Well Rounded Birth Prep

Our Christmas Eve home waterbirth story

2012-01-29T15:38:00.003-05:00

I've really wanted to write up this birth story, but it seems so big, too daunting to even begin. I've felt that way with each of my births. I'll give it a shot anyway.

Quick backstory:

2002 Hospital birth of our 1st baby. Unmedicated birth as was my goal, but hospital routines that were not appropriate for my situation led to very difficult and painful recovery.
2004 Our 1st home waterbirth with midwives. I had sought a different model of care with this pregnancy to prevent the problems and pain that happened with my first birth. Healing birth.
2006 Our 2nd home waterbirth with midwives.
2007 Missed miscarriage followed by D&C at 14 weeks 5 days. Devastating.
2008 Our 3rd home waterbirth. Accidental unassisted birth. Long story.
2011 Here we go again... You can see my posts from this pregnancy here.

*****DISCLAIMER: THIS IS A BIRTH STORY. PLEASE CLOSE THIS TAB IF YOU ARE NOT PREPARED TO READ ABOUT DETAILS OF PREGNANCY AND BIRTH.**********

I will also upload (modest) photos from my labor and birth, but these are still labor and birth photos. If you are uncomfortable discussing cervical dilation and how to keep a perineum intact during pushing, please don't read further instead of leaving bizarre comments or telling me that I overshared. Mkay?

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Who's who:
me: Sarah DeGroff
hubby: Rick DeGroff
doula: Tara Gilkey, DONA
midwives: Angy Nixon, CNM, and Dorothy Kaeck, CPM
apprentice midwife: Pia Long, DONA

I was at a prenatal checkup at my midwife's house on Wed. Dec. 21 when I had a bit of bloody show. How exciting! I was 39.5 weeks along, and hoped that would mean onset of labor within the next few days, although I have a friend who had steady bloody show for two full weeks before labor began at 41 weeks along. I really hoped I wouldn't have to wait two weeks, but I was prepared to wait until baby was ready on his own time.

The next few days were spent nesting with joyful anticipation. I had set a salon nail appointments for myself, my mom, and my 7 year old daughter for that evening, and I hoped that getting a pedicure would be all my body needed to let little man arrive.

My 7 y.o. daughter's and my pedicures. We have sparkly snowflakes painted on our big toes.

My hubby took me out to eat after that (while my mom watched our kids), our last date without kids for a lonnnngggg time.

The next day, I got my hair cut, since that hadn't been done since mid-September. A girl can only go so long without having her bangs trimmed.

The next day was my mom's last day with us. (She had come to stay Monday through Friday to help cook and fill my freezer with postpartum meals. A wonderful gift!) I had kind of thought that I would go into labor as soon as I got my mom out of the house because I am rather private about who is around me during my labors and births. I would have felt self-conscious with mom there.

After 3 days of continual bloody show and Braxton Hicks contractions that got gradually more intense and crampy, I did start having stronger and longer contractions as soon as my mom hit the road at 4 p.m. on Friday Dec. 23. I put together my labor music playlist, made red raspberry leaf iced tea/punch and RRL punch popsicles, readied last minute birth supplies and snacks, and headed to bed at a decent hour. (I loved my labor playlist throughout my labor, but the playlist needed to have been twice as long! It was on repeat for a l.o.n.g. time.)

Prelabor/ super early labor, evening of Dec. 23, about 24 hours before the birth. Putting together my labor song playlist on Rick's iPad, from my notes on that notebook next to it.

All night long, I awoke with contractions that were intense enough to wake me up. I had to get on hands and knees over my wedge pillow that I slept on to prevent reflux. I intensely wanted Rick to provide counterpressure on my sacroiliac joints, pressing straight down. Occasionally, I would time my contractions using my ContractionMaster.com iPhone app, but since they didn't seem to be getting closer together, I mostly just tried to sleep in between contractions. All night long, they were from 6 to 30 minutes in frequency (averaging 10-13 minutes apart), averaging from 50 to 90 seconds each, and varying in intensity. I knew that since they were so sporadic, it likely meant things were still very early, and that it could indicate malpositioning. Baby had been ROT for my entire last trimester and it seemed that he was still ROT, judging by where I felt his movements. (ROT = Right Occiput Transverse, meaning head-down with his spine aligned with my right side, facing my left side.) I wondered if his head was asynclitic (head tilted slightly toward his shoulder), a malpositioning which often is responsible for irregular contractions, abnormally long contractions for the stage of labor, contractions that are more intense and painful than they should be for that stage of labor, and piggybacked contractions, which started late morning.

Even though the contractions were as far apart as they were, they were definitely intense and painful enough to want support through them. I found myself watching the clock to see when it would be "late" enough to reasonably call my doula, Tara. Her family lives not far from us, and she basically had to drive by our house to get to her family's house on Christmas Eve, so she had already planned on stopping by to check on me and visit for a bit on Christmas Eve, even if I hadn't been in labor. I wanted to see if she could come earlier to spell Rick for a bit so he could get something to eat, feed our four kids and spend a little bit of time with them, and help me get my grounding. I called Tara around 6:15 a.m. and filled her in. She said she would come over after getting everything ready for her husband and kids to be able to head to her family's house later in the day.

At that point, I figured I was up for the day and took a long shower in the dark by candlelight, letting the water and my playlist soothe me while I let Rick sleep. The water was very soothing to me. I still needed to be in a forward leaning position during contractions, slowly swaying back and forth, and I found that singing along with my playlist during contractions helped me have a relaxed jaw per Ina May Gaskin's recommendations ("As above, so below. An open, relaxed jaw means an open cervix.") A friend had mentioned that during her labor, having familiar songs helped her cope with contractions because she knew the lyrics and it gave her a known in a time of unknown. Maybe it was because I read that, or maybe it would have happened anyway, but I, too, found comfort in my early labor in the familiar lyrics. It gave me something to do, something to focus on other than the contractions.

My plan had been to do a #twitterbirth and post my updates as things progressed (with my doula tweeting for me after I could no longer do so myself), but I was afraid to post that my contractions were more intense or that I had called my doula in, because my contractions were still so erratic. I knew that this was either very early labor or possibly prelabor, but that didn't change the fact that I needed support through these contractions. I didn't want to feel like a watched pot then be embarrassed later if I had to admit publicly that I had called in labor support all for nothing, so I just waited to see what would happen. It was low key and no pressure, since Tara had to drive that direction for her family gathering anyway, so she told me she would hang out with me for a few hours and help me get comfortable, then we would play it by ear. If I needed her to stay, she would. If my contractions slowed down or still weren't in any discernible pattern, she would go on to her family gathering and come back whenever I called her.

Tara got to our house around 10:30 a.m. and took over labor support so Rick could tend to our kids. They both made sure I had enough to eat and drink. By this time, I wanted my electric heating pad on my lower back along with SI countersupport with each contraction. Throughout my labor, I needed to be forward leaning during contractions, either on hands and knees, sitting on the birth ball and leaning forward onto my bed, or standing and leaning onto my bed or onto the bathroom counter. It makes sense that those were the positions that felt right to me, because those positions help babies rotate, especially if they're posterior or transverse (but head-down).

Early labor, maybe 11 a.m. Forward leaning, sitting on the birth ball. Heating pad on my back. Eating Greek yogurt, enjoying distraction from my 3 y.o., and writing my blog on RRL tea labor punch.

Tara suggested wrapping my belly with her rebozo, a thin scarf-like fabric which has many uses in helping get babies better positioned in labor. I wish I had a photo, just for reference, but basically she spread the fabric across my midsection from hips to ribs and tied it tightly behind my back to help lift and bind my belly, to help baby get repositioned. We left this on for an hour or two, then I decided to get in my tub for a bit to try to get my uterus to relax from these long-lasting contractions. My uterus felt tight and painful even after contractions ended, sort of like a charley horse, and a bath can help with that.

11:30 or noon? Trying to relax between contractions.

During contractions. Sacral counterpressure helped so much.

Candy cane scented candles to set a relaxing spa mood.

I continued to eat and drink all day, everything from peanut butter crackers to apples with peanut butter, colby jack cheese cubes, toaster waffles, and chicken noodle soup (which I ate an entire bowl of about 30 minutes before I had my baby). I drank red raspberry leaf tea/punch (and RRL popsicles--yum!). I needed the calories to keep my energy up.

Since I didn't know whether this was "really it" and whether I'd have the baby today, we didn't want to call and bother anyone on Christmas Eve to have them come help us with the kids, so they mostly fended for themselves, playing Wii and watching cartoons on Netflix. We let them open craft and game gifts every few hours to keep them occupied. Here they're opening a Wii Babysitting Mama game from uncles.

My contractions were still averaging 10 minutes apart, but they were painful enough and intense enough that I wanted labor support. Tara asked if I would be OK if she went to her family's Christmas Eve gathering with family 35 minutes away from my house, if my second midwife Dorothy came to be my labor support. Tara left around 12:30, and Dorothy got here around 4 p.m.

I'm not an advocate of routine vaginal exams in labor, but since my contractions were still in that same pattern, I asked Dorothy to check me around 4:30 p.m. Mid-morning, Tara and I had discussed how far along we thought I might be, and based on how intense and painful they were, we guessed 4-5 cm, and that had been hours before. At this point I was hoping Dorothy would tell me I was around 6 cm. Nope. 3 cm. You have GOT to be kidding me. Baby was -1 station and I was 80% effaced. I know that numbers don't technically mean anything, but this was discouraging. That's part of why routine vaginal exams in labor are such a bad idea. This wasn't what I would call routine, though, because we were trying to get info on what was going on with his position and what to do next, if anything.

I spent the afternoon in and out of the tub, in for a while to try to relax and take the edge off, then out for a while to encourage baby to rotate and descend, but all the while, on hands and knees or forward-leaning, with Rick or Dorothy pushing hard straight down on my SI joints. I felt a little self-conscious that I was having such a hard time coping with the pain of these contractions because neither Tara nor Dorothy had attended any of my previous births, so they had to take my word for it when I told them, "I really have done this 4 times before without an epidural, and this doesn't feel like it did before. I promise I'm not being a wuss. I really do know how to handle contractions." They laughed because they believed me and I didn't have to explain myself, but that's just me.

Since my contractions were far apart and in an ineffective pattern, the endorphins that usually bring a mom into LaborLand in a dreamlike state and help mom manage the pain, weren't there. I was in a conscious, alert state throughout the labor. I'm guessing that the endorphins weren't sustained enough from one contraction to the next to be able to produce the LaborLand effect.It sounds like a treat, on paper, when I tell people that my contractions averaged 10 minutes apart for my entire labor, but there's a reason it's not "supposed" to be that way typically. I've had it both ways, and LaborLand is FAR more manageable.

I don't know how many hours it went like this, but for maybe 4 hours, my contractions were painful enough that they felt like transition. I kept telling Dorothy, "I don't know what's going on with this, but I cannot get on top of the pain." One birth affirmation I tell my childbirth class students is "I can do anything for a minute and a half," which is the average amount of time of contractions during transition, the hardest and most intense part of labor. Since my contractions were piggybacking, they totaled 3-4 minutes (combined) and that mantra wasn't cutting it. Dorothy told me, "Just keep breathing. All you have to do is breathe." That made sense to me and was exactly what I needed to hear. I couldn't get on top of the pain, but I didn't have to. All I had to do was keep breathing. I was vocalizing loudly through these contractions, moaning out the pain. Dorothy matched me through the toughest ones, and it helped a lot. I found I felt most right on hands and knees in my tub, with my feet braced against the wall of the tub during my contractions, rocking forward and backward a bit with my contractions.

More challenging to me than the physical pain and demands of my labor was the mental game, knowing that I was "only" 3 cm and "only" in "early" labor. If I had thought it was almost over, I'd have been fine, but I started getting discouraged and crying because I didn't know how I'd make it through if I had 12 hours more of this. Rick had been texting my other (former) midwife, Jennifer Stewart, who had worked with my primary midwife Angy at all my other births. Jennifer moved to California to work at a birth center in November and I was so sad that she couldn't be at this birth. She was not only the midwife who caught my 2nd and 3rd babies, but she is also one of my closest friends. Rick filled Jennifer in on what had been going on, so she called when I was between contractions to try to encourage and buoy me. I don't even remember what she told me. I was a little preoccupied. I had to hang up on her when another one came.

As it approached 8 p.m., Dorothy told me I needed to decide what I wanted to do. I had been up a lot the night before and hadn't gotten much sleep, and I was getting tired and discouraged from all day of labor like this. I could A) try to speed the contractions up and get into a better pattern, B) try to slow the contractions down with either 2 Benadryl or half a glass of wine and catch a nap so we could start fresh and maybe things would be more effective after that, or C) do nothing to change it, and just take it as it comes. My hips hurt too bad from SPD to go up and down the stairs to try to speed labor up. I had been upright a lot and changing positions. I lean toward wanting to let labor chart its own course and take option C) and just see what happens, but I asked her to check me again to gather what info we could for decision-making. I had told her that I really didn't want her to go because I felt like once my contractions firmed up and once my little man got into position, it would all be over, and she wouldn't make it back in time. (Like I said, I had an accidental unassisted birth with my last baby due to the fact that I had a long prelabor and early labor, didn't recognize it once contractions did get more intense and was in denial of transition, and I did not want another unassisted birth.) Dorothy said that if I hadn't made progress, she wouldn't leave me. She would sleep on the couch all night if she had to.

I got out of the tub so I could waddle to my bed to allow Dorothy to check me. The bath water was getting too cool for comfort at that point anyway, so it was time to drain the tub. Then I did something really smart. I asked Rick to go ahead and fill the tub again. He was skeptical because we had been talking about trying to back off on focus on labor since I "wasn't making much progress" and we were going to watch A Christmas Story since it's on TV on some channel for 24 hours straight on Christmas Eve every year. Here's what I told him, verbatim: "Water is cheap." I was afraid that once the urge to push came upon me, whenever that was, if the tub wasn't full already, we wouldn't have time for the tub to fill. I told him that if we need to drain it and fill it again, we could, but I would feel safer knowing it was ready. This turned out to be very important.

I arranged myself on my wedge-shaped pillow that I slept on every night to prevent reflux, and Dorothy checked me. She said that I was now at 5 cm, my cervix was still pretty thick and not very stretchy, and baby was a bit lower, maybe +1 now. I asked her to do Leopold's maneuvers to determine if he was still ROT position as we had suspected. I had to change positions again to move on the bed to a spot with enough room to lie flat for this. She confirmed that he was still ROT. Since I had made some progress, she called all of our birth team to tell them to go ahead and come. Dorothy would begin charting and auscultation (listening to fetal heart tones with the Doppler). She went to her van to get her birth bag with all her equipment, oxygen tank, etc. I got up and grabbed my laptop so I could tweet this:

I also posted on my Facebook page, "Maybe baby tonight?" with a link to my Twitter.

Something in all that changing positions that I had just done helped baby get his head right where he needed to be, because as soon as I stood up after that, I told Dorothy something felt different and I thought I'd need to push soon. It was a feeling of impending dread almost, sort of like when you know you're going to have to throw up, it's just a matter of time. I waddled back to the bathroom. The timeline is blurry. Rick asked if he should turn on the video recorder I had set up on a tripod. I said yes but I knew there wouldn't be enough light. Rick tried turning on the light in the adjoining powder room and leaving the door cracked, but the light was unbearably painful for me. I've read about the importance of having dark during labor, pushing, and postpartum, but this was the first time I had felt that on such a primal level. I told him I didn't care that we wouldn't be able to see the video, just TURN THE LIGHT OFF. (We had 5 votive candles from the pic above as our only light, other than a bit of light coming in from the bedroom.)

With my births, I don't have an "active pushing stage" per se so much as Dr. Michel Odent's definition of Fetus Ejection Reflex. My body does it for me, and I have little or no control over pushing. I can try to slow it down so that my tissues have time to gently stretch, but no guarantees. I got in the tub, and with the next contraction, I was pushing. I couldn't find a position that felt right, though. I felt cornered, panicked. I tried squatting, I tried a kneeling lunge, nothing felt right. Eventually I ended up sitting on Rick's hands like a hammock. Dorothy asked Rick if he wanted to catch, but he couldn't because I was sitting on his hands. Baby emerged like a train coming. Thankfully, I didn't tear (well, a tiny surface tear that didn't need a stitch). That goes to show you what your body can do when birth is instinctive. He cried very quickly after the birth, and his APGARs were 9 and 10.

No wonder it felt so intense. I went from 5 cm and a thick cervix, to baby out, in 14 minutes, including only 4 minutes of pushing. Take THAT, Friedman's Curve!

That was crazy intense. I'm so glad he's out!

We heard a knock at the bedroom door, and our kids said, "We heard the baby cry, can we come in now?" We let them in. I pushed the placenta out then it was time for our 5 year old to cut the cord. This was "his" job that he had asked for more than 6 months prior. It was very special. I don't have a great pic of him cutting the cord, just this pic taken from above, but it captured the moment of how many people were next to my tub. It was a little hectic, but I was glad that my kids could be a part of this.

My hubby is holding baby while our 5 y.o. cuts the cord, and the others watch, fascinated.

The other midwives and my doula were en route when I gave birth and arrived just in time to do all the newborn assessments. One of the wonderful benefits of a homebirth is the ability to shower (in my own shower) then cuddle up in my jammies with my baby in my own bed.

First nursing. It's a team effort.

My 7 y.o.'s job was to help weigh and announce his weight. 8 lb 10 oz! My second-largest baby.

Sweet little (peeling) feet.

My 9 y.o.'s job was to help measure him and announce his length. 21 1/2", so tall! No wonder I was so uncomfortable.

My midwife Dorothy who caught him.

Watching the newborn assessments.

Sign of the times. Daddy doing FaceTime with his brother & parents so they could see the baby.

The rest of my birth team: Doula Tara Gilkey, Midwife Apprentice Pia Long, and Midwife Angy Nixon.

In retrospect, my midwives and I feel that baby's malpositioning was the result of my SPD. His head couldn't easily find the right position and path due to my pelvic instability. It could have been so much worse, though! I understand even more fully now how and why so many malpositioned babies end up to be cesarean deliveries. When a baby is poorly positioned, it makes labor so much more painful, and if I had been in a hospital with an epidural, stuck on my back, I don't know how he would have found the path he needed to rotate and descend. I was so blessed to have him at home.

When I was recounting the events to a relative, and how intense and painful the contractions were, that I just could not get on top of the pain, she asked me if I was scared. I was glad she asked, because I hadn't thought of it in those terms, but I wasn't frightened at any point. I wasn't concerned that either my baby or I were in danger. I knew that we were safe and healthy, and that I had to just keep breathing.

As more time has passed since the birth, I look on it more and more fondly. I fully remember how much it hurt, but the great thing about unmedicated labor is that you feel 100% normal in between contractions. Plus, I felt like a million bucks as soon as he was out. Recovery has been a breeze. I feel strongly that it was necessary to give him the gift of the safest birth possible. It was totally worth it.

I feel that this birth was a perfect example of how pain in labor does not have to equal suffering.

We got to bed around normal time on Christmas Eve (midnight) and the kids let us sleep in until 8 a.m. We came downstairs and watched them open gifts. We were together as a family. I can't imagine what it would be like to be stuck in a hospital over Christmas.

This was a magical Christmas, our best Christmas ever.

Christmas morning

Our other 4 blessings, ages 9, 7, 5, and 3. Christmas morning.

You can see baby's newborn portraits here, including pics of him in a stocking wearing a Santa cap. Too cute.

Artistic maternity portraits celebrating pregnant beauty

2012-01-11T00:22:00.002-05:00

"When I am with child, I feel beautiful...not a vain beauty, but the beauty of the might of creation growing inside of me....the undeniable truth that something so amazing could only come from the hands of a mighty God. I love seeing my belly, feeling my belly and baby, & capturing all those beautiful changes that take place." ~Trebor Sutler

My best friend, Trebor Sutler, is due any day now with her 6th baby/5th birth. She has had an incredible journey to get where she is today, having been through what she describes as 2 preventable cesareans, then a challenging but victorious hospital VBAC, then her first home waterbirth on Christmas Day 3 years ago, and now awaiting her 3rd VBA2C/HBA2C.

You can see her slideshow of her birth stories up to and including her 2008 home waterbirth here.

Trebor graciously shared her beautiful maternity portraits with us. (She photographed them herself! Isn't she multi-talented?) Trebor is always gorgeous, and I thought these photos especially captured her beauty and this special moment in her life. Pregnant bellies are so beautiful and miraculous.

Baby's 1st outing: chiropractic adjustment

2012-01-07T23:09:00.000-05:00

Yes, my baby's first outing was to the chiropractor's office at three days old.

