On December 13, 2020, I visited my parents' home.  I was carrying three things:  my mask, my purse and a canvas bag filled with homemade broth, a T.E.N.S. unit and a fur-covered hot water bottle.  These are most likely the final gifts I'll ever give my father for Christmas, save for one.  I await the delivery of a picture of my children - his grandchildren - embossed onto a slice of wood, with my handwritten message embossed on the back.  I hoped that it would fit onto his bedside table.  I hoped that maybe it would be the last thing he would see before he passed away at home. 

There is a nice quote from Ram Dass about how we are all just walking each other home.  What gives someone the audacity to say that someone else is dying, when we are all just at a different measure from that predictable end?  How do you make the leap from the abstract ("The cancer is terminal") to the finite:  ("My father is dying.") For me, it happened in rapid increments, one of which occurred during the above visit.  It was then that I read the MRI results from August 2020.  These forms are always filled with so much medical jargon, as though it should only be read by someone who studied this kind of thing in an overseas immersion program.  My eyes skimmed for the familiar, the words I knew, the words I could "Google" and understand.  I found the words and they were jarring.  They were the kind of words that can blow a hole through you.  When I finished, I knew that my father had a mass 5.3 cm x 4.3 cm in his left lung, malignancies in four vertebrae, in his ribs, in his lower abdominal cavity and in his scapula. On December 13, 2020, my father weighed 107 lb and walked with the defined stoop my grandmother had when she was in her 90s.  Still, he was frank about his situation.  "Isn't it something?"  he mused about the deterioration of his body.  "I'll bet you never thought you'd see your Dad like this, eh?" He liked the T.E.N.S. unit, partly because it promised relief from pain and partly because it was a gadget and he always liked gadgets. 

What gives someone the audacity to say that someone else is dying?  I think it's when your spirit recognizes transition.  I had a dream a couple of weeks ago.  My father walked through the backyard of my new house, admiring the mulch that Joseph and I had placed under a neglected Japanese Maple tree.  The tree seemed to come alive afterward in a subtle way.  Formerly, it had sat with exposed roots in a plot of eroding soil and bramble.  He was impressed, in this dream.  "Nice.  Looks nice," he said, in his quiet way.  When I woke up, I knew with certainty that he was never going to see our home.  I knew that his Spirit had gone strolling around because his body never would, and perhaps it was a little bit of unfinished business for his soul to see our hard work before leaving our physical plane.  Maybe my Dad was having the same dream?  Several weeks after that, I had a dream that we were at the kitchen table together, but he grew transparent.  I could see through him.  I started to have memories about my father's side of the family - his mother, his brother, his uncle.  They were memories that came with such specificity, I started to wonder if I had been awaking at 3 am because they were next to me, whispering in my ear: "Do you remember that time...?" 

On the Saturday before Christmas, I remembered that my Dad and I had a tradition together.  We used to head out to the mall every Christmas Eve to find my mother a Christmas present.  He always trusted my judgement so much, probably more than I ever did. There was one unfortunate year when he purchased a vacuum cleaner for my Mom and she cried.  This became the kind of familial legend that gets revisited every year around the holidays.  Together, Dad and I would always find something wonderful for her.  He was a practical creature, and for one day of the year, I got to be his guide to things beautiful and sparkly and soft.  We would go into a music box store, a jewelry store, and department stores.  We bought her lovely pieces of jewelry and created a tradition of hiding the tiny boxes within the branches of their Christmas tree. 

Remembering this tradition, I was struck by two thoughts.  First, I wondered if this would be his last Christmas on Earth.  Second, I realized that he really had no way to buy a meaningful gift for my Mom this year.  It was effort for him to walk to his own kitchen, and with his health, he couldn't risk crowds anyway.  I decided to do this for him, a little twist on our tradition.  In the store, I had trouble choosing between two pieces, and finally settled on both. 

I brought them over and sheepishly kicked my Mom out of their bedroom so I could show him the pieces. It seemed to make her very happy to see us co-conspiring. I smiled and told him that I thought he might not be up to a trip to the mall this year, but knew he would still want to do something for Mom.  Both of them seem befuddled by the fact that Christmas is days away, as though everything froze after my Dad's back surgery in September, and they are only now realizing that time has been passing for everyone else.  I showed him the first necklace, a delicate gold chain with a pendant formed from two interlocking gold rings.  I told him that it made me think of them, and how their marriage has lasted more than fifty years.  He loved it and teared up a little, happy and proud of all of that time.  After all, fifty four years is a long time to love someone.  Then, I showed him the next one, a small navy blue locket embossed with a Family Tree/Tree of Life.  I told him that we could save that one for her birthday, in March.  Silently, I hoped that he would be here to give it to her.

My Aunt V looks enough like my Mom that they are easily recognizable as sisters, but aside from that I've always marveled that they were raised by the same parents.  My Mom is a peaceful, generous creature and a born nurturer - often to her detriment.  She is a caretaker.  My Aunt V is vibrant, intellectual and a born problem solver.  She was a CPA and perfectly suited toward it.  She and I are both Libras.  She and my son share a birthday, only two days after mine.  All of us have a restless curiosity about the world and all of the people and animals that inhabit it.  At our best, we're the kind of people that close around you at a party as though you're an exotic creature that we are giddy to have encountered - charming and genuinely interested in everything you have to say. 

Typical Libras, at our worst, I suspect we all fall into intellectual hydraulics, convinced that if we just had a little bit more information or understanding, we could stop heartbreak and roll back tides.  So, I knew that any conversation with Aunt V regarding Dad would bring questions.  Not just any questions, but insightful and prescient ones.  She is no amateur after all, but a Libra refined by six decades of life experience. 

She came to our doorstep on December 22nd with presents for the kids.  I was still in the clothes I had worked out in, and threw a blue mask over my face when I heard the doorbell.  I wanted to hug her, but we kept our distance because of COVID-19.  I spoke to her through the screen door.  We talked about how this seemed to be a good week.  My father was more alert and had more color in his face.  I told her that when I saw him on Sunday, he was even eating a sandwich.  These things are now major successes - a sandwich a point scored against Fate.  I told her about how I read the MRI report from August 2020.  I told her what I had read.  She asked questions:  Why did they keep everything a secret for so long?  Did they even tell you when he had the kidney out?  When we were all at that anniversary dinner in 2016, they knew but didn't say anything? 

I tried to explain it to her as best I could.  After all, I was raised by my parents and I believe I understand them.  "When you tell people things, you start to see your reality reflected back to you in their faces - their concern, their worry.  I don't think that they want that."  She mentioned that it seemed like denial, and I agreed.  I continued, "I don't think there is any harm in being in denial.  If all of his affairs are in order and he doesn't feel like he has any unfinished business, why not be in denial until the time comes when denial is not an option anymore."  She pointed out that he couldn't possibly be in denial, as he was having treatments regularly.  I told her that I think he is.  I told her that he knew that there were "spots" in his lungs and spine, but mused on the fact that he would often look to my Mom and I to sort out details of life.  He would look to me to write a recommendation letter he had no problem dictating.  He would look to my Mom to rehash a doctor's appointment he had just attended.  I told Aunt V that while he knew what was going on, I didn't think that he had ever read the MRI report.  I watched that recognition cross her face. 

For a family so fiercely committed to honesty, it must seem strange to see privacy cloaked as evasiveness or denial or shielding.  I told her the details of the MRI.  She asked if he was on a morphine patch.  She mentioned that Grandma Schild had one at the end of her life.  She didn't know what it was when she saw it.  The nursing home workers told her that Grandma had started to curl into a fetal position and it was painful, so they had given it to her.  "Give him anything he wants for pain," Aunt V. stated bluntly.  "Your Mom told me that she was giving him pills two times a day for pain, and that she didn't want him to get addicted."  This struck her as outrageous, a concern about addiction.  I suspect that my Mom's real concern was the one I stated aloud to Aunt V.:  "Once the pills stop working, where do you go?  A morphine drip? I think that's why you need the pills to work for as long as possible."  Because the other options are tethers, because the other options are risky, because the other options are not followed by other options.  She asked all of the questions she needed to, but the one that stood out was when she asked if my Dad was coughing up blood.  A friend's husband had died from lung cancer and he had coughed up blood.  I stumbled, affirming that Dad didn't have any trouble breathing.  She said that this man hadn't either.

It was a few minutes later before I realized I had taken that question like a bullet.  She said something about wanting to do everything possible to ensure that my Dad didn't suffer.  I just crumpled when she said it.  "That's the hardest part..." I trailed off, fighting off sobs behind my blue mask, behind my screen door.  She and I looked at each other.  She couldn't hug me because she wasn't wearing a mask, wasn't even inside of our home.  She left, I think partly because she felt she had caused damage she hadn't meant to cause and partly because it was only supposed to be a brief little visit, a little pick me up of Holiday cheer.  I felt terrible, but also proud that I hadn't instinctively said "I'm sorry" when I started to cry.  I caught myself as I was just about to say it aloud. 

People don't seem to understand why we've kept so much of this to ourselves, but I do.  When people know the truth they might ask you if someone you love is coughing up blood.  Sometimes even people who love you more than anything might ask you things like that. 

On Christmas Eve, I sat at the dining room table writing out cards and gift bag tags.  Henri was bursting with excitement.  He and Joseph called me into the living room urgently.  As it turns out, there was a blue jay in our yard, only steps away from our front door.  Blue jays are not exactly rare in the Midwest, but they don't seem to make many appearances in suburbia, which makes their presence a little magical.  It was mesmerizing watching him flit around the grass and dogwood in our front yard.  Henri and I stood at the window of our front door for a long time watching him.  When I sat back down at the table to complete my cards, I instinctively reached out for a set of free address labels I received after donating to a wildlife protection cause.  I stopped when I realized that they too had blue jays on them.  A single blue jay, nestled with a bright red cardinal.  At times like that, I wonder if the Universe is trying to send me a sign.  I try to remember which of my departed relatives loved blue jays.  Both of my grandmothers used to feed birds - one all of the waterfowl, the other all of the songbirds.  I hoped it was a sign from one of them. 

My son turned seven in October and we bought him a big set of helium balloons.  All of them have gone by the wayside, but inexplicably, we've held onto a shiny red "7" balloon.  Only recently has its ability to float waned.  Usually, it stays tucked in a corner of the dining room, another relic that should probably be a victim of decluttering, but which gets to survive because we are all just a little sentimental and think that red, crunchy balloons are funny.  I had been working on December 23rd, while Baby Girl was napping and the "boys" were out of the house.  It was a rare moment of stillness and quiet in a house usually teeming with noise and activity.  It was actually strangely quiet!  At that moment, the "7" crept slowly out of the kitchen and swept across the floor until it was right next to me.  Then, it turned and "looked" at me.  In its crinkles was the clearly discernible outline of a face.  I couldn't stop staring at it.  Then, it backed away, still "facing" me, and rested in the living room.  A scientist at heart, my mind already released a couple of tangible theories about the air currents in the rooms, the draftiness of our 1965 house.  But I was there, and it was strange.  I told the boys about it a day later and they thought it was the most fun thing they had heard.  "What would you do if it lunged at you from across the room?"  Joseph asked gleefully.  "I would sell the house," I laughed.  Henri was exuberant - "the SEVEN is looking at you!"  It was one of the best laughs we've had in the new house and I couldn't help but wonder if that was why it had happened. 

I'm writing this at 6:16 AM, but I've been awake since 4:30 AM.  I wake up at that time a lot now.  I've been a proponent of Chinese medicine ever since accupuncture helped me heal in the past.  4:30 AM appears to correlate with the lungs and the processing of grief and sadness.  Yesterday was Christmas, a strange one, marred by the ever-continuous presence of COVID-19.  My Mom came over to spend time with us, but my Dad was not well enough to come, so he rested at home while we tried our best to bring joy and fun to a much smaller celebration than we are used to.  It was restful and quiet and the kids really seemed to have a nice day.  Joseph and I didn't buy each other anything.  We figured all of the money we've spent on home improvements was enough generosity for us.  Mom didn't have an opportunity to buy anything for the kids, and I didn't want her out and about with the virus around anyway.  I had started ordering gifts for the kids back in November, and simply saved the best of them and said they were from "Grandma and Grandpa" on the tag.  Henri was jubilant, both at her presence and these final gifts of the day.  Charlotte was enamored of this lovely woman who smiled at her and shared her enthusiasm for the fact that she has a bellybutton Every Day!  Still, it was the first Christmas I did not spend in my Dad's physical presence, something that I silently regarded all day, not wanting to call attention to it and risk upending the day.  Instead, I wake silently at 4:30 AM to read, and write, and exercise. It's a little easier to be up so early at this time of year, a little easier to be sad in the glow of a Christmas Tree and fireplace.  It's a little easier to have an entire day before the day even begins. 

