bearing blog

Pregnancy update power. Form of: Quick Takes.

1. I have written a few blog posts but not finished any of them because my powers of concentration and attention span are seriously attenuated. Hence, this.

I have a post about Elisabeth Leseur and I have a post about natural childbirth. Neither is done, I really want to finish both of them, and that desire is clogging up the queue. This tendency is my blogging kryptonite.

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2. My energy levels are overall pretty good, considering, but plummet to near-zero at unpredictable times. I have embarked on a program of eating lots of iron-rich food, which means that by now I could probably write an entire cookbook's worth of recipes for different liverwurst sandwiches.

Tomato and liverwurst on pumpernickel rye flatbread crackers, with just a little salt and pepper, is pretty good. This morning it was liverwurst, onion-chive cream cheese, leftover vinegar-sugar coleslaw, and sriracha on a toasted English muffin. I think sometime this week I may make banh mi.

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3. "So, how are you feeling?" has a split answer.

All the soft stuff feels pretty good for seven months pregnant. Decent energy (as long as I get periodic naps and infusions of liverwurst), good appetite and digestion, not a single leg cramp, circulation is great, no heartburn, no nausea.

The skeleton and associated attachments, are way out of whack. The drunk staggering for the first ten steps after I get up out of bed or a chair, I could overlook or pretend is normal. But I have noticed a disturbing tendency to walk with my feet rolled out, on the outer edges of the soles, which is something I Do. Not. Do. in ordinary life and have never noticed before in pregnancy either. Something's up. Also, the other day I tried the psoas release position (scroll down) on SpinningBabies, and I could not believe the intensity of the sensation in my back and hips.

I think it is about time I embark reluctantly on a daily program of things like brisk walks and pelvic tilt exercises and squats and sitting on the exercise ball (which at least has the advantage of keeping the children from throwing it at each other).

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4. For the first time, we aren't traveling to Ohio for Thanksgiving, and we don't have plans to get together with anyone else either. This seems very weird. We waffled about it for a while but in the end decided it wouldn't be all that good for me to travel or to commit to anything big, so the nuclear-family Thanksgiving it is. Mark promised to deal with Thanksgiving dinner for me. I said I would do the grocery shopping and help where I could. This will be new.

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5. Till last night, I had not had any Weird Pregnancy Dreams. No Dropping Dreams, no Misplacing The Baby dreams, no Giving Birth To Nonhuman Animals Dreams either.

Last night I had the first weird pregnancy dream, in the category of Labor And Delivery Fantasy, in which I looked down in bed to discover to my surprise that there were feet emerging from my body. I gave them a yank and out came a perfectly healthy, normal-sized human baby. I wrapped the baby up and held her in my arms (in the dream it was a girl, although I am carrying a boy), and the baby looked up at me in the way that newborns do as soon as all the drama is over and the lights are dimmed.

And that was that, except for the vague feeling of disappointment on awakening and discovering that I still have eight weeks and a non-fantasy childbirth between my arms and #5.

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I have no idea where he got this.

Yesterday afternoon my almost-four-year-old was angry at his brother, so he ripped up one of my paperback books.

I said, "Don't rip up my book!  It makes me sad!"

He said, "It's okay, mommy.  It'll be fine."

I said, "No, it won't.  The book is broken now.  I can't read it anymore.  It's ruined.  That makes me sad."

He said, "I was mad at [the 10-year-old]."

I said, "I'm angry at you!"

He looked concerned and asked:  "Will you be mad at me all of the times?"

I was mixing up medicine for his sister and I paused.  "I will be mad until I calm down," I said.

He looked at me quite seriously and then said firmly:  "Mommy!"

"What?"  I was back at the sink.

"Take a deep breath!"

He pronounced it "breff."  

I paused again and turned around.  He was standing there, his head level with the countertop, looking at me expectantly.

I inhaled.  

He pantomimed exhaling, exaggerating the motion of his chin and head.

I exhaled, feeling the corner of my lip curl upwards.  I suppressed it.  "Now what?"

"Take a deep breath again," he told me.

I inhaled.  He pantomimed exhaling.  I exhaled.

"Now what?"  I asked again.

"Now you are all calmed down," he said.  And he went off to play.

And you know, he was right.

 

Emily Oster on the conventional wisdom of pregnancy.

Darwin of DarwinCatholic recently pointed me, via Facebook, to an interview with author Emily Oster hosted by EconTalk host Russ Roberts.  

Oster is the author of Expecting Better:  Why the Conventional Pregnancy Wisdom is Wrong--And What You Really Need To Know.  

I have been meaning to pick it up for some time;  now, thanks to the instant-gratification feature on Amazon (aka the Kindle store) I should be reading some of this book later today if I get a chance.

Here are a few interview quotes gleaned from the transcript highlights posted on the EconTalk page.

OSTER:  I think that patients sometimes will just say: "Look, I just want you to tell me what to do. I don't want to have to make this choice"....in combination with doctors sometimes saying: "Look, I don't have 45 minutes to go through all this with you; I'm just telling you, you should make this choice." 

I think those two things....interact poorly in a way that makes us not always make the best choices. 

