Thursday, December 11, 2014

And Something Blue...

There's no wonder that women get postpartum depression. The weeks after pregnancy are extremely tough, both physically and psychologically - add wild hormones to the mix and you have a percolating pot that is ready to boil over. 

While I wouldn't diagnose myself as clinically depressed, I have been getting the blues and numerous times since my son has been born I've cracked and broken down in tears, in the foetal position on the bed. 

Lack of sleep is probably a major factor, but as an attorney in New York, I've run on a few hours a night for a long time and it's certainly not the tipping factor. Physical pain is one of the primary suspects. After the pain of childbirth, I had pain from the stitches for several weeks - the bleeding was so bad that I ended up in diapers, along with my son- and then when the pain and bleeding subsided, I continued to have breast pain. This pain continued to increase until at nearly 7 weeks, I have done the rounds of what could go wrong with breast feeding and am still recovering. My son was tongue-tied and until a lactation consultant came last week and advised him to have a frenulectomy, he had been chewing on my nipples and not effectively suckling, causing plugged 4 milk ducts, nipple bruising, mastitis, nipple thrush and vasospasm. I've had to pump for the past week to give my nipples a rest and have slowly eased back into breast feeding, although it is still very painful - and not to mention how painful it is when I'm out in the cold (does anyone make nipple mittens?). 

Apart from the physical pain of breastfeeding, the inability to solely feed my son from my breast and my milk has been crushing and I've felt inadequate. I never thought I would have issues doing something so natural. However, the more I have discussed it with people, including medical professionals and certified lactation consultants, it appears that although natural, breastfeeding is much more difficult than we thought. After all, childbirth is natural and many women died during it or had stillborn children for years. Likewise, many women couldn't breastfeed and either had the aid of a wet nurse or had to feed their babies cow milk, contributing to higher infant mortality rates. Although knowledge of these facts makes me somewhat more accepting of the situation, it still pains me. 

One other factor is the massive life change that occurs when the little one arrives and changes take some getting used to. Suddenly, the whole epicenter of your life shifts and everything you've done before seems like a distant memory. When you and your partner find time alone together while the baby sleeps, you pass out along with them ("was that sleep as good for you as it was for me?") or rush to get errands done that you otherwise could not do. While the change itself can be daunting, the change of having total responsibility for another life, that can only communicate by cries that you at first cannot decipher, can be overwhelming. As many books as you may read, you will encounter a perplexing situation which leaves you cuddling your screaming baby in your arms, having run through the gauntlet of possible solutions (feeding, changing diaper, burping, adding clothing/blankets, removing clothing/blankets), crying along with them. My husband and I, for instance, were extremely panicked around the end of week 4 when our poop monster became extremely fussy and did not poop for four whole days. Then we found out it was perfectly normal for a breastfeeding baby to go even a whopping 20 days without pooping as their stomachs get more efficient at absorbing the breastmilk and they undergo a "poop conversion" - how could we have ever guessed that??

There's also the physical aspect. I was 106 lbs when I got pregnant, now I look at the scale - and I never even weighed myself before!- and cringe when I see 132 staring me in the face. I still wear my maternity clothes and haven't even put my wedding bands back on (I'm afraid that if I try again to wear them and they don't fit, a deluge will follow). My mobility is also impaired - the other day I was flabbergasted that it took effort to do a shoulder stand. I also haven't been exercising since I gave birth as I was petrified of ripping my stitches until I saw the doc at my 6 week test and she gave me the go ahead. For a movement junkie like me, it has been another psychological toll. 

Each woman faces her own particular sets of pressures on top of the pain, the massive life changes, the added weight, the hormonal roller coaster and the sleep deprivation - for me, one major pressure was going back to work three weeks after I gave birth. I didn't go back into the office, but I did draft an opposition to a motion to dismiss and prepare for and attend a mediation on behalf of one my clients, for a case in which I was lead counsel and the opposing side were going to use any extension to prevent a mediation occurring (which my clients really wanted, believing the magistrate judge would persuade the opposing side to settle). While I filed my motion on time on the eve of Thanksgiving, to my chagrin, the opposing side asked for an extension for their reply due to the Thanksgiving holiday. It took some effort not to claw at my colleague opposing me in this matter, albeit I did question him as to why he pushed for all motion papers to be filed before the mediation, which I did so with great effort after giving birth and he, knowing full well when my deadline was due (and we all know we never file early) switched his tune right after. I felt overwhelmed and started to resent my clients and my life choices - for it was my decision for greater flexibility (ha!) to leave a larger firm and become of counsel to a smaller firm, thus controlling my own clients. Unfortunately, while week to week you control your own time in the sense that you do not have to deal with "face time" in the office any more, when it comes down it, owning your own business (which is essentially what of counsel do) means you have more inflexibility- there is no one to carry the load when you really need to off load it. Just like motherhood, minus the miracle and joy...


Thursday, December 4, 2014

The Middle Ground

Six weeks in to parenthood and I've already learnt a major life lesson. Flexibility. Preconceptions have gone out the window. 

We were determined to breast feed and while we have been breast feeding, we have also been supplementing to feed our hungry hippo, particularly since my milk production decreased after I got mastitis (more on that and my breast feeding travails later). I know many other parents that are resolved not to supplement while they sort out their particular feeding issues, but facing the line between possible "nipple confusion" (which I garner is really that babies, who are much smarter then we give them credit for, realize that if they don't take the breast, they have the supremely easier option of the bottle, for which they do not have to work to obtain their food) on the one hand and dehydration and emaciation on the other, we opted for the former. For the next couple of days, he will be getting more formula (usually a 95/5 ratio) as after severe bruising of my areolas (which is unbearably painful) my lactation consultant advised me the only way to heal was to not feed for a couple of days and pump instead. Before mastitis, I was producing 2 oz from pumping, now I am producing 1 oz and 1/3 if that. Not enough to satisfy my hungry hippo. And so we are supplementing. I feel very inadequate supplementing - as if I am failing in an intrinsic duty handed down to my sex and neglecting my son. I fear the look he gives me when he takes the bottle (whether it's my breast milk or the formula) is one of appeal mixed with confusion. Why have you denied me? While I had other concerns about formula - even the organic formula we use-  for instance, how well regulated are they to provide a sterile product that only includes what is on the label? etc I realized my main concern was my hurt ego and decided to swallow my pride and get on with it. 

The other major decisions we've had to make have concerned our son's hydronephrosis. From his second day of birth we were advised that our son should be on a daily dose of antibiotics. The dose would be low as it would be preventative, but the concern was that if he did have the antibiotics, he risked kidney infection, which at such a young age, could lead to permanent kidney failure and death. While both my husband and I believe we overmedicate in our society and utilize antibiotics too much - causing all sorts of havoc to our necessary gut flora and leading to antibiotic-resistant strains of bacteria-  and were determined to be very careful in our antibiotic use with our son, the risk of kidney failure was one risk we could not take. So from his third day of life, our son was placed on a low daily dose of amoxicillin. 

After two ultrasounds showed that it was not decreasing, the pediatric urologist advised to do a VCUG, which is an exam performed to see whether our baby had any reflux of urine going back into his kidneys, causing the dilation. Our little babe would have a catheter inserted inside him and dye so that once he peed, x-rays would follow the trail and see whether there was any reflux. We were worried about the radiation (thankfully, it was digital so the radiation was minimal), about the dye (not radioactive itself fortunately) and the catheter (which is much easier to insert in boys) and the possibility of infection. However, the option of not examining was more dire - continuing the antibiotics for a whole year, without a need to do so. We decided to do the exam and the people at Cornell were amazing. Unfortunately, the exam revealed that he had quite severe vesicoureteral reflux ie when he peed it flowed both ways - down the normal stream and up to the kidneys. This is a condition that one can have their whole life without any trouble if one manages to avoid a UTI. However, particularly the younger one is and the weaker the immune system, the risk of chancing a UTI is the risk of chancing kidney failure and death. Particularly as babies cannot control when they poop (and here we patted ourselves on the back for using cloth diapers, with another unforeseen benefit being the fact that babies are way more uncomfortable when they have done their dirty deeds, cry out sooner and therefore stay in their urine and poop for far less), we did not want to chance the risk. In the end, it was not so much the probability of risk that he would get a UTI that made us continue with the recommend course of antibiotics for a year until his problem either resolved on its own (one can hope!) or he had surgery, but the consequence of taking the risk, however small the risk was. The consequence that a UTI could lead to permanent kidney damage was sufficient for us, as wary of antibiotic use as we are, to call it. So our little guy stays on the antibiotics and we are giving him daily probiotics to aid his gut flora. 

A decision over antibiotics faced us again when I had mastitis as the antibiotic would flow through the milk and he would be getting essentially a double dose. I tried to heal on my own, by resting, letting my fever do its work and my expressing the milk (having got mastitis in the first place from another plugged milk duct). However, when my fever hit 103.9, I called it. I was not helping him by getting myself incredibly sick so that I was unable to take care of him nor continue to feed.

Another fine line we drew was to use, on limited occasions (he's had about eight in his six weeks of life), non-cloth diapers (we've been using Honest diapers, they seem to work well and do not have the harsh chemicals conventional diapers do, but have not finished our product research and there may be better products out there). We realised that for us, the ease of convenience on limited occasions outweighed the risks we were concerned about with regular diapers and also that products were available that addressed our risks of conventional diapers to some extent. 

