Category Archives: pregnancy

Infertility and academia

We often talk about how and when to combine having babies and an academic career, but we don’t often recognize (at least openly) that having babies is not something you can always plan. I was fortunate enough to not have to struggle to have my two children, but I have seen the pain and suffering that infertility causes very closely. This week is Infertility Awareness Week and TenureSheWrote has a great post about dealing with infertility as an academic scientist. Go check it out!

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Filed under academia, baby, health insurance, postdoc, pregnancy, science, women in science

Why I decided not to have a home birth

This blog post has been in the making (in my head at least) for months if not years. Normally I write a blog post in 10-15 minutes after having thought about it for a while, but this one has taken me way longer. It has had different titles and different angles, but I think this is the final version.

When I was pregnant with Little Brother I was debating whether to have him at home. I wanted to blog about that process but I was afraid that my search of where to give birth would turn into a heated debate and I didn’t feel like putting on my meat pants. So I kept this search to myself. I do however want to share the process after the fact.

“Why would you consider a home birth?” one might ask. I think for the majority of women having a home birth in the US it isn’t about putting videos of your birth on YouTube. It’s about looking for an environment where you feel safe and have your wishes respected where possible. I considered a home birth for what you might call selfish reasons: wanting to sleep in my own bed after having given birth, not wanting a nurse to have to take my temperature while I was pushing a baby out because that was exactly an hour after she had last taken my temperature, not having to drive to the hospital while already in labor, because otherwise contractions might stop on the way in. So I asked my midwife (CNM, not CPM) at my first visit when pregnant with Little Brother whether she thought a home birth was an option (the CNMs in this practice attend births at a hospital, not at home). She told me that even though she thought I would be a good candidate (young, healthy, relatively smooth first birth), she couldn’t refer me to any CNMs because there are no CNMs attending home births in my area.

So I turned with my question to the lady who was my doula at BlueEyes’ birth. She was also the person who gave a child birth class, not hindered by much scientific knowledge (for example explaining how the cervix is a sphincter, which it’s not). And, as an important aside: this is what I hate about the current “child birth industry” as you might call it in the US: it is nearly impossible to find people to educate you about what kind of choices you can make regarding birth, and especially unmedicated birth, that are driven by scientific evidence rather than personal opinions.

So my former doula sent me an email with a bunch of names of CPMs in the neighborhood. I googled them and found some of their names on a listserv talking about learning to suture at someone’s kitchen table. And since I had a third degree tear with BlueEyes birth, that was too difficult for my midwife to suture and required the trained hands of the head of OB/GYN at the hospital, I started to get a bit hesitant about having a home birth attended by someone who learned to suture at someone’s kitchen table.

-For those of you who are going to say that if I wasn’t in the stressful environment of the hospital I wouldn’t have had a third degree tear: I don’t think that was true. I was laboring on my knees without anyone telling me how to push (which seems to be better for your urodynamic factors) but BlueEyes came out in one push with his hand next to his face. Little Brother’s birth taught me that even with very gentle pushing, a super comfortable environment, and my midwife having her hand on my perineum, a hand next to the face still meant a second degree tear in my case.

Also: what would I do if I switched to a CPM for a home birth but my baby would be breech or it would otherwise not be a low risk birth anymore? Then I could probably not easily switch back to my wonderful CNM practice. And would I trust this CPM to know if my baby was breech? And, the most important factor in my decision: you can’t argue with data. The recent release of the home birth death rate shows the home birth death rate in the US is 450% higher than hospital birth. (although these data weren’t there yet when I was deciding whether to have a home birth or not).

Another important reason was that in The Netherlands, where many low risk births happen at home, a significant proportion of women need to transfer at some point during or right after birth (sorry I can’t find this stat anymore, will keep looking to link to it!). What would happen if I would need to transfer in a country where this isn’t happening on a daily basis? Would the CPM dare to go to the hospital or would she be hesitant to take me there because of her fear of a law suit? Would I be in time? And how would the OB on call react to someone having attempted a home birth? What would my insurance say?

