10/23/2014

My HBA2C Journey

Last summer, and by great surprise, we discovered that another baby was on the way. By the time we found out, I was already nearly 9 weeks along. We went to my usual OB for a first check up and were told, first off, that I WOULD be scheduling a c-section. They do not allow VBA2C (Vaginal Birth After 2 Cesarean), and surgery was my only option. Now, it was this practice that had preformed both of my cesarean births, one for which there was no explanation, and the other which was caused by their own medical interventions gone wrong. "Hmmmm", I thought to myself, "I am outta here! They won't see my face again."

*A brief history: first baby was cesarean, second baby was VBAC (and my biggest baby), third baby was another VBAC, fourth baby was my second cesarean caused by medical intervention.

We discussed our options:
1.) Home Birth (no midwives could be found, via our online searches, who would attend a VBAC home birth)
 2.) Unassisted Home Birth (this option seemed far fetched, since this would be our first natural child birth and we were both, at this time, SO ignorant of SO much. Plus, Scotty- my husband- said, "NO WAY!")
3.) A practice that would allow VBA2C- which we weren't even sure existed.

For lack of another option, we chose number 3. Now the search was on to find a practice that would support VBA2C. Ugh. Where to begin?

Thankfully, my sister-in-law, who was 3 months ahead of me and planning a home birth, knew of a practice that supports VBAC and one of the only places that allows VBA2C in our state (that we know of). We quickly made an appointment. This practice seemed too good to be true. They claimed to follow the Midwifery Model of care rather than the Medical Model of care. Yes! That's what I wanted! So, I began my care there as well as reading books and articles, and everything else I could find to educated myself about birth. Yes- this was my 5th pregnancy, and Yes- I was SO ignorant about birth! How ridiculous!

Contrary to my natural personality, there was a strong sense of calm and courage that had settled in my soul about this birth. During my other pregnancies I had been very timid and filled with uncertainty and fear. But this time, I felt the strong hand of the giver of life. He was at work and my job was to step aside and just trust. Oh, I was so relieved and in awe of this! (VERY personal and hard to explain)

Everything was going well, except for this nagging feeling that a hospital birth was going to be too difficult. Despite my practice's midwifery model of care, there would be *some* interventions that I would have to endure simply because of hospital policy and my "high risk" status as a VBA2C. I felt like all of my attention and focus would need to be on my labor, and that the interventions and restrictions at the hospital would be too much. I felt like if labor were compared to running a marathon, then I could do that, but it would take all that I have in me. The hospital interventions were like hurdles being put in my path, and I did not feel like I could (or should have to) jump hurdles along the way. After all, having a VBAC is already a challenge- so why make it even harder by including unnecessary interventions? By week 36, I knew I had to do something different.

So here I was, just 4 weeks away from my due date and not knowing what to do! Scotty told me to ask my doula if she knew of any midwives that would attend a VBA2C home birth- an HBA2C. It was a long shot, but I asked her. And she did know! In fact, she knew of a couple who were LOCAL! WOW!

Not only was my midwife willing to take me on as an HBA2C (Home Birth After 2 Cesareans), but also this late in my pregnancy! AND she had an opening for the month of my due date! We set up an interview and asked her a long list of questions. We both liked her right away, and felt peaceful about hiring her. Many prayers went up, and we were on a new path...home birth.

The next couple of weeks went on completely uncomplicated and normally. Home check-ups, ordered birth kit, copies of records, filled out paperwork, and an appointment with the back up physician, which included an ultra sound that showed a head down, happy baby. We were good to go! Yay!

And then, just 4 DAYS before my due date, I stopped feeling movement and went in for an ultra sound and non-stress test. Our baby had turned completely transverse (sideways) in my womb. Her feet and legs were behind my anterior placenta, which is most likely why I was no longer feeling her kicks. We didn't panic too much, and decided to go to the chiropractor for the Webster technique to see if baby would turn. At this point, I was having no real indications that labor was near. The chiropractor told us that the technique has a 90% success rate, and at their practice- 100%. So we gave it a try, going back 4 times to have it done. She did turn. Then, she went breech. Then, she went head down again.

