Geeking out with Christ's birth

I found this tonight which I think is interesting:

December 8th: Immaculate Conception of Maryis celebrated in many Latin countries as, according to Catholic doctrine, the day of the conception of the Virgin Mary. The doctrine says that God had preserved Mary from original sin, giving her his grace, the divine life of Jesus Christ.

Read more at Suite101: Winter Holidays, Celebrate December!

This is actually referring to Mary's conception and birth but my mind immediately went to thinking about Christ's conception, and Mary's pregnancy with him. Fitting as its Christmas time and all.

We know that Christ wasn't actually born at Christmas time with most scholars thinking that he was actually born early to mid-Spring. Latter-day Saints believe he was born in April. Using the date, April 6, I thought it would be very cool to know the date of his conception AND birth.

If he had been born at 40 weeks gestation exactly, he would have been conceived in mid July. Using the birthing window that many women not ever faithful in their calculated due date, He may have been born between 37 weeks to be full term and 44 weeks at the outside, meaning he could have been conceived as early as mid June or as late as early August.

Wit that, I then ponder what those last few days of Mary's pregnancy was like based on those 2 scenarios.

First:

The Mary is compelled to go to Nazareth with Joseph to pay the taxes decreed by Cyrenius and she was full-term but not quite to 40 weeks. Maybe she was 37 or 38 weeks pregnant. She hopes that on the trip the baby will not be born and she can return to her home in Galilee to give birth after the tax collecting is done.

The long, arduous, dusty and dehydrating trip caused contractions to start before her due date. As she arrives in Nazareth and they are looking for an inn, she is having contractions and they are increasing in intensity and regularity. If she were me, she'd been freaking out a little. They settle into the stable and within a few hours, Christ is born into hers or Joseph's hands.

The other scenario:

She's past her due date like the majority of first time moms, the baby hasn't been born yet and they have to get to Nazareth to obey the decree of the governor. She hopes that either the baby will wait until after they get back or that the baby can be born before they leave. In most mother's minds, anything is better than laboring on the back of a donkey or giving birth far from home without the presence of wise women: mother, aunts, sisters and cousins. She doesn't get her wish and contractions start during the trip. She's contracting while trying to find a place to birth her baby. The stable does the job and the Christ child is born there.

Either way, my heart goes out to this young girl who gave birth far from her family and home amongst animals and hay. Maybe she was as Zen about it as she is portrayed in the scriptures, but maybe that was a very stressful and upsetting situation for her to be in. Either way, I've been in both of the situations described above. And honestly, I think the over-due scenario would be worse.

Though its not mentioned, I do guess that Mary and Joseph would have been able to locate a midwife to attend the birth if they so chose. Though perhaps it was in the day when the midwife only was called when assistance was needed after some concern or complication arose. Whether Christ's birth was attended by a midwife or unassisted is a toss-up. The unassisted birthers like to claim that Christ was an unassisted birth, so for the sake of not knowing, I won't rain on their parade.

Alright, end of birth geek mode at Christmas time, but that's what you get from a midwifery student...

Update on Pregnancy and Previous Birth Trauma

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

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

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

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

None of those things happened.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Bottom Line About Birth

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

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

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

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

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

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

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

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

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

Why I am a UCer

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

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

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

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

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

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

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

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

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

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

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

Mothers and Fetuses: Whose Rights Trumps Who's?

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

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

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

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

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

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

Indecision and Straddling the fence

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

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

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

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

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

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

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

Its really real

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

TRUST Birth Conference

A few months ago, I became acquainted with the Trust Birth Initiative. That initial interaction and Amy from Crunchy Domestic Goddess prompted me to start this blog (see my early entries). The current push of the Trust Birth Initiative is the Trust Birth Conference taking place in Southern California March 7-9. I would love to attend but family business and responsibilities is keeping me from being able to. But that's okay!

Because Carla Hartley, the founder of the Trust Birth Initiave, is making downloads available after the conference for those who were unable to attend.

I will be able to hear the presentations by Michel Odent, MD, Rixa Freese's presentation on portrayals of birth in media, Henci Goer, Sarah Buckley, Laura Shanley and Carla Hartley herself. Topics will include discussions on unassited birth, the technocatic version of birth, the research and the evidence of cesarean, midwifery managed births, homebirths, prenatal care, circumsision, the power of belief, intuition and touch during prenancy, birth and infancy. Can you tell? I am very excited that this option is available to me.

This is also a great option for those who do attend the Conference but couldn't see all the presentations that were of interest to you. Conferences are like that...you have to prioritze and plan which presentations are most important to you, while missing others presentations of interest happening simultaneously during each session.

Next Time

I have been carefulling reading and reflecting on Willem's birth story recently and have found some things that I want to change for next time. Those things are the times when things went off course, or I made a decision that I regret now.

First thing:

I'm not going ANYWHERE!

The furthest I may go from my home with be a nice walk on the nature trail or to the shopping center behind my complex. No getting in the car, going to an appointment, going to the hosptial, just to be sent home and go back again.

Next:

Forget the numbers!

I won't worry about dilation, or timing contractions to "prove" to anyone that my labor is for real. As I learned with a newborn, the clock will not be my guide. I will go with the flow of the labor process, trusting my body to do what it knows how to do. I will not impede the progress by stressing out about the numbers like I did last time.

And:

I'm not paying someone to be paranoid for me!

Last time (and I'm still shocked by this fact), I paid an organization to treat me like dirt. I paid them to inflict a trauma on me that led to PTSD and for them to interfere with a process that my body was made to do without "assistance." Their paranoia, time clock, and need to clear the room did not assist me in any way. Also, since I do trust my body to complete the process of birth, I am not going to pay someone to come into my home to worry about "what might go wrong." My husband and I can do enough of that for ourselves. And we can also educate ourselves to learn what to do if that "what if" happens.

This next time, we are relying on our own knowledge and ability to educate ourselves and to have trust in creation. And "if" that something happens, we'll know what to do and where to go to get the assistance needed.


I will also:

Relax!

With Willem's birth, I was so excited to start the marathon that would bring him into my arms that I forgot to rest and conserve strength and energy. I know for next time to take things slowly, as they come, and to sleep when I can. The whole time I was actively doing: focusing, willing my body and baby to hurry up. I know now that is counterproductive and can lead to exhaustion and frustration. Each of the above items will also aid in this goal.

Above all, I will:

TRUST

I am disappointed in myself that I normally approach every life process with faith, prayer, seeking the Spirit of God and when in labor with Willem, I didn't. With Willem's birth, I think I took for granted that the Lord would be my help and I didn't turn to him during the time I was working to bring his spirit child into the world. Next time, I will seek the comfort, guidance and inspiration of the Spirit by seeking a priesthood blessing from my husband who has given me countless blessings in the time we have been married. The birth of a child is a sacred event that I will welcome the great Creator to attend this time and through trust in His process, I be confident in the ability I have been given to become a mother.