Thursday, November 20, 2008

misc

I'm at my parents' house today, having taken a day off to hang out with my brother who's home for a week. Brother and Mom are at the grocery store, and Annika is finally down for a nap, so I have a few minutes with nothing pressing to do.

This is a very weird feeling.

Not really sure what to do with myself.

Borrowed a few books from my parents' bookshelf to read on the train: "Blue Blood", the memoirs of a NYPD cop, and "Eggs in the Coffee, Sheep in the Corn", an account of a city girl turned farmwife.

I'm almost done reading "Crime and Punishment." I bought it in one of those moments when I felt that I should really read more classic literature, that was probably at least a year ago, but now I'm finally reading it. Why are Russian novels always so gloomy?

Yesterday Dooce.com announced that they're pregnant. I gasped and got choked up about it, and then spent the rest of the afternoon pondering how it's possible that I can feel so emotionally invested in someone I've never met or spoken to personally. I definitely don't have more than a passing interest in celebrity pregnancies or babies. Then I realized that if closeness is created by the sharing of information - what are you doing? what do you like and dislike? how are you feeling and why? Then I have a lot more information input from Heather than I do from most of my close friends and even family. The internet is a strange and wondrous thing.

Tuesday, November 4, 2008

Lucky 13

I hit the polls early this morning, and was the 13th voter in line. Hopefully this is a good omen, not a bad one.

For me, it was certainly convenient - it meant that I only stood in line for about 10 minutes, and crossed one item off of my day's "to do" list before 8 am. Not bad.

Now, the mantra for the rest of the day:
Must not obsessively check election results.
Must not obsessively check election results.
Must not obsessively check election results.

Friday, October 17, 2008

Snippets

Usually, I only bother posting on this blog when I have some big news, or at least something to ramble on about, at length.

I'm going to try posting shorter bits, more frequently, about more day-to-day things.

For example -

This morning on my way to the train station, I heard two songs on the radio that were a good start to the day: Weezer's "Troublemaker" and Jack Johnson's "Bubble Toes".

Sometimes I think it's odd that with all the different ways to get a music fix these days, I still listen to the radio a lot. I like not knowing what will play next (not just my iTunes library shuffled, but songs I don't own) - and also it's maybe the main way I keep in touch with mainstream pop culture, since I don't watch TV or movies much.

Tuesday, August 19, 2008

Not exactly on the ball

So. I posted my monthly Annika-letter over on the dedicated Annikablog, and it's only two weeks late. Only. I think from now on I'll put most of the babynews over there, along with pictures (I wanted to upload more pictures but kept getting error messages last night).

Here, I'll keep rambling on about life, the universe, and everything. When I actually manage to think up a topic, write down my thoughts, and then type it up. That's a big accomplishment, lately.

Although I'm not writing much, I've been reading. Mostly on the train to/from work.

Since Annika was born:

Tangled Webs (Anne Bishop)
Operating Instructions (Anne Lamott)
Merle's Door (Ted Kerasote)
Sense and Sensibility (Jane Austen)
The Ill-Made Mute (Cecilia Dart-Thornton)

and currently reading: The Briar King (Greg Keyes).

I think I'm forgetting at least one book somewhere in there; I'm not counting books about how to deal with babies, of which I've read or skimmed several. Frustrating. Maybe I'll remember it later.

Wednesday, July 9, 2008

Letters and Adventures

We're back from our 4th of July trip to Oregon, and I will blog about that in more detail soon.

For now, what I wanted to do is to post the first in what I hope will be a series of monthly letters to Annika. I'm shamelessly stealing this idea from Heather over at Dooce.com (a wonderful blog in general, but especially when she's writing about her daughter). I like the concept of not only writing regularly about each month's new developments, events, joys and sorrows, but to address it to the person who's most likely to be interested later on. I'm starting with Month 3, because I found it easier to write than months 1 or 2.

______________________________________________


Dear Annika,

At the start of this month, you started "Trena-care" and I went back to work. This required some adjustment for both of us, but all in all, it seems to be going well. Aerik has repeatedly declared his love for you, and Trena has negotiated with your dad so that Aerik may ask you on a date when you're 25. Anyone else must wait until you're 30. Kira is not sure whether you are something that might be good to eat, something to play with, or just a thief of Trena's time and attention.

When you look up at me with your sapphire x-ray eyes as you drink from a bottle, I wonder what it is you can possibly see in me. You look so knowing, so wise - and then you forget to coordinate swallowing, sucking and breathing, and start coughing and spluttering. The expression on your face says that you're a little annoyed that the bottle is trying to drown you.

Sometimes when you smile, you scrunch your nose and gasp in glee, and you look as though I just told you the most outrageous, juicy piece of gossip imaginable. It must be fun to watch grown-ups get so giddy every time you grin at them, and then make absolute fools of themselves trying to coax another grin out of you. But the best smiles are the ones you give me for no other reason than that I've magically appeared at your crib in the morning, or after a nap when you've started fussing.