Another major hurdle facing us is language. Once more, I had developed a very rigorous plan. I would only speak Serbian, my husband only Greek and he would learn English on the go. I was worried that if we mixed languages, he would not be able to differentiate the internal grammar and would end up speaking a broken mix of all three, retarding his development. However, it was only when he was born that I realized how difficult it was to stick to one language when I never do so on a daily basis, flowing naturally from one language to the next. It was far easier to pass judgement on people that mixed languages before I tried to do it myself. I am still teetering on what language to use - should I use my native tongue or the language I have more capability in? Should I develop his brain to know multiple languages, thus sparking connections that he would otherwise not have, or should I nurture the development of his main language? There are pros and cons of each side, but I am steering towards the former, albeit it appears that this too, will end up being somewhere more in the middle than I had previously planned.

The choices we have had to make thus far have placed us on a less rigid note and we have come to see how judgmental we have been of other parents, not understanding the mosaic of elements that underpin each and every decision. We now look at our criticism of parents that occupy their toddlers with ipads and iphones or TV and understand why they do so. Further, we understand that nothing is a hard line. Giving a toddler an ipad on very limited occasions is far different to using it as your regular babysitter. Additionally, you have the power to control programming with the ability to chose shows or games that stimulate the brain and aid in learning and development -the ipad itself is a mere platform and the consequence of its use is in the way you choose to utilize it. Possibly at three, my husband could teach our son rudimentary programming - would that be somehow bad for his development solely because it occurs on a piece of technology?

By throwing decisions in your wake and challenging your preconceptions, parenthood is a great learning experience. Particularly as parents make decisions on behalf of their children, this responsibility of making decisions for another person brings to light how much one's ego sways their decisions. For instance, with respect to breast feeding, I realized how much force my determination to be "a real woman" and breast feed without supplement was driving my choices and how little that should matter in the interests of my son. In no small way, parents grow up with their children. 

Tuesday, November 11, 2014

Duct Duct Noose

My son favoured my right breast from the start, possibly due to my "incompetent" left nipple, as the lactation consultant at the hospital had adjudged it. I succumbed to his protestations and made the mistake of allowing him to suckle on my right breast, leading to engorgement and plugged milk ducts on my left. Another joy of breastfeeding.

The first thing I noticed was that my left breast became very hard, with thick sturdy lumps and that there were white dots around my areola. The next thing I noticed was that the inner side of my breast, where the hard lump was, was bright red and hot. I cringed. It looked like the beginning of mastitis and I panicked. I was worried that if I had an infection, I couldn't feed my little one and that at this early stage of breast feeding, my milk factory would close shop and we would be vanquished under the dominion of formula for ever. Before I called a doctor, wondering whether to go to my OB, my GP, or just ask my son's pediatrician, considering we had a scheduled appointment with her the next morning, I checked in with Dr. Google. After a while I conferred with my husband, who likewise had a session with the search engine and we agreed it was time for surgery.

Heat packs, alcohol, needles, tweezers and a pump surrounded me as I lay on the bed, propped up by a pillow, eyes closed, wincing in pain. The heat pack came on first, which felt quite pleasant and then we pumped. A few droplets came out. Next, my husband assessed which milk ducts appeared to be working and we stopped pumping and he got to work. I closed my eyes as he inserted the needle into the uncooperative few. Next, curdling yellow matter frothed out of the popped milk ducts and he pulled it out with tweezers. No wonder my son had refused this breast, I thought, as I looked onto the puss that trickled out. I wouldn't want to be anywhere near that, let alone eat it. When no more came out, we pumped again and as we feared, more of the pussy substance trickled out and the tweezers went to work again. It was probably the least sexiest moment anyone could have scripted.

"I have never seen anything so gross" my husband said, continuing to tease out the puss, transfixed as if viewing a car crash. My breasts had been demoted from objects of desire to objects of disgust. Not only was there no sexy time, there was no dignity. I started to cry. My mind wondered back to when we had first met, when all the huffing and puffing had been reserved for one activity alone. Little had I known then, when we were on our extended third date, a one week sojourn in Puerto Rico, that four and a half years later, my husband would be poking my breast with needles, muting a conference call he couldn't get out of and I would be screaming in pain, our son blithely sleeping through the travesty across our loft, in his makeshift nursery. Every so often, he would stop, unmute his call and provide advice, as I waited for the next thrust of the needle, biting my lower lip.

Occasionally, I would yelp from the pain. My husband stopped his surgery and looked at me. "I hate that I have to do this to you" he winced. I grabbed his hand. "Do it. Ignore me" I yelped. "It has to be done." He nodded. The things you do for your children. We danced this danced three times that day until finally, my breast was shooting out milk. We were ecstatic.

"Let's never speak of this again" I said. My husband nodded. Some things are best left contained in the sarcophagus of faded memory.

Saturday, November 8, 2014

The Land of Milk & Honey

During my pregnancy, I had been advised to attend a lactation course. I didn't do so because I thought the only reason "lactation consultants" existed was to exploit the fear of new parents and commodify an event that was instinctual. I reasoned that as the human race had evolved and survived over hundreds of thousands of years without formula, there couldn't be such a trick to it. If a proto-human breast fed without a lactation consultant, why should I?

I am now convinced that the proto-human must have had the aid of other nursing mothers in the group, not merely for advice but also for nursing itself, as breast feeding is bloody difficult. 

I was flabbergasted when Luca was on my chest, looking up at me with serene, curious eyes and I was told it was time to feed. As instinctual as I had believed it was, neither of us knew what to do. I gently nudged him to my breast and he just lay there, looking at me, as if asking for instruction. We called the lactation consultant in the hospital right away, fearing we may be losing our opportunity to provide Luca with my colostrum. The lactation consultant jovially entered and in a second was kneading my nipple, expressing my colostrum. I cringed through the pain. Then she grabbed Luca's head with one hand and pinched my nipple with the other, creating his first latch. It felt like multiple daggers stabbing me around the circumference of my areola. "There" the lactation consultant smiled victoriously, "that's a good latch." I limped a thank you through my pain and consoled myself with the fact that at least I had milk. 

As I had started to express colostrum from my 19th week of pregnancy, I had been confident that I would have no trouble breast feeding. The first crush to my confidence came when on the first day, after the first successful feeding, I could not get Luca to latch again and a new lactation consultant came in, assessed my breasts and dryly noted that my left nipple was incompetent and needed to protrude more. I looked over at the traitor. Stand up! I directed it. You have a job to do! I was advised that the only way to have my nipple behave appropriately was to keep pumping and keep having Luca breastfeeding. I spent the whole day abusing my breasts with the machine and his mouth until they were scaldingly painful and I nearly passed out from the pain of my breasts, my uterus and the tears of labour. I had also unwittingly made him more famished as he expended a lot of energy suckling without obtaining the needed caloric intake and perpetuated a downward spiral causing him to lose weight and increasing my distress.

The next couple of days stormed through an emotional turmoil, in which Luca didn't latch and I was dry. We both cried throughout the days and nights together. My husband came home once and found us both wailing on the glider, exclaiming that both his babies were crying and rushing over to calm us both. To some extent, I did feel like a newborn. My body felt mutilated, my nipples drawn out and bleeding from Luca's initial latches, not being able to walk from the pain of my stitches and bleeding so profusely that like my son, I was also wearing diapers. Combined with lack of sleep, I was a somnambulant waking in and out of torture, not recognizing my own body. I had been prepared for lack of sleep after labour, but I had not expected the wear and tear that ensued, the constant pain that overwhelmed me. I could hardly stand the first few days and after two weeks, still can't walk more than a few minutes without unbearable pain. There was no space between the pain and the feedings, the days and nights lulled together into one throbbing experience of being reduced to two milked udders. I was told I was going through "recovery", which seemed a euphemism of grand proportions.

I was also flummoxed at how difficult - and how painful - breast feeding was - I had seen many women breast feed while multitasking or even in company and they seemed to not only feed their babies without much ado, but were not in any pain. I felt inadequate. My husband pointed out that the women I referred to, the "better" kind, may all have gone through the same painful process in the beginning, as I had seen them months into their breast feeding regimen. This made me feel slightly better although I still felt inadequate, looking over at my increasingly ravenous and distressed son, knowing my lack of milk was the cause of his turmoil. 

We quickly caved in and gave him formula. I continued to pump and became ever more disappointed at the miserly drops that I produced. Other parents are more resolute in their choice to only breast feed, avoiding supplements until a full milk supply arrived, but we caved in the first day, only hours after it was apparent he was famished and not urinating, and possibly becoming dehydrated. The reasons we were given against supplements did not persuade us. First, we were told that providing formula would lead to "nipple confusion" but the mothers that pumped and provided their milk through such method before their babies could latch were using a bottle also. Besides, our little ravenous monster seemed to want to suck on anything. Second, we were told that he could get accustomed to the formula and not want breast milk. I was a little incredulous that we could produce a powder that would contain the hormones that breast milk has to connect mother and baby and was confident that these hormones would reel him in, even if he were particular to formula. It turned out that when he was starving, he did not want to work - the suckling takes a lot of energy- and wanted the bottle, but he didn't care whether it was formula or breast milk - just that it came to him as soon as possible. 

In any case, we reasoned that even if we had to continually supplement, he would be obtaining the antibodies, nutrients and hormones of breast milk. Further, if I were low on certain vitamins and minerals (for breast milk is only as good as the particular breast produces) he would be obtaining the missing elements from the formula. So while we were against providing a powder to our son, knowing that the corporation that produced it had only its bottom line as a concern, we were more resolute that he wouldn't starve.

