Monday, November 7, 2016

The Birth of Deidre

This story begins a bit before labor. I had been worried about my baby's position through the end of pregnancy, mostly because Audrey was posterior and I had a long labor with her. This baby was also posterior most of the time, despite me doing many things to make more room for them to turn (daily spinning babies, rebozo, chiro webster technique, walking, sitting and lying so my belly was a 'hammock' for baby, etc.)

So I was pretty excited when my midwife confirmed at 39 weeks that baby was finally LOA (baby facing towards my spine with their back on my left side, an optimal position for birth). At this time I felt very ready for the baby to come whenever they were ready - I'm a big believer in letting the baby choose their birth day, no matter how long that takes.

Unfortunately at my 40 week prenatal baby had moved back into a posterior position. And not just any posterior position, but the most difficult one for a baby to be born in - direct posterior or OP. I was super bummed. My midwife could tell by palpation that my amniotic fluid levels were a little low as well, so she advised drinking a gallon of water a day. This would also give baby more room to turn.

The next evening I took pulsatilla, a homeopathic remedy that can encourage baby to move into an optimal position. I also had a third session with a massage therapist who specializes in prenatal bodywork and spinning babies techniques. And that night I listened to the Hypnobabies Turn Your Posterior Baby track while taking an epsom salt bath. Right before bed I noticed a small amount of bloody show which made me excited, but I also knew that didn't mean anything besides my cervix was changing.

The next morning at 3 am I woke up with mild but definite contractions. I was really excited so I had trouble going back to sleep but I managed to after a few hours. Ryan left for work early that day so I didn't have a chance to tell him but I was enjoying doing my thing and not letting anyone know yet. I knew that I could be in early labor for days (like with Audrey) or it could go away so I didn't want to tell people prematurely.

When I woke up I went about my day. I listened to the Hypnobabies Birth Day Affirmations track, which I really enjoyed. I did a load of laundry, picked up toys and cleaned a little, and even set up the birth tub in our bedroom. That was interesting to do while having contractions and dealing with a very excited Audrey who kept wanting to get into the tub with her baby dolls! Contractions were still fairly mild and varied from 10-20 min apart. I was continuing to have bloody show too. I thought about doing some spinning babies techniques, assuming baby was still posterior, but many of those require a helper so I thought I'd do them when Ryan came home from work.

Audrey was doing a fairly good job at waiting while I had a contraction. If she tried to talk to me or needed something I would tell her I was having a contraction and to wait a minute while I breathed through it. We had practiced this so she was familiar with it, but like any typical 3 year old she wasn't always able to wait. This was fine because they were so mild and far apart that I could deal with it for now.

We had some lunch and I let her watch tv while I napped. Balancing activity and rest are important during early labor. I was also staying hydrated (remember that gallon of water a day goal?). Ryan called right before I fell asleep and I told him what was going on. I told him to stay at work and I would update him later.

When I woke up I decided to take Audrey to the library because I knew she wouldn't get out of the house too much postpartum and thought it would be a good distraction for me. Contractions still varied from 10-20 min apart but some were getting stronger.

At the library I was very self conscious and was tempted to go hide in the corner when I had a contraction. I really didn't want people watching me, especially random strangers who probably have to idea about natural birth. I did my best to ignore the librarian shelving kids books and breathe through the contractions. They were definitely getting stronger and closer together now.

At 3:30 pm I decided I had enough and convinced Audrey it was time to go home. The library is only 5 minutes from our house but I did have a contraction at a red light. Ryan also called me to say that he was done with work early and was on his way home. I asked him to pick up dinner because I didn't feel like cooking even if I was still in early labor. He took forever to get home and I found out that he had stopped at the liquor store to buy my favorite wine.

He got home around 4:30 pm and convinced me to call the midwife to let her know. I felt like it was too early but agreed. My midwife advised me to rest for awhile and to start filling the birth tub. I kind of laughed at that, thinking it was way too early to start filling the tub! But since we use a tub that has a heater and cover I knew we could fill it and it could sit for quite awhile before being used.

It was a good thing Ryan started filling it then because I had forgotten to turn up our hot water heater so we kept running out of hot water! Ryan would fill it for awhile until the water ran cold and then turn it off to give the heater time to heat more water.

During this I was lying in bed, trying to rest between contractions and remembering when I did 3 nights of that during Audrey's labor. At 5 pm my water broke during a strong contraction, which took me by surprise. I called the midwife to let her know but I felt like it was still early. Contractions were getting pretty strong but were still about 10 minutes apart. I knew that things could go fast now though so I decided to call my friend. Jody, who was our sibling doula. I told her "I'm in labor. I think." My hesitation was because of my previous long labor: I didn't want her to come too early and have to be away from her kids for many hours. She said she would be on her way as soon as her babysitter arrived.

