The care and feeding of a new (human) mother

(A joint blog post)

AKI: True story: One night, a couple of weeks before Anno’s due date, I googled ‘Care of a new mother’. It was the first time we had begun to see past the pregnancy and into the new life we would all be entering with our second baby. On the first page of results (and isn’t that Google’s whole value proposition: most pertinent results up top?), there were only four properly responsive hits (sorry, but ABC news’ article entitled ‘Mother Sues New York for $900 Trillion For Taking Her Kids’ was not on-point). Of these four, one related to the care of cats having recently given birth. The remaining 3 were written in the manner of quasi-sassy first person self-help guides, and included such tips as ‘Get a Pedicure’. Thusly, this post!

ANNO: My second maternity leave (this time in Nairobi) has been spent largely luxuriating in the newness of our son Faris, while being in the care of my husband and nanny who allow me those precious minutes needed to bathe, check email and feel human while being a new mom.

This is in sharp contradistinction to the experience of having been a new mom in the US. As new arrivals to NYC, I spent most of my days alone, underslept and baffled at the task of making my newborn sleep, eat so that I have some brief respite. In the course of nine months of unemployment, I ended up gaining more weight than I put on during the pregnancy, endured periods of utter loneliness, and generally believed that I would never be myself again. I was sleep deprived, overwhelmed by the demands of breastfeeding and caring for a newborn and perhaps most importantly by the fact that my life had gone from one that was multi-faceted and interesting to one dominated by leaking breasts and changing diapers which few of my friends could relate to (I was one of the first to bear children). Good advice was in short supply and I found very few who were able to relate for some bizarre reason. I found myself the target of irritating platitudes… ‘ now the baby is the most important thing in your life, you have to forget about everything else’ , ‘ no one said it would be easy’, ‘try and sleep when she sleeps’. Everyone agreed that having a child was a bombshell but no one seemed to be able to provide any granular advice that helped (and yes, I was laying off the vacuuming!)

Aki would come home to a hugely relieved wife who would promptly hand off baby and run off to shower, run or whatever it was I felt needed to be done to regain sanity. In brief, it wasn’t exactly the cascade of awe and wonderment that seems to pervade women’s discussions of their first children (particularly in North America) but it wasn’t also the other end of the spectrum where I was hopelessly depressed. I simply longed for the support and care which I now firmly believe should be forthcoming for new moms but which in the US is seriously missing. New moms in the US tend to find themselves in a void upon having a new baby – if they aren’t fired , they have no maternity leave, no public health care beyond the birth and a system that takes for granted the free social and economic service that mothers provide. In addition, as a new mom in NY I felt there was even contempt in the way city services, businesses and attitudes… i.e. very few escalators or elevators in the subway and a ban on strollers on buses meant mothers of small children were very confined to where they travelled. Breastfeeding in public was still something that sparked public controversy and I had friends who were asked to leave such places as public libraries for doing as much. And I can’t even count how many times I was scolded in the subway by strangers for venturing out with a young child for exposing them to germs, not to mention by street vagrants who felt they were more qualified than I to impart advice on how my child was dressed (adequately or not ‘ put a hat on that child!’ or to let me know when she was hungry ‘ feed that child!’) It seemed to me that being a new mom in NY was to be the hidden underclass – disempowered economically and socially and preferably hidden away at home, doing the donkey work that is new motherhood. Better unseen than acknowledged. No wonder so many women have PPD and that the term was coined there and how much easier it must be for a doctor to prescribe Prozac than to fill the social void that exists for new moms!

My intention in putting pen to paper on this was simply to offer a reflection on the simple but monumentally different approach we took the second time around and why this made such a difference to my outlook, health and well-being as a new mom. I offer this simply to fill a void I felt existed when I sought this reflection and advice having my first child.

Much like our birthing experience, we were determined to have a better experience in maternity and actually feel the ‘magic’ that many had said they felt having a new child .

Not being from the US, the conditions to which pregnant women and new mothers are subjected in that country was a rude shock for me. Essentially, pregnancy is viewed (from a policy and societal perspective) as smoking: as in, you chose to do it, now deal with the consequences without any regard or help from society. I have friends that cannot even bring themselves to speak to of their delivery and post-partum experience, for fear of cracking up (or worse, being perceived to) under the pressure and loneliness of it all. I have other friends, suitably supported and plugged in socially (these persons tend to be in Canada or overseas) and they tend to gloat about how well they are doing (almost as if to say ‘what’s all the fuss about?’). In fact, I now belong to this latter group. Having been in both camps (i.e. in the US and outside now or rather unsupported and now supported), I am now writing not to crow but to draw a neat distinction between the alleged genetic weakness of women who succumb to depression/’PPD’ and the sort of post-partum environment which allows for a safe and speedy re-entry into life (wearing the new hat of ‘mother’).

