Birth Days

July 11, 2014, 10:38 PM: This time last year I was in Room 5 at the Alta Bates Birthing Center with an IV in my arm, an epidural in my spine, two disk-shaped monitors strapped around my bulging convulsing belly, and a catheter and a more sensitive contraction monitor shoved up my lady bits. My blood pressure had been, for hours, dangerously high and my temperature was starting to creep up. My cervix held strong at five centimeters despite a full working day’s hours on Pitocin that induced beautiful peaking contractions every two to three minutes, and despite my leaking sac being tugged open with a large crochet hook. This time last year I was rounding out my fifth day of labor.

You read that right: my fifth day of labor. Right about this hour last year, the epidural was wearing off. I would throw up right after the anesthesiologist re-upped my dose. My doctor, soft with sleep, would come in and “suggest” I “consider” a Cesarean section. Within minutes of our decision, I would throw up the drink they gave me to prepare my stomach for surgery and I would be splayed out in the meat locker of an operating room, my sister-in-law, a neonatal resuscitation nurse, appearing like an angel to stroke my clammy forehead, returning to the hospital just four hours after her 12-hour shift had ended. The spinal block used for the surgery would give me the shakes so violent and constant that my chattering teeth would carve deep gashes on the insides of my cheeks. My husband would see my uterus outside my body, perched on my abdomen, as he held my shaking hand. And we would both burst out crying the moment we heard our son make his first protest known. In just a few short hours, I would be a mom to a beautiful, healthy, funny, clever baby boy. I know that’s what counts. The means don’t matter. My son is my glorious joy-filled end. People tend to encourage me to forget the messy part when I mention it. And man, were my parts messy. But how can I? How can I gloss over or shrug off my crappy birth experience?

Those of us with crappy birth experiences are haunted by them. We don’t talk about them, not to each other, or to our girlfriends, our sisters, or our mothers (who, I find, are the most dismissive) and never– not ever–to expectant mamas. Our partners listen–they were there after all–but their empathy is limited by the mere fact that they were not in our taut skin. I know at least 20 women who gave birth last year, and of those 20, I know of three who confessed their bad birth experiences: one told me about hers over a Facebook private message, one commiserated with me when she met my son, and the other told me in passing that her crappy birth experience is the reason she is looking to adopt. A bad birth experience is like this dirty secret, this trauma that we tuck away inside our bodies. It is an albatross of which we try, futilely, to let go. Every time I look at my scar, I remember. It often itches, the sensation fiery and hot, and no amount of scratching satiates it. “You can’t hide,” it declares. I will feel its ropey texture and remember that I have two scars, the internal one thicker and fatter. And then I will remember the tugging sensations from the other side of that blue curtain in the operating room, the rough yanking as my doctor put back and sewed up my insides. And I will remember the sharp pulling pain on one side of my belly that followed me as my uterus shrank back down to normal size, and how my doctor explained that the pain was probably from how tightly they had to pull the corners of the incision. And then I will remember the numbness: the dead spot in my abdomen that lasted for months. And then the high blood pressure, a condition known as postpartum preeclampsia, that threatened to pull me down that first month of recovery. And the depression, and so on. These bodily memories spiral. They sting. They touch a deep vulnerability in me. My body can’t forget my bad birth experience. Not yet. And especially not as my husband and I contemplate baby number two.

First birthdays are a joyful celebration of milestones and accomplishments, of the rapid growth that transforms infants into little people. They are a celebration of this miraculous life you created that you have the privilege of sharing every day. First birthdays are about the baby, about your peanut enjoying cake for the first time. They are about elaborate, themed parties that your monkey will only remember in photographs. I am so excited to celebrate my son’s first birthday: his “mustache bash” is this Saturday. We made it a year! And what an amazing and exhausting year it has been! My life and body have been turned inside out by this human being I grew with my cells and blood and oxygen and food. He stretched my skin, moved my ribs and shook my organs. And now he gives me zerberts on my soft mommy belly. He sits with his ankles crossed, gnaws at my collar-bone, sings and dances with me. When he’s intrigued he cocks one eyebrow.  He flips his light switch on and off to signal he is done sleeping, his own kind of Morse code. He hides around corners, plays peek-a-boo like a Whac-A-Mole, walks like a drunken sailor with a goofy grin, climbs drawers and step ladders and up our torsos, and oh, does he laugh! Our beautiful miracle, born from within me. Happy happy birthday, my little man!

First birthdays are also, for mothers, whose bodies bear the scars and labor of pregnancy and birth, a reminder of a painful, and sometimes, ugly journey. Me? I am spooked by my birth experience. Spooked. I love my son so much more than I ever thought possible. But I cannot begin to imagine going through another birth, even though I know intellectually that a scheduled C-section has an entirely different element of control than an emergency one. I wish I had years for the pain and fear and sickness and the hard recovery to fade so that I could get on board with another baby. At 38, biology does not afford me that luxury. Birthing was hard, and for me, getting pregnant was harder, an experience filled with self-administered hormone injections in the belly, vaginal ultrasounds and blood tests every three to four days, and migraine upon migraine upon migraine. I know every pregnancy and birth is different, but my body is still too rattled to shoulder the gamble.