According to the Authorities, babies your age should get "tummy time" to encourage upper body strength. You have a goodly amount of strength, you can hold your head steady, you can support your entire weight on your legs, but being placed on your stomach makes you grumpy. First you squirm, then you start making frustrated little noises, then you start to fuss - it's like you know you can't justify really crying hard, so you just go "Wah. Waawaah. Wah. Weh. Wehwaawaahweh." All the while, trying to use your legs to crawl, but not succeeding because you haven't yet figured out that your lower half won't move forward unless you use your arms to move your upper half forward at the same time.

This, obviously, is not your favorite activity. Your favorite? It's a close call between having a boob in your mouth, versus lying on the changing table kicking and squirming. You get so excited, and jerk all four limbs around so emphatically that it always puts me in mind of a marionette whose strings are being pulled by some kind of maniac. At times you look as though you yourself aren't sure who's controlling all this activity - your eyes get really wide and surprised-looking, and your solemn expression doesn't at all match the flailing and kicking.

You've gotten very good at cramming your entire fist into your mouth. Your dad and I look at the fist, and then your tiny rosebud mouth, and wonder how you do it. And recently, you made the astonishing leap of reasoning that if you can put your hand in your mouth, and if you can grasp an object in your hand, then that object can also be shoved into your mouth. You put a fuzzy toy alligator into your mouth the other day, and then made the most awful face, probably because fuzz on your tongue offended your aesthetic sensibilities. Those are some big words for someone who can, at best, say "ah-goo".

About two weeks ago you started sleeping through the night. At first, we would only speak those words in whispers, lest they turn out to have been simply a sleep-deprived hallucination, or a one-time deal. But now, we can reliably get you to sleep sometime between 10 and 11, and you sleep until 6 or 7 am. After the first two months, the sleep deprivation that made us feel more dead than alive, this is our idea of heaven.

I wonder if there is such a thing as too much affection - I have to fight the temptation to squeeze you too hard, to eat you alive with kisses. So far, you don't seem inclined to protest being gobbled and tickled and cuddled, and I intend to make the most of it before you're old enough to say "Aww Mom, stop it!" and push me away.

Love,

Mama

Wednesday, June 18, 2008

Parenthood Part I - The Birth

I'm finally sitting down to start writing about the journey into mommyhood. I'll do this in several pieces, since it would be a gargantuan post if it were all in one.

I started my maternity leave on Wednesday, April 2nd. I hoped that not too many days would go by before the baby was born, although I did have grand ambitions of getting the house clean and organized before her arrival.On Friday at about 7pm, I had the first indication that things were starting to happen - a phenomenon called bloody show. This means that labor will start soon, but "soon" might be hours or days. I told my husband that if he wanted any more pregnancy photos, he'd better take them soon, and we spent part of the evening doing belly pictures. We went to bed as usual, but while I was waiting to fall asleep, I felt a contraction. Probably just practice... but it was followed by another, then another, around 10 minutes apart. I waited a while to see if they'd keep coming, and they did, although not at precisely regular intervals. They were somewhat uncomfortable, but not too bad at all.

At around 2 am, I woke the husband, and we finished packing our Birth Center bag, I called the midwife on call, and we got in the car to head down to Wilmington to the Birth Center. When we got there, I was disappointed to find that I was only 1 centimeter dilated - in other words, I had a looooooooooooooooong way to go.

We went to my parents' house 10 minutes away, and later in the morning, contractions started to seem more intense, so back to the birth center we went. But still, I was only about 2 centimeters dilated! Still, I thought I'd feel more comfortable staying at the Birth Center; with each contraction, I could feel myself sort of fighting it even as I tried to relax, maybe because of some subconscious fear that if I just relaxed and let go, things would happen too fast. Maybe if I settled in at the Birth Center and made myself comfortable, things would speed up.So, for quite a few hours we stayed there - I laid on my side on the couch, then I sat on the birthing ball, then I kneeled on the bed with my arms holding me up on the birthing ball, then back to the couch with one leg hanging over the side to try to get the baby to turn around. She was facing my front instead of facing my back as would be ideal.

Eventually, Katie told me that I might want to reconsider camping out there, because I was still dilating only very slowly. Because the Birth Center is a short-term care facility, they can't keep a patient there for more than 24 hours. And if my labor didn't speed up, I might end up having to transfer to the hospital just because of the time limit. I hadn't known about that before, so back to my parents' house we went. The plan was to take some Benadryl and try to sleep for a few hours, to give my body a chance to rest before "real" labor began.This was sometime in the afternoon. I decided I would take a shower to try and relax, and then take the Benadryl. But by the time I got out of the shower, contractions were getting more intense and closer together. Instead of taking the Benadryl and trying to sleep, it wasn't long before we were heading back to the Birth Center. Now, just breathing wasn't enough to get me through a contraction; I had to hold on to something or somebody, especially if I was standing up when one hit. Trying to climb up onto the examining table was really difficult, because the change in positions caused a contraction, and on top of that I had the shakes. Katie said "That's good, the shakes usually mean you're at least 4 centimeters!" At this point, I didn't feel especially great about the whole thing, but at least things were moving along, and 4 centimeters it was.

