At 41 weeks, Jacob and I started doing everything, literally EVERYTHING, to induce my labor. From eating spicy food, going on bumpy rides every single day, walking until my feet felt like they would fall off (BTW I didn’t swell during my entire pregnancy because I drank plenty of water), doing the dirty, acupressure, massages, bananas, yoga, stripping my membranes (twice!), whatever you can think of, we did it, and NOTHING WORKED. So my conclusion on inducing labor based on my personal experience is that nothing can induce labor, your baby comes whenever he/she decides to come.

I was scheduled to be induced Monday morning, and as much as I was opting not to be induced, I was going to let them because one, it would be safer for the baby not to exceed 42 weeks in utero, and two I would be more than ready at that point for Natalia to be here. Fortunately my water finally broke the Friday afternoon prior to my induction date. At first I wasn’t sure if it broke or not, so I asked my mom what it felt like. She said it feels like you’re uncontrollably peeing on yourself. Soon after that, about 15 minutes, I was confirmed of my water breaking because liquid started pouring out, lol. I didn’t call the Doctor nor did I go to the hospital. I waited until I started having contractions 5-10 apart for an hour like my doctors instructed, which didn’t happen until 18 hours later. Bad idea for me to not go in right away because of the risk of infection, but how was I supposed to know? This is my first time having a baby, and BOTH of my GYN’s told me not to come in until I started having contractions. There was no mention of my water breaking. And since I’m totally healthy, I didn’t think there was any reason for me or my baby to develop an “infection”. According to what I researched, the vaginal exams are what cause infections in the first place, which makes complete sense to me.

So the next morning around 6am I started having mild contractions, then they increased in pain and decreased in time apart, so by 8 am Jacob and I were on our way to the hospital. When we got there the nurses asked me if my water broke & I told them yes it did, yesterday afternoon. They all looked at me like I was crazy and asked why I waited so long to come in. I told them that I didn’t feel the need to come in because everything seemed fine and that my Doctor told me not to come in until I was having contractions, so I was simply following instructions. Well, when they started my IV they told me they were going to start me on antibiotics. In shock I asked “for what?” And the nurse said “the GBS that you’re positive for”. I was in total disbelief and said “excuse me, but what in the world are you talking about?” She explained to me that I was positive for Group B Strep, (the test they give you when you’re 36 weeks) and that the baby has been swimming in infected amniotic fluid for the entire time since my water broke. GBS (Group B Strep) is a bacteria that is carried by both men and women, that does not affect adults but can be very harmful for unborn babies, which is why pregnant women ate tested for it at 36 weeks. Men will never know if they have it or not because they will never be tested for it since they obviously can’t get pregnant. Well when I took the test, nothing was ever mentioned about it after that, so I assumed I was negative. I would expect a Doctor to tell you the results of your tests, ESPECIALLY if you’re positive for it, don’t you?! So yeah, I was carrying this infection and had no idea about it. I was infuriated by this new found information because now my baby is at risk. If I would’ve known about this infection, I would’ve been at the hospital the day before when my water broke.

Anyways, once your water breaks you have 24 hours to get the baby out or it can become something serious. So I had 6 hours to deliver my daughter and I was only 2 cm dilated (and have been for two weeks!). They started me on pitocin right away. 2 hours later they checked my cervix to find that I was still only 2 cm dilated, so a c-section was the final decision. At first I wanted to cry because I felt cheated out of my wanting for a natural delivery since I was never informed about this infection that could be potentially fatal to my unborn daughter. I also was not so phsyched about having such a dramatic surgery, especially since I’ve never had surgery of any kind. I asked the nurses if they had c-sections and even asked if I could see their scars because I also wasn’t very excited about having such a large scar on my belly. One of the young nurses showed me not her scar because it was so low, but pulled her shirt up just to show me that the scar was below her panty line. I couldn’t even see it! And she was so skinny you wouldn’t even be able to tell that she had a baby, and she had 2! So that made me feel A LOT better about it. So on we went with the procedure.

They had me fill out all kinds of forms and explained to Jacob and I what would be happening. He had to change into scrubs so he could be there with me while the doctors carried me into the operation room so they could numb me from the waist down. They gave me a spinal anesthetic that literally took 5 seconds to kick in. I felt a rush of a numbing sensation that actually felt really good, lol! I felt very shaky though shortly afterwards which I didn’t like too much. Also, the shot they gave me was a MUCH smaller needle than that of the epidural, which I was very happy about because that was the very reason I had decided I wasn’t going to have an epidural if this would’ve happened naturally.

They cut me open and tugged, pushed and pulled (which I could feel a lot of although it didn’t hurt, it was just a lot of pressure) and then out came the baby, 7lbs. and 14oz. of her. About a minute later I heard her first cry and was in tears at the amazing sound that I had waited 9 long months to hear. Jacob cried with me and we were both very happy. However, because she was infected, they took her from us right away. I got to see her and kiss her cheek before she left and dad asked to see her hair because she was wearing a cap. When they took it off, we were amazed to see a head full of dark hair, just like I dreamed about!

So they took me to the recovery room while we waited to hear from the doctor’s what was going on with Natalia. Now there are a lot of details to what was happening between the surgery and the end, so I’m just going to make the long story short: The doctors were concerned about her breathing patterns. They ran blood tests and white blood cell tests which came back triple the amount of what was normal, meaning that her body was already building white blood cells to fight off whatever infection she had. They were also concerned about some “seizure-like episodes” that she was supposedly having which made the nurses decide to transfer her to Wolfson Children’s Hospital in Jacksonville because they were a small town hospital that did not have all the tools needed to run the tests they wanted her to have. They weren’t sure what she was doing because she’s a  newborn, hence their wanting to run tests just to make sure she was acting normal. I was completely devastated because the doctors made it seem like she was having all these problems, they even mentioned a possibility of meningitis. I cried so hard and asked “what are they going to do to my baby?!” Jacob tried his hardest to keep his composure because I was so upset about everything and then he broke down and started crying with me.

