Wednesday, September 25, 2013

We Denied Our Nanny Health Insurance

Once upon a time, we had a nanny. Ok, it was a nanny share. HeyMama was 3 months old, and my friend/coworker had a son who was a few months older. They lived less than a mile away. We decided to share a nanny to care for both kids. 

We're law-abiding citizens who happen to have work benefits that encourage paying childcare on the books vs. under the table. So we payed payroll taxes. We got workman's comp coverage. We enlisted a payroll company to prepare weekly paystubs and make sure we filed all of the appropriate paperwork with the government. We wanted to do it all right, and be good employers to the person who would care for our child. 

So we didn't offer health insurance to our nanny.

This might sound a bit odd. Let me explain.

We live in Massachusetts. We have Romneycare. (It's the inspiration for Obamacare, if you didn't know). So everyone has to have health insurance. Everyone. If you can't afford it, it's given to you, or heavily subsidized. 

Now, in case you've never worked in childcare, let me inform you that nannies don't make much money. Especially if you work for people like us. But that's a good thing in the world of Romneycare. Because that means you qualify for subsidized or free insurance. BUT only if your employer doesn't provide it for you. 

We ran some numbers. If we payed for some of our nanny's insurance, she would have to pay for the rest of it out of the money we paid her. And it was expensive. If we payed nothing towards her insurance, she got the money we paid her AND she got insurance. We had a finite amount of money we could pay her, and it wasn't enough to approximate a reasonable weekly wage PLUS provide insurance. In fact, paying for her health insurance meant that she barely made any money at all. So why would we pay for her health insurance if it hurt her instead of helping her?

We read the rules. As household employers, we were not required to provide insurance. We were required to provide workman's comp coverage. We were required to file payroll taxes. We did these things. We went into the situation expecting to provide all of the benefits that our employers provided us. And them we realized that the healthcare laws of our state actually incentivized us NOT to provide benefits for our nanny. It would actually HURT our nanny if we did. 

So I was not at all surprised when I heard about companies cutting most of their employees to part time in advance of the coming Obamacare changes. If the employees aren't full time, they don't have to be provided with health insurance. I was not surprised at all. Unlike our situation, they're not doing it in the best interest of their employees, just their own company pocketbook. But is anyone really surprised? And what other unintended consequences will we see? What's the likelihood that they will help employees instead of hurting them?

Only time will tell. 

PS. Our nanny share ended when the nanny stole my friend's engagement ring and was seen wearing it in public. But that's a story for another day.

Tuesday, September 24, 2013

Sleeping Through the Night

It's 4am. I'm awake. Little Debbie is not. In fact, she hasn't been awake since around 9:15pm. It's a bit odd, and disconcerting. I was awake 3 times with her last night. Tonight, she hasn't awoken yet. Yes, she's still breathing. I checked. And double-checked. And triple-checked.

That's the funny thing about a baby sleeping through the night. The first time it happens, you can't enjoy it. You're too worried that something's wrong. Certainly she should be awake by now, right? Certainly she should be hungry by now, right? The worry that something is wrong is greater than the relief of getting more sleep. Is she really still breathing? How about now? Still breathing? Still asleep?!?!

So why am I awake? Let's just say that there's an oversupply issue that I'm managing at the moment. My body thinks she should have eaten two or more meals by now, and is wondering what to do with all of that food. Again, the irony. I should be luxuriating in the extra rest time. But I can't. As usual, I'll go back to bed just in time to fall into a deep sleep before the alarm goes off. 

I'm not going to expect this to be a regular thing. Sure, Little Debbie's big and old enough that it's not out of the question. But I don't want to be disappointed when it doesn't happen. 

Immediately after writing this, I heard noise on the baby monitor. Sure enough, she woke up hungry at 4:30. And we were up until 5:30. Which allows a quick nap before the alarm goes off. I jinxed it. Oh well, I did sleep from 11pm until 4am, so 5 uninterrupted hours is nothing to sneeze at...

