Afraid of Giving Birth

Today I was reading something I never should have read - an article about some women choosing cesarean because they simply are too afraid of giving birth. And then I read something I REALLY never-ever should have read - the comments to that article. Some people saying that childbirth was painful so they don't want to do it again, some people saying that cesarean was even worse and some people saying that regular birth was painful but seeing the baby made up for the horrible experience. Well yeah, I do seem to have a very high pain threshold - I didn't scream or curse and I didn't beg for an epidural. And still, as I was reading other people's experiences, my mind took me back to that day with all the horror and desperation of being helplessly alone and suffering. I've tried to gloss over it thinking that Siiri made up for it and that it became okay the moment I saw a healthy baby. Of course nearly passing out from exhaustion did feel so wonderfully heavenly at that moment. But then again, when I think back at the entire experience, I get butterflies in my stomach and the urge to hide under some blanket.

I thought I was supposed to forget childbirth. There's some stupid urban legend about women being able to forget childbirth the moment it's over and then it becomes really foggy. For me, I think it keeps getting worse and worse. I mean, I remember how it didn't seem such a big deal right afterwards. It was simply a foggy memory of a truly sleep-deprived night that tested my patience and mental stability and all time became just minutes passing by, with the clock ticking too slowly and everything being a hazy nightmare that has to end sooner or later. I guess it's similar to soldiers going through their extreme hiking trip with heavy equipment and too little food. They survive it, it makes them feel stronger for surviving it and later becomes a foggy memory of past hardship. They don't really think about the experience but when they do remember it, they really want to avoid ever going through that again.

I didn't really think about birth for a long time but last week my pregnancy crossed over from carrying a fetus to carrying a potentially viable baby. If I have a preterm baby now, it will probably survive! This makes it all so real. I'm not simply pregnant - I'm actually carrying a baby that will soon want to come out! I'm gonna have to do that child birth thing again! It really is a horrible thought. It's like knowing that your dentist's appointment is approaching, only many times worse. Cesarean isn't a solutions either. With the dentist analogy, if a regular birth is like having your tooth yanked out bit by bit, then cesarean would be the doctor proposing, "There's an alternative to all that yanking - I could have someone punch the tooth out.".

I shouldn't think about the subject but on the other hand, I can't ignore it indefinitely. If I had birth right now I'd panic. Well, okay, I wouldn't panic. I'd simply get really defensive and spiteful in the birth department. I'd treat all the midviwes as potential enemies who just want to leave me alone with my contractions and everything. I keep reliving what I should have told them two years ago. I should have demanded a piece of paper to write my complaint on it. I should have told on them and accused them of endangering my life and Siiri's. They left me all alone - I could have died of a bleed in there! They didn't show me any emergency "call for help" button and even when I managed to tell some passing-by nurse to send someone to see me, it took an hour for that someone to arrive. Outrageous! Some people give birth in less than an hour. Should I have screamed for help? Should I have called the ambulance for some attention? I keep thinking that the least I could have done is to accuse them of neglecting me. If they told me I seemed perfectly healthy the moment they left me alone, then I would have just told them that I was giving birth and if giving birth is really so safe then I could have done it in some remote cave in the mountains. Why bother visiting THEIR hospital in the first place if it's as safe as giving birth in a remote cave...

I'm so angry at them for making me be afraid of childbirth. I know they're the best hospital in the area and they simply made a small mistake. It was some student who took me to that birth room and she really thought I wasn't really giving birth and I was calmly sleeping in that bed. When she left, she dimmed the lights and nearly tried tucking me in. I guess she had never seen an active birth with irregular contractions and there's a first time for everything. On some level I don't blame her at all but still, when I think about that night, I get really scared. The worst part is that I don't simply start thinking scary thoughts, I get physically scared. I get all tense, pull my shoulders up, feel shaky inside my chest and I bet I look deeply worried as if the doomsday is approaching. That's extremely far from the inner calm and well prepared attitude that is needed for a pleasant birth experience. I have to deal with my fear, otherwise the second time might be even worse than the first one. I could get very tense and make a potentially bad experience into a horrible one.

I'm gonna have to start preparing myself for the inevitable. I have no plan of action. I'm hoping tomorrow I'll be back to ignoring that the due day is approaching.

