What not to say to a pregnant lady...

No one should ever ever say anything to a pregnant lady about how big or little she is. Really. Just don't say anything at all. All you should say about appearance, if anything, is "You look great!" or "What a cute shirt."

I'm not someone who's very sensitive about my body. Even for a few years in my 20s, when I gained a substantial amount of weight, and really wasn't healthy, I was pretty sure I looked just fine. I probably should have been a bit more concerned than I actually was.

I thought maybe that would give me a by on the whole pregnancy body image crisis thing, and largely it has (ask me again postpartum, though). But what I hadn't expected was people talking incessantly about how little I am (or rather, how little my belly is). I've been tolerating comments like "is there really a baby in there?" since the very beginning, and now, "You can't seriously be about to have that baby, you barely look 5 months pregnant." These comments are coming mostly from women who have themselves been pregnant, and thus should know better. I am already pretty darn worried about this kiddo, especially since he (it feels so strange to use pronouns) is coming a bit sooner than we thought. I really would rather not be worrying that he might not be big enough in there. (Never mind that my million and two care providers keep assuring me he's growing right on schedule. Between the incessant comments and that story in the "Business of Being Born" where the mom is measuring on target but still has a growth-restricted baby, I can't seem to shake this particular worry).

"A good day in liver land"

Two good things happened yesterday:

1) As Gail said, I got some labs back yesterday that indicate my liver could be a lot worse. We are nowhere near a level that would mean "get-the-baby-out-now," though things can change quickly. That result was for blood drawn when my symptoms were much worse than they are currently (the meds have helped), so I'm optimistic that the next round of labs will be even better. This is good, because the worse this particular lab is, the more risk the baby is in. Thus we can wait a bit longer to induce, until closer to 38 weeks, which feels like a bit of a reprieve.

2) Last night, we went to a meet and greet with the doctors in my OB's group, followed by the hospital tour we never thought we'd take. Last week, when we were first wrapping our heads around things like, say, Gail should meet my OB, I suggested to Gail that we could go to this meet and greet as a way to get more comfortable at the hospital. Her response was so heartbreaking. She was silent for a few beats, then her eyes welled up and she said very softly "but I don't want to meet any doctors..." (Yes, it was a bit overdramatic, but be gentle, we'd only just found out and were deep throws of navigating a major change in plans, all while worrying the baby was about to die).

But by the time we got to last night, we were able to go in with a positive attitude. The doctors were pleasant, and seemed like folks we'd feel OK with at the birth if we manage to get me going before the induction date (now more of a possibility with the date pushed back). The hospital is as hippie-ish as you can get in the area, and they gave answers we were either expecting or comfortable with to questions regarding hospital procedures. The doctors didn't even trip over their inclusive language, which was a nice touch. The discussion was followed by a tour of labor and delivery, and we were both really trying to picture being there, and it being OK. The rooms looked like hotel rooms, and as Gail said, "Hotels are pretty nice."

As we left, we agreed that we're feeling OK with the new situation, especially since it's the one that protects the baby. We're going to make it work, and it might not even be too much of a stretch to do so. Between our warm-hearted feelings towards the hospital, and the encouraging labs, Gail was inspired to say, "It's a good day in liver land," and that's the first time we've been able to say that since last Tuesday.

I am grateful for the chance to be an NGP

In part because of Lyn's recent complications, I've been spending a lot of my time taking care of her. Some of that care is physical: massages are particularly soothing for her right now. Some of the care is emotional. Much of the care consists of doing the lion's share work needed to take care of Leigh and our increasingly filthy house. Lately I'm tired a lot and emotionally drained from all of the worrying. But I'm also grateful.

I've realized over the last few days what a gift it is to be the supportive partner to a woman who is giving birth. I get to be protective and nurturing in way that Lyn does not because she has to be focused on herself and getting her body through to the finish line. I remember from my own labor how completely self-absorbing the experience of labor is. I didn't think about the imminent arrival of Leigh during labor. Mostly I thought about getting myself through the next hurdle. I wasn't being selfish, it's just that labor is a pretty all-encompassing experience; there simply isn't room for anything or anyone else.

