Firefly Mama

She is here

2009-02-22T05:59:00.000-08:00

Whew. The baby finally came out. :) I was actually starting to wonder, being 5 days overdue and a full 3 weeks later than my last kid.

My daughter was born on Tuesday, February 17th at 7:45 am after 5 easy hours of labor. She weighed 8 lbs 14 oz and was 20.25 inches long, and had a 13.75 inch head and 14 inch chest (big!). She's got 10 fingers and 10 toes and is absolutely perfect. The birth was wonderful. I really couldn't have asked for better. Despite being by far my largest baby, I didn't tear (!!!) and felt in complete control pretty much the entire time. Keith was able to catch his daughter, and I reached down and grabbed her as she completely emerged. It was awesome.

Now, at 5 days old, we are dealing with weight loss, jaundice, and a lack of pooping. This is something I've seen before and is very frustrating. We have a midwife visit later today so we'll see how it is going. Otherwise, things are going quite well. The older kids absolutely ADORE her. My body is healing very quickly, thanks to the easy birth. She's even sleeping a fair amount (though that might be because of the jaundice). If we could just get the milk flowing and get her weight up.

Officially Overdue

2009-02-13T13:34:00.000-08:00

I can't believe it. My due date was yesterday. I'm still pregnant.

Granted, this is normal for most women. The average pregnancy is longer than 40 weeks. But MY pregnancies have all been weeks shorter. I've always known it was possible I could go longer, but considering my other two kids were 12 and 16 days early and were healthy and of good size (7,4 and 8,6), I really didn't think this pregnancy would go so much longer.

So here I am, weeks more pregnant than I've ever been, measuring much larger than I've ever been, wondering when this kid is coming out. I wonder what will be different since this baby has cooked so much longer. Will I notice less vernix and lanugo? My other kids were covered in it. My son had a pretty good case of jaundice too. Could we avoid that this time? Will this baby be more awake and alert because of the extra weeks? I hope so. Could breastfeeding be easier? That would be so cool. And of course, I AM wondering how much BIGGER this kid is going to be. Still curious whether it is a boy or girl too.

Today is Friday the 13th. I don't really have a problem if baby chooses to come today, though I think Keith is a little freaked by it. The kids both have colds right now and I'm getting one too. And I've got a new cold sore brewing. But I don't really want to wait until we are all healthy for this baby to come out. That might not happen until May.

So baby, please please please come out!

Who isn't ready?

2009-02-04T21:55:00.000-08:00

We've only had 18 months of warning. And free assistance. And reminders everytime you turn on your tv. So who the f*@! isn't ready for digital cable? Are you freaking kidding me? Postpone it by 4 months, postpone it by a year. It won't matter. If you aren't ready by now, you probably never will be and there is only one person who can fix that.

Is this what it feels like to be overdue?

2009-02-01T20:59:00.000-08:00

I'm not overdue. In fact, I'm only 38 weeks 3 days pregnant. But this is now my longest pregnancy. My daughter would have been born yesterday, and my son 5 days ago. So it kinda feels late to me. With all the prelabor activity starting at 34 weeks, and the several false starts I've already had, I really thought I'd be holding my baby by now. I guess this is what they mean by "the third baby throws you for a loop!" My midwife laughed and admitted she was waiting for me to go 2 weeks overdue, though she also said she didn't think I actually would. God, I hope she's right. No way I can imagine this pregnancy being a MONTH longer than my other two, not to mention that my son was nearly 8.5 lbs at 37.5 weeks...so an extra month could mean a rather large baby!

I'm hoping this extra time means no jaundice or breastfeeding problems this time. And it would be cool if the prelabor lead to an extremely short and easy labor. Wishful thinking? Probably. But I've got a lot of time for thinking right now, and I'm choosing to think about that. :)

Ouch

2009-01-20T13:18:00.000-08:00

I think I may have a broken rib. I can't believe this little critter inside me could be so mean to his/her mama. I guess quarters are getting very tight in there. This pain has been present for 1-2 weeks, but it is just getting worse and worse. I still have a cough too, which makes it so much worse. Certain postures and a cough or sneeze just make it feel like a knife in my side. Guess there isn't much that can be done, except wait for relief from the pressure once the baby is out. Speaking of which...I started seeing some mucus last night, but it was only very minor. It could be anytime. If this baby picks a timeframe similar to when my other two arrived, he/she will be born between Tuesday and Saturday of next week. I'm nesting like crazy, and in 2 days I will be free of all commitments. I can't wait to meet this new person.

A New Day

2009-01-20T13:15:00.000-08:00

I'm happier to be an American today than on any other day I can remember. I watched (on my big, crisp tv) the first African-American President take the oath to be Commander in Chief. I have so much hope for this change in our government, and for Obama's energy to stay the course. We have so much to do, but for the first time I feel like people are willing to work to make things better.

Wish I could have been there in person.

Where have I been?

2009-01-06T14:07:00.000-08:00

Where on earth have I been? Wow. I can't believe my last update was in September. That is pretty sad. The truth is, life has just been very busy. I was forced to reduce computer time, and my blog is one of the things that had to take the back-burner. I'm not quite ready to say, "I'm back," but at least I'm here for today.

For the fall I was teaching two classes at the local university, and that kept me very very busy. I was also teaching childbirth classes (for which I have my certification exam TOMORROW), attending doula births, raising 2 kids, and of course, gestating a third. In mid-November I was in a car accident that tore things up a bit. I have "minor" injuries I guess, though it is now almost 2 months later and I'm still seeing the chiropractor, acupuncturist, and massage therapist. The accident was caused my an insurance-less fuck who plowed at 35 mph into a stopped car (and that stopped car then plowed into me). Three people, including myself, were taken to the hospital. I was sent straight to L&D because of frequent contractions (at 27 weeks), but things settled down with rest and hydration. And we had another ultrasound, but resisted finding out the gender again. The at-fault driver's car was totaled. My car wasn't too far from totaled. And come to find out he had no insurance, no driver's license, no car registration, AND he had 2 kids in the car who were not his kids and who were not in proper child restraints. How can people be so clueless?

Anyway, that accident has left me with even less time for blogging because of the HOURS of weekly appointments. Things are considerably better now. Then in December I got REALLY sick. It has been about 5 weeks now and I'm still sick. The holidays were non-existent because I could barely drag my ass out of bed. Finally now, things are starting to look up. I'm nearly 35 weeks pregnant - exactly 3 weeks away from when my son was born. The house is almost ready for baby. We even had a house cleaner come visit yesterday. I just bought a new nursing bra, which makes me sooo excited. And my birthday is in just a few days.

It is hard to imagine I'm going to have another newborn soon. My oldest is really excited about it. It has been a completely new journey to have her so aware of her new sibling this time. I'm very excited to meet this little person. I would sure like it if he/she would lay off my SI joints.

It is confirmed...I'm carrying a mini Homer Simpson

2008-09-30T16:34:00.000-07:00

The "big" ultrasound was yesterday. For each of my kids, I've left the 20-week ultrasound feeling like the baby looked like something specific on the ultrasound screen. With my first, she looked like a turtle...it was something about the placenta resting against her back. With my second he looked like a duck. This baby looked strikingly like Homer Simpson. There was a particular shot when they measure the distance between the eyes that really brought out the Homer image with eyes bugging out and big round forehead. Anyway, I'm hoping the kid is a bit cuter in 4 months.

We don't have the official report yet, but everything looked good from my eyes. Baby was extremely uncooperative for most of the measurements. Even if we had wanted to know the gender, they would not have been able to tell. I guess that is the way it is supposed to be. We truly weren't meant to know. I still have this feeling about a boy, and my daughter is convinced it is a boy...but we'll see. We're definitely coming up with girl names too, just in case.

Otherwise, things are going well. I'm STILL gagging and vomitting on certain food items and when I brush my teeth. Almost 21 weeks...sheesh. Between the sickness and the uncooperative behavior for doppler and ultrasound, I'm still thinking this baby might be a handful when he/she emerges on the outside. Contractions are getting more regular. I've always had lots of "practice" contractions very early on, so this is nothing new for me. It is exciting though.

Last week I attended my last doula birth for probably the rest of the winter and spring, and it just got me soooo excited to be in labor again. Birth went very well, though it was long. But mom got exactly what she was hoping for - it was about as close to a homebirth in a hospital that you could hope for. And the neat thing, at least from a doula perspective, was to really see how as the baby's position changed from posterior to anterior, it really changed the contractions. Had this mother had an epidural, I feel certain she may have needed a cesarean. This baby liked to be posterior, and only turned with extended time on hands and knees (which an epidural would have prevented). Anyway, it was a beautiful experience.

Otherwise life is very busy. I'm teaching two university classes this fall, plus doing a bit of research work. I was offered a teaching position for winter term too, which I had to turn down because of the baby. And I now have one lined up for spring, as well as 2 research proposals to work on and a proposal to work on some e-courses for quite a bit of money. Though getting the PhD was a major pain in the arse, I'm sooo happy to have it now. Pay is more than quadruple what I was making before (which obviously wasn't much), and I feel this invisible measure of respect coming from the other faculty. Pretty sweet.

Boy or Girl?

2008-09-09T21:02:00.000-07:00

We've decided not to find out this time. I kinda can't believe it. I was so sure I wanted to know with both of my previous pregnancies, and though we told the ultrasound technician not to waste time hunting for it, we were relieved when baby made it really easy to guess their gender. But this time, the ultrasound instructions will be to steer clear of the goods! And we are totally comfortable with that plan.

I still think it is a boy though. I've just felt that way from a few weeks in. We didn't try for a boy or girl this time, so it really could be either. But I just feel boyish. Plus I've been sicker than sick (still puking about every other day...at 18 weeks!), and though I wasn't THIS sick with my son, I was certainly sicker with him than I was with my daughter. Each pregnancy has just gotten sicker and harder. We have plans for a 4th after this, but for the first time I'm actually dreading the whole pregnancy part of it. I just don't enjoy pregnancy very much. I like the idea of it, but my pregnancies have been very hard on me. Guess I'll never grow up to be a surrogate.

Baby is safe

2008-08-25T21:21:00.000-07:00

It took a while, but baby is making him/herself known now. I've been pretty certain I'm feeling movement, and then today we FINALLY found the heartbeat on a doppler. Whew! Coming up on 16 weeks and all is well.

When it hits the fan

2008-08-18T21:17:00.000-07:00

A week ago, we were on top of the world. We'd just sold our house for a very sweet price. We'd just bought a new house for a very sweet price. We were moving in just a few weeks, and were VERY excited about it. Then Thursday hit.

On Thursday we had our inspection. Nothing really scary came up, but definitely a few annoying things. However, the buyer obviously saw something that terrified him because he went running. His reason? He said he didn't think any bank would give him a loan. Not sure where he got that, cause there was nothing that serious in the inspection. Regardless, he's gone. Our new house deal is gone. And we are back on the market. NOT. HAPPY.

And, on that same day, we had an appointment with our midwives. At 14 weeks, they were unable to find a heartbeat. I'm trying not to be too worried about it since I'm still pretty sick and we had that ultrasound just 2 weeks ago. Plus I think I'm starting to feel movement. But still, I'd think there would be a loud heartbeat by 14 weeks. Next appointment isn't until 18 weeks, but I may go back next week just to check unless I start getting some majorly reassuring kicks this week.

Bleh. I'd like some good news now.

How Many of Me?

2008-08-05T09:08:00.000-07:00

HowManyOfMe.com

There are
116
people with my name in the U.S.A.

How many have your name?

Not too bad. Only 116, out of 300,000,000+. How common is your name?

Confirmation of life

2008-08-03T15:03:00.000-07:00

Those first few months of pregnancy are rough, when you are sick and feel bloated, but haven't heard a heartbeat or felt the baby move yet. There's just no confirmation you feel like ass for a reason. These months have been dragging on since I've been feeling so badly, more than any of my pregnancies before. I was pretty nervous going into our ultrasound last week, just hoping to see a healthy fetus. I knew being sick was probably a good sign, but there's nothing like seeing your baby flip you off to know things are going well.

All's well with this one (nicknamed P3). At 12 weeks exactly, we went in for an Ultrascreen (combination ultrasound and blood test that looks for Down's Syndrome and Trisomy 13 and 18). We hadn't heard the heartbeat yet, so this was our first glimpse of life. And that little bugger was wiggling! Everything looked really healthy. The baby had a great heartbeat and was extremely active. We got to watch some hiccups for a while. And our test results were fabulous too - chance of Down's or Tri 13/18 is less than 1 in 8000 and 1 in 10000, respectively. And best of all, baby was measuring perfectly. I love to see that when it happens, because I always set my due dates according to my ovulation date. My ovulation date is the most accurate, and I know this (and my midwife trusts this). Had we used my date of last menstural period, my due date would be nearly a week off. So hooray for knowing your body!

Happy Birthday Ava!

2008-07-26T20:26:00.000-07:00

My oldest turned 3 years old today. I can't believe she's soooo grown-up. Pics soon perhaps, if our computer doesn't go up in smoke.

This baby is gonna be trouble

2008-07-25T16:20:00.000-07:00

I've never been this sick before. I blaim that for my extended absense in blogworld, and it probably isn't over yet. I'm still sick, though having occasional moments of normalness that tell me perhaps the end is near (in a month maybe). It is bad enough to make me wonder why I wanted to get pregnant again, and to seriously question our plan to have one more baby after this one. I'm sure I'll see things differently when I feel better, but damn...this sucks.

Pregnancy seems to be going well. Just over 11 weeks now. Haven't heard or seen the baby yet, but we have an Ultrascreen (includes an ultrasound) scheduled for next Thursday. Heartburn started about a month ago, but is treatable with papaya so far. Tired as hell, but that doesn't surprise me. My belly is growing quickly and I can easily find my fundus nearly halfway to my umbilicus. Guess third babies push your body out quickly.

Our 3 year-old (birthday tomorrow!) is SUPER excited about the baby. I'm really looking forward to having her conscious and present throughout this pregnancy and birth.

1930s wifedom

2008-07-03T21:50:00.000-07:00

Good think I'm not a wife of the 30s.

As a 1930s wife, I am
Very Poor (Failure)

Take the test!

Blehhhhhhhhhhhhhhh

2008-06-29T20:54:00.000-07:00

Morning sickness sucks. I know I remember morning sickness once it is over, but I don't remember who crappy I feel really. This stinks. :( All day bleh.

In other much more exciting news, we made a bid on a house today. :) :) :) It is a contingent offer, so even if it is accepted, we still have to sell our place. But it is a great house!

How much worse can they make themselves look?

