Sunday, June 21, 2020

Trusting in the Midst of Grief


    In the days after my miscarriage all I could think about was having another baby. I deeply felt that our family was not complete and that I did not want to end my fertility journey with this loss. I have always felt set apart from others in how intensely and for how long I have wanted to have babies. In college all I really wanted was to be a mom. I couldn't wait to finish school, get married (my husband and I have been together since high school), fully become an adult, and get pregnant. I even researched birth related topics and wrote papers for a research class.
    Once we had been married for about 6 months, I was more than ready to start our family! I started learning about the fertility cycle, how to chart your temperature and other fertility signs, and ways to naturally increase your odds of getting pregnant. Our infertility journey before we had our first daughter was long and difficult. It was the first really hard thing I had gone through in life. I had a "break" from infertility while I was pregnant and my daughter was young but I knew I wanted more children. So I had to go through the process again and this time different issues came up. After another long and difficult time, we had our second daughter.
    This third time I thought I had everything finally figured out, and indeed we did get pregnant on the first try. But a part of me was not surprised when the babies died and it turned out I have another long and hard journey ahead of me in order to (hopefully) finally get my baby. I know it doesn't necessarily work this way, but I am hoping that I have gone through that difficult part of trying to get pregnant now, which seems to happen every time, and that maybe things will go well from here.
    So this has been a really big part of my life for over 10 years. 10 years, with breaks in between, of being focused on the intense struggles of just trying to complete our family.
    I have prayed every day since my miscarriage that if I cannot or am not supposed to have another baby, that God would take this desire out of my heart and replace it with contentment. But it never wavers. It is as intense as it ever was.
    I was discussing this with a kind friend who said she believes that good, deep desires such as this do not come from us alone, but are given to us by God. So now I wonder if God has given me such an intense desire to have children because He didn't want me to give up when it got really hard.
    And it has been so very hard at times. We have a unique infertility situation where I think most people would not have decided to not try again after this 16 week loss. I think most people, if in our situation, would have accepted having two children and moved on. I can't. I really wish I could because to risk getting pregnant again is to risk another loss. But I just can't let this be the end of my story.
    So after deciding that we are not meant to be done having children yet, I had to navigate the hows. I wanted to do everything I could to prevent another miscarriage from happening. I thought that if I could figure that piece out, I would feel more confident about our chances. I also regard all life as precious and I did not want to be flippant about my babies lives. I did not want to go through more miscarriages before I decided that there was something medically wrong that I needed to address.
     I went to an OB who is well known for helping women with infertility and recurrent miscarriage and who uses NaPro technology. Essentially, NaPro can help prevent miscarriage by supplementing with bioidentical progesterone if the woman has low levels of natural progesterone. The OB thought that low progesterone may have played a role in my miscarriage. He said that the protocol at their clinic is to closely monitor HCG levels (which aren't always accurate. And I don't want to know ahead of time if my baby is "probably" going to die), lots of ultrasounds (when pressed he admitted that they are mostly for mom's peace of mind and rarely do medical decisions change because of early pregnancy ultrasound results. Basically there's little you can do to prevent a miscarriage if things don't look good on ultrasound). He also suggested to do a full clotting panel to make sure I didn't have any conditions that can cause miscarriage.
    The clotting panel showed that I have the most mild type of MTHFR - heterozygous A1298C. People with MTHFR cannot process synthetic folic acid into folate, so they have to avoid foods with added synthetic folic acid and take vitamins with natural folate instead of the typical folic acid.  Sometimes MTHFR can cause miscarriage.
    I was really surprised and distressed to learn I have MTHFR. I have no symptoms and have taken synthetic folic acid in the past. Of course I started researching MTHFR like crazy, joined several Facebook groups, read books. Most of the information I found was inconclusive at best and contradictory at worst. I tried taking this recommended form of folate called methylated folate. My anxiety was through the roof. I had trouble sleeping and just basic level functioning during the day. Severe anxiety is a side effect of methylated folate and my indecision about what to do in my next pregnancy was amplifying everything tenfold. One of the most difficult decisions for me was deciding whether to take daily low dose aspirin.
    MTHFR can cause blood clotting issues as well. The theory behind low dose aspirin is that it crosses into the placenta and prevents clots that can lead to the baby's death. I really did not feel comfortable with taking this drug during pregnancy even though I tried to convince myself it was the right thing to do. No drugs have ever been proven to be 100% safe for an unborn baby. My oldest daughter's kidney abnormalities may have been tied to an antidepressant I was on during her pregnancy. I heavily researched aspirin and found that there are several severe risks to the baby. But if I decided not to take aspirin there was the risk that another baby might die. I thought maybe having two healthy, uncomplicated pregnancies previously was just luck and that maybe I go too far down the natural route sometimes.
    The research on my specific type of MTHFR was very unhelpful. Mostly because there is very little research on it. Some experts say it is just as bad as the more extreme form, some say it has little to no effect on health. The Facebooks groups I was in were divided as well. What to do? Who to believe?
    I kept researching, did more blood work on my thyroid (another huge rabbit hole) and overall nutritional status. I consulted with other practitioners in the area, most of whom wanted to sell me their expensive services and products. I reached a point of extreme anxiety and fear. And this was what I wanted to avoid most.
    In pregnancy after loss, it is very common for women to have a lot of fear and anxiety. This is very understandable as their sense of safety has been torn away. So many women turn to more medical care during pregnancy to provide reassurance and a safety net. They have lots of testing and ultrasounds done to help them feel like everything is alright. The problem is those tests aren't always accurate and ultrasounds carry risks, one of which actually is miscarriage. And many women don't even feel relieved for long afterwards. They spend their entire pregnancies in a state of intense anxiety and fear that their baby is going to die. I do not want this for myself. I'm sure that I will have some difficult times in my next pregnancy (assuming I will get pregnant again) but I refuse to spend 9 months in agony for something that, at the end of the day, I cannot even control.
    I had a long talk with my friend Jody who asked me if maybe I was delving so deep into everything as part of my grieving process. That maybe I was trying to find out what happened and exert a sense of control over my next pregnancy that I might not be able to have. I also discussed this issue, trying to figure out whether to go a more medical route or not, with other women who decided not to go the medical route in a pregnancy after loss. I decided that I needed to make decisions that were right for me regardless of what all the "experts" said. 
    Taking aspirin during pregnancy is not right for me. Hiring an OB who is medically minded and will push lots of tests and ultrasounds, as kind and well meaning as he is, is not right for me. Taking methylated folate is not right for me. Obsessing about my thyroid not being picture perfect and making difficult lifestyle choices because of that, which may do more harm than good, is not right for me.
    Taking vitamin E instead of aspirin is right for me. Of course there's no research on this but I have seen it recommended in several places as an alternative of sorts to aspirin and it does not carry the same risks. Taking food derived folate is right for me. Hiring homebirth midwives who are trained in the NaPro technology and who can empathize with my loss and my desire to mostly avoid the medical path, is right for me. Using supplemental bioidentical progesterone is right for me. I have not found any risks to the baby with bioidentical progesterone and I do have some indications that low progesterone might be an issue for me - specifically that I have a short luteal phase. So I am not against all interventions, but I am against the ones that carry risks and increase anxiety without any clear benefits.
    I had to come back to the place of trusting my body, trusting my baby, and trusting pregnancy and birth. Trusting the process, as it has been so exquisitely designed by God, has always deeply resonated with me. My pregnancies and births have been such amazing and indescribable spiritual journeys instead of medical procedures. I will always be grateful for the gift of that insight. Trying to go against that was causing me intense anxiety and distress and I needed to lean back into what God has shown me to be true.
    This entire experience has been a time of tremendous spiritual growth. I have reacted so differently to this situation than I have reacted to negative situations in the past. Normally I get very angry at God and blame Him for not intervening, and then push Him away. This time I have really leaned, so deep, into my faith. I wonder if that is what He is using this terrible experience for. To teach me to trust in Him more, to lean on Him more. To trust that if another baby is meant to be, she will be. And to trust that if another baby is not meant to be, that I will be ok.
    This all sounded so cliche to me in the past. It really resonates with me now. And most days I feel much more peace than anxiety. I am still mourning for my babies. I don't think that will ever really "go away." I still have my moments of doubt. But now instead of feeling overwhelming hopelessness I feel hopeful.

