Becoming Mother

A book and a blog for first-time mothers

Tag: health

Postpartum Weight Loss Reality Check

Someone, somewhere started this saying, “Nine months to put it on, Nine months to take it off.”

Ha, I say.

Nine months?

I wish.

For both of my pregnancies, it took a solid 15-18 months to get it all off.

And it took the magic of intermittent fasting to get the last 10 pounds off.

First, disclaimers. Everyone is different (duh) and I’m not a medical professional (obviously).

But here’s what I experienced.

Basically, the experience of pregnancy and birth puts your body into metabolic overload.

Chugga-chugga-choo-choo!

Then, after birth, your body continues in its highest gear for a period time, before it completely powers down. It takes a while for your body to figure out it’s new normal metabolism. We’re talking months. Even if you’re eating well and exercising.

I’ll detail it out here:

Birth – 6 Months Postpartum: The Engine Slows to a Crawl

  • Birth – 1 month postpartum
    • Exercise: Moving self through the house
    • Diet: Eating whatever I was hungry for–and I was hungry a lot
    • Lost 10 pounds

It’s too bad that I was too sleep deprived to fully appreciate how quickly I lost weight in that first month postpartum. Pretty sure I’ll never lose weight that quickly ever again in life.

  • 2 months – 5 months
    • Exercise: Walking, light aerobics and weightlifting, 3-4 days per week
    • Diet: Eating whatever I was hungry for–and I wasn’t hungry as frequently
    • Lost
      • 2 months postpartum: 3 pounds
      • 3 months postpartum: 1 pound
      • 4 months postpartum: 1 pound
      • 5 months postpartum: 1 pound

I started keeping track of my measurements around this time.

Why? I’m sure some of you are asking. Why would you do that to yourself?

A few reasons. First, any change in my measurements gave me motivation to keep going–especially since I started out with six inches to lose from my hips.

  • 6 months
    • Exercise: Light jogging and weightlifting, 5-6 days per week
    • Diet: Keeping intake to 1600-1700 calories per day
    • Lost 0 pounds

Undoubtedly, six months postpartum was my peak dissatisfaction with body. I mean. Really. Lost 0 pounds.

When the dust settled and my body figured out that it wasn’t carrying another human being anymore, my metabolism settled on a nice comfortable rate of losing 1/4 pound per week. It wasn’t the rate that wanted, but at least I was moving in the right direction.

7 months: Second Gear

  • 7 months
    • Exercise: Medium-impact aerobics and weightlifting, 6 days per week
    • Diet: Keeping intake to 1600-1700 calories per day, eating more protein
    • Lost: 2 pounds

At 7 and 8 months postpartum, I had recovered enough (Kegels, ahem) to get back into my higher intensity aerobic training. It was a gradual ramping up of intensity, being careful to avoid injuries. This higher intensity training helped to kick start my metabolism again and begin the path back to my previous fitness level.

8 months – 13 months: Figuring Out How To Keep the Engine Going

  • Exercise: Running and heavy weightlifting, 6 days per week
  • Diet: Aiming for 1500-1600 calories, eating more vegetables and protein
  • Lost
    • 8 months: 3 pounds
    • 9 months: 2 pounds
    • 10 months: 2 pounds
    • 11 months: 1 pound

Over time, I saw my metabolism slow again. At 11 months postpartum, I was still 10 pounds away from my pre-pregnancy weight. And I just wanted to be done with the whole thing.

Nevertheless, I just couldn’t stomach counting calories at all anymore. I had been pretty laissez-faire about it from eight months postpartum onward, but at this point, I just cringed at the thought of keeping any more tallies of calories. Instead, I would just eyeball what I was eating and try to keep meals in an acceptable range.

My husband recommended adding more protein to my diet. So I added some peanut butter to my oatmeal. I didn’t change anything else. Just added the peanut butter.

  • 12 months
    • Exercise: Running and heavy weightlifting, 6 days per week
    • Diet: Not counting calories–added peanut butter to daily oatmeal
    • GAINED 3 pounds

It turns out that adding the peanut butter was not such a great idea. So I went back to my old routines.

  • 13 months
    • Exercise: Running and heavy weightlifting, 6 days per week
    • Diet: Return to old diet without the peanut butter
    • Lost 2 pounds

This is the month when I was ready to do something drastically different. ANYTHING different.

Enough already! I’m running 3.5 miles three times per week! I’m eating healthy! I’m tired of just dropping 1 or 2 pounds a month!

This is when I heard that one of my friends (Thanks, Cate) was doing intermittent fasting. She said that for two days per week, she was restricting her calories to 500 calories. On the other days, she would eat normally.

Oh brother, I thought. That can’t be good for exercising.

“You can exercise,” she told me, after I asked.

“Really?”

“Yeah, look it up.”

So I did.

What’s really funny is that I had been reading The Secret Life of Fat by Sylvia Tara for several months–but I stopped reading just before I got to the section about intermittent fasting.

Secret Life of Fat

There are different ways to do intermittent fasting, and eating 500 calories two days a week didn’t really fit in with my need for daily consistency.

But there was a version that would work great for me: Fasting for 16 hours and eating for 8 hours.

For me, that would mean skipping breakfast. Then eating lunch and dinner.

The idea behind intermittent fasting is to extend your body’s natural fat-burning mode, which happens when you sleep. While you sleep, your body consumes its energy from the day before. When it runs out, it starts burning your fat reserves. As soon as you start eating, your body stops burning fat and starts working on the food. If you can keep your fast going for a few months hours, you give your body a chance to burn more of your fat reserves.

And if you exercise in the morning on top of intermittent fasting?

Powerhouse.

14 months – 18 months: Intermittent Fasting = Quick, Permanent Results

So here’s what happened to me:

  • 14 months
    • Exercise: Running and heavy weightlifting
    • Diet: Eating in an 8-hour-window, 10:00 a.m. – 6:00 p.m., no calorie counting, aim for lots of protein, good fats, and vegetables.
    • Lost 4 pounds
  • 15 months
    • Exercise: Running and heavy weightlifting
    • Diet: Eating in an 8-hour-window, 10:00 a.m. – 6:00 p.m., no calorie counting, aim for lots of protein, good fats, and vegetables
    • Lost 4 pounds

And I’m still going. At almost 18 months postpartum, I’ve returned to my pre-pregnancy weight–and I’ve lost an additional 2 pounds.

