Thursday, June 26, 2014

Dear Mom at the Bookstore

Dear fellow mom at Carmichael's Bookstore today,

First off, I've never done one of these open letters before. Many of them tend to be passive aggressive attacks on someone's parenting. Others are a bit on the cheesy, kumbaya side. I'm aiming for neither.

But I just wanted to take a moment to reach out to you. I walked in the store on this hot afternoon, my ten month old son bobbing around in my Maya Wrap, my six year old daughter walking beside me. We came in to pick out a couple of gifts for the back-to-back birthday parties she has this Sunday. Ah, the life of a kid.

You were already in the kids section with your adorable baby son.You snickered when I rejected an activity book that Stella proposed because I said, "It looks like it'll be more work for that girl's mommy than for her."

I liked you instantly, because I, too, tend to eavesdrop on others' conversations and laugh when I hear something funny. And I really, really, really like it when people laugh at me when I think I'm funny.

I smiled at you. You told me my kids were cute. I told you yours was, too. Your boy was crawling around on the floor, picking up and putting down some board books. You said, "Yeah, I'm letting him crawl around on this dirty floor." Something in the way you said that made me realize that you might think I was judging you. I hated that thought. I really, really hated it.

So, I took Sam out of the wrap and put him on the floor, too. I told you that he's my second, so I've been anything but neurotic about letting him ingest dirt. We laughed.

You asked if I recommended any board books and I did - anything by Sandra Boynton. We watched as our sons totally wrecked the children's book section and my daughter very carefully searched for gifts.

At some point, you went to your stroller to get the bottle for your son. Maybe I'm wrong, but it seems you were looking at me out of the corner of your eye. Were you? I hope I'm wrong, but I'm a pretty intuitive person, and my feeling was you thought I, again, might be judging you.

And then it dawned on me. I have a look these days. I don't wear makeup (mostly because it melts off my face in the summer), my son tends to spend these hot days only in a t-shirt and his cloth diaper, and I'm carrying around my son in a carrier rather than a stroller. In this day and age of Mommy Wars when it seems nearly everyone has their team, I guess it seemed that I belonged to a team. A team that might just judge another mom for using a stroller and disposable diapers and a bottle.

This thought made me so sad. Maybe you thought none of this, but the fact that I thought you might think it also made me sad. What's happened to mothers these days? Why are we so quick to find a style and plead an allegiance to it and suspect anyone who does things differently?

I took out a pouch of baby food and gave some to Sam. True, he was hungry, but I also wanted you to see that I don't fit any type, because if I were truly the type I seemed, I'd have made my own baby food. But I'm too damned lazy for that.

This is my second baby, so I worked through a lot of my self-consciousness with Stella. But I still feel twinges of insecurity. For example, I wonder if you could tell how pretty I thought you were, how envious I was that your baby belly had melted away into a flatter stomach. I'm not proud of that thought because, as a feminist, I know how important it is to accept my body as it is. But for a second I felt like an awkward, lumbering elephant next to you.

Regardless, it was nice spending some time with you today. Our encounter was brief, but it made me think about the forced separations we moms impose on ourselves daily. How we have our "type" and seek out other mothers who also are in that "type."

Well, I am not in a type. I carry my son in a carrier because I hate lugging a stroller around, not because I think strollers are bad for babies. In fact, Sam wouldn't let me put him in a carrier for months, not until I tried the ring sling, so he was a stroller baby for exactly nine months, and still is about half the time. I remember reading a post on the local mother's board from a woman who felt sorry for the babies in their car seat carriers rather than a body carrier at the doctor's office. I kindly let that woman know that my baby didn't need her pity.

Anyway, maybe next time I can get your number. Making new friends as an adult is tough. And not very likely through an open letter on a minimally-read blog.

Your fellow mom,

Randi

Tuesday, June 24, 2014

Why I Give a %*&@ about Birth

A very pregnant me wishing this was a real pina colada. Not a very "earth mama" sentiment, right?

I'm passionate about birth. I'm even taking a workshop this weekend to learn how to be a doula - a person who offers support to the birthing mother and anyone else who's with her during birth. I read every article about birth I can find, I watch every documentary I can find (and my husband laughs as I cry when the baby is born every. single. time.) I love to hear others' birth stories and see others' birth pictures. I can't get enough.

It's funny. As a kid, I found birth SO GROSS. In fact, anything relating to "that area" gave me serious willies. Then, I got pregnant with Stella. I was in awe of the changes in my body, and totally curious about the birth to come. A friend who just had a baby told me to consider looking into natural - or unmedicated or low-intervention - (it seems whichever term I use pisses someone off, so I figure I'll just piss everyone off) birth, because it was so much better for the mother and baby. That seemed like b.s. to me, because I don't like pain. Pain makes me cranky. And I like modern inventions and stuff.

