Guest Post: "My journey toward Fertility Awareness, or why I don't use hormonal birth control..."

I married my husband when I was 22. Before getting married, I enjoyed a lovely pap smear and was told to get on the pill by my Doctor. So I got my prescription filled, and started faithfully taking the pill, months before our wedding.

My husband used to have a reputation as the plate cleaner when we were hanging out in college. He would eat a full meal then start mooching off of everyone else’s plate. So it was a complete surprise to me when he mentioned that I was out-eating him. On my end I was starving. STARVING. So I stepped on the scale, and discovered that in the two months I was on the pill I gained a little more than 20 lbs.

Not cool body. Not cool.

Since we were not having sex before marriage, and actually accomplishing this task, I stopped taking the pill. A few months later I had another conversation with my doctor, and this time I tried the NuvaRing. It seemed like a good idea, localized birth control hormones=less hormones in my body screwing things up.

The NuvaRing was good for a while, but never managed to line up with my cycles. You are supposed to insert it vaginally for 3 weeks, remove for 1 week (and have your period on this off week) then insert a new ring and repeat. This works great if you have 28 day cycles. My cycles were 35 days long, so I ended up inserting for 3 weeks, removing for 1, reinserting and getting my period. Or keeping it out for 2 weeks, trying to “catch up” or something. After our wedding we used condoms on the off week, because I wasn’t getting satisfactory answers from my doctor about why this was happening or how to “fix it.” We were not planning to get pregnant.

But then I had a positive home pregnancy test. Umm, what? Then I had a second positive home pregnancy test. Oh crap.

Called a friend. Called my doctor. Freaked out with my husband. Bought a baby book and tried to get excited about this unplanned but very much wanted new life.

We went to the doctor, like you are supposed to. She congratulated us, and thought we were crazy to ask for a blood test after two home positives, but sent me to the lab anyway.

A week later I got the news. A very bubbly office girl, who I assume had no idea what in the world the test was for, cheerfully told me the lab results were negative. Have a great day!

I couldn’t make it through the rest of my work day. I came home and cried with my husband. We set up another appointment with my doctor who told me about a chemical pregnancy. It was probably a chemical pregnancy, when egg and sperm meet and do their thing, but are unable to implant in the uterine lining, for multiple reasons. Its no big deal, she said. We weren’t trying to get pregnant right now anyways.

The ring is supposed to make you not ovulate, supposed to prohibit sperm from going where it wants to prohibit accidental ovulated egg meeting great swimmy sperm. It is not supposed to prevent implantation, but it might prevent implantation sometimes.

During the next few cycles we continued to use the ring while doing much soul searching, research on how various forms of birth control actually work, and looking for personal stories of NuvaRing users in the same boat. I found a lot of other women had also experience chemical pregnancies while on the ring, and it seemed like the ring did a better job preventing implantation of a fertilized egg than its promotional materials would tell you.

Many tearful nights lead us to the decision to only use a barrier method to prevent pregnancy. We chose to use condoms, knowing that if a condom fails, it was important to us to allow the possible baby a chance to find its way to a uterus that would be able to receive it.

All this before our first marriage anniversary.

Codi is a mom of almost 2 from Southern California. She spends her days getting ready for baby #2 and giving her daughter those last only child days. If you'd like to connect with Codi or ask her questions, please comment!
Conclusion to follow, please subscribe to the blog to make sure you don't miss the rest of Codi's story!

The Importance of Birth Plans...

Birth Plans are a great idea for any pregnant person to have ready! We all know birth is unpredictable and having a "plan" in place is no guarantee that anything will go in any particular way. However, the great thing about putting together a Birth Plan is that it makes you think about how you'd want things to go ideally…and it helps prepare you for the alternatives.

There are so many interventions that you may wish to avoid (or elect to have) during your birth experience, and preparing your Birth Plan is a great way to discover what all these interventions are and what they mean for you and your baby. I found that for my pregnancy, the easiest thing for me to do was find a template for a birth plan (BabyCenter has a good one HERE) and then researched the options in each section to determine what best fit my preferences.