If you’re thinking about intermittent fasting, I will say that the first week is probably the hardest. I was extraordinarily hungry until I would eat at 10:00 a.m. But drinking water helped. After a week or so, my body had re-adjusted to a new normal and it’s not nearly so hard to make it to 10 a.m. now, several months later, as it was then.

Not only did I lose weight, but I think that the fasting helped to reset everything in my body.

Read: PMSing and periods have been pretty tame and I haven’t really been sick at all–even though my petri-dish children have given me plenty of chances to travel into the depths with them.

Furthermore, allowing myself to feel hunger for a period of time helped me realize that I was still thinking about hunger from a pregnant mindset. During pregnancy, hunger = nausea. And when I was pregnant, if I allowed myself to go hungry, I paid for it with wanting to throw up.

But not anymore. Now, I can feel hunger again, without the nausea.

More than anything, I’m just thrilled to be back at my old weight, wearing my old clothes, feeling like my old self. It definitely didn’t come easy.

So if you’re out there, trying to lose the baby weight, I’m with ya, girl. It sucks. It really sucks.

My advice to you when you first get into (or back into) exercising: Embrace humility.

No one looks great exercising when they’re first starting out.

And it’s not about “looking hot” anyway, right? You’re over that, right? You just had a baby come out of you. Remember how crazy that was?

Tell yourself you’ve been through harder things then this.

High five to you for hangin’ in there.

I think you’re amazing.

 

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41 weeks, 3 days: Totally done.

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Two days postpartum (No Kate Middleton here. I think she has some special line in her genetic code?)

 

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4 days postpartum

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Two weeks postpartum

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2 months postpartum: Beginning of exercise, still in maternity clothes 

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6 months postpartum: Down to my old yoga pants.

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15 months postpartum: Wearing my old jeans. Jeans, I say!

 

 

The Last Mile

In that last mile, my body remembers Birth

The opening, the stretching

The pain, the power

An explosion of endorphins

Water pouring over flame

I remember Birth’s great paradox,

that very first thought with a newborn in arms,

How can so much Destruction

bring about such Flawlessness?

 

In that last mile, I am part Khaleesi

Circle of Fire

Bearer of Blood

Khaleesi

Someone who burns, but is not consumed

Someone who turns nothing, into something

I remember with my body

I am the Sex that brings Life into this world,

And this is Holy to those who understand

 

In that last mile, I am part Mhysa

I am more than Self

Connected to all the Souls who came before me

and all those who will come after me

Life after Life after Life

Link in the Great Chain

Those whom I will never know

Will never see

Will never touch

But in this space

As my feet slow against the earth

They are here with me

In my breath

In my blood

In my heart

And this is Holy to those who understand

mhysa

Pieces of Parenthood # 4: Good-bye Old Friends

A woman’s best friend in pregnancy isn’t ice cream. Or pickles. Or brownies. Or whatever other non-sense popular media tells you.

No. Her best friend is stretchy pants.

And I was lucky enough to have two best friends.

 

 

They weren’t yoga pants.

They weren’t maternity pants.

They were actually Victoria’s Secret Pillowtalk Pajamas.

These pants were truly made of magic and grace. Magic, because they transformed from Smalls to Ex-Larges, right along with me. Grace, because they didn’t make me feel like any of these changes were inconvenient for them. They moved out of the way. They said, Oh, excuse me for not accommodating you more quickly. Here you go. 

I wore them so much they frayed at the bottom hems.

I wore them mostly around the house.

I admit, I may have worn them to the gas station.

Maybe also Target.

Maybe.

***

I’m now about 8 pounds from my pre-pregnancy weight (which means I’m 37 pounds lighter than my last days of pregnancy. Woot.) One more inch off my hips and I’ll be back in my pre-pregnancy pants and a whole new section of my wardrobe opens back up.

When it’s all stacked and folded like this, it feels like a geological record of the last 21 months of my life.

 

So I say good-bye.

Good-bye to all the postpartum clothes that have served me in all the hard In-Between Phases of transformation.

All those months of looking in the mirror

and not seeing myself at all

and then not really seeing myself

and then not quite seeing myself

and then kind of seeing myself

and then

quite suddenly

seeing that first glimpse of the the version of me that I used to be

Things I Don’t Miss About Being Pregnant (a.k.a. talking about big bellies and peeing)

I was sitting on the couch the other day, working on my laptop, and I pulled my legs up to the cushion and crossed them and thought…

Whoa… Been a while since I’ve been able to do that.

Six months postpartum and 28 pounds lighter–and just now starting to realize that I’m starting to really move past the physical limitations that pregnancy put on my whole body.

From the second trimester until now (October 2016-August 2017), I haven’t felt comfortable with/haven’t been able to…

  • lie on my stomach (duh)
  • lie on my back (heavy uterus on my spine)
  • hunch forward (it cut off my air supply)
  • sit with legs crossed (belly in the way)
  • sit with legs closed (again, the belly)
  • sit much, period (weight of belly would pull me forward)
  • stand in place for a period of time (low back pain)

Now, think about your day. Think about how much time you spent in any of these positions.

Now, take that time away and replace it with either walking or lying on your side. Because that’s how I basically existed for most of Week 40 and 41.

Miserable.

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41 weeks, 3 days

I remember in that last trimester being horrified that my boobs were literally resting on my belly.

And worse, my belly was resting on my thighs.

From my neck to my knees, I just felt like pure belly.

I did not find this reassuring or comforting or magical or any other variation of positive.

I just felt e-nor-mous.

Now that I’m six months postpartum, I’m starting to regain a lot of my old physical self. I can do kickboxing for an hour and running for forty-five minutes. My legs and feet aren’t so swollen that I don’t recognize my legs.

And, hey, I can pee. Normally.

It’s hard to believe that it’s been about a whole year of altered peeing.

At first, it was frequent peeing because of hormones.

Then, it was frequent peeing because of more amniotic fluid.

Then, it was frequent peeing because, geesh, my bladder was completely smooshed under the weight of the baby.

