24-week visit

Another monthly appointment passed with flying colors. My blood pressure is normal and the baby's heart is beating at a healthy 152 beats a minute. All that made this routine appointment more interesting is that I started at a new clinic and met my new doctor, who I think is great. Vibrant and spunky are the two words that come to mind and she's got an energy level that matches my own. I imagine she's the type to leave a party with the famous "Minnesota goodbye," (see definition from urbandictionary.com below). She also came across as having the kind of bedside manner I think would counteract my stress level while in the throws of labor.

As someone who's always been very healthy and rarely needs to see a doctor outside of a yearly check-up, it feels out of the ordinary to be seeing a doctor every month. Yet then I surprised myself that more wasn't happening at most of the appointments, because I thought that with all the advances in medicine, surely being pregnant in 2009 would come with some heavily monitored program from the get-go. Aside from some standard tests or procedures, (such as a blood test at the first appointment, the ultrasound at 20 weeks and a glucose test at 28 weeks) most of the early appointments in the first seven months are what I describe as "meet and greets." The doctor asks you how you're doing, he or she checks the baby's heart beat and then you're on your way. But I've realized, just because you're pregnant, you're not sick. As long as you and your baby are healthy, as fortunately has been the case for me, these prenatal appointments are not all that much more different than that annual check-up.

I've also learned that while modern medicine can detect or fix many problems that can occur in pregnancy, ultimately, how healthy your pregnancy will be is actually determined before you become pregnant. Whether or not you're blessed with good genes aside, the health of you and your baby is mainly contingent upon whether you ate well, exercised regularly, maintained a healthy body weight, didn't do drugs, didn't smoke and drank moderately - nothing we haven't heard whether we plan to procreate or not. Even though salad doesn't look as exciting to me these days and I can't even envision myself having the energy to play 90 minutes of soccer like I sometimes did pre-pregnancy when no subs showed up, I try to remind myself that my (former) healthy habits are what really counted. I thought I'd have to completely revamp my lifestyle and purge myself of anything remotely unhealthy - go completely organic, kick that sweet tooth, pump myself full of extra vitamins and anti-oxidants. But really, all the advice has amounted to is, keep doing what you're doing and see you in four weeks. It was possibly crazy to think I'd have to make major changes in my lifestyle just because I'm pregnant. Such drastic changes would set anyone else up for failure, like the person who suddenly cuts out carbs or only drink Slim Fast in a quest to lose weight. It's too difficult to make too many changes to one's lifestyle overnight and it's not sustainable, even over nine months.

Now I also see why first-time moms are a breed of their own. By my second pregnancy, I predict I'll have that "been there, done that" mentality and be much more relaxed with the responsibility of having a new life growing inside of me.

The only advice the doctor has for me is that she suggested I take an omega-3 supplement, in addition to the prenatal vitamin I've been taking. Because I'm a vegetarian, I'd done my own research on whether I needed to take a supplement, but couldn't really find any helpful information (even in the baby books), and my old clinic didn't think it was an issue, and only recommended the prenatal vitamin, mainly because of its folic acid, which helps prevent birth defects. And every woman, regardless of diet, is advised to take a prenatal vitamin starting before she even tries to become pregnant. Despite how much I pressed, no one was concerned about any vitamin deficiencies because of my vegetarian diet and basically told me to stick to the bedrock of good nutrition - the well-balanced diet. (Easier said than done when you're pregnant though!) The omega-3 supplement was admittedly less based on hard science, but rather on my doctor's opinion, which was that supplementing that flaxseed meal I sprinkle on my oatmeal each morning doesn't hurt. Easy enough. I obliged by stopping by Target and bought an economy-size bottle. When Chris notices that the capsules are made with fish oil, (there are omega-3 capsules made with flaxseed and other vegetarian-friendly ingredients) I hope he doesn't get excited and think the omega-3 capsules are a "gateway meat." I won't be coming home with a big bucket of KFC any time soon.

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Minnesota Goodbye - noun
The act applying to most Minnesotans while visiting others in which, when one person has to leave, they proceed to talk for another hour, then the departing party is walked to the front door, where they talk for another hour, then the departing party gets walked to their car while the host family talks to them through the car window for an hour, and finally the departing couple SLOWLY departs down the drive, yelling back & forth with the host family.

