Countdown to Christmas Eve Baby!

About a week before Thanksgiving, my kids and I constructed an advent chain of sorts to countdown the days until Christmas, since my due date was December 25/26. This gave my kids--especially the two younger ones--a more tangible way to understand how many days remained until Christmas, and, possibly, the approximate time until our baby would arrive. Of course, I fully expected that he would arrive closer to New Year, but it was still a good countdown for the children. It also helped me cope when I began to get impatient with the remaining time to wait for baby's arrival. When I looked at these paper strips, they didn't look like many, and the chain got noticeably shorter quickly. Here's our countdown chain a few weeks ago:

What a worthwhile wait. Look at our Christmas Eve baby! I can't wait to post his birth story and the few photos I have from that adventure.

He's so long he doesn't come close to fitting in this stocking! 21 1/2"

8 lb 10 oz means nice round cheeks/jowls on my newborn!

Look how long he is! No wonder I was so uncomfortable. How did he fit inside me just yesterday???

Photography by Trebor Sutler

Red Raspberry Leaf tea/punch & popsicles

Red raspberry leaf tea has many benefits for 3rd trimester expectant mommas, but of course, consult your care provider to see if it's appropriate for you, don't sue me, etc. Here's a link where you can read about the uterine tonic and nutritional benefits of RRL tea.

My doula and monitrice friend Sarah Booten in Chicago (who is also the owner of In Bloom magazine) gave me this recipe for a tasty labor tea/punch that can also be used to make healthy labor popsicles. It has the herbal benefits (uterine tonic), nutritional bonus, and natural source of calories for energy in labor, minus the high fructose corn syrup and artificial colors and flavors in most popsicles.

Red Raspberry Leaf Labor Punch

Strong-brewed red raspberry leaf tea, 1 pitcher (any amount)
Equal amount of 100% apple juice (no sugar added)
Honey to taste, optional
1 lb. frozen red raspberries, crushed on kitchen counter when the bag is still sealed

I made 2 dozen labor popsicles and still had a substantially full iced tea pitcher of labor tea/punch. I hope you enjoy this recipe. It's a great drink or popsicle to take with you to the hospital or birth center, especially if your facility has restrictions on eating and drinking in labor. (I hope it does not, for a lot of reasons, explained here.)

Not pictured: 100% apple juice

Labor music & reducing pain perception

Lots of mommas report that having their favorite music playing during labor and birth helps counteract the Fear-Tension-Pain cycle and assist with lessening their perception of pain, helping make labor more manageable. What kind of music you'll want to have ready is totally personal. I find that most mommas prefer slow music for early through active labor (anything you could slow-dance to), but that slow instrumental music is frequently more relaxing as the mother approaches transition through pushing. The lyrics can be too distracting at that point. Of course, it's up to you. One momma told me that she had rave music playing throughout her entire unmedicated birth at a birth center. Whatever floats your boat.

Find out if your place of birth has a CD player in each room. If not (and not many do), be prepared to have your iPod, iPad, or other MP3 player ready *with speakers* since it's difficult to keep earbuds in place while changing positions frequently during labor. It also makes for nice ambiance for your labor partner and labor support team.

I started drafting my labor playlist on notebook paper six months ago. The list kept growing until I realized that not only could we not afford to download that many songs on iTunes, but also that by the time I realized it was active labor, I likely wouldn't even have time to listen to the entire playlist I had written up! I have shown my "dream" playlist to a few friends, all of whom commented on how eclectic and varied the genres of my picks were. I figured I'd post both my finalized list and my "dream" list for anyone looking for ideas. Anyone who likes the same music I do, that is. Otherwise, make sure you have your rave music ready to play. It's all good.

My final playlist, most of which we already had on iTunes:

• "Don't Let Me Be Lonely Tonight" James Taylor
• "Something in the Way She Moves" James Taylor
• "You've Got a Friend" James Taylor
• "Fire and Rain" James Taylor
• "Sweet Baby James" James Taylor
• "Carolina In My Mind" James Taylor
• "Walking Man" James Taylor
• "Daughters" John Mayer
• "Don't Know Why" Norah Jones
• "Try a Little Tenderness" Michael Buble
• "More Than Words" Extreme
• "Bed of Roses" Bon Jovi
• "Kiss from a Rose" Seal
• "She's Always a Woman" Billy Joel
• "To Make You Feel My Love" Billy Joel ("Our song" played at our wedding)
• "Lullaby (Goodnight, My Angel)" Billy Joel
• "New York State of Mind" Billy Joel
• "Shameless" Garth Brooks
• "I Melt" Rascal Flatts
• "When Can I See You" Babyface
• "Take a Bow" Madonna
• "Crazy For You" Madonna
• "Forbidden Love" Madonna
• "Love Don't Live Here Anymore" Madonna
• "I'll Remember" Madonna
• "One More Chance" Madonna
• "Something to Remember" Madonna
• "You'll See" Madonna
• "Wicked Game" Chris Isaak
• "Just the Two of Us" Grover Washington, Jr.
• "Your Song" Elton John
• "Tiny Dancer" Elton John
• "Layla (Acoustic Version)" Eric Clapton
• "Take it to the Limit" Eagles
• "I Don't Want to Miss a Thing" Aerosmith
• "Nothing Compares 2 U" Sinead O'Connor
• "A Whiter Shade of Pale" Joe Cocker

Additional songs I'd have added if I felt like spending the cash:

