Sunday, June 13, 2010

What I Believe About Unassisted Birth

For some birthing women, having an attendant at their birth is a comfort to them and helps them feel empowered. While others may feel that having an attendant makes them nervous and uneasy. For these women, having an unassisted birth would be a safer choice.
In order to let natural birth unfold on its own, the mother must be completely surrendered to the process. Some women feel that having a birth attendant helps take away the distraction of being aware of potential anomalies during the birth process so that they can be more focused and centered on the task at hand. For them, an attendant that they trust is an asset to normal birth and not a liability.
Other birthing women believe that having anyone attend them would interfere with their birth process. They might feel nervous about the attendant making suggestions which they might not agree with but wouldn't have the presence of mind to ignore in the moment. Or they might feel that they are being judged on their performance and not able to fully let go and do what feels comfortable for them. There are many other reasons why some birthing women are not comfortable having a birth attendant other than their family or friends and some would even feel safest birthing alone.
The process of normal birth is dependent on the mother feeling safe and supported. Therefore, she must do what she feels most comfortable with. Having an attendant is not a requirement of having an normal birth.
Birth belongs to the mother and her baby. No one should ever take the power away from the mother and tell her where or how to birth her baby. The process of birth is a very sacred event and the decisions of where, how, and with whom to share that event are the mother's to make.

What I Believe About Home Birth

Sunday, June 6, 2010

AFP (Alphafetoprotein) Test

This is another brochure I made for my doula course. Again, if you would like copies, let me know!

Q. What is an Alphafetoprotein Test?

A. An Alphafetoprotein Test (AFP) is a blood test taken to screen for Neural Tube Defects such as spina bifida, anenecephaly etc. as well as, more recently, to predict the risk of Downs Syndrome.

Q. How is the test preformed?
A. A sample of blood is drawn from the mother for testing. This can be done in the caregiver’s office or at a separate laboratory.

Q. When is the test done?
A. The test has the greatest accuracy between 15 and 17 weeks of gestation. Accurate dating of the pregnancy as well as knowing the number of babies in utero is very important to the accuracy of the test results.

Q. What at the risks of the AFP Test?
A. Other than mild discomfort at the sight of the blood draw, there is no risk from the test itself. However, depending on the results of the test, the AFP test may lead to further tests which do carry risks. Further tests that may be recommended are an Amniocentesis and/or Level II Ultrasound.

Q. Who is the test recommended for?
A. All pregnant women are offered the test, however, most practitioners especially recommend it for women who have a family history of birth defects, are 35 years or older, have used possible harmful drugs during pregnancy, or who have diabetes.

Q. What do the AFP results mean?
A. It is very important to note that the AFP test is a screening test and not a diagnostic test in any way. This means that it is used to note if a woman is at risk of carrying a baby with a potential disorder. It is not used to diagnose any disorder. If the test produces abnormal results, further testing must be done in order to reach a diagnosis.

Q. How accurate is the AFP Test?
A. The benefit of preforming the AFP screening is that 70% to 90% of babies with neural tube defects are discovered. However, about 10% of women who receive the AFP test will show abnormal results. Of these women, 1 in 50 will actually have an affected baby. This means that 49 women will receive false positive results. The downside of receiving false positive results is undue emotional distress.

Q. How can I decide if I should have the AFP test preformed?
A. In order to decide whether or not to have the test preformed, you should ask yourself what you would do if the test showed abnormal results. Choosing to have 
further testing could help you research potential medical interventions, start 
planning for a special needs child, start anticipating lifestyle changes, and find support groups and resources. You might also choose to not have further tests preformed because you would be comfortable with the results no matter the outcome, making a decision about carrying the baby to term is not an option, or you want to avoid any testing that poses any risk of harming the developing baby. Because making a decision about having an AFP test preformed can be a very difficult one, it is important to have all your questions and concerns addressed by your caregiver.

Wednesday, June 2, 2010

Jazmyn is Two Today!

