Uninvolved

- Mala, I heard you're moving to Kenya?
- Yes. I'm excited and terrified! I've got a place to live, but I don't know what my general security will be like.
- Are you going through an established organisation or company? And will you be living with other ex-pats? In Ghana I lived with a Ghanaian and had a nightwatchman sleeping in front of my window every night, and had no problems. In Istanbul we had three ex-pat women in one apartment, no security, and had big problems. But that was like 10 years ago.
- I didn't know you lived in Africa and Turkey! Don't you ever feel like you just can't relate to people anymore because of all the experiences you've had? I'm worried that normal life just won't be possible anymore after living abroad for so long.
- Mala, I'm married, own a condo, and just had a baby. Every one can relate to me.
- Ha, true.
- And yes, there were definitely chapters where I couldn't relate to my friends back home, but then 6 months later in a different context in a different life, you can't relate to who you were in those un-relatable chapters. We are constantly feeling involved in something, and uninvolved in something else. Life goes on, we adapt.

What I didn't have the heart to tell Mala was that every time you leave a place, you leave a piece of yourself there. And every time a friend leaves you, you retract just a little bit more in the next friendship. So the life of a nomadic ex-pat is one of slowly retracting yourself into a self-sustaining island, slowly becoming less and less involved in your surroundings.

- Guy's brother just had another baby.
- How many is that now?
- 5 children.
- How do they cope? And in the diplomatic corps, don't they have to move every 5 years? How do the children build reliable friendships?
- Exactly. That's why you need to have such a large family. You sort of breed your community.

I think army families have it even worse, because they know they have to move every 2 years. I was listening to an interview with an army woman on the BBC, and she said in her first week in a new place, she joins a minimum of 3 clubs. That's how she feels like she "lives" there, like she's involved, rooted. And then after two years of getting the house just right, when she's starting to find serious character flaws in her "friends", and as the clubs change and aren't like they "used to be", it's time to move on anyways. And the cycle repeats itself.

With virtual communication, you can build a sort of virtual community these days too. And in Amsterdam, there are months of the year when I don't have any time to see my local friends because I have so many visitors that they keep me occupied. So it's a sort of international community of travel-a-lots and we get to see each other more than our local friends at times. But it's not a real life somehow.

This is the longest I've ever lived in a place since leaving my hometown almost 13 years ago, and this is the least I've travelled too. When I was pregnant, and people would ask if I was planning on putting my child into Dutch school or international school, I was completely dumbfounded. The thought of knowing where I would be when my unborn baby was going to primary school was completely alien to me. And now as I research childcare options I have to keep reminding myself that I need to think through to her needs as a walking, talking child, and not just as a still baby.

I've joined a neighbourhood group. I'm planning on joining a choir in the new year. And I'm actually learning about the personal business of my neighbours. I'm becoming involved again.

Feminism and childcare

- I have everything I ever wanted in my life -- career, travel, lifestyle -- except a man and my own little family.
- Yes, but if you had a man and a child, you likely would have had to re-prioritise career, travel and lifestyle in order to accommodate your family.
- I don't think you need to sacrifice your life for your family.
- It's more about re-prioritising what's in your life. Your life is full, so when you add things into it, the rest needs to be...er...re-distributed.
- I don't buy it.
- Well, I would not live in Amsterdam anymore if it wasn't for my husband's commitments here. I would have given it two years then wrapped up the party and gone somewhere else where my career could effortlessly flourish and feel like an empowered professional again.
- But do you regret that?
- Definitely not! I get much more personal fulfillment out of my life with my husband and baby here than I got out of my life with my career elsewhere. But the blunt, feminist truth is that I have sacrificed my career, first for my husband's career, and now to care for my child.


I think above anything, the feminist and civil rights movements were meant to give people choices.

When I was a [overly-principled] teenager, I thought feminism was about women doing what men do, and not falling into gender stereotypes. I didn't want to be a nurse, teacher, or secretary when I grew up. And I would have viewed many of the things I now hold true in my early thirties as cop-outs.

But not doing what you really want because it's a gender stereotype also means you're letting gender stereotypes impact your decisions.

• Do you love caring for your child(ren) full-time, and can afford to live off of one salary? Be a fabulous stay-at-home mom / dad!
• Do you feel like a better mother if you're able to express yourself as a professional, as a woman, as well as as a mother? Go back to work and schedule lots of time for socialising!
• Do you need to escape your family life periodically and re-collect your inner drive? Travel alone!