2008-06-18T13:08:00.000-07:00

The AMA is really making themselves look pretty bad here. Open mouth and insert foot. They've joined ACOG's movement with recent resolutions (Resolutions 204 and 205) both to completely BAN all homebirths AND births in freestanding birth centers and criminalize mothers who choose to continue doing this, plus they are going after the entire midwifery model of maternity care by suggesting all non-nurse midwives be OUTLAWED, and nurse midwives come under even greater levels of OB control. Um, what? And, to make it even better, these resolutions are made with absolutely no medical basis. They don't mention a single study, a single statistic, or even a promise that this would be good for mothers and babies. Nope. Their resolutions read more like, "I'm scared for my job and Ricki Lake has made this powerful movie that makes us look really bad so now we better just throw everyone in jail and make it a law that all pregnant women must pay us directly...no other options."

Reaction in the normal birth world is mixed. Some are scared, just because it does suggest there will be a fight ahead and the AMA is waaaaay more powerful than any midwife group (the AMA controls the entire insurance industry, for example). Others think this is good publicity for midwifery and for homebirths. Because their statements are sooo outrageous and have no medical basis, they do seem rather ridiculous. Kinda like shooting guns with no bullets. I have a difficult time seeing how this could ever become a real law...given there is NO medical research supporting the AMA and ACOG's statements (quite the opposite actually).

Well, I'll tell you how much this has changed my mind. I had a very nice talk with my HOMEBIRTH-ONLY, NON-NURSE MIDWIFE yesterday. I'll be seeing her apprentice as my primary midwife, so not only is she NOT a nurse, she isn't even certified OR licensed. HA! And thankfully, my right to do this is completely protected by the fabulous state of Oregon.

Doctor Firefly Mama

2008-06-18T11:52:00.001-07:00

Dead cat, open house, and sharing the news

2008-06-14T23:52:00.000-07:00

That was my day. Well, there were some other things thrown in there too, but this is the part I choose to share.

We're taking care of a neighbors cats, and this morning husband returned to say he thought one of the cats was dead. Poor kitty. Sure enough, "Yoda" was curled up in a tiny box under the sink in the laundry room, and was stiff as a board. He was still warm, but definitely not with us anymore. I've never had to wrap a cat in a garbage bag and stick them in a freezer before. The owners will return tomorrow to a sympathy card taped to their door. Don't want to surprise them when they open their freezer to find a frozen kitty...

Just after finding the cat, and just before placing kitty in the freezer, we jumped in the car to go look at a house. It is the first house we've actually gone to see...and turns out it is owned by someone we work with. House needs work, but is livable and has EXCELLENT potential. Location is great too. But if we buy it and want to make some upgrades, it would be more than we can afford.

A few hours later, my folks arrived for tomorrow's graduation ceremony. They haven't been here in a year, haven't seen daughter in a year, and haven't seen son in 9 months. It is really great to have them around. And...I got to actually tell them in person that we are expecting another baby. This is the first time I've gotten to tell them in person, though I think they kinda suspected since we mentioned we were looking at bigger houses. Still, it was great to see their faces as the comprehension sunk in. I had one of those digital pregnancy tests that just says "Pregnant" and I asked daughter to carry it in and hand it to grandma. It was pretty sweet.

Now tomorrow I get all dressed up and receive my PhD. It feels a bit surreal.

By the way, I was in Vermont for most of the week at a conference. Nearly saw a tornado while there, and I've got pics. Hope to get those up soon.

Recent kid pics

2008-06-06T11:24:00.000-07:00

In Praise of Telling Too Soon...

2008-06-03T12:09:00.000-07:00

You may be surprised to hear I'm pregnant, when really I'm not even 4 weeks pregnant yet. Lots of folks wait until 8...10...12 weeks to tell, and I'm just not like that anymore. I am happy to be pregnant right now, and if something happens and this pregnancy does not make it all the way, I want to share that and receive support too.

One of my friends sent this message to me not long ago, after her own miscarriage. From Mothering.com:

In Praise of Telling Too Soon
By Katie Silberman
Web Exclusive, January 28, 2008

That thing they warn you about: it happened to me. I got pregnant. I was thrilled. I told a bunch of family and friends—and then I lost the baby in my second month. I had to untell a whole lot of people. That story was swirling around in my head. You know the one. The one "They" always say about how you're "not supposed to tell people too soon."

I always hated that one. I hated it when my sister would whisper that her friends were pregnant, and then warn me, "...they're not telling people yet." It seemed so negative and scardey-cat to me. I always swore that when I got pregnant, I'd tell the whole world.

Well, I did (practically). And it was great. I got the most wonderful responses, full of excitement and anticipation and appreciation for my husband Bryan and me. We had a great two months—it was fun when my clothes started not to fit; it was fun when my husband had to go out at night and get me ginger ale, just like in the stories. We even got a few cards and gifts.

Then we went for our first OB appointment. The doctor saw the baby on the ultrasound, but she could not detect the heartbeat. "I think your baby has died," she said. The words didn't even sink in. My husband and I are pretty optimistic people—it truly had not even occurred to either one of us that the baby might not be okay. When we finally registered what she had said, the news was crushing; it was devastating; I felt like a balloon had been popped.

Any loss can surely be utterly distressing, painful and sad. What seemed different about this particular loss, besides the fact that it was happening to us (this wasn't supposed to happen!!!), is that when I was pregnant I was coming from a place of such elation. It wasn't just normal life—it was flying high, excitement, euphoria, anticipation. And then the crash. The distance to fall seemed farther—the chasm between zenith and nadir more vast.

That's where "in praise of telling people too soon" came in. My husband and I were crushed with grief and disappointment. All I wanted to do was to lay on the couch in my bathrobe all day (sometimes Bryan would gently inquire around 4 o'clock in the afternoon whether I wanted to get dressed. I would scowl at him and say no.) Not up to talking on the phone, I sent out an email message to my friends and family briefly explaining what happened. Along with "untelling," I explained that I did not much feel like receiving calls. We were inundated with caring replies, and reading the messages that poured back in was all I felt like doing those few weeks. Bryan smiled that every time I checked my email, tears rolled down my cheeks as I was touched by the waves of support from the people who loved us, recognized what we were going through, and offered us their kindness. If we had not had the outpouring of care and support from our friends and family, I am certain that couch-laying phase would have lasted a lot longer than it did.

The thing about miscarriage that I most feared was that it seemed so invisible. I hadn't really looked pregnant yet; the baby was just a tiny thing (the size of a raspberry, the books said). With the code of secrecy surrounding the "don't tell too early" story, there did seem to be a residual sense of shame about what was happening; as though it should be kept in the realm of women's maladies that happen "down there," in the dark, that we're not allowed to talk about. But I knew that something real had happened to me; it was not invisible.

If I had kept my pregnancy and miscarriage a secret, if I had bought the shame story, then I would not have been real. I can't even imagine having to fake it with the most important people in my life: to pretend that nothing was wrong, during one of the most heartbreaking experiences of my life. That, to me, seems much more traumatic than having to "untell" and then tell the people who love you that you could use a little love and support. And then let them give it.

Cesareans may mean you lose health insurance?

2008-06-03T10:32:00.000-07:00

Interesting article. I'm not surprised, but it really sucks that moms are left in the middle. Docs pressure them into cesareans that are often unnecessary, and then their insurance drops them over something they generally feel they had no control over. Perhaps in the long-run this will lead to an overall drop in the number of cesareans, but in the meantime, it is painful for innocent families who get screwed over.

#3

2008-06-02T22:09:00.000-07:00

Notice tickers on the left. :)

PA Court tells State Medical Board to shove it

2008-05-25T11:31:00.000-07:00

Big news in the midwifery world on Friday. I know lots of people across the country were tuned in to hear the outcome of this one. Thankfully, the humans came to their senses and an innocent midwife pervailed!

Diane Goslin has been a practicing midwife for like 25 years, and she's attended over 3,000 births. In that time, she has received one (ONE!) complaint against her - and it wasn't even by a parent or family she was serving. It was by a coroner, who examined an infant's body from a birth she had attended. You see, the coroner found the infant's death had nothing to do with the birth or the midwife, but he didn't like that the midwife had attended the birth at all so he complained to the PA Medical Board. What a kind fellow.

So Diane was ordered to cease and desist her midwifery practice and was brought up on numerous charges, including practicing medicine without a license, and given $11,000 in fines. Diane is a Certified Professional Midwife (CPM), an internationally-recognized certification for midwives. But silly Pennsylvania doesn't recognize them and therefore won't give them licenses of any kind. There were a bunch of rulings, and it looked like homebirth midwifery was about to be shutdown in Pennsylvania. But Diane fought hard, and she had thousands of supporters along the way. Save Homebirth joined the fight. The Amish and Mennonite (Diane's primary customers) came out in full force to support her. You can see some amazing pictures here.

Well, it all worked. Diane won. The court decided that practicing midwifery was not the same as practicing medicine, and therefore Diane wasn't guilty of practicing medicine without a license. AND, the court gave the PA Medical Board a slap on the wrist for trying to claim she was practicing as a nurse-midwife, because the Board is only allowed to police women who are trying to do this, and at no time did Diane advertise or call herself a CNM. PLUS, the court decided Diane was denied due process in these charges. Wow. You can read the final ruling here.

This is amazing news for all supporters of midwifery and homebirth. Midwifery is not "practicing medicine" and it should never be judged as such. Midwives should never be prevented from practicing because of misunderstandings about what they do. If states are afraid of midwifery (and that is what it comes down to here - FEAR), they need to take the time to learn what a midwife does and what a midwife doesn't do. If they would open their minds just a little, they would realize that supporting midwifery (and specifically homebirth midwifery) is not only cheaper, but better for the health of mother and baby.

Man, I'm so glad Pennsylvania saw the light. And now onto the local fight - whether or not Oregon will begin mandatory licensure for all practicing midwives (it is currently optional). OMC (Oregon Midwifery Council) is debating how to coordinate a unified front and what they should be arguing for. More to come...

Pushing pedals

2008-05-25T11:17:00.001-07:00

We took our inaugural bike ride around town this morning. We've had our Burley for over a year, and my bike is brand new but has collected dust for a year. We got both while I was immensely pregnant, and the Burley isn't fit for infants, so we knew it would be a while before we hit the streets. But we made it out today and it was great! Both kids loved it and wore their helmets without a peep. We cruised the neighborhood in search of "For Sale" signs...yep, we're kinda sorta house-hunting.

Homebirth montage

2008-05-19T16:57:00.001-07:00

I linked to this before but want to imbed it now so I can find it easily in the future. Amazing photos...

Vaginal Birth of Twins and Triplets!

2008-05-12T11:44:00.001-07:00

This is awesome inspiration for those not interested in an automatic cesarean with multiples. The lady named Lindsey has been my friend for years, and the lady named Lisa is an online aquaintance.

D-O-N-E!!

2008-05-08T20:56:00.000-07:00

This morning I turned my final revisions into the graduate school for my dissertation. It almost required a degree just to turn it in and meet all the requirements (10x13 inch manila envelope with metal clasp with 2 flyleafs, 3 extra title pages, 1 extra signed abstract, taped title page on front, receipt for archiving fee, etc etc). My revisions were pretty simple - took about 3 days. As of this afternoon, my online transcript says "Doctor of Philosophy degree requirements met on May 8, 2008." DONE DONE DONE DONE!!!

In other news, I've attended two births in the last two weeks too. Birth stories coming soon. One was a 92-hour marathon birth (I was only present for the last 25 hours). The other was an induction with hx of embolism complications that ended well with 4 hours of pushing. Both were good. Can't believe I fit them in there with all the defense stuff going on.

So now I'm taking a little time off from school. Gonna work on relaxing and reclaiming my sanity and health, develop my childbirth classes a bit, go see a movie, and go meet some new babies...

FREEDOM!!!!!!

Welcome Baby D!!

2008-05-08T20:54:00.000-07:00

Super-duper happy for Franny and Dave as they welcomed Baby D at 2:24 this morning. :) Can't wait to see him! Congrats guys!

Doctor

2008-05-01T21:09:00.001-07:00

Firefly Mama, PhD

I think I like the ring to that.

Defense went well today. First I presented my research in a quick 30-minute seminar, which was followed by a brief Q&A from the public. Then I had 2 hours of grilling from the profs. They excused me for 30 minutes, then brought me back in to shake my hand. Pretty good feeling being part of the club. Finally. Now I'm tired. Got a birth coming up in the next few hours too.

T-minus 6 days

2008-04-25T22:26:00.000-07:00

Life is crazy as I prepare to defend my PhD next Thursday. I can't barely keep up with things. Plus, I attended a marathon 92-hour birth earlier this week (I was only there for 25 of those hours). And I've got another mama due tomorrow too. How did all this stuff end up happening at the same time?

Cool thing this week was picking up my cap and gown. When you become a Dr, they give you very fancy robes.

Honda Odyssey ad

2008-04-16T22:06:00.001-07:00

Merck is evil

2008-04-16T10:46:00.000-07:00

Merck, makers of the infamous Vioxx, as well as a suite of pediatric and adult vaccines, has not only been marketing drugs they knew were dangerous, they've also been covering up death in drug trials and hiring prominent physicians to sign their name on research that Merck was doing in-house (to make it look legit, so it could prove the safety of their drugs). JAMA has been so kind as to allow free access to these two important articles. You can read about ghostwriting here and death cover-ups here.

Sadly, I am not surprised. I would bet all the drug companies are into this practice. It makes me sick though.

For vaccines, Merck makes Varicella, MMR, one of the HepBs, one of the Hibs (which was recently recalled for other problems), the Hib/HepB combo, one of the HepAs, and one of the Pneumococcals. Wonder much foulplay was involved in the studies proving the "safety" of these vaccines...

Sweet rides and happy days

2008-04-11T10:37:00.001-07:00

Picked up the new minivan last night. It is soooooo nice. I'm in love! It feels so big and luxurious compared to our past vehicles. And now today it is GORGEOUS outside, and I got my final comments back from my professor on my dissertation, and he LIKES it! This are looking good today. I think this afternoon we're gonna go out for a joy ride.

Big Blue

2008-04-07T21:35:00.001-07:00

We bought a new car today. :) Got a good deal too...over $1000 under invoice. We get it on Wednesday or Thursday. I can't wait!

Can you find Barack in this picture?

2008-04-07T21:30:00.000-07:00

Barack, I think I love you

2008-03-28T10:04:00.000-07:00

I'm only a week late in sharing this news...but hey, I've been busy lately.

I saw Barack Obama. In person. Not from the nosebleed section at a rally, no. On the street. Shaking hands (he didn't get to mine though). Standing in front of the pizza restaurant (American Dream) I was trying to get into to. I was close enough to see his skim blemishes. Ten feet maybe? He's kinda like a drug...makes you want to do stupid shit for him. I wanted to run up and throw my arms and legs around him in a great big hug, but I was pretty sure my kids would miss me while I spent the night in jail. I can't believe how electrifying I feel in his presence. It is pretty freaky. For the first time, I feel like I understand the power behind some of the major political movements of the past...such as for JFK and RFK. And I think I am beginning to understand how devasting it would be to lose some as strong as say...MLK. I feel it in my heart that Obama will be our next President, but I also can't shake the feeling he will face more than a few assassination attempts. Thankfully, he travels with an army of secret service types. I saw far more of them than I did of him on the street that day. I'd show you my hastily-snapped cell phone pic, but it is a blurry mob of suits, coats, and the backs of people's heads.

