Wednesday, December 27, 2006

A New Found Purpose

After floundering for several weeks with this blog, I've decided what I want to blog about. Once the birth was over and done, I had to find a new focus for this blog. That focus will be my book. I watched as an old aquaintance of mine published a beautiful book that I didn't even know he was intending to write. I want my book published, but first I have to complete it. This is my goal for the coming year. I know that I can do this, my life and purpose demand it. It will be a challenge with a new baby, but I can't let that be an excuse not to get it done. I will finish my book, publish it, and hopefully find fulfillment in where it leads.

Wednesday, December 20, 2006

A Shot in the Dark

I took Josiah for his first immunizations last week. I'm happy to report he is now 8lbs. and 14oz. Yipee! He has fat rosy cheeks and a kissable little bottom. It's nice to see him plumping up so nicely. I'm still supplementing him after every other feeding. I'm still hoping to get to the point of not having to supplement but for the time being, I want him to have what he needs. I always have anxiety about immunizations and last week was no different. The flea blogs have been brutal on the immunization issue lately ( I know that immunizations work to eradicate deadly disease (I only have to listen to my mother-in-law's stories about the iron lungs that were around when she was a pediatric nurse) but I also know there is some risk-small though it may be. I always approach it with some anxiety. Josiah was uncharacteristically cranky that day, but was fine the next. Whew! I don't believe the anti-vax folks propaganda that vaccines kill, but I also don't believe the medical establishment that says there is no risk. I risk out the ones I think my kids really don't need to have and cross my fingers as they get the rest. I wish there were a better way.

Monday, December 11, 2006

For unto us, a child is born

I just got these Christmas pics from my friend Rebecca and couldn't resist posting them. She took them at my husband's fancy hotel- we were there anyway for the annual employee party and Rebecca came and snapped a few shots in an empty party room (after hubby turned on the gas fireplace). Note the real live manger I stole from church (left over from last year's Christmas play). These will go out on our Christmas cards.

Wednesday, December 06, 2006

Milk Drunk

Milk drunk is the term I created to describe that look of pure ecstacy on a baby's face when they've fallen asleep satisfied from a good breast (or bottle) feeding. You know the look, eyes closed, slack-mouthed, with a dribble of milk clinging to one corner, a small contented sigh, perhaps even a quick upturned smile of the lips and then a return to post meal slumber. That's milk drunk. I love to see Josiah milk drunk- slurping at the breast one minute, milk drunk the next. Since some of his hair has rubbed away, his widow's peak is even more severe. He looks even more liked some wizened old man, toothless and bald. He's not as scrawny anymore but still small. He's not pretty yet there's something quite beautiful about him. His skin is flawless and fair. I took him yesterday to be photographed. I had a coupon for a free sitting at a fancy private photography studio. He was photographed on a big white furry bean bag with simple white tule wrapped around him. The whole thing had the appearance of 'swaddling clothes' or an angel floating on a cloud. The photos will be so cute and will be Christmas gifts for grandparents. How can I explain how much I love this baby? My life is devoted to his wellbeing. I don't want to be away from him. I can just sit and stare at him for hours. Perhaps I'm baby drunk!
We went to a Christmas party last night for our multi-racial family support group. My kids always love their events. The party was held at my friend Sarah's home, a huge turn of the century mansion in the city. My kids love her house, and so do I. The spaces are so generous the architecture so intricate. No space or structure is to obscure for the finest detail. I remarked to my kids that they still build large homes today, but there's not the same attention to detail. Anyway, I spent most of the party talking to a couple with a new baby. They were adoptive parents to a biracial baby named Iris. I could hardly take my eyes of her, she was so plump and beautiful. She was younger than Josiah but much bigger. I was so greedy to hear their stories about her and to laugh and smile with them as she cooed and yawned. I felt so happy for them to have her. It was clear they were over the moon about her. I thought, every baby should be like Josiah and Iris. Every baby should be so wanted and cherished.

Friday, December 01, 2006

Weight Update

A quick update on Josiah. He had gained weight at his last Ped check earlier this week. Not quite up to his 2 week weight but over 7 lbs. He is finally plumping up and looking meatier. His little cheeks (both sets) are nice and plump and he is robust and alert when awake. As for my milk supply, it is ever so slowly increasing. I still supplement after most feedings as I can tell he's not satisfied. I still take the domperidome and reglan, although my mother tells me that my cousin has some herbal stuff that's sure to help. I haven't talked to my cousin yet to find out what it is, but I'm curious. Nothing that I've taken has helped to the extent that I thought it would so I'm ready to try something new. Right now, we're all snowed in here, so I won't be going out for a couple of days. Whatever my cousin has for me will have to wait. Right now I'm content that Josiah is gaining weight and thriving. For that I'm very grateful.

Thursday, November 30, 2006

Hey, Just Act Natural

Just a quick run down of places and situations I've breastfed my baby in:

on a panel, giving a presentation
during a Toastmaster's meeting
during a board meeting
in the chair getting my eyes examined
in front of a room full of med students doing rounds
at the airport during a protest
at a women's investment group meeting
at the mall
hotel lobby
at the grocery store
in the waiting room of the pediatrician's office
in front of relatives at family gatherings
at restaurants
at a breastfeeding committee meeting

At no time and in no place have I recieved negative feedback- to my face. My philosophy is simply this; anytime, anyplace. I've lately wondered why I 'get away with it' Am I so discreet no-one knows I'm doing it? Am I so bold and brazen folks are shocked into silence? Am I so confident and natural about it, that no one questions me? Perhaps a little of all the above. At any rate, I'm tickled pink to be nursing all over town and doing my part to make breastfeeding an accepted and acceptable behavior in public venues.

Wednesday, November 29, 2006

Have Agenda, Will Travel

Well, I guess the hiatus is over. I have applied for 3 speaking engagements for next year. I didn't speak at all this year (except through this blog) because of the pregnancy. Now that opportunities are presenting themselves I can't wait to jump in start again next year. So far (if I'm accepted by all) I'll speak on breastfeeding in San Francisco in Feb, SIDs in KC in Feb, and breastfeeding in Florida in Oct. I'm glad I've devoted time to refining my speaking skills through Toastmasters this year, and private coaching last year. Now I can devote myself to content and not making a fool of myself in front of scores of my colleagues. Yesterday at our monthly Breastfeeding Committee meeting someone mentioned an LC position at the city hospital (they don't currently have an LC, their bf rates are in the toilet and they have a high population of Latina, AA, and immigrant and refugee populations- some might think I would be a descent match for this.) I asked myself yet again, why I didn't see myself in that role. I could become an LC within the year if I wanted to, but I don't want to. Its not my calling, neither is being a midwife, or a doula, or a cbe. This is problematic for me because I very much want to talk about breastfeeding and birth- even while my career choices take me further away from active practice. I have no intentions of doing L&D again, yet its that credential that lends me the most credibility. I get excited about writing and speaking, but not about doing the things I want to speak about. This seems inconsistent to me and somewhat uncomfortable. But I'm older and wiser now. I won't stretch myself to fit someone else's mold- I have to do the things that in my heart I know I must do. Someone better than me will have to take the LC job (I hope she's African-American and bilingual and works well making change within systems). My job is to create change with my writing and speaking abilities, or make a fool of myself trying.

Tuesday, November 28, 2006

What Would Mr. Rogers Do?

Boy, am I ticked. I found out a few days ago, that my midwife, Kirsten can no longer continue her homebirth practice! Why you ask? Because her collaborating physician's malpractice insurance will no longer cover him if he backs homebirth after the end of this year. Talk about a catch 22. Certified Nurse Midwives can't practice without a collaborative agreement with an OB and OBs can't collaborate without risking thier malpractice coverage. How's that for a kick in the head. Can you say "restraint of trade" boys and girls?

Thursday, November 23, 2006

Thanksgiving Meditation

I sit here profoundly grateful for my life and those who fill it:
my husband, whom I am blessed to share this life with
my baby Josiah who breaks my heart with his beauty and stregnth
all my other children who are so bright and healthy
my grandchildren who are well rooted and grow strong
my parents and grandmother who love me and keep me grounded
my sisters and thier families who fill my life to the very edges
my in-laws who gird us up and provide a strong support
my friends who keep me vigilent and accountable
my two cats and dog who give love and companionship so freely
all those in my life who freely share who they are and what they have
my creature comforts of hearth and home
my will to give, to take, to produce
my sense of mission
my saviour
my vision

Tuesday, November 21, 2006

Down in the Delta

Just back from the National Nurse-In. Josiah and I were the only ones there! What a disappointment : ( But I'm glad we went anyway. My sign read, "Delta's treatment of breastfeeding mothers is offensive" I passed out breastfeeding info, talked to a couple of folks and Josiah did his part by waking up to have a leisurely nosh at the breast (what a good little protester). He actually got more attention than I did. More people stopped to look at him than talk to me about my sign. Anyway, its done. Sorry Kansas City had such a low turn out and hope other cities fared better. But I feel great that we did our part.

National Nurse-In

Today is the National Nurse-In. Josiah and I will be at the Delta counter at our airport. I don't know if anyone else in town will be there, but we will be! I did sent out a few emails to the BF community but got no definite responses. I wish there had been more lead time, but it is what it is. For those who haven't heard, the Nurse-In was organized in response to a breastfeeding mom being removed from a Delta flight for failing to nurse "discreetly" (i.e. she refused to use the blanket the flight attendent brought her). I wouldn't use the damn blanket either. Seeing as Josiah and I will be flying several times next year (Mexico in January, San Francisco in February for starters) I certainly don't want to be harrassed while feeding my baby. I can't wait to get to the airport this morning. I've been working on my sign. Perhaps it'll say something provocative like "The boobs at Delta are offensive, not mine!" (okay, I won't make a sign like that, but part of me wants to) My sign will probably say "Delta unfair to nursing mothers" Anyway, kudos to all my Dear Readers who plan to attend the Nurse-In in your city.