I had been getting weekly chiropractic adjustments since my first trimester with this pregnancy to help optimize fetal positioning, prevent or lessen SPD, and further reduce my risk of needing a cesarean. (Although I did still have SPD, I feel that the symptoms would have been far worse and more debilitating had I not had regular chiropractic care.) I couldn't wait to go back to get adjusted again after having my baby. I knew it would feel great! My friend Dawn met me there to hold baby while I got adjusted.

I also wanted for our chiropractor to assess baby to see whether he needed adjusted. Many babies do need chiropractic adjustment after birth, whether the birth was vaginal or cesarean, but especially if it was a challenging or difficult birth. Studies have shown that chiropractic adjustment can help correct babies' latch in some instances of breastfeeding difficulties, and that it can sometimes lessen symptoms of colic and reflux.

Here's a pic of our chiropractor adjusting baby on me. (He said that babies in this position on mother's tummy are most stable and content during their adjustment.)

Baby's 1st chiropractic adjustment, 3 days old.

What have been your experiences with chiropractic during pregnancy, labor, postpartum, and/or for your babies?

Our Christmas Eve Baby: newborn portraits

2012-01-07T00:47:00.003-05:00

I finally figured out how to make a slideshow from the newborn portraits my best friendTrebor Sutler took of our Christmas Eve baby. These photos make me melt. I've never had nice newborn pictures with our other children, and I'm so glad to have them of Baby H with his brother and sisters.

Even though Trebor was 37 weeks pregnant herself, and even though Christmas Day was her 4th child's 3rd birthday, and even though she had gotten her entire family to church on Christmas morning, and she was undoubtedly exhausted, Trebor hauled herself over to visit me and Baby H on Christmas Day in the evening so we could get some good pictures taken and she could meet my little love. What a wonderful gift. Christmas truly was blessed for us.

Countdown to Christmas Eve Baby!

2011-12-25T23:04:00.000-05:00

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

2011-12-24T11:23:00.001-05:00

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

2011-12-23T21:12:00.000-05:00

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

2011-12-19T23:04:00.001-05:00

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

2011-12-14T22:43:00.002-05:00

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

2011-12-03T22:47:00.001-05:00

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

2011-11-27T18:26:00.001-05:00

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

2011-11-13T22:59:00.000-05:00

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

2011-11-10T15:38:00.001-05:00

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

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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?

2011-10-18T22:36:00.006-04:00

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!"

2011-10-17T19:00:00.002-04:00

"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

2011-10-16T17:40:00.002-04:00

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.

2011-10-15T23:31:00.003-04:00

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???

2011-10-12T20:14:00.008-04:00

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

2011-08-29T22:26:00.011-04:00

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

2011-08-22T18:28:00.000-04:00

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

The Back-up Plan? Not so much.

2011-08-09T22:38:00.000-04:00

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

2011-08-03T23:32:00.012-04:00

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.

Guest post: A Journey Down Granola Blvd...

2011-07-14T20:47:00.000-04:00

By Courtnie Thorsen

I have been asked more than once, about my reasons for being "crunchy", when I used to be so "mainstream". Why now? What persuaded you? What made you change your mind?

The answer is alot of soul searching, alot of maturing, and alot of research.

I was 19 when I got pregnant with my oldest son. I sat in silence on the toilet watching the pee spread across that stick- the lump in my throat almost suffocating me as I seen the line turn pink. It didn't work out with the sperm donor and I, so I went at this thing called parenthood alone. I moved home- broke as hell, no job, and 6 weeks pregnant.

I had no plan, no idea what I was getting myself into, and no clue how to be a mom.

I put no effort into researching anything aside from breastfeeding. I was an excellent OB patient & went along with whatever I was told to do- or not to do.

My son was born 5 days before his due date. My labor was incredible. I spent the majority of it alone, at home in my bathroom. When my mom returned home from running errands, I was screaming upstairs...we arrived at the hospital at 9 centimeters. I was terrified at all the rushing around. Something must be wrong, this can't be a normal experience with all this panic going on.

I got the trusty epidural. No one bothered to tell me- it would all be over soon, that I had done and was doing an excellent job, that my body would not fail me now. Three hours later, after the threat of a cesarean section for not pushing him out fast enough- he was born. Covered in sticky meconium he was the tiniest, most innocent, most perfect creature my eyes had ever seen.

I sent him off to be circumcised. It is what all boys go thru. "How gross", I thought. 'Who would want to have such a disgusting penis?"

I took him home. His penis oozed this nasty pus and blood combination & try as I might- somehow the vaseline was always missing somewhere.

Breastfeeding was hard. He ate more than I could pump. We switched to formula at 11 weeks old. We got all of our shots on time, we made all of our well child visits. Soon my son developed severe constipation.

I met my Husband when my son was 7 months old. He loved us both, and we loved him. We got married in 2005 when Jack was 2. Jack started preschool and we were happy. When Jack was 4- his preschool teacher thought we should have him tested for ADD/ADHD. He was diagnosed a month later.

Around this time, my husband and I decided we wanted another baby. Jack's adoption by my husband had just gone thru & we were ready to expand our family. We conceived quickly and were ecstatic to learn our baby was a girl.

I knew I wanted to breastfeed. I feel the formula Jack was on, played an integral part in his bowel issues. I researched breastfeeding benefits. I also researched vaccines. What if having all those shots contributed to Autism, to ADHD, to other behavioral issues, his bowel issues?

My daughter was born 4 days before her due date. I was waiting for labor to begin & at my last doctor appointment- I begged to be induced. My daughter had turned and was laying on my sciatic nerve. I was so unbelievably tired of the strong "false labor" I had been having for weeks. Twice it needed to be stopped with medication in hospital.

My induction was routine. The labor was awful & my hopes for a drug free delivery were pushed futher into the hallway with each drip of the pitocin. I argued with our crappy nurse pretty much thru the whole thing. I was really pissed though, when I was told to "labor down" as my daughters head was about to crown. And let's not forget when I was told I was complete at 5 freakin' centimeters.

None the less, when they placed my pink, perfect Savannah on my belly- the rest of the world faded into the background. She was here and she was awesome!

Our breastfeeding relationship was strong. So strong it took us thru two bouts of mastitis, new teeth, and an attempt at ending our co- bedding arrangement.

We nursed everywhere. I began to see how important my breasts were to my daughter. How she couldn't wait to snuggle me and them when I got home from my part- time job, when she hurt herself, when she was tired, when she needed reassurance, when all was not right in her world. When she broke her arm- it was my breasts that comforted her in post op.

Our delayed vaccine arrangement was working too. She was healthy & at home with one of us, all the time.

Someone was missing in our family. I stayed up late at night thinking about it. It consumed my thoughts. I cried when I packed up clothes Savannah was growing out of.

We again conceived quickly. Only this time, I had done my soul searching. What was I trying to fix? What was I trying to prove?

I KNEW there was a better way. A more natural way. An instinctual way to parent. I hired a doula, and drove 40 minutes each way to a midwife. I wanted to birth my way. I didnt want to tear because I was pushing to slow & had better get it out or else. I didn't want to be told to stay in bed, or labor down or have a cathater stuck up my urethra. I didnt want to be told when to push, how to push or where to push. I didn't want someone to start an IV, to make me change into an ugly, scratchy hospital gown, or stick their fingers in my vagina every 2 hours to check if I was progressing on their time. I didn't want my son's genitals cut up without his consent. I didn't want him stuck with needles upon his entrance into the world. I didn't want crap in his eyes, spread so thick I couldn't see their depth. I didn't want anyone to clamp his cord to early, severing the rich blood that had nourished him for 10 months. I wanted to feel my son be born. I wanted our bodies to work in tandem to meet each other. I rode those powerful waves of perfection & it was divine.

Brody was born in a freestanding birth center on October 12, 2010. While his birth was not perfect, it was damn close. I was respected & so was my child.

For our family, there is a better way- a more natural way. An intended way of going about giving life & living life. I have made my mistakes along the way & still do. But I know now that no one but my husband and I have our families best interest at heart.

I will not be responsible for someone turning a profit over my families well being. I make it my job to be informed in regards to how I raise my children and the choices I make for them & the ones I allow them to make for themselves. Birth is normal, natural and incredible. Vaccines are a personal choice & should not be forced upon anyone. Circumcision is abuse, a violation of the child's human rights & should not be acceptable. Breastfeeding is bestfeeding, and good nutrition is key. Doctor's only know what they are taught & good or bad- all of them make a profit off of you. Babywearing is good for your baby & promotes the most basic of bonding principles that is trust. I will not leave you to cry it out for your needs are just as important as my own. Co-sleeping is amazing. You sleep- I sleep, we all sleep with co- sleep!

Follow your gut, and your heart. No book, or doctor, or article can tell you more than your instinct. If something isn't sitting right with you- speak up & speak out!

Courtnie and her children

16 week belly shot

2011-07-10T21:56:00.001-04:00

Guest post: surprise unassisted homebirth VBAC with classical incision scar birth story

2011-07-09T11:59:00.000-04:00

by April Hager

I wrote this up for the Special Scars Group that has been sooooo wonderfully supportive and encouraging for the past nine months. My 1st 4 were unmedicated birth center births. #5 was an emergency CS at 26 weeks with classical (vertical) incision.

This first week with our new little blessing has flown by, but the thrill of it all will stay fresh in our minds for a long time to come! Like all special scars mamas, from the start I’d been reading, researching, and praying to make the most informed choice about a VBAC. When I found an OB willing to be on call for my delivery and a midwife in his practice who agreed (although not so willingly) to attend my birth, I felt a plan coming together. I tried to think of everything I could do for a successful delivery: exercise, excellent diet, a natural protocol to ensure that I’d be GBS negative (and my labor would not be slowed down by antibiotics required if a positive GBS test) having my favorite homebirth midwife act as my doula in the hospital, taking Gentle Birth herbal formula the last 5 weeks of my pregnancy to make labor go quicker (less chance of rupture, right?) and not go over my due date with a larger baby that might be more stressful to push out.

I was due Sunday, June 26th. On Saturday, the last shoe of my plans dropped. My oldest daughter was finished with her job at a summer camp for the week. I picked her up that morning so she could take part in her sister’s birth. She joked that I could go into labor just as soon as she took a nap! She got her nap and I still wasn’t dilated beyond the 3 cm that I had been for several days.

My Braxton Hicks contractions seemed to have lessened even though I’d been pushing acupressure points (especially BL 32) all day. I finally took a walk around our yard and got one hard contraction to happen. I started dinner at 5:00 and seemed to be having good contractions every 30-45 minutes. I was beginning to need to breathe through them, but still only dilated to 3 cm at 10:00 pm. I just knew that I’d be in labor in the wee morning hours and exhausted from not getting any sleep, so I thought I’d lie down for awhile and perhaps the contractions would taper off and I could sleep a little? I anticipated making the one hour trip to the hospital in a few hours when (as the OB instructed) contractions were closer together. By the time my husband came to bed at 11:00 he noticed that I was breathing constantly and asked if we shouldn’t be thinking about going?

I was having bad back labor pains (still pushing BL 32 to alleviate them) and felt like I’d better get out of bed and perhaps use the toilet. Contractions were so intense that I worried I’d be stuck on the toilet. My water conveniently broke before I made myself get back up and I checked to find that I seemed to be fully dilated! I tried sitting on the birth ball while my husband called my doula to tell her that we were going to the hospital. As soon as I was somewhat in between contractions and could talk I told him to just tell her to come to the house that there was no way I was going to get in a car the way I was feeling. I asked her if it was possible for a baby to come that fast and she said that it was. She instantly turned back into my midwife and said she was on her way!

To relieve my back labor I knelt beside an ottoman in the living room and immediately felt like I needed to push. Hubby later told me he was scared to death at this point, but I felt like since we had no choice in the way things were going and if God allowed it to be this way, it must be going to turn out OK. I felt no pains in my upper abdomen where I’d imagined my vertical scar to be. Hubby asked my girls to get a towel to put under me and then called them over to help him catch the baby. I had her head out in a couple pushes. Tremendous relief followed but no immediate contractions to help me push her the rest of the way. I was waiting on another contraction to keep from tearing (I’d had episiotomies with the previous 4 natural births) but when hubby saw her breathing he encouraged me to go ahead and push. Out she came at 11:37!

The first part of her I saw was her tiny little feet, a visual I’ll never forget, as I flipped over to get her on my chest. Every inch of her was beautiful-so perfect. I thought about that signed birth plan in the diaper bag. All my picky little details that I was prepared to ask for at the hospital. And now I could do whatever I wanted! I had so much energy because it wasn’t even my bedtime yet. I felt like I’d just run a quick sprint. My girls were crying tears of joy, hubby was still in shock I think, and the midwife was just coming through the front door. I was just amazed that my little girl was there in my arms on my living room floor. I got the homebirth that I’d wanted since seven years ago when my son was taken by emergency CS at only 26 weeks. God knew what I really wanted and gave me the desires of my heart without my even asking. Caroline had a peaceful, beautiful entrance into this world. I shudder to think of what it would have been like for her if I’d given in to the fears of others and had a RCS. I believe that God understood my wanting to ensure the safety of myself and my baby by choosing to birth in a hospital, but in his omniscience He also knew that it would be just fine for me to birth at home and unassisted at that! He worked it all out and used all of my prior preparations in the perfect way that only He can and I’m so grateful!

April, her husband, and their 6 beautiful children

In which I admit that bedtime is a total failure at my house.

2011-07-06T21:50:00.001-04:00

Go ahead, judge all you want. Provided that you have successfully raised 4 or more young children close in age. If you have done this and lived through it and enjoyed the experience, feel free to post all sorts of advice on how I could be doing this differently. When I only had 1 kid--indeed, even when I had only 2 kids--I did a "good mommy" bedtime routine, as well. It's when you have 3 kids age 3 and under that things begin to get hairy.

I am pregnant with our 5th baby. Our oldest kid is 8 1/2. Bedtime is a disaster at our house. I felt saddened and guilty when I read this "Please, Go to Sleep" NY Times editorial. Bedtime here more closely resembles the one the author so disliked from her own childhood, minus the relaxing glass of wine to reward a harrowed mom at the end of the day. And that was only describing bedtime with ONE child. Try it with 4. And my husband works late frequently and unpredictably, so I never know whether he'll be home at 6 p.m. or at 9 p.m. It's a total crapshoot. He's an involved and loving father--when he's home. Since we have no family support or help, I'm on my own most of the time. I also homeschool our kids, so it's just me and them--24/7/365. Yes, this is a lifestyle choice, and one I'm glad that we made. I'm not trying to complain. I'm just being honest.

By dinnertime every day, I'm exhausted and nearing mommy-burnout stage, wondering what time my hubby will get home that night and whether I should just go ahead and feed the kids without him. After that, whether or not he's home, I'm stick-a-fork-in-me-"done" in terms of mediating the kids' squabbles or dealing with their toys on the floor ("I thought I asked you to pick those up before dinner!") or helping the kid who was roughhousing and bumped his/her head. I don't mean to sound callous. Really, I'm not. I'm a loving, devoted mom who is committed to attachment parenting. I'm also not talking about a newborn here. These are kids ages 2 to 8 who sleep contentedly in their room without me, etc.

A lot of nights, I feed them dinner then tell them, "Good night, go upstairs. Brush your teeth. Brush your sister's teeth. GOOD NIGHT. I LOVE YOU. GO TO BED. GO UPSTAIRS." Then I do not want to see them again until morning. It's somewhere between 8 and 8:30 p.m. when I send them upstairs to manage their own bedtimes. (No, I'm not proud of this. I'm exhausted and cannot do better.) They rumble around up there until 10 p.m. or later many nights. Augh! It's so frustrating! I can't relax or wind down or read anything of substance or even think until they go to SLEEP. And by that time, I'm too fried to care. All I want is to wind down and go to bed myself.

I feel bad that I don't help my kids take a fun bubble bath, then dry them off and dry their hair, then supervise careful teeth brushing and flossing, then read one chapter per night of a sweet and relaxing bedtime story where they all lie cuddled on and around me like a pile of puppies. Sorry, I can't do it. I hope they remember all the good things I do and did, not Mom's failure to do the "right" thing at bedtime. Nobody's perfect, not even perfectionists.

Baby chooses birthday vs. "family centered cesarean"?

2011-07-05T23:26:00.005-04:00

This post is my rant about the between-a-rock-and-a-hard-place situation that moms who know they will be planning a cesarean face. This post is *not* for discourse regarding whether a cesarean is or isn't the "best" choice for any specific situation. Whether a mom has a medically indicated reason that is foreknown and is planning to have a cesarean, or whether she is having an elective cesarean, moms deserve to have choices and options open to them.

There's lots of talk in the media now about "family centered cesareans," "natural cesareans," or "gentler cesareans," which allow mothers more involvement in the birth, immediate skin-to-skin contact and bonding after the birth, earlier establishment of breastfeeding, and more.

More and more mothers are aware of the dangers of early elective deliveries (whether by induction or cesarean). There are many awareness campaigns encouraging moms to wait a bare minimum of 39 weeks before scheduling a delivery of any sort. Many moms are also aware that there are benefits to baby if he or she has the advantage of the hormonal changes of spontaneous labor as well as the physical effects of labor (squeezing effect of contractions that help push mucus out of baby's lungs, for instance) and dangers of baby not being ready for birth if it's scheduled (higher likelihood of respiratory distress, NICU admission, neurological issues, breastfeeding problems and more). These moms know that in many instances, it's possible to wait on spontaneous labor to begin before going to the hospital and requesting the aforementioned cesarean that she had planned.

Here's where the problem lies: it's difficult for moms to have a "family centered cesarean" without having it scheduled. Most OBs are in a rotation of who is on call, and most American OBs have never performed (nor even heard of) a "family centered cesarean," "gentler cesarean," or "natural cesarean." If a mother is blessed enough to find a care provider who will support her desires to have an atypical, involved, gentler cesarean birth, odds are that the other OBs in the practice will not honor her birth plan. If mom doesn't schedule her family centered cesarean, she's not likely to achieve her birth goals (unless she happens to go into labor when "her" OB is on call).

It shouldn't be this way! Moms shouldn't be forced to choose between "best cesarean birth for mom" (family centered cesarean) and "best cesarean birth for baby" (allowing baby to signal readiness to be born and having a cesarean at the onset of active labor). I can't see any good reason (legal or monetary reasons benefitting OBs don't count as a "good reason") why moms shouldn't be able to request a family centered cesarean on demand at the onset of labor. In fact, I can't see a compelling reason why gentler cesareans shouldn't be the norm for cesarean births and offered for all non-emergency cesareans (the majority of them).

I know that this is available in other areas (UK and Australia), so it's possible here, but it will take educating mothers and educating care providers to make it happen. It will take a push from consumers to request a better cesarean experience, or take their healthcare dollars elsewhere to an OB who *will* accommodate their birth wishes.

What are your thoughts? Have you had or attended a family centered cesarean? Was it scheduled or upon natural onset of labor? How did mothers/doulas/birth activists make alternative cesareans available in your area?

12 week belly pic & stuff I'm doing to try to stay healthy

2011-06-12T23:04:00.005-04:00

Hello all,

Thanks for your patience. I haven't written much lately--sorry about that. I have a stack of Post-it notes literally an inch tall with blog ideas that I need to get around to writing "when I have time." I do mean to...

Here's what I've been up to thus far with this pregnancy. (Please consult your care provider regarding the best supplements, exercises, etc. for your situation. I'm not diagnosing, prescribing, or recommending anything at all, just sharing my experience.)

I'm on Rainbow Light One-a-day Prenatal Vitamins. I'm also on 5000 IU of Vitamin D3 and refrigerated Now brand acidophilus. I plan on adding garlic tablets for immune boosting after the nausea is gone altogether, and possibly Floradix Iron + Herbs as I approach mid-pregnancy to reduce risk of anemia.

I have been taking a Pilates class 3 days a week (30 minute class) on and off for 4 years now. After finding out I'm pregnant, I've been far more diligent to attend whenever possible. My 6 year old and 8 year old daughters attend and take the class with me while the 2 year old and 5 year old are in babysitting at the gym. Considering that this is my 6th pregnancy in 9 years (5th live baby), I can't afford not to have good abdominal tone. When a mom's abs and uterus have been stretched from this many pregnancies, it can tend to make the abdomen hang and stretch even further late in pregnancy. This is a less favorable position for pre-labor and labor. I'd like to do what I can to keep strong abdominal tone for optimal positioning.

