Breastfeeding fashion: What works for me

Since I'm planning to breastfeed Eden for a long time, probably into an overlap with our next baby, it was imperative to me that I find a breastfeeding wardrobe that was comfortable and efficient as soon as possible.

I started out wearing my maternity tops, since they were what fit best postpartum anyway. Even once the maternity shirts got put away, I continued to use these maternity/nursing tank tops from Walmart, which were cheap and surprisingly durable. (I bought one in white and one in black--mediums--and for size reference, I was 140lbs/B cup prior to pregnancy, 190lbs/D cup while pregnant.) While many commenters noted the annoyance of having the strap fly away after unsnapping it (vs more expensive nursing tanks, such as the ever-popular Bravado, which feature a strap which anchors everything nearby), I found them stretchy enough to just pull down for nursing, as opposed to having to actually unsnap them. I was also lucky enough to get a couple of Bravado tanks as hand-me-downs, and they are awesome--flattering, sturdy, stretchy. They're $45 a pop new (though you can often find them for less on eBay, Craigslist, etc). They do contain a very supportive internal bra (vs just a shelf bra on other tanks/camis, although I have found a shelf bra to be plenty, even at my new cup size), and so while $45 for a tank seems like a lot, if you use it like I do as the foundation to bridge your regular wardrobe into a nursing wardrobe, it might not be so bad.

As far as a nursing bra, I had ordered one of these from Walmart.com and wore it toward the end of my pregnancy. I found it supportive (if with somewhat unnecessarily wide straps--but it was comfortable) though some sort of hidden tag or something left the middle of my back itching like crazy, but that could have just been a fluke. Early on I decided a nursing bra was too much to fumble with, and since it was summer, I was largely wearing my tank tops and camisoles anyway, and so I started wearing those either alone or under another top, basically using them like a nursing bra. Worked like a charm and saved a ton of money!

A few weeks postpartum I invested in some nursing tops from Expressiva. We were taking Eden to church and other places where being able to breastfeed easily and somewhat discreetly was nice. While I can't speak highly enough about doing business with Expressiva, as they're great with returns and exchanges and ship quickly (and props to them for their organic line), I did find much of the clothing to be overly heavy (for many of the shirts, the "nursing option" is a whole second layer of cloth with boob cutouts) and actually somewhat more awkward than just pulling down a regular (V-neck or stretchy) shirt. (Especially if I was also wearing the nursing bra.) Getting the second layer to lie right without looking awkwardly bunchy (like I had a dishtowel under my shirt) , not to mention fishing through the hidden openings to try to hook and unhook a nursing bra with one hand, wasn't easy and usually wound up taking more effort and drawing more attention to myself than the simple maneuver I used with regular shirts. Unfortunately, as a result, I've largely quit wearing them and will probably go ahead and Craigslist them soon.

As noted above, I've now evolved into a system that is based around wearing either one of my hand-me-down Bravado tanks, maternity tanks, OR any reasonably stretchy camisole with a shelf or other built-in bra (I have a number of my sister's castoffs from American Eagle, Express, Target, Maurice's; you can also get them at Walmart.com--never thought I'd be their spokesperson!--for around $5 apiece) under either a top that is a) stretchy, b) low-cut, c) V-neck, or d) button-down; OR under any other top that is loose enough to pull up from the bottom. For the first bunch, I pull the top and the camisole down to nurse, then pull it back. That's it. No snapping, rearranging of layers, or anything like that. Yes, the top of my breast (gasp) is exposed while I nurse, but I'm comfortable with that. For the second group of tops (this includes things like Tshirts and pullover sweaters), I pull the shirt up and the tank down. While not quite as quick and easy as feeding from the top, I like this option for its ability to let me wear a lot of my pre-baby tops without flashing around a bunch of belly and back (which is sort of awkward, and hey, it's December now!).

I'm also lazy and so I like that at the end of the day, I can take off whatever I'm wearing over it and voila: easy nursing pajamas!

If you utilize this system, you can easily take your maternity/pre-maternity wardrobe through nursing with only the addition of a few camisoles (ranging from $5-$45). Compared to $30 and up for a single nursing top, and the fact that this system is overall much more convenient for me, I feel like I've landed on something that really works.

What about breast pads? Personally, I never got used to wearing them. I found them itchy, uncomfortable, and ridiculously obvious under just about anything. I wore While I was sometimes leaky, especially early on, I personally preferred to deal with a few drips on my shirt (which can happen even with breast pads, depending on how messy an eater your baby is) than trying to yank around and readjust uncomfortable breast pads. I also learned quickly, as I'm sure most others do, that clamping my opposite arm over the breast I wasn't feeding with prevents it from spraying through my shirt when my milk lets down. On the whole, I just figure that I am a breastfeeding mother and there is bound to be evidence of it (besides the baby attached to my breast, that is), and I'd just as soon that evidence be milk as giant breast pads showing through my shirt. If I were going to wear them (say if I had a more formal job, and/or an expensive or dry-clean-only wardrobe vs scrubs, tshirts, and tank tops)? I'd definitely go with these wool ones.

From one of my favorite blogs by a breastfeeding mom, her own tips for a breastfeeding wardrobe, along with an excellent post on how to be comfortable around a breastfeeding woman. She's currently breastfeeding a toddler, and is a source of information and interesting anecdotes about that.

Life after....

photo by wellcome images

Now that Eden is four months old, I figured it was time for a post on the subject that originally launched this blog: natural family planning, or life after birth control.

Coincidentally, I'm currently taking a women's health class (basically, gynecology) in midwifery school right now and am delighted to report that one of our main textbooks, Contraceptive Technology (19th ed.), is far from the dry, medical, and, well, technology-focused tome it might initially appear to be. Instead, it's engagingly written and easy to read, and a book I would recommend for anyone who is or might someday be in the position of considering contraception of some kind. (Which is to say, just about everybody.) The thing that surprised me the most about this book was its unabashed cheerleading for breastfeeding and its respect for natural methods of birth control, such as fertility awareness-based methods, withdrawal (almost as effective as condoms when used correctly--who knew?!), and lactational amenorrhea method (LAM).

While just about any maternity discharge teaching I've ever seen has included the phrase "you CAN get pregnant right after you have a baby, even if you are breastfeeding," and we're all familiar with the argument that pre-ejaculate contains 'millions of sperm,' " along with the joke about couples who use rhythm-based methods (what do you call them? Parents!), this book deconstructs those myths and gives success-rate statistics for all of them. In fact, pregnancy is highly unlikely for the first six months of exclusive breastfeeding (however, you have to understand and practice what is really considered exclusive breastfeeding), pre-ejaculate does not contain sperm, and fertility-based awareness methods are highly effective when practiced correctly. Here are the statistics on these three methods, all of whom share the advantages of being safe, completely free, and relatively effective:



(from Contraceptive Technology, 19th ed., Hatcher et al.) Except for LAM, this information is available from the authors here.

When it comes to breastfeeding, it's generally understood that breastfeeding slows the return of a woman's menstrual periods and therefore suppresses her fertility for a time. This occurs because the hormone prolactin is released during suckling, and prolactin suppresses hormones needed to induce ovulation. This effect has recently been quantified by the lactational amenorrhea method, which consists of the following three questions:

1) Is your baby less than six months old?
2) Is your baby exclusively or very nearly exclusively breastfeeding? (Generally, this means feeding on demand, day and night, no more than 4 hours between feedings during the day and 6 hours at night, with no or very little supplemental substances given.)
3) Are you amenorrheic (no periods since the birth of your baby--or, more specifically, no bleeding after 56 days postpartum)?