Natalia went through so much in the first days of her life in the outside world. She IV’s since she was born, she had all kinds of tests run on her, she had MRI’s she had her spine tapped, all kinds of bullshit. I know that they were just trying to be on the safe side, but what new mom wants to see her first baby go through all this trauma?! Anyways, in the end Natalia was completely fine. They ran all these tests just to find nothing wrong with her. She just had an infection and the antibiotics they started me on before the surgery killed it just in time. So we went through all this heartache for nothing. It was very crazy. We ended up being in the hospital for 5 days before finally bringing her home.I was in the hospital for 3 days recovering from the surgery. They transferred Natalia on my second day of recovery so I couldn’t even go to the hospital to be with my baby until the next day. Jacob had to drive from Lake City to Jacksonville, back to Lake City to pick me up, back to Jacksonville so we could be at the hospital every day and then finally back to Lake City so we could come home, and then he had to drive back so he could go home, lol! Lots and lots of driving.

At the end of the day, there were a lot of lessons learned from this entire experience. Although it was scary, it was very worth it and I am happy to say that I am a new mom to a very happy and healthy baby girl. According to her pediatrician she eats better than the average baby for her size and is growing at a great rate. She is such a good baby, hardly ever cries unless she needs something. She is always very content and has such a well-developed personality already. She’s definitely mommy and daddy’s little diva girl!

I also would like to mention that my perspective about c-sections have dramatically changed since I underwent the surgery. I actually prefer to have the c-section because I didn’t have to feel any pain WHATSOEVER, everything went by so quick it was unbelievable. The entire procedure took a total of 55 minutes. No contractions, no pain, GREAT pain meds during and afterwards lol, and my little girls head did not get squished and my vagina didn’t rip! The scar is barely noticeable, looks like a pen line just below my bikini line and nobody will ever be able to see it unless I show them, which means I can still wear my bikini this summer! Best of all, this entire event brought me and Jacob closer together and he loves me more now than ever before since having to be there with me and watching me go through all of this craziness. I definitely want to share my story because I think it’s well worth mentioning to people. Always prepare for the worst because you never know what’s going to happen, and always be optimistic about negative things that you have no control over because they are not always as bad as they seem.

Today my baby girl is 2 weeks and 3 days old and she is making the cutest “ooh” and “ahh” sounds, she picks her head up all by herself to look around because she wants to see everything, she will NOT fall asleep without being held, so she’s already spoiled, lol! (Thanks Jacob!)

One more thing I want to add before I conclude my super long birth story; because Natalia was taken from me right from the beginning, we didn’t get to experience the first bonding of mother and baby to establish breastfeeding, which is essential! And I am completely against giving my baby formula for several reasons. One because I’m pro-natural, two because I don’t feel that formula gives babies everything they need like breast milk does, three because of all the side effects that come from formula fed babies that I’ve researched, such as being more prone to obesity and becoming sick with diseases, and four because although the formula feeds the baby for longer periods of time (formula fed babies eat 6-10 times a day vs. breastfed babies eat 8-12 times a day) which means the formula “sits” in their stomachs and that just reminds me of McDonald’s food which is totally gross in my opinion. I already decided I wanted to breastfeed exclusively. Well since I didn’t get to breastfeed for the first week, I didn’t establish a good milk supply, so I couldn’t produce enough milk to feed my baby. Not only that but the doctors shoved bottles and pacifiers in my newborn baby’s mouth which pissed me the **** off! If they needed to syringe feed her then okay, but I was not about the pacifiers or bottles because of nipple confusion. So Natalia had a difficult time latching on for the first week and a half of our being together. It was making me sore and I was to the point where I was about to just give up all together. But then I decided “screw that!” I’m not going to give up because I WANT this for my baby, so I’m going to MAKE SURE it happens, no matter what it takes. If I have to breastfeed her every half hour then so be it. I consulted with a lactation specialist who was so inspired by my determination and told me that that’s what it takes, you have to really want to breastfeed for it to work out, which is what I truly want, exclusively. I only will use formula if I have to supplement, but otherwise I want to strictly breastfeed my baby mostly because it’s the healthiest for her, but also because it does establish a bonding relationship with you and your baby that just feels like pure love, and I want that with me and Natalia. So I have a $700 hospital grade breast pump that I’m using FOR FREE for a week-2 weeks just because my lactation specialist wants to help me because she sees how bad I want this. Unfortunately Natalia and I had a rough start, but now that things are back to normal we are going to work this out to both of our benefits. My advice to anybody else out there with this problem is to never give up on the things that you truly want. I am proud to say that Natalia has gotten MUCH better about latching on (although she still needs some improvement) and I am finally being able to produce enough milk to catch up with her needs. (:

Bringing Natalia Home <3

Natalia & I Now (:

We hit the 12 week mark on Wednesday. Baby is the size of a peach, which may not seem like much but knowing it was the size of a poppyseed when we found out our cycle worked, that’s a huge change!! My clothes are getting pretty tight now – getting dressed in the morning is getting a little depressing. I bought some new ones thinking spring was right around the corner, but it’s still much too cold for capris and short sleeved shirts. I may need to go back for a couple more pairs of long pants to get me through until the warmer weather finally decides to show up. I am feeling really good aside from the occasional ache and pain as things start to move around to make room. I still get pretty tired after a long day but I have gotten better about taking it easy, fitting naps in when I can and getting to bed early every night.

