Thursday, October 15, 2015

Bully Bees

In what appears to be the ongoing demise of our beehive, Tom captured this video of bees fighting. He suspects foreign bees raided our weaker hive.

A few days later I went to look at the hive and there was more activity around it than I'd ever seen.

Tom hasn't had a chance to go back out and open the hive to see what's really going on. Stay tuned!

Thursday, October 1, 2015

Baby Nathan's Birth Story

Many people have been curious about how a (now-) unconventional home birth goes down, and some people just like to read birth stories, so I thought I’d share mine. If you are squeamish about blood, poop, and lady bits, pass this post on by. Otherwise, read on to hear the tale of how baby Nathan Scott came to be born in a log cabin!

We decided to use a midwife after my hospital experience with Kyle’s birth was not what I’d hoped for. When we learned the famous FarmMidwifery Center was only an hour from our new home in Tennessee, the decision was simple. Their founder, Ina May Gaskin, literally wrote the book on natural childbirth. Their practice, around since The Farm commune was founded in the ‘60s, is regarded as one of the best, if not THE best, in the world. People travel from around the country and world to rent cabins on the idyllic property for weeks on end to wait out the time until their babies arrive. I was referred by Kyle’s pediatrician to contact Stacie Hunt, one of The Farm midwives. During our first meeting with her, she pointed out it was silly for us to rent a cabin by the week when we have a perfectly good home just an hour away. So a home birth it was!

Prenatal care was pretty much the same as at an obstetrician’s office. I had regular checkups, with all the same blood tests, ultrasounds, fetal heartbeat monitoring via Doppler, etc. that you would get in a doctor’s office, though some tests were outsourced to the local hospital or other clinics and there was no pressure to do any unnecessary testing. The Farm services the large local Amish community, and their patients forgo most testing, and often times much of the prenatal care, with generally positive outcomes. The midwives are thoroughly trained in the areas of medicine pertinent to childbirth and are certified by a national board. In fact, I’d wager that Stacie, who has delivered 1,800+ babies and been present at more than 4,000 births, probably has more experience than the doctor who caught Kyle. And we knew that if something went really wrong, we could be at a hospital in ten minutes under the care of surgeons. 

Overall, I felt as safe, if not safer, with our choice this time around.  The somewhat intangible pros and cons of my experience were: PRO – Prenatal visits lasted about an hour, with great personal attention paid to us. About 15 minutes was spent doing the actual tests and checkup, and about 45 minutes chatting about the pregnancy, gardening, parenting, gossip, etc. It is rare that you get to bond with a medical professional in this way. This is the person helping welcome your most precious possession into the world, and it's nice to know them on a first name basis (and even as facebook friends!). CON: Because I was working with one midwife (and her team) rather than a practice of several interchangeable doctors, my appointments would frequently be cancelled or rescheduled when Stacie was called out on a birth. But, I just rolled with it.

I also decided to hire a doula, which is basically a birth coach. With Kyle’s birth I felt I caved and asked for an epidural when I didn’t want one. I felt ill-equipped to manage the painful contractions, and my loving husband was no better equipped than I. I hoped to have someone on-hand who could offer me support and encouragement, as well as various ways to cope with the pain and struggles of labor. I told Stacie I wasn’t always good at taking direction so I needed someone who could be a bit of a bitch if necessary. She referred me to Kari Jenkins. We met several times before the birth to get to know each other and discuss what I envisioned for Nathan’s birth.

OK, so on to the birth. Nathan was due on September 24th. Because Kyle was a few days early, we all kinda thought Nathan would be, too. I felt in my gut, however, that he was a bit of a late bloomer simply because he did not hiccup nearly as much as Kyle did. Hiccupping strengthens a baby’s lungs, and I recently read that a protein in fully developed fetal lungstriggers labor. So my hunch was he’d likely not be THAT early. However, from a week or two before his due date, I began having mild contractions. With Kyle, the day I started feeling that way was the day I went in to labor. So for weeks I was on pins and needles. The contractions would come every couple days, for hours on end. Not painful, but semi regular or constant pressure. At my weekly checkups, I found that the baby was very low, I was dilated to 1 or 2 cm, and my cervix was softened, which meant I could really go at any time (those were the same conditions I had at my checkup the day before Kyle was born). I was texting the midwife and doula so often saying, “This might be it!” that I was afraid they’d think I was “the girl who called baby.”

