Unexpected Gifts

Since leaving girlhood, I have been plagued with varying levels of painful cycles. By the time I was twenty-four I was used to doctors considering me a hysterical (pun intended) woman. I was used to pain and there seemed no cause or solution. Then I had an appointment with a young, new doctor. My indication that something was different came when the first thing he said was, “I was reading your chart...” Not only had he actually read my chart, he put the pieces together from my history. He discovered I had adnexal masses- a fancy term for something wrong with my ovaries.

Various tests later, the ovarian masses were confirmed to be semi-solid and my Ca-125 levels high. At age twenty-four, with my favorite actor being Gilda Radnor's husband, I had a scare that I was going to die of ovarian cancer. My doctor was level-headed. He explained there are other reasons for these findings, but all can be definitively confirmed or denied through surgery only. I saw a second opinion- who had the same condescending attitude I had gotten used to and told me to “just go on birth control.” Been there, tried that, didn't work. I went in for my first surgery.
 

I was diagnosed with Stage IV endometriosis. Endometriosis is a mysterious disease, even after all these years of study. It is staged like cancer, invades body tissues in the abdomen and sometimes beyond, and can be debilitating. My innards were so innundated with this disease my doctor told me he would have diagnosed Stage V, if there had been a category like that. The normal treatment for Stage IV is complete hysterectomy. I will forever be grateful I had a young surgeon who recognized that very early, surgically induced menopause would be more devestating that the effects of this disease.

I was told that I would never be a mother. I could not imagine myself as a mother.

Three years later, I was on the surgical table again. Different surgeon. Same diagnosis. I had done research myself and knew that hysterectomy was not an option for me. I had learned the disease is estrogen-based, and removal of the ovaries does not cure the problem. Estrogen is still present, and surgically-induced menopause often requires hormone replacement therapy- putting that same old hormone right back in my body to keep the disease active.
 

Infertility was still the byword. My biological clock had started ticking.
 

Three more years, and my surgeon and I decided to take a different tactic to deal with the pain. I was going to try a hormonal drug first, followed by surgery. I had to call the office the day my period showed up. I waited. And waited. After a little while, a little nagging feeling convinced me to just try a home pregnancy test. I actually tried ten. When I called my surgeon's office and told him I was pregnant, he said, “No, you're not,” and sent me for bloodwork.
 

Yes, I was. I was going to be a mother.
 

I had an early ultrasound to make sure it was not ectopic. Everything was found to be healthy, though I still had large ovarian masses. While I was pregnant, the masses went away. So did the pain. The pain was gone for a total of six years- pregnancy through breastfeeding.
 

My surgeon was an obstetrician. I adored him as a surgeon treating me for a difficult and extensive disease. I very quickly discovered I did not adore his philosophy on pregnancy and birth. A scheduled cesarean section was offered at my first prenatal visit. I thought it had something to do with my disease and surgical history, but it turned out to just be a suggestion as women “get tired of being pregnant.” I switched to a homebirth midwife.
 

My daughter was born in a hospital after many days of labor necessitating a nonemergency home to hospital transfer. My back up physician was amazing. My midwives were amazing.

My daughter is amazing. Being a mother is incredible.
 

Two years ago, my pain level was becoming very high again. Tests confirmed one ovarian mass had returned (later the other was also affected). I delayed and delayed further tests and treatment, as I did not want to go through surgery again. I finally made the decision to see a specialist who would help preserve my lady parts, rather than assume I didn't want them anymore. Test results did not surprise me, being similar to previous experience. The chances of pregnancy were listed as very tiny.

I faced the anxiety of upcoming surgery. Worse was my anxiety I might lose any chance of ever having another child again.
 

Because of my age, and the extent of my disease history, the risk of cancer was higher. But all indications showed the same kind of tumors I had already had- endometriomas, which was reassuring. I had also had a pregnancy and had breastfed for years, so risk of cancer was reduced. I figured things balanced out, and made an agreement that I would only consent to a hysterectomy if cancer was found.
 

