Postpartum with Nancy

With Nancy on the morning of Eli's birth

 I had my 6 week postpartum visit with Nancy yesterday.

She called me late last week to ask me to come by and re-sign the birth certificate.  She'd filed on the old form because the health department kept not providing the new state form to her.  So all of her births for February and March had to be re-filed on the new form.  When she called she realized I was at 6 weeks and it was time for me to come in.

So yesterday morning while Sabine was at school I packed up Eli and we went out in the rain to Nancy's house for the last time. The visit was quite straightforward.  She checked me out and I'm "perfect" and healed quite well.  (eventually I'll share the birth story and you can read all about it, woo-hoo).
She checked my weight and I've lost 18 of the almost 50 lbs I'd gained.  But if you count Eli's 8 lbs,  only 10 have gone from me... and most of that was probably fluid.  She said there's an initial drop in the first 2 weeks, then a plateau, then a drop around 3 months, plateau, drop again around 6 months or so.  She says the belly stays for 6 months to a year and then comes back at menopause.  "It's just as annoying around menopause as it is now" she says.  But she told me it's important fat, it is there in case something happens so that I can still make milk for Eli.  Eli needs that milk for the first year so it is there for him.  Put in that perspective I can be a little sweeter to myself about still feeling like I look like I'm pregnant when he's already a month and a half old.

She asked about birth control and gave me a recommendation of a book to read about how the female anatomy effects arousal etc.  She said I have a posterior uterus which means fewer nerve endings concentrated in that space.  Positive to that is less pain and faster labors.  Negative well... fewer nerve endings means less feeling and I'll leave it at that.  So the anterior uterus people have harder slower labors but more feeling at other times.
The book is: Woman's Anatomy of Arousal by Sheri Winston    I can't recommend it because I haven't read it, but I trust Nancy.  I bet it's pretty good.  She told me Max would like that I read it (and "it isn't porn")

As I was leaving I told her I was sad to go.  She said that maybe I'd be back one day but we're pretty sure Eli is our last little addition to the family.  So she told me to come back and bring something for the room where she sees clients.  As we left she hugged me and told me it's not good-bye yet.  Which was pretty much what I needed to hear because I don't want it to be good-bye.  (though it is)  I'll print some pictures for her room and bring them, and bring a huge thank you letter telling her what a profound impact she's made on my life and hopefully get to see her at least one more time.

And, Eli slept the whole time!

Nancy visit 27 weeks

(27 weeks, 3 days)

I'm making myself feel a little less guilty that I"m blogging so infrequently about this pregnancy by thinking that it'll be a boy so he'll care a lot less than a more sentimental girl would care.  who knows.

Also, I'm less open to commentary which means, I'm less open to sharing much this pregnancy.

BUT.  I do want a record, and I do want to share at least a little bit.

So this was my 4th visit to Nancy.  It came after the birth of my brother's daughter by C-section last week,  here in town.  Darling baby, I have to say, and wonderful parents, of course.

Monday.  Monday afternoon is not the time to have an appointment with Nancy.  She's swamped and is running behind most days. Plus she's getting bazillions of phone calls from folks who didn't call over the weekend.  I think I'm her last patient and she zips through because as she says "You're easy" and she always thanks me for being so.  I guess I am easy, but sometimes the squeaky wheel gets the grease, maybe I need to squeak more often.  I'm changing days starting in January though.  It's fine.  And there's really nothing much to talk about just now.  Well, except that I feel like I've forgotten everything I need to know.

But when I first came in she told me I looked pretty.  That was nice. She is so much about business most of the time, so it was an unexpected complement.  She said I looked like the holiday season wasn't making me too crazy. What was interesting was that I'd just been sitting in her waiting area for the last 20 minutes and thinking about how I disliked the hand-me-down clothes I was wearing.  Especially the top which came from a stranger and is too big.  How I'd rather go buy what I want to wear but don't want to spend the money when I'll only wear it a few more weeks.  And that I wished I could wear the dress I'd gotten for Thanksgiving that is pretty darn awesome.  Maybe I just need to wear it in a casual way all through my pregnancy.  I could do it.  Anyway.  I think it was the combination of hair down, brown shirt and these bright gold earrings that went well together.  Nice to be told that these days for sure.  Especially since I pretty much live in my sweatshirt most of the day.

We spent some time talking about the birth of my niece and about how nice it was for me to get to go and hold her when she was just barely a day old.   Nancy encouraged me to go to birth circle and hear some home birth stories too.  (I haven't been at all yet because I work on the same night it happens, but I might be able to sneak in late tomorrow)

She set my appointments from here on out and she gave me the drink for the glucose test which I'll need to do next time.  Ugh.

I asked her if my hormones are shifting now because suddenly I'm feeling a little more almost morning sickness-ish, and way more TIRED.  Like I'm made of lead.  After checking in that I'm taking all my supplements she did assure me that YES hormones are changing.

Then she asked if I'd been feeling more irritable.  (uh, yeah)  And she said because it's a boy there's testosterone floating around in there and that could lead me to feel cranky.  Crazy!  Our bodies are crazy!  But that gives me ammunition to feed my brain - and excuse to feel and behave irritably.  I'll have to work hard to keep that in check.

And of course she checked baby brother.  He was in the perfect position this time!  Praise Shiva/Shakti.  The last two times anyone saw me they immediately said "oh, he's breech!" Well. that got me all worried about a C-section, which is something I never even considered with Sabine.  Luckily I knew he had plenty of time to turn, and I feel kicks all over my belly which is also a good sign.
But today. head down in the perfect spot, and a little foot up under my right ribs.  As soon as she put the doppler on him to listen to his heart he gave a startled kick, and another on the second attempt.  So she said 'well, we know he can hear' which was no surprise given that he responds to me reading and singing to Sabine by throwing a party in there.

Nothing massive at this appointment.  And she let me go with instructions for the drink and an appointment in January.  After that I'll start going every other week already.

I'm just reaching this point of realization that I'm into the third trimester starting this weekend and we have SO much to do.  We have a ton to do physically, and I have a lot of psychological prep to do too. But.  This baby will come and we'll be as ready as we can be.  From there we'll just have to roll with whatever life has to offer.  The adventure begins again!

Back to Nancy

(14 weeks, 3 days)

I had my first appointment with Nancy this morning.  Finally! After all of this time of being pregnant, I get to be with Nancy again.  Hooray!  I think women in RVA get pregnant for their 2nd 3rd 4th times just to get to be with Nancy.  She's awesome.

So I was pulling up to her house when she called me to say I was LATE!  Yikes!  Somehow my brain thought the appointment was half an hour later than it was.  Luckily, this is my second time around so it wasn't such a huge big deal, we just booked through everything.

Went in and did my loo run and weight check.  Then sat down.  She checked me right away and said that I measured exactly right for my dates.  Then she checked the baby.  First of all we commented on how right in front and right out there the baby is as a 2nd baby.  Then she got out the doppler.  First we heard a big kick, and then she eventually found the heartbeat - at almost 160 (more than Babe ever was).

Then questions.  Mine and hers for me.  I asked about travel because we still want to get away this winter and she told me to cut off flying by 32 weeks.  She told me a story about one of her mamas who recently took a plane ride.  When the plane dropped altitude the woman passed out, vomited, and wet herself.  They thought her water broke so they landed the plane and then she was put on a no-fly list.  Uh. Yeah, that doesn't sound fun!