During this Ryan was trying to feed Audrey dinner, convince me to eat something, fill up the birth tub, and take care of other random things. Audrey was running all over excitedly, wanting to help Ryan with everything. It was getting difficult for me to relax through contractions now, even with the Hypnobabies Easy First Stage track on, and Audrey was distracting. I was starting to have a "poor me" attitude and wondering why I wanted to do this again. I was in the bedroom standing by the dresser and leaned over it when a contraction came. Ryan plugged in the Christmas lights I had strung up and I put on the birthing necklace made during my Mother Blessing.

Each woman that came to my Mother Blessing brought a bead or two that reminded them of me or birth. I wore this necklace through labor and birth.

I asked Ryan to call the midwife at 5:45 pm and debated over the phone about whether I wanted her to come over yet. Later she told me that she knew labor was going to go fast and she was really hoping I was ready for her to come! I decided to have her come, hoping it wasn't too early still. Ryan told her about the hot water situation and she advised him to start heating water on the stove because she didn't want to risk the tub not being ready in time.

Jody arrived and I asked for her and got emotional. I told her I didn't want to do this and that the "stupid Hypnobabies" wasn't helping. She has had difficult homebirths herself and has been a great source of emotional support for me through the months of trying to conceive and then pregnancy. Her quiet and reassuring presence really helped me. Jody noticed that the contractions were still spaced out and short, even though they were strong, so she encouraged me to walk around to move things along. Then she switched places with Ryan and went into the living room to play with Audrey. Ryan was in and out of the bedroom with me, still trying to get the tub filled.

The midwife arrived at 6:15 pm and I asked her to check on the baby's heart rate since I hadn't felt movement for awhile. We had agreed during prenatal visits that unless there was an emergency I would take the lead on everything and ask her if I wanted any help. Otherwise she would just sit and observe. Baby's heart rate was 120-132 and she asked me what the position was. I had felt baby's back on the left side all day so I knew that at least she wasn't direct OP anymore. Ryan came into the room to stay and the midwife went into the kitchen to make the comfrey root tea and compresses to use during postpartum healing.

At about 6:30 pm I got into the tub, saying it would be ok if I had to get out later if labor slowed. I was still somewhat in denial about how fast labor was going, even though contractions were now strong, long, and close together. The water helped but the contractions were still really intense. I was having trouble relaxing through them and was vocalizing loudly. I decided to check my own cervix and was surprised to find only an anterior lip left. But this also made me mad because I knew that sometimes it takes quite awhile for a lip to recede and I didn't want to be going through these intense contractions for much longer. I did feel that the baby had hair which was exciting. I told Ryan and he somewhat jokingly said he was jealous that I got to feel our baby's head and he couldn't.

Ryan was kneeling outside the tub by me, still trying to get me to eat. Then he started repeating after the Hypnobabies and that really ticked me off! I told him to shut it, that I was listening and relaxing as best I could. Later he said he was trying to help me focus, because I kept vocalizing loudly and appeared to be ignoring the hypnosis suggestions.

After every few contractions I would reach up to feel the progress of the lip of cervix. It didn't appear to be moving much. Contractions were still very intense and I felt like I was fighting my body instead of relaxing and letting it do what it needed to. After a particularly long one I said "I can't do this!" Ryan was quick to reassure me that I could and would do it. This was about 7 pm.

My body started pushing during contractions and I tried to relax through it, because I wanted to "breathe the baby out" and experience the fetal ejection reflex. But the urge to push was too strong and I also really wanted to be done. At about 7:08 pm I reached up to feel her head starting to crown and I breathed in relief "there you are baby!" I told Ryan to call everyone in - the midwife, Audrey, and Jody. Audrey was super excited and ran over to the floor beds to bounce around on them while saying "the baby is coming!" Jody called her over to the tub and Audrey asked "what's the red part?" referring to the bloody show in the water. I was deep in labor land and this didn't bother me but I was really glad that Jody was there to quietly explain things to her.

I didn't really experience the ring of fire with Audrey but I definitely did this time! I started out a contraction with vocalizing and then it quickly turned into me saying "ow ow ow ow!" I again tried to relax and breathe through it but that just wasn't happening. At 7:15 pm her head was out and with the next contraction I pushed out her body.

I immediately scooped her out of the water and became very emotional, crying and saying "Oh baby!" and "I did it!" I definitely felt the natural birth high which was amazing! When Audrey was born I just felt numb for awhile, probably due to exhaustion and hemorrhaging after the long labor. I had been imagining this baby's birth since before I got pregnant and it was so close to what I had hoped for. It was thrilling to have my long awaited dream become reality.

Moments after birth. My midwife is in the background preparing the bed for me when I'm ready.

A few minutes later I asked Audrey "should we see if it's a boy or a girl?" I opened the baby's legs and the three of us saw together that we had a baby girl! We had all thought it was a boy so this was a lovely surprise!

