Making peace with formula


When I attended a breastfeeding class at the community health unit, I noticed two posters on the otherwise sparsely decorated walls. Entitled “Formula” and “Breastmilk,” they listed the benefits of each. The breastfeeding list stretched the length of the poster, whereas the formula list was…succinct. Throughout the class, formula feeding and breastfeeding were placed in diametric opposition—feeding babies formula was actually likened to raising them on a steady diet of fast food!

 

 

I didn’t think about it too much at the time. Of course I would be breastfeeding; that’s why we were all here. And we had fun in the class, diligently practicing our latching technique with baby dolls and crocheted boobs. I left feeling proud that, by breastfeeding my soon-to-be-born son, I would be giving him the greatest gift I could.

 

Or could I? At no point in the class did they address the possibility of being unable to breastfeed, so I was totally unprepared for what was coming.

 

Perhaps the unplanned C-section was the culprit, but my milk took a long time to come in, and squeezing out the first precious drops of colostrum was excruciating (several different nurses also took a turn, not all of whom seemed to be aware that my breasts were connected to me). I already felt like a failure because I’d needed a cesarean, and this wasn’t helping—I resolved that I was going to breastfeed my son if it took everything I had.

 

Life became a long blur of feeding, pumping, and bleary-eyed researching. I wasn’t able to get much milk from pumping but was assured by medical staff that babies are much more efficient than a pump, and that the latch was good, so to keep trying. Everything I read discouraged the use of formula in these early days because it could reduce milk production, and “breast is best.” I was hopeful that my milk would soon come in, but I worried because my son was losing weight. Still, I was told that it’s normal for newborns to drop some weight in the first two weeks and that, as long as he started gaining soon, it was nothing to be concerned about.

 

But he didn’t start gaining, and at his three-week check-up, our doctor saw the situation for what it was. He secured a next-day spot for me at the breastfeeding clinic in the city.

 

After doing a weigh-feed-reweigh, the clinic doctor disappeared for a few minutes. She returned holding a just-mixed bottle of formula. While my son noisily slurped it down, she said that he must have an extraordinarily tolerant personality, because he seemed so happy, yet he was so hungry. There was no way the amount of milk my body provided in a  feeding could sustain him.

 

My heart broke. My baby, the person most precious to me in the world, was essentially starving, because I was deficient—and, ironically, because I was trying so hard to do what I had repeatedly been told was “best” for my child. On the way home I stocked up on formula, covering the “evil” boxes in the cart because I was so deeply ashamed.

 

I rented a medical-grade pump and every two hours executed a sequence of breastfeeding and then formula feeding, while I pumped out anything left, in an attempt to amp up my production. I drank liters of water and took galactagogues (blessed thistle, fenugreek, and finally, domperidone). My life was consumed with feeding my baby.

 

And I continued to go to the breastfeeding clinic. At each weigh-in I held my breath, praying that he had gained more than two ounces in a feed. It never happened. Finally, the doctor said we’d done everything we could, and my son would need to continue relying on formula.

 

Nothing that anyone had preached about the virtues of breastfeeding had prepared me for this situation. I was devastated. My body had betrayed me—and I, in turn, felt like I was betraying my son!

 

“Sometimes it just doesn’t work,” the doctor said, her voice memorably kind. “Thank goodness we live in modern times and we have formula.”

 

It was the first time I’d heard formula referred to in a positive way. She went on to say that women have been unable to breastfeed throughout history. Only before formula, there were wet nurses.

 

For weeks, I had been feeling like less of a mother. This angel of a doctor assured me I was normal and reminded me that, just by trying, and then by feeding my son what he needed, I was being a good mom. This was something I had desperately needed to hear from a healthcare professional.

 

Moms are so much more than food factories. I couldn’t fully nourish my son with the much-exalted nectar of breastmilk, but he is the daily recipient of as much love and unconditional support as he can handle.

 

Today, three and a half years later, my son stands tall, healthy, and strong. He is curious, athletic, articulate, and compassionate. He eats a wide variety of nutritious foods and, despite his early formula intake, shows no affinity for fast food, preferring his broccoli florets to hamburgers.

 


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How I dealt with gravidarum during pregnancy


They say that every little girl dreams of her wedding day. But all I ever dreamed about was becoming a mom. My mother was one of seven children; there was always somebody having a baby in our family, and I loved spending time with the cute, chubby-thighed little things. I remember my older cousin at her baby shower. She was wearing a red, calico-print maternity dress. When she walked outside, it was as if there was a second sun, that’s how much she was glowing. I thought that’s what pregnancy looked like, red calico and radiance. No visions of bridal gowns for me—that’s what I wanted.

 

So when I finally found out I was pregnant, my husband and I were overjoyed. Granted, the circumstances were unusual: We were in Florida visiting family, but instead of hanging out on the beach, I was in the ER with bronchitis and, unbeknownst to me, the beginnings of morning sickness. Right before I was supposed to have an X-ray, the doctor asked if there was any chance I was pregnant. One urine test later: “No X-ray for you today. Congratulations!”

