Crash Into Me

She's coming.

There's something about the end of pregnancy. It is June 4th, and I am 35 weeks and 2 days pregnant today, and yesterday, my OB designated June 22nd as the big day: induction. Being a type I diabetic, I knew they wouldn't allow me to go to July 7th, which was my original due date. Too much can go wrong too quickly; already my blood pressure is beginning to climb (128/77 yesterday, a small increase over previous measurements, and probably having more to do with an intensely annoying nurse than anything else) and my blood sugars are becoming increasingly difficult to control. It's par for the course when dealing with diabetes, and pregnancy. There's only so much one body can take.

And believe me, mine is just about at its limit. Between insomnia, general discomfort, a precarious emotional state caused by hormones, and my totally non-pregnancy-related lack of patience with pretty much anything, I am at what could only be described as the end of my fricking rope.

This is, with luck, the last time I will be pregnant, and I would be savoring that fact if it weren't for the fact that it is almost impossible for me to savor anything right now, except the thought that my mother will be here in less than two weeks, and a week after that, I won't be pregnant anymore.

I just have so fucking much to do between then and now. I need to go through the clothes that we culled from Max's hand-me-downs one more time, figure out what we need now and what we'll need later, pack a bag, consolidate backup plans with our friends who are being kind enough to back us up with Max. I need to pick out a present from the new baby to Max, whose 4th birthday is June 21st, the day before induction. I have to do more laundry, put together lists and things for my mother, who'll be responsible for Max while I'm in the hospital, and in the middle of all of this, give Max as much love and attention as I possibly can so that he doesn't end up feeling too displaced by the little stranger who's coming to turn his world upside down.

Max seems to be doing fine. He is excited about the new baby, although I am quite sure she's not a great deal less abstract a concept to him than string theory at this point. He wants to share his toys with her, let her sleep in his bed, feed her French fries--I'm sure all of this will change as soon as she is old enough to do any of these things. The little boy who laid down on the floor of the ultrasound suite and sobbed when the tech announced that it was going to be a little sister and not a little brother is gone, and I'm not surprised. Max is a great deal like Dan. One of the things I've always loved about my husband is the fact that whatever space you put him in, he expands to fill. He is shockingly flexible when it comes to change, and that's one of the many things that makes him remarkably easy to live with. I'm not sure how to do more to prepare Max for a new baby than we've already done. One of the things we've had to do is all but abandon active potty-training--he just isn't interested enough in it to be responsible for any of it himself, and I don't see us fighting the yes-you-WILL-sit-on-the-potty-every-twenty-minutes fight with a brand-new baby in an upside-down household. It's fine. We'll just pick it up again later, when things calm down a little.

But as I was saying, there's something about the end of pregnancy. I used to have a variety of nightmares as a child, all different, but with one theme: something or someone is coming for me and I cannot do anything to prevent them from doing so. I have that same nightmare sense of foreboding now. Part of it is that I just don't feel like I'm prepared. There's just so much to do, and it's complicated by the fact that while we are doing all of the baby-preparation things, we are also cleaning and packing and getting ready to move halfway across the country, a situation which I haven't addressed here because, OH MY GAWD, I don't want to do it on so many levels, and on other levels, am really looking forward to, and can you say CONFLICTED EMOTIONAL STATE? I CANNOT TAKE IT. I am really looking forward to meeting this little girl, finally being able to tell people her name, see Dan like this again.

But the end of pregnancy--it has a flavor all its own. Nothing else feels like this, this sense of things flying at you, knowing that a collision is inevitable. The first weeks (months? Years?) of parenthood are really, really hard, there's no way around it, and it feels so weird to feel so conflicted.

Is it awful that I feel this conflicted, or that I'm admitting it? I can't wait to meet The New Girl, but at the same time, our life is what it's become, and it's all going to change when she crashes into us.

It's been pretty much all-baby-all-the-time here, I know, and it's because I haven't been doing much else besides being pregnant and doing all the things that have to be done in order for that to be true. I promise that I will eventually be interesting again.

Where Babies Come From, Part Four

Part Three is here.

One of the first things they do after the birth is over and the sewing up and the general painfulness is over is turn off your epidural. An epidural is, in essence, safe, but I can't imagine that an open door into your spinal column is something that they want to remain open for that long. That's what they did with me, while Max was having his first bath and being checked out in the NICU and his blood glucose was being monitored and we tried nursing a little, and slowly the numbness began to fade away, starting at the tips of my toes and working its way up.

Except. Except that the numbness was fading away from my right toes, but not my left. I could feel my right foot, flex it and point it. I could point my left foot, sort of, but I couldn't flex it at all. It was as if those muscles had totally forgotten what they were ever there to do, had gone missing.

"This doesn't feel right," I kept telling people. "I should be able to feel both of my feet by now, shouldn't I?" The nurses were changing shifts and the nurse who'd been there for my epidural the day before was back. I was hungry and it was dinnertime; why the hell wasn't my foot working yet?

A NICU nurse came down to tell me that Max was hypoglycemic: it's a common side effect for new babies of diabetic mothers in the few hours after birth. Would I prefer that he receive a bottle or an IV? To be honest, I didn't care really, just as long as the problem was solved (it's not serious, but it can be if it's not handled.) They checked with me, though, because they knew I was planning to nurse, which I appreciated. "Whatever's quickest," I told the nurse. "Just fix it."

The nurse took out my Foley catheter and wanted me to get up and go to the bathroom. I felt pressured. "I don't know if I can," I admitted. "I still can't feel my foot."

"You really should by now," she said disapprovingly. Did she think this was my fault for some reason? She practically dragged me out of bed and to the bathroom, and I felt tentative and anxious about dealing with the realities of any of the aftermath of birth: stitches, blood, pee, or any of the other, ahem, scariness. I was presented with a whole bunch of unexpected equipment: a spray bottle of warm water instead of toilet paper, an adult-diaper-sized maxi pad, a pair of giant-sized mesh underpants with a pocket in the crotch for an icepack. Talk about things that nobody tells you, I told myself. I knew there'd be blood; I didn't know it'd look like a mass murder scene. I felt like I was floundering around like an idiot and I could barely stand up off the toilet and get the whole arrangement of giant underwear and pad and icepack pulled up, let alone walk across the room on my still-numb (Still numb!) foot. My hospital gown was spattered with gore and blood. The nurse handed me a new one. "I still can't feel my foot," I told her. "I think there's something wrong."

Those became the two sentences I repeated more often over the next 72 hours than any other, and to almost no effect. The L&D unit was at capacity and they wanted me shifted to post-partum post-haste, and off I went, to one of the few private rooms in the unit. Can you imagine a post-partum unit without private rooms? I couldn't. The thought of having a roommate was absolutely awful, so bad I had trouble wrapping my head around it, and I was relieved I didn't have one. I told the post-partum unit nurse that I still couldn't feel my foot and she seemed less concerned with that than with my dinner order.

My dinner order didn't arrive. It was after 8 and I was starved. Dan hadn't eaten in hours either. Nobody seemed particularly receptive to my complaints, and eventually someone located a couple of dried-out turkey sandwiches, leftover from the previous day's lunch, by the look of things, but then nobody seemed to know how much insulin I should take with it. My insulin needs had grown exponentially over the last few weeks of pregnancy and I knew I wouldn't need that much anymore, but should I take half as much? A third? "Where's your endocrinologist?" the nurse demanded. "I'm quite sure he doesn't know he's supposed to be here," I told her, not particularly appreciating her tone. "I've been a little busy. If you've got a question for him, go ahead and give him a call."

At this point, it had been a couple hours since I'd seen Max or received any kind of an update on his condition, and Dan called the NICU, asked for him to be brought to my room. Two nurses showed up without a baby. "He's sleeping," one of them told me. "We were told you wanted to rest and didn't want him down here."

I was dumbstruck by the lack of professionalism. "Bring my son in here now," I told her, "or get me the name and number of your supervisor."

"Why don't you go ahead and do both?" Dan suggested. He was at least as upset as I was. The two nurses eyed each other apprehensively and disappeared. The NICU supervisor appeared a few minutes later, still without Max. "His blood glucose is still being monitored," she said. "I don't know who told them that you wanted to sleep and didn't want him in your room. I'll check it out though."

It was one fiasco after another for the next three days. Nobody seemed to know who my doctor was or why I hadn't been checked on by an actual physician until 48 hours after I gave birth, when Dr. Kane finally showed up, sheepishly apologetic. Because I'd come in while Dr. Hassan was the on-call doc for the practice, he explained, I'd been listed as his patient, not Dr. Kane's or Dr. Bushrod, the doctor who'd actually delivered Max. Was I ready to go home?

No, I wasn't, I said. I'd been complaining for for the past two days that I still couldn't feel my left foot, and people seemed more concerned with the elaborate and humiliating ritual of checking my episiotomy stitches than with the fact that I couldn't make it to the bathroom and back without the assistance of my husband. Was someone going to do something about that? And would someone please, please address the fact that I could not get a meal menu, let alone any food delivered to my room? For the past two days, I'd been getting whatever was leftover on the meal trays for three meals a day, several hours after anyone else was fed. It usually meant oatmeal in the morning (which I loathe and never eat), some kind of dried-out sandwich at lunch, and an inedible entree of some kind at dinner, cold and long-forgotten and consisting of mostly simple carbs--not an ideal diet for a diabetic or someone who was still waiting to poop for the first time after giving birth. My mother and Dan had been bringing me sandwiches and salads from the hospital cafeteria and the deli from the local Safeway, so I wasn't going hungry, but I also wasn't exactly amenable to the fact that the hospital was going to be charging my insurance company for meals that I wasn't getting.

The doctor agreed that, based on the condition of my still-numb foot, that I certainly wasn't ready to be discharged. "Let me call a neurologist I know," he said. "We'll get to the bottom of this." He patted my foot. I couldn't feel it.

The nurse-supervisor showed up the next morning in response to the litany of complaints Dan and I were waging. Several minutes after she left, I got a phone call from the head of the nutritional services department, who apologized for the fact that I hadn't been fed in several days. I was not feeling particularly gracious at this point. She read off a menu to me and took my order for lunch personally. It never arrived.

