fredag 11 september 2009

"Open Preschool"

Today was different. BB turned 6 months. We didn't make the goal of exclusive breastfeedinf since we have been doing baby led weaning and for two weeks and she's tried advocado, banana, parsnip, carrot etc.

Me and BB went to what would literaly translate into "Open Preeschool" today. In our part of town there are two of them. We live in concrete suburbia (1), Biskopsgården (2) and the "Open Preeschools" are at two different squares: Friskväderstorget & Vårväderstorget.

Open Preeschool is better described as an open/free communal day-time activity center for families with children 0-5 on a drop in basis. You decide when you want to go there, and you only stay for as long as you want to and partake of the activities that suit you and the child you bring the best.

At this particular one you could take part in cooking groups, they often had baby and toddler music-time, a pediatric nurse from the health center comes to visit once a week, there is a room for sewing, one for playing and they have a LOT of exciting, learning toys. I found the toys to be very ungendered. There was a computer in their "quiet room".
They also engage the visitors in Nordic walking (3) and had just bought new poles.

They had a regular staff of two women, aged about 55 who told me they grew up around here and both started working at the preschool near my house in the 1970:ies. There was also a woman there who said she used to "Fika" there to train her swedish. The coffee was 2 SEK,
0.28 dollars, just so they could buy more. You could bring any food you liked and cook or heat it in the kitchen if you wanted to.

I had called in advance and they told me they currently had no visitors because of Ramadan (4)
BB was excited, a looked around in amazement at the big, well lit rooms. Then they prepared a soft playmat on the floor for her and picked out some age apropriate toys for her to gnaw on. I sat on the floor and talked to the women about organic meat, free range animals, farming, the politics of food untill BB became hungry. Then I just pulled up my dress and nursed her sitting on the sofa. No one battered an eye. The staff had passed my test.

Then we went home, she fell asleep in the Patapum babycarrier and when she woke up we nursed and had some lunch, which for her meant some majskrokar and pieces off advocado.

It'll be interesting the next time, or after Ramadan to meet the other parents. Half my collegues are from Iran, but most of them are secular, even if they d celebrate Ramadan & Eid ul-Fitr  (5). I expect some to be christian, some to be secular muslims and some to be different kinds of muslims. I've seen some rastafarians around too, and on wednesday I swear I saw an older Pastafarian (6) woman.

So it's free and anonymous (you only tell them your first name). You are responsible for the children you bring, they wont normally baby-sit, since it's not day care.

In sweden, the goverment doesn't provide day care for children under one year since we get parent money and are supposed to look after our own children. For those who have family or friends they trust they are used only as baby sitters occasionaly, some very rich people use nannies & au pairs, and since a recent tax reform it's become possible to get nanny-service through some companies and get a tax reduction on it, but that is a subject for a totally different post.

With lots of love.... Karin.


lördag 5 september 2009

Giving birth, about my birthing experience.

In March 2009, I gave birth at a baby friendly hospital(1, 2) - since 1998, all hospitals in Sweden but one was baby friendly. I remember leaving the maternity ward and having an ice-cream and a cup of coffee in cafe of the woman’s clinic with my family and seeing the plaque:
“This is a baby friendly hospital and at this café everyone is welcome to eat! Please respect breastfeeding mothers!”
It felt good. I sat down and nursed. A few people passed. They smiled. Another mother complimented my grip, saying she wasn't able to do "that" (eat and nurse at the same time) until her first baby had been much older. My BB was 2 days old and beautiful.

But I'm fast tracking.
I had a medicated birth, I'm the first to admit.
My baby had been in breach position to and fro in the last weeks before she was born in week 41 +2 and my blood pressure had been a tad high during those last weeks. I'm also overweight. I had planned on working until week 38, but after an intensely stressful day in week 36 I called my boss and said I'd take my maternity leave from then on and went home to wait. And wait. And wait. February the 28:th came and went. My mother had her first four children about two weeks earlier than her due date, and my grandmother said it was the same for her, but pointed out the last two were twins and therefore didn’t count. So I had expected not to make it to my due date.
It was Sunday evening around 6 pm that I felt my first contraction. I never had one before. I never felt any of my Braxton Hicks contractions so this was my first feel for labor. We waited, and they didn’t die down. We timed them online and they were irregular. So we called in to the labor ward. “It’s not very busy here said the midwife. You can come in if you want to.” Me and my partner got into a cab and had a smooth ride over. Somewhere between 10 pm and 11 pm the same midwife I talked to on the phone said “If these contractions has actually dilated you, you are in for an easy ride.” I nodded. She asked if I wanted her to check. “Yes please”
She had big hands.