The only good news that graced us after the first couple of days was that my left nipple had rejoined the ranks but unfortunately to a dry front. The pump distended my nipples to grotesque proportions and as painful as it was to endure and as distinctly unpleasant as it was to view the mutilation of my breasts in their metamorphosis to udders, it did not solve the situation, for Luca was still hungry. 

On the third day, I started getting in more milk but insufficient for our hungry hippo, and we were still supplementing. We were advised by our pediatrician that Guinness may aid in production. I am more of a hoppy drinker and not particular to stouts, but I gave it a shot. The barley used to make Guinness contains polysaccharides that aid milk production.Whether or not it was merely a coincidence, the milk flowed on the fourth day. I was ecstatic. However, our hungry hippo still wanted more. In the morning and evening, he wanted to cluster feed and after sucking out all my milk, we needed to supplement.

We were trying everything - different nursing positions, different diets (avoiding cabbage and eating figs in order to entice him with what we hoped would be sweeter and less gassy milk, according to my mum's advice) and even different methods of feeding. At first we did a schedule of 20 mins on each breast every 2 hours, then thought he was not getting the fatty hind milk resulting in his continued hunger and switched to feeding from one breast only as long as he wanted every two hours and then returned to the 20/20 regimen after his doctor's instructions due to his decreased weight. We were flabbergasted that he still needed supplement despite the grand opening of my factory, which was producing up to 1 1/2 oz per breast and despite his constant feedings. We had reasoned that it must only be due to a growth spurt and couldn't understand how he was losing weight. The doctor asked if he were latching property. We both firmly agreed that he was - I knew a good latch when pain burst forth and even when he was fussy, we got him to latch together, me holding him while my husband propelled him to my areola. Latching in our house was a family affair. 

After trying so many different things and out of ideas, I couldn't stop the tears at the doctor's office - with all the breast feeding, the gymnastic latching and the supplements - he was still losing weight. And then the doctor proved why it serves to have a medical degree. There was snot up his nose, preventing him from breathing properly and therefore suckling sufficiently to be satiated. Our poor little son was expending so much energy trying to suckle that he was losing weight and always hungry. When she showed us how to take the snot from his nose, he cried bitterly but the snot flowed out. The mystery was solved! As much as I was a milk factory, he was a snot factory, countering the flows of my production. 

While he hates the repeated operations of sucking out his snot, he is one happy hippo after feedings now. 

Wednesday, October 29, 2014

Luca Baby! (Or There's a Reason it's called Labour)

Luca (who began his journey into this world on Diwali) was born last Friday, October 24, in Room 603 at 11:11 am, weighing 7 lbs 7 oz, on the third day of my thirty ninth week of pregnancy - and he is just magical - a pure gift from the universe. I would not describe the means I brought him into this world in this way. In fact, I would say it was exactly the opposite. But he is worth every sweaty, shaky, screaming second of it.

Everyone tells you to have a labour plan. I'm not discounting that you should figure out what you want and hopefully for your case you will be fortunate to be able to labour and deliver according to your chosen gospel, but in my case, the raised eyebrow of all medical professionals to my assertions of wanting a natural childbirth that accompanied their too prescient warning that the baby has its own plan and that quite possibly it may all go out the window, proved too true.

I opted to have my birth in hospital, although I would have preferred a birthing centre connected to a hospital (ie in the same building), not been so keen on a house birth in the knowledge that the number one cause of death for women until recently has been childbirth. I did however want to make the experience as natural as I could and enjoy the mystery of giving life. I had yoga poses and stretches all worked out and had dragged my partner earlier to a yoga message workshop so he would know how to help me labour through the contractions. I envisioned squatting, walking, stretching, labouring in the child's pose, in the shower (as our room would not have a bath), to the tune of Sanskrit chants, Tibetan bells and my hypno tape. Having experienced much pain in my life due to many broken bones and ligaments as well as a quick and dirty affair with amoebas, I thought I had it all down pat.

My confidence only increased when I started to get nightly contractions in week 37. These contractions dilated me by week 39 to 2 cm. They bloody hurt, but I could certainly deal with them. In fact, two days before I gave birth, I was working to finalize a motion I had to file late into the night through my contractions.

As always happens in my life, the universe took a turn to deflate my expanding head.

Week 39, Day 2, I had my usual ultrasound to check my little boy's kidneys. My husband and I ran in a mad rush to the appointment, having slept in, both of us up cramming against deadlines (I had just finished what I needed to do in order to give myself six weeks off and I wonder whether my son was being considerate enough to wait until this point to come into the world). We never found out about his kidneys that day as the sonographer took one look at my amniotic fluid, went pallid and said she was calling in the doctor to speak to us, without even waiting to finish the rest of the ultrasound. We waited in agony for the doctor to return and were surprised she came in with what seemed an indecently wide smile in the circumstances. "Today is the day!" she jovially said. She explained my fluid had dropped from 11 to 4 and in particular considering my son's possible hydronephrosis, there was no reason to delay. They were going to induce me right away. I asked to speak to my OB, in shock, not prepared to start labouring that day. I didn't even have my hypno tape!

Rather than induce me right then, I was sent home for the sole reason that the maternity ward was overflowing, with the warning that I should gather my things and return within the next couple of hours. My husband and I rushed home and scrambled to finalize my hospital bag, leading me to fall into tears because I could not find my Sanskrit chants nor my hypno tape. After I calmed down, my main concern was going to the bathroom, more worried about pooping in front of medical staff and my husband (as I have heard is quite common in labour) than the pain awaiting me. What a fool I was. Once the pain kicked in, I did not care in the slightest in front of whom I was bleeding, peeing or pooping. Later I found out that I did poo a little bit during the pushing and I was in too much pain to even notice. My husband assured me he was so freaked out about the deluge of blood that was coming out of me and more enraptured by seeing his son arriving (even though I had warned him to keep his gaze only north of the belly button!) to even care.

When we arrived at the maternity ward around 4 pm, it was an overflowing madhouse. There was a low pressure system over the city and the evening would see a solar eclipse. Whatever you may think about the influence of the stars upon our actions, it certainly seemed to have an effect on many a uterus in New York that day. We had to wait outside of the maternity ward as triage was overflowing and I took the opportunity to walk, naively trying to start a natural labour and avoid an induction. As I walked back and forth I saw a few women sweating and nearly screaming in pain as they entered active labour - a little foreshadowing of what lay in store for me- and were cruelly confined to the waiting room chairs. The staff kept coming out to apologize explaining they had no rooms nor even medical staff to deal with all the contracting uteri and that they were doing their best to the tune of heightened grunts and screams as I continued to pace.

Lovely M came with sustenance and an encouraging smile. They had ordered me not to eat but I snuck in food anyway as it looked likely that they would not even see me for hours in triage. Once in triage, they hooked me up to my prison of monitors and provided me with the most painful IV I had ever experienced - three hours and a bruised bump later I begged them to reinsert it. My contractions confused them- instead of a pattern, they appeared to come in sets, one overflowing into another and then a pause of sometimes nearly ten minutes before another series tried to conquer my sanity. I was then even more confident I could handle the pain as it was again confirmed that I was feeling the pain of actual contractions and able to walk and squat through them. This was going to be a cinch.

Hours later, my whole body shaking, bleeding down both my legs and crying, all I could handle was sitting, my confidence ruptured. At 10 pm they had inserted cervidil inside me. The insertion itself was really painful. They told me to lie still for 2 hours and get some rest as nothing would happen for 12 hours and then all the work would begin. Ha! As I needed to pee desperately, my son edging up against my exhausted bladder, my husband and I watched two episodes of Twin Peaks until I was allowed to pee. Then we said goodnight and settled in for much needed sleep before The Big Day. Less than one hour later, before I had a chance to take one wink of sleep, I was experiencing seismic pain rushing through me, my groans waking up my husband who had fallen into a deep, restful sleep and The Big Night began. 12 hours my arse. In two hours, I had started bleeding everywhere and was having one contraction after another, without break. My husband asked if I wanted the yoga massages, if I wanted to squat or do other poses or stretches with his help, if I wanted my chants on and all I could say through clenched teeth was that I didn't want him to touch me, that I wanted darkness and silence and didn't know what I wanted. I believe I kept murmuring I didn't know what I wanted as I sat in different positions, curled up, suffocated in my own surging pain. My bewildered husband didn't know how to help. I told him just holding my hand helped. Not knowing the strength of my grip, at one point, he politely told me that while he could handle my grip, if I kept pulling back his thumb, I would dislocate it.

Some time during this madness, my IV fell out and my husband grew pallid and called the nurse. "My wife's IV dropped out" he said shakily, "there's blood everywhere." I didn't care - I had been bleeding with each contraction down my legs, my husband at first scurrying to clean the floor until I growled at him that he should be more worried about me than the floor. At that point, my previous fear of doing dirty deeds in public had flown out the window. I would not have cared had I had diarrhea and it was all filmed and put on Youtube. All I could concentrate on, through the constant shaking and bleeding, was the pain. Each swell a tsunami of shattered nerves, hitting my pelvis, my abdomen and my back, which felt as if it were on fire(back labour - another gift of experience from the universe). The nurses intermittently came in to ask me if I wanted an epidural and I kept refusing. They constantly readjusted the monitors, which kept falling off. I asked if I could labour in the shower and they very nearly laughed at me. I could not be off the monitors for one second.

Hours later a new nurse came in and checked my contraction chart, her eyes growing wide. She said she would be back with the doctor in a minute. The overworked doctor came in, viewed the chart and immediately told me she was taking out the cervidil, which was another painful experience, causing me to bleed more.

