Opening the Back

Jamaican midwives having a saying that when the back opens the baby comes. This is referring to the period of time around the fetal ejection reflex where the baby moves down to crowning and birth. Opening the back occurs when the sacrum moves backward to allow more room for the baby to move through the pelvis. Its amazing to learn how much space is gained by this--up to 4 cms in some places! I had never come across it before in any of the other reading I have done on birth. I thought this is so cool, I can share it here. Especially since I can even tell a personal story about it.

I encountered this term in my copy of Holistic Midwifery Volume II written by Anne Frey. It is one of the texts in my midwifery program and covers extensively (its almost 2,000 pages!) the physiology and care of labor and birth.

I remember when this happened during Belle's birth. I even commented on it when I wrote her  birth story. I didn't know the name of it then so I'm pleased to learn about it now. At the time I described it as:

I felt tightness radiating down into my thighs and it felt like the bones of my pelvis and hip were being stretched outwards.

I later thought that this might have something to do with the hip pain that lingered after that pregnancy. I learned that it might be SI dsyfunction (sacroiliac joint) and posted about it here. Finding out that it was an actually physiological process that is part of normal birth helped me feel that the strange sensation wasn't an injury but my body working as it was designed to.

I thought at the time that when I felt my hips spread during Belle's birth that something unnatural had happened. I still think that maybe my SI issues have something to do with this spreading. It happened so quickly--it was like my SI joints abruptly slid out as far as they could like sticky slide locks on a door. Perhaps they slid more forcefully and quickly than is typical when the sacrum moves and the back opens.

This phenomenon is only observed when upright birth is allowed. When a woman in laying on her back in bed, the sacrum is prevented from moving and the pelvis does not expand in conjunction with the fetal ejection reflex.

I don't recall feeling this happen when giving birth to my son. Not surprising, since I felt pressured into birthing on my back. The only way I felt that I had been able to reposition more comfortably as he was descending and crowing was by twisting my hips so that I was more on my side.

Someday I may find more detailed description of this phenomenon. It seems like it hasn't been described or investigated by researchers enough to know what is normal "opening of the back" and what is extreme. As it is, the term is hardly known except in some circles. Hospital birth attendants and medical researchers wouldn't see it because the vast majority of birthing women they see are on their backs. Upright/vertical birth isn't even an option in many hospital birth environments.

Have any of my readers heard of this? Care to theorize with me on the possibility of normal opening of the back and extreme opening on the back?

What does birth mean to me?

We are celebrating the birthday of my first child. It was three years ago today that I became a mother. Three years ago, I fought for an unmedicated, vaginal birth. Three years ago, that I breastfed for the first time. Why then am I still writing and talking about birth?

There is something profoundly special about birth and in recent months there has been alot of talk about what that something is. Rixa clued me this discussion with her post "Thinking No Conclusions Yet". I was also inspired by this post by Keyboard Revolutionary and how she describes how birth impacted her as a maturing, developing individual and mother.

I originally wrote the following statement about birth in April of 2009 when I was 8 months pregnant with my little girl. The top paragraph is a statement of what I believe about birth followed by the logical implications I could think of as well as explanation for why I believe my statements to be true. This post is an exercise for me to see if my thoughts have changed in anyway now that I've given birth a second time and grown in my logic, knowledge and though processes regarding the life event.

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.

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.

Since experiencing Belle's birth, I have to say that the similes between birth, menstruation, and defecation hold true for me. Her birth was such a normal and as I experienced, pedestrian process that it was in some ways boring for me. It certainly doesn't make for an exciting story, there was little drama. Just an emergence and a completion for a normal bodily process.

I did fail to state in my original writing however to emphasize that birth is altogether a more physically demanding bodily process and it is a very special life event for a mother. I do not believe that it the most important events of a mother's life like Jan Tritten states, as I believe that it is overstating a simple transition from one state to another. As a mother who as been traumatized by events relating to childbirth, I know too well the long-lasting emotional effects that a mismanaged, "pushed" birth produces in a woman.

