I have not posted anything on this blog for a very long time. I don’t even want to think about how long. However, what I am posting today cannot wait. It’s too important. There is a new way to share breast milk with those in need, in addition to MilkShare, and it’s also directly mother-to-mother. It’s called Eats on Feets (http://www.eatsonfeets.org/), and it’s fabulous! There is no charge for this service, and since it’s connected through Facebook, it’s almost immediate for both potential donors and their recipients. Please, if you have extra human milk to give, check out Eats on Feets. There is one for every state (sometimes more than one for each state), and it’s available in several countries as well! I cannot say enough good things about Eats on Feets! It is seriously making the world a better place.
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I’ve used powdered infant formula maybe two times in the entire time I have supplemented for my daughter (I have supplemented with formula for over a year, out of necessity due to breast hypoplasia and breast surgeries). The main reason why I was never keen on using powdered formula is because of the theory of free radical damage from using a powdered reconstituted animal product. Now, I don’t know if the ready-to-feed and concentrate forms of infant formula I’ve been using contain reconstituted powder in them. If they do, I’ll probably feel like the world’s biggest schmuck. But the more research I do on the subject, the more I realize the oxysterol powdered-milk theory isn’t the only reason why using powdered infant formula isn’t a good idea.
Powdered infant formula is the most affordable form of infant formula there is. Every other form (concentrate, ready-to-feed cans and bottles) is significantly more expensive. This is why most people who for whatever reason decide not to continue lactation (or who can’t easily lactate because of a physical barrier which impedes it — think adoption or breast surgery) usually decide to buy powdered infant formula. It’s not cheap, but it’s cheaper than the already prepared stuff. Many people who would otherwise be able to breastfeed or pump milk for their babies for a lot less money (the price of renting a hospital grade breast pump can be as little as $35/month, or less; the service of a lactation consultant is often cheaper than the cost of one month’s supply of formula), instead buy the powdered infant formula because it is erroneously perceived to be a “cheap” and “good” alternative. There are many barriers impeding the success of breastfeeding for new mothers, but one of the biggest ones is the fact that it is easier (and less taboo) to learn how to prepare infant formula than it is to learn how to breastfeed or pump (also, figuring out how to prepare infant formula can be done easily in public; figuring out how to breastfeed, topless, for example, is unfortunately not acceptable in most places — and trying to figure out how to breastfeed while wearing clothing is like trying to figure out how to swim by practicing in a bathtub — it’s not very effective). Formula companies exploit this whenever they can, seducing women with the promise that formula is “just as good” for their baby and much easier to figure out than breastfeeding in the middle of the night when holding a screaming, hungry newborn and without anyone to help you.
Unfortunately for most mothers, formula companies don’t actually care (in deed; they always pay lip-service to “caring”) if the product is prepared properly or if it’s even safe before preparation. They feel that’s “not their problem,” legally speaking, so they sleep easily at night, even if infants who use their mislabeled products die.
I do not recommend infant formula use at all unless there’s no other feasible option, but I especially do not recommend the use of powdered infant formula. Powdered infant formula is not sterile. Infants have already died from contaminated powdered infant formula (even when prepared according to the manufacturer’s directions). The United States’ Centers for Disease Control and the Food and Drug Administration advise against the use of powdered formula in hospitals because of the contamination risk it poses. It is impossible to sterilize powdered formula in the factory in the same way that liquid formulas can be. Furthermore, if preparing the powdered formula with boiling water to kill the bacteria, some of the vitamins in the formula may be damaged beyond even what the sterilized liquid formulas undergo.
Even when prepared according to the manufacturer’s directions, however, powdered formula never dissolves completely. You can shake the powdered formula with the proper amount of water in a baby bottle until the cows come home (this is what the directions on most if not all powdered infant formulas say to do — shake the measured scoops and water together in the baby bottle), and you will inevitably be left with undissolved lumps in the resultant liquid mixture. These lumps mean the concentration of formula in the liquid is less than it should be, and the lumps often stick to the sides of the baby bottle and never get consumed like they’re supposed to.
In addition to powdered infant formula not being sterile, the possibility of free-radical cell damage from oxidized cholesterol/fat from the formula powder, and the problem with the formation of lumps upon reconstitution, there is also the very real possibility that the directions on the can won’t be followed properly. Most women in the third world don’t have schooling beyond primary school. Consequently, a basic understanding of weights and measures (like liquid measure and powdered formula scoop measure) is often not understood very well. This sometimes leads to formula being prepared at too high of a concentration if the powder is measured before the water is, or it sometimes results in a too-dilute preparation if the woman in question is trying to save money by using less powder than is called for on the can. A too-concentrated formula can lead to dehydration, renal failure, and death in the infant. A too-dilute concentration of formula can lead to malnutrition and a lifetime of health problems, in addition to the possibility of eventual death by starvation. While it may seem “affordable” in the short-run to provide a third-world woman with “free” formula for a time, in the long-run, the results are disastrous and not worth the true, human, cost. The woman dries up, no longer produces milk with her own body, and becomes needlessly dependent on a far inferior, even dangerous product. It becomes like a drug, then. A woman will do anything to get more of it for her baby, because it’s the only feasible option left to her for nourishing her baby once her milk dries up (her milk will start drying up as soon as she starts supplementing with formula if she does not provide stimulation to her breasts — often the woman is not aware of this consequence because not many people are aware of the supply-and-demand aspect of breastfeeding). Over more than one generation, this dependence on infant formula will lead to a loss of knowledge of breastfeeding for a given society (and increased breastfeeding ignorance), leading more women through the generations to become dependent on an external, purchased product rather than trusting their own bodies. It is unconscionable to provide formula to third world countries for free for these and other reasons. It’s also immoral to encourage people to buy “cheap” powdered infant formula when the truth is that the female body can produce a far superior (and practically free!) product, if only the proper education were disseminated about it.