For me, one of the hardest adaptations to mommyhood has been the realization that I now have to take exceptional care of myself so that I can take care of my child. I’ve lost my biological father and my stepdad so I know the impact this kind of loss has on a child. I now need to take care of myself for the short-term and long-term–not for me, not just for my husband, but also for our boy. Because I am a mom, by default, I am afforded very little “me-time”, my needs come dead last, and I am on year two of chronic sleep deprivation. Despite these factors, or maybe because of them, it is absolutely necessary for me to protect my body from injury and illness, and to maintain the mental fortitude to keep my son safe from harm. My brain’s version of this pep talk: Stay strong, keep your shit together, and always, always keep your eye on the prize. This is a real challenge in the blur of parenthood.

My son’s first birthday marks moments of expressionless joy and deep pain for me. It makes me understand how awe-inspiring and fathomless my love is for my child. It also makes me realize just how much another crappy getting pregnant and birth experience jeopardizes my paper-thin resilience and my worn-down stamina. My inclination, in a fight-or-flight knee-jerk reaction way, is to protect myself from another baby. That just seems like the antithesis to what first birthdays are all about. It hurts me to feel that way. But the reality is that it hurt me to have our son–our beautiful, amazing, gifted son. I am so truly blessed by him, and cursed by my crappy birth experience.

My son’s first birthday, like many of milestones we will celebrate with him, presses together beginnings and endings, bleeding one into the other, and wrapping the moments and memories in both joy and sorrow. If my feelings around my crappy birth experience are life’s version of “because I said so” at least let me talk about it. Let me talk about it without solutions or resolutions or neat and tidy bow-tied ends. Sometimes our ends need to be outside our bodies. Loose. Slippery. Messy.

Parenthood, I have come to understand over the past year, is a lesson in humility. It is also a lesson in living with contradictions, learning to be comfortable with discomfort. Some of those contradictions rub at each other a little harder, the friction catching roughly, and sometimes it just so happens that your heart gets caught uncomfortably in the middle.

originally published 6/12/14, copyright 2014

Pumped

Tuesday, 3:45 AM: I wake up with eight ounces of milk on my chest. And a nightgown that feels like I entered, and won, a wet t-shirt contest. I touch the valley of clammy wetness between my swollen milk balloons. What to do? The monitor light moves from green to orange to red. Chirps stretch into cries. The boy is waking and he is hungry. Which means I am safe from a double pump session at 4:00 AM. I’d rather change 10 poopy diapers in a row at 4:00 AM than pump. I climb out of bed pulling my wet nightgown away from my sticky skin, wander into the nursery and lift my son out of his crib. We snuggle into our position on the futon, our bodies curling toward each other like parentheses, so close our bellies touch. The kid takes on the right boob and drains it until it goes slack, supple with relief. The left one is left up to me. And the pump.

I shouldn’t complain, I know. There are so many stories of women who struggle with breastfeeding, whether because of production issues or latch problems. In the past three months, I’ve heard so many dispatches from the frontline: Mamas who have to pump after every feeding (babies eat an average of 12 times a day early on), for up to 25 minutes, to increase their supply; mamas who, while pumping, have to look at pictures of their babies to coax a letdown, the release of milk from the milk ducts; and mamas who’ve restricted family and friend visitations to reduce stress in hopes that it will help increase supply. I’ve heard about cracked and bleeding nipples from babies’ sloppy latch and frustrated gnashing (a verb that should never be paired with the noun nipple); plugged ducts; a mysteriously dried-up supply; babies rejecting bitter milk; babies snoozing and snacking for hours on end; and babies not gaining weight despite hours (that turned into months) of nursing and pumping. I’ve also heard about mamas who’ve accepted milk from lactating friends and relatives, some of the supply shipped across states, overnight, via FedEx.

All of our prenatal classes emphasized the virtue of breastfeeding (Food, medicine and comfort all in one! Cheaper than formula!). One lactation consultant even suggested we save all of our bad or expired breast milk to cure whatever ails the family. “Husband has a sty? Squirt some breast milk in it!” (That is a direct quote). They encouraged skin-to-skin contact and nursing straight out of the womb: Baby pops out and is put to chest and on boob. It’s what’s best for the baby, and everyone wants what’s best for the baby. The classes did mention obstacles like low supply, poor latch, plugged ducts and infections. A postpartum doula warned me I would never feel so tethered in my life. Our birthing center sent a lactation consultant daily to every postpartum room to help troubleshoot any issues. Women give up, they all told us. Don’t give up, they cheered us on. Stick it out! Push through! Breastfeeding is worth it! We came away knowing breastfeeding, while a natural process, takes hard work. Sometimes even tear-filled blood-stained hard work. No wonder all of us ‘70s babies were bottle fed.