If you can answer "yes" to all three questions, your risk of pregnancy is considered to be less than 1%--equal to perfect use of highly effective methods such as the pill, and in fact better than rates of typical use (since you can forget to take a pill much more easily than you can forget to breastfeed your baby).

Here is a good source of information on LAM.

What about when you don't quite meet those criteria, though? Having a four-month-old, I can tell you that those six months after the birth of your baby are going to fly by.

Then what?

Also, what about breastpumping? Can you use lactational amenorrhea if you are pumping? Most sources are very clear that only "very little" supplementation (ie formula or solid foods) are acceptable for maintaining LAM. What if your baby receives no supplementation, but is occasionally or regularly given your breastmilk in a bottle (or spoon, or cup)?

And what if your baby sometimes sleeps through the night?

Obviously the waters get a little bit murkier. It's all well and good for statistical purposes to set rules like the above, but very few of us will meet those criteria for very long. Does that mean we should give up the idea and, perhaps unnecessarily, choose another method?

Pumping is an area most sources don't address directly, and some decry altogether, but it appears as though pumping full-time only drops the success rate of the methods from 98-99% effective to 94-96% effective. Hello! That's still a lot better than typical use of most contraceptives, it's still free, and it gives considerably more leeway to those of us who are pumping some, but not full-time. Personally, I think this is the information to present to women, rather than "No, it doesn't work." If I chose to go it on nothing but LAM, and were pumping all or some of the time--I would be aware that fertility might return sooner, but if I was still feeding breastmilk exclusively and still amenorrheic, I'd be willing to chance it (with some additional precautions--see below).

As someone who works part-time (probably pumping for 6-8 feedings a week) and whose baby sometimes sleeps through the night, whose baby is rapidly approaching the 6-month mark and who has successfully used natural family planning in the past, it seems like combining the methods would be a useful way to extend lactational infertility for the duration of its natural course. As a result, I monitor fertility signals (mainly cervical fluid--though I'm trying to get back in the saddle with basal body temperature (BBT) measurements too) even though I'm still amenorrheic (I find the "65 days postpartum" rule a helpful cutoff since I experienced postpartum lochia for ~6 weeks following birth, a dry spell of about a week, and then a couple more days of spotting--but have been amenorrheic ever since).

In the past month or so, I've had the odd isolated day of stretchy mucus here and there, helpfully pointed out to me by practicing NFP. On those days, we either abstain, or... use the newly-exonerated withdrawal method.

So far, it's a system that has worked well for us. I would love to see studies done on the triangulation of these three methods because I have a hunch that they would be pretty solidly effective, especially in women who are breastfeeding up to a year or two or even three--particularly since these women are likely to be the type who would be interested in safe, natural, and effective birth control which doesn't affect one's milk supply. I also enjoy the liberation of a method that is completely within our control, which involves bodily awareness and cooperation, and which capitalizes on practices that were already important to use anyway. The addition of withdrawal is also a handy one for new parents, who will inevitably find that their "safe days" with NFP don't coincide with the days that the baby falls asleep on time! I should point out that some NFP methods allow using a barrier method OR abstinence on fertile days , others are very fervent about the point that if you choose to use a "backup" method on days you are known or suspected to be fertile, you are not practicing natural family planning. You are relying on the success (or failure) rate of the method you are using (be it condoms or withdrawal or a diaphragm or whatever), making it anything but a backup since you are using it precisely when you are most likely to become pregnant. Meaning that you are looking at the 4-27% rate (depending on how perfect your use is) of withdrawal, not the high rates of success boasted by perfectly-practiced (meaning periodically abstinent) NFP. Clearly, this may not be a method for couples who would not want to risk a pregnancy for whatever reason; however, being as we know that we want more children and have preferences but not absolute contraindications as to when, it works well for us.

The book Breastfeeding and Natural Child Spacing is an excellent one about what the author calls "ecological breastfeeding," which includes on-demand and through the night but also the concepts of babywearing, near-constant togetherness, and cosleeping as important, the proximity of the baby contributing to hormonal changes which suppress fertility as well. However, she's very strict on these matters, moreso than modern life unfortunately permits for most of us, so I am happy to see statistics on LAM alone that show a high efficacy even when these activities--though definitely a part of our lives-- are not completely constant.

Elimination Communication: How it's going

In a word: well. In three words: Incredibly, surprisingly well. While I had lapsed for a week or so after I wrote the last post, diving into Diaper Free: The Gentle Wisdom of Natural Infant Hygiene by Ingrid Bauer proved to be just the inspiration I needed to get back into it. And while it took us a little while to get reattuned to Eden's signals, I'm happy to report that it's going really well now.

Per Bauer's book, we picked up a Baby Bjorn infant potty for less than $10 on Amazon and we LOVE it. While we occasionally still use the toilet or even a sink depending on what's handy, this sturdy, ergonomically-shaped little potty can travel room to room with us, and it's also good to give Eden a consistent place to go. However, we've even embraced wholeheartedly the idea of pottying her while out and about. Previously we'd only been EC'ing at home, but recently we've taken her to potty when it was convenient (the ladies' room at a restaurant, a friend's bathroom, the great outdoors while we were out for a walk) and it had gone so well that I wondered why we hadn't been doing it all along. After all, grownups go to the bathroom when they're out and about without resorting to crapping in their pants--why should it be any different for babies?

What I do is put Eden on the potty and cue her to go just before we leave the house. Then, if she's showing any signs of fussiness before or when we get to our first destination, I put her on her "travel bowl". I also put her on when we come out of a store or if I nurse her while we're out. While it might sound like a lot of trouble, pulling down her pants and putting her on a bowl is actually less trouble to me than listening to her fuss when she has to go, cry hysterically when she's wet, and attempt to change her wet or dirty diaper in her carseat while she's frantically wiggling--not to mention then taking care of the dirty diaper.

While she occasionally wears a diaper during her fussy time in the evenings or on a long outing, for the most part, she's wearing these 2T training pants (a little baggy, but comfy and absorbent). For clothing, dresses were an easy option in the summer, and her sleep sacks are nice at night (though she hasn't gone at night since she was about a month old, but they're good for those early-morning piddles), but pants are a good easy-up-and-down option too, especially now that the weather is cooler. Some sleepers have snaps that allow strategic access; some don't unsnap in a helpful location, and some have zippers (which require getting her totally undressed to go to the bathroom--fairly impractical). So pants and undies are what she wears most of the time. When we're outside on a walk or coming and going from somewhere, it's incredibly easy to squat down with her, slide her pants down a little, and pee her in the grass. Probably not an option during a cold midwestern winter, though!

So how do we know when she needs to go? Timing is one way: we always put her on the potty and make her "psssss" cueing noise when she first wakes up and right after she eats. I've found that if I have her in a carrier during a nap and pay attention to when she first starts to seem restless, I can often potty her without completely waking her up, and she'll return to sleep and sleep another 30 minutes or so. This wasn't the case with diapers, when she would wake up wet, angry, and have to be changed and wiped (and thus fully awakened). We also pay attention to when she seems distressed, wiggly, or even just distracted--she'll be playing with toys or breastfeeding and suddenly get a faraway look in her eyes, and generally it means she needs to go potty. Sometimes it's just been awhile and it seems like she might need to go. And every once in awhile, as I'd read but not quite believed in various accounts of EC--I just "know" she needs to go. Finally, in addition to the obvious timing of peeing when she wakes up or eats, she has her own patterns that I've come to know. She seems to have a few distinct "wringing out" periods during the day when she'll go as often as every 20 minutes. One occurs around 11am, another sometime between 2:30 and 5, and another shortly before she goes to bed. We try to be especially conscientious about watching her signals and just frequently putting her on the potty during those times. As a result, the rest of the day tends to be pretty predictably dry, so we often take her on walks or even short trips without needing a diaper bag!

