What has she been up to?

Its been a busy few months and I have neglected to do anything beyond posting a facebook update about the going-ons. If you've been following my facebook page, little of this will be new to you, but if not, be prepared for some surprises.

June

I was introduced to essential oils and found a wonderful community of women belonging to my church who are embracing the role of woman healer. The oils were instrumental in helping me treat a very stubborn and confusing illness going on with Belle and have become our go to form of treatment since then. In order to get the wholsesale prices, I signed up as a consultant and continue to get one or two oils sent to me every month. I haven't done much with the marketing to earn income, but who knows maybe that will change. If you are interested in getting the wholesale prices as well, let me know and I can help you get signed up.


July

In July, I learned more about one of my favorite companies. Both of children have loved Signing Time so the last few holidays, I've been collecting the Signing Time videos for them. When I found out about Signing Time Academy, my children were actually very excited to think of me as a signing time teacher and they loved getting the new signing time videos. The prices for instructors are really amazing compared to retail. One of the newest exciting things that is coming out of Signing Time is that they will be releasing digital copies of the videos to put on iPad, iPhone and other mobile devices. The instructor rate is awesome and Willem is so excited. I haven't been able to coordinate a class yet but I'm working on it. I think I'll be starting from my home, and then try the local community centers. Check out my Instructor page by clicking on the Signing Time Academy logo on the right sidebar and watch some free samples of the shows!

In July, we took a family tour of South Lake Union in Seattle on a paddle-wheel cruise ship. Here's me and my not so babies anymore.

August

In August, I had a big brainstorm that would put all my passions into one endeavor. All it required was $30,000, a full time commitment and becoming a business owner. I spent a good amount of time trying to figure out if I could make it happen. The idea was that I would create a play and learning center in my town where parents of infants to primary aged homeschoolers could come to share learning activities. They would have access to a complete learning environment and a trained facilitator to assist them in finding activities in line with their goals and current interests. In addition to the playspace, parents would be able to connect with one another and learn from the variety of classes, workshops and seminars that would be regularly offered. Connections would be made during playgroups and families would gain support networks among other families in the community. A quiet room for breastfeeding and consultations with doulas and lactation consultants would be available. A small boutique would sell the essentials of attachment parenting. I was going to call it "It Takes a Village" and it would be awesome. I'd have a space to teach my Signing Time classes, be able to facilitate the Play and Learn groups I fell in love with during my graduate program and be a happening cool spot for parents in the community.

And then...

On my 7th anniversary, I found out I am pregnant with our third baby.

This was a complete surprise. We're talking highly unlikely for dates. It was so unlikely that my midwife commented on it. I've heard that sperm can live up to 6 days within a woman's reproductive tract, but our case would  have been 7 days. With my pelvis and joint concerns, we are excited but also rather concerned as well. I'm redoubling my efforts to address those concerns so it can be a healthy, as comfortable as possible pregnancy.

In September, Belle and I saw Rachel Coleman live in concert. She is the creator and personality of Signing Time.

September

Also just before I found out I was pregnant, I put in an application for a scholarship to become trained as a birth doula. I had this feeling that I was ready to take my birth training to the next level and that meant contacting my midwife who told me that when I was ready I could tag along to a birth with her and doing the birth doula training. Unfortunately it didn't work out with my midwife, but two other midwives are keeping me in mind. I also ended up getting the scholarship for the birth doula training, so in September, I spent 4 days getting trained by Penny Simkin and Teri Shilling at the Simkin Center for Allied Birth Vocations.

After the training, one of the local birth doula collectives offered me a spot to cover the northern part of the region and I became a Doulaville Doula! Its great to be apart of a community of doulas from the beginning. Its like I have built in mentors.

At this point, I'm hoping to attend the three births required for certification before the new baby is born. I don't know how realistic that is, but I have until March/April. If you know of a pregnant mama expecting in the North Puget Sound who is in need of a very affordable doula, please send her my way!


October

So far this month, I finally followed through with my post Midwifery As a Calling.

Birthing in Zion: The LDS Midwife, Doula and Birth Professional Directory is now a reality! A companion Facebook community has been made to go along with it. You can "like" LDS Midwives, Doulas and Birth Professionals on Facebook to keep up to date with an amazing group of faithful, Christian women.

The part of the directory I am most excited about is the opportunity for LDS women to list themselves as volunteer peer support doulas. By doing so, they make themselves available to sister Latter-day Saints in their communities to provide the type of labor support that has been happening informally for centuries. The response has been inspiring and I hope that we can start seeing midwives and doulas listed in each stake (geographical divison) of the church.

In addition to all these things, I'm still busy and involved with my three non-profits.

A project I am working with Solace for Mothers on is Voices of Trauma. We are collecting stories from women who have experienced traumatic childbirth and compiling them into a book focused on causes/predictors of trauma, healing and prevention.

With CIMS, I am now the Grassroots Advocates Committee Co-Chair and I am on the national leadership team. Most of my work recently with them has been putting out the e-CIMS, the organization's quarterly email newsletter. If you aren't yet subscribed, do it! Its always full of great information and opportunities to be an involved birth advocate.

As you can see, I've been busy and will continue to be so in the next few months. The good news is that I'm not starting a business while pregnant! Maybe someday, it'll work out to see that vision realized. Until then, I will continue loving the little naked people who just ran into the backyard, the little one growing inside me, and doing what I can from my home to move forward the goal of woman-centered, mother and baby friendly maternity care throughout the world.

My special Mother's Day

On Mother's Day this year, I attended a speech given by Ina May Gaskin at Town Hall in Seattle. There were over 800 people of them, many midwives and doulas but a surprising number of expectant parents. She spoke on her story as a self-taught midwife in the 1970s, described some of the keys to a healthy safe delivery and how important it is for those who care about birth to advocate for increased access to midwives and better obstetric practice.

At the end, it was opened up to the audience to ask questions. During that it became clear to me that Ina May is not familiar with Solace for Mothers as a resource for women who have had traumatic birth experiences. I should have gotten up and mentioned it but I didn't want to sound like an advertisement. Sometimes I just don't know how to deal with public relations!

