Hypnosis

Kelly and I went to the first class in the hypnobirthing series last night. Our instructor seems pretty flaky, and also pretty on-board with what appears to be a for-profit venture to market hypnotherapy techniques. You know, “HypnoBirthing(R) – The Mongan Method.” But despite the HypnoBirthing(R) Institute’s moneymaking aspect – certifying legions of official HypnoBirthing(R) labor companions, doulas, childbirth education trainers, and fertility therapists to spread the gospel of the HypnoBirthing(R) system – it does seem to be grounded in actual science.

I didn’t know much about hypnosis before reading Hypnosis for a Joyful Pregnancy and Pain-Free Labor and Delivery, but it seemed pretty bunk-like to me.  My previous exposure comes from the middle school party games I used to play at sleepovers, like “light as a feather stiff as a board” and “bloody Mary.”  A memorable experience was at Rachel’s birthday party one year.  We took turns relaxing on a couch and being led into a trance state by a friend slowly counting backwards from 100, pausing every few numbers to suggest deeper relaxation.  I was self-conscious so it didn’t work on me, but Rachel was very able to get into a trance, and we ended up asking her where she was and what she saw (a castle with a red flag).  Then, when she woke up, she didn’t remember what she had seen – she was embarrassed that it had worked.  But the game I played most often was one you could do on a playground.  You stood behind someone and chanted while they closed their eyes and relaxed.

Part of the chant went like this:

Concentrate, concentrate on what I’m saying.  People are dying, babies are crying.  Concentrate, concentrate on what I’m saying.  Crack an egg on your head, let the yolk run down, the yolk run down, the yolk run down.  Crack an egg on your head, let the yolk run down, the yolk run down, the yolk run down.  Stab a knife in your back and let the blood drip down, the blood drip down, the blood drip down.  Stab a knife in your back and let the blood drip down, the blood drip down, the blood drip down.  Spiders crawling up your back, spiders crawling down your back.  Spiders crawling up your back, spiders crawling down your back.  A pinch, a squeeze, cool breeze.

The point of that one was to give someone the chills and creep them out.  For each part of the chant, there is a corresponding action with light touch, and with the final words you blow on the back of their neck.

There was another one where you would stand behind someone and lead them through a guided meditation up the stairs of a skyscraper until they stood completely relaxed on the roof.  Then you would have them look over the edge and you would give them a sharp shove in the back to throw them off their balance and jerk them out of their trance.  When they turned to look at you, you would ask them what color they saw as they fell.   I usually saw red or green.

The point of all this is, I spent a considerable amount of time as a tween conditioning myself not to relax during hypnosis!  As we all know from watching movies, as soon as you are completely relaxed, something horrible and ominous happens.  For instance, if you take a relaxing, long, hot shower, you might end up either stabbed (Psycho) or with your girlfriend torn apart by semi-trucks (The Hitcher).  If you enter a trance and symbolically re-live a calming memory, you might find yourself cutting into a birthday cake filled with blood (Alias).

In the hypnobirthing class yesterday, the teacher led the class through a script that involved standing in a familiar kitchen, visualizing a lemon, picking up a big kitchen knife, cutting the lemon in half, and taking a bite.  The point of the script was to illustrate the mind-body connection, because if you really spend time imagining eating a lemon, you begin to salivate and possibly even feel that sharp twang in each side of your jaw you get from eating very acidic foods.  But to begin in a comforting, familiar place and then pick up a giant kitchen knife!  I just felt like that was tapping right into the horror movie archetype.

