Guest Post: "Adoptive Breastfeeding is Possible!!!"

From a very young age I knew that my heart, my home, and my family were in Africa. Two years ago I found my heart and home in Uganda and shortly after that I found my family in my (at that time) 12 year old daughter Eva and at the beginning of this year my second daughter Lilly who was just 10 days old. Lilly was abandoned by her birth mother and fed milk straight from a cow for the first 10 (we are guessing) days of her life, this caused her to be severely lactose intolerant and give her severe GI issues. So I began giving her lactose free formula, this helps but she has major tummy issues. I began researching and asking questions and found out the coolest thing ever, adoptive breastfeeding is possible!!!

 So I crazy researched and talked to some awesome moms and decided that Dr. Jack Newman's protocol would be the best for us. I started really tightening up my diet to eat mostly foods that help make milk!

At first baby girl was not interested in trying the breast and got super frustrated every time I tried to nurse her. I would put her to the breast and and she would fuss and cry. This was a hard hit for me, I was feeling rejected and discouraged and some one shared with me something beautiful that honestly may be the only reason I continued trying she said "that is where a baby belongs and is supposed to feel safest, I think it is just where she feels most at peace to let her frustration out" and I thought how true that is and it gave me the strength to keep trying! 

I was told eating garlic encourages babies to latch so I thought why not give it a shot and so I made some super garlic hummus ate it for a snack that afternoon and that night she latched!!!

About 8 days after I started the protocol me and baby girl were getting in the shower I looked down and realized I had milk!!! It was more of a clear milky looking stuff but I knew this was a great sign that this is working!

We still have issues with her latching, my milk is very small but we are learning and loving it and the bond and getting to give my baby amazing nutrition is worth not having my coffee in the morning (I am and addict) and worth every hard moment and every feeling of rejection and every weird look! Mamas you can do this, mamas with low milk supply and mamas of babies that came to them in ways other than from their belly, you have got this! I am in your corner and your biggest cheerleader! Love your babies well!!!

Now here is the logistics of making this work!

 *I am in no way endorsing these particular brands or products they are just what is working for us! Also I am by no means a professional this is just all from personal research and trial and error. 

As previously stated we live in Uganda so we are waiting on our Medela pump and SNS to get here. I highly recommend these two products if you have low milk supply or are re-lactating or inducing lactation. The SNS is a bottle with a small tube that attaches to your breast you fill bottle with formula/donated milk so baby is getting everything she needs right at your breast even if you can not provide it your self, and you are stimulating your body to tell it to make more milk all at the same time!

I would recommend renting a hospital grade pump, that was not an option for us but will be your best bet! Pump at least every 3 hours and once during 1-5 am as that is when your milk production is at its highest, and power pump at least once a day. 

How to power pump:

Pump 20 min

Rest 10 min

Pump 10 

Rest 10

Pump 10

I am also going to be doing the following supplements

Blessed Thistle 

Fenugreek

Motherslove More Milk Special Blend

Mothers Milk Tea

The following diet is my personal one and excludes a lot of good things because we don't have access to them here. But you can search Pinterest "breastfeeding food" and find some awesome stuff!

What I try to include in my daily diet: 

~Non-instant oatmeal with either honey, banana, or apples and cinnamon. Keep it interesting as oatmeal is your best friend right now and you don't want to get sick of it! 

~We have a very strong ginger ale here so I try to drink a few a week as ginger is great for supply!

~LOTS of water!!!! Hydration is you bestest best friend! Love the water!!

~Half of a dark beer (I hate it but they say it helps...)

~Lots of carrots as they are one of the few milk helpers available here and I love them! 

~Hummus with LOTS of garlic and cumin as chick peas and cumin are good for milk and garlic encourages her to latch! 

~Green Papaya

~I add garlic to everything! Cause we are all about the latch!

~Avocado

~Rice (we live in Africa so this is a given!)

~WATER!!!!!!

Avoid:

-Caffeine

-Peppermint

-Strong herbs or seasonings

-Antihistamines as they are meant to dry you up and this can also effect your 

milk.

Like I said I am no professional this is just one mommy to another. Good luck! Ask questions, don't be ashamed, love your babies! Know that at least one person is out there supporting you and cheering you on! 

