Monthly Archives: February 2013

Six reasons to not get an epidural

I have moved! I am now blogging at The Energizer Mommy. Please come join me there!

Let me start by saying that if you want an epidural for your birth, more power to you, go for it! This post is not to judge the decisions of others. It is to ask that the decisions of other not be judged.

Today at lunch I was talking with a coworker who recently decided to go for a home birth for her current pregnancy. As we were talking about out-of-hospital (OOH) birth, another coworker entered the staff lounge and overheard  my pregnant coworker saying she was happy to not be going to a hospital because she didn’t want an epidural and thought it would be harder to avoid if she was in a hospital. The newcomer entered the conversation to say:

“Do you know what my nurse said to me about epidurals when I was in labor? Antibiotics were invented for a reason, and epidurals were invented for a reason. Science progresses. There is absolutely no reason to not get an epidural and to be in pain and suffer through your labor.

I made a bland reply along the lines that being in pain and suffering were not the same thing, but the comment really got to me, probably partially because my pregnant coworker was so happy with her decision to switch to an OOH birth and there was no reason for her to be derided for her desire to avoid an epidural. It is far from the first time I’ve heard such a comment; it is regularly stated by those deriding OOH birthers that there is “no reason” to not get an epidural. The remark, and follow-up statements by the woman, stayed with me, and I began to think of what I wish I had said.

There are reasons to not get an epidural. Just like there are reasons to get one! For some, getting one is the right decision, even if just because they want one, and I do not dispute that.

However, for some getting one is not the right decision. And that seems to be something that many, many people refuse to acknowledge.

I wish I could go back and reply to her again. I would say that there are reasons to not get an epidural, including:

  1. PositioningIf your labor stalls, if your baby is in a poor position, or if, like me, the last little bit of your cervix simply doesn’t want to get out of the way, changing positions is one of the best things you can do to help things get back on track. Additionally, during pushing many people in a hospital have a baby who gets “stuck”, but simply getting off your back and squatting increases the pelvic opening by 30%. Gravity works even while you’re in labor, and your hip joints and other parts’ positions can be drastically changed by how you are sitting/standing/laying. With an epidural you either partially or completely immobilized, and the range of positions you can achieve is severely limited. This may mean a longer labor, a malpositioned baby who doesn’t want  to drop, a cervix that doesn’t want to finish effacing, an “inability” to push out a baby, or many more complications which are created or worsened by being stuck in bed.
  2. PushingIf given enough time and left unmedicated, virtually all women will have the urge to push. The urge does not not necessarily start right when the cervix is dilated to 10, because at that point the baby often drops down into the opening and it can take awhile for the uterus to shrink to be pushing on the baby again, but once your body is ready the urge is nearly irresistible! Pushing is far more effective with an urge from your body. During my labor, because I was so tired, my midwife gave me the option of having her hold my cervix out of the way while I pushed, which I took. My body was not ready to push, and I had no urge for about the first hour. My pushing was progressing, but it was hard and painful. Once I got the urge, however, there was no stopping me! It felt FABULOUS to push! At one point they even suggested I rest through a contraction and I couldn’t; my body knew its job was to push that baby out and she was coming with or without my consent! In addition to the urge, pushing feels a certain way, and the feelings you have during pushing give you feedback on how to push better. Imagine trying to learn how to “roll your r”s while your mouth was shot full of novocaine and you couldn’t feel your tongue or mouth. Even if you could hear yourself and see yourself in a mirror, it would be much more difficult to learn than if you were getting tactile feedback from  your efforts. The tactile feedback a woman gets from pushing is important as well. An epidural takes away or dampens a woman’s pushing urge and her body’s feedback on her pushing. This, again, can lead to many women who are “unable” to push out their baby, though they may well have been able to if they were left to feel.
  3. Pain is not the same as sufferingPain is a part of life. Sometimes it is to no end but to tell us something is wrong, and once we know something is wrong there is no need for it. However, sometimes it is communicative. Would you want to exercise while completely numbed up to avoid the soreness and pain that can be associated with a good work out session? Of course not! That is pain with a purpose. So is labor pain. Pain is a physical response, suffering is a mental response. It is possible to feel pain without suffering, like when you are achieving a good work out. For many the purposeful pain during labor is worth feeling and does not lead to suffering.
  4. Lingering NumbnessI have a friend who got an epidural and asked for it to be very light. Since it is not always possible to control how strong an epidural is with that degree of finesse, she ended up with an epidural that left her completely unable to feel anything from the waist down, and whose effects did not wear off until hours after she had given birth. She really disliked that she was unable to stand, walk, or even adjust in bed, and that she felt so uncomfortable being numb, in the first hours of her child’s life. Unfortunately, there was nothing to do but wait for the medicine to wear off. This type of occurrence is not uncommon; it is hard to control exactly how strong an epidural is. Is this a life-changing side effect? No. But neither is experiencing pain during labor. It may be  a strong reason to avoid an epidural for some women, just like avoiding pain may be a strong reason to get one for other women.
  5. Epidural headacheAn epidural is a medical procedure and has a long list of possible side effects like any medical procedure. One of the most common side effects, occurring in up to 1 in 100 epidurals, is an epidural headache. An epidural headache occurs when the epidural needle, which is supposed to be placed just outside the spine, punctures the dura surrounding the spine. This leads to spinal fluid leaking out of the puncture wound. Spinal fluid surrounds the brain, and if too much leaks out the brain tends to sag and rub against the bones of the skull, causing pain. An epidural headache can range in severity, but can be debilitatingly painful. The duration varies from a few days to months or years, with most healing themselves but some needing treatment. A woman may not want to risk this relatively common complication in the first days or weeks of her baby’s life.
  6. Higher chance of interventions, possibly including c-sectionOne main reason many women have for avoiding an epidural is to avoid the interventions which often come with it. An epidural increases a mother’s risk of longer labor, fever during labor (which leads to antibiotics for mom and baby), perineal trauma (e.g. 3rd and 4th degree tears), and operative vaginal delivery. Some studies show that it doesn’t increase the risk of c-section, but some show it does. For example, one article in OBGYN News (a source definitely not biased towards downplaying a connection) discusses a small study which showed a 30% risk of c-section for women who got an epidural and an 8% risk of c-section for women who didn’t.This larger study of over 2,000 women also found a link between epidural administration and c-section rates. For women who want to avoid these and other interventions, this is a huge reason to not get an epidural.