Maybe if everyone had to pay the price of liquid formulas when choosing to formula feed (which is what would happen if everyone knew just how inferior — and even dangerous — powdered formula was), perhaps then breastfeeding and pumping wouldn’t be seen as “gross” and “too much trouble.” It would definitely incentivate a lot of people who erroneously believe formula and breastmilk are “just as good” as one another to at least try breastfeeding and/or pumping before the “easier” formula-feeding, and it may motivate new moms to stick it through the tough times for longer. At the very least, if no one were to buy the powdered formula anymore, it would incentivate those in the formula industry to charge less for their liquid “premium” products, which would be better for everybody — (except, of course, for formula manufacturers and their shareholders).
Formula does not have to be part of the cost of raising a child. It’s not a necessity like a car seat is (for those people who own a car). It is an artificially created need, artificially created through baby-unfriendly hospital policies, aggressive marketing tactics, and the unofficial endorsement of many health care workers (doctors, nurses, hospital administrators, some midwives, etc.) the world over. This artificially created need causes needless illness and death, and it’s all for the sake of making a buck. It is never about the health and well-being of mother and child.
The use of infant formula (homemade or commercially prepared) should be the option of last resort, to be used after all other (better) options have been exhausted. Breastfeeding should always be the first choice, except for the very rare case of severe galactosemia. Powdered infant formula should just never be used at all — babies have better options no matter where in the world they are; much of the time, it’s just a matter of allowing breastfeeding to succeed. Too often breastfeeding is sabotaged by the inappropriate introduction of formula by health care workers, misinformed and exhausted postpartum moms, or well-meaning but misguided family members.
Due to all the health risks associated with consumption of any type of formula, moreover, it is completely inappropriate for any hospital employee or volunteer to feed newborns infant formula routinely unless the mother of the infant is dead, has abandoned the baby, is HIV+, or does not have functioning breasts. And actually, for extreme cases like that, the infants involved should be fed donor breastmilk whenever it’s available (in the case of an HIV+ mom, the mom can try manually expressing her milk into a clean container and flash-pasteurizing the milk to kill the HIV before feeding it to her infant — it would still be far superior to any formula). Funny that if breastfeeding were considered as routine as formula-feeding is now, more healthy donor milk would be available to feed babies whose mothers cannot… Imagine that: A world where every baby is fed breastmilk, and where no corporation is profiting off the sale of human milk. That would surely be a beautiful thing.
There is an important bill that is stuck in committee right now. The bill is named the Breastfeeding Promotion Act of 2007. (The following bullet points are my interpretation of the bill. You may interpret it differently.) The Breastfeeding Promotion Act:
- asks that breastfeeding/lactation be protected by federal law, as an amendment to the civil rights act of 1964.
- will provide employers tax breaks for supporting lactating employees (by providing them pumping rooms, time for pumping, etc.)
- asks for a classification/quality standard for breast pumps (right now there isn’t any — for example: the words “hospital-grade breast pump” are essentially meaningless at this point because there’s no third party entity in place that has defined what “hospital-grade” means)
- asks for a provision to be made so that tax breaks be given to those who need breast pumps and/or services related to breastfeeding (like the use of a lactation consultant)
If you have the time, read the full version of the bill. This bill was first proposed by Congresswoman Carolyn Maloney (D-NY) on July 18, 2003. That’s over FOUR years ago. It has died numerous times now, never even being voted on in the House or Senate because it’s never made it past a committee. It probably never made it past committee because the public has probably not drawn enough attention to it to warrant consideration. It’s been re-incarnated numerous times (by Maloney and a bipartisan group of representatives) and was re-introduced most recently on July 17, 2007. As of this very moment, this bill’s fate is in the hands of these people (there’s a scroll bar underneath the pictures; if you slide it all the way across, you can see what most of the representatives look like). There is a total of 49 people in this H.R. committee, and I count only ten women among them. Perhaps if all the Representatives were contacted and urged to send this bill to the House for a vote, we could get this bill voted on in the Senate as well and then (hopefully) signed into law. Without getting past this committee, though, the bill will die once again and will have to be re-submitted. Again. This is getting tiresome, so, in order to avoid more needless delays, let’s get this show on the road, shall we? Let’s get the Breastfeeding Promotion Act made into law.
