Sharing the love (i.e. breastmilk)

To date, Ilse and I have had so few nursing issues it's ridiculous. She's a super nurser, and I've had massive amounts of milk.

But I think back to 2008. My sweet newborn Uli. Such terrible, terrible troubles feeding her. A very small mouth that couldn't latch well despite several visits with different lactation consultants. And my milk supply simply refused to come in, whether it was the c-section or the medications or just me... ugh, it didn't matter. It was awful. For a mama who wanted to breastfeed exclusively it was more than disheartening, it was nightmarish.

I pumped round the clock to build my milk supply until she could learn to latch, but we had to come up with some way to feed her in the meantime. Our midwives had connections with a for-purchase milkbank, and I was very grateful for the breastmilk we were able to buy from them. But at $4/oz we weren't going to be able to afford it for long, and I worried my supply wasn't coming in quickly enough to meet Uli's needs.

Have you milkshared? There's a chance this was your milk!

I tearfully told one of my friends my situation during a phonecall, and she showed up at my door that same week with nearly 40 oz of her own expressed breastmilk. I felt blessed. Her gift, along with the purchased milk and what meager amounts I was pumping, was enough to feed my hungry little one until she finally grew enough to latch and my milk finally had a chance to come in. It took nearly six weeks, but we did make it. We were a nursing pair!

And then I went back to work. And my supply that had been doing so well with direct feedings dipped once more. The anguish! So I upped the number of times I pumped per day. And took fenugreek. And dropped by the daycare mid-day to get a dose of milk-making baby vibes. And pumped more. And nursed and nursed and nursed whenever my baby and I were together. And it was just enough.

Until one day, it wasn't. I showed up at our daycare provider's house, and I didn't have enough milk for my daughter for the day. The freezer stash I'd carefully built before returning to work had been wholly depleted, and I hadn't gotten enough from pumping the day before. I handed our provider the few ounces I did have and broke down in tears. I didn't know what to do. I was so embarrassed to find myself crying over breastmilk. What would this woman think of me? I imagined her rolling her eyes and telling me to just buy some formula already. But she didn't do anything of the kind. Instead she hugged me. And then offered me something I hadn't expected. She said her daughter (just a month older than Uli) refused to drink from bottles, and thus she had unused expressed milk in her freezer. She offered to share her entire freezer supply with my daughter. I can't fully describe how I felt at that moment, my feelings of gratitude. It was amazing, her gesture. Amazing. I accepted wholeheartedly and Uli thrived.

After that I upped my fenugreek supplementation and pumping sessions. Uli began to eat solid food during the day and nursed more at night. Once she turned a year old we introduced goat and cow milk and then I breathed a sigh of relief. I continued to pump for a few months past her first birthday, but eventually felt okay giving that up. She gradually reduced her time at the breast, eventually nursing only at bedtime.

Uli nursed for the last time earlier this year, when I was a couple months pregnant with Ilse. The first night I didn't nurse her to sleep she asked for my milk a few times but soon accepted that I wasn't able to give it to her. There were no requests the second night. She was weaned. Just like that. I'd imagined the end to our nursing relationship was going to be as dramatic as its beginning.  But instead it was simple and sweet. To be cherished.

I am so thankful to the other mothers who shared their milk and helped make Uli's and my nursing relationship possible. If it hadn't been for them we may not have been able to nurse in the first place. Or our nursing may have ended earlier in frustration and with feelings of failure. But instead, my daughter was provided with the breastmilk she needed and I was given the time my body needed to build and rebuild my supply.

 Milksharing. It's a beautiful thing.

The Past Six Weeks: A Review

I was pregnant.

41 Weeks Pregnant

And then I wasn't anymore.

Ilse Louise

My firstborn has a little sister.

Two beautiful girls!

I have a nursling!

Lots of snuggles

Ilse has tons of hair.

Swoopy Curl care of Neko [the cat]

I think she looks like her daddy.

Uli is taking it all pretty well. (As well as a nearly-three-year-old can.)

The new "smile for the camera" smile

We Propsons are a happy family of four. :-)

Why Did I Want the Placenta?

Nope, I still haven't written Ilse's birth story. Workin' on it. ;-)  But I thought I'd write about something else in the meantime. Of all the comments/questions I received about my birth plan, there was one most common. What on earth can you want with the placenta? several people asked (in varying tones of panic).  At the risk of alienating a few readers and frightening my family and friends, I've decided to tell you.

