The Pod is gone! Which means this weekend Lonnie worked his behind off lugging in all sorts of stuff that we don’t really know what to do with (a lot of it, mine, including an art studio and kindergarten classroom’s worth of stuff, which, uh, does not have a home in this house). What to do? Now we have a new pile of boxes to unload, and furniture to arrange (or purge), but at least its in and we can slowly start to process it all. Or, well, someone can, I am not of much use, unfortunately.
Working on a "birth plan" today. It seemed like a huge deal the first time around, and then we found nobody really looked or cared about it at the hospital. Of course, in some ways it is really just a guide for you, so that you can remember and remind folks what is important to you at the time, but in the heat of the moment, and amidst all the hospital routines and procedures, I found a lot of it was mostly lost/forgotten during Emma’s birth.
We have to be even more flexible this time around, with all the unknowns of twins, and possible prematurity issues. And I know you can never really KNOW how things will go, so in some ways it seems silly to even try. But I also don’t want to just give in and let the nurses and doctors completely manage my labor and delivery, and early postpartum& baby care, either. Some of things on my mind:
the epidural. In my ideal world, I would like to attempt a natural birth, sans meds (I worry about the side effects of an epi or other meds on the babies — mainly, sleepiness, and poor muscle tone, which means difficulties with sucking). My docs all agree they want one in place and going by pushing stage (or earlier) so that manipulating baby B (basically, shoving whole arm in an yanking kid out) is easier, or in case an emergency C-section is needed. If I did not have it, they might have to put me under general anesthesia to do the emergency C. That would suck, definitely. As would the whole manipulation/yanking baby out thing, without an epi.
There is sometimes the option of having an epi placed, tested, and then turned off, ideally early in labor before the contractions don’t ramp up too much (so that you don’t have an hour of no pain, and then get plunged back into it, without time to get used to it). Then it can be turned on later, when the docs want it, and the babies get less exposure overall. While I am kindof hoping for this option, it seems a bit iffy and very dependent on the specific anesthesiologist/doctors I am working with.
Of course, if I have the kind of pain/labor I had with Emma, I will want the epi, anyway, so this will all be moot. Though we do have a doula that will hopefully be helping me try different pain management techniques. And supposedly second labors can be easier. We shall see.
The other things that seem really up in the air is how things will go once the babies are out. Ideally I would get to hold and nurse the babies as soon as they are out, within the first hour at least (it was longer than that with Emma, for reasons that are still unclear to me) , but being in the OR (required for twins), and having them likely slightly premature, this will probably not happen. Boo.
There’s a whole lot of other breastfeeding related issues that are also on my mind, like allowing for lots of kangaroo care and nursing attempts early on, health permitting. I know most NICU’s lean towards the theory that bottle feeding is easier and less tiring for the babies, though I have read things that have said otherwise — there are so many stories out there of quite tiny and premature babies latching and nursing effectively. We had so many suck and latch issues with Emma, which I think could be partly due to very early pacifier and bottle use, but again, with premature babies in the NICU or special care nursery, I think that could be a very hard battle to fight (I have heard good things about syringe and finger feeding as an alternative, but will they let us try it?). I guess this is all stuff we will have to play by ear, depending on the size and health of the babies. Its hard to not have a plan, though, on something that is so important to me.
In other news, I think I may be developing PUPPPS. Ugh. Scratch scratch, itch, itch! Luckily, its not really bad yet, and I know the end is in sight, sooner, rather than later. Its certainly something a pregnancy thing I can handle, and I’ll take it over more serious side effects, that could actually affect my or the babies health…
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Hang in there! I hope that the nurses and Dr. who are on call when you deliver will totally respect your birthplan and desire to breastfeed as soon as possible. I’m praying that the twins need little NICU (none!) time and are home with you and breastfeeding beautifully as soon as possible. Oh, and somehow part of my last comment was embedded into your 3rd paragraph