Yesterday, we attended 2 mandatory classes to make us eligible to use the Birthing Center at SLRHC. They require you to take their "Intro to the Birthing Center" and "Early Discharge from the Birthing Center" classes, which ended up being extremely informative but it felt really odd to pay $40 a head to basically be informed about their policies and procedures. I guess if they didn't charge, then they'd get way too many people who weren't committed to it? Or they just want money...

There were about 20 couples there in a big conference room, and the teacher, Janet, was just the nicest sweetest lady! I had brought a list of questions, and she covered nearly all of them through her presentations which was great! So, let me go over the basics of the birthing center!

The birth center is on the 11th floor, directly under and connected by a private staircase to Labor & Delivery (L&D). They only have 3 rooms, but with an average of 35 births per months it is extremely rare for them to be full. (if they are full of laboring/pushing, or JUST having birthed moms, then you'll just have to go to L&D unfortunately). They keep a nursing staff ratio of 1 to 2, but you have a nurse with you 1-1 during pushing. There are 2 birth stools and 2 wedges (to help you sit more upright in bed) per the 3 rooms, and each room has a regular bed (they said queen, but looks more like full) - not hospital beds. You must bring your own birth ball, for sanitary reasons apparently. Each room also has a jacuzzi which moms and dads are encouraged to use, but water birth is not permitted. You get one private room for the entirety of your stay: labor, birth, and post partum. After birth, you must stay a minimum of 12 hours and average is 12-18 hours - you are permitted to stay only 1 night post partum in the birthing center. The husband is encouraged to spend the night in bed with mom, with baby at the side in a little bassinet. There is no nursery for birthing center babies - so no option of "rooming out" - it's always "rooming in" and actually if the baby is healthy they'll never be taken from your room! You might be moved earlier than the 12-18 hours if the room is required for an incoming laboring mom. If you need to stay a 2nd night for emotional ("I'm not ready to go home!!") or for medical reasons, we'll be transferred to the regular post-partum floor for the 2nd night in a semi-private room (unless you want to pay $900 extra for a private - um no thanks!!).

To be eligible to use the Birthing Center in the first place, you have to take the 2 classes I mentioned, as well as a general and complete birth education class (which is why we're taking the Lamaze course at the hospital). You have to be within 37 weeks 0 days and 40 weeks 6 days, no exceptions. You have to meet a multitude of health requirements at admission, of course, as they only will accept truly no-risk "clients" (not patients, cuz we're not sick!!), including that the baby must be head down. They want you to stay home as long as possible, ideally not rocking up til you're in active labor at about 6cm. This scares me, since we're about an hour from the hospital (and I'd much rather be done with the horrific tax ride before the labor is at it's peak of intensity!), I don't want to go too early or too late, and as first timers it's gonna be really hard to know the difference!!

So, you call your midwife and they supposedly help you know when it's time to head in and they'll meet us there for admission. We'll either meet at the birth center or on the next floor up in L&D, where I'll be strapped up to the fetal monitoring device for 20 minutes, have my blood pressure checked, and get the dreaded internal exam (checking dilation/efacement). Assuming all looks good, and there is a room open, then you're checked in and good to go! Reasons you would be transferred out of the birthing center include: 1) you want an epidural (they can only give tylenol or a shot of narcotics stadol or demerol in the Birthing Center, no epidurals), 2) you have no progress over 2 hours, 3) you dilate less than 2 cm over 4 hours, 4) you push more than 2 hours with no significant progress or more than 3 hours without delivery. Apparently 1 in 5 women will transfer out of the Birthing Center for one of these reasons, though their cesarean rate is only 5%, compared to the hospital's rate of around 30%.

Many policies differ from the L&D, such as you are allowed to eat and drink as you wish, are not required to have an IV or even a hep lock, and can have up to 3 supporters with you during the birth (not including midwife/nurse/etc). Optionally, if you want, they can give you an IV if you're very dehydrated, can give you the IV antibiotic treatment if you're Group B Strep positive, can give you a local anesthetic for post-partum stitching up, can give oxygen to mom and/or baby, and can give a shot of pitocin to help the uterus contract post-partum if needed. The arithomiacin eye ointment and vitamin K shot are both state mandated but can be delayed toward the end of the 1st hour post-partum, and you can delay cord clamping if you choose to do so. Standard practice is baby is put immediately on the mom - skin to skin - and encouraged to breast feed immediately (which helps to expel the placenta and get the uterus to start contracting and shrinking). A really high level NICU is located just one floor up, which is reassuring.

There is a pantry with a fridge and microwave we're allowed to use. But unfortunately no open flames and no plugging in of electronics!! This really bummed me out as we were thinking about stringing up some Christmas lights to make a nice warm environment, and of course playing music and/or our hypnobabies tracks during the labor. They said some people do plug in dying phones or cameras and usually don't get yelled at, but I'm thinking Christmas lights would be quite obvious and a big no-no... Maybe we'll go out and get some LED battery operated tea lights? Or maybe I won't really care about that kinda stuff when it comes down to it! haha!! Each room has it's own temperature control, which is awesome!