So to those who berate natural birthers, scoffing, “You don’t get a medal for doing it without drugs!” or declaring, “There is no reason to not get the epidural!” I say, you are wrong. There are reasons to not get it, just like there are reasons to get it. Neither choice is wrong, and the choice should be left for the mother to make without belittlement or scorn.

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Updates

I haven’t been a good blogger, so why don’t I try to catch you up. Each of these things could be a blog post in and of themselves, but since we all know THAT’S not going to happen, let’s go with a bulleted list:

-I started student teaching four weeks ago. It’s been going well. I love teaching and being in a school, and I find it very fulfilling. Baby Love is doing well with her nanny and slowly adjusting.

-I started student teaching four weeks ago. It’s been going horribly. I hate being away from my baby all day. I am counting the weeks (ten plus one off in the middle!) until I can go back to being a stay at home mom. I feel even more lucky than before that I have a husband who is willing and able to support us financially himself and is fully behind me staying home. So much for this new degree.

-One of the things I hate most about being gone is how it affected Baby Love’s nursing. She dislikes the bottle, so is taking much less milk and nursing much less since I’ve been gone. I realize partially this is natural, since she’s taking in more solids, but it feels like this has really accelerated that process. It makes me sad that we’ll never get back the stellar nursing relationship we had before I started working, simply because she’ll be almost a year when I stop, since it feels like this process was rushed to me. I hope she still is nursing regularly when I stop so I can try to rebuild some relationship around it, but right now she’s not too interested. Hopefully this dropping off of interest plateaus or reverses soon.

-Baby Led Weaning is going fabulously. I love it and Baby Love loves it. Every time I watch her explore new foods curiously and openly at her own pace I wonder how I could deny her the opportunity to enjoy and experience her food like this! The other night we went out, and she had an appetizer of cheerios, followed by chicken, carrot, water chestnut, rice, cheese, broccoli, and raw onion (which she ate hand over fist), topped off by half a French fry which she stole off my plate and got in her mouth before I could retrieve it. Half of those foods were new, but she jumped in and tried them eagerly with no fear. She had quite the spread in front of her, and it was adorable watching her evaluate and select her next bite each time. I don’t know many toddlers who are that adventuresome in their eating, let alone 8 month old babies, and I love it! With all my own food issues,I love seeing my daughter growing up without any.

-Another sad thing about being gone is that ec is going out the window. The nanny does potty her some, but it just doesn’t work as well. We’ve gone from never pooping outside the potty to not pooping in it in weeks (which extra sucks as breast milk poop is replaced by solid poop) and barely even tolerating being held on it anymore. It is very frustrating to see all that hard work go out the window, and I hope I can get some of it back when I’m back to being with her full time.