One of the things that Ina May said she wished for was to have all of the birth advocates be better connected and able to work together. I share that desire with her and really hope that my current efforts will be able to bring that to pass. I really feel that we need an online social network that gathers birth advocates together in the same place and use platforms like the Care2 petition site, facebook, online forums, Change.org and Salsa Democracy to use viral advocacy techniques to bring a strong, united voice to what would truly improve maternity services in the United States and the world. I guess that's my job isn't? Since I am on the CIMS Grassroots Advocates Committee... Big plans, in progress... I just wish it was all ready and that it was common knowledge in the birth community!

I wish that I had had the opportunity to sit down and talk with Ina May but if that had been doing to happen, I should have attend the MAWS conference the Friday before. When prioritizing my desire to see her in person, I had to decide between being away from my kids all day Friday and leave them with a babysitter or be away for 2 hours on Mother's day Sunday and leave them with their dad. It was a tough decision but I chose to have more time with the children and be away from them on a day that's supposed to be especially for me as a mother anyway.

Someday I hope that I can meet and talk with her because I have so much respect for her work, especially on the Maternal Mortality Quilt. I would love to see a complimentary effort to honor and remember mothers who have experienced trauma and PTSD from their birth experiences. For each mother who died in childbirth, I am sensitive to the fact that if they lived, they likely would have been deeply traumatized by their experiences and their memories of being close to death. People traumatized by life events and who live afterwards know the special hell that comes from surviving something horrific and terrifying. I want those mothers to be remembered to. For women who experience trauma, they often find that they become shadows of themselves. They are the walking wounded and we need to be just as aware of them as we are aware of the family members who lost a woman in childbirth. I don't want what that would look like, whether it would be a Solace (thinking Support in Overcoming Labor And Childbearing experiences) quilt or a paper sculpture in the shape of a tree with leaves symbolizing one of the 1.4 million mothers who are traumatized each year. I had a nice talk with Penny Simkin about this and she is encouraging me to come up with something good and a plan to enact it. If you have ideas, please help!

Anyway back to the event with Ina May. After the questions and answers, there was a Birth Fair with birth and baby organizations and services from around the Seattle area. I met the midwives at Puget Sound Birth Center. When I told Val that PSBC is the most highly and frequently rated out of hospital birth center on The Birth Survey, she literally started crying she was so happy!

I was so glad that I was able to attend with my mother and my good friend Shawnette who became a doula after she attended Willem's birth as a volunteer doula. It was a really nice event and obviously, as seen by this post, inspired a lot of ideas and renewed energy and drive for me. It was definitely a special way to spend Mother's Day and a special thanks to my husband and children who were willing to facilitate my attendance.

What will they (I hope) say about me when I die?

also posted on my spirituality blog: Jenneology

I am lifting the following exercise from a recent post on Feminist Mormon Housewives. A new self-help book aiming to assist people of my generation to find their purpose in life provided the exercise. What follows are my answers:

Thought Experiment: You’ve died. You are at your own funeral. What do you want your friends and family to say about you? What did you do with your life? Write down five things you hope people say about the legacy that you’ve left. Write down five things you hope people say about your personality.

1. She was a seeker of truth and was open-minded, and respectful in the finding of it. She embraced the belief in the gospel that all good things come from God and that all truth can be circumscribed into one great whole. She would embrace truth, quite literally, wherever it could be found--in Islam, Unitarian Universalism, Paganism, Gnosticism, Physics, Astronomy and Chemistry. She was a student of life and found great joy in it.

2. She wanted to make a difference in the world and she worked diligently to address some of the injustices and inequalities that people, especially women throughout the world face. Her involvement in non-profit organizations and humanitarian works helped the lives of many. One of the things she was fond of saying was that she didn't want to make a difference in the life of a child, but she wanted to make a difference in the life of many. She worked at the systems level to address the root causes of poverty, abuse and barriers to living a full and happy life.

3. She prioritized her family while at the same time set the example to them to be anxiously engaged in a good cause (or in her case, many). Her children were involved with her and shared her with the people of the world. They had the opportunity to see and do many things that provided service to others because of the example and encouragement of their mother. She was actively involved with them at all levels of their lives and somehow found a balance in the limited hours of each day to show them they were loved and benefited from her presence and involvement in their lives.

4. She was a believer in the radical Jesus: the Jesus who was friends with the sinners and who was compassionate to their experiences, the socialist who believed in complete redistribution of wealth, the empowerment and equality of women and the Christ-like love that each person needs to achieve their potential.

5. She knew hardship, difficulty, pain and injustice and she was able to find strength from her experiences and turn them around to be compassionate towards others, to support and comfort them.

5 personality traits: tenacious, determined, creative, compassionate, advocate

Core Values: Discover what drives you. What principles guide your actions and ideal self? Try to strip away all cultural conditioning and/or religious rhetoric and assess five core values by which you live your life and inform who you want to be. Write these down. Evaluate if there any disconnect between what you wrote down in step one and step two.

Maybe I already did this up above. Just pulling from there, we find that I value: openness to truth/goodness, compassion, advocacy, social justice and idealism.

Find Your Purpose: Why does what you are doing matter? What motivates and inspires you to keep following these values? Chose a purpose. It can be big or small, but has to be intentional. It is the reason for your goals and can change over time. If you are struggling to find your purpose try this experiment. Write down your five most valuable gifts and talents. Next, write below those what each of these can be used for. Finally, evaluate what types of careers or activities you would enjoy that would utilize some of these talents.

I'm already doing many of the things I hope to be remembered for so my purpose is described above. Involvement in Solace for Mothers, LDS WAVE, The Coalition for Improving Maternity Services already address some of those values that I hold so deeply. I would someday like to turn those desires and abilities into paid employment and I hope that it will be doing something that addresses the root causes of injustice in the world. I would love to work in humanitarian aid (whether it is at the local, national or global scene) but at the systems level. One of my skills is to look at big picture and see ways to build coalitions and to bring people together, to create ways that people from very different viewpoints can interface with each other in cooperative ways. Most of my efforts are somehow related to system building and connecting people in large communities to harness their combined power into a stronger more unified voice.

Test Your Purpose: Today my purpose will be _____________. To accomplish that I will use my gifts for ________________ to accomplish these specific goals_______________. Later change the timeline to week, month, and year.