The Happiest Baby on the Block

I had resolved to throw away the baby books, but I loosened my stance when I learned about a book that wouldn't make me feel guilty, but rather might actually help reduce the stress of caring for a newborn. Can't lose there, I decided.

Pregtastic produced a show on the topic of the "Fourth Trimester," a term I had never heard before. The guest was Dr. Harvey Karp, a Los Angeles-based pediatrician who wrote the book The Happiest Baby on the Block. The book teaches parents and caregivers methods for how to calm a crying baby. "Colic" is the most often cited blame for fussy or inconsolable babies, but Dr. Karp's research points to a different cause. It wasn't just the promise of being able to calm my baby in minutes, and with practice, even seconds, that intrigued me, but also his explanation of why newborns cry.

The term the "Fourth Trimester" is based in the theory that babies are actually born three months too early. Many animals can walk and even run within hours of birth, because their survival depends upon it. Although this is not the case for human babies, they have bigger brains than their animal counterparts, and Dr. Karp theorizes that big-brained babies can only be born safely if they are born early...say three months early. This new world, where the baby isn't held, fed and inundated with noise (the womb it turns out is a noisy place) 24 hours a day can be unsettling to some babies. Thus, Dr. Karp's techniques for calming a crying baby are rooted in replicating the experience in the womb and turning on the baby's calming reflexes. He has nicknamed the five techniques the "5 S's," and practically promises that when used together and correctly, all but the fussiest of babies (who may then truly have colic or an underlying health problem) can be calmed quickly.

1. Tightly swaddling a baby mimmicks the womb's compactness.
2. Using side or stomach positions to mimic the position the baby was used to being in, since a baby was never flat on his or her back in the uterus (not to be used when putting a baby to sleep, of course, just for calming).
3. "Shhhing" the baby to mimic the wooshing sounds of the womb.
4. Swinging or jiggling the baby to mimic all the motion if felt before it was born. (Reading about this technique makes me think every time I go for a walk or run up or down a set of stairs that fetuses really are getting bounced around a lot.)
5. Finally, sucking also acts as a calming reflex.

Dr. Karp's book is an easy read, even if it is a bit repetitive as he tries to drive home some very simple points. However, he goes into much more detail about the fourth trimester, calming reflexes and how the techniques work, than I could even begin to do in this entry.

Since I have spent so little time around newborns, (and was able to hand them back to their parents the second they started to fuss) I have no idea how well these techniques work and whether I'll be successful with them. I have really bought into Dr. Karp's theory though, because I haven't heard about anything else that is as effective. While I wonder why such supposedly simple and effective techniques haven't caught on like wildfire, I'm willing to give them a try. I've read the book cover-to-cover and Chris has been warned that the accompanying instructional DVD is on its way through inter-library loan.

The only occupants of the Teen Section at the Stillwater Public Library looked to be about ten years old, and I assumed actual teenagers most likely thought of themselves as too cool for the area, which is strategically located next to the watchful eyes of the circulation desk staff. As I waited to check out my books, (despite my vow to listen to my doctor and "throw out the baby books," I'm now reading The Happiest Baby on the Block - more on that later) the snippet of conversation I overheard from the two girls seated at the computers threw me 10 years into a future I probably won't recognize a decade from now. The one girl was asking her friend if she had a Facebook account, as if she had just discovered something no one else knew about. (Would she have thought it was cool if she knew her parents made up the fastest growing demographic on the site?) The girl answered no and seemed genuinely disinterested, while her friend reacted as if she was so much cooler because she was on Facebook and the other girl barely knew what it was.