Simon's Cat 'Let Me In!'

2008-03-26T23:23:00.003-07:00

More fun with Simon's cat

Simon's Cat 'Cat Man Do'

2008-03-26T23:23:00.001-07:00

Simon has obviously been spying on my cat Terri

Bicycle Awareness Test

2008-03-24T20:49:00.000-07:00

This is just too funny. And it has a point.

May 1st, 2008

2008-03-24T19:18:00.001-07:00

Okay, just kidding in that last post.

I will be defending on Thursday, May 1st. It is official now. I've submitted the paperwork to set things rolling. From 10 am till 1 pm on May 1st, I'll be sweating buckets. Hopefully by 2 pm, I'll have successfully defended my dissertation. Whew.

April 24, 2008

2008-03-23T22:20:00.000-07:00

I will be defending my dissertation on Thursday, April 24, 2008. Time TBA.

I can't freakin' believe this is going to happen. I will then have 15 days to complete all my revisions and turn everything in to the Graduate School.

Then, on Sunday, June 15, I will become Dr. Olsen. hehehehe

She was meant to be a midwife

2008-03-09T11:26:00.000-07:00

SageFemme is definitely in the right profession. Kudos to her for handling a 13 MINUTE shoulder dystocia of a nearly 13 lb baby girl. At home. With no broken bones. And full resuscitation. Oh. My. God.

Baby girl is doing well.

SafeFemme is also an amazing photographer of the births she attends, and has created this gorgeous montage of some of her homebirths. Beware - not for office viewing.

Reality

2008-02-26T20:54:00.000-08:00

As if it weren't obvious, I'm taking a break from blogging for a bit. Life is just too much right now. School and life are taking over. I hope to rejoin the blogging world soon. I'm still around and reading, just saving myself the pressure of feeling I need to make posts.

A great response to ACOG's stupidity

2008-02-08T14:21:00.001-08:00

This is an awesome, honest, and accurate response to ACOG's statement on homebirths.

I couldn't have said it better. And I agree whole-heartedly with her point that ACOG's statement was defensive, insulting, and paternalistic.

Citizens for Midwivery offers facts as talking points

2008-02-08T12:15:00.000-08:00

This is a really nice collection of talking points (in no particular order) from Citizens for Midwifery (CfM):

Twenty-four states license direct entry midwives, several for more than twenty years. Twenty-two use or recognize the Certified Professional Midwife (CPM) credential administered by the North American Registry of Midwives (NARM) as the basis for licensing, and two states have voluntary licensing. In all theseyears, no state has repealed their midwifery law for any reason. Furthermore, in 9 states licensed midwives receive Medicaid reimbursement for their services. These records demonstrate that CPMs do not pose any threat to the health and safety of pregnant women and newborns.
An economic analysis of the cost benefits of a licensed midwife program (Washington State) indicate that the cost savings to the health care system (public and private) is estimated to be ten times the cost of the program, even with this licensing program being the most expensive in the country. (Midwifery Licensure and Discipline Program in Washington State: Economic Costs and Benefits, (A report to the Washington Department of Health), Health Management Associates, October, 2007)
Contrary to ACOG’s uninformed assertion, many rigorous scientific studies, published in leading medical journals, have found that for a healthy woman having a normal pregnancy, a planned, midwife-attended home birth is as safe as a hospital birth and with far lower rates of medical interventions. The most recent is also the largest study, based on prospective reporting for all the births attended by Certified Professional Midwives in 2000, published in 2005 in the British Medical Journal . ("Outcomes of planned home births with certified professional midwives: large prospective study in North America." Kenneth C Johnson, senior epidemiologist, Betty-Anne Daviss, project manager. BMJ 2005;330:1416 (18 June). Also see CfM’s summary fact sheet.
About 99% of births in the US take place in hospitals. If standard obstetric practice is so good, why does the US rank so abysmally when it comes to maternal mortality and neonatal mortality?
The Complete Mothers’ Index 2007 shows that mothers in the US have a higher lifetime risk of maternal mortality than the mothers in 27 other developed countries.
The World Health Report (from the World Health Organization) indicates that the neonatal death rate (death in the first 28 days of life) is greater in the United States than in 35 other countries.
ACOG claims that "complications can arise with little or no warning even among women with low-risk pregnancies". However, complications seen in low-risk women laboring in hospitals are often related to the many routine practices and interventions that disturb the birth process and cause or lead to complications and more interventions. In fact, most of these practices were adopted without being studied for safety, and many are still routine even after being studied and found to be either worthless or harmful or both. (Enkin et al. A Guide to Effective Care in Pregnancy and Childbirth) Midwives attending home births avoid unnecessary interventions and the use of drugs, allowing normal birth to proceed. They are trained and experienced in noticing any signs of problems and taking appropriate action, including transfer to medical care in a hospital when necessary, which is rarely. (see the BMJ article cited above)
The press release states "ACOG acknowledges a woman’s right to make informed decisions regarding her delivery…" but goes on to say that ACOG does not support any of the alternatives to a doctor-controlled birth in hospital or birth center, or anyone who provide or supports home birth. So how is ACOG supporting informed decisions?
ACOG claims that an "emerging contributor" to the rise in cesarean section rates is "maternal choice." However, there is no evidence for this claim. In fact, recent surveys of mothers found that less than 0.08% of pregnant women request a C-section. Applying these numbers to a recent figure for annual births, a scant 2,600 out of 4.1 million pregnant women actually requested a C-section. (Declercq ER, Sakala C, Corry MP, Applebaum S. Listening to Mothers II: Report of the Second National U.S. Survey of Women’s Childbearing Experiences. New York: Childbirth Connection, October 2006.) Clearly, this number is so small it could not possibly explain the doubling of cesarean section rates in the last decade. Furthermore, when he was President of ACOG, Benjamin Harer publicly promoted maternal choice cesarean sections on popular TV news and talk shows, for reasons for which there was not evidence. (for example: Benjamin Harer on Good Morning America, 2000. Having actively worked to create a market for cesarean sections for no medical reason, based on lies and misinformation, ACOG is now blaming women for the increased cesarean rate??
When attending births outside the hospital, both Certified Nurse Midwives and Certified Professional Midwives referred fewer than 5% of mothers for cesarean sections, while obstetricians were performing cesarean sections on nearly 20% of low risk mothers in hospitals. (see CfM fact sheet with references)
Some women are going to choose to deliver their baby at home, for a variety of very legitimate religious, social, health or economic reasons. These women deserve to have the best care available the care of a well-trained midwife with experience in out-of-hospital settings. (Firefly Mama thinks this is the most important point!)
While ACOG states that childbirth is a normal physiologic process, today’s obstetrical profession performs cesarean sections for nearly one third of births, induces labor in nearly half of births, and administers drugs of one kind or another to more than two thirds drugs that pass through the placenta and harm the baby. In fact, almost the only women who give birth with no interventions are those who give birth at home. (Listening to Mothers: Report of the First National U.S. Survey of Women’s Childbearing Experiences. New York: Maternity Center Association, October 2002.)
Apparently obstetricians are not trained to support normal birth, but oppose the very health care providers who are: midwives who are trained and experienced in attending births outside the hospital. The Certified Professional Midwife credential is the only maternity are credential that requires experience in out-of- hospital settings.

Childbirth Connection addresses ACOG's policy

2008-02-08T12:01:00.000-08:00

From Childbirth Connection:

ACOG Place of Birth Policies Limit Women's Choices Without Justification and Contrary to the Evidence

In October 2006, the American College of Obstetricians and Gynecologists (ACOG) released a Statement of Policy on "Out-of-Hospital Births in the United States." Following feedback from ACOG members and from Childbirth Connection and many other concerned organizations, ACOG issued a revised Statement of Policy on "Home Births in the United States" in May 2007. This Alert and Response describes Childbirth Connection's concerns with the statements and their implications for mothers and babies.

What place of birth policy did ACOG set in "Out-of-Hospital Births in the United States" (October 2006)?
The earlier statement asserted that "studies comparing the safety and outcome of U.S. births in the hospital with those occurring in other settings are limited and have not been scientifically rigorous." ACOG also claimed that the hospital "is the safest setting for labor, delivery, and the immediate postpartum period." Consequently, it concluded, ACOG "strongly opposes out-of-hospital births" and "does not support programs or individuals that advocate for or who provide out-of-hospital births." However, the statement failed to cite any evidence to support the assertions and failed to acknowledge impressive existing evidence regarding the safety of planned home birth and out-of-hospital birth center birth.

What place of birth policy did ACOG set in its revised statement, "Home Births in the United States" (May 2007)?
The revised statement was identical to the previous statement with the exception of limiting the focus to home births rather than to all out-of-hospital births and acknowledging the safety of birth in out-of-hospital birth centers that meet standards of relevant accreditation organizations. The revised statement concluded by stating that "ACOG strongly opposes home births" and "does not support programs or individuals that advocate for or who provide home births." Again, no study was cited to support this position, and existing research in support of planned home birth was overlooked.

What was the response to the earlier statement?
Some ACOG members objected to the policy, and numerous organizations submitted letters of concern and posted the letters online. These included American Association of Birth Centers, American College of Nurse-Midwives, Consumers United for Evidence-based Healthcare, Lamaze International, and White Ribbon Alliance for Safe Motherhood. In addition, Childbirth Connection and other consumer advocacy organizations together sent a letter identifying special concerns from a consumer perspective. Joining together with Childbirth Connection were Center for Medical Consumers; National Partnership for Women and Families; National Women's Health Network; and Our Bodies, Ourselves, as well as the Executive Director of Families U.S.A. signing as an individual. In general, the letters asked ACOG leaders to review the policy in light of the plethora of high-quality scientific evidence supporting the safety of planned out-of-hospital birth.

What were the major concerns of the consumer groups?
The joint letter from organizations writing from the perspective of best interests of mothers and babies expressed several concerns. First, the groups were troubled that the policy would undermine women's choices and legal right to informed consent about where to give birth and noted that ACOG's own document, Ethics in Obstetrics and Gynecology (2004), strongly supports women's right to informed consent.

Moreover, the groups were troubled by the complete lack of evidence to support the statement's assertions and its failure to acknowledge impressive existing evidence. With respect to home birth, they noted a large prospective study of 5,418 American women planning home births with Certified Professional Midwives (Johnson and Daviss 2005), and a systematic review of home birth (Olsen 1997). With respect to birth in out-of-hospital birth centers, they pointed to the large prospective National Birth Center Study of 11,814 mothers who began labor in out-of-hospital birth centers (Rooks et al. 1989) and a systematic review of care in out-of-hospital birth centers (Walsh and Downe 2004). Notably, both of the large studies achieved 4% c-section rates whereas about one mother in three now gives birth by major surgery in the United States. All four studies found very low rates of many widely used obstetric interventions and no sign that the settings or conservative use of obstetrical procedures involved extra risk when out-of-hospital births were compared with low-risk women giving birth in hospitals. The systematic reviews concluded that there is no a priori basis for denying planned out-of-hospital birth. The large prospective studies were published in the most prestigious general medical journals, New England Journal of Medicine and BMJ.

The letter from the consumer groups also pointed out that in rejecting the strong available evidence ACOG displayed a double standard. The letter referenced an analysis of ACOG's recent obstetric practice recommendations that found that just 23% are Level A, that is, "based on good and consistent scientific evidence," whereas 35% are Level B -- "based on limited or inconsistent scientific evidence," and fully 43% are Level C, "based primarily on consensus and expert opinion" (Chauhan et al. 2005). In evidence-based medicine, expert opinion when not backed by sound research is the lowest and least reliable level of evidence (Oxford University 2001). Despite the weak scientific evidence for over three-quarters of ACOG’s professional practice recommendations, some obstetricians feel that they are vulnerable to malpractice claims and suits if they deviate from ACOG policies, and recent research supports this (Ransom et al. 2003). Finally, the letter to ACOG from the consumer groups pointed out that the policy endangers the health and well being of mothers and babies in two ways. First, in opposing those who support out-of-hospital birth, ACOG could jeopardize appropriate physician back-up for the considerable number of women who will continue to choose out-of-hospital births. All health professionals need to be able to call on other health professionals for specialized services that are beyond their expertise and scope of practice. Obstruction of such professional collaboration jeopardizes the welfare of mothers and babies and is of grave concern. Second, in taking the position that all women should give birth in hospitals, the statement would consign low-risk women to the high rates of invasive procedures and other interventions that are now the norm in U.S. hospitals, as measured in Childbirth Connection’s Listening to Mothers II survey (Declercq et al. 2006).

Did the revised policy statement address concerns of the consumer groups?
The revised policy statement reflects the best available evidence about planned birth in out-of-hospital birth centers, but continues to reject home birth without justification and contrary to the best evidence. After describing results of the best available research and concern about typical maternity care in U.S. hospitals, the consumer groups wrote:

"These major [out-of-hospital] studies set a standard for what is attainable among healthy low-risk pregnant women in North America and raise troubling questions about current practice trends. Care in these settings should be emulated rather than denigrated."

Another available research review is consistent with the studies and systematic reviews cited above: Stotland and Declercq (2002).The current ACOG policy statement about place of birth continues to raise troubling questions about: current standards of maternity care in the United States, ACOG's disregard for best available evidence, and ACOG's infringement on rights of childbearing women.

References:

American College of Obstetricians and Gynecologists. Ethics in Obstetrics and Gynecology, 2nd ed. Washington, DC: ACOG, 2004.

American College of Obstetricians and Gynecologists Executive Board. ACOG Statement of Policy: Home births in the United States. Washington, DC: ACOG, May 2007.

American College of Obstetricians and Gynecologists Executive Board. ACOG Statement of Policy: Out-of-Hospital Births in the United States. Washington, DC: ACOG, October 2006.

Chauhan SP, Berghella V, Sanderson M, Magann EF, Morrison JC. American College of Obstetricians and Gynecologists practice bulletins: An overview. American Journal of Obstetrics and Gynecology 2006;194:1564-75.

Declercq ER, Sakala C, Corry MP, Applebaum S. Listening to Mothers II: Report of the Second National U.S. Survey of Women's Childbearing Experiences. New York: Childbirth Connection, October 2006.

Johnson KE, Daviss B-A. Outcomes of planned home births with Certified Professional Midwives: Large prospective study in North America. BMJ 2005;330:1416.

Olsen O. Meta-analysis of the safety of home birth. Birth 1997;24:4-16.Oxford University, Centre for Evidence-Based Medicine.

Oxford Centre for Evidence-Based Medicine levels of evidence, 2001. Available at http://www.cebm.net/index.aspx?o=1025 (accessed June 20, 2007).