Today my purpose will be two fold:

1) to connect with my children and show them the value of caring for others

2) learn about how to structure my family economically so we can be Equal Shared Parenting and Radical Homemaking folks.

To accomplish that I will use my gifts for being involved in national organizations and reading to accomplish these specific goals:

1) I will walk with my children in the March of Dimes walk, teach them to sew and make things we can sell on Talents of Sisters.

2) start reading the book Equally Shared Parenting and discuss with my husband the possibilities that our interests lead us to.

Otherwise, I would say that my goals are year long, or at the very least, seasonal. This year I hope to create an online community for birth advocates that can become a hub for the thousands who care birth issues in our world. This season, we hope to grow some of our own food and make some of our own household products to develop our skills and save money.

Write It All Down: Once you have a purpose you can stick with, write it all down and it will remind your of who you are and what you want to be. I.e.My five core values are ____________. My five core talents are ______________. In the next ten years my purpose will be ______________. The key features of my personal mission statement are ______________.

My five core values are openness to truth/goodness, compassion, advocacy, social justice and idealism.

My five core talents are:

1) building community and cooperation around advocacy efforts

2) addressing root causes of social issues

3) looking at the big picture

4) being respectful and open to differing view points

5) embracing and valuing the good that is inherent in differing perspectives

In the next ten years my purpose will be to:

1) achieve equal partnership in my marriage

2) find paid part-time employment in advocacy work

3) support and contribute to organizations addressing global poverty

4) continue to develop current advocacy organizations

5) educate my children through experiential learning in living the gospel of the radical Jesus.

The key features of my personal mission statement are make a difference in the world, aspire to the ideal, encourage potential, and value balance and compassion to oneself and others.

Birth Trauma Round Up

I've been meaning to get around to this for awhile. Each day when I read news articles and blogs, I'll bookmark it if its something I want to come back to or if I have something to say about it, or agree its important and needs to be said again and again until the right people listen. Generally, the articles that stand out to me are on the topic of birth trauma. So here is an anthology of birth trauma related articles over the past few months. On analogies: Keyboard Revolutionary: An Interesting Parallel

So what does it mean when another wielder of authority says, "Do what I say or your baby will die"? Are they looking out for your best interest....or are they a bully, a rapist, an abuser, deliberately playing on your unignorable instinct to protect the ones you love in order to get what they want from you?

And when its seen like this, how obvious is it that a mother can come away from her birth experience with PTSD?

Raising My Boychick: Just Like Athletics: Exploring a Childbirth Analogy

Rather than coerce with stick or carrot, what we do in athletics (again, thinking especially of charity racing; a particularly apt comparison to birth as it is physical effort that benefits another) is cheer, support, encourage, commiserate. No one stands at the sidelines of a charity marathon yelling “give up! it’s not worth it! stop trying to be a martyr! you’re not going to win a medal!” Nobody whispers in their ear when they’re doubting, “take these drugs [that will actually make running harder], let us drive you to the finish [we'll tie you behind the car], finish in five minutes or we’ll whisk you away for surgery [for a torn ligament you don't actually have].” No one tells an athlete she can only have a “trial” of running if she has no food or drink, if she’s hooked up to machines that purport to measure how hard her muscles are working, that take her blood pressure and heart rate and temperature and send it all to the medics’ station and meanwhile are hindering her movement and reminding her she’s on a clock and she’s not running fast enough (or running too fast and they’ll “have to” stop her “for her own good”.

The analogy works well. What would happen if hospital birth attendants had this analogy called to their attention? It seems so simple, yet a strong paradigm shift is engendered in it.

On feminist activism:

Courtroom Mama: Feminism Behind the Veil

[How many women] suddenly realized that grown-ass people in a medical office were calling them “mommy” and telling them what to do as though they themselves were children. And the fact is, for a number of women of relative privilege (cis-gendered, heterosexual, middle-class, etc.), the journey into motherhood might very well be the first point of friction with patriarchy. Many of us lucky enough to not feel the weight of oppression can manage to skate by with just our carryon baggage, but add a pregnancy or a child to the mix, and suddenly you’re “actually” a woman, or rather “just” a woman.

Fertile Feminism: Mainstream Feminism and Motherhood

That’s why I’m so pleased to have discovered all the feminist mother blogs that have been springing up recently, and why I want to work with feminist mothers to help bring your voices and battles and mainstream feminism together. It’s been all too easy for childless feminists to ignore motherhood, and it really, really shouldn’t be. We need to listen, learn and become allies to mothers by not only centring your voices but using our own to advocate for mothers everywhere.

The previous two articles both discuss how stereotypical feminists (or rather the dominant cultural idea of feminism) doesn't understand the issues facing mothers in dealing with injustice in maternity care. It now appears that some "majority" feminists are becoming aware of what us feminists in the minority are facing. Like Courtroom Mama, my first run-in with patriarchy may very well have been in my first birth experience and it certainly played a large part in coming to self-identify as feminist. I too felt, before birth trauma, that feminist history afforded me a "post-feminist" spot in my world.

On cruelty:

Henci Goer: Still Cruel Maternity Wards

We have a culture of impunity in maternity wards. Once pregnant, a woman effectively cedes her right to autonomy and bodily integrity to obstetric staff who sometimes—on grounds of fetal welfare, self-protection from malpractice suits, or mere convenience—manipulate women into compliance in ways that would be considered fraud in any other venue. Without fear of being called to account for it, they can bully, coerce, humiliate, and threaten. And, yes, they can physically mistreat or even sexually assault them

It is this that needs to be exposed. In her article, Henci links to recent news stories that highlight some of these abuses. Its starting to be uncovered but it still seems to far-fetched so far from the norm, but then what is normal seems irrelevant because of its normalcy. It seems the media has not just captured the sameness of these outrageous cases with the outrageousness of the "normal" cases. The whole history of hospital birthing has been this way and its just sick.

The Unnecesarean: Women Have Right to Complain about Mistreatment During Birth

I really believe that someday, our daughters or granddaughters will be amazed that any woman was ever arrested for refusing a c/section, or operated on against her will, or prevented from moving or eating or making noise while she labored to birth her baby. They’ll regard much of what is still considered normal today as cruel, and uninformed, and backwards. And they’ll be right. But only if we keep refusing to be silenced.

