Friday, January 31, 2014

challenges

This post could also have been titled "Many Sources of Stress", but I'm trying to be, y'know, positive.

At my last OB visit I got a lot of very good answers to my questions about inductions and interventions: this particular hospital has policies which make a lot of sense to me, but my doc also kept saying, "We'll see what's going on with you; these aren't rules we implement no matter what," and that was exactly what I needed to hear. (I mean, I never believed Ina May Gaskin's claim that standard hospital policy is to perform a caesarian if the doctor feels like going for coffee, but I had heard about the "twenty-four-hour rule" from other places as well.)

Also, I have only gained seven pounds since the beginning of December. I was very proud of this, and wrote a whole long draft about Trusting My Body and Fat-Shamers Can Suck It, and then because my hubris is the fast-acting kind I promptly failed the glucose tolerance test. Cue the sad trombone.

Failing the first test doesn't necessarily mean I have gestational diabetes (though you try getting me to be that rational when the e-mail with the test results arrives at eight o'clock at night [or in any other situation which combines the words "test" and "fail"]). It just means that I have to take the second, infamously awful, three-hour test. If I fail that one, then things get unpleasant: I will probably have to see that terrible nutritionist on a weekly basis, and I doubt she will be above saying, "I told you so," and food will be a source of complications and guilt for the next two and a half months at least, possibly longer. I know women who've had GD and who say it wasn't a big deal, but food restrictions and denial are really, really triggering for me, so I'm quite worried. We'll see.

(My blood pressure and urine results show that I don't have pre-eclampsia, so that's good. I am, however, still anemic. That's bad. Sigh.)

The great thing about pregnancy (and parenthood, down the road) is that there are always new standards for you to fail to meet: at 28 weeks you enter the realm of the "kick count". This means that twice a day, in the morning and evening, you are supposed to sit still and count how many times the baby kicks in ten minutes, and if it's fewer than ten times, you're supposed to panic. (I have also seen the recommendation be ten movements in an hour, which initially seems much more reassuring until you read the fine print on how it has to be movements, not kicks, and I'm really not sure how to differentiate between those two. Also the hour recommendation uses the same times of day, meaning you're supposed to have an hour first thing in the morning when you can do nothing but sit and count. Yeah, I'll just pen that in around brushing teeth / putting in contacts / yoga / making coffee / taking dogs out to pee / breakfast / dogs' breakfast / taking dogs out to poop / getting dressed / doing face and hair / packing lunch / starting car / human interaction with husband / etc. No problem!)

My little incubatee has long shown an unwillingness to perform on command. She has her own schedule and it does not correspond to the Recommended Kick Count Times. Yes, there is frequently movement when I'm reading in bed just before sleep, but if I start to time it, then she stops; and first thing in the morning she's always napping to make up for the three a.m. party and in preparation for the ten a.m. one. So far I still find this amusing rather than panic-inducing, and will not be giving much of a crap about the kick counts unless she has a really quiet day.

(In your final month, you're supposed to panic both if there is not enough movement and if there is too much, which is enormously helpful [no, I have no idea how you're supposed to know if there is "too much" movement]. And if the movement becomes "jerky" or "frantic", RED ALERT! This is also helpful, since normally the feet slamming into my esophagus have the fluid grace of a tiny Baryshnikov, so of course I'll be able to tell if suddenly things are "jerky". Sure.)

Last, and worst, is that Darcy's paw is not improving. The swelling went down and for a few days we thought it was better, but he's now trying not to put any weight on it at all, and is obviously in pain. He went back to the vet tonight; they still couldn't figure out what is wrong. Samples were sent to the lab, and hopefully we'll know more soon. I would happily eat plain oatmeal for the next three months if that meant my big wolfy dog was okay.

Also-also, I'm reading an enormous novel about the Nazis which is like being beaten with a stick, but I refuse to give up now. If I get through it I will allow myself vast amounts of fluffy reading afterwards. And hey, I gotta have something to read while I sit fasting for three hours in the lab waiting room, being called in every hour for more blood removal. WHY NOT NAZIS? 

Geez. Some years February just comes sooner than others, emotionally.

Saturday, January 25, 2014

a midwifely mixed bag of a book

So this week I read Ina May's Guide to Childbirth, by Ina May Gaskin. She is a midwife who founded a hippie commune / birthing center in Tennessee called The Farm. The book is new-agey as all-get-out, but I expected that, and it contained some interest for me nonetheless. 