I'm also taking water aerobics 3 days a week (1 hour class), back-to-back after Pilates. That sounds really intense until you find out that I'm one of 2 non-senior-citizens in the water aerobics class. I would like to try to find a way to continue taking water aerobics throughout this pregnancy, if possible. I also keep thinking that I need to add in 2 days a week on the treadmill in between the water aerobics days. The reason I'm so focused on this is that my pregnancy where I took the best care of myself with diet and exercise was my easiest labor, delivery, and recovery of all of them. I realize there are many factors, but that's the point. There are things I can control, and things that are out of my hands. I may as well stack the deck to my favor with the factors I *can* control.

I'm not strictly following the Brewer diet, but I am shooting to eat a minimum of 80-100 g of protein daily as outlined by Brewer's recommendations to help prevent pre-eclampsia, PIH, IUGR, and other problems. As with the other things, there are more factors than just diet, but I'd like to do the best I can proactively. I use the meal tracker on free site babyfit.com to track my protein intake. (Let me know if anyone knows of a more user-friendly free online diet tracker and food database than that one.)

I'm finally starting to get my appetite back and I'm hungry frequently. I graze all day long, nibbling on little portions, rather than eating large meals at any point. This helps stabilize my blood sugar which is very sensitive during pregnancy (I'm not diabetic though). I carry food with me everywhere I go. Usually in my purse or diaper bag is a string cheese, whole wheat crackers, a Luna bar, a Kashi granola bar, a Larabar, a pear or apple and a small Tupperware of dry roasted almonds. I carry 32 oz of water with me everywhere I go. I never drink soda. I drink 100% juice (no sugar added) a few times per week.

I'm trying to be mindful of posture to promote optimal fetal positioning and encourage baby's anterior positioning for the future. My posture *now* does matter. I'm trying to sit up straight more, slouch less, sit on the exercise ball more, engage my abs more, and avoid slumping on the couch. I'm also trying to train myself to stop crossing my legs (really hard to stop!) since the pelvis narrows in the front when momma frequently crosses her legs, which can contribute to posterior positioning (and a longer, more difficult labor).

I got established with a chiropractor who specializes in pregnancy chiropractic and the Webster technique, for preventative care during this pregnancy, starting at 7 weeks gestation. I had moderate SPD with my 3rd pregnancy in 2006 and severe SPD with my most recent baby in 2008, so I want to do what I can to prevent it from becoming debilitating this time. Some SPD is hormonal and chemical in nature (relaxin and other pregnancy hormones) and there's little that can be done beyond management of SPD symptoms, but some SPD is positional. It's then that chiropractic can help prevent and/or treat SPD.

I would feel better telling you all this if I hadn't had a donut for breakfast and an ice cream sundae after dinner today. I guess it's all about balance. No ice cream tomorrow. Pilates, water aerobics, and real food instead.

Here I am at 12 weeks along. And yes, there's only one baby in there.

Coping tips for "morning sickness"

2011-06-01T22:42:00.014-04:00

My personal stash of nausea remedies. Top row, l-r: Old Ballycastle Ginger cocktail mixer; The Ginger People Ginger Beer; Vita Coco coconut water; lemon juice; Gatorade; Barritts Bermuda Stone Ginger Beer; Middle row, l-r: ginger Altoids; Reed's Ginger Candy Chews; The Ginger People Gin-Gins hard candy; Buderim Ginger Bears; The Ginger People Crystallized Ginger; Bottom row, l-r: Crystal Light Pure Fitness; True Lemon, True Orange, True Lime; Earth Mama Angel Baby Organic Morning Wellness Tea.

It's funny. I posted this link by the InfantRisk center on safe remedies for Nausea and Vomiting in Pregnancy (including safe OTC medicines) the day BEFORE I got my positive pregnancy test in April. Then it became relevant.

I really feel badly for mommas who have severe nausea and vomiting in pregnancy, which is the official term for "morning sickness," since the symptoms can occur any time of night or day (or even non-stop). For many moms, symptoms will ease up on their own by around the 14th week of pregnancy, but a few have various degrees of nausea and vomiting until delivery.

Unfortunately, not much research has been done on the causes of nausea and vomiting in pregnancy (beyond knowing that it's a side effect of hCG and other pregnancy hormones), nor in available treatments. It may be a matter of trial-and-error to find something that will help you cope, because what works for one momma has no effect for another. What worked with the last pregnancy might not bring relief with the next pregnancy for the same woman. Whatever gets you through is the "right answer."

Here's a list of options that have worked for some moms (some of whom contributed on my Well Rounded Birth Prep Facebook page). I hope you find something that works for you.

General diet:

Healthy, well-balanced meals in general.
Avoiding consuming liquids and solids at the same time.
Eating small meals more often (5 or more times per day) as opposed to larger meals 3 times per day. Some moms find relief eating small amounts almost hourly. Some issues with "morning sickness" are related to low blood sugar, and frequent small meals can help prevent this. A midnight snack can help if this is the case.
Avoiding greasy or fatty foods.
Reducing or eliminating refined sugar. Reducing dairy.
B complex vitamin supplement.
Keeping food by the bedside to nibble on before arising in the morning. Some moms swear that eating a cracker or half a cracker before arising was their salvation. Others find it doesn't make much difference.
Eating a low-fat or fat-free protein with a complex carb at each snack and meal when possible, such as string cheese with whole wheat crackers, or peanut butter with apple slices.

Foods and drinks:

Ginger in a variety of forms can alleviate morning sickness, heartburn, or reflux. Some options: Candied ginger, ginger gummy bears, ginger caplets or tablets for those who don't like the strong flavor, ginger Altoids, ginger hard candy, ginger chews.
REAL ginger ale or ginger beer (non-alcoholic) (most ginger ale is artificially flavored).
Ginger tea, which you can purchase or make by steeping a slice of ginger root in hot water. One great brand of ginger tea is Earth Mama Angel Baby Organic Morning Wellness Tea with ginger root, spearmint leaf, chamomile, orange peel, lemon balm leaf, and peppermint leaf.
Ginger syrup non-alcoholic cocktail mixer with real ginger. Can be mixed with seltzer water, Sprite, tea, or drink of your choice.
Crackers in many forms. Saltines, Wheat Thins, whatever works.
Gentle foods that you would eat when recovering from a stomach bug. Dry toast. Unsweetened applesauce. Bananas. Rice or plain noodles. Plain yogurt (lightly sweetened with honey, jam, or berries). Toasted whole wheat bagels. Chicken noodle soup. Broth. The same things that make good labor snacks.
Peppermints. Altoids. Mint hard candies or Tic Tacs. Mint gum.
Hard candies such as Lemonheads or cinnamons. Suckers. Preggie Pops.
Sour candies and foods. Sucking on a lemon. SweetTarts. Dill pickles and pickle juice. No joke. I've heard a few moms say they drank it straight up and it was the only thing that helped their morning sickness.
Decaf tea, hot or cold, unsweetened or lightly sweetened with honey. With or without a squeeze of lemon.
Lemon water (squeeze lemon wedge in water or use squirt of bottled lemon juice). True Lemon crystallized fruit wedge, also True Lime and True Orange. Eating powdered True Lemon straight out of the package may appeal to you if you find sour lemon soothing.
Beans. There's no research to back this, but some nutritionists say that legumes are the answer to helping the body absorb and eliminate the excess bile caused by hCG, which will alleviate or completely eliminate morning sickness. If you think about it, pharmaceutical companies are unlikely to fund or promote any research that could show that simple nutrition could help with morning sickness. There's no risk to trying to eat more beans to see if that helps; they're inexpensive, nutritious, and loaded with fiber and protein, which will help you meet the 80-100 g of protein expectant moms need daily.
Popsicles. You can make your own from juice, herbal tea, or fruit smoothies. Electrolyte drinks don't freeze well due to the salt content. Some moms find that popsicles, ice chips, or blended frozen drinks stay down more easily.
Electrolyte drinks, especially if you are becoming dehydrated from vomiting or from avoiding drinking due to nausea. Some options: coconut water (*not* coconut milk), Ultima Replenisher, Vitalyte, Crystal Light Pure Fitness, Gatorade, or make your own.

Aromatherapy:

Identify and avoid smells that nauseate you.
Avoid perfume, scented lotions, or fragranced soaps and shampoos if they bother you. Switch out your partner's and/or childrens' soaps or shampoos if they're bothering you. You can always switch them back after your nausea subsides.
Keep fragrances around that are pleasant to you. Some moms find mint, ginger, citrus (lemon, orange, or grapefruit), or chamomile to be soothing fragrances during morning sickness. Options: scented candles, sprays (body spray, linen sprays, room sprays), or essential oils applied to a cotton ball then double bagged in zip-top bags so you don't have to smell them unless you want to. Earth Mama Angel Baby sells a wonderful multipurpose Happy Mama aromatherapy Spray that may help.
If you have a toddler in diapers and it nauseates you to change poopy diapers, and if you can't find someone else to change him or her for you, it's OK to take them outside to change them so long as it's not subarctic temperatures out there. I've changed my poopy toddlers outside on a covered porch in too-hot or too-cold temps since I had everything ready and did it as quickly as possible. If I have to choose between that or smelling the aftereffects in my living room, I'm choosing the outside diaper changes.
If you can't stand the smell of food cooking, using the crockpot and plugging it in in the garage or basement is an option. Excellent for when you don't feel like eating but have to prepare something for everyone else, for when you're too tired in the evenings, or when the smell of cooking bothers you. Also good for those who are queasy earlier in the day but feel like eating by dinnertime. Your partner might be able to help you prepare the crock pot the night before and load it, ready to go, in the fridge, so that all you have to do is plug it in in the morning.

Other options:

Moderate exercise. Taking a walk. Getting fresh air.
Air circulation. A fan with a breeze pointing on mom's face.
A cool, damp washcloth applied to the face and/or neck.
Chiropractic can help alleviate morning sickness, and is extremely beneficial throughout pregnancy for many reasons.
Acupressure has been used for centuries to combat morning sickness. One simple way to try this is Sea-Bands which are sold in any pharmacy and are designed to prevent and treat motion sickness.
Acupuncture by a licensed practitioner can sometimes help.
Hazelwood necklaces. From Inspired by Finn: "Wood from the beaked hazel tree has the medicinal property of neutralizing the body's acidity, and helps the body create and maintain an alkaline balance. It is an ancient remedy first used by aboriginal people, and is effective for people of all ages... Beaked hazel wood can relieve acid-related ailments such as acid reflux, ulcers, heartburn, and other acid-related ailments. Our necklaces are a great remedy to take the edge off of heartburn and morning sickness during pregnancy."
If excessive salivation is an issue, it's better to spit it out than to swallow it, as swallowing it can exacerbate nausea.
Some moms find that homeopathics can help. Ask your care provider whether this is an appropriate option for you.
Some moms find that Vitamin B12 injections can help alleviate their symptoms for up to a week, for severe cases of nausea and vomiting. Ask your care provider whether this is appropriate for you.
Anecdotally, I hear moms say that when they are highly stressed and/or have a heavy schedule at work, their morning sickness is worse. Saying "reduce stress and work less" is easier said than done, but something to consider when looking at the big picture and possible options if morning sickness is severe.
Some moms report that when they have to get out of bed quickly in the morning, it makes them feel worse. For some, setting the alarm clock a bit earlier and hitting the snooze while snacking on crackers helps them acclimate. For others, letting natural sunlight in the windows helps awaken them gradually and gently. In any case, slowly rolling over, then slowly lowering legs to the floor, then slowly sitting up, slowly getting up and slowly walking to the bathroom may be less jarring to the body than hopping up suddenly when the alarm goes off.

Coping in the meanwhile:

Keep a few plastic bags tucked in your purse and in your car in case you can't get to a bathroom in time (or even pull over in time when driving).
Scout out where the nearest bathroom is wherever you go. This will come in handy when you have to pee on the hour anyway, even if you don't throw up.
Dehydration can lead to contractions and potentially preterm labor, so finding some way to keep some fluids down is crucial. Dehydration can also cause a urinary tract infection (which also causes contractions) and/or bladder infection which needs to be treated with antibiotics, which can lead to a yeast infection and gut flora imbalance. If dehydration is severe, your doctor or midwife may recommend an enema to help you absorb some fluids, or you may need to be rehydrated by IV.
Prescription medications are available for moms with hyperemesis gravidarum (severe nausea and vomiting in pregnancy). Ask your doctor what meds are available, what the risks are vs. the benefits, and whether this is could be a viable option for your situation. In some cases, prescription meds are the only way moms with hyperemesis gravidarum can manage to keep any amount of sustenance down.

More links:

Nausea and vomiting in pregnancy-- (safe non-medicinal tips as well as safe OTC and prescription meds)-- InfantRisk Center

The importance of staying hydrated while pregnant--Associated Content from Yahoo!

Morning Sickness: Tips on how to combat it naturally & drug-free--Earth Mama Angel Baby

Common treatments for Hyperemesis Gravidarum-- Mothering Magazine

What remedy or combination of treatments worked for you? Or did nothing seem to help? Was it different with different pregnancies?

On seeing baby's ultrasound and uncertainty after loss

2011-06-01T12:35:00.002-04:00

Trigger warning: This post is about coping with the emotions and issues of pregnancy following loss.

I've been getting really antsy lately to find out whether my baby is still alive. Judge me all you want, but unless you have lost a baby, you have no idea what it's like to wonder if your baby is dead or alive. I've had people judge my faith in God over this, telling me that I just need to have faith. How do they know how much faith I have or don't have? How much faith I have is irrelevant to whether my baby will make it. I had faith in God when my Evan didn't make it. I had faith in God when my others did. I've even heard some say that by worrying about it, it's more likely to happen due to the Law of Attraction. Sorry, but I don't believe in that. Nobody deserves a miscarriage, attracts it, "asks" for it, etc.

Since my 2007 miscarriage was a "missed miscarriage," everything felt fine and normal. I had no symptoms of miscarriage (other than a dead baby). I had no cramping, no spotting or bleeding, no pain. I still had morning sickness. My uterus continued to expand and I was measuring on target because my womb was filling up with blood and amniotic fluid after my baby's death. I carried him around 6 weeks after he passed on, without having any knowledge of it until the next checkup when my midwife couldn't find the heartbeat.

For this reason, it has been no consolation to me that everything has felt fine and normal. It's not reassuring that I'm definitely showing. These "signs" didn't mean anything when Evan died.

I had my 10 week prenatal checkup this morning. I wasn't sure how long I would wait until asking to hear baby's heartbeat with the Doppler due to the small risk of possibly doing damage or causing miscarriage. I hoped to wait until I was at least in the 2nd trimester to reduce the risk since baby would be less fragile at that point, but I really wanted reassurance. I realize that listening in is only one moment in time and can say that baby is alive at that instant, but can't guarantee what will happen next week or next month. Nevertheless, I need to buy maternity clothes and I have been too scared to buy any for fear of taking the tags off then the baby might die and I would be stuck with the reminders.

The other midwife had taken the regular prenatal equipment bag on rounds today, so my midwife had the backup Doppler that only works half the time. It didn't work today. She hauled out an old monitor to try to listen in. Yes, a monitor, like a hospital monitor to listen to baby's heartbeat in labor. One monitor paddle is a Doppler, just in a different shape, but its flat shape made it impossible to angle downward into my pelvis to be able to hear baby's heartbeat. As a courtesy, my midwife offered to take a peek with her ultrasound machine. By this time, I already had my mind made up that I wanted to see/hear that baby is alive, so I accepted.

We saw ONE baby (not twins, despite how big people think I look for first trimester), right size for 10 1/2 weeks, with a heartbeat. That was reassuring, but not to the degree that I expected. I hoped to feel much better, perhaps even "back to normal." Maybe there is no such thing any more. Maybe it's just because we have no assurance of tomorrow. Knowing that my baby is "fine" today doesn't mean much since we're still in that first trimester when there's the highest risk of miscarriage.

I'm thankful for a good prenatal checkup today (all other measurements and markers were perfect as well), but I'll feel much better when I feel baby's movements. I pray that I'm blessed with a squirmy, active baby who makes his or her presence continually felt sometime in the next month or month and a half.

Belly shot: 8 weeks along

2011-05-16T21:41:00.002-04:00

This photo was taken at 7 weeks 6 days along with New Baby, right after the James Taylor concert hubby and I went to. (We bought the tickets with my Well Rounded Birth Prep teaching money from Jan. & Feb.! Thanks to you, my clients!)

Pregnancy #6, live baby #5.

Before I got the positive pregnancy test at 4 weeks 4 days along, I already had to unbutton my jeans when sitting down. I've lost 3 pounds from nausea, but still have to unbutton my jeans when sitting. I've already worn my Bella Band over unbuttoned jeans a few times.

My body gets one whiff of hCG and says, "We totally know what to do with this! Let's GOOOOOO!"

...and my best friend is pregnant, too!

2011-05-11T15:23:00.000-04:00

Trebor on left, me on right, w/ our 4th babies. Nov 2010.

You might remember my best friend Trebor's Sutler's birth story from her previous baby. She had a peaceful home waterbirth with midwives, on Christmas day a few years ago, which was her second VBA2C (vaginal birth after 2 cesareans). Here is her birth story and what led up to it. Her story was featured in several local newspapers.

Trebor and her husband Rob have a lot in common with me and my husband, Rick. We each have four children close to the same ages, lost one to miscarriage, homeschool our kids, similar lifestyle choices (try to eat healthy, teach our kids manners, etc.), homebirth, baby-led weaning, and more. Trebor and Rob decided a few months ago to try for Baby #5. Rick and I cheered them on but did not plan on joining that club.

Then I found out I was pregnant. That was supposed to be Trebor, not me! At that point, Rick doubled up his efforts to root for Trebor to get pregnant ASAP so that he and I wouldn't be the only ones in this boat. About two weeks after I got my positive pregnancy test, Trebor got hers. Wow. Our due dates are only two weeks apart!

We share the same homebirth midwives and now we're in a race to the finish. Who will get our primary midwife (maybe we both can)? What will the weather be (due late December or early January and we both live up a steep hill)? Surely we won't go into labor at the same time. I was counting on having her as my doula and birth photographer. If all goes as planned, we'll still be able to doula each others' births, but one of us will have to attend the other's birth with a newborn in a Moby Wrap and hope that he or she sleeps a lot.

My husband had a different idea. He thought that it actually *would* be a good idea for me and Trebor to go into labor at the same time so that we can get it over all at once, share a birth tub, moo together, then catch each others' babies. Then the men could go watch TV while we women do all that birth stuff. Haha Rick. Um, no thanks.

At any rate, a true best friend will walk with you through any journey in life, and I'm looking forward to sharing this crazy ride with Trebor. It will make for some awesome maternity photos!

I'm pregnant (yes, AGAIN!).

2011-05-09T17:27:00.009-04:00

Wednesday, April 20, 2011, I was on day 32 waiting for my cycle. This wasn't unusual for me, since my cycles vary from 26 to 34 days. Rick and I were going on a 3-day-2-night mini-trip without the kids; Rick had a work conference he had to attend and I was tagging along, figuring that I could shop and relax while he was in meetings. (This was a first, literally. We rarely have a babysitter even for one evening. We had never taken a trip without the kids.) We were leaving that evening, so I took the test early that morning, just so I could get a negative result and have it off my mind. I really did NOT anticipate seeing two lines. Just to be sure, I took the second test, which was a different brand, and figured that the odds of two false-positives were nearly nil.

So, I'm pregnant again. This is my 6th pregnancy (5th live baby); my oldest child is 8 (but will be 9 by the time baby comes). I'm due late December 2011 or early January 2012. This should be interesting.

I've put off posting it publicly for a number of reasons. I've had several time-sensitive, time-intensive, stressful issues that I've had to deal with. I'm homeschooling my four kids. I have been teaching private birth classes. My hubby usually works late. And I was just recovering from 2 bouts of strep within a month.

But mostly, I'm not prepared (still) to deal with any criticism. It's nobody's business how many children we have. We're not on public assistance, so nobody can complain that my kids are a tax drain (they're not). I wasn't particularly worried about what my blog readers would say, since many/most of you are birth advocates, birth junkies, and/or birth professionals, and you will probably be happy and excited for me. Maybe you'll follow me on this journey. It's mostly acquaintances or complete strangers who make snide comments.

We believe that every child is a blessing and a gift from God. Even so, this was a bit of a surprise and I'm left feeling a bit unprepared to start alllll over again when things were just starting to get a little bit easier. My (former) youngest is 2 years old and can entertain herself somewhat. My kids can play independently and even make themselves a sandwich (and put all the ingredients away). All 4 of my kids can dress themselves (the oldest two help dress the 2-year-old) and even get themselves buckled into all their car seats in the van. I realize that these things will make life easier when the new baby comes. My children have always been big helpers for whoever the new baby was at a time, and they'll be even more helpful this time around. I'll figure it out, because people do.