• "Lucky" Jason Mraz
• "Waiting on the World to Change" John Mayer
• "Body is a Wonderland" John Mayer
• "Isn't She Lovely" Stevie Wonder
• "When a Man Loves a Woman" Percy Sledge
• "Givin' Him Something He Can Feel" En Vogue
• "Let's Get it On" Rascal Flatts or Marvin Gaye
• "Let's Stay Together" Al Green
• "Easy" Commodores
• "Desperado" Eagles
• "Hotel California" Eagles
• "Best of My Love" Eagles
• "Wasted Time" Eagles
• "One of These Nights" Eagles
• "I Can't Tell You Why" Eagles
• "Landslide (Acoustic)" Fleetwood Mac
• "Rhiannon" Fleetwood Mac
• "Angel" Aerosmith
• "What it Takes" Aerosmith
• "The One" Elton John
• "I Want Love" Elton John
• "The Way You Look Tonight" Elton John
• "Goodbye Yellow Brick Road" Elton John
• "Patience" Guns & Roses
• "Knockin on Heaven's Door" Guns & Roses
• "Weak" SWV
• "Must Have Been Love" Roxette
• "Faithfully" Journey
• "Lights" Journey
• "Open Arms" Journey
• "When You Love a Woman" Journey
• "Strange Magic" ELO
• "Careless Whisper" George Michael
• "Sara Smile" Hall & Oates
• "Vision of Love" Mariah Carey
• "Open Arms" Mariah Carey
• "Can't Let Go" Mariah Carey
• "Without You" Mariah Carey
• "I Still Believe" Mariah Carey
• "My All" Mariah Carey
• "I'll Be There" Mariah Carey
• "Fragile" Sting
• "When We Dance" Sting
• "In the Air Tonight" Phil Collins
• "Rain" Madonna
• "Just the Way You Are" Billy Joel
• "Honesty" Billy Joel
• "Leave a Tender Moment Alone" Billy Joel
• "She's Got a Way" Billy Joel
• "And So It Goes" Billy Joel
• "Into Temptation" Crowded House

And for transition onward, if the lyrics of slow music are too distracting, I plan on playing Pandora Radio channel for Pachelbel's Canon in D (another song played at our wedding). 

Did you have music playing during your labor and/or birth? What music did you prepare ahead of time? Did you end up wanting what you thought you would want?

39 wks basketball in mah belleh

Yes, I'm aware that I waddle. I know that I don't walk terribly well. I realize that I must not have much longer, by the looks of things. No, I do not need any commentary about how I look like I might pop (or worse--explode) any minute now. Who ever thought it was a good idea to compare childbirth to explosions? Not a positive mental image, people!

And before anyone is tempted to get me started, read this before any thoughts of commenting on how you think I'm big as a house or must be carrying twins (I'm not, and I'm not).

I'm still seeing my chiropractor weekly. Who knows how bad my SPD and SI issues would be if I weren't. It's pretty bad as is, and I know that chiropractic is helping. I've been drinking Earth Mama Angel Baby Third Trimester Tea every night before bed. That's been a fun countdown, watching my stock of it dwindle.

I just found out that I'm GBS positive, so I have to decide what course of action to take (or not to take). As of right now, I'm likely to take the course of treatment based on risk factors as opposed to prophylactically, considering the Cochrane Review of the research on GBS and IV antibiotics in labor.

I guess that's all the news for now. I'm just hanging out, waiting for Christmas or labor, whichever comes first. It's a little bit hard to wait, knowing it *could* be tonight, but it *could* be 3 more weeks. It does make it easier to wait, having so much to do. I haven't even started wrapping gifts and I have a ton of nesting to do, so I'm content to wait on my son's timing. (Even if I weren't content to wait, I wouldn't evict him without pressing proof of medical need to do so, in case you were wondering. Here's why.)

What we sacrifice for our growing babies: dignity

I remember a post by Gina Crosley-Corcoran (The Feminist Breeder) shortly after she had her daughter this past April, in which she rocked a motorized cart scooting around Target, nursing her baby, 2 or 3 days postpartum. That mental picture stuck with me and reminded me that there are times to swallow our pride and get on a motorized cart when the time calls for it.

That time, for me, is now. I have SPD, symphysis pubis dysfunction, which, in a nutshell, is intense pelvic/hip pain due to pregnancy hormones. It will self-resolve after delivery, but for now, my hips hurt constantly, whether I'm moving or stationary. [If you suffer from pregnancy SPD, here is Kmom's article on recognizing, coping with, and alleviating symptoms of SPD. It's the most comprehensive I've read.] Walking and climbing stairs are difficult and painful. A big trip to Walmart to stock up on all the stuff I won't have time to get after the baby is here? Nearly impossible. That is, unless I suck it up and use a motorized cart.

Like so.

My dignity is GONE.

A sweet friend offered to watch my children for the afternoon so that I could get this huge shopping trip done, and that time is precious and rare, so I had to take advantage of it. Fortunately, one of my dear friend's daughters, Katey (who is also a sweet friend and our favorite babysitter), was able to come with me to help on short notice, or else I wouldn't have been able to do this trip at all. I needed her to push the actual buggies while I motored on this awesome cart and quickly filled its little basket.

(For the record, I don't like giving my business to Walmart, and I'm not proud of publicly admitting that I shop there, but in this life stage, multiple shopping trips to various small(er) businesses is not a possibility.) (Also for the record, we were not buying alcohol in this aisle, although I can see how it would look that way if you look at the background. We were there to get bottled water, which, also, for the record, I don't use often, but wanted to have around for quick access in labor for myself and my midwives and doula, as well as for company.)

Katey and I filled two full size buggies completely full, plus the little basket in my cart with laundry detergent, dish detergent, toilet paper, paper towels, canned food, string cheese, frozen waffles, light bulbs, coffee, a vaporizer/humidifier for the kids' room, diapers for my three-year-old, and, yes, as you can see by this VERY candid photo, postpartum maxi pads. And, yes, that is a donut in my hand, because by this time, I AM A PREGNANCY CLICHE. I may as well revel in it.

I was in a motorized cart, 38 weeks pregnant, eating a donut, and wearing my "good" sweatpants along with my widest sneakers.

My total for this stock-up was $580, the most I've ever spent at one time (not counting house, vehicle or furniture). I was grateful for multiple Walmart gift cards and payment for teaching several Well Rounded Birth Prep classes lately, which covered 2/3 of that bill. Now I'm one big step closer to feeling ready for baby. The weather was mild, and the timing was perfect. I'm so glad I got the job done. Even if it meant wondering if I was a public spectacle or if someone was taking my picture for peopleofwalmart.com. (Don't even THINK about submitting this on there.)

What about you? Have any of you had to resort to using a motorized cart to get around when shopping at the end of pregnancy? A few of my friends said they had. How was it for you?

37 weeks pregnant belly pic

Be forewarned: if you're tempted to comment on how "huge" I look, or to ask if it's twins, please read this blog post first or face 3rd trimester hormone wrath.