She asked if I'd been feeling little kicks and I think actually I have.  Just faintly and not often.  I can definitely tell when the baby is in a new position because of the way it sticks out of my body wherever it is.

All of my blood work and stuff from the initial visit with the nurse practitioner was fine.

Then Nancy mainly went over what to eat and what not to eat.  And she said I should try to go as organic as possible, and to eat seasonally.  She wants me to add fish oil and probiotics around 20 weeks.  Also now she said they're wanting women to make sure they're getting enough vitamin D in pregnancy and while nursing.  It's good for both Mom and Baby.  So that means time outside in the sunshine for 10-20 minutes daily with no sunscreen.  Or, as the weather gets colder, a supplement of about 1000-2000 IUs daily.  She doesn't want me to add this stuff or the prenatal tea until about 20 weeks when all of the nausea and sick feeling has gone, because if I have one bad burp of any of it I'll be turned off and not want to take it for the rest of the pregnancy.

Another interesting topic for us to discuss was the flu shot.  I didn't have to worry about it last time because she was an October baby, but this time, especially with Sabine in preschool, it's something to consider.  She gave me some alternatives too though for good self-care during flu season.  She also said I can wait and see for a while and see what the season is starting to look like.

We ended our half session with her giving me a folder of information including contact phone numbers, approved OTC medicines, and the consent form.  We set a date in October for the next appointment and she even told me how to set up the 20 week ultrasound sometime in mid-October.  That seems so soon, but I guess I'm a tiny bit later starting with Nancy this time than before.  We still have a while to go.

-----

Then the mother duties just didn't stop as in the afternoon Sabine had a fever and complained of an earache.  Of course it was just after our Dr. office closed.  So we went to KidMed, which is like a patient first for kids.  They were lovely and the checked her ears and throat and pronounced no infections there, probably just a virus.  By the time she had some dinner she was bouncing off the walls but started to go down again by bedtime.   A little motrin and off to bed for her.

And now off to bed for ME!  plenty to do tomorrow!

9 month check-up

For sabine's 9 month check up max was out of town so i took her on her own. this was about a week after seeing the DR at UVA so she was not thrilled to be back at the dr's office. she burst into tears as soon as the nurse took us back to the exam room and once again cried through measurements. she's gained 4 ounces and 1/4 inch in the week and weighed 16.4, length 26 in. those measurements put her in the 25th percentile according to the nurse, but when the dr. looked at them she said sabine was 10th percentile. (it's all so subjective isn't it?)
so first we ended up seeing a student nurse practitioner. she was GREAT. i wish i could have her all the time. she was very respectful of me and of sabine and she listened great to everything i had to say. sabine liked her and calmed down for the exam until she tried to look in sabine's ears. but when she loaned her the stethascope sabine was very happy.
then the dr came in and sabine LOST IT! it was like night of the living dead in there even when the dr and i were just talking. and FORGET it when the dr examined her. i could NOT get sabine to calm down, she was just over having drs mess with her.
the dr didn't seem super concerned but i could tell she didn't like that sabine was 10th percentile. didn't like that sabine hadn't been eating solid food very consistently, didn't like that sabine didn't sleep through the night in her own bed... etc. luckily, she was surprised that sabine uses a sippy cup. and she liked that sabine does use Mama and Dada pretty consistently and she seems to be a lefty.
i was instructed to put her on 3 meals a day, no more than 5 nursings a day, and do the three night fuss -- cry it out cold turkey-- so she'll sleep in her own bed. add to that all talking we'd done recently with friends and relatives.... and with those instructions i pretty much left there feeling like the crummiest parent in the world because my 9 month old has some serious stranger/doctor anxiety and doesn't sleep, eat, play by herself, or crawl (or do anything like it) yet.
and then she had to get caught up on vaccines since she missed some while she had the cast on. so after i finally got her calmed down by letting her look at the light switch, the nurse came back and gave the shot. luckily that nurse is quick and good and sabine was so upset just at having to be on the table it didn't seem to matter that she got a shot.
needless to say it was a tough morning.

Hip Update

We went back to see Dr R at UVA a few weeks ago for a follow-up x-ray. Sabine did great in the car and for much of the appointment. she does NOT like to have x-rays taken and i don't like that she has to have so many, but what can you do. the only part she REALLY freaked out about was having her length and weight measured. absolute DRAMA over those. it was fun to finally have a length 25.75 in and weight 16lbs after all the time of guessing. max and i both thought she weighed more though.
anyway the x-ray looked good but not awesome. the way he put it 'the hip is still underdeveloped' but the bones are still in the right spot, it's very stable, we're just waiting for the bones to harden up a bit more. he asked us to get her to practice standing and she is more than happy to do that. the standing puts the head of the thigh bone into the socket even deeper and the pressure helps bone formation. (like ladies lifting weights to help prevent osteoporosis) otherwise we're just waiting to see. to see what happens and if anything needs to be done. it's a pain that we can't just say 'SWEET' we're all fixed but at least he didn't want to put on a brace or anything like that.

Dr Visit 4 months

Four months old and very very sweet i must say.

yesterday we went to dr. d again for the 4 month check-up. everything looks good. she now weighs 13 lbs which puts her into the 50th %ile. her length is 10% and her head is 25%. otherwise the check up was pretty straight forward. sabine demonstrated her sweet pilates moves and the dr advised us not to put her on the sofa in her carseat because she could lurch right out. (uh, i wasn't planning to do that anytime soon, but OK). her tummy time still rocks, and she was very talkative. internals and externals seem good. she also got a shot and this nurse ROCKED we didn't even know she had given the shot at all, she was quick!
dr. d advised us to go ahead and start rice cereal. she said they're finding that babies that don't start foods before 6 months end up with allergies (where as before it was breastmilk only to 6 months to prevent allergies/ my mom waited 7 with me and i'm the least allergic person i know!). and then she proceeded to tell sabine about all the 'yummy squash and carrots and orange and yellow veggies' she'd be eating after she was on rice cereal for two weeks and then pears and fruits after that. my thought was that she didn't really explain how to best go about introducing solids to US -- the parents who will be doing it. i felt like she assumed we knew what we were doing.
we also talked about the changes in sleep patterns and she suggested we help sabine discover that falling asleep is a one person process -- you don't have to nurse to fall asleep etc. that way when she rolls over in the night and wakes herself she doesn't have to cry or nurse to go back to sleep. but dr. d didn't give any suggestions as to HOW to teach that in a nurturing way. and we didn't ask because we didn't think to and probably wouldn't have followed her advice anyways.
and that was the gist of the visit.

so, we probably won't start the solids just yet. sabine could care less about food right now even though everything she grabs goes right in her mouth. she isn't looking specifically at food or reaching for it or watching us put it in our mouths even as she sits ON the dining room table while we eat dinner. plus our lives are pretty busy with max's work into next month so we'll wait until we're in a slightly calmer spot to start that next fiasco.

this next rant will sound like i hate our pediatrician, and i don't i think she's very very good actually... but
my complaint against the medical community in general is that they expect all of us to be cookie cutters and exactly the same. so many of the things she said sabine was doing (because i assume dr d thinks sabine is a normal average 4 month old) she either isn't doing at all or has been doing for months so is nothing new. she made suggestions without even talking about what could be best for the family as a whole. she speaks in a baby voice mainly to sabine not to us, and she has never ever asked our names. it just didn't feel like she saw the uniqueness of our child or our life. i would like to feel like my care provider at least stops to ask my name, you know. and i feel the same way with most of my other doctors, too. they just don't have the time to have the good bedside manner... and then i'm supposed to trust them. (on the other hand, my dentist comes in to see me for two seconds after the hygenist cleans my teeth but always always greets me by name -- i know it's on my chart outside the room, but at least he checks it!) i guess i'm still in mourning that nancy isn't also a pediatrician and primary care physician. and i guess i'm so lucky that i DID have her for my pregnancy and birth care. i don't know how i would have made it through if i only saw an OB for 10 minutes once a month.