I liked a lot of what the book had to say about childbirth, and it had stuff that I know will be personally useful to me, particularly about how women underestimate their bodies and how the Western obsession with telling pregnant women horrifying birth stories actually propagates more horrifying birth stories, because if you go into your labor convinced that it's going to be thirty hours of the worst pain you could possibly imagine, your tension and fear probably will make it pretty awful. I didn't even realize how much I'd been thinking of the labor process as something to be dreaded and endured until I read that part, and I feel like I can have a different attitude about it now. But I have some major quibbles, and quibbling being my way, I'll talk at length about those.

The first section of the book contains the personal birth stories of women the author knows and/or has worked with. For the most part, these stories aren't bad, although they start to blend together into one patchouli-scented, self-congratulatory mass after a while. Of course they are all written by women who wanted midwife-supervised births, because otherwise those women wouldn't have come in contact with the author. But not all of them have the births at The Farm that they planned: some have home births either by choice or necessity, and some end up giving birth in the hospital. Only a few of them push the objectionable perception that your birth choices are either a misogynistic male obstetrician or a loving female midwife, with nothing in between (yes, many of the stories are quite dated, but I have heard this perception, in almost literally those words, come out of the mouths of women I know within the last couple years, and I always want to respond, "You do know they let women go to medical school now, right?"). There are many stories which are hilariously hippie-ish (I never thought I'd have to read the word "yoni" again), and some which were clearly written by women who think they're special snowflakes ("a hospital birth is fine for women who don't care, but I actually wanted to bond with my child" or "I was briefly crazy enough to realize why other women ask for pain medication, but my strength pulled me through that insane moment") but even in those there was usually something which made me say, "Hmm, I could use that."

HOWEVER. QUIBBLE NUMBER ONE. There was one story in this section which stood out, and for all the wrong reasons. In it a woman describes her child's birth under circumstances which could only be explained by her having no prenatal care whatsoever and thus, when she goes into labor, ending up at an inner-city ER on a Friday night (there is no background given other than that she's in NYC, but it's clear she has no doctor of her own and hasn't been to this hospital before). Her experience involves being unattended for hours, strapped to a bed in an open ward, forcibly sedated, and unable to find a single doctor on the floor who speaks English. And she opens her story by saying she had a "standard-procedure hospital birth". Really. 

The fact that the author allows this phrase to stand, without any editorial comment, made me very annoyed, because it goes completely against her claims of being anti-fear-mongering. She lets the claim that this is a standard-procedure hospital birth go unchallenged, even though there are several other stories in this section about women ending up in a hospital and having good experiences with good doctors. This one nightmare story is the one I remember, and Gaskin (I believe) knows perfectly well it's the one the reader will remember, and that said reader will subsequently be too terrified to go to a hospital lest the same thing happen to her. So I felt manipulated, and cranky about that. (There will be more about this manipulation later, because it unfortunately didn't end here.) 


Now we come to QUIBBLE NUMBER TWO. The number of times Gaskin uses the adjective "orgasmic" in the introduction alone was excessive to say the least, and throughout the entire book she never lets that topic go (there's a whole section entitled: "Remember, Birth is Sexual"). Look, I am all for as positive an experience of childbirth as I can possibly have, but I don't need that to mean it's orgasmic, any more than I need a delicious savory food to be sweet, or a good book to be the same as a good walk with the dogs, or even the endorphins from exercise to be the same as the endorphins from sex. Positive experiences can be positive in different ways. Women can have powerful and wonderful physical sensations which are completely non-sexual, and setting the bar for natural childbirth at "you should have an orgasm if you're doing it right" doesn't seem to me like it could possibly make a laboring woman feel better about herself. Also, if you need to come up with an analogy for your female patients about feeling physically strong and bodily-present, and you can only think of using an orgasm... that's a little sad. But it seems to be all Gaskin has to draw on, and all that she thinks her patients and readers have to draw on. Does she assume women don't run, or climb mountains, or dance, or do intense yoga, or practice martial arts, or... anything else physical, for heaven's sake? That the only time we like being women or being in our bodies is when we're having sex? (And that some of us would not run screaming for the nearest restraint-equipped hospital bed if our midwives instructed us and our partner to make out as passionately as possible, during labor, in front of everyone, as is apparently standard practice at The Farm?)