Saturday, March 28, 2020

The Birth Story of Cedric John and Celeste Star: Born into Heaven at 16 weeks

This is such a hard story to write. Just like most people, I never thought I would be in this situation and it still feels surreal. I'm writing this 72 hours after it first started. It feels like so long ago but also like such a short time has passed. I have found a lot of contradictory feelings during this whole process. The most prominent one being that while I am so sad my babies are not here on earth with us, I am also so relieved and happy that they are in Heaven with Jesus. They never knew anything except my warmth and my love. And now they know nothing except the perfect love of God. I know I will see them again when I go to Heaven and that does bring me comfort and joy.

I have suffered a lot with infertility, the difficult birth of my first daughter, serious medical problems when she was a year old, infertility again, and now the loss of my twins. Some people have said it seems especially unfair that we should have to suffer this burden after everything else we've gone through. Strangely, I do not feel angry with God like I did when we went through infertility. I do not feel outrage at our circumstances and the unfairness of life after the fall of man. I feel sadness yes, but also peace. Maybe the anger will come in time.

I had felt like this pregnancy would be my last for many reasons. Trying to get pregnant has always been a horrible and difficult time emotionally. This time I saw a therapist, which helped, but it was still very hard. We were so blessed to get pregnant on the first try (previously it took 2 years and 1 year) and we found out on Christmas Day. Everyone was very excited, including our daughters Audrey (7) and Deidre (3).

First trimester was unbelievably difficult. I had morning sickness in my previous two pregnancies, but it was fairly manageable. This time it felt like I was run over by a truck while on a wildly rocking boat. Both the nausea and fatigue were unreal. I was basically bedridden during February. Sleeping was great because it provided some relief. I tried lots of natural remedies and finally resorted to a half dose of the B6 and Unisom combo. That helped take the edge off enough so I wasn't throwing up several times a day. For me to even consider using pharmaceutical drugs meant I was really desperate. I usually don't take anything unless I'm dying, especially in pregnancy. My oldest daughter had kidney defects which were possibly due to an antidepressant I was on during her pregnancy.

I was really worried that extreme nausea would last the entire pregnancy and I didn't know if I could do it. It felt like I was in the transition phase of labor where you say "I can't do this anymore!" And then the baby comes out.

This experience further convinced me that this was our last baby. I really never wanted to go through the emotional and physical experiences of trying to get pregnant or first trimester again. I was so miserable that I regretted getting pregnant, and then I felt guilty about that. I didn't blame my baby but was mad at my body for reacting this way to the hormones.

Since I was having such extreme symptoms I had absolutely no worries about how the baby was doing. I felt like my body was falling apart but that baby was healthy and thriving. Morning sickness is usually a sign of a healthy pregnancy. Normally during pregnancy I have a little anxiety about loss because I know how common it is in the first trimester. But this time I was completely at peace. I did suspect twins but I also knew that the extreme symptoms might mean an opposite gender baby than I've carried before (boy) or could simply be a fluke.

I normally choose not to have any routine prenatal ultrasounds or blood tests to check on hormone levels. I've done a lot of research over the years on these, and other, pregnancy and birth choices and know that they are not risk free. I also feel strongly about tuning into my body and my baby during pregnancy instead of relying solely on what outside experts say, especially those who are not on the same page about birth. Now I kind of wish I had done an early ultrasound, just so we would have had the joy of knowing about both babies while they were alive, instead of just the sadness of finding out after. But we don't know when the absorbed twin passed so ultrasound may not have seen her anyways.

