Another reason to close up shop

In yesterday's discussion about family size, I left out one really big factor: how children affect a marriage. I'm not saying that having children makes me want to do something crazy like leave or get divorced or have an affair. But children can take a toll on relationships.

When I'm pregnant, nursing, and/or caring for little children all day, I have little emotional or physical energy left over for Eric. I'm touched out, I'm tired, and I definitely don't want to "give" any more after days full of giving and giving and giving. I tend to run away from physical touch, sexual or not. Some of it is due to the hormones of pregnancy and lactation, and the rest comes from the exhaustion of being on call night and day. It's a lot of work to connect with my spouse, and sometimes more work is the last thing I want.

I'm not generalizing this experience onto all couples. Eric has always had a higher need for physical touch and emotional connection than I have, even pre-children. Starting a family has just accentuated those differences between us.

So our decision about family size also includes the health of our marriage. If I have a fifth baby, it will be at least another 3-4 years before I'm done with the pregnant/frequent nursing/little baby stages. Whereas if I stop with this baby, about a year from now the baby will be (crossing my fingers) sleeping well at night, moving independently, starting to eat some solid foods, and playing with siblings.

I'd like to hear how you balance your relationship with your spouse/partner against the demands of raising children. How do you find time for emotional and physical connection, especially when one or both of you have little desire/energy? How have relationship concerns factored into your decision about family size?

How do you know when you're done?

a.k.a.

Stop at Four or Have One More?

The question of being done having children never came up until this pregnancy. Eric is more than happy to close up shop--and he's volunteered to have a vasectomy whenever I ask. I don't have a strong feeling either way. We both grew up in big families. Eric was one of 7 children, and I was one of 5. I've always had this magic number in my head of a nice, big (but not TOO big) family. 3 kids definitely seemed way too small, 4-5 was just about right, and 6+ was way, way too many.

It's strange to think of being at the end of my childbearing years. I feel like I barely started! I know some women who absolutely know they're "done" and never look back. I don't know if I'll ever have that strong feeling. Instead, I'm just going to have to decide and go with it, as bittersweet as it might seem. I mean, it's really sad to think that this might be my last pregnancy, that it might be the last baby I ever nurse. 

I've really enjoyed the years of not trying and not preventing between Zari's birth and now. After "preventing" for 5 years, we then "tried" for several years before I got pregnant with Zari (up to and including IVF). I didn't mind being on birth control, but I hated those years of trying. My body naturally spaces children between 2 - 2 1/2 years apart, so we haven't felt the need to do anything in particular until now.

But I am definitely not okay just "letting things happen" indefinitely. My mom is turning 60 this year, and she STILL hasn't hit menopause! So I can't assume that my fertility will naturally wane in the near future. 

So it might be time to stop. I'm 34, Eric is 38. I don't feel old, but I certainly see the benefits of being a younger parent and grandparent. Eric is ready to move on to the next stage of our life. I'm not 100% certain that I am, but I am willing to take more long-term preventive measures in the meantime.

Here's our short- and long-term plan:

• Have an IUD placed some time before my fertility returns (probably around 8-10 months postpartum). I don't want anything I have to think about: no condoms, no pills, no diaphragms, etc. I'm definitely leaning towards the Mirena over the copper IUD. I really don't want heavier periods & cramps, which often happens with the copper IUD. 
• In a few more years, when we're really, truly sure we're done, Eric will have either a vasectomy or--if it's available by then--RISUG/Vasalgel. (RISUG is 100% effective, less invasive than a vasectomy, and reversible. Clinical trials have been going on in India for many years, and they will likely start this year in the U.S.) 

So tell me how you knew you were "done"? How did you and your spouse/partner come to this decision? What methods did you use for birth control? Did you change your mind down the road?

Belated pregnancy announcements

I was organizing files on my computer, and I found these photos I took last August. I guess I was going to use them to announce my pregnancy? It's fun to see how much the kids have changed in the past half year!

32 weeks pregnant

Zari finally got her turn in a pregnancy silhouette! She's not quite this tall--she was standing on a small step stool. Don't you love her outie? It was even more pronounced when she was little.

Things have been going really well with my pregnancy. My sacrum/sciatica hasn't been bothering me  except for a few small twinges. I'm sleeping reasonably well.