I've already relayed this story to my dad, who just narrowly escaped raising children coming of age in the Internet era, but who, as a soccer coach until recently, has mentored a generation of kids growing up in a much different world than my teenage years. The first e-mail I sent was in 1995 and was considered a novelty, but it wasn't until I entered college in 1997 that I became a regular user (or addict). However, even as e-mail use exploded, my cohort's utilization of the easy communication tool was still innocent. In one instance, a charming, good-looking and outgoing floormate was left in a rare state of embarrassment upon the discovery of a cheesy e-mail he supposedly wrote to the whole school to publicly express his love for our RA. In fact, the e-mail was sent by the computer science boyfriend of our RA (who was in on the prank) to just our floor (but was made to look like it had gone out to the whole student body). Then there was the time my roommate didn't log out of her e-mail and went to take a nap and two guys from the floor below who were hanging out in our suite decided to write an e-mail from her account and send it to the whole dorm. It was so over-the-top that anyone reading it should have realized it was just a gag, but that didn't stop about ten people showing up at my door within minutes of the e-mail going out to say with a combined genuine disbelief and glee over the latest gossip that they never knew Julie felt that way about John. Julie woke up from the commotion and John and Dwight immediately issued a clarifying e-mail - from one of their own accounts - and the incident was quickly filed away as a happy memory from our "wild and crazy" college days. The most mischievous our e-mail pranking became was when my other roommate was dumped by her boyfriend, who thought he was God's gift to women. She either knew his password, or just got lucky by stumbling upon a computer he'd failed to log himself out of in the main library of our very small school, and changed the sender from his name to "I think I'm God's gift to women." Ah, those innocent days. Now teenagers are being arrested for "sexting," spring break pictures (or even just an image of a beer in an underage kid's hand) are disqualifying students from graduation ceremonies or even jobs, and people are spending years trying to erase vicious rumors from websites devoted solely to "outing" guys who are considered bad dates or women on campus who are supposedly "sluts."

Bullying, spreading rumors, cliques - this all existed in my day. But camera phones, text messaging, the ability to send videos or digital photos over e-mail, You Tube and social networking sites - these weren't around to make poor adolescent judgement (and not that only adolescents are guilty of poor judgement in the use of technology) that much more damaging. So when I overheard the conversation between the two girls about Facebook, my immediate reaction was "Uh oh, do their parents have a clue what's going on?" I don't think a ten-year-old has the maturity to understand the implications of her use of a site like Facebook. I'm actually a lot less worried about the stranger danger we hear about so often on the news and more about her posting a picture she shouldn't have, opening herself up to bullying (whether as a victim or perpetrator) or even just hurting a friend's feelings. As a 30-year-old, I've been hurt by discovering via Facebook that I wasn't invited out with a group of friends. To a 10-year-old, seeing pictures of the sleepover party she wasn't invited to is devastating.

So on the phone with my dad, I was insisting that the computer in our house will be in a public place and that when my kids are older, any computer they use in their rooms to do homework won't have Internet access. They won't have private e-mail accounts until a certain age and those options on cell phones to block texting during certain hours (such as during the school day!) or to limit calling to specific people will be taken advantage of.

But then I wonder why I'm worrying about this now. I can't predict what the technology will be in ten years and what issues my children will face. I thought I was cool when we got a second line in the house and I could talk to my friends whenever I wanted to on "my line" without tying up the main number. I don't know if my parents gave much concern to their decision, because the implications weren't that dire. But they probably never predicted that one day kids would have their own phones - tiny ones they could hide from their parents, take pictures with or text at all hours of the night (when they should be studying or sleeping) to who knows who. Gone seem to be the days when parents knew more or less who their kids were talking with, because those friends had to call the house and actually identify themselves to whomever picked up the phone. And they were forced to call at a decent hour too, or risk an angry parent answering the phone.

I also know I can limit technology, but not ban it. As much as I wish something like cell phones (or whatever we're going to be using in ten years) existed only for my convenience, but would be of no interest to my kids until of an age I consider appropriate, I'm guessing there's going to be a power struggle. I can only hope that Chris and I will stay on top of new technologies and what kids are into and be able to set appropriate limits and expectations. I won't let their be free reign. I've witnessed a number of instances where a parent is trying to talk to a kid who's too tuned into his or her iPod and cell phone to bother even looking up. "That won't be my kid," I practically scream when I get on a rant.

In essence, no matter what the world looks like in ten years, or what rules I say now that I'm going to have, in essence what I'm promising to do is actually parent. But God still help me.

Class of 2014

Two thousand fourteen is the year Baby P.C. will graduate from preschool and head on to kindergarten. Chris and I are already looking forward to photographing the little tyke with new lunchbox and an oversized bookbag on the first day of school, as our proud parents had done with us.