Ransom SB, Studdert DM, Dombrowski MP, Mello MM, Brennan TA. Reduced medicolegal risk by compliance with obstetrical clinical pathways: A case-control study. Obstetrics & Gynecology 2003;101:751-5.

Rooks JP, Weatherby NL, Ernst EK, Stapleton S, Rosen D, Rosenfield A. Outcomes of care in birth centers: The National Birth Center Study. New England Journal of Medicine 1989;321(26):1804-11.

Stotland NE, Declercq ER. Safety of out-of-hospital birth in industrialized nations: A review. Current Problems in Obstetrics, Gynecology and Fertility 2002;25:134-44.

Walsh D, Downe SM. Outcomes of free-standing, midwife-led birth centers: A structured review. Birth 2004;31:222-9.

ICAN responds

2008-02-08T11:54:00.000-08:00

ICAN’s Response to ACOG AND AABC Statements on VBAC and Homebirth
Redondo Beach, CA, February 7, 2008:

The International Cesarean Awareness Network would like to publicly condemn both the AABC (American Association of Birth Centers) and the ACOG (The American College of Obstetricians and Gynecologists) for their statements this week that limit not only women’s choices in birth but imply that birth is a fashion trend rather than a safety concern.

Since VBAC is the biological normal outcome of a pregnancy after cesarean, ICAN encourages women to get all of the facts about vaginal birth and elective repeat cesarean before making a choice. This decision should not include weighing the choices of your doctor’s malpractice payments but only be a concern of the mother, her baby and their health and safety.

Since some mothers will make the choice to give birth outside of the hospital, we encourage the AABC to not cave into ACOG’s demands that all women give birth in a hospital facility with a surgical specialist, but instead allow women to make their own choices about care providers, birth settings and risk factors. ICAN respects the intelligence of modern women and accepts that the amount of information available about VBAC and elective cesarean should serve as informed consent.

ICAN further encourages the governments of individual states to look closely at their cesarean rates (31.1% national cesarean rate as of 2006) and the informed consent laws that apply and help women to reach a standard of care that lowers the risks of major surgery and the risks of elective or coerced cesarean without medical indication. Women and children should not bear the brunt of malpractice risks being conveyed into physical, mental, emotional and spiritual health risks in order to protect their physicians.

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. There are more than 94 ICAN Chapters across North America, which hold educational and support meetings for people interested in cesarean prevention and recovery.

AABC statement

ACOG statement

Big Push for Midwives fights back

2008-02-07T16:00:00.000-08:00

This is the first (of many, I'm sure) responses to ACOG's statement.

PushNews from The Big Push for Midwives Campaign
CONTACT: Steff Hedenkamp, (816) 506-4630, RedQuill@kc.rr.com
FOR IMMEDIATE RELEASE: Thursday, February 7, 2008

ACOG: Out of Touch with Needs of Childbearing Families

Trade Union claims out-of-hospital birth is “trendy;” tries to play the “bad mother” card

(February 7, 2008) — The American College of Obstetricians and Gynecologists (ACOG), a trade union representing the financial and professional interests of obstetricians, has issued the latest in a series of statements condemning families who choose home birth and calling on policy makers to deny them access to Certified Professional Midwives. CPMs are trained as experts in out-of-hospital delivery and as specialists in risk assessment and preventative care.

“It will certainly come as news to the Amish and other groups in this country who have long chosen home birth that they’re simply being ‘trendy’ or ‘fashionable,’” said Katie Prown, PhD, Campaign Manager of The Big Push for Midwives 2008. “The fact is, families deliver their babies at home for a variety of very valid reasons, either because they’re exercising their religious freedom, following their cultural traditions or because of financial need. These families deserve access to safe, quality and affordable maternity care, just like everyone else.”

Besides referring to home birth as a fashionable “trend” and a “cause célèbre” that families choose out of ignorance, ACOG’s latest statement adds insult to injury by claiming that women delivering outside of the hospital are bad mothers who value the childbirth “experience” over the safety of their babies.

“ACOG has it backwards,” said Steff Hedenkamp, Communications Coordinator of The Big Push and the mother of two children born at home. “I delivered my babies with a trained, skilled professional midwife because I wanted the safest out-of-hospital care possible. If every state were to follow ACOG’s recommendations and outlaw CPMs, families who choose home birth will be left with no care providers at all. I think we can all agree that this is an irresponsible policy that puts mothers and babies at risk.”

The Big Push for Midwives calls on ACOG to abandon these outdated policies and work with CPMs to reduce the cesarean rate and to take meaningful steps towards reducing racial and ethnic disparities in birth outcomes in all regions of the United States. CPMs play a critical role in both cesarean prevention and in the reduction of low-birth weight and pre-term births, the two most preventable causes of neonatal mortality.

Moreover, their training as specialists in out-of-hospital maternity care qualifies CPMs as essential firstresponders during disasters in which hospitals become inaccessible or unsafe for laboring mothers. In addition, CPMs work to ensure that all babies born outside of the hospital undergo state-mandated newborn screenings and are provided with legal and secure birth certificates.

Currently, Certified Nurse-Midwives, who work predominantly in hospital settings, are licensed and regulated in all 50 states, while Certified Professional Midwives, who work in out-of-hospital settings, are licensed and regulated in 24 states, with legislation pending in an additional 20 states.

The Big Push for Midwives (http://www.TheBigPushforMidwives.org) is a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care.

Media inquiries should be directed to Steff Hedenkamp (816) 506-4630, RedQuill@kc.rr.com.

ACOG declares war

2008-02-07T13:58:00.000-08:00

The American College of Obstetricians and Gynecologists (ACOG) has declared war against all non-nurse midwives and homebirth. We've known their stance on the issue, but now it is public and in a press release. And, they've tossed in a number of lies to help make their point.

Deep down, I really do believe that someday they will be sorry they fought so hard for inferior care.

The full text of the press release:

ACOG NEWS RELEASE
For Release:
February 6, 2008
Contact:
ACOG Office of Communications
(202) 484-3321
communications@acog.org

ACOG Statement on Home Births

Washington, DC -- The American College of Obstetricians and Gynecologists (ACOG) reiterates its long-standing opposition to home births. While childbirth is a normal physiologic process that most women experience without problems, monitoring of both the woman and the fetus during labor and delivery in a hospital or accredited birthing center is essential because complications can arise with little or no warning even among women with low-risk pregnancies.

ACOG acknowledges a woman's right to make informed decisions regarding her delivery and to have a choice in choosing her health care provider, but ACOG does not support programs that advocate for, or individuals who provide, home births. Nor does ACOG support the provision of care by midwives who are not certified by the American College of Nurse-Midwives (ACNM) or the American Midwifery Certification Board (AMCB).

Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre. Despite the rosy picture painted by home birth advocates, a seemingly normal labor and delivery can quickly become life-threatening for both the mother and baby. Attempting a vaginal birth after cesarean (VBAC) at home is especially dangerous because if the uterus ruptures during labor, both the mother and baby face an emergency situation with potentially catastrophic consequences, including death. Unless a woman is in a hospital, an accredited freestanding birthing center, or a birthing center within a hospital complex, with physicians ready to intervene quickly if necessary, she puts herself and her baby's health and life at unnecessary risk.

Advocates cite the high US cesarean rate as one justification for promoting home births. The cesarean delivery rate has concerned ACOG for the past several decades and ACOG remains committed to reducing it, but there is no scientific way to recommend an 'ideal' national cesarean rate as a target goal. In 2000, ACOG issued its Task Force Report Evaluation of Cesarean Delivery to assist physicians and institutions in assessing and reducing, if necessary, their cesarean delivery rates. Multiple factors are responsible for the current cesarean rate, but emerging contributors include maternal choice and the rising tide of high-risk pregnancies due to maternal age, overweight, obesity and diabetes.

The availability of an obstetrician-gynecologist to provide expertise and intervention in an emergency during labor and/or delivery may be life-saving for the mother or newborn and lower the likelihood of a bad outcome. ACOG believes that the safest setting for labor, delivery, and the immediate postpartum period is in the hospital, or a birthing center within a hospital complex, that meets the standards jointly outlined by the American Academy of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers.

It should be emphasized that studies comparing the safety and outcome of births in hospitals with those occurring in other settings in the US are limited and have not been scientifically rigorous. Moreover, lay or other midwives attending to home births are unable to perform live-saving emergency cesarean deliveries and other surgical and medical procedures that would best safeguard the mother and child.

ACOG encourages all pregnant women to get prenatal care and to make a birth plan. The main goal should be a healthy and safe outcome for both mother and baby. Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby. For women who choose a midwife to help deliver their baby, it is critical that they choose only ACNM-certified or AMCB-certified midwives that collaborate with a physician to deliver their baby in a hospital, hospital-based birthing center, or properly accredited freestanding birth center.

# # #

The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.

Democrats

2008-02-06T09:32:00.000-08:00

So I couldn't have been more wrong. I really thought we were going to see a clear leader after yesterday's elections. I thought it was going to be Obama. But alas, he's trailing just a little right now. I can't believe how close this is. I both love it, and hate it, as I fear it will cause voters who are currently rooting for the eventual loser to have difficulty voting for the candidate in the general election. I hope I'm wrong. Anyway, I've got my ear glued to the news and can't wait for the next round of elections (Saturday we have Washington, Nebraska, and Louisiana for the Dems). Oregon's election isn't until May 20th. I've been assured that by that time, we'll know who the candidate will be.

Updates

2008-02-05T15:31:00.000-08:00

I haven't posted in a while. I know. I think my blog is going to suffer a little in the coming months as I near the end of my school career. My stress and anxiety are just overwhelming sometimes, and it leaves me wanting to lurk more than post on the internet. So I will try to speak up when I can, but know that if I'm MIA, its cause I'm buuuuuuuuusy.

So updates...

Last weekend I attended Neonatal Resuscitation Program with Karen Strange, and it was an AMAZING class. We learned far more than just resuscitation of newborns. We learned about newborn physiology and some techniques to encourage a peaceful transition from intrauterine to extrauterine life. And, I got to meet Sage Femme, someone I've admired for a while and hope to interact with more frequently.

Alder is coming up on 9 months now. He still isn't crawling, and has no teeth. He's been on the verge of crawling for about 2 months, so I'm starting to wonder if he'll skip crawling all together. He's doing okay with standing if propped up in that position.

The life-after-school question is still up in the air. A big job came up but I've decided to pass because it is: 1) in Eugene, 2) full-time, and 3) research focused, and I want none of these things. My advisor has remained noncommital about whether I can work for him after graduation, so I'm starting to assume that means no. He's sending some hints that it is no, though I think if he really KNEW it was no, he'd just tell me no. Anyway, I'm definitely not counting on that. Right now I'm excited about developing my doula and childbirth education business, and possibly getting the opportunity to do some assisting at homebirths in the near future (Pssst...any area MWs reading this...I'm available!).

School is coming along, but pissing me off too. I'm still revising my final chapter, and time just keeps passing. My advisor is being tough on some of the revisions, so we aren't setting a defense date yet. Now it looks like I may stray into spring term. If so, at least my advisor has offered to pay me (a teeny, tiny amount) for spring term too. But dammit, I gotta finish!!

What else...

We got a new tv today. (grin) Finally...my piece o' junk tv can be retired, in favor of the nice, new, CLEAR imagine of our LCD flatscreen. As a LOST junkie, I can't wait to see my favorite characters on the big screen.

I've been doing a draft of our taxes, and it looks like we're going to get quite a little refund this year. Thank goodness...cause we're shopping for a minivan this summer and need more for that downpayment.

Not much else really. Just busy...and stressed.

Super Duper Tuesday!!!

2008-02-05T15:22:00.000-08:00

You can taste the electricity in the air. There is no voting in Oregon today, but most everyone I know will be tuning in tonight to hear the results of the various caucuses and primaries. I'm really feeling like we will have a clear leader in the Democratic race after today. And because I feel the country just HAS HAS HAS to swing to the Dems this year, I feel that the leader after today will be our new President come 2009.

So who do I want? Well, my first choice was Kucinich. I've always matched very well with his politics and am sad he'll never have a real shot at getting elected. Between Clinton and Obama, I'm quite torn. They aren't terribly different in policies. Each has some strong qualities they could bring to the Office. I've always wanted a woman in office, and I've always wanted an African-American in office. I can't believe we have to choose. When it comes down to it, I feel Obama is more electable and has a better shot against McCain. So in interest of getting a Dem in the Office in '09, I am hoping Obama is the leader after tonight.

Penny and Me

2008-01-27T21:14:00.000-08:00

I had a FABULOUS time in Seattle at Penny Simkin's workshop on attending laboring mothers who've experienced early childhood sexual abuse or previous birth trauma. It was really phenomenal, and should be required training for all birth attendants. Among the attendees was Karen Strange, CPM, instructor for neonatal resuscitation program, which she's teaching in Corvallis in a week. I'll be in on that class too.

More soon. I've got some catching up to do at home. It was a long 2.5 days away from the kids.

Busy

2008-01-23T09:42:00.001-08:00

Sorry...I know I've been slacking about posting lately. And I feel like there has been a lot going on to post about...but I'm just not finding the time. I'm racing to finish this dissertation. I'm battling a little cold right now. I've had doula engagements right and left lately (fun meeting with doulas in neighboring town, interview, prenatal, book club, etc). Tomorrow I head to Seattle Midwifery School to take a class from Penny Simkin on working with moms who are sexual abuse and birth trauma survivors. I just decided I'm going for childbirth educator training in March. And I'm trying to figure out what happens after my last paycheck. SO yeah, just a lot going on lately. Oh, and I've been hanging out a lot with a friend who is 5 days overdue now. She's trying to be patient, but is not a happy camper at the moment.

Anyway, hope to be back to more regular posting soon. Will certainly try to blog about Seattle, cause it will be awesome.

Freaking out

2008-01-20T21:37:00.000-08:00

The end of my life in school is near, and it has me thinking constantly about what I will do next. If all goes well, I'll be defending my dissertation in as little as six weeks. My last (little tiny) paycheck as a graduate research assistant comes at the end of March. Then what? The answer is...I still don't know. My advisor may have work for me. I've asked him about it in the past, but he's been unwilling to discuss it until we knew when I would finally finish the degree. I think we could discuss it now...I just need to get up the guts. There is also a chance he won't have anything for me, as I recently learned he hired another friend (who is significantly cheaper than I would be). If I can't work for him, then what? Perhaps another professor will have work, but it is unlikely. Ideally I'd like 10-20 hours per week and I don't really need benefits, so I'm really not THAT expensive, but my field is not funded as much as it should be.

If I don't work at school, then I really don't know what I'd do. Stay home with the kids while I search for something else? I'd like to avoid pulling the kids out of daycare if I can help it, as it was hard enough to get them in that place. I definitely don't want something full-time, and it shouldn't be too permanent, as we plan on me needing another maternity leave or two in the next couple of years. I've been browsing tenure-track faculty positions around the country, and a few things have caught my eye. But I'm just not ready for that yet. I hope I can find something come spring though. I like to have my mind challenged a few hours a week, by something other than playing Scrabble I mean.