For the baby, the birth (and the manner thereof) is important bio-chemically and throughout development. This is reflected in the research suggesting that babies exposed to pain relief drugs in childbirth are more likely to become drug addicts when they become adults, as well as the research linking birth practices to autism and maladaptive attachment between parents and child. But to say that the events of childbirth are a strong predictor of child's health, well-being and capability as an adult ignores the functional adults (often the mothers who are now fighting for natural births themselves) who experienced less than ideal births when they were babies. It is safe to say that most of the adults up to at least age 70 were brought into this world not in the way that research shows as optimal for development and bonding. How one was born does not often make that child less capable of facing their life's challenges.

So if I just stated the ways that birth is not special, why is it special and what does it mean to me?

Birth is special because it was the moment I got to meet my children. The emotions, environment, thoughts and feelings of my body are still strong in my consciousness as I remember what it was like to bring them into the world and hold them in my arms for the first time. With Willem, I was frustrated with the people around me that is caused my focus to not be solely on my child and I still resent that he was born into a moment of bitterness and frustration. With Belle, the laughter and excitement of the final moments of her birth and the joy of having my husband and child look on still cause me to relive those feelings. With Willem's birth, when I relived his birth. It was in the form of flashbacks and PTSD. With Belle, I relive her birthday and I know joy.

Birth is a woman's battleground where the inherent and supremely unique strength of womanhood is exerted in its fullest. A woman each time she gives birth "walks through the valley of the shadow of death" because there is the possibility that she will die bringing life into the world. So in a sense, a woman faces death and walks away conquerer bearing new life in her arms. Its amazing! No wonder, Goddess worship is common throughout history! She faces fear and pain, discouragement, exhausted and comes out experiencing the highest high of her life (granted she's not facing the commonly disturbed birth environments of today). With both of my children, I fought to bring them into the world without experiencing things that I felt could be damaging to their health. One the fight took place while I was laboring. The other I fought and prepared and schemed before labor so the actual event of her birth could be peaceful and private.

Its because I had to fight, and that all women who are seeking a normal birth the way nature is intended are having to fight for it, that is why birth is so important to me. That its become a cause that I feel like I have something I can do to keep other women from experiencing the emotional suffering and stress that I experienced. Its a matter of right and wrong for me too. Its simply wrong for a woman to be told by authority figures that she is not capable of making decisions for herself. Its wrong that an entire system is structured in a way that many women and babies suffer unnecessary risk, damage, ill-health and distress in the name of what is culturally acceptable. Its these issues that I'm taking on and that I want to work to correct for my daughter and my sister-women so they can give birth undisturbed, in joy and have access to the help they need when it is appropriate.

What does birth mean to you?
How is it special?
In the course of life, how important is it?
How important is mode of entry (vaginal, cesarean, medicated or not)?

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!

Sacroiliac Joint Dysfunction

I've mentioned before that I've had intermittent hip pain since my last pregnancy. I had a spell for about a year where it didn't bother me (from August of 2009 to around May of 2010) so I thought it was something that I could just let work itself out. At some point, I realized that its become too much of a fixture in my life so I needed to do something about finding the root cause. On my birthday this year, it got really bad again so I became serious about addressing it.

I recently visited my naturopathic doctor/midwife who listened and poked around my hip and lower back to try to isolate where the pain was coming from. She mentioned the sacroiliac joint (a joint connecting the sacrum in the low back to the pelvic girdle. Its connected with ligaments and covered with cartilage). She then referred me to a physical therapist who specializes in lumbar-pelvic PT. While I'm waiting for an appointment with the PT, I've been doing some internet homework to try to figure out what is going on. With sacroiliac as a clue, I started my searches.

