Monday, 18 November 2013

On how you spend your day

I am in the mood for writing long, philosophical posts on the nature of Things at the moment. This is partially because my only plan for the day is cleaning, which I have absolutely zero enthusiasm for (my mum arrives in 2 days, which I'm certain will provide all the necessary 'motivation' I need) and partly because I am still ill, despite hard-working penicillin and steroids. The ear infection just won't clear, and I remain vaguely in pain all the damn time. I've gone from wishing the ear infection would just go so I can have the baby already to wishing the baby was out so I could really seriously blast the ear infection and sleep for a couple of hours in a row (I'm not fussy- two hours would do nicely. And probably optimistic if the baby is here...)

But I don't want to write about ear infections, or incidentally, about the Cystitis the cat developed over the weekend, meaning that first thing in the morning and last thing at night have become some sort of insane merri-go-round of medications. This made me think of my old job at Bankfoot, a respite centre for children with learning disabilities. I worked there for 18 months, and despite it being one of the hardest jobs it's ever possible to undertake, I miss it horribly.

I spent the morning reading blog posts, as I often do when I don't have to be anywhere early in the morning; cup of tea in hand, stacks of pillows around me in bed and Feedly making a good looking magazine spread on my Kindle. I read the words- your words, mainly, people who read the things I write, and spend the day mulling them over. The 8-hour time difference means I can rarely join in the discussions about them, the moment has passed and the article is old news by the time I get to it, but I think and think and think, imagining my responses. Today, I read The Little Pip talk about a Guardian article on Motherhood as the 'most important job in the world'* and found myself nodding along like mad with her response. Now I come at things from a fundamentally opposite viewpoint of the author, since I am going to be a stay at home mum, rather than a working mum. Her blog is predominantly about being a working mum, so often lots of it doesn't feel relevant to me. But the idea of parenting- in any and all of its guises- being a social relationship rather than a job makes my heart sing. 

I adored working at Bankfoot. I would accidentally turn up early and just start work. I'd stay late and not think twice about it. I would work for 12 hours, then sleep over and get up twice during the night to deal with things that came up and get up at 6am and work for another 2 or 3 hours before getting on a bus that would take me an hour to drop me off at home and then do it all again when I got a 'we're short staffed' phone call a few hours later. I worked a night shift, awake all alone for 12 hours, then got 2 buses, got lost and walked for 40 minutes straight after because I realised that one of the young people did not have his swimming kit, and he would miss out if I didn't get it to him by 10.30am.

That job, whilst it was most definitely a job- I definitely got paid for it- was completely underpinned by social relationships. My own tiredness, my own revulsion at the task at hand (and believe me, there was PLENTY to be revulsed by...) the bruises (including a black eye just days before my wedding day) and cuts (so many cuts) was always negated by the needs of the young people, by the joy I got from walking through the door and hearing the loud music and seeing the smiles or hearing screeches or roars of laughter. And it was hard. Harder then anything else I have ever done or ever will do. Whether that was watching a child self harm out of sheer frustration, getting a knock to the head from a stray fist that left me seeing stars, or even when I knew I was irritating my colleagues because I didn't agree with them about the best way to do something (they irritated me too at times. Those were LONG days to work under stress in such a small team.) I was never, ever sorry that I was there. I have never known hard work like it. But it wasn't just my job, it was a part of me. Or more specifically, those relationships, with the kids and the other staff, were.

Now of course being a parent is different because not only do you have tiny overlords you can have a great deal of fun with, but you made those overlords yourself. I guess I am thinking about how lucky I am to have had a job where it was so much more than 'just a job'. It sets up being a stay-at-home-mum in some ways. The thanklessness of so many of the tasks (we were certainly not appreciated as heroes at the respite centre. There was always something we were doing wrong. Usually many things. But that's another conversation for another day) mixed with the never ending propulsion to do them because they needed done and the person you were caring for needed you and JUST GET ON WITH IT. There is no glamour or glory in being a care worker. It's a minimum wage job (for many, not us, thankfully) with next to no qualifications required. There is no status, or 'pioneering' in it. It does nothing to forward the role of women in the wider world- I'm sure it would be considered positively anti-feminist to read stories and hold hands and clean up poo and be another woman in a care role but I didn't care and I loved every minute of it. It was the role that has had the single biggest impact in my life, and one I would go back to in a heartbeat, regardless of what others feel my degrees and education are 'worth'.