 

We were beyond thrilled, but by the time we flew home, I was in pretty bad shape. I couldn’t stand up without making myself motion sick, and started throwing up four or five times a day. I was so happy to be pregnant and so miserable at the same time. I thought the misery was temporary, though. Soon I would be glowing and wearing red calico.

 

But it turns out that morning sickness can last an entire pregnancy as a condition called hyperemesis gravidarum (HG). Roughly 1 percent of pregnant women experience its symptoms: nausea, vomiting, weight loss, dehydration, and feeling like you’re losing your mind.

 

I tried all the usual remedies like saltines and ginger ale. Nothing worked. I tried acupressure bands on my wrists—no luck. The doctor prescribed Zofran, an anti-nausea medication, which was my savior… for about three days, until it stopped working.

At work, teaching second grade, I relied on colleagues to watch my class while I ran to the bathroom, hand slapped over my mouth. (I may have even thrown up once in the classroom trash can.) I drove more than an hour each way for work. I prayed I wouldn’t have to stop on the highway, but there I was flinging the passenger door open daily to throw up with traffic rumbling past.

 

The weeks came and went and morning sickness stayed. I was eating like crap, not gaining weight, and couldn’t keep down prenatal vitamins. I worried about my baby. The doctor assured me that the hormones making me sick were keeping the baby healthy and safe and that my body would make sure the baby got what it needed. The lack of nutrition was only going to impact me. Great.

 

Sometime during my second trimester, with an empty stomach and seriously dehydrated, I went to the ER. The IV drip made me feel better than I had in weeks. I wanted to take the stupid thing home with me, which many women with HG end up doing. The doctor prescribed a different anti-nausea medication. It worked for a week, before the nausea came roaring back like a Mack truck to flatten me again. Several weeks before my labor, I was throwing up every day. I discovered I could keep green beans down—until I couldn’t. My husband grilled steak when my doula worried about my iron and protein levels, and though I’d been a vegetarian for years, my body convulsed with relief as soon as I tasted it. I ate meat steadily until I went into labor.

 

During my pregnancy, I heard from other women who had experienced HG but went on to have other children, experiencing HG all over again. They assured me that once I was holding my baby, I would forget all about it and would perhaps even brave another pregnancy.  

 

In the delivery room, I threw up about five minutes before I pushed the baby out, at which point the relief from the nausea was immediate. Some women with HG have a hard time recovering from childbirth, but I felt like a million bucks. After nine months of definitively not glowing, I was finally glowing. Somebody bring me my calico!

 

People were wrong. As you can see, I didn’t forget about the misery of my pregnancy. They were right, though, that it was all worth it. Damn if they weren’t right, too, that I’d do it all again for another baby.

 


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Milking it


The first time I breastfed in public, I hid. I found a deep, dark corner at the American Museum of Natural History, near the mountain goats and brown bears, and I hid. Baby was three weeks old and hungry, having just taken his first trip on the subway. I was 38 and struggling, leaking and awkward. Burrowed into the corner, I shielded my hungry son and exposed breast with my hunched body and what felt like 82 blankets. When my husband got up to go to the bathroom, I panicked: Who would hold the covers?

 

And then I had another thought: If it’s this hard three weeks in, how am I going to keep doing this?

 

Minutes after he was born, my son nursed for the first time. I’d expected a moment of blissful bonding, but at the time all I could think was “Oh, so that’s what nipple clamps feel like. Pass.” When my milk came in a few days later, my breasts hardened into solid spheres worthy of a 1980s centerfold. Pass again.

 

But then, after much trial and error, he latched and began to nurse, my life flowing into his. Never had I felt more mammal.

 

Twenty-four months later, I was still breastfeeding that child. To my even greater surprise, I was still doing so in public, this time without shame. I have whipped out a nipple while ordering a meze in a busy pedestrian plaza in central Athens. I’ve nursed my child totally unsheathed, with nary a blanket in sight. I’ve even made eye contact.

 

Honestly, I always thought women who breastfed toddlers were kind of kooky—the kind of women who make their own yogurt and use crystal deodorant. Yet I had somehow joined the ranks of women who breastfed children who were capable of using forks.

 

Even though it was clumsy at times, breastfeeding brought us together. He’d roll against my stomach or rest a tiny starfish hand against my arm. Unlike some infants, mine didn’t inherit a cuddling gene. While he breastfed, though, I was able to experience that closeness. So I kept nursing. Through his first solid foods—an apple, a scrap of dosa, a Trivial Pursuit card—to the six-month mark, then on to the one-year mark. By then he was eating whatever my husband and I were, along with drinking cow’s milk. At 18 months he could hold a cup and say “pweazeee”; at two years, he could help order the pita that went with the meze.

 

I practiced breastfeeding on demand, which is exactly what it sounds like, emphasis on “demand.” On the one hand, I loved having an instant, always available soother, a readymade wound healer and problem solver. I felt like a magician casting a never-fail spell.

 

On the other hand, the magic milk came with a cost. I had to be always available, regardless of circumstance or location. Mom’s Cafe was open for business, 24/7. Although I might have preferred the comfort of my couch or bed, it was rarely up to me (welcome to parenthood, I know). Playgrounds, churches, planes. The uptown C train, a sailboat with my in-laws, the tomb of Agamemnon. To keep up my supply, as well as our physical bond, I had to overcome any hesitation—initially about doing it in public, and later about doing it with a walking/talking child— and just do it.