But once I started doing even a tiny bit of research, the facts couldn't be ignored. Interventions like inductions and c-sections can be life-saving when needed, but they are often overused for no evidence-based reason. They are hard on mothers, and they can even be harmful to babies. Although I dreaded the pain, I really wanted to do what I thought was best for that little bean. So I did it. It was crazy and intense and so painful I thought I might die, but I did it. And then I became obsessed with it.

But there's a problem. The problem is that even though I did what I thought was best for my baby, and even though I want to learn more and educate others about how birth doesn't have to be traumatic and can be much healthier for all involved, I'm apparently a "type." In fact, when many people hear that I want to become a doula, they often either cringe or say, "Oh, you're one of THOSE."

I'm a type. So much so, that an article was just written about how people who are passionate about birth are part of a cult. I've never been in a cult in my life, but apparently I am now. And apparently I think that if you don't have an unmedicated birth, you're less of a woman. Or you didn't have a spiritual awakening. Or you suck. Whatever.

Well, for the record, I don't think that. I don't get mad at women at all. Women go to care providers they trust and follow their recommendations. I do that with my doctors, too. Unfortunately, when it comes to birth, many care providers are relying on practices that are simply not evidence-based.

And I don't think birth has to be spiritual. It was for me. It helped me heal from the sexual trauma I suffered as a kid. But for many women, it is something to be endured. That's fine. It still doesn't have to be terrifying for the mother. It doesn't have to be awful. And for so many women and their loved ones, it is.

So. Let me dispel some myths.

1. I think that women who don't have unmedicated births are less than. I don't. You had a baby. I think you're a mom, and I think that's incredible. I hope you felt supported and healthy and not terrified during your pregnancy and birth, because I like and care about women. That's why I call myself a feminist. Proudly.
2. I don't think c-sections and inductions are ever necessary. Ha. No. I've been lucky that I didn't require either, but I know they're life-saving. My sister had preeclamsia with my nephew, so an induction saved both their lives. There was a time when babies and mothers routinely died, all because we didn't perform c-sections. I think both are amazing. I also think they're overused for purposes that make no sense.
3. Epidurals are the devil. Nope. I asked for one each time, but my birth crew reminded me that I wanted to do it without one. (My main fear was of the headaches some women suffer from them, because I'm prone to headaches anyway.) From what I've read, if an epidural is placed after a woman has begun actively dilating, and she continues moving after its placement, epidurals can be fine. They can slow down labor to the point that other interventions are necessary if used too early or if the woman is not allowed to move around; that's my main beef with them.
4. Birth is wonderful and you are an idiot to miss out on that. It's too bad there are no videos of me giving birth. I'm not the serene woman singing during her contractions, I'm not the smiling woman floating in a pool. I'm the woman shouting expletives and telling my husband to get out of my face and screaming at my midwife, "WHY AREN'T YOU DOING ANYTHING?" Yes, the intense experience of birth was, in fact, spiritual for me, because it helped me to love and trust and revere my body. And the surge of endorphins afterward was, in fact, amazing. But the process itself did not feel great. And I think that if you never experience that in your whole life, that's OK. I'll never run a marathon, and I think I'm still pretty cool.
5. I think doctors are quacks and not to be trusted. No. I love my doctor. I love my friends who are doctors. Modern medicine is a marvel. However, I prefer midwives for birth. They are lower stress, lower intervention, more woman-centered. There are amazing obstetricians out there, I've heard. And if I got pregnant a third time and had some complications, you better believe I'd go to one.
6. Home is the only place to give birth. Home births are actually illegal in some states. Which is stupid. There's no reason why a healthy pregancy can't end in a healthy birth at home, and home births are considered quite normal in many parts of the world - like Scotland. (You can read more about that in Brigid Kaelin's fantastic blog, by the way.) In Kentucky, you can only have a home birth if it's performed by a certified nurse midwife, not a certified professional midwife. But in Louisville, where I live, there are no area CNM who perform home births. So, in essence, if you want to have a legal home birth in Louisville, you have to travel to an out-of-town certified nurse midwife and expect her to travel to you on the big day. Which is why many people opt for "illegal" home births in Louisville, overseen by CPM. (Yes, this is confusing. And it really shouldn't be.) Regardless, I gave birth in hospitals - both times. It was a compromise. I wanted a home birth, but Dave liked the assurance that came with a hospital. I really don't care where people give birth, but I do wish that every woman who gave birth in a hospital had the experience I had at Clark Memorial Hospital. It was so calm and nurturing. Birth centers are a wonderful compromise, but they are few and far between. So give birth where you feel comfortable. If you don't get arrested, that is.
7. The birth experience for the mom trumps the health of the baby. This is, by far, the most hurtful piece of b.s. propaganda about birth enthusiasts out there. I did not start down this path for my own "experience." In fact, I endured the pain for the health of my babies. Those interventions that can save lives can also have side effects for the baby. It has been proven that babies born by c-section are at a higher risk for asthma and allergies. Additionally, a recent study found "that induction and augmentation of labor with oxytocin [Pitocin] was an independent risk factor for unexpected admission to the NICU lasting more than 24 hours for full-term infants. Augmentation also correlated with Apgar scores of fewer than seven at five minutes." Plus, I recently wrote how new evidence shows that many interventions can make breastfeeding more complicated than it has to be. So, no, I didn't put myself ahead of my baby, nor do I think anyone should. In fact, I see it the other way around. Interventions that save lives = wonderful. Interventions that are not necessary can be harmful to babies as well as moms. This is how I see it.

