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 sacred and 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, so there's a large degree of empowerment for me.

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, praying, 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 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 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. This 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). 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!

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

I get one of two responses when I tell people we conceive via at home IUI. Either they are unfamiliar with what IUI is or they believe that it is difficult and dangerous, or at the very least, painful. My husband and I have done a total of 18 IUIs at home and I have not experienced any adverse effects. After learning about this the next questions many people ask is "How do you do an at home IUI?" So I have chronicled our experiences doing at home IUIs for those who are curious or hoping to do an at home IUI themselves.

(The reason we have done so many is because it took 7 cycles (2 IUIs per cycle) to conceive our second baby. We were unaware at the time that I am probably one of the rare women who cannot get pregnant while breastfeeding. So we tried 6 cycles without success and after weaning my first daughter, we conceived the 7th try.)

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. After a year of trying to get pregnant on our own, we went to a fertility specialist called a Reproductive Endocrinologist (RE). He said everything looked good with me but Ryan's sperm count was very low. He saw a urologist who also did some genetic testing to figure out if that's why his count was so low and we found out that he inherited this condition from his father. So now our options were: IVF, adoption, or donor sperm.

After much thought, prayer, and therapy we decided to go with donor sperm. I have personal ethical concerns with IVF and did not feel good about the drugs used and invasive nature of the procedure. Plus it is very expensive. Adoption is also extremely expensive, you run the risk of the birth mother changing her mind, which would be very traumatic for me, and I would not get to experience pregnancy and birth. I felt a very strong calling to experience pregnancy and birth which I realize may seem selfish. But perhaps I felt that calling for a reason. After researching our options, including trying to figure out how we could finance IVF or adoption, we decided to use donor sperm.

The RE charged a lot of money for insemination and we didn't feel that it was necessary for us to go through a medical professional for a simple vaginal insemination. So I researched online to find a cryobank that would ship to any residence rather than requiring the client to use a medical provider as most others do. Together we went through the list of donors and one stuck out immediately to both of us. It was important that the donor was open to contact from the child in the future, rather than remaining anonymous. We also choose a donor based on some of Ryan's physical characteristics and personality. We were able to see general information about that, 2 childhood photos, and some open ended questions they answered, but no identifying information. Lastly, it was important to me that other clients using the donor had been able to have a successful pregnancy (meaning a live, term baby) because we didn't want to take any chances on that. Luckily it was pretty easy for us to agree on the same donor.

Our first cycle was an ICI (intracervical insemination. Basically it's like a vaginal insemination) and was unsuccessful. On the scond cycle the donor 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 intrauterine 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 reading about others who had done this, we decided to do two at-home, DIY IUIs. And.... it worked! Pregnant! We went on to have an amazing, beautiful, and transformative homebirth.

Fast forward about 3 years and we decide we're ready for another baby! 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.)

I also decided I needed to wean Audrey because although I was ovulating it was delayed and I had a short luteal phase. Luteal phase is the time between ovulation and menstruation and if it's too short an embryo may not be able to implant into the uterine wall. Delayed ovulation and short luteal phase is common during the gradual transition to full fertility after exclusive breastfeeding but in most women it isn't as long as I experienced.

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 Ryan started 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 I know my 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 40 cycles in my life. That's a lot, but I would really only need to chart and check all my fertility signs for about least 3 months. I read Taking Charge of Your Fertility did the tutorials on the fertilityfriend app to learn about fertility charting when we were TTC the first time. Once I've charted a few cycles I can look back and see when I typically ovulate. I can start to predict ovulation based on my body's signs - high, open, soft cervix and fertile cervical mucus.

Knowing my cycle and my body is really important for doing an IUI at home because washed sperm doesn't live as long as semen from sex or from an ICI vial . So timing is everything! When I got pregnant the second time 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 along with the shorter life span of washed sperm your window of actual fertility is pretty short). I also had ovulation pain. So that made timing pretty easy for us to figure out, although my cycles before my first pregnancy 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.

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.

My firstborn helping with the dewar! (She was not present during the actual IUI)

Opening the box. The paperwork is on top.

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

The cryobank takes their dewars very seriously! This letter says if I lose or damage it I owe them $800 to replace. 