Anyway, more than the class itself, it was the book I linked to above that introduced me to the idea that hypnosis is a legitimate method used to relieve pain in many different medical and clinical settings.  It involves a trance-like state (called both focused concentration and deep relaxation) characterized by a high degree of suggestibility.  Hypnosis can be used to introduce suggestions to a willing participant, and is effective enough that it can reduce or eliminate the need for anesthesia in surgery.  In childbirth, the purpose of hypnosis is twofold.  First, a first-time mother is often tense and afraid, and her tension and fear can prevent the labor from progressing until she is physically exhausted and needs intervention.  Hypnotic suggestions to induce feelings of relaxation and well-being can speed the progress of labor while making it a more pleasurable experience.  Second, a state of hypnosis can allow you to reduce your brain’s reaction to pain stimulus using a technique called glove anesthesia, which allows you to temporarily transfer a feeling of numbness to any part of your body.  Using hypnosis takes practice, and it has some pitfalls.  If you work with a professional hypnotherapist, you can often re-create the trace state later, once you know what it’s like.  As an individual working with books, tapes, and a HypnoBirthing(R) trainer, it will probably be more difficult.  Also, you can screw yourself up if you, for instance, forget to turn off the numbness to a part of your body, or if you are in a suggestible state and people tell you to do things without realizing your greater vulnerability.

Overall, I think that with relaxation, meditation, and hypnosis, as well as facing my fears about giving birth and being a parent, and with the bellydancing movements, and doing art and reading a lot, and having a tub to relax in during labor, if everything goes well I will end up with a drug-free, intervention-free childbirth.  Yay.

Finally, pictures!

Click on the pictures to see bigger versions.  You can now see my belly (22 weeks in the photos above), even though there’s not much to see.  Several people have mentioned that if you didn’t know I was pregnant, you would just think I had put on a few pounds.  Haha!

Kelly and I go the first class in the Hypnobirthing series tonight.  Exciting!

Anemia!

Self-diagnosed anemia, that is.  Let me back up a little bit.

Monday I got my standard 18-week ultrasound, which takes about an hour and in which the technician looks for anatomical abnormalities.  Once again, my baby was lying with its feet towards the ultrasound wand and its head towards my spine, making it impossible for the technician to look at the heart and brain, two crucial things this ultrasound is supposed to accomplish.  I have another appointment in 2 weeks, and hopefully by then my baby will have grown too large to hang out in that position.  I guess I could just blow the whole thing off – I mean, at this point I have had 2 1/2 hours total of ultrasonic waves directed right at my fetus over the course of 4 appointments – is it like standing in front of a microwave?  It doesn’t seem like it could possibly be a good thing, and I am not sure how necessary it is since even the technician said that the huge increase in routine ultrasounds in the last 10 or 20 years has not had much effect on outcomes.  But…I like it.  I like to see the baby feet and ‘wittle toesies’.  It makes me feel closer to the baby inside me.  If for no other reason than that, I will go back again for another hour of someone banging on my bladder with a lubricant-covered plastic wand.

Wednesday I saw Tiffany.  Kelly was with me for both appointments, which was nice.  We got the blood test results, and everything came out okay – no higher risk for folic-acid related abnormalities.  We also got to feel the bulge where the uterus is – it’s about at my belly button right now.  I gained another pound this month, right on target.  And I was pleased to report that I have been feeling some movement down there – both the “fluttering” sensation the books talk about, as well as some round ligament pain that feels like quick jabs or pinches.   All in all, my baby looks healthy and well.

I got a prescription for Flagyl, aka Metronidazole tablets, to treat my bacterial vaginosis, which I have some trepidation about.  The last time I took metronidazole tablets was last August, and it made me feel weak, out of sorts, and also completely took away my appetite…one of the possible side effects is anorexia, and I lost about 5-10 pounds in the week or so I took the medicine, which is the main reason I was at the low end of my weight when I got pregnant in November.  It doesn’t seem that there is any other way to treat b.v. than with this incredibly strong drug, which has a laundry list of side effects.  I wish there was some sort of alternative treatment I could try first.  Any leads, anyone?

