Hapai in Hawai’i

April 29, 2024 No Comments

This might be unpopular opinion,…but I love being pregnant.

PAST

I’ve met a few other women in my life that have felt the same way but most don’t. And that is totally ok. There is no right or wrong way to be pregnant. I was very fortunate in my pregnancies that my symptoms were limited. Food aversion in the first trimester and some hip pain with sleeping in the third trimester. I admire my sister for having gone through three pregnancies where she was ill and throwing up essentially until the baby was born. Knowing I would feel ill for 9 months, I don’t know if I could have done it three times. And she did all of this while being in residency or already a mom to two kids and an OBGYN attending. I wholeheartedly understand when she says she doesn’t like being pregnant.

It’s also ok to like certain aspects of pregnancy and dislike others. Pregnancy, like many things in life, is complex and not black/white. I don’t want anyone to feel they have to have the same experience as me or feel bad that they didn’t enjoy pregnancy.

In my experience, pregnancy was wonderful. I loved the growing belly, and the baby kicks, and looked forward to the birthing experience.

First Trimester

As I mentioned, I had food aversions during the first trimester. I didn’t feel ill, I just had no appetite for anything. This didn’t bother me too much during my first pregnancy. With a toddler at home to feed, however, it seemed like such a big task to find nutritious food to offer my toddler and not just live off of noodles every day. Thankfully, noodles are a favorite food in my toddler’s book. But I wanted to make sure we hit a few more food groups with our meals.

I ended up losing a few pounds (similar to the first pregnancy). However, I started at a lower weight than the first time around. This was mainly due to the hectic life of a full-time working solo mom and not that I was actively trying to lose weight. I was at the lowest weight I had been since graduating High School which scared me a bit so I tried to eat, even if I wasn’t hungry.

Thankfully, I didn’t have the nausea or extreme fatigue others experience. Shortly after entering the second trimester, the food aversions started to lift. I rejoiced in the fact that fruits and vegetables were appetizing again.

Second Trimester

The second trimester was fairly uneventful. I noticed a baby bump quicker than with the first pregnancy, which is expected. I also felt the first fetal movement much earlier, at about 15 weeks.

My ultrasounds and genetic testing happened in Honolulu. It was WILD to me that the Women’s Health Center on Moloka’i didn’t offer genetic testing. Especially since the facilities of the same hospital system in Honolulu did. One would think they could extend their lab contract to Moloka’i and spare the pregnant patients an expensive trip to Honolulu for a blood draw.

As with my first pregnancy, I did not want to know the sex of my baby in advance. I feel we have so few good surprises in our lives these days that this was a surprise I was curating for myself. I repeatedly told doctors that I absolutely did not want to know at every appointment. Especially the ultrasound appointments! I always closed my eyes when they placed the probe on my stomach until they told me it was safe to look.

As the sex was not mentioned in any report, only the doctor who did my fetal anatomy ultrasound and my OB at the end of my pregnancy knew in advance which sex my baby had. Ultimately, I didn’t care which sex my baby had. I feel there is way too much pressure put on a baby’s sex. However, I can also understand parents being interested in finding out as soon as possible.

Third Trimester

I stayed in Hawaii until I was 35 weeks pregnant. The belly continued to grow and I continued to go about life as usual. The pregnancy hardly slowed me down while caring for my energetic toddler. I occasionally went to bed earlier, but I still did all the cleaning around the house, the grocery shopping, and packing for our departure. What other option did I have? I felt physically well too so it was fine.

The office staff threw me a baby shower during my last week at the office. They are such sweet people.

I also managed to shoot with a local photographer again. It was sort of spontaneous and the rain cut our session short but we still managed to get some great pictures!

At 35 weeks pregnant, I schlepped my toddler, car seat, carry-on, and two suitcases from Moloka’i via Honolulu to Ohio. We were only there for a day before my toddler and I flew to Texas to meet up with a fashion photographer. I’ve known her since High School and have always wanted to shoot with her. Our schedules didn’t align during my first pregnancy so it was a top priority of mine that I make it work this time around.

We got some amazing shots! I’m in the process of printing a selection out as posters for our current apartment.

After the shoot, I drove to Austin to meet up with my good friend and finally met her baby boy. We enjoyed a day of mommy/children time together. The following day, it was back to Ohio to pack and get ready for Germany.

The final stretch

I arrived in Germany just shy of 36 weeks pregnant. We stayed with my aunt and uncle for a few weeks while we got the basics set up in our new apartment. I celebrated my birthday with friends I hadn’t seen in over 6 months. My toddler started German daycare and loves it.