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

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 we'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 I 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 needed for an IUI: speculum, catheter, syringe, and missing is a flashlight or headlamp. We sterilize the speculum after each use but we could also buy one-time-use plastic ones. The catheter and syringe are one-time-use. They are called TomCat IUI catheters and are 4.5 inches long, 3.5 fr with an open end. I like the catheter and syringes from here

(Before I do this, I need to make sure I have scrubbed and scrubbed my hands very clean! Or I could use sterile gloves. Sanitation is super important when doing IUIs because we are bypassing my body's natural filter, the cervix). Here I am aspirating the sperm out of the vial and into the syringe. After the sperm is in the syringe I will put the catheter on it. I 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. Basically, I lie down on an elevated surface with my legs butterflied and the speculum is placed. This can take some practice and patience so we practice beforehand. Oh, and Ryan 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 my body really well (feeling my cervix during my cycle) can come in handy if Ryan 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 (painful!), but if one is inseminating at the peak of the fertile phase, the cervix should be at least slightly open. Then Ryan very carefully and slowly inserts the catheter into my cervix until it meets resistance, which is usually about 4 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 the sperm is headed up where they need to go. There is usually some leakage, which is likely from cervical mucus rather than sperm coming back out.

And that's it! We're onto the two week wait! Pretty simple, actually. The main things are: getting our timing right, going slowly and having patience, and taking proper sanitary precautions. We've done a total of  at 21 home IUI's (usually two IUI's per cycle) and I've never had any bleeding, pain, or infections. 4 of those cycles have resulted in pregnancy! (Except for when I was breastfeeding and unable to conceive, most times it has only taken us 1 or 2 cycles to achieve pregnancy. So 12 of the IUIs were done while I was breastfeeding and likely unable to conceive. Most women can get pregnant while breastfeeding but I seem to be the rare woman who cannot.)

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.

Coming Out of the Infertility Closet.... Again

Yep. We're going through infertility. Again.

Ryan and I have been trying to get pregnant with the donor sperm for the past 6 months without success. It's been difficult. Not as much as the first time, but still really hard. We've even looked into adoption, as in called a bunch of agencies asking tons of questions, but found out it's so astronomically expensive that it won't be an option for us right now.

I know you don't get to pick what your hardships are in life, but I so wish it could be something else. Something not so important to me. Birth and babies are my big passion. I think about Audrey's birth all the time. I think about my next pregnancy and birth, and what I want to do differently all the time. I even made a part-time career out of my obsession interest! It feels especially cruel to have to go through this struggle again. Infertility is a special kind of hell. It can be a repeating cycle of intense grieving and hopeful optimism, depending on where you are in your menstrual cycle.

Usually in the beginning of a cycle, when I get my period, I am extremely depressed and angry. Because that is when we know the attempt failed and my womb was not filled with new life but was empty. After about a week I start to feel better and look forward to the current cycle. After insemination I typically feel really excited and hopeful, even if I didn't want to. I tried so hard not to think about it, but it was always lurking in the back of my mind. The last few days before my period is expected is excruciatingly slow. Every time I use the bathroom I hold my breath until I saw there was no blood. Sometimes I break down and take pregnancy tests, which are always negative. But I know that it might be too early for a positive so I wavere between still hopeful and pessimistic. After the first cycle I stopped taking my temperature daily (basal body temperature charting) after I confirmed ovulation because any little dip or rise would set me off on a whirlwind of emotion, whether I tried my best to ignore it or not. And then I would get my period and the cycle would continue.

I generally don't handle emotionally pain well. Give me physical pain over emotional anytime! And this process is especially hard emotionally. So far I've been able to stay off antidepressants but I know the worst part of the year is coming up so we will see how it goes.

I've tried SO MANY natural supplements, vitamins, herbs, acupuncture, you name it. I even tried Clomid, a fertility drug, for two cycles. And those of you that know me well know I would have to be really super desperate to try a pharmaceutical option. The Clomid "worked" to improve my cycle but I still didn't get pregnant.

One of the reasons why I haven't been able to conceive yet may be because I'm still nursing Audrey. Most women can get pregnant while breastfeeding, especially an older toddler. I really really wanted her to self wean. I didn't think she was emotionally ready to wean. I wasn't emotionally ready to wean. I was even looking forward to giving tandem nursing a try! But breastfeeding can affect your cycle, usually by causing delayed ovulation and a short luteal phase (the time between ovulation and your period is the luteal phase and it's thought that if this phase is too short an embryo can't implant in the uterine wall). This is what happened to me and what Clomid "fixed." (Clomid is compatible with nursing an older toddler, by the way).

I thought about waiting longer to try for another baby and see if she would wean in the meantime. But I've wanted to have another baby for so long, and if I have to choose I want another baby more than I want to keep nursing her.