By sunrise, I was defeated, near to collapse and crying. I gave in. I told my husband I had no more energy and would take an epidural. I was worried that if I didn't, I would have no strength to push. As we watched the sunrise over the Brooklyn Bridge in front of our window, I clenched my teeth through the pain, shaking so uncontrollably that I could not stand. "Isn't it beautiful?" my husband asked me. I nodded, having lost the strength to talk. It was as beautiful, brute moment of tortured sanity. I saved my last verbal effort to look my husband in the eye and sternly ask "where the fuck is this anesthesiologist? Call the nurse!"

I always read everything I sign. I'm an attorney. It's second nature to me. When the anesthesiologist came with her paperwork, I only looked at the signature line. She told me my contractions were too quick for her to wait for a pause and I would have to lie very still. I nodded. Just give me the drugs! The relief was almost instant. My nurse smiled at me. "There" she said, patting my shoulder. "Much more civilized now."

We later learnt that I was the only one that hadn't taken an epidural that night. My husband nodded, comprehending why I was the only one that people could hear on that floor. "They were probably all taking bets when you would give in" he laughed. I smiled stupidly at him, the drugs released into my system. I still felt the constant pressure, but no pain. He could have said he had an affair with a ewe and I would still have smiled up at him.

As against the epidural as I was, I believe it saved me from the C. From 8 am until half past 10 , when I began pushing, I could not sleep due to the constant pressure, but I could rest. My husband slept soundly by me, energized to be my chief cheerleader during the Big Push. By the time the doctor came in and said I was plus 3 (which I also wonder whether I would have reached had I not relaxed by taking the epidural, as the body clenches during pain) and ready to go, I had regained some of my energy. And boy did I need it. Pushing took all my strength and by the time he was out, I was out of it, screaming through my last three pushes.

I was confused when my boy came out silent. My husband was pallid and immediately left my side. I started to cry, not knowing what happened. My husband later explained that his shoulders had got stuck and that they had to resuscitate him, which explained all my tears. In a second, Luca was on my chest, looking up at me serenely with his enchanting eyes. It was one of the most amazing moments of my life - to have carried him and felt him squirming, hiccuping and kicking inside me, to have him so serenely looking up at me on my chest.

After my son was born, I had to push the placenta out and was surprised at how it looked - massive bulbous, iridescent. My attention was only diverted by the doctor preparing a massive syringe. "What's that for?" I croaked. "Nothing" she gently said. I nodded, not caring, looking enchanted at my son. "There's been an abrasion and some tears" she explained. I nodded and looked back at my son, my husband and I both crying with an outpour of insurmountable joy.

Nothing had happened the way I planned. Even the doctor on call, it being Friday, was the one doctor in my OB practice that I was not comfortable with - and yet, she was amazing - and it was right that the universe showed me once again that I was too quick to judge. Nothing in the end mattered but the fact that a new soul, part me, part my husband, born of our love, was looking up at me, lying on my chest and is now soundly asleep as I type away. I can't wait until it's feeding time again to pick him up in my arms and cuddle him. He is my other beating heart.

Saturday, October 18, 2014

Kidney Blues

When we had our 36 week ultrasound, we thought it would be a breeze. We were going to see how big our little guy was and considering the immense fortress of my stomach and that my husband was 9lbs 3 oz (4.167 kg) when he was born, we didn't think small. So we were not astounded that he was on the big size - measuring nearly 6 lbs (5 lbs 14 oz) at 36 weeks and nearly 8 lbs at 38 weeks (7lbs 10 oz) - we both felt the force of his kicks!

We however were very unpleasantly surprised to find out that all the organs of his urinary system showed dilation. The most gut wrenching part of our ordeal was when the sonographer, who had up to that point been very chirpy and garrulous, widened her eyes and became taciturn in response to me asking for her to check whether she could see two healthy kidneys. For the next half hour as she pursed her lips and looked stoically at the screen, we thought the worst. Before I had asked her to check the kidneys, she was checking his blood and we were both embroiled in stygian thoughts that our son had kidney failure or an issue with his blood. I tried to be calm and not cry, as it moved my belly and affected her exam, but they welled up and gushed out. My little guy! How could this be happening to him? And, why? I immediately started to wonder whether it was something that I did. Did I not drink enough water? Was it because I drank coffee and wine at times in my pregnancy? Was it because I had too much acid in my diet? Too much potassium? Was it because I exercised too much? Was it because I slept on my right side as often as my left? What kind of mother was I, that I hurt my son before he even came out of the womb!

I understand - particularly as an attorney- that the sonographer cannot voice their opinion and that you must wait for the doctor's assessment but the ordeal of waiting is agonizing, particularly as you can see the panic and concern on their face and so you think the worst and ask - are his kidneys OK? Is his blood OK? And the learnt response - "the doctor will be here shortly to explain everything to you" - that strikes at your heart with a bitter blade.

When the doctor finally came to explain what had caught the sonographer's eye and stunted her in a brooding silence, it was much better than we expected. He had moderate dilation of his bladder, both kidneys and ureters. The doctor explained that the organs were healthy and whatever obstruction he may have was not preventing him from peeing as my amniotic fluid was at a healthy level. However, he did warn that there appeared to be some obstruction and that either it would go away after he first peed out of the womb, he would need antibiotics or he would need surgery. He reassured me they caught it in time to avoid kidney failure. On further research, I found the odds were on his side. My doctor made me feel a lot better when she said patients that were dilated up to 20 mm (he was at 11) were fine after their first pee. In any case, I am going to watch his pee like a hawk and take him to the pediatric urologist to err on the side of caution. My (not so) little one!

We've been having weekly ultrasounds since then and so far his condition is stable. I have been trying to employ the art of biofeedback, visualising his urinary system working like clockwork, but I am not sure whether biofeedback transfers from the mother to her baby in utero. It can't hurt.

Once we knew his condition was stable, we looked at the tragic humour of it all. I had just finished writing the first draft of my novel, which centers around a spontaneously sentient kidney and a girl dying from polycystic kidney disease. It had to be his kidneys....I did briefly wonder whether my research and writing on kidneys, kidney diseases and their trafficking somehow was at fault - oh, the cruel caprice and connivance of the cosmos!

I suppose worrying is part of the package of being a mum and I've already started to metamorphosize into the worry bean. My center of gravity has also shifted (physically as well as emotionally). Yesterday I craved an iced coffee from a particular cafe and walked there only to spot their cleansing juices. I knew this was better for my son, so in I went with a tooth for coffee and out I left with a citrus ginger blast (which is also yummy). En route, I spotted earrings that I wanted to buy and went inside the shop ready to indulge myself, not having bought myself anything for a long time -apart from maternity wear- and left without earrings and with an elephant onesie instead. I didn't want to splurge on both, so without thinking, once I saw an outfit for him, I instinctively lost the desire for my little indulgence and indulged in the bigger happiness of buying something for him - I can't wait to dress him up in it! So that's the instinct of motherhood and how a girl becomes a protective and caring mama bear.

Friday, October 17, 2014

Water baby!

I only found out about water exercise in my 36th week of pregnancy and it has been the best thing I have ever done in my pregnancy. Now, I know what to do in my next pregnancy - it's amazing! Throughout my pregnancy, I have been continuing my yoga practice, attending only prenatal classes and continuing my pre-pregnancy ballet bar workout (although with increasing modifications) and in the past few weeks (despite my modifications) my joints started aching after both. It's fairly common for your ligaments to loosen up due to the release of relaxin and for your joints to ache in pregnancy and I was not surprised when it started to affect my old knee and wrist injuries. Water takes the pressure off your joints so you can have a great workout without any pain. What's more amazing is simply just being in the water when you're pregnant - or like me, very heavily pregnant (38 weeks and already 2 cm dilated!). I am so buoyant in the water now, due to to all the water in my body and it's a fantastic feeling. I also feel more connected with my son, with both of us immersed in water. When the class ends, I don't want to leave the pool! The other benefit of indoor pool classes, is that the temperature is always just right and you're out of the sun - I for one, found a day in the sun insufferable throughout my pregnancy, even though pre-pregnancy I craved the sun and beach.

I had to fight to get into the workout however. In fact I have never had more difficulty trying to throw money at someone before. I suppose it's a faint glimmer of what lies in store, since if we continue to live in the city, we're not only going to be forking out our income for good preschools (what's going on with your plan there, De Blasio??) but enduring a series of waiting lists and tests. Enrollment in New York starts as soon as you dip that stick in and see red. I've heard stories of preschools accepting DNA tests from foetuses for early enrollment. Apart from the waiting, there is of course the dire scrutiny of both you and your child. Many parents leave in a deluge of tears after being told that their John or Jenny just didn't make the cut - either their temperament didn't fit the school ("I'm sorry, he just appeared to act like an infant") or they didn't pass the test ("she just couldn't get the pattern right - it's obviously the purple trapezium in the black checkered background that slants to the right that comes next!). I decided to try one of these tests for kicks. It may be pregnancy brain, but even so, I even found some questions required strict concentration and I'm nearly 32. It was more than a little embarrassing to discover that while I have my undergraduate and graduate degrees from two of the top ten universities in the world, I most likely would not be able to enter an elite New York preschool. I'm going to keep that little fact to myself. The harsher afterthought was that if I couldn't make the cut, how could my two year old?

I could of course always beg and connive my way through - just as I did with my water workout.

