Leaves make me sad.  Things tend to go to hell in a handbasket (or more) in the Fall.  I’ve NEVER liked Fall.  Even when I like Fall, I’m wary of Fall.  And for good reason.

Do you see this picture?  I suppose I look happy.  I’m not.

By this time in 2007 I had suffered two consecutive miscarriages.  I was starting to panic.  I was starting to lose it.

This photo also reminds me of our last good day with Alfred, the first dog my hubby & I had together.  We were playing in the leaves that day and with our baby girl.  Life seemed complicated then, but things were good and we knew it.  Alfred died soon after.

Leaves surround me now and make me remember the wonderful things I’ve lost this time of year.  And I’m thinking of a student (and friend) with two young daughters who just lost her husband.  Another loss in the Fall.

These losses also remind me of the many blessings of my life.  I prayed and prayed for another baby . . . and lo and behold I have had 3 more!

Silver linings abound.  Blue skies lurk behind the grey menacing clouds.  If i were more of an optimist, I’d always be looking for those silver linings and blue skies.  However, the wicked past has taught me that the grey menacing clouds return, perhaps more frequently than I would like.  Does the blue and silver merely tease me?  Or does the grey remind me to be thankful for the brilliance of the others?

I continue to ponder this . . . this chiaroscuro that is life.


Re-Birthing Catherine

Background:  I spend a lot of time mulling over the amazing information on kmom’s Plus Size Pregnancy site.  Today I was drawn to the “Emotional Homework” suggestions found under Increasing the Odds for a Safe and Successful VBA2+C.  I started tearing up and getting a lump in my throat . . . not that it takes much to touch my poor lil feelings these days.

Try ‘rebirthing’ your cesarean births – Although it is often a very emotional exercise, many women find it particularly helpful to recall every detail of their cesarean births, and then later re-script the labor and birth so that it goes the way they would have wanted it to go.  Start by recalling (either verbally or by writing it down) every sensory detail of a prior birth. [ . . . ]  Then, when you feel ready, re-script and re-experience the labor and birth the way you would LIKE it to have gone.  Change whatever needs changing, as small or as big as needs be.  Concentrate particularly on healing things with your child, having the wonderful birth and nurturing time afterwards that so many of us grieve missing.  Write out the storyline of the changed birth so you will have it and review it as needed.

My 2004 birth story (the hind-sight is 20-20 version) is here.  I will say that re-reading my surgical report and going over it with my midwife recently was quite illuminating, and that makes this re-birth process a bit easier on my left brain though my right brain is in agony right now.

Deep breath.  [Contraction]  Ppphhhhhhhhh . . . here we go.

my last belly pic 12/2004!

I went to my 40 week pre-natal appointment with my CNM a day after my guess date passed.  I was a bit disappointed that nothing was going on – very little effacement or dilation, but also wasn’t terribly surprised since I had learned that many first time moms go into their 41st week before natural labor sets in.  All of our family had been in town for Christmas, but the brothers and sisters had to head back out to jobs and school and stuff.  It was just us, our dog, and both sets of parents left in town at this point.  Still we’d both had enough family time, so after a good lunch at one of our favorite burrito places, DH and I left for home ALONE to just chillax.  I think I spent most of the afternoon on the couch sleeping through movies.  DH was gaming on-line.

Later in the day I started getting really sick.  I guess it could have been as early as 6:30pm or as late as 8:30pm, but regardless, I was a sick puppy.  My blood pressure runs a bit low, so vomiting + being on the toilet = passing out for me.  It was a fun game to see if I could finish my business before falling to the floor.  So, I was in and out of bed and the bathroom.  There wasn’t much DH could do for me, and I was so sick that I wasn’t staying remotely hydrated.  And I was contracting (though I hardly even remember that detail).

DH insisted on calling our midwife, and of course she just advised that he do his best to get me hydrated and not to worry about the contractions, because of course, there’s no way that I’d be in labor!  That made sense to me.  I certainly didn’t feel like I was in labor.  I felt sick as a dog, and I was getting sicker and sicker.  After a few more hours of this, DH called the midwife back saying that even if I wasn’t in labor, he was worried about how dehydrated I had become.  (We’re both professional singers, so we’re very conscious about hydration.)