Dr 2 months

this is really cracking me up. i sat down with a happy baby to check email really quickly... she passed out in my arms sitting up. you can just see her head in the pic....


we went back to dr d today to check sabine out. the stats are: weight 10 lbs (she gained more than an ounce a day since last time) 25th % length: 21 1/4 almost 2 inches longer 25th % and head 14 3/4in 10th % so dr d was fine with that. max said 100th % for hair!

heart, lungs, liver, spleen everything is good. sleep is better than expected with a full 8 hour stretch last night. apparently the lack of real naps is normal and we are to expect catnaps until about 6 months -- so we're probably ahead of the curve on that too since she does nap for an hour or more sometimes (if we hold her)

she got two immunizations. rotovirus and whooping cough and she did fine with the shot.. was more angry with dr d for messing with her earlier. she'll go back next month for more shots.

and we got the OK to fly to florida for a visit... we'll just watch out for sickies on the plane.

so all good news.

then the hips. dr d found a clicking in her left hip so we have to go to the orthopedist on thurs to have it checked. could be nothing but ligaments (like mom) but could need a little bracing to get strong. we'll see. happily, the nurse called and made the appt for us while we were in the office. and it's lucky she did because apparently the office will be closed until 1/14 starting the next week. that's a nice long vacation.
maybe we should just go back to see april the vet and check her ourselves.... or not. tyco is due over there soon. i guess we'll take the dog to the dog dr and the baby to the people dr. it was really convenient the last time though.

Dr. D 1 month

Babe is officially 1 month old today. (it's so funny, i call her Sabine in real life, but when i sit down to type, she's always babe)

so we went to the pediatrician. actually, first she woke up ready to party at 5 am which NEVER happens, then she didn't go back to sleep and barely nursed. i was worried about how she'd behave at the pediatrician's office but she's always a good girl for the most part.

we're seeing Dr. D at st. mary's at the recommendations of several friends. this was the first time we met her because last time she was out for the day when we took sabine in. i liked her just fine. my only complaint was that she isn't nancy and we didn't get an hour to sit and chat, hear her opinions, ask lots of questions, and have her drool over sabine. oh well... i guess it's back to reality with dr. visits now. (so i guess the medical update posts will be a lot shorter now too)

Here's the info: Sabine has grown 1/2 inch since birth, now 19.5 inches. Sabine has gained 2lbs 6 ozs since birth ... which is 2 lbs 11 ozs since the last pediatric appointment and 1 lb 2 ozs in the last two weeks. (she now weighs 8 lbs) Eyes, Ears, Throat, Lymph nodes, belly, back, heart, lungs, and hips are all in excellent condition. and she is ahead of the curve on her tummy time. she lifted head and chest off the table which dr. day said she usually sees in 3 month olds. also, ahead of the curve in sleeping at night time in that some nights she sleeps 5 to 6 hours at a stretch... also usually not until much later.

Dr. d was a proponent of breastfeeding and of allowing on-demand feeding, not scheduled. and she said with sabine's weight gain i don't have to worry about waking her to eat. she said i should put off peanut butter as long as i could stand it ... but it doesn't have to be for the duration of nursing (THANK GOD!! the last pediatrician said no peanuts until nursing was finished). she also recommended max giving a bottle once in a while so that sabine knows what to do with it if i'm ever needing to be away from her for a while.

and finally we talked shots. american academy of pediatrics recommends infants get vaccinated for Hepatitis B beginning at birth now. dr d said it's because babies born to women who area positive for hep B can get really sick and die... so 'they ruin it for the rest of us' but according to the dr. sears book a healthy baby is highly unlikely to contract hep B. i mean, i don't think Sabine's going to disappear in the night to go get a tatoo from a dirty needle. she would have gotten hep B vaccine in the hospital, but we weren't in the hospital. so we're delaying ( i personally got the hep B vaccine when i was 15 and i survived).

dr. d just asked us... 'are we doing shots?' which i think was actually really cool. she didn't say SHOTS are mandatory. or try to scare us into vaccinating or make us feel bad if we weren't going to do it. it was very clear that it was our choice. she did just say that she has concern about whooping cough because it is in VA and could be contracted if she was out in public.
i told her we would be doing shots but were considering the dr. sears alternative schedule. she then took a look at the schedule, said she liked it A LOT and made a copy of it. she said she actually liked it a bit better than the alternative schedule they had at the office. SO, that's good. no complaints there. now i'll actually read the book and decide if it is truly the way we want to go or if we'll just follow the normal schedule. at least i know our options and it won't be a fight to get our pediatrician to cooperate.

and that's it. next appointment will be at 2 months on dec 16th. she'll get her first round of shots : (

Nancy visit 17 days old

we sort of cheated. we're not supposed to go back to see nancy for 6 weeks, but it's weird to go from seeing her every week. to having her deliver your baby in your home to then not seeing her for 6 whole weeks. especially when she's the person who's been hearing every intimate detail of your pregnancy and preparation for the baby to come. then suddenly you're just on your own. SOOO.... we went to see her today.

we still had the tub and i wanted NOT to be a tub-hoarder as some people are. but nancy really wanted us to be sure to paint on the tub. so i spent some time last week getting sabine's name and information on the tub. it says SABINE Full of Grace with a sunflower on it because katie brought sunflowers when she was born, and sabine was born into the sunlight of a sunday. and then below that i painted : Sabine Margaret October 12, 2008 Born into the love of Sarah and Max.
here she is with the tub. ignore the crazy eyes we couldn't get one where she wasn't bugging out of her head.



when we brought the tub back i asked nancy if we could just bring Sabine by to weigh her. she sleeps so much and sometimes i'd have to wake her to eat that i wanted to be sure she was gaining enough. nancy'd told me that as long as she's gaining it's ok if she sleeps, but if not we'll have to wake her.
so today we went over to nancy's, stripped sabine down and put her back in the scale nancy had. when we last weighed her two weeks ago Sabine weighed 5lbs 5 ozs. Today.... 6lbs 14oz almost 7 lbs! hooray. you can tell by looking at her chubby cheeks, but i wanted to be sure. so that means since she's gaining well, she can totally sleep as much as she wants and i don't really have to worry about waking her up. nice.

nancy told us ' you have the baby everybody wants. the baby that sleeps well and eats well' we are incredibly lucky i assumed. nancy also credited us with having a very easy pregnancy with low stress and a fabulous birth including the music that all helped to ease sabine into this world. whatever it is, i'm grateful. because at this point i'm not nursing 24/7 and we're getting 8 hours or so of sleep a night (in two shifts) and aren't up for hours at a time with a screaming infant. she is quite simply an easy baby. only fussy when she needs to poop or is trying to throw herself to sleep.

at the end we gave nancy the check from our insurance. why does insurance think that homebirth is only worth $1500? i just wonder how much they would pay for hospital birth? we talked about the craziness of it all that the insurance doesn't cover nancy's full price and we're left to cover it. whereas a few years ago they would've covered all but about $50 of it. now we had a bit more than $50 to pay. BUT totally worth it! i just wish it was in the covered care by our insurance and EVERYone's insurance. i could go on about that forever but what's the use. maybe the next president will fix all this.... or is that just wishful thinking.

in happier news. we really knew sabine was gaining weight (just wanted to be sure it was enough) just look at those cheeks!!!
these are from her chillin in her crib this morning....

