In Gratitude for Good Nurses and Modern Medicine

My new baby is now seven weeks old and as I think about everything that happened throughout my pregnancy and labor and delivery, I feel a great sense of gratitude. This was my fourth pregnancy and I thought I knew what to expect, but it ended up being the hardest and most complicated pregnancy I've had. Nothing major, as it turned out, but a lot of unexpected things. All those things made me grateful--again--for the blessings of modern medicine. I don't always agree with how things are done in mainstream medicine and believe it's important to educate myself about all things health related, whether Eastern or Western, herbal or pharmaceutical. But because of my body's inability to produce enough oxytocin--or whatever it is that prevents me from dilating naturally--I have to give birth in a hospital, hooked up to a "Pit" drip. (See a detailed post on this topic here.) Knowing how close to death my maternal ancestors came during childbirth who had this same problem, I am grateful for Pitocin every time, even though everyone tells me it makes the contractions much worse. Without it, I would not have been able to have otherwise natural deliveries. This is just one aspect of modern medicine that I am thankful for.

I am thankful, too, for another wonderful Certified Nurse Midwife (my fourth) who is so caring and respectful, knowledgeable, and experienced. I am grateful to have options in modern medicine and be able to decide whether I want an OB/GYN or a CNM to deliver my babies at the hospital. I have always had great midwives and OBs whom I can trust with my care.

There are also many, many good nurses out there who make a positive difference in the lives of their patients. Some of my favorite people are nurses, including one of my sisters, and I know how much they do--very often beyond the call of duty--for those in their care. Such was the case this time with my baby's nurse. After the baby's initial feeding shortly after birth, she couldn't seem to latch on again. I tried not to worry, as I remembered how sleepy my other three babies had been the first couple days after birth. And, just like them, this one had also swallowed a fair amount of fluid before she was born. In my experience this was all "normal." But her nurse didn't accept these normal problems. Not only did she work with me and the baby for quite a while to get her to latch on when she really preferred to sleep, but the nurse also worked with her in the nursery. Because I couldn't sleep with the baby in my room, since she coughed and spit up fluid about every 10 minutes, I opted to have the nurses take her to the nursery in between feedings. It was such a relief to be able to give my baby into their hands for a couple of hours at a time, knowing she would be well taken care of while I got some much needed rest. And while that first nurse was on shift, she worked with my baby in the nursery, getting her to spit up a surprising amount of fluid. Her theory was that because the baby's stomach was full of fluid she felt no need to eat. I think she was right. By the time her shift ended, my baby was latching on again and starting to eat as if she were hungry. And by the time we left the hospital, she was actually 2 oz above her birth weight, which has never happened before with any of our other babies. I attribute it all to this diligent nurse who took a personal interest in my baby and determined to figure out the problem and fix it if she could. What a blessing it was to actually have my baby latching on well and gaining weight as we returned home! I felt like that got us on the right track from the beginning, which has made all the difference. I will always be grateful to that nurse.

So here's to all the good health care providers who are invested in improving the lives of those in their care, and here's to all that is good and helpful about modern medicine.

Telogen Effluvium and on Being a Survivor

My hair now

I've jokingly told my kids they can call me "fuzzy head" and have wondered how many others around me have noticed my perpetual "bad hair days." I haven't let it bug me too much, trying instead to just focus on how grateful I am that it's growing back in. Although, some days I wish I had a shirt that says something like I'm a Pneumonia and Childbirth Survivor. Those who have been through grueling cases of one or both of these can empathize with me. The problem, in my case, was that I went through both within two months of each other. (I've written about this a few times here.)

My hair at about 6 months pregnant

During pregnancy, the rate of my hair growth increases (and it normally grows fast) and I lose very little, so I have great "pregnant hair"! But a few months after I have the baby, all that hair I retained begins falling out in clumps. It's always alarming, but I've learned that it's normal and I'll be okay. This last time, however, my hair started falling out within a couple months after my son was born, and a couple months later it still hadn't quit. In fact, my hair loss seemed to have accelerated, and I was truly beginning to feel frantic. About five months after the birth of my baby, my hair loss finally slowed down and I discovered "baby hairs" growing back in--all over my head. Thus, "fuzzy head." As I had lost a fourth to a third of my total hair volume, this discovery came as a great relief!