And this is what I found:

Another common cause of SI joint dysfunction is pregnancy. During pregnancy, hormones are released in the woman's body that allows ligaments to relax. This prepares the body for childbirth. Relaxation of the ligaments holding the SI joints together allows for increased motion in the joints and can lead to increased stresses and abnormal wear. The additional weight and walking pattern (altered gait) associated with pregnancy also places additional stress on the SI joints.

Any condition that alters the normal walking pattern places increased stress on the SI joints. This could include a leg length discrepancy (one leg longer than the other), or pain in the hip, knee, ankle, or foot. Patients with severe pain in the lower extremity often develop problems with either the lower back (lumbar spine) or SI joints. In most cases if the underlying problem is treated, the associated lumbar spine or SI joint dysfunction will also improve.

The most common symptom of SI joint dysfunction is pain. Patients often experience pain in the lower back or the back of the hips. Pain may also be present in the groin and thighs. In many cases, it can be difficult to determine the exact source of the pain. Inflammation and arthritis in the SI joint can also cause stiffness and a burning sensation in the pelvis. 1

Several things can aggravate the SI Joint too. Continual sitting or lying on the affected side will impinge nerves and skew the pelvis. Remember, the body will adopt a bad posture and accept it as normal after a period of time. The pain often worsens when riding in a car, sitting in a movie theater or putting weight on the hips while walking (for example, carrying a child). 2

As I read these findings, I was nodding along.

Pregnancy? Yes

Short leg? Yes (caused by scoliosis)

Pain in the low back, hip, thigh, and thigh, stiffness, burning, and difficulty determining the source of pain? yes, yes and yes.

Sitting or laying on the affected side aggravates? Yes

Worsened pain when carrying a child and walking? Yes (that's exactly what brought it on today, actually)

I'm still using chiropractic, yoga, massage and hip circles to address it. Hip circles, actually, make the most difference when my SI is tight and hurting. I'll have to remember to eat eggs for breakfast tomorrow and its probably time to make my grandma's famous baked custard because that's a mega dose of eggs and so good.

In addition to suggesting physical therapy, my naturopath suggested looking into craniosacral work. She also gave me a medical referral for massage. And she reminded me, which is embarrassing that I completely forgot, about homeopathic arnica for muscle soreness. I've also been seeing an Upper-Cervical chiropractor which is new and different for me than the typical pop and crack chiropractors I've been seeing.

At this point, my husband and I swearing off conceiving another baby. In my lower moments, I come close to despairing and giving up getting pregnant again ever. We even put the option of surgical sterilization on the table, which is a momentous and terrifying thought to me. In having those conversations, I realize in a new way how much I love and appreciate the children I have. I knew then that I can be happy being mother to my two and not regret having another. Still, if it is possible, I hope to recover enough that I can physically handle another one or two or three pregnancies and births. My hopes aren't so high so I can content myself with whatever that is coming my way.

Based on what Vanessa said on my blog page, I'm glad that I'm planning to put off more births. She told the story:

"That is what derailed my planned homebirth with Tess. It was excruciating and worse than any labor pain -at one point, I almost blacked out, threw up and peed myself from the pain. Thought I was in transition -except I was 1cm and 50% effac...ed. Saw an osteopath at 40+3 who tried her best to fix it, but couldn't really do anything. It took a long time to get better. I mainly saw the osteopath, but have also considered a chiropractor (and acupuncture) in case it comes up again in a future pregnancy."

I definitely hope I can avoid that. I have heard acupuncture being helpful for hip joint problems but I haven't pursued it yet either.

I'll update as I meet with and learn more from the physical therapist. I do hope that we can welcome additional biological children into our family and that it will not be at the expense of my physical well-being.

If you are interested in reading other posts that chronicle what I now know is SI joint dysfunction see the following posts (starting from earliest to most recent):

Belle's Birth Story: I describe the moment I felt my SI stretch abruptly.