Successful VBAC 

Prior to delivery, one of my biggest hopes and wishes was for a successful VBAC - something I actually achieved!  I feel incredibly blessed by this fact.  Having had both a C-section and a long vaginal delivery, I can honestly say that they can be equally painful, exhausting, challenging and damaging.  With that said, the recovery from this VBAC is much faster.  I've been working out with weights since getting cleared at six weeks post delivery.  With my C-section, I didn't even think about working out until a year after my son was born.  Frankly, I'd like to see the dialogue around C-sections change to acknowledge it as the major abdominal surgery that it is.  As it stands, I think that because it seems "common," people don't really give it the credence it deserves.  Even my partner often refers to this surgery with the casual air people often reserve for really unpleasant root canals.  

The key to a successful VBAC?  This will be completely different for every woman.  Here is what helped me along:

First, my daughter's head was in the 35th percentile at birth, although she quickly made it up to the 50th percentile shortly thereafter.  So, even though she was technically bigger than my son (by 5 oz), I had a small advantage due to luck and physics. 

Second, I was in much better physical condition, despite being almost six years older than at my first delivery.  When I had my son at thirty-six, I was a very zen, walking-and-yoga kindof-girl.  This time?  I knew what I was in for and spent the years prior to conception (and pregnancy itself) lifting weights and doing cardio.  If I had not done this conditioning, there is no doubt in my mind that I would've tapped the mattress after about six hours. 

Third, I didn't go straight to the epidural, instead favoring morphine for a couple of hours.  In addition, prior to giving the epidural a green light, I agreed with my doctor that we would dial down the dosage so that I could have more body awareness during the pushing phase.  With the first delivery, I had zero feeling and never felt an urge to push.  I can absolutely see where a natural delivery would benefit someone pursuing a VBAC, but frankly, the long duration of my labor this second time around made that an impossibility.  

Fourth, I worked closely with my doulas to postpone my trip to the hospital until the right time.  Labor progresses differently for all women.  One of my friends gave birth a month before me and her labor was four hours.  For me, labor was taking a while, and had I gone to the hospital sooner, I believe I would have been a more likely candidate for another C-section.  Most hospitals expect things to progress a certain way once you are under their care, and it is challenging for them to resist the urge to "help" you along, whether by early interventions or simply a few well-timed statements encouraging you to have surgery.  When I went to the hospital, I could see the change in the nurses' faces when they realized or learned that I was attempting a VBAC.  They know instantly from a clinical perspective that you are more likely to end up with a second C-section, and this can lead to a lot of discouraging - albeit often unintentional - statements and actions from staff. 

Fifth, I hired a wonderful team of doulas.  You can see my prior post for more detail about this.  Suffice to say that I wish I had worked with them earlier in my pregnancy.  They simply bring the right energy to the room, even if you are otherwise having the most clinical of hospital deliveries.  

Sixth, I believed it was possible.  This requires a certain amount of self-awareness.  In my heart, I knew that it was possible to get through a VBAC, something I based on a certain amount of (flawed) logic ("It's a girl this time!  Surely, she'll be TINY!") and intuition (I just "saw" it happening when I visualized the process.)  At one point in delivery, I was just about done and said so.  Then, I looked across the room and saw the empty glass bassinet.  I somehow knew the minute I saw it that she was going to be fine, I was going to be fine and it was almost over.  It was as if she was saying "I'm going to be there in just a little while.  Hang in there, mama.  Be patient.  It's going to work out."  This was very different from my first delivery, where even at the beginning of the pushing phase, I just felt something was fundamentally "off."  

Newborn Care After Forty 

Women (and men) make all kinds of dismissive comments about newborn care after the age of forty.  Guess what?  It's about 100x easier this time around, even without the benefit of quite as much youth on my side.  Partly, this is because my expectations have adjusted accordingly.  I knew what I was in for, and I knew how transient it would be.  At the time I write this, Baby Girl is already well out of her newborn clothing and starting to think about dropping a night-time feeding.  My golden rule for child-rearing is basically to wait:  just when you think that you can't take another minute of whatever phase they are in, they move on to the next one!

Still, the biggest reason it is 100x easier this time is a simple one:  My partner is home full time with me during this period.  He is able to continue his education via online courses while I'm on maternity leave.  His presence allows me to gain extra rest and thus heal faster and take steps to restore my health. 

Behold the power of a decent paternity policy, Employers.  This two week standard is utter nonsense.  Most families I know do not have a bunch of grandparents and aunts and uncles and affordable babysitters surrounding them - many have only their partners and other children.  Giving men more substantial paternity leave allows them to support women, and supported women have lower incidences of post-partum depression, better health outcomes in general and - gasp - likely re-enter the workforce in a much more productive and expedient manner.  Two weeks is a joke, and hankers back to a time when men were primary breadwinners in all but a handful of families and interest rates for student loans were under 4%.  

Those aren't Braxton Hicks contractions - those are the real thing! I've been continuing with twice weekly fetal non-stress tests.  During Tuesday's test, my OB/GYN poked his head in half-way through and asked "How are you feeling?  Are you in pain?"  I was in a little discomfort, but hadn't been thinking much of it, and said so.  Basically, it felt like really unpleasant menstrual cramps, but would subside and reappear throughout the day.  He pulled the print out off of the NST machine and it looked like a Richter scale.  He pointed to the bottom of the page, where a series of small waves bounced across the page with the reliability of any favorite ocean shoreline.  I was having *real* contractions, every two to three minutes. 

"Am I in early labor?"  I asked.  My OB/GYN shook his head and said "I can tell by looking at you that you're not in labor."  He was right.  That was exactly one week ago, and although the contractions have increased a bit in duration, intensity and frequency (and I've dilated to about 1.5 cm), I have no other signs of labor.  It would have been easy to pass these off as Braxton Hicks, but they are different for two reasons:  (1)  They actually come in a regular, "timeable" pattern - but then they go away; and (2) They are actually doing some work in terms of dilation, which genuine Braxton Hicks will not do.   I have basically entered into an early-early stage of labor sometimes referred to as prodromal (or "precurser") labor. 

My poor stomach

The contractions are not strong enough to dilate my cervix very much, but they are intense enough to give me a stomach ache almost every single night - at three in the morning.  There are no dietary changes to manage this, because it's largely brought on by the presence of prostaglandins in the body.  I ate rice for dinner with a little salt and pepper on it and might as well have entered a hot wing eating contest.  My stomach feels like confetti and this is an almost daily occurrence.  I keep telling myself that this is just part of my body's natural instinct to make extra room for the baby during delivery by, well, not letting me fully digest any food ever. 

Hello Darkness My Old Friend

For some reason, contractions like to hit at night.  It's not an Old Wives' Tale.  It has been over a month since I've slept past four in the morning.  Now, I reliably experience my most painful contractions around that time (hopefully the nurses on the early shift at our labor and delivery ward have a steady supply of coffee going!) I've actually adjusted to this new schedule and find myself with a decent window of energy between four and nine in the morning.  I'm beyond grateful to have taken a week of vacation from work prior to my due date, because this schedule was leaving me feeling absolutely exhausted and overburdened. 

Spinning Babies Daily Exercises

Since these are real contractions, they can get pretty intense.  I pull out the following stops to manage the pain.  First, I pull out an old fashioned heating pad and keep it focused on my glutes and lower back for about 20 minutes at the lowest setting.  If you use a heating pad, be sure to keep it away from your tummy and be cognizant of overheating.  Second, I get up and chug water.  Third, I pull out a yoga block and sit on it in a deep squat position, resting my back on the side of my bed  for extra support.   Fourth, I get my Tone it Up beach ball and sit on it, doing at least forty hip tilts and forty hip circles.  If I'm really in pain, I'll kneel and just wrap my arms around the ball, letting it support my upper body.  Then, I'll remind myself over and over about some article I read on Pinterest that said that having prodromal labor was associated with a shorter delivery time.

Sense of Humor

It isn't all that easy to be in pain on a daily basis with no way of knowing when your actual due date will be!  Plus, although I'm grateful to be finished with the burden of getting ready and going to and from work, I miss the distraction of it!  Humor puts everything in perspective.  It's pretty easy to find humor in these last few days or weeks of pregnancy.  My nesting instincts practically had me installing a Dewey Decibel system to our refrigerator.  My belly is so big that I have "sharms" (i.e. short arms) and can't even reach the lowest top cabinet in our kitchen anymore.  My maternity shirts have become crop tops, giving my wardrobe a sexy Winnie the Pooh vibe. 

NOW do you see why women need to be represented...???

Men still largely control government and that means they still largely control where a massive amount of government funding for research is allocated.   For real, ladies:  If men gave birth, believe me when I tell you that by now it would be a pain free experience, probably involving a drive through, and a pack of IPA and diapers.   People let the discourse around funding for reproductive health circulate so heavily around abortion and that's a genuine shame, because it distracts from the fact that the medical options for birth haven't really been updated all that much since my Mom gave birth in the 1970s.  The Doppler Fetal Heart-rate Monitor?  Created in the late 1950s.  The Epidural?  Created in 1909 and "perfected" over time, becoming popular in the 1940s.  The Episiotomy?  First mentioned in a medical journal in the 1800s.  Pitocin?  Synthesized in the early 1950s.  The areas of maternal healthcare that have actually experienced worthy innovation over the last decade or two focus heavily on diagnostics and genetic testing, which, while awesome, do exactly NOTHING to make the experience of labor and delivery less painful or more efficient.  Maybe we can all shift our discussions around reproductive health from topics like abortion to the fact that for ALL pregnant women, much of our prenatal care is not really any more impressive than that offered to our grandmothers. 

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My last day at work was on a Friday.  By Tuesday of the Thirty-ninth Week, my doctor confirmed (through a REALLY painful cervical check) that I was dilated to about 2.5 cm.  I had quite a bit of bleeding after that particular exam, and my contractions came on a lot stronger.  I used the Baby Tracker app on my phone to monitor the contractions I was having from Tuesday through Thursday.  They were coming approximately three to eight minutes apart over the course of that time.  They were painful enough that I had no mystery about whether I would be able to go into labor naturally.  I would never have been able to make it through the week of my labor and delivery without the extraordinary support of my doulas, my Mom and my partner.  Here are a few things that really stand out to me about my experience with labor and delivery.

Be Prepared to Send Your "Backup" Person Home...and then Beg Them To Come Back

I just happened to have an extended prodromal (i.e. "precursor") labor.  The challenge with that experience is that it was real labor and felt like it.  So, of course, I called my Mom over to watch our five year old son in the event that I had to head into the hospital.  At one point, I was breathing through contractions every three minutes for several hours.  I was absolutely convinced that I was going to deliver a baby in the car on the way to the hospital.  However, after getting advice from my doulas, I took an Epsom salt bath and found that the contractions subsided enough for me to get some sleep.  My Mom spent the night (which I didn't expect to make it through at home).  Amazingly, I woke up the next day and didn't experience such strong or frequent contractions again until much later that night.  Seeing no immediate need for her to be there, I told her to go home and get some rest.  Thankfully, my parents and I live close to each other and enjoyed completely flexible schedules over this time period (e.g. neither of my parents work or have other regular obligations that are difficult to cancel on short notice.)  If this is not the case, it might be useful to create a Plan C for your Plan B. 

I Can't Believe I Ever Balked At the Cost of a Doula

Although I interviewed with my doulas back in February, when I was only three months pregnant, I did not retain their services until I was Thirty-Six Weeks pregnant.  Why did I wait so long?  Well, partially because I was feeling good physically and not very focused on labor and delivery yet.  In addition, I had to spend some time justifying the cost of the service, which was not insignificant ($1,200.00).  I had already been through labor and delivery once, and had been left with the impression that Fate was largely in charge of that event, with the Doctor and Medical Staff coming in second and third.  I had relegated myself almost to the role of bystander, having had my birth plan completely annihilated the first time around. 

That all changed when I arrived at the doctor's office one day to find that they had scheduled me for an elective C-section.  I believe they did it just to ensure that they could secure a surgical suite if I decided to go that route, but it was totally contrary to my deep seated desire to have a VBAC.  Frankly, I was shook and panicked a bit.  Then, we entertained questions about how long I was willing to allow the pregnancy to progress if I did not naturally go into labor by my due date.  This was complicated by the fact that having received a prior C-section, I was not eligible for inducement of labor (this increased my risk of uterine rupture, something that did not sound like very much fun at all).  Without the possibility for inducement, blowing past my due date left me with only two options: (1) wait; and (2) elective C-section.  When I realized that my son's first day of Kindergarten was only one week after my due date, I finally caved in and reached out to the doulas.  I knew that if I had a C-section, there was no way that I would be in good enough shape to truly participate in his first day of school.  To the contrary, if it was anything like my first C-section experience, I would be lucky to get out of bed without assistance. 

In retrospect, the services provided by my doulas were worth a hundred times what they charged.  During the forty-eight hour period during which I was actively laboring at home, I was in constant contact with them via group chat.  I sent them screen shots of my contraction patterns.  I begged for advice about managing the pain at home.  I followed their guidance about exercises to ensure that Baby Girl was well positioned for delivery. 