I'm taking 6 months off of work, and then returning to work 3 days per week for at least a year. If I loved my job, I would work 4 days a week.

I live in a country where all parents have the right to reduce their work week by one day per child. Many men take "papa dag" and only work 4 days per week, and many women only work 3 days per week when they have children (but don't seem to go back to full-time when their children grow up!). I don't imagine we will ever live in another country that facilitates part-time work so seamlessly, and I really encourage my husband to also take advantage of this situation while it lasts.

And that's another thing I really hold true, which I didn't appreciate in my overly-principled years: my life occurs in chapters. How I define myself now is different than 5 years ago, and may be different 5 years from now. I'm very lucky to have gotten to experience the career-driven, jet-setter lifestyle for a long and important chapter of my life, and I fully intend to return to an emphasis on career in a few years. But I'm also happy I get to experience being a wife and mother settled in one place who doesn't think about work after 5PM. Having a job that doesn't consume you has it's benefits too!

And the more of these different lifestyles I get to experience, the less I seem to judge the decisions of others.

My [Dutch] first weeks with baby

"You must feed the baby every three hours, above all other needs"
"You must listen to the baby's rhythm"
"The baby needs to eat a lot, or it won't have the energy to wake up"
"Feedings should never go more than 45 minutes, even if the baby hasn't eaten very much"
"Don't use a bottle to supplement breastmilk"
"Your feedings are taking too long, you must use a bottle"
"The baby should lay against your body with its head aligned with its stomach horizontally when feeding"
"Always have the stomach below the head when feeding"

In The Netherlands, new parents are supported by:

• A maternity nurse, who spends 6-8 hours in your home with you for the first 8-10 days of your baby's life
• A midwife, who visits you at your home twice in the first week
• The consultation bureau, whose nurses and doctors monitor your child's development until it is 4 years old
• Your family doctor
• Hospital staff from the hospital where you gave birth, if applicable

Each of these trained medical professionals gives you advice, with absolute conviction. Each piece of advice conflicts with the advice of the other trained medical professionals.

Eventually we realised that caring for a newborn baby was a matter of blindly re-prioritising dozens of "essential" needs, and blindly judging the validity of conflicting medical advice.

The Internet
- Is Amy in labour?
- Yes! And I'm on call to google anything that the doctor says that sounds dodgy.

I don't know how people -- especially expats -- had babies before the internet. Most anglo expats have more faith in their own medical systems than the country where they live, and whenever any information comes into conflict with our intuition / upbringing, we google it.

• Does she seriously need to be woken up every 3 hours? And for how long?
• How do you use a baby wrap / sling?
• How long before we can use a soother?
• How long does expressed breastmilk last? Formula?
• How to sooth cramps?
• When is sex safe again?
• Why doesn't colic exist in The Netherlands? And how long does colic last?
• When does this start becoming rewarding?

We quickly learnt, however, that Google does not simplify the whole conflicting-baby-advice issue.

Doing the math

Our Dutch maternity care nurses kept us on a busy Dutch schedule for our baby's first days. We were instructed to feed the baby every 3 hours, calculated from the beginning of the feed.

Every three hours = 8 X 3 hour cycles per 24 hour period
A feeding takes a minimum of 45 minutes, and up to 1.5 hours
Burping, soothing, and putting baby back to sleep takes a minimum of 15 minutes, and up to 1.5 hours
The baby should sleep a minimum of 16 hours a day = 16 / 8 cycles per day = baby needs to sleep 2 hours per cycle
Waking baby enough to feed takes a minimum of 15 minutes, and up to 45 minutes

[Horrible realisation]: If baby takes more than 45 minutes to feed, and more than 15 minutes to wake up + put back to sleep, baby cannot have minimum 16 hours of sleep per day! And each time baby gets less than 2 hours of sleep in an interval, baby is impossible to wake up for next feeding, perpetuating the cycle!

What was happening is the wake-feed-burp/cramps-fall-asleep cycle was generally taking 2-2.5 hours, giving baby a mere 30 minutes to an hour of sleep per cycle. Which was completely contrary to her natural rythm which meant we were constantly battling with her.

Battling to wake her up.
Battling to feed in under 45 minutes, but not so quickly that it aggravated her cramps and/or burping.
Battling to put her to sleep.

With both the maternity nurse and the midwife in the room we demanded that they make a decision for us. What is a priority: feeding every three hours vs. feeding the baby fully at each feeding vs. letting the baby sleep uninterrupted? We never really got an answer except "follow the baby's natural rythms...but make sure you wake her often enough to feed".

