Browsed by
Category: Pregnancy

Journey to a Peaceful Planned C-section {Twin Girls}

Journey to a Peaceful Planned C-section {Twin Girls}

My story begins when I was just a child. Ever since I can remember, the one thing I wanted to be was a mother. Sure, I had other dreams and aspirations as well – but, while my idea of the perfect career and life was constantly changing, my goal of becoming a mother never once faltered or waned. That dream, however, would come true too soon when I became pregnant at the age of nineteen by a man I’d only been dating for a month. It was bad timing, and there were a lot of struggles – but in my heart I was overwhelmed with happiness. I was growing life! What could possibly be better than that? But, as time wore on, my happiness began to be whittled away by the stress and terror of being a young mom in a new relationship. I spent the majority of my pregnancy alone while my partner worked out of town. I had no vehicle, no friends – I didn’t even have cable TV or the internet to help me pass the time. I was constantly lonely and afraid. And, during the times that my partner was at home, he was cold and aloof – dealing with the stress of the pregnancy in the only way he knew how.

I became bitter; angry. I’d always suffered from anxiety and depression, but now it was out of control. I went days without getting out of bed. I had always wanted to have a baby, but my fairy tale was turning into a nightmare. I felt useless, unwanted, ugly, and broken. Weren’t pregnant women supposed to feel gorgeous and glowing? Weren’t their partners supposed to adore them, support them, and tell them how amazing they were? I felt cheated out of something I had looked forward to since childhood. I was terrified that my child would become tainted in my womb, malformed because of all the fear and hate that I held in my heart.

And then there was the traumatic birth. The only research I had done while I was pregnant included reading a book that my mother gave me and watching reruns of “A Baby Story” on TLC. I had no idea what birth really was – I truly believed that the doctor and nurses had my best interest in mind and would take good care of me. I went into “preterm labor” three times the month before my due date – each time my labor was stopped and I was sent home after one night’s stay in the hospital. Looking back, I am certain that my child and my body knew that we were ready to deliver at that time.

May 14, 2006 – Mother’s Day. My water broke as I was getting ready to go to bed for the night. We immediately went to the hospital, and I was given pitocin to “help things along.” I wasn’t contracting at all, and still didn’t even after they began the pitocin. I slept that night, with my partner and my mom taking shifts watching me. In the morning I was beginning to have some contractions, but nothing regular or painful. Months after my birth, we found out that the hospital had received a “faulty” batch of pitocin at the time of my delivery, so it’s definitely possible that I was given bad drugs.

Later on, sometime early afternoon, my contractions finally started to kick in – but they were far from normal. I would have four or five contractions back to back, and then I would have ten or fifteen minutes of nothing in between. It only took a few hours of this before I became exhausted. I’d previously requested to not have an epidural – but after some “convincing” from the nurses, I finally agreed to have one put in. By the time the anesthesiologist made it to my room, however, I was past the point of being able to have one. At that point, in the middle of a cluster of contractions, the nurses convinced me it’d be best if they gave me a dose of stadol. I don’t remember agreeing, but I must have – because the next thing I knew I was woozy and out of it and I didn’t even know my own name. The next few hours were a blurry haze. I remember being told to push. I remember pushing, and being yelled at to push harder, and crying, and being yelled at, and feeling like I wasn’t good enough or strong enough to have this baby. At one point I looked over at my partner and my mom and begged them to make it stop. Shortly after, consent forms for a C-section were being shoved in my face. I signed them. I just wanted it to be over.

The C-section was probably very normal, as far as sections go. I was terrified of being cut open, but after the spinal took the pain away I was in such a state of relieved bliss (part of this was probably the drugs) that I didn’t mind. My partner stayed by my head while our baby was being delivered – a baby that was so stuck in my pelvis that the doctor was out of breath after tugging and yanking and pushing him out. I remember the doctor saying, “Well, no wonder. This baby is way too big; he never would have come naturally.”

It was late at night, and by the time I went into recovery most of the hospital was shut down. So I lay in a bed, by myself, in near darkness (apparently they didn’t want to turn on more lights than they had to), for over an hour. I remember hearing the doctors and nurses complain about having to come in at 7pm on a Monday to perform an emergency section. I felt like a failure and inconvenience. I ended up shaking more than the nurses were comfortable with, so they gave me a drug to help, which also meant I had to wait longer to see my baby. By the time I got out of recovery, the nurses had convinced my partner and mom that they should go against my wishes to exclusively breastfeed my baby because I was “taking too long to recover” and my baby would “starve” if they didn’t give him formula.

But then I saw my son, and got to hold him for the first time, and suddenly everything else didn’t seem so bad. I was elated and giddy with happiness – I had a son! He was perfect and gorgeous and the most amazing thing I had ever seen. Unfortunately, that feeling of peace and happiness was extremely short lived.

When my mom and partner left for the night, I was left alone with a newborn who didn’t want to latch on because he’d already experienced the easiness of eating from a bottle. He cried, I cried, and we continued on this way for nine months. He was an extremely colicky baby, and I had no idea how to handle it. I remember staring at him and feeling like the worst mother on the face of the planet – because I didn’t know how to make my son stop screaming. He screamed nearly every second he was awake, and every time he screamed I cried. That, along with the PPD that kicked in about a week after he was born, made my life as a new mom worse than any hell I could possibly imagine. I hated myself. I couldn’t bond with my son – and I hated myself even more because of it. And so began my three year stretch of just barely scraping by on a day to day basis.

When my son was three, I made the hard choice to leave my boyfriend and start a new life on my own. I didn’t have a job, a place to stay, and no money – but I knew in my heart that I needed a fresh start. I built myself up from nothing and, with the help of my parents; I succeeded in securing a decent life for me and my son. It wasn’t ideal – but it worked for us. I finally faced my issues with depression and anxiety, and for the first time in forever I felt like I was regaining some control over my life.

Fast forward a couple years – a couple jobs, a couple boyfriends, and a couple stressful situations later. I’d grown remarkably as a person, as a woman, and as a mother. I felt in control and happy. I had a great job and a new boyfriend that I adored. I wasn’t on birth control because my previous partner had a vasectomy, and I was looking into getting an IUD. And then I found out I was pregnant.

Fear. Panic. Denial. Was this really happening to me again? How could I be so reckless and stupid? I was terrified of going through another traumatic pregnancy and birth. Luckily, my boyfriend turned out to be an amazing source of support – he showered me with love and affection from the moment the test came up positive, and every time I panicked and tried to push him away he would stand strong and stay by my side. But I was still scared of everything to come – what if I had another child that I couldn’t bond with? What if I lost everything I’d worked so hard to achieve? I couldn’t stand the thought of going through what I went through with my son, even if everything did turn out okay in the end.

But then, the most amazing thing happened. When I was ten weeks along, I went in with a bit of spotting and had a precautionary ultrasound. What we found was a completely healthy TWIN pregnancy. I was having two babies! I don’t know why, but as soon as I saw my two little angels on that ultrasound screen, everything suddenly clicked into place. I was at peace with myself and this pregnancy. A couple months later we found out that we were having girls, and the joy grew even more. I was having daughters. I felt like everything was finally falling into place. This is what I was MEANT to do – this was the life I was meant to have.

But, slowly, a new type of fear kicked in. The internet is a wonderful thing, but it can be terrifying for a pregnant woman – especially a woman with a “high risk” pregnancy. I read horror stories about TTTS and Vanishing Twin Syndrome. I’d never worried about my son while I was pregnant with him. I didn’t realize how many things could go wrong. So, while I was finally enjoying a joyful pregnancy with a wonderfully supportive partner, I was constantly terrified of something horrible happening. When we found out that our twins were sharing a placenta, the fear got worse. And when I showed signs of my cervix shortening and was put on bed rest at home, the panic truly reached its peak. I spent every waking moment terrified that my water would break and my babies would die, that something beyond my control would come and take my precious girls away.

When I was put on bed rest, a friend of mine who was training to be a doula sent me some information about the effects of bed rest on pregnant mothers. I began to realize that women had been birthing babies since the beginning of time, and that a mother has the ability to know her own body better than any doctor ever could. I did more research – and that’s when I found your blog.

I spent days going through your site. It opened my eyes to a whole new world of babies and birth. It all made so much sense. I read countless stories about beautiful, brave mothers who listened to their own bodies and had wonderful, peaceful births. The new awareness that dawned on me changed me in ways I can’t even begin to explain. For the first time I began to realize how much damage my first pregnancy and birth had done. I began to understand the resentment and guilt that I still carried from it. I began to acknowledge the fear and pain I’d been holding onto since then. I realized that I had spent the last seven years feeling like a failure as a mother, and I saw how that negativity had infected every aspect of my life. And, even more remarkably, I began to forgive and let go. I cried for days. Afterward, I felt like a new person. I felt strong, capable, and informed. I felt peace. I felt joy. I felt the beauty of the lives growing inside of me, and for the first time in my life I felt capable of being the mother my son and girls deserved.