So what is my point? I don't have one really. I miss working there. I think it's prepared me for being at home. Most of the young people were non-verbal, so I'm used to not having 'adult conversation' for large chunks of the day- I had really great communication though. I know that changing a nappy is the most unrelenting, soul destroying thing you can do with your day, safe in the knowledge that you will have to do it all over again in a few hours. But I also understand the value in treating such a task as something important, a way to show the person you are caring for that you respect them. 

I imagine that it's in large part my personality, but in my mind EVERYTHING is better is you treat it as a continuation of a social relationship rather than a 'job', although I know life doesn't always work that way. Working in the bookshop at WH Smith felt like a series of social relationships through warm and affectionate interactions with customers. My insurance job did, until I was moved to the sales department and it suddenly didn't. So how I spend my day, from now on at home with a baby and a cat, is important to me, to us, to our family, but probably not anyone else. And that is really ok with me.

*Who says it is? Seriously, I get so confused with this constant supposed 'battle' between parents who have a job and those who stay at home so confusing. I don't know anyone else who will be at home with their kids. Literally everyone I know works. I have no strong feelings about any way of doing anything because a) I just don't know and b) honestly, don't really care. I swear newspapers just perpetuate it so this lady and contemporaries can write articles.

Thursday, 14 November 2013

On being sick

I have been unwell. Really, properly unwell rather than the litany of colds, migraines (although I NEVER wish to underestimate the hideous power of a migraine, I'm lucky mine only usually last a few hours after the aura has appeared) and other crappy day-to-day illnesses that plague every day life. I have an ear infection. Well, two ear infections (ears infection would be more correct, I suppose, since it it the same infection spread across two ears, but it sounds clunky and unpleasant, like Culs-de-Sac.) It's funny how easily we trivialise traditional childhood illnesses, really. Almost every child ever has had an ear infection at some point, and happily munched down the the banana medicine that was kept in the fridge. I don't remember the sore ears specifically, though. I certainly wasn't hounded by them the way some kids are (I seem to recall my sister being a frequent attender for them) but Good Lord this has knocked me for six.

It's the relentless, grinding, aching pain that has shocked me. Do they hurt kids this much? On Tuesday I cried for 6 hours straight. This is not an exaggeration. Sobbed. It was horrendous. I had been awake since 2am, the doctor had poked at it and made it more painful and reassured me I'd start to feel better in 24 hours. She said it was bad, and there was an awful lot of pressure behind my eardrum, but hopefully it wouldn't burst. She gave me a massive dose of antibiotics I will almost certainly still be taking after Kick is here. I thought back to those grizzly, miserable toddlers I would see as a nursing student in GP waiting rooms, or in A&E during night shift, with exhausted, defeated looking parents and thought 'I know exactly how they feel.' And I meant the kids, not the parents. I couldn't imagine sitting in a waiting room with Kick feeling how I felt. It breaks my heart in advance to imagine her ever being that unhappy.

On the one hand, I know this is insane. Childhood illnesses are a way to build us up to be strong, healthy and adaptable adults. As a nurse I've seen kids plumb the depths of despair one moment then, after a dose of Ibruprofen, be running round the playroom like a banshee, only to crash again precisely 20 minutes before the next dose of medicine is due. On the other, this is not my patient, this is my baby. My girl, who I wish to protect from ear infections, chickenpox (they vaccinate against it here, thank goodness) and horrible bouts of diarrhoea and vomiting. Completely unrealistic, but there you have it. 

On Tuesday night, Kick stopped kicking. I'd barely felt her all day, but managed a 'count to 10' kick count on a couple of occasions, but at night there was nothing. I felt her once in 2 hours, and husband decided it was time to go to our Labour and Delivery ward. The on call doctor agreed, and fifteen minutes later we were safely in a cosy room, listening to our baby's heartbeat through the monitor with SportsCenter on TV and someone giving birth next door. We met our own doctor in corridor, even though she wasn't on call that night, who gave me a hug and lots of sympathy. She told me Kick was fine, but since I felt crap, she felt crap too. This is the point the guilt struck. And not really because my crappy illness had impacted on the baby (we both felt a WHOLE LOT better after an IV bag of fluids, which the nurse ran in record time and got us home an hour and 15 minutes after we got there) but because until that moment, I really hadn't really been thinking about the baby at all.