However, 2014 is also the estimated year Chris will finish his MBA from the University of St. Thomas in St. Paul. Yes, he was accepted! He's also just relieved to have the GMAT and the application process behind him and is looking forward to being a student again, even if continuing with a full-time job means the program will take longer to finish. But as he talks about different directions he could take his career with an MBA, it's heartening to witness him dream, and I couldn't be prouder of him.

21-week visit

We had another routine doctor's appointment today, (they occur monthly for the first two trimesters or so) which included an extensive ultrasound to assess the baby's size, heart beat and organ function. Out of all appointments up to this point, this one, which usually occurs around 20 weeks is considered the "big one," and definitely the most exciting. The good news is that all looks a-okay - all organs and limbs are there and functioning properly, including two adorable little feet the ultrasound technician purposefully zoomed in on. I surprised myself by how awed I was over that final image and immediately popped my head up to catch a glimpse of Chris's reaction. He seemed equally enthralled. The technician guesses Baby P.C. weighs about one pound, but it's too big now for her to try to measure from head to heel. Based on on an estimate we read online, we assume it's probably just under a foot. The technician didn't see anything that concerned her, so she didn't feel the need to call the doctor in and instead will just pass along the selected images for her to review later.

The only uncomfortable part of the ultrasound is that you're supposed to drink about a liter of water shortly before the appointment. The full bladder allows for a better view of the lower part of the uterus and verification of the location of the placenta. While I think the ultrasound experience is really neat, at the same time, I couldn't wait for the first opportunity to go to the bathroom.

We had a special treat at the end when we got to see 3-D images of our baby. The images were rather amazing, because there was enough clarity for Baby P.C. to look like a real baby. As the technician zoomed in and out on different areas of the body, it was often difficult to tell what I was even looking at, except that she would conveniently type in "heart" or "brain" alongside the image. But when the first 3-D image popped up on the screen, all I could think was, "Wow!" We were given a few printouts and I'll let family members be the judge of whom Baby P.C. resembles.

The appointment concluded with meeting with the clinic's only midwife, who listened to the baby's heart beat and, for the first time, measured my stomach with a tape measure. The ever-bulging gut measures at 21 centimeters.

I like everyone I've met at the clinic, but I really liked the midwife. She asked me if I'd ever considered working with a midwife and thought that because of my health, low-risk pregnancy and my curiosity and desire to learn, (and the latter for Chris, as well) I'd be a good candidate. Hurray for being encouraged to ask a lot of questions! Despite all I've read and the many Pregtastic podcasts I've listened to, which have featured midwives on some episodes, I admitted I still wasn't quite sure what role a midwife would play in my prenatal care and during delivery.

A midwife is licensed and is an advanced nurse practitioner who, like an obstetrician, handles the care of expecting mothers before, during and after childbirth. Midwives and obstetricians are both autonomous practitioners, but can also provide complimentary care. Although midwives are medically trained to handle complications and emergency situations, they maintain working relationships with obstetricians, who can be called in at any point if a more advanced or invasive level of care is needed. Unlike the obstetrician who just pops in when the baby is ready to be delivered, but who has left all the hours of labor preceding to the care of nurses, (My mom, who had spent weeks in the hospital after open heart surgery, resolutely declared that it was the nurses who ran that place.) the midwife remains with the mother (and that team of nurses) throughout labor.

The biggest difference I saw was related to philosophy. Stereotypically, (and she really stressed that these are stereotypes and that if one approach works well for one woman it doesn't mean it works the best for all women) obstetricians are trained to manage labor, while midwives are trained to support labor as a natural process. While our understanding of medicine and how we have learned to manipulated labor has changed drastically over the decades, the labor process in itself has remained unchanged since the beginning of time. I imagine that before modern medicine, delivery practices (well-intentioned, even if not always the best of practices) were passed down from generation to generation. I've read that midwifery (pronounced mid-wiff-ery) as a profession, so to say, dates back to the 1300s. It's the holistic approach steeped in a long tradition of caring for women that I really go for. I liked that midwives are more likely going to encourage as natural of a process as possible, will actively include the support person and are sensitive to the cultural or personal wishes of the expectant mother.

