anna in med school

We’ve taken Ari out and about a bunch in the last week.  Our three dinner parties this weekend seem to have sufficiently worn out our little champ, as she has been found napping while she was supposed to be burping.  Submitted as evidence:

Her hair and eyes might scream “John,” but her sleeping habits she definitely got from me…I can just see her years from now, in one of the front rows of a lecture hall, nodding off mere yards from the professor.  Or, worse yet, if she chooses to go into medicine, falling asleep in an OR like her classy momma.

We took a flying trip to Charlottesville right before Christmas.  We spent as much time as we could (never enough) with people we love, ate our way through some of favorite restaurants, visited old stomping grounds, and even had our first date post-baby, thanks to our friend Alaina, a pediatrician–okay, seriously, our first babysitter was an attending pediatrician!  Who does that??!  We also swung by Barboursville Vineyards, where we were married almost three and a half years ago.  This visit prompted us to start testing out her tastebuds (I know, I know, no solids until 5-6 months, and no alcohol for another couple years).

Wine: puts her to sleep.

Beer: less interesting than the ceiling fan.

Fro-yo: mmm…have we found a decent substitute for mama’s milk?

Yaya Megan: cannot get enough!

Oh my little bear, you make a trip to the post office fun.  My bar for excitement is so, so low.

Today I will finish the first draft of a paper I’m writing on the laborist model in obstetrics…I got the data back in early September on the interviews I conducted in 2011-2012.  Since then, I’ve only managed to write about 2127 words.  Today I will finish, likely while breastfeeding with the brest-friend (nursing pillow, my fav) propped between me and computer.  So it is written…

Baby is crying.  Daddy passes baby off to mommy so he can use the bathroom.

20 minutes pass.  Then 30.  Mommy notices daddy’s cell phone and book are nowhere to be seen.

Baby miraculously falls asleep after lots of bouncing, swaying, and singing.  Daddy emerges from bathroom, at which point he generously offers to give mommy a break.  Meanwhile, he is being praised far and wide as being progressive for knowing how to change a diaper.

I love my husband and I think he is a phenomenal partner and father (even during his half-hour escapes to the bathroom at choice times–let’s be honest, we can all use them).  Folks now need to make current their concept of fatherhood.

When you have friends with kids older than your own, it’s hard not to constantly be looking forward, excited for the day when she too will be able to reach her arms up toward you with desire and anticipation–hell, right now I’m eager for the day she’ll have enough muscle control to stop slapping herself in the face.  But that’s a problem I’ve had in most/all walks of life: looking ahead instead of appreciating the now.  So some of the resounding advice I’ve received recently has certainly struck a chord with me: appreciate the portability of the two-and-a-half-month-old child.

I hadn’t considered the ease of going place to place with our young infant.  Every time Ari and I leave the house together feels like a traumatic event.  I dread the 15 minutes before departure spent trying to gather what we need, all the while Ari is making her discontentment known, that I’m we rarely leave the house.  But now she’s robust enough for her carrier, she’s developed (had forced upon her) some immunity, and I think our recent trip to Charlottesville has given us more practice in the ways of carting infants to and from.  I’m determined to make greater efforts to not be couch bums.  We will attempt to leave the house at least once a day, tears and frustrations (much more mine than Ari’s) be damned!

On New Year’s Eve we took care of all the errands!  Then Julie was kind enough to let us bring Ari out to her New Years bash–oh what fun it is to have real adult conversation while sipping on crazy strong cocktails and still be able to see the look in your kid’s eye when she sees fireworks for the first time!

On New Year’s Day we were hungover and decidedly less ambitious, and a stroll around Haverford and the neighboring strip malls (see below…I probably chose the least scenic location at which to snap a picture) more than met our quota:

(Notice me looking like a tool with a headset in place.)

So confused and tuckered out post-walk, tangled in said carrier because mom hasn’t figured out how to properly remove baby:

Our feeble attempts to get dad home from work:

Warning: do not watch on a full stomach.  Happy New Year!

The last thing John said last night was, “I love the man who invented that swing.”

I don’t want to jinx it, but our darling girl has given us much-needed 5-hour sleep stretches for the last three nights.  Perhaps just as appreciated is that we can set her down into the swing before she’s asleep, and she’ll just look up, mesmerized by rotating leaves and birds, herself cooing away, as she gently drifts off into slumber.

The hilarious thing is that now we both associate the crooning of the swing’s mechanical-sounding lullaby with our own relaxation and sleep.  As I hear it playing upstairs, I’m struggling to keep my eyes open.