So, there. I'm not in a cult. I didn't drink placenta-flavored Kool-Aid. (Sorry? Too much?) So why do I care? I care because I don't like how many women feel scared of birth. Birth is natural and amazing and can be very empowering (whether it ends in a vaginal birth in a rose garden or a c-section in a hospital). When women feel afraid of their bodies and bullied into procedures about which they haven't been properly educated about risks and side effects, I see that as a feminist issue. One that I'm excited to fight for. No matter how much propaganda is thrown my way.

Wednesday, June 18, 2014

I'm Not (Just) Lucky: How to Succeed at Pumping By Really, Really Trying

 My Voodoo Magic Combo
 Unflattering Self-Portrait on My Last Morning of Car Pumping

Pumping at work. Oy. What an adventure. Sam is now 9.5 months and we made it. We did it. We're still nursing now that my school year is over. And I'm taking an extended vacation from that stupid pump.

Can I tell you how many times throughout this process someone said, "Oh, you're so lucky - pumping didn't work out for me?" While I have nothing but sympathy for anyone for whom nursing doesn't go as planned and/or doesn't work out at all, I really got tired of hearing I was lucky. It's like telling someone who got promoted due to their hard work and tenacity that they were "lucky." It's like, "Um, no, buddy, I WORKED for this."

So, in order to both document this wild ride and offer support/advice/humor for anyone in a similar boat, the following is a list of ways that luck did play a part, as well as ways my own hard work played a part. You need a special mixture of both to survive this, that's for sure.

1. The Birth
Luck: I'm so lucky that I had a healthy pregnancy, despite the fact that I was classified as a "geriatric pregnancy." (SO MANY EYEROLLS.) I carried Sam to term and then some (40 weeks, 5 days), and never had any complications - no gestational diabetes, no group strep b, no high blood pressure, etc. Why would any of this relate to breastfeeding? That brings me to...
My Hard Work: I had a vaginal birth. That is becoming increasingly rare, especially in my neck of the woods. Of course, whether or not I had a c-section was not entirely in my control (see all my luck above), but I did do my part. I sought out care providers who use evidence-based practices, namely not inducing unless there is a medical reason to do so. Inductions increase the risk of c-sections, and c-sections increase the risk of breastfeeding difficulty. I also had an unmedicated birth - not because I felt the need to show off (I'm actually a wimp when it comes to pain) or because I'm such a hippy (we ate at McDonald's the other day), but because it is the most assured route to avoid a c-section. (Even epidurals can slow down labor to the point where care providers feel the need to use inductions, which often lead to c-sections.) I've said it before and I'll say it again: c-sections are miracles. Before them, babies and mothers died in childbirth routinely. But they are widely overused, and women are not made aware of their risk factors nearly enough, especially when it comes to breastfeeding. Can a mother successfully breastfeed after a c-section? Absolutely. I know many women who have. But it is more challenging.

2. Starting Our Nursing Relationship
Luck: I'm lucky that Sam latched on like a champ, moments after birth. I'm lucky my hospital, Clark Memorial, had fabulous lactation consultants on their staff who came in to help me, despite the fact that I was a second-time mom who successfully nursed her first kid. I'm lucky I married a guy who understands how intense the first few days of nursing are so he fetched me water after water and countless snacks as I nursed Sam on demand.
My Hard Work: I nursed Sam on demand. Day and night. Night and day. That's the key to breastfeeding in the beginning. After about three weeks, I did start pumping, and I let Dave give Sam one bottle per week, so I could get a bit more sleep. Even that goes against lactation consultants' recommendations, but I had to take a balanced approach, because my mental health seriously suffers with lack of sleep. But mostly, I just fed the dude when he asked for it, and that mostly happened between the hours of 10pm and 5am. (Yawn.)

