Original recipe from: Mother Rising
I know these are uncertain times. I understand anxiety and depression have increased because of the unknown and the fear. I am so sorry you are going through this. Please reach out if there is anyway I can help, including just listening.
Here is some updated research from the awesome Rebecca of Evidence Based Birth.
Research Update from Monday, March 16:
This is information is from Evidence Based Birth - to visit their resource page, click here.
Guest Blog by: Sarah H.
When I got pregnant at age 27, I had been married for almost 5 years, completed my graduate degree, was working towards a license in Marriage and Family Therapy, and had a great internship working in private practice. I attended church regularly and believed in God and his promises with all my heart. Of course I’d experienced challenges, hardships, and difficult times, but I’d always come out on the other side doing just fine. As most of my life had gone pretty much according to my plan, I naturally I assumed my pregnancy and birth would be the same: pretty uneventful, ordinary, and easy. I could not have been more wrong, and though I didn’t know it my faith and relationship with God were about to be radically tested.
Things started out great. My husband and I went to my first appointment with my obstetrician and heard the baby’s heartbeat. It was amazing, and all that I hoped that moment would be. There in the doctor’s office, we stared at the screen, holding hands, and I remember feeling excited and a little bit scared. After all, I’d never done this before. I was comforted by the fact that the baby looked totally healthy. So when they sent me to a specialist at 12 weeks along to consult on whether I’d need to talk about changing the medication I was on for epilepsy for the safety of the baby, I naturally assumed they would tell me “Yes” or “No”, either change or not change my medication, and send me on my way. I had no idea how much our lives were about to change or how much chaos was about to shatter my beautiful image of my pregnancy and birth.
As I lay there on the table at the perinatologist’s office, my husband by my side, I made polite small talk with the ultrasound technician. As she located what she was looking for on the screen, she said, “Ok, well, they both look really good.” What? I assumed I’d heard her wrong or that she was playing some (really unfunny) practical joke on us. “Excuse me?” I asked. She glanced at me, appearing confused, and ventured, “You know you’re having two, right?” I stared at her, dumbfounded. No, I wanted to say. My OB must have missed that! I’m not sure what either of us actually said after that point. The doctor came in, and I remember snippets of our conversation—words mostly—that stuck out to me. Words like “monochorionic diamniotic”, “identical twins”, “high risk”, “Twin to Twin Transfusion Syndrome”, and “frequent monitoring.”
Even in the face of all this new information, I wasn’t terribly scared. Shocked and overwhelmed, yes. Scared, no. In fact, as we went through the process of telling our friends and family, I was all smiles, excited by the future and all we had to look forward to. After all, we were getting two babies! I ignored the lingering anxiety that the doctor’s words had provoked and though I followed his plan for the pregnancy, I focused only on the fun stuff. So when I went to his office for a routine appointment at 23 weeks, I was not prepared for what happened next…
After reviewing my ultrasound, Dr. Kurtzman told me that one of my boys had way too much amniotic fluid and the other one not enough, and that this was a sign of Stage 1 Twin to Twin Transfusion Syndrome (which essentially means that one twin takes nutrients and amniotic fluid from the other, usually resulting in the death of both if not treated). Though it hadn’t progressed to Stage 2, it could do so quickly a. Needless to say, I was speechless. And because this was supposed to be a routine appointment, I was totally alone. I was told I’d need to meet with a fetal surgeon the next day. As I absorbed it all, the weight of our situation finally hit me. The pregnancy and delivery I’d imagined were gone. Walking into the lobby, dazed, confused, and in shock, I started to cry. I could barely form words as I called my husband to tell him the news.
The next day, my husband, my Mom, and I traveled to Pasadena to meet with Dr. Chmait, the fetal surgeon. He did some scans and became very quiet as he surveyed the images. He excused himself to study them further, and a short time later, the three of us sat down with him in his office. He calmly explained that the baby who was getting too much fluid and blood (the recipient) was in heart failure and that the TTTS had skipped Stage 2 and jumped straight to Stage 3. He gave me a list of options, one of which was terminating the pregnancy. Unable to speak, I shook my head and my husband spoke for us both: “That’s not an option. Which is the option that gives both babies the best chance?” Dr. Chmait confirmed that the only option that gave both babies anything resembling a fighting chance was a laser ablation surgery, where they would insert a probe into my uterus to sever blood vessels on the placenta. My babies would be lucky to make it into this world at all, but knowing that surgery was the only viable option, we pushed ahead with it. We would have to act immediately if either of them were to be saved.