My own pain and misery was so overwhelming that I barely gave a thought to the baby. She wasn't moving very much, so I didn't have that constant reminder of her presence. The mild contractions I had been having every 30 minutes for 2 days had completely ceased. I felt less pregnant than I had in weeks. I was just me, and me needed a lot of attention, I didn't have any to spare for her. Thankfully husband was on top of things, and got into action. I remember wondering why on earth he was messing around with the hospital bag that sits packed in the corner of the bedroom. Then I realised he was putting all the last minute things in it from the check list on the fridge. I couldn't figure out why he thought we needed that, but eventually it occurred to me that if there was something wrong with the baby, she'd be coming out tonight and I would need the bag. It gave me a start, a reminder that my head was so focused on managing my own pain and discomfort that I'd forgotten why we were going to the hospital. 

I've not felt particularly maternal towards the bump. I don't think I'll miss it, I really don't think I'll miss having Kick inside, battering my internal organs whenever I drink something/go for a shower/pick up the cat/sit down and relax/it's Wednesday. I've not felt particularly 'bonded' to her, though I know some women are madly in love as soon as the see those little pink lines. I sometimes think  the miscarriage left tiny scars, near naked to the eye until the light hits them just right. Maybe this has been one of them- that distance between my heart and the wriggling lump that seems to enjoys loud music and the cat's purring. 

My head adores her, has transposed a personality onto her already. We talk to her like she is feisty and fiery and somehow larger than life. Everyone does, actually. Husband,  my doctor, colleagues from volunteering, even the nurse on the Labour and Delivery ward. And I wonder, did I do that? Did I create that personality for her based on the fact she kicks anything that dares to touch her? Is that just what babies do and I have invented a badass, passionate personality to go with it because I'm a wee bit like that and I secretly want her to be like me? Or do I want her to be more than me, to be less timid and less worried what people think? Do I think this will be how the world will be easiest for her, so I'm projecting it on to the outline under my skin? Maybe she'll be shy and quiet and considered and laid-back, and all babies kick and roll with such force they leave faint bruises on their mummy's bump. I don't know. But I know that being ill and letting myself get so dehydated and forgetting my hospital bag and somehow forgetting about the baby has shaken me up a little.

All day yesterday she rolled and kicked and stretched away to her hearts content, and I just let her and enjoyed it. I've mentioned a few times before on here that I have never been a huge fan of the kicks. I keep waiting for the bit when they calm down, like the book promises because she has run out of space. Kick makes her own space, at the cost of my insides. Increasingly my outsides too. I think at 38 weeks I just have to accept that the lull is not coming. And I'm really ok with it today. My girl is pushing and shoving and pulling to figure her way out, testing her muscles and trying to make herself heard amongst the voices she listens to all day long. And I still wouldn't say my heart is swelling and bursting with a mother's pride and love, but I can see how it will. And that is a pretty amazing cure for earache.

Tuesday, 12 November 2013

On Breastfeeding controversy

Another day when Breastfeeding hits the media (or more specifically, the internet*) The BBC reported this morning (as did all the major British media outlets) that there is a project taking place in South Yorkshire which incentivises breastfeeding for certain groups of women by offering them shopping vouchers. My twitter feed erupted in horror. I wasn't so sure. Here's the thing. I have a degree in Children's Health. I am well educated, come from a family where breastfeeding was the norm, most of my friends breastfed their babies for 6 months and I can afford to pay for private lactation consultants to support me, yet I am STILL far more terrified about breastfeeding than anything else labour, delivery and new motherhood will throw at me. I will do it because I feel like I have to, but I have absolutely no joy at the prospect, and it makes me feel a cold, hard nausea whenever I dwell on it too much. I'm the freakin' poster child for someone who should make this work, and yet I feel this way. So I started doing a bit of reading, thinking about my own experiences as a student nurse working with new mums in both highly affluent and extremely deprived areas, and a few key points struck me. 

