The mothers group

My neighborhood has one of the more active new moms groups in the city. They meet weekly at a local library, organized into cohorts that re-form every four months. This seems like a nice thing, and I am planning on trying to attend these because it will give me a reason to get out of the house and go for a long walk. I think my cohort has already started to meet.


An offshoot of this group is a facebook discussion group for current and former members, which I am also a part of. Mostly for comedic effect. This is a pretty crunchy area, but the postings can be so over the top. Right now, there is a long discussion about a mother trying to wean her two year old. Is she ready? Over how many months should she gradually extend this process? Such a milestone, but so sad as well. There are many comments, sympathizing, they are going through weaning pre-schoolers as well, only you know what's best for you and your baby, it could take up to a year, which is totally normal, you are loved and supported.


This makes me chuckle but also makes my head spin! Is the two year old ready?! Who cares! If a woman decides she would like her life, and breasts, back after nearly three years of physically catering to a small tyrant (lets not forget the pregnancy!) she should worry about whether the kid is ready? I kind of want to troll them with responses like this (I think she was born ready!), but I would get kicked out of the group. Maybe I'll post my own query about how to wean four month old twins because I'm going back to work and who has time for pumping, plus nursing is kind of a drag? I can only imagine the gently worded horrified responses. "Only you know what's best, but I would urge you to consider blah blah blah..."


I suppose there is the small chance that I will fall in love with nursing and earth-mothering and become fully sympathetic to all of this hand-wringing, although I doubt it.  My basic attitude or personality is usually not very malleable to life events. For example, getting married did not make me gushy about weddings or love. I most emphatically do not feel that pregnancy is magical. But we shall see! I would be very interested in my transformation to a stay-at- home* earth mama who makes her own detergent to wash cloth diapers.


*I do not get the sense that most of the women in this group are stay-at-home moms at all- this is very predominantly a two-income area. Which makes it even nuttier to me that they devote all of this time and energy to knitting cloth diapers and nursing pre-schoolers.

34 weeks

I made it to my final goal of 34 weeks.* Truly this seemed like an impossible thing 8 weeks ago. The sonogram tech told me at the last appointment that she didn’t expect that I would make it, mostly because of the effacement. Assuming my water doesn’t break, it’s now all on baby girl* to demonstrate adequate growth or else they both get evicted this Friday. If she cooperates, I could theoretically make it to March 8, assuming I don't otherwise go into labor. I hear a lot of stories of water breaking around this point in twin pregnancies (and much earlier, of course) which I imagine has to do with lack of space, and lots of limbs with sharp nails flailing around. After 34 weeks, doctors don't really try forestall labor because of pre-term rupture of membranes, so if my water breaks, that's it.

At the last appointment, baby girl ALSO seemed like she has a giant nose. I'm very curious what these two will look like.

We went to the infant CPR class last weekend, and it was helpful. I wish I had gotten around to signing up for a basics in infant care class, but I didn't. Hopefully my mother remembers everything. I think these classes should be offered to all new parents for free, like the car seat inspection. It would decrease the infant mortality rate and create more helpful bystanders to administer first aid, in general. The Swedish style box would be nice too. One can fantasize. But I digress. Instead, I am reading What to Expect the First Year because someone gave it to us. I found the Expecting version of this book to be incredibly annoying, and I feel similarly about this edition. But it does have helpful, super basic details that I would otherwise not be aware of, having never attempted to care for another human being. Like, the mechanics of changing diapers, bathing, and dressing babies. I just wish every paragraph didn't end with a chirpy admonishment to breastfeed. "Here's how you clip a baby's nails. Remember, breast is best!" Ughhhhh.

We've started to review au pair profiles to interview. It is really hard to evaluate who would be a good fit! It feels  strange to say, I don't think she has enough experience with infants to take care of them, when I have literally spent a combined total of about 30 minutes with newborns. This is the blind leading the sighted. This is compounded by the fact that I have never hired anyone, much less a personal employee, and she will live in my house. Strangeness!

*Revised, emergency goal. Original goal was at least 36 weeks, both babies over 6 lbs, no NICU stay. 36 weeks is still a theoretical possibility, but I don't think baby girl will avoid a NICU stay regardless, because of her small size.

*We wanted at least one girl for many reasons, but one was because two boys seemed hard- however, it is baby girl that is causing all the problems! Her growth rate, the fact that she is breech, and the fact that she has one foot permanently wedged in my bladder.

