Friday, 26 August 2011

A little blip along the way

I have just got back from hospital an there is so much to say - I am going to rant first and then go back to tell you about my really positive experience of the hospital an Cesarean later. First I need to let off steam! I am sitting hear with cracked nipples and engorged breasts because I was not listened to until I registered on their system and then I was bullied into taking extreme action.

Beanie was born and was perfect! Despite being a Cesarean within 35 minutes of birth he had latched on perfectly and the transition from bump to bond was seamless. The downside to the Cesarean was that I know that he was not ready to be born and the vital body signals had not been fired. I remember the pattern with the Pickle - she latched on perfectly after birth but she would suck constantly and leave the breast furious, with angry tears. One night when she refused to settle a nursery nurse checked her out an saw the tell tale sign of urates (tiny salmon coloured crystals) and suggested that she was dehydrated as my milk had not come in and I should top up the breast feeding with a little formula. I tried expressing a little milk and sure enough there was nothing there - so the next 24 hours I breastfed and topped up with formula until my milk came in. It was hideous seeing her in thay way and despite wanting to avoid formula it seemed a reasonable price to pay to restore her good health. The Pickle then went from strength to strength and breastfed happily from there on in an I never saw her in such distress again.

Needless to say I remembered this  vividly as dehydrating my daughter was distressing to say the least. I could tell that I was going down the same path with Beanie. My breasts seem to know no half measures, they are barren then they miraculously gush! I flagged this up to the midwife and we gave him 5ml of formula then she dismissed further top ups as unwise - writing it up in my notes as a bad idea of mine. At the same time Beanie started to do rather spectacular mucus pukes, not little delicate possets but full on vomits. The midwife actually congratulated me saying that as a c-section baby it was great to see him bring up all the mucus that he could not expel while in the course of a natural delivery. I was changing him and his sheets continuously. Then to a final blow to the little Bean the sun came up over the building adjacent and started to bake our room.

I did not really think much about the overall impact of these factors as I had expressed my concerns and the professionals had allayed my fears. Anyway, at this stage my milk came in so I knew that Beanie would soon be as right as rain. All the focus seemed to be on me an my blood pressure the was slowly coming back down. Finally, on day four I was well enough to be released! hooray! One last formality was to weigh the Bean and I could be back home - simple? That was where the nightmare began!

He had lost 12% of his birth weight and that set off all the alarm bells! I was a bad Mum - Beanie had to be assessed at the specialist unit with blood tests and all sorts of prodding and poking.  He was both mildly jaundiced and dehydrated - erm, what had I been saying? That was just the start of the journey and the nursery nurses were delighted to be in control - as I was obviously failling.

The remedial routine was specific and it made Gina Ford look mild:
- breastfeed for no longer than 15 minutes (it was never explained why any longer would be detrimental)
- top up with 40ml expressed milk - as bottle fed milk feeds the mouth further back than breast milk so is better for babies. (later this particular fact was contradicted by everybody as being just daft)
- change him and play with him for the rest of the hour - but not over the hour that started with the 15mins of breastfeeding.
- put him down in the cot for exactly three hours for sleep. Any form of contact: cuddles etc will disrupt the benefits of the pure rest required. (This seemed at odds with all the posters they had advocating skin to skin contact and 'kangaroo' care.)

Just to prove that she was human and in touch she talked about her sister, having given birth six weeks previously. When I started to cry (it was on the notorious 3rd day after birth, when hormones would unsettle a cart horse) she explained how her sister was often in tears 'not that she has post natal depression or anything.' Is she so sure? I got the impression that she was saying that because her sister was not the kind of person to get post natal depression. Either way I was concerned that a professional dismissed so casually a condition that effects around 10% of mothers who have recently given birth and is still often subject to stigma.

Anyway I expressed 30ml in no time then prepared to start the regime. I breastfed (I forgot to set the stop watch) bottle fed the expressed milk, played and changed ready for the enforced sleep. Needless to say Beanie was not impressed and started to howl - so eventually to calm him down I fed him a little more and had a little more play. As a three day old baby I did not want to ruin the bond that I had forged with him on the basis of a concept that seemed a little extreme based on just his weight loss. A new Nursery Nurse had taken over and she came in to insult consult me, and say that she would be spying on looking after me, after an hour of rest in his crib he had woken, was ready for a feed and starting to let rip. The nurse was adamant that in order to help Beanie I must follow the routine, but that I could not breastfeed until I had the next lot of expressed milk on stand by.