Monday, November 20, 2006

My New Mantra

Created for me by Dear Reader, Celeste,

Flow milk flow
Grow Josiah grow!

A Steady Incline

So thankful that you both are well. I think there is still so very, very much we *don't* understand about nursing (and birth too)--nobody cared because it was "women's business" for years, and then formula came along and the medical establishment decided that was good enough, so why bother? Lots of women have so much trouble for no reason anyone understands! Is it the environment, or chemicals in our food, or something like that? Was it always this hard, or is it harder now?We *should* know a lot more than we do, so mamas like you might at least know how to work on it more effectively, and more babies would stay breast fed. It makes me angry that we don't. I had so much trouble with my supply, much like yours..but I assumed it was because of my c/sec. And I was so depressed that I had to put all my energy in that fight, not in nursing, so he became a formula baby at 2 months. And I felt like a failure, because everyone told me it was supposed to get easier. If I have another, I'll know I might have a fight on my hands, and plan accordingly. Thanks for blogging about it.

This comment from Dear Reader, Emjabee, really hits home the point that breastfeeding mothers are being failed. I'm all about stemming the tide of this societal failure. But first I had to confront my own predjudices. I fought giving Josiah formula in the hospital for two days. I didn't want to believe the problem was my milk supply. Then my 28 year old visited me and told me not to resist on account of my pride. He was right. I was prideful about being a successful breastfeeding mother, proud that I was the mother of nine and had homebirthed and breastfed 5 previous babies. I was also embarressed that this was happening to me- the town breastfeeding self-proclaimed guru (chairperson of the breastfeeding committee, yada, yada, yada) People came to me with their breastfeeding problems. Now I was having problems- major problems. It was a blow to my pride to give Josiah formula. I let the nurse give him the first formula bottle- still too proud to do it myself. As the days passed and it became indisputable that my milk supply was the problem, I remembered something I had heard Dr. Newman say at the conference last month. He spoke of formula feeding as a medical intervention. Surely, in this case, that's exactly what it was. I have no intention of abandoning breastfeeding. I'm taking 3 herbals and 1 medication (+ the beer) to boost my milk supply, and using formula in the meantime to increase his caloric intake. My baby needed the food, and if I couldn't supply him with adequate amounts of the best type of food, then the second best will do- for now. The more I saw him plump up as the days passed the more I became committed to supplying him with what he needed. I feel ashamed that I refused the formula at first on account of my pride instead of doing what was best for Josiah. I look at him now, his face fuller, his skin no longer sagging against his lanky limbs. I'm so thankful for the lactation consultants, and the nutritionist who worked with me to boost my supply while gently allowing me to introduce formula slowly and at my pace. I also thank you, Dear Readers- I feel your prayers and support. They are being answered because today, I pumped twice as much milk than I was getting when I was in the hospital.

Sunday, November 19, 2006

Shut Your Humble Pie Hole

We're home! Josiah's weight gain was sufficient this morning that Dr. W and the team let us go on home. We left the hospital and went straight to church. I felt the need to formally give thanks- and I wanted to see my friends after being isolated for a week. When I got home, I left Josiah in the baby-starved hands of his siblings, and crawled into my bed and slept peacefully. Its so good to be home with my baby-so good to see my kids. I feel full of gratitute. So what's the lesson here? I got to help myself to a great big helping of humble pie. I have to confess that in my heart, when a woman complained about her milk"going away" I dismissed her as lazy or uncommitted. After having my infant hospitalized for 5 days on account of a diminished milk supply, I think I'll have a little bit more compassion.

Saturday, November 18, 2006

A Slow Increase

The LC hooked me up with a lactaid device yesterday. So now I can breastfeed and supplement simultaneously. Its a pain in the butt but it keeps him on the breast while my milk supply rebuilds. This Medela hospital grade breast pump is sweet. I can pump both breasts in about 10 minutes. If only Josiah could work so efficiently! Dr. W and the team rounded this morning and said if his weight gain continues, he can go home on Monday. Yipee. You know, despite all the stress and work, this has been kind of a respite for me. Is that sad or what?

Dropping- Not So Much

Well, its done. I'm either breastfeeding or pumping and fortifying the milk, then following that with formula supplementation. After doing that for 24 hours now, I really do think he wasn't getting enough milk. All signs point to a reduced milk production. All his labs keep coming back normal (a few are still out). He's been gaining about 1/2 ounce per day. His face looks plumper to me. Even his little bottom no longer looks like sagging old man skin. I should be thrilled he doesn't have some dread metabolic disorder, but I feely badly that I was feeding him on starvation rations for two weeks. I'm still working on getting my milk back. My son will smuggle in some beer today. Hope to get my reglan perscription filled also. I've barely left this room in days. My kids came to visit last night and I took them down to the cafeteria for treats. I realized I hadn't even so much as stepped into the hall in two days. Making and feeding Josiah milk takes all my time. His Ped called yesterday and told me to take more naps to help my milk production. I'm following her orders. To say I'm exhausted and sleep deprived is an understatment. But its worth it to finally see progress.

Friday, November 17, 2006

A Drop in Spirit

The Gold Team just left. Josiah's urine output dropped. That means he's really not getting enough milk. More confirmation that I'm losing my milk supply. How is this happening and why? I'm working hard to get my milk to come back, but I pump less and less each time. What am I doing wrong?

A Voluminous Drop

Josiah's labs keep coming back normal. My milk supply keeps dropping. I started to supplement him last night. Each time I pump, I get less and less milk. I don't know now if my milk supply started dropping and made Josiah lose weight or if the stress has made my milk supply fall. Either way, despite the galactagogues, I'm losing my milk.

Thursday, November 16, 2006

The Waiting Game

I sit here in Josiah's room awaiting a visit from the "Gold Team" Dr. W and her legion of residents. I have started my regimen of galactagogues and medication for thrush. I've stepped up his feedings to every three hours around the clock and pump after each feeding to further stimulate my breasts to greater production. I'm doing my part but I'm not sure Dr. W will be impressed. He did gain weight in the last 24 hours but they attribute it to the IV fluids. Just to make things more interesting, I've had a tooth ache for 3 days and can barely talk. My dentist can squeeze me in this afternoon, so I'll leave Josiah with dad while I run over and get this tooth taken care of. I'm looking forward to seeing the Lactation Consultant this morning. I wish she would come at the same time as the team but I guess they don't coordinate that way. I'm hoping I'll hear something conclusive from all these tests they've been running. Some of them take a day or two to get back, so it may be Friday before all results are in. In the meantime, I just enjoy watching his sweet little face as he sleeps or nurses or earnestly searches my face and coos. Such a sweet little guy!

Wednesday, November 15, 2006

A Precipitous Drop

Dear Reader,
Please do not be unduly alarmed by the news I have to share. Josiah was admitted to the local children's hospital last night. This is what happened. Over the weekened, I began to think that I should take him to the Ped for a weight check. He just didn't seem to be gaining any weight. At his two week exam, he had gained a full pound, but I just didn't see him plumping up. He looked as scrawny as ever to me. After going around in my head all weekend about it, I called the Ped on Monday to bring him in for a weight check. I took him in on Tuesday afternoon. I couldn't believe my eyes when the nurse put him on the same scale as two weeks previous and it read 5lbs. 10 oz.! His birth weight had been 6lbs, 14oz. What the hell happened? He was a beautiful and robust nurser. He peed and pooped continuously. How could he have lost 2 lbs in 2 weeks and I not notice??? I couldn't even go home and pack, the Ped sent me to the children's hospital and gave me 20 minutes to get across town and admit him. I looked at my beautiful little boy. I so didn't want this for him. I felt like I had failed him. The Ped, a handsome young man who looked young enough to be one of my kids (my regular Ped was off yesterday), tried to comfort me by telling me I had done what I was supposed to do- I thought I saw a problem and brought him in. I knew he needed to go, but I confess I didn't want to take him to the hospital. I called my husband, and then headed in. My husband met me in admissions and we took him up to his room. All the rooms are private and quite lovely. (we're quite fortunate to live near such a first rate children's hospital- its a real show place) It held a crib for Josiah and a daybed for me, a bathroom, a small fridge, a closet a rocking chair, and lots of space for visitors. I settled Josiah in, and made a list for my husband of my things to bring me, especially my laptop. My husband went home to take care of the other kids, while I silently vowed not to leave Josiah's side. Whatever procedures he had to endure, I would be right there with him. The team of doctors (this is a teaching hospital, I've probably seen about 12 residents already) ordered lots of labs that have to be spread out over a couple of days, as he can only spare so much blood. He's a very difficult stick since he's so skinny and dehydrated besides. Its taken multiple sticks for each blood draw (poor baby). The last nurse finally just drew from a vein in his head and got sufficient blood. They also started an IV in his head as well. The upshot is the weight problem is either due to insuffient milk supply/calories, or inefficient metabolism. He nurses well, pees and poops, has no vomiting or diarrhea, and no fever. I would hate to think that my milk supply is the problem, but thats better than a metabolic disorder. Of course the docs wanted right away to supplement, I told them no. If milk supply/caloric intake is the problem, then I should work to correct that. The lactation consultant along with the nutritionist put together a plan, that the docs grudgingly will go along with- for a day or two. I am boosting my supply with more frequent feedings, post feeding pumping, domperidone pills, fenugreek tablets, and mother's milk tincture. This regimen should have me swimming in milk. If we don't start to see weight gain, then we will move to fortifying the expressed milk. We also discussed using human milk from a milk bank. I have liked working with a multidisciplinary group- and they all are agreeable to letting the lactation consultant lead the way- for now. The labs so far show nothing, except a little dehydration, but most are still out. They've taken blood, stool, and urine and seem to be leaving no stone unturned. My friends have been priceless. They gathered the domperdome, funugreek and tincture and got it to me at the hospital. The lactation consultant was very impressed that I could get my hands on these items, and so quickly. I simply told her, its all in the network! Those meds passed through many hands coming across town to get delivered to me. What wonderful friends and family. My mother-in-law is with the other kids so my husband could go on to work. Tonight, my job is to feed and pump, and rest when I can. I feel blessed that Josiah is recieving good care and that I can be here with him every step of the way.