It exactly this that I could not and would not believe before I contemplated becoming mother. It seemed so blatantly wrong that it seemed impossible that it could be indicative of systematic injustice. It really did feel like just being pregnant and giving birth that I was going into a dark and dirty underground system. ACOG has been labeled a cartel and for good reason.

Amy Romano @ Science and Sensibility: Patient safety, disciplinary action, and the marginalization of midwives

But whether disciplinary action is against midwives or physicians, is punishment the best way to deal with breaches in patient safety?

When this question is posed to someone who has experienced birth rape, the answer is: They have to held accountable somehow. If its not through a hefty check from their administrators, then it needs to be some censuring from their superiors. If not that, then it needs to be criminal charges. When a woman is feeling like her OB or midwife is entering her body with the same force and skillful manipulation of a rapist, yes, the provider must be held accountable. RH REality Check: The Cure for An Ailing Maternity Care System

The idea that maternity care should be evidence-based, safe, and efficient seems like a no-brainer but one key goal to note is how these imperatives lay the groundwork to minimize “overuse, underuse, and misuse of care practices and services.” We need to make sure we’re providing optimal care to all women by guaranteeing women are able to access the services they need if they need them. However (this is a big one), let’s also start from a place of understanding that pregnancy is a healthy state of being – not an inherently sick state – and so let’s also minimize the amount of unnecessary interventions that now drive up costs and place women and newborns at risk for poorer health outcomes.

It must be said: the "overuse, underuse and misuse of care practices and services" are causing trauma to new mothers, rendering it exponentially more difficult to care for their babies in their early years. Its not yet known what sort of long term effects can be had from a traumatized mother in early life, but there are studies that show that children of depressed mothers are more likely to experience depression, children whose parents experienced PTSD are more likely to experience PTSD after a potentially traumatic event. Are our children being hardwired to face life's challenges with disorder? Its not just about health care costs, its about a mother's sense of confidence in her ability to care for her children. Its about the baby's sense of being cared for and loved. Michel Odent equates these early unnecessary challenges to a threat to humankind. He even poses the question "Can humanity survive?"

Its starting to sound pretty melodramatic and that's exactly what I would have labelled it before my experience, and before I learned that I was not alone. I find its a coping mechanism to write in this manner and that I cannot be objective and unemotional when I read the stories of birth trauma at Solace for Mothers and the MDC birth trauma board. Some of it seems so fundamentally, viscerally wrong that I struggle to articulate how and why it is so wrong. So instead, I try, though my blog to illustrate, highlight and show case examples so it can become clear to others without my feeble attempts to spell it out.

What Trauma Looks Like

Warning: this post will be triggering for birth trauma survivors

Make an on-line slide show at www.OneTrueMedia.com

When watching this video, I was reminded of the pictures taken of me holding my babies for the first time after their births. They are starkly different. I've pondered over the differences before and now that I've seen this video, I feel like posting the photos to illustrate to others what trauma looks like.

After a traumatic birth, described as birth rape:





























The joy at meeting my baby comes through (and a sense of my victory over the system's efforts to control me), but look at that far away stare showing the disconnect between me and my baby. And do you see the timidity and the reservation with which I'm holding my baby boy? And how the smile doesn't make it to my eyes?

When my son looks at pictures from his birth, this is what he is going to see. I hope he never questions because of these pictures, "Why is my mama sad? Did she want me? Does she love me? Is she mad at me because of how I was born?"








And then compare, to this:









From this, and another example from a friend's blog, I see that birth experience matters. Not to the mom's hedonistic desire for self-satisfaction, but to the baby that the mother greets. I feel my babies deserve to be greeted by a mother who feels victorious, respected, capable and empowered; not one who has been victimized, disrespected, dehumanized and demeaned.

Not Letting it Happen to You Can Lead to PTSD

The blogger at Nursing Birth posted last year a series called "Don't Let This Happen to You: The Injustice in Maternity Care Series" and in one of the posts, she described a phenomenon that I had never heard about, but recognized it immediately as what was attempted on me when I was pregnant with Willem.

In my prequel, I described how at 37 weeks 6 days, contractions started at 11 pm. At 11 am the next day, I was 3 cm dilated having contractions every 6-15 minutes. The midwife at a prenatal appointment that day told me that I was in labor and should check in with Labor and Delivery to be admitted to the hospital. The midwife on call at Labor and Delivery called failed to progress and, after performing cervical exams every hour for 4 hours ,started advocating for pitocin/AROM augmentation as she called it. It was 9 pm, 3 to 3 1/2 centimeters dilated with contractions between 6-10 minutes apart.

In the prequel, I asked if this sounded like a phenomenon that you've heard of before. Do you know?

Nursing Birth taught me that this is called a backdoor induction and she defined it this way:

If a woman is 4cm dilated but is not having regular, noticeable, and painful contractions that are causing cervical change she is NOT in labor. If said woman is sent into the hospital and any interventions to stimulate contractions are started, then it is by definition considered an induction NOT an augmentation. And if said patient was not scheduled to be admitted on such day, then it is considered a backdoor induction. I knew it as soon as I read it. This is what happened to me. It is unethical and just as Nursing Birth calls it, an injustice perpetrated on a birthing woman.

Even at the time, I knew it was inappropriate for labor to be stimulated artificially and I refused. This is where my story and Nursing Birth's patient's story begins to differ. I did not go along with it with the recommendation for induction. If I had been more savvy to manipulative tactics such as this, I would have known to not trust the midwife who referred me to L&D. But then again, if I had been more savvy, I would have known that hospitals are not the appropriate place for low-risk mothers to give birth in the first place. Even then, we weren't understanding why the midwife would make the recommendation to check into the hospital obviously in early, non-progressing labor but in our excitement, we decided to trust her. To our detriment.

Because in my experience, I then learned what PTSD is like. I'm not faulting Nursing Birth for leaving the story off as she did, but I have something to add to it. If you fight the system, even if you win, which is not likely or common, you will still lose. You will lose a sense of being human, the feeling of being respected and treated like the person deserving of dignity that you are. Such dehumanization can have indelible impact on the psyche.

The converse is true, letting it happen to you, can lead to PTSD. But not knowing it is happening to you seems to be a protection. It appears to me that the mother, Jessica, in the story was unaware at the unsavory practice that she was being subjected to. So what is worse? Not knowing you've been victimized, or knowing the feeling of violation because you do know you've been victimized?


