I'm a homeschooling mom to 9 lovely little people (some aren't so little anymore).
When I'm not functioning as a mother I'm a midwife and childbirth educator. I have a real passion for pregnancy, moms and babies.
One Birth, One Woman at a Time I was reading this article, it's one I chose to comment on for my studies with AAMI I was inspired, Jan is such a wise woman, full of inspiration and support. This article is a wonderful reminder of why we do what we do. I’ve recently had a string of “bad” births, epidural and vacuum assist, 2 c-sections, and my preceptor had to call child protective services on a mother who refused to take her failure to thrive baby into the hospital. With all this I sat back and wondered what am I doing? What’s the point? But as Jan pointed out, I have changed people’s lives, even these women who had less than ideal circumstances, their lives, their ideas about birth were changed. Their family’s ideas were changed and I even think I made an impression on a nurse or two. It’s hard to keep going when you feel like you’re stumbling along. But I look up from the dirt I’ve fallen into and I see the light in a woman’s eyes who sees something new, who has hope for something better and I have strength to pick myself up, dust myself off and get on with my work. This is the work God has for me, I often feel like He’s trusted me with too much, I can’t possibly live up to it, and then I’m reminded I don’t have to do it alone, I have all my sisters in birth working along side me. Together we can create a better world for the motherbaby dyad.
A recent study in the Journal of Clinical Endocrinology and Metabolism showed a link between low serum levels of Vit.D early in pregnancy and an increase in the risk of having toxemia later in the pregnancy.
"Low vitamin D early in pregnancy was associated with a five-fold increase in the odds of preeclampsia," said Dr. Bodnar, who also is an assistant investigator at the university-affiliated Magee-Womens Research Institute (MWRI). "Data showed this increase risk persisted even after adjusting for other known risk factors such as race, ethnicity and pre-pregnancy body weight. Also troubling was the fact that many of the women reported taking prenatal vitamins, which typically contain 200 to 400 International Units of vitamin D," she said.
It's interesting to note that these women were taking prenatal vitamins with vitamin D in them, however the study doesn't mention how much time these women spent outside. From wikipedia
Vitamin D2 is derived from fungal and plant sources, and is not produced by the human body. Vitamin D3 is derived from animal sources and is made in the skin when 7-dehydrocholesterol reacts with UVB ultraviolet light at wavelengths between 270–290 nm. These wavelengths are present in sunlight at sea level when the sun is more than 45° above the horizon, or when the UV index is greater than 3. At this solar elevation, which occurs daily within the tropics, daily during the spring and summer seasons in temperate regions, and almost never within the arctic circles, adequate amounts of vitamin D3 can be made in the skin only after ten to fifteen minutes of sun exposure at least two times per week to the face, arms, hands, or back without sunscreen. With longer exposure to UVB rays, an equilibrium is achieved in the skin, and the vitamin simply degrades as fast as it is generated.
In most mammals, including humans, D3 is more effective than D2 at increasing the levels of vitamin D hormone in circulation; D3 is at least 3-fold, and likely closer to 10-fold, more potent than D2. However, in some species, such as rats, vitamin D2 is more effective than D3. Both vitamin D2 and D3 are used for human nutritional supplementation, and pharmaceutical forms include calcitriol (1alpha, 25-dihydroxycholecalciferol), doxercalciferol and calcipotriene.
So sunshine without the use of sunscreen is very important to proper vitamin D balance. This goes into another rant of mine on the over usage of sunscreens, but that's for another day. Vitamin D is fat soluble so you can ingest too much, so taking a supplement isn't really the answer. The answer is to get off your butt and go outside for a walk! Spend a little time in the sun!
I want to be sure to point out that newborns get their vitamin D stores directly from their mother, so a mom deficient in vitamin D is going to have a baby deficient in vitamin D. Vitamin D is very important to bone health. Vitamin D deficiency is linked to Rickets, Osteomalacia, and Osteoporosis.
I'm actually getting tired of this topic. I just want a plan. Well really I just want to assist women in their ideal birth...