At just after 13 weeks I finally started to feel better. I was so excited to get past the worst part of pregnancy and into the fun part where I would start to look pregnant and feel my baby moving. I did start feeling movement around this time as well, very subtle and not everyday, just like you would expect. My energy and appetite quickly returned and I focused on following the Brewer's Diet and getting some gentle exercise while also resting plenty.


15 weeks and 2 days

I also measured my fundal height for fun and noticed that I was measuring a few weeks ahead. Normally I measure small so I thought this was interesting. I knew that fundal height isn't always very accurate and that there are lots of reasons for measuring large, especially for a third pregnancy. I never had a super strong feeling that it was twins but it was always in the back of my mind. I have always wanted twins, and thought it would be awesome to "break twin myths" as I would most likely birth my twins at home full term, nurse them exclusively and for years, etc.

My two favorite experiences of this pregnancy were hearing Cedric kick the fetoscope and when Ryan felt the baby moving. I was right at 16 weeks when I decided to use my fetoscope for fun to see if I could hear anything yet. Usually 16 weeks is too early but it can be possible to hear a heartbeat. I did not hear my placenta (I figured it was posterior since I had been feeling movement almost everyday) and I did not hear a heartbeat. But I did hear thumps several times that were not consistent like my own heart beat and did not sound like my intestines or other bodily noises. Now, I'm no expert with using the fetoscope by any means - it does take a lot of skill and practice to use correctly. I've only used it during my pregnancy with Deidre. But I do think those thumps were Cedric kicking at the fetoscope.

A few nights later Ryan and I were watching Third Rock From the Sun and relaxing. I felt a LOT of movement both inside and out. Still very subtle, but very much there. Ryan came and felt very patiently and he was able to feel it too! It was a really nice moment to have together.

Two mornings after that on Tuesday, when I was 16 weeks and 4 days, I was half awake at 7:30 am and having weird dreams. I kept half waking up due to strong braxton hicks. I had been feeling braxton hicks off and on since early pregnancy and knew this can be normal for a third pregnancy so I wasn't very worried. I thought "when I wake up I'll drink a lot of water and take an epsom salt bath and they should go away." Then I felt my water break. I woke up Ryan saying "Ryan. My water broke." I did not feel an immediate sense of despair but felt calm, detached, and like I was still in a dream. I think I knew deep down at this point that the babies had already passed away. Ryan immediately jumped out of bed and cried out "No! Nooo!" I told him to be careful not to wake up the girls but it was too late. 

I had him call Jody (friend and across the street neighbor) and I called the midwife. Jody took the girls to her house where her husband and older children would watch them and she came back. My midwife called back and started the very difficult conversation of what to do next. She said that the risk of postpartum hemorrhage is higher with a second trimester loss and that attending this type of birth at home was out of her scope. I was absolutely devastated at the idea of a hospital birth. I have very strong beliefs about birth and both of my girls were born at home. I also knew that we would be lucky to find a hospital that would even let Ryan in with me because of the Covid-19 pandemic. My last concern was having the baby taken away from me. My friend had gone through a second trimester loss a few years previously and she said the hospital would not let her bring her baby home. This was of utmost importance to me, also because I wanted my girls to see and hold the baby. The midwife said she would call around to hospitals and see what they said about these things. 

I started writing a birth plan and Ryan packed a bag for me. We called our immediate families to let them know what was going on. My mom literally dropped everything and hopped on a plane from Florida to come up and support us. The midwife called back and said she had talked to the charge nurse at a local hospital. The nurse said I could absolutely have Ryan with me and I could take my baby home. I started to feel better about a hospital birth and I started to think I might want induction and pain medications. Induction because I didn't want to wait for labor to start naturally. With a loss it can take weeks and even months sometimes. I am completely patient when I get to full term with a live baby, because I believe only they know when they are fully developed and ready to be born. But with a miscarriage I did not want to have to wait days or weeks to birth them. I also had concerns about a complete shut down of the state and how that might affect our options for having Ryan in the hospital or having a funeral.

I thought about an epidural because I had read about other people's late miscarriages and stillbirths and they had said it was like real labor physically and harder emotionally. My first birth was 68 hours long and my second was short but intense so I knew all about real labor. I have no doubt in my ability to naturally labor and birth a live term baby, but I didn't know if I could do a real labor when I was going to birth a dead baby. Natural birth is usually intense and hard work - and you are doing it mostly for the amazing experience of meeting your baby without hindrance and with the intense euphoria from oxytocin (which your body does not have with pitocin or pain medications). It's also a spiritual experience for me and in the hospital birth becomes more of a medical experience that is very different. Another big reason I birth naturally is because of the risks of interventions to the baby. But none of that applied in this situation except for the spiritual experience. But I wasn't sure if that outweighed the drawbacks of the physical and emotional pain I thought I would experience.

I was crying and feeling like I was betraying my principles and all that I stood for, even talking about wanting an induction and epidural. I felt very conflicted on what to do and went back and forth about what I thought I wanted. I also had a lot of hesitation about doing this unassisted at home, without a midwife present, and having to possibly manage excessive bleeding on my own with Ryan's and Jody's help.

Jody reminded me that we didn't even know if the baby had for sure passed yet. She knew women who had their waters break about the same time but the baby was fine, so they were on strict bed rest for the rest of the pregnancy and their babies were born close to term. Regardless of viability at this stage. there is no way I would ever consent to inducing labor if my baby was still alive. I would not kill my baby for any reason. So the next step was to have an ultrasound and get more information before deciding anything about birth place.

First I had a a swab test done to see if it was really my amniotic sac that had broken and not urine, discharge, or fluid from a subchorionic hematoma. The test, which is fairly accurate, was negative for amniotic fluid. I know that the fluid I had was not urine or discharge. It was a substantial amount of fluid, crystal clear, and did not smell like urine.