And then, it was my organs moving back into their original places and my brain readjusting my expectations of how long I can go between peeing and then being amazed when, wow, I haven’t peed in two hours and I’m still okay! And, look at that!, I didn’t pee myself when I sneezed!

Woot.

At six months postpartum, a woman’s body (particularly hormones) start returning to pre-pregnancy levels, making it much easier to shed the baby weight. I’ve started to really notice this in the last three weeks. While it took me 5 weeks to lose 1 pound when I was between three and four months postpartum, I’ve now started to drop about 1 pound every two weeks.

To which I say, ” ‘Bout time.”

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4 days postpartum

 

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2 months postpartum

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6 months postpartum

17 pounds left to go.

Bring it.

Why are American Women Dying in Childbirth?

 

American women are more likely to die from complications in pregnancy and childbirth compared to women in any other developed country.

It’s true.

But why?

***

At 1:27 p.m. on February 2, 2017, I gave birth to an 8 lb. 10 oz. boy.

Because there was meconium in my amniotic fluid, a NICU team was paged to be present at the birth to make sure that the baby’s lungs were clear.

Those first minutes after birth were very blurry. There was just too much going on to fully appreciate everything that was happening. From my perspective as the birthing mother, I remember my son turning his head upward and looking me in the eyes (that really happened). I remember seeing that he was a boy. (A boy!?! Really!?! What?!?!)

I remember dropping my head back against the bed and crying in relief that it was over. I remember thinking, “Well, that’s the last time I’m doing that.”

I was euphoric and so, so grateful. We had made it. We had survived that. Both of us. That was what I was thinking.

I did not know that I was hemorrhaging. 

This is the thing about hemorrhaging: It happens so fast.

It happens while mothers are crying from happiness that their baby is alive and breathing. It happens while they’re trying to get a good look at their baby’s face. It happens silently as the room’s atmosphere turns from the intensity and suspense of the pushing phase into joy and excitement of the delivery phase.

No woman wants to believe that it’s going to happen to her. I had none of the risk factors associated with postpartum hemorrhage.

But it still happened to me.

While we were celebrating and crying and basking in the joy of the birth, my midwife was tracking my blood loss. I remember looking down and seeing her furrowed brow every time more blood poured out of me. But I didn’t think anything terrible was happening. I was flooded with joy and gratitude that labor was over.

But in the first ten minutes after birth, more and more nurses entered the room and the treatments started. My midwife told me each treatment that she was doing to stop the bleeding. By this time, I had lost about 1200 mL of blood, about 2.5 pints of blood. In other words, I had lost about 25% of the blood in my entire pregnant body.

Surviving postpartum hemorrhage requires a medical professional who quickly realizes what is happening and starts treatment immediately.

In my case, the midwife tried a shot of Pitocin. When that didn’t work, she gave me Cytotec. When that didn’t work, she gave me IV Pitocin. She kept massaging my uterus. She was on her last treatment before starting a blood transfusion: a shot of methergine.

That’s how close we were to a true emergency.

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My heart rate during labor. You can see exactly when the hemorrhage begins and how my body responded.

 

Hemorrhage is one of the leading causes of death in childbirth.

Causes of Death in Childbirth

Still.

Let me be clear: postpartum hemorrhage isn’t caused by a lack of care. This would probably have happened to me if I had given birth anywhere else.

But women die from hemorrhage when doctors and nurses don’t quickly recognize the amount of blood loss and begin treatment. Some states, like California, have codified and implemented standardized procedures and training for nurses and doctors so that teams can quickly and efficiently follow protocol to prevent postpartum hemorrhages from killing mothers. Instead of “eye-balling” how much blood a mother loses during delivery, nurses were taught how to collect and measure postpartum blood loss to help them quickly identify hemorrhage.

“Hospitals that adopted the toolkit saw a 21 percent decrease in near deaths from maternal bleeding in the first year; hospitals that didn’t use the protocol had a 1.2 percent reduction.”

But not all states have such standardized protocol.

***

A joint investigation by NPR and ProPublica found that more women are dying of complications related to pregnancy and childbirth compared to any other developed country.

In every 100,000 births in the United States, 26 women die. In other developed countries, the numbers range between 5 and 9 births. And those numbers have climbed from 17 to 26 deaths from 2000-2015.

Seriously.

Seriously.

It seems unimaginable. Really? In the United States? But we have so much technology. We have some of the best hospitals in the world.

Maternal Mortality

What the hell is going on?!?

There were several major findings from this investigation.

  1. The U.S. is spending more money on research, equipment, and training for improving infant outcomes. Think of how much progress we have made in helping premature babies and treating newborns born with previously fatal deformities and diseases.
  2. Decreased education and training about caring for birthing mothers, for both doctors and nurses. This leads to a lack of knowledge that is passed on to the mother when she is discharged from the hospital.
  3. Lack of standardized best practices for caring for birthing mothers among the states. Unlike other developed countries, there is no nationwide effort for reducing the maternal death rate in the United States. Responsibility has been left to individual states to decide if and how they investigate maternal deaths.

America has not conquered maternal mortality. We like to think that because we have advanced technology and highly trained medical professionals that tragedies like a woman dying in childbirth just simply don’t happen anymore.

At least not nearly as much as it used to.

It’s a kind of hubris, really. To think that we have mastered childbirth. We have tamed it and told it who’s boss. In fact, we’re so good at childbirth that we should just focus most of our attention on the infants. They’re the ones that are the most vulnerable, right?

But the truth is…

“In recent decades, under the assumption that it had conquered maternal mortality, the American medical system has focused more on fetal and infant safety and survival than on the mother’s health and well-being.”

~Nina Martin & Renee Montagne, “The Last Person You’d Expect to Die in Childbirth”

***

If there was one major takeaway from this report that I want to share with everyone it’s this:

Women still die in childbirth. 

Giving birth in the United States does not guarantee that both mother and baby make it out alive.

I completely agree with the report’s observations that labor and birth put women in the most vulnerable position in their entire lives. They don’t know what’s going on. They’re immersed in the pain and process of labor. Birthing women depend on everyone around them, doctors and nurses alike, to notice the signs that an emergency is unfolding.