We had another relatively positive appointment yesterday. Baby girl looks like she's holding her own and maintaining her growth curve. They estimated her to be at three and a quarter pounds, which doesn't really sound that small to me for a 32 and a half week twin. Baby boy continues to fatten himself up, and is measuring just over 5 pounds, which is giant- almost the size of a full term baby, even though he theoretically should have seven more weeks to keep cooking. Ultrasound measurements have very large margins of error- almost a pound in either direction, which is huge, when you are only talking about a few pounds- so I am trying not to put too much faith in them either way. But I will take good news where I can get it. In addition to the growth scans, biophysicals, and dopplers, we are adding in non-stress tests to our weekly appointments, which take up close to half the day now. Basically, I'm hooked up to the straps and machines that women in labor are hooked up to, to monitor a baby's well-being over time, as well as to monitor contractions.


Both babies did well on all of their many tests yesterday. They were super feisty during the sonogram- baby boy actually kept kicking at the sonogram wand whenever they tried to measure his head, and it seemed like my stomach was shaking throughout the exam. I bet they are tired of all these tests as well. The doctor seemed positive and happy with all the results, which makes a huge difference in how I take the news. She told us we should be relieved because we past a big prematurity milestone of 32 weeks, that all indicators were good, and that if things stay this way, we could go past 34 weeks, to 36 or even 37. I am not getting my hopes up- 34 or 35 is fine with me, but it's nice to hear something positive about the pregnancy for a change. Baby girl, the lower twin, is still breech, and they don't think she will move at this point, given the 5 pounds of brother she has sitting on top of her. She is essentially squatting on my bladder. So that means a C-section is a given. This is not my favorite thing, but I'd much rather have a planned C-section than an emergency one after going through many hours of labor, or, worst case scenario, deliver one, and then have to have an emergency C-section for the second. Recovering from BOTH procedures is just not fair.


Now that I am relaxed enough that not ALL of my thoughts during the sonogram are, will my babies die?, I can sometimes think about fun stuff, like what they might look like. In all of the sonogram pictures, baby boy looks like he has huge cheeks and a very prominent nose! He is also always frowning with pouty lips. A very intense baby. He doesn't look like anyone I can think of in our family. Baby girl always looks very serene- she has a Mona Lisa expression- and I think she looks like me. But maybe since she is tiny she will take after Jason and his family, and beefy baby boy will take after me.


I had the car seat installations inspected, and it was very helpful. She made a lot of modifications, and gave good advice about safety. She is not a fan of those rearview car seat mirrors, or sunshades, or any other object that could become a projectile in a crash. I still like the idea of the rearview mirrors though.


This weekend is the infant CPR class. We were supposed to take it over a month ago, but it was the same week we got the referral to the specialist, and I was too upset to think about choking babies for half the day. I re-scheduled it thinking we probably wouldn't make it to the later date because we'd be in the NICU. So, getting to the class, and having the twins not be born on superbowl weekend, will be wins for me.

Hooray!

Hooray! I made it to my first major goal- 32 weeks and the baby shower, which happened to coincide with each other. The twins are very likely to be ok now (barring other complications) even though they would still be looking at a long NICU stay. My next goals are to make it to February (two days!), and then to 34 weeks. And then I think I am really in the clear- again, barring other complications. I have also been heartened by hearing stories from three people over the past week of their small babies that were lower on the growth curve than baby girl, and who are fine. The main difference is they weren't harassed about it every week. I know my situation is different because the twins and the discordance make it higher risk, but I still feel more hopeful than I have since any point before the awful appointment that referred me to the specialist at 25 weeks. I only ever got about 5 weeks of feeling positively that this pregnancy was going to be healthy and viable- between the 20 week anatomy scans and the 25 week referral. So it's nice to feel less awful now. Although I was advised to start bringing my hospital bag to my weekly appointments- yikes.


We have another meeting with our doula this week. I don't know why, but she wants to meet. She is just so cheerful and positive and I find it super annoying. Plus last time she made me cry with her suggestion that I start taking my hospital bag to appointments- this sounds different at 26 weeks than 33 weeks.


We had three baby showers last week, and they were all great! Although my house is overflowing with stuff now, and I don't know what to do with most of it. How do stupid people have children? I find it very mentally taxing to open everything, read the instructions, and figure out the best use for it. I opened the breast pump, looked at its many parts, and immediately packed it back up. To be fair, I also have not taken any classes that may have explained some of these things to me. When I was scared of delivering very early, I wasn't sure which hospital I would deliver at (I'm still not) and decided I didn't want to do the tour and class at either of them. Listening to people talk about their fears of being induced at 39 weeks and whether or not they should have an epidural would have made me crazy. My doula recommended a high risk class specifically for parents of multiples, but hearing about potential birth complications for twins just seemed like it would stress me out more. Do I want to tour a NICU? Nope! So, here we are at 32 weeks- I don't know what hospital I will deliver at, I don't know how to change a diaper, prepare a bottle, or use a breast pump. I still fail to understand what a boppy is, or if I need bouncy chairs. Alas.