Tuesday, November 14, 2006

Solving the SIDs Mystery

I read this excellent article in this week's issue of US News and World Report. Its been about 2 years since I've heard or read of any new info on SIDs (Sudden Infant Death Syndrome). I attended an excellent SIDs symposium here in my city in 2004 that included input from all the players, from docs, to social workers, to psychiatrists, to police detectives, and district attorneys and medical coroners, to community outreach workers. SIDs was examined from every angle, they even showed case studies of how SIDs investigations are carried out. I learned so much from that community symposium. I discuss what I learned, regularly in my pediatric CPR and first aid courses with students, (mostly nannies and childcare workers). I encourage you to read it, its not so very long, the jist of it is that new evidence points to SIDs being a disease caused by an abnormality in the brain. If this is so, a screening test could be developed to determine which babies are at risk, at birth. I remember my hermitess friend, Sr. Morningstar telling me once, (while she was taking a CPR class from me) that putting babies on their backs was *counter-intuitive.* While I agreed, I also couldn't discount the research that showed the dramatic drop in SIDs deaths since the practice has been implemented. I thought of Morningstar as I read the article. If effective screenings were created, then identified "at risk" babies could be put "back to sleep" while perhaps those not at risk could go back to sleeping on their bellies. I'm also excited by this research in that proving SIDs is a disease will not only give us tools for prevention, but will provide an answer to all those suffering parents who have lived through the experience of SIDs and ask themselves, "Why?" I'm sending my prayers to all those researchers, even as Josiah naps (on his back, of course) while I write.

Saturday, November 11, 2006

Have Baby, Will Travel

I have taken Josiah along me now to three meetings, my biracial family support group, my women's investment club, and the healthcare foundation board. He nursed at all of them. I also had him in tow as I attended two school functions and taught a couple of CPR classes, with him tucked into his sling. He causes quite a stir everywhere we go- all of it positive of course. I may face some friction, but I've decided to keep on carrying him to my meetings. He is such a sweet little thing, I can hardly bear to leave him. He should be with me, its his rightful place. I love the convenience of breastfeeding wherever I go. To see his angelic little face, his eyes shut tight, his little fists balled tightly, his nose twitching and jaws working back and forth as he concentrates on the work of getting milk. He's an incredible delight. I love to snuggle with him against me and breathe in his warm milky breath, to nuzzle his fuzzy little round head. I'm getting better at sharing him, taking him out of the sling so others can hold him. At first I didn't want to share at all, and would wickedly keep him all to myself. Now I can see the joy he brings to others- its a rare treat to snuggle a newborn.

Wednesday, November 08, 2006

A Birth Mother's Story

Last night I participated in a panel of birth mothers at a meeting for multi-racial families. Most of the audience were adoptive families with biracial or African American children. The panel included myself and two ohers, Peggy whose child is 35 and Sheena whose child is 15 months old. My adopted son will be 24 this month. Sheena was accompanied by her son's adoptive parents and together they spoke about open adoption. Both Peggy and I had closed adoptions so seeing how open adoptions works was very eye opening and educational for me. The audience seemed very grateful to hear the point of view of birth moms. I still think there is a stigma for birth moms even while everyone extolls their courage and selflessness. The three of us had an opportunity to tell our stories and take questions from the audience. Peggy had a particularly touching story of reuniting with her adult son a couple of years ago and how it felt to come full circle. My adoption search is still in the future. I don't know the impact to the audience, but I hope they found it helpful. I learned more than I was able to share. As I sat in front of the audience playing with my newborn, it struck me that at least some of the women in the audience were adoptive mothers because of infertility issues. It made me wonder if this is the crux of the divide between adoptive and birth mothers- perhaps the birth mother is a constant reminder of what the adoptive mother cannot accomplish and as such must be put out of sight, out of mind, marginalized and stigmitized. At any rate, I'm glad I sat on the panel and told my story.

Tuesday, November 07, 2006

The Nipple Nosher

Josiah is having his 3 week growth spurt. How do I know? By his dedicated attempt to nurse my nipples into bloody stubbs. Being a highly trained professional (ha), I recognize the signs of a growth spurt in progress and am not panicked by his seemingly insatiable appetite. I know this is when inexperienced, first time moms run for the phone in tears to their OB, pediatrician, LLL leader, fill in the blank whatever, about how breastfeeding is not working because the baby is hungry ALL the time. Does this in any way make the experience easier for me? No. After nursing him for over an hour last night (visiting each breast, twice) he continued to fuss, where before he would have settled down to sleep. Not wanting to compromise my tissue integrity (ie. develop sore nipples) and satisfied that he couldn't still be hungry (and that even if he was, my breasts were, for the time being, empty) I opted to hold him in my arms and let him cry. I didn't have the heart to abandon him to his cold lonely crib. He cried about 15 minutes, then slept till morning. This morning he again nursed over an hour while my nipples screamed for lanolin cream. I had forgotten how much fun growth spurts can be.

Bless the Lord

Bless the Lord, oh my soul and all that is within me, bless His holy name.
Bless the Lord, oh my soul and forget none of His benefits.
Psalm 103

Ok, maybe God knew what he was doing after all! At any rate He sure does good work. Even though my husband refers to the baby as "Golem" (you know that long skinny creature in Lord of the Rings) I think he's beautiful and perfect in every way. It's scary how much I love this baby. I'd do anything to protect him and keep him safe. I feel so blessed to be entrusted with him. I stopped by my kids old school yesterday, to show off the baby and visited nearly an hour with the school secretary, Lisa, whom I've always liked a great deal. She and her husband have four kids but have been trying to get pregnant again. After hearing her longing for another baby (and some infertile ladies I've talked to) its easy to see there is something worse than having a baby unexpectedly after eight years- not being able to conceive when you want to desperately. Oh how I shudder at some of the things I said and wrote before. Such ingratitude, such arrogance. I wouldn't change one step of this precious journey. I'm so glad Josiah is a part of our lives. I would have missed so much if he had never come to be. Thank you, Lord, thank you, a thousand times, thank you for knowing better our wants and needs than we know them ourselves.

Sunday, November 05, 2006

Big Blessing in a Small Package

I've just spent two days doing no work and holding my baby almost continuously. What a great two days. He's so long and scrawny. He doesn't really look like any of our other kids. He's quite unique. He loves to nurse and is quite good at it. I love the way he raises his eyebrows when he's sleeping, and the way he greedily sucks at his fingers when he's hungry. He has my husband's thin lips while the rest of the kids inherited my thick luscious ones. His thin fine baby hair is developing a 'crimp' so I'm wondering if he'll be the first of our kids to have kinky hair. All of my other babies were nice and plump, Josiah is long and skinny with piano player fingers and elongated feet. The crown of his head is nice and round but his face is long and lean and triangular. He oftentimes look like a wise old man while he sleeps. His eyes are huge and round and turning a lovely shade of brown from their current dark and murky hue. His skin is fair and his eyes often cross when he tries to focus on images close up. The girls fight to change his poopy diapers. I carry him everywhere in our sling. Most of the time people don't even know I'm carry around a baby. He's so small, he can't be seen in the sling, he slumps down into it. People always carry on likes its such a nice surprise to discover a small baby in a pouch. I love to show him off. I took him out of the sling at church today (for the first time) and let others hold him. It felt good to share him. My friend, Lee is dying from lung cancer that has metastisized to his brain and lymph nodes. It was especially satisfying to see Lee holding Josiah. He has two grandchildren due next year, that he may not live to see. I really wanted him to hold Josiah and smell his little fuzzy head. I wanted to give him that as a gift. I know its not the same as him holding his own unborn grandchildren, but its something I can give him. The airy sweet weight of him, no more than a small sack of potatoes, takes my breath away. His sweet little cry breaks my heart. What an incredible blessing this little guy is.

Friday, November 03, 2006

Farewell My Beloveds

I said goodbye to my beloved Brits yesterday. I will miss Larry and Lucy and baby Harper. I visited them to see my birth video and to say goodbye until they return in December. It was so good to see the video. Its funny, how my perception of the birth is that it was dark in the room, but the video showed a brightly lit room with sunlight streaming through. Watching the video I realized my eyes are closed most of the time (which accounts for the perception of darkness- ha!) Even though I lived it, I was really cool to see it on tape. My face looked at times in great pain and discomfort and at other times serene and beautiful. I loved seeing myself own my own birth experience and utilize coping skills that worked for me. I loved seeing my birth. The best part was after Josiah was born and I'm holding him and turn around and sit on the sofa. I didn't remember this, but on the video, I start laughing and laughing and laughing as I hold him and look at him. I don't remember doing that but celluloid doesn't lie. Its such a free and hearty laugh, so appropriate for the high that follows a joyous birth. Larry and Lucy will take all the video back to England and begin the editing process. They will send me some clips which I will *try* to post.