I've started the Birth Relaxation Kit, a birth hypnosis program similar to Hypnobabies (only at 1/3 the cost). I'll be writing up a full review of it after this birth. I'm pleased with the product so far. It's created by a husband-wife hypnotherapist team. Dr. Mavi Gupta is also a family physician, and her husband Jeremy is a musician. You can read their birth story here.

My only complaint: I cannot stay awake during the hypnosis sessions! I had the same problem when I did Hypnobirthing and Hypnobabies. I usually can make it all the way through the first time, but after that...ZZZZZZZZ! However, I always wake up right at the end of the track, so I hope the hypnosis is doing its job. In theory it's supposed to work even if you fall asleep. Or maybe I am just really, really good at going deep into hypnosis :)

Eric has been in Calgary for an academic trip, leaving me on my own with the kids. Every time he leaves, I realize how much admiration I have for single parents. It's hard enough being on my own for a few days at a time. The worst is the late afternoon/early evening, when I just need a few minutes to myself but cannot get it, ever. Dio and Inga have been waking up multiple times most nights, which is unusual. On top of everything else, Inga has been really sick. When she woke up this morning, her whole crib was covered in vomit--sheets, blankets, herself, even some of the carpet. She's been puking and having diarrhea all day and developed a fever this evening. Poor girl. Despite it all, she's been acting really happy and calm. We caught her last puke in a bowl, once I learned how to read her signs (if she whines and cries out of the blue, I have 5 seconds to grab a bowl).

I started removing the kitchen backsplash. I'll be posting a how-to DIY about removing old tile and re-tiling. I'm going back and forth between a modern mosaic and a more classic white marble subway tile. I'm leaning towards the marble tile. If I get ambitious, maybe I'll do a herringbone pattern.

Inga likes to measure her belly and listen to herself with my fetoscope. (Here's Zari listening to Dio back in 2011.) I measured 34 cms today, so only 2 cms ahead, rather than 5-6 cms ahead like I was measuring earlier.

Homebirth legislation in Slovakia

I recently received this update from Iva Jancigova, who helped me translate some articles about home birth legislation from Czech to English:

This time it's about my own country--Slovakia. At the end of December, the Minister of Interior Robert Kaliňák introduced some law changes to the Law of Registration Offices (I don't know the proper English translation...these are the offices that issue birth certificates, marriage certificates and death certificates). The new law says that if a birth occurred out of hospital, the baby can only be registered at this office (and have a birth certificate issued) after the mother has a gynecological exam by a doctor. Until now, parents only had to show their IDs and announce the birth at the Registration Office. There are no "official" homebirth midwives in Slovakia, but some women still choose homebirth either with an underground midwife or without one. If these changes in law are approved, they will complicate the matters significantly for women who want to avoid obgyns and/or birth at home without the need to go anywhere. I'm not even starting on the violation of privacy, because then this e-mail would get really angry.

Two nonprofit organizations (one of them is the Women's Circles I already wrote you about) wrote an open objection and collected enough signatures that it has to be heard. See http://www.zenskekruhy.sk/nase-aktivity/napisali-sme/item/195-podporte-pravo-zien-zvolit-si-okolnosti-porodu. Now we're waiting to see how the negotiations will go. I really hope that the changes won't go through.

Iva Jancigova

Help us choose a new car!

With baby #4 on its way in about 2 months, we're facing a big decision: buying a car that will fit 6 people. We love our 2003 VW Golf, a diesel-powered car that also runs on used vegetable oil thanks to a Greasecar conversion kit. We get 45+ miles per gallon, and we love the compact design. We're so sad that we have to find a new car...and we've been frustrated at how few choices there are in North America.

We've lived in France, where you'll find tons of ingenious sedans or ultra-compact minivans that carry 6-7 people. Almost all come with manual transmissions and diesel-fueled models, giving a fuel efficiency that comes close to our Golf.

But here? There are really only two choices: minivan or SUV. No thanks.

So we need help finding a new vehicle. Here's what we're looking for, in order of importance:

• Seats 6+ people
• Good fuel economy
• Manual transmission (a.k.a. stick shift)
• Not too big
• Around 3-6 years old, $8-10K maximum budget
• Diesel fuel (we can always wish...)

So far, Eric has found ONE car sold in North America that meets most of these qualifications: the Mazda 5. It is the size of a car and looks like a tiny minivan. It seats 6 people and has the option of manual transmission. It gets around 21 mpg city/28 mpg highway, which isn't fantastic but is better than SUVs and other minivans.