It wasn't until my mom happened to mention her hair loss last fall that I realized there might be a pneumonia connection, since she had also had pneumonia that summer (a month before I had it). So I decided to do some research and found out there is actually a scientific name for this condition: Telogen Effluvium. It "occurs when sudden or severe stress causes an increase in the shedding of the hair. In Telogen effluvium a sudden or stressful event can cause the hair follicles to prematurely stop growing and enter into a resting phase. The hair will then stay in the resting phase for about 3 months after which time a large amount of hair will be shed. (This other site says it may only take 1 month, which was closer to my case.) Often the person involved will have recovered from the event before the hair loss occurs. In most cases the hair loss is temporary and the hair soon recovers." (see this link for more information)

For me, this has felt anything but soon. It has now been a year since my baby was born and I have a long way to go to get back to the very long, fairly thick hair I had last year at this time (I had to keep having it cut shorter and shorter as it became thinner and thinner). At least my hair does grow fast and it is growing back.

Until then, I'll just keep remembering I'm a survivor.

Guest Author: Adrienne's Story

I asked my friend, Adrienne, if she would write an article about her family's recent lifestyle change. I am always intrigued by why people make health changes, how they do it, and what motivates them to make such changes permanent. I also knew enough of the details to know Adrienne's would be an inspiring story. But even I was amazed with the full details...

First a little information about my family.  I’m a wife and a mom of two tiny boys. One is 15 months old; the other is 3 months old.  We live in Kentucky, and grew up in the suburbs just outside of Cincinnati. These facts each play a role in the health journey I’m about to share with you.

When I was pregnant with my first son, I didn’t gain much weight until the very end of my pregnancy.  I slapped on a whopping 30 lbs in the last two weeks, and my blood pressure spent some time going much higher than it should.  After battling blood pressure the entire pregnancy, the doctors started to talk about preeclampsia and induction.  Luckily, it stayed just barely under control and my cute (not so) little guy was born weighing 9 lbs and 7 oz.  Just a few short months later, I was pregnant again with the second baby.  The first trimester was brutal, but again I gained almost no weight.  I ate everything I felt like eating and scoffed at those who ate organic foods and turned up my nose at anyone who’d go out of their way to eat healthily.  “We just can’t afford it,” I said. “I don’t like vegetables,” I complained.  

Then something changed.  

My baby (the one not in utero, obviously) started to crawl.  That little sucker was FAST!  So I started to chase him.  Chasing a crawling baby while 5 months pregnant isn’t the easiest thing I’ve ever done.  I was worn out.  I was tired.  Something had to change.  So I started doing prenatal yoga, but that didn’t seem to be enough.  Then, one random day, I noticed something.  My dear sweet husband was eating a TON of peanut butter.  Jif creamy reduced fat peanut butter.  It was his favorite snack.  A spoonful while preparing a meal.  A spoonful after a meal, “just to top off.”  A spoonful as a snack.  I’ll spare you all the gory details, but a little research quickly showed that reduced fat peanut butter had almost the same number of calories as the regular peanut butter, and a lot more sugar, not to mention the copious amounts of synthetic ingredients.  Then we calculated the number of calories he was eating in peanut butter every day.

Almost 2000. (See?  I told you it was a TON of peanut butter!)

It was time to make a real change.  He went to the grocery store and bought some natural peanut butter.  Within a week, his cravings for peanut butter were completely gone.  After we realized the change, I started doing some research into making healthy changes.  I started with wordofwisdomliving.com.  The blog lists a healthy change for every week to make over your diet.  We did the first two right away, and went straight to healthy change #3.  It says, “Cereal products must be made of whole grains, and have more grams of natural fiber than grams of sugar.”  In order to make this change, we opted to shop for new cereals at Whole Foods. While standing in the cereal aisle at Whole Foods, my husband started talking to me about Jamie Oliver’s Food Revolution. Katrina mentioned him here.  

Then and there, in the cereal aisle at Whole Foods, we decided we were going to completely overhaul our eating by following one simple rule.