Feeling good
While I was on my mandatory 4-weeks-before-due-date maternity leave, my biggest job was to feel good. Sure, I had lots of little projects -- knitting a baby blanket, completing my Dutch exams, enjoying the sun, riding my bike daily -- but my primary responsibility was to feel good. In fact, my midwife repeated several times in one visit "You must take more naps!"

If I felt tired, I should cancel my plans and take a nap. If I had lots of energy, I should go out on my bike. Don't feel like cooking? Don't!

After birth, I was much more in need of care, and while I did have 3 people to help me, I was the sole food source for a little creature who needs to eat every 3 hours. And it often takes 2 just to feed her. Even though my best-husband-in-the-world (yours is too!) was doing literally everything else -- changing diapers, soothing cramps, bath time, waking her up, putting her to sleep, feeding me -- it was really a struggle to keep up with feeding her and recovering me.

- How's motherhood?
- So far I mostly lay, bleeding and feeding.

I really under-appreciated the damage to one's body that labour causes. I think we're all so focused on the labour itself and, most importantly, meeting the little "familiar stranger" (borrowed from my friend Sara) we've spent the last 9 months dreaming about, that we don't imagine how mom's going to feel after birth.

Given that we only really had 30 minutes - 2 hours maximum every cycle to wash everything, feed ourselves, wash ourselves, and sleep, the only way to survive was to cut corners. And the pressure to sleep on cue, eat on cue and pee on cue resulted in me loosing more sleep, eating less, and being too lost to remember to drink water.

Six weeks
The one consistency that seemed to pop up across medical advice, Google, and frantic phone calls to our families was that everything seems to come together at six weeks.

Baby starts to smile around 6 weeks
Sleep patterns emerge around 6 weeks
Mom's pelvis is healed around 6 weeks
Baby's cramps ease around 6 weeks
Mom stops bleeding around 6 weeks

It doesn't seem imaginable, but here we are at six weeks (which feels like forever) beginning sleep training with a smiling, cramp-less baby!

My [Dutch] labour experience

Our little girl was born last week at a birthing centre in Amsterdam, and I just wanted to document my very positive Dutch birth experience while it's still fresh. Best of luck to all my friends who are delivering in the coming months! It's a baby boom!

The Dutch way
The Netherlands is all about natural childbirth, and ex-pats in Holland spread horror stories about pain relief being illegal, home births required by law unless there is a medical indication, and being given only paracetemol (tylenol) to women recovering from c-sections.

There is some truth to this, but these days expecting parents have more choices for their childbirth in The Netherlands than anywhere else in the world. The whole birthing process is lead by midwives, and you can choose to give birth at home, in a birthing centre, or in a hospital (though if there are no medical reasons for a hospital birth, you have to pay a hefty premium to your health insurer), if you've had a c-section, you can try to deliver "naturally" on future children (though only if it is deemed entirely safe), and there are choices for pain relief (though you must be in a birthing centre or a hospital, even for simple pain relief like laughing gas or remifentanil).

And, most importantly, in The Netherlands you get a trained "maternity care giver" -- think "professional mother" -- who comes to your house for 8-10 days after birth to train you with the Dutch system of raising babies.

Labour
I was one week late, my husband had just wrapped up all his projects at work, handed in his thesis proposal at school, and had his last class the day before. I had just finished the baby blanket and hat -- the last of my pre-baby maternity leave projects. We went for a date, dinner and a (very violent) movie, and came home to watch comedies to lighten the atmosphere.

Just as we were showering before bed, my contractions started around 2AM, were straight away 6-8 minutes apart, and almost immediately my water broke. There was clearly meconium in the water (which meant we had to go to the hospital), and the midwife came to our house to confirm this diagnosis.

I was quite relieved that we had a medical indication that forced us into a hospital birth. For months I had been making an ambiguous response to the question "Are you planning on having a home birth?" Natural childbirth at home just sounds so romantic, and is so valued in The Netherlands. Imagining candles, soft music, and an intense peacefulness in our loving home.

- Are you sure you want to be open to a home birth? There's a lot of blood and stuff. Which room / piece of furniture are you imagining giving birth on?

- Yah, I feel like I'd be more comfortable in a hospital, but we also live on the fourth floor in a building with steep stairs and no lift. Do you want to carry me downstairs in full labour? Home birth may seem like a really good option then.