This was after midnight.  He’s scurrying around the house trying to figure out what to put in our hospital bag, and I’m thinking that he’s nuts for trying to take me out of the house in this condition.  I remember not wanting to leave the house.  No, no, no – this is just NOT right.  And how the hell am I supposed to get to the car without passing out, pooping myself, or vomiting everywhere?  Hmmm??  And once I’m in the car, how the hell am I supposed to ride in the car without pooping or vomiting everywhere?  Hmmmmmmm???  Oddly enough (thought I get it now), I stopped getting sick.  I became more aware of the contractions, I guess, but I was more curious about why I had suddenly stopped getting sick!

We arrived at the hospital a few minutes later.  The intake gal wasn’t the slightest bit concerned about me . . . taking her sweet ass time while I’m contracting away and wondering when the next wave of sickness would take over my body.  I didn’t think I could get to L&D on my own, so once DH got back from parking the car, I think he wheeled me away to L&D.  I was kind of excited in a way!

Get to L&D.  Everyone is in slow motion.  They knew that I was on my way, but yeah yeah . . . 1st time mom thinks she’s in labor, yeah right.  They didn’t have a proper L&D room ready for me, so they put me somewhere else for my initial assessment.  It didn’t bother me any.  I was just trying to manage contractions.  So blah blah whatever questions that I couldn’t focus on but DH was mostly able to answer.  Taking their sweet ass time.  They check my cervix and holy moly SHE’S 9 CM DILATED!!!  GET HER MIDWIFE HERE STAT!!!  All hell breaks loose.  It was comical.  They readied a L&D room and transferred me.

So here we go!!!  We get set up in our room and our midwife arrives looking a bit sheepish since she insisted TWICE to my DH that I was NOT in labor.  After confirming that I was 9cm dilated, she offered to break my water to help move things along faster.  I knew that she was just trying to help since I was so sick, but DH reminded her that we were not interested in any unnecessary interventions.  He asked again about my dehydration, and they said the quickest way to remedy this was IV fluids.  It sounded like a good choice even though I was bummed to be connected to tubing that could restrict my movement.

At some point the labor nurse noticed fluid coming out of me.  I think she thought that was amniotic fluid, but no . . . ick, it was from uhhhhmmmmm, somewhere else in the vicinity.  I was a bit embarrassed that I was having diarrhea everywhere, but I knew that in order to bring this baby down, I needed to move and change positions.  For some reason, it seemed logical that I would turn my butt to the room and sort of drape myself over the back of the elevated head of the bed.  That was just a great position for me, even though I was making such a mess.  Thank God for chux pads, people!!!  Anyway, from this position, I was able to sway my hips and bounce like a maniac and still ‘rest’ my head.  Upright positions definitely felt the best and seemed the most productive.

I didn’t ever really ‘hit the wall’ like I had expected because obviously I transitioned either at home or in the car when I was still so sick.  Once I got to the hospital, I was still having diarrhea, but I stopped vomiting thankfully!!  I started feeling pushy, so my midwife examined me again and encouraged me to push.  However, she had me on my side for pushing and was having me push for counts of 10.  This was horrible.  They had to give me oxygen, and the position was excruciatingly painful.  My contractions were one on top of the other even though the stupid monitor was telling them that my contractions were ending.  I hated that damned machine.  I wasn’t making progress.  I was getting tired.  I was frustrated.  I was sick.  I was contracting and grunting and moaning and getting nowhere fast.  My midwife estimated that the baby was stuck at 0 position and not tolerating pushing particularly well.

DH & I thought back on our childbirth education series.  We knew something had to change.  So, I got back into that other strange position of draping myself over the top/back part of the bed and pushed in that position.  The counting to 10 was driving me crazy, and I yelled for everyone to stop.  I just decided to push whenever for however long and see what that did.  I felt my baby girl making her way down.  Eventually, that is.  My midwife wanted me to lie down so she could check the baby’s position, but I didn’t see how I could possibly do that, so she contorted herself and checked me and found that I was +1 or +2 . . . can’t remember.  Aha, progress!  That was all I needed to invigorate me.

