My Parenting Bookshelf--Pregnancy/Birth

For some women, it's shoes. For me, it's parenting books. I read every one I can get my hands on. Whether I agree with them or not, I find them fascinating. I didn't start out collecting them on purpose. The first couple of weeks after my eldest was born, I started worrying about breastfeeding. Was I making enough? Was I doing it right? I picked up a couple of books.

Then, after a horrendous experience with a child abuse manual (TTUAC), I stumbled across a Sears' Baby Book for 90% off (changing editions). I started getting more books on development and gentle discipline. When Joel had the bad reactions to vaccinations, I found several books on that topic. Once we decided to do a natural birth with Elena, I got several books on that.

By the time our fourth was here, I already had shelves full of books that have helped me tremendously. Like old friends, when I need advice, ideas, or reassurance that things are normal, I go back to many of my favorites.

Since there are too many to share in one post (I read a *lot*) I'm going to break it up by topic and share pregnancy/birth this time, breastfeeding another, gentle discipline, etc. Some will overlap, of course. There are no doubt many goods ones I've missed, but here is a list of some of the best:

Ina May's Guide to Childbirth by Ina May Gaskin
Hands down, my favorite. I grew up with a lot of horror stories surrounding birth, and it was amazing to read so many happy, peaceful birth stories. The section with her advice and techniques was practical and easy to remember.

Orgasmic Birth by Elizabeth Davis and Debra Pascali-Bonaro
The title had me both skeptical and intrigued, but the actual book is very good. Again, positive stories and good advice.

Adventures in Tandem Nursing: Breastfeeding through Pregnancy and Beyond by Hilary Flower
When I became pregnant with Joel, Ariana was still nursing at least 8 times in 24 hours. I didn't want to wean her, but was hearing a lot of comments that suggested health risks, etc. This book is exceptionally well researched and gave me all the info I needed to nurse through pregnancy. I also appreciate the real-life stories. Nursing through pregnancy and tandeming can be emotionally and physically challenging, and she handled that with empathy, encouragement and no guilt trips.

Also-reads:
There are several others that I read from libraries, etc, but don't actually own, either because I didn't have the money to purchase them at the time, or whatever.

Spiritual Midwifery by Ina May Gaskin. The hippy-lingo made me smile, and Ina May is excellent.

The Thinking Woman's Guide to a Better Birth by Henci Goer
Tons of research and info. Not as light as some of the others, but definitely worth the read!

The Pregnancy Book and The Birth Book by the Sears. The Sears books were my first introduction into parenting according to my heart. I was so anxious to do things the "right way" and they were the first voice to give me authoritative, researched-based permission to cosleep, to breastfeed as often and as long as my daughter wanted, to respond to her without suspicion.

There were many others whose specific titles I can't recall. Some fantastic ones were lent to me by my midwife on active birth, and a couple that are mentioned in my previous pregnancy/birth/homebirth posts.

There were also, of course, some not-so-great books. I *loved* The Girlfriend's Guide books by Vicki Iovine during my first pregnancy. It was entertaining and fit perfectly with my preconceptions. After more research, I was in an entirely different mindset, however.

I read one moronic book on easy labor that was essentially an entire book on getting an early epidural, blindly following any and all suggestions by any medical personnel and being as convenient as possible for the hospital system. There was no research or helpful info other than saying that you are not being a good little girl if you ask questions or do anything without the maximum level of intervention and profit to the hospital.

There were a couple of others that just distilled all the columns from mainstream parenting magazines and said, "Well, you can *try* for an unmedicated birth, buuuuuut, you probably won't make it. Still, it doesn't hurt to learn some techniques to use while you are waiting for the epidural. Eat right and exercise right during pregnancy, etc." Generic stuff. And of course, there are a few that emphasize all the possible birth defects and complications (except complications that result from routine interventions). The "What to Expect" type of book. After my first pregnancy, I just read the weekly development of the fetus stuff and skipped the rest.