I wish I could adequately describe the terror, anxiety, anger, and frustration I felt that night as I awaited surgery the next day. I couldn’t help but think that my babies were dying inside me and I was powerless to stop it. I sobbed, I stared into space, I tried to sleep to no avail. I spoke to no one except my husband, who was filling our family and friends in for me. I could barely wrap my head around it myself, let alone explain it to someone else.
It all culminated in the surgery the next morning. I was awake but sedated, and I watched on the screen as the doctor moved the probe with a camera around inside my uterus. And then there were my unborn babies, on the screen in front of me. It was breathtaking and I couldn’t hold back tears. Just hold on a little longer, babies, I thought. And lo and behold, they did. The surgery was a huge success. The TTTS was not completely reversed, but it stayed stable as we played the waiting game. At home and on bedrest for the rest of my pregnancy, I felt as though I held my breath for months, praying that I’d make it to a reasonable delivery date for the health of both my babies. I found out later that Dr. Chmait wasn’t even supposed to have an opening the day of the surgery, and that he’d worked us in last minute. I was told after the fact that had the surgery happened mere hours later, I would have lost them both.
I have never, in my entire life, been as scared, confused, and angry as I was the night before surgery. It didn’t make any sense to me that God would allow suffering in two tiny babies that hadn’t even been born yet. What kind of God would allow that? It shook my faith to its core. To be honest, I’m not sure that I can even answer that question today. But I still believe with all my heart that things happen for a reason, even if I have no idea what that reason is. Maybe it was to strengthen my own faith. Maybe it was to show me just how powerful of a tool prayer can be. I may never know, but I thank God every day for my two precious, miracle boys.
And though it wasn’t the birth I’d imagined and our boys were born with other complications that made their first few months really hard, my c-section was a beautiful moment. Again I cried, not from fear, but because I had a front row seat as these two beautiful little lives came into this world. I didn’t get to make many choices about my birth experience. Most of it was entirely up to God, and I’ve never been forced to relinquish control like that before. Nothing about my pregnancy was conventional or normal, and yet I felt like a warrior who had come through battle and won. I’ll never, ever forget it.
As of June 16, 2018 my family and I have moved to Portland, OR! This move was unexpected of sorts. My husband decided to find a new job around November 2017 but we never imaged it would lead us to Portland. My husband got a job at Oregon Episcopal School as their Middle School Band Teacher. We are very excited to be in Portland and discover all Portland has to offer! We are looking for recommendations on hikes (appropriate for toddler children), the best Farmers Markets and your favorite restaurants. Give us your favorites in the comments! And, if you know of a pregnant person in the Portland area (I'm in Raleigh Hills), feel free to give them my information! Thank you!
Photo credit: www.appleblossomfamilies.com
The umbilical cord has connected the baby to the placenta for the last 9 months. It has helped to provide the baby with everything the baby needs. Even after birth the umbilical cord and placenta continue to provide blood, stem cells and T cells to the baby through their connection.
Cord burning, instead of cutting the cord, can be a gentle and respectful way to sever the bonds between the placenta, umbilical cord and baby. It can also be a safe and sanitary way for people without access to sterile scissors. Traditionally it is a beautiful and usually spiritual ceremony that honors the role of the placenta and umbilical cord to the baby and gently and slowly servers the connection between the three.
Research shows that delayed cord clamping/cutting has many positive benefits (even for premature babies). Delaying even 3 minutes has a great impact on the baby, specifically their iron levels. ACOG now recommends delayed cord clamping and cutting. Cord burning can be a gentle and effective way to delay cord clamping.
What You Will Need:
If you would like to read a birth story that includes a cord burning ceremony - click here
Link for cord burning box set: Moontide Midwifery Shop (*I am not affiliated with this shop.)
