Friday, February 13, 2009

Velma's Quote of the Week

Velma: (sitting next to me, talking to baby Norah) Are you ready for a little brother or sister?

Me: (giving Velma a dirty look): Are you crazy?!? Besides, I'm on pelvic rest for at least 6 weeks.

Velma: You can't dance??

'Nough said.

To Norah

To Baby Norah:

You are four weeks old now and you are the light of my life. I marvel at the miracle you are daily - how one day you didn't exist and then suddenly, miraculously, you were my little love with your own, perfect, beating heart, your tiny eyelashes, and your bouts of hiccups that used to tickle the inside of my belly and now make me pat your back to soothe you. You are a miracle and I want you to know you were desperately loved and desperately wanted from the very first moment we knew about you. We have always loved you, and we will never stop.

I am writing this today because I have been thinking of all the things I want to teach you, and I want to have them on record somewhere. I want you to see that my intentions are good and to glimpse at the parts of my love for you that are so important. It is my hope that this letter is nothing but a footnote; a written record that sums up the things you have come to know are true simply by watching me live. It is my hope that I teach you to live well by default - that your life with us left you no other option. I will do my best, little Norah, but I am writing my intentions to you now.

I am writing this also so that I can come back to it at times when I don't know how to live or what to do. It can be so hard to get through each day being even half of what I want to be. Its easier to take the path of least resistence, but not always better, and I know there will be times when I need to be reminded of this. And so I write this for us both.

Dearest little Norah, my little love, I hope to teach you how to love well - how to make yourself vulnerable and accept love, and how to see past the surface and find beautiful parts of people who need to be loved. This is why I tell you stories about Dingo - about how she barked and growled at us like a mean dog, but when we took her home we gave her all the love we could muster and she started to become a good dog. And now she is the sweetest dog and she loves you to bits and protects you. But it took a lot of love to get her there. I hope you learn to love the bleeding and broken and the people you see every day who are different than you, and the people who are so much like you that it drives you crazy. And I hope you learn to be loved; to accept the love that is bestowed on you. Remember, the greatest thing you'll ever learn is just to love, and be loved in return.

I hope you learn that love is a verb - it is something you do every bit as much as it is something you feel. It is a kind word, a helpful hand, a smile when you feel like scowling. It is asking, "What can I do to help?" and then following through. Love is the act of listening with patience. Love is surrendering your time and sharing what you have. Love is an act, a motion, a way of being. I love your daddy by cooking his dinner and folding his laundry and giving him time with his friends; he loves me by keeping the cars running and going to work each day and paying the bills. This is what love looks like. When you don't know how to love someone, its okay to ask them, "What can I do for you?" or to tell them, "I want to love you, but I'm not sure how". How else will you know what to do?

I want to teach you how to be happy with what you have and how to live simply. I hope I teach you the opposite of consumerism - that the things you own can so easily end up owning you, so it is best to rely on community and family and love to make you happy, rather than relying on the things you have. I hope you grow up unencumbered by debt - so that you never have to forego the important things in life because you have to pay for something that is not really important. So many people I know don't live the lives they want to live because the price of car payments and credit card debts and cable TV keeps them trapped. I never want you to know what that feels like. I want you to learn to loosely own the things you have so that you are free to do the things that really matter.

I hope you learn the balance between being content where you are and pushing yourself to grow. May you live in a state of constructive discontent - never quite satisfied with your character in such a way that you feel compelled to pursue growth. But at the same time, I wish contentness and an inner peace for you, that you can be okay with where you are and accept that growth is a process you've embarked on. May you learn to eloquently stand exactly where you fit while never being afraid of taking the next step in growth, onto the next place where you will fit.

I hope to teach you the value of a story, particularly human stories. When all is said and done and we are gone, our stories will remain. And these stories... these stories are limitless. Our stories make us what we are. I hope you learn to ask for stories and I hope you learn to love the stories you hear - for when you learn to love a person's story, it becomes almost impossible not to love the person as well. I hope you learn to love your own stories as well, and to value them as part of what has made you what you are.

I hope to teach you interdependence - to lean on the people you love and to let them lean on you. Our culture has such a strong focus on independence and I think at times its gone too far. We don't know how to ask for help or live in the context of community. I want to teach you these things because I don't believe we were made to live so alone. I hope you learn how to build community and how to live within it. I hope you learn that this makes you stronger, not weaker. It gives you the opportunity to give the very best parts of yourself and find your niche, and it gives you the strengths and help of those around you - so much more than you could ever achieve alone.

