Return to the L&D ward

Tonight my husband and I went on a tour of the labor and delivery ward at the local hospital.  This was a big step for us: we haven’t set foot in that part of the building since I delivered our daughter at 18 weeks last September, and we knew it would be emotional.  It absolutely was!  But it was also bearable.  As my husband has been saying, we didn’t really need a “tour,” since I have in fact given birth there before, but the goal of tonight’s visit was to get us back in that space that holds so many sad memories, (hopefully) well in advance of when we have to go back so that I can deliver our son.  We figured it’d be less awful if we did it early, while labor is hopefully still far off, and I think that was ultimately a good decision.

Things started off with an info session about labor and delivery at this particular hospital.  One thing that I was excited to hear, which is a new development since we were there with our daughter last September, is that they now offer nitrous oxide (N2O) for pain management during labor.  (Those of you in civilized countries will probably be thinking “so what?” but availability of N2O has been extremely limited in the US until just the past year or two, and apparently they are one of only two hospitals in our state that currently offers it!)  That already made me feel more positive about this hospital, since I like that they’re keeping up with still fairly cutting-edge (in the US) medical trends, and since I had read about N2O and had wanted to try it but didn’t think I’d be able to.

After that positive start, the nurse led us into and through the labor and delivery ward.  It was hard to be there again, to remember the night that we walked ourselves in and got settled in a room only to experience some of the saddest and most traumatic hours of our lives.  We both remembered exactly which room we had been in, and I’d been nervous about going near the room, but for better or for worse, we weren’t allowed to go in that part of the ward anyway since there was a woman actively giving birth in that wing. So we saw it from a distance, but didn’t actually walk past.  We went into another birth room, and saw the same furniture and equipment, and that was quite enough, thanks.

I had somewhat anticipated the difficulty of dealing with naive, bubbly first-time pregnant women, but it was still hard.  One woman’s only question or concern was to ask the nurse how to make sure she could tell everyone that she didn’t want to hold the baby until after it had been washed off.  Oh, if only that were my biggest worry!  Another woman in the room kept asking questions that made it clear that her biggest concern was totally minimizing any medical care for her or her baby — she wanted to know if the hospital would let her deliver in water, wanted to see where the tub could go, and she practically jumped on everything the nurse said with “is that required or can we opt out?”.  I’m not sure why this bothered me so much — I believe that women should be supported in giving birth in the way that they want, and I won’t judge any other woman’s birth plan.  I know that unmedicated birth can be beautiful and powerful for many women, and I thoroughly respect (and to some extent share) the desire to minimize unnecessary medical intervention.

I think I was more rattled by the juxtaposition: while my husband and I were actively fighting our anxiety about dead babies and placental abruption, which was brought back more strongly than ever by being in the place where our daughter was born, this woman was clearly primarily worried about having her birth go the “right” way — which is just really far from where we are right now (which is more along the lines of “we want a live baby and a live me at the end of all of this and anything else that goes well along the way is a bonus”).  I liked the nurse’s eventual response to the incessant natural birth badgering, which was that she was happy to help us come up with a “wish list” and do her best to make the birth happen exactly as each of us wanted, but that we should realize that birth is unpredictable and might not live up to our expectations, and that to avoid being disappointed in our birth experience we should think of the birth plan more like a Christmas list of things that we would really like to have, even if we know we might not get all of them.  That seemed reasonable to me, and quieted the hyped-up natural birth lady as a bonus.

