Thursday, November 15, 2012

First Time Pregnancy: Some Stuff You Might Want To Know

Here I sit in my rocking chair, finally on maternity leave, about to have my first child (or so they tell me), and I find myself reflecting on some of the things I have learned over the course of being pregnant.  I thought I'd share them with you all, so that 1) people who are considering becoming pregnant can have a sneak preview of some of the joys and non-joys of the pregnant state as experienced by just one person; and 2) people who have "been there, done that" can sit back and have a self-satisfied chuckle.

1.  Miscarriage is surprisingly common.
Having a positive pregnancy test doesn't mean you will stay that way.  We all sort of know this, but I was very surprised to find out when I miscarried at 9 weeks last December that nearly every woman I knew who had children had had at least one miscarriage somewhere along the way.  It can be emotionally and physically challenging to have a miscarriage for some women, especially if you have been trying to become pregnant for a long time.  Just go into it aware that there is a very decent chance you may experience this yourself. 

2.  You can test positive later than you think on a home pregnancy test.
I tested positive only after three tests and ten days after my expected period, and I have a regular cycle.  Everyone is different.

3.  "Morning Sickness" 
"Morning" my ass.  Try 24/7 sickness for 9 weeks (some people have it even worse, with dehydration, hospital admission, IV fluids, and so on).  That made having a full-time job, at a public school, where the cafeteria is right near the front door cooking mystery meat first thing in the morning, a challenge in ways I cannot adequately explain.  I had to resort to sniffing lemon essential oil vials in my workroom while others weren't watching.  I have never disliked food -- or even plain water --  so much in my life.  The only things I could consistently keep down were milk and Gummy Bears, and I only discovered the Gummy Bears because I was craving sweet things, averse to chocolate, and desperate for protein. 

4.  Less Testing is Sometimes Best
I found out after an early ultrasound for dating purposes -- with which I was fine -- that my embryo's development was measuring a week and a half behind where the professionals thought it should.  I thought that made sense, considering that my test was positive a week and a half later than I would have expected.  They told me they wanted to schedule a follow-up ultrasound a week later to "check on things."  The thing is, I had figured out a few things about myself during my previous pregnancy.  One is that excessive testing was total hell on my nerves.  I could not think of anything other than the tests.  Not knowing any better at the time, I had four ultrasounds, no fewer than ten blood tests (ostensibly to monitor hCg levels), and almost wound up with an exploratory surgery I didn't actually need.  This isn't to knock the work doctors and medical professionals do.  They have reasons for wanting to do things like this.  On the other hand, how was having four ultrasounds going to prevent a miscarriage?  The answer -- it wasn't.

This time around, I told the nurse who wanted to schedule my follow-up that I wanted to wait a month before having a follow-up ultrasound in order to help keep my anxiety level low.  She didn't seem totally pleased, but it was a game-changer for me as I realized that 1) I had choices, 2) I did not have to undergo testing if I did not want to, and 3) It felt much, much better to say a genuine "hell, no," even if it pissed someone else off, than it did to placate someone else and give myself up in the process.

5.  Be Prepared For Comments About Your Appearance
I was so grateful that the vast majority of comments about my appearance over the course of this pregnancy were along the lines of, "you look great!"  I don't care if they were lies or not, though I was extremely surprised by the marked frequency of such commentary.  Occasionally, I did get well-intentioned but mildly annoying comments about making sure I didn't gain an excessive amount of weight.  There were also the humorous comments about cankles, which made me smile.  On the other hand, I did get a few comments later in my pregnancy about how I "didn't look so great."  Fortunately, these didn't come from anyone I'm particularly close to, so I was able to easily blow them off with comments like, "It's because I'm wearing black" or "It's because I haven't slept through the night since July." 

6.  Weird Things Can Happen To Your Body That You've Never Heard Of Before.
It started innocently enough, with stretch marks on my abdomen.  I had heard that might happen.  Sometime in the middle of my third trimester, though, it started to feel as if fire ants had taken my entire abdomen by storm.  I was itching intensely, day and night, and nothing seemed to help except the occasional cold pack.  No one had ever mentioned severe itching to me as a pregnancy issue.  

Let me point out here that if you are having abnormal itching anywhere on your body during pregnancy, you ought to check with your doctor or midwife right away.  Some itching conditions are "benign" (although you feel like you've descended into the ninth circle of hell) and others pose real health risks to your baby.