They tried to find a heartbeat with the doppler but could only hear mine. This can be normal at 16 weeks. We then waited for an ultrasound which would tell us definitively if the baby had passed or not.
I was very clear with the ultrasound technician that we were literally only doing an ultrasound to see if the baby was still alive. I wanted and needed no other measurements and I normally do no ultrasounds during pregnancy. She said that she was required to do xyz measurements. Fine, whatever, I'm not going to fight with you.

I could see Cedric right away and he wasn't moving and I knew. I'm no expert on ultrasound, but as far as I know 16 week old babies don't act completely unresponsive when they have the high frequency sound waves shot at them. The tech didn't say much and she did all her measurements. I still was holding onto some hope. I asked her if she had seen any movement and she said no. Then she checked for a heart beat and there was none. All remaining hope instantly shattered.

The tech was very kind. She said everything looked structurally normal with the baby, the placenta looked normal and was posterior, the amniotic sac was intact and had plenty of fluid, there was no hematoma that she could see. I know that in many cases there are no medical explanations for miscarriage so that didn't surprise me. She did say that he was measuring at only 13 weeks and 6 days and that he had for sure passed then. I don't believe that. For one thing, many times babies will shrink when their heart stops. I also tend to grow "smaller" babies. I would think it's pretty normal for some babies to be smaller than others even at the beginning of pregnancy just like they are at birth. Also, when Cedric was born he did not look like he had died weeks before and his genitals were fairly prominent. At 13 weeks it's often difficult to tell gender. Even though Cedric only measured 3 inches from crown to rump, if I believe he died at 13 weeks that means I didn't have any positive experiences of pregnancy and I was sick the whole time. It means I didn't feel him moving. Ryan didn't feel him moving. And I didn't hear him kicking the fetoscope. I don't think I can go there.

So after this I wanted to go home and think about what I wanted to do. Our options were: wait for labor to start, cytotec induction at home, cytotec induction at the hospital with lots of cytotec that might end up in a D&C, or nonmedical induction at home. I really did not want the possibility of a D&C. I was not about to let a doctor that probably performed abortions cut my baby into pieces. I did not feel very comfortable with doing cytotec at home. Cytotec can be dangerous and cause longer, stronger, and more intense contractions than natural contractions. I was also still concerned about postpartum hemorrhage. Jody and I collectively knew friends and family who had had second trimester births and did not hemorrhage. The ones who did started labor naturally also said that it was not as hard as term labor.

I'm going to pause for a moment and talk about how Jody was absolutely amazing as a resource and support for me. I suppose she acted as doula but she is also my very good friend and I could not have done this without her. She helped with so many things during this entire process, both concrete practical things like supplies and researching and thinking through all my options, but also the emotional support and empathy. She is my rock. No one should have to go through a loss without a Jody.

By now it was late afternoon. I decided to wait and try any induction until the next day and see if my body would go into labor naturally during the night. I still had some cramping and bleeding but not much. I called our priest to ask about a funeral service and if we could bury the baby in the memorial garden at our church. She expressed her sympathy and said that will be fine and to keep her updated about when we want the service. Jody went with me to Hobby Lobby where we got a small box to bury the baby in, cloth to wrap his body in, and a garden stone for a grave marker. (We will get an engraved stone with their names and birth date later.)

When we got back the girls came home and we told them the baby had died. That was almost worse than finding out ourselves. They were both very excited about the baby and Audrey had said beforehand that she was worried about the baby dying. She cried so much when we told them. Ryan and I cried too. It is really hard to see your child in so much emotional pain over a really big thing. This was their first experience with death.

We told them that the baby had died and was in Heaven with Jesus. That the baby's body was still inside me and after he was born we would get to see and hold the baby's body, but that the baby himself was not here on Earth anymore. We didn't know why the baby had died. Most babies live but sometimes they don't and it is very sad. We will always love and remember the baby and he will live in our hearts. And we will see him again when we go to Heaven. Deidre said, "I want our baby to be alive."

Ryan's parents brought dinner and my cousin brought my mom from the airport so with all the people around I figured that my body was not going to do anything much for a while. (I did keep aware of any signs of infection during this entire process.) I felt very conflicted about lots of things. I wanted pain medication but also to do it naturally. I wanted to induce in some form but was afraid of labor. I wanted to be alone but also be with people. I wanted to give birth as soon as possible but also did not want to let my baby go. I would feel "okay" about everything and then totally devastated.

People left and we finally went to bed and I lay there for hours unable to sleep. My brain would not shut off and I was having stronger cramping and a bit more bleeding. I was so tired but it was more of an emotional tired than a physical one. I finally fell asleep around 3 am but woke every hour until 7 when the girls got up.

I thought and prayed about what to do, as I had been during the night. Since I was still having some cramping and bleeding I figured my body was close to doing this on its own and only needed a little push (or patience). With all my now available options, the risk of being pushed into a D&C at the hospital, and not wanting this process to drag out for days, I felt like I was only left with one good choice: herbal induction. I was very mad that because my baby "only" measured 13 weeks I was probably "not eligible" for a hospital birth that would include more induction options, pain medication besides IV narcotics, or nurses trained in loss like I would be if the baby had measured only a few weeks older. I was mad that they would offer to cut up your baby via D&C or send women home with cytotec to do this on their own, especially women who don't know about natural birth or who don't want one. But in hindsight I'm very happy with choosing to stay home.

Jody went to an herbal store in the cities when it opened at 10 and got blue and black cohosh, as well as yarrow and shepherd's purse tinctures to help with bleeding afterwards. I felt like this was the right choice for me and I wanted it to be over with already, but I also didn't want to let my baby go and I was afraid of the emotional and physical pain. So much fear during this entire process. I have never had so much fear before giving birth. I took pulsatilla to help with decision making and shortly afterwards felt ready to start the induction.

I have never thought I would induce myself because I am so comfortable with waiting until my baby is ready to be born, so it was weird to be doing this. I started the induction around 11:30 am. I held each tincture under my tongue before swallowing. It stung so much! I Around 1:30 pm I was finished with the induction. I felt very tired and wanted to go lie down alone in the bedroom. My mom had taken the girls out as planned. I wanted them to hold and see the baby if they wanted to after the birth but I didn't want them around during what I thought would be a difficult and painful birth, emotionally and physically. Ryan went downstairs and Jody went home.

