Jinxed it

Yesterday while on a family walk, I sadly watched an ambulance drive towards the Children's hospital near to our home, sad for the family and the child impacted by the need for doctors and hospitals. I thought in my head that I'm glad we've never had need to take Willem to the emergency room for anything. I choose to not say anything to my husband walking along side of me for fear that I would jinx it and something would soon happen that would take our little one to the ER.

It happened last night. After our travels, I'm not surprised that Willem would be coming down with a cold. Around 2 am, he woke up crying, hot and irritated. I decided to take his temperature to get an idea with what I was dealing.

The thermometer reported 107.3!

I thought for sure that the thermometer gave a faulty reading. I switched to the back-up thermometer which was taken between 30 seconds and a minute to register a change in one tenth of a degree. I wasn't about to wait for it to get to 107 if that was really his temperature. I knew then that I all I need was a reliable, working thermometer, but at that hour the stores I could get to quickly would be closed. Any other time of day, rather than the middle of the night and that's what I would have done, or gone to my neighbor's to borrow theirs. But I wasn't about to do that and so we headed to the ER after dosing with children's acetomeniphen.

At the ER, he was cranky and tired but feeling cooler. Their cool temporal artery thermometer reported no fever. The diagnosis was acute upper respiratory infection, with clear chest sounds and ears. Big surprise.

Thank goodness for state medical insurance, with our old insurance that visit probably would have cost us between $200 and $400.

Since I was in need of replacing our thermometer, I looked into the temporal artery scanner at medical supply stores thinking that even $100 for a more reliable piece of medical equipment was worth it to me. I was surprised to find out that home models are sold at major retailers very affordably- $30. I was even more surprised that there were some in stock when we took our Costco trip. I am now the proud owner-mama for a temporal artery thermometer.

For the nifty technical sounding description of how it works:

The superficial temporal artery demonstrates the necessary requirements for the skin thermometry method: it is easily accessible, contains no mucous membranes, and notably, it has no or very few arteriovenous anastomoses (AVA).1,2 Lack of AVA's means that perfusion rate is reliable under essentially all conditions, and the blood flow is relatively free of vasomotor control in response to thermomoregulatory stimuli. This property is unique to the temporal artery when considering all accessible cutaneous blood vessels. The high and reliable perfusion allows accurate mathematical computations of the heat lost to the environment due to the cutaneous flow, and thus an accurate calculation of the source arterial temperature at the heart. http://www.exergen.com/medical/eductr/temp_assess.htm

And a fun video: http://www.exergen.com/medical/videos/TemporalScanner.mpeg

Week 18 Update

In the last two weeks I got over my desire to hear baby's heartbeat on the Doppler. I don't need to hear evidence of life when I'm feeling an active fetus moving around thumping and kicking in my uterus. We are already able to feel the baby moving from the outside as well. Peter has felt our new little one a couple of times already.

Willem is showing more and more interest in the baby as well. He kisses my stomach and talks about baby all the time. For Christmas, he was given his own baby doll that he conscientiosly make sure is given milk, held, taken for walks and diapers changed. The newborn size diapers I bought for our baby fit the doll--they may make for a very big butt but its a fun enterprise!

When we take the pictures off the digital camera, I'll post the video of me walking at graduation carrying Willem across the stage with me. We had a great time on our trip staying six days on the island of Hawaii and ten on Oahu.

Next steps are to prepare my manuscript for publication in family science journals and to prepare for our new little one. We are still planning on the anatomy check/gender ultrasound where I suspect my intuition will be verified that we are having a little girl.

Why is Govt Promoting Marriage?

This is a topic that has been a interest of mine, and a major focus of my research throughout my undergraduate and graduate degrees. My readers can think of it as part of my grand scheme to make our society and country a better (safer and happier)place for children and families.

From the Department of Health and Human Services, Adminstration for Children and Families:

Benefits of Healthy Marriages

For Children and Youth
Researchers have found many benefits for children and youth who are raised by parents in healthy marriages, compared to unhealthy marriages, including the following:

More likely to attend college
More likely to succeed academically
Physically healthier
Emotionally healthier
Less likely to attempt or commit suicide
Demonstrate less behavioral problems in school
Less likely to be a victim of physical or sexual abuse
Less likely to abuse drugs or alcohol
Less likely to commit delinquent behaviors
Have a better relationship with their mothers and fathers
Decreases their chances of divorcing when they get married
Less likely to become pregnant as a teenager, or impregnate someone.
Less likely to be sexually active as teenagers
Less likely to contract STD's
Less likely to be raised in poverty

For Women
Researchers have found many benefits for women who are in healthy marriages, compared to unhealthy marriages, including the following:

More satisfying relationship
Emotionally healthier
Wealthier
Less likely to be victims of domestic violence, sexual assault, or other violent crimes
Less likely to attempt or commit suicide
Decrease risk of drug and alcohol abuse
Less likely to contract STD's
Less likely to remain or end up in poverty
Have better relationships with their children
Physically healthier

For Men
Researchers have found many benefits for men who are in healthy marriages, compared to unhealthy marriages, including the following:

Live longer
Physically healthier
Wealthier
Increase in the stability of employment
Higher wages
Emotionally healthier
Decrease risk of drug and alcohol abuse
Have better relationships with their children
More satisfying sexual relationship
Less likely to commit violent crimes
Less likely to contract STD's
Less likely to attempt or commit suicide

For Communities
Researchers have found many benefits for communities when they have a higher percentage of couples in healthy marriages, compared to unhealthy marriages, including the following:

Higher rates of physically healthy citizens
Higher rates of emotionally healthy citizens
Higher rates of educated citizens
Lower domestic violence rates
Lower crime statistics
Lower teen age pregnancy rates
Lower rates of juvenile delinquency
Higher rates of home ownership
Lower rates of migration
Higher property values
Decreased need for social services


[Source: Why Marriage Matters, Second Edition: Twenty-Six Conclusions from the Social Sciences, September 2005.]

The Human Microbiome Project

The same friend who told me about outsourcing health care told me about a fascinating research project that he is working on as an employee of a bio-tech company on the East Coast.

You've heard of the Human Genome Project which catelouges all the genes in the human species. This is a little different: they are looking at all the organisms that live in the human species.

The average human body, consisting of about 10 to the thirteen power (10,000,000,000,000 or about ten trillion) cells, has about ten times that number of microorganisms in the gut. Somewhere between 300 and 1000 different species live in the gut,[3] with most estimates at about 500. These microorganisms are helpful the human existence: the microorganisms perform a host of useful functions, such as fermenting unused energy substrates, training the immune system, preventing growth of harmful species, regulating the development of the gut, producing vitamins for the host (such as biotin and vitamin K), and producing hormones to direct the host to store fats. However, in certain conditions, some species are thought to be capable of causing disease by causing infection or increasing cancer risk for the host.(see references on wikipedia.org)

The Human MicroBiome Project is trying to figure out what all of those microorganisms are, just as the Human Genome Project sought to determine all of the genes in our genome.

The process is not a pleasant one, definitely a study I would not sign up for. Participants are given a strong antibiotic that kills all of the microorganisms living in the digestive tract, and then they are asked to collect stool samples over the next weeks as the flora repopulate in the gut. Then the lucky lab techs get to analyze the stool samples.

Many holistic oriented, health conscious people, especially mothers, are aware of the importance of maintaining healthy intestinal flora for proper immune and health functioning. The Human Microbiome Project has the potential to make that information for well-known and accessible to the public, providing evidence for the importance of microorganisms in association with health and disease with applications across the medical and healthcare fields.

Outsourcing Health Care

A friend informed me of a new concept that has implications for childbirth: outsourcing healthcare. Evidently, there is a new trend for insurance companies, to cut costs, to send patients outside of the United States with cheaper healthcare services for procedures, etc. The example my friend told me about was patients being sent to India for heart transplants. While there, patients are given "gold-star treatment", first class flights, nice hotels, limos to and from the hospitals, gift baskets, etc.

I have heard about the birthing mother's receiving celebrity treatment for extra cash-- $15,000 for continuous labor support provided by an obstetrician, extra special hospital accomdations, incentives, etc. but outsourcing takes it to a whole new level.

Next, will there be reports of U.S. insurance companies sending birth women to India, France, Spain, etc for gold-star scheduled inductions to decrease costs?

In order for that outsourcing to be effective in the case of labor and birth, the birth would have to be scheduled, otherwise women might be living out of hotels for 2-6 weeks waiting to go into labor. I can't imagine how that could still be cost-effective. So let's assume that a woman is put on airplane at 38 weeks and the induction is schedule for a day or two after arrival.

Would that be cost effective?
Do we need to see more inductions of labor and scheduled c-sections?
Would those births be granted dual citizen status?
How would the birth stats be reported--in the country of birth or in the United States?
Will this be a new trend or will common sense prevail?

Northwest Taking Legal Action Against VBAC Bans

This was recently posted on ICAN, providing legal representation for women seeking Vaginal Births After Cesarean (VBAC), inspite of hospital policies in the Northwestern United States banning them.