We go in for another appointment on Tuesday. This is the longest we have gone without being seen by someone and it’s a strange feeling. I am glad I don’t have to go in every other day, or even once a week. I do not miss the blood draws, and neither do my veins! This appointment is extra exciting though because it is with my OB/gyn. When I was in a few weeks ago I saw her PA, and I like her a lot too, but my OB is awesome!! I remember going in for my follow up appointment after my laparoscopy and her giving me the ok to get pregnant in January. She hugged me before I left and told me she hoped to see me in March or April. Well, here I am!! Pregnant!! Me, pregnant! As in, having a baby. Wow, sometimes it is still so surreal! I was starting to think I would never get to speak those words. Infertility really messes with your mind, that is for sure! For any other infertiles that read my blog, there is hope for all of us!! I am hoping we get an ultrasound. I know it may be unlikely, but I just want to check in on our little peach. We have been spoiled by getting 4 ultrasounds already!!

Quirino Memorial Medical Center (QMMC) is a public hospital serving patients mostly from Quezon City. It is named after the second president of the Philippines. Over 70% of the patients are indigent. As a public hospital, several differences are immediately apparent from my experience at Kaiser Permanente Santa Clara. At Quirino, there are three triage beds separated by curtains. For patients admitted in labor, they go to the labor room which is a single room that can have up to 7 beds. For very busy days, patients may be sharing two people per bed. Patients’ families stay in the waiting area until delivery. Only 1 in 20 patients receive epidurals and those are usually the patients who bought an insurance plan through the government.

Health care in the Philippines is similar to the U.S. system where there is no nationalized health care system. Though this is a public hospital, patients are still required to pay a minimal amount for their care. For those patients who are unable to pay after their treatment and/or hospital stay, they go to a special ward. There are no beds in the ward, only chairs, and patients stay here until they are able to pay as they are not allowed to leave until their bill is paid. Patients can sometimes get their bills paid by petitioning a local politician or waiting until the social worker gets an outside donation so that they can go home.

Most of the patients labor quietly in their bed. Once they are at +2 station, they get transferred to the delivery room which contains three delivery beds next to each other. Every labor patient admitted pays

 for a delivery kit containing two sterile gloves (almost always size 7 only), one suture, three bottles of normal saline 500ml, a few sponges, and other small miscellaneous items like syringes. Because resources are limited, p

atients requiring operative delivery are all delivered with forceps. Vacuums are expensiveand expendable while forceps are reusable aft    er a quick autoclave. Multiparous patients are allowed to have a vaginal breech delivery depending on the clinical picture, but nulliparous patients get a Cesarean if they are found to have a breech presentation.

There are 27 Ob/Gyn residents at QMMC including four residents from Nepal who will return there after they finish their residency training. It has been very interesting to note the differences in the duty hours as there are no duty hour restrictions in the Philippines. I feel like I am experiencing residency as it used to be in the U.S. over fifteen years ago. All of the residents do a 24-hour call every three days, and residents cannot go home post-call until all the patients they took care of the day before have had their final disposition plans. For example, a patient who was admitted in the early morning who required a tumor debulking surgery got her case bumped for emergency cases so her surgery did not start until 5pm. The resident in charge of her case who was on-call the previous day and evening had to stay to do her case. So that resident did not go home until after 8pm on her post-call day, essentially working a 37-hour call day. Also, residents stay until the patients who require consults, such as from Pulmonology or Cardiology, receive their consultation. There is very little handoff for cases. It makes for great continuity of patient care though of course at the expense of resident quality of life. I look forward to working more shifts with the QMMC residents who demonstrate great temawork daily and I have appreciated how armly they have welcomed me into their fold

.

Halle Berry is pregnant again at age 46. “Biggest surprise of my life!” I wish her and her baby health and wellness.

This Turkish woman will find out if she’s pregnant following a womb transplant in 2011. I hope it goes well with her, especially since the media will be hounding this story making a non-pregnancy all the more painful.

Molly Sims gained 72 lbs. during her pregnancy and was so ashamed she didn’t leave her home. Thank you medecine and cookie-cutter expectations for hearding women into worrying about their weight during a time that is supposed to be joyous and focused on the health of the baby. I even feel bad for Kim Kardashian and all the flack she’s getting. That’s saying something.

And in case you’re living under a rock, Cinderella, err, Kate Middleton, is pregnant. *waves british flag with mock gusto*

Hmm? What’s that you say? Oh, my pregnancy? Yes, well, let’s get to it.

This week we found out the gender. Let the nail biting begin. 

Thing is, we don’t plan on announcing the gender of the baby until the baby shower. We’ve been dropped a hint from a co-worker with three kids that if you don’t reveal the gender of the baby prior to the shower your gifts will be practical and thoughtful rather than 101 blue or pink onesies. I’m not sure whether it’s true, but it’d be nice to recieve something for the kid to sleep in. Since this is baby #1 for us and grand-baby #1 for both sides of the family, we’re trying to maintain focus on baby’s needs and not just the usual OH-MY-GOD-BABY! hype.

Registry will come soon, both online and in-store options. I’ll probably write another post on registry alone. I’m sure it’ll be an ordeal of one form or another.

So with learning baby’s gender came an ultrasound. That was the more important part. We verified our baby has not only all of its limbs, but also all of its fingers and toes. They’re also quite certain it’s human. (I’d been hoping for a velociraptor. Maybe next time). This ultrasound took a long time and challenged everything I’ve been taught by my pregnancy books regarding “don’t wait to use the bathroom.” I was a little disappointed at how quickly the tech breezed by the gender. She just kinda hovered for a second, asked if we wanted to know, told us, and moved on. No picture print-out, nothing. Just oh it’s a blah, now let’s get on to the good stuff! *sigh* I’ll be having a followup US this friday to verify a few things they couldn’t see too well (baby was contented to be rather difficult). During that ultrasound I’ll probably ask for gender confirmation just to get some photo evidence. That way I can whip it out during teenaged years and family functions. I mean, that’s what you do with ultrasounds after the baby years, right?