Not a very interesting update: I describe the hip pain for the first time
Been Away: Started yoga at 3 months postpartum to be gentle on my hip (instead of returning to Irish dance)
Preparing to conceive again: I started wanting another baby but was feeling ambivalent because of my hip problems.
A remedy that might help my hip pain: I learned about lecithin to relieve joint pain
Check that Off the Bucket List: My husband and I took a massage class where he learned some strategies to help massage my hip when its hurting

Two weeks of Facebook updates

March 15:
* successfully replicated Mimi's corn chowder without a recipe! Peter is so proud, especially since he didn't think he liked corn chowder.

March 16:
* Willem has decided that he wants to let his pink eye "heal on its own and not use medicine" instead of letting me put the antibiotic drops in his eyes. The drawback is that he will not be attending preschool until it resolves. Its a valid choice and one that I believe he is capable of making for himself, but I'm very surprised that he's sticking to it.

* couldn't go back to sleep after the baby woke because my mind is busy brainstorming areas of life that LDS women might be interested in advocating for. I know better than to wait when I have time to write my ideas; I'm writing them now so I don't forget.

* I was hoping to go back to sleep when I got home from yoga, but there's an awake baby...

March 17 (I hope you had a festive St. Patrick's Day!)
* is celebrating St. Patrick's Day with corned beef and cabbage and ceili dancing tonight! But before, I'm speaking live video streaming about The Birth Survey on Bellies To Booties Web TV at 2 pm Pacific.

March 18:
* thinks I had a cool, but not so good idea: use the pattern for my Ren dress to make a temple dress. White brocade skirt and vest over a white chemise, with white braided cording...March 19:

* laughed and laughed when I heard Willem say to Belle, "Leave my train station alone, you naughty kitten!"

March 20:
* won an ERGObaby organic baby carrier today, with backpack and front pack at the Healthy Kids and Green Parenting Fair!! I'm so excited!!!

March 21:
* totally scored a rain water collection barrel today because If there's a Water Shortage, Why Isn't Anybody Collecting Rain? Thanks to my neighbor for enabling me!

March 22:
* 's joy at health care reform is tempered by all the revisions that will be needed over time. Its a start, which is a relief, but there will be much more fighting. I'm kind of exhausted at the prospect.

March 24:
* wants some energy back. How about a nap today children?

* thinks its a travesty to pipe fake buttercream frosting on to a delicious cheesecake.

* if there's such a thing as cabbage chowder, I made it tonight. And then put it in a breadbowl.

March 26:

* is struggling to write my personal experiences into an article on childbirth.

*is listening to Peter tell me about travel warnings throughout the world and I misheard "terrorist concerns in India." I heard "terrorist insurance." Now that would a lucrative business... They would pay your ransom, extricate you from the hostage situation and pay any medical or therapy bills.

March 27:
* has a baby that WILL NOT cuddle to sleep in bed with me. She spent an hour rolling around in the dark and only settled down to sleep when I put her in her bed, covered her with a blanket and walked away. Not cool, little girl.


March 28:
* Belle climbed up on a box and now can't figure out the way down. Good for her that she's still trying.

* and the sickness goes on. Willem has a fever and has spent the day cuddled under blankets sleeping on Peter.

March 29:
* And thus begins Belle's 10th month of life outside the womb. Let the toddling commence.

* Willem just pointed to the plushie for Gonorrhea and just said "I want to see that S T B."

March 30:
* Carla Hartley is tempting me again. Her offers for enrolling in AAMI (Ancient Arts Midwifery Institute) are always so very appealing...

* First half of the day: I was pleased to find that "children are a joy and blessing" applied to the happiness in our home. Second half of the day: I had to remind myself that "children are a joy and a blessing."

March 31:
* was taken on a hike by her 10 month old. Who knew a 10 month would actually hike? The Cascade mountains are beautiful and I'm so glad that Peter was willing to take a day away from studying to spend time with the family in nature.

April 1:
* is CRANKY today. Any ideas to help a mama chill out?

