August 3, 2017

Thoughts on Pregnancy, Labor, Delivery, & Taking Care of an Infant

Content Warning: This is a no-holds barred post that will go into graphic detail about my personal experience with pregnancy, labor, delivery, breastfeeding and other aspects of taking care of Zoe. Likely lots of TMI.

Links within this blog post to products or services are using referral or affiliate programs so I'll get a kickback if you click through and buy, but these are all my own opinions and I was not paid to promote any of them, except where noted.

Pre-Pregnancy
It took me over a decade of wavering between "sure, I could see myself having kids" and "no way, I don't think I want to sign myself up for that" before I decided to make the huge, life-changing decision to have a baby. I'd read a wide gamut of books and articles about it, both fiction and non-fiction, so I felt sufficiently apprised of the hardship and suffering that went along with having a bundle of joy, but had trouble seeing why I would want to introduce that to my relatively uncomplicated life.

A few things happened that changed my perspective on the matter. First, I spent about half a year to a year going through an existential crisis because I felt like I should be happier than I was. I had all the ingredients to being content, yet I was dissatisfied. I eventually realized that life is not just about trying to be as happy as possible. Then, my partner and I became serious in our relationship and he wanted to have kids. But more importantly, he gave me the space to decide whether or not that was for me and assured me that he would be parenting alongside me and that I wouldn't be alone in raising a kid, which always seemed to be my main source of stress whenever I imagined having a kid. And finally, during a lunch with a childhood friend where we were discussing kids, my friend told me what a friend had told him, that having kids was "a crazy stupid thing to do, but he'd be damned if he was going to miss out on that adventure."

We planned when we would start trying carefully, so I wouldn't be possibly pregnant during a trip to Alaska or various festivals, but I stopped drinking just in case and so did my partner. We went on our honeymoon and about two weeks afterwards, on Thursday October 6th, I had a positive pregnancy test. I had an inkling that I might be pregnant, but put off taking a test because I had already taken a few earlier and felt like I was over eager already. So I was in the middle of brushing my teeth as I waited for the test result to show up. And when that second line showed up, I called for my partner, but since I was still brushing my teeth, I had to nod towards the pregnancy test and he waited awkwardly until I finished to celebrate. We told both sets of parents and our siblings that same day and our friend who we asked to be our doula.

1st Trimester
The first trimester was mostly checking my underwear every time I peed for signs of blood and being stressed out about having a pregnancy loss until my doula finally just told me it was more important to not be stressed out and that there wasn't anything I could do about it if it did happen.

I was also lucky in terms of morning sickness. I only threw up twice during the entire process. Once at work before I had gotten pregnant at all, when I had my prenatal vitamin without having had breakfast first. I felt so nauseous that I had cold sweats and ended up throwing up in the wastebasket next to my desk. The second time was during labor, which I'll go into more gory detail about later. Instead, I had mild nausea, which made eating healthy a struggle, and I ate only enough to feel no longer hungry.

My partner did all of the work of meal planning and making sure I was eating healthy during my entire pregnancy. Every morning he made me breakfast and a smoothie that was packed with veggies and fruit and other proteins, because I didn't really want to eat any vegetables. The smoothie was actually my idea because I worried about being constipated and thought the smoothie would be an easy way to get lots of fiber. I also found that because of the mild nausea, I could no longer tell whether or not I was getting hungry, until it was too late and my stomach started to hurt. So I had breakfast, then a mid-morning snack, then a small lunch, then a mid-afternoon snack, and then dinner.

I also almost immediately stopped sleeping through the night, having to get up in the middle of the night to go pee. I was very thirsty all the time, which at first I worried about, that it might be a sign of gestational diabetes (it was not, I was fine).

We moved into a new apartment that month and I helped clean the old apartment's kitchen with my brother, until the cleaning fumes started to make me feel lightheaded and then we all decided to just bail. We didn't even vacuum. I wasn't around for the actual move either, we had hired movers and my partner and my brother worked with them, and I went to a coffee shop and read a book.

That was a theme throughout the pregnancy, no lifting of anything remotely heavy and trying to be as low stress as possible. Emotionally, I definitely started to have moments where I would be crying over something seemingly inconsequential. The first time it happened, it was in the middle of the night, when I got up to go to the bathroom I stumbled a little and sat/fell on the bed. I was fine, but it spooked me something fierce. I think part of it was the realization that my balance, and thus my body, was no longer just mine and that this was one of many changes that I'd experience. My partner went and bought motion-sensitive lights that ran on batteries and placed them around the bed so they would light up as I went past.

It was mostly during this trimester that I had the heightened sense of smell, which seems like a cool super power, but it turns out that most of the world smells bad. I had to hold my breath going past garbage containers and the smell of mushrooms, which I usually love, made me feel nauseous.

We decided to go with the midwives at Swedish First Hill, mostly because I saw a picture on Facebook of my doula and one of the midwives with an acquaintance and her baby and thought the midwife looked nice. It was a great choice. There was always ample time to have all of our questions answered at the appointments. Early on, one of my questions was what a typical labor and delivery looked like, which, having all of my knowledge on the subject from TV and movies, was very illuminating. I had a lot of misconceptions, the main one being that when someone said they had a 27 hour labor, I thought that meant they were physically pushing for that long. Turns out, that's not true at all.

We got to meet almost all of the midwives during the pregnancy, though it just so happened that the midwife that delivered Zoe was one that we had not had an appointment with and had just met during one of the monthly "Meet the Midwives" events. However, we liked and were impressed by her even from that short meeting and were completely confident and secure in her abilities.

