Mira pretends

It started with Elmo.  She began making her Elmo doll blow kisses to her about 2 or 3 weeks ago.  She would take Elmo's hand, press it to Elmo's mouth, make a "kissing" sound, and then move Elmo's hand away from Elmo's face and toward her.

After that, she started putting her baby doll into the high chair.  She'd then go get some of her fake plastic food and hold it up to the doll's mouth and say "Mmmm".

Next came putting Mr. Bear (her teddy bear) to bed.  (See the video.)



In the video, I'm talking to her to keep her on track for the purpose of making the video shorter than an hour, but actually the origin of all of these activities was Mira and Mira alone.  After I discovered her doing these things, then I would talk to her about them and encourage her to continue playing and pretending, but I didn't prompt her to begin doing them in any way.  She had the idea all on her own, which is pretty neat.

Pregnancy update - 12 weeks (again)

Last week, I had two prenatal appointments: one at my birth center and one with my Ob/Gyn.

In my appointment at the birth center, I met 2 of the 4 midwives over the course of my initial appointment.  It was all pretty routine: get your weight, measure blood pressure (manually, yay!), pee in this cup, yadda yadda.  Until we got to the point where we were reviewing my medical history and the midwife asked me how long my menstrual cycles typically were.  I explained to her that I had always had very regular 28 day cycles my entire life, including after Mira's birth, right up until last November when I missed a period.  After that my cycles were typically around 40 days.  She asked me about my doctor's findings relating to that and asked if she could request the records from him to see if there was any additional testing they wanted to do about it.  "Of course," I replied.  Then she said that she'd like to do an ultrasound to date the pregnancy since my cycles were abnormal. She explained that my prolonged cycles probably also corresponded to a delayed ovulation, which would effect my due date.  I was hesitant.  I told her that the way I felt about it was that the baby is going to come whenever the baby decides to come and what do I care if it's a week early or a week late?  I'd like to avoid unnecessary tests.  Couldn't we just wait till I get the anatomy ultrasound at 20 weeks and use that to date the pregnancy?  She explained that we couldn't combine the two ultrasounds that way because using ultrasound to determine the date of conception is accurate to within 5 days if done around 10-12 weeks because at that point fetal growth rate is pretty similar from one baby to the next, but by 20 weeks the baby's genetics are starting to have an effect on their size so the accuracy drops to 14 days at that point.  She went on to explain that the reason she wanted to have an accurate due date was because, being a birthing center, they can only deliver babies born between 35-42 weeks.  Outside of that window, they have to refer the patient to the hospital.  So in order to increase my odds of delivering within the safe window, they needed to make sure the window was placed accurately and not skewed one direction or another.  She then asked me if my hesitance was due to financial reasons or if I had some other concerns about getting an ultrasound.  I told her that my hesitation was purely financial, as all of our maternity costs are out of pocket.

The midwife then went on to try to listen to the baby's heartbeat with the doppler.  She was uncertain whether she'd be able to find it though, since I was still only in the first trimester.  Sure enough, she couldn't locate the heartbeat.  So she asked me if it'd be ok with me if she wheeled in the ultrasound machine just to check out what was going on.  "We don't have to charge you for an ultrasound unless we have to call out the sonogram technician for official documentation," she explained.  Sure, why not.  So she went out of the room and while she was in the hallway, she ran into another midwife and she asked her if she would assist in dating my pregnancy.  So these two midwives bustle into my room with the ultrasound machine and in a jiffy they have performed an unofficial (i.e. free) ultrasound in which we saw the baby's heartbeat, watched as baby rolled over, and got the pregnancy dated.  They even printed a picture for me.  (Baby is in profile, with the head to the right, hand up in front of his/her face.)



So anyway, they found that my pregnancy is actually about a week younger than my last menstrual cycle would indicate, likely due to a delayed ovulation.  So they adjusted my due date from January 9th to January 15th.  Which essentially means that I'm currently "repeating" my 12th week of pregnancy.  *Shrug*  I've adjusted my pregnancy ticker accordingly.  -->

Anyway, I left there with pretty good feelings about my decision to birth there.