Let’s see. . . what else happened this week? Oh, that’s right, I gave myself one of those things I swore I was trying hard not to get: a hemorrhoid. It’s fading fast with a few quick Google searches for relief (use the bathroom whenever necessary, as soon as necessary and try using moist wipes instead of scratchy paper). I’ve been taking baby aspirin in order to help blood flow to the placenta (which they tell me is much improved), but since baby aspirin is a blood thinner that isn’t marketed as a blood thinner, it’s both helping swelling go down more quickly and taking longer for the ouchies to heal on the surface. Wild. I don’t know if it’ll go away entirely, especially since increased blood flow alone makes me predisposed to having one up until birth. I happened to get it while out and about and so far I can manage it on the go. We’ll see how that progresses.

That’s about all for this week. Welcome to week 20, where I can re-assure myself that I’m halfway there (even though I don’t feel like it at all).

Dr. O’Toole attended medical school at UNT Health Science Center in Fort Worth and then completed her internship and residency at Good Samaritan Hospital Medical Center in West Islip, New York. She has done extensive research on Fragile X and the effects on female reproduction, particularly being a Fragile X carrier and having premature ovarian failure and thyroid disease.

She has been married for five years and has a 22-month-old child and a 13-year-old black pug.

Dr. O’Toole – why did you get into medicine, and in particular, obstetrics?

I grew up surrounded by medicine.  My father was a small town internal medicine physician, and I grew up watching him take care of our community.  People always admired him so much, and he seemed to make such a difference in their lives.  I decided I wanted to have that kind of impact on people when I grew up.

I truly enjoy taking care of women and helping them through the different stages of life.  From adolescent changes and puberty, to pregnancy and childbirth, and finally through menopause, I want to help my patients make it through these times of transition with ease.  I like being able to answer all their questions and treat any conditions that are necessary.

What is one thing you wish every expecting mom would do/know?

Pregnancy is not easy!  Your body goes through so many changes throughout the entire process, sometimes you might feel like a totally different person. 

What kind of reassurance can you provide to first-time moms-to-be?

It is normal to feel overwhelmed at times.  You are experiencing something completely new and foreign.  Most of the strange things you are experiencing are normal to pregnancy, but I like to be there and explain anything that my patients feel is strange.  Reassurance can go a long way for a first time mom!

What’s your best advice for someone who’s thinking about becoming pregnant?

Go for a preconception visit with your OB.  There are things that can be discussed and testing that can be done before you get pregnant that cannot be addressed once you are already pregnant.  Things like vaccinations and genetic testing can be taken care of ahead of time.  Plus, you can get started on the correct prenatal vitamin for you.

What is your best encouragement for someone who is having trouble conceiving?

Don’t give up.  There are so many different options out there to help women with issues conceiving.  It is a very rare case these days that isn’t able to eventually become pregnant.  And even for those rare few individuals who are unable to conceive despite intervention, the option of surrogacy is available

How has having children influenced the way you practice medicine or interact with your patients?

Experiencing being pregnant – having the morning sickness, having preterm contractions, going through childbirth – has made me have so much more empathy for my patients.  When they call me with problems or questions, I have actually experienced a lot of the things they have questions about so I can help them from both a medical perspective and a personal perspective.

My daughter is the most important person in my life, but I also have a very demanding job.  I have learned how difficult it is to be a full-time working mother and still have quality family time.  I think this also has helped me relate to my patients on a personal level because so many mothers do work full-time now.

What new advancements in technology or medication are you most excited about?

All the genetic testing that is now available is so exciting to me.  We are able to prescreen so many patients now for diseases that before seemed to pop up out of nowhere.  Being able to counsel my patients appropriately prior to them being pregnant, and being able to offer them options regarding conception, has changed how I practice medicine.

When you’re not delivering babies, what do you do in your free time?

I LOVE to travel and my bucket list of places I want to go is extensive.  I lean toward places with warm climates and beaches.  My husband and I have a phenomenal group of friends and family in the area.  We like to get together with them on the weekends and cook out and have game nights.  And after living in New York for four years, I have a big interest in musicals.  I try and catch as many of the traveling shows that pass through here as I can.

For more information on Dr. O’Toole or to make an appointment, visit her  profile on the North Hills Hospital website.

Her: No, it should reduce in time, drastically reduce and the pain should be much less acute.

Me: Oh good.

Her: You know, the best way to get rid of endometriosis is to have a baby. It just clears it right up, and you’ll probably never have problems again!

Me: (nervous) oh, haha! I’m not sure we’re ready just yet for children. Perhaps in a few years.

Her: Of course. (Telegraphed by a polite but cautious smile) You have two years. Then it’s going to get much more difficult. 

I’m sure versions of this scene have played out thousands of times over in doctor’s offices across the world. I’m now 32 and have been married a year. Friends and relatives tactfully inquire as to “plans for children?”; it must be soon or the window will close is a given. There’s a polite distance, as if pressing the issue would force me into adolescent defiance, or perhaps it’s just the quiet acknowledgement that I may be having problems conceiving.

The truth is, it’s been one of my major considerations over the past four years. Since my late twenties, when I started to realise I would not, after all, be young indefinitely, I’ve been turning it over and over in my mind. I never wanted kids but if I don’t have them, if I lose my chance, will I regret it later? I’ve had treatment for cervical cancer that increased my likelihood of miscarriage, what if I can’t carry to term? Am I sufficiently responsible, knowledgeable, wise, thoughtful enough to be charged with the total care of another human being? My husband would probably accept a child if I got pregnant, but he doesn’t really want kids. Don’t kids deserve parents that want them?