Wednesday, September 11, 2013


12 years ago, about this time, I was lying in bed, listening to the airplanes.

It wasn't the sound of large airliners slowing their descent into Logan airport, as I usually heard at this time of night. No, it was the fast whine of fighter jets. War planes. They were patrolling the East coast, in the hopes of preventing further attacks on our country. The airliners had been grounded hours earlier, after 4 planes were hijacked, and thousands were killed. 

I remember lying there in the dark, wondering what would happen. Were we at war? Would we be going to war? Was Boston the next target? And who was targeting us? How do you deal with the idea of your loved ones being vaporized when an airplane loaded with fuel slammed into their workplace? How would the survivors move on?

I prayed. I cried. I think we all did that night, even people who weren't prayers or criers. 

So I stop to remember. 

How can any of us forget?

Saturday, September 7, 2013

Big News!

We have big news here in the Bundles of Joy household.

Little Debbie has discovered that hands can go in the mouth. And they're delicious!

She woke up from a marathon nap, chugged 5(!) ounces of pumped milk, and demonstrated some new motor skills. Including the hand thing. Now, she's not yet a master of her hands, but she's making progress.

And you parents out there know that a baby who can chew her hands at will is well on her way to being an effective self-soother. So, while this is a good example of a true "baby step", we're pretty excited here. Ok, maybe just I am. 

Yay Little Debbie! And yay for hands!

Friday, September 6, 2013

First Week of Kindergarten

I'm the mother of a kindergartener. Wow. 

HeyMama just finished her first week of kindergarten. Every morning, she has bounded out of bed at 6am, put on her uniform with its plaid jumper, bounded to the kitchen to eat breakfast, packed her food into her lunchbox, and chattered her way to school. She loves it. 

We decided to send her to a local Catholic school that would allow her to start kindergarten early. She'll turn 5 later this month, which is too late for BPS. But early enough for St. Mary's. The class is small. The school feels like a community. And HeyMama LOVES IT.

I simultaneously have a newborn and a kindergartener. This is a fun contrast. But the kindergartener needs to be at school at 8am sharp. Preceded by a 20-45 minute commute, depending on the day. This is a bit of a bummer. Little Debbie tends to want a feeding around 4am. This lets me get back to bed around 4:30. Which gives me a quick nap before the 6am alarm rings. And she wants to eat again before we leave the house. This is a bit of a challenge. This aspect of having a newborn and a kindergartener is kicking my butt. I know we'll settle into a schedule, and things will get easier. I'm very much looking forward to that day.

In other news, I'm back to my previous raging coffee addiction. Oh coffee, how I do love thee...

Birthing Habits

So I shared my recent birthing experience in the last blog post. Some would say that my experience, midwife-assisted delivery with no medications or surgical interventions, is the ideal birth. Some would claim that I did it the "right" way. Some would call it "empowering." Some would call anything other than natural delivery to be "failure".

I've read posts on my local mommy network from women who don't have unmedicated natural births and become depressed and anxious, because they consider themselves to be failures. Sure, they have healthy babies. Sure, their physical recovery has been fine. But their c-section means their successful delivery of a healthy child was a failure. 


Maybe it's because I've never had a c-section that I don't understand. But to me, a birth that requires a c-section = a birth that had a potentially bad outcome without a c-section. So a c-section = successfully avoiding a bad outcome for your baby = success. Not failure. 

Perhaps I should take full credit for my unmedicated natural birth. Yes, I got my baby to turn head down all by myself. Yes, I got her to stabilize her vital signs. Yes, I got my cervix to dilate at the right time, and got my contractions to progress in a timely manner. Yes, I grew my baby to just the perfect size to pass through my pelvis. I did it all by myself. I am a really good mom. 


I had no control over any of this. The conditions were right for a natural birth. I didn't make it happen. I just let it happen. 