I was unable to sleep so I watched The Office in my dark bedroom. I love The Office and had been saving it to rewatch during my babymoon. It didn't make me sad to watch it without my baby but I really enjoyed the comedic relief and it felt right to watch it now. I was having what I would describe as strong early labor contractions but there was no break - it was constant. I thought ok, this is early labor then. I was bleeding a bit more but not much. I did tell my baby that it was ok. That he could come out now. That we would both be ok.

After about an hour my eyes were getting really tired so I put on music instead. I started drifting off to sleep a bit despite the continued strong cramping. It still felt like easy early labor and I figured I had awhile to go yet. It was very peaceful to be laboring alone in my bedroom. I had always visualized birthing this baby in my bedroom. Deidre was born in the bedroom of our old house and it was very nice and had a sense of privacy and safety that the other parts of the house don't.  I also labored alone with Deidre for most of labor and I really liked that.

I started feeling like the contractions were getting lighter. Sometimes herbal inductions can take hours to start working. I texted Jody that they were getting lighter and she suggested resting and waiting, going on a walk later, or trying clary sage oil or sepia homeopathy. I got the clary sage and started smelling it. Then my water broke (felt exactly the same as when I thought it had broken on Tuesday morning). I waited for the contraction to ease a bit and I got up to make sure it was my waters and not a lot of bleeding. As I stood up the baby slipped right out! I was SO surprised! I couldn't believe that labor was already over and it was SO easy! He was born at 3:40 pm on Wednesday, March 25th, 2020.

The baby slipped from my pad to my pants leg and I called out "HELP!" because my mom and Ryan were both downstairs. Ryan came in and helped me take my pants off and mom came in shortly after. I asked them to call Jody to come. She gave me a lot of practical support during third stage and took many wonderful pictures at my request.

I saw my beautiful, perfect son on my right thigh and I laid down on the bed holding him to my leg. "Oh! Look at him!" I cried. I thought his skin might be red but it was a light beige color. He felt very smooth and squishy. I was worried about him falling apart if I touched him but Ryan reminded me that he wouldn't. His bones were still cartilage and very flexible. He had all 10 fingers and toes, little eyes covered by little eyelids, a mouth that would open and close, a definite penis, and such a tiny, sweet umbilical cord. I laid him on a small square of blue cloth that I had chosen at Hobby Lobby. Blue for my favorite color, not because I knew he was a boy.







I felt SO much relief that he was born and that it was "over." I felt the adrenaline and oxytocin rush after a natural birth where are you so relieved and happy that you did it. And also sad that it was over and he was out, but then so much relief that I was done and had rocked it.

I was bleeding and was worried it was too much. Jody and Ryan looked and said it was not that much but I wanted to stay on top of it with the tinctures so I took those every 15 minutes.

During this the girls were watching tv. Audrey saw my mom and Ryan rushing to the room and knew the baby had been born. I said I wanted them to come in if they wanted to. Audrey wanted to see the baby but was understandably a bit squeamish about touching him or getting too close. 

Deidre really wanted to see the baby and said "Wow!" She wanted to touch him, and we let her gently touch him. They didn't ask questions about him being dead and seemed to understand. Deidre had a lot of questions about my bleeding as he was still on my thigh. I pointed out his tiny arms and legs, fingers and toes. 




I wanted to leave the umbilical cord intact. I had been contemplating a lotus birth already (not cutting the cord at all and waiting for it to naturally detach at the umbilicus) and that felt right. Unfortunately when I passed what I thought was the placenta but ended up being a large clot, it was stuck around the cord and as we pulled that away the cord broke.

The first placenta came out. It was a perfect, beautiful round circle with the cord attached right in the middle. A smooth side with the "tree of life" veins and a rough side that had been attached to my uterus. It was completely whole and the size of my palm.


3 minutes later the second placenta came out. It definitely wasn't a clot and also would not have fit into the other placenta at all. We could see a yellow area near the edge, which looked very different from the other placental tissue. Comparing to photos online we realized that this was the twin. 2 placentas, extreme morning sickness and fatigue, fundal height measuring high (I had checked it again right at 16 weeks and I measured 20 weeks), intuition. Twins. This baby had passed away much earlier and was absorbed into her placenta, but she was there. A human being with a unique, unrepeatable set of DNA even if she didn't look like a baby at this point.


It is really hard to tell in this picture, but Celeste is on the top right of this placenta.

Ryan and mom held Cedric and then Jody measured him, arranged his body and cord, and took more pictures.








This bunting was knitted by a dear friend for our baby

Ryan rubbed his body with oil to help preserve him. There was an option to put him in a saline solution to help preserve his body but neither one of us wanted to do that. We put him in the bunting and that into the box and slept with the box that night. Before we went to bed we picked out names. I liked Celeste because it means heavenly. Ryan chose Star for her middle name. I have always liked the name Cedric for a boy so we chose that and John was Ryan's grandpa. Cedric John for our big boy baby and Celeste Star for our absorbed twin.



This was taken about 6 hours after birth and you can see the cord is already completely dried out and that his body is starting to dry out too 

During this process Ryan had asked me a few times what I thought I would feel most at peace with afterwards, regarding home or hospital, induction or not. At first I thought I wouldn't care afterwards what birth place or process I had chosen, but he was right. I am so glad I choose what I did and that I stayed home. I believe everything went exactly as it needed to and I had all the right support during the entire process. And mostly I feel so grateful that the herbal induction worked. I am so grateful that I did not choose to go to the hospital because if I had ended up with a D&C we never would have known about Celeste. In the aftermath I can say that I am very happy with my second trimester birth experience. It wasn't necessarily a happy experience but it was empowering and wonderful in its own way.