I was a week past my due date on Sunday, June first and I was getting really impatient. I hadn't been able to sleep comfortably for months and I had constant, nagging heartburn. All I could think about was going into labor and having my baby already!
My friend and midwife, Tiffany, came out after church to see how I was doing and I asked her to strip my membranes to help get things going. She said that I was five centimeters dilated and very stretchy. It was encouraging to know that I was dilating but I wanted active labor to start so bad!
We visited with Tiffany and her family outside in the sunshine and I started to get really nauseated and weak feeling. I just wanted to lie down and rest so, after they left, I went into my dark bedroom and laid down on the bed. I tried to sleep but I was feeling really sick to my stomach. I went into the bathroom and, sure enough, I threw up. My stomach felt better after that but I was still very tired. I laid back down and drifted in and out of sleep for a while. At about six thirty I started to get some contractions that were mildly uncomfortable. After I got several of them, I texted Tiffany, told her what was going on, and asked if she thought they were anything. She said that she thought that they were the real deal! I was really excited but I didn't want to get my hopes up.
When I realized I wasn't going to be able to sleep through these contractions, I went out into the living room where Nathan was and said "I think you should start filling up the birth pool." He jumped up and started filling it right away. I made some calls to make arrangements for Angel and texted people to let them know I was finally in labor!
I kept getting steady contractions after Angel left with some friends of ours and I finally got into my birth pool. By then is was about ten o'clock and all I had eaten since that afternoon was jell-o and yogurt so I asked Nathan for some broth. My contractions started slowing down and I realized just how exhausted I really was. So, at about eleven thirty, we crawled into bed and I was thinking that everything had stopped and it was another false alarm.
Just before three o'clock, I woke up really hungry. So I got up and ate some cereal and noticed that my contractions were still going, they just weren't painful. I went back to bed just before three thirty and I had a huge contraction that woke me up. I was thinking "Ow... this hurts…" and then POP! My water broke! There was a warm gush everywhere and I smiled and laughed. I was so excited! I woke up Nathan with "Hey, my water just broke!" He bolted up out of bed without saying a word and I was thinking, "Where is he going?" He quickly came back with towels.
I called my midwife telling her that my membranes had ruptured and that it was clear. She was so calm when she said "Ok, cool, well just go back to sleep and call me when you need me."
After I got changed and had texted people telling them that my water had broken, I cuddled up to Nathan feeling all happy and excited. We both said that there was no way we were going to sleep after this! And we wouldn't have been able to anyway because my contractions started coming on hard and steady. I was like "This is it! This is where the real work begins!" We stayed in bed and I worked through the contractions for about an hour and then I called Tiffany again and told her she should probably start heading out to our house.
Tiffany and her assistant, Annie, got to our house a little after five and by this time I was begging for the pool. It had cooled down a lot so Nathan was working on 
heating it back up. It seemed like it was taking forever. I must have asked him a thousand times when it was going to be ready! Annie checked my blood pressure and Jazmyn's heartbeat while I was on the bed on my hands and knees with my face buried in the pillows.
The pool finally warmed up and I was able to surround myself with the warm water. Tiffany and Annie set up their supplies and checked their oxygen tanks while we talked and laughed. The mood was very light and exciting. The pool ended up being too relaxing and my contractions slowed down. Tiffany said that she wasn't going to tell me what to do but if I stayed in there I would probably stay in there a lot longer. So, I reluctantly made the decision to get out of the pool to speed things back up.
I went back to my bed and after a few contractions on "land" I said "Ok, I think we've proven that these really suck out of water!" I was hungry so Nathan brought me some cereal and I would eat as fast as I could before another contraction would hit me, and then I would flop forward and stick my butt in the air (it seemed to help). After I ate I laid down on my side and cuddled with Nathan some more. I felt so antsy and I hated just laying there taking that pain so I said "I have to walk, move, DO something!" Tiffany said, "So go walk!" And we did. We went outside and circled the house a couple of times. It took a while because I had to stop quite often and hang onto Nathan as I worked through the contractions. They finally got so strong that I figured it would be ok to get back into the pool and if not then I really didn't care.

