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Having a baby is…

Breastfed Babies can’t get (too) fat

It is hard for babies who are exclusively breastfed to become overweight. It is another wonder of breastfeeding that babies can’t easily eat too much, because breasts auto-regulate and if babies want to feed more often, they simply get more of the watery, foremilk (rather than the fattier hindmilk). So it quenches their thirst, allows for comfort sucking but won’t up their calorie intake significantly… until they are ready for it. Ain’t Mother Nature a star?!

Green Poo

When Anya was six weeks old her poo turned green. Hey, I had read somewhere that babies’ bowel movements changed, often dramatically at about that age; plus I had heard there was a range of colours baby poo came in all of which were healthy, so I didn’t worry.

Until, at about 10 weeks, I was in a ‘baby and me’ group and another mother saw Anya’s pooey diaper and said, and I quote: Ewww!

Her baby was way older than mine yet she seemed utterly surprised by its green hue. Could it be less than normal?

So, what could I do? I googled it.

The virtual oracle offered two possible explanations: food intolerances or an imbalance of fore and hind milk (resulting from an over-production of milk). Well intolerances were going to be much harder and take much longer to investigate [don’t I know it – as I am going through that now] so I thought I’d try the protocol suggested for dealing with over-production of milk.

First, let me explain this potential imbalance. As breastfeeding mammas will now, babies need to get both foremilk and hindmilk. Foremilk, the first milk that comes through at each feed, is more watery and thirst quenching. The hindmilk is richer in fats and will provide satiety. However, if you are producing too much milk (and or swapping breast too soon) your baby will get all foremilk and not enough of the essential fatty hindmilk which makes them full. And apparently this will show up as green poo (as the lining of the intestines gets irritated by the lack of lovely fat).

So, I did what the moms on this forum I found suggested and fed my child from the one breast everytime she chose to feed in one two-hour period and only then would I change breast. And, lo and behold, within the predicted 48 hours Anya’s poo was back to the normal mustardy-seedy yellow. Hoorah!

After thinking at one time that I didn’t have enough milk and despite my still really quite small breasts, it turns out I had an over-production of milk. This certainly is verified by her incredibly fast weight gain, she has gone up by 65 percentile points since birth – quite something, ei?

Anya’s Birth

Below is the story of Anya’s birth. It is long because I wanted to capture the details for myself, for posterity.

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So, I think my ‘birth story’ has to begin way before the birth. Let me start with the dream. Throughout the pregnancy I had many vivid dreams including visions of my baby girl (even before we officially knew the gender) but there was one other reverie that really stood out. I dreamt I was in hospital and the doctors were going to have to open me up. Well, having lived ‘naturally’ my whole life and only ever having treated any health issues with herbs and supplements, surgery was a big step in a direction in which I would normally never go. In the dream it was a chest operation (for palpitations I was experiencing in real life). But something happened in that dream, something shifted in me and I submitted, I surrendered knowing that if I needed an operation, I could do it.

I have always said that natural medicine and mainstream medicine should stand side-by-side, complementing each other… but in practice I still turned always to traditional medicines, spurning the more chemical and intrusive interventions of the medical establishment. With this dream I felt a peace come over me and knew that I could and would have an operation or take harsher drugs if that was what I needed to do for my baby.

Fast forward some months. We discover our baby is breech. The most common outcome for breech births is cesarean. I went into overdrive and tried everything anybody suggested for turning a baby in the womb: homeopathy, acupuncture, chiropractic, yoga inversions, etc. Baby remained head up. All of these approaches helped me in some way. But none of them turned the baby.

So I went up a notch. I went into hospital (after much fandangling with insurance people to clear this) for an external cephalic version – where they turn the baby, manually by pushing on the belly to move the baby. That didn’t work either. It bloody hurt (as I did it with no anesthetic) but she refused to turn. She kind of half turned and then came back to the same position. I decided I have a strong-willed baby with a mind of her own, who is, much like her mother, a non-conformist. She was going to do it her own way.

I felt I had relaxed fully, despite the pain, during the version, allowing the doctors to work… but Kelly (my homebirth midwife) and K (my partner) convinced me there may be a chance that if I did another version, this time under anesthetic the baby might turn and I could still have the homebirth we had all planned for, together. I didn’t feel it would work, but went along anyway, just in case and so nobody could say I hadn’t tried EVERYTHING.