And on to QUIBBLE NUMBER THREE. The second section of the book is split in two parts: the first contains a lot of useful labor advice from Gaskin, which I liked; the second part is all the fear-mongering Gaskin swore she wouldn't use and then some. I had to skim most of that part, once I realized that the chapters might as well be entitled: 

If You Give Birth In a Hospital, You Will, Literally, Die: Here's How

Hospitals Perform Caesarians Just For the Heck of It

You Can and Must Have a Vaginal Birth After Caesarian: What Kind of Woman Would Let Something That Unnatural Happen Twice

I did read, in its entirety, the "You Will Die" chapter, and it was TERRIFYING. I sat there quaking and saying to Berowne, "Oh God, what if they tell us this intervention is necessary? Because this book says it will KILL ME," and he had to talk me through remembering that I actually feel very safe with our team and I trust them, and that we had a good talk with the midwife at our first visit about the very low rate of interventions at this hospital. And then I was so mad at Gaskin, especially since at the chapter's end she tacks on this blatant lie about how she's not trying to scare anyone away from necessary medical intervention. Seriously? The chapter has no purpose but to scare women away from hospitals and medical intervention! And that is so awful for someone like me, who has medical issues which mean that a home or birthing center birth would be stupidly risky. (Gaskin claims there is virtually no medical issue which requires anything other than a bunch of voyeuristic midwives to resolve, and I'm sorry, but that's just not true.) I skimmed or outright skipped the rest of the chapters in this section. 

That said - and this may seem bizarre after all that ranting - on balance I am less afraid of labor than I was before reading this book. I know that if medical interventions become necessary, I'm going to trust the OB team in front of me, because I know them and respect their expertise. And as far as pain and my ability to cope go, I do feel more prepared. Even in the birth environment I've chosen (which may be a hospital but has tubs in every maternity suite, midwives as part of every prenatal team, and rooming-in as the standard), I think I got a lot of advice from this book that I can use. 

Final quibble: Gaskin is NOT pro-choice. Two minutes on Wikipedia reveal that The Farm community is strongly anti-abortion. One woman's ostensible "birth story" is actually not about her child's birth at all, but about having had an abortion years before and being justifiably punished for it (!) with severe post-partum depression; that story's inclusion made so little sense to me, and set off so many alarm bells, that I ventured into the internet search territory. What I suspected was quickly verified, and then I needed to make a definite choice to set that knowledge aside if I wanted to finish the book. I was able to, because I was already pretty sure the practical benefits would outweigh the preaching, and because I hoped that story would be the last of it (which it was; hence my decision to not make this a Major Quibble). But it added an extra-sour layer to the orgasm obsession, making me think that perhaps Gaskin believes birth is as sexual as she claims it is because she believes that sex unconnected to procreation is wrong. I believe you cannot profess to empower women and women's bodies as your life's work if you make an exception for birth control and abortion. Just... no. 

In conclusion: I object to a lot of Gaskin's prejudices against hospitals and hospital-based doctors, rolled my eyes at the orgasmic stuff, and there are parts of this book which are really blatant fear-mongering. But even as a non-new-agey, pro-choice woman, I came away from this book with a fair amount of practical advice, and I'm glad I read it.

Tuesday, January 21, 2014

more of the usual

Recently read:

Stern Men, by Elizabeth Gilbert. I was intrigued by her fiction, of which I haven't read any before, because her new novel is getting such rave reviews. While I'm waiting for it from the library, I figured I'd check out her first book. It's, well, a first book. The descriptions of life on a isolated New England island, and the experience of lobstering, are not bad, but I didn't like our heroine much and the story was stronger when it wasn't focusing on her.

Little Face, by Sophie Hannah. Hmmm. I found it difficult to put down, and I plan to read more by Hannah, but I don't think the hype is quite warranted. The culprit is obvious from the first couple of pages, and the Big Twist was completely revealed in the blurbs on the back cover (that's just a poor marketing choice, and not Hannah's fault, but still). Like I said, I'll be checking out more of her stuff, but this felt a bit unsatisfying after all the praise.

Hitler's Furies: German Women in the Nazi Killing Fields, by Wendy Lower. Interesting but oddly paced. Lower goes into great detail about the backgrounds of half-a-dozen women, but then truncates their behavior during the war into basically one compressed chapter. It seems to be an unwillingness to linger on the actual horrors these women perpetrated, perhaps because doing so would seem sensationalist, but that has the effect of making their teenage years seem more important to Lower than their actual roles as "Hitler's furies". The early chapters made it seem like this book was going to be a lot longer and more detailed than it was, and then it wrapped up really fast.