See, this whole thing feels so selfish too. Like I'm putting my needs above Audrey's. I *know* 99.9% of 3 year olds in America aren't nursing and I *know* she will be fine and won't "remember" but a part of this still feels wrong and selfish to me. I feel somewhat comforted by the fact that she stopped nursing during the day about two months ago, on her own accord. So maybe she is "ready." But this is still so hard for me!

We know that our insemination timing has been spot on, thanks to my cycle charting. We've been doing IUIs (intra-uterine inseminations) at home, which is how we conceived Audrey. IUIs have a higher success rate than conceiving naturally and most of the time it's recommended to go onto IVF after 2-3 cycles of IUI. So having done 6 without success is not a good sign. Even though I've spent hours researching IUIs and donor sperm insemination at home I still wonder if maybe we're missing something. So I've also decided to go see a great, naturally minded OB who specializes in fertility in January. I hesitated to go in because A) we did this successfully on our own before, and B) it's very expensive. We've already spent about $6,000 on trying to conceive so far, which is A LOT of money for us. I thank God that I have my business because that is what has paid for most of it. I honestly don't know how we're going to pay the possibly very high bills that come with seeing an OB on a regular basis, which may include tests, ultrasounds, and even minor surgery. My insurance covers nothing infertility related.

Right now, we are taking a break from trying. I thought it would be hard to stop but it's actually been really nice to take a break from "living in the cycle!" I was able to enjoy our much needed vacation in Florida, Audrey's birthday, and look forward to the holidays.

But sometimes I still get angry, depressed, and jealous. I don't always 'like' or comment on friend's posts on Facebook if they are pregnant or have a new baby. I sometimes dread teaching my class or going to visit my doula clients, which normally brings me only joy. So the reason for this post is to let everyone know if I seem to act weird or if I've disappeared on Facebook: it's not you, it's me. But also because many people don't share when they're going through infertility. I chose not to tell most people we were trying because I really wanted to surprise everyone with the news that I was pregnant. Since that hasn't happened and we are going through infertility again, I'm tired of hiding this secret. I'm tired of pretending that everything is alright when it's not. And I shouldn't have to hide because infertility is real, it's not shameful, and more people go through it than you might think. We are 1 of 8.

Talking to a 2 Year Old About Her Donor Conception Origins

Recently we purchased a book for Audrey that discusses the origins of a sperm donor conceived child. I've done a lot of research on this topic (big surprise!) and what I found was that telling your children about their donor conceived origins was not only recommended, but that there are benefits to starting "that talk" early in their life. Before we decided to go the route of donor sperm I had read several books on the subject that included stories from donor conceived persons. Many said they remembered when they were told about their origins and that it was traumatic for them. I didn't want Audrey to remember a specific day where her belief that Ryan was her biological father was shattered when we told her the truth. We decided it would be best to start talking about it during the toddler years in a simple, easy way for her to understand and adding more age-appropriate details as she grew older. In this way we treat the issue like we would if she was adopted: these are the facts, they are not a shameful secret, and you have a right to know about your biological origins.

Every time I think or write about this topic I feel a bit conflicted and worried about how she will feel in the future. There's a very real possibility that she will hate the decision we made to use a donor and prefer that she didn't exist. Many persons of donor conceived origins feel this way. We are hopeful she can have contact with the donor in the future, but that's not a guarantee. We are in contact with many of her half-siblings at least, but there's still an entire "family" of blood relations she does not know. This is very similar to the situation many adopted persons and families are in, but of course adoption does not still carry the stigma that donor conception does. And there's the argument that adoption is morally acceptable because those children already existed, but with donor conception you are purposefully creating children who may never know their biological relatives. For now, we do the best we can for Audrey and only time will tell how she feels about her origins and our decision to conceive her from donor sperm.

So onto the main point of my post: how we are beginning this conversation with Audrey!

I was really excited about this book (you can read the whole book, and their other books, here. I didn't post pictures of the entire book, only the pages I read) but after reading it a few times I realized it was too complicated for her current level of understanding. So when I read it to her I basically read my own invented version, shown below:

I begin with talking about how "Mommy and Daddy met and fell in love. We had a lot of fun together!"

"Mommy and Daddy got married and became a family of two" (at which point Audrey usually says "TWO!!") But we wanted to have a family that included children."

"Mommy and Daddy tried really hard to have a baby, but it didn't work. We were very sad because we wanted you SO much!"

"We needed to get help, so we went to the doctor." 