I slept better that night than I had the night before but I had a lot of trouble falling asleep. I felt more peaceful and more relief but I also cried a lot. I didn't want to part from them the next day but I also wanted it all to be over. I listened to the song 21 Years by TobyMac and cried a lot more.

The funeral was set for the next day, Thursday, at 3:30 pm. I spent the morning making the program with Jody (yet another thing I hadn't even thought of that she reminded me of!) and making last minute funeral arrangements. There was concern that it might not be legal to bury the babies and placentas in the memorial garden at our church. I did find a back up church where my friend had buried her younger than 20 weeks old baby. State law does not recognize babies born before 20 weeks as people so there are no laws regarding their burial. That made me angry because I knew it had to do with abortion but it also made the process easier for us as we didn't have any paperwork from a hospital or funeral home since this was a homebirth. Thankfully it worked out and we were able to bury the babies as planned at our church.

It was odd to feel postpartum, but yet not really postpartum like you are with a live baby. I have healed very quickly compared to my other births and bled much less. My abdomen is nearly back to it's pre-pregnancy state already. I suppose I also have the feeling of "postpartum but not" because I'm not nursing and sleeping with a baby. Even though it feels like it's "not really" postpartum, I know it is. I still gave birth to 2 babies. I still have 2 placental sites in my uterus to heal. I still have some of the same postpartum hormones. But as far as experiences go this feels more like my first trimester, where I laid in bed because I was too sick to get up. That was difficult physically and emotionally while postpartum with a live baby is usually such a happy, wonderful time.

Ryan and I have also discussed how this experience is actually easier in some ways than infertility was. Infertility drags on and on. You have no closure. It is a slow burn and there is a lot of uncertainty about what will happen. If you will ever get pregnant. Having babies die is a huge, intense shock, but you have closure. You are not left in lingo, uncertain about what will happen. Because it has already happened and you can fully grieve about the past without also having your eyes on the future.

People also understand this type of grief more. And maybe it was because I was 16 weeks compared to very early in pregnancy. People don't always understand why you would be so devastated while going through infertility. They don't know the cycle of great hope and then despair that you go through every month. And the long, long moments of slow painful waiting to see if this is the month that "worked."

The previous night Ryan had told the girls that we found out it was actually twins. Deidre didn't really understand since there was only one body that was visibly a baby but Audrey did understand. She made a little card for them and put a beaded bunny for the Cedric and a bead for Celeste into the box. She had a lot of questions for me about heaven that I tried to answer the best I could. Such as: will they play with their toys? Is everyone in heaven naked? Is heaven in the clouds? How do you not fall through the clouds?

It was nice having the girls around, doing cute things and snuggling with us. The house would have felt so lonely and sad if I didn't have other children playing in the background, asking me questions, and cuddling in bed with me. I have always been so grateful for my daughters, but I feel especially grateful now that God has blessed me with them.



Right before we left for the funeral, we had to put the lid on the box. That was very difficult for Ryan and I. Audrey said goodbye and watched us shut the box. Deidre was upset that we had put the lid on and wanted to open it.

The funeral service was lovely. Our immediate families and close friends attended. The hardest part of course was having to give up the box to Ryan to put into the grave. And Audrey sobbing as Ryan cried during the speech he gave.












"Is it just across the Jordan?
Or a city in the stars?
Are you singing with the Angels?
Are you happy where you are?
Well until this show is over
And you run into my arms
God has you in Heaven
But I have you in my Heart"

- 21 Years by TobyMac

Friday, December 7, 2018

Nursing in Public Etiquette - Toddler Edition

Hey, fellow toddlers! I'm a 2 year old expert nurser who's hobbies include: running around naked in the winter, nursing, painting on my arms, and nursing. I've seen some really bad nursing etiquette in public lately. While it's completely fine to put your toes in your Mom's eyeballs in your own home, you should observe some decency out in the public eye.

Rule #1: Body Position.

It's most comfortable for your Mom if you cuddle up nicely on her lap. I know it's more comfortable for us to stand and jiggle our butts in the air to the beat of 'Jingle Bells' but apparently that draws too much attention.


Looks like groovy dance moves but keep it to the privacy of your own home.





This position is better but difficult to maintain for more than 40 minutes.


Rule #3: Feet Stay Down.

Moms have this weird thing about what our feet are doing. You should leave them down next to her side, preferably holding them still. Kicking frantically, holding your toes in your hand, or putting them in your Mom's mouth is rude.


Mom doesn't look very happy here. Put your foot down, dude!


Rule #4: Deep Latch.

Getting red teeth indents on your boob is fairly unpleasant. So is popping on and off. Just commit to either nursing for awhile or pouring Dad's full glass of water onto the cat. Don't try to multitask. For the best latch open wide and aim the nipple towards the roof of your mouth. And don't forget Rule #1 too! Otherwise your teeth will slide down onto the nipple while you're trying to twist your body to see what's on TV.


In my defense, they decided to play 'Frosty the Snowman' right in the middle of my very important, 30 minute nursing session.


Rule #5: For the Love of God, Stop the Nipple Twiddling!

Mom said this should be a rule for all the time and not just in public. I disagree, but to each their own. It's also frowned upon to have both boobs out of the shirt at once or even to just dig into her shirt to pull the other boob out.


Since my Mom is a bad photographer it's hard to tell but I am twiddling the free nipple here. I prefer to nurse with both boobs out at once, a nursing style I refer to as "Boobie Bongos."


Rule #6: Leave the Hungry Toys At Home.

It's so cute to have Mom pretend to nurse your toys! But screaming "Mommy, nurse Unicorn!" in the grocery store gets a lot of looks. Especially when combined with pulling the other boob out of her shirt. So leave the temptation at home and focus on chucking food out of the grocery cart instead.



Here's an example of great NIP etiquette. You can tell because the man behind us is asleep instead of being really concerned that he was subjected to the horrific act of public lactation. It's just a coincidence that I'm asleep here. I can totally nurse this nicely even while awake!

