Saturday, March 31, 2007

The Opinionated Faith: Birth Matters

For those of you uninterested in the following topic, I've scattered adorable unrelated pictures of the boys throughout. Feel free to just scroll through to view, and then go forward with your day.

First, a disclaimer:
All of the following is my opinion, and should be taken as such. If you choose to do differently, please feel free to do so -- the point of this post is to encourage you to think for yourself. I am very strongly opinionated, but that doesn't mean that I think your birth choices, should they be different than mine, are wrong. The most important thing to me is that you feel and are safe, healthy, and in control of your pregnancy and delivery.

Also, please be aware that I have experienced both the medical side of things (as I have had a doctor for this entire pregnancy up until about a month ago when I found my midwife), and the "community homestyle" or "natural" side of things.

Second, a clarification:

There are many kinds of doctors, and several types of midwives. Some Obstetricians (OB's) have been specifically trained to deal with nutrition and preventative health. Most, however, have not. In this post I deal with the issue of the latter.

Midwives in the states come (as far as I know) in two flavors: Certified Nurse Midwives and the "illegal" Uncertified Folk Midwife (my own title for them). The certified tend to act as a cross between a doctor and a nurse, working under direct supervision of a doctor. They are allowed to prescribe medicine, do prenatal care, and deliver a baby, but they cannot do c-sections. Folk Midwives, on the other hand, operate illegally in their communities, using knowledge that they have not only gained through study, but through intense, hands on apprenticeship through another established Folk Midwife. These midwives also almost always assist you in delivering your baby in your own home. In this blog, when I say "midwife", let's assume that I'm talking about the Folk Midwife, and home delivery.

Thirdly, a request:

Please leave any questions or concerns you may have in the comments, and I will follow up with answers (or, in the least, clarifications) in the next post, so that we can all be involved in the conversation.

38 weeks! (Photo taken last Sunday)

Many of you have asked me at different times why I make seemingly ancient and/or "hippie" choices about pregnancy and birth. With all of the technology available to us -- and it's free for me, because of the military -- why not take full advantage of the benefits medical science has brought us?

Those are good points, so I'm going to share with you my pregnancy and birth philosophy, and then perhaps you'll understand.

I am not a patient. When a woman becomes pregnant, she is immediately treated as a sick person. Have you ever heard the phrase "in her condition", when referring to a pregnant woman? This, apparently, is a condition that needs careful monitoring by the medical system, and likely intervention to free her from her state.

In the first visit to the doctor, I was informed that I would need to take a class on all of the tests they would like to perform on me and my baby, mostly having to do with invasive procedures to discover if my baby had any abnormalities such as Downs Syndrome (my question: What am I expected to do if the baby does? also: Do you realize that none of these tests are 100% accurate, and that you can easily test a false-positive?).

Several visits later, the doctor started to set me up for a routine ultrasound. When I declined, he was shocked. As it turns out, I am the first person in his 20 years of practice who has ever turned down an ultrasound.

Now, viewing the baby inside has it's place. If there is something suspected to be dangerously wrong (like Placenta Praevia, or similar), you would definitely want to verify this (although a skilled midwife or doctor generally tells this by listening with the SonicAid or fetal stethoscope for the location of the placenta). I am all about medical inspection and intervention if it happens to be needed. Also, if you wish to know the gender of your baby before it's born, that would be another good reason.

However, using ultrasound just to check the position of the baby, size, gestational age, are all unnecessary. A skilled OB or midwife should be able to verify all of these things with no trouble through prodding the mother's belly. Exposing the baby to ultrasound waves for these purposes alone is completely needless.

My midwife prescribed this tea for me to drink in the last few weeks, along with crushed linseed, which I eat in yogurt. It's not actually as bad as it looks, but I don't think I'll be craving this after the baby's born. =)

I believe in preventative health. In medical school, OB's-to-be are usually trained to think in terms of "fixing things". There are so many nutritional ways of increasing health and preventing different complications, that I find this surprising, and more than a little bit disconcerting.