2nd Trimester
As soon as the 2nd trimester started, my mild nausea went away, but I wasn't as ravenously hungry as I had been led to believe from the media. I chalked it up to being used to eating just enough from the 1st trimester. I was a little disappointed though because I thought I'd be able to tuck away as much as I liked, but instead, my stomach felt smaller (probably because it was starting to get crowded in my midsection), and I just ate small meals throughout the day.

We announced the pregnancy on my partner's birthday, mostly because I had commissioned an art piece by our good friend Teo Acosta as a birthday present that also doubled as the announcement. We had a wonderful Christmas with my partner's family in Sacramento, where they stocked up on all the foods and drinks I liked and we took walks with his sister's dog, Bella.

It's true what they say about feeling the best during this trimester, I felt almost normal. I started walking slower and we were especially concerned during our New Year's trip to Vancouver BC because it was horribly icy and snowy. I continued to be involved in political actions, volunteering, and social activities. In March, we went on our babymoon with my partner's parents to Maui and had a fun, relaxing vacation and I had a great time floating in the pool. The only downside was when I had to get out of the pool, I felt like I weighed a million pounds!

I continued to have heightened emotions. For example, after we got back from our trip to Hawaii, we went to go see the movie Get Out. I don't typically do scary movies, but I didn't know anything about this movie besides that it somehow dealt with Black issues, so I assumed it was like Moonlight. My partner wanted to go see Get Out and so I bought tickets. He had heard a bit more about it than I had and thought me knowing nothing about the movie would help avoid spoilers, and didn't think about the fact that I didn't like scary movies. I screamed four or five times throughout the movie. At the end of the movie, as the credits were rolling, I turned to him and said, "Why didn't you tell me this was a scary movie?! I was so stressed out during the whole thing!" And upon reflecting on all the scary things that happened, I burst into tears, stress crying for a minute before we could get up and leave. I could almost immediately see the humor in the situation, like, oh this'll be a funny story later, but as I'm saying that, I'm still crying. He felt very bad about it of course (though he felt bad also because he really liked the movie), and we went and had Katsu Burger with all the fixings and only did relaxing things the rest of the day to help calm me down.

3rd Trimester
The number of times I had to get up in the middle of the night to go pee continued to increase. I started walking even slower everywhere and tried to cut back on activities as much as possible. I had one baby shower at work and another one at home. And we started the Childbirth Prep five week course, which had a lot of great information and went over in detail the various things that could happen during labor. By the time Zoe was born, I had gained about 25 lbs.

I read couple of articles about the use of VR to manage chronic pain and specifically in labor and since we had several friends in the VR gaming industry, I put the feelers out and our friend Tim Cullings very graciously lent me an Oculus headset. Unfortunately, my labor wasn't as clear cut as we were taught from our childbirth class, so we weren't able to try it out.

People finally started noticing that I was pregnant when I was on public transport and would start giving up their seat for me. I took the week before Zoe's due date off from work and that was really nice. My partner's parents were in town and we got to spend time with them and have some food adventures. It was relaxing and gave me some time to finish all the little pre-baby tasks that I felt like still needed to get done.

Labor & Delivery
The night before, I didn't sleep well, my partner and I had an emotionally-charged discussion about how I could be more comfortable in bed and he ended up sleeping on the ground.

That morning, Saturday, June 10th, 2017, we got up early so that we could take his parents to Bakery Nouveau. We bought lots of delicious pastries and had a wonderful brunch at home before we spent the rest of the morning doing organizing chores for baby stuff. Turns out that would be the last meal I would have for the rest of that day. Good thing it was heavy on the carbs!

On the walk back from the bakery was probably when I first noticed that I was feeling a bit poorly, which I only noticed because occasionally I would feel better. It was like a constant low-grade cramp that had no distinct start and the only way I noticed that it stopped was when I suddenly felt better. I wasn't able to do much else but direct everyone in what needed to be accomplished and at one point, I went into the bedroom and got on the bed on all fours, kind of in a pregnant person's child's pose with my butt in the air and just stayed like that until my partner finally came in the room and found me. I remember thinking, I could maybe be in labor right now and no one is with me, everyone is busy elsewhere and not paying any attention to me. *pouts*

I told my partner that I didn't feel well and that I had noticed some mucous-y discharge. I decided to message my doula on Facebook at 12:43 PM (fun fact, almost exactly 12 hours later, I'd have Zoe), but after an hour, decided to give her a call. I sat on the yoga ball in the living room while I made the call and explained to her how I was feeling and something about putting it into words made me start to cry. I was anxious and unsure about what was happening, but she told me to try taking a warm bath. We managed to get the tub filled with about a foot or so of water before I got in, but the stopper wasn't in the tub so the water was draining out. Then, when we found the stopper and put it in and tried putting more water in, it turned out that the hot water had run out. And so we started a train of hot water that had been boiled in pots on the stove and in the electric kettle and then finally brought to the bathroom to be poured into the tub. I felt like I had been transported back to the Middle Ages. Eventually there was hot water from the faucet again and my partner stayed in the bathroom with me and poured water over the parts of me that weren't able to be fully submerged in the tub. That whole process probably took a couple hours. Then I got out of the tub to go to the bathroom and when I wiped, there was some blood, so we called the midwives. Since I was Group B Strep positive, they wanted to give me antibiotics at least twice before the baby was born, and they told me that if my water broke, I was supposed to go straight to the hospital so they could start the antibiotics. I wasn't sure if my water might have broken while I was in the tub, so they told me to go ahead and go to the hospital and get triaged.

We quickly gathered the rest of the items that needed to be in the "Going to the Hospital bag" and then my partner's parents drove us to the hospital. Of course, in our rush, my partner neglected to bring anything for himself, but his parents brought him a change of clothes later.