So, I'm 37 weeks pregnant, which means I could have this baby as early as "any minute now" or as late as January 8, but likely between Christmas and New Year.  The big milestone that comes with the pronouncement of 37 weeks is that if, for some reason, this baby decides to come sooner rather than later (which is unlikely, but still...), he would not be premature, and I'd be cleared for a safe homebirth. (Homebirth is not safe for premature babies.)

How do I feel? 9 months pregnant would be the best descriptor. I'm uncomfortable but healthy overall. I really don't have much to complain about, but since you asked... My SPD and pelvic pain are worsening. I generally do OK during the day if I stay up and moving constantly, but if I have to stand or sit in one position for an extended time, my pelvic/hip joints "freeze" and moving is very painful after that. This means that sleep is miserable because I can't change positions easily.

I'm still sleeping on a huge wedge pillow to prevent/reduce reflux, in addition to taking nightly OTC heartburn medicine that my midwife recommended. It only helps a little. I cannot lay flat whatsoever. Combine that with the fact that I'm a left-side-sleeper by nature, and with my pelvic issues, and it's not great. I wake up jackknifed on my left side, on that wedge, with my hips torqued oddly and entire pelvis aching. I have to keep my knees together to hobble to the bathroom in the night, holding onto the wall with every step. Several times, I've considered waking Rick to have him help me get to the bathroom, but I haven't resorted to that yet. The fact that it's nearly that bad isn't encouraging, considering that I still have a month or so to go (probably).

It's also hard to breathe because he's pressing against my lungs. Drop, son, drop! I remember the instant feelings of relief after the birth of my last baby with regards to easier to breathe and heartburn gone instantly. It took about a month or month-and-a-half my pelvic pain to resolve last time, for the pregnancy hormones (relaxin) to flush from my system. I hope it doesn't take that long this time, but if it  does, I won't have to be afraid that I broke something.

OK, that's that, it's late and I'm 9 months pregnant and going to bed so I can pretend to try to sleep, then wake in a few hours to read magazines on my hubby's iPad since I can't sleep. I better get to it!

36 week pregnancy affirmations

Nowadays when I leave the house, strangers say things like,

• "You look like you're ready to go any minute now!"
• "You mean they're going to 'LET' you go that long???"
• "Are you sure that's your due date?"
• "You look really uncomfortable."
• "HOW much longer???"

Pregnancy (for me, anyway) is uncomfortable enough without strangers rubbing it in, reminding me, bringing me down, and/or discouraging me. See related post "Wide variety of healthy and normal in pregnancy."

These are things I tell myself to counter the negative things people say:

• It's easier to take care of baby now, inside of me, than it will be once he's here.
• He's growing on his timetable, getting exactly what he needs. It doesn't matter if he goes past my due date because a 40+ weeker is often more neurologically mature, a better nurser, cries less, easier to comfort, etc. than a 37 weeker. (I realize there are exceptions to this. Let me reiterate, these are things I tell myself to comfort myself since I know that I will almost certainly go past 40 weeks and I'm committed to allowing him to choose his own birthday, barring medical problems.)
• My body is well designed and knows exactly what it's doing. I'm healthy (in spite of my heartburn, SPD, and waddle). My baby is healthy. My body has grown my baby from the size of a mustard seed to 7, 8, or 9+ lb without any input from me, and my body is smart enough, capable enough, and competent enough to continue its important work for this upcoming last month. My body knows when to go into labor, and what kind of labor this baby needs for his timing and positioning. 
• My body also knows how to nurse this baby. What a sweet reward that will be for my labor!
• As we count down days to my due date on a paper chain, the chain starts looking a lot smaller, while the list of nesting that needs done before his arrival keeps getting longer! There's no need to wish away these last few weeks when I need every minute of that to prepare our home, as well as prepare my body and mind for greeting this baby.
• It won't be much longer, and I won't be pregnant any more. This *might* be my last pregnancy. In spite of all the discomforts, pregnancy is still a miracle. It's still thrilling and amazing to feel his every move inside of me, in spite of the fact that this is my 6th pregnancy and 5th live baby. I know I'll miss feeling him squirm inside of me. I'm trying to treasure that now.
• The minute that labor is over with and he's in my arms, my round-the-clock heartburn and reflux will be OVER!!! Like MAGIC!!!! Another sweet reward for labor!
• Yes, I'm a public spectacle when I go out in public with my children, ages 9, 7, 5, and 3--with an obvious 3rd trimester baby bump. Oh well. Who cares. My children are well behaved, and I have nothing to be ashamed of. My children are a blessing!
• The next few weeks will be a great time to work in a few last one-on-one activities with my first four children. There's no use in wishing baby would hurry up when I haven't completed these quality time activities with my kids!
• Friends gave us a Chili's restaurant gift card, Starbucks gift card, and offered to watch our kids so that my husband and I can have a special date together, stress-free and guilt-free, before baby comes. There's no use in wishing baby would hurry up when we haven't even gotten to claim our date yet!
• A friend gifted me with money for a pedicure before baby comes, and offered to go with me to get it done. There's no use in wishing baby would hurry up when I haven't gotten my pedicure yet!
• Some time ago, I bartered a childbirth class with a friend who is a massage therapist and promised me a massage. I haven't claimed that massage yet, and she encouraged me to find a time that she can give me a massage before baby arrives. How welcome that massage will be for my poor aching pregnant body! There's no use in wishing baby would hurry up when I haven't gotten my pedicure yet!
• In summary: there's no use in wishing baby would hurry up! All in good time.

What positive thoughts or phrases helped you survive the last few weeks or months of pregnancy?

Belly shot at 32 weeks along

The info on this photo says it was taken Oct. 30. I've lost track. I think I was 32 weeks? I'm behind on posting stuff. I still haven't even posted my 20 week ultrasound pictures! I don't have a scanner, so it would entail taking good photos of the physical paper ultrasound images (without glare), then straightening and cropping and uploading. 

I'm feeling... well... 8 months pregnant, I guess, is the most fair and honest way to say it without complaining too much. I realize I'm blessed to be healthy and not to have any health problems or complications, and we're blessed that baby is healthy and growing on pace. I'm aware that there are many moms who would gladly trade me places if they could, even with all the pregnancy discomforts and inconveniences. If I'm going to be honest, though, I'll confess I'm pretty uncomfortable a majority of the time. I know I'm in the home stretch, though. I know I'll feel better right away as soon as this baby is out of me.