I spent over forty five minutes on the phone trying to convince the owner/instructor to let me enter. She wanted to know about my health, about my exercise routine, about my career, my personality and how I found out about the program. This is one business that does not covet clients (we come grovelling!). They do not advertise and keep their classes small (max 10 to a class). I started perspiring when I was asked how I found out about the classes- friends can let friends in but how wide was their definition? Is a girl I've spoken to only a few times in my prenatal classes sufficient to encompass the "friend" that holds the key to the most amazing workout ever? I floundered when I was asked her name, wondering whether I had it right. I knew I was being assessed when I was asked to describe her. Luckily, my description fit and I was allowed a coveted pass into this pool paradise. Each time my class approaches, I go through a blitzkrieg of nail biting wondering whether the instructor has spoken with E and asked about the "friend" whom she recommend the classes to, resulting in a confused expression and my quick expulsion from the group. So far, this hasn't happened and the main threat to my weekly joys seems to be giving birth itself (I am nearly there!). But then again, I would not crave the classes so much then.

Go out there and immerse yourself in water! You will feel amazing. And if you're in New York and pregnant - book those preschool prep classes.

Sunday, September 28, 2014

Prods & Pokes of Pregnancy

During pregnancy, you get kicked, poked, prodded and rumbled by the little bundle of joy you are cooking and while that can be extremely painful (for instance when your muscle detaches from your rib bone), it's nevertheless one of the best experiences in the whole world. It's a truly miraculous experience when your tummy rumbles with a seismic surge and you feel that there is another conscious being inside you as opposed to merely knowing abstractly that you are housing the most lovable parasite you will ever meet.

The other prods and pokes, by your doctors, are not comfortable nor as inviting but necessary.  I am not one to believe that just because birth is natural, we don't need to medicalize pregnancy and childbirth. After all, the number one mortality factor for women for, oh, let's see, ALL TIME, has been childbirth and child and infant mortality has steadily decreased with better medical care. The infant mortality rate in the United States does not fare well compared to other countries and all the states in the top ten of lowest infant mortality have unsurprisingly very good health care systems for their citizens, including Iceland, France and Sweden. The issue in this country, despite the prevalent literature of over-medicalizing, may actually be the converse, the fact that many mothers are left without adequate care due to an inefficient and iniquitous health care system.

As most issues in the US, the US should be seen as a mosaic of different and completely contrasting value systems and services. For instance, my OB's office is located in Tribeca and my hospital, Presbyterian Lower Manhattan, is in the Financial District and we are fortunate to have good health insurance. The average resident mother of Mississippi, I would wager, would have a different experience - but then so would someone in the city with different insurance. This medical segregation is a reprehensible state of affairs of which this country, which espouses pride and describes itself with an assortment of superlatives, should be ashamed.

For me, however, prods and pokes have been the way to go. From my first visit, my OB made patently clear to me that, " (I was) in Tribeca, (I was) going to be tested for everything." Boy, was she right. I fainted my first appointment when they took ten vials of blood and on waking up, was high as a kite, with my husband carrying me home as I laughed at everything and was the best audience for a shy, novice comedian. Viewed as high risk due to a past thyroid issue, I had numerous ultrasounds in my first trimester which were performed vaginally. From the second trimester, the ultrasounds could be performed on my stomach, which was more pleasant, although I could understand why my son complained and squirmed against the prying eyes of the paparazzi. They push down hard! The more he resisted, the more they pushed. In the end when we realized they were just  trying to snap a picture, having confirmed all was picture perfect during the anatomical scan, my husband and I called off the hounds. To the sonographer's disappointment, we left with a 3D picture that showed an extremely abstract face, which we decided not to share with the grandparents, but all we cared about was the fact that we saw two lobes of the brain, two eyes, two arms, two fingers, ten fingers and ten toes, two kidneys and a healthy beating heart and the absence of any dragon wings and the like.

A pattern I've noticed is that they decline to tell you when you're about to be injected, prodded and poked. Maybe they like to see the surprise on your face when you're told, after being over the moon that you were now elevated to stomach-only ultrasounds that in fact, you had to take your clothes off and have a more painful examination to see whether your cervix was "competent."  Thankfully, my cervix passed the test, albeit through the discomfort, I was also quite nervous about the ability of my cervix. It had never taken such an exam before - I doubted it studied and if it were anything like its host, it would have cut class, sneaked a smoke in the valley of the high school and only crammed the weekend before the test. Last week when I was told they were going to do a routine Strep swab (again, without any warning) and she went for equipment, I tensed up and was surprised it was really just a swab, barely three seconds and much easier than a Pap smear.

Apart from blood tests, urine tests and vaginal probing, you even get the benefit of vaccines. This surprised me most of all, because I thought that you weren't meant to have vaccines when you were pregnant.  I was hesitant at first, but my doctor explained to me that our son, who we understood would be born with a weak immune system as all babies are, would be born at the height of the whooping cough and flu season and that my husband and I, and even my mother, who graciously agreed to come help us in the first couple of months, all had to get the vaccine. Our son would get the antibodies through me, while "primary care givers" ie me, hubby and mum, would need to be protected also in order to protect him. Now, I'm all for vaccines, after all, they've ended epidemics and wiped out many diseases, such as smallpox and polio, although recently an anti-vaccine craze has seen polio rates rise. See, vaccines only work to eradicate a disease if we all take it, which people don't seem to realize. In Europe, where I was born, a baby has a vaccine passport and they will knock on your door if you refuse to vaccinate your child. However, there are some vaccines that I think are a bit overdone. The only time I took a flu shot was when it was made a condition of my green card. But back to our V-day. While I was hesitant, I decided to take the doctor's advice - after all, she had been to medical school. It would be like her arguing case law respecting employment discrimination to me. So, I handed over my arm. The biggest surprise that day, however, as I was by now used to being surprised with what seemed like impromptu exams, was that my hubby was asked to take the shots as well. He was floored, used to simply sitting there and watching me get poked and prodded. He complained about his arm for days, which provides solid evidence why we are the sex that carries and delivers the child.

The worst test - well, I should qualify with thus far - is the Sugar Surprise. Every time you go to your OB, you give them a sample of your urine. They check for bacteria (UTIs are common in pregnancy), protein and sugar levels as well as your hydration levels. While gestational diabetes is a real threat they have to investigate, surely the urine would reveal at least whether you were in a risk group? However, it's standard that around week 26, you arrive at the OB and they tell you with a smile that you must ingest some glucose and wait around for an hour to have your blood taken. I had just had coffee and a blueberry muffin (not my healthiest day). Ingesting that glucose was extremely difficult and I was near a rampant rage by the time my blood test came around and would have charged like a bull in the Pamplonian encierro had I any energy (all the better for everyone else). I failed the test and was told to return for a stricter one. I had to fast twelve hours before it so they could take my blood whilst I was fasting and then I had to ingest the same glucose drink and then wait three more hours while they tested my blood each hour. By the time the fourth hour came along, I was near to faint and extremely nauseated. My darling hubby came to pick me up. I was shaking. We went straight to eat, which seemed like a fantastic idea at the time, but halfway through my meal, I began to pass out again. I spent the majority of that day sleeping on our couch and leaving my clients in the lurch, not having planned I would descend into such a stupor.

I found out later that nearly 20% of women fail the first test and have to undergo both - why not just give us one day of hell and have it over and done with? I would wager a price tag determines the conclusion of that issue.

It's week 36 now (home stretch!) - I wonder what other prods and pokes are waiting for me before the Big Day.

Monday, September 22, 2014

Name Games

Nearly 35 weeks in, we've finally come up with a name and a middle name. Phew. Otherwise he may have to go by the nickname we've been calling him, "Moose" (due to our recent hiking in Newfoundland, where their majesty presides and due to alliteration with my hubby's surname). We'll probably still call him Moose between ourselves though, particularly as his antlers have already shown through his solid stubbornness. Our little boy knows what he wants and no one is going to stand in his way. Running out of room in his home, my little tenant has realized that putting his feet up between my ribs is comfortable, not knowing how that affects his landlord. Ouch! When we move him, he comes right back to position. Every time I get hungry, he starts fretting, kicking this way and that as if to communicate to me that he has to be fed. One time, Sir Moose voiced vociferously through his ferocious kicking that he did not appreciate his napping disturbed by my laptop on top of my belly, blasting out tunes.

If Moose were a girl, we would have a name set by the end of the first trimester. I made it clear no exes and paramours would make the cut and we both liked the same names. After discounting one name for its popularity and one due to our goddaughter having the same name, we finalized a name we both loved that just 'fit' - save for the fact that I was carrying a boy and the name we picked was distinctly female.

Unisex names are quite fine by me - I was named after my father and we both use the shortened form name. However, coming from a more masculine culture, which has no doubt pervaded my perspective on all issues of sex and gender, I prefer unisex names for girls. After all, there have been many previously male names that have been completely coopted by the female camp so that now naming your son one such name would be tantamount to putting him in high heels and a pink tutu (which might actually be quite liberating, but as hilarious my husband's expression may be on seeing such a scene, I would not want to see its consequence, which I imagine to be his 6'2' 195 pound frame on the floor and my 5'1' 110- pre pregnancy!- inability to pick him up). Hardly anybody would name their boy Leslie, Ashley, Hillary or Vivian  (which really did go with the wind with the rise of its star) these days, albeit these were historically male and/or unisex names.

Although we had said we wouldn't follow our cultural traditions of naming our children after our parents, my husband posed both our fathers' names. In particular he liked my father's name, but as much as it is dignified, Greek and imposing, it's also my name, and having three generations respond to one name was not something I fancied. I did acquiesce to have my father's name as a middle name, which I think he would favour (our tradition however being that it should be the father's name, but to heck with it - as Gandhi said, we must swim but not sink in the waters of tradition). My husband then fought for his father's name, but I was not fond of his father's name, which always impressed upon me an older person and was also tainted by the fact that it used to be my dog's name. I pointed out that his dad got the benefit of having his surname passed on and after a while, my husband gave in to my veto.