"The doctor told us we needed two parts to have a baby. A part from Mommy and a part from Daddy." (I omit the 'nest' referral here for simplification) "Mommy had her parts, but Daddy didn't have his parts." (Not fully true, Ryan actually has a very low sperm count but IVF isn't an option for us for several reasons. But for her level of understanding, I currently omit that complicated detail.) "We needed help!"

"Since Daddy didn't have a part, we got the part from another man called a 'sperm donor.' Donors are people who help other people build families."

"The donor's part worked and you started to grow in Mommy's uterus in her belly! Mommy and Daddy were SO happy and excited that you were coming!"

"You grew for a very long time in Mommy's uterus and then you were born at home!" (I usually add a detail or two about "coming out of Mommy's vagina." She has watched many birth videos with me while I prepare for teaching class and seems to remember this is how [most] babies come out!). "Mommy and Daddy were so excited to hold you and meet you!" (Enter additional details about being born in the water and having 'nursies' for the first time - this usually results in her wanting to have some 'nursies' right now)

"Now we are a family of three" ("THREE!!" says Audrey) "Our family is Mommy, Daddy, and Audrey!"(And then she talks about the bikes - bikes are a big deal lately)

As Audrey gets older I will add in more details about her half-siblings, how most families have babies, how a biological father is different from a father who raises you. And I'm sure she will have lots of questions. But I'm so glad we've at least started the process of telling. And hopefully we will continue to have an open and honest dialogue about it.

20 Lies We Tell Women About Pregnancy, Birth, and Postpartum

Things women are taught by our culture that aren't necessarily true. 

1) Getting pregnant is very easy. If you can't get pregnant you probably just need to relax! And pray more.

2) Learning about your body's fertility signs and cycles in order to prevent or achieve pregnancy is ineffective and a waste of time.

Boring and pointless!

3) The best part of being pregnant is buying lots and lots of new things! Newborns need MANY material items and no nursery is complete without a: crib, bassinet, cradle, co-sleeper, swing, bouncy seat, jumperoo, activity center, rocking chair, changing table, dresser, high chair, bathtub, pack n' play, bumbo, sound machine, humidifier, lots of toys, lots of clothes, etc.

That's a lot of presents! But they probably only contain a fraction of the necessities for newborns.

4) Your OB is like a God. They are the absolute authority on your pregnancy and birth and you should always do whatever they tell you to. The health and safety of you and your baby is always their top priority (hospital policy, medical malpractice insurance, and their personal lives never affect their decisions). And all OBs practice evidence based care, so they're all pretty much the same!

5) Pregnancy is awful. The physical and emotional transformation your body and mind are going through aren't part of the process to prepare you for motherhood but are unnecessary and annoying. Thankfully there are lots of drugs that can mask any uncomfortable issues! And hopefully in the future  we will have artificial wombs so women won't have to go through the unnecessary inconveniences of pregnancy. Just like women don't have to give birth naturally or breastfeed anymore.

6) Pregnancy is a disease and birth is an emergency medical situation. Hospitals are always the safest place to have a baby and outcomes for hospital birth are vastly better than planned homebirths for low risk women.

7) Homebirth midwives are crazy, earth-worshiping hippies who have no real experience or training. Their birth supplies include a tambourine, flower wreath for your hair, and smudge sticks. They will respond to an emergency situation with chanting and lighting candles.

This is what a typical homebirth looks like: Birthing woman in the kiddie pool, lots of other people there staring at her, bright lights, screaming, and the token tambourine lady!

8) Natural childbirth is excruciating and worthless. It's better to be emotionally and physically separated from the birth process. Pain medications have no real risks for you or baby!

9) The only important outcome of birth is an alive baby and mother. The birth experience itself is of no consequence. And no one wants to hear you talk about how your cesarean was medically unnecessary - who cares that you had major abdominal surgery for no reason??

10) After birth (and maybe 10 minutes of skin to skin, if you're lucky) your baby should go to the warmer for assessment, routine procedures, and to stay warm. But you'll get to hold him soon - he'll look so cute all swaddled up like a burrito with a hat!

Aww! Just how I want to meet my newborn! You can kind of see his face... Not any other part of his body, but that's ok - they all look the same anyways!

11) Your partner's wishes on how your son's genitals look are the most important aspect of making the circumcision decision. Since you don't have a penis you don't really have a say in this like he does. But he is an expert on both circumcised and intact penises! And he knows what kind of penis your son would want. He went into the future to ask him.