With preparation for Thanksgiving and then Christmas coming up, I'm sure the last few weeks will go pretty quickly. I'm glad to have a lot of distractions.

Guest post: plans for hospital VBA2C change to repeat cesarean

Well Rounded reader Sarah shared her birth story in her own words. Thank you for sharing, Sarah.


***********************************************

I’ve had three cesareans.  The first one was not by choice.  The second one was a decision based on lies.  The third was part of the big picture, not mine, but part of a plan, nonetheless.  

When I was pregnant with our first child, I had never even considered going to a birthing center or a midwife.  I went to a practice of obstetricians that had three male doctors.  I went to a birthing class given by the hospital.  Wasn’t that what all pregnant women did?  

Around month 7, I noticed a very hard lump under my rib cage.  I kept asking the doctor if this perhaps could be my son’s head.  He kept reassuring me that he could feel the head “down there”.  My husband even voiced his concerns and again the doctor said it was all fine.  At week 40, my cervix was 85% effaced, but I hadn’t dilated at all.  My official OB was in Paris on vacation, so I saw another doctor from the practice.  He immediately ordered an ultrasound to determine the baby’s position.  Breech.  He said, “You are going in tomorrow morning for a C-section.”  I cried.  It didn’t even occur to me to question this decision that was made for us.  Our birth story was forever altered by a stranger.  

There was never any mention of exercises to correct a breech presentation.  There was never any mention of attempting aversion.  There was never any mention of attempting labor to see if the child might flip over during contractions.  They didn’t cover cesareans in the ill-informative birthing class.

When I became pregnant with our second child, I inquired about attempting a VBAC.  My OB immediately shot my request down.  “Why would you want to do that?”  Also, he said that the rate of uterine rupture was much higher than they originally thought.  He said the risk of rupture was over 30%. [Well Rounded Birth Prep adds: The actual statistics for uterine rupture for VBAC range from 0.7% to 0.9%.]  Who would want to take that risk?  My husband and I immediately scheduled the repeat cesarean.  It never occurred to us to check those statistics out on our own.  Why would our doctor lie to us???

I was all set to have my third cesarean with our third pregnancy.  But, I had met some other women who had stories to tell.  I felt that God was urging me in another direction.  Believe me; I didn’t want to go there.  Who is crazy enough to attempt a VBAC after two C-sections?  How misinformed I was!  After much prayer, my husband and I decided to go for a VBA2C.  We hired a doula and educated ourselves with informative, private birthing classes.  What an eye-opener.  Why was this information not presented in a doctor’s office or a hospital-sanctioned birth class?  We prepared to deliver our third child naturally, but in a hospital setting.  

At week 41, I finally went into labor on a Wednesday.  I was still having consistent and stronger contractions on Thursday.  By the time Friday rolled around, I was having pretty strong contractions like clockwork, every 4 minutes and 60 seconds long.  We decided Friday evening to go to the hospital.  

Within an hour upon arrival, the high-risk doctor came in to tell us our baby was in distress and we needed to immediately go to surgery.  My husband kicked everyone out of the room and we prayed together.  The baby’s heart rate instantly dropped to normal.  This would be just one out of many urgings from the many doctors we saw to have a C-section.  The fear of uterine rupture from the staff was palpable.  We ignored them.  I found out that there had never been a VBA2C in that hospital before, according to our labor nurse of 30 years in that facility.  I think the staff thought we were complete freaks, but we were given our space to labor alone.  

Saturday morning, I was still laboring naturally.  My husband and I were having an extremely emotional, intimately bonding experience, even in the hospital.  It was very spiritual with our praying and quoting scripture and breathing through contractions.  We made the decision to not use our doula; it was that special for us both.  We were walking and eating and drinking.  I was taking hot showers.  Basically, we were doing everything the hospital said I shouldn’t/couldn’t do.  

Around 3 pm on Saturday, the baby went into distress for the second time.  The doctor suspected meconium in the amniotic fluid.  So, I agreed to let him break the water to check.  It was tainted.  The doctor strongly urged us to have a C-section.  Again we requested to be alone and prayed and the baby’s heart rate returned to normal.  I continued to labor for the next five hours until we had a cesarean Saturday evening.  

I am not privy to the big picture.  I totally felt God’s presence through this entire experience.  I had wanted to have a vaginal birth and felt that God had opened us to this idea.  Lots of people had questions as to why didn’t we do this or why did we do that.   I can’t answer that.  I know God’s hand was in the entire experience and delivered us through it safely.  It was an incredible birth.

My husband and I, as well as so many friends and family, had prayed fervently to have a labor-friendly nurse and OB on call when I went into labor.  I definitely feel so blessed to have had that particular doctor on call that Saturday.  He was very honest and up front about not doing anything we didn’t agree to do.  He even stayed past his designated shift because he felt that he couldn’t leave us with the next on-call doc.  Our labor nurse told us directly that she could only recommend something, that she couldn’t enforce anything.  I highly respect these individuals and am not in any way trying to bash medical professionals.  The key in this was our vocalization.  My husband was the voice.  He said “No!” on more than one occasion.    

What I do know is that I have choices.  It is up to you to inform yourself about birth.  Don’t let someone else decide for you.  I fully believe cesareans are a necessary surgery when it is necessary.  I am not anti-cesarean at all.  I just believe all women should be informed about the “typical” birth in this country.  That is what I take from this experience.  I will educate my daughters (and son, for that matter) to be their own advocates.  They will have choices that I never knew I had.  They will get to write their own birth stories, I hope and pray.  

What do prenatal checkups look like with homebirth midwives?

I remembered viewing this video some time ago, posted by another momma who had an OB for her previous pregnancy and was seeing a midwife for this pregnancy. (Not sure of her birth location for either.) She put together this funny but 100% true video outlining the actual time spent and how it was spent, at her OB appointments vs. at her midwife appointments. The average amount of time a pregnant momma spends face-to-face with her OB at each appointment is 6 minutes. This momma actually spent 3 minutes face-to-face with her OB. That doesn't leave a lot of time for asking questions, discussing birth plans and preferences, and scoping out OB's birth philosophy and standard routines/practices, let alone relationship-building. My first pregnancy and birth was with an OB group that had 2 midwives in the practice, but the midwives practices were closely in line with the OBs', both with prenatal checkups and at births. The timeline in this video lines up with my experiences at the OB office.