3. My Leave from Work
Luck: I took a three month leave from work, much to the shock (and dismay?) of my students and coworkers. I'm lucky that I qualified for FMLA (Family and Medical Leave Act) at my job, and I'm lucky that my boss was amenable to the situation.
My Hard Work: I felt that, for me, six weeks wouldn't be enough time to establish a solid nursing relationship so I could pump successfully. (I also felt I wouldn't be ready emotionally or psychologically, but that's another story). We worked hard to budget for this, because I was only paid for five weeks of the leave through disability (although I certainly didn't feel disabled after birth). We saved and scrimped, for sure. I also knew to look into the possibility and know my rights. I also had to plan three months worth of sub plans for two different grades so I could be away from my classroom all that time. That was so fun. Yeah.

4. Pumping Time and Space at Work
Luck: I had so much luck here. My boss was 100% supportive of my decision to pump at work. He told me not to worry about being late to meetings because my family came first. I was able to pump in my classroom, which was easy and convenient. I just had to cover up the window on my door (I had an interior room, so it was my only window) and lock my door. I already had a mini-fridge someone gave me for free to keep all my stuff in, and I was able to use those nifty wipes so didn't have to schlep my milky goods to the public sink to wash them off. My schedule wasn't perfect, but I was able to pump every four hours (once before school, once during my planning/lunch, once after), and that worked OK for me. My planning period was also the lunch period, meaning it was an hour and a half, rather than an hour, and that was a true godsend. My fellow coworkers on my team were also totally sympathetic and supportive, understanding when I had to jump up to leave a meeting.
My Hard Work: Even with all this support, I still had to stand up and demand my time to pump. It would slip people's minds and they'd plan two back to back meetings, or someone would show up knocking on my door when the pump was going. I had to stand up for myself and, sometimes, I had to cope with the fact that someone was annoyed with me. I never hung a sign on my door, because if my students knew what I was doing some would use it as fodder for drama, so kids often knocked relentlessly on my door while pumping, and that was very stressful. Not to mention the fact that I had to pump in the car on the way to work many days. I started work so very early, and I had to help Dave get the kids ready, so it was the only way to get it done in time. Once, I forgot breakfast, so I ran through a drive-thru strapped to all my equipment. Another time, my pumping bra fell out in the parking lot and was run over by another car. Another time, one of my very sweet students spotted me out of the back of his bus and waved enthusiastically, thankfully not noticing my weird get-up. I did wear a cover over the pump, but it still looked very weird. Oh! And twice, custodians walked right in on me while pumping in my classroom. I like to think that was the highlight of their days.

5. Maintaining Supply
Luck: When I came back from my leave, I had a great supply. I'm talking "I better make sure I have my breast pads or else" kind of supply. I pumped plenty for Sam's daycare, plus I had plenty to spare.
My Hard Work: And that's where my luck ends. First off, when Sam was only three weeks old, I started pumping once daily. I was busy and tired, but I knew that I wanted a freezer stash of milk. So, by the time my leave was over, I had 60 oz of milk in the freezer. And I was able to add to that stash at first, due to my plentiful supply. Very soon, though, that supply started to plummet. So, I started playing around with foods and beverages, and eventually settled in on a daily routine that worked for me: steel-cut oats for breakfast, lactation cookies as a snack, tons of water, and a Guinness each night before bed. That worked for a while, but then it started to drop again. So I added the supplement, More Milk Plus, despite the fact that it was expensive and gave me tremendous gas (sorry students). That helped, too, but I wasn't making enough. So we bought some organic formula when my freezer supply was finally gone. I took my first pump (see below) to Babyology, where they tested its effectiveness for free, and deemed it fine. But, eventually, I decided to return to them to rent a hospital grade pump. Although it was large and clunky, it worked wonders and finally saved my supply (along with all the above foods/beverages - none of which I could skip without seeing a dip).

6. The Pumps
Luck: My wonderful friend Bethany had an extra pump, an Ameda Purely Yours, that she just gave to me. That is lucky, especially considering pumps cost between $100 - and $300. And, when I had to rent the pump, I'm lucky I could afford that.
My Hard Work: I guess mostly I worked hard trying new things in order to save my supply. I lugged around the hospital-grade monster when I had to, and finally I discovered that now, thanks to Obamacare, most insurance plans pay for pumps! So I was able to get a Medela Pump in Style FOR FREE from yummymummy.com. And let me just say, it is so much better than the Ameda.

So, that's that. I'm not tooting my own horn. I got very lucky in many ways. But I also worked my rear end off maintaining this relationship. And I'm so glad I did. Now, when Sam and I want to go out, I don't have to pack bottles - just me. And although I'll need to start pumping again to build up a supply for those days I actually go out, right now I'm letting that pump gather some dust.

Good luck to all who are trying to pump and work. It's hard work! Make sure you tell your spouses that every day.