I managed to hold it together pretty much until the end of our tour.  At the end, the nurse gave us each her card and asked each couple personally whether we had any questions.  My husband and I had talked about our main requests from the hospital, namely that we not be put in the same room or have the same nurse as when our daughter was born, but I didn’t really want to ask those things in front of everyone.  So we stayed and listened to everyone else’s questions, and then when they had left or were talking amongst themselves we went and talked to the nurse quietly.  She was very nice about it and said that they should easily be able to accommodate those requests, which really helped put me at ease.  But still, having that conversation, and having to put into words why we were making the request, sent me over the edge into weepiness, and as we walked out of the hospital I started sniffling and then totally lost it in the car on the way home.  I’m not even sure I can articulate why — it was just such an emotional evening, and brought back so many memories of the night we spent at the hospital and the birth of our daughter.  I still miss her so much.  I want her back, and I want to know what our lives would be like today if she hadn’t died.  I know that these wants are nonsensical, and I’m very grateful that we are fortunate enough to have another baby on the way, and therefore thankful for the situation that is making us revisit these difficult emotions in the first place.  But the tears were just an uncontrollable emotional response to being back there and revisiting everything that’s happened to us over the past 13 months.

So, anyway, that was our evening.  I’m also grateful to have a loving and supportive husband with whom I can both cry and snark about people who are afraid of slimy babies.  As I write this, I’m about to hit the 23-week mark with our son, who has been kicking away in my belly for what now feels like ages.  Earlier this week, he kicked me so hard in such a weird and constant way in my side that I got extremely ticklish and started writhing in bed.  My husband thought I was nuts!  Our little guy also kept running away from the doctor’s doppler at our appointment on Tuesday.  I would have been more worried, except that instead of his heartbeat we heard the “zip”s of his movements as he scooted away from the doppler every time she tried to get a measurement of his heart rate — and on top of that, I could feel him moving away from the wand, so I was never really worried that there was a problem.  It was more funny than scary, for once.

I hope all is well with all of you out in blog land.  Thanks as always for your incessant support and kind words!

Thinking Ahead: Labor & Delivery After a Loss

First, a quick update: all is well!  We had our first growth scan Thursday, and in addition to showing a nicely growing little guy who weighs about a pound now (at 21 weeks), we got the last view of the heart that they couldn’t get at the anatomy scan and it was fine.  As the doctor said, “There are never any guarantees of a healthy baby… but everything looks fabulous.”  Our little guy is kicking up a storm, and I’m getting bigger too.

It’s still a long way off, but something that’s been bouncing around in my brain a lot lately is the question of how to approach labor and delivery with this baby.  My first L&D experience was traumatic for various reasons, but mostly (aside from the obvious fact that I was giving birth to our dead daughter) because I felt out of control and in extreme amounts of pain, and as I found out afterward, the inexperienced midwife made some really poor medical decisions.  So as I start to think about what L&D will feel like for me in this pregnancy, I worry that I’ll be panicked and fearful, and that I won’t feel that I can trust our new providers, and I don’t want it to be that way.

Penny Simkin, author of “Pregnancy, Childbirth, and the Newborn” and famous childbirth educator, distinguishes between pain and suffering in labor.  She believes that it is possible to experience labor pain without suffering, and that suffering comes from feeling out of control or believing yourself or your baby in danger.  I certainly experienced both pain and suffering with the birth of my daughter, and it has made me feel panic and fear when I think about giving birth to my son.  But I don’t want it to be that way — I want to feel prepared and powerful when my son is born, no matter what the circumstances.  And whether or not I feel pain (my plan is to start off without pain meds and decide as I go — I’m not going to berate myself if I opt for an epidural), I do not want to suffer with this birth the same way I did in my first.

So, I’ve been trying to think about ways to prepare myself for L&D well in advance of going into labor with my son.  I’m starting to compile a list, partly based on things that I came up with on my own, and partly thanks to suggestions from an online group for women who are pregnant after 2nd trimester loss that has been very helpful to me in this pregnancy (I won’t advertise it here because it’s non-anonymous, but if you are interested and can give me a way to contact you privately I’d be happy to share the information!).