I’m a lawyer with the Northwest Women’s Law Center in Seattle. I’m
investigating possible legal responses to bans on vaginal birth after
cesarean at hospitals in the northwest states - Alaska, Idaho, Montana,
Washington and Oregon. If you are currently pregnant and want to have a
VBAC, but are facing a hospital policy that would require you to have a
c-section regardless of whether you want it and whether it is medically
necessary, and are willing to consider working with a lawyer on this, we’d like to talk with you. Please email us at vbacbanhelp@ican-online.org Our services will be provided free of charge.

I believe this is a follow-up to the Seattle PI editorial from September 2008.

Updates

The last couple of weeks could be called the weeks from Hades. Between me and Peter, he had his comprehensive exams to be advanced to Ph.D. candidacy or ABD status (all but dissertation) and I was making the final revisions to my thesis that were suggested by my committee at my defense. On top of that, I'm in my 11th week of pregnancy, the week where either my dream from a few weeks ago would be realized or not. I guess maybe the stress of those weeks could have resulted in a miscarriage but thankfully they haven't.

I'm still pregnant, yay!

Peter passed his exams! yay!

My thesis is done, mailed and delivered! yay!

Not surprisingly, my house is a mess. I guess that's what we'll be working on today. After my massage (my reward for the last couple of weeks).

Willem present at birth

Someone recently asked me the question if I planned for Willem to be present at the birth of his younger brother or sister in May. I have given lots of thought to that and had an experience in the past week that have really made me think about it.

I do want my Chunka to be present while I'm laboring and birthing. My dream is that he'd play with his cars and toys, cuddle with me, come to me give me hugs and kisses, and nurse occasionally, and be asleep for good parts of it. I'd love it if he played in the water with me and made me laugh through labor. Realistically, it could work out that he's sleeping through the night while I bring his brother or sister in the world. But in all fairness he'll be 2 years old, the process can be long and require lots of concentration and space; he may need a place away from mom for both of our sakes. He'll definitely need some of his own support and help because I'll be a little busy during that time.

I was trying to make plans accordingly by asking my doula friend to be there for him during labor and birth. She was okay with that for awhile and then she got freaked out when she realized that she and Chunka won't know each other and he could be uncomfortable with her. She also realized that as a doula/midwife/child care person, her focus would be pulled in all sorts of directions even though she's hired to be there as help for the kid. I understand that and I'm glad she told me that sooner than later, because I'd really be stuck in a lurch if she told me that and I was 33 weeks pregnant.

Now I'm trying to find out what my Plan B is. I do live in a very supportive community where I have friends living next door and across the courtyard. Chunka is comfortable with the kids and the parents, and he'd be nearby so taking him somewhere is not a big deal and having someone bring him back is not a big deal either. Sounds ideal, but I'm very concerned about how supportive my neighbors/friends are of homebirthing. Everyone has had their kids in a hospital and I have no idea how much fear/doubt/discomfort they have regarding homebirthing.

One neighbor is probably more comfortable with it than the others (she's the one who lives right next door, in fact we share a wall). Her sister has had babies at home and is a Bradley instructor and her mom has been a Lamaze instructor. I think she's comfortable with birth but I need to ask her if she's willing to help me out when I'm birthing next door to her.

The other neighbor is very openminded and non judgemental. She's a reader of my blog in fact so she knows exactly what my plans are, and since she knows that I'm worried that she would balk at being apart of those plans.

And the other neighbor, she's kind of in awe of me and never said anything negative about me giving birth at home this pregnancy but at the same time probably harbors all sorts of fears and doubts so I'm really hesitant to ask her.

Basically, I don't want to open myself up to all sort of questions and fears and concerns. Ideally I want someone there for him (and nearby me) who:
1) knows Chunka and he's comfortable with them.
2) is comfortable around birth.
3) lives nearby.
4) won't project their fears surrounding birth on me or my husband.

That's already made me reject the offers from two friends who live locally but further away from me. They are more likely to be more comfortable with birth but they wouldn't have the advantage of taking Willem for a nap at their homes or playing with their children nearby.

At least its still early in the pregnancy and I do have time to figure these sorts of things out.

An emotional link to morning sickness?

Who has ever heard of 2 am morning sickness?

I hadn't.

And I really like that my bout of toilet hugging is connected to the worrying I was doing last night. I honestly think I worried myself sick.

That needs to stop.

Vent

I feel nauseous.

But not so nauseous to do anything about it.

Other than complain.

Complain.

Indecision and Straddling the fence

Blame this post on pregnancy hormones, if you would like. I'm struggling right now on separate but related issues.

I can't decide if I can be confident that this will be a pregnancy that results in a living child or if I'm going to be experiencing a miscarriage in the next 10 weeks or so. Some may call it irrational, but I have this fear of miscarrying. I know that statistically I will likely experience at least one miscarriage during my childbearing years. Knowing that can kind of prepare me for it, but I don't ever want the current pregnancy to be a miscarriage. Willem was my first pregnancy and he was born alive and healthy and is a wonderfully loving one year old now. That makes me think that I'm even more likely to have a miscarriage with this one, because its bound to happen sometime, right? I think the only thing than can remedy these fears is some patience. I'll know within the next 10 weeks if this pregnancy will miscarry or not. Not very comforting. Of course, I have been turning to prayer to find peace on this issue. I'm hestitant to seek a priesthood blessing because of the outcome from the last (which is also contributing to my fears now). Maybe Peter is ready to try to give me another but he said after that last one that he's afraid too.

The other struggle I'm facing right now is overcoming my cultural heritage when it comes on being more reliant on my self and my God, instead of medical professionals. I feel drawn, out of habit, to make all the prenatal appointments, have the early viability ultrasound and all the bells and whistles of modern maternity care even though I know that its not effective, or based in evidence and best practice. I'm also drawn to the unassisted prenatal care because it seems like it can be part and parcel of unassisted birthing. Feeling like I'm being pulled in both directions, I struggling to figure out what my balance will be. I have a midwife that I will consult with on a semi-regular basis for prenatal appointments, even though many of the clinical services I'll decline (even though I'm tempted to take everything that is offered).

Having a midwife for prenatals (and back-up for the birth) is my way of making sure that I have an advisor, counselor and consultant when it comes to concerns and questions that I may have. Part of having a solid consultant/consultee relationship is taking the time to nurture and grow that relationship, which makes me feel obligated to schedule more prenatal appointments than I would like it. I also fear that feeling obligated to building that relationship will lead me to feel obligated to accept attendance at the birth.

Last night at my first prenatal appointment, I felt my first bit of accepting something that I otherwise wouldn't choose for myself, because of a sense of obligation. There were two other women who attended the appointment with the midwife. I had gotten a heads-up from my doula friend who works with the practice that one additional person would be there (a midwife assistant). But I was surprised that there was another person there as well, I think a student. I wish that I didn't feel that more people than I comfortable with are being pulled in to work with me. Next time if there are assistants or students present, I will likely request that they stay out of the room for my appointments because my goal is to build a relationship with the midwife, on the level that I'm comfortable with, as I figure out that balance between keeping professional emotional distance and building a trusting advising relationship.

And then to further complicate my feelings on that issue, I can go back to being afraid that I may just lose this baby anyway, making all this thought and worrying unnecessary. Sigh. Help thou my unbelief...

I'll accept prayers and positive thoughts on my behalf to those who are willing to give them.

Consumer Reports Health Condemns Common Obstetric Practices

Consumer Reports Health is a new public service from the well-known Consumer Reports. They are now providing reporting data on medical procedures and treatments in an effort to assist consumers of health care to be more informed. I am impressed, and pleasantly surprised, that they are present the research-based evidence regarding obstetric practice, instead of what the American College of Obstetrics and Gynoecologists is promoting. This is what Consumer Reports Health have to say about basic obstetric practice:

Despite growing evidence of harm, many obstetricians and maternity hospitals still overuse high-tech procedures that can mean poorer outcomes for baby and Mom. Test your knowledge with our quiz below.

T/F: An obstetrician will deliver better maternity care, overall, than a midwife or family doctor.False. Studies show that the 8 percent to 9 percent of U.S. women who use midwives and the 6 to 7 percent who choose family physicians generally experienced just-as-good results as those who go to obstetricians. Those who used midwives also ended up with fewer technological interventions. For example, women who received midwifery care were less likely to experience induced labor, have their water broken for them, episiotomies, pain medications, intravenous fluids, and electronic fetal monitoring, and were more likely to give birth vaginally with no vacuum extraction or forceps, than similar women receiving medical care. Note that an obstetric specialist is best for the small proportion of women with serious health concerns.

Induced labor can halt fetal development.
True. The vital organs (including the brain and lungs) continue to develop beyond the 37th week of gestation. There is also a five-fold increase in the brain's white matter volume between 35 and 41 weeks after conception. Inducing labor (with synthetic oxytocin, for example) might stop this growth if the fetus is not fully developed. Between 1990 and 2005, the number of women whose labor was induced more than doubled.