I choose to entrust my life and the life of my new little person to proven rather than just certified hands. Upon completion of their training (which includes some hands on experience), doctors receive a certification, and are released to work with the paying public. If the OB tends to have a terrible bedside manner, or a high rate of complications or deaths for patients in their care, it doesn't necessarily affect their certification status. It's also difficult to discover these stats, since those things don't qualify or disqualify him/her from his/her job. Doctors tend to be trusted for their medical opinion, because they have been certified.

Throughout the ages, folk midwives have depended on apprenticeship training, passing down their knowledge from older to younger, learning through doing, as well as research and study. The new (and generally younger) midwife proves her skill in the community while working with her mentor. She becomes known for her skill (or lack of), and her reputation follows her. If she's good, she'll get work. If not, she'll have to find a different profession.

I would rather have prenatal supervision than prenatal care. It may not seem like there would be a huge distinction, but to me it goes back to the whole "I am not a patient" thing. An OB will usually consider the woman who comes to them for prenatal check-ups to be under his or her care. A midwife considers the woman to be in control of her nutrition, health, and overall well-being, coming to the midwife for the purposes of guidance and knowledgeable friendship.

It is important to me that the person who sees me prenatally will be there for my labor and delivery. When a woman in labor is admitted into a hospital, she is attended by the staff of nurses until she is ready to literally push the baby out. She is usually hooked up to all manner of devices to assist the staff in caring for her, since it's usually impossible for a nurse to stay with her physically the entire time. The woman is given internal checks to determine the status of cervical dilation. It is then that the doctor is called in (hopefully the one that has been seeing her for prenatals the whole time is actually on call at the time!), delivers the baby, and hands the little person over to the pediatric specialists. Then that's it. Their job is to see her through her pregnancy, develop a relationship with her, then literally deliver her baby.

When the laboring woman calls a midwife, the midwife goes to the woman's house. She stays with the woman throughout her labor, assisting and advising as needed, suggesting different laboring positions that might speed things up or slow things down as things progress. She has built a friendship with the woman through the prenatal visits, and has earned her trust and respect. The husband, if he is at home and willing, is called upon to help make decisions if need be.

The husband and the midwife work as a team to assist the mother in delivering the baby in the most peaceful, graceful way possible, with minimal interference. The woman is not hooked up to any monitors, because there is no need -- her birthing team (husband, midwife, and whoever else has been chosen to be there), stays with her the entire time, monitoring her progress personally.

Internals are needless in this situation; they are only given if the woman wants to know how far along she is. (Even so, you never know when you might get temporarily "stuck" at a certain point of dilation for an hour or so, or if you're just about to suddenly open up all the way -- there's no way of knowing, so I don't find the information helpful. On top of that, it is less than comfortable on a good day -- way worse when you're actually in labor, and who needs that stress?)

One intervention leads to another. Many of my friends have been induced to start labor. As a woman nears her due date, Doctors will often reassure them that the doctor won't "let" them go more than 2 days past their due date, although it is perfectly safe to go two weeks overdue. "If you don't go into labor by Sunday, come in at xx:xx am, and we'll induce you." (At this point, I often wonder if the doctor truly thinks that the baby will stay in there forever without their help. Has this ever happened?) When a woman is induced, she is given an intravenous drip of pitocin which causes artificial contractions.

While a natural contraction has an arc of intensity -- beginning, middle and end -- the artificial one only gives you the peak sensation, with no build-up. It is very possible to endure and even work with natural contractions through methods such as total body relaxation (like the technique taught at the end of a Yoga session) and acupressure.

When on a pitocin drip, it is often physically impossible to imagine enduring even a few of these with no help, so medication is often the only option. These medications may or may not even have the desired effect on the woman, and it can even vary from one labor to the next with the same person.

One of my friends had an effective epidural with her first baby, but when she asked for the same method with her second, it worked until she was 7 centimeters dilated, and then suddenly quit at the height of her pain. Another friend had something to take the edge off of her contractions (I think it was Demerol, but I'm not sure), and she just had the feeling that, while her pain persisted, she felt completely helpless and miles away from her husband, who was standing right there next to her.

Besides the fact that the pain medication may not work as expected, it can also cause complications. While the pitocin is slamming the baby's head down, over and over in a mechanical style, the pain medication can actually slow labor down at the same time, since the woman can no longer actively work with the contractions. In the end, forceps might be needed to get the baby out (often because they're so jammed in the wrong way because they could not naturally flex their head and make their way down), vacuum suction, or even emergency c-section.