I've been thinking through what I want to do. Finding a preceptor is proving impossible. So the next options are a year at Maternidad La Luz or a few stints at Casa de Nacimiento MLL is really my first choice. It's a complete program, everything would be done in a year's time and I would have direction to keep me on task. (I'm a master procrastinator) but it would mean the whole family going which means the house we're in either has to be sold, which this house sat for a year before we bought it. Or we have to have enough money saved to take care of payments on this house for a year. Nathan wants $20K in savings to make sure we don't default on this house.
I'm really feeling like this is just an impossible feat at this point. We seem to have an impossible time saving money. I could go get a job, but it would have to be after Nathan is home in the evenings and really, I wonder how much I can really make. AAMI is a minimum of 4 years and I still need a preceptor after that. I'm definitely sticking with AAMI, I think it's a very comprehensive course and an excellent continuing education opportunity. I don't think that it's necessary to start assisting in births though.
WoW! WoW! WoW! There is nothing better than going to a beautiful city, enjoying great food and delicious wine while being in the company of 300+ women passionate about birth! I suppose the only thing that could have made it better would have been to catch a baby LOL!
I made some great friends! Nothing like a bottle of wine to bring people together! Really though we had a fabulous time talking about things we likely haven't talked to too many other people about. I suppose the safety of anonymity allows people to open up. I hope we remain friends and in contact.
I think my favorite discussion was on the placenta, oh how I love the placenta. Such an amazing organ. Followed closely by Robbie Davis-Floyd's presentation about the renegade midwife. It's a fabulous presentation about the need for autonomy for midwives. Currently the autonomous midwife is usually practicing outside the general "rules". The need for this kind of midwife, the one who will bend protocols to give the the mom who is 42.6 days time to go into labor on her own, or the one who will support the 2x c-section mom in a VBAC, or the one who will take on the grand multiparas are all assets to the birthing community. Without these midwives we could lose valuable skills. I also had the opportunity to talk with Pamela (right? it is Pamela... man I'm horrible with names) she blogs as Sage Femme. She brings a new/old perspective. I say old because I think it's the more traditional role of a midwife, sit back and wait until your needed, and assume that you're probably not. I say new because it seems that many midwives have forgotten this idea and have become much more hands on, many who project the idea that the birth can not/should not happen without them. I hope she is asked to speak at more conferences.
I hope that I can assist with the next conference somehow and possibly develop relationships with some of these very experienced women.
I had the pleasure of attending Sam and Carie at the birth of their 5th child, Ronald Hayden. It was a beautiful homebirth. Carie labors so well, if I wasn't an experienced mother and doula it would have been hard to tell where she was in her labor. She handle the contractions "apparently" with little effort as you usually see in early labor. Her midwife, Janessa, took a back seat, and let things progress on their own. She didn't insist on numerous vaginal exams or monitoring etc. It took a little longer than "normal" for Hayden to descend the birth canal, but she never seemed concerned or said anything. She even appeared open to birthing the baby on the toilet! A good friend Abby was there to take pictures. She's a 17yr with a fledgling photography business (http://www.abigailsmithphotography.com), she has immense talent and patience. This was her first view of birth, I'm so glad it went so well. This birth renewed my faith in my own abilities to doula, in the power of natural childbirth and in midwives who truly trust birth. It was just such a fabulous experience! We walked, we laughed, we talked and I cried (I always do!) Congratulation to the Means family, may God richly bless you.
I went to a little mini-conference put on by the Heartland Midwives Association. It was nice, I had a good time just chatting with other women about birth and babies. It's so uplifting to be able to candidly share your feelings about pregnancy, labor, and birth and not be looked at like a crazy person! There are times I feel so alone on this path it's nice to connect... We went to the spaghetti factory afterward and it was so much fun! I laughed so hard!! Sarah and Ann are just like me humor-wise. It was great and I'm so glad I went. I learned that Damiana may help with the PPD. I want to look into a bit more but I think I'd like to hang out with Margaret and Aileen to learn more about herbs.
8/30 A few days ago I admitted to my husband that I felt suicidal. I can't recall ever having to say anything so difficult in my life.