Due-date estimates can be off by up to two weeks.
True. This inaccuracy can lead to a baby being delivered by induction or Caesarean section up to two weeks earlier than its estimated due-date, cutting off important weeks of fetal development.

"Breaking the waters" helps hasten labor.
False. There is no evidence to support the fact that this common practice (about 47% of women) shortens labor, increases maternal satisfaction, or improves outcomes for newborns.

Induced labor increases the likelihood of Caesarean section in first-time mothers.
True. The cervix may not be ready for labor. Other effects of induced labor include an increased likelihood of an epidural, an assisted delivery with vacuum extraction or forceps, and extreme bleeding postpartum.

Once you've had a C-section, it's best to do it again.
False. Studies show that, as the number of a woman's previous C-sections increased, so did the likelihood of harmful conditions, including: trouble getting pregnant again, problems delivering the placenta (placenta accreta), longer hospital stays, intensive-care (ICU) admission, hysterectomy, and blood transfusion.

Labor itself can benefit a newborn's immunity.
True. When babies do not experience labor (if the mother has a C-section before entering into labor, for example), they fail to benefit from changes that help to clear fluid from their lungs. That clearance can protect against serious breathing problems outside the womb. Passage through the vagina might also increase the likelihood that the newborn's intestines will be colonized with "good" bacteria after the sterile womb environment.

Epidural anesthesia is a low-risk way to make labor easier.
False. Many women welcome the pain relief, but might not be well-informed about the increased risk of its side-effects, including lack of mobility, sedation, fever, longer pushing, and serious perineal tears.

Epidural anesthesia presents risks to newborns.
True. Babies whose mothers received epidurals during labor are at risk for rapid heart rate, hyperbilirubinemia (the presence of an excess of bilirubin in the blood), need for antibiotics, and poorer performance on newborn assessment tests.

Episiotomies reduce the risk of perineal tearing.
False. Evidence shows that routine use of episiotomy offers no benefits but rather increases women's risk of experiencing perineal injury, stitches, pain and tenderness, leaking stool or gas, and pain during sexual intercourse. Yet in 2005, 25 percent of women with vaginal births continued to experience this intervention. Episiotomy is one of several obstetric practices adopted into common usage before being adequately studied.

Source: "Evidence-Based Maternity Care: What It Is and What It Can Achieve," a detailed review of clinical evidence by Carol Sakala and Maureen P. Corry published by the Childbirth Connection, the Reforming States Group, and the Milbank Memorial Fund, October 2008.

Saga of a Deep Pelvis

I learned I had a deep pelvis when I was pregnant with Willem and went to get the 20 week ultrasound. The technician had a difficult time capturing him because he was tucked so entirely in my pelvis. With his pregnancy, my torso did not ever get to the tell-tale this-woman-is-ready-to-birth size. At 38 weeks (when Willem was born), many people thought I looked closer to 7- 7 1/2 months pregnant.

So being 10 weeks with another pregnancy, I'm not surprised that I can't feel the fundus of my uterus above my pelvic bone yet. Its not strange that I can't feel it yet, even though it should be more likely since my uterus has already expanded in size before. Yesterday was our first appointment with my midwife and we hoped that we would hear the heartbeat.

It would have been a very exciting and happy way to end a difficult week for both me and my husband. I have been making the final revisions to my thesis and my husband had taken the written portion of his qualifying exams to become a Ph.D. candidate (4 days of intense testing). So hearing our babies heartbeat would be a comforting way to end the week.

Not surprising, we didn't hear the heartbeat using a doppler. I chalk it up to the deep pelvis of mine and being at the early cut-off for hearing a baby's heartbeat using a doppler. I thought I could handle that slight disappointment without needing proof of pregnancy. At an OB's office, I could have been very tempted to agree to a transvaginal ultrasound so I'm glad that temptation was removed. Instead, I got a few laughs when I asked for a pregnancy test from the midwife, just to see some indication that I am still pregnant.

I'm still laughing at myself for that. But yes, indeed, two lines appeared. I still feel pregnant and at least my urine is indicating that I am.

My readers may remember posting about a dream where I miscarried this pregnancy at 11 weeks. I'm still not there yet and I'm trying to remain optimistic that the dream was a product of my fears and not preparation for reality.

By way of other updates, my due date club of friends is growing. A friend from high school whose little boy is a little bit younger than Willem called to tell me that she is also pregnant again. Another friend local to me is also expecting. I'm glad to have at least one local friend who we can share our pregnancies together.

A Happy Birthday to me!

On Saturday, it was my 24 birthday. That's not the remarkable part, its that I really enjoyed it!

Birthdays are just kind of days to me even though I appreciate it when others try to make it special. This year everyone succeeded very well. I think it was helped by being on a Saturday. Everyone's birthday should be on a Saturday.

I was expecially happy to receive the gifts I received. A number of them were books, you know the kind that can be read for enjoyment. Being pretty much finished with my degree program makes me very happy to see a stack of unread books to read.

The books on that list (no birth books, but that may be what I get with the money I was given):

Irish Crystal by Andrew Greeley (in the Nuala Anne McGrail series)
Feeding the Whole Family: Cooking with Whole Foods by Cynthia Lair
Brisingr by Christopher Paolini (book three in the Eragon triology)
Wise Woman's Herbal for the Childbearing Year by Susan Weed
World Without end by Ken Follet (the sequal to my favorite historical novel: Pillars of the Earth)

I was also given a super soft robe and blanket set that has replaced my favorite purple robe. I know I'll be enjoying the comfort of that set for the next few months. I also was given a hand carved nativity set from the Philipenes and a lovely ivory pendant from Alaska. The pendant reminds me of the full beauty of a pregnant belly complete with eternity knot at the top. I will treasure that during my pregnancy.

Peter also was very good to me that day. He made me breakfast. It would have been in bed but I got up before he finishied making it. Then we took a walk as a family to the park and then napped when we got home. I really enjoyed cuddling with Willem and getting a birthday nap. I highly recommend it! After we woke up, we were greeted with dinner (coconut curry chicken) and a fresh baked cheesecake. Many thanks to Peter for making my birthday special and to the family members who sent thoughtful gifts that I enjoy.

Moving to Canada

That's not true, but based on the current economic status of the United States, my husband and I have been in serious talks about moving out of the country, temporarily, after he finishes his PhD. To underscore some of our reasons why we would move out of the United States, see this funny from jibjab.com

Come On, Move to Canada! | Funny Jokes at JibJab

Its not about the abortion, or medical marijuana but I do admit that public radio sans pledge drives is very appealing. Really, my husband and I see ourselves as elitists who are in need of the Expatriot, Liberal, Intellectual's Theocracy Escape Plan.

Willem News

There have been a few Willem anecdotes from the last few days that I've been particularly impressed with so I'm sharing them here:

The other night, Peter, Willem and I were getting ready for bed by sharing a bit of chocolate. We finished the chocolate bar and we had the resulting wrapper. I handed the wrapper to Willem and told him to go throw it in the trash can in the bathroom (one room away). He held onto it, climbed of the bed and walked out of the room. He came back into the room a short bit later without the wrapper. Both Peter and I knew it could be anywhere--the toilet, the other bedroom, the floor in the hallwa--and we knew that when we got up in the morning, we'd find out where it ended up. The next morning, I found the wrapper...guess where? The trash can! Way to go, Willem!

Yesterday, I was busy with something online and Willem was telling me he wanted to go outside. He brought me his shoes but he was only wearing a diaper and a shirt. I told him that he needed socks and pants. The next thing I knew he was gone from my knee and had gone off somewhere. Then I heard him coming down the stairs, he came over to me and handed me 3 socks. Two of them matched well enough and I put them on. I was impressed that he would follow such complex directions and bring me socks!

We have kind of started potty learning with Willem. He will let me when he needs a new diaper (if his diaper is off) or that he needs a diaper change after he's used the diaper he's wearing. He also will sometimes sit on the potty that we have for him. Today while I was making lunch, I looked up and saw him sitting on his potty in the living, reading a book. He had a diaper on but he was doing exactly what I've been trying to show him. Other times that he's sat on the potty, he's sat perfectly well without a diaper on, but he still hasn't actually relieved himself into it. That will come with time. I'm wondering if I should get some of those cloth training pants that he could pull down by himself (no pull-ups around here!).

He's also learned where Grandpa and Grandma live. The other night, Peter and I were talking and I mentioned a town in Texas. Willem heard the reference and immediately said (and signed) Baba (his way of saying Grandpa). He hasn't said Texas yet, but he knows that's where his grandparents are! He'll also point to airplanes that fly over head and say Baba and Nana. I'm pretty sure that means he wants to get on the airplane and fly to Texas to see them.

He is also starting to show empathy. On Saturday, I came home from an Irish dance performance with sock glue residue on my leg. The fuzz and lint from my pants stuck to the glue and I had these furry rings on my calves. Willem say them, touched it gently and said "Uh-oh! Oww..." He also gives kisses to ouches, like when Peter had some road rash from a bike accident. Willem would gently kiss Peter's elbow. Willem also kisses his knees when they have scrapes on them. One time, something fell on my toe and he kissed it for me.