I have no answers to these questions because this is where I stopped my search and decided to have Little Brother in the hospital, with the same midwife practice as BlueEyes. It is a great practice where they encourage you to express your wishes and try to adhere to them as much as possible within the boundaries of science and reason. Looking back I don’t even know why I went on this quest of deciding to have a home birth or not but I guess it was necessary to feel that I made the right choice. I might have decided otherwise if I had lived in my homecountry or if my midwifery practice hadn’t existed.

Unfortunately, my midwifery practice is having a hard time staying in business. Not because they have too few patients -they are flooded with patients- but because apparently hospitals are hesitant to have women come in with birth plans and doulas. As Emily Willingham wrote better than I can say it:

“The obvious solution to the controversy is to offer choices that reduce perinatal stress, minimize interventions, and personalize birth—the great appeal of home birth and midwives—while ensuring a safe outcome with well-trained attendants and access to emergency facilities. The absence of options in the United States leaves this solution elusive, especially where hospitals lack a homey, low-stress environment and local midwifery care fails to meet the gold standard. Strange, isn’t it, that our nation, in the 21st century, can’t offer more uniformly safe choices for a low-risk pregnant woman seeking a healthy, low-stress birth for her child … and herself?”

I really wish the kind of care that I had was available for anyone.

I avoid the words “childbirth experience” because it makes it sound like you’re looking for the thrill of a rollercoaster ride instead of the safe and supported process of having a baby. I also avoid the words “natural childbirth” as a synonym for a pain-mediation free birth because what is natural these days? Can you drive your car to the hospital for a natural childbirth? Can you eat GMO-containing food after your natural childbirth and still call it that? I think it’s a weird word. 

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Filed under baby, birth, cultural differences, decisions, doula, health insurance, pregnancy, safety, science

The real test to know whether you’re in labor

So you know those lists that help you identify whether you’re in true labor or not? Turns out, the only real way to know is whether you walk out of the hospital with a baby inside your belly or outside*.

This is what he looks like and we’ll call him Little Brother on the internet.

*coming from yours truly, who had to go to the hospital THREE times before actually having a baby. Turns out, you can go to 4 cm dilated with hours of very regular contractions and baby all descended and what not and then go home and wait another 6 (SIX!) days before having said baby.

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Eating dates to speed up your due date?

When you’re very pregnant, even if you’re a rational scientist-type person, you can sometimes not help but googleing “ways to induce labor”. My google even already autofilled it for me, it must know more than me about myself. And instead of reading scientifically sound pieces about what might determine when the baby comes, I find myself reading about acupuncture, castor oil and all that. But wait a minute, what does it say on the bottom of the page? Something about a recent scientific study showing that eating dates has a favorable effect on labor and delivery? I had to check that out.

The paper is from a group of scientists from Jordan, published in a journal with the astonishing impact factor of 0.55, and looks at two groups of 45 and 69 women. One group of women eats at least 6 pieces of date fruit in the four weeks prior to giving birth, whereas the other group eats none. It’s a prospective study, meaning that the women who eat dates are not assigned to that group, which I think is important to notice. The researchers find that in the date-eating group, the women arrived to the hospital more dilated than the non-date-eating group, had their membranes intact more often, had more spontaneous labor, and the use of Pitocin was lower. Also, the duration of the first stage of labor was shorter, but I wonder if that isn’t just the case because they arrived at the hospital more dilated. I don’t know about Jordan, but I could imagine that the group of women who eat 6 dates each day, is a different group of women to begin with. They might be the women who refuse induction with Pitocin, stay home longer before going to the hospital, refuse to have their membranes artificially ruptured, etc etc. We might just be looking at two different groups of women who happen to be different in their date fruit consumption. The researchers conclude: “that the consumption of date fruit in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labour, and produced a more favourable, but non-significant, delivery outcome. The results warrant a randomised controlled trial.” I totally agree with that final sentence.

And for those of you wondering, I have not been eating any date fruits over the last couple of weeks.

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We made a co-sleeper!

