Why Hemophilia Isn't Stopping Us from Having More Children

Ana 2010

Soon after Matt and I got married, we agreed that we would have as many children as God gave us.  We put our faith in God, trust in Jesus and believe the Bible.  God always refers to children as a positive thing: gift, blessing, treasure, reward, inheritance, etc.  We were both uncomfortable with any form of birth control.  It just didn't seem right to us to try to prevent a possible gift, blessing, treasure, reward, or inheritance that God might have for us.

So, we were very delighted to find out we were expecting our first little blessing right before Thanksgiving, just 5 months after our wedding.  Then, we were filled with grief when we buried that sweet baby just a month later.  I have given birth to 5 healthy babies since then, and I can tell you that the pain of miscarriage is the pain of death.  The pain of birth is life, and so much easier.

Malakai, Eli, Isaiah, and Ana 2011

God filled our hearts with joy once again when we found out our little Isaiah was on the way.  We actually heard his heartbeat on our first baby's due date, an unexpected gift from God.  That day would've been very hard otherwise.  Then, after Isaiah was a year old, my womb was full again.  This time with Ana.  Isaiah got in the pool for her birth.  I caught her myself.  So priceless.  Then, our not so little Elijah came (10lbs 14oz!) less than 2 years later.  His birth was the most spiritual I've ever experienced.  It gives me chills to this day.

It was when Eli was 4 months old that we were introduced to the world of hemophilia.  He had a couple hematomas along his waistline.  Blood tests showed that he had less than 1% of factor 8, severe hemophilia A.  A few months after that, I was tested.  I thought he probably had a spontaneous mutation.  I didn't have any family history of hemophilia at all.  Well, I remember getting that call like it was yesterday.  The test came back, and I was a carrier.  My heart sank.  Was this my fault?  Could I have more children in good conscience now? What does this mean for my home births? All these questions and more weighed me down immediately.

Our family of 7 with Matt's Mom and Grandma 2011

We reexamined our original decision:  We trust that God would give us as many children as we should have, and He would give us the specific children we should have.  Had all that changed since hemophilia?  The truth was that if it had changed, then we'd never truly believed it.

So, we stuck to our plan.  A few months later, we were blessed again.  This time, birth planning was a lot different.  We chose to get an ultrasound to find out if the baby was a girl or a boy:  BOY.  Then, we started interviewing midwives.  It definitely puts a twist in the interview when you mention, "Oh, by the way, our baby has a 50% chance of having a severe bleeding disorder. . . "  It wasn't so easy finding a caregiver this time.

Then, my husband lost his job, and we moved clear across the country from California to New York where he got a new job.  Homebirth just wasn't working out this time, but we had a great midwife who had privileges at the Women's and Children's Hospital.  I insisted on a water birth to give my baby the most gentle birth I could.  They'd never had a water birth, but in the end, they approved my request.  We used our pool, and they moved the bed out to make room for it.  Malakai was born, making hospital history!  His cord blood test came back that he did not have hemophilia.

Malakai and Silas 2012

Malakai is now 2 1/2 years old, and his little brother, Silas was born last September.  Silas is 5 1/2 months old now.  We were able to have a totally awesome home birth with him, and coordinated with our new (moved again!) HTC to get the cord blood tested.  Silas does have severe hemophilia A like his older brother, Eli.  He has shown little signs of his hemophilia so far.

Matt and I are very excited to look forward to the future.  Our beautiful family is growing, and although they keep us hopping, we just love our little crowd!  If God wants us to have more children with hemophilia, then it is what is best for our family.  If not, then that's what's best.  We choose to trust Him.

Matt and I have lots of friends and family whom we highly respect that do not share our beliefs on childbearing.  We believe it is a personal choice for each couple to decide on their own.  I know that I may have lost some people when I mentioned God, but I wanted to share our heart with you, and I can't do that without mentioning God.

Anyway, isn't having any child a risk?  People who don't carry a genetic disorder are not guaranteed a perfectly "healthy" child every time.  Elijah and Silas are just as much a blessing to our family as Isaiah, Ana, and Malakai are.  I believe with all my heart that God has a special plan for each one of our children.  I believe that everything in their lives is there for that purpose, to make them exactly who they are meant to be.  No matter what happens, God always loves us and we can always trust Him.

A Simple Guide to "Bubble Wrapping" Your Birth:

We put bubble wrap around things that are special to us:  special Christmas decorations, fine china, crystal, figurines, and other treasures.  There is nothing more special than finding out you are carrying a new life inside your body.  You don't want anything to harm your most precious treasure of all: your baby.  "Bubble Wrapped Birth" means a birth planned with care to keep your baby safe through the birth process. 

But, how? 
Here are six key points to planning your own bubble wrapped birth:

1.  Be healthy. Making healthy choices and having a healthy diet is the foundation for a safe birth. This link is a good place to start.

2.  Know your body.  Understand your unique health facts:  birth history, factor level, bleeding history, etc.

3.  Know your baby.  Study fetal development.  Understand the impact that prenatal health, gestational weeks, and birth choices make on your baby.

4.  Understand birth.  Research the natural birth process, what things hinder the process, how to work with your body, how to safely deal with labor pains, and when interventions are truly necessary. Click here for an excellent resource to get you started!!

