Saturday, May 30, 2009

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!

Saturday, May 23, 2009

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.

Tuesday, May 12, 2009

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.

Sunday, May 10, 2009

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.