37 Weeks Pregnant: An Epileptic Mama’s Postpartum Plan

March 2 – March 8: 37 Weeks 0 Days – 37 Weeks 6 Days.

Belly and Baby Update

Babies are a little more robust when born after 39 weeks, but at 37 weeks they’re considered to be at term. Hitting that milestone this week lit a fire under my buns to finish doing our taxes, add some final items to the hospital bag, and place one last small Amazon order for baby things we were still missing. Okay, maybe it was a large-ish Amazon order that included more than 25 board books, Dr. Seuss books, and Robert Munsch books. I’ll probably need a dolly to get that box inside, but books are an investment worth the effort.

Books for baby

Part of my book order showed up this morning! Some of these books are a little advanced for a newborn, but we want to read to her every day, and I’m hoping having a variety of books will help us stay engaged and committed to this.

I also managed to research makes and models for a reliable second car (chauffeuring Richard to and from his shuttle stop every day is no longer going to work with a baby in tow), find us a suitable car from a private party, set up a test drive, arrange mechanic’s inspection, buy the car, and register it at the DMV all the span of one week. The last time I went to the DMV without an appointment, I swore I’d never do it again, but I couldn’t get an appointment within the allotted title-transfer period, so I had no choice (Richard offered to take time off work to do it, but that seemed silly). I went to the DMV armed with a giant sun hat and sunglasses, a small camping stool, a granola bar, a water bottle, and my Kindle app loaded up with a book my friend recommendedThe Happy Sleeper: The Science-Backed Guide to Helping Your Baby Get a Good Night’s Sleep-Newborn to School Age. So far the advice in the book is resonating with me—it’s a balance between compassion and structure. I looked ridiculous, but I think people were jealous of my seat when, true to form, the DMV’s computer system went down for 45 minutes. By the time the system came back up, the rest was a breeze because so many people in front of me had given up and gone home, but the whole experience still last two-and-a-half hours. My body was pretty committed to being horizontal for the rest of the day.

Family Car

Completing our suburban lifestyle with a second family-oriented car. Having a second vehicle will probably be more fuel efficient than our current schedule of me chauffeuring Richard to and from work (since I go to work in the opposite direction or back home during the day, then go back to pick him up).

My mom has told me about how when she was pregnant it was arduous to roll over in bed, and I’ve empathized, but this is the first week I’ve really known what she meant. When laying on my side, my belly weighs me down so much that I can’t roll over unless I use my hands to bring my belly along for the ride. With my awkward size, certain movements are almost comical now. On the weekend I was out for a picnic with friends, and when it came time for me to laboriously get up off the ground I couldn’t help but feel like a topsy-turvy Winnie the Pooh.

My belly button goes between being flat and inverted, depending on the baby’s position. I think I may have developed a small stretch mark or two on the underside of my belly since the baby descended, but I can’t see anything below my navel without a mirror, so I can’t tell for sure. I don’t know if what I’ve been feeling lately are Braxton-Hicks contractions or just generic pregnancy sensations, but almost every day this week my body has told me, “Go take a nap,” in the language of menstrual-like cramps. I take it as a sign my body is preparing for labor.

37 Weeks Pregnant

37 Weeks Bump Update: Ready to go on a picnic.

Preparing for the Postpartum Period

When people ask me about my fears around childbirth I don’t many to report. This is probably because any worries I have about childbirth are far overshadowed by the uncertainty I have around the postpartum period, and I don’t have the bandwidth to concern myself with both. Caring for a newborn baby makes me nervous because I have a history of sleep-deprivation-induced seizures, and the number one thing people tell expecting parents is about how sleep-deprived they will be.

For the last eight or nine years, my condition has been manageable without medication. I simply do what it takes to get enough sleep every night. (Many of my healthy lifestyle habits like avoiding alcohol and caffeine stem from this). However, control over my lifestyle is going to be completely usurped by the baby. As any parent, I want what’s best for my baby, but I’m going to have to navigate some trade-offs around my condition. Here are three things I desperately want for my baby and me, but it would be a feat to achieve all of them:

  1. I want to breastfeed. There are enough public awareness campaigns out there that by now nearly everyone knows that breastfeeding is the way to go, if possible. Newborn babies need to breastfeed ten to twelve times per day, which works out to be about every two hours (although, some babies cluster feed, so I may get longer stretches to sleep). Sleep deprivation is almost built into that schedule. Before learning more about breastfeeding, I thought I could pump during the day and Richard could bottle feed at night to give me some longer stretches of sleep, but in the first month using bottles may turn the baby off the breast.
  2. I don’t want to expose the baby to unnecessary medication. I choose to control my lifestyle instead of taking medication because I don’t like that stuff in my body, and I’m even more hesitant to expose my baby to it through my breast milk. I’ve consulted with my doctors and lactation consultant, and they agree that the baby getting the drug they have in mind through my breast milk is better than me not breastfeeding at all, but there are still potential side effects for the baby (to which the solution would probably be to reduce or discontinue breastfeeding) and me (including reducing my milk supply).
  3. I don’t want to have a seizure. I don’t even want to think about having seizure while home alone with the baby or while holding the baby. The idea is horrifying. To avoid seizures, I need to get enough sleep (which may not be compatible with breastfeeding) or take medication.

