On Courage

While I was at the salon today, I overheard several women of different ages sharing their birth stories with a young stylist, who is newly pregnant, and some of her co-workers.  I wasn't part of this conversation, but it was impossible for me to ignore their discussion, and it reminded me yet again how very important birth is in all of our lives.

There are those that will say it doesn't matter how a baby enters this world, but ask any new mother and she will agree that birth changes you.  It's important, and it does matter.  How could a group of women sit with foil-wrapped hair and share their stories, some in painstaking detail, with complete strangers if it did not?

April is Cesarean Awareness Month and I'm reposting this piece because it is so beautifully written and meaningful.  I cannot read it without tears.

My sister is in the midst of her own defining birth story, one that will likely play out over the course of the next few weeks and months, and she and her unborn baby can truly use your prayers.  She is the very essence of courage, and I admire her so much.

On Science and Technology

I ran across this article on ICAN's Yahoo list today, and I found it quite fascinating, for my own personal reasons.  I'm a huge advocate for natural birth, and while my own experiences were quite different than the writer's, as I've discussed in great detail in the past, I agree with her point of view completely.  Please consider the article on its own, separate from the vitriol in the comment section, and form your own opinion.

ICAN CBAC Week

My friend, Melek, is the official blogger for ICAN's website, and she designated this past week as CBAC (Cesarean Birth after Cesarean) Week.  I'm so thrilled that she chose to focus on this issue, because it's important for CBAC moms, like both Melek and me, to feel supported in our decisions, especially when our plans for a VBAC change.

You can read the week's worth of stories here.

Age of Innocence?

As with most things these days, I'm late to discover this article about later in life motherhood, but it is truly fascinating.  The pictures are lovely, too. 

Tooting My Own Horn

My friend, M., is the official blogger for the ICAN site, and she recently asked me to do a guest post.  I jumped at the chance and it's featured today.

I can't believe I get to say this, but come see me here!

Happy Birthday, Rhys

(Photograph by Mary-Beth Archer)

My sweet Baby Boy,

We are so happy that you came into our lives in such a wonderful way, and we love you very much.  You are such a joy to all of us, and Daddy, James, and I love you with all of our hearts.  You complete our family perfectly, and we would not be the same without you.

Daddy and I love your silliness and your ability to laugh all the time, so much so that Daddy calls you his "Party Boy."  You have a tender heart, and I know that you will be a very loving man.  James loves you because you are his best friend and playmate, and he can't wait for you to run wild with him very soon.

I love the fact that you are still so young and need me so much, and since you are my last little one, I treasure these days of babyhood with you.  Too soon, you will be walking away from me, as you should, and so I am enjoying this fleeting time of innocence with you.

I love your blond hair and blue eyes, such a striking contrast to the rest of our family.  And the way you love to cuddle and get butterfly kisses, which you eagerly attempt to return with your little, wet tongue.   I love your tummy, which has to be the cutest baby tummy in the history of the world, and the fact that you are such a great eater.

You changed our family in more ways than you may ever know, Rhys, and we are better and stronger because of you.  I wish you a wonderful day and an amazing year filled with new discoveries.

I love you with all my heart, Rhys Racer.

love,
Your Momma

Let Them Eat Cake

Almost one year ago, my sweet little Rhys was born in the most beautiful and healing way.  While I waited for the spinal to be placed before my c-section, my labor nurse tried to steady me as I struggled through those last painful contractions.  I will never forget her words that day.

As I leaned over the operating table into her arms, she held her hand to my mouth, offering up an invisible cupcake, and told me to blow out the candle because, "We are about to have a birthday and next year, there will be cake."  Her words, in that moment, calmed me instantly, and I was able to relax and think about my baby's imminent birth.

And yesterday, surrounded by family and friends, we celebrated Rhys' first birthday with good food, presents, and cake.  Just like she said we would. 

(Photo by Aunt MB; icing by Aunt Mo)

"Opting-In" to Newborn Screening

I've written pretty extensively in the past about the issues with Texas' newborn screening procedures, and it appears that a new bill allowing parents to "opt-in" versus "opting-out" is about to pass in the Texas legislature.  This means that, once the standard newborn tests are performed, the samples will not be stored indefinitely unless the parents expressly grant permission. This is a huge victory for those of us concerned with protecting the privacy of our children.

Remember that these are the heel-prick tests put on a small card, performed at birth in the hospital (or at home by a midwife) and again at the two week pediatric appointment.  Each test previously required its own "directive to destroy" form, which had to be mailed to the state lab for newborn screening if the parents desired the destruction of the cards.

I am absolutely on board with newborn screening to rule out disease, but I refuse to allow my child's DNA to sit in a drawer at Texas A&M or to be traded or sold for lab equipment, as happened in previous years.