This Is the Story of a Happy Marriage, by Ann Patchett. Essays by Patchett about her writing life, her two marriages, her dog, and much else. I quite liked most of them, and there were times I wanted to copy out multiple paragraphs because they said EXACTLY what I think about divorce, or canine love, or something. (Although her self-justification about cheating on her first husband to force a divorce - "the house was on fire, and I got out through a window instead of the door; what matters is that I got out" - does not wash with me, I can tell you that much. I'm well aware of my own bias in that regard, and was still able to really appreciate everything else Patchett had to say about a failed marriage.) Her writing is pretty great, in my opinion, and I liked this a lot. 

A Christmas Hope, by Anne Perry. My Early Reviewers book. Every year Perry writes a short novel that takes a secondary or tertiary character from one of her long-running series and involves them in a mystery taking place at Christmas-time. The Christmas motif was very faint in this one, and it had an extremely melancholy atmosphere, but it was still a cozy read.

Visitation Street, by Ivy Pochada. Hype = warranted. A wonderfully-written story of what happens to a New York neighborhood in the wake of a tragedy.

In life:

The pregnancy continues to chug merrily along; I'm only a few days away from the third trimester. I still feel good, with one exception: my back.

I'm carrying very far forward (tilted uterus, my OB says, which has no medical implications other than said carrying forward). Nothing is spreading out; all twenty-five pounds I've gained is in a protruding belly. Which is fine, other than that a) it's causing a lot of the "how can you possibly not be eight months along??" comments and b) it's killing my back. Imagine twenty-five pounds strapped to the front of your hips, and you can have some idea of what my lower back is suddenly trying to handle. Yoga and being mindful of my posture help during the day, but nights are rough, even with strategically placed pillows. Oh well.

Over the weekend, one of Darcy's front paws swelled up and we took him to the vet. Several traumatic x-rays later (he lay down on the waiting room floor and cried), there was no sign of breakage or bone degeneration, so we were sent home with antibiotics, painkillers, and the hope that it's just a twisted ankle and will resolve itself. At least the lack of bone degeneration means it's probably not cancer, which the vet said does, tragically, come to mind when she sees an older dog of unusual size with swollen joints. So sad and scary. Hopefully he will be all right. 

Monday, January 13, 2014

several mysteries and the usual pregnancy babbling

First, re: life and pregnancy:

Twenty-six weeks along, and feeling good. At my last visit the OB said my weight gain and measurements are "perfect", which (unfortunately) is pretty much the only adjective my brain will accept. I know I'm not working out as much as I should, but a) I'm also getting over the Death Cold; b) when there's road salt everywhere, the dogs can't have long walks because they get the salt in their paws (we drove them to the beach the other day and they got some good running with Berowne, though); and c) I'm still trying to figure out a new exercise schedule now that I live with someone whose work hours are roughly the same as mine. Claudio would get home from work two to three hours after I did, so exercising when I got home from work was something I could do in privacy, and after twelve years of 5-6 p.m. being The Exercise Hour, changing that is proving really, really challenging. I'm going to have to figure it out at some point if I want to get back into shape post-baby, so this is a project.

But despite that, and probably because I'm avoiding the scale at home, I feel good. I'm wearing fitted maternity tops and enjoying the belly, which is definite but not huge (my navel's still an innie), and my skin - finally! - is better than it's ever been. The promised glow! There it is! (Having said that, I will wake up tomorrow with all the zits.) I actually like looking at myself in the mirror. My energy's good, when I don't have a cold; my appetite's more or less leveled out, so that I'm no longer starving any time I'm not actually shoving food into my mouth; and the silver lining of every food giving me heartburn is that I don't have to restrict myself to sad bland meals, I just accept that I will need antacids after each one. (My cereal gives me heartburn. After any dinner, whether spicy or bland, I have the magma belches. It's just what food does now, apparently.) I'm even having fun with the baby registry, although to register for anything with puppies or dinosaurs on it you have to be willing to put stuff labeled "baby boy" on a registry for a baby girl. Not surprising, and not going to deter me, but disappointing.

They say the second trimester is the cute phase of the pregnancy. I only have two weeks left in mine, but I always was a late bloomer. Hopefully I will continue to feel good about myself, at least until I start waddling.

As far as books go:

White Nights, by Ann Cleeves. A murder-mystery set in the Shetlands, which focuses less on the crime and more on the atmospherics of the place. I liked it, though it was slow-moving and not a page-turner in the sense of not being able to wait for the resolution. I felt like the resolution could come in its own sweet time and that was okay.