A car seat is not required for discharge, unless you're using a private car. That said, they highly recommend one since it's much safer. So we'll probably borrow the carrier/car seat from Ryoji's co-worker.

Soooo... that's the birthing center in a nutshell!! Any questions?? ^_^

For a couple of weeks I've randomly felt these pulse-like movements going on in my belly. Actually, it feels exactly like a pulse, but it doesn't match my own and last night Ryoji confirmed it didn't match the baby's either. He was really freaked out, and I have to say I was a bit concerned as well. It would go on for several minutes at a time, sometimes much longer. But the baby is usually moving around so it seems all is well. Still, decided to give it a google search today and seems it's "practice breathing"! I'd heard about this, but I thought it would feel more like, well, breathing, not like tapping or pulsing sensations! Anyway, when the internet can often make you freak out over nothing, it was nice to have a reassuring

By now, your baby weighs 3.75 pounds and is about 16.7 inches long, taking up a lot of space in your uterus. You're gaining about a pound a week and roughly half of that goes right to your baby. In fact, she'll gain a third to half of her birth weight during the next 7 weeks as she fattens up for survival outside the womb. She now has toenails, fingernails, and real hair (or at least respectable peach fuzz). Her skin is becoming soft and smooth as she plumps up in preparation for birth.

To accommodate you and your baby's growing needs, your blood volume has increased 40 to 50 percent since you got pregnant. With your uterus pushing up near your diaphragm and crowding your stomach, the consequences may be shortness of breath and heartburn. To help relieve your discomfort, try sleeping propped up with pillows and eating smaller meals more often.

Ryoji and I went to the birthing film night at the hospital this week, which was part of our "Enriched Lamaze" course. We saw several vaginal births, medicated and non, saw a film on Cesarian though they didn't show the actual surgery just a few stories highlighting different reasons to have it done, and also a film on epidurals. All in all, I felt it was a waste of time, nothing we couldn't just watch at home on YouTube and not be stuck at the hospital after work and getting home at 11pm on a work night!!

But one fun thing that happened was Ryoji got to experience the wild belly dancing that has been going on with Akapanchan recently!! I had on a fitted polkadot shirt, and when Akapanchan started rolling and jerking and kicking, you could see it sooooo well and we both stared gape mouthed at my belly for a good couple of minutes going "holy crap, what's going on in there!?!?!". It's so interesting!! What I wouldn't give to have a window to see what's going on in there - the movements, the facial expressions, oh gosh!

So, at my 28 week appointment, my uterus measured right on for growth and size at 28 centimeters, and we found out the baby was breech.  At my 30 week appointment this week, the midwife was a tad concerned because I again measured at 28 centimeters - not showing any growth in my belly. Granted, there is certainly some room for error as they just feel my uterus and use a tape measure. But she asked what kind of movements and body parts I felt and where, then did a bit of a mashing around exam with her hands, and came to the conclusion that she thinks Akapanchan is hanging out in there SIDEWAYS!! It seems his head is under my right rib, and then he's kinda laying across the middle of my belly with his feet kicking about on my left side. This might be why the vertical measurement of my uterus hasn't grown in the last two weeks, because I've gotten wider and they don't measure that direction. Oh my goodness, this kid has just got his own way of doing things huh??

I found a website, www.spinningbabies.com which is really interesting and shows you how to "map" out your baby's position, and gives great tips on how to change to optimal head down backward facing position. So now I've tried twice kneeling on the couch, with my forearms down on the floor, for 30 seconds. But man, the blood rushes to my head and feels like my face is going to explode, or stroke out! That hasn't seemed to have any effect on Akapanchan yet. So tonight when I noticed him moving about a bit, i.e. awake and in my opinion more open to repositioning, I grabbed a bag of frozen tortellini and my blackberry and decided to try my midwives suggestion from week 28. I placed that frozen bag of tortellini on the top of my tummy, by where his head usually bulges out, and put a music video from glee on my phone and placed it at the bottom of my tummy. Boy oh boy, Akapanchan went nuts moving around!! I was convinced he was flipping!! I gave it 2 songs worth, and then went about my business. But now as I'm sitting here I'm feeling the head-like bulb bulging around under my right rib again, so either he didn't change his position or he's back in breech - great! Will just have to keep on trying!

Ryoji joined his first birth class with me today. We got to practice 2 types of breathing, and also some labor positions such as the slow dance and a couple of ways to walk together with him supporting me. We're the only couple in the class with the mom bigger than the dad, and it will definitely effect which positions work for us, but we'll figure it out!

