Published on September 5th, 2013 | by Amra Brooks6
AMRA BROOKS Wishes More Doctors Were Poets
One of the biggest myths about motherhood for me was that there was going to be this super mamaness that would take over. I had been around and cared for kids my whole life. I was a nanny to rock star children, which meant I had taken toddlers on tour buses and transatlantic flights, which is like parenting boot camp torture. I had handled emergencies, I wasn’t afraid of vomit or poop, I felt calm around newborns. I thought I would know and be able to intuit my baby’s every need and we would just be in total synch. This was not the case all of the time, and certainly not at the very beginning, and I felt like a failure because of it. I didn’t know it would take time for us to get to know each other – I grew this amazing new person in my body (which is still completely surreal to me). He is seven months old and it gets a little more real every day. As I write about what it was like in the early days of motherhood, I realize how much of my intuition and trust I have gotten back, but it took time.
When I came home with my baby every decision down to what kind of diaper cream felt hugely important. I thought that I would trust myself more when it came to making decisions about what was right for my son, but because my pregnancy and birth became so medicalized I felt like I had no room to foster or listen to my inner wisdom that I was so connected to while we were trying to get pregnant. My caregivers and practitioners while I was pregnant certainly didn’t want to know anything about what I was intuiting about my son’s well-being or health. So I kind of had to learn how to get that back postpartum and also deal with a thousand other things that no one told me about. When you are pregnant, birth is like the most massive thing in the world and impossible to comprehend, a barrier that you just can’t see beyond, so it’s almost impossible to think about planning for what you might need or what it might be like when it’s over you are home alone with this tiny being.
I think it’s impossible to talk about postpartum without telling my whole story, because everything from the beginning of getting pregnant affected how I felt after I had my son. I had a few friends that had a really difficult time getting pregnant, so when I was 38 I had my hormone levels tested, just to see what was up. My AMH came back really low – not good. My doctor basically told me that I had very few eggs left and that the quality might not be so great. I felt like I was in mourning. My partner and I started trying to conceive pretty soon after the bad news and got pregnant on our first real try. I was amazed and felt like it was a sign, a miracle even! I told way too many people because I was so excited it had happened, given the bad news about my hormones. It made me feel like I had a super mama goddess body, that all was right in my world and this baby was meant to be!
When I went in for my first Ob appointment 8 weeks later, they couldn’t find a heartbeat. I was devastated. A week later I had a D and C during a crazy Halloween snowstorm blizzard blackout. My partner and I had planned to get married that December in northern California and we went through with our plan, tickets had been bought and arrangements made, and I walked through what was the most idyllic small perfect wedding I could have imagined totally numb and depressed and out of my body. What did it mean that this had happened? I knew miscarriage was very common, but it didn’t make it hurt any less.
In January my doctor tested my hormone levels again and my AMH had gone down even further. I was told it would be very difficult to ever get pregnant on my own and I was sent to a fertility clinic. The specialist told me my numbers were too low to even try IVF, that they would monitor me and we could try for an IUI and see how that went. In the meantime we started to try again on our own. I took a lot of DHA and CoQ10, and wheatgrass, and brown rice, and exercised, and tried to get back in touch with my meditation practice, and went to acupuncture, and just decided that I was going to get as healthy as I could and that this would make me feel better regardless of the outcome. I was going to trust my body. I didn’t feel entirely comfortable with the fertility treatments and starting hormone injections yet. I would have if I felt it was my only chance at getting pregnant, but I wasn’t convinced the doctors were right. I had friends with great numbers, perfect hormone levels that had been trying for years and couldn’t get pregnant. I had friends who had successful and unsuccessful tries with IVF and IUI, with all kinds of hormone levels. It just didn’t seem like the numbers really told an accurate story.
In March, I accepted a job in Massachusetts and we decided we were going to move to Providence Rhode Island in late summer. One catch was this new job was at a Catholic institution and the health insurance would not cover any fertility treatments. That meant that if I wanted to try for an IUI I would have to start the process in April. The day before I was to start the hormones, I found out I was pregnant. That morning when I woke up I did a visualization meditation about the decision to try the IUI that was recommended in a book I had been reading, and came out of it with a very strong image of abundance. I called my acupuncturist to make an appointment and told her I hadn’t gotten my period yet. She told me to take a pregnancy test, and it came back positive. I was cautiously thrilled, impressed by my body and my intuition, that had been not to trust these numbers or doctors. But I was so scared and anxious that something could go wrong, and so was my husband. I don’t think he actually believed that it was all really happening until he saw our son.