Are there any other vehicles in the North American market that meet our needs? Please, please let me know if you find anything else! We only have 2 months left to look.

ps--anyone want to buy our VW Golf? It has 108K miles, heated seats, power windows, Monsoon sound system, roof rack, Greasecar conversion done in 2006 (secondary 13-gallon heated fuel tank for waste VO), and more. You can fit 3 car seats side-by-side: 2 front-facing & 1 rear-facing, or 2 front-facing and 1 booster.

NYC mothers needed to share out-of-hospital birth stories

I received the following request from a researcher at the NYU Institute of Journalism:

I am currently in search of New York City mothers who would be interested in sharing their out-of-hospital birth stories.

The interviews would be used as part of my dissertation for the New York University Institute of Journalism. My research focuses on the increase in home birth and birth center births in the past decade, specifically in New York City. I've so far primarily conducted interviews with midwives and birth professionals, and now I’d like to get in touch with parents. We would mainly discuss your reasons for an out-of-hospital birth, as well as the actual birth story and your reflections on the experience.

If you have had—or are planning to have—a home birth or a birth center birth in the New York City area, and would be interested in participating, please let me know. I’d be happy to provide more details and set up a brief interview with you (done either in person or by phone). I can best be reached at annawilliams@nyu.edu.

Thanks in advance for your time, and I look forward to hearing your stories.

Anna Williams

Has medicine failed breastfeeding?

I think you'll enjoy both this recent Time article Is the medical community failing breastfeeding moms? and the following response by a breastfeeding counselor. I'm still surprised and a bit appalled about how little we know medically about breastfeeding. Did you know there are only 88 fellows of the Academy of Breastfeeding Medicine in the entire world? The author of the Time article notes,