 

Some women decide not to breastfeed. Some women cannot. Some women breastfeed but stop when the kid becomes capable of intelligible conversations. You’ll hear no judgment from me, at least not anymore: all of us are doing our best to work with whatever we’ve got, in whatever situation we’re in.

 

Everywhere we turn, there are stories of women being shamed or sexualized for breastfeeding. Thankfully I was l lucky enough to never experience either, even as Baby grew into Boy. He called my breast milk “manna,” less a reference to the Bible and more a corruption of “Mommy snack.” He’d pull off my breast to launch into a monologue about trains or tractor-trailer trucks. There was no precipitating incident, no comment from a friend or family member implying that Baby was too big to breastfeed, but I began to sense the time had come for us to stop nursing.

 

At 27 months, my son was down to one pre-nap and one pre-sleep feeding. By this point, I’d hit every milestone I’d set out to hit: first minutes of life, six months, one year. I kept going because I liked the physicality and the intimacy. But I worried that going even further past the two-year mark might push me into the aforementioned kooky territory, and goodness knows I’m loyal to my Lady Speed Stick. My vague sense about timing transformed into resolve after my pediatrician mentioned that breastfeeding not longer had any benefits for Baby, and could possibly have some detriments.

 

The internet will disagree, of course. Plenty of people, especially outside the United States, choose to nurse children until they are three, four, or older. But stopping felt like the right decision. For me.

 

“Manna?” he asked hopefully one night. “No manna,” I said. He handled the news with his usual equanimity. Perhaps it had been time for him too. He never asked again.

 

I found new ways to soothe and help him. He discovered his daddy’s special storytelling powers, which helped him unwind before bed. Although not anti-cuddle, our son prefers what he calls “love attacks”: charging at us from across the room, arms outstretched, mouth primed to tackle us with kisses.

 

The other day he shoved a stuffed animal in his shirt. “Look, Mommy,” he said. “I have a baby in my belly.” He moved it higher, onto his chest. “And now it’s hungry.”

 


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The importance of a birth plan


The thought of giving birth has always terrified me—in fact, I have always had to mentally prepare myself for hours before a gyno appointment and reward myself afterward. But I assumed when I got married that I would have lots of time to think about ways to conquer my fear of pregnancy, especially because I figured my type-A personality would kick in and help me plan: first for when my husband and I wanted to start a family, and then for how to actually go about giving birth. But less than a year after our honeymoon, I was nine months pregnant without much of a plan at all.

 

In the early months of the pregnancy, I would check my Pregnancy Tracker app to see what was happening with our little burrito and my body. I tried reading the labor section of What to Expect, promptly burst into tears, and put the book in the back of my closet. About the time I could no longer look down and see my toes, my friend suggested I go to a prenatal yoga class. The class was centered around community: We sat in a circle facing each other the entire hour, went around doing a check-in, and sustained conversation the entire practice. The yoga teacher was also a doula and was a wealth of knowledge on all things pregnancy and birth.

 

Each week she had a topic of discussion for when our class conversation lulled. Each topic made it clear that I was traveling a different pregnancy journey than these ladies. The majority were planning home births, and I was going to a hospital; they were investing in cloth diapers, and I was stockpiling Target diaper coupons; they were afraid they would have to get an epidural, I was afraid I wouldn’t be able to get an epidural. The most glaring difference between us was that these women had been preparing for their births in various ways—they read books, they took classes, and they had a birth plan. I did none of that.

 

When it was my turn in the circle to talk about my birth plan, I boldly stated: I want an epidural and I want to give birth. When pressed, I was also able to articulate that I probably wouldn’t want to be induced, because it sounded horribly painful. After class, the doula-teacher tried to express to me the importance of having a plan—but I wasn’t having it. Despite my super rigid, type-A tendencies, this, of all times, was the time I decided to freestyle it. My inability to cope with whatever vagina-induced trauma I had built up throughout my life translated into an avoidance of the reality that I would in fact be giving birth sometime soon. I preferred to ignore it.

 

Looking back, I am thankful for that prenatal yoga class for many reasons. Most importantly, it led me to begin contemplating some semblance of a birth plan, even if I never solidly committed to one. But I did start to look into some things, namely what being induced actually meant and how to deal with it if it had to happen. There was more I could have done: I could have chosen music, taken hypnobirthing classes, repeated a mantra, or spritzed essential oils on my face when I felt like my experience was becoming more than I could handle. But I didn’t do any of those things. In fact, I mocked some of those things. And, when the time came, I grasped for anything I could, well aware that I was not mentally equipped to deal with my situation.

