Archive for the 'Lactation' Category

Weight

24 May 2012

My mother’s always been rather dramatically up-and-down with her weight and it’s a great concern of hers. From where I sit now I think that as a kid and during my adolescence I had a perfectly healthy weight and body shape. And then, as now, in fact, my body image has always been decent. Even at my highest weight I have always been able to look in the mirror and think I look somewhere between okay and fantastic (the same is not always true of photographs), and I’ve never been one to talk negatively about my body to myself or others. While to some degree what my weight is doing is a reflection of my self-regard, it’s not at all the main source of it.

There were a few months when I was 13 when I dieted severely in reaction to social pressure (a jerky boy and the naturally slender girls at my lunch table) but for the most part any worrying about my weight when I was growing up came courtesy of my mother, despite my reasonable-for-me then-size-8 shape. I remember lots of forced time on the stair climber and a preponderance of dinners consisting of tofu and cabbage. I’m not naturally and never will be a slim person, that’s true, but I certainly wasn’t overweight, so when my mother’s doctor at my pre-college health exam told me my BMI was too high, I recall feeling like it there was no point in trying to control the quality and quantity of my food if I was going to be “fat” regardless.

That’s why it’s no surprise that, once off at college and in charge of my own diet and exercise habits, they became extravagantly unhealthy. My first year of college I gained weight from grilled cheese sandwiches. My second year of college I gained weight from macaroni and cheese. My third year of college I gained weight from pizza. My fourth year of college I gained weight from cheese enchiladas. (I guess I really like cheese.) By the time I graduated I had gained something like forty-five pounds!

I married and got a miserable job that required me to drive around a lot, leading to my eating a lot of fast food. When I got a desk job, I spent a bunch of time hunched over at the computer, snacking. Then I went through infertility and became depressed and gained even more, and my particular version of infertility was worsened by extra weight. The medication for my fertility-reducing insulin problem (which I’d had symptoms of even back in high school, before I was overweight, just for the record) and the reproductive endocrinologist’s insistence I exercise helped me slim down a bit, and as a result of these various factors and the mysteries of reproduction, I eventually became pregnant.

Morning sickness the first third of the pregnancy helped me shed around twenty pounds; I eventually gained forty back, but by the time I finished lactating I was dozens and dozens of pounds slimmer than when I’d gotten pregnant. It was the first time in my life I’d lost significant amounts of weight and I put no effort into it at all. After I stopped breastfeeding the weight loss slowed, but healthier eating habits (gained from caring about what I fed Little Girl) and a more active lifestyle (especially when we lived by the beach and I was swimming and jogging every day) helped me get to what I think was a perfectly reasonable adult weight for me. It was still twenty pounds over what I weighed in high school, but I think it was a good, healthy size for Adult Me.

But then we moved to Sweden. Chocolate balls, cinnamon buns, ice cream trucks, strong Swedish coffee which I had to put tons of sugar in to tolerate, a long, snowy winter, boredom, loneliness, immigrant stress—they all took their toll and I gained weight. I became pregnant and had no morning sickness and gestated a boy who made me very hungry, and, by the end of that pregnancy, put on forty pounds. I didn’t breastfeed long enough to shed much of the baby weight.

This left me unable to fit into lots of my clothes and feeling rather lumpy. But not exactly unfit. Even at 41 weeks pregnant I was hiking in the forest and climbing flights and flights of stairs without getting winded. It was just extra fat from extra calories from too much sugar that I’ve been carrying around; I kept up my pregnancy eating habits long after the pregnancy was done. After a few months of just sort of hoping I would magically lose weight, I discovered that my summer shorts wouldn’t close.

Since I’m way too cheap to buy new shorts, that was the motivation I needed, evidently. Over the last six weeks or so I’ve cut out most sugar and snacks and eaten smaller portions of healthier food and, hardest of all, gone hungry a fair amount (I’m hungry right now). It’s been really very challenging and extremely slow going and I have had days where I’ve gotten frustrated and eaten chips and salsa for breakfast, but I can finally button those damn shorts. In a few more pounds I’ll even be able to wear them in public. That’s all I ask. I hope I never gain a bunch of weight again and have to try to lose it, because now I finally know what everybody is talking about when they say losing weight is so hard.

