Wow, 36 Weeks

Okay, I have finally made it to 36 weeks.  Just two more weeks until I am considered full-term!  And probably four or five weeks until I give birth.  It seems so close now.  Oh wait, that’s because it is close.

I have noticed that I am a lot moodier, which is probably due to a combination of factors:

1.) Not enough sleep.  Last night I was up until 11:30 with heartburn, but then I slept well until 7:15.  I only got up once to pee and fell right back asleep.  Also, tiring extra quickly.

2.) I think that the acyclovir makes me feel a bit out of sorts.  If I take it on an empty stomach I get a little nauseous.

3.) End of pregnancy hormones.  I have been extra weepy lately, and a little out of it – sort of disoriented, often having a feeling like I’ve forgotten something, not reacting sharply to situations that take actual thought.  It’s like the pregnancy brain fog I’ve been having has suddenly stepped up a bit.  On Saturday morning I spent like an hour weeping into the pillow for no reason.  Yay!

Kelly and I got a lot done, baby-wise, this weekend.  On Thursday after work we went to Diaper Lab and bought 10 newborn cloth diapers, some diaper covers (2 Thirsties X-Sm and 2 Happy Heinies X-Sm pocket diapers), 2 snappis, a roll of diaper liners, 12 flannel and 3 hemp cloth wipes, 2 pail liners, and 2 wet bags.  We wanted more newborn cloth diapers, but she was out of Green Mountain brand, and the alternate brand (All Together) hasn’t come in yet.   All Together doesn’t seem as soft and I wish we could have all Green Mountain brand, but on the other hand I have very little desire to spend an entire day in the laundromat washing and drying a load of diapers 8 times.  We also special ordered some Dappi diaper covers and Happy Heiny changing pads.

Yesterday we moved the other floor-to-ceiling shelves into the hallway and cleared out the corner for the baby.  He hauled the chair next to his side of the bed into the living room so I could take pictures of it and post the pair on craigslist.  We also moved the incredibly crappy chest of drawers out of the front room closet and into our bedroom for baby stuff.  I wiped all the drawers out, but I am going to try covering the bottoms with contact paper tonight.  We got this chest of drawers for free, and it was worth exactly what we paid.  It will be useful for the few weeks we are in Somerville with a baby, though.

Kelly also did some loads of baby laundry with a baby-friendly laundry soap, Ecos Free & Clear Liquid Laundry Detergent, purchased at our local Whole Foods.  Unlike All Free & Clear, which we currently use for laundry, Ecos has no additives or residues (such as optical brighteners).  Ecos is recommended for washing diapers.  We got the pleasure of going over all the cute outfits we received at our various showers and from Glenda and Alex.  Yay baby mittens!

The next step after getting all the baby clothes into the drawers will be cleaning the pile of clothes and junk off my chair and getting it out of the room and then setting up the bassinet (no, we haven’t done that yet).  We also really need to get the bags of books to sell and the bags of clothes to give away out of the house – they take up a LOT of space in the hallway.  The money the books generate will be poured back into baby and moving costs.  Some of the t-shirts we had planned to give away I rescued so I can cut them up into baby wipes.  I wish I had that sewing machine so I could serge the edges.  I found this awesome site about sewing your own diapers, but I am not sure that I am that motivated!

Kelly and I also prepared for baby in another way: we’ve received the advice to go to movies now, while we still can, so we went to see Hulk on the Fourth of July.  It was pretty good, except that the emotional climax of the film took place before the obligatory big-cgi-fight-scene climax, and the latter was waaay too long.  I really enjoyed the story, though.  Good characterization by Edward Norton and Bill Hurt, and actual chemistry between Liv Tyler and Norton (amazing since Liv never seems to have chemistry with anyone).  I’m really looking forward to the Batman movie coming out.  We’ve also been renting a lot of films, and two I highly recommend are Lone Star by John Sayles and Blame it on Fidel! by Julie Gavras.  Both really, really good examples of complex storytelling.  Of course, there’s been a lot of chaff as well.

We also got to hang with friends this weekend: Kelly at the Esplanade for fireworks on the 4th, and both of us on Saturday for an awesome game of Dungeon and Dragons at Summer’s house.  That was the most fun gaming I have had in a long time – not boring at all, and it made me want to do it again soon.