After a bit, I started having a lot of pain in my back, and Katie suggested trying the Jacuzzi. I climbed in, and immediately felt better - the contractions still hurt, but the back pain in between contractions was gone, and I could relax more easily. My husband sat by the tub and held my hands during each contraction, and during the worst ones, he helped me stay calm by telling me to breathe with him. If I focused on trying to match my breathing to his, it helped me stay in control.

Time no longer had any meaning; contractions came and went, and I started to take mini-naps between them. They started to become further spaced apart, but more intense when they did come. Finally Katie had me get out of the tub because the contractions were slowing down, and because things were moving so slowly - it was early dawn on Sunday morning, and this had started Friday night around midnight!When I got out of the tub, I was getting ready to insist that I couldn't do this anymore and needed drugs to hurry things up and take away the pain. Katie told me that all women say they can't, at some point. But I think she was just about getting ready to agree with me. She examined me and said, "Do you want some good news, mama?" I nodded. "You're at 10 centimeters... you're ready to push this baby out!" I wasn't sure whether to sigh in relief, or to cry. Push? PUSH? You've GOT to be kidding me, my body said.

I didn't feel much like pushing; unlike many women, I didn't have the urge. Those muscles were just too tired. So it was a battle of wills, me against this THING that was stuck inside me and was the cause of all my troubles. Contractions were far apart, and sometimes I napped between them; sometimes I caught my breath and then got bored and tried pushing in between contractions. I tried different positions: sitting on a birthing stool (which terrified me because I was sure I would tear if I let her come out too fast), on the bed on all fours, on my left side, on my back. Peggy (one of the nurses) took a set of handles with rope attached - I held onto the handles and pulled, while she provided resistance. This forced my tired abs to help with the pushing, but it also made my arms tired. Katie and Peggy switched my iPod playlist from my soothing labor playlist to a lively, upbeat, somewhat random and eclectic selection. They were greatly entertained by my music collection; I was too tired to really be amused.

The shift changed; Katie left and Dorinda came in. I was getting really close now; a tiny patch of the head showed with each push, but I couldn't seem to get any farther. I switched to my right side, with someone holding my left leg up out of the way. They tried to motivate me by saying that soon I'd get to see my baby; at that moment though, I didn't care about any flippin' baby, I just wanted it to be over. Finally, the tiny patch of head got bigger, very slightly bigger, and I got mad. Godf*^&ingdamnit, I had had ENOUGH - if I had to rip myself in two to get rid of this thing that was tormenting me, I would do it. So I pushed like I was going to turn inside out, and that head slowly came out. I remember feeling that it was out, and realizing "Oh shit, now I have to get the shoulders..." but that wasn't so bad; another gargantuan push and she was out, and I can't really say what happened next; they suctioned her nose and mouth, she cried, my husband cut the cord, and then after a bit they put her on my chest.

I sat back against the pillows, and paid only minimal attention to what was going on around me; I vaguely remember getting a pitocin shot to help my uterus contract, and one last push to get the placenta out, and lots of other activity. But mostly, I was busy looking at my new baby. She was tiny, and wrinkly, but surprisingly pristine-looking considering what she'd just been through.

One thing that was funny about the birth is the music selection: I hadn't intended that particular playlist to be used during the actual birth, and the song that it happened to play at that moment is definitely NOT what I would have selected, but I was too busy at the time (go figure) to change it. It was Eminem. Slim Shady. Dorinda politely commented, "I've never birthed a baby to Eminem before." Apparently, this has become somewhere between a legend and a joke among the midwives at the Birth Center, since it's more usually folk music, or spiritual music, or New Age. Not... Eminem. Sigh.

But the important thing was, she had arrived, she was healthy, and... not least... I did it! I had survived a 32-hour labor!

Monday, June 9, 2008

Vaccinated

Friday, Annika had her 2-month visit to the pediatrician. She's now 10 lbs, 13 oz., and nearly 24 inches; in other words, she's growing just as she ought to be, and the doctor was impressed by her muscle control and her vocalizing - while the doctor asked me questions, Annika carried on her own monologue of coos. I think she intended to distract my attention and re-focus it on her. It worked well, I have to admit.

But then, after all the happy fun stuff, she had her first round of vaccination shots. Four of them, in the thighs. Baby skin is tender, so maybe I shouldn't have been shocked and horrified when she bled. But I was. As soon as the nurse was done, I picked her up and held her, but that didn't do much to quiet the screaming. So I put her to my breast, and like magic, she stopped crying and nursed instead, and soon had apparently forgot her trauma. I, on the other hand, walked around for the rest of the day with a bloodstain on my shirt and an ache in my throat whenever I thought about it.