• Birth classes – This falls into the “obvious” category, but I think it’s going to be very important for me as I prepare to give birth to my son.  The first time around, I had signed up for childbirth classes, but they hadn’t taken place yet, so I only knew the bare bones of what to expect (and I wasn’t exactly in a frame of mind to be educated and deal with things calmly, either!).  As I think about going through L&D again, I want to be informed and prepared for the process of normal labor, as well as common complications and interventions.  For me, as always, knowledge is power.  We are signed up to start childbirth classes at our hospital in November.  One woman from the 2nd trimester loss group suggested seeking out a couple of different classes through different organizations, since the information and format is often very different.  This sounds like a great idea, and I’ve seen free birth classes offered by a local community center that I might look into.
• Hospital tour – I don’t really need the tour to find my way to the L&D ward of our local hospital — after all, I’ve been there before, for some of the saddest and most painful hours of my life.  When I think of going back there, I shudder.  But I’d rather go back when I’m feeling well and in control than show up when I’m already panicky and in labor.  So I’ve signed us up for an early tour next week, and I might drag my husband back there another time or two before we have to do it for real, just to build some memories and experience there that is different from the birth of our daughter.
• Making staff aware of our loss – Many people have suggested this in one way or another.  Some are planning to call the L&D ward before they go into labor, others are writing it prominently on their birth plan or making a sign for their door.  Obviously our local OB group knows about our previous loss, but since we won’t know until we get there which doctor will be on call or which nurse we’ll get, we’ll have to think of a way to be prepared to communicate our history and our need for extra understanding and reassurance.
• Hiring a doula – This is something that we’re considering, but haven’t firmly decided on yet.  There’s some evidence that continuous labor support from a doula can reduce rates of interventions and c-sections… but like most of the literature surrounding pregnancy and birth, the strength of the evidence is a bit shaky.  Still, it seems like it might fall into one of those “can’t hurt, might help” categories, which makes it at least worth looking into.  One of the women in the 2nd trimester loss group has been working with her doula to help prepare herself for birth after loss, which I think sounds great if you can find a doula who is sensitive to the needs of someone who’s pregnant after a loss.
• Reading positive birth stories – This is something that hadn’t even occurred to me, but it’s true that most of the birth stories you read on the internet are negative.  Since my own first experience with birth was also quite negative, it might help to read about what happens when things go right, to prepare myself with some different visions of what my reality might be, or what I might hope for in a birth.  I think I’ll have to be careful not to get my expectations too high, but since I have plenty of negative birth images and experiences to color my thoughts, I might as well add some positive ones to my arsenal too!
• Hypnobirthing fear release – This method may be a little too crunchy for me, but since it’s helped other women in the 2nd trimester loss group, I thought I’d mention it.  Apparently if you just purchase the fear release track it only costs $4 — link is here if you’re curious.

So, that’s where I am at the moment.  If you have other ideas for dealing with fear left over from a previous traumatic pregnancy experience, I’m all ears!  I know it probably seems early to be thinking about all of this, but as I found out last time, you just never know when you’re going to wind up in the hospital — so the sooner I deal with my issues the better.

I do feel like I’ve entered a point of relative calm in this pregnancy.  I still feel good physically, I’m enjoying the “new” pregnancy experiences as I get bigger and the baby gets stronger, and I’m starting to plan ahead, just a little bit.  Our nursery is still an empty room… but now it has curtains!  My husband had ordered some curtains for the main upstairs bathroom, which will be the “kid” bathroom eventually, and while they were totally adorable, they clashed with the shower curtain.  So I found us some solid-color curtains for the bathroom to go with the patterned shower curtain, and tentatively suggested that maybe these curtains would look nice in the nursery?  My husband agreed, and installed them immediately.  I think they look great.  Maybe I’ll post a picture once we start to accumulate actual furniture!  After many months of feeling like time was slipping away from us while everyone else’s family was growing and changing, it’s nice to feel like things are moving forward again, to start to make plans, and to keep hoping as hard as we can that things will work out this time, and that our son will fill our house with baby cries and gurgles soon.

Halfway point! Also, dealing with sudden student interest in pregnancy.

Today I am 20 weeks pregnant, halfway to my estimated due date of February 18, 2016.