12) Circumcision doesn't hurt your baby. He's just screaming because he doesn't like to be held down in the circumstraint. Hey! I can't move! Oh you're slicing away at my genitals, I didn't even notice.

13) Learning how to breastfeed is super easy and natural! But if it doesn't instantaneously click for you, then you aren't meant to breastfeed - don't bother getting professional help. It's a good thing formula is available because otherwise your baby would starve!

14) Formula feeding is just as good as breastfeeding. And it may be better because breastfeeding "ties you down." There are way more important things you should be doing! Like folding your husband's boxers or leaving your baby in the care of someone else so you can do what's really important - going to work to make money!

15) If you do manage to breastfeed - that's great and very healthy for you and baby! But don't do it in public. That shit is gross. There are MEN and CHILDREN here and they might glance over and see your BREAST!

Stop whipping your boob out of your shirt! Disgusting!

16) When your baby cries he's trying to manipulate you. Babies don't cry to communicate their needs - they have no clue what they need!

17) It's important to get back to your regular routine as soon as possible after you have a baby. You should be able to jump right back in: take care of your baby, keep up with any work from your job, maintain a spotlessly clean house, run any errands, be intimate with your husband, and entertain all the guests who come to see your new baby!

18) Speaking of visitors, it's important that they get to hold your new baby as much as they want, so they can bond. They will be seeing your baby every Christmas and Easter after all! You can take advantage of this time to wash the windows or dust. And don't forget about offering your guests some refreshments while carrying on an interesting conversation - Hospitality first!

This is almost right! The new mom looks like she just stepped out of a salon, so that's a step in the right direction. Now she just needs to get off her lazy butt and offer her guests some homemade appetizers and cold drinks!

19) If your baby wakes up every 20 minutes despite establishing a bedtime routine, swaddling, using a pacifier, white noise, lullabies, waiting to put him down until he's deeply asleep, and using a fancy contraption like a rock n' play or hammock bed your baby needs to learn how to sleep: Time to start sleep training! (This problem has no relation whatsoever to your baby's biological need to be close to his mother and to eat frequently. That's just a silly myth!)

20) Only the experts can tell you how to parent. Your instincts are nonexistent and wrong. But don't worry, all the experts are in agreement on these subjects and they all base their recommendations on the latest research!

Audrey's Story Part 2

I've procrastinated writing this for a long time, partly because I feel like I've forgotten much of what happened a year ago. I've been rereading some of my earlier posts and WOW did we go through A LOT! But I really want a record of it, at least for Audrey to read when she's older.

So part one of her story left off with us getting home after two weeks in the hospital. At the time she was on a feeding tube that went through her nose and into her stomach and was being fed mostly Nestle Boost Kids Essentials. She was also on a daily multivitamin with iron, twice daily heparin injections because of the blood clot that developed from the PICC line, an antibiotic for her UTI, and possibly something else I can't remember.

Shortly before discharge

Soon after getting home, within a week or so, she started vomiting frequently during and after tube feedings. She was also starting to lose weight again. I was frantically trying to find a more holistic practitioner and so we tried going to Newbridge Clinic in Edina. They were very nice (although her problems were way beyond their scope and I wish they would have told us that) and suggested trying a hypoallergenic formula. Well those ingredients and price was even worse! At that point I pretty much said "fuck it" and decided she was going completely on breastmilk, both mine and donor milk, because that was the only thing she could keep down and I believed that was much better for her than any synthetic formulas with unhealthy ingredients.

Our pediatrician at the time was very concerned about this plan because it was thought that Audrey would need such a large volume of breastmilk in order to gain weight that it wouldn't be feasible. But she was willing to try it and even said she would back up our decision to use donor breastmilk if the rest of Audrey's medical team questioned it. The nutritionist we were working with wasn't happy about it either but calculated that she would need about 45 ounces (about 900 calories) per day in order to gain weight.

So I asked in the local Attachment Parenting community I'm a part of as well as the two donor milk organizations that connect donors with recipients: Human Milk for Human Babies and Eats on Feets. We were blessed with a TON of milk - over 1000 ounces! Some was even newborn milk with a bit of colostrum! Audrey stopped vomiting so much and started gaining weight again!

Donor milk stash!

At this point we were doing weight check ups once a week plus seeing various specialists to try and figure out the root of the problem. She was also having blood draws done frequently to check levels of various things (iron, thiamine, etc.) and for further testing. This continued into the new year. Basically our whole lives revolved around Audrey's appointments, trying to get her to eat solids, the daily tasks of caring for her plus her added special needs care, and me constantly researching online.