None of this was too settling to our midwife. We knew our baby wasn't small, yet she was moving all over the place and changing position at will. My due date came and went. Still no signs of labor. Stress was starting to mount, and now the weather man was getting in on the drama: An ice storm was coming our way. Great!!

The night before the ice storm, we had a home check up. The midwife didn't like what she was feeling when she palpated our baby. It felt like the baby's head was down, but tilted to the right and her shoulder was hovering above my pelvis. This is bad news if the shoulder settles into my pelvis. The only option for delivery if that happens is a c-section. So now we are hoping that labor doesn't come for 2 reasons: ice storm with dangerous road conditions, and possible mal presentation of baby. Oh, stressful day! All I could do was sleep in a position my midwife showed me that might encourage baby to move, and do pelvic tilts. And PRAY!

The ice storm knocked out our power for 33 hours. For the first time I was glad that no labor came. Not even one single contraction. I stayed up all night, worrying about the baby's possible shoulder presentation, and trying to mentally prepare myself for another c-section. And as soon as the roads were open and clear, we headed straight for an ultrasound to check baby's position. We had my suitcase in the trunk in case we were going over to the hospital. Thankfully, she was head down and in position for birth. Whew!!! What a relief! HOME BIRTH- BACK ON! I was ready! And still.....no labor. :-(

Now, a week past my due date, hormonal as all get out, STILL not having ANY signs of labor, and processing ALL of the stress from the last week and a half, I had my first mental breakdown. Poor Scotty! Not knowing what to do, he called our midwife to tell her what was going on. She is such a patient person! The next morning I called my doula who talked me down and told me to take the day and de-stress. It was the best advice ever. And I followed it.

Then, on Saturday night, our midwife came for another check up, but instead, we just ended up having a meeting. She needed to see where we all stood. After a wonderful Shabbat of de-stressing and a good nap, I assured her that I was calm and confident and still wanted to try for a home birth. In 5 days I would have to be turned over to her back up physician for a hospital birth, as she couldn't continue my care past 42 weeks. I was at peace with this. And the back up physician is an amazing doctor who supports women and supports normal, natural birth. But I still had 5 days before I HAD to be turned over to him! So, she encouraged us to take a day or two to think about it and decide if we wanted to go ahead and switch to his care early, for a planned, natural hospital birth. I knew I didn't want that! But did she? Was this all too much? I felt so bad for putting her in this position. She was so courageous to take me on in the first place. And now I was over due, a basket case, and my baby was doing flips and flops. She left me with a very sweet card and a journal and a relaxing lavender candle. The card made me cry, and the journal was to write down my every thought. Except there were too many thoughts swirling around inside of me to write down. She left late that night with a hug and a look of sad uncertainty. Or at least, it looked like sad uncertainty to me.

So, we went to bed. I was weary and confused and felt heart broken. But in all of this craziness I kept being reminded by a small, steady voice, that said to my heart- "Trust in Me" It was all I had to hold on to, and I clung tightly.



To read my birth story, see post titled:
"Birth Story: HBA2C of Hannelise Mayim"

Marshmallow Making



Homemade marshmallows are scrumptious and easy to make! I order grass fed beef gelatin to use in mine.
Here is the recipe:
Ingredients
3 tablespoons unflavored beef gelatin powder
1/2 cup ice cold water
 

Syrup: 
1/2 cup water
1 1/2 cups granulated sugar
1 cup light corn syrup
1/2 teaspoon kosher salt

 
1 teaspoon quality vanilla extract


Coating:
1/4 cup confectioners' sugar
1/4 cup cornstarch

 
Nonstick spray or butter

 
Directions
Put the gelatin in a stand mixer with 1/2 cup ice cold water. Leave it to "bloom" while you make the syrup.