Now I'm here to admit it to the rest of the world in hopes that some woman will gain the support she needs to get through this herself. I plan to edit this post as I progress so it'll all be right here for anyone who someday may need it...
At about 4 weeks postpartum I began feeling depressed and agitated. I would get frustrated that my baby needed me. That my other children needed me. I would blow up at everyone over anything and frequently cry soon there after. I felt guilty for being so mean...
It has progressed to panic attacks... that tightening of the chest and feeling like I can't breathe. Fear of nothing and everything, I can't pin down what I'm afraid of but I feel scared. A knot in my stomach and the feeling that I'm about to throw up. Crying unexplainedly. Thoughts of killing myself, more like fantasies of how good it would feel to die. I've had visions of hurting my baby, always as a reaction to frustration but scary thoughts none the less. I have a hard time concentrating, I can't seem to make decisions, I feel like I'm forgetting something all the time, I blow up easily and can't seem to think clearly. I shake occasionally and I feel like I'm going crazy. This makes me feel ashamed, I don't want other people to see me as weak or incapable. I don't want people to hold it against me, I don't want people to think it makes me a bad person. I love my children and there are many times that looking at them is the only joy I feel all day.
Last night I got a prenatal, B-complex, Valarian root, Calcium magnesium,L-lyinsine an amino acid and Omega 3 fatty acids. The Valarian is a nervine and I'm hoping it'll have enough of a sedative effect to help keep me from blowing up at my kids all the time.
I'm supposed to call my doctor about getting on the progesterone pill. In the past I have taken normal birth control and had a bad reaction (wild mood swings and headaches). My doctor came to the conclusion that it was too much estrogen, the progesterone pill didn't have any negative effects. During pregnancy (a time when I feel very normal) the placenta releases large amounts of progesterone. I suspect that the decrease in progesterone maybe largely responsible... but I'm finding it difficult to call my doctor. I don't know what to say to her. I really want her respect and feel I have it. I feel at this point she sees me more as a peer than a patient and I'd like it to stay that way.
9/1 Yesterday was a very bad day... I really wish I could pin point triggers or something. Nathan left for work around 8 as usual, and as usual I was still in bed, a movie was on for the kids. I generally spend an hour or two half awake while they watch movies (yes I feel like a horrible mother but at this point I can't bring myself to do anything else)and then I finally get up, usually when the baby gives me no other choice. Typically I have to referee a few arguments and answer a question here and there, ordinarily it's not too bad but yesterday.... yesterday I could have literally beat a child. Everything in me wanted to double up my fist and hit someone. I called my husband who thankfully came home right away. I stayed in bed until nearly 4pm. I woke only to nurse the baby and at 3 when Nathan asked me to call my doctor for the mini pill prescription. I did feel much less stressed when I did finally get out of bed but the self induced guilt is awful. My husband is a saint though. He came home right away when I called, supervised the kids all day, fed them, made sure chores got done, did his own work and even did school with them. He talked with his manager today. I was hesitant, again self-induced guilt and shame, but it was for the best. He's been coming home frequently and I was worried how his employer would look on that (although they are extremely understanding and have always been super flexible). Turns out the manager has seen this in his own family and even said he suspected that was the case. So he's very understanding and praying for me.
9/3 not a good day. It's about 7pm. I've been "sad" all day a few minutes ago my youngest needed to nurse, I wasn't moving fast enough and he was tired and hungry and started to cry, it took everything I had not to just toss him to the floor! I even yelled at him (like it could help to yell at a 10 week old) to be quiet. Now I'm feeling really stressed and just plain irritable. Every noise my children are making is bothering me, I'm gritting my teeth and clenching my fists and I feel a headache coming on. I haven't taken any of my vitamins today...
9/4 Oh dear Lord! How am I ever going to survive this? I can't stand noise. Any noise. It's not like I have a headache and the noise hurts it's just intensely annoying. My first reaction is to do anything to make them shut up. I locked myself in the closet to get some quiet today. It's driving me over the edge, I'm sure you can imagine what a house with 6 kids sounds like! I haven't taken any vitamins today either. I had thought that I would see what the progestrone pills alone would do but now I'm second guessing that.
