Sunday, September 29, 2013

A Breastfeeding Advocate's Fear of Breastfeeding in Public.

I have two confessions to make.

The first is that I have never feared childbirth. Well before my views on childbirth were shaped by becoming a labour doula, I never feared the pain of labour. I didn't fear it before I had children, while I was carrying/birthing twins, or now that I'm carrying a singleton. In fact I used to want to be a surrogate just so for the pregnancy and popping babies out (though now I realize I loath being pregnant, so that plan is less attractive to me now). I see the pain as a challenge to be conquered, a rite of passage, something that can only ever be experienced a handful of times, an adrenaline rush, and an important part of bringing life into the world. I don't expect other women or my clients to feel the same way as I do. But I do understand that the less fear a woman has surrounding birth, the more at ease and empowered she becomes and thus the less pain she will experience (this is called "the fear-tension-pain cycle"  -see below for further resources), so I strive to help friends and clients find strength within themselves to conquer any/all fears around childbirth.  I have so much confidence, even excitement at the thought of childbirth that it provides such a strange juxtaposition to my other confession:
I fear breastfeeding in public. And I'm a breastfeeding advocate.

As the weeks tick closer to meeting my newest baby I find my anxiety at the thought of nursing in public rising. I'm so, so relaxed about preparing for the baby: I haven't bothered buying equipment or preparing a second bedroom, when it comes to birthing I'm so relaxed I would be happy to squat in a field and catch my baby unattended (don't worry mum, thats not the plan! lol), so relaxed that the fact that we have to buy a new vehicle to fit this child with zero money barely finds its way into my conscious worry. But nursing in public, terrifies me, it keeps me awake at night.

As a doula I am often spouting the wonders of breastfeeding, helping clients get the breastfeeding relationship started off well and to have confidence and pride in themselves as they nourish their infant whether its at home or out in the world, covered or uncovered. I truly believe that breasts are for babies first and that the breastfeeding relationship is one of the most beautiful and purest exchanges of love between mother and infant. And I believe that there is no shame in breastfeeding in public. Or at least should be no shame. In reality many of us feel it. From the negative influence of culture we are raised in, to the dark demons of our own tainted self image. From the time we are little girls we are taught to be modest and hide our bodies and then all of a sudden as young teens, and even preteens we are noticing that the world praises beauty and sexuality, and that bare skin turns the eyes and attention of men and women alike. We are caught between hiding our natural form out of shame and flaunting it for attention. There are many factors why mothers may feel shame while breastfeeding in public and many other articles written about those influences. I am aware that much of my struggle with bringing my children to my breast comes from the culture around me, but there is also a deeper and darker issue at play than outside influences. You see I'm a sexual abuse survivor. At least I have survived in many other aspects of life. Through lots of healing I have overcome my resulting post traumatic stress disorder. I've been able to forgive my assaulters. I have a healthy, happy marriage and sex life. And I am able to share my personal journey with other sexual abuse survivors. But when it comes to breastfeeding I realized I am not a survivor in this area but still a victim. I know I can't control the minds of men around me. I know that a man can and will lust over me and objectify me in his mind without me even having to be present, let alone breastfeeding in front of him. And more importantly I know I am not responsible for the "sins" of another's mind. However, what I *know* intellectually to be true and what I *feel* are at odds with each other.

Sexual abuse destroys to the core of your being. Its ugly fingers will reach out to touch every part of your life. Breastfeeding is not always immune to the affects of abuse. I know I am not alone. I once asked a friend who is a lactation consultant if in the 20+ years she has been helping breastfeeding mothers if she has had clients who have been victims of sexual abuse. She replied with sadness in her voice, "Yes many. And I have never seen one meet their breastfeeding goals yet."

I wasn't able to exclusively breastfeed my twins. Originally I had enough milk to feed triplets, but because of my discomfort at nursing in public, I often turned to pumping my milk and bottling it for outings.  Also when I was out in public and my boys were hungry I would give them pumped milk. While they were sipping on their bottles my breasts were engorged, which meant I would have to ignore the pain or pump again. The cycle of ignoring my engorgement or pumping lowered my milk supply. A mother produces milk as she is actively breastfeeding, pumping can lower milk supply because a nursing baby is more efficiant at building a mother's supply. And skipping a pumping or nursing session is even more detrimental to supply because it tells your body that you have no baby to feed, so it doesn't produce as much milk. By the time my boys were 10 months old, the majority of their bottles were formula and by 12mths my once abundant milk supply had completely dried up.

Some people may think: "Why not just nurse in private if you feel so uncomfortable? Or why not cover?" Well first if mothers are to meet their breastfeeding goals, nursing in private can prove a great barrier. I found this to be true when I was struggling to nurse my twins. You see babies get hungry A LOT and its not always predictable and its not controllable. Having to stay home and never leave the house in case your baby gets hungry or being in public and having drop your groceries/latte/get off the bus and  run around looking for a backroom/bathroom/change room/alleyway while your baby cries in frustration to nurse in is a real pain and discouraging. Also not all babies, especially those older than 3 months like to nurse under a cover, they sweat, squirm, bite, cry and flail wildly. And arguably a nursing cover sometimes draws more attention than just simply holding your baby in your arms.

There are a plethora of reasons for me to get out of the nursing closet but the most important one for me is: This is something I need to do, this is for healing. When I'm in public and my little one starts to fuss, I will tell myself: "This is for healing. My breasts are good. They do not belong to anyone except myself. They have been used, abused, objectified, but THIS is good and this is my choice!" I will stand up to the shame and say, "No, not this time. I am not a victim. I will not hide." You see I believe that, like birthing, the less fear a woman has about nursing in public the more successful she will be in nursing overall. I want to conquer this challenge, to find complete healing, and be an example to so many other women who are struggling in the same way as me.