Finding out the gender

I stayed in the tub for a few minutes while Audrey bounced around excitedly on the bed saying "I have a sister! I'm a big sister!" Then I was ready to get out as my bottom was stinging (I knew I had tore again) and I wanted to snuggle my baby in my bed. We cut Audrey's cord after 15 minutes and I passed her to Ryan before getting out of the tub and into bed.  This time I really wanted to wait to cut the cord until after the placenta was out and I didn't want to pass the baby off to anyone for at least an hour. So Ryan helped me step out of the tub and climb into bed while I held the baby.

We all snuggled together in bed for awhile, then Audrey wanted to go play in the living room so Jody took her out. Baby latched with minimal assistance in the laid back position 20 minutes after birth and nursed for half an hour. I was having afterbirth pains that were fairly strong but nothing compared to labor. I had several remedies ready to use for the afterbirth pains but I never felt the need to use them; I just relaxed and breathed through the contractions.

One of the best parts of a homebirth: snuggling all together in your own bed!

First nursing

The placenta came about an hour after the birth and I was excited to look at it! I started doing placenta encapsulation after Audrey was born and I've seen a fair number of placentas now so it was neat to look at my own and have some idea of what I was looking at.

Healthy baby attached to a healthy placenta! Notice how white the cord is; she's gotten her full blood supply.

I put on our fall themed cord tie and then Ryan and Audrey cut the cord together, about 1.5 hours after the birth. After the midwife examined the placenta Jody took it into the kitchen to prep it for placenta smoothies. (I plan to talk more about this in my next post about my baby moon, but wow I really loved the smoothies!)

Ryan and Audrey each held the baby for the first time and then she came back to me for more nursing. The midwife did the newborn exam 2 hours after birth. She was 7 lbs, 20 in long, 13 in head and chest. Then my midwife checked my tear and I did indeed have a second degree tear but not as bad as my tear with Audrey. My next post will talk about how I heal tears naturally, without stitches.

Shortly afterwards, the midwife and Jody left and our new family of 4 got ready for bed! My midwife was wonderful; it was very empowering that she trusted me, trusted birth, and fully supported my request to sit back and observe unless there was an emergency. And Jody was the best sibling doula in addition to many other things she did, including take pictures and video of the birth and prepare the placenta for smoothies.

I still can't believe that I got my dream birth! Of course it would have been nice not to tear and to have a pain free birth, but all of the important things I was hoping for happened. And I'm still on that natural birth high!

Friday, October 14, 2016

Prenatal Visits with a Traditional Homebirth Midwife

For anyone who is curious about what prenatal care with a homebirth midwife can look like!

It's important to note that most homebirth families choose to do some testing and ultrasounds, so this isn't necessarily what typical homebirth prenatal care looks like. I choose to opt out of most of the routine tests and procedures based on the research I've done and my philosophy of pregnancy and birth.

What is my philosophy on pregnancy and birth? I believe that this is an inherently safe process for most healthy women and babies. I believe that much of the routine testing and procedures can actually cause more harm than good and they certainly are not without risks. Sometimes the results cause worry and stress (which can be harmful to the baby) and additional tests and procedures.

When any issues arise, I prefer to try natural things first, which typically have fewer side effects, before moving onto medical solutions. For instance, my iron has been low this pregnancy (I haven't had a blood test but have had some symptoms of anemia) so I am raising my iron levels with iron rich foods and a food based supplement.

Of course there is always an element of risk during pregnancy and birth because just being alive is risky. Most of us don't walk around in our everyday lives in fear of dying, even when we do something statistically risky such as driving a car. I view my pregnancy and birth in the same light: I don't walk around worrying that something is wrong with me or my baby or stressing about the 'what ifs.' It's an unusual view to have in our society, but I do trust my body, my baby, and the pregnancy and birth process itself.

A typical prenatal appointment for me:

I hear my midwife drive up to my townhouse in her car and my dog goes insane, barking at the door (yes, you can have a homebirth in a townhouse or even apartment!) After containing him, I let her in and she says hi to me and Audrey, who always has something exciting to share like "I colored a picture!"

Audrey plays with toys or watches tv while we sit at my kitchen table and talk. This is often the most important part and is sometimes closer to a therapy session than a medical appointment. My mental and emotional state play a huge role in pregnancy and birth and it's vital that we address anything that is affecting me. This didn't seem as important during my first pregnancy but this time I have had some unexpected emotional issues I am working through and being able to discuss this openly with one of the people who will be there during my most vulnerable time (birth) is essential. I personally need to feel that I can absolutely trust everyone who will be present for my birth. For me, talking about my thoughts and feelings is how I build that trust. Talking through things also helps me prepare emotionally to birth this baby. Giving birth is a huge, life changing event not only physically but also mentally and spiritually.