You can start putting together your preferences as early as your first trimester, although the recommendation is to have some sort of idea ready by your 5th month of pregnancy. It's important to know as early as possible what is important to you (for example, perhaps you absolutely DO NOT wish to have continuous monitoring so you can move freely during labor, or maybe you absolutely NEED to eat and drink during labor) so that you can discuss these things with your care provider. The reason it's best to do this early is because it gives you the best chance of finding a doctor or midwife you LOVE, should you decide your current care provider is not the best match for the type of birth experience you have in mind. *By the way, remember you can ALWAYS change doctors…even at the very VERY last minute!

If you and your care provider agree that your plan is feasible and safe, and you are SURE your provider is giving you the best possible care and not just considering what is most convenient for THEM, then a good idea is to have the doctor sign your birth plan. It's not in any way a binding contract or anything, but the idea is that if you go into labor and arrive at the hospital or birth center before your care provider does, you can have something to show the nurses and support staff that shows that your care provider is on board with your preferences. It's also important to have several copies on the day of the birth for the nurses, your doula, etc. Every one that comes in contact with you during your labor should see your birth plan, to avoid miscommunications or misunderstandings.

You can include things in your birth plan regarding pain management, what you wish to happen to the baby immediately after birth (like immediate skin to skin and waiting to do newborn exams for an hour so you have a chance to bond, for example), and your plans for feeding your baby (bottle or exclusively breast feeding?).

It's definitely important to be flexible and be ready to forgive yourself if things don't go exactly as you'd hoped…The most important thing is to be educated about all of your options so that if things DO need to go in a different direction, you are equipped to make the best choices for you and your baby. Remember, even if your Birth Plan doesn't come to fruition, preparing one is always beneficial because it familiarizes you with your options (and their risks and benefits), and the policies of your care center and provider.

What advice would you give a first time mother about preparing a birth plan? What is something you think every plan should include?

My Thoughts as a Pregnant Woman about Forgiving Myself

This is a post I wrote on the blog I was keeping throughout my pregnancy...little did I know that less 24 hours later, I would be admitted to the hospital and induced into labor...another story for another day. But this post is an example of how sometimes in pregnancy, like in any other aspect of life, things may not go how you plan and you have to accept that it's not always your fault, especially if you know and do your best.

 

Maybe not an epiphany, but…

…definitely a tough realization. I had “it” last night while talking to my sister…it was one of those things where you talk and talk so much that eventually something profound pops out of your mouth without even thinking about it.

I was explaining to my sister all the reasons why I want a completely unmedicated birth (in no particular order):
1) I want to avoid the slippery slope of unnecessary interventions. For example, if you are induced and they start you on Pitocin, your body is forced to labor before it is ready, which leads to much stronger and more painful contractions than you might have actually had if you had avoided the drugs. Now that the pain is SO strong, you feel like you need an Epidural, so you get one. the thing about an epidural (or any pain medication) is that it slows down your contractions, and before you know it, you’re being given MORE pitocin because you’ve plateaued or slowed down more than the hospital would like. The pain is back full force, so you get more pain medication. Lo and behold, the doctor walks in and tells you that the baby’s heartbeat has slowed/risen/become erratic, etc. and now you need an emergency c-section. What they won’t tell you is that the heartbeat got like that because the baby couldn’t handle the constant changes in the uterus due to the medications.  Now your baby is in danger and you need emergency surgery just because of one intervention that didn’t even need to happen.
2) It’s safer for the baby to labor naturally, not just because of the reasons I listed above, but because every medication you could be given (and there are LOTS of kinds, not just pitocin or an epidural) can leave your baby in a stupor for hours, even days after birth. I would rather bond with a baby that is more alert than know he has no clue who I am because I made sure he was born zonked out.
3) the most important reason in my gut is that I VALUE the hard work and dedication it takes to give birth naturally. I don’t know if it’s this city and it’s “get in, get out, get on with life” superficiality, or what…but there is ZERO support here for mothers that want to go natural. You’re likelier to be told you’re insane for trying (even by other moms) than receive any sort of support. There’s no natural-method birthing classes in the entire county, insurance doesn’t cover midwives (if you can FIND one), there’s no resources on cloth diapering or baby wearing…even breast-feeding past 3 months is weird and taboo here. I’ve spoken to two OBs and even hospital staff regarding my wishes for a natural birth, and every SINGLE time, I was answered that all my requests would depend on what drug(s) I was on at that particular stage of labor. So literally EVERY person I spoke to regarding my birth assumed that I would have some sort of drugs at some point of the labor, even when I had prefaced the conversation with “I want a natural birth, so…”