In the delivery room, I was blown away by the level of support they offered.  Since I was in the hospital for an extended period, two doulas took a "shift."  The first blew me away with her composure and advocacy.  I had a painful cervical check performed by a resident (by "painful" I should emphasize that I was in tears and she did not honor my repeated requests to stop the exam.)  My doula, Kristen, calmly, politely and firmly took her to task for it, emphasizing that this was not just a "well, sure, this hurts every pregnant woman and you should be prepared for the discomfort" scenario.  She emphasized that I had a history of multiple cervical surgeries and that this "simple exam" was not just physically painful, but also emotionally wrought and extremely invasive for someone who had that medical history.  It was a level of advocacy that neither my partner nor I would have ever provided in that moment, and I'm eternally grateful for it. 

Aside from that, I can state with certainty that their participation helped me to get through labor with much less medical intervention.  For example, a nauseous spell was dissipated with peppermint essential oils, as opposed to anti-nausea medication.  Various positions and use of a rebozo moved things along in meaningful ways.  Perhaps most importantly...

I had no freakin' idea how to actually push

I had read articles and attended birth classes.  I spent an entire lifetime in and out of yoga studios, learning to breathe properly.  I had even pushed for two hours with my son's delivery five years prior.  Still, I can honestly say, I didn't "get it" until my doula literally coached me through the process. 

​Basically, the secret sauce was this:  Take a deep, deep inhalation.  HOLD IT for a count of TEN.  During the hold, push.  Sometimes, your body will help you out.  I had a couple of amazing pushes where I could feel the smooth muscle in my body involuntarily moving Baby Girl along.  However, this was definitely not the case with 90% of the pushing stage.  90% of the pushing stage for me involved sucking down ice chips, struggling to take a deep inhalation despite feeling raw and dehydrated, wondering why I couldn't hold my breath past a count of "six" and getting gently reprimanded every time I would cry out ("Make each breath work for you!  Don't cry out or yell - that's wasting it!") 

​

The last two weeks have been like hitting a brick wall.  No one expects the Third Trimester to be easy, but I was startled by the new pregnancy issues that showed up seemingly out of nowhere. 

Where did you go, Sleep?

I considered myself lucky for most of my pregnancy, because my sleep would only be interrupted by an occasional bathroom break.  Suddenly, the last two weeks, my sleep is interrupted by everything from my hands aching (carpal tunnel from mild pregnancy swelling - I finally got a prescription for splints from my OB/GYN last week but haven't had a chance to fill it yet) to heartburn (which, I've learned, I can now get off of a single piece of toast) to mild dehydration (it's been hot) to aches and pains to the fact that I rolled over onto one of my son's stuffed animals.  Last night, I woke up seven times.  SEVEN TIMES.  Some people are so good about getting back to sleep, but I am not one of them.  I usually eat a bowl of cereal or drink water, pet my hauspanther, read the Economist or lose a few hours to Pinterest before I can doze off again. 

Grape-Nuts and Cherries

I have absolutely faith in myself to down an entire box of Grape-Nuts and a pound of cherries every single day now.  Considering that my pregnancy cravings have been pretty mild up to this point, I was intrigued.  Well, as it turns out, Grape-Nuts are super high in iron and folate, two of the most valuable nutrients during pregnancy.  Cherries on the other hand - well, what's not to love?!  They are high in antioxidants, which help manage inflammation and melatonin, which helps manage sleep cycles.  They also contain a lot of potassium, which is a super valuable electrolyte to consume during a summer heat wave.  Another wonderful feature of cherries is that for all of their natural sweetness, they don't actually rank all that high on the glycemic index, meaning that indulging doesn't spike my blood sugar too much. 

I just cut my bangs!  What on Earth...?

People devote a lot of energy to expounding on the joys of magical, fast-growing, shiny, healthy pregnancy hair and nails.  I never really noticed much difference.  Then, all of the sudden, I looked like a sheepdog only two weeks after having my bangs trimmed.  The next week, I realized that my nail polish had grown out to the middle of my nails - in three (THREE!?) days.  It's pretty cool.  I feel like Wolverine, like I can just make my body rejuvenate.  I also clogged my bathroom sink drain twice already.

Twice Weekly Fetal Non-Stress Tests

I've continued to go into my OB/GYN's office twice per week for Fetal NST.  I generally get these done on Tuesdays and Fridays.  I've been fortunate to schedule them in the late afternoon so that I can work most of the day and then just leave a little early.  So far, everything has been completely normal and I am so very grateful.   I also had another ultrasound at Thirty-four weeks.  I looked forward to this ultrasound for weeks because I thought I would get to see Baby Girl's profile, or something precious, like her sucking her thumb.  Nope.  I got to see her ear.  One lone ear.  And a femur.  At least she is no longer breech!

Group B Strep Test...well, um, that was...invasive.

I honestly did not remember this test from my first pregnancy at all.  In my mind, I must have vaguely recalled it as a simple vaginal swab.  Well, it's a vaginal AND anal swab to test for Group B Streptococcus.  Women who test positive for Group B must take antibiotics prior to delivery, as this little simple bacteria can cause all kinds of scary issues, the least of which is infection in your newborn.  My Group B Strep Test was immediately followed up by a manual exam to try to evaluate whether my pelvic opening veered on the narrow side (it does).  This was basically as comfortable as someone sticking their hand in your vagina to try to evaluate your spine.  Let's just say my thirty-five week appointment couldn't end soon enough. 

Delivery?  I'm pretty sure it's tomorrow.

I'm four weeks away from my due date.  Once you get that close, I feel like your body and your mind start to work together to narrow your focus to only your pregnancy.  For example, the last week or so, I feel like it it is difficult to concentrate on anything unrelated to the baby.  I also feel like my body's demands for rest have become loud and clear.  Even a couple of weeks ago, waking to an alarm and getting ready for work seemed a thoroughly manageable task, now it often feels Hurculean.  Emotionally, closing the distance of four weeks makes everything feel so imminent!  This last month is going by like a bullet train!

Exercise Program

Here is my typical workout schedule right now. 

Monday:  30 minutes of swimming or "water aerobics" movements, aided by kickboard
Tuesday:  30 minutes of swimming or "water aerobics" movements, aided by kickboard
Wednesday:  30 minute walk
Thursday:  15 to 40 minutes of toning with 3 lb weights  or bodyweight only (like Cardio Barre Arms on the Studio Tone it Up App).
Friday:  Rest Day
Saturday:  Gardening or 30 minutes of swimming; 15-25 minute toning with 3 lb weights or bodyweight only.
Sunday:  Rest Day

As you can see, I'm spending a lot of time in the pool.  My son is just becoming an independent swimmer this year, so a lot of the time, I'm focused on assisting him in the water.  When he has his wings on and I don't feel the need to be right on top of him, I'll do leg lifts, arm circles, skipping, bouncing and anything else to keep me moving in the water.  Gravity and I have been having some disagreements lately, so it feel great to move without additional strain on my body.  I keep it laid back and don't follow any specific workout routine in the water.  I just try to stay in motion! 

I continue to follow the Studio Tone it Up weekly schedules.  That has required a bit of humility lately!  Sometimes, I'll have plans to complete a rigorous workout and tap out after fifteen minutes.  I  just remind myself that this short phase of my life is not about gaining muscle or endurance, but rather about boosting circulation, stretching, maintaining health, managing pregnancy weight gain and just getting a couple of endorphins running around.  Even five minutes of exercise can meet most of those goals, so I try to keep my expectations reasonable. 

MEAL ONE:  A piece of Ezekiel Toast with natural peanut butter and low-sugar, natural jam.  16 oz of infused water (lemon and mint leaves are my favorite).  Sometimes, I'll make a protein smoothie instead (1/2 frozen banana, 1 cup almond milk, 2 cups of frozen berries, 2 dates, 1 scoop of vegan protein powder).

MEAL TWO:  A Tone it Up Protein Bite (my favorite flavor is Snickerdoodle), together with a small apple.  Sometimes, I like to have an entire Tone it Up Protein Bar instead.  My favorite flavor is Birthday Cake.  

MEAL THREE:  I have been focusing a lot on cold salads lately.  I've noticed that it is hard for me to eat meat at this point in my pregnancy, so I try to obtain protein through plant sources.  Today, I had a cold chickpea and veggie salad with olive oil and spices; together with an un-buttered piece of French bread and roasted veggies.  This has been my largest meal of the day for a while, because it doesn't help heartburn to eat a big, substantial dinner.  I have one goal for Meal Three now and that is to pack it solid with as many nutrients as possible, because (as you'll see), I've been struggling to eat much at all for dinner. 

MEAL FOUR:  No lies here.  I have been grabbing a few "mini" pieces of chocolate at this point.  I limit myself to 3 mini chocolates - like the kind you would hand out at Halloween (or about 140 calories). I also like to snack on nuts or seeds at this time, and sometimes throw together my own trail mix at home. 

MEAL FIVE:  Honestly, I can't win.  I've eaten things as bland as banana-strawberry smoothies and still spent the night up multiple times with awful heartburn and stomach pains.  Lately, I've tried to incorporate a small bowl of chickpea pasta with a little olive oil, just to have something more substantial to get through the night.  Sometimes, I down a bowl of yogurt with a spoonful of natural peanut butter and raisins mixed in.  Sometimes, I down a bowl of Grape Nuts or Oatmeal with almond milk.  Sometimes, I eat a Popsicle, nectarine and raid my five year old son's snack drawer for fruit gummies.  It's a victory when I'm motivated enough to make homemade "Nice Cream" or a smoothie. 

Meal Five is a bit of a free-for-all, based on whatever I think I can handle now that my stomach is somewhere around my clavicles.  I definitely can't even look at Mexican food, Indian food, Thai food, pizza, or meat-based dishes, and my significant other is beside himself.  If he wasn't able to eat these foods, he would surely starve, muttering dramatic last words quoted from an episode of Top Chef. 

I definitely can't say that Meal Five has been "TIU Approved."  With that said, I've given it the Old College Try and avoided fried foods, artificial sweeteners, no high fructose corn syrup, and minimal refined breads or pastas.  I'm also committed to staying with five meals per day to keep my energy levels stable. 

I've read that during the last few weeks of pregnancy, the placenta creates as much estrogen in one day as in a single year of not being pregnant.  This seems about right now that I'm crossing into Thirty-seven week territory.

Weight Gain

I've gained 30-35 pounds total with this pregnancy, 38 pounds with my last one.  Strangely, this slight difference seems profound.  I get a lot more comments this time about being "all baby" and "not even looking pregnant" until people see my stomach, and can only attribute that to the fact that I worked out harder and more consistently during this pregnancy and must be carrying a bit differently. 

Women place a lot of importance on their weight gain during pregnancy, but in my experience, that last 10% of total gain has nothing to do with you.  In the last 60 days, I feel like the biggest driver of weight gain is water retention and the baby itself, things that are not impacted all that heavily by diet and exercise (unless your afternoon snack consists of a salt lick.)  I was SO committed to keeping my weight under a certain number this time, and devoted a lot of effort toward that goal, and blamelessly blew right past that number four weeks before my due date.  Pregnancy is a great example of how the whole "calories in, calories out" mythology of weight gain can be shortsighted and misleading. 

Appetite

Almost out of nowhere, my appetite completely changed.  I can honestly say that I've only had ice cream a couple of times during this entire nine month period.  Suddenly, I downed an entire mini-container (850 calories!) in one sitting.  It's funny, because last time, I went into labor on my birthday after eating five pieces of cheesecake.  I'm someone who can make an entire bar of dark chocolate last an entire week, so when I start to crave super high calorie "bombs" I know that my body is trying to stockpile energy for something big. 

Zzzzzzzzzzz

I always wish that I was a napper, but I'm not.  I often lament the fact that even when I'm desperately tired, I just can't fall asleep during the day.  Suddenly, once I hit this Thirty-seven week point, my body started to crash HARD from fatigue.  For example, I had a busy day at the beach on Saturday.  On Sunday, I was awake from 3 AM to 6 AM, when I decided to just lie down and rest a little.  I passed out cold until almost 1 PM, and when I woke up, I was like "Where am I?"  Just like the high calorie food cravings, my body seems to want to stockpile a few extra zzzzzz for the big event.

Hips don't lie

My hips suddenly feel like a game of Jenga, as though all of the parts are not quite fitting together the way that they should.  This sensation arises from a mix of things, primarily the hormone relaxin, repositioning of my center of gravity, the significant weight at the front of my body, and the baby dropping lower into the pelvic region.  Basically, if I roll over in bed, my hips crack or pop in about five places they didn't used to!  Like most women, I also tend to get a bit of back pain or sciatica, especially after walking.  At the recommendation of my doula, I've decided to focus heavily on hip openers. 