My midwife and I also discuss how things are going in pregnancy physically and she gives suggestions for discomforts as needed. If certain physical symptoms arise that require further action, we discuss it at this time. We talk about my desires for birth and I consult her on various things. She advises me on decisions, but does not tell me I absolutely can or cannot do something. She is more of a partner than an authority and I have the final say in any decisions. Since she is an independent midwife her practice is not dictated by policies or rules put in place by others, such as happens with a birth center or hospital.

For the medical side of the visit, my midwife visually checks me for swelling and takes my blood pressure. Then I lie down on the couch and she measures my fundal height (how much my uterus has grown) which indicates the growth of the baby. My midwife also palpates my uterus with her hands, which tells her many things such as the baby's size and position and my amniotic fluid levels. Palpation is a difficult skill that is essential for a good homebirth midwife to be well trained in.

A care provider palpating, also called Leopold's Maneuver, to determine baby's position

The last thing my midwife does is listen to the baby with a fetoscope. This looks similar to a stethoscope and is the only way to listen to the baby's heartbeat without using ultrasound. This type of fetal heart rate monitoring is very accurate but it does take some skill. She can also tell the approximate placement of my placenta by listening to it with the fetoscope. I have my own fetoscope that I purchased to show in my childbirth education classes and I've had a lot of fun listening to my placenta and baby on my own this pregnancy!

A midwife using a fetoscope at a prenatal

That's pretty much it! Prenatal visits are usually 45-60 minutes long This pregnancy I have chosen for many reasons to opt out of routine:

  • Ultrasounds or doppler use
  • Blood tests
  • Genetic Screening
  • Gestational Diabetes Screen
  • Group B Strep Test
  • Urine Tests
  • Vaginal exams

I chose not to do these tests and procedures based on research I've done during Audrey's pregnancy and as a Childbirth Educator, along with my philosophy that pregnancy and birth are inherently safe. (I'm not going to go into all the research and my reasoning here because that would be an extremely long blog post! If you are curious about why I choose not to do any of these things let me know.) A big factor in my decision is that routine use of most of these tests or procedures do not improve outcomes for mom or baby and each of them carries different risks. If my midwife would deem one of these necessary at any point we would discuss it further and I may choose to do it at that time. I do take steps to stay very healthy before and during pregnancy, which certainly helps my body to perform optimally and my baby to be healthy.

Although I have opted out of these, my midwife is able to order certain tests and procedures if her clients want or need to have them done. For example, I had two ultrasounds during my first pregnancy which were ordered by my midwife through an independent diagnostic imaging center. Although if I knew then what I know now, I'm not sure I would have opted to have either ultrasound but it was great to have access to that technology while still seeing a traditional, homebirth midwife.

I have found that during this pregnancy, it has been very empowering and freeing to simply gestate and trust my body, my baby, and the process of pregnancy and birth. 

My good friend, also a homebirth midwife, doing henna at my Mother Blessing Ceremony

Friday, October 7, 2016

Preparing Big Sister Audrey for Birth and Baby

We are planning on having Audrey present during the actual birth of her little brother or sister and have been preparing her for that experience. It may not work out (she may decide she doesn't want to be in the room at the time, for instance) so we are being flexible about it. But we are hoping and planning for her to be there.

We have also been preparing her for her role as big sister and life after the baby is here. It will certainly be quite an adjustment (for everyone!) and will take some time and patience for us to find our "new normal" as a family of four.

Preparation for Birth

Audrey has known about my pregnancy since early in first trimester. I was too excited not to share it with her! She actually helped share the news with all her grandparents. Every few weeks during pregnancy we talk about how the baby is developing and I show her pictures from a pregnancy app or the book A Child is Born, which has actual pictures of babies in utero.

She loves this page and talks about how the baby is playing with his umbilical cord

One thing Audrey and I have enjoyed doing since before I was pregnant is watching homebirth videos. She really likes these, especially the ones with big brothers or sisters! I explain in simple terms about the "mommy working really hard to get her baby out" and that it takes a long time. If the woman is vocalizing we talk about how being noisy can help the baby come out. During the actual birth part I talk about the baby's head coming out first and that there can be a lot of "water" and blood (but the mommy and baby aren't hurt). She knows that babies grow in the uterus and come out of the vagina. (She's actually corrected people who ask if there's a baby in my "belly!") And then we see the baby's body born and I point out the umbilical cord. Later we discuss the placenta (if shown) and the baby getting "nursies" or breastfeeding. Some videos show the older siblings holding the baby and she loves that part!

A big part of her preparation for the birth has been me practicing being in labor! The last few weeks we've pretended mommy is having contractions and I will go in various positions, such as sitting on the birth ball or leaning over the counter. I remind her before the contraction starts that I will be focusing and can't talk to her for a minute. The "contraction" lasts 30 seconds or so and I will usually vocalize during them. She isn't always able to let me go through the contraction without talking or trying to climb up on me, but I just remind her. And that is one reason we are having our good friend be our "sibling doula!" A sibling doula is a doula for the older siblings and will take care of Audrey during labor and birth so Ryan can focus on me. Our sibling doula will also explain what's happening, answer Audrey's questions, etc. And she's going to prepare my placenta for smoothies after birth, but that's a topic for another post!