So if I didn't make my natural birth happen, how did the others have a role in their c-sections? Ok, so there are some women who schedule their c-section for convenience sake. And there are the ones that are possibly done for the convenience of the delivery team when the birth isn't progressing very quickly. I'm not talking about those women. They aren't the ones calling themselves failures. It's the ones looking for empowerment and fulfillment through childbirth that are calling themselves failures. And this makes me sad.

Are we really "empowered" if we feel we can "fail" at childbirth? A century ago, a mother would have thanked God for a surgical procedure that could save her life and that of her child. Now it's considered failure? Is this a cultural or social advancement for women?

The history of childbirth through the 1900's does involve some medical protocols that we would consider obscene now:  strapping a mother to the bed with her legs in stirrups, anesthetizing her and manually pushing/pulling the baby out, forced routine episiotomies. I'm glad the pendulum is swinging the other direction towards less medical intervention. And I realize that it takes a significant amount of lobbying to make this kind of shift.

But are we really helping the situation if we make mothers feel "less than" or not a "real" mother if she takes advantage of the modern interventions available? Is this progress?

Thursday, September 5, 2013

The Miracle of Birth

Ok, forgive me if this gets a bit sappy in places. I just had a baby a few weeks ago. The oxytocin can make me a bit fuzzy-brained at times. And forgive me if this gets a bit graphic at times. I'm going to talk about childbirth. It's graphic. It just is. Any process that starts with a creature living inside its mother's body and ends with her as an independent creature in the outside world, well, it's going to be a bit dramatic. 

I had a request to hear Little Debbie's birth story. So I'll oblige before momnesia kicks in and I completely forget. 

I was one of the lucky ones who was able to have 3 healthy unmediated natural births. They all occurred in the hospital, supervised by a midwife-led team. They were all good experiences, and I'd highly recommend it. I realize that not everyone has similar birth experiences. And, despite the claims of some, I don't feel like I birth "better" or in a more "empowering " way than others. But I'll rant more about that in another post. 

It was early afternoon when I suspected something was up. I was running errands. I found myself moving more slowly than usual, doing my relaxation breathing as I waited in line at Staples. I honestly felt a bit embarrassed to realize that I didn't remember what contractions felt like. Um, I'd done this twice before. I should remember how things went. Right?

I had an appointment with the midwife. The plan had been to strip my membranes during that visit if labor hadn't started. I was past 40 weeks, we had travel plans. And a baptism scheduled. The baby needed to come sooner rather than later. But it was unnecessary. I was 1cm dilated, and 50% effaced. Some women can walk around for weeks like this. I am not one of those women. They hooked me up to a fetal monitor to check the baby's heart rate and measure contractions. Well, lying down, the contractions slowed considerably, but the baby didn't. They kept me hooked up for over an hour, waiting to get a slower baseline. But Little Debbie had no intensions of settling down. I was there for 2 hours. 

I was annoyed. I had errands to run! And my typical 25-30 minute appointment would have left plenty of time to do errands and nap. Instead, I had to race to get the girls. And then go to the grocery store. And then make calzones for dinner. And I really wanted that nap. 

By the time I got to making the calzones, I was really uncomfortable. I was pretty sure I was in labor. BestestHusband came home. I handed over the task of calzone-prep to him. I headed downstairs to the bathtub. 

We have a large whirlpool bath tub that my SIL calls the "sex tub". It's a pretty big tub. For the record, we have not used the tub for procreative purposes. But I highly recommend it for the early and mid stages of childbirth. I retreated to its warm relaxing waters for an hour or so. The contractions became stronger, more regular. I was pretty sure I'd be holding my daughter by daybreak. 

I got out of the tub to say goodnight to the girls. We told them we might not be there when they woke up. We told them they might get to meet their sister tomorrow. They were excited. 