Much much love, Emily

Emily is the 22 year old mama of 2 beautiful daughters through the blessing of adoption and foster mommy to two more. She is originally from South Carolina but now lives in Uganda, East Africa where she is the founder and executive director of Salvation Ministries and Kwagala Baby Home. She also serves in the local hospital as a midwife and is in the process of opening a birthing center and maternity home. You can read more about Emily, her daughters and their ministry at http://salvationinuganda.blogspot.com/ and find out more about the ministry at http://www.salvationministriesinuganda.com/

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

Frequently Used Abbreviations

Thanks to Kristina Sharrer for compiling the list for us! I added a couple as well, if there's any we're missing, please comment so they can be added. 



ACA = Anti-Cardiolipin Antibodies
ACOG = American College of Obstetricians and Gynecologists
ACTH = Adrenal Corticotropic Hormone
AH, AZH = Assisted Hatching
AI = Artificial Insemination
ANA = Anti-Nuclear Antibodies
AO= Annovulatory
AP= Attachment Parenting
APA = Anti-Phospholipid Antibodies
APTT = Activated Partial Thromboplastin Time
ART = Assisted Reproductive Technology
ASA = Anti-Sperm Antibody
ASRM = American Society of Reproductive Medicine
ATA = Anti-Thyroid Antibody
AVA = Anti-Ovarian Antibody

B
BBT = Basal Body Temperature
BBC = Baby Center
BC = Birth Control
BCP = Birth Control Pills
BFP = big fat positive
BFN = big fat negative

C
CAH = Congenital Adrenal Hyperplasia
CASA = Computer-Assisted Semen Analysis
CCCT= Clomiphene Citrate Challenge Test(Clomid Challenge)
CD = Cycle Day
CF = Cervical Fluid Chromo = Chromopertubation
CL = Corpus luteum
CM = Cervical Mucus
CMV = Cytomegalovirus
CNM = Certified Nurse Midwife
CP = Cervical position
CVS = Chorionic Villi Sampling
CY = Cycle

D
D&C = Dilation and Curettage
D&E = Dilation and Evacuation
DE = Donor Eggs
DES = Diethylstilbestrol (a synthetic estrogen)
DI = Donor Insemination
DIPI = Direct Intra-Peritoneal Insemination
DOST = Direct Oocyte-Sperm Transfer
DPO = Days Post-Ovulation
Dx = Diagnosis

E
E2 = Estradiol
EB, EMB = Endometrial Biopsy
EDD = Estimated Due Date
Endo = Endometriosis
EPT = Early Pregnancy Test
ET = Embryo Transfer
ETA = Embryo Toxicity Assay
ETF = Embryo Toxic Factor
ETLA = Enhanced TLA
EW = Egg White Consistency (refering to CM)
EWCM = Egg-white cervical mucus

F
FAQ = Frequently asked Questions
FET = Frozen Embryo Transfer
FM = Fertility Monitor
FMU = First morning urine
FP = Follicular Phase
FRE = First Response Early
FSH = Follicle Stimulating Hormone

G
GCT = Glucose Challenge Test
GIFT = Gamete Intra-Fallopian Transfer
GnRH = Gonadotropin Releasing Hormone
GP = General Practitioner
GTT = Glucose Tolerance Test

H
HVBAC= Home vaginal birth after c-section
HBAC = home birth after c-section
HCG = Human Chorionic Gonadotropin (pregnancy hormone)
HEPA = Hamster Egg Penetration Assay
HMG = Human Menopausal Gonadotropin
HPT = Home Pregnancy Test
HRT = Hormone Replacement Therapy
HSC = Hysterosco
HSG = Hysterosalpingogram
HSG = Hysterosalpingogram
Hx = History

I
ICI = Intra-Cervical Insemination
ICSI = Intra-Cytoplasmic Sperm Injection
ICSI = Intra-Cytoplasmic Sperm Injection
IF = Infertility
IM = Intramuscular (injections)
INF - Infertility
IOR = Immature Oocyte Retrieval
ITI = Intra-tubal Insemination
IUGR = Intrauterine Growth Restriction
IUI = Intrauterine Insemination
IVF = In Vitro Fertilization
IVIg = Intravenous Immunoglobulin

J

K

L
LAD = Leukocyte Antibody Detection Assay
LAP = Laparoscopy
LH = Luteinizing Hormone
LIT = Leukocyte Immunization Therapy
LMP = Last Menstrual Period (start date)
LP = Luteal phase
LPD = Luteal Phase Defect
LUF = Luteinized Unruptured Follicle