But I confirmed, then, that all the struggles I've had with breastfeeding, the pain and the tears and pumping and the exhaustion and questioning my own sanity and pumping and guilt and frustration and lost sleep and did I mention pumping? Yes, all of that (I'll write in more detail in another post) and finally I'm certain it was worth it. Because even though the breast isn't her only or even main source of food, it's the one thing that is guaranteed to comfort her. It's hard to even express how much that is worth.

Thrifting

Saturday and Sunday, I went on a dual mission of thrift-shop visitation. Both parts of the mission were driven by new-parenthood.

Part the first: to buy clothes that fit my current size and shape instead of bitching and moaning about how few of my pre-pregnancy clothes fit. I'm not going to go on any weight-loss diets while I'm breastfeeding, so unless I find the time and motivation to start working out, those pregnancy pounds will stay put for a while. Although I'd eventually like them to go away, I can accept the changes much more gracefully now that I have clothes that fit. At Impact! Thrift in East Norriton, I found several sleeveless tops, two skirts, and a pair of pants to expand my summer work wardrobe, and at the Philadelphia Aids Thrift just south of South Street, I found four pairs of pants, three tops, and another skirt. All this, for about $60.

Part the second was to browse the childrens' books section and find nifty books for young 'uns, but especially old books, the ones that I remember from my own childhood. I succeeded at both Impact! and P. A. T.; I found "The Little Engine That Could", "Robinson Crusoe", "A Fisherman's Tale" by Beatrix Potter, and some that aren't so old, or at least I don't remember them: an amazing pop-up book called "One Red Dot", an illustrated "King Arthur", and... Heather will be so pleased... my child's first book featuring a bat (Stellaluna).

I've started reading to Annika, and although she doesn't show much interest at this point, if nothing else it's good practice for me!

Monday, June 2, 2008

Two Months

Yesterday, Annika turned 2 months old. And today, I'm back at work... wondering whether it's too soon, or just soon enough. My mother in her wisdom warned me that the longer you wait to go back to work, the more difficult it can be, because babies get so much cuter and more interesting than they were at 4 weeks or 6 weeks. She's learned the art of the social smile and is starting to carry on whole conversations made of "oooh" and "aah!" and sometimes a high-pitched "eee!"

It feels odd to be typing with two hands, instead of holding Annika with one arm and typing with the other.

I've been planning to do a series of posts about the transition into motherhood: the labor and birth, the first two weeks, the next two weeks, the second month. So far, I have part of the birth story written, but it's not nearly finished yet (it's a long story). I finally decided that I should write something, anything, on the blog instead of waiting and trying to do posts in chronological order.

My brother Alex and his girlfriend Anne were in Delaware last week, and they were both delighted with Annika. Whereas my youngest brother was afraid to hold the baby lest he break her, Alex couldn't wait to gather her into his arms and coo at her. It was definitely "love at first sight" on Alex's part, and although it's hard to tell with a baby that young, it seemed that she liked him too.

Over the weekend, she had her first party at the grandparent Khavins' house. She was a big hit with everyone, but especially her great-grandparents. A cousin suggested that to keep everyone updated with the latest news and pictures, we should start an Annika blog. Before I actually had a baby, I would've thought that idea was silly, but now it seems to make sense - I've had a lot of requests for pictures, and a baby blog seems like the best way to disseminate them.

Thursday, March 13, 2008

Perspective

For a while now, I've been certain, but without evidence other than intuition, that this baby will arrive early. I've been told several times by the nurse-midwives at the birth center that first babies have a tendency to be overdue, so I shouldn't be surprised if nothing has happened by my due date.

On Monday at my appointment, I got the first hint of evidence that I might possibly be right: the cervix is still closed, but has gotten softer and thinner (a process called effacement), and the baby is positioned fairly low in my pelvis, with her head down. Neither of these things necessarily mean that labor will start soon, but they're some of the preliminaries. I asked when I would be considered far enough along to deliver at the Birth Center, and the answer is "it depends." If there are no complicating factors whatsoever, they'll allow it at 36 weeks - a milestone that I just passed yesterday. If the mother is positive for Group B Strep and will therefore need antibiotics during labor, they require 37 weeks or better. I haven't gotten my culture results yet to know whether GBS will be an issue or not, but I'll soon find out.

I was excited both by the news that pre-labor changes are starting to happen, and that if labor did start early, I might be able to deliver at the Birth Center earlier than I thought. On Tuesday morning, it seemed that labor might actually be imminent - the baby had shifted even lower, and I was getting cramps that felt a lot like menstrual cramps. Braxton-Hicks contractions, probably; there was no distinct pattern to them. The intensity would vary, but I couldn't distinguish the beginning or ending of individual contractions. By the afternoon, the cramps had faded, and by the next morning, the baby had shifted position slightly so that she didn't seem to be pressing downward as much.