Picture on the right: photo credit to Oxytocin Space
Cool Facts About the Umbilical Cord:
Sources Cited & Resources:
- Placenta the Forgotten Chakra by Robin Lim (buy it on Amazon here)
- American College of Obstetrics and Gynecologists: delayed cord clamping recommendations
- PDF: Umbilical cord clamping is not a physiological necessity: Hutchon 2010, BJM April 2010, Vol 18, No. 4.
- Research: Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomized controlled trial
- Research Review: Late versus early clamping of the umbilical cord in full ter neonates
- World Health Organization: Recommendations on delayed cord clamping
- Research: Stem cells in the umbilical cord
- Scientific Impact Paper: Clamping of the umbilical cord and placental transfusion
- Birth Takes a Village: more information on cord burning
Homemade Energy Bites - for pregnancy and postpartum.
Aren't they lovely and tasty looking? :) I whipped up a batch today to take to a friend who recently had a baby. I found the recipe while looking for postpartum meals. These would also be great to make up for pregnancy and for those middle of the night breast feeding or pumping sessions. The recipe would double and triple quite well as long as you had a large enough bowl. Make up a bunch for pregnancy and beyond!
I found the recipe on moneysavingmom website and tweaked it. The following is what I did (I will also post the original recipe at the end).
2 cups oatmeal
1 heaping cup peanut butter
1/3 heaping cup honey
1 1/4 cups coconut flakes
1/2 cup raw sunflower seeds
1/4 cup chia seeds
1 cup ground flaxseed
2 teaspoons maple syrup
1 teaspoon cinnamon
2 teaspoons vanilla
Mix all ingredients together. Roll into balls. (I found this harder to do than it should have been! :)
To freeze: Place energy bites on a cookie sheet and freeze for one to two hours. Remove from cookie sheet and place in an airtight container.
To serve: Remove desired number of energy bites and thaw at room temperature for 15 to 30 minutes. Can also warm for 30 seconds or so in the microwave. Or, just eat straight out of the freezer.
Original recipe here
What is the difference between midwives and doulas? This is the second most common question I get asked (the first being “You are a what?? What is that??). The simple answer is: medical - a midwife does the medical side of birth, a doula does not.
A midwife is a medical professional. Most midwives have extensive medical training. A certified nurse midwife (CNM), for example, has a nursing degree (and passed all those nursing exams) and then went on to midwifery school – more training, more testing/exams, more learning and best of all: catching babies! You can have a midwife as your healthcare provider instead of an OB/GYN. A midwife has a model of care that is different than an OB/GYN (that is another blog post!), which focuses on the mama and baby and has a more holistic approach. It generally means less medical interventions and more time spent with each laboring woman.
Midwives are on-call for your birth. They are also who you can see for all your prenatal appointments. There are birth center, home and hospital midwives. Midwives come once you are in active labor (for the most part) and work to stay with you until an hour or two after your baby is born (sometimes more, sometimes less). Hospital midwives might have multiple laboring mamas and have to spread their time between them (that sometimes happens to birth center and home birth midwives as well). A midwife is usually with you before they “catch” your baby, and they spend time coaching and supporting laboring women. They also help with breastfeeding and postpartum care. Midwives are wonderful people and health care providers. I highly recommend them!
A doula does not do any medical care or support. A doula provides emotional, physical and informational support. A doula is on-call 24/7. A doula discusses your fears, hopes, dreams, concerns, questions with you at length. A doula is with you from the beginning. A doula is there holding your leg during labor, doing hip squeezes, helping you stay cool by fanning you for hours on end, massaging your legs, your neck, your arms or back. A doula is there supporting your partner with food, emotional support and giving ideas/tips so your partner can support you better. A doula holds the partner when he is crying in the corner because his wife lost a lot of blood, and now everyone is okay and he can’t be strong any longer. A doula spends hours on her knees supporting you while you labor in the tub. A doula gives massages to your family who has been with you for the last 30 hours. A doula helps you write a cohesive and clear birth map. A doula empowers you. A doula encourages you. A doula holds your hand. A doula holds space for you. A doula watches as you find your inner strength and beauty and roar your baby out. A doula cries with you while you hold your baby in your arms for the first time. A doula takes pictures of the emerging baby, the new family, the support team. A doula is there, present, the whole time. A doula doesn’t have other laboring women that she has to spread her time between (normally – that is what back-ups Doulas are for!). A doula is there to focus on you as long as you need her, in whatever way you need her.