5.  Know your options in your area.  Is there a birth center available to you?  What options are offered at your local hospital:  midwives, water birth, doulas, competent NICU, etc.?  Are there good home birth options with competent care and medical backup such as support from your HTC with cord blood testing, etc.?  What policies will you have to work with at each birthing location?

6.  If you are unsatisfied with the options in your area, work to change them!!

"Why Home Birth?" by Stacey Rainer

The following was written by a hemophilia mom who worked as an OB nurse.  With her permission, I have republished it here from where she originally posted it on "cafe' mom" back in June 2007. 

__________________________________________________________________________________

So, someone asked me why I choose home birth, so I decided to write a journal entry to explain it, as I think it's too long for a reply to a previous entry.

First, my birth history. My first three pregnancies were induced because I had high blood pressure. The first was the worst, but the other two were not far behind. I was over 39 weeks each time, so no preemies or anything. I was never sick enough to need meds for my blood pressure. The first two times, I had Pitocin to start my labors. The third time, I did not want it, so I requested to be induced by rupture of membranes. By this point, I had been an OB nurse for a year, so I had a pretty decent working knowledge of the birth process from more than just a participant. During my pregnancy, I began to question circumcision. I talked to several doctors about it in the course of my work, and decided I'd not do it to my children. I had all girls up to this point. After that third baby was born, during my foray into the anti-circ world, I became acquainted with things like not vaccinating your children and home birth. When that child was 9 months old, we made the decision to stop vaccinations. I also decided that my future children would be born at home.

Two years later, I was pregnant again. I could not find a midwife in my new state, Illinois. So, I called a midwife I knew back home in Kansas, and asked her if she would attend my birth. I would travel there at 37 weeks or so, and hang out with my sister until I went into labor. It was all arranged and working well, until 7 weeks along. A sonogram showed twins. I immediately dismissed my home birth plans and while I hoped desperately for a vaginal birth, I knew my chances were slim. I was right. C-section for "unfavorable" position. After that, I'd had it. No matter what happened, I was having a home birth next time. Of course, I still have not found a midwife. Not to be one to wait until I needed, I got on the internet and began searching shortly after my boys were born. Didn't find a midwife, but became acquainted with something else new. Unassisted home birth. This was cool! By this point, I'd been working in OB for 4 years. I felt confident that we could do this. So, two years later, when I was pregnant again, this was the plan. I opted for an unassisted pregnancy as well. I did my own prenatal care. I did finally meet a midwife, just 2 weeks before she was born, but I had already made my plans, so stuck with them. I had a fantastic, 2 1/2 hour birth, in a pool in my family room. It was the most amazing thing ever! I knew then, that I'd never have another baby in the hospital again. So, two years later again (yeah, I know. I have a pattern), when I became pregnant, we didn't even discuss it. We knew we'd be having another unassisted home birth. The time came when labor started, and it was a long, grueling, 52 hour labor. I required a bit of assistance this time. I was ready to throw in the towel and head to the hospital at 50 hours. A midwife friend came over, broke my water and left. Two hours later, I was holding my screaming baby boy.

That's the birth history. Now for the whys of it all. During my career as an RN, I began to see how much stuff is done to women simply because it's what's easiest for the care providers (OB and RN). It's much easier to watch a continuous feed of fetal monitoring at the nurse's desk than it is to hunt down the walking mom every 15 min. to listen and count with a doppler. It's certainly more convenient to break mom's water or give her Pitocin when things are going a bit slower than the OB would like so he can "get that mom delivered" by a decent hour. Those late nights are hard, after all. I began to realize that birth is so much less traumatic both for mom and baby when it's left alone. However, it's nearly impossible for birth to be left alone in the hospital. Everyone's got to get their hands in it, literally. That's not something I want. My first baby was taken to the nursery for the first 6 hours of her life. I needed to rest, you see, because of my blood pressure. It was the longest 6 hours of my life (longer than that labor had been, actually). I hated it. My second was given for adoption. My third, the took her from me, put her in a baby warmer where I could see her. She was messed with, poke with a vit. k needle and a hep b needle. Junk was put into her eyes... she was exhausted by the time I finally got to hold her. She was way too tired to breastfeed. Fortunately, it didn't hamper future attempts and she nursed fine. My twins were taken from me since I had to go to recovery. But, by then, I knew to request no needles, no goop. I wanted them alert when I got them back, so they would nurse and so I could meet them. That was fine. I only had to wait an hour to finally hold my babies. It was better than before, but still not ideal. When my twins were 5 months old, one of them was diagnosed with hemophilia. His blood does not clot properly. So, things like a circumcision, or an intramuscular injection can cause bleeding that won't stop. Thankfully, we'd avoided that. However, the question then became, is it safe to have a home birth when this is a possibility for future children? Well, the next baby was a girl and I knew she was before she was born, so no worries. Then came Ian. There is a 5% risk of bleeding on the brain with vaginal birth. After some reading, I discovered that the risk of this bleeding without the use of instruments to deliver goes down to less than 1%. Well, that's a no brainer. I don't own forceps or a vacuum extractor so there was no concern about an instrument delivery (however much I thought I wanted one by the third day of labor). Well, I knew this baby was a boy, and I knew he had hemophilia. I did not know this through any tests of any kind. I just have a great gut instinct for this kind of thing. Well, he was born, I drew blood from the placenta as we'd arranged, and my husband took it to the clinic for testing. I was right, but my baby was fine. Some would suggest I got lucky. I would say I planned things in such as way as to be sure my baby would be born gently so that there was no risk of bleeding of any kind. Let's talk about risk of bleeding, since this was a question asked of me. Besides that less than 1% risk of brain bleed jumping to 5% in the hospital, there are many other opportunities for a hospital birth to actually cause bleeding. Artificial rupture of membranes - bleeding from the big scrape that is now on the scalp. How about that deep suctioning they do after birth? GI bleed. Rough handling, flicking of the feet, vigorously rubbing the back all to stimulate crying - muscle bleeds. IM injections - muscle bleeds. Of course, there is ample opportunity in all of this for big ugly bruising to be left behind by uneducated staff. This all just addresses the hemophilia. But why home birth at all?