When a Crocodile Eats the Sun: A Memoir of Africa, by Peter Godwin. Godwin's a reporter who grew up in Zimbabwe, and this book is more reportage about the Mugabe dictatorship than a memoir, for the most part. I found it fascinating and well-written, and at the end when it starts being about having aging parents, it was fairly devastating. 

Dead and Buried, by Barbara Hambly. Her series, about a free black man living in 1830's New Orleans, continues to be good, though the books are getting shorter and less detailed. Perhaps that is inevitable in a long-running series. 

Shoot Don't Shoot, by J.A. Jance. Easy little mystery for a Sunday afternoon's reading. 

The Beast, by Faye Kellerman. Talk of phoning it in. Very difficult to distinguish from the last three or four books in the series. 

Black and Blue, by Ian Rankin. Mmm, incredibly dark Scottish police procedurals! Just what a girl needs. 

Monday, January 6, 2014

death cold

So this week I learned what it's like to have a terrible cold while a) your immune system is basically defunct and b) you can't take any good drugs. Essentially, what it is like is some sort of ghastly Victorian melodrama but without the laudanum with which the heroine of a Victorian melodrama would invariably be dosed. For three days I lay either in bed or on the couch, coughing racking dry breath-stealing coughs that by day one were already making my ribs ache, blowing my nose until it also was in major pain, and becoming rapidly willing to sell my soul if it meant I could take one freakin' DayQuil. We will not even speak of the nights. Some people might say, "Oooh, good practice for when the baby comes!" but, frankly, while I am growing the baby is not the best time to be rehearsing sleep deprivation, thanks.

Poor Berowne had to deal with not only being the sole person taking the dogs out and running the errands in over a foot of snow and subzero temperatures, but with his wife staggering around like la Dame aux Camélias if said Dame wore a giant puffy bathrobe, had a chafed nose, hadn't showered in four days, and was petulantly demanding pho and tea most of the time. Not to mention that when the cough woke me in the night, it woke him too. The only time he got grossed out by any of it was on Night Three, when the cough finally turned productive and the result was a symphony of phlegm. He's a noble man. 

It is still a symphony of phlegm around here, but I went back to work, which meant a lot of discreet hornking in the work bathrooms and a lot of people commenting on how terrible my voice sounded and then expecting me to talk at length. Yay.

As you can imagine, a fair amount of reading material has been consumed, though if you are looking for promises that I absorbed lots of information or for deep profound reviews, you will not be getting that.

The books:

On Paper: The Everything of Its Two-Thousand-Year History, by Nicholas Basbanes. This starts really slowly, and then is uneven - I found the chapters about books and documents, which were only tangentially about the paper on which those books and documents were written, far more interesting than the chapters about paper-making. But it's definitely comprehensive and Basbanes clearly loves his subject matter. 

Silk Is For Seduction, by Loretta Chase. She's phoning it in a bit, these days. If you enjoy romance novels, I can honestly only recommend her early books. 

The Animal Dialogues: Uncommon Encounters in the Wild, by Craig Childs. Childs thinks he's Annie Dillard and Edward Abbey all in one, which is... not endearing. Also his writing is so melodramatic and forcedly-poetical that it overwhelms the actual, interesting stories he has about nature and animals. All I came away with from this book is that he would be an incredibly irritating dude to go hiking with, since with every sight of bear scat you're suddenly on the road to Damascus. "Aw jeez, Craig's having a religious experience again." 

Dallas 1963, by Bill Minutaglio. Amazing. A description of the years leading up to 1963 in Dallas and how the city became a place where the Kennedy assassination seems, in retrospect, completely inevitable. It's written in present tense and with irresistible momentum, and is pretty horrifying in terms of how people used (and, alas, use) hatred as a point of pride and an open motivator. 

Anno Dracula, by Kim Newman. Newman mashes up every imaginable Victorian book and character into a story about Count Dracula marrying Queen Victoria and taking over England, and for most of the book it's damn fun. The end fell apart for me, but I have to say I quite liked the rest of it. 

The Broken Token, by Chris Nickson. Mystery set in the early 18th century in Leeds. Not too challenging but I enjoyed it.

Spice: The History of a Temptation, by Jack Turner. Informative and fun history of the spice trade and perceptions of spice in cookery, literature, and religion throughout the centuries. 

And now back to our regularly scheduled hornking noises.