I’m still considering this and knowing that time is running out to give my final answer. It’s no easier now than it was four years ago.

Choosing an OBGYN is an important decision. OBGYN stands for obstetrician and gynecologist. An obstetrician delivers babies and monitors a pregnant mom throughout the course of her pregnancy. A gynecologist cares for the well being of a female and her reproductive system. This is a woman’s most intimate physician. When it’s time to choose a new one, due to moving, becoming pregnant or simply desiring a new provider, care must be taken to make a good selection.

Here are some tips to aid in the decision making process:

Philosophy: Medical philosophies differ greatly among practitioners. Natural childbirth, holistic methods, pro-Cesarean and more should be considered. It’s wise to make consultation appointments with a few doctors in order to discuss philosophical beliefs. This is an important foundation for the relationship.

Specializations: Infertility specialists are just one example of possible arenas of focus a physician may have. If a couple is having trouble conceiving, they may want to work with a doctor that has a broad range of knowledge in this area. Once pregnancy occurs, the doc will be able to follow them through until delivery of the infant(s). Another specialization is oncology, which is the study of cancer. If a person has had cancer or is at a higher risk for whatever reason, she may want to seek medical treatment from a practitioner who has expertise with this disease.

Insurance: Check to see if this medical practice accepts the type of health coverage you have before signing up. It’s a good idea to check with the doc’s office as well as your own insurance company. No one wants to find out they weren’t covered after the fact.

Office hours and location: Convenience and alignment of hours are important. Finding out what hospital the physician delivers babies at is important, too. A mom in labor doesn’t want to drive clear across town in order to check into the hospital.

Gender: Sometimes moms-to-be prefer to be seen by a female doctor. Others feel more comfortable under the care of a male OBGYN. This is definitely a personal preference that should be pondered.

Taking new patients? Make certain the doctor you’re interested in signing up with is taking new patients. The best way to ascertain this is by a simple phone call to the receptionist or scheduler.

Office Staff: When you first call the office, you will probably get an initial impression of how the place is run. If the secretarial staff is cranky, this is a red flag. The staff’s demeanor often reflects the medical practice’s mood.

Personality click: This is an important business relationship where a woman will be discussing intimate body parts and sharing the births of her children. It must be a compatible one in order for it to be successful. Do the two of you click?

Emergency back-up: It’s also important to find out what doctors will be on call in case your primary obstetrician is unavailable. Babies can be born around the clock and the doc is only human. He or she must sleep sometime! Who are the alternates that may be on duty the day that junior decides to make his way into the world?

One piece of advice I had read was to make sure that you not only like your obgyn (since you’ll be dealing with him/her for 9 months) but also the receptionist, since that’s who you’ll be making all your appointments with.

I had forgotten how much of a dipsh*t the receptionist is at my obgyn’s office was. I was kind of in a rush because the office didn’t open until 9am and I was worried that my coworker was going to come in and hear the conversation. Note to self:write an entry about how being stealth sucks balls. She told me I could get an appointment in 2 weeks. I’m like “umm, isn’t that too early? I thought you guys don’t start seeing pregnant patients until 8 or 10 weeks”. She’s like “umm, i don’t know. Actually April 15th doesn’t work. It’ll have to be in May”.

I was practically in the 2nd trimester by the date she said I could be seen. I”m like “uhhh, that’s way too far down the road.” Then she tells me that indeed there is a spot on April 15th. I”m like “I thought there wasn’t a spot. Now there is?” which then had her typing furiously while she attempted to learn how to use a computer.

So I’ll be going in a bit early but I don’t care, I figure it’ll be easier to figure out from the Obgyn herself how often I’m supposed to go in rather than deal with the receptionist who seemed confused when I said “Hi, I’m pregnant, I need to see Dr. Lopez”.

First, there’s the list of methods that I considered for about the length of time it takes a toddler to consume a Go-gurt. For the uninitiated, about zero-point-two seconds. Now, in certain areas, I’m an all or nothing kind of girl, and 76-85% effective sounds like a whole-lot-a-nothing to me. So, I’ll pass on the diaphragm, the sponge, the cervical cap.

I’ve ruled out the female condom – yeah, they’re still around…never really caught on did they? I think I was in high school when they invented it, or at least when I first learned of their existence. I remember hearing about it for the first time and wondering what a ‘female condom’ looked like. I thought maybe it was like a raincoat with a deep pocket that you used to cover your vagina, but what held it on? Some kind of garter? Pube velcro? These were the days before you could run to the internet and pull up a description, a picture, and most likely, a demonstration video to explain the concept. So I was left to wonder…turns out I was kinda right about the pocket part. Not so much about the velcro.

Let’s see…then there were the slightly more effective, but ‘let’s not go betting the existing children’s college fund on it’ methods (91-99% effective): the ring, the shot, the patch, the pill. Still not liking those odds.

The pill’s a great choice if you have a good memory and a consistent schedule; if used correctly, the percentage of effectiveness is definitely on the higher side of the range. Oh yeah, did I mention I have a baby and a toddler? Sleep deprivation and the resultant momma-brain don’t begin to cover the reasons why this might not be the best choice for me…

That leaves, apart from some snipping and tying (wait, are we talking knitting or birth control) the top contenders – implant or IUD. I’m not sure I can explain why I ruled out the implant. It just skeeves me out. I feel like I’d always be rubbing my arm and feeling like if I leaned against something it would hurt. Or that the government would track me down using the GPS chip hidden inside. And they’d tell my husband I wasn’t really at the library like I said, I was at Taco Bell. Again. For the third time that week. Curses, foiled again!

Okay, so we have a winner! IUD it is. So which one do you want, the doctor asks me,

1) the one that often causes longer heavier periods and worse menstrual cramping, or

2) the one that might cause weight gain and acne (Mirena)?