 
In a small saucepan combine the 1/2 cup water, granulated sugar, corn syrup and salt. Bring to a boil on med-high heat. Watch closely, as it can boil over QUICKLY. As soon as it is boiling, clip a candy thermometer onto the side of the pan and continue to cook on med. heat until the mixture reaches 240 degrees F (soft ball stage), approximately 7 to 8 minutes (or longer). Once the mixture reaches this temperature, immediately remove from the heat.
Turn the mixer on low speed and, while running, slowly pour the hot sugar syrup down the side of the bowl into the gelatin mixture. Be careful not to splatter the molten hot sugar on yourself ;-) Once you have added all of the syrup, slowly increase the speed to high. Continue to whip until the mixture becomes a white, thick, and lukewarm marshmallow cream, approximately 12 to 15 minutes. Add the vanilla (or any flavoring/coloring) during the last minute of whipping. (Some of the flavors we've made are vanilla, banana, bubblegum, grape bubblegum, caramel sea salt, butter rum, and strawberry using flavorings and extracts. I added a bit of citric acid to the grape bubblegum to give it a tart kick. The kids loved it! Next time: orange cream. Yum.)

 
While the mixture is whipping prepare the pans as follows:

 
For regular marshmallows:
 
Grease a 9 X 13 pan with butter and coat with cornstarch & powdered sugar mixture (like you would flour a cake pan) Be generous because the marshmallow fluff is STICKY! Pour the fluff into the cake pan. Spread it out using a buttered spatula or buttered hands. This part is messy. Sprinkle coating on top and pat as flat as you can get it. Let dry/set for 4 hours to overnight.

 
Turn the marshmallows out onto a cutting board and cut into 1-inch squares using a pizza wheel dusted with the coating mixture. Once cut, lightly dust all sides of each marshmallow with the remaining mixture, using additional if necessary. Store in an airtight container or freezer bag. These are nice and big and oh so good for roasting and toasting!

 
For miniature marshmallows:
 
Grease parchment paper with butter and dust generously with coating. Scoop the mixture into a gallon zippy bag, then cut off the tip to a 1/2 inch opening. Pipe the mixture onto the prepared parchment paper lengthwise, leaving about 1-inch between each strip. Sprinkle the tops with enough of the remaining cornstarch and sugar mixture to lightly cover. Let the strips set for 4 hours or up to overnight. Roll the strips to coat them then cut into 1/2 inch pieces using a pizza wheel or scissors dusted with the coating mixture. Once cut, lightly dust all sides of each marshmallow with the remaining sugar mixture and store in an airtight container or a freezer bag. These minis are in the hot chocolate pictured.
 
These mallows stay soft for at least 2 weeks (maybe longer, but ours never last past that) My kids enjoyed watching and helping and all our family and friends who have tasted these have liked them. A lot. No one has eaten just one.

Messy, but worth it!







3/09/2014

Birth Story: HBA2C of Hannelise Mayim

A brief history:
I've had 4 babies, previously, all in the hospital. My first was a cesarean, 2nd was a VBAC (vaginal birth after cesarean), 3rd was another VBAC, and 4th was another cesarean caused by unnecessary medical intervention. I had an epidural with all of them. After two C-sections, it isn't necessarily easy to find a practice that will allow VBA2C (vaginal birth after 2 cesareans), but we did, and all was going well. However, what we truly wanted was a home birth, and at 37 weeks, with the help of our marvelous doula, we found a midwife who would take me on- high risk, almost due, and all. She is my HERO! So, this is the story of our HBA2C- home birth after 2 cesareans.


We went to bed very late on Saturday night. I was weary, both physically and emotionally, from a very trying couple of weeks. In less that 10 days we had been through everything from going overdue, to an ice storm that knocked out our power for a day and a half, to baby presenting in several positions- one of which was dangerous, to facing a hospital birth if I went past 42 weeks. Only 5 days left until then. And I still had NO signs of labor. Nothing. Nada. I was spent. Why wasn't I going into labor? What was wrong? Why wasn't my body working like it is supposed to? and other worrisome questions floated around in my head as I tried to drift off to sleep. And a reminder from my Heavenly Father: "Trust Me" Yes! I want to. I'm trying.

And then, there it was. A cramp that grew into a pain.