Anyone who criticizes this device as being a non-human babysitter has clearly not known 10 weeks of continuous sleep deprivation.  We are abundantly appreciative of its existence.

One of my attendings during my pediatrics rotation sent me a congratulatory email shortly after the birth of Aurelia in which she stated, “Now you have to get used to ‘no guilt allowed.'”  I took that to mean that I should try not to feel ashamed if it was suddenly 2pm and I hadn’t managed to wash my face yet (to wash my face before noon, now that was a great accomplishment).  I stopped thinking twice before spending the extra 29 cents for precut vegetables at Trader Joe’s if it meant one less step on the way to a healthy meal.  (During clerkships, home-cooked meals most weeks felt like a choice: a decent dinner or an extra half hour of studying.  During my first six weeks of parenthood, setting my wailing infant down for a few minutes only for her to cry louder did not always feel like a choice.  Thank God the woman in the duplex next to ours spends most nights at her boyfriend’s.)  Any and all shortcuts are welcome in this household.

I like crafts.  And when I think back on holidays as a child, it’s the homemade stuff that made the magic.  Part of me wanted to make a first ornament and a stocking for my firstborn, but the better part of me wanted that time to actually spend with the babe, her father and her visitors, or to spend that time sleeping.  So without guilt I turned to some of the craftspeople on Etsy.

Jacki of City Details made the most beautiful, simple ornament in what seemed like the blink of an eye.

Since John and I had our first tree together in 2005, we’ve gotten a new ornament each year.  Jump back to 2005 (whoa):

And we thought it might be time to retire the 99-cent felt stockings, names written in puffy paints, we once bought at Kmart.  In lieu of putting my surgical suture-tying skills to the test, we wisely connected with Heather of EverydayGraces, who created these rustic beauties:

I like the fact that the money is going, for the most part (that I know of), directly to the craftsperson.  And you can develop a sort of rapport with the artist, which makes everything feel a little more personal.

Below is a sliver of our home explosion of merriment, mixed in with all things baby.  I can’t help but laugh that even our dining room cannot escape, as it is the place we park our BOB stroller, our carseat, and our apocolapse-size Purell dispenser.  Our dining room table has also become our work space, since I can set the babe on the floor of the living room for a few moments before she goes ballistic on me.  Our life looks so different from six months ago.

Recorded over Thanksgiving.  I love how much she appreciates her food.  Apple doesn’t fall far from the tree.

Goodness, I’m still marveling over her muscle control.

a.k.a. “giving birth without an epidural.”

I would like to preface this post by saying that I’ve been dragging my feet in the writing and posting of it.  I have many conflicting thoughts, and I’ve tried to restrain myself with hopes of coherence.  Here goes…

One night, when he was on his OB rotation during his intern year of residency, John came home stressed, and the first words words out of his mouth were, “Please tell me you’ll want an epidural.”  At the time, it was a no-brainer to me.  Of course I’ll want and get an epidural.  In the U.S., it’s associated with minimal risk to mother and baby, and it allows mom to experience childbirth with less trauma.  Since it doesn’t act systemically, it doesn’t create the 1950s/60s vision of drugged-out-of-her-mind mama and, consequently, child.  In fact, it many hospitals, it’s use is associated with a lower cesarean rate.  Why the hell wouldn’t I want it?

But I am incredibly susceptible to peer and social pressure.  As more of my friends started considering unmedicated childbirth (note the wording, which is still problematic; personally, I consider birth with an epidural just as “natural” as safe births without), I weighed the advantages and disadvantages.  My thought process on the advantage side was as follows:

1. Having been catheterized twice before, I thought I would prefer not.  That said, I hear once you have an epidural, you could care less.
2. In my mind, I thought it might be nice to be able to walk around, and the ability to do so is compromised by epidural.  Although, as I learned during my OB rotation, anesthesiologists nowadays are really good at their job…if you want to walk, they can try to help you walk with an epidural in place.
3. I did not, and I still don’t, like the idea of continuous fetal monitoring.
4. I kind of liked the hippydippy idea of experiencing birth with my child, and I wanted to at least try to not have any element of that sensation and awareness to be dampened.