Best Thai food ever...in America

2008-01-16T10:45:00.000-08:00

What do you think? Does this look like an exquisite Thai dining establishment? It is called "The Woodsman" if you can't read that sign, and apparently they have fried chicken on Wednesday nights. It is in the thriving metropolis of Philomath (population ~4,000). It looks like a bar. It has a bar, and they serve Coors Light (among other things). It is decorated in chainsaws and cross saws and pictures of large trees that were cut down. And it is the best darn Thai food I've had since being in Thailand. We ventured there last night for a belated birthday dinner sans kids (thank you in-laws!) after getting a tip from a friend that we might find good Thai food there. Wow. What a great jewel to find right under our noses.

Doula meeting

2008-01-16T10:07:00.000-08:00

Night before last I attended our monthly doula meeting here, and it was a really great night. We alternate locations for the meetings, and this time it was at our hospital in one of the L&D rooms. We always extend the invitation to the L&D nurses, CNMs, and OBs, but have had few attend before (and no OBs). This time we had an L&D nurse (who is also a doula), a homebirth midwife and her assistant, a CNM, and an OB! It was awesome! Feedback continues to be very positive for doulas in our community, though most of us are working far less than we would like. In fact, there has been a significant lull in business lately for everyone, with some of the women having no births since early last summer. We are working on more marketing and getting ourselves out there.

In other doula news, I have one client due in April. I recently had an interview for one due in February, which I was secretly hoping I wouldn't get because it just feels like too much on my plate with finishing school and all. So I didn't get them, but they chose me as back-up. Perfect! I also had a contact about someone due in March, but referred them to other doulas because I don't want to take a birth on during the same month I think I will be defending. Beyond April, I have nothing though there are two hopefuls in May. Hoping to get some more births lined up.

Night pottying update

2008-01-16T10:02:00.000-08:00

Definitely NOT NOT NOT done with diapers here, at least at night. Ava did well for the start of the night, getting up to pee a half-dozen times. But once she is asleep, she has difficulty waking enough to get up and make it to the bathroom before peeing. I heard her up in the bathroom at 2:30 am, so I went to check on things. She was cold and wet, as was the bed, so she'd obviously peed sometime earlier in the night. At that point I just pulled the wet stuff off the bed (had clean, dry sheets underneath), changed her pjs, and put a new diaper on her (with no protests this time). And last night she didn't protest at all either. I think she knows she isn't ready to go diaper-less at night.

Nap training continues to go well though. Yesterday she kept her bed dry by managing to get up after waking and walking all the way into the bathroom before letting lose. So she soaked her pants, but at least it wasn't the bed. I was proud she woke up and got up before going. That is a huge forward step. :)

The Business of Being Born comes to Corvallis

2008-01-14T22:43:00.000-08:00

Ricki Lake's wonderful film, The Business of Being Born, will be playing in Corvallis as part of V-week on Wednesday, February 13th from 4-6 pm on the OSU campus in the MU Main Lounge. There will be a panel Q&A afterwards with a homebirth midwife, a certified nurse midwife, an OB (hopefully), an RN, a birth doula, a postpartum doula, and a family doctor. Vagina Monologues goes on stage in LaSalles Stewart that night from 7-9, and again the next night (V-Day) too. There will be several other events that week as well. Sounds like it is going to great fun!

Goodbye to diapers?

2008-01-14T22:40:00.000-08:00

One certain not-yet-2.5-year-old refused to put on a diaper at bedtime tonight. FLAT OUT REFUSED. Hmmm... She's very well trained during the day. We're working on naptime, and she doesn't wear a diaper then anymore (but still has accidents maybe 50% of the time). But this was a first at night. I didn't think we'd tackle night training for a while. We'll have to see how this works out. I'm fairly certain she's going to be soaked at some point in the middle of the night, and again in the morning if she still refuses a diaper after getting changes. But maybe she'll surprise me.

Hysterectomy and cesareans

2008-01-13T10:58:00.000-08:00

More bad news about cesareans: moms who've been cut are more likely to lose their wombs in future pregnancies. Ouch!

With all the negative outcomes that research has recently linked to cesareans, I just can't fathom HOW the cesarean rate continues to climb. The liability argument just doesn't fly for me anymore if the surgery just increases all these risks.

Thanks to Doulicia for pointing out this new information.

Happy Birthday to me!

2008-01-10T12:17:00.000-08:00

Today I turn 32. It has been a low key day really. I slept moderately last night. This morning I took the kids to daycare, as usual. Then I went to the gym. I was bummed I didn't get on my favorite machine, but it felt good to move my body regardless. Then I came home, played some Scrabulous, and took a loooooong shower. Then I got Keith for a lunch date. We enjoyed pizza slices from a new restaurant here in Corvallis that has the closest thing I've tasted to REAL New York pizza. We also dropped in a framing shop to get a painting framed that used to hang in my aunt's home (the one who died 2 months ago). Getting the painting professionaly framed is my birthday present (plus the awesome massage that I got yesterday). Then I took Keith back to work and went to a movie. BY MYSELF. I've never done that before, and it was pretty awesome. I love going to the movies. I need to do that more often. I saw I AM LEGEND and boy...it was spooky. As someone trained in the biological sciences, the concept of a super-virus (that we engineered, no less) wiping out the human population is pretty terrifying. And now, I'm home and relaxing with the kids. I'm going to pick something yummy for Keith to pick-up for dinner (Indian maybe?) and then I'm going to start baking my birthday cake, which will be shared this weekend when some friends come over to celebrate.

Yeah, it has been a pretty nice day. 32 feels a little different than 31 because I can vididly remember when my Mom was 32 (I was 10) and she seemed old. Guess I'm getting up there.

Waterbirth International needs to stay alive!

2008-01-09T22:01:00.000-08:00

Please help Barbara Harper keep waterbirth alive

Waterbirth International may close doors. Here is a note from Barbara Harper of Waterbirth International

Barbara Harper wrote: I cannot yet imagine a world without the voice and work of Waterbirth International - we get calls and emails every day from women who need help convincing one hospital or another to let them labor or birth in water. If we die - a big part of the movement dies. Waterbirth has shown us all that women know how to give birth and babies know how to be born. Waterbirth gave us "hands-off", sit back and let the baby out. I see waterbirth mentioned on Blogs every single day, not to mention Baby Story on the TV. I took Waterbirth International to ACOG two years in a row - and was the ONLY booth showing birth films to obstetricians and especially to student physicians. There were tears, laughter and outrage - just the thing to stir up those young crop of doctors. I am finally realizing a life's dream. But now I am faced with letting this dream go. Perhaps I have done enough. Perhaps it is time to quit.

About 18 years ago, maybe it was longer, when Mothering Magazine was facing bankruptcy Peggy did a heartfelt plea asking their readers to consider ordering a Life-time subscription. I think the subscriptions were $1000 or $1200, I can't remember now. I do remember that I couldn't imagine not reading my Mothering. So, I bought two and gave one to my obstetrician's office. How can you help us stay open to take the next phone call? - to convince the next obstetrician to incorporate waterbirth into his/her practice - to work with the nurse midwives to install pools in their facilities? To educate an entire hospital on the benefits of allowing women freedom of movement in the water. How much is it worth to see waterbirth become the norm in the US, like it is in the UK? I think we only need a few more years to make that happen. Do women really want waterbirth to be an available choice in every hospital? I think so.

Can you help us by getting the word out on blogs and lists? I had to let go of all of the staff except one person to process orders. Miraculously, we made payroll today, but we can't hang on much longer. We need a miracle. If I need to call every single waterbirth parent personally, I will. I don't want 25 years of work to end over a measly $200,000. The work that we have done the last few years has been phenomenal. How God arranged for me to teach in hospitals and medical schools around the planet - Taiwan, Venezuela, Turkey, Mexico, Canada, Holland, Portugal, China, Trinidad, Croatia - I'll never figure that out. I laugh out loud sometimes when I get up in front of an audience of physicians in a medical school overseas - who all want to hear about waterbirth and the incorporation of Gentle Birth practices and principles into their routines. Think about what you can do and call me if you want to chat or if you have some great ideas on how we can quickly move into the black and keep waterbirth alive and thriving. We need your help. Barbara Harper needs your help. The waterbirth/gentlebirth movement needs your help.

Blessings,

Barbara

Barbara Harper, RN, CLD, CCE Founder/Director Waterbirth International
www.waterbirth.org
503-673-0026 - office (out of US or in Portland)
800-641-2229 - toll free
503-710-7975 - cell phone

We LOVE helping women get into Hot Water!! And have been doing it for 24 years!!

Mama!

2008-01-08T20:44:00.001-08:00

Alder's first word: Mama. He's not even 8 months old, but it is crystal clear that he is trying to talk to me. It sounds more like mamamamammaamammama, but he ONLY does it when he WANTS me and it is really obvious he's trying to get me to come pick him up. If Keith picks him up instead, he continues to say mamamamama. I just love it. Ava wasn't identifyably saying mama until like 12-14 months, so this just really speaks to my heart.

Yep, Alder is a mama's boy.

"I don't want to!"

2008-01-08T20:38:00.000-08:00

This is how my 2.5-year old says NO. We rarely ever hear the word NO around here. Is that weird? A toddler-near-preschooler who doesn't say NO? "I don't want to!" I absolutely love the way she says this. It sounds so polite, so mature (at least compared to screaming NO!). Ask her if she wants toast for dinner and she says, "I don't want to." I have no clue how we grew a child who doesn't say NO, but I love it and hope Alder follows in her footsteps.

Year in review

2008-01-06T11:21:00.000-08:00

My buddy Amanda did a year in review like this, and I like the idea so much I'm stealing it for myself.

2008 In Review

January - I was 4-5 months pregnant and I turned 31. Keith and I rented a yurt for the weekend to celebrate and went there ALONE. As in, Ava stayed home with Grandma and Grandpa. It was a first, and it went really well. We also (on my birthday) learned that we were going to be having a little boy. And, though a strange twist of fate involving the death of a friend's dog, we realized this little boy would be named Alder.

February - One of my very dear friends committed suicide. This was a hard blow and to this day, I still see her ghost ALL OVER campus. We were workout buddies so her presence is especially strong in the gym. I missed her memorial service because we (the family) flew to Virginia to visit my folks during this time. We all got extremely sick the second we stepped off the plane, so the entire week-long visit was spent just trying to survive. Ava met my Grandmother for the first (and probably last) time, though she was in a feverish haze and probably had no idea what was going on.

March - Sinus infection hell for me. I finally give in to antiobiotics - something I prefer to avoid when pregnant (well, I prefer to avoid them at all times actually). I finished my final term as a full-time student (because it was the last term I had an assistantship for). I attended an awesome birth for a dear friend.

April - I'm writing writing writing and trying to finish as much of my dissertation as possible before the baby comes. This is the final month we have Ava in daycare as well. The house gets rearranged in prep for the new baby. Keith turns 35 and I throw him a party, despite feeling like a giant whale with my growing belly. We decide to tile the backsplash in the kitchen as one list big project before life gets crazier.

May - We spend Cinco de Mayo in a yurt on the coast when I am 36 weeks pregnant. It is not the most comfortable experience of my life. Ava loves the beach, as always. My Blessingway happens on Mother's Day at 37 weeks pregnant. Five days later, Alder comes blasting into the world. It was a fantastic birth and is the highlight of the year.

June - My parents come visit to meet their new grandson. It is wonderful to have them here to help with the kids. Most of the month passes in a blur as we adjust to living as a family of four.

July - Ava potty trains at just under two years old. We brave the wilds on a camping trip WITH BOTH KIDS to Sunset Bay. It was tiring, but fun. Ava looooooooves camping. Ava turns two at the end of the month and bawls at the candle smoking on her cake.

August - I get myself back at school more frequently now, back on the track to finishing. My wonderfully generous in-laws agree to watch both kids for half-days three times a week. Wow. I attend a surprise premature birth on the very same night Alder sleeps straight through for the first time, so he didn't even know I was gone. I am struck by a terrible case of tendonitis in my right foot and can only limp short distances. I We brave another camping trip, this time down a looooong and nearly impassable (for Honda Civics anyway) primitive road at Olallie Lake. It was another great trip.

September - We cram in one more camping trip before the weather turns fowl, this time to Ice Cap Creek. We've got camping down to a science now, so this is the most enjoyable one of the summer. We actually get to relax a little. At the end of the month, Keith and I celebrate our 3rd anniversary with a nice dinner out ALONE. I attend a really awesome midwife assistant's training. And as always, I'm working hard at school.

October - We head out to the Wallowa Mountains for a "deluxe" cabin trip. It is glorious out there, and since it is late in the season, almost no one is around. On the drive out, I get a call from my brother that my aunt and godmother is dieing. Our vacation is cut short so I can fly out to Virginia to be with her. On Sunday, October 14th, after four days of providing hospice care alongside my mother and brother, I hold my aunt's hand as she passes away. At the age of 58, she died of liver and kidney failure after decades of depression and alcoholism. I brought Alder with me on the trip, so she got to meet him before she died. We return to Oregon and proceed to do nothing for the next several weeks as I process this loss.

November - Back at school, trudging along. I finish my dissertation (a draft anyway). I attend another amazing birth for a good friend. Alder turns six months old and gets his first taste of food, which coincides exactly with him starting to sleep through the night almost all the time. And I finally admit to both an eating disorder (and I'm not ready to say anything more about that right now) and long-standing depression. I find myself a good shrink.

December - Constant work on the dissertation. I'm very near the end now. Just revising based on comments I've gotten on the final chapter. But it is still a slow process. Both kids start attending daycare two days a week again, and the in-laws drop their care down to two days a week. So now I have four days to work. We spend a little holiday time up at a cabin in the snowy mountains. Ava loooooves to dig in the snow. We all get sick this month, for pretty much the entire month. Ava gets croup, Alder gets an ear infection that bursts. I have a sinus infection. Keith gets food poisoning. And when those things weren't happening, we all had colds. I ring in the new year with just Keith as company, as our guests for the evening left before the ball dropped.

Midwife gift

2008-01-06T11:11:00.001-08:00

It is customary to give your midwife a gift if you have appreciated your services after a homebirth. I always knew I wanted to give my midwife something handmade. After Ava's birth, we hoped I would have time to make some stained glass, or that Keith would have time to do some pottery. But that didn't happen, so her gift ended up being a check (which is always welcome, as homebirth midwifery does not make you rich!). But this time I really wanted to find the time to make a special gift. And somehow, even though I've got two kids and am finishing my PhD and work as a birth doula, I managed to make it happen. The piece above was actually quite easy to make compared to my previous pieces. There were far less curves to grind out on this one. The lead came and solder are silver in color, though you can't tell from the picture. I like this pattern quite a bit. I think I'll be making another one for myself.