The nurse-supervisor came back to my room with "some concerns" to address with me. One of the nursing aides had complained that she'd seen me doing "something inappropriate" with my husband that morning. I was stunned and uncomfortable and overwhelmed and full of loathing for this awful, stupid bitch, not to mention the fact that I had no idea what she was talking about and broke down in tears, unable to even respond to her accusations. "Your aide," Dan fumed at her, "saw me helping her out of bed to go to the bathroom. She's needed help every single time she's gone and she can't get any from your nurses, no matter how many times she's asked. In fact, any time she's asked for anything, any time either of us has, the only response we've gotten is, 'We'll get to it when we get to it.' She can't see a lactation specialist, she can't get ibuprofen for a headache, she can't get her goddamn breakfast! I've spent the last three days trying to make sure she gets to eat and take the medication she needs to keep her alive and the medical care that she needs. I'm about to start billing your stupid-ass, shitty hospital for my time, because I already have a job and I'm sick of doing yours!"

In my entire life, I've never been more proud of Dan.

I wanted to get the hell out. I wanted to take my baby and go the fuck home and forget this place ever existed. I was grateful, beyond grateful, to the L&D department and the NICU and all of the people who'd gotten us there, but I was at my limit of degradation. "Check me out of this place," I wept furiously to Dan after the nurse withdrew. "I just want to go the fuck home."

It took a little time and I still had to see the neurologist about my foot, but finally we got some action. Max was discharged that afternoon and I was finally discharged at about 9 that night. There was a long, dull session during which a nurse came to our room to make sure I knew how to take care of his umbilical stump, not to take him out of the car seat in a moving car, even if he cried (duh.), and under what circumstances I should bring him or myself back to the emergency room. One of the last things that they did was dress him in the clothes I had brought for him to go home in (a little red sleeper with bumblebees on it, the smallest piece of newborn clothing I had and the one that came the closest to fitting him; I'd never have guessed he would be so tiny) and at that point, the strangest thing happened.

He became mine. Up until that point he'd just been a little stranger who I was sort of partially responsible for caring for, when he wasn't in the NICU or having a hearing test or doing something else that took him out of my room, where I was confined by the fact that I couldn't walk without quite a bit of assistance. One night they'd brought him down to my room at around 1 a.m., where I was suffering from insomnia (and the fact that I hadn't had dinner) and watching a Discovery Channel marathon of some show or another. He was crying. "He's waking all the other babies up," the nurse told me. "Can he stay here with you for awhile?"

Of course he could. I tried everything I could think of to get him to stop crying, but he seemed miserably unhappy. I felt terrible and Dan and I couldn't think of anything that we could do to make him happy. Finally I turned off the TV, turned the lights down, and just cuddled him, and he drifted off to sleep in about thirty seconds. At that point, I felt more like a parent than I ever had before, but he still didn't feel like mine, despite the fact that he looked absurdly like a little-old-man version of Dan. It felt like Mom Boot Camp.

But as they wheeled me out of the maternity ward, Dan and my mother behind me with the assortment of stuff that we'd arrived with and were being sent home with, me with a semi-awake, squeaking baby in my arms, as people who passed by cooed at us, where we were left in front of the hospital to deal with the proper snapping-in of the car seat and the fact that I wasn't ready to sit in the passenger seat of my mother's car while my son sat in the back, the next six sleep-deprived and blurry weeks looming in front of us, for the first time, I remember looking down at him and thinking, I think this is how it's supposed to feel. I can walk away--or limp away--from this awful place and be this person's mother.

It's four years later, and I've watched him go from that little stranger, the little 7-1/2-pound meatloaf who doesn't do anything to the person who's driving me crazy this morning jumping on the couch while I just want to sit here, the person who wants to sing "You are my Sunshine" to my pregnant belly every night before he goes to bed, the person who wants a peanut-butter-and-lettuce sandwich for lunch today. The strangest thing has happened in four years: he's gone from being Max, the abstract concept to being Max, the person with opinions, who knows how to spell purple and rectangle and boom, but who, for some reason, spells the word orange O-R-A-N-G-L-E, the totally-potty-training-proof little boy who convinced Dan to shave his head last weekend so that he could have "none hair, like Daddy." I know him forward and backwards. I know when he's trying to manipulate me. I know when he's fake-crying and when he's really upset. I know when a kid at the playground is really getting on his nerves and when he can let something roll off his back. He says things that astound me. He uses Brickle Blocks to build a camera to take pictures of me. His imagination is humongous. He likes to play ice cream store. Sometimes he comes walking up to me and says, "Mom? I want something," and I'm supposed to know what it is, and I almost never do, mostly because he almost never does either.

He's mine, in ways that no other kid could possibly be, and being Max's mother has been an honor and a privilege I couldn't have ever imagined before becoming his mother. I am having a hard time wrapping my brain around the idea that soon I will be The New Girl's mother too, that she will go from being the annoyingly-active, kicking, flipping fetus who is still, at 34 weeks and 2 days gestation, still not head-down, to being a real person. She feels as unreal to me right now as Max ever did, despite my freakishly large belly, despite my myriad discomforts, despite the fact that earlier today she had the hiccups until I thought I was going to go out of my mind.

This last chapter of Max's birth story has been a long time coming, and it's because I'm not sure how it ends. It didn't end when they handed him to me and sent me home from the hospital. It didn't end in the L&D unit that they were in such a hurry to rush me out of. I feel like I'm still living his birth story, like every day is just an extension of it, how he's still becoming who he is. People ask me what his birth was like and I'm never sure what to tell and what to leave out: the part where my water broke in the middle of Sears? How absurd so much of the experience still seems to me? How awful the post-partum unit was and how much I hated being there?

It all ends up being okay. Now, with the possibility of a C-section looming in front of me, with the still constant threat that pregnancy poses to my health and my health poses to that of my daughter, with the daily discomforts, I keep reminding myself that it all ends up being okay. I've been listening to Rob Thomas singing "Little Wonders" a lot in the last few weeks, especially the part where he says "The hardest part is over." I'm not so dumb as to try to convince myself that the hardest part is over--I'm quite sure that I haven't imagined the hardest part yet, let alone survived it--but I find it incredibly reassuring to hear him say that In the end, We will only just remember how it feels.



Epilogue: the numbness in my left foot was a sciatic nerve injury. When I was having that awful pain in my left hip during the Transition stage of labor, the nerve was being compressed under my tailbone. By the time I went home from the hospital, I could flex my foot very slightly, half an inch maybe. It spent the next six months improving to about 95%, which is where it still is. I have numb spots in the back of my left leg and the sole of my foot, and my toes feel a little like they have rubber bands wrapped around my toes. I've found I can live with 95%.

Southern Maryland Hospital Center in Clinton, the hospital where I gave birth to Max, lost its accreditation as a teaching facility.

I never received an answer as to why the nurses thought I wanted Max kept away from me that first night, why I couldn't get a meal the entire time I was in the hospital, or the nature of the total breakdown in communication or professionalism that waged a completely merciless war on my entire birth experience. I would never be that woman who gave birth in a kiddie pool in my own living room, even if my health allowed for it, but I am still appalled by how truly awful the post-partum unit of Southern Maryland Hospital Center really was, and understand completely why women choose to have babies every day in birthing centers and in their own homes.

The New Girl will be born at Holy Cross in Silver Spring, where more babies are born every day than any other hospital in the D.C. area. I am cautiously optimistic.

Where Babies Come From, Part Three

Continued from here.

That night, and the early part of the next day, is fuzzy to me, and probably for good reason. I was on drugs. I understand the appeal to those people who get addicted: you feel sort of disconnected, and though I was summoned regularly to check my blood sugar or give myself a couple of units of insulin throughout the next 18 or so hours, I did so with a sort of detachment. One of my clearest memories is injecting insulin into my upper thigh, a spot I typically avoided because it's painful to give shots there. I couldn't feel my upper thigh at the time. It's a weird thing: when you're looking at your own hand gripping your own leg, and your hand can feel your leg, your brain doesn't necessarily get the message that your leg can't feel your hand. It felt like someone else's leg in my hand--I remember feeling surprised that it felt a little cold, but I'd complained since I arrived of how hot it was in my room, and they kept ratcheting up the air conditioning. My flesh felt a little like how I'd imagine a dead fish would feel.

They were giving me increasing amounts of pitocin, and as they'd turn up the amount I was getting, the contractions would start to hurt and I'd ask for more medication. I was relishing the feeling of being comfortable, after nine months of heartburn and backache and insomnia and various other complaints. I liked being reclined at 45 degrees, my feet slightly elevated, having ice chips brought to me. It was a little like being on vacation in a nice hotel except for the medical interventions, none of which phased me.

It was now June 21, 2005, and by noon, I'd officially been in labor for 20 hours. June 21 is the summer solstice, and believe me when I say that giving birth on that day brings new meaning to the words "longest day of the year." I kept waiting and waiting to feel different somehow, but with medication managing any pain I might have otherwise been feeling, I just didn't. I remember settling back after checking my blood sugar once with my blood sugar meter still balanced at the apex of my belly just as a contraction started, and watching the it on the monitor I was hooked to and the meter balanced on my belly, both rising exponentially as the contraction that I couldn't feel at all built and built and then falling as it receeded. I watched it with a sort of detached fascination, sort of a "Whoa, that was completely weird."

I don't like to throw up, not at all. I am one of those thoroughly perverse people who would prefer to sit miserably curled over myself for hours, sweating buckets of cold sweat, than throw up, feel better, and drive on. I was warned while I was still pregnant, that all women in labor throw up; it was a veteran L&D nurse who warned me, so I believed her. I threw up once shortly after I arrived at the hospital--just the remains of the leftover barbecue that I'd had for lunch that day, and then again in the early afternoon--that time it was just water, since all they'd let me have was ice chips.

That second throwing-up seemed to trigger an extra flurry of activity in my room. At that point, I had two nurses: a long-time L&D nurse who was training a student. "We need to check your cervix," she told me after I threw up. "You might be in transition."

They had been avoiding doing pelvic exams as much as possible. Since I'd come in with my water already broken, they wanted to avoid forcing any bacteria or anything else any closer to my cervix, and they were treating me with antibiotics, since now I'd been in labor so long. The veteran nurse gave directions to the student nurse on how to check for dilation. "You're eight centimeters, easy, maybe eight and a half," she told me. She snapped off the rubber glove and patted me on the leg. "Not long now."

It was right around this time that I began to feel a pain that was centered on my left hip that I didn't think should be there. Wasn't I supposed to be numb in that whole area? Why could I feel nothing but that one pain? Why did it coincide with every contraction I had? Why was I the only one who seemed concerned by it? And who the hell was making that awful wailing noise every time I had a contraction?

