25 Feb 2014

Contraception Conversations

I would never think to do a post on contraception. It's such a private and personal subject but I wanted to share and hopefully educate people on an option I recently decided to make. It's an option which I think is seen in a negative light hence why I don't think most people even consider it.

  • This is a post best read for my female readers and contains concepts and description that make make men go "Eww!!"
  • I'm not here to sell or suggest any one form of contraception is the best option, but to hopefully provide information on different options. 
  • Obviously please see and discuss your medical professional regarding your circumstance and medical history when deciding on a form of contraception. 
A few weeks ago I had my four month post pregnancy check up with my doctor. We discussed how things were going with me, baby, home dynamics and anything else that comes to mind. Four months after giving birth most doctors ask parents about their thoughts on family planning. That is whether discussion of more children have come up and time frames the parents are thinking to achieve this.

For us ... we're agreeing to disagree on this topic at the moment. Ian is happy with two, where as I'm open for more .... but not right now. So we want to put a plan in place to make sure we stick to that in the mean time.

I didn't want to get back on the pill because I'm horrible at taking it. If you want an example of someone falling pregnant while being on the pill ... I'm your girl. Admittedly I was skipping a few days, then taking it a few days, then missing again. A behaviour I had been doing for years.

I first got on the pill for my skin when I had severe eczema in my twenties therefore never really cared about the science behind its contraception powers nor understood the risks of not taking it regularly. So over the years I developed a lazy attitude towards taking it regularly especially after my skin condition cleared.

Anyways .. two kids on and although they can be a form of contraception, I knew I had to be proactive about not falling pregnant. I asked female friends about what options they use or know about. Here are some options I've heard about and the knowledge I had (prior to speaking to an actual doctor) about these different types of contraceptions:
  • the "Rod" which is an implant inserted under your arm that slowly releases the same hormone as the pill. 
  • Get a needle (shot) of hormones ever few months, which also releases hormones into the blood stream that prevents ovulation. 
  • And last option I heard about was inserting a device internally and some how prevents pregnancy. 
Bottom line every contraception option had a list of pro's and con's as well as potential side affects and ultimately I knew if we're not planning to grow the family right now I need to decide on one, even if the decision was to go back to taking a pill a day.

My doctor asked me a series of questions to gauge which options she would suggest for me and discussed the advantages and disadvantages of each option. As she informed me more about the inserting an internal device option, I soon realised it seemed to fit me and my life style more than the other two options. But before I make a final decision I had lots of questions about this option and the key question I had were:

What's the official term for it? 
Intrauterine System (IUS) is a type of intrauterine device (IUD). Mirena is the approved brand of IUS used in Australia. It's a long acting reversible contraception method.

What does it look like?
It's a small T-shaped soft flexible plastic device with a string at the end of it. Some images can found here and here.

How does it work, as in how does it prevent me falling pregnant?
It creates a barrier preventing sperm from entering the uterus and it also thins the lining of the uterus making it harder for an egg (if fertilised) to attach to the womb therefore hopefully preventing a pregnancy.

How is this thinning achieved and is it safe to have a thin lining? 
The plastic device contains a small amount of hormone which is released directly the uterus which thins the lining. Every month when a women is ovulating, their body naturally grows and thickens the lining of the uterus to prepare for the release of an egg. So when and if you decide to have children, once the device is removed your body will continue this process naturally.

How is it inserted and will it hurt?
Similar process to having a pap smear, a speculum is used to assist in the process so of course its going to be a little uncomfortable. The doctor will insert the speculum into your cervix and clean the area using an antiseptic. The doctor will then insert the device inside the cervix using a narrow applicator tube. Once the IUS is inserted, the application tube is removed and the arms of the t-shaped device opened.

