Becoming Mother

A book and a blog for first-time mothers

Tag: hospital

We Are Not Used to This

Both kids are now home.

Both of us are trying to work remotely, tagging each other in as the day allows.

We are creating a New Normal.

We are trying “home schooling” and mandated House Clean-Up times and schedules and nipping bad attitudes in the bud.

We are also just trying to not lose our minds.

I consider it an astounding feat that we have managed to limit TV time to less than 3 hours per day. Winning.

Here’s a real conversation that happened this Tuesday, 3/17.

  • Henry: “Is it Sunday?”
  • Me: “No.”
  • Henry: “Oh, it’s Saturday.”
  • Me: “Nope.”
  • Felicity: “No, Henry, it’s Monday.”
  • Me: “No.”
  • Henry: “No, it’s Saint Patri’s Day!”

Aren’t you jealous?

3/17/2020

***

On Thursday, 3/12, the first wave of anxiety hit me with the announcement of the closure of all K-12 schools in Ohio.

On Sunday, 3/15, we learned that all restaurants would be closing to dine-in customers. The second wave of anxiety hit me. Not because we eat out a lot. Not at all. We actually eat a lot at home.

But it felt like the first sign that soon, very soon, public places were not going to be an option for occupying the kid’s time.

Read: No kid’s museum, no indoor parks, no library, no movies, no all-the-typical-places-where-we-might-take-them-to-stay-sane.

I’m not prone to anxiety. I worry, sure, but anxiety? No, not really.

But the thought of losing my go-to methods of occupying the kids, actually, not even really having a break from home life for 2, 3, or 4 months…

Oh, Sweet, Sweet Jesus.

This is fine meme.
Art credit: KC Green

So after driving to at least four stores to find toilet paper (still haven’t found any. Thanks to friend, Cate, for sharing some rolls), my husband decided that we should order take-out from a local Mexican restaurant, while we still can.

But by the time we got home with the food, he had decided to drop us off with the take-out bags and continue his search for needed supplies, as the thought loomed in our heads: When we will be officially told to shelter-in-place? And are we ready for that?

The kids ate the tacos and beans like champs, happily and hungrily. I stared at my food, cold waves of anxiety rising and washing over me again and again. Feelings that I haven’t had since I had my first baby and my mother returned to her home in Minnesota. That feeling of floating alone in the ocean, holding on to a life preserver, not knowing when the circumstances were going to change. Not knowing if a wave was approaching that I couldn’t see. Not knowing if I had the fortitude to hold on. And then all of the guilt because, let’s face it, I am likely to be just fine. A healthy, 30-something in the suburbs.

Before I knew it, the kids were done with their food, and I was still sitting there, thinking of what I needed to do to get ready for a week with my daughter at home.

They abandoned their plates, leaving the mess behind and disappeared somewhere else in the house.

When I realized they didn’t wash their hands before they had gone upstairs, I yelled at them to do so, but remained there, paralyzed, looking at the take-out bags.

But they washed their hands before dinner. Pretty sure they did. Yeah, they did. Or was it just Henry’s hands?

And then the thoughts started.

You can be asymptomatic for up to 24 days. Wash your hands. Cough into your sleeve. Wash your hands to Happy Birthday. You might not even know you have it. Stay home. Don’t go out. Wash your hands. My hands, but also the kids. All the time. Wash three sets of hands, that’s six hands. Every time you enter and exit a room. The virus can live on surfaces for up to two days. It floats in the air. Someone doesn’t need to cough on you–You can just breathe it in. There aren’t enough ventilators and there may not be enough hospital beds. What about my friend who is pregnant? Is she okay? What about Mom? What if she gets it? Can’t think about that. Can’t let the kids see her until this whole thing is over. What happens when the daycares close?

And then, I started eating. One taco. Two tacos. Three tacos. Chips. Beans. More chips. Salsa. More chips. Beans. The second bag of chips. More salsa. Oreos? What the hell. Sugar felt good. Where’s all the chocolate around here? Maybe some ice cream. Oh, there are cones, too. Hm.

Oh my God, I realized. I’m stress eating.

I haven’t stress-eaten in probably 15 years or more.

When my husband got home, we let the kids play alone upstairs while we processed what was happening around us.

“Sweets, people are getting f***ing crazy out there,” he said, eyes wide. “I saw a guy, two older guys actually, at Sam’s with–I swear to God–nothing but Swiss Miss packets in their cart. Just boxes and boxes of Swiss Miss.”

“Shut up,” I said, relieved at having something to laugh about.

“I’m serious. I’m serious,” he assured me.

It felt good to laugh. (Is there anything more attractive, at this moment, than a partner that can genuinely make you laugh? I think not.) And he was more than happy to oblige, with story after story of Ridiculous Carts in Sam’s Club.