 

My birth ended up only following one part of my “plan”: I gave birth. I developed extremely high blood pressure and was induced a week before my due date. I knew that induction could slow down a labor, so I was able to plan to steady myself until I hit my desired level of dilation, and I made it through delivery. Luckily, I had my husband and my mom in the room and a team of nurses that were able to say things I needed to hear and support me in ways I needed, but when it was all over I found myself wishing I could have supported myself a little more. At the time, I felt justified in not having a plan. I felt as if I’d won some sort of argument with my yoga group—I couldn’t even execute a plan with just two stipulations. I realized later that the women in that circle didn’t have birth plans for how everything was going to be, but they had hopes for how it should go and back-ups for when their births were no longer going the way they planned. Instead of planning for a perfect birth, they were planning for when things would inevitably go awry.

 

There were many aspects of my birth that I was not prepared for that I wish I had planned for better—or, you know, at all. For instance, I wish I had prepared myself for coping with the emotional aspect of giving birth. Although pushing a human being out of my vagina was about as pleasant as I had anticipated, what I wasn’t ready to deal with—what I refused to deal with—was the emotional stickiness surrounding my panic. If I couldn’t make it through a gynecological exam, if I couldn’t make it through months of nurses and doctors, why did I think I would be able to endure hours of birthing without some sort of plan to manage my emotional state? If I give birth again, I already know where I need to begin.

 

Months later, I was able to reconnect with many of those mamas in a “baby and me” yoga class with the same yoga teacher. We each came into the circle with our own birth baggage—the things that didn’t go according to plan, the things that did, the unexpected, and the beautiful. It became clear that despite this, most of the women in the circle had been able to weather their births, no matter how difficult or unexpected, at a level that I could not. After all, it’s easier to stock up on information and strategies and then adjust the course than it is to show up without a map.

 


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The power of midwives


When I had my first child, I unexpectedly went into labor on Christmas Eve, (a little over three weeks before my due date). And that’s when I met Maureen, my assigned midwife. At a guess, Maureen was 15 years older than me. She had short blonde hair and wore royal blue scrubs and a friendly smile. I found her Santa hat and flashing Christmas earrings a little disconcerting, but I liked her immediately.

 

Midwives’ jobs are many—and in Australia, where I live, midwives are always a part of the birthing staff in the hospital, along with an obstetrician. They undertake numerous medical and patient care duties. Midwives examine, assess, monitor, test, advise—all necessary and important responsibilities. But they also provide a deep level of emotional support and practical guidance during labor, much like a doula does in other parts of the world. In my case, Maureen moved from stranger to trusted support person in a flash.

 

My partner and I were nervous but excited, unsure but hopeful. Without being pushy or falsely familiar, Maureen cultivated a sense of trust. I used a gym ball during much of my labor to help manage the pain of my contractions. Between some of the contractions, we’d chat. It was like having a cup of tea with a friend, except it was 3 a.m. and I was partially naked and leaking fluid.

 

As my labor intensified, Maureen’s approach shifted to match. She moved into more of a coaching mode. She’d offer gentle guidance like “Would like to try this?,” “Why don’t we dim these lights a little more,” and “Try resting completely between contractions.” You could tell she had a deep pool of acquired birthing wisdom to draw on. Not the stuff of medical textbooks or patient care models—she understood and respected the birth process and the capabilities of women’s bodies. She also knew how to be present and simultaneously give enough space—a tricky feat.

 

Finally, a moment came where I felt like I couldn’t go on or cope any longer. I suddenly felt out of control, my rational mind left me, and everything felt strange and primal. Maureen took swift action; she moved me into a position ready for birth and called the obstetrician. She knew I was in transition. I met my sweet Christmas baby 45 minutes later.

 

The thing is, up until the moment I arrived at the hospital, the role and contribution of a midwife weren’t really on my radar. During my pregnancy, I’d been a diligent student: I went to prenatal classes, read books and fact sheets, and talked to my doctor. I “understood” the basic mechanics of the birth process and gathered information about birth techniques, medical options, potential risks, and interventions. I had some sense of my preferences, but I didn’t “get it.” How was I actually going to give birth? How could a healthy baby possibly emerge from my body and both of us be OK?

 

It turned out I’d somehow overlooked just how integral midwives can be in supporting you during birth—a vital lesson I learned with Maureen by my side. Aside from medical due diligence, what did she bring to my birth process? So much. Birth wisdom, care, compassion, reassurance, and practical guidance. She fostered an environment that was conducive to a positive birth experience. And she bore witness to a wondrous event — the safe arrival of a tiny human and the making of two brand-new parents. It’s difficult to say for sure, but I think if Maureen hadn’t been in the birth suite with me during labor, my experience would have been vastly different—she directly contributed to my positive experience.

 

I regret that I didn’t connect to a midwife before my birth. My chosen care model wasn’t geared that way, and at the time I didn’t understand the implications. I underestimated (or failed to consider fully) the power of midwives, but their depth of understanding and experience is invaluable.

 


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Homebirth was a badge of honor with my first— not so much with my second


My two children came into the world in pretty different ways: one dictated by ideals and the other by practicality. And while one of those births may look better from the outside, both of the experiences are precious to me, as are my two very different, very loved, children. And just like my kids teach me daily about being their mom, my births taught me about myself and how motherhood—sometimes imperceptibly, and sometimes all at once—changes everything.