April 2:
* had a reminder that trauma resurfaces unexpedectly and can suck you back into it. Given that its 2 am now, I don't think I'll be waking up in 4 hours to go to my early morning yoga class. When you see my blog post, you'll know what I'm talking about.

* loves seeing the simple joy that comes from playing with a box. Belle's new carseat came yesterday and Willem now gets what boxes are all about. We got a big package when he was Belle's age and he did not understand why we put him in the box at all. Belle gets it though because she sees her brother playing in it. They ...turned it into a slide until it became too squished for that.

April 3 (General Conference of the Church of Jesus Christ of Latter-day Saints):

*has been appreciating the words spoken at General Conference this morning. I especially like the promptings I've gotten from what i've heard. What did you think of the quote from Eliza R Snow that Julie Beck used?

* Me to Belle: "You are such a silly child." Willem to me: "You are just a silly mama."

April 4:
* is watching Emma: Her Story on BYU TV (internet streaming) right now. I'm excited to see it. The first few minutes are boding well.

* is making bone broth for the first time tonight. Out of the bones from the lamb rack we had for Easter dinner. We'll see how it turns out.

April 5:
* For some reason I do not understand, Willem is calling all soldiers and knights "Lamanites" today.

* Quote from Willem: "Do not kill me before you ask my permission!"

* And another "Lightning (McQueen) has blue eyes like Belle!"

Quotes from Famous People:

"Her baby constitutes for her a powerful symbol of her motherhood, her individuality, her new family, the beauty and wonder of nature, and the perfection of her own body and her procreative powers." Robbie Davis Floyd

"It is intriguing this [those born between 1935-1975 who were separated from their mothers after birth for several hours or even days] is the age group that has experienced spiralling divorce rates, increased incidence of child abuse, and greater extent of familial alienation than that seen in previous generations, and... the temptation to associate this with US birth practices is hard to resist." Wenda Trevathan

"We do not ask you to give up any good you have, but we invite you to come and get more." Joseph Smith in talking about the gospel of Jesus Christ

Links to Articles:
Obama's Out of Control Health Care Costs (my comment: Peter and I had a good conversation about this article today. "Obama's Out of Control Health Care Costs" because we can all see this happening: The federal gov't promises to pay all health care costs, and doctors then jack up their prices just because they can. Regulating health care costs is essential to health care reform.)
You Probably Are A Feminist
Top 5 Myths About Having a Homebirth
Path to Freedom: the Original Urban Homestead
Family and Home Network (a new volunteer organization I'm excited to work with)
Calling for Integrative Medicine to be Written into Health Care Reform
Women are Saving the World Now: a new advocacy organization that featured Rikki Lake for BOBB
The Onion: Increasing Number of Parents Opting to Have Children School-Homed
Woman Catches Baby During Own Cesarean Section
Fertile Feminism: Mainstream Feminism and Motherhood
Breastfeeding Saves Money and Saves Lives: Analysis Says
Citizen Commentary on Health Care Reform: Written by my husband's mission president

Links to Products (in the crunchy vein):
Selling My Fuzzi Bunz Perfect Size Stash
Baby Steals.com had a shocking deal on Ergo's on the 25th
Chemical of Concerns in Car Seats: Healthy Stuff's Ratings for 2009
Organic Cotton Mattress Toppers
The Femivore's Dilemma (article links to the book Radical Homemakers)

Links to Advocacy Opportunities:
Make Animal Abuse a Felony
Take Action: Tell the EPA to Protect Americans from Dioxin
Requesting Greater Transparency in Health Care: soliticed by Health and Human Services
Play an Online Game and Give Rice
Petition to ACOG: Increase Women's Access to VBAC
Switch to Kijiji to Protest Human Trafficking on Craigslist

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.