It’s one of those moments that makes time feel like it’s passing quickly and slowly all at once.  February sounds incredibly far away, and sometimes I have trouble imagining that come February there might finally be a living baby in our house.  At the same time, it’s exciting to be reaching the “new” parts of pregnancy, and now that the semester has started it feels like time is flying by.

Speaking of the semester starting, it’s now becoming blindingly obvious enough that my students are starting to notice and ask questions about my pregnancy.  One of our masters students was in my office earlier this week talking about an issue she’d been having (a closed-door sort of issue)… and when that subject was exhausted she tentatively asked when I was due, and said she wasn’t sure it was appropriate, but she’d been wondering.  I reassured her that it was fine to ask, but apparently that blanket reassurance was all she needed to quickly launch into personal questions like what does it feel like when the baby kicks and aren’t I so excited to be pregnant and, and, and… it was just a barrage.  I get it, and I remember being fascinated by pregnancy at that age.  She’s got a live-in boyfriend and she’s probably thinking about marriage and kids someday.  She has also mentioned before that she’s adopted, and I wonder if that plays into her intense fascination with pregnancy and all things baby.

She’s not the only one.  My women in science group noticed (just the four who are on the Steering Committee), and during our meeting last week they wanted to know it all too: was this my first?  Did I know if it was a boy or a girl?  How big was he?  (When I gave the standard 18-week produce answer of “about the size of a mango” they just about dissolved into girly rapture.)

I’ve been surprised by how difficult I’m finding it to deal with student questions.  On the one hand, they’re truly adorable, and their enthusiasm is very sweet.  On the other hand, I just don’t feel comfortable talking about my daughter’s death with them, and I feel some pressure (which I’m sure I’m placing entirely on myself) to be the cool, calm, collected, bubbly pregnant lady and feed their enthusiasm about pregnancy.  I just can’t imagine turning their eager smiles into awkward grimaces by telling them that no, this is my second, but my first baby died at about this point in my pregnancy last year.  Or telling them that while I’m excited and grateful to be pregnant, I’ve also had to deal with a lot of anxiety and uncertainty because this is a high-risk pregnancy after a loss.  Those are things that I’m now comfortable saying to many adults my age or older, but still not to my students.  When I think about it, I wonder if I’m really doing them a disservice by perpetuating the myth of the easy, magical pregnancy… but I also don’t think it’s my responsibility to puncture that myth for them if I’m not comfortable with it, which apparently I’m not, at least for now.

So I grin and bear it, or fake it til I make it, or whatever cliche you prefer.  In some ways, it’s nice to have a category of people who treat me like a “normal” first-time pregnant lady — so far, that’s how I’ve left it at the therapeutic riding center where I volunteer as well, and it’s kind of fun to slip into that persona and just let people be giddy on my behalf.  But I feel most relaxed and like myself with the people who know my history, who get it, and who don’t mind when I say slightly weird or morbid things.  People like the people who comment on my blog, so thanks, you guys. 🙂

So here I am.  Halfway.  Pregnancy feels (physically) very easy right now, and this little guy is quite a kicker — so much so that my husband has been able to feel him for the past week or so during his dance parties.  He kicks during meetings with students, he kicks when I’m relaxing after classes, or when my husband and I are snuggling on the couch after dinner.  I took the big (for me) step this week of signing us up for prenatal classes — it was so painful to have to cancel them last time around that I kept putting it off, but now we’re committed, and I feel relief knowing that whatever the outcome I’ll hopefully be at least a little more prepared for labor and delivery this time.  I also signed us up for an October tour of the L&D center at the local hospital, figuring that it would be better to go back to the site of our traumatic first birth experience sooner rather than closer to delivery (our plan is indeed to go back there for our son’s birth, although hopefully I can put in a request for a different room and a different nurse).  So we’re moving forward, taking steps toward getting ready to welcome a living baby, and just generally being hopeful.  After a long period of feeling like parenthood was slipping farther and farther away with each passing month, finally it feels like it might actually be getting closer and closer.