Butterfly Confessions: How Writer, Advocate and Mother A'Driane Nieves Gives Birth With Confidence

I am excited to introduce A'Driane Nieves to the Giving Birth with Confidence community. A'Driane is a well-knlogown bger and maternal mental health advocate. Her artwork inspires, and her chronicle of her pregnancy is a testament to self-advocacy in prenatal care. By sharing her journey through pregnancy and motherhood with bipolar II disorder, A'Driane gives courage to all women to give birth with confidence.

Tell us a little about this pregnancy.

This pregnancy, my third has been&physically overwhelming. It's honestly been one for the books! Every symptom the first trimester was far more intense than what I'd experienced previously, especially my morning sickness and the withdrawal symptoms I was experiencing from having to stop my mood stabilizer (Lamictal) until my second trimester. I also struggled with hypotension, migraines, and severe symphysis pubis, which rendered me immobile most days and landed me on bed rest quite often these past 9 months. Since the beginning of my third trimester I've had fairly strong contractions daily-ones that are usually 3-4 minutes apart most of the day and force me to stop and breathe through. I ended up in labor and delivery twice and given various medications to try and stop them, often to no avail, which led to stricter bed rest and having to be put on a monitor every appointment. Like I said, this has definitely been one for books...

How do you approach giving birth with confidence with this birth?

This is the first birth that I feel like I actually prepared for mentally in terms of actually learning about the labor process, birthing methods, pain management, etc. With my previous two births, the bulk of my preparation was external, ensuring everything I needed to care for my sons after they were born was purchased and at the ready. I simply didn't place much value or emphasis on the experience-I solely cared about the end result.

However, with this pregnancy, I took time to really reflect on my previous labor experiences and came to realize that I hated both of them. I found that because external circumstances had me living in survival mode, I went into both of my labors anxious, stressed out, and uneducated about the labor process and mentally unprepared to manage what I was experiencing physically during each one; back labor with my first, and five days of prodromal and early labor with my second. With this pregnancy I decided that while the end result (healthy baby) was still what mattered most to me, I did want to enjoy my labor and delivery as best I could.

To help facilitate this goal, I've read several books, articles, and blog posts on various birthing methods, and have pulled different aspects from each to use that I found appealing. I've researched & practiced breathing & relaxation techniques I could employ to manage not just the pains of labor but any anxiety I will most likely experience. I explored the idea of hiring a doula, and talked at great length with my husband about what kind of role he felt comfortable fulfilling during my labor and what kind of atmosphere he'd like us to have during the process. This was a first for me, because with my first labor, I was a single mom, and on my own. With my second, my husband and I were together, but we never discussed anything about labor or what "kind" of birth experience we could have. This time I've made sure to include him, which has helped us bond in a way we didn't my last pregnancy.

Taking the time to inform myself of my options, and actually read what happens during labor has definitely helped me approach my upcoming birth with a sense of vigor and enthusiasm I haven't experienced before. I've been able to communicate more with my OB confidently, and feel far more empowered as a patient...

How has taking care of mental health played a role in that?

While being prepared and informed mentally for the birthing process has been important to me this pregnancy, my top priority from the moment I saw the plus sign on the test has been to take care of myself mentally. As a woman with a history of PPD and currently living with rapid cycling bipolar II, anxiety & OCD, I've worked hard this pregnancy to ensure I have what I need to do that. From finding an OB with experience treating pregnant women with mood disorders, to finding new psychiatrist who is knowledgeable and up to date with treatment methods, to educating myself on what treatment and medication options are available to me, to attending talk therapy, I've fought hard this pregnancy to advocate for my mental health both during pregnancy and in the postpartum period. I've asked both my husband and closest friends to help me be aware to any shifts in mood they may notice that I don't, and to tell me if they notice anything that concerns them during this time or in the days and months to come. I've read up on my risk for postpartum psychosis and have talked with other mothers who have experienced it to gain their insight and support. I have also made it a point to ramp up on my self-care, even during periods of depression this pregnancy. Painting, watching a favorite show, listening to music, reading, and even some days just forcing myself to shower-these are all things that have helped me manage my illness aside from medication and therapy these past nine months.

Reflecting on my previous birth experiences and how they impacted me mentally-especially my last where I experienced prodromal and early labor that went nowhere without augmentation-also empowered me this time to talk at great length with my OB about what my options are this time. I've expressed how triggering the physical strain of this pregnancy has been on me, and how triggering the end of my last pregnancy and labor was on my mentally. I stressed my desire to not go into this labor exhausted and drained mentally, and my fear that doing so would increase my chances of struggling in the postpartum period. After two weeks of cervical checks that saw no change in my cervix despite having regular, moderate-severe contractions, and other early labor symptoms, we decided last week that scheduling an induction would be best, as I expressed I was already starting to cycle between moods-mostly depressive, and had reached my limit physically. I love my OB because he heard me and took my mental health into account and not just that of the baby's at this stage. I'm grateful that he was able to look at my maternal health, the baby's health, and my mental health, and come to a decision that benefitted all three. Very grateful for that.

How has the blogging and online community offer you support?

I'm also incredibly grateful this pregnancy for the online support system I have this time around. I found my online tribe and place in the blogging community three years ago while battling PPD, and both my tribe and the blogging community at large have become a lifeline for me. Thanks to the blogging, I've met strangers who have become my sisters and confidants, and I've found my voice as an advocate. They help me stay informed, encourage me, hold me accountable to taking care of myself, and are there to listen and sit with me when needed. They've enabled me to have a strength and confidence this pregnancy that I didn't previously and even though I know being a mother of 3 with a mental illness such as mine will be a challenge, it's one I know I'm capable of succeeding at.

I go in for my induction on Tuesday 11/12 at 6am&.and I can barely contain my excitement and relief :)

I know I speak for everyone in wishing A'Driane well as she welcomes this beautiful baby into the world!

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