OK. The people that need to be contacted are these. They are all congresspeople, in other words, members of the House of Representatives (The “Rep.” in front of their name stands for “Representative” and not “Republican”). They are all members of the House Committee on Education and Labor, which is the committee that will decide whether to let the Breastfeeding Promotion Act move on to the House of Representatives, or be ignored and die. This is how the House Committee on Education and Labor breaks down:
- California = 5 Representatives (Rep. George Miller, Rep. Howard McKeon, Rep. Lynn Woolsey, Rep. Susan Davis, Rep. Linda Sánchez)
- New York = 4 Representatives (Rep. John Kuhl, Rep. Carolyn McCarthy, Rep. Timothy Bishop, Rep. Yvette Clark)
- Michigan = 4 Representatives (Rep. Peter Hoekstra, Rep. Vernon Ehlers, Rep. Timothy Walberg, Rep. Dale Kildee)
- Illinois = 3 Representatives (Rep. Judy Biggert, Rep. Danny Davis, Rep. Phil Hare,)
- Pennsylvania = 3 Representatives (Rep. Todd Platts, Rep. Joe Sestak, Rep. Jason Altmire)
- New Jersey = 3 Representatives (Rep. Donald Payne, Rep. Robert Andrews, Rep. Rush Holt)
- Texas = 2 Representatives (Rep. Kenny Marchant, Rep. Rubén Hinojosa)
- New Hampshire = 1 Representative (Rep. Carol Shea-Porter)
- Connecticut = 1 Representative (Rep. Joe Courtney)
- Kentucky = 1 Representative (Rep. John Yarmuth)
- Hawaii = 1 Representative (Rep. Mazie Hirono)
- Iowa = 1 Representative (Rep. David Loebsack)
- Maryland = 1 Representative (Rep. John Sarbanes)
- Arizona = 1 Representative (Rep. Raúl Grijalva)
- Oregon = 1 Representative (Rep. David Wu)
- Ohio = 1 Representative (Rep. Dennis Kucinich)
- Massachusetts = 1 Representative (Rep. John Tierney)
- Virginia = 1 Representative (Rep. Robert Scott)
- Nevada = 1 Representative (Rep. Dean Heller)
- Tennessee = 1 Representative (Rep. David Davis)
- Utah = 1 Representative (Rep. Rob Bishop)
- North Carolina = 1 Representative (Rep. Virginia Foxx)
- Louisiana = 1 Representative (Rep. Charles Boustany)
- Georgia = 1 Representative (Rep. Tom Price)
- Washington = 1 Representative (Rep. Cathy McMorris Rodgers)
- Minnesota = 1 Representative (Rep. John Kline)
- South Carolina = 1 Representative (Rep. Addison Wilson)
- Florida = 1 Representative (Rep. Ric Keller)
- Indiana = 1 Representative (Rep. Mark Souder)
- Delaware = 1 Representative (Rep. Michael Castle)
- Wisconsin = 1 Representative (Rep. Thomas Petri)
- Puerto Rico = 1 Resident Commissioner (Luis Fortuño)
It’s important to contact these specific representatives and alert them to the importance of this bill because right now these people are all looking at hundreds, if not thousands, of other bills. It’s hard for them to know which ones to really give their attention to, and oftentimes, even important ones — like the Breastfeeding Promotion Act — get ignored in favor of other ones with a perceived higher importance (meaning, people have written, called, essentially hassled the representatives until the representatives got the message that a particular issue was important enough to warrant their attention). With enough emails, telephone calls, and letters alerting these representatives about the importance of getting this bill, The Breastfeeding Promotion Act, passed, it’s more likely they’ll approve it for vote in the House of Representatives.
Here’s a to-do list to help you focus:
- Find out your representative(s) from the above list (I’ve listed them by state, not by district) and contact him/her (them). Their contact information should be relatively easy to find on their official sites, which I have linked to if you click on their names. The representatives I’ve listed may not be your representative for the zip code in which you live, but that shouldn’t stop you from trying to contact them anyway. Some of these representatives don’t want you contacting them (and discourage you from contacting them) if they’re not representing the specific district you live in. Don’t let this dissuade you if your district isn’t listed. Call those representatives on the phone and let yourself be heard anyway; telephone numbers are almost always listed on representatives’ contact pages. If your state isn’t represented in the above list, contact one of the listed representatives anyway. Just pick one (or two or three) to contact and alert to the importance of this. Remember, it is the people listed above that have the power, right now, to move the Breastfeeding Promotion Act in to the House and get it voted on. It’s never been voted on before; it’s never moved past the committee phase (which it is in right now) since 2003. It never will move forward unless people bring it to these representatives’ attention. One last note: you can still contact your own specific representative and bring this to his/her attention. It will still make a difference, even if your representative is not a member of the House Committee on Education and Labor. Every email, phone call, and letter a member of the House receives that calls attention the importance of getting the Breastfeeding Promotion Act passed into law counts!