He also is starting to think symbolically. He "pretends" that blocks are cars or that his finger is an airplane.

He's also learning to pray. Last night, I told him it was time to pray and he folded his arms across his chest. I started the prayer and then asked him who he wanted to pray for. I started with Grandpa, and he said Baba and then Nana and then Daddy and then Mama. I finished the prayer and at the end when I said Amen. He said May-may (which is what he calls our neighbor Eamon).

I am happy that Willem is learning skills that are needed to be successful in life. Following directions, empathy, praying, dressing oneself and toileting are important milestones that he needs to learn and I'm impressed that he is working on some many of those skills at his age.

His language (as seen from above) is coming along and he is learning new words frequently, including the signs for many of those words. His favorite newest sign is seal--clapping your hands together like a seal clapping its flippers.

A Scary and Weird Dream

Last week I had a scary pregnancy dream. Ever since that blessing my dreams have been centered around the things that could go wrong with this pregnancy. The worst one so far was dreaming of miscarrying the baby.

I dreamt that I started bleeding and was spending a lot of time on the toilet letting the bleeding happen and then I noticed some tissue that was different from the rest. I reached down and caught it in my hand and found a 2 in fetus where I could see the anatomy is detail. I was saddened to know that I had lost my baby but at the same time I was amazed to actually hold a baby at that stage in development.

Because my husband and I are both scientifically minded, my first thought was that he would like to preserve the body of this child the same way he had preserved the body of his pet octopus that died last year (he works in an animal behavior lab so he's got all the materials and chemicals available to him). I was okay with that. I'm also no stranger to having family member's remains in my home as I kept my brother's ashes on my bookcase for years when I was growing up, and my father's ashes are kept in my mother's home still.

The end of the dream was when I walked by my dresser and saw the little vial with my baby floating in it, and I was glad to see it there.

Aside: A baby is generally around 11 weeks when its 2 inches long. I've got 4 more weeks until I can be comforted that I won't actually experience that.

Finally!

Today was the big day to print off all 125 pages of my thesis and put 4 copies of the whole thing in the mail. Such a relief!

This last week has been so frustrating. I think my advisor has revised and made changes to each section of my thesis a minimum of 4 times. Even today, after she had okay'd it to be sent to my committee, she emailed with me changes to the title page and abstract. Even after it had been sent to Fedex for printing! Oh I cried.

But here's a big, glowing recommendation for Fedex business services (I will conveniently ignore that they are also Kinkos--being the grandaughter of a competitor's franchise owener). Not only was I able to email my documents to them, they completely understood when I had to resend with the changes that had been made. And to make it all good, they are going out tonight in their shipment.

In two weeks, I meet with my committee by phone and discuss my work. And then (I'm trying not to think about this) they'll tell me what changes I need to make. Then I'll have 18 days to make those changes (and get it approved by my advisor who will probably kick it back to me a few times...argh!!) before I print it again and then mail it to the Graduate Division. But I have a few days before I have to think about that...

Detergent for Cloth Diapers

When it comes to detergents for cloth diapers, I'm pretty clueless. I've gotten some scant information and gone with it, instead of really digging deep to find good information. The other day, my friend passed this resource along to me:

Detergent Chart for Use in Cloth Diapering

There is also a guide for different types of diapers. Since I use pocket-diapers, I found this chart especially helpful:

Detergents for pocket diapers

Some Cause for Concern

Over the weekend I asked my husband for a priesthood blessing for this pregnancy. He was very unnerved to find that he couldn't say, guided by the Spirit, that this baby would be born healthy and whole. He struggled to find the words that the Spirit was telling him and the only information that we got was that we would be faced with some difficulties this pregnancy but that everything will work out in the end.

We don't know what that means. It could mean something as mundane as me struggling with low energy and taking care of two children, or some normal first trimester bleeding. It would mean events as serious as a miscarriage, a premature birth or complications during labor and birth which necessitate transfer to the hospital for either baby or me. We believe that all things work together for the good of those who experience them (Romans 8:28, D&C 90: 24, D&C 98:3)--that there is purpose in whatever difficulty or challenges we are faced with.

If its an awful, scary outcome for this pregnancy, we trust in the Lord that those experiences will work together for our good. We beleive that through the temple covenants we have made that our children will be ours forever and through the eternities and that any children or family members we lose in this life, we will be reunited with after this life. That is our faith, so we do not shun the prospect of miscarriage or stillborn baby, although we would be deeply disappointed and mourn for our loss. We hope that the worst of our fears won't be realized but we will be accepting of them if they do come to pass.

I have found comfort in the words of the hymn "Come, Come Ye Saints:"

Come Come Ye Saints no toil nor labor fear
but with joy wend your way
Though hard to you this journey may appear
Grace shall be as your day
'Tis better far for us to strive
our useless cares from us to drive
Do this and joy, your hearts will swell.
All is well,
All is well.

Why should we mourn or think our lot is hard?
'Tis not so, all is right.
Why should we think to earn a great reward
if we now shun the fight?
Gird up your loins, fresh courage take
Our God will never us forsake.
And soon we'll have this tale to tell,
All is well,
All is well!

And should we die before this journey's through,
Happy is day! All is well!
We then are free from toil and sorrow too;
with the just we shall dwell.
But if our lives are spared again
to see the Saints their rest obtain,
Oh, how we'll make this chorus swell,
All is well,
All is well!

I hope that my readers do not find my attitude cavilier and insensitive. It requires a great deal of facing my biggest fears to be able to post that its okay with me if I should "die before this journey's through." I hope that level of loss is not necessary for my family. I feel needed on this earth to be a mother to my children, to bear future children and to faithfully endure to the end of my long life on this earth. I obtain comfort from recalling my patriarchal blessing and other blessings which I have received that indicates my life will be long and full of love as I watch my children grow and mature.

Answers for Susana

Susana left some questions on my blog and I thought I would answer them here.

First she asked whether we were planning to learn the gender of this baby.

Yes, we are. A few months ago, I went to my husband with my findings that ultrasounds are unproven to have no effect on the developing fetus. It appears that more conservative parents and doctors decide that as few as possible are best in pregnancy so serial ultrasounds (those performed frequently without good cause) are to be avoided. With Willem's pregnancy, I had two ultrasounds performed: a transvaginal to check gestational age and viability at 9 weeks and the anatomy check (aka find out your baby's gender) at 20 weeks. I have since learned that ultrasounds in a normal low-risk pregnancy are not necessary, but then again if I had thought carefully about it then I would have told you the same thing. But I'm older, wiser and more experienced now.

When I told my husband about this, he agreed that ultrasounds are not necessary but he also stated that they aren't so dangerous that they need to be avoided all together. I was prepared, if he agreed, to refuse all ultrasounds for this pregnancy but he felt strongly about the 20 week anatomy check. I think he wants it more for the reasons that he finding biology fascinating (he is a biologist afterall) and he loved the experience of seeing Willem in utero--so he would like that opportunity again. Also, he's a cautious, worried kind of guy when it comes to pregnancy and birth. He fears for the unlikely what ifs. So he wants to make sure that all parts are there and accounted for at least once during the pregnancy. Knowing to him is comfort, even though finding out about potential problems would not change our decisions to birth and rear a baby.

And there's the issue of gender. I could go without knowing the gender of this baby, but I admit that there is a part of me that really likes the convenience of knowing and being able to prepare all the stuff that goes along with a baby of a certain gender. It is also helpful to know because it curbs the spending of overzealous relatives (as we learned when we were pregnant with Willem). So a part of me wanted to know because I don't look forward to the shopping with a newborn and a toddler, I'd rather have it done before the baby arrives. Peter, my husband, also wanted to know for those reasons too. Together, we made the decision that both of us could support. One ultrasound, at 20 weeks, and we'll find out the gender.

The other question that Susana asked was why I felt it was so important to pin down the gestational age/due date for this pregnancy.

First, my reasons for wanting to know have little to do with the due date. I hate the term due date because it implies there is a deadline for a baby's birth and I disagree that a baby has to come before a certain time. I strongly trust in the need for a baby to come when he/she is ready and to wait patiently for labor to begin on its own. But my concern for this pregnancy is that possibly I conceived a month before I thought (which might explain the clearly positive line that appeared immediately on the home pregnancy test), and being off in my dates by a month was too big of a window for me. For my comfort, I needed to know at least the month the baby was conceived.

Birth after a normal gestation can occur anywhere between 37 weeks to 43 weeks, with some women birthing after that. The longest human pregnancy I've heard of is 52 weeks! Being off by a month (conceiving in August instead of September) could make this baby due as soon as the beginning of April. And if I went into labor in the beginning of April with a baby conceived in September, that baby would be 33 weeks in gestational age-- a premature baby. So based on that, I would like to know that when I do go into labor that its an appropriate and healthy time for that baby to be born, and especially not too early where medical support would be necessary.