Mammagrupp

29 November 2011

Sweden puts its money where its mouth is when it comes to children’s well-being. They think kids should stay home with their parents when they are small? They provide years parental leave. They want to encourage breastfeeding? You get three months of all-you-can-ask-for lactation consulting. They want to encourage bonding and make sure new mothers aren’t isolated? They offer free baby massage and infant care classes to mothers of babies of the same age who live in the same area.

Last week we started baby massage. I had three rules for myself:

1) Do not speak English! Even if somebody tries to speak English to you! (This one proved tricky when I realized I always talk to the baby in English.)
2) Speak Swedish s-l-o-w-l-y. My Swedish is fine but I get complaints I speak it too fast (just like with English). Plus I’m more likely to speak it correctly and with a decent accent if I take my time.
3) Do NOT talk about America and how awesome/cheap everything is there.

The first session I did pretty well with my rules, though my Swedish was iffy at times. Will speaking Swedish ever feel easy?

Today I talked about America maybe too much, but it’s because someone asked what we wanted for our babies for Christmas, and ladies kept mentioning various baby items and wondering if they were useful (Bumbo seat, swing, bouncy seat, jumperoo). Since I have now, and had for Little Girl, all possible baby entertainment devices, and evidently nobody else there did (where do they put their babies when they are showering???), I kept sharing my opinion, and then I felt compelled to point out that all these items are way cheaper in the US and it’s not that extravagant to have them all and I had either brought them when we moved or bought them (used) here.

Overall, though I participated in a mommy group in the US when Little Girl was small, I had kind of forgotten how totally boring it is to sit around with a bunch of other ladies you don’t really know discussing babies and breastfeeding and sleeping. Unless I already know you, I kind of do not really care where or how or how long your baby sleeps.

There was also some light Mommy War stuff about breastfeeding (one lady kept interrogating people about whether or not they were exclusively nursing, and trying to correlate their responses to the baby’s sleep habits). That can be a point of contention here, evidently, and how fancy your stroller is (and how you use your stroller; I received some light snarking about strapping the car seat into mine), but otherwise there was nothing about being a working mother or cloth diapering or babywearing or starting solids or preschool or vaccinations or co-sleeping or rear-facing car seats. I think the working mom thing is a non-issue (everyone stays home at least a while, and then everybody goes back to work) but maybe the others will come up in later conversations. Swedes can be pretty non-confrontational though, so maybe there will be no such drama.

I’m not sure which I prefer: boring accounts of how little sleep people are getting or passive aggressive commentary. Well, either way, I’m getting out of the house!

How we are doing

16 November 2011

Now, having had two, I feel like I can make some generalizations about the babies I produce: they are good sleepers with troubled gastrointestinal tracts. Honestly I can’t figure out how Baby Brother is remaining so very fat since it seems like most of his milk ends up on my shirt. For the most part he doesn’t even seem to notice he’s leaking food so I guess it’s not a serious problem. To deal I just ordered masses of more bibs and burp cloths and thank goodness my mother sent additional sheets for Baby Brother’s little bed since I keep finding him and it soaked in sour milk, poor dear.

Baby Brother’s interests, at ten weeks, include: watching his big sister, chatting with his mobile, and conversing extensively with his parents. What a talker! He finds lots of little games hilarious and enjoys story time. Bath time is the highlight of his day. Baby Brother is still largely unaware that he has hands, though at this age his big sister already had a favorite toy. I guess he has more to look at than she did (since she had no fascinating older sibling who was always doing something interesting and loud) so he doesn’t feel the need to try to entertain himself yet. Anyway, he’s doing fine.

Little Girl is really enjoying her time at the village day care/preschool and informs me whenever the dogs, baby, and I have walked over there to pick her up that we have arrived much too early, and also that she wants to live there. She’s gotten much more comfortable with speaking Swedish and sometimes even uses it when she is playing by herself. However, her pooping issues are still highly troublesome and frankly disruptive to the whole family, so I am really looking forward to her doctor’s visit in a few weeks and hope we can find a resolution. Although since these problems have been going on for most of her life and we have tried endless remedies, physical and psychological, already I just don’t know what can happen. I really worry for when she starts school. I feel so much like I’ve failed her.