I was definitely uncomfortable at that point, it felt like when everything is slightly dulled and surreal because you don't feel well or hadn't gotten enough sleep. But I could still walk and knew where to go to get to the birth suites. It was about 3:30 PM.

While I was in triage, they put a blood pressure monitor on my arm and when it inflated, it hurt pretty bad and cut off circulation to my arm so that my hand and arm went numb. The nurse told me it'd go off every ten minutes. She also put other monitors on my belly to monitor the baby's heartbeat and the contractions. Then she leaves.

The longest ten minutes of my life go by and at some point, I ask my partner, "How has it not been ten minutes yet?" I'm pretty sure at this point that I'm going through contractions. He's like, oh, it's definitely been at least ten minutes. I mention that the blood pressure arm cuff monitor hasn't gone off, which was what I had been using to measure time by. I ask him to go tell the nurses. The nurse comes back in and is all like, oh whoops, forgot to press a button! I make a joke about how it felt like the longest ten minutes of my life.

At some point later, my water does break while I'm on the triage bed. The midwife on call, Marilyn Derksen, comes in and checks the monitors and asks some questions. They tell me I couldn't tell when I was having a contraction because they were pretty much right on top of each other. They tell me that the good news was that they were going to admit me and that when I left, I'd have a baby. I mostly just felt relief because now that I was at the hospital, it didn't matter what my body decided it wanted to do, someone else would be cleaning it up.

They have me walk to the birth suite assigned to me, which was close enough that even though I wanted to pee, they forced me to walk to the suite (leaning heavily on the nurse), because it had its own private bathroom. In retrospect, they probably wanted me to use that one so they would have one less bathroom to clean my blood from.

They made me get up on the bed so that they could take more vitals, get the monitors on my belly again, and put the IV stint in. I really didn't like the IV stint. In fact, over a month later, I still have a mark on my wrist where it was put in. The antibiotics that they put in took half an hour to slowly drip into my system and it burned. Finally, after all of that was done, they let me get in the jacuzzi tub. By this time, I started having strong enough contractions that they started telling me to focus on a stationary object and do some sort of breathing. So I laid in the tub, sitting up when a contraction hit to stare at the soap dispenser's PUSH and then when it passed, sinking back down, trying to get a comfortable neck/head prop going. My partner draped towels over the parts of me that weren't fully submerged and every once in a while, drained some of the water so that he could add more hot water.

Then someone's like, when was the last time she ate something? At this, I look up for the first time and notice that it's 5 PM. I think, oh shit, I remember from the classes that you're supposed to try and eat and stay hydrated and I did pretty well on the latter, but not so much the former. Unfortunately, since we left the apartment in such a hurry, the only food item that we had were Tanka bars. I had a whole plan to eat Totino's pizza while laboring at home and to bring delicious spaghetti with meat sauce with us to the hospital, but of course we never got around to making it.

So my partner's like, babe, I'm sorry, all we have are these Tanka bars, do you think you could try eating some? I felt like I was pretty compliant throughout the entire labor and delivery, so even though I thought it was a terrible idea, I gamely took a few bites and swallowed them. A few minutes later I'm like, I'm gonna throw up. He quickly grabs the trash bin in the bathroom and holds it while I throw up and later, the nurses are all like, wow, she threw up a liter. I'm pretty sure they had to take the trash bin liner and pour the contents into a "throw up bag" so they could measure the amount.

Later, when I announce that I feel nauseous and might throw up, they grab a skinny blue bag, that you open up by sticking your arm into it and my midwife puts in a few drops of lavender. I end up not throwing up again, but those bags probably make it pretty easy to measure.

Soon after the Tanka bar ordeal, I have a contraction that makes me feel like I want to push. They take my temperature and determine that I'm getting a little hot, so they make me get out of the tub. I spend the next approximately six hours of contractions being told I can't push. We cycle through a few different positions, on the yoga ball and on the bed, and I'm told to say "pa-pa-pa-pa" during contractions to help with not pushing. For the most part it works, but every once in a while, the urge is too strong and while I don't actively push, I make a different grunt-y noise.

I avoided looking pretty much everyone in the eye during contractions because I didn't want to get too emotional, what I wanted was to be able to concentrate on getting through it and it helped me to be dispassionate about it and not see the possible concern or worry on my partner's face or my doula's face.

The first nurse on shift didn't mesh well with us and I had the impression that she was equal parts annoyed, frustrated, and a little too high strung. She kept asking where my midwife and doula were and told me every time I made the grunt-y noise not to push. Yeah, just being told not to do a thing doesn't actually help and asking where my midwife and doula were (as if I would even know) didn't actually make them appear any faster. I didn't have the energy at the time to do anything about it, but just noted it all down mentally for later. Anyway, during those six hours I drank lots of water, I try to drink some apple juice and coconut water and eat some gummies, but most importantly, I don't ask what time it is or how much time has passed and just tried to accept that this was my reality for the foreseeable future.

At 7 PM, the nurses change shifts, so we got a new nurse, who we really liked and my doula arrives after being stuck in graduation traffic. The monitor on my belly that was monitoring the baby's heartbeat didn't do a great job of picking it up, so the new nurse spent a lot of time sitting by me and physically holding the monitor against my belly, which was really nice of her. They check how things are going and tell me that I have an especially thick amniotic sac membrane, and that it had been my forebag that had broken earlier on the triage bed and that my main amniotic sac hadn't broken yet and that pressure was what was causing me to feel like I needed to push.