Uhhhhh…..

———————————

Part 2: Decisions, decisions…

———————————

Please remember, as always, don’t make any decisions based on what you read here – for all you know, I’m just some schmuck talking smack on the internet. Always check your facts with your doctor. Or, for more information on the birth control methods mentioned above, check out a reliable source, like this one…then talk to your doctor: http://www.plannedparenthood.org/health-topics/birth-control/birth-control-effectiveness-chart-22710.htm

Diet & fitness
[  ] Work on getting any weight problems under control
[  ] If either of you smoke,quit
[  ] Get on prenatal vitamins
[  ] Balance out your diet
[  ] Get moving
[  ] Start weaning yourself off alcohol
[  ] Begin limiting the lattes
[  ] Scale back on extreme exercise
[  ] Decrease your stress
[  ] Get plenty of sleep
[  ] Potential daddies — avoid cottonseed oils

Doctors, tests & checkups
[  ] Interview OB/GYNS
[  ] Schedule a preconception checkup
[  ] Make a list of preconception checkup questions
[  ] Discuss your (and your partner’s) medical history with the doc
[  ] Get immunized
[  ] Visit the dentist
[  ] Talk to your doc about genetic testing

Money & Home
[  ] Talk it out — make sure you and your partner are on the same baby-making page
[  ] Check your home for harsh chemicals and asbestos
[  ] Check out your health insurance
[  ] If you’re self-employed,apply for private disability
[  ] Plan a baby budget

FIRST TIME MOM

This post involves discussing poop and constipation. If that makes you super uncomfortable feel free to skip it. It makes me pretty uncomfortable too.

The bottom line is that I’ve been having some really bad constipation off and on. I haven’t talked about it on this blog because it’s really weird for me to talk about poop. I could rattle off my most personal details if I felt they were being used as an educational tool; I’m not shy about my marriage, sex life, or even big flubs in my past.

I can’t think of a single application where my poop has been an educational tool. But alas, now that there has been a lack of poop, let the education begin.

Don’t worry about the doctor’s office, I’ll get back to that. We’ve gotta talk about poop right now. Don’t stop me, I’m on a roll.

One of the bigger things on my “no one warned me about this happening during pregnancy” list is constipation. I heard it rumored that some women have constipation during pregnancy, just like you hear rumored that some women get severe morning sickness, requiring prescription medication during pregnancy, or some women become pregnant with their own twin. (I shit you not, click the link). If you’re the first of your friends and family to get pregnant, you probably won’t know about all the strange things that happen to your body until they’re happening and you’re furiously googling them to ensure your baby won’t have three heads or gills. You’ll then find about twenty different blogs with lists of “what no one tells you about pregnancy” and you’ll find out that it’s totally normal to get falcon-kicked in the cervix by your pride and joy (hellooooo lightning crotch).

So on my personal list is constipation. In fact, it’s the first item. I knew about weird food cravings (yet to strike in full force), I knew about heartburn, swelling feet, gaining a shoe size, gaining a few cup sizes, morning sickness, discomfort, anxiety  and plenty of other things you would expect with pregnancy (like ending up with a kid). No one had ever warned me, “When you’re pregnant you’ll go days without a good poop.” Perhaps they had the same reservations about discussing their bowels.

Well, I am here to tell you: I have never had constipation in my life until now, during pregnancy. Every pregnancy blog I’ve read is written by a woman who has suffered constipation at the mercy of her unborn child.

I’ve found my own ways to minimize the damage. Fruit in the morning really helps things get moving, and if I’m pressed for time I just have a big glass of pulpy orange juice. (I’m really sorry if those of you with morning sickness just suppressed vomit at the thought of OJ).

So back to the doctor.

[Danger Will Robinson: bowel movement discussion ahead!] The previous night I had a very large bowel movement following some particularly bad constipation. I’d been trying to avoid larger bowel movements because something I was warned about in advance was hemorrhoids. I had very mild hemorrhoids following my whey reaction and I have no interest in having them ever again. So rather than forcing any movement of my bowels I’ve been happy to take the extra time on the can reading a book and letting things pass naturally, however slowly that may be. To put it as delicately as I can, this poo needed some help. So I helped it.

Following a shower and some relaxation my husband and I had some fun time and when I used the restroom following our fun time, I noticed some pretty thin discharge.

Thus far during my pregnancy all of my lady mucus has been just that: mucus. Most women find that they have a greater amount of mucus during pregnancy which is thicker and denser than the discharge they may have during their regular cycle. Some women have a great enough amount to warrant panty-liners or pads, particularly late in term. But the thin stuff really concerned me, particularly after the bowel movement. I wasn’t concerned that sex was the culprit as it’s certainly nothing new, but with watery stuff following strain on muscles in that area, I was a little concerned. I was determined not to panic, so I resolved to wait until morning to call a nurse at my office.

In the morning the thin stuff was still there. Really watery, no mucus-like qualities, so I call the office and the nurse says put on a pad and call back in an hour if it’s wet. Brilliant, why hadn’t I thought of that? So I did, it was, they say come in and see us today. Great. Panic might be warranted now. I mentally kicked the weepy pregnant girl back into the cage of reason in which I keep her locked, gathered some overnight items in case of an escalated situation, and headed to the office.

After a long waiting room wait I saw one of my nurse midwives who examined me, took a swab, reassured me and had me re-dress. When she came back in she informed me that there was absolutely nothing to worry about.

*whew*

There was nothing coming out of my cervix (like amniotic fluid would have been, were that the culprit), the internal mucus she could see was still very thick and mucus-like, and the swab she took was only normal discharge. Apparently all kinds of things from warmer weather to top notch hydration to being one day more pregnant than you were yesterday can cause your discharges to become all watery. If I had an amniotic fluid leak (like I’d been panicking about) it apparently would have gushed like no one’s business. Their biggest concern was a yeast infection.