It was me, of course, who was wailing. Maybe the wailing was all in my head; I don't remember it bothering anyone else in the room, including my husband or my mother. Dan said I mentioned a pain in my hip sort of offhandedly; it was why he wasn't aware that anything had happened to me. I also remember it going on for hours and hours, when in reality, it was evidently just a few minutes. Dan tells me, still, though, that I didn't complain, although I began asking for more medication than they were willing to give me at that point. They did put more medication into my epidural line at one point, and it didn't help significantly. "This isn't working," I told them over and over again. "It only hurts in my hip." And it hurt a lot. It hurt like a knife stabbing me in the meaty part of my left hip. Apparently, though, I never complained.

"You're ready to push," the nurse told me. I felt like I'd been in terrible pain for hours, and I had no intention of pushing until I had more drugs. I was afraid pushing would make the pain worse, if that was possible; worse pain seemed inconceivable to me at this point. "What if you tried just one push?" she asked. "You're dilated to ten, this baby is coming." I hadn't felt any irresistable urge to push like I'd heard other women describe; I was focused on the pain in my hip and getting from one break between contractions to the next and just surviving the pain in between. There was beginning to be a lot more activity in the room, NICU nurses were coming in and setting up the table and scales across the room in the little nook that was reserved for the baby; other people were coming and going. Some of them looked vaguely familiar to me; most of them I'd never seen before. It seemed like a strange time and place for me to feel so exposed, although I wasn't really: I was wearing a hospital gown, and had blankets and pillows. I only felt like an obscene, crazed spectacle. I was still watching things with a sort of detached fascination; I don't know if it was an effect of all the drugs I'd taken or if I really was just much calmer than I remember feeling at the time. I had a short chat with a NICU nurse who'd seen me just after I'd gotten the first hit of narcotics; she poked a little good-natured fun at me for having not much of a head for the drugs.

The nurse finally convinced me to push. "Did you take a childbirth class?" she asked. We hadn't; everyone who I'd ever talked to said that they were a waste of time and money and they never used anything they'd learned in them. I shook my head no. "You'll want to push down with the same muscles you use to poop," she said. "When you have a contraction, you'll bring your knees up and tuck your chin into your chest and push from your middle, not from your head. Take a couple of big deep breaths, then push out the last breath."

Knees? Chin? Middle? Poop? What the hell? I was thinking. "I can't pull my knees up," I said. My legs and any muscular control I'd once had over them had left the building.

"We'll do it for you," she said. She grabbed one and the student nurse grabbed the other, my mother was standing down by my left foot. The end of the bed detached and rolled away; most of the parts of my anatomy I have never been eager to display publicly were now public domain in the middle of the room. There were bright lights focused on it and lots of people seemed to be gathering around it and I found myself wishing my mother would stand somewhere else, although I didn't say anything at the time because I was hoping she wouldn't notice it and I would prefer not to call attention to it. I can't fathom what I was thinking.

A contraction started and the nurse instructed Dan how to count backward from ten slowly for me, staying close to me so I'd focus on his face. He drew a chair close to the right side of my bed and put his chin on the rail of the bed, reached for my hand. One of the things I've always loved about Dan has been his ability to convey whatever he was thinking with a touch. I instantly felt better and more confident and secure; his faith in me came through as soon as I grabbed for him. I gamely followed all the directions they'd given me. "Good, good, good," the nurses were all saying. The pain in my hip was gone as soon as they'd flexed my knees back towards me and it felt exhilarating to be doing something, finally, after lying there for so long waiting for something besides the drugs wearing off to happen. I pushed maybe three times before they released my knees and put my feet in the stirrups that were at the end of the bed. "The doctor's not in here yet," the nurse told me. "I can do it without her, but I don't want to. So don't push."

Don't push? Whattayoumean, don't push? Pushing was doing something, I wanted to do something. I flicked on the television to distract myself while I waited and talked myself through the contractions. "Don't push," I hummed to myself. It felt like there was a grapefruit stuck in my butt; I wanted to push but I didn't dare.

Dr. Bushrod strode efficiently into the room wearing scrubs, shedding her white coat and exchanging it for a long-sleeved, cuffed blue cover-up sort of thing, donning gloves and a big plastic faceshield. "Do you want a mirror?" one of the nurses asked me. A mirror? I thought. Is my hair really awful? She must be thinking about pictures after...no. That's not what she was thinking of. She was thinking of a mirror so I could see what was happening. And, no. I very much didn't want a mirror. As much as I didn't want all my parts on display to the whole world, I didn't want to see them myself. Dr. Bushrod pulled up a stool, positioning it between my feet. The first thing I noticed was that the mirror would have been totally unnecessary; the plastic faceshield she was wearing was conspiring with the bright lights to become totally reflective; anything I didn't want to see I could now see as clearly as I could see Dr. Phil and his big stupid moustache still on the TV across the room. I had lost the remote control and frankly, I realized, I didn't care. I'd rather look at Dr. Phil than a reflection of my own gory genitals, especially after Dr. Bushrod picked up a tiny pair of scissors--no kidding, little scissors--and snipped an episiotomy.

A word about the episiotomy: yeah, I didn't really care. A lot of women take it as some kind of a personal affront; I just didn't care. Either I was going to tear or I wasn't, and I'd been hearing for weeks about how enormous Max's head was on ultrasound. I was picturing the Hamburgler in there; I didn't really care that much about how he came out. I guess I don't understand the women who are so horrified by their episiotomy; I picked good doctors that I was comfortable with and got educated and didn't let all of my control issues totally take over my head in the moment. I trusted them to do the right thing, and they did. It was fine.

"Here we go," said Dr. Bushrod.

It all happened fast after that. I was prepared to be pushing for hours; but all that time that I'd spent having to be coerced into pushing by the nurses seemed to have paid off. Dr. Bushrod gave good directions with each contraction: push just a tiny bit, push as hard as you can; push at 50%. I remember seeing Dan's face next to me and the wooshing of the oxygen mask they slipped over my face; I also remember my mother turning vaguely purple every time I pushed; she was pushing too.

Suddenly, I felt the baby slither free. It was a huge relief: seconds before I'd been pregnant, now I was most decidedly not. The difference was night and day and I remember heaving a huge sigh of relief. Dr. Bushrod held Max up for me to see him for a split second before passing him off to the NICU nurse who was waiting with a towel spread over her arms to receive him. He had fuzzy tufts of blondish hair that was full of bits of blood and other gore; he and I exchanged what I can only imagine was an astonished look of holy fuck! and he was whisked off to the other side of the room. I could hear him bleating noisily in protest at whatever was happening over there but I didn't mind; the activity on that side of the room was efficient, but not frantic; if he was crying he was breathing and I'd seen him; he'd been squirming and clearly a healthy newborn, even if he looked a lot like Dan's older brother in squashed-old-man form.

The doctor sewed up the episiotomy with a few quick stitches and positioned a basin under my butt to catch the placenta. I had to push more for the placenta than I had for Max. The heartburn I'd been suffering from for months finally paid off; I'd had a cough caused by reflux for weeks and finally by coughing in conjunction with the enormous pitocin contractions I was still having, the placenta dropped into the basin with a graphic-sounding squish. I never looked at it; I'm not squeamish per se, but there's some stuff I can live a long time without seeing.

They brought Max back to me, tightly swaddled in one of those ugly flannel receiving blankets with a hat squished down over his face. The first thing I did was strip all of that off of him so I could see him. He was totally normal looking: he looked just like a baby. He had giant hands and cute little feet and I thought he looked a lot like Dan. He did need to be monitored more closely in the NICU, though; low blood sugar is a major concern for babies of diabetics because they get excess insulin from the injections. He did have a couple of episodes of low blood sugar that first night, but I was, to be honest, a whole lot more concerned with what was happening to me at that point.

To be Continued...

Where Babies Come From, Part Two

Continued from here.


I waddled out to the car and got into the front seat with an old beach towel wrapped around me. We weren't out of the driveway of the apartment complex before the on-call doctor, who wasn't one of mine, called on my cell phone. I had only met this doctor once, and I wasn't a big fan at that point (it was during that hospitalization back in February for gastroenteritis, during which he questioned my ability to check my own blood glucose or decide how much insulin I needed for myself, one thing that typically turns me off to a medical professional faster than anything else), but my three-doctor practice was covered every fourth night by this guy, and this, apparently, was the fourth night, so I didn't have much choice in the matter. "Come straight to registration, not the emergency room," he instructed me. "They'll be expecting you."


After I hung up with him, anyone I had promised to call when labor started began to call me back. I had the same conversation many times: "Oh my God! How do you feel?" "Fine." I didn't know what else to say. I felt fine. It didn't hurt. I was uncomfortable, but I'd been uncomfortable pretty much my whole life, and labor seemed to have little to do with it. My mother-in-law, who I have a hard time listening to under the best of circumstances, was describing in detail to me a salad she was eating, when I handed the phone to Dan. "You talk to her," I said. "I can't do this right now."


They were indeed waiting for me when I reached the hospital registration desk. Within five minutes, I was registered, tagged on both wrists with hospital bracelets, and in a wheelchair, being hustled back to the L&D unit. A tiny Asian woman in scrubs met me. "Whassamatta, Booboo?" she asked me. "You having contraction?"

"Um, I don't know, I don't think so," I said. "My water broke."


"You sure?"


Suddenly, I wasn't. What if this was going to turn out to be some awkward incident that everyone (except me) would laugh about? "Um...I think?"


She asked me a few more questions, all of which I was very tentative about answering. I had never been in labor before; it only made sense to me that she would be much more effective in determining whether or not I was in labor, with all of her monitors and speculums and things, than I would be. I shrugged at her helplessly several times. All of this discomfort, I kept thinking, and I might not really be in labor?


"Okay," she said finally. "You go on into bathroom and put on gown, and we take a look." I pushed myself up out of the wheelchair, leaving behind the beach towel I'd had wrapped around me since we left home. I glanced at it: It was soaked. "Oh," said the nurse. "You in labor, Booboo."


I was, frankly, elated to hear it. I undressed and put on a gown, leaving my clothes behind in the bathroom--it was more work than I was really up to doing, at this point, to pick up after myself. I crawled up into the hospital bed. "I might need some kind of towel or something under me," I told the nurse. "My water broke, and it's leaking."