Yesterday, I felt fine when I woke up, but at work in the morning I started to feel nauseous and got a sinus headache.  I ate something and the nausea went away, but then around noon I began to feel extremely light-headed.  I was just sitting at my desk when my eyesight went completely red and the insides of my ears went rushing and cold, like a sudden drop in blood pressure.  It sometimes happens when I stand up, but this time I was just sitting there!  I knew that I was about to throw up, so I went to the bathroom and tossed the soup and bread I had had as a snack.  I was afraid of fainting on the stairs on the way to the bathroom!  I sat on the bathroom floor for a while with my head between my knees.  After I went back to my office, I went home for the rest of the day and mostly rested on the couch or in bed.  This morning my headache is still there, as is the faintness and weakness.  I feel crummy.  I came into work, but I’m not getting much done (evidence this post).

I think this is happening because at around 20 weeks ( I am at 19 weeks and 4 days today), your blood volume shoots up.  This can cause anemia if you don’t have enough iron to create new red blood cells.  At the last appointment I had a month ago, Tiffany told me that I had started my pregnancy with low iron numbers – not anemic, but the possibility of developing anemia if I didn’t eat enough iron.  Anemia can cause low blood pressure, faintness, and headache.  I am going to start supplementing with iron, washed down with orange juice, and hopefully that will help.

One of the books I have (“What To Expect”) says that it is almost impossible to eat enough iron during pregnancy.  That seems insane to me – what did women do before supplementation, then?  Kelly and I call “What To Expect” the “Will it hurt my baby?” book because the whole book is organized around fearful questions followed by the phrase “Will it hurt my baby?”  Fortunately, you’ll be glad to know that anemia, in general, will not hurt the baby – it is very rare for babies to be born iron-deficient, and it seems that this is one of the cases where the baby manages to satisfy its nutritional needs before the mother.

I’m showing now, enough that I can’t wear any of my work pants, but not enough that the casual observer could possibly tell.  I seriously need work pants with a stretchy waistband!

Tummy ache

Well, I was going to write earlier this week, but during my opportunity WordPress wasn’t working for some reason – the server would just time out when I tried to go to the site. Bummer.

I saw my midwife Tiffany last Wednesday, and she is really really awesome. I look forward to working with her. During our conversation, I found out something interesting – Massachusetts is not a very midwife-friendly state. If you are a Certified Nurse-Midwife, you can’t keep your license and attend home births, so midwives who attend home births have a different credential – they are mostly Certified Professional Midwives.

Last Thursday or Friday, I got that twinge that signals an oncoming urinary tract infection, so Kelly and I ran out to Whole Foods and got a ton of unsweetened cranberry juice. I cleared the infection and am now symptom-free! Yay.

New things I have cooked in the last week: bean and veggie crumble, “hamburger helper” vegan style, raspberry muffins. Plans for upcoming cooking: sugar cookies with frosting, Pennsylvania German apple dumplings, spicy curry lentil-potato casserole. Also, a ton of kale, which it turns out is very easy to cook.

Kelly and I have been very romantic lately, doing lots of “hanky panky” of various sorts, as Zach would say. And I have finally been getting hungry and not been nauseous. This is what I imagined pregnancy would be like: having energy, bring horny, and being hungry. It’s great!

I went to a Country Western Line Dance class on Tuesday night, but I was disappointed that the class was very casual, and they didn’t dance the whole time. As soon as I would begin to get my heart rate up, the song would be over and everyone would sit down to chat for 10 minutes. Ugh! Got to find another way to exercise. I am going to take another dance class this weekend through the MIT ballroom dance club. I am also going to go to the Tufts gym next Tuesday and do some running on the elliptical. Got to buy some tennis shoes!

I sure am tired. I have not been sleepy at my normal bedtime, and then I wake up early, making it so I am overall getting about an hour less of sleep a night (and Kelly, too!). I guess this is to prepare us for life with baby, but being tired makes me feel spaced out and distracted.

Oh, and I had a tummy ache last night that I woke up with this morning, hence the post title, but it is gone now.