For a while I was suffering from something I thought of as post-partum boredom. The constant, repetitive drudgery of the upkeep of small children was wearing on me. The feeling has faded a bit, and even if I am not excited about it, I’m not dreading so much each day’s promise of more loads of laundry, more dishes to wash, more children to clean, more food to prepare, more dogs to feed, ad infinitum. If I can connect with friends occasionally, leave the house once a day, and have just ten minutes alone to drink coffee and read a magazine I’m pretty okay. Now that winter’s here and it’s starting to get dark ungodly early and going places is starting to get to be a hassle (e.g. having to scrape ice off the car while the baby wails in his much-detested car seat kind of makes you just want to stay home) I hope my mood doesn’t deteriorate, though. But I do truly delight in and feel grateful for the children, which helps. Honestly I still can’t believe I have two healthy children. I spent several miserable years thinking that would never happen and I am constantly surprised to find that it has. What good fortune!

Since moving to Sweden this is the longest I’ve remained in the country at a stretch. For one or another reason the first fifteen months I went abroad about every season. The US, the UAE, London. It’s now been five months and I’m starting to feel pretty ants-in-my-pantsy about jetting off. But since the baby can barely even tolerate a trip to the library I guess that’s going to be pretty far in the future. Current travel ambition: an entire trip to a grocery store with nobody crying.

While I don’t recall any such feelings the first time around, I am not that happy now with my post-partum body. One problem is the two c-section scars. That’s a bit over-the-top. And also I’m stuck at a number somewhat higher than my pre-pregnancy weight. With Little Girl I lost weight continuously the whole time I lactated with no effort at all and ended up something like thirty pounds lighter. Once I weaned I never lost weight again, and that’s been the case this time, except I didn’t breastfeed long enough to lose that much baby weight. As an adult I’ve never lost weight any other way, actually and even with the daily hour-long walks nothing is happening. Plus I’m on the pill now and suddenly have the worst skin. And I’m always covered in spit-up and my hair is stringy and somehow my glasses are constantly smudged. Well, Husband doesn’t seem to care, and I’m usually wearing a gigantic parka anyway if I go out in public, and who’s looking at me when I have a cute baby, so I guess it doesn’t really matter.

Resolved

14 October 2011

Today Baby Brother is six weeks old, and I return the rented breastpump! It’s calming, really, knowing I will never lactate or have to try to breastfeed anybody ever again. I’ve weaned. The thrush, the open and weeping sore, the low supply, the lazy sucking, the eventual disinterest in latching, the pain during pumping…yeah, that was about it for me and breastfeeding. I managed to make do with low supply and no latching for Little Girl for way too long, but I just couldn’t do it to myself this time.

And though I am disappointed for both my sake and Baby Brother’s that he won’t be a breastfed baby, it also feels, well, okay. Formula has been a life-saving substance for both of my babies and I am grateful to have it. Baby Brother is growing and happy and loved, and that’s what really counts, and maybe growing up bilingual will make up for the IQ point deficits from not being breastfed (ha!).

Now I can leave the house for more than two hours at a time and take the kids to the park and out to lunch; accompany Little Girl to gymnastics; plan innumerable fun outings that will keep me and the children from languishing inside the house. My mood is better without the frustration and worry of making breastfeeding work and I’m more positive and present when we are home. So yeah, there’s lots I can do as a loving mother to benefit my children besides breastfeed, and I’m turning my focus to those things instead of forcing the issue given my body’s near total disinterest in making milk.

Two healthy children, a loving husband, a secure home: things are really, really good! I keep thinking I should be sadder about stopping so relatively early, but I just feel so fortunate.

Déjà vu

28 September 2011

I guess it would be hard anyway, but the very lot of work I am putting into breastfeeding these days feels infinitely more difficult because it doesn’t feel like I’ve been at it for just three and a half weeks, but three and a half weeks plus the nine months I put in exclusively pumping with low supply for Little Girl, trying all the while to make more milk. I’m in almost precisely the same situation again. Apparently, as determined by Baby Brother’s lack of weight gain plus test weighing him before and after a feeding, and forcing the poor infant to undergo blood tests to rule out other causes, I don’t have anywhere near enough milk. How I was able to believe that lactation consultant who told me I had plenty of milk is beyond me; wishful thinking, I guess.