See when you tell someone to cover up, you don't know what kind of damage you are doing to them. You could be unintentionally retraumatizing them.You could be reinforcing this belief that their bodies are shameful, dirty, that breastfeeding is some how wrong and sexual, that they need to be small, unseen, and hidden. These are lies. Lies that plague too many women, too many victims. NO! Breastfeeding is natural, breastfeeding is good, breastfeeding is beautiful, breastfeeding is about choice, its about love, life and nourishment. And breastfeeding can be an agent of healing! I want to be healed. I want to be a part of others' journeys of healing. If I'm nursing in public I want to have a smile of peace on my face and feel peace in my soul.

The choice of how and to whom I lost my virginity was taken from me but the choice of how and where I feed my baby is my own. Isn't that what empowerment in maternal healthcare is about? Isn't that was motherhood is about? Choice.

Giving one of my boys a bottle of pumped milk during a photoshoot. I was too nervous to nurse in front of the photographer. The boys cried for most of the shoot because I hadn't pumped enough.

***Disclaimer: This is an article written as part of my personal healing journey and to convey to others with honesty how sexual abuse and breastfeeding can be intimately linked with each other. These are my OWN my personal thoughts and feelings regarding my journey as a sexual abuse survivor and my struggles with breastfeeding. In NO WAY do I want other mothers who have experienced sexual abuse to feel that they have to breastfeed in order to find healing or that by not breastfeeding they are some how still victims of sexual abuse. I also do know a few women who are abuse survivors and have had no problems breastfeeding, so this isn't going to be a struggle for all survivors. For some, breastfeeding may be retraumatizing and not an appropriate step in their healing journey. If you are struggling with these issues find comfort in knowing you are not alone. There are many resources out there. I personally will be sharing this blog with my midwives and therapist so that they can be better support for me throughout the rest of my pregnancy and postpartum experience. Reach out, find your support system. <3

Links about the "Fear-Tension-Pain Cycle":

Wednesday, September 18, 2013

Announcing Parenting Multiples' New Admin: Kerry

The facebook page Parenting Multiples has now reached over 3,300 members. This is super exciting and means that we need an additional admin to the page. We are excited to announce that Kerry O'Hora Bergeman will join Bridget and I in making Parenting Multiples a fantastic community.

Below is a mini interview we did of this mama so that you could get to know her a little better.

Parenting Multiples: 1) Introduce yourself and where are you from?
Kerry: I grew up in Northern VA where most of my family still resides.  In 1992 I moved to Ocean City MD and about ten years later to Salisbury- a town just outside of Ocean City.

2) Tell us about your multiples, how many, what age, etc.? Do you have other children as well?
I currently have fraternal girls born in Dec of 2008 and am pregnant with identical girls due this Dec.  Life will be crazy in December with 4 birthdays and Christmas all very very close together!

3) Whats your favourite part of being a mom to multiples?
Watching their interaction.  Watching them play, discover, explore and become the best of friends.  It is absolutely amazing and a blessing even if hard at times I would never trade it!

4) Whats the most challenging part for you right now?
Right now the girls are at an age where they are challenging us with defiance and independence.  Being pregnant this is so challenging because I don't have the energy or patience I need to guide them through this phase in their childhood.

5) How do you keep sane?
Talk to others.  My girlfriends are so important to my sanity.  Also keeping the girls engaged helps us all.  My husband is a huge support and gives me the reprieves I need when I need them.

6) Who is the biggest support to you as your raise your children?
Aside of my husband?  My mom and sisters.  They are always there for me and support me.

7) What do you enjoy most about being a member of the Parenting Multiple's community?
The interaction with other moms going through what my family is going through.  The good the bad and the ugly.

8) What are you looking forward to as an admin to this page?
Getting to know the women more intimately, definitely.

Kerry, her husband, with their fraternal girls (turning 5yrs old). This family of 4 will soon be a family of 6 with the arrival of her identical girls in Dec. 

Congratulations Kerry and welcome to the PM team. :)

Monday, April 22, 2013

Twin Mama goes "Overdue" to 41wks 3ds

I have a guest birth interview from Parenting Multiples community member Cori Ramsay. Cori went "overdue" with her twins and was happy to be interviewed by me about this rare experience for carrying multiples. She jokingly called herself:
“that crazy lady who carried her twins overdue”

Disclaimer: There is no 'one-size-fits-all' when it comes to birth. So often mothers expecting multiples are told 'You must birth this way, or that way, there is only one safe way to birth twins.' This birth was right for this family; please work with your health care-provider, a Doula, and your own intuition to plan the birth that is right and safest for YOU and your babies. -Sarah

1) Introduce yourself, where do you hail from, and who is in your family?
My name is Cori Ramsay, and I am happily married to Matthew and have been for 7 years, and we have three kids.  I have a brilliant 4 year old girl named Amy, as well as boy/girl twins, Alex and Amber, who will be two in May 2013.

2) When did you find out you were having twins? What was your reaction? What was the reaction of your health care providers?
We had decided to have a home birth and had retained a midwife.  I wanted very minimal interventions in my pregnancy and refused most tests.  Our 2 year old daughter was asking a lot about my growing belly.  At around 21 weeks we decided to get an Ultrasound to see a picture” of the baby inside.  So far, the only real intervention I had was a heartbeat check around 12 weeks.  My husband was to meet me at the lab, but of course, that morning there was the the worst snowstorm of the season.  I was 5 minutes late and my husband texted he was stuck and had no idea how long he’d be, but would get there as soon as he could.  I went in for the Ultrasound alone, and the lady was chatting away and then looked at me and said, “Oh!  You don’t know, do you?”  “Don’t know what?”, I said, but in that moment I had a feeling I knew what was coming....”You’re having twins!”  I yelped, “What?!”  I didn’t realize how loud I had yelped until the lab security stuck their head in the door and asked if everything was ok.  The tech said calmly, “Oh yes, we’re fine.  I just told her she’s having twins.”  She proceeded with the pictures.   Meanwhile my husband texted he had arrived.  I asked if someone could go and get him, but they said no.  I was just bursting, wanting to tell him so badly.  I’m ashamed to admit it, but I faked a urinary emergency and ran out instead to the waiting room and stage whispered “’s TWINS!!!!!” and then ran back into the Ultrasound room.  It was then that they decided to let him in the room after all.  We gazed in awe at the two little babies.  We locked eyes.  Our older daughter had been a really difficult baby.  I saw fear intermingled with elation.  We had an exciting 24 hours letting everyone know our special news.  My midwife was new to Canada and was dismayed to find out that in Alberta midwives must transfer care of twin pregnancies because they are considered “high risk”.  Although neither of us was happy about this, I retained an excellent doula and we proceeded to find a doctor who would understand my desire for minimal intervention and a hospital that would allow me to take the home birth experience and move it into a hospital setting.