Here's a list of stuff not to say to me, at the risk of me snapping at you. Don't push me or you might be on the receiving end of a pregnancy-hormone-laced response.

"Don't you know what causes that yet?"

What I might reply: "Why yes, yes I do. In fact, I teach classes on it; would you like for me to draw you a helpful diagram?"

What I'm thinking: "Do I look THAT dumb to you? Seriously??? No, I really DON'T know what causes that, because I'm an IDIOT. What do YOU think??? Do you really think you're the first smart-aleck to come up with that one, anyway?"

"You know there's a way to stop that, right?"

What I might reply: "To each their own. I'm glad that your decision worked for you."

What I'm thinking: "How rude! I don't tell others what to do with their bodies or whether they should or should not be using contraception or have surgery. What right do they think they have to tell me what to do!"

"Oh you poor thing. I don't know how you're going to do all that with 5 small children. You sure are going to have your hands full!"

What I might reply: "I'd rather have my hands full than empty. We're really blessed. We love our kids."

What I'm thinking: "Some days I'm discouraged and intimidated and I don't know how I'll manage this, although I'm trusting God to give me grace to handle it the way He would have me to. However, I don't need any Eeyores hanging around telling me how awful it's going to be. The baby is coming whether you like it or not, so how about offering me encouragement or help or SHUTTING UP?"

"Are you trying to have enough to have your own baseball team?"

What I might reply: "Haha. Maybe. I hadn't really thought of that."

What I'm thinking: "Another genius who thinks he's original."

"How are you going to pay for college for that many children?"

What I might reply: "I'm an only child, yet somehow nobody managed to set aside money for my college. I was told from a very young age that I would earn an academic scholarship. I knew that I needed to work toward that goal, and I did it. Scholarships are a great possibility."

What I'm thinking: "College degrees have been devalued to the point that they might or might not be the best option for my children when the time comes. They may want to work in a trade or apprentice. Who knows? Besides, what business is it of yours? How are YOU going to pay for college for YOUR children?"

"Are you sure there's only one baby in there???"

What I might reply: "I'm measuring on target for one baby. I'll see baby at the 20 week ultrasound. This is my 6th pregnancy in 9 years, so my body responds to pregnancy hormones and I 'show' very early."

What I'm thinking: "I'm sorry that you think I look like a COW. As if I weren't insecure enough about my belly without your help bringing me down. Try a little sensitivity."

"Are they all yours?"

What I might reply: "Yes, they are. We have good kids."
What I'm thinking: "No, they're *not* all mine, I just thought it would be a good idea to babysit a bunch of kids and drag them all over town instead of staying home for the few hours I'd be babysitting."

"Wow, better you than me!"

What I might reply: "I agree!"
What I'm thinking: "She set herself up for that one."

That's just the list for starters. I'm sure I'll think of others later. I've heard them ever since my 4th pregnancy (with Evan, the baby we lost in 2007) so this will make the third pregnancy where I have felt that I have to defend myself. Also, I know I'll feel better once I round into the second trimester and the risk of miscarriage drops substantially. Wondering whether this baby will make it has made defending myself doubly hard.

In spite of all that, I don't want anyone or anything to steal my joy. There's a baby inside of me!

The Day My World Came Crashing Down--4 year anniversary

2011-04-27T21:00:00.002-04:00

***trigger warning*** This blog is about miscarriage.

I realized that I have never written about That Day, the day I found out that my baby was dead, at 14 weeks 3 days along. I've written about the day after, researching my options and trying to decide whether to be induced or whether to wait it out to allow my body to go into labor naturally or whether to choose a D&C. I've written about the path to healing. But not about what happened That Day.

Four years ago today, I thought everything was fine. I was pregnant with my fourth baby, and my oldest child was four and a half years old. I had a regular prenatal appointment at my house with my midwife That Day. My last prenatal appointment had been at 8 weeks 3 days along. I had asked my midwife if we could stretch the next prenatal appointment a bit farther than the usual 4 weeks between visits because I had a busy schedule around that time, and she accommodated me.

The first part of my checkup went normally: blood pressure, pulse, weight, urinalysis, my midwife asking me how morning sickness was going and whether I had started to feel better yet. (My morning sickness had been normal, with queasiness starting around 6 weeks along and lessening around 13 weeks. My pregnancy hormone levels were high and healthy.)

Everything was fine until my midwife got out her Doppler to listen to baby's heartbeat. She couldn't find it right away, but I wasn't alarmed. She tried to reposition it to see if she could hear it from a different angle, but still couldn't locate it. I still wasn't worried. I figured that it could be possibly still be difficult to find the heartbeat on Doppler this early. My midwife wanted to get me an appointment for an ultrasound right away. Like, 3 hours later. I was a bit taken aback at the seeming urgency for this, but went along with it, knowing that I would feel much reassured after seeing that baby was fine when I had an ultrasound.

At first, my husband Rick said that he wasn't sure if he would be able to take the afternoon off. Neither he nor I understood the seriousness of the situation. My midwife said that if he couldn't come, she would go with me, because I should not go to that appointment alone. Uh oh. That doesn't sound good. Rick managed to hurry home and we got the kids into the car and rushed them off to my friend's house so we could go to the ultrasound alone.

I remember that it was chilly and drizzling that day--same as today. I remember being on the interstate nearing the hospital, thinking it was so surreal, still thinking that everything was fine. I remember thinking that we would look back on this afterward and think, "Wow, that sure was a close call. Pretty scary. I'm glad everything was OK." I just didn't get it.

We didn't have to wait in the lobby for long. They took me and Rick back to the private ultrasound room. The ultrasound tech started the scan--and my heart sank right away. She moved the transducer around, but my baby didn't move. There was no heartbeat. And I've seen enough ultrasounds to have a general idea what babies look like at different gestational ages on ultrasounds; this definitely wasn't right. My baby not only didn't move, but was way too small. The ultrasound tech said she was sorry, but there was no heartbeat, and the "fetus" measured 8 weeks 5 days. She left to get the doctor to confirm. I was shocked. My world was crushed in an instant.

The doctor was very matter-of-fact and sort of cold. I don't remember his exact words; they cut too deep for me to record them at the time. He was quite casual about it, saying that 25-50% of all pregnancies end in miscarriage, often before the mother even knows she's pregnant. That may be true, but it didn't change the fact that my baby just died. MY BABY DIED. Whatever else he said involved the words "product of conception," the first of many times I would hear that phrase from medical professionals over the next few days, unfortunately.

I cried. Rick held my hand. Then we did the Walk of Shame as they ushered us quietly out the rear exit. I was embarrassed because I realized that it was more for the sake of the other pregnant mothers in the waiting room, to spare them from having to see me shaking with sobs, rather than to spare me from having to see other pregnant women.

We made our way back to our van. I had no idea what to do next. We called my friend who was watching our kids to let her know what had happened, and she said to take as much time as we needed. Rick and I took a drive for a few hours, talking it over and calling our family and a few close friends to tell them the news. Ironically, the sky cleared and the sun came out. The rest of the day was beautiful.

This happened on a Thursday, so I knew that I was pressured for time to decide what to do. If I decided to wait it out for my body to miscarry naturally, I would be in no hurry, but who knows how long until my body got the memo. I had not had any cramping, bleeding, or any other miscarriage symptoms yet. But I wanted this over with. My baby was gone already, so it didn't matter to try to have the "best birth possible to keep baby safe." I could not begin to seek closure while my baby's body was still in my womb, and waiting could potentially take weeks. I was also frightened of what a natural miscarriage could be like. I wish I had known more people who had been diagnosed with a "missed miscarriage" like mine, who did choose to wait it out, because I might have chosen differently had I not been so afraid. I felt rushed because if I didn't make my decision that night, I'd be forced to wait out the weekend and would not be able to have a D&C or induction until Monday. I didn't want to be cornered into a decision because I was pressed for time.

I would never be the same person after That Day.

Good labor snacks--and why moms need them

2011-04-17T01:07:00.021-04:00

There's an old wives' tale that you shouldn't have anything to eat other than ice chips during labor (with the possible exception of clear liquids such as popsicles). The good news: research has shown for years that there are clear risks to withholding food and drink from laboring moms, and that they need calories and hydration to complete the hard work of labor and birth, with literally no benefits at all to withholding food or drink. This means you should be able to eat and drink anything you want! The bad news: most OBs believe the old wives' tale and aren't even aware of research contradicting it.

Chapter 4 of The Thinking Woman's Guide to a Better Birth, by Henci Goer, is called "IVs: 'Water, Water, Everywhere, Nor Any Drop to Drink." She details the history behind current obstetrical traditions and superstitions regarding eating and drinking during labor, as well as the risks of withholding food and drink from a laboring woman, and risk/benefit comparisons. There are several pages of explanation of why routine IVs have serious risks of their own with no potential benefits; routine IVs do not replace eating and drinking in labor.

Synopsis of Ms. Goer's Bottom Line on Forbidding Food and Drink in Labor:

Pros: None

Cons: Hunger, thirst, discomfort, dehydration sometimes resulting in fever, exhaustion leading to fewer or less effective contractions (which is viewed "Failure to Progress" and is seen as a necessity to augment labor by means of Pitocin or other drugs and interventions), imbalance of electrolytes, drop-off in blood sugar levels producing ketones which can cross into fetal circulation causing fetal blood to become more acidic (acidosis) which is a symptom of fetal distress. Increased perception of pain when hungry and/or thirsty. Seizures can result if mom's electrolytes are out of whack and blood sugar is bottomed out.

What kinds of foods make good snacks during labor? Here's Ms. Goer's suggestion: "Fat delays digestion. Solids must be broken down into tiny bits to pass into the intestines. High concentrations of sugar and acid and either low or high concentrations of salt also slow digestion. Heavily sweetened drinks can also cause nausea and acid in the stomach, which, as we have seen, should be avoided. Icy liquids empty more slowly as well. Given these criteria, choose food and drink that you know you tolerate well, the kind you would consume if you were recovering from the stomach flu."

Eating and drinking small quantities more often is easier on the digestion than larger quantities less frequently.

That being said, it's your labor, and if you're craving something that's on the forbidden list (for example, greasy or rich foods) and don't care if it comes back up, have at it. While not all moms vomit during labor, vomiting can help with dilation.

Many mommas can manage to eat lightly in early labor but don't want to eat as labor progresses. Some moms aren't hungry in labor or are nauseated and food doesn't appeal to them. For a short labor, that's fine; listen to your body. For a long labor, momma will need sustenance from somewhere (if not from food and drink, then from IVs. See chapter 4 of The Thinking Woman's Guide to a Better Birth for full list of pros and cons to that option). Sometimes it's easier to drink little sips in between contractions even in active labor, transition, and pushing, than it is to eat.

I've compiled a list of popular labor snacks and drinks. Feel free to take what works for you and leave the rest behind, keeping in mind your particular dietary needs and preferences.

Labor drinks:

water (will meet your hydration needs but not needs for calories, blood sugar, electrolytes, and more). Bring plenty of bottled water for your birth partner and doula, as well as for yourself for dumping in electrolyte powdered drink mixes.

100% fruit juice (non-acidic). If packing for hospital or birth center, 100% fruit juice boxes are convenient.

electrolyte drinks. You can make your own safe electrolyte drinks if you don't want to ingest the artificial ingredients in Gatorade. Some moms have enjoyed Emergen-C powdered instant drinks for a labor pick-me-up, but as the previous linked article explains, there's a question whether Vitamin C overload (or possibly the imbalance of calcium and other minerals/vitamins in the presence of large volumes of Vit C) can contribute to hemorrhage. A sort-of-natural alternative to Gatorade is Crystal Lite's Pure Fitness powdered electrolyte drink, which contains no artificial colors, flavors, or preservatives, and is sweetened by Stevia. While traditional artificial sweeteners such as aspartame, saccharin, acesulfame K, etc., are clearly not safe for pregnancy, Stevia may be a safe alternative. I'm not turning this blog into a discussion about Stevia; you can Google it if you're concerned. I've also heard good reviews about Vitalyte electrolyte drink, but I do not have personal experience with it.

coconut water, which contains many nutrients and also contains electrolytes and outperforms electrolyte sports drinks and plain water in research on rehydration.

decaffeinated tea, unsweetened or sweetened with honey

Red Raspberry Leaf tea, which also confers labor benefits (as well as 3rd trimester benefits). You can also blend RRL tea into Pregnancy Punch with apple juice, honey, and frozen red raspberries for a delicious and nutritious labor snack, or freeze it as popsicles.

skim milk

fruit smoothies made with non-acidic fruits (and any other ingredients from this list that sound good, such as honey, yogurt, skim milk, etc.) Here's Birth Faith's Birthing Brew for labor nutrition and possible prevention of hemorrhage (this statement has not been tested by the FDA for effectiveness of use, etc.).

protein shakes/drinks

Light carbs:

honey. Honey sticks, honey packets, honey bears, whatever is most convenient. Honey sticks are easiest for mom to suck on without changing her position.

soft, non-acidic fruits

100% applesauce. If packing for hospital or birth center, individual packs are handy. Here's an innovative form of applesauce packaging: you slurp it through a built-in straw. Handy so that mom doesn't have to change positions.

rice cakes (with jam, honey, applesauce, etc.)

plain bagels (with jam, honey, applesauce, etc.)

toast (with jam, honey, applesauce, etc.)

oatmeal

Cream of Wheat

graham crackers. saltine crackers, any other crackers

cooked pasta, plain or with a bit of salt or cheese

cooked rice. If packing for hospital or birth center, the ready-packs of rice that only need microwaved 90 seconds are a convenient option.

granola bars or trail mix

cereal with skim milk

pancakes or waffles. You can make your own healthy ones ahead of time and freeze them to reheat, or buy pre-made ones. They have healthy alternative ones in the organic frozen section now.

puddings, custards (nonfat or low fat)

Jell-o. Make your own or buy pre-made packs.

sorbet. Individual cups are always a good idea. Do you really want to be looking for an ice cream scoop during labor?

popsicles

lollipops, especially sour ones. They tend to be less nauseating than sweet ones.

Light proteins:

fat-free yogurt or Go-gurt (These taste great frozen, and they have new natural Go-gurts with no HFCS and no artificial colors, flavors or preservatives.)

cheese cubes or string cheese

peanut butter crackers

eggs

chicken noodle soup or broth

protein bars

Don't forget to have more substantial food to sustain your birth partner (husband or significant other), doula, and possibly your midwives (if homebirth). Crackers likely won't tide them over. Also, Mom will likely be ravenous after delivering and will want a hearty meal to reward her for her hard work.

If your hospital has a policy of "nothing but ice chips or clear liquids," it's best to discuss this well in advance with your care provider to see whether this is strictly enforced or whether most moms do in fact eat and drink freely while in labor at that facility. Find out early enough so that if this is going to be a problem, you have time to shop for another care provider or another birth location. If you cannot or choose not to change birth location, you can pack a small lunchbox/cooler of foods and drinks for your birth partner who will certainly be very hungry and thirsty. If any staff asks about the food stash, you can truthfully tell them that your birth partner gets hungry and needs to eat to maintain blood sugar and supportive mood. Do you catch my drift? Good, because I would never tell you to lie to staff or care provider.

Now, go eat, drink, and be merry!

What did you eat and drink during labor? What did you wish you could have but didn't/couldn't? What was satisfying?

Celebrating my 1 year anniversary as a childbirth educator

2011-04-09T00:50:00.001-04:00

Today marks one year from the beginning of my journey as a childbirth educator. April 8-9, 2010, I attended an ICEA workshop taught by Connie Livingston in Dayton, OH. I wasn't even quite sure what my goals were as a future childbirth educator. I had spent countless hours reading books, articles, and research about pregnancy and birth, and it seemed like sort of a waste to have no outlet for that information other than preaching to the choir in message boards for birth junkies, doulas, childbirth educators, and midwives-to-be. I had helped a few friends find the information they needed to make informed decisions about their births, but my scope was limited since I was "just another mom who might have read one too many birth books." I didn't even know what certification might entail. I felt that I needed to take this workshop to become a more effective help, no matter how many or few couples I would teach.

A year ago today, I could never have foreseen how far I would come in a year. I acknowledge that I have so much still to learn, and I'm continually striving to learn more, but I can see progress in a year's time. I've completed the majority of the requirements for completing certification as a childbirth educator with ICEA. Now if only someone would come watch my kids for me so I could get the rest of my reading finished, then I can take the written exam and make it official! (ICEA gives applicants two years from the date of application to complete certification, so I'm ahead of my goal dates.)

* I was required to attend a minimum of two births to satisfy ICEA requirements for my certification. So far, I've attended four births since June 2010.

* In June 2010, I completed (and recorded, and sent to Connie on DVD) a four-week, 12 hour childbirth class series, which she and my clients/students evaluated in depth on ICEA's evaluations. To count for certification requirements, I had to teach a real pregnant momma and her birth partner (not just teach to a camera in an empty room); I was blessed to have 4 pregnant mommas with birth partners for my first teaching series! In the past year I have taught a total of 20 expectant mommas and their families.

I look back fondly at the past year, at the classes I have taught, friends I have made, myths I have busted, and foundations I have built. I'm thankful for these opportunities, and I won't take them for granted or let them go to waste. I look forward to my future.

How to have a "natural" cesarean

2011-02-17T22:56:00.013-05:00

I get asked this one a lot and figured it would be faster to put together a blog with links than to re-type the same email several times a month.

Maybe you have a rare medical condition that requires a scheduled C-section. Maybe you are going to be induced and are aware that induction doubles your risk of needing a C-section and would like to plan to have the best possible C-section if it comes to that. Maybe you're attempting a VBAC and would like to have a backup plan in place. Maybe you're a healthy, low-risk mom who is planning an unmedicated birth (whether at home, birth center, or hospital) and would like to prepare for the slim chance that a cesarean may become necessary. Maybe you are having an elective cesarean.

In any case, all moms have the right to be treated with dignity and respect. Many moms are unaware that they have options to make a cesarean the best possible experience (considering the circumstances) and that often, there are options moms can request to help with bonding with baby, allow immediate skin-to-skin contact with baby, facilitate breastfeeding, reduce your risk of postpartum depression, and more.

"Family centered cesarean" or "natural cesarean" can mean a wide variety of things. You can view some of these options on this sample cesarean birth plan by Preparing For Birth. Personally, I think it's a good idea for all expectant mothers to have Plan A, Plan B, and Plan C lined up just in case, because a birth plan is not designed to be a script for how the birth should go, but rather, it's a well thought out list of preferences the family would have in the event of different circumstances.

Please remember that no birth plan is legally binding. It's crucial to find a care provider who truly supports you as you work toward the birth you want, whatever kind of birth that is. Many care providers will give lip service to supporting moms, but will deny them at the end. Finding the right hospital and OB to perform a family-friendly cesarean will be worth the effort. Hiring a doula or having your midwife present for this role can help boost your odds of achieving a gentler cesarean. A doula can help calm your nerves in the hours before a planned cesarean while you wait and fill out paperwork, and she can answer any questions you have along the way as to what is going on, why something is happening, whether that's normal, and what options (and legal rights) you have. She can also tag in to the OR if your partner leaves you after the delivery to follow the baby to the nursery, so that you don't have to be alone while they stitch you back up. She can assist you with relaxation and breathing techniques to keep you calm, as well. Here's doula (The Feminist Breeder) Gina Crosley-Corcoran's blog about her experience supporting a client during her cesarean.

The natural caesarean: a woman-centred technique--National Institutes of Health (NIH)

Family-Centered Cesarean--ICAN (International Cesarean Awareness Network) White Papers

Ideas for the best cesarean possible--by Penny Simkin. Free PDF printable.

The new "natural" cesarean--UK Times

"Natural" cesarean mimics vaginal birth experience--Reuters UK

"Every bit as magical": A British doctor is challenging convention to pioneer the 'natural' cesarean. Joanna Moorhead watched one baby's slow and gentle arrival.--Guardian UK

Delivered safely by caesarean with his mother's hands ("assisted cesarean")--The Age (Australia)

The Case for Kangaroo Daddy Care--Baby Gooroo--One family's story of how Dad provided Kangaroo Care for baby while mother was recovering post-cesarean, and why babies can benefit from this.

Above is the 8 minute trailer for the documentary, "Breast is Best," showing how to get breastfeeding off to a good start. The opening scene shows a "natural" cesarean with baby being brought skin-to-skin on mom's chest so he can nurse while she is still being stitched up on the OR table. Immediate skin-to-skin contact on mom's chest immediately after birth helps stabilize baby's breathing, heart rate, blood sugars, and body temperature, all while promoting bonding and reassuring both mom and baby in each other's presence.