I've adopted the following stretches, which I perform daily:

1.  Butterfly asana
2. Wide legged stradle - right leg
3. Wide legged stradle - left leg
4. Wide legged stradle - center (e.g. Russian split)
5. Frog asana (yin yoga)
6. Modified dragon asana (keeping the back leg bent)
7. Pelvic tilts (modified Cat/Cow asana, watching for minimal back extension)
8. Pelvic tilts on an exercise ball
9. Hip circles on an exercise ball
10.  Deep squats, supported by a yoga block
11.  Goddess asana (wide legged "plie" squat) sometimes supported by an exercise ball
12. Lunges
13.  Psoas stretch with modification (low lunge or "foot to opposite knee" pose)

I have been lucky to retain quite a bit of flexibility, so this sequence does not cause pain or discomfort.  Everyone is built differently, so please do not push it if any of these are uncomfortable.  There are a million ways to modify a stretch or asana, and just as many ways to replace it entirely with something new. 

Wrist Splints

My son took a look at my brand new wrist spints and said "it looks like your arms are broken."  I took one look at them and said, "Wow, this is the first time I've been able to feel my fingers when I wake up in the morning in more than a month."  When it became difficult to do simple tasks like button a shirt or open a can of cat food, I knew it was time to just suck it up and get a pair.  Binson's Medical Supply was a joy and helped me find a pair that fit my tiny wrists.  It's amazing how just a tiny bit of swelling was having such a huge impact on my day to day life. 

When I was Twenty-six weeks pregnant, my doctor informed me that my glucose was "+1".  This means that the amount of glucose in my blood stream measured in excess of the accepted normal limit, albeit not by much.  Still, in combination with my advanced maternal age (41), even this single test result earned me a 3.5 hour Glucose Tolerance Test at Twenty-seven weeks. 

A little background:  Adult onset Type II Diabetes exists on both sides of my family.  On my father's side, my grandfather was diagnosed with Type II Diabetes in his late 60s, and managed it through medication.  On my mother's side, my grandmother was diagnosed with Type II Diabetes in her late 70s, although it appeared to be paired with the onset of fairly aggressive dementia.  As early as high school, I figured out that excessive sugar intake was not really my friend.  After passing out cold during cheerleading practice, and suffering from a few other odd symptoms, I had a six hour Glucose Tolerance Test at the age of 16.  I found that while I was not diabetic (phew!), I had a strong tendency toward reactive hypoglycemia.  The test was MISERY, but as a result of it, I made a few permanent lifestyle changes that kept me in great health for the following decades:  I gave up drinking pop.  I never indulged alcohol.  I cut back on candies and other high glycemic index foods, like white breads.  I tried to sneak in a little bit of protein at each meal.  I learned to eat every three hours so that I wouldn't get lightheaded.  This was all in the early 1990s, decades before phrases like "keto" or "Whole 30" or even "plant based" would enter the common vernacular.  For that reason, I had to learn what a healthy "low sugar" diet was on my own, largely by relying on things like the Mayo Clinic's nutritional guidance.   For more than twenty years, I had absolutely no abnormalities.  Getting even this test result was a bit disheartening, as though my decades long run of good luck had finally come to an end.

The 3.5 hour Glucose Tolerance Test came back normal, but believe me, I prepared for it by limiting simple carbohydrates for the entire week preceding it.  Cereal has been one of my pregnancy cravings (probably because it is enriched), so this was not the best week of my life.  I also switched the prenatal that I was taking from Premama Prenatal Drink Mix to Rainbow Light Prenatal One.  Frankly, I can't say that one is better than the other.  I switched for the following reasons: (1) I had tired of the taste of Premama Prenatal Drink Mix after so many days of drinking it and was relying on juice and Mio drops to make it more palatable, something that I worried would influence my test results (Mio contains nominal amounts of sucrose and sucraolose).  (2) I had taken Rainbow Light Prenatal One 35+ during my pregnancy with my son, and knew that I tolerated it well.   I also completely cut out even the tiny amount of caffeine I was consuming each day.  I had a really hard time with even this 3.5 hour test because it requires that you fast for such a long time.  Still, I was grateful for normal results. 

My happiness was a little bit short-lived.  The next week, my routine urine testing returned +2 glucose and +1 protein.  I had also gained four pounds in one week, including a lot of water retention.  Hearing about the protein and weight gain stopped me in my tracks, as these can be the earliest markers for preclampsia, a very serious pregnancy complication.  Certainly, other things can cause a positive protein result as well, such as a mild urinary infection. It is not clear what led to my result, as I did not have (and have not developed) any other symptoms of preclampsia.  However, despite favorable results after that week, I had already earned twice weekly Fetal Non-stress Tests (Fetal NST) for the remainder of my pregnancy. 

Emotionally, I was surprised at how stressful this period was for me.  The minute that I realized that my test results were not completely perfect, I engaged in a bit of catastrophic thinking.  I never engaged in any serious concerns about Baby Girl, because I have complete faith in my health care providers to see to our welfare, and had the benefit of being a bit farther along in my pregnancy.  Still, I had a LOT of concerns about being placed on mandatory bed rest or needing to deliver weeks earlier than my due date.  I was also absolutely terrified to tell my boss that I was going to need to have medical tests performed on the other side of town twice per week for the foreseeable future.  Thankfully, she was exceedingly understanding.  With that said, I could tell that it was a bit of a "wake up call" for both of us, and I immediately went to work on creating a written Maternity Leave Plan and making arrangements - just in case. 

I'm now Thirty-three weeks along, and in the process of submitting my Maternity Leave Plan this week.  I've continued to drastically limit simple carbohydrates (e.g. candy, ice cream) and caffeine. I still work out 3-6 days per week (although, having gained twenty-five pounds, I've been moving those workouts to the pool where possible!) Luckily, the first three Fetal NST tests have been relaxing and demonstrated no abnormalities at all.  I have them each Tuesday and Friday.  During the last one, Baby Girl had the hiccups, which was adorable and hilarious to listen to over the amplified speaker. 

Purpose of Writing the Plan

There are many reasons to put together a written Maternity Leave Plan for your employer.  For me, I really enjoy and appreciate my coworkers, and realize that my extended absence may present them with challenges or changes.  The plan offered me a forum to make things a little easier on them, by answering their likely questions.  These questions ranged from the obvious ("When do you expect to have your last day in the office?  What is your due date?) to the not-so-obvious ("Do you have any recurring meetings set up?")  It also helped me to fulfill a legal requirement - in order to qualify for FMLA leave, you must provide your employer with no less than thirty (30) days prior notice.  I also found that the Maternity Leave Plan helped me to feel more confident about two things: (a) my financial situation during leave, part of which will involve reduced pay and part of which will involve no pay at all; and (b) my general career direction (specifically, it was nice to have solid estimates about when leave would end, because I could predict what kind of projects or activities would be going on at that time. 

Include Key Dates and Contact Information

The first page of my plan includes the following important dates and contact information:
1.  My last day of full time work (I'm taking a week of vacation prior to my due date)
2. My last day in the office (Important for those who may work remotely for a little while)
3. Length of leave (12 weeks)
4. Estimated last day of maternity leave (i.e. last day of FMLA coverage)
5. Estimated date of first "official check-in
6. My OB/GYN's contact information (just in case I go into labor at the office *shrug*)
7. Health Care System/Location of Delivery contact information (see #6)
8. Request for enhanced remote work schedule (for first 6 months post delivery)
9. Personal Contact Information

When I requested an enhanced remote work schedule, this is the exact language I used: "For consideration - Transitional remote work 2x per week through March 2020.  This would be very helpful to navigate the numerous infant pediatrician visits, recovery from surgery (if needed) and establishment of sleep/feeding/care cycles over the first six months.  At Company's discretion." 

As a second time mother, I am now well versed in the fact that humans have ZERO Circadian rhythm until they are at least 4 months old; breastfeeding is an activity that can take 40 minutes up to 6-9X per day for young infants; and recovery from surgery or other medical issues do not always neatly line up with maternity leave timelines.  Also, the gross inadequacy of U.S. parental leave practices is well established at this point, so no one should ever feel ashamed for asking for a concession that will make it easier for them to be a better parent and employee.  

Please note that especially if you are going to have a period of uncompensated leave under FMLA, you really should not be working.  Resist the temptation to be a "people pleaser" and make yourself available for work functions or contact too early during leave.  For one, taking that "one conference call" can impact your legal rights to leave.  For another, especially if you are a first-time parent, I promise you that you are grossly underestimating the physical, emotional and mental resources needed to take care of a newborn and infant.   This is one time in your life to practice strict work versus home boundaries (a skill you'll refine over and over for the next eight-teen years!)

Status of Open Projects or Negotiations

One of the biggest "fears" that your boss and coworkers likely have about your departure is that an open project of some kind will fall through the cracks.  I'm lucky to have had many discussions with my boss about my upcoming leave, and can confirm that this is one of the items that she brings up frequently.  This is nerve-wracking for them because they have to step into the middle of something.  It's like a toddler entering the classroom when they are already doing "morning circle time."  No one ever wants to be caught off-guard!  As a priority, I would ensure that you have a list of all of the things that you are working on at the time of leave, as well as a a plan for who will step in to complete those items if you are unable to do so.

Recurring Meetings

I have an ongoing meeting each week with one of our customers through the next year.  Since I will be absent, it is important to establish what other employees may be able to participate in my stead.  Alternatively, you may consider which recurring meetings can be suspended or cancelled.  For my plan, I included a paragraph setting forth the status of our discussions, all of the participants (including contact information) and flagged any items of urgency.

Outside Support

Everyone's role is different, as are the plans for covering that role during an extended absence.  At many companies, a temporary employee may be brought in to assist.  At other companies, the existing employees may absorb additional work during the leave period.  For me, the latter situation applied.  One of my primary areas of expertise is a bit specialized, so I made sure to include contact information for a third party vendor capable of providing specialized support in this subject area.  I included information about pricing and an overview of past services this vendor has already successfully provided for us.

Inside Support

I think it is important to take initiative to identify those people that can step in and help fill your role during maternity leave, instead of just leaving it up to your boss to figure it out on his or her own.  Your management team is likely busy and lacking in genuine insight into the nuances of your day-to-day (unless they are micromanaging, which would be a completely separate issue!)  By coming to your boss with both external and internal contacts who support you regularly, you are making their life a lot easier.  In business, I often feel like 50% of success is just knowing the right person to reach out to for information. 

Locating Important Information

Since I perform legal activities for my employer, a considerable amount of the work product I generate is not suitable for public (or even company-wide) consumption.  For this reason, I worked with my IT Department for several weeks prior to leave to arrange for two different electronic locations to store my documents, memos and reports during leave.  Our primary goal was to create locations that allowed access by anyone who needed the information, but did not risk improper disclosure of confidential information to unauthorized individuals.  I ended up creating one shared drive accessible only by my boss that contains EVERYTHING (searchable by keyword) and a second shared drive accessible by a select group of peers that contains only a few important folders.  This process involved the transfer of more than 2,000 individual documents.  You probably underestimate how much electronic content you generate at work, so it is never too early to reach out to IT and ask for their guidance about how best to manage it.

E-mail Out of Office Response

This is another item that can be highly variable depending on your role.  For me, I proposed an e-mail automatic Out of Office reply that will direct people to one or two individuals, depending on the nature of their request. 

Annual Functions and Reviews

It can be helpful to identify any key annual functions that may occur while you are out of leave and address them in advance.  For me, I realized that my leave would coincide with our annual performance review process.  By flagging things like this in advance, you are communicating to your employer that you are a forward-thinker and taking a comprehensive approach to planning your leave. 

Human Resources

I know that there are many women who hesitate to inform their employers about their pregnancies early on, for any number of reasons.  However, if you feel comfortable doing so, I encourage you to share the news early.  I told my boss at about 6 weeks, and I believe I informed Human Resources and key coworkers by about 10-12 weeks.  Now that I am well into the third trimester, I'm grateful for this approach because it means that everyone I work with has had plenty of time and notice to address questions, express concerns, assist with planning and mentally prepare for my upcoming leave.  Basically, there should be no surprises when I go out in a couple of weeks, and that provides me with peace of mind.  In addition, I've been able to schedule multiple sessions with Human Resources to review the terms of my maternity leave.  Even with a legal education, this stuff can be confusing!  Be sure to set aside time with Human Resources and don't feel ashamed for asking questions until you really "get it." 

Maternity Leave Impact

Taking maternity leave can be one of the most critical moments of your career.  My first maternity leave experience eventually ended with me settling with the company about two years later after extended disputes over blatant discrimination and harm to my career.  In short, the contract worker they hired to assist during my leave never left.  Over the next couple of years, I found that my work relationships were harmed and my most valuable and important work was siphoned off to her, including several opportunities for advancement. 

Many women have a fantastic experience with maternity leave, and may even have access to mentoring, phased returns to the office, group coaching, well appointed mothers' rooms or on-site childcare, and general support for employees who are also parents.  However, my experience is not a unique one either.  Sometimes women are shocked to find that they return to a culture that does not take them seriously, passes them up for promotions, or fails to express understanding for the challenges of working parents.

Creating your Maternity Leave Plan may present an opportunity to consider your long-term goals in your career and how your current situation supports (or does not support) those goals.  It can give you a wonderful forum to really engage with your boss or coworkers about what you want to accomplish in life. 

