PEN newsletter article

This article was published last May.  It is about public forums and uses our story as an example.  I sent a question to Laurie Kelley, and she passed it on to her readers.  I did get lots of feedback.  Some was helpful, but some was very insulting and judgemental.
http://www.kelleycom.com/pen/may2010pen.pdf

Malakai's Birth Video

I've never shared Malakai's birth video on this blog.  Here it is if you are interested.  This is the first birth we planned with the knowledge that our baby had a 50% chance of hemophilia.  http://www.youtube.com/watch?v=hvRJB5V0nxk

You are welcome to "Like" the BWB facebook page!

http://www.facebook.com/#!/pages/Bubble-Wrapped-Birth-How-to-safely-birth-a-hemophiliac/168141116541416

Sorry for the L-O-N-G absence!! I'm back!

Since last May, I have started a BWB facebook page.  That seems to be the best way to contact people, but I want to get back to writing!  I really don't get too much feedback on my page, but I hope some of the topics make some people think.  I have gotten a few birth stories.  One thing that continues to dominate my thinking is the fact that bleeds are caused by interventions!!  My husband and I want to have more children.  We did have an awesome birth with Malakai at the hospital, but the newborn care protocols are not very hemophilia safe.  For example:  if he'd had hemophilia, the heel prick would've probably caused a bleed.  We were able to get oral vitamin K, though.  That was very good since they wouldn't let us refuse it.  If we could be guaranteed that our baby would not be handled roughly or be poked, I would definitely have another hospital water birth, and consider that our best choice.  Until I can have that guaranteed, I still have my doubts.  #5 is not on his/her way yet, but if we get any exiting news, you are welcome to join us in planning for another bubble wrapped birth!  ;o)

My Bubble Wrapped Birth

If I were putting together a birth plan for another baby, I would look at my options and decide where my baby would be the safest.  That is simple enough, but what is "safest" to me?  I choose water birth with a midwife nearby who is trained in newborn and adult emergency response.  I would choose to be in a place that does not interfere with my natural birth process.   If you have read my birth stories, you know that I have had 3 home water births, and one hospital water birth.  I prefer home because there are no hospital protocols to deal with.  Some could even cause a bleed.  I want to have the cord blood tested immediately after birth as opposed to getting it drawn a few days later.  That's rough.  My motivation is my baby's safety.  So, I would draw from my experience, assess my options, and choose the birth plan that keeps my baby the safest.  The purpose of this blog is to gather and discuss information that would help make this careful decision.

I consider water birth a huge asset to hemophilia carrier moms who want to avoid a c-section. Most hemophilia "experts" recommend that we have scheduled c-sections. Yet, I have searched and searched on this subject and cannot find any proof that a normal, calm, un-intervened birth has ever caused a bleed in a severe hemophiliac. All bleeds I have read about are caused by interventions during labor and delivery. Water birth has so many benefits to mom and baby, but the most important is that the mother is more comfortable. This relaxes her muscles. The warm water makes her stretch much better. The buoyancy of the water makes it much easier to move anywhere at will weightlessly. You naturally ease your baby out. These facts make the birth more gentle on the baby, and isn't that always the goal with a hemophiliac?

Our Fourth Birth - Malakai (part 2 - Birth Day!!)

My mom and Grandma arrived Thursday morning. I was miserable! I felt so sick, and was so upset about not being able to fully focus on our soon coming birth. Everyone agreed that Matt should take me out to dinner, and get me out of the house. I hadn't been out for about 2 weeks due to flu season! We went to Red Robin for dinner. Then we walked around Target and Walmart. It was so refreshing to be out with Matt. Throughout the evening, my mild contractions became pretty regular at about 5 minutes apart. I told Matt that I bet Malakai's birthday would be November 6th! We came home, and I went to bed. Matt stayed up making sure everything was ready if we needed to go to the hospital in the morning. I had contractions all night, and also got some sleep.