Funny thing, the next version, under anesthetic didn’t work… but I had a profound experience in the OR room which really helped move things for me.

I went in alone (i.e. without K) as they administered the pain killer and K scrubbed up (ready to join me and hold my hand during the actual procedure). As I entered the room, exposed, in a hospital gown, surrounded by doctors and nurses I had just met and sterile medical equipment, I started to repeat a mantra in my head. Then something a friend had said to me recently came to mind. He had said, with the best of intentions (but not knowing baby was breech): “I hope you have a conscious and spiritual birth”. Well, that conjured up for me the image of a homebirth, in a water tub, with dolphin music in the background and some women chanting… something like that, you know?! But suddenly, as I lay in the OR, in a flash, the absurdity of it hit me. Do those things really make for a more ‘spiritual’ birth or a more ‘conscious’ one, at that? How could they? Is the Buddha more enlightenment when he is in a cave, than when he is the city? Was Jesus more self-realised on the mountain top than when he walked in the city and spoke to prostitutes?? Surely not… my job is to be conscious no matter where I am or what kind of birth I have. Spirituality is in me, not in my surroundings.

So, though I hadn’t wanted to go for this version and though in the end it did not work… it was still this experience that pushed me to find peace with whatever arose for me, during the rest of this process and the birth.

We had to come into hospital a couple more times after that (so much for the low intervention birth I had planned): once to check fluid levels, once for pelvimitry (a catscan/x-ray to measure the size of my pelvis). This was not optional. If I wanted to even consider a vaginal birth, still (with baby inverted) this hospital, UCSF, is the only one on the West Coast that does this and this X-ray is one of the conditions. Between my palpitations and now, baby being breech, I had more ultrasounds and X-rays than anyone I know, during pregnancy… despite having started this journey saying I didn’t want more than one ultrasound (as I read some research which linked it to developmental problems for kids). Oh well – you get the birth you ‘need’, not the birth you ‘want’, as they say.

So, I was cleared for a vaginal breech delivery. This is good news

A few days later, I lost my mucus plug – great excitement. I had a few contractions later that day, while walking through IKEA! I spoke to my midwife and asked if this was it and she basically said, “Keep watching see what happens”. Nothing much happened and the contractions subsided – much to my parents chagrin as they were really hoping to meet their first grandchild, before having to go back to Europe in a few days.

Thankfully a few days later, contractions re-started, this time I was buying a car, negotiating the price, while pretending nothing was happening (contractions, what contractions?!). I came home and had dinner, timing the surges on an iPhone ap… But without telling my parents ‘cos I didn’t want to get their hopes up in case this wasn’t the real deal, again. Had a lovely dinner cooked by my mum. As soon as they left to go to their hotel, I jumped in the bathtub to relax. The rushes kept coming. They were still quite manageable (obviously, as I could disguise them all through dinner) – like mild period cramps.

During the night they started to intensify. Rushes were coming every 5 to 10 minutes and getting stronger. I let K sleep through the night though as I felt he’d need the energy to support me tomorrow. I too was able to sleep between contractions, but each one woke me up again.

Early in the morning (around 5.30 or 6.00) I woke K and said it was getting stronger. We texted Kelly as we didn’t want to wake her but it turned out she was already attending another birth. Full moon will do that – draw all the babies down.

Because it was the holiday season, UCSF had given us a schedule of when the doctors who are able to do this type of birth (vaginal breech delivery) were on schedule. Today was New Year’s Eve… from 8am there would be no doctor on call with a specialty in this area. We would have to be an automatic cesarean if nobody could help deliver her ‘normally’. So, Kelly advised us to get our arses into the hospital, even if chances are we were still in early labour – just in case the night doctor (due to leave at 8.00) was still there and would stay on to make sure we had a chance of delivering her naturally.

We got into the car to go to the hospital. K forgot to close the boot… then after noticing that and getting back in the car, he forgot how to drive!