Although I knew that I should be feeling relieved, I was mostly just disappointed. It's difficult to be patient at this point, even though it's irrational to want to hurry things up - physically, it's almost certainly easier to be pregnant than to be recovering from childbirth and dealing with a newborn. But that didn't stop me from being cranky and wondering how I can possibly make it through another month - possibly even six weeks - of the various discomforts, plus the waiting and wondering if every cramp or backache just might be the start of the real thing.

Sitting at my computer and looking, I guess, for commiseration, I did a google search for "tired of being pregnant." As it happened, one of the first things I came across was the opposite of what I was looking for. It was a blog post written by a labor & delivery nurse, about how she is tired of pregnant women whining at 34 or 36 or 38 weeks that they're tired of pregnancy, ready to get the baby out, and want to be induced or c-sectioned. She raged against women who don't seem to realize or care that an early baby is more likely to have trouble breathing, trouble nursing, trouble fighting off infections, and convince their doctor to give them an early delivery. She held that women who carry their babies full term should be thankful for it, and think of all the women whose babies were premature and didn't make it, or had serious problems because of it. The post ended with "Go ahead readers...flame away at me over my opinions on this subject []", but the long, long string of comments that followed was almost entirely from moms who agreed, because they'd had a premature baby themselves, or been induced early because of pre-eclampsia or other complications. Many of them said something like "I would have given anything to be pregnant for longer, and it drives me crazy when women who stay pregnant for the full term complain about it!"

It made me feel guilty about wishing that mine would be early, even though I would never have an induction or elective c-section to bring it about. I don't feel too guilty about it, though, because every woman who's getting close to term gets impatient. But that dose of perspective did make me realize that I shouldn't feel too sorry for myself - I'll take all the pains and annoyances of late pregnancy over coping with a baby that's not ready for the outside world yet.

Thursday, February 21, 2008

Brains and guts

One thing that came up during my first Birth Center prenatal appointment, while going over my general medical history, was that I have a few episodes of depression and/or anxiety in my past. No huge drama, no hospitalization, not even any medication for it, but still it's there. The nurse-midwife cautioned me that women who have such a history are more likely to suffer from post-partum depression than women who haven't had past problems. That doesn't mean I will have PPD, but that I should be alert to the possibility. She said that many women have trouble recognizing the signs because there's so much else going on at the same time - sleep deprivation, the physical recovery from birth, sore breasts from starting to breastfeed, body image issues, the sense of huge new responsibility, and the list goes on. With all that, it's hard to say what's "normal."


I wondered whether that might happen to me - would I be able to tell if I was having problems more than just the usual adjustment period to being a new parent? Thinking about it made me realize that at least for me, mental health is nowhere near as self-evident as physical health. I know at any given time whether I'm in a good or a bad mood, but if it's a bad mood I can't say whether it will go away in an hour, or a day, or whether it might drag on for much longer. I can tell after a specific stressful event that it caused a stress reaction, but if it's the more ongoing, long-term kind of stress, I can't easily say whether it's getting to be too much, or if I'm coping well. I can't tell by "asking myself" whether I'm just having a bad day or a bad week, or if it's something that I need to take steps to fix.


Then I realized that I do have an excellent built-in barometer of my overall mental health: my stomach. I may feel stressed or moody, but if I'm eating normally, that's a good indicator that it's nothing too serious, and will resolve itself soon. When I lose my appetite or feel sick to my stomach and there's no obvious physical cause, it's a probable sign that there's something that I'm having trouble dealing with. In particular, during a few times in my life that were especially stressful, I thought that I had some mysterious stomach ailment; eventually I figured out that I was having panic attacks, but without the stereotypical hyperventilating and heart-pounding.


So for me, as for many people, a "gut reaction" is a not just a metaphor. It's an interesting example of the inseparability of mind and body. I wonder whether this tendency to physically express mental turmoil evolved for some reason - can there be any possible advantage to having physical symptoms of unhappiness? Or is it just a side effect of the fact that the physical brain is part of the body, and that having thoughts and emotions is a chemical process, and is not independent of the rest of the body's workings? It just seems funny that for all its power, the brain isn't very good at identifying and troubleshooting its own problems.

Thursday, February 7, 2008

Unintended consequences (long post)

Two weeks ago, Vlad and I went to a "tour for expectant parents" at Abington Hospital. I suppose such tours are intended to familiarize couples with the layout of the hospital, and reassure them that the hospital is a wonderful place to deliver a baby. I went to the tour assuming that's exactly what I would get out of it.

I was wrong.

Let me go into some background first, then I'll explain.