Nancy Appt 39 weeks

Currently Craving: Chocolate Silk

Monday morning 8 am... even nancy was complaining about it this morning, and we were interrupted by several phone calls from other clients too. but we were back.

she continued to go over what to expect in labor and particularly transition and then pushing and delivery of the baby and placenta. she said that i'm not going to remember any of this stuff that she's telling me but she's putting it in there anyway and then when the time comes maybe i'll remember a small amount of it and that's fine. she'll remember and that's what's important. and she stressed again that it is scary for the people around me who have never seen birth before (katie and max). she also stressed that it is ok and even though my adrenaline will kick in and scare me, i am really ok. and it will be quite helpful for max to say 'you're doing fine.' and she went over again the beginning part of labor and that i should really really Rest, Nourish, and be Peaceful without trying to be social or anything. i'll need to be 'unobserved' to figure this all out. as she put it... 'when you feel that first labor pain, you won't like it' and then it's up to me to find my rhythm and how to work with my body to get through. (HELLO, yes, this is all a little scary at this point)

and then we checked on Babe. and for most of the rest of the appointment we checked babe. somehow she was way high up this time, definitely higher than she'd been yesterday for most of the day. so when nancy first checked we determined back to my right again. and i asked nancy if i should try to switch her to the left and she said it didn't really matter what i did, babe would be where she wanted to be and she's probably just facing her placenta.

so then we did the internal. and here's where it got tricky. babe's head feels like a bum from the inside. so is she breech is nancy's question. so then nancy was back and forth trying to get a good head 'bobble' at the bottom of my pelvis and feeling for bum at the top near my ribcage. she definitely felt like bum at the top but kind of like bum at the bottom too. AND babe was sleeping in this morning so she wasn't moving at all and giving nancy any clues. finally nancy got me some juice and we found a foot and then a thigh and nancy decided she was 98% certain babe isn't breech. she would like to be 100% before we go into labor though. (i think there's a trip to the vet in our future). she thinks babe is head down, back to my right side, feet on the other side, and she probably has her hands up by her head. who knows. nancy reassured me that if she is right side it doesn't necessarily mean anything bad for labor just as if she's left side doesn't guarantee textbook labor. we'll just have to see what happens. if it turns out she's breech though we'll have to work on turning her which can be difficult for a first time mom because my muscles don't want to let that happen. if she's surprise breech once labor has progressed it's an automatic C-section. i'm just going to rest assured that she isn't breech and be happy with that.

the rest of the exam said i'm about 80% effaced and not open at all. nancy expects to see us back at our next monday morning appointment. she said 'i think i've got one more with you.' but the best part was that she told us we're next. there's nobody else due to deliver before our due date. she got the last three done over the weekend and then me all by myself really and then she has a cluster near the end of october. so that makes me feel good. if babe comes close to the due date then we should have nancy all to ourselves. sweet! we left with an article about how to keep things intact down there as i push a baby out and the plan to come back next week. and we both left slightly annoyed and antzy that we'll be waiting at least another week but i guess we can't complain. and i can only remind myself that every minute she's in there is better for her lungs and everything else. soon she'll be here and we won't believe we ever lived without her probably.

Nancy appointment Week 38

Currently Craving: Frosted Flakes

Yesterday morning was Monday morning so at 8 am promptly we arrived at Nancy's door. and she let us in for our 38 weeks appointment. this time we brought Katie with us. since she's going to be at the birth we figured it would be good if she got to meet nancy. so there was some figuring out of chairs but after that we were all set.

the appointment was very straightforward. essentially i had nancy go over all the labor stuff that she went over with me 2 weeks ago when max wasn't there. so she talked about what to plan for and when i would need help and when i wouldn't need help. and it was good timing for her to go over this stuff because it's the same things katie needed to hear as well. she also told katie 'you can be empathetic, but not sympathetic' so she can care for me but not try to baby me. and she told max and katie that it is very difficult for the people who are watching me go through the labor process but that we do not then say 'take her to the hospital and get her an epidural' she also reminded them that while i may feel totally exhausted because there isn't enough blood in my brain, actually my body has plenty of energy and i'll do fine.

she didn't check me and i think she may have wanted to but she said for my privacy she wasn't going to. if she was way worried about needing to know anything she could have kicked katie into the waiting room and she didn't. so it doesn't seem that we have any urgency at this point to know what's going on down there. that was when she said she figured we'd probably go right up to our due date. she kind of looked towards me as she was saying that... like she is gauging from what i feel. i DO feel the same way, but what do i know? i've never done this before.

she did check the baby though and babe is back to the right (arg!) which nancy finally told me would mean that the early labor (getting to 4 cm) would be longer because she has to turn more than if she was on the left. but nancy also said that the baby is just going to face the placenta and that's how it goes. and the getting to 4 part is the part when i'm supposed to 'do life' and ignore labor as much as possible. babe's bpm was about 130-140 and nancy said she sounds good. nancy also thinks she dropped more from the previous appointment and i agree. HA now that i think of it.... nancy should just give me the doppler and i can get babe to move to the left using that thing... she hates that thing.

at the end we went out back of nancy's house and picked up our tub. one woman i'd met described it as a horse trough and i thought she was kidding. but no. it really is a horse trough. we got the smaller one because the bigger one had a lot of drama with the last mama and i didn't want to invite that, plus the smaller one seemed cozier. nancy said since i'm a first time mom i can stay in an hour or so but then have to get out again and use the gravity to get babe moving. so i won't be camped out in it all day and night (no matter how nice it sounds). we loaded it into the truck and headed out. next appointment.... you guessed it ... next monday 8 am.

until then we still have plenty to do including hosing out and super deep cleaning the birth tub and getting it ready to move into our bedroom when the time comes.