M
MC, m/c, misc. = Miscarriage
MESA = Microsurgical Epididymal Sperm Aspiration
MF = Male Factor
MFM = Maternal-Fetal Medicine (High Risk Ob)
MS = Morning Sickness

N
NEST = Non-surgical Embryonic Selective Thinning
NK = Natural Killer Cells (CD56+)
NO = No Ovulation
NORIF = Non-Stimulated Oocyte Retrieval in (office) Fertilization
NP = Nurse Practitioner
NSA = Non-Surgical Sperm Aspiration
NST = Non-Stress Test

O
O = Ovulation
OB = Obstetrician
OB/GYN = Obstetrician/Gynecologist
OC = Oral Contraceptives
OCT = Oxytocin Challenge Test
OHSS = Ovarian Hyperstimulation Syndrome
OPK = Ovulation Predictor Kit
OTC = Over-the-counter

P
P4 = Progesterone
PA = Physician's Assistant
PC = Post-Coital
PCO, PCOD = Polycystic Ovary Disease
PCOS = Polycystic Ovarian Syndrome
PCP = Primary Care Physician
PCT = Post-Coital Test
PESA = Percutaneous Epididymal Sperm Aspiration
PG = Pregnant
PGD = Preimplantation Genetic Diagnosis
PI = Primary Infertility
PID = Pelvic Inflammatory Disease
PIO = Progesterone In Oil
PLI = Paternal Leukocyte Immunization
PMS = Pre-Menstrual Syndrome
POAS = Pee On A Stick
POF = Premature Ovarian Failure
PROM = Premature Rupture of Membranes

Q

R
RE = Reproductive Endocrinologist (Infertility specialist)
R-hFSH = Recombinant Human Follicle Stimulating Hormone
RI = Reproductive Immunologist
ROS = Reactive Oxygen Species
ROTBA Reality on the Blink Again
RPL = Recurrent Pregnancy Loss
RSA = Recurrent Spontaneous Abortion
Rx = Prescription

S
S/A = Sperm/semen analysis
SA = Semen Analysis
SART = Society of Assisted Reproductive Technology
SHG = Sonohysterogram
SI = Secondary Infertility
SLE = Systemic Lupus Erythematosus
Sono HSG = Sonohysterogram
SOP =Standard Operational Procedure
SPA = Sperm Penetration Assay
STD = Sexually Transmitted Disease
SUZI = Sub-Zonal Insertion

T
TeBG = Testosterone-Estradiol-Binding Globulin
TESE = Testicular Sperm Extraction
TET = Tubal Embryo Transfer
TL = Tubal Ligation
TORCH = Toxoplasmosis, Other, Rubella, Cytomegalovirus, and Herpes test
TR = Tubal Reversal
TRH = Thyroid Releasing Hormone
TSH = Thyroid Stimulating Hormone
TTC = Trying to Conceive
TUFT = Trans-Uterine Fallopian Transfer
Tx = Treatment

U
US, u/s = Ultrasound or ultrasonography
UTI = Urinary Tract Infection

V
V = Vasectomy
VBAC= Vaginal Birth After C-section
VBA2C= Vaginal Birth After 2 -section
VR = Vasectomy Reversal

W
WBC = White Blood Cells

X

Y
YI = Yeast Infection

Z
ZIFT = Zygote Intra-Fallopian Transfer

Guest Post: “It was the worst of times…. Another infertility story”

There is a deep feeling of pain every month, one you hopefully will not become used to. But for many of us, it’s all to familiar a feeling: you got your period this month, again.

We had hit the 18 month mark before I had to stop counting. For the first few months, aunt flow came with all my familiar cramps and pains, and I would smile through the rest of the week with shrug: it was healthy not to get pregnant right away. Then the second half of that next year, I would get a little more down trodden, but I had nowhere to turn. By the end of the first year, I was a mess every month when the “crimson tide” started, because I knew it meant one thing…Not pregnant yet.

I didn’t have a lot of support. My family thought I was too young to start a family: every time it came up, the infamous “I’m too young to be a grandma” would rear its head, and I would just smile and nod, pretending that I wasn’t doing everything I could to get knocked up. My husband didn’t truly understand my anguish, because as a man you just don’t worry about these kinds of things. My girlfriends all had different agendas, finishing school and finding careers. My first doctor shrugged me off as a fat, young girl that needed to hold her horses. At 23, I was hit with this feeling that I would not ever get the family I had dreamed of as a kid.