Perhaps a blogging hiatus

On April 10, my mother woke up and found she could not move her left arm or left leg. It took a few days for it to be called a stroke definitively, but it was treated accordingly all along in case that is what had occurred. I spent close to two weeks waiting to hear what was going to happen next and making arrangements from afar. As she lingered in the hospital with no transfer in sight, I traveled to be with her to get a better sense of the situation. It was not my intention to stay for very long, but after I assessed what her real needs were, I felt that she didn't need much help that I couldn't give to her at home.

Conventionally, given her situation, she would have gone to a skilled nursing rehabilitation facility where nurses and nurses assistants would care for her daily needs and get her to physical therapy. That's really expensive care that I knew, given my background in providing at home caregiving, that I could do just as well, if not better. And what better occupational therapy is there than actually doing the tasks that would be required of her at home?

I decided that I could stay with her. Mainly the help she needs from me is getting out of bed and into her wheelchair and then into the car, shower, toilet, etc. Pretty much everything else she can do with a minimum of assistance. In fact, today she washed dishes, changed the sheets on her bed, started laundry, paid bills online, and played Wii tennis and bowling.

My values played into the decision to put my life on hold and care for my mom. As evidenced by Belle's birth, I take personal responsibility very seriously and do not typically outsource care to professionals that I can be capable of providing to myself or my family. Its also been a very intuitive process is knowing how to help my mom in this difficult situation. Each step of the way, I felt what I call the Spirit confirming my thoughts and plans. I also have considered throughout my life that traditionally it was a sign of respect and gratitude to care for elder parents when their health began to fail. Though, this is coming at an age where I'm much younger than I would have expected (25, with two small children).

On May 4, I brought her home. We've been adjusting since then and today has been the best day yet. It was rocky on day 3 and 4 but after some frank discussion, we better understand what is expected of both of us.

Its a blessing that as a stay at home mother, I have the ability to move and add to my "work." Both children are with me, though my husband has had to stay in school two states away. If I employed, I would not be able to drop everything and then at the last minute decide on my originally intended 5 day trip to extend it to 2 months. The hope is that by July, my mom will have made significant recovery with physical therapy that she will be able to either walk, or be able to support enough of her weight to transfer herself in and out of bed.

The baby is struggling with my added responsibility and just wants to be held all the time. She'll follow me around the house screaming waiting for me to pick her up. The answer to that: babywearing. Belle goes in the Ergo on my back and I continue with what needs to be done.

Willem is my rescuer and comfort. Because he's a playful three year old, he makes me stop every once and a while and just play with him. A wrestle on the floor or on the grass, a hug and cuddle, some catch or frisbee or baseball or building with blocks, or reading a story. And the rest of the time, he is getting to explore and play and develop his own inner world. When I am feeling overwhelmed or discouraged, I can ask him for a hug and I can't help but feel better. His hugs are exactly what I need. He is at an age where I'm not struggling to care for him. He also entertains and plays with Belle (when she's not too busy hassling me).

In a way, I'm glad to have this time with my mother. Usually when we visit, she is working all day and then very tired by the time she gets home, so we struggle to enjoy our time with her. Now she's home all day with us and we can interact and spend time with her. I hope that in the next week we can start going out on walks in the afternoon.

Because its not easy to be constantly needed by someone, I am being very careful to maintain my evening a week rule. I do it at home with my husband as well where at least one day a week, arrangements are made where I can get out of the house and do something for me. Last night, a friend and I went to a movie while her mother babysat. It was exactly what I need. Next week, I'm planning a 1 hour massage. I'm also back to my nocturnal habits (staying up until 2) for computer time and catching up on my favorite shows. Fish oil and Vitamin D and good food are keeping my mood elevated.

All that to say that things are going much better than I would have expected (in general) and that my blog will probably be much quieter in the coming weeks.

I did recently create a facebook fan page for my blog where I post links and status updates. Those don't take as much time as preparing posts so I feel good about maintaining my connection with blogging and birth and family advocacy. I'll certainly be able to keep up there.