She tucked a giant waterproof pad under my butt. "There, you all set," she said. Nurses and other people were putting monitors on me, starting IV's, doing a pelvic exam. "You have a little mucous," said the little Asian nurse, who was manning the speculum. "You lose your mucous plug yet, Booboo?"


"No," I said. "Um, I was just coming from the doctor's office when it broke. They did a pelvic exam then too."


"Ohh," she said. "This not mucous. This KY Jelly!" She giggled. I did not find it nearly as funny as she did. She glanced at the monitor. "One centimeter," she said. "And you're having contractions every two minutes."


Really? Really? From nothing an hour ago to thirty contractions an hour and one centimeter dilated now? This was going to be a snap.


The doctor I didn't particularly care for came in, and he didn't seem to remember me, which was fine with me. As I always do in a medical setting, I immediately explained that I am diabetic, my control is excellent, I will be monitoring my blood sugar myself, although I'd be more than happy to check it for them anytime anyone wanted to know what it was, and I would be administering my own insulin. I do this simply because I liked to choose my own injection sites and give my own shots; the lancets that hospitals use for a blood sample for blood sugars are enormous and hurt way more than the ones I use and nurses like to give injections in the upper arm, which hurt more than the abdomen. This was something I'd written into my birth plan months before and that my own doctors had approved. "I have no problem with any of that," the OB said, surprising me a little. "Your water's broken, so you're not leaving here without having a baby," he said. "How's your pain?"

I considered. "Maybe a two out of ten." It really hurt a lot less than I thought it was going to.

"Okay," he said. "Well, let the nurse know if it gets worse."

The nursing shift was changing over, so the little Asian nurse was leaving and a younger (younger than me, I would guess) African-American nurse was coming in. One of the last things that the Asian nurse said to me was, "They're starting four C-sections down the hall in a few minutes. You want epidural, you want to do it now. Otherwise, there might not be an anesthesiologist for awhile."


Well, there was a thought that was gonna fester. How long was "awhile?" Until midnight? Sometime the next day? I might already have a baby by then. Having an unmedicated birth had been absolutely nowhere in my plans. What if the next contraction was the one where it really started to hurt? The nurses could give me pain medication by injection, but everyone who'd ever had a baby that I'd talked to said that shots didn't make the pain better, they just made them care less about it. There's nothing like the prospect of giving birth to bring out a woman's issues with control. "Okay," I said. "Let's go ahead and have the epidural then."

They sent Dan and my mother out of the room to do the epidural, leaving me alone with the young African-American nurse and the anesthesiologist. I don't remember why, but Dan said that it was a non-negotiable; they didn't give him or me a chance to argue. The nurse had me sit on the edge of the bed with my arms over her shoulders like I was hugging her. I don't like to hug strangers on my best of days; this wasn't my best of days and I was now uncomfortable in a multitude of ways. I was braced for a lot of pain when the anesthesiologist gave me the numbing shot before inserting the catheter. It didn't hurt really at all, just a quick hot jab and that was it. He was fiddling around behind me, his equipment laid out on the bed by my bare butt. "Okay," he said, "I can't get this catheter to go in. I'm going to have to flush out the space between two vertebrae with some saline solution. This is going to hurt a lot."

When a pain-management specialist warns you that something is going to hurt a lot, do yourself a favor and take him at his word. I am not a screamer and I think I have a pretty decent threshold for pain, since I'd endured a couple of unmedicated hours of pretty rapidly-progressing early labor without complaint so far, and worse pain than that before. I screamed involuntarily. A lot. There were noises coming out of me that I didn't recognize as being human; they reminded me of a night a couple of months earlier when we'd been sleeping with the window open and two wild animals--foxes, maybe--had had some kind of a death match right underneath our window. It felt like someone had plunged a red-hot knife into my spine and was twisting it. The hugging nurse rubbed my neck and said some things that I'm sure were meant to be soothing, but it was the kind of pain that would have, under circumstances when there wasn't a pointy wire dangerously close to my spinal cord, made me thrash around and kick whomever was causing it.

I almost gave up on the idea of the epidural, but he'd gotten the catheter into place and almost immediately I began to feel the effects. All of a sudden, it was as though my hips were gone. Then my thighs. Then my knees and eventually, within a few minutes, my feet were gone too. They let Dan and my mother come back into the room, and the nurse came back to put in a Foley catheter. I wasn't thrilled with the idea--for some reason, that one small indignity seemed like just a bridge too far. She did point out, logically, that the Foley was something of a must when you couldn't feel anything from the waist down, including the urge to pee, and lacked the muscle control to prevent yourself from doing it involuntarily. I tried not to think about the weird set of plastic giant-tweezer-looking things she came at me with, or the Betadine, or the rubber tubing. "Is it going to hurt?" I asked her apprehensively.

She took a seat down between my feet. "It probably would," she admitted cheerfully, "if you could feel anything. You can't feel anything, can you?"

"No," I admitted, feeling stupid. It's just that if anything was going to be as painful as the epidural had been, I was willing to pretty well give up on any of what might be coming next, including the part where I pushed out a baby.

Like every other L&D nurse that I encountered that day, she was efficient and pleasant while taking care of that particular task, and when she was done, offered me a little binger shot of some kind of pain reliever to give the epidural a head-start. The epidural had a pretty good head-start all by itself, but at this point, the thought of experimenting with narcotics was sounding moderately intriguing to me, so I agreed. She put a shot of something in my I.V., and within seconds, my head was so pleasingly fuzzy I could barely keep track of where I was. "I like the epidural man," I told Dan. "I think we should send him a Christmas card this year. Or maybe buy him a new station wagon." The room was swimming around me. "Maybe I'll take a nap," I told him and my mother. "This might be a long night."

To be continued...

Where Babies Come From, Part One

I am officially, by the most conservative of estimates, 30 weeks pregnant today. That means that in less than 10 weeks, The New Girl will be putting in an appearance.

I am officially beginning to freak out, in several different ways. I was so totally gobsmacked to be pregnant, finally, last fall, and to be pregnant under such an unbelievable amount of financial and personal stress, that, to be honest, I had a very difficult time accepting the idea that I was pregnant at all, despite my constant morning sickness, despite my official status as a run-on sentence (translation: my missing period. Get it? God, I'm funny), despite my bone-crushing fatigue that had me asleep on the couch by 8 o'clock every night, despite the multiple pregnancy tests that came up positive.

Everything seemed to happen to me all at once--I got a new job, our car was stolen, the holidays that ended up being so thoroughly dismal, Max going back to school full-time--to a degree that I didn't feel totally able to process the fact that I was finally pregnant with the baby we'd wanted so much for so long. So I didn't. We didn't make any plans to move out of this tiny condo that would be the perfect size for one or maybe two people, but is exhaustingly cramped for two people plus a three-year-old. We didn't buy a crib. We didn't buy anything at all, really, until after we found out we were having a girl--a fact, incidentally, which only served to make the entire thing more unbelievable. Partially this was just practicality--why buy a bunch of new baby clothes for a second boy? We've already got one boy and a whole lifetime's worth of clothes, and if it's a girl, we'll need different stuff anyway. But partially, it was my reaction to being pregnant at all.

I have ten weeks to do 40 weeks worth of worrying, and have come cruising out of denial mode into full-on WTF??? mode. I'm worried about a million things this time that last time never even crossed my mind. In an effort to talk myself through the crippling anxiety I am feeling, I am currently trying anything I can think of.

It occurs to me that I have never actually written down Max's birth story, which is practically unheard-of on a Mommy blog, which, more or less, is what this is. It's one of the first things I go looking for when I'm reading some other mother's blog for the first time, reassured by the fact that none of the weird, painful, awkward, embarassing, uncomfortable, startling things that happened to me were really that weird, painful, awkward, embarassing, uncomfortable, or startling.

So, in an effort to quiet some of the worrying that I am finding myself trying to cram into ten weeks worth of pregnancy, I'm going to spend the next few whatevers telling Max's birth story in a reminder that sometimes things just happen in an average, totally expected, not at all premeditated way, which, overall, was my experience with Max.

On June 18, 2005, I was 38 weeks and 3 days pregnant with Max. A few days earlier, I had gotten a call from my OB, Dr. Bushrod (a hilarious name for an OB-GYN, I think) saying that she wanted to induce me on June 21st, as she'd be going out of town and wanted the baby to be born on her watch. While I am technically a high-risk pregnancy, due to being a type I diabetic, it was as uneventful a pregnancy as anyone could have hoped for, save for one short hospitalization at 22 weeks due to getting a gastrointestinal bug that made me as sick as I've ever been in my life, requiring several days of IV fluids and an anti-emetic that is still by far my drug of choice. I'd had no problems with high blood pressure or anything else, and the baby was responding well to the multiple tests I was having every week. I was having an ideal pregnancy, even for someone whose didn't have health issues that could turn pregnancy into a nightmare.

My parents arrived by car with, among other things, the frozen top layer of our wedding cake that afternoon. Our first wedding anniversary was July 17th, and I was looking forward to finally getting a slice of that cake. On my wedding day, I'd been too busy running around, talking to people, to ever eat more than just that one bite that Dan had fed me for photos. Their plan was for my stepfather to fly back to Kalamazoo on the 20th, leaving my mother here for the first several weeks to help out, then fly back in early July to drive home with her again, with Dan's parents arriving that afternoon for 9 days.

The night before my stepfather flew back to Kalamazoo we went out and picked up take-out barbecue, then took it home to eat it. It was punishingly hot already, and I was spending most of my time either on the couch, complaining, or in the apartment complex's swimming pool. Most of the time I was there, I complained too. My mother baked me a blueberry buckle, which is a really yummy yellow coffee cake studded with blueberries and topped with a brown sugar strusel topping, which I was eating entirely too much of, mostly because it seemed to be one of the few things that didn't require me to chase it with a handful of Tums.

The next day, June 20th, we drove Tom to Dulles, which is, inexplicably, the airport which my parents prefer to fly to and from whenever they visit, which I don't understand--it's the least convenient and farthest away from us. We'd only been there once, and I didn't know the way--nor did I particularly care. I was riding along only because I was tired of complaining inside my own apartment, and also, because Dan didn't like to be that far away from me, and he was going along.