Thus I say, these charts need a huge FIRST TIME MOM sticker or something. I felt like such a dunce. Even so, I’m really glad I went. I still feel like a dunce, but it was important enough to verify my child’s safety and risk looking stupid and inexperienced.

What else is there this week? Well I *am* compiling a list of things no one told me about prior to my pregnancy. I’m not sure when I’ll have it done. I might save it for the end of trimester 2, just before I start talking about birthing classes and birth plans.

I recently decided that being a first time mom (read:dunce) it would be a good idea to have someone in the labor/delivery area who knew what was going on and wasn’t medical staff. So I asked around about doulas, since just the name alone sounded a little hokey to me. I think I imagined a woman turning a rain stick and shaking a gourd over me while screaming ululations or trying to hypnotize me into believing I wasn’t feeling pain. And she would look creepy too. Like this:

Ermahgerd, tell meh ahll about yerr bebeeeeeees.

But I found that my preconceived notions regarding doulas were totally false. Doulas are pretty much what midwives used to be: women who attend births regularly and aid women through delivery.

I asked about them at my last CNM appointment and found that Johns Hopkins has a free program called Birth Companions, who are certified doulas training to become nurses. Because they’re still in school, the service is totally free. I have a lot of confidence about the program, mostly because I have a lot of faith in my nurse midwives. I’ll be much more at ease knowing that someone at my delivery will be on my team and able to tell me what the heck is going on. I have a great deal of regard for medical professionals, but it’s easy to become jaded in any job, and I like that the doula will be tending primarily to me and also to my husband during what I’m sure is bound to be a crazy experience.

One of my biggest concerns regarding doulas was that I didn’t want to replace my husband’s position in the delivery room. I mean, a guy can only do so much in that situation and I didn’t want him to feel out-performed by a trained professional. So I asked my husband if he’d be comfortable having a doula or if it would make him feel out of place. He responded that he’ll probably feel out of place regardless of whether or not there’s a doula present, and he agreed it’d be better to have someone who knew what was going on around. After some further research I also found that it’s common for men to feel more at ease with a doula present because their experience eases the situation and the doula is able to encourage the husband’s involvement where it is practical and applicable.

I might still have her bring the gourd and rain stick.

I ‘ve been having some pain when I stand, especially when I stand quickly or after having been in a sitting position for a long time. It’s a very specific, normal pain caused by the strain of the weight of the uterus on the ligaments holding it up. Apparently these ligaments form a kind of a hammock (who knew?) and a sudden use of them when they’ve been resting can cause them to strain a bit. Sometimes it feels stabby, but most times it just feels like you’re stretching a ligament as you would when attempting to do a split. It’s just in your hip area and there isn’t much you can do about it. If it’s really bugging me I’ll lift my bump a little bit, and that relieves some tension.

Also, I’ve been sleeping on my stomach still, which is slooooowly turning into side sleeping. I was really worried about this during my first trimester because everyone recommends sleeping on the left side as being best. I of course read that the only option was to sleep on my left side, and though I eventually fell asleep in this mildly comfortable position, I’d wake up on my stomach and panic.

I don’t sleep entirely on my stomach, but in a far more bizarre position.

Like this, but without the pillow in the way.

So basically my body is just slooooowly turning as my uterus gets bigger and more in the way. I’m sure eventually this will be a really uncomfortable way to sleep come trimester 3, but it seems to be slowly and naturally adjusting itself. I haven’t noticed any increased stretch marks due to this position, or any other negative effects. I also don’t sleep only in this position, but I sleep on my sides too if this is feeling uncomfortable (like when I have heartburn and I’m too lazy to walk across the room for the tums). All that being said, if you’re concerned about safety, the link in the first window will take you to a website where a few doctors tell you not to worry about it. I haven’t yet found a website where doctors tell you to worry about it, so I think we’ll be alright.

Also sleep related, I started wearing a comfy cotton bra while sleeping. I tried a nylon Walmart bra, but that just didn’t cut it, so I got a cotton sports bra with no wire. It helps keep my boobs in line so I don’t wake up with one under my arm, yowling in pain. Not that that’s happened yet, but they do seem to have a mind of their own these days.

That about sums up this past week. I’ll leave you with this:

Dr. Robinson-Brown graduated from Meharry Medical College in Nashville, TN, and then completed her internship and residency at Howard University Hospital in Washington, DC. She has been married for over 20 years and has two sons – a sophomore in high school and a junior in college.

Dr. Robinson-Brown – why did you get into medicine, and, more specifically, why did you choose obstetrics?

Growing up I saw first-hand how limited healthcare affected the lives of many in my community. My interest was sparked early in life.  Born premature weighing only 2lbs and 12 oz, since childhood I yearned for the knowledge to understand the circumstances of my birth. While in college, I became involved in the Health Professions Club which allowed me to participate in the Med-Dent Start program. Through this program I was able to witness various surgeries, the birth of a child and the sorrow and loss brought on by the death of a patient. These early experiences increased my desire to pursue Obstetrics and Gynecology.

What is one thing you wish every expecting mom would do or know?

Seek prenatal care early in your pregnancy. Do not assume that because you have had one pregnancy that the next pregnancy will be exactly the same. Every pregnancy will be different and may require different treatment based on your medical condition for that current pregnancy.

What kind of reassurance can you provide to first time moms to be?

Know that your doctor is there to help guide you through your pregnancy process. Do not be afraid to ask questions about what is happening with your changing body. Sometimes the questions you ask may be important to the care or management your doctor is providing.

What is your best advice for someone who’s thinking about becoming pregnant?

