Stand and Deliver: FuzziBunz giveaway!

Stand and Deliver: FuzziBunz giveaway!

Violence Against Women During Birth

Solace for Mothers is announcing a letter-writing campaign to Lynn Rosenthal, the newly-appointed Presidential Advisor on Violence Against Women, an office within the Department of Justice, and First Lady Michelle Obama.

You are invited to join Solace in writing to Lynn Rosenthal and Michelle Obama in an effort to bring awareness to the violence women experience at the hands of some maternity care providers. First Lady Michelle Obama has made recent remarks championing the rights of childbearing women, and may be an ally for this cause. Lynn Rosenthal is a former executive director of the National Network to End Domestic Violence.

We are calling for an official review of perinatal practices to investigate common and flagrant violations of patients’ rights; mainly the right to informed consent and refusal. We are asking that enhanced and enforced mechanisms for accountability follow the investigation.

For more information: http://www.solaceformothers.org/campaign.html
To read Solace's letter: http://www.solaceformothers.org/letter.html

Been away

I have not taken any time for my blog recently which is a good thing, because I've been busy! I've got a number of entries that I've been thinking about for a long time which I hope I can get to, but I'll start with an update.

Belle is a healthy, sort of rolly-poly baby. I recently weighed her at a friend's house (our scale has been broken) and she weighed 18 pounds at four and a half months old. Based on that alone, breastfeeding is going well. Thankfully, we have no more choking on let-down so no more screaming. She sleeps well, usually from 10 pm to 9 am with one or rarely two wake ups. She sleeps in the side-car so when she does awake, she's pulled into bed along side me to nurse. We started ECing, which I hope to write more about in a separate post. Most poops are into the potty and upwards of 80% of pees. I was surprised how easily that became apart of our lives.

Willem is learning many things. With some neighbors, we started a twice-weekly preschool co-op where we are using the Letter of the Week theme. I'm having a lot of fun preparing curriculum for the once a week I teach. Its very nice to put my education and training to work. Our biggest challenge with Willem is sleeping. He hates napping and going to be at night takes a long time for him to settle to rest. I've been tempting to not let him sleep one night to demonstrate to him so much he really does appreciate and need sleep! Because of the challenges to get him to sleep at night, he often sleeps in another room from us, although we all prefer when he shares the bed with us. He is also learning to use words to communicate his feelings. So often he hears from me "words!" when he tries to communicate with crying. He's becoming interested in games with rules so we have introduced backgammon, Uno, dominos and Yahtzee.

The projects I've been busying with are writing an journal article with a Nov 1 deadline, the letter to the Presidential Advisor Against Women, the poster of my thesis findings for a conference in Nov, the journal article of my thesis for publication, and the preschool lessons. I've made some headway in applying to PhD programs for next year, although I'm discouraged in finding an advisor who is a good fit. Because I've been so busy, really, the best way to keep up with me is by following my facebook updates (www.facebook.com/jenneology).

I've also been taking a yoga class once a week. I think due to it, that the problems with my hip haven't returned since August. I'm also feeling stronger and leaner. At this point my postpartum weight loss is to the point where I weigh as much now as I did before I got pregnant the first time.

The blog posts I want to write:

The beginning of our EC journey
Becoming a Mythological Midwife
Reviews of Birth Crisis, Permission to Mother and The Caesarean
More Silly Songs for Infancy and Toddlerhood
The Gain Equals Loss Phenomenon of Babywearing
The Parental Rights Amendment

I hope to get to them.

Only waxing poetic when angry?

After Willem's birth, I found it therapeutic to write poems about my feelings regarding his birth. Since Belle's birth, I have felt at a loss for even the words to express my feelings regarding it. I began to wonder if I only could be poetic when grieving or angry. Come to think of it, there was another point in my life where I enjoyed poetry and it too was a time of sadness, confusion and loss.

Belle's birth was so the opposite of that. In trying to express my feelings, I don't get very far before I come up short. So much went into the decisions I made for her birth that the resulting emotions are so very scattered and incoherent.

All that build-up to say that I was finally able to write a poem. Its all I could do to get the many layers of thoughts and feelings I have about her birth.

Technically boring
Mundane
Gently introducing
Surrounded by love
Spiritually uplifting
Prayerful
Emotionally freeing
Rebellious
Early beginning
Wakeful
Quickly ending
Sooner than expected
Unbelievingly yawning
Father
Innocently witnessing
Brother
Lovingly birthing
Sister and child

Cryptic is the only way I can describe this poem. I hope to go back to it someday and describe what each of the couplets mean to me. There was much strength and power in her birth, but words like happy/joyful/sadness don't cut it. At 3 1/2 months, I'm still figuring out what that experience means to me.

The end has come

The story is that for 5 months or so, Willem has been leaving teeth marks on my nipple that I've found uncomfortable and sometimes painful. I could no longer breastfeed him in comfort and often had to tell him when it was time to unlatch or switch sides because I could no longer take the discomfort. I was still willing at that time to continue breastfeeding him in hopes that he would figure out a way given some time to stop making it uncomfortable for me. Instead over time, it remained the same and he began to resist my directions. When I told him it was time to let go or pointed out the teeth marks that were there, he would refuse and deny. This basically led to me getting frustrated and him being sad. I continued to try to be patient explaining to him why it was important for him to follow my directions at those times. I was resistant to give up and begin to wean him because I was hopeful there would be a solution and improvement.

That solution hadn't come before the day (first time in his life) when I dreaded the next time he asked to drink mama milk. I didn't want to and it surprised me the force of that feeling. At that point I realized our breastfeeding relationship had to come to an end. That night I told him I was done trying to give him mama milk and done with the arguing and the frustration, sadness and hurt. That's also when I realized that I had to be consistent and firm in that resolution. There wasn't going to be and couldn't be an gradual weaning process.

Over the next few days when he asked, I wanted to go back on that resolution. I still wish that there could have been another way. I wish that breastfeeding older children was more understood. If I could contact a lactation consultant who would know what to do to teach an older child to fix his latch, I would have done it. Although I assume that most LCs wouldn't have a clue with a child his age.

I'm not very hopeful that someone can help because he and I working together has not yielded a solution. I thought it might be one of those examples of a stage in a child's life where if you as the parent don't like it, be patient and wait a few weeks and it will resolve itself. In this case, the resentment came first. In fact, I'm glad to not have breastfed him in a few days. My main regret is that he can no longer benefit from the immune boosting powers and motherly connection.

Often quoted to me is the maxim that extended breastfeeding is only constructive when it is working for both mother and child. Once its not, its time to stop. I felt I tried to persevere having found a balance that I considered acceptable. But it was no longer acceptable to me when I didn't even want to try. I don't want to know what the next nursing session would have been like with me knowing I didn't want to and going ahead anyway.

I've actually replaced the breastfeeding with spoon feeding for the time being. The last couple of weeks, he has discovered that he is too busy to eat. And often the only way to make sure he was getting the nourishment he needed was to interact with him over food, the best way to do that was hand feeding. He still can feel the connection with me and there isn't crying on either end. I don't have to feed him by hand all the time but in times that he is struggling to focus on eating, I will.

I had hoped that our breastfeeding relationship could have lasted longer--until he was 4 years old or so--knowing that in many cultures in the world, that is normal. Instead, we made it 2 years, 6 months and 3 weeks.

I probably could have stopped right after Belle's birth with the simple explanation that babies don't eat foot, they only drink mama milk and Willem was not a baby anymore and he needed to eat food to stay healthy. Instead, I tried to find the mixture of food and mama milk for his diet. Then he started using mama milk as meal replacement so I had to put limits on his breastfeeding like only after breakfast, not before because he wouldn't eat breakfast otherwise. I know he'd love it if some pumped breastmilk made it into his cup, but I'm not yet sure if I should do that. I know I'm not going to go out of my way to pump milk for him, but if I happen to have extra, I think I will share with him.

Not a very interesting update

Belle is healthy. Sleeps well, nurses well, is growing well. She's really cute--the same can be said for Willem. Their smiles and laughter bring much joy to my heart.

I hurt. A few weeks ago it was bad enough that I couldn't bear my weight on my right leg. My right hip is particular is experiencing extreme soreness at the joint and in the muscles. I only assume that it is the looseness of my joints postpartum that is causing this. Chiropractic, massage and light exercise (walking, yoga and hula) have been helping. I expect I will experiences period of reoccurrence of the next few months.

I discovered I have slight abdominal dystasis above my bellybutton (where the umbilical hernia occurred).

Between those two conditions, I've resolved (although I had planned previously) that I will not be getting pregnant again within the next 3-4 years. Since that space of time is alloted, I've also felt drawn to apply for a PhD program at the University of Washington. The hope is that I can complete coursework before Peter graduates with his PhD and then I can complete my dissertation wherever we end up moving for his postdoc. And then the next baby can be born either during my dissertation years or after if I can complete the whole degree in 4 years. My body needs the time to not be pregnant so my joints and muscles can knit back together.