Having my toddler in daycare and not working as a physician, this was the first time in almost three years that I consistently had a few hours of “me-time”. Much of that time was still spent getting errands done that were more easily done without a toddler. However, I also made it a priority to sit in a cafe and enjoy a beverage peacefully. Had I not been pregnant, I would’ve made several trips to a spa for a massage or facial.

Differences in Prenatal Care Before Delivery

With both of my pregnancies, I worked until about 35 weeks. In the first, I then traveled from South Dakota via Wisconsin to Ohio. For this last pregnancy, I traveled from Hawai’i via Ohio to Germany. For both, I did my routine prenatal care with a different provider than the one around the time of delivery. In America, my delivery was assisted by an OBGYN. In Germany, my prenatal care was done by an OBGYN but my delivery was assisted by a midwife. Midwifery is much more prevalent in Germany than it is in America. Many women do their prenatal care with midwives as well.

German Benefits

Since I didn’t work in Germany, many of the peripartum benefits didn’t apply to me. I spoke with my friend about what benefits are available. Just to name a few things:

Some women are not allowed to continue working the moment they become pregnant if their job poses a risk to the pregnancy (such as daycare workers, teachers, flight attendants). They stop working but continue to get their full pay.
Physicians (interestingly enough, given the constant exposure to disease) are still allowed to work BUT are only allowed to work the day shift, and aren’t allowed to draw blood or administer chemotherapy (among other restrictions).
The pregnant person receives 100% of their salary during the time they are not allowed to work
6 weeks before the due date and 8 weeks after are protected times and no pregnant person has to work while still receiving pay and job protection
After the 8 weeks postpartum, the “Parent-time” starts. The regulations are currently changing a bit but essentially, you get paid a percentage of your salary up to 1,800 Euros a month during the parental leave which lasts 12 months.
You can take unpaid parental leave until the child is 7 years old and your job is secured during that time.

Pregnancy pokes

One of the benefits I was able to partake in was prenatal acupuncture. I went once a week to see a midwife who performed acupuncture on my lower legs. The thought was that the points targeted increased the energy flow to the cervix and uterus and would decrease the time of labor. The week before my due date, we added a point that was meant to induce labor. Did it work?

It felt like a little spa treatment of sorts. It was an opportunity to just relax and focus on the pregnancy. Ultimately the delivery was shorter than with my first child (not uncommon for the second child). The delivery happened 4 days after the induction points were targeted. So, who knows?

PRESENT

We went on our first family trip since the last post. We drove to Stuttgart for my godchild’s confirmation. It was a 4.5-hour drive. We made it with just two potty/breastfeeding breaks along the way.

It was a nice weekend of spending time with family. The view from my great-aunt’s house is always lovely. The pretzels in the south are just better, so a lot of pretzel breads were eaten. I wish we would’ve stayed a bit longer but the weather was oddly freezing and rainy. We wouldn’t have been able to do much with two small children. Wrangling a toddler in someone else’s house is not exactly relaxing for me. Hopefully, we will head back again in the summer.

FUTURE

I am fully in planning mode for future trips. These plans seem to constantly be changing as family and friends ask if I want to join them on trips. If plans work out as they are currently planned, we will have about two trips at least per month for the rest of the year. I’m excited to be going on some trips with my sister (who currently lives in Austria). Many European destinations but also some northern Africa and Asia will be included.

Should be quite the adventure to travel with two small children as a solo-mom. Stay tuned!

mfg

Happiness, Motherhood

And just like that… we are three.

April 10, 2024 1 Comment

The news is out! I’ve welcomed a second child into the world. It was always my intention to have at least two children if possible. I’m beyond grateful that this is now my reality.

I will be taking off the rest of the year from my work as a locum physician to spend time with my kids and do some traveling. My goal is to share much more about my solo motherhood. I’ve received several requests to do more content about being a solo mother by choice. I’m thrilled there is a demand for it and excited to deliver. I’ve always been an open book about this topic whenever anyone would ask me about my decisions. I’m hoping to bring more awareness to this lifestyle, support those considering it for themselves, and cheer on those who are living their lives as solo moms!

I will be sharing videos and info on Instagram/TikTok/Facebook. Additionally, I’ll continue to go more in-depth about these topics here on the blog. As I plan on traveling with the kids soon, I’ll be sharing this as well. I will continue to respect the privacy of my children. This involves not showing their faces in pictures or using their names in text.

I plan to cover the different stages of becoming a mother for a second time as well as being a SMBC. Hopefully, you’ll continue to join me on this journey. Feel free to suggest topics you’d like to see covered or questions you’d like answered! I will do my best to address them!

