Tuesday, January 31, 2012

Hannah's Birth Story: Part 3

Hannah arrived in Part 2 of this series, so we're done- right? Not even close!

A disappointing misconception within the general population is that the birth process ends when the baby arrives. Both neonatal care and maternal care would benefit from a huge overhaul within the hospital system. The main reason I've already decided that any future births for this family will take place with a midwife was the poor care we received directly after the birth and the non-existent follow-up care after leaving the hospital. Granted, this is not a decision I could have been confident about for my first birth because of nerves and a family history of c-sections. However, it's one I will gladly make in the future. It's because I'm selfish and I would like to have attentive, personalized care for both me and my baby. Call me crazy.

(Editor's Note: Jeannette has the utmost respect for individuals in the health care profession. Many of the people she encountered during her stay were wonderful and professional. Her criticism is of the system that prevents personal attention. In general, I try to keep the messages on this blog light and positive. Unfortunately, this post will not have the same tone. I encourage you to read anyway because the more people are aware of this issue, the better chance there will be for change. After all, Maternal and Infant patients make up 38% of the healthcare industry's yearly visitors. Don't we deserve better?)

To be honest, it only hit me about 4 months ago that my maternity care was below par. I suppose I was living in "maternal bliss" and thinking about how wonderful it was to HAVE a baby! Who cared if I got off to a rough start with breast feeding? Did it matter that my recovery seemed to drag on longer than it should have? Would it really have helped to have a follow-up in-home visit to make sure I wasn't at risk for some of the most painful nursing problems one can experience? Not in my mind! As long as I had a healthy baby, that was all that mattered. Looking back, I can't help but feel mistreated and I found out I'm not alone. The CDC is pressing for improvements within the system. There's even a group to establish the Maternal Health Accountability Act of 2011. Everyone comes into this world the same way, so this affects us all. It is more important than any other political act- but we have yet to hear about it in the presidential debates.

I'm not going to claim to be an expert on this subject, or submit a 932 page proposal to congress for a complete overhaul of the system. It just seems that in a country that touts superiority in the world, we should be much higher on the patient satisfaction scale for this type of care and we're not. Why am I dissatisfied? My visits from the nurses were few and far between. They were rushed, forgetful, and disorganized (presumably because there were too few nurses for the number of patients.) It was more difficult to get regular Tylenol because it wasn't on a list of standard drugs that new mothers could receive. I didn't receive any topical treatments for my "bottom" until the second day, because it wasn't clear that this was something I could ask for. When the only positive things I can say regarding the maternity ward are about the hospital food, you have to wonder if this was really a decent situation.

Enough about me, let's talk about Hannah's care. We were at a "rooming-in" hospital that promotes closeness of the mother and baby by encouraging you to have your baby in the room as much as possible. I can't imagine what it's like at other hospitals, because I barely got to spend more than 2 hours at a time with Hannah. It was really difficult because I had to attempt to nurse her for 20 minutes, then pump for 15 minutes, then feed her a bottle for about 20 minutes. By the time we changed a diaper and got her re-swaddled (another 20 minutes #newparenthood), it was practically time to get her back to the nursery and then start all over. Not only was the feeding process difficult and time consuming, but the assistance came in quick bursts of an overwhelming amount of information.

In my county, there are 5 hospitals. Only 2 still offer Lactation Consultant services (one is part time.) During my stay, I didn't see a consultant until nearly 12 hours after Hannah's birth. I also saw three different consultants, each with different suggestions. I was given hurried details about using a pump to stimulate production and a shield to better fit my nipple to Hannah's mouth. It's no wonder we weren't able to get a proper latch without those items- they only spent 1/2 hour with me at a given time. There is also no follow up care available to nursing mothers through the hospital. If you need support (which we did), you must see a lactation consultant at the rate of $150 for one hour. Starting next year, this service will be mandatory for health care to cover. It's good to know that issues like this are being addressed and improved for the future.

Thankfully I had the support of my husband through it all. He fed Hannah many times and immediately developed a wonderful bond with her. He is totally onboard for taking a more natural approach to our next birth. In fact, because of his general loss of confidence in the political system and his love of the outdoors he's hopeful that Armegeddon is around the corner, and I think he would happily deliver our baby on his own.

I have to hope that better care is out there. If you had a great experience and you shared it on a blog, please post a link in the comments. I'm not discouraged from having another baby, and I still regard this as one of the best experiences of my life, but I think that Mothers should be treated less like surgery patients and given the option to blissfully bring new life into this world with positive care practices.

