Thursday, September 10, 2020

Pregnancy in the time of COVID-19 (with a splash of "must-haves")

When your blog goes dormant for about four years, it’s sorta random to start up again out of the blue. I guess a new life experience or chapter is all the more reason to write; processing the changes as they happen through writing feels like a reasonable thing to do. I’m currently nearly 39 weeks pregnant with our first child (a girl!), and have always found advice from my beauty pals of yesteryear that have entered the threshold of motherhood very helpful, so I thought I’d share some thoughts on my pregnancy so far. 


This year has obviously been a bit of an odd one as far as pregnancy goes, as it isn't exactly the norm to trudge through this massive life change whilst the world faces a pandemic. I'd been diligently keeping notes on how pregnancy has felt from week to week; from March onwards, I found myself writing more and more about thoughts on COVID-19 than my pregnancy. The note-taking kind of fell off from there, but thoughts have found their way into some paragraphs below. As usual, probably worth noting I'm not an expert on anything medical, let alone pregnancy and it's also worth stating every single pregnancy is different and that comparing one person's journey to the next is largely pointless. In my experience, it doesn't make it less engaging to read about someone's journey - I find every story related to pregnancy, labour, delivery and the fourth trimester fascinating because of the nuances, but that's just me. 

First Trimester Thoughts
We found out I was expecting by way of chance. We had been trying for a while (I chalk it up to only having one fallopian tube - my right tube was twisted and damaged in 2000; we imagine stress also factored in) and were about to begin cycle monitoring as we entered the new year. Cycle monitoring is when you visit a fertility clinic for an internal ultrasound and bloodwork from day 10 of your cycle every other day until you ovulate in order to pinpoint when you and your partner should try to conceive. With the help of basal body temperature tracking and PreMom ovulation predictor testing strips/app (pretty clutch), I knew that I ovulated late in my cycle, so the concept felt both daunting and invasive, knowing I’d probably be looking at 5-7 visits until we successfully detected ovulation each month for...as long as it would take, I suppose. We learned about cycle monitoring on January 6 and I was instructed to call them on day 1 of my cycle, aka when my period would start (which was due to start any day thereafter), and we’d be slotted in for appointments to monitor my ovulation progress thereafter. Days passed and my period never came. 

The hilarity/absurdity of early pregnancy is that the signs of pregnancy are basically identical to the signs of your period starting. I had cramping, I was fatigued, I felt all the usual menstruation symptoms I had each month for years. I decided to take a home pregnancy test the morning of January 14 and had a very faint positive. I contacted the fertility clinic that was going to conduct cycle monitoring for us. They offered to confirm the home pregnancy test results with a blood test later that week. On Friday, January 17, I went in for bloodwork first thing in the morning and that afternoon, I received a text saying a new message was awaiting me in the clinic's online portal. I logged into the portal to see that I was indeed pregnant with strong hCG levels. I screencapped the message and texted it to my husband. Soooo 21st century pregnant millennial, I know. We confirmed that my hCG levels were still on the rise with another blood test the following Monday, and away we went, determining I was about 4 weeks along already.

For me, pregnancy was pretty foreign territory. We weren't ready to share news widely, so we rode that wave together. In my experience, the level of exhaustion I felt was overwhelming. I could get through the work days, but by 7:30 p.m., I was out like a light. Hormones are working overtime to support embryo development until the placenta fully forms in second trimester, so that’s basically why first trimester is largely devoid of energy or desire to do just about anything. I took a step back from exercise entirely, eventually mustering up some ability to push through a spin class here or there. 

We went to Florida for a few days at the end of January to visit my mom (she had been there since the holidays); I spent most of it horizontal on the couch, staring at the ocean. Right before we went to Florida, we had an ultrasound that showed us two yolk sacs and two fetal poles and one heartbeat. We were potentially looking at a twin pregnancy. It was a lot to process, and not the easiest thing to fathom that early on in the pregnancy (we were about 6 weeks along at that point). As time went on, Baby A continued to grow and thrive while Baby B's heartbeat never developed and eventually, Baby B's yolk sac diminished and was no longer visible in our ultrasounds, a phenomenon known as vanishing twin syndrome. Our ultrasound tech urged us to focus on the notion that having one healthy baby would mean less complications than having twins that may struggle throughout the pregnancy. It wasn't easy to get past and our minds occasionally went to Baby B, but we were grateful that Baby A was growing on track. A couple of weeks later, we also found out that I had subchorionic hemorhagging and went on bed rest for a while. That was a curveball we didn't expect, which was a bit tough on our nerves. We also discovered that we couldn't do any NIPT testing or find out the gender of the baby before the 19-week anatomy scan because of the vanishing twin syndrome. It was a weird trimester and things were only getting weirder in the news cycle. We were away as COVID-19 entered Canada with the first known case officially surfacing the exact day we flew to Florida. From there, the cases mounted and we made a conscious effort to stay in or closer to home as the weeks passed in February.