“It’s really hitting me,” he said, “just how many people there are that have literally no idea how to cook. They’re like holding these cans of food and saying things like, ‘Could we make this or this?’ ‘What about this?’ There are people walking the aisles of stores with actual faces of fear and panic. I’ve never seen it like this before.”

And welcome to Life in the Time of COVID-19.

A time when we will choose to either battle our internal demons of the fear of scarcity or succumb to them and war with each other. Over toilet paper and Swiss Miss.

Those end-of-the-world disaster and pandemic movies that massaged our basest instincts to flee or fight, it feels like our brains are feeding on them to fuel our daily behaviors.

We didn’t think we would be here.

Disasters on this scale don’t happen to the U.S., right?

They happen in “third world countries.” They happen in places with less technology and fewer resources. They happen in countries without the same number fighter planes, tanks, and missiles.

Turns out, they happen here, too. We are not so special that we get a pass on this one. Perhaps we shouldn’t have disbanded the National Security Council’s pandemic team in 2018 in the name of reducing big government because “we can get them back if we need them.”

But for some global perspective, let’s remember that Syrians continue to run for their lives as Russian planes swoop in and bomb the living hell out of Idlib. Meanwhile, we are experiencing a very, very, very mild version of the panic and fear that these refugees face every day of their lives.

But we are not used to this.

More specifically, affluent White America is not used to this.

We are not used to restrictions and limitations and “unavailable” and “2 per person” and postponing elective surgeries and schools closing for months and church services moved on-line for safety reasons and March Madness being cancelled. (Okay, honestly, that last one doesn’t bother me at all.)

This is Land of Freedom and Choice and Individualism, baby.

Right?

Not today.

Actually, not for the next 2-4 months.

Now, we’ve got to learn how to be Collectivist, to behave in a way that benefits the common good, to postpone or abandon plans, to cooperate and be kind, to put competition aside so that we can protect lives and ensure that we don’t end up holding the hands of our 60-, 70-, and 80- year old loved ones as they die without proper treatment because of health care rationing.

Think about that.

Toilet paper is the least of our worries.

I’m concerned that there is not enough emphasis on looking out for each other and supporting each other through this difficult time.

That’s what led to my meltdown on Monday night this week, as our son came home from his last day of daycare.

No more daycare. No more support, was how it felt to me.

Now, it’s just the four of us.

No help from grandparents.

Now, we will have to alternate work with care-taking. Now, we will have even fewer quiet moments together without the kids.

Our village of friends, daycare, school, after-school programs, libraries, and church just collapsed into the space of our home.

I wasn’t prepared for this. None of us were.

So that’s where I’m at with coping. How about you?

If you’ve got a story about Ridiculous Pandemic Carts, I could really use a laugh.

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.

screenshot_20170207-165547

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

Week 5: The Hospital Bill Arrives (A.K.A. Why You Can’t Shop for Health Care)

One of the major talking points of Republicans about their plans for replacing the Affordable Care Act is that…

“It will encourage Americans to shop around for their health care.”

To which I say…

Bullshit.

“Shopping around” for health care isn’t a thing in the United States.

You cannot shop around when you don’t know the prices ahead of time.

I mean… Duh.

(You also cannot shop around if there is only one hospital in your area, as is true for all Americans who live far from larger cities.)

If we’re “consumers” of health care, shouldn’t we have the same amount of information that we have when we are consumers of cars or computers, or even breakfast cereal?

But we don’t.

We often don’t know how much our health care costs until we tear open the bill that finally comes to our mailbox weeks later.

Surprise!

***

Before we had this baby, I tried to figure out about how much it was going to cost us out-of-pocket.

You know. For budgeting.

For planning our Flexible Spending Accounts.

You know. Because we want to be responsible. Because we want to make sure we’ve saved enough money to cover our health care costs.

We’re not in poor health. We don’t have pre-existing conditions. We’re fairly young. We’re gainfully employed.

Republicans should love us. Any plan put forth by them should definitely benefit us right? We’re kind of what they had in mind for good American health care “consumers.”

But the truth is you can’t blame “consumers” for the complicated mess that is the health insurance industry, nor can you blame them for the high costs of health care. You can’t tell Americans to just save their money and choose wisely.

I tried that approach and it didn’t work. Not because I didn’t try hard enough, but because the system is not designed to be transparent to patients.

The patients are an afterthought.

***

Our health insurance provider had some estimates for the costs of giving birth in the two main hospitals where I live. These costs were based on their negotiated rates for medical procedures with those hospitals.

But they were just estimates.

So I called the hospital’s pricing line, staffed by the billing department, for a more precise answer.

Ha. Ha.

First, no one picked up the line. It went straight to voicemail. Over and over again.

So I left a message.

Someone called me back the next day.

When I asked the billing department’s representative about specific prices for having a baby at their hospital, he said that he couldn’t give me any prices.

The pricing line. Couldn’t give me any prices.