Almost nothing had happened. We went home, a bit giddy. When I stepped through the door at home the world rocked. I wanted to pee so BAD but my body just locked in a contraction that made me laugh, jump around and be in agony at the same time. “Ineedtopee!!!”

We spent some time at home, I think my partner had a nap between 1 am and 3 am, then we had some fish fingers and pasta and I spent some time in the bath while my partner timed my contraction from when I screamed “NOW!” and put my head under water until the next “NOW!” It just kept coming, wave after wave of intense pain, starting in my back, reaching around my belly. We called in again before 6 am. Said I wanted to come in again, that I wanted pain relief. “Eat breakfast and come.” Was the answer. We were there at 6.43 am Monday. My first Midwife was named Solveig Jansson.

At 7.20 am the cervix was 2 cm long and I was dilated 1 cm. I was hooked up to the fetal monitor. I had actually thought about not using one but now I was absolutely fascinated by it. My contractions came with about 3-6 minutes intervalls. My baby's heartbeat was 130, and my own was 80. They informed me that I was in the latent phase but that I could stay for the doctors round. I don't remember meeting the doctor and I actually think they just let me stay because me contractions were so painfull.
I came of fetal monitor and most of the time I spent walking around, saying YESsssss… a low husky voice whenever contractions would grip me. At 11.20 am I was open 3 cm, and the cervix was 1 cm.
At some point I was asked if I wanted my membranes ruptured and have my babies heartbeat tracked with a scalp electron instead and to my surprise I yelled “YES!” and just gave this BIG SMILE. I was alone with the nurse, don’t remember why since my partner almost never left my side. It was such a great relief to have my membranes ruptured and the water come out. I told her thank you. She looked surpriced. After the scalp electron was placed I wasn’t hooked up anymore but roamed freely.
For pain relief I used:
  • Nitrous Oxide inhalations: I started with a 50/50 mix with oxygen at 11:40 am monday. At first it helped, but I have mixed feelings about it. It made me funny in the head and I think some of my weird thought was because of it. Midwife said I spoke of chipmunks and Danish people. I overdosed quite a lot and have bouts of amnesia that went on for hours. Had I been able to control myself I would have less side effects.
  • Acupuncture: It worked, but not a lot. I liked it.
  • Bath: I took a bath 5 pm but it was HORRIBLE! Hated it. Hated getting naked, hated getting in, tried to drown myself in it, hated getting up, being wet. Not doing it again during labor this bad. Don’t know why I insisted on trying it. I was desperate.
  • I had sterile water injections placed under the muscle in my back to alleviate the back pain. I liked this too. The time was 10:30 pm monday.
  • Positive thinking helped a lot, thinking how the pain was leading up to something, getting results.
  • I also had a epidural(3), more about that below.
At 3 pm I had my next midwife, Christina Johansson, since Solveig had to go home. My contractions came at 4-5 minutes intervalls. She has written in the journal that the head was somewhat jammed (but in medical speak) and above spinae.
Then, at 6.30pm I had given up and had the epidural. I had written in my birth-letter that I was open to having the Epidural but I wanted to be the first one mentioning it. And I did. I begged for it as soon as I was open enough. Swedish midwifes has to have a doctor order the epidural and an anestheisiologist come down and place the cathether. It took a while to get into effect. At first it took away all of my pain. This kind of epidural is called a Sufenta-Eda 5ml/h, a "stand-up-Epidural" designed to allow the mother to be able to move around. The drugs used are typically bupivacain(4) and fentanyl (5)
One of the nurses asked me to pee and I headed for the toilet. I couldn’t so she gave me a cathether. With the pain subsided I had a hospital dinner, I think it was fish and potatoes.
Well, you can guess what happened. Contractions slowed down & I was put on a ocytocindrip at 8 pm. We started 10 units of Syntocinon in 1000NaCl at 20ml/h at 8pm and cranked it up to 60ml/h at 9.15pm (the midwife told me we could “back down” if it became to intense). I met my next midwife, Magdalena Göthberg, at this time. She brought a student, Annika Strand.