 

For my first pregnancy, I knew that if my body and the medical profession would allow it, I’d have a homebirth. I read books on natural labor, like the classic Ina May’s Guide to Childbirth, and practiced nightly with a hypnobirthing CD. Homebirth felt like a means of proving my fortitude, a perfect complement to the all-natural, yoga-teaching street cred I had worked hard to cultivate. It felt important to set the tone for the kind of ideals-driven parenting I would soon rock; I was more determined than afraid.  

 

 

On a cold midwinter’s night, regular contractions began. All through that night I was wakeful but calm—sitting, standing, pacing, breathing, staying present with the pain. By morning, my midwife had arrived, and the contractions were growing more intense. Sometimes I would get down on all fours and pant as if it were a blazing hot summer day instead of January in D.C. The female animal part of me was taking over, and that part didn’t give a damn about appearances.

 

As labor dragged on another day and night, I felt in each moment like I’d reached the limit of my capacity to do what I was doing. But the next moment I had to—and did—continue. My mother, anguished at my pain, begged me to go to the hospital. But barring an emergency, I didn’t even consider it.

 

After hours of pushing, my son was on the threshold, but stuck. Despite every effort to move him one excruciating centimeter at a time, he would fold back into me again and again. “I don’t usually do this,” said my midwife softly, “but I could cut an episiotomy.”

 

Knowing the answer in all of my tissues, macerated with pain and effort, I uttered just two words: “Do it.”

 

She took a scalpel to my most tender parts. The cut hurt—but not nearly as much as the seismic pulses my womb had endured— and with relief and a rush of blood, my healthy son was born.

 

Moments later, I held his slippery body in my arms and knew that though the pain was real, it was in service to this life. I would now do anything to shepherd and nurture him.

 

My husband stood next to the bed with his hands on our son’s small back, tears in his eyes. At that moment my mother rushed in and snapped a picture of us looking wrung out yet substantial. The pain and my determination to get through the birth, followed by the dawning realization that, ready or not, we were parents had brought us wholly into the moment where nothing else mattered.

 

*

 

Though it took two months to recover from the tearing and episiotomy, I was proud of my homebirth. It felt like a badge of honor, like something I had to do.

 

Not so the second time.

 

Life circumstances had changed by the day, three years later, I faced giving birth to my daughter. My family had recently relocated to California, where I felt disoriented and isolated. Immersed in the beautiful mayhem of meeting a toddler’s constant needs, labor was something I began to see as important—not as an end in itself—but as a gateway. Perhaps, I remember musing in a haze of sleep deprivation and exhaustion, labor wasn’t the biggest decision of all; perhaps I could reserve my grit for the after-part, the mothering of two children that would follow.

 

My new midwife—cheery and efficient—also advocated homebirth, but I wasn’t convinced this time. As a mother who’d been in the trenches for a couple of years now, I had slowly, almost imperceptibly, migrated from the aspirational side of the birthing question to the practical one. But I neglected to tell my midwife how I felt, worried about what she and others might think.

 

With my second pregnancy, labor wouldn’t progress even after my water had broken. My midwife seemed dismayed that we would now have to go to the hospital, but in truth I wasn’t. I knew what awaited me afterwards: sleepless newborn nights, days with a needy toddler, the mothering of two. Labor, this time, was just something to get through.

 

At the hospital, Pitocin to start contractions led to more Pitocin to intensify them. When I asked for an epidural, my midwife’s face fell. “But you’ve done this before,” she said with the hint of a plea in her voice. “We know you can have a natural birth.” But it wasn’t that I couldn’t endure a second natural birth—just that I didn’t want to.

 

After a night’s labor on the epidural, my daughter was born into a clear California morning. And this birth, too—even with all the interventions and pain meds I once thought I would never accept—yielded exactly what it was supposed to: a healthy baby and mother. When my daughter, a tiny, perfect package of swaddle and powerful lungs, was handed to me, I felt just as swept into the gravity of that moment as I had with my first.

 

Giving birth, at its core and essence, is this: welcoming a child with open arms. Vowing to protect, nurture, and love the child from that moment on. I don’t need any particular kind of birth for that to be true.

 

My newborn daughter writhed and screamed, as she was meant to do. I put her to my breast, and though I was still numbed from the waist down, colostrum flowed. The birth was done, nothing left to prove.  

 


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I had hoped for a natural birth—but that’s not what I ended up with


Although I was desperate to have children, I wasn’t excited about the prospect of giving birth; in fact, I often wondered how the human race has survived at all. I’m terrified of pain, even more terrified of needles, and I can’t stand hospitals. But I figured I’d get pregnant and then worry about my phobias. So that’s what I did.

 

I knew how painful labor was supposed to be, but I wanted a natural birth without any drugs.  Plus, the thought of a giant epidural needle made me want to die (and I knew it had the potential to affect the baby too). I also wanted to avoid a C-section at all costs, because there was no way anyone was coming near me with a knife. So with these dilemmas in mind, I devised a genius plan to have a pain-free, drug-free, needle-free birth. It involved hypnobirthing and a water birth. I should also mention that I’m a control freak and like everything to go according to plan. Perfect for childbirth, I know.