So I’m back to nursing-supplementing-pumping every few hours around the clock, trying to increase my supply while also feeding my baby. And I’ve already done this before. It is so immensely hard to be motivated to do it again. And it didn’t really end that well with Little Girl; it never got easy, I mean, and finally I got fed up and over it. I never wanted to pump again. And yet here I am again. Pumping, and getting panicky every time he seems hungry. Will I have enough? Will he be satisfied?

I keep fantasizing about a refrigerator full of bottles, just ready for whenever he needs milk, instead of this draining schedule of work and hope and discouragement.

But at the same time, how wonderful to give my baby my milk, how beautiful is nursing when it is working, how important this is to at least try, who knows how I may be able to make it successful and comfortable in some way at some point in the future? The odds are against it, but…maybe?

But in the meantime it’s endlessly demoralizing and just plain hard and unfair.

The Goldilocks of Breastmilk

23 September 2011

So I thought I had too little milk, and maybe I did, maybe I just psyched myself out, I don’t know, but I spent the second week of Baby Brother’s life nursing and pumping and taking galactagogues and nursing and pumping and taking galactagogues. And then it felt like my milk came in all over again, and I was just supplementing with my own milk, and an LC insisted she could tell I had plenty of milk, so then I spent a week just nursing. Baby Brother seemed happy and slept great (every night he gave me one five-hour stretch!) I thought things were working out! Wonderful!

And then Baby Brother got weighed yesterday, at almost three weeks old, and he had lost weight from the previous week and is still not at his birth weight. Now the LC is telling me it’s because I have too much milk (foremilk/hindmilk issue). Since all my previous experience with babies losing weight is due to my not having enough milk I am having a hard time believing this and acting on a solution. Whatever the reason, my baby is not thriving on my milk and I have no clue how to fix it. I’m doing what that LC suggested (pumping before feeding, waking him up to eat more often) but if he continues to lose weight…I just don’t know what I’ll do. What’s bizarre, like I said before, is that he seems happy and satisfied. How could he also be starving?

It’s really fucking miserable. What a big deal it is to be tasked with keeping a baby alive, and growing, with your body alone. Sure, you do that with pregnancy, but that’s pretty much on autopilot. And I’m failing at it. Again.

Simultaneously, and possibly relatedly, we have been battling the worst case of thrush. Baby Brother seems symptom-free, but my nipples and breasts are causing me constant anguish. All of this is constant anguish.

Old history

11 September 2011

Did you know that, originally, this was basically a lactation blog? It started as a private journal about my pregnancy with Little Girl and then, after her birth, was filled with our tortuous and rather long breastfeeding saga. I eventually went public with the blog basically in order to participate in the exclusively pumping/low supply online community. But time passed and Little Girl grew and breastfeeding ended and the blog continued. Since the move to Sweden my experience as an immigrant has been a focus, but these days we’re going to be in for a lot of mommyblogging.

And since once again breastfeeding isn’t turning out to be easy, you’ll probably be hearing at least a bit about that. Advanced breastfeeding practices: the nursing edition, as opposed to exclusively pumping.

First, let me say that I love nursing. It’s so easy, for one thing. Nothing to wash, nothing to warm up, it can make the baby so content. Love the closeness. Little Girl never really learned to nurse so I had no idea, but this guy is totally on board with both the theory and the practice. I think he wouldn’t mind being eye to eye with my breast allll day. So that part is good. Sadly, my breasts are not as on board. As with Little Girl, my milk supply is low. Now, it does seem to be better than it was with her at this stage (I know this thanks to obsessive record-keeping on my part of pumping output), and I have the benefit of past experience, pessimism, and obsessive planning, meaning that I already had a good stash of milk-making supports of various kinds in place that helped last time (everything from oatmeal to prescription meds). I started using them at the first signs of trouble. So I know how to improve this low supply situation, and I’m doing it (every 2-3 hours nursing, supplementing if needed, and pumping). It sucks, though. It’s very, very disappointing and hard.

I can’t do all this Advanced Breastfeeding for too long. I have, of course, another child, and I also want to enjoy this new one, and not have him spend his babyhood propped up beside me, staring as I pump. So I’m not sure how this will resolve. I am giving it my all now to get my supply up, but my role as a mother to these children is not just about making milk. That’s something I didn’t know with Little Girl but can appreciate this time. If I can’t turn this into a sustainable, easily-workable feeding method by six weeks, well. We’ll see.