I cannot count the number of times I've heard an awful birth story end with "if the doctor hadn't been there, I would have died". What I want to say (although I don't), is "if you hadn't allowed the doctor to interfere, your life wouldn't have been endangered in the first place."

Also, there has been a huge increase in recent years of planned c-sections. Sometimes there is a good reason for it, such as when a baby is presenting breech. Although it is still possible to give birth naturally in this case, it can actually be life threatening for the woman and the baby. When women choose it for convenience sake, however, I often wonder if they realize that they're choosing to risk their life through major surgery. That the surgeon will need to slice through 7 layers of the woman's person, and then go back through and sew them all back up. That the recovery time is terribly painful; everything is a challenge, from lying down to sitting to standing, since it's the stomach muscles that have been affected.

If, for whatever reason, a woman chooses to be induced or plans a c-section, I do not hold it against her or think less of her in anyway. I do, however, hope that she realizes that she has a choice and realizes her risks and options. It is also important to realize and that the doctor may or may not want to respect her opinion. I also hope that the woman realizes that she has the right to disagree and go against medical advice (AMA) if something doesn't seem right or necessary.

I choose to be fully involved in my labor and delivery. I've made a decision not to use pain killers during my labor. This is not because I want to prove something or show that I can "handle it" better than the next person. It is simply that labor is a rather intense thing, and I would be very nervous if I couldn't tell what was going on. I'm not a sucker for pain, and that's why I use Acupressure (booklet available for free PDF download here), which helps to manage it greatly. I like to be able to make the conscious decision to relax my entire body, Yoga style, even while the most intense contractions imaginable grip my body. I feel powerful being able to work with my body, feeling the strength of the uterine muscles doing their job. I am able to walk around, sit on a birthing ball, lie down on a bed, focus in a rocking chair. I am free to move around, not trapped by pain medications that slow down my mental state, and impair me physically.

Most importantly, perhaps, is the fact that once I do give birth to the baby, I am able to experience and enjoy 100% the joy and the elation of holding that brand new person for the first time. I will be able to feel the giddy excitement and adrenaline rush that can only come after such an intense physical feat.

Babies naturally have about an hour of alert time immediately after birth, to learn how to eat, and connect with their moms. I can be alert and connect with my baby during that first hour, after which I, too, will fall into a wonderful, deep sleep.

When the mother has received pain medication during her labor, it not only affects her, but also the baby (a tiny bit of it goes into his or her system, often making him/her sluggish). This, obviously, can get in the way of the whole After Birth Experience.

I do not look forward to the intensity and pain of the upcoming birth. However, I do know that I will, once again, come out on the other side of it amazed at the strength of my body, the endurance that I am capable of, and the gorgeous baby that I will be able to enjoy.

I want to know that I have made my own, informed choices. The most important thing to me is that each woman knows the choices available to her. That she realizes how her choices will affect the baby, and that she is able to relax in the knowledge that she is having the very best birth experience possible. Whatever that means to her, whether it be giving birth in a hospital, a childbirth center, at home, taking advantage of technology and medication or not, it is paramount that she is confident and at peace.

My hope is that no one feels bad about making choices that may differ from mine, but instead that you make your own informed decisions on each thing surrounding your birth.

Please leave any thoughts and questions in the comments so that I can respond to them in the next post.