I've had several people ask me what a typical midwife appointment looks like. It will vary from midwife to midwife, and it will also depend on where she practices (hospital, birth center, or homebirth). Her practices may depend on state laws or on the policies of the hospital or birth center where she works, if she's not independent.

Here's a photo essay of a typical prenatal appointment with my primary midwife of the last nearly-8 years, through 3 home waterbirths (thus far), 1 loss, and this upcoming birth. Angy (Angelita) Nixon, CNM has been my primary midwife through it all. Jennifer Stewart, CPM, was my assisting midwife at my other homebirths, and I love her to pieces, but she has a wonderful opportunity to move to California to attend homebirths. She'll be moving before I have my baby, so Dorothy Kaeck, CPM, will be the assisting midwife at my upcoming homebirth. Dorothy is wonderful too, and I'd have been happy to have had her at any of my prior births, but she has only been in WV for 2 years. Here is an overview of the personalized, one-on-one care I receive from my gentle, experienced midwives.

I arrived at my midwife's home/office for my prenatal appointment. What a view.

I got my kids settled in with the toys they brought and the toys that my midwife keeps in her living room for visiting children.

Unlike OB appointments that frequently require moms to wait with a full bladder in a waiting room for up to 30 minutes, I headed directly for the powder room, where I collected the sample, then tested it myself with the test strips my midwife leaves under her bathroom sink.
*Note* the Urine Collection Container in this photo is clean and empty. You're welcome.

This is my midwife's exam room. I didn't need it today.

My primary midwife, Angy, with her cup of coffee, just the way a prenatal should start.

My assisting midwife, Dorothy, making notes in my charts. I told her my weight from this morning when I weighed myself at home, then I told her that my urine sample was negative for both glucose and protein (which is good news on both accounts).  How freeing it is to have that kind of trust with one's care providers.

My kids think that my midwife's spiral staircase is the most fun part of the appointments. That, and smelling her candles to find their favorites.

Dorothy gets ready to prick my finger for the fasting blood sugar test.  She looks way too happy to be inflicting this... Just kidding. It wasn't bad. (At my previous appointment, she drew a vial of blood for the thorough 2 hour blood sugar test plus hemoglobin check and other blood screens. It all came back with healthy results.)

Explaining to my kids what Miss Dorothy is doing and why.

She checks my blood pressure.

My son tries to get her to smell his feet, while stealing her chair. Successfully. He's a charmer.

Having the fasting blood sugar test behind me, now it's time for breakfast. My midwife made me Starbucks coffee and put half & half and sugar in it and brought it to me. I had brought with me 3 pumpkin muffins I made, and I shared the 3rd one with my midwives.

Leopold's Maneuvers, which allow Dorothy to determine baby's position. He is head-down, Right Occiput Anterior.

My son is the blur on the left, always in motion, taking it all in.

Are your prenatals this fun/funny?

Dorothy gave me the option of listening to baby's heartbeat using fetoscope or Doppler. I prefer to use fetoscope when possible to limit unnecessary exposure to ultrasound waves. Dorothy was able to find his healthy heartbeat.

My son is fascinated. I wonder how this will shape his views of healthy and normal pregnancy and birth, for his own future wife and children?

My 5 year old knows more than most adults do about normal pregnancy and birth.

Dorothy let me try to hear baby's heartbeat with the fetoscope, but I couldn't hear it over my children's (quiet-ish) noise. I was content to take her word for it that she heard it and it sounded great. 

Dorothy measures from my pubic bone to my fundus. Baby is measuring 31.5 cm when I'm at 30 weeks, but that's within normal, and could just be a growth spurt or a due to his position.

I arrived at my midwife's home/office right at 9:30 for my checkup (9:30 checkup time). I had 0 waiting time. In between photos, we discussed how I'm feeling, whether I've experienced swelling (some but minimal), how frequently I've been noticing baby's movements and how/when to do kick counts, whether I've had Braxton Hicks contractions, whether I've had any troubling physical symptoms (I haven't), how to recognize symptoms of preterm labor, how and when to get rid of Braxton Hicks contractions, benefits of perineal massage and when to begin, benefits of Evening Primrose Oil and when to begin, what kind of birth control plans we have, what plans I'm making with my doula, scheduled my next appointment for 2 weeks from now, and chatted about what's new in the last 2 weeks since I saw them.

All inclusive, I was there 1 hour 15 minutes, with everything covered at a leisurely and relaxed pace. No wonder I so look forward to prenatals. It's just about the only time I have to devote to real focus on my pregnancy and baby, since life gets so busy with the everyday functions of running a house of 6.

I realize that there are a lot of variations in care among OBs and midwives. This is just *my* experience with *my* midwives. What have been your experiences? Have you changed care providers and experienced different practices?

"Look, Mom! I made a placenta!"

"Look, Mom! I made a placenta!" My 7 year old said this to me, completely not staged. This was with her brand new Silly Putty. See the umbilical cord attached to the placenta. I was a mixture of amused and proud of her. I guess it's pretty clear that she's the child of a childbirth educator. I'm sorry the pic is a bit blurry, but it's the only one I took, and I can't go back and re-do the whole thing and force her to make *another* placenta out of Silly Putty.

30 weeks along belly pic

Yes, I'm 30 weeks along. Yes, I'm aware that's only 7 1/2 months. Yes, we're sure it's not twins, and we're as certain as we can be about our due date range.

I'm doing OK. I exercised so faithfully until a little over a month ago, then discovered that I couldn't manage to get myself and all 4 kids to the YMCA and back in a reasonable enough time to exercise *then* do homeschool when we got home, so something had to give. "Something" turned out to be both my Pilates class and water aerobics class. I am still trying to find something I can do that doesn't interfere with school (either with the time slot or with my energy level and ability to keep up with other life responsibilities). With my third baby, I did a great job getting on the treadmill 4-5 days a week, walking 25 minutes, but I have so much hip/pelvic pain that walking (waddling) is a challenge. I'm still seeing a chiropractor weekly for upkeep, maintenance, and prevention of malpositioning. I'm still taking the "right" supplements for my needs. I am still doing Spinning Babies inversions daily for prevention of malpositioning. I had lots of SPD pain and pelvic/hip pain with my last pregnancy. Sacroiliac pain began months ago. SPD started about a month ago, but not yet as painful as it got with my last baby. I guess it's the fault of relaxin + 6th pregnancy.