I wanted it for this:

Shakes. Smoothies. Of placenta (and juice and fruit).

Now, to some of you placentophagy (ingesting the placenta after childbirth) isn't a foreign concept. You're probably the ones who, like me, have been frequenting some crunchier online forums, edgier mom's groups, or reading the more natural parenting magazines. You may or may not have consumed a placenta yourself, but you're aware of the practice and probably know other moms who've done so. 

But if you're hearing about this for the first time or are firmly entrenched in more mainstream customs you might be... alarmed by this idea. I understand. I was once alarmed (i.e. totally disgusted and freaked by the thought). Before you gag on what you're eating or throw up bile or whatever you are going to claim happened to you just now,  just keep reading.  Because, while I understand it sounds unusual, it's not as gruesome as you may suppose.

I'll first mention that many women who ask to keep their placenta do not intend to ingest it. There are other reasons to want a placenta. 

• You might want to make a placenta print (which looks remarkably like a tree. Tree of life. Call it a birth tree, etc.) with the placenta as an art piece commemorating the birth. You can see a woman providing instructions on this here on YouTube. They can be quite lovely and a truly unique piece of artwork.
• Others may plant/bury their placenta. They may intend to hold a ceremony (and say a few words about birth/their child/motherhood) or they may simply dig a hole and perhaps plant a tree over the placenta.
• I'm on a forum where one mother, though vegan, cut up and fed the placenta to her dogs, believing that to allow it to be incinerated at the hospital was to unduly deny her pups a meal of ethically obtained meat.
• And there's always the placenta teddy bear. Seriously. Click here. (Or don't. I actually find this one mildly disturbing.)

But back to consuming the placenta. It's claimed that there are nutritional benefits to the practice:  

[T]he placenta contains vitamins and minerals that may help fight depression symptoms, such as vitamin B6 ...[and] the placenta is considered rich in iron and protein, which would be useful to women recovering from childbirth, and a particular benefit to vegetarian women.                              

 http://placentabenefits.info/medicinal.asp   

Beyond iron/protein, it has been claimed the hormones found in the placenta may ward off postpartum depression.

Now, some say that these benefits are only really helpful to an undernourished mother and that we modern humans don't need (and thus should turn away from) any sustenance which may be received from the placenta. And I would agree that most of us mamas don't *need* the placenta as a meal like, say, a mama cat might. After I give birth my husband and family brought me other nutritious food. And even if they didn't, I'd been well fed prior to labor and I wasn't birthing out in the wild in need of a sudden jolt of protein so I could be on the alert for predators. Nevertheless, there are nutrients and hormones in the placenta and consuming them may provide the new mother with something necessary (and possibly even unstudied/unknown). The social rules disproving of a mother's ingestion of the placenta seem unfortunate. If there's a chance to receive benefits from the practice I think a mother should be able to receive them without censure.  

Of course, the benefits I've received may all be from a placebo effect. I'll give you that. But even if it's a placebo effect, I do feel better emotionally after this labor and birth than I did the first time around. Was this birth different? Absolutely. It was a gentle birth at home vs. an unwanted c-section. Is healing from my vaginal birth taking less of a toll on me than the surgery? Yes, and I suppose that's true for most natural births when compared to cesareans. Is my avoidance of court TV a benefit to my mental health? Absolutely;  People's Court and Judge Joe Brown did not contribute last time to a feeling of wellness or peace or foster a positive outlook about our country. But might some of my happiness and energy be from my shakes? I think so. I truly do. And (according to some viewpoints) if I think so, so it is. And that's good enough for me.

There are three main ways to consume a placenta: 

1. Raw (which includes being frozen and blended into smoothies)
2. Cooked (It's just meat, after all. Click HERE for actual placenta recipes to cook. Even if you're squeamish, don't worry:  no pictures on this particular link)
3. Dehydrated and encapsulated (I've found this is by far the most socially accepted way to consume a placenta, but it also costs money--about $300 in my city. That is, it costs money if someone else does it for you. You could give it a shot yourself and try it for free. See HERE or HERE for a tutorial on how to encapsulate a placenta at home)

I chose option one. My midwives offered to cut my placenta into small pieces and those pieces were placed into mini ice cube trays which were themselves put inside Ziplocks and then into our freezer. Because the pieces are small and frozen I'm able to pop them into my smoothies without any gross-out factor. Easy and gives me some voom each morning. 