This time around I actually get to focus on my love for the people involved. I get to take good care of my wife and do everything in my power to help her have a positive and healthy experience. I get to take care of my baby-to-be, sending him positive energy he goes through the most difficult experience of his life so far. This is an experience unique to the non-gestational parent. You get to pull yourself out of your own head and really be there for two people you love. I didn't realize until there was great need how satisfying I would find that experience.

As for the update, things are looking pretty good. Lyn got back good labs today that leaves us feeling hopeful. Our induction date is somewhat later than we had thought it would be -- not until early in the last week of May. It still may get moved up, but the later date will allow us time to work on less invasive induction/preparation methods like acupuncture.

The milk project continues to go well. On Sunday I pumped 9mL, on Monday 15mL, and on Tuesday 30mL. We'll see what I get today. These amounts might seem tiny, but the pattern looks vaguely exponential to me (with an equation looking something like 5e^0.6). If this trend continues, then in a week I'll be pumping about 68 ounces a day and my breasts will explode.

Oh, and eagle eyed readers will note the use of the pronoun "he." Yes, dear readers and friends, we are having a boy. So there's another new experience we'll get to write about!

The first drops of milk and a brief update

In anticipation of our earlier-than-expected arrival, I decided to accelerate my schedule for inducing lactation. Tuesday night I took my last birth control pill and last night, for the first time in almost two years, I used my old friend the breast pump.

After pumping for 5-10 minutes I was able to produce a couple of drops of milk out of each breast. That might not seem like much, but Lyn and I were both thrilled! This thing may actually work. This morning when I woke up my breasts were noticeably heavier. I let Leigh "help" me pump which meant holding onto one of the shields while I turned on the machine and later pressing the "let down" button. While she watched me, she said, "Ima, your belly button is going up and down!" I corrected her confused anatomy and told her about how I was trying to make milk for the baby. She wants to do it now too.

In other news, I've gone this week from being worried sick to feeling like we have things under control to feeling intense sadness at losing our second chance at a homebirth to feeling ready to take on the problem and back around to feeling worried sick. I'm a bit unstable.

Yesterday, Leigh and I took the bus to the hospital where we peeked in at the maternity ward and ate in the cafeteria. Leigh enjoyed herself (I let her have two cartons of chocolate milk, teddy grahams, and some potato chips in order to encourage maximum enjoyment). However she is complaining about not being invited to the birth itself ("But I want to watch Mama squeeze the baby out"). It was nice to have something fun to do with her and to start feeling more comfortable around the hospital myself.

"Is this your first child?"

This isn't an easy question to answer. In a medical situation, the relevant answer is "Yes" since they need to know I've never been pregnant before, but I refuse not to claim my first daughter, and if I don't mention her, I miss out on all of the great bonding conversation over how cute and infuriating 2 1/2-year-olds are, or maybe some unsolicited advice on preparing the big sister (I actually like unsolicited advice of that sort, I'm kind of weird that way). So usually I say something like "This is my first pregnancy but our second child." If I feel like coming out, I'll clarify that "my wife gave birth to our first." If I don't, I'll leave it at that, and let whoever is asking puzzle out the situation. That all works great if I'm alone. But the last two days, as we've interacted more with the hospital and Gail has been with me, it's not working as well.

Prior to this whole liver thing, Gail was coming to all midwife appts but I was handling the OB appts on my own, since we considered them secondary. She hadn't actually even been to the hospital until our appointment on Monday. Our plan is now for her to come to pretty much everything, since she needs to get really comfortable at the hospital ASAP and it would be good for the various staff/nurses/OBs to see her around. We certainly have plenty of appointments so she should catch up quickly.