........

After I had begun to process my birth experience, I wrote an email to the referring midwife telling her the outcome from her recommendation. To my surprise, I received a conciliatory email in response.

After I learned the term backdoor induction, I was upset for a couple of days. I talked through it with my colleague from Solace for Mothers and felt better sharing the stress with someone else. Since, I've intended to blog about it, but I'm only finding myself able to do so after writing the prequel and being triggered by the previous article I wrote about.

Sharon with Solace for Mothers asked me the question, "What are you now going to do with that knowledge?" I answered that I would write a letter to the hospital saying I knew what they did and emphasize how distasteful and unethical the practice is. I have not done that yet, because I'm struggling to find the words to express how and why that is so wrong.

So, I'll ask my readers, after telling my story in a letter to the hospital and midwifery supervisor, how do I support my claim that practicing backdoor inductions is an unethical practice?

What Triggered the Prequel

My post from last night, The Prequel of my Traumatic Birth Experience, was prompted by a friend posting this article on facebook. Though it is reporting a study saying that that anxiety in pregnancy can predict developmental delays in the baby once born, my attention was drawn to this paragraph:

"Contrary to old beliefs, however, research shows that ordinary day-to-day job and home stress isn't likely to cause low birth weight or other problems for most women. Traffic delays, work deadlines and other everyday hassles aren't likely to pose a threat to unborn babies, researchers say, and pregnant women who feel they are coping well tend to do just fine."

I disagree with this statement based on my experience (copied from the prequel):

When I was in week 34 of my pregnancy, I was working part-time at a preschool (9am-1:00 pm each day). I had a commute and prep time before class started so I was waking up at 7 am. I'm not a morning person (if you ever notice when most of my blog entries are posted you'll know that I'm a night owl). I was constantly tired in my pregnancy. I'd get home from work and have to take a long nap each afternoon just so I could function the next day. One day, I had to rush away from work for a prenatal appointment, but that day had already been a struggle. I was fighting nausea the whole day (strange for the third trimester) and had thrown up 3 times, once as I was getting into the car to head to the appointment. Already feeling tired and sick, I encountered unexpected traffic which was making me late to the appointment. I generally get very stressed when I am late to something so the combination of being impatient, stressed sick and tired was not boding well for that appointment. I then parked rather far away from the clinic and had to walk (more like jog since I was worried about being so late).

I also remember there was a journal article that linked maternal employment in late pregnancy to increased blood pressure. The researchers of the study being discussed in The Wall Street Journal either were unaware of this study published in American Family Physician in 2001 (Increased Blood Pressure and Working in Late Pregnancy. American Family Physician Oct 2001), not considering increased blood pressure as a "problem" for women, or had reviewed the findings of that study and disagreed with its findings.

To me, my experience leads me to support the findings of the 2001 study. Even though, I was incorrectly diagnosed with pregnancy induced hypertension at that appointment, it is true that my blood pressure was elevated from my baseline (diastolic at 88 after that stressful day, but its 60 when not pregnant, and at 70 when pregnant).

Reading the Wall Street Journal report last night brought that all back. Even at the time, my husband and I ascribed my working, the stressful commute and the brisk walk to the increase in blood pressure. I still do not understand why the midwife was not willing to accept that as a possibility. We felt it was lunacy to then think that rechecking my blood pressure later in the appointment, AFTER diagnosing me with gestational diabetes, putting my on bed rest and leading me to believe I was experiencing PIH, was going to result in a lower blood pressure reading, because I had time to "relax" during the appointment!?!

That was precisely the time when I stopped feeling like I could enjoy my pregnancy. Up until that point, I had felt very excited and happy as the birth approached. After that appointment, that happiness was clouded by the specter of the dead baby and dead mother card, as well as an induction that I knew made a cesarean more likely, which increases the chances of complications and death. All of this then caused greater confusion in my mind because at the beginning of my pregnancy, I was given a priesthood blessing by my husband and adopted father in the gospel which told me that I would give birth and go through the pregnancy without complications. Given what my husband and I knew, we believed the blessing was still true because the midwife was mistaken in her diagnosis. But how to handle a situation with a maternity care provider where our version of reality didn't mesh with hers? It all added up to a great deal of stress in our minds and just paved the way for the trauma I experienced as a result.

I often think that if the birth experience had happened in isolation of the prior stress, I wouldn't have experienced PTSD to the degree that I had. As it is, I felt there was so much manipulation and lies that I knew I wasn't safe going into labor so my stress response to what was happening in the hospital was amplified.

The Prequel: My Traumatic Birth Experience

Although my birth story is often cited on my blog, I have never written out the prequel to the story. My traumatic birth didn't start in early labor, it actually started weeks before.

When I was in week 34 of my pregnancy, I was working part-time at a preschool (9am-1:00 pm each day). I had a commute and prep time before class started so I was waking up at 7 am. I'm not a morning person (if you ever notice when most of my blog entries are posted you'll know that I'm a night owl). I was constantly tired in my pregnancy. I'd get home from work and have to take a long nap each afternoon just so I could function the next day. One day, I had to rush away from work for a prenatal appointment, but that day had already been a struggle. I was fighting nausea the whole day (strange for the third trimester) and had thrown up 3 times, once as I was getting into the car to head to the appointment. Already feeling tired and sick, I encountered unexpected traffic which was making me late to the appointment. I generally get very stressed when I am late to something so the combination of being impatient, stressed sick and tired was not going well for that appointment. I then parked rather far away from the clinic and had to walk (more like jog since I was worried about being so late).

That sets the stage for what happened at the appointment. In typical technocratic style, once checked in, I was weighed, pee collected in a cup, blood pressure assessed. Would anyone like to guess what my blood pressure was after my previous hour?

168/88

The midwife comes in and goes over the results of the glucose intolerance test from the previous appointment. The values were higher than normal prompting a discussion regarding gestational diabetes.

As an aside, I knew the results were going to be skewed because I was unable to handle the glucola being the only nutrition in my body at the time. Rather than sweating it out since I felt very close to passing out, I snacked on my ever handy blood sugar stabilizing snacks I carried around with me. The good news is that I didn't pass out on the way to the lab, the bad news is the false result on the test.

