Wednesday, August 19, 2009

The end has come

The story is that for 5 months or so, Willem has been leaving teeth marks on my nipple that I've found uncomfortable and sometimes painful. I could no longer breastfeed him in comfort and often had to tell him when it was time to unlatch or switch sides because I could no longer take the discomfort. I was still willing at that time to continue breastfeeding him in hopes that he would figure out a way given some time to stop making it uncomfortable for me. Instead over time, it remained the same and he began to resist my directions. When I told him it was time to let go or pointed out the teeth marks that were there, he would refuse and deny. This basically led to me getting frustrated and him being sad. I continued to try to be patient explaining to him why it was important for him to follow my directions at those times. I was resistant to give up and begin to wean him because I was hopeful there would be a solution and improvement.

That solution hadn't come before the day (first time in his life) when I dreaded the next time he asked to drink mama milk. I didn't want to and it surprised me the force of that feeling. At that point I realized our breastfeeding relationship had to come to an end. That night I told him I was done trying to give him mama milk and done with the arguing and the frustration, sadness and hurt. That's also when I realized that I had to be consistent and firm in that resolution. There wasn't going to be and couldn't be an gradual weaning process.

Over the next few days when he asked, I wanted to go back on that resolution. I still wish that there could have been another way. I wish that breastfeeding older children was more understood. If I could contact a lactation consultant who would know what to do to teach an older child to fix his latch, I would have done it. Although I assume that most LCs wouldn't have a clue with a child his age.

I'm not very hopeful that someone can help because he and I working together has not yielded a solution. I thought it might be one of those examples of a stage in a child's life where if you as the parent don't like it, be patient and wait a few weeks and it will resolve itself. In this case, the resentment came first. In fact, I'm glad to not have breastfed him in a few days. My main regret is that he can no longer benefit from the immune boosting powers and motherly connection.

Often quoted to me is the maxim that extended breastfeeding is only constructive when it is working for both mother and child. Once its not, its time to stop. I felt I tried to persevere having found a balance that I considered acceptable. But it was no longer acceptable to me when I didn't even want to try. I don't want to know what the next nursing session would have been like with me knowing I didn't want to and going ahead anyway.

I've actually replaced the breastfeeding with spoon feeding for the time being. The last couple of weeks, he has discovered that he is too busy to eat. And often the only way to make sure he was getting the nourishment he needed was to interact with him over food, the best way to do that was hand feeding. He still can feel the connection with me and there isn't crying on either end. I don't have to feed him by hand all the time but in times that he is struggling to focus on eating, I will.

I had hoped that our breastfeeding relationship could have lasted longer--until he was 4 years old or so--knowing that in many cultures in the world, that is normal. Instead, we made it 2 years, 6 months and 3 weeks.

I probably could have stopped right after Belle's birth with the simple explanation that babies don't eat foot, they only drink mama milk and Willem was not a baby anymore and he needed to eat food to stay healthy. Instead, I tried to find the mixture of food and mama milk for his diet. Then he started using mama milk as meal replacement so I had to put limits on his breastfeeding like only after breakfast, not before because he wouldn't eat breakfast otherwise. I know he'd love it if some pumped breastmilk made it into his cup, but I'm not yet sure if I should do that. I know I'm not going to go out of my way to pump milk for him, but if I happen to have extra, I think I will share with him.

Sunday, August 9, 2009

Not a very interesting update

Belle is healthy. Sleeps well, nurses well, is growing well. She's really cute--the same can be said for Willem. Their smiles and laughter bring much joy to my heart.

I hurt. A few weeks ago it was bad enough that I couldn't bear my weight on my right leg. My right hip is particular is experiencing extreme soreness at the joint and in the muscles. I only assume that it is the looseness of my joints postpartum that is causing this. Chiropractic, massage and light exercise (walking, yoga and hula) have been helping. I expect I will experiences period of reoccurrence of the next few months.

I discovered I have slight abdominal dystasis above my bellybutton (where the umbilical hernia occurred).