 

I loved the idea of the more relaxing experience of a water birth. And I was drawn to hypnobirthing because of the promise of a gentle, calm, and natural birth. The theory is that the fear associated with childbirth actually creates physical pain. The program “unteaches” you all the negative things you might think about birth and instead instills techniques for breathing, visualization, and self-hypnosis, which are all meant to help you reach a state of deep relaxation during labor, to combat the fear and consequent pain. Ideal for me and my phobias.

 

I dragged my husband to weekly hypnobirthing classes, which I could tell were way outside his comfort zone. We watched videos of relaxed earth-mother types in labor, read self-hypnosis scripts aloud, and did group visualizations. I also listened to the relaxation CD we were given every single night. Finally, when I was 10 days overdue, I arrived at the hospital to be induced. But I was told the water birth was a no-go as soon as the doctors realized I had a heart murmur. I should have been given antibiotics in advance, but this somewhat important fact had been overlooked, and it was too late. My heart sank. My careful plan was already falling apart.

 

Once I was induced, labor started quickly, the pain going from 0 to 10 in what seemed like minutes. I forgot everything I learned in hypnobirthing. I no longer felt in control. The air turned blue as I screamed the F-word every time I had a contraction. I couldn’t help it. Meanwhile, my husband froze like a rabbit in the headlights. I think he was wondering if I had been possessed by demons. I remember thinking “how I wish I’d arranged a doula.”

 

After five hours of contractions, which felt like 15, I was told I had dilated less than half an inch. This was not the news I wanted to hear. Then things suddenly shifted up a gear as the baby became stressed, and within minutes they were prepping me for the C-section I didn’t want. What followed was a blur. I still had to have that giant needle in my back to numb me, and I had to be knocked out, as they didn’t have time to wait for it to work.  

 

Fast-forward an hour or so, and I came round. The nightmare was over. In my arms was my beautiful, tiny baby, but instead of the pain-free, drug-free natural birth I hoped and planned for, it had felt more like a horror movie, with me playing the lead role. I had been subjected to all the things I had been desperate to avoid and I couldn’t do a thing about it. The ordeal put a damper on what should have been a very happy moment and I had conflicting emotions. Of course I was thankful for my baby, but I also felt traumatized, angry it didn’t go the way I wanted, and annoyed with myself for not being tougher.

 

Did it put me off having another one? Despite everything, no—and I realize this is why the human race has survived. Did it make me braver? I wish I could say yes. Next time around, I had to have a planned C-section, so I chose to be knocked out (anything to avoid that epidural). It still wasn’t easy, but at least I knew what was coming.

 


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Learning to love again after childbirth


Having a baby was  the most mind-blowingly positive experience of my life—and there’s nothing I’d give back about it (save a few stretch marks). However, as happy as my husband and I were to get pregnant and become parents, my son’s birth also created a tectonic shift in our relationship. It wasn’t just disorienting—it was a terrifying vertigo of hormones and logistics and new pressures that, for the first time, threatened to rock the foundation of our previously impenetrable bond. The pull from the new (little) leading man in my life was an unexpected, destabilizing force in our marriage, and for a time, I worried my heart had strayed too far.  

 

 

For starters, in the maelstrom of post-childbirth chaos, we broke every single rule about the basic care, feeding, and upkeep of a relationship. It was simply too easy to put all kinds of other stuff, important as they were, first: sleep, work, baby playtime, alone time, health. But after a while, these misallocated emotional expenditures backfired: We found ourselves quick to anger, jumping to the worst conclusions about each others’ intentions, and not giving each other the benefit of the doubt. And, predictably, not having sex.

 

Like so many couples in the early days of postpartum parenthood, it wasn’t hard to replace sex with almost anything else—an extra snooze, half an episode of GOT, a shower—but for us, weeks rolled into months until one day we woke up to realize we were living more like roommates than partners. But sex wasn’t the half of it. Whether by choice or circumstance, we stopped doing almost anything we previously enjoyed in couplehood: art festivals, wineries, hiking, getting champagne-tipsy, a sweet nightly ritual we used to call “candle time” (i.e., reading and cuddling before falling asleep). In fact, even when we tried for candle time now, the candles themselves bothered me; behind weary eyelids all I saw were dancing strobelights of agitation; I asked for them to be blown out. Cuddles—mine—had become twitchy with new anxieties. And perhaps revealingly, my husband started sleeping in the guest bedroom to avoid my uncontrolled, dead-tired snores, too sonorous for even his exhaustion level.

 

We were both clearly, criminally, letting our son’s needs eclipse our own. And the transgressions took other forms, too: mistrust, for the first time, came crawling into our relationship and tried to take root. We each now felt separately, immensely responsible for The Most Important Thing in the Universe, and it sparked a whole new level of concern about how things were done, why they were done, and who was going to do them. We questioned each other’s decisions. We balked at technique.

 

But perhaps our worst mistake—because it’s the one we got wrong from the very beginning—was to assume that the mostly inconsequential problems that plagued our pre-kid relationship would stay the same size forever. Small problems though, left unfettered, have a way of growing into big ones. Particularly under the stress, weight, and pressure of parenthood. What was tolerable as two mature adults going about our lives became less so as a just-getting-acquainted threesome.  