-Sleep is the one thing I have kept you updated on, more or less. It’s..going. Three steps forward, three steps back and I just hope the steps forward were slightly bigger. We were making fantastic progress until we went on a week long cross country trip followed by four teeth cutting in two weeks followed by me going back to work followed by the eight month wonder week/sleep regression. Yeah. I’m not sure how I functioned my first month at work waking up with her 5+ times every night. We’re finally starting to see some progress again towards the positive (*knock wood*). Unfortunately, her longest sleep stretch tends to be the last of the morning…and I get up for work 2-3 hours before her. So I miss it. But with forward progress I can hold on through anything!

-Baby Love has learned a ridiculously cute behavior from her puppy brother. When she wants to move with something rather than trying to hold it in a hand and crawl or cruise she now puts it in her mouth and holds it in her teeth while heading to her destination. It’s ADORABLE. And hilarious.

In summary: I have the cutest, bestest baby ever. The end.

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Sleep myths debunked!

As any good mathematician knows, it takes a solid proof to prove that something is true, but only one counter-example to prove it is false. Allow my baby, who STILL wakes five times night at 8 1/2 months, to be the counter-example to these amazingly prevalent sleep myths.

1) “You should introduce solids, that will help her sleep through the night!”

Scientific studies have proved this one false, but if that’s not enough for you (as it doesn’t seem to be for the large majority of people), it sure as heck did nothing for my baby. Not a darn, blessed change. And I log sleep every night then graph trends, so I can say that authoritatively there was no difference when Baby Love started solids, nor when she started eating a respectable amount of them.

To be fair, this could be because I didn’t start Baby Love on the hard-to-digest sludge known as rice cereal (the hard-to-digest piece is actually why some argue it helps sleep since it sits in the belly) and instead gave her whole fruits and veggies. However, I have a friend who did start with rice cereal and she also saw no difference in her non-sleeping child.

2) “You need to teach her to fall asleep on her own, then she’ll sleep through the night better.”

aka “You need to do CIO,” aka “You should always put her down sleepy but awake,” aka “You need to stop nursing her to sleep.”

This one comes in many forms, all of which are a dirty, disappointing lie. I put so much stock in this one. After all, it makes sense: if Baby Love can’t put herself to sleep how can she put herself back to sleep during her light awakenings? But my sweet daughter has taught me that falling asleep and falling BACK asleep are two very, very different skills. She has been putting herself to sleep in her crib for weeks now consistently, and her sleep is, quite possibly, the worst it’s ever been. I doubt the going to sleep on her own CAUSED the worse sleep, but it certainly didn’t do anything to help it.

3) “CIO’s only drawback is that it’s hard for the mom. If you can be strong enough to do what’s best for your child it will work.”

Actually, no. Studies have shown CIO can cause what extremists call brain damage, and while I certainly wouldn’t look down on anyone who tried it it is not without risk. It also certainly doesn’t always work.

Allow me to give an example. Say you are afraid of spiders. Now say someone locked you in a closet full of spiders for an arbitrary period of time and did not relent no matter what you did; you would stay in the closet until the time was up. This was repeated several times a day for weeks. Eventually you may stop screaming and pounding on the door, you may find your happy place, or you may even decide spiders aren’t so scary after awhile. Alternately, you may reinforce your belief that spiders are the most terrifying thing in the world and start to dread all closets, feeling your stress and anxiety rise any time you approach the area where the closet of your experience is.

Out of desperation I tried CIO one night. After over an hour and a half of desperate, panicked screaming Baby Love finally collapsed into sleep. When she woke it had been awhile so I fed her, and then she started panicking when I approached the crib. I said screw it and we’d call it a night. The next day she got tense if we went upstairs, the tension increasing as we approached and enter her room. She’d cry if we went near her crib. If I kept it up might her anxiety have peaked and broken? Possibly. But it’s also very possible she would have strengthened her negative association with her crib, which we then would have had to work through. As it was we had to build her trust in her crib back up, and months later it’s still not fully back. The problem wasn’t I couldn’t listen to her cry, it was that it made things worse for her.

So there you have it: proof by counter-example!

Now does anyone have some advice that actually works? Because I’ve tried it all.

I’m off to bed. May your night be more restful than mine will be!

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As if I needed another reason

I fucking hate work. All those people who said it would make me treasure the time I had with Baby Love more? They’re wrong.

Do you know what it IS doing? It’s making me angry at her. Actively, strongly angry. She’s a BABY. That is not ok.