12 minute video describing "The Natural Caesarean: a woman-centred technique":

The "natural" cesarean described by the above links, with baby's slow, gentle emergence from the womb, somewhat reduces baby's risk of respiratory distress after cesarean birth, which is common for cesarean babies since they do not receive the benefit of having their lungs squeezed and emptied of mucus, which occurs naturally in a a vaginal birth.

Having a cesarean birth is compatible with having the placenta encapsulated (placentophagy). If you're unfamiliar with this, you'll have to hang tight until I can post a blog with all the research and reasons why it's a great option for postpartum, regardless of the method of birth. To make a long story short, the placenta can be steamed, dried, ground, and encapsulated into geltabs so that it's no different than taking a multivitamin. Research indicates that placentophagy, which has been traditional around the world for thousands of years, may potentially offer the following benefits: reduced risk of postpartum depression, reduced risk of anemia (by restoring her iron reserves), helps bring postpartum hormones back into balance, improved mothers' energy and sense of well-being postpartum, and a boost in establishing milk supply. While all of these are wonderful benefits for any mom postpartum, they are especially beneficial post-cesarean. Here's a great FAQ on placenta encapsulation, including tips on how to get your placenta released from the hospital.

For many moms who are planning a cesarean (whether for medical or elective reasons), waiting on labor to begin before going in for the cesarean is an option. If this is a possibility, based on your medical situation, this is helpful for mom and baby both. By allowing labor to begin, you can rest assured that baby was "ready," precluding the all-too-common iatrogenic (doctor-caused) prematurity which is on the rise. Mom and baby both receive the chemical/hormonal benefits of the beginnings of labor, and if mom has a good series of contractions before a cesarean, baby's risk of respiratory distress and other respiratory problems is somewhat lessened because the squeezing effects of efficient contractions help push mucus out of baby's lungs (which occurs naturally in vaginal births).

A gentler cesarean birth is possible--even here in America. However, it is going to take informed consumers to drive this change. If enough moms request this, it can become the standard for cesarean care. With the current state of affairs in American maternity care, I'm not optimistic that I could see that scale of change in my lifetime, but that's irrelevant. You don't have to wait until evidence-based care of any sort--including "natural" cesarean--is the norm. You can find a way to make it possible for *you*, regardless of what everyone else is doing.

It would be irresponsible to post all this information about "natural" cesarean without making sure that you have links to weigh all the risks of cesareans. Cesarean birth is a major abdominal surgery with serious risks and consequences, both short-term and long-term, for mom and for baby. The point of this blog is not to encourage an even higher cesarean rate (32.3% of US births are cesarean as of 2008, while the World Health Organization has stated that 10-15% should be the maximum), but rather to make alternative options more widely available for situations when cesareans are needed or desired, based on fully informed consent.

The Risks of Cesarean Section Fact Sheet--Free printable PDF--CIMS (Coalition for Improvement of Maternity Services). Current (Feb. 2010 publication). Includes checklist for expectant mothers to read during pregnancy and discuss with their care providers.

Cesarean Fact Sheet--ICAN (International Cesarean Awareness Network)

Cesarean Section: Myth vs. Reality--Childbirth Connection

Patient Choice Cesarean Position Sheet--ICAN (International Cesarean Awareness Network)

Where to turn for more information about cesareans--California Watch

A Woman's Guide to VBAC. How to weigh the National Institutes of Health recommendations for considerations of VBAC vs. repeat elective cesarean, based on each woman's individual circumstances.-- Giving Birth With Confidence/Lamaze International.

(Disclaimer: I'm not a doctor. I'm not trying to tell you to have a cesarean or not to have a cesarean. I'm encouraging all expectant families to READ, READ, READ and learn their options so that they may make fully informed decisions with their care providers as to what is the safest route for their individual situation.)

"Is the hCG diet safe for breastfeeding?"

2011-02-16T22:42:00.009-05:00

I got an email from a blog reader asking, "Is the hCG diet safe for breastfeeding? the OBGYN's nurse said she doesn't know if its safe to take the HCG drops while nursing. We all agree no one while nursing (probably not even not nursing) should cut back to 500 calories a day... but they say the diet will still work if you just eat healthy and take the HCG drops, it'll just work slower, not so dramatically.
DO you know? Is it safe to take the HCG drops while nursing? Does it cross over through the breast milk? Does it affect the breast milk supply or anything?"

I had never heard of this fad diet and had to Google it.

I think the first question to ask is, "Is the hCG diet safe for anyone at all?" We'll get to that.

HCG supplements/injections are not listed in Dr. Hale's Medications and Mother's Milk guide which I own because it's a supplement and not a medication.

The official hCG diet website says regarding the hCG diet and breastfeeding: "So, is it ok for a woman to breast feed while on the HCG diet? The definitive answer will need to come from her doctor. However, it looks like it wouldn’t be a good idea, simply because the caloric needs during breastfeeding are just too great and not a conducive to following the HCG diet."

Consuming a mere 500 calories per day, as outlined by the hCG diet, is not safe for any adult (man or woman), let alone a breastfeeding mother. Breastfeeding burns about 200-500 calories per day, and the best research says that breastfeeding mothers need to be consuming a bare minimum of 1500-1800 calories per day (often more). If a mother is not eating enough calories, her milk supply will suffer. Here are a few articles outlining how to lose weight safely while breastfeeding, so that you can maintain your health and your milk supply:

http://www.kellymom.com/nutrition/mom/mom-weightloss.html

and an article on herbal supplements and other diet aids while breastfeeding:

http://www.kellymom.com/nutrition/mom/mom-herbalweightloss.html

I am highly cautious with anything involving artificial hormones. While they can have their place in certain medical situations, it's not to be taken lightly. I tried to find info on the side effects of hCG injections and found this about the hCG diet on Discovery Health online. HCG is only approved by the FDA as a fertility drug (you heard that correctly--should newly postpartum moms be taking a FERTILITY DRUG as a weight loss supplement???), and it is not FDA approved as a dietary supplement.

According to Discovery Health, "There have been few reports of health problems developing as a result of the hCG diet, although there are some risks, among them an increased risk of blood clots, headaches, restlessness and depression. Also, you may feel, well, like you're pregnant -- swelling, breast tenderness and water retention, anyone? HCG can also cause a potentially life-threatening condition called ovarian hyperstimulation syndrome (OHSS)."

One aspect of the question was whether hCG supplements could cause a drop in milk supply, even if the mother ate a sufficient number of calories. While this might be a question better answered by an endocrinologist, I would be concerned that along with the other pregnancy symptoms that are a side effect of hCG supplementation, a drop in milk supply could be a potential side effect. I looked far and wide to find the chemical mechanism by which many mothers experience a drop in milk supply when they become pregnant while still nursing. Rising levels of progesterone are responsible for the drop in milk supply, but I could not find an answer as to whether hCG supplements could stimulate a rise in progesterone (subsequently causing a drop in milk supply even if mom's caloric intake were sufficient).

The hCG diet official page states a breastfeeding myth, "If she fails to eat properly, this will negatively affect the quality of the milk she produces. The baby may not receive nutritious milk if a woman does not eat enough or enough of the right things." Contrast that with research from La Leche League on the quality of mom's diet and its effect (or lack thereof) on the quality of her breastmilk: "In recent years, research has confirmed that even if some nutrients are missing in a woman’s daily diet, she will still produce milk that will help her child grow. There is very little difference in the milk of healthy mothers and mothers who are severely malnourished. For example, if a mother’s diet is lacking in calories, her body makes up the deficit, drawing on the reserves laid down during pregnancy or before." Mother's milk supply may drop and her health may suffer for her lack of adequate nutrition, but the quality of her breastmilk will not be affected.

I'm not really in the loop in terms of what's popular, and since this diet fad seems to be having its 15 minutes of fame, I wanted to make sure that moms had the info to weigh the risks.

So thankful to make a difference.

2011-02-06T20:50:00.001-05:00

I had such a wonderful private childbirth class tonight, for two couples, first time parents. This was my second private class for them, and while I really *need* 12-15 hours of face-to-face contact to cover what first-time parents need to know, I had to condense it to 6 hours (2 private classes, each 3 hours long). I couldn't shortchange them; I had to stay to cover what they needed/wanted covered, 1 1/2 hours "late" tonight. I didn't charge extra and didn't want to. I *wanted* to help. It is my pleasure, my joy, my heart's desire.

I so relate to one of my midwives' recent blog (Jennifer Stewart of Joy in Birth Midwifery) titled, "Can I help you? Please?". I can't stand to see mothers have traumatic births when there were preventable interventions that led to the trauma. (I'm not implying that all interventive births are traumatic, because they are not. I'm not implying that all traumatic births are preventable, because they are not. Many are both, and therein lies my struggle.) I don't teach childbirth classes because I hope to get rich in the process. (Trust me, childbirth educators, doulas, and midwives do not get paid much. They're in it because they believe in it.) I teach birth classes because I am compelled to, driven to. It would be unethical if I did not share this information, not for my sake or glory, but so that families have the evidence-based info they need to make empowered, educated decisions regarding their pregnancies, birth, breastfeeding, parenting, and childbearing year.

When I hear that a friend or acquaintance who turned down my help has an outcome she did not want, a traumatic birth that did not have to be, separation due to complications and/or NICU, I am so distraught for them. Sometimes I cry for days, mourning for their loss. I pray for their recovery, for health for mom and baby, and for God to make a way to reunite and bond the family.

I realize that not everyone wants my help. I try to mind my own business and only give information if they ask. It's so hard to sit aside and say nothing if I see that a family is making fear-based decisions or are accepting the default routine interventions that their care provider does to everyone in their assembly-line birth practice. I can accept any decisions that someone makes for their birth--if I feel confident that they have researched their options thoroughly and are making their decisions with purpose, rather than by default or backed into a corner. Just ask my variety of clients I have served: planned homebirth with midwives clients; birth center with midwives clients; hospital unmedicated birth clients; planned induction clients; and elective scheduled cesarean clients. Regardless of their choices, I want them to know what their options are and how to have the safest birth possible, considering their circumstances.

Tonight was so refreshing. It's easy to become weary when looking at American maternity care as a whole. It's easy to get discouraged when so many expectant parents turn down my help, saying, "Thanks, but I trust my doctor. I'm sure s/he wouldn't do anything unsafe," without researching their birth options. These two couples, each expecting their first child, were eager learners and renewed my soul. They were thankful for my help. Once in a while, God puts people like this in our lives to help recharge and inspire us so we can continue with our work. I'm reminded why I do what I do, and that while I can't help everyone, I am making a difference for *someone*. I'm so thankful for that.

Wordless Wednesday: beautiful nursing toddler (guest post)

2011-02-02T18:37:00.002-05:00

Thanks to Christine Marasco for sharing these beautiful, intimate professional portraits taken with her husband and their first child when their son was 17 months old in January 2004. Photographer: Kathleen Swisher. (You might remember Christine from her birth story posted here, home waterbirth of her 4th child with cord wrapped around his neck 4 times.)

And for good measure, in case you are wondering why on earth someone would nurse a toddler beyond a year of age:

Breastfeeding past infancy: fact sheet (from kellymom.com)

VBAC and Scrabble

2011-01-30T19:41:00.001-05:00

A friend texted me a few days ago and told me that she was playing Scrabble (not sure whether it was online or on iPhone) and her entry was "VBAC," but Scrabble wouldn't accept it. We joked that Scrabble *should* accept VBAC and possibly VBAMC, VBA3C, HBAC, HBA2C, and others.

Then I got to thinking about it. Why *shouldn't* VBAC be accepted as a regular word--both in options for birth, and in our national conversations? Wouldn't it be nice American mothers had true informed choice of care for their pregnancy? Wouldn't it be great if evidence-based care were the rule rather than the exception? Wouldn't it be awesome if VBAC were such a mainstream term that every American of childbearing age knew what a VBAC is and that it's a “reasonable option” for most women with a previous cesarean section, according to the National Institutes of Health?

Radar, laser, and snafu are all acronyms which have become regular words in American vocabulary. Isn't it time for VBAC to go mainstream, for the safety of mothers and babies?

For the uninitiated,

VBAC = vaginal birth after cesarean

VBAMC = vaginal birth after multiple cesareans

VBA3C = vaginal birth after 3 cesareans

HBAC = homebirth after cesarean

HBA2C = homebirth after 2 cesareans

(All of which can be safe options, depending on individual circumstances, consult your medical charts and care provider, do your own research, and other disclaimers.)

Wordless Wednesday: Trebor's "In Silent Prayer" maternity portrait

2011-01-27T11:26:00.000-05:00

Trebor's name might be familiar to you. She shared her written birth story here of her home waterbirth VBA2C (vaginal birth after 2 cesareans), then shared her touching photo slideshow of her homebirth. Trebor has graciously given permission to use her beautiful maternity portrait, "In Silent Prayer."

Reflecting on this photo, Trebor said, "Prayer and Meditation are such an important part of my pregnancy and who I am. I often find myself by the window and decided one day to capture the moment. I love the silhouette created by the natural light and using no flash with camera." Trebor was 34 weeks pregnant with her soon-to-be homebirth VBA2C baby at the time of this portrait.

Guest post: Margaret's 2-hour med-free labor & delivery

2011-01-22T18:20:00.001-05:00

by Margaret

The day before my due date I saw my midwife for a regular check up and she did a stretch and sweep. I was hot, miserable and done. It had been an absolutely brutal summer, humidity of 90+% almost every day. Temps well over 100F. No a/c. (In Canada we only need it for a few months of the year, so most people don't bother) I was done. She promised that if it didn't work she would do another one a few days later. It did nothing. So on Friday (2 days after my EDD) I went in for another one. She did it, and then did it again...lol. She kept telling me that she was trying to make me bleed. Nice :P I was about 3cm by this point.
I had lots of cramping after leaving, but wasn't hopeful for any labour starting....

Over the weekend I lost my mucus plug in huge globs. Still no bloody show though. I still wasn't convinced that anything was going to happen. The weather had cooled off FINALLY and I was actually enjoying being pregnant.

Sunday night we went to a friends house for a bonfire. While I was there I had a few contractions. They were more intense then they'd been before, but still felt way too much like braxton hicks for me to think 'this is it'. But I was suspecting that I would be in labour that night or the next day for sure.

We came back home around 9 and I decided I was just going to go to bed. Everything had stopped anyway, not a twinge of a cramp or anything.

I woke at exactly 3am (on LABOUR DAY!!) with a contraction. It was a REAL contraction. I got up, went pee, noticed some bloody show finally, and then went back to bed. By 3:30, I'd had 4 more contractions in bed. I decided to let John sleep and take my 'breathing' elsewhere. I decided to stand in the shower for awhile. Within a few minutes the contractions were VERY intense and I knew 'this was it'. I was down on my hands and knees during every contraction and only stood up in between b/c my knees were sore...lol. I thought of getting a towel to kneel on and I thought of telling John to wake up...but I just couldn't move. I was so focused on the contractions that I couldn't do anything else. I knew I was in transition and was more than a little freaked out that I would be delivering the baby by myself in the shower.

Finally around 4am, only an hour after the contractions started, I managed to get out of the shower. (the hot water was running out anyway...lol) I waddled to our room and yelled at John, "wake up, call you dad to come over, call the MW! We're going to the hospital NOW!!"

He looked confused and no wonder, it was 4am, I had just woke him up from a dead sleep by running into the room yelling at him:P I almost killed him when he asked if he had time to take a shower first. "NO! NO WE DON'T HAVE ENOUGH TIME. AND I USED UP ALL THE HOT WATER ANYWAY." He got the point.

All the noise (especially the cow-like moaning I was doing during each contraction) woke up Megan, our oldest (almost 6yrs). John managed to get her right back in bed and told her that we were going to have the baby very soon. She told John that even though she was really hoping for a sister, it would be ok if we brought her another brother:) I was happy she went right back to bed, b/c I did NOT want her to see me in labour. It was moving so fast and I was making so much noise that I was worried it would scare her...heck, it was scaring me!

I managed to call the midwife and told her we were going to the hospital right away. She called her back-up and they left to meet us there. John's dad showed up around 4:15 and we were waiting in the car already. I was hanging over the back of my seat on my hands and knees. John drove, fast. I am pretty sure he went through some red lights, but I didn't care. I told him I felt like I was going to throw up, which worried me more than it did him, b/c I did NOT want to have the baby in the car.

Since it was night time, we had to go into the hospital through the ER. The nurses there looked pretty worried that I was going to give birth in the waiting room. I was on my knees on the floor leaning over the seat of a chair moaning away. Probably the dirtiest place in the world to be.... They tried to get me into a wheel chair to take me upstairs, but I told them right away that there was no way I could sit, I needed to be able to lean over things. So they helped me walk down to the elevator and made me promise NOT to have the baby in there, b/c its too small;)

I got up to my room and my MW wasn't there yet. A few minutes later, John (who had been parking the car) came in and it was still about 15 more minutes before the MW's got there. I was having contractions every 2 minutes by this point. I knew it was going to be very soon.

I was just trying to deal with the contractions. They were so close together and so intense I could barely stand it. I was even banging my head against the wall (lightly...lol) during some of the worst ones. I could feel myself tensing up and was trying so hard to relax, but just couldn't. John was standing next to me helpless. I didn't need him for anything...there was nothing he could have done for me anyway. I went into the bathroom at one point to splash some cool water on my face, but I only could get warm water out of the tap. I still can't figure out why I couldn't get it to go cold, but I remember wanting to rip the sink off the wall and hurl it across the room.

The MW's were rushing around getting things set up and told me that anytime I wanted they could check to see how far I was. I waited for a contraction to end (it was around 5am at this point) and quickly hopped onto the bed. The MW still had to get her gloves on, and it was just taking too long for my liking, so I hopped back off the bed as another contraction started. After that one ended, my MW said she could check me as I was standing, so she did. She said "Great! You're complete!" I thought, as another contraction started, "There is no way! If I were 10cm, I'd be holding my baby by now. I've never had to push my other babies out. I hit 10cm and out they fly. What is wrong??" As soon as it ended I hopped up on the bed for her to check me again, b/c I was still doubtful of being 10cm. and sure enough she said "yes, it is harder to check when you're standing...you're 7cm."

I was MAD! Pi$$ed!!!! ONLY 7cm???? AAARRRGGGHHH! She offered to break my water and I knew the baby would be there instantly, but I was still nervous about it. I'm not sure exactly what was holding me back, but I was scared to give birth again. I just wasn't embracing it like I had with my previous births. I kept tensing up and was not looking forward to what I knew was coming.

A few minutes later I could feel surges sort of rippling down my belly and I knew the baby was moving down and going to be there in a few minutes. I finally said "Ok, fine. Break my water." So I hopped back on the bed. (when I say 'hopped'...I mean hopped. I can only imagine what it looked like to see a half-naked MAD woman hopping up and down) She checked me first and I was 9cm now. She got the hook out and started to put it in, but I screamed at her to "Get out!" because I was having another contraction. I rolled on my side to try to ease the pain, but during that contraction I felt the baby on its way. She didn't need to break my water after all.

I was scared to push. I knew I had to, but I was holding back, which made the pain unbearable. I couldn't stop my body from pushing though...even though I tried. I screamed out "OH NO THE HEMORRHOIDS!" as I gave the first push. Not my finest moment...but I didn't care. I had horrible hemmorhoids with other births...and as I said before, I've never had to push any of them. It was very unfair:P
The other MW grabbed a warm compress to hold on my rear-end as I gave a push. It was more of a scream, but it did the job, the head was out.

At this point I screamed at the MW to "Just pull it out!!!" To which they laughed and said "We can't, you have to push!!" Yeah, again not something I'm proud of..hehe. They helped hold my legs way back to make more room for baby's shoulders and I gave one more big push and out popped my baby at 5:16am, just over 2 hours after the first contraction!!

I've never made so much noise in labour before. But I've never experienced something so intense or fast as that. I couldn't believe it when I looked at the clock and saw the time. Days later, I'm still sitting here in shock....I joke with people that I 'think I had a baby...I'm pretty sure I was there, but I don't really remember'.

It was absolute euphoria. I had my baby on my belly and lifted up a leg to see what we had. It was a GIRL! I was so excited I didn't believe it. I looked again and again, just to be sure. Yup, no penis there! lol.

