Home Birth, Midwives, and The Law

Silas in our herb bath still attached to his placenta (in a bowl next to him)

When you birth at home (assuming you have a great midwife), the focus is what is in the best interest of you and the baby, no strings attached.  At a hospital, even if you have excellent care, there are often hospital protocols and impatient medical personnel that you must choose to appease or fight.  I've had a great hospital birth, but even so, my midwife had to deal with a bunch of junk in the hallway to fight for my desires instead of just focusing on me and the baby.  There were things that happened to Malakai that we did not want, but had to because the hospital said so:  eye goop, vitamin k, ridiculous hearing test, not going home when we wanted to, etc.  At the hospital, the baby belongs to the hospital.  At home, we can just be a family.  Having a