What are the potential side affects?
There are a range of side affects but the most common one's are:
  • Abdominal pain including cramps, which should subside shortly after insertion. 
  • Infection as the uterus is a very sterile area therefore inserting anything that is not properly sterilised inside can cause infections. An infection will be evident within the first three weeks of placing the device in.
  • The device could fall out by itself if not properly placed.
  • The device could perforate (damage or create a hole) the wall of your uterus. This is very rare occurrence and may happen when the device is being inserted. 
  • Changes in bleeding. Period may become irregular and may spot between menstrual periods. After a few months when you body adjusts, periods usually get lighter and the number of days bleeding is likely to decrease but remain irregular.
She did inform me of very rare side affects related to this option including:
  • Does not protect you from sexually transmitted diseases.
  • During insertion bacteria could enter the uterus causing an infection.
  • If not inserted carefully could puncture the wall of the uterus which could then move around and harm other organs of the body.
How long is it affective?
The IUS contraception is good for up to 5 years. If you do decide you want to have children it can be removed and commence trying to conceive straight away.

I'm still breast feeding can I use this as a form of contraception and will it affect my baby or milk supply?
Yes you can still be on IUS while you are breastfeeding. It is a progestin only contraceptive (like the mini pill) which does not affect milk supply. There have also been no adverse effects found in the health, growth or development of nursed babies. Although small amounts of the hormone released is pass onto the breast milk of nursing mothers.

Will I or my partner feel it?
You or your partner should not feel the device during sexual intercourse as it is inserted into the uterus, not the vagina. If you do it could mean device has moved and wont be effective and best to return back to your doctor to verify placement.

I've heard so much negative experiences and stories about IUD is it safe?
The main difference with the Mirena is releases small amounts of hormone and has only been around since 2001 where as the older IUD "coil" technology has a copper filament wrapped around the T shape and had no hormones.

What are the benefits of IUS over other contraceptive options?
  • Cost effective.
  • Safe to use while breastfeeding. 
  • Can be removed whenever you want to stop using. 
  • Fertility return after the first cycle following removal. 

After I decided to go with this option she gave me a script to collect my IUS device from a chemist. When I returned she proceeded with placing the device inside my uterus. Yes it was as uncomfortable as a pap smear, the antiseptic stung a little and she did warn me that I will feel a hard cramp slash contraction kind of pain while she attaches the device. The whole process probably took 5 minutes it could've gone quicker but there was a medical student in the room she was also teaching along the way. 

Yes I agreed to let a medical student sit in the room. Yes she was a girl and no I didn't mind cause after giving birth to two kids all shame goes out the window ... No, not really. I just remember a friend who was doing his time as a medical student saying he barely got to sit in actual examinations cause most patients opt not to have a student present. So I let this girl who looked like she just finished high school, doing her first day of work experience (is that what its called?) sit in on a intrauterine system insertion - lucky her. 

So a month on and I'm pretty happy with my contraction decision. My experience so far has been positive.  I only experienced some spotting during the first few days. Only other thing I noticed is I've been getting headaches some days for a short period of time, nothing that would make me take a panadol. I don't usually get headaches so I concluded it must be related. Other positives of course no more worrying about taking a pill every day and cost savings.

I will need to get an xray and see my doctor again in 6 weeks time to check that the device hasn't moved and discuss how it's all going so far. 

There you have it ladies my personal experience of the IUS. I think so many women don't even consider this option because due to the fear, misunderstanding or lack of knowledge available from people with first habd experiences. I also think it built up a bad reputation amongst older women because when it was first introduced the technology as well as the experience of doctors with this option was limited. It has come a long way and the benefits in my opinion out weighs so many of the existing other forms of contraception out there.

So, if you're like us and not ready to extend the brood (or not ready for kids at all) and want a form of contraception you don't have to think about and has no on going cost, think about the Mirena IUS. I encourage you to still talk to your doctor about IUD/IUS, discuss all options and ask lots of question even the one's you think are dumb, like my "is it safe to have a thin lining?" 