Accordingly, this blog entry is essentially about what is needed to care for a new mom,. So in descending order of what I felt has been most beneficial for me – it essentially boiled down to six fairly straight-forwardmust-haves (and none of them involve a prescription):

1. The opportunity to groom, bathe, and generally recover from the sheer physicality of birthing - This requires a capable and caring someone to hold the baby – husband, fulltime nanny or mother preferably. Being able to hand off baby for even a half hour in the morning so I can have a coffee and bathe has been a wonderful part of my care routine. Likewise, being able to nap with someone else on guard of sleeping baby can also be a relief – obviously sleep is a huge factor in recovery.
   
   
2. Someone to have fun with – a husband, friend with whom to take walks, talk about other things than the baby. My husband and I walk, write, take pottery lessons together and are generally enjoying the time together. We’re new in our city so not yet plugged in socially but having a partner in crime even helps in expanding our social network.
   
   Above: F.'s first pottery class
   
   
3. Small projects to keep one’s mind busy outside of baby care – for me it was helping my husband’s business, blogging, writing, pottery and art lessons…nothing too heavy or deadline driven but gave me direction in my internet surfing and connection with others.
   
   Above: S. (kinda) getting into the whole pottery thing...
   
   4. Healthy prepared food. This helps endlessly with feeling in control of your recovery, weight gain and body image. It’s way too easy to dig into a bag of chips when you’re underslept, scattered, starving and on the baby’s schedule…
   
   5. Paid mat leave. Being given the license to check out from work for a meaningful amount of time to focus on the baby and recovery gives me the sense of being valued , of having an fixed horizon to my time off and a sense that I should make the most of this time. By contrast, in my last mat leave, I was unemployed with the prospect of doing this endlessly which for a new mother, can be a bit unnerving, particularly if you’ve been working up to that point.
   
   6. An empowered birth. See our last blog post on this but essentially, this can set the tone for your early maternity days and as such should be viewed as an essential ingredient in the health and wellbeing of a new mom.

Finally, this blog post is a raised fist in protest of the ludicrously macho nature of the whole baby industrial-military complex. We are convinced that all must be always be ok, and that we are weak if we complain, and that all other women are at all times in love with their babies and their roles as new mothers. We compete passive aggressively by telling rose-tinted stories of our deliveries and breast feeding. We retreat from engagement with the world around us, as the other pillars of our identity crumble without the nourishment of broader stimulation.

The motherhood experience has thus been parcelled, marketed and sold to us, to be consumed and regurgitated without thought. To say that one is tired, or that one feels scared, or confused is tantamount to saying that one is not grateful for the chance of having and raising a beautiful healthy baby. I, for one, reject this false duality.

Household tally: 4 humans, 2 other mammalian life forms

Since F.’s arrival, the house has gotten very cosy very fast. To me, he remains something of a mystery, with his software coder’s hours and kaleidoscope of facial expressions (half-smile, vacant, frown, deep frown (think, checking your investment portfolio kind of frown), back to half smile). Second time around, however, I have much more tenderness towards a newborn, because I know how brief this phase is (we have the 3.5 year old walking, talking, singing, dancing, joking proof of this in the very next room), and because I know how lucky we are to be experiencing this completely and mindfully.

Anno’s getting the hang of the whole maternity leave thing now, abandoning her Blackberry for an unlisted iphone number. Despite her sleep deficit (I essentially hang on to F. for very brief stretches because of the whole underdeveloped mammary thing, and the fact that I seem to make him cry within seconds – my personal best of not-crying wakefulness thus far can’t be much better than 3 minutes!), Anno is amazingly active and is thoroughly enjoying her time and space with F. I heard them this morning cooing to each other at 445am – now that’s a miracle!

We have decided to make the most of the overlap between the maternity leave and my not having a full time office job by working on joint projects and enjoying ourselves as much as possible. As Gareth C. mentioned, we probably won’t have such a length of time together again until retirement. We accordingly decided to celebrate F.’s second week birthday by having a small party.

One of the tasks was to arrange for coffee for about 35 people. In NY, I might have gone to DunkinBucks or some other such chain to get one of those box’o’joe arrangements so we thought this would be easily done here. We visited all the major chains (most of which give you that sense of any-place-ism – the wifi, the $5 frappucino, the blond wood counter etc.), only to be met with confusion:

Us: Hi, we’d like to arrange for coffee for about 30 people at our house. Do you offer such a service?