All of the books contributed in different ways to each of my birth experiences. Especially in my last two births, I learned a lot from some wonderful authors.

Next post: your baby is here, now what? books. :)

Bigger is...better?

Or at least, not bad. I should give a disclaimer, I suppose. I am not a medical professional. Still, after the recent birth of our beautiful daughter, who happened to weigh 9 pounds and 6 ounces, I've been rethinking our view of appropriate sizes for babies in this culture, and I am wondering if perhaps it is just that: cultural.

The OB who assisted my midwife made several comments about potential size, which in retrospect were probably leading up to a warning about her being too big to be born vaginally. At the time, however, I was too focused on giving birth to read anything into it. She is our fourth, and in my experience, subsequent babies tend to be larger. She had measured on target, and I didn't have GD, so I wasn't going to waste energy worrying. Also, I had read so many accounts of home births where healthy babies were born weighing nine or ten pounds or more that I didn't see a large baby as being a problem.

Our society expects babies to weight around seven pounds. Of course, a couple of generations ago, we expected them to be around six pounds. I think there were a lot of things that influenced that: many women were still smoking and drinking during pregnancy, and they were limiting total weight gain to 15 pounds or so during pregnancy. The mothers themselves were smaller, not just in weight but also in height.

Now there are still many women who restrict their weight gain in pregnancy, not by following healthy diets, but by limiting food intake. The high number of false positives in standard glucose testing causes many women to go on diets in pregnancy, and there are still plenty of OBs out there who warn women against gaining much weight or who automatically schedule C-sections based on their best guess of the baby's size. Add to this the fact that most hospital births take place with the woman flat on her back, which causes her pelvic opening to be 30% smaller than in other positions, which likely contributes to the myths about women being unable to deliver larger babies.

In reading numerous accounts of homebirths where women followed healthy eating guidelines, but didn't otherwise restrict their caloric intake, and gave birth in whatever position they wished (almost never on their backs), I have been struck by the significant number of babies that were well over nine pounds. They were healthy babies, their mothers did not have diabetes, they were birthed naturally without complications, but they were generally larger than babies born under standard OB care.

What if that is actually normal, perhaps even optimal? What if smaller babies are more a result of our attempts to restrict birth weight rather than a reflection of what is most healthy for the babies and mothers? Anecdotally, I can say that the larger babies I've known of (including my own) tend to be more content, sleep better, are healthier and are easier babies than those who are born smaller.

It would be very interesting to see research comparing both models of pregnancy care, birth weights and outcomes.

How sweet it is!

Since becoming a parent, I've had a lot of practice in thinking for myself, doing my own research, and coming to my own conclusions. The truth is, though, that I am an approval-junkie. Even when the rational side of me is convinced that I have made the correct choice, if anyone in a position of authority disapproves, I get a little stressed.

I was under the care of an OB/GYN for my first three pregnancies, and had a wonderful doctor. There was mutual respect between us, and he treated me like an adult. I was also pleased as I did my own learning to see that we matched up pretty well. He encouraged me to keep breastfeeding through pregnancy as long as my children and I wanted. When I failed the one-hour glucose test all three times, he didn't panic. His nurse, however, was a different story.

Her expression when she found out I was still nursing was priceless, and provided me with a great deal of inner amusement. Her response to the glucose test was a lot stronger, though, and not nearly as much fun for me. The first time around, I took the three hour test and passed, but she warned me strongly that since I had failed the one-hour, I still needed to do everything that a mom with gestational diabetes would do, except take insulin. I diligently followed all the advice, and stressed out constantly about every bite I took. I dreamed about food every night, and battled cravings every day.