I watched friend after friend post new baby updates, and with each one, I found the “hide” setting. I wanted to be happy for them, but I couldn’t be happy. My husband’s close friend from work had a new baby boy, and I broke down in our bedroom before going to see them, while he watched not sure what to say. A cousin in the family got pregnant: no job, not married, not readily paying her bills and moved back home with her mom shortly after finding out she was pregnant- and hasn’t left- and it was all on accident. Barely out of high school, she couldn’t take care of herself, much less the dead-beat father she was trying to support and a new baby. But she was given the greatest miracle in the world, to be a mom, and I was a bitter because I wanted it to be me!

It broke my heart. I cried myself to sleep. I laid awake guilt ridden at all hours of the night. I kept a journal about how unfair it all was, and how broken I felt. No matter how much I tried, or how much I wanted to get pregnant, my body just wouldn’t. I watched the months tick by, and knew that all these “delays” were adding up. It would make the difference between my husband’s Grandmother meeting our daughter –he was her favorite grandson- because her health did not allow her to stay with us that long. I blamed myself a lot, and brought myself down. I let myself hit the lowest of lows, truly believed that this was just not going to happen for us. In order to write this post, I went back through those old journals, and it made my heart hurt all over again.

I have mild PCOS: the cysts on my ovaries were not very large, and the extra chemical progesterone was only mildly over what it should have been. We had my thyroid tested, and all came back clear. I could grow facial hair like my husband, and had gained weight over the years that I really didn’t link up with the PCOS until now. I was one of the lucky ones, where in a 12 month span, I would only skip a period 2 or 3 times because I hadn’t ovulated that month. My first doctor did not run additional tests at all, other than the basic ultrasound, and left me with the diagnosis to see her again in a year and lose weight. Notice how I said first… if you don’t like or agree with your doctor now, do you think you will later, when you do get pregnant? Ditch any negative nancies now, and find a new OB/GYN that is willing to help!

After the close to two years of trying of trying, I really stopped counting. I looked up adoption, starting writing up a biography about us, and started looking up what kind of fees I would need to pay, and how I was going to save up for them. I forced my husband to see his doctor –and let me remind every one of you beautiful, hurting ladies: it takes two to tango here! His test results were similar to mine: again, we were sent away with a diagnosis of lose weight, try harder, and then it’ll work. I then turned into some sort of monster: I blamed him for not taking his vitamins, drinking one more soda than he should have, putting his left shoe on before his right… Things that were totally unrelated became a bullet point on my vendetta list. I went from sobbing emotional sad-sack to bitter bitch-zilla in a 10 minute span (influenced mildly by Clomid) and I was not fun to be around, even to myself, I would realize later.

I won’t sit here and tell you what the magic trick is to being okay with not being okay. Take a moment to yourself, don’t just pretend and smile through the day. There are days you are going to need to cry it all out, nights you just need loud music, or a quiet hot bath. It gets much harder before it will ever be easier, but it does make victory so much sweeter. Here’s the thing: you can throw as much as you want into your fertility, but there’s never a guarantee that it’ll be enough. Take each month in stride, make positive changes, and do what you can to help yourself.

I’m no expert, but I do have some experience in the area. If your doctor is unwilling to help you, there are a lot of things you can do to help yourself. Start by knowing as much as you can about fertility: learn how to track your cycles, find those ‘super foods’ the internet talks about, cut out the bad things from your life, like smoking, before you begin to try. My favorite book was “The Impatient Woman's Guide to Getting Pregnant” by Heidi Murkoff. I read it three times through or more. There’s certainly a lot to learn, and a lot to change. Because it takes two, you also want to help your partner make changes too: quitting smoking, reducing alcohol and coffee intake, even switching to different underwear. I highly suggest you both take a prenatal vitamin: part of this suggestion though, I would use an empty bottle of vitamin whatever and fill it with prenatals, if your partner isn’t as on board as you are. Folic acid for him is equally as good as it is for you! Sperm is, however, made in advance, so what you are using today was actually “created” 3 months prior. Changes on your partners side will take effect 2 to 3 months later.