The day before surgery, I had this little nagging feeling.
 

Much to everybody's surprise, I tested positive for pregnancy.
 

I realize there is a theme here.
 

My journey into motherhood started with the dire prognosis of infertility, followed by an unexpected pregnancy and birth. Ten years later, aching for those baby years, knowing the devestation of endometriosis, adding in the term advanced maternal age, with my hopes fragile, I faced the prognosis of secondary infertility only to have another unexpected pregnancy.
 

I have the chance to treasure another child.
 

With this pregnancy, I am choosing midwifery care again. I know that a healthy pregnancy is not a disease. I know that my endometriosis will be helped by rather than hinder my pregnancy. I know that, with love and support I will be strong and capable. I hope that, should a medical need arise, I will find a physician who can be as caring and compassionate- midwifery oriented- as the back-up I had with my daughter.
 

My first born miracle is very excited to be a big sister. I look forward to the day I meet my second born gift face to face.

State Laws for Moms & Newborns

In this list are links to state laws that affect families and newborns:

Midwives. Midwifery care is the standard world-wide. The medical model- obstetrics- is the standard of care in the United States. The US also scores poorly, depite all the medical advances, in mother and baby injury and death prevention. Countries that use midwives as the primary pregnancy care-givers have better mother & baby health. Midwifery organization in the United States are working to protect a mother's choice to use a midwife, at home, a birthing center, or in the hospital, rather than have obstetrics ast he only option.

Newborn's and Mother's Health Protection Act (1996). This is about the length of postpartum stay.

Newborn Screening for Metabolic & Genetic Disorders. Different states mandate different blood panels, so not every state requires the same screenings.

Newborn Hearing Screening.

Breastfeeding. Breastfeeding is the natural and best way to feed a baby.

Maternity Leave.

Vaccines. Many people think vaccines (immunizations) are absolutely mandatory, but they are not. A parent may choose to not vaccinate or delay vaccines.

The following link is for a national organization that works to prevent legalized abuse of women during pregnancy and birth:
National Advocates for Pregnant Women.

Emergency Preparedness for Pregnant Women and Families

With all the focus on "Frankenstorm", does your family know what to do to prepare for an emergency?

There are National and State-wide resources for emergency preparedness. Families and individuals do need to maintain the basics of being prepared so that when an emergency may or does happen, response can be quick and panic is reduced. Here are some links for emergency preparedness:

Ready, a National source.
FEMA, another National source.

For those in Maryland:
MEMA, for the state of Maryland.
Each county will also have its own source.

Pregnant women and families with small children and infants have additional needs:

March of Dimes: Prepare for disaster. General advice and ways to keep safe.
ACNM: Guide to Emergency Childbirth. Not a plan for a planned unassisted birth, but a plan to be prepared if you cannot connect with your caregiver during a disaster situation.
Make a Plan from WomensHealth.gov. Please note: they do advise knowing how to wear your baby!
Breastfeeding and Emergencies. Breastfeeding is the safest way to feed infants during emergencies!
Gribble, K. "Infant Feeding in Emergency Situations." Please note she recommends relactating or wet nursing as safer for infants than use of breastmilk substitutes, She also recommends using a cup rather than bottles and nipples if not breastfeeding, as sterilization is a problem during emergencies.

Please note that infants and toddlers who are breastfed will have a ready source of safe fluids and nutrition in their mother. The biggest risk with artificial feeding during emergency situations is contamination of the water needed to mix formula, lack of enough water or formula, being unable to safely store breastmilk substitutes, and inability to sterilize materials needed to artificially feed a baby. Families who choose artificial feeding need to be prepared ahead of time to have enough safe water and formula available, and whatever else they need to reduce risk. I have read information that claims pre-prepared formula is safest, to avoid having to use contaminated water to feed your baby, but please remember that during power outages, pre-prepared formula cannot be stored- the fridge will not keep the formula cold enough to be safe to use.