And that’s how I ended up here, 30w2d along with my Mo/Di girls, and confident in my own strength as a woman and a mother. I’ll be having a repeat C-section this pregnancy – the hospital here doesn’t even consider VBAC and pushes for sections with every case of twins. But I’m at peace with it, and I don’t feel forced or taken advantage of in any way. I feel informed, capable, and like I’m choosing the option that’s best for me and my babies – not like I’m a passenger along on a ride that I can’t control. So, even though I’ll never get the dream birth that I’ve always wanted, I know in my heart that the resentment and guilt I felt with my first C-section won’t be an issue this time around. I feel beautiful, strong, and calm. And I feel immensely grateful to you and the wonderful women of BWF for opening my eyes and sparking my healing process. Thank you, you beautiful souls.

The first picture is of me and my son, who is now seven. The next three are me and my girls at fourteen weeks, twenty-eight weeks, and thirty weeks. Hopefully in a couple months I’ll have more pictures and a second, happier birth story to share.

Day1

Day2

Alternative Methods of Checking Dilation {The Purple Line and More}

Alternative Methods of Checking Dilation {The Purple Line and More}

Through several years of being a part of the birth world I have noticed a trend. Dilation is *the* birth topic. No matter how a mother plans to birth, when the time draws near, dilation is the one thing on her mind. Why? Cervical dilation tells us one thing and one thing only – where you are right that second. It tells you nothing about what came before that check (when you compare to other labors or women) and it tells you nothing about what is to come. It only tells you about the here and now.

cervical check

The news of little or a lot of dilation can either help or hurt a mother’s mental state in labor. If the mother has been in early labor for days (which is normal), the news of a only 1 or 2cm of “progress” can completely take her out of a peaceful state of mind. If the mother has only been in labor for a few hours and finds out she is already at say, 7cm, she may think her time is nigh…only to find out that she has many more hours of work ahead. Basically – the information can back fire on you.

But there are times when the information can be of use. For instance, a mother may plan to wait to get an epidural until “x” dilation. Or she may be waiting to call her family until she is sure things are really cooking. So what are the ways of getting this information? The first thought that comes to mind (and the only thought usually) is that you must have a vaginal exam.

Guess what? You don’t! That’s right – no one has to put their hands in your vagina to give you this information. Vaginal checks come with their own set of risks, from accidental rupture of membranes (or not so accidental – some care providers have used it as a good time to break mother’s water without asking) to increased risk of infection.

Studies also show that vaginal exams are not really accurate. When checking for exact dilation, studies show the accuracy to be around 48-56%. When allowing a margin of 1cm (which is a large margin of error when this information is used to time interventions or labor “cut-offs”) the accuracy is around 89-91%. [One such study abstract from real women in labor. And another study abstract which was done on models.] When you add in multiple people checking, the accuracy gets even worse. Yet, vaginal exams are considered the “gold standard” of assessing labor progress. And lets not forget that vaginal exams are just plain uncomfortable at the best of times – in labor they can be downright hellish.

So what are some ways of figuring out your dilation without actually touching the cervix?

The Purple Line or Bottom Line

This is a purple/dark line that shows up and extends well, to put it delicately, along your natal cleft. Or rather – your butt crack. The line starts at the anus and moves up the cleft. When it is all the way to the top, you are 10cm. Normally – you do have a bit of a line there. But this Purple Line or Bottom Line is not he line that is normally there (which is usually pink). This is a dark purple line. My suggestion is to check out your bum in early pregnancy so that you know the difference.

A study was done in 2010, and published by BMC Pregnancy & Childbirth, that proves the existence and accuracy of the purple line for many women. In this study, the line itself was present at some point in labor for 76% of women. The line was more apt to show in women with spontaneous labor than in those with induced labor (80% vs. 59%). The further dilated a woman was, the more likely she was to have the line show up. The line showed up most when women were around 7-8cm dilated, and seemed to fade in some women at almost complete dilation. And according to this study sample, the line seems to first show for most women around 3-4cm.

An earlier study was done in 1990 and published in the Lancet which also proved the existence and accuracy of the line, though the sample size was smaller. In this study, the line was seen about 89% of the time and was only completely absent in 10% of women. They noticed a significant correlation between the station of the baby’s head and the length of the line.

The reason for the Purple Line is believed to be due to the increased pressure on the veins around the sacrum. This pressure on the veins creates the dark line where the thin skin of the cleft can show it. This pressure from the head creating the line also means that you can reasonably assess the station of the baby’s head as it moves down. Lower head = more pressure = higher line.

Here is a great example of the Purple Line from a wonderful mother in our support group. Obviously – she is complete in this photo, and baby is on its way out! But you can see the Purple Line so clearly (though I did take the liberty of highlighting it for you). Thank you Sara for sharing this moment with us!

purple line

With the relative accuracy of this method, and especially considering the inaccuracy of vaginal checks, this is a great way for women to check themselves without “checking”. This would also be a pretty accurate way of judging when to head to the hospital (if that is your plan) if you are one of the 76% of women this line shows up for.

The photo below is from Jackie, who was so excited when her purple line showed up around 8cm she actually asked her photographer to snap a photo!

Purple LIne

Sounds of Birth

The sounds a woman makes in labor can tell a care provider (or partner) much about where the woman is in labor. Obviously, this will not work the same for all women. Some women are noisy all the way through – which is fine. Some women are quiet until the very end – also fine and normal. However, there does seem to be a pattern for most women in the way they vocalize in labor.

In early labor (0 to 4cm) a women can normally converse easily or with little effort during contractions. She does not feel the need to rest between them very much, and will most likely continue or pick the conversation right back up after each contraction. In active labor (4 – 6 or 7 cm) the woman usually has to do some breathing or vocalizing during contractions, and normally stops speaking during them. She may have to rest more between them.

In transition (7 – 9cm) the woman tends to really need labor noises – groaning, moaning, and sometimes repetitive mantras or noises. At full dilation the women may really retreat within and become quiet. She may not want to speak at all, even between contractions. Pushing of course has its own set of noises. And just a note on noises – low and open noises seem to help women dilate. Keeping the jaw slack and not clenching helps the pelvic area to open and not clench as well.

Smell

This is something that birth workers will talk about and recognize. Just before the start of transition, the woman emits an earthy and very “birthy” smell. Musky and deep, it speaks to some inner part of our being and psyche.

Fundal Height

This is a documented way of measuring dilation externally. When not in labor and full term the fundal height is normally 5 finger-breadths between the fundus (top of the uterus) to the bottom of the breast bone. As labor progresses, the uterus pulls up on the bottom of the uterus (which is the cervical opening) and this is what creates dilation. Think of it as the uterus “bunching up” at the top in order to pull the bottom up and open.

As dilation progresses, the finger-breadths between the fundus and the breast bone becomes smaller and smaller – at full dilation, you can normally no longer find the gap between the two. This measurement must be done at the height of the contraction, and while mother is on her back. This means it will not be the most comfortable way of assessing progress – but it does work.

Emotions

Basically – as a mother gets more serious, her dilation is increasing. Naturally (like with noise/vocalizations) this is not true for all women. However, in reading birth story after birth story (and watching video after video) I do see this trend. Mothers start out chatty and light hearted. As the harder work sets in, mothers retreat inside and tend to ignore those around them or get serious in other ways.

This seems to be a very accurate sign of transition for most women. Transition is typically the last stage of dilation and is normally the most intense. It is during this stage that mom may get irrational or scared. Usually this is when women feel the “I can’t do this” emotions and may express sudden fear or want of pain medication. When women are prepared for this stage they can be reassured that this means labor is almost over and baby is near.

Bloody Show

Many women hear about the bloody show at the start of labor. Not all women have this, but it is the “mucus plug”…basically, it looks like a large wad (or wads) of well – snot. I know, not the nicest way of saying it, but it is true. The mucus plug is probably one of the weirdest looking parts of labor and birth. However, around 6cm or so, most women get another (or first) bloody show. This usually comes out during contractions, and may be a gush of fluids and mucus and blood. If a woman’s membranes were broken before this point, she may have another gush of fluid at this point.

Estimate Without Fear

All of these methods can be used to assess progress in laboring women. Some may be more accurate than others, but perhaps we should ask ourselves about why we want to know dilation in general. In some situations the information can be very useful, for instance if a mother does not want to head to the hospital too early or if she is negotiating for more time in labor but does not want a vaginal exam at the moment (or at all).

However, my suggestion is that for the average laboring woman we learn to not equate cervical dilation with progress or lack of progress. As I stated at the start, dilation is only a snapshot of where you are right now and tells you nothing about where you will be an hour from now or even 30 minutes from now. Long labors with slow dilation can suddenly speed up and reach full dilation (and baby in arms) in mere minutes or hours compared to the slow dilation of the previous hours or days. Women who are not dilated or effaced at all during a prenatal appointment can suddenly have a baby in arms an hour later. [Though, prenatal dilation checks are another subject that will need a separate post.] Dilation is simply not a crystal ball.

If you are a mother who wants to avoid cervical checks completely, or wants to know how to assess dilation before your care provider comes (or you go to them), then these methods can serve you well. As always, continue your own research and talk to other supportive women.