For this (and possibly future posts) I will split it up into Past, Present, and Future segments. This way, I can discuss my pregnancy journey that was but also keep you in the loop of what is going on now and what is to come!

PAST

Trying To Conceive

My siblings and I are all about 2 1/2 years apart. I wanted a similar age gap for my children. Although trying to conceive and pregnancies can be very unpredictable, I did more or less achieve my goal. After several months of being in Hawaii, I started looking for clinics. It will come as no surprise that there was not one located on Moloka’i. I did speak to the midwife on Moloka’i, who recommended a fertility clinic in Honolulu.

Thankfully, the fertility clinic offered virtual visits for the initial visit. I am a rather straightforward case. I have no known fertility issues. A workup was done with my first pregnancy. I already had sperm bought and didn’t need any hormone assistance for my cycle. Nonetheless, they did want me to do an ultrasound before the first IUI. For regular readers, you’ll know the difficulties of traveling to/from Moloka’i. For the first few trips to Honolulu, I traveled with sort of an entourage. My sister was still in town watching my first child while I was at work, so everyone came along for doctor’s appointments. It was a nice change of pace for us to be in a big city for a few days.

Attempt #1

Since everything looked fine on the ultrasound, I was able to attempt an IUI with the next cycle. I had regular periods for many months before trying to conceive which ended up being extremely helpful with travel planning. Given how unreliable the local airline was, I couldn’t book a ticket the same day or the day before. Consequently, we would spend two or three days in Honolulu. This in itself was not cheap given how expensive Honolulu is. However, given how time-sensitive an IUI is, it was a necessary expense.

I was so stressed during the first attempt. Besides the usual stressing over whether I would get pregnant, I stressed whether we would make it on time with our flights. Not surprisingly, our Honolulu flight was moved by the airline. I felt it was safer to fly to Maui rather than Oahu from Moloka’i and then catch a flight with Hawaiian Airlines from Maui to Oahu. The flights from Molokai to Maui seemed to have less disruptions than those to Honolulu. My sister was back in Austria at this point. Luckily, she had a friend who lived in Honolulu. She was able to watch my child while I went to the fertility clinic for the IUI.

Two weeks later, I took that test. And it was negative. I wasn’t really surprised by this. I just felt too stressed and I didn’t expect it to work right away anyways. Becoming pregnant is ultimately up to Mother Nature (aka biology). You can only do so much but there are so many things that can happen along the way that result in you not getting pregnant. Almost immediately after the negative test, I went ahead and booked my flights and accommodations around the time of my expected next fertility window.

Attempt #2

Having everything booked and squared away at work made me much more relaxed the second time around. My toddler and I flew to Honolulu, ate some good food, and waited for the smiley face on the ovulation test. It appeared as expected and I was able to go into the clinic the next day for the IUI. My sister’s friend again had some time to watch my toddler during the procedure.

An IUI, or intrauterine insemination, is rather straight forward. A speculum is inserted into the vagina to help visualize and access the cervix. A very thin catheter is inserted through the cervix into the uterus and the washed sperm is inserted. I had to lay on the exam table for an additional 10 minutes before I was able to get up and leave. That’s it. Easy peasy.

Clearly, I had a very limited non-work-related wardrobe

Halfway around the world

About a week after the 2nd IUI, we headed on a very long journey to the other side of the world, Germany. This was probably the longest traveling journey I had done so far with a toddler. The time difference between Hawai’i and Germany is 12 hours. Given how long the traveling was (we arrived two days later than we left), my toddler didn’t have significant jet lag. I have only ever experienced jet lag by proxy (because my kid would wake up at odd hours) but not for myself.

I was in the kitchen of my aunt and uncle’s place when I read the result of the pregnancy test.

Positive!!

I was so relieved.

Those who have actively tried to conceive will likely be able to relate to the feeling of relief from that positive pregnancy test. Not only the joy of being pregnant but the instant resolution of stress related to further attempt planning and waiting on a positive result. I am nonetheless always very reserved with my joy about pregnancy because I know how much can go wrong before it all goes right. But at that moment, I was just so happy that it had worked again.

It’s always a gamble to announce a pregnancy early on but considering we were throwing a family reunion, I did inform my family and close friends of the positive result. Always with the caveat that it was still early and a lot could happen. Ultimately, it was up to Mother Nature and I let her take the wheel.

PRESENT

Life with two kids has been a transition… for us all.

Before the arrival of my second child, it was just me and my toddler. Living in rural Moloka’i, this was even more the case than if we had been around family. It was just the two of us against the world. I prepared my toddler weeks in advance for the arrival of a baby. I made a personalized book explaining what would happen when I go into labor so that they would know what’s going on. They were so excited to become a big sibling. I was excited for them,…and also a bit scared of what the transition would be like for them.