However, I have since obtained enough evidence that this baby was conceived in September so I am no longer concerned about being off of a month or more. If I had conceived in August that means I had a period that tricked me into thinking that I wasn't pregnant when I was. I felt that my suspicion would be validated if in September I had period like bleeding, but since I haven't and an official period has been missed, I'm no longer concerned about conceiving earlier than my body was indicating. And I didn't need an ultrasound to prove it, thereby being able to avoid the viability ultrasound.

At this point, I am able to trust that this baby is viable and this pregnancy will continue normally until I get some indication that it won't. But having an ultrasound telling me that my 6 weeker or 9 weeker is showing all normal development is not necessary for me. An ultrasound can only clue me in on whether I will miscarry soon or not. If I was going to miscarry, the knowledge obtained by an ultrasound wouldn't provide me much comfort. It would basically draw out the process while I waited for the spontaneous abortion to occur since I would refuse any offers for an assisted miscarriage. I feel that an early ultrasound would not give me any more pertinent information that my body isn't already capable of giving me. I also am looking forward to keeping all hands, devices and instruments out of my vagina over the course of this pregnancy. I feel the transvaginal ultrasound is not only necessary, but invasive. I am aiming to protect my bodily integrity this pregnancy by refusing such examinations.

So yes, Susana, those are my responses to your question. I respect your desire to understand and I know that you are not being disrespectful in asking.

I thought I might escape

I found out 10 days ago that I'm pregnant and the last 10 days have been great. The only pregnancy "symptoms" I've experienced are needing to eat more frequent, smaller meals, and going to bed earlier each night. I have been able to eat whatever I want and be as active as I want. I thought I might be able to escape the morning sickness that is so common in pregnancy, and which I experienced when pregnant with Willem. With him, I had to eat first thing in the morning (literally before I picked my head up off the pillow) and I typically threw up once a day and spent the rest of the day nauseous.

But I haven't had any of that and I really did think I was escaping. I wondered if it might be because I'm supplementing with B-complex vitamins, or that I've cut back on dairy, or because I'm eating healthier than when I got pregnant with Willem, or if my body has just gotten "better" at being pregnant. Regardless of the reason, I was filled with gratitude to be escaping that discomfort.

Then this morning I was caught by surprise. Halfway through eating breakfast I had to run upstairs and throw up what I has just eaten. I hadn't felt any indication that was coming on.

So this may be the beginning of a few weeks of relative discomfort and hardship as I get my thesis printed off and mailed, and chase a toddler and a 10 month old (my newest source of income) around and defend my thesis. Regardless, I'm still a happy and excited woman to be carrying this child.

Graceful Womanhood

I've never been one of those women to fear aging. In fact, I spent most of my youth trying to grow up and gain independence. I hoped as a young woman that I would age gracefully and beautifully; like the energetic older women with hair streaked with gray and silver, laugh-lines and smile line showing a happy, well-lived life. I hoped that my hair would have silver or white streaks or individual hairs running through my still darker hairs. How I envision it is visually beautiful.

Well today, I discoverd my first gray hair. It was closer to silver actually and it was right where I also wanted my first streak of silver to appear. Right along my part at the crown of my head, that stretches into my ponytail when my hair is pulled back.

I'm probably a bit young for silver hair, but it was about the age I am now that I discovered my husband's first white hairs. I happen to think that white, silvery hair is very pretty on women, and distinguised on men (except OBs, but that's a whole 'nother topic, so its a good thing I didn't marry an OB).

As for the silver hair I found on my head, I welcome it as a symbol of maturity, experience, wisdom and strength. Those are all virtues I wish to pass on to my children, especially my daughters. And if my gender prediction for this pregnancy is correct, I will have that opportunity starting now to be an example of graceful, wise womanhood.

Who knows maybe that gray hair was caused by the little woman growing in my womb now....

The end is in sight!

Today, my advisor informed me that I'm just about ready to submit my thesis to my committee....

WA-HOOOOOOOOO!!!!!!


All I've got to do is make a last round of corrections, but it sounds like she doesn't even want to see them before I send it off.

I expect I've got another 4-5 hours to complete those changes and then its DONE.

I guess I would be working on that, instead of posting about my excitment...

Back to the thesis.

(As I go happily skipping away humming "Ding-dong the beast is done, the beast is done, the beast is done....ding, dong the awful beast is done!!")

School?

This is a conversation I have with Willem probably 5 times a day:

W: Zoe?
M: You want to play with Zoe? I'm sorry you can't right now, she's at school.
W: E-mama? (Emma)
M: She's at school too. I'm sorry.
W: Daddy?
M: He's at school too. He'll be back tonight.
W: School?
M: Yup Zoe, Emma and Daddy are at school.
W: Ba-ba? (Grandpa) School?
M: Laughing. Nope, sorry, Grandpa's in Texas.
W: School?
M: Nope, Grandpa doesn't go to school anymore. We left him in Texas.
W: Nana?
M: She's in California. We'll see Nana in November.

I'm just looking forward to when he starts trying to say "Texas" and "California." That will sound really cute in his little toddler voice.

Gender Prediction

Based on my last cycle and the date of conception in relation to ovulation and the evidence of early implanation and relatively high levels of the pregnancy hormone, I predict that our wee one is:

A Girl

Our nickname for her throughout this pregnancy will be Kernel. With derivations including Kernel Mustard because it was through our faith that she will be coming to us.

In about 16 weeks, I will get the 20 week ultrasound which may confirm if my suspicion is correct. Of course I will update my blog when I know more.

I Birth My Babies...

...Thank you very much.

Its been reported that the American College of Obstetrics and Gynecologists after issuing a statement deploring homebirth,gave its members a bumper sticker which stated "Home Deliveries are for Pizza."

Clever.

Except I reject their premise that babies are "delivered." In my experience, babies are birthed by mothers, not be obstetricians. And mothers do not need to be "delivered" by their saviors the OB. Also "delivering" babies connotes to me that mothers are delivering a load, or depositing excrement. And babies are far too precious to be termed as a "delivery" like unto one that is deposited and flushed down the toilet. Although it wouldn't be the first time I've thought that OBs would like birth to be equated to a bowel movement (see my blog: POOP on the ACOG)

If we want to follow that logic that normal, psychological process are not supposed to take place at home, then process such as defecation, sexual intercourse and even sleep would have to be carefully observed and assisted by medical professionals. In that birth is a normal psychological event like sleep and pooping, its domain in within the home where a person is able to allow their body to work in a normal, undisturbed, unobserved manner. Home birth is safe, safer than hospital births because the occurance of risky interventions is much less likely in a home environment.

My babies are birthed, by me, through the power of my body which was given life by a Divine Creator. The one person I feel I need to be delivered by is my personal savior Jesus Christ. And whoever is in attendance at a birth, be it husband, midwife, obstetrician or doula, are only there as observers. They do not have the active role of birthing the baby. I take hold of that power and claim it for myself: I Birth My Babies, thank you very much.

Documentary on Birth Trauma

Coming 2009 is "The Other Side of the Glass" a documentary on birth trauma from the eyes of the baby and the father. Featured in the film are Karen Strange, Sarah Buckley, David Chamberlain and Michel Odent. I'm looking forward to seeing it.

Its really real

I have been preparing and planning for an unassisted birth since I realized how traumatized I was by my first child's birth. It was that trauma that also brought me to the awareness that medical attendants at a birth are not neccessary all of the time. When it came to unassisted birth, I think of it as something I'm going to do, but when not pregnant it like saying someday I'll hike Mt. Everest.

But now I'm pregnant. I found out yesterday. Which illicits from me a hushed "yay" because I'm happy, its what I wanted but now the prospect of an unassisted birth is real. Its really being planned. But, between not knowing I was pregnant and knowing now, honestly nothing is different. Other than the fact that before it was all hypothetical and now its real.

For so long now, I've thought about what will be different with this birth and how to prevent being coerced and bullied by others during labor and birth. But all that time, no concrete plans could be made. There were plans made for what to do once we learned about being pregnant, but none of those things could occur until that positive proof was there.

Of the things we have agreed on, this is what we now our course will be for this pregnancy:

1. A reduced prenatal schedule. Even though we plan the birth to be without a midwife in attendance, we plan to see a midwife for infrequent pregnancy visits. The average prenatal schedule in the United States is 14, if I recall correctly (from "Expecting Trouble" by Thomas Strong, MD). The fewest number of visits for European countries (with lower maternal and infant mortality rates) is 5 with many countries only scheduling 9 for pregnant women. I plan to follow a schedule more similar to Luxembourg than the United States. Now that I'm pregnant, I need to figure out when and how often they are occuring.

2. Routine 20 week ultrasound. My husband and I have agreed to the routine 20 week ultrasound which is the anatomy check for fetuses but is better known by parents as the time to find out the baby's gender. We went around on that issue but have determined that at or around the 20 week mark, we will have the anatomy ultrasound and find out the gender of the baby. If its a girl, she'll be named Carolyn Belle. If its a boy, he will be Joey (Joseph) David.