3) You ended up going "overdue" with your babies. Why did you make the decision to skip induction?
I was induced with my oldest daughter.  I had not researched induction and was tired of being pregnant.  When my doctor calmly said, “Well, you’re a week overdue, I’ll schedule your induction for Friday, ok?”, it sounded like a good idea to me.  Well, although my head was in agreement, my body was NOT.  It fought the induction and they had to up the picotin (the IV drip that induces labour) until I was just having one, giant, massive contraction.  Despite all my faith that I could pull off a drug-free birth, I ended up begging for an epideral after hours of solid contractions.  I lay there, no longer in pain, but feeling defeated.  They upped the picotin even more and after another 6 or 8 hours my body finally gave in and I pushed Amy out.  The nurses in the hospital didn’t let me make any choices.  I was being treated as if I was unable to give birth by myself, which seemed, to me, unreasonable.  Women had done it for millions of years, and deep down I found conviction that my body *was* built to have children, and *not* built to have the hospital remove them.  In an emergency situation, it is wonderful that we have hospitals.  But the overbearing concern and that mental stress we pile on expecting mothers these days can’t be good for the mother or the unborn child(ren).  I decided that I would take control of my next pregnancy.  I would be informed of the real risks.  My twin pregnancy was completely unremarkable and I was healthy throughout.  Had I experienced any difficulty I would most certainly have checked it out, but I didn’t.  I firmly said I would *not* induce.  I would *not* do further Ultrasounds.  I would *not* have internal exams (although when my 40-week “due date” came and went, I did ask for a check, only to be completely disappointed by him saying “you are not dilated at all” and then chiding myself all the way home, “Well now Cori, what good did that do, exactly?”).  I knew that fully developed lungs is usually what triggers labour.  I looked inward and found a peaceful, quiet centre, where I knew my babies were ok, that no babies had an exact “due date”, and made the decision.  I would let my babies be born when they were ready.  It took until 41 weeks, and 3 days, and when they came it was QUICKLY.  From the time the first contraction hit until I held them in my arms was less than 3 hours.

4) Did you have support for the choices you made?
Of course, nobody thought I would go overdue.  Until I did.  Then, I enjoyed tremendous support from my husband, doula and midwife.  But I’d have to say the group that really helped me out was  Ten Month Mamas on facebook.  It is a group devoted to “overdue” mothers.  I found many other moms who had come to the same decision I had.  I found other mothers of twins who had gone overdue!  (It was only two, but they were out there!)  I found stories of mothers who consistently carried their babies to 43-44 weeks, just as their mothers had.  It helped me believe that there was nothing wrong with my body, which to me is implied when we suggest inductions to women for no other reason than their supposed “due date” has passed.

5) What research/resources were most valuable to you making the decision to go as natural as possible?
Again, my resolve mostly came from deep introspection.  During those pregnant months, I read.  A LOT.  The sites I visited most were kellymom and, but I found many, many personal stories of better birthing through natural means all over the internet, and these were what I focused on the most.  I also spent a lot of time in European midwifery sites and forums, where some of them claimed the “real” estimated due date should be 42 weeks, not 40 weeks.  I decided to consider my personal due date to be 42 weeks, too.

6) What did you learn from this birth experience?
This birth experience left me feeling stronger.  I felt empowered.  I had trusted my instincts and had birthed two healthy, beautiful babies naturally.  I learned that I did have the power to decide how I was treated in the doctor’s office, in the hospital, and during post-care.  I took charge of myself and my children.  I felt peace and wonder instead of worry.

7) Would you have done anything differently?
I would have either left for the hospital sooner, or else just had them at home.  The van ride during transition, with my husband pressing on my back and my doula fighting traffic, was excruciating!

8) What do you hope other women pregnant with twins can take from your story?
If you are having twins, or just a singleton, I would urge you to stay away from induction unless absolutely necessary.  Twins not being born by 38 weeks is not a complication, it is just your body being very good at cooking babies.  If you want to have a vaginal birth with a breech baby, you can.  You just need to find a doctor or midwife willing to deliver that way.  If you do not want to do a test, you don’t have to do it.  If you don’t want to have Ultrasounds, you don’t have to.  If you want to wear your own pajamas in the hospital instead of that horrible gown, you can!  If you don’t want your baby to get drops in it’s eyes or have a Vitamin K injection, they don’t have to!  If you want to breastfeed twins, YOU CAN.  A lactation consultant and a couple Le Leche meetings will help you tremendously. I would encourage mothers to do their own research on all of our modern birth practices, and make informed decisions about what they want for themselves and their children.  Make a definite birth plan and take control of your birth story! 

9) What are your hopes for your children as they grow up? Is there anything you want your daughters to learn from you when they start having children?
My kids are 4 and 2x2 now.  I want them to have love and support from our family no matter what they do with their lives.  I love how having twins has allowed me to see so clearly how very different each child is, despite being raised in similar circumstances.  I really hope that I can support my girls when they have kids.  I had a little bit of support, but not a lot.  I’m hoping they will allow me to help them and make those first few months easier.  I’m hoping also to let them know that their bodies are amazing, and that they should learn about them and take control of them, from the food they eat to the exercise they get to the medical attention they receive.

You can read her full birth story in Birth Issues magazine here. Just go to page 8.