And as I always remind myself: you make plans and then Heavenly Father intervenes. We'll see what he has in store for us. For right now, I feel he is pleased with my plan to apply to the PhD program. The next baby will be born on His timetable. And if its a surprise like my pregnancy with Willem, the timing will be perfect and we could not plan it better.

Come to the help of women

Solace for Mothers is currently starting a letter writing campaign to the newly appointed Presidential Advisor on Violence Against Women. We are writing to her to describe the violations of women's civil rights and violations of federal law that are happening to women as they give birth to their children. We are hoping to include letters from mothers who have been denied their right to refuse medical treatment during labor and birth.

Also being invited to write to the Presidential Advisor are organizations who champion women's reproductive rights including The National Advocates for Pregnant Women, the International Cesarean Awareness Network, The American Civil Liberties Union, The Coalition for Improving Maternity Services and Conscious Woman.

This is all a work in progress right now but it is the direction we hope to take in the next few weeks. More information will become available on the Solace for Mothers website, as well as the opportunities to endorse the letter we will be sending and include your own thoughts and comments.

Today I was reading in the Latter-day Saint canon of scripture and found a verse that I found parallels this project. In Doctrine and Covenants 124:11, The Lord says "Awake, O kings of the earth! Come ye, O, come ye, to the help of my people, the daughters of Zion" (paraphrased to accentuate the parallel). Wouldn't it be nice if God were saying that, in this day, on the topic of women's reproductive freedom to birth without unnecessary medical intervention, and with women's consent before an intervention is performed. It is my prayer that the leaders of the nations become aware of the abuses that are being done to women in the name of birth, and then come to their help and protection by creating punishments for providers who violate their right to refuse treatment.

There has been recent news about a court case in New Jersey were a woman's child was taken into state custody after she refused a C-section that her doctor was claiming was medically necessary. My partner with Solace for Mothers recently wrote a commentary on the story (link to original Huffington Post article) at The Birth Activist.

Then there was this story where a woman was remanded to the custody of the hospital when she disagreed with her doctors recommendation to remain on bedrest.

All over the internet there are stories of women who were not consenting to an episiotomy but one was performed anyway. Often procedures are performed without even informing a woman that it is going to occur, not even giving her the opportunity to consent. It happened to me during my son's birth where I wasn't even informed that the midwife was going to begin suturing a minor second degree tear. Given the opportunity to be informed, I would have denied the sutures preferring to allow the wound to heal on its own. This is a minor example. Other women have been given pain medications without being told that was was going into the IV line, others were given episiotomies or vaginal exams despite their screams of No, Stop and Dont!. Hence, why its called birth rape.

Health care professionals are mandated by federal regulation to grant patients complete informed consent (ACOG's guidelines here). Of course there is no legal recourse or consequence to providers who do not gain a patients consent before performing any procedure. This was discussed in the recent Coalition for Improving Maternity Services Webinar on Informed Consent in Maternity Services. To read more about informed consent, see Goldberg. (2009). Informed Decision Making in Maternity Care. Journal of Perinatal Education. (Winter issue).

Abstract here:

In the United States, federal acts and regulations, as well as professional guidelines, clearly dictate that every pregnant woman has the right to base her maternity care decisions on accurate, up-todate, comprehensible information. Despite these efforts, evidence suggests that informed consent within current health-care practice is restricted and inconsistently implemented. Patient access to evidence-based research is imperative under the scope of informed consent and is particularly important during a time when perinatal mortality and morbidity rates, interventions, and disparities are on the rise in the United States. This article describes the Coalition for Improving Maternity Services' investigation of the breakdown of informed consent in maternity care.

The letter writing campaign is an attempt to advocate for changes to the federal regulations that would create punitive measures and due process when providers do not grant a woman's right to informed consent. As the regulations stand now, there is no recourse available so violations occur without fear of consequences.

5 weeks

I'm surfacing from the babymoon and getting back to real life. The last two weeks I've been adjusting to life with two children pretty much on my own since my husband has been away doing his summer research. Thankfully, I'm not feeling lonely because I'm staying with my mother and she is helping in the evening after work.

In five weeks, Belle has grown impressively. She weighs approximately 11 pounds now (up from 7 lbs. 6 oz). She's starting to hit some milestones. At a day old, she turned her head from the left to the right while on her stomach. Now she's lifting her head and upper body using her arms to push up. She's also starting to seek out places to settle her feet in order to "stand." When she's on her stomach, I can place my hand against her feet and she will push against it and scoot forward. I've seen some genuine smiles. Today she smiled at Henci while she and Sharon were visiting! The other day, I heard her first laugh.

She is just as active as she was in the womb and enjoys her dance periods throughout the day. When she was inside me, I frequently would feel her stretch an arm out and wrap it around my body. I've seen her do that now and I'm kind of glad that I'm seeing it from the outside and not feeling it from within. She is a generally calm baby and she loves bathtime. She finds it very soothing and she looks like she's swimming when she kicks in the water.

Belle has is very taken with her namesake. She sleeps in grandma's arms frequently which gives me time to connect with Willem; play with him, cook, get him to sleep, etc.

Since she has gained as much weight as she has, its rather obvious that breastfeeding is going well. My supply is still regulating and I'm waiting for let-down to become less forceful. She really doesn't like being drowned in milk and she will sometimes yell at the breast when it sprays too quickly for her taste. I've also found that because I have such an abundant supply that she will sometimes have the characteristic green poops from a fore/hind milk imbalance. I've been block feeding and getting Willem's help to get her hindmilk more frequently.

Tandem nursing is not going so well however. There is something off with Willem's latch where he is almost always leaving teeth marks on my nipple. I find that uncomfortable and very annoying. I have been attempting to get him to change his latch and I haven't been having much success. I'm considering ending that breastfeeding relationship because its become frustrating and stressful for me, especially when I tell him to unlatch because of discomfort and he either refuses or tantrums.

Generally I am coping the transition to 2 well. I am puzzling through the challenges and trying to be patient with myself as I reflect on effective ways to structure the day and get each of our needs met.

And a cute picture:

Read about Solace for Mothers in Midwifery Today

The Summer Issue of Midwifery Today has been released. The topic of the issue is "Healing from Sexual Abuse and Trauma."

There is an article about Solace for Mothers in the issue that discusses some of the ways women are traumatized by their birth experiences and how Solace provides support for mothers seeking it and providers who work with postpartum mothers who may be experiencing trauma.

Belle's Birth Story

I feel like I should start her story with Peter's return home on Wednesday night. He was so tired and sad but relieved to be home. The last two weeks have had him experiencing the most intense and varied emotions. He got a day to recover before a whole new range of emotions swept by him.

Or I could start Belle's birth story the same way Willem's starts. "Thursday night, sex did it..."

I hoped that the prostaglandins in the semen wouldn't start contractions, or that if they started they would stop after a while. At 3:30 I woke up feeling a mild contractions. At that point, they were seven minutes apart. Within a half hour, they were 3 minutes apart. I decided then that I wouldn't be sleeping anymore that night and got up to ready the house for the birth. I put towels in the washing machine, finished making my laborades (lavender lemonade and sweet rose tea) and started inflating the birth tub. At 4:45, the contractions were getting stronger but still at 3 minutes apart. I decided to wake Peter up and get him to take over inflating the pool. He was completely groggy and too was hoping that the contractions would stop and that we’d be going back to bed.

While he pumped up the pool (we were using a manual bike pump, efficient but we wished we had purchased an electric), I straightened and gathered supplies while pausing for contractions.

At 6:30, Willem woke up and “helped” me through contractions. I was on my hands and knees on the floor and he curled up underneath me. When the pool was filled with air, he was ready to get in. We started filling it with water and when it was the depth of a normal bath, Willem and I got in together. He was so excited to be in a “warm bath downstairs with Mama.” Peter started boiling water on the stove and periodically added more water.

While the pool filled with water, I asked Peter for a priesthood blessing, in part to gauge the rightness of calling the midwives for any unseen reason. The blessing was one of comfort and reassurance: that my body was strong and I could be confident in my ability to birth the baby. I was counseled to meditate and use the relaxation techniques I had learned from my studies. During the pregnancy, I had listened to the Hypnobabies scripts but I did not turn them on during labor. I applied principles of visualization, affirmations and prayer throughout the process. I spoke to the baby and breathed deeply through contractions. As they built, I found the visualization of getting to the peak of a hill helpful because I could feel when the "steepness" changed and I knew I was headed back down the hill again.