We met Kelly at UCSF. She said as soon as she saw me she could tell I was ‘only’ in early labour. It felt like real labour to me!! The hospital staff did an assessment on me. I was dilated to 4 cms, 50% effaced and contractions were coming every 5 to 7 minutes. Validation: I was (just) in active labour. However by the time I had been assessed the doctor who could have helped deliver my baby vaginally was no longer on call. The new attending physician, Dr Schaeffer , came in and talked to me along with an intern who we had met already Dr Rasha Khouri. Dr Schaeffer said that due to the fact that she was breech and there was nobody on call today (New Year’s Eve) that could deliver her naturally, we should move to a cesarean, now. They could get the OR prepped in half an hour!

I was relieved and happy that we were allowed to go into labour naturally (something my yoga teacher had reminded me was important – to follow the baby’s rhythm)… but was shocked that my chances of a natural birth were dashed that quickly, after all this. Having said that, work in my birthing class had helped me find a great peace with having a cesarean if that was what I needed. I had discovered in me that what counted was my baby coming into the world, triumphantly – no matter which ‘exit’ she chose. Anyway, things seemed to be unraveling very fast.

Dr Khouri who knew us and our wishes for a natural birth interceded. She is very pro-vaginal-breech-delivery herself – a lot of the interns are, as that is what they come to this hospital for, their unique approach to birthing, very respectful of women’s wishes and nature’s ways (for a hospital, especially). She took the list of all the doctors who are able to oversee this kind of birth and called them all to see if any would be willing to come in to assist my birth today. One said yes. The catch was that she was only free till 8pm. If I was not ready to birth by then she would not be able to come in (she had an end of year party to go to, understandably). At 8am the next morning another doctor would come in who could do this. Therefore there would be a 12 hour window at night in which nobody could handle this procedure (and again we’d have to go straight to cesarean, if baby were to come at that time).

So, I was allowed to continue in labour and they would see how it was going and re-assess at 8pm.

We were given our own room to labour in – with a fantastic view of the bay. Like a hospital version of a penthouse, we decided. I also texted my parents who came over to check in and give support.

Most of the time it was just Kelly, K and me in the room, as I laboured. For most of those hours (from about 10am onwards) I dozed or rested between contractions and then pulled all my resources together for each contraction. I wanted to scream and to start with I did. It felt like a big relief but Kelly told me to conserve my energy and use my breath instead. That felt very different, in some ways it was less gratifying as it gave me less of a release, but I could see how it was stronger, too, somehow. I also realised everything I had learnt in my Birthing from Within class was useless to me now. Hey, as I said, the emotional processing we did there was brill… but the techniques for coping with pain did not work for me at the time. The only things that helped me were a) following my breath and b) having K breathe with me, leading the tempo – but in fact, though he offered often, we only did that a couple of times. K said that I was so self-sufficient that he felt rather helpless, shut-out even at that point.

Later as the pain intensified, the only thing that brought relief was pressure on my back K brought out some tennis balls he brought. I put them under my lower back in the bed and pushed against them with each surge. Later I got K and occasionally Kelly to push my back, that was even better, as they could push stronger. In one of my dozing periods I felt my dad came to me in a dream with some more practical advice, which helped.

I had no drugs at this point, only a saline drip to keep me hydrated.

Kelly tried to get me to move positions. I resisted it as moving sounded so hard… but once I got there it did indeed feel better: standing up leaning on a table or kneeling on the bed with my arms on a yoga ball. Kelly said these would help move labour along, as it was progressing slowly.

There was a hospital nurse who checked my progress, too. She was very nice. My parents, especially, bonded with her as she would bring them news of my progress as they waited outside. They did come in a few times. Dad gave me a reflexology massage which helped, and it was good to see them… although mostly I needed space, to get on with it.

The nurse urged me to get into the bathtub for relief. Kelly wasn’t pushing that at first. Some hours later, when I had been labouring a long time but was still ‘only’ at 6cms, Kelly suggested I get into the tub. K told me later this was to slow my labour down as she realised at this point I would probably not make the 8pm deadline but if labour were slowed down I might be able to make the 8am window the next morning.