First trimester was kind of like a sleepy, foggy haze cast over regular life. Habits were shifting or falling to the wayside (what was exercise or clean eating?), I personally hadn’t really processed the mental or physical changes I was about to undertake and it all felt straight-up odd because there was so much unknown with so much to learn ahead of us. Pregnancy was somewhat isolating at this point by our own choice to not share news until we were ready to do so. I wonder if we would make the same choices to withhold news and not socialize much during first trimester if we knew how unusual and isolating the rest of the pregnancy would be. We basically didn't socialize from Christmas onwards with anyone except family, which, unbeknownst to us, would become our norm for a while.  

Second and Third Trimester Thoughts
My dad, a retired doctor who had been following the pandemic perhaps too closely (he’d been housebound due to a recent knee replacement), instructed us to stock up on food and supplies to last us three months. I was rattled by his advice and thought he was projecting his anxiety onto us. Turns out he wasn’t entirely off the mark. We thankfully haven’t touched our emergency stash of nonperishables, but it’s been a surreal experience to be pregnant and not be able to fully embrace and utilize our final months as just the two of us the way we probably would’ve. I always envisioned many meals out and a trip or two to celebrate spending time with simply each other. I was in the midst of baby shower planning for July, which we then cancelled upon lockdown. I had never touched a stroller before, I’d never picked up a car seat or explored baby clothes or gadgets before. We've gathered everything we need with the help of family and friends. It’s sad that this pregnancy has largely been in lockdown, and that we couldn’t celebrate as intended, but we have had many loved ones rally around us with so much excitement for our baby girl. Shoutout to our coworkers and friends that held virtual baby showers for us and our kiddo - they were incredibly heartfelt! 

There have been moments of frustration and upset brought on by the circumstances we have found ourselves in for this pregnancy. It's been wildly isolating to largely commit to essentially only going to OB appointments and ultrasounds by myself with no support person due to COVID restrictions. At the anatomy scan, we found out the gender, but instead of sharing that moment together, my husband had to wait in the car. I asked if I could call him or FaceTime him or have them write it down on a piece of paper that we could read together. I was told 'no' to all of the above, so instead, he waited in the parking lot and I walked out and verbally told him when I handed him the sonogram photo. It was not the moment we had in mind. We told our families on a Google Meet (very fun to coordinate with the 65+ crowd). It was kind of devastating to not be able to hug any of our family members when we told them our baby's gender. There were lots of moments that we simply were not afforded, but that's life, isn't it? At times, it has felt like it's one thing after another that we're contending with in terms of concerns related to the baby's health and I suppose I've come to terms with the notion that that's what parenthood is - a steady current of worry and concern that underscores your days and nights. Mixed emotions and pregnancy twists/turns aside, we are incredibly grateful we were able to conceive at all and that our little lady is almost here. 

Pregnancy is weird in the best of times, but being largely out of sight and out of mind has made this time fly by for me, personally, while others largely lose track of how close we are to welcoming our daughter into this world. Many friends ask how many weeks we have to go and when we say it could be any day now, they're shocked. I imagine we're all shocked given that we started sharing our news via text in March (as the video calls started mounting) and it's now September and we're still largely spending time at home (well, we are, as we're quarantining prior to labour/delivery). We know it'll remain this way for a while for us as our kiddo arrives and develops her immunity. We will do everything we can to ensure she's safe and healthy, so we're settling in for a fairly quite fall. 

I've mulled on things that have made my pregnancy more bearable through the different trimesters. Here’s a brief rundown of things I found useful:

Physiotherapy (ideally specializing in Pelvic Floor Therapy)
We were well into lockdown when I started experiencing groin tightness and tenderness that was extremely uncomfortable. It was particularly tough in the evenings and overnight to get past, so I reached out to a physiotherapist friend and asked her if she knew anyone that was doing virtual sessions. She connected me with a colleague who specialized in pelvic floor therapy and was indeed treating patients virtually... and she was also pregnant! We had 3 appointments total before she went on maternity leave for her own daughter’s birth, but the impact she made on my pelvic floor health was tremendous and so greatly appreciated. Everything I had read related to pelvic floor health and pregnancy could be summed up in two words - “Do Kegels!” That’s good and well, but ultimately, I was experiencing an overactive/tight pelvic floor, so simply “doing Kegels” wouldn’t actually benefit me since I was already so tense. I’m incredibly glad I listened to my instincts to not just keep marching forward with this wild pain I was experiencing (legitimately couldn’t walk without discomfort or get out of bed without pain before seeking treatment). I’ve been keeping up with my stretches and I’ve also found that a pregnancy body pillow has helped minimize the discomfort as well. My physiotherapist also hooked me up with specific stretches and exercises to do from week 34 onwards to help prepare for labour/delivery, so I’m feeling like I have some good structure to follow as I prep physically for delivery. I think this is also a great thing to explore pre-delivery as it can help analyze and assess where your pelvic floor strength is before labour to help plan for post-labour stretches/exercises that can be done. 

I think being proactive when it comes to pelvic floor health is important when it comes to pregnancy. In order to prepare for my postpartum care, I sought out a local pelvic floor physiotherapist for in-person treatment before labour/delivery to clearly establish correct perineum prep to stretch/relax these muscles leading up to our due date and to have a physiotherapist to turn to postpartum (specifically after the 6-week post-delivery mark). Regardless of how anyone delivers their baby (vaginally or via c-section), the pelvic floor has worked overtime for 9+ months carrying extra weight and could likely use some dedicated time/attention/therapy to heal. I've been told this multiple times and now I'll preach it even before I've experienced it because honestly, I don't know that I need to delivery a baby to understand how important this is - don’t overlook your own health once baby arrives. Healthy mom is as important as healthy baby. I'm carrying this sentence with me into the fourth trimester - believe that. 

Lululemon Align Super High-Rise shorts/pants
As a person who has owned Lululemon Align pants since the initial launch in 2015 (I still have my first generation Align pants kicking around that I have worn during this pregnancy!), I was a touch skeptical that my pre-pregnancy size could actually fit me throughout my pregnancy. I’m now mere days out from my due date and can confirm my size 10 pants are holding up increasingly well! I also picked up the Align bike shorts (size 10) in a 10” super high-rise inseam (bold choices that could potentially look disproportionate on my 5’3” frame, but turned out just fine!), and I love them. They were great for the summer heat, painfully on trend (oh well!) and the compression is minimal yet still supportive for the belly. 

I also have dabbled in pregnancy-specific gear like Blanqi belly-support leggings and tanks (read: these seem to go on sale randomly, do not pay full price for them!). They smell absolutely strange (like...fuel?) and the smell never really subsided with my initial leggings and tank order despite multiple washes. I DM’d the brand about this on Instagram and they sent a replacement set without me even suggesting it, no questions asked, no exchange request, nothing. They just issued a new order immediately before they even replied to my direct message. It was great customer service (albeit a bit extreme?!), ...but the new set smelled the exact same. Stench aside, the support is pretty good, but it’s hard to get past the weird scent when your sense of smell is super heightened and on par with a blood hound thanks to pregnancy. I have still worn them plenty when I know I’m going to be stationary for a good chunk of the day at my desk (they are high-compression and minimize swelling), but I have found that by 3:00-4:00 p.m., I can’t keep wearing them! They just sort of slowly drive me nuts, which I suppose makes sense, as I am more compact in the mornings and gradually expand as I eat/consume fluids all day. I ordered a large in the tank and leggings and probably could’ve gotten away with a medium for the tank. The sizing was a bit large at first, but I’ve filled these garments out as I’ve moved towards the end of this pregnancy. Overall, if you luck out and don’t get a Blanqi purchase that smells like chemicals, enjoy the support! The fabric is quite compressive and thick, so I'd recommend these more so for pregnancy that doesn't stretch into the summer. 

Gin Gins (especially for first trimester)
I have been fortunate enough to not have thrown up at all (so far! we'll see how labour goes) in pregnancy. Nausea, however, was a steady challenge for a good stretch of my first trimester. Gin Gins ginger chews (pick your flavour or texture type - they’re all good) and organic ginger tea were the only saving grace. I found my appetite was pretty strong in the early weeks and then it was a “carbs are helpful, how did I ever eat salads daily?” stretch. I found I ate a lot more when I was at work, commuting back and forth. I think one of the important things to note is you only need 200-300 extra calories per day to support a singleton pregnancy (i.e. one embryo/fetus). I didn’t really understand why I’d always hear that deciding what to eat next was so challenging in pregnancy....then I started experiencing nausea and understood it entirely. One bad choice and it can throw off your whole day. I still have little bouts of nausea here and there and have stuck to mini meals and snacking over larger, proper meals, as they just don’t really appeal to me. This has remained true through third trimester thanks to raging heartburn. Tums should probably eventually go on your shopping list, too. 