Rarely will you be presented with such a clearly delineated break from your chosen career path.  This can be a great time to journal, meditate, explore, and daydream about what kind of parent and professional you want to be. 

Over the last two weeks, I've learned the hard way that pregnancy can really impact your nose and sinuses.  We have been aggressively renovating our little condo, leading to a parade of new appliances, new paints, new carpet and new floors.  I was totally unprepared for how sensitive I would be to all of these new (and not all-together innocent) smells.  The best thing I've done during my pregnancy so far was to invest in a wonderful air purifier.  This little workhorse pulled a lot of the harmful VOC and toxins from the air.  I was so impressed with its instant and tangible benefits, and so grateful that we managed to dispel most of these toxins before the baby (and her delicate little lungs) arrived.  I've also had our humidifier running almost full time.  Between both of these magical contraptions, I have faith that I can make it through the end of winter until it's time to use my favorite air purifying device:  open windows. 

I'm definitely showing a bit more now!  Everything is stretching internally, which can lead to a bit of discomfort and paranoia.  For example, I had terrible cramping in my abdomen and instantly assumed the worst before realizing that it was just related to digestion.  With an avocado-sized baby swimming around, it can be hard to tell exactly what mysterious internal organ is making things achy!  My mantra for these weeks is "Slow Down."  Unfortunately, that is much easier said than done.  Last weekend was filled with lots of fun and activities, but I'm definitely paying for it with a bit of extra fatigue.  It's so easy at this point to forget that I'm carrying around extra weight and blood volume.  My body tends to remind me of this with some extra dizziness or discomfort.  Tonight, I'm planning to relax with a bubble bath - the long overdue first of my pregnancy. 

It was bound to happen, and I'm just grateful it wasn't worse!  I caught a mild head cold.  Sadly, when you are expecting, even a mild cold can mean absolute misery.  I spent an entire minute of my life gazing longingly at a bottle of DayQuil.  Somewhere at the end of Week Seventeen, I also suddenly became really aware of the weight of our baby girl.  I've been showing for weeks.  I often joke that my abs just gave up the minute the heard the news that I was pregnant.  Still, during that time, I wasn't really aware of any weight or pressure.  Then - KAPOW - it suddenly felt like I had a ten pound dumbbell in my abdomen every time I rolled over in bed.  It's exciting, because I've also become aware of movement - like her shifting around or (possibly) doing those first little kicks or reflexes.  It's also a little disconcerting, because I'm suddenly much more aware of the extra burden on my body, and find myself short of breath in the mornings.  Short of breath + cold = one long, long week.  Here is how I've been managing:

Catching A Cold While Pregnant:  Survival Guide

Eucalyptus Essential Oil

I'm not even fancy.  I don't even use a diffuser.  I just boil a massive pot of water on the stove and keep adding drops of the oil at intervals until my partner cringes when he comes upstairs and laments that the entire house smells like Vick's Vapor Rub.  When I feel desperate, I stand over the pot and breathe in the steam.

Honey

In the morning, my throat has some strong opinions.  The best way to ease the scratchiness is a hot cup of lemon water with honey.  I'll also take a spoonful of honey by itself to soothe irritation. 

Vitamin C

We're going old school here.  I don't even mess around with supplements, particularly as my prenatal vitamins contain Vitamin C.  I've been adding a little extra to my diet by eating oranges.  A favorite recipe - dipping mandarin orange slices in chocolate and leaving to harden in the fridge for an hour.  I recommend eating citrus earlier in the day, as it can exacerbate heartburn issues if eaten at bedtime. 

Ricola Classic

Our pharmacist advised us that this was the best cough suppressant for pregnant women.  This is an individual that my family has known for years and absolutely trust.  However,  the internet spooked me and I was petrified to take it because it has trace elements of herbs that I don't consume frequently.  I limited my intake to 1-2 daily and was convinced that I was a terrible mother the entire time, despite absolutely zero scientific evidence of Ricola being harmful.  It just goes to show you that even people with degrees in biology are not totally immune to the fear-mongering and misinformation campaigns that permeate the internet.  My brain knew better, but my overprotective, over-analytical, mom-to-be heart was like "Why don't you just make a LISTERIA SMOOTHIE!!??"

Smoothies With Ginger

Adding fresh ginger to just about anything is a good idea when you are pregnant, as it helps with nausea and stomach discomfort.  Plus, I wasn't all that hungry after feeling so sick.  This was just a way to keep nutrition on track with minimal effort, and get that nice gingery-burn in my throat. 

Hot Shower

Nothing feels better than a hot shower when you can't breathe very well (and, also, have been wearing the same clothes for three days.)  My love for hot showers isn't necessarily the best for the little one, so I tempered the experience by keeping the shower door open.  I still ended up feeling quite light-headed when I stepped out, so this is a recommendation to be followed with a solid dose of good judgement about your personal limits for temperature. 

Putting My Feet Up

I'm one of those people that tends to come home from work and immediately search my house for tasks, like a T-1000 in Terminator.  I was convinced that the entire household would collapse like the fall of Rome if I just lounged on the couch in front of Netflix instead.  Much to my chagrin, this did not happen.  Convinced that I just got lucky this time, I'm back to nagging and wiping off counters and boiling vinegar water in microwaves and emptying lint traps. 

Baby Bum Hand Sanitizer

Germ eradication in the form of a petite little spray gifted with the scent of a tropical vacation.  I use their sunscreen every single day too.  Please, I ask of the Corporate Powers That Be, please do not ever let them stop making these products.  I'm buying this Hand Sanitizer in bulk for when the little one arrives. 

To be responsible, I feel like I should add two little pointers for any first time moms who may be reading this: First, please know that it is acceptable and fine for you to consume certain medications while pregnant - acetaminophen is one of these and can really help with aches and pains from falling ill.  Second, please ensure that you follow  your instincts and get right into your doctor's office or urgent care if you think your cold may be taking a turn for the worse, especially if you run a fever.  This is not the time to "tough it out."  Having the flu (or even a severe cold) during pregnancy can have ramifications for your health and that of your little one, so don't use this experience to prove you are Superwoman. 

The list of restrictions when you become pregnant is not short!  Here are a few of the items and activities that I'm missing by now, along with my "replacements." 

I miss:  Ice Skating 

I'm a fairly experienced ice skater, having learned at a very young age on the canals near Lake St. Clair.  Still, as anyone who has ever watched Olympic-level ice skating on television can tell you:  You're never so good at ice skating that you can't take a serious tumble.  Especially now that I'm showing, I've also noticed that my balance is nothing to be arrogant about.  My ankles have a tendency to buckle that wasn't there several pounds ago.  I grudgingly stayed away from the rinks this winter and replaced this activity with Barre classes.  I miss the feeling of acceleration over ice, but at least I can still enjoy some girly athletic attire and exercises that challenge my balance in a much safer way.

I miss:  Bragg Fresh Raw Apple Cider Vinegar

Especially in the summer, I've been known to subsist off of a mix of maple syrup, fresh lemon juice, cayenne pepper and Bragg Fresh Raw Apple Cider Vinegar.  Unfortunately, it's not pasteurized so it's off the menu.  Thankfully, there are plenty of pasteurized versions on the market, like Heinz Apple Cider Vinegar.   However, I've used this break to be creative and make my own salad dressings.  My favorite is a Citrus Tahini, which I make with a mix of lemon juice, orange zest, tahini and olive oil. 

I miss:  Retinols

I used to get blemishes in my late teens and early twenties, which is when I first started using prescription products on my face.  Back then, retinols were so strong they would take the finish off of your car.  They often left my skin red and irritated.  Still, they were effective, so I stayed with them.  Formulations improved so much.  Eventually, I settled on prescription Tazorac for mild break-out control, preventing and treating mild melasma on my forehead, and just general "good skin hygiene."  Since they speed cell turnover, as I got older these products had the dual benefit of keeping temperamental hormonal blemishes in check while also acting as an anti-aging agent.  Well, I really could have used that stuff when pregnancy hormones decided to send my complexion back to seventh grade!  But alas...I've been using Josie Moran Argan Oil, Dr. Gross Alpha-Hydroxy Peels, L'Oreal Paris Clay Masks and Honeydew and Chamomile Overnight Mask from CVS.  Dr. Gross's products do the closest job of mimicking what an actual retinol will do.  Still, these other products are worth mentioning since it's the combination of all of them that has finally brought a nice clarity and glow to my skin.

I miss:  Sushi

Thankfully, there are plenty of vegetarian sushi dishes to choose from!  In addition, we keep Seaweed Crisps around the house as an alternative to chips.  They have just the right crunch and salty touch to help with cravings.  When we are out at our favorite Sushi restaurant, I've found that they were very cool about cooking seafood through before using in a roll.  It never hurts to ask. 

I was walking through a picturesque park surrounded by glassy inlets of calm lake water, some still with remnants of ice cast over the surface.  Dozens of people were kayaking and I was eager to join them.  I walked on a narrow strip of grassy land toward a clubhouse like structure about five hundred yards away.  Just then, I ran into a friend from high school. We exchanged hugs and caught up on small talk.  I cut it short, explaining that I was just going to rush to the restroom and then join everyone else kayaking.  I ran over to the clubhouse and found the bathroom after a couple of wrong turns down a few narrow hallways.  I finally sat down to relieve myself and...then...WOKE UP about a second into the process of peeing my pants (thankfully our master bathroom is only a couple of steps from the bed or this morning could have been - ahem - unpleasant.)  Behold the power of pregnancy dreams, people!  Now that I'm in Week Eight, disrupted sleep is already a prominent symptom.  To compensate, I've been making a diligent effort to move my bedtime (and my son's!) up by almost an hour. 

I've had cravings for dairy products, especially yogurt, which I'm happy to oblige.  Fetuses are efficient, and if baby needs calcium, I'd rather suffer a little indigestion to consume it than have it taken from my bones or other stores.  I've had mild aversions to meat and chicken.  The first medical visit entailed a lengthy intake interview with a senior nurse practitioner at my OB/GYN's practice, as well as urine and blood sampling. 

The woman drawing my blood smiled "Oh! My daughter is pregnant.  She's coming in right after you."  A few moments later, a young woman stepped in with a mouthful of braces and the demeanor of someone who just left their study group to donate plasma.  Her coyness and shyness reminded me of a key truth - it is difficult to be on either side of a bell curve.  Women who give birth in their late teens and early twenties are greeted with their own set of assumptions - whereas, people just assume a woman my age postponed kids for a career and then paid up for expensive IVF; people assume that the youngest mothers were irresponsible, unprepared.  Her face didn't wear any of the marks of age, but nor did it wear of any of the benefits - the confidence, the security of knowing you have already faced down decades of adult challenges and experiences.  It seems to me that what many women learn most in their 20s and 30s is how to be an advocate for themselves  - their positions, their beliefs, their perspectives, their rights, their needs.  I'm grateful for the practice, as so much of parenting is about being an advocate for your child. 

MEAL ONE:  7 AM

1 cup of raw oatmeal with 1 cup of almond milk, 1/2 cup blueberries or blackberries, and 1 tsp honey

MEAL TWO:  9 AM

3-5 mini "Blondie Muffins" from the Tone it Up Nutrition Plan.  One serving is 3 mini muffins.  I find that my appetite is stronger during the morning, so I gently enhance my portion if needed.

MEAL THREE:  12 PM

4 turkey meatballs and a kale salad with cucumber, chickpeas, sliced almonds, and homemade citrus dressing (orange juice + honey + lemon).  Here is a great recipe for turkey meatballs! For some reason, meatballs have still been appealing to me, even when a lot of other foods - like steak or grilled chicken - have not.   I also like to add a single serving of dark chocolate here.  It's a nice way to score extra magnesium and keep my sweet tooth at bay in advance of the afternoon slump.

MEAL FOUR:  3 PM
 
Dried fruit - prunes, apricots, and apple slices. 

MEAL FIVE: 7 PM

This is always the most challenging meal of my day because I generally go so long between lunch and dinner, mostly because of a lengthy commute.  I've started to carry a Larabar with me on the drive home, in case I need a little something around 5 PM.  That way, I'm not ravenous (or plagued with horrible morning sickness) when I walk through the door.  Lately, my morning sickness has been hitting me hardest in the evenings, so I've been skipping "real" dinners in favor of protein smoothies.  I try to include all of the food groups into the smoothie:  flaxseed for healthy fats, banana and berries for fruits, almond milk with calcium as a "dairy" product, frozen spinach for veggies, and protein powder for protein. 

Let's talk about migraine during pregnancy.  I've been a lifelong migraine sufferer, part of a genetic legacy that stretches back to my great-great-maternal grandmother.  My migraine profile is as follows:  (a) I get them rarely, a few times per year; (b) My triggers seem to include a trifecta of hormone levels, barometric pressure, sleep disruption and stress; (c) I am part of a very small group of migraine sufferers who have both visual and auditory disturbances during migraine aura (for me, I see what appear to be two-inch sparkling "tadpoles" of light that swim through my entire field of vision at a distance of about twenty-four inches in front of my body and...well...I hear voices.  Not the schizophrenic or "scary movie" kind of voices, but more like a muffled television playing several rooms away down a hallway) (d) I tend to get extreme head and neck pain during the experience, as well as vomiting; and (e) I experience a pronounced prodome as well, which basically means that for about 24-48 hours after a migraine episode, I don't even know what year it is.  If any of this sounds like something you wouldn't mind experiencing during pregnancy, well, you're made of pretty hearty stock. 