Good news, everyone

I haven’t written this week because looking at my computer screen increases my nausea. However, I do have good news to report: I switched midwives at the birth center, and I really like the new midwife I am working with, named Tiffany. In addition to the Cambridge Birth Center, she also sees patients at a location that is much closer to work/home (the Somerville hospital), so I can reduce the amount of time I am out the office. My next appointment with her is February 13.

I also saw a different midwife, Lorrie, for an urgent appointment on Wednesday about my yeast/bv. Lorrie recommended I take Terazol for the yeast. There was a whole deal where the terconazole cream contains propylene glycol as an inactive ingredient, which I am super sensitive to (it stings like a bitch). Eventually, with the help of two different pharmacists at compounding pharmacies who went way out of their way to help me find a solution, I figured out that Terazol also comes in a suppository form suspended in a vegetable oil base without any of the petroleum-based additives present in many vaginal creams. I got the prescription today, so I am set on that front, too.

At my urgent appointment with Lorrie, I also got to hear the heartbeat of my fetus. Yay! It sounds really fast, kind of like a beat machine. A great moment, but I wish Kelly could have been there.

I have one more upcoming appointment (the morning of January 28th), for the “ultrascreen” prenatal testing. This is a combination ultrasound and blood test that screens for the probability of chromosomal abnormalities and neural tube defects. Because I was not taking an adequate source of folic acid during the first few weeks of my pregnancy before I realized I was pregnant, Kelly and I decided that we would go ahead and get the screening. What I think is that the testing will confirm we have little to worry about, but it would be nice to know early if, for instance, our fetus had anencephaly. Kelly and I have talked about “what would we do if…” and for me, it would be much, much harder to terminate the pregnancy past the point of quickening even if it turned out that it like had no brain or something. I’m already pretty deeply attached to the pregnancy.

I thought that the point of “quickening,” or when the mother can first feel movement from the fetus, was significant in Judaism, but the internet seems unable to enlighten me on this point. Can anyone else find info on this or knows what I am talking about?

I appreciate all the comments I’ve been getting lately, everything from support to eating tips to the medical perspective (thanks, Stace). As Laura suggested, I have been eating a lot of calorie-dense foods like olives and avocados, which unfortunately is expensive in the winter. Thank goodness for the global agricultural economy, right? (No, wait…)  Anyway, your comments mean a lot to me.  Thanks for reading.

The weather is beautiful today, but there is a severe cold warning in effect for the weekend. Bummer.  I think tonight Kelly and I are going to go to Grasshopper Restaurant again, and then to services at Temple Sinai.

Nutrition and acupressure

First, thank God for my girlfriend A. She came over last night and gave me some anti-nausea acupressure wrist bands, and they are really really helping. A lot. I am still nauseous, but only a little bit as opposed to omfg I wanna die. Also, it was just nice of her to come over, since she had to walk.

I am calling all my peeps by a single letter on my blog because I want to preserve their and my anonymity, but on the other hand who cares? I can’t decide on this issue. Input, loyal readers?

I didn’t blog yesterday about my visit with the nutritionist, so I will do it today. First of all, I brought with me the book Becoming Vegan by Davis and Melina, and the nutritionist said that it was a great book and she used it to help me figure out what I should be eating. When I described my typical diet, she said that I am a healthy vegetarian – I guess she sees a lot of people who just eat junk food. She emphasized the following for my diet:

1. I need to be getting 3-4 servings of protein a day, with a single serving being 14 g of protein. She suggested that I eat at least one serving at each meal. For instance, for breakfast I could have a smoothie with protein powder, or some soy yogurt and toast with peanut butter. For lunch I could have some veggie meat, and for dinner I could have beans or legumes.