We got lost on our way back from Dulles. It's easier to do than you'd think, especially if you need to stop for gas, and, like my mother, you manage to do so in the least likely spot on earth. I sat crankily in the back seat of the car, wishing like hell that I wasn't pregnant. Somehow, we ended up in the middle of downtown D.C., on Constitution, while my mother gazed around and remarked repeatedly about how exciting it must be to actually live here. I wanted to punch her in the face.

Dan managed to get us back to 295 southbound, which took us through several not-great neighborhoods and along a rather heavily potholed route. In the back of my mother's Jeep, I kept picturing the contents of my uterus bouncing off my cervix every time she hit a bump. "Sorry!" she kept calling out merrily. "Doing okay back there?" I grunted at her, picturing the flat spot on my kid's head, that I was sure would result from his skull being bounced off my pelvis for two hours.

We went to my last doctor's appointment, where I shed my pants and gave my OB one final look at my cervix. "Still closed," she said. "Maybe a little shorter than earlier this week. No contractions or anything?" she asked.

"How would I know?" I asked. I'd never had a contraction, not so much as a Braxton-Hicks contraction, that I'd been aware of.

She laughed. "You'd know," she said darkly. "We'll see you tomorrow night at the hospital for induction." I felt like I was joining the army. I put my enormous maternity pants back on and waddled back to the waiting room.

We'd been waiting for the crib that we wanted to be in stock at Sears Essentials in Clinton, Maryland, for several weeks. On the way home from the doctor's, which was in the professional building next to the hospital, I asked Mom to stop at Sears so that we could pick it up.

Dan and I made arrangements for the boxed crib to be brought from the back of the store to the front, which required several walking trips through the store. Mom lost interest and wandered off to look at baby clothes. Finally, we were walking from the back of the store to the front one last time, me waddling several steps behind Dan, who'd never really learned to adjust his walking speed (typically, I walk much faster than him, because my legs are longer) to accommodate my pregnancy. Dan was talking, not really aware that I'd fallen behind him by several steps, as is his wont, and I was not really listening to him, thinking to myself, God, I'm just so effing uncomfortable, I'm so tired of feeling so totally uncomfortable, and what is this thing that's happening now, this is fucking miserable, I just wish it would stop--when all of a sudden, it did stop. Instantly. At the same instant that it stopped, I felt what can only be described as a hot, wet bomb going off in my crotch. It didn't hurt--in fact, it relieved some of the intense pressure I was feeling, so it actually felt pretty good--but an instant later, I felt something warm and wet running down the inside of both legs.

I stopped instantly where I was, and just about that time, Dan realized I wasn't walking with him. "Dan," I said. "My water broke."

Dan looked at my feet, then at me. "Are you sure?" He was looking for the puddle that he assumed I would instantly be standing in. But all I could really feel was a trickle--like I'd had to pee really badly, and I'd sneezed, or laughed hysterically.

"Yes," I said. I'd never been so sure of anything. It wasn't a feeling you could mistake for any other feeling in the world. I could feel my underwear and pants becoming increasingly wet.

Dan and I stood there for a couple of seconds, staring at each other. "What should I do?" I said. I was afraid to move.

"I don't know," he said. "Where's your mother?"

Just then, she stuck her head out from one of the aisles. "What's going on?" she asked.

"My water broke," I said.

"Oh," she said. "Oh! I'll buy a beach towel."

It was good thinking on her part. We were only a couple of miles from the hospital at that point, and the logical thing would have been for us to just get in the car and drive back. Logic, however, was not my strong suit at this point. My pants were wet, I had a bag packed at home, waiting to go to the hospital, I wanted my own pillows and things, and I thought it would be silly to go to the hospital with a crib in the back of the car. "Take me home," I ordered. "I want my stuff."

Dan and Mom didn't try that hard to argue with me. Instead, they shuffled me into the front seat of the car and drove me home, where I was beginning to feel increasingly uncomfortable. I called my doctor's office, which had closed in the twenty minutes since we left, and I left a message with the answering service, as the recording instructed me to do. "I'm one of their patients," I explained. "My water just broke." It felt like a huge relief to say so: even though I was anxious about when things would start to hurt, or I would start throwing up (which I hate to do), or things would otherwise increase in unpleasantness, I was relieved to think that there was a light at the end of the endless tunnel of pregnancy, one that hadn't even appeared when they'd given me a date for induction. The answering service said that the doctor would call me back. I felt remarkably calm and collected at this point, feeling mostly just that sense of relief that it was all almost over.

I went into the bathroom to change my pants, which was beginning to seem like more trouble than it had been worth. The pair I'd been wearing were soaked, of course, and they were the only pair of maternity shorts I owned. I'd also been wearing my most comfortable pair of underwear. I somehow managed to peel both of these off, despite the fact that I was increasingly uncomfortable, although not really in pain, and drag on another pair of jeans. The amniotic fluid wasn't a steady stream--just an occasional gush when I changed positionts or the baby moved. I found a heavy-duty maxi pad under the sink and pasted it into my maternity underwear and hoped it would suffice for the trip back to the hospital, managed to stand up and drag my pants up past my hips.

As I did, there was another gush of amniotic fluid and it was clear that any precautions I'd taken against having to go out in wet pants were going to be fruitless. I absolutely did not have it in me to change my pants again. I threw the bathroom door open. "Fuck this," I said to my mother and Dan. "Get me a towel to wrap around my waist and let's just go."

To be continued...

Fear of Falling

When he was about 14 months old, Max took a big face-planting fall off the arm of the couch, headfirst into the back of a chair that was sitting nearby, onto the floor. It was truly one of the most awful moments of my entire life, that split second of stunned silence between crash and screaming. It's the first time I can remember him having really hurt himself--he'd had stomachaches and other minor ailments before, and he'd certainly been uncomfortable, I'm sure--but he'd never really been hurt before. In the second it took me to get to him on the floor and flip him over, looking for blood or broken teeth or anything visibly terribly wrong with him, I burst into tears too. Dan was in the kitchen correcting papers at the time, and I screamed for him. He came running, I sat on the floor holding Max and wailing, Max flailed wildly and cried, and once he determined that there wasn't anything really wrong with any of us, Dan sat on the floor next to us and comforted his crying wife and son.

He wasn't hurt, luckily. Max is like a cat: it seems to me like he should have gone through all of his nine lives ten or twelve times over by now. I've read more near-misses and horror stories recently: babies who've rolled off their parents' bed onto a hardwood floor, toddlers who've miraculously been caught by a passing stranger as they've fallen from a third-story window, and of course, like nearly every blogging and Twittering mother on the planet, I was shocked and horrified to read earlier this week about little Maddie Spohr.

It's gotten warm here over the last few weeks, and for several hours in the afternoons most days, we've opened the windows, and Max has taken a particular and somewhat peculiar joy in pressing his face against the window screen in his room and screaming out the window at the top of his lungs. Yes, I'm aware that my kid is a bit of a total weirdo, but at any rate, no. We live on the third floor, and there will be absolutely no pressing of our heads against a window screen. The screaming I can live without, but the real issue is the visual I have of the screen giving way and Max falling headfirst out of the window, three stories, into the parking lot below. It's one of the few infractions of the rules that has earned Max a spanking: we only spank for things that could seriously hurt him or someone else.

I can't prevent every header that Max is determined to take off the couch. I just can't. This kid is three and a half. Sometimes they have to fall down, just to check to see if gravity is working. I get that. I can (and do) keep the machetes and heroin and porn out of his grasp (yeah, the heroin and porn are all mine; hands off, kid), but I can't eliminate every sharp corner and edge and forehead-level-everything from our house. And furthermore, I don't want to. He is, after all, three and a half. At some point, you should learn not to walk headfirst into things.

When he was six months old, Max was exposed to whooping cough from a ten-month-old who had not been immunized according to the CDC's childhood vaccination schedule, or, as it turned out, according to any medically-recognized vaccination schedule at all. Max had just received his third dose of the DTaP vaccine when he was exposed, but I was concerned enough to call his pediatrician immediately. I was further concerned a few days later, when I learned that the older baby had, sadly, died. Max has a wonderful pediatrician, a brilliant clinician and an extremely capable woman who's never pooh-poohed my concerns, no matter how outrageous they may have sounded to her, and the first thing she said to me was, "You've done the right thing calling." She immediately looked at his vaccination records to see that he was fully up-to-date, saw that he was, and said, "My immediate thought is that he should be completely fine, but keep a close eye on him over the next two weeks." Done and done, I thought. I was a stay-at-home mother at that point; I had not a whole lot else to do besides keep a close eye on him.

Max never developed so much as a sniffle. In checking with the local health department, I learned that six cases of pertussus were reported in conjunction with the baby who died; all were children who were on "alternative" or "delayed" vaccination schedules. They never ascertained exactly how many people were exposed to pertussus; but no fully-vaccinated children or adults reported becoming ill.

Let me repeat that, because I think it's significant: no vaccinated children or adults reported becoming ill. There has been a lot of talk about vaccination lately; Heather Armstrong at Dooce is a lightning rod for most internet-based parenting controversy and this is no different.

My feelings about vaccination is pretty straightforward: I have and will continue to vaccinate my children on schedule against anything that they have vaccinations for, including measles, mumps, rubella, diptheria, pertussus, polio, varicella, hepatitis A and B, rotavirus, Haemophilus influenzae type b, pneumococcal, influenza, meningococcal, and HPV. These are, by all reliable accounts, medically safe and proven to prevent, not cause, life-threatening and devastating diseases, anecdotal evidence notwithstanding.

I could not be more sympathetic to the parents of children who suffer from autism-spectrum disorders. I have a nephew who's suffering terrible social, developmental, and learning delays due to an autism-spectrum disorder. As a parent of an energetic and precocious pre-schooler, I am struck multiple times a day by how much of a challenge a totally normal kid is; I simply cannot fathom the depth and breadth of challenging a delayed child.

When Max fell head-first off the couch, I immediately blamed myself. I was sitting right next to him; why didn't I grab him? Why did I let him climb the arm of the couch? What was I thinking? He could have broken his skull, his neck. I could be sitting here holding his dead body right now! What is the matter with me? That's why I cried, not because of him getting hurt. I cried because it was my fault he fell.

You spend nine months, minimum, anticipating and growing this tiny little human being, and they hand them to you, and they're perfect, a total stranger to you, but still somehow exactly what you were expecting. When this perfect little person turns out not to be perfect, of course there must be a reason for it. Of course. Of course parents struggle to find some reason that the train has come off the tracks in such a thoroughly hideous way.