Further Reading

Bellies and Babies Blog on Dilation

Science and Sensibility post on the Purple Line

A Midwife’s Perspective on Cervical Exams

“Find a positive within this darkness.” | Infertility And Pregnancy

“Find a positive within this darkness.” | Infertility And Pregnancy

Thank you to Holly, for sharing your story and thoughts.

When I was first asked to write this piece, initially I was overwhelmed… Despite being completely content with all of it in my head, how do I put the last decade of feeling and emotion into words coherent enough for people to read and make sense of? But after sifting through years of thoughts and feelings, it seems it could be done… Coherent, I am not certain of, the reader may have to be the judge of that themselves!

I had my first born in 1998, at 21yrs of age. After being diagnosed pre-teen with severe endometriosis, I had always been told to expect that conceiving children may always be a struggle without the help of assisted conception. Luke was a planned pregnancy, and despite expectations that he would not be conceived easily, he was… And here he is now at almost 15yrs old. Lukes birth, unfortunately, was less than easy… and after 56hrs of active labour, a body that just would not (or could not) dilate, an emergency c section, and a handful of infections later, I was left with secondary infertility.

My second son was born in 2010, 12yrs after his brother, with over a decade of surgeries, different specialists, and multiple IVF attempts in between.

My first pregnancy was just amazing. A completely drama free, enjoyable, text book pregnancy. I had known only fortune in terms of fertility and health, and had absolutely no need to be anything other than contented and wonderfully in the moment.

Here’s the thing about infertility.

After experiencing the harsh reality of all that it is, it changes things so that they may never be the same again. Over a decade of doing my best to find hope, to find faith, to find belief… And then to hold onto those things in what sometimes seemed like an endless tunnel of darkness to fight for a positive outcome? That changes you.

After living with infertility now for as long as I have, I have learnt many things along the way.

I have learnt that there is a fine line between being cynical and being realistic. I think it’s important to acknowledge that in such a journey – in any journey with great disappointments – and then to have learnt to constantly remind myself of that fact in order to keep a clear mind and not fall victim to the cynical side.

Before infertility, and throughout my first pregnancy, I can honestly say any fears there could have been for me concerning the pregnancy or birth were just not even great enough to raise. After infertility, during my second pregnancy, I could not have been any further in the opposite direction.

After dedicating years upon years to this one focus of conceiving a child – once I was finally blessed with that miracle, it’s a hurdle I found I passed, only to then have a handful more presented to me.

I remember vividly the moment I was told I was indeed pregnant. I had the scan, I saw the heartbeat for myself and at that moment, I was told from this point, I would be just the same as every other pregnant woman now in terms of prenatal care. I remember smiling to myself at the irony of those words – words I had waited to hear and a situation I had waited to be in for so very long. But to be just the same as any other pregnant woman now? That was something that would never, ever be.

You spend such a long time getting to this point that once you reach it, it’s impossible to relax, to be just ok. It’s impossible to be like ‘just your average woman experiencing your average pregnancy’. Every twinge, every feeling, every EVERYTHING you feel throughout the pregnancy has the potential to send you into a state of panic, of paranoia – because this tiny growing life inside of you was so hardly fought for, all of a sudden it’s fragility has increased to a level beyond measure. An inability, really, to relax, as I just knew I could not breathe easy until that much awaited new person was safely earth side and inside my arms.

And safely earth side inside my arms…. There lies another fear and anxiety of how to bring that situation to head – the birth.

I have many good friends who have birthed babies in all ways we know are possible. Vaginal births, drug free births, caesarean births, home births, doulas, obstetricians, midwives.. The list is endless. And if I am to be completely honest, once upon a time I would have looked at all of these options and had a preference of how I envisaged this to play out.

My first birth I had plans, and dreams of a lovely active labour, drugs if only necessary, and a natural, vaginal birth. After 10yrs of struggling to get to this moment, to even be carrying a baby – for my second birth, I was just happy for this baby to be here.

Infertility will do that to you.

As it turned out, during the pregnancy, I developed placenta previa, and so any other birth other than Caesarean section was not an option. Honestly? I was completely 100% fine with that. I had so many people along the way tell me how sorry they were I didn’t have the ability to make the choice, but realistically, I just needed this baby birthed, safe, and in my arms. Some could say I was a little cheated in terms of birth choices but for me, personally, after everything I endured to get there, it was the last thing on my mind.

image_1366955887618512

I don’t think for a second that this is a generalisation of every woman though, who has gone through the hell that is IVF or infertility. I know many women – even most of the women who have been through this – and their birthing choices for them were just as passionate and determined as the dedication to the journey that got them there.

The most important thing? Acknowledgement. Acknowledgment and honesty within yourself. THAT’S the most important thing. Expectations. Hopes. Fears. Acceptance if those expectations fall short. To know them is to acknowledge them, and for me, admitting these things made it possible to get through the additional struggles of the pregnancy and birth that I believe the infertility contributed towards.

I am a huge believer in positive thinking. I do believe that in order to keep sane throughout this entire process, you need to have a certain level of positivity, of faith that everything will happen as it will happen, and you have the ability to endure whatever is put in front of you, regardless of the outcome. To be honest with yourself and know when you are great to continue on, and when to accept that you have come as far as you can.

To walk your own path, to have the strength to not let others who have not known your heartache to make judgement or have an opinion on your choices or your sacrifice.

They say never judge a man until you’ve walked a mile in his shoes…. Never judge a woman who feels her purpose in life is to grow, birth and raise children – yet the Universe has decided that this simple privilege to so many others will be her greatest personal hurdle that she may ever have to overcome.

Infertility is hell. But that’s a topic all of its own that I could honestly write forever about. But I believe if you can find a positive within this darkness, it makes the experience or the living of it become bearable. To be able to continue on.

I have found many positives along the way – over the years to have found other women who have endured the same heartache, hopes & fears has been a lifeline for me. I have been incredibly lucky to have had amazing support from family and friends, however, having other women who have been through this experience to talk things through with is a gift that is priceless, and for me I could not be more grateful.

I am one of the lucky ones. I spent over a decade walking this road, but along the way met some of the most incredible people the world has to offer. Amazing women who have shared in similar heartache. An amazing fertility specialist of whom I could not have more respect, admiration or appreciation for. A team full of nurses and administration in my IVF clinic that have picked me up many times along the way without sometimes even knowing they have done so. An absolutely incredible husband. A relationship with him that plunged into hell and back many times over, yet reached a level of love and respect that otherwise I could not have imagined was even possible.
So much personal growth. So much I have learnt about myself and who I am – to have learnt how to allow something such as infertility change you – and yet not to define you. To have learnt empathy in its purest form, both to have given and received, that is a gift within itself.

And then at the end of it all to have been blessed with the ultimate prize, as my happy, healthy, perfect 3yr old goes about his day…. For that, I am eternally grateful.

Infertility is a change of life as you knew it previously. As you will never know it again. It becomes a lifestyle. It is not something I would wish upon my greatest enemy.
Enduring pregnancy and then birth after infertility – while it is indeed victorious – it is by no means any easier than the path that has been taken to have reached this point.
My experience proves that all of this can be done – I have a healthy 3yr old as evidence.

Will it make it any easier for me to endure the next time I choose to try again and experience another pregnancy? No chance. Infertility leaves emotional scars that for me will never allow that innocence to ever be again. But I am really ok with that. Finding the balance between acknowledging that and then the strength to know I can do this anyway is what will allow me my sanity to do it all over again.


image_1366955862857457

A Journey to Conception {IVF, Twins, and a Naturally-Minded OB and Midwife Group}

A Journey to Conception {IVF, Twins, and a Naturally-Minded OB and Midwife Group}

When we decided to get married, we knew we wanted to wait a few years to begin having children.  Doug didn’t want to rush into things, and I wanted to accomplish a few goals and take time to enjoy life as a family of two.

We traveled to Germany, I completed my Masters Degree in Special Education, we hiked mountains with elevation over 14,000 feet, enjoyed weekends in the mountains, bought a house, celebrated with many friends as they began having children, I engulfed myself in teaching, my husband faced many ups and downs in his job, we taught ski lessons at National Sports Center for the Disabled, and generally lived an exciting and spontaneous lifestyle.

Meanwhile, around 2007, we decided it was time to begin trying to get pregnant.  After a year of trying, I started to become discouraged and wondered if it was time to see a fertility specialist.  Almost three years later, we still had not become pregnant and finally sought help.

We contacted the local fertility clinic that has a reputation as a world leader.  We were reluctant, but hopeful.  When we first walked into the clinic, I had a grateful attitude towards the people inside those doors who were going to help bring us closer to our goal of having children. The clinic ran some tests, and after the first of many very long waits, called us in to deliver our results.

Unfortunately, the office would not give us any information to help us prepare for our appointment. We walked blindly into the office, where the doctor delivered a devastating blow.  He informed us that we would not likely be able to have children without a $25,000 procedure called in vitro fertilization.  He made a crude joke about not needing to worry about unplanned pregnancy anymore.  We walked out of his office devastated.  Feeling completely lost, hopeless, sad, alone, and frustrated, we went home to gather our thoughts.