Between those two conditions, I've resolved (although I had planned previously) that I will not be getting pregnant again within the next 3-4 years. Since that space of time is alloted, I've also felt drawn to apply for a PhD program at the University of Washington. The hope is that I can complete coursework before Peter graduates with his PhD and then I can complete my dissertation wherever we end up moving for his postdoc. And then the next baby can be born either during my dissertation years or after if I can complete the whole degree in 4 years. My body needs the time to not be pregnant so my joints and muscles can knit back together.

And as I always remind myself: you make plans and then Heavenly Father intervenes. We'll see what he has in store for us. For right now, I feel he is pleased with my plan to apply to the PhD program. The next baby will be born on His timetable. And if its a surprise like my pregnancy with Willem, the timing will be perfect and we could not plan it better.

Come to the help of women

Solace for Mothers is currently starting a letter writing campaign to the newly appointed Presidential Advisor on Violence Against Women. We are writing to her to describe the violations of women's civil rights and violations of federal law that are happening to women as they give birth to their children. We are hoping to include letters from mothers who have been denied their right to refuse medical treatment during labor and birth.

Also being invited to write to the Presidential Advisor are organizations who champion women's reproductive rights including The National Advocates for Pregnant Women, the International Cesarean Awareness Network, The American Civil Liberties Union, The Coalition for Improving Maternity Services and Conscious Woman.

This is all a work in progress right now but it is the direction we hope to take in the next few weeks. More information will become available on the Solace for Mothers website, as well as the opportunities to endorse the letter we will be sending and include your own thoughts and comments.

Today I was reading in the Latter-day Saint canon of scripture and found a verse that I found parallels this project. In Doctrine and Covenants 124:11, The Lord says "Awake, O kings of the earth! Come ye, O, come ye, to the help of my people, the daughters of Zion" (paraphrased to accentuate the parallel). Wouldn't it be nice if God were saying that, in this day, on the topic of women's reproductive freedom to birth without unnecessary medical intervention, and with women's consent before an intervention is performed. It is my prayer that the leaders of the nations become aware of the abuses that are being done to women in the name of birth, and then come to their help and protection by creating punishments for providers who violate their right to refuse treatment.

There has been recent news about a court case in New Jersey were a woman's child was taken into state custody after she refused a C-section that her doctor was claiming was medically necessary. My partner with Solace for Mothers recently wrote a commentary on the story (link to original Huffington Post article) at The Birth Activist.

Then there was this story where a woman was remanded to the custody of the hospital when she disagreed with her doctors recommendation to remain on bedrest.

All over the internet there are stories of women who were not consenting to an episiotomy but one was performed anyway. Often procedures are performed without even informing a woman that it is going to occur, not even giving her the opportunity to consent. It happened to me during my son's birth where I wasn't even informed that the midwife was going to begin suturing a minor second degree tear. Given the opportunity to be informed, I would have denied the sutures preferring to allow the wound to heal on its own. This is a minor example. Other women have been given pain medications without being told that was was going into the IV line, others were given episiotomies or vaginal exams despite their screams of No, Stop and Dont!. Hence, why its called birth rape.

Health care professionals are mandated by federal regulation to grant patients complete informed consent (ACOG's guidelines here). Of course there is no legal recourse or consequence to providers who do not gain a patients consent before performing any procedure. This was discussed in the recent Coalition for Improving Maternity Services Webinar on Informed Consent in Maternity Services. To read more about informed consent, see Goldberg. (2009). Informed Decision Making in Maternity Care. Journal of Perinatal Education. (Winter issue).

Abstract here:
In the United States, federal acts and regulations, as well as professional guidelines, clearly dictate that every pregnant woman has the right to base her maternity care decisions on accurate, up-todate, comprehensible information. Despite these efforts, evidence suggests that informed consent within current health-care practice is restricted and inconsistently implemented. Patient access to evidence-based research is imperative under the scope of informed consent and is particularly important during a time when perinatal mortality and morbidity rates, interventions, and disparities are on the rise in the United States. This article describes the Coalition for Improving Maternity Services' investigation of the breakdown of informed consent in maternity care.

The letter writing campaign is an attempt to advocate for changes to the federal regulations that would create punitive measures and due process when providers do not grant a woman's right to informed consent. As the regulations stand now, there is no recourse available so violations occur without fear of consequences.