At home, we average about 1-3 "misses" per day. These might be times when I don't get a clear signal from her, or times when I miss it because I'm distracted (I've gotten peed on a number of times while talking on the phone or watching a movie. Once, even, while writing this post). She's even pottied when friends of ours are watching her. There are also times when our signals are fine but we end up with a wet lap or bed because we spill the potty or don't get her on at the right angle. However--I'll take my accidents when her pee and poop are totally benign, versus when she's two or three and eating solid foods!

Home girl

Matt and I recently made the decision to try to keep Eden as close to home as much as possible. While we've always been big fans of long country drives, Eden decidedly is not. When she was a newborn, she'd sleep peacefully in her carseat, but that time is no more. She's been growing progressively more agitated in her carseat for the past several weeks, and after a car trip out to Shenandoah during which she screamed at an ear-splitting volume for over an hour, we've decided it's in everybody's best interest to limit ourselves to things within walking distance as much as possible.

And that's really fine with us. We like to be at home and we knew that having a baby was going to change things. The big difference is that where we previously ran all of our errands together, now one of us will likely end up staying home with Eden. But it's probably best for her health anyway, and we know it's best for her comfort. And we know it won't last forever.

I'm pleased to announce

...the ringing in of a new era.

Ladies and gentlemen, for the first time in six months...my rings fit again!

Stuff we love: Rescue Sleep Remedy

I'll be the first one to admit that the philosophy behind the Bach Flower Essences sounds pretty wacky to me. Unnamed substances distilled from flowers used to balance complex emotional problems? Kind of farfetched even for people like us. But when we tried them ourselves about a year ago, we were particularly pleased with the results of Rescue Sleep, which we found calming and sleep-enhancing.

So it's only natural (at least for us) that when we found ourselves with a restless, fussy baby, we gave a couple of squirts to her. It stopped her crying, anyway, as she tasted it with a funny and amazed look on her face. It didn't knock her flat out or anything, but within minutes, she was calmer, and then--asleep. Over the past few months, we've repeated the process a number of times a week and always been really impressed with the results. Even with her teething pain, we've actually found it to be more effective in calming her down than Hyland's Teething Tablets, a homeopathic remedy lots of parents rave about.

It could be the flower essences, or it could be the 27% alcohol solution they're preserved in (grape brandy, to be exact--and brandy is a time-honored remedy for teething babies). Either way, I'm not arguing with success. The bottle runs around $8-10 and lasted us over a year with occasional use; the next one will probably only last about half that long or less, since we're using it more often with Eden. Still, probably not much more expensive than something like Children's Tylenol, and we don't like the idea of giving our baby drugs unless absolutely necessary (and that stance finds more support every day). We get it at Whole Foods, but you can also order it online. Amazon has it for under $8 with free shipping! And right now, Mambo Sprouts is offering a $2 off coupon. Effective, natural, and a coupon to boot--what more do you need to know?

Krill oil: My cure for baby eczema

A number of weeks ago, to my dismay, Eden started developing rough, red patches of eczema on her arms and legs. Having struggled with various bouts of itchy scaly skin throughout my life, I had hoped she would be spared. Alas, she apparently was not. I rubbed coconut oil on it in vain--while it might have kept it a little softer, the angry pink outlines were still there.

It wasn't until a bottle of Omega-3 krill oil capsules arrived in the mail from my mom that I had an epiphany. I'd taken either fish oil or cod liver oil pills throughout the pregnancy, and had continued doing so since Eden was born. However, I get them through my mom, who is some kind of vitamin dealer, and I had run out and was waiting for her to send more. It wasn't until I started up again that I realized that the period during which I'd run out was exactly when Eden had developed her skin trouble. I hardly dared to hope that taking them again would rectify the problem, but it did! Within about a week after starting up again, her patches of eczema were all totally gone, and so far they haven't recurred. I'm convinced that was what did the trick, since it was the only thing about our diet and lifestyle that changed--both when she flared up and when it went away. Below you can see the difference:

The great thing about breastfeeding is that I don't have to try to figure out how to get her to take fish oil--just take it myself. But when she strikes out on her own, foodwise, you can bet that I'll be sure to figure out a way to do so.

Natural remedies for breastfeeding first aid

Michele at Frugal Granola has a great post up about how to create a natural Breastfeeding First Aid kit and her experiences with clogged milk ducts. I am crossing my fingers and feeling fortunate that I haven't had to deal with these yet, but based on the experiences of other nurses I work with (we don't exactly get predictable--or even regular--breaks sometimes), I know it's probably only a matter of time, and so I've bookmarked this excellent resource! I love Michele's blog because it lives up to its name: affordable, natural solutions to all kinds of issues in family life.

Natural Baby Essential: Coconut oil

Image by JPhilipson

Matt and I are all about products that do double, triple, or quadruple duty. Particularly those that are a single ingredient. Like baking soda--aka deodorant, toothpaste, kitchen cleanser, catbox deodorizer, stain remover, etc etc. Since we've had a baby, coconut oil has become one of those.

Eden's never really had what I would consider a full-blown diaper rash, but every once in awhile her butt will start to look a little red. We were using Burt's Bees Diaper Ointment, which worked beautifully and smelled wonderful, for the first month. Then all of a sudden one day I put it on her--no broken skin and no more red than usual--and she screamed absolutely bloody murder and would not stop. Assuming it had to be the cream, I quickly washed it off and she eventually settled down. We tried it one more time, just to be sure that was it, and sure enough--the same thing. She obviously developed some kind of sensitivity to one or more ingredients in the product--which was a shame, because we really liked it, but there was nothing we could do.

So we were on the hunt for something new. We'd obtained some refined coconut oil (basically it's processed and flavorless and cheaper than the raw or virgin coconut oil that's pricier and healthier) when I was pregnant in an effort to help slow stretch marks (it didn't work, but it is a wonderful moisturizer). I decided to try some of that on Eden since when I'd used it, I had appreciated how quickly it melted into my skin without making it feel greasy. Anything oily or greasy (like zinc oxide or petroleum-based balms) are a concern with cloth diapers because they can cause the diapers to repel water, which leads to leakage.

It worked beautifully. We applied a little coconut oil (easy because it's sort of a soft solid when you scoop it out, then melts at body temperature and soaks right in) to the red areas with each diaper change and by the next day, all traces of redness were gone. We've been using it for over a month now and it's shown no signs of causing problems with her diapers, and usually clears up her skin overnight.

Eden also developed a case of baby acne around 4 weeks old, which didn't seem to bother her much, but was something of a bummer to me, since she'd had such lovely creamy baby skin. I'd read that 4 weeks is a common time to develop it, and that it nearly always clears on its own by about six weeks, but I noticed that heat, drool, and dry skin seemed to exacerbate it and so though it might seem counterintuitive, I rubbed a little coconut oil on her cheeks in an effort to help her skin balance out. Sure enough, by six weeks her skin was beautiful and clear. I think it probably would have cleared up by itself anyway, but it seemed like the rough texture was improved by applying the coconut oil once or twice a day. Her cheeks still tend toward dryness and so I usually apply it to her face every morning and after a bath, and these days she looks like an "after" model for Clearisil.