Hold on, I had been running myself ragged getting into their routine - in little over an hour I had expressed my first batch and breastfed but not started to stock up supplies of milk for future use. The atmosphere was somewhere between glacial and police state. It was clear they felt I had failed and they were doing their best to save my baby. To make it clear she pressed her views home saying "You should have planned properly in advance" letting me know that it was my failure that was the issue. This condemnation was being played out to the strains of Beanie's hungry cries.The Hubster had taken Pickle for a walk and so it was left to my Mum to hold Beanie while I was trying to reason with the nurse and for her to offer fierce moral support.

Then the Doctor came in - and so did the rationale. With the words "there seems to have been a misunderstanding" my life started to take shape again. Gone were the proscriptive rules - and clarity was restored. Beanie needed feeding at least every 4 hours - the 4 hour gap just allows Mums some time to recover and sleep through the night and not get ground down and ill. Each feed period should be topped up by expressed milk just so we could guarantee that Beanie was getting the quantity. Apart from that there were no hard and fast rules.

Come shift change who should appear but the lovely Margaret who had been so amazing with the Pickle. I told her our story and she decided to help again. To give me the maximum sleep she woke me up at feed time during the night with bringing the last lot of expressed milk, then later when ready picked up the next lot milk for the fridge before letting me sleep again. She then suggested that she could weigh the Bean secretly before her shift ended - and if the weight gain was significant she would get me discharged that day. I felt that I was feeding up a veal calf - relentlessly forcing milk into the mouth of a newborn. I wanted Beanie well and at home where I could listen to his needs and respond to him rather than waiting for him to hit or miss standardised targets. Don't get me wrong, I respect the Doctors and think that everybody at the hospital were genuinely doing their best for both me and Beanie and that most of them were well informed and professional - just there is (as the saying goes) no place like home!

By the next morning Beanie had put on 200g and was less then 10% under his birth weight - and ready to leave the hospital for the first time. Home sweet home!

The most important thing is that Beanie is well and was never in danger. As a Mum the wellfare of my children is paramount and any personal discomfort is irrelevant compared with the importance of their health.  I am cross that my concerns were ignored until they suddenly they registered on a measurement that they accepted and then I was made to feel at fault. i was given contradictory advice, and had I not queried it I am concerned as to the impact it would have had. I was left with excruciatingly painful cracked nipples from the expressing and the temporary enforced catch up milk production left me with painful cannon ball boobs that looked more pneumatic Babewatch than human as they stretched to accommodate the extra milk. But three days on I can feed without screeching in pain, Beanie is eating his fill and his nappies indicate all is well. I predict a happy future!

Wednesday, 17 August 2011

But I wanted a home birth...

I'm a natural kind of a girl - much as I love aesthetic form and function (well, handbags, shoes and Space NK) my philosophy is more trees and skies than pounds, dollars and conformity. When I was pregnant with the Pickle I had visions of a hypnobirthing home birth - and then I got pre-eclampsia and my body started to pack up and my choices became limited and to secure the health of me and the Pickle I had to have an emergency Cesarean.

This time around I was hoping to avoid the medical interventions. I was healthy and avoided stress and everything seemed to be going so well. The consultant gave me a reprieve and rather than the Cesarean at 40 weeks as threatened she was happy for me to try for a natural birth up to 42 weeks.

I am really aware that I have free will and can challenge the medical opinions and have a say in my treatment. I have spent much time unpacking some of their statements that initially could have cowed me into submission "Beyond the age of 40 the statistics of having a stillborn child are hugely increased if you go beyond term" or "After 42 weeks the risk of still birth is doubled". These quotes will send a chill down the spine of any Mum - but analyse the data and you can read that general in the UK, the risk of stillbirth is about 1 per 3000 pregnancies at 39 weeks, 4 per 3000 at 42 weeks and 8 per 3000 at 43 weeks - which while significant is the figures are not paranoia inducing.

However, despite my long held wish for a natural birth I am preparing for an elective Cesarean tomorrow. I have analysed the statistics, I am aware of my age, my history of pre-eclampsia and the fact I now have issues with rising blood pressure and the fact that it took us 5 years to conceive and then only with the assistance of clomed and a hormone jab. Already I have a miracle baby living in my womb, I am his Mum and I think that on balance at 41 weeks and 6 days that Cesarean is our collective best option for a positive outcome.