I ate some dinner, mostly because I knew I needed to, not because I was particularly hungry. Then I retreated downstairs again. I finally decided that distraction might be better than relaxation at this stage of the game. What's better than distracting me through tedium than Downton Abbey? Nothing. Hulu to the rescue. 

By this time, I was tracking my contractions on my iPhone. When they were 1 minute long and 6 minutes apart, I called the midwife. Noting my fast labor with MeToo, she suggested that I come in sooner rather than later. BestestHusband was showering, so it was a little on the later side. 

The hospital is only about 10 minutes from our house without traffic. We left around 11pm, leaving the girls in Grandma's capable hands. The hospital offers valet parking. This is good when you're in labor and don't want to wait in the lobby for your husband to park the car. I had done the registration paperwork previously through my midwife practice. They knew I was coming. Checking in didn't take too long. I got my ID bracelet. BestestHusband got his. We headed to L&D. I declined the wheelchair. If walking sped up childbirth at all, I wanted to use that to my advantage. It was a long slow walk. But we made it up the secure elevators. We waited about 10 minutes before I was ushered into an exam room. I'm glad the baby wasn't in too much of a hurry... 

They asked the requisite "do you feel safe?" questions before ushering BestestHusband in.  The contractions kept coming. I kept doing my relaxation breathing. They took my medical history. I met the midwife. She checked my progress: 4-5 cm. This is serious for me. Again, I'm not a woman who walks around 5 cm dilated for a week. It was too close to midnight to have the baby that day. But she was coming soon. Very soon. 

I walked to my delivery room and got settled in. I was hooked up to a baby monitor again. Little Debbie was doing well. I was ok. I was better when the dang volume was turned down...

The contractions kept coming. They were increasingly intense. I kept up my breathing, but it was harder to stay relaxed, and I was struggling to find a comfortable position. The rocking chair was no good. The birthing ball was no good. Walking was absolutely no good. I optimistically kept trying. But it was repeatedly no good. Lying down was no good. Sitting bolt upright in the bed was ok. Sorta. So I sat up on the bed and tried to keep my noise to a minimum. It was getting harder. 

I decided to try the shower. I hadn't tried it with my other deliveries. I love showers, and the bathtub had helped previously. So I gave it a try. It was wonderful for a few minutes. Then another contraction hit. And I felt the urge to push. I decided it was time to get out of the shower. 

BestestHusband got the nurse and helped me out of the shower. I desperately wanted to be back in bed. The midwife was there. She checked me and announced "9 and 3/4 cm with an anterior lip". 9 and 3/4 cm is pretty close to 10 cm. Things were getting very real. She called for more staff, and told them the same thing. Carts appeared. Gloves appeared on everyone. Face masks appeared. BestestHusband was instructed to get warm water. It sounded slightly archaic to send a husband for warm water in a hospital... But the baby was on her way, and rational thought was becoming more difficult. I just wanted to find a comfortable position. And I couldn't. MeToo was delivered while I was upright on my knees. Little Debbie didn't like that position. The midwife encouraged me to try my back, as 3rd babies like to come fast, and fast deliveries can result in needing lots of stitches. I didn't want any of those. So I tried to follow her instructions as she applied warm compresses (made with BestestHusband's warm water) to ease the baby's exit. 

Throughout all of the labor leading up to that point, I felt like I was ok, and I had this labor thing under control. Suddenly, I wasn't ok, and I didn't think I could do it any more. I felt physically incapable of getting a baby out. But I knew that I had no other option. But I didn't know how I was going to do it. Was it possible that my pelvis would shatter? That I would rip in half? I seriously felt like the child would break me. How had I managed to get out two previous babies? It didn't feel like those two previous births were helping at all.

I think I said a lot of silly things. Things like "No, I can't do this." And "get this baby out of me. Just pull her out." And "No! No! No! I don't want to!" And "I want her out. Get her out of me!"

The midwife encouraged. Then she became insistent. The baby needed to come out. And I needed to push. Now. 