Oh, and the really cool thing about this - the week before I gave my midwife this piece, she was at my house for the Blessingway of another expectant mommy and she commented on the large fish and turtle glass piece I have in my bathroom window. She said it was really gorgeous and remembered that I used to do glass work and was glad to see I'd gotten back to it. :) I didn't tell her at the time I had this gift for her, because it wasn't finished yet. But it made me feel really good to know she was going to appreciate my gift. And she did.

Peas

2008-01-06T11:02:00.000-08:00

I know it is normal for kids to be picky eaters at times. But what about an infant that doesn't want to eat anything but peas? Alder is just nuts about peas. He won't touch fruit. He is not a fan of cereal. He doesn't even like sweet potatoes. But peas? He'll chow 3 jars for every meal. (no, we don't give him 3 jars of peas for every meal) I'm hoping this phase passes soon, or else my kid is going to turn into a pea.

Diaper bag giveaway

2008-01-02T21:34:00.002-08:00

Anybody interested in a chance to win a cool Lands' End diaperbag? Visit Marketing Mommy and read up on how to enter. I'm throwing my name in.

Super cool animation of a vaginal birth

2008-01-02T21:34:00.001-08:00

It almost looks easy, eh?

Franny

2008-01-02T20:20:00.000-08:00

I'm just twiddling my thumbs here...waiting...waiting to hear tomorrow if the Mizz will have a brother or a sister. :)

GBS

2008-01-02T01:33:00.000-08:00

Good information about GBS and Hibiclens can be found here.

Insomnia

2008-01-02T01:28:00.000-08:00

I haven't felt this AWAKE in a long time, and it is 1:30 in the morning. And darnit if I wasn't reeeeeally tired earlier today. I have a baby that is going to wake up soon and I can't get to sleep! Ack! This stinks.

2008

2008-01-01T16:17:00.000-08:00

Welcome to a new year! I'm really glad 2007 is finally over. While there was some good things that happened in 2007 (Alder was born, and that was awesome!), it was a very hard year. I had a very good friend commit suicide, and then my aunt died too in what was essentially a very long, drawn-out suicide. I thought I was going to finish school, but with delay after delay, it didn't happen. I slipped into another depression and gained some weight (source of eternal difficulties for me). I can't say I'm feeling especially optimistic about 2008, but at least it is a fresh start. I should DEFINITELY finish school this year (probably by March). I'm working on the depression issue. I'll probably start getting PAID again, so our family financial situation will improve. We might even have another baby by the end of the year (nothing to announce right now though). We'll see.

As for last night, we celebrated the evening with two other couples here at our house. One couple has a 5-month old, who went down for the evening on our bed. The other couple is 37.5 weeks pregnant with their first baby. Both of the women were present at my birth with Alder, so we are all quite good friends. We enjoyed pizza, beer, sparkling cidar, and some ice cream. We talked and laughed and joked around. And then everyone got tired so they bailed early, but actually didn't walk out the door until 11:45 pm. I thought that was funny. So Keith and I popped on the tv and watched the ball drop, then hit the hay. One of these years I'd like to attend a real NYE party again.

Back to work tomorrow. We've now had 3 weeks of extra-long weekends. I think next week with 5 days of work will be really hard to handle.

Perspective on living with depression

2007-12-29T22:49:00.000-08:00

Two posts in blogland have spoken to me recently on a very deep, emotional level. They were written by a husband and wife pair. Heather's contribution is about living with depression and her adventures with medication and wonderful things it has done for her. Jon's contribution is about living with someone who is depressed.

These are good. And yes, there is a personal reason I bring this up...which will probably be explained further in a future post.

Toddler cuteness

2007-12-29T21:25:00.000-08:00

Despite the raging illnesses in our house, I've have seen glimpses of some darn cute kids lately. Ava is definitely in that phase where you wish you had a tape recorder going at all times. The things that come out of her mouth are sometimes hysterical, and sometimes amazing.

While at the doctor's office a few days ago, the doc came in and chose to start examining Alder first (both kids were sick and going to get checked out). So Keith started taking off Alder's clothes and the doc came over to take his temperature and Ava got REALLY upset...muttering that the "doctor is going to poke Alder". Poor kid has some obvious associations with the doctor and getting injections now. Anyway, it was both sad because she was so upset, but also endearing that she showed such strong concern for her little brother. (and no, Alder didn't get "poked" at this visit)

Today while playing on the floor with some blocks, I overheard Ava saying, "No Ant! You are supposed to be outside. You are not supposed to be inside. You better go outside!". Then she came and got me to help her take the ant outside. It struck me as amusing that she spoke to the ant so directly, as if she expected it to speak back. But I guess all her books and the few videos we let her watch do involve talking animals and bugs, so why wouldn't this ant talk back? Luckily she wasn't too attached to the ant, because I promptly squashed it.

Overall I'm really loving these stages with my kids. They are both just so fabulous. Next big challenges will probably be night potty training and FINALLY taking the pacifier away from Ava (still used at night only), and crawling for Alder and all the new challenges of babyproofing with tiny toddler toys around all the time.

Ick confirmation

2007-12-27T15:18:00.000-08:00

Sometimes you just don't want to be right. I guess this is a lesson for me though - I should trust my instincts with my kids and illnesses, because I've been spot-on just about everytime.

Ava has croup. She's actually been much better today, but still has a touch-and-go fever and gives a good example of the cough on occasion. I expect tonight to be torture again. Because last night was the first night (so we caught it early) and croup usually peaks on night 3 or 4, we are opting to start the low-dose steriods tonight in the hopes it won't get much worse. Oh, and she's got the start of an ear infection too, but we're gonna let that run its course. Thank goodness at least her lungs were clear.

Alder has a ruptured eardrum on the left side. I was pretty sure he had an ear infection over the last week, and yesterday I saw the crusty drainage coming out of his ear. He still has the fever though, so we know the infection is still raging. We're gonna start antiobiotics since it has literally been weeks we've been battling this stuff. This will be the first antibiotics we've ever given to either kid.

Please send healthy vibes over to our corner of the world. I'm tired of this crap.

The sickness never ends

2007-12-27T08:59:00.000-08:00

I guess it is the season, but man, this season is off to a rough start. Both kids have been sick for pretty much the entire month of December. There have been a few (maybe 3?) days of relative health, but other than that, there have been fevers, coughs, sneezes, and snot everywhere. I can't think of when they DIDN'T have a fever right now. It has been a week at least I think? Now it looks like Alder has at least one if not two ear infections, and Ava appears to have croup. Last night was TERRIBLE. We're headed to see the doctor at 1:30. Hopefully they can at least pass me some wisdom on how to juggle 2 sick kids.

White Christmas

2007-12-25T12:18:00.000-08:00

There is real-live snow falling from the sky today. It isn't much, but it is enough to make me GRIN. We live in an area that just doesn't get snow, so this is really awesome. I wouldn't quite call it a white Christmas, but it is magical.

NORAD tracks Santa

2007-12-24T10:30:00.000-08:00

He was in Ethiopia last I checked. Where is he now?

YouTube

2007-12-22T21:04:00.000-08:00

Ever find yourself bored? YouTube can fill that void. Here is a great example. First, take an obscure band from some country in Europe (anyone know what language this is?). Visit YouTube and you can find their original "hit". Then this brilliant guy decides to lip sinc to it and post it on YouTube too. A hit is born. He gets so popular he does another song too. Numerous hysterical videos follow the first one though: legos, misheard lyrics, Elijah Wood (Frodo) and some monsters, Elmo and Grover, Japanese school girls, various Chipmunk versions, Chicken Little, Resident Evil (in English), American Idle, Israeli Idol, Yoda, The Lion King, etc.

My favorites are the misheard lyrics and legos.

People really have too much time on their hands, don't they.

The Birth of Baby Boy LK

2007-12-21T22:38:00.000-08:00

The Birth of Baby Boy LK
Monday, November 26, 2007 at 12:40 PM
9 lbs 13 oz and 21.75 inches

Original due date: November 23rd

2nd baby, VBAC attempt, repeat cesarean

Mommy M had been my good friend for a couple of years now, ever since the birth of our first kids, so I was thrilled when she announced she was pregnant again. It was even more exciting when she asked me to be her doula. Yippee! Nothing could be a greater honor than to assist a friend during the birth of a child. It is simply amazing.

Mommy’s first birth was a cesarean after she dilated to 8 cm but no further. With meconium in the water, slight non-reassuring heart tones, and several hours of no dilation, the cesarean was performed with zero complications. Turns out that 9 lb 3 oz baby boy was posterior. He was born on his due date.

This pregnancy started very differently because conception happened without the help of fertility meds! Mommy also decided to search for a new care provider. Her old OB was not supportive of a VBAC, so Mommy signed on with a midwife group who attended births at Generic Hospital. The new group was very supportive and was willing to work with Mommy to give her the best chances for a VBAC.

Fast forward to the end of pregnancy. The baby was measuring large again. Mommy was ready for him to be born. Her due date (Thanksgiving Day) came and went. She had several bouts of pre-labor, but things always fizzled out after a few hours. She was somewhere around 3-4 cm dilated and 60% effaced. I tried to reassure her that though frustrating, this was important early work and that it was doing something! Finally, Mommy’s house emptied of family and she settled in and got serious about birthing this child.

On Sunday, November 25th, 3 days after her due date, Mommy was watching football with Daddy, Big Brother, and Daddy’s parents when contractions got started again. Mommy estimates they started around 4:45 pm, though she didn’t start timing them until around 5:20. At this point they were 4-8 minutes apart and 35-60 seconds long. I had called her earlier in the day, just to check in and say hello. She called me back at around 6:45, but I had to return her call just a little bit later. At 7:10, we got to talk and she filled me in. She said these contractions were definitely strongly than anything she had felt so far, and at that point they’d been going on for about 2.5 hours. I suggested she call her midwives and let them know what was going on, and see what they thought she should do. Mommy feared heading to the hospital and having everything stop, but I felt it was important to get the midwife’s perspective on this. She made the call, and they encouraged her to come in. With the VBAC, they wanted to make sure that if this WAS it, she was monitored closely for her safety and the safety of her baby. I asked Mommy to call me when they were parking at the hospital and if the contractions were still coming strong, I was going to go ahead and leave.

At 8:15 pm, Mommy gave me a quick call and said they’d just arrived at the hospital and things were still going strong. I told her I would leave in about 20 minutes, and asked them to call me back once she was checked and we knew if the hospital would be keeping her or sending her home. By 8:40 pm, I was out the door and on my way to the city.

At 9:00 I got a call from Daddy. He said Mommy was 4-5 cm and about 90% effaced, so they were staying at the hospital. WAHOO!!! This was it! I arrived at 10:30 and found them walking the halls. Mommy said her contractions were 3-5 minutes apart and about 60 seconds long. She was beautiful in her gown and fancy fuzzy socks. She had a telemetry unit for the continuous electronic fetal monitor, so Mommy was able to walk and roam and change positions to her heart’s content, as long as the belts kept the monitor in place. Mommy and Daddy looked excited and optimistic. They hugged often and were beautiful support for each other. Mommy continuously checked in with Daddy, almost as often as we checked in with her. It was a fantastic environment to be laboring in. I settled in, checked that everyone had water and encouraged eating since they’d both skipped dinner. Throughout the evening, I occasionally grabbed the camera and took some shots of Mommy and Daddy as they welcomed the labor and worked together to birth their son.

By 11:05 pm, Mommy made another bathroom trip and then continued standing and walking. She said that though she was feeling some discomfort in her back, it wasn’t excruciating. It didn’t sound like the typical back labor I heard stories about, but Mommy did say it felt just like it did during Big Brother’s birth, so I was a little concerned about baby’s position. When I asked her about it, Mommy said they’d been told baby was probably occiput transverse based on where his heartbeat was. At 11:35 pm, she asked for a birth ball so I hunted one down from the nurses. Mommy started looking more serious. Daddy turned on some music as Mommy hung out on the birth ball, and the midwife and the nurse adjusted her belts. At around midnight, Mommy requested some food and was told “clear liquids” only, so she enjoyed her chicken broth as best she could.

By 12:15 am, Mommy was back up and walking again, just going with the flow. I talked to her about her activity and what she felt was going on. Daddy was getting tired and Mommy ordered him to sleep, so he laid down to rest. We turned off the lights, turned on a few electronic candles, and set the room into “rest” mode. Mommy made another bathroom trip and then at 12:40 laid down to get some rest. Her right side was more comfortable to her, and it allowed the belts to stay in place, so that is what she did.

For the next hour, Mommy tried to rest and I just observed from the rocking chair. Her contractions were varying quite a bit. First they were 7 minutes apart and 80 seconds long, then 2.5 minutes apart and 90 seconds long, then 4.5 minutes apart and 90 seconds long. The midwife visited again and reiterated that she felt this was early labor because of the contraction pattern, but acknowledged that Mommy’s contractions seemed to be feeling stronger. A phlebotomist dropped in for a visit, and disrupted the rest time by turning on the lights and speaking very loudly. Mommy needed another blood draw because they’d messed up the last sample. Finally she left and Mommy was able to rest a bit.

While resting, Mommy seemed to drift to sleep, but then be shocked awake by each contraction. She was able to stay in position and breathe through each contraction, but I could tell they were growing quite uncomfortable. At times Mommy would let out a soft whisper of an “Ow” but otherwise, she was very quiet and determined to rest.

By 1:40 am, Mommy needed to pee again (yay! We were doing a good job with the water!). Contractions were between 3 and 7 minutes apart and 70-120 seconds long. They seemed to be getting stronger. The nurse popped in for another monitor check. Throughout the evening, the nurse visited at least a dozen times because the monitor fell out of place. While we knew these visits were necessary, they were quite disruptive, as they always flicked the lights on and spoke very loudly. Still, Daddy managed to sleep through much of it.

At 1:50 am, Mommy headed out to walk the halls again and then laid down again after that. Again, her right side was most comfortable, so she went with that. For the next hour, it was blissfully quiet and Mommy and Daddy were both able to sleep. Mommy was breathing beautifully through each contraction and would snooze in between. Contractions were 6-7 minutes apart. I draped myself in a towel (it was freezing in the room) and relaxed in the rocking chair.

Shortly after 3 am, Mommy got up to pee again and decided to try sitting/reclining in the bed for a bit. At 3:15, the midwife visited and offered another cervix check. Mommy wanted to know, so she got set up for the check. She was 6 cm and 90-95% effaced with baby’s head at -2 station and a bulging bag of waters. Contractions were still 6-7 minutes apart. This dilation was only a small change from 6+ hours ago, but it was progress, so we held on to that. The midwife suggested breaking her water (which she had also mentioned a couple of times earlier too), and Mommy politely but firmly declined. Mommy asked about the baby’s position, and the midwife indicated she believed the baby was anterior, but that she couldn’t feel the babies skull without breaking her water. The midwife suggested a shower or the tub. Mommy said she wanted to save the tub for later when things were more intense, and she certainly didn’t want to slow anything down at this point. But a shower sounded like a great idea. She asked me what I thought she should do and I agreed a shower sounded great – something different! The midwife additionally suggested Mommy try some manual nipple stimulation while in the shower and see if it brought on stronger contractions. So by 3:30 she hopped in for a good 20 minutes. Because of the telemetry unit for the EFM, she was able to stay on the monitors while in the shower.