I kept saying to John "It's a girl!! It's really a girl!!"... I was over the moon! I'd been hoping for a girl the whole time, but was pretty convinced near the end of my pregnancy that I was having a boy. He told me later that he saw she was a girl as she was being born, but didn't want to ruin the surprise for me so he didn't say anything until I had looked. We now had 2 girls and 2 boys:)

I birth the placenta within about 10 minutes. My MW's marveled over the length of the cord! They said they'd never seen such a long one. Everything was well and my bleeding was very minimal. I felt great. I got up and took a shower within the hour and really didn't even feel like I'd had a baby.

We left the hospital at about 8 am, only a few hours after arriving! Surprised my father-in-law who was just getting the older kids their breakfast when we walked in the door. He couldn't believe that we were home already!

Madelyn Faith was 7lbs 8oz and 20.5" long. I thought for sure that she would have been much closer to 9lbs b/c I'd never been so far past my EDD (she was 40w 5d).

She is absolutely beautiful and so content. I can't stop staring at her. Even in the middle of the night when I know I should be sleeping, I just sit and stare at her. God has given me a very mellow, easy baby, something I needed as having 4 kids under 6 years is a bit crazy to say the least.

I had intended to get John to take pictures during the labour and birth, but it was all so fast, I just didn't think of it.

People have said "Wow you're so lucky that it was so fast!"...I'm not sure what I prefer, fast and intense or longer and not so crazy.
All I know is that I have PRECIPITOUS LABOUR written in really big letters across the top of my records...as warning for next time. (Did I just say 'next time'???)

9 lb 8 oz hospital VBAC 1 yr after C-sec when 4 lb baby was "too big"

2011-01-21T00:24:00.003-05:00

Remember January 6, my sister-in-law Candi DeGroff posted on our Well Rounded Birth Prep Wall asking for prayers and words of encouragement for her friend Christina who was in early/pre-labor with her VBAC. (You may remember Candi from her home waterbirth photos and firsthand birth story here on my blog.)

Here was Candi's message: "I didn't want to post this as my status, but I thought maybe this might be a good forum to ask for prayers and positive thoughts for a friend doing a VBAC soon! She's having irregular contractions and is at 2cm! The hospital sent her home (yay!) and she is laboring at home. Her C-sec was actually less than a year ago.... I've told her labor support that she is going to need LOTS of support and encouragement and to keep reminding her of her goal to have a un-medicated, natural birth with minimal medical intervention!"

From time to time over the next few days, I texted Candi to ask how Christina was doing. Every time she would say that Christina was about the same; her OB said to stay home and keep walking. She was just having a long pre-labor (which is sometimes called prodromal labor, or stop/start irregular contractions that can tire a momma out).

Jan. 18 (after 12 days of exhausting pre-labor), active labor began for Christina around 9:30 p.m. She labored at home until she, her hubby, and her doula went to the hospital at 4:30 a.m. By 9 a.m., Christina was exhausted got an epidural in hopes of getting a little bit of sleep so she could gather enough energy to make it through the end. By 2 p.m., she was getting discouraged and wasn't sure whether she would be able to progress. By 9 p.m., she was fully dilated and laboring down. She gave birth VAGINALLY to her ***9 pound 8 oz***, 20" daughter at 10:35 p.m. She did tear, but overall she was thrilled, and she and baby were both doing great. Baby was nursing like a champ. She was born exactly on her due date.

This VBAC is particularly incredible when you consider it in the context of her C-section birth. Christina was naive and trusting as a first time mom, and when her OB told her that she was measuring "too big" by the ultrasound estimate and that--I kid you not, he really said this-- her uterus would not stretch to accommodate the size of this "too big" baby, Christina believed him. He recommended a C-section at 37 weeks since there's no way that baby could have been born vaginally. Her firstborn baby was only ***4 pounds*** at birth, and while he did have some symptoms of a late preterm baby, including difficulty breastfeeding, it was a miracle that he was healthy overall and didn't have to stay in NICU.

I could write an entire post about what was wrong with her first OB's diagnosis and recommendation. I don't even know where to start. Can I begin by saying that "Your uterus won't stretch enough to accommodate a big baby" is just about the most ludicrous statement I've ever heard? That's not even the same thing as CPD, which is misdiagnosed and overdiagnosed widely. Any OB who would say that is either 1) lying through his teeth and needs his license pulled for willingly violating his vow to "First, do no harm," or 2) so inept and ignorant about birth that he needs his license pulled for having such a misunderstanding of women's bodies and of birth. Let alone the fact that ultrasound estimates at or near full term have a plus-or-minus 2 pound margin of error (giving a guess range of 4 pounds). Augh, I have to stop there or else this birth story will morph into a rant about what Christina was told by her first OB.

What would the odds have been for Christina to have a successful VBAC when her first baby was not even a year old when his baby brother was born? Thanks to determination, getting a second opinion, finding a VBAC-supportive OB, having a doula, and the love and support of her husband and family, Christina achieved her goal she has worked so hard for over her months of pregnancy. I'm so happy for Christina. What an amazing inspiration.

Part 2: Your replies to Obsolete: landline phones, film cameras, and... vaginal birth???

2011-01-18T23:44:00.001-05:00

I recently posted about the rising cesarean rate (almost 1 in 3 and rising for the 13th consecutive year) and wondered, "Will the next generation think vaginal birth is obsolete?" I asked my readers, "What do you want *your* children to believe when they are grown about birth, cesareans, and women's bodies' ability (or inability) to give birth? What would you tell your child (in an actual or theoretical conversation)?"

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Vaginal Child Birth From a Cesarean Mama's Viewpoint by Jamie
Blogger-- Parenting Three (When Can I Pee Alone?)
mother of 3 children, all born by cesarean

A close friend of mine is a birth instructor. She is very knowledgeable about everything related to birth, but a lot of her focus is on protecting normal vaginal child birth in our society, and teaching women how to make decisions that give them the best chance of achieving a good experience with their vaginal child birth. She's been working on a blog recently about how many things that we are all familiar with such as cameras with film, paper phone books, etc are all things that children born in 2011 will have no knowledge of. The premise of the blog is that, if the trends continue as they've begun, will children born in 2011 have any knowledge of what vaginal child birth is, or like encyclopedias, will that be something that's lost in time.

As preposterous as that might seem to some, if you've been paying any attention to the statistics, you know that despite the World Health Organization's repeated warnings that a cesarean section rate above 15% is doing more harm than good to our country's mothers and babies, America's most current cesarean rate is 32.9% (2008 statistics), which has climbed for the 13th consecutive year. If this trend continues, it's easy to see how cesarean births could tip the scales into being the standard method of birthing your babies. Particularly when we live in a culture of fear where television, movies, and grandmother's stories make birth something to fear, an emergency, and a punishment. The truth is that we've gotten so far away from our roots that no one seems to know what a natural vaginal birth looks like. We're in hospitals, surrounded by noisy monitors and machines, accosted by countless people who come in and tell us to relax while they invade our most personal areas with fingers and instruments, we're numb to the sensations of labor and birth, we're pumped full of chemicals, and we're told not to trust our own instincts, but to push, push, push on the flat of our backs, in time to the counting of the professionals. This is what normal birth looks like to us now, so why wouldn't women fear it?

So much of our maternal and obstetric care in this country is not evidence based. It's frightening how many women are grateful that their ob saved their lives and their babies' lives, never realizing that they would not have needed saving if that same dashing hero hadn't created a situation that was unsafe for them. Yes, they were saved, but not from the dangers of childbirth. They were saved from an emergency situation that never would have existed if they had been left to birth according to their own instincts and needs. Yes, there are instances where all of those interventions and emergency protocols are necessary, but for the vast majority of women birthing in America, we've been had.

I myself have had 3 cesarean sections. I feel that had I not had mismanaged care with my first pregnancy, I probably would have had no problem whatsoever giving birth vaginally to all 3 of my children. I'm okay with what happened, because it's in the past, and it does me no good to dwell on what might have been, or if only. I won't go into specifics, because there's not time or space here, but I now know that my situation was entirely mismanaged, my surgical births were almost certainly preventable, and there's no reason why, if I am blessed with another baby (And, no, I'm not planning on having more, but I wasn't planning the last one either.), that I can't attempt a natural vaginal birth again. I have done a lot of reading and research into vaginal child birth after repeat cesarean births, and I feel comfortable with the risks for me. I feel strongly that every woman should do just that. Research, research, research, then make the decision that she's comfortable with based on the facts, not on the pervasive fear that runs rampant in our culture when we discuss childbirth.

The close friend I mentioned at the beginning of this blog has asked me, “What would you want your kids to know about birth? Cesareans?” What would I want my children to know? I want my children to know the same thing that I want every woman to know. You are not broken. Your body is not broken. There are very few women on the face of the planet who are not physically capable of having a healthy vaginal child birth. There are no guarantees, but there's no reason to think that you couldn't have a wonderful experience giving birth vaginally. Do the reading, do the research, search your soul. Make the best decision that you can and let no one take your power to choose away from you. In a culture of fear, you have the power of facts. Use it. Nothing in life comes without risk, and it's a matter of looking at all of the risks to each option and deciding which set you're more comfortable with. Don't let anyone put you into a position where you decide in fear. Take comfort in knowledge and trust yourself. That's what I want my children to know. I also want them to know that regardless of how things turn out, they are strong and can overcome anything life throws at them. Things don't always turn out the way you hope for. You can do things to stack the deck in your favor, but there are no guarantees in life. We all just do the best we can with what we've got and move forward from there.

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By Trebor Sutler, owner of Tre'Slings custom ring slings
mother of 4 children: 1 unplanned cesarean, 1 scheduled cesarean, 1 hospital VBAC with epidural, and 1 homebirth VBAC.

When having a VBA2C and Homebirth with my last two pregnancies, I have had to answer some questions that my older children have had, such as, "Why were we born at the hospital?" which led to "Why were cut from your belly?" This question my daughter seemed more interested in. The answer I gave her was similar to this. "When Mommy had you, I trusted that the doctors were acting with my best interest in mind. Later I learned that wasn't the case. My doctors didn't do the job the way the should have. They used medicine to control the way you were born, and Mommy's birth was medicalized rather than being normalized. So that is why Mommy decided to trust the way God made me to birth the next time and educate myself with the real facts about birth."

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Michelle Jervis, mother of 3 children
first 2 children born vaginally, 3rd child born by cesarean

After having two vaginal births, my third child, a daughter, was born via c-section. My OB had sent me for an ultrasound at 38 weeks to check the position of the baby. Everything spiraled downhill from there. Within three hours of the ultrasound I was being prepped for an emergency c-section. Little did I know that this wasn't an emergency at all. It was truly one of the worst decisions of my life.

Even though my daughter is only 4, I have already started telling her about my birth experience. Of course due to her limited understanding at this point, the details are kept simple. Nonetheless, I want her to realize that Mommy didn't make the right decision. I allowed the doctor to "convince" me that this was necessary, when in fact it truly wasn't.

As my daughter grows older I will share with her in much more detail. I will tell her that I'm sorry she spent the first 12 hours alone in the nursery because Mommy was so sick from the medication in the spinal and unable to hold her. I believe this fact alone attributed to her being a high-needs child. She didn't receive the care and nurturing from me she so desperately needed so soon after birth. I will tell her that she should have been delivered vaginally and that God created women with the ability to do so. I will tell her that I should have said no to the doctor. I will tell her I should have researched things more and I would have known that her position at 38 weeks didn't qualify as an emergency at all. I will tell her that no matter how she came into this world, I love her more than anything. I will tell her that I want her to have the best possible experience when it comes to the birth of her own children and that if she listens to her own instincts, it won't even need to be in a hospital at all.

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Dawn L. Meisenheimer Lewis

For my girls:

Birth is like all things in life, we have to be ready for any outcome. However, there are patterns of birth and things that happen in a regular birth. First, they need to know that under normative circumstances birth can happen vaginally and without medications. Under normative circumstances they can stay home as long as they like, even have a baby at home. If they do go to the hospital, under normative circumstances they do not need extra intervention, the help at the hospital is nice if needed but if not, then they have a right to be left untouched in birth. When birthing, contractions are different for every woman, but it's always better to take one at a time. Remember to be open to try different ways of movement, water, rocking, and such to cope. Read about it, decide what you are willing to try (some things might go against your religious beliefs, don't do anything you are opposed to in this way). Have a plan but remember birth is like a journey, sometimes things don't go as planned so just be prepared. Have support with you, a husband, mother, sister, doula, whoever you need. Pick your provider and don't worry if you have to change. They are there to serve you. Be polite but do stand up for what you think is right. Get to know your provider and stay with the one you trust. Once you trust the person, you will feel better if intervention is needed because you can be partners in deciding what is best. Rest, eat, move, breathe to avoid panic, and often if it is less painful to do something it's what you need to do. Sometime though, what hurts more is what you need to do, just sometimes. Once the baby is born, again, be prepared for the unpredictable but know that in a normative circumstance, you can hold your baby right away and keep your baby with you...even for assessments if in the hospital. Hold your baby and nurse whenever. Babies will let you know if they need you normally. Mostly what they need is to be held, loved, nursed, cuddled, changed, and to rest. Rest with your new baby. When baby sleeps, you sleep. Others should do your work for about 6 weeks if you can get help. Plan ahead for this just like you did for labor and birth.

For my boys:

Birth is like all things in life, we need to be ready for any outcome. The mother of your child needs you to research or at least listen to her as she teaches you. Mostly, when she is in pregnancy, labor, and birth, be with her. Pay attention to her, listen to her. Encourage her. In pregnancy, help her out and make meals for her, walk with her, encourage her to be healthy. Encourage her to spend the time she needs preparing for the birth and the baby. If she feels she's uncomfortable with her provider, help her find a new one if that's what is best. Share your feelings with her too, and remember that she likes for you to be there most of all to lean on, to listen. The day of labor, help her to stay home as long as she needs. Walk with her, serve her food, listen to her, breathe with her, encourage showers, whatever. Your goal is not to get to the hospital fast and hand off your responsibility to her. Your goal is to help her have as peaceful a birth as possible. Remind her with encouragement that she will see the baby soon, that she is doing well. When she is tired, suggest rest, food, drink. When she is talking, listen, talk back, keep her mind going. When she is quiet, protect that silence. If you're birthing at home, prepare the scene, keep the towels warm, rock with her, dance with her. Rest when she rests, if she needs to be alone use the time to either prepare something or rest. Keep everyone at a distance unless she wants them to come in. If you are going to the hospital, be there for her. Ask questions if an intervention is suggested. Work with her on what she wants. Be honest with her, and asses the situation. Be on her side always. Encourage her to move, be creative and if she's told to stay in bed that doesn't mean she cannot move. Do break a silly rule if need be, be cool about it...(like you cannot get out of bed...well, it's okay to get out of bed to labor and you are not the children who have to obey). Give her a drink (remember to bring drinks and crackers...or something to keep her nourishment up). You can easily pick up a cup with a straw and let her drink any time she needs it, don't ask the doctor/midwife just do it. If all is going normally, she will be able to labor without intervention no matter where. Encourage position changes, encourage coping strategies like shower, massage, etc. Hold her hand. When she is pushing, let her push in any position possible. If things seem stuck, you can suggest she try a different position, it might help. When everyone is talking above her, make sure you tell her what she needs to know (example, your Dad has made sure to tell me things are going okay when people are talking over me, if baby has been taken to a warmer he runs, looks at the baby, comes back and says what actually is happening so I am in the loop). Don't yell at her, don't count as she pushes unless there's a real medical reason. Always tell her encouraging things while she is going through the pain, while she is pushing. Get involved as much as you can. Remind her how beautiful she is. Don't forget to kiss her. If intervention is needed, help her transition. Help her know she's still doing great, she has been trying hard, and she's doing what is right. If her worst fears happen, hold her hand, be near her. Be her best ally. Once baby is born, momma wants the baby. Do everything you can to unite mom and child. After a nurse takes baby for any reason, be the first to suggest/remind to put baby back on momma. Be the one to get the baby. If momma cannot hold baby, you need to hold baby. Keep baby warm and in contact with you or momma as much as possible. If baby goes to the NICU, find out when momma and you can see baby...and insist on finding out when you can be with your child. It is normative in birth for a baby to be okay and momma to be okay. Most times this can all happen without interventions. When interventions are needed, thank God for the technology that helps. Things can happen that no one can help, and that's when you need to be real with her and also be there for her. Love, that's the first thing...most important.

Oh, most important for the girls...pray. I prayed during labor, in my head, out loud....and for the boys, offer to pray with her. Prayer after a baby is born can be very special for a family.

**************************************************************
Michele C.
mother of 3 children, all 3 born vaginally

The "what do you tell your kids" part reminded me of Lauren when I was pregnant with Hannah. She was only 3 when she asked me if the baby was going to, "come out your poo poo hole." LOL I cleared up the confusion. :) (We've always been very open and honest about sex and childbirth in our home, age appropriate, of course.)

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

What about you? What do you want your children to know/believe about birth (both in general, and for themselves personally)? Which would you prefer that your children believe is the norm and which is the exception: vaginal or cesarean birth?

Wordless Wednesday: My daughter: good little mommy-to-be

2011-01-12T10:07:00.000-05:00

This is my oldest daughter at age 5 1/2, when I was pregnant with my 4th baby. She and my then-4-year-old daughter walked around "pregnant" all the time. So cute! I thought it was funny that this time, my daughter's baby was frank breech. It didn't concern her. :-) Good thing! Like mother, like daughter.

Obsolete: landline phones, film cameras, and... vaginal birth??? Part 1

2011-01-10T12:55:00.007-05:00

A friend posted this link to an article listing common, everyday items that today's adults used for years, which are now obsolete. Will babies born in 2011 know what any of the following items are: landline phones, film cameras, video tape, paper phone books, maps, or encyclopedias ("You mean like Wikipedia, Mom?" "No, dear, it's not the same thing.")?

It reminded me of an insightful blog post by childbirth educator Donna Ryan (Banned From Baby Showers). She told of an experience she had with her 9 year old daughter Abby's friend who was shocked to learn that Abby was born at home in a pool of water. Her response? "Did a doctor come to your house to get her out of your stomach?!"

This is all too common. The first time I heard something similar was 2004, when I was pregnant with my second baby. At a moms' group, one mom shared that she had had all four of her children by cesarean and she was very glad for that because it made explaining "The Facts of Life" a lot easier for her. All she had to say was simply that to get the baby out, mommy goes to the hospital and the doctor cuts the baby out. I didn't want to make waves, since I was the newcomer in the group and a fairly new mom to boot, so I didn't speak up, but is that what you want your children to think? That normal, average birth means major abdominal surgery?

With each of my pregnancies, I let my children watch natural birth videos with me (positive and less graphic ones) to help them understand how the new sibling would come out. I explained as much as they seemed ready to understand, and it was pretty simple when they were 3, 4, or 5 years old. "God makes a way for the baby to come out through Mommy's vagina like a tunnel. It's a lot of hard work. It hurts, but it's pain with a purpose, and there's nothing to be afraid of. With the pain is joy and love. It's totally worth it, and I look forward to it." How difficult is that?

Several friends lately have told me that their daughters, now coming into preteen ages of 8 through 10, have said that they don't want to have kids when they grow up because they don't want to have surgery. How sad is that? They really believe that surgery is the only way babies are born. Nobody can promise anyone who will or will not need a cesarean, but the World Health Organization has stated that the cesarean rate should not exceed 15% or else more harm is being done than good. America's most current cesarean rate is 32.9% (2008 statistics), which has climbed for the 13th consecutive year.

One mom has two older children (a son 10 years old and a daughter 8 years old), both of whom were born by cesarean. She realized after the fact that the first cesarean was likely preventable, and the second cesarean did not have to have been an elective repeat cesarean and said that if she had another baby, she would seek a VBAC. With her next pregnancy, she was fearful, and her OB pressured her to schedule a repeat elective cesarean. During discussions with her husband and children as to the pros and cons of trial of labor VBAC versus elective repeat cesarean, her son said, "Mom, you may as well schedule it. You know the baby isn't going to come out that way [vaginally]." Even though she *did* eventually choose an elective repeat cesarean, that comment still hurt her, the fact that her son had no faith in her body's ability to give birth normally.

What are we doing to the next generation? Will children born in 2011 think that vaginal birth is obsolete? In my geographic area, many hospitals have a 50% or higher cesarean rate. Will children automatically assume that if and when they have children, they or their spouse will have to undergo major surgery to give birth?

I'm not trying to belittle cesareans (nor mothers who have had them), no matter whether individual cesareans were elective or scheduled or emergency or life-saving, and this isn't the post to weigh risks versus benefits of cesarean or vaginal birth. Regardless of the parents' experiences, the next generation deserves to know the truth: normal, vaginal birth is possible and attainable for the majority of mothers...IF they want it.