A couple days later, I went to see my regular Ob/Gyn, the one who I love and who has been providing all my feminine care since forever.  My mom said before I went that I needed to be prepared for him to try to talk me out of the birth center, since she thought that would be his reaction.  I doubted that would be the case, but I prepared myself mentally for that situation anyway.  When I got back into the exam room and had a chance to talk to him, I told him that I had decided to use a birth center.  I was just about to explain my reasoning when he chimed in with, "I think you're an excellent candidate for that type of delivery."  I just shut my mouth and took a second remembering why I love my doctor so much.  I told him that the birth center provided prenatal care, but I still wanted to see him a couple of times throughout my pregnancy, just to know that I have an MD's blessing to continue with an out-of-hospital birth.  (The birth center has a perinatologist to oversee emergencies, but I want to know that any warnings/red-flags are recognized and addressed by a doctor *before* the emergency arises).  He said that that was not a problem at all; he has many patients who do the same thing.  He said that I'd just need to have the birth center fax over any test/procedure results and then he'd want to see me back in my third trimester.  He told me that the birth center I've chosen has an excellent reputation, but that if at any time I become uncomfortable with anything or I have any questions for him, to just call and set up an appointment.  Awesome.  How great is my doc?

So... that's the business end of things.

As far as how I'm doing... My morning sickness is almost completely gone.  (Yay!)  I still occasionally get a little queasy when I haven't eaten in a while or when I try to force myself to eat something that I'm just not in the mood for.  But otherwise, my stomach is so much better.  I'm exhausted a lot of the time, though.  And over the July 4th weekend, by belly seemed to explode outward.  It got really hard and then just bulged right out, all over the course of about 4 days.  I'm wearing my maternity clothes now, but I'm unfortunately in that awkward phase where anyone who doesn't know I'm pregnant probably just thinks I'm really fat.  I'm thinking of going out to buy some maternity t-shirts that say "baby bump" on them or something; I need some more casual maternity tops anyway....

It's a fish! .... Oh, wait, it's just Mira.

Last summer, when she was only about 5-7 months old, Mira spent a lot of time at the pool. This summer has been no different. We've been going to the pool usually at least weekly since April. The first time that we got in the pool this season, she was a bit unsure, clinging desperately to my swimsuit strap the entire time. But the second trip she really enjoyed, and by the third trip it was clear that everything she had been doing last summer came right back to her. And then some. She loves the water and actually is showing some impressive skill already in the swimming department. If you hold her on her stomach, face down in the water, she'll kick her feet and blow bubbles. And her kicks are STRONG; they really propel her forward. If she can touch the bottom, she's completely comfortable walking through the water, getting as deep as her chin. We're still working on floating on the back because every time I put her laying back in the water, her feet pop straight up out of the water. But she's fascinated by watching other people float on their back and she expresses the desire to try to do it herself. When we dunk her head completely underwater, she goes easily with no complaint and usually no coughing or sputtering... though she does usually stick her tongue out and blow raspberries shortly after coming up. I think that's her way of saying that she doesn't like the way the pool water tastes. And now recently she has really taken a liking to "jumping" into the pool. Basically, we sit her on the edge of the pool and let her propel herself off the edge and into the pool from a sitting position. At first when we were doing it, we were catching her before her face went under, but eventually we started letting her go all the way under before catching her. She still loves it, as you can see from the video below (sorry about the quality, I took the video with my camera instead of my Flip). I've debated about putting her into swim lessons, but at this point I think she'd be way too advanced for the classes taught to her age. I guess we'll just have to continue making the most of having an ex-swim-instructor for a daddy. ;-D

Mira loves her sandbox

A couple months ago, my mom got Mira this great sandbox. Mira loves to play in it. She would do it every day if it were up to her. It usually buys me at least 30 minutes of easy, hands-off, sit-back-and-relax type supervision. I've been using that time to read some books on natural childbirth. It's great. Also, we have it situated in a part of the backyard that gets shade all day, so we can go out there any time of day.