[Y]esterday I was on the radio with a doctor who said: "Well, statistics is really hard, and so ...we shouldn't really expect people to be making a lot of these decisions with data."

And I think ... "Are you kidding? You *have* to make these decisions with data."

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OSTER:  I think one of the things that is definitely true is there is variation across doctors. And there is also this very clear set of constraints that I think doctors face, some of which just has to do with not having that much time and some of which has to do with legal issues. 

...And I think for both of those reasons, it is in some sense incumbent on women to think through these choices for themselves.

And this extends past pregnancy into other parts of medicine: that there just isn't really a choice--you have to do this, to some extent, by yourself. There isn't another option.

On one of her examples, caffeine use during pregnancy:

OSTER:   [I]n a lot of what I researched in pregnancy there is a very clear problem with causality....

So, the concern with having too much caffeine in pregnancy is that you might have a miscarriage. .... And so the way that this is studied early in pregnancy is you look at women who drank some coffee early in pregnancy; you ask them how much coffee they had; and you look at their rate of miscarriage and you compare them to women who didn't have coffee, and you look across different amounts of coffee. 

[W]hat you find is...

• that up to 200 mg, which is about 2  eight-ounce cups, is fine....you really don't see any increased risk of miscarriage up to that level.
• When you start looking at, like, 8 cups of coffee, you see ....that there is an increased risk of miscarriage.
• When you look in the middle, like 3, 4 cups a day, the evidence is a little bit mixed.

So ... it's clear a little bit is okay; it's probably the case that a lot is a problem; but in this intermediate stage it's unclear.

And part of the issue is that when you look at these studies, the kind of women who drink coffee are just different from the kind of women who don't. And this is a problem in any observational study like this. And they are different in ways that are also, themselves, linked to miscarriage.

[W]omen who drink coffee tend to be older. Age is the biggest issue with this.

 In addition, in the case of coffee--and this was in some sense the most interesting thing for me research-wise--there is also a problem with nausea. So, if you are nauseous in early pregnancy it's a very good sign about the health of the pregnancy. Women who are nauseous--good news, ladies: you are less likely to miscarry. But women who are nauseous are also more likely to avoid coffee.

So when you look at women and you see some of them drink a lot of coffee, those women are also on average women who are less nauseous. And when you see that they then miscarry at higher rates, it may well be just that not being nauseous is a sign of miscarriage and caused them to drink coffee, but it's not that the coffee caused the miscarriage. And I think getting around that kind of challenge is very complicated. 

There's more, on epidurals, alcohol, deli meat, and cats, among other things.  Unfortunately the interview transcript is poorly formatted, but you can also listen if that's your thing.

A scary Halloween story.

My daughter is feeling much better now, to the point where she hasn't quite stopped complaining about pain from her incision, but we are starting to notice that she tends to do it when it's time to unload the dishwasher.  So it's about time I start buckling down and blogging a little more if I can.

I'll start with a story that doesn't have me in it.

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On the day before Halloween, Mark dropped the three big kids off at religious ed and then rushed off to do the grocery shopping as quickly as possible so that he would have time to stop by the hardware store and buy dowels for my nine-year-old's Archer-Cloaked-In-Black-From-Head-To-Toe costume.

Note the dowels emerging from the quiver on his back.  Mark is now an expert in duct-tape fletching.

 

Anyway, Mark rushed my three-year-old in the Car Cart through the grocery store, made it to the big-box hardware store, grabbed dowels and headed for the checkout with the 3yo in tow.

Just before they got to the checkout, Mark remembered that the three-year-old had been extra-wiggly back in the grocery store, and asked him:  "[Three-year-old], do you need to go to the bathroom before we check out?"

"No, Daddy."

But that's always a dangerous question.  Much as one should not point a gun at an aggressor unless one is prepared to deliver a disabling shot, one should never ask whether a three-year-old child needs to go to the bathroom before entering the checkout lane.  All asking does is begin the process of percolating the idea through the brain and down to the nervous system, eventually to find its way to the bladder.   One should either issue a firm parental command ("Time for the potty!") or else remain silent.

Mark entered the self-checkout lane and began scanning dowels.  Three-quarters of the way through the transaction, the three-year-old informed him:  "Daddy!  I need to go to the bathroom!"

Uh-oh.  "I'll take you to the bathroom as soon as I'm done paying for this stuff," Mark told him.  Then he let go of the three-year-old's hand to extract the credit card from his wallet.

A moment later, the 3yo darted out of Mark's peripheral vision.  Mark looked up and saw him running toward the front of the store, where the big sliding entry doors are.

And also where the displays are.  Display shower enclosures, and display vanity sinks, and...

There was an attendant there to assist people in the self-checkout lanes.  Mark handed her the dowels, screeched, "Hold these!" and sprinted after the three-year-old, who was already lifting the lid (and the seat) of a display toilet and pulling down the front of his pants.    Mark scooped him up from behind just barely in time.

"He was so very, very confused," Mark told me later.

Mark carried the objecting three-year-old back to the checkout lane and one-handedly retrieved his dowels from the attendant.  On the way out he passed a sign that said "Ring Bell if you received excellent service!"

Mark rang the bell.  After all, he did get his dowels back.