"Birth makes you a Woman" - or Nancy appointment week 37

Currently Craving: Nothing, just ate lunch

Monday morning 8 am... back to Nancy's house for our 37 (!) week appointment.

this time we brought our homework from a few weeks ago. answers to the questionnaire she gave us about what we want the birth to be like. she said all of the births have similarities, but by answering these questions we help to create a more unique and personal birth experience.
the questions were things like: what do you want from this birth? fantasies about the birth? what do you need from the people around you? strengths and weaknesses... all sorts of stuff. i've been thinking about them since she gave them to us but finally sat down to write it all down last night. (then was wide awake at 5 am and decided to just get up and type it out so she can actually read it, arg!)

when we gave it to her i thought we might glance over it and then she'd spend a bit of the time telling max much of the same stuff she told me last time. instead, she read the whole thing bit by bit and picked out the key words and key ideas that we want.. making a huge list on three pages of paper. she said several times that i did a 'great job' and how 'beautiful' it was and that we were going to have a 'great birth' so that was all encouraging.

we talked about the fear of death being very real. at some point the laboring woman gets there and really thinks she's going to die. nancy explained it as 'first, you're not going to die. but then at the same time you really do have to die. the childhood part of you is over. and birth makes you a woman' she described her one sister who doesn't have children and how she isn't an adult the same way the rest of her siblings are. and she continued to empower me and max to make this journey together and as adults. so that feels really good too and in line with how i've been feeling and what i've been thinking about.

we seriously spent an hour talking about all these ideas. and then she took our list and told us we are to make a Birth Invitation. she showed us examples by others. essentially we take the ideas and pair them down to their most important essence and then create some sort of invitation... artwork, a card, just a computer sheet... whatever. but it is something we can give to the people who are around us during the birth so they know what we want AND it is something we can look at through the whole thing for our own inspiration.
it is meant to be more of a right-brained activity. so i love that. and this pretty much replaces the 'BIRTH PLAN' idea that many people have when they go to the hospital. the birth plan is probably really needed in a hospital when you're trying to 'fight the establishment' and do it your own way... you have to write things like 'i'd like low lighting' 'i'd like the baby on my chest right away' etc. at a home birth you don't really have to write that because nancy does it or you just turn out your own lights. but you might put that you are inviting feelings of safety and privacy... that you are inviting health and endurance. whatever feels right and needed.
the appointment really energized me and i feel very positive about the entire thing. seems that i'm in good emotional shape and good physical shape to have a good birth experience. and since the appointment i've been designing the invitation in my head and it rocks. i feel a major art project coming on.

then she finally did check on babe: stats are good still. my bp is good and her heart rate is fine. she changed positions this week so this time she was over on my left side head down with her bum swinging up towards my right rib cage. knowing she went left made me feel better. she is completely active too (she seems to want to help me type this post right now) so she may dance back and forth a few more times before the actual event. we had a LONG braxton-hicks before nancy could truly feel the position and nancy says that's good because the uterus is getting nice and toned, and my abs are helping to hold her in place. nancy described her as being essentially in child's pose from yoga which makes sense as to why we never see an elbow or a foot distinctly sticking out and why she always feels like she has two bums or something... she's just curled up.
we left with three DVDs to watch. two on breastfeeding for me. and one on waterbirth for both of us. then next monday, same time, same place... and we take max's truck to pick up the tub.

Nancy Appointment 36 weeks

Currently Craving: Only Chocolate All the Time

now that i'll be going to see nancy once a week until babe comes i'm going to have to update about her more often too i suppose. that's fine.

yesterday morning we had our 8 am appointment. we made our appointments 8 am on mondays because it is a good time for max with the way his work flows... but of course, yesterday he couldn't come. yesterday max got in at 6 am from driving all night from a race weekend in Ohio where he scored 6th in the nation. babe and i are very proud. but i was pretty tired when i got up and went out to nancy's.

appointment was the same as ever. i'm still gaining weight and i'm looking forward to the end of that part. maybe i'll even lose a pound or two before she's even born. but probably if my diet is only chocolate that won't happen. and my blood pressure and babe's heart rate sound good. babe was in the same position as before with her back to the right side of my belly and her bum way up in my ribs. that was a move from sunday evening when she was totally curled in a tiny little ball near my belly button. still head down though so no complaints. nancy essentially said i'm in good shape as far as getting ready for delivery because the way i'm carrying is nice. she's not hanging out everywhere like a big basketball and i'm 'all baby.' (as opposed to some chocolate some baby maybe?)

we spent most of the time talking about early labor and moving into the more intense stages of first stage labor. she gave suggestions of things to eat that will come back up easily if needed. (fun). and generally suggested in the beginnings of labor to think about three things: "rest, nourishment, and being peaceful" and we talked about how it would work with her being the care provider. essentially we'll be in contact by phone for a while until either we ask her to come or she says it's time for her to come. since max wasn't there she's going to go over much of the information again because she said the men need reassuring that the baby isn't going to just be born before nancy gets there... especially when the contractions get to about 2-3 minutes apart. it was pretty interesting to me that she says she can pretty much hear how the labor is progressing over the phone and can even judge a bit how dilated the woman is through the conversations. she said in coming weeks after she checks me again she'll talk to us specifically about what we can expect from my labor based on what my cervix tells her. do OBs do that? so cool.

after that she gave me two herbal supplements to go out and buy and asked me to start on the raspberry leaf tea. supplements are 5W and Evening Primrose Oil. they do a few things that i can't really remember. what i know is that by taking three pills at every meal and drinking the tea i will be helping to tone the uterus, limit the amount of bleeding during and after the birth, regulate hormones, and specifically prime things up for the prosteglandin receptors. and Prosteglandin is what gets labor started so we want those receptors up and running when the show decides to get on the road.

that's about it. next appointment will be next week and it will probably be pretty similar to this one if max comes with me. and eventually we'll have to pick up our tub too. that should be fun.

oh and my mom and my aunt were wondering if nancy still had their birth records. turns out she does... but finding them would be a whole other story. they're all filed in a back room by year and that's it. she said it can take hours to find them. (sounds like a system i would have in place)

Nancy visit 35 weeks

Currently Craving: Graham Crackers with Peanut Butter

well, we were supposed to meet Nancy last friday at 8am for our appointment but then she called at 7am and said she had to attend a birth so we were pushed. turns out that when we went in at 8am this morning she had just gotten home from another birth and we were almost pushed again. i am amazed she could keep her eyes open and keep her head on straight.

first the normal stuff. everything still looks good. my weight gain is still fine, i'm still fit with no major complaints. bpm was 130-140 range so babe sounded fine. she was head down with her back to my right side and her bum right up to my ribcage. as i told nancy 'she's EVERYwhere' and she still has a few weeks to move around on us before she actually has to set up fully. nancy said she felt like she'd dropped some since she saw us last and i agreed.

nancy did the group B strep test and since she was down there she went ahead and did a check. that was interesting because babe moved up out of my pelvis more and nancy decided to check her position again to make sure she wasn't tricking us. it took a little while but nancy decided yes, she is definitely head down not breech... that her little elbows were probably up by her head for a minute (that's probably what i've been feeling in my bladder sometimes). but the check revealed that we're not going to have a baby any earlier than expected probably. cervix is soft and not 'grissley' as nancy described some of them. but not dialated at all, so that's fine. and we'll find out about the group B in the next few days. if it's there i'll just have to take some oral antibiotics.

now that we're in childbirth classes we are starting to think about labor more so we asked 'when do we call you?' and so she gave us information about false labor and when to call. essentially she said we will KNOW when it is labor first of all and second of all, definitely call sooner than later and BOTHER her. she doesn't like it if we wait too long and then she's out living her life and has to change her plans. she said if average first labor is 12-18 hours she'll be there for 5-6 of them. that sounds reasonable.

we asked her about cord blood banking and she said we could do it if we wanted to but it didn't sound like she was the biggest proponent of it. mainly that the technology isn't in place for using it very very well just yet. plus it's taking blood away from the newborn. as max put it 'it's like a full blood donation from a newborn' after hearing how much has to be collected for it to be useful. it also sounds easier in the hospital than at home.