Ultimately, I have a very strong faith in my Maker and the way He created me. I am a strong, healthy woman. My body was designed to conceive, grow, carry and finally birth a baby all on it's own. I also believe that a vast majority of fetal distress and failure to progress cases are caused by hospital intervention. The use of continuous fetal monitoring has NOT improved outcomes when it comes to fetal mortality. It has, however, increased the incidence of c-sections 3 fold. Pitocin has become a drug of convenience rather than emergencies. Docs going out of town? No problem We'll induce before she goes. Mom is only here to help you for one more week? Ok. Let's induce. You're due tomorrow? Well, let's just get you scheduled. Something like 90% of all inductions are not medically necessary. Labor's going to slow? We'll augment with Pit. Why? Oh, just to get it over and done with for you. Sheesh! No one even talks about the RISKS!! Yes! That's right! There are RISKS to this drug! In fact, it's not even approved by the FDA to use for augmentation! But, who needs to follow labels? Let's use this great new blood pressure drug, Cytotec to stimulate labor! So what if it causes ruptured uteruses? That doesn't happen to every one. Think of all the time that can be saved by getting labor started on a time table. Obstetrics is the only medical specialty that is not evidenced based. It's tradition based. There have been multiple studies that have proven the old ways are wrong but it's still going on! Why? Why is there such a need to manage something that works just fine on it's own? Pregnancy is not a disease. It's not a sickness. It's not an emergency waiting to happen. It's a normal function of life. We go to the doctor when normal functions aren't happening normally. Your hearts not working right? See a cardiologist. Blood not working right, as in our family? See a hematologist. Birth IS working right? See an OB anyway. Do you get it? Do you understand why someone might choose to flee as far and as fast as possible? Because what I DON'T get, is the American practice of obstetrics. I don't get it, and I won't have it. Home, where there is peace and gentleness surrounding the entrance of my baby into this world. There's enough violence throughout life. It doesn't need to start with the first breath of life.

"He has it." I said to my midwife. . .

It was evening.  Matt had taken the cord blood up to the hospital, and had been home for a few hours.  We'd taken our herb bath and were now resting and breastfeeding in bed.  Now, Matt was on the phone with our hemotologist getting the results of the blood test.  He was on the phone for a long time in the next room.  That was my first clue.  Then, I heard him say, "No, we haven't seen any bruising at all." 

"He has it."  I said to my midwife. 

Matt got off the phone and confirmed that I was right.  The first thing I felt was a heaviness.  Here's this perfect baby boy nursing in my arms, and now we know that he has a severe bleeding disorder.  Of course, I was not shocked or suprised.  We knew he had a 50% chance of inheriting my gene mutation.  However, knowing it's a possibility and finding out it's a fact are 2 very different things.  I didn't cry.  I just felt some heaviness in my heart as I thought about what was ahead for this sweet baby. 

Our midwife left.  Then, Matt called Eli into the room.  Both of us wanted to tell him first.  When he heard that Silas had hemophilia just like he did, his little face softened in a way that I'd not seen before.  He moved over to Silas, and warmly said, "Aw, Silas!".  He had the most loving smile on his face. 

"Do you want to hold him?"  I asked.  He did, and climbed up on the bed to hold his new baby brother. 

Perhaps even sweeter than Eli's reaction was Isaiah's.  When we told him that Silas had hemophilia, his face lit up with excitement.  "Really?!"  he exclaimed, and he jumped up and ran to Eli.  (He was unaware that Eli already knew, and ran out before we could tell him.)  "Eli, guess what?!  You have a little buddy now.  Silas has hemophilia just like you!"

Of course, Silas didn't have to have hemophilia to be Eli's buddy, but we knew what he meant.  It was so precious!

I had my cry later that week when I checked facebook and read the tragic story of a little boy with hemophilia in the Philippines who recently died because he couldn't get the factor he needed so badly.  It was too much!  "That's our boys, honey! If we ever couldn't get factor, this could be them!"  I cried to Matt.  I really cried.  It's been a while since I cried that hard.  We talked for a while.  I asked Matt, "Is it ever hard for you?"

He replied, "No, it isn't.  I just look at it as something God has put in our lives for a reason, and we just need to make the best of it.  That's why I am going to nursing school to be a nurse and help."  Matt wants to be a nurse manager in pediatric hematology.  He wants to help other families the way our nurse helped us.
 
"Why did God have to mess up my X chromosome?!"  I sobbed.

Matt said, "I don't know, but honey, look at what you are able to do because of this (BWB) and all the people you've been able to meet."

I said, "But, honey, I would give it up in a heartbeat in exchange for my children's health!" 