HMF Prenatal Probiotic
I was seeing a naturopathy doctor for a while in 2019, as I was trying to regulate my hormonal health after well over a decade on the birth control pill. She put me on a HMF Genestra probiotic that helped balance out years of stomach challenges (I grew up lactose intolerant, I also had been on antibiotics for appendicitis and other infections over the years) and as soon as I discovered I was expecting, I sought out the prenatal version of the same probiotic on well.ca and started taking it daily. I’ve been very grateful that my digestion has been pretty consistent throughout pregnancy, which is not usually the case in pregnancy for many! Highly recommend this if you’re a person who already grapples with digestion challenges pre-pregnancy.

Province Apothecary custom facial serum
Switching up skincare was something that felt sort of hard to do when it came to pregnancy (and knowingly into postpartum). I have been a devoted user of retinol since 2013, so having to step away from it felt like such a shift in normative behaviour. I’ve taken short breaks from it before and have instantly seen expression lines deepen on my forehead where I raise my eyebrows. It’s a part of my routine that I am so steadfast about that cutting out virtually all actives felt like a weird compromise in my identity, which sounds so dramatic, but I think that’s pregnancy in a nutshell. You’re sharing your body, you’re making decisions that effect two lives, it’s all a huge shift that gradually prepares you for parenthood (if one can ever actually be prepared for such a shift). During lockdown around my 33rd birthday, I ordered a few hand sanitizer bottles from Province Apothecary and discovered that they offer custom facial serum blends. I filled out the questionnaire to determine what my skincare needs were and purchased the trial size. This stuff balanced out my skin in a way that was almost hard to believe. My breakouts vanished. I still had an abundance of post-acne hyperpigmentation (no actives meant no diminishing those for a *while*), but my skin was smooth, even in texture and hydrated so well. It’s not a small price to pay, but every other product I had been using was not agreeing with my skin, so I was happy to find something that finally did. It was a small victory that made me feel more like myself again, which is also something I was low-key hellbent on - not losing myself entirely in this very different stretch of life.

Natural Deodorant
There are lots of reasons to use natural deodorant, which I touched on years ago. I’ve flipped back and forth between deodorant and antiperspirant dependent on circumstances and weather. I usually opt for antiperspirant when working in an office space or in the summer months. That being said, It’s been a great stretch (working from home) to shift to a natural deodorant in order to get through the adjustment period. I’ve read that natural deodorant may not cut it when it comes to postpartum hormones and how they impact body odour (it’s apparently to help your baby identify you!); that being said, I’ve been using and surprisingly enjoying Drunk Elephant Sweet Pitti Deodorant Cream. I had never tried a formula that featured mandelic acid before, which is pregnancy-safe (hallelujah!); I am not a huge almond extract or essence fan normally (no, not a marzipan fan either), but I appreciate that there isn't a bold or fresh or 'spa-like' scent associated with this deodorant. It agreed with my body chemistry as soon as I tried it and it holds up pretty well (even through the ridiculous heat waves we've had this summer). Fingers crossed it continues to hold up in the fourth trimester and beyond. 

Pregnancy Pillow
As I entered the third trimester, my husband heard from a childhood friend that suggested we get a pregnancy body pillow. I had been resisting this so hard for a multitude of reasons. I felt like it was such a temporary stretch that I'd use a body pillow, I hated the idea of an object occupying such a huge chunk of our bed (I had already put a memory foam mattress topper on half the bed in order to spare my hips and shoulders when sleeping exclusively on my side)... the list goes on. Well, a 20% off coupon at Bed, Bath and Beyond later and this pillow was on its way to us. I wasn't even that big when it arrived, but I can say with confidence that I wouldn't be able to sleep at all without (not that I'm really sleeping that steadily these days in the homestretch). It provided support in places I didn't realize I needed it and I imagine I'll find uses for it postpartum as well. It's proven to be worth it's price given that sleep is seriously choppy as pregnancy progresses and you don't really sleep through the night. The short stretches you do get need to be sound, and I feel this pillow really helped me make the most of the brief periods that I can actually sleep.



I'd load this post with a bunch of photos, but honestly? I'm pretty wiped. Sleep is scarce already (anyone who says you should sleep before the baby comes is full of it), my body is tired and achey from carrying extra weight and I'm impatiently awaiting our baby's arrival. I hope this was somewhat useful for someone out there! 
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