The Royal Women's Hospital, Intra Uterine Device (IUD), The Women's Organisation, accessed 17 February 2014, <https://www.thewomens.org.au/health-information/sex-sexuality/contraception/intra-uterine-device-iud>

Kelly Bonyata, 2011, Birth Control and Breastfeeding, Kelly Mom Parenting and Breastfeeding, accessed 17 February 2014, <http://kellymom.com/bf/can-i-breastfeed/meds/birthcontrol>

22 Feb 2014

Kai ... 5 Months

My baby Kai ....

You finally laughed. And it was kuya that made you laugh. You thought his innocent "Boo!" was the funniest thing you've ever seen. Ian thinks he's heard him laugh before ... but I don't think it was like the way he laughed at his kuya.

You want to put everything in your mouth. Your hand, my hand. You lunged forward at my ice cream and I let you have a few awkward sloppy sucks ... you loved it. You still however are not inclined to the dummy but that's fine with us. And because you love putting things in your mouth you're always drooling and we go through so many outfit changes and bibs.

You don't fit in the car capsule or your pram bassinet anymore. We've swapped them for more appropriately sized options for awhile now. You're so solid and big. I love it! At your four month immunisation you weighed 7.1kg you little fatty! Keep growing I love that there's so much of you to hold.

You slowly move around the house on your walker. You fit in kuya's old walker, so we put you on there when we need to put you down somewhere we can see you. You are entranced by all the sounds it makes and suck on the various handles. And because your feet touch the ground, you're able to move around and sometimes you surprises us when we find you at the other end of the room.

You love your kuya Eli. You're always looking for him and when you hear him speak you stop. When you see him you're fixed onto him. When he accidentally hits or sits on you, you never cry. When he attempts to make you laugh you smile. He is far more interesting than I. I know you adore your kuya and he adores you too.

You have some separation anxiety issues with me. Even if daddy is holding you and you catch a glimpse of me you start to cry and do your sad face. When we're together you're fine as long as you can see me but as soon as you can't the water works begin. I hope this will be a short phase.
Side note: such a different experience with Eli. Eli would go to anyone when he was a baby, even now we jump into elevators or go into shops and he'll say hi to randoms. He is such a confident kid while Kai shows signs of a more sensitive spirit. This is what they mean by each child is different. 
You're so alert. You will look at the direction of the smallest sound or dimmest light. You jump when I raise my voice to call out to your brother. You will watch what I watch like you understand it and you always seem to be looking for something or someone. 

You're a chatter box. You have been quite early on but now the volume and frequency has increased. I swear I think you're singing along in the car when the music is on.

You get mad at me. When I've left you to cry for too long and after I pick you up, you avoid eye contact with me. I turn you towards me and you turn away. Wonder if this a sign of things to come? Cause it reminds me of someone.

You look so much like you're dad when he was the same age. The resemblance is so uncanny. 

Sometimes I look at you and think 'When did you grow?'. As much as I wish you weren't so fragile I also wish I could keep you as a baby forever. 

Love you baby Kai. 

4 Feb 2014

The Childcare Experience

As I've mentioned previously, Eli has started going to childcare twice a week.

It's a decision which was financially difficult to make as we had to consider whether it was an expense we needed on our budget especially on only one salary. We always knew the kids would go to child care prior to attending school as it was a discussion Ian and I had ages ago, so it was just a matter of when. When we found out I was pregnant with baby number two we knew that time would need to happen relatively soon for Eli. Why? Just so I could spend some one on one time with bub number 2.

I started the process again of inspecting various childcare centres and putting his name down on the crazy extensive waiting lists for the ones I liked. Then I contacted the ones I liked the last time I went through this process and fortunately one had availability and we jumped at the opportunity.