We also use the coconut oil as an allover moisturizer after her bath, and I know some people swear by putting a dollop in the bathwater as well. We wash her in our bathtub and so since we don't want to slip and break our necks on an oily floor, we tend to avoid that measure. But as a moisturizer, it's effective, surprisingly nongreasy, and happily, completely nontoxic--so when she puts her hands in her mouth immediately after we apply it, we don't have to anxiously scan a list of ingredients to make sure she's not eating poison. It has just one ingredient, which we love.

Lastly, Eden has a tendency to develop a dry and occasionally flaky scalp--and I've found it helps quite a bit to rub some coconut oil into her head before she gets in the bathtub. In the tub, I just rub her head with a wet washcloth and that's it (no soap). Afterward, I rub in a little more coconut oil and she's good to go. Her hair and scalp never look or feel greasy--just soft.

We received ours from a generous friend who had it on hand, but there are a number of sources for coconut oil on the internet or at health food stores. You can get a 14-oz jar from Amazon for about $7 shipped. It also makes an easy and flavorless cooking oil. What we've done is take a larger batch and scoop it out into smaller containers--like baby food jars--so that we can have one in the kitchen, a small one by the changing table, one in the bathroom, etc. I usually scoop it into a jar and then microwave until it melts, then re-solidifies into a smooth block.

Relatively cheap, completely nontoxic, extremely effective, and very multipurpose--we're sold.

Baby love

I've been thinking a lot lately about what it's like to love a baby or a child. People tend to speak of it like it's something concrete and universal, things like you'll love them more than you ever thought possible or you'll fall in love with them immediately or you'll love them more than you've ever loved anybody, but I think it's probably more individual than that. The rate, depth, and expression of falling in love with a new baby are probably different for every family.

For example, many women speak of the overwhelming sense of emotion and besottedness they feel with their newborn from the moment of birth. Natural-birth advocates in particular speak of the cocktail of "love hormones" that promote deep and immediate attachment between mother and baby. Perhaps because I went into labor at 38 weeks and it only lasted about two hours, and so I hadn't yet had time to get my mind around the idea that hey, we're having a baby, not only soon but today, not just today but before breakfast time!, the most powerful feeling I had when I first held Eden was that of being completely stunned. Stunned that birth was over (heck, that it had even started!), that she was here, that she was a "she," that pregnancy was no more and her life was beginning. I remember looking at her and thinking that she looked right to me, like she belonged to our family, and feeling protective of her in the sense that I thought that we needed to get her a hat and a blanket and warm her up, but there was still a certain sense of disbelief that she was actually mine. It was only looking back at it a couple of weeks later, once I'd had a chance to get to know her, that that scene became infused with a new tenderness for me. It's a lot like looking back at my first dates with Matt--superimposed over the awkwardness that was actually there is a powerful sense of nostalgia and fondness born of what was yet to come.

There are also those who say that romantic or marital love "pale in comparison" with how powerfully one loves a child. I have to say that I honestly don't feel like Matt's and my love pales in comparison with anything. Instead, having Eden together has opened up all kinds of new things for me to love about Matt--how attentively he took care of both of us in the first hours, days, and weeks after birth, and still does; how much joy he gets from our daughter; his concern for her wellbeing. While I adore Eden--her baby smiles, curling up with her on the couch while she contentedly nurses--how can I adore any less the person who bustles around, cooking dinner and cleaning, so that she and I are completely free to do that?

On the other hand, it is very different from romantic love--in which you get to know someone incredibly well, then choose to make them part of your family. With a baby, you choose to add them to your family, they come to live in your house, and then you spend the next years getting to know them. I've also considered how crazy it will feel when Eden starts to talk. So far, I've gotten to know her as this being who definitely communicates, but does not speak--a lot like our cats. I imagine that her beginning to talk will feel something like if one of the cats opened its mouth and spoke words one day--a sense of "I never knew you could do that!"

Becoming a parent and falling in love with my baby have been different for me than the way they're described by many people. Just as it's nothing I could have really understood for myself before doing it, it's nothing that anybody else could prepare me for, either. And for me, that's part of the beauty of it--that out of the uniqueness of my relationship with Matt, we're creating a family dynamic that's also one of a kind.

Heavy

...is how taking care of Eden has felt in the past day or so. Mainly I mean this literally--she's probably at least a good 13 lbs or so now now and that is a LOT to have hanging off your body all day and night. Which, most of the time, she is--either being held, worn in the Ergo, or nursed. One the one hand, I love that she's a snuggly baby and likes to be held, and we believe pretty closely in most principles and applications of attachment parenting. On the other hand, I have a permanent crick in my upper back, and I've gotten so used to holding her all the time that even when I'm not, I catch myself picking things up off the floor with my toes. It feels so good when I finally get to straighten up and stretch--when for a minute, I'm just one body--and when I do, I sometimes realize it's the first time I've done so all day.

Part of this is my fault. I've gotten used to doing things in a decidedly un-ergonomic fashion (such as way too much time spent holding Eden in one arm, cradling the phone against my neck, and using my other hand to change over laundry/type with one hand/make dinner etc) and I should probably work on that. She also seems to be in a very high-needs period right now (my own mother would likely point out that if she's anything like me, that "period" will last anywhere from three to twenty-three years) and so my approach for this week, at least, is to pick out the top two or three things I need to get done in each day, do those while she takes her naps, and then just try to focus on Eden.

For today: register for classes (done), take a quiz (next), and vacuum (saving that for when she gets fussy because it usually puts her to sleep). Anything beyond that is a bonus but I'm not going to sweat it. Instead, I'm going to do everything I can to try to enjoy my baby--and, barring that, at least to fully be there for her.

There's also a certain level on which things sometimes feel heavy in a more figurative sense. Remembering that we can't just dash off for the day because there are those among us who hate their carseats and can go through a dozen diapers in the space of a morning. Having three in the bed, which is almost always cozy but every so often feels crowded instead. Never making it through a meal without someone else yelping to be fed (no matter how recently this just occurred) in the middle. I feel so incredibly lucky that she has another loving, caring, attentive parent who is ready and willing to jump in and totally take over at moments like that. Thank you, Matt. I don't know how any mother--especially one with a more demanding baby than Eden, which I think most are--does it without a Matt.

On the other hand, when I do go away, like to work, I miss her so much. I never understood how a person could really miss a baby (miss what? their stimulating viewpoints?), but I do now. I miss her soft, fuzzy head and her gummy (and occasional) smiles and her heartbreakingly plump and squishy cheeks. And I guess that's what it's all about.

Elimination Communication

Matt and I had talked before Eden was born about the idea of trying out Elimination Communication (EC)--also known as diaper-free, or natural infant hygiene. Basically the premise is that you learn to recognize your baby's cues when s/he is about to go to the bathroom, and you put them on the toilet or another receptacle.

Well, believe it or not, we got busy during the first six weeks and didn't get a chance to try it. I'll admit I was also a little skeptical--on EC websites and message boards, moms are always singing the praises of how well it works. Come on, we thought--how well could it really work?