- Write an email to the representative you’ve chosen above (or use their online contact form, if applicable, or call them on the telephone) about the importance of getting the Breastfeeding Promotion Act passed and the relevance of it in your personal life. If you don’t know where to start with writing a letter, copy the following sample letter and paste it into the body of your message. Make modifications to it so that it reflects what you want it to say.
- After you send your message to your representative(s), tell everyone you know how they can do the same thing. (Link to this page to make it easy for others to find out more). Too many people don’t know they have the power to help change the law so that it is more supportive for lactating mothers. Often lactivists wonder how they can make a difference. Here’s a golden opportunity!
Sample letter (for email or snail mail):
Dear Rep. [insert full name of your representative]:
I’m writing in regard to a proposed bill, the Breastfeeding Promotion Act, which I think is very important. I am a(n) [breastfeeding mother, pumping mom, working mom who needs to pump, supportive husband of a breastfeeding/lactating mom, employer of a lactating mom, etc.] and I firmly believe that breastfeeding is essential to the health and well-being of babies and toddlers. However, there is no federal law that protects women from being fired for needing to pump while at work, nor offers protection to a breastfeeding mom from being harassed for breastfeeding in public, nor is there any support for employers who wish to help lactating mothers accomplish their breastfeeding goals. The Breastfeeding Promotion act, particularly in light of the lactivism protests you may have seen in the news lately, would be a very timely and appropriate response to these problems. The bill proposes, among other things, tax cuts for employers who provide accommodations for lactating mothers, amending the Pregnancy Discrimination Act of 1978 (which is itself an amendment to the Civil Rights Act of 1964) so that it includes lactating women. The Pregnancy Discrimination Act of 1978 was originally intended to include lactation, but unfortunately, some courts have not recognized the need for pumping or breastfeeding a child to be protected rights. This Breastfeeding Promotion Act would clarify the intent of the Pregnancy Discrimination Act to properly include the state of lactation as well. It would also offer necessary legal protection to mothers from being discriminated against for breastfeeding in public.
I know that the Breastfeeding Promotion Act is in the House Committee on Education and Labor right now, a committee of which you are a member [only write this if this applies to the representative you’re contacting — all of the ones listed in this post are members of the House Committee on Education and Labor], and I implore you to pass the Breastfeeding Promotion Act on to the House of Representatives so that it can be voted on. As a(n) [breastfeeding mother, pumping mom, working mom, supportive husband, employer, etc.], as a resident of [insert your state here] and as a citizen of the United States of America, I thank you in advance for your consideration of this bill.
Edited to add: For more information, please see this page on how to lobby your elected officials.
Edited further: My letter not easy enough? Go to MomsRising.org and fill out their online form, which emails your elected officials directly. So easy anyone can do it… It would only take five minutes out of your day to read, edit the message, and email your representative, but it could make all the difference in the world for lactating moms and their babies. Do it for our future. Please. The moms and babies of the future thank you.
This is what human milk looks like when it’s been allowed to sit in the refrigerator for a few hours:
Notice that it looks layered. The top, opaque layer is cream. The bottom two layers are called milk plasma, or more commonly, skim milk. It is NOT recommended that you skim human milk before feeding it to an infant. You want to make sure your baby drinks the cream. The cream is chock-full of dense and vital nutrients to a developing baby, like cholesterol and fat, both of which are necessary for proper brain development. I would imagine that this is where most of the DHA found naturally in breast milk resides, too.
A lot of people recommend against shaking a container with breast milk in it, citing vague and slightly alarmist claims about “damaging the fragile milk components,” but I tend to think those people haven’t actually had to deal with preparing a bottle for a hungry, impatient baby. Also, I tend to think that while it’s not ideal to “damage the milk components,” shaking is also probably not nearly as “damaging” as it’s made out to be. The usual recommendation instead of shaking is “gentle swirling.”
“Gentle swirling” doesn’t always cut it in the real world. If you have the time, by all means, “swirl” away. But if your baby is hungry now and you’re faced with the dilemma of either giving the baby milk with less fat in it (because you’re afraid of shaking the milk and “gentle swirling” isn’t incorporating the fat stuck to the sides of the container) or shaking the container to get all the fat mixed well into the milk, well… Shake the container. It’s okay. Really. Obviously you don’t want to go overboard, because you don’t want to turn the cream into butter (unlikely, but it can happen… If you shake the container for about two hours), but you should harvest all the cream and get it back into the milk plasma however you can. Make sure your baby gets all the fat he/she needs to thrive. Note: It takes far less than two hours of shaking to accomplish this. More like 15 seconds.
Here’s a non sequitur that’s still about human milk:
What do you do with extra breastmilk that you don’t want to donate to anyone?