Reflux started several weeks ago, as well. I avoid eating late in the evening, and if I'm feeling refluxy, I eat ginger products that I have around from morning sickness prevention/remedy. The best solution, for me, has been sleeping on a wedge pillow. You know, ones from the home health section of pharmacies? I don't like sleeping on an incline, but it's the best of the available options. It beats getting up, going downstairs, then attempting to sleep alone on our recliner. It also beats sitting bolt upright every 20 minutes with reflux.

Church friends of ours, Kim and Dave, gave us an upright freezer for our garage! This was the most exciting baby gift I could have asked for. How was that a baby gift? I'm hoping to fill it before baby comes, since I won't have time or energy to cook for quite a while. Maybe I can get by with fewer grocery store trips if I stock up now, too. I have been saving an article from Better Homes & Gardens since October 2009 with brilliant organizing ideas for an upright freezer. Just wait til I'm done with this freezer. It'll be a work of art.

I guess we're cruising right along, trying to tread water with the same everyday things we all have with children this age (school, afterschool activities, feeding our family of 6+, and trying to keep up with the laundry). I just figured it was about time for an update, in case anyone was wondering.

Pregnancy and Infant Loss Remembrance Day, whether I wanted to or not.

October 15th rolled around again: Pregnancy and Infant Loss Remembrance Day. I haven't mourned my loss of Evan Michael in so long I can't remember. (If you want to read the backstory, here's my post on The Day My World Came Crashing Down.) There are lots of reasons, I guess, but primarily because I've been too busy with responsibilities, deadlines, and other emotionally demanding issues that I haven't devoted any time to grief. I think I mistakenly tried to convince myself that I'm "making progress" or "moving forward" or some such baloney, since I haven't cried about it in so long and I can almost always talk about what happened calmly and with a level voice, as if I were recounting something that happened to somebody else, or maybe something I read about. On the anniversary of my loss this past April, and on the anniversary of burying Evan's remains in May, I didn't even get out my memory box or photo album.

It might have been October 15th last year when I last cried about Evan. I didn't pay much attention to October 15th coming up today. I didn't make special plans to memorialize his short life, light a candle during the Wave of Light around the world, or even post anything in particular about it on my Facebook. In fact, I rather wanted to avoid the subject altogether because I felt that if I ignored it, I'd be able to go along with my weekend as I have any other weekend.

Today snuck up on me and overtook me. Part of the difficulty of October 15th, for me, is that it coincides with Evan's due date/week, October 21, 2007. I feel on edge and melancholy from October 15 through 21, most years. Maybe I'm hormonal, at just-now 30 weeks pregnant. Maybe I needed a release valve for a number of other (unrelated) stresses. Or maybe I'm *still* ignoring the obvious: it was time to remember Evan, whether I was ready to or not.

I cried on and off all day. I managed to busy myself doing laundry, re-organizing the laundry room, culling outgrown kids' clothes, changing out seasonal clothes and new sizes for some of the kids, and using my label maker to get my laundry room and kids' dressers better organized (on the off chance that we could have people helping us with laundry after the baby comes). Anything that involves using my label maker substantially brightens my day. Additionally, Rick took me and our two older girls (ages 9 and 7; the 2 youngers are at their aunt's house tonight) to a Japanese Hibachi for dinner, which is a great show and an amazing meal. It was the girls' first time at a Hibachi, and they thoroughly enjoyed it. I felt much better once I got out of the house. I was too afraid to leave the house earlier in the day because I was afraid I'd have a blubbering meltdown, completely unprovoked, in the middle of the grocery store, at 7.5 months pregnant (but looking full term). I couldn't risk it.

Today, it felt like my emotional dam burst. I wanted to get it over with and move on with my day, but it kept resurfacing. I couldn't control or contain it. I just had to ride the waves.

I'd like to say, "Tomorrow will be better. Tomorrow is a new day," but I know that I won't truly feel the shroud removed from me until October 21 has passed, which would/could/should have been Evan's 4th birthday.

I guess I'm not immune to grief. Few are, and the odds were against me. It's part of the process, so I may as well embrace it, rather than feel like a failure for crumbling, for revealing vulnerability.

Midwifery = witchcraft???

One of my midwife friends, Laura Matthews, shared an experience with me recently that left me aghast. She gave me permission to post her story here.

Let me set up the backstory. Laura is a CNM with 12 years of clinical experience. She has supported births in both hospital and in birth center settings. She got her undergraduate degree at Bates College, her nursing degree at Fairview Hospital School of Nursing, and her Master of Science in Nursing/Midwifery at Case Western Reserve University. She has nearly completed her Masters in Biotechnology at West Virginia State University. She is researching her options to see which medical school will be the best fit for her as she pursues her goal of becoming an obstetrician. I'm thrilled that such a capable, qualified, holistic-minded midwife will serve in that capacity, and I'm really hoping she'll stay in our geographic area after she graduates from medical school. What an asset and a resource she is, and will be.

All this to say, Laura is a very educated midwife who has worked extensively to help and support mothers "within the system."

Laura was speaking with a recruiter of a prestigious medical school, who was set up at a table in the front hall of the science building to recruit medical school students and talk to them about the school and the admissions process. There were numerous current and potential medical students around the table. The recruiter introduced Laura to the group of students as, I kid you not, "Laura Matthews, who has 12 years of clinical experience as a witch." A worse Freudian slip has never been spoken. The crowd fell silent. Many of them turned bright red in embarrassment for the recruiter who so horrifically misspoke. Some of the students even tried to rescue the recruiter with jokes. The recruiter then stammered and tried to backpedal and salvage his introduction with a series of, "What I mean is..."

I realize that he didn't intend to call Laura a witch, nor did he deliberately attempt to publicly call midwifery "witchcraft," but that's the deep-seated-truth-telling essence of Freudian slips. Unless he had just concluded a prior, unrelated conversation with someone else about a witch costume for an upcoming Halloween party, it's my opinion that he must have accidentally revealed his true bias against midwifery and its legitimacy as a profession.