When I first found out I was pregnant, my general practitioner recommended Abington Hospital, which is one of the largest hospitals in the area. I hadn't been thrilled with my prenatal experience at the UPenn Hospital during my first (brief) pregnancy, so I thought okay, I'll try Abington. The first or second ultrasound showed that I had a low-lying placenta, which can cause problems in delivery. Before I found out about that, I was mulling over the idea of delivering at a birth center instead of a hospital. But with the low-lying placenta issue, I put those ideas on hold and remained at Abington through the first and second trimesters, because a birth center will typically only accept low-risk pregnancies with no complications.

About 6 weeks ago, when I last had an ultrasound, the placenta had moved up and was no longer a concern, and everything else looked fine. I was delighted, and although I didn't get around to it right away, I soon called the Birth Center at Bryn Mawr (a suburb of Philly) hoping to transfer there. They took a week to get back to me, and then it was only to tell me that they were booked for April, and weren't accepting any more patients due then. I sighed and figured that I'd just resign myself to having the baby at the hospital, like a normal person - and anyway, hospitals offer epidurals and most birth centers don't. Who wants to face a painful experience without at least having the option of some heavy-duty pain relief at hand? I wasn't sure I did, even if "birth center" does evoke a much more warm and fuzzy image than "hospital."

So, back to the tour. We arrived early, and I was impressed by the big atrium in the lobby, complete with a fountain - it looked almost more like a large hotel than a hospital. The conference room in which all the new parents gathered was also very sparkly-modern. So far, so good. I was pleased, and looking forward to the tour. But then our tour guide, a perky blonde RN, started to talk. With nearly everything she said, I could feel my stress level ticking higher. EFM, IV's, pitocin, alarms, c-sections, NICU, bathroom privileges (privileges?!). The supposedly "home-like decor" of the labor and delivery room consisted of a few pastel watercolor pictures on the wall, one of which turned out to be a clever hiding place for an array of medical instruments. At one point she mentioned a birth plan, asked how many couples there had one. About a fifth of the audience raised their hands. Vlad whispered to me, "What's a birth plan?" I indicated that I'd explain it later. On our way out, I told him through clenched teeth that a birth plan is a document intended to make a woman feel as if she has some control over what happens once she walks through the hospital doors. Everything I had heard made me feel certain that whoever would be in control, it wouldn't be me. And I didn't like it. At. All.

My own reaction took me by surprise. I've never considered myself anti-hospital, anti-Western medicine, anti-authority, anti-technology, or anything along those lines. When it comes to alternative therapies, I'm interested but skeptical - it drives me crazy to hear people talk about herbal remedies as if they're inherently safe because they're natural. If natural equals safe, go snack on some Atropa belladonna. Likewise, I distrust anyone who says that because birth is natural, it is safe.

So why then did the hospital tour leave me foaming at the mouth and ready to bite anyone in a white coat who'd come near me? I'm not sure, but I think it has to do with having some pre-existing exposure to the idea that the way hospitals approach childbirth is not necessarily ideal for the mother or the baby. Without specifically looking for such information, I had come across various arguments that the fewer interventions, the better, unless a specific situation required otherwise.

I learned when we did the hospital tour that my opinions and feelings are a lot stronger than I thought. I knew I wanted a minimum of medical intervention, but I didn't fully realize that if I went to the hospital, I would immediately have an IV stuck in my arm, and an electronic fetal monitoring device strapped to my belly - that these weren't merely available options, but pretty much mandatory. I hadn't thought about the fact that if I am sick or injured, I'm fine with handing over control to the medical establishment, but birth is not an illness, and shouldn't automatically be treated as such. At the same time, I'm aware that the birth process doesn't always go smoothly or safely, so I don't want to be too far away from all that fancy medical technology should it be needed.

So I started looking into other options in our area, and found the Wilmington Birth Center. They will provide the happy medium that I'm looking for - the freedom to move around as much or as little as I want, to eat and drink if I feel like it, to give birth in whatever position feels the most comfortable. The freedom to wear my own clothes and not a hospital gown, to go to the bathroom when I damn well feel like it, to have a calm environment free of the hospital's hurry and noise. And importantly, the support of a certified nurse midwife who can reassure me that everything is going well, and knows what to do if it isn't. They have arrangements with St. Francis Hospital (just a block away) and Christiana Hospital so that if necessary, they can quickly transfer a patient.

One of my worries was that perhaps birth centers aren't as safe as hospitals - they are, after all, less equipped to handle emergencies on the spot. I thought about various scenarios, mulled it over. Then I realized I don't have to rely on intuition and guessing - I have access to all sorts of primary medical literature, so I looked up some numbers.

A 1989 study of birth center outcomes for 11,814 women, published in the New England Journal of Medicine, found that there were no maternal deaths, and a neonatal mortality rate of 1.3 per 1000 - which is less than the overall rate of around 4.5/1000 as of 2003. Cesareans were 4.4%, compared with a recent national statistic of almost 25%. Another study in Australia with data from 1999-2002 had very similar perinatal mortality numbers, and a few smaller studies also found that birth centers are quite safe.