As the due date approached, I tried every method I could to bring on labor. Some were old wives’ tales, and some were more scientific. But they were all primarily ways to prepare my body for labor and move things along from the false labor to real labor if my body was ready. I tried them all, to no avail – physical, herbal, dietary, etc. Tom’s parents arrived from Hawaii for a week-long visit on the 23rd. They hoped to meet the baby, and offer help during the birth or afterwards, as needed. As the due date came and went, and none of the labor-inducing tricks worked, I began to wonder if their visit (although really wonderful in its own right) would be in vain. So, with Tom’s prodding, on the last day it made sense to try, I inquired about the one method I swore I’d never use: castor oil. Stacie said to give it a go! So around noon on the 28th I dumped two ounces of the stuff into a chocolate milkshake and tossed it back. It tasted like some brownie batter I’d made a while back using stale vegetable oil. Castor oil is a powerful laxative, but it works to contract the muscles of your bowels and in turn the muscles associated with childbirth. The laxative took effect (and for me it was not accompanied with any pain or nausea), and the contractions, similar to the ones I’d been having for weeks, also began. In the evening Stacie and her assistant Laura came by the house to check on me. They found I’d progressed since our previous checkup but that labor was not in progress. They headed out, saying to call if anything changed, and we went to bed, disappointed and tired, at 9:30.

Around 12:30 I woke up, as had become standard for me in the third trimester, and rose to pee, get some ice water, pee again. A little over an hour later I climbed back in bed, still wide awake. As I tried to fall back asleep, I noticed new contractions picking up. These were different- rather than in my abdomen, these were in my pelvis, and were slightly painful. I decided to start recording their frequency on an app I have on my phone starting at 2:15. At 2:50 I felt the unmistakable gush of my water breaking, and waddled to the toilet before the floodgates opened. As I sat, I felt fluid pass, but also many clots. I peered in the bowl, horrified to see a huge amount of blood. I called Stacie even while the amniotic fluid and blood still gushed out of me. She asked me to send her a photo (ah, technology!) of the carnage. I’ll spare you all that image. Luckily our rag bin was in arms reach so I grabbed an old towel, curled up on the bathroom floor, and called for Tom. I was very light-headed, I assume from the combination of blood loss and squeamishness/shock from seeing all that blood. I rested my head on Tom’s lap until I was able to return to bed. Stacie told me to monitor the baby’s movements and I could feel him some – he was never a wiggly fetus to begin with. I know that if the placenta is damaged, it can be very dangerous to mother and baby. So I was hoping that was not the case. At some point I also called Kari, the doula.

Within an hour Stacie and Laura (Stacie’s apprentice/assistant) arrived, with rolling cases full of supplies. They immediately checked the baby’s heart rate with the Doppler (which was strong and healthy) and began an IV of lactated ringer’s to try to help me following the blood loss. Stacie assessed the blood, fishing about two cups of clots out of the toilet (it’s a glamorous job sometimes). The whispering from the bathroom made me a little concerned but the news upon her return to the bedroom was positive. She determined it was not placental, but likely a cervical bleed from a varicose vein that ruptured once the pressures of labor began (a rare condition called cervical varix). The blood likely began to pool and clot as I was timing my contractions, resulting in the deluge when I got up. I found out after the fact that this was not something she had seen more than a few times, and she told me she’s never seen that amount of blood in all her experience. She told me later that when she arrived and saw all the blood that she thought I might have to go to the hospital, but when the baby sounded good and the blood stopped, she decided we could carry on at home. Her level-headedness in the situation kept me (and Tom) calm. I appreciate that her experience prevented her from having a knee-jerk reaction, but that she would have taken further measures if necessary. As she checked me, I also learned that there are two layers of the amniotic sac, and only my outer one had broken. There was some fluid between the layers, but I guess most of what I felt as my water breaking was actually the blood.