Reflection and Growth

The transition has been beautiful but also hard at times. I never really felt that motherhood was hard until I found myself in the position of my toddler having an age-appropriate meltdown and my newborn needing my attention as well. My heart felt torn in two. I had to triage what needed to be done. Thank goodness for the years of medical training to help with that task and stay (relatively) calm. There have been moments where I was not as collected as I would’ve liked to be. The sleep deprivation likely didn’t help much in those moments.

My patience wasn’t as high for toddlerisms as it typically was. After reacting more harshly than I’d like, I’d feel awful that I reacted with a harsher tone. I made sure to apologize to my toddler for my tone so they know they don’t deserve to be spoken to like that. After reflecting on these moments, how they made me feel, how they must have made my toddler feel and how I would like them to feel instead while also reiterating the age appropriateness of their behavior, things have improved.

One of the things that surprised me the most was how I mourned the loss of the closeness to my toddler. Before the baby, I could focus my entire energy and attention on my toddler. Now I couldn’t. I missed our snuggles, our hugs, our playtime. I felt us growing apart. Thankfully, I have family and friends here who jumped in and took over some of those needs. But it still meant they didn’t have their mom there all the time and I didn’t have those experiences with them.

Now, I make the effort to seek closeness with my toddler in the few moments I don’t have the baby in my arms. Even when I am holding the baby, I get down on the ground and play with my toddler as best I can. I feel we’ve developed a new form of closeness that is meeting most of our needs at this point. I am confident we will continue to find our groove.

FUTURE

Not surprisingly, I’ve been feeling the urge to travel again. I’ve booked the three of us a trip to Mallorca, Spain towards the end of May. We might take a road trip to the Netherlands towards the beginning of May (depending on the weather). In a couple of weeks, I am taking the kids to southern Germany for a family event.

Traveling with two kids will certainly be another learning experience I am ready to take on. I recently came across the Bucket List Family on Instagram. Although they seem to be living the life I would love to live, being a solo mom with two kids would make such a lifestyle much harder. I’m happy to do a light version of their lives and travel often with my kiddos. I’m excited to show them the world and experience different cultures together.

I hope you’ll continue to follow along!

mfg

Motherhood

Let’s talk about Postpartum (Part 1)

November 9, 2021 1 Comment

Peanut is now 6 months old and it feels like just yesterday but also oddly really long ago that I was in the postpartum phase of my fertility journey.

As a medical student and resident physician, I did not receive a lot of training about the postpartum period. The postpartum period is generally considered the 6-week timeframe following delivery. I knew the big pointers and things often tested on exams:

the difference between Baby Blues and Postpartum Depression
vaginal bleeding goes through different phases of coloration
the uterus size decreases over several weeks
breastfeeding does not necessarily come naturally to the birthing person and/or baby
sore nipples if breastfeeding
how to monitor baby’s weight gain appropriately

That’s about it. I would venture to say that most of you reading this know about most of those things even if you or your partner haven’t gone through the postpartum period personally.

My co-residents/baby doctors visiting us Postpartum Day 1

Learning from experience

I definitely did not feel fully informed/prepared for the recovery time after delivery. All of my knowledge was so generalized. Yes, I knew I would bleed, but for how long? I knew that I would have sore nipples if I was successful with breastfeeding, but for how long? And I figured the vaginal area would hurt after pressing a human out of it, but again, for how long? When would it be ok to start working out again? Which workouts would be best?

I had a great birthing experience, was able to do it without pain medications, but I did have an episiotomy. Every birthing story is unique and I can only speak from my own experience from the singular birth I’ve ever gone through (as the birthing person). So the experience is likely very different for someone who had an epidural or difficult delivery or there were problems with the baby.

Talking to my tribe

Speaking with my friends in Germany who have given birth and following their postpartum journey, I was reminded of how very different the postpartum period is depending on your location. It’s a special feeling speaking with others who have gone through labor and delivery because they can understand and relate so much better than someone who hasn’t. That’s essentially the case with any experience in life though really. That’s why support groups can work so well.

I asked my friends and my Instagram followers to share some of their stories and experiences with me. I want to summarize some of the things they shared over several posts. Additionally, I’d like to highlight some of the differences between a postpartum journey in the USA versus Germany. Finally, I’ll share some of the products birthing people and their partners shared with me which they found particularly helpful during the postpartum period. (I am not receiving any merchandise or financial reward for mentioning any of the products. These are purely recommendations from people who felt it made their postpartum lives a bit easier.)