Midwives were the targets of persecution and literal witch hunts for several hundred years. Apparently, some modern-day medical school recruiters are *still* under the misimpression that midwifery = witchcraft. How sad.

Wide variety of healthy and normal in pregnancy

I predicted a few weeks ago that by the time I would be 6-7 months along, I'd get comments from strangers wondering whether I'd have the baby any day now. Yes, I carry obviously, with each of my pregnancies, pretty much from the time I get a positive pregnancy test. No exaggeration, I actually had to unbutton my jeans when I was sitting down, for several days before I got my positive pregnancy test this time around (and I had no idea I was pregnant), and have been wearing maternity clothes since about 8 weeks along.

There's such a wide range of normal! I wish more mothers--and America in general--understood and accepted this. People seem to have a very narrow idea of what is normal, but people come in all shapes, heights, builds, weights, and more--why wouldn't there be such a wide variation in healthy pregnancies as well?

So long as both mom and baby are faring well, there's nothing wrong with a mom carrying so "small" that she's barely showing, nor anything wrong with a momma who gets asked if she's having twins every time she leaves the house (even if she's carrying a singleton). Let's don't undermine another mother's confidence by questioning whether her size/appearance is too big or too little (unless you happen to be her care provider).

Take my friend Christy and me, for example. In this pic from this weekend, Christy is nearly 37 weeks along with her 4th baby (that is to say, she could go into labor any time between now and a month from now), and I'm 23 weeks along with my 5th. We're both healthy and fine.

My friend Trebor is due with her 5th baby around 2 weeks after I'm due. Just wait until later in our pregnancies and the difference will be photo-worthy, I promise.

Sarah 22 weeks, Trebor 20 weeks

In summary, here is a list of things nobody should ever say to a pregnant woman:

If you think mom looks "too big":

• "Wow, you're huge!" (Does this sound like it could EVER be a good idea to say to a woman?)
• "You look like you're ready to pop!"
• "Are you sure there's only one in there?/Are you sure it's not twins/triplets?"
• "I hope you don't go into labor right here and now!"
• "Are you sure you're not due for 2 more months?" along with
• "There's no way you're going to make it to your due date, since you're so big now." (The mom might go early, on due date, or 2 weeks late. How she carries/looks is not a predictor or indicator of how long baby needs to gestate. You'll either have her worried that she'll end up with a premie or disappointed if she gets her hopes up that she won't go all the way to her due date but then goes "late.")
• "You had better not eat/drink that!" (This is sometimes said to a mom with a dessert or coffee in her hand. The observer has no idea what the rest of her diet looks like, not that it's any of their business.) 
• "Your baby is going to be HUGE!!!" (Even if the mom has successfully and healthfully delivered 10 and 11 pounders already, this is NOT what a mom wants to hear. It's not encouraging.)
• "How much weight have you gained?" (This is NEVER a good idea to ask a woman, unless you are her care provider.)

If you think mom looks "too small":

• "You're so tiny you don't even look pregnant!" (This one can be especially upsetting for a mother who has lost one or more babies in the past, who might be concerned whether this baby will grow to full term healthfully.)
• "Are you sure you're due that soon?" (No mom wants for people to imply that she needs several additional weeks/months to gestate, beyond the biological norm.)
• "You'll probably have a teeny tiny baby." (No mom wants for anyone to imply that she'll probably end up with a premie or sick baby.)
• "You should eat more." (No mom wants for random strangers to judge her diet. She might be eating the most healthful diet possible, and this is just the shape her body takes. Or she might be eating only junk. Either way, it's nobody's business but hers and her care provider's.)
• "How much weight have you gained?" (See above.)

Here are a few starters for acceptable things to say to a random pregnant woman:

• "You look great!"
• "How do you feel?"
• "Congratulations!"

Mommas, are/did you carry "large", "small," or in between? Did you receive any comments from people who thought you were carrying "too large" or "too small"? What affect did that have, if any? What positive things did people say about your pregnant appearance that encouraged you (or what do you wish had been said)?


**** UPDATE****

October 11, 2011

Remember how I told you that belly comparisons with my friend Trebor would be interesting over time? She's due two weeks behind me, with her 5th pregnancy this far along as well. She and our friend Eileen (3rd baby) share the same due date, and we three all have the same midwife. (This should be an interesting competition for who gets our midwife, and when. We're hoping we don't go into labor at the same time!)

L-R: me (Sarah) at 29 weeks; Trebor and Eileen at 27 weeks

************** UPDATE  Nov. 6, 2011 *************

Sarah at 33 weeks, Trebor at 31 weeks

Sarah at 33 weeks, Trebor at 31 weeks.

Can I say "I told you so" yet?

************ UPDATE December 1, 2011 *************

Same 3 mommies, same 3 bellies, a bit closer to due dates.

I'm on the far left. I'm 36.5 weeks along. Trebor and Eileen are both 34 weeks along. Yes, I'm aware that my belly is roughly 1.5 times the size of Eileen's and twice the size of Trebor's. You may also notice that Trebor and Eileen are a good 4 inches taller than me (I was wearing wedge heels; Trebor and Eileen were in flats).  When you're as short as I am, with a short torso, there's nowhere for baby to go but *out*.

Belly photo at 22 weeks

22 weeks along with our little boy and feeling pretty good. Yay for the middle trimester!

The Back-up Plan? Not so much.

I've heard so much about the homebirth spoof scene in The Backup Plan that I had to get it on Netflix DVD to see for myself. I knew it would be bad, and I was prepared for the fact that if homebirth appears in mainstream movies, it is almost universally made fun of. What I *wasn't* prepared for was the main character's sister's anti-child, anti-birth, anti-breastfeeding agenda.

In the first few minutes of the movie, J Lo's character explains how badly she wants a baby, but doesn't have her sister's support. Her sister has 4 kids and tries to talk J Lo out of having children. She says they "ruined her life" and destroyed her vagina (if that were true, she had very difficult, atypical births; this is not the physiological norm). She actually said "I hate them" (referring to her children)--within earshot of them. Wow, nice.