A doula works with the partner. A doula works with a midwife. A doula works with nurses. A doula works with an OB/GYN. A doula works with the family of the laboring woman –the mother who is a retired L&D nurse, or the mother-in-law who has only had c-section births, the dad who is so strong and silent in his support, the sister who laughs and supports, the cousins who just want to see the baby. A doula also protects the laboring woman and her birth space. A doula turns the lights low, shuts the door to keep the noise down, whispers, murmurs words of affirmation, silently holds a hand, rubs a shoulder or moans with the laboring woman as she moves her baby down. A doula does not tower over the laboring woman, instead a doula is always down on her level or lower.
A doula (usually) has also had extensive training and if they are a certified Doula (like I am), they have also met the extensive qualifications and passed the certification process through a trusted organization. Doulas aren’t usually nurses (although some eventually go that route). Doulas can be a doula anywhere - hospital, home or birth center. There are doulas that work only in one place or the other, and their are hospital-based doula programs. Most doulas, however, are independent and work with clients in all situations and from all walks of life. Doulas support you through whatever labor/birth choices you make and experience. A doula can support a woman under going a c-section, having a vaginal birth, requesting medication or going for an un-medicated birth. A doula supports all woman and all birth experiences.
Doulas provide benefits for all families. According to a 2013 Cochrane Database Systematic Review, “continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth.” (read full article here).
As one of my clients said to me “my husband is my right hand and my doula is my left”
More on Doulas from the web:
DONA – What is a Doula? https://www.dona.org/what-is-a-doula
DONA – Benefits of a Doula: https://www.dona.org/what-is-a-doula/benefits-of-a-doula
Why Pregnant Women Love Doulas: https://www.bellybelly.com.au/pregnancy/doulas-what-is-a-doula
Nursing School - Difference between Midwives and Doulas: http://www.allnursingschools.com/articles/doula
Breast milk! It really is liquid gold and you want to take the best care of it that you can. We all know the phrase "no one cries over spilt milk" was never created by a mama! I have cried over spilled breast milk every time.
I have used the Medela Pump in Style and the Spectra. I used the Medela with my first (pumped and breast fed) and the Spectra with my second (I am exclusively pumping). The Spectra is by far the better of the two. It doesn't pull, it gentle suckles. It has numerous settings and choices for how it is suckling and how hard. It is quiet! Multiple people have commented on how quiet it is. I get more milk from the Spectra (had to use the medela for a weekend when I forgot my Spectra). I also don't feel like a cow! (Can I get an amen!?) The spectra is less expensive. Both should be covered through your insurance. Make sure you call and get directions on how to get a free pump! Some companies make you buy the pump and then reimburse you and some companies will purchase it for you from the beginning. Also, most insurance plans will cover a new pump with every baby! (Never hurts to have a back-up!)
To get the most out of your pumping time, it helps to use moist heat on your breasts and to massage your breasts. This article talks all about breast massage to increase pump supply- it is an easy "trick" and helps every time! Also, make sure you are relaxed and drink lots of water! If you are dehydrated your milk supply will drop. Here is another article with a bunch of pumping tips, including find a great pump, know your pumping rights and look at your baby or photos of your baby at the beginning of your pumping session. Get those oxytocin hormones working! :) This article is geared towards exclusively pumping mamas and goes into more of the science behind breast milk production. And lastly, an ode to all you mamas who are exclusively pumping.
For mamas who are planning on going back to work and are pumping at work, check out this article from balanced breastfeeding. Lots of good information and tips.
If you are going to pump exclusively, or at work, you will want to buy a pumping bra! Believe me, it makes it so much easier to pump when you have a bra to hold everything in place so you have your hands free to read, look at your phone, or type on the computer (I've done it all, including driving while pumping, working on my computer while pumping and holding my babies while pumping.). You can find one online at Amazon here. There are various styles to chose from.