After more crying, talking, and hugging, I started seeing something I didn't see so well before.  God gave this to us as a gift.  He put us right in the middle of a special group of amazing people.  It is our blessing to know them and love them. 

No, hemophilia does not define Eli or Silas or our family for that matter, but it is a part of us.  It's a very special part because it is not just a bleeding disorder, it is a new family into which we were welcomed with open arms.  God bless you, dear hemophilia family.  You are a gift from God to us, and I pray that we can be as much a blessing in your lives as you are in ours. 

Our Fifth Birth - Silas

17 weeks

31 weeks

After a very busy pregnancy with my husband's career change, a major move, many blog and facebook posts, and much prayer, the time finally came for Silas to come out and join us. . .

On Wednesday, September 21st, I started to feel like "I really want to have this baby soon!!!"  My sporadic contractions had been picking up in frequency and intensity that week.  The day before (20th), I had really begun nesting, and on the 21st I was insanely energetic.  There was crazy hyper nesting going on, and the house was looking great!!  I hit 39 weeks on the 22nd.  That weekend, I started feeling like "This baby is never going to come!  I will be pregnant forever!!"  That is significant because I always feel that way a couple of days before the baby is born. 

Grandma "Kat" helping with bedtime

Isaiah beginning to record
my contractions

Sunday night, the 25th, my contractions were getting stronger, thanks to some alone time with my husband and nursing our toddler.  In the morning, I had some bloody show and more mucus plug, but my contractions were weaker.  I was really discouraged!  I told my husband, "I feel like a car in the winter time that you keep trying to start again and again, but the engine just won't turn over!"  He sweetly and firmly replied, "No, that is not a good comparison.  When a car does that, there is something wrong with the car.  There is nothing wrong with you.  Your body is doing exactly what it's supposed to do.  Don't be discouraged.  You are making progress, and getting ready to have this baby."  Well, that put me right at ease.  I love him.

Birth pool filling up next to Isaiah's bed

Matt went off to work that day ready to come home in an instant if needed.  I kept him updated throughout the day.  When we were on the porch waving to him, our oldest, Isaiah (7yrs) said, "Don't worry, Mom.  If Silas comes, I'm here."  My contractions started getting stronger that afternoon, but were 20 minutes apart.  As the day went on, they got more frequent.  Isaiah started tracking them on a paper.  That evening, I called my mother in law, and asked if she could help me with bedtime.  She came over and was a big help.  My contractions were between 5 and 8 minutes apart.  I was putting sheets on a couple of the kids beds while my mother in law fed them and got them ready for bed including reading books to them.  I would've gone crazy if she hadn't helped me through that evening!

Laboring in my bed with my phone
(I was keeping my fb crowd updated)

Matt came home as quickly as he could after he got off at 10:00, and our midwife arrived soon after that. Or maybe she got there first. . . I can't remember.  She brought her 2 children with her, and right away, her kids and ours were piled on Isaiah's bed playing with Isaiah's game boy!  She got her kids to bed quickly, and Matt got ours back to bed.  Then, I tried to get some sleep. 

Malakai came in to check on me

My contractions were getting more intense.  We decided to at least fill the pool halfway, but I was getting such strong contractions, I ended up telling him to just fill it up all the way because I wanted to get in!  However, when I got in the pool, my contractions slowed down a lot.  We called our doula at 11:30.  She got there when I was lying in Isaiah's bed next to the pool.  I was so tired!
Back in my own bed, I tried to sleep, but lying on my side brought on great contractions.  I just focused on relaxing, knowing that those more difficult ones were the ones that were helping Silas get to my arms faster.  When they were extra hard and I just wanted to survive through it, I would totally surrender my body to the contraction and remove my mind and emotions from the pain.  I would think about my baby, and how the contraction was opening my body for him.  It really helped.

Back in the pool

Whenever I got back into the pool, my contractions slowed down.  This was a very weird labor for me.  My midwife and Matt made sure I was eating and drinking well throughout my labor which helped my energy and endurance level a lot.  My midwife gave me some Valerian herb in tincture form to help me rest.  I did rest, and continued to contract all night.  Our doula had to leave to get back to her baby at home around 8:00am.  She said to call her if things picked up.

Silas, right when I brought
him out of the water

One of the times that I got back in the pool during the early morning hours, Eli walked in the room.  His first words were, "See, told ya I would wake up myself!"  I had told him that someone would wake him up if Silas was coming during the night.  He was very excited that the pool was filled.  Then he said, "So. . . is your belly gonna crack open like an egg?"  I proceeded to give him a basic understanding of where babies come from and the special way that God made mommies to birth them.  He was satisfied enough.  We chatted for a while.  It was so nice to have one of our children in the room.  It made me feel so comfortable, and the atmosphere felt more normal.

Instant Joy after lots of hard work!

While Indian style on the bed, my contractions came every 5 minutes and their severity was very good.  Then, during one contraction around 11:30, I felt Silas move down.  It was pretty cool!  When my legs got tired of that position, I tried the birthing ball.  While I was lunging on the birthing ball, Matt said, "I feel like it's Christmas, and we're trying to squeeze Santa down the chimney." It was really funny, and we both laughed!

After the birth ball, I got down on the floor.  There was a short time (just a few minutes) that I was alone.  I tried to sing "Edelweiss" to Silas, rocking and rubbing my belly.  I couldn't.  I was so overcome with emotion on the lines, "bloom and grow" and "you look happy to meet me", I could not sing!