Work takes all of my energy. I get home and I’m happy to see her, but I’m exhausted. I have nothing left for any little set back or abnormal fussiness.

And night time…we are having a major sleep regression. It SUCKS. I have gotten frustrated, not been sure how to go on, wanted to cry, and wanted to give up in the past when Baby Love was having a bad night…or week…or month…or lifetime. But I have never felt angry at HER. Always primarily at the situation. Tonight while in her room for the fifth time at 4am I was very angry at her. A hot anger. I knew I had to get up for work in a few hours and I was angry at her for refusing to sleep.

I HATE getting angry at my infant. It’s not her fault. She can’t help it. She wants to be sleeping. But the anger still rose up and overwhelmed me so I didn’t trust myself to pick her up for the first time ever. Never has my frustration with sleep woes been so directed at her. It’s always been at the universe. But now I just don’t have enough spoons to be able to deal with this.

I hate feeling this way. I just want work to be over. But I can’t stop for three more months. And that makes me want to cry.

I’m so sorry, baby. I’m trying to be a good mom even while sabotaging my ability to be so. I love you even when I can’t show it.

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Leaving baby

This week I started student teaching, the last step in the masters program I’ve been in for the past two years. I have known this was coming. Since having Baby Love I was not looking forward to it. But I do love being in the classroom, so I thought it would be ok.

I was wrong.

I haven’t cried. I get to leave while Baby Love is still sleeping, so no tearful goodbyes. While I’m at school I’m busy and happy working with the kids. It’s been surprisingly easy to leave her.

And that is much of what I hate.

I’m gone for most of her waking life now. I miss SO MUCH. If this was all I knew, it would be fine. I do see her awake every day. But comparing it to what I had? What I’m missing is painfully obvious and huge.

People say it will get better. The thing is, I don’t want it to. I don’t want this to be my new normal. I don’t want to get accustomed to missing most of Baby Love’s life. For me, this is not what I want in being a parent.

People told me I would appreciate the time I had with her more. But I don’t. The time feels exactly the same, even now when I’m feeling extra tender; there is just less of it. If anything, I cherish the time less, because I feel like I have to cram more extraneous stuff into it. I need to go to the store, do laundry, run, cook dinner, etc., but now instead of having all day I have a few short hours. Before I was enjoying our pace and fitting things in as I could, now I am less patient because I feel I have to be more efficient.

And on top of that, I need time to decompress from work. I hear working moms say that when they work some they are better moms because they feel more able to be fully present to their kids when they are there. For me, it’s the opposite. Maybe because of my invisible illnesses that made it impossible for me to keep my engineering job, but I cannot be fully present at home when I give all my spoons to work.

Before baby, I thought when I was a SAHM it would be boring. I thought I’d need part time work to feel sane. But I don’t think I do now. My days were full and satisfying. Watching Baby Love grow was amazing, and it just kept getting better. I wasn’t looking for a way out. I wasn’t needing accomplishment elsewhere.

I have a wonderful husband who fully supports me in throwing away this degree for awhile (or forever) and not working once I have it. So I only have the next 13 weeks to get through before I am done for the forseeable future. Done being gone all day. Done missing her time awake. Done missing all the little details of her life. Done giving her my leftover time.

I can try to get through that time. I can look forward to when I am home with her all day again. I can give up on all else, like cleaning and running, so I can give as much as possible to her. But the fact remains I will still miss most of her waking time.

And there is nothing, nothing, I can do to get these 14 weeks back.

And I hate that.

Today my mind was going around in circles trying to find a solution. A way to make both things work. And I couldn’t. There isn’t one.

I will miss the last third of her babyhood. At least, I will miss it in the intimate way I have known the rest of her life, and by a long shot. And there is nothing I can do about it.

I know this sounds silly. I’m sure if I read words like this two years ago I would have rolled my eyes and thought the author was pathetic and needed a life outside of her kid.

But you know what? I love my kid being my life right now. She won’t always be. As my mother tells me, parenthood is a series of letting-gos. Baby Love will grow, she will get more independent, she will need me less, and eventually she will move out and have her own life which I will be only a small part of. And that is right and good. But right now, my baby needs me fully. I am her life, and she is mine. This time is short, it is fleeting, and I want to live it fully.

So I will get through these next thirteen weeks. I won’t count them down, because I don’t want to miss what I do have of Baby Love’s days in the meantime. But I look forward to when I can leave the workplace and she can return to being my world.

Because one thing I have learned about myself since having her, something I would never have thought to be true before she was here, is that, at least for now, I am totally and completely fulfilled being “just” a stay-at-home-mom.

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