Just before I took these next pictures, Mira had put a few shovels full of sand into the bucket, then she held the bucket up to her face like she was going to drink out of it, and of course ended up with a mouth full of sand. She thought it was shocking. I thought it was kind of funny. She was trying to spit it out, so she kept sticking out her tongue and blowing raspberries. It was pretty funny. Eventually I stopped making fun of her long enough to get her a cup of water to wash out her mouth. The experience didn't seem to dissuade her from enjoying the rest of her time in the sandbox, though. Once her mouth was de-sanded, she went right back to filling up the bucket.

Pregnancy update - 11 weeks

I'm now 11 weeks pregnant. (You may notice I've added a pregnancy ticker to my sidebar. --->)

The morning sickness is getting better. I started taking my prenatal vitamin at night right before bed, and I think that's helping. The reason I started taking it at night is that I was taking it right after breakfast, but then I'd usually throw up between breakfast and lunch, so I was concerned that my body didn't have enough time to digest it. So I figured that if I took it before bed, I'd be sure to get the full dose since I wasn't waking up to throw up in the middle of the night. I think making that switch helped for two reasons. First, the vitamin itself can cause upset tummy, so now if it is I'm just sleeping through it. Second, prenatal vitamins are jam-packed with vitamin B, which has been shown to relieve morning sickness. If, by taking my vitamin in the morning, I was throwing up before all that vitamin B could be processed, then it wasn't helping as much as it is now that I'm taking it at night and keeping it down. So now I'm still getting queasy a couple of times a day, but I haven't thrown up in a week or more. Which is a great improvement.

The typical first trimester exhaustion is hitting me pretty hard. I think it's gotten worse lately. I'm finding that I get really tired right around 4pm. I've tried taking a nap when Mira's napping, but that just hasn't worked for me. Mira's nap is usually from about noon to 2:30, and that timing is too early for me to be ready to fall asleep. But I can thank my lucky stars that she is a good sleeper (11 hours straight at night and 2 hours for nap, putting her self to sleep easily every time). So at least I get a good night's sleep every night. Or I *would* if it weren't for... (see the next paragraph).

I've found that in this pregnancy my bladder is hyperactive. It's quite common for pregnant women to have frequent urination even before the uterus is putting any pressure on the bladder. Apparently, it's due to an increase in the amount of blood in the body. In my first pregnancy, with Mira, I didn't have this problem until my third trimester, when the issue was just all the pressure. But in this pregnancy, I've got it pretty bad already. I have to get up twice in the middle of the night to pee: once around 2am and again around 6am. Luckily, I don't usually have trouble getting back to sleep afterwards. So at least there's that.

As far as my health is concerned during this pregnancy, the thing I'm most concerned about is high blood pressure. If I develop either gestational hypertension or pre-eclampsia during this pregnancy, it's possible that the birth center I've chosen may turn me over to a hospital, since they only take on low-risk births. Needless to say, I really don't want that to happen. I didn't develop high blood pressure when pregnant with Mira, but since having had her my base blood pressure has been higher than it was previously. Not too high, but not as low as I'd like either. So while my chances of developing high blood pressure related complications during pregnancy are not high, it is the one thing I'm probably most at risk for, statistically. Healthy diet and routine exercise are the best ways to prevent hypertension, and on those fronts, I'm all set. I have always eaten more fresh produce than anyone I know; Brian says I eat like a rabbit. And my current exercise routine involves either my regular exercise video that I've been doing (off and on) for over a year now, or swimming with Mira at the pool (she has a float that she can sit in and I push her while swimming laps).