Normally, I save all my craftiness for in the lab. When not in the lab, I don’t really enjoy making crafty things, and if I ever attempt, I’m horrible at finishing projects. This is illustrated by the fact that I have several unfinished craft projects in my old room in my parents’ house. Nowadays, I just don’t really try it anymore. But last Friday Dr. BrownEyes and I did a very crafty thing: we made a co-sleeper from our IKEA Somnat crib and our IKEA Malm bed. Ours is not as fancy as this example from a slightly different crib, but I’m still very proud of the result.
We used this equation:

The Malm bed.
 +
The crib that BlueEyes used for maybe 2 months, after which we realized we kept walking back and forth and he kept ending up in our bed anyway.
 =
A huge bed, so prospective baby can co-sleep safely.

In short, we removed the side of the crib (which is a feature this crib already has), we elevated the crib with wooden blocks and since the Malm bed has a wooden edge next to the mattress, when elevated just enough, the crib mattress can lay on that wooden edge and align nicely with the big mattress. We pushed the crib against the wall and the bed against the crib and will fill the hole on the left in the crib with rolled-up towels, so the two mattresses are snug against each other.

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Filed under attachment parenting, breastfeeding, pregnancy

If I stand for too long I faint


Both pregnancies I’ve had this annoying thing that if I stand for longer than 30-40 minutes, I get lightheaded and am on my way to fainting. I don’t know why this happens, because my blood pressure does not drop very low; last time when my midwife measured it, it was a very average 120/70. Usually this is not a big deal, because if I sit down for a little bit it goes away. But sometimes there’s nowhere to sit, for example when waiting in line at a very busy restaurant that just opened. This happened a couple months ago and I was put on a chair by a colleague just before falling to the floor. Or when waiting in line at the airport, but then I can usually move my legs enough to prevent actually fainting. 
Another occasion where you have to stand for this amount of time is when giving a talk about science. That happened yesterday. My talk went very well I think, but a couple minutes into the questions I felt kind of lightheaded. I was hoping it would go away but I felt myself get more and more dizzy and was hoping people couldn’t see anything… At some point, when I realized I wasn’t done answering questions anytime soon and I just had to sit down. So I did, mumbled some apology for it and luckily the two fellow post-doc moms that I knew in the audience looked very understanding. I felt embarrassed, but I guess fainting in front of an entire audience would have been worse. I finished answering questions and the PI that invited me said he was impressed that I came to deliver my talk at 7 months pregnant, so I guess it wasn’t a big deal. But I did leave the talk feeling a bit embarrassed about the situation.

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Filed under giving a talk, networking, pregnancy, work-life balance, working mom

This is your brain on pregnancy


Last pregnancy, I did mostly experimental work and very little writing. That was nice, as my auto-pilot worked very well, but my thinking and focus abilities seemed a bit disturbed by being pregnant. This time around, I still need to finish 4 grants before this baby is due by the end of November. Truth be told, one is a resubmission and the other three have been in the making for a couple months, so I still think this is very doable. However, I do feel that some days my ability to stay focused and remember where I read something, or which paper to refer to seems a bit off. Is this really a pregnancy thing? Is something happening to my brain?! The all-knowing Dr. Oz says the following about it

 “Dr. Oz says a woman’s brain also shrinks by about 8 percent. “You don’t lose cells. The cells get smaller,” he says. “It might be because you’re focused on one thing, but the good news is after you give birth, your brain begins to rewire quickly. … Your brain actually gets more powerful than before you got pregnant.”

Apparently he knows more than the rest of us, because the only data I could find were structural MRI studies showing that indeed the brain shrinks a bit, and the ventricles containing cerebrospinal fluid get a bit bigger when you are pregnant. The 8% (that you read on a lot of popular pregnancy websites by the way) seems to be a bit much too, as this study for example just finds a change of approximately 4% in brain size (in healthy pregnant women that is, women with preeclampsia have more brain shrinkage). And with MRI there is really no way that one can say that this is your cells shrinking and especially not that after birth your brain rewires quickly: you can simply not see that on an MRI.
Yes, this is your brain on pregnancy, from this study. A is the pre-pregnant brain, and B is the pregnant brain, at full term. Note that the ventricles are enlarged in B. (Are you also that annoyed by popular science magazines saying “this is your brain on… [insert whatever] and then show a picture of an MRI? Me too!)

So yes, your brain gets a bit smaller when you are pregnant. But does a 4% decrease in size affect your ability to write grants? Only time will tell.

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Filed under grant writing, neuroscience, pregnancy