October 10th, 2005

Continuing, belatedly

Once upon a time, the medical community claimed that postpartum bleeding would stop in 10 days to 2 weeks. Then they started researching it, and revised that first to a month, then to 6 weeks. However, scheduling postpartum checks at 6 weeks really doesn't work well, because a big enough fraction of women are still bleeding (or, as we'll get to in a minute, bleeding again) that the pap smear one might do then has to be delayed. Some midwives are starting to do 8 weeks checks instead.

That period would come back, in the absence of breastfeeding, according to the same medical community we don't particularly trust any more, in 5 to seven weeks (which you can see might mess up even the 8 week check up). A quick glance around some of the online forums associated with articles on this topic suggest, however, that the range on when period bleeding returns, and what it's like and how regular it is ranges from days after delivery to years. Toss breastfeeding into the mix, and while the average or typical may move, all the possibilities are still in play. Yet so many people emphasize that breastfeeding delays menstruation and often ovulation that a lot of health care providers do not believe that a period during the first 8 weeks could be a period if breastfeeding exclusively. And yet, that same medical community, once it pulled its head out of wherever it had parked it, has showed convincingly that some women _do_ ovulate while exclusively breastfeeding before the 56th day.

Based on this, a reasonable health care provider should say, hey, don't have sex until you've stopped bleeding for at least a week. We'll at least talk on the phone at 6 weeks. Monitor what's going on with you, write it down if you can, so we can figure out what the next step is together.

Furthermore, we need to get the word out more widely that men should not be expecting intercourse or anything penetrative for at least a month, more like two, after a woman has a baby, however it was delivered. That should at least reduce the pressure on women. Some women (one of my older friends, and my sister) both adamantly said they had a strong desire to return to sex within this time frame. It is worth nothing that breastfeeding ended quite quickly for both of them. This is a small data set, but I think we ought to consider studying hormone levels, and tracking them against bleeding patterns, breastfeeding, return of ovulation and menstruation, and overall mood. I think if we studied this for a while in a wide range of women, we might gain some insight into what is actually going on, what is worth intervening in, and what interventions are helpful (and which ones are harmful).

Rant off. Mostly.

We've had a couple really good night's sleep, not interrupted, but getting Teddy back to sleep for three hours in the morning is a huge win. He did that Friday night and Sunday night. Woohoo! Cloth diapering continues; we got a diaper pail and my current goal is to Not Have to Do Laundry Every Day. This requires enough clothing for me, and Teddy to get through a couple days without running out of clean clothes (I expected this to be difficult, but somehow it didn't occur to me to buy a postpartum wardrobe ahead of time. I'll do that next time, since I now have some sense of how to size things). We're still using disposables at night, which means 2-3 in a 24 hour period, instead of a dozen. This has drastically slowed our progress through the Big Box of Diapers from Costco, and may mean we don't need to buy more until the next size up. Kinda cool.

Under the heading of TMI, the whole cloth diapering thing has caused me to give into Crunchitude and order some Luna Pads. Also some Lily Padz, silicone breastpads that _stop_ leaking instead of just trying to absorb the milk and getting soggy. I'll let you know how they all work, whether you want to know or not.

We all went around Green Lake on Saturday without stopping once! Wow! I was very excited. R. carried Teddy, which was why this was possible. It rained, which meant parking was not difficult. Afterwards, we went to Kidd Valley for burgers, then stopped at a friend's house to drop off a late birthday present and feed Teddy in the car and change his diaper in the car (which worked! omigod! I amuse easily, as I'm sure you can tell) and then we went to Whole Paycheck and bought groceries. Teddy lost it big time on the way home, hardly surprising. That was a long day. Sunday was much mellower and he seems to have mostly recovered his equilibrium.

Last week Teddy and I got through a whole week without a doula, or R. spending a day at home. He did help out a _ton_ in the mornings, which made a big difference. I hesitate to say we've gotten the hang of this, but we are improving.

Currently reading _Playful Parenting_ by Lawrence Cohen, which I highly recommend. It's just like the Gottman book, but instead of being all about talking, it uses play to connect instead. Previous read was Jan Hunt's _The Natural Child_, which is good, but less useful in terms of detailed ideas.

I called my oldest sister to tell her she had a new nephew and talked to her for a while. The light box she got a couple days ago has made a huge difference in mood and energy levels (at least temporarily; with CFS, anything can happen, because a lot of CFS is about managing limited energy, and people with CFS are not necessarily great at doing that). We had a very pleasant conversation that gave me furiously to think after. Pity poor R. who then had to listen me review every story I tell about my childhood and adolescence (and a few others I don't often or even ever tell) and rethink it in light of realizing that (a) while D. taught me all the math I learned until 3rd quarter freshman college calc, she doesn't remember doing this at all and (b) she has thoroughly confused me with my younger sister. It's almost like I wasn't there my whole childhood. I knew I was somewhat neglected (I attribute my adult outcome being relatively good directly to that neglect, since my sisters got more attention and took more damage), but a sharper adult eye on the events of my raisin' suggest I'd underestimated how little any one in that family paid attention to any one else at all, and me in particular.

Quite shocking. This will not be repeated in my next generation.