They suggest performing an amniotomy (using a little hook to break the sac) and placing an internal fetal monitor. The internal fetal monitor was something that we learned about in the birth class, and we weren't wild about the idea, but luckily, Zoe came out with a full head of hair, so it wasn't noticeable unless you were really feeling around her head where the monitor had been placed.

A while after that had been done, they found out that the baby's head was asynclitic and that her hand was up by her head. The midwife says, we can try this new technique I learned yesterday. The nurse and doula immediately perk up and get all excited. My midwife had learned about Sidelying Release from another midwife that had gone to a conference, so we do that for a while and it ends up working. I was kind of grumpy during it though because for once, everyone's attention was on the technique and not on me, and I had to focus on relaxing my leg and not moving during contractions, which was not great.

Later, the midwife checks again and my hopes are momentarily gotten up, but it turns out I had an anterior cervix lip, so I had to turn around and spend more time mauling the hands of my partner and doula. The last couple hours of the labor I spend on my hands and knees, with my partner on one side and my doula on the other side, each holding one of my hands, which I crush, while rocking back and forth. At one point, they decide to switch sides, probably because they lost feeling in their hand and I remember distinctly that right around that time I started to regain coherence. I suddenly was able to speak in whole sentences again and started saying stuff like, I just want this baby out, will someone please cut this baby out of me, and I noticed that both my doula and my partner still had their rings on when they switched sides, so I told them to take off their rings. In retrospect, that was probably the moment I was finally at 10 cm and fully dilated.

When I was given the go ahead to push, you better believe I was goddamn ready to push. It took less than half an hour and with every push, I could physically feel the baby moving out. When the baby's head started crowning, my midwife asked if I wanted to reach down and touch the baby's head and I was like, nope, not at all. I remember feeling frustrated that the contractions now seemed super far apart, especially when Zoe started crowning and the whole burning sensation started. I definitely started cursing at this point. It was nice having something to do and the ability to act more like myself.

On the last push, when Zoe was born at 12:45 AM, June 11th, 2017, the gush of her coming out and probably all sorts of blood and fluids was both a relief mentally and physically. It seemed like almost immediately they plopped her on my tummy and were rubbing her vigorously with the receiving blankets, which are really not the softest, but are everywhere and what they used to swaddle her during our stay in the hospital. I spent the first few minutes just trying to keep a good hold on her, I couldn't actually hold her because of the umbilical cord and while I don't remember her being grossly covered in gunk, she was still kind of slippery. My partner cut the cord, though it was more like sawing through the cord, and felt really weird. They told me Zoe was pooping on me, but I never saw any of it, because they were pros at cleaning. They even gave me a quick abbreviated sponge bath of sorts and changed my socks and I felt like a new woman.

We waited a little over half an hour for my placenta to show up but unlike Zoe, it did not want to vacate, so my midwife had to do a manual extraction. They gave me a shot of fentanyl through my IV stint and it started working almost immediately. They told me it feels like having two shots of tequila, and it did, just without any spinning. It didn't completely remove all sensations, and it made me a little chatty, so the whole time I was saying "ow" over and over. At one point, I joked, it feels like you're trying to fist me, and the nurse and midwife gave each other a look. The nurse slowly says, "well..." and that's when I realize that my midwife is actually up to her elbow and that yeah, I just pushed a baby out, and it takes a bit for that to return to normal. She manages to successfully extract my placenta and holds it up for me to see saying, doesn't it look like a tree of life? And I'm like, no, it just looks like a bloody mess. She sticks her hand back in to make sure she got it all and I felt her hand pop in that time.

I also needed to have one stitch, she said I had a small tear just inside. They also inserted a catheter to empty my bladder, which was so full that they kept on exclaiming that there was still pee coming out and the container was filled to the brim. I definitely stayed hydrated! I didn't actually feel like peeing the whole time, though they had me sit on the toilet a few times during labor. During all of this, the baby is having all the baby stuff done and my partner is with her, taking pictures.

When all of that is squared away, our families are allowed in and there is much joy, tears and pictures taken. I start saying stuff like, well, next time should be easier right? And everyone looks at me and the nurse says that's the soonest she's ever heard anyone start talking about doing it again.

Honestly, going in, I had no idea whether or not I'd be able to do the labor and delivery without an epidural. On our birth plan, I put down -6, with a -5 being "I have a strong desire to avoid pain medication. I will accept medication if my labor is very difficult or long." and a -7 being "I strongly desire an unmedicated birth. I will be disappointed if I use pain medication." When I was in triage, they asked me what my pain level was, and I told them a 6. At no point during my labor and delivery did I ever feel that the pain was unbearable. For me, it wasn't a sharp, stabby pain, which I don't think I could have dealt with. Instead, what stuck out to me as parts of my labor and delivery that were terrible were having an IV stint and the arm cuff blood pressure monitor. None of which an epidural would have done anything about, but if the pain of the contractions had been like the pain of the arm cuff around my arm, but instead around my midsection, I don't think I could have gone nine hours with that happening every few minutes.

Postpartum Hospital Stay
I had to get additional antibiotics dripped through my IV stint because of the manual extraction, so when we transferred from the birth suite to the postpartum room, an extra nurse came with us to wheel my IV bags. The wheelchair that they had me sit on was very hard and had no suspension. If I had actually been in pain or discomfort, it would not have been a very pleasant ride.

We ended up having to stay an extra couple nights in the hospital because of concerns over Zoe's fast breathing combined with the possibility of meconium aspiration (she pooped in utero & might have breathed it in). Every four hours a nurse would come in and take our vitals. I was offered Tylenol and stool softener right away, and was actually somewhat pushed to take the Tylenol. I took the first dose, but not more later. In retrospect, I think I didn't need any Tylenol during those first few days because I still had all the hormones and adrenaline from labor and delivery coursing through my veins. It wasn't until I got home and was breastfeeding the baby on the bed that I could feel that one stitch. Luckily, the rest of my body wasn't sore at all, my main complaint the first couple days was my sore throat.