Make “momsicles!” This site shows you (with pictures!) how to cleverly make your own homemade teethers with mother’s milk. Awesome idea. I wish I’d thought of it myself. Although, even if I had, I don’t have any extra milk to spare for that… However, I could use yogurt as they suggest. Sounds like fun!
This next part is where I get a little upset. It bothers me more than the cattle-prodding, more than the invasive checks, more than the vomit-pushing, more than the subsequent exhaustion and all the pain combined.
A nurse took our baby from my husband “for observation” in the nursery. My baby was born completely healthy (thank goodness!) and had already been given a preliminary examination which determined she was A-O.K. (Whew!), so there was no medical necessity for the separation.
My husband tried to intervene and asked, “How long will she be gone?” He even tried to take her back from the nurse, but she held the baby away from him and said something to the effect of, “We’ll give her right back. We promise.” The nurse (not the labor nurse, who was awesome) made an obnoxious little giggle at her own joke. I think at this point I may have protested some, but I can’t really remember because of all the drugs and pain, aching desire to slip into a coma, and the general feeling that my husband was taking care of the situation.
Before I knew what was happening, my daughter was whisked away “for observation” for an unspecified amount of time. At the time, everyone attending us made it seem like she’d be gone for, at most, 20-30 minutes… Like she would be taken to the nursery, given a quick once-over, and then handed right back. I think this is another reason why we didn’t fight any harder than we did to keep her from being taken. It didn’t help matters that we were both dead tired. Well, I was dead tired and in quite a bit of pain. My husband, who got to nap intermittently throughout the day and night, got to eat whatever he wanted, whenever, and experienced everything in all its comfortably distant, third-party, painless glory, was also “tired.” I think, though, that his “tired” was the sort of tired you might feel after pulling a semi-all-nighter at an exciting slumber party, whereas my “exhausted, ravenously hungry, and in incomparable pain, not to mention, possibly traumatized” “tired” was more like what you’d feel after… well, after laboring for 24 hours and pushing a baby out your grumpelstiltsken.
I remember saying, though, that from the moment the nurse had her in her arms to take her away, over and over again, “Please bring me my daughter.” I didn’t care if she was covered in vernix and goo. I couldn’t have cared less if they never gave her a bath. All I wanted to do was establish breastfeeding with her after my stitches were done and I could finally get off my back. I remember their vague and ultimately meaningless promise, “We’ll give her right back.” And then she was gone, taken I-don’t-know-where to be with I-don’t-know-who and done I-don’t-know-what to.
This is what ended up happening immediately after my baby was taken away and my perineum was finally stitched up: my OB disappeared, and a big burly man came in the room and put some panties on me. They were disposable fishnet panties. This wasn’t nearly as sexy as you might imagine. He placed a special cold-pack style pad in it to put between my legs to help stop the bleeding (I didn’t even know these existed before, but wow, what a great invention!). Then he gingerly dressed me in a hospital gown and placed my sore, iced ass in a wheelchair. Did I care that this strange man saw me not only naked but at my very worst? Not really. I figured it’s his job, so he probably sees a lot of bloody, loopy, fat, smelly post-partum women with stringy hair. I was just grateful he had a soft touch, despite his brawny appearance. Also: drugs. I still had a bunch of them in my system, what with my liver not working right, and they made things like modesty and social mores go right out the window. He wheeled me out of the birthing suite and into a room on the other side of the floor. What’s strange about this part is that the hospital I birthed in prides itself on having only “all-in-one” birthing suites, so I never imagined I’d be taken to another room after the birth. What’s it like in other hospitals, then? You get moved twice? Three times? More?
The dressing and transport only took about 10-15 minutes, tops. In that time they could have done an examination on my daughter, washed her up, whatever. When I arrived at my room, the big burly man helped me to get (painfully) settled in the hospital bed, and I immediately called up the nurse’s station so they’d bring me my daughter. I think they said they’d be by.
I waited and dozed off a little thinking she’d be wheeled in any minute. I still had a lot of Nubain in my system and I was utterly dead, dead, dead tired. But the anxiety of not having my daughter in the room with us kept jolting me awake. I’d spent her whole life with her living inside me, she’d been with me always, and now, after waiting for so long to finally meet her face-to-face, she was wrenched from my presence and taken to a room down a long corridor far from me when I was at my most vulnerable… It was a hollow, sickening, helpless feeling.
Whenever I’d come-to and I remembered where I was and what the situation was, I’d call the nurse’s station and ask for my daughter. I must have called them at least five times. I sent my husband there a couple of times, though he was reluctant. The hospital staff and hospital vibe made him feel uneasy. I have to admit, it’s a pretty clever operation they have at many modern hospitals, where they intimidate parents into feeling like they don’t have the right to be with their own children, or feed them the way they wish, or even to see them. I won’t use the word “kidnapping” to describe this practice, but it sure comes uncomfortably close.