Here’s the hilarious thing: not one of my stated advantages actually came to fruition:

1. Although my lacerations were relatively minor (second-degree: into the perineal muscle but not into the rectal sphincter), they were both posterior (toward the rectum, common) and anterior (toward the urethra, less common).  Therefore, a straight catheter was recommended for the repair in an effort to minimize the risks of future problems during urination.
2. By the time I got to the hospital, I was fully dilated.  As soon as I got on my back to be examined, I was not on my feet again until post-repair.  I guess it was kind of nice to be able to get up to use the bathroom and change the chucks saturated with blood…but this was not a highlight of the whole birthing experience.
3. Again, when you show up to the hospital fully dilated, you lose a few options, such as walking around, receiving any type of medicated pain control (epidural, nubain, or otherwise), and intermittent auscultation.  Everyone gets monitoring for at least 20 minutes to look for accelerations and variability…if your baby happens to be delivered before the 20 minutes or up, then looks like you have a monitor strapped to your abdomen during the delivery.  You know what?  I didn’t even remember that detail until I just now jotted down my reasons to try without an epidural; it was a non-issue.
4. Maybe some sense of awareness will come with my next delivery, if I’m lucky enough to have one.  Because this delivery was an absolute shit show.  I was so unaware that I mistook transition (the dreaded limbo period before you’re fully dilated but you feel a strong, uncontrollable urge to push) for early labor, and I thought I might literally lose my mind.  I don’t remember some ethereal joint birth experience with my daughter–I did what I was coached to do by my husband and the midwife on-call to have a healthy birth, and I mostly remember the wave of love, happiness, and relief when my wailing girl was placed on my stomach.

Truth?  I wanted to prove that I was strong enough.  I wanted to somehow feel woman enough to be able to experience labor in full force.  I wanted to be a “war hero.”  And when I was transitioning in the upstairs hallway of our duplex, I desperately wanted anything that would pull me out of it, but I worried about how I would be perceived if I caved.  How absurd is that?  I, at least in that moment, thought more about image than the safe birth of my child.

So it was with both relief and disappointment that I read the passage below in Bringing Up Bebe.  I dislike the attitude toward epidurals that seems to have taken over the culture of childbirth in our country.  I recently found out that a friend of mine (a badass, strong as hell, and brilliant woman) was publicly criticized for her decision to undergo a scheduled c-section when her baby was still breech at full term by a woman who preferred to do things “naturally.”  Are you kidding me??  Or, in reference to this fantastic article (thanks Anne!) that I read every time I feel like my mind is going to explode with all the free advice being doled out, “really?!”  JJ Keith goes on to say, “Childbirth is just one really rough day with — odds are very good — a happy ending.  Prepare for it, but don’t let it define you.  Epidurals suck, but there’s no gold medal for pain endurance.  If you get a C-section, you still get a baby.”

Without further ado, the eloquence of Pamela Druckerman:

Birth, like most everything else, is something we try to customize. My obstetrician says she once received a four-page birth plan from an American patient, instructing her to massage the woman’s clitoris after the delivery. The uterine contractions from the woman’s orgasm were supposed to help expel the placenta. Interestingly, this woman’s birth plan also specified that both of her parents should be allowed in the delivery room. (“I said ‘no way.’ I didn’t want to be arrested,” my doctor recalls.)

In all this talk about giving birth, I never hear anyone mention that the last time the World Health Organization ranked national health-care systems, France’s was first, while America’s was thirty-seventh. Instead, we Anglos focus on how the French system is overmedicalized and hostile to the “natural.” Pregnant Message members fret that French doctors will induce labor, force them to have epidurals, then secretly bottle-feed their newborns so they won’t be able to breast-feed. We’ve all been reading the English-language pregnancy press, which emphasizes the minute risks of epidurals. Those among us who deliver “naturally” strut around like war heroes.

Despite being the birthplace of Dr. Fernand Lamaze, epidurals are now extremely common in France. In Paris’s top maternity hospitals and clinics, about 87 percent of women have epidurals, on average (not counting C-sections). In some hospitals it’s 98 or 99 percent.

Very few women make a fuss about this. French moms often ask me where I plan to deliver, but never how. They don’t seem to care. In France, the way you give birth doesn’t situate you within a value system or define the sort of parent you’ll be. It is, for the most part, a way of getting your baby safely from your uterus into your arms.

In French, giving birth without an epidural isn’t called “natural” childbirth. It’s called “giving birth without an epidural” (accouchement sans péridurale). A few French hospitals and maternity clinics now have birthing pools and giant rubber balls for laboring women to hug. But few Frenchwomen use these. That 1 or 2 percent of nonepidural births in Paris are, I’m told, either crazy Americans like me or Frenchwomen who didn’t get to the hospital in time.

The absolute earthiest Frenchwoman I know is Hélène. She takes her three kids on camping trips and breast-fed them all past age two. Hélène also had an epidural at each delivery. For her, there’s no contradiction. She likes some things au naturel and some with a giant dose of drugs.