Throughout our stay, Zoe had chest x-rays done (they wheeled in a mobile x-ray machine and my partner got to help with it), several blood draws (they draw blood from the heel of babies, and by the end of our stay, both of Zoe's heels had been pricked multiple times), and her oxygen levels checked. Luckily we found out early on from breastfeeding help that you can put your finger in the baby's mouth (nail down towards tongue) for them to suck on and it's such a strong soothing technique that Zoe didn't cry at all with the blood draws. Which makes everyone much more calm.

We tried learning how to swaddle her from the nurses, but it seemed like the only thing that worked was the double swaddle, where you use two blankets, so if you swaddle poorly the first time, the second one on the outside keeps the arms from escaping. Unfortunately, this technique came back to bite us when we got home and she got a bit of a heat rash from being double swaddled one night.

Our families visited during visiting hours and brought lots of food and spent time holding the baby. There was a nutrition room down the hall that had Lean Cuisine frozen meatloaf meals and mac & cheese meals, as well as an assortment of drinks, jello, popsicles, and soups. It was meant to be a stop gap for the hours that the hospital cafeteria was closed, but I ate quite a few mac & cheese meals on top of ordering from the hospital menu. I should have ordered a meal from the hospital cafeteria three times a day, but I wasn't sure if it would be covered in our stay or if it was extra. My partner's meals we had to pay for and we paid in cash because it was easier. So bring some cash in your hospital bag.

I was fond of the orange-flavored jello and one of the nurses told me I was her only patient, so when I told her that our nutrition room was totally out of orange jello, even though the red jello had been restocked, she went over to the other side of the postpartum floor and took the last two orange jellos from their side. That was really great. I didn't want to eat both right away, so my partner wrapped them in a napkin and wrote our name on the outside and put them in the fridge.

I wasn't allowed to take Ibuprofen because I had high blood pressure near the end of pregnancy and during labor and delivery. This wouldn't have been an issue, except that with Tylenol, you can only have 3 doses in a 24 hour period. This would become an issue later with breastfeeding.

The one main thing that caught us off guard was cluster feeding. Even though we knew that she wouldn't get much colostrum, she was feeding three times an hour for 10-20 minutes around the clock with some breaks for diaper changes and a bit of sleeping. Again, because of the hormones, I was able to handle this a lot better than my partner did. He did all the diaper changes and getting her from the bassinet and putting her back and swaddling her, but that meant while I was breastfeeding her, he had to stay somewhat awake, so that when she was finished, he could take care of the rest.

The second night of cluster feeding was the worst, we kept on putting her down, expecting her to sleep a little, but less than half an hour later she would wake back up. For the third night, we agreed to treat it as if we were just going to pull an all nighter, and have fun with it instead of trying desperately to get her to go to sleep. We never got to enact it though because she did end up sleeping a bit more that night. It's definitely one of the things I've noticed that affects my mood the most, that if I try to will her into a certain state, that it's miserable for me, but if I'm hopeful but not actively trying to have things go a certain way, I feel a lot happier with how the day went.

The bed that I slept on was a weird anti-bedsore bed, which is the standard hospital bed, but it meant that every time I reclined or raised up the bed, it would spend a couple minutes inflating and deflating the bed. I got used to it, but that was definitely a couple minutes that I could have spent falling asleep.

Since we stayed in the hospital for so many days, we were visited by several midwives that were on call, which was a welcome surprise and gave us an opportunity to chat and ask more questions. I really can't say enough positive things about my experience with the Swedish First Hill Midwives, I always felt comfortable with them, they never made me feel rushed or that my questions weren't important and they were always just so warm and positive. Just as importantly, I felt confident that they would fight tooth and nail to make sure my birth experience was everything I wanted it to be if it was within their power. I had no doubt that they were on my and my baby's side. Later on, I asked about the percentage of people who get epidurals and those who don't and was told that for the midwives, their percentage is 50/50. For OB-GYNs, it's more like 90/10.

Life with an Infant
When I look back at that first couple weeks, it was fraught with not enough knowledge about the potential problems of breastfeeding, solutions to those problems, and that you could supplement with formula and not be a failure. But it was also so, so much overwhelming happiness and embracing every moment.

I was very very emotional the first few weeks, not just because of the trouble with breastfeeding we had, but I would start crying whenever I thought about Zoe growing up. I had a song that I made up that I sang to her every day for the first couple weeks. The first part was always the same and then I would make up lyrics. One day I was singing about how she was eight days old and that today would be the last day she would be eight days old and that made me cry. I definitely felt like I was crying more than I had at any point in my pregnancy.

We had breastfeeding help from two nurses and two lactation consultants while we were in the hospital, but it wasn't until the lactation consultant appointment at the Lytle Center six days after Zoe was born that we found out she had ankyloglossia, also known as tongue-tie. We were fortunate enough to get an appointment two days later on the following Monday to have the frenotomy done. Up until that point, the only way breastfeeding was bearable for me was by taking Tylenol and Ibuprofen. There was a rough night early on when I was told I shouldn't take Ibuprofen because of concerns with my high blood pressure, but I could only take Tylenol every 8 hours. By hour #5, I was in agony and we had to make the decision to take a dose of Ibuprofen so that I could continue to breastfeed. It's impossible to imagine or describe, even for me now, how incredibly painful breastfeeding was for the first two weeks. I would have gotten an epidural immediately if the contractions had been as painful as breastfeeding was.