A few minutes later, she tells J Lo that breastfeeding will ruin her breasts and turn them into drooping "tubes" (total myth--it's PREGNANCY that can potentially affect perkiness/sagginess, NOT breastfeeding), and that childbirth will destroy her bladder (again, not the biological norm).

I'm sure the homebirth scene later in the movie would have been a hoot, but I didn't have the patience for it. I gave up after I had heard more than enough myths perpetuated for one night, let alone the horrible attitude the sister had toward children. I know it's just a "comedy," but I don't think it's funny. Someone is bound to believe those things when they hear them perpetuated in the mainstream. Not many people are likely to look it up for themselves to see what's true.

Cord blood banking vs. delayed cord clamping

A reader wrote in, "Sarah, What can you tell me about cord blood donation, I have heard so many different things on the contribution and I just want correct information to make an informed decision. Thanks for any information you can share."


I'll put together a link roundup so that each family can decide what's best for their situation.


Before we look at cord blood donation or banking as an option, let's first consider the importance for baby to receive his/her own cord blood immediately after the birth. There are options for collecting cord blood for donating or banking that *are* compatible with delayed cord clamping. 


If you haven't yet seen Academic OB/GYN Dr. Fogelson's Grand Rounds on Delayed Cord Clamping, it's well worth the 50 minutes to watch. He touches upon volumes of data supporting the importance of delayed cord clamping, including the effects of premature cord clamping that is common in the US, namely baby losing approximately 40% of his or her blood volume and the oxygenation from that blood. Baby also receives that rich store of his or her own stem cells, which is sometimes called "Nature's first stem cell transplant."  


The World Health Organization supports delayed cord clamping as well. Specifically, WHO states, "The optimal time to clamp the umbilical cord for all infants regardless of gestational age or fetal weight is when the circulation in the cord has ceased, and the cord is flat and pulseless, approximately 3 minutes or more after birth." 


The World Health Organization continues with these reasons for the recommendations:

• "For the first minutes after birth, there is still circulation from the placenta to the infant, the majority of which occurs within 3 minutes, generally coinciding with the end of cord pulsations.
• "Clamping the umbilical cord immediately (within the first 10 to 15 seconds after delivery) prevents the newborn from receiving adequate blood volume and consequently sufficient iron stores. Immediate cord clamping has been shown to increase the incidence of iron deficiency and anemia during the first half of infancy, with lower birth weight infants and infants born to iron deficient mothers being at particular risk. Up to 50% of infants in developing countries become anemic by 1 year of life, a condition which can negatively and perhaps irreversibly affect mental and motor development. According to one longitudinal study, Costa Rican children with chronic iron deficiency in infancy had 10 to 25 point lower cognitive test scores at 19 years of age, when compared to similar children with adequate iron status. Waiting to clamp the umbilical cord allows a physiological transfer of placental blood to the infant which provides sufficient iron reserves for the first 6 to 8 months of life, preventing or delaying the development of iron deficiency until other interventions—such as the use of iron-fortified foods—can be implemented.
• "For premature and low birth weight infants, immediate cord clamping can also increase the risk of intraventricular hemorrhage, and late-onset sepsis. In addition, immediate cord clamping in these infants increases the need for blood transfusions for anemia and low blood pressure."

Australian midwife Rachel Reed's blog "The Placenta: essential resuscitation equipment" is well cited and helpful in understanding the crucial roles the placenta plays immediately after birth. She also explains how delayed cord clamping need not be at odds with neonatal resuscitation, should that become necessary. In many other countries, resuscitation equipment is on wheels and is brought close to the bed so that baby can continue to receive oxygenated blood while medical teams administer oxygen or other helps. 

Here's an article from the UK: "Trolley saves lives of newborn" with a description of a mobile bedside resuscitation unit that is currently used in 3 UK hospitals and may become standard in all UK hospitals. Here's a news clip that shows the Trolley and describes its use.

Here's an FAQ page on cord blood donation at marrow.org. Their page does not appear to address the need of each newborn to receive his or her own cord blood before considering donation for other purposes. It does state "No blood is taken from your baby, only from the cord and placenta after the baby is born," but this is only true if delayed cord clamping is done first. Otherwise, up to 40% of baby's entire blood volume IS taken from baby, only a small amount of which is donated for useful purposes, and the rest of which is disposed of as medical waste.


It's easy to find materials promoting the potential benefits of cord blood banking (many of which are industry advertisements for private banking). I don't currently have any bookmarked links on any solid independent research weighing the pros and cons of private cord blood banking. I do, however, have this article from an Irish newspaper titled "Stem cell storage can put lives 'at risk''. An excerpt: "‘‘In the vast majority of cases, the costs of storage are therefore not justified and the rationale being used by commercial companies recommending storage is misleading," said Sullivan. Sullivan said there was insufficient evidence to recommend its practice in Ireland except for a small number of at-risk families with rare blood diseases, malignancies or bone marrow failure... Collection of cells usually happens within minutes of a baby being delivered, ‘‘where there is a risk of post-partum haemorrhage and when both mother and baby require one to one care’’, Sullivan said.The harvesting of stem cells at this time led to added complications that might actually put the lives of mothers and babies at risk, he added."

For those who feel that cord blood banking or donation is right for them, Science and Sensibility posted an excellent article on the skill of some care providers to accommodate both delayed cord clamping AND cord blood collection after the birth of the placenta. This would mean that baby receives all of the blood that he or she needs, and that cord blood would be collected from the "excess" after the cord quits pulsating. It's not always possible as sometimes the cord blood has begun to coagulate by that time, but it's worth a try, if you would like to have the best of both worlds. Here it is for more info: "Journal of Perinatal Education 20.1 Feature Article: Umbilical Cord Blood: Information for Childbirth Educators."

See also my previous blog "Photo illustration: delayed cord clamping vs. immediate cord clamping"


As I collect more research on the subject, I'll add more links. I hope this helps as a springboard for more info.

UPDATE:

Nurturing Hearts Birth Services posted this fantastic series of time lapsed photos of an umbilical cord transitioning from full of blood immediately after birth, to thin, limp, and empty in fifteen minutes, after which time the cord was clamped and cut. If you are wondering how you will know whether the cord is ready to be cut, this is a great resource. Magic Umbilical Cords