I got back into the pool and Nathan 
burned some of my essential oils and put in a Bach CD. He fed me some more jell-o and read to me out of the American Academy of Pediatrics book. It helped keep things light as we laughed about how clinical they were about everything. By this time the contractions were very close together and very strong. I moaned through them and gripped Nathan's fingers so tight he said I could crack an egg with my grip! Annie checked my blood pressure and Jazmyn's heart rate and reminded me to keep my "birth sounds" low and deep in my throat to help keep things loose.
I started to feel that things were getting really intense so I asked Nathan if he would get into the pool with me. He got in and started rubbing my feet and then I had a monster contraction. Right after that one another one hit me and I think I said something like "Oh, my gosh!" Tiffany and Annie came into the "birth cave" and I looked up at them and said, "I have to push!"

I flipped over onto my knees and wrapped my arms around Nathan for support. The urge to push was unbelievable! Tiffany asked me how it felt when I pushed and I said that it felt better. She asked if she could check to see if I was fully dilated. When she checked she said, "Well I feel a head!" She told me that Jazmyn had like an inch to go and that was encouraging. Everyone was saying, "You're doing so awesome!" "You're amazing!" I gave several short pushes and ended up bellowing like a moose because it just felt like she was coming too fast. Annie put an oxygen mask on me and told me to breathe deeply. Tiffany was telling me I had to get the baby out but my contractions had pretty much stopped by then and I was exhausted and just wanted to rest.
I whimpered, "I can't do this!" Tiffany said, "Yes you can! You're doing it! Do you want to feel her head?" so, I reached down and felt Jazmyn's head right there ready to come out. It was such an amazing feeling. I started thinking, "Ok, I want to see my baby." So I gave a huge push through all the pain and out came her head! I reached down again and felt her head with so much hair! It was exciting and gave me the courage to push one last time for her shoulders. It was so intense and seriously felt like a freight train was barreling out of me. I lunged forward away from the sensation on top of Nathan. But then, at about eleven-thirty, she was out!
After she was out, some drama began. I turned around and held Jazmyn close, rubbing her chest. She gave a tiny cry but that was it. The pool was quickly filling with blood so Annie gave me a tincture and some homeopathics to help stop the bleeding. We were all trying to get Jazmyn to start breathing and get some color. Everyone helped me get out of the pool and Tiffany kept saying, "Jenni, stop bleeding!"
The placenta basically just fell out, it was so small. I was shaking badly and still bleeding so Tiffany gave me a shot of Pitocin and they covered me in blankets. Annie had Jazmyn on oxygen and she started pinking up. They kept asking me how I was doing and I just kept saying "It hurts! It hurts!" I was having awful contractions and it stung really bad to sit down. Tiffany asked if I wanted to lie down on the sofa or my bed and I said I wanted my bed. They helped me into my bed and kept me on oxygen. I was so exhausted and I remember wondering why they wouldn't let me sleep but I guess they didn't want me to pass out. So they brought me my precious baby and I got to nurse her right away. It was so amazing to have those first moments with her. She was so perfect.
Tiffany and Annie explained that Jazmyn's heart rate had gone down to about ninety beats a minute when I was pushing and that it didn't go back up, which is why they wanted me to get her out so fast. The umbilical cord vessels were weak and had separated from the placenta which kept her from getting adequate oxygen. But thankfully, I had been able to get her out fast and she pinked up nicely and looked beautiful!
They washed me up which I thought was so nice because no one did that when I was in the hospital with Angel. They said, "Well that's because we actually care about you!" It still makes me tear up every time I think about how tender they were. Then they let Nathan and I bond with our new baby while they cleaned up the "birth cave". After a while, they came back in to weigh and measure Jazmyn and to check her reflexes. She was six pounds, fourteen ounces and twenty inches long.
The whole experience was just indescribable. It fueled my passion for home birth and helped heal some of my hurts. God is so good.

Happy Birthday, Jazmyn. I love you, sweet girl.