Even though my hip bones felt like they’d all come painfully unglued and I was bleeding like only the postpartum can, I almost hobbled out of bed to go get her out of the nursery myself. Just as I was about to get out of bed, though, a nurse finally wheeled her in, wrapped up like a burrito and asleep in her bassinet. She was sleeping so soundly I wondered if they’d fed her, which I’d been COMPLETELY INSISTENT they NOT do. I told every single person I came across in that hospital that I was breastfeeding my baby, and was very explicit about NOT giving her anything by mouth: not formula, not water, not even a pacifier. I said this before and after she was born.
To this day, I still don’t know if those wishes were carried out.
It took the nurses over four hours to bring me my daughter. She’s a year old today (Happy Birthday, Baby Bear!), and I have yet to be separated from her for that long again.
My precious, perfect newborn daughter was immediately placed on my chest. My arms could barely hold her up. I was asked to hold my beautiful eight-pound daughter with shaky, spaghetti-weak arms while trying to push out the placenta, still in the lithotomy position.
My perineum had torn. It was reportedly a second-degree tear, so, pretty average, but still. It needed stitches. I still had to deliver the placenta, though. I thought the pain would stop at this point, but it did not. The BIG BAD PAIN had stopped, thankfully, but the postpartum pain would stay for at least a month. And at that moment, my uterus was still cramping up painfully to deliver the placenta. I didn’t know it would be that painful at the time. Nobody ever talks about the pain that happens after the baby is already born. I was thinking since the worst was over (it was) that it would be relatively pain-free from that moment on. (It wasn’t.)
Delivering the placenta was hurty. I know that’s not really a word, but that’s what it felt like. Like that, and like someone is pulling out your insides, because my OB pulled the umbilical cord to help deliver the placenta. If you do this, you have to be really careful not to pull too hard or too fast, but to pull firmly enough to try and detach the placenta. I hear it takes quite a bit of finesse. Thankfully my OB has decades of experience with this sort of thing, and nothing bad happened, except for more pain, which is, I guess, normal. I delivered the placenta intact, while I tried to convince my daughter to latch on to my breasts. She was more interested in learning how to process air with her lungs, which is pretty normal for just having come out of the womb, or so I’ve heard. The whole scenario felt very rushed. I wasn’t allowed to get in a good position to calm her down, so she kept crying inconsolably. Also, my noodle arms felt like they could barely lift their own weight, let alone hers.
Ideally, I would have been allowed to calm her down and then let her feed peacefully at my breast whenever she was ready. But, alas, it was not meant to be.
Someone took my baby and gave her to my husband so the suturing could get finished without distraction. He held her to his bare chest and someone draped a blanket over the both of them so she wouldn’t get cold. He was tickled pink with his brand-new baby girl! I was thrilled for us too, but at the moment all my body and mind wanted was to sleep for about two hundred years. I honestly would have been fine staying up longer, though, and had already made a mental note to myself that I’d stay up for as long as I needed to in order to bond with the baby and get breastfeeding started right.
At that point, I honestly believed that what would happen next was that as soon as the suturing was done, my husband would give the baby back to me and I’d hold her and initiate breastfeeding.
That’s not what happened, though.
Hours passed. They felt like days.
The nurse checked me. I had arrived: 9 cm. I remember feeling ecstatic about this, even through all the pain. I could see the light at the end of the tunnel. I felt like pushing, though I was told I still had a bit of a “lip” and that I shouldn’t push. The urge was pretty powerful, though, so I did a tiny bit of pushing.
I made a wonderful discovery. Pushing, though scary at first, feels good. Well, good in the way vomiting feels good when you’ve got food poisoning.
I did some more scary vomit-pushes. I tried it in different positions: squat, all-fours, side. Nothing happened; no further progress was made and I was wearing myself out. Finally my OB asked me to get in the classic lithotomy position because as she explained it, it opens up the pelvis more. I had zero energy to discuss this with her, the contradictory information from all the childbirth books I’d read over the years notwithstanding. However, she’d attended over a thousand deliveries in her OB/GYN career, so I figured she had some experience in the matter. Plus, she told me once about how she labored naturally and delivered two babies of her own. Upon remembering that, I took her advice with complete confidence.
Lithotomy position it was. Let me pause for a moment to describe what being in the lithotomy position feels like when you’re nine months pregnant and have been laboring for about 24 hours on no sleep. Strap a fifty-pound boulder to your midsection. Make sure it’s strapped very tightly so that all your organs are uncomfortably compressed. Do the treadmill/cattle prod thing for 24 hours straight. No breaks allowed, not even when you’re having an ungodly internal check or while a tiny vein in your hand is being poked for an IV. After 24 hours of strict treadmill-cattle-prodding torture, invasive internal checking, and needle-poking, you then need to lie down flat on your back with the boulder still tightly strapped to your belly, lift your knees, and wait for more electric shocks so that you may vomit-push your boulder out your vagina. Also, you’re naked and there are at least five people in the room focused entirely on your bloody, possibly poopy crotchal region.