Wednesday, November 01, 2006

My whole world fits in a sling

I visited with the videographers a couple of days ago. They came over to do the final filming to follow-up the birth. I always worry that I won't sound convincing. Hopefully, the birth will speak for itself. Films and pictures have a way of conveying things we never meant to say, but it is what it is. Larry and Lucy (and American-born Harper) head back to the UK on Friday. I will miss them. I'm going to try to go over to their place today to view some footage of the birth. They didn't want to show me any before all the filming was done. I'm eager to see it since I only "viewed" the birth from inside my head. I want to see what it looked like from other's perspective. I feel so blessed as I sit here and type, with a little baby in my sling resting on my lap all squished up in a little warm breathy ball. He loves the sling (as all my babies did) and I love using it! He's so sweet and wonderful. I wish I could spend all day holding and staring at him. But I didn't go to the office yesterday, didn't even check phone messages, so I've got to get some work done today. I'll just take him along with, or if he falls asleep, leave him with his Dad while I rush there and back. Funny, I used to think, 'how will a baby fit into my life?', now my whole world revolves around him.

Saturday, October 28, 2006

The Doctor is In

Josiah is two weeks old today. How can it be, we've only had him two weeks and he is such a part of us, such an integral part of our family? We had our first visit to the pediatrician yesterday. She offered me formula, in case of an emergency. I tried to envision some emergency, short of a coma or death, that would induce me to give my little guy formula. Funny, I couldn't think of a one. Other than the formula offer, (and I still can't figure out why she felt compelled to ask ME that, twice!) Josiah was in fine form and had gained a pound. He had a little jaundice the first week but it had mostly cleared up by yesterday, to my relief. When last I worked in the hospitals (earlier this year) the bilirubin protocols were simply out of control. Picture two pages of algorithms briming with risk factors (of which breastfeeding was one), designed to keep kernicterus on high alert. (There must have been a high dollar malpractice suit here in town lately.) I was concerned that the Ped would want bili levels but she was satisfied that he was fine, (as was I). We did have to have his PKU redrawn. The midwife did it but it came back. What an ordeal! It took forever to get it done in the hospital lab, but fortunately, Josiah slept through the procedure. The lab went and got someone who was good at baby sticks, so I shouldn't complain about how long it took. We talked about immunizations (which I do 'selectively'). I must say, it's nice to have a Ped that I don't have to argue with about this. I've had to change Peds over this issue in the past. All in all, my Ped and I don't tend to bump heads, but I'm skittish about Peds in general. I do think they tend to be lukewarm on breastfeeding when they should be (in my opinion) its biggest promotors. I did love the fact, that as we went from the Ped office to the hospital lab, I realized that Josiah had never been in a hospital nursery, out of my sight. I took such comfort in that thought. The Ped also asked about a circ, which I refuse to have done. What a horrific procedure to inflict upon a newborn, and for what? I'm tired of the AAP's lukewarm policy on circs (changed 3 times in the last decade) this last time to say nothing definitive. But Josiah will, like my younger boys, remain intact.

Josiah also attended his first play yesterday, as he and I and my 18 year old went to see my friend Julie in the lead role of "The Hiding Place" the story of Corrie Ten Boom, whose family hid Jews in their home during the German occupation of The Netherlands. I had read the book when I was in my twenties and remembered it in detail as the play progressed. It was a stunning performance (Josiah slept through the whole thing) and I was so proud of Julie, and got to tell her so, as she cuddled Josiah after the performance. There was a scene where a young Jewish mother with a newborn came to the Ten Booms seeking refuge. I held Josiah tight thinking what would I do if he were in danger, at risk in some way. How I would give my very life to preserve his. His little life is in my hands. It is at once a joyous and somber task. He makes me want to be a better mother.

Friday, October 27, 2006

Processing the Process

My doula, Nadah came over yesterday so we could chat about the birth. I love an opportunity to talk about it with someone who witnessed it and may have a different perspective on things. She said she had never seen anyone give birth upright on their feet before. Perhaps its just a fluke, but I had my last 4 babies that way, it just seems right for me. She also said I seemed very calm. I think thats because all my processing was internal. It was very hard for me to come out of myself. Plus, I'm not a worryer by nature. I assume things will go fine, and then if they don't, I start to worry at that point, not before. Nadah also said she felt like she didn't do much. I had to laugh since her presence was the only one I was really registering and felt essential to my ability to cope. We talked a little about what I wrote about not liking the assessments and interventions. I do think most of that was tied to the realization that I did those things to women (and much much worse) as an L&D nurse without realizing the impact it had on them. We also talked about the documentary. I meet with Larry and Lucy next week, before they return to the UK to look at some snippets of what they've put together and get some final postbirth footage. Nadah seemed surprised that I want no input in the production of the film, but I think it will be more powerful if they edit it as they see fit from an outsiders perspective. I know they've learned a lot just going through the birth of their own daughter the past year. I trust them, to do justice to the project. I'm excited for the film, but its really their work. My work is to finish the book by the end of the year. My head is swimming with ideas. I am equally afraid and excited.

Tuesday, October 24, 2006


Following the birth, my kids all came down to see the new baby. I remember sitting on the sofa (covered in plastic) and cuddling Josiah. After the placenta came, only a few minutes later, we decided to move upstairs to my bedroom. I walked up the stairs and settled into bed. My bleeding was still free flowing so I took some po methergine and a little later a shot of pit. I felt fine, and was mostly just focused on the baby. A little while later my husband bought me a plate of pancakes. You know how the first food you eat after labor tastes so good. Those pancakes were like manna from heaven. All tucked in with my baby, I felt so pampered. A little while later after the doula, videographers and midwives had left I snuggled with the baby and napped. I had made several attempts to nurse him, but without success. It took him the better part of the day to get the hang of things. A week later he's doing great. Working with Josiah on breastfeeding has made me think a great deal about how I worked with my patients in the hospital. Josiah sleeps a lot. I never stress if he's been asleep for four hours or six hours till he eats again. But in the hospital we doggedly had to document breastfeeding every 2-3 hours or hear about it from the oncoming shift nurse. It feels so luxurious to feed him when he wants to be fed, not when someone else thinks he should be, to never have him out of my sight, not to have to send him to a nursery to have them do things to him that I can't see (things I used to have to do to babies). I feel overjoyed that I get to do things my way, and at the same time, guilt that other women were and are denied this same luxury, guilt that I denied them these things. I so treasure the ability to birth this way, to recover this way, to parent my baby this way. Every time I make one of these little "discoveries" it makes me renew my vow, never to return to hospital nursing. How can I? How can I choose to care for women in a way that is so personally unacceptable to me? I want women to know instead, how this feels. How it feels to birth and breastfeed intuitively and to trust one's own wisdom is such a gift. I love spending my days cuddling with my sweetylicious. To watch him nuzzle at the breast, even watching him sleep is a marvel. This is my little guy, my little baby. I grew him, and birthed him, and now I nourish him with my own milk. I inhale his baby sweetness and feel great contentment.

Sunday, October 22, 2006

Birth Musings

I spoke to Lucy (the videographer) a couple of days after the birth. I found out later after the birth that the filmmakers actually missed the birth. I was in transition and not terribly aware of my surroundings. I had long ago drowned out everyone around me and retreated into my labor. Just prior to my pushing the midwife had sent everyone upstairs for breakfast. Apparently my husband was making pancakes (I didn't even know he was gone!) I didn't know that only the doula and midwife remained as I entered into that very last contraction. I just assumed that as Iwent into that one and only push that someone was standing behind me to catch! My doula was there, but she was the only person I actually saw. Fortunately the midwife was there to catch, but unfortunately it was her apprentices turn to catch. (Sorry!) When Kirsten caught and passed the baby between my legs, I saw the nuchal cord and passed the baby back (between my legs) to Kirsten again. (I couldn't lift the baby up to me because of the wrapped cord.) Kirsten unlooped the cord (that explains the decels) and passed him back to me. He was squalling his head off and was so slippery I almost dropped him, but just then my husband was by my side helping me grab him. I lifted him up and saw that little penis. Oh, a boy, I just knew he was a boy. My little boy, Josiah. I realized in that moment that I was meant to have him. We had selected his name years ago. I wanted to name him after my father-in-law who died a few years ago, and whom I miss dearly. I knew I would have a little boy named Josiah when I was in my 20s. I had predicted as a child that I would have 9 children (one of my cousins reminded me). Once I held his warm, wet, squiggly body next to me, I just knew it was meant to be. Josiah, Josiah what blessed luxury to hold you in my arms and inhale your sweet baby smells. I spend hours just looking at him, I can't get enough of seeing him, holding him, smelling him. I love the look of bliss on his face as I nurse him. His little fists balled in utter concentration as he imbibes the milk I make for him. He has captured me. I absolutely and resolutely adore him. He's simply fabulous- I love this baby.

Wednesday, October 18, 2006

Leaving the Cocoon

As labor progressed, Kirsten the midwife had requested hourly heart tones. I knew ahead of time that that was her protocol. Still I was surprised when I heard the decelerations down to the 80s. I knew this was not good. At Kirsten's request, I began to drink lots of water. I was content to stay in the labor coccoon and just work the contractions- that was work enough. I didn't want to deal with anything else. I was in a tug of war with myself. The decel forced me to leave to cocoon and work with my birth team as a team. Up to that point I had been flying solo. Now I had to come out and join the others. I had to admit to myself, some dependence on them. Drinking the water was an intervention (yes a simple, and effective one I know) but it still meant that someone had to intervene and I had to comply. It was another role shift- a necessary one, but one that was difficult for me to make. After the decelerations continued for a few more contractions, I was checked for dilation and found to be 6-7 with a bulging bag. Kirsten suggested breaking the water, but I was unsure. She then suggested prayer. That was the best intervention yet. Kirsten prayed. It was powerful and I knew something had changed. I continued to drink and pee, drink and pee. The contractions grew stronger and closer together. About an hour after the check, I stood up for my next contraction, the strongest yet, I felt pressure and pushed with it. I pushed again and felt the familiar burn-stretch sensation of the baby crowning. "Baby's coming" I said to whoever was near enough to hear then, whoosh, the baby was out.