Them: Err, we can sell you powdered coffee and you can make it at home.

Us: Hmm, that’s not quite what we had in mind. Perhaps you could deliver a canister of coffee to us?

Them: We can make coffee for 30 people and you can pick it up from us before your event.

Us (hopeful now): Yes yes, so do you have a large enough container for this?

Them: Now (this is a classic Kenyan opening gambit for delivering bad news), you would have to provide the container.

Us: SILENCE

Our nanny F. (who has appeared in these pages before, and is a card carrying AN) finally resolved the issue by making pot after pot of strong stovetop espresso and putting it into the large yellow thermos which we use to deliver tea to the night guards.

Unrelatedly, except in the spirit of having maximum fun, S. had her school photo day recently. Parents were asked to bring children in full school uniform (I am guilty of allowing her to wear her Barbe-a-papa tshirt every so often), so we timely delivered a clean, smiling and be-gelled (S. pronounced her hair to be ‘cool looking’) girl to school. When I can back to pick her up after Karate at the end of the day (1pm), I noticed that she was wearing a tattered red tshirt (not the regulation white polo she had been wearing at drop-off).

I asked the teacher where S.’s shirt was (mildly annoyed that my daughter was wearing a torn shirt for no apparent reason, on photo day), leaving implied (thankfully) the question of ‘what kind of show are you running here?’. Ms. M. (the teacher, and, I'm beginning to suspect, also a full blown AN) cheerfully replied that S. had volunteered to take off her shirt to lend to one of her classmates who had apparently not worn the correct uniform. Now I know this isn’t exactly cleaning lepers’ bed sores in Kibera, but I was still pretty damn proud. S. continues to be a curious and affectionate big sister, but leaves the house for longer stretches of time (up to 20 minutes at a time) to hang out with the askaris (the guard watchman) or the groundskeeper, or just play with the dog. The guardbox near the gate has a bewildering panoply of hulahoops and stuffed dolls by it. Anno and I are trying to make sure she knows that F.’s arrival does not represent a zero-sum scenario…I'm feeling mild anxiety at how quickly she's getting so big.

As the cliche goes, the days are long but the years are short. Here's proof (on rollerblades) of how self-sufficient S. is getting now:

Introducing Faris!! - GUEST POST BY ANNO

Above: Nairobi, January 21, 2012 @ 412pm - One small step for man...

Faris means (literally) horsesman and (figuratively) one of upright bearing in Arabic (Farasi also means horse in Swahili), and Rai means ‘bearing lightning and thunder’ in Japanese. An unlikely combination of languages, but we liked that it gave Faris a superhero-ish name, and it reflected the intensity of his arrival.

My guest post is intended to help consolidate the experience of Faris’ birth for our collective memory, since it was a very positive experience, and one likely to fade with time. We spent a lot of time trying to make the experience a bonding one for our family, having just moved to Kenya and feeling a bit adrift in the bustling city.

My water broke on Thursday January 19^th, a day before my due date, while we were in the green grocer (named Mama’s after the portly and suitably bossy matron that runs it) buying melons. With a melon in each hand, I looked across the tomato display at Aki, trying to convey what was happening without outright saying it … we were in a 4 ft square store with helpful attendants everywhere. Aki understood after some considerable eyebrow sign language, and quickly paid up. (Aki: Extra points to Anno for having the presence of mind to make sure that our shopping basket wasn’t left in the shop!)

When we get home, we confirm that in fact my water has broken, that the fluid is clear (i.e. all-clear with baby), and that there are no contractions yet. In accordance with our plan, we decide to not call the doctor until labour has begun in earnest. The theme of much of our planning was ‘NOT NEW YORK’ – as in:

• no going to the hospital early,
• no being told that your labour is failing to make progress,
  
• no to getting hooked up to a hospital bed,
  
• no to unnecessary medical interventionism.
  

For Sofia, my water broke early and in our excitement and naivete we promptly called the doctor, who then immediately informed us were officially on a ‘deadline’ to deliver within 24 hours for fear of ‘infection’ as per NY state law.

Flashback to Sofia's birth in July 2008: Midwife suggests I try to naturally induce labour with castor oil and acupuncture to avoid chemical inducement in the hospital (a much more brutal process), I do this, it helps a bit but not enough and when this doesn’t work, I get kicked out of the natural birthing centre (report card reads; FAILURE TO PROGRESS). Inducement begins with Pitocin in the main ward, countless physical exams by every nurse, intern and midwife who happens to walk by our room (the primary vector of all manner of infection to an otherwise totally sterile womb, creating a catch22 which further galvanizes the medical professions’ need to get baby out by any means necessary!). Inevitably, under the circs, I come down with an infection and narrowly avoid a c-section. Thankfully my wise midwife (the most experienced and respected in Manhattan) shows up at the 11^th hour, sees the situation, assesses that rather than cut me up, she can deliver the baby in 30 minutes the ‘normal’ way.