I should point out, though I'd hope it'd be obvious, that I am writing a silly blog post talking about at a few bits of evidence found when looking at breastfeeding in Scotland and relating them to my own, very unscientific anecdotal experiences. Nor do I pretend to understand the whole picture, to presume to know what is and isn't an issue for a mum in an area of high social deprivation. I'm also not a statistician, so my understanding of some of these documents might not be perfect.  This really isn't intended to be an in-depth critique of the subject matter, rather a way for me to get my head around  my experiences of a complicated issue.

The first instinct of nearly everyone who read this story and commented seemed to be 'What a waste- much better to fund improved support services for breastfeeding instead'. I find myself thinking 'well, yes and no...' Part of the issue here is that the project is aiming to incentivise breastfeeding to six months- to me this means to encourage women who wouldn't have started at all to give it a go. Am I convinced shopping vouchers are the way to do this? Em, no, not really. But as projects like this show, a support network offering little 'treats' can help women, particularly young women, get involved. This report highlights some really interesting points about why (in this case young) women from areas of high social deprivation are particularly reluctant to start breastfeeding- When age and social deprivation were taken into account, just 4.4% of Scotland's youngest, poorest mums were breastfeeding at 10 days old. The national average was 47.1%.

This case study also shows that it's not necessarily that there are not support services available, but rather they don't feel accessible or appropriate to this particular group of mums. Whilst I'm certainly not arguing that more lactation consultants and specialists are required, I do wonder how many of the young women in Edinburgh from areas like Sighthill and Wester Hailes (two of the poorest communities) felt they could attend any of the city's Breastfeeding clinics, groups or seek peer support? Lack of transport, or available money for paying for public transport are automatic barriers. The breastfeeding group that takes place weekly in the Ikea Straiton cafe sounds simply marvellous to me, but I'm fully aware of why it would sound completely horrifying to someone else. The 2 hour long clinic appointment may also really help those who are having significant difficulty, but who will watch the other kids whilst they are there? And what if there has been previous Social Service involvement- do I want to invite that much intrusion? It's so easy to see why not bothering to begin with, or giving up after the first week or two seems logical for so many people. Especially when the general environment is not pro-breastfeeding. My mum breastfed me and my siblings- it was normalised in my house. I'm not actually sure there were even bottles in the house- I certainly don't remember any. If the normalisation you experience is of bottle feeding, then it would make sense to begin there or switch back to the devil you know as soon as there are difficulties, which almost everybody experiences in the beginning.

The idea that somehow all the public health messages about 'breast being best' are somehow 'not for them' actually resonates with me personally. Nothing turns me off a pro-breastfeeding message faster than someone starting a sentence 'I breastfed my child until they were two/three/went to school'. It's simply not the direction I wish to go in myself, and I find it oddly boastful, as if I am somehow supposed to congratulate them and hand over a shiny rosette. I know breastfeeding is incredibly challenging and breastfeeding for a long time is absolutely an achievement, but I can't help feel this alienates some women, particularly in the first few weeks when the idea of surviving just one more feed seems overwhelming. The talk of tiny increases in IQ points means very little to most in the real world, particularly if they were bottle fed and turned out just fine. As the case study points out, diseases like gastroenteritis and diabetes seem totally alien when you have a teeny newborn you are hell bent on protecting. Even knowing and understanding the research, I find myself dismissing the reduced instances of respiratory infection argument through my experiences of begging mums for just 20ml of breastmilk to pop down a tube in her Bronchiolitis baby's nose, or else they would have to have formula. With serious respoiratory infections tiny, specifically timed feedings were of vital importance. Sick babies in hospital with exhausted, stressed mothers make pumping a challenge.