Nathan was born in a log cabin!
While I was being assessed and monitored, Kari arrived. We also woke Tom’s parents around 4:45 am, who were sleeping in the small log cabin on our property, so that we could move our crew out there. The plan was for them to entertain Kyle during the birth so he wasn’t scarred by the sights and sounds of labor. He could remain in the house, in his element, while we did our thing out in the cabin. Tom and the midwives brought all the supplies out to the cabin and prepared the room (old sheets on the bed, turned on my labor playlist, etc.). Once we got to the cabin, I was still very light-headed, so I spent the next bit of time on my side in bed. The contractions were painful, but manageable. Between contractions we chatted and laughed. I think I dozed off a few times between contractions. Every few contractions the baby was monitored with the Doppler, and his heart rate stayed steady in the normal 130-150 range. This continued throughout the labor. Laura had gone off to get the fancy baby monitor from Stacie’s house, like they have in a hospital, just in case it was needed. Fortunately, it never was. Another midwife apprentice, Angela, also arrived.
Tom helping me through a painful contraction while on the birthing chair
Thumbs up to a home birth!
After a while, a change in position was recommended so I moved to a birthing chair. It was a collapsible, Amish-made chair with a U-shaped seat. I stayed there for a while, and the contractions began to intensify. Tom held my hand during them and I shushed the room so I could concentrate. At one point I looked out the French doors of the cabin, saw one of our geese looking back at me. Everyone laughed when I exclaimed, “Oh, a goose!” But I was weak, dizzy and tired, and wanted to put my head down. During a few contractions I even felt difficulty breathing. So I moved to straddling a yoga ball and leaned forward with my head on a stack of pillows on the bed. Angela and Kari helped with massaging my back. The contractions intensified, and at a certain point I felt like the baby was catching on my hip bones or something, because I was leaning forward. Stacie and Kari were going to try out a rebozo, a scarf-like cloth that they could use to help comfort me and position my body to ease the baby into place. But as I stood up from the yoga ball, another contraction hit, and I suddenly felt the urge to push.
Because I was still weak, I decided to do my pushing in the bed, as I’d done with Kyle. In theory I understand that positions like squatting or using the birthing chair are optimal to allow gravity to assist, but I was not up for that. So in to bed I went and began to push. The cervix was not fully cleared, so Stacie helped make way for the baby’s head. As I pushed, the inner amniotic fluid sac still wouldn’t break, and she commented that it was super tough. As I was pushing everyone was saying, “Get behind it!” I don’t know what that means, but in the moment I understood. Every time I pushed, Stacy leaned out of the way in anticipation of being sprayed when the fluid sac popped, but it never did. Stacy kept saying the head was right behind the fluid sac, and I just needed to keep pushing. After about 10 minutes, Tom asked if manually breaking it would help, and she agreed and went ahead and did it. The pushing phase took about thirty minutes, contraction after contraction with breaks in between where I could catch my breath. Finally, out slithered Nathan at 10:46 am, almost exactly 8 hours after my water broke (the same as with Kyle!). Surprise number two: He was sunny side up. That’s the layman’s term for posterior birth. Babies are typically born facing down (facing the mother’s back). Nathan came out completely face up- a “textbook” posterior presentation, according to Stacie. In retrospect, I wish we’d videoed it because I was told he came out looking around at everyone! I was surprised because he spent much of his time in the womb in the correct position. Stacie also told me the cord was wrapped around his leg.