If you or someone you know will be giving birth in the United States in the near future, I strongly encourage you to read ProPublica’s full investigative report on this topic.

This is not a political issue. ProPublica is an independent organization that is not funded by political donations.

This is a human issue.

American women are not immune to maternal mortality.

For the women who die every year from pregnancy and childbirth from preventable or treatable conditions, let’s raise our awareness of this problem and insist that we study this at the national level, not just the state level.

We can do better than this.

The death of a new mother is not like any other sudden death. It blasts a hole in the universe.

~Nina Martin and Renee Montagne, “The Last Person You’d Expect to Die in Childbirth

I Wore a FitBit During Pregnancy and Childbirth: Here’s What I Learned

Disclosure: I’m a bit of a data nerd.

Not in the sense that I like to design studies and collect data. Just in the sense that I like to look at charts and graphs and timelines and other visuals.

Call it “data-nerd-light.”

I began wearing a FitBit Charge HR last February, shortly after I started running as a regular form of exercise.

At first, it was useful for keeping track of my exercise. Having information about my sleep patterns and steps was just fun information to use to challenge myself.

Then, in early May 2016, I got pregnant.

Over the course of my pregnancy, I regularly wore my FitBit and amassed loads of interesting data about how my body changed and responded differently to exercise over the course of my pregnancy.

The FitBit Charge HR will monitor your heart rate and calories burned, as well as your number of steps, floors climbed, and miles traveled. Then, it spits out all of this data into usable and easy-to-read charts. (UPDATE: My Charge HR started separating around the display and I had to replace it after 16 months of use. I recently upgraded to the Charge HR 2. It’s just $20 more and much more durable. The bands are replaceable too, so the same problem can’t happen on this model.)

fitbit

I started this pregnancy at 147 pounds (at 5′ 7.5″) and my ending weight was 192 pounds, which is a 45-pound weight gain. My pre-pregnancy condition was quite good. I was running about two miles in the morning every day and lifting weights once or twice per week. I was maintaining my weight. I had good energy. I could climb several flights of stairs without getting winded.

So what does pregnancy do to a healthy body? Let’s take a look.

Resting Heart Rate

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My pre-pregnancy resting heart rate was about 56 beats per minute, a sign of a fairly athletic lifestyle. You can see my heart rate climb steeply in the second trimester when I have my first major growth spurt, and then again in the last trimester during the last month of growth. Both time periods correspond to an increase in blood volume in my body.

Fun fact: at the end of pregnancy, a woman’s blood volume increases 40-50% throughout pregnancy.

Weight Gained

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I put on most of my weight during the second and third trimester growth spurts, and just a few pounds gained in the first trimester. This is a healthy weight gain curve, although, I assure you, it didn’t feel healthy at the time. I remember that I kept thinking, No! Four pounds in a week! This baby is going to be twelve pounds by the end of this!

Daily Calories Burned: Pre-Pregnancy

On the left is a typical day of exercise on a pre-pregnancy day, which includes a two-mile run in the morning and regular movement at work.

On the right is a day that I’m proud of: the day that I ran six miles around the National Mall in Washington D.C. Included in this number are the other calories that I burned throughout the day, just by existing. See the number of calories burned? Keep that in mind as I show you how many calories during the late third trimester.

Daily Calories Burned: First Trimester

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In my first trimester, I continued to run whenever I felt well enough. (Weeks 7-11 were Nausea City, so I limited my exercise to walks during this time.) But I took it easy. I didn’t exercise in the peak heart rate zone if I could help it. I monitored my run pretty closely so I stayed in the lower heart rate zones.

Daily Calories Burned: Second Trimester

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I continued to run in the second trimester. In the early second trimester, I incorporated more indoor aerobic exercise because it was so damn hot outside in late July to August. In this screenshot, you see the end of October, when I was 24 weeks pregnant, right at the end of my second trimester growth spurt.

The important difference is my resting heart rate, which has jumped to 70 beats per minute. Because of that elevated resting heart rate at this point, I was more likely to reach a fat-burning heart rate for daily activities, beyond the time when I was intentionally exercising.

Daily Calories Burned: Early Third Trimester

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I continued to incorporate running in my exercise all the way to 32 weeks of pregnancy, but over time, I slowly decreased my running in favor of walking. By 33 weeks of pregnancy, I was done running. This screenshot is from Week 30. It’s not terribly different from my second trimester stats. Notice that my resting heart rate continues to rise.

Daily Calories Burned: Mid-Third Trimester

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This is when pregnancy becomes an outright test of endurance. This screenshot is from Week 36 (which, for my 41.5-week pregnancy, was mid-third trimester). On this day, I walked for 30 minutes. And I existed. End of story.

I mean, it’s the day after Christmas, for goodness sake. What could I possibly have done? I’m sure I was doing things like eating my fifth sugar cookie and picking up bits of wrapping paper and rogue pine needles. Along with a rousing game of “Ketchup or Mustard?” with our three-year-old. (What? You’ve never heard of that game? You just ask the person if they want ketchup or mustard over and over and over again. That’s it. Fun, huh?)

So that’s why pregnant women say, “God, I’m so tired” at the end of the day. Not only are they carrying around a lot of extra weight, but their resting heart rates are elevated, causing them to be burning loads of calories for hours.

But wait. It gets harder.

Daily Calories Burned: Late-Third Trimester

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Okay. So here I was at five days past my due date. At this point, I was desperate to get this kid out of me. So I decided to go for two thirty-minute walks, which you can clearly see on the graph. My pace was much, much slower than normal because my hips were so gelatinous and my gait was off. But pace isn’t important. It’s getting the heart rate up there that counts.

With just two thirty-minute walks and existing for 24 hours, I burned as many calories as I did when I ran six miles and existed for 24 hours. Courtesy of an elevated resting heart rate and additional body weight.

In addition, my body’s center of gravity was off, it was difficult to move, and I had an assortment of new aches and pains to deal with just to get through the day (and night).

What were your calories burned on the day you gave birth?

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So glad you asked.

Now, I know what you’re thinking. That peak heart rate must have happened during my pushing phase.

Nope.