9/8 Yesterday was a very good day! I've been very good about taking my vitamins and progestrone, drinking tons of water and making an attempt at getting to bed by midnight. I don't think I had a single panic attack yesterday! I know I didn't have any "scary" thoughts and I was able to feel when my anger was about to burst and circumvent it. I feel good that I went a whole day and didn't have to call my husband home. I took my daughter to cheerleading practice and left the baby with Nathan. It was about 2hrs after I ran to the store and it was good. I'm hoping it wasn't a fluke and that I've found something that works. I also talked to a very good friend the other day and was surprised she had post partum depression as well after one of her kids. I was surprised because she had never said anything, but then I suppose it's hard to admit. It felt great talking to her, just sharing similar experiences and knowing that she really *knew* exactly how I felt. I mean my husband is wonderful and he tries and I know he empathized with me but he can never really know the feeling of being paralyzed by fear but that fear has no source, it's totally in your head and you can't even designate a source for it, it's just there and it has you by the throat. And because you're an intelligent woman you feel totally crazy, like you should be locked up because you're afraid of nothing! Try as he might he'll never totally know what I'm feeling, I'm wondering if I should find a support group...
Links that may help My Dog Harriet another blogger shares her battle with PPD
1/5 It's a new year and I've been horrible about updating this. I'm sorry. I'm doing fairly well. I'm regularly taking progesterone, EFA, and a complete B. I still have my moments, which I don't think my dh understands. It seems he thinks we've found the magic pill and all should be well now. He doesn't seem to understand the immense struggle it still is to get up and function. Maybe this isn't related to PPD but it's there none the less. I love him dearly and I know if I talked to him about it he'd understand and be great, but I feel like I'm making excuses. I mean how many times can you tell the teacher your dog ate your homework before he starts to question the reality of it. I've started reading What Your Doctor May Not Tell You About(TM): Premenopause It's pretty good. I'm hoping to finish it soon and start using a natural progesterone to treat my depression. In early December I tried going off the progesterone pills so I could do some hormone testing, it didn't go well. I had all the original symptoms back in a few days and by the end of the week was not really functioning.
2/2 I've stopped taking the progestrone pills and am now on a cream Progestacare. I seem moody, and irritable and a general depressed mood. I've been feeling isolated and rejected lately. I had trouble sleeping the first few nights and I've spent most of this week with a migraine and intense nausea. I'm going to try to go back to the supplements, I'm just not very good about taking them. I also am beginning to suspect my thyroid isn't functioning properly, I'm exhausted all the time. Nathan thinks I'm not getting enough quality sleep, enough REM sleep. I kind of agree, but not sure what I can possibly do about it.
3/4 Swimming, trying desperately to keep my head above water. At the same time wanting to just slip away. The water is dark and icy cold, the sky is black and looming. Nothing can be seen in any direction Which way do I go? What do I do? I want to just stop stroking I know I can't
Things are getting bad again. I'm using the progestrone creme in the morning and at night. I had my TSH tested, it's normal. I'm going to see an endocrinologist for further thyroid testing and hopefully a natropath for hormone testing.
3/21 I'm back on the pill. I really don't like the idea, but it's impossible to ignore the help it provides. I still struggle with a general sadness and some anxiety but no where near where I was. I have hope again and feel like I can function. I hope to write about all this at some point. I think it's important to get women and men understanding that this is a real problem and not one to be ashamed of. I had the opportunity to talk to a midwife at the conference who also suffered from PPD, though we both thought that Post Partum Psychosis might be a better diagnosis given the symptoms. I was amazed at how we could finish each other's sentences. We had such a similar experience it's amazing. Sad that she had to suffer too, but encouraged that she came through it. One thing she mentioned that I haven't mentioned here yet and I think it's important is that part of what has kept me from seeking more help, and being more open is that I am viewed as a "birth professional", a strong woman in the community. To admit that I'm not always strong, I don't always have the answer and that birth and post partum isn't always fantastic is hard for me. I hope I can shift this paradigm by writing about it.