My dearest little Norah, these are my greatest hopes for you. I hope for so many other things, like every parent does. I hope for good health and strong character and for you to grow up happy and smart. I hope you find talents and make friends and find a career path you love. Of course I hope these things for you - I am your mother. But mostly I hope for these things I've written about. Part of the reason is that if you learn these few, important things, other success will follow. How could you not make friends if you learn to listen to stories and how to love? How can you not succeed if you learn how to ask for help and if you pursue growth continually? But mostly, these few things are the things I have learned that have helped me to be truly human and happy and content. I consider that a success - that I can wake up each day feeling content with where my life is, appreciating the moment, and knowing there is any number of people I can call if I need help or if I just need to be with people. These are the things that make my life a life I am happy and proud to live.

I don't have all these mastered, Norah, and there is a good chance I will fail miserably at any one of them. And so, even as I hope to teach you, I hope to grow. I hope we grow tpgether, my little one.

All of my love to you.

~ H

Monday, February 2, 2009

Maternity Service Provider Recommendations (Northeast Indiana)

Now that I'm done with the whole pregnancy/labor thing for awhile (maybe a looooong while, *wink*), I would like to give a shout out to the service providers who I felt were invaluable. If you're looking for care in Northeast Indiana, here are my recommendations:

Birth Matters

D, Velma, and I took childbirth education classes through Birth Matters (click here for their website) and loved them! The courses were thorough and explained everything we should expect during labor, from what my body and emotions would be doing to what kind of technologies would be available to us. We also got hands-on practice for pain relief techniques and points to apply pressure to a laboring woman (this was especially helpful as I ended up having back labor). Hallie & Jordan taught this class and helped us to consider the pros and cons of different treatment options while encouraging us to advocate for ourselves.

D & I also took a breastfeeding class and a newborn care class through Birth Matters that we found helpful. Charts that helped us record our daughter’s feedings and diaper changes through the first week of life were particularly helpful.

Even though these classes cost more than your traditional hospital classes, I’d say they’re worth every penny. I felt that at the hospital classes I’d learn a lot about hospital policy and how to be a good patient, but at these classes I learned how to labor and care for my baby in the way that was right for me. Hallie and Jordan obviously care about maternity care for women and about the individual families they serve. In fact, Birth Matters wasn’t offering a babywearing class during my pregnancy, but Hallie took the time to meet with myself and a friend for coffee to show us how to use various slings and wraps since there wasn’t a class available.

Stephanie VanderHorst, C.N.M. (Auburn OBGYN)

I switched my pre-natal care to Stephanie when I was about 16 weeks pregnant and never looked back! It is because of Stephanie that I was given the opportunity to have a birth experience free of unnecessary interventions that I felt good about. Starting from my very first visit, I knew that Stephanie was going to be the kind of care provider I needed. At my previous OB’s office, I had only actually seen the OB once – I had been seeing various nurse practitioners at my other appointments. The one time I did get to see the OB was a short visit to listen to the Doppler and then get bloodwork drawn.

At every visit I had with Stephanie, she started by asking me what questions I had. She would answer my questions and help me to make decisions regarding my care until I was satisfied. Then she would measure me and listen to the baby’s heartbeat. Though Stephanie planned to attend my birth, she had a back up plan in the event that she couldn’t be there. I met the other midwife in the practice and felt comfortable with her as well. This is in sharp contrast to the OB’s office where I did not know who was going to deliver the baby – whoever was on call would do it, and there were over 15 doctors in the practice. I also knew that Stephanie would be with me during my labor whereas my OB was only planning to come in for the actual birth and the hospital nurses would attend to me during my labor.

Stephanie was also very supportive of my decisions not to use most interventions. I was not required to have an IV, continuous fetal monitoring, or other routine hospital interventions during my labor. Stephanie agreed to intermittent fetal monitoring through a Doppler, which was the most invasive intervention I had to have. For the most part she was content to let me labor at my own pace in my own way, as long as it was safe to do so. I believed I was probably going to go overdue, so I was nervous about being induced, but Stephanie didn’t put pressure on me there either. She was going to wait at least 2 weeks past my due date to induce me, and even then she said we could try several different things before resorting to Pitocin - if we did have to use Pitocin, she said we could hook it up until my body started contracting and then stop the IV to see if labor would commence on its own. Overall, I felt she was my best chance for a natural labor and birth.