Use the time you have before being pregnant to do things you wanted to learn to do: I am thankful I had a chance to learn to crochet before we had baby-on-board. I got a second dog, and trained him before we got pregnant (another blessing in so many ways!). I could financially prepare for what we were going to need, and the delay was a good thing,  that allowed my husband to change jobs to something more reliable, with a higher wage which was nice too. Maybe it’s a trip to Hawaii you’ve always been dreaming of, or learning professional photography. Keep your partners feelings in mind too: maybe there’s something he would like to do before baby too, and squeeze these simple pleasures and new hobbies in beforehand. For secondary infertility, enjoy your first child just a little longer. Make a few fun outings that you don’t normally, like a road trip to the beach, and just enjoy their excitement. Soon, you’ll have to try to find time for two, and you’ll miss these days.

In the end, do what makes sense to you. Your mind knows what it wants. If you just need to rant, or cry, or hit something, find a constructive way to do it! You are doing all you can, and good things really do take time. Surround yourself with people you can talk to, doctors whom you trust and respect their advice, and who are there to help you through your struggle, not just shrug you off with a “lose weight” or “get older” verdict. There is no magic trick to getting pregnant, no wonderful pill you can take and make it easier. Anyone who has never had trouble getting pregnant has no idea what it feels like, and they give bad advice –take it with a grain of salt. Talk about it, even if it’s just to a word document on your computer, or a notebook at home, and let go of all your frustrations and unwind! You are not ever, ever alone in this journey!

So, my last piece of advice. Go into the bathroom, look at yourself in the mirror. Tell yourself that “We are going to do this!”. Repeat every day. You really are going to be able to do this, in your body’s own time. And, that feeling every month? It makes it totally worth it in the end!



Amanda P. is a soon-to-be mom from Arizona. She works at an airline call center and also has a website that you can check out here. Sending Amanda lots of well wishes, as she is due to give birth February 2014!

Gestational Diabetes - How is it diagnosed? (2/3)

How is the test administered? A one-hour test screens for (but does not diagnose) gestational diabetes mellitus (GDM). If your blood sugar levels seem high after a one-hour test, you'll have to come back for more gestational diabetes testing.The best method for diagnosing gestational diabetes is taking a glucose test (glucose tolerance test). The test measures how the body reacts to a large amount of glucose (sugar).

According to The US National Library of Medicine: "For this test you will drink a glass of water that contains 50 grams of dissolved sugar. You do not need to fast beforehand. One hour later, blood will be taken from a vein in your arm to determine the blood sugar level. If the value is below 7.5 millimoles per liter (mmol/L, about 135 mg/dL), the results are considered normal and no more testing is done.
If an elevated level is found in the glucose challenge test, it is still not considered a final diagnosis. It only serves to determine which women will be offered a second and final test. This second test, called the oral glucose tolerance test, is more involved. For the test, the pregnant woman must fast beforehand, which means not eating or drinking anything but water for at least eight hours. The first step in this test is taking blood. After this the woman drinks a sugar solution containing 75 grams of glucose. Blood is taken from an arm vein again after one hour and after two hours. If any of the following three blood sugar values is exceeded, gestational diabetes will be diagnosed:

• After fasting: 5.1 mmol/L (92 mg/dL)
• After one hour: 10.0 mmol/L (180 mg/dL)
• After two hours: 8.5 mmol/L (153 mg/dL)" 

Testing for Gestational Diabetes can be done as early as 8 weeks in women that have certain risk factors, and is done routinely on all women at about 28 weeks gestation. Interestingly, however, not all women NEED to be tested for diabetes during pregnancy.
 
According to pregnancy.com:

"One of the most intriguing recommendations is that a woman may not need laboratory testing to screen for GD if she meets all of the following criteria:

• less than 25 years old
• not a member of a racial or ethnic group with a high prevalence of diabetes (eg, Hispanic, African, Native American, South or East Asian, or Pacific Islands ancestry)
• a body mass index (BMI) 25
• no history of abnormal glucose tolerance
• no previous history of adverse pregnancy outcomes usually associated with GDM
• no known diabetes in first-degree relative

Women who are at a higher risk for GDM usually have one of the following risk factors:

• age
• ethnicity
• obesity
• family history of diabetes
• past obstetric history"

 Before testing, you should eat normally for the few days prior. Women used to be told to eat less carbs or sugar in the days before their test, but that could just make your body react more aggressively to the glucose in the drink, giving a false higher result. If you are opposed to drinking loads of sugar water and various other chemicals, you can arrange to eat a specific breakfast and have your blood drawn at an interval following your meal instead. Many doctors frown upon such a request, but it is your right to request it.  
 