I didn't get an official diagnosis that this is what I've had, but I'm 99% certain that when my midwife said, "looks like a pregnancy rash" at 39 weeks, she was talking about the condition known as PUPPP.  So I went to Dr. Google to learn that there are some women who get stretch marks on their rapidly-expanding bellies, and their bodies have some kind of response to that that causes them to develop an itchy rash.  I started looking for remedies online, since lotion, oatmeal baths, and scratching myself into oblivion were failing strategies that brought on real concern that I might have to just peel my skin off and start over completely.  I wanted to limit hydrocortisone cream and Benadryl, so I discovered a way to get the itching from this maddening issue under control. 

What follows is how I treated this issue.  The itching had dramatically decreased by day 3, and by day 5, it was almost entirely gone.  Your mileage may vary.  Please note:  I'm not a doctor, so please use your own judgment and common sense, and take responsibility for your own decision to use these recommendations or not:

1.  Get Grandpa's Pine Tar Soap.  They sell it at GNC, natural food stores, or online at Amazon.  Grab a washcloth, get into a cool or tepid (not hot) shower, and lather up on all the itchy, rashy areas.  Start with three times a day (I'm serious).  Let the soap stand for 5-10 minutes, then rinse off.  If the washcloth makes you too itchy, don't use it.  At the end of day 2, I had some stinging on my skin after using the soap.  The next day, the majority of the itching had gone away and I decreased the use of the soap to 1-2 times a day, depending on what I needed on a given day to manage the itching.  NOTE:  You will smell like a campfire for a few days.  If you have PUPPP, though, you will definitely not care.
2.  Aveeno sells an eczema therapy/colloidal oatmeal bath product.  Get it.  After you use the soap, take some of the oatmeal out of the packet.  Don't use it as a bath; that's bullshit.  Instead, make a paste and apply it to the itchy spots.  Leave it there for 5-10 minutes and rinse with cool or tepid water.  Use it with the same frequency that you use the tar soap.
3.  When you get out of the shower, either pat yourself dry or set your blow dryer to a cool air setting and use it to dry yourself.  Yes, you will freeze, but at least you won't itch.
4.  My spouse made a concoction of oatmeal, mint herbal tea, jasmine tea, salt, and sugar that he heated and then stored in the refrigerator.  It made a sticky paste that I applied to the itchy spots which dried and helped soothe and protect my skin.  Be sure to strain well so that you don't have tea leaves sticking to your belly.  Use as needed.
5.  I found it helpful to keep myself as cool and dry as I could comfortably manage, and to drink lots of sugar-free liquids (both hot and cold) to stay hydrated.  I recommend lemon water and herbal teas.  I found that moisturizing lotions were not helpful, even in New England in November, and that if my body got warm, this would make itching worse.
6.  If the benefits outweigh the risks for you, take an antihistamine as recommended by your doctor or midwife.  My midwife approved Benadryl, if absolutely necessary.  I took one tablet (25 mg) for three nights before bed to help manage some of the itching and so that I could sleep.  Benadryl on its own did not take away all the itching.

7.  Be Prepared To Go Past (Maybe Way Past) Your Due Date.
First-time pregnancies are notoriously long, dates can be miscalculated, and Mercury can go retrograde, all of which can contribute to a later due date (well, I don't know about the Mercury thing for sure).  Don't obsess, but start to think about what you will do if you go past your due date.  Will you opt for medical induction?  Will you try natural induction methods?  Will you wait a certain amount of time past your due date, or are you just ready to get on with giving birth?  No one can tell you what is right for you, but trust yourself to know what the best course of action is and speak respectfully but firmly with your prenatal care provider about your options, benefits, and risks.


8.  Early Labor Can Take DAYS.
I've been having legitimate irregular contractions at night and in the early morning for the past 3 or 4 nights.  Then I wake up and they go away.  I've heard this called false labor or pre-labor.  I can think of other names for it, but none of them are suitable for sharing here.  Some point out that your body is doing SOMETHING and can even talk about having had this sort of early labor feeling for as long as a week before their water breaks and they have a relatively short active labor.  Just, you know, don't be surprised or think there's necessarily something wrong with you or the baby if this is what is happening for you.  Obviously, check with your care provider if you think something is amiss -- it's appropriate and reasonable to err on the side of caution.  Other than that, keep yourself well hydrated, stay with your exercise, and keep yourself distracted by doing early holiday shopping or writing super-lengthy blog posts.