you switch hands and use other colors to draw images or write words in the four corners of your paper that will help you, should that greatest fear come to pass. I did this exercise yesterday and I think it was helpful. I cried while I did the first part, but felt much better as I did the second part. And feeling better was surprising to me because I really didn't think there would be anything that could comfort me should my greatest fear happen. I guess maybe that is the point of the exercise: it shows you that you are stronger than you think.
The technical part of my prenatal visit went well. My BP and pulse were fine, urine was fine, and my weight was up a half pound from last week's visit with Katherine. The baby measured well (my little basketball belly) and his heart tones sounded great as usual. Now I just need for him to get a little bigger and a little stronger for his journey to the outside world to meet us.
It won' t be long now and I am so looking forward to seeing his face for the very first time.
But this appointment was different because Dana was back and he hadn't seen or spoken with her since the childbirth class we took back in January. Even more importantly, it was the last time before the baby's birth that he would have a chance to meet Jennifer, as she lives on the coast and doesn't get to Portland all that often. I thought the appointment went really well. The five of us sat in a circle and talked a lot about the birth plan that Michael and I put together, and also about some of my fears surrounding labor and birth.
These last two and half weeks that I have been free from work, I have been trying to prepare myself mentally for our big day. I've been reading from Birthing from Within, by Pam England, which I've found to be a great resource. There are numerous exercises to choose from that help a woman and her partner explore their thoughts and feelings around birth, tips on what one might expect during a hospital birth versus a home birth and many, many suggestions on pain coping techniques for labor.
I've also read birth stories in Ina May Gaskin's book, Ina May's Guide to Childbirth, (thanks, Christi!) and have likewise found it to be an invaluable resource. One of my biggest fears around labor has been that the baby might get stuck on his way out. The other day I read story after story of babies who had gotten temporarily stuck due to shoulder dystocia (where the head is born, but then the shoulders have trouble coming through), and Ina May and the other midwives would simply have the woman move to a hands and knees position. In every case, the baby's shoulders had no problem slipping through once this change in position had occurred. It was very comforting to know that a simple change in a laboring woman's position could shift her pelvic bones enough to open up even more space for her baby.
I'm not going to lie . . . I've been nervous about the pain of labor and of how I will handle it. My biggest concern is that it will be like the menstrual pain I've had with endometriosis--awful, awful, awful. I've had a few twinges of that pain here and there lately. At times I think it could be from the baby inadvertently bumping one of my cysts, but I notice it most when I am having a strong Braxton-Hicks contraction. I've read stories of other women with endo who have said that labor pain was nothing compared with the pain they'd had for years with their monthly cycles, and I am hoping very much that that will prove true for me too. And if it doesn't . . . well, I tell myself at least there will be spaces between the pain where I can rest. When I've had endo pain with its accompanying symptoms (nausea, vomiting, diarrhea), there has been no break for the duration of the "attack." Granted, in my experience endo pain attacks never lasted as long as labor will, but I think having at least a minute of rest between contractions /rushes will help a great deal.
My hugest, biggest fear around labor and birth has always been for the baby. It's the unknown and for someone (me) who feels most comfortable around things she can control, having to surrender to the process and trust that what she wants most (safe birth of healthy baby), will take place. I found some great affirmations from a doula service website in South Africa: http://www.birthbuddy.wordpress.com/, and have written down my favorites. My plan is to read them aloud at least once a day until the birth and maybe have someone try reading them to me during labor too. Words hold the most power for me, and I'm hoping they will work their magic to bolster my confidence that everything will go just as it should.
Dana gave me an exercise to try as well: birth art exploring fear. With your non-dominant hand you draw your greatest labor and birth-related fear in a dark color. When you've got that done,you switch hands and use other colors to draw images or write words in the four corners of your paper that will help you, should that greatest fear come to pass. I did this exercise yesterday and I think it was helpful. I cried while I did the first part, but felt much better as I did the second part. And feeling better was surprising to me because I really didn't think there would be anything that could comfort me should my greatest fear happen. I guess maybe that is the point of the exercise: it shows you that you are stronger than you think.
The technical part of my prenatal visit went well. My BP and pulse were fine, urine was fine, and my weight was up a half pound from last week's visit with Katherine. The baby measured well (my little basketball belly) and his heart tones sounded great as usual. Now I just need for him to get a little bigger and a little stronger for his journey to the outside world to meet us.
It won' t be long now and I am so looking forward to seeing his face for the very first time.
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