The same story plays out with our beliefs on our bodies' abilities to go into labor on their own, to give birth vaginally, to breastfeed, and more. I've heard many variations of this from moms of my generation:

"My mom (sister, etc.) wasn't able to breastfeed, so I probably won't be able to, either."
"My two sisters didn't go into labor on their own and had to be induced, so I probably will have to as well."
and now that the cesarean rate is so high "My mom had to have cesareans with all three of us, so I will probably have to have a C-section, too."

There's no reason to put unnecessary fears into mothers-to-be. The majority of moms can, if they choose to, safely birth vaginally and breastfeed... with the right information, preparation, support, and encouragement.

My question is this: What do you want *your* children to believe when they are grown about birth, cesareans, and women's bodies' ability (or inability) to give birth? What would you tell your child (in an actual or theoretical conversation)?

If you would like for your response to be included in the Part 2 post, email it to me at wellroundedbirthprep (at) gmail (dot) com. I'm accepting submissions until January 15. Your submission by email gives me permission to post your response. I can post your response with your name (first name, initials, or whole name) or withhold your name, at your request. The length is up to you, anywhere from 1 sentence to 1 paragraph to 1 page. Thanks!

How to become a childbirth educator, doula, or breastfeeding counselor

2011-01-09T23:20:00.011-05:00

I get this one a lot: "I'm fascinated with pregnancy/birth/breastfeeding. How do I get started if I want to become a childbirth educator/doula/breastfeeding counselor?" There are a lot of answers to that question. I'll try to touch upon a few options.

While you don't have to become certified to become a childbirth educator, doula, or breastfeeding counselor, the certification process will help you obtain breadth and depth of knowledge and experience on the subject, give you credibility, and open doors to opportunities and clients. For instance, most hospitals and birth centers require accredited certification to be eligible to teach their birth classes. Independent doulas and instructors can be self-taught or find a mentor.

There are various levels of time commitment involved in becoming a birth or breastfeeding assistant. Take into consideration your current life stage. Do you have reliable childcare? Do you have someone who could watch your children at any hour if you are called to a birth? If not, you may still be able to become a childbirth educator, lactation specialist, or postpartum doula until a later stage of life. If your goal is to become certified but you can't afford the process, you could see what the reading requirements are for the certification organization that you will be joining, and start reading now. You can borrow the books through inter-library loan; from another doula, childbirth educator, or doula in your area; or partner with another birth professional who is working toward certification and split the cost of a lending library.

Some organizations offer multiple certifications, which can be helpful if you only want to pay annual dues to one organization (for instance, doula certification and childbirth educator certification).

Here are just a few of the organizations that offer education and certification for becoming a childbirth educator, doula, lactation specialist, postpartum doula, prenatal exercise consultant, or other.

In alphabetical order:

Birthing From Within. "mentor" (childbirth educator) and doula certification

Birthworks International. childbirth educator and doula certification

The Bradley Method of Husband-Coached Natural Childbirth. childbirth educator certification

Childbirth and Postpartum Professional Association (CAPPA). labor doula, postpartum doula, antepartum doula, childbirth educator, lactation educator, and teen educator certification.

Doulas of North America (DONA). birth doula and postpartum doula certification

International Birth and Wellness Project. childbirth educator certification, doula certification, and midwifery training.

International Childbirth Educator Association (ICEA). childbirth educator, prenatal fitness educator, birth doula, and postpartum doula certification.

Lamaze International childbirth educator certification.

Prepared Childbirth Educators, Inc offers certification for nurses only. Breastfeeding counselor, childbirth educator, infant massage instructor, labor doula, and prenatal/postnatal fitness instructor certification.

If you're interested in being a breastfeeding counselor in some capacity, perhaps becoming a La Leche League leader would be a fit for you as an intermediary step or to complement your other roles. LLL leaders must have at least 9 months personal experience breastfeeding, must agree with LLL's philosophy, and complete accreditation requirements such as reading requirements, essays, interviews, and more. It's a volunteer position, but it's very rewarding.

Factors to consider when looking at organizations for certification:

Birth philosophy. Is it a fit for your beliefs? When you read their mission statement, do you feel as though you could identify with that organization?
Cost. Not just for certification for the program, but for initial joining fee, annual dues, cost of any workshops required for certification, and materials (books, etc., some of which you may be able to get from the library or used from amazon.com or half.com).
Location of training workshops. Proximity to your house, timing of workshops. Availability of a mentor to assist with your certification process and answer any questions along the way.
Continuing education requirements.
Community needs in your area. If there are already 3 Bradley certified instructors in your area, you could interview them to see whether they think the market demands could support a fourth Bradley certified instructor, or whether you might find more clients if you certified with a different organization.
Will you be independent (thus have control over the subjects you teach and discuss with clients) or will you look to work for an institution (and possibly be limited to teaching policies and routines of the institution, while being restricted from speaking on alternatives)?
Do you have a location in mind for teaching? Possibilities include your home, your clients' homes, churches, senior centers, YMCAs, Pilates/yoga/dance studios, hospitals, birth centers, and more.

Here's how I selected ICEA (International Childbirth Education Association) to pursue certification as a childbirth educator. After having 4 pregnancies (3 homebirths and a loss at 15 weeks) with my midwife, we've spent so much time together that she's more than just a midwife: she's my friend. I call her when I have questions about something I read about birth or about cause-and-effect of birth problems I hear about. In March 2010, I told her that I really do want to become a real-live childbirth educator "some day when I have time." I knew that my scope and effectiveness in helping families would be greatly expanded if I were certified. My midwife suggested that ICEA could be a good fit for me and suggested I check out their website.

I immediately loved their motto: "Freedom of choice based upon knowledge of alternatives." That's really a fit for me. I can respect EDUCATED, INFORMED decisions even if they're not the decisions I personally would make. I want to help my clients make informed decisions from a position of knowing their options, no matter where their birth takes them.

Here's the path I'm taking to get ICEA certified:

http://www.icea.org/content/traditional-childbirth-educator-certification

Here's Birth Source owner Connie Livingston's article on becoming a childbirth educator:
http://www.birthsource.com/Scripts/article.asp?articleid=408

Another great option is to find a local birth meetup group to learn more and network. To find one near you, if a Google search isn't coming up with an answer, ask around: moms' groups, La Leche League, babywearing moms, midwives, doulas, childbirth educators, homeschoolers, naturopaths, health food stores and/or chiropractors may know of a group. My midwife, Angy Nixon, CNM, organizes birth meetups in Scott Depot/Charleston and in Huntington, WV, that each meet once monthly. I blogged about the birth meetups here. At these birth meetups, anyone who is interested in learning more about pregnancy and birth is welcome to attend, no matter where or how (or even whether) they have given birth or plan to give birth. It's about learning what birth options are available and connecting with birth professionals and other moms (not about birth location).

If you can find a local contact who is an experienced childbirth educator, doula, or midwife who would be willing to mentor you and help you along your path, that can be very helpful. She may even have an established lending library and could possibly allow you to borrow books that you need for your certification.

Read, read, read! Read as many birth books as you can from the required reading lists from the organizations I posted above. I have a blog in progress with lists of birth and breastfeeding book suggestions. Read birth stories online.

Subscribe to free e-newsletters of professional birth and breastfeeding organizations. Follow them on Twitter and friend or "like" their pages on Facebook. If you would like a suggested starter list, you can see my favorite pages on Facebook on the lower left of the profile and who I follow on Twitter.

Most (all?) childbirth educator or doula certification organizations require you to attend a minimum number of births. Your role at the birth will be determined by what you are working toward (childbirth educator might be required merely to attend and witness a labor and birth, while a doula would have more requirements: physical and emotional labor support, working with staff, etc.) as well as what role the birthing couple want you to fulfill. Although you will have to register with a certification organization before any births you attend will count toward your certification requirements, the more births you can attend, the more you will learn. If you have any pregnant friends or family members who might let you attend their births, it would be a great opportunity if they'd allow you to attend. Read Penny Simkin's The Birth Partner and other birth books for inspiration and what to expect, then discuss your role at the birth with the mother and her partner. Will you be there just to observe quietly, to photograph or videotape, to help mom's partner support her in the birth, to bring a goodie bag of massage tools? Just be sure that the couple understands that you are there to learn and to support, and that they are aware of your level of experience and education.

This isn't an exhaustive list of how to become a birth or breastfeeding professional, but it's a good start. I'm sure I'll add to the list. Best wishes on your journey to serve families in their childbearing year!

Those of you who are childbirth educators, doulas, midwives, or breastfeeding counselors of various sorts, how did you start your journey into your career? Did you mentor or certify (or both)?

Wordless Wednesday: Family Planners/Planning

2011-01-05T00:04:00.002-05:00

You know you're a birth junkie when...

you see 3 shelves labeled "Family Planners" at Walmart...

and what goes through your mind instead is...


Image from flikr http://www.flickr.com/photos/perlgirl/2397837838/

"Family Planners"... heeheehee.

Gestational Diabetes Myth-conceptions via Pregnancy App for phone

2011-01-04T20:22:00.002-05:00

Expectant momma Julie Ann Samples shared on Facebook today, "One of my pregnancy apps on my phone updated me to 24 weeks today and informed me that if I am found to have gestational diabetes, then my baby will have to be born by cesarean section, ugh!!! I'm glad it was a free app!" Thankfully, Julie knew that this advice was wrong.

She said that the app is an Android app called Pregnancy Assistant. When she went to their website to leave a review, she saw that her fellow pregnant mommas gave it 4 1/2 stars! Augh! Most of the moms using the app are likely not reading all the Cochrane Reviews or Medscape journals or even ACOG's own recommendations and have NO IDEA what advice is evidence-based and what is thoroughly fabricated, such as advising a 24 week pregnant mother that if she is diagnosed with gestational diabetes, that a cesarean birth would be necessary.

The fact of the matter is that gestational diabetes alone is not a medical indicator for cesarean section. Cesarean birth has serious risks both to mother and baby. If gestational diabetes is poorly controlled or not managed at all, baby can possibly grow too large and need a cesarean. If gestational diabetes is well managed (by diet, exercise, and/or medicine under advisement of OB), mom and baby have the best chance for a vaginal delivery. Isn't it far better to empower mothers to know what their options are to safely control and manage their gestational diabetes from the earliest point possible and decrease their risks of needing a C-section?

It's easy to say, "Don't look a gift horse in the mouth," or "You get what you pay for," but I don't think this applies to a free pregnancy phone app. This is a damaging lie, one with far-reaching consequences. It would really be better to have NO ADVICE AT ALL than to have advice that's contrary to the evidence when it comes to your health and safety. This app needs to get their act together and give factual information or get out of the business of advising pregnant women altogether.

If any of you have tried out pregnancy apps for iPhone or Android, I'd be interested in hearing a product review in the comments here. Which are neutral ("Your baby is now 24 weeks along and has such-and-such abilities and characteristics"), which are helpful, and which dispense flat-out lies?

Childbirth Connection full chapter on Gestational Diabetes from A Guide to Effective Care in Pregnancy and Childbirth (pdf printable)

Edited to add: I just sent the following email to Pregnancy Assistant app's customer service address, along with the link to this blog:

"To whom it may concern,

"I am a childbirth educator. One of my clients informed me that she was using your Pregnancy Assistant app and received dangerously incorrect information in the 24 week gestation pregnancy notification. You have the duty and legal responsibility to include evidence-based information. I have blogged about this incorrect information with the hopes that pregnant women can learn the truth and avoid unnecessary major surgery.

"Sarah DeGroff
Well Rounded Birth Prep"

If you would like to send them a (professional, courteous, non-flaming) email, you may do so at info@apps.dzieciowo.pl

Unmedicated vaginal breech hospital birth story in photos!

2011-01-02T23:42:00.010-05:00

If you know this fabulous couple and their story, their doctor or hospital, please don't post their real names in the comments. This momma gave me permission to share her incredible story and photos so long as I blurred their faces and withheld their names. She has told her story far and wide and is proud of her accomplishments, but would like to not be associated with the photos as far as Google searches for her name and things like that. If it were me, I wouldn't want high school friends seeing pics like this, either. Maybe she will comment anonymously and fill in any details that I miss. (I'm still waiting for her to write her own birth stories!)

****THESE BIRTH PHOTOS ARE GRAPHIC. FACES HAVE BEEN BLURRED; THE BUSINESS END HAS NOT.*****

We'll call them Jessica and Eric. I met Jessica early in her pregnancy and we became fast friends. She was pregnant with her 3rd baby and was thirsty for info. I forget how our first conversation about birth came about, but it's probably not a surprise to you that birth and/or breastfeeding just happen to come up often when I'm around. It's funny how it works out that way. :-)

I try to sow seeds gently and see how much interest moms have. If they get defensive or change the subject, I (try to) drop it. It's better to leave it be and let them know I am here if they want to talk about it later. But Jessica took interest right away. I explained the Cascade of Interventions to her and some of the risks of some of the most common interventions. She was intrigued and wanted to know how it was that so many birth interventions were pushed on her without any of the risks being explained.

With her previous two births, she went into labor on her own (around here, it's a major feat to escape induction), and everything that was done to her in the hospital was done because of routine. She didn't want the epidural but had one both times because the staff told her, "Now it's time to get your epidural." She was led to believe that was safest for her baby, and that it was what everyone does. She did manage to have vaginal births both times, but she had quite a few side effects that she didn't realize were results of the epidural and other medications that were subsequent interventions (such as Pitocin). With her first baby, she pushed for 10 minutes and the OB gave her a deep episiotomy and pulled her son out with forceps. With her 2nd baby, she had told the OB that she did not want an episiotomy and did not receive one, but tore badly due to the epidural. Both times, Jessica had blood pressure problems as a side effect of the meds, as well as PPD, a disconnected feeling from the birth and her babies, and difficulties breastfeeding. Once she learned the cause-and-effect, she wanted to avoid duplicating her previous experiences.

Over the next few months, I recommended a lot of great books and articles for Jessica, including The Thinking Woman's Guide to A Better Birth by Henci Goer, Ina May's Guide to Childbirth by Ina May Gaskin, and Birth Your Way by Sheila Kitzinger. (There are plenty of other great birth books--see my Amazon.com widget to the right of my blog for others--but these are the ones I had on hand at the time.) I lent her my DVD copy of The Business of Being Born and asked her if Eric would be willing to watch it with her. I find that a lot of husbands are more willing to sit through an 84 minute documentary on birth and the failure of the American maternity system than to read a thick book on the topic. Besides, The Business of Being Born is short, riveting and easy to follow and hold attention for a layperson--even for a husband.

Jessica learned about birth plans and options and normal, physiologic birth. She and her husband were my first clients in my birth classes for my ICEA certification as a childbirth educator. She asked me if I would attend her birth as her doula. She started attending birth meetups to network with midwives, doulas, childbirth educators, homebirthers, and other birth advocates to learn what their birth options were.

Jessica left her OB when she asked a few questions that led her to believe that her OB would be less-than-supportive of an unmedicated birth this time around. She interviewed several other care practices and started seeing a CNM (certified nurse midwife) with an OB practice at the hospital with the lowest cesarean rate around.

Things went along smoothly until her baby flipped breech at 35 weeks along. This was unexpected! I wanted to make sure that Jessica knew what her options were: even if her baby stayed breech, breech vaginal birth *was* a real, safe possibility. The most current research says that vaginal breech birth can be the safest option for some moms and babies. Jessica read everything she could find on breech and did everything she could to encourage her baby to flip vertex. Avoiding a cesarean (unless it was an absolute medical necessity) was very important to her.

Jessica re-read the full chapter on pros and cons of breech vaginal birth versus breech cesarean risks in The Thinking Woman's Guide to a Better Birth, as well as positive breech vaginal birth stories. In the meanwhile, she did *everything that could be done* to encourage baby to turn head-down on his own. She practically memorized the breech section of SpinningBabies.com. Jessica practiced inversion of various sorts as often as she could at home, including inversion over an ironing board leaned against her couch and inversion in a swimming pool. She tried hot/cold therapy and lights and music to coax baby head-down. She started regularly seeing a chiropractor who specialized in the Webster technique to encourage baby to turn head-down. She crawled down stairs head-first. One of the OBs at her midwife's practice attempted an external version. All to no avail. This baby was persistently frank breech, but fortunately, this is the safest breech position for vaginal breech birth, and one of the OBs at the practice said that Jessica was an excellent candidate for breech vaginal birth. I couldn't believe she found a hospital OB who would agree to take her on as a client! (Well, "patient," not "client," technically, but I get so miffed about perfectly well mothers being called "patients" when they are not sick! I digress.)

The OB was pleased that Jessica was planning for an unmedicated birth and told her that this would give her the best odds of having a vaginal breech birth. With a vertex birth, it's important to feel your body's cues to help baby rotate and descend, but it is even more important to feel and respond to those sensations with a vaginal breech birth. I was pleased that everything Jessica said that her OB said, lined up with the research. This sounds obvious but you would be amazed at how many times OBs' advice is contrary to evidence-based information.

I had my doula bag packed and ready and was on call for Jessica once she reached 37 weeks. Jessica had had sporadic stretches of contractions that kept her up at night for about a week and a half (commonly known as prodromal labor). At 38-and-a-half weeks, I received a phone call at 3:40 a.m. Jessica sounded calm but told me that this was probably it and her contractions were about 4-5 minutes apart and that she and Eric were leaving for the hospital after the drop their other children off with a family member. I had almost an hour's drive to the hospital and was out the door less than 10 minutes after receiving the call.

Jessica later told me that she had been managing to cope through the contractions with techniques I had taught her in her birth class, from a little after midnight until 3:30 a.m. so well that she didn't even bother waking Eric. Once they got closer together, that's when she awoke him and they got ready to go to the hospital, but she still felt that the contractions were manageable and tolerable. Once they got in the car, Jessica's contractions intensified suddenly. She was in transition and didn't know it.

I didn't know any of that. I arrived at the hospital at 4:40 a.m. and came to the OB floor front desk. I asked the nurses which room was Jessica's, and introduced myself as her labor support, then handed them a goodie bag with Baked Tostitos, salsa, and chocolate chip cookies as bribery of sorts. (I've read mixed reviews as to whether this will *actually* get a patient preferential treatment over the next 2-3 days that they will be admitted, but it was an inexpensive insurance policy just in case. Plus, nurses are underappreciated in general. It doesn't hurt to thank them and bring them food.) They told me Jessica's room number and looked a bit confused; they told me they've been trying to keep her from pushing. Whaaaat?

When Jessica arrived at L&D and explained who she was and that her baby was breech, there was a bit of confusion, and one of the nurses asked if she was here for a C-section ("Um, no! I'm here for a planned vaginal breech birth!"). Thankfully, her OB who had been on call specifically for her *had* been notified and was on the way. When the nurses checked Jessica, she was at 10 cm and the nurses begged her not to push until her OB arrived. Even in the midst of that chaos, the nurses tried to talk Jessica into getting the routine IV, which Jessica had already discussed with her OB. She asked for the hep lock instead. She had the presence of mind to advocate for herself at 10 cm!

I turned toward her room and saw the OB walk in seconds before me. Here I was with my bulky doula backpack loaded up with a camcorder ready to record the birth, a tripod, fake battery-operated candle for aromatherapy and visual comfort, heating pad, massage tools, my Labor Progress Handbook, and more. None of it mattered! Jessica was in the zone and already involuntarily pushing. The whole thing happened so quickly that there wasn't even time to turn down the bedsheets. Jessica was pushing on a chux pad on top of the blankets and sheets and everything. There was no time to move anything. I was up against the door--literally--camera in my hand and my hands shaking with excitement and adrenalin.

Folks, I realize that my photography is disappointing. I was nervous and rushed and cramped and at the foot of the bed. I was trying to take these photos with the camera raised overhead like you would at a concert. I didn't feel that it would be appropriate for me to ask that nurse to please move so I could get a better shot. But Jessica gave me permission to post her photos and I'm over the moon! I'm sad to say that attending a vaginal breech delivery is probably a once-in-a-lifetime opportunity. I remembered about my camcorder that was in my backpack, ready to go, and Jessica wanted me to record with it, but I literally could not reach it and could not set my backpack down. Things were going so quickly that I knew that I'd miss it if I moved at all.

Jessica started out pushing on her side. What you see is her bulging bag of waters--still intact!

Soon her water broke on its own. The rump started rumping (I guess you can't call it crowning?). What you see here is baby's testicles on the left (the darker part) and his bottom on the right, emerging.

More of baby's rump is emerging. His testicles are at 9 o'clock. He's passing meconium, which is normal for a breech birth, since he's being squeezed that direction.

OB gets ready to help rotate baby a little as he emerges.