By 4:00 am, Mommy was back out of the shower and ready for more action. The nipple stimulation didn’t seem to help a whole lot, but things didn’t slow down either. Mommy did agree the shower felt great! I demonstrated some lunges to her, and she worked on that with Daddy’s support a while. Because of the extended time with little progress, I continued to worry about baby’s position. The midwife had recently said she thought the baby was anterior, so I began to wonder about the position of his head. Could it be asynclitic? If malpositioned at all, the lunges might help and Mommy found that they felt really good.

Mommy had been reaching for her back during some of the contractions, so I asked her if I could help her by providing pressure to her back. She agreed, and it seemed to really help. So for a while, we three worked as a team. Mommy stood in the middle, content and talkative until a contraction hit when she would lift her leg onto the bench and lunge and sway with the energy. Daddy was facing Mommy and would hold her shoulders and support her balance. I was behind her providing pressure to the sore spots on her back. Throughout this entire time, I was amazed at how “normal” Mommy seemed between the contractions. It really seemed like her. It was an enjoyable time to spend with these expecting parents.

At 4:30, Mommy retreated to the birth ball again. This remained one of her favorite positions. We talked a little about emotions. I asked Mommy about being scared, and she acknowledged that she was (afraid of the pain). We talked a bit about how things really did need to get harder, but that it was good and necessary for this birth to move forward. Mommy seemed ready to accept what needed to happen.

At 5, the nurse checked Mommy’s blood pressure again (which was perfect). Mommy decided some jello sounded good, so I visited the nurses’ station to get that ordered. Mommy visited the bathroom again too. Contractions seemed to be getting still stronger and closer together with her new activity, sometimes as close as 90 seconds apart. At 5:30, Mommy decided to lay down again (right side). She was growing tired. Contractions spaced back out again to 4-6 minutes apart, sometimes 7.5 minutes apart. Back pressure continued to be helpful. After another 30 minutes, Mommy was back up to pee again, and then she went for a walk.

Just as the midwife’s shift was ending, she came in to check on Mommy one last time. She offered another cervix check, and Mommy agreed. I was so hopeful that all the activity over the last 3+ hours had resulted in dilation, but was skeptical because the contractions just didn’t seem strong enough, and they were still so variable in pattern. Sure enough, Mommy was 6-7 cm dilated, 95% effaced, and baby was still at a -2 station. I was feeling very frustrated for Mommy. Again, the midwife offered to break her water, and again Mommy declined with the plan to save it as a last resort. Shortly after the check, Mommy visited the bathroom again. We discussed a plan to get things going. I suggested we continue with the activity. The lunges seemed to speed things up. I also suggested we try acupressure, belly lifts (in hopes this may resolve any malposition we weren’t detecting), more position changes including hands and knees, and Mommy take another shower. Mommy began doing lunges.

By 7:30, Mommy had been visited by the new midwife, the old nurse, and the new nurse. All of them, including the old midwife expressed concern for how slowly things were going. The new midwife seemed very willing to work with Mommy and try hard to get things going, but she did acknowledge she would shortly be required to consult with the OB on call. Dr. OB was the OB, and the midwife said she would want to come in and meet Mommy before potentially meeting her in the operating room. I immediately felt uncomfortable with this change in language – suddenly we were talking about operating! I guess the reality was soon approaching, and Mommy seemed to know this deep down, but it was still hard for me to see this path before us when we still had so many tricks to try. Baby was doing fine and seemed very healthy, and Mommy was willing to keep working, so I didn’t see why we had to start talking about operating all ready.

Mommy also asked the midwife about using a breast pump for the nipple stimulation – something I suggested she ask about. The midwife said because Mommy was a VBAC, she was uncomfortable using the breast pump. While frustrated that she wouldn’t let us use one, I was pleased to realize she was acknowledging how strong nipple stimulation can be! The midwife also argued for AROM at this time, and suggested it was probably time to really consider it. Mommy suggested we wait just a little longer and really try hard to get things going, and that if at the next visit progress hadn’t been made, she would consent. The midwife agreed this was a good plan.

After she left, I snuck down to the cafeteria for a quick breakfast, giving Mommy and Daddy some much-needed alone time. I returned to find out through Mommy, through the nurse, through the midwife, that the OB was going to put Mommy on a shorter timeline. We were all worried about this news.

At 7:45 am, the OB came for a visit. She was very calculated in her language and movements. As she walked in the room, I felt immediately she just wanted this surgery to get going. I think Mommy could sense it too, as she later expressed how much she disliked this doctor. The OB discussed some time limits. She asked Mommy where she got stuck in her last labor (8cm) and where she was now (6cm). She asked about the size of the baby (estimated 9.5+ lbs). She strongly urged Mommy to allow the midwife to break her water. She suggested we do this immediately, or plan to move right on to surgery. She said if the AROM didn’t get things going, we just move on to surgery. And with that, she turned to leave and saluted Mommy on the way out while saying, “Hopefully things will get going, or else I’ll see you in the operating room.”

Daddy immediately embraced Mommy as she began to cry. This had been a rough hour, with visitor after visitor expressing doubts. Mommy had been in labor for about 15 hours, during which time she’d hardly slept or eaten, and she’d only dilated about 1 cm. I sensed that Mommy was tired, and disappointed. She talked about “having been down this road before.” I couldn’t help but cry too. The 3 of us just circled together and released our frustration. And then, we discussed really getting serious.

At 8, Mommy got back in the shower with instructions from me to be more aggressive with the nipple stimulation. By 8:30 she was back out. Contractions were definitely closer together, sometimes only 90 seconds apart and 60 seconds long, but still weren’t strong enough. Daddy ran down to the cafeteria for some breakfast, so Mommy and I had some time to work together. At 8:45 I instructed Mommy on applying acupressure on her Hoku point on her hand. She tried this for a few cycles, but didn’t notice any increase in intensity with contractions. So I moved on to trying acupressure at her Spleen 6 point on her legs. I kept up with this for quite some time. While contractions were longer and closer together, they still just didn’t seem strong enough. At 9:00, I alternated the acupressure with belly lifts using the rebozo. Mommy said these felt really good. We watched the EFM to make sure the lifts weren’t affected the baby’s heartbeat. Everything looked good. While doing this, one of the nurses visited and commented that we were doing something right, because the contractions were getting closer together. She looked confused at seeing Mommy wrapped in the rebozo with me down on the floor pressing on her legs. It made me chuckle…she probably really wondered what the crazy doula was doing to her labor patient.

The midwife came in to break Mommy’s water, but Daddy was still gone and then she got a page, so the AROM was temporarily held off. This was a blessing in a way, as it gave us one last hour to try all our tricks and to focus on powerful contractions. We continued the acupressure, belly lifts, lunges, rocking, standing, and leaning on the bed. Once Daddy returned, I retreated to the bathroom to pump (something I’d done every 3-6 hours all night). While in the bathroom, I could hear that the midwife returned and was ready to check Mommy. Bad news. There was no change in dilation. So Mommy consented to AROM. Thankfully, the fluid was clear. Mommy was moved to an upright sitting position in the bed. The way the bed was cranked up, Mommy looked like a Queen up on her pedestal. Immediately afterwards, she didn’t seem to notice any difference with the AROM. But things changed quickly. The midwife had suggested that Mommy needed to dilate 1.5-2 cm/hour now to avoid a cesarean, which seemed really fast to me. Little did I know Mommy would have NO problem with this.

Within 5 minutes, things were ramping up. The contractions seemed to be overwhelming her. They were now less than 2 minutes apart and 75-90 seconds long. Within minutes, Mommy started verbalizing doubt that she could not do this. I recognized this as transition and told Mommy I thought she was there. She didn’t believe me. She thought it was too soon. The contractions were just killing her in this sitting position, so she asked me to get the nurse so she could be hooked back up to the telemetry unit so she could move around again. I walked out the nurses station and got the nurse’s attention and she acknowledged that Mommy was really getting slammed (she’d been watching the monitor). The midwife was also at the station, so she came in the room too.

By 10:10, Mommy was getting hooked back to the telemetry unit. The midwife suggested IV fluids. She said she often saw this response to AROM because of dehydration, and that the fluids may make the contractions more manageable and a little more spaced. Mommy declined at first, but after getting hit by another couple of contractions, agreed. By now she was off the bed. I held her in a standing position through a couple of contractions, and then eased her back onto the birth ball. Contractions were just coming strong and hard, and after just a minute on the birth ball, Mommy let out a tell-tale grunt. The nurse, the midwife and I all looked up at each other and smiled. Mommy’s body was bearing down. It was 10:15 am.

The midwife and the nurse checked in with Mommy and asked her what she was feeling. Mommy wasn’t sure, but it was strong! Mommy’s sounds were pushing grunts. I looked to Daddy and mouthed that Mommy was doing great, and that things were moving fast. At about the same time, the baby’s heart rate dipped a bit. It was enough of a drop to concern the midwife, and Mommy was just getting overwhelmed by the contractions, so the midwife told Mommy she wanted to get her back on the bed to check what was happening. Mommy didn’t want to move. She didn’t think she COULD move. But with help, they got her up to standing and discovered bloody show. This was a very good sign!

By 10:20, Mommy was up on the bed on her right (preferred) side and continued bearing down with each contraction. Daddy was by her side, holding her and whispering in her ear words of love and support. It was obvious how strong his support was to Mommy during this time. The midwife checked and found she was almost fully dilated, with just a lip of cervix remaining and baby was at 0 station! Mommy had FLOWN right by transition. Unfortunately, the baby’s heart rate was dropping down under 90 bpm and remaining low for extended periods after each contraction. The midwife and nurse worked with Mommy to turn her to her left side, which Mommy resisted, but they got her turned rather quickly. At the same time, the nurse prepared an oxygen mask and put it on Mommy to try and give the baby as much oxygen as possible. I could tell this position was not very comfortable for Mommy, but she knew it was important for her baby.

At 10:35 the midwife checked Mommy again and she was fully dilated. The heart decels started to improve, so Mommy was able to remove the mask shortly. Pushing now begins in earnest. Mommy started pushing with her legs pulled up and rolled slightly to her left. She pushed in this position for a while, and the baby was bulging low in her bottom with each push. She didn’t believe us when we said she was DOING IT. I asked her if she thought we were lying, and she said yes! She was doing a fabulous job, putting all her energy in each push. In between contractions, which were now between 1.5 and 3 minutes apart, she appeared to drift off to sleep. By 11:00, it seemed a position change might help bring the baby down further. So the midwife and nurse got the squat bar set up for Mommy to try. In transitioning to the squat, Mommy was hit by a contraction and collapsed into a kneeling position, where she remained for a contraction or two. She then got up and prepared to use the squat bar. This seemed to be a very powerful position for her, as she continued to bring the baby down.

At 11:10 am, the midwife checked again and felt the baby was at about a +2 station, but that a caput (swelling) was forming on his head. She suggested Mommy lay back into a reclined position and prop her feet on the squat bar for support. Mommy then used the bar to push off of, and then was sometimes encouraged to grab her legs and pull them up high against her in an exaggerated lithotomy position. At times the midwife said she could even see the baby’s hair. I was so excited. It seemed Mommy was really going to do this!

Thirty minutes later, nothing had changed and Mommy was not only tired, but really starting to doubt. The midwife, nurse, Daddy, and myself were continuing to give her support and encouragement. Mommy continued to ask though, “Is the baby going to come out?” The midwife was honest and said the baby hadn’t come down much anymore, and it was obvious Mommy was pushing very hard. She needed the OB for a second opinion now that they’d been pushing for over an hour. Mommy voiced her dislike for this OB, but there was no one else available and it was clear another opinion was necessary. So the OB was called. Meanwhile, Mommy continued to push. At 11:45 am, the OB arrives and examines Mommy. She said the presenting part was all caput, and that the head was actually at around a +1. This meant in about 90 minutes of pushing and bearing down, the baby had only moved from a 0 to a +1 station. This was difficult news. Mommy was trying so hard. She was changing positions and trying all kinds of different pushes. She was doing everything right. But the baby wasn’t coming down past the pubic bone. And Mommy was DONE. Because the presenting part was all caput, the OB said she could not do an assisted (forceps or vacuum) delivery. She said the baby wasn’t coming out, and that Mommy had tried very hard, but that it was time to go get the baby out. The cesarean was recommended, and Mommy agreed.

For the next 15 minutes, people were rushing around getting Mommy ready for surgery. Mommy immediately requested pain medication, so the anesthesiologist came in very shortly. There was some discussion over whether the surgery would happen immediately or later, but once it was resolved Mommy was informed of the risks of her impending spinal. The OB discussed the risks of the repeat cesarean, and Mommy signed her consent. Daddy rushed around and tried to pack up the room, then suited up for the operating room. Mommy, Daddy and I had previously discussed me accompanying them in the operating room, but the nurse told me they do not allow that in this hospital. So I stayed behind and packed up the room. At 12 noon, Mommy was wheeled away. After packing the bags, I retreated to the waiting room, expecting to hear something in an hour or so.

The waiting room was an uncomfortable place. There was a television which blasted Scooby Doo cartoons, and there were several families waiting for their own exciting news – and they all seemed to speak a different language. I was tired, needed more caffeine, and needed to pump, but I didn’t want to leave the waiting room in case I missed Daddy coming to tell me about the birth. So I stayed and tried to relax, making a few phone calls to check in at home. I also found two messages from friends – Lauren and Kendra – who’d called to hear how things were going.

By 1:30, I still hadn’t heard anything, so I decided to ask the receptionist. She called recovery and said Mommy had just arrived there, and it would be at least another 2 hours before anyone was allowed in. I couldn’t believe it! Nearly 4 hours of isolation for a cesarean? I had no idea. I knew I couldn’t stay that long. I was so tired, and every hour I stayed at the hospital was making it harder for me to drive home safely. So I asked the receptionist if I could get a message to Daddy. He said he would come out and speak to me. So finally, I got the word that Mommy and baby Baby Boy LK were fine. Baby Boy LK was born at 12:40 pm and weighed 9 lbs 13 oz! What a big boy! I was so delighted to hear they were well. Daddy confirmed for me that after Mommy received her spinal, she was content and happy with the decision to move to a cesarean. He said she talked about having tried everything to get him out, and that this was how Baby Boy LK was choosing to be born. I was happy to hear her feelings about this. I really wanted to talk with her, but this was not the time. So I gave Daddy a big hug, congratulated him on the birth of his son, and took my leave.