And there was the PAIN again! All the Epidural gave me was time to eat. My back labour was back with a vengeance. I think this was around 10 pm monday so at 10:30 I had the student, supervised by the midwife, place the sterile water injections. They told me it would feel like bee stings, a fitting description.
At 11.05 it was noted that my epidural cathether was causing a bleed. Maybe this was the reason it no longer helped? It was fixed by the anestheisiologist at 11.50pm but he said it was working. He also gave me an extra shot of painkillers into the epidural pump but I never felt any effect.
I inhaled my Nitrous Oxide, screamed for a birthing chair and was gone. When I returned several hours had passed. I tried asking people what was going on, they didn’t understand that I had NO MEMORY of the last few hours. It was time to push, it took me 25-35 minutes of pure POWER, but I was too weak to change position so I gave birth lying on my back with my legs in the scaffolds.
And when I pushed one last time, my baby girl came out and the world turned NORMAL in the blink of an eye. It was ok. I threw away the breathing mask and reached for my child. We had asked for them to wait with severing the cord until after it stopped pulsating and they respected this. Delaying the cutting of the cord is new in Sweden but has spread rather quickly. You can also donate blood in the cord to the umbillical vord blood bank but then you often cut it immediately.

onsdag 2 september 2009

The breech

My baby had been in breach position to and fro in the last weeks before she was born in week 41 +2 and my blood pressure had been a tad high during those last weeks. I'm also overweight. I had to come in to the midwives office so that she and a colleague could use an old ultrasound to examine what was up, and what was down. We we're actually wrong once, mistaking a butt for a head. First time around we gave it a week and she turned by herself, but by the next appointment she was the wrong way around again. I think this was in week 37. We talked and I was asked if I was willing to try external cephalic version at the labour ward, made by a doctor. I was informed they only have a success rate of 6/10 and that many find it “highly stressful” mostly due to the cortisone-injection that is so huge the heart starts racing. Also, they said some went into labor, so I had to be prepared.

My alternatives was the reversal, waiting it out & maybe having a breech birth or having a scheduled c-section. I opted for the reversal and my partner took time off from work. We were scheduled for the next morning at 11 am and he fasted with me at home in sympathy. We got there early, as instructed and I changed into hospital gowns and were hooked up to a fetal heart monitor. A nurse arrived with her student and the student felt through my stomach and they did an ultrasound. The student stated the baby was in breach and then the nurse agreed after doing her own check up. Then we waited while the heart monitor whirred. My partner fell asleep. They were going to give me the cortisone next so they put a needle in my arm.

Then the doctor entered, she was Norwegian and had a funny dialect, stating she was going to give the baby a gentle “push” which in her dialect became the Swedish word for “fuck”. I giggled.

She looked confused. Then she started the ultrasound, wanting a good look at the baby before they injected me with anything since they we’re worried how I’d react to heart palpitations. She looked puzzled. “But this baby isn’t in breech position!”

She called the nurse & student and showed them the screen. The student flushed. The “head” she had felt with her hands and seen on the screen was once more a butt.

They removed the needle in my arm and it began to bleed quite a bit and so I was given a unreasonably big bandage on my arm.

Everyone apologized and I said it was a nice (unmedicated) adventure and then me and my partner broke our fast with a nice steak lunch.

Now, if she had stayed in breech and I had opted for a vaginal birth this would have been important. She had to weigh more than 2 kg (4,4 lb) and less than 4 kg (8,8 lb). They would have x-rayed my pelvis to see if she would have fit through. They would also have tried getting me a midwife that had done many breech births since it’s become more and more uncommon to try a vaginal births with these. 9/10 babies in breech position are delivered by a caesarian.