Vaccines are taking the heat for things that they're just not responsible for, and as a result, there are individuals out there who are making the decision not to vaccinate. As a result of that decision, diseases that should be practically extinct on this continent are making a comeback, and my kids are being exposed to things like whooping cough. Here's a news story from today, about patients who've been exposed to measles in a local hospital.

I know it's not pleasant, the idea of your baby getting a shot. But at the risk of sounding intolerant, the mothers that tell me, "I'll never vaccinate my precious children, I can't imagine making them get a shot," well, don't get pissed at me or anything, but I'm going to be forced to push you in front of a bus. That's what's known as thinning the herd where I come from.

The same goes for parents who tell me, "I won't vaccinate my children--everyone else does, and they'll never be exposed to anything for that reason." Well, your thinking is flawed, and you clearly don't have much of a grasp on, you know, science, but whatever. Do me a favor and don't let your kid come within twenty yards of my kid, okay? They probably don't wash their hands either.

And for the parents that cite the anecdotal evidence of vaccinations causing developmental delays, I don't know what to tell you, except that I'm afraid of my son falling down. I'm afraid of him falling off the couch, I'm afraid of him falling off the bed, I'm afraid of him falling out the window, I'm afraid of him falling off his bike and off the playground equipment and from the loft in our condo and down the stairs. I'm scared to death of the feeling of helplessly watching him fall, the anticipation of the sound of him colliding with a hard surface, the sight of my own hands reaching toward him just a second too late. I'm afraid of that moment of silence before he starts to cry, of that moment going on and on and on, holding my breath while I wait for him to start to cry, and what will happen if I never hear him cry again, how I'd ever be able to stand it.

But I know he will fall down. I know he will. I know he'll hurt himself, probably, at some point seriously. I did. When I was about Max's age--younger, maybe--I fell skiing and sprained my ankle badly, an ankle I've reinjured numerous times since then, probably due in part to the injury that I sustained when I was three. Kids do that. It happens. You take risks, calculated risks. You spank them for leaning on the window screen on the third floor, but you cheer when they ride away from you on their bikes. You stop them from jumping on the bed, but not from jumping down the last two stairs.

I am vaccinating my children because I feel that it's not only the responsible thing to do for them, but it's also the responsible thing to do for my community. I can't depend on other people to be responsible, so I do my part. Herd immunity is something everyone has to contribute to; I do my part by contributing, and I will continue to do so. I have no good evidence that vaccinations cause anything other than immunization.

Sure, go ahead and don't vaccinate your kid. But don't tell me I'm harming mine by vaccinating him. Don't tell me I'm putting him at risk. I'm not stupid and this is the calculated risk I'm taking: the slim possibility of vaccine reactions versus the much-less-slim possibility of devastating neurological damage or death due to a preventable illness. I get it, okay? You take risks as a parent. This is the devil I know versus the devil I don't.

And do me a favor: if you're not going vaccinate your kid, keep him away from mine. I wasn't kidding about that.

Six Years

Six years ago tomorrow, Dan told me that he was really enjoying the conversation we were having in the parking lot of our job, standing next to our cars, and he'd really like to continue having it, but he was cold and tired and would I like to come over for awhile?

I said yes. And six hours later, he kissed me for the first time.

In the past six years, we've moved in together, worked together, gotten new jobs, planned a wedding, moved halfway across the country, had a baby, lost jobs, made new friends, gotten pregnant again, changed plans mid-stream, evaluated and re-evaluated and re-evaluated what was the best thing for us and our immediate family and our extended families, and now, six years later, we've come to another bend in the road.

I lost my job earlier this week. I know for a fact that my former place of employment knows about this blog and I am still waiting to hear about unemployment benefits, although I was assured it was not a factor, so I won't go into the finer points of the loss of this job, but suffice it to say that, working in media, it wasn't totally unexpected and the economy has a great deal to do with it.

I am 26 weeks pregnant and I can't go running out to get another job right now. We can't make it here on one income. We're having a baby in July. Our parents are getting older, and we want our kids to really know them. We miss having the backup of family. Dan isn't happy with the school where he teaches, he feels that it's been a hostile work environment and the administration is phoning it in in the worst possible way. And worst of all, in five years, we feel like we haven't made any real progress toward the things we want--a real home, some security. It's incredibly expensive to live here, and becomes more so all the time. Add to that the expense and inconvenience of Dan having to re-certify as a teacher this year, and it's all just a little more than we can handle.

So. We've come to a decision. We're going to finish out the school year and have this baby, and then we're going to move back to Kalamazoo, permanently. In a lot of ways, it breaks my heart. I love it here. I've always loved it here. I have friends here. My best friends are in town twice a year, minimum, and I've loved that I've had the chance to see them so often. There are great restaurants and museums and places to go, an endless supply that we'll never get tired of seeing. I love it here.

But our families are a long way away. We need the backup, especially with a new little person arriving so soon. We've been the victim of crimes here, repeatedly, and every time it knocks us down and it's just so fucking hard to get back up. And we're exhausted.

I don't mind that it's hard. I don't. This is being a grown-up, and I'm not afraid to stand on my own two feet, especially with Dan standing next to me--I couldn't ask for a better partner in life. But it should be a little easier, shouldn't it? After five years, should we still be fighting this hard, every day? I want to let my guard down a little, and I still can't. I don't mind that it's hard, but it shouldn't be this hard.

I don't know exactly what we're going to do. Dan can absolutely sub until he finds a real teaching job, and his teaching certificate, which he originally got in Michigan, is still good there. He'll have to take some classes this year in order to keep it current, but he's willing. The economy in Michigan is terrible, and I'm pretty well assuring myself a boring job in marketing or something like that, stuff I've done before, but I'm also giving The New Girl a chance to have me all to herself for awhile. Max got that chance, and I feel like I owe it to her as well. I owe it to myself. This is the last baby I'm going to have, and I want this for all of us.

My parents are thrilled of course. We're having a hard time getting a read on Dan's mother's feelings on the subject, mostly because her reaction was to immediately change the subject to something totally unrelated, which enraged me to the point that I had to get off the phone and find something else to do. I am probably going to leave this topic alone for the time being, as I have nothing productive to say about the subject. We anticipate staying with my parents for at least a few weeks, and then, depending on the job situation, either looking for an apartment or a house--home prices in Michigan cannot be beat right now, and we're pretty happy about that. A lot of the salient details of all of this remain firmly up in the air at the moment, but we're putting our ducks in a row to make all of this work in the best, easiest, most expedient way we can think of. Additionally, living in Kalamazoo, our kids will qualify for the Promise, possibly the best college scholarship program in the country.

The lesson in all of this is that I am learning, once again, that things that feel permanent seldom are, except for things like the love you feel for your children, your partner, your friends, and your family. Six years ago, Dan took my hand and stepped off a cliff, and the results have been serendipitous; I couldn't have asked for more. This summer, we'll take a step off another cliff, and it's scary, but I've got no choice but to hope that our luck holds.

Almost Paradise?

There is a weird thing that happens when you can't get pregnant when you think you should, for whatever reason. You start to think of the state of being pregnant as this sort of quasi-nirvana. I think it has something to do with the grass always being greener; you want the baby of course, but more than that, you crave -- what? The act of outgrowing your pants overnight? The loss of your appetite for three months? The overwhelming urge to fall asleep any time you aren't physically in motion?

Well, it all comes back to you pretty quickly. I was feeling pretty decent with this baby until the middle of Thanksgiving dinner. If you'll recall, when I'm in charge of Thanksgiving, there isn't turkey or cranberry sauce or pumpkin pie; there are mini crabcakes and cocktail meatballs and boiled shrimp and hummus and cheese spread and all the other things that I usually like about the three hours before Thanksgiving dinner. That's what we had this year, and I bit into a perfectly poached, perfectly seasoned, perfectly chilled shrimp with homemade cocktail sauce, and my universe instantly changed shape. And not in a good way.

Goodbye, appetite. See you sometime in mid-February.

A partial list of things I couldn't/wouldn't eat while pregnant with Max: Yeah, I got nothing. My food aversions were not terrible with him. Cereal grossed me out a little, and dairy.

A partial list of things I couldn't/wouldn't eat while pregnant with The New Girl, only in the first trimester: ground meat of any sort, or really meat or poultry of any kind, dairy, citrus fruit, tomatoes or tomato products of any kind, nothing sticky or gooey, or anything sweet of any kind except for the possible exception, on very good days, of Sour Patch Kids. They actually were pretty great as far as a short-term cure for morning sickness. I pretty well subsisted on apples, diet Ginger Ale, saltine crackers, frozen bean and cheese burritos and Chef Boyardee ravioli.

Those illusions about how great pregnancy was flew pretty well out the window in the months of December, January, and the first half of February. I felt shaky and sweaty with a combination of fatigue and hypoglycemia pretty much all the time, had an overwhelming schedule of doctors' appointments with a variety of specialists and a brand new full-time job, and the three-and-a-half year old who lives with me couldn't understand why I was far more likely to fall asleep mid-sentence than I was to get down on the floor and play with him. I was not enjoying myself very much at all, and I'm pretty sure no one else around me was enjoying me at all either.

Right around the time that I experienced a brief but violent bout of the stomach flu--how's that for a kick in the pickle?--the morning sickness eased and I found my appetite again. It was really great, to be honest: food hasn't ever tasted as good to me as it has in the last three weeks, and after two and a half months of not even wanting to think about, look at pictures of, or discuss food, let alone eat it--well, sufice it to say, I've been a very happy girl.

In general, I am happier than I tend to be most of the time, to be honest. The cloud of low-grade anxiety that typically floats around me has magically cleared and despite my initial shock at the news that I am pregnant with a girl, I don't feel as much sheer terror at the thought of raising one as I thought I would. I never enjoyed traditional girlhood that much, not being really a big fan of clothes and makeup and dolls and stuff, and guiding someone else through it--well, the thought didn't exactly make me do the Snoopy dance. But I survived it, and it was not that much fun at the time, but I am basically no worse for wear because of it, and so will my daughter.

I am a little sad about all of the adorable little boy clothes that I am currently sorting through, all of the memories of 6-week-old Max, round and drowsy and adorable in the smallest baseball jersey I've ever seen. The fact is, we're not having another baby after this one--we can't afford it, for one thing. For another, it's a good round number--two kids, two grownups, and maybe a dog eventually. Nobody's outnumbered that way. So we just don't have the need of all of the boy clothes, and we've culled out most of the things like pajamas and things that are sort of unisex, and we're sorting things into too-tired-looking-and-stained-for-anything-but-the-trash, donate, and send to Kimberly and Michael for their little Sprout. It will actually be kind of great to see Sprout wearing a Nationals uniform, however deeply it will most certainly gall his Cubs-fan parents.