We've been reading this book too! It's not perfect but was the best one I could find about homebirth for children. There's a few home water birth books but I didn't like the illustrations or how the midwives were so hands on. This book focuses more on the family and the midwife is in the background (which is how our midwife practices).

 This is my favorite page. :)

Preparation for the Baby

I talk about how babies needs lots of "nursies," they sleep a lot at first, and cry sometimes. We've talked about how mommy will be in bed for many days after the baby is here and she and the baby will need to sleep during the day. She knows about wearing babies and bed sharing - she sleeps in the master bedroom on her own mattress.

This book has been a great resource and is geared towards natural parenting practices, such as breastfeeding, co sleeping, and baby wearing. Most conventional books for older siblings depict bottle feeding, separate sleeping, and baby in what I refer to as "containers."

One really big project this pregnancy has been making Audrey a "busy box" for every day of the week. These are boxes that contain many different learning activities that she can mostly do on her own, although I'm sure she will want adult interaction with them sometimes! I'm planning on utilizing these all throughout the coming months as part of her preschool-at-home education. Some of them I made and some I bought. Here are my favorites:

Various puzzles and matching

Literacy: putting a story in order and telling it, letter matching, name writing practice (that's a laminated tracing sheet with her name)

Felt activities: make a pizza, make a snowman, play yard for small animals. And build a pen for a dinosaur using popsicle sticks

Lacing - fine motor skill practice

Math: patterns, match the numbers, match the shapes

One box with a variety of activities for every day of the week!

Next week I will be writing a post about my prenatal care, which looks very different from conventional prenatal care. (Think less technology, more hands on skills)

Monday, September 5, 2016

Top 10 Ways I'm Preparing for Birth and Baby

Most women do some type of preparation for their birth and baby during pregnancy. Usually it consists of things like: taking prenatal vitamins and avoiding harmful substances, going to doctor's appointments, lots of ultrasounds and prenatal testing, baby showers - especially for a first baby, maybe taking a class on birth and baby care, and so on.

 Pregnant woman getting an ultrasound. Something we chose not to do this pregnancy.

My pregnancy journeys are a little different and I focus a lot more on the physical and emotional preparation for birth than most Americans. Pregnancy, birth, and postpartum are also a very spiritual time for me. I feel much more connected to God and nature and I view the journey of pregnancy through postpartum as a challenging spiritual journey through which I experience dynamic changes and growth. There is just something really indescribable about creating and growing a human life, and then giving birth and breastfeeding - and these are things women's bodies do all by themselves.

Here are some of the things I'm currently doing to prepare for my upcoming birth and baby!

1) Nutrition: this is the single most important thing you can do for your baby during pregnancy. It's super important to have excellent nutrition preconception through breastfeeding but especially during pregnancy. You can actually prevent many complications of pregnancy by eating well and baby's growth and development depends directly on what you eat.

I loosely follow the Brewer's Diet, the basics of which are: eating lots of fresh fruits and vegetables, whole grains, adequate fats and fluids, and at least 80 grams of protein daily. Eating real foods is also key. So minimizing processed, prepackaged, fast foods, additives, preservatives, sugar, etc. I also try to eat organic as much as possible. I shop mostly at Aldi and they have a great selection of organic foods for the lowest prices around!

Of course I'm not perfect and I doubt any woman eats perfectly during pregnancy. I have eaten unhealthy foods on occasion but I do try my best to eat well most of the time. There will always be time to really indulge when I'm not pregnant.

2) Vitamins and Supplements: this pregnancy I have been using Garden of Life Raw Prenatals, some extra vitamin D (decreases pain in birth and transfers to baby via breastmilk, so I won't have to use a separate supplement for baby), Floradix (liquid iron) (this stuff is seriously amazing if you have low iron), and Garden of Life Raw Probiotics (to balance my vaginal flora and minimize any GBS I may have).

3) Pregnancy Tea: I make my own blend which consists of red raspberry leaf and stinging nettle. Red raspberry leaf is very nutritious (high in many vitamins and minerals) and helps to tone the uterus during pregnancy. Nettle is also highly nutritious and one reason I chose that herb is because it's high in vitamin K. Vitamin K is essential for the blood to clot which benefits both me and baby after birth. Newborns naturally have low levels of vitamin K. I drink two cups a day since starting third trimester.

3) Prenatal Appointments: I have my babies at home with a traditional homebirth midwife. I follow the typical prenatal appointment schedule of once a month until 28 weeks, then once every two weeks until 36 weeks, then once a week until birth. I'll be writing another blog post on this soon because my prenatal care is very different from the typical care an OB provides!

4) Processing Audrey's Birth: Mid-pregnancy I was surprised to find myself with some unresolved emotional issues surrounding Audrey's birth. I have been journaling, meditating, and talking to my midwife and friend to process that birth so I can focus on this baby and birth.

