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December 16, 2000
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Choices

So we're finished with all the labor parts of the class, today. That was actually good to know. Next week is just the nurse coming to give us new-born infant care instructions, everything from diapering to feeding, bathing to clothing, and how to set up the car seat. So the scary parts are done.

We got there a few minutes late, and I noticed that one of the women and her mother, who were both here last week, weren't here today. I knew that the French pair were going to be in Paris this weekend, but I hadn't heard a reason from Shannon and her mom as to why they might not be there this week. So I wondered a little, but things happen. We went through the last stages of labor and what can happen, excluding C-sections, epidurals, and all the possible drugging options as we were going to cover all that later, and got all the detailing on the pushing stages and actual delivery. Then we got to go upstairs and see the birthing rooms.

The birthing rooms at Boulder Community Hospital are pretty keen. Monitors, heated bassinet, jacuzzi bathtubs in all the rooms, completely powered birthing beds, and a full sound system in each room. There are squatting bars, hangers for clothing, drawers, and other nice amenities along with a rolling chest of drawers filled with delivery equipment. It's still a hospital, but the rooms aren't too cramped, are well equipped, and they even have a bed for the coach in a small couch. Which, of course, needs a pillow from home as the pillows they have there can be completely sterilized without even touching their texture, i.e. rock hard.

As we were wandering over, a very harried and tired looking woman popped out of one of the rooms and blinked at all of us and then grinned, big, and invited us all into the room! It was Shannon's mom! Aie... Shannon, it turned out, was delivering a few weeks too early. They say all pre-term babies are delivered before 37 weeks. Most are around 40. First time moms, on average, deliver around 41. She was at something like 35 weeks. I'm at 32. She'd already had a baby pre-term because, the last time, she had to have her appendix taken out. This time, it looked like the delivery was coming early because she had strep throat. Ow.

So we got to see her, all strapped in and with an epidural in her back and at peace against the pain. She was smiling and very grateful to our teacher for the breathing exercises she'd been given and they actually had all the things on the list of Things to Bring. Which made me very conscious of the fact that John and I hadn't even looked at packing the list, yet. It was fascinating watching the contractions show up on the muscular activity monitor and have it not affect her at all because of the epidural. She was in enough pain as it was from the strep, plus it's just to exhausting to be sick in the first place, it was plain to see it was necessary.

It really set us up for the later parts of the class. After that we got to see the post-partum rooms, which aren't nearly as posh, but usable. Not too bad light wise, a bit of entertainment, but mostly just quiet and rest areas. Which just seemed very clean and very hospital-like and useful for sleeping a lot.

By the time we were done with that it was lunch time. So John and I went over to the Breadworks, which is an independent bakery that had really good bread, mostly from sourdough starters, in various whole grains, so the breads are really substantial and great tasting. They also had a special deal on soup and bread. So we got that along with a sandwich that we shared. Good food. Not a lot of salt. Which was very comforting for me. They also had some spectacular desserts, but I didn't have any room for them by the time we were done with our meal. So I passed them up easily.

In the same little strip mall is a really nice little toy store called Pickles and Feathers and it's filled with just really cool stuff. Mrs. Mason had told us about this place and it was fascinating to explore it on our own. They have all the old toys, wooden toys, or even the metal true Caterpillar construction toys. It was just really cool to look and touch and remember and wonder. There was a stuffed dragon that I thought was really, really keen and would make for an excellent guardian of a baby room.

We didn't buy anything, yet. Instead, we wandered over to the Idyll Market across the street so that I could get a bottle of water. John got a cold coffee drink, so I also picked up a four pack of old style ginger ale. Then I saw the Knudsen's fruit juice sweetened sodas. They're sodas that are nearly 80% fruit juice. No added sugar or corn sweetener. I got a six pack of the stuff, as I wanted to try it out and see if the no sugar part would make it so that I didn't get the dead, salt taste in my mouth from when I do drink or eat something too sugary. So poor John had quite a haul to take back to the class.

I just drank the water during the rest of the class.

During lunch Shannon had delivered her little boy. Four pounds eleven ounces and doing very well for his size. They had him on oxygen but other than that they'd had to do very little intervention, so it looked like things were doing to be just fine. Someone bought a bunch of flowers for her, and we all signed a card. Wow. The class' first baby.

The afternoon got into all the options and possibilities with drugs and procedures that are now available to modern women. Even four years ago, a few of these things wouldn't have been considered a choice, like the little cut they sometimes do to get the head to come out quicker. Most doctors used to just do it as a matter of routine, and in some hospitals it is still done routinely. Now it's something of a choice that can be made depending on the circumstances of the delivery and Boulder's instance of the sometimes hard to heal cuts is down below 20%. Epidural usage is higher than 80% in some California hospitals, but is only 23% here at Boulder Community, mostly reserved for women that really are having problems with the pain or other problems to contend with. It's interesting to see the range of choices. Turns out that there are three levels of drugs that can be used well before an epidural that don't have the risks and possible problems that come from inserting something in my spine. Those drugs even have options so far as how much I want to take for any particular problem.