Really, quite well, as a matter of fact. We started last weekend with Eden, and we use an old plastic cereal bowl--now marked with a "P" on the bottom, for pee/poop/potty--because she's still too small and wobbly to comfortably hold over the toilet. Plus, it's easier to take the bowl wherever we are (the bedroom, the living room) as opposed to running into the bathroom every time we think she might need to go. We don't tend to bother with it when we're out and about, but when I'm home with her during the day, she probably does 2/3 of her pees and all of her poops that way. It was incredibly easy to get started, and while it's probably more work for me than just changing and washing diapers, she's always hated to be in a wet diaper, even for a little while, so it's cut down on the amount of time she has to do that. It's also significantly reduced our diaper laundry, but that was only a load a day anyway, so it was no big deal.

Here is a great article by Sarah Buckley called "Mothering, Mindfulness, and a Baby's Bottom," in which she explains more about various aspects of the practice. While it might seem new-agey and crazy to some, it's actually how native cultures have dealt with infant elimination for thousands of years. We enjoy the insight into what's going on with Eden--what we thought before was unexplained fussiness is actually almost always the signal that she's going to go to the bathroom. I can usually tell by watching her face when she's on the bowl whether she's done or not--watery eyes, flared nostrils, puckering her lips like she's whistling are all signs that she's still got more to go. I usually sit cross-legged with the bowl on my lap and either hold her under her arms or cradle her (sometimes nursing her), and both work well. When she's done, I dab her off with a cloth wipe, rinse the bowl into the toilet, and dry it out for next time.

Here are some other good sites if you're interested in giving it a try:

Elimination Communication Positions
Diaper-Free Baby
Potty Whisperer

Postpartum: Life AFTER life after birth control

One of my midwifery professors calls it "the forgotten period," due mainly to the fact that in traditional obstetrical management, a new mother doesn't see her care provider again until six weeks after giving birth. Plus, it somewhat lacks the excitement and novelty of pregnancy and birth. Rixa at Stand and Deliver, who had a baby herself not long ago at all, recently opened an honest discussion of feeling "dumpy and frumpy in one's postpartum body." I was still pregnant when she posted it (5 days before I had Eden), and so I admit most of my attention was taken in by this excerpt:

For the first few weeks after giving birth, I feel incredibly attractive. Every day, especially during the first week, I look thinner and more shapely. My breasts get bigger, my stomach gets smaller, and when I see myself in the mirror each morning, I think, "Wow! I look good!"

I find newly postpartum bodies incredibly beautiful. Very feminine--or perhaps the better word is womanly. I love the empty, rounded belly; the soft bread-dough skin; the flush of hormones.

It seemed too good to be true. But like a prophecy, that was pretty much how I felt in the days after giving birth. Losing 32 pounds in under a week (10-lb baby, 3-lb placenta, and evidently about 19 lbs of fluid) didn't hurt at all, and neither did getting back those ankle bones I'd been pining for.

Rixa went on to say that a few weeks later, the dramatic body changes hit pause for awhile, and she's left feeling less than pleased with her appearance. By way of perspective, though, she posted a link a couple of days later to an article entitled "Maternity leave--or reprieve?" in which the author calls for the "need to respect the time parents spend with newborns." The author notes, "It would be a shame to lose reverence for those gentle, maddening months after a child is born, when you are in a sleep-drained reverie, stitched to a baby's rhythms and sweet suckling; when you watch them unfurl, watch their eyes focus on the world, their lips curl into smiles, their startled limbs jerk and then grow strong."

So, right now, are the days of our lives. While I am getting past the honeymoon stage of no longer being pregnant, and I am struggling a little to come to peace with the idea of all the things about my body that will never quite be the same, I'm also inclined to marvel that the price of creating human life--of suddenly producing into our living room a whole new ten-pound being, our daughter--isn't in fact any steeper. And I try to remember to be amazed, as well, at what my body can do: create a baby, efficiently discharge a baby, and now continue to feed and nourish a baby (no less, after being up all night with said baby).

And on the whole, I've felt remarkably good: despite the exhaustion, optimistic and energetic the majority of the time. The day Eden was born, we took her for her first walk outside; my coworkers are still surprised that I haven't felt at all teary or bluesy since she was born. The closest I've come was a surprising torrent of tears when we buried the placenta, when she was a little over a week old. I think in large part that was because of the sense of closure it gave me, the feeling that this pregnancy and birth--which were such a wild and beautiful and spiritual adventure--were really over. As Matt put it, "You've put so much work into this pregnancy and this birth, and growing such a good strong baby--and now all of that seems like it's forgotten." Not that I'm not overjoyed to be moving on to the next step, because I am, but goodbyes, for me, are always hard.

Other than that, though, I'm doing my best to identify with and take comfort in the final sentence of the previous article:

When you delight in the life you have created, it becomes a lot less important to get your own life back the very next day.

Then here's to delight.

Ode to my cloth pads

I have a lot to catch up on with this blog--Eden's birth story, for one, but also all of the postpartum-y things I've become intimately aware are part of "life after birth control"--but I can't help myself from taking the quick opportunity while Eden is sleeping to share my deep and abiding passion for cloth postpartum pads. Matt and I were actually cutting them out (loosely following this pattern, but there are tons of others out there) before we went to bed the night I went into labor, so obviously we didn't have time to sew them ("we" meaning "Matt" because I can't sew) by the time I gave birth. I was almost ready to throw in the towel and just keep using disposables, as my motivation was largely environmental and I figured the planet would understand, just this once--but Matt, bless his heart, sat down a few days ago and finished them, and I am now the proud owner of about 16 of the softest fleece-backed flannel pads with snaps on the wings that I have ever seen. The comfort is absolutely out of this world--to go from feeling like I was wearing a crinkly, sweaty, leaky plastic diaper and being constantly aware of that fact to being essentially unaware of the whisper-soft flannel lying absorbently next to my skin is one of the closest things I know of to postpartum heaven. They're slim, they're soft, they breathe, and they don't leak!

I'm sure the next question on everyone's mind is what you do with a used cloth postpartum pad. We've rigged up a nice system wherein we have a 1-gallon bucket under the bathroom sink that has several inches of water and a splash of Biz thrown in (upon my mother's recommendation, Biz is about the only thing we can find that gets out tough "human" stains like blood, sweat, and ring around the collar; we figure that in our largely chemical-free lifestyle, it's a concession we can make). I put the used pads in there and then dump the bucket in the wash when it's full. A little Biz and laundry detergent gets them sparkling clean again.

Plus, at $16-23 a pop to buy cloth pads (which you can do on Etsy or many other places if you don't have a sewing-inclined husband), we've saved literally hundreds of dollars by making them at home from a flannel sheet we got at Goodwill for a couple of dollars, a fleece blanket we picked up at KMart, and snaps we got for under $2. Plus, they were custom-made by my loving husband. It just doesn't get better than that!

38 weeks: Here she is!

And not a moment too soon, considering that Eden Leah weighed 10 lbs and 2 oz at birth--following one of the fastest and most intense first-time labors I've ever seen! More on that later, but in the meantime, we're resting up, cleaning up, and enjoying our little girl.

37 weeks: belly casting!

One of the members of my birth team was kind enough to bring things over yesterday to do a belly casting (as well as an aromatherapy foot bath)! We had a great time doing it and I think it turned out really well. Here's a photo of the process, plus front and side views of the finished cast:

36 weeks: On the home stretch

Here is the updated progression, with my 36-week picture on the right. Notice how despite cheating and switching to a maternity tank top last picture (at 32 weeks), the tank top can still no longer contain me? Yeah, neither can most of my maternity clothes, either.