Breast milk Bags:
I have used numerous brands of breast milk storage bags. Most of them are the same. They freeze fine, they store great and are easy to write on (I use a sharpie). I hated
I really like Nuk and Lansinoh brands. They can be found at most places and online. They seem to have the thickest bags that hold up the best in the freezer. They do not leek and they seal easily. They are easy to pour from and usually don't spill everywhere (you do have to be careful though).
I did not like the Avent or Medela brand. They are thin. They have a really long pour spout which does not tear evenly (you tear it to open to put the breast milk in) and so it was always a mess to pour. The medela brand tore all the time after it was frozen. I lost so much milk. It is too thin.
I have found that people who use bottles are usually very particular about the bottles they use. Babies are also known to be picky about the bottles they like. I currently use three different brands in my house, have researched bottles for hours and talked to lots of mama friends. I recommend you buy one bottle at a time until you find the one you love and your child loves. It is also depend on the age of your child, if they are colic-y and if they are using bottles and breast feeding.
Munchkin Latch are the closest to breast and nipples that I have found. They move around like a breast, they release more milk if a baby pushes against the nipple of the bottle and they have the availability for lots of movement/give. They also have an anti-colic valve. They are on the more expensive side. They only come in one size (8 ounces). They do not have any designs or colors. We like these bottles the best. They took some getting use to. My husband had a harder time getting use to using them with our son than I did. Our son also loves them. I think they are definitely worth the extra investment. (*site note- I have found that putting them in the dishwasher can cause them to leak out the bottom for a while. I just hand wash them - with a bottle brush - and they do not leak from the bottom anti-colic valve) You can find them in stores - Target and Fred Meyer and online - Amazon and Diapers.com. I would recommend these bottles if your child is breast feeding some times and using a bottle some times.
We also use, and have lots of friends who happily use, Dr. Brown bottles. Dr. Brown bottles come in varying sizes, shapes and materials-glass and plastic. They are one of the only bottle companies that make glass bottles. Dr. Brown's are known for their anti-colic piece inside the bottle. You do have to put it in and take it out. You can use them without the anti-colic piece. They are min-price I would say. The glass are more expensive. They do not have designs or multiple colors. They can be found at most stores including Target, Wal-Mart, Fred Meyer and online.
We also use Nuk orthopedic bottles. We started using these when our oldest had to switch to formula at 10 months. They are not a fancy bottle. They come in numerous designs and colors and are pretty inexpensive. They can be found at most stores including Target, Wal-Mart, Fred Meyer and online. Nuk also makes toddler cups and transition bottles/cups.
American College of Obstetricians and Gynecologist (ACOG) Names Doula Support as Associated with Improved Outcomes for Women in Labor
Doulas have been helping woman in preparing for labor, birth/labor journey and postpartum for hundreds of years. They might not have had the title "Doula" but women have been helping, supporting and encouraging other women since the beginning. Science is now behind the awesome benefits of labor support and Doulas!
The American College of Obstetricians and Gynecologist has once again endorsed improved maternal/fetal health outcomes for doula support in labor. The committee opinion report titled Approaches to Limit Intervention During Labor and Birth released this month highlights several factors that can lead to improved outcomes and higher patient satisfaction for women in labor. Additionally, the report was endorsed by The American College of Nurse–Midwives and the Association of Women’s Health, Obstetric and Neonatal Nurses.
The report states: Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor. Benefits found in randomized trials include shortened labor, decreased need for analgesia, fewer operative deliveries, and fewer reports of dissatisfaction with the experience of labor (1, 17). As summarized in a Cochrane evidence review, a woman who received continuous support was less likely to have a cesarean delivery (RR, 0.78; 95% CI, 0.67–0.91) or a newborn with a low 5-minute Apgar score (fixed-effect, RR, 0.69; 95% CI, 0.50–0.95) (1). Continuous support for a laboring woman that is provided by a nonmedical person also has a modest positive effect on shortening the duration of labor (mean difference –0.58 hours; 95% CI, –0.85 to –0.31) and improving the rate of spontaneous vaginal birth (RR, 1.08; 95% CI, 1.04–1.12) (1)
Also included in the report were recommendations on delaying hospital admission in the latent phase of labor, suggestions for using nonpharmacologic pain management techniques (for pain or fatigue in latent labor) including massage or water immersion, frequent position changes to enhance maternal comfort and optimal fetal position, as well as recommendations for hand-held Doppler devises for fetal monitoring in healthy labors.