   Since becoming vegan, I always read the ingredient labels on my food, but I don’t usually read the nutrition facts. This suggestion has focused me on reading the protein content and serving size of my food, and I have found some surprising things. First of all, most dairy substitutes in my kitchen (soy cheese, tofu cream cheese, silken tofu, and soy ice cream) do not have comparable levels of protein as what they are substituting for. You have to eat a lot more tofu than cheddar cheese to get the same amount of protein. Even more disappointing is that the soy cheese (Follow Your Heart brand), tofu cream cheese (Tofutti brand), and soy ice cream (So Delicious brand) have effectively no protein content at all – they are not protein-rich foods. In other words, while these substitutes may fill a hole in my diet in terms of flavor, they do not actually serve as substitutes in terms of nutritional content. Bummer! Soy meat substitutes can have similar drawbacks: for instance, one vegan Flame-Grilled Gardenburger patty has 11 g of protein, but one ground beef patty of comparable size has almost twice as much protein. This doesn’t mean that I can’t get enough protein from a vegan diet, but it does mean that I can’t assume that taste substitutes are also nutritional substitutes. I need to be a lot more careful so I can make sure I get at least 14 g of protein 3 times a day.

2. I need to get enough calcium every day, and it needs to be paired with Vitamin D in order to be absorbed. The nutritionist suggested I eat foods fortified with Vitamins A, D, and calcium, and that I take a calcium supplement that contains Vitamin D. I have been taking Tums, but apparently that is not a good source of calcium because it contains no Vitamin D. She suggested that I eat calcium-rich dark green vegetables, and gave me a list.
3. I should be eating a higher-than-normal calorie diet, which because of the nausea means I need to eat a number of small meals throughout the day. I have always been a little confused by serving sizes – if I am supposed to eat 3 or more servings of fruit a day, how much fruit is that? The nutritionist gave me a list of serving sizes that I can stick on the fridge, and I am hoping to start a food diary so I can see what I am getting and what I am not (Becoming Vegan has a really good example of this). She also gave me a couple of tips about how to figure serving sizes. If I generally use the same bowls at home, I can measure out a serving of fruit or beans or whatever using measuring cups, and then put it in the bowl. After a couple of times, I should be able to know how full the bowl has to be to contain one or two servings of food. Like any system, once I get used to thinking about portions of food in terms of servings, I should be able to calculate how many servings of different food groups I have eaten at a particular meal.
4. The nutritionist also suggested I add more oils such as canola oil, corn oil, and peanut oil to my diet, and said that olive oil alone does not supply what I need in order to maintain digestive health. She suggested I eat avocados, nuts, and other oil-rich foods.
5. We talked about iron and she said that with my prenatal vitamin I should be getting enough iron for the first two trimesters, and might want to consider a supplement in the third trimester.

Anyway, the wrist bands don’t work completely, but a can of ginger ale and a couple of handfuls of oyster crackers later, and somehow I managed not to hurl.

Appointments

Tonight K and I are going to the information session at Cambridge Birth Center. Tomorrow I have an appointment with the chief nutritionist at Harvard Vanguard Medical Associates in Somerville, my primary care practice.

Finally tossed my cookies

…or rather, breakfast cereal.

Blech. I just barfed in the bathroom at work. I shouldn’t have had such a big breakfast. Now my mouth tastes like barf and I don’t have any gum. That was the first time I barfed, which is good…on the other hand, I was kind of hoping that my nausea would lessen, not worsen.

I had an appointment with a midwife at Cambridge Birth Center on Friday. It was my first real intake appointment, and I was disappointed by it. First of all, they run a lot of tests at the first intake: they took 6 tubes of blood, I peed in a sterile cup, and I had to get a Pap smear and multiple vaginal STD swabs, as well as a complete physical exam (heart, lungs, reflexes, breast, and manual vaginal exam). The Pap smear was incredibly painful. I think it was one of the most painful Pap smears I have ever had. The midwife did not use lubricant, and when I asked her about it she told me that you can’t use lubricant when doing a Pap smear. LIES! Recent studies show that lubricant does not adversely affect pap smear results. I have a chronic vulvar pain issue, possibly exacerbated by increased sensitivity because of increased blood volume during pregnancy. I could not believe how much it hurt to have the speculum forced inside. You would think that if they knew you were going to have to have an unlubricated thing inside you, they could warn you so you could do some kegels or something to get yourself a bit more aroused and relaxed and wet. Or they could let you do it yourself – can you imagine someone else putting an extra-large tampon inside of you? How much more painful would that be than doing it yourself. I thought a midwife would have gentle hands, but this one definitely didn’t.