It already was not a good day to hear news like that, coupled with the way the midwife said it. She seemed very unaware to my stress level and was not sensitive to how concerned I was regarding the way in which she stated it and my frustration with her for not consenting to the 3 hour fasting test as a follow-up. If I had had such a negative reaction to the 1 hour test, having eaten lunch just before that appointment, how in the world would I cope with a overnight, drink the glucola on an empty stomach after waking up even earlier than usual and then waiting 3 hours test?

So after that conversation, the midwife plunged right into, "...and your blood pressure measurement from earlier indicated that you have pregnancy induced hypertension." If you have a copy of William's Obstetrics handy, or any other prenatal care textbook nearby, you'll find that the minimum criteria for a diagnosis of PIH is a diastolic value of over 90. In the same paragraph in William's it states that some practitioners like to make the diagnosis when a woman's diastolic is elevated 15 points above her baseline, which would have been true in my case, but if one were to continue reading, one would see that William's states that is not a recommended procedure for diagnosis.

I was visibly upset by this time at the appointment and receiving no assurances, compassion or comfort from the midwife who was speaking to me. I called my husband and in tears told him what was happening. He at the time had been having a conversation with his advisor and when he heard my husband say, after looking at his phone, "Oh. Its a number from the medical center. It must be Jenne probably calling from her prenatal appointment right now," said, "That means something is wrong. Go. Now."

He ran over to the clinic (on campus) and we sat down with the midwife. My husband was surprised at how the midwife was handling the situation because based on what she was telling him, he didn't see that she was making a reasonable assessment. She counseled that I go on immediate bedrest and cut salt out of my diet entirely. Although we were not entirely trusting her judgement, we decided that bedrest was better safe than sorry. We spent the next week trying to get a better sense of the risks of PIH (by this time they had dropped the concern of GD) and we couldn't get a better sense of their concerns based on the information they had given us. We consulted with a number of the midwives and nurse's assistants on staff and we basically got, "PIH can lead to preeclampsia and preeclampsia can mean that the baby dies and the mother can stroke out and die."

We did our own homework and read up on what we were being told, and it didn't add up. I still stayed on bed rest and attended the non-stress test appointments that were scheduled twice weekly. But we knew that what was happening was not as serious as they made it out to be.

A couple of weeks later, at an appointment with another midwife in the practice, I was told, "In all my 20 years of being midwife, I've never see a woman with blood pressure like yours go into labor on her own without being induced." Not only does that say something about her practice style, it also says something about her knowledge.

Up until this point, in my prenatal care, I had tried on a number of occasions to discuss with the midwives policies relating to the birth. Each time I had been told that we would discuss it later. I had never had a satisfactory discussion about my desire to have an unmedicated birth using Hypnobirthing. The midwives did not seem interested in discussing it.

Now at this appointment where I'm being told, they'll basically pressure me into an induction whether I like it or not or whether its indicated or not, I felt like I needed to run away from that practice. But I was 35 weeks pregnant with my first baby, living in a big city that I wasn't familiar with having moved there less than 6 months before, and not very knowledgeable regarding birth options. I thought, if a midwifery practice is going to be this unpleasant to work with, how could working with an OB be any better? We considered and discussed transferring over care to the OBs in the practice, but I was scared of the medical mindset. I wanted midwifery care, but didn't know enough and felt that I didn't have even time to find out about out of hospital options.

So I stayed, like a domestic abuse victim in a violent, toxic relationship.

A friend volunteered to be my doula to help protect me from the unwanted advances of the hospital staff. Having made those arrangements, I told myself that I would hope for the best and pray that labor started on its own before the threat of induction became more real.

In week 37, after 3 weeks on bedrest, and having made it to "full-term" I asked my husband what the soonest time would be okay with his schedule as a first year graduate student for the baby to be born. He said that after Thursday Jan 25 all his tests would be done and that weekend would be an okay time.

Bedrest was, in some sense, a blessing. At the time I was enrolled in my M.Ed program and I had work to do. I spent the month of bedrest doing assignments and getting started on my thesis. It was helpful. But the drawbacks were also considerable. I felt myself getting weaker the longer I stayed inactive and immobile. I'm pretty sure the baby moved into an unfavorable position and further exacerbated the scoliosis in my spine. I started getting headaches and being dizzy, which just made the midwives want to say I told you so since those are indication of progressing preeclampsia, but its also a sign of weakness as a result of inactivity and a lack of salt in the diet. I believe these factors contributed to the long labor (38 hours) as well as the hours of back labor (17 hours worth). Add that to being a first time mom, going into labor earlier than it would have likely been otherwise at 38 weeks, its not surprising that I had a long early labor. It would have been very helpful to know of Ina May Gaskin's teachings for husbands and wives to; as she calls it, "cuddle and smooch" during labor.

We made it to that Thursday, and we decided that we would try out the strategy of starting labor via intercourse and what I've jokingly heard referred to as "prostaglandin application." And then we prayed. We prayed that labor would start and the baby would come, so that we would be protected from the providers that at this point we did not feel safe with. We then fell asleep and I was woken up 4 hours later by menstrual-like cramps coming every 15 minutes.

I let Peter sleep but I couldn't. I was so excited and so relieved that labor had started on its own. At six am, I couldn't keep my excitement to myself anymore and I woke Peter up. We talked, we were happy and we decided that it was just be stupid to go to the hospital at that point because we knew for sure that we were going to avoid going to the hospital too early. We then discussed if I should go to the scheduled non-stress test at 11 am. We decided to keep the appointment, if not to avoid the within 24 hour cancelation fee. But before, I wanted a big breakfast. So like a runner getting ready for a marathon, we went to IHOP and I throughly enjoyed my breakfast feeling exhilarated that not only had I thwarted the mid-witch, I was going to meet my baby.

At the appointment, we knew it was too early to go to the hospital, even though I had been contracting for close to 11 hours at that point (still 6-10, sometimes 15 minutes apart, easy to manage). The NST showed that I was having irregular contractions and my cervix was dilated 3 centimeters. We were surprised when the midwife at the clinic called up the Labor and Delivery and told us that we would be checking in. I thought it was still too early, but went with the recommendation.