The midwife made all the arrangements with the birthing centre attached to the Saint Lucas Andreas hospital in Amsterdam, and drove us there. It was such a smooth process, timing our movements between my contractions. When we arrived at the hospital, we just walked straight through into our private room, no hassles, no paperwork, no waiting. The birthing centre rooms are spacious, you have your own bathroom with shower, bath, and toilet.

My husband managed communication with the midwives, students, and nurses, and I managed my pain. My tactic to withstand the contractions was that he would pinch both of my Achilles tendons (an acupressure technique recommended by a work colleague), and I would focus on that pain and my breathing. This really kept me in "the zone", and enabled me to keep it together (I only had to ask my husband once to "Please stop talking" -- use of the word "please" constitutes "keeping it together" in my books). I spent most of my labour laying on my side with a big pillow between my knees, enjoying the spaces between the contractions as much as possible. I probably should have moved around more to speed up my contractions, but I was far too content laying on my side.

Almost immediately they ran tests to make sure the baby was not in distress (though I was never doubted it, I just knew the baby was fine), and after a short time we had the results: we were not in the unlucky 10% of cases where meconium is a serious indication, our baby was in great condition.

After about 5 hours of labour, I was nearing dilation but my contractions were still only 5 minutes apart. They explained that it was important my contractions were a minimum of 2 minutes apart before we could push the baby through the birth canal, because if something were wrong 5 minutes was too long to wait between pushes. They gave me oxytocin to speed up the contractions, at which point I also requested remifentanil -- with all the tubes and elastic bands I was hooked up to, it was one more that would actually make me feel good! I didn't find that the remifentanil did anything to lessen the intensity of the contractions, but they made the spaces between contractions even more enjoyable.

- Are you sure you would like remifentanil?

- I wouldn't be asking for it unless I was at my wit's end. Yes.
- Can you wait 10 minutes and then decide if you would like it?
- It will take you 10 minutes to set it up, so no, I don't want to wait an additional 10 minutes.
- Wait 10 minutes, then press this red button and we will start you on remifentanil.
[9 minutes later...]
- Do you still want remifentanil?
- I wanted remifentanil 10 minutes ago...OF COURSE! YES!

After the labour was over and I had my little girl in my arms they asked me if I was glad that they made me wait 10 minutes. I was far too tired to deliver a collected and calculated response which somehow articulated the depth of my displeasure with them, that the unnecessary and non-medical postponement of remifentanil was the only major disappointment I had in my entire labour experience, and that it explicitly states in my birth plan that if I ask for pain relief, I am to be taken seriously with immediate action because I tend to push my body beyond its capabilities.

- No.

Once the contractions were every two minutes (and I was already involuntarily pushing during contractions), we started the pushing phase. After 5 minutes, they said I would need an episiotomy because the baby was showing signs of distress (but again, I was not worried about it). I didn't really feel anything, and then we resumed pushing and within about 5-10 minutes I had a beautiful slimy baby placed directly from my womb onto my chest.

Although I could feel everything (the remifentanil is only used for a short window before the pushing phase, and leaves your system within 4 minutes), I almost couldn't believe that this little creature on my chest was our baby. All I could see was this little head, which shielded the rest of her body from my sight.

We waited 15-30 minutes or so for pulsations to cease, and then my husband cut the umbilical chord. She breastfed within the hour, and as soon as I was stitched up, everyone cleared the room and left us alone with with our baby for two glorious hours -- she was alert, calm, and such a delight for us. A while later they came with food and champagne for us. Eventually they weighed the baby with my husband (the elation of birth started to be replaced by the exhaustion of labour, and I spent the rest of the day laying down), and we were released.

Maternity care
We walked out of the hospital 5 hours after our baby was born, and a maternity care giver (in Dutch, a "Kraamverzorgster") was at our house within an hour of arriving home to help us settle in. This is something which I think is exclusive to The Netherlands. All new parents and babies are cared for in your own home by a maternity nurse / care giver for the first 8-10 days of your baby's life. The maternity care givers provide daily checkups to the baby and mother, assist with breastfeeding, diapers, cook, clean, fetch groceries, let you sleep, shower, and provide daily (Dutch) parenting tips. 

24 hours of bliss
The first 24 hours, the baby doesn't really need to eat much, and it was such a blissful and joyful time for us to spend with our calm and happy baby before the feeding pressure started the next day.

Always get pregnant in September

Most couples trying to conceive do not have much choice in the matter, but if you live in the Netherlands and can manage the conception date of your baby, I suggest always getting pregnant at the end of September:

1. In the Netherlands, woman must take maternity leave 4 weeks before their due date (but can take up to 6 weeks), and 12 weeks after their delivery day (or 10 weeks, if you've taken 6 weeks before your due date).