We've now had two slightly disturbing incidents where I was asked if this was my first child (once by the PA who does the initial BP check, and today by the very nice nurse who did the non-stress-test that the baby passed quickly with flying colors). I gave my standard answer and indicated that Gail had given birth to our first daughter. In both interactions, the person inquiring immediately turned to Gail and asked her how old the first is (one may have even said "how old is your daughter" to Gail, but I'm not certain), even though they had previously been talking directly to me. The first time, we thought maybe this was just a one-off thing. But the second time, we realized it is probably a pattern, at least in an institutional setting where you have lots of interactions with lots of people who don't necessarily know you very well (this was never an issue with our midwife, but she already knew us, so that makes sense).

In both cases, we did our standard thing where Gail tried to quickly punt questions back my direction, but it was kind of tricky and didn't go all that smoothly (we got in this habit when Leigh was a baby and we had the rule that "whoever isn't holding the baby answers the questions." It was a great trick to make sure we were perceived as a family). This automatic assumption that Gail would answer about Leigh, presumably since she had birthed Leigh almost three years ago, rankled both of us, and Gail proposed that she simply not answering at all next time. It will make for an awkward silence, but might get the point accross. I think we'll try that. Since we're at appointments about this baby, and she's the "note-taker" and "researcher" (she's reading up on all of this, not me) she is automatically doing great public parental interaction re: baby two, so I think we'll be covered on that front.

I also think that, particularly at the NST today, when we were booking about a million monitoring appointments, and quickly talking back and forth in shorthand about what to do for childcare for the various appointment times (certain days necessitate sending Leigh to a neighbor, some times necessitate a grandma daycare pick-up, it gets a little complicated), it probably became very clear that we are both parents to both kids. It is those kinds of interactions that help to break down some of the assumptions that rub us the wrong way, but it is interesting to be reminded, precisely because we are now interacting with so many people who don't know us as a family already, that the assumptions really are there.

The other shoe

While neglecting this blog the last couple weeks, what we haven't been writing about is how this pregnancy has now shifted from extremely healthy and extremely low-risk (although not necessarily easy, see the nose incident and that persistent morning sickness) to a moderately risky one necessitating pretty vigorous medical management. Great. We all know how much I love doctors.

The short story is that over about the last two weeks we've determined that I have developed a not-so-common (but not necessarily so uncommon) liver problem specific to pregnancy, with relatively conclusive labs coming back yesterday morning. I'm not going to name it, because expectant parents read here and you have enough to worry about; you don't a new tempting scary link. I promise, if you really need it, you can find out more than you ever wanted to know starting with the info here, but really, don't look it up unless you have good cause.

In addition to the most insane skin itching I've ever felt in my entire life, which was our tipoff that something was really wrong, this condition comes with substantial increases in scary stuff like pre-term labor, stillbirth, fetal distress and some other stuff. As near as we can tell, the real risk is to the baby, while the risk on my end is primarily completely losing my mind due to being up all night itching and itching and itching. The risks to the baby are minimized (to the point of being nearly eliminated) with medication, sufficient monitoring to make sure things are OK in there, and most effectively, early delivery at about 37 weeks.

Especially given that we've been earnestly planning our home birth, encouraged in our plans by that super-healthy pregnancy I was having, this is extremely unwelcome news. I'm at 34 weeks now. We will most likely have a baby in 3 weeks if not sooner. We had thought we were on more like the 6 to 8 weeks schedule, especially since for first pregnancies, the babies like to come a little late.

Obviously there are plenty of worse late-term complications out there. Even though moderately risky and unpleasant, this one doesn't seem to represent a huge hazard to the baby as long as we do what we need to do. I get that. I really do. But I'm still not happy about it.

We do at least now get some payoff for my putting up with those pesky back-up OB appointments. I was able to get labs through quickly without having to futz around to find a doctor willing to take me this late in the game, and even though I have a general distrust of doctors (oh, except my father, sorry Dad), for a host of reasons, some good and some not, I do at least like this OB, and count her among the "good ones." She was willing to be unofficial back-up for my midwife at a time when that is really not at all politically expedient in this area. She also seems to have a good grasp of what actually is and isn't evidence based in obstetrics. At my appointment this morning, she was extremely reassuring and is handling the transfer of care appropriately and respectfully. I feel like we're in good hands, even if it's not where we want to be.