In the morning, my contractions began to get better. I couldn't talk through them at about 8:30. We began timing them. They were between 5 and 7 minutes apart. They got a little closer together, and I decided to take a shower. That really helped! I had 6 good contractions while I was in the shower. When I got out, I called Matt at work, and told him it was time to come home! We left for the hospital in about 15 minutes or so. The ride really wasn't as bad as I had feared it would be. Matt did speed, and didn't exactly obey every traffic law!

We arrived at the hospital a little after 10:30 am. Our midwife, Eileen was waiting in our room. The pool was set up and filled. The bed had been moved out to the hallway. :o) We met our nurse. This was one of the many amazing things God had planned for us. Our nurse had had 4 homebirths. 3 in the water! She was so exited about us. She had requested to be called in to be our nurse whenever we checked in. She was awesome! I had to get some blood work done between contractions, but refused the IV. I am not sure when I got in the pool, but I fell in love with that pool! Oh, soooo nice!! I had to get more blood taken. It was ok. We just went with it.

Eileen knew I wanted lots of privacy and space. So, she and everyone else left Matt and I alone for a while. It was nice! She checked on us periodically. My contractions got better and better. It was getting nearly impossible to be in a comfortable position through them. Yay!! Then, I told Matt to kneel down in front of me. I grabbed his shirt and got through my much stronger contractions. Quietly in my heart, I was really hoping Malakai would be born with just the two of us there. A couple minutes later, I braced myself, gripped Matt's shirt and felt my body begin to push! Matt asked me if my water had broken, but I could not speak. My body bore down again very strongly. I felt my tailbone move up and out of the way as Malakai's head came out!! At that time, Eileen and another midwife came in to check on us. Eileen heard me make a grunting noise, and said, "Oh! Is it time?!". I said, "Yes, the head is out." In fact, his bag of waters was still intact around his head! When I felt his head, it felt so amazing being in a water balloon! I relaxed for a moment. Then, my body pushed the rest of his body out. His water broke as his shoulders were born. I lifted him up out of the water and to my chest!

His heart rate was good. He was limp and getting more purple, though. We rubbed him, kissed him, spoke to him, and he wasn't snapping out of it. It had only been a minute, and sometimes water babies don't breathe for a whole minute just because they are not stimulated to breath until they are out of the water. Eileen gave him a few breaths mouth to mouth. He gave a little gasp and squeaked, but not enough. Katherine (OB that works with Eileen) gave him a few more breaths, and they cut the cord to get him to a flat surface. When they suctioned him, they found that he had swallowed some meconium. He pinked up right away. This particular situation would've been handled well at home too. I am very pleased with the care he received at the hospital. Everyone was very calm and acted quickly. They were great!

They brought him back to me in the pool. It didn't take him long to show me he was a pro at nursing! Soon my placenta was born. Then, we got out of the pool.

So, that's it! All of the fear, planning, tears, praying, and frustration about Malakai's birth came down to a very unusual hospital birth! Matt and I got to share a moment between just the two of us that we couldn't have even had at home! His birth began as an unattended birth, and I caught him myself! Malakai's birth was definitely the easiest I have ever had. I guess it helps to have a 10# 14oz baby before to plow the way!! lol!

For the record, the birth itself was the best part of our hospital experience. We were not thrilled to have to deal with the many unnecessary hospital protocols that you don't have to deal with at home. It is definitely not as restful to stay at the hospital, and soooo many people have their hands on your baby. You don't have as much say in your baby's care as you do at home. Yes, I'm still partial to homebirth, but now I know hospital birth can be awesome too! For us, the baby care afterwards was the main headache. We had nice people. All the required tests and procedures and middle of the night disturbances are not nice though!

God totally blew me away! . . . and, Malakai doesn't even have hemophilia after all of that!

Malakai Thomas Reeves was born on November 6th, 2009 at 12:32pm in a birth pool at Women's and Children's Hospital in Buffalo, NY. He was 7lbs. 12oz. and 21 inches long. His actual birth was mainly attended by his Daddy, and he was caught by his own Mommy.  "God has not given us the spirit of fear, but of POWER, and of LOVE, and of a SOUND MIND."  "I can do ALL things through Christ Who strengthens me."  God is truly awesome!!!  That was the beginning of Malakai Thomas Reeves!!  Whew!

