Saturday, May 3, 2008

GBS Screening

I had a midwife appointment on Monday (we’re down to every week now). She did a blood draw and asked about GBS testing. I wasn’t prepared for it, as I had it in my mind it was done at 37 weeks. Casey and I hadn’t discussed it, so we decided to wait until next appointment (the home visit) to let her know. This must have happened with my last baby, too, because she did the test at the home visit last time. We’re thinking that we’ll have the test done and *maybe* do the other home remedy (the one she says she’s seen results on), but no antibiotics. The fact is that *for me,* I don’t consider GBS that dangerous. I know it can be, and I personally know a midwife who almost died 3 times (and so did her last 3 babies) due to GBS infection. So I’m not saying I don’t think it can be bad. I just have had the flora (not the infection itself) the last 2 births (the second one without any antibiotics) and it has not caused problems for either me or my babies.

So, one may wonder why, if we’re not going to do antibiotics, we would go ahead with the test. It is simply my “curious” and “researchy” side that wants to know. If we have a healthy, no-problems baby, some may claim it was because everything was “fine,” medically speaking, and there will be no way to know afterward if I was GBS positive at the time. I assume that I’ll test positive again, and I imagine I’m just a carrier and nothing will come of it, and I think that’s a legitimate thing to consider. The fact is that *most* babies are not in danger of complications re: GBS, and even fewer mothers are. The routine testing and administration of antibiotics seems to be unnecessary.

Of course, my midwife keeps a close eye on babies and moms when there is a positive GBS result, but she is very thorough as it is and I do not believe an infection would escape her notice, even without a positive test. Another posting altogether would be all the reasons why we feel very confident with home birth with our midwife: her excellent credentials and experience.

Wednesday, April 30, 2008

Getting Better

Here I am, taking it easy (again) in order to speed recovery from this illness. It has been over a week now since I started getting sick, and only yesterday evening did I begin to feel better. Two nights ago, I went to an urgent care near our house once Casey got home from work.

They did a rapid strep culture which was negative, and the Nurse Practitioner (whose bedside manner was lacking) could not find anything wrong with me. She sent me home with a prescription for an antibiotic, should I find myself not getting better within a few days, telling me it was the “safest” of the things she could prescribe. She also advised me to do a sinus rinse to aid in relieving the pressure I was feeling.

I went home and did the rinse, which didn’t work because of the congestion (I did feel a little more justified about the pain once I discovered this). Starting before I went to the urgent care, I noticed a building pressure in my ears, which, by night, had completely cut off any hearing in my right ear; throbbing and piercing like a needle in my eardrum. It reminded me of ear infections while growing up. I was not able to sleep. Finally, around 1:30 a.m., I called the nurse line and the nurse on call gave me several really helpful tips (all natural and none to affect the baby). I joked with her that even if they didn’t alleviate the pain and pressure, at least I’d be exhausted after doing everything she said, so I may be able to sleep despite the pain.

Having gone through all the steps, I headed to bed, laying my right ear on a heating pad set to “low” under a towel. The heat was soothing enough to allow me to fall asleep. Some time in the night, I woke to notice my ear pop slightly, and the pain was no longer as sharp. Still lots of pressure, and no hearing, but at least the pain was lessened.

By the time Casey’s alarm went off, I knew I still wasn’t doing well. Between the pain of my continuing sore throat and the pressure in my ears, I couldn’t picture how I’d get through the day caring for the girls. Casey graciously decided to use some personal time from work (what we’re trying to save for when baby comes!) to stay home. I stayed in bed all but about an hour of the day.

I ended up calling my doctor’s office to set up an acute care appointment, and they called back saying that since she would not be able to prescribe anything if she did find something wrong (since I’m pregnant), there was no purpose in me coming in. They gave me a few tips over the phone and that was that. Some women may have been very discouraged by this, but I really respect my doc’s opinion. She is pretty conservative when it comes to medications, and it said a lot about how “safe” an antibiotic really is in pregnancy that she wouldn’t prescribe one. (As “safe” as any drug is, since there have been no studies to prove any drug’s “safety” in pregnancy.) Needless to say, I will not be filling that prescription from the NP tomorrow.

Casey headed off to work this morning, asking me to please take it easy. I assured him I would. I know how discouraging it would be for him if I overdid it and ended up feeling worse tomorrow. I can see him wondering “Why did I even bother staying home that whole day?” It would really seem like a waste of the time he sacrificed, and as strange as it may seem to me, one of the best ways I can show my appreciation is to go easy, not try to “catch up” right now. (This is especially counter-intuitive knowing my husband the way I do. Normally, nothing says appreciation and love and respect to him like a clean, orderly house with well-behaved children and a good meal on the table. Barring an absolute miracle, he will not find ANY of this when he returns home today.)