So now we were getting close to Christmas and we were really hoping to have a nice holiday where we could forget about everything for a day. But unfortunately the second round of norovirus hit our household. On Christmas Day. Ryan was the first to feel sick and he laid on the couch while Audrey and I opened presents. Then she started vomiting and one session was so severe that her feeding tube came flying out! This meant a trip to the ER, because of course all the other clinics were closed. And I really didn't want to take her alone so poor Ryan came with, lying on the bed meant for Audrey and vomiting in the garbage can. The nurses felt so bad for us and gave him a bunch of cans of sprite and crackers. The next day it was my turn to get sick, which was my second time with the virus already that winter.

Christmas tree fun before getting sick on Christmas Day

Audrey started going to feeding therapy (blergh!) and we started experimenting with her tube feeding schedule to try to get her to eat more on her own. Part of the problem with the tube feeding is that you need to give them enough so they gain, but then they don't feel hunger and so the little desire to eat that they already have is even more diminished. It can be a hard cycle to break. After researching I asked if we could try switching her tube feedings to night time in the hope that she would feel more hunger during the day. This can be tricky though since a toddler her age doesn't normally eat at night. With the pediatrician's support we offered food during the day (ALL THE TIME) along with sippy cups of my breastmilk and ran the tube feed continuously throughout the whole night making up for the calories she didn't eat during the day. This usually amounted to about 30 ounces of donor breastmilk. The first few weeks she did great and seemed to be eating more every day!

At this point the pediatrician suggested that we do the genetic testing since we still didn't know the cause of her failure to thrive. We found out that Audrey is a carrier of a mild form of cystic fibrosis (you can read about that here). Audrey was also having more trouble with vomiting again a few weeks after starting the night feedings, and was not as interested in solids anymore, often gagging. The Occupational Therapist at Gillette where we were going once a week suggested we do a scope test of her esophagus to see how it was working. I was skeptical of this as she had never had issues swallowing before, but decided to rule it out. Of course there was nothing wrong and the end result was a crying and screaming Audrey while the Amplatz therapist force fed her yogurt. I'm sure the therapist meant well but I still remember what she said that day "patient is unlikely to be off the feeding tube for at least a year" HA. Audrey was off it a few months later!

Although I didn't think Audrey had swallowing problems I was suspicious that she had another UTI. Just like the first time, she didn't have a fever but was fussy, had low energy, and bad smelling urine. Sure enough, a traumatic catheter insertion (which was unnecessary, I later found out they can use bagged urine just as well for the culture) revealed her second UTI.  I'm thankful Audrey isn't a boy so we didn't have to also fight against forced retraction of the foreskin or recommendations of circumcision to "fix" the UTI problem!

At the appointment confirming her second UTI Audrey was put on periactin for appetite and another med for reflux as she was still vomiting and gagging, although not nearly as much as when she was on the formulas. At this time I was also very concerned that she was going to wean, which was a very upsetting thought for me. She would latch on to nurse but kept gagging and then didn't want to keep nursing. It broke my heart because I knew she wasn't wanting to wean on her own accord! When I brought this up to the pediatrician she didn't even respond to my concerns, which isn't surprising because Audrey had passed the magical age of 1 after all, so at this point breastfeeding was "useless."

Shortly after she was diagnosed with the second UTI we went to a pediatric gastroenterologist which was the worst experience we had with a medical "professional." He was extremely condescending and hinted that he blamed out decision to use baby led solids as the reason for her failure to thrive. This is supposed to be an expert in the field of infant and child feeding and diseases of the digestive tract! And he claimed he had never heard about this feeding philosophy, which is becoming fairly common. This attitude of various practitioners thinking they don't need to keep on top of the research in their field just disgusts me. It's like they think they're done learning after they graduate. Ridiculous and ultimately their patients are the ones that suffer for it.

He also wrote some very inappropriate things in her chart, such as "CPS was not involved" (implying, we felt, that they should have been), "parents did not feed purees and instead did 'baby led weaning' and fed toddler appropriate foods," and the worst one "maternal beliefs may impede patient's progress." We were livid and immediately requested that these statements be taken off her chart (which they were, thankfully!) and requested a new specialist.

Ironically, he was the one who scheduled her for a diagnostic ultrasound because upon examination of her abdomen he felt an abnormally large organ, when ended up being her right kidney. He also noted that her abdomen appeared swollen, which we kept asking the other practitioners about but they didn't see it as concerning.