I was eating and drinking during this whole time. Silas's heart rate was very good.  My midwife suggested that I start walking around.  That was very effective.  My contractions' intensity increased noticeably.  They were more difficult to get through, but I stayed on top of them.  My midwife told me to get in the pool, walk around in the water, then squat down for contractions to ease the pain.  That plan worked very well, and that time ended up being the sweetest and most personal part of my labor.

Our younger 4. Isaiah was busy playing with the midwife's son!
He did peek in from the hallway though.

Matt came in the room with me.  We closed the door for privacy.  Sunlight was pouring in the windows, and our birth play list was playing softly in the background.  I felt so silly walking around in the pool with Matt sitting there watching.  So, I asked him if he'd like to walk with me.  He held my hand, and walked with me around the pool (he was outside).  When I felt a contraction coming, I would squat down, and relax.  Then, I got back up to walk.  Well, our walk became a dance, like a tango or something silly like that.  We laughed so much!  Matt said, "OK, we are not supposed to be having this much fun during a birth!!"  It was such a sweet, funny, and romantic time between the two of us.  

When my contractions were well established, still 5 minutes apart, I stayed down in the water.  Apparently, some were 3 minutes apart because that is what is written in my Labor Record for 1:15pm.

At 1:28, I checked myself, and felt my sweet baby's head!  He was 2 knuckles in, and I felt the molding of his head.

Beautiful pic of Silas and Daddy
(Stacey Rainer Photography)

Gradually, my contractions changed to pushing contractions.  It was NOT easy like Malakai's birth because he had never tucked his chin! So, I did push with my body.

I had asked my midwife to call the children in when I started pushing.  When the children were coming, I pushed his head out.  His bag of waters were still intact until his head came out!  Remember, in Malakai's birth, when I softly stated, "Yes, the head is out." Not so this time!  I exclaimed with exhaustion "HIS HEAD'S OUT!"  After that, there was a brief rest period before the next contraction.  I was caressing his little head.  My midwife came around behind me.  She said his color was good, and said she would check for a cord.  "There is a cord." I told her.  It was loosely around his neck once.  Then, at 1:50pm while Chris Tomlin's "Indescribable" was playing on Matt's iTouch, Silas slowly came out with the next contraction.  I was carefully getting him unwrapped from the cord.  Matt told me to bring him up.  So, I started moving faster.  My midwife said, "Wait, let's get it off his shoulder."  I did with her help, and brought him up.  My midwife stripped Malakai's clothes off and put him right in the pool.  He loved Silas immensely right from the start.  It was so sweet!  Eli told her, "I do not want to get in the pool!"

After our happy relaxed time rejoicing over our newborn and phone calls to our moms and our doula (My labor was so weird that we never knew when to call her until it was too late!), it was time to think about that cord blood.  I carefully got out of the pool, and sat on the birth stool.  Almost immediately, Silas's placenta was born into the bowl below me.  Then, our midwife drew the cord blood.  Silas was still attached to his placenta.  So, she wrapped it in a chuck pad, and put it in a plastic bag.  We chose to do physiological cord clamping for Silas.  We researched the risks and benefits, and decided to let him receive all of his own precious blood and stem cells.  It would take a whole separate post to express all the protection and benefits that newborns receive when they are allowed to get all their own blood and stem cells!  Our midwife was able to get plenty of blood without cutting the cord.  His cord was not clamped or cut for 4 hours.  We did learn that the physiological cord clamping doesn't work the same with a hemophiliac.  First, his cord was cut very long, and didn't need any clamping at all.  However, later that night, when we cut it shorter with no clamps, it did seep a bit, and we had to clamp it.  Next time, we will wait a full 24 hours before cutting the cord short.  With help, I walked to my bed to lie down with Silas.  Matt was soon out the door to run the cord blood to the hospital.

When Matt got back, it was time for our herb bath.  That's always a nice time, and we got lots of beautiful pictures of Silas in the bath.  I think I might make a whole post full of herb bath pics!

A few hours later, we got the call from our hematologist about the blood test results, and learned that Silas does have hemophilia.  I will write more about that later since this post is already so long!

Silas taught me that just because a baby is small, it doesn't mean that the birth is easy.  Silas was only 6# at birth, and his birth was one of my most intense (and I've had a 10#14oz baby!).  I really had to work for him!!  No, size is not the issue, it's all about position.  Silas did not tuck his chin probably because his cord was right there and it was uncomfortable for him.  He came out in an anterior brow position.  However, it was another amazing and beautiful birth, and it was so nice to be back home and share the experience with our children.  Welcome, Silas Martin Reeves!!

The Last Few Days / Weeks Before the Big Day

Everything is ready except for a few more towels that we are getting from Matt's mom.  The pool is blown up and cleaned.  The liner is on and cleaned.  A sheet is laying over the pool to keep it clean.  All the birth supplies are gathered and organized.  Our midwife and doula have both been to our home making sure they know the route well.  We have Silas's clothes washed up and in his drawer, the blankets washed up, and we have diapers ready for him.  The HTC sent the blue capped tubes for collecting the cord blood to be tested, and things are set up with the local hospital.  The carseat should arrive today. . .  Lets's see, anything else?

