Barely promoted

The whole birth thing

You might remember that Dr. Pippi-Poisson told me not to worry about it. I've done a very good job of that up until now, actually. But, as Thomas Kuhn described, contrary evidence has been accumulating until it can no longer be ignored:

—The lovely doctor in British Columbia who simply didn't assume that births would take place in a hospital, and who felt it necessary to explain exactly why various tests were done—in the sense of, explaining just how much the knowledge gained reduced the risk of particular poor outcomes.

—My new doctor here, who believes IVF pregnancies are automatically at higher risk of preeclampsia and who says she'll induce at 41 weeks, should we get that far. (Can anyone provide data for the former assertion? I found some papers agreeing for IVF multiple pregnancies, but nothing for singleton. And yes, I know the infertility blogosphere has seen some horribly difficult cases in the last year or so. I know several normally fertile people IRL who got it, too, and I think every case I know of has involved more risk factors than I have.)

—The one-day childbirth class we went to last weekend. Run by the giant teaching hospital we'll be going to, which has a 35 percent c-section rate and an 80 percent epidural rate. Yet natural was still presented as, well, what to strive for.

—The good women of Granolaton, who appear to have been doing it without drugs since 1950. (Although at least one doesn't think it was worth it.)

So here's where I used to be: modern medicine is groovy, okay? It's kept Beaker alive for the last 35 years, it got me pregnant, yada yada yada.

But, dumb intervention, i.e. intervention where broad evidence shows it's dumb, annoys the fuck out of me. Especially when "broad evidence" means huge interational comparisons. And the more I read, the more I learn that commonly used interventions might be dumb.

The cascades that can get started bother me, too: the decisions aren't independent. Nil by mouth goes to dehydration goes to IV set goes to glucose drip goes to hyperglycemia goes to hypoglycemia goes to baby in nursery with a bottle of formula. Induction to epidural to uncoordinated pushing to stalled labor to c-section. Et cetera.

So I get angry, but I don't want to be angry. I don't want to be bitter after the birth, either. I just want to have the damn baby.

To the extent that there's a plan, here's what it is. First, find a doula. Second (a), see if it's too late at 35 weeks to switch to the midwife group at the hospital we've chosen (I'm guessing yes). Second (b), get a list of questions ready for my next doctor's appointment. Third, get everyone I know to retell me their birth stories: I listened to a friend tonight who did a calm and respectable job of managing her own care at a large research hospital (ate normally during early labor, refused continuous monitoring until they convinced her to start a pit drip at 6 cm, etc.), and that calmed me down a lot.

Note: that means you, too! I'll be doing a bunch of reading around the blogs, but please feel free to post a link to your story. Or throw random advice. This healthy, but totally paranoid, woman approaching labor is willing to be a dartboard: I've let a lot of decisions slide, what with the travel and all that wasn't over until very very recently, but now is the time to think.

A reasonable question to ask: why are we going to the giant hospital? Answer: because I am a fucking snob, that's why, and simply don't trust medical professionals around here who don't work there. Look, it's hard enough finding a good hairdresser out in the sticks; if anything goes wrong at all, I want to be at the huge place with the nationally-renowned NICU. (And it's not like I'm not worried about this hospital, too, after having had the pregnancy monitored for various periods at three separate institutions elsewhere that were, each in their own way, better.)

Meanwhile: smaller sharper body parts have become visible when "kicking" (are they feet? like I can tell). There's indigestion after every meal, and I'm only sleeping about 6 hours a night. At least one out of every three days is totally chewed up by fatigue. The dizzy spells (clearly inner ear—my left ear goes somewhat deaf and vertigo sets in; resolves in less than 10 minutes, but leaves me very tired) that no one can explain continue to pop up every week or so, with a nasty one happening earlier this evening; the most recent guess is that they might be connected to my migraines? but no one knows. And yesterday I assembled our overpriced Dutch stroller, dragged home a changing table that folks a block away had put out in their trash, and considered submitting myself to David Brooks as a case study.

Rainbow blankie I: What I learned from the test swatches

Once upon a time, a nice social worker taught me to knit using a couple of pencils. I spent much of junior high school starting little projects in rainbow ombre yarn. During a long, lonely, semester abroad, I even knitted a giant brioche rib alpaca sweater, way too warm to ever wear.

Now everyone knits. And I'm having a baby. Shouldn't I knit again too? I feel like I'm hiding something when people talk about knitting: I still know more about certain kinds of patterned stitches than most people who knit, even though I can't work in ends and have them stick. (A confession: I even made a sloppy little garter stitch scarf back last winter, during my IVF cycle and all that accompanied it. Still haven't worked in the ends, though.)

So, when I was in Weatherwood in June, bored out of my skull and looking forward to a month in a dormitory in British Columbia, I remembered the Hoover blanket pattern I'd somehow run across in Knitty, and I went to the brand new yarn store downtown.