Then we enter what I call the flight pattern period of my labor. Labor and Delivery said they were full, they could take me so I should go home. At home, I got a visit from my visiting teachers--they thought it was very strange that I was in labor and welcoming them over and how calm I was dealing with it, but it was early labor and it was easy to handle. After calling and checking with Labor and Delivery a couple of times, they were still busy. So I waited. All I wanted to do at that point was to go into my labor space and focus, turn inward--what I called at the time "holing-up." I couldn't do that at home knowing that I'd have to leave. (This is about the time that homebirth started sounding appealing but completely out of the question since it would have been completely unplanned). We went out to lunch, basically tried to distract ourselves and stay near by the house and the hospital in case we got the call saying we could come in.

At 4 pm, we were finally able to get into Labor and Delivery. No progress. Contractions still 6-10 minutes apart. Hourly vaginal examines commence. We walk the halls of the hospital. At the gift shop, we find a mini set of bowling pins with a marble to "bowl" with. We buy it in celebration of the anniversary of the day we met three years to the day before at the bowling alley in the BYU student services center. Looking back, we should have just gone to the bowling alley and bowled through early labor.

At 9pm, 1/2 centimeter progress and the midwife starts talking options. She offers 1) send me home with an Ambien to sleep, 2) give me morphine, move me to another room in the hospital (not L&D) and make sure I'm sleeping or 3) pitocin augmentation and breaking water.

Is this starting to sound like a phenomenon that you've heard of before?

As I sat on a birth bath and handle contractions as they come, we refused, refused, refused. My husband tried to talk to them but they refuse to talk with anyone other than me. We countered with, sure, its reasonable to clear the LDR room for another mother in labor, but we'd refuse the morphine and go to another room to let labor progress on its own. Its surprising how hostile the midwife was to that. The room was only offered if I accepted medicinal sedation. At the time, that felt so dehumanizing. Like I was being viewed as a dying horse that needed to be take out back and shot to be put out of its misery. Or that she wanted to make me the hospital's prisoner, but instead of using shackles, she was going to use drugs (hello, 24's use of medical torture?) An OB was called in and we were told, "You have no more options. Its time for you to leave. Get out."

As we pack up and get ready to leave, we look for a nurse, or a midwife or the receptionist at the check-in test to find out when they would like us to call back or at what point to return, and there's no one around. So we leave, feeling neglected and confused.

Go figure, that once at home, labor picks up pretty quickly and intensely. I started having a hard time finding a comfortable position. I could lay down comfortably and I had been upright for so long that my legs were tired. I started having back labor and it was difficult to support myself on the birth ball. My husband and doula tried to get some sleep. They gave up pretty quickly and then helped me into the bathtub. The water was too shallow, and not hot enough, the tub walls hard and uncomfortable. So I lay hurting, cold and shivering. I start to get frustrated and despondent. I call L&D and I'm told that I can come back in and get checked for progress but I might be turned away again. I'm gun-shy at this point and I'm too afraid to go back in, too upset with the insensitive way I was treated earlier, knowing that the same midwife would still be on the shift. I found that she was going to get off shift at 8 am, so I became determined to stick it out.

We get to the hospital at 8am and she's still there. She does the triage exam which I've blocked from my memory. All I remember from that is spots of blood on the floor of the triage room that did not belong to me.

That's a good point to stop and refer you to birth story that I wrote soon after Willem was born, and have edited slightly since then.

In the next few days, I'll post regarding some insights I've learned since experiencing this.

Review of Birth as an American Rite of Passage

I just finished reading "Birth as an American Rite of Passage" and I found myself wishing that if I had read just one book to learn about what giving birth in an American hospital would be like, I wish this book written by medical anthropologist Robbie Davis-Floyd. Through the words of women in response to interview questions relating to their birth experience, readers get a very realistic view of what obstetric culture is like and the expected role of women birthing in hospitals. I often said that if someone had told me what giving birth in a hospital is like based on culture, medical ideology, current practices, etc., I would not have believed them because it all sounds so very irrational, paranoid, conspiracy-theorist and unethical. However, after reading "Birth as an American Rite of Passage" I think I would have been convinced through Davis-Floyd's analysis and the selected quotes from women's birth stories. She clearly describes the "technocratic model" that predominates our current culture and how it renders women as objects who malfunction who are not to be trusted and who threaten the very premise that our world can be saved by technology.

In the article I recently wrote for the Exponent, I quoted the author's definition of technocratic birthing rituals and I'll also include it here:

“The term technocracy implies use of an ideology of technological progress as a source of political power. It thus expresses not only the technological but also the hierarchical, bureaucratic and autocratic dimensions of this culturally dominant reality model—dimensions that are immediately visible in many realms of post-industrial American life.”

Davis-Floyd goes on to state:

“According to the technocratic model of birth, the human body is a machine. The medical system [which is inculcated by the technocratic culture] has done a thorough job of convincing women of their defectiveness and dangers in their specifically female functions”—pregnancy and childbirth foremost.

Through reading the book, I've also come to have a greater understanding of why women are so steeped in our culture and why non-technocratic birth is unlikely (as 98% of women in the US give birth to babies in the hospital, and only 1% birth at home). Indeed, when as I became a mother, I too felt the obligation to follow the dominant culture. If only I had know the historical underpinnings of hospital birth and read this book, I may have been able to be convinced that birthing in a hospital was not the way I wanted to welcome my child into my arms.

I was pleased to read that Davis-Floyd recognized and named trauma as a result of birth experiences; however, the symptoms of post-traumatic stress disorder were misidentified as mild postpartum depression. In my research on PTSD resulting from childbirth, the earliest citations I have found declaring the diagnosis of PTSD were from 1995--before the first edition of the book was published. However, I am disappointed that in the revising for the second edition, the author did not update sections on trauma to reflect the new diagnosis.