Tuesday, October 17, 2006

The Parellel Universe of Labor

Now it is time to continue my story. When I left off, it was about 4am Saturday morning and the midwife, her apprentise, and the doula had arrived. The filmmakers were already here and sleeping in the downstairs bedroom. I had set up my birth space downstairs in the family room because my bedroom was too small, and I don't birth on a bed anyway. The doula arrived and bought her big birth ball which would turn out to be my best friend in labor. I had one also but is was smaller and as we later found out, had a slow leak in it. The doula, Nadah was lovely and wooed me with herbal teas and a scented hanky. She put my frangrance, lavender, on a hanky and I kept it near me my entire labor. She changed the scent as I entered transition to clarysage, and again to rose postpartum. I don't know how it helped or why, but I sniffed it all through my labor. Its still sitting on my dresser with the rose scent still on it and I smell it several times a day. Nadah always stayed near, but didn't speak much. When I needed her she was just there. She made a few suggestions for this and that but mainly I appreciated her presence. She did provide counter pressure toward the end that I found invaluable- hers was the only touch I wanted- not even my husband's would do (he wasn't doing it right anyway). Anita, the apprentice arrived just shortly before the midwife. She immediately wanted a set of vitals. I quickly realized that not only was I going to be annoyed by interventions (of course there had not been any yet) but that even assessments were a constant irritation. I submitted without comment, but inwardly I knew I had not prepared myself for the interruption of assessments- vital signs, heart tones and the like. These simple seemingly uninvasive procedures made me feel like a patient- the very feeling I was hoping to avoid. Yet there it was staring me right in the face- patients require baseline assessments. How many times had I done these procedures on women without thinking what an intrusion and irritation they are? I didn't like the feeling at all. I could dish it out, but I couldn't take it. I birthed at home to avoid being made to feel like a patient, yet a simple request for vitals brought it all rushing back to me. I immediately thought about my conversation the previous day with Dotty about autonomous birthing. She and her husband had six of their eight children at home, unassisted with her husband catching. I had toyed with this idea many times, but was committed to the presence of a midwife. I realized that just as the presence of filmmakers would be a sacrifice of privacy in this birth, so would the presence of a midwife represent a sacrifice to some degree of my autonomy. After the midwife arrived the whole entourage moved downstairs to the birthing space. The filmers woke up and started filming. I cleansed the room with my burning sage, gifted to me at my blessingway by Sr. Morningstar. I lit my candle and insence and put my selected CD into the player. The music was short-lived as the filmerstold me it was copyrighted and couldn't be a part of the film without permission. It was turned off. Another sacrifice. I was laboring heavily at this point and needed to focus on the contractions and worked hard to shut everyone else out- it wasn't that difficult. My husband was upstairs sleeping and I decided I wouldn't send for him till it was time to push. I knew he was tired, so I just let him sleep. The doula, my hanky, and the birthball were all the tools I needed. Between contractions, I sat on the sofa with my eyes closed. I could still hear their whispered conversations but was glad noone tried to address me directly. During contractions, which were deep and hard, I stood up, Nadah put the ball on the sofa and I leaned onto it and rock back and forth, stretching my legs far apart and standing on my tippy toes. When the contraction ended, I sat back down again with my eyes closed. I had no interest in communication with those around me. I only wanted Nadah to be there with the ball, giving counter pressure, to pick up my hanky if I dropped it, or to refill my water bottle. This was my whole world. Managing the contractions and resting between them. I had a thought- this is too easy, I should make it seem harder or they won't really believe I'm going to deliver in the next few hours. There were no vag exams so up to this point no one really knew how dilated I was- we were just going by how I said I felt, the baby was low, the contractions every 10 minutes lasting 45 seconds to a minute. I knew the baby would be born in the morning but did everyone else know it? I could not or would not communicate- I only wanted to cocoon into my little world and be left alone.

Midwife Musings

Here is the link to my midwife's blog, per reader request.

Monday, October 16, 2006

Saturday, October 14, 2006

It's A Boy!!!!

Josiah Thomas, 6 lbs. 14 oz., made his speedy entry into the world at 8:30 am this morning! He came after about 24 hours (give or take) of the lovliest labor, in one push over an intact perineum. He cried and pinked up almost immediately. More details to come later. We are both resting and doing very well. I did get a shot of pit for bleeding but nothing major. I appreciate all the love, support and well wishes received through this blog. Thanks everyone for your comments of support- they really did make the labor extra special! Blessings to you all.

Upright Birthing

It's almost 4 am. The midwife, apprentice and doula are here. I've achieved a plenary birth team at last! Baby is working its way down. Contractions are deep and hard but I dive right in. I have to stand upright for each contraction- the pain is worse if I sit or god forbid, lay down. My body wants to be upright. Everyone I've shown my birth space to, keeps saying, where's the bed? I won't birth in a bed, perhaps a squat or on all fours if I don't feel like standing. I'll do what my body tells me when the time comes. Now my job is to get through each contraction that comes faithfully every 10 minutes- the downward pressure is all encompassing- like diving into the deep end of a pool.

Friday, October 13, 2006

Labor of Love

The photos were taken by my good friend Rebecca. She is very talented with a camera, so good at getting good angles. My husband and I had a double date with Rebecca and her husband, Tom tonight. Obviously, we had to amend our plans. Rather than cancel, we decided that they would pick up dinner, at an Italian deli and bring it over. What a feast! Lasagna, stuffed portabella mushrooms, spaghetti squash, salads, and breads, and for dessert some magnificent bowl shaped cake, the inside of which was filled with Italian cream. We had the best time, talking about our kids (we met when our 15 year olds were newborns) and sharing this labor with them. After dinner, Rebecca took the pictures and helped me upload them onto my computer and into the blog. After that, we did a belly cast! I tried to get my husband to take a picture with me- it would have been a lovely contrast, his pale skin again my dark, but he refused (too shy to take off his shirt for Rebecca!) My three daughters got into the act though. Its now about 1 am. The Brits have been here filming since about 8pm. I can no longer sleep through the contractions. Thats when the midwife said to call her. I'll call her and the doula to come now. The contractions are about every 10 to 15 minutes but hurt like crazy and last at least a minute and the pressure is so low. I always labor at night and birth in the morning, so I think this is it.

Labor Neclace

Labor Photos

From Active Back to Latent

Just as I was going to call my doula to come over this morning, I felt an incredible drowsiness come over me. I decided, why call her to watch me nap? So I napped first. When I woke up my contractions had spaced out few and far between. Oh well. I took advantage of the lull and ran some errands, you know, bank, store, post office, that sort of thing. Stopped by the office to check the mail. When I got back, I was in the mood for another nap, so I slept some more. I'm just getting up, its about 3pm. Still contracting intermittently with pressure on my bladder, I know the baby has moved down. I'll call my friend Dottie to come over and visit with me a while. I'm ready for company now. I'll wait just a little bit more to call the Brits and doula, I really want to save them for active labor. My dear husband has been shampooing carpet ALL day just to please me. What a sweetie (I really did want those carpets cleaned!) Right now I noticed our bathroom needs to be cleaned so I'll do that till Dottie gets here.

My Birth Plan

Birth Plan

My plan for this birth is that it be (birthing) woman-led which includes the following tenets:

· No interference or medical intervention without medical provocation
· Respect for intuitive wisdom and knowing of the mother and caregiver
· Obedience to the mother’s bodily wisdom and functioning
· Limited reliance on technology and pharmacology
· Positive and readily available emotional and physical support for mother and caregivers
· Silence when requested, and respectful speech and touch
· Presence, when desired, of those who have been selected by the mother to
support the birthing process
· Recognition of mother and baby as the primary focus of the birthing process
· Responsible and informed decision-making
. Faith in divine design and reliance on divine presence

Friday the 13th

Well it looks like Stephen Covey and the DMV (Department of Motor Vehicles- for my international readers) will have to wait. It looks like my baby will be born on Friday the 13th. Good thing I'm not (too) superstitious. I got up at midnight awakened by contractions, cleaned house until 3am, then took a much needed snooze. Mercifully, I slept till 7am, even though the contractions kept coming every 10 minutes and actually got stronger. I did feel them in my sleep but they didn't wake me. I can only attribute that to the prayers of so many. I really needed the sleep. Using the pain scale (0-10), I would rate my contractions right now as a 4-5. Pretty painful, but manageable. I'll call the Brits over now, and my doula. The midwife doesn't want to be called till the contractions are 5 minutes apart, but I'll give her a head's up around 8am. The kids are out of school today (how did that happen?) but I'll call my mother-in-law to see if she will take them costume shopping or something. All is proceeding well, baby is kicking a lot, and the sleep has renewed my energy.

Thursday, October 12, 2006

From Latent to Active

I went to bed at 9pm and woke at midnight with contractions 10 minutes apart. Not sure whether or not to start calling folks, or try to sleep some more. Decided on laundry instead. Will clean a little and get things ready first.