Ultimately, we had three choices: 1) Have no children 2) Pay $25,000 for an adoption or 3) Spend $25,000 for IVF which is known to have a 30-50% chance of working.  I made the executive decision that we would be having children, so we knew we were a long way away from having the money we would need, and that we had some difficult decisions to make.  Doug still wasn’t sold on adoption, and I really wanted to experience pregnancy, but IVF was a real financial risk. We were nervous about the possibility of a failed attempt.  So many thoughts flooded into our minds.  “What if this doesn’t work?”  “If we try IVF and it fails, we most likely won’t be able to afford another round of IVF or adoption.” “It is a very real possibility that we won’t ever reach our dreams of having children.”  We were in a very dark place in our lives.

We decided the next step was to find a new doctor for a second opinion.  His diagnosis was the same, and he agreed that IVF was most likely the only way we had a chance of becoming pregnant.  Instead of making sex jokes, his comment was ‘I’m confident this will work for you and I’m saving a place on my wall for a photo of your baby.’”

This was exactly what we needed to hear. The idea of having kids became a real possibility again.

After the appointment with the second doctor, Doug and I went to an adoption class, and he decided that he still wasn’t ready for adoption.  So, without much discussion, we decided to start saving for IVF. I had been desperately awaiting pregnancy for quite a long time.  I didn’t know how I would possibly wait any longer, but didn’t have a choice.  We put together a budget, limited our spending, and off we went. We would need to save a lot of money before beginning treatment.

It seemed that the decision was meant to be, as money seemed to just fall into our laps over the next months.  Doug received a nice bonus at work, I was able to have a payroll error corrected, and tax refunds were in our favor.

Waiting was agonizing, so to pass the time, I decided to tackle another life goal: running a marathon.  I began training in December 2010, with a goal of running the LA Marathon in March.

During the training and saving period, we kept in contact with the Reproductive Medicine office.  I had so many questions, and the nurse was so easy to reach and extremely helpful.  She was also a runner, so she also had running advice and tips for me through the training process.  Everything about working with the new doctor’s office was great.  The relationship with the nurse really helped through this difficult time.

I ran and completed the marathon in late March 2010. One month later, we began the IVF process.

Physically, the process wasn’t fun, but it wasn’t as bad as we feared.  Emotionally, however, it was far harder than we anticipated.  It seemed that every time we turned around, there was another roadblock that raised fear, doubt, and sadness.  In the beginning, I was actually excited to get started with the shots, because that meant being one step closer to the dream.

I should give a quick explanation of the IVF process here for anyone who doesn’t know how it works.  It’s an amazing process, just one that I wish no one ever had to endure.  Initially, you are put on birth control (cruel, right?!) and begin giving yourself shots to shut down your body’s natural ovulation process.  Next, you begin another shot to ramp up the body’s production of follicles (inside each is an egg). In a typical pregnancy, the body only releases one mature egg (from one follicle).  In IVF, the goal is to have the body produce just under 20 mature follicles. Throughout this phase of IVF, you go into the doctor’s office about every other day for a blood test and trans-vaginal ultrasound. The doctors use the numbers from the blood test and the information from the ultrasound to determine whether to change the medication dosage.  Once enough of the follicles reach maturity, you give yourself another shot that makes your body prepare to ovulate all the mature eggs.  Just before the eggs would naturally be released, they use what I have dubbed the “giant-ass needle” to retrieve the eggs from your ovaries.  This needle goes through your vagina and straight up into the ovaries.  Meanwhile, a sperm sample is collected, or prepared in the event of sperm donation.  Depending on the cause of the infertility, the eggs and sperm are either placed in a “dish” to find one another, or in some cases, the sperm are inserted into the eggs.  The embryos are then turned over to an embryologist for observation. Typically, most, but not all of the eggs retrieved will be fertilized. Each day, the embryologist will call to give an update of how many are still alive and dividing.  It is typical for several to stop dividing each day.  This goes on for 3-5 days.  The longer the better, but if the embryos are not doing well outside the body, they will move ahead at day 3.

The final process is the transfer of usually one to three embryos into the woman’s uterus.  The woman gives herself another round of shots to prepare her body for pregnancy.  Again, depending on how well the embryos are doing, the transfer will happen on day three or five after the retrieval.  They choose the best embryo(s) to transfer.    They use a tiny flexible tube and ultrasound to place the tiny embryos into the uterus.  If there are any embryos still alive and dividing the following day, they will be frozen and stored and can then be used for another attempt later on.  After the transfer, you just wait…and wait…and wait for a pregnancy test that happens two weeks post-transfer.

So, with that knowledge, I will return you to my story.

Throughout the process, I had to go to the doctor several times for blood tests to determine the effectiveness of the medication.  The first major roadblock came when the results revealed that my body wasn’t responding as quickly as they hoped to the dose, and the round might need to be cancelled.  When you have come so far and gone through so much just to get to this point, the news is devastating, not to mention my hormones were all sky high from the medications.

With an adjustment in medication, things began to respond, and we were back on track, and just a few days behind schedule.  This is not a big deal, but in the moment, and after waiting so long, it was heartbreaking. We continued as planned, and eventually came time for retrieval.  This went great, and we had a large number of eggs to work with.  Even better news was that the next day, all but one was alive and beginning to divide.  The next two days saw a positive report each day.  Only two more stopped dividing by day 4.  On day 5, we went in for the big transfer.  We had decided to transfer 2 embryos, no matter what.  Although the doctors were very clear that the goal was to have only one baby, our goal was to have twins. As I was being prepared for the procedure, the embryologist came in and said, “I have good news and bad news.”  We couldn’t imagine what the bad news could be.  Just yesterday they assured us we would easily have 2 embryos to transfer and probably 6-7 to freeze.  “The good news is you have one perfect embryo,” said the embryologist.  “The bad news is that there is only one other even worth transferring.  The rest aren’t doing well.”

We had really mixed emotions.  We were excited to finally have arrived at this moment.  We were devastated, yet again, that there would not be any left to freeze.  All along, we kept reassuring ourselves that it would be OK if the first round didn’t take, as long as we had several left to freeze.  Our safety net was ripped right out from under us, but without anything we could do about it, we carried on.  Through the entire journey we just kept carrying on.  They sent us home with advice to rest and take it a little bit easy over the next two weeks – that and return on May 5, 2011 for our pregnancy test.

The next two weeks went surprisingly fast, and of course had both ups and downs.  Most of the time, I didn’t feel a thing, but one day I had two strong twinges in my abdomen.   This was extremely exciting, as it was possible that I was feeling the embryos attach to the uterine wall.  Several days later, I had a migraine which sent me spiraling into a deep dark despair.  See, each month for three years, having a migraine was a sign that I was not pregnant.  A migraine always proceeded my period by three days. By having this migraine, I was certain that she was not pregnant.  Three days later, May 5th arrived.

Knowing how anxious we would be waiting for the pregnancy test results, we had taken the day off work to await the news. We had been told we would get the results by the end of the business day, so we were surprised to get a call from our nurse at 9 a.m.  I, afraid to hear the news, made small talk and asked her how she was doing.  Politely, she replied that she was doing well, and asked me how I was doing.  I replied, “I don’t know, you tell me.”

On the other end of the receiver, I heard her voice deliver the incredible news: “Well, you’re pregnant!”

Despite the odds, we were pregnant!!

 I just broke down.  Doug was crying, too. I can’t describe how I felt.  I cried and cried tears of joy

Although Colleen, our nurse, was ready with information to prepare us for pregnancy, we were unable to comprehend anything more.  I asked her to call back in a little while once I had calmed down.

jamie's IVF story

The moment we heard Colleen deliver the news will go down as one of the happiest moments of our lives.  From that day on, the process got better and better.  Four weeks later we found out we were having twins! Eight weeks after that we found out we were having a boy and a girl.  Each appointment after that we were able to see that they were healthy and very active.  After a long road with so many roadblocks, detours, pitfalls, and devastations, it was amazing have smooth sailing and positive news the rest of the journey.  The pregnancy was difficult for me, but the babies did great the entire time.

We were working with a combination of midwives and an OB, since we were having twins.  We had planned to birth our baby at an independent birthing center with only a midwife, but that was not possible once we found out we were having twins.  The nice thing about working with an OB who routinely works with midwives is that he is open to a more natural approach.  At 38 weeks, when they would typically induce twins, our babies still had not arrived.  He allowed us to wait another week.  Also, despite having a marginal placenta previa, he was willing to let me attempt a vaginal delivery. By the time we were almost to 39 weeks, it became clear that it was no longer in my or the babies best interest to continue the pregnancy.  Our goal was to slowly induce, but ended up that didn’t work.  We had to start with a cervical ripener, which did nothing in terms of kick-starting labor.  As my pre-eclampsia set in, we veered farther from my birth plan by starting Pitocin.  Ultimately I ended up having an emergency c-section because of bleeding from the previa.

All in all, my babies arrived, and that is all that mattered in the end.  I was sad about loosing my dream birth, and I had to grieve it.  Ultimately, however, I believe we only did interventions that were medically necessary, and am happy with the outcome.  My long-shot dream had come true.  We had not only one baby, but two!