Ariana was born weighing 7lbs even, with no sugar issues whatsoever. When I became pregnant with Joel, and failed the one hour test again, I asked my doc if I could just go straight to the diet, etc, and skip the three hour test. It had taken more than nine needle-pokes to get blood the first time and I had felt sick all day from the nasty syrup. I really didn't want to go through all that in a three hour test (What? 27 tries with the needle???) *with* a toddler! He said that it would be perfectly fine. The nurse gave me a long list of all the possible complications and some dire warnings again, and once again I went through the tension and cravings, feeling hungry every minute. Joel was 6 lbs 12 oz, and no sugar issues, either.

When I failed the one hour test with Elena, I asked again to bypass the three hour test. Again, my OB was unconcerned, the nurse was not. I got regular A1C checks, which were always normal. I had done enough reading at this point to have a better idea of the true value (or lack thereof) of the typical US version of the tolerance tests, and I knew I had the support of my doctor. Still, all the warnings would echo in my head. If you have taken a lot of pictures, you probably are well aware that whatever object you are looking at most closely is usually in the center of the frame. Constantly focusing on carbs kept them prominently in my mind, and the nagging worry that the nurse might be right didn't help.

This time around, I was a little nervous about the sugar issue, knowing what an ordeal it has been in the past. The hospital midwife that we had considered in the beginning made it clear that she sided with the former nurse and that this time around there would be no option on the three hour test. I knew my homebirth midwife was more up-to-date on current research and thought she would take a different approach, but nervous habits are hard to break.

What a difference the right midwife makes! She moniters our measurements at each appointment, but there was none of the stress or dire warnings from previous pregnancies. Rather than drinking the horrible sugar concoction on an empty stomach, she gave me a glucometer and had me take my readings following my normal routine. There was competence and security, but no anxiety-provoking, stern lecture on endangering my baby.

Guess what? The glucose levels were perfectly normal! No problems at all. I can't explain what a relief it is. Even though I knew I had research on my side before, there was always that niggling doubt in the back of my mind that maybe my sugar levels were out of whack. It is so nice to know that I have "proof" this time around that doing what I normally do is OK. And I suspect that the peace and lack of stress about my glucose levels can only be good for both me and the baby. Of course, I don't plan to go crazy with junk food and sugar snacks--that certainly wouldn't be good for us, either!--it is so much more peaceful not to try to make calculations over every single bite I take.

Blessings on you, Heather! You have made this pregnancy very sweet, indeed!

One step forward, one step back

I've been interested in home birth for quite awhile now. During the pregnancy with Elena while preparing for an unmedicated birth I learned a lot. The last week or two, I've been obsessed, er, extremely interested in it. I've also done a lot of praying and thinking.

I am one step forward from my previous post. I feel completely set on home birth now. There is a deep, peaceful, quiet inside me when I consider it. Intellectually, I've been doing my homework. Birth is not something that any mother should be uninformed about (and I shudder at how little I knew with my first two births!). But in all honesty, it isn't an intellectual decision for me. I feel so compelled to follow my heart in this that disregarding it would be unthinkable.

My Belovedest, however, is not there at all. Which makes things a little complicated. When he told me that he didn't see any advantage at all in a home birth and no disadvantages in a hospital birth I mentally shrieked, "Have you paid any attention at all to the things that I've shared with you or that we learned last time around?" I didn't scream aloud, because my sense of humor quickly reminded me of the hours that my dear husband has spent patiently educating me on the merits of certain electronic equipment or stuff about cars. Truthfully, I couldn't care less about the differences between a plasma TV and and LED? LCD? Anyway, whatever the other kind of screen is. As long as a car functions reliably, I remain in blissful ignorance of features like a cold-air intake system.

And, in his favor, we did succeed in a natural birth last time despite the hospital setting. I still don't want to go back. So, while we've got plenty of time off work the next few weeks, we'll both be praying and talking a lot. It is important to me that he be comfortable with the decision, too.

Our step back is that I will be calling my hospital-midwife soon and letting her know that we won't be continuing as her clients. I still get alarm bells screaming at me and I don't have clear reasons for why. I have nothing against her at all, but I have no doubt whatsoever that we need to go in a different direction, even if we were to wind up with a hospital birth.