In other news, VEINS. Huge network of big scary blue veins! haha! The sides of my belly and of course the big mama jama cans are covered in them, but I find them fascinating!! Most times of the day they're not so obvious, but when I get home from work they're just ridiculous! Maybe the vascular system is worked up after my 10 minute walk home? Not really sure, but MAN they're CRAZY!!

This week, your baby measures over 16 inches long (the size of a pineapple). He weighs about 3.3 pounds and is heading into a growth spurt. He can turn his head from side to side, and his arms, legs, and body are beginning to plump out as needed fat accumulates underneath his skin. He's probably moving a lot, too, so you may have trouble sleeping because your baby's kicks and somersaults keep you up. Take comfort: All this moving is a sign that your baby is active and healthy.

Your baby's about 15.7 inches long now, and she weighs almost 3 pounds (like a head of cabbage or a cucumber). A pint and a half of amniotic fluid surrounds her, but that volume will decrease as she gets bigger and takes up more room in your uterus. Her eyesight continues to develop, though it's not very keen; even after she's born, she'll keep her eyes closed for a good part of the day. When she does open them, she'll respond to changes in light but will have 20/400 vision — which means she can only make out objects a few inches from her face. (Normal adult vision is 20/20.)

You may be feeling a little tired these days, especially if you're having trouble sleeping. You might also feel clumsier than normal, which is perfectly understandable. Not only are you heavier, but the concentration of weight in your pregnant belly causes a shift in your center of gravity. Plus, thanks to hormonal changes, your ligaments are more lax, so your joints are looser, which may also contribute to your balance being a bit off.

Also, this relaxation of your ligaments can actually cause your feet to spread permanently, so you may have to invest in some new shoes in a bigger size. Remember those mood swings you had earlier in pregnancy? The combination of uncomfortable symptoms and hormonal changes can result in a return of those emotional ups and downs. It's normal to worry about what your labor will be like or whether you'll be a good parent. But if you can't shake the blues or feel increasingly irritable or agitated, talk to your doctor or midwife. You may be among the 1 in 10 expectant women who battle depression during pregnancy. Also let your caregiver know if you're frequently nervous or anxious.

So, our birth class at Roosevelt Hospital started today. I didn't know what class to take or where to take it, but the Birthing Center has strict guidelines of what has to be covered in your class for it to count as fulfilling their educational prerequisite, so it was just much simpler to go with the one they recommended at their own hospital. It's called Enriched Lamaze and includes 5 3-hour classes, a film night (with movies about vaginal and c-section births), and reunion (where the group comes back with their babies). Today was our first class, but unfortunately Ryoji was away in Chicago on a business trip, so I was like a sad single mom!

It started out good, there were 5 other couples, 3 were due on 12/10, one on 12/1 and one on 12/12 so I was the latest one with our 12/23 due date. Everyone but me was using an OBGYN (not midwives) and no one else mentioned wanting to use the birth center. The teacher is 80 years old and very frank with naughty jokes, haha, but she seems very supportive of natural birth and the only book she recommended for us to read was "Guide to Childbirth" by Ina May Gaskin which is the only one I've actually read - Ina May is like the world's most famous and respected midwife who ran "the Farm" for natural childbirth and living for years and years. So, while I know we'll learn every possibility of birthing and preparation in this class, it's nice to know our teacher is quite on the natural side, helping us to avoid unnecessary interventions and overbearing insensitive care providers.

The class started out terribly, however, when the teacher announced "I have good news and bad news. The good news is you can all have your Saturdays back. The bad news is our class has to switch to Tuesday evenings 6:30-9:30pm". Um WHAT!?!?!! When was this decided and why wasn't I told? That will NOT work for Ryoji, and I will miss at least 1 of the classes and probably be late to several. And now it's likely too late to get into any other good weekend classes at another facility. I sat there fuming for the next few minutes and when she came by me to pass out some papers I told her I think I have to quit and find a different class on the weekend. Well, that was all the resistance she needed to hear I suppose cuz her next announcement was that "Someone can't make Tuesdays, so I guess we'll just stick with Saturdays". I felt really guilty for causing trouble, but later 2 other couples came up to me and said "Thank you - Tuesdays were gonna be tough for us too!". Like, HELLO, of course we're all in a Saturday class because we specifically wanted a Saturday class!! Anyway, problem solved!

The rest of the class was good, not all that informative for me cuz I feel I'm a bit more informed than most first time moms. I've been listening to this podcast for over a year, called "Pregtastic" which is a forum of pregnant women who meet to discuss their weekly "ups and downs" and have special guests to discuss big issues such as epidurals, hypnobirthing, breastfeeding, etc etc etc. It's really fun to listen to, like hanging out with a group of girlfriends, but sooooooo informative and helpful!! I also read Ina May's book, and have done random research. But in today's class we went over the basics of what happens during labor with effacement and dilation and breaking of the water and posterior position etc etc etc. It became quite apparent that many couples were not quite as educated as me. One of the couples had never heard of "mucus plug". REALLY!??! Wow, I was surprised.