This time we didn’t tell many people. And because I was already a patient at the fertility clinic, they wanted to see me every week for the first 8 weeks to make sure the embryo was measuring correctly. This weekly ultrasound was both anxiety provoking – I wasn’t sure I felt totally safe exposing my embryo to it – and comforting, because it assured me of his growth. It did start the process of a very medicalized pregnancy and birth for me that, had I been in a better state of mind and more confident, I would have refused.
Each week before the ultrasound I would be riddled with fear and anxiety. It was the ultrasound that showed there was no heartbeat the first time around, and I was definitely experiencing some PTSD. I just kept waiting for the time that I could relax into this pregnancy a little and hippie out a little like the Santa Cruz Earth Mama I was raised to be. And there were some moments, like the first 3D ultrasound where I saw my son floating around in what looked like the outer space swimming pool of my uterus and I realized and fully understood that women are the most amazing and strong beings on the planet and men just have no clue, even if they are as amazing as my husband is. (This prompted me to go home and write a letter to my still sexless child about women) It also made me feel this overwhelming feeling that there is still so much we don’t know, that can’t be explained, that is vast and magic, and that is one of the most strangely spiritual and comforting feelings I have ever had. Then another moment, when I woke up from a dream at about two months pregnant with the very clear thought that we were having a boy and that his name was Matteo, a name that stuck because I felt like he told me he was coming and who he was.
As the weeks went on things continued to look positive. Our genetic screenings came back with good enough numbers that we opted out of an amnio or any other more invasive testing, though the more appointments I had the more I began to hate hearing, “Because of your age…”. Right before we were about to move to Rhode Island a doctor at my Ob practice started a sentence with those dreaded words and ordered a glucose intolerance test early to screen for gestational diabetes, something I had never heard of and didn’t know existed until she mentioned it. And I failed. Something about this just made me doubt the confidence that I had been building about my well-being and, more importantly, Matteo’s.
So here we were: moving to a new state were we really knew no one, starting a new job, my husband without work and me pregnant, possibly with gestational diabetes and no doctor. I took a 4-hour glucose follow up test, which determined that I did indeed have gestational diabetes and was stuck with the label of ‘high risk pregnancy’ for the rest of my time. After our move, it took months to find a practice where they would let a midwife deliver my baby if I had to go on insulin, which I eventually did.
Having the gestational diabetes diagnosis meant that I had to meet with a nutritionist and come up with a meal plan, test my blood sugar 4 times a day, and meet with my practice once a week to go over my weekly readings. At a certain point my readings were deemed too high and I was put on the smallest dose of insulin, which meant nightly injections into my abdomen. There are many who believe this test is inaccurate, and a midwife involved in a national study told me they would never have put me on insulin with the numbers I had in her practice. I am needle phobic, so the beginning was awful, but after a while, like anything, I adapted and even got brave enough to do it myself, always with my eyes closed or blurry.
All this meant that after 30 weeks I had to go to the doctor twice a week for monitoring. One appointment was just fetal monitoring for movement and heart rate, and the second weekly appointment was monitoring, ultrasound, and meeting with a doctor. It was very anxiety provoking not to just get to relax and be pregnant and have my own experience. And it was REALLY hard to be on such a restricted diet while pregnant when all I wanted to eat were carbs and Haagen-Dazs coffee ice cream. But the hardest part about gestational diabetes is that most practices won’t let you go past your due date even if all of your millions of tests come back with positive, healthy results, and I really wanted to avoid induction at all costs.
The first reason they wanted induction was macrosomia, meaning a super big baby. This worried me a little too, until I did some research and found out that all evidence shows the largest babies are not in fact gestational diabetes babies —plus, my husband and I were both biggish babes and are tall, sturdy people. The measurements they were taking during my weekly ultrasound also had a margin of error of up to two pounds either way. This made me crazy that I still had to have them, given I didn’t feel great about the safety of ultrasounds, period.