He also threw in a veto on a name I was set on by the end of the first trimester. Of Latin origin, it meant "fortunate" and was not very popular and I had zero connection with it. My husband thought it more attune to a pet and vetoed it. I then composed a list of my favourite male names and handed it to my husband with the express disclaimer that some of those names contained ex paramours (the names of my more serious engagements permanently affecting those names in my memory and not on the list). I figured, like me, he would immediately ask me to take them off the list, but instead, he said he didn't care and asked me not to tell him which names they were. Then, he vetoed a bunch of names, leaving three, with one soon discounted by the joyful announcement that we were to be godparents to a boy with one of the names.

I agonized for a few months over the fact that my husband's favourite of our short list was the name of an ex paramour, as I would not be comfortable with the converse situation. I voiced to him one more time that one name on our short list included a possibly "tainted" name and he continued to assert he didn't care. I then confided in my friends, who told me to leave the issue alone, but I still fretted. Maybe he wasn't understanding what I meant, so one day, I brought up the list of three and bluntly stated one name was a longer than usual fling. My husband waved me away, stating he didn't want to know. I then called my sister in law and asked for her advice. Once she told me that her brother really didn't care and didn't want to know, I let it go.

We love the name because it's a standard in both our cultures, easy to pronounce for everyone (but the Japanese - oh well, you can't have it all!), means "bringer of light",  is not overwhelmingly popular, passed the "tease test" - after going in character as five year olds to fifteen year olds and putting all the names on our list to the test (after all kids can be cruel!) and fits his stubborn, fiery character.

Moose, you have a name!

Tuesday, September 16, 2014

Prep talks

My husband and I are firm believers that the reason the human gestation period is nine months, is that it takes about nine months for the reality of being a parent to set in and the limit the human body could take. At 34 weeks, I stress the latter. Back pain, fatigue, constant peeing, pelvic pressure and difficulty breathing are just a few of the uninvited companions that join you for the ride. In the grand mammalian scale of gestation periods, however, we fall fairly in the middle. Whales have a gestation period from 400 to 500 days, for instance, with the sperm whale at 480 and the orca at 500 having the longest gestational periods. That may seem insupportable, but at least they are swimming. Camels and giraffes have to trudge it on land and their gestation periods are just as long, at 400 and 450 days respectively and rhinos have anywhere between 486 to 548 days. Whenever you reach the point in the day when you really want to scream at the injustice of it all, the back pain wearing you down, the pressure on your bladder and pelvis mounting and the little one hanging out by pushing his or her feet between your ribs, think of the poor elephant, who carries her baby on average for 660 days, up to a whopping 760 days!

There are mammals that have a much easier ride of it and they of course tend to be much smaller - I suppose there is no room for the baby to grow.  The mountain beaver has a gestation period of 30, the mouse 21, the hamster 18 and the opposum has lucky number 13. While this may seem like a breeze, imagine finding out you are pregnant and that you will be a parent in less than a fortnight!

So as mammals go, we fair pretty well in terms of ability to prepare (both practically and mentally) as well as physically (who wants to swap places with the opposum or the elephant for instance?).

Luckily not opposums, my husband and I were consistently advised by our friends and family with kids over these many months that we should spend as much time together as possible and enjoy being able to go out on a whim, because "it  will all soon be over" they warned. While we've snuck in a few dates here and there, our chaotic lives at the moment (who has time in New York?) hasn't really given us much time to indulge, although we did spend ten mesmerising days up in Nova Scotia and Newfoundland (I definitely recommend the babymoon!). Our spare time was focused on finding a new apartment in unfortunately the hottest mark this city has seen in years, leading to many offers and disappointments and our recent realization that we were welcoming our son in our west village loft.

With his due date looming, it's finally hit us that we have to rearrange our whole apartment, buy a cosleeper, carrier, stroller and other necessitates and learn as much as we can about parenting. There are baby books and baby things sprawled around our apartment - he has taken over even before he has even arrived!

Sunday, August 31, 2014

Let it rain

I'm entering my 32nd week and as expected, it gets a tad harder every week. The past few weeks I've had uninvited guests consisting of lower back pain, pelvic pressure, massive nose bleeds and just a few days ago, the fashionably late arrival of shortness of breath. Walking the dog to the bakery just ten blocks up gets me wheezing and dizzy as if I were an octogenarian who had just ran a marathon. While I'm wary of the nostrums that are advertised for all our carrying ills, I have succumbed to buying a few and admittedly have adored them. My first try on the pregnancy pillow fell short as it was too large, but the second try, with a smaller number, found a loyal companion for my sleep (I hug it between my knees). Bra extenders descended unto my life as a seraphim - whomever thought of that product is a genius (sometimes the most simple solutions are the best). I had spent several unfruitful hours before I discovered their magic trying various sizes, unsatisfied. Now, I've just bought a belly support, recommended by my OB and yes, it does feel better! Although baby doesn't like me wearing it when I'm sitting or lying, informing me of his distaste with forceful kicks, so I only wear it when I'm up and about. And yes, I've moved on to the granny pants. None of my pre-baby clothes fit me now, so I wear the maternity clothes I bought (the staples  - jeans, work pants, shorts, a few dresses and a few tops) and have borrowed  (thank you J!) and have taken over my husband's wardrobe when at home.

Apart from these necessities, which have been worth every penny, I don't see the need to buy all the speciality products that have been made just to snap expectant mothers' dollars. There is a product for just about everything you don't need - and it gets even more elaborate when it comes to baby. I refused to give into the marketing. Noting the ordeal surrounding my wedding decorations, it seemed that everything that had "baby" in front of it, followed the "wedding" rule that it was 3 times more expensive than a product for a person not getting married nor having a baby. For instance, place "wedding" in front of serviettes and you pay the "wedding" price, even though, say, your engagement might have broken up the next day because you realized your soon to be life partner was an egotistical maniac and you ended up using the serviettes at your "freedom bash." For no other product do you get a tax, as if the merchant were a single embittered soul, solely for your intended use of the product than when you are about to have a wonderful life changing event such as getting married or having a baby. Or more likely they charge more because they can - knowing that in the reptilian depths of our psyche, faced with two equal objects wherein one is specified to be used for our special day or special arrival, we cannot but fail to choose it, lest it have the power of an added blessing.

Today I was bombarded with speciality baby products (you can't just buy any small blanket - it has to be a baby blanket and priced accordingly). We did the registry walk through. My friends insisted I have a baby shower. I had resisted a bridal shower and prevailed on that count, not having a desire to open gifts I had picked out in front of family and friends and then rave about how much I like them - thank you, this towel set is just so charming! My pleasure, I had a sneaking suspicion you liked it as you put it on your registry.

However, I was turned on to the baby shower idea. It would be party in the evening, including Y chromosomes and I wouldn't have to open gifts in front of people (and the gifts would be for baby!). That seemed fun! I held firm on the registry however... that is until today when my dear friend, my husband's cousin's wife, J, took me under her wing and introduced me to the zapper. I zapped away at 116 items, my husband trailing behind us, rolling his eyes. Does everything have to have an elephant he protested. Yes. They are wise, godly creatures. My rational self was consumed by my love of cute drawings. Aww, look at that elephant and giraffe blanket - how could I not get that? Aww, look at that rhino hooded towel! He has to have that. 116 items later (and two bathroom breaks) we were zapped out and now a little afraid to go online and see the consequence of our strikes.

Friday, August 29, 2014

The birth plan part I

The more D day approaches (I trust they call it "labour" for a reason), the more decisions loom and the more we are bombarded with various experts pandering their nostrums for the best birth for mother and baby. Should you bank the cord blood? Eat your placenta? Encapsulate it or cook it? Have a doula? Go to Lamaze classes or Bradley classes or Alexander technique classes? Have an epidural? Give birth at home? At a birth centre? In a hospital? Have first contact? Have the dad cut the umbilical cord? Will you breast feed? What breast pump will you use? Will the baby sleep in your room or in their room? What co-sleeper will you buy? What crib? And so it goes. All the minutia seem to be able to be taken care of by a few clicks on the internet - you can book a doula, a birthing class, a cord blood bank and placenta encapsulation all with a few clicks (I see a future google ad in the works, the clicks that start life).

In aid of some of these decisions, various people tell you to have a ready birth plan. The type where you list you want to listen to David Bowie, have a bath and have nag champa everywhere and then end up going into labour on the subway or having a caesarian, cursing the cosmos that this was NOT in your birth plan. Though I haven't given birth to any child yet, from what I've read and seen, it seems however much you would like to control one of the biggest events in your life, you are but an actor in a script that your baby is writing and directing. I suppose it's only appropriate since from the time the little tykes in your tummy are born, they will be running the show anyway. Mine has already displayed his dictatorial tendencies. He wakes up me up at 5 am daily so that I could eat and he can gorge on yoghurt (he is half Greek).

Before attending any birth class, I decided to do some research and decide which would be the best. The first method I started to look at was the Bradley Method and quickly discarded it. I found his book quite misogynist. Before I was thirty pages in, he had accused women of overcomplicating labour, pointing out that cows and sheep do not seem to have as much of an issue. His thesis to include the dad in a more major role (although not having developed a way the father could of course do the labour himself) and congratulate him on the mother's labour by rewarding him with orange juice also raised an eyebrow from this reader. The dad's part in labour is to take whatever abuse we need to yell at them and withstand our grip. I barely restrained myself from throwing the book across the room. So we crossed that one of that list.