Those first couple of weeks were rough also because we didn't have enough good options for feeding her. One of the pediatricians that visited us in the hospital dispassionately said that we might have to use formula and I later cried about it because that was not what I had wanted to hear. Later on, we were told essentially the same thing by a different pediatrician, but in a much more compassionate way and that it wouldn't be forever and was only a stopgap.

I remember one of the early days when I started pumping to try it out and had pumped but then Zoe woke up and wanted to feed. It was terrible because we didn't have any good solutions to feed the milk that I had pumped to her so I spent several hours feeding her and felt so bad that she was hungry and angry at myself.

When we had our second visit with a lactation consultant, it turned out that Zoe wasn't gaining weight fast enough, so the lactation consultant suggested that we go on what I later named "The Routine." We rented a hospital-grade breast pump and at each feeding, I would feed 10-15 minutes on each side, then pump for 15-20 minutes and my partner would use a supplemental system to feed Zoe the milk that I had pumped the previous session. The goal was to finish a feeding session within an hour, because we had to make sure to feed her every 2-3 hours.

Sometimes at night we would let her sleep 3-4 hours, but we followed The Routine for a week or two. The first few days we were able to use the frozen bags of milk that I had pumped "for fun" during the supplemental feedings, but when those ran out, we bought some formula and used that when there wasn't enough milk. I also started taking fenugreek pills and drinking a tea kettle of mother's milk tea every day, which literally contained all of the herbal plants that are supposed to help increase your milk supply.

I was also prescribed three tubes of ointment (Mupirocin 2%, Hydrocortisone 2.5%, Miconazole Nitrate 2%) that I mixed together and applied to my nipples. They said that I didn't need to wipe it off if it had been more than half an hour, but it bothered me that some of the ingredients were steroids and anti-fungal so I always wiped it off. The creams performed miracles on healing my nipples even though I was still breastfeeding constantly.

For the last month, I've been keeping track daily of how much mL I pump, how many times I breastfeed and how much formula we feed her. I initially also kept track of when the expressed milk was fed to her, but for the last week or so, it's been almost optional to feed her a bottle of expressed milk at all. It is incredibly reassuring to see the numbers start to stabilize and to count up the number of times I breastfeed and pump to make sure it adds up to at least 8 (the "magic number" it seems like most books recommend to keep your supply up).

So in terms of the breastfeeding saga, for now at least, things are looking pretty good. My nipples have toughened up and what would have had me crying with pain during the first two weeks doesn't bother me now. It did take about three weeks to get there, but now that it's behind me, having her cozied up to me and seeing her smile sleepily after getting milk drunk is something that I treasure immensely. Sure, some days I get overloaded with all the skin-to-skin contact or feel like I've permanently become part of this rocking chair, but then I just try to take a nap or a shower and/or have my partner give Zoe a bottle. And I try to keep in mind that this phase is short, it'll pass and be over and that'll be it. The hours and days will continue to march on no matter what. I'm just trying to enjoy it as much as possible and gloss over the difficult parts.

Since my partner has gone back to work full-time (he works from home) our schedule for the last few weeks has looked something like this, plus or minus a couple hours:

  • 3 AM - I wake up to pump, which takes about a total of 15 minutes, from when I get up from bed to when I get back into bed. I only pump for about 5 minutes, which is enough to just about fill the Medela tubes (80 mL, though I usually only go to about 70 mL or so because it's hard to see that last 10 mL).
  • 5:30 AM - Zoe wakes up, my partner changes her diaper and I spend about 15 minutes feeding her from one side, she falls back asleep.
  • 8 AM - Zoe wakes up, my partner changes her diaper and I spend about 15 minutes feeding her from the other side, she falls back asleep. I try to eat something while I'm feeding her. Sometimes, these early morning feedings are less straightforward, with feeding from both sides, multiple diaper changes, and re-swaddling. This is usually when my partner gets up, showers and starts his day. I go back to sleep.
  • 11 AM - Zoe wakes up, and while my partner is changing her diaper, I brush my teeth and wash my face. I feed her and try to put her down in her bassinet in the living room when she falls asleep at my breast. If she wakes up when I put her down, I check her diaper, then continue feeding until she stays asleep. She sleeps anywhere from 1/2 hour to 3 or 4 hours at a stretch.
  • 11 AM - 10 PM - When Zoe is asleep, I eat. If I have more time, I worked on this blog post, looked through my email for important ones, and other such tasks. At around 6 PM, when my partner is no longer working, I take a shower and pump, while he gives her a bottle. If I have to leave to go anywhere, I pump before I leave. I've managed to store about five bags of 4 oz of milk in the fridge, and about the same number in the freezer.
  • 10 PM - 11 PM - Zoe goes to sleep for the night. She's been sleeping between 5 - 7 hours per night. I know, I'm super lucky. I pump before I go to sleep.