I have found it best not to voice any baby-related anxieties to people over 50. They are cranks! "We didn't have any of this stuff in my day! Babies slept on their stomachs and were strapped to the roof of the car! We all survived!" Gah. The person in question clearly survived, yes, but lots of other people didn't. The rates for SIDS and traffic fatalities have declined considerably since the 1980s. Why are people so flippant about death?


Assuming I am still pregnant this weekend, my next big task is to start screening and interviewing au pairs. I'm not looking forward to this. It's a very weird thing to hire someone to take care of people you have never met!

In which I continue my sunshine and roses approach to life

Two days till week 30! A week with a three in it was my goal when I found out I was 50% effaced at week 26, and got steroid shots in case I delivered within 7 days. My next goals are week 32, after which I will relax a lot, and then 34, after which I have no goals.


Both twins passed their profiles yesterday, and there was no growth measure, which I appreciate, because repeatedly being told baby girl is too small gets me down. Next week they have both profiles and growth measures, sigh. I have gotten better about relaxing in between appointments, but the day of, I am a mess, because there is the possibility that it will end in me being transferred for an emergency C-section. At yesterday's appointment, the boy was actually the more worrisome one, because he was asleep for most of the exam, and they had to count his movements. He didn't wake up even after being prodded with the ultrasound wand, and since even the slightest potential issue sets me off now (thanks, doctors and ultrasounds!) I had a mini panic attack. But then I drank some apple juice and he woke up. Then I came home and self-soothed with cheesecake.


Since being referred to the specialist and being put on reduced activity, a lot of women have told me their own complication horror stories. These are scary, but much more interesting than the "natural childbirth, doula, I know some twins" stories I had been hearing before, which are just boring. How is it that so many people have these "rare" issues?! Detached placentas, incompetent cervixes, bed rest for months, water breaking late in the second trimester.... I have met two women whose livers stopped working due to pregnancy, and the doctors knew because they had bile seeping out of the pores of their skin! This is all among my acquaintances, not people I have met at the maternal fetal specialist's office or anything. This furthers my contempt for the natural childbirth mantra of "your body knows what to do, nature is perfect!" In these instances, their bodies most certainly did not know what to do, and without medical intervention, their babies would likely have died.


Basically, all of the things that annoyed me before about this process annoy me even more now. Two people who I know (and like!) have expressed to me their absolute devastation at being told they have/had to be induced at 39 weeks due to some health issues, because this is just not the way they envisioned their labor to be. Pregnancy hormones can make people over-emotional, so I try to be supportive, but I am SO not the audience for this. I want to say, "are you kidding me? I have been trying my very best not to deliver three months early. 39 weeks is a pipe dream for me. Get over yourself."


Similarly, my doula has been a source of annoyance since this diagnosis as well. I get that her role is to be supportive during delivery, and because I don't really care about the delivery, we don't have that much to discuss. I want her to basically be a logistics manager, especially in a NICU situation, since Jason is unlikely to be conscious/capable of this. After sharing the diagnosis, she came over to discuss plans, and asked about what types of scented candles we like, comforting lighting, music choices, etc. Again, I get that this is part of what she does, but let's look at the hierarchy of needs- we had just gotten news that our children might be very premature and may not be healthy. Why would I care about candles?! And then she asked if I had my hospital bag packed, because maybe I should start taking it to appointments, which made me cry.  Afterward, she sent me an email saying that a planned C-section (which I don't have?) could be "such a blessing." What does that even mean? Ugh.


While on the topic of things that frustrate me, I have been reading Happiest Baby on the Block. Like What to Expect When You Are Expecting, I somehow expected this to be a serious book, based on actual research, but really, it is pop science written in a breezy, grating way. I don't doubt the techniques- they seem pretty basic and intuitive- but the assertions are in no way based on actual research. Maybe at some point I will stop being surprised about this and just accept that in the realm of maternal and infant health, there is a distressing lack of actual, rigorous research, as well as experts able to speak to issues without being totally obnoxious. This book says you should use pacifiers because African tribeswomen strap infants to their chest and nurse them up to 100 times a day, and those babies don't have colic. If you cannot manage this type of Earth Mother approach, a pacifier is a decent substitute. Also, all of the language is directed to "Mom," which seems totally unnecessary in a book about baby care, which can be done by a variety of caregivers.


I'm planning to go to a baby shower this weekend. Hopefully I can keep my mouth shut since I am such a joy about childbearing at the moment.