Lamaze, which is not trendy these days, appears to focus on relaxation and breathing and the Alexander Technique (which aided me through a ghastly knee injury a decade ago) focuses on posture. You may wonder why there are so many classes that focus on breathing techniques in labour - we need to breathe to live, so why learn something so natural? Sadly, we don't breathe well in our daily lives (with a tendency to breathe only from the upper lungs and failing to utilize our full breathing potential), let alone breathe well when we are in panic or in pain- and hence the classes, although I wonder how many women remember and utilize the breathing they learnt in class. Contractions can be so painful that women may well not be able to breathe through them, which is why breathing between contractions is so important. One of my issues with these various breathing classes (even in yoga) is that there is so much focus on the particular breathing technique- whether you exhale through your nostrils or through your mouth or which nostril your breathe into and exhale from and how long you inhale and exhale - that some people get so caught up in following the right technique that they get nervous, which affects their breath and they are incapable of breathing as directed. Really, the instructions should be simply- breathe and breathe deep. You may notice that after taking some time to breathe deeply and slowly, you will feel at ease - all those lovely endorphins are rushing through you. The trick is being able to breathe and calm yourself down when you are in panic - for instance, when you have to squeeze out a watermelon in front of strangers.

As far as birthing classes go, I've opted for a yoga workshop with my husband wherein we practice yoga breathing and poses for labour and more importantly, he practices yoga labour message techniques. If I can push out the baby, he can push on my muscles - it only seems fair.

I've been given a hypno birthing tape to listen to, but have not had the pleasure of it yet, so stay tuned. Apparently you shouldn't listen to it before week 34, which is at about the time you are guaranteed a healthy baby, although their lungs aren't quite up to scratch and they need to stay in the incubators for a while. With such a warning, you may wonder how well it works - maybe even women who haven't conceived end the tape with a tyke and a lot of explaining to do.

Everyone has been raving about doulas, but I am a little recalcitrant to have a complete stranger be my birthing coach. I know it may seem a little silly as the hospital staff will all be strangers and the OB is not exactly my BFF and could be one of the three doctors I've only met once or depending on the insanity of the particular day, a complete stranger - but since you can't help all those strange souls, why add another one to the mix? I'm also a little hesitant to have someone so gregarious and ebullient (as the ones I've met all seem to be) holding up pom poms to me when I'm in my most uncomfortable state. I'd rather just yell at my husband like the good ol' times - you did this to me!

I asked my OB about the hospital's policy on epidurals, having decided that I would not have one. It wasn't so much my fear of the effect it may have on my son, although I was concerned, as the fact that I wondered whether an epidural prevents you from feeling the need to push, creating a need for pitocin, which creates a need for a stronger epidural and a downward spiral that may well lead to a caesarian. I decided that for both issues, it was better to err on the side of caution. My OB looked at me, smiled and said, in a tone reminiscent of a rehearsed phrase, "as you wish, but honey, let me tell you, no one is going to give you a medal for not taking pain medication."

How much more painful can contractions be to say, tearing your meniscus or tearing your scapholunate ligament to the point of your bones dislocating or breaking your coccyx? I should be thankful for all my past injuries in preparation for this upcoming pain...of course, it may well pale in comparison, in which case....I could always just yell abuse - it's the only time we're really permitted to, so we might as well as let it all out. Yeah, you. That's right. You look like a wet porcupine!

I am giving birth in hospital, which is not the most magical setting, but considering that the number one cause of death for women for, well, EVER, was childbirth, I've decided to err on the side of caution and be around the minds and equipment that can handle an emergency, should one occur. After all, I've had a terrible medical history so giving birth at home in a blow up pool is just inviting disaster for myself and my son. While I haven't had the tour yet to see the maternity ward, which apparently you can only do with a lactation consultant, I do know that unfortunately Lower Manhattan Presbyterian does NOT have baths, which I was rather looking forward to. I suppose a shower would have to do (which thankfully they do have in the room).

I would have opted for a birthing centre, one that sat as an adjunct to a hospital, if New York had more of them, but the only one we have in the city is connected to St. Luke's and my OB is not affiliated with it. Even if my OB were affiliated with the hospital and my health met their standards, my husband and I would have to be picked from a personal interview in order to be allowed to give birth there - and of course, if it's a full moon and everyone's water breaks, you may get to the centre just late enough to lick the door and be told that it's full and your hospital room awaits you upstairs. I wonder what they ask you in the interview. How many comebacks do the 80s have left?

My prenatal yoga class is full of St. Luke birthing centre mums who beam ebullient during our introductions when the teacher asks everyone how we're feeling, where we're giving birth and whether, if it's not our first, we had a vaginal birth before. I always try and come late to avoid this discussion as it's extremely judgmental for a yoga class and feels quite incongruous. As we go around the room and some women reveal they are pregnant with their second and had a caesarian before, the teacher immediately expresses her sympathies and encourages them to try for a vaginal birth this time around- not bothering to ask whether her student intends on having one in the first place. As most women are having their first child and ecstatic that they are enrolled in St. Luke's birthing centre, the class becomes one big high five for their right decision. As for the rest, to give my example, when I said I was giving birth at Lower Manhattan, the teacher furrowed her brow in horror and with her best encouraging face, said, "well, I'm sure you'll have an OK birth anyway" as the St. Luke mums looked on aghast. I'd like to see them all mid-way through their labour when they are screaming for drugs and being told that they picked a location where they wouldn't have any, but as a consolation prize, they do have a bath.

Saturday, August 9, 2014

The seventh month itch

I had heard my friends, who were in the dreaded third trimester or had already had one or a few tikes, roll their eyes and shake their heads, warning me abjectly about the Big Itch. I insouciantly did not take heed to immerse myself in a coco butter bath daily, not having any issues with my skin. Curse the caprice of the cosmos! With one slap of fate, I am battling an imperious itch through a policy of attrition and am submerged in my own Verdun.

While no women wants stretch marks, I had determined that there was no panacea for pregnancy's ills and no prophylactic for any of its symptoms, so that the use of coca butter, which I do not deny is quite nourishing for the skin in any case, would not withstand the conquest of stretch marks. Admittedly, the heat and humidity of NYC in the summer did much to sway me away from adding layers of butter onto my skin, particularly as my A/C, as if harboring animus for me all these years, decided to dramatically end its days in a burst of spite in the middle of July.

One other factor in my shrewd calculation was that I already had pre-pregnancy stretch marks from puberty and concluded that if puberty caused me stretch marks, which is not common (but then again nor is being 14 with a stick boy figure and not wearing any bra as there was nothing for such bra to hold, to in a matter of months gain 9 kilograms and wear a C cup - with my breasts displaying what appeared as the frayed wings of a rising Phoenix from thereon), then the marks of pregnancy already had my fate in their clutches, so that my choice was merely to go with the flow or follow in Oedipus's footsteps. I chose the former.

I did have some concern for my tattoo, a souvenir from a spontaneous stroll down Portobello road to its market when I was 23 and immersed in the "moment" (save for the day of July 7, 2005, which brought us to heel). I had chosen to have a small star on my right hip, to the the distress of the artist who complained that it would be too small. I retorted that the tattoo was for me and not for display (although I can't even see it anymore!). I chose a star for two reasons. One, I was born and lived till the age of 7 in a Communist country that later ended its days in self-mutilation and disembowelment, in a much less elegant way than performing seppuku, and I remember the time, before the cloud descended and the storm unleashed its fury, growing up with my extended family there as a haven, and two, I understood that I had spent the smallest part of my existence as me - that I came from stardust and would return to the stars. Every time I was embroiled in my own concerns and cursing why the cosmos had determined to foil me at every step, I had my souvenir to remind me that none of this mattered and I was part of the whole. And now my little souvenir has been lost underneath the conquest of my rising belly and I dare not think what shape my star may have turned into once my little boy arrives and my belly packs its bags and leaves for an extended and well deserved sojourn.

The first thing I noticed apart from my darkened and expanding nipples, was the descent of the linea nigra, as if an incision had been made down my tummy. For months it has been darkening and is now quite noticeable (a Chinese lady remarked to me that I was having a boy because it was so dark - she was right, although I am not sure whether having a darkened linea nigra is a good measure of sex) with a swirl around my belly button (or more accurately the area where my belly button used to be since it has since disappeared into the depths of my belly and something utterly different has taken its place). I have read that hormones affect pigmentation and hence we receive this line, however, that answer seems highly inadequate to me. For while it can account for the darkened pigmentation, how does it account for the actual line and circle that it produces? I must admit I haven't thoroughly investigated, but then again, I enjoy the mystery of it - the magical mark of pregnancy displaying the miracle that it truly is.

But back to my battle with the Big Itch. Once it came, it came with fury. At first I couldn't help but scratch, which caused red rashes on my stomach and quite a few raised eyebrows from surrounding company and a meek explanation from me that I was not carrying lice. I was quickly humbled and became a faithful user of coca butter. I also avidly use coconut oil and kukui oil. They may not conquer the march of the marks, but they certainly quell the fury of the Big Itch, at least for a time and any time without the need to madly scratch the surface which houses your baby is good enough for me...

I am embarrassed to admit, but tis true, the unseasonal temperate weather we have been enjoying in NYC the past couple of weeks, due to another polar vortex - a symptom of the destruction of our earth's current environment caused by our myopia- has only put a smile of relief on my face. I know it's selfish, but walking around immersed in butter and oil and carrying a lot more weight in a seasonal August - and without an A/C!- is a horror I am thankful, at at least in this limited time, I am living without.