It's hard to say much about being 36+ weeks pregnant in June without sounding like a whiner. So, I'll just let it rip.

The heat doesn't bother me all that much (though that's easy to say when one spends most of one's time indoors these days), but the now-permanent swelling has gotten a little old. My (c)ankles are like grapefruit, my fingers and toes like sausages, and my face, well, I feel like one of the Munchkins or something. NOT FLATTERING. (Other people are afraid of having their neither regions caught on camera during birth--I'm totally cool with that, it's the idea of a head shot that makes me cringe.) My blood pressure is still good and everything else is fine, so no true concerns--I'm just massively bloated, and no amount of drinking water or cranberry juice or herbal tea or keeping my feet up seems to help (though plenty of things seem to make it worse). And just when I thought I was home free in terms of the final indignity--hemorrhoids--all of a sudden one day my rear end looks and feels like a cluster of grapes that somebody, somehow, for some reason decided to attack with a piece of sandpaper. Because I'm all about solutions on this blog, I'll admit I have finally gotten a decent amount of relief with warm and cool compresses and frequent applications of Florasone (thank you to my helpful husband for the suggestion, as well as the sympathetic ear), but I'm haunted by the thought of what these bad boys are going to be like after birth.

Being on my feet for very long is exhausting, but you know how good it feels to fall into bed at night when you're really exhausted? Well, that respite is now soured by a) how stiff and uncomfortable I am after spending more than 15 minutes in any given position, b) how incredibly uncomfortable it is to try to CHANGE positions, and c) the prospect of getting up to relieve myself of a tablespoon of urine approximately every hour and a half. Nighttime is not the right time, anymore--at least not where rest is concerned.

Besides that, and gaining 45 pounds despite eating more healthfully and remaining more active than the majority of pregnant women that I know, well, besides that I'm doing well and I do know that I have a lot to be thankful for. Though crabby and uncomfortable, I'm healthy. The baby is big and active and we're getting so excited to meet him or her. I have the world's most loving and helpful husband. We have another baby shower coming up on Saturday and things are already pretty well set. (You can see our crib, changing table, and diaper stash here.) I'm anticipating the kind of birth that many women can only dream about, surrounded by a few cherished loved ones and warm water and familiar things. Matt and I both have downright heroic birth stories in our families, and so despite the concerns voiced by everyone from my coworkers to checkout clerks, I'm not worried that this baby is too big to come out the old-fashioned way. I have faith in birth, in myself, and in my birthing team. It's late pregnancy that's the challenge!

New angles

Something besides the standard white tank top/belly shot.

Or my grapefruit ankles, which was the other option.

32 week picture

Once again...I look at the last picture we took and it makes me think I looked downright skinny! Obviously I've increased in size yet again since the 24 week picture, and these days anytime anybody asks when I'm due and I tell them, I'm met with raised eyebrows, incredulous looks, or comments like "Are you sure your dates aren't off?" or "Do you think it might be twins?" (Yes, and no.) My measurements are right on (fundal height of ~33cm at just over 32 weeks), so I don't really have an explanation of why I'm carrying so big. Some days I feel it more than others; after we moved, I had several days of seriously puffy feet/hands/ankles, backaches, and aching feet, but I seem to have normalized again and am actually feeling quite good. During the same period, I had another bout with feeling like I might be starting the first twinges of a UTI (possibly due to dehydration), but my cranberry/blueberry juice and Vitamin C regimen has me good as new again--except that I have a few more pounds of baby sitting on my bladder than I did last time.

Otherwise, we're doing really well, and starting to kick our preparations into high gear. In addition to the move to a bigger apartment (though our plan is still for the baby to sleep with us--the extra room will function as an office/spare bedroom/repository for all the baby's gear), my work threw us a shower a couple of weeks ago and we were thrilled to receive a variety of cloth diapers (including BumGenius, FuzziBunz, and plenty of unbleached prefolds) and covers, all of which we need to launder to get them ready for use, as well as plenty of baby clothes and other essentials. We found an Ikea dresser which matches our bed, for $30 on Craigslist. We're planning to use it for the baby's things, and it's also the perfect height for a changing table. Double duty is a definite plus when space is limited!

Other than that, my size and the frequency of Braxton-Hicks contractions I have would leave me unsurprised if this baby showed up a week or two before his or her due date, so we're anticipating having everything ready to roll by the end of June, just in case!

The big 3-0

30 weeks. To some extent, I feel like I'm settling into this pregnancy--starting to understand its rhythms, its rhyme and reason (if there is such a thing). There are fewer surprises these days, and knowing what to expect counts for a lot. Even discomforts like the sometimes-excruciating pelvic pain seem to be somewhat predictable: if I overdo it, or if the baby and I seem to have a growth spurt, I'll have a very painful several days, over the course of which acupuncture, chiropractic, ice, and rest will gradually help me back to a functional (though not totally pain-free) state. Bike riding, unfortunately, is another thing which seems to aggravate it very predictably, and so I am most likely going to give that up until I'm no longer pregnant--much to my chagrin, since it's the only way I can propel myself around in a way that makes me feel light and speedy. Otherwise, I'm more or less getting used to feeling large and slow and short of breath a lot of the time (I always say I have room in my belly for the best 2 out of 3--my stomach, my lungs, or the baby. Especially after I eat, my lungs seem to be the ones to get short shrift).

On the other hand--I can't say that I'm not looking forward to having the baby in a couple of months (which now feels like the home stretch to me--I am a good 75% done!). My body seems to be slowly but steadily gearing up as well: The Braxton-Hicks contractions I've felt since 10 weeks are slowly getting stronger, the baby's movements are getting progressively stronger, and my bladder capacity once again seems to be shrinking. Annoyingly, my expanding girth means that I bump into things almost constantly and people bump into me, and I find this leaving me increasingly short-tempered at times. My walk has settled firmly into a waddle (as people don't seem to mind telling me), which seems to have a lot to do with my pelvic issues, and I'll be glad to resume some semblance of a normal stride--along with the ability to move with some degree of speed. I had to try to chase one of the cats around the apartment tonight to take away a rubber band she was chewing on, and the effort it took made me reflect wistfully on how athletic and energized I felt at this time last year. I also miss my wedding rings, and my ankle bones.

At the same time, I still feel lucky to have had such a healthy pregnancy so far, and I'm optimistic that we'll have a healthy, normal birth as well. I know the discomforts I'm feeling are both temporary and worth it.

And, I'm beyond pleased to report that some of my stretch marks are even starting to fade already.

Puff plus

photo by Omgayeo

All I can say is that I am so swollen this weekend!

Granted, the fact that this is my number one complaint is an improvement over other weeks, when I've been unable to keep down nourishment or have been in excruciating pain, but still. Rampant discomfort is no picnic either.

It started toward the end of last week and it started where it always does: in my hands. Even before I was pregnant, my hands have swollen in response to heat and/or exercise. So it's no surprise that at 7 months pregnant and with the thermometer tipping 90 degrees this weekend, I finally had to take my wedding ring off (or face the idea of having someone cut it off).