Check Out This Mug

Click For Larger Photo

So, here in Germany, they attempt to save taxpayer dollars by putting technology to work, rather than having to pay more workers. One of the things the Polizei (Police) have been using are strategically placed "camera cops" to catch speeders, rather than having a patrol car sitting roadside for hours. Unfortunately these cameras, which also work at night, using a bright red strobe, are programed at exactly the speed limit, with no deviation. So, a couple of months ago, I got flashed.
Now before the jokes start flying, please allow me to explain the circumstances. I was on my way to pick up Hannah at Frankfurt-Hahn Airport, and there are four different ways to get to Hahn from Kusel. I had already tried three of the routes, and so I thought I'd try the last one, which I had heard was the fastest.
It was night time, I had just exited the Autobahn, and was straining to see signs for my next turn. However, of course, the sign that I missed was the speed change, from 70kph to 60kph. Only a few hundred meters past the 60kph marker was one of these speed cameras, set up on a tripod, hidden in the parking lot of a gas station. And so, I got flashed. And there was no mistaking it, because it was really, really bright. Then, insult to injury, the route I was looking for ended up being closed, so I turned around to investigate the contraption, which was, as I expected, an oblong, telescope-looking thing atop a tripod, set up in just the right spot, so as not to be seen. I was only traveling 69kph in a 60kph, which, in miles-per-hour, translates to a difference of only about 4mph. So the Germans got their 10 Euro and I hope they're happy.

Saturday, March 17, 2007

Knitted Braggery in disguise

OK, first, the tiniest bit of knitting braggery, and then on to the "good stuff".

Example 1:

The coolest hat ever, which I knit for Greg about two months ago. It's stretchy cotton and very soft. It's the most difficult thing that I've knit so far, because the cables on it are so intricate, but Greg likes it and wears it often, so it was worth it.

Example 2:
This bolero is actually for the new tiny person, but since they're not able to model it yet, Purple Bear is filling in.
Probably no one cares, but I spun the yarn for this myself. If you do care, you probably already read my fiber arts blog. If not, then don't click on that blue word.

Now, on to the stuff that you come here to read about. Hannah is in France this week, so it's the perfect opportunity to blog about her.

No, actually, I've just never got around to posting these pics of a "Wildpark" that we visited a few weeks ago, so here they are.
Inadvertently, several of us are sporting Faith Handknits.
The hat I'm wearing is some more of my own handspun. (See, even though you don't really care, I'm finding a way to slip it in there anyway, amongst the cute pictures.) =)
Andrew, wearing his skully sweater and blue knit hat, and Hannah, wearing a knit ensemble from the former The Pink Bag boutique. (She's still learning to knit, so we can't blame her for wearing something store bought.)
The wildpark actually wasn't open, but we walked around the fence on the outside and looked at whatever animals would venture close enough to us.
(Greg is wearing the brown cabled hat.) I never get tired of watching Greg interacting with the boys. He was never interested in babies or children before we had them, but now he's incredibly good with ours. I love the way he treats them like little grown-ups. I often eavesdrop on their conversations because the dialogue is so funny. Sometime I'll have to record a conversation for you.
This is just a random shot, but this is where I found Hannah and the boys when I got out of the shower the other day. It's so nice to be able to shower in peace behind a locked door. A true luxury, which I do not take for granted!

The next post will be about midwives and birth choices. I keep promising that post, because I know a few of you are interested, so check back soon. (I'll also include a few gratuitous "cute little guy" pictures, for those not at all interested in what I'll be discussing.)

Tuesday, March 13, 2007

The castle is our playground

I am finally feeling confidant driving around Germany. Yesterday, I dropped Hannah and Hayley off at the train station and didn't get lost going there or on any of my other errands that I ran afterwards. I was so proud of myself. Things are set up here just different enough to throw me (I know, it doesn't take much to get me lost in a new city, but seriously, this is a different country for goodness sake! It really is different to drive here!), and I feel like I'm finally getting a handle on it.

Hannah and Hayley left to spend a few days in Berlin, and then off to France for the rest of the week. Andrew is very concerned that Hannah hasn't "come home yet" today, even though I've explained that she'll be gone a little longer than just a few hours.

Sunday was gorgeous weather (as was yesterday and now today), so we went to Burg Lichtenburg. There's lots of open space for the boys to run around, and it's always pleasant walking amongst the walls and ruins of the old castle grounds. (All pictures are clickable for bigger.)

Upon finding the gardener's shed, they began throwing dirt with great abandon.

The view from one of the castle walls.

Hannah and Hayley

Climbing (Hannah at far left w/Andrew. Elijah is in the lower right window)

We've had rain nearly every day this winter, so it's quite a novelty to see a beautiful, clear blue sky.

Elijah runs at a tilt

Friday, March 09, 2007

A taste of butter

Butter. I've always taken it for granted. Certainly I've always preferred it to margarine or any type of "butter flavored" spread, but up until recently, butter was butter.