My own experience and advice for others that are deemed "borderline" like I was: I demanded a retest and that one came back ok but they were "concerned", so I compromised and told them I'd do my best to follow a GD diet and I'd monitor my sugars for a couple of weeks to "put their minds at ease". I figured I could use healthy eating guidelines anyway (though I did still have my daily vanilla ice cream cone) and when monitoring was all good, they left me alone. They insisted I get urine/ketosis sticks and keep a food log which I was meant to fax to them, but I did neither because EFF THAT, THEY'RE NOT MY MOMMA.

I had a bit of a rebellious streak during my pregnancy as you can tell ;) But honestly, I think it's a fair compromise and it'll give you AND the doctors a chance to see how your sugars are doing in the real world over time, rather than just once during a lab test. And then I think no matter what happens, everyone will have peace of mind that they're making the right decision on how to proceed; whether your sugars really ARE high or not. This was something I did in order to appease my doctors because I had one slightly elevated level on my test but otherwise showed no symptoms, but you can also request to have this several-times-a-day self-monitoring in place of the glucose challenge. Again, your doctor might fight you on this request, but as I mentioned previously, this is the best way to get a REAL WORLD view of your glucose metabolism, which is much more accurate than a one-time lab setting.

In the next last post on GD, I will discuss the various ways that Gestational Diabetes can be treated if you are, in fact, diagnosed with GD after your tests. 

Guest Post : "Jellybean’s Arrival (VBAC)"

When I learned I was pregnant with my second child, I was so excited and thankful. I immediately began planning for my VBAC (vaginal birth after cesarean). With my first child, I had a scheduled cesarean section for various reasons: Borderline high blood pressure, high optic nerve pressure, and an unusually shaped pelvis that wouldn’t be able to birth a baby. My asthma and obesity further complicated things and my OB/GYN felt that a planned c-section would be the best option for both of us. I was young and somewhat scared of childbirth pain, so I went along with the plan. My first child arrived in 2003 at 6 pounds, 6 ounces.

I began seeing a local OB/GYN for my second pregnancy in the summer of 2010. There were bumps along the road and various things caused me to heighten my guard. I learned that my local hospital banned VBACs, so I began searching for another way to have my VBAC. I don’t think it truly hit me that I was going to have to have a repeat c-section until the OB/GYN began discussing the date of the scheduled c-section.

Bethany and Heidi, a couple of wonderful homebirth midwives and I finally connected in December 2010. I wasn’t sure if I would be a good candidate for a home birth because my “problems” in my first pregnancy were still problems in my second pregnancy (aside from the high optic nerve pressure). Some friends of mine had been successful with home births, but I was still a little apprehensive. I continued to read information online and I purchased Ina May’s Guide to Childbirth. Following a friend’s advice, my husband and I watched The Business of Being Born and that was a turning point for us. We were both convinced that we needed to pursue a home birth as long as Bethany agreed. After some discussion with her, we hired her as our midwife.

Throughout the rest of my pregnancy, Bethany and I were in constant contact. She gave me her cell phone number and told me to call or text any time with questions. I was also able to email her. We communicated at least once a week, sometimes several times a week. I saw her for my prenatal care and she monitored the same things the OB/GYN had been monitoring: blood pressure, fundal height, fetal heart rate, weight, urine protein levels, group b strep status, etc. Bethany explained everything to me in a very calm manner and my questions were answered to my satisfaction. This was a completely new level of prenatal care for me. I was used to being in and out of the OB/GYN’s office in 30 minutes or less and my appointments with Bethany usually took 30 minutes to an hour.
My water broke on Thursday around 6 PM, at 40 weeks, 6 days gestation. Labor started slowly and did not become “regular” until nearly 24 hours later after lots of walking and stairs. I called Bethany around 3 AM Friday and she came right away, along with Heidi who would be assisting her for the delivery. Bethany assessed baby and I. Her experience told her that it would be awhile before baby arrived. After several hours, we discussed our options and decided to try some natural things to encourage labor and Bethany and Heidi would leave for a few hours. Bethany shared a contraction timer with us and instructed us to call her when the contractions became three to four minutes apart with regularity.