Now I’m done pumping, and somebody small has beautiful little eyes that need staring into, and soon Little Girl will be home from the store with her father and I’ll see if she wants to play Candyland or jump on the trampoline. At least until the next feeding…

Story time

6 September 2011

Honestly I personally can only barely tolerate other people’s birth stories, so I’m not going to go into centimeters and whatnot. But I know some people are into this stuff, so:

Thursday night I went in for an induction. The doctor on call was running late, and while we were waiting I went into labor on my own, of all things. I did that for half a day before they broke my waters and inserted an internal fetal monitor and tortured me with Pitocin, so I was trapped in the bed in an agony beyond all imagining OMFG. I tried that stupid useless goddamn laughing gas and it just made me nauseous, so there I was, having non-stop artificial contractions and just out of my mind with pain so I got an epidural, which was totally awesome even though it was what I guess you call a walking epidural, so you can still move your legs and feel the contractions, it’s just that you don’t prefer you were dead anymore. But then the baby’s heartrate started to go haywire and they kept taking samples of his blood from his scalp–did you even know they could do that? horrible–and I think some other things happened and anyway it turned into an emergency c-section after 21 hours of labor. I was so happy I would finally be having that baby I think I was the most cheerful person they’d ever had on that operating table. However, I didn’t get to see my baby for a few hours afterwards, which totally blew, and when I did get him in the ICU (I was there just for a bit) I couldn’t use my arms because of all the IVs.

But whatever, finally I did! And he was and is just the most precious, sweet-smelling, lovely little creature. I’m so in love. SO fortunate. He’s healthy, too. For a while everyone was worried about a rapid breathing issue he was having, and there were scary NICU tests, but now it seems he’s totally fine, thank goodness goodness goodness.

I mean, he still has a serious design flaw: you’ll stuff him with milk and get him to sleep, and then he poops and you have to wake him back up with a diaper change. Also, if someone were rocking you and feeding you warm milk in a dark room in the middle of the night, wouldn’t you be sleepy? What’s with all the looking around in the middle of the night and then wanting to eat again?

And the constant desire to nurse? Because yes, my friends, I have a baby who likes to nurse! It’s a surprise every time! And wonderful! At first we had trouble because he had this theory his lower lip might be good to suck on, but (I believe) we have the latching pretty figured out now. (If he seems happy and it doesn’t hurt, it must be right, right???)

However, despite our mutual inclination towards breastfeeding (hoping to make breastfeeding easier was the main reason I submitted to that horrible labor/induction experience in hopes of a VBAC), we’re supplementing with a cup with formula sometimes because he was having blood sugar issues in the hospital and they insisted. With my history of supply problems it makes me feel more secure to have the formula as a back-up, but hopefully, fingers crossed, when my milk comes in, if it’s enough or even mostly enough, we can cut it out with the cup-feeding since nobody enjoys it. (My mother thinks I should just nurse him, but I’m just too nervous about his weight check on Wednesday to do it, and Husband’s support is…debatable. He just wants everybody to be content and isn’t convinced the nursing can do that).

I’m pumping a bit, but I apparently have post-traumatic stress about pumping and I can only barely tolerate it. I want to hold my baby and enjoy him about 10000% more than I want anything to do with that goddamn pump. I do NOT want a repeat of Little Girl’s pump-satured babyhood. It’s about the only thing I remember about when she was small and I don’t think it’s good for anyone to do it over. So I just won’t.

For her part, Little Girl is psyched we are home, and was also very thrilled to see Baby Brother (as he is known–we can’t decide on a name), but now she’s seeing he’s not that much fun, especially what with him wanting to nurse all the time. She wants to hold him and poke at him or have me do stuff with her and she just can’t, which is frustrating. It’s been a little bit hard in that way. Right now he’s asleep with her father and we’re hanging out like old times, but her life’s going to be so different now, and change is difficult.

Well, it’ll be different, but even more wonderful. What a beautiful baby I have. I’m going to go cuddle him right now. He’ll never be four days old again!