We are as prepared as we can be.  Now, we just wait.  This last bit of pregnancy always seems to be the longest, and it is very hard to focus on anything except for baby and birth.  However, I can't just neglect everything else.  I have a husband and four other children!  We homeschool, there are dishes and laundry to be done, and messes to clean up. 

The unknown is always aggravating to a certain extent.  I was just talking to another mom about her birth, and it has me puzzled.  Her baby's cord was wrapped around his neck twice close to the placenta.  Everytime she stood up, his heartrate dropped.  Pushing him out was strangling him.  I will talk to my midwife about this, and find out what is the best thing to do in a scenario like this.  One of my weaknesses is trying to figure everything out.  I want to understand what happened, and why, and how to best deal with it if it happens to me or someone else. 


Meanwhile, it's time for breakfast and everyone needs to get dressed.  We need to have a great school day and lots of housework is needing to be done.  I love my job.  It is not easy, but being a mom and devoting all of my time to taking care of my family is the best job I could have.

Silas will be here very soon!!  I'll be 39 weeks in just 4 days! 

Details, details, details!! (Of our hemo birth plan)

We put padding in our little hemo's clothes, use a helmet, and don't have a coffee table. We do these things to control our little hemo's surroundings to avoid bleeds in early life.  To the best of my ability, I need to control my baby's surroundings when it comes to birth.  Well, I am my baby's surroundings!  If I am tense, my muscles are tense and less flexible.  If I am lying on my back, my pelvis is up to 30% smaller, and my baby has to hit my tailbone and fight gravity to get out.  If I do not have freedom of movement in any way, I am compromising the ease of my baby's birth because I am not able to move with my baby's descent and delivery.  If I force pushing, I am potentially forcing my baby into the birth canal before he is ready and putting more pressure on his head.  If I am induced with Pitocin, my contractions are much more severe than natural contractions, making a lot more trauma for baby.  If I am drugged with an epidural, I am not as aware of my body throughout the birth and cannot respond to my body's cues (position, pushing, etc) In this light, we have designed a very careful birth plan with hemophilia in mind. 

Here's the details:

1.  I will be having a water birth.  Being in the warm water helps me fully relax and have full freedom of movement.  The warm water even helps me stretch more easily, preventing tearing.  It is also so pain relieving for me that it removes the need for an epidural (which usually leads to pitocin). 

2.  I will birth in an upright position: hands and knees, squatting, standing, or sitting on a birth stool.  The last two being out of the pool if I choose to get out.  The only exception would be laying on my side if for some reason I felt like laying down.  These positions let gravity help my baby and let my body open to the max!

3.  I will have intermittent monitoring as opposed to having a monitor strapped on my belly.  This also helps me have total freedom of movement.

4.  I have an IV available if needed, but I'm not planning on using it otherwise. This is also to help with freedom of movement.

5.  I will be eating and drinking through my labor, keeping my energy up and staying hydrated.

6.  I will not start pushing until my body starts pushing on its own.  If I get an undesirable urge to push before then, my midwife will check to make sure I am fully dilated. Ideally, I will try not to ever push to make sure the baby comes out as easy as possible.  This seems to be a small baby anyway.  So, there's a good chance he will be born without me pushing at all. 

7.  When Silas is born, we will not cut his cord.  We will allow him to receive all of his blood and stem cells.  We will wait until his cord is empty of blood, and his natural "Wharton's Jelly" has naturally sealed (clamped) his cord.  Then, we will cut the cord.  I believe that this approach will help him in many ways including reducing/eliminating bleeding from cord site if he has hemophilia.

8.  Our midwife will draw tubes of blood from the placenta to have his factor 8 level tested.  She has experience with this and I am confident that she knows what she is doing.  We have worked with her before and she is amazing!

9.  We are working with our HTC to arrange getting his blood tested right after his delivery.

10.  If Silas has any bruising or any sign of a bleed we will take him to the ER immediately to get him checked out. The hospital is less than a mile and a half away. Since we already have a hemophiliac, we do have factor on hand as well. 

11.  We've asked another hemo mom to attend the birth as our doula.  She is also a trained L&D nurse. 

12.  Also, I will be going to a chiropractor weekly until the birth to be sure my pelvis is in perfect alignment.  This will help the birth be easier on Silas as well.

Our approach is to do everything we can to give Silas the most gentle, non-traumatic birth possible to prevent a bleed in the first place.  We have hired a midwife who is highly skilled, and carries emergency equipment, drugs, and herbs.  I am pleased that we'll have another hemophilia mom attending the birth, and that she is a trained L&D nurse.  I am so excited and looking forward to an incredible birth!!

As always, I want to remind all my readers that I am sharing what we have decided for our family.  In no way do I think someone should use this as a blueprint for their own birth.  I only want to share what I've learned and spark thought.  If anything on this page interests you, look into it for yourself and discuss it with your doctor/s.  Thanks for reading!

33 1/2 weeks and planning a HOME birth!! :o)

The last time I wrote, I was unsure where we were going to be, or what kind of birth we would be planning for Silas.  We are now in IL.  We have hired a licensed midwife from out of state to attend our home birth.  We had this midwife for our firstborn, and love her very much.  She gives excellent care, and is extremely competent in handling emergency situations.  We have also hired a doula to attend.  This doula has nursing training and is a hemophilia mom herself.  We live 2 minutes away from the hospital, and we have a new hemotologist who has accepted and run cord blood from home births in the near past.  We are officially meeting with him in a few days, and do not anticipate an issue. 