Our Fourth Birth - Malakai (part 1 - pregnancy and planning)

I didn't realize how emotional it would be to revisit my pregnancy with Malakai.  I've shared my birth story with so many, but his story begins a few months before he was created. . .

One month before Elijah was a year old, I got the news that I was indeed a carrier of severe hemophilia A.  (For those who aren't as familiar with hemophilia:  It is possible that a hemophiliac is the result of a spontaneous mutation, and did not inherit the gene from a parent.)  That was November 2008.  In March 2009, we found out that we were expecting #4.  Within the next month or two after that, my husband learned that he was losing a huge part of his job that would make it impossible for us to stay in CA.  This was a very personal thing, and not just a business downsize.  Also, Elijah was one week from his port surgery.  I was under extreme stress, and had to choose where my energy would be spent.  That was not a hard choice.  I had to take care of my family.  My husband needed a lot of support, I was growing a baby that needed me, and I was gearing up to hand off my older baby to surgeons.  There was no room for anything else.  But, still, it didn't make all the other pressure go away.  On top of all that, I had to start planning my upcoming birth.  We got an ultrasound to determine the sex of the baby.  It was a boy!  I started doing extensive research on hemophilia and childbirth, and was not satisfied with what I found. I'll get into that in another post. 

Several facts were in the mix: 

1. Our baby had a 50% chance of having severe hemophilia. 

2. I had to plan my birth with wisdom in the new knowledge that I may have passed on this gene. 

3. I could not base my decision on the success of Elijah's birth, although that did play a part in the decision.  All hemophiliacs are not the same, and have different bleeding patterns. 

4. Until my third trimester, I did not have any idea where we would be for the birth. 

5. We needed to have his blood tested right after his birth.


6. Our son's hematologist recommended that I schedule a c-section.  Then, when she could see that I was not welcoming that idea, she recommended a plan B:  Have my birth as natural as possible in a hospital where they can do an emergency c-section if needed.


Near the end of my second trimester, my husband was offered a job in NY.  He accepted the position, and we had to pack up our house in a week.  We decided to drive.  After all, when would we ever get the opportunity to drive from CA to NY again?!  So, Matt drove the big truck, and I drove the van.  Yeah, it was pretty crazy!  It was fun though.  We made lots of memories.   I met with the only licensed midwife in the Buffalo area a couple weeks later.  We were planning a homebirth, hoping the local hospital would support running the labs for us (Matt would take the blood to the hospital immediately).  In some cases, this does work. However, this time, it did not.  Our new pediatric hematologist tried to work out the labs for us, and even an on call emergency transport.  However, the hospital would not support this plan.  Our midwife, who we loved, could not help us with a homebirth.  She was under fire from the hospital, and could only offer to help us with a hospital birth.  I was devastated.  We met with another midwife, but we couldn't work out the labs.  I met with the nurse manager at the hospital.  I told her that I wanted a waterbirth.  She told me that they did not offer waterbirth, and the room was so small that it just wouldn't work.  I was determined to have the most relaxed non-traumatic birth possible even if that meant having my baby at home and compromising the immediate lab work.  I was trying to avoid causing my baby a bleed.  I would keep him safe!!  I met with the perinatologist who asked me about my birth history and what I wanted for this birth.  When she heard my reasoning and that my only concern was the safety of my baby, she told me that I should get exact measurements of the birth pool, and get them to the nurse manager.  I did, but the NM said there was simply no room.  I asked her if we could make room for the pool by moving the bed to the hallway.  She said I shouldn't hope for this to be approved, but she would speak to "the powers that be", and get back to me.  I again shared my heart for my baby's safety with her.  The next morning,   I wept tears of joy when the NM called me and told me to order the pool!! 