The Prodromal Ooze

No new news to tell. The cramping continues, but is harder to ignore. Went to the elementary school to help with the haunted house- part of my room mother duties. I'll be working behind the scenes to get the Halloween party done, since I probably won't be in actual attendance. I feel slow, and heavy, like I have maple syrup for blood. Tomorrow, if things don't pick up, I'll face my greatest challenge yet- go to the DMV to get my new liscense. Its time to do it, and I'd rather get it done BEFORE the baby comes. I already went once but the computers went down shortly after I arrived and there were like 30 people in front of me in line. (That place really is like purgatory.) I'll try and get there as the doors open and hopefully get it done fairly quickly. I also want to get in a trip to the library and get some reading material for when I'm resting after the baby. I've been wanting to read Stephen Covey's new book and a few others on leadership and marketing. The kids are out of school tomorrow and want to shop for Halloween costumes- we'll see if I have the energy for it. I may punt that task to my husband. I'll turn in early tonight and get some extra rest.

Sweets for the Cantankerous

Having a lovely day. I went for my massage this morning. It was heaven on earth. Nadah is a master with her hands. After the massage, we talked about my birth plan and how she could best serve me as a doula. I still keep going back to my desire for woman guided birth. I think everything is flipped. Everyone in the room should be taking their cues from me and following the direction that my body leads. As the person experiencing the birth, I should be giving directions, not following them. Thats my birth philosophy in a nutshell. Still cramping/contracting intermittently, but mostly ignoring them and going about my business. Working on my corn chowder, doing laundry, and organizing the linen closet. Nadah inspired me to get out the candles, incense, and soft music. I so enjoyed all those elements at her place this morning. Since I was in the neighborhood, I stopped at my favorite chocolatier's and purchased some nice chocolates, just because.

Night Moves

The mild cramping has definately transitioned into uterine contractions, albeit, mild to moderate ones. Its about 4:30 am, got up to get a drink of water and pee and wanted to post. I'll try to sleep a couple more hours then get the kids up for school. I did about 4 loads of laundry last night, but resisting the urge to start another. I still need to vacuum downstairs also- will start that after kids are up and going. I think I'll sleep better if I plan my work. I'd like to get in a massage tomorrow and a quick trip to the library- we'll see.

Wednesday, October 11, 2006

Good Night and Good Luck

As soon as I icing my cake, I'm going to bed. Husband should be home a little before midnight, kids all sent to bed. Mild cramping unchanged. I'm hoping to have another day or two (I refridgerated my food, it'll keep) to get more stuff done. I really really wanted the carpet shampooed and hubby promised to do it for me tomorrow if I haven't delivered! Tomorrow I'm making corn chowder and will maybe go for a massage- also need to order more lungs for my manikins. I'll post again in the morning.

The Beat Goes On

My blissfully quiet afternoon is past. Now the kids are home and want dinner. The mild intermittent cramping continues. I've made a lasagna and a pot of chicken noodle soup for labor food for my helpers. I've washed all my bed linens and set up my birthing space. I haven't called anyone to come over yet, still too soon to tell if this will go anywhere. After I get the kids some dinner, I think I'll bake a cake.

Have Chux, Will Travel

I lost a little bit of mucus plug this morning and have been cramping throughout the day. My son really saved my bacon. I had two classes to teach today and he came through and taught both of them for me. What a relief. I came home after helping him get started with the first one and packing for the second one. Now I can concentrate on getting my house ready for the birth. My birth kit came in the mail today (in the nick of time) so I'll be busy setting things up and cooking some more. Don't know if this will turn into real labor yet, I just want to be ready if it does. The kids are all at school and hubby's at work. Its nice to have some quiet time.

Tuesday, October 10, 2006

38 Weeks and Counting

No baby yet! I've spent the last several days trying to learn to add photos, links, and other stuff without success I'm afraid. I've started several blog entries but couldn't complete them. I guess its back to plain old text for now. I've been in a flurry getting things ready for the birth. I ordered my birth kit (I shouldn't have waited so long) and am assembling other things my midwife requested. I'm cooking and freezing food, and purchased a new nursing gown and sling. The crib is assembled and all the baby's things put away. We had to rearrange our bedroom to fit it in, but it looks nice. I made a stunning discovery. I reported last time that I had Braxton Hicks contractions, but now several days later, I don't think I've had any. I think I only dreamed every night that I was having them- crazy huh? I haven't had one uterine contraction during the day, only vague remembrances of having them in my sleep. I'm almost sure now that I only dreamed that I was having them. The only discomfort I continue to have is this unrelenting heartburn, but I know the cure is coming. I'm writing my birth plan and my to do list is growing shorter every day. Still lots of cleaning and organizing around the house to do but everyone is pitching in. I hate to leave the house these days but still have several classes to teach. I'll have to teach till I go into labor, still short of trainers, but it can't be helped. Still easily annoyed but not yelling as much. I was greatly annoyed today when I went to the breastfeeding store to purchase my sling. The owner of the store was telling me about mutual aquaintances who both delivered their babies by induction last week, one for postdates, the other because she wanted to deliver at the same time as the first so they could share a hospital room (You see the hospital where they both worked and were delivering is remodeling so everyone has to double up while the construction is going on. She chose to induce so she could bunk with her co-worker rather than a stranger.) If that isn't the stupidest reason for an induction I've heard yet, please enlighten me. Have you heard anything stranger than that one? If so, please share. In fact lets take a poll, please share for all our devoted readers the strangest/goofiest reason for an induction that you've ever heard of. Stories like this make me want to climb on the roof and shout to the world that this is why I'm having my baby at home- to counteract all the madness in the world surrounding birth. What kind of dumbshit induces because her friend is inducing? Especially when she's 37 weeks and the friend is postdates? What kind of dumbshit doctor goes along with it? Even in plain text, I bet you can hear my annoyance.

Thursday, October 05, 2006

From the Sublime to the Ridiculous

My midwife sent me this great list of research abstracts from the Lamaze International website:
(I bolded the meaty parts and put my (smart ass) comments in red)

Home Birth and Breastfeeding May Set the Stage for Healthy Immune Systems in Infants (Cool!)
Penders, J., Thijs, C., Vink, C., Stelma, F. F., Snijders, B., Kummeling, I., et al. (2006). Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics, 118(2), 511 - 521. [Abstract]
Summary: In this prospective cohort study, researchers examined the influence of several factors on the microbial environment of infants' gastrointestinal tracts. Fecal samples from 1,032 infants between 3 and 6 weeks of age were collected by the parents and presence and quantity of various "beneficial" (e.g., bifidobacteria and lactobacilli) and "harmful" (e.g., C. difficile, E. coli, and B. fragilis) species of microbes were determined by polymerase chain-reaction tests. The study took place in the Netherlands where home birth and exclusive breastfeeding are common. In this study, 47.5% of the infants were born vaginally at home (n = 480), and 70% were exclusively breastfed during the first month of life (n = 700). The cesarean-section rate was 10.7% (n = 108).
After adjusting for confounding factors, infants born by cesarean section had a significantly higher rate of colonization with C. difficile and lower rates of colonization with bifidobacteria and B. fragilis than those born vaginally at home. Each day of hospitalization after birth was associated with a 13% increase in the rate of colonization with C. difficile. Exclusively breastfed infants were significantly less likely than formula-fed babies to be colonized with E. coli, C. difficile, B. fragilis, and lactobacilli. Term infants born at home and breastfed exclusively had the highest numbers of bifidobacteria and the lowest numbers of C. difficile and E. coli compared with any other group of infants.
Significance for Normal Birth: The newborn's gut, sterile at birth, rapidly becomes colonized with millions of microbes. The number and type of gut flora have been shown to influence immune system development, the risk of allergies and asthma, and metabolic functions such as the production of vitamin K.
In normal vaginal birth, newborns encounter their own mother's microbes during the critical first hours. Some of these microbes are beneficial and promote healthy gastrointenstinal development. Other microbes are pathologic (may cause disease), but maternal antibodies, passed to the baby via breastfeeding, help ensure that the baby tolerates their presence. When a baby is born by cesarean surgery and/or subjected to prolonged hospitalization, unfamiliar hospital-borne pathogens such as C. difficile dominate the microbial environment of the newborn's gut. Minimizing the baby's contact with these harmful organisms by avoiding hospitalization for normal birth while maximizing newborn's exposure to antibodies and beneficial microbes by promoting exclusive breastfeeding may decrease the likelihood of newborn infection and optimize the baby's developing immune system for lifelong health benefits.
(I love this finding- more proof that the hospital environment in and of itself can be toxic to the newborn- yet another reason to breastfeed, you can bet I'll be bringing this up at my next LLL meeting.)

Physiologic Pushing, Birth of the Head Between Contractions Reduce Genital Tract Trauma at Birth
Albers, L. A., Sedler, K. D., Bedrick, E. J., Teaf, D., & Peralta, P. (2006). Factors related to genital tract trauma in normal spontaneous vaginal births. Birth, 33(2), 94 - 100. [Abstract]
Summary: This secondary analysis of a randomized, controlled trial of perineal management techniques evaluates the maternal and clinical factors associated with genital tract trauma during vaginal birth. The researchers analyzed data from 1,176 midwife-attended, spontaneous vaginal births where episiotomy was not performed.
Greater maternal education, directed pushing while the woman holds her breath, and higher infant birth weight increased the risk of trauma requiring suturing in primiparous women; however, birthing the infant's head between contractions reduced the risk of trauma requiring suturing. In multiparous women, prior sutured trauma and higher infant birth weight increased the likelihood of trauma requiring suturing, and birthing the infant's head between contractions was protective.
Significance for Normal Birth: This study provides strong evidence that two modifiable factors may reduce trauma to the mother's genital tract at birth: physiologic pushing (when the woman follows her own urge to push without direction from maternity-care providers) and birthing the baby's head between contractions.
The authors note "a calm and unrushed approach to vaginal birth improved the health of new mothers by lowering overall trauma rates and reducing the need for suturing" (p. 99). In normal birth, the woman follows her own body's cues to give birth.
(What?? Women following their own internal cues to push??? What kind of madness is that? Everybody knows purple pushing is what gets the baby out! Besides, who cares if women's coochies get all torn up- they should just be happy to have a healthy baby. After all, we'll sew them back up and even put in an extra stitch for Daddy!)Attendance by caregivers who are confident in normal birth, such as the midwives who conducted this trial, supports the natural unfolding of the birth process and, thus, reduces maternal injury.