I am so excited about this birth!!  Matt and I will be ordering the birthing pool and supplies this week.  My mom and Grandma plan on coming down for the birth.  All 4 of our children will be able to be there too.  Although, Isaiah, our oldest (7yrs), plans on playing video games through the whole thing!  ;o)  I love that we are receiving such excellent care.  I love that another hemophilia mom will be there too, and that she is a nurse.  I love that we can still get his cord blood tested from a home birth, and I love that we are so close to the hospital in case of any emergency. 

God has worked this out incredibly.  We are looking forward to another beautiful birth.  I want to live post/blog Silas's birth when the time comes if I can work it out.  All the pics posted will be "G" rated as I am not comfortable posting graphic pics of myself on the internet.  I would love for you all to be "with me" through our special day!

The Last 4 1/2 Weeks. . .

Four and a half weeks ago, we found out that the baby we are expecting is a boy.  As you probably know, this was significant news for us since I am a carrier of severe hemophilia A.  I've been off facebook a lot ever since. This was first because of a virus that hit our family right after finding out our little one is a boy, and second because we have a lot going on right now, and I have a lot to mentally and emotionally process.  I want to take some time and talk about that.

When I first saw that second pink line appear, I knew I was having a girl.  Of course I was having a girl!  I was so emotional, and we already had 3 boys and 1 girl.  Also, planning a birth for a girl is much less stressful for us than planning a birth for a boy, and I just knew that this time, we'd get a break.  This summer, we are moving, Matt will be going back to school in the Fall to pursue a nursing degree, and work full time on top of that.  It is very exciting, but also pretty stressful.  I was thinking that at least the birth planning would be a breeze.  We are hoping to move to MI where we already have a great midwife.  A girl would mean planning a simple homebirth with a midwife I already know and love.  Even though I said, "Oh, yeah, we could be having another boy!", I didn't really believe it.  I knew I was having a girl.  Then, it was time for our ultrasound. . .

The technician was so friendly and happy with us about our expecting our 5th.  She couldn't see anything revealing for what seemed like so long!  She was busy measuring all kinds of things, and then. . .

"Well, you've seen that before!" she said.

It was NOT the cord!  We saw very clearly that we were having another boy!  Matt and I just laughed.  4 boys and 1 girl?!  Wow!!  I was already very much in love with this tiny little guy, and now I knew that he was a HE.  We even knew his name:  Silas Martin Reeves. 

Even though we were very happy, we were in shock.  A boy meant a lot more work.  Yes, he could have severe hemophilia, but that wasn't what was weighing so heavily on me.  I was counting on having a break this time with birth planning, and having a simple homebirth.  With all the things we are dealing with right now, this was not going to be one of them. . . BUT now I knew it was. 

2 days later, our family was hit by a horrible stomach virus.  Eli was first.  He had a fever, and since he has a port, that meant 48 hours in the hospital.  It hit us all, and it was bad.  It lasted 5 days for each person, and it took 2 weeks total for us all to be well.

After we were well, I started thinking about Silas's birth, and things started hitting me.  Once again, I don't know where we are going to be for this baby's birth, and now, I have to plan for a severe bleeding disorder!  I still am not convinced that there is any danger for a severe hemophiliac with a gentle vaginal delivery unless drugs or interventions are involved (with the exception of breech, placenta previa, etc).  My main concern for planning a birth for a boy has always been getting his cord blood tested.  If we didn't get his cord blood tested, we would have to take him in for a blood draw which is traumatic for a baby. 

Our 4th, Malakai, was our first hospital birth.  His birth was awesome, but there were some things we didn't like especially afterwards:  the lack of rest, all the strangers (drs and nurses) coming in to touch the baby, the fact that the hospital pretty much owns the baby until they discharge you both, the ridiculous hearing test, the required vitamin K (although they did allow us to use oral instead of a shot), having to be separated for a few minutes from the baby so they could help him start breathing at birth (ended up being meconium, and they did a great job; but at home, we would've been set up right at the pool), our children couldn't be there at all due to a flu epidemic at the time (not to mention the fact that there was a flu epidemic at the time, and we were there with our newborn!), and the heel prick.  Malakai didn't have hemophilia, and we had an amazing hospital experience to say the least.  All the issues I just listed are nothing compared to what I've heard other people complain about, but still. . . I am a homebirther at heart.

I do not think that homebirth is the right choice in every situation, and maybe it's not the right choice for Silas.  I don't know yet, but I can't plan his birth until I know where we are going to be.  Matt has applied for so many jobs in MI, but has no leads.  He has started applying here in NY as well in case there is nothing in MI.  Soon, he will probably expand his search to other states as well.  We really can't afford to be picky right now!  Our income will end in just a month or two.  I decided that right now, I will just focus on keeping myself and Silas healthy, and when I know where we will be,  I will start planning his birth.  Before then, it's just too overwhelming for me. 

Even with all the birth planning stress and the possibility of more hemophilia in our family, I am SO excited about our new little guy!  Silas is a sweetie.  I am 21 1/2 weeks along now.  I feel him moving around more and more everyday.  My heart is full of love for him!  I know that everything will all work out, and when he is safely in my arms, I will look back on these days and smile.  God has always taken care of us.  We have been in more stressful situations that this, and everything is going to be ok. 