Again start prenatal care early. You may want to see your physician for a pre-pregnancy counseling and examination. During that visit you can discuss current medications, health issues, substance use, daily habits and family illness that may affect your pregnancy. 

What’s your best encouragement for someone who is having trouble conceiving?

Do not give up too early on trying to conceive. The process may be longer than expected. Also do not let your disappointments and frustrations cause stress in your relationship.  Early intervention is important. Female age is an important factor when planning for a pregnancy. Females 35 and older need to seek care with a healthcare professional to start the evaluation process as soon as possible. Both partners should be involved and will require a medical evaluation to identify the cause.

How has having children influenced the way you practice medicine or interact with your patients?

Having children allowed me to be able to relate to the discomforts that often occur in pregnancy. Often I am able to incorporate personal accounts and helpful tips from my own experiences to help my patients cope and adjust to each situation.

What new advancements in technology or medication are you most excited about?

I am excited about the new advances in minimally invasive surgery such as robotic surgery, hysteroscopic removal of fibroids and polyps from the uterine cavity, endometrial ablation for bleeding and hysteroscopic sterilization techniques that allow patients to return to their busy schedules if required.

What do you do in your free time?

During my time away from the office, I am an avid foodie and I love to cook. I love to sing and I enjoy various styles of music.  I also enjoy traveling with my family, going to movies, bowling and participating in the W.O.W. (Women of Worship) Choir.

For more information on Dr. Robinson-Brown or to make an appointment, visit her  profile on the North Hills Hospital website.

Our Birth Hopes

Gestational Parent/Father-to-be: K
Non-Gestational Mother-to-be: C
Doula: Marie
Location: Our Hospital Birthing Suite

Hi there and thank you for your care and expertise during this exciting moment in our growing family! We’re K and C and this is our first baby. We appreciate you taking the time to learn about us and our birth preferences.

It is really important to us that you know that K, who is delivering our child, identifies as a man, uses male pronouns such as he/him, and will be our child’s father. We’d like you to also be aware that C is our baby’s mother. While we know that mistakes and confusion can occur, we hope that you will do your very best to refer to us using these terms.

Birth preferences:
We know that labor and delivery are unpredictable. Ultimately, we want the health of K and our baby to take precedence. Whenever possible in non-emergent situations, we’d like to discuss all procedures, including their risks and benefits, before they take place.

Labor:

• We would like only necessary people in the room during labor and delivery. This includes C, our doula, a nurse, and our doctor.
• K wishes to be able to move freely in order to naturally manage his pain. To this end, he would like a port to be inserted upon our admission, and for an IV to be used only if it is determined to be necessary. He would also like intermittent monitoring instead of constant monitoring techniques, when at all possible.
• K wishes to be able to utilize natural comfort measures, including but not limited to the use of a shower or tub, changing positions, and the ability to walk to stimulate/progress labor.
• We are aware of the availability of pain-relieving medication, and will request it if the father feels it is necessary. Please do not offer pain medication.

Delivery:

• K would like to be able to push as he feels naturally compelled to do so (i.e. spontaneous/patient-directed pushing style). Please do not direct his pushing by counting.
• We would like the ability to try different pushing positions, including but not limited to squatting, hands and knees, and toilet sitting. Please do not limit K to birthing our baby while he is on his back.

Cesarean Section:

• We wish for both C and our doula to be present if a cesarean section is necessary.
• So that we feel involved in the process, we would like for the doctor or nurse to describe what is taking place during the cesarean section.
• While K is recovering from the cesarean section, our infant should remain with C, unless he is experiencing a medical emergency that requires immediate medical care.

Newborn care:

• Cord cutting: We wish to allow our child to continue to be attached to the umbilical cord until it has stopped pulsing. At that time, C would like to cut the cord.
• Temperature regulation: We wish for our child to be placed, skin-to-skin, with C or K, immediately after birth.
• Eye treatment: We wish to forgo the antibiotic ointment in our child’s eyes.
• Rooming in: We wish for our child to remain in our room at all times, unless he is experiencing a medical emergency that requires immediate medical care.
• Circumcision: We do not want our child to be circumcised.
• Feeding: We are unable to breastfeed our child and would like to use bottled formula.
• Bathing: Due to a risk of severe maternal allergy, please do not bathe our infant with any product other than what we have provided.

It has come to my attention that today is Doctor’s Day, and so I want to congratulate my Dad, Dr. Kofi Sefa-Boakye OB/GYN, for over 20 years of great service and care to the city of San Diego.

Thank you for delivering the many babies here in San Diego–especially your three sons: Prince, Asante, & Kojo.

Proud to be your son.

Happy Doctor’s Day to doctors everywhere!

Eden Gabrielle Fromberg, DO, is an osteopathic physician, Board Certified in Obstetrics & Gynecology (1999) and Board Certified in Holistic Medicine (2003). Dr. Fromberg has an extensive and diverse background in yoga and women’s healing arts, and is a highly regarded consultant in natural childbirth and holistic women’s health & fertility. Born by natural childbirth in Brooklyn, New York, she was fully breastfed, weaned onto a naturopathic diet, and raised as a third generation vegetarian.

Courtesy of Dr. Fromberg’s web site

Would you? Could you?

Other snarky posts:

• Justin Timberlake’s hair
• Does Beyonce do this?
• My most popular tweet

We’re feeling quite the range of emotions. K had a massive hot flash after we left the office and also felt pretty teary. I felt slight panic but also felt vindicated. I’ve been trying to convince K that, at the end of this week, Falco will be considered full term, and that labor and delivery could really occur at any time. Two things are certain: this baby will come when this baby is ready and, within the next few weeks, we’ll be parents.

Needless to say, our hot Friday night date consists of packing our bags (and, of course, updating this blog). Fingers crossed for an April Fool’s baby, y’all!