Week 37

Things are escalating quickly. I am waking up 3 times a night to pee (ugh – for about a week now) and Fetus’s movements continue to feel like she’s rearranging my organs, or worse, kicking my spine from time to time. I beg to differ with whoever claims babies move less at this point because they have less space! She has plenty of space and is having a great time in there. It’s like the alien movies where someone’s body has been invaded by an alien and it starts trying to break out of their abdomen and you can see it wriggling and moving and poking underneath the skin.

I’m done with all the reading I intended to do (including Battle Hymn of the Tiger Mother, heh) and we also finished infant care and breastfeeding classes.  We took a CPR class over the weekend, which is the last thing on the schedule. I sort of feel like I’m cramming for finals here. A lot of the information is not at all intuitive and it’s a marvel what kind of education and learning is required when it seems most other animals can figure all this stuff out by instinct.

Still continuing to exercise:

Monday:  I walked the hill by our old house twice, but had to pee like crazy the entire time. This is not a long exercise, and I went to the bathroom right before we left the house!

Wednesday: Walked the stairs at the beach 5x, did 3 sets of 24 lunges, and a couple of wall sits. My knees are irritated at me so I might cool it on the squats for a little bit.

Thursday: Prenatal Yoga

Saturday: Yoga at home

Sunday: Walked the hill and did three sets of squat jumps.

Thoughts on Ignorance as a Cause of Post-Partum Depression

I am not a psychiatrist, a medical specialist, or even a scientist, but I have a sneaking suspicion that post-partum depression, while obviously a complex condition, is rooted at least in part in one phenomenon: distorted expectations from lack of sufficient and accurate information.

Likely owing to society’s desire to increase the population of humans, and general squeamishness and avoidance of gross subjects, most women are exposed to only a very topical and rosy view of pregnancy, birth, and motherhood throughout their lives leading up to the decision to reproduce. Everyone’s heard of “pregnancy glow.” On the other hand, things like pregnancy constipation, pregnancy constant flatulence, pregnancy insomnia, pregnancy leaking of urine, and pregnancy leaking of amniotic fluid are less frequently mentioned, if at all. After labor, everyone knows about the “bundle of joy,” but probably not the bundle of shit on the delivery table.

Unless a woman happens to keep company with a horde of brutally honest women who don’t mind sharing things like a desire to literally die during childbirth because of the horrible pain (thanks mom!); how badly their vaginas tore, got infected, then tore again; among other horrifying stories not fit for dinner conversation, a woman may find herself pregnant and learning these very real possibilities for the first time. Society wants you to think of the glow, not the farting, leaking, pain, tearing, and shitting, because if women carefully considered all these downsides, some undoubtedly would have second thoughts. It is true the more women know and contemplate the implications of these realities, the more careful they are going to be about their decision to reproduce, but this should not be a bad thing.

Again, I’m not a medical professional, but I speculate jumping into pregnancy imagining the glow and the rewards of motherhood, then being subsequently ambushed by a slew of physical ailments, followed by serious physical compromise or injury during labor, topped off with the reality of becoming responsible for a squirming, screaming, crying, shitting bundle of mess all while suffering sleep deprivation and possible problems with breastfeeding, is an easy recipe for depression.

This is exactly why all women should seek out all the relevant information, both positive and negative before deciding to have children. Having worked in the field of healthcare law for many years, I know the detailed and precise description of risks and complications, both common and rare, discussed with women before they have so much as an appendix removal, brow lift, or boob job. For almost all surgeries, no matter how minor, physicians will review risks, benefits, and alternatives, providing an overview of common complications, expected outcomes, and even some remote risks, such as death. They are required to do this for every procedure, even life-saving surgeries most people in their right mind would never refuse. The basic rationale behind this practice is that people should know what they are getting into, and that includes not only common and expected risks and outcomes, but at least an idea of remote and unlikely complications as well.

Yet, as it relates to reproduction, a completely elective choice in this day and age, women hear merely about “pregnancy glow,” “bundle of joy,” and perhaps vague references to fatigue and morning sickness before committing to something of significant medical, physical, and emotional impact not only for the next 9 months, but indeed, possibly for the next 18 years. With this in mind, it’s actually amazing more women do not suffer post-partum depression.