Also I felt a category of women's experiences was missing. Davis-Floyd stated that of the 100 women she interviewed for the book that women either fully accepted and embraced the technocratic model of childbirth, they rejected it entirely or they were somewhere in between. To give the benefit of the doubt, there is a chance that the reason why my missing category was not included was because none of the women in her sample would have matched it. The in-between categories included:

• Women who maintained conceptual distance from the technocratic model by achieving "natural" childbirth in the hospital (15%)
• Women who maintained conceptual distance from the technocratic model by placing technology at the service of the individual (10%)
• Women who found conceptual fusion with the technocratic model with cognitive ease (42%)
• Women who found conceptual fusion with the technocratic model during birth by experiencing cognitive distress, e.g. trauma (9%)

And now, because you are wondering what this missing category I am referring is: I feel she left out, or did not have a woman in her study matching the profile, of a women who maintained conceptual distance from the technocratic model by achieving "natural" childbirth in the hospital with cognitive distress.

For this was my experience, I was able to attain the ideal unmedicated, low-intervention birth in a hospital and the detriment of my mental health.

Perhaps it could be argued that my experience would fit into the last category of finding fusion with cognitive distress, but I did not find fusion. And if someone wants to state that I did, because I consented to AROM at 5 cm, I'm not listening...

An interesting correlation can be mentioned however, that the percentage from Davis-Floyd's study of women who experienced cognitive distress is the same commonly cited percentage rate of PTSD after childbirth--9%. Making her omission of PTSD as a sequelae of childbirth, even more disappointing.

So in conclusion, this book is a very persuasive case for birth as a initiation rite for women as they transition to motherhood and current obstetric practice as a vehicle for gaining compliance and reinforcing the dominant cultural view of technology reigns supreme. If I were to create a list of influential, informative books for future mothers, this would be near the top.

To end, a quote from the book that summarizes why birth is so exceptionally profound and important to me:

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.

Deadlines and Disappointments

Thinking I was going to be able to get back to blogging and post about all the stuff that is piling up in my blog folder, I have once again been pulled away towards other projects with tight deadlines.

First there was an invitation to write a 1,000 word article for Exponent II, a literary magazine for Mormon women. An exciting opportunity for sure, and now I'm hoping that my submission justifies the invitation.

Next is preparing for an online TV show through the online TV channel Bellies to Booties where I will be introducing and describing The Birth Survey to expectant and new mothers and birth advocates.

The details of the event:

Event details:
What: The Birth Survey
When: March 17, 2:00pm-3:00 pm
Description:
Whether you are pregnant, have had a baby or are interested in birth advocacy, The Birth Survey has something to offer you. Learn how to use The Birth Survey data to help you in your choice of caregiver and birth location, how you can add your birth experience to the data and how you can become involved in spreading the word about The Birth Survey.

Description of Presentation:
Jenne Alderks, M.Ed., Regional Coordinator Co-Chair will introduce and describe The Birth Survey, an online consumer reporting resource for expectant families and it brings greater transparency to maternity care services.

Don't tell me if you'll be watching or not, I'm nervous enough as it is!

And in other news, I heard from two of the programs I applied for; Public Health and Women's Studies and I was not accepted to either of those programs. I still haven't heard from Public Affairs but all along I've thought that was the least likely. The reasons I was given were three that I anticipated: funding shortages, competition between applicants and not having a close enough fit with a primary advisor. As I've said all along, if I don't get in its just as well because I'll not miss the time at home teaching and caring for my children while they are as young as they are.

If the last couple of months have been any indication, maybe I'm busy enough and involved in advocacy pursuits enough for my tastes that I don't need to take myself away from them for schoolwork.

As I spent all November and December of last year, preparing my PhD applications, I spent all of October writing a submission to the Journal for the Association of Research on Mothering. Last week, it was announced that ARM is going to be shutting down unexpectedly and the upcoming issue that I submitted to will not be published.

The director of ARM, Andrea O'Reilly has submitted an invitation to anyone who is disappointed by this announcement to petition York University to provide the base funding to sustain the Association.

Hello all,

I am meeting with York administration on the morning of Tuesday March 16. If you are inclined but have not yet done so, please send a letter of support for ARM before Tuesday morning. Names and emails for York administration may be found on the “ARM closure” Letter, (March 2, 2010) on ARM’s website: www.yorku.ca/arm Thank you once again for all the support. Andrea O’Reilly, Founder and director, ARM

To keep updated on ARM's effort to stay open, join the facebook group Friends of the Association for Research on Mothering.

I also discovered that I missed the deadline for submitting a proposal for The National Council on Family Relations Conference on the topic of childbirth trauma effects on family relationships between the mother and her partner and herself, her new baby and other children. Given the derth of information on the topic, it likely would have been difficult to get enough together for a proposal, but I'm especially sad about this one because I won't have a good reason to visit Minneapolis, Minnesota (where the conference is being held) to visit my colleague for Solace for Mothers who lives in the area.

Recent birth news

There has been a lot going on in news about birth in the last couple of weeks.

First there was the mom in Australia who had police show up at her door after she chose not to show up for the induction that her doctors scheduled her for. Her doctors decided to call the police to escort her in.

Later, the hospital issued her an apology. Ironically, they claimed that they were not trying to pressure her into an induction. Right..sending police isn't an intimidation tactic?

If The Birth Survey was available for mothers around the world to take, I'm sure Rochelle would be able to report that she did in fact feel pressure to induce from her providers.

Then there was the mom who is going to court over being court-ordered to remain on bedrest while confined in a hospital and undergo a mandatory C-section.

Both of these stories are disturbing to me because it shows the lengths that medical professionals will take to force women to act according to their recommendations.

I have been on the mothers end of disagreeing with the medical professionals I'm paying to advise me on my health. In the two cases described above I see enough evidence to know that the mothers were informed about the research and known risks of the proposed treatments and in good conscience chose what was actually more evidenced based and better for them personally. My experience fighting to prevent an induction leads me to empathize with these two women who experienced much stronger attempts to manipulate their choices and force them into things that they knew they had the right to refuse.

It may be unfair to expect, but I would not be surprised with either of these women were traumatized by these experiences where they had to fight for their bodily integrity and to make health choices for themselves; without fear of reprisal. I hope that if they are experiencing trauma, that they will find the support they need and know about Solace for Mothers as a resource for women who have been traumatized by experiences relating to childbirth.

To quote directly from an ACOG publication:

"Even if a woman's autonomous decision seems not to promote beneficence-based obligations (of the woman or the physician) to the fetus,...the obstetrician must respect the patient's autonomy, continue to care for the pregnant woman, and not intervene against the patient's wishes, regardless of the consquences."

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.