7/23/07 well his first birthday has come and gone. I think I'm past the worst of it. I still need an incredible amount of sleep. I'm constantly tired, crave sweets something terrible. I'm often forgetting I'm hungry and skip way too many meals and I'm not thirsty hardly at all so my water intake is way down. I know this isn't healthy for me. I'm just really struggling with turning it around. I've been off the pill since I got back from Oregon. I started taking brown kelp which seems to have helped some. I also had my thyroid checked. All my levels, including cortisol and adrenal function, came back on the very low side of normal, not low enough however, for this particular endocrinologist to supplement. I wonder if it has anything to do with the fact that I'm not insured. I'm trying very hard to get up in the morning by 8 as opposed to my usual noon and exercise first thing. It's a huge struggle, especially since my husband, as amazing as he is doesn't want to see me suffer so he has a tendency not to work to hard at getting me out of bed. I'm hopeful though, there is definitely light at the end of this tunnel, and my son couldn't possibly bring me more joy.
9/19/07 I feel normal most days now, finally! I still tire pretty easily, but generally speaking I think I'm pretty close to my old self. Unfortunately in the last year the kids have gone totally out of control, the house is a complete disaster and I've lost contact with pretty much everybody in my homeschool group and online friends. I feel like I just got out of rehab, feeling great, yet still ashamed and out of touch. But, I'm holding on and taking it one step at a time.
I'm sure this is a topic that could go on and on but I want to explore the comments made on my last post...
Maybe it's just the way my state is going about this that has my panties in a twist. See the way the bill reads right now there would not be an option for waivers, there wouldn't even be a specific standard of care consistantly in place. At least not guaranteed... The bill gives power to the health department with recommendations from a board that is primarily midwives, though there are two doctors and a parent (or maybe it's two parents). So my issue is that the board only gives recommendation and that the way the bill is written it is all together feasible that the health department could change on a whim what the scope of practice is. Yes it's not likely, and it's a pretty good bet that the board will have a good influence on the health department and it's a pretty good bet that once the scope and practice are laid out that they'll stay that way. BUT IT'S NOT GUARANTEED! and I really don't want to "bet" with what I see as my path... And the way it's written now there is no provision for patients who disagree with the scope and practice, no waiver to get them past it. If a client and midwife agree that 44wks is fine there is nothing to allow the client to choose that without still endangering the license of the midwife. I'm trying to remain optimistic, the bill still hasn't passed and as far as I know it hasn't even been argued. It's all together possible it'll just fade into the distance and we can go on as we are.
I don't have issue with certification. I think it's an awesome choice for a midwife to have and a way to carry her abilities on her shirt sleeve so to speak. I think that certification (sitting the NARM) should be enough, why do states need to take it any further? I mean do you learn more by being licensed by your state? Probably not, as you prove your abilities to the state through the credentials you already have. It might be different if they required you to go through classes etc. to obtain licensure then you could say that as a licensed CPM you have added education over the non-licensed CPM but a CPM is a CPM regardless of CA or NY it's just a matter of what their state is trying to regulate.
This link Showed up in my in box yesterday morning. Thank you Gloria ;-) It presents an interesting point, one that I hadn't really given much thought to and that is that through licensure the state is admitting that homebirth is safe. I do think this is important but at the same time what has our society come to that we need the state government to tell us what is safe and what is not? Are we not capable of determining that ourselves? But another point it made was that 49 of 50 states have some law regarding "practicing medicine without a license" and that without legislation to rebuttle the legislation brought about by the AMA back in the 50's (more on that later) midwives have the potential of being prosecuted all over the country. This is the general idea behind the midwives of Oklahoma supporting the bill that is currently in the house. Oklahoma has laws regarding the practice of medicine and it doesn't include midwives.
much to think on. I shall be back, I want to rant on about the ACOG's attempt to squash WI legislation and thier general stance on homebirth with CPM's but it's time to do some school with the kids!
On a list I'm on we're discussing the pros and cons of licensing midwives. In my state there is currently legislation in the house to require all midwives to be CPM's. The "rules" that it has laid out currently aren't too bad, but it gives power to the health department. Anyway I don't want to pick apart my current states legislation... I want to talk about legislation in general.