3. Private Childbirth Education Classes. My husband is supportive of the idea of having this next baby at home without a midwife present but he is still nervous at his ability to handle that situation. Because of that he has requested that he and I take childbirth education classes that address the specific preparations for an unassisted birth, especially detecting and handling abonormal situations and complications. The typical childbirth education class does not contain information detailed and accurate enough. Instead childbirth education classes are often orienations to hospital policy and how to cooperate with medical professionals. We have found a childbirth educator who will be preparing and teaching us those classes, starting after my husband finishes his qualifying exams as a PhD candidate and after my thesis is submitted.

4. Not disclosing an exact "Due Date." Because EDDs (Estimated Due Dates) are often treated more like deadlines for the birth of babies and in the age of a 40% induction rate taking place often just days after the 40 week deadline, we are only telling people that this child will likely be born between Mother's Day and Father's Day of 2009. We do that to prevent some of the well-meaning but annoying comments about going "overdue" or from having to disclose definite plans to people who are not likely to understand the rationale of our actions.

5. Praying and relying on the power of the priesthood and personal revelation. My husband's and my faith is such that we beleive that God will guide our decisions for what is best for this pregnancy. While I beleive that unassisted birth is the ideal birth for me, I also know that everyday situations that arise in pregnancy and birth may not be ideal. Based on the best of knowledge and understanding that we can gain from seeking out accurate information and education and the guidance of the Lord's Spirit, we believe that if it not right in our circumstance for an unassisted birth, then we will make alternate plans for more emergent situations and seeking out medical assistance.

6. Having a water pool available. Warm water pools in labor and birth are called the "natural epidural" for its ability to soothe and relax some of the intensity of labor. We plan to have one available. Nothing fancy here, just a $35 inflatable 22" in high kiddie pool with cartoon fish on the side. There's a clever device that can attach a garden hose to an indoor faucet that will bring warm water from the kitchen to the living room. And there's always heating large pots of water on the stove.

7. Practicing Hypnobirthing and Hypnobabies. With Willem's birth, I prepared using Hypnobirthing. I found it to be very useful to coping with contractions and some hours of back labor. Since then I've learned about Hypnobabies and their greater selection of scripts for pregnancy and birth. I'll invest in some of those for this coming birth.

8. Being selective in who we tell about our plans. We hope that it will not become common knowledge for people to know we are planning an unassisted birth. They are also the people who are a) not likely to read this blog and b) are very indoctrinated with modern birthing practices to think that anything out of hospital is unsafe.

Beyond those plans, there are somethings we don't know or haven't decided yet.

One is what are we going to do with Willem while I'm laboring. I want him at home with me for nursing and cuddling and being present for the birth of his sibling, but my husband will need another support person who can help attend a toddler and a laboring woman. A doula comes to mind as a qualified person to do that, but I have continued fears about being negatively influenced by having another person present while I'm trying to birth. Since unassisted birthing is so far out of the norm in our society, I fear it would be difficult to find a doula supportive and encouraging of me and our plans.

I also don't know what I'm going to do about the early ultrasound. It is typically for a transvaginal ultrasound to be performed between 9 and 10 weeks gestation. This is when any differences in due dates from the last menstrual period might be detected. I had anticipated to refuse that ultrasound but there is some concern in my mind that my dates may be off. Conceivably, I could be a month further along than I think I am because possibly there was bleeding that I mistook to be a period. I will continue thinking on that one...

I need to figure out the prenatal visit schedule and figure out when I want to notify the midwife. Its a good thing there is time for that...

Blessings of Safe Passage

Today we leave Peter's childhood home to return to our home in Seattle. I'll return a few pounds lighter after picking up food poisoning from the Seattle airport 4 days ago. That's really not a pleasant way to spend a trip. However, in all of that, I have enjoyed watching Willem get to know his grandparents who he calls "Na-ma" (Grandma) and "Ba-Ba" (Grandpa). He was fascinated by all the model cars, airplanes and army vehicle models that his dad and uncle had put together as children, but he was also very frustrated that he wasn't able to play with many of them. By the end of the trip, he's become very adept at clearly saying "I want that"--his first sentence.

We hope that our flight home brings us safe passage, safer at least than the trip here, which in addition to the food poisoning also included a flight that left without us (leaving before the scheduled departure time).

While here, we also learned of another safe passage that we are expecting, between Mother's Day and Father's Day of this year. A vivid line on a pregnancy test verifies that I am expecting my second child to come into this world. I look forward to 32 weeks from now having a Blessingway and have henna on my pregnant belly saying "Blessing of a Safe Passage."

I also find it rather appropriate to make this announcement on my blog's 100th post.

Where is this all coming from?

Many of my recent posts were prompted by a thought process that Rixa started me on when she posted a blog about doulas making a difference in the birth outcomes of women. She expressed her reservations that doulas may unintentionally support the status quo in our maternity care system.

This is my response to her post, and what started me on thinking about what an "organized effort" to promote change in the maternity care system would look like.

On August 20, at 9:58 pm I wrote:

In the last few months, I've been having a crisis of faith in doulas which has kept me away from going through the certification process.

From a first time mom who then came into the birth community, I learned that doulas tend to represent themselves as advocates and spokespeople for laboring women. But then the same doulas turn around and change the definition of advocate into something that doesn't mean what is being heard when a pregnant couple hears "advocate."

I also know that I am one of those mothers who found a doula as a no confidence vote in the hosptial. And while I avoided the cesarean, my plan backfired when I experienced PTSD after being forced repeatedly to find my voice in order to speak up for myself like Jen said. I did that and it was like trying to stave off a freight train that was trying to barrel down on me. And Jen is right, it is the responsibility of DOULAS (not mothers!) to correct the misconception that they aren't there to be advocates or spokespeople.

In addition to all of that, I do believe that doulas are contributing to the status quo of what is happening to women during birth. I see them spending more time trying to make women "more educated" when all that ends up happening is that those women go into the situation that is stacked against them. Doulas should be mounting organized efforts against hospitals and maternity care providers that change the face of birth in hospitals so in time it will become what we know is the true face of birth is supposed to be.

I see the efforts to make those changes being kept separate from the work of doula-ing. I've heard doulas say "when I'm older, I'll take on the system but now I'm going to focus on the individual family." While I understand where they are coming from, I strongly think that most doulas have the responsibility to do both: care for their individual familes and take on the system. As they do that work, women will join them.

This is also a time to say that when I do see doula efforts to take on the system, it is very disjointed and in little pockets. While that is the way grassroots changes come about, its important to connect those pockets and getting them to work together. It is that organized effort that is needed now.

To see the posts I've written aspects of what an organized effort would look like go to:
Birth "Think-Tank"
Legal Rights to Informed Consent in Birth
Framing Birth As Public Health, Reproductive Rights Social Issue
Speaking of Frames

Stay tune as my vision and ideas coalesce themselves, and how the organizations that I volunteer for (The Coalition for Improving Maternity Services and Solace for Mothers) fit into that vision.

Speaking of Frames

A couple of my recent posts have been on "frames"--concepts and ideas that are associated in the consciousness about issues.

If birth, as well as pregnancy and breastfeeding, issues can be framed as social issues and concerns relating to the legal rights of patients and reproducing women as well as public health concers (which I believe it can be with the proper practice and research to back it up), then what type of coalition building can occur?

One important aspect of framing issues is selecting the messenger. The messenger can assist or hinder the effective communication regarding an issue and can either reinforce the unwanted, past frames or can support the development of new, more accurate frames in the public consciousness.

Which brings me to my theory that is childbirth issues are social issues, including legal issues that also makes birthing a civil rights issue.

And who is a better mesenger for civil rights battles than the ACLU?

The American Civil Liberties Union's job is to "conserve America's original civic values - the Constitution and the Bill of Rights - and defend the rights of every man, woman, and child in this country." Many people may view the oranization as extremely liberal and opposed to tradition American values.

The ACLU has issued this article which addresses some of the misconceptions of their organization. I also beleive it can be seen from this article how the ACLU could work with birth activists to fix many of the legal issues inherent in the modern maternity system.

Three Things You Should Know About the ACLU

We're for traditional American values. In many ways, the ACLU is the nation's most conservative organization. Our job is to conserve America's original civic values - the Constitution and the Bill of Rights - and defend the rights of every man, woman, and child in this country.

We're not anti-anything. The only things we fight are attempts to take away or limit your civil liberties, like your right to practice any religion you want (or none at all). Or to speak out - for or against - anything at all. Or to be treated with equality and fairness, no matter who you are.

We're there for you. Rich or poor, straight or gay, black or white or brown, urban or rural, pious or atheist, American-born or foreign-born, able-bodied or living with a disability. Every person in this country should have the same basic rights. Since our founding, we've been working hard to make sure no one takes them away.

In my vision of a concerted effort to change the modern maternity system, the ACLU would partner with a birth think-tank and the grassroots birth activists to petition change, make midwifery care more accessible and affordable to American women and descrease the high infant and maternal mortality rates around the time of birth and make unhindered, normal birth the norm.

