Sunday, March 29, 2015

Of Birth and Boob Fail

I had my daughter on March 17th at 10:59 pm. She was just shy of 7 pounds, 20 inches, and gave a good healthy cry.

This was after my water broke earlier the day before at the grocery store, before labor started, something that only happens to about 1 out of 11 women. We had to go to the hospital immediately since an early rupture can lead to infection. I’d had my 38 week OB appointment that very morning where absolutely nothing indicated I’d be checking into a birthing room at UCLA less than 10 hours later. That’s how much you can’t predict how things will go.

12 hours later I was having excruciating contractions and not dilating very much. My OBGYN recommended I take an epidural, something I’d wanted to avoid but had never been adamantly against. My birth plan had always been flexible for a reason. Namely: I had no idea how birth would go until I was doing it and I didn't want to be so rigid and fixated on a plan that I didn't recognize when things had to change. It was the same reason I’d chosen to give birth in a hospital birth center for the unthinkable “what if” scenarios rather that at home or a non-hospital birthing place. Yeah, it's great if everything goes perfectly. But what if it doesn't? I’d done enough research to know the peace of mind that came with the birth center I chose being at UCLA would help make a scary process a lot more manageable.

So I took the epidural and things started to go better with more dilation in the next few hours than I’d had in 12. It felt very strange to be basically numb from the waist down and I nearly had a panic attack when I heard the word “spinal fluid”, but considering labor was another 14 hours I know I made the right decision.

Birth was, for me…weird. I pushed for 3 hours, though when you’re in that zone it doesn’t really feel like it. There’s nothing quite like that particular focus. As a sensation it’s not exactly what you think. Labor contractions I felt mainly in my lower back, in a rolling wave of cresting pain. Pushing was pretty butt focused until near the end when it finally feels vaginal. And then it’s a knobby, bony, gethisOUTNOW, feeling. It’s pain and pressure, concentrated yet enormous. And then the baby is out and its head is all long and strange shaped almost like an Alien and you’re staring at the person who’s been kicking you for months as they come into the world, wondering how on earth they fit in there, ever.

There were a few scary moments after where, because birth is as shocking to a baby as it is to you, she needed to be aspirated. Then she was yelling her head off again. I was having a small tear sewn up (no episiotomy, that’s not really routine anymore in spite of what some birth books tell you) and then she was back with me. She clung to me and then she fed on colostrum for a good 30 minutes.

We were taken to recovery and bonded, skin to skin. They gave her a hat with a giant bow that made her look like some 50’s Grand Dame. My husband, who was amazing throughout, and I were pretty much entranced. We could already see that she had his hands in miniature, clasping with a strong, vice-like grip. We stared at her in the bassinet while her big dark eyes roamed around, not really focused, but aware.

Then things started going not so well. When they checked my daughter’s temperature later it was lower than it should be. We did more skin to skin, which helped, but then it would go down again. I’d feed her but then they found she was hypoglycemic. She was alert and active, but something wasn’t right. They put her in a warmer in the nursery, which I hated because they had to take her out of our room. I started to really worry.

When her temp kept going up and down they decided it was time to get her into the NICU to treat her for a potential infection. During my labor I’d run a slight fever towards the end and been given antibiotics. The placenta had been very warm and was likely the site of infection. They took blood cultures that never yielded any results. I’m told all of this is common when you rupture so early.

Common or not, it was awful. Especially when they told me she’d have to stay in the NICU for 7 days to get a full course of treatment. This was not how things were supposed to go after a totally healthy pregnancy. My daughter wasn’t premature or unhealthy, and yet. There we were.

Physically, I was a wreck. A few hours after birth and the epidural wears off you feel like someone has taken to you with clubs. Everything hurts and aches, you have to wear enormous pads for the fluid and blood, and you sit on an ice pack between your legs, suddenly realizing that birth is traumatic. I got the shakes for the next few nights and by the 2nd day my nether bits felt battered. Another fun side effect: you may not be able to pee on your own again for a bit and that means a catheter. I don’t recommend them and thankfully I only needed it once. You would will your body into peeing if you’d had one, too.