To me, these points raise the question of the place of an incentivisation scheme. Or even better, a study to assess if such a scheme would be worthwhile. Do I think it has the potential to increase worry and stress in mums who are already struggling? Possibly, but I'm not sure they are the target audience for this particular study. And I'm extremely wary of how such a scheme can be 'policed' and by whom- maintaining involvement and building trust between health care professionals and those parents on the margins is so vitally important. Is it 'patronising and naive?' Well, money alone is, yes. As part of a bigger program of societal change, I would argue no more so than any other kind of incentivisation such as weight loss or smoking groups that offer rewards. Even if the young women themselves in the North Kilmarnock case study did not breastfeed for any length of time, a foundation has been laid whereby it becomes a little more socially accepted than it was before. The danger of all breastfeeding, and indeed all health promotion is viewing it as a target-meeting exercise rather than a longer process of changing things for the better.

*Well, my internet. Which is mostly filled with educated young women who either have babies, are expecting babies or might be thinking about it soon.

Wednesday, 6 November 2013

Half-baked Maternity Leave and other stories

It seems a bit rich to claim I am now on maternity leave, since I don't actually have a job, but yesterday was my last day of volunteering until March 2014. Lots of hugs and well wishes from volunteers, staff and a couple of my favourite doctors. It was lovely to feel part of something, that I will be missed. My plan, initially, is to go back 2 mornings per week, from 7am-9am. Husband will stay at home with the baby on those days and then bring her to the hospital at 9am, when he'll start work and I'll have a coffee then take the baby home. This is a rough plan, and it may end up changing, but I feel it's really important for me to do something out the house, just to keep my employability skills up a bit and to give me a chance to be something other than 'mum' for a few hours.

I really love being at the hospital too. I enjoy speaking to families, trying to explain hospital policies and procedures in a way they can understand and trying to help set minds at ease. It's incredibly sociable, and at times challenging. I really love having it as an outlet and a point during the week where I don't get to think about myself at all. When you are home alone all day it's easy to get so caught up in your own head you lose sight of the real world. Being in the hospital helps give me perspective. One of families in the last few weeks was waiting for their son to finish surgery. He was just a toddler, and last year had nearly drowned in 3 inches of water. He has been left with brain damage due to not getting any oxygen during that time. He needs a tracheostomy to breathe and a gastrostomy tube to eat. It was an accident. These things happen. And personally, I like to be reminded of that. Of how lucky I am and how quickly things can change. There is no where like a hospital to give you that perspective.

This morning, to celebrate not having to be anywhere at any specific time for the next few months, I went and got a pedicure. It's a 20 minute walk to the beauty parlour, and the most beautiful autumnal day. The sun is shining, the leaves are actually changing colour (this happened in February last year as the weather was so warm) and I get to walk through the most beautiful residential area. So much of LA is apartment buildings, scary looking housing estates or grand mansions, but these are picture postcard houses with immaculate gardens and white picket fences. It doesn't feel fake; the locals do their own gardens and all the front porches are decked out with varying sized pumpkins, celebrating the decidedly fall-like feel to the air (it's still 72/23 degrees...) I dream of living somewhere like that: in the heart of the city but with basketball nets on wheels at the edge of the sidewalk, so the kids can wheel them out and play on the road after school. These houses sell for $500-900,000 so pretty much out of the realms of possibility for us right now (or indeed ever, being realistic) but a girl can dream.

The massage bit of the pedicure was the most uncomfortable of my life. Seriously, I actually grimaced a few times. But I didn't say anything because I could see it working. My hands and feet have puffed up like sausages the last few weeks. I get claw hands I can't straighten, and my feet go really gross- toes like uncooked chipolatas*. But after my uncomfortable massage, and even after the twenty minute walk home, they are barely swollen at all. I will be back, I think, maybe once more before Kick arrives. I just wish I could have afforded the manicure too. Alas my mummy is coming in two weeks (!!) and the baby will be coming in 3 and a half (please God) so pennies must be saved. I can justify the cost of a pedicure purely because I cannot in any way, contorted shape or form reach my feet, and my nails were in desperate need of being cut. The glamour of the end of pregnancy is never ending, and unfortunately so is the reality of doing it all on a limited budget.

In other gross pregnancy news, I am apparently one cm dilated. This, of course, means nothing since I can sit like that for the next 4 weeks** and it doesn't really make a difference to anything. But in my mind, finding this out was a whopping big deal. Purely because it means that something is happening. I have spent a lot of time recently struggling with pretty severe pain and pressure on my cervix and rectum (TOLD you it was a gross update) with Sunday night being a particular low point. Now I know this particular discomfort isn't for nothing, and I no longer desperately try to move Kick to another position as soon as it happens. She wants out soon, and she's working to make it happen. I can't really complain at that.