Amazing what one can choose. It really was all presented as choices and attendant risks. Interesting to see the emphasis 'natural birth' has with the Instructor and most of the women in the class. Most seemed to think an epidural was a thing to be avoided at nearly all cost, when, on the other hand, a doctor that thought a local anesthetic wasn't necessary for finishing up the stitches on a tear was a barbarian and should be sued out of his practice. I could kind of see the other side of where a woman would say it's barbaric to go through the pain of delivery if one could simply have a very modern and relatively safe procedure to stop it. Especially since there are no studies that conclusively prove that an epidural actually harms the infant and the actual probability of risk to the spinal cord is so small. It was, however, interesting to find that when epidurals are done, the probability for a C-section goes up significantly.

One important point, I thought, was that a C-Section really is only done when necessary and it is a complete success when the baby and mother end up healthy and well. As the instructor said, it's the best thing after a natural birth, because, on the most part, it's only done on the people that, for one reason or another way beyond their control, can't give birth to an alive and happy and healthy baby without it.

It's interesting what myths and stories TV and movies have perpetuated about birth and birthing. The idea of a woman flat on her back with stirrups propping her feet way up in the air is, in actuality, a horrible thing. It's the one position that is the worst for giving birth in, as it doesn't allow the muscles to work well, it makes it really hard to stretch the muscles that need to stretch, and worst of all it makes the mother work nearly against gravity to get the baby out. It worked fine back when moms were drugged senseless and the doctor had to have the room to get in and pull the baby out with forceps; but that, thank goodness, seems to be long, long gone.

Still, I wonder how many women who don't do classes like this demand an epidural simply 'cause they learned from TV or the movies that it was something that was supposed to 'make the pain of childbirth go away'? Without the attendent information about the fact that it can make a C-Section more likely, that it can't be given until a certain stage so that it won't just stop the labor completely, that it can slow the birth down, that it can make the labor longer, that it can make it much harder to feel to push and finish it, and that it is often turned down during the pushing phase so that the woman can feel to push? I think that the most interesting tradeoff of an epidural is the fact that once one is hooked up, one can't move from the bed. I'd rather have the ability to move around all I wanted, I think, for a 12 hour labor. All kinds of interesting thoughts about how information gets around.

The latter part of the afternoon was all about pushing and all about getting the baby out and how many ways there were to try to do it. A couple of movies showed various couples doing the last pushes to get the baby out, along with a bunch of the pushes in between. One of our friends from Redmond days had given their consent to have their delivery filmed and we actually got to see them deliver their child! That was pretty astonishing. I think the movies are so important in some ways. As messy, grumpy, nasty, painful, and entirely human as they are, they're also, in emotional terms, awesome, amazing, and astonishingly powerful. And it seems that the important message is that while things will happen and some of them might disappoint you, but you'll get through it and the results are really powerfully good.

There was a pretty fluffy movie on breastfeeding, but since Beth gave me The Womanly Art of Breastfeeding it mostly covered things I'd already known about. Though it did help to have a bunch of women say that some of the scary things that they'd been told about didn't happen to them at all. It's useful to put probabilities into perspective.

I think I ended up knowing a lot that I really needed to know. I think I'm now armed with the knowledge of how to manage things when things come. I also know that I'm not hung up on having a 'natural childbirth' nor am I really intent on 'have to have an epidural'. Not so much wishy-washy as I'm ready and open and willing to see how things go and let what really happens decide me. If it is too painful, I now know what to ask for. If it really is something I can manage and handle, it'll be kinda cool, but I don't have my self-esteem wrapped up in it, which is a nice thing to know.

After class, John and I went to the new Flatirons Mall and shopped until we had pretty much everything we thought we needed. Stopped about halfway through to eat dinner at the California Pizza place in the mall, and we sat down at the bar instead of a table and were instantly waited on by a rather tired looking man. He said that it was the first lull he'd had all day. Poor guy. He was very quick with the service and I had half a chopped salad and a bowl of potato and leek soup. John had a sweet and hot sausage pizza and ate some of my salad as well. The food was great and filled me up so that I couldn't eat dessert again, so we happily skipped it. The very best thing about it all was that the restaurant had a restroom. This is the mall I talked about before that had the absolute worst design in the whole wide world for their bathrooms. A mall with a hundred plus shops had only two women's bathrooms with two stalls each. A complete sham, especially for pregnant women with small bladders.

We got what we could get in one massive power shopping experience, and then went home. We got extremely lucky on the way in and got the first parking slot from the door to Nordstrom's. On the way out, John was chortling happily over our perfect parking spot. That was very fun to listen to, and we got home to pretty much fall asleep. The packing and wrapping and all that left for tomorrow.

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