*All pictures are from our trip from California to New York in August 2009*

      

Our Third Birth - Elijah

We were in California at this time. My mom and grandma had flown all the way from MI to be with us for this birth! So, they were there.  Isaiah was almost 4 years old.  Ana was almost 2 years old.  I knew I was in labor around 1:00am.  I laid on my side in the bed for a short time.  I got up, walked around.  While Matt was filling up the birth pool, I asked for a chair in the room.  I got on my knees, and leaned on the seat of the chair with my arms bent.  I moaned softly through the contractions.  It was getting stronger.  I really wanted to get in the pool.  When it was finally filled, I got in.  Aaaaaaah. . . . so nice. . . Isaiah was getting concerned, and was hanging around me a lot.  He needed a job.  So, I asked him if he could give me a hug through my contractions.  He was happy to do it.  So, when I felt a contraction coming, I said to Isaiah, "Ok, come here"  He reached his arms as far around me as he could.  He was outside the pool, in front of me.  It was so sweet.  He really did help me.  I had prepped him and Ana about the funny sounds I would make during birth.  So, it didn't scare him.  We had practiced and laughed about it for weeks!  When my midwife got there, I was almost to transition.  She asked me, "Sarah, do you feel the urge to push?"  I said, "When I feel the urge to push, you'll know because I'LL BE PUSHING!!!!"  I was so nice.  ;o)  Soon after that, it got a lot harder.  I threw up (in a trash bin outside the pool).  The contractions were so intense.  I tried a little push with one contraction.  No, it wasn't time yet, but I could tell that this was going to be harder than Ana's birth.  I thought, "I CAN'T DO THIS".  At this time, God impressed on my heart not to speak and claim those words of defeat, but instead to call out to Him.  It was between contractions.  Everyone was totally quiet.  I was facing the wall and couldn't see anyone in front of me.  It was just God and me and my baby.  I prayed out loud, "Father, thank You for giving us this baby.  Thank you that he's coming today.  'I can do all things through Christ Who strengthens me.' Thank You, Lord.  You bring this baby out.  This is all You.  Come on, let's go!"   After that I was on top of my pain (because my Jesus was carrying me).  It was time to push.  How did I know that?  I felt like pushing, remember?!  Oh boy.  Wow.  This was another big one.  I could tell!!  I pushed like I have never pushed before or since.  After his head came out, my body needed rest.  I had a couple minutes before the next contraction.  I P-U-S-H-E-D!!!!!  I had to push this one.  I started with my hand on his head, but then put it down to brace myself.  THen his body popped out, and I said, "There's my boy!!" (I did not know what we where having before this!) I reached back to bring him up, and Matt and the midwife said, "One more push!" He wasn't even out yet, but by the time he was out to his waist, it was such a relief, I thought I was done!  So a little push, and he was out and in my arms!  That big bubba was 10lbs 14oz!!  No wonder I had to work so hard!!  Elijah was born to his Daddy's hands at 5:30am on December 23rd, 2007, exactly 5 years to the day that we moarned our precious Faith!!  God was so good to us.  I was so close to God during Elijah's birth.  It was completely amazing.  By the way, all that pushing took place within about 7 minutes.  I had no tearing either.  4 months later we learned that he had severe hemophilia A.  He had no bruising at birth.  That was the beginning of Elijah Jesse Reeves!