Do not eat any ingredients you don’t recognize on the label.

We began to eat only real foods.  We went home and threw out everything that wasn’t clean, (don’t worry!  I hadn’t grocery shopped in far too long, we didn’t waste much!) and packed our kitchen with healthy ingredients.  In less than a week, we felt 100% better.  More energy.  Better brain function.  We were eating vegetables and enjoying them!  We started visiting local farmers’ markets on the weekends.   Within two months, my husband lost 30 lbs without even thinking about exercise.  

It stayed off.

My blood pressure stayed in a normal range.

Then it got harder.  I was still pregnant, and hadn’t lost any weight, in fact-I’d gained weight!  I was starting to get discouraged, but then just a few weeks later, I gave birth to my sweet second baby with one easy push, and a very quick recovery.  I felt much better than I ever had.  

In the few weeks that followed his birth, I discovered that I weighed less than I did on my wedding day.  I noticed that I had more energy than I’d had as a new mom with my first.  Postpartum depression faded much more quickly the second time around.  

The key to keeping up with these changes was an easy one;  it was never a diet, it was a calculated lifestyle change.   It was hard work.  At the beginning, grocery shopping trips felt like they took years to complete.  I had to spend more time cooking.  It was a challenge.  Then I learned which items at the store were clean.  I started to enjoy cooking.  The foods without preservatives, artificial colors, and artificial flavors tasted better!

It’s really not hard to keep up and continue making new healthy changes to the routine we already have, because every little change we make helps us feel even better than before.  So we’re off on a new adventure in 2012-

Project exercise.  

What a difference a year can make.

Rethinking How to Make Yogurt

A few days ago a friend of mine brought us some homemade yogurt.  I've made a lot of yogurt for my family in the past, but I stopped a while ago, partly because I was discouraged by how runny it kept turning out.  My friend's yogurt, on the other hand, is as thick as cottage cheese!  I asked her how she makes hers (without a yogurt maker, like I have) and learned a couple things.  Then when I saw this video online by YogaMama, I learned some additional things I can try.  Now I'm more excited about trying yogurt-making again!

Speaking of probiotics and promoting healthy guts, YogaMama also has an interesting article about gut bacteria  and how it influences early development in infants.  Fascinating stuff!  (I'm repeatedly amazed at each new evidence that shows vaginal births are best for babies and why.)

Waiting to Cut the Cord

Our new baby is now three weeks old and I feel the need to write a post about waiting to cut the cord, which was one of the things that my husband and I decided to do differently this time around. I had read enough about the benefits of waiting to want to give our baby that advantage, and now I am learning even more. Here is an excerpt from my account of our baby's birth, detailing other unexpected benefits we experienced:

"We wanted to let the baby's cord stop pulsing before it was cut, and [our doctor] was happy to comply, so for the first time I got to hold my baby without any kind of intervention in between, with only a blanket between me and his bloody, vernix-coated body. He seemed to share my exhaustion and utter relief that it was over. When the doctor first held him up, his whole body was purple; I don't remember the girls being quite that color. But it didn't take long for him to start looking more pink, and we admired all his little parts. I was surprised at how long it took the blood in the cord to drain back into him. But it was so nice to have all that time with him just to myself... I kept wondering when I would have pains to deliver the placenta, but that didn't happen until [my husband] cut the cord [about 20 minutes later]... Things have always happened so quickly after delivery that I've never gotten the chance to see the cord or the placenta, so this time I asked if I could see them. [The doctor] was happy to oblige and gave us...Placenta Basics 101, which was very interesting. It really seemed that taking that time to let the cord stop pulsing slowed everything down and made the post-birth experience gentler and more peaceful. We definitely want to repeat that!"

So, what are some of the benefits to waiting, from a medical standpoint? This site calls cord blood "liquid gold" and says that even waiting 30 seconds to cut the cord is beneficial to baby because "this blood contains a high number of red blood cells; it is iron rich and contains maternal antibodies... Higher red blood cell flow to vital organs in the first week was noted, and term infants had less anemia at 2 months and increased duration of early breastfeeding."