Second thoughts

31 July 2011

I know it’s only a few more days until this pregnancy is full-term, but, um…I’m not so sure this whole “having a baby” thing was such a good idea. Little Girl is regressing in pretty much all possible arenas, for one thing, and for another, my sisters-in-law recently recounted their birth experiences here in Sweden, and they featured alarming elements like people sitting on other people’s stomachs and episiotomies. I had sort of gotten the impression from my midwife that Sweden had somehow magically figured out how to make birth very relaxing and easy. She didn’t say anything about vacuuming babies out; she talked about bathtubs and birth balls. Now I am freaked!

The hospital info session for expectant parents was likewise non-alarmist. It was a forty-minute PowerPoint presentation that did not at any point mention c-sections or Pitocin. I’m not even sure I remember hearing anything about epidurals but there were ten minutes talking about how the newborn will be left to crawl to the breast on its own, and that they recommend you carry the baby in a shawl. They made it sound like those were the major issues to consider but now I am cognizant again of the possibility of extreme pain and drama and not looking forward to that at all. Or trying to breastfeed–God, that was so horrific last time. And newborns–they cry! They wake up all the time! You have to try to keep them alive and clean and they are so confusing and angry! This is all I’m remembering. Judging from the letters I wrote to Little Girl and the pictures I took of her I was very much in love with her as a baby, but I can’t for the life of me figure out why. Newborns are not that great.

While I may not be ready, the nursery is. It used to be a closet filled with crap my in-laws left behind. I cleaned it out, then Husband renovated it (new ceiling, new window, wood paneling for the walls, new outlets, new lighting), and we furnished it with Little Girl’s gigantic American crib, the world’s tiniest recliner (brought from the US), and an IKEA dresser to use as a changing table. (Swedish people put their changing tables in the bathroom, which is actually totally sensible, what with the running water and all, but when we renovated the bathroom we didn’t have that in mind, so there’s not a good space for a table, so we’re just doing it the American way.) The room is off our bedroom and we’re removing the door and I can see the crib from where I sleep so it’s basically like one big room. I slept in Little Girl’s nursery for, like, years, so I imagine I’ll want to be similarly close to this baby, ready or not though I may be for him. (We may also co-sleep but we’ll see what the baby likes.)

Swedish pregnancy

14 March 2011

Swedish pregnancy-related terminology is kind of hilariously literal. I have a hard time not giggling about:

moderkakan = the placenta = literally: the mother cake/cookie
livmodern = the uterus = literally: the life mother (aww)
livmoderhalsen = the cervix = literally: the life mother’s throat/neck
fostersäcken = the amniotic sack = literally: the fetus sack
fostervatten = the amniotic fluid = literally: the fetus water
navelsträngen = the umbilical cord = literally: the belly-button string/cord
bröstvårtor = nipples = literally: breast warts
vårtgård = areola = literally: wart farm/yard

Tee hee! (Here’s some more funny Swedish words.)

It’s notably different being pregnant in Sweden than it was in the US (I am now 17 weeks!). For one thing there is significantly less testing and checking. This sucks for me because I love medical intervention in pregnancy. Given my history I find it very reassuring. This is in contrast to my first pregnancy, where I read stuff like Thinking Woman’s Guide to a Better Birth and Birthing from Within and anything by the Sears and kept trying to remember all manner of details like: was it the Cervidil or the Cytotec I was supposed to avoid? What was I supposed to say if the doctors said the fetus was X’ing and they wanted to do Y?

In the end I had to give all the natural childbirth prep up; I found it much more stressful to see my OBs (which, sure, I didn’t have to choose out the outset, but I got high risk pretty fast) as Out to Get Me than as my knowledgeable helpers on whom I would rely. And I’ve always been comfortable with medicine. I was eeked out at first when I ended up needing a c-section (for breech), but truly it was fine. The outcome (a living, health baby, plus a living, healthy me) is just way more important to me than the methodology involved. And I don’t naturally find birth very interesting. I don’t really want to read anybody’s birth story. I don’t care how many centimeters you were at transition. I don’t even feel like checking to see if that previous sentence makes sense. When it comes to hearing about birth, I just want to know how you are feeling, and how big your baby was, and to see a cute picture.