5) Exercise: I was really good about walking and doing yoga in my first pregnancy but now it's a little bit harder to find the time while chasing after Audrey! I do try to fit this in at least 4 days a week. Natural birth can be physically demanding and it's important to increase my strength and stamina. And of course exercise is essential for good health in general!

6) Spinning Babies: Now that I'm in third trimester (actually about halfway through third tri!) I've been focusing more on daily spinning babies exercises. I do the daily activities, which not only consist of some specific exercises but also how I position my body all throughout the day! I try not to lean back while sitting or resting because that can encourage baby to be in a posterior position (sunny-side up) which sometimes makes labor longer and harder. I experienced a long, difficult birth with Audrey who was posterior, and am very motivated to do what I can to encourage this baby to be in a more optimal position! I do the Daily Essentials DVD every night while Ryan puts Audrey to bed followed by a a forward leaning inversion. Ryan also does rebozo sifting for me a few times a week which not only encourages baby to get in an optimal position but feels amazing!

 Not as hard as it looks :)

7) Relaxation: This is the key to having a natural birth. Tensing up against contractions makes them much more painful. You can try this experiment yourself to see what I mean: hold your arm out and tense your upper muscle while someone squeezes it very hard. Then have them squeeze while you relax your arm completely. Huge difference!

Of course it's easy to relax when nothing much is going on or while falling asleep but it can be much harder to do during labor if you haven't practiced. This pregnancy I have been using Hypnobabies as a tool for relaxation, although I don't completely buy into the entire philosophy. The tracks are great for relaxation though!

8) Preparing Audrey: Not only are we getting her ready to be a big sister but we are also hoping she will be with us during the actual birth! I'll be writing another blog post about this soon.

9) Getting Baby Items Ready: Not much to do here. I've learned that babies, and newborns in particular, need very little in the way of material items. I spend most of the first weeks in bed or on the couch with my babies which is essential not only for bonding and breastfeeding but also my own recovery from giving birth. So I have a few things left to do, like wash the baby's clothes and cloth diapers and put them away, but not much in this category.

10) Babymoon Preparation: In the early weeks it's essential for me to spend my time recovering from birth and establishing a good milk supply. I actually plan on not leaving my house for about a month after birth and instead having a "stay-cation" of sorts, also referred to as a babymoon. I will be focused on getting our nursing relationship off to a good start, taking care of baby, and recovering from birth. Sleeping and resting as much as possible and eating well are key. So basically I get to hang out in bed or on the couch with baby while other people take care of Audrey, the house, and me!

Ryan will be home the first two weeks and then my mom will be coming for another two weeks. I'm really looking forward to this time and have a couple books set aside (the newest Harry Potter and Tracy Chevalier novel) and a TV show to watch (Dr Quinn Medicine Woman. Don't judge - Sully is hot! Hello, extra oxytocin!). We will have some visitors but they will be very limited and will be asked to bring a meal, run an errand, or do a chore in exchange for visiting and holding the baby.

One day old Audrey and I enjoying our babymoon: skin to skin in bed!

I will also be making a bunch of freezer meals while pregnant which will mostly be eaten after my mom leaves. We just got a deep freezer for this purpose and I'm excited to fill it with healthy meals!

Sound like a lot? Sometimes it feels like a lot! But I really feel like these things are important and it's only for a short period of time. And then our baby will be 'earthside' and I will be super busy with raising two children while Ryan completes the final year of his master's program!

Friday, April 1, 2016

Successful and Safe IUI At Home?? Yes, it's Possible!

By popular request I am finally getting around to writing this blog post! I meant to write it much sooner but when I finally had time to write at night when Audrey was asleep I was usually exhausted and nauseous on the couch. (Thanks, first trimester!) But I'm feeling good tonight and first trimester is almost over! FYI, this post is longer than I originally intended and includes some back story, so feel free to skim or skip ahead to the interesting parts!

Also, please take note that this blog post is intended to journal our experiences with infertility and at home IUI's and is in no way giving medical advice. I hope this is helpful for others who find themselves in similar situations, but please do your own research and don't rely solely on my experiences!

Most people are probably unfamiliar with the term IUI or why we choose this option, so I'll explain from the beginning: Once upon a time there was a young hetero couple who wanted to have a baby. They had lots of unprotected sex at the time of ovulation each month but no baby was conceived.

After a long year of repetitive sex and temperature taking, they went into a fertility specialist called a Reproductive Endocrinologist (RE). He said everything looked good with the incubator-partner but the swimmer-shooting partner had a problem with his swimmers. After another awkward visit with a bad porn magazine in the office of a urologist, the couple was given the options of: IVF (very invasive for the incubator-partner and crazy expensive), adoption (very, very expensive and no chance of incubating or pushing the baby out of her vagina - very important for this couple), or donor sperm (much less expensive and invasive, incubating included, but baby will not be biologically related to the swimmer-shooting partner).