So today, I’m parenting from the couch, and when the girls have their naps, so will I. My one goal for the day is to get one load of laundry done. Casey has been good about keeping up on things here and there, but (like they would be if Casey had been sick all this time) things are still piling up. There’s only so much one person can do. I don’t know how single parents do it when they’re this sick.

Sunday, April 27, 2008

Deb's Birth Story

My sister had her baby boy Friday, March 28th at 11:40 p.m. He weighed 7 lb, 11 oz and was 20 inches long. She and her husband were very well educated on birth and options and risks and such, and it shows in her great hospital birth experience. It isn't often that I get to read such an encouraging birth story, since so few people take the responsibility to educate and prepare themselves for a great birth. (It takes a whole lot more than leafing through "What to Expect When You're Expecting" to be truly educated. :) I got her permission to post the birth account she recently wrote.

Deb kept the story mostly to facts and didn't express too much of what her thoughts and emotions were doing during labor. I believe it is very helpful to know in particular the mom's perspective of birth, because that's where I find I need most of my preparation for birth: on the mental side of things. I find that the physical part of labor can be made much easier if the mental and emotional parts are kept in check (relaxation is key, and one cannot relax very well physically without first relaxing mentally and emotionally). This is why I look forward to her visit next month--hearing all the juicy specifics on what was going on in her head in those hours and hours that are succinctly summed up in a few paragraphs.

And without further ado: The Story:

I started labor sometime in the very early morning on Friday the 28th (due date was approx 3 April) maybe 2 or 3a...was awakened by a couple of mild contractions and then every 10 or so minutes I would have another. I kept getting up and walking around. Brett went to work that morning. I labored with some moderate contractions all morning, took a bath, drank a lot, had some snacks tried to sleep. B came home for lunch. By then my contractions were getting pretty intense and I wasn't in the mood for much. I tried to sleep in between contractions and I watched a movie. I still wasn't sure if this was the real thing so I didn't want B to stay around for nothing, so he went back to work.

All afternoon I tried so hard to relax and breath through the contractions, they were so intense though. It took me a while to figure out the reason they were so intense was that I was having some significant back labor. So much so that I didn't really feel the contractions in my uterus...just my lower back. I tried another hot bath and warm packs to my back which did help a little. About 4:30 or so I texted B to ask him to come home after work instead of heading to the grocery store like we planned. He got home about 5:30 and I was upstairs on all fours laying on pillows and crying.

We labored for a few more hours, B gave me firm counterpressure on my lower back during contractions which helped a ton. I wished I had asked him to come home earlier, but I still wasn't sure where I was in this little marathon. B called the doc on call (our midwife had just left town that evening). He said to head in when any of three things happened - water breaking, bloody show or contractions 5 minutes apart or less. B and I walked around the house a bit. I went to the bathroom and what do you know...there was the bloody show. My contractions were still a bit erratic, some 7 minutes apart, some 2 or 3.

Here's the part where we show how truly organized we are. B and I had made a couple of changes to our birth plan and had kept meaning to print off the new one. B had it saved on his work hard drive which of course can't be accessed from home. We knew we should start heading to the hospital soon and of all things important to bring with us, the birth plan was it. So there is B upstairs typing frantically from our draft. I came upstairs sat in the office, had a contraction and then ran to the bathroom to throw up 4 times. So then we decided it was definitely time to go. As we jumped into the car and headed north, I was actually feeling a bit better having vomited. I was a little more talkative and excited, so I thought in my head, "oh great here we are on our way, and we are way too early...we're going to sit in the hospital for hours and hours!"

We got to the birth center and were put in a triage room about 9:45 or so. The nurse came in, checked me and I was 7 cm!!! We were very relieved...I thought she would say 2 or something. So we walked over to the LRD room. When we walked into our room, I saw two of my college classmates who were our nurse and the charge nurse. I was glad to see someone I knew. I sat down on the bed. B ran downstairs to get our stuff and park the car. My nurse and I started the admission history. She was very good (she'd have to be since she is a Beth-El grad:)). She told me, "I am going to be asking you questions, but when you have a contraction, just do what you need to do."

I had about 4 or 5 contractions while B was getting things settled and they were getting more intense. I kind of wish looking back on it that we had gotten to the hospital just a little bit earlier, so B could be helping me instead of having to worry about our stuff. Then I told my nurse "I either need to have a bowel movement, or I need to have a baby."

My nurse checked me and I was 8 cm and she could feel the head. We walked to the bathroom. I sat on the toilet for two contractions and those were wammos! B was done getting the stuff and back in the room now. We walked back and I sat on the birth ball and leaned over the bed for 3 or 4 contractions. Those were even more intense, but it was still mostly in my back. I was shaking and saying "Oh God, oh Lord help me!" over and over..I wasn't taking the Lord's name in vain...I really meant it!:) I was feeling even more pushy now. I told B "I can't, I can't," and he knew exactly what that meant.:) I was close! My nurse checked me again and I was complete!!! In this case having frequent exams was fine and helpful, since I was progressing so quickly.