Thanks again Cori for sharing your personal story with us all -Sarah :)

Wednesday, February 27, 2013

A Satisfying Twin Hospital Birth with a Very Supportive OB

I have a guest birth story from Parenting Multiples community member Sera Fradgley. Sera shared her beautiful journey through pregnancy and the hospital birth of her twins Isaiah & Elijah. She writes: "I wanted to share my birth story with the community in case anyone is wondering if they can have a birth they want with an OB - I have now found out it IS possible although I had to fight really hard for it due to hospital 'policy'. I declined every single protocol and left (2 hours after birthing the placenta) without vit k, eye goop, IVs or epidurals."

Disclaimer: Every mama with the help of her care provider must decide what is the best birth for her. For Sera it was the help of a Midwife & an OB through her pregnancy and a hospital water birth.

I had just taken a pregnancy test and it showed negative. I asked my mom what could be wrong with me as I had to pee all the time! She looked me straight in the eye and said, “it is because you are pregnant with twins.” I assured her I was not and asked for other suggestions to determine the cause of my new discomfort. She was not convinced but agreed to Google with me to see what else it might be.

Four days later I decided to have another pregnancy test because mom kept asking me if I was sure I was not pregnant that week. This time, the test was positive and I contacted my midwife immediately to assure myself a spot! I was ready for a home birth and so excited to have this option. We had not anticipated getting pregnant this quick as our son was 3 and our daughter 11 months.

Pregnancy was completely normal other than feeling nauseous daily as I had not experienced that with our other children as bad. It has seemed to get worse every pregnancy however (this being my fourth) so I decided it was totally normal. My midwives were pretty convinced I was only carrying one however with mom's conviction and the plan of a home birth, I decided to get a 20 week ultrasound to ensure baby was healthy as we are an hour away from the hospital and I felt better knowing things were normal inside me. Within the first two minutes of the ultrasound I hear 'wow' out of the technicians mouth. I looked at her and asked, “did you just say wow?” Then immediately added, “there are two, aren't there?” She confirmed it and a 40 minute ultrasound turned into an hour and a half (much to my husbands demise who was trying to keep our two other babies happy). Now I finally understand why I could never fool my mom as a teenager!

During the ultrasound I found out there was one placenta and two sacs. I am told that there is a small chance the babies could be a boy and a girl so I decide this is what we are having although I did not want to know for sure. I am also advised the doctor will want ultrasounds every two weeks to catch any issues with the babies. I am not happy to hear this frequency as I am not convinced ultrasound is 100% safe – especially with that many.

So excited for twins yet devastated for the loss of our planned home birth, we leave the ultrasound clinic. My husband and I discussed the possibility of having an unassisted birth away from the hospital.

I called my midwife that night in tears over the impending doom I felt in being transferred out of her care. We spoke and she assured me she would transfer me to a wonderful OB/GYN and that no matter what, she would still attend my birth, even though she could not provide any actual care. I was blessed beyond belief as I know midwives do not attend nor get paid for twin births and I am so incredibly grateful that she would do this for me. I feel a little better as I know she will be able to provide me with the best outcome possible despite the hospital surroundings I do not look forward to.

The OB my midwife wanted for me accepted me as as a patient and I had my first appointment two weeks later. Upon arriving to the hospital, I could not find parking which made me 5 minutes late for the appointment. I got upstairs to the offices and the clinic had my birth date wrong so I was sent downstairs to show proof of ID to change it. Everyone was exceptionally nice however I was starting to feel the sadness of not having it as cushy as with my midwives. I got back upstairs and waited and waited. When it was finally our turn to go into the exam room, my daughter had a complete diaper blow out and I had no extra clothing for her. The nurse advised me she would come back later so I could change her in private. My daughter had become sick and was becoming very fussy. I cleaned up her pants as best I could and put them back on her and looked at the time... I had only paid an hour for parking and here it was, time was up! I went out to the nurses desk and asked how I might deal with that to which they told me they would take care of everything. I then went back into the exam room and bawled. I didn't want to be here; I had a sick baby, was feeling overwhelmed with the changes to my birth plan and very anxious about meeting my new care provider. I am emotional at the best of times but combining the above and the hormones during pregnancy and I was a wreck! I eventually wipe the mascara running down my face and try to get it together.

I started to breast feed my daughter to comfort her and my doctor came in to meet me. The first thing she said is “So you are having identical twins.” I was devastated as I knew identical meant same sex and we did not wish to find out what we were having. I told her I did not want to know what we were having and I was not happy the surprise went from being one of three combinations to one of two. I also told her I was caught off guard with this news as this was not what the ultrasound technician told me. My doctor said that she is obligated to discuss the details with me as identical twins carry a risk of more complications than do fraternal twins. We discuss the risks involved with identicals although she is very careful not to use any fear tactics or blow any risks out of proportion. From the way she is talking I can tell she will be an awesome doctor and I start to feel a bit of relief. I asked her if she would allow my midwife to catch one of the babies and she said that would be no problem. She told me about the bi-weekly ultrasounds and I discussed my concern with doing that many. I was 22 weeks at this point and she was willing to discuss a different schedule but wanted me to go to the high risk ultrasound clinic first to get more details on my pregnancy. I asked her if she would be at my birth and she advised me of the rotation the OB's do at the hospital. This sunk my heart (and I am positive it showed on my face). While I was just meeting her for the first time, I felt she would be the best person to oversee my birth and I really didn't want a stranger in my delivery room. She booked me for an ultrasound 2 weeks later and we would discuss additional ultrasounds as well as if I could labour in the tub (my main request) at our next appointment.

After my first appointment, my doctor took time to call my midwife and advised her she could be as active in my birth as she would like and that she would do her best to be there. I think she saw how much I needed her support and care versus getting whoever was in the day I went into labour. I was so pleasantly surprised when my midwife called me with this news as it is unheard of for a midwife to have anything to do with twins once they have transferred care. It is also uncommon for a doctor to be on call for a birth at that hospital. I had the most generous and compassionate midwife and the most amazing OB who really cared about my wishes for this pregnancy and birth; both agreeing to be selflessly on call so that I could have a chance at the best birth possible. I also could not believe my doctor would be willing to give up her place catching the babies as a gift to me knowing how much I trusted my midwife and had such a strong relationship with her. I was feeling much better about the change of plans away from the home birth I had really wanted.