The good news is that my migraine occurrences tend to decrease during pregnancy, which is common for a lot of women.  The bad news is that "decrease" does not mean "zero."  So, as I entered my ninth week of pregnancy, a combination of stressful news (e.g. a massive mistake made by my mortgage company resulted in them deducting my mortgage payment FOUR TIMES over two weeks and a dear childhood friend passed away after a long struggle due to a stroke); barometric pressure changes (the temperature this morning was "one degree;") and hormones (week nine correlates with peaking HcG hormone levels) led to one miserable night.  Acetaminophen ("Tylenol") is regarded as safe during pregnancy, but frequent doses have been correlated (that does not mean they CAUSE) minor cognitive delays in female offspring.  For this reason, I have no qualms taking it, but I definitely test the limits of human suffering a bit before doing so.  During pregnancy, my rule is that medication should be treated as a last resort and used judiciously. 

Being pregnant, options were limited, but I eventually found relief through the following: (a) a 15mg dose of my son's liquid Tylenol; (b) an ice pack; and (c) deep breathing exercises and mantras.  It goes without saying that my nutrition and exercise were completely messed up over the weekend.  I'm restoring my body today with a ginger, pineapple and veggie smoothie and banana/peanut butter flatbread. 

Week Nine brought the first ultrasound and meaningful interaction directly with my OB/GYN.  There were a couple of noteworthy discussions that took place because of the fact that I am over forty.  First, he spent a little bit of time emphasizing that for many women over forty, conception is not as difficult as pregnancy maintenance.  However, before I could balk at the statistics, he reminded me that the risk of not carrying to term is pretty high even for most twenty-year-olds (let's say the risk evolves from 20% chance to 30% chance over the course of your twenties and thirties).  As so many women know firsthand, pregnancy loss is so much more common than our utter lack of cultural vocabulary for it would imply. 

However, once a heartbeat is detected and normal fetal development confirmed at eight to nine weeks, the risk drops to 5%.  Those are odds that I will take!  I noted that he was much more forthright about the risk of loss than he was the first time, and I think that stemmed not from his concerns, but from those of his typical over-40 patients.  It's the elephant in the room and he gets it out of the way quickly.  He was also more forthright about genetic testing, and spoke in more detail about the difference between NIST and more invasive (but informative) tests like amniocentesis.  Again, I never felt that he had specific concerns about my pregnancy, just that (again) genetic testing is another elephant in the room for the over-40 crowd and he addresses it up front and with candor.   He mentioned that many doctors will recommend baby aspirin to over-40 patients, as a preventative measure against preclampsia.  Since I had no history of preclampsia with my last pregnancy, he said that he would not require the baby aspirin at this time. 

For those who are curious, I am opting to have an extensive panel of the MaterniT21 test by Natera performed in two weeks (the genomic panel instead of the standard panel).  If this test is returned without abnormalities and fetal development continues to appear normal via ultrasound, I will abstain from amniocentesis. 

Amniocentesis is a wonderful procedure and provides genuine diagnosis (as opposed to just a "screening test,") as well as information about possible infections or fetal lung development. However, it's not without risks, so I am not willing to undergo the procedure unless a factor other than my age dictates its necessity.  The challenge with the approach that I've chosen is that, if amniocentesis appears necessary, I have to wait longer to have it (i.e. the length of time for the screening tests to be completed, plus scheduling). 

This appointment was really special, because I walked away with my first picture of my baby!  He or she measured at exactly nine weeks and three days. 

This week, I took time to sit down with the Benefits Administrator at my company.    Frankly, I have very mixed feelings after that meeting.  First of all, I work for an extremely ethical company that strives very hard to provide excellent benefits and competitive salaries to its employees.  I feel very grateful for these efforts.  Moreover, I view my workplace as being fairly progressive.  We go to considerable lengths to ensure that women and minorities are not just given employment opportunities, but leadership opportunities.  So, it came as a surprise to be disappointed after a review of the company's maternity leave, short term disability and FMLA leave policies.  Basically, for 30 days after delivery, I receive my full salary via short term disability.  After that 30 days is up, I am eligible for another six weeks of paid leave after a vaginal delivery or eight weeks of paid leave after a C-section.  The catch is that these latter weeks are covered at only 66% of my present salary. 

About two years ago, our family made the decision to have my partner stay at home with our son and focus on continuing his education (key to a mid-career shift).  If he was working, we would be able to offset these costs with relative ease.  However, that is not our present reality.  My current salary is well budgeted, but with two cars, (public) preschool, two phones, a mortgage, two sets of moderate student loans, two sets of moderate consumer debt, and regular contributions to retirement investments, we often cut it pretty darn close each month.  We are not living frivolously at all.  My debt to income ratio is generally regarded as healthy and hovers around 25% total.  We also didn't get here by overspending (at least not in the materialistic sense.)  We got here largely because modern life is exceedingly overpriced for value in many arenas.  For example, over the last few years, we often paid more for quality part time child care and preschool than for the mortgage on our 1252 sq.ft. home ($994 versus $887 for those who are curious.)

Taking a 33% reduction in salary at this point seems like a monumental undertaking.  Added to this is the fact that even the best health insurance available through my employer covers only 80% of labor and delivery costs.  That sounds pretty good, but since this is my second child, I know all too well that medical interventions related to labor and delivery can easily escalate to $20,000.00, twenty percent of which is four thousand dollars.  You could have a pretty fantastic vacation to Hawaii for four thousand dollars.  If you are on a budget, like my family, four thousand dollars represents the emergency fund that you are always trying desperately to maintain, or meaningful updates to our most significant asset (our appliances are all in their "twilight years" and this could replace each of them.)  Instead, this money is essentially being thrown out a window for our insurers to gather up from the front yard.  If I felt that this money was going directly to the amazing people that provide my medical care, I wouldn't have such cynicism.  In reality, we all know that a significant portion is simply lost to administration. 

For the privilege of giving birth to both of my children in a hospital setting, I expect to pay approximately eight thousand dollars out of pocket.  Had I invested this eight thousand dollars with even a fairly low interest rate of 6% over 20 years, I would have had $25,657.08.   Even eight thousand dollars on its own would do well to fund anything from a semester of online education or about three weeks of conservative living in the South of France.  I've spent too much time as a corporate attorney not to be miffed at this lost opportunity cost. 

Considering that many middle class families struggle to save even modest emergency funds (e.g. $500 - $1000.00), this could be a catastrophic expense that could move a family into credit card debt, personal loans or delinquency.  Without cash on hand, where else would the money come from?  Thankfully, I already know that payment plans can be established with most reputable hospitals to offset the jarring nature of waking up on the same day with both a new baby and new four-figure debt.  

The most disappointing fact is that it is an absolute privilege for me to even whine about this online.  I am exceedingly fortunate to have both gainful employment and the means to acquire excellent health insurance through my employer.  Millions of Americans do not have the privilege of either of those things.  One of my friends gave birth to her son in 2003 without the benefit of insurance.  Her uncomplicated, unmedicated vaginal birth cost her approximately $10,000 out of pocket back then.  In 1978, Good Housekeeping concluded the average cost of childbirth was around $1500.  This inflation has hardly slowed down.  I suspect that if my friend gave birth today, the cost would be much closer to $15,000.  If the "Average American" brings home a salary of $55,000, that's about 27% of income.   Most people don't part with 27% of their annual income to put a down payment on a house!

When my partner and I discussed all of this last night, common refrains were "Maybe we should have the baby in Mexico where the costs of delivery will be cheaper!" and "The maternal health outcomes are probably be better there anyways" and (from my partner, who has a bit more candor than I do in most situations) "Fuck this country."  To be honest, I can't help but feel that any country that makes it this hard for middle class families to spend even three months with their newborn children deserves every single ounce of his ire and disgust. 

While I may not look all that different (thanks to a couple of strategic wardrobe choices), I am still navigating a plethora of physical symptoms.  I'm grateful to keep food down, but continue to struggle with morning sickness for most of the day.  It is still worse in the evenings, so many nights "dinner" has just consisted of avocado on Triscuits or a smoothie.  Of all the cravings, I've been eating tabbouleh by the bucket.  Go figure!  Out of curiosity, I looked up the nutritional profile of tabbouleh, and discovered that it is actually a fantastic food during pregnancy.  Parsley contains twice as much iron as spinach, as well as a lot of vitamin C, vitamin A, manganese, calcium and potassium.   Cucumbers are not just refreshing, but a fantastic source of B vitamins, as is lemon juice.  The addition of olive oil even provides heart-healthy fats.   We have an amazing Lebanese or Middle Eastern restaurant on every other block here in Metro-Detroit,  so I shouldn't run out of this superfood anytime soon. 

This week, I've also been greeted with a crazy symptom of pregnancy that I was definitely not expecting:  my complexion has reverted to that of a tragically unlucky fourteen year old.  I usually don't have any blemishes at all.  This morning I counted nine.  Since many effective treatments for these kinds of issues are prohibited or questionable (e.g. retinol products, benzoyl peroxide, and saliciylic acids), I'm facing this down with a little bit of humor, Dr. Gross Alpha Hydroxy Peels, St. Ives Apricot Scrub and Micellar Water.  I've also been doing a clay mask a couple of times per week. 

Due to the general fatigue and malaise that is so common as the First Trimester comes to a close, I've struggled to work out lately.  Instead of weight training, I've focused on just walking or riding our stationary bike every day for 20 minutes.  My weight has actually remained fairly steady for the last couple of weeks.  I seem to be one of those women who gain a lot right out of the gate and then level off as the Second Trimester approaches.  I have a feeling that will change soon, so I made sure to pick up a couple of additional maternity items - a cute dress, pair of leggins and shirt ($14 each at H&M.)

Tomorrow will be a big day:  I will have blood drawn for the MaterniT21 genomic panel.  It can be terribly nerve wracking to consider whether the test will reveal chromosomal abnormalities, so instead I'm focusing on an ancillary benefit of having the tests performed:  They reveal gender!  We should know whether this little Seamonkey is a boy or girl weeks earlier than if revealed by an ultrasound (although I'll be having one of those tomorrow as well!) 

I discovered I was pregnant during Week Four, which is quite early by normal standards.  I tested via Easy@Home pregnancy test strips after my period was approximately two days late.  I absolutely expected a positive result because I had already been having vague-but-undeniable symptoms.  The most pronounced symptom was a massive increase in highly visual and intense dreams.  I'm likely understating the "highly visual and intense" part.  In one dream, a zombie was on top of me and within inches of devouring my head until I placed my hands in its mouth and broke apart its jaw.  Remembering detailed dreams is not a particularly unique experience for me, but having four straight nights of dreams that would take a massive special effects crew to recreate is:  by the end of this week, I was positive I was pregnant, even before my missed period.  I had also noticed a consistent, extremely mild sensation of nausea throughout the day.  I only experience nausea in relation to terrible flus (rare) or migraines (rare), so this was another somewhat unmistakable symptom for me.  I also seemed to have what could best be described as a "congested" feeling in my lower abdomen (likely a sensation of increased blood flow and slowed digestion.)  None of my pants seemed to be fitting in a particularly flattering way and I couldn't quite figure out why. 

By this point, I had taken three Easy@Home pregnancy test strips, all of which were positive.  The latter two tests were extremely dark pink lines, the first a bit paler.  This signified a promising increase in levels of human chorionic gonadotropin (hCG).  Since the first line had been a bit pale, the additional tests assured me that the first positive had not indicated a chemical pregnancy (i.e. pregnancy that ends very soon after conception, but still leaves a detectable amount of hCG in the bloodstream for a little while).  By Week Five, I was floored by a couple of symptoms: (1) weight gain - holy smokes!  I was already up several pounds, attributable largely to water retention and digestive troubles; (2) almost daily appearance of mild nauseous spells, especially after consuming a large or rich meal (this was the week of Christmas, so well...yeah); (3) unregulated digestion, which is a polite way of saying that food was either moving much too slowly or quickly through my body, neither of which seemed very pleasant; (4) breast sensitivity; and (5) dizziness after going a couple of hours without food or water.  I also became aware of a subtle "marled" appearance to the skin on my torso.  My skin is really pale, so I suspect that this was the effect of slightly increased blood flow in the capillaries in and beneath my dermis.  