Good luck everyone! And remember, rules were meant to be broken!

Wednesday, November 14, 2018

Revising Tongue and Lip Ties: An Ethical Consideration

Tongue tie or ankyloglossia is a condition present at birth. It is generally defined as "a short, tight band of tissue tethering the tongue's tip to the floor of the mouth. It can affect how the child eats and speaks and can interfere with breastfeeding." (Mayo Clinic).




An upper lip tie is also present at birth and is generally defined as: the labial frenulum being short, tight, and restrictive. Like tongue ties, lip ties can potentially affect eating, speaking, and breastfeeding.

Awareness surrounding this issue has grown exponentially in the last few years, especially in breastfeeding and alternative health support groups and communities. When women ask for breastfeeding help on social networking sites such as Facebook others almost unanimously ask if the baby has been checked for a lip or tongue tie. Some people will ask for a photo in order to diagnose a tie. Parents are urged to have these ties cut or "revised" at the earliest opportunity, not only to ensure breastfeeding success but also because leaving the tie intact is said to cause a myriad of short and long term health problems.

Following is a list of some of the issues said to be caused by ties that are not revised: colic, reflux, breastfeeding problems (shallow latch, mastitis, misshapen nipples, nipple pain and damage, clicking sound, oversupply/undersupply, unusual nursing patterns), slow weight gain, carseat discomfort, tooth decay, gaps between teeth, orthodontics required, high palate, sleep apnea, snoring, speech delay or difficulties, facial tension, headaches, mouth breathing, difficulty eating solids, food, intolerances, ADHD, autism, and more. Many of these claims are anecdotal at best and these issues may be caused by multiple things. Even if the mother reports no breastfeeding issues: no pain or sore nipples, ample milk supply, baby is gaining weight well, she is strongly advised to have the tie revised in order to prevent possible future breastfeeding problems or other health problems in the child. Revising ties is also commonly advised for older children and adults regardless of if they are currently experiencing problems from it. But in the absence of a clearly defined current medical need, does cutting a tie more closely resemble cosmetic surgery?

The two main ways to revise ties are by scissors or laser. The exact procedure can vary and varying amounts of pain medication may be used depending upon the practitioner. As with many other procedures, it is generally recommended to revise ties as soon as possible in order to breastfeed successfully, prevent future problems, and to have a minimal impact on the child. Newborns are thought to recover faster and to feel pain less than older babies and children as they don't always react in the way a parent might expect. Recent research suggests that "infants not only feel pain the way adults do, but also that they have a lower pain threshold." (https://www.huffingtonpost.com/2015/04/23/babies-pain_n_7117812.html)

Anecdotal reports of newborns who have a tie revised show that the recovery sometimes takes longer than expected. Many parents report that their baby will not readily latch on to breastfeed after a tie revision and that they are fussy and seem to be in pain for hours and sometimes even days afterwards. Some mothers report that their babies go on a 'nursing strike,' refusing to breastfeed and screaming when breastfeeding is attempted. Refusing a pacifier and bottle is also common. Some babies reportedly never breastfeed again even when the mother seeks help from a lactation consultant. Post surgical stretches (such as here: https://www.drghaheri.com/aftercare/) are often recommended for months after the procedure so the tissues do not reattach. Manipulating the wound site is likely to be painful for the baby and may lead to further oral aversions.

Most experts agree that revision is warranted in cases where the tie is very severe, the baby clearly cannot breastfeed well, and the mother is struggling with sore nipples due to a poor latch caused by the tie. Usually a recommendation to revise the tie is suggested by a provider, such as a pediatrician, dentist, or lactation consultant, after a visual exam of the baby's mouth. Some providers will also observe the breastfeeding dyad during a nursing session in order to see how the baby is able to function rather than routinely advising revision for all ties.

(Such as suggested by these IBCLC's:
http://mammaeblog.blogspot.com/2015/06/a-tongue-frenulum-vs-tongue-tie.html
http://www.theboobgeek.com/blog/tongue-tie.html
https://www.breastfeedingbasics.com/articles/tongue-tie)

It should also be noted that there is currently no standard of protocol for tie assessment or even a universally agreed upon definition of what constitutes a tie.

Amidst all the controversy, there is one question that is rarely being asked. If a tongue or lip tie is causing no current problems for the baby or the mother: baby is breastfeeding well, gaining weight well, and the mother is reporting no latching problems due to the tie, is it necessary to cut it? What about the option of waiting until, or even if, the ties do cause problems and revising it then? And if the breastfeeding dyad is experiencing nursing difficulties, what about first putting time and money into a consultation with an IBCLC who may be able to offer non-surgical solutions?

Is it ethical to perform a likely painful, prophylactic surgery on a newborn in order to prevent things that have not been proven in research to be caused by ties?


Saturday, September 1, 2018

Moving Across the Street From Your Best Friend: A How To Manual

1) Have a friend who you want to live by.



2) Have your friend constantly ask the neighbors if they are moving so she can inform you immediately about any new houses that may or may not be up for sale in the next few weeks or years.

3) Convince your husband that he really does want to mow a lawn, shovel snow, and live in a less desirable city than you currently do. This may require a bribe of beer, steak, and lobster.



4) Contact a real estate agent. They will show up unannounced at the potential house and ask "Hey, are you selling your house? I have someone who wants to buy it! Oh, but they want to poke around inside first!"

5) Get a pre-approval letter for financing from your bank. Unfortunately, most sellers will not take a loud, brown dog in place of actual money.




6) Go to an unofficial showing of the potential house. Fall in love with it and loudly declare to your skeptical husband that if you don't get this house that is across the street from your best friend, you will die of a broken heart.

7) Put an offer on the house, which they will immediately decline because it is contingent on the sale of your townhouse. Fall into a deep, devastating depression while your husband is furious that they dared to refuse your offer.

8) Convince your husband that he really does want to buy this house. In fact, he wants to buy it so much that he should sell your current house first so then you can come back to the sellers with an offer that is not contingent. Remind him that even if this plan doesn't work out, as a former case manager he knows all the best homeless shelters in the area.