The ultrasound found her right kidney to be enlarged, dilation of her right ureter, and the ureterocele on her bladder (an abnormal pouch where urine would collect and sit instead of being expelled). So now we had to do another test to further see what the problems were, called a VCUG (voiding cystourethrogram). This involved using a catheter to insert a dye into her urinary tract system and an ultrasound to see how the system expels the dye, etc. We were referred to our urologist, Dr. Jane Lewis, for further consultation.

Dr. Lewis scheduled the VCUG to take place at the Maple Grove medical center which I later found out was unable to provide any type of sedation or pain medication during the procedure. Audrey had reacted badly to the two previous, brief catheter insertions and I had serious concerns about her being held down for a catheter test that would take at least 20 minutes. My friend, whose children also have kidney reflux to a much lesser degree, also greatly emphasized that we should not do this test without sedation at her age. So I switched the procedure to happen at Amplatz where she would be able to have some sedation in hopes that it would be less traumatic for her.

I'm so glad we did that because the test was rather long and she had to be fairly still for the entire 20 minutes! I don't think it would have worked very well if we had done it without any sedation. The test revealed a confirmation of an enlarged right kidney, enlarged right ureter, grade 5 reflux (worst level of reflux where the urine flows back towards the kidneys instead of to the bladder. This can cause recurrent UTI's), and a ureterocele (pouch) on her bladder. Her right kidney was only working at about 25% rather than 50% so the left kidney was working harder than it normally would. In our follow up consultation with Dr. Lewis we discussed the necessary surgery to fix the abnormalities and she said depending on how her organs looked during the surgery, she might need to remove her right kidney if it was too damaged to fix.

We scheduled her surgery for early March and in the meantime kept going to feeding therapy and check ups with the pediatrician. Feeding therapy was becoming increasingly frustrating, as the therapist was now wanting to do behavioral modification in the form of rewarding Audrey with a toy when she took a bite of food. I put my foot down at that because I strongly believe that appetite and eating isn't something that should be externally controlled by another person. I write more about that here.

Her surgery went great and the urologist was able to fix the abnormalities without removing her kidney! One thing that was funny while prepping for the surgery was the anesthetists wanted to use an epidural as part of her pain management and Ryan was initially very opposed to the idea because of everything he learned about them in the Bradley Classes we took during pregnancy. I knew that this was a great method of pain control with small risks and side effects, compared to the other methods available, and I convinced him that we should do it.

Dr. Lewis was able to remove the ureterocele on her bladder and taper her right ureter, which she hoped would reduce or eliminate the reflux as well as improve the functioning of the right kidney and reduce the size. The latest ultrasounds of her kidneys show that her kidney function has increased a little bit and her kidneys are growing well. The reflux is gone and swelling of the kidney is gone. She has not had any more UTI's to date either.

During her surgery both of our parents and Ryan's sister came to support us but I really didn't want to talk to anyone. I just wanted to be alone and distracted by something else instead of sitting and worrying with everyone. So I went to the computer lab where they provide free access to the internet and printer and I printed out tons of handouts for my Bradley Class. I figured I might as well take advantage of what they offered!

Although her surgery and recovery went very well, we still had to stay in the hospital for a couple days. And that really sucked. Ryan and I both hate the hospital with a fiery passion of a thousand suns. You can read more about that here.

Going for a wagon ride a few days after surgery.

The pediatrician advised that we should consider putting in a G tube while she was already under general anesthesia for the kidney surgery. A G tube is a portal directly into her stomach for food and medications, instead of relying on the NG tube which kept getting pulled out and replaced. Both the pediatrician and the feeding therapist had concerns that the NG tube may have been impeding her progress because it can cause gagging and it's supposed to be a more temporary solution. Neither of them thought she would be off the feeding tube for many months yet. Ryan and I were both very hesitant to go the G tube and as it turned out both couldn't be scheduled at the same time until months later so we decided not to do it. That was one of the best decisions we made because a few weeks later Audrey was off the feeding tube for good!

After the surgery we switched to day tube feedings and Audrey was on several medications and supplements. I also received my order of domperidone, which is a drug that increases breast milk production as a side effect. You can read more about that here.

A few weeks after her surgery we were all getting frustrated with how much Audrey was pulling out the NG tube, both accidentally and intentionally. Both Ryan and I thought she might actually do better with eating progress if we took away the tube feedings altogether. So when Audrey pulled it out on a Thursday night we decided to try leaving it out over the weekend to see how she did. More about that here.