Quality-Improvement Study Finds Induction, Early Labor Admission Predictive of Cesarean Surgery in Low-Risk Mothers (no shit, Sherlock)
Main, E. K., Moore, D., Barrell, B., Schimmel, L. D., Altman, R. J., Abrahams, C., et al. (2006). Is there a useful cesarean birth measure? Assessment of the nulliparous term singleton vertex cesarean birth rate as a tool for obstetric quality improvement. American Journal of Obstetrics & Gynecology, 194, 1644 - 1652. [Abstract]
Summary:This prospective, quality-improvement study provides data on the association between elective obstetric practices and the cesarean-surgery rate in "nulliparous, term, singleton, vertex" (NTSV) births (those with one baby born in the head-down position after 37 weeks to a mother who has not previously given birth). The American College of Obstetricians and Gynecologists and the U.S. Department of Health and Human Services have identified the NTSV cesarean rate as an appropriate proxy for the cesarean rate in low-risk mothers. The study took place in 20 birthing units in a large hospital system that serves a diverse population of childbearing women.
Researchers analyzed 41,416 NTSV births taking place between 2001 and 2003. Data on the frequency of induction of labor prior to 41 weeks, admission in early labor (less than 3cm dilation), and 5-minute Apgar scores <> 25%. Statistical tests of the correlation between NTSV cesarean rates and low Apgar scores failed to reveal an optimal NTSV cesarean rate but demonstrated that lowering the rate to 19% did not compromise newborn outcomes. Some of the hospitals with NTSV cesarean rates below 19% had excellent newborn outcomes while others in this category showed the possibility of increased risk to newborns. Due to this wide variation the researchers call for further research into the conditions that support both low NTSV cesarean rates and favorable newborn outcomes.
Significance for Normal Birth: Low-risk nulliparous women are 4 - 10 times more likely to undergo cesarean surgery than their multiparous counterparts, and this population contributes significantly to the overall increasing cesarean rate. This study suggests that induction of labor and admission in early labor are strong determinants of the rate of cesarean surgery among low-risk women giving birth for the first time. This is of particular concern because, in today's climate, almost all women who give birth to their first child by cesarean will go on having surgical births for all their future children. Although the study did not differentiate among elective or medically necessary inductions, the authors acknowledge that many inductions in low-risk nulliparas are purely elective or performed for "soft" indications (i.e., those without evidence-based medical rationale). The study suggests that the wide variation in NTSV cesarean rates across hospitals has less to do with intrinsic differences in the populations of women served than with the hospitals' obstetric practices. Expectant families should be counseled that avoiding unnecessary inductions and laboring at home until an active labor pattern is established are two of the most important means of avoiding cesarean surgery. Choosing the birth setting carefully, with attention given to rates of elective and routine obstetric practices, may also help avert surgical births. (This one really pisses me off- how many times did I see this as an L&D nurse (and with my daughter-in-law)? Potentially perfectly normal labors and births ruined by arbitrary inductions and interventions. This is why normal healthy first time 20-30 year olds can't have a damn baby. Once they have that first cesarean they are forever branded, internally and externally as being unable to birth vaginally. They think they can't birth vaginally and the system works to deny them VBACs for subsequent births. Early admission can be a big culprit, these first-timers fall off 'the curve' before they're even on it. If Friedman were still around, I'd bust a cap in his ass.)

Cochrane Systematic Review Confirms Effectiveness of Breastfeeding for Reducing Procedural Pain in Newborns
Shah, P. S., Aliwalas, L. L., & Shah, V. (2006). Breastfeeding or breastmilk for procedural pain in neonates. The Cochrane Library, Issue 3. [Abstract]
Summary: This systematic review by the Cochrane Collaboration evaluated the effectiveness of breastfeeding or supplemental breast milk on pain in newborns undergoing painful procedures. The researchers extracted data from 11 studies that met predetermined eligibility criteria for inclusion in the review. All of the studies compared the effect of breastfeeding or supplemental breast milk versus a control intervention on pain in newborns during a single procedure (heel lance or venipuncture). Pain was determined by physiologic (heart rate, respiratory rate, etc.) and/or behavioral (cry, facial actions) indicators. In some cases, validated composite pain scores were used. Both term (≥ 37 weeks) and preterm (<>In this case, strong evidence emphasizes the role of breastfeeding in alleviating pain in newborns undergoing venipuncture or heel-stick procedures. Whether the mechanism of pain relief is the comfort of being close to the mother, the sweetness of her milk, the hormonal composition of breast milk, or a combination of these factors remains to be determined. Although many different interventions were compared with breastfeeding in the 11 studies included in this review, breastfeeding was consistently beneficial. The evidence is compelling enough to command a change in the practices of all birth settings where infants are denied breastfeeding during painful procedures. Nonseparation of mothers and infants and unlimited opportunities to breastfeed in the newborn period are the culmination of normal birth and optimize mother-infant bonding and the breastfeeding relationship. When painful procedures are necessary, these care practices also optimize pain relief, potentially decreasing trauma to the newborn and reducing anxiety in the mother. (I've been glad to see more attention paid to neonatal pain. Remember the days when it was thought babies couldn't feel? Perhaps hospitals could look at letting mothers nurse babies during heel sticks and other pain-inducing procedures rather than the use of sugar coated pacifiers, sucrose water bottles and other artificial agents.)

Tuesday, October 03, 2006

Lunch with the Girls

My midwife and her apprentice did a home visit yesterday. Plans are moving along nicely. I need to order my birth kit, but otherwise have what I need. We talked about the possibility of a postpartum hemmorhage and her management protocols. She uses pit, rectal cytotec, and methergine (no hemabate). Sounds okay, I never saw cytotec used for anything but inductions in the hospitals around here. Its nice to know for precaution. We talked about emergencies. My back up hospital is 7 minutes away (if its not rush hour) and there should be no impediment for ambulances should one need to be called. I've decided to deliver downstairs in the family room rather than our bedroom, since its so cramped. There is a bathroom down there, the laundry room, and two bedrooms (belonging to the teenagers). The downstairs is much cooler (temperature-wise) and a lot more spacious. The space needs to accomodate myself, husband, midwife, apprentice, doula, and the Brits for filming. The whole thing is beginning to feel like an orchestration- one I'm starting to get a handle on.
Finally found the baby bed I wanted, after 3 stores. Hubby can put it together today so I can organize baby's things.
Two of my girlfriends who missed my shower took me to lunch at one of my favorite haunts and gave me the stroller that was on my registry list. How sweet! I felt so loved and pampered. I shamelessly ordered whatever I wanted off the menu. They took me to Webster House, a turn of the century converted school, that now holds a fancy imported antique shop downstairs and an equally fancy restaurant upstairs. I love going there, my favorite former boss is manager there so I get to visit her whenever I stop by for lunch. The restaurant is first rate. I ordered tenderloin blue cheese soup to start, Croque Monsiour for main course (fancy french grilled ham sandwich), my favorite peach ginger tea to drink, and black and white bread pudding for dessert. I tasted my friend's parsnip and lobster bisque, but like my soup better. I think I smiled all the way home. I just felt so full- not just of good food, but of good love and acceptance. My visit with Sarah and Kathleen was such a lift to my spirits. They are long time friends. We knew each other when we were all struggling, single moms. We talked about how our children have grown into adulthood, and second generation motherhood (we all have a new younger set of children), our husbands (some marraiges turned out better than others) how life changes and becomes more wonderous as one ages, and lifestyle. They quizzed me about our move to the suburbs last year, they both live next door to one another in the city in a neighborhood I can only fantasize about, full of the most fabulous turn of the century mansions. I had to confess, after a lifetime of city living, the move to the burbs was not traumatic. I have wonderful neighbors, and my kids go to good public schools (though I miss the historic old houses and ancient tree lined streets of the city). This conversation gave me such perspective on how much we've all grown as women. Its such a sweet thrill for me to see my friends children grow into adulthood and watch as they bloom- Sarah's daughter persuing an acting career in California, and Kathleen's son entering law school - the same with my girlfriends how we grow and change and absorb the lessons of life and become who we were truly meant to be. Of course we talked about the baby as well. I still have no idea how this baby will fit in my life- but I'm gaining a stronger sense that he or she should be, even must be in my life. Kathleen asked a marvelous question. She asked why I think this pregnancy came into my life and what the lesson was? I confess I probably won't begin to know the answer except in retrospect, but I like the idea of pondering it. A sense of peace came over me as I thought about her question- driven by the notion that the pregnancy was no accident after all, but very intentional (if not on our parts- surely by greater divine design) that all of this was meant to be. I've fought this idea for many months now, choosing instead to cast myself as a victim, but now I let it wash over me. What if my life is not ruined or even inconvenienced, what if I was meant to have this child at this time of my life? The reasons have yet to be revealed but the master plan was set in place long ago. I feel a shift in my perception, a desire to embrace was has come upon me and a sadness at its lateness in coming.

Monday, October 02, 2006

The Angst of Uncertainty

I'm tiring more easily these days. Its nice to be home and not running around to appointments though. I'm working on press releases and drumming up PR for the upcoming birth/documentary. I feel a sense of angst- not sure why- all the birth blogs have been so heavy and downbeat of late. I should probably stop reading them for a while, but I can't- too addicted. Will what I'm doing make even a drop in the bucket's difference? I just don't know. All I know is I love birth and want to make a difference. I'm offering all that I can- hoping there will be an impact.