My basic recipe is:

• 1 cup juice (I prefer orange or pineapple but apple is also very good)
• 2-3 Tablespoons yogurt (whole fat vanilla is my preference)
• Mix of frozen berries 
• 1-2 Tablespoon raspberries
• 1-2 Tablespoon blueberries
•  2-3 large strawberries
• 1/2 banana (optional)
• 4 pieces of frozen placenta

It's good, I swear. You taste only juice and berries. 

And that's why I wanted the placenta. So now you know. 

Gross. Just Gross.

You know there's too much clutter when you confuse your daughter's toys with real animals. And vice versa. 

This week, coming down the stairs and entering my living room, I saw this monstrosity on the carpet, seemingly frozen mid-scuttle:

Plastic Cockroach.
Rumored to be even hardier than a regular cockroach.

I nearly (nearly) immediately realized it was one of Uli's toys and laughed at myself.  How silly of me, to be startled by a plastic insect!

And then I surveyed the rest of the living room floor and all its crazy mix of toys (mainly comprised, on the evening in question, of plastic insects and cloth barn animals).

And I found myself thinking, "Yup, I'm so stupid to have been scared by the plastic bug. It would be like me being startled by that toy dead mouse that's lying next to it. With gashes in it's belly. Made to look like it's in full rigor. And, seriously, how silly would it be of me to be scared by something like that?"  

It was a few seconds before I realized that Uli doesn't have a plastic toy mouse made to appear it'd been mauled to death by cats. 

Ugh.

Reenactment of Said Scene
(lacking a pic of the actual dead rodent)

41 Weeks :: A Birth

Operation Homebirth was a success! Meet my newborn daughter:

Ilse Louise

Born 08-08-11

8 lbs 2 oz

Lots of golden hair

Nurses like she's done this before (but I don't think she has)

I haven't typed up the birthstory quite yet. I've found myself very busy with things like looking into my baby's eyes, cuddling with my two year old and telling her I love her, watching TV with my husband, and eating and sleeping. It's a busy schedule and I am uncertain when it'll let up.

I'll tell you one thing now. She was worth the wait.

40 Weeks

Technically this pic is from Saturday, so it's 39 weeks, 5 days. But close enough, right?

So. My estimated due date. Today. Will the baby come? Perhaps. But probably not. It was bizarre that Uli was born on her EDD and I would fall over if that happened again with this baby. Not that I would complain (Come Baby, if you'd like! Mama would be happy!) but I just don't really expect it. It'd be more likely to be tomorrow. Or Weds. Or next Saturday.  Any day but today.

And as difficult as it is to wait, there are some things to be grateful for in all this waiting. I get to revel in the last bits of pregnancy. That's right, revel! I do truly enjoy being pregnant. I haven't had the heartburn or swelling or aches that many other women (including myself, to a point, last pregnancy) have to suffer through.

Justin says it's not a good reason to think about having more babies just because pregnancy is fun for me.  I don't know if I agree with him...

Things that I'll miss about being pregnant:

• Fast-growing nails
• Healthy hair
• Clear skin
• No joint aches (I've been enjoying the Relaxin experience lately. Very bendy and happy and fewer aches than when I'm not pregnant!)
• Constant company (Hello, little one! I  sure can feel you in there, be-boppin' around!)
• A tight belly (True, it's also a giganto belly, but tight is tight, and I'm enjoying wearing form-fitting shirts and even showing my belly off in a swimsuit and not feeling self-conscious about squishy abs.)
• A reason to read as many birthy-ish blogs and books as I want (love birth! So fascinating.)

As much as I enjoy pregnancy, I am ready to meet this little one. So I'm not hoping I go until 42 weeks or anything. But I guess that if I were to be pregnant for 42 weeks, this is the type of pregnancy to have... (But don't get any ideas, okay, Baby? We're ready now!)

I'm now planning for a homebirth

That's right, ladies and gentlemen, in the past couple of weeks every plan for my labor and delivery has changed. Unexpected, but definitely a positive.