A few months ago, a listener of the podcast emailed me and suggested that next time I shopped the cheese truck, I should ask for French butter with salt. I did so, and the same day went to the grocery store and purchased German unsalted butter, and Irish unsalted as well (Irish Gold, I think, which also happens to be sold in the states). We had American butter already at home (both Organic Valley and Land 'O Lakes), so I also got a nice crusty baguette and we conducted an Official Taste Test. To my utter surprise, they all tasted completely different (you didn't see that one coming, did you?).

Five butters, five distinct flavors.

The Land 'O Lakes was tasted both first and last, since it's the "regular" standard in this house. At first bite, it just tasted normal, like butter should. After all the others, it had a slightly off flavor. It reminded me of when you leave milk out and re-chill it, and that "warm", ever so slightly sour edge it gets.

Organic Valley was quite good, with a balanced creamy butter-fat to salty flavor.

The German was pure and sweet, and we decided that it was "good".

Irish was not only sweet, but it was the creamiest butter I've ever tasted. The fat melted quickly on the tongue, and when I made Irish Soda Bread the next day, it was an absolute match. This butter never needs to be left out to soften. It would never tear bread, and has the highest percentage of butter-fat in the sample group.

And then we tasted the French butter. Oh my. It tasted of fresh cream and cheese and salt and... well, would you be shocked to find that it stood up to the baguette perfectly? And who wouldn't love something that comes packaged like this, anyway?

Tuesday, March 06, 2007

Blue and funny

Andrew has been coming out with some very funny things lately. A lot of it is just conversational, so it's hard to transcribe, but here are some quotables. (Blue icing pictures throughout, just because they needed to be.)

This cake was left over from Greg's change of command ceremony (yes, I really should have posted these pics sooner!). None of us wanted it and it had gotten a little stale, so....

We were in the living room, I asked Andrew to bring me a diaper and the box of wipes from his room so that I could change Elijah. Andrew came back after a few minutes and said:
"I could only find the freakin' box of wipes, but the freakin' diapers are not freakin' there." (All I can say to this is, what the daddy's do in moderation, their children will do to the excess.)

Andrew and I had been discussing how pink usually goes on baby girls, and blue on boys to show their gender. I wasn't sure if any of it sunk in, much less mattered to him, but he brought it up (had to do with something I was knitting). The next day, he was playing with this thin pink shoulder pad that he found around the coat closet (no one has any idea where it came from -- it might actually be a bra "cookie" but no one is owning up to it.) Andrew came to me after a little while and said:
"This pink thing has been like a sister to me"

(A distorted view because of the close angle, but hey, at least you can see his tonsels!)

During one particularly frustrating day last week, Elijah would not stop fussing or crying, and needed me constantly. I had a headache, and didn't feel so well. I had finally gotten the boys to be content, building blocks with me in their room. Andrew decided to start crashing the blocks into things, and the noise level was just too much for me. I got a little impatient and demanded that he stop, on no uncertain terms. He thought about it for a minute, then said:
"Mommy, you're really freakin' me out 'bout that.", and moved his little game out into the hallway instead.

I think the finger pointing is Elijah's, but I'm not sure

(If you've ever watched a Thai Chi, Yoga or Pilates video, you will be familiar with a phrase that includes "listen to your body for cues on what feels good".)
After watching a Thai Chi excercise video with Hannah:
"Mommy, I was watchin' the excercise video."
"Oh yeah? Did you work out with Hannah?"
"No, 'cause I don't know how to listen to my body."

Monday, March 05, 2007

Kaiserslautern, finally

The boys are finally feeling better, and after a weekend with lots of Daddy Time, their attitudes are back on the right track as well (I find it necessary to spoil them during times of illness, which then leads to a time of intense readjustment in the aftermath). I got a little bit of what they had, but my head is clearing out the stuffiness, and it's been easier to sleep the past few nights. So. I'm going to start blogging again.

Hannah's friend from school, Hayley, got here on Friday, and we've been having a great time all together. She's from Australia and was an exchange student also at the university Hannah was attending in England. (You might remember her name from the post about Thanksgiving, when she was here last time.)