In the last couple of weeks, I have begun to feel The New Girl kicking, prodding, rolling around, and in general being as active as Max ever was. This weekend, I was sitting on the couch and noticed that she was kicking me hard enough for me to be able to see my shirt moving. I am looking far more pregnant at this point than I did with Max--I have all but given up on even my fattest fat-jeans, the ones I bought right after Max was born, ones that have been too big for me for two years now, and am splitting my time between maternity jeans and my most forgiving yoga pants. I am carrying this baby very high, much higher than I carried Max, and as a result I look far more traditionally pregnant than I did with her big brother, with whom I looked mostly just fat and never more than about six months pregnant.

Despite the fact that Max had his heart set on a "baby brudder" and there were several meltdowns on his part after the ultrasound that revealed girl bits--I really wondered about some kind of prescription sedative in a dose safe for a preschooler--he is as excited as we are about having a girl, and far less trepadatious about what having a 13-year-old girl around the house will be like.

The thing about second babies is that they're unpredictable. You learn your way around the first baby, figure out what they like and what they don't like, whether the bouncy seat makes them cry and the swing puts them to sleep, what kind of blanket they like and which they can't stand. Then the second baby comes along and you start fresh and you don't know anything again, except that you're still overwhelmed by love and a number of years older and more tired, and as it turns out you still don't know anything.

And that's really the thing that's causing most of my small amounts of anxiety surrounding this baby--I have no idea who this little stranger is. A week or so ago, I demanded that we decide on a name for her, because I couldn't bear that I didn't even know what to call her in my own mind. I suspect that I rushed Dan into making a decision, but in the meantime, I think all three of us have become a little more at-ease with the thought of a little person whose name we at least know.

So in general, I am very much enjoying this pregnancy. Despite the fact that I have "stranger danger" in regards to my own daughter, I feel good--energetic, most of the time, clear-headed, not too physically uncomfortable, my health is good. Basically, I don't have a lot to complain about. The grass, in this case, really is greener on this side of the fence, and I'm pretty relieved about that.

In the Pink

Yes, it's a girl.

Dan and I could not have been more surprised on Friday by the sonogram if there had been five or six babies in there. We just have been thinking of ourselves as the parents of boys, maybe because The Max Show is so all-boy-all-the-time.

I have a lot of emotions. Like I said, I am really stuck in a mode of thinking of myself as the mother of sons, and I have to admit that it's hard getting myself out of that mode. I mean, dresses? Bows? Barbies? Really? I was never that great at being a girl--I always felt most like myself when I was doing things that I tend to think of as gender-ambiguous. I never felt particularly girly or feminine--I don't dress that way, I don't think that way, and I don't really feel like I relate that well to women who do.

But the feeling I've had with this pregnancy up until now, the feeling that this is all old-hat to me and nothing to get that excited about, is sort of gone. I mean, I was excited, but not like I was when I was pregnant with Max: that feeling of anticipating a totally brand-new experience. But with a girl, now this feels like a whole new ballgame to me, and I'm finally starting to feel excited in a way I wasn't before.

Also, I'm starting to anticipate what this kid will be like. Max is so much Dan's kid: it's Dan who he wants all the time, and while it gives me a little free time to be pregnant and exhausted (both of which I really am; I am looking enormously pregnant already and I am so overcome by exhaustion that I am usually asleep on the couch within an hour of getting home from work every night), it does make me a little wistful when Max only wants his dad and never me. I keep joking that I'd better be this kid's favorite, and it's only half a joke.

I really wonder what being mother to a girl will be like. I am trying not to get too hung up on what ages 12 through 19 will be like (those are the years of my life that I like to refer to as "The Seven Year Bitch"), and instead think about all the things I am so enamoured of in Max: his sunny personality, his enthusiasm for everything he does, his curiousity, his one-track mind, his eagerness to please everyone, especially himself. I'm trying to imagine those traits in a little girl, and when I do that, it doesn't make me want to hide under a large piece of furniture for the next 20 years.

Like I said, Dan and I couldn't have been more shocked on Friday when the sonogram technician said, "To be honest, everything I'm seeing here says girl to me." We had a boy name picked out, but it's not even remotely unisex, and we hadn't really gotten anywhere with a girl name--that's how sure we were that we were having a boy. We have a few ideas, but I am open to suggestions. I made the observation to Kimberly the other day that as much as I tend to dislike the ultra-popular, Best-Girl-Names-Ever baby name lists, the fact is just that some names are popular because they're just good names. The requirements are as follows:

1. Nothing that rhymes with Max or Maxwell (what rhymes with Maxwell anyway?)
2. Must sound good with the last name Chase (Grace, for example, is out.)
3. No unpleasant associations: Dan's first wife's name was Melanie, his mother's name is Rosetta, and he has an ex-girlfriend who I found totally stupid and annoying named Erin. I went to school with a really mean girl named Nikki and another named Carolyn. Thumbs-down to all of these.

Also, if you happen to have a girl and you're now pregnant with a boy, and you'd like to trade baby clothes, send me an email. I dressed Max much more stylishly than I ever dress myself, and I feel incredibly sorry for this girl, who will probably inherit my sense of feminine style.

In Which our Heroine Goes Totally off the Reservation and Writes a Letter to a Random Body Part

Dear Lower Back,

Please stop it, you're hurting me.

Seriously, whatever it is that's happening right now...wait, I know what's happening right now. I have a 20-week-old fetus in residence, and their head is resting against the top of my tailbone. That's according to my new, very sweet obstetrician, who I saw this week. She is a part of the practice who will be delivering the fetus-in-residence on June 27th, give or take.

Not that you care about any of that, Lower Back. All you care about is yourself. That's fine. You're selfish, I get it.

Listen, you know that I can't do anything about all the pain you're causing me. I know that, because you and I have talked about it before. Seriously, just this morning, when we were lying in bed together--remember, I was crying, I was asking you to just stop hurting me, because ohmigod, the pain...Okay. No, I didn't think you were listening at the time either, but I just wanted to let you know how I was feeling.

The very sweet obstetrician was just so nice that I kept almost forgetting that she was a doctor, and when she took a look with the ultrasound yesterday and saw 20-week-old-fetus butt, and that was about it...she hypothesized that the reason you're hurting me so freaking much is that there's a forehead pressed against my lower back. I understand, you know? It can't be all that comfortable to have a forehead pressed against you. I'm sure it's unpleasant for you.

I just...I don't know. I think you're being a little bit self-centered, is all. You know, we're stuck with each other for a little while, and the lease on my lady bits doesn't run out until June, so we're both stuck with the fetus, too. I think we all ought to learn to get along together. I've been talking to the fetus on your behalf; I know you're not great about talking about your feelings, so I just thought I would say something. I know it's not that fun to have a head pushed up against you. It's not a big head or anything, but still--it's a head where there usually isn't a head. I understand. Also, when I have another, more advanced ultrasound on Friday, I really want to find out whether it's a boy fetus or a girl fetus, and unless it moves around a little by Friday, we won't be able to see much of the determining factor. I'm just trying to think about all of us here, you know?

It's just that the thing I'm not sure you're aware of is that when I would usually seek some sort of pain remedy in order to deal with the fact that you're really causing me a lot of pain right now, I no longer have that luxury. I guess it's bad for the fetus for me to take Aleve, or Motrin, or to inject pure Pakistani heroin directly into the sclera of my left eyeball. I don't know if you knew that was bad for the fetus...I mean, I'd heard, and I said something to you about it this morning, but I know it was early, and you really don't do mornings that well. I can take Tylenol, but, I mean, come on. My three year old can take Tylenol. What's that supposed to do to help me? I use the heating pad on you--I know you like that a lot, because when I do that, sometimes you leave me alone for, like, a whole hour--but I can't bring it to work, because I don't have anywhere to plug it in.

Listen, I really hate to be a nag. You don't want to listen to me whine for the next 20 weeks, do you? Could we work something out? Like, maybe I'll just write you this letter, and you'll stop hurting me, and we can both just move on from here? Try to get along and live together? I know we can--we've done so well together up to this point. But like I said, you're really hurting me. I just want you to stop. I'll forgive you, I promise--it'll all be water under the bridge. But I need you to really make an effort, show me that you want this as bad as I do. We're in it together now, Lower Back. I can't do this without you--and by this I mean, you know, walking around, or sitting, or standing, or pretty much anything--and I'm pretty sure you won't get far without me, so can we try to work it out? For the baby?

Please?

Love,
Molly

Day 7: Two Things

Yes, so I missed yesterday. I came home, laid down on the couch, and promptly fell asleep. I don't know what to tell you. Fatigue is kicking my ass this pregnancy, even more so than last time. I think it's because there's a 3-1/2-year-old already living here, which could make anyone tired.

So today, I will think of two random things about myself to make up for yesterday. As long as we're talking about it, I may even make them pregnancy-related.

1. When I was pregnant with Max, I craved chili-cheese dogs and graham crackers. I ate both a lot. With this one, whom we've nicknamed Ghostrider (yes, we have real names picked out, and I probably won't reveal them until Ghostrider makes an appearance, because otherwise, how will I get you to come back?), I am craving root vegetables in their least healthy forms: maple-brown sugar glazed carrots with pecans and bacon, roasted garlic mashed potatoes, beer-battered onion rings, raw radishes sprinkled with salt. Morning sickness also was a lot different with Max than it is with Ghostrider: with Max, I felt sick all day, every day, but just enough to make me feel terrible, not actually terrible enough to make me throw up. With Ghostrider, I feel terrible in the morning and the late afternoon, and I have actually been throwing up this time. Luckily, it's only been in the morning, when my stomach is empty. I hate to throw up.

2. I am one of the only people I know whose water actually broke without having to have it broken for them. I was in Sears at the time. We were coming back from my last doctor's appointment. It was two days before I was scheduled to be induced at 39 weeks, and we stopped to pick up Max's crib, which had been back-ordered. I was following Dan through the store, shuffling along, thinking about how uncomfortable I was, how tired of feeling uncomfortable I was, how I was tired of going to doctors and taking off my pants and having things put places where, frankly, things were already a little too crowded for my liking, and...you know, I really am uncomfortable, maybe more so than I was a minute ago, I just wish this would stop...and just like that, it stopped, and as it did, I felt a wet, hot explosion. That is exactly what it felt like, and I apologize for how graphic it sounds, but there is absolutely no other way to describe it, and I knew instantly what it was.