Now that labor and delivery are over, I am still sure that I made the right choice by choosing Stephanie to provide my care. I am very pleased with my birth experience and I feel that everything went as well as it possibly could have. I’m grateful that I didn’t have to deal with routine hospital interventions and that I really didn’t even have to advocate for myself during labor because Stephanie was taking care of me the way I wanted to be cared for the whole time.

You can contact Auburn OBGYN, where Stephanie practices, at (260) 927-0035.

Indiana Donor Services

Indiana Donor Services was able to use the umbilical cord and placenta from my pregnancy to collect cord blood and stem cells that can be used for research and medical procedures. I didn’t have any big plans for my cord or placenta anyways, so I feel good that I might have been able to help someone else simply by having my baby and signing some consent forms. If you don’t want to keep your cord or placenta, please, please contact Donor Services at (260) 749- 9105 and talk to them about their donation program. It’s easy and requires almost no effort on your part – Donor Services will take care of almost everything for you.

Baby is here! Birth story attached!

There really is a reason why I haven't posted in weeks. No, really. I'm not just being a slacker. But two weeks and three days ago, I gave birth to the cutest little baby you've ever seen.

Norah Ann arrived on January 16, 2009 at 9:29 p.m. at DeKalb Memorial Hospital. She weighed in at 8 lbs, 10 oz, and was 22 inches long.

The short version of her birth story follows. For the long version (with all the details - beware if you're squeamish) click here. For service provider recommendations for maternity care in Northeast Indiana, click here.

Birth Story
I woke up about 2 a.m. Friday morning (or Thursday night if you prefer) starting to have contractions. I wasn't sure if it was labor or not, so I waited awhile to wake D up. I woke him around 4 and told him I thought I was in labor and I would wake him again if I was sure. By 5:30, I was pretty sure so I woke him again and we began to gather up our things and time the contractions.

At 9:30, I called my midwife's office and she said to come in and get checked out. She confirmed that I was in labor and told me I could check into the hospital if I wanted, but I didn't have to. We went to eat lunch and walked around a store for awhile. We were going to deliver in DeKalb, so we didn't want to drive all the way back home to Fort Wayne just to drive right back. Around 2, I was having painful contractions and didn't want to be out in public anymore, so we decided to check into the hospital. We called my sister Velma at that time and she headed to the hospital.

Labor continued, and unfortunately I had pretty intense back labor. Velma and D spent most of the labor putting pressure on my lower back to relieve some of the pain. I think they worked as hard as I did! Around 5:00, I got in the tub and labored there for awhile. This was when labor was getting really intense. Finally around 8 or so, my water broke, my midwife checked me and found I was nearly dialated, and I felt like I needed to push. My midwife inserted sterile water papules into my back, which I had never heard of. Basically, she put four tiny needles into my back right under the skin and then inserted sterile water. It hurt like nothing else, but it relieved the back labor right away. Apparently, it tricks your body because your brain can't figure out what's going on and so it can't process the back labor anymore. After that we pushed for about an hour or an hour and a half and Norah was born at 9:29. My midwife helped D to catch her as her head and shoulders came out, and D placed her on my belly right away. She is beautiful!

Donor Services was also able to use the placenta and cord, so they came and took them away shortly after the birth. Norah latched on and fed great right away and she continues to be a great little eater!

We didn't actually name her until about 2-3 hours before we left the hospital, so everyone was pretty anxious to hear what we decided. We decided to name her Norah for my great-grandmother, and Ann for D’s mother.

Birth Story! (Long version with all the details)

Long Version

This is the long version of Norah's birth story, with all the details (gory or not!) For the shorter version, click here, or for recomendations for maternity service providers in Northeast Indiana, click here)

I am pleased to announce the arrival of Norah Ann, born January 16, 2009 at 9:29 p.m. at DeKalb Memorial Hospital.

8lbs 10 oz.