That was when I started hemorrhaging after the birth. Obviously, this wasn’t part of the plan and it isn’t a typical part of the birthing process for most women (thank God). Only about 4% of women will experience a postpartum hemorrhage. (The most likely cause of my PPH was an “overdistended uterus” due to my baby being over 8.8 pounds.)

As a result, my heart rate soared in the peak heart rate zone for close to an hour. As blood poured out of me, my heart pumped loads of fresh blood to the affected tissues and organs. All of this put my body into metabolic overload and it was the main reason I ate like a crazy person for the first five days post-birth.

Most of my labor raised my heart rate into a low fat-burning zone rate, so it was still important that I ate and drank during labor. This is what I will never understand about typical hospital policies regarding labor. Is it really worth it to deny women the right to eat during labor simply because of the minuscule possibility that 1) she’ll have a C-section and 2) during that C-section she aspirates?

Labor burns a lot of calories. And if you’re restricted to clear fluids, you’re pretty much relying on the sugar in Sierra Mist to pull you through. I think that if you have the urge to eat, you should be allowed to eat. The risk of eating harming a woman in labor is just far too small.

I mean, really… When you are awake for days and laboring for hours and hours, you burn a lot of calories.

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So there you have it. An inside look at one slice of what a woman goes through when she carries a child and gives birth. It is a test of strength and endurance simply to carry a child to term and give birth.

The fact that women give birth so often might make the process seem ordinary, but it is truly an extraordinary feat for both mother and child to come out on the other side, whole and alive.

Hey, what is sleep like after having a baby? Continue on to the following post.

Link: https://becomingmotherblog.com/2018/01/03/i-wore-a-fitbit-for-the-first-year-postpartum-heres-how-much-sleep-i-lost/

 

UPDATE: Just wanted to thank you for stopping by this post, which has been gaining a lot of traffic lately (probably because this post shows up in Google searches that include “pregnancy” and “FitBit.” Ha!) If you’re a new reader, please check out my book, Becoming Mother, available in print ($12.99) or Kindle ($2.99) editions.

Peace.

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What Bleeding Taught Me About Trump’s America

Betsy DeVos. The refugee travel ban. The Syrian War. Trump/Bannon. Alternative facts. The war with the press.

It’s just so much that it nearly paralyzes you.

Then part of you thinks, Hey, it will be okay. Things will work out. They always do. Let’s just see what happens.

To that voice in your mind, I say this:

Fight.

Fight like hell.

Fight for your life.

Fight for the future of this country.

Don’t listen to that voice. Don’t be lulled into thinking that things will take care of themselves.

This country is bleeding. We are bleeding.

It’s true that if we’re healthy, the bleeding will stop on its own. But does it seem like we’re healthy? And if you feel like things are okay, are you blind to the signs that you see from everyone else?

Do you see the pain of others or do you blame them for their pain? Or worse, do you belittle their pain?

Do you realize that you are bleeding? Or will you allow yourself to bleed until you’re too weak to fight anymore?

***

I’ve been thinking a lot about blood loss in the past few days.

Just a week ago, I suffered from a postpartum hemorrhage.

I was afraid something like this would happen. I even wrote about it in my book, Becoming Mother. Dissatisfied with the difficulty of having an unmedicated labor in a traditional hospital setting, I decided to give birth in a natural birthing center attached to a hospital for my second birth.

Sometimes, people would ask me if I would ever be interested in a home birth.

Here’s what I wrote:

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Eerie.

To lose that much blood moves your mind into a place of limbo, caught somewhere between reality and dreams. Awareness and unawareness. The physical and the spiritual. You become light. Hazy. Detached. Almost as if you’re drifting off into sleep.

But it doesn’t feel quite right.

It feels like you’re leaving something behind.

Let me take you into those moments just after it happened to me.

At first, it’s uncontrollable shaking. I’m so, so cold. Nurses cover me with heated blankets upon heated blankets, but still I shake and shake. Then, the weakness. I can barely lift my head from the pillow. The nurses won’t let me walk to the bathroom, so it’s the bedpan for me. Once. Twice. Three times. Four times. With all my strength I push my hips up so the bedpan can slide underneath me.

When they finally let me stand, each of them takes an arm and helps me to my feet. They tell me to look up, not down. They ask me if I’m ready and I say yes.

“Actually, let’s wait on that,” one of them says. “Your lips are blue.”

Then, the fogginess. I can see my husband talking to the nurse, but I don’t immediately understand their words. My understanding is on a several-second delay. The nurse tells me to drink the entire contents of a giant plastic cup of water. I don’t know what to do with it until she puts it in my hands. Using both sight and touch, my thoughts finally click into place. I should drink this.

My husband asks me if I want to eat. I say yes and he hands me the menu. I hold it for a moment, my eyes seeing words that I know are food, but that I don’t understand. Turkey hot shot? What is that? Salmon… is a fish. Salad… Vegetables. Side items are… oh, like fries. Dressings… are for salad. 

The menu falls against my face and I doze off.

But when the food arrives, I eat like a mo-fo.

My husband feeds me bits of burgers, fries, carrot cake, cheesecake, salad, juice, more juice, water, soda, salmon, broccoli, pizza, waffles, sausage, fruit cups, and more. I eat it all and with each bite, a breath of life comes back to me. My mind opens and clears. Voices make more sense.

I feel myself coming back.

The next day is deceptively good. The happiness of new life and the excitement of going home overshadow how hard it is to walk and move from one place to another. I tell myself that I’m already doing better than after my first birth. Look at you move! I praise myself. I didn’t tear this time, so I can sit (mostly) comfortably.

I continue to eat and eat and eat. Chicken, kale smoothies, lamb, mushrooms, baked potatoes covered in butter and salt, granola bars, bananas, apples, thick peanut butter and jelly sandwiches, spoons of peanut butter straight from the jar.

It makes sense later on, this hunger. For fun, I check my Fitbit stats during labor. Look at this.

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I know what you’re thinking. The peak must have been during the pushing phase.

You. Are. Wrong.

That period of peak heart rate happened when I started to hemorrhage. As blood poured out of me, my heart pumped more and more blood to keep delivering oxygen to the tissues and cells that were under attack.