YAY BYU!

I found this article quote on Hathor the Cow Goddess's page:

First I want to say, Yay BYU for funding, sponsoring and conducting research on the importance of breastfeeding. You don't have a medical school, and the women in the church associated with you frequently wean their children early, but you are taking the issue on. Good on my alma mater!

Next, the issue of breastfeeding can also be framed as a social issue relating to public health. The book Baby Matters presents a ponderance of research showing that not breastfeeding or weaning early contributes to many of the childhood illnesses that can sometime be perpetuated into adulthood, including mental health issues.

Three out of four new moms try breast-feeding over the bottle, but most of them have quit by the time the baby reaches six months, a new study shows.

Breast or bottle? (Francesco Tonelli for The New York Times)
A report from Brigham Young University shows only 36 percent of babies are breast-fed through six months. The American Academy of Pediatrics recommends breast-feeding through the first year.

The data are based on a weighted sample of more than 60,000 children, collected from national immunization surveys compiled by the Centers for Disease Control and Prevention. Although the data are focused on childhood immunization rates, questions also were asked about breast-feeding, giving the researchers a representative sample of nursing patterns in the United States.

The researchers found that children who were most likely to be breast-fed for more than six months typically had mothers with higher levels of education and income. Married women and those who lived in Western states were also more likely to breast-feed. Hispanic women and women born in other countries were also more likely to breast-feed.

Returning to work, being a smoker or living in the Northeast decreased the likelihood of long-term breast-feeding. Notably, low-income women who participated in the subsidized Women, Infants and Children program, which provides food, milk and formula to mothers and young children, were also more likely to stop breast-feeding sooner.

“Breast-feeding promotion programs encourage women to start but don’t provide the support to continue,” said Renata Forste, co-author of the report, published in the August issue of the Journal of Human Lactation.

Framing Birth As Public Health, Reproductive Rights Social Issue

In a previous post, I shared the legal connection between informed consent and birthing choices. Sara Ainsworth in the Seattle PI article, framed women's birthing choices as legal issues relating to reproductive rights, patient's rights, as well as the public health concerns stemming from the risks of Cesarean births.

Framing is a process of developing communications that change the way that people think about social issues. People tend to have existing intellectualized constructs that provides their interpretations of events and issues. Sometime those dominant frames are called "pictures in our heads," "mental shortcuts." (Source: Frameworks Institute)

Effective framing, combined with field building can bring out social change where coalitions of social policy advocates work together to effectively communicate about their issue.

I learned about framing policy issues in my graduate coursework from this summer. For that purpose, my cohort members and I worked on framing early childhood education as a social issue. However, my involvement in the birth community has led me to change my focus to framing birth issues as social issues that need policy changes that benefit infants, mothers and families, instead of the current system where its the obstetricians and insurance companies who benefit.

The dialouge about social frames has gotten started and the Northwest Women's Law Center has joined it. Who else will?

Will a think-tank (a policy, research and advocacy organization) ever be formed for birth issues? What type of effort is needed to accomplish the desired changes?

As one can tell, I'm not content to sit at my computer and bemoan all that is wrong with childbirth in the United States, as Rixa says.

Legal Rights to Informed Consent in Birth

This article from the Seattle PI "High rate of C-section births is health concern for women" was a breath of truth and reality of what women are facing with birth.

This is the first time, in a news media outlet, that I've seen hospital practices framed as coersive and trying to manipulate women's birthing choices. And the first time I've seen the abuses of the fields of obstretrics frames as a health issue, as well as a legal issue regarding reproductive rights and patient's rights.

One particularly persuasive quote from the article, says:

Such reasoning inappropriately views a pregnant woman's decision about her and her baby's needs as suspect, and it ignores her legal rights as a patient. All pregnant women, whether they view birth as a natural event only rarely needing medical intervention, or whether they willingly accept medical assistance with the birth process, have the legal right to informed consent and to direct the experience of bringing their children into the world.

The issue needs increased awareness. It goes beyond the talking point of VBACs and coerced Cesearans although those are grave concerns that need to be addressed. Please post comments to the PI article.

Transition in My World

Rixa posted about transition over on her blog, and it got me thinking of how I experienced tranistion when birthing Willem.

Rixa described transition like this, "hmmm, I sure would like this to stop but I know it won't. But I see why people would say things like that."

Another commentor on her blog said, "My transition was only about 20 minutes, and I really had to ride through it so I didn't get swept under. The moment I got swept under, I started to panic and the pain increased ten fold. I also remember saying, 'I'm not ready, I'm not ready, I'm not ready' over and over - as it was all happening so quickly and intensely."

I experienced a little bit of both, as I recall.

When I reached transition, I was in the warm water tub. I had been using Hypnobirthing during my labor and I had been handling contractions very well. The sensation and cramp-like contractions started to get stronger than I had been accostomed to. From what I remember, I felt like everything in my pelvis was stinging and cramping. I started saying to my doula "I don't know what to do right now. I can't breathe the hypnobirthing way." I also started waving my hands alot, similar to the hand-waving stims of austic children. That how my panic mainfested itself.

For some reason my doula left the room for a little bit (or maybe she merged in with the background to be very inobtrusive). The midwife and nurses were out of the bathroom. For the first time while at the hospital, I was alone.

It was then that I was able to regroup and get on top of my labor. And that's when I had the distinct thought, "Now I know why women ask for epidurals, but its not so bad. I don't need one, its almost over anyway."

I find it striking to realize that the time I found the most success in coping with transition contractions was when I felt unobserved, unhindered by watchful eyes. This would not be surprising to Michel Odent or Sarah Buckley, but it provides me a measure of relief in recognizing that being alone in labor was helpful to me.

One of my husband's fears of unobserved birthing is that I won't be able to be independent and labor effectively on my own. Making this realization helps me know that, based on my prior experience, being alone and idependent of "assitants" will be helpful to me.

Daddies are Free from Poopy Diaper Changes

Of all the things that are blog-worthy from the book "Baby Matters: What Your Doctor May Not Tell You About Caring for Your Baby," I'm choosing this topic first.

Linda Palmer writes on page 124:

"We also know that when mothers stay close to baby and are exposed to baby's saliva via kisses and stools during diaper changes, this helps mother provide appropriate immune factors to baby through her milk. The "enteromammary pathway" is the name given to the process by which mother supplies specific immune factors in her milk according to what she has been exposed to....High levels of sanitation between the nursing mother and her infant can prevent this valuable transaction from occuring."

That, to me, is an interesting fact. I didn't realize that there was a biological purpose to diaper changes and handling poop. Of course, when I shared that finding with my husband his first response was, "You mean I don't have to change diapers anymore?"

Aside from the egalitarian virtue of sharing responsibility with the mother of one's child, why not?

Still AWOL

Its been pretty silent over here in Descent-world. I don't know how Rixa does it... she's able to work on her dissertation, move, start home improvement projects, go to France for six weeks, love and care for her toddler and stay updated on her blog.

Me, on the other hand. My blog was very much neglected as I spent the last month intently working on my thesis. Today I'm posting to say that I just finished my Discussion section!!!!

Yay!!

Now its time to hear my advisor's thoughts and suggestions for changes that will take place, because of course there will be those. I just am hoping that they won't be too major. Little tweaks I can handle and still graduate on time. Big revisions and bye-bye graduation ceremony and 2 week vacation to Hawaii....

After my family and I got back from California in August, we spent a week at a conference in Oregon (on acoustic communication, for my husband's research). There we celebrated our 4 year anniversary. We ate dinner at an awesome bakery in Corvallis Oregon called New Morning Bakery. Then after dinner, we were strolling around the streets downtown and we found The Pottery Place where the three of us painted a platter commemorating the occasion. Since we forgot to pick up when we left town, we are waiting for it to be mailed to us. Maybe I'll post pictures when we get it.

When we finally got back home (oh how excited we were to sleep in our bed!), I turned to thesis writing. Our schedule basically consisted of waking up and then I would get to work while Peter and Willem went around to whereever they could find to play. I got between 3 and 4 hours a day to work. I pounded out the results section, updated my literature review, formatted according to the APA and UH style guides and then wrote the discussion of my results. Maybe later I'll post a summary of the findings.

I really cannot wait to go back to normal life. When school starts for Peter again, it'll just be me and Chunka doing our thing. I hope to introduce Signing Time to the kid and get back to working with the Birth Survey and Solace for Mothers.

In January, I'll also be applying to the University of Washington's PhD program in health services with an emphasis in maternal and child health . I'm considering registering for some of the webinars offered through Conscious Woman on the topic.

Other planned adventures are a trip to Texas so Willem can see his grandparents and see where his daddy grew up, a trip to Washington DC for a conference where Peter will present some of his research and we will also visit Peter's aunt and grandparents, a trip to the Cal-Stanfurd Big Game (because no one puts the FU in Stanfurd like Cal does) and a trip to Hawaii for GRADUATION!!!!!