The results of the ultrasound at 24 weeks showed both babies growing exceptionally well with none of the potential twin issues. I was happy to know all was well and was looking forward to meeting with my doctor in two weeks. At my 26 week appointment we discussed when to do the next ultrasound and instead of the 2 week timeline she recommended I go back at 31 weeks for another which I was very happy about! We also talked about her partnership with my midwife and that she would allow me to labour in the tub assuming the room was free when I arrived at the hospital. I was starting to feel more and more astounded by her willingness to be flexible on my care and her genuine concern in providing me an optimal birth experience. We booked an appointment for the ultrasound in the morning and then I would go see her in the afternoon on my 31st week.

I made plans for a full day in Calgary at 31 weeks – ultrasound in the morning, a hospital tour and lunch with my midwife in the afternoon and then my midwife accompanied me to the appointment with my doctor where we went over my birth plan. My doctor had to take my birth plan to the head OB and Nurses at the hospital for approval as many things in it were out of the standard of care for twin hospital births. We booked an appointment for 2 weeks later to discuss the results of the hospitals decision.

At my 33 week appointment, I was advised that the meeting had not yet taken place so confirmation of my birth plan requests was still not available. My doctor wanted to do a 3 minute ultrasound just to confirm the fluid levels around both babies so I agreed since I could tell she was a bit concerned.

Around 34 weeks my midwife called me advising me the hospital did not like my birth plan at all and things were not looking good for a water labour or freedom from continuous monitoring and IV as I had requested. We spoke for over 1½ hours and I could not believe this was happening. Again I contemplated staying home to have the babies unassisted. I had luckily obtained my doctors email address at an earlier appointment and was so thankful. I sent her an email telling her I could not wait until our next appointment and I needed to resolve this as I was very upset about what I had heard.

She called me the next morning and we spoke in detail about why I requested certain things and that the water labour was extremely important to me. She discussed her concern with declining the monitoring and after hearing each others side, we agreed to compromise. She would make sure I could have the room with a tub if available and I would agree to continuous heart rate monitoring of the babies. After the discussion I felt this was a very fair compromise and was much relieved about the birth plans again.

I booked a late afternoon appointment on Feb 29 (35 weeks) as I was planning to go into labour this day and figured if I was going to be in town anyways... Well, I knew it was wishful thinking which is why when my doctor suggested a 36 week ultrasound at this appointment I asked her to bump it to 37 weeks because I had a feeling we would be having discussions about getting babies out and so I wanted very few extra ultrasounds.

March 11 I finally went into labour! I was so excited that I was going 'early' as I was now 37 weeks. By the time my husband and I got to the hospital, my contractions were 2 minutes apart. It was around 8pm and both my doctor and midwife came. The only problem was the tub room I had wanted was not available. I made peace with that since I had both my midwife and doctor here for the birth and that was most important. I had a great nurse and ended up walking with my midwife to try and get my contractions stronger. We did flights and flights of stairs and my midwife did acupressure on me. While the contractions were constant, they never progressed. 5 hours later, we all decided nothing was happening and that we should leave. We were advised to book a hotel since the contractions were so close and going home would not be wise. An hour after booking the hotel my contractions totally stopped. Neither my husband nor I could sleep and so after being at the hotel 4 hours, we started on our way home around 6:30 in the morning... what a huge let down heading home without babies on the outside!

At my 37 week ultrasound, I was advised both babies were doing exceptionally well and scoring 8/8. From there I went over to see my doctor prepared for “the talk” about getting them out. At this point the risk of stillbirth goes up but only by .06% so I was ready to decline any intervention. The sonogram doctor had faxed my OB the ultrasound report and with the results we decided to have “the talk” next week. My doctor told me I get the big blue ribbon at the farm show for biggest identical twins she has ever had. I'm not sure if she was calling me a cow? We had quite a jovial relationship. I remember being excited hearing we were having twins as I thought I just might have 6lb babies but I should have known...

A day before my next appointment I received a call from my midwife advising me that this pregnancy was going on too long and no one was comfortable with this much longer. She suggested I agree to a membrane sweep and that the doctor had made mention of induction 2 days after should that not work. I am also told that a number of things had changed since the beginning of my birth and that I may not have the support I wanted there should I not get the babies out in the next very short while. At this point I am completely devastated as everything was looking so very great and positive and now I am feeling huge pressure to make decisions to get babies out sooner than they may be ready. I have had this pressure at the end of all of my pregnancies and it is so stressful for me. My body is strong an can carry babies longer than average I suppose. Everywhere I go people are telling me I am huge, I however feel great and don't even really 'feel' pregnant. I continue to do my normal daily activities (measuring the equivalent of 54 weeks pregnant).

The next day was my appointment. I did not sleep well that night and was very anxious about what my doctor would say. I was very upset and so I brought my husband along for support. My doctor sat down with me and very compassionately told me my 38 week identical twin pregnancy was like a 43+ week singleton pregnancy and as the risks increase, her comfort with letting the pregnancy carry on is dwindling. She also clearly tells me it is entirely my choice and as long as babies are doing fine, she is happy to work with my wishes. I apologized for being the client to put so much pressure on her as I know there are people around her who are are not supportive of my birth wishes and I can't help but feel horrible about the extra stress I am creating for her. I am positive my doctor has fought for my desires and am pretty sure she has been given a really hard time for not strong arming me to protocol so for that and a few other reasons, I agree to having my membranes swept to try and encourage babies out. We booked an ultrasound for about 48 hours later to check on babies if I am still pregnant then...