The pool was filled using a garden hose attached to the kitchen sink and then run across the kitchen, through the pass through that separates the kitchen and dining area and into the pool. That was about 7:00, I stayed in the pool only getting out to trek upstairs to the bathroom. While on the toilet, I felt the beginnings of pushing sensations but attributed it to a bowel movement. I checked to see if I could find the baby’s station and I think I felt a head with bulging waters. I didn’t even try to determine dilation because knowing that there was a head there was enough for me. Contractions were 2 minutes apart.

Around this time, Peter admitted that this was truly labor and it wasn’t going to stop until the baby was born. Both he and I thought that we would have several more hours. I then remembered that we had been remiss throughout the pregnancy and hadn’t documented it with pregnancy pictures. I had been completely unclothed in the pool so on one trip upstairs to the bathroom. I pulled out the maternity bathing suit that my friend had lent me. On the way downstairs, I told Peter he should start getting some pictures before it was too late.

Between 8:30 and 9:00, Willem started getting antsy in the house so we started preparing him to go to a friends house. This was about the time that I moaned to Peter “I want to take a break. It’d be nice if I could have three minutes between the contractions again.” I don’t really remember his response but I remember it was sympathetic. I think I heard Willem one time say “Mama sad” and I moaned through contractions, and I tried to explain that I wasn’t sad. I was just working hard to get the baby to come out of my body. We think looking back that was transition.

Around this time, I asked if Peter felt like he wanted the midwives to be present and he said that everything was going so well—and it would probably be awhile until the baby was born anyway—that he didn’t feel the need to call them. I knew I didn’t and reflected on what it might be like if they were present. I imagined that they’d be pleasant, supportive and kind but that they’d be gathered in the living room watching me and I did not like the idea of being watched, even if by benign and happy presences such as my midwife and her assistant. I didn’t need it, didn’t want it, and was doing the whole process as it was made to unfold for me.

This was when I realized that with every contraction, I needed to flip over to my hands and knees to get through it. I felt tightness radiating down into my thighs and it felt like the bones of my pelvis and hip were being stretched outwards. I did not experience any back labor, and contractions were low, tightening with pressure. This part is hard for me to explain, I was pushing gently with contractions but I’m not sure if I was doing because I felt like it or if it felt good. My thighs were getting very tired and at one point, I felt like asking Peter for some double-hip squeezing but he was busy trying to wrestle Willem into some pants. Somewhere in this time, I felt like I was getting more rest between contractions, even though they were any further apart. Looking back, I think it was an example of “ask and ye shall receive.” Maybe it was the actualization of a positive thought. Whatever it was, I was grateful for it!

As Peter was on the phone with our neighbor who was going to watch Willem for us, I checked the baby’s station again and I felt her head as deep as the middle knuckle on my index finger. When I told Peter that, he was shocked! To him, he had just barely begun to believe that this was really the birth of his baby.

Again I checked to feel if the amniotic sac was still intact and attempted to pinch it with my finger nails (I don’t really know why), I got a hold of something that might have been sac and pulled gently. And then I realized that I had just pulled baby’s hair! Oops! But based on that, I have no idea when my waters broke. I was hoping I’d know and be able to experience that sensation as it happened. This event was one of the decisions I regretted from Willem’s birth because I consented to AROM. I either wanted to know and feel it as it happened on its own or if it was a decision I made on my own, without feeling pressured by others around me.

A few minutes later, as they were about to walk out the backdoor, I yelled “the baby is crowning!” I roared a couple of times as the new sensations took over. I felt my first undeniable urge to bear down, immediately followed by sharp stinging in my tissues on either side of the baby’s head (not like the ring of fire). Instinctively, I stopped pushing and snapped my knees together. Then I laughed at myself, squatted and focused on letting the baby ease down. I felt another undeniable urge to push and the baby’s head was out. At this point, Peter was standing over the birth pool with Willem in his arms and they watched. There was a pause after the baby’s head was out and then another urge to push, a little more stinging, a shoulder, a shoulder and then another slight push for the chest (her chest is broader than her head circumference). I reached down and pulled her to the surface of the water, and then leaned back with her cradled in my arms. This was 9:31 am (I didn’t look at the clock until 9:34, so Peter verified the time).

I realized I saw the cord around her arm, and then her neck. I got a little confused as I figured out it was over her right shoulder across her neck, under her left armpit and wrapped around her arm. I unwrapped her and then noticed that she was looking pretty purple and was quiet. I wasn’t surprised that she would be quiet, especially as I could hear and see her breathing, with mucus clearing itself from her sinuses and mouth. But the purple was a little concerning. Peter noticed too and gently told me to hold her against my chest and rub her back. I did and she started crying, and then turned pink.

We saw a gush of blood into the water—which concerned Willem—and then we commented that we had failed to do the hemorrhage test in water. We knew what 200 CCs and 500 CCs of blood looked like on a chux pad but not in a pool of water. It was then that we decided that I should get out of the tub to monitor bleeding (and by that point I didn’t want to be sitting in bloody water anyway). Twenty minutes after she emerged, I squatted against the side of the pool and the placenta came out looking amazing. The membranes of the amniotic sac were trailing behind but came out easily too.

I had planned on using some purple cording to tie off the umbilical cord after the placenta had emerged. Earlier while I had been gathering supplies, I went to find the cording and couldn’t. I poked into my sewing box and found some white cording that I had intended to use on the bodice of my wedding dress but hadn’t. I felt it was very appropriate and meaningful instead to use it during the birth of our baby. Peter and I each tied off the cord (two ties with about two inches between), and then Willem held the scissor handles while Peter cut the cord.

I leaned against the wall, sitting on the chux pad to monitor bleeding while I suggested that I call the midwives for the newborn exam and filling out the birth certificate. I hadn’t known beforehand when I wanted to call them but at that moment, it felt good to welcome them and share the happiness. I called them while Peter took Willem to our neighbor’s house.

They arrived around 10:45, bearing a huge bouquet of flowers from the midwife’s garden—evidently I called her while she was out watering this morning. They were so happy for me, and so cheerful. This was also when I realized that the day before, my friend and I agreed that she’d come over Friday at 11 am so the kids could play together. I called her while she was on her way over and told her that the baby had been born and she was welcome to meet the baby and could she please supervise Willem on the playground outback for a little while. She came, she did just that (bearing Jamba Juice!) and washed dishes for us during the newborn exam. It was wonderful!

When they all arrived, I had settled on the couch with a blanket. That was where the newborn exam was performed. She weighed 7 lbs 6 oz, a half pound more than Willem at his birth. Before she was weighed, I asked Peter what his guess would be based on her appearance and he guessed exactly that! Length was 20 ¾ inches long. She has a lot of dark hair: like Willem did at his birth. We expect that hers too will change to blonde. She’s got the same butt-chin as Willem—they inherit that from Peter’s mother. And she has Peter’s dimple in her right cheek.

So far our babymoon has been lovely. The midwives helped me settle into bed upstairs and told me to stay horizontal for the next three days. I spent the rest of yesterday cuddling my new baby and nursing (her latch is pretty good for a beginner). I called friends and family then got a visit from my chiropractor. Before getting pregnant, she said that she’d like to visit the day my next baby was born so I took her up on it! It was so nice to see her!

Belle slept soundly last night from 1 am to 6 am and then again from 10 am to 1 pm. I slept with her during those times and then napped with her this evening between 7:30 and 10. She’s been sleeping soundly next to me while I’ve typed this out.

Today we had a little bit of an adventure when I was showering. Peter came in and said he was concerned that there was a gas leak in the house so he was going outside. He told me to be quick. As I stepped out of the bathroom, I smelled when he meant and hurried to get dressed. I met them outside and found a spot in the shade. Peter then told me that a plastic plate had gotten too close to a heated burner on the stove and had melted. I laid outside on a blanket, leaning against a pillow outside, talking to neighbors and nursing while the apartment was aired out. It felt so good that I didn’t want to go back inside so we were outside under the shade for 3 hours. During that time, my friend Shawnette and her mother visiting from my hometown in California dropped by to say hi and we enjoyed the fresh air together. We also broke into the cheesecake that I had made for Peter while he was out of town. I had intended to eat some for energy during labor, but it happened too fast to do so! I didn’t need it!

Announcing Belle!

Belle was born yesterday at 9:31 am after 6 hours of labor. She weighed 7 lbs 6 oz (I asked Peter to guess her weight and he was right on!) and 20 3/4 inches long. She was born at home, into the water with her father and brother present.

After I was settled on the couch with the new baby in my arms, the midwives came over and Peter and I filled out the birth certificate, assisted with the newborn exam and then I got help getting settled in bed upstairs. It was lovely.

I will post the whole story later, but right now I'm hungry and need to plug the laptop battery in to charge!

The last two weeks

Last time I posted, I had just found out definitively that the pain behind my bellybutton was from a hernia. At the time I was very concerned that I could go into labor with the pain still there, or that the pain could last 2-3 weeks. Thankfully, the pain was almost entirely gone the Wednesday after. By Friday, I felt 100% and very relieved.