There are times when the Big Itch rises and I do not have butter nor oil at the ready. I have decided to try to take this in stride - some yogis intentionally go through manufactured torture - so I am (trying) to utilise the Big Itch as a chance for me to let go even in maddening circumstances. Last night, during my prenatal yoga class, as the Big Itch descended, I was proud of myself for letting go and breathing through it. Then the fan decided to clank every two seconds. I couldn't help but laugh. The clank would either bring me down back to the beginning when I gave into the scratching or make me stronger in my practice. I breathed through it and wondered what the third would be, challenging the universe to slap me with another annoyance. And yet, none came as if I had passed some test, at least for that day.

Tuesday, July 29, 2014

Bones behaving badly

There are innumerable joys to pregnancy, from nausea to unbridled emotions, fatigue and a recent companion, joint instability. In continuance of my experience that the more painful the ailment the more painful its pronunciation, as if its name alone should cause one to shudder (except of course for labour, the exception to every rule, that aptly describes its experience with the one word), I have had the blessed visit of uninvited symphysis pubis dysfunction and like the best of dysfunctions, it is graced with its own acronym, SPD. Put simply as relaxin is released throughout your body to aid in delivery, but somehow badly programmed to not specifically target the pelvic area and be released only right before delivery ( an example of code cheating by our biology), all our ligaments are let loose and set out to party, including the symphysis pubis. So if you're wondering why you're suddenly more supple and flexible, conquering poses in yoga that you may have been struggling through pre-belly, it's due to a hormone gone wild.

As I started with loose ligaments in the first place, leading to a few cartilage conundrums in my wrists and knees pre-pregnancy, I took the now familiar hot pain in my knees and wrists with what I hoped was stoic acceptance. Proud of myself for letting go and accepting the return of joint pain, my continual party crasher, I did not expect that this time it would come vamped up, bringing pelvic pain into the mix. I spent one whole day utterly miserable, feeling what I can only describe as a continual burning pressure in my pelvis and was admittedly quite irascible throughout. The only relief was to get on my mat in balasana, with my legs separated more than usual to make room for my big frontal companion.

Along with ligaments letting loose, the gap in the pelvic joint widens a few mm during pregnancy (we all end up with child bearing hips!) and if it widens too much (please, no!) you face another latin tongue twister with its own acronym, DSP, or diastasis symphysis pubis and a lot more ouch. I'm going to try and focus on the bright side of this hip widening - yes, there's the arrival of my son but also, from a girl that never had hips for Fosse moves, maybe I'll finally have that hour glass figure ( but alas, would require a whole new wardrobe).

In addition to my pelvic predicament, I've had the blessing of round ligament pain, which started quite early on in the second trimester. In part, I believe this is may be ill targeted karma for unwittingly causing my husband massive amounts of pain after his hernia surgery when I thought a good past time would be watching comedies (in hindsight, I advise the tragic genre instead for such circumstance). The pain does not last long but it's a stabbing pain that makes up in force what it lacks temporally. Twisting, turning, laughing and coughing can bring it on and it forces me to double over in pain.

The fun never stops! At least not for another trimester....

Friday, July 25, 2014

Last hot days of the honeymoon

I'm a few days away from the beginning of the behemoth of the third trimester (not all pregnancy weeks are equal), which leers at me with a wink askew from the approaching shadows...and I admit, I am scared.

I know everything is going to become more difficult and it's already no picnic (and here I am solely using the idiom, for in truth picnics can be quite stressful - what charcuterie to bring? What fromage? What vin? Whom to invite? How not to invite those insufferable people that have clawed their way to the periphery of the group and are clutching as if their health depended on immersion into the clique).

Not only am I finding the weight difficult to deal with (unashamedly making suggestive statements to hubby in order to lure him into more foot massages which readily will simply turn to "another, please" with an expectant smile on my face-  he can't say no to the belly, right?) and am never comfortable, although most comfortable with my pregnancy pillow (my new best friend!) and ordinary movements difficult to negotiate (such as putting on my shoes, getting out of our futon-style bed and soon fearing issues with that delicate act of independent personhood, wiping my own butt), but my brain has packed up shop and is currently sipping a white Bordeaux, looking out wistfully at the shore in Côte d'Azur leaving me to scramble with no short term memory, unforgivable syntax and the logical aptitude of a maggot.

Just a few minutes ago, during a call in which I explained my hubby and I had to leave our loft in the village which we love so much, I stated to a somewhat awkwardly silent reception that "unfortunately, we're having a baby in two months and have to leave." A few days ago, I signed my name "Australia" in an email, albeit I did not feel overly patriotic at the time (in fact I had just been reading some delightful insights by our PM and was lugubriously laughing) although to my credit, both proper nouns start with "A" and have nine letters.

I can only imagine the delightful gaffes I will make at the pretrial conference at the Southern District I have coming up. On the positive, it may give opposing counsel a false sense of security, which I trust I will crush when my intellect returns from its sun dappled sojourn.

My dad, an avid believer of Murphy's Law, always quick to say that things go wrong just at the moment you need them the most (with a smile that invades any conversation and a laugh with seismic effect), thought it hilarious that our A-C went kaput a few days ago. I did not find the same humour during the 33 degree (celsius people, nine years in this country and I still don't get Fahrenheit - I wonder if it's a question on the citizenship exam?) heat, not exactly uncommon for mid July in the city. I drenched myself under a cold shower trying to keep all thoughts on the world's freshwater crisis firmly tamed. I stuck my head in the fridge and ignored creeping thoughts as to the needless emissions I was creating. I even strolled over to the supermarket a block away and walked around the frozen food aisle, acting interested at bags of frozen pees and pizza to get away from the strangling heat until the staff started passing me by with inspecting looks and I knew it was time to face the heat anew.

And so a new trimester begins...

Monday, July 21, 2014


Exercise is not so ninja when you have a belly.

Lately, even stairs have become my nemesis. Pre-pregnancy, I would scoff at our lift and had a very loyal relationship with our internal fire escape. Now, I still grumble up the stairs, albeit in a much slower fashion with an exasperated expression and much heaving.

Bending has become an obstacle (but on the other side of the coin, I have a great excuse for hubby to do all the housework! And yes, I will be utilizing it). I reflexively groan whenever I bend, a low rumble from another time, like a preserved mammoth awakened from its bed of ice. Not a feat to attempt around small children.

This makes exercise a little more imaginative, with a lot more adjustments. In my first trimester, I continued as normal and in my second, I made progressive adjustments until now, less than one week away from my third, I am strictly adhering to the prenatal label.

While I resisted going to prenatal yoga rather than doing adjustments in my regular class, I quickly realised that I was having to adjust or sit out the majority of poses (inversions, twists et al) and I swiftly joined the prenatal ranks. It was great not being the only belly in town. Plus, the prenatal teachers know what stretches you are aching for - it's amazing! If I wasn't practicing yoga every other day, I believe I may have been arrested for disorderly conduct quite a while ago (particularly respecting the times I have been craving a particular ice cream only to find out that the ice cream truck had indecently sold out of my flavour and most recently and egregiously decided to discontinue cinnamon right when I am entering my third trimester! Do these people have no empathy? I only survive by stocking up on ginger and coconut).

I must admit prepreggers, I was a little addicted to the endorphin rush after exercise. You name it, I probably tried it. Running (resulting in continual arguments and misunderstandings with my right ITB), yoga (practicing various styles from Ashtanga, to Iyengar, to Hatha to Bikram - the anti-yoga yoga- to a mixed vinyasa flow), pilates (both mat and machine), kickboxing (resulting in a torn meniscus), pole dancing (I loved this so much I posted a pole in my living room and ended up with multiple tears of the scapholunate ligaments in my both hands) and lately the barre method (Pure Barre to be exact). Needing my solace, I have been determined to continue my work outs, albeit in right belly fashion. Previously scoffing at work out videos, as often happens in my life (I have learnt to be a little less judgmental, as the universe has a habit of putting me in people's shoes - even literally, as once I ended up buying a pair of shoes that I had previously raised a critical eyebrow at), I am now ardently following the routine of a few.

Is it just me or do the "prenatal" instructors in various "prenatal" videos, claiming they are well into their second trimester, look not only decidedly NOT pregnant, but a little emaciated to you? I can't help but smirk every single time, albeit I can dictate the routine's narrative verbatim,  I hear the belly-less instructor exclaim "Oh, it is harder with a belly isn't it!" as she smiles ebullient and without a missed breath plunges into a decidedly fanciful exercise for a belly that knows no boundaries, such as the one that houses my son.

The more difficult negotiating exercise, or even just every day tasks such as sitting and standing up and bending are, the more my son exercises in my belly. He seems to have taken after me, as every day, at different times, suddenly my dormant belly erupts in an earthquake of ceaseless activity for minutes at a time, with such force that it interrupts whatever I may be doing. In the last few days, I have been able to not only feel him but see him moving. It's a trip, alright. Is he doing star jumps in there? We won't be doing them together for a while yet.

I can't finish a rant about prenatal exercise without broaching the subject of kegels. I must admit I have to work harder on mine- I realize their importance and lay prostrate at their throne! I was told by my yoga teacher to do ten sets a day. Ha! I am still getting to the point of practicing my kegels once daily and even then I can only do the rudimentary exercises, let alone the "elevator" reps they encourage you to do. The great thing about kegels is that you could do them anywhere. In the office. On the subway. Oh yes, just think, wherever you go, a soon to be mama is practicing her kegels somewhere near you.