22 inches long

Thursday morning (January 15th) I went into my midwife’s office for my weekly appointment and an internal exam. She found I was 1-2 cm dilated, 70% effaced, and said baby was at 0 station. I hadn’t been having much in the way of contractions and didn’t feel I’d be having the baby any time soon. My midwife agreed that I’d probably be pregnant somewhere around another week and sent me home with instructions to continue using the Evening Primrose Oil I’d been using. She said if I came back in another week with no more progress, we’d start looking into a few other tricks.

I went home and made bread and monster cookies with J, and finished up sewing the blanket I’d been working on for baby.

On Thursday night, D and I stayed up like normal to watch Grey’s and our Tivo’d CSI. We went to bed around 11, after watching a bit of the news that said we were getting record low temperatures. We both said we hoped I didn’t go into labor due to the weather being so miserable.

Around 2 a.m., I woke up and had to go to the bathroom. I was having bloody show, but the blood was really bright red and worried me, so I called L&D. They said this was normal and told me to go back to bed. I knew that bloody show usually meant a baby was coming in the next few days, so I started mentally planning everything I needed to get done the next day. About 10 minutes later I felt a period-type cramp, but didn’t pay much attention. I kept feeling the cramps about every ten minutes or so, so I started to wonder if I might be in labor. I decided to sleep in between cramps and see if they got closer together or just petered out.

Around 4:30 I was still having to cramps, so I woke D up and told him that I might be in labor. I told him to go back to sleep and I would wake him if it was the real thing. By 5, I was sure I was having contractions and they were coming about every 5-6 minutes. I decided to take a hot bath, thinking that if the contractions continued it was probably really labor, but if I wasn’t really in labor, the bath might make them stop. After a half hour I got out of the tub, definitely sure I was in labor. I woke D and told him I wanted to get things ready in case this turned out to be the real thing.

D woke up and immediately went into super-husband mode. He showered, dressed, turned on a heater in the garage, warmed up the car, threw clothes into a bag, and ate breakfast – all before 6:30. I had to send him out to turn off the car as I didn’t feel it was time to leave quite yet. We timed the contractions for awhile and at this point I was already feeling the back labor I was going to have. About this time we decided to watch an episode of LOST from our Season 3 DVD to pass the time. D knew it was real labor when Ben shot Locke and left him for dead and I didn’t even notice. We gave up on LOST and just focused on the contractions.

At 9:30, we called my midwife’s office and said I thought I was in labor. They said I should come into the office to get checked out. We packed up all our stuff and headed out a little after 10:00. Because we live in Fort Wayne and we were planning to deliver in DeKalb, we made sure to grab everything because we weren’t planning to make the hour-and-a-half round trip again before the baby was born.

About 11:30, my midwife did an internal exam and determined that I was definitely in labor, 3-4 cm dilated, 90% effaced, and baby was at +1 station. She told us we could go home, check into the hospital, or go out and about for awhile. We decided to go eat lunch and then see how I felt. We stopped at Dairy Queen briefly before realizing that the bathrooms were outside. The high for the day was -1 degree Fahrenheit and I was planning on being able to run to the bathroom during my contractions so as not to completely destroy Dairy Queen’s chances of patronage for the day, so this wasn’t going to work. We packed back up and went to the Wendy’s down the street which had a nice indoor bathroom. I could tell when a contraction was coming because my back would start to hurt first, so when my back started to hurt I went to the ladies’ room and hung out there until the contraction was over. I somehow managed to eat a spicy chicken sandwich, which was pretty darn good.

Once we finished eating, we decided to go to the dollar store and walk around. We figured the dollar store wouldn’t be too busy in the middle of a week day, and I didn’t want to be around a lot of people. We walked around for a little while, but I was having a contraction in every aisle, and I started getting tired of being in public. We decided to head to the hospital so that I could have some privacy.

We checked into the hospital around 2:00. When we got to our room, the nurse had already pulled our birth plan and contacted Donor Services for us (per our birth plan), so I was pretty impressed. We answered a bunch of medical questions and I was on a fetal monitor for about 20 minutes. We called Velma at this time and told her to come on up to the hospital. I also asked her to call Lisey and let her know I was in labor, and to text J, Jeana, Cuthbert, and Mia with our secret ‘H is in labor’ code, which was “ThunderCats are go!” I had every intention of having Velma contact them all again when I was ready for them to come to the hospital. However, by the time my labor progressed that far, I’d completely lost my social self and didn’t remember. So, that’s the last I sent as far as messages to friends and family.