In my 90 minute drive home, I started having a hard time staying awake, so had to stop and stand in the cold air to make it all the way. I collapsed into my bed at 3:45 pm, but my mind couldn’t shut off for a while. I thought about all the things we did during the labor and felt good about all our efforts. Still, I couldn’t help but wonder what was holding little (big) Baby Boy LK up. When I spoke to Mommy the next day, I learned that he was posterior afterall! I couldn’t believe it! Mommy said the midwife discussed this with her, and suggested that perhaps there was something about Mommy’s hip structure that encouraged babies to swing posterior as they descended, because Baby Boy LK had been anterior earlier in the labor. Still, I couldn’t help but kick myself, wishing we’d spent some quality time in hands-and-knees, just in case.

As a doula, this was a great experience for me because we got to try so many things during the labor. It was my first all-night birth, and my first cesarean. This was also my first experience walking away and wondering if we just tried one or two more things, if that would have changed the outacome. I know that we all did our best, and that is what I should remember. And Mommy is really happy with the outcome, having made it all the way to pushing and getting to try that in several positions. Mommy later said she felt this even healed her some from her first birth, because she realized the transition feelings she had at the end of her first birth were really about as hard as it would get, so she no longer felt she’d wimped out. And having her second baby choose the “side door” as Mommy puts it, despite multiple tricks to invite him out the “front door”, validated the necessity of her first cesarean too. Overall, it was an incredible experience for all of us. I feel blessed to have been a part of this event, and only wish I could have seen Mommy and Baby Boy LK after the birth. I’m so proud of Mommy for working with her body and allowing her baby to receive all those precious squeezes. And Daddy was an amazing partner, always supportive and attentive to Mommy.

Congratulations to the Family! Thank you for allowing me to be with you on this important day. And welcome Baby Boy LK!

Cabin in the snowy mountains

2007-12-17T17:16:00.000-08:00

I am here. It is gorgeous. Internet is slooooooooow. That is all.

Car insurance update

2007-12-15T11:23:00.000-08:00

Turns out when that insurance agent said I was "involved" in an accident, she meant as a witness. Whew! I didn't think she could possibly be asking about that, because it was 6 weeks ago that the accident happened. But I guess the drivers in the accident didn't report it until this week, so I didn't get the call until then. I'm so relieved it wasn't something bad for me, like someone claiming I hit them. I offered my name and number to both drivers of this accident I witnessed because of an accident I was in a year ago. A very VERY very old man hit my car, and while I was busy calling the police, he was out in the street getting witnesses. Long story short, I had no witnesses and he had several who spouted a modified version of the truth...and I was found at fault (even though he HIT me while I was completely stopped...and he drove away without realizing he hit me...and then his story included the completely wrong part of his van too). So I learned the lesson that witnesses are more important than just about anything else. Next time I won't move the cars out of traffic either, until I have taken pictures at least.

Anyway, I was glad to do my duty and help these drivers settle their accident.

Curious

2007-12-10T16:47:00.000-08:00

I got a call today from a car insurance company about a recent accident I was in. I find this very curious, as I haven't been in any accidents recently. Hmmm... My mind is swirling with the possibilities. Mistaken identity? Stolen identity? Could I have possibly hit someone, causing ZERO damage to my car (a small car that simply does not hit things without major damage), and not realize it? Very curious indeed. Unfortunately, the insurance rep and I seem destined to play phone tag for now, and I'm not getting any juicy details out of that. This will drive me absolutely crazy until I know what is going on!

The wrong pizza

2007-12-07T19:58:00.000-08:00

We have a Friday night pizza tradition in this house. It is something I look forward to all week, cause I looooove pizza. While I think pizza pretty much stinks in Corvallis, we have learned to tolerate and even kinda like American Dream Pizza. But they've got this problem with screwing up our order. It has happened...oh...like 6 times in the last 4 months or so. Most of the times it has been a simple mistake - wrong kind of cheese, or they put chicken on the entire pizza instead of half. But after the 4th screwup I called them and made a complaint, because at that point we were talking about $75 worth of messed up pizza. That complaint earned me a $35 coupon, which was great, and they now seem to be VERY attentive to our orders.

But that didn't stop them from screwing up again tonight. Thank goodness Keith checked the pizza at the door, as we've learned is absolutely necessary to my evening happiness with our dinner. We ordered a large pizza with BBQ sauce as the base, and 1/2 of it covered in gouda and the other half covered in chicken. Sounds weird, I know. But try it. You'll like it. Anyway, the pizza that showed up had tomato sauce as the base. One one half it had pepperoni and gouda cheese (at least the gouda part was right). On the other half it had mushrooms, bacon, and ham. Could they have screwed it up anymore? Anyway, the store manager immediately called and apologized and hijacked one of their drivers to bring us our proper pizza immediately. We got the keep the screwy pizza too. Too bad we don't eat pepperoni, bacon, or ham.

Depressed

2007-12-07T15:27:00.001-08:00

Sometimes that is all you need to say.

It is wet here

2007-12-04T18:16:00.000-08:00

That might not sound like news. I do live in the Pacific Northwest afterall, and it is December...the time of dark days and damp air. But it is really wet here right now, so wet that I-5, the major interstate that runs north-south from Canada to Mexico through Washington, Oregon, and California, is currently under 10 feet of water. Footage on the news stations looks like New Orleans after the levies broke, but nope. It is just here, and it is just from heavy rains. Thankfully, Corvallis has largely been spared, save some flooded intersections and minor wind damage. Tens of thousands are still without power, and many people are missing. Thankfully, now the weather is supposed to turn a bit sunnier. But Oregon did lose a big treasure - a Sitka Spruce which was the largest living thing in Oregon broke during the storm.

Sick babies

2007-12-03T11:52:00.000-08:00

We are weathering our first double-kid cold in the house. This is actually Alder's very first bug - not too bad making it all the way to 6.5 months! Anyway, it has proven to be fairly mild for both of them. There were slight fevers (under 100) and lots of snot, but it kept flowing so no bulb suctioning was necessary. Yesterday was the worst day. Today is looking slightly better. They both even slept okay. I kinda like this...a nice, gentle warm-up to what I'm sure (with the addition of daycare starting Thursday) will be a killer cold season.

Sore

2007-11-28T14:54:00.001-08:00

Seems I was sympathy pushing with the mom the other day. It has left me feeling a little like I had a baby (granted, a very very small baby). One of my friends heard that sympathy pushing is a major cause of hemorroids in L&D healthcare providers. Uh oh! I better watch out! But it was just so hard not to want to push with her.

Almost a VBAC

2007-11-27T20:57:00.000-08:00

She was so close. The midwife said she could see the baby's hair. It seems crazy to me that we could see the baby's hair, but he wouldn't come down anymore. I guess I don't have a very good image of the pelvis, cause I really thought that once we could see the head, there was no way he wasn't coming out. But he didn't come out.

This mom was absolutely amazing. Baby #1 was a cesarean after 15 hour labor, 5 hours of which was at 8 cm. She never got past an 8. During the stall, they tried breaking her water (and found light mec), tried an epidural (and got slight decels), and when he wouldn't drop and she didn't dilate, they went to cesarean. Turns out baby was posterior. He was a 9.5 lb baby on his due date.

With baby #2, he decided to come 4 days after his due date. We knew he would be big. One major goal was to encourage baby away from posterior. Well, mom was 4 cm before labor even started, and when checking into the hospital she was 4-5 cm. 14 hours later, she was 6 cm. Her labor pattern was still variable, and contractions really should have been stronger. Something was amiss. We tried tons of things to encourage good positioning (the midwife said baby was anterior, but I was leery of asynclitism) and to bring on stronger contractions. The OB on call started interferring and demanded either progress or a cesarean. So mom agreed to AROM at 6 cm. A few minutes later, she was getting slammed with back-to-back 90-second contractions. I knew it was transition. She didn't believe me. Twenty minutes after the AROM, she started pushing. Unfortunately, in 90 minutes of the most incredible pushing I've ever seen in a half-dozen different positions, baby had only gone from 0 to +1 station. Mom was done. She was in terrible pain. The OB came in, took one look, and said the baby wasn't coming out. So off to cesarean she goes. Baby was 9 lbs 13 oz. And he was posterior afterall.

Unfortunately, because of the long recovery after surgery, I wasn't able to see mom and baby before I really needed to head home. This was my first all-night birth. I had 90 minutes to drive home. I talked to the mom today and she sounded really happy with her experience. We tried so many different things and she got so much further than last time. Having it end this way also gives her a sense of justification for her first cesarean too. In the end, she pretty much had a complete vaginal birth, except for the ring of fire part.

As a doula, this is the first cesarean client I've had, and it is the first client who didn't achieve exactly what she was shooting for. I have mixed feelings about it. I'm THRILLED she got to push and feel that power for so long. I just can't help second-guessing what we did. Could we have tried a different position? Should she have pushed for longer? Was this going to be a cesarean no matter what? I guess it shouldn't matter as long as mom is happy.

Writing skills

2007-11-25T10:55:00.000-08:00

Apparently my blog doesn't quite equal my education level. I am, afterall, only a few months from a PhD. But my blog rates only at the high school level. Hmm... Wonder what criteria go into that. Wonder what would happen if I tossed some random scientific names in there. Anyway, I suppose it is good my blog doesn't rate too highly. If it were too complex, who would want to read it, right?

Mmmm...pie...

2007-11-24T14:01:00.000-08:00

You Are Apple Pie

You're the perfect combo of comforting and traditional.
You prefer things the way you've always known them.
You'll admit that you're old fashioned, and you don't see anything wrong with that.
Your tastes and preferences are classic. And classic never goes out of style.

Those who like you crave security.
People can rely on you to be true to yourself - and true to them.
You're loyal, trustworthy, and comfortable in your own skin.
And because of these qualities, you've definitely earned a lot of respect.

What Kind of Pie Are You?

Thanksgiving Tradition

2007-11-23T19:37:00.000-08:00

Seems almost everyone has a Thanksgiving tradition. Most of the people I know gather with family for this holiday, but not us. No, we have the tradition of saving Thanksgiving for friends. Every other holiday goes to family. This is the one we save for celebrating our "other" family - our best friends.

It all started in college, when the very short weekend was too expensive for most people to fly home to see their families. So we started Thanksgiving for friends. And then when my parents split up, I no longer wanted to spend Thanksgiving at home, because it meant trying to balance two separate Thanksgiving dinners on the same day. I flew to Paris for one Thanksgiving, then I drove cross-country for the next one. Once we (Franny, Dave, and I) moved to Oregon, we started planning all our Thanksgivings together. That first year, we actually flew to Tucson to visit friends from college. Others flew from around the country too. It was one of the most memorable holidays of my life. The following year, the whole gang congregated in Portland. Nearly all of my Thanksgiving holidays have involved Franny and Dave since then (except last year, when I was stuck in Corvallis waiting on a doula client who was late).

This year was no different. We loaded up the car with both kids, an emergency change of clothes, and some prepared dishes for the feast, and we drove north to Portland yesterday. It had a pretty different feeling with toddlers running around, but it was wonderful just the same. We laughed about how much we used to drink at Thanksgiving, and how each year seems to involve less and less imbibing. I think I downed about 3/4 of a beer before I started feeling sluggish and tired, so I set it aside. I got to see my buddy Lisa, whom I haven't seen in probably a year and a half. And I got to see Dave's parents, which was a blast. Yep, it was a great time. And I only checked my phone about 20 times (waiting on another doula client to go into labor, though thankfully this time she's in Portland so I was able to come to the feast).

Next year we've reserved Thanksgiving in Corvallis. We've never hosted in Corvallis before, but I think the time is right. With some luck, I'll either be enormously pregnant, or holding a newborn too. Now only if we could expand our house just a bit...

Oh, and our contributions to this year's feast: cheesey risotto with sun-dried tomatoes, organic herbed stuffing, and fudge. The whole meal was delicious!

Fear of surgery

2007-11-21T20:50:00.000-08:00

Navelgazing Midwife has done a few posts about awareness while under anesthesia, and she posted a link to this story. OMG! This is one of my biggest fears. I just have this feeling deep down, that if I ever need a cesarean, I would be one of those people who feels every cut. For nearly every procedure I've had with anesthesia in the past, it hasn't worked completely. I can't tell you how many times I've felt dental work when I should have. And after both of my births, I've required a few stitches down under...and I've felt EVERY ONE. Those experiences have left me with goose bumps every time I think about it. I just can't even imagine being paralyzed but awake through a cesarean. I might just go insane.

Pins and needles

2007-11-21T10:11:00.001-08:00

I'm just sitting here on pins and needles, waiting to get a phone call. One of my doula clients is due tomorrow (Thanksgiving!) with her second baby. Her first baby was born ON his due date. And last night she had a couple of hours of contractions that were consistently 10 minutes apart. I'm so excited! The birth time is just so magical. This client is a good friend too, and I'm so excited for her to meet her new soon. This is a VBAC too--my first--so I'm very excited to be getting this experience and happy to support my friend.

So now I've got my doula bag packed, the car tanked up (this birth is 90 minutes away), my caffeine in the fridge, my hair washed, and my teeth brushed. I'm ready. And I'm sure this mom is ready to go too.

Dissertation

2007-11-19T14:13:00.000-08:00

WORLD TAKE NOTE! Just 5 minutes ago, I finished my Ph.D. dissertation. Granted, it is just a draft and will have probably several months of revisions before the library gets its official copy. But I've got a complete dissertation in my hands!!! Shout it from the rooftops! I might actually finish this degree! Dangit, I feel good. I know getting a Ph.D. is an enormous task, but I tell ya...take things one day at a time and you will find yourself here...with a complete dissertation. I'm hopeful for a defense in January. We'll see what my advisor has to say in a few weeks.

She has discovered the TV

2007-11-18T10:22:00.000-08:00

Ava has finally discovered what a TV does. She is sitting beside me right now, glued to Alice's future as she wanders through Wonderland. I can't believe I managed to have a kid who at nearly 28 months, only JUST decided she enjoys watching TV. Now when she was younger, we kept her away from the TV. I didn't buy into the Baby Einstein craze. She watched maybe 15 minutes of TV her entire first 18 months. But at some point I sorta started hoping she would take an interest. Not that I want a TV hog, but there are occasions that you just want to be able to plop the kid down in a safe place and now they are happy and entertained. So here we are, finally. So far the daily limit (no more than 1 hour average per day) isn't causing any tantrums. She has asked for "Alice and Underland" each morning lately, but on the days that isn't an option she seems okay with it. I know my mother-in-law has introduced a 30-minute ABC Winnie the Pooh video to her that she enjoys. And we've watched Finding Nemo once or twice. But so far, that is it. Thank goodness she doesn't know we have like 5 cartoon-only channels available on cable. I'm sure that day will come soon enough...