later she gave me a big list of 'birth affirmations' to read through. she said i should pick some that really resound for me. or even i could write my own. she said i should watch myself and find out what my fears are as i'm approaching labor and birth and then create affirmations to counteract those fears. then i have to practice them or post them around where i can see them. (somehow i feel an art project coming on). what is interesting to me is that last night i was reading the oct. issue of yoga journal which is perfectly timed for me.... all about using yoga to empower yourself and really connect to your personal source of power within. and i decided today to look back at my prenatal teacher training notes to look for affirmations to use during meditation and in general. so somewhere in this big list i'm sure to hit on just what we need.

nancy also said she doesn't need to have a doula there. that we don't need one to do her job for her. and that we should just have the person or people who will really make me comfortable and won't slow down progress. she said again... don't invite anyone just yet because it's really hard to uninvite. very true.

and that's about it. she gave us an article about hormonal systems in labor and how if they're working right labor and birth are working right. so we're to read that (max too!). and now as she said we've "graduated" so we'll go back next monday morning at 8am. and EVERY monday morning at 8am until babe arrives. luckily she said the appointments get shorter towards the end. nancy will do more educating in the next few weeks and then at the very end it's short and sweet and we go on our merry way. so all good news. now i'll just expect that increase in estrogen and decrease in progesterone in the next few weeks and we'll see what kind of crazy nesting flurry we have.

Nancy Appointment 32 Weeks

Currently Craving: Peaches

This morning we had our next appointment. at 8am. 8am is too early for me to have an appointment, i'd only just fallen back asleep from my 4am wake-up when the alarm went off. but oh well. we made it there on time and it was the same routine.

the stats are still good. weight gain continues at a good rate (she actually said 'good' when she's never said anything before). and babe's house measures well. Nancy says 'good she's growing' and she told us babe could grow as much as a half a pound a week at this point so i'd definitely be feeling that. and i have to agree that yes, i'm feeling that. babe's heart rate sounds good at 140-150. and she's in a good position: her back to my belly on the left side, bum up, head down. she is not terribly far down in my pelvis just yet. nancy says with the shape of my body and my birthing genes she'll probably move into position quite easily when the time comes. she also said not to get attached to 'optimal fetal positioning' because essentially the baby will be in her own specific optimal position and we can just let her go there. with her position as it is i tend to get lots of kicks and tickles on my right side. and her head is sitting right on my bladder... hence the need for three potty breaks just to get this far into the post. (ok, slight exaggeration, but not much) when she drops she'll be below my bladder and conditions should improve.

our questions for her were about how to go about choosing a pediatrician and she let us know that if we're not going to be non-vaccinators we're in good shape. and she let us off the hook for going in and having interviews. personally i was not specifically excited about doing that. it seemed not fun and like something we don't want to spend time on when we have limited time together, and i'm NOT doing it alone. (i'd much rather spend time worrying about important things like: curtains for the nursery....hmmm priorities?) her thought was that nobody in town has a really BAD reputation and that as long as they're ok with the home birth and aren't unreasonable about seeing the baby once she's born then we're fine. we can go on friends' recommendations and convenience to our house. and if we don't gel with the ped's personality we'll just find someone else. and that's good because i didn't know what to ask anyway.

and her topics for us started preparing us for the birth gently. we filled out at much info as we could on the form she'll send in for the birth certificate. and she gave us a questionnaire about planning our birth. thirteen questions ranging from 'what is your fantasy birth' to 'strengths and weaknesses' to 'fears' etc. we are supposed to each think about it and answer separately and then come together to talk about it and then bring it back to nancy. some of the questions help to specifically prepare her for how to help us through the birth process. she talked a little bit about other women giving her heads up about their particular ways of handling stress and how that is helpful for her to know going in so she isn't alarmed if i suddenly start doing something really strange.

she also loaned me a copy of birth reborn by dr. michel odent. he's the french OB who started paying attention to letting the mother really have what she needs in birth. he also started using water for pain relief and found that women would request the water over the drugs. so he started the whole water birth idea unintentionally when women got so relaxed in the tubs that they ended up delivering faster than they could get out. she firmly believes we should have a tub for the pain relief. and i'm such a water person i have no problem with that. she cautions about absolute attachment to water birth in that she says the baby will tell us where she needs to be born.... on the bed, on the floor, in the water, at the hospital ... and we'll listen to what she says. i like the idea that really Babe directs the show. it is so much about trusting our bodies to make this birth happen and not about what is convenient for nancy or sounds 'fun' for me.

in our discussions she mentioned a few time 'end of pregnancy hormones' in reference to other women and i had to stop her and ask 'are those starting by now for me?' and she said 'yes'. honestly, judging from my previous post and just how much more emotional and whacked out in my body i've been feeling lately i already knew but i didn't want to be starting too early. but she says with the emotional and physical changes i'm showing i'm in good shape and they don't mean we should expect babe any earlier than she is meant to be here. whew!

and then we pretty much looked ahead to scheduling the next appointment. it would normally fall two weeks from today, but that is labor day so i'm a little further out on that next friday. another appointment 10 days after that and then i'll start going once a week. and then one day or night...

Appointment 28 weeks

Currently Craving Pregnancy Tea i left downstairs

Obviously, i saw Nancy yesterday. the entire appointment did not revolve around the glucose test.

so first the normal stuff. Babe's home is growing just fine. 27.5 cm at 28 weeks. and weight gain continues but at a fine rate. when i rested back to let nancy measure and get the heart rate i had a long braxton hicks so we had to wait for that. then Babe was way down low in my pelvis so Nancy had to bring her up higher to get the heart rate. then she was moving away from the doppler, just like she does every time so nancy really had to pin her to get it. but heart rate is fine. nancy said it's good that babe goes so low in my pelvis. i'm likely to birth just like the women in my family. that my pelvis is made for birthing children and babe going low means she'll know just what to do when the time comes. quick labor. (probably that's relative, but it sounds good to me)

the rest of the appointment revolved around being given instructions for preparing for the home birth. max didn't come with me this time since he was heading to the track with his dad so nancy just gave me a check list of things to do, buy, and think about before the day comes. the goal is to have all of this done by our "safe date" at 37 weeks... which is Sept 21.

Emergency Plan : phone with list of emergency numbers, know the way to the hospital and where we would enter, pre-registration for the hospital (so they know we'll pay). and know that 911 is our best bet in an absolute emergency

Pediatrician: Uh, find one and find out when he/she wants to see Babe after birth. we have to decide about the eye drops and the vitamin K shot, then the pediatrician will have to do the PKU and hearing test. luckily, we don't have to think about circumcision this time around.


after decisions, we move more towards supplies
Birthing Area: clean well-lit room at 75-80 degrees at time of birth
accurate clock for noting time of birth
heating pad with extension cord
large hand mirror
flashlight with fresh and extra batteries
extra pillows
three large sized black plastic bags
two or three large plastic shower curtains

Linens: one set of sheets for the bed
at least 4-6 old bath towels
at least 6-8 cotton receiving blankets or baby towels.
clothes for baby to include: hat, socks, diaper, infant undershirt, choice of outer clothing
mom clothes for after birth
All of these items are to be washed, dried, and stored in labeled plastic bags until birth