2. The Netherlands only has a few public holidays a year, and most of them fall in April / May. Check your calendar and see when the last public holiday in May is for the following year, add 4 weeks (maternity leave) to it to arrive at your ideal due date, and then count back 40 weeks to see when the first day of your last period should be.

This will optimise your chances of good weather + not losing any public holidays while on maternity leave. I was, sadly, one week too early and missed Pentecost this year.

Other great advice that I was given, and really worked for my pregnancy (but find the advice that works for you and your pregnancy):

1. Pregnancy is really long. Don't talk about it, think about it, or make decisions too early. It will go on forever.
2. Slow down, but don't stop. Once you stop doing something, you often can't pick it up again (I stopped jogging for 3 weeks halfway through my pregnancy, and couldn't jog after that again. But I did cycle throughout my pregnancy and am still very mobile on my bike 5 days before my due date). Being active has been so important to me in my pregnancy. However...
3. It's not necessarily all downhill. Every time I started getting cramps at night, or exhausted for a week, I thought to myself "This is it. This is how I am going to feel for the rest of my pregnancy." But actually I felt much more comfortable and was more active and mobile from 30-40 weeks than I was around 8 weeks, 22 weeks, and 36 weeks. But everyone's different.
4. Keep planning social activities right through your due date. Life must go on. Most women are late with their first child, and thinking beyond your due date will relieve the stress and pressure mounted on that day (and may also speed things up).
5. Get maternity clothes and a body pillow as soon as you start to feel uncomfortable -- don't wait. The body pillow can be used for nursing after baby is born, and you don't need to spend a lot of money to buy a few pairs of maternity trousers and some long shirts.
6. Find what works for you. It took half my pregnancy to figure out what I needed to make my pregnancy smooth. In my case, I really needed to micromanage my liquid consumption (drinking water all day did not come naturally for me), I needed to take iron, fiber, and magnesium every day for me, and just vitamin D for the baby (and folic acid for the first 12 weeks). And I ate sushi every week (for baby's brain development, and mummy's sanity).
7. Relaxed parents make relaxed baby. The only complications I had was when I was highly stressed at work leading up to my mid-pregnancy holiday in Italy.

Advice I didn't take, but wish I had:

8. Take a prenatal yoga or other course that encourages you to embrace your pregnancy. For at least 1 hour a week you can really take the time to enjoy being pregnant. I didn't really embrace my pregnancy, I only embraced my maternity leave.

Wonderful idea. Wrong species.

I was thrilled when I found this list of quotes that was compiled for me by a British friend in Japan in 2002, as I was migrating data to my new computer today!

"We are here on earth to do good to others.  What the others are here for, I don't know."  W.H.Auden, poet.

"If dogs could talk, perhaps we would find it as hard to get along with them as we do with people."  Josef Capek, artist.

"Egotist: person of low taste, more interested in himself than in me."  Ambrose Bierce.

"An idea isn't responsible for the people who believe in it."  Don Marquis, journalist.

"Wonderful idea.  Wrong species."  E.O.
Wilson, naturalist and ant expert, on Marxism.

"A curious sport where the object is to put a very small ball in a very small hole with implements ill-designed for the purpose."
- Winston Churchill on golf

"If one regards oneself as a sceptic, it is as well from time to time to be sceptical about one's scepticism."   Freud, psychoanalist.

"It's good to do nothing and then rest."  Spanish proverb.

"Never interrupt your enemy while he is making a mistake."  Napoleon, Emperor of France.

"He who praises everybody, praises nobody."  Dr Johnson, writer.

"Millions long for immortality who do not know what to do with themselves on a rainy Sunday afternoon."  Susan Ertz.

"Buy land.  They aren't making it any more."  Mark Twain, writer.

"When two people in business always agree, one of them is unnecessary."  William Wrigley Jr., businessman.

"A bore is a man who deprives you of solitude without providing you with company."  Gian Vincenzo Gravina.

"Some cause happiness wherever they go; others whenever they go."  Oscar Wilde, writer.

"Never confuse motion with action."  Benjamin Franklin, politician.

"I do not feel obliged to believe that the same God who has endowed us with senses, reason and intellect has intended us to forego their use..."  Galileo

"Charm is the ability to make someone think that both of you are pretty wonderful."  Kathleen Winsor.