The process of IVF and infertility in general is excruciating.  My lasting wish is that people understand that.  I want the general public to understand that by asking if twins are “natural” they are asking a deeply personal question that often brings up trauma and grief.  Thanks for taking the time to understand this process and my journey.

IVF story

The Magical Menstrual Cycle

The Magical Menstrual Cycle

{guest post by Samantha Bice}

When did you first hear an explanation of your menstrual cycle? Apart from asking my mom or step mom what pads or tampons were upon seeing them in the cabinet, I don’t have a memory of an explanation until third grade. We all had to get a permission slip signed so that we could learn about our “bodily changes”. Boys and girls were sent to separate rooms in the school…I remember the girls were sent to the computer lab.

We were given small booklets that talked about breasts growing, “periods”, and feminine products and hygiene. We were told that a confusing time in our lives was fast approaching and that we would start to bleed, once every 28 days, and that it was okay. We could use pads or tampons, and as long as we were careful to be ready and if we washed ourselves, no one would ever know that we were “on our period.” Most of the talk was focused on the products we would use to take care of this issue. [And they didn’t even teach about the good ones!]

Fast forward to middle school. I had started my “period” and managed to avoid getting blood on my pants or “smelling.” I still really had no idea what a period was for other than to tell me I was not pregnant. At that point in my life that seemed like a useless thing to do since I was not having sex.  Same story in high school, only add in a small amount of knowledge of an egg dropping and that my period was to get rid of the unused egg each month.

It was not until I was a married woman and thinking about babies that I stumbled upon the book Taking Charge of Your Fertility by Toni Weschler in the book store. I picked it up, thinking that since I was a take charge kinda girl with everything else that I should add my fertility to the list too. This was also after many unsuccessful attempts at finding the right birth control for me (come to find out, my body hates all chemical birth control), so that was in the front of my mind as well.

That book changed my life.

Imagine my surprise when I read that my “irregular periods” were actually pretty normal, and that I was not broken. Every cycle (not month – we work in cycles, not on a calendar) my body was performing a magical and specific dance of hormones. Eggs matured, temperatures changed, ovulation occurred, hormones shifted, my body prepared. I was amazed. I suddenly had respect for my body and did not find my cycles annoying anymore.

WHY had no one explained all this to me? Why was the focus on managing the bleeding and not on the reasons why it even happened? Beyond knowing “period=not pregnant; no period=pregnant” we were told nothing. We were told that we should perform this task like clockwork, every 28 days. No room for error or we were “irregular”, like a badly cut puzzle piece. The focus was on all the things we needed to buy and do in order to cover up the fact that our body performed as expected.

Now, I want to share some knowledge with all of you. I can not cover everything – hence why the book Taking Charge of Your Fertility (TCOYF) is large. But I can give you the basics on how things work and the basics of keeping track of all this.

The Menstrual Cycle: A Carefully Choreographed Dance

I think most of us have the basic knowledge of what the cycle does (generally speaking) – it is the preparation and “dropping” of an egg that then awaits fertilization. If that fertilization does not happen (or if implantation does not happen), you have menstrual bleeding – your period – and a new cycle starts. But lets talk about specifics.

The first hormone that causes things to happen each cycle is the Follicle Stimulating Hormone (FSH). This hormone does just what the same suggests – it stimulated follicles. These follicles are on your ovaries, and each one contains an egg. Generally about 15-20 follicles start to mature each cycle.

During this time period (anywhere from about 8 days into your cycle to more than a month) your estrogen is rising. Shortly after you reach your estrogen threshold (one or two days after), one of the eggs bursts through the ovary and starts the journey down the fallopian tube. Sometimes more than one egg makes it out (fraternal twins or higher multiples – if all are fertilized). The eggs that didn’t “make the cut” dissolve.

This high level of estrogen (which drops off after this peak at ovulation) triggers a surge of Luteinizing Hormone (LH). This surge of LH is what ovulation tests detect and occurs just before the release of the egg during ovulation. [Please note – an LH surge does not mean you *did* ovulate, but rather that your body is preparing to.]

After the egg is released, that follicle that it came from turns into the Corpus Luteum. This will release progesterone for about 12 to 16 days. Normally a woman’s luteal phase (the time from ovulation to the start of a new cycle) does not vary much within that woman by more than a day or two during each cycle. The luteal phase is the one part of our cycles that is locked in for most people and they will have their own “normal” they can depend on.

The progesterone released by the Corpus Luteum is very important. It causes the lining of the uterus to thicken (for implantation) and prevents further egg release that cycle. It also causes a change in your fertility signs (more on that later).

After this 12-16 day period of the luteal phase, if the egg has not been fertilized and implanted, the Corpus Luteum dissolves and a new cycle starts (your “period” comes). The first day of bleeding is the first day of your new cycle.

A Quick Word on Averages

Please note that during this entire post I am going to be speaking in terms of the average cycle. There is a large amount of normal variation within these numbers – and outside them. The 28 day cycle is not a golden rule or number. Each woman has a cycle unique to her – just like the particular color of her eyes or her love of a certain food. Please do not take these average numbers to be the only “normal” and count yourself as abnormal. They are simply for simplification purposes.

Conception

Conception is the process of fertilization – sperm meeting egg. When and where does this take place? Once the egg is released by the ovary, it is sucked up into the fallopian tubes quickly – normally within 20 seconds. The ovary is not actually attached to the tubes by the way – they sort of barely meet at the end of the tubes where the “fingers” of the tube stick out to catch the egg. These fingers are called fimbria.

Fertilization has about 24 hours in which to occur. The egg does not sit around waiting for sperm for the entire luteal phase. Around 24 hours is all the chance we get. The egg is fertilized in the lower third of the fallopian tubes, not in the uterus as is commonly thought. The egg will continue its way down the tubes and burrow into the lining about a week after ovulation, on average. If the egg is not fertilized, it dissolves and is absorbed, or it comes out with the menstrual flow.

In order to stop the process of the shedding of the uterine lining, as soon as the egg implants your body starts to make a hormone – I know, another hormone! This hormone is called Human Chorionic Gonadotropin (HCG) and is the hormone that pregnancy tests detect. This hormone not only stops the lining from shedding as normal, but it signals the Corpus Luteum to stick around and keep making progesterone to sustain the lining (which feeds the fetus). This progesterone is important as it sustains the pregnancy until the placenta takes over after several months. [This is why low progesterone causes miscarriage.]

As you can see – this dance of hormones and processes is complex. Complicated steps, but seems effortless and fluid when observed. Our bodies do all this without prompting in most cases, and is just as miraculous as the actual process of growing a baby. Our bodies do a lot of work just to get the egg ready to create the baby, and to maintain the system for many years “just in case”.

Charting: Your View of the Dance

Charting with the Fertility Awareness Method (which is taught in TCOYF) is based on three basic fertility signs. These signs, when charted together, give you a view of what your body is doing and where you are in your cycle.

Waking Temperature (Basal Body Temperature)

This is the fertility sign that gives you a view of what hormones are acting at the moment, and when you have ovulated. It is the “graphic” portion of the fertility chart. To get this information you need to take your temp first thing in the morning before you get out of bed. You need to use a Basal Thermometer for the best results, as they are more accurate than a fever thermometer. They are usually available in the fertility section of your local drug store or WalMart/Target. That would be the aisle with the pregnancy tests and contraceptive devices.

Before ovulation your temperature is lower (between 97.0 and 97.7 on average) due to the temperature suppressing effects of the rising estrogen at the start of the cycle. After ovulation, within a day or so, your temperature will rise due to the heat producing hormone progesterone. If you conceived, the progesterone stays around and your temp stays higher. If you did not conceive, the progesterone stops and your temperature drops as well – a sign that says your menstrual flow will start soon.

A few notes about your waking temperature. 1) You need to take it at the same time each day, trying not to vary it by more than 30 minutes or so. When you first start to chart, try to be as precise as possible in order to get your “normal” readings for a few cycles before messing with anything. 2) You need to take it after at least 3 hours of sleep (this gives your body time to regulate and get to the basal state) and before you get out of bed. Keep it on your bedside table. 3) Your readings may be off if you have a fever, have drank more than a drink or two of alcohol (or if you rarely have alcohol), or are using more warming devices to sleep than you normally do. Illness can also effect the temp in other ways – think about if you normally sleep with your mouth closed, but then sleep with it open because you are congested. This would cause your mouth temperature to be lower in the morning.

There are two ways to get your temperature. Orally – the way you do for a fever, or vaginally. Vaginal temps tend to be more precise for many women and you do not have to worry about the effects of occasional mouth breathing either.

Cervical Fluid

Cervical Fluid, or cervical discharge, is an important fertility sign. In my opinion this is the sign that we should absolutely be taught about from day one of becoming a woman. The normal fluid our body makes – which changes throughout the cycle – is not dirty. It is not defective. It is a sign of where our fertility is at that point. I suggest you begin to think of it as awesome and not dirty (in other words – not “discharge”) because this stuff is cool.