The way I was able to treat it was using a rebozo to bind my belly--providing counterpressure on the sore spot, and a couple of times a day rubbing caster oil on my belly topically and then heating it with a heating pad. The heat provided a great deal of relief. Each treatment was recommended by my midwife and naturopath. And the rebozo was kindly provided by my friend Shawnette, who unintentionally became my doula once again, but this time for the L&D trip relating to the hernia.

A couple of days after I started feeling better, and totally mobile again, Peter had to go out of town. My mother generously decided to come stay with me knowing what the last couple of weeks had been like for me. It was very nice to have her company and her help while Peter was away.

Sadly the day she went home, we found out that Peter's grandfather had passed away. Even though the end of my pregnancy is fast upon us, we felt at peace after prayer for Peter to travel to Pennsylvania to be with his family for the funeral. And my mother is once again coming to stay with me while he's away. I don't think that the baby will be born while he's away, but if I'm wrong then at least my mother will be with me. He will be away from Sunday through Wednesday and I feel based on previous spiritual impressions that he won't miss his baby's birth.

Today I finished the last project I wanted to accomplish before the baby was born: a charm bracelet of my favorite pendants that have significance for me based on aspects of my personality, likes or gifts that loved ones have given me. I typically wear a simple chain with a pendant around my neck and the necklace rotates depending on significant events. For the months after Willem was born I wore a Celtic Claddagh with a garnet (his birthstone). For a period, I wore a pendant of an Irish dance ghillie (the soft shoe used in Irish dance). Since graduation with my M.Ed., I've been wearing the pearl pendant that Peter bought me in Hawaii. The pearl is set surrounded by three maile leaves: a Hawaiian symbol of honor and accomplishment. I've been wanting to somehow represent all of my favorite pendants during the baby's birth and I decided to do that by linking them to a bracelet. I hope to post pictures soon.

One of the other projects was a quilt for the baby. I pieced 6 in fabric squares around a 6 piece panel of white fabric where I embroidered the words "Sleep my child and peace attend thee"--the words from the lullaby "All Through the Night." In high school, my women's choir sang an arrangement of the song and when reflecting on the thought I would like to express on the quilt, it came back to me. Basically, I was attempting to avoid any cliche girl quotes like "sugar and spice and everything nice" or "thank heaven for little girls." The colors of that quilt are deep purples and greens with a purple satin binding which unfortunately doesn't photograph very well. Each time I try to take a picture of it, the purples end up looking blue.

At this point of the pregnancy, I've been pregnant longer than I was with Willem. He was born at 38 weeks exactly. Now I'm approaching the 40 week mark and I'm happy to still be holding my baby. Willem may have different ideas because he has told me a couple of times now "Baby Belle come out mama body today." Each time he has been wrong, and I hope she stays in for at least another 5 days.

All along, I've felt like she's going to be a June baby. We'll see if I'm right or if she sneaks out the last week of May. Somehow it seems fitting that she would be born in June: a different month than her "due date" since Willem was also born in a different month than his. Except she'd be born in the month after, and he was born in the month before.

Today's Appointment with Radiology

Today, I got an abdominal ultrasound (not deep enough to see baby) and we discovered that I have a herniated pocket of brown fat (the kind that cushions and insulates internal organs). I had suspected that I have been experiencing an umbilical hernia, and it was confirmed. Somehow that pocket of fat made itself through my abdominal muscle wall and is now stuck, inflamed and dying between my ab muscles and connective tissue/skin. That's why it hurts. There didn't appear to be a separation of the muscle, so if at some point there was, it appears either to have reconnected, or its so thin right now, it was impossible to know if there is a breech. Regardless, I have that pocket of stuff that isn't supposed to be there that will probably correct itself in time. The radiologist said that my body will naturally be able to break it down and be removed; possibly before the baby is born. I should have asked how long that process ought to take, but right now I'm just hoping and praying that is happens before labor starts. I feel like this is a time when the prayers of others would be greatly appreciated that the mass can be removed (by my friends the phagocytes) quickly and efficiently so the baby's birth can be unhindered.

On a funny note, the radiology technician was at first very confused by what she saw when using the ultrasound on my bellybutton. I don't blame her, its not like she's done many (if any) abdominal ultrasounds on a 38 week pregnant woman. At one point, she said that she wished there was another pregnant woman nearby who was not complaining of pain in the region that she could compare in order to see what the normal physiology looked liked. Surprisingly enough, when she went out of the room to consult with the doctor of radiology on call, the doctor was a 36 week pregnant woman who was gracious enough to become a test subject for a moment. Together, they looked at the normal physiology between the doctor's bellybutton and abdominal wall and were able to determine that the little bubble of fluid and mass of tissue that they were seeing was abnormal. I'm grateful for the coincidence that the pregnant doctor was on call and that she was willing to expose her belly for me.

And now if you are ready for some science, essentially the break down process of that fat deposit should work like this: The cells in that pocket are beginning to die off. The body has a system to removed dead and and dying cells: phagocytes which are found in white blood cells. The fat deposit should begin to attract the phagocytes to the area through a process called apoptosis where the dying cells communicate that they are being starved of blood supply (likely because its trapped and being compressed between my abdominal wall and skin layers). The phagocytes are then supposed to come along and do their work on the dying cells.

Now, I feel like I need to come up with a name for my new friend that is causing me so much discomfort, and hope that it goes away very soon.

Its nice to have an explanation for my pain and comforting that its something that can correct on its own, and that no scary procedures are necessary. Once again, I'll be turning to my Father in Heaven in order to determine if any further steps are needed on my part. Definitely there will be prayer for the quick breakdown and absorption of those wayward fat cells.

Update on Pregnancy and Previous Birth Trauma

(first part is copied from a post on the Solace for Mothers online community)

I'm 38 weeks pregnant and I've started feeling just awful pain in my belly, in the skin and tissues around my bellybutton. It got to such a point that I felt like I need to consult with a specialist to rule out anything particularly scary. So last night, I went to Labor and Delivery at the hospital where Willem was born.

I don't know whether I was really lucky or if the standard of care has changed there since Willem was born, but they were very respectful of my decision making power and very sensitive to my needs to be in control of the situation. Maybe I owe it all to the nurse who was attending to me because through our small talk, she learned that I had had a traumatic birth at that hospital and maybe she warned the resident and attending who was there.

I was so afraid going in. Afraid that I would be treated negatively for planning a homebirth, afraid that they wouldn't take my complaint seriously, afraid that they'd over-react and try to pressure me into an induction or c-section, afraid they try to bully me into transferring care to them...

None of those things happened.

And I think there may have been some good that came out of it. In talking to the nurse, she felt like she recalled my name from somewhere (probably from the Mothering dot Community forums. I think that's when I mentioned that I work with Solace and she felt like she recognized my name in connection with that. I gave her a couple of our business cards and told her about the two discussion boards. That's when I found out that one of her births was traumatic as well, and I was able to offer this board as a resource to her, as well as inviting her to participate in the advocates board since she's a L&D nurse who is sensitive to the topic of birth trauma.

Coming away from that experience, I'm really surprised, a little bit pleased and kind of confused. Surprised that what I expected to happen didn't.--I was really stressed out being there because my initial blood pressure was way high, as was the baby's heart rate.--I'm just so surprised that the attitude of the staff and providers last night was so different from the care I received when Willem was being born. And that's what confuses me: was it special consideration for the fact I had had a negative experience there previously? Or have things really changed there?

I'm kind of hoping (but I don't know how realistic it is) that after I complained to the hospital about the treatment that maybe there were efforts to better train staff in principles of informed consent and so every L&D patient is getting improved care. I would be so pleased if I knew that were the case. I was so upset after my experience that nothing would be done and the same things (and worse) would be happening to other women who were birthing their babies there. I know its standard practice not to inform people who have complaint that steps have been taken to prevent the same thing from happening to others (because that would be an admission of guilt, right?). But maybe, just maybe, there was some good that came out of my birth experience there, and things have changed for the better....I can only hope.

Or I got lucky with who was there last night...

In other news, I can tell more about the last couple of weeks in the pregnancy.

Everything was going great until about 36 weeks when I started feeling more tired than I had. I was feeling a lot of (self-driven) pressure to get things done while I still could so I started burning myself out on projects. I asked for help from my husband, and it took some effort and strong emotion to get him to understand what my needs at the particular time were. After we discussed and worked that out, I felt like I was getting much more support and understanding from him. So I thought things were going pretty good and that I'd just be enjoying the last few weeks of pregnancy without much stress.