Some rights reserved by Travis S.

I do remember wondering when pushing would end.  I thought I recalled reading that 1.5 hours was fairly standard, but I had been pushing for twice as long at least.  However, I was surviving (I think thanks to that bag of fluids), and the baby was now doing better with the pushing.  Hooray!  What seemed like an eternity later . . . eventually resulted in me feeling like my vagina was on fire and going to explode.  Baby was crowning!!  My midwife applied counter pressure to the perineum so I wouldn’t tear and encouraged me to ‘go easy’ with the pushing if possible.  Eventually I couldn’t resist any longer, plus I was tired of the out and in game that the baby was playing.  I pushed really hard – I think I was on all 4s at this point – and her head came out.  Relief.  It feels so much better once the head is out, I can’t even tell you.  A couple more pushes and the shoulders and body were out, and my sticky gooey baby was in my arms.

Many women feel like birthing their babies was a transformative experience.  I am one of those women.  I felt like, if I can do that, I can do anything.


Recurrent Miscarriage: My happy endings

I am somewhat pleased and sad to know that my post about Pregnancy Hormones and Miscarriage is consistently one of my top posts.  I wish I could hold everyone who comes by looking for answers.  I remember being there.  It’s still a healing wound that opens up from time to time.  I still grieve that I’ll never know those souls I lost.  Or do/will I?

Nutshell background:

After an uneventful first pregnancy that produced my 6 year-old daughter in 2004, I suffered three consecutive first term losses.  Getting pregnant has never been my issue; staying pregnant was becoming a real problem for my body and my psyche.  The last straw, the one that nearly killed me, was the 10-week loss, and the OB standing over me as I woke from the curetage telling me my uterus was too thin to ever consider a vagina birth, and this same OB wanting to put me on Clomid to treat my losses.  This OB had also refused to test my progesterone levels, saying that even if they were low she’d not treat for low progesterone.

Here’s what I had to do:

  • Change providers – I’m in a small town, so no one is super specialized in this area, but I at least found a doc willing to work with me; he had also dealt with infertility personally
  • This OB did ultrasound to check for PCOS (which he thought he found in me) and HSG to check for uterine abnormalities
    • PCOS markers may include u/s, but that’s not the only determining factor, so I ruled that out myself
    • The HSG showed an abnormality, alright; the OB thought it was a double uterus
    • I decided it was time to find a specialist
  • I found a yahoo group that supports women with Mullerian Anomalies (double uterus is a type of MA)
    • This group has an anonymous consulting doc who looked at my HSG film and believed the anomaly to be either a septum or bicornuate uterus shape
    • This group had a fantastic resource – a database of recommended reproductive endocrinologists and repro surgeons
  • Because I have family in Denver and was planning on being in Denver the Summer of 2008 for a voice science research program, I chose a RE in Denver.  Tough stuff when you’re essentially ‘out of network,’ but thank God we ponied up and did it.
    • The RE looked at my film and didn’t think it was a MA; he was sure it was a fibroid
    • SHG confirmed his suspicions
    • Extensive blood work revealed . . . LOW FRIGGIN’ PROGESTERONE . . . actually, really really crappy luteal phase progesterone (I am still so angry with the OB who refused to test my progesterone; I still blame her for that loss.)
  • The RE also recommended a myomectomy to remove the fibroid
    • He wanted to do it laparascopically which means cutting through connective tissue and the fundus to reach the fibroid
    • I didn’t want the integrity of my uterus further compromised and requested a hysteroscopic myomectomy instead; he agreed
    • Folks, do your research so you can advocate for your needs!!  I can’t stress this point enough!!!!
  • Thank goodness we did the hyst myo because instead of a regular fibroid, he found adenomyosis which he attributed to the PREVIOUS CESAREAN!
    • Hyst myo turned out to be the best way to remove as much of the adenomyosis as possible
    • Otherwise my uterus looked normal, no thin LUS, cesarean scar wasn’t even visible
  • This RE had a drug protocol that worked to address my progesterone deficiency
  • 3 months later my local OB examined my uterus via ultrasound and said that I was healed and ready to TTC!
  • I also made sure that the RE confirmed that the integrity of my uterus was not compromised from the surgery; my OB was nervous about ‘letting me’ VBAC