 I mentioned that earlier this week, I had a breakdown because I was so frustrated with the anxiety of the upcoming birth and not being able to plan for everything because every time I spoke to someone else about my birth plan, I was told at least a couple more things I could not count on having. While I was talking to my sister, I realized that my problem was the planning. I desperately want a natural, drug-free birth, but the fact is that all the books I’ve read on the topic and all the videos I’ve watched to prepare all assume that I will be among supportive people in an environment suitable for natural labor and delivery.

I am not. And I will not. And as much as I blame myself for that, it is unreasonable to because there’s nothing I can do about it.

The hospital requires continuous fetal monitoring. They don’t have wireless OR waterproof monitors. This means that once I am admitted to the hospital, I will literally be strapped to a bed in one position until I have the baby. In my original birth plan, I wanted to labor in a tub, or at least in a shower because I’ve found throughout the pregnancy that all my pains can be eased substantially with warm water. Well, there ARE no tubs, and I am not ALLOWED to shower until after the baby is out, “considering whatever drugs you’re on have worn off at that point”. Why? “Hospital rules.” That’s it. I’ve not once been given a legit medical reason why I can’t do X, Y, Z…all I get is “it’s hospital policy and they’re not flexible” which is basically they’re way of saying “don’t try to fight us on this, you’re going to lose.” In fact, I was even told by one of the doctors that if I want to labor in the shower, I better “stay at home as long as possible”. Hmm.

Because the hospital requires continuous monitoring, I am also not allowed to walk, squat, or otherwise change position at all because I cannot take the monitor off. Every resource I’ve come across says that changing positions can be the difference between tolerable and intolerable contractions, and that laying on your back is the absolute WORST and most PAINFUL way to labor. Well, that’s apparently the only choice I have.

I’ve been mentally preparing for the fact that labor is going to be hard and painful and will require a LOT of determination on my part, but that’s considering that I’d have the ability to labor in a way that would encourage or facilitate what I want/need. In my current situation, I’m fighting an uphill battle because I’m putting pressure on myself to do something that’s ALREADY so difficult, PLUS I have the hospital policy pushing back at me. It’s an uphill battle at best.

So what conclusion did I come to?

I cannot plan. I should not worry. I am as prepared as I can be, but I do not know what to expect, and I shouldn’t expect anything because it will only lead to disappointment if/when things don’t go the way I thought they would.

So I am still going to do my best to cope with the pain naturally using the techniques that I have been focusing on for months. But I am also trying to come to peace with the fact that I might feel I need pain medication, and that I shouldn’t hate myself or feel disappointed if I go that path. As it is right now, I know I will feel like an absolute failure if I opt for pain medication, but I realize I need to cut myself some slack because the hospital is literally making everything as backwards to what I need as they can, and there’s nothing I can do about that.

As soon as I said out loud to my sister that I should try to forgive myself in advance in case I DO opt for pain medications, a calm came over me. As long as Bu gets here healthy, I should focus on that and not HOW he got here, though I do still feel it’s so important to do my best and go natural for the both of us. I’m not 100% ok with being this flexible yet, but I can’t  regret something I haven’t even done yet, and if I DO do it, I can only use it as a learning experience for next time.