A lot of people nowadays are having the cord blood saved for possible future needs, but as the above site points out, the blood belongs to baby, so why not give it back to him?

Another site contains an article written by a midwife, who states that, "Scientific methods are now able to prove that our standard immediate cord clamping protocol is an intervention that needlessly deprives a baby of a substantial percentage of his or her own blood supply and is one of the most major and potentially lethal inventions possible from the perspective of the baby's wellbeing." This site also contains numerous other articles on this and related topics that are quite interesting.

Another benefit (and one I didn't know beforehand) is that "delayed cord clamping ensures that a baby receives important clotting factors" (see this site, which includes pictures). I find this ironic, since babies born in hospitals in the United States are routinely given a shot of vitamin K, which provides artificial clotting factors (and which we declined this time)--after their cords have been clamped quickly. ???

So if you're expecting or are planning/hoping to have another child (or your first), this is a topic you may want to look into in more detail so as to make the most informed decision you can. It's such an easy thing to do for your baby to get him started healthily on the outside of you, and it can also sweeten the bonding experience, as I detailed above.

When Intervention is Neccessary

I think anyone who knows me would consider me conservative by nature. And if you've followed my blog for any length of time, you know that along with this conservatism comes the constant pursuit of doing everything as naturally as possible. Which extends to childbirth. In fact, if I could, I might even be one of those who would prefer to give birth at home, as a few of my cousins have (on both sides of my family).

But I can't. And the reason is that I can't do everything naturally when it comes to childbirth. Most things, yes, but not everything. My body simply doesn't do what it's supposed to, so I need some medical intervention to have a successful delivery and a healthy baby. While this saddens and frustrates me, I am grateful I live now and not 100 years ago--or less.

This story actually begins back when I, myself, was a baby. I was my parents' first child and, therefore, my mom had no idea what her body needed in order to give birth to me. Her own mother had no trouble, so I imagine she expected to be the same way. But she wasn't. Being the amazing woman she is, and having an incredible ability to withstand pain (and for an unbelievable length of time), she somehow survived laboring with me for 8 days. Yes, you read that right: Labor pains every five minutes for eight days! Thirty-one years later I am still flabbergasted by this knowledge. I wouldn't have been able to do the same in her position, even though I have a high pain threshold as well. And I sincerely hope that no medical professionals today would allow such a scenario to play itself out like that.

(In actuality, this story goes back at least to my maternal great-grandmother, who almost died giving birth to her first child because she had been in labor for so long and wasn't dilating enough to have him. With any luck, maybe this family "curse," which skipped my maternal grandmother, will also skip my daughters.)

As it turned out, when my mother finally refused to be sent home from the hospital again, the doctor finally gave her Pitocin, and then I was born, less than an hour later. Hearing this story my whole life, I always hoped I wouldn't be the same. Especially once I learned that Pitocin often actually makes contractions more intense and painful. But when I was one day shy of 41 weeks pregnant with my first child, with no sign of going into labor (my cervix was dilated to a 2 and supposedly very effaced, but that was it), my certified nurse midwife (CNM) stripped my membranes in an effort to get me going. A few hours later I knew I was finally in labor, but after about 17 hours, my cervix was still only at a 3 1/2. That was devastating news! And the contractions were not being consistent or productive. I was exhausted by this point and almost at the end of my rope, not to mention terrified this first time. It was recommended that I be started on Pitocin to help my contractions do their job. And my midwife, who normally wouldn't recommend an epidural, told me that she felt that in order to make it through to the end, especially with the addition of the Pitocin, I should probably have one. I agreed. (Unfortunately, this didn't prove to provide much relief at all, since the baby was posterior and, as a result, I experienced excruciating back labor, but couldn't keep moving to help me deal with the pain.)

Well, to make a long story a little shorter, the Pitocin eventually did the trick and I delivered my firstborn after 22 hours of labor--vaginally but with the help of forceps. (The medical staff determined that the baby's heart rate kept plummeting too low and they needed to get her out, even though I wasn't yet dilated to a 10.) My first daughter finally came into the world, then, but due to her being post-term and with all the pressure (literally) and stress of a long, difficult labor she was born with meconium aspiration and had to stay in the hospital for almost a week.