The impending sense of change has touched Joan the cat a little. She seems more content to just sit on the sofa with me, with far fewer episodes of biting when I don't play with her quickly enough. But from 5pm she waits at the front door, sitting patiently knowing that husband will be home soon and she'll get to run around like mad for a while. The last few nights he's been quite late and you can see her frustration and impatience grow. He's a total sap and loves nothing more than rolling around on the floor with her and playing way rougher than I am brave enough to. I'm hoping we can still manage a little of that once Kick is here. I imagine soon enough Kick will be doing enough of the playing for all of us, and poor Joan will end up hiding under the sofa. They are already sharing toys, even if Kick isn't aware of it yet. Husband bought a little stuffed hedgehog for Kick at Ikea at the weekend*** and on Sunday morning, Joanie came trotting through with it in her mouth. We think that she thinks she killed it herself, and she will play with it for HOURS. It's adorable, hilarious and a bit disconcerting to stand on, slightly damp, at 3am on your way to the bathroom in the dark...

This weekend I mostly caught up with people. With time-zone issues it can be really hard to keep in touch with family and friends, even just the ones who live on the East Coast, but the week's difference in changing over to daylight savings time between here and the UK made it easier. It was my Granny's birthday on Saturday so I had the chance to catch up with my family, aunties and gran. They were all talking at once, were too far away from the computer for me to hear them and generally were laughing and chatting too much for it to make much sense. It was EXACTLY like being there. Then I got to speak to my aunt in New Orleans, who surprised me by announcing that her and my uncle are coming to LA for Thanksgiving. This is amazing news. I cannot wait to have more of a usual family experience over a holiday. If Kick comes then, I will have visitors in the hospital, which leaves me feeling all warm inside, as it was making me a bit sad that I wouldn't get to show her off to relatives and friends, beaming in a dressing gown. If she's not here yet, I will have more people to bring me drinks and sympathy. Win-win.

I also got to hear the (rather unpleasant in places) birth story of a friend whose baby boy is now one week old. I knew the bare bones details but hearing it left me pretty upset and emotional, which totally took me by surprise. I'm normally pretty good at separating people's medical stories from my own experiences- it's par for the course with nursing. I spoke a lot about it with husband and the next day with my amazing friend Pamela, and I think it brought up a lot of memories of my D&C, which I don't dwell on but was a pretty horrendous experience. After speaking with both of them, I felt so much better. The thing is, I would go through the D&C unpleasantness again, because as painful and upsetting as it was, it was the right way to do things for us at that time. And it was only one day. I can survive anything for just one day. This is my new mantra for labour and delivery, I think.****

Crafting has all but stopped. My hands get too swollen to finish the few projects I have left, unfortunately, so I'm going to be relying on mummy to finish them for me. This is SO frustrating to me, as I just feel bored and useless, but (bringing all this full circle) I feel a little better being on Mat Leave of some description. It feels ok to resubscribe to Netflix and just watch TV for the next 3 weeks, cat on my knee curled round the bump, watching the palm trees blow in the breeze out the window and drinking approximately one hundred cups of tea per day.*****Aside from the Ikea trip, all shopping is now done online and I go on a walk to the supermarket or Starbucks once per day and that is it. The hospital bag is completely packed, with nothing more to get than some magazines to keep me entertained. I am going to hunker down and wait it all out, with Orange is the New Black and the cat to keep me company. I'm not very good at waiting, but thankfully I am VERY good at watching TV.

*Chipolatas are like cocktail sausages, American friends. But not dried up and cold. Hot and juicy and marvellous. I miss good sausages.
**Please GOD, don't let it be as long as 4 weeks. Two weeks and one day would be PERFECT.
*** Went back to Ikea for photo frames and candles. Much more fun than buying furniture there.
****Plus I'm planning to have an epidural. I can definitely cope with anything for one day if I can't feel it...
***** I'm reintroducing caffeine after giving it up due to migraines in the first trimester. It's heavenly.