Just shy of Week Six, I finally scheduled appointments with my OB/GYN, who is one of my favorite humans on the planet.  He is proficient and has a sense of humor drier than the Sonoran desert.  The first appointment will take place in about two weeks and will involve only the intake nurse and a likely confirmation of my pregnancy tests via urine or blood sample.  The second appointment will take place approximately four weeks from now and involve a visit with my OB/GYM himself.  Honestly, I'm in no rush to involve medical professionals, because it generally opens the gate to a plethora of uncomfortable poking and prodding.  However, because of my "advanced maternal age," there may be recommendations that I want to obtain earlier rather than later, such as progesterone supplementation or extra vitamins.  In addition, I'm holding off on telling everyone except my partner until I have my first doctor's visit and confirmed heartbeat, so I'm eager for that confirmation.  

Aside from scheduling doctor's appointments, I also picked up a couple of very simple and cheap pieces of clothing to help "hide" everything until we feel comfortable making an announcement.  Although I have a flat tummy when I wake up, the water retention has made many of my trousers and jeans uncomfortable, especially by the end of the day.  See this LINK for a few items that are useful if you are hiding the bump during the First Trimester of pregnancy.  

This is actually a challenging period of time in the first trimester, for the following reasons: (1) We don't feel comfortable informing anyone else about the pregnancy until we have a confirmed heartbeat, so there is the constant presence of a Very Big Secret; and (2) My weight gain fluctuates up to 10lb right now, based solely on water retention and digestive sluggishness - just yesterday, when I woke up my weight was 131 lb (let's say a solid 5-10lb heavier than usual) and 136lb at the end of the day.  Then, today, I woke up to a flat stomach and a weight of 129 lb.  I've already been sleeping in sports bras and they feel much more "filled out" than usual.  If my brain wants to keep everything a secret, my body is not cooperating.  I've already put away my skinny work pants and jeans (possibly forever! haha!) and replaced them with a pair of petite tummy-control leggings and oversized sweaters.  I haven't bought any classic maternity clothing yet, but it took exactly one day for me to replace my normal work wear with the office equivalent of pajamas.  I'm also experiencing chills, mild nausea, and mild fatigue.  I had a dream that I was eating paper.  Pica is a symptom of iron deficiency anemia, so I took it as a reminder to watch my iron intake. 

The other thing that makes this period somewhat challenging is the emotional landscape.  I am a little nervous about this pregnancy, although I have no reason to be anything but optimistic.  I would say that this is due 10% to legitimate concern over age-related risks and 90% to the fact that we really, really wanted this baby and knowingly tried to get pregnant.  Our first pregnancy was a complete and total surprise - we were not actively trying to get pregnant (at thirty-five, we simply assumed things would probably take a while, so pregnancy was far from our minds even though I hadn't taken birth control medication since I was in my twenties.)

This pregnancy is different:  We actually got exactly what we prayed and hoped for, without any difficulty - could it be taken away as easily? I'm dealing with those feelings by choosing not to dwell on them or empower them, instead celebrating every single day as it comes and not getting too far ahead of myself. I think I will feel these fears dissipate after we confirm heartbeat and receive our first medical intervention at about eight weeks. 

Moreover, the twenty-five year old girl who works the front desk at the office gym just had the most adorable baby girl about three months ago.  The simple fact is that this twenty-five year old girl could be my daughter by now, had I been a little careless with a prom date.  There is no word in my vocabulary for how this fact makes me feel sometimes.  I definitely appreciated every silly article about "celebrity pregnancy over 40" this last week.  

I also find myself reminiscing about my last experience with maternity leave:  I was off twelve weeks.  My boss, who happened to be in the UK, became pregnant the following year and was able to have protected leave for one year.  Five years after the fact, the maternity and parental leave policies in this country are still firmly entrenched in an era where the Earth was still cooling.  My vocabulary has PLENTY of words for how I feel about this fact.  I really adore my job and my boss and have already started to give consideration to how best to manage preparing for and taking maternity leave. 

For now, I'm continuing to workout 30 minutes per day, with two days off per week. 

A typical week looks like this:

Monday:  Tone It Up Prenatal Total Body Workout (weight bearing)
Tuesday:  30 minutes on the stationary bike
Wednesday:  Prenatal Barre Workout (weight baring) and Prenatal Arms Workout
Thursday:  30 minutes on the elliptical or Denise Austin Prenatal Cardio Routine (the "OG")
Friday:  Rest day/30 minutes of walking
Saturday:  Tone it Up Prenatal Total Body Workout (weight baring)
Sunday:  Rest day/housecleaning and meal prep

After completing a kettlebell workout (12lb) I found that I had a lot of pelvic and abdominal discomfort, so I'm retiring the Kettlebell of Doom for the rest of the pregnancy.  I did a lot of deep squats during that particular workout.  While squats are generally safe for pregnancy, you have to listen to your body.  I am taking a break from squats for a few days, and then plan to revisit without weights.  I've definitely had an increase in morning sickness this week and it had disrupted my sleep.  No one feels like working out when they've been up since 4:00 AM.  On those days, I just try to eat healthy and walk a little bit more throughout my day. 

The Pregnancy Dreams are still in full effect.  It probably sounds overly dramatic to say that this is one of the most challenging "symptoms" so far, but it is!  In the last two weeks, I've dreamed about zombie attacks, witchcraft, abandoned orphanages, ancient Feudal conflicts over land, ambush attacks on foggy inlets, sea monsters and at least half of my most disappointing and embarrassing moments from high school.  It's actually really difficult to wake up and go about your day after such distressing or intense dreams.  It feels like someone is excavating the deepest recesses of my subconscious.   

This week, I've commenced my prenatal fitness and nutrition program in earnest.  For my size, that means consuming approximately 1800 calories per day of healthy, Tone it Up-approved foods that pass the "morning sickness" test and at least five days of exercise per week.  I'm a little nervous about not gaining too much weight in the first trimester. 

This is a complete 180 from my first pregnancy.  When I was pregnant with my son, I was so scared of missing vital nutrients in my diet that I actually overate a lot of healthy foods.  In addition, my workout routine the first go-around was based solely on walking and yoga.  While those activities will keep you feeling relaxed and healthy, they won't necessarily shave off any pounds. Last time, I weighed approximately 156 lb when I delivered my son, and frankly, it was a difficult amount of weight to hold on a frame that can be healthy at 105 lb.  It was even harder to shed!  I feel like I spent an entire year in plank pose just to fit back into my pre-pregnancy size(s).

It is a challenge to fit in the workouts now because I'm experiencing some of that First Trimester fatigue, nausea and frequent urination, the last of which likes to appear at two in the morning.  Still, if I can keep the total weight gain a bit lower this time, I think that I'll feel better and recovery more quickly.  Please don't feel bad for the baby!  He/she celebrated the kickoff of this fitness program by downing an entire bag of veggie sticks over a single "girls' night in."  Gleefully.  And with abandon. 

I have my first prenatal doctor's visit this Friday.  My biggest concerns right now are about cervical insufficiency and prenatal screening panels for chromosomal or other abnormalities.  Of course, I'm also really looking forward to confirming the heartbeat!  Once we have that confirmation and the first set of ultrasound pictures, we'll share our news more broadly. 

I'm actually really looking forward to being able to openly participate in this year's Tone it Up Love Your Body Challenge as a pregnant women.  It can be hard to maintain relationships with female friends when you are a busy working mom, and morning sickness does not help that cause.  It's nice to have the extra support and companionship of women who are going through similar experiences. 

I am currently four weeks along with my second pregnancy at the age of forty-one.  I've seen countless articles devoted to women who are trying to conceive at ages often regarded by the medical community as being a bit advanced, and it inspired me to put my two cents in.  I'm certainly not a doctor, but I do have a degree in biology, so hopefully some of this will be helpful.  It can be challenging for many women to conceive naturally at any age, and perhaps even more so for those over the age of thirty-five.  I've outlined some of the things that I think may have contributed to our success in conceiving naturally at the age of thirty-five and forty-one.

TLongevity. 

There are quite a few studies examining the relationship between human longevity and age at conception, including the impact of older parents on the health and longevity of the children born to them (this is basically negligible, so please don't add it to your list of worries!)  A study in the Journal of Science Research and Reports (2014) examined evidence from eight studies demonstrating that smaller body size is related to greater longevity.  My family seems to bear this out!  The women are generally petite and tend to live for a very long time.  My paternal grandmother was my height (five feet) and lived to the age of 96.  My maternal great-aunt was about five four and lived to be 97.  My maternal grandmother was about five foot five and lived to be 83.  Through my life, I've often joked that I take such good care of my body because I expect to be in it for such a long time!  This is relevant for two simple reasons: (1) there appears to be favorable correlation between advanced maternal age and longevity, although it can be hard to figure out which causes the other; and (2) I have always felt that my genetics (not only my lifestyle) allow me to skew a "real age" younger than my actual calendar years. 

I think it is important to note that what is most valuable here is the concept of an "inherited" longevity - how long will you be on this beautiful Earth if everything goes well and you make responsible choices?  If your relatives barely made it out of their fifties due to lifestyle choices, such as ill-managed diabetes, smoking or illicit drug use, this is not relevant to you at all.  What is more valuable is being aware of the genetic legacy your family has bequeathed you and properly managing any negative tendencies (e.g. a propensity toward diabetes or cardiovascular issues) so that you can optimize your health and longevity. 

If the women in your family routinely make it to their nineties and people often confuse you for being much younger than you are, these are things that imply that you have been favored with a robust ability to repair age related damage to your cells - not a terrible thing if you are trying to conceive naturally. 

Regularity.

When I was in my twenties (e.g. college years) my menstrual cycles were a bit all over the place.  I was quite a bit thinner at those ages, and this may have contributed.  My frame was likely 15-17% body fat, and my hormones had clearly not found their happy balance yet.  Still, by the time I entered my thirties, my body fat percentage increased to 20-24% and you could set Greenwich time according to my cycles, trends which continued to my present age. Having a predictable cycle implies that the underlying biology is working as designed - again, this can't be a bad thing if  you want to conceive naturally.  For women in their forties, cycles also offer a huge clue as to whether you have entered peri-menopause or menopause; natural events which can certainly impact fertility. 

Prior History

When I delivered my son at the age of thirty-six (I literally went into labor on my birthday after eating five pieces of cheesecake), I had originally expected to have a natural childbirth.  I was so committed to this idea, having done meditations every single day for more than six months, that I declined any intervention for six hours of active labor.  Well, flash forward twenty four hours later, and I had a baby and a discharge sheet that looked like Keith Richard's 1970s.  Still, my body had demonstrated that it could naturally conceive a baby and carry to term.  This was especially important for me, as I had a history of multiple cervical surgeries (three to be exact) in my early thirties.   I really had no way of knowing whether scar tissue would impede my efforts to get and remain pregnant, and was greatly relieved to find that it did not.

This favorable history was another "plus" when we attempted to conceive at the age of forty-one.  While there are plenty of things you can do to foster a healthy pregnancy, the bottom line is that anyone who has been pregnant understands that much of the process is out of your control.  Again, favorable prior history speaks to the underlying biology working as designed at least once.  With the exception of progesterone supplementation, I had a history of needing little medical intervention to conceive or carry to term. 

Longevity, regularity and favorable prior history are blessings that I did little (or nothing) to earn, foster or cultivate.  They are simply statistically significant items that help move the needle in a slightly favorable direction.   Moreover, they barely scratch the surface of blessings most of us have received that foster fertility, such as access to clean drinking water, affordable medical care, freedom from pollutants, publicly available education and access to healthy foods.  Even those who struggle with challenging fertility issues have more things in their favor than they will likely ever really realize. 

The purpose of starting with items "out of our control" is to establish a bit of a baseline:  If your periods are not regular, you will likely need to work with a medical professional to fix that up before you can make any meaningful attempt to line up your - ahem - extracurriculars with your ovulation date.  If you do not see youth and vibrancy when you look in the mirror, then you may need to work with a medical professional to understand what is dragging you down (e.g. a subtle hormonal imbalance or stressful lifestyle).  After all, four decades is plenty of time to accumulate the effects of bad habits or otherwise trigger an underlying disease propensity: those who will be diagnosed with Type II diabetes in their 70s likely show signs of metabolic syndromes or imbalance as early as their 40s.  If you have a history of challenging conception(s) or inability to carry to term, you need to seek understanding of your personal biology and environment to best confront those challenges. 

Biological processes are intricate - any improvement you make will likely have a ripple effect.  That is how the body works:  change one variable either internally or externally and watch for its impact.  Pregnancy - at any age, for any woman, with any history - is partially an exercise of fate, which we humans can influence one way or another only by trying to take statistically meaningful actions based on the research in existence that particular day. 

I actually take great issue with the common phrase "getting pregnant."  The word "getting" seems to imply an action of grabbing, grasping, obtaining, and these concepts completely trouble me when used with pregnancy, especially because the word "get" is so fraught with connotations about deserving-ness - we "get" what we deserve, some people just "get" lucky.  Creation of human life is no different than creation of any other life.  Flowers don't "get" blooms, trees don't "get" seeds - the continuation of life for any organism is simply cultivated or not cultivated by its environment.  All we mothers can hope for is that we have been partially blessed with and partially created the proper environment for such cultivation, just like a garden. 