By Saturday, my feet had joined in the party and I was rocking full-on cankles. There are those who would say that a hotdogfest around an open fire probably didn't help things any, but as this article aptly points out, too little salt can actually prevent your body from being able to keep fluids in your bloodstream and contribute to swelling as well. In general, my salt intake is pretty moderate, so I'm not too worried that this is my problem. It also felt like everything I drank just stayed on board, despite my best efforts to flush my system with water, cranberry juice, and decaf iced tea. I can see it in my face, too, in the pictures we took on our camping trip this weekend. Uff. Few things leave a person feeling less sexy (or even particularly mobile) than feeling like you've bloated up with a few extra pounds of water weight...

And summer hasn't even begun yet. So, the game plan: acupuncture (which I got yesterday, after skipping a week due to working nights last week), regular swimming, forcing myself to drink more fluids, and staying as cool as I possibly can, since I know that heat is always a trigger for me.

A few new weapons in the arsenal

The thing about aches and pains when you're pregnant is that there's really no throwing in the towel and just taking a pill. Your commitment to natural and alternative means of pain relief is all you have.

So I've been forced to continue my quest to cope with or eradicate my pubic bone pain as best I can, without the aid of traditional pharmaceuticals. In addition to those I've already mentioned, here are a few I'm currently trying:

http://www.inspiredliving.com/body-pillows/pillow-pregnancy.htm

A maternity body pillow. This is one of those things I'd always dismissed as kind of silly and unnecessary, but which really seems to be a lifesaver in my current situation. I was prepared to shell out for one, but first put out a call on my local Freecycle instead--and boy, was I glad I did. Within hours I had a high-quality, full-length down one in a washable pillow case. I slept with it last night and didn't wake up once, not even to pee.

http://www.twin-pregnancy-and-beyond.com/exercise-during-twin-pregnancy.html

Swimming. You hear a lot about the benefits of swimming during pregnancy--relief from gravity, decreased swelling, low impact on the joints--but it really hits home once even walking becomes too painful an exercise to bear. Matt and I are lucky enough to live in a community where we have a wonderful indoor pool (discovered last night) as well as 14 community outdoor pools, all of which are well-maintained and very affordable. For $3 apiece last night, we spent about half an hour swimming laps in a just-comfortably-warm and nice-sized pool (the only caveat for those with symphysis pubis dysfunction is to avoid breaststroke and sidestroke), then spent 5-10 minutes loosening up in their hot tub--which was huge, not hot enough to have me concerned, and which had steps that allowed me to sit with my pelvis submerged but my belly and upper body out of the water.

http://www.gaiaherbs.com/product.php?id=168

Arnica oil. Known for its anti-inflammatory, healing, and pain-relieving qualities when taken internally (homeopathically) or topically (as an oil or gel). It has been shown to be as effective as an ibuprofen gel for reducing soreness and stiffness. I'm using arnica oil directly on the painful area, as well as taking internal homeopathic arnica.

http://www.householdgoods.com/tens-unit-two-channel-machine-pads.html

A TENS unit. In other countries, TENS is one of the first modalities used for back and labor pain. It works by blocking the transmission of pain signals from the spinal cord to the brain, and also results in endorphin release. Here's a link to an article from Australia discussing TENS unit use for SPD.

The only thing I'm not yet currently using is the TENS unit--my parents are mailing me one that my dad used to use for back pain. I am, however, using the body pillow at night, applying the arnica oil before bed, taking the arnica internally 1-4x a day, utilizing hot and cold packs as necessary, sitting on my exercise ball whenever possible, and planning to swim a couple of times a week for exercise and buoyancy. I'm also continuing with chiropractic and acupuncture at least 1x a week, each.

What's the cost of all these things? The TENS unit and body pillow were free for the asking, and both could probably be obtained used for $20-50. I already had the exercise ball. The arnica preparations were each around $8-11 and will last quite awhile. Acupuncture costs a minimum of $15 a session, except that Matt and I have been doing a few hours of a volunteer work at the clinic per week and have thereby earned a number of free sessions. My chiropractic co-pay is $30. Swimming is $3 a day. So on a weekly basis, I probably spend an average of:

$30 chiropractic
$15 acupuncture
$6 swimming
$1 arnica preparations
______
$52

Which is not cheap. Neither, however, would medication or physical therapy be, nor would allowing myself to become debilitated so that I'm unable to work for the duration of my pregnancy. And there are certain things in live you just aren't given a choice about; in terms of maintaining a healthy body and a healthy pregnancy, as my dad would say, "Those are the things your money is for." We'll make up for the cost by cutting corners in other ways.

Like I've done before...

photo by X-it

I spoke too soon. After working three days last week, by Friday night, my pelvic pain was back with a vengeance. We went for acupuncture Saturday morning, and I was suffering enough even after that to call my chiropractor and ask her to stay late to see me that day--which she did. But while last time it seemed like everything I tried helped at least a little bit, this time, nothing seemed to help at all. Not the acupuncture, not the chiropractic, not a hot shower or two hot baths, not ice packs. No position was any more comfortable than any other and the only thing that made it more excruciating than it already was was trying to ride in the car--I don't know if it was the vibrations or the position or what, but it was just intolerable. I spent a decent portion of Saturday afternoon literally writhing on the couch and crying, until I feel into an exhausted sleep for about half an hour. When I woke up, it seems like things had quieted down to a dull roar. I slept OK last night, and much of today was fine, but late afternoon found me back on the couch in the same state I was in yesterday.

One more thing I've found that does seem to lend a little relief is sitting on an exercise ball. It seems to offer the right mix of stability and "give," and I think is also helpful because it's not a static sitting position--I'm constantly shifting around. And that's sort of what I've found to be the most helpful thing--just constantly changing positions, because no one position is very comfortable, and especially not for very long. Unfortunately, that's kind of exhausting. It's discouraging because my pelvis feels too painful and unstable for any real activity--like walking or hiking--but at the same time, I feel exhausted and drained, just from dealing with the pain. Needless to say, this is a huge setback and disappointment for me right now. I'm hoping that maybe things were just stirred up by the acupuncture and chiropractic, and that by mid-week I'll be feeling better again, but it seems like by then going to work, I get myself into a vicious cycle that's hard to break. Though again--resting it doesn't seem to help substantially either, and it's really way too early for me to be off work anyway. Matt has been wonderful, quick to draw me a bath or help with massage or suggest something he's read about, and most of all, just lots of moral support during this very trying time for me. And that helps. In the meantime--we'll just keep our fingers crossed, and keep trying.

Me & my belly

Symphysis pain gone!

Contrary to what I'd expected, which was worsening pelvic pain up until the time of birth, it instead seems to have subsided entirely. This seems nothing short of miraculous to me, considering how much pain I was in just a few weeks ago. The acupuncture seems to have set off the initial healing reaction, helped along by an activator adjustment by my new chiropractor. I can't recommend these two things highly enough, and you can go to this site to find out whether there are any acupuncturists offering sliding-scale fees in your area.

The things that helped me most during the actual flare-up were an ice pack to the area, and also doing the exercise described in the previous post which involves putting your fist or a flat pillow between your knees and squeezing it for a count of five. That one sounds counterintuitive, but I found it to give me an almost instantaneous measure of relief, especially if I did it a few times before standing up from a sitting position (which previously really exacerbated the pain). It resulted in kind of a "good hurt" during the exercise, like a good deep stretch, and then the area felt better afterward.

