Friday, 24 August 2012

Stuff I know now...

(that I wish I'd known last time)

Recently a few people have said to me: "at least you'll know what to expect this time"
I'm afraid my response tends not to be: "oh yes it'll be much easier this time". More: " ahhhhhhhhhhhhh" *terrified, wide-eyed look* "Yes. This time I know EXACTLY what's coming" (vocalising this may possibly have worried a few members of the pilates class. Oops).

But it is true that I have the benefit of hindsight this time and that despite desperately over researching everything before E was born, there were a few things I only learnt through experience. So in an effort to stay positive (and in case I forget them all in the sleep deprivation haze that will no doubt follow Smidge2's arrival) I'm going to put into writing the stuff the books didn't tell me. Listen up SouthwarkBelle:

Baby feeding:
Breastfeeding is really really bloomin hard.
At the start Its excruciatingly painful and not just where you'd expect. It encourages your womb to contract, which really hurts, plus it takes hours and hours and hours so pretty soon you'll have a sore bum too. At some point It will seem like you don't have enough milk, then you will get a cold and not be able to take any drugs for it, which sucks. You will wonder how the human race ever survived when this was the only option and if lactation is now the sole reason for your continued existence. BUT hang on in there for those first months, once you get the hang of it it's cheap, easy and totaly worth it and  yeah, its really rather lovely.

Anyone feeling a bit er Friesian ?

Mummy feeding:
4 or 5 frozen meals in the freezer is not enough. Fill the freezer with as many pre prepared meals as you can before the baby is born. It's not just that you won't have time to cook once it is, no one else will either. Babies eat milk and time - without sufficient preparation you'll just have to subsist on crisps and kitkats. Also- make sure that whatever you cook can be eaten one handed, preferably with a spoon, as you'll probably have all of your meals for the first few weeks while also breast feeding. ( and it is probably considered bad form to drop an entire steak on a suckling infants head)

You won't get much, sometimes none at all, but you'll cope. I have no idea how, but you will. Don't drive yourself mad counting how much you've had and certainly don't start comparing sleep deprivation with your partner. It's not a competition. You're basically both losers in this anyway.

Proof - we did sleep (at least once)

Personal hygiene:
Yes, having a shower is an achievement. If you then manage to find some non sick/milk/dinner encrusted PJs to put on afterwards then that's the mummy gold medal. Actual clothes may be aiming too high though, don't set unrealistic sartorial targets.

Ask friends to lend you DVDs, This will reveal that:
A some of your friends have surprising taste in films,
B breast feeding your way though every series of "The Wire" won't actually lead to your child having a Baltimore accent (phew)

Ask for it. This is going to be really really difficult. You may normally look after yourself,  but this isn't something anyone should attempt alone and you know what? There are lots of really lovely, kind people out there who'd actually like to help. Let them. Right now it doesn't mean you are needy or a burden. It means you are a mummy. 

Everything is temporary
Eventually the baby will sleep, s/he will feed properly and do something other than scream and vomit. There will be first words, first steps, birthday partys and trips to the zoo and those first few weeks and months will be just a tiny segment of your life that you vaguely remember having to get through, before the real fun started!


Wednesday, 15 August 2012

Decisions. Part 1 - Show Me The Stats!

I have a decision to make.

Suddenly I am 26 weeks pregnant (ok I should have seen that coming I know) and it's looking increasingly unlikely that my preferred method of birth (neonatal teleportation) is going to be an option.

So, I have to decide - repeat C-section or VBAC*?

There are a huge number of things to consider physically, emotionally and practically in this but I'm trying to remind myself that childbirth is, at worst, a few days. What comes after, the child, is the rest of my life and his/hers too. With that in mind, safety has to be the trump card.

Recent studies have shown that repeat cesareans are slightly safer than VBACs for both mother and baby, but the risks are so small in both scenarios that you may as well start worrying about being killed in a car crash on the way to hospital. Emergency cesareans are considerably more risky.

So, before I just go for the planned c-section, I want to know this - how likely it is that an attempted VBAC, would end in another emergency trip to theatre?

Billions of women have given birth, millions have had c-sections in modern hospitals, with scientifically trained doctors, and gone on to have more children - we should have the stats on this right?

Well, I'm hoping someone reading this can tell me I'm wrong, but it seems like the answer is no.

When I put the question to my obstetrician he gave me the standard figure - 70% of VBAC attempts result in a vaginal birth. But when I started to dig a bit, there were no more answers.