Must Have List
Here's a list of items that we use on a daily basis, in no particular order.
  • Tinybeans - a site where you can upload pictures, videos, and text about the baby. I like it because I can tightly control who has access to it and compared to having a Facebook group dedicated to Zoe, I'm not giving Facebook access to all the pictures. The link is a referral link, so I'd get a month of free premium if you sign up.
  • Miracle Blanket Swaddle - swaddling is essential, but Zoe is a little Houdini, so we got one of these for her, which we use pretty much every night. The velcro ones initially didn't fit her well and she still tends to be able to get an arm up and out. We have so so many soft and beautiful muslin blankets, this one by aden + anais is my favorite, but we cannot safely swaddle her in any of them because she breaks out of them right away, though they are great for draping over her when she's just in her diaper for warmth when I'm breastfeeding her.
  • Medela Symphony breast pump - because of concerns with milk supply, we rented this breast pump from the hospital/Lytle Center. It's very easy to use and was $90 for a month. I called my insurance and it turns out it's completely covered, especially because I got a prescription for it, so I ended up renting it for an entire year!
  • A hands-free breast pump bra - there's several different kinds, but you'll definitely want one so you can pump both breasts at the same time and not have to awkwardly hold the flanges. 
  • Milk storage bags - though if the pump you got from your insurance allows you to pump directly into a bag, you might want to go with whatever bags allow you to do that.
  • Bras for breastfeeding - I pretty much live in these bras.
  • Itzbeen Pocket Timer - initially we used this to keep track of everything, as well as in a little notebook. Nowadays, I use it to keep track of the last time I breastfed her, how long she's slept, and the how long it's been since I pumped.
  • OXO Tot Brush Cleaner - OXO makes a lot of great kitchen tools and this brush has a really soft brush, making it really easy to clean the breast pump stuff and bottle. We've been using Dr. Bronner's Unscented Baby Liquid Soap with foaming hand soap dispensers in a 1:5 ratio. I decided to use unscented soap because in the beginning, we were sticking our fingers in her mouth pretty frequently, to feed her, massage the underside of her tongue, and to calm her.
  • Nursing pillow - my friend lent me a ton of baby stuff, including a Boppy and a My Brest Friend nursing pillow. I used both, though mostly the Boppy these days in my rocking chair, though for the first few weeks, I practically lived in the My Brest Friend, which I used in bed.
  • Places for the baby to sleep - we got a Pack 'n Play for Zoe's main nighttime sleeping and it's in our bedroom, but we spend the majority of the day in the living room, and bought a bassinet off Craigslist to put on the futon.
  • Diapers - we decided to go with Baby Diaper Service (put down my name, Feiya Wang, if you decide to sign up!). It turns out that it's not that expensive, and it's true that the customer service is very friendly and helpful. Zoe has not had diaper rash at all. You'll want to get diaper covers though, we have about 14. 
  • Wipes - we use a ton of wipes. Amazon sensitive wipes have been strong (we got a sample of Huggies that we keep in the diaper bag and those tear all the time), not too wet, and plenty big. We signed up for the subscription service, but after two weeks, we looked at our supply and it seemed like we might run out before they sent us the next batch, so we upped it to send us 2 packs of 6 wipe containers, we might have overdone it, but we'll see how many are left at the end of this month.
  • Large drink container - Swedish First Hill had these big, pink plastic drink containers with a lid and a handle and a straw that I have literally been using every day since I left the hospital. The only downside to it is that the front of the lid has a pour spout, which has caused multiple accidents. Luckily, all I've ever used it for is water. This is maybe one of the most important things to always have on hand so you can stay hydrated for milk production.
  • Bottle - our lactation consultant gave us a Dr. Brown's preemie nipple, because it's the slowest flow bottle nipple available, so that early on, the baby doesn't start to prefer the bottle because it's easier. We ended up using Munchkin Latch Stage 1 nipple bottle because it's what my father-in-law was able to find at the store because the Dr. Brown's bottles that we had, the nipple was too small to fit them and we didn't have time to order one that would. The shape of the bottle is weird, and you have to turn the bottle upside down to get the last bit of the milk into the nipple, but there's less parts to clean than Dr. Brown's, which is nice since we don't have a dishwasher.
  • Car seat - I'd recommend taking a car seat class. It's not fun, but makes installing a car seat way less intimidating. We went with a Graco car seat, but most of the people in our PEPS group have Chiccos. Though we don't use the car seat every day, you can't actually leave the hospital without one.