9) Have your parents coincidentally visit during this time so they can help you paint, fix things, and get your house ready to show. This is actually the ideal vacation during the retirement years!

                           


                                        


10) Your realtor will then call you with a last minute, unofficial showing. You are on a timeline because the house you want will be going live on the MLS in a few days. You are hoping to get it before that. since it's a seller's market. Put the kids in front of the TV while you and your mom dash around like mice on caffeine to clean and stage the house.


The correct way to stage your house.



The incorrect way.

11) Do the same thing the next day for another unofficial showing and the photographer. Make sure to bring your dog with you when you leave since he will bark ferociously otherwise. Look online for restaurants with a patio that allows dogs since it's already past dinnertime and everyone is starving and crabby. Drive all the way to the restaurant and be told that no, they in fact do not allow dogs. Repeat with another restaurant. Amidst the screaming and crying, give up and get fast food for the third day in a row.

12) Sell your house after only two showings the morning before it officially goes live on the MLS. Now you have about two business days before the house you want goes live. Send in your new offer and pray, pray, pray. Chocolate, wine, and binge watching season six of Orange is the New Black will help during this step.



13) Hear back after a few very strained days that.... You Got the House!!




14) Feel relieved and excited! Everything is working out and all the stress is gone!

15) Inspection and appraisal on both houses, solidify your financing, get boxes, get rid of stuff you don't want and be thankful that you've already done most of that since becoming a minimalist, pack, rent the moving truck, make arrangements for your dog and children during the move, get friends and family to help you move, change your utilities, change your address, prepare your children emotionally for the move, cry about leaving the house your girls were born in, what happened to no more stress??








Monday, April 16, 2018

How to fit 6 Days of Vacation into 2 Backpacks and 1 Baby Carrier



My parents were fortunate to retire young and move to Florida. I am even more fortunate to visit them and have done so four times in the four years they've been there. And every time I go I pack less stuff!

The first time we visited Audrey was two and we brought: one very large suitcase that we checked, two carry on's, and one personal item each. Since we had so much room I thought it would make sense to bring a lot of toys and books (kids get bored without lots of toys!), two outfits for each day (toddlers are messy!), and all the cloth diapers (I'll definitely want to spend time washing and drying diapers on my vacation!).

It turned out that grandma had a box of toys and books for her (plus we were so busy doing things we didn't have a lot of down time at their house), I needed to do laundry anyways so the extra clothes were unnecessary, and spending a week in disposable diapers would have saved time and stress (not to mention that a poopy cloth diaper is not fun to haul around all day at the beach).

Thankfully each trip I cut down on the amount of stuff we brought. My natural inclination is to over pack, especially when traveling with our young girls. This last trip was a spur of the moment decision because I found a really good deal on tickets. But we were flying on Spirit airlines, which only allows one personal item for free. Since I didn't really want to pay to bring stuff that I might not even use, I had to reconsider what I had packed in the past and only bring what was truly necessary.

Here's what we packed in our backpacks:





The girls clothes. Each girl had 3 outfits, pjs, swimsuit, sun hat, 3 pairs of underwear for Audrey, and enough diapers to last the travel day for Deidre. Grandma had diapers for us at her house but if we were going to a hotel I would still buy diapers at our destination instead of bringing them with.





My clothes: 3 outfits, pjs, swimsuit, sunhat, 3 pairs of underwear, and bra. Since we only packed 3 days worth of clothes I did laundry once. If we were at a hotel I would still plan on dong laundry even if that meant I had to hand wash our clothes.
Also pictured is my wallet and our vitamins, toothbrushes, comb, and a few hair ties. My mom provides shampoo, conditioner, toothpaste, deodorant, and sunscreen (we are low maintenance). If we were staying at a hotel I would use what is provided there or buy it. It's not worth the hassle bringing liquids through TSA when you're wrangling two kids by yourself!





Here's what we brought for entertainment on the plane (if Deidre was a bit older we could get away with a fraction of this stuff! But she has a typical attention span for a 17 month old). Our in flight entertainment included: kids magazine, 3 thin books, folding felt board and felt shapes, memory game, lacing animals, 2 coloring books, twistable crayons (great for travel!) and stickers, finger puppets, sunglasses, beaded necklaces, Audrey's tablet and headphones and charger, my headphones, and my book. (This is a GREAT book by the way! And every time Deidre sees it she says "BOO-BEE! BA-BEE!" ðŸ’“) Not pictured is my phone which I used to take this picture.






For travel outfits we wore layers. A necessity when traveling to Florida from Minnesota in an arctic spring (It was January 74th when we left and the day after we got back was the historic April blizzard - 22 inches of snow!) Wearing layers versus just a sweater allowed us to bring an "extra" t shirt to wear there. We wore thin pants, t shirts, sweatshirts without hoods, and this lovely socks and sandals combo!


Some other things that Grandma has for the girls are a high chair, car seats, and umbrella stroller. I would rent these things if they were truly necessary instead of bringing them on the plane. The only thing that I think would be truly necessary would be car seats unless we stayed in one place or relied on public transportation. 

I've found a huge benefit of crunchy/attachment parenting is that we don't need a lot of the baby gear deemed necessary by mainstream culture. I exclusively nurse, negating any need for bottles, pumps, or formula. When my babies start eating solids they just eat real food so we don't have to worry about purees or puffs. Highchairs are convenient but your baby can also sit on your lap or stand up in a restaurant booth (Deidre's favorite). I bed share from birth so all I need is a bed larger than a twin, although that will do in a pinch. I do a lot of baby and toddler wearing, so while the small stroller is nice it's not a true necessity. 

My advice when packing for a trip is to lay out all the stuff you're going to shove into the suitcase on your bed and then put half of it back. 😊 Think about what you truly need instead of what you think you need. You'll be happy to have less stuff to keep track of and haul around the airport. Less is more!