Number three is non-negotiable. Between the other two, and I’d rather take medication than forego breastfeeding. However, I hesitate to jump on a resolution before I meet my baby. Maybe she will be all about cluster feeding, and I’ll be able to take long enough naps to keep seizures at bay without drugs (I’d have to be the luckiest mama ever, but there are “easy babies” out there). Maybe there will be an unrelated reason I can’t breastfeed, so I could take medication without affecting the baby or Richard and I could feed in shifts so I could sleep. Instead of choosing now, I’m choosing to wait and see. My body gives me plenty of warning signs well before escalating to a full out seizure, so I’ll have time to respond in a way that makes sense for my situation.

In the meantime, I’ve been developing a plan to set up my postpartum time so that I have a shot at having my cake and eating it too (breastfeeding off meds and seizure-free). Here’s one epileptic mama’s postpartum plan:

  1. Hire a postpartum doula. Birth doulas (professionals who coach women through childbirth) are getting to be more mainstream, but many people don’t know there are postpartum doulas as well. The idea is that the postpartum doula takes care of and educates the mother so the mother can care for her baby (sometimes this means they take care of the baby so the mother can take a nap). I’m hoping that having a baby expert come in several times a week to teach us how to best care for my baby will help us iron out any kinks that make the baby more fussy than she needs to be, and reduce my stress and anxiety so I can relax. Richard and I chose to work with Melitta Hoder, who has many years of experience and is also a certified lactation consultant. We have her for thirty hours over the first month, which makes me feel much more at ease. I considered hiring a night nurse (someone who stays overnight and cares for the baby), but newborns don’t really have nights and days, and whether I have extra help or not, I’ll still need to wake up to breastfeed every couple hours. If we have a high maintenance baby or I’m still relying heavily on Richard when it’s time for him to go back to work from paternity leave we may reconsider our options.
  2. Visitor blackout period. My only hope at achieving all three of the desires listed above is to follow the old adage and “sleep when the baby sleeps.” Every minute I spend entertaining visitors is a minute I should be napping. As such, Richard and I have chosen to snuggle into a cocoon for the first two weeks of the baby’s life so we can focus completely on coming into our rhythm as a new family. The last thing I’ll want to do is wake the baby up or interrupt her feeding schedule so she can interact with visitors. So, in the first two weeks we won’t be having guests over to see the baby, hold the baby, or gush over the baby. I do want her to be surrounded by loving, supportive people in her life (and all my amazing friends and family fit the bill), but in the first couple weeks what we could really use are people dropping off meals, picking up our laundry to be washed, or taking our dog out for some exercise. When visitors come over I want to want to hand over the baby rather than feeling like people are disrupting our bonding time, and I’m hoping the two-week buffer will foster this.
  3. Try out different sleeping arrangements. We have practice with this from pregnancy. I already wake up every two hours to go to the bathroom, or change position, or stretch, or drink water, or get a snack. A few months ago, neither of us were getting a good sleep: I’d wake up uncomfortable, but try (unsuccessfully) to go back to sleep without changing positions so as not to disrupt Richard. Inevitably I’d end up moving or getting up, which would wake Richard up. We tried a couple different sleeping arrangements and settled on sleeping in separate bedrooms, which has been amazing. Sleep deprivation drives a far bigger wedge into a relationship than sleeping apart. I know I want to sleep with the baby close to one of us when she’s a newborn, but I’m not sure how close (On us? On the bed? Beside the bed? Across the room?) and I’m not sure if all three of us sleeping in the same area will maximize anyone’s sleep. I’ve found advice pointing in all different directions on this topic, so we’re going to have to wait and see what works for us.
  4. Start “shift work” as soon as is sensible. I’ve got my fingers crossed so hard that breastfeeding will be smooth for me. Ideally, parents wait to introduce bottles until the baby is a month old so breastfeeding is firmly established, but my lactation consultant says that if absolutely needed she can help us use techniques introduce the bottle earlier. This will be a game changer, because Richard and I will be able to care for the baby in shifts, which will give us both more sleep. I’m an early bird and he’s a night owl, so I think we’ll be able to work out a schedule that’s appropriate for both of us. I’ve already got my breast pump and milk storage containers, so I’m ready to go when the baby is.
    Update: After reading this post, some friends advised me that there are nipple-free alternatives for feeding newborns. Syringe feeding, spoon feeding, and cup feeding shouldn’t cause nipple confusion. I’m so glad to know we have options!
  5. Visitor welcoming period. After our two weeks of cave time, the baby will start becoming more active, if she’s going to be colicky that will be starting around two or three weeks (I was fussy baby, so I may get my karma), and toward the one month mark she may be starting to take a bottle for some feedings. Needless to say, at this point, there will be much more visitors can do to help out with the baby instead of just doing chores for us (and interacting with the baby is what many people really want to do when they come and visit). If the baby hasn’t let me put her down for two weeks, I will probably happily pass her off to a friend or family member who wants to rock her while I eat, take a shower, or lay down down for a bit. My family is planning to come stay with us during this time to meet the baby and help out, which I’m really looking forward to. We’ll also be excited to start inviting friends over to see us and our little one.

There are so many unknowns that this is just my best guess at what will work for us. Maybe on day three I’ll be eating my words and calling friends begging them to come over and help me out physically, emotionally, or mentally. Even so, it feels good to have a vision and to practice being assertive about what I want for my baby.