Just to confirm what I was already fairly sure of - that I'd be happier and just as safe at a birth center - I asked some questions of my ob/gyn at Abington at my appointment last Thursday. Found out that yes, I would be hooked up to an IV as soon as I was admitted, and not allowed to eat. Next, I asked about electronic fetal monitoring - that too would be required as soon as I was admitted, and I was surprised by what the ob/gyn said next. "Bad things happen to unmonitored babies, we've seen bad things happen. Not long ago we had a woman who didn't want monitoring, so we basically sent her to a birth center instead because we're not comfortable with that." Wow. Scary-sounding, yes?

As far as my research has been able to uncover, her statement does not hold up. Electronic fetal monitoring hasn't been shown to improve outcomes for the baby, especially in low-risk births, but it does increase the likelihood of a c-section. I couldn't find a single study that showed any real advantage to it. Even the American College of Obstetricians and Gynecologists, a rather conservative organization, states that intermittent monitoring by handheld Doppler or electronic fetal monitoring can be used, and they do not recommend one over the other. So was the obstetrician lying to me? Or was she misinformed? Either way, it further reinforced my feeling that Abington wasn't right for me.

I had my first visit to the Wilmington Birth Center yesterday, and what a difference! In the waiting room, there's a large bookshelf full of books about pregnancy, birth, childcare, and women's health - you can borrow books by signing them out. Any place that has its own lending library has already made a big leap towards earning my respect, bookworm that I am. The nurse-midwife who examined me took plenty of time to explain how the birth center does things, and to ask and answer questions, whereas at Abington I always felt like the doctor had one foot out the door already when they asked if I had any questions. And she sent me home with a hefty binder full of information about pregnancy, labor and birth, and postpartum care of mom and baby. Now, much of this information I had already found on my own - but definitely not from my doctors!

Several people, upon hearing that I plan to give birth without an epidural, have expressed sentiments that I'm either really brave, or crazy, or some combination. Crazy I may be, but brave has nothing to do with it. It's simply that I'm more afraid of the hospital than of birth pains.

If you've read this far, you probably have at least a little bit of interest in the subject of childbirth. If that's because you (or someone you're close to) might have a baby at some point in the near future, don't be like me and wait until trimester 3 to think seriously about this stuff! Early on, maybe even before conceiving, find out the options available to you, and decide for yourself rather than letting the path of least resistance decide for you.

Friday, January 25, 2008

Finances - A wealth of books

Some people, on discovering a need to learn about a subject that's currently a mystery to them, will ask people they know. Some will take a class. Some will rely on the internet. Some will read a book. And some will read ALL the books.

I'm one of those who will tend to read all the books, or at least as many as I have access to, and time for. Fortunately for my budget, I've learned not to buy such books unless I'm certain that they'll be useful beyond the first reading. Mostly, I borrow from the library, and spend an occasional evening at a bookstore perusing their books.

As I mentioned in my previous post, money is one of the three major things I'm thinking about these days (the other two being my MA thesis, and the baby I'm carrying), and my interest in the topic has resulted in a reading binge; I've borrowed quite a number of books from the library and from my dad's bookshelf.

Here are some of the books I've read thus far, with nano-reviews of each.

Rich Dad, Poor Dad This is one that if I had bought, I'd be embarrassed to admit it - there's a lot of salesmanship and pseudophilosophizing here. But it's less boring than a lot of books out there, and makes some interesting points. The main point is that many of the attitudes that people hold about money (including the reluctance to even think about it) prevent them from becoming wealthy. Useful for: thinking "outside the box", getting started thinking about money in general.

The Average Family's Guide to Financial Freedom One that's written by a "normal" couple, not some financial planner or hotshot investor. Lots of practical advice on frugality, debt reduction, and conservative investing. Useful for: getting started, living below your means.

Leg the Spread A riveting adventure story about the high-risk world of futures trading, focused on the few women who participate. Not a how-to, although you pick up some of the terminology along the way. Useful for: entertainment, and an inside look at part of "the Market" and the people that make a living by trading.

How the Stock Market Works A guide to the mechanics and behind-the-scenes happenings that make up what we think of as "the Market." Goes into a fair amount of detail about what actually happens when you place a trade order, or when a company makes a public offering of stock. On my first read, a lot of it was too detailed for me and/or went over my head, but I will likely read it again. Useful for: It's like a book explaining what happens inside your car when you're driving, and how road systems are developed and maintained, as opposed to giving you advice on how to drive.

Two for the Money Co-written by twin brothers, both professional financial advisors but who differ sometimes in their approaches and opinions. Aimed at "baby boomers" but has a good all-around overview of dealing with personal finances, from the basics of getting organized to the complexities of choosing investment vehicles for retirement, college savings, and so on. Useful for: covering the breadth of personal money management without getting too bogged down in the complicated stuff.