You have several types of fluid. I will work from least fertile to most fertile. First is the lack of fluid – this is called a dry day. This generally means you are not currently fertile. This normally occurs right after menstruation ends, and after your fertile period (ovulation). Then there is sticky fluid. This is the dry feeling fluid that clumps and looks almost like rubber cement (a type of glue). This is also considered not fertile. It usually occurs after menstruation but before ovulation – and sometimes for a few days after ovulation. The next type is creamy – this is usually thick and white or yellowish, and feels and looks like lotion. This is not a fertile fluid, and normally occurs before ovulation, and occasionally after ovulation. All of these types leave no mark in your underwear, or they leave a streak or line.

The first type of fertile fluid is called watery. This is just the way it sounds – like water. Usually clear or only slightly colored, it leaves a round wet mark on your underwear due to the high water content. This is a fertile fluid. Fertile fluid is one in which sperm can survive. You must have a fertile fluid present for sperm to live and move in. This fluid usually shows up around ovulation. If you see this, assume you are fertile. The other fertile fluid is egg white. This is the most fertile fluid and is what you want to look for if you are hoping to conceive. It looks just uncooked egg whites, sometime streaked with pink or yellow but is mostly clear. Sperm love to live in this and can swim well in it. This will also leave a round wet mark in your underwear due to moisture content. It is also stretchy between the fingers – stretching up to a couple inches or more.

A typical pattern of fluid would go like this: Menstrual blood, dry, sticky, creamy, wet/egg white, dry or sticky, menstrual blood. Again – this is just an example and each woman will have her own pattern. After a cycle or two of charting, you will see your personal patterns. Occasionally a woman gets a last surge of fertile fluid just before menstruation. This is not another ovulation but rather a reaction to the drop in progesterone.

Cervical Position

This is the one sign of the three that is considered optional when charting. However, I would encourage you to try it. It really does help with charting (especially when your other signs do not seem to match up) and teaches you a lot about your body. It does take practice. My “favorite” way to check my cervix (in other words, the easiest) is to squat down all the way – bum on my ankles – and feel for the cervix. Your cervix is a small “bump” at the end of your vaginal canal or rather at the bottom of your uterus – it feels much like the end of your nose for most of your cycle, only with a dimple in the middle (the cervical os).

When you are not fertile, your cervix is low and firm and closed (keep in mind, those who have birthed children have a slightly open cervix for ever after in most cases). When you are fertile, the cervix moves up higher and becomes soft (like your lips) and opens a bit. It is also very wet when fertile as it puts out a lot of good fertile cervical fluid. To notice these changes, you need to check yourself each day in the same position. You will start to notice after a cycle or two what your normal fertile and infertile patterns are for your cervix.

An amazing site to look at is The Beautiful Cervix Project. This site has collections of photos of real cervices in all stages and ages. Being familiar – and comfortable – with what all portions of our body look like is an important part of embracing the whole woman, our whole self. This project is dedicated to helping with that.

Other Signs

Not every woman has these signs but they are worth charting if you have them. Midcycle spotting, pain or aches around the ovary area (note the side), increased libido, full or swollen vulva, bloating, increased energy, breast tenderness – all are rather common signs during the cycle. If you chart them, you may see a pattern. For instance, women who get midcycle spotting tend to find through charting that it occurs around ovulation. The pain in the ovary area has a name – mittelschmerz – and typically indicates the release of an egg.

Charting

I think the easiest way to explain charting as a whole is to show you a chart. I will add one of mine to illustrate.

Chart

This is one of my older charts. You can see the lower temperatures before ovulation. The “cross” is the day of ovulation. You see that my temp rose after ovulation and stayed above the “cover line” (the horizontal line) until shortly before the new cycle started. This cycle was 32 days with ovulation on day 2o and a 12 day luteal phase. The blue days are infertile days, the green days represent likely fertile days, and the orange/tan days are the luteal phase.

As you can see on my chart I have a few things that are not typical. First, I tend to have a few random days of fertile fluid before ovulation. I also have what is called a “slow rise” in my basal/waking temperatures. These are both a variation of normal and are normal for me. I am able to line up my typical cues of ovulation to know when I have ovulated – for instance I always get ovulation pain and chart it. This is (for me) a very reliable sign.

Sometimes you might not ovulate. This is called an annovulatory cycle. Most women have these from time to time for various reasons. Stress and illness are two big reasons. I once had a cycle that lasted 147 days – during which my husband and I were apart for my job. After we were under the same roof again, a new cycle started the same week and things went back to normal. Here is an example of an annovulatory cycle for me:

Annov. chart

As you can see, the signs are all over the place, and my temperatures never really get a pattern. I may have ovulated around day 34 or so, but no other signs confirmed that other than a slight rise in temperature.

Getting Started

For more information I highly suggest the book Taking Charge of Your Fertility. It really is an amazing resource and goes into full detail of how to chart and how your body works. I have simply given you the starting building blocks. There are several methods of charting fertility, but FAM (Fertility Awareness Method) as taught by TCOYF is my favorite. You can find classes in most major cities about fertility charting as well.

Fertility charting can be used both to help conceive, and to avoid conception. I have used it for both purposes.

When using to avoid pregnancy, and you understand it thoroughly and use it correctly every day, you have only a 2% chance of conceiving within a year. That is if you use condoms during the fertile phase (correctly) or abstain while fertile. [Condoms have a failure rate of around 2%.] If you use other barrier methods during your fertile time then your chances would be close to that of whatever barrier method you choose. Keep in mind that the failure rate and user failure rate are different, and you should research any barrier method you decide to use with FAM. Also, the user failure rate of NFP (Natural Family Planning – which includes multiple types of charting or fertility tracking) is anywhere from 2% to 20% depending on the study you look at. This is not the fault of the method, but rather the user. “Cheating” (not following the rules) is much less forgiving with NFP than it is with other types of birth control.

When using this method to achieve pregnancy it can be very helpful. First and foremost – you learn about your normal. The 28 day cycle and day 14 ovulation is probably the biggest myth of womanhood. That is a “clockwork” example and is simply not true for all women. In fact, you can have a 28 day cycle and still not ovulate on day 14. And as we learned – the egg is only viable for about 24 hours. If you miss the egg, you miss it – and thinking you ovulate on day 14 when you ovulate earlier or later can mean that you miss the egg again and again.

You also start to see your patterns. You notice when your cervical fluid changes and what the fertile period looks like for you. Past cycles do not dictate future cycles – BUT they can help you to get a good guess going of when to time intercourse to catch the egg. Another thing it does is alert you to issues. You would be able to see if you do not ovulate, or if you do not have fertile fluid when you need it. You can catch a short luteal phase (which means the fertilized egg may not have time to implant) and possible issues with progesterone. In other words – you can arm yourself with information and avoid some expensive and time consuming testing.

Please keep in mind that I have only given you the basics here – the building blocks. Now it is up to you to research and read or take a class. Please do not run with this small amount of information and use it to avoid pregnancy, and on the same hand – please don’t chart for fertility just based on what I have written here. My hope is to clear some myths, help you learn, and help you appreciate your body a bit more. Please feel free to post questions below and I will try to answer them as best I can. I am not an expert or teacher, but I have read and researched the subject extensively and used the method in both ways for several years.

Hire a Care Provider with Care

Hire a Care Provider with Care

I was told all of these in one day…

  • “I fired my OB at 20 weeks and hired a midwife to have an amazing homebirth.”
  • “I found a new OB for my 3rd child, after my previous OB told me I needed cesareans when I didn’t.”
  • “I fired my OB and found a new awesome OB to have a wonderful hospital birth last time.”
  • “I hired midwives this time to have a healing HBAC.”

This is not about midwife vs. OB. This is about good care provider vs. bad. That simple.

Ladies, please please please choose your care providers carefully. I meet and talk to women who have traumatic hospital AND out of hospital births because of incompetent and disrespectful midwives and OB’s.

birth labor supportI also meet moms who hire wonderful, skilled, amazing midwives and OB’s (sometimes after firing the crappy ones). PLEASE do your work to interview, talk to other clients and patients, ask questions, and don’t be afraid to fire someone and hire someone else. You would do so in any other aspect of your life, so why not for the birth of your child?! I can not say it enough or express how important this truly is.

You can take the most ‘educated’ and ‘informed’ woman and put her in the territory of others who do not support her, in a vulnerable moment, and watch her get abused, mistreated, and her spirit broken. You can not prepare for that. What you CAN do is make sure you only have people who will love you, guide you, be honest with you, and support you in your birth.

Birth is amazing, raw and vulnerable. Only have people there you trust completely.

care providers for birth

Photography credit: Dusti Lynn Photography.

“Infertility is a funny beast.” | Thoughts On Infertility, Loss, Pregnancy And Motherhood

“Infertility is a funny beast.” | Thoughts On Infertility, Loss, Pregnancy And Motherhood

Thank you Sarah, for sharing your thoughts and experiences.

Infertility is a funny beast; it affects your life in so many different ways.

We had issues conceiving our first child, spent almost 30 months trying to conceive and had begun the testing process that had showed up a few issues. Miraculously I found out I was pregnant only two days prior to our IVF consult with the fertility specialist. At the time we were the first of our friends and close family to have a child so it was all new and wondrous and exciting for everyone involved.