This is great news and will hopefully speed things along in regards to insurance companies and public knowledge of Doulas. Doulas are a tool and are beneficial to all laboring women. Who is your Doula?
“A life well lived it usually messy”
That sentiment is on a kitchen towel my mother-in-love recently purchased for me. I love it. I feel it encompasses my life. J I’ve been thinking about it a lot recently. I went over to a friend’s house to borrow cookie sheets and she opened the door with “I’m a hot mess today!” I was just thinking she looked great (she got the “hot” part right) and was admiring her tree. My sister-in-love recently asked for prayer because she “was a mess” due to recent circumstances. And I’ve told my awesome husband that I feel like I am “a hot mess” (to borrow from my friend). I also heard a family member mention that if only she hadn’t fed her child so many preservatives (in food) when he was younger, he wouldn’t be this way.
I was devastated when I heard that. Being an outsider, I can see that this family member did their absolute best and the particular way this child is, and has been from birth, has nothing to do with preservatives and everything to do with genetics. Being an outsider, I also saw the beauty in my friends “hot mess” and was enjoying hanging out with her. Being an outsider I can see my friends and family are doing their absolute best with their children, family, and life. I enjoy watching their journey. But I get it. I feel the feelings they do. I say the same things they do. I put pressure on myself, blame myself, obsess over things…I’ve done it. You’ve probably done it. My friends and family do it. Why?
Is it society? Is it internal pressure? Is it something in our make-up gone array? Is it our children, our family, our partners? What makes us feel as though, as women, we need to apologize for the messiness of life? Life is messy! “A life well lived is usually (almost always) messy.” It’s a fact. It’s a joy. It’s a mess. J I don’t think we should apologize for it. I would say, 90% of the time, when my friends say “I’m so sorry my house is a mess…” I’ve been admiring it, I’ve been thinking it looks great, I’ve been enjoying their life. Most of the time, when I say to my husband in exasperation “our house is a disaster!,” it really means we spend 6 minutes picking up toys (& socks) and its clean again! (I can’t wait for our babies to reach the age where they can finally begin to pick up their own toys…although I’m not excited about the “fights” that I am sure will ensue around picking up their toys.)
I read a book recently and it had a story about “The Moms Club.” The rules are easy to understand but harder to follow. I also think everyone should follow them. One of the rules is “don’t judge other moms/families.” Another is “don’t clean your house before other mom club members come over.” I think both of these should just be rules of life. Don’t judge other moms/families. Haven’t we all been there? And, if people are coming over to hang out, eat dinner, etc, don’t spend hours cleaning your house. Sure, pick up the dirty clothes and wipe down your toilet, but otherwise? Don’t clean! We have toys on the floor at our house; your toys aren’t offensive. We have coats by our door, it is cold outside; your coats don’t offend us. Don’t succumb to the pressure to have a “perfect” house when people come over, especially other Moms.
And what is perfect anyway? My perfect includes toys on the floor, handprints on the walls and color pages on the table. Why? Because my husband and I struggled for 5 years to get pregnant, we had years where we believed we would never have children, I cried for months. Now, I cherish the things that remind me that we do have children, two miracle babies, who steal my heart every day. Their laughter erupts and my heart bursts with delight. Are there times I don’t want to be around them? Sure! I am human. I do need time to rejuvenate myself and my marriage. But I wouldn’t trade toys everywhere, hand prints on the walls, and food in the carpet for anything! My life is messy. I have children. I have an awesome husband. I have family and friends. I have feelings, needs, desires, dreams, fears, emotions. I have a life! I want to live a life well lived, mess and all. Who is with me?
So, to help myself, and anyone who wants to join me, in living a messy life and enjoying it I’ve come up with a couple ideas/goals:
Share your messy life stories below! I’d love to hear from you.
Doula Rachel has put together a blog of resources, info-graphics, and articles, with an occasional self-published blog. Enjoy!