The timing may be tricky, though. For one thing, we are changing insurance companies at the first of the year. For another, I want to be honest and not lead her on. At the same time, I don't want to have a big gap in prenatal care, either. So, we really need to make the decision by the end of this year. Which is easy for me to say, but I'm not sure about Carlos. Prayers are greatly appreciated, for both of us. I feel very confident right now, but if I'm wrong, I'd like to know. Have I mentioned how much I hate waffling? I want whatever we decide to be the best choice and for us to be in true unity and for it to happen quickly. Not too much to ask, is it? ;) At least it is the season for hope, peace and dreams coming true.

Contemplating homebirth

One of my favorite things about pregnancy is that the spiritual, intuitive side of me seems to become much stronger. I don't know if it is just a case of me listening more, or what, but especially after Elena's birth, I pay close attention to any impressions or feelings I get.

Lately, the feelings are an increasingly stronger pull towards homebirth. We have not yet made a firm decision, but it seems that each moment I feel more peaceful about giving birth at home and a tense, anxious feeling like alarm bells at the idea of giving birth in the hospital. So, of course, I will be processing a lot of those feelings here! Feedback is welcome, regardless of your views.

What appeals to me about a homebirth?

The safety. While mortality rates tend to be about the same in all of the major studies comparing hospital births with planned homebirths, the chances of injury/illness in the mother or baby are actually higher in hospitals. There are all the cascading interventions, hospital-acquired infections...the list is long and sobering.

The peaceful atmosphere. In both Ariana and Elena's births, I had people screaming unhelpfully and unnecessarily during the pushing phase. I know from experience that the calm, quiet voices of my husband and midwife are far, far more helpful.

Having birthed naturally, I know that my body knows what to do, and I don't want to have to fight people who would try to get me to be flat on my back and still when that is counter-productive to labor and delivery.

Then there are all the procedures after the birth that I don't want--eye drops, Hep B vax, scrubbing the baby. I can decline them (and would) but it is so nice to not have to argue with anyone at that time.

I hate leaving the kidlets for days with a hospital birth, and would feel much more relaxed knowing that they are nearby. Both Ariana and Joel have expressed interest in being present for the birth, and at home there is much more flexibility than at a hospital.

This will most likely be my last birth, and I would like for it to be a peaceful, gentle welcome into the world, and that is much more likely to happen at home.

There are more, but those are some of the reasons that have been resonating inside me.

The reasons for a hospital birth?

Ummm....

Carlos is more comfortable with that right now. And his feelings are important to me. On the other hand, my feelings are important to him, and if I am anxious and unhappy about a hospital birth, he isn't going to feel good, either.

Insurance. At the moment, our insurance covers hospital births really cheaply for us. However, I have an amazing midwife who has been incredibly generous. And really, if we wind up with interventions or a long hospital stay because of birthing in the hospital, would having insurance help be worth it?

Emergency situations. Sure, those can happen. I have total confidence in our midwife and her ability to recognize a rare situation in which we would need to transfer to a hospital. And, ironically, Elena's birth had a rare complication (prolapsed cord), and yet the outcome would have been exactly the same if she had been born at home. Had I had a different OB, chances are good that it would have been an emergency C-section, but she was out in about four pushes, despite me being flat on my back!

Er...does it seem that I am talking myself into a homebirth more and more?

My favorite commercial

This is amazing. I had hospital births, but have many friends who have had homebirths, and I am open to the idea for future births (not so sure that Carlos is). Regardless of your stance, this commercial is beautiful.

For those who don't speak Spanish, it is a commercial for a bed/mattress company, with the slogan that your bed is the most important place in your world. It features the couple talking about how their son was born at home, and how important it was to them for their daughter to be born there, in the same bed. The mother speaks of the miracle of bringing a new life into the world, and how special to be able to give birth in your own place, the way you wish.