Until Tuesday of last week, when I pulled the entire sheet of abdominal muscles on the right side of my belly. Something like it has happened when I was pregnant with Willem so I figured that a couple of days and some patience would resolve it. It was on Thursday that I realized that the muscle pain was gone but I had residual soreness around my bellybutton where it was sensitive to touch (especially if my 2 yr old bumped against it, or if the baby moved against the spot). The pain honestly was more intense than any discomfort I felt from Willem's 38 hour, lots of back labor birth. Never before had I experienced pain so sharp that I would cry out, tears would spring to my eyes and I would tense completely. The way I described my pain was like it felt like my bellybutton would going to rip apart from the inside out.

Of course, I wanted to understand what it could possibly be so I started internet searches for search terms like "bellybutton blowout" (just for fun, I wanted to see what would come up--not much), and "conditions of the bellybutton or umbilicus." The results that came up described an umbilical hernia which is known to happen in adults rarely but typically if the adult is obese or pregnant. I wanted to get that ruled out and then discuss with someone who knew about the condition what effects that might have on the end of my pregnancy, labor and birth, and if it would require some sort of treatment postpartum as well. I'd also like to know what sort of effects it might have on future pregnancies. So off to a specialist...

In some ways it has been a good experience because I've seen that I can trust health care professionals and turn to them in times of need in order to apply their knowledge and skill. (Of course the attending who saw me on Saturday didn't know much about what could be causing the pain, and couldn't necessarily rule out the umbilical hernia, but she was able to refer me to radiology where the technicians there would know what to be looking for in such a case).

I've also seen that complications in pregnancy can happen to me, even if its this really obscure one. This pain has definitely been a challenge because my mobility and ability to care for myself and family is very limited at this point. I remembered the priesthood blessing I received at the beginning of this pregnancy that warned me of challenges that I would face in this pregnancy. I would call this a challenge, with possibly more challenges to come as a consequence.

Tomorrow, I will go back to see the radiologist for an ultrasound of my umbilical region to rule out the hernia and possibly find an explanation for the pain I'm experiencing. Hopefully then, I will be able to consult with the various departments of medicine to figure out what the implications are for birthing this baby.

Prayers are appreciated because I am afraid of hearing that an induction or C-section is recommended or that this pain could make a non-medicated labor much more difficult. I do not want to be faced with the situation where I might need to choose between the gentle, non-interventive birth I believe is so important for my child and the hospital birth with epidural, induction or C-section. Based on my initial judgement, I'd take the more severely painful homebirth over the promise of reduced pain in a hospital if the risks of my discomfort is what is being weighed against the health of my baby. I know I am strong, I know I am capable and I have faith that I can labor and birth this baby on my own with this pain, even if its worse than I can imagine right now. Especially if I can give my baby the healthier, safer birth that I long to give her at home.

How does that affect my decision to UC? Depending on the amount of pain I'm experiencing and my need for support and comfort, I am more than willing to give up on the UC aspiration to have the midwives (plus additional assistants) there supporting and encouraging me.

Last night at the hospital, I had my husband, my friend (who was the doula at Willem's birth) and the nurse providing physical and emotional support during the exam where the resident palpated my bellybutton. I think that if I needed (and greatly appreciated!) that much support for that, I may have a much increased need for support during labor.

I suppose there is the possibility that the pain could resolve before labor begins (even though I've been experiencing sporadic contractions since Tuesday night) or that the pain in my bellybutton will not impair my ability to labor. I can hope for that.

Bottom Line About Birth

I haave been trying to come up with a short statement that describes my beliefs about birth. I've been thinking of it kind of a guiding statement that can inform my efforts. This is what I've come up with so far but I know that it will evolve. Originally this was posted in an online discussion board. At the end of the statement, I discussed the implication of my belief statement.

Birth is a normal process in a woman's life much like the menstrual cycle. Typically, in the majority of cases, it is a process that women can handle on their own without medical assistance. Sometimes the process goes outside the normal range so its a very good thing that traditional and medical knowledge and intervention is available for consultation and judicious use. Menstruation, like birth, can be a painful (intensely painful) experience for some, even most experience pain in relation to that womanly process. Therefore it is perfectly reasonable for women to seek out ways to minimize that pain (unfortunately a tylenol isn't so effective in labor as Morphine!).

What are some of the implications of this belief?:
1) Drs, hospitals and midwives are not necessary in most cases for birth. It would be like going to a hospital when menstruation starts and staying for the duration of the bleeding cycle while efforts are made to speed the shedding of the uterine lining, reduce pain and discomfort and prevent excessive bleeding.

2) Sometimes consultation is needed when something is varying widely from normal and its a good thing that those experts and facilities exist.

3) Those facilities and trained experts need to exist, know the role they are intended to play and use practices that are based in logic, evidence, safety and effectiveness with minimum intervention. I cannot say that I believe that current obstetric and even midwifery practices support this.

4) I'm not going to begrudge anyone who seeks to find pain relief for either womanly process, but I will point out that the big guns of anesthesia are not typically warranted for pain associated with such a normal event (and I'm going to say it) everyday event.

5) Birth is not treated like an everyday event in our world, but in many ways it is. Its a normal part of life that is filled with significance and symbolism, but its just birth like defecating is just taking a poop and menstruating is just the shedding of the uterine lining.

6) There needs to be levels of involvement based on need when something is going wrong. The first response to derivations from normal is the individual relying on knowledge sought and shared by peers and women who have taught her about the process. Self-comfort measures, then possibly herbs, then possibly stronger pain relievers, then consultation with an outside trained consultant who offers the minimum of support for a normal process. As more is needed, those services can escalate to meet the need presented before them. But prophylaxis is not really warranted. Treatment of symptoms and finding the root cause while supporting the overall process ought to be maintained as the standard of care. What this implies is that midwives need to be able to consult freely and make referrals to obstetricians without fear or reprisal. OBs need to remember their place in the process not as the director but as consultant. Women need to accept and act on the belief that help and assistance is not needed and its something that they, their bodies and their babies do as an everyday fact of life.

7) Where does trauma fall into this? When things goes serious wrong with any health related concern, the emotional trauma can be profound. Women in childbirth aren't the only ones who are traumatized by a major health crisis: cancer, injury, surgery, hemorrage all are scary because there is a threat to our sense of safety within our own bodies. Those crises are scary and its no wonder that people have long term emotional effects from those experiences. For birth, there's also another cause for trauma besides the pain, besides the fear of when things go wrong. There is what happens when people who shouldn't be meddling in a normal process get involved and screw things up. Providers don't realize the physical and emotional damage they are doing when they push for unecessary and not evidence based practices to control and process that they are afraid of. Its not something to be afraid of in most cases. Yes, sometimes it can be scary but that doesn't mean that every poop needs to be closely monitored and controlled. Doing things that don't need to be done will just make things worse.

Why I am a UCer

One of my online groups asked each member to explain their personal reasons for UCing. This was my response:

I came to UC through a traumatic hospital birth, but I feel I can truly say that
it is not why I choose to UC. Before my son's birth, I didn't know that UC was
an option, and not one that I would have considered. I thought that babies were
born in hospitals for good reason, not knowing (or taking the time to find out)
the history behind hospital birthing.

After becoming a mother, I started really learning about birth: to make sense of
what happened in the hospital and to prepare myself for something different and
better for the next birth (which I'm about a month away from now!--so be warned
that the following is all theory at this point. We'll see if and how the
following changes after the new baby is born).

Being LDS, knowing that I am meant to have more than one child and having a
strong sense of justice, I knew I had to find a better way to birth. I likely
would have been comfortable with a birth center with a midwife but I felt drawn
to UC when I heard about it for a few different reasons.

Here they are:
Faith and trust in Heavenly Father and His creation (my body and baby)
Intimacy with husband
Freedom to follow instinct
Privacy/ not being hindered by observation
Being fully responsible

As I studied and reflected upon the scriptures after my first birth, I
frequently came back to "leaning on the arm of flesh." I felt that is exactly
what I did during my first birth and pregnancy. Rather than trusting in HF and
turning to him for guidance and support, I turned to the omniscient cult of
medicine and put my trust there. I was burned big time and I feel I needed that
experience to teach me to truly turn to God and put my faith there with Him.
This desire to trust Heavenly Father also ties into my respect for His creation.
Life on earth amazes me as I learn more about it. Birth and the woman's
capability to grow and birth a baby is another example of how his creation works
most of the time. And I believe that its works best when the organism is
trusting in Him as it strives to fill the measure of its creation. The measure
of my creation is being able to birth my babies and to give Him the glory I feel
it deserves, I want those births to be the purest they can be so the credit is
given to Him and his ability to create a body that can grow and birth a baby
without a bunch of meddling. When I learned about UC, I saw that the practice
could be a pinnacle of faith in that process because the outcome would be the
ideal: a healthy mother and baby united by peace and love. Since then, I've
learned that, for me, the pinnacle of faith would know be to trust in man in a
case of an emergency birth. I would have to receive VERY strong promptings from
the Spirit to turn to the hospital for assistance in birth. I'm that terrified
and distrusting of the whole medicalized system of birth care. And then my
decision to UC plays into my faith in the abilities of babies. HF has engineered
them to be so capable of so many things that many adults don't give them credit
for. Because babies aren't believed to be capable of those things, the
opportunity is taken away from them. The breast crawl is an example of this. I'm
just amazed at the active role that babies play in the birth process and I want
to respect that innate ability and once again glory God in His creations of
babies that most of the time come out healthy and perfect just like He intended.