Courageous Moms

Since my baby is 10 months old now, my family is complete, and my heart is healed, I'm not focusing on birth and VBAC stories as much as I did in the past.  But I did run across this post on my friend's blog this week, and it really touched me deeply.  Mother's Day was last weekend, but this piece deserves to be read and shared.  All mothers make sacrifices, and this reminds us of that fact.

There's also an example of cesarean art on the page, and if you've never run across that before, it's shocking and meaningful at the same time.

Cesarean Awareness Month

I can't let April pass without mentioning Cesarean Awareness Month once again.  My family is complete now, and I am fully at peace with the birth of my sons, which is a wonderful, wonderful feeling.  I've been honest about my struggles in the past, and I know that my experiences have shaped me into the woman and mother I am today.  A bit like the lady in this poem.  Oh, and April is also National Poetry Month, so this ties in nicely, don't you think?

Truth in Advertising

 If we'd moved her,
she'd still have 'em,

the ad for Acme
Moving says, with a photo

of Venus de Milo.
But who, intact,

would Venus be?
Some standard-issue

ingénue. Give me
a woman who's lived

a little, who's wrapped
her arms around the ages

and come up lacking: that's
the stone that can move me.

--Andrea Cohen

Maternal Mortality in the United States

I ran across this article on another blog today, and it's extremely insightful and well-written.  I also learned that several pieces of legislation to improve maternity care in the U.S. have recently been introduced to Congress.  That's definitely a step in the right direction.

One Year Later

A year ago today, as fires burned across Austin, we found out we were expecting a healthy little boy to round out our family.  We fought incredibly hard to have you, little Rhys, in the best way possible, and I'm so proud to be a part of your life's journey.  You are the icing on the cake and I love you very much, sweet boy.

A Sign of the Times

Tina Cassidy has a piece in New York Magazine today in which she examines the growing trend of texting during labor and the issues that go along with our culture's need for immediate and constant communication.  She argues that, because birth has become so controlled and cold within the hospital setting, parents are doing everything possible to stay connected with supportive family and friends, most of whom are outside the delivery room.

I'll admit that I am uncomfortable with labor updates from friends and family, especially the cervical dilation checks.  That just seems really private to me, and when I was in labor, I didn't want my husband's friends (or my dad) knowing how far my cervix had opened.  As if they even cared.

I do know several women who have tweeted their way through home births after cesarean (HBAC), and it was interesting to read their experiences as I cheered them along from the privacy of my own home.

And I'm forever grateful for the birth videos of both my children, which our hospital allowed my husband to film, since without them, I would have no actual memories of their very first moments.

I guess, as Cassidy points out, it's just one of those things that happens as times change and we seek to maintain the personal connections that society used to value more.

Happy Labor Day!

My friend M. is currently laboring at home with her second son, and I want to wish her a quick and easy Labor Day!  She's having an HBAC (home birth after cesarean) attended by midwives, and she's tweeting all the way through the process.

Her little one hasn't been in a hurry to come out, and at 41 weeks, she had henna applied to her stomach by Henna Kim on South 1st Street in Austin, Texas.  Isn't it beautiful?

Here's hoping she meets her little boy very soon!

(photo courtesy Jason Speros)

"Now the First of December..."*

On the first of December two years ago, our house was quiet as we awaited the birth of our precious first son. Little did we know that less than two years later, that same house would be filled with the sounds of, not one, but two little boys.

I'm a bit wistful this year as we prepare to celebrate J.'s second birthday, and I can't believe how much he's grown. He no longer looks like a cuddly baby, but has become a little boy before my very eyes. He's studious, sweet, and incredibly loving to his younger brother. J. misses no detail and has an unquenchable thirst for knowledge, so this year, instead of toys more suited for children his age, we're getting him a few objects that, hopefully, will last a while: an emergency weather radio and a real wristwatch.

And there's also the Big Wheel, because he's still a toddler, after all.



*from "Sweet Baby James" by James Taylor

Letting Go

I'm having a garage sale in a few weeks, so I've been busy cleaning out my closet and boxing up the clothes that no longer fit me. After having two babies in less than two years, I have lots of clothes like that. I'm not really a sentimental person, and I don't hang onto lots of mementos, but there's one bag of clothing that I'll be sad to see go.

It's my bag of maternity clothes: the pants, skirts, dresses, and tops that saw me through 20 total months of pregnancy as I carried my sweet sons inside me. Even as I write this, my eyes are filling with tears.

After my first son was born, I struggled with the reality of his birth that was so different than the one I had envisioned. It took me months to let go of those feelings of sadness and inadequacy, and while I mourned, I left my maternity clothes hanging in my closet, as a reminder that I would one day need them again. Eventually, I put them away, only to dig them out, joyfully, a few short months later.

