week 36 belly shot

We're getting close now.

First holiday tree

Was put up last weekend. Along with the first decorations. These are meaningful because they were decorations given to my mother, by her aunt, for her first holiday tree as a married woman. Though Mark wasn’t eager about a tree, he kindly put it up. River was thrilled to help with the decorations. He looks at the tree with magic and appreciation in his eyes, and that alone makes it worth it.

I feel like I’m turning into a boring, stereotypical adult, taking on the rituals of holiday cards, a tree, and a soon-to-occur cookie exchange. But the truth is that I like it. I like the soothing glow of the lights, the family history represented in the ornaments, the beauty it adds to the room. I’m glad number two will come back to a place that looks welcoming and that she’ll see photos of her early days that reflect the season when she was born.

I like that River takes pride in his home and his environment. He’ll make comments, entirely unprovoked, such as “Our house is so big and beautiful. There is so much room to play.” (It’s actually not very big, but it’s larger than the place he spent his first 18 months).

Or “I don’t like (insert name of neighboring street).”

“Really?” I ask. “Do you prefer (insert name of our street)?”

“Yes.”

It’s good to have a base, a shelter and a family, where we all feel safe and comfortable and warm. I appreciate that now.

Close call

Last night I thought I could maybe, possibly be in labor. After taking my vitamins before bed, I puked them all up. As a person with a stomach of steel, vomiting is a rare and usually serious thing. Afterwards, when I tried to go to sleep, I felt a lot of movement, and some of it felt like rectal pressure. That wasn’t what I remembered from last time around, but I thought I’d read of some people feeling something similar during labor. I wondered if it could be it.

But no, even though I’ve been wanting this to be over for ages, I realized I didn’t want it to come last night. For one thing, River’s birthday party was today. We had a ton of people planning to come over. The last thing River said before he went to sleep was, “Sera muy, muy, muy, muy, muy, muy, muy, muy, muy, muy divertido!” (It’s going to very (to the tenth or so power) fun!) That would not be fair to deny him his party. I almost became weepy thinking about how it would suck for him. And I was annoyed, even a bit angry at the baby for possibly ruining his one last, special day before her arrival.

I also realized that we are just not ready. Those people I thought I’d maybe ask if they would be willing to watch River when we go to the hospital – I hadn’t gotten around to asking them directly yet. Who in the world would I call in the middle of the night? I didn’t have a bag packed. I hadn’t sent in my hospital admission forms. I didn’t have anything ready for River. I hadn’t prepared my birth plan. I hadn’t rejected the enema yet. I hadn’t even communicated with my doula for a couple of weeks. Help!

Luckily, it was a false alarm and we had the party. Making the fire truck cake extended my abilities to their max and I answered the door for the first guests unshowered and wearing an inside-out t-shirt covered with frosting. But it went well, the cake was tasty and though we were short on space, people had a good time.

Now I’ve received the wake-up call that I need to start getting things in order. This would be the week to do that.

First trip without baby booked

The baby isn’t here yet, but I’ve just booked my first evening away from her. She’ll be approximately two months old and it will be our fourth wedding anniversary.

I received a great Groupon offer, from a hotel an hour from our home, that includes dinner for two and a night’s lodging. Two months is a bit young, but it’s only one night and it’s so close to home.

I didn’t leave River for any extended period until he was three months. Then I left him for 12 hours with a woman in Mexico, while Mark and I took a van far away to go see monarch butterflies. I didn’t mind being away from him for that period, but the conditions didn’t allow me to pump, and it was a killer on my boobs.

This trip is more likely to be 18-24 hours and it will be overnight, but we’ll probably know our sitter much better than we knew the (kind and wonderful ) woman in Mexico, we’ll be in control of the transportation, and we’ll be in easy phone contact.

Mark and I haven’t slept together in what feels like ages. He’s been complaining about the couch lately and asking when he gets to sleep in a real bed. We agreed that whoever is on baby duty at night will get the real bed after the birth, while the other sleeps on the couch with earplugs. So his only prospect for a mattress in the near term comes along with a baby that will probably be wakeful.

I’m excited to have a date on the calendar in which we’ll be able to share an evening together, share a bed, and have some time alone. I don’t even care much about the attractions in the town. I’m thinking dinner, a movie, some wine, a good night’s sleep, breakfast and perhaps a stroll. That sounds like a fantastic, and sufficient, celebration.

It may not be easy – we’ll have to find a sitter, I’ll probably be dealing with breastfeeding issues, it might be hard to leave so early. But I think it’s a good thing for us to do and I’m already looking forward to it.

A taste of what leave might feel like

I took the day off today, in order to prepare for the brunch/birthday party we are hosting this weekend. I was going to do a bit of work, but computer issues prevented that. So I had a taste of what it’s like to spend a weekday on leave. It was great.

I woke up a half hour later than normal. I didn’t shower. I didn’t get dressed until 11. I was able to move at a leisurely pace as I got River up and could agree to his request to read two stories before we did anything else. I baked a cake, went shopping for party supplies and indulged in a pedicure.

I didn’t plan to nap, thinking I had too much to do. But when I was overcome by fatigue at 3:15, I sunk onto the sofa and fell into sleep. There was nothing to stop me. River helped out by taking a four-hour nap, so we both awoke refreshed. I did more cooking, more preparing, picked up things around the house, and had time to play some more and read more books to River.

I’m ending the day tired, but feel accomplished. Besides the pedicure and the nap, I didn’t do much for myself – no reading, no studying, no exercising. But I loved the time available to get things done, I liked having more down time with River, and I really liked being able to sleep when I needed to.

I’m very much looking forward to my leave.

An enema during labor?