I have to say that I was swayed by Lynn Greisemer's theory of husband
involvement in birth. I like the romantic notion that the person who put the
baby in my body during an intimate, sacred act of creation would be the one to
witness the coming forth of that fruit in another intimate, sacred setting. I
have this sense that birth is supposed to be spiritual and intimate with a
deepening of the husband/wife connection. I also know that during my first
birth, labor was started by engaging in intercourse. So I learned that being
intimate with my husband was one way to call a baby forth from my body. Then
later I learned that it might have been advantageous to be intimate again during
early labor and maintain that cuddling, kissing connection throughout the whole
process. I found having birth attendants there just interfered with that ability
to connect with my husband to the point that he was a peripheral character that
was just present and pushed to the side. I don't want that to happen to him
again. I want the birth of our babies to be something that we do together since
it was coming together than created that baby in the first place.

Just like I felt that the typical birthing settings interfered with the
husband/wife connection, I also felt like it interfered with my own ability to
listen to what my body was telling me. I was so in the mindset that I was going
to be guided by more knowledgeable people that I didn't take the opportunity to
follow my instincts, which I trust and believe were ingrained in me by Heavenly
Father. So being able to follow my instincts ties into being able to have the
trust in God and his processes.

In order to have that freedom to follow my instinct, my faith and the connection
with my husband, I feel that privacy is very important. I don't think that I
could experience those things with strangers present. Especially strangers that
are "paid to be paranoid" (<---borrowing from Jeanine Parvati Baker). I learned
that I could not trust them because invariably their own sense of
comfort/perservation/convenience is going to interfere in some way. And even if
the attendant is the best they can be in not interfering, just having their
presence there would be intrusive to me. Even them knowing that I'm in labor
would be intrusive to me...which is likely why I don't plan on informing the
midwifery practice I have as back-up when I go into labor. I anticipate that I'd
be able to feel their thoughts and concerns and I'd just ruminate on what they
were thinking, feeling, etc.

The last reason is likely my strongest bit of rebellion. I feel that it is
deeply ingrained in our culture to give away our responsibility to others in
order to share the blame in case something bad or wrong happens. Outsourcing or
hiring out for help in something, to me, is an indication of seeking to not be
responsible in case it is done wrong and to have some one else to hold
responsible. I don't want to give away my responsible and stewardship as a
parent starting with birth. I want to be the one to make decisions for myself
and my children, according to my conscience and the guidance I receive in my
decisions. As a preschool teacher, I saw so many parents abdicate their roles as
parents to someone else and it saddened me to see that rift occurring at such
young ages. I was surprised to learn that it started during pregnancy and birth.
Since I had never witnessed it before, it took experiencing it to know that
there are entire systems out there that (inadvertently) undermine parents'
autonomy. In my understanding of the gospel, that's not how it is supposed to
work. Self-reliance and trust in God are important values to me and I see how I
can apply those principles to birthing and hopefully that will be a lesson to my
children in taking responsibility for their own actions so they will make
prayerful, well thought out decisions without going along with the pack.

I really am interested to see how my perspective changes after this baby is
born. Like I said this is all in theory now, not having given birth UC at this
point. I'm looking forward to it though! I'm 34 weeks now. I have to admit that
there is some fear in me that says that I'm going to sour on the idea of UC when
I attempt it and fail. We'll see how the process unfolds. I'm believing that all
will be well and I'll have a lovely private, intimate homebirth. And maybe if
someday I have to turn to the maternity care system for assistance that I'll be
humble enough to do it...and in the meantime I'll hope that I never have to.

Inspiring Monolouge

Helping and Preventing Birth Trauma

We are pleased to announce the Solace for Mothers Friends and Advocates Online Community which provides a forum for those who support mothers who have experienced birth trauma, have been impacted by witnessing birth trauma, or want to connect with others to advocate for gentler birth practices.

Solace for Mothers is committed to providing resources and support to professionals and loved ones supporting women through the difficult emotions following a disappointing, hurtful, or violating birth experience. Spouses, family, and friends of mothers who have experienced traumatic births are offered a space to find information, support, and resources through participation in the Friends and Advocates Forum. Birth attendants are also provided with the opportunity to process their own emotions in response to births they have attended. Birth professionals and birth advocates are provided a space to discuss the causes of birth trauma, how policies and programs can be enacted to prevent trauma from occurring to childbearing mothers, and methods of treatment when trauma has occurred.

The Solace for Mothers Friends and Advocates Online Community welcomes birth activists, mothers, families, and professionals, all of whom are stakeholders in providing healthy, safe, and empowering births that enable families to successfully transition to parenthood. Users of the online community are invited to contemplate and discuss the current state of birth and what evidence based practices best support childbearing women, their babies and families. Advocates who are interested in becoming involved in organized efforts to promote these practices are encouraged to participate and share their thoughts.

The Friends and Advocates Online Community can be entered from www.solaceformothers.org/advocates-forum.html. The forum is made public for browsing and registration is required to post and respond to topics. To view the online community, go to: http://forums.solaceformothers.org/mb/birthtrauma

Mothers are welcome to participate in the Friends and Advocates role but they are invited to register and participate in the Online Community for Healing Birth Trauma (www.solaceformothers.org/forum.html) which provides peer support to women who have had traumatic childbearing experiences. Birth professionals, family members, and friends please respect the privacy of the Community for Healing Birth Trauma and register only for the Friends and Advocates Community.

If you have something to say regarding childbirth and want to be a part of a larger conversation, please join us. We are interested to read your stories, thoughts, hopes and goals for the future! Please also feel free to pass this invitation on to organizations and individuals who would be interested in the topics of birth trauma and improving maternity care.

Warmly,

Sharon Storton, Founder of Solace for Mothers, Inc.
Jenne Alderks, Creator and Moderator of Online Communities
Jennifer Zimmerman, Creator and Moderator of Online Communities

If I were to birth in my hometown

I recently started entertaining the thought of birthing my baby in my hometown of Stockton, CA. Many of my friends are still living there and beginning to have babies, so I've learned a little bit about the birth climate there. All of my friends there have had hospital births, which is not too surprising. I have been disappointed by the number of primary cesareans that my friends have experienced. I took that to be an indicator that the hospitals in Stockton aren't incredibly supportive of physiological birth.

A quick search showed me that there are no homebirth midwives working in the city of Stockton, and no out of hospital birthing centers. The nearest birthing center is 50 miles away in Fair Oaks, with two more in San Francisco and Oakland, respectively. The nearest homebirth midwives are 40 miles away in the Sacramento area.

I decided to look at the websites for the two main hospitals in the city of Stockton: Dameron (where I was born 24 years ago) and St. Joseph's. I was not encouraged with my options when I read this:

The baby's father or support person may visit from 7 a.m. to 10 p.m.
Only two people, in addition to the support person, may visit at one time.
Children under age 12 are not allowed in the department. Exception - after delivery, brothers and sisters of the newborn, accompanied by an adult, are welcome during regular visiting hours. Short visits are best for your children.
Visitors must not have fever, cold, cold sores, diarrhea, vomiting, rash or skin sores. Those who have been exposed to illnesses such as chickenpox or measles may not visit.
Labor and Delivery:

One additional person, other than the support person, may be present during labor and delivery. We ask that all other visitors wait in the visitor's lounge, (not the hallway).
Only the support person may accompany the expectant mom for a Cesarean delivery.

For a more detailed description of their practices, see their PDF entitled "Welcome to Life--Guide to Pregnancy, Birth and Postpartum."

Dameron's information was a little more encouraging:

The Alex and Faye Spanos Start of Life Center
This holistic focus is reflected in our Start of Life Center. A generous gift from Alex and Faye Spanos, the Start of Life Center operates on the concept of "Family Centered Care," where birth is treated as a total family experience. From the time an expectant mother experiences her first labor symptoms and arrives at the hospital, through the actual delivery of her child, she receives total maternity care without ever having to leave the pleasant and comfortable environment of her home-style birthing room.

The Labor and Delivery Department is staffed by highly trained Registered Nurses sensitive to both the emotional and medical needs of pregnancies and birth situations.