This second time, things were different, and as I realistically planned the best birth for my son, I also looked forward to the time I could wear fitted tops and pants with zippers again. And then my son was born in a beautifully healing way, completing our little family of four, and those clothes that I wore so proudly for two years are no longer needed, at least by me.

But I won't be selling them at the garage sale, since I can't bear to watch others browse through my memories, and I don't know how to put a price on those precious pieces. Instead, I'm donating them, so that some mother, somewhere, will wear them with pride as she carries her child within her. That makes me really happy to think about.

So tomorrow, by 8 AM, I'll have my clothes outside on the sidewalk, clean and neatly folded, awaiting the next leg of their journey in someone else's story.

I also have a hair appointment scheduled this Saturday, and I'm cutting my hair short. I grew it long during my last pregnancy, and it was full and shiny. Now, I'm in the middle of that awful postpartum shedding process, and I find my hairs everywhere. It's time to start fresh again as the mother of two active little boys.

On Birth and Politics, (As Usual)

So I had my postpartum check-up yesterday, and everything has healed very well. My husband and I thanked our doctor for making little R's birth such a wonderful and healing experience, despite the fact that it was a VBAC attempt that turned into a CBAC (cesarean birth after cesarean). She said that she knew how hard we had worked to have the best birth for our son, which was true, and she felt as emotional as we did. Even though, to our doctor, it was a routine day at the office, she said R's birth was as profound an experience for her as it was for us. And it definitely showed in the kindness and compassion we experienced in the operating room that day in July. I will always remember that.

We discussed the possibility of future children and I mentioned that I would most likely just schedule a c-section next time, if we decide to have another baby. She agreed that was the best decision and also explained that it's possible my scleroderma contributed to the failure of descent in both of my births, since the connective tissue of my pelvis could be affected. In my case, it's not an issue of true CPD (cephalopelvic disproportion), in which the mother's bony pelvis cannot accomodate the size of the baby's head, because I dilated completely in both labors, and quickly and easily in R's birth. Instead, it's possible that the tissue was simply unable to stretch far enough to allow proper descent into the birth canal.

I was about to bring up ACOG's recent change in VBAC guidelines, which states that most women with previous multiple cesareans cannot be denied a trial of labor, but my doctor beat me to it. The new recommendations mean that doctors cannot force a cesarean on anyone and many mothers with previous cesarean scars should be allowed to attempt vaginal births. Unfortunately, my doctor explained, the hospital where I delivered, North Austin Medical Center, is refusing to change their guidelines to accomodate this new bulletin. She and the other doctor in the practice are working hard to convince NAMC to change its mind, but so far, they've had no luck.

This is the same practice that successfully brought midwives back to the hospital setting in Austin, after much debate, so maybe, just maybe, they'll be able to shake things up once again. Not for me, necessarily, but for all the other moms in Austin who deserve a chance to heal their hearts and minds, as I did.

Gotta Make Peace With It

My mom showed this to me today, and I love it! After having two babies in less than two years, my body doesn't look the way it used to, and it probably never will again. And I'm okay with that.

Our Own Texas Newborn

So Little R. had his two-week checkup today, which is when the second newborn blood screening is performed. We now have both "directive to destroy" forms from the hospital test and today's, and we just have to mail them off to the state lab. Hopefully, that will be the end of things.

Full Circle

Our precious son, Rhys Andrew, arrived safely and happily on July 7th, 2010 at 4:07 pm. He weighed 8 pounds, 2.1 ounces and was 20.5 inches long. Though I did eventually have a repeat c-section, I was blessed to labor completely naturally until I entered the operating room, and it was an amazingly intense experience. Below is the text of the very long email I sent to my VBAC supporters, detailing Rhys' birth.

***

I did end up having a repeat c-section, but it was an absolutely beautiful experience and I am at peace with everything that happened. Because of some autoimmune issues, I was induced at 39 weeks, but we got our doctor to wait until after the long holiday weekend, which meant the induction was scheduled for the day before my due date. I was already 4 cm. dilated and 90% effaced, so all it took was having my water broken to get things going. That was done at 8 am, and since I was already having contractions, they just became stronger and closer. R. and I wandered the L&D halls for a while, and came back to the room to rest and call our doula around 10:30, as
things progressed. Contractions got really strong and close together quickly, and by 11 that morning, I was beginning to feel really out of sorts and like I was losing my nerve at attempting a natural birth, which are classic signs of transition.

My doctor came to check on me around 11:30, and she suggested postponing a vaginal exam, since she didn't want me to be disappointed at that point. I agreed and continued laboring, and the contractions kept coming really close together, like 1-3 minutes apart. At some point, I mentioned that I had to use the bathroom, and my doula asked if I needed to have a bowel movement. I said I thought so, and she reminded me not to push if I felt lots of pressure. R. went with me to the bathroom and I sat on the toilet for a couple of contractions. That's when I started feeling more pressure and told him that it was not a bowel movement, but the baby! My doula must have been right outside the door listening, because she burst into the room and told me not to push, but to blow through my mouth. They got me back to bed, called the nurse, and things started going fast from there.