When women have trouble breast-feeding, they are often confronted with two divergent directives: well-meaning lactation consultants urge them to try harder, while some doctors might advise them to simply give up and go the bottle-and-formula route. “We just give women a pat on the head and tell them their kids will be fine,” if they don’t breastfeed, says Dr. Alison Stuebe, an OB who treats breast-feeding problems in North Carolina. “Can you imagine if we did that to men with erectile dysfunction?” 

~~~~~

A breastfeeding counselor's response to "Is the medical community failing breastfeeding moms?"


I loved the article. I'm a breastfeeding counselor and I've been saying much the same thing for years. Because by the time a mom has a baby in a hospital, spends 2-4 days there (assuming her baby has no problems and isn't kept longer), heads home, keeps trying to breastfeed for a week or two before things get bad enough that they find a LLL leader or an LC, or even comes to a community like here, it is much harder to help her. The baby's learned to breastfeed incorrectly and will have to relearn how to suckle properly, her supply is either tanked or not what it could be, the latch sucks and her nipples hurt. I see a dozen different variations of that theme a day and it pisses me off how many times I can trace that back to crappy support at birth.

It won't make a damn bit of a difference how we restrict formula, or improve nursing in public laws, or work on mother education if the very first advice she gets in the hospital is bad. I am as educated as it is possible to get as a layperson. I still had a nurse, less than four hours after my babies were born, bully me into supplementing because they thought one of my twins' glucose was too low and she threatened that the peds would put him back in the nursery. I had just had 35 week old twins. I had to wait two hours to see them because none of us were stable, and one of my babies was still in the NICU. I was NOT up for a fight. I knew that I could get him to latch and I tried the SNS to humor her, and ended up ripping it off when I got him to latch well without it--but what if I hadn't known everything I do about how to latching a low muscle tone infant? What if I hadn't known that the sips of colostrum he could get were fine, and would bring his glucose up no problem once he got a little more rest and could nurse a little stronger? What if I hadn't known how to express the most colostrum for my NICU baby? What if I had been scared enough to keep using the SNS every feed, and eventually got fed up with it and it was too hard to use and nurse twins at the same time, and well if they're getting formula anyway, what harm is a bottle?

And even then, even if you get out of the hospital without being sabotaged, what happens after? What happens when you go to a pediatrician and they tell you formula fed babies sleep better, and your mother who's there with you says "See, I told you so!"? What happens when you get thrush or mastitis, and can't get proper treatment, and you're in massive amounts of pain or dying of chills and fever, and someone with an RN or MD after their name tells you to stop torturing yourself and wean? Or your baby has a tongue tie or arched palate, and nobody knows how to deal with it, and so every single feed rips your nipples up?

Forget nursing in public. Forget laws for pumping working mothers. Forget formula on prescription. If we can't get a mom to two weeks postpartum nursing exclusively, we as a medical community have made some deeper errors. And I don't think that problem can be solved by your average breastfeeding advocate, or even the best team of IBCLCs, because while you CAN fix those things, and you CAN come back from a bad start, it's really hard to convince somebody THEN that breastfeeding is worth it, and you should keep pumping, keep using the SNS, keep up the fenugreek and the domperidone, just try this one other thrush treatment, well maybe we can try a different nursing position to fix the crappy latch that has poor milk transfer that leads to your recurrent mastitis... that's an unfair burden on everyone, advocates included.

It's not reasonable to expect most mothers to have that level of knowledge and dedication to resist the "formula is just as good/formula is fine/most kids are formula fed and end up okay" spiel, especially a first timer (I was pretty educated for a first timer, and I wouldn't have known what to do in my situation if it had come up then.) And this was at a BABY FRIENDLY hospital, the best one in my state for lactation support, where a ton of the nurses were IBCLCs (not the one that bullied me, thankfully) and the pediatricians were very educated about breastfeeding. Yes, it can be done, obviously- I did it and dozens of the rest of us do it every day. But there's no reason for it to be this hard, for any of us, but especially not for a new mother who is scared, tired, and sad, and people just say, "Well, it's too bad your boobs don't work, that happens sometimes!" I completely agree with the author that no one would ever dare tell a man, "Well, shame your penis doesn't work anymore, that happens when you get older." Which is actually physiologically normal!

IBCLC education needs more grants and more support from the government--if they save one mom a month from having to use formula, that saves everybody healthcare dollars because her baby will be healthier, it saves money for WIC, and it helps a mom get back into the workforce without tanking the nursing relationship. It needs to be PAID FOR BY INSURANCE. (I am still incensed that circumcision has this huge push by the AAP but we can't get their support for IBCLC coverage--THANKS. Glad to see you're so interested in infant welfare.) We need better postpartum care--a single checkup at two and six weeks is not enough. Home visits need to be covered. Support services like housecleaning and childcare for older children need to be more available to all women, not just the ones that can afford a postpartum doula or a housekeeper. I do think the IBCLC model works, and I'd like to see a model for them becoming more like the midwifery model, where you've got your direct-entry LCs that can handle your average breastfeeding relationship and prenatal education, then you've got your IBCLC that handles the trickier stuff, and I would like to see a rank like a CNM, where they could diagnose and prescribe on their own.

So yes. We've failed breastfeeding mothers.
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30 weeks pregnant

Dio had to have his turn in the pregnancy silhouette series. It ended up being almost the exact same pose as last time, just with a different child!

A week ago I had a major sciatica flareup. For a few days I could hardly move or walk; I would be grabbing onto furniture or walls, hobbling from place to place. Not funny, even though I was laughing at myself because I looked so ridiculous. I've always had some discomfort in this exact same location (right to the left of my sacrum), but it was mild with previous pregnancies.