This ex-New-Yorker is angry

I've never really gotten used to reservists with giant guns wandering around Grand Central Station. But I accept it—as I basically would accept the kind of CCTV surveillance now standard in all public locations in England (on my last visit there, I would amuse myself trying to count cameras: 16 around a university parking lot?!).

But this is going too far:

New York City will begin making random checks of bags and backpacks at subway stations, commuter railways and on buses, officials announced today in the wake of a second wave of bombings on the London transit system. The checks will begin on Friday morning. [...]

The city's subway system alone has 468 stations and carries some 4.5 million passengers on an average weekday. Some of the larger stations have at least half a dozen entrances and exits. In New York City, relatively few people own cars, and the majority of those who commute via subway carry a bag of some sort filled with items needed for the entire day, including computers, business documents, gym clothes and makeup. Many people carry two bags. It is unclear how invasive the searches will be.

"We live in a world where sadly these types of security measures are necessary," Mr. Bloomberg said. "Are they intrusive? Yes, a little bit. But we're trying to find the right balance."

So invasive. So futile. (The more random the searches are, the more futile, too.)

But yes—this crosses a line for me, not because I've hammered out a theory of what the government should or should not do in balancing privacy and security, but because I can so easily imagine myself back on those trains with a giant backpack. Because when I go back to visit I see the current crop of high school students hauling their giant backpacks up and down the stairs. They've come for people like me.

Meanwhile, much as I hate vigilantism, much as I deplore concealed carry laws, etc. etc., I have to wonder about this:

At least one of the bombs was being carried on a tube train in a rucksack by a man who shouted in surprise when it failed fully to explode, and who appears to have then vanished in the scenes of panic and confusion that followed. A second was carried on to a tube by a man who dodged fellow passengers and fled when its detonator apparently went off.

Police and anti-terrorist officials were clearly delighted at the "forensic bonanza" which they say the bombers' failure offers, and each of the devices will be examined for clues to the identity of the bomb-makers. But the failure to capture any of the men at the scene means that a group of dedicated would-be bombers remains at large.

In the U.S.—heck, in New York, 'cause where the hell else in the U.S. would something like this ever happen—would all four have gotten away? The rest of the Guardian story portrays the underground panic very clearly—so yes, of course, perhaps. But perhaps not.

34 and a half weeks

Yesterday was pretty much an all-baby-all-the-time day. First I went to a breatfeeding support group recommended by a friend. It was run by a lovely lactation consultant^*, who will happily supply replacement plastic parts for the hand-me-down Medela I've got. The other women there were a lot more interesting than I'd expected.

Then to lunch with the friend who took me, and her tiny sleeping baby. Readers, I ate sushi. Genuine raw tuna, even (just one piece).

Then to my 34-week-checkup. All is well: blood pressure the same, fundal height right on schedule, and I'd only gained 6.5 ounces in two weeks. This lattter was pleasing, and nearly unbelieveable: the standard comment from total strangers has shifted from, "Congratulations!" to "When are you due?", followed by a gasp of horror when I say, "Another six weeks!"

This time my appointment was at the big city teaching hospital where I'll deliver, not the suburban outpost I went to last time. The OB-GYN group is right next door to our old fertility clinic^**, but they've changed the office layout in a way that does a much better job of protecting the fertility patients' privacy. I'd say sanity, too, except that the two departments still share an ultrasound suite. From the end I visited today, I could see a pregnant 14-year-old (or perhaps even younger?) waiting there...

I'm still not thinking hard enough about where this process is heading, but we're going to an all-day childbirth class this weekend and on a hospital tour in a couple of weeks. I don't have strong opinions about the kind of birth I want—and I have to say that it seems like just setting myself up to be disappointed to develop any—but I do want to at least understand the spectrum of possibilities a lot better than I do now.

I stopped at Babies-R-Us for the first time on the way back. I don't know quite what I was expecting, but it was oddly disappointing. I paced listlessly for an hour and left without buying anything, not even the bouncy chair I'd already decided to get, not even any socks. (There are a couple of pieces of clearance furniture I have my eye on, though.) The odds that our changing table will have an Intermetro base have gone up a lot, though.

In the evening, Beaker and I fruitlessly revisited the which-room-will-be-the-nursery discussion (if I actally buy some of the clearance furniture, that may force a decision—hee hee hee). His mother called. She's still trying to convince us to go to the family's vacation cabin (6 hours away, on a nice lake up north) about two weeks postpartum. This sounds like the worst idea ever to both of us.

^* She comes highly recommended for post-partum home visits by people who collectively agree on nothing else about parenting small infants—all of whose small infants are exclusively breast-fed and clearly thriving. She's pro-pumping, too, although not especially pro-building-a-stockpile-early—she worries that if one artificially increases one's suply, one might overfeed the baby.

^**Dr. Brash may have great stats, but, if everything I hear in the local rumor mill is true, he's done a piss-poor job of getting Granolaton faculty pregnant.

Role models

The stay-at-home wife of a(n untenured) colleague called at 4:00 p.m. on Saturday. They have a baby son and she wanted to know if I was interested in outgrown diaper covers and other gear. Deep into our chitchat she said offhandedly, "Well, Joe had to go into work today, so I'm here alone with Jamie." Jamie chortled happily in the background—laughing is a recent accomplishent of his.