At the ultrasound it was determined that baby B was now larger than A and had turned breech. Both babies were looking great and my doctor came to meet me after my appointment to discuss next steps. She made it clear she would like to induce but that the ball was in my court. I decided another sweep would be a reasonable compromise for us both and booked an appointment for 3 days later as I did not want the babies to come that weekend since she was away. I was praying to be able to have these babies on a schedule that would work for her. I knew I needed her at the birth to get the support from the hospital and I had become very attached to her way of working so compassionately with me and not scaring me into submitting to her wishes. At this point I couldn't even imagine working with another OB.

With timing being what it is as my doctor was away, I of course nested... I was panicked that the babies were coming as she was gone. Thankfully the nesting was short lived and it never turned into anything so I went in for a second sweep after that weekend. This time she was no where near as gentle... I could tell she wanted these babies out. I was now 39 weeks and I have a feeling the pressure was on behind the scenes that she would 'let' me go this far with identical twins which are almost always out or taken before 37 weeks. I couldn't believe I was pregnant either as these babies moved from being possible Aquarians to likely Pieces and now Aries. No one thought this pregnancy would go on this long! My doctor asked that I would have an ultrasound again at my 39.5 week appointment to which I agreed to an in-office one to quickly check fluid levels. Baby B was back head down and she was happy to offer induction at any time. I declined as per usual and she respectfully accepted after booking another ultrasound for 6 days later as we were at a point where we were having to monitor the babies very closely due to them being considered far post dates at a 46 week equivalent.

Since my aunt was here from out of town, we decided to get steaks and have a nice dinner. (last time she was visiting and our daughter was “over due” we had just sat down for steak and ended up rushing to the birth centre so we figured we should try that again). I had put the steaks on the BBQ and was bending over to get our dogs their supper and pop, my water broke. My water had never broken before steady contractions in past so I was unsure how this would play out. It was about 5:30 and I called my midwife to let her know. She said to come in once contractions were steady and so I waited, wondering how long it would be. Brian suggested we go in right then but nothing was happening so I said we should wait. Oh how I wish I would have listened to him... My midwife called my doctor and told her my water broke so my doctor used her influence to hold the room I wanted with the labour tub. I was so thankful to her and could not be more blessed by her going so far above and beyond for my birth. My midwife then headed to a meeting she had for around 6:30 and I watched everyone eat steak (yet again) as I was not in the mood. By 6pm I was getting strong contractions and they were very close so we were in the car and on the way to the hospital by 6:10. It was an hour drive and by ½ way there I knew it would be the longest hour of my life (although it was a little less as the speedometer was above 160 the entire drive). Hard contractions were now 2 minutes apart and my midwife was on the phone to me the whole drive into the hospital telling me I could do this and to NOT push! Within 15 minutes of the hospital I had the overwhelming need to push. It was all I could do to keep this baby in. Each contraction pushed baby further down and I was having a VERY hard time not giving into my body. I fought and fought and we finally arrived at the hospital where my doctor, midwife and a nurse were waiting for us outside with a wheelchair. My husband was permitted to park at the emerge door while they wheeled me up to the room – I was SO ready to get into that tub... but my doctor and midwife had other plans; they wanted to get the heart rates of the babies and the tub wasn't filled yet. AHHH, PANIC! I needed in that tub an hour ago! Here I am stuck being monitored with baby not cooperating so I finally said half jokingly, half assertively that they could check the baby's heart rate AFTER it was out. The tub now had a few inches of water in it and I happily jumped in... the tub was so much better than I pictured it as I was told it was so small and with my size I may not even fit. That was not the case at all; I was SO thankful to be in there! Once in the tub my thoughtful midwife provided me a cool cloth for my forehead and I was able to relax for the first time in almost two hours. Approximately 20 minutes later, Baby A was caught by my midwife and placed on my chest. I was very excited to look down and see a boy! He looked nothing like either of our other children and I was surprised to see that as they had looked so much alike. His cord pulsed for a really long time while he laid on me in the warm water. We knew to now expect another boy.

After about ½ an hour I felt I may have more contractions coming on so we had an ultrasound to see baby B's position. He had turned breech from just a few hours ago. Since I knew a breech water birth wasn't an option and I wanted to be in the tub I asked my doctor if we could turn baby vertex. I wasn't sure if she would let me back in the tub since hospital policy did not allow water births. I had been very careful to not share baby was coming so I could have at least one water birth. My doctor told me I would have to get out of the tub but before I did, I decided to ask last minute if we could leave the babies and cords uncut until the placenta was out. I had signed a 3 page waiver regarding delayed cord clamping and all my other non traditional requests at a previous appointment however I never made mention of the cord clamping being this delayed. She accepted my new request and so I utilized everyone's help to get out of the tub and onto the bed with baby A still attached to me. We decided to use external pressure to get baby B head down so my doctor moved him gently with her hands. His heart rate started to fluctuate and I was advised to have my water broken to get things moving quicker and ensure he stayed head down. I was ready to meet him, so I agreed and my doctor broke my water. Everyone was shocked how much fluid there was – I guess that is why he was able to move so freely!

Contractions started fairly soon after that and I was told his heart rate was iffy. After a few minutes my doctor said very seriously and firmly that she was very concerned about this and that I really needed to get him out. I had a couple more contractions and pushed very lightly until she finally said to me: “Sera, I would not pressure you at all unless I was really concerned, you know that.” I shook my head in agreement. She said, “You have one more contraction to get him out or we are going to have to use the vacuum.” A whole bunch of people filed in the room including a man. I said to get them and him out of there, what were they doing in here? (apparently my doctor told me the NICU team was coming in from waiting outside - at her request they were asked to not come into the room at all unless needed – I appreciated that!) I somehow did not hear her telling me they would now be coming in and was surprised by their appearance when I pulled the cloth off my eyes. My midwife took notice of my demeanour immediately and asked them to close the curtain for my privacy. I am so thankful for such intuition from her. At this point I realized my doctor was very serious and so I covered my eyes again and I prayed out loud. I prayed for a strong contraction and I prayed for strength to push. I continued to pray while I was reassured from my midwife that I had the strength to do this. It was like everyone disappeared and I begged God for help. My next contraction came and I pushed with all my freshly replenished energy. We went from showing no head at all to having a whole baby caught by my midwife and again placed on my chest.

