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!