Sunday, October 01, 2006

One Mean Mama

Boy am I getting cranky. I yelled at the kids all night last night. I stayed away from them because I didn't think I had enough impulse control not to take a swing at one of them. I'm incredibly discontent with my husband and saying the meanest things to him. I'm a straight shooter, but not ususally this bad. Why am I being so mean? I hope I'm not like this for the birth, being bossy and pushing people around. Part of me thinks its hormonal, part of me thinks that no excuse for bad behavior.
I have a new doula. My initial doula was overcommitted with school, and such, so I let her off the hook and asked someone else. The new doula, was the same one with my son and his wife, and with the Brits. She's one of the best in town, and a massage therapist to boot. Nothing will be ready when the midwife makes her home visit- oh well, I still have a couple more weeks to prepare. The main thing I want to talk about is the birth itself and her treatment protocols for postpartum hemmorhage- the one complication I think I'm at risk for and only because its baby number nine. I've been drinking my uterine stregnthening teas and have never had a problem before- just covering my bases. I'm feeling stronger and stronger about a hands off birth. I don't know why I feel so strongly about not being talked to or touched, but I do. Is this an outpouring of my newfound crankiness or am I just feeling the need to truly birth independently?

Friday, September 29, 2006

Convert or Die!!!

Another observation on the Terri Irwin interview: The segment showed two snipets on the births of the Irwin's two children. During the first birth Dad delivered the baby, mom appeared upright on a normal bed. In the shot of the second birth, Dad was still delivering, but they were drapped, masked, artificially lit, stirruped, and a doctor (I suppose) was helping Steve catch the baby (he didn't seem to need any help with the first one). It made me wonder if they had their first baby in Australia and their second in the US, or perhaps a birth center, then a hospital. Anyway, I would have been deeply disappointed with that second birth after the first one was so untampered with.
I thought of this later yesterday when I was having a conversation with another business owner on my block. I stopped in to commiserate because we have so much in common: both nurses, both business owners, both pregnant and due soon. We were both moaning about the state of our accounts receivable, when the topic turned to our pregnancies. She asked where I was delivering (always a loaded question), and I told her at home. Of course she began her tirade about how she MUST have her epidural. I began my equally emphatic tirade about my preference for control and how easier it is to bounce back after a drug free delivery. Now I sit here kicking myself- I should have asked her for her views on how labor and delivery styles impact breastfeeding. She owns a breastfeeding store for god's sake, surely she's thought about the impact of birth practices. She is also a neonatal nurse, surely she's seen the fallout to babies of bad birth practices. After all these years I'm still shocked that nurses look at these things as NORMAL and even worse than that, they see them as benevolent. They really believe they are giving the best care possible to their patients. When I think about how many have never even SEEN a normal birth, it blows my mind, since they attend births for a living. How will my former compatriots view my book? I'll probably be branded a heritic, and burned in effigy. Or perhaps they won't be surprised at all, after all I've been preaching the same sermon for 20 years now. All I'm saying is, nurses are the hardest converts.

Thursday, September 28, 2006

The British Are Coming!

Just spoke to my doula friend on the phone. The Brits had a baby girl early this morning!!!! She was their doula and I woke her out of a post-birth slumber because I had a feeling I should call and get an update. I knew they were due any day now. One of our concerns is that they were due to have their baby only a few weeks before me. Kinda hard to film a birth when you're in labor yourself! Seems her water broke a couple of days ago so it was a long labor (typical for a first birth) but the doula said she had a wonderful, natural, drug-free labor and birth with my favorite midwife practice. I'm so glad for them. I'll wait a couple of days and give them a call. I like to avoid that initial onslought of calls and visits that happens the first few days when mom and baby need their rest. The doula told me they named her Harper. What a great name.

Much Ado About Everything

I had a few Braxton-Hicks last night. Just a gentle reminder that time is short and this pregnancy will not last forever. I feel rather like a time-bomb waiting to explode. Will I get everything I need to do done in time? Now that I am 37 weeks (and often deliver at 38 weeks), I need to really focus on getting things ready for the birth. Today I move back home to office- a move facilitated by the fact that yesterday, I tripped over my laptop cord and sent it sailing to the floor where the screen cracked into a million slivers. It's en route back to the factory for repairs (thank God I purchased that warrenty!) To top yesterday off, my husband's car won't start so we may be down just to one vehicle again (damit, I was hoping that car would get us through the winter). When I got home from the office, my husband was grilling our dinner. I told him about my bounced check and broken computer. He told me about his car and the missed vet appointment (that damn cat disappears every time he has an appointment- its like he knows). We just sighed and held each other. This too shall pass, I suppose. We had a very nice dinner that my husband had prepared, took the girls out for ice cream and watched our favorite family shows; America's Next Top Model, and Lost. (Don't ask me how ANTM become a family favorite but we all watch it and root for our favorite girl.) Later I watched the interview with Steve Irwin's widow on 20/20. Of course I cried. Again, it made me remember how much I have to be grateful for. I can't imagine, the long stretch of years ahead, without my best friend and confidant. I also thought my life would be very well lived, if I left this earth having had at much influence in my chosen sphere as Steve Irwin had in his. What a legacy he has left. I want that for my own life as well- what will I leave behind when I go? One of the highlights of a mostly bleak day, was my appointment with my counselor. We continued to talk of my struggles with my feelings about my parents but I can feel things resolving- finally after weeks of agonizing. I told her how I wanted to write a letter to them, and she encourage me to go ahead and write it, but that I might find that I won't necessarily feel the need to actually send it. Fair enough. Of course, their letter will have to stand in line behind all the thank you notes I need to get out. I have to order my birth kit- like today! I'm still cleaning and organizing the house for the birth. My midwife will do a home visit next week so thats my deadline. We still have to go buy the crib and dresser, because until those are assembled and in place I can't unpack the huge pile of baby stuff still in boxes sitting in a corner of our bedroom waiting to be put away. So much to do, and if the Braxton-Hicks are any indication, so little time.

Wednesday, September 27, 2006

Will Work for Therapy

Yesterday was full of blessings. My Toastmaster group treated me to a rather unorthodox baby shower that was a modified TM meeting. We had a Table Topics meeting where everyone got to tell a birth story, or their favorite nursery rhyme, or a piece of parenting advice. It was very sweet and really fun. I was presented with a generous gift certificate to the store of my choosing. It was more than enough to get the crib I had pre-selected. I'll think I'll use the extra to get a porta-crib to keep at the office. My son called me mid-day (the 28 year old) to ask me to pick him up from work because he had a migraine. I just happened to be a few blocks a way when he called, so I picked him up and took him home. After dropping him off I had an urge to visit my parents, who live just down the street from my son. I've been feeling really weird about them lately, but my dad had a burst appendix last week and had to have emergency surgery. I left for LA without seeing him and hadn't visited since my return. I'm really glad I stopped by. My mother was out, but Dad was shuffling around in his pjs and robe and my grandmother was there as well (she's lives with them and is mostly bed ridden). My visit with my dad was very healing. We had a really good and honest talk, something we rarely do. He acknowledged that he had not been a good father (he was neglectful and laxidazical) and I accepted that. He also said he was very proud of me and the person I've become. (That was nice to hear since I'm not feeling so accomplished or responsible these days with two overdrawn bank accounts, a bounced check and bills piling up to my pregnant belly). I have forgiven my parents. I know we were poor, but I also know they partied a lot. I know I didn't have a bike, or ballet lessons, or dental visits. I think I could have had at least some of those things if they didn't party, drink, and drug away part of their limited financial resources. Its hard to stay mad at them especially since neither of them are those people anymore. Now my mother is in church 3-4 days a week. (Where was this person when I was growing up?) Now, my dad is a devoted family man, it seemed when I was growing up, he couldn't find enough reasons to be out the door and away from us. (My parents cared for my dad's mother for years until she passed away then immediately took in my mother's mother.) If I complain about my parents, my friends look at me like I'm nuts because they are such fine upstanding citizens, NOW. Well these people are not the people who raised me. When I was growing up my mother was a depressed drug addict, my dad the worst kind of womanizer. Oh well, it is what it is. I do look forward to talking more to my counselor about all this and hashing it out with her, (even though I can't really afford the visits- I feel like one of those panhandlers I see standing on street corners holding up cardboard signs- "will work for food- and or therapy") I want to be mad at them, but mostly I'm just sad about it all. I felt good about my visit with Dad though. I wanted to tell him, how disappointed I was in him as a father, but when he admitted it first, I didn't have the heart to bash him with my feelings. Especially with him sitting their recovering from a near fatal experience, gaunt from weight loss, and looking older and frailer than ever. We talked and hugged. I did feel redeemed, somewhat. I went in to visit with my grandmother and rubbed her feet as she told me stories of her own grandmother. I prompt her for family stories everytime I'm in her presence. My dad gave me the best compliment he's ever given me when he told me that I have my grandmother and mother's spirit. A light went on in my head. I do have their spirit- I am strong and courageous and stubborn as they are. It is why I will not only survive, but thrive. As I drove away, I thought, just because I didn't have a real father/daughter relationship with my dad when I was a kid, doesn't mean I can't have one now. I can invite him to things, involve him, and do things with him now. I'm so used to his being an outsider in our lives, this thought only just now occurs to me. I never invite him to anything, assuming he won't come. I invite my mother, and if she gets him to come along, fine. I'm shocked at how accustomed I've become to not having any expectations of him. But I love the thought- that at 44 years of age, I can begin to work on filling that father-daughter void.