(A friendly coworker across the hall gave me some gum. Score!)

The second reason I was disappointed is that I thought that the first appointment would include time for the midwife and I to talk about our goals for the pregnancy, to get to know each other, and to talk about the model of care used at the birth center. How can I meet other moms-to-be? Are there opportunities to hear birth stories from women who gave birth at the birth center? I asked a number of questions, but the midwife said that usually it is the second appointment at which the patient asks questions. Well, sorry I am doing things out of order!

Finally, I am disappointed by the statistics offered by the two birth centers I am considering. For instance, Cambridge Health Alliance has a primary (first-time pregnancy) cesarean section rate of 16% and Mt. Auburn has a primary c-section rate of 14%. Neither of these seem particularly good. The Coalition for Improving Maternity Services’ Mother-Friendly Childbirth Initiative says that a mother-friendly hospital, birth center, or home birth service has a total cesarean rate of 10% or less in community hospitals, and 15% or less in tertiary care (high-risk) hospitals. This means that Mt. Auburn is within the threshold, barely. I was also disappointed to learn that at Cambridge Birth Center, fully 20% of women who begin their labor at the birth center are transferred to the hospital. This becomes more disturbing when you realize that few women are even allowed the opportunity to use the birth center: you must have a completely “normal” birth with no complications and desire to give birth without pain medication or medical intervention. Once women are transferred to the hospital, they no longer have contact with the midwife they have been laboring with. Instead, there is a single hospital midwife who was described to me by the midwife I saw as “extremely busy” and who apparently tends to all of the women giving birth in the hospital at one time. To be considered mother-friendly, a hospital, birth center, or home birth service would have clearly defined policies and procedures for communicating with the original caregiver when transfer from one birth site to another is necessary.

Oh man, am I going to barf again? (Stomach of iron, stomach of iron)

I am in the process of getting a referral to a nutritionist, and hopefully I can make an appointment today for sometime in the next week. I have to figure out ways to get more protein – maybe I should get some of that soy protein powder so I can put it in the fruit smoothies I make. I was so happy this weekend because it looked like I was getting my appetite back. Now I don’t even want to see any food.

On the K front, everything is going well. We had a really good talk yesterday about our fears and expectations, and while we’re both still like, “aaaaaaaaaah!” about our financial future, we’re also looking forward to increasing the love and joy in our lives with a child. Also, we had sex for the first time while pregnant (well, while KNOWING I was pregnant), and it was pretty good. There was no bleeding afterwards, which I guess can happen (but isn’t a problem), I wasn’t freaked out about the cervix-bumping, and there was no pain even after that horrible exam the day before.

Car accident

Yesterday I went to get an ultrasound to more exactly determine the age of the pregnancy. I am 7 1/2 weeks pregnant, with estimated conception date November 11, and a due date August 5. My husband K and I got to see our embryo’s heart beat, which was very exciting.

On the way home, we got in a car accident. Now my neck is stiff and my lower left back hurts. My left hand and right knee are also sore. Fortunately, there doesn’t seem to be any major, lasting damage. The accident was not my fault. There was an oncoming car that I thought was going to hit me head-on, so I moved my car to the right, but lost traction in the snow and slid against a parked car (not really doing damage to it – we tracked down the owner and he wiped the scratches right off his car). The car that had been tailgaiting me hit me a moment later, breaking my rear bumper and bending a metal panel on the car.

I fucking hate Massachusetts. After the accident, we got lost twice (twice!) trying to get back to work.