Velma arrived at the hospital and her and D undertook the task of putting pressure on my lower back every time I had a contraction. This was the only thing that seemed to relieve my back labor, and I am eternally grateful that they were there to do this. It was also a good thing there were two of them because by the end of my labor they were both getting very tired and it was good that they were able to relieve one another. I labored on my hands and knees for awhile, and then the nurse asked if I would like to try the birth ball (per my birth plan). I decided to give it a try, but I didn’t really like it because when D and Velma would push on my back I felt like I was going to fall off the ball. We tried using the ball in several different locations (near the bed, against the wall, etc), but I never could get comfortable with it so I went back to being on my hands and knees in the bed.

Around 5:00, the contractions had started getting pretty long and the nurse asked if I would like to use the tub (again, per my birth plan). She said she would check me and if I was at least 4 cm I could get in the tub. She checked and said I was 5-6, and went to get everything ready. At that time she also called Donor Services, because they had asked her to call them when I was at 6 cm. I also decided to eat some yogurt right about then, which they let me take with me into the tub. I wasn’t really feeling hungry, but I thought I should probably eat while I was still able.

We got into the tub and hung out there for awhile. Velma got in with me and D stayed right by the side. It was a nice Jacuzzi tub with the fancy jets and everything. However, it wasn’t helping me as much as I thought it would. I think this is because of the back labor I was having. Once I was in the tub I felt like labor was getting fairly intense and a lot of details start to get fuzzy, so forgive me if I make a mistake or get things out of order. Stephanie (the midwife) came up at some point after her office hours were over and just sat with me for a long time. I’m honestly not sure how long it was, but I know that she was there from then on until the end of the delivery. During my entire time in the tub all I really remember was that I felt like I was bleeding a lot even though I wasn’t, and I was making very low moaning sounds in my throat to get through each contraction. A few times I started to feel panicky because the contractions were very long and I was worried about getting through the entire labor.

Somewhere around 7:00 (I think) I felt like I needed to have a bowel movement. Now I learned in my childbirth class that this meant I was probably getting ready to push, but for some reason I didn’t think it meant that I was really getting ready to push – I thought I just had to go to the bathroom. Not sure why I thought this applied to everyone except me, but I did, so I said I had to go and got out of the tub to sit on the toilet. I sat backwards on the toilet so that D & Velma could keep pushing on my back (for the record, I did not actually have to go to the bathroom – I was just getting ready to push). From here things are really fuzzy. I know at one point I started crying and D told me not to cry and I told him I was fine and that sometimes I just have to cry (which is true of me in general – sometimes I just have to cry to cope and it doesn’t necessarily mean things have gotten bad). At one point I also told D I hated him, but I don’t remember why. I think it was because I was hot and taking the towels off of me that had been put on me (when I said I was cold previously) and he said something about it. I’m not really sure. I’m also told that I started hyperventilating somewhere in there and Stephanie reminded me how to breathe, but I don’t remember that at all.

Eventually, I think I said that I felt like I needed to push, so Stephanie decided to check me. She said I was at 9 ½ and to go ahead and give a little push. I did, and my water broke. I’m not sure why, but this scared the crap out of me. I think I’d just forgotten that my water needed to break or just assumed it had broken when I was in the tub, so I wasn’t expecting it. I actually screamed a little when it broke because it startled me so much.

I think it was shortly after this Stephanie inserted the sterile water papules into my back. Like I said, things were a little fuzzy, so I’m not sure of the timing. Stephanie told me she had a trick she could use to get rid of the back labor that was “just water, not medicine”. At that point I figured if water was going to get rid of back labor, I’d take it however it came. She said it was going to hurt like “the mother of all bee stings” and went ahead and inserted them. The pain comparison was, sadly, the biggest understatement I have ever heard in my entire life. Stephanie and the nurse, Pam, inserted two sets of two needles and I screamed like someone was murdering me. It was, by far, the most painful part of my labor, but it made the back labor stop immediately. With the next contraction, it was gone.