 

So we did hard things. We had tough conversations. We also got help, in the form of counseling. In session, we got to take out all those old incompatibilities, dust them off, and give them the time and attention they’d always deserved. To decide what to do about them as the two mature adults we still were, after you washed away the layers of excretions, playdough, yogurt, and goo.

 

A few new realizations helped, too. We let go of perfection. We started trusting each other again, by accepting that one of us doesn’t always have to be wrong for us both to be in the right. And though it took some creative (and sometimes unsexy) approaches to find the fun and intimacy in our marriage again—like snore strips, mandatory date nights, expensive champagne, and candle time 2.0 (this time sans fire hazards but replete with dim lighting and plenty of cuddles)—we eventually did.

 

The most cherished of our new strategies, though, has been the institution of a ritual we call “firesides.” Every so often we’ll give ourselves the time and space to discuss the things in our relationship that deserve attention. My husband jokingly refers to them as “organized fights”—but in truth they’re the healthiest of preventative measures, moving our communication forward, if doggedly, so we can get by. So we don’t get buried in another quake. And all of this, simple or unglamourous as sounds, were the makings of the boost we needed to get up and out of what felt like the Grand Canyon of post-kid slumps.

 

In other words, we found our footing again. Our child got older, we course-corrected, and the crisis we thought was the end of our marriage, wasn’t. Hard-fought lessons, for sure—but the biggest for me was remembering that the heart is a mutable muscle, capable of growth, expansion, and forgiveness. In mine, I’ve now built a sturdy home for both of my leading men—and am now convinced ours is a family love story that’s only just begun.

 


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Urination & pregnancy: What frequency is normal?


Ask anyone—whether they’ve been pregnant or not—what one of the symptoms of pregnancy is, and they’re bound to say frequent urination. The fact that pregnant women pee a lot is by now  widespread knowledge. In fact, going to the bathroom more often than usual is many women’s first indication that they’re pregnant. But why does it happen? And how much should everyone be peeing, anyway?

 

pregnant woman standing behind wall

 

Why pregnancy leads to frequent urination

There are a number of reasons why pregnant women pee a lot, often so frequently that they’ve memorized the location of every bathroom everywhere they go. Let’s break down some of the most common causes.

 

Hormones. As soon as that embryo implants in the uterus, the body starts making a hormone called HCG, which is meant to help the body support a growing baby. HCG sends more blood to the kidneys, making the kidneys process waste more efficiently—which also means more urine. The amount of blood circulating in a pregnant woman’s body is higher too (by a whopping 50 percent!), so not only are the kidneys working faster, they’re also just processing more blood than they’re used to!

 

Pressure on the bladder. There’s not a ton of extra room inside the body, and the uterus obviously needs to expand. It goes from being roughly the size of an orange to being the size of a watermelon—and in doing so, it pushes the surrounding organs around. Therefore, sometimes the bladder gets shoved into especially uncomfortable positions. Not only that, but by the time the third trimester rolls around, the rapidly growing baby also often puts pressure on the bladder. This can cause frequent urges to pee and can also lead to some stress urinary incontinence, meaning involuntary leakage.

 

UTIs. Unfortunately, pregnant women are exceptionally prone to urinary tract infections; about one in three experience one. This happens because the bladder, due to its awkward positioning during pregnancy, has trouble emptying completely and stays open longer, giving bacteria more opportunity to enter and infect it. In addition to a UTI’s unpleasant symptoms such as pelvic pain and a burning sensation, frequent urination is also a common side effect.

 

Drinking water is important! In addition to all the bodily changes that are influencing your peeing patterns, there’s also the simple fact that pregnant women have a steady fluid intake. It’s recommended that pregnant women drink 10 glasses of water a day—which, frankly, would make anyone pee a lot even without extra hormones and bladder pressure. (The average bladder holds 16 ounces, so no wonder it needs constant emptying.) Drinking water is vital during pregnancy because dehydration can trigger pre-term labor. Water also helps prevent UTIs and constipation, which about half of pregnant women experience.

 

How frequent is frequent?

It’s hard to say what’s “normal” when it comes to peeing, because everybody (and every body!) is different. But a non-pregnant person usually pees around six to eight times a day, or about every two or three hours. There’s no set rule for a “normal” amount for a pregnant woman to urinate either, but the number of times she goes to the bathroom is bound to increase. Just how much depends on individual circumstances and on the stage of the pregnancy. Some women report going to the bathroom once an hour; others say they feel like they’re peeing 20 times a day during waking hours.

 

Waking up to go to the bathroom in the middle of the night is also typical. While most (non-pregnant) people are able to sleep through the night without urinating, it’s not uncommon for women in their third trimester to get up three or four times a night needing to empty their bladder.

 

Frequent urination starts in the first trimester largely due to changes in hormonal balance. In the second trimester, many women experience a bit of a respite as the uterus rises out of the pelvis and into the abdomen, releasing some pressure. However, by the third trimester, when the uterus and the baby are both large, the pressure becomes intense and the urge to urinate becomes incessant.