And by next time, I mean I am NEVER setting foot in an OB or hospital again when it comes to having children. I must find support for a more natural path here, otherwise I foresee all of Bu’s future siblings being born outside this city. This pregnancy has made so many beautiful things in my life, but it has also made me deeply dislike this city and it’s attitude, and I’d love nothing more than to give my children a chance to live AWAY from it and it’s influence.

Guest Post - "Cesarean SOLELY Due to Breech"

 In 2009, I was pregnant with my first daughter. It was a very uneventful pregnancy even though I gained about 50lbs during the 9 months making me 300lbs at the time of birth. She was head down from somewhere around 35 weeks till 42 and I was starting to dilate and efface. I went in to my 42 week OB appointment at which they did a U/S to check on the baby. Turned out she was had flipped to breech at 42 weeks.

It all happened so fast in the office, after they found out she was breech they wouldn't check me at all because suddenly now my only option was a c-section. The OB brought us into his office to talk about it and told me I was going to have a c-section because I was 42 weeks and she was breech, if she hadn't been breech they would have let me be. I started crying right there, I hadn't ever thought I would be having a c-section... I had a textbook perfect pregnancy and she had been head down!

I asked if there was anything we could do and I was told no. He told me to stop crying because I was crying for no reason at all but that didn't help, I knew this was a major surgery. I remember my husband commenting after we got out of there that he wanted to punch the OB because of how he was acting. He was very rude and made me feel stupid for crying when they told me I had to have a major abdominal surgery I had not been expecting. I cried off and on for the next two days, I was scared because I'd never had a surgery in my life and now I had to have this one. I had been looking forward to going into labor so I could meet my sweet little girl but now I was dreading giving birth.

When I showed up for the c-section they put me on monitors, checked that she was still breech and told me I was having contractions I just couldn't feel them yet. I was crying a little bit when she was born, I hadn't wanted it this way but she was healthy and I was going to be ok so I thought maybe that was all that mattered right then. I didn't find out about ECV (external cephalic version), spinningbabies.com or that I could have just not gone to the c-section because they can not do anything without your consent until after my surgery. I was so angry when I found out there had indeed been stuff I could have tried to turn her back to breech and avoided that surgery. I was angry that I never got to experience labor, I was angry at myself for having not switched OBs like I had thought about earlier in the pregnancy and vowed to never let myself be talked into another c-section.

I had learned that I couldn't just rely on the word of the people I was seeing, I had to research for myself these things and stand up for what I wanted so in 2013 I gave birth again this time vaginally because I had this previous experience my next one went exactly how I wanted. I didn't let anyone stand in my way, even went so far as not having a OB from 26weeks to 34weeks because the first OB tried to schedule me for a c-section at 40+3 days and I knew because of my older daughter that I likely wouldn't be going into labor till 42 weeks. I did what I had to to find someone who would support me properly so now I try to help other women out there by giving them the knowledge I didn't have during my first pregnancy to prevent them from having unnecessary c-sections.

Felicia is a mother of two little girls living in the Midwest.

Breech Presentation...What? Why? How?

A baby in "breech" position is basically considered an automatic cesarean, at least in the United States. Many doctors are no longer trained in breech deliveries, and so the immediate conclusion that they come to is that mom will need major abdominal surgery due to their lack of training. It is what it is, right?

Wrong.


What is Breech?

• Frank Breech, which tends to be the most favorable. This is when baby’s bottom presents first and feet are by the head.
• Footling Breech is when baby has one or both feet presenting first.
• Complete Breech is when your baby is comfy sitting cross legged.

Why won’t my doctor do a vaginal breech birth?
This could be due to a variety of reasons:

• They may not have a lot of experience attending vaginal breech births.
• May not feel comfortable attending vaginal breech births.
  
• May have had a bad experience in the past.
  
• There may not be suitable back-up at the hospital where they practice (on call anesthetists, pediatricians, experienced midwives, 24 hour operating room staff).
  
• They may not believe in vaginal breech birth.
  