The appointment I was most dreading has come and gone. I'm not sure how I feel about it- on the one hand there is good news. I am still pregnant on the cusp of week 29, the twins are still doing ok, and the physical issues predicting pre-term labor seem to have slowed or improved. However, the twins are still discordant in size, even more so than last time (but within the margin of error of their last measurements, which I keep reminding myself are pretty loose estimates.) The boy is growing like gangbusters and appears to be a good deal larger than average, while the girl continues to grow much more slowly, and is way below average in size. This could indicate a problem, or it could just be that she is small. The frustrating thing is that they have no idea what the problem could be, if there is one. They are able to evaluate things like her cord connection to the placenta, the blood flow and artery quality, and those things all seem fine. She could have a bad placenta, which they can't evaluate until after delivery. And having a bad placenta may or may not mean bad outcomes for her.

This was the first week they are able to do biophysical profiles, so they did one on her and she passed with high marks! She was moving and kicking a ton, which is good. She is breech and baby boy is not, so they seem to be kicking each other in the head. However, because she is so small, I have to start going in weekly for these profiles, as well as to check on her growth. These tests take up to 90 minutes and are extremely anxiety inducing. I think I may need to take up something crunchy like meditation, because I am sure my nerves are not helping anything. I don't think doctors take into consideration the anxiety that all of their testing and speculation about possible terrible things generates, and how this contributes to poor outcomes. I am starting to see the wisdom of the hands-off midwives....

Rita sent me a bunch of message board threads of women who have dealt with fraternal twin discordant growth. All of them either had healthy babies that happened to be different sizes, or their twins were close in size and the measurements were just wrong. I also have a coworker who was terrorized weekly with scary sonograms showing poor growth for her baby, and she gave birth to a 7 lb healthy baby. So I am trying to take all the news in stride and not panic.

Another somewhat positive thing is that the doctor said she wouldn't recommend delivery until at least 34 weeks, unless baby girl fails her profile, or has stopped growing completely. Those two things would likely trigger an emergency c-section. So, I have glimmers of hope of making it to February, and of a weeks-long, rather than months-long, NICU stay. I have also explained to the twinnies that if they make it to March, they have a much better chance of hosting their birthday parties outside in the park, rather than in some dank community center room. Incentives!

I am starting to go a little stir crazy during the week from not leaving the house. I drive Jason to and from the metro (see the laziness that car-owning encourages!) and other than that, I lay on the couch with Sal, who tries to sleep through my singing, poking, and petting. On the upside, I am not sick, which was a major problem for me throughout the second trimester. I have to say, I'm not sure I can imagine ever being pregnant again, with what I know now is a pre-disposition to high-risk pregnancies. What if I had a child right now? How would I function, with strict limits on my ability to walk, stand, lift things, keep my eyes open past 8 pm? Barely able to make my 40 hours of work per week because of constant doctors appointments, nevermind taking care of the health needs and appointments of a small child?

We are having the first major snow of the season right now, and it's very pretty. Good thing I don't have anywhere to be.

Welcome, 2017, welcome

I am relieved to be in 2017 and still pregnant. I know it's tiresome to blame all bad things on 2016, but really, it was a relentlessly bad year and I had no plans of becoming a mother in it. I am not under any illusions that 2017 will be any better politically- it will likely be worse- but it still feels cathartic to leave it behind. This past week I woke up every morning feeling anxious about getting through the day still pregnant, and went to be relieved that another day had passed. In between, I tried to eat as much as possible and get up from the couch as little as possible.* The first day of this year corresponds to the first day of my 28th week, officially the third trimester. It would still be scary and dangerous for the twins to come any time in the next few weeks, but likely less of a crisis situation than if they had come before this week. I will be further relieved in two weeks at week 30, and would calm down about preterm labor almost completely at week 32. That would still be two months early and require a long NICU stay, but I have greatly adjusted expectations now. It would also be great if the twinnies were not present for the travesty of January 20th.


Of course, the other big issue is whether my doctor will induce me early regardless of how long I can carry because of baby girl's growth rate. This is a bigger fear than going into labor prematurely. I think I'll have more information on that after an appointment on the 6th. I am very much dreading it. The longer I stay away from doctors, the better my anxiety levels. I have bad dreams about people chasing me and trying to take the twins from me. I wonder if I should get third or even fourth opinions. I am trying to comfort myself with the knowledge that in the dozen or so sonograms I have had, they have never found anything wrong with either of them. She is just growing slowly, but still steadily. There is no reason (in my non-medical opinion) to think she'll continue to do anything differently. She has been at least a week smaller since the first ultrasound at week 6. My doctors don't seem to pay attention or care about my theory that she implanted later and is just younger, in addition to being a smaller baby than her brother. But I still think it's true.


*It seems like I did this, but in retrospect, over the past week and a half, I left the house for dinner four times, went to the movie theater and grocery store, hosted a brunch, and had friends spend a couple of nights in our house. Perception of time and activity is weird. I would sometimes feel bad about being out and about but I am not on bed rest, just "limited activity," which is a vague and nebulous state.