Our second pregnancy was a lot different to the first and I put that down entirely to infertility issues. By the time we fell pregnant with our second child, our friends were having their firsts. Four friends, all falling pregnant within a very short time frame, yet here we were struggling after a year. Again. The pregnancy announcements were hard, but the avoidance of certain friends was harder, they didn’t know how to talk with us about their pregnancies.

Our second pregnancy, our daughter, was conceived on our first cycle of IVF. The pregnancy was easy, but I found so many people treated me differently. I asked a coworker why she treated me differently compared with our first pregnancy and she simply stated that it was because this was an IVF baby, so it was different. It made no sense to me, but people perceived IVF babies as more fragile.

[IVF Medication]IVF Medication

Fast-forward and our daughter was my second emergency caesarean. I was devastated. My baby was artificially conceived and artificially came into the world. There was nothing natural in her conception or delivery and I had to get something back, so I breastfed her. The plan was to breastfeed our first as well, but nature had other ideas as my body went into shock after a very long and difficult labour and subsequent emergency caesarean.

The only reason I continued breastfeeding was our infertility struggles. THE ONLY REASON. There were so many times I wanted to quit in the first six months. She was a big baby (9lb 14oz at birth) and she was insatiable. I fed two hourly for six months. I dealt with some serious breastfeeding issues, but instead of giving in, like so many had recommended, I plodded along. My baby had to such a medical, impersonal beginning thanks to our fertility issues that I had to give her something natural. In the end, she breastfed until she was 15 months old and I was proud that I stuck with it.

breastfeeding at 10 months after IVF and emergency cesarean

We lost our third (natural) pregnancy to miscarriage at ten weeks. Again, people’s perceptions astounded me. I got comments telling me that obviously I wasn’t meant to have a baby naturally (despite my first son) and that it didn’t matter because we had embryos frozen & in storage. Charming, right?

Our fourth pregnancy was the result of a frozen embryo transfer, the embryo created at the same time as our daughter. We had a few scares in the beginning and because I had invested so much, time, money, love, I was terrified of losing this little being as well. I was on bed rest and refused to move, exactly as I was directed. I couldn’t bear to face another loss and our chances of having another pregnancy were already diminished with only two embryos left in storage.

The baby, our son, arrived by scheduled caesarean and again I chose to breastfeed him to give him something as natural as possible. At the time of writing, he is 13 months old and still breastfed, despite a postnatal depression diagnosis and subsequent medication.

Even though we have now completed our family I find that infertility still haunts us.

My children are no different to any others, they push buttons, they don’t sleep, they argue with each other and I am just the same as any other mum. There is a difference though. Having struggled to conceive all three and using IVF for two, I find it difficult to complain about even the most normal of childhood behaviour. I feel like I need to be grateful for everything they do, even the bad stuff, because I am lucky enough to have them.

I had a conversation with a customer at work one day during my last pregnancy. He asked how many kids I had & when I told him this pregnancy was my third he joked asking if I knew what caused it. My response was, “yes, handing over thousands of dollars to my fertility doctor”… If you can’t laugh about it, you’d cry!

A Daughter’s Birth Story {With Videos}

A Daughter’s Birth Story {With Videos}

My pregnancy with you was an amazing and trying time. In the first few months I was tired and nauseous which is to be expected. After those first weeks I started feeling better but still very tired. I had so much to look forward to with you in my belly.

The first kicks, hiccups, punches and rolls. They all happened and were a constant reminder of how amazing it was that I got to be a part of this miracle. Pregnancy and birth is the one time in a woman’s life where she gets to assist God in a miracle. It’s pretty spectacular.

Around 20 weeks I started feeling light headed and was having chest palpitations. I went to see the doctor who sent me to see several other doctors. My blood count was down to 7 so I had to have a blood transfusion at 25 weeks pregnant. After that I felt SO much better! I could enjoy the rest of my pregnancy.

Your little brother was so excited that he was going to have a sister. He would rub my belly everyday and give you kisses. He also had a little doll that he fed and took care of to practice being a big brother. It was so sweet!

maternity 36 weeks

I worked up until the shift before my due date. I started having contractions every night at work so Daddy worked my last shift so that I could rest. A week before my due date labor started….

It all started on the night of November 18th, 2011. I felt hugely pregnant and wanted to take your brother to the zoo to see the Christmas lights before you arrived. We decided that Friday night may be the last chance before your big arrival so we piled into the car and headed to the zoo. We had a great time looking at all of the lights, drinking hot chocolate and walking around.

When we were walking out of the manatee building I must have been waddling, as sometimes happens in pregnancy, because the woman behind me asked her husband, “What’s wrong with that girl?” I guess from the back I did not look pregnant. What was wrong with me is that I had a fully grown baby inside of me about to drop out!

After we were done looking at all of the lights we piled back into the car and headed home. We got your brother to bed and did a little cleaning around the house before we settled in for the night.

Around 1:00 am Daddy and I headed to bed. Around 4:00 am I started dreaming about obstructive sleep apnea. (Which was not all that unusual because mommy spends a lot of time scoring sleep studies) I kept seeing a squiggly line that would go flat for about 1 minute and then pick back up. Around 4:30 am I woke up to go to the bathroom and realized that I was having contractions! I had been dreaming about obstructive sleep apnea when I was having contractions! When the line was squiggly was when I had a break and when it went flat was during the contraction.

After using the restroom I decided to try to go back to sleep and see if the contractions would stop. They did not stop and were getting worse. I was beginning to think that this was it. You see I had been having bouts of contractions for about two weeks before this but they always fizzled out.

These contractions woke me from my sleep, kept coming and were getting stronger and stronger.

Since I was really beginning to think that this was it I woke up Daddy and told him I thought maybe I was in labor. At that time I was working from home (mommy was working two part time jobs during your pregnancy, one as an RPSGT in a sleep lab and another scoring sleep studies at home) and I had a little bit of work that I needed to finish.

I told Daddy that I was going to go into my office downstairs and try to finish up my work just in case I was really in labor. All I had left to do was write a report for the doctor.

I sat down and started writing the report, which was not unlike the other hundreds of reports I had written for her, and I could not for the life of me concentrate on what I needed to write in that report. When that happened I shut down the computer and got into the bath.

In the bath I took a candle, some relaxation music and a towel. I turned the lights off, turned on my ocean waves music and put the towel over my belly to keep my belly warm. The contractions kept coming so I called grandma to have her get ready to come over and take care of your brother when he woke up. She got up, showered and headed over.

After I got off the phone with her I started timing my contractions and they were between 5 and 6 minutes apart lasting 1 to 2 minutes. At 7:oo am I called my doula Catie and told her what was going on. I checked my cervix before I called her and I was about 4 cm dilated at that time and bleeding just a little bit. She said that she thought I was for sure in labor.

Catie told me to call her when I wanted her help. I wanted to labor at home as long as I could stand it before heading in to the hospital. A little after 8:00 am my labor was getting pretty intense. I checked my cervix again and was about 5-6 cm dilated and I could feel your bag of waters bulging. I decided I needed to head to the hospital.

Before we could go to the hospital I had to install your brothers car seat into Grandma’s car. So there I was almost in transition installing a car seat! After helping me with that Daddy decided that he needed to set up the DVR to record the football game he was going to miss.

Finally we got into the car and headed to the hospital. On the way there I called my OB because it was her day off and she gave me her cell phone number to call her at home when it was time. She said “Here’s the thing. I have tickets to the football game at 3:30 today.” I said don’t worry I think the baby will be here before then. She said “Ok well I’ll get ready and call the hospital in a half hour to check on you.”

The drive there was horrible but the traffic was not to bad. Going through transition in the back seat of a car was terrible. I had about 7 or 8 contractions in the car before finally making it to the hospital.

I had a contraction in the parking lot right when we got there and then jumped out of the car and practically ran into the hospital to try to get to labor and delivery before I had another one. I got to the elevator, the elevator doors opened and I practically ran over the poor man trying to get out of the elevator.

When I got up to the second floor Catie (my doula) was sitting in the lobby and just smiled at me and said “you look SO low!” I smiled at her and I think she thought I may not be in labor because I looked so happy. Then a contraction hit. She said “That was a strong one.”

I had to try and fill paperwork out but mostly I just could nod my head agreeing with everything Daddy told them about me. I got to the hospital at 9:10 am and they took me back to triage by 9:15 am.

I had to get in the bed long enough for them to run a strip to check your heartbeat and check my dilation. You looked good and I was dilated 7 cm and 100% effaced. I was quickly moved to room 11. Our doctor called and said she would be there in a half an hour.

Slow Dancing
While I was in transition I got to move freely. They used a doppler to check your heartbeat every so often. I felt the best slow dancing with daddy. When it got to be too much I tried the birth ball, and then finally I got to get into the labor tub. Around 10:00 am our doctor arrived and pulled up a rocking chair and sat next to the tub just talking to everyone. She was so supportive for a doctor. Daddy held my hand and stroked my hair and Catie poured warm water over my belly. I was very thirsty after every contraction. Daddy gave me a sip of water when each contraction ended.
Support from Dad
At 10:43 am I asked to be checked because I was starting to feel pushy. The doctor checked me while I was still in the tub and I was 9.5 cm 100% effaced and 0 station. At that time my contractions started to space out a little bit. It was great because I could rest. I was always told you will know when you are in transition because you will not be able to think clearly between contractions. That was not the case at all for me. When a contraction would start I would breathe heavy. When it would peak I would be screaming (only in transition) and then I could just relax. In between the contractions I could laugh and jump right back into conversation.