So, I took the classes and read the books. I studied breastfeeding positions. I watched exactly one YouTube lactation video by Abington Hospital, where I was born, and subsequently bottle fed. I read up on the importance of nutrition and made a list of breastfeeding-friendly meals and snacks. I hoped that my production and his latch would just work. I most dreaded the relentless schedule of on-demand feeding. I worried about my stamina to have a baby on my breast every one to three hours for three months straight.

I have been lucky. My nursing experience has been seamless. Which I feel like I deserve after five days of labor that ended in a c-section, not quite my ideal birth experience. Nursing is the one thing I really really wanted to go right, so that my son would have a leg up: His genes are stacked against him when it comes to asthma, allergies, and a screwy digestive system. And for me, nursing really has gone right. My baby was born to latch. He knew what to do before I did. I can count on one hand the number of times I’ve had to adjust his mouth. He was the talk of the postpartum ward at Alta Bates. The lactation consultants came by to see “the newborn with the amazing latch.” So there’s that. Then, there’s this: in lactation terms, I am an over producer (our ever-so-positive pediatrician calls me a super producer). Due to some random hormone imbalance (probably the same imbalance that made it so hard for me to get pregnant), my body produces either just enough milk for my baby, or, as seems to be the case most of the time, too much. I have fire hose boobs. Which does have its downsides. My milk comes out so fast that my son gasps and sometimes chokes on it, but he has learned to manage it, a skill that will no doubt come in handy some day at a college kegger. The volume and pressure of my milk overfill him easily, which makes him grunt and arch his back away from me and pummel my boob with his tiny fists. Any change in our feeding routine–missed feedings, bottles, nursing on the same side twice in a row because I can’t remember where we left off–throws my production into overdrive. Which leads to engorgement. My breasts become so swollen and taut that I feel like my skin is splitting open. And if the searing pain weren’t enough, I leak like a pricked water balloon. I don’t just get a spot of wetness. The milk seeps so heavily though my bra and shirt that it drips milky white drops as if the fabric was not even there.

Engorgement is most problematic during the quiet hours of bedtime when I am supposed to be catching some delicious consecutive hours of Zzzs. The first night my baby slept 10 hours straight, I woke up so engorged at 5:00 AM that I had to place a burp cloth across my chest and gently prod the rocks, trying to hand express enough milk to ease the pain. My boulders rained watery foremilk into the muslin fabric, quickly soaking through. It brought me a peewee token of relief. The boy would have to handle one. I would have to pump the other. I counted the minutes, eyes glued to the monitor for signs of stirring.

So I become engorged and I leak, and I admit it, the nursing “high” makes me feel nauseous—I know, poor me. I also have what is called a painful letdown. My ducts tingle and throb each time they fill with milk. They fill when my son starts nursing. They fill when I fold his laundry. They fill when I think of his sweet smile. And every time it hurts. Let me amend that statement: it burns. The pain is a stab, a throb and a burn all at once in both breasts. It emanates. Sometimes from deep within my chest, sometimes into my shoulders. When I asked what was up with the pain, a lactation specialist said: “it is a sign that things are going really, really well.” She told me, basically, to suck it up. Most nights, before what I hope will be hours of boob inaction, I plead to my ducts to stop letting down. Inevitably, at 10:00 PM, as I get ready for bed, I feel that tingle and the throb and my breasts get heavier, pushing closer to engorgement. “No, no, please, boobs, stop,” I beg. Boobs never listen.

And thus starts the debate I have every night: to pump or not to pump. Pumping makes it better. But pumping, even for five minutes, makes everything worse.

While I heard about all these breastfeeding war stories, the thing no one ever mentioned at length was pumping. Sure they mentioned how you got what you paid for with the machines. And they cautioned about over pumping because of the whole supply and demand principle that dictates breastfeeding. We heard about a woman who pumped after every feeding and convinced her body that she had twins. All the books we read had sections for working moms about keeping up a supply by pumping at the office. Dr. Sears even suggested a working mother find fellow nursing moms to pump with during their lunch hour. (The horror! Really. I can’t even imagine hiding in a conference room, pulling open or up my shirt, pumping both breasts for efficiency, praying no one opens the door, sopping up my sticky milk-covered boobs and tender reddened nipples, and then washing my equipment off in a bathroom or kitchenette sink, all the while worrying about my co-workers complaining; never mind doing all of this alongside a work gal pal.) Pumping gets glossed over. You just do it. It’s part of the process.