Of course, while society has a tendency to give women inaccurate impressions, women need to take responsibility for their own decisions. I doubt many women look into the full panoply of risks, complications, and outcomes associated with pregnancy, labor, and the post-partum period in great detail before deciding to become pregnant; I know I didn’t, and I am actually someone who really took my sweet time deciding to have children at all. I had cataloged in the back of my mind a collection of horror stories from honest women over the years, and went into this with an understanding of a lot of worst case scenarios, because that’s my personality. I figured if I could accept the possibility of these worst case scenarios, then I would not have any regrets, but as far as being actually informed, this is totally not sufficient, and I met with plenty of surprises upon finding myself pregnant.

As with most things in life, preparation is key, and I surmise the more women know, the more they can do to prepare emotionally and physically, and the less shock and disappointment they will experience, which in turn would reduce the likelihood of post-partum depression.

Preggo Book Review

Expecting Better by Emily  Oster

This was the first pregnancy-related book I read. My husband picked it, and I loved it (not pictured above because he bought it for us in Kindle form). Emily Oster, an economics professor at the University of Chicago, describes her motivation in writing this book:

“When I got pregnant, I pretty quickly learned that there is a lot of information out there about pregnancy, and a lot of recommendations. But neither the information nor the recommendations were all good. The information was of varying quality, and the recommendations were often contradictory and occasionally infuriating. In the end, in an effort to get to the good information… I tackled the problem as I would any other, with economics…”

Faced with numerous studies on what to/not to do, drink, and eat during pregnancy, some of which seemed questionable or unduly restrictive, she decided to pore through the medical literature herself and undertake statistical analyses on a variety of studies. Her analyses included reviewing study reliability, sample size of subjects, and actual risks pertaining to everything from gardening, litter box cleaning, eating sushi, eating deli meats, drinking alcohol, sleeping positions, and weight gain, to c-sections, epidurals, continuous fetal monitoring, and beyond. Her goal was to paint a better picture of actual risks, advantages, and disadvantages, so women can make informed decisions, rather than subject themselves to discomfort and displeasure for 9 months based on faulty science and/or over-restrictive recommendations based on fear-mongering.

She wrote the book to provide women a better source of information to be able to reach informed decisions as an individual, and likened this approach to her teaching philosophy:

“…making good decisions – in business, and in life – requires two things. First, they need all the information about the decision – they need the right data. Second they need to think about the right way to weigh the pluses and minuses of the decision… The key is that even with the same data, this second part – this weighing of the pluses and minuses – may result in different decisions for different people.”

Oster’s book was immensely helpful to me, as I loathe the idea that a woman is a vessel for reproduction whose duty is to abandon her personal preferences and joys for over nine months with unquestioning obedience. If you are one of those so inclined to lecture others, as an example, in the following styles,

  • “It’s only 9 months of your life.”
  • “The health of a human being is at stake; don’t be so selfish.”
  • “It’s better safe than sorry.”
  • “Is it so much to ask?”

This book is not for you. Enjoy your 9 months of misery devoid of the smallest pleasures of life, in blind adherence to every single one of the absurd rules that blatantly treat pregnant women like children, idiots, or worse, objects. If you truly want to be safe rather than sorry, you are free to lock yourself in your house for 9 months, and become a prisoner in your own home and body. The rest of us would like to live in a more reasonable manner.

I read this book and decided I was fine with eating sushi occasionally (excepting fish prone to higher mercury concentrations), along with other foods associated with potential, but unlikely, food poisoning issues. On the other hand, I decided to forgo deli meats (I did slip up once at a party), hummus, and other foods linked to listeriosis, a much more serious condition. Oster’s work has generated some pretty severe criticism in the medical community, as she is not a medical doctor, much less an obstetrician (nor does she claim to be). However, it is also worth noting that most physicians, while experienced and knowledgeable in their field, are not statisticians. The beauty of this book is that it largely avoids telling you what you should or should not do, but provides the information so you can make an informed decision suited to your lifestyle and needs.

From the Hips by Rebecca Odes and Ceridwen Morris

My husband bought this for me. It is a self-described “Comprehensive, Open-Minded, Uncensored, Totally Honest Guide to Pregnancy, birth, and Becoming a Parent,” which is fairly accurate. It was indeed a good overview to the entire parenting process, and I read the bulk of the book while 3 months pregnant, then stopped when it came to issues of selecting an appropriate daycare, as I felt these issues were becoming too remote at my particular point in pregnancy.

This book covers everything from body changes to doctor’s visits, birth and delivery, etc. It is rife with personal anecdotes from numerous women, along with the practical pointers, such as what to pack for the hospital. This book was obviously less scientific and data-driven than Oster’s book, but it was a nice follow-up to my first read.