So I got specific. I told him that I would be giving birth in the birthing center that is attached to the hospital, where I would be rooming in with my baby 24/7. So we wouldn’t be using the nursery. Would we be charged a fee for the nursery? I asked.

“Yes,” he said.

“Why?” I asked.

“Because it’s available to you.”

“So how much will the nursery cost us?”

“I can’t quote you a price on that. It all depends on your insurance and how long you stay.”

“But don’t you have average prices for average stays? Anything?”

“We have a price sheet you can look at, but it’s not going to be inclusive of all of your expenses.”

“I’ll take whatever you have,” I said.

So he referred me to this pricing list, published on the hospital’s website. Why he didn’t give this to me at the beginning of the phone call, I’ll never know.

hospital-claim-2

Indeed, these charges showed up on my insurance claim for the birth.

hospital-claim_ink_ink_li

But so did this mysterious $3500 charge. And a boatload of other charges that are all labeled “Ancillaries” and have no identifying characteristics other than a medical code that only medical transcribers can interpret.

hospital-claim-3_ink_li

I mean, really. Don’t I deserve a little more information than this? If we’re going to pay $1800, I’d kind of like to know what it pays for.

So I wait for the hospital bill to show up. Maybe they have more information than my health insurance company.

Not really.

IMG_20170306_134632

From this bill, I can see that the ambiguous $1850 charge on my insurance claim is actually for the “Recovery Room.” But the other charges?

Who can tell?

The underlying message here is,

Please just accept this price. Your insurance company and the hospital have already decided on a negotiated rate and it’s really just best that you accept this price, pay it, and move on. See how expensive this birth was? You’re lucky that your insurance company is paying so much. So just suck it up and pay. There’s no free lunch, Friend.

***

I’m not the only one who has a problem with this.

“Childbirth is the number one reason why people go to the hospital,” reports Vox’s Johnny Harris in this well-researched video on this very topic. He finds that prices for uncomplicated deliveries in the United States vary from $1189 to $11,986.

I have to admit, I am slightly jealous that their out-of-pocket expenses were only $841.

But who am I kidding? Many, many Americans now have deductibles as high as $6000 now, making my $1000 deductible seem enviable.

The truth is that knowing the costs of this birth would have been helpful for me and my husband, but it didn’t break our bank. We earn enough money jointly that we can absorb a financial blow like this.

But what about the millions of Americans who can’t save $5000 to have a baby in a hospital?

What about those Americans who are “too rich” to qualify for Medicaid, but not rich enough to afford any kind of useful health insurance plan? One that doesn’t deter people from seeing the doctor simply because of the cost?

So politicians, quit telling people that they should learn how to make wise choices so they can save for their health care costs.

And quit telling people that they should “shop around” for their health care costs. 

Not only is it demeaning, but often it is completely impossible.

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:

img_20170208_102352

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.

screenshot_20170207-165547

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.

When Pro-Life is Anti-Health

I’m an avid watcher of Samantha Bee.

I love her so much.

In a recent episode of Full Frontal, she dives into the murky intersection of women’s health, abortion, and miscarriage. While the media prefers the clear-cut terms of “pro-life” and “pro-choice,” Samantha Bee has brought together a collection of women’s interviews that demonstrate just how complicated these issues are.

Especially when those issues are governed by a specific set of religious views.

In these interviews, women describe how and why they were denied care by Catholic hospitals that were required to follow a Catholic health care directive that forbade doctors from providing birth control, performing tubal ligations, or performing abortions.

Even if the life of the mother was at risk.

I’ll let these women speak for themselves.

***

Mindy Swank: Forced by a Catholic hospital to continue an unviable pregnancy after her water broke.

“…he tried to breathe, he was turning blue… he wasn’t conscious. It wasn’t a magical time, like people think.”

Dr. Rupa Natarajan: Describes how the directives restricted her ability to care for her patients at the Catholic hospital where she worked.

“…to save her life, I needed to terminate the pregnancy. But because of this religious directive, I had to transfer her to another facility when she was medically unstable.”

Jennafer Norris: Denied a tubal ligation by a Catholic hospital during emergency c-section, even though her life would be at risk if she were to get pregnant again.

“I had to make a choice to survive and to give my child the best option.”

Melanie Jones: Spent two weeks bleeding and in unnecessary pain after a physician at a Catholic facility refused to remove her dislodged IUD.

“…Because my IUD was a non-hormonal type of birth control… (the doctor told me that) the sole purpose of your IUD is to prevent pregnancy, so we can’t help you.”

***

Take a good look at these women.

I hope that you remember them the next time you think that anyone–religion or government–should come between a woman and her health care.

I believe and will always believe that women deserve to be trusted to make the best decision. As Mindy Swank said,

“I was the only person in the world who loved my baby… and yet people who don’t know me and don’t care about us, who never have to live with the repercussions, were making decisions for us. And that just feels very wrong.”

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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