We practiced 1 type of breathing she said is good for stage one phase 1 and 2 of labor. Basically deep breath in and breathing out slowly through pursed lips, all the while picturing your "focal point" in your head and messaging your belly. She suggested picturing your baby. I hadn't thought about what I would picture, but when I closed my eyes Ryoji's smiling face & dimple popped into my head, so that was what I went with for today! I felt very very silly practicing this with the group, cuz you can hear everyone breathing, so strange.

We also talked about foods and drinks to avoid during early labor (most kinds of meat, dairy, acidic stuff) and what is good to prepare and have on hand (home made chicken & vegetable broth) and juices. Apparently it's hospital policy that you can't eat during labor (cuz the chance of aspirating if you have to go under general anesthesia), but she said no one goes under general anymore and it's a stupid rule and you should bring your chicken broth and drink it secretly cuz you need your energy! haha!

All in all, it was a good class. I don't think I'll become best friends with anyone in there, which is disappointing, but hopefully we'll learn some helpful techniques and so far she's really bashed anyone who's mentioned birthing being "painful" and saying that all these fears are coming from what we see on TV and they are ridiculous and that birthing can be nice and a good experience. So I'm hoping her class won't be so detrimental to my hypnobabies course, which says that taking a regular birthing course will take away from its ability to re-program your mind to perceive the  pressure waves (contractions) of birthing time (labor) as mere pressure or tingling rather than extreme discomfort (pain). Yes... hypnobabies makes up different words for all these things, so funny!

Your baby now weighs about 2 1/2 pounds (like a butternut squash) and is a tad over 15 inches long from head to heel. His muscles and lungs are continuing to mature, and his head is growing bigger to make room for his developing brain. To meet his increasing nutritional demands, you'll need plenty of protein, vitamins C, folic acid, and iron. And because his bones are soaking up lots of calcium, be sure to drink your milk (or find another good source of calcium, such as cheese, yogurt, or enriched orange juice). This trimester, about 250 milligrams of calcium are deposited in your baby's hardening skeleton each day.

You’re probably already getting a little preview of baby’s personality, the more your feel him move. You might get some playful kicks and jabs, and start to feel little hiccups, too! At 29 weeks, he’s not just moving a lot, he’s also plumping up. And as he continues to put pressure on your digestive system, you’re going to feel the effects: hemorrhoids, heartburn, pelvic pain and frequent urination are all common at this stage in the game. Week 29 is a good time to start finalizing stuff, like stocking the nursery with baby care essentials and checking out a few potential day cares. You’ll also want to start packing a few things you know you’ll want with you at the hospital at baby’s birth. Leave it by the door, so you can add stuff you think of along the way -- and so you can grab it at a moment’s notice.

Leg cramps are one of the multitude of symptoms you read about plaguing pregnant women, and I have to say I have noticed a major increase in this realm of body issues going on. Before pregnancy, I probably got a charley horse in my calf like once a year, but it would go 0-60 instantly, no warnings, just dire pain causing me to dive down to my foot to stretch it out and relieve the cramp. But what's going on now is a whole nother ball game and it's WEIRD!!!

A few months ago it started. We'd be sitting on the couch watching a movie. My feet are up on the coffee table, of course, and I'd notice my right bit toe start to curl down all by itself. WTF!?!?! No pain, just moving at it's own will in no connection to the other toes. This would happen from time to time and one time I pointed it out to Ryoji who was also a bit freaked out by it, but we never really thought anything about it. Fast forward to a month or 2 ago and now it's the whole foot involved, and it seems this is the precursor to the leg cramp. It usually happens at night. I'll wake up with a weird sensation in one of my feet and notice the foot is starting to curl down. It's not painful, but kind of tense, you can feel that the muscles are contracting and thus pulling the toes and foot down. Usually I'm able to catch it at the first stage, still lying on my back, and just use my foot muscles to stretch the foot back and it's over. But I've noticed there is a point of no return - if my foot manages to curl down past a certain degree, it's all over and my foot/leg muscles lose the ability to stretch it out, and if someone doesn't physically get down there to pull the foot back it's a full blown charley horse attack! This happened last night, and Ryoji was on a business trip. I woke up and my foot was curled down and I was like "oh no, oh no" I couldn't do anything so I lifted that leg up to where i could to stretch it out, and that worked, but then I realized that was a bit of a strain on my belly muscles and probably in another month or so I might not be able to pull that maneuver off. Yikes!! It might be Ryoji to the rescue from here on out! Unless I concoct some sort of strange sock to sleep in that will keep my feet in a flexed position...