Before I found out I was pregnant, I was on a 1200 calorie diet. Due to my nausea, I've not found that hard to stick to since becoming pregnant. But now that my morning sickness is starting to clear up, I'm beginning to wonder how much I should be eating. With Mira I gained around 28 pounds, about 15 of which I'm still carrying. I don't think I need to gain near that much this time. My goal is to keep my weight gain under 20 pounds, but I feel like I could even do less than that and still be healthy. Indeed, my midwife confirmed that my goal was quite reasonable, given my current weight. Unfortunately, our scale broke a while back and I haven't replaced it, so I don't know how much weight I've lost since becoming pregnant, but I *do* know I've lost weight because my clothes fit more loosely. By this time in my first pregnancy, I had already gained 5 pounds and was already wearing maternity clothes. So I think I'm on track for my weight goal. (I know doctors warn against weight loss regimens during pregnancy, but rest assured that I am going about this in a healthy and restrained way. I'm not starving myself and I'm not over working myself. I'm doing this because I know I can do it in such a way that it will be healthier for both me and the fetus than if I "let myself go".)

I've tried on my maternity clothes, left over from my first pregnancy. They all still fit except for two pairs of pants (which I couldn't wear toward the end of my first pregnancy anyway). So luckily, I won't have to buy much this time around. Though I do think I might need to pick up some more casual maternity wear. During my first pregnancy, I was still working, so my maternity clothes are more geared toward looking cute in an office setting than staying comfortable while chasing a toddler. ;-)

Mira goes Boom.

I think it's funny how she "falls" down sooooooo carefully. (Do you see why I say she has a cautious personality?)

[Edit: I should have said make sure to watch this with audio.]

Mira has words

In regards to yesterday's post by Brian, a demonstration of Mira's linguistic capabilities:

Mira has 3 words now: Mama, Dada, and Baby. She also makes some sound effects, like Boom (said when something falls over) and Vroom (said while playing with toy vehicles). Several months ago, she was saying Cat and Dog (or something very close), but she seems to have lost those over time.

I admit, I can't wait for her to learn to talk. Mostly, so that she can tell me what she wants rather than me guessing at her gesturing. Granted, she's really good with gestures, so I'm able to guess correctly most of the time. But sometimes I just can't understand what she wants and then she gets frustrated. She has also gotten into a bad habit of whining when she wants attention. So whenever she comes up to me and whines I say, "No whining. If you want my attention, say 'mama'." That usually works and also prompts her to use her words.

She's not much for verbal "play", meaning she's not a babbler and doesn't tend to try to mimic sounds that she hears. As a result, several of her friends who are the same age or younger already have vocabularies of 10-20 words. I'm not worried at all about her being a little behind in this department, though. It's clear that her hearing and comprehension are excellent because she responds physically and appropriately when spoken to, she listens and can follow directions. I think this may just be another manifestation of her being a cautious person. For example, when she was learning to walk, she had the balance and muscle to be able to walk a month before she actually did, but she wanted to be sure she could do it before she tried. I think this is another case of wanting to be sure she can do it before she tries. Apparently, late speech runs on my mom's side of the family, too. Supposedly, my mom started talking late, but her first "word" was an entire sentence. Maybe Mira will be the same way: getting started late, but once she does start, taking off running.

She Said Da Da

Today, just after Noon I got a call from my wife's phone.  

"Oops baby dial" my wife says.  Obviously fumbling the phone a bit.

"No problem".  It's my standard reply.  

(overheard) "Mira, you wanna talk to your daddy?"

"Hi Mira, How are you - I love you."  I start my mantra and then wait a second.  Usually this is where I hear silence that Laura informs me is filled with big baby grins.

(overheard) "Mira, can you say Daddy?  Can you say Da Da?"  We've been working on Mira using  the few words she's mastered so far, encouraging her to use them.  I wait with baited breath... she usually only mouths the "Da Da" silently.

"Da Da"!!!!!  !!!!!  !!!!!!

WOOT

"Da Da"

"I love you my precious baby..."

"Da Da"


The utter joy I feel at those two syllables is stunning, thrilling, humbling, exciting and... yeah I can keep going.