So, in pain, trying to do even moderate self-care like eating and sleeping, I then had to shuffle to the NICU every few hours to try and feed and spend time with my daughter. Other people hovered around her, took care of her, and it felt like she wasn’t mine. It was the first feeling of failure but it wouldn’t be the last that week.

If you give birth vaginally and don’t have any complications
you are discharged after 2 days. I can tell you: it’s not enough recovery time. We need to seriously rethink this as a culture. The next 5 days were spent going back and forth to the hospital, usually for 10+ hours to be with her as much as possible. To hold her and try and feed her and weep every time we had to go.

This is when we discovered that my breasts were having trouble producing milk, I was pumping every 2 hours and getting 5mls, maybe. Sometimes a little more if she latched in the NICU. Within a few days she was taking 40mls of formula at a feeding and my breasts were clearly not keeping up. Now, at first we thought this was just because she was in the NICU. It’s common for women to have this experience when they can’t nurse normally. So I stuck to a punishing pumping schedule, and tried and tried to be the kind of milk providing mother mine was.

Except it turns out I will never be able to nurse normally.  Everyone kept saying it would be fine, my milk would drop, I just had to try harder. Only in my case it’s not an issue of trying or working harder at it.

Our first day home where I was still trying to make breastfeeding work was hellish. I was weeping all the time, feeling horrible and wrong, able to do very little bonding between feeding her, trying to get to her latch, supplementing, then pumping. With that schedule I could only maybe manage 45 min of sleep if I was lucky. I dropped nearly ¾ of my baby weight in the first week. I couldn’t eat because I couldn’t feed my daughter, food made me sick and shaky. I was so guilt ridden I refused to sleep and my husband had to purposefully not wake me up just so I’d get more than an hour in a day.

I would look at my daughter’s lovely, serious, face and feel like the most inadequate mother. What kind of woman can’t breastfeed? What was wrong with me? I talked to a lactation consultant who asked me a bunch of questions. And then things started to become more clear.

It was looking increasingly likely that I have IGT, or “insufficient glandular tissue”. My breasts simply cannot, and will not, produce enough milk. It’s probably genetic, my mom tells me her mother had the same problem though we don’t know any details as people back then didn’t talk about it. And they don’t today because we know that “breast is best” and for most women this isn’t a concern. Over production? Lots of support and information about that. Under or no production? Well…you’re sort of shit out of luck.

By the first well baby appointment I had decided that I could give it another week but then I’d have to consider formula exclusively instead of breastfeeding. I made an in person lactation consultation appointment at a local place just to make sure. I was ready for both to be confrontational, judgmental, hostile.

Instead, my pediatrician immediately told me that we feed our babies how we can and there’s no shame in what we can’t control. To her, it was time to move on and forward. My daughter was already back at birth weight, strong, with great reflexes and a healthy appetite. I cried, I was so relieved.

The lactation consultant after told me the same thing. This is a person whose whole job is helping women breastfeed and she said, matter of factly “ This isn’t in the cards for you. You’ve done all you can.”  No one really diagnoses IGT officially but I have all the most common markers for it. We discussed pumping a few times a day for what limited amounts I can get for another week, and if it’s still the small 5-10mls  per session(which it is) it will be time to stop. I cried again, again with relief.

This isn’t my fault, even though it does still feel like it is when I’m tired and thinking about it too much. But then I look at my daughter sleeping, her arms doing dramatic gestures, after a good feed, and I know I’m loving her and caring for her the best I can.

If you go online you’ll find a lot of horror stories from women who formula feed. Usually about strangers yelling at them or lecturing them when they buy formula or feed from a bottle. Others have even worse stories about friends or family shunning them. “Breast is best” is an accepted truth with plenty of data to back it up. No one is debating that, in an ideal situation, you breastfeed.

But life isn’t ideal. It doesn’t go the way you plan, ever.

