Examining my fertility

When I pushed Riley's shoulders and body out, I made some of the only noise I made during labor and delivery. It was such a relief of pressure that it deserved a good sigh/moan. I made sure to tell my mom that it wasn't that I was in pain, because it didn't hurt (since I had such a good epidural). It just simply seemed like the right thing to do at the time, and helped to release some of the pressure. After they stole him away to be weighed, measured, and cleaned up a bit, I thought to myself: "I could do this again." I was amazed that I felt that way. Sure, the heartburn sucked A LOT. Sure, I really didn't enjoy being a Gestational Diabetic. But all of that didn't matter to me anymore, and I would truly do it all again in a heartbeat.

Logically, I know that I should wait at least a year to allow my uterus and body to heal fully. I also know that the exhaustion I feel now would be dramatically worse with two little ones. But would you believe that I've considered what it would be like to get pregnant again? I'm crazy. I blame the hormones. Financially, we wouldn't be able to do it. I wouldn't be able to have much time off with the second babe, and how sad would that be to have to go back to work within 6 weeks of birth?! Also, if it was less than a year, I wouldn't qualify for any time off because FMLA is only allowed once within a year. (However, I'm sure they make exceptions to that rule for maternity leave.) I can't believe I'm even discussing this...

This all leads me to my two-week postpartum check up. Basically I went in to talk with my midwife, she did no examination. One of the first things she said to me was: "What are you going to do for birth control?"

My gut reaction was: "How dare you ask me that!" I didn't say that out loud of course, but I was actually offended. Me, the pro-choice, lover of medicinal forms of birth control was offended. I shocked myself. I never thought that I would feel this way about birth control. Again, I blame the hormones.

Realistically, I know that if we don't use some form of birth control, I'll have a newborn again in 10 more months. At least there is a huge risk of that happening. It was simply too easy to conceive Riley.

After pausing to get my head straight, I finally told her I didn't know what we would do for birth control. So, she reviewed our options:

Condoms. Since I hate the smell, and they are a bit of an inconvenience, we do not do well with these. Case and point: Riley. We should have used a condom the night he was conceived, I knew there was a chance, but thought there was no way it would happen that night. We all know what came of that decision. (Only the cutest little boy in the world!)

Progesterone-only Birth Control Pills. These are extremely time sensitive. I barely remember when the last time I ate or peed, let alone whether I took a pill or not. I used to set an alarm on my phone, but even then would sometimes take a little bit to take the pill. Sometimes hours.

Arm fat implant. Please excuse my description, I can't remember what this was actually called, but ultimately it is a rod that is inserted under the skin in the upper arm. I am weirded out by having something inserted there, especially since I plan on working out a bit and trying to tone up my upper arms. I don't know how that would feel to have a rod in my arm while doing push ups. It might not feel different, but I don't much care to find out. One perk to this type, however, is the cessation of menstruation. (I think...)

Depo-Provera. Hormonal injections. My midwife wasn't a big fan of this option. She doesn't recommend it for the long term, I forget the exact reason for that. But she said there is a huge risk of gaining 20 pounds in less than a year with this option. But it is a good option if used only while breastfeeding and transitioning to estrogen containing BCPs after weaning. She had some other disadvantages that I can't remember now. The risk of gaining 20 pounds is enough of a turn off for me.

IUD. (Intra-uterine device) This is something I considered using prior to going to this appointment. It is one of the easiest methods of birth control, since it is inserted and can stay in for 5-10 years depending on the brand. It is pretty effective at 99.9%, and one of the brands gets rid of menstruation. Which, let's face it, is kind of a gift! ;) Ultimately I decided on this one.

My logical side knows that I have to use some sort of birth control, and my impulse control is not so good that we can rely on NFP. At least not for the immediate future, only once I'm really ready for another child can we use NFP. Because that is technically what we were using when Riley was conceived. I do realize that at the time, we wanted to get pregnant eventually. And that we had very superficial reasons to prevent pregnancy at the time: I wanted to avoid a December/Holiday birthday. I know that now, our reasons to prevent pregnancy are much weightier: it isn't good for my uterus to go through pregnancy again prior to a year postpartum; financially I won't have benefits to cover my leave; and of course how physically exhausting it would be to be pregnant with an infant in tow. So I do realize that it might be a bit easier for us to prevent pregnancy using condoms and NFP, but I honestly don't trust myself. I want another baby far too much. I know that in the back of my mind I will think how wonderful it would be to have another little one, even though my logical side knows how crazy I'm being.

Do you follow me? Again I blame hormones if you don't. ;)

Well, I went to schedule my appointment to have an IUD inserted. She likes to do it at 8 weeks postpartum when the uterus has hardened up enough that the risk of her puncturing my uterus (!) when the IUD is inserted, is decreased. They wouldn't let me schedule an appointment, because it is something that needs to be pre-approved by insurance. That meant that they would call me to schedule the appointment. But of course, it isn't that easy. The Mirena (the hormonal form of the IUD) costs about $850, and the insertion costs $180, and my insurance will cover it at 85% after I meet my $250 deductible. So, that means it will end up being about $377.50 total. They do accept payment plans, and I do have a flexible spending account for health care, so I would get the money right back after I submit the appropriate paperwork. But it is very upsetting how expensive it will be. I haven't called to schedule my appointment yet. But I think I will on Monday. Logically, $400 is cheaper than getting pregnant again soon.

We are allowed to have sex again at 6 weeks post-partum, that leaves 2 weeks in between insertion where we could get pregnant. I am clinically insane and sort of hope that we do...