So I did. During a break in contractions, I got control of my breathing, gave myself a pep talk, said a prayer, and prepared for the next contraction. And I pushed until I felt like blacking out. Her body felt bigger than her head. The other two didn't feel like that...

They laid her on my chest, and all I could say was "thank you Lord, thank you Lord". I was thankful she was out. Thankful she had a powerful cry and perfect little ears. Thankful I was done pushing. I think I cried. I know BestestHusband did. 

They did all of the good things after birth - skin to skin contact, waiting to cut the cord until it was done pulsating, encouraging immediate nursing. The pitocin   shot in my leg hurt. How can a shot hurt after pushing out a child? I don't know, but it did. I delivered the placenta, and saw one for the first time. It truly is an amazing organ. Not amazing enough to eat, like some women like to do, but amazing nevertheless. I was thrilled to discover that the warm compresses worked - no stitches needed

Little Debbie wasn't so thrilled to be born. She howled for a long time. She got quite the respiratory workout. I was surprised to find out that she was a full pound heavier than her sisters, a solid 8.0 lbs. We prayed every day for a healthy baby. And that's what we had. 

The birth was mostly what I hoped it would be, but harder than I remembered the others being. Perhaps that's the standard momnesia effect? Would women keep having babies if we remembered all of the unpleasant details? 

Why do I like natural birth? Well, it lets me avoid needles, for the most part. I don't like those so much. It lets me avoid side effects of the medications and interventions that go along with chemical pain relief. I don't like spinal headaches, the inability to walk after birth, and medicated newborns so much. And our bodies were created to birth babies without drugs. I like to give mine the chance to do what it was created to do. Our foremothers have done it for centuries. 

Why do I like natural birth in a hospital with certified nurse midwives? Well, what was one of the leading causes of death for women of childbearing age during the preceding centuries? Yep, childbirth. I like to hedge my bets. When childbirth goes smoothly, no interventions are really needed. When childbirth doesn't go smoothly, mothers and babies can die. I'm not interested in that outcome. I like having a crash team and world-class NICU on standby.

I'm also blessed with babies who want to be born naturally. They haven't been breach, sunny-side up, or overly large. They might stay past 40 weeks, but when they're ready to come, they come pretty quickly. That makes a huge difference! If I was stuck at 5 cm for 2 days with regular and strong contractions, I'd be begging for drugs that would let me get some rest. I'm thankful that hasn't been my situation. So, while I'd never call childbirth "easy", I think I do get off pretty easy in the childbirth department. So I could never judge a woman who wanted drugs or a scheduled c-section. I have no right to judge. But this is a topic for another post. Because there are some people out there who get pretty high-and-mighty on the topic of childbirth...

Wednesday, September 4, 2013

A Message from Little Debbie

Dear Mama,
It's been 3 weeks now that you've been employed in my care. I think things have been settling in adequately, but I wanted to provide some constructive feedback and clarification of the expectations I have for you and the meeting of my needs. Please make note of the following issues:

Meals are expected to be on time. MY time. This time may or may not be predictable. But don't worry, I'll let you know when it is time. 

I prefer to poop in clean diapers. You might suspect that I will poop in a diaper as soon as you put it on me. You would be correct. Just keep those clean diapers coming, and I'll take care of the rest. 

Proximity is important. Please ensure that I am attached to your body all day long. Yes, all day long. If you forget about this, don't worry, I'll remind you. 

The car is nice, but only when we're driving rapidly. Sitting at red lights or in traffic is highly unsatisfying. Please avoid these situations. 

Those two smaller mama-like people in the house are interesting. Please keep sending them my way. They're rather entertaining. I think I like them. 

Dinner time, including the time for preparation and consumption, is MY time. Please rearrange your schedule accordingly. 

All in all, I think we're off to a good start. Please correct some of the errors you've been making in the aforementioned areas, and I'm sure we'll get along just fine. 

Little Debbie