I hope I’m never asked to justify my decision. I hope I never run into someone so awful they’d lecture a stranger about something they know nothing about. I’m steeling myself for it, the same way I did for unsolicited pregnancy advice. I know exactly what I’ll say if/when it comes up: Fuck. Off.

When it comes to mothering women can’t really win. Even with breastfeeding and everyone knowing it’s “best”, women are still shamed for doing it in public. Feed your kid but don’t do it where anyone can see you. Bottle or formula feed? You’re obviously terrible and lazy and poisoning your child. And women are often the perpetrators, feeling justified in judging and lecturing others based on superficial information and assumptions. The truth is: you don’t know why someone is bottle/formula feeding instead of breastfeeding. You don’t know if it’s a choice or a “choice”, or simply how things worked out for them. You don’t know their body, their situation. Just like they don’t know yours.

Since reaching the decision that formula is going to be how my daughter is fed, I’m beginning to accept it and move on. I still cry. I cried while writing this. But I’m done punishing myself for a genetic condition I can’t change. As the lactation consultant said, you wouldn’t tell a diabetic to just work harder to make their pancreas produce the right amount of insulin. You wouldn’t tell someone with scoliosis to just try harder to have a straight spine. Breasts aren’t magic wands, they’re organs. And sometimes organs don’t operate as they should.

I know some people will read this and still think, well, she’s just a bad mother. She’s wrong and didn’t try and here are a million reasons why I should have done x, y, and z. There’s probably an herb you think I should take (I have them all, and the tea. My sweat smells like celery maple syrup). You’re entitled, I guess, though I think it’s kind of sad to waste time being that kind of person. There are probably a ton of things you do on a daily basis other people don’t approve of that you have good reasons for doing. And that are ultimately for the best even if other people don’t know that.

And if you’re the sort of person who approaches strangers to lecture them about mothering, I think it’s a good rule of thumb in general to not assume you know why a stranger is doing something. There’s a time a place to step in, like when someone is actively abusing their child. But evangelizing breastfeeding at the supermarket at people you don’t know? Assuming you know their situation, genetics, or reasons? That just makes you an asshole, not an advocate.

Me, I’m going to continue feeding my thriving daughter and save my guilt for the next 18+ years of mistakes I’ll make. I’ll save my worry for watching her breathe while she sleeps, checking a million times that she’s on her back when she does sleep, holding her when she cries, and all the amazing terrors of having this new little person in my life.

This time doesn’t last and I want to enjoy every frustrating minute of it.

Sunday, March 1, 2015

Being Pregnant

Pregnancy is weird and uncomfortable. I haven't really liked it as an experience, though I'm looking forward to the result immensely. I suspect I'm not the only pregnant person to feel this way. Ads and pregnancy sites paint this rosy picture where women are glowing, smiling, svelte things in white yoga pants with perfect round bellies and no stretch marks. The reality for many of us is a bit different.

How would I describe the feeling of being pregnant, overall? Well, I think The Dark Crystal scene where the Skeksies start screaming: "ESSENCE! DRAIN HER ESSENCE!" sums it up nicely.

How do pregnant people feel when you "joke" about how they're not going to get any sleep when the baby is born, even though we've been exhausted since the first trimester and it's literally impossible to sleep for more than 2 or 3 hours at a time during the 3rd?

When dudes say pregnancy is "no big deal" and women complain about it too much.

When people act like, because millions of women have babies, it's not difficult, scary, or dangerous.

What it feels like my baby has been doing every day in utero since month 7 or so.

How I feel about well meaning, unsolicited advice about how I should be more "positive" and concentrate on the miracle of growing life and not the fact that everything aches and I have to pee a million times a day and shortly I'll be squeezing a live human being out of my vagina.

When people say things like "all pregnant women are beautiful" when you say you don't feel well and are waddling around like a distorted duck.

Whenever anyone suggests that disliking the physical reality of being pregnant means you aren't aware of how lucky you are or won't be a good parent.

What I wish I was doing most of the time.