My happy endings:

I naturally conceived twins in 2008.  Luckily, I was in Denver over Christmas, and the RE was involved with my early pregnancy care.  My HCG levels were abnormally high, and an early early ultrasound revealed twins.  I enjoyed an easy term pregnancy (39 weeks!) with di-di twins!  My twins are such a blessing – can’t believe they’re almost TWO!

I became pregnant again in October 2010.  God has a sense of humor for sure.  I followed (more or less) the same treatment plan for low progesterone.  The first week of my pregnancy was stressful because I was having a hard time getting ahold of my OB and who had different ideas of how to treat low progesterone that conflicted with the RE’s protocol.  Can you believe this RE’s nurse was still supporting me through this stressful time . . . 2 years later?!  I was able to e-mail her and call her and they were willing to oversee my meds for the 1st trimester if I couldn’t get it worked out with my OB.  I had to ‘correct’ my OBs script a couple of times, and thankfully he was compliant.

Again, you have to advocate for what you need.  Right this minute.  Trust your intuition.  Know that infertility and pregnancy loss is more ‘art’ than ‘science’ at this point.  Know that there are widely disparate ‘camps’ when it comes to treating infertility and loss.

Currently, I am 37 weeks pregnant with my Happily Ever After baby.  May you find a way to yours!

Birth Witness: My Friend’s Amazing Birth

My girlfriend gave me an extraordinary gift last week.  She’s had a complicated pregnancy due to polyhydramnios, and no one thought she’d actually make it to term.  She did!  And I witnessed it!

She and her doctor decided that induction was appropriate.  I certainly wasn’t going to pass judgment on that given all she had been through.  When she went in for induction, her fundal measurement was 48 weeks.  Bless her heart.  Of course I worried about her and hated that I had to be at work while she was being “treated.”  She was induced early in the morning and had her water broken around 2:30pm in the afternoon.  I was concerned about that decision since we all knew the baby wasn’t engaged at all.  That could have caused cord compression and/or prolapse which would have been a quite route to a cesarean. 

Pitocin was of course used to increase her contractions, and at some point, the pain became unmanageable, so she was given an epidural.  I think it was a pretty good epi, because she still had a lot of sensation in her legs and pelvis.

I arrived around 7:30pm to keep her company.  She was quite nauseated, poor thing, because she does not tolerate medicine well.  She had been checked at 7pm and was only 4cm dilated.  I don’t think anyone was very happy with that progress.  However, her nurse was very supportive of my friend’s desire to avoid the cesarean, but of course, since my friend couldn’t really move, the way she was supporting this goal was through medical management – increasing pitocin, increasing the epidural to cope with the pain, flipping my friend side to side (when the baby’s heartrate ‘allowed’). 

We were all very pleasantly surprised when she was about 6 or 6-1/2 by 8:30pm or so.  She was becoming more uncomfortable, and things started to progress much more quickly.  Her hubby called her mom and told her to hurry on her way.

Soon after, my friend started to feel pushy.  It was pretty exciting.  The nurse delayed calling the doctor because she assumed it would still be a while.  (I guess you don’t call the doctor until you’re really sure . . . Her doc wasn’t on call but was still planning on delivering the baby.  Good on him!)

Anyway, lo and behold she started making progress rather quickly, and I swear it was no time before you could see the baby’s head.  It was amazing for me as an observer since when I arrived, she was feeling pretty certain that the baby wasn’t making adequate progress.  And it’s not like anything active other than medical management was being done for her to encourage the baby to engage. 