The thing is, 70% seems a little, well, vague. There are a huge number of reasons for that initial cesarean; a planned c-section for a breach baby, a terrified dash to theatre because the foetal heart rate suggests the baby is in distress etc. etc. What I want to know is - what is the chance of success in my specific situation?

Does the fact that I got to 10cm dilated (all be it with chemical assistance) mean I am more likely to give birth vaginally this time than, say, someone who's previous labour never got going after a failed induction? Or does the fact that my last baby was physically stuck in my pelvis mean my chance of success with a second is less than someone who may well have popped the sprog out easily had they only got the chance?

When you start asking about the specifics, 70% is utterly meaningless. Perhaps 90% of women who had the same problems as me succeed in giving birth vaginally next time or maybe its only 5%. I've plucked those figures from the air but either is possible if there were enough women in other groups whos success/failure rates are different.. 

You wouldn't need elaborate experiments to answer these questions, just someone to keep good records of lots of births and then crunch the numbers.  I spend my working life with scientists who study the tiniest actions of genes and molecules that may or may not  influence rare human diseases. It is exquisitely precise, detailed, study into things so tiny no human could ever see them, the interactions and variables are mind boggling but it's work actual humans can do. Surely we should be able to answer a simple question about getting 8lbs of baby out of a space hopper sized womb?

I need to make the decision in 10 weeks time. What do you think my chances are that a study will suddenly emerge that answers my questions by then?

Perhaps I should just keep hoping for teleportation.


*VBAC - Vaginal Birth After Caesarian

Friday, 10 August 2012

Too much information?

If you've had a difficult experience of childbirth, what do you say to first time expectant mums if they ask you about it?

This came up earlier in the week when I attended a pregnancy pilates class. All the other members of the group were first timers and, after the lesson, the conversation inevitably turned to labour and birth. One lady was telling us about her NCT classes and hypnobirthing sessions and how using this technique gave x% of mothers shorter/drug free/tear free births. Then another women asked me about E's birth.

So what to say?

I got a healthy baby, that's the main thing. But the truth is that it was the most exhausting, humiliating, terrifying experience of my life. After 20 hours of unremitting contractions with only hypnobirthing to help me I'd have sold my soul for an epidural. After a further 14 hours of drugs, interventions, failed interventions and emergency surgery I thought I was going to die and I didn't even care. Frankly, it was all a bit grim.

Or is that a bit too much information?

You're not supposed to tell horror stories to pregnant women, and while I don't agree with the theory that fear is the main hinderance to easy, natural childbirth, I would certainly concede that being terrified can't possibly help. Also, if you leave aside the issue of "truth", then what is the point in giving all the gory details? Will it stop anyone from putting their faith (and large sums of money) into unproven techniques? Will it leave them more prepared for the realities of childbirth and therefore better able to cope? I doubt it.

Thinking back to first time me, if I'd have heard a similar story from a stranger I'd have assumed she was exaggerating. Just one of those people who love to tell you how awful it all is, how afterwards you'll never sleep again and life as you know it is about to thunder down around your ears. First time me would have suspected this stranger had been silly and scared, unhealthy, suffering from some other undisclosed risk factor. Basically first time me would have thought it wouldn't happen to me.

 So what - or rather how much, to say?

The group already knew I'd had a C-section (I'd "confessed" in class in a slightly pathetic attempt to excuse my total lack of abdominal muscles) so I did my best to explain, without any drama, why it had happened.  E was big and back to back, hypnobirthing etc, was fine while everything was normal, but in the end it was just bad luck, her head was stuck in my pelvis and a C-section was the only option.

So should I have said more? Less? I'm not really sure.  I don't want to be that lady with the horror story. Most healthy, western, pilates-class-attending women will have more straight forward births than me whatever I say, so it's hardly sage advice. But I don't want to pretend it was all wonderful, self-affirming loveliness either. If you're a  healthy, western, pilates-class-attending women then you probably get plenty of that already and (at least in my case) too little fear can be just as bad as too much.

What do you think? Is it only right to tell the truth? These things happen and people need to be prepared for them or is it all a bit TMI?


- Posted using BlogPress from my iPad

Friday, 3 August 2012

A Sneaky Peek at Smidge2

E's 3rd Birthday is very nearly upon us, so it's all about her at the moment but we have managed to give Smidge2 a little bit of a attention.

We had a 4D scan with E and were amazed at how much it looked like her when she was born so, even though we're having far more scans at the hospital this time, we gave into temptation and had one done to get a peek at little sister/brother. E found it all utterly fascinating too.

If you find these things spooky - look away now:

Smidge2 at 24 weeks