Thank you for your patience right now, and all your love, support, and prayers.

We're having a boy!

I am now 17 weeks pregnant.  Yesterday, my husband and I went to our ultrasound appointment and found out that our baby is a boy!  So, that makes 4 boys and 1 girl now for our family.  We were shocked silly.  Yes, of course we weren't truly shocked, but we did laugh a lot!  Another boy?!!  So much for having a break with birth planning, right?!  No, we are very happy about our little guy.  He even has a name:  Silas Martin Reeves.  He is a sweetie, about 6 ounces, and quite a wiggle worm.  We absolutely love him!! 

So, now for planning Silas' bubble wrapped birth. . .

We are hoping to move to MI in a couple months.  By then, I will be about 6 months along.  I spoke to our midwife there, and she gave me the name of a CNM who works in a birthing center there.  I will speak to her today.  The big hospital connected to Children's Hospital of Michigan says they offer water birth with midwives as well.  This hospital also happens to be one of the best in the country for hemophilia.  I will definitely be looking into that! 

The problem with homebirth is getting the cord blood tested.  Our midwife can draw it, and Matt could run it to a hospital lab to be tested, but they can't accept it without a prescription.  We would have to find someone who would write a prescription for us, and a 24 hour lab that would accept it from my husband/midwife. 

What we are looking for in a birth is:

• a totally hands-off approach
• water birth
• cord blood testing
• gentle baby care afterwards (ZERO separation, no heel prick, no vit k injection, etc.)

Obviously, if we could work out the cord blood testing, homebirth would be great.  If not, we have to find the most gentle hospital/birth center situation.  Getting the cord blood tested is very important because if we don't get it done, then we have to take our newborn in for a blood draw.  That is miserable torture for a baby, as any hemo parent knows! 

It will all work out.  I will not fear.  Although, I know I will have my moments. 

~Silas, we will make the safest birth for you, sweetie.  We love you so much!~

Why I Love Water Birth: part 2

Before Ana could start walking, we were looking at two happy pink lines again!  We had been in IL for Isaiah's birth, MI for Ana's birth, and now we were in CA looking for a midwife.  We couldn't possibly have more than one baby in any state, could we?  We found the best midwife for us, and began planning another home water birth. 

I knew I was in labor at about 1:30am.  I labored in bed for a while on my side.  I got on my knees and leaned over a chair, all the time moaning through contractions.  By now, Isaiah was about 1 month from being 4, and Ana was about 2 months from being 2.  I had practiced these birth noises with them so they wouldn't be scared when the time came.  It worked.  They weren't scared at all.  I had nice breaks between contractions too, which really helped.  Isaiah wanted to help me so badly, but kept getting in people's way.  So, I asked him if he could hug me through my contractions.  He was my doula for this birth!   

The pushing stage for this birth was way more intense than it had been with Ana's birth.  For the first time during active labor, I called out to God, thanked Him for this baby, and that "I can do all things through Christ who strengthens me" (Phil 4:13).  When it was time to push, I pushed like I had never pushed before.  His head came out.  There was a small break before the next contraction (seemed like forever!).  Then, I was pushing again.  He was so huge that I thought he was completely out when he was only out to his waist!  Elijah was 10lbs 14oz!  I couldn't believe it!  His birth was so gentle, and he was a beautiful chubby newborn.  Four months later, we found out he had severe hemophilia.  I am so thankful that we had such a gentle birth for him.  I believe the water birth was a major reason why he was so big and did not have any bleeds or bruising, and I did not tear at all. 

By the time we were expecting our fourth little one, we knew that I was a carrier of hemophilia.  I have written all these stories before, and have recently posted the story of "Our Journey".  Please read it to get the full story of how we began birth planning with the knowledge of hemophilia being a possiblility.  We moved from CA to NY when I was 6 months pregnant.  I found a midwife, and we started planning a homebirth with the goal of drawing cord blood and transporting the specimen from home to a lab.  That plan did not work out.  We had to consider a hospital birth.  I met with the perinataltologist.  I explained to her that water birth was the safest, most gentle way I knew how to birth, our large hemophiliac baby had been born in water at home with no problems at all, and I insisted that our fourth baby's birth was just as gentle.  Malakai was the first water birth ever for this hospital.  His birth was so gentle that his water never broke until his shoulders were born. 

I know I've shared all these stories in length before, but I wanted to give a fresh review to illustrate where I'm coming from with water birth.  Based on my experience, I love water birth because:

• It calms my pain and discomfort.
• It relaxes my body.
• It softens my perineum, and helps me not tear.
• Because I am so relaxed, I can get in the best possible position for my pelvis to be at maximum size.
• I can easily move to different positions at will.
• Because I am so relaxed, my whole body opens to birth my baby as gently as possible.
• It gives me my own space, and I feel safe. 
• Being in the water helps me feel covered, and I don't feel so exposed and vulnerable.

I am now 13 1/2 weeks pregnant with our fifth baby.  Malakai is 16 months old, Eli is 3, Ana is 5, and Isaiah is 7.  In about 5 weeks we will find out if this baby is a boy or a girl.  There is no question that we will be planning another water birth.  We hope to have a home birth, but if we must consider a hospital, we will plan a water birth there.  Hemophilia babies need a gentle birth even more than other babies do, and I am so thankful that we already practiced such a gentle way of birthing even before we knew hemophilia was a part of our lives.