The other reason for induced labor they liked to throw around was stillbirth. The first time a doctor said this to me I have never wanted to throat punch someone so badly in my entire life. And when I asked her to explain to me why they believed GD babies were at greater risk for this she could not. I was fed so many statements that just felt like lines from a protocol script, I almost lost my mind. And that women could deliver these lines, and even some midwives! It infuriates me that so many female practitioners, mothers themselves, buy into this male-dominated fear based medicalized institutional structure. But I digress, because here I was being swallowed by it, and it felt like there was nothing I could do. Even if in my heart I knew my son, Matteo was fine, no mama wants to hear the word ‘stillbirth’ thrown around. There were so many times I wished we could run away to Ina May Gaskin’s Farm and have our baby there. I so badly wanted them to leave me alone to enjoy my pregnancy.
At 38 weeks I started to feel a few contractions, was partially dilated and pretty well effaced, had my membranes swept, and was told by my midwives (who I grew to love in their own special way, even if they were buying into some bullshit I knew was not true) that I would probably go into labor on my own very soon and not to worry about the induction part of things. Fast forward two weeks to me trying every witchy/hippie recommendation I could find and no labor. Also, lots of Sons of Anarchy. Itwas so weird and awful that the only thing that could distract me from the anxiety of waiting was this terrible, sexist, violent show—this was so not hippie-ing out. But it all meant that I was headed for induction. Which meant a greater risk of C-Section, constant monitoring, more painful contractions, and all sorts of other interventions.
I don’t mean to sound like an asshole, but I’ve always found a way to get things done the way I want them to be done. Okay, maybe it is slightly asshole-ish, but I never feel like rules need to apply to me or my situation – like, I don’t really believe in rules. So when I ended up having to go in for induction at 5 am on my due date, I felt pretty defeated. And it sucked like I thought it would. It took way too long to get strong enough contractions going, they had to break my water, I was tied up to machines the whole time, and when the contractions finally hit I had the most intense back labor which was a pain I never thought possible. The short story is there were late epidurals that kept wearing off and didn’t help, many hours of pushing, Matteo’s head stuck under my pubic bone, the threat of c-section and episiotomy, and then this totally amazing moment fifteen hours later when I had lost all confidence in myself yet pushed him out on my own while these little cardinals (I found out later cardinals are a symbol of confidence and pride and feminine energy) watched us through the window. And Matteo was perfect. Which brings me to the point of this whole thing – you can’t plan for your birth. At all. I mean you can, but you just have no idea what the hell is going to happen. I think about the money we spent at birth class, and the birth plan we wrote (which wasn’t entirely useless). There’s my friend who had the most blissed out homebirth planned and didn’t feel any contractions and then had her baby on the bathroom floor super fast while her husband was trying to inflate the birthing tub before the midwives could even set anything up. You just don’t know how it is going to go down. But what you do have control over is what happens when you are home with your baby right after birth.
We now have this amazing poet pediatrician family doctor and homeopath. I can’t believe I can say that after all of the crap I went through trying to find someone to care for me in a way I felt comfortable with while pregnant, but I am so grateful that we do. He’s a dream. During my first visit with him, while I was still pregnant, after we talked about Dostoevsky for an hour, he asked what I had planned for postpartum. I was like what do you mean, like boxes of gluten-free frozen macaroni and cheese? Like eating the nacho plate I’ve been denied these last nine months? Which was true, but I remember my heart sinking a little too, because we didn’t have family close, and we barely had friends, and we didn’t have money to hire a postpartum doula. And our freezer was too small to make a lot of meals in advance.
After being under the super intense medical microscope for months, all those crazy biweekly tests, feeling like they didn’t trust me to take the best care of my baby in utero, I did most intensely physical thing of my life which can completely wrecked me, and they just send you home and are like, ‘See you in six weeks!’ I had been so pumped with fluids and drugs I could barely walk. I passed out when I stood up for the first time. I had no control over my bladder for about a week. And no one tells that you and your baby are crazy until your milk comes in, which might take a little while, and how you feel awful not being able to satisfy their hunger. How after two days of labor and two sleepless nights in the hospital you won’t get any more sleep for a long time. How even the few tiny stitches I had took forever to dissolve, and hurt and pulled for over six weeks. I had a hunch that the injury to my collar bone and shoulder that I got by falling in platforms shoes in Brooklyn in the nineties would flare up from nursing and lugging a baby around, but not to so badly that I would be unable to carry him some days. My pregnancy carpal tunnel still hasn’t gone away and sometimes my right hand just doesn’t work. It is still a huge, gigantic accomplishment if I can take my vitamins, brush my teeth and hair, moisturize and shower, and eat all in a single day. Sleep deprivation is a form of torture for a reason.