I may not have looked into a midwife, because I knew I was comfortable with, and preferred, a hospital setting and the use of pain medication. I was under the misconception that midwives practice mostly natural (i.e. unmedicated) home or birth center births, while in fact, the majority of them work out of a hospital, as this midwife does. Since the obstetricians and one midwife at my clinic are on an on-call rotation, who actually delivers your baby would depend upon who is on call. She just recently started working for the practice and her goal is to be able to hire additional midwives, so that patients could choose one of two circles of care - from an obstetrician, or a midwife.

I was also assured that pain medication or an epidural are not frowned upon and she stressed again that midwives support choice. After just a short visit, I was growing increasingly convinced that a midwife in a hospital setting might be the perfect combination between a conventional and a natural labor. While I consider alternative medicine or practices legitimate, I would prefer to use them in conjunction with conventional medicine. I haven't grown up in a culture with an extensive practice of alternative medicine and I haven't been taking classes in natural birth, so I know I would be unprepared for a natural, unmedicated birth and the experience could easily be traumatic for me (and Chris!). But I am curious about seeing what works best for me and one of my biggest worries about labor is having decisions made for me. I respect a doctor's extensive medical knowledge and experience, but if it's not a life-or-death situation, I want someone with the patience to explain the alternatives and consequences and who is comfortable with allowing me to make decisions that are best for me. If there are two options and one procedure is easier for the medical team to perform, but the other offers better potential outcomes for me or the baby, I know which one I'm going to pick.

I was ready to sign on as this midwife's patient, but Chris and I are going to switch clinics so we can be closer to home. As appointments increase near the end of my pregnancy, it'll be more convenient for both Chris and me to be a short drive to the clinic, which is also in the hospital. But my conversation with the midwife at today's appointment made me more open to considering a midwife as an option and something to look into at the new clinic. Unfortunately, the new place also only has one midwife on staff, so I will most likely not be able to work exclusively with her.

And finally, for all those (okay, so I know there are only about seven of you reading) who've been eagerly waiting to find out the sex of the baby, well, all will be revealed in due time.

Somersaults

After a bit of worrying and a reassuring chat with a nurse at my doctor's office, I think I've finally realized that I've been able to feel my baby moving. If no one had told me that I could start feeling movement as early as 15 or 16 weeks, or if I hadn't been asked by curious friends whether I've felt it move yet, I wouldn't have given the lack of detectable movement a second thought. Despite all the changes in my body, it appears I had actually gotten used to all the noises and odd sensations coming from my belly. Or since I've forgotten what it feels like not to be pregnant, it's possible I'd just thought the inner workings of my stomach were always that active.

By yesterday, the "bubbles popping against the inside of my stomach" sensation that started intermittently maybe two weeks ago erupted into repeated "butterfly flutters" throughout the day. It was one of the oddest sensations I've ever felt and actually, a lot of times it tickled. And it was tickling parts of my body that have never been tickled before, which made the experience sometimes uncomfortable. Chris, who loves to tickle, was delighted when I described how the baby's movements felt, and exclaimed, "That's my child," as he tried to tickle me some more. I was being attacked from both sides!

I was still in a bit of disbelief about all the new sensations. "I think this is really the baby moving," I told Chris. "Yes, it's the baby," he replied with a twinge of his own disbelief that I couldn't really recognize all these crazy movements being that of the baby and not just crazy stomach rumblings. Hadn't he read to me numerous times what those first movements might feel like? "So it's actually a baby and not tapeworm?" I half stated, half asked (in reference to a joke of mine about me finding it hard to believe I'm actually pregnant and that is what is really causing my stomach to expand). "No, it's really just the baby," he said hardly looking away from the Stanley Cup game on TV, and visibly unconcerned.

Someone from my soccer team thought the explosion in movement was just because the baby was excited about opening day - that is, the opening day of the summer season for Hansa, an intramural soccer team from Minneapolis. As the child-to-be of a sports fanatic who grows giddy in anticipation of going to a pro baseball game or remains captivated by ice hockey, even when the season stretches into June, (the sports fanatic is Chris, not me, in case you are confused) I can believe that the baby was doing somersaults of delight in a pool of amniotic fluid in anticipation of a new season for a scrappy local soccer team.