 

How to prevent frequent urination

The truth is that frequent urination during pregnancy is basically inevitable.

 

But a few factors might be able to mitigate it somewhat. First, hydrating often early in the day can help you drink less in the evening, which might make the nighttime intrusions a bit less prevalent. But it’s imperative not to dehydrate yourself in an effort to pee less; that will only have adverse effects on both you and the baby.

 

Avoiding caffeine can also help, as can leaning forward to urinate (which helps empty the bladder), and doing exercises to strengthen the pelvic floor. Using incontinence pads and liners can also be useful to manage any surprise leaks.

 

When does it go back to normal?

After the baby is born, women might still experience frequent urination for a few days as the body starts to reorient itself and flush out any excess liquids from pregnancy. Most women are peeing on a normal schedule within a week.

 

However, for many women, frequent urination and UI don’t always go away immediately—and sometimes not at all. If you experienced bladder leakage during pregnancy, that might linger for months because of a change in the strength and structure of the pelvic floor. Doing regular exercises can sometimes help bring the body back to normal—and a number of products can help keep any embarrassing or unwanted situations at bay.  

 

 


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Non-binary & experiencing UI: A unique perspective


What does it mean to be nonbinary? To me, it means that I feel safest and most authentically myself when I live in the gray area when it comes to gender. I’m not a man or a woman, I’m something else. I’m masculine in some ways and feminine in others. I’m free of rules and roles based on gender, which is truly liberating.

 

Unfortunately, the world has not caught up yet when it comes to nonbinary gender identities. There’s still a lot of work to be done around the gendered language we use every day. Gendered language is everywhere! It’s in our day-to-day language and educational tools; it’s even on our street signs. And it’s especially prevalent in the medical industry.

 

Going to medical appointments can be extra triggering for someone who experiences gender differently than your average cisgender man or woman. That’s because the language used by medical professionals is often purely anatomical and paired with gendered language that refers to a “typical” cisgender male/female anatomy. Talking about “women’s health,” when discussing ovarian cysts is one example of this. How does using that kind of language impact someone who is not a woman but has ovaries? It can make you feel invisible, demeaned, and uncomfortable.  

 

When it comes to my personal experience with the medical industry, I’ve had to do a lot of work around self-advocacy. Asking that offices only refer to me as J, the non-gender-specific name I’ve used for many years, is just the tip of the iceberg. I’ve spoken with medical professionals about using my neutral pronouns and exchanging words like “female” and “woman” for person. It is exhausting to have these conversations. But they’re so worth it. If I can not only make my experience at the doctor feel more safe and affirming but also potentially help another trans or nonbinary person feel comfortable seeking medical help, why wouldn’t I? Still, it is tiresome.

 

I was pleasantly surprised by the inclusivity of my physician’s office when attending my last physical. I went to give a urine sample and saw a page on the wall in the bathroom. It was an info sheet about urinary incontinence, encouraging patients to check in with a doctor if they have had that experience.

 

This is the kind of ad that I normally avoid reading further, because I’m often trying to minimize exposure to language that will make me feel uncomfortable. However, I kept reading. Why? Because this page used completely non-gendered language. It did not refer to UI as a “woman’s issue.” It did not compare the rates of prevalence in men versus women, which would have erased the potential for nonbinary folks to exist entirely.

 

Instead, it talked about the issue itself: urinary incontinence. It stated something simple: “Do you experience leakage or loss of bladder control? Does it happen when you cough and/or sneeze? There are all kinds of reasons this could happen, and we can help! Talk to your doctor about it.”

 

Simple. To the point. Nondiscriminatory. And the impact? The impact is about inclusivity. I know this ad was made for me. I know this office prioritizes inclusivity in hopes of allowing its patients a safe environment to really delve into personal physical issues they may be experiencing, regardless of what kind of people usually experience them. Because of their intentionality, I thought to myself, “This isn’t just a women’s or a men’s problem—anyone can have this issue. I think this happens to me?” I brought this conversation to my doctor immediately after.

 

The medical world should be accessible. It should foster an environment in which feeling vulnerable feels safe. In this small, simple example, gender neutrality helped start a very productive conversation between me and my doctor.

 

Turns out I needed to do some serious pelvic floor exercises. I needed to strengthen my muscles. Nothing about this conversation felt uncomfortable to me. I felt seen by my doctor. Truly seen. And safe. This is crucial to building rapport. I knew that my gender identity was seen as valid in that space, which allowed me to seek proper medical advice.

 

Far too often people in marginalized groups have difficulty accessing proper medical care for all kinds of reasons. Whether it be transportation issues, financial difficulties, or racial and transphobic discrimination, there are large groups of people having a hard time getting in to see the doctor and being truthful about their ailments. How do we combat that? How can we improve access to medical care?

 

We must combat negative stereotypes, educate and train professionals to the highest and most inclusive degree, and fight systemic oppression. Change has to happen on the macro, mezzo, and micro levels. On the macro level, we must fight for change of policies. On the mezzo level, we look at access to medical care in our own communities and problem solve as needed. On the micro level, we change our language in one-on-one interactions and make ourselves inclusive and respectful. Inclusivity aids in access.

 


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