At some point the nurse told her to stop pushing.  Yeah right.  As soon as the nurse left to call the doc, I told her to go ahead and push.  There were plenty of people around there who can catch your baby.  So she went on about her business.  I was surprised that she was purple pushing (pushing to counts of 10), but it seemed like she wanted someone to count, so that’s what was done.

The doctor arrived and told her to slow down.  I didn’t get how wise that was at that particular moment.  But he told her, and I’ll remember this, “let it build, and then push when you can’t resist.”  All in all, I think she pushed for about 45 minutes, and she only needed 2 stitches.  Because he was encouraging her to control her pushing, she didn’t tear badly.

The baby emerged – first the head, of course.  I left my position by my friend’s head, grabbed the family’s camera, and started taking pictures.  I don’t know if she’ll appreciate having pictures of a baby sicking out of her vagina, but man, it was the most beautiful thing I had ever seen in my life.  It seemed like the shoulders were a bit sticky, but they freed eventually, and the rest of the baby slid out easily.  A beautiful big cord hung from my friend’s body.  The baby had a huge conehead – the head really had to mould to get through my friend’s pelvis.

The baby took a while to come around.  I was distressed that they weren’t bringing the baby over to my friend very quickly.  It seemed like they were doing a LOT of unnecessary stuff.  My friend kept asking for him.  I’m not sure she even got to see him for 15 minutes or so.  Ick.

Stage 3 of labor was over-managed, in my opinion.  The OB applied traction to the cord.  An enormous placenta came out.  It was impressive!!  The OB then began externally massaging my friend’s uterus.  I don’t recall what else was done to/for her.  I was more focused on her emotional state and the baby. 

We were all amazed to discover that the baby was 9lbs and 15.4 oz!  No wonder the baby’s head was so pointy.  I am so glad the doctor encouraged my friend to adjust her pushing strategy.  In the end she only needed 2 stitches!  Amazing.  With the cone, the baby measured 24 inches long.  He was so beautiful.

Mom and baby were finally united, and he was latching on within minutes.  I left soon after to give the family some private time to bond.  I had a hard time going to sleep I was so “high.”  I figured I’d be an exhausted puddle of a woman the next day, but I was still “high” from her birth.

I can’t adequately verbalize how much it meant to me to be there as a witness and as a support person.  I don’t know that she really needed me there, but she knew I needed to be there.  As I write this, I am tearing up.  I’ve never seen or experienced a vaginal birth.  It was such a marvelous thing for me.  And it’s helping me “see” my own upcoming birth.

I’ve studied birth.  I’ve watched movies.  I’ve watch natural birth videos on YouTube.  But there’s nothing like being there in person with a laboring mom.  There’s no substitute for seeing a new person emerge from someone’s body.  And now I am bonded to birth – this experience can’t be taken away from me no matter what happens in the next few months.

We already feel inadequate

I watched Orgasmic Birth last night on Amazon.  When I told my husband what I was watching, he gave me a look like “oh no, you’re going to be one of those women this time, huh?”  I told him that despite the title, the movie was supposed to be good, and for the most part it was.

If you go to the OG website, you’ll see that they define the word orgasmic differently than you would expect: “Intense or unrestrained excitement or a similar point of intensity or emotional excitement.”  I’d agree that all of the normal physiologic births shown on the video demonstrated intensity.  It’s important to read the definition above with the word “or” in mind.  A woman does not have to achieve orgasm during labor/birth to have an orgasmic birth.

I found it interesting that one of the interviewed NCB experts suggested that we don’t share our birth stories because we don’t want to make other women feel inadequate.  Perhaps a woman who consents to an epidural in a hospital setting will feel inadequate, I don’t know.  But, a woman who has undergone a cesarean after trying to labor will almost always feel inadequate in some way.  (I know there are always women out there who will say different.)  Let me explain.

A woman is told that babies come out of vaginas, and that most of the time that is possible.  Women may enter into the last stages of pregnancy knowing that they want an epidural or to be induced, but they still expect that in most cases, the baby is going to come out normally.  However, most hospital birthers are not given the right kind of support to achieve a natural physiologic birth or normal birth.  Inductions are fairly normal.  Augmentations are fairly normal.  Epidurals are extremely common.  As one expert pointed out on the movie, when most (like 90%) laboring women receive an epidural, and you don’t, you take the staff out of its comfort zone.