Leading up to his first full week we had a few "orientation days" or day visits where he went into the centre for a few hours and I stayed close by to the centre to gauge how he deals with the environment. First time he love it! Eli isn't shy naturally. He's not scared of new surroundings and he doesn't need convincing to participate in activities. Second time around I think he remembered that I would be leaving him there, so when I dropped him into his classroom he held my hand and dragged me along to the play area.

The following week was his first full two days at childcare. Ian decided to take the day off so he could be there to drop him off and pick him up in the afternoon. I think we all had good intentions but may have made the experience worse for Eli. When we dropped him off he cried and begged for us as we were leaving. The carer in charge of his classroom did call me later to give me a progress update on him but when we arrived that afternoon he was crying again. He didn't eat, he slept only for a few minutes and only when held, and when parents started arriving to pick up other children it upset him again.

The next day when I dropped him off he was latching onto my neck and tried to wrap his legs around my body. The carer had to peel him off me when I left and again called me later to give me an update. However when I picked him up that afternoon this time he was outside playing with other kids. When he did see me he ran up to me and gave me a hug but also left my side to play some more, which apparently is a good sign.

Over a month on and he's still adjusting. Some days he must peer out the car window and although we're still streets away from the centre, he's already saying "Ai don't want to go to ch'ald kare!" - amazes me how good his memory is. I try to put a positive spin the situation and tell him how much fun he'll have and that he gets to hang out with all his friends. Once we're in his room a teacher is still required to take him away from me but some days there aren't any tears.

It's funny cause some days, like the days he's being a handful, I'm so looking forward to dumping him at childcare, but then seeing him so upset every drop off makes me feel bad about leaving him there. I worry about how long he keeps crying after I leave, I worry he's upset the whole time he's there and I worry he's so unhappy about being there that he's not participating in anything. My biggest worry, only cause I witness it with another child when we were doing day visits, is that the carers have other children to attend to and ignore Eli even when he's clearly upset.

I've heard it may be like this for awhile and that all kids go through it.

Hope you start to look forward to going to childcare Eli. Mum and Dad love you and want you to have the right balance of experiences in life and this is the main reason why you go, even though I'm at home.

Any tips for making the childcare drop off experience less painful and stressful for everyone?

All smiles during his day visits

 First full day

1 Feb 2014

January Review

My first month of 2014 in images via Instagram
Key Dates this month were:
  • 3/01 That time of the year again ... revisiting our family budget. Something we should all be doing frequently, is like a blue print to where your money is going. I've blogged previously my tips on how to start and maintain a budget.
  • 5/01 We started the toilet training Eli. Overall I think we were lucky Eli picked it up easily. Sure we still have the occasional accident and yes we still put a nappy on him over night, but I couldn't be more proud of my son to have learned something relatively straight away.
  • 18/01 The constant hot weather meant lots of time avoiding the heat and finding alternative ways to cool down. Eli was gifted an inflatable pool over Christmas and it was the perfect time to use it. 
  • 22/01 Kai turned four months. 
  • 24/01 Our 5th Wedding Anniversary. We spent the most of the day children-less, eating meals without being disturbed or rushing, having a bit of a boogy to end the night and some dancing too (see what I did there ;) ). It was the year of gift vouchers. We all get given them and having busy lives, or in my case being a mother to two children under three, we forget about them and eventually does not get used. So this wedding anniversary we claimed as many as we could and the day was relatively easy on our pocket because of it. Thank you to people who have been so generous in the past and allowed us to have a memorable day and stay. We also headed over to Marble Bar on our anniversary night and to our surprise Brown Sugar, the same band that we had at our wedding was playing. We managed to catch the lead singer, Lady Lyric at the hotel lobby and tell her she sang at our wedding 5 years ago that day and snag a photo. 
  • 25/01 Australia Day.
  • 27/01 New layout for the blog goes live.
  • 30/01 My sister turned 30 and she threw a beautiful soirée at The Bar at the End of the Wharf at Walsh Bay. It was a perfect setting for her party with views of the Sydney Harbour Bridge and North Sydney. 

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