Quick hits:

• My MD transferred me from her care because her clinic felt my prenatal and delivery care would be better handled by an OB than a family practitioner. This was because I wasn't comfortable submitting to the ultrasounds and non-stress tests they were asking of me (I felt like they were looking for issues that weren't indicated. They felt they needed to check in order to rule them out.)
• The OB's care to whom I was eventually transferred did, in fact, seem to be competant and friendly and would have been able to handle my prenatal care. He told me he was made of "tough sauce" and everything I wanted was on the table (he'd give me his opinion but it'd be up to me to choose what to do). But he's only on-call at the hospital every 13 days, so chances weren't good that he'd be the one to deliver my baby (he said 20%). This is one of my main complaints about the OB care in Madison--you spent time developing a relationship with a doctor only to get one of their collegues seeing you in labor and guiding you through your medical needs on that date. 
• My doula (who is also a midwifery student) told my story (with all its weird diagnosis and provider switchero drama) to her instructor.  As it all turns out, this CPM is not only comfortable with primary VBAC attempts such as my own (with the initial c-section performed due to breech presentation) but she was also willing to drive to Madison to attend a homebirth.
• And drive here she did, to visit with me. This week we've finished gathering all our homebirth supplies and we're now waiting for Baby to decide to arrive. At home! Uli talks positively about the "big wives" and we're all looking forward to having the newest Propson delivered right here in our own bed. Or the futon. Or the bathroom. Or the living room. Or wherever. But here, at home. With no last minute 9 centimeter car ride to the hospital. No random on-call OB. Just us and our midwives.

Conclusion:  I feel great. Excited. Happy. Ready.

Birth Plan

38 Weeks

As promised, here's my birth plan! Kind of.

For the purposes of this post I'm combining a few separate birth plans. I've written one for my doula (not really represented below) so we could discuss what I anticipate as her role in my labor/delivery and give her insight into my head and what I'm requesting of the doctor and hospital staff. Another version was written specifically for my doctor, to be reviewed prior to the birth so she knows what I'm hoping for and we can discuss any divergence from local hospital policy and get the waivers (going against medical advice) signed if need be. The third (shortest) version is for the hospital nursing staff, whom I will meet for the first time hopefully late in labor, so they have an overview of what I've already discussed with the doctor, and I can share with them how best to assist me in my labor and the short time I'm there postpartum.

So far I've shared these plans with my doula (and made some changes based on her suggestions and experience) as well as my family practitioner (the doctor and nurse versions, anyway).  Reviewing them with my doctor was incredibly interesting. We had a great conversation and some points I thought she might question didn't make her blink (such as eating and drinking during labor, which I've since removed from the plan anyway since I'll eat/drink if I want to and won't if I don't but I don't feel like I need it in the plan itself) while other things (like not wearing the fetal monitoring belt continually--assuming no distress was picked-up by intermittent monitoring--and delaying automatic pitocin injection post labor--assuming no hemorrhaging) led to detailed discussions about hospital policy.

(I don't think I've mentioned this yet on my blog, but my provider has since decided she could not provide me the care I hoped for--mostly to do with my refusal to let my delivery plans be decided by the results of fetal weight ultrasounds, not the items on my birth plan--and I, at 37 weeks, have been forced to search for a new prenatal and labor care provider. And found one! But that's a different story for another time.)



So, here you go, a mix of the lengthier plan I've written up for the doc and the shorter plan for the nurses.

My Birth Plan: 

• I plan on laboring at home for as long as possible, transferring to the hospital only in advanced labor (8-9 centimeters at least).
• Justin (husband) and Hannah (doula) will be present with my throughout the labor as my birth partners.

Environment / Pain Relief / Medical Assistance

• I will be attempting deep relaxation akin to self-hypnosis. I prefer a quiet environment with dim or natural lighting. Please allow me to focus inwardly during contractions an avoid references to pain.
• Alternatively, if I abandon the self-hypnosis/relaxation method, I may decide that to best manage my pain I need to vocalize. If this is the case I anticipate it may get quite loud! (Please allow me my voice.)
• I intend to move about during labor as I feel the need. I may avoid the hospital bed entirely, laboring and delivering instead on the couch, floor (I'll bring a "sit-upon" and/or use towels), birthing stool, toilet, and/or shower/tub.
• I will wear the clothing I brought--no need for a hospital gown.
• My doula and spouse will support me in non-pharmaceutical comfort measures (showers, baths, birth ball, movement, changing positions, etc.)
• I am aware of my pain medication options--please do not offer pain meds unless I ask for them. If I do ask, please note whether I am asking in the middle of a contraction and, if so, wait until after the contraction, provide encouragement, and see if I was making a true request (versus just vocalizing).
• I am receptive to an initial 20 minute monitoring/strip of the baby's heart rate and regular intermittent doppler checks of the baby and monitoring of my blood pressure thereafter. Please check vitals wherever I am laboring (versus asking me to move to the bed).
• I may consider continuous fetal monitoring if a mobile monitoring unit is available that will not restrict my movements.
• Please ask my permission before every routine procedure including internal examinations, medication or interventions such as AROM. If it is not an emergency situation I will consider my options and review the alternatives before consenting to routine procedures.
• If I am unable to keep swallowed liquids down and it is determined I'm dehydrated I'd appreciate a saline lock placed somewhere that allows me to freely bend my hand so I'm able to move around between IV sessions as needed and crouch on hands/knees for pushing.
• I look forward to freedom of movement and the ability to change positions frequently during labor, including going on walks, talking showers/baths, bouncing on the birth ball, slow dancing with Justin, etc. I'd also appreciate suggestions for pushing positions if I need them. It's my understanding that many unmedicated women instinctively move into squats or onto hands/knees when it's time for pushing, but that they're also highly suggestible. Please suggest I stay off my back.