The male paediatric specialist now came over and introduced himself (boy was I embarrassed for freaking out on everyone!). He looked over the baby on my chest and was very happy with his condition so he and his team left the room. I looked down at this baby who looked nothing like his brother. He was much fuller in the face and seemed totally different. I was so thankful at this point that both of our boys were here at last and perfectly healthy!

Both boys were still attached to the placenta at this point and it was now time for the final birth. I wanted confirmation that they were identical so I asked my doctor to look over the placenta to see if the placenta fused as I was surprised identical twins could look so non identical! She looked it over and confirmed the blood vessels crossed over the membranes and thus they were indeed identical. We took a picture of the boys still attached to their placenta after my midwife made heart shapes in their umbilical cords and then my husband cut the cords. We are both so very thrilled with our new additions!

My nurse confirmed I was not hemorrhaging and checked my vitals. The blood pressure cuff was causing my veins to pop out of my skin – it was so painful and my midwife again advocated for me, advising that my nurse could leave as she would finish up with me. I had no tearing or bleeding issues and felt no need for any drugs so I declined the oxytocin that was expected I would have – I said I would breastfeed instead.

I then got up and thanked my doctor for allowing me the birth I wanted. It went about 60% of the way I had envisioned but it was 100% perfect. I have never felt so overwhelmed by the selflessness and kindness of a doctor before. I know how much she went out of her way for this birth and I am in such awe of her courage and compassion. She left very shortly after the births and I was sad to say goodbye.

We got some pictures with my midwife and nurses and I had wished I thought about pictures before my doctor had left.

It was now just my husband, our midwife, me and the boys. The boys were Isaiah: born at 1929 weighing 7lb, 9oz and 19 3/4” and Elijah born at 2025 weighing 7lb, 13oz and 21”.

I nursed the boys then my husband and midwife dressed them while I got dressed. I then wrapped both babies on my chest in a carrier and we all walked down the hallway to the exit.

It was like walking down the green mile! Upon passing the nurses station everyone was staring at us. I don't think anyone who just had twins a couple hours ago has ever walked out of there! We said thank you again to our nurses and walked out to the car to buckle babies into their seats for the drive home. My midwife gave me some arnica to help with the afterpains and made arrangements to visit us at home the next day. We were in the hospital less than 5 hours, it was fantastic!

My husband and I drove home with the boys talking about what a fantastic blessing we had been given with such an amazing birth, mostly due to the compassion of our amazing midwife who stuck with us through this pregnancy and delivery as a total gift since she had transferred my care almost 20 weeks earlier and our doctor who had so much care and concern for me that she went well out of her way to make this birth extra special. We are in awe of both of their selflessness and compassion as well as the two very healthy boys we have just added to or family. God and these amazing ladies have made this amazing day one which we will be blessed by forever!

Thank you Sera for sharing your positive hospital birth experience with us all!

Thursday, February 21, 2013

Interview: Breech Twins Homebirth w Video

I have a guest interview from Parenting Multiples community member Melissa Watson. Melissa shared her incredible birth video of her home water birth of twins Noah & Liam. Both unexpected breechlings. This is an unusual birth for twins in our culture so I thought I'd take the time and interview Melissa about her experience and the choices she made.

Disclaimer: Every mama with the help of her care provider must decide what is the best birth for her. For Melissa it was the help of an OB & midwife through her pregnancy and a homebirth with midwives and a doula present. This video is graphic and not workplace appropriate unless you work somewhere where your boss is awesome and perhaps a birth junkie!

1) Please introduce yourself, where are you from, tell us about your family (how many kids, etc).

My name is Melissa I was 29 when I conceived(30 at birth) husband John 28 (his first children). I am from omaha, ne John from Roanoke, VA. We married after first ultrasound (dated 4 yrs). Noah and Liam were babies 4 & 5. Older brother Aiden 7, sister Madison 6, Makenzie 4. First 3 children were planned natural hospital birth however were vaginal but augmented with pitocin and medicated epidurals in transition (all after 8cm) due to lack of support and encouragement from hospital and CNM and my natural fears that I now know is a normal part of transition with proper support a natural/unmedicated birth is wonderful.

2) What pregnancy symptoms were you experiencing that made you take a pregnancy test?

I took pregnancy test 4 days before my expected period I had tender breasts a little more than normal but mainly I took test bc I had a strange feeling I should (motherly instinct). 1st test had 1 vertical line but not the horizontal line to make a + so I immediately retested with digital test that was instantly positive. (I had a copper IUD in place at this time) confirmed with blood test at hospital at 5wks pregnant. My IUD was removed at this time. 

3) When did you have your first ultrasound, what did you discover and how did you feel about it?

First "dating" ultrasound preformed at 6.3 weeks. I went alone hubby was out of town for work. I expected a normal u/s although motherly instincts kicked in night before appointment and I found myself "googling" possibility of multiples with pregnancy with IUD. To this day I have no idea why I searched this other than instinct. The u/s revealed 3 beating heart all dating within weeks of 6.1 & 6.3wks 2 babies in 1 sac 1 baby in another sac and 1 undeveloped baby in another sac. I was expecting TRIPLETS! I was scared excited and in shock my response was oh my god are you kidding me? I cried all the way down to my midwife appointment where they were equally in shock. The immediately deemed me high risk (multiples) denied me care and a follow up call was made by the perinatalologist in the practice. I was even more confused on what to do or not do and what to expect. I was simply sent home to wait.

4) Why did you choose the care providers you did during your pregnancy?

I saw the perinatalologist around 11wks and was shocked to see only 2 babies in 2 sacs but fused. No bleeding no cramps no symptoms. I was told identicals sometimes reabsorb without symtoms. I didn't feel comfortable or reassured by this Dr so I searched for a natural minded dr or mw that would care for us and treat me as low risk. I saw a family care doc and a lay midwife throughout pregnancy to keep all options open. The dr's appointments were stressful and not reassuring I was facing a csection all though I was told a trial of labor would be "allowed" if both babies were head down although talk of a breech extraction of B was brought up my research and instincts said home birth was best

5) What did you dislike and enjoy the most about being pregnant with multiples?