My Child's Genitals Are Not Up For Discussion

So mostly I talk about silly stuff my kid or my husband says, or something funny I saw on the internet, or something I'm eating (or would like to eat.) Occasionally I get a little maudlin and talk about politics or something else that I take seriously, usually in regards to how it relates to me or my family.

This is a little bit like that. But not really. But sort of. I'm deadly fucking serious right now.

There is a lot of talk out there on the internet about circumcision, especially among parents or about-to-be parents. Especially right now, in light of the Momversation webcasts.

I would like to go on the record and say that I think all of the participants made excellent points. I think some of them made them in ways that left something to be desired, but people have strong points of view on circumcision. I understand and respect that.

However, some of the commenters on some of the participants' sites have left a bad taste in my mouth. Because I left the last comment on Mighty Girl's blog before she closed the comments, I am concerned that a lot of wind might blow in this direction, so I would like to fully articulate my position on the subject.

• I have a son, so obviously, the topic of circumcision has come up between my husband and I.
• I am pregnant again, and for that reason, I anticpate that the subject will come up again.
• Male circumcision is a personal choice, typically made by a parent or parents.
• Male circumcision is not the same as female circumcision, also known as female genital mutilation. They are comparing apples to oranges.
• My son's penis is the business of expressly no one but myself, his father, and his pediatrician, should need arise.

For the record, I very much resent on the behalf of parents who have made or will make the decision to circumcise their sons the implication that female genital mutilation is comparable.

Here are some facts about this practice:

Female Genital Mutilation (FGM) is the partial or total removal of the female external genitalia. External genitals include the clitoris, labia, mons pubis (the fatty tissue over the pubic bone), and the urethral and vaginal openings. (Source: World Health Organization, 1995. "Female Genital Mutilation: Report of a WHO Technical Working Group". )

The practice of FGM is often called "female circumcision" (FC), implying that it is similar to male circumcision. However, the degree of cutting is much more extensive, often impairing a woman's sexual and reproductive functions. (Source: Toubia, N., 1993. "Female Genital Mutilation: A Call for Global Action." New York: Women, Ink)

Female Genital Mutilation is practiced globally.

FGM is practiced in at least 26 of 43 African countries; the prevalence varies from 98 percent in Somalia to 5 percent in Zaire. A review of country-specific demographic and health surveys shows FGM prevalence rates of 97 percent in Egypt, 94.5 percent in Eritrea, 93.7 percent in Mali, 89.2 percent in Sudan, and 43.4 percent in the Central African Republic.

FGM is also found among some ethnic groups in Oman, the United Arab Emirates, and Yemen, as well as in parts of India, Indonesia, and Malaysia. (Source: Toubia, N., 1993.)

FGM has become an important issue in Australia, Canada, England, France, and the United States due to the continuation of the practice by immigrants from countries where FGM is common. (Source: Ibid.)

In 1995 the World Health Organization classified FGM into four broad categories. They are as follows:

Type 1
Excision (removal) of the clitoral hood with or without removal of part or all of the clitoris.

Type 2
Removal of the clitoris together with part or all of the labia minora.

Type 3 (infibulation)
Removal of part or all of the external genitalia (clitoris, labia minora, and labia majora) and stitching and/or narrowing of the vaginal opening leaving a small hole for urine and menstrual flow.

Type 4 (unclassified)
All other operations on the female genitalia, including:

• Pricking, piercing, stretching, or incision of the clitoris and/or labia;
• Cauterization by burning the clitoris and surrounding tissues;
• Incisions to the vaginal wall;
• Scraping (angurya cuts) or cutting (gishiri cuts) of the vagina and surrounding tissues; and
• Introduction of corrosive substances or herbs into the vagina.

Type I and Type II operations account for 85 percent of all FGM. Type III (infibulation) is common in Djibouti, Somalia and Sudan and in parts of Egypt, Ethiopia, Kenya, Mali, Mauritania, Niger, Nigeria, and Senegal.

Complications arising from FGM are frequent and often serious.

The highest maternal and infant mortality rates are in FGM-practicing regions.

The actual number of girls who die as a result of FGM is not known. However, in areas in the Sudan where antibiotics are not available, it is estimated that one-third of the girls undergoing FGM will die.

Conservative estimates suggest that more than one million women in Centrafrican Republic (CAR), Egypt, and Eritrea, the only countries where such data is available, experienced adverse health effects from FGM.

One quarter of women in CAR and 1/5 of women in Eritrea reported FGM-related complications.

Where medical facilities are ill-equipped, emergencies arising from the practice cannot be treated. Thus, a child who develops uncontrolled bleeding or infection after FGM may die within hours.

Immediate physical symptoms may include the following:

Intense pain and/or hemorrhage that can lead to shock during and after the procedure. A 1985 Sierra Leone study found that nearly 97 percent of the 269 women interviewed experienced intense pain during and after FGM, and more than 13 percent went into shock.

Hemorrhage can also lead to anemia.

Wound infection, including tetanus. A survey in a clinic outside of Freetown (Sierra Leone) showed that of 100 girls who had FGM, 1 died and 12 required hospitalization. Of the 12 hospitalized, 10 suffered from bleeding and 5 from tetanus. Tetanus is fatal in 50 to 60 percent of all cases.

Damage to adjoining organs from the use of blunt instruments by unskilled operators. According to a 1993 nationwide study in the Sudan, this occurs approximately 0.3 percent of the time.

Urine retention from swelling and/or blockage of the urethra.

Sound pleasant? Not so much.

Let's talk about male circumcision now.

Male circumcision is the removal of some or all of the foreskin (prepuce) from the penis. The word "circumcision" comes from Latin circum (meaning "around") and cædere (meaning "to cut").

This is an operation as old as mankind, highlighted today by Jewish and Muslim tradition in which all males are typically circumcised as a part of their faith and culture. It is performed worldwide by many tribes and cultures as an initiation rite and, despite some aggressive opposition, it is routinely done at birth for the majority of boys in the USA as well as many in Australia, Canada, New Zealand, South Africa and much of the English speaking world. Overall it is estimated that a quarter of the male population is circumcised - about 750 million males.

Benefits to circumcision:

(I freely acknowledge that this information is appended from a source who is pro-circumcision. Not being in posession of a penis of my own, I have to rely on secondary sources.)

1. Many older men, who have bladder or prostate gland problems, also develop difficulties with their foreskins due to their surgeon's handling, cleaning, and using instruments. Some of these patients will need circumcising.

2. Some older men develop cancer of the penis - about 1 in 1000 - fairly rare, but tragic if you or your son are in that small statistic. Infant circumcision gives almost 100% protection, and young adult circumcision also gives a large degree of protection.

3. Cancer of the cervix in women is due to the Human Papilloma Virus. It thrives under and on the foreskin from where it can be transmitted during intercourse. An article in the British Medical Journal in April 2002 suggested that at least 20% of cancer of the cervix would be avoided if all men were circumcised.

4. Protection against HIV and AIDS. Another British Medical Journal article in May 2000 suggested that circumcised men are 8 times less likely to contract the HIV virus.

5. As with HIV, so some protection exists against other sexually transmitted infections. Accordingly, if a condom splits or comes off, there is some protection for the couple.

6. Lots of men, and their partners, prefer the appearance of their penis after circumcision, It is odor-free, it feels cleaner, and they enjoy better sex. Awareness of a good body image is a very important factor in building self confidence.

7. Balanitis is an unpleasant, often recurring, inflammation of the glans. It is quite common and can be prevented by circumcision.

8 Urinary tract infections sometimes occur in babies and can be quite serious. Circumcision in infancy makes it 10 times less likely.

In comparison, the WHO and every other recognized health, human rights, and civil rights organization who have addressed it have acknowledged that there are few, if any, health or social benefits to FGM, and the drawbacks are numerous and severe.

I am aware that a cost-benefit analysis when it comes to circumcision is not necessarily appropriate. Lots of people have very strong feelings one way or another, which, as I said before, I understand and respect. However, let me say that the research that I've seen against circumcision mostly deals with the fact that it is unnecessary.

At this point, I would like to make something perfectly clear, so sit down, put away your righteous indignation, and listen very carefully, because I am going to say this probably multiple times before anyone listens to me. You can save yourself some time by catching on right now.

Circumcise your son, don't circumcise him. Do it as an infant, do it as a child, let him make the decision for himself later on as an adult. Do it for medical reasons or social reasons or religious reasons. I honestly don't give a tiny rat's ass about your kid's schwantz. I have enough to do, teaching my own son responsible penis usage, without worrying about yours.

One of the things that has truly shocked me as a parent is other parents' willingness to mind my business for me. I would never be so presumptuous as to inquire about a stranger's intent to circumcise their child, or not; and yet I was asked by no fewer than six when I was pregnant and when my son was an infant.

I politely declined to answer that question, the reason being that I certainly hope no one is discussing my genitals with strangers behind my back, and I think it's an inappropriate topic of conversation. Max may have that conversation with anyone whom he chooses to once he is old enough to do so appropriately, at which point, it will no longer be my business.

I don't care whether your son is circumcised. Please don't ask me whether mine is. It's not your business.

As Maggie points out in the Momversation video, why is it so necessary for people to convince others that they are wrong in order to believe that they, themselves, are right? The tenor of this discussion has gotten way, way, way out of hand and I am insulted on behalf of people who have the temerity to make their own decisions.

Do not tell me how to raise my child. Do not tell me he is too young for potty training or too old to be wearing diapers. Do not tell me why I should have nursed Max longer or gone back to work sooner. I am a full-grown adult, and I will handle that decision for myself. Please feel free to do the same for your child. I will do you the small courtesy of not judging you.

And finally: I welcome vigorous discussion and debate on the topic, but one thing I will not change my mind about is that my son's penis is his business, not yours. By all means, let's talk about it, a lot, but you won't change my mind on that topic. Also, I won't tell you you're wrong, even if I disagree with you, but you also won't change my mind on the fact that circumcision and female genital mutilation are, in fact, not the same thing. Let's just assume that I'm actually quite bright and don't try.