All I could think: I will have to be both of them, won't I? The professor. And the mommy.

Mission creep

My goal this morning: scraping and painting a medicine cabinet we picked up off the street several years ago. (It needs to go into the upstairs bathroom, which has no storage and which will be our only bathroom for the foreseeable future, since no one is willing to tile the downtairs bathroom until the new wallboard is ripped off and replaced with even newer wallboard whose walls are, say, perpendicular to each other.)

Beaker's goal this morning: getting a doorbell working. (We keep missing deliveries of important things, like faucets.)

Beaker starts by mixing some shellac.

Then we both work to clear space in the basement for me to work. Our workbench is covered with construction dust, so Beaker hauls it up to the backyard and drags out the power washer.

What else needs to be power washed? All the furniture from the side porch! And the side porch deck, too. The power washer removes a truly horrifying amount of mud from the (coir embedded in rubber) doormat—it's hard it believe the manufacturer would have authorized the method, though.

The birdseed lives on the side porch, so I start refilling the feeders. Beaker notices the birdfeeder pole is awfully askew, so he pulls it up and screws it back into the ground. This ultimately requires three trips back the basement for tools: once for a mallet to pound it down, again for a screwdriver to use as a lever arm, and finally for a wrench to undo the damage caused the by mallet, so the next piece of the pole will fit on the base piece again.

Time for lunch! (Hey—at least we can sit on the porch now. That's progress.)

Germ cell micromanipulation is hard

Or so says a science reporter who actually went to summer school to try it.

WHY AREN'T THERE MORE STORIES LIKE THIS? Where reporters actually get in the damn lab?

Well, because neither the organizers, nor the granting agencies, nor the other students would generally want to expend the extreme resources involved on someone who will not go on to a career in the field. I know. And, because in fields less controversial than cloning, the reading public doesn't care either.

But still.

IVF ladies (and gents), if you think that story's fascinating, you should read Sherman Silber's book. Lots and lots and lots of information on what actually goes on in the embryology lab—ICSI is somehow much more, well, violent than I would have expected.

My drinking problem

It all started small, back in my first trimester. I'd have a glass on the rocks with dinner. It helped me (and my esophagus) relax.

Then it was two or three glasses with dinner—well, that's a whole bottle there. In Canada, I had no car and had to lug the glass bottles home myself. The exercise couldn't be a bad thing, I rationalized.

The Midwestern heat has pushed me hard. (Well, the heat and the distinct agricultural runoff flavor to our tapwater.) I started drinking earlier and earlier in the day. Right after breakfast, even, I'd pour myself a tall one. Soon I was at three bottles a day.

Today I hit a new low. I brought a cold bottle to work with me and drank the whole thing down with lunch. I caught myself wondering about getting a small fridge for my office, too—a private one that only I'd use. Sure, I could use it for pumped breastmilk, when the time comes. But that's not what I want it for now.

All is well...

... I'm just sort of overwhelmed, is all. House triage proceeds at an intense pace (look! the dryer vent doedn't need to be threaded through a window anymore! We have temporary storage in the kitchen! and the upstairs bathroom! I've unpacked at least 6 of the 200 or so boxes that have infected the house! And we're anticipating a quote, any day now, from cabinet people who only have an 18-week lead time!). The diaper stash has gotten its initial washings. My ankles have realized we're not going back to British Columbia any time soon and have consented to occasionally not swell, despite the heat. And friends keep inviting us over for dinner, even the ones with tiny babies, and bless them all.

Work? Not so much. Today I will go into my office and send confessional e-mail to Dr. Wow, that I took a few more days off than I'd intended. Ooops.

Basketball belly? Huge. I gained 6 pounds in the three weeks between my last two checkups. That early-second-trimester I'm-so-hungry-I-could-cry-right-now hunger has returned. Blood pressure is okay, and everyone (except Beaker, sob, whose mother blames her permanent basketball belly on her third pregnancy, during which she was 4 years younger than I am now) keeps telling me I look fine and healthy, so, whatever.

Granolaton matrons are very happy to tell me about their early Lamaze experiences. "Of course, if you need the medication, that's okay. But the breathing really allows you to oxygenate during the contractions..."

Some good news: I'd been afraid to call Cornell to ask, well, what was left on ice. We shipped out 4 vials of Beaker's sperm, way back when, and we hadn't gotten any storage bills. And it's not like Cornell is shy about asking for money! But, we finally got a bill—looks like the last one got lost in some forwarding tangle—and let me tell you, they charge for that Upper East Side real estate. But, they still have 3 vials left: only one was used.

Which keeps the possiblity of trying all over again, which I know we shouldn't even be thinking about, which would be very difficult indeed—teaching schedules! financial ruin from the earlier cycles! from the renovations, too! my ever-aging ovaries!—well, it keeps it open. And if it weren't, I would have cried very, very hard.