The bathtub was a mixed blessing. Between contractions it felt good, but when contractions came (and they were getting stronger now) it was very hard for me to find relief as there were no tennis balls there and K and Kelly found it hard to get a good angle to push on my lower back. With each contraction I remember a repetition of thoughts, something like this: as it started I would think ‘Oh my God I have got to get out of this tub’, as the contraction reached its peak I would think ‘I can’t do this’ and as the contraction began to subside I would think ‘I am doing this’. Between contractions I would instantly forget the pain and feel all was right and wonder what all the fuss was about… and then it would start up again.

At 8pm Dr Schaeffer came in and said they couldn’t hang on any longer. An intern checked me and said I was fully effaced but still only at 6cms. They suggested I went in for a cesarean now. I asked if I could hold on and keep labouring till 8am. I had always thought the tiredness would get me. When I heard labour often lasted 14 or 15 hours I thought it sounded unbearably long, yet here I was about 24 hours into it and still asking for an extension! I think the Australian Bush Flower Essences I was taking were really helping to sustain me.

The doctors explained that, for a breech delivery, they needed everything to progress, in a text book manner (as it already carries higher risks). If I were somehow able to slow my progress down and ‘hang on’ till 8am before giving birth, by then I would have been in labour so long that it would no longer be considered an easy, straightforward birth and they wouldn’t recommend me for a vaginal breech under those circumstances, anyway. So, cesarean it was.

I had given it my all and was grateful that I had been able to go into labour naturally, as I said and now I was thankful that me and my daughter had been able to labour together for so long, too – at least we would benefit from all those lovely labour hormones like oxytocin and pro-lactin which help mood, bonding and perhaps most importantly breastfeeding.

And so to the OR it was. By this point I could feel the baby coming down (though they had said she was still too high) and really wanted to push. Contractions were coming every one or two minutes (max). And this is the point they wheel me into the OR for the anesthetic. The anesthesiologist was really nice and said soon I would no longer feel them… but the thing was in the meantime the contractions were at the strongest ever, coming really fast and there was nobody who could push on my lower back – that was awful. A nice nurse pushed once but after they had sterilised my back ready for the spinal block nobody could touch that area. Those were the worse contractions ever: me sitting there in a gown, surrounded by strangers and nobody to push on my back for relief… but it was only a few, 5 at most. And then they put the needle in my back, between my vertebrae and seconds later my legs started to go numb. K was then scrubbed up and allowed in the room. He held my hand through the procedure. We were both behind the sheet that divides the sterile field in which they operated. I could feel nothing of course but could hear people chatter. It didn’t bother me at all – I was soon to meet my daughter.

Then they took her out. They asked if K wanted to watch but he said no (too squeamish). They cut the cord but K got to perform the second cut it, bringing it down to size. I still hadn’t seen her. I had detailed all I wanted on my birth plan. And the doctors did follow it. They conserved my placenta, for example… but meanwhile I still hadn’t seen her. They were cleaning her or whatever. Then they brought her over to the weighing station and by wriggling my head, I could just see her… just her butt. Funny. she would have come out butt first had she been delivered vaginally, she came out of the ‘window’ in my belly butt first and now, even I first had sight of her butt… then I wriggled some more and saw her face: she was cute!!!!! I was soooo happy. She was beautiful, my darling baby girl. I had asked to have skin-to-skin immediately, even just cheek to cheek if nothing else. The young nurse I think was also learning and wanted to whisk her right away to put her under a warming lamp but I insisted and they brought her to me first and we put our faces together and felt each other’s warmth this way for the first time.

Then they took her to the nursery and K went with her. Kelly was then allowed into the OR while they stitched me up (with my uterus out of my body!!!).

Later, they brought Anya into the room I was in. Kelly put her on my chest, in the middle. It was amazing, we watched her wriggle and move her way instinctively to my breast. In about 5 or 10 minutes she found my nipple. Kelly helped with the final bit and positioned her head. She latched on immediately and that was it, we were breastfeeding. What a miracle!

I was in love… K and I were and are in love with this beautiful baby girl. What a joy. We are so grateful to Kelly, my parents and the amazing staff at UCSF for helping her come into the world. Indeed, thank you to all who supported us in this journey and got us to where we are now: at the start of an even bigger, better, more challenging and ultimately, we hope and pray, more fulfilling one.