I hate pumping. I know I am not the only woman who feels that way. No one ever mentioned, not even in passing, what a deeply dehumanizing and utterly (and udderly) humiliating experience it is to pump milk out of your breasts. Imagine taking a tender part of your body, vacuum sealing it in a plastic cone, turning on a machine attached to the cone, and watching the machine pull and tug and elongate, unnaturally, said tender body part. Imagine listening to the methodical wub-wub of the machine as it pulls and tugs. Imagine doing this for 10 to 20 minutes. Once a day, several times a day, every three hours. It doesn’t matter the length of time that you are physically held captive by this droning device, it still makes a natural—albeit challenging and yet noble—process feel ugly. There is nothing sweet, sexy or sexual about being obliged to a machine that tugs on your tender bits as those bits expel liquid into a plastic receptacle at the other end, precious food (and medicine and comfort) that you will use at room temperature in the next six to eight hours, refrigerate for three to five days, or freeze for three to six months (that’s all the sleep-deprived need: a mind-numbing calculation exercise). Pumping makes you feel worse than cattle on a dairy farm.

Of all the noise we make in our apartment, the only one our 20-something neighbor has complained about is the vibration of my pump. Even my neighbor hates when I pump.

I started pumping during my baby’s third week to introduce him to a bottle and so Dad could bond with him on a deeper level. “During the third and fourth week of life babies take both breast and bottle beautifully”, we were told. Our pediatrician suggested I pump in the morning off one boob while my son nursed on the other. Only five to seven minutes of pumping, she said. One bottle every three to four days to prevent bottle rejection. I also had grand plans to build a freezer supply of milk so that others could take over the feeding duties, thus freeing me from the ball-and-chain of on-demand feeding.

I set up a nursing station in the nursery stocked with water, trail mix, nipple cream (natural and lanolin), and nursing pads (washable and disposable). The first time I used my Philip’s Avent breast pump–carefully selected for its closed system, easy assembly, and guaranteed comfort–I didn’t follow my doctor’s orders. Instead I opted to pump both breasts, just to see what it was like. This was before I knew about my overproduction problem. I sat down in the glider, tucked a burp cloth in the bottom of my nursing bra, unlatched both sides of the bra, fit the cones lined with “massage cushions” over my nipples and hit start. My pump has a stimulation mode to get the milk flowing. It is a fast suck that primes the boobs to let down. The wub wub wub of the machine withdrew small drops of milk. By golly, it worked! It took me a bit to realize I was then supposed to hit a button to switch to one of three suction speeds. Here is where I hit my first speed bump. How was I supposed to maintain an airtight suction of the cones on both breasts while switching modes? I needed a third hand. I tried using my nose, then my tongue, then my elbow to select the middle speed. I considered calling in my husband or my mother to select it for me but I couldn’t bear for them to see me so vulnerable? Stripped? Exposed? I was actually all of those things but this act made me feel something darker. It made me feel less human. So, while carefully balancing the pressure of the cups against my chest (because God forbid your nipples get off center in the massage cushion, it takes about five minutes to reposition them just right) I leaned my body, right breast leading, toward the unit and changed modes with my outstretched pinky finger. The sucking slowed down and elongated, waauub waauub waauub. I willed myself to be soothed by that rhythmic din but watching the rose-colored pieces of chewing gum attached to my chest being pulled and stretched did little to comfort me. Instead, every fiber of my being felt like the piece of chewing gum being chomped on and spit out.

It didn’t take me long to realize that once I started pumping I was enslaved to the pump. Especially because of my overproduction problem. It is a vicious cycle. If I pump, it tells my body to make more milk. Engorgement ensues. If the boy takes a bottle, I miss a feeding, and engorgement ensues. The only thing to relieve the pain of engorgement: pumping. For a brief period, my boy and I were being treated for thrush, a yeast infection of his mouth and my breasts. Because of the thrush, I couldn’t pump. My relief was palpable. For twenty days, I enjoyed soft, malleable boobs.

Pumping is just plain embarrassing. After my neighbor’s complaint, I started to hide my machine. I now bury it on the couch in its bag under a blanket and I expel milk only in the wee hours of morning when no one can bear witness to my shame.

Yet, as dehumanizing as it is, pumping, I have come to understand, is the key to restoring a nursing mother’s autonomy. If I want to be known as something other than the milk truck (what my mother affectionately refers to me as), I need to pump. If I want to break out of the two-hour time slots my day is tightly scheduled into, I have to pump. If I want to return to work and continue nursing, I would have to pump (but not alongside a gal pal, no way!). Pumping is what allows nursing to go really really right. But it’s more than that. All nursing mothers need to pump to regain some semblance of identity beyond the boob. Pumping stretches and elongates that motherhood tether so that we can have enough room to establish our new sense of self. That’s why no one mentions how awful it is. I may hate to pump but I need to to feel more normal.

originally published 9/23/13, copyright 2014