Time to Push!

• In the interest of opening my pelvis as wide as possible I intend to totally avoid the lithotomy position; instead I would like to be encouraged to push while seated on the birthing stool, while using the squatting bar or my spouse or doula for support, or in a hands/knees position.
• I would like to push instinctively and as gently as possible. Please do not announce a time to push--I want to follow my body's prompts. I'd appreciate support (not stretching!) of the perineum if needed, but it's not required if things are going smoothly without. 
• I prefer to tear over an episiotomy.
• I might like to assist in catching my baby if possible and if I feel comfortable with it in the moment. I would appreciate support and direction at that time.

Afterward

• Please allow me to learn my baby's sex on my own.
• Please do not cut the umbilical cord until after it stops pulsating.
• I plan to hold the baby skin-to-skin immediately after birth.
• I am open to vitamin K being administered to the baby once we have had time to snuggle. Please administer this while baby is in my arms and weigh the baby next to me at that time. Please, no other routine post-birth interventions for my infant (including blood draws, eye ointment, Hep B vax, or bath).
• I would like to allow my body time to expel the placenta naturally, with no immediate injection of pitocin. At the half-hour mark I would like to discuss with you what other measures (besides continuing to wait) may be possibilities. 
• I plan to take my placenta home with me--please do not dispose of it.
• If baby is a boy:  no circumcision.
• The majority of my/baby's post birth care (bilirubin and blood sugar watches, weight checks, PKU, etc.) will be completed by a nurse midwife at my home. I will keep my and my baby's hospital visit very short in order to return home soon after the birth so this care can begin.

************

And that's that. Now, whenever a woman discusses her birth plan inevitably someone starts in saying, "But what about if you pass out or change your mind about the drugs or the baby is in distress?" or "You can't plan something like a birth so why write-out anything?" or "This is what the nurses are for, so you don't have to think about these kinds of things." And I mostly understand what they're saying. Generally they mean well. But I nevertheless totally disagree with them. 

I think it's essential that you talk about these sort of things, from the mundane and perhaps not even all that direly important to you (I want to wear my own clothes but I'm not going to go all gladiator style on someone if they toss me a hospital gown) to the your preferred method of pain meds (whether you were hoping for an epidural as soon as you crossed into triage or whether you hope to soak yourself in a warm tub for hours to cope) to the big and bad (few to no cervical checks! No AROM! [I've personally decided to leave these firm 'no's off my plan, though I believe I'll refuse checks and artificial rupture of membranes. I'll just keep my legs together and say no at that time if that's how I'm still feeling.]) 

This is the stuff that a woman can remember and may make/break the memory of her child's birth (one co-worker just mentioned to me that the nurse at her son's birth pulled her hands away from feeling his head at crowning. 18+ years later that still bothers her. It was her baby and her body and she was denied that moment. And it makes me sad that that happened to her and still lingers in her mind.)  So when possible I think it's good for these things to be discussed by a woman and her providers (and at least the quick notes written down for the labor attendants). So we all know where we all stand. 

And if things change because circumstances change, they do. Hopefully, by that point, we'll have enough knowledge of each other's leanings that no one will be surprised by anyone else's stance or reaction to the changes. Going in with an understanding of the other, essentially. What else can you do when you're facing something as amazing and as unpredictable and as important as the rite of passage of giving birth? Prepare and believe. 

Prepare and believe.