Supplies: At least 2 packages of large disposable underpads
large 3oz ear syringe
sanitary pads in various sizes
large tray for emergency equiptment
antibacterial soap
one bottle of 70% rubbing alcohol and q-tips
one large bottle of hydrogen peroxide
Crock pot with extension cord
clean old wash cloths
one squeeze bottle
one thermometer
Baby or adult wipes
one large and one small bowl
One large cooking pot
Juices, ginger ale or other drinks for hydration during labor and gatorade type drink for post partum
plan for high protein meal postpartum (not a steak dinner she said)

For water birth or facilitated labor: Birth tub/pool
plastic shower curtain liner for under it
extra towels
New garden hose
adapter

Comfort Items: advil
ice bag or frozen veggies
Epsom salts
vaseline or chapstick
straws that bend
protein snacks
sour candy
honey
cornstarch or favorite massage oil
exercise/birth ball
Stanley, my stuffed seal (ok, i added that one)

Other optional supplies: Camera with supplies (charged batteries)
special music, candles, aromatherapy items
prepare anyone else who might attend the birth
list of people to call after the birth
birthday cake, champagne or anything we desire to make the birth a special, joyous occasion
COFFEE for Nancy


as she said, it looks like a lot but it isn't really all that bad. many things are to be thought over rather than bought. and she said gathering it all up is fun. she also said if babe arrives before we have everything it's ok, she always has a back up. she has everything she needs. that's reassuring.

after going over all of those things that was about it for the appointment. i'll see her again in about 3 weeks and then we start twice a month. birth prep classes start next week too --- and in between, THE BEACH hooray!!!

Glucose Test

Currently Craving: Grapes

Today for my appointment with Nancy i had to do the 28 week glucose test. My appointment was at 12:30 so she counted backwards and set me up for the test. First, eat breakfast (happened around 8:30), then around 9:30 a protein snack. then at 10 the two-hour fast started. of course, this was a bummer for me because at about 10:30 i started to get pretty hungry.
then at 1200 i had to chug the drink she gave us the last time we were there. it wasn't SO bad. it tasted like flat orange soda but not too horrible. then i was a little late to the appointment and she was running a little late so thank goodness she plans for that. at a few minutes past 1 she did my finger stick.

for the glucose test you want to score below 140. she said she waits a few minutes past the one hour mark to give time for the score to come down a point or two because a score of 143 will require the 3-hour test while a score of 139 is totally fine. she said usually folks test around 120 if they aren't having any real issues and don't have quick blood sugar drops.

i scored around 100.

ugh! no wonder i felt AWFUL when i got there, and still don't feel quite right three hours later. so what happened was my blood sugar spiked and my body took care of it super fast and it dropped very quickly. she'd told me to bring a snack and i ate that right away.

and she said this tells us that i'll probably need to have some protein during labor/delivery so that i don't start to feel faint. and also that we'll definitely plan to have protein food on hand for after the birth.

we talked a little bit about my diet because i was telling her i'm having a hard time eating these days. i'm either not interested or starving. when left to my own devices i don't really eat meals but just have snacks all day. and she said that was perfect. she said at this point in the pregnancy and especially in the heat of the summer grazing is perfectly acceptable instead of trying to get in real huge meals. she just said fruits are great and then pair them with protein. so a peach and cottage cheese or nuts. some crackers with cheese... that kind of thing. essentially she told me to feed myself as if i'm trying to feed a two year old and to always carry snacks. she finished up by saying i'd probably do better if i was served rather than trying to take care of myself. so if i have to go to the kitchen to get it i'm less likely to eat but if max or someone walks over with a plate of food already prepared i'll sit and eat it and feel fine. i might even be hungry and not even all that interested unless someone else is taking care of the preparation.

maybe that's why i ate so well in Charlottesville this week. Yum!

Appointment 25 weeks

Currently Craving: Ice Cream

On Tuesday we had our 25 week appointment with Nancy. And since we're still right in the middle of the pregnancy, it was still more about gathering information in general than about specifics about what will happen with this home birth.

First the general info... we're still right on. weight gain is right (i weigh more than i've ever weighed at this point) and Babe's home measures 24.5 at 25 weeks so that's fine. it sticks up just above my navel now and my navel is getting more shallow (or is it shallower?). When nancy was trying to listen for a heartbeat first i had a LONG braxton-hicks. right now they don't hurt but i'm getting them quite often, essentially every time i change positions, and i do that a lot in yoga... i think i have the fittest uterus on the block. then Babe did NOT want to be heard and when nancy first put the doppler on she moved away and then started kicking like mad which was funny because we could see it from the outside. nancy said 'this is fun because you're so slim we can really see her' but finally Babe did allow herself to be heard and she sound good still.

talking about being slim.... a lot of people have been telling me 'you're so small' and that doesn't bother me but i am wondering when i'll look really really pregnant. i thought i'd be huge by now. so i brought that up to nancy and she said not to worry. i've got three things going for me 1. first baby 2. height and 3. level of fitness. she said i look great and she can see the growing. she also told me i may never get the really round belly particularly because of my height and i might not start to look very pregnant until into the 7th month. so i guess that's reassuring. and it's fine with me to stay small because it makes life a bit easier not to be bumping into myself left and right or to have random strangers touching my belly. nancy said people want to connect and the only thing they know to say is about size 'you're small or you're so big' and she recommended that i learn from this never to say either one to a pregnant woman and just to tell her she looks beautiful and at most ask how the pregnancy is going for her. asking about size can be pretty undermining and make the woman self-conscious... am i going to have a tiny baby? is there something wrong with me or my baby? am i going to have a huge baby? am i a whale? am i not eating right? etc. and pregnant brains don't need anything else to worry about. she also very pointedly told max to ONLY tell me how great i look. (as if he would ever say anything different)

Education this time came about two things. first was the glucose test. here is where having a home midwife rocks!! she gave me the drink to take home, we scheduled our appointment and i'm just supposed to fast and then drink it on my own 30 minutes before my appointment. that is very doable. much easier than going to the clinic twice OR having to go there and then stay for an hour. she said i was the last person she'd expect to have gestational diabetes and that it's more of a safety net to catch people who aren't eating well and to get them on a better diet for the last trimester.

Education point number two was about breast feeding (isn't that one word? blogger says it's misspelled as one word) anyway. she asked if we wanted information even though i've already seen lots of breastfeeding women in my life (mom, marty etc) and i said yes, any information from nancy is going to be good for me. essentially when Babe is born her stomach is the size of a marble and then grows later. but at first she'll nurse for maybe an hour or two but then could go 12 hours or more without nursing. this is for SLEEPING for mom and baby. then for days 2 and 3 Babe is hungry, mom is frustrated because milk hasn't come in. and this is the time when NO ONE is to suggest that mom 'isn't feeding Babe properly' 'child is going hungry' or 'we should switch to formula' because it is precisely this hungry time of Babe rooting for nipple and working around there that stimulates milk production and causes the milk to come in. Babe will be fine despite the frustration. and then with proper latch things should go pretty smoothly with minimal injury to mom (protect the nipples at all cost, nancy said). and by two weeks old, nursing should be firmly established. Again, the great thing about having a midwife is that Nancy comes back and helps get this established. she'll help with getting proper latch and with proper latch, things should go pretty well. she also said that before Babe even arrives she will give me a DVD to check out that has images of proper latch and using that tends to help people a lot because then they know what things are supposed to look like. (i'm also super lucky that one of the moms on the block where i grew up is a lactation consultant and i would have NO problem calling her with questions)