My husband held my right leg and my dear friend Ann held my left. I waited for the next electrocution, I mean, contraction, and I pushed. It felt great and scary, like a good vomit should. Like all cathartic vomits, though, they happen in clusters. So one good push wasn’t enough. I needed to experience a few more to be done with this. I was ready. But my body wasn’t. My contractions put up a little “Be back soon!” sign on my uterus while I lay there, fuming and pushing impotently. I decided to stop pushing and reserve my energy until the next contraction. That’s what they’re there for, after all.
I remember the OB and the labor nurse (who were both awesome, especially the nurse) said, “Oh wow, she’s a good pusher!” and I clung to that like a shipwreck survivor to soggy driftwood. I also remember Ann and my husband, well, actually, everybody, saying, “Oh, I see the head! I see the head!” That alone gave me more strength than the pitocin. Thank goodness they didn’t say instead, “She’s pooping! She’s pooping!” Because I would have grabbed my feces and flung it at the lot of them.
The next contraction came, and I rode that wave for all it was worth. One more solid push and she was out! Whew! What a relief! Good thing, too, ‘cause I’m not sure I could have done that for much longer.
From the moment the Cytotec had been inserted into my cervix to the moment I pushed my daughter out of the birth canal, 24 hours had elapsed.
It was 6:30 am, I was 6 cm dilated, and my OB just broke my waters. I’d been in active labor for over twelve hours. Oh goody, I thought (as I lay there in agony), we’ll finally get this show on the road and I’ll get to meet my daughter. Yay!
(Long before she broke my waters, when I was in the relatively blissful state of 3 cm dilated, Dr. OB came into my room to tell me she’d run some tests and discovered that I had HELLP. Because of this, I couldn’t have an epidural or I stood a good chance of being paralyzed for life. At the time I actually said, out loud, “That’s okay ‘cause I didn’t want an epidural anyway.” I may have even smiled smugly through my puny 3 cm contractions. She gave me a knowing look and exited quickly.)
By the time I got to six centimeters dilated, I was tearfully begging for an epidural. I thought irrationally (the pain will make you do that) that maybe the nurses didn’t know about my condition and that the anesthesiologist could just run up and give me an epidural anyway, while my OB wasn’t looking. I figured we could all keep it hidden from her when she came back. If she noticed the plastic tubing sticking out from my back, I could just say, “Oh, that? That’s not a legal liability staring at you, Dr. OB. That’s just my, uh, plastic tail. You never noticed I had a tail?”
Unfortunately, I think she may have foreseen this scenario, so all my nurses were very much up-to-date on what I was and was not allowed to have. No amount of begging resulted in anyone giving me any kind of epidural.
They did give me a little intravenous Nubain, though. Nubain, for the uninitiated, is an analgesic similar to morphine. While normally I balk at the idea of someone jabbing my vein with a needle and keeping the needle in there, I totally did not mind it in this case. So, a vein in my hand was eventually located and the IV was inserted. It stung, but I’ve had much worse IVs before.
I thought this would take the pain away. I really did. It didn’t. What it did was keep the pain just as intense as before, but made me even more tired. It would have been very difficult to stay awake at all if not for all the Cytotec-induced
cattle prodding contractions and the pain that came with it.
I labored on until 1 pm. They checked me again (AHHHHHH!) and I was still at 6 cm. I’d labored for seven more hours and hadn’t progressed one iota. If I hadn’t been so busy at the time, my fury alone may have resulted in somebody’s untimely demise. Probably my own.
At this point, I was begging for not only an epidural, but a spinal, a cesarean, euthanasia, anything to put an end to the agony.
So then the game plan changed. No, I couldn’t have any of those other things, but I could have pitocin. What is pitocin, you say? It’s a “labor enhancer” or synthetic oxytocin. It makes the contractions increase in intensity, if that was even possible at that point. With the little energy I had, I expressed my adamant opposition. “No! Nonononononononono!” I told them. I told them good.
When I was finished with my tantrum, I was hooked up to a pitocin drip. To the OB’s credit, she upped my Nubain, as a consolation prize.
I became very loopy, drugged and quieter but still in complete agony. The electric cattle prodding continued to intensify, and I sobbed and moaned pitifully as I lay on my side in the hospital bed. Though I’d torn off the hospital gown hours before, I was boiling hot, even as others in the room wore sweaters and wrapped hospital-issue blankets around their shoulders in the air-conditioned birthing suite. My body barely moved, yet I was doing the most arduous physical work I’d ever done in my life.
This is why they call it labor, I thought.
I was forty weeks pregnant, and I felt like something was wrong. Not necessarily wrong with the baby, but my body didn’t feel right. My normally petite, dainty feet looked like they belonged to the Michelin Man’s wife, my normally low blood pressure (90/60) was 145/104, and I had an excruciating, sharp pain on my right side which I later found out was my liver dying. Also, all the air felt like it was being squeezed out of my lungs, so I was having trouble breathing. I hadn’t slept well in weeks because of heartburn which would wake me up every night at random intervals, choking me on my own searing bile and gasping for breath. I tried using an incline pillow, but I’d still wake up sputtering with burned, acid-washed lungs and no sleep. So, for the last month or two of my pregnancy, I “slept” sitting up in a recliner. I’m sure that did wonders for my circulation.