A visit to a chiropractor immediately fixed the spasms that kept me from walking, although the overall pain has taken much longer to subside. But I am mobile now, so that's great. I'm going to see him again next Monday. He also happens to be our city counselor, so I gave him the run-down on the crossing guard situation at Zari's elementary school. He's very supportive of walking to school and has been seeing what strings he can pull.

Measuring 33 cms at 30 weeks along. Weight hasn't changed this past month. BP is great and baby is moving and kicking a lot. I feel lots of big kicks near the top of the fundus and smaller wiggles and hiccups near the pubic bone.

We had a nice afternoon playing outside and then dancing. The purple dresses are from my mom. I put on music I danced to growing up: Blue Danube waltz by Strauss, Polovtsian dances by Borodin, and Night on Bald Mountain by Mussorgsky.

Dio was sad that he didn't get a dancing dress, so I pulled something out of the closet for him.
 

Review of Birth Boot Camp

Below is a review of Birth Boot Camp, an online course to prepare couples for natural childbirth. It's written by my older sister, who had her first baby about 8 weeks ago. Birth Boot Camp had originally contacted me to review their childbirth education program. I suggested my sister since I wasn't currently pregnant at the time.

Review of Birth Boot Camp

By Diedra S. Jardine

As an expectant first-time mom, I wanted to have an unmedicated birth, and for medical reasons I needed to be in a hospital setting. I knew that I’d need to thoroughly prepare not only to give birth naturally in a hospital but also to avoid unnecessary medical interventions. Birth Boot Camp ($300 for the 10-class course, available at www.birthbootcamp.com) gave me the knowledge and tools essential for preparing for unmedicated birth, and also bolstered my confidence in my ability to succeed. I highly recommend Birth Boot Camp to other women who are looking for tools to help them have a successful unmedicated birth, whether in a hospital, birthing center, or home birth setting.

Birth Boot Camp is a series of ten online classes aimed at couples—not just mothers—preparing for an unmedicated birth. I took some of the online classes on my own and had my husband watch others with me, depending on the lesson material. Each class lasts from one to two hours and is available whenever students wish to view it online.

While the online format inherently precludes interaction between instructor and students, the instructor and other presenters supply sufficient information about most topics as to answer most basic questions that participants might have. A significant number of additional resources, presented as part of each class, guide students in finding further information.

The supplemental resources include stand-alone videos and online resources related to each class, a training manual with weekly assignments and further resources, recommendations for further reading, and a DVD. The supplemental resources offer students further reading on material presented in each class. The weekly assignments contained in the training manual reinforce concepts taught in each online class and assist each student to apply the concepts taught in preparation for the upcoming birth.

Donna Ryan, the course instructor, speaks from her perspective as both an experienced natural childbirth educator and woman who has had multiple unmedicated births. Donna is knowledgeable and her presentation style is engaging. Also a part of each class are medical practitioners—from midwives to obstetricians—who offer medical explanations of certain concepts, as well as couples who prepared for natural childbirth and subsequently had various birth experiences, from unmedicated births to births with various medical interventions.

The ten classes cover topics including the advantages of natural childbirth, prenatal exercise and nutrition, various birth settings, the phases of labor and the immediate postpartum period, support for birthing mothers, tools for identifying when medical interventions are and are not necessary, birth plans, adjusting to life with a new baby, and breastfeeding.

The materials presented as part of each class are thorough and, for the most part, unbiased. Donna does share numerous anecdotes throughout and rarely cites sources when presenting information; women who want a strictly factual course may be put off by Donna’s anecdotal, conversational style. At first I disliked how anecdotal it was, but that only lasted through the first class or two as she was introducing the material. The classes are organized logically, with information presented in each class building off that which was presented previously.

Birth Boot Camp offers thorough preparation for couples interested in unmedicated childbirth. Both first-time parents as well as couples who have had medicated births but would like to prepare for an unmedicated birth can benefit from this course. The course is convenient, informative, generally unbiased while being oriented towards unmedicated births, and well worth the cost. Birth Boot Camp helped me reach my goal of an unmedicated childbirth—which happened for me after four hours of active labor, all of which occurred at a hospital—and helped this be a positive experience for me, my husband, and my new son.

My sister and nephew

28 weeks pregnant

Isn't this a fun silhouette? I love how a toddler pot belly + outie belly button looks so much like a pregnant belly. After Inga climbed up on a stool next to me, all the kids wanted to get their belly profiles taken. Soon we had three naked kids running around in our bedroom posing in front of the camera!

My crazy growth spurt has slowed down...I'm measuring about the same fundal height as 3 weeks ago (around 31 cms), so I don't think there are twins! At my last visit, my midwife a few large pockets of fluid. The baby was also floating way, way above the pelvis. We'll see how things look at the next visit and decide if I want to pursue an ultrasound or just leave things be. 

Because I was measuring ahead, she suggested I make sure my blood sugars were normal via either a GTT or a few days of checking fasting and postprandial blood sugars. I opted for the latter. They're low (82 fasting, 110 an hour after dinner), so we can rule out GD as a possible culprit.

I've been able to stay pretty active lately, going on walks, repainting several rooms, and hanging new light fixtures. We're starting our kitchen renovations this week: take out the old backsplash and install new mosaic tiles, repaint trim & walls, replace light fixtures, and buy a new oven. This last item was unplanned; our double wall oven just broke, and the part we need is no longer available. So we have to shell out mega bucks to buy a new one. (Hint: Sears Outlet is a fantastic place to shop for scratch & dent, floor model, and new-in-box discounted appliances.)
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