Some things i already knew... like breastfeeding is law of demand and supply. baby demands it, mom supplies it. baby needs more or different calorie make of of the milk and the milk changes to fit baby's needs. the colostrum (first milk) coats the stomach with bacteria for babe and it tastes like amniotic fluid so she's used to sucking that. and it is recommended that women feed only breastmilk for the first 6 months of life and then continue to breastfeed for at least the first year. nancy said in the US only 30% of women make it to 6 months (that really surprised me, but i live in a sheltered natural world i suppose) and she said in new zealand and australia where they do a lot of studies (can't do them here because formula companies provide the money and they don't want women to breastfeed) women do much better at making it to a year and beyond because they know what to do and they have a lot of support. nancy also told me that human mammals have one more breast than normal number of babies and we are actually designed with enough milk to feed TWO babies. she said over and over you have enough milk you have enough milk. and she told max he's not allowed to ask if Babe is getting enough to eat, she is.

finally nancy recommended the local la leche league if needed. also she gave me the card of a lactation consultant if we need her in the future. and some books. she specifically mentioned anything by Dr. Jack Newman as he is the one doing all the research in the field. then also Breastfeeding made simple by Nancy Mohr Bacher.

she finished by recommending the book "the happiest baby on the block". she hates the title and thinks it should be named something like the continuing development of the human mammal in the fourth trimester... but she knew nobody would actually buy it if it was titled that. so nancy spent some time preparing us for the first three months where as she and others put it the baby is still underdeveloped and should still be in the belly so things are just sorting themselves out. sounds like you kind of go under or into hibernation in the first three months and then things open up again. and of course, don't expect to sleep.

at the end of the appointment we scheduled every single appointment from here on out. after the glucose test one i'll start going twice a month and then at 36 weeks it's once a week. when we got into october we scheduled through the 20th. but hopefully Babe will be here by then.

15 weeks to go. it's feeling a lot closer suddenly.

Appointment 21 weeks

Currently Craving: Sleep on my stomach (not going to happen any time soon)

Today was our appointment with Nancy #3. back to her house, sit on the bed and chat. and since we're at the mid-point she's already told us anything she feels that is particularly important for us to know about pregnancy. and since we're at the mid-point she's not going to burden us with tons of stuff about the actual birth. so we kind of all just visited together and she answered our questions that have come up since the last visit and since we watched The Business of Being Born

Our question: If we have to transport to a hospital, do we go to Dr. F's hospital or just go anywhere?
Nancy: first of all, it's not a transport, i prefer to call it a 'change in location.' and she then went on to tell us that we will go to Dr. F's hospital because that's where they're really nice and she has a relationship and we want to go somewhere where they are ready for us. that we would be moving into care if we went there. and we DO NOT want to go to an ER where it would take us more time to get into a place where we could deliver. she also said if a change in location was necessary it would happen way before the actual immediacy of birth and it wouldn't be like i was delivering on the way to the hospital (uh, mom) but we'd get there in plenty of time. she shared with us that there are some things that with first time mom's are just game over for home birth and we go. like meconium in the water. (which recently happened) she kept saying it was about moving INTO care and that with first time mom's it's a 50 50 shot on what's going to happen, but not to be disappointed or think it's a failure if we change location.
i told her i'm totally in that mindset. home birth is my ideal but if nancy says go, we go.

Our question: Does she bring a birth assistant? (this came out of a conversation with my mom last night)
Nancy: that's really dependent on you. she said if we want someone we could hire someone for an additional fee. and that she felt if she needed someone she would let us know but she generally is ok without an assistant. she asked us to think carefully about who would actually be present at the birth. and gave us moment to think about that if lots of other women are there then the husband tends to shrink away and he has a very different experience, plus he then can get sort of pushed aside. she was stressing the importance of the two of us as the primary unit. she said something to the effect of: well max you might be squeamish, but if i ask you to help cut the cord because i only have two hands and you're the only one there, you're going to step up and do it because you can help and because you would do anything you can for your wife and for your baby. and if other people are there you have a different role, a different experience, and don't help so much.
that was really helpful as i think about how this thing should go. it freed me up to feel ok if i only want max around me (which would be true to my form).

she did say that it is helpful to have additional help after the birth for feeding the new parents and doing laundry and getting set up. she said she's had times when there's a friend of the parents there as an assistant who then leaves right after the birth but nancy said most of her work happens in the delivery and then in the 3-5 hours after the birth so the person leaving isn't really much help.

other things she shared: Normal Human gestation is anywhere between 38 to 42 weeks. 40 weeks is the average. so all those babies at 42 weeks really aren't Late they're just over their date but not necessarily late, some babies just need to cook longer. she compared it to farmers with animals. they know a general range of when to expect the baby and they don't mess with the mom in that range, she'll do it when the baby is ready. and the baby tells her.
she also shared that first time moms tend to be surprised because it takes longer than they expect and it hurts more than they expect. (so i guess i shouldn't count on a 4 hour experience here) she did reassure me that with the birth history in my family things look pretty good for me. but i still won't get my hopes up for a short process. she said 95% of people could birth entirely on their own because their bodies know what to do but 5% would die of complications. so we've got her there to tell us if we need to make a change.

and she generally gave her opinions on the birth movie, on water birth in this country, the status of home birth vs. hospital birth and how C-sections can happen just because a doctor's shift is coming to an end and the baby hasn't been delivered yet (so the OB gets paid rather than someone else getting paid, UGH!)

then the nuts and bolts: my weight gain was exact for this month at one pound a week. how that is possible on a diet of things like potato chips and lots of cookies and ice cream is beyond me, maybe it's the tea. Babe is getting bigger. her home is 21 inches (or cm?) at 21 weeks which measures dead on for where she is supposed to be. her strong kicks started in the middle of May which is dead on for a middle of October delivery (exactly where we're supposed to be). And her heartbeat sounds good in the 150s right where she's supposed to be. so all signs have us pretty much exactly right. my mom was almost dead on in 3 out of 4 babies and was dead on for the 4th for due dates so i'm betting we'll be pretty close. all good news. rest easy until the next appointment, first week of July.

Sonogram #2

Currently Craving: Chocolate and a Nap (i'm going to bake later)

Today was Ultrasound #2 day. the last time we went everything looked good, but she was only 17 weeks 6 days and she was bouncing around in there. so our ultrasound tech told us to come back so she could get a good solid look at Babe's heart. so this morning we went back and got to check her out on the big screen again. Still as cute as ever i must say! and her heart looks fabulous. the ultrasound tech checked again and she's still a girl. and she asked max if he had a small gun because she's going to be very cute! (watch out when she's 16) so all in all a good trip. we got more pics and i'll scan them up once max is here to photo them.

today i also taught my final class out at the high school where i've been teaching the teachers yoga all year. i was surprised they actually got me a gift certificate to Babies R Us. it was very sweet of them. i'm excited to go use it on something ridiculous that i want to get for her. who knows what that will be.

so a nice easy day. i've felt more energetic this week, probably due to resting a lot over the weekend. but this afternoon i'm starting to feel sluggish again. since i have a full weekend planned i'll take the next few hours before max gets in for another nap. i am seriously, the queen of naps now. and from what i hear, i'd better enjoy them while i can.