It will be the first time I'll have a vacation in Hawaii. Every other time I've gone has been for "work" either performing with my dance company or taking classes for school. On this trip, we'll be there two weeks and hope to fly to the neighbor islands of Kauai and Hawai'i, we'll hike Diamond Head, Peter will scuba dive, Willem will play in the ocean again. We haven't figured out everything we want to do, but it will definitely be a good trip. My mom and best friend will fly out for the graduation ceremony and we'll party at the Waikiki Aquarium afterwards.

All in all, there are good times behind us and good times before us. I am blessed.

World Breastfeeding Week

I almost missed it! I didn't even know it was happening. But this week has been designated World Breastfeeding Week by the World Health Organization.

Here is the main website:
http://worldbreastfeedingweek.org/

Some brief information about World Breastfeeding Week (from the WHO website):

World Breastfeeding Week is celebrated from 1 to 7 August in more than 120 countries to encourage breastfeeding and improve the health of babies around the world. Breastfeeding is the best way to provide newborns with the nutrients they need, according to the World Alliance for Breastfeeding Action, the event coordinator. WHO recommends exclusive breastfeeding until a baby is six months old.

The week commemorates the Innocenti Declaration made by WHO and UNICEF policymakers in August 1990 to protect, promote and support breastfeeding.

They have also put together a concise, and accurate fact slideshow (10 Facts on Breastfeeding).

Wish I had know about it sooner and found out how I could be involved.

Screaming Birth

You know how birth is portrayed on TV:

Commonly, TV birth happens mere minutes after the water breaks, precipitating a mad rush (in a taxi) to the hospital, frantic calls to the doctor, and apoplexy by the father-to-be.

The rest of the episode is spent with the pregnant character in pain, sweating, man-bashing ("You did this to me!"), and culminating with the screaming actual pushing a kid out of their crotch scene. This is finished with a damp but otherwise perfectly clean (four-month old) baby being held by a beatifically smiling but exhausted mother and an ecstatic father or father-figure.

To read more, go here:

It chronicles famous TV births and coins them "Screaming Births" a dramatic device that is a favorite of directors and screen writers.

The best part of the article states:

Since all directors and script writers do their research on obstetrics and midwifery by transporting themselves to the 19th century, the delivery will always be performed with the woman lying flat on her back. This is perhaps a sub-device which we should label Sadistic Obstetrician because this is the hardest position in which to give birth, although the easiest for the doctor.

To see clips of births portrayes on TV, you can go The True Face of Birth and email Rixa for the DVD she compiled for the Trust Birth Conference. At one point, she was selling the DVD for $5 each to cover the cost of burning and shipping. She may still be offering them.

Birth "Think-Tank"

The Tatia Oden French Memorial Foundation is currently partnering with doulas and childbirth researchers and birth activists in forming a birth "Think Tank". The purpose of the Think Tank is to gather information, perspectives and solutions to the state of childbirth in the US, which now focuses on the "medical" model of childbirth. We hope to change the direction of birthing in the US and bring it closer to its natural state. Understanding HOW childbirth evolved to where we are now .... and the educating women regarding natural childbirth. If you would like to join us please contact us at momoden@sbcglobal.net

I found this today on Tatia Oden French Foundation website. Through the course of my graduate students, I had begun to wonder if the birth activist community needed a think tank to further the work of improving maternity services through research, advocacy and policy.

For those unfamiliar with what a think tank actually does, here is the definition from wikipedia: "A think tank (also called a policy institute) is an organization, institute, corporation, or group that conducts research and engages in advocacy in areas such as social policy, political strategy, economy, science or technology issues, industrial or business policies, or military advice."

I am most familiar with think tanks relating to issues regarding early care and education (since that is what my graduate degree is in) but as I've been transitioning from preschool issues to birth issues, I've realized the birth community can benefit from the coordinate efforts of a think tank created for the purposes of correcting what is wrong with the way birth is treated today.

This blog post is a call to other researchers and activists to consider what your role can be in assisting in the organization and efforts a birth think tank. As I find out more information, I will post.

Cytotec Adverse Events Site

Today I received this letter from Maddy Oden, founder of the Tatia Oden French Foundation.

Dear Friends:
A childbirth activist (Christal Lutz) and myself have just gone live with a new website. Cytotec Adverse Events(www.cytotecadverseevents.com). We have put down the stories of some of the moms and families who have been given cytotec to induce their labor and subsequently endured tragic side effects. Some wanted their names used, others did not.

The site also was designed for the purpose of creating a place where health care providers, nurses, doctors, midwives, doulas, could write their experiences of cytotec inductions without using their names. This will give us a bank of information, first hand, that can help us in dealing with the FDA, ACOG and most importantly, the educational efforts with the public.

Please take a minute to check it out. All your comments, thoughts, suggestions are greatly appreciated.

Thank you for all that you do.
Sincerely,
Maddy Oden

Please pass this on to mothers and birth professionals in order to collect the stories and facts about the effects of misusing drugs that are not approved for the FDA for the induction of labor.

Start At Home

Today as I was watching HGTV, I had an idea based off the current slogan "Life's Biggest Moments Start at Home" and some of the taglines in the commercials that describes home as a place for new beginnings and celebrations.

If there ever were to be slogans and taglines for homebirthing families, those would be it. There are alot of birth shows on TV, all of which are centered around highly medicalized births. There are a growing number of families in the United States who are considering, planning and having at home birth (sometimes called DIY births). I see that HGTV has a unique opportunity to show how homes can be the best place to start life and a place where that new beginning can be celebrated.

I can envision a show where a homebirthing expert (typically a midwife) consults with families planning a homebirth to make the necessary preparations for their homes: including birth tubs, birth kits and bedding for expectant families, new moms and newborn babies.

I would love to see a show like this portraying birth as a "normal" event that families can celebrate within their homes, as opposed to the unnaturalness of hospital birthing. The homebirthing community and supporters are looking for the media to portray birth in the way it ideally can be for the majority of families. HGTV could place a special role in this.

I wrote the above to HGTV today and I'm now looking to garner support for a TV show that would portray homebirth accurately as a safe option for birthing babies. I've created a petition that will hopefully indicate the level of interest in the homebirth community for a TV show of this nature:

To sign the petition and show your commitment to positive portrayals of homebirth in the media, go to: http://www.petitiononline.com/TVbirth/petition.html

Unlocking Birth Plans

When I was pregnant, I thought of a writing a birth plan for a hospital birth was like a cafeteria, you had choices--you could take and leave what you wanted. That's when I developed my birth plan based on the real life example of others. I wrote all the things I wanted with provisos about all the things I didn't want. It was three pages, complete with a very nice letter to the nurses, midwives and doctors I would be working with.

Then after I discovered what hospital birth is really like, I heard birth plans being maligned. I learned that birth plans aren't typically read but are often scoffed at before they are thrown in the trash. But information still promulgates that birth plans are useful tools in having individual desires, wishes, cultural and religious values being respected; while others state that birth plans are useless.

I've been trying to figure my through this chasm of opinion. I wasn't quite prepared to throw away the birth plan idea all together, but understood how they often do not have the effectiveness that families desire. One solution I've heard touted is a birth plan should take up no more space than a 5 x 7 index card with easy to read font (no 7 pt business). I didn't understand how that was possible, based on the number of birth plans I'd read and the one that I too composed in preparation for birthing in a hospital.

Recently, in the book "Pregnancy, Childbirth and Your Growing Latter-day Saint Family" written by a registered nurse and certified childbirth educator, I read an example of what a index card birth plan would look like and I began to see how this would be plausible. I will attempt to reproduce what I found:

Room: Labor, deliver, and recover in same room at local hospital
Other people present: husband, doula (a woman who provides professional labor support), and maybe mother
Food and drink: light foods, juice, water as desired
Fetal Heart Rate: intermittent, with initial 20 minutes electronic monitoring, then hand monitored every 15 to 5 minutes as needed.
Pain Relief: relaxation, breathing, comfort measures, shower, hug and kisses from husband!
Labor Stimulation If Needed: walking, changing positions, nipple stimulation
Labor and Birth Positions: mother's choice
Pushing Techniques: short (limit to six seconds), spontaneous bearing down
Perineum: try to prevent tearing with support, gentle pushing, no episiotomy
Cord Cutting: father cuts cord after pulsating stops
Immediate Baby Care: baby held by parents for first hour and given opportunity to breastfeed
Feeding and Contact with Baby:feeding on demand with 24 hour rooming-in

I had to see it to believe it, but that fit on a 3 x 5 index card (admittedly with probably 8-9 pt font). It concisely described a family's desire to have "as natural a hospital childbirth as possible." Having seen the example, I can see how it can be adapted to an individual's wishes. In the space remaining on the line regarding immediate baby care, I would make a note refusing the Vitamin K shot, vaccines and erythomycin). I would make use of those blank lines and add no artificial nipples of formula supplementation; supported squat, upright pushing positions; warm compress and counterpressure on perineum, etc.

But there you have it, a short, concise, fit in the palm of your hand birth plan. They do exist.