I have been welcoming pain of any kind for weeks! But they all fizzle into nothingness. I have even had several sets of contractions that last for over an hour and are 4 or 5 minutes apart! Very promising! One set has even included lower back aches! But they have all betrayed me by ending suddenly. And then I wake up the next morning feeling normal. And sad. It has now been almost 2 weeks since I have felt any type of cramps or contractions, so at this point I am sure that labor will never come. My comment to Scotty is that I won't believe I'm in true labor until I see the head. And that is still how I feel when this first cramp comes. This feels strongish, but surely it isn't "real". I turn over and try to fall asleep.

Soon, another identical contraction came. I breathed through it and then tried to sleep again. It was about 3 a.m. I knew I would wake up in the morning feeling normal. And discouraged. But then....another one came. In my stubborn denial I turned over and over, breathing through each one, and refusing to wake up my husband. They would stop soon.

Now, in addition to breathing, I'm making quiet sounds to get through the ever stronger contractions. I decide that if I have 3 more, I will begin to time them. Just for kicks. Since this isn't real labor. On the third one, Scotty wakes up to my sounds. "Are you okay, babe?" I tell him that I've been having contractions for an hour and a half. But they might go away. He talks me through a couple more and then gets his phone to start timing them- just in case. They are 2 minutes apart and almost a minute long. I tell him I'm going to the bathroom, because they'll stop once my bladder is empty- as they had done in weeks past. They do not stop. And I have some "bloody show". Now I am slightly more convinced that this could be real.

We decided to get up and go into the living room. This was the moment we had been waiting for! I sat down on the couch and got comfortable, and then another one came. WOAH, NELLIE!! Sitting on the couch made them hurt WAY worse! Next, I tried kneeling on the floor and leaning over my labor ball. That ball. I had been waiting to use that ball for so long. I had read other birth stories of how wonderful and comforting it is to lean over or sit on a labor ball. Somebody lied to me!! Another one came: OUCH. Kneeling and leaning on the ball was clearly not the way to go!!

Now I'm confused. I thought I would be able to get into any comfortable, resting position, and concentrate and focus on contractions, then rest between them. But so far- sitting and kneeling are OUT! So, we decide to go back to our bed. I lay down on my side- another contraction- NOOOoo. Not good! So then, the only way that they are even bearable is standing or lying on my back, propped up on some pillows. We do this for a while, still timing them. Still wondering, in the back of my mind, if they will ease off and go away. But the sounds I am making to get through them are getting louder and they are getting super, seriously strong. Seriously. I am afraid I will wake the kids. I am thinking the birth must be near since this is SO STRONG already! I am thinking What do we do? Who do we call?

We called my mom to ask her to come get the kids. I was SURE that Scotty could NOT leave me to help the kids get breakfast when they got up. I needed him for every contraction now. Then, we began to pray about who to call and when. We asked our Heavenly Father to allow only His will. We asked for wisdom. Then, we called our midwife.

I get in the shower to see if it would help. After a couple of contractions in there I ask for my labor ball so I can sit down and rest. The next one comes and it is NOT good! OWWWW!! That dang ball has failed me again! It hurts so much to sit on that thing through contractions. I get out of the shower and back in bed. My midwife is setting up in the living room and my kids are up and getting dressed and ready to go to Mippi's house. We call our doula. This labor is in full swing!

Suddenly everyone was there. My mom was holding one hand and my doula was holding the other. (Scotty was filling the bath tub, but I didn't know where he was at the time) The moment of truth had come when our midwife was about to check the baby's heart rate and see how dilated I was. I had it in my mind that if the baby's heartbeat was not in the right spot (like if she was breech) then we were off to the hospital. So what a huge relief that her heartbeat was really low and in the center, and a lovely 140. I was so glad that she was in the right position. Home birth- still on! Yes! Then, she checked me. I was at 6-7 cm. I remember being kind of surprised that I wasn't, like, 9 or 10 cm because this was so intense. But at least I was over halfway there. So, I labored on.

My midwife says I can get in the tub if I want, which Scotty has already filled. Since I have heard that warm water is a huge help with labor pains and is "nature's epidural", I am so looking forward to the relief! I get in the tub and sit down. OH SNAP!! Sitting is simply unacceptable during contractions- warm water or not!! I don't notice much or any relief! All I notice are extremely powerful contractions that can't even be real, followed by brief moments of sweet and blissful rest. I lean back on a towel and forge ahead through many, many contractions that rock my world and make me wonder how anyone relaxes through this. I wonder how long I can hold on. How long can I endure this? What have I gotten myself into? Sometimes, as a contraction comes on, I beg, "Help me! Help me!"  to which Scotty or my doula respond with encouraging words...they don't know I am not saying it to them.