Success, and beautiful baby Sofia is brought into the world without the need to unsheathe the scalpel set (much to medical resident’s chagrin). The downside, mother is comatose from Pitocin, epidural antibiotics for 2 weeks post birth, baby Sofia is in intensive care for a week, breastfeeding off to a rough start as hospital does not allow ‘rooming in’ with mom or breastfeeding, insists on formula feeding baby for first week mom is told she will starve her baby if they don’t do this…Aki is not allowed in the hospital beyond visiting hours, and I am alone in a room shared with a drug addict mom who is awake all night ranting about invisible spiders crawling over her face. The hospital scene is so unappealing that Aki and I actually deliberate smuggling Sofia out of hospital, but ultimately decide that we will endure present situation and just try to avoid this at all costs in future.

Fast forward to Nairobi 2012: So we decide we don’t want to be on a deadline for birth and want to distance ourselves as much as possible from physical, emotional and social aspects of the first birth experience - that breaking of waters is not the calamity that the medical profession makes it to be. In fact, we discussed this at length with our doctor during our medical visits and her take was similar inasmuch as we would be given 48-72 hours to see if labour kicked in naturally before we then decided the way forward. So following her advice on this (and not totally trusting the medical establishment to stick to this advice), we decided to give ourselves 48 hours of at-home laboring before triggering the broken-water stopwatch.

Above: Emotional signpost: excitement - we're in labour!

Above: Sofia helping me through a contraction on Saturday morning.

Thursday night, about 10 hours after water breaks, mild contractions begin. I am able to sleep through them but wake up on Friday with them ongoing – about every 20 minutes. Friday we go to the mall(Aki: I love that Guava frozen yoghurt!), take Sofia to swim lessons and try to take our minds off the contractions which we know are early stage and the real show has yet to begin (and we don’t want to exhaust ourselves by thinking the labour has really begun as yet). We know in the typology of labours I’m unflatteringly a ‘putterer’ – that is, it takes a long time for things to get in high gear. By Friday night (now about 36 hours after water has broken), we get some serious contractions, about 10 min apart now. We try to sleep but they are too painful so we end up awake all night with Aki coaching me through contractions (we practised and endorse the Bradley method of childbirth – husband coached labours). It works beautifully – who would have thought that relaxation and power of suggestion were so effective at pain relief? Seriously, I doubted it but having practiced much of this, Aki was able to guide me through some rough seas that night! I’m sure he’ll blog more on this soon… By 6am, contractions 6 mins apart and now 41 hours post water breaking we decide to let the doc know what’s going on.

We get our story straight like a couple of bank robbers about to be interrogated in separate cells, and call her – bald-facedly lying about when the water broke, saying that our water broke the previous evening (not two evenings ago) and that we’re in a good labour now… Despite our Rumsfeldian ‘truth-management’, she tells us to come in right away and that she’s caught up somewhere all morning, and that she will pop in when she can that morning. Seeing as the doc wouldn’t even be at the hospital, and with the hope that Saturday morning traffic wouldn’t be too bad, we decide to hold off going for another few hours.

We end up arriving at 11:30am, when contractions are close to 3 min apart. When we arrive the nurses excitedly proclaim, 5 cm dilated…’we’re going to have a baby very soon!” . This is great news, and we’re vindicated in our home-made risk management stratagem, and proud that we’re close to the finish line. In Sofia’ s birth 5-10 cm went very fast so our thinking was that it would happen again that way.

However, our doctor, whom I’ve really liked up to this point, then conducts a quick exam of her own, shakes her head gravely, and delivers the following bomb: “Oh, only 5 cm, you’re very slow! Considering that you’re water broke last night, you should be further progressed. We’re going to have to think about inducing you if things don’t pick up.” She then pronounces my contractions to be ‘not productive’ – things are suddenly looking grimmer for Team Faris! Doc suggests I take a walk to speed things up. She’s obviously keen on having her Saturday back and in the process I’m worried has all but stopped my contractions in their tracks – again power of suggestion (‘You call this labour??!! This is a joke!’ she seems to be saying to my uterus and my uterus seemed to be replying ‘errr, maybe you’re right’).