We had been considering switching from this local back-up hospital to one a long drive south with a better c-section rate, but with our midwife's encouragement, we'll be staying with the local hospital, not only for continuity of care and to avoid the stress of traveling so far for monitoring, but also for the safety of having the hospital close in case of pre-term labor. Our midwife will also be continuing to work with us, but now in a labor support role. We trust her. She's been smart about all of this, encouraging testing at the right time and supporting appropriate transfer of care to a more medical approach. We'll be glad to have her there.

I suppose now we have to figure out what to do with those nice boxes of birth supplies out on our porch. Does anyone need a lot of chux, vinyl table cloths or drinking straws?

Three Years Ago: Looking Forward to Being an Onlooker

The last time Lyn and I were having a baby, we started to keep a joint journal in order to record and remember our experiences. We sent the journal back and forth on the computer, each of us writing in it when inspiration struck. Today I opened up that file and rummaged around in the past, trying to reconstruct the pregnancy and reconcile my thoughts then with my feelings now. We’re going to be posting some findings from this journal from time to time over the next few weeks.

January 2006. (Background: When I was pregnant with Leigh, Lyn was a graduate student and I was a full-time instructor of mathematics at a big-name university. After Leigh was born, Lyn and I had a summer in which we were both on leave. In the fall, I returned to work and Lyn stayed home with Leigh. I was able to take a partial day at home each week while Lyn went into work.)

I've been reading a book about how mothers get the shaft economically, and today I came across a passage in the book that stated something to the effect of that mothers are economically penalized because they are unwilling to be benevolent onlookers while their children are growing up unlike men who don't seem to mind that role. A number of things happened to me all at the same time when I read this. First, I felt a sudden sympathy for men. Perhaps some men don't mind it, but I suspect that many are trapped in the role. This thought led immediately to the second thing that happened to me which was thinking, "Wait, she's talking about me. I'm the benevolent onlooker!" I don't want to be a benevolent onlooker, but how is my family going to thrive if I don't keep working to make sure that we have enough money to live (and even have the "perks" in life like health insurance)?

At the same time I was struck by something Lyn had said a few days earlier -- we're both going to be mothers, so we're both going to be economically disadvantaged by having children. And, I thought, we're also both going to be emotionally damaged by having to make choices that take us away from our children. Next year we are wrestling with the decision of what do to about child care. I'll be working full time and we both think that it is best if Lyn finishes her PhD. So we are likely going to get half-time child care at a daycare center [Note: We ended up choosing full-time care at home, mostly done by Lyn]. Resting on top of all of these thoughts was an anticipation of loss. Earlier this week I said to Lyn that while I thought we are making the best and most logical choice that we can, I don't think that we're going to be emotionally prepared for what it's going to be like to go to work and leave the child in daycare. I'm pretty sure that I thought meant that she wasn't going to be prepared. Because right now Lyn is sitting in the traditional woman's roll. She's the one with the "choice" of being at home with the baby or working outside of the home. This morning I realized that I really meant that I'm not prepared. I know that the only way we can really move forward is for me to go back to work. But while I might be in the traditional "male" roll of breadwinner here, the fact is that my writing right is peppered by the wiggling of a tiny baby inside of me and I will bring that baby into the world just three months before I go back to being the breadwinner.

Lesbians are lucky in many ways when it comes to having children. We have the "spare womb." We also have a spare mom. If I can't be the mom because I have to work, then Lyn can. How great! No one has to give up anything. Except that right now our spare womb, Lyn, is struggling to figure out how she can be a "real mom" when the child grew in my belly and will come out of my vagina and suck at my breast, while I am starting to realize that things might not be so rosy for me after I fall in love with our baby and then have to leave it with another mother for eight hours a day.