Rationally I know that I am doing the right thing, but I still have emotional reservations. I feel a failure that despite two attempts I can not deliver in the way that evolution intended; does that make me less of a woman - a failure. Will my milk come in and will we bond? Cesarean Mums are much more likely to suffer from post natal depression. After five years of focused attention suddenly the Pickle will not only have to share me with a brother but I will be sleep deprived and recovering from a major operation that will have cut through many layers of fundamental muscles. You see, I have a few issues over this course of action. I could refute each of my problems one by one - I know that they are not rational or I have put in place wonderful remedies, but I need to acknowledge these things so that I can move on.

I have also had many angels! I went into my final ECG monitoring today and had a long chat with the midwife. She did a final attempt at a Stretch and Sweep but my cervix was not just closed but almost welded close - unlikely that without the section we would have any movement fast. Forget the sweep though, this midwife was everything you could hope for. She, herself, had ended up having a Cesarean for each of her two children, and talked of the emotional impact, saying how rarely it is acknowledged. She talked about giving myself time to grieve for the changing course of my delivery and methods for dealing with post natal depression.

As I was wondering out of the hospital and I saw the head of the unit going into work, still off duty, and I stopped to say how amazing I found her team; regardless of being off duty we stopped and chatted and she gave me loads of advice on how to benefit from the Hubster's private health insurance (despite being firmly in the NHS, and yes I do love the NHS).

My second angel was, naturally, the Pickle. When I got back from the hospital she had made me a card. "To Mummy and Beanie Love Pickle. I hope when Beanie is born it does not hurt. ...I am am a little fairy I like to sing." That got the tears going! We then went upstairs and packed my hospital bags together, spending an hour or so just chatting and packing and calming each others anxieties with questions and reassurance.

When I was packed I had just the time to pick up an old friend from the station. This really was an angel - it was a friend who I knew from when I lived in Paris twenty years ago and she was in the country for a few days, on route to Portugal from her native San Fransisco. We all headed out for a chilled out afternoon of Ethiopian food and long chats. Just what you need the day before an operation!

Then Twitter has also been amazing. T-J from Bras for Mums sent me the most amazing link from You Tube about Natural Cesareans Okay I could not watch it in full, but it was great to have an alternative perspective. In in her 'Simpley Hayley' blog Hayley wrote so eruditely about The Planned C Section - which was amazing to read, an honest blow by blow account of the whole procedure.

So at 10.30am tomorrow I go under the surgeons knife - think of me. I am the lucky person with the angels looking out for me. Thank you! xx

Friday, 12 August 2011

Shh - just don't speak about it

 This post has been a while in the planning - and with my most emotional writing  I need to press 'Publish' before I think of a million reasons to delete or refine it out of existence. Back in June in my post Confessional or slander? mentioned some bloggers who have inspired me to write about this subject, they have finally prompted me to take my first step to blog about this subject. I hope that you enjoy the read.

Motherhood should be natural, easy and wonderful. It should be a coming together of generations and a way to celebrate the continuity of family and love. I say that it should....When Pickle was born I was besotted by her, I could watch her for hours, just marvelling at her perfection. We bonded, she latched on and everything seemed to be perfect. I remember the forms that the health visitor got me to fill out about my emotions and I ticked all the happy boxes and felt like the perfect new Mum.

Time went by and life was not that simple. I was living first with my step son then my step daughter (both recently out of University)  who took the news of a younger sibling as an invitation to have emotional meltdown, and I was to be the lightning conductor of their bile. On the surface things were fine and they were always superficially normal, but their was a strange and unsettling atmosphere in the home that made life poisonous. I longed for the happy family I had never experienced, but I was still high on euphoria of what I had - and that was an amazing daughter and husband I adored.

Little by little my facade started to crack. Work was shit (I even had to consult a lawyer) and the Pickle was not a great sleeper. I realised that things were not perfection, despite waking up feeling happy and loved, in unguarded moments I just found myself crying. I was functioning well, I was not acting out of character and it was not impeding my ability to be a wife and mother but I knew that something was amiss.

I went to the Doctor and asked for help - and left with the possible offer for a prescription if I pushed it further and an A4 print out of possible sources of help from the Samaritans to unaffordable therapy. I binned the flyer and dug deep in myself and found reserves and solutions to keep on going.