I briefly considered the distance to the nearest epidural, but then quickly rejected the idea of riding in a car during these contractions. No stinkin' way.

I am only really able to cry out in a sort of (very loud) groan/roar and manage to relax my face and bottom. Otherwise my whole body is like a giant muscle spasm. Trying to relax my legs or anything is a big joke! And just when I think it can't get any worse, my doula says to get out and empty my bladder. Okay. So sitting, kneeling, lying on my side, and the labor ball all hurt like the dickens...but sitting on the potty during a contraction is like the worst thing I ever hope to experience in life. For real.

And then, for some reason, I got back in the tub! We carried on this way for some time as I laid there wondering why my husband wasn't an anesthesiologist, and being slightly annoyed with him for not taking that career path. Obviously, I was not in my right mind by now. I was seriously wondering how much longer I could take these contractions. They were more powerful than a locomotive. I was in awe of them. And I wanted them to leave me alone and let me have a nap!

None too soon, my midwife comes and tells me to get out of the tub so that she can check me. Yes! Thank you! Being in this tub has sucked!! (So why was I still in there? No one was making me stay in the tub. Duh.) I wander out to the living room to see a beach towel laid on the floor with a pillow at one end. I think to myself "Oh no! What new torture am I about to endure lying on the FLOOR through these things!?" They also had a pillow and some towels on the couch. Who knows what's in store for me next!  Scotty slips a clean nightgown on me because part of my birth plan is for him to keep me modest during labor, if possible, even if I don't seem to care about being naked. Like now. I stand through a few more contractions, holding onto Scotty for dear life, and stretching the crap out of the neck hole of his shirt. And then the assisting midwife suggests that I sit on the labor ball. Oh-to the-no! Reluctantly, I agree, only because they know what they're doing and I don't. So I sit on the ball of horrors. Yep! It doesn't disappoint!! Still horrific!! But they tell me to stay there for a FEW MORE!! Ugh!! REALLY??! But I listen to them. And endure a few more on that hideous ball of torture. As I'm laboring on the ball of doom, Scotty is sitting on the couch leaning forward and letting me hold on to him when a contraction comes. Another one comes, and he doesn't sit down in time, and I just grab onto his legs. My hands and arms are up the legs of his shorts, wrapped around his thighs, and I am clutching his boxer briefs with all my might. He tells me later that I was slowly pulling his underwear down and he was deciding whether to let go of me and save himself from mooning the whole room, or just let his back side shine for all to see in the name of good, dedicated coaching. Thankfully, the contraction ended before any hard decisions had to be made, and his dignity remained in tact.

Another trip to the bathroom was suggested. Worse news had never reached my ears. But I knew my bladder needed to be emptied, so I agreed to go. (They had been putting water or a smoothie Scotty had made for me in my face all morning, and I had felt obliged to take sips...even though it meant I would have to pee. Ugh.) I had one contraction while sitting on the pot and they asked if I felt the urge to push. I said no. Then, the next contraction came and I changed my answer to yes! I did feel the need to push. But it wasn't overwhelming and I wasn't really feeling the pressure that I was waiting for that meant birth is near. At this time, my long awaited mucous plug finally made it's appearance. I had been watching for it for weeks. I look at it, thinking "Better late than never, my disgusting little friend." So, back to the living room and one or two more standing contractions (some of which felt a little "pushy", but not too much) and I made an announcement. I told the whole room that I was tired and I didn't know how much longer I could go on, and I was gonna lie down on the couch and rest for a minute. I didn't really care what anyone had to say about this. I WAS going to lie down and rest. Even though I knew I would pay dearly for it when the next contraction came. To my surprise, no one argued with me, and in fact, they seemed delighted with my decision! Weird!