“This next one is going to be much stronger.” Catie warned. “When you get a long break like that it’s your body’s way of saving your energy to deal with the next contraction.” The next contraction hit and sure enough it was the strongest and longest one yet. By the end of it my body was pushing without me being able to control it.

Laboring in the tub
“She’s pushing” Catie yelled. “No I’m not” I yelled. “Get out of the water” shouted my doctor. “NO” I said. First of all I was not pushing, my body was and second there was no way I could get my pregnant self out of that tub during that contraction. As soon as it ended I jumped up and out of the tub. While I had the option to deliver anywhere but in the water, I wanted to be on the bed. I ran over and jumped up on the bed. It was show time.

AT 10:53 am I was completely dilated and ready to push. I had the head of the bed all the way up with two pillows behind me. I was sitting at a 90 degrees. The next contraction came and I began pushing. I pushed when I wanted and how long I wanted. Pushing was such a relief. It took the edge off of the contractions for sure.

I pushed a couple of times and your head was starting to crown. I told Catie and the doctor that it was burning and they used mineral oil to help stretch everything out and a warm cloth against my skin to keep me from tearing. Another push and my water broke.  I felt a pop and then a huge gush of clear fluid. Catie later told me that it was so cool.

She could see your hair floating around in the waters. It’s called being born in the caul and it means you are going to be very special! I reached down and could feel my baby girls head! A few more pushes and your head was out and then a final push and I delivered my baby girl. You were placed directly on my chest and you were perfect!

Annabelle
Annabelle Grace arrived at 11:24 am! Daddy and I got a real good look at you. You were perfect! Your Apgar scores were 8 and 9. We did skin to skin for awhile.  Daddy told Catie that he was surprised. When you came out you looked right at him! I think that is when you became wrapped around his little finger.

Daddy and I asked that your cord clamping be delayed. When it stopped pulsating Daddy cut it. Then I nursed you and you nursed like a champ for about an hour. After that they took you to be weighed. 7 lbs 11 oz and 19.5 inches long.

When you came out you had your hand next to your face and that tore me just a little. One stitch and I was as good as new.

After my doctor stitched me up I started hemorrhaging. I lost over 800 mL of blood quite quickly and got really pale. I was given 600 mg of cytotec and a bag of pitocin that I was on until 8:00 pm that night. This did get the bleeding under control. While they were working on getting my bleeding under control daddy held you skin to skin.

Once I stopped bleeding, about 30 mins after I started, Daddy gave you back and we did more skin to skin. This whole time they were taking my temperature, and they said I had a fever. I knew that my temperature was going up because I was holding you. Which ever side of my chest you were on got really warm.

Mothers are amazing being able to feed and regulate their babies right at the moment of birth. Once they moved me to my postpartum room you got a bath and they took my temperature again when I was not holding you and it was normal. After your bath I held you and again my temperature went up. I thought that was so amazing how my body changed its temperature to keep you warm!

We stayed in the hospital for 48 hours of which time you did not sleep at all. You were seriously awake most of the time. Then we headed home to start our life as a family of 4. Once we got home you only woke up every 3 hours to eat for the first three weeks or so.

My milk came in around 36 hours after you were born so you were a happy baby right from the start. As soon as your tummy was full you went right back to sleep. Once you hit three weeks old you started to be awake more and more. You are 11 weeks old as I write this and you are up most of the day and sleep between 6 and 11 hour stretches at night.

You love being held and loved on. You get upset when Daddy and I put you down so you are held or worn most of the time. You like to be warm, with a dry diaper and a full tummy.

You would only sleep on a pillow called a newborn lounger or in the crook of my arm until you were 6 weeks old. If you drink expressed milk out of a bottle it has to be exactly body temperature or else you gag. You are for sure our little princess but we would have you no other way!  We LOVE you sweet baby girl!!!

Maternity Photo credit to Stephanie Barnes Photography
Together as a Family, Part IV

Together as a Family, Part IV

This is the fourth post in a five-part series on loss and healing, a story shared by Shannon from Brisbane, AU. Yesterday, she shared her early pregnancy fears, and her decision to pursue midwifery care at the local hospital. Today, she writes about her experience of early labour. Check back tomorrow for the complete story and pictures of the birth of her son, Jasper!

“Fast-forward to September and my due-date of the 16th – I was still feeling quite good – waking every two hours at night to empty my non-existent bladder, but still relatively comfortable and enjoying feeling my baby moving about inside me. My pregnancy had thankfully been trouble-free and I had enjoyed rubbing my belly and day-dreaming about this long-awaited child.

I felt calm and confident that I could not only handle this birth, but make it as positive an experience as possible, no matter what happened. Jeremy had also been reading and learning about what to expect, and we had discussed the many things that we wanted to experience, and what we wanted our baby to experience as he or she came into the world. His knowledge and confidence reassured me that even though I had so much to do on my own, I was strongly supported and prepared. If it didn’t go to plan, we would deal with it together.

On the 18th, I went for a walk along the river near my house, and found a quiet seat to sit and look at the river flowing past. I had a chat with my baby and explained that I was ready to meet him or her now. In the previous few weeks I had been a little scared and overwhelmed by the idea of caring for a baby, and had been quite happy to have the baby stay put for a while longer. But now, I realised that I was ready, and it was normal to feel a little nervous, but I was more excited to find out if I was carrying a boy or a girl, and just who this little baby about whom I had been daydreaming for so long really was. I envisioned my body opening up and the baby moving down. I walked along the river for 45 minutes and returned home feeling relaxed and content.

At 4am the next morning, the cramping that I had been feeling on and off over the previous few days suddenly became much stronger. They made me head straight to the toilet, and though I suspected it might be the start of things, there was also the possibility that it was just an upset tummy. Five trips to the loo and a number of stronger contractions later, and I was pretty certain that today would be the day we would meet our baby. Jeremy had woken with me at 4am, but I had told him to go back to sleep and I’d wake him if I needed his help.

I spent about an hour and a half sitting on the fit ball, standing and rocking my hips and breathing through the contractions, as well as trying a tens machine someone had lent me. There was a big enough gap in between to eat some breakfast and pay a phone bill.

At 6am, I woke Jeremy with the sound of me vomiting up the breakfast I had eaten. I was then able to tell him that it was on – today he would meet the little being that he had felt kicking and squirming inside of me for the last nine months. I vomited again after another couple of strong contractions. My body was clearing itself out in readiness for the demands of the day ahead.

It was about this time that I realised the tens machine wasn’t really helping me. Jeremy suggested trying a hot bath. As I waited for him to run it for me, I knelt over the fit ball, rocking my hips. Once the bath was full, I hopped in, lying down in the soothing warm water. My contractions were now lasting for about a minute, and were somewhere between three and five minutes apart.

After a while, lying down wasn’t working for me – I felt that I had to get myself more grounded in order to cope with the tightenings. I turned over and got on my knees, holding onto the end of the tub. Jeremy had put on some music – the XX – which I found somewhat soothing when I was able to rest in between the intensity. I found that now, I HAD to vocalise throughout the contractions – I was making an ‘ooooh’ sound – and this helped me to focus and release the pain and tension from my body.

Jeremy had spoken to our midwife a few times, and she confirmed it sounded as though I were in active labour, and to remain at home as long as we felt able to cope. By this time, it was peak hour traffic, which could potentially make a 20 minute trip to the hospital into a 45 minute mission. I started to feel as though I wanted to head to the hospital soon, but Jeremy made some suggestions to try to get through three more contractions, or to wait until 8:30, and see how we were going. I am glad for this – having more contractions in the car than was necessary would have been challenging.

By about 8am, I needed to get out of the bath. Jeremy warmed up the heat pack and held it firmly onto my lower back with each contraction. I swayed my hips on all fours on our bed, still ‘oooohing’ away. During the lulls he raced around throwing last minute items into the hospital bag, and packing a nice big food bag to ensure he could keep energised (it didn’t get touched until we got home). We decided that we would leave for the hospital at about 9:20, and called our midwife, who arranged to meet us there.

We made our way to the car and began driving. Within seconds, I felt another contraction beginning. I immediately yelled at Jeremy to “stop the car!!” and moaned my way through it. I somehow managed to let Jeremy keep driving throughout the five more I had on the way to the hospital. It was quite surreal, looking out the window at the commuters on their normal drive to work, as I moaned and writhed inside our car on what was sure to be the most monumental day of our lives…”

Jasper newborn copy

Jasper with Dad copy

Shannon is a Brisbane-based family photographer specializing in unique, natural portraits. Her work can be seen at langbecker.com.au.

Can't Get Enough Birth Without Fear? Sign Up For More Inspiration!
We respect your email privacy.