What Healthcare Reform Means to Me

I loved having an unmedicated birth for Hannah and I plan to do it again. It took about a month for me to realize that I was dissatisfied with the care I received in the hospital because they're really not equipped or experienced with that type of labor. (Read Birth Story Part #3.) I decided to look into a Midwife practice since they are the experts in helping healthy women through a healthy labor.

In my first meeting with the midwife, I came prepared with a million questions. I was pleasantly surprised to learn about midwifery. It's not an antiquated practice. She monitors your health through routine prenatal visits similar to those with an OB. She is able to order blood tests, ultrasounds, administer rhogam injections for those with O- blood type, and has the training to recognize risk factors that might lead a woman to deliver in the hospital instead. After the baby is born, she will offer the same general infant care that a hospital and pediatrician would perform for the first few days of life. She even provides the routine injections that babies receive at the parent's discretion. On top of all this, she'll teach me how to have a natural birth and offer coaching throughout labor. Hopefully this will result in a less-smashed nose on Baby #2 upon exit!

Knowing all this, it should have been an easy decision. However, I got sticker shock. All in, the cost nears $4000 and insurance companies rarely cover any of this. I knew that the services were worth this price, but it's a daunting number to swallow with a second baby on the way in a one-income household. We brainstormed ways to make it work, but ultimately it seemed like the easiest way to move forward would be with the same practice and same hospital I used for Hannah.

Enter Obamacare.

I booked my first prenatal visit and entered a counseling session for billing details. Thanks to a change in my husband's insurance, we were looking at a grand total of $5000+ to deliver in the hospital. Even last year, with the best insurance Cigna offered, we still paid more than $2000 for the birth. The billing rep let me know that these changes have only come about in the last 2 years. In the past, births routinely cost insured families $200 to $500 total. Although Cigna appears to be the worst, nearly every insurance company has changed the plans offered to non-government employees to defray the majority of the costs back to the families, to the tune of 10 times the cost.

A light at the end of the tunnel.

After digesting the scary numbers, we've decided to move forward with a home birth under the supervision of a midwife. I'm happy that we are going this route because I truly believe that this is the best birth plan for our family. When I spoke with the billing rep from my OB's practice to let her know I was switching providers she told me that she expects to see this happening more and more frequently. That's the main reason I'm sharing this information. From personal experience, I can say that I believe a non-medicated birth is the best way for a healthy mother to deliver a healthy baby. I recommend that all parents-to-be take the time to learn about natural birth. Even if you don't choose this route, you are sure to learn ways to improve your health and your labor.

My motivation for a birth without medical intervention.

33 Weeks Old!

I've spent a lot of time the past month sleeping and/or in a sleep-deprived, zombie state. Thankfully, Hannah continues to nap regularly through the day (knock on wood!) so I am able to catch up on some extra sleep that way as Baby #2 drains my energy. I am eagerly looking forward to the second trimester! Hannah has been a wonderful sport and it's so inspiring to see her grow. She's learning quickly now. One of the exciting new developments is her emerging personality. She's finding more and more humor in the games we play and stories we read. Plus, she can now show that she is proud of herself with a beaming smile!

I noticed early in the week that she was enjoying tickles more than ever. Then she laughed and laughed as I stretched and bent her little limbs. She's been such a good little eater that I've been able to regularly say, "All gone" at the end of her meals. She figured out what that meant quickly and now she responds with a proud smile! Hannah is mostly only mobile by rolling and stretching, but she can get around that way. I was surprised to watch her grasp and pull at toys that seemed out of her reach.

Tuesday, January 24, 2012

32 Weeks Old!

Last week we battled the sniffles and several sleepless nights. Just before that, we were making some real progress on the sleeping-through-the-night front, so it was a shame to have the setback. I don't like to talk about Hannah's good sleeps because I'm positive it's a jinx, so I'll just say her nose is starting to clear up and things are looking up in general. In my "walking zombie" state I managed to completely forget that we had a dehumidifier set up for her. Consider this a PSA for new Moms to turn them on!

We also got Hannah an Exersaucer-type activity gym. She really likes it, but I'm finding that it overstimulates her. Even though it seems like a great toy, it's sometimes easier to set her in the high chair with one toy if I need two hands because it keeps her happier after playtime. Her favorite thing about standing in the toy is that she can see her puppy!