Nathan was brought up to my chest and we were instantly smitten, of course. Tom cried, which surprised him. His love for his son was instantaneous. The baby was covered in vernix, the waxy coating that develops during the third trimester. He was a nice pink color and crying. Laura cleared his airways while we cooed over him. After the umbilical cord stopped pulsating, Tom cut the cord.
Stacie began talking about delivering the placenta, so I handed Nathan off to daddy for some skin-to-skin.  Stacie was working on the placenta, which was caught behind my pubic bone. I knew from the ultrasounds that it was an anterior placenta, which means it was located towards my belly rather than my back. It was the main reason I couldn’t feel Nathan move very well until well into the second trimester. Stacie had to pry it loose so it could be delivered. When it flopped out, Stacie’s eyes widened. She held up the placenta and showed me how large it was – easily 50% bigger than the normal size she outlined on my massive placenta. She placed it in a Tupperware to be inspected and sent off to be encapsulated. (I’d won free encapsulation in a raffle at a breastfeeding event. It turns out that will be a blessing in helping to replenish my blood supply and iron levels following the blood loss during labor.) The midwives confirmed that the placenta was fully intact and that the blood loss definitely did not come from there. Fun fact: The placenta looks like a stingray. I’ll also save you from that image.

I was stitched up and cleaned up, then given some medicines to help my uterus contract and to stop the (normal) bleeding. Nathan was checked over, and everything was great. He weighed 8 pounds 9 ounces, was 20 1/4” long, with 36 centimeter diameter head. Slightly larger than Kyle, all around. At his 2 day pediatrician visit he had lost some weight, which was to be expected, and was in the 50th, 75th, and 60th percentiles, respectively. 

mmm milkies
Nathan took to the breast quickly and easily. His latch was perfect. He’s continued to nurse well over the first two days of his life, cluster feeding just as I’m ready to go to sleep for the night (of course), and nursing throughout the day, every few hours. We’ve been negligent about tracking the details of his input and output, but it’s been good. I weighed him before and after nursing at the pediatricians, and he took in an ounce, which is the stomach capacity of a 2 or 3 day old baby.
And now we are four
After Nathan had nursed, we brought Kyle in to meet his baby brother. Kyle received a gift from his brother, a story book (which was actually sent by the boys’ Great Gram). We read the story, and then Daddy brought the baby over to Kyle. Kyle was (and is) fascinated with the baby. It was interesting, while I was pregnant we referenced the baby in Mommy’s tummy, pointed out babies when we saw them out, and gave Kyle a baby doll. We told Kyle he was going to be a big brother and that his little brother would be called Nathan. Kyle would say baby, pointing to my tummy, but he would never refer to the baby as Nathan or brother. After seeing the baby in the flesh, he began using both terms. He enjoys pointing out the baby’s facial features. Interestingly, Kyle and Nathan look almost exactly identical to each other at birth. Putting pictures of the two of them side by side, you would think they were twins.
I am recuperating slowly. My uterus is still contracting back to its normal size, and the cramps are painful. They come on spontaneously, but are also triggered by the oxytocin release when I nurse Nathan or hear him cry (or even sometimes while just gazing upon him). I started out very light headed on the day Nathan was born (I even fainted trying to go from the bathroom to bed, but fortunately Tom was supporting me as I wilted), but my endurance is improving. I am working on increasing my iron levels and blood volume through diet and supplements.

The awesome birth team!
All-in-all, despite the peculiarities of the birth itself, I enjoyed my home birth experience. I suspect that had I been under a doctor’s care, I would have ended up with a C-section from the get-go. Instead, I am enjoying the first days of my baby’s life in the comfort of my own bed, taken care of by a doting baby daddy. I confirmed with Stacie at her follow-up visit that none of the oddities of this birth should repeat in subsequent pregnancies (Tom would like me to get a second opinion on that- seeing his wife crumpled on the floor next to a toilet bowl full of blood has that effect on a person), so I would definitely want to do the same thing next time if we have that chance.