Based on the experiences of my friends and my own interpretation of available materials, I'd probably choose Dameron over St. Joseph's if I needed a hospital, but I'm so opposed to a planned hospital birth that I'd be more likely (if I lived there) to find a homebirth midwife outside the city. This investigation has not encouraged me to change my plan in the slightest. I feel that the state of Washington provides me with more choices and access to better care than I could get in the Stockton area.

So the plan goes forward that both of our first children will be able to claim Washington as their state of birth. Once the new baby and I are fit to travel (no sooner than 1 week postpartum), we'll be driving down to spend the summer in Stockton while my husband does his summer research on the California coast.

More general information on birth choices in the Stockton area is that St. Joseph's has an all out ban on VBACs while Dameron does allow VBACS, although a statement refusing the C-section must be signed. That leads me to believe that women are strongly encouraged to consent to an elective repeat cesarean. It appears the hospital staff is rather persuasive since in the county, 96.5% of women have a repeat cesarean(source: March of Dimes Peristats for San Joaquin County, CA).

Reporting on CIMS

I came away from the 2009 CIMS Forum feeling like the take home message was the same as we all know: the maternity care system is messing up women and children. It was interesting to me to find out what different people are doing in different places.

I went to one presentation that discussed violations of the Mother-Friendly Childbirth Initiative as violence against women. The researchers (from Canada) qualitatively analyzed women's experiences (using interviews) that showed how women felt victimized by their maternity care. The researchers put together a really cool little chart that helps to illustrate it and I'm planning on filling one out with events from my own birth experience. I am just gratified that it is being framed in those words--that violations of informed consent are violent acts being perpetrated against women. I hope that the awareness becomes more accepted. I felt that their presentation and Solace for Mothers presentation worked well together, because they made the case for us that birth professionals are causing trauma and then we were able to follow up with the message "this is the outcome for women who experience that trauma and this is how we can help."

There was talk at the conference that the powerpoints from many of the presentations will be available on the CIMS website at some point, including the one I participated in for Solace for Mothers.

I also finally attended the Birth Survey marketing training and I realized that since I helped edit the training manual and powerpoint presentation that I pretty much knew all of it. But I did meet Nasima and Elan (the co-chairs of the Birth Survey Project) and it was really good to be able to meet them in person and visit a little bit. Here is a run-dowm of some of the Birth Survey results that Nasima unveiled: The sample of people who are responded so far is a little more educated that the national average, but not shockingly so. The most typical time for women to complete the survey is actually 9-15 months postpartum so marketing ambassadors are now being told to target pediatricians offices (and they will be more like to post the info than OBs because peditricians aren't going to be as threatened by the results). Probably most surprising is that the birth outcomes are pretty inline with the national data: the C-section rate isn't too far off, the percentage of hospital births, etc. Nasima did find that the questions regarding if you would recommend a provider, if a provider answered questions well and were respectful were highly correlated to whether a woman ranked that provider positively or negatively. So it appears that those questions are good indicators of overall quality and if women are saying they had a good experience.

Henci Goer gave a really good presentation on interpretting the research. She pointed out that a lot of birth activists are citing "Evidence Based Care" as the answer to the maternity care problems (think of the new report that came out a couple of months ago). I saw alot of that too but it must be realized that a lot of research is inherently flawed, that some researchers mess with their data, others draw conclusions not supported by their data, etc. Its stuff that I already knew, as a researcher, but may not be known by those who don't have the background in research. I think its a good thing to get the word out about.

For most of the conference, I was just making due since I had Willem with me. One day I couldn't find any childcare for him so he ended up attending the sessions with me. He did great and didn't appear to be a disruption to anyone but I didn't get as much out of it as I would have if he had been able to stay home. I'm not complaining though because it was still a very good experience. I'm happy to have learned what I did, and met the people that I did.

At one point, the different CIMS committees did overviews of their work and I'm kind of drawn toward working with the Informed Consent Committee. Coming up in the Winter 2009 issue Journal of Perinatal Education will be an article compiled by that team called "Informed Decision Making in Maternity Care." Another article with Maddy Oden as the lead author will be published in the May issue. Solace for Mothers is working on a tool that would be available for expecting mothers to use when choosing their maternity care provider. It may be an advantagous partnernship for CIMS and Solace to work together.

Going to CIMS

This weekend, I'll be attending the CIMS (Coalition for Improving Maternity Services) Forum in San Diego. Sharon Storton from Solace for Mothers will be speaking on the services that Solace provides mothers who have experienced traumatic birth and how the utilization of the CIMS Mother Friendly Initiative can prevent birth trauma from occurring. Other speakers will be Henci Goer and Phyllis Klaus. I'll also be able to attend the CIMS Marketing Ambassadors Training which I haven't been able to participate in yet. When I get back, I should have some good information on how to promote the Birth Survey in Washington state. This is my first birth conference and I'm very happy to be able to attend. I'll summarize and report upon my return!

Recent News Articles

I've found and read these recent news articles that have interesting implications for women who are mothers:

VBACS:
This piece in TIME magazine is getting a lot of coverage: The Trouble with Repeat Cesareans
A follow-up story to the TIME article: Childbirth Without Choice

Breastfeeding:
Breastfeeding Benefits Moms with MS
Baby Food: If breast is best, why are women bottling their milk? : article from the New Yorker offering a stunning history of expressed milk

Changing Ideals for Birth

On discussion boards and surveys, the question has been posed, "What is your ideal birth?"

In preparing for another pregnancy, my ideal birth was something very close to this: I go into labor at home with my little boy. I do my typical thing until the contractions get closer together and more intense. I pray throughout to my Father in Heaven that all will be well. I either call or wake up my husband and he starts to fill the labor pool with water. I take walks with my husband and toddler. I eat a little and drink the special tea and laborade blends that I've prepared. I cuddle with my little boy and encourage him to nurse. Maybe my husband and I will have sex if my waters haven't broken. Maybe I ask him to give me a priesthood blessing. I labor in the pool submerged in water. Maybe I'll get out of the pool when I feel the urge to push, but maybe I will stay and the baby will be born with just me, my husband and my little boy present. I'll give the baby the opportunity to do the breast crawl to nurse for the first time and then baby and I will rest. Maybe husband and toddler will rest with us. When we wake up, we call the chiropractor who promised to come by and adjust me and new baby after birth, as well as grandparents, friends and the midwife to schedule a postpartum visit for the next day.

My plan has stayed pretty static for sometime, and my preparations during the pregnancy have been to support that end result. However what I consider my ideal for this birth has begun to change since I've started reading the book "Rediscovering Birth" by Sheila Kitzinger. She describes the history of birth through a cultural anthropology lense and describes how birth is viewed across cultures and history. If you were to analyze my ideal birth story above using her presentation of ideas, you would find that it has shades of contemporary American (no surprise there), tribal African, and medieval European birth practices.

I thought an unassisted birth a home with my family was what I really wanted. That it was even what I would choose in a perfect world where maternity care was appropriate and family and friends were nearby and culturally accepting of my choices. However reading Kitzinger's book I am realizing that my "perfect world" birth experience would be surrounded by women like in medieval Europe where it was a party atmosphere were the birthing woman's husband, mother, mother-in-law, sisters, aunts, cousins, friends, neighbors and young women of the community gathered together to support and comfort the mother, to celebrate the birth a baby with food, laughter and bustle.

I see the drawback of that setting: my husband would be terrified to have that many women around and can you imagine the offense taken if the birthing mother tells someone to leave? The largest reason why I do not feel I can in good conscience invite a group of women to support and surround me during birth is that almost every woman I know is strongly steeped in the American culture of birth. And the ones that aren't live very far away from me and I only know them through the internet. I know the women who could gather around me during would be fearful and concerned about not being in a hospital or not having a midwife or doctor present would permeate the atmosphere. They wouldn't have the experience of being present at many births except their own.

So I guess I basically am wishing that I was living in medieval Europe or that the entire way birth is viewed, engaged in and celebrated in the US dramatically changes before June. Of course its not going to happen but as a result, I am struggling to not feel that I am settling for what I believe is realistic given the circumstances and climate of birth.

I wish that women in our society were included in the birthing room for other women, without being paid as consultants or providers, but that their presence was the loving, benign presence of friends and family rejoicing in a typical life event. I wish that my daughters will not be strangers to birth when they birth their first babies, but will have been exposed to the gentle, natural birthing practices that take place at home surrounded by love, without fear and without unnecessary intervention.

Update: Week 25

Last week, I saw the midwife at 25 weeks and it was a very good visit.

I learned how amazing cool it is to hear a fetus's heartbeat using a stethoscope rather than a doppler. The doppler sounds to me like a"woosh-woosh" sound while the heartbeat using the stethoscope sounds like a quick little heartbeat. Mine could even more heard slower and deeper in the background. I could listen to that sound for hours. Which is why I'm seriously contemplating buying a stethoscope for home.