Postpartum Surprises

Personally, I didn’t anticipate how hard it would be to just sit down anywhere after my episiotomy. Healing from that was really the only thing I disliked during my postpartum period. Everyone gets instructed on perineal care after delivery even if you don’t have a tear or episiotomy that needed suturing. Essentially every time you use the restroom, you have to flush the area with water to keep it clean. Now imagine a major wound healing in the perineal area. It made walking uncomfortable and sitting comfortably nearly impossible.

Add to that the normal bleeding after delivery. Going to the bathroom was such a process. Changing the blood-drenched padding, waiting for the water to be somewhat warm so you could fill the squeeze bottle with it, flushing the area, patting the area dry, applying the pain-numbing spray, and getting all dressed again, every. single. time.

Poop PSA

Speaking of using the bathroom. Let’s be very frank about pooping after delivery. (Pooping during delivery is totally normal and I assure you neither the nurses nor the doctors care one bit. If you are worried about your partner feeling some type of way about it, maybe reevaluate your choice in a partner) Postpartum pooping is not a joke. My advice to everyone having a delivery… DO NOT FORGET TO TAKE STOOL SOFTENERS! Between the hormonal changes, not drinking sufficient (if any) water during or after delivery, the organs shifting into a new place after the baby is out, and extremely decreased physical movement after the delivery, constipation is nearly unavoidable.

I was very diligent about taking Miralax during my pregnancy. In the hospital, I was given a stool softener. When I arrived back home 24 hours after the delivery,… I forgot to continue taking the Miralax. BIG MISTAKE. I have never been so constipated in my life. I was also worried about the episiotomy wound healing ok while trying to have a bowel movement. If you remember anything from this post, please remember to take your stool softeners after delivery!

What surprised the Tribe?

Here are some of the responses I received when I asked, “What surprised you the most about the first few weeks after birth?”

How I slept with the light on because I was afraid of everything!
How awful breastfeeding is./The struggles relating to breastfeeding./ That breastfeeding is not a given and works right away
All the blood. All the belly. And how quickly it went away!
The impact of sleep deprivation on every. Single. Area. Of my life
How little sleep I actually needed
My joints did not feel strong for a long time! They almost felt wore out. Boo!
That first post-birth poop. Nothing prepared me for that lol (Remember people, stool softeners are your friend)
No time for anything – even though we were two people. Sometimes hardly found time to eat
How tired/emotional I felt, how terrified I was of doing something wrong
Bladder control after, cramping while nursing, overproduction of milk
Crying for no reason!
How the baby was emotionless until week 4-6. Cried at birth, but within 10 minutes just quiet and examining.

I can relate.

I could relate to quite a few of these. It took me a few nights to figure out just how much light I needed in the room to sleep and function when the baby was awake. I tried different night lights and having the lights on in the hallway. Eventually, I landed on just having the light from my Owlet base station be enough for me to see in the dark once my eyes adjusted. That is still all the light I have on during the night now.

My breastfeeding experience was rather uncomplicated except for the sore nipples. Oh my. It is quite the transition from not using your nipples and trying to avoid wardrobe malfunctions to having them constantly being used and whipped out in all sorts of settings. I’ve been a rather flat-chested person for most of my life. The engorgement and sudden seemingly Pamela Anderson-sized boobs were an experience. There were definitely a few days where it hurt pretty bad for the first 30-60 seconds when the baby latched on. With time, lots of nipple cream, and repeated use, the pain disappeared and the cracks healed. My boobs had a different shape, size, and consistency to them multiple times a day for the first several weeks. Eventually, those changes become more subtle.

Sleep deprivation was not a huge issue for me. It just feels like I have been on call for the past 6 months lol. Medical school and residency definitely trained me well. A while back, I learned that breastfeeding parents don’t interrupt their sleep cycles like non-breastfeeding parents do when they are awake with the baby. The body is wired in a way that allows breastfeeding parents to quickly fall back into the sleep cycle pattern they woke up from. Mother Nature’s way of trying to help with the sleep deprivation a bit, I guess.

Postpartum awareness

Society at large knows more about pregnancy than it does postpartum. There is also the weird fact that pregnant bodies are admired and praised while postpartum bodies are immediately judged and misunderstood. I hope to raise some awareness about postpartum and normalize it. It’s the fourth trimester and belongs to pregnancy as much as the first three trimesters with the baby still in the belly. It has its own unique challenges and I would say a much steeper learning curve than any of the trimesters with baby still on the inside.

I would love to hear from you about what surprised you the most about your own or your partner’s postpartum journey! Let’s share our experiences so postpartum parents don’t feel so alone in their experience and soon-to-be postpartumers are a bit more prepared for what’s to come!

mfg