Contractions picked up and we called Bethany to return around 6 PM. My pregnancy was now 41 weeks gestation and she wrote “looks serious” in her notes. She and my husband supported me through the contractions. A few hours later, Bethany called Heidi and told her it was time to come. Heidi and Bethany took turns encouraging me to breathe through my contractions and applying a cool washcloth to my head and neck. Blood pressure, fetal heart tones, and my temperature were monitored closely throughout my labor. Around 2:30 AM, I felt pushy and Bethany declared that I was complete after a quick cervical check.

Baby was now 41 weeks 1 day gestational age and he would be arriving soon. I pushed in various places and positions: standing, sitting on the couch, sitting on the birthing stool, leaning back against the couch, and side-lying on the couch. Baby’s head emerged with the cord around his neck. Bethany quickly unwrapped the cord and baby’s body came in the next minute. I had just birthed my 9 pound, 2 ounce son!

For me, the right choice was to birth with a Bethany and Heidi. If we’re blessed with more children, we will do the same again.

Megan

Story reposted with permission from Megan Brust, original author. Megan is a mother of 2 and a VBAC veteran. Megan is a Birth Doula in Springfield, Oregon. Find out more about her services at her business page, Abundant Life Birth Services. 

VBAC vs RCS risks

VBAC vs Repeat CS Risks as presented by iCAN

VBAC or Repeat Cesarean
What is safe? What are my options?
If you have had a cesarean delivery and are planning another birth you have to make a decision to have a Vaginal Birth after Cesarean (VBAC) or a Repeat Cesarean Section (RCS).  This can be a hard decision with all the misleading information out there on both topics.  Lets look at some of the facts.
VBAC (Vaginal Birth after Cesarean)
The biggest concern with VBAC among women is uterine rupture. Permitting labor to begin naturally with a low transverse scar ("bikini cut") VBAC after one previous cesarean carries a risk 0.4% of uterine rupture with an increase in an augmented or induced labor. (Landon, 2004)  Successful VBAC's have lower complication rates than planned RCS which have lower complications than a "failed" VBAC. (Landon, 2004)
VBAC is a safe and appropriate choice for most women with one prior cesarean and for some women with two prior cesareans according to ACOG, 2010.
"the chance that a VBAC candidate will require emergency surgery, is for all practical purposes, no higher than that of any other pregnant woman" and "the risk of VBAC is not substantially greater than the risk of any type of childbirth" (Bruce Flamm, MD, Birth after Cesarean)
VBAMC (Vaginal Birth after Multiple Cesareans)
Here is a link to a study done in 2006 by Landon, Risks of Uterine Rupture with a Trial of Labor in Women with Multiple and Single Prior Cesarean Delivery.
The study of 975 women with multiple previous cesareans found a rupture rate of 0.9%. They also showed VBA2C within two years of a previous cesarean delivery to have a 1.1% rupture rate. Not nearly as high as many doctors tell you. Those risks are still lower than those risks of a 3rd cesarean.
Landon concludes, Vaginal birth after multiple cesarean deliveries should remain an option for eligible women.
Overall trial-of-labor success rates were 73%Single prior cesarean delivery success rate of 74%Multiple prior cesarean deliveries success rate of 66%Two prior cesarean deliveries success rate of 67%Three prior cesarean deliveries success rate of 55%
Cesarean
When a cesarean is necessary it can be a life saving procedure for mother and baby.10 true reasons for a Cesarean
Cesarean Risks include placenta accreta, hysterectomy, blood transfusion, ICU admission, which increases with each surgery and uterine rupture. Whereas with successful VBAC uterine rupture and other labor related complications decrease significantly.
The risks associated with RCS increase with each cesarean performed.
Maternal death is very low with each option: 0.02% with VBAC and 0.04% with RCS. (Landon, 2004)