But during my own pregnancy I want all kinds of information. With numbers. Now, in the US it is totally normal to use a Doppler to check the heartrate of the fetus at your check-ups. But evidently there is some sort of risk to this, at least in the eyes of the Swedes, and so at my 15-week appointment, they didn’t listen for a heartbeat! Honestly, what the hell was I even there for? Basically the midwife (super-nice) took my blood pressure, talked to me and Husband about our future appointments (not another regular check-up until 25 weeks of all things, plus a diabetes test and an ultrasound before that), and that was that. I was really hoping for some confirmation that there is a live person inside of me that would make all of those subsequent appointments meaningful. I’m a big worrier, so for me being pregnant is like being a human Schrödinger’s box with a fetus inside that may or may not be alive, and the reality is only clear upon direct observation.

I’m trying to be optimistic. My stupid placenta (or may I say “mother cake”) is in the front, so I’m not 100% sure still if I am feeling movement or if I am just a gassy lady with a strong imagination. I haven’t gained any weight to speak of but my stomach is growing nonetheless. Despite my love of medical attention during pregnancy, I’m interested to see, should we get that far, if I can have a relatively intervention-free birth. I hope I’m healthy enough is the main thing. Vaginal births after just one c-section are actually mandatory here–there’s no choosing a c-section, anyway. Ironically, I find this almost as irritating here as I did the near-mandatory repeat c-section in the US. What, I have to mess up my stomach and my vagina? No choice? But the regular way is justifiably better when it is possible so it’s definitely worth a shot. Plus, I heard they have birthing tubs!

Too bad my nice midwife won’t be there. That’s because, weirdly, in Sweden you have one midwife who works with you your entire pregnancy, but when the time comes, you just get whatever stranger is on shift at the hospital that day. Huh? I don’t really get the point.

(Oh, I decided to do the medication [metformin] the Swedish way, and stopped taking it [and a subsequent glucose test showed I’m doing normally so far on my own. By the way, the glucose tolerance test does not involve gross orange soda-like substances here, just some sickly sweet water, and takes two hours, not one or three, and they just stick your finger instead of drawing blood]. In the end the very small, theoretical risk of brain damage to the fetus the doctor informed me if I continued the meds about outweighed the bigger, more realistic risk that I will have milk production issues as a result of stopping the met. Breastfeeding is just less important to me than the baby’s brain. But it was a hard decision to make nonetheless.)

Ten week ultrasound!

26 January 2011

Hooray! All was well! There was a 2.8 cm long somebody in there with arms that waved and some legs and a back it stretched and, best of all, though I guess it goes without saying what with the arm waving, a heartbeat! The doctor would not tell me the heart rate because it was not “interesting.” Excuse me? If I am asking, that means I am interested! Sweden is weird. How am I supposed to obsess about the portent of the heart rate in the American style? But she said all was good and normal.

This time they had me see the high-risk OB who specializes in endocrinological issues to talk about our medication dispute. We talked for about an hour, actually, this time in English. Can you imagine such long conversations in the US? Swedes are not that comfortable with confrontation, but there was only one really awkward bit, when she asked me why I thought my body was so different from Swedish women’s that I don’t want to follow the same recommendations! But then I explained how adamant my US doctors about the absolute opposite recommendation to what I was hearing from Swedish ones, and the reasons given, and she seemed to understand my uncertainty.

She explained Sweden’s reluctance for women to use metformin in pregnancy; the concern is apparently the small risk of low blood sugar in the fetus, which can cause problems with brain development, and which can’t be easily monitored. But she also wrote me a prescription for metformin and I can decide for myself. If I go off it (Plan A), they’ll want me to act like I have gestational diabetes, with the special diet and the constant blood pricking and maybe insulin. If I stay on it (Plan B), I’ll just have random glucose checks. I haven’t quite decided what to do. I was on metformin with Little Girl for most of the pregnancy and she’s fine, and my US doctors wanted me on it for the entirety of future pregnancies, and many studies say it’s okay to use and in some ways better than insulin, but I also understand why the doctor would rather me off it than on. I can accept a medical reason better than a bureaucratic one! There’s also the consideration that I may not actually really need this medication anymore in general, since I’ve lost a fair amount of weight since my diagnosis of PCOS and the doctor says its symptoms decrease with time. If anyone has any thoughts about this, let me know!