Although it was a very slow process, and Audrey did lost some weight initially (some of that was excess - you can clearly see on her growth chart that her weight went above her 'normal' curve) and her weight plateaued for awhile, a few months later we could say that it had been a success and we were probably in the clear! She was slowly but surely starting to gain weight on her own! You can read about that journey here, here, here, here, and here!

So that leads us to today. Where are we now? Well, Audrey is in speech therapy, which is going super well! She is a happy, energetic 2.5 year old who usually has a great appetite and no health problems! This past year she's had about 3 colds and no other illnesses. She's still nursing, mostly to fall asleep and during the night. She loves to read books, play outside, and build with blocks. Ryan went back to school last September to get his master's in Counseling Psychology and still works full time. I'm a mostly stay-at-home-mom while doing part time birth work: teaching Bradley Classes, attending births as a doula, and encapsulating placentas. In short, everything is back to 'normal,' aside from the once yearly kidney scans and the upcoming well child visit just to make sure Audrey is doing well. Although our journey was difficult and at times painful and traumatic, I can say that some good has come out of it. We are a stronger family. I really learned how to advocate for Audrey to get her what she needed despite the recommendations of the medical professionals (which are not always based on the best scientific evidence!) And we are really enjoying living a "normal" life and to see what the future brings!

What's In My Doula Bag?

I've had a couple non-birthy friends ask, "Hey, when you go to a birth as a doula (labor support person), what all do you bring? Is your car filled to the brim with gadgets?" Well I do bring quite a few things for both the client and myself, but luckily it all fits into a medium sized bag! The most important things I bring with me to births are things that cannot fit into a bag. My head, heart, and hands.

But for those of you that have asked, here's a less "hippie" answer:

 This is my doula bag! It's actually the bag for my electric breast pump but it works super great for fitting all my doula items in! It has 2 side pockets, one for my water bottle and the other I stuff my wallet and keys in because I don't want to drag my purse in to hospitals births. Especially if my clients need help carrying in their bags.

This front pouch is handy for:

Snacks and caffeinated tea! During births I need quick, easy to eat foods that will give me energy and fill me up. So I choose ones with lots of sugar (which I normally stay away from) and protein.

I also bring other food with me that doesn't stay stored in my bag, like sandwiches and fruit.

In the front pouch I also have gum and deodorant (laboring moms can be sensitive to smell), lip balm for me, comb with hair ties, and a tampon for me, just in case!

Lastly in the front pouch I bring drinking straws so she can easily stay hydrated and honey sticks in case she needs an easy boost of energy.

The main pocket of my bag contains:

A rebozo (Mexican hand woven shawl) for helping the baby reposition if needed (see here), as a comfort measure, or for use in pushing (see here). The green kneeling pad is for me, the mom, or the partner when kneeling on hard floors. The rice pack is heated and used on the lower back with counter pressure or other areas of the body. The tennis balls are also used for counter pressure on her lower back.

A ball pump in the left corner is great if the birthing balls at the birth place are too flat. My cell phone charger is a huge necessity, especially if I'm at a long birth. Tea light candles are great for giving enough light in a dim room (dim lights are preferable during birth as it helps the mom's hormones stay at an optimal level. We are mammals and mammals generally need privacy, darkness, and quiet when birthing!) The ziploc bags are for if the mom needs to vomit and there's nothing else on hand. I also use them as a cold pack with ice. Lastly here I have my essential oils that are usually used only as aromatherapy on the cotton balls and oil for massage.

This is one of the most important things I bring: my notebook and pen. I keep a list of events during the birth, such as when the client leaves for the birth place, vaginal exams, or what time she starts pushing. Then I type it up and give it to the client at our postpartum visit.

This awesome notebook also has folder pockets inside where I keep the notes from our prenatal visits, a copy of the birth plan, and my business cards.

A change of clothes for me in case I get wet from mom laboring in the water or from bodily fluids. Also very nice if I'm at a long birth and I want to just feel fresher. And a sweatshirt because hospitals can be very cold!

And lastly there is a handy pouch on the inside of the main section where I keep small items for the mom, such as:

A washcloth, comforting on her forehead or back of her neck during transition or pushing. New hair ties and hair clips for her as there's nothing more annoying than hair in your face when you're giving birth! New lip balm for mom, as women often get chapped lips when mouth breathing during labor. A "preggo pop" candy if she feels nauseated, and band aids because the last thing you want is an open wound in a hospital.

So there you have it! All my doula secrets and tools I bring with me to births! After a long winter of not attending births I have quite a few coming up and I'm looking forward to using my doula bag once again.