At my 36 week appointment, I was told that the medical group has a practice of giving an enema at the hospital. I was told this is in order to:

1. Stimulate labor
2. Prevent pooping
3. Make the baby's movement down easier.

The doctor said that in his experience, he sees less tearing when women have an enema because it allows more space for the baby to move. He said it's a lesson learned from midwives, who use castor oil. I was kind of surprised by this, having no discussion or use of enemas during my last labor.

But I did poop and I did tear. Though I don't like pooping while pushing, I can deal with that and wouldn't get an enema just for that reason. Nor do I see much need to stimulate labor if it has already begun or to endure any extra discomfort. Given the significant tearing I had last time, if an enema would reduce that, then perhaps it would be worth considering. I told him I’d look into it. I asked if I could reject it if I didn't want it and he said yes.

When I started googling, the information seemed dated. Many women wrote of hearing from their mothers that they had enemas, that it was terrible, and their mothers were glad their daughters didn’t have to experience that. It seemed it was often does for the comfort of the medical provider and had been rejected as an outdated practice. So why was my doctor recommending it?

The most compelling arguments were the possibility of reducing infection during delivery, the possibility of making the baby’s trip down easier, thus reducing tearing, and reducing the need to poop after delivery, when the area is fragile. I know I was terrified of pooping in the days after delivery, thinking that a bowel movement would rip out all the stitches and cause the toilet to fill with blood, as happened when I took my first pee.

When I looked for scientific evidence, this is what I found on the Cochrane Collaboration. In 1999 it was determined that research doesn’t show any benefit to getting an enema. But there is the risk of greater discomfort, of watery stools (which could increase infection) and of speeded up labor. This report was updated in 2010. I also found this page, which referred me to Cochrane, helpful.

So far, this is the most reliable information I can find. I discussed it with Mark and he thought there was no need to endure any additional discomfort. He was the one most bothered by seeing me poop last time, yet he thought it was better to poop again then to try to hold in an enema for 1-10 minutes while simultaneously dealing with contractions.

I wrote to my former doula, an expert who has been at well over 100 births, to request her opinion. She also did some searching and couldn’t find anything that would recommend its use. Out of all of her clients, only one used an enema, out of “a certain fastidiousness” as she described it. She said if the baby needs extra room to get out, then I will poop. She suggested having one on hand at home, in case I want to push labor along, and to bring it to the hospital for the same reason. But she didn’t see any other reason to get one, besides the doctor’s convenience.

So perhaps I’ll get one to have on hand at home. But I plan to opt out of getting one at the hospital. Since it seems the medical practice will put an enema on my chart for the hospital to carry out, I’ll have to add my opt-out to my birth plan and make sure the doctor is on board.

Now I’m starting to worry about my medical practice. One doctor of the three, the most senior, gets pretty bad reviews on bedside manner. He is the one I’m afraid of encountering. I’m imagining the policy probably comes from him.

Another non-patient-friendly policy I was just told about is that the practice doesn’t distribute the doctors’ schedules. My last practice did. I knew exactly who was on call on which days and I tried my best to not have to go to the hospital on the day when the doctor I was least comfortable with was on duty. I was also reassured when I did go into labor and I saw it was a doctor I was comfortable with on call.

The doctor explained that some people prefer one doctor over another, and so in order to not make it uncomfortable for the doctors, they don’t distribute the schedules. But whose comfort is paramount in this situation – the laboring woman or the doctor who is being paid for his or her services?

I told him that at a time that is stressful and painful, any additional uncertainly adds more difficulty to the situation. I told him how I find even not knowing the nurse ahead of time stresses me out, and is why we got a doula. We had one great nurse last time, and one horrible one. To also not know who the doctor will be is like walking helpless and in pain into a great abyss, where you don’t know if you will be aided and soothed, or treated roughly.

He did tell me the days he was on duty, and unfortunately, it looks like he’ll be off on the days immediately surrounding my due date. Given his willingness to violate the “policy,” I’m again suspecting that this comes from Mr. poor-bedside-manner, who seems to put the doctor’s comfort over the patient’s.

I asked my doula what to do if I get the doctor I’m afraid of and she said to take the support of the nurse and our student doula. I guess there is nothing more I can do.

Did you know who would be on duty when you went to the hospital? Did your doctor recommend an enema, or did you give one to yourself? Would you recommend doing it or avoiding it?

cute baby girl clothes

These outfits (I don't know why blogger rotates the picture) almost have the effect of a 4-D ultrasound in making me excited to meet the new one. My co-workers threw me a little baby shower, which was very kind of them. I didn’t expect it, since their policy is usually to have showers only for first babies. So it was a nice surprise.

My energy seems to be up and my mood is definitely lifted. I found out I’m already one centimeter dilated. Yay! I’m ten percent of the way toward pushing and without major pain. I know it’s not a big deal – the doctor said it’s normal at this time during second pregnancies. But I’m going to take it as an achievement.

Getting closer to the end gives a boost to my spirits. I’m taking a vacation day to get a pedicure and to shop and prepare for River’s birthday party this weekend. I turned the party into a brunch for our friends (mostly with kids) followed by birthday cake. Which means I broke my own rule of only inviting as many kids as River’s age. We are expecting 16 children and quite a few adults.

I asked people to bring a brunch dish rather than a gift, so I don’t necessarily have to feed 40 or so people. But since it’s been over a year since we threw our last party, I do want it to be nice. Today I bought champagne for mimosas, ingredients for potato basil frittata, baked French toast, and double chocolate layer cake. I’m aiming for this – which is pretty ambitious. I bought all kinds of fun cookies and snacks for pu-pu platters. Tomorrow I’m buying flowers, poinsettas and mylar balloons for all of the kids, which will make our home colorful and festive.

Good food, flowers, champagne, balloon, friends and a little boy excited about his birthday all make me happy. As does approaching the end of the 40 weeks.