Needless to say, I wanted to give birth right away, so I asked to be induced. It turned out later that I’d made the right call because, unbeknownst to anyone, I had developed HELLP syndrome, a serious and sometimes fatal condition (to both mother and child) which is only curable by giving birth. We didn’t find out about the HELLP until later, though. It pays to trust your instincts.
So my hospital birth adventure began.
At 5:30 pm or so, my OB inserted a quarter tablet of Cytotec into my cervix to help it ripen, because apparently it wasn’t ripening on its own quickly enough, though I was 1 cm dilated already. Cytotec also helps initiate contractions. I felt some mild contractions after a while, but it wasn’t anything I couldn’t handle.
After about three hours of this, I had dilated to 3 cm. I thought this was great because it hadn’t been that long, and if it kept up being this relatively pain-free with such progress, well, the baby would be out in no time.
It actually was a little more work than that.
By 6:30 am the following morning, I’d only progressed to 6 cm and I was in considerable pain. I still had all the discomforts I had before, but now I was also in full-blown labor.
For those of you who have not experienced full-blown labor, allow me to illustrate it for you with an analogy: You’re running on a treadmill. The treadmill is set to a speed that is faster than you are comfortable running. You weigh 30-50 pounds more than usual, so this running thing is even harder on you than it would normally be. You haven’t had a full-night’s rest in weeks, so you’re already very tired, and you have no choice about the speed of the treadmill. While you’re running and thinking you’re going to pass out or die from exhaustion alone, someone electrocutes you in the stomach at fairly regular intervals with an electric cattle prod. The more you get cattle-prodded, the stronger the electric shock gets. You don’t have time to recover from one electric shock before another one is administered to you.
(You do have a choice about whether or not to be on the treadmill at all. Here’s your alternative if you choose not to do the treadmill: You will be stabbed in the spine with a large scary needle that paralyzes you from the waist down, hopefully not permanently. Your belly will be sliced open in order to remove your baby from your body. This surgery will require you to be separated from your sweet baby — the same sweet baby you’ve been dying to meet for nine months as he/she gestated inside you — for several hours starting immediately after he/she is born. After your baby is out and you’re stitched (or stapled) up, you’ll have to endure painful recovery from major abdominal surgery for weeks, perhaps months, possibly incapacitating you as you re-learn how to move the lower half of your body and assimilate the delicate art of keeping your precious newborn alive.
Knowing all this, you choose the treadmill and fervently hope it all works out without ever having to go the alternate route.)
I’ve read a lot of birth stories, and before going through the experience myself, I always wondered what labor and delivery would feel like. Most stories say that labor hurts or feels like “really bad menstrual cramps.” Some describe it as an “all-consuming pain.” I told myself that if/when I’d experience it, that I’d try to put it into words as it was happening in a way that anyone, female or male, would understand. The treadmill/electrocution analogy does this fairly well. It also describes pretty much exactly what it felt like for me.
To continue with the story:
There was some indignant yelling. And moaning. And some throwing of various things, like pillows and blankets and one sweaty hospital gown. And some grabbing and impotent shaking of bedside rails. Also, some cussing, which I will not repeat here.
To try to speed things along, my OB decided to break my waters. I think she used a needle, but I’ve heard it’s more like a crochet hook. I didn’t really get a good look at what instrument she used — I had other concerns at the time — but I can tell you it was very small and thin, like a sewing needle. She broke my waters after I’d gotten checked at 6:30 am and was determined to only be at 6 centimeters.
Incidentally, “getting checked” to see how dilated you are is no walk in the park. It’s not like someone shines a flashlight up your hooch, takes a quick gander and goes, “Yup, 6 centimeters dilated.” For some reason, that’s what I used to think it was like.
It’s not. In fact, to check you, OBs and nurses don’t use their eyes at all. They use their fingers and they estimate how dilated the cervix is based on their sense of touch.
Or in my case, they use their entire arm. At least, that’s what I could discern from what it felt like and from what I could see of the (small) amount of arm that was still outside my body whenever I’d get checked. Also, I should note that “getting checked” involved a fair amount of time commitment, as well as pain and discomfort. Using one’s sense of touch isn’t nearly as fast as, say, looking at something. So each time I got checked it took maybe 2-3 minutes, which at the time felt more like 20-30. (Time perception gets pretty distorted when you’re being electrocuted in the stomach while running on a treadmill.)
Here’s a video to teach you how to fold an International Breastfeeding Symbol T-shirt pretty professionally in under ten seconds. Get your own International Breastfeeding Symbol tee in the store. You can also find onesies, bumper stickers, patches, and toddler T-shirts. Donations for this month go to La Leche League.
Video contains no audio, so please don’t turn your volume up all the way.
Inspired by this video (contains audio in Japanese):
Sorry it’s incomplete; it’s the longest version I could find on YouTube.