It began after I delivered the placenta. My midwife noticed the bleeding wasn’t slowing. She massaged my uterus. A nurse gave me a shot of Pitocin in my right thigh. Another nurse was prodding my left arm, trying to get an IV started as my tiny veins rolled and rolled. I apologized to her as she stuck me and dug and dug and dug for the vein. Stick after stick.

When the Pitocin didn’t work, the midwife gave me Cytotec.

But I kept bleeding.

The nurse finally got my IV threaded. Pitocin and fluids entered my veins.

But warm blood kept flowing out of me.

If you’re cringing in pain, don’t. All that bleeding was completely painless. My body sent me no signals that I should fear it.

What my body did feel were all the people trying to save me. The nurses, poking and prodding me with needles and IVs. The midwife grinding and massaging my uterus to help it contract. It was those who were working to keep me here that I protested against. My body didn’t understand that those pains were signals of my salvation.

I asked my midwife how much I had lost so far.

“500 ccs is what we usually want to see… You’re probably at 1,000 right now.”

And I kept bleeding.

More uterine massage. I groaned. I moaned. I looked for my baby, but I couldn’t see him. I heard my husband talking and figured that he was the one holding the baby.

I must assure you that I wasn’t afraid when any of this was happening.

You forget.

I just had a baby.

I had climbed the highest mountain I had ever attempted in my life and I had pulled both of us up by fingernails of sheer will and grit. This birth was nothing like my first, which had been a thirty-six hour humbling of body and soul that felt more like spiritual possession.

No, this birth was a struggle. From beginning to end. This birth was a seemingly impossible task that required me to engage and confront over and over again. (Don’t worry: I will write more about this later.)

So as I lay there on the bed, painlessly bleeding life out of me, I was not afraid.

What I was feeling was relief. Peace. Profound gratitude. Love. All covered with the surprise that I had just given birth to a boy.

Then, finally, the drug that works: methergine.

***

The seriousness of what had happened to me did not fully set in until the next day. My husband told me that he could tell from the expressions on the nurses’ faces that the situation was getting tense. That we were probably only minutes from a true emergency.

But hey, I had come through and I was fine. Right?

All’s well that ends well. Time to move on and forget about the whole thing.

After all, I had another hurdle to overcome: establishing breastfeeding.

But just like the last time, inverted nipples and poor milk production have their way with me. Every few hours, I try something new. In the beginning, I use a nipple shield while my husband drops formula from a syringe onto the shield to encourage our baby to not get frustrated and continue to feed. Sometimes, my husband feeds him with a bottle while I pump. Sometimes, I just pump between feedings. Then, I try to get him to latch without the shield.

I don’t realize it at first, but I’ve started to lag behind in my eating and resting.

It’s not something I do on purpose. It happens naturally as my mind focuses on what we can try next to continue breastfeeding.

Then comes the Dreadful Day Four Postpartum. The day when my body starts to register the absence of my placenta, which just days ago was flooding my body with estrogen and progesterone. But now, like a baby rooting for nourishment, my body cries out for that hormonal lifeline that is no longer there and will never return.

This is when the shit hits the fan for me.

At first, I’m doing okay. Marveling that I’m not the sobbing, crying mess that I was with my daughter. After my first birth, I would be tearful and weepy all day long. But it’s different this time. I tear up every now and then, but I’m mostly composed and collected. Is it because of some different hormonal cocktail that I’m experiencing because I had a boy instead of a girl?

But at the end of the Day Four Postpartum, I’ve decided to stop breastfeeding. I climb the stairs to where my baby boy is sleeping in the bouncer, and I have to stop to catch my breath. My Fitbit reads 116, 115, 117, 114, a fat-burning heartrate. I hold onto the walls and allow my breathing to slow.

Then I see his face and it’s over.

The crying starts. The choking sobs build and I don’t make an effort to push them down. I close the door and let it out. All of it. I let all of the thoughts surface. All of the memories of when I stopped breastfeeding my daughter come forth, as clear as the day they happened three years ago. I let them come and talk to me. I let every doubt and fear and reassurance express its voice.

I don’t deny myself the right to feel any of it.

These are my emotions and I’ve learned that I need to let them out.

One voice says:

You shouldn’t give up yet. We have so much breastfeeding stuff! Pillows and the pump, nursing pads and bottles, lanolin lotion and nipple shields. Your milk is coming in this time. Give it a chance!

Another voice says:

You did all you could. It’s okay. You know he’s going to be fine. You know it. And fuck anyone who even subtly holds this over your head. They don’t understand. 

But the loudest voice of all says:

Sharon, seriously. You cannot do this again. Your body cannot go through that hell again. This is the last baby you will give birth to and hold and care for. Don’t you dare rob yourself of the joy of enjoying your child. 

That final voice is right. I know it.

But, God, it still hurts.

I call for Doug and he holds me while I cry. But now the afterbirth pains have skyrocketed because of the weeping and I’m moaning in pain. Doug leaves for a moment and I’m in the bathroom, feeling a tiny stream of blood falling from me. And when I stand, a golf ball sized clot falls into my hand.

That blob of jet black jelly now stains my skin blood red.

I shudder.

I call for Doug.

***

But it gets better.

The next day, I’m relieved that the weaning has begun.

But then the tiredness has returned. At the baby’s first doctor’s appointment, the pediatrician comments that I look really pale.

In the car on the way home, I review my hospital bloodwork that was drawn on the day after the birth by accessing my on-line records. My hemoglobin and hemocrit are way down. I read a brochure about life after a postpartum hemorrhage and I understand that I need to take this more seriously.

I need iron. I need to eat and eat and eat. And rest and rest and rest.

So I do. Eating and resting is what I do.

After I make breakfast, I’m completely spent. So I eat and sleep. Then I rise and I shower. I sleep again. I get up and eat lunch. I rest on the couch and talk with my mother. I sleep some more. I eat a huge snack and I sleep again. I let my friends bring food and I eat and eat more. I sleep.

I do not do the dishes.

I do not do laundry or even pick up my clothes.

I don’t take out the garbage or get the mail.

I forget about any plans to go on a walk anytime soon.

Instead, I conserve and gather my strength.

Every time I eat, I feel life coming back into me. I feel my body swallowing life whole and absorbing it.