The doctor checked and said that I was 8-9 cm. dilated and the nurse told me to prepare for an intense few minutes as I dilated the rest of the way. Right after she said that, I started feeling the urge to push, and R., our doula, and the nurse coached me through the contractions for a while. K., my doula, actually whispered that it was okay to push a bit if I really needed to, but not too hard. That helped to ease the pain a little. When my doctor checked me again, I was almost 10, but with a bit of lip that she could push back on the right side of my cervix. I labored for a bit on my right side
to try to melt it away, and things were soon set up so I could start pushing.

Pushing was an amazingly intense experience, and I literally used every ounce of energy from my whole body to try to bring my baby out. It is something I will always remember. The nurse was great at guiding my pushing and really helped me focus on where and how to do it. I began to notice what felt like a rock in my bottom (which was probably Rhys' head), and I concentrated all of my energy on pushing that out. I pushed and pushed for almost 2 hours, and the nurse could see Rhys' hair on the other side of my pelvic bone. He was moving lower during contractions, but would slide back in between, and we tried different positions to try to get him past. I was exerting all of my energy, and I just couldn't get that stone to move. Eventually, my doctor came back and said we were looking at the same outcome as my first delivery, just under different circumstances.

It took R. and me a few minutes to fully comprehend what she was saying, but we soon realized that Rhys had not descended at all during the process and he simply was not going to come out vaginally. I was extremely frustrated at that point and having contractions one minute apart, so we asked for a couple of minutes of privacy to discuss things. K. stayed with us and helped me through the contractions, urging me to push, but not as hard. We decided that the c-section was the best option for us, and we knew that we were doing the right thing for Rhys, so we let the nurse know our plans.

The scene in the room quickly changed as I was prepped for surgery, and since I wasn't on any meds, just a heplock (a port for an IV), they had to start an IV in the room before administering the spinal. I was still having expulsive contractions and pushed through them to ease the pain, and since R. was not allowed in the OR while they administered the spinal, I begged my L&D nurse to stay with me so I wouldn't be alone. I couldn't imagine pushing while they wheeled me to the OR, and I think she gave me something to lessen the contractions just a bit. She assured me that she would not leave me, and she stayed with me the entire time, helping me onto the table and letting me lean over her as they administered the spinal. I had several strong contractions while it took effect, and she coached me through them.

Soon, I was all set up, R. came in, and the surgery began. I was shivering like crazy and they put a plastic sheet filled with warm air over me to help. I also noticed a lot of tugging this time, which I didn't experience with James at all. The doctor soon told R. to stand up, and he filmed Rhys right as he emerged from my body. It was amazing, and R. was crying the entire time. They then lowered the screen and I got to see Rhys for a minute. R. then went over to Rhys while he was assessed, and they kept him near my left side, so I could see and hear them the entire time. When the nurse weighed Rhys, she told R. to announce his weight, and the entire room oohed and aahed when his weight (8 lbs. 2 oz.) was announced. R. was allowed to hold Rhys, and he carried him over for me to see him. They stayed with me in the OR for a little while before heading to the nursery for the rest of the assessment. We felt like active participants in our son's birth this time, while James' arrival had felt more like a tooth extraction.

The closing up took a while and I kept asking if the doctor was finished, because I was so ready to meet my little boy and see R. again. After what felt like forever, they wheeled me to recovery and R. and Rhys joined me in a few minutes. We stayed there for over an hour, just nursing and enjoying Rhys, who latched on immediately and nursed like a champ. My labor nurse gave us lots of privacy and she told me later that the nursery kept calling to get Rhys back for his bath, and she told them that we weren't ready to give him up yet. So this time, R. and I got the quality bonding time with Rhys that we had missed with James. After an hour or so, I was taken to postpartum and R. went with Rhys for his first bath.

I ended up with some major abdominal bruising, most likely as a result of taking baby aspirin for a clotting disorder, so I've had complications with my incision. Rhys' little head, which was 14 inches around, also got quite mashed in the pushing process, and he had bruising and serious molding that took days to disappear. Just looking at his head let me know that he was simply not going to fit through my pelvis, and I know we made the right decision regarding the c-section. He was in the optimum position for birth, but he simply couldn't fit through my pelvis, and I'm going to find out more about this at my 6 week appt.

It's so strange, because it took a second surgery to heal my sadness from my first birth experience. I just feel so blessed that I was able to experience about 95% of a natural birth, which I will always remember, and we know that we did everything possible to have the best birth for Rhys, which is all that anyone can ask for. We're completely in love with our little son, and my only sadness is in the fact that I can't lift James right now. But I'll get better and be back to normal soon. I have no regrets at all.