The charge nurse went to call the doc and I got into the bed. After all this back labor, the last thing I wanted to do was lay on my back, so even though it was awkward, I was on my side, clinging to the bed rail to support myself. B had my top leg. By this time I was burning hot and any clothing I may have had was long gone. Instead of pushing B away like I thought I might, I hung onto his neck and pulled on him so hard. Poor guy, good thing it didn't last too long. The charge nurse came back in and said "the doc is on his way, but he's 20 minutes out, so try to hold off on pushing." HA! What a ridiculous thing to tell a laboring woman. I had a couple of pushing contractions and on one of them my water broke just like a water balloon. It made such a distinct pop that it surprised everyone in the room.

I tried as hard as I could to breathe through a couple of contractions and not bear down, but it was impossible. B whispered to me so the staff couldn't hear, "just let your body do what it needs to." We knew there was an on call in house OB who was prepared to deliver if ours didn't make it in time. Brett told them something like, "listen, we don't really care who delivers, because it's happening regardless." They got the on call OB who came in and started helping stretch my perineum. About 5 minutes later our covering OB came in. I was very relieved to see him. I had about 4 or 5 pushes before the head was out.

There was this battle in my head, "I don't want to push, because it is hurting when I do, but I want my baby and I want this to be done!" I tore very superficially when the head came out. The rest of his body practically slid out. Active pushing was maybe about 15-20 minutes. They suctioned him and put him on my belly. I hadn't heard the OB when he said it was a boy, so as soon as I got him, I spread his legs to see what in the world this baby was. Apparently Caiden urinated when he came out. He was a little blue from the cord being wrapped around his neck once, so they gave him a little blowby O2 and he let out a big cry. It was an awesome sound. Nothing prepares you for those emotions.

He was able to latch on for a few minutes. They did all his measurements, bath, and assessment at the bedside. We did a lot of skin to skin to keep up his temp after his bath. He stayed in the room with us the duration of the stay. Right after my stitches were done, I had the worst shakes. I was so cold, but it resolved quickly with warm blankets. I had my OJ, ate some food and got up to go to the bathroom.

I have to say something about our hospital experience. Our nurses were wonderful. Besides the whole "hold off on pushing thing," they were so accommodating. They made sure I had plenty of juice for B to give me, that I could move around. They said they would bring pain meds only when I asked and wouldn't push them on me. I was able to be on and off the fetal monitor as needed. They let me choose whatever position I felt most comfortable in. I do wish I was able to push when I needed to and that my midwife was able to be there. There were a couple of the routine newborn meds/interventions that we decided to either forego or wait on and they didn't argue with me. Overall it was a wonderful, doable experience. Hooray for no meds! However, I have decided something, I don't like back labor. All in all the labor was about 20 or 21 hours, but it really didn't seem that long.

And to this I add from my soap box: as a nurse, can I make a request to please be kind to your nurses?! They are people who have feelings and work 12 hours shifts (some of them are 9 months pregnant) taking care of often grumpy and demanding families. Please don't go looking for a fight with the hospital staff. Remember you are coming into a hospital where the focus is not on what should normally happen, but preparation for what might go wrong. This is not a bad thing, it's just the nature of birthing in a hospital versus home or a birth center. Healthcare professionals are bound by lots of protocols, liability and concerns for your safety, so don't be too hard on them when they are overly cautious. You may be very educated in natural birth and the Bradley Method, but they have gone through years of education and experience. Just respectfully and kindly make your requests as a team collaborator and not a demander. When you interact with your nurse, picture me 9 months prego taking care of you.:) Several of us have wonderful husbands who are great advocators. Please share this part with them as they will be the ones interacting with the staff. It may bug you to have the staff around, but if something were to happen with you or the baby, you'd better believe you want them there! There, I am done.

Recovery has been pretty good. Sore off and on. My lumbar area has been the most sore. I haven't been afraid to take Ibuprofen! I have taken a hot bath every day and that is wonderful. If I try too much activity in a day, then I pay for it later, but for the most part I have felt pretty good. One thing B and I found the first week was that we needed a daily outing. We would go to sonic and get drinks, go hang out at my parent's house. One night we spent 3 hours at a coffee shop (our first date). It's been very good for my spirits and good for our marriage.

Breastfeeding is going really well. I was afraid of the day my milk came in that I would be a basket case, but it turned out to be okay. Just a little weepy:). Caiden has been a little jaundiced so I've been feeding him frequently and putting him in the sun for a little while everyday. Nights are doable. It's incredible the grace God gives you when you need it. I really don't feel put out having to wake and feed. I forget how tired I really am. A few times I have had to wake him up because he would try to go 4+ hours between feedings at night. I told him, no sir, we are going to get rid of this jaundice and then he cooperated.