Our Second Birth - Ana

A couple months after Isaiah's first birthday, we were expecting again. We were so exited! At this time we were living with my parents. I was SO emotional during this pregnancy, a little scary at times actually. Yikes! My midwife just laughed at me. She said that it was so obvious that I was having a girl. My pregnancy with Ana was just very emotional! The day before her birth, my midwife noticed that my body looked so peaceful. I did feel really peaceful too. Later that night, I started getting real contractions. My sister in law came over to help with Isaiah, and my sister came too. When my contractions were getting on top of each other at about 11:00pm, they made the executive decision to call the midwife! She got there soon after that. I remember moaning softly through contractions, being so relaxed sitting in a yoga position, eating strawberries and yogurt when she came up the stairs. When the pool was ready, I got in. By then, my cousin was there too, and of course my mom was there! I asked my midwife if she needed to check me, and she said, I don't need to, but if you want me to, I can. I said I did, so she did. I said, "Well, what am I?" She said, "Sarah, you already know what you are. You tell me." I said, " I don't know, 8?" She said, "Yes! I told you you knew!" I asked her if she would tell me when I should push, and she said, "No. You will tell us when it's time for you to push!" I said, "Ok!" A short while after that, my body began to push. I asked Tammy (s-i-l) to wake Isaiah up (that's what he wanted). He got up out of bed, took off his pajamas, and diaper, and wanted to get in the pool. I asked my midwife if that was ok, and she said, "Sure!" So, Isaiah got in with us (Matt was in the pool). A couple minutes later, I felt Ana's head crowning. I kept my hand there, and told everyone when her head came out. Then, at 1:30am on Feb 26, 2006, that baby girl came right out into my hands!!! I caught her and brought her up. She looked so little! It was amazing and so precious! My Grandma and Dad came up to see her before the placenta was even born. Then, I started nursing her. Well, Isaiah came right over and I tandem nursed them right in the pool! The placenta was born, we got out, weighed her (7lbs 4oz), had our herb bath, and it was time for bed. That night she started crying in bed. I tried nursing her, and she wouldn't nurse. I got up, and took her to the other room, and she wouldn't nurse. I changed her diaper. Nothing would stop her crying and screaming! Then, I held her in front of me, and just listened to her. I agreed with her, responded to her, and do you know that little girl's cries softened into coos! She then nursed and went to sleep. She had a big day and needed to be heard! That was definitely the beginning of Ana Isabella Reeves!

Our First Birth - Isaiah

My pregnancy with Isaiah went very well up until the last trimester. I was dilating and contracting for four weeks. My midwife really pushed protien, water, and epsom salt baths. She also had me on a bunch of herbs. It worked! On Feb 1st (my brother's birthday), 2004, at 5:00am, I went into labor. My sister was there with her two little boys, and my mom was there. My midwife got there around 10:00am. I was already in transition. She checked me and I was fully dilated. I began pushing with my contractions because my midwife said I could if I wanted to. Looking back, I don't think I should have done that. I was wanting to get him out asap instead of waiting and listening to my body.  I didn't realize that at the time.  First birth, you know!  ;o)  I was pushing for 4 hours, and he was crowning for the last hour. My midwife kept a close eye on his skin color and heartrate. He was doing fine.  Matt was in the pool with me, and he played with Isaiah's hair in the water while he was crowning. It was very peaceful. My sister was in front of me, right outside the pool, nursing her baby.  I talked to him between pushes. It was kinda funny. Isaiah's head was half out, and I'm baby talking with my nephew! When his whole head came out, Matt says, "I think he has your lips!" haha (btw, he doesn't. He looks like a carbon copy of Matt) Well, I will never forget how amazing that felt when his body finally came out into Matt's hands. Matt passed him to me, and I brought him up out of the water. He was so big! 9lbs 8oz. His placenta was born soon after that. When I got out of the pool, I started losing big clots. I walked over to the rocking chair, but passed out as I sat down. My midwife slapped me in the face, and gave me a shot of pitocyn in my leg. That and my mom's roast beef and potatoes took care of it. I had been working so hard, and my body was just wore out! If I had Isaiah's birth to do over again, I wouldn't have forced the pushing. I should've just relaxed and waited until I felt like pushing. Because he was crowning so long, the plates in his skull overlapped so severely that it also affected the roof of his mouth. He had some trouble nursing the first few days. We massaged the roof of his mouth and the top of his head, and it worked out in just a few days. That was the beginning of Isaiah Matthew Reeves!

Our First Pregnancy - Faith

We were married in June of 2002, and that Thanksgiving, my sister and I both found out that we were expecting. We were due just two days apart. I loved that little one, talked to her, rubbed my belly. Then, just a few weeks later, on December 23rd, 2002, she (I felt she was a girl) was gone. It was so painful.  It was much worse than a live birth.  I was delivering death.  It hurt so badly, and I was so sad.  Because of all the pain I was having, I went to the ER.  They were so kind to us.  It was Christmas day, our first Christmas since our marriage, and I was in getting a D & C.  I do not regret that.  When the pain was gone, I could deal with my grief a lot better.  I was only 8 1/2 weeks pregnant, but that was a very hard loss. We named her Faith because we felt that was what God wanted to teach us through it all. We were surrounded with love and support during that time. We had a private ceremony, and buried her in a heart shaped box on my parent's property. It is now a precious memory, and a joy to know that she has a life greater than I could ever provide her. I am very happy for my little Faith, and I will meet her someday! Just a few months later, we were expecting again. My sister was still pregnant. ♥ We met with our midwife for the first time on July 29th. It was Faith's due date!! On a day that could've been very sad for us, we heard Isaiah's heartbeat for the first time. There are no words to describe what that meant to me!