Late at night in early postpartum I felt so dark and incapable and trapped. I knew it was the lack of sleep and not ‘real’, but it still felt bad, really bad, and what is true for babies – sleep begets sleep – is also true for me. The less sleep I get, the less able I am to sleep. So insomnia happens when I am most sleep deprived. Oh, and Matteo doesn’t really nap. Ever. Never has. He has only slept for more than one hour during the day a handful of times, so there’s that. In the mornings I felt better, even if I hadn’t slept much because Matteo’s such a cheery curious guy that I can’t help but start the day smiling.
It’s taken a long time for me to learn how to take care of myself as an adult, and I feel like I got really good at it for a while. I ate healthy, did yoga, had a meditation practice, and an active social life. When you have a baby all of that disappears and you slowly have to find a way just to get the basics again. A female artist friend said she had always wanted to feel more, and having a child definitely made that happen for her. Me too. Sometimes the feelings are overwhelming, though; both the hard ones and the amazing ones. The joy and happiness I felt when Matteo looked into my eyes and smiled for the first time, giving me the affirmation that I was doing an ok job, was so badly needed and appreciated that for a while I cried every time it happened. I have to always remind myself about impermanence. It’s the good and bad news, right? The good things are fleeting, but so are the hard ones—they will pass.
And it really does take a village. Being in a new place, without my people meant I had to find some. I am so not a group person, but I joined a new mom’s group. Though they tended to be pretty heteronormative, I did meet some amazing women and it felt really good to not be alone. I also had our poet doctor, an herbalist, a new therapist, and lots of time out of the house walking with Matteo once the snow melted. I have become the mom I hate who is on her phone a lot, but I hide it – under the boppy when I’m nursing and texting because my best friends are too far away and they help keep me sane. You really need your people in the early months especially other parents who can reassure you that things like green poop can be normal.
Having a baby changes you physically, but in so many other ways, too. My identity is still forming in this new role. I wonder all the time if people can tell I’m a mom, wonder how long it is a viable excuse for being late or out of it or unavailable or ill prepared. I wonder a lot about when and how I’ll find the time to write. I was a big consumer of things – movies, food, art, music – and I wonder how long before I can do more of that and I’m excited to share it with Matteo.
New mothers really need to be mothered, or at least I did, and I hadn’t arranged for that, didn’t have someone who could take on that role. Not knowing how I was going to feel after giving birth I’d made some boundaries with family, asking people only to come when we gave the green light and knew both Matteo and I were stable. When my dad and his partner, Matteo’s grandpas, showed up two weeks later I didn’t want them to leave. They grocery shopped, cooked, bought me nursing bras, and quietly ticked away on their laptops in the dining room while I breastfed or tried to sleep. So many of the friends I had wished to meet Matteo and be around us in the early weeks of his life were too far away or busy; some still haven’t met him. I think a lot about my grandparents’ generation who all stuck together to help raise their kids, and how much I would like to live closer to Matteo’s grandpas.
I wish there was better care for pregnant women and new mothers in this country and that there were more doctors and practices that supported their choices. I’ve broken down in the poet doctor’s office many times since Matteo was born. Early on I said to him “I just want to trust myself more,” and he said “That’s why I’m here, that’s what I do as a doctor for first time parents, help you learn how to do that.” Swoon. He also offered to be part of our family support system in a very tangible way knowing we were just building one here. I can text him. He also always wants to know what my gut feeling is about whatever is going on first. And when I get totally freaked out about the future, I just try to remember that his name is Matteo and he told me that he was coming. Sometimes I say it out loud to him, to remind us both just how deeply we are connected, and that early feeling I had is the thing I trust most and am just getting back to. And I know now that my role as a parent isn’t just about being a teacher, it’s also about learning from this tiny magic person.