The Undercover Economist If you read Freakonomics and liked it, this book is in a similar vein, but not quite as sexy. Has some interesting stuff about a wide range of topics, from how grocery stores price their goods to global trade economics and the environment. Useful for: thinking about "everyday economics" and pondering the economic aspects of politics and environmental issues.

Die Broke I couldn't resist the title, especially since right next to it on the library shelf was another book called "Don't Die Broke." Unlike many personal finance books that try to use fear to put you on the path of the money-righteous, this one aims to reduce fear. The main points are 1) Don't make yourself panicky by setting some arbitrary date for retirement, many people are actually happier and healthier if they keep working. Just go at your own pace, building up assets that will support you once you're no longer able to work or no longer want to. 2) The ideal of passing on an inheritance is outdated; it's much more efficient (because of estate taxes) and much more enjoyable to pass on your wealth while you're living. Useful for: some contrarian ideas on retirement planning.

This is Not Your Father's Stockpicking Book Actually, I did borrow it from Dad. But anyway, it uses lots of examples to show how cues from everyday life, that most people don't think have anything to do with stocks, can be used for investing ideas. The weather, politics, television shows, fads, and advertisements are the main signal sources discussed. Useful for: learning about some of the things that affect stock prices.

The Warren Buffett Way It's impossible to take even a passing interest in investing without hearing about Warren Buffett. This book isn't written by the guru himself, but is about him - it is a sort of biography focusing on his business and investment decisions. Useful for: An insight into the life and strategies of the most successful investor in recent history.

And here are some other books that I'm currently reading, or plan to read in the near future, and why:

Unconventional Success: A Fundamental Approach to Personal Investment - Why most mutual funds are not a good place for your money. Right now nearly all my investments are in mutual funds, so I'm curious what this guy has to say about them that's so bad.

Rule #1 - A system for picking individual stocks, mostly based on the fundamentals of the companies. A mass-marketed, sometimes tacky, but understandable approach to applying a Warren Buffett-like investment strategy.

The Bogleheads' Guide to Investing - I've heard it's a good "getting started" book.

Your Money and Your Brain - What is going on, neurobiology-wise, when you make investment decisions. Why people tend to make dumb moves when investing, even when they know better.

The Alchemy of Finance - A lofty-minded tome by famous successful investor George Soros.

Wednesday, January 23, 2008

Goals, 2008

I've never been one for resolutions. Not at the new year, or really any other time. The cynic in me says that if the resolution-maker (whether it's me or someone else) really has both the desire and the ability to change, they would already have done it, and not waited until January 1.

But the idea is firmly entrenched in our culture that the transition from one calendar year to the next is an ideal time to take stock of where you've been, and where you're going. 2006 and 2007 were eventful years for me, with a lot of changes that I would not have foreseen. At the beginning of 2006, I was a graduate student in Kansas, working towards a PhD in ecology, living in an apartment, with no near-term plans of buying a house or starting a family. The end of 2007 found me in Pennsylvania, employed at UPenn in a cell biology research lab, while simultaneously making gradual progress on a Master's, discovering the joys and pains of homeownership, and expecting a baby girl in April.

So, they're not exactly resolutions along the classic lines of "lose weight, quit smoking, spend more time with family." But I do hope to achieve certain goals for 2008:

- complete my Master's degree at KU
- increase my salary
- add $8000 to our savings/investments
- write to one friend or family member each month

These are the primary goals, and I figure that with a new baby that will take up much of my time and energy, that is plenty. There are numerous lesser goals or related aims that I could also list (get more organized, get parts of the thesis published, get various things fixed or improved around the house, and so forth), but I'm sticking with goals that are quantifiable, so that at the end of the year I can easily say whether or not they were achieved.

Many people that know me might be surprised to see that two of my goals are financial in nature. In the past, I was never especially interested in money. As long as there was enough to meet our immediate needs, and preferably to put some into a savings account as well, I didn't care how much we earned, or how much we spent. But owning a house and preparing for parenthood have changed my perspective. As the one who does most of the banking and bill-paying, I had become vaguely aware that since we bought the house (almost exactly a year ago), our bank account wasn't shrinking, but it also wasn't growing. It occurred to me that this was a worrisome state of affairs if our expenses were slated to increase and/or our income would decrease. I decided that a more proactive approach was needed, and that I should learn something about managing money other than "don't spend more than you have." So, I used Quicken to help me collect data on our spending, and I started borrowing books about personal finance from the local library. Together we started talking about planning for the future (farther ahead than next month's bills), about budgets and saving and strategies for investing. So far, we're only two months into our efforts to be more financially responsible, but I think we've made a lot of progress. We've set up a budget that should be workable when the baby arrives, and that includes saving up some money. We're still pondering what to do with our savings once it has been set aside; I still feel like I have a lot to learn about investing. Overall, the plan is to keep some in savings, and to invest some. The allocation to each, and the types of investments we make, have yet to be decided.