Last week I started reading a book about raising kids the Montessori way. I was inspired to look into this by my friend at Mama May I. Jessica's blog and shop showcase some of the fantastic ways she is fostering a love for learning in her little girls. I'm hopeful that we will be able to incorporate some of what I've learned into Hannah's day-to-day routine. It's a good thing I looked into this early because there are so many recommended tools and toys for kids! I can start collecting jars and safe household treasures now so that Hannah (and ultimately Baby #2) will have plenty to explore and discover.

Saturday, January 21, 2012

A Different Kind of Pregnancy. A Different Kind of Baby?

I'm only 11 weeks into this pregnancy, but I can say definitively that this one is different. My entire lifestyle has changed since last year, so there are a myriad of factors that could be affecting the way I feel. Plus, I learned enough through trial and error the first time around to avoid some of my sickness-inducing habits. I'm happy for some of the changes, namely that I do not have to praise the porcelain Gods every day. On the other hand, I'm noticing that my motherly instincts towards this baby have changed. All these differences have me wondering... is this baby a boy?

Maybe it's not that easy to tell, but it would be funny if that works out to be the case. My husband noticed it the other night, too. I fumbled through offering him an explanation for my feelings, but I couldn't find the right words. Obviously I'm excited and I love that our family is growing. I may have just been naive the first time around and fallen in love at the sight of two pink lines. It's easy to do that when you're longing for a baby to fill your arms and your heart.

Sometimes it's strange enough to make me think that I'm not even pregnant. After all, I only feel tired- and can't that be attributed to the little one waking up a few times through the night? I think my motherly instinct hasn't fully set in with this one yet because it's working overtime on Hannah. I'm sure that as soon as I start to feel the kicks and flutters of this baby, I'll snap into it. Until then, I may just meander through these early days stunned that it's all happening again so quickly.

Monday, January 16, 2012

31 Weeks Old!

This week is my birthday and I've asked Hannah for a very special gift. I'm hoping that she says "Mama!" It has to be coming soon because she already wails, "Ahhmmmomomomom" while she cries. She's showing recognition of sounds and she loves reading books with me. Most of the time she puts the books right into her mouth, but that's common for babies at this age. Luckily the rhymes are easy to memorize so I can generally continue reading even if she takes a break to gnaw. Sometimes I'll offer her a toy or other book to hold so that I can get through the story. I'm finding that she even enjoys laying on a blanket with her toys while I read to her. It's exciting to watch her begin to learn and understand about reading!

She's also exploring more and more with her hands and it seems like she realized this week that we both have hands. She looked at both sides of her hand, then felt her hand with the other, and then examined mine along with the pair. It's also getting easier for her to sit and play with her toys. She has a new stack of rings that she plays with from every different direction.

I am certainly thankful for her naps during the day now that I'm 11 weeks pregnant. I remember wondering during my first trimester with Hannah how anyone could possibly cope with pregnancy and another child. Well, my nightmare has come true and it's hard but manageable. I literally sleep whenever she sleeps. Luckily, I'm not dealing with morning sickness anywhere near the level I had with Hannah. Women often wonder which is worse- nausea or actual vomitting. I can tell you with 100% authority that it is worse to heave.

So, we'll continue on this trend of napping as often as possible and hopefully sometime soon Hannah will sleep through the night. She's getting so close I almost feel rested some mornings when I wake up! I can't wait to get to the glorious second trimester so that I can go back to being a non zombiemom. I'm also going to need to start working on getting back some brownie points as a good wife before the third trimester. Whew! I'm already imagining what a challenge it will be to pick up a baby with a baby belly.

Any Moms of back-to-back babies have advice to offer?

Friday, January 6, 2012

30 Weeks Old

It's been a happy and noisy house ever since the holidays. Hannah babbles all the time and blows noisy bubbles, too. She's been gurgling for quite a while, but has recently become a total chatterbox. Most frequently, she "oohs" "ahhs" and squeals. There are a few prominent consonants in there every once in a while, and she has said, "Hello" to greet me twice this week. I'm so excited that she's taking the first steps toward singing and talking!

Now that Hannah is nearly 7 months old, she is learning to recognize familiar faces and she is developing her opinions. Object permanence is really coming into play. If she drops a toy, she'll look for it and quickly let me know she'd like it back. She also likes to have a toy available while I prepare breakfast and she'll ask about it if it's not there.

Hannah adores our puppy and loves to watch him. She'll sit on the floor with me while we teach him to fetch or look for him from her high chair. I can tell he likes her, too since he always rests outside her door when he has the chance. It's sweet to see a happy relationship forming between the two kids.