I was able to go to a conference last week on support techniques for natural birth, and was fortunate enough to hear the Bagnells, a husband-and-wife chiropractor team, speak on their techniques for pregnancy adjustments and resolution of fetal malpresentation. While my chiropractor doesn't specifically practice the Bagnell technique, she is very hands-on with pelvic adjustments, and hearing the Bagnells speak made me glad that I was able to find effective interventions for my symphysis pain so early on. One interesting point they made was that any time a pregnant woman experiences severe round ligament pain, especially early on, one should suspect pubic bone malposition. As you may recall, I started with round ligament pain in the first trimester, and interestingly, so did my coworker who also developed pubic bone pain (and actually referred me to my current chiropractor). A misalignment there is associated with a much higher incidence of malpresented babies, including breech, posterior, and transverse presentations, which is not anything that I am interested in!

A good site for those who want to learn more about the interaction between maternal tissues and fetal position, and how that affects the duration and ease of labor, is Spinning Babies.

Another good resource for understanding the physiology of pregnancy and birth and beyond, and what you can do to maximize it, is Elizabeth Noble's Essential Exercises for the Childbearing Year. I got mine used off Amazon for $0.01, bringing my total to $4 with shipping--an investment that is well worth it.

Symphysis pubis pain

I mentioned in an earlier post that around 22 weeks, I started suffering from pain in the front of my pubic bone, or symphysis pubic dysfunction (SPD). This is the best online resource I've found so far, which includes a good explanation of the physiology of SPD, frequently asked questions, medical and alternative relief options, and considerations for birth.

This article details the use of a support belt and stabilizing exercises to treat SPD. I recently obtained a maternity support belt (a lot like this one) and wear it when working or walking for long periods, and I think it's somewhat helpful. I don't wear it all the time, because I want my muscles to have to work to maintain their own stability as well, but a 12-hour shift is a lot to ask out of anyone's back and pelvis and so the extra support is nice. The subjects were given the following instructions with regard to exercise and lifestyle:

Abdominals: "Sitting with your feet resting on the floor, gently pull in your lower abdominal muscles abdominal muscles as if you are hugging your baby. Hold for 5 seconds. Repeat 5 times, continuing to breathe normally."

Pelvic floor: "Sitting tall, squeeze to close around your openings. Lift and hold for 5 seconds. Repeat 5 times. Breathe normally throughout."

Gluteus maximus: "Sitting or standing, squeeze buttocks together. Hold for 5 seconds. Repeat 5 times."

Latissimus dorsi: "Sit on a chair in front of a table or a closed door. Grasp door handle or table with both hands and pull toward you. Hold for 5 seconds. Repeat 5 times."

Hip adductors: "Sitting down, put your fist or a rolled towel between your knees. Squeeze knees together. Hold for 5 seconds. Repeat 5 times."

Self-help Management

The aim is to reduce stress on the joint.

It is essential that you tighten the muscles of your pelvic floor and lower abdomen before and during the following activities.

When getting into bed:

* Sit on the edge of the bed, keep knees close together, then lie down on your side, lifting both your legs up sideways. Reverse this to get out of bed.

* Do not attempt to pull yourself up from lying on your back.

When rolling over in bed:

* Keep knees together.

* Do not roll with your knees apart.

When getting up from a chair:

* Keep knees close together, put your hands on your knees, and lean nose over toes to stand up.

When sitting down:

* Do the reverse to sit down.

* Ensure that you feel the chair at the back of your legs first.

When getting into a car:

* Sit down first and then swing legs in, keeping knees together.

When walking:

* Take smaller steps.

When using stairs:

* Step up sideways one step at a time.

* Avoid stairs if possible.

Remember to:

* Sleep with a flat pillow between the legs.

* Take rest breaks.

* Move within the limit of pain.

Avoid:

* Sitting on soft sofas and chairs.

* Walking as an exercise.

* Active stretching.

I've started sleeping with a flat pillow between my knees, and I try to use the body mechanics suggestions whenever I can. I've heard conflicting things about whether walking is contraindicated as an exercise, and it's free and healthy, so I haven't given that up yet. I am planning to start to implement the exercises.

However, I was perhaps most interested in this article from the British Medical Journal, which reports a greater decrease in pelvic pain in subjects who underwent acupuncture than those who underwent interventions involving exercise, support belts, or both.

I'm figuring I can't go wrong with all three. This morning I had my first acupuncture appointment with a delightful acupuncturist in Frederick, Maryland, who has made a name for herself offering treatments on a sliding scale from $15-35 per session. This was my first experience with acupuncture and I was very pleased. A couple of the needles stung a little as they went in, but on the whole I was very comfortable during the approximately 20-30 minute treatment. My pelvis has felt sort of achy and sore all day, and it's hard to say if that's left over from yesterday or if it's a sign that things are resettling themselves, but time will tell. I'm placing a lot of hope in this, because otherwise it's going to be a long next four months...

24 weeks

15 weeks, 18 weeks, 20 weeks, and 24 weeks

Every time we take a picture, I look at it and think how big my belly has gotten, and how I can't imagine it getting any bigger. Then, by the time we take the next picture, I think the same thing about that picture, and look back a little wistfully at how tiny I look to myself in the previous picture. It's crazy and you'd think I'd be used to it by now, but the thought process is remarkably similar each time.

First, the good news: I'm measuring perfectly at 24 cm for 24 weeks. (Which strongly dispels the likelihood of twins, despite what my round girth might suggest.) The baby is delightfully active and literally feels bigger and stronger every day. The heartbeat sounds great, my blood pressure is good, and by every other objective measure of pregnancy, I'm doing very well. The number on the scale is a lot to wrap my mind around, but we're eating incredibly well and I take at least a 30-minute walk most days, along with a variety of prenatal exercises, so I'm doing my best to let my body be my guide on that front.

On a less-pleasant level: the hormonal discomforts of pregnancy (morning sickness, etc) have all too quickly been replaced by the mechanical ones, as I mentioned in my last post. My symphysis pubis pain can literally bring me to tears, especially if I've been working all day, and I'm going to do a separate post on the efforts I'm making to correct that. Bending over has become rather a challenge, and I have a job that requires me to do that many times in a 12-hour period. Changing positions requires ever more (and noisier) efforts, and I had a recent tearful episode remembering what a wonderful, active summer we had last year and mourning the fact that I will most likely not be doing all of my grocery shopping by folding bike this summer, nor will I be doing any 7-mile hikes in the Shenandoah mountains. (Matt is wonderful about comforting me through such times, however, and pointed out, "We'll just plan to have a really active fall!") I'm also getting up probably 3-4 times a night to pee (during the day, I go at least once an hour). My mom says I've had a tiny bladder since I was a baby, and pregnancy has certainly brought out that condition. Also being crowded out of the way: my lungs and my stomach.

Otherwise, though, we're happy and thankful. We're getting more and more excited about the birth, and talk all the time about what it will be like when the baby gets here. We went to an excellent cloth diaper information session put on by a locally owned Web-based business, Abby's Lane, which we were completely impressed with. We've decided that we'll most likely go with prefolds, pins, and wool covers to start with. We'd originally thought we might go with an all-in-one, but she convinced us that these are often not a good fit for newborns and we want something that we can start with and that will then grow with the baby, as opposed to changing systems midstream. It's also much more economical and seems like a better fit for our lifestyle and philosophies. We've also been incredibly blessed by Freecycle and hand-me-downs from friends, so that we feel like we have a good stock of what we'll need to at least get started. Which is good; now that the weather is warm, it's starting to feel like summer and this baby are just around the corner.

At least, that's what I keep telling myself, when four more months of pelvic pain and a waddling gait and going to the bathroom 20 times a day starts to sound like a very long time...