I enjoyed watching my belly grow quickly and feeling my babies move. Other than morning sickness the first 3m and heartburn throughout it was easy.

6) At what point did you decide you wanted to have a homebirth? Did you have support about this choice from your family? friends? medical providers?

I had friends that had used this midwife with singletons at home. She has a great reputation and a lot of knowledge. I had always researched and wanted a home birth but wasn't in contact with the "natural community" until this pregnancy. My husband was nervous but we agreed to go through pregnancy keeping both hospital and home as options as long as checkups and my instincts supported home birth this was our first choice. I had zero family support I reached out to the natural community and found other moms through social media, support groups, and references through my midwife of other twin moms that had home births or planning them. The backup family practice Dr said it was our choice but did use scare tactics and bullying to get us to NOT have a hb but admitted if legal he would attend our home birth and medically the babies and myself were perfect.

7) What resources did you use to make this decision (books, movies, research, community groups, etc)?

Resources stated above also documentaries like "The Business of Being Born", Pregnant in America and videos on YouTube of moms of multiples having natural birth. My midwife was the best resource I could have had.

8) Did you know your babies were breech? Would it of affected your decision either way?

Throughout my pregnancy I had u/s that showed B breech most times so I prepared for B to be born breech bc he seems to like it that way. Baby A was always shown head down. When labor started it was difficult so say so we were unsure of his position and we still felt very comfortable and safe staying home. My midwife was comfortable and confident with breech births so no it didn't change our minds. 

9) What was the most rewarding part about your babies' birth (other than meeting them :D )?

Most rewarding was that I did it! We did it! Everyone was safe and healthy and we knew we made the best choice for us! Regardless of people who thought otherwise.

10) What would you change if you could?

I would have kept all kids home from school during the entire labor and birth. The older 2 went to school just as I entered the tub. My 4 year old present entire time and helpful. She is the closest sibling to her brothers I believe it was bc she played a part in the process.

11) What did you learn from your birth experience and how would you like it to effect other women expecting multiples?

I learned fear causes pain. Also that are bodies are meant to deliver without intervention it is natural it is safe and it can be painless and rewarding in many ways even with multiples. I share my story as inspiration for other moms who would like a natural/vaginal birth no matter what kind of birth they strive for it can be done. Ask questions believe in yourself and your babies and don't be scared to say no and do what you feel is best for you and your babies. Knowledge and confidence is power!!

12) What are your hopes and dreams for your little men as they grow up?

I hope my boys grow up knowing we were strong and always wanted the best for them. Also to be strong supportive men (husbands) and believe in birth. Overall to be great positive people and always follow their hearts.

Thank you Melissa for having the grace and courage to share your journey. :)

Saturday, February 2, 2013

The New Era of Parenting Multiples

Its a new year and I have been reflecting on the growth of the Parenting Multiples facebook community. When I started PM in October 2011 I didn't expect much from it. I was just coming out of the shadows of postpartum depression and feeling disconnected from the multiples world. I needed to connect with some other parents and start bonding with my babies with the help of community. The group was slow to grow at first, crawling from 11 members to about 100 where it hovered for many months. I was content with 100 members, the page was a pleasant hobby for me and gave me a sense of purpose. Well today that community has grown to over 1,100 members! And is very active with between 450 - 800 members communicating on it each week.

Which brings me to a new conundrum. This page has outgrown me, its so successful I'm unable to keep up with comments, questions, and posts. I am now a healthy, well connected mother of twins, the page has completely filled my personal reasons for creating it. I was toying with the idea of shutting it down, but I often get messages in my inbox from parents sharing their struggles or celebrations with me. Parents thankful that PM exists. It warms my heart and my passion for PM has grown with each additional parent, grandparent, godparent, friend, twin, triplet, who've clicked the "like" button. Each seeking to ask questions and share their woes and joys, advice and photos. Each looking for community. PM has changed my parenting style, my life, my career, and ultimately filled my heart to overflowing. And I hope that it continues to do the same for every person who scrolls through the wall each day.

So that brings me to an exciting announcement! I have added a new admin to the page. In order to keep the "doors" to Parenting Multiples open I need some help. Triplet mama Bridget Ilardo Williams has always been an encouraging presence in the PM community and I'm excited to partner up with her.. Please join me in welcoming her:
1) Introduce yourself and where are you from?
My name is Bridget Williams, and I am from Buffalo. NY.
2) Tell us about your multiples, how many, what age, etc.? Do you have other children as well?
On Nov 5, 2009 I was blessed to bring 3 healthy babies into the world. Their names are Zaria Rose, Ezra Charles, and Eli Gabriel. They are my only children, however, I would love to have one more.
3) Whats your favourite part in being a mom to multiples?
Favorite part - Of course all the extra hugs and kisses. :) Also watching them play together and interact, bonding in the special way that multiples do.
4) Whats the most challenging part for you right now?
The most challenging part right now, is if they are tried, sick, or just cranky for whatever reason, and all needing me at once.
5) How do you keep sane?
One thing that helps keep me sane, is realizing that they will not be little forever, and I might as well enjoy whatever stage we are in at the moment. If we do happen to have a rough day though, sometimes I will leave to go shopping for an hour or two when hubby gets home. It helps so much to step away from the situation for a bit, and I almost always come back feeling much better. :)
6) What do you enjoy most about being a member of the Parenting Multiple's community?
I think my favorite part might be seeing all the adorable pictures! There is just something extra specially cute about multiples, not that I am biased at all or anything. ;)
7) What are you looking forward to as an admin to this page?
I am looking forward to more interaction with the community members, offering encouragement and advice whenever it is needed.

New admin Bridget Williams, her husband Jeff, and their 3yr old fraternal triplets, Zaria, Ezra, & Eli