Essential for Me at Least
I don't use these items daily, but when I needed them, they were super crucial.
  • Nipple cream - the hospital sent me home with several packets of lanolin, but my friend sent me this kind, which comes in a cute little pot. I tried using coconut oil for a while, but Zoe seemed to dislike the taste.
  • Gel pads - the hospital gave me Medela Hydrogel pads, but I ended up buying some Lansinoh Soothies gel pads because they have a cloth back and are much nicer. They're great for soothing achy nipples so that you can go to sleep and have protection against the nipple rubbing up against anything.
  • Fridababy Fridet - they'll give you a bottle when you're in the hospital to wash your bits with, but I packed this in my hospital bag and it was so great and easy to use.
  • Fridababy NailFrida - I used the file to file down the baby's nails during the first couple weeks, and since then, the clipper to trim her nails every few days. She's started to claw at her face and it's really easy to use the nail clipper when she's in a milk coma. The little window on the nail clipper is ingenious. I got both Fridababy products in a kit with a couple other items, which we haven't used yet.
  • Baby monitor - sound doesn't travel that well in the apartment, even though it's not that big and especially in the first few weeks, if we put Zoe down to sleep in the bedroom, it was reassuring to hear when she started crying right away so we could go to her. 
  • Avent Soothie pacifier - sucking is incredibly soothing to babies, and once you learn what it is they need, whether it's a diaper change, they're hungry, or it's the middle of the night and you're changing their diaper and don't want to wake everyone else and rush through the diaper change, a pacifier is amazing for both your stress levels and the baby's. This pacifier is specifically made for 0-3 month olds. We always have one in the diaper bag, since it's not always possible to tend to her needs right away while we're out, and also by the diaper changing table. We didn't start using one right away, because of worries about it affecting breastfeeding, since that wasn't going well, but I wish we would have started using it sooner during night time diaper changes, it probably would have made everyone in the household calmer and less sleep-deprived. However, I also feel like it was good that we waited because we're much better at pinpointing what it is she needs based on her cries and the situation and we try to reserve using it only when we're out and about.
  • Burt's Bees burp cloths - Zoe initially didn't spit up at all, but she does fall off the nipple and have a dribble of milk escape the side of her mouth all the time. These are some of my favorite burp cloths that we have, once you wash them a couple times, they're really absorbent and feel like your favorite t-shirt. Sometimes a burp cloth is just nice to have on your bare shoulder when you're burping the baby so that their face doesn't stick to your skin. I got a set of Carter's burp cloths from a co-worker at my work baby shower, which are really nice too and match the outfit they gave me. We're constantly misplacing the burp cloths and they seem to just disappear, so it's nice to have some all around the apartment within easy reach.
  • Nursing tops - I mostly go around the apartment in just a bra and stretchy pants, but when I need to leave and anticipate the possibility that I might need to nurse Zoe, I found I had almost no clothes that both fit me and were comfortable to use to nurse in. This nursing tank top is my favorite so far, for ease of use, style, and comfort. I got it in small, and it fits, but also got it in medium and it's much more comfortable. There's a lot of nursing tops out there and I got a few that have holes that are covered by cloth, but for now all that extra cloth just makes it difficult to wrangle the baby, her arms, the opening in the shirt, and my breast into her mouth, so that by the time I finally get her to latch on, we're both sweaty.
  • Bath stuff - there's tons out there, but you need something to wash the baby in once their belly button stump falls off. We had no trouble whatsoever with the stump, besides the fact that it had some pretty sharp edges, so if Zoe didn't have a shirt on, it would poke uncomfortably into me during skin-to-skin. Our friend got us this adorable rain cloud bath toy and we've been using it as a mini handheld shower and it's nice to use to get her face wet and get her used to having water on her face without splashing a bunch on her head at once. We got the Babyganics foaming shampoo & body wash and the fact that it comes out foaming is nice.
  • Panty liners - I used hundreds of panty liners, starting sometime in my 3rd trimester and for 6 weeks after I gave birth. Carefree panty liners were the best that I found.
  • Diaper bag with a changing pad - key here is the changing pad so you can change a diaper almost anywhere, like in the park.
  • Stroller - ours pairs with the car seat, but has terrible suspension. It's nice that it's light and folds up though. You'll have to decide what features are important to you.
  • Babylist - we had several registries and was able to import them into Babylist and also ask for things like people's favorite books and for cash for diapers. It was even still useful now to help me make this blog post!

Nice to Have
You could definitely do without these, but I thought they're pretty useful.
  • Baby 411 book - we all have easy access to Google these days, but the problem is that you can easily fall into a rabbit hole of conflicting information, and in the middle of the night, when you just want to know if yellow poop vs green poop meant anything, we found it was easier to look at the index and flip to the page, than do a search online.
  • Expecting Better book - I actually found out about this book after I'd already had Zoe, but from friends who have read it, it seems like a Baby 411 but for pre-baby questions. I definitely plan to pick up a copy in a few years when I'm ready to have my second baby!
  • Baby wrap/carrier - we got a Moby wrap on loan from a friend and I was contacted by someone on Facebook to try out the Beebeerun wrap for free in exchange for a review. The material for the Beebeerun was different, lighter, which I liked. But a wrap of some sort is really nice when you don't want to have the bulk of a stroller and it also calms the baby and she spends most of the time in the wrap sleeping. A sling seems like it might be easier to put the baby into and out of, but slings don't grow with the baby. We also got an Ergobaby 360 and have recently been able to start using it because a friend gifted us with an infant insert, so we don't have to wait until she can hold her head up consistently to use it.
  • Food you can eat with one hand - one of the nice things about having my mom living with us for the first month and my dad living with us for the second month is that there's always someone there to hand me what I need if I'm buried under the baby. And most of the time those things are my phone, water, or food. If you're on your own, take the extra minute or two to make sure you have everything you need (and on the side that you'll have a free arm) before you let the baby latch on, otherwise you'll be uncomfortably distracted.
  • Padsicles - my partner helped me make these and while I didn't use up all 25 that we made, they were definitely really nice to have. I probably would have used more if it had been easier to remember to get one out before I went to the bathroom. Definitely have more than 25 that aren't in the freezer, because no matter how you have the baby, you'll be bleeding for a few weeks. It won't seem like a ton of blood because yous should be going to the bathroom every couple hours if you stay hydrated.
  • Motherlove Sitz Spray - For vaginal deliveries, it was nice to have this to spray on if a padsicle wasn't readily at hand. There's "bath" versions which you can immerse your bits in, but I thought that was too much hassle.
  • Dreft baby detergent - we've been using this since before day 1 to wash all baby stuff and she hasn't had any skin problems besides a bit of newborn rash for a couple days after she was born and the baby acne that showed up after the first week is still clearing up at week 7.
  • Nursing pads - you'll likely be sticky with milk at some point, but you'll be able to save your bra from being soaked. These are nice and thin, and these are my favorite because they're perfect size for smaller breasts and are cone-shapedThese are also nice and would work better for bigger breasts.
  • Maymom breastshield/flange for breast pump. You'll want to find which size works best for your nipples, I used 26 mm and went through a phase where I tried other ones, but just stuck to the same ones that the lactation consultant suggested. They say that after a while your nipples might change. These are specifically for Medela breast pumps, but I like them more than the Medela brand ones. However, you can't use the manual pump with these flanges. I bought these so I could have a set at work and liked them so much that I got another set to use at home. They cause more condensation in the tubes, but because the tube is connected at a more horizontal angle, it almost never gets accidentally knocked out. I just continue to run the pump while I wash or rinse the pump pieces to dry out the tubes.