• Defensive practice in current childbirth culture means that doctors are more likely to err on the side of intervention (cesarean section) rather than non-intervention (vaginal birth).
  
• It is easier for a doctor to perform a cesarean section than a skilled vaginal breech birth.
  
• Cesarean is an accepted birth method in today’s culture.

How should I approach my child's breech position?
*Do nothing.
Depending how many weeks pregnant you are, you may decide just to wait for your baby to turn. The majority of babies turn spontaneously pre-term.

*Non-medical turning
Alternatively, there are various non-medical turning techniques you can try.  You can read more on Spinning Babies. 
 
*Look for a care-provider who will support you in whatever option you choose
Many maternity care-providers do not support vaginal breech birth and will advise a planned cesarean section at 38 or 39 weeks if your baby does not turn.  This is partly because most obstetricians and midwives do not possess skills in vaginal breech birth and so they are unable to offer this option safely. However, depending on various maternal and fetal factors, vaginal breech birth is not necessarily any riskier than cesarean section, particularly with the support of an experienced attendant. 

Before 37 weeks of pregnancy, breech presentation is much more common - about 20% of babies at 28 weeks are breech, and 15% at 32 weeks. Before term, which is defined as 37 weeks, it doesn't matter if the baby is breech, as there is always a good chance that she will turn spontaneously. Some babies do turn by themselves after this time, but it is much less likely, and some preparations should be made to decide how delivery is going to take place. About 10% to 15% of breech babies are discovered for the first time late in labor!


Very soon, I will post two guest birth stories. One of these stories is from Felicia, who had a cookie-cutter, non-complicated pregnancy but was forced into cesarean delivery solely due to a breech presentation. The second is from Kristel, whose daughter came out booty-first at home in the water. These ladies are examples of how having supportive care providers can make the difference between the birth experience you want and the experience that is forced upon you.

Further Reading:
Spinning Babies 
The Webster Technique
Breech Decision Making Sheet

UPDATE: Please click HERE for the Breech Babies tab, so you can read the birth stories mentioned above and any other resources on this site regarding breech babies.



Sources: 1, 2, 3, 4

Guest Post: "A Story of Strength: Know Your Options"

Hello, my name is Brittney Horn and this is my birth story.

I am a 27 year old stay at home mother to one amazingly smart 3 year old little girl. I am married to the love of my life, TJ. We have been together for nine years, married for five. One year into our marriage, we decided to try for our first child. First time was a charm for us. We got pregnant right off the bat but my first trimester was extremely hard on me due to the nausea. Was in and out of the hospital getting iv fluids to maintain hydration. I couldn't hold water down. Second trimester was amazing! Loved it! Then the third trimester hit.

I had just started my 34th week of pregnancy, on our way home from the hospital tour and as we approached a green light, the car in front of us locked his brakes. We had to do the same resulting in my seatbelt tightening around my stomach.  Later that night I felt pain, didn't think anything of it. 

During the night, the pain got worse. I got up the next morning, got ready for work and went about my normal day, with continued pain. After four hours at work, I drove myself across town to the hospital where they said I was in preterm labor with contractions less than two minutes apart. I was dilated to one cm. After what seemed like forever, I was sent home on bed rest. The next five days were just a repeat. Labor starting and being stopped. 

Fast forward almost six weeks to five days before my due date. At exactly midnight my water broke. I didn't want to be sent home from the hospital again so I allowed my husband to sleep while I paced the house and sat on my birthing ball for five and a half hours. I then woke him up and off to the hospital we went. Once there, the rest of my water broke. At 3 cm I was taken to get an epidural. My contractions were about one minute apart. The anesthesiologist missed the first epidural. Second one was a success until the pump they had me on died. I started feeling my legs, third epidural on its way along with pitocin. Neither worked because by that time I was stuck at 8cm, my daughter flipped her head and was stuck in the birth canal. My temperature starting skyrocketing and I couldn't stop shaking. The doctor said emergency c section and I saw 5 nurses and 3 doctors running in. 