So after these interventions and more (constant monitoring, restricted movement in labor, etc.), women are still expected somehow to birth vaginally.  And a third of us are sectioned – or more, depending on the location.  Our bodies failed us, we are lead to believe.  “Thank God I was in the hospital or my baby and I would have been in big trouble.”  Our inadequacies are magnified by the overwhelming successes of the medical machine.

Women who have had cesareans are defensive.  “My cesarean was necessary” is a common belief.  But to suggest that women don’t share their birth stories because they don’t want to make a cesarean mother feel inadequate is not understanding the situation.  We already feel inadequate.

I am 1 of 3 women sectioned in childbirth.

I am one of numerous women told that her body wasn’t capable of birthing her baby.

I am 3 of 4 women sectioned in Montana for twins.

I am nearly 100% of women in my community told they cannot have a VBAC in the hospital after multiple scars.

I am nearly 100% of women told to be thankful that they have a healthy baby after a cesarean section.

Share your birth stories in a supportive, instructive, and hopeful manner.  Give cesarean mamas hope that next time can be different, if she chooses.  And she has to choose; you can’t choose for her.  I myself am preparing for a transformational experience this summer.  I can’t get there unless I embrace stories of uninhibited natural physiologic birth.

Nearly a Year Ago

My babies will be ONE tomorrow.  I can’t hardly believe it.  I never thought I’d be the type of woman who would say that the year just flew by or grieve the passing of such a special year, but I guess I am.  I take my babies for granted every day . . . and yet, every day they are a miracle to me.  I can hardly believe that after several years of heartache and pain, that I have two one year old girls and one five year old daughter.  I am blessed.

So why do I feel so crappy?  My mother in law is worried because I look pregnant.  No, I don’t think she’s rude for saying that . . . she said what I had been thinking, so I have to take it that much more seriously.  Why does my lower abdomen still hurt to be touched?  Why do I not EVER want to have sex?  And the constant spotting and cramping – I’m so tired of it.

Tonight I began researching the side effects of the Mirena IUD.  I tried to schedule an appointment with my OB/GYN, but he referred me to a GI person.  I’m going to cancel that appointment.  Perhaps I’m having GI trouble, but I really think it has something to do with the way Baby E was positioned, or the fact that my bladder was nicked during the cesarean, or a fibroid, or the reappearance of adenomyosis, or something.  I also suspect the Mirena.  It seems like there is an adjustment phase, an ok phase, and then a shit phase that continues to worsen.  I’m in the worsening shit phase, I’m sure.  So, I called and scheduled an appointment with my GP.  I’ll have her take it out and hopefully change my depression meds.  If that doesn’t work, Lord help me.

I have so much to be thankful for . . . why am I in so much mental and physical pain?

Cesarean Recovery, v.1

I am annoyed by my cesarean recovery.  I am more than 5 months post partum and still have pain and tenderness on the left side of my abdomen.  I’m sure I must have a number of adhesions that need to be broken down.  I did attend ICAN’s webinar about scar care and have been doing some massage.  I use a few drops of Young Living’s lavender oil – I recommend a therapeutic/medicinal grade essential oil – and massage it into my skin.  I have to massage all along the left side of the top layer of abdominal muscles (rectus abdominus), and it’s tender from pelvis to ribs.  Not good.

I am also annoyed that so many people are resigned to putting themselves, their babies, and their patients through this major abdominal surgery without a really really good reason.  Fetal distress, small pelvis, cephalo-pelvic disproportion, maternal demand, and previous cesarean are the usual suspects and are not necessarily indication for a cesarean.  <sigh>  I recovered easily enough from my first cesarean, but this time around it’s a different story.

I’ll end v.1 here.  To recap, I am not pleased with my recovery because I still have significant tenderness and pain more than 5 months after my surgery.  Does that sound like fun to you?