Make an informed choice about the risks of Repeat Cesareans vs. VBAC's
1st C-section Risk of hysterectomy: 0.65%Risk of blood transfusion: 4.05%Risk of placenta accreta: 0.24%
2nd C-section 1st VBAC Risk of major complications: 4.3% Chance of successful VBAC: 63.3% Risk of placenta accreta: 0.31% Risk of uterine rupture: 0.87% Risk of hysterectomy: 0.42% Risk of hysterectomy: 0.23% Risk of blood transfusion: 1.53% Risk of blood transfusion: 1.89% Risk of dense adhesions: 21.6%
3rd C-section 2nd VBAC Risk of major complications: 7.5% Chance of successful VBAC: 87.6% Risk of placenta accreta: 0.57% Risk of uterine rupture: 0.45% Risk of hysterectomy: 0.9% Risk of hysterectomy: 0.17% Risk of blood transfusion: 2.26% Risk of blood transfusion: 1.24% Risk of dense adhesion's: 32.2%
4th C-section 3rd VBAC Risk of major complications: 12.5% Chance of successful VBAC: 90.9% Risk of placenta accreta: 2.13% Risk of uterine rupture: 0.38% Risk of hysterectomy: 2.41% Risk of hysterectomy: 0.06% Risk of blood transfusion: 3.65% Risk of blood transfusion: 0.99% Risk of dense adhesion's: 42.2% NOTE: "Major complications" include one or more of the following: uterine rupture, hysterectomy, additional surgery due to hemorrhage, injury to the bladder or bowel, thromboembolism, and/or excessive blood loss.
All VBAC stats for this chart are taken from the Mercer and Gilbert study, 2008 which includes induced and augmented labors. Additional studies have shown lower uterine rupture rates (especially with spontaneous labors) and higher VBAC success rates with non augmented or induced labors.

According to the World Health Organization (WHO) Countries with some of the lowest perinatal mortality rates in the world have cesarean rates of less than 10%. There is no justification for any region to have a higher rate than 10-15%.
In all 50 states VBAC is legal and in some states it is legal for a midwife to attend an OOH (out-of-hospital) VBAC. However of the women interested in VBAC 57% are unable to find a supportive care provider or hospital.
With the new AGOC (2010) guidelines in place we hope to see VBAC's increase and have more women find supportive care providers!You CAN birth!!

Setting my intentions

Some backstory:
I have been slowly getting crunchier and crunchier since 2011 when I got pregnant with my one and only little guy, who is known as Bu on the interwebs :) I am basically the only remotely crunchy mom I know IRL, and I'm used to getting stares for baby-wearing, what I feed my son, my discipline style, etc. I am also in the middle of a lifestyle change while eating as few processed foods as possible because my husband and I hope to TTC when Bu is 3, and I am trying desperately to have a VBAC. I had a 46 hour augmented labor without pain medication that ended in an emergency c-section, and I want to be able to have the birth experience that I felt I worked for the first time around.

I have constantly and consistently run across opposition since I got pregnant, due mostly to my size or my desire to raise my son in an attached, natural manner. I found that a lot of the time, I felt unsupported in my choices, and sometimes became unsure regardless of how much research I'd done and how sure I was that a given path was the path I wanted to take.

I've shared most every detail of my pregnancy, labor and delivery on the internet, as much for my own reflection as to hopefully educate and inspire others that if you want to do something, you can do it. The education and support is out there if you seek it out. I found several like minded moms online and learned from them about cloth diapering, breastfeeding, cosleeping, babywearing...and whatever they couldn't answer for me, I sought elsewhere. I became obsessed with learning all I could because if my pregnancy and labor taught ME anything, it was that no one will advocate for you like you can.

I have joined several groups and forums now, from crunchy living pages to VBAC support groups, and found that the one thing missing was a page for plus size moms to get together and discuss all of these things. I created Plus Size and Pregnant to fill that gap, and three months later we are a handful shy of 100 members.

I've become sort of notorious among my friends for having as much knowledge as opinions on parenting and labor, so a lot of my non-plus-size friends have sought advice from me as well. "Wouldn't it be wonderful," I thought, "to train specifically in labor, delivery and parenting practices so I could REALLY turn my passion into a calling?"

Hence, Momma Friendly. I want to help all moms, moms to be, and anyone who's ever wanted to be a parent. As long as you're interested  in doing what's best for your children, future or otherwise, I want to do what I can to make that happen. I am about to start training to become a postpartum doula, and I will be talking about that in this blog. In the meantime, I am going to keep bringing articles and resources about related topics, sharing my experiences and thoughts, and answering any questions I receive from any interested parties. If I cannot answer your question myself, I will do my best to point you in the direction of the right resources.

Thank you for reading. I look forward to sharing with and learning from you all!