Shall I introduce you to my inner self? I am quite amazing! For over 20 years I have been assembling the jigsaw of my psyche. Most of my tools have been common sense, meditation and New Age philosophies - and most importantly a sunny disposition and an amazing ability to listen and see things from many perspectives. I have put in thought and effort into making myself a well functioning adult who can have mutually supportive relationships with friends and a couple of long term lovers (and when I found Mr.Right I had the sense to settle down with him). However I am also self aware enough to realise that life has been complicated and my emotional foundations could be a little shaky!

Motherhood affects us all differently, some of us have excellent role models and others of us are careful not to repeat dysfunctional patterns. I love my Mum, she has always done her best, but motherhood just is not her thing. There is a saying that the child of lovers is an orphan and my Mum's love for my father obliterated her bond for her children to the extent to which I remember asking my Nanny who the kind people were giving us such nice presents on Christmas day before they disappeared for their adult lunch: they were my parents! My hands on approach to motherhood could not have been more different to my mother's,  immersing myself the love the Pickle and my family was the richest reward.

I think that my emotional status quo would have been maintained, but sometimes life prompts you to take action. I read Oliver James' They F*** You Up: How to Survive Family Life - and it started me to question not only myself but more importantly myself as a mother. He advocates that everyone should do an emotion stock check of their lives and work out what messages their upbringing has enforced on their lives. There was one thing feeling a little weepy at times but the knowledge that inadvertently be passing on negative behavioural patterns to the Pickle was of real deep concern to me.

In spite of having drifted away from my New Age philosophies of old, feeling slightly amused by some of the platitudes and fluffiness of their certainties there were some common threads that I could see. Even James discussed how some elements of the theories were gaining scientific credence. Armed with  the fruits of my past soul searching and the tool kit described in the book I saw that this was an area that demanded closer scrutiny. I read other books, including the excellent Why Love Matters: How Affection Shapes a Baby's Brain by Sue Gerhardt and started a re-examination of my life, the messages that informed who I was and how I act and those messages that I could be passing on.

The past 18 months have been revelatory, my understanding of myself and family relations have been transformed. The thread of my relationship with my mother has been woven through many posts in this blog - and maybe that could have been both the effort and rewards of my battle with delayed post natal depression. Maybe...but in reality it has been a stepping stone. It has taken me several seasons to find the words to describe the start of the journey - time for me to take a deep breath and hope that I can return with the next chapter in this particular journey.

Monday, 1 August 2011

5th Birthday Celebrations

Don't you hate it when you start to sound like your parents, but I'll inflict my first thoughts on you regardless. Where have five years gone? ....This weekend the Pickle was the grand old age of FIVE.

She loves her parties, she starts to plan one from the moment she has said goodbye to her last friend. My aim is to keep the parties as simple and innocent for as long as possible. Maybe I am just nostalgic for my parties - actually, it must be in part the reason as we had to have Iced Gems to make the party complete, a must for all 1970's children's parties!

We always start with a simple craft activity as this is a good way to get even the shy ones involved. In keeping with the Princess and Pirates theme that was demanded I customised the party hats with a little net - and they loved them - well, most of the girls did. I was delighted that one really cool girl made a pirate hat - just as well the boys ignored the craft activities altogether.

We had a few of the standard games - all running smoothly. Have I mentioned that the Hubster's family are something special? Well at 8 1/2 months pregnant they came to the rescue. I had a blissful sit down when the Hubster, assisted by his team of sisters and nieces ran around playing pass the parcel and making sandwiches, fruit salads and all manner of goodies. After tea came our speciality - the treasure hunt - you have to work for your party bag here.

This year we had a treasure map and each number hid a clue. They had to work out the clue, find the destination, then (in case it was too easy) find a decorated Post It note hidden somewhere to win their prizes. This is very much a group activity - as you can see from the Hubster being mobbed!

It must have been quite successful, one little Pirate has since told me that he wants to marry me when he grows up!

What did I learn this time around?
I still love the toy library for a few big garden toys
I love my sisters in law even more - and the Hubster is the best.
As well planned as you can make it it is still a sod of a lot of work
Sandwiches take forever, but less time if you take the butter out of the fridge in advance!
The cake was fun to make, but I should have turned it upside down to have a flat top and then the Castle towers may not have slid off until I rammed them upright with some cocktail sticks.
Bribing parents to stay with wine and extra pastries is a very cunning plan!
I thoroughly recommend having a party at 8 1/2 months pregnant - everybody helps and who, would have guess it, with a history of pre-eclampsia and high blood pressure, at my next check up 2 days later my blood pressure had come down.
Yes, I am really yearning that first long glass of wine!