Rice Socks

Doulas almost always have the handy-dandy rice sock available for laboring mommas. Rice socks are also useful for postpartum and any other time heat or cold might help with pain or injury. Rice socks can be scented using essential oils. They are easily made.

Basic ingredients:

• One pair long tube socks
• Plain, uncooked rice (different types of rice smell differently when heated)
• Funnel, if preferred
• Thread and needle, if preferred
• Essential oil, of preferred (lavender, vanilla, etc.)

To make a rice sock, take one sock, and pour the uncooked rice into the sock, filling it about 3/4 of the way. Use of a funnel can make this process easier. If you want to add an essential oil, you can add a few drops to the rice before closing the sock up. Tie (or sew, if you are handy with a needle and thread) the sock tightly closed. Use the remaining sock as a washable cover- roll it onto the filled sock and when it gets dirty, take it off and wash, then place back on the rice sock. Do not wash the sock with the rice in it! If you are good at sewing, you can also make a soft cover out of pretty fabric.

A rice sock can be kept in the freezer, ready to use as a cold pack. More often, they are heated for 2-4 minutes in a microwave and then used as a heat pack. You can make them different sizes. Long men's tube socks work great to mold around a laboring mother's belly or across her back and hips. A shorter sock can be used to across the neck and shoulders for tension relief.

World Breastfeeding Week 2012

Today starts World Breastfeeding Week 2012- the 20th annual celebration of breastfeeding!

This is a terrific time for anyone to learn more about breastfeeding and supporting mothers who choose to breastfeed. There are numerous obstacles in the way of a woman choosing to breastfeed- from body image to family pressure to not knowing how to handle issues that might develop and, especially, not knowing the accurate information and resources that are available. Even if breastfeeding isn't for you or your family, it still helps to support mothers who choose to breastfeed!

Here is the official website for World Breastfeeding Week 2012.

Here is a long list of resources on breastfeeding provided by Mothering.com.

Mindful Birthing by Nancy Bardacke, CNM: A Book Review

Walking through the bookstore- one of my favorite places to be- I happened on a bright yellow birth preparation book that I had never seen before. Prominently displayed in the front of the store, the book's cheerful cover beckoned. A quick examination of the back cover and the table of contents piqued my interest even further. As a birth advocate and doula, as well as slight familiarity with the practice of mindfulness, I was doubly curious to explore this unique text.

Mindful Birthing is a beautifully written description of the Mindfulness-Based Childbirth and Parenting (MBCP) program. Mindfulness is an ancient meditation practice that teaches the experience of the moment and suspension of judgement. This program takes the attitudes of mindfulness practice- beginning mind, non-judging, patience, non-striving, trust, acknowledgment, letting be, and kindness- and works them into the process of preparing for birth, giving birth, and handling the highs and lows of parenting. While there is some discussion of the mechanics of birth, the pain and fear surrounding birth, and the realities of the high-tech obstetrical experience most American women will experience, Ms. Bardacke goes above and beyond and gets to the heart of the matter- teaching skills that benefit parents long past those hours of labor and the birth of their child. The true beauty of this program is the transformation from where a mother and her partner are during the pregnancy into a self-awareness that helps them cope and grow beyond the birth.

For mothers-to-be, this is a book that can help you and your partner through pregnancy and beyond. Exercises for learning mindfulness and how to use mindfulness during labor and birth are clearly explained and practice guidelines are given. There are also examples of how mindfulness helps as you parent your new baby and grow as a couple and family.

For doulas, childbirth instructors, and care-providers, this book offers a look at techniques that can help mothers and support people we work with. Many techniques will seem familiar- breathing, walking, relaxation- but seen through a mindful awareness.

“Your labor will be as unique as you are in this moment...”

“These attuned moments of interaction between you and your baby and between your baby and intimate others are forming her or his neurological pathways, pathways that develop their capacity to form strong bonds, tell them that people can be trusted and that the world is basically a safe- and pretty interesting- place. Its part of setting a tone for their entire lives.”

To learn more, visit Nancy Bardacke's website.