My Daughter called me on the phone to say "Da Da!"

Happy days.

A bold new direction (part 2)

Continued from yesterday's post...

So because I'd had some negative experiences during my hospital stay while birthing Mira, I've been thinking about how I can avoid those pitfalls again, now that #2 is on the way.

My first thought was to hire a doula to assist me in another hospital delivery. A doula would know my preferences and help me express them to the hospital staff. She would be my advocate so that I wouldn't need to fight for my desires and could just focus on my labor. A doula would also have a lot of experience in assisting labor and delivery, so would know tips and tricks that would help me avoid getting to the point of needing an epidural again. A good doula might also be able to measure my blood pressure manually and monitor the fetal heartbeat with a stethoscope so that, presumably, I would not need to be hooked up to a bunch of machines during my labor.

Because Brian's current employer is not offering him a group health plan, we have our own private health coverage. It's a very good plan, but it doesn't have maternity coverage (coverage only kicks in if there is an emergency situation that arises during the pregnancy or during childbirth). So that means that, assuming we have another healthy uncomplicated birth, we will be paying out of pocket, no matter where we deliver or with whom. There is a possibility that our health care policy could change before the baby is due, but we don't really want to *count* on that. When we had Mira, the total bill for the hospital birth was around $16,000. At that time, we had group insurance through Brian's previous employer, which included maternity coverage, so our out of pocket expenses were somewhere between $2,000-3,000.

So the price of doing a hospital birth with a doula would be something around probably $18,000 (hospital fees plus doula fees). This would be a stretch for us, financially. We could do it, but it'd be tough.

But that number got me thinking... Do I really need a hospital this time? Certainly, I feel like it was the right call for my first pregnancy, for me, personally. Like I said, I needed to be there to feel safe. And that was very important to me the first time around. But this time, I'm more confident. I know my body responds well to labor. I know that the contractions are painful but manageable. And statistically speaking, if your first labor is uncomplicated, your risks of having issues during your second labor plummet. So while I do still want quick and easy access to a hospital just in case, do I feel like I really need to be delivering in a hospital? Well, no. And honestly, it'd be nice to avoid the intervention-based mentality of a hospital.

And if you want quick access to a hospital without actually being in a hospital, that basically means a birthing center. So I researched the birthing centers here in Austin, and between recommendations from other moms I know and online resources, a clear front-runner quickly stood out. It's called Austin Area Birthing Center, and we are pleased to have chosen to birth there.

Brian and I toured the facilities earlier this week. The location is great for us: only 15-20 minutes from our house, 2 minutes from my mom's house (where we will hopefully take Mira during the labor), and within 5 minutes of not one, but two major hospitals. The facility has a clinic for prenatal visits and a separated more private birthing center. The birthing center has 3 birthing rooms that all look like very comfortable hotel suites. (Only 3 rooms, but they say they have never not had a room for someone who needed one.) The birthing rooms have deep water tubs with jets for hydrotherapy during labor or even for water delivery. There is a full kitchen and separate waiting area in the birthing center. It's all very quiet and relaxed, opposed to a hospital setting. The staff that we met was all very friendly. The midwives are all certified nurse midwives. During your prenatal visits, you rotate through the 4 midwives, getting to know each of them so that you will not be unfamiliar with the person who delivers your baby. The mindset is very much to allow the mother whatever she needs to be able to birth her own baby naturally. A very different mentality than that at a hospital where the mindset is more "let's deliver this baby for the mother using whatever means and interventions are necessary". There is a doctor associated with the center who oversees any unexpected events, and should transport to a hospital become necessary, there is a very organized, quick, and precise plan for that. But because the center only takes low-risk women, and because the midwives are skilled at anticipating issues and avoiding them, transport to the hospital is only necessary for a very small percentage (8%) of their clients. Additionally, they are trained to be able to handle certain issues on-site. For example, they can give stitches if vaginal tearing occurs, they can administer antibiotics and certain narcotics, and they can even resuscitate a newborn. BUT (and this is a bonus in my book) they do NOT offer epidurals, nor are they allowed to speed up/ slow down the labor process through any medical means (so no pitocin to induce labor etc). Families are usually discharged 6-8 hours after delivery, which is great for us: we'll be able to get back home to Mira quickly. And the cost is a fraction of what we would pay at the hospital: their out-of-pocket patients pay $3,500. Very doable for us.