After much thought, prayer, and therapy the couple decided to go with donor sperm. They contacted the RE who said the procedure would cost X amount, more than the couple had anticipated. So the incubator-partner went online to research (note, this becomes a major addiction habit of hers in the future) and found that some couples inseminate with donor sperm at home! She found a cryobank that ships to any residence (most require you to use a medical provider) and together they picked a donor.

First cycle was an ICI (intra-cervical insemination. Basically it's just like regular, hetero sex: the semen is placed into the vagina near the cervix) and was unsuccessful. Second cycle their donor of choice did not have any more ICI vials available (rookie mistake: only buying enough vials for one cycle) but he did have IUI vials. IUI stands for intra-uterine insemination where the semen is washed so only sperm remains. The sperm is placed directly into the uterus with a catheter and syringe.

So after more obsessive thorough research online the couple decided to do an at-home, DIY IUI. And.... it worked! Pregnant! 9 months later a baby girl came out of the incubator-partner's vagina in a large tub of water at their house (because after an IUI at home, a birth at home couldn't be that much more complicated!) Cue angels singing Hallelujah! - But seriously, A) homebirth was the best decision I ever made, ever in my life and B) it was the most empowering, amazing, and beautiful experience! If you're curious to read my first birth story, I'm going to be posting that next.

Fast forward about 3 years and we decide we're ready for another baby! (Yes, I realize I'm switching from the third to the first person and I'm ok with that). So I do lots of things to prepare my body and we try IUI's at home for 6 months with no success. See here to read more details.

While taking a break from TTC (trying to conceive) for a few months, I went to see a highly recommended naturopath who did muscle testing and determined that I had mild hyperthyroidism which was throwing off all my hormones. She was not surprised I wasn't able to conceive. I did some supplements and dietary changes for a month to address this issue. (I know I know, this is another "weird" alternative voodoo thing, but she was able to tell a lot about me just from the muscle testing, such as my blood type and that I had a mold problem in my house. Combined with my friend's experiences and my getting pregnant after following the personalized regimen for a month, I am a believer! Here is the link to her website with more info.)

So a few weeks after weaning Audrey and implementing the changes suggested by the naturopath we decide kind of on a whim to try a month earlier than originally planned. Partly because my husband starts an intense internship for his master's program in December and he wanted to have some time with the baby before being really busy for 6 months.

First of all, it's very important that you know your typical cycle very, very well. I had been charting my temperature, checking my cervix, and doing OPKs for almost a year at this point, and in total I have charted over 24 cycles in my life. That's a lot, but I recommend charting and checking all your fertility signs for at least 3 months. Read Taking Charge of Your Fertility or use the app for more information on that. Once you've charted a few cycles and can look back and see when you typically ovulate and get used to the signs of impending ovulation, figuring out the timing of IUI's is a lot easier!

Knowing your cycle and your body is really important for doing an IUI at home because washed sperm doesn't live as long as semen in an ICI vial (or semen from hetero sex). So timing is everything! I was ovulating very soon after I got a positive OPK - about 12 hours (I took these 3 times a day, not just once as the box says. Your LH surge can happen anytime of the day and you have a much smaller window of viability with washed sperm versus fresh semen from hetero sex). I also had ovulation pain. So that made timing pretty easy for us to figure out, although with my daughter I didn't have any ovulation pain. The timing issue is why we do two vials every cycle. This way we can extend the amount of time my uterus/fallopian tubes have live sperm in it. We do two vials about 12 hours apart, but depending on your body's individual  patterns you may want the timing more spread out.

All right, here comes the best part of this post: the pictures! No, not pictures of us doing the IUI or anyone's body parts but pictures of the dewar the vials are shipped in and the process of preparing to do the IUI.

Helping Mommy with the dewar! (No, she was not present during the actual IUI!)

Opening the box, you can see the paperwork on top

The dewar! There's liquid nitrogen inside which keeps the sperm very frozen until you open and thaw the vials. The dewar is guaranteed to keep frozen for a week from when you receive it.

NW Cryobank takes their dewars very seriously! This letter says if you lose or damage it you owe them $800 to replace. 

Paperwork verifying the donor number and all the testing they do on the semen.

Written and illustrated instructions on how to remove and thaw the vials. Don't remove the dewar from the box!

Opening the dewar and removing a vial on insemination day! Yes, gloves are essential because you're working with liquid nitrogen. You can see two canisters in the middle of the tube which are holding the vials. They are set firmly in there and you have to kind of pry them off.

First the vial sits by itself for 3-4 minutes until all the frost is gone.

Next I hold the vial in my hand for 10-15 minutes until it has come to body temperature. 