OB is supporting/rotating baby a bit. His legs have emerged and baby is born as far as his belly. The rest of him just slid on out easily, after a grand total of about 10 minutes of pushing!

Congratulations, Momma! You did an amazing job! Jessica enjoyed skin-to-skin contact with baby and rooming in to help establish breastfeeding. With the right information and support, Jessica has been able to exclusively breastfeed her son, which she wanted to do but did not know how with her others. I love seeing Eric's hand lovingly stroking his wife's forehead in this pic.

First nursing

Dad Eric gets ready to cut the cord after about 25 minutes of delayed cord clamping.

After that, they weighed and measured baby while Jessica pushed out the placenta (on her body's cues, despite the nurse's INSISTENCE that she get it done in the first 10 minutes postpartum). Jessica's bleeding was so minimal that she did not need a shot of Pitocin. Isn't it neat to see baby's legs piked in the frank breech position with which he was so familiar?

This is Jessica's favorite photo from the birth, with her son's inky little feet from getting stamped on the birth certificate. (Gee, you don't want to frame the one with your son's rump "crowning"?)

This proves I was there.

Oh and by the way, Jessica didn't tear A BIT this time! She felt great and said she would do it again in a heartbeat! What a victory!

On one hand, I was thrilled and honored to witness this beautiful, rare natural breech birth. On the other hand, I was saddened--why should this be such a rare event? I heard one nurse say to the other, "Gosh, how long has it been since we've had a vaginal breech birth here?" to which the other nurse replied, "There was that one vaginal breech birth about 10 years ago," and the first nurse said, "No, I think that was more like 15 years ago."

Yeah. That ONE.

Edited to add: "Jessica" has posted in the comments below. If you have any questions or comments that you would like to post for her, I'll email her to let her know.

Photo illustration: delayed cord clamping vs. immediate cord clamping

2010-12-31T09:00:00.052-05:00

World Health Organization supports delayed cord clamping. Here's what research shows:

25-50% of baby's blood volume is in the placenta and cord immediately after birth.
In the minutes following birth, baby's circulatory system retrieves exactly the amount of richly oxygenated blood he or she needs.
Premature cord clamping cuts off baby's oxygen supply from the placenta before the lungs begin to function, which is essential for brain function.
Babies whose cords are clamped and cut prematurely are more likely to have respiratory problems, need resuscitation, need a blood transfusion, and/or be anemic.
Cord blood provides baby with his or her own essential stem cells when the cord is allowed to continue pulsating until it is physiologically finished.

Nevertheless, many OBs (and even some midwives) continue to routinely clamp and cut the cord within 30 seconds after the birth. Why? Tradition and convenience.

Research also shows that pushing in upright positions on the mother's cues and instincts is more beneficial for both mother's and baby's health in the majority of instances. Here's an excellent 2 minute video clip on pushing positions. Although many OBs and midwives routinely practice active 3rd stage management (including immediate cord clamping and cutting, cord traction and fundal pressure to assist delivery of the placenta, and routine Pitocin shots), much has been written that suggests that these practices can cause many of the same problems they purport to prevent, such as hemorrhage.

Below are photos which two mothers have graciously given me permission to publish. They illustrate the difference in appearance of placentas after pushing on instinct in an upright position, physiologic 3rd stage management, and delayed cord clamping, versus placenta after directed pushing in lithotomy position (on her back), active 3rd stage management, and immediate cord clamping. These educational photos are graphic, therefore I'm giving fair warning to anyone who does NOT want to view photos of placentas.

*please continue to scroll down to see photos of placentas

*please continue to scroll down

*please continue to scroll down

* You can't say I didn't warn you if you haven't closed this page by now.

The first is a placenta after delayed cord clamping and cutting (30 or so minutes after the birth). The mother pushed on her body's cues in an upright position. She had a waterbirth and delivered the placenta into the birth pool on her body's cues about 30 minutes after the birth, then the placenta was transferred into this bowl right away. The amount of blood that was delivered with the placenta was so minimal that it did not even change the color of the water.

The next photo is of a placenta delivered after active third-stage management. The mother pushed in the lithotomy position (on her back) with directed pushing. The cord was clamped and cut within seconds after the birth. While the mother was still on her back, the midwife directed when and how to push the placenta out, while she gave cord traction. (This was not nearly all of the blood that was delivered with the placenta. It came out with a gush of blood, much of which went directly into a biohazard bag at the end of the bed.) I realize that much of this blood was mother's blood, not baby's blood (placental blood), but it still shows an interesting difference between examples of pushing on instinctive cues and directed pushing; between watchful waiting and active third-stage management.

It is an interesting pictorial of the variations of third stage management, placentas, and cords.

I have a collection of links (including NIH, Cochrane Review, and PubMed research) on delayed cord clamping and the consequences of routine cord clamping here. I continually add to this bookmark site.

Here is Midwife Thinking's blog post on the role of the placenta and cord in the newborn transition.

Edited to add: Even in the case of C-section, moms can request delayed cord clamping (barring unexpected complications). It's being done safely in some major hospitals by OBs who are meeting consumer demands for delayed cord clamping and other options for a family-centered cesarean. You can read more about family-centered cesareans on ICAN's White Papers and here at Preparing For Birth's sample birth plan for family-centered cesarean. Preparing for Birth is owned by Desirre Andrews, who is ICAN's president as well as a childbirth educator and doula. Family-centered cesareans are another post for another day.

Wordless Wednesday: A Father's Labor Support

2010-12-08T00:01:00.006-05:00

I took this photo of an amazing couple during labor. The father and mother's love for each other shined so beautifully. His caring presence and touch was a great comfort to her.

Remembering our angel babies at the holidays

2010-12-07T13:59:00.004-05:00

I've been asked to write a blog on grief/loss/remembering lost babies over the holidays. It's such a tough topic to handle for so many reasons. There are so many different ways to grieve, different ways to honor memories of our lost babies, and even so many different ways of celebrating that time encompassing Thanksgiving, Christmas, Chanukah, New Year's, Kwanzaa, Winter Solstice, and Festivus (did I leave anything out?).

I feel the need to give a disclaimer that whatever works for you, is the right answer for you. As I've said before, fear of criticism for saying the wrong thing has held me back from writing about grief and loss.

The holidays are often a grief trigger following a loss, even if things have seemed to be "fine" or at least "better" for a while. Why is that? Sometimes it has to do with expectations we had of that holiday: showing off an ultrasound, baby bump, or our new baby in our arms. Sometimes it means being around a mixture of relatives, some of whom don't know about the loss and it feels overwhelming to tell the whole story allllllll over again. Sometimes it feels like too much to answer questions about what happened. And all too often, it's awkward because there are no questions; everyone acts as though nothing happened. "Please pass the turkey." It's the elephant in the room nobody talks about.

Or maybe it's because nobody knows that the loss occurred because we hadn't announced the pregnancy, and we preferred to keep the loss and grieving process private. It can still be difficult to face a crowd when you are mourning and no one knows why you are not quite acting like "yourself."

Sometimes we *want* to talk about it but we don't know how to bring it up or who will be a sympathetic listener. Or we don't want to be the one to ruin the family get-together. Or we don't want to be accused of being self-centered or making the event "all about me." Or maybe that was just what I heard from certain family members. Or maybe we don't want to ruin our makeup when we tried so hard to put on a brave face and attend this thing after all.

Sometimes it's hard to be around family or friends who were pregnant at the same time as us or whose child(ren) is/are the same age as our baby would have been by then. It's hard to hold their baby, even though we want to hold them and love them.

Sometimes it's simply hard to be around festivity when deep down, we don't feel terribly festive.

Think about what brings you comfort: privacy and curling up on the couch with your honey, or being surrounded by friends and family at a gathering that is bustling and takes your mind off things for a while? Talk it over with your significant other and see if you can find a compromise that works for you both. Would you feel most comfortable attending a family gathering but setting a time limit on it? Would it help to have a code word that means "I can't do this, we have to leave now!"? Maybe this could play out: "Where's the mistletoe, honey?" "I'll get our coats."

If you just don't want to attend, and if you would rather send the gifts by mail or give them to a family member to take for you, or even if you want to send your significant other (and/or kids) as your ambassador and explain that you weren't feeling well and you regret that you couldn't be there, that would be 100% true.

Some families opt to do something different altogether to ease the pain of the absence of the loved one. This could be a temporary solution for one year, or a new tradition to keep each year. It's a bit of a different situation, but several years ago, my friend's mother died on Thanksgiving day after dinner after a long illness, and her father died of cancer a few months later. For the following Thanksgiving, she and her sister took a cruise over Thanksgiving instead of attending dinner at extended family's houses. I thought it was a great idea. Since that time, they have celebrated Thanksgiving with various other family members, but it really helped them make that transition for that first rough Thanksgiving without their mother. Getting away for a while could be a nice way to reconnect and recharge the batteries, physically and emotionally. Alternately, a new tradition closer to home could give a new way to honor baby's memory at the holidays, such as helping others (donating time, money, or needed items to a local family or charity in need) or even some fun activity such as going bowling or ice skating as a family.

Some moms find comfort in making or buying a memento, whether it's a piece of jewelry etched with baby's name, due date, or loss date; a Christmas ornament; a suncatcher; naming a star in his or her memory; donating to a charity in his or her name; a piece of art (custom or one you find) that represents your memory; a doll, stuffed animal, or blankie; a birdbath, fountain, or garden stepping stone (perhaps with a phrase or scripture that comforts you). Some parents write a poem (and even frame it) or journal to help in the grieving process. There are endless options for finding a way to honor your baby's memory in a way that represents you, your family, and your traditions.

If you receive money as a gift or want to buy a treat for yourself, My Forever Child is a great company owned by a jewelry artist who has lost a baby as well. Here are photos of my pendant I received as a gift from friends shortly after my loss. If you have actual handprints or footprints of your baby, you can scan and email them to her and she will custom-etch the images onto a pendant or keychain.

front

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As for me, I wanted a Christmas stocking in memory of Evan, my baby who I lost in 2007. It is basically a place-holder, in my eyes. I didn't want to pretend he was never here. My mother-in-law made stockings for my husband and me when we got married, then gave a stocking of the same shape/pattern to each of our children for their first Christmas. I asked her in June 2007 if she would make a stocking in memory of Evan, but she said that she would not have time to do that. I asked my dear sister-in-law Candi if she would make a stocking for Evan, since she has my mother-in-law's pattern and this stocking would match all the others. Even though it was a sacrifice of time and effort, Candi took time every evening for several days straight to put together this stocking for me, allowing me to choose which fabrics I wanted and where. Her gift of love meant--and means--so much to me.

To mark the significance of the stocking, I added a Precious Feet pin, which is an accurate replica of a baby's feet at 10 weeks gestation. I lost Evan at nearly 15 weeks gestation, but he stopped growing at nearly 9 weeks gestation, so the pin is pretty close to the size of Evan's feet at the time we lost him.

Evan's stocking is the one with the snowman, in the middle.


All our stockings: the 5 children's, then mine and Rick's.

Having Evan's stocking as a physical way to honor his memory made the approaching Christmas season feel much more bearable. My children know whose stocking that is, and sometimes they tell visitors about it. It is a tangible witness to their baby brother's existence. They know that he was a real baby, that he is still their brother, and that he is in Heaven now.

I've put up Evan's stocking along with all the other stockings, each year. However, I also bought a Christmas ornament in Evan's memory in 2007, but this is the first year that I have felt strong enough to bring it out of its place in my memory box and hang it on the tree. I bought it October 2007 from a WV artisan at an arts and crafts festival, and the artisan inscribed it with his name and the year.

The underside of the blankie reads "Evan Michael DeGroff, 2007"

Maybe on a tree this size, no one else will even notice Evan's ornament, but I know it's there.

What are some of the ways that you or someone you know has handled the holidays after a loss?

Commercial baby carriers: what's available other than crotch-danglers

2010-12-05T15:54:00.005-05:00

Maybe you're looking for an ergonomic, safe baby carrier or sling, but you don't have a high-end baby boutique that would stock brands like Ergo, Boba, Beco, or Sakura Bloom. [Update: Toys 'R Us now stocks Ergos, both online and in some retail stores!] Maybe you are in a hurry and have to buy a baby gift for a shower this afternoon, and you don't have time to email Tre'Slings and custom-order a gorgeous, designer fabric ring sling (she ships anywhere in the US & Canada). Maybe you read my previous post "Babywearing FAQ" and you want a readily available baby carrier from Target or Toys 'R Us, but you want to avoid the pitfalls of crotch-dangler carriers. Here are a few great options.

One of my favorite carriers for newborns, among widely available commercial baby carriers, is the Moby Wrap. You can find them at most Target or Toys 'R Us/ Babies 'R Us stores for around $40.

I was so excited when I was at Marshall's the other day and I saw this new Infantino Wrap & Tie, otherwise known as a Mei Tai style sling, for only $24.99!

"Buy this..."

The package was sealed so I didn't get to look at it closely or try it out, so I can't vouch for the quality, but this style carrier is so much more ergonomic for mom and baby both! As with many carriers, the packaging did show a photo of wearing a baby forward-facing using this Wrap & Tie, and I would advise against forward-facing babywearing for all the usual reasons, but this carrier looks like a great compromise for an affordable, safe, easily available baby carrier.

Unfortunately, right next to that Wrap & Tie, Marshall's had these crotch-dangler carriers, also $24.99 each:

"...not that."

I can't for the life of me figure out why these Infantino Front 2 Back Riders, Infantino Comfort Riders, Baby Bjorns and the like are even still on the market when there are such nicer alternatives for the same price. Maybe they're like pleated pants: they're not good for anyone, but so long as there are people willing to buy them, manufacturers will continue to produce them. They do not provide adequate support for baby's legs or spine in this position where baby's legs dangle straight down, whether baby is forward-facing or facing the wearer. Baby's weight and center of gravity are also pulled down and away from the wearer, instead of being wrapped around the wearer's body.

Although I haven't seen one in person yet, I've heard good reviews of Infantino's new Ergo knockoff, the Infantino Balance which sells for around $60 at Toys 'R Us. I'm encouraged that possibly market demand is forcing commercial baby product companies to offer better alternatives than the past. I'd love to see this trend continue, and who knows, maybe some day we will see BabyHawk, Ergo, Boba, Beco, Sakura Bloom, or even Tre'Slings offered at Target and Toys 'R Us.

For more information about the difference between good, supportive baby carriers and crotch-danglers, see this helpful blog post by Becoming Mamas.

What about you? Have you seen any good, ergonomic, affordable baby carriers in chain stores? Which carriers? Which stores?

Myth-conceptions about Episiotomy,The Unkindest Cut.

2010-12-01T16:20:00.002-05:00

This MyOBsaidWHAT.com entry particularly hit a nerve with me.

“I’m almost done, just putting in an extra stitch. It will make your husband really happy.” -OB during tear repair.

Where to even begin with how wrong this is. *sigh* You can read the comments at the bottom of the post to read the thoughts of childbirth educators, doulas, midwives, and other birth advocates. A great read on the facts and mythology regarding episiotomies is Chapter 14 from Henci Goer's Obstetric Myths Versus Research Realities, which can be read in its entirety here.

The assault on the woman's genital integrity and bodily autonomy by this OB's use of the "husband stitch" is so bad that it would require a whole other post. The mother whose original post that was did NOT consent to that procedure, and there's no way that an "extra" stitch would help her heal better in any way. If anything, her recovery would be prolonged, possibly by many months. That's a rant for another day.

At any rate, I hear this one a lot. It makes me really sad.

Often, my clients in my childbirth classes (or private in-home classes) will bring to class their mother, sister, or best friend who they want to be present at the birth. With this example, we will call the mom-to-be Ashlee and her mother (the grandmother-to-be) Jane (not their real names). As part of what I regularly cover in my classes, I explained to mom-to-be Ashlee that episiotomies are only medically necessary about 5% (or less) of the time and that most of the time, they amount to nothing more than genital mutilation. We discussed how a tear will often be far WORSE and deeper with an episiotomy, and how recovery from an episiotomy has been found in studies to be more painful and difficult to heal than after a natural tear. I also shared with them the most common (totally preventable) causes of tearing and how to prevent/avoid a tear. Grandma-to-be Jane nearly teared up after hearing this, sharing a bit of her birth story. She was glad that chose to have unmedicated births with her (now-grown) children and encouraged her daughters to have an unmedicated birth, if possible. She said that she treasured her memories of her own births--until she found out that what happened to her didn't have to be that way.

She said that everything went great up until the time that her OB cut a deep episiotomy on her, then as he stitched her up, he told her he was putting in "one more stitch for her husband." Jane said, "At the time, I thought that was normal, but now I think I should have popped him one!" I told her that I was sorry that she had that experience. She replied that she was glad she found out the truth so that hopefully her daughter wouldn't have to go through an unnecessary episiotomy and subsequent painful recovery.

Informed consent: Moms, do YOU want to be vaccinated after giving birth?

2010-11-23T16:06:00.003-05:00

I wanted to give a heads up to moms who will be giving birth anytime soon in a hospital and possibly in freestanding birth centers. Several different moms have told me recently that after they gave birth in a hospital (two different hospitals), staff offered vaccinations to the mother. I'm not talking about the Hepatitis B vaccine typically offered to newborns. I'm talking about vaccines for mom.

One mom, in her post-birth blur, said that she was pretty sure that one of the vaccines may have been pertussis and she wasn't sure what the second one was (possibly flu?). She consented because the healthcare worker (I'm not sure whether it was a nurse, doctor, or other) rolled up her gown sleeve for her and told her that she *had* to have these vaccines. She did receive both vaccines, but she didn't feel that it was informed consent.

The other hospital did not present it falsely as a mandate, and the mother at that hospital declined the vaccines without any further struggle.

I'm not telling you to accept or decline any vaccine. I'm just here to give moms a heads up that they may need to make such a decision shortly after giving birth in an institution, so it's best to research your options and make your choices on available information instead of in a rushed manner, without having time to read product inserts or ingredient lists, and when they know that you're distracted with a newborn on your chest. Whether to accept or decline vaccines for mom is not something that most women think to include in their birth plans.

Links to CDC list of vaccine ingredients, PDF (US licensed vaccines)

Links to package inserts for US licensed vaccines

CDC page listing possible side effects of US vaccines

CDC list of vaccine contraindications (US vaccines)

VAERS (Vaccine Adverse Event Reporting System), co-sponsored by CDC, FDA, and US Dept. of Health and Human Services

National Institutes of Health/ Cochrane Review to "assess all studies evaluating the effects of vaccines against influenza in healthy adults." Conclusion: "Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.WARNING: This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding."

It's always a good idea to research ingredients and relative safety/risk of each vaccine vs. the relative safety/risk of each illness as well as the effectiveness (or lack thereof) of each vaccine. It seems that many people spend more time reading the ingredient list on the back of their cereal boxes than they do reading what is injected into their (or their children's) bodies.

One man's trash is another man's treasure?

2010-11-16T22:22:00.003-05:00

A few days ago, I was making small talk with another mom who asked me what I do for a living. I told her that I homeschool my 4 kids and I teach childbirth classes. That's an interesting conversation opener. You'd be surprised how many people automatically start telling me about their births--even men, sharing how their wife had to have 2 Cesareans and why.

Like so many others, she told me how she has had cesareans with all three of her kids. She didn't say why she "needed" her first cesarean, but she did say that she scheduled her cesareans with the next two children. After all, her dad had read on the internet about "those VBACs." (I'm not making this up.) Besides, she elaborated, it made it so much easier to schedule her in-laws' visit around the scheduled C-section, and her husband could plan ahead when he needed to take off work.

I smiled and nodded. She didn't ask me any questions, and I didn't give her any commentary. I didn't even tell her how my own children were born. Someone changed the subject, and that was fine.

Then I received a text message from a friend who is a doula. She had been keeping me updated for days about her VBAC client's progress. She had texted me a few times for advice or encouragement, and I was honored to be a text-witness to something amazing. The text I received while sitting with this mother: "VBAC!!!!!!" Yes, she had finally achieved her VBAC after a 60 hour, unmedicated hospital VBAC. She worked so hard for that birth, not just those 60 hours but for the previous 40-ish weeks, preparing for and working toward this birth, overcoming incredible obstacles from her previous traumatic birth.

It was an interesting juxtaposition to observe, sitting at the table with a mother who knows nothing about what her body is capable of or designed to accomplish with birth, who was content with her three cesareans and said she would schedule cesareans if they have any future children, then receiving that text: "VBAC!!!!!!" Knowing what incredible event had just transpired, and how much that mother had wanted it--what victory.

It's interesting to observe who is content with what and why.