I'm confident and happy with this decision. I'm certain that I will have a much better* birth experience at this birthing center than I would in a hospital. I feel very lucky that I'm able to consider this as an option, since I know that, were I a high-risk pregnancy, they would turn me away at the door. And for many women, that is their reality.

*By "better", I mean an experience that is closer to my own personal goals and desires. I certainly understand the desire some people may have for a hospital surrounding, it's just not one that I feel anymore.

So barring any unforeseen complications, this is where I'll be birthing #2. I have an appointment with them in a couple weeks; I'll keep you posted on how it goes.

A bold new direction

I birthed Mira in the hospital. At the time, my reasons for choosing to do so were: 1) I like my OB a lot and wanted him to be the doctor at Mira's delivery and he has a specific hospital with which he works, and 2) I needed to feel safe. And really, the second reason was the biggie. It was my first time out the gate, so to speak, and while I had read a ton of books and attended a handful of classes and felt educated about my options, when I really got down to it, I didn't know what labor would feel like. I didn't know how my body would respond. I didn't know how painful a contraction would be. I didn't know if I was as strong as I needed to be. But at the hospital, I felt safe. I knew that I was in the best place possible should something go wrong. If Mira or I needed it, I was in a place that was equipped to handle pretty much anything.

But there were some negative aspects to having Mira in a hospital. The big problem I had was that I was strapped to a bunch of machinery (fetal monitors, blood pressure machine, etc). When my contractions got really strong, the only thing I found that helped was to walk around. But that was impeded by all the monitors. So it was a constant struggle between me and the nurse: every time the nurse left the room, I kept taking off all the monitors so that I could walk around, but then she'd just come back in and put them back on me and tell me to keep them on. I didn't listen. I'm sure she found me to be very annoying. The feeling was mutual. And I think this was a big contributing factor to me deciding to abandon my hopes of a natural birth and give in to request an epidural: at some point I just got tired of fighting her. The other reason that I requested the epidural at that point was that, with all the adrenaline and endorphins rushing through my body, my legs were shaking badly, but my contractions were only tolerable if I was standing. I was afraid I'd fall down. If I'd had the right support people around me, that could have been worked through. But I didn't. All I had was a nurse who kept telling me basically to lay down and shut up. (Oh and a husband who knew even less about what was going on and how to respond than I did.)

The other negative experience I had at the hospital was that they wanted me to deliver Mira on the doctor's schedule. At some point, I could feel through the epidural that it was time to push and I quickly discovered that it felt better to push with the urges. So I did. But the doctor who was supposed to deliver me was in an emergency c-section. Over the course of an hour or more, I gave light, half-hearted pushes when it felt right. And during that time, the nurse told me no less than 3 times that I needed to stop pushing and wait for the doctor. At one point she even told me that I needed to "cross my legs". Umm..... no. The doctor arrived just in time: I only pushed twice in the presence of the doctor before Mira was out. And my OB didn't end up delivering Mira after all because of the on-call rotation. So one of my two reasons for choosing a hospital birth didn't even really apply.

And then a day later when we wanted to leave the hospital and go home, the process took forever. We were cleared to leave by both my OB and the baby's pediatrician by 8am. But because the staff were dragging their feet, we didn't get discharged until right around 5pm, just in time to fight rush hour to get home.

So now that we're pregnant with #2, I'm starting to think back to my experiences with Mira and brainstorm about how I can make the outcome of this birth experience mesh more closely with my goals and desires...

Stay tuned for the continuation in tomorrow's post!