I don't honestly see too many pros. In fact that one that keeps getting brought up is that parents then know that their care provider is practicing within certain parameters and she's achieved certain standards in her education. My thoughts is "why is it the states responsibility to do this research for parents?" As a parent isn't it my job to research care providers? Find out their credentials, seek out references, and if there is a local group (not a governing body but a peer review group) be sure they are in good standing with that group. Isn't it my job to make sure that I am getting the care I need. Why does so many people think it's the states responsibility? Whatever happened to personal responsibility? Okay this rant is going in a different direction so let's try to get back on topic.
Cons to licensure... there are many! One midwife posted that she believed in the state of Florida a midwife can not assist a woman with a hemoglobin below 9. Now I understand the thinking behind this, there is some thought that a low hemoglobin increases your chance of hemorrhage. BUT! what about women like me who barely are 9 when they're not pregnant! I generally deliver around 7 and where as I've had slightly heavier bleeds certainly not anything that should prevent me from a homebirth because this is MY range of normal. Now some midwives wouldn't be comfortable assisting me and that's okay, but many wouldn't mind especially when looking at my history. Licensure takes away the right of the woman to choose to take that risk and the right of the midwife to choose to take that risk. Now the state has determined that neither the midwife nor the woman are capable of determining what is an acceptable risk. And that my friends is my biggest issue with licensure, that the state takes away a mother's right to self determine care and a midwife's abilitly to practice in a way she is comfortable with.
I hate politics... I really, really hate politics. Oklahoma has long been an alegal state in regards to midwifery, meaning that it was neither legal nor illegal. There was nothing governing the practice in the state at all. Apparently sometime in the last year or so a woman from the Church of the Firstborn died shortly after birth. She bled out from a retained placenta piece, something that easily could have been treated with a midwife or doctor. However, the Church of the Firstborn doesn't believe in using doctors, they are faith healers. So rather than seek medical attention they prayed over her. The women that attended her birth call themselves midwives (or so I've been told) although they do no clinical assessment, they simply pray. At any rate, the woman's family contacted a state senator and requested that something be done. The response was to legislate midwifery. An initial bill was proposed and a local midwife is meeting with the senator to get the language significantly changed. The problem with all this is that it's not going to do a thing about the issue that the senator was contacted for. This group can continue to practice the way that they do under religious exemption laws. I'm feeling extremely frustrated, having just decided on my educational path, one that I could manage and afford and now it appears that I will be forced to sit the NARM's test and be a CPM which means registering with that national organization and then with the state organization. I have LONG felt that I needed to avoid being registered anywhere. I'm just praying that the language won't completely exclude the practice of midwifery without registering with the state. I feel like I'm going to end up in quite the quandary, either I register and go against what I think is my conscious, or possible loose respect among the midwifery community in the area. I also feel like my hands are tied, because I'm not currently a midwife I really don't have much of a voice, but this is going to drastically affect my future as a midwife.
because you might go to fast!! What on earth! A woman on a board I frequent recently posted that her doctor is concerned that her labor is going to go to fast. Her first was 5 hours and she doesn't want her "stuck in traffic having a baby". So instead lets pump you up with artificial chemicals, increase your risk of c-section, uterine rupture, maternal infection. Let's reduce your pain coping mechanisms and your bodies natural hormone flow all so we don't risk the baby coming without us being ready. And the response... Oh my goodness!
My boss was in the hospital hallway when she nearly gave birth to her third son...she was going thru labor so fast they couldn't even give her an epidural and were telling her NOT to push because they weren't prepared to catch the baby!!! So I think she must know what she's talking about!
We live almost 2 hours from the hospital, so a friend of ours had hers induced at 39.5 weeks and had her second baby after 2 hours. It went so fast! It's definitely something to consider, so it's good you have lots of time!
yes let's bring our babies into the world as early as possible!! Who cares if they are ready or not! I'm just blown away at the naivete of some of these women and their apparent lack of desire to educate themselves. Yes I was naive once too, but I did everything I could to educate myself! I really just want to cry, these poor women will never know the empowerment that birth can be! They'll never know how strong their body really is and how awesome the whole biological dance is.