I feel reconnected. I feel my mind hook into awareness and reality.

I start to crawl back to the living.

***

This is what I want you to understand about blood loss: it doesn’t just get better on its own.

You have to know that you are not okay. But to know that you’re not okay, you have to rely on more than just your instinct to respond to pain.

Bleeding is painless. It’s the wound that hurts. It’s the attempts to stop the bleeding that hurt. And once the bleeding is over, you can still be slaughtered by it if you don’t equip yourself with enough armor for the battle. If you spend too much of your energy preoccupied with things that don’t ultimately matter, you have halfway lost that battle. And once you realize that you are too weak to fight, it will be too late.

Right now, I am tired. I am weak. I am worn.

Right now, I’m fighting to bring myself back to independence. Part of it is because I didn’t appreciate my own condition. Part of it is because I neglected to understand my own limitations. That instead of pouring energy into nursing, I should have been strictly eating and resting.

Right now, I fight for myself and for my son and we are slowly winning. I look down at his face.

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And I think, we are going to be okay.

But not because things naturally become okay.

Far from it.

We will be okay because I’m recognizing and engaging this weakness and tiredness. I’m conquering it with food, food, more food, and rest.

I am not sitting back and assuming that my body will naturally take care of itself.

This is a struggle.

The same is true of our country. If we sit back and assume that our county will be okay because God blesses the USA and screw everyone else in the world, we are in for destruction.

Things don’t naturally become okay. We need to work for it.

But when I read the news, do you know what I see?

Hope.

That’s right. Hope.

I see so many of you fighting. Protesting. Calling our senators and representatives. Even my husband now has Senators Rob Portman and Sherrod Brown on his speed dial and is planning a group meeting to sit down to talk with our U.S. House representative.

Many of you are responding to the pain of watching your rights and freedoms threatened. The right for every child to access good public education. Freedom of speech. Freedom of the press. The right for every American to have health care.

These battles are good and just.

But we need to vigilantly search for the ways that we are painlessly bleeding.

Where is our attention and what are we missing?

Men, do you fight for women’s equal pay?

White Americans, do you speak out against racial profiling?

Cis-gender Americans, do you squash the laughter when someone points at a transgender person?

U.S. citizens, do you fight to create a welcoming environment for those who are fleeing war and systematic killings on par with the Holocaust?

Christians, do you seek to understand your Muslim brothers and sisters? Or do you paint them all with the same broad brush of suspicion?

Which wounds do we not feel or see yet?

When you can’t see your own wounds, you need to be willing to hear when others tell you that you need help.

Because we need you. We cannot afford to blind ourselves from the truth of what is happening.

Because we are fighting for this future.

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We are fighting for this planet because, in the end, this is what we truly leave behind for our children and grandchildren.

We are fighting against insatiable greed for power and the deceit that feeds it.

We are fighting because we see ourselves in those who are fleeing war and displacement and fear.

We are fighting because we understand that it’s not such a crazy reality to imagine that we could be the ones who are fleeing next.

We are fighting for the future.

For life.

For love.

This world still smells like everything I hate

But I’m learning to love, ’til that’s just not the case

And all my friends, they feel the same way too

We look inside the mirror, and all we see is you.

The water’s still rushing and the blood is still gushing

From the wound you left inside.

….

My eyes have seen the glory of your love

And I won’t turn back this time.

No I won’t turn back this time.

Week 40: Ticking Time Bomb

Tick, tick, tick.

I knew it was possible that I would go beyond my due date again. I went to 40 weeks and 5 days with my first child.

But who really wants to believe that they’ll be put through that again?

But, here we are.

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So what do you do when you’re past your due date?

Hand off responsibility of raising your children. Let Grandma take center stage. Send your kid to daycare without an ounce of guilt. If you can’t do either of those, turn on the TV and embrace the zombification of your kids because it’s preserving your sanity.

Walk. Because it’s the only exercise you can really handle at this point. And moving at least 30 minutes a day gives you a better chance of going into labor.

Do yoga. Practice your breathing. Get in some good down-dog and butterfly poses.

Lie on your side. Because it takes the weight out of your back and pelvis. Which now feel like jelly.

Avoid people. Or at least the people with whom you have to engage in small talk. You don’t want to constantly think about the fact that you’re beyond your due date. But it’s the only thing on everyone else’s mind. Don’t get pissed about it. They either can’t help themselves or they don’t know what else to talk about with you.

Read. Start books that you don’t mind if you don’t finish. Because you probably won’t.

Nap. This is the best part. By far. Especially since you’re only sleeping in 45 minutes increments throughout the night now. Because you need to pee, or shift sides, or eat at 3:00 a.m. (Because, of course, the baby is hungry again.)

Google the probability of going into labor on this particular day. I liked this website. I currently have a 57.93% chance of going into labor today. Tomorrow, the probability increases to 61.79%.

Do puzzles. This one is driving me nuts right now. But I’ve got a feeling I’m ready to bust this case wide open.

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Write. Whatever you want. Without much thought. Because it’s mostly about passing time and not so much about imparting words of wisdom.

Be still. Honor the beauty of silence and suspension. Because soon the day will be full of crying and cooing, dishes and laundry, visitors and friends.

Let go of the perpetual need to accomplish. Because soon “accomplishing” will have much, much different definitions than it does today.

 

On Using the Snotsucker: A Letter to My Colleague

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Last weekend, one of my colleagues became a father for the first time. Thinking we had plenty of time, our work planned to have a baby shower for them today. Well, life happens, and his wife gave birth a full three weeks before her due date.

A healthy (8 pound!) baby girl.

Our work is still hosting a shower for them today. And frankly, my hat is off to these new parents if they actually show up to this shower when their baby is not even one week old yet.

Unfortunately, I won’t be able to attend.

Still, I wanted to do something nice for them, beyond the typical baby registry items. So I emailed my colleague and asked him what they still needed. He requested some diapers, size 3, for the future. I got those.

But what else?

What else could I get them that would actually be something they would really need as first-time parents?

Then it came to me.

The Nosefrida.

A.K.A. “The Snotsucker”

nosefrida

But such a gift would require some explanation.