In my pregnancy with Willem, the only way I ever heard his heartbeat was using the doppler device, in spite of some researchers' concerns that doppler sound waves can harm the fetus. This pregnancy I'm trying to avoid the doppler and I'm so glad I did because I've discovered listening with the stethoscope. To me, the experience doesn't compare. I don't feel like I'm intruding on the baby at all, but that I'm listening without disturbing her at all.

In the week leading up to that appointment, I had had two birth dreams. This was exciting and unusual for me because I longed to dream about birth and the baby when I was pregnant with Willem, but never did. These recent dreams of mine had two things in common: they were wonderful, perfect, gentle and loving unassisted births and in each the baby was large. In the first dream, I gave birth to a 15 pound baby! I've never even heard of baby that big being born vaginally and it was a wonderful birth. The second dream, I was submerged in water to my shoulders (I've never heard of birthing in a swimming pool, but in the dream it was great!), I watched as the baby emerged from my body, she twisted in one of the cardinal movements and looked into my eyes through lovely blue gray eyes. During that dream, she wasn't weighed but I knew by looking at her that she weighed at least 10 pounds.

Of course, I have been puzzling over what this meant. Is it a premonition that I'll be birthing a baby at least 4 pounds heavier than my first? Or does it mean I'm just that confident in my ability to have a joyous birth?

I seem to be getting some indications that its not likely for me to have a large baby, especially since Willem was born at 38 weeks and not quite 7 pounds. At the recent week 25 appointment, my fundal height was measuring at 24 weeks. That could easily be normal variation and she's small for dates but in the normal range, or it may be an indication that the calculated due date is off.

Since gestational dating is such an imprecise science, I am not about to try to determine if that supposition is correct using any obstetric techniques. Instead I decided to do what I vowed to do at the start of the pregnancy: turn to God who I believe is the source for all knowledge for guidance and truth regarding this pregnancy. If anyone can or will know, it is my loving Father in Heaven. To me it is an application of the scriptures "trust the Lord with all thine heart and lean not to thine own understanding (Proverbs 3:5)" and "I will not put my trust in the arm of flesh; for I know that cursed is he that putteth his trust in the arm of flesh. Yea, cursed is he that putteth his trust in man or maketh flesh his arm (2 Nephi 4:34)." I knew that taking this matter to the Lord might not matter in big picture (applying the principle in Doctrine and Covenants where the Lord says, "it mattereth not unto me") but if it was something that he felt I should know that I wished to know if the dating was off.

I have suspected from the beginning that instead of the EDD being the last week of May, it should be the first week of June based on when the baby was conceived, my menstrual cycle, as well as just a feeling that she is going to be a June, rather than May baby. The fundal height measurement was enough to make me consider that possibility once again. When I asked of God, I felt strongly impressed by the spirit that indeed the more accurate EDD should be placed during the first week of June.

I have been enjoying throughout this pregnancy what I believe to be revelation concerning the baby and my body's work at carrying the baby. Before this baby was conceived, I felt the strong impression that a little girl was on its way to our family and then I believe it was the Spirit whispering to me that I was pregnant which is what prompted me to take a home pregnancy test in the first place. After the pregnancy was confirmed, I once again felt impressed that the baby was indeed a girl, which was then confirmed by ultrasound at week 22. I would have been perfectly content to have the gender confirmed at birth, however. The biggest question weighing on my mind however is the Lord's support and knowledge of the best birthing environment and situation for the baby. I have received impressions that he is supportive of my plans and that all will be well with the birth. That assurance is the greatest knowledge I can receive in regards to this pregnancy.

An interesting part of the impression is actually that to God, it doesn't really matter which birth setting I choose for this pregnancy, the outcome will be the same. That leads me to believe, that the Lord doesn't prescribe one "right" or ideal way to birth and that it is one of those things that he would prefer for us to study it out in our minds and our hearts (Doctrine and Covenants 9: 8) what is best for us and he will guide and support that learning process. To me that means that with each pregnancy the situations and therefore decisions made regarding birth will be different. How thankful I am that I can trust in Him to be there every step of the way in making those decisions.

That was week 25-26 of this pregnancy. I'm feeling well--particularly active and energetic. For a while that had me concerned but then I realized that I am probably rejoicing in the fact that I am done with my thesis and master's program and can now throw myself into other activities that I had to restrict myself from previously. I'm excited that in the next couple of months before the baby comes, I can focus on working with Solace for Mothers, assisting progress with The Birth Survey and reading from my book list.

Mothers and Fetuses: Whose Rights Trumps Who's?

One of the fears facing homebirthing and unassisted birthing mothers is a transfer to the hospital where their motives and "fitness" as a mother are called into question by hospital staff; sometimes resulting in CPS taking the newborn from its mother and the mother faces criminal charges. Another fear is the court-mandated Cesarean where a women is forced into a surgery that maybe against her wishes.

Lorna A. Turnbull discusses these issues in the article "The Legal Characterization of Pregnancy and Mothering: Does Mother Know Best?" in the Spring/Summer 2001 issue of Journal of the Association for Research on Mothering.

She states that the legal system has historically relied on a medical model of pregnancy that dictates the behavior and decisions made by a women. The state has then attempted to regulate pregnant women's behavior through criminal prosecutions or by allowing civil actions against the mother.

"The medical model removes the power of women with respect to their pregnancies and places it in the hands of doctors, or in some cases, the state. The model allows women to be depicted as self-interested or incompetent. The standards of medicine become the norm against which a pregnant woman's behavior is judged and a woman who decides against the norm of medical science is cast as irrational and selfish. A woman who defies the truth of medical knowledge becomes a bad mother, one who has declined to put the perceived needs of the foetus ahead of her own concerns."

Homebirthing and unassisted birthing mothers know this frame of reference all too well. By choosing to birth a home with or without a professional who is not a doctor, women are considered to be flouting what the medical establishment has deemed proper behavior for birthing women. The American College of Obstetrics and Gynaecologists have repeatedly decried the dangers of homebirth calling mothers "selfish," "irresponsible" and "incompetent." Conversely the vast majority of mothers who do choose to birth their babies at home do so beleiving that it is within the best interests of their baby and themselves; as to not be exposed to the risks attended with hospital birth. Ironically, the evidence based research of the most appropriate care for birth aligns with homebirth practices moreso than hospital births for low-risk women. Yet women are still being framed as unable to understand medical practices and then stupid and irresonsible for choosing to go against those practices. It seems that we still live in a world of "doctor knows best."

Rixa of Stand and Deliver also gave a talk discussing Risk, Responsibility and Safety at the 2008 Trust Birth Conference.

Yay Obama!

As an undergraduate, I studied family life education, apart of which is marriage education. I worked as a research assistant on the National Healthy Marriage Resource Center where I summarized research studies on marriage as the optimal arrangement for children, men and women (see recent post: http://descentintomotherhood.blogspot.com/2008/11/why-is-govt-promoting-marriage.html).

In 2006, George W. Bush sponsored legislation that would promote and encourage marriage as that optimal arrangement. The Healthy Marriage Initiative was authorized under Temporary Aid for Needy Families (TANF/welfare funds).

Although the social science research is very clear (I recommend reading The Case for Marriage, 2001), I was worried that in a time of economic downturn and administration change that the funding to provide marriage education services would not be continued.

Today I learned that Barack Obama has been a firm supporter of marriage education efforts and plans to continue supporting the funding of such programs. On the Healthy Marriage Initiative homepage, there is a quote from his book The Audacity of Hope, 2006:

"...Finally, preliminary research shows that marriage educaton workshops can make a reall difference in helping married couples stay together and in encouraging unmarried couples who are living together form a more lasting bond. Expanding access to such services to low income couples, perhaps in concert with job training and placement, medical coverage, and other services already available should be something everybody can agree on..."

By placing that quote on the webpage, I am heartened that the research will continue to speak for itself and that programs and efforts to stablize American families will continue.

Week 22 Update

Today, we saw our little GIRL by ultrasound. I felt before I was pregnant that my next baby would be a little girl and since becoming pregnant, I've felt very strongly that same way. And my belief was confirmed today.

She looks totally healthy, placenta is in a good position. She looks kind of squished in there right now so I'm thinking I'll have a spurt in uterine growth soon.

Still feeling great, with lots of energy and a more active mind than usual, and my mind is usually pretty active.

Willem is affected by the pregnancy; either because I'm producing less breastmilk or he no longer likes the taste of it. I can tell he's beginning to wean himself because he's asking for cow milk more frequently than mama milk. I'm hoping that after the baby is born, he will go back to nursing more frequently.

Grandma, aunts and neighbors are very excited for a little girl in our family, and so am I. Maybe sometime I'll write an exposition on my thoughts of having a little girl. And if my scanner can start working, I'll get pictures posted.