Sterile water papules are just little tiny shots of sterile water inserted into the back just below the skin. Stephanie said they trick your brain into not feeling the back labor because having the water under the skin like that is so weird that your brain just can’t figure out what’s going on. Because it’s so confused, it can’t process the back pain at all anymore. Eventually the water soaks into your skin, so the pain relief is only there for an hour or two. This is why she waited until I was ready to push before she inserted them. There was no way I’d have ever let her do a second round if the first round had worn off. It seriously hurt that much.

After this, someone (who? I have no idea) helped me over to the bed where I was going to push Norah out. I was lying on my side for a little bit but I was having trouble getting situated enough to push effectively and I couldn’t figure out what to do with my leg. Someone put up a squatting bar above the bed for me to rest my foot on, but pushing on my side still wasn’t working. Stephanie said she had another trick (I reportedly asked her, skeptically, ‘It’s not like the last trick, is it?’) and asked me to lay flat on my back. She said if we couldn’t get baby to move past my hips, we’d move my hips up past baby. I think it’s important to mention this because part of the reason I chose to use a midwife was because I was afraid of being stuck pushing flat on my back, tied up to a monitor with an OB. But when Stephanie said to get on my back, I got on my back because I felt I could trust her. I wasn’t lying on my back to make the delivery easier on her; I was doing it because she thought it would get the baby out. I think that’s an important distinction. I pushed like that for a long time. I’m not actually sure how long – maybe an hour? Maybe a little more? Stephanie and Pam, the nurse, kept telling me I was almost there but I didn’t believe them. I knew pushing would take awhile, so I just kept right on not believing them for at least an hour. D & Velma did believe them, so when Stephanie had to leave the room for a few minutes to deal with another patient who had showed up at L&D, they kind of freaked out a little. I just kept right on pushing, figuring that she’d be back in plenty of time and that Pam had it under control. Stephanie came back and everything was fine.

Toward the end, I got up and kind of hung from the squatting bar to finish delivery. I was having a very hard time squatting at that point. My arms and legs were very tired from having labored on my hands and knees for an extended period of time, and I was having trouble using my legs to support me. As a result, I think most of my support came from my arms, which were very sore for the next 5-6 days. I saw Stephanie put on long gloves and a Dr. smock-thingy, and I knew we were getting close. She helped D to catch baby’s head as it came out, and then she turned the shoulders and pulled them out for D to catch. Once the baby was born, D put her on my belly right away. She was extremely blue and had the most horrible cone head I’ve ever seen, but she was the prettiest blue, cone head baby in the entire world, if you ask me.

I’m not sure how much time went by, but I heard Stephanie say that the placenta had detatched and she asked me to give a little push. The whole thing came out and she showed me which side had been against me and which side the baby had been on. D cut the cord a little earlier than we had planned because the baby looked good and we were hoping to donate the cord, cord blood, and placenta to Donor Services. Donor Services took it away to be shipped out Fed Ex (kind of weird to think of one of your body parts being shipped Fed Ex!) for cord blood and stem cell research and use.

After Norah was born I held her for a little while and then D went with her to the other side of the room to be checked out while I was stitched up. I had a second degree tear, which was rather unpleasant, but as of today (2 weeks and 3 days later) it’s pretty much healed up and I don’t even notice it was there. To be honest, the first 45 minutes or so after Norah was born are also kind of fuzzy. I felt very disoriented and confused. I knew who all the people around me were and I knew what was going on, but I felt like I couldn’t connect with anyone or really respond to anything very well. It was like viewing the world through a TV screen for awhile there. I also got very, very cold and shaky which kind of scared me. The nurse said it was because my body was still trying to warm the baby, but the baby wasn’t there anymore. I was able to nurse Norah about an hour after she was born (also in my birth plan), and she latched on great with the help of one of the nurses.

Overall, I would say I had a good birth experience. I could have done without the back labor but I guess there wasn’t a whole lot anyone could do about that. Stephanie thought the baby may have been posterior and causing the back labor, but it turned out she was positioned perfectly. It may just have been that she was big enough that she was going to put pressure on my tailbone no matter how she came out. I think the biggest keys to my good labor experience were staying active throughout my pregnancy, having good labor support people who took care of my immediate needs, and having a care provider that I could trust, who allowed me to labor how I needed to without intervening too much.

D, Norah, and I are all doing well at home as of the time of this post. I sure could use more sleep and at times I'm not exactly sure what I'm supposed to be doing with this baby, but overall things are looking good!