Homebirthing Hemophilia Mom Found!!

http://www.cafemom.com/journals/read/259320/Why_home_birth

Check this out!!  A year ago, I sent out a question that Laurie Kelley made public to her broad base of hemophilia families.  I wanted to find a hemophilia homebirthing mom.  I recieved one response from a mom who planned a homebirth knowing that her baby had hemophilia.  A friend of mine just found her whole story in her own words!!

"Bubble Wrapped" Birth??? O_o

It is often said by hemophilia parents, "I want to just wrap him up in bubble wrap, you know?!"  It is a very big job to keep our little ones safe, especially when that little one has a severe bleeding disorder.  We make sure he wears his helmet and knee pads.  He is always in good supportive shoes.  We don't have coffee tables.  We put a little padding under his knees when he sits in his high chair.  Stairs and ladders are avoided.  You get the picture.  That loving protection begins when that little one is growing inside your belly.  When you are aware that your sweet baby has a 50% chance of having a severe bleeding disorder, your birth plan requires even more thought and consideration than usual.  I named my blog, "Bubble Wrapped Birth" because just like everything else in the life of a hemophiliac, your birth plan needs to be what you believe keeps your baby the safest.  The main concern with birthing a hemophiliac is intercranial hemorrage (bleeding in the brain).  Bubble wrapped births comes in many different forms: quiet midwife attended homebirths,  closely monitored hospital births, water births,  c-sections, and more.  I believe this is a very personal choice for each hemophilia carrier and their families.  The key is to make your decision based on truth, and never on fear.  So, what is your bubble wrapped birth?  and why?  What is your story?  I would love to hear your thoughts no matter what is your background.  I will share my birth stories with you, and my bubble wrapped birth choice in my next post.

This Blog is Dedicated to My Daughter

This blog is dedicated to my daughter, Ana, who is a carrier of severe hemophilia A, and my possible future granddaughters who will also carry the gene. I am passionate about birthing, and specifically safely birthing hemophiliacs. My hemophiliac son, Elijah was 10 lbs 14 oz at birth, born at home in a birthing pool with a midwife present. He did not have any bruising, and I did not have any tearing. He was diagnosed with severe hemophilia A at 4 months old because of 2 unexplainable hematomas along his waistline. It was pretty scary. I found out that I was a carrier just before his first birthday. A few months later, right before his port surgery, I was pregnant again. This was the first time I would plan a birth with the knowledge that I was a carrier of a severe bleeding disorder. Of course, I wanted to have another home waterbirth! After all, Elijah had an amazing birth, right?! I soon found out that it wouldn't be that easy this time. No licensed midwife could take me for a homebirth despite my birth history of 3 perfect waterbirths at home, one being a nearly 11 pound severe hemophiliac. My hemotologist even suggested that I schedule a c-section. I searched and searched the internet for information on hemophilia and childbirth. I found nothing on waterbirthing a hemophiliac, and I didn't find anything that convinced me that the normal natural birth process put a potential hemophiliac in danger for a bleed. In fact, all the bleeding problems I found were a result of using interventions during the birth. In the end, we had our fourth baby's birth in the hospital. This amazing hospital allowed us to bring our own birthing pool, and even made room for it by moving the bed to the hallway. We had a great midwife, and our baby boy had the most gentle birth yet! 2 hours later, we learned that he did not have hemophilia.

The purpose of this blog is to share stories and information to learn together about planning the safest birth possible as a hemophilia carrier, for our babies and ourselves. Wouldn't it make life easier if we could just keep them in bubble wrap?!!