First of all, a huge congratulations to my friend Alicia, who just gave birth to a beautiful little girl. Also to Aunt Susie, who just welcomed her precious second grandbaby (also a girl), this week.

I've got 5 weeks left until my due date (April 8th)! My mom, Joel and Rachael are flying in sometime after the 20th of this month (can't remember which day exactly, and as it doesn't really matter to any of you, I won't worry about getting the details correct at the moment). I'm glad that they'll be here a little early; having my mom here for the birth is very important to me, and it's a relief that she'll most likely make it on time. Andrew was 8 days early and Elijah was 1, so I think we're pretty safe.

Three weekends ago, Greg and I were planning on actually traveling several hours away to this resort for a little get-away, but they were booked out. Instead, we decided to go to Kaiserslautern, which is only about 20 minutes away. Hannah thought that this was a little strange, but really, anywhere in Germany that we haven't been is interesting and new, and car travel isn't all that comfortable for me at this stage, so it was totally fine with me.

Kaiserslautern ended up being wonderful. We stayed for two nights, and Hannah watched the boys for us, so it was just Greg and I, and we really needed the time together. It's kind of funny when holding hands becomes a novelty again. ("Wait -- I don't have to hold onto a little person! I think I'll hold onto you instead.")

The hotel was cute and comfortable, with a breakfast like none we've ever had at any place we've stayed at. Besides eggs and bacon (made to order when you step into the dining room), there was also endless coffee, tea, and a spread that included (but was not limited to) this:

Grainy bread with plum butter, muesli, creamy qwark ("w" is a "v"), stewed prunes, chocolate slices

The muesli, qwark and stewed prunes didn't sound as though they'd be good together, but it was incredibly tasty, and so filling that neither of us really wanted anything other than a little snack between our late breakfast and dinner. Amazing, since we are both usually starving almost as soon as a meal is done.

Someone's going to ask, so I'll just tell you now: qwark is some sort of a thick dairy product that tastes like a combination of yogurt, sour cream, and creme frech, although not really any of those things at all. Isn't that all kinds of helpful?

At the round-about ("traffic-circle" for those in the US), there was this group of soccer player statues:

Back view. Notice the spectators sitting on the overpass.

A closer view.

I know, strange. Then after you go beneath the overpass, there's a field next to the police department with an entire game blocked out with statues.

I realize that what follows is the ultimate touristy thing to do, and we got some looks from passing cars, but we couldn't help ourselves.

There is a large shopping district (which in Germany means that there are "walking only" streets paved in cobblestones with little shops all along), and we spent several hours on Saturday walking all around until my back and legs couldn't take it anymore. (It's hard to carry this much weight on the front end!)

During our travels, we saw this guy:

He stood as still as a statue until people would drop money into his tin cup, at which point he'd bow or something to thank them. My question was, why are we paying this guy? I understand the random coins thrown to street musicians and the like, but how do I know if this guy is entertaining me? How can I make that decision while he just stands there, barely breathing? I suppose that all this wondering was entertaining in itself, but we still didn't tip him. There was another dude, who was doing the same thing a block or so up, so it must be the popular thing to do there. No idea why.

I also noticed this statue in the middle of one of the walking streets:

It was some sort of a guy, I guess, and if you look closely you will notice that someone had graciously given him some pretzels.

Dinner on Friday was at an Italian place with "ok" food, but on Saturday we went to the highly recommended restaurant "21", which is on the top floor (happens to be floor 21. Didn't see that one coming, did you?) of the tallest building in the city. Our appetizers were stellar (Greg got a thin creamy lobster soup -- not bisque. I had tomato and grilled eggplant bruscetta.), and Greg's main course of fillet was incredible. My meal was rather tough baby lamb chops, but because of the language barrier, I didn't feel comfortable sending it back to the kitchen, and just choked down one or two of them in spite of the fact that I had to essentially swallow them whole.

For dessert we had a very interesting sampler platter of both stewed and fresh fruit, various chocolate things, and a large square of tirimisu.

View from the restaurant:

This photo and the one below were taken at the same window. This one with the regular "auto" setting on my digital, and the other with the "night" setting.

(Can you see me?)

I'll post soon about the funniest things Andrew's ever said.