It was such a rush to the operating room. Once placed on the table and drape was up, I was crying for my husband whom they said was getting in his coverups. After a few minutes of prep, the doctor informed me that they couldn't wait and were going to do the first cut. He did so and I about flew off the table. It was like I had absolutely no pain meds or anything on board. I screamed and the last thing I remember was the doctor yelling stop, she feels it, she needs to go under. 

At 6:55 pm on February 21st 2010 our beautiful daughter, Audrey Lynn was born weighing in at 7lbs 5oz, 20 and a quarter inches in length. She was pulled out by her right foot due to being stuck in my birth canal. I woke up eight hours later on a sleep apnea machine. I never heard my girls first cries, I never got to feed her her first meal or change her first diaper. Thank God my husband was there to do all of that. Having my daughter was a true blessing, just wish I could remember the most important parts of it. I refuse to go back to that hospital and I am now researching midwives and doulas. My husband and I are trying for our second child and I want nothing more than to have her/him naturally. With C-Sections growing by the day, we all need to know what our options are. I now know that I have other options and I hope to be able to use a better one for our second child. 

 

Thank you for reading my long story. Its not easy for me to talk about.

Gestational Diabetes - What is it? (1/3)

This will be one of a three part series I'm doing on gestational diabetes. It seems to a be a topic that has been coming up a lot lately in the forums/groups I belong to, and what I'm finding is that a lot of women are being told they have it or being threatened that they will develop it, but no one is really receiving proper information regarding what it is, how it's diagnosed or how to treat it.

What is Gestational Diabetes?

According to the American Diabetes Association: "Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational diabetes. Based on recently announced diagnostic criteria for gestational diabetes, it is estimated that gestational diabetes affects 18% of pregnancies."

Basically, your growing baby needs glucose to grow. Your body errs on the side of "too much" rather than "too little" so the baby doesn't go without. As the placenta grows, the hormones it creates may interfere with your body's processing of all that glucose. This is why testing tends to be done later in the pregnancy (if no other risk factors exist) because the placenta is larger as the pregnancy progresses.

Non-Caucasian women, and women that are overweight pre-pregnancy, are likelier to develop Gestational Diabetes.You are also likelier to develop it if there is a history of diabetes, gestational or otherwise, in your family. Granted, it's not to say you WILL develop GD if you fall into any (or all) of these categories, your chances are simply greater.

Some of the risks of having Gestational Diabetes are macrosomia (baby growing too large), which could mean a broken clavicle or collarbone upon vaginal delivery, among other complications. This is why doctors are quick to induce as early as 39 weeks when the diagnosis for GD is present, or even elective c-section.

AGAIN, let me be clear...the doctor will be quick to suggest (or even insist) upon these interventions, but they may not be necessary. Also, ultrasounds are not, have never been, and are not meant for measuring your baby, and they are usually off by 1-2 pounds either way, so don't be alarmed if the doctor decides your baby weighs 10 pounds solely based on ultrasound...but that's another topic for another post.

Women that have had GD are likelier to develop Type 2 Diabetes later in life, but many of these cases are because the women studied may have had undiagnosed Type 2 Diabetes before pregnancy, and GD may not have been a factor.

Most of the time, GD can be kept under control by diet and exercise, and only in extreme cases will an insulin regimen be needed...so please, do not worry right off the bat that you will need to inject yourself several times a day until you've spoken to a specialist about the severity of your case! Stressing about it will do no one any good, though I know that is easier said than done.


On the next post, I will write about information, evidence and resources surrounding testing for Gestational Diabetes and how it is diagnosed. The last post in the series will be about treatment options. I'll also talk about my own borderline GD diagnosis during my pregnancy and what I went through as far as testing and treatment. If anyone would like to share their GD experience, whether just the testing or actual treatment if you were diagnosed, please email or comment. Also, please let me know if you have any specific questions and I will try to answer them in an upcoming post or at least point you to resources that can help.