The Girlfriend’s Guide to Pregnancy by Vickie Iovine

This book honestly did not provide a wealth of memorable practical advice in terms of how to go about your decision-making in terms of pregnancy, labor, delivery, and parenting, but it was nevertheless useful in that it was hilarious and fun to read. The title says it all: this is a book that provides the gross, gory, and awkward details of pregnancy that only your friends would be willing to discuss in detail with you, including hemorrhoids and what Iovine describes as “pregnancy insanity:”

Keep this Girlfriend rule of thumb in mind as you read this chapter: CRAZY PEOPLE ARE OFTEN THE LAST TO KNOW THEY ARE CRAZY. Therefore, if you are tempted to skip to the next chapter because you don’t see how this one applies to you, think again; you may be crazier than you look… In fact, ask around, because you may be surprised to learn that you, too, are a victim of the Body Snatchers.

To illustrate,

You may spend the entire day fantasizing about wild animal sex with your husband…Then when he finally gets home, and he starts to go through the mail instead of studying the ultrasound Polaroids of the baby that you have taped to the refrigerator door, and you start screaming about how this is just one more sign that he is indifferent to you and your baby. By the time you have calmed down and might be able to think about sex again, you have fallen asleep in the bathtub.

It’s genuinely funny and entertaining and brings a much-needed levity to the whole pregnancy business. Yes, she emphasizes her love for pain killers and medical intervention a little too much, and I entirely disagree with her recommendations on exercise, but she is neither a doctor nor a statistician, and the point of the book is not to help you make medical decisions, but to emotionally cope with pregnancy and the accompanying changes in your body and life.

Ina May’s Guide to Childbirth by Ina May Gaskin

Gaskin has serious qualifications and experience as a midwife, and her book focuses on presenting the labor and birthing process in a positive, comforting light. She emphasizes birth as a natural process that should occur without fear. Unfortunately, the first 80 pages of the book did not appeal to me at all and after reading the first 20, I skimmed the next 60 before I got to what I considered the more useful information. The first portion of the book is composed entirely of personal birth stories and anecdotes told in exaggerated, one-with-nature, tree-hugging, pseudo-psychedelic terms. For instance, one woman shared her experience thus:

I wanted to connect deeply with her and share my recent experience to help her relax and open. Pamela was naked, propped up on pillows on the bed, holding on to her knees. I took my clothes off… and crawled up on the bed with her. I laid next to her—head to head, breast to breast, womb to womb. I told her about my cave and ocean and the great rushing, swelling, and opening. I told her about surrendering over and over and letting go. We began experiencing her contractions together. We held each other and rushed and soared together. My womb, though empty, was swelling and contracting too. I could feel blood rushing out with the contractions, but not too much—I knew it was okay.

In retrospect, I wish I had seen this Amazon review, which was right on point: “To each her own, I suppose . . . but this is a little much for me. The thought of one of my BFFs coming to be with me during labor, stripping down, and telling me about her oceanic ‘yoni’ while I’m having contractions is, frankly, laughable. Call me unenlightened if you must.” I felt the exact same way while flying through the first 80 pages and wondered if I would gain any value at all from this book. “We held each other and rushed and soared together”? What in the actual fuck? Could I help myself to some of those mushrooms as well?

That being said, the rest of the book was quite informative in terms of anatomy, biological functions during labor and birth, and contained excellent advice for keeping focus, maintaining calm, and getting through the birthing process with minimal medical intervention. She provides a lot of detailed examples and explanations regarding the importance of the mind-body connection during the labor and delivery process that are unrecognized or ignored by the mainstream medical community (e.g. The chapter on “Sphincter Law” – it is as interesting as it sounds. Read the book!)

While the focus of this book is on home-birth and midwife-operated birthing situations, this is an excellent read for women seeking to give birth without medical interventions such as epidurals and c-sections, even if they choose to do so in a hospital. Gaskin has some harsh criticisms of the medical establishment, many of which are valid, but some of which may be a bit over-the-top and warrant further investigation. I also wholly disagree with her support for various state-sponsored interventions as it pertains to medical care and healthcare policy-making. That being said, overall, this book is a good complement to the information you will receive from doctors and nurses if you are hoping to avoid an epidural and c-section.

I am currently reading Mindful Birthing by Nancy Bardacke, based on a friend’s recommendation. I am not too far in, but it contains useful meditation exercises and tools for relaxation and mental regulation during the birth process. This is particularly good for me, as my thoughts can be fast and erratic, and my tendency to play out worst-case-scenarios could use some regulation. So far, so good. More on this one later.