So Aki and I decide to take a walk, and as we’re just on the verge of hatching an escape plan from the hospital (notice the trend of escape plans from health institutions as part of every birthplan thus far!), my contractions take on a seriously painful new approach. I can barely stand through them and we accordingly return to the hospital room. Contractions are now coming in a seemingly endless, break-less pattern, and have switched to the torturous sort with nothing providing any relief except a hot shower which is broken and intermittingly spitting out cold water (almost the only developing country taste in the hospital. Ok, that, and the pair of white gumboots left mysteriously lying in the tub in the bathroom).

I’m having back labour and the contractions are now pushing the baby in the wrong configuration (posterior). I keep saying “this is not normal pain!” which undoubtedly unnerves Aki (ed. – I was cool as a cuke the whole way through, hehe nervous laugh), and the doctor is still out on her Saturday errands. I can only describe the pain in the last two hours of labour as ‘hanging from the chandelier’ type pain – it made me crazy. I was beside myself, and thought this would end either in my death or in the birth of our child – with slim odds favouring the latter.

Nothing seemed to relieve this pain other than the knowledge my labour was in fact progressing quite fast, or so I was told. The doctor returns at last, declares that I’m in fact almost ready to push and within another hour or so, baby is in my arms! I go from a delirious hollering wretch in the last hour to my wise-cracking self in about 30 seconds flat – the baby out of my body is a huge relief, I feel as though I’ve completed a half-ironman (which I’ve done, and can therefore empirically assure you this is harder and the stakes are higher given the fact that here, not only can you actually die but the course duration/difficulty is not predetermined, so as trained as we were we hadn’t prepared for the back labour and had no idea what the pain level would be). I’m elated and able to make phone calls within a half hour of birthing to anxious sets of (grand)parents. We really were in awe and wonderment of our new child in a way that I wasn’t capable of when drugged up and delirious the first time around. Aki, Faris and I spend the first night in hospital together.

In fairness, we are very grateful for all the care and tests to which we and Faris were subjected. After a 48 hour stay in the hospital (for observation purposes, and during which he and I ate, slept and played together constantly), Faris was declared fit to join gen-pop.

Note to my future self on what we enjoyed most:

- We did most of our labouring at home, with humour, fun and in a supportive environment (Aki: Thanks also to American Analog Set for a great playlist!).

- We spent as little of the experience in the hospital and offered very little opportunity for doctors to go nuts with needless interventions

- We were hyper-educated and trained, and knew what to expect and where not to freak out

- We felt that we controlled the narrative not the doctors – we were never corralled into a situation.

- Aki stayed with me in the hospital.

- We had a private room, roomed in with the baby, had visitors and weren’t tightly controlled in that environment.

- The hospital staff supported and were knowledgeable about breastfeeding.

- The doctor’s intervention was limited to catching the baby, and administering/backstopping all medical clearances etc.

- The consistently glorious weather allows for comfy dressing, walking, and breast feeding

In retrospect, we did lie to our medical practitioner which ultimately reflected that we didn’t trust her surgeon’s worldview, but it paid off. In the labour room, everything she said in the consult room didn’t hold – our risk management must trump any other person’s (given that it is my body, my baby, and my role to solely bear all consequences). It seems in labour and pregnancy everything is about the baby and mothers, are simply a carrier, that can be split open, diced and sliced in any which way all in the interest of ‘the baby’. I find this approach to childbirth a bit of a George Bush approach – if you’re not for the baby and willing to completely surrender to our inadequate ill-informed and knee-jerk approach to childbirth- then you’re against the baby.

This no-nuance perspective is unsustainable and intolerable. Childbirth is tough and physical – there are great medical advances that can help, but it doesn’t need to be either a highly medicalized spectator sport where you are railroaded into procedures you don’t want/need (all in the notional and extremely short-term interests of the baby), or else have to go totally granola natural in order to avoid all of this. As in all things, there is a spectrum of experiences, and a vast middle ground, which, in our case, warranted lying to care providers to be reclaimed. Good (and, candidly, lucky) for us that we achieved what we set out to, but shame that that’s what’s required to have a decent birthing experience in this day and age.

In any case, we are as happy as clams with Faris (hereinafter, F.). S. is proving to be an excellent big sister, with the need to curb her enthusiasm by only 30-40%. Watch this space – I think so F. is just getting started (Aki: that phraseology is one of S.'s patented grammatical enhancements to the English language)

Above: Minutes after the birth - happy, mindful and lucid.

Above: Nurse: "Hmm, as I suspected, your boy is a genius..."

Above: Proud big sister at the hospital seeing Faris for the first time.

Above: Getting a little carried away with the affectionate sentiments...