So here is the letter that I wrote to go along with my colleague’s gift.

***

Colleague,

Okay, so listen.

Your baby is going to get sick.

Maybe (hopefully) not right away. But she will get sick. And it’s going to suck. Big time. Not just because it hurts to see your kid in pain, but also because you don’t get any sleep if your kid doesn’t get any sleep.

And your kid can’t sleep if she’s so congested with thick mucus that she keeps coughing. And bonus, she can’t blow her nose either.

So with that in mind, I’m presenting you with several items that can help you get through a bad cold. Not all colds will require this level of care. But—God forbid—if she gets RSV (Respiratory Syncytial Virus), getting out that thick mucus could save you from a trip to Children’s Medical Center (and the hefty bill that goes along with that.)

Looking at the Nosefrida (A.K.A. “The Snotsucker”), I know what you might be thinking.

Ain’t no way I’m doing that to my kid! Sick! That’s sooo gross! Forget it!

I thought that, too. And hey, I completely understand the repulsion that drives you to arrive at that decision. In fact, go ahead and continue to think that. You are totally justified in thinking that. It seems rational. It makes sense now.

You’re thinking, I hate snot! You don’t understand. I really have a gag reflex. I’ll puke all over my kid at the very thought of sucking snot out of my kid’s nose!

Yes, I know how you’re feeling. Go ahead and continue to feel that way.

As long as your child is healthy.

But when it’s 2:00 a.m. and your kid has been coughing and coughing and coughing… And you know she’s not going to get better unless she sleeps… And you are out of your mind without sleep… You’ll try anything.

So when you’re ready to “try anything,” here’s what you do.

  • Get your wife. You will need two people to do this.
  • One of you holds your daughter’s head in place. She’s not going to like this at first.
  • The other person sprays the saline mist into each nostril. Be prepared. Your daughter is going to cough. And if she’s a hefty cougher, she might take it too far and actually puke. It probably won’t happen. But better to be prepared.
  • Get the Nosefrida. Make sure the blue spongy filter is in place.
  • Put the light blue end of the Nosefrida up to your baby’s nostrils. Pin the other nostril closed with your finger.
  • Put the red part of the Nosefrida into your mouth.
  • Suck in air. As hard as you can. If you need to empty the gunk in the blue tube into the sink before doing the other side, do that.
  • Repeat on the other side.
  • Wipe your baby’s nose with a Boogie Wipe. They will keep her nose from getting too raw.

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  • Evaluate if you need to repeat. Listen to her to determine if her breathing is less rattling.
  • Comfort her back to sleep in whatever way works for her.
  • If you have a humidifier (and I recommend you get one), turn it on close enough to where she sleeps so her breathing passages don’t get too dry. This is especially useful in the winter.

So there are my tips for getting through that first awful cold. Like I said, not every cold is going to require this level of care. But some do. And having things on hand to help you get through it will make life a lot easier.

One last little truth. Even though taking care of a baby can be tough, the love that you have for your child numbs you to how hard it really is. You’ll get through it.

Wishing you both all the very best,

Sharon

(P.S. Here is my cell phone number in case you need clarification on what to do.)

Global Billing: Wait, You Want Me to Pay Before the Baby is Born?

Let’s imagine that I need knee surgery.

Let’s say the total estimated expenses for my knee surgery are $20,000.

I have “fairly good” health insurance (at least these days…) so I will pay my $1000 deductible and then 20% of the total costs as co-insurance, which is $4000. And of course, we’ll be paying with our credit card which has a 10% APR (because who has $5200 in their savings account anymore?)

When will I pay for these costs? After I have the knee surgery, right?

Ah, but then the surgeon says, “Yeah, we’re going to need you to pay for the procedure in full, at least a month before your scheduled surgery.”

Wait, what?

Seriously?

And this is becoming a standard practice for obstetricians now. Take a look at these discussion forums, in which mothers talk about the different variations of this wonderful billing protocol called “global billing.”

In some cases, you may have the added bonus of paying two deductibles if your baby was conceived in one calendar year, but born in the next. (Which, by the way, is anyone who conceives a baby from April-December.)

(And in case you’re wondering, it’s also terribly expensive to not have a baby. When I miscarried last year, our out-of-pocket expenses were $1500 for a D&C.)

Global billing can be useful. It simplifies all the billing involved in prenatal care by bundling all the prenatal visits and the obstetrician’s fees for delivery into one big package.

When I had my first child, that obstetrician also practiced global billing, but she didn’t send me a bill until all the services were performed. Then, we got a big, fat $3000 bill about a month after our daughter was born.

That was exciting.

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***

With this pregnancy, our estimated out-of-pocket expenses begin at about $1400, just for prenatal visits and delivery.

And then there’s that lovely line in the letter explaining that they would like to start immediately collecting payment for all of these services… at my next appointment.

At 23 weeks.

Oh, and…

“These fees are to be paid in full by the 35th week of your pregnancy.”

Their administrative assistant delicately told me that these expenses would not include the hospital costs or ultrasounds.

So let’s add those expenses here:

  • One ultrasound at 20 weeks. (about $300)
  • Any non-stress tests.
  • My hospital bed for 2 days: $1720 (20% of $8600)
  • My baby’s bed in the nursery for 2 days: $1120 (20% of $5600)

Even if I don’t use it. That’s right. Even if I room-in the whole time, I will be paying for the availability of the nursery bed. Ha!

  • Anesthesiology fees, if I have that.
  • That newborn hearing test machine that will roll into my room and seem like a good idea. ($400. Not covered by insurance).

I mean, really. What other medical procedures do physicians require to be paid for in full before you have them done?

And by the way, I really hate referring to birth as a medical procedure. I did all the work until the baby came out. I humbly acknowledge how many people were required to pick up the aftermath of the birth and take care of me during recovery, but I was the one doing the “medical procedure” for the first 34 hours.

Maybe I should be paid. Ha!

When I told my husband about all of this, his response was, “They aren’t getting a dime until after January 1st!”

You know, when next year’s FSA accounts go into effect.

You know, after the baby is born.

The good news is the hospital’s billing department is agreeing to let us start paying after January 1st. Nice of them, huh?

But really, isn’t it a bit strange that we have to request this?

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