Iron Rich Foods

The last time my hemoglobin level was screened, it had dropped from 129 to 112. I was expecting something around 125, which would be very healthy for anyone, especially during pregnancy, but all I got was a lousy 112. The midwife said they don't worry until it's under 110, then realized how close my result was to 110 and corrected herself by saying that they don't recommend iron supplements until hemoglobin level drops below 105. Not so reassuring .

I have an idea why it might have dropped so fast during this pregnancy. I eat less meat. During the first trimester I suddenly didn't feel like eating meat and I didn't mind eating similar food to the one I make for Siiri - lots of carbs, plenty of vegetables and a bit of meat. I didn't fry a pork steak or serve a plate full of chili con carne with a slice of bread. I made REGULAR food. You know, the kind that is usually considered "healthy" . And this "heatlhy" nearly vegetarian menu almost made me anemic.

Problems are to be recognized and dealt with. I clearly don't get enough iron with food so I should eat more foods that are high in iron content. Right? Well that's what the midwife said so it must be right. So I should just eat plenty of beetroot, strawberries, beef, spinach, cereals and soybean?

There are so many foods loaded with iron but it's important to note that there are two kinds of iron: heme iron and non-heme iron. I've understood it has something to do with iron oxidation states. In animals iron is usually stored inside a structure called heme and has an oxidation state Fe(II). This heme with the iron is then used in red blood cells for oxygen transport. This kind of iron is quite easy to absorb from food. The other form is called non-heme iron, usually Fe(III) and that's hardly absorbed at all.

It's actually helpful to consume non-heme iron with antioxidant vitamin C, partly because it helps reduce Fe(III) to Fe(II) (source). Otherwise non-heme iron is actually pretty useless. Also, non-heme iron is usually consumed with lots of fiber. You know, "eat lots of healthy fruit and vegetables, they're full of fiber!". Fiber is horrible for iron absorption! It gets even worse. Most fruits or vegetables contain oxalates which bind divalent metallic cations like calcium or Fe(II). So the little amount of iron that gets reduced to Fe(II) and could possibly be absobed, in stead gets stuck on some oxalate and gets peed out. All you vegetarians out there, good luck getting your iron from food!

Lets talk numbers. Men need 10-20 mg of iron per day and women need around 20 mg. Pregnant women require roughly 30 mg of iron daily and anemic people are supplemented with 60 mg of iron once or twice a day. I should aim for at least 30 mg, if not even more. To simplify matters, I want to know how much I would have to eat each food to get 30 mg of iron. What I'd have to eat in one day, starting from heme iron: I would have to eat 860 g of beef, 2300 g of chicken leg, 1300 g of turkey, 670 g of trout, 3750 g of canned tuna or 350 g of oysters. That sucks. I can't eat that much meat every day! How about vegetarian sources of iron... Lets see, 860 g of cooked spinach, 670 g of oat flakes, 680 g of almonds, 1760 g of dried dates, 2140 g of potatoes, 1760 g of brown bread, 3000 of beetroot, 7500 g of strawberries, 3000 g of broccoli or 860 g of beans. That doesn't really help a lot.

Today I bought strawberries thinking they're a good source of iron. If I had known that I'd have to eat 7 and a half kilos of strawberries to reach my daily iron need, I would have only bought them for their taste. Also, I didn't know strawberries were a rich source of oxalates so the iron won't get absorbed anyway. Another food usually mentioned as a great source of iron is spinach. Popeye ate it for its high iron content and it made him strong. I guess he never read that spinach is so full of oxalates that they practically negate all the iron they contain. Rhubarb is sour because of oxalic acid and in not recommended for people with iron deficiency. I think this fact I'm going to have to ignore. I want rhubarb pie! I need my rhubarb pie and I'm gonna eat it no matter what those nutritionists say!

Uhm... I guess all that talk about simply eating iron rich foods is about as trustworthy as taking homeopathic medicine to relieve iron deficiency. It is nearly impossible to get the recommended amount of iron with food and it's practically impossible for vegetarians. 200g of beef each day with various iron-rich foods might add up to 10 mg of iron and that seems very realistic. However, three times that would simply make me fat.

I dislike the idea of food supplements, and I dislike the idea of having iron pills in my home since iron poisoning is the leading cause of poisoning in children in USA. Not the safest thing to have in the same apartment with a creative and curious toddler. I'll try eating lots of heme iron and non-heme iron with vitamin C with various foods. I doubt it will help much but at least now I know not to eat strawberries with the intent of getting my daily iron.