So, I lie down on the couch and, OH MAMA, do I ever pay for it with the next contraction! Now my midwife is listening to baby again and finally about to check me as she said when I first got out of the tub. Baby sounds good and I am complete (Yes! FINALLY!!) Now, how much longer before it's time to birth the baby? I'm thinking I still have more labor to endure because I am not yet feeling the extreme pressure that I have always felt before when it is time to push (even with an epidural- there is no denying this pressure!). I'm thinking I had lain down to rest and now it's time to get back up and keep laboring. I'm thinking that it cant be time to push until I feel that mega pressure- like I have to go to the bathroom really, really, really, really, really bad- which I am not yet fully feeling. But my midwives know better and with the next contraction I am P*U*S*H*I*N*G to my own surprise!

Now the contraction that I am feeling seems non-stop. It is like a force unknown to this world. It is like power and pain, crushing my pelvis, and prying it apart. It is like death and life all at once. It is a force like no other I have ever known or imagined. And I am trying to push through. All of my might is so pitiful compared to this POWER and this pain. No words that I know exist to describe it. It is like a presence that I can almost see around me. And in the midst of it, there is wonder, and there is a comfort. So strange. I am amazed by this fierce pain, and most surprisingly, I am not afraid! And it feels like my midwife is shoving me down into the couch. And then there is what must be the "ring of fire", except in the midst of this pain it feels really puny. More like the ring of warmth. But the assistant midwife sprays some cooling spritz on me and I feel some sort of relief. Funny, that I could feel some cooling relief from a little mist even in the throws of "the-pain-for-which-there-are-no-adjectives", as I have nicknamed it. And then, suddenly, something comes out! And then my midwife giving me urgent instructions to "PUSH! You're not done!" So, I muster all of my strength and bare down with all of my might, and PUUUUUUSH! And then my uterus says, "Psssht. Is that all you got? Step aside. I got this." And she shoves the rest of our baby out like it was nothing. My uterus is awesome.

My labor was eight and a half hours. It was fiercely intense. It was the hardest thing I have ever done. It was mighty. It was excruciating and severe. It was crushing. It was healing. And it was wondrous. It was beautiful. 

At 11:20 a.m. a tender and precious baby is on my chest, all lovely and perfect. I am told that she has been born inside of her unbroken bag of waters, known as being born "in the caul", which is rare and delightful! She has dimples- 3 of them! One under her left eye, and one on each chubby cheek. Her light brown hair is longer on top and sticking up into a point. She is so divine! I love her. And she poops on me right away. A big 'ol poop. I can hear Scotty's sobs of joy and relief and gratitude that we are both safe and healthy. Our Creator is so good and merciful. We have been remarkably blessed.

 

The placenta didn't come quickly, so they asked me to stand over a chux pad. It had been 23 minutes since the baby was born, and it was starting to get slightly tense in the room because when there is a cesarean scar on the uterus, the placenta can grow into it and cause an emergency. So when that placenta hit the floor we were all relieved.


 
 


9 lbs. 6 oz. 22" long
 

After some stitches and being able to empty my bladder, it is time to rest, heal, and savor our beloved new baby! (I had been unable to pee at all after my two previous VBACs, and had to wear a Foley catheter for 3 weeks each time.) Being able to pee is a HUGE, GIANT relief!! I give a prayer of thanksgiving each and every time the urine flows. Seriously. People don't understand what a blessing it is to be able to pee. Trust me. It is. 

We named our darling baby Hannelise Mayim on the day after she was born. (Her name is pronounced Hannah-leese  My-eem) Her first name means "Favored by Elohim", and her middle name is the Hebrew word meaning "waters", because she was born inside of her bag of waters (which I consider to be His own Hands delivering her). Woven all through this 9 month journey has been a message, a theme, a very personal lesson from my Heavenly Father: "Trust in Me. Hide in Me." He provided every need, and more. Oh, how humbling!! My midwives and doula took such excellent care of us. I have felt incredibly well after this birth. Considering ALL we have been through with five births, Scotty and I both agree that this one is the best ever, without a doubt.

We are forever grateful for our little birth team and for this very precious day when we could feel the Eyes and Hands of the Giver of life on us.


1st Shabbat


Baby Blessing