I don't believe that the things we do "on and off" do much to impact our chances of conception (unless that "on and off" activity is rolling around in pesticides or the like).  So here, I am only going to focus on things that I do religiously, every single day, as these are most likely to be pertinent to an actual attempt to conceive. 

Consuming a LOT of nuts and seeds.

I will go out on a limb and say that my consumption of cashews, almonds, flaxseeds, sunflower seeds, pepitas, and peanut butter is probably higher than fifty percent (or, um, ninety percent) of the population.  I don't do this because of any attempt to improve my fertility.  I do it because sugar/insulin sensitivity runs in my family and nuts and seeds are a quick, easy snack with enough protein to keep me away from things like fudge or Fruit Loops.  Nuts and seeds are quite nutrient dense, containing zinc, omega-3 essential fatty acids, protein, and vitamin E (all of which are utilized in biological pathways relevant to fertility.) 

Increasing my heart rate - a little bit

I've mentioned before that I believe having a low body fat percentage may have unfavorably impacted my hormonal balance when I was younger.  What can I say? I wanted abs.  So, I think it is important here to note that overdoing anything - including exercise - will likely have a negative impact on your fertility.  For me, I make an effort to simply boost circulation and build strength without taxing myself to the point of exhaustion: no Bikram/hot yoga or strenuous HIIT programs, even outside of pregnancy.

I aim to keep my heart rate at an appropriate range (generally below 179 bpm - actually who am I kidding? generally below 160 bpm).  If I went harder, I'm sure that I would be pleased with the aesthetics, but I suspect it would have other deleterious effects over time (as it did when I was younger).  Exercise is very personal, and advanced athletes may have a lot more latitude to challenge themselves than the typical desk-bound lawyer. 

I would only say that regular exercise is essential to flood ALL of your organs with nutrients and oxygen, and cleanse away toxins.  Exercise sends key biological messages to your brain:  "I am healthy.  I am capable.  I am safe.  Look, I am not under physical stress or strain, nor at risk of exhaustion or overheating."  This is the kind of biological atmosphere that fosters fertility, and frankly, better health in general. 

Drinking green tea

I drink one or two weak cups of green tea every morning.  This is not a meaningful intake of caffeine, which can be detrimental to pregnancy.  In low amounts, green tea offers a nice boost of antioxidants and (surprise!) folic acid.  It also contains trace amounts of potassium and polyphenols that have been linked to reduction of inflammation.  People often talk about green tea as a panacea - a cure for everything!  I think that likely overstates its health benefits.  Still, as a substitute to sugary, caffeinated drinks like the ones I covet from Starbucks, it's a solid choice.  As a daily beverage, it likely provided me with a consistent level of compounds that helped to keep the inflammation load within my body fairly low.  The rest of the day, I attempt to consume at least 60 oz of plain old water.  When I bore of regular water, I mix in a little bit of apple juice or a few drops of Mio. 

Sleeping eight hours

Sleep is your body's repair cycle.  Lack of sleep can disrupt your monthly cycles, impact hormone levels of hormones linked to both dietary and fertility cycles and thwart your body's ability to repair cells properly.  I am in bed no later than 9:00 PM every night, and aim to be asleep no later than 9:30 PM.  The sleep-wake pattern of human beings is intimately tied to fertility.  There is a reason that our cycles line up so beautifully to that of the lunar transitions. 

The CLUE App

I've been using the CLUE App on my Note 8 for about a year and it's fantastic.  I currently use it to track the following: Period start date, PMS symptoms (e.g. cramping or headaches), emotions and temperament, the amount of sleep I had that night, extracurriculars (sorry, I was raised by a literal 1950s housewife!), digestive issues (e.g. nausea or bloating), and even cravings.  The app provides predictions based on past entries, including the start date of your cycle and your most fertile days.  Perhaps most importantly, it's so nice to have this information at my fingertips when I go to the doctor.  Doctors can still sometimes be dismissive of women, so it is nice to come "armed," especially if you feel that something with your health is not quite right.  CLUE is a fantastic free app, even if having a baby is the farthest thing from your mind.

Easy@Home Ovulation Test Strips & Pregnancy Test Strips

We had tried for a couple of months using only the CLUE App to guide us to our optimal days, without success.  Around this time, I had a candid conversation with a close friend who had recently had her second child.  She is a couple of years younger than me, so I was a little taken aback when she revealed that they had not been cavalier at all about conceiving their second child.  My partner and I had always had a really chill, "whatever happens, happens" approach.  Still, I was starting to feel like maybe being that laid back was irresponsible at our age, when it seems like every article I read admonished me with a huge ticking biological clock.  She mentioned that she had used these strips and found that the ovulation date she identified by using tracking methods was actually off by a couple of days.  Sure enough, I used them for one month and found that the strips actually informed an ovulation date about 24 hours prior to the "peak fertility day" represented by CLUE.  Although this seems like a subtle difference, apparently it was a notable one, as we conceived that month.  I definitely recommend combining both the tracking and test strips into one approach. 

Consuming heme iron sources

Having been vegetarian for twenty years, I found that as I entered my late thirties I was finally struggling with nutritional deficiencies.  For a couple of years, I scoffed at my symptoms, such as extreme fatigue ("What working mom doesn't feel tired all of the time?"), disrupted sleep cycles ("I must have had too much to drink before bed?"), heart palpitations ("It must be caffeine") and tingling and numbness in my extremities ("I must have slept wrong.") 

While all of those rationalizations may have held a kernel of truth, the simple fact was that I was significantly deficient in iron, zinc and most B vitamins, despite my efforts to incorporate sources of these into my diet.  So now, I eat heme protein (a delicate way of saying "Meat") every single day.  I try to obtain this from sources that are most respectful to the environment and cause the least offense to my personal ethics. 

I make no mistake about the fact that reincorporating heme protein sources into my diet has been absolutely critical to the restoration of my general health and fertility.  Other women may be able to overcome such nutritional deficiencies via supplementation, an approach that proved unsuccessful for me.  I think that the most important point I can make here is that I "thought" I had been eating extremely healthy, and still had significant deficiencies in vitamins and minerals that can directly impact fertility and general health, so I have to assume that many women out there may also have a similar dietary profile.  Particularly if you subscribe to any kind of specific diet, such as keto, vegan, vegetarian, paleo - I recommend paying for an extensive blood testing panel by a qualified functional medicine clinic to identify deficiencies - plus a healthy dose of humility and openness to change when reviewing the results. 

Avoiding Alcohol

At the age of forty-one, I can still count the times that I have consumed any sort of alcoholic beverage on my fingers.  I've always been a teetotaler, even in high school and college.  A lot of this simply stems from a general intolerance of alcoholic beverages - I would usually get sick to my stomach long before any sign of that fun "buzz" everyone assured me was waiting around the next corner.  In addition: I'm tiny.  I've felt the effects of a shot glass of beer or wine.  I have no moral or religious prejudice against imbibing, I just simply don't like it, it doesn't make me feel particularly good, and I have yet to identify a single meaningful benefit to its consumption.  The presence of alcohol is so ubiquitous, I can't help but feel that I may be painting an inaccurate picture by not mentioning my abstention.  I'm not sure if it impacts my fertility or not, but it is a noteworthy feature of how I live my life, so I suspect the answer is likely "yes." 

Having degress in biology and law, I tend to view myself through the lens of a very skeptical, "logic oriented" person.  So, it would probably come as a pretty big surprise to many of my friends and colleagues that I had even pursued pranic healing in the first place.  I probably would not have done so, if it wasn't for a very strange set of circumstances.  In November 2018, I found myself involved in my fifth rear-collision, a startling event that left me with more than two thousand dollars worth of damage to my (brand new) vehicle.  I drive approximately thirty thousand miles per year, so while this seems ironic, it may simply be a product of likelihood over time (i.e. simple statistics over fate).  I had already had my brake wear patterns examined to see if I had a tendency to brake too hard, and I did not. 

I had a few prominent concerns and curiosities after this fifth accident (aside from the financial and physical implications, which were mildly unpleasant).  First, I had premonitions about the accident for about four weeks before it happened.  Out of nowhere, I had started to "hear" a car slamming into me from behind almost every time I stopped at a light or stop sign.  I tried to view them as a simple throw-back to an old case of PTSD, but they kept increasing in intensity instead of responding to my efforts. 

Second, for twenty-four hours after the accident, I couldn't so much as make a right turn out of a driveway without having an anxiety attack, always envisioning a massive freight truck slamming into my car on the drivers' side.  I had never caused an accident, nor been broad-sided, so this was actually a non-linear way for my brain to address the trauma.  Again, I tried to address this through deep breathing and other techniques, treating it as a flare of prior PTSD.  I wasn't getting very far.  For that first twenty-four hours, I was plagued with severe mood swings, anger and anxiety attacks strong enough to leave me in tears. 

Third, I had the feeling that there was something metaphysically "off" that kept bringing this experience into my life.  Many biologists and attorneys would stop reading at the word "metaphysical," but then again, most of them wouldn't explain this kind of event without reference to "bad luck" either.   Something told me to visit a local shop called The Mind's Eye, which offers aerial yoga classes and typical accouterments of the "New Age" lifestyle.  Something told me they might have a modality that would help.  I had responded well to things like yin yoga, EFT and acupuncture in the past, so my hopes were not misplaced. 

I have to admit that I expected pranic healing to be more like reiki or even massage, as in "I thought they would touch you."  I also thought that I would lie down.  I thought that I might receive intermittent instructions through the process.  None of this was true! 

I was guided to a reclining chair and offered a cloud-soft blanket and pillow.  Rita, my healer, told me that I should lie back and close my eyes, but try to keep my palms outstretched in a receptive posture.  She also told me that I would hear intermittent spritzing of salt water.  There was a bucket on the floor partially filled with saltwater.  She explained that this is where any negative energy would be disposed of.  I told her she should have brought a bigger bucket.  Finally, I leaned back, closed my eyes, let the soft music in the background lull me, and started to unwind. 

Curious, I peered at Rita from time to time, and saw her drawing shapes in the air, sometimes with a crystal.  At intervals, she would grasp something invisible from the air and throw it into the bucket.  Her motions were intentional and rhythmic, and left me with an inexplicable sense of ease.  I started to realize that I was essentially signed up for an hour of non-motion and meditation, and tried to embrace it, letting go of the sense that "something" should be happening, or that "someone" should be doing something physical.  For the next hour and fifteen minutes, I had nothing to do except sit and be, an act difficult enough for those that don't have PTSD. 

As mentioned above, I was having powerful recurring imagery of a driver's side collision when I walked in.  These remained with me even after the session started.  PTSD "flashes" are experienced as reality, almost like a hallucination.  Although I knew that it was not happening, my body reacted as though it was in that present moment.  About thirty minutes into the session, the imagery became truly intense, to the point where I had to stifle a scream.  Then, I began to have a very realistic "daydream" about that particular accident, during which I experienced it with considerable detail...from the 1950s. 

My mind quickly transitioned to a funeral - my own - during which I was trying to comfort two teenage boys sitting in the front row - brothers.  During this moment, there was no question that they were my children, and the grief and guilt I felt in that moment was real.  I had an instant understanding: "You are afraid you will be killed in a car accident in this life, but you see?  It is the past you are fearing.  You were brought into this life so that you could heal."  When I saw the two boys in the my mind, they were instantly and irreparably tied to two people in my own present life (that I often have some level of conflict or difficulty with, if only because of our close relationships.)

After that moment, I couldn't recapture the thought of the car slamming into my driver's side window.  I could still recognize the thought, but I couldn't see details or bring any emotional currency to it.  Several moments after that, I was just overcome with sadness, grief, and disappointment.  Shortly thereafter, the negativity passed and I felt completely and utterly at ease.  This sense of ease didn't leave me for at least a week afterward, even through otherwise stressful or upsetting events (e.g. realizing that we had neglected to add rental insurance, realizing the repairs were going to take almost two weeks, and preparing for and cleaning up after the Thanksgiving Holiday.) I still can't recapture those powerful images of collision. 

There are almost always logical explanations for many types of New Age healing methodologies.  Perhaps I had a rapid improvement in my PTSD  purely because I had interrupted its development by with what was essentially a super long, relaxing, meditation session shortly after the accident.  Perhaps I had such powerful imagery solely as a symptom of PTSD, which often brings with it realistic nightmares and flashbacks, as well as sleep disruptions and feelings of dissociation.  Perhaps I imagined being a mother in the 1950s simply because I've always had an affinity for that post-war era. 

Regardless, I feel better and I feel better because I had a pranic healing session.  It's hard to argue with results, even those that arise purely from a placebo effect.  What is most important to me is that there is no doctor I've ever encountered that would have taken me through this type of healing activity, despite its clear benefits.   For this reason alone, I see value in these types of healers.  If you choose to utilize pranic healing based on my experience, I wish you all the best and ask only that you do not completely forego any traditional medical treatment that will otherwise work to your ultimate benefit.  Energy healing is an excellent companion, but not not always a worthy replacement.