My first pregnancy I had horrible, terrible nausea. With my second, which was unsuccessful, I felt fine. This one has been in between. I feel at least a little crappy every day, sometimes very much so, but have only thrown up once. Meat is the main issue. I don’t even wish to hear the topic discussed. I’m grossed out just writing this. Bleh.

This pregnancy has been quite new in another way. My breasts have always hurt for a while in early pregnancy, but never for this long, and never so much. And they don’t just ache (nevermind the agony when Little Girl persists in jabbing me with her sharp little elbows at storytime) but they’re changing. They were already big, but now somehow there’s just more there there. More stuffing, can I say? I hope this bodes well for milk production, if I do continue being pregnant.

Here’s my ultrasound picture. Compared with my pics from high-risk big city docs in the US, I haven’t been super-impressed with the quality of the ultrasound images I’ve seen in my small city in Sweden. But really we’re just lucky the doctor gave us the print-out at all. She seemed to think it was a weird request. The head is the bottom-left of the fetus. Such a relief! I’ll go back to being pessimistic soon enough I guess, but today I’m feeling happy. It was great seeing that little arm waving about!

Reproduction from a four-year-old’s perspective

18 January 2011

Little Girl happened upon me when I was reading a pregnancy guidebook recently and subsequently has developed a full-on obsession with the subject. I let her look at all the graphic photographs in the book, and you know which one she kept going back to with questions? Not the head emerging from the vagina, not the breastfeeding, not the waterbirth (though she thought that was pretty wild), but the one of the pregnant lady heading to the car to go birth in the hospital. “Why is she making that face?”

Overall she has had a LOT of questions, but nothing about what starts off the whole show to begin with, so thank goodness for that. And not being a crazy person, I haven’t told her I myself am pregnant. I certainly wouldn’t want to have to discuss a miscarriage with her (especially since it would be ad nauseum, since she is four), and if I do continue to be pregnant, it would be quite a few long months of constant queries on the order of if the baby was coming NOW? What about NOW? How big is it NOW? What is it doing NOW? If I keep on being pregnant, there will be plenty of time for that when I’m showing. I don’t want it to begin quite yet.

But due to her curiosity, we are still talking all the time about how babies grow and how do they eat in there and how they are born and how they drink milk, some of it general and some about her own case, some of it starkly factual and some of it rather glossed over. Little Girl frequently acts various aspects out with her toys (yesterday her llama had eight babies on the landing of the stairs!). And today when I was dressing her, she tried to drink from her own nipples. I told her you have to be a mommy who had a baby come out of your tummy to have milk in your breasts, and then she wanted to know if I still had any milk, in that case. But I explained that when the baby is done needing milk, the milk goes away, so I didn’t have any anymore. Then Little Girl had an idea. What about if I married a new husband and had a new baby that could be her sister and then I would have some milk?

Never before had she entertained the notion of my having another child or her having any siblings (though she has had for a year now an imaginary brother named Key from China, but he has different parents). I did ask her once if she would like another kiddo to live in our house, but she said, “No, because then there would be too many.” (And honestly she doesn’t seem to like babies all that much when we have spent time with them. They try to pull her hair and touch her stuff and make weird noises.) Now I see she was under the impression there was a one-child-per-marriage policy. There are a lot of only children on my side of the family, but she certainly knows lots of people with siblings, so I’m not sure where she got that.

And she’s adamant you have to be married to have a baby, despite my examples to the contrary. We had lunch the other day with my Japanese friend from school, who’s in her late twenties and having trouble getting her Swedish boyfriend to marry her (Swedish people are typically much more comfortable with just living together indefinitely) because she wants to have a baby. Little Girl agreed. “You need to get married before you have a baby.” I had no idea I was raising such a conservative!

These days she’s more interested in my pregnancy books than I am. Pretty much everything about pregnancy stresses me out and/or worries me so I try not to dwell on it overmuch (ha, like I am successful there). I will never understand those people for whom pregnancy is an easy state of joy and hopefulness. But still it’s enjoyable to experience Little Girl’s inquisitiveness these days. She’s so clever and curious and verbal. Despite all the talking about babies, though, she says she doesn’t want one herself. Instead, she’s going to be an astronaut, then a teacher, and then come live again with mommy and daddy and tell us what she saw. I guess she doesn’t think motherhood and career can mix. (I need to get back to work so she can see that they can!)