Here are the supplies you need for an IUI: speculum, catheter, syringe, and missing is a flashlight or headlamp. We sterilize the speculum after each use but you can also buy one-time-use plastic ones. The catheter and syringe are one-time-use. I like the catheter and syringes from here

(Before you do this, you need to make sure you have scrubbed and scrubbed your hands very clean! Or use sterile gloves. Sanitation is super important when doing IUIs because you are bypassing your body's natural filter, the cervix). Here I am aspirating the sperm out of the vial and into the catheter and syringe. Although I'm using the catheter attached to the syringe I recommend you aspirate with only the syringe and then place the catheter on. And open the vial very slowly and very carefully because there will be some pressure built up like a can of pop. (Yep, pop. Guess where I live based on that term!)

Now we come to the actual IUI of which there are no pictures (sorry not sorry!) Basically, I lie down on an elevated surface and spread my legs out (you can 'butterfly' your legs but I prefer to just bend my knees and place my feet flat on the surface), and my husband places the speculum inside my vagina. This can take some practice and patience so I recommend you work this out beforehand. Oh, and my husband has scrubbed and scrubbed and scrubbed his hands because he is the one actually doing the IUI.

He puts the flashlight in his mouth (this is where a headlamp would be especially useful) and gently positions the speculum to where he can see my cervix. Now this is the part where knowing your body really well (feeling your cervix during your cycle) can come in handy if your partner has trouble locating it. Sometimes he can't see my cervix at all and he takes the speculum out and tries again. Since I've had a vaginal birth my cervix is always open a little but even when we conceived the first time we had no problems with this. I've read online accounts of IUI's done by medical professionals where the cervix was closed tightly shut and needed to be opened manually, but if you are inseminating at the peak of your fertile phase, it should be at least slightly open. Again, it can depend on your individual body. Then he very carefully and slowly inserts the catheter into my cervix until it meets resistance, which is usually about 6 inches or so. Next he carefully and slowly pushes the plunger on the syringe until it's emptied, then carefully and slowly pulls the catheter out. I stay lying down for about a half hour after this to ensure all the swimmers are headed up where they need to go. There is usually some leakage, which is likely from cervical mucus rather than sperm coming back out, so don't be alarmed if this happens.

And that's it! You're onto the 2 week wait! Pretty simple once you get down to it. The main things are: getting your timing right, going slowly and having patience, and taking proper sanitary precautions. We've done a total of 9 at home IUI's and I've never had any bleeding, pain, or infections. 2 of those IUI's have resulted in successful pregnancies! Happy inseminating!

Thursday, January 28, 2016

Preschool - At Home!

What are Audrey and I up to now that she's done with speech therapy? Reading lots of books, going to AP playgroups, other outings, and doing a homeschool curriculum for preschoolers! It's a nature based curriculum called A Child's World. The curriculum is divided into 20 units, each of which is focused on a certain element of nature, such as a season. Each unit has 25 different activities that span the content areas: reading, math, science, art, cooking, sensory play, etc. Right now the curriculum is geared for children of preschool and kindergarten age but it's a new curriculum and still a work in progress so eventually it will include activities for ages 2-7. For more information on this curriculum go here.

We just started this curriculum a month ago but so far we both love it! We did the winter theme this month and here are some of the activities we did:

While going on a nature we collected some branches from a pine tree, painted them, and made prints! On the walk we also talked about winter: the snow, leaves gone from most trees, cold, short days, footprints and tracks in the snow from animals, etc.

This was one of her favorite activities! It's the book The Mitten. The animals in the story climb into a mitten one by one. While reading the book we did an activity called sequencing: as each animal climbed into the mitten in the story we put a picture of that same animal into my mitten. 

We read several books about winter and this one coincided with an outing that our homeschool group, Little Urban Explorers, went to! We saw the play version of the Bear Snores On, which was super cute.

Here Audrey is putting "snowballs" (cotton balls) into empty toilet paper tubes. Each tube has a number written on it and she puts the corresponding number of cotton balls into it, with lots of assistance from me. Her favorite part of this activity was lifting up the toilet paper rolls, squeezing them, and making them "poop the snowballs out" :)

It's hard to tell what she's eating, but it's a "snowflake": a tortilla folded and cut (like you would a paper snowflake), then brushed with butter and cinnamon sugar, and baked. She loves to cook! We did this activity after being outside when it was snowing and talking about the snowflakes.

This isn't an activity from the curriculum but getting out to playgroups, the Children's Museum, and other outings is an important part of our week! Audrey loves the Children's Museum; here she is being a construction worker.

Sensory bins with rice and beans! These can be super messy (hence why we're doing it in the kitchen) but super fun! We talk about the different beans, scoop, pour, sort, and just have fun.

It's hard to tell from the picture but this is a calming jar. It has a piece of pine branch from our nature walk and glitter. You shake it up and watch the glitter fall. On a side note, I've learned that glitter and toddlers make an even bigger mess than the sensory bins! I thought, "hey it won't be that hard to contain the glitter." Oh but it is, my friends, it is.