From this experience I learned 1) that my body, like my mother's, needs Pitocin in order for my cervix to dilate, and 2) that I don't want to have another epidural if I can possibly avoid it. (Not being able to move to help myself combat the pain was almost as bad as the pain itself--not to mention the fact that being stuck flat on your back increases your chances of having the baby rotate to a posterior position, which I think now may have actually been what made her rotate.)

And so, I found out what intervention I need. I joke that without Pitocin I would still be pregnant with my 6-year-old, but the truth is, I would probably have died (assuming there were no other possible interventions, such as c-section--which I sincerely hope never to have to have). In fact, if not for this same intervention, I probably would have died as a baby in my mother's womb, and she with me.

And so, while I wish I could have my babies completely naturally, I have learned what my body needs and am just grateful for the option. And I hope that this third time around will be as smooth and successful as the second! Because, if all goes as planned, I will be having my baby today. (Don't worry, I wrote this weeks ago and scheduled it to post automatically.)

When I was 39 weeks with my second baby, my cervix, once again, reached a 2 by itself, and was supposedly very effaced. But that was it. Again. And I felt very strongly that going overdue again would not do me or the baby any good, like it hadn't last time. So my midwife stripped my membranes and I hoped that that would get me going like it had the previous time. But other than give me more Braxton Hicks that tired me out but didn't keep going, nothing else happened. So my midwife scheduled an induction a couple days later. I was nervous about that, but up for the challenge. My midwife did everything in the right order for me: she started the medication slowly, waited before breaking my water, etc, and it worked like a dream. And from when my Pitocin-induced contractions began until our second daughter was born was only four hours. Four versus 22 truly felt like a miracle! In fact, it was exhilarating. With no epidural and a better sense for how to move and deal with the pain (and relax in between contractions and not be so scared and tense), my cervix responded so quickly to the medicine that I was at a 9 before I could even use the hot tub.

All of the above is why, despite all the studies (here's one) that say inductions can cause other (sometimes long-term) problems to Mom and/or baby, and knowing that being induced greatly raises the risk of having to have other interventions, I am one of those women who honestly and truly needs Pitocin. And this is sometimes a hard matter for me, because I believe that the percentage of inductions in this country is way too high, as it is for c-sections. And what is most troubling to me is that many of these two types of inductions are done purely for convenience's sake. Of course, there are also many other women who feel the same way I do about this, and some of them have expressed disapproval on finding out that I have a planned induction. I don't feel that I should have to explain my reasons to anyone, but at the same time I want to be understood. And I guess, in light of my own needs, I shouldn't jump to judgment on others, since I don't know all the details about other women either...

Evening Primrose Oil

The last few weeks of my last pregnancy, my Certified Nurse Midwife suggested I add Evening Primrose Oil to my daily regimen of Red Raspberry Leaf. She explained to me how it can help soften and ripen the cervix and prepare it for labor. Being an herb person anyway, and knowing from my first labor experience how much help my cervix needs, I was game. And I believe that it, along with the Red Raspberry Leaf, are part of the reason my second labor was so much more effective and productive and went so much better and faster. Going from 22 hours to 4 hours felt miraculous, as you can imagine. And instead of my cervix never even getting to a 10 (like the first time), the second time I was at a 9 before I realized it.

I can't find where I wrote down anywhere my CNMs suggested dosage (and I now have an OB since, sadly, there aren't any CNMs in my town), so I've been doing the research again to figure out how much I should take. I remember waiting until 36 weeks to begin taking Evening Primrose Oil last time, and the information I've found online confirms that. So last week I started to take it orally, two or three capsules a day. I will increase it weekly thereafter, and at about 38 weeks I will also begin inserting a capsule(s) vaginally at bedtime (which is actually the most effective method).

For others who are interested in learning more about this natural way of helping to prepare your body for labor (which, by the way, studies indicate it will only do if your body is ready to be helped), and what Evening Primrose actually is and contains, check out the following sites:

Pregnant Health
Families.com
Passionate Homemaking (which also discusses its other, non-pregnancy uses)