I got in a big argument with Kelly Saturday night though about whether we are living up to our vow to be hospitable, something we both take very seriously.  I’ve been so concerned lately with being at home and getting it all ready for the baby that I haven’t paid much attention to his desire to be social – and in the local group of friends maximum sociability comes with playing host to a party.  Not that we could have hosted the game (we just don’t have a table big enough), but we could have hosted the after-party and then offered a place for Josh and Casey to sleep over.  Or alternately, I could have personally opted out but not told Kelly he needed to be home by 10:30 so we could get a full night’s sleep and have the energy to work on the house the next day.  Sometimes my needs seem so loud to me that I forget that Kelly has needs too, and his priorities may not line up exactly with mine.  Or that even when our priorities do match, the way that we choose to fulfill them may differ.  Anyway, after talking it out we both felt a lot better.  We even had hot make-up sex the next day!

Current pregnancy fear: that the baby is in a side-lying position and will not turn head-down before the birth.  (They still move around a lot, so there doesn’t seem to be a big reason for concern.  I don’t feel that the baby is stuck, for instance.)

Current pregnancy excitement: after some focused nipple stimulation, I can get a large drop of colostrum out of each of my nipples.  The taps are on!

Diet plans

It’s been a while, and I have lots to say. The nausea and vomiting have gotten worse in the last few weeks, which is one of the reasons I have not been sending my daily missives out to the world. The other reason is that I have decided to be way more chill about this whole pregnancy thing. I am going to stick with my midwife, Tiffany, and go ahead with thinking about giving birth at the Cambridge Birth Center at least until later in the pregnancy (like, summer).

The biggest concern for me right now is making sure that I am getting enough nutrients. I found this handy chart:

Meal Planning Guidelines for Pregnant Vegetarians

Food Group	Serving size	No of Servings	Comments
Grains	1 slice of bread;1/2 cup cooked cereal, grain or pasta; 3/4 to 1 cup ready-to-eat cereal	7 or more	Choose whole or enriched
Legumes, nuts, seeds, milks	1/2 cup cooked beans, tofu, tempeh; 3 oz of meat analogue; or 2 Tbsp nuts, seeds, nut or seed butter; 1 cup fortified soy milk; 1 cup cow’s milk, 1 cup yogurt) (1 serving protein = 14 g)	5 or more	Calcium-rich foods such as dried beans, calcium-precipitated tofu, calcium-fortified soymilk, cow’s milk, and yogurt should be chosen often. A regular source of vitamin B-12 should be used.
Vegetables	1/2 cup cooked or 1 cup raw	4 or more	Calcium-rich foods such as kale, collard greens, mustard greens, broccoli, and bok choy, should be chosen often.
Fruits	1/2 cup canned fruit or juice or 1 medium fruit	4 or more	Choose calcium rich figs, and fortified juices often.

I have posted before about how disillusioning it can be to actually read the labels of the meat and dairy “substitutes” in one’s vegan kitchen. I have since realized that in order to eat well, I am going to have to make some major changes in eating habits. It is hard to introduce food items into a daily diet when right now I don’t use them at all. Like, 2 Tblsp of flax oil a day seem pretty important, but because most people eat so much fat, social messages about eating tend to say that you should reduce the amount of oil you just pour on your food. Even though the reasons for that restriction in the general obese American population don’t really apply to me as a skinny vegan, I have still paid attention to that message, resulting in less–not better–health. It seems gross and unhealthy to just add oil or nutritional yeast to whatever I’m eating, but it seems that is to be my new, delicious, healthy habit.

I also need to figure out an easy way to cook more than one vegetable at a meal. Like, if I use a lot of pots and we don’t do all the dishes, then the pots are dirty the next day and I don’t make the vegetables. This was the downfall of the “a smoothie a day” plan – we didn’t clean the blender every night, and then the next morning I wouldn’t have time to clean it and make the smoothie as I ran out the door. I also want to retain the most nutrients in the vegetables – I think steaming is more nutritious than boiling, but I don’t have a lot of experience on how you can steam stuff, especially together. Does anyone have a good resource on this or easy ideas about how to get lots of veggies in their diet?

It’s kind of embarrassing to admit, but changing your diet is difficult. My goal this week is to actually make a chart for each day and then fill in what I eat on it. And carry around a half-cup measure for serving size approximations.

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.

“Morning sickness”

Television is just wrong.  Morning sickness is not just dry-heaving before breakfast.  First of all, nausea happens all day long.  And second of all, barfing isn’t satisfying like normal barfing – you don’t feel better afterwards.  I just barfed again in the bathroom, and my stomach is telling me it’s going to happen again pretty soon.

Isn’t this supposed to be getting better as I approach the second trimester, not worse?

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.

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.

Too cold here

It’s so cold I am freezing my hiney off. Seriously, I had to dance like I was at a disco to keep warm in the car this morning as the engine reluctantly warmed up. The pipes froze in our kitchen again. Winter here sucks.

I canceled my prenatal appointment today with a nurse at the Burlington office of Harvard Vanguard Medical Associates. I don’t want to keep seeing them if I don’t plan on working with them. I got an appointment tomorrow with a CNM at the Cambridge Birth Center – she is actually the director of the center. At lunch today I have to go get my records from HVMA so I can have uninterrupted care tomorrow. I like the idea of working with a midwife and giving birth at a birth center. I want my peeps to be able to hang out – I expect prolly K, R, A, and K’s mom will be around keeping me company, doing massage, baking pie, et cetera while I labor. I am thinking that in a couple months I will take a hypnobirthing class. K and I spent 10 minutes meditating last night. It was very calming. I forget how easy it can be to do sometimes. We’re going to try to meditate together for 10-20 minutes every night. I also watched through my new “Buff Moms-to-be” DVD. All the moves look doable except this one bit with tricky footwork, but I’m sure I’ll pick it up. The problem now is going to be finding the space to do the work. I also need tennis shoes, a beach towel, and 2-lb. hand weights, but those should be easy to get.

Still nauseous. Yesterday was one of the worst days so far. I thought I was going to barf on the way home in the car. My appetite is back, but my food aversions are still here, so I am having trouble figuring out to eat. Fortunately, K and I are going out to dinner tonight for our 4 year anniversary. That’s right. Can you believe it’s been that long?

Back at work

It’s January 2, and I’m 9 1/2 weeks pregnant. I’m back at work today after the holidays, and so far it is going well. I am still a bit nauseous, and I’m hoping that goes away in a few weeks. I now have a substantial library of books on pregnancy and birth, thanks to my sister, mother, and mother-in-law. I also ordered a book called Pregnancy and the Vegan Diet online, which I hope arrives soon. The next thing I want to tackle is choosing a place to get prenatal care and give birth: over the next two Mondays, I am going to visit the Cambridge Birth Center and the Midwives at Mt. Auburn Hospital. I would like to have a natural birth in a relaxed, less institutional setting. I am also confused by the differences in prenatal care between OB-GYN practices and CNM practices. Do midwives offer the same prenatal tests and screenings? Can they prescribe medications? I’ll have to find out.

My appetite seems to have picked up again, but foods still smell and taste all wonky because pregnant women have an increased sense of smell.

The story so far…

I had been feeling nauseous, fatigued, and out of sorts, and it wasn’t going away like being sick usually does. I told a coworker at my office, and she said, “Maybe you’re pregnant!” I thought, *ding!* “What if I am?” As I thought more and more about my symptoms, it seemed to make sense, especially since my last period never really happened. It was all spotting and I never even used a pad.

I took a home pregnancy test on Saturday, December 15th and it was a strong positive. I couldn’t believe it. I threw the stick away, but kept fishing it out of the garbage to look at it again. Finally I just kept it on the counter so I could see it any time I wanted. The evidence was there, but it took a while to sink in.

On Monday I called my OB-GYN and got a prescription for pre-natal vitamins. I also went to the lab to have my blood drawn to confirm the results of the pee test. On Tuesday a nurse called me to tell me I was definitely pregnant, and perhaps even more pregnant than I thought. I had been thinking that we conceived around Thanksgiving, but perhaps it was earlier in the month. Today, Thursday, I have an appointment for an intravaginal ultrasound to help determine more exactly the age of the pregnancy.

K and I hadn’t been trying to conceive, but on the other hand we had talked about starting a family and had been, as a rule, very careless about using reliable methods of birth control. While the news came as a surprise and even a shock, it was very easy to see how this could have happened.

Telling people has been interesting. It makes it feel more real, and more exciting, for people to know about the pregnancy. At this point we have told our families, coworkers, and close friends by phone, and announced it to the world via gmail chat, livejournal and facebook.

I do have to say, though, that there are a lot of things about being pregnant that I already don’t like. Our culture has a lot of bad ideas about what it means to be pregnant. I have known that I am pregnant for all of six days, and already I have a long list:

1. Pregnant women should eat whatever their bodies tell them to; their bodies know what they really need.
2. When you are pregnant, your body is not your own any more.
3. Being pregnant means that you need to follow a strict regimen of diet and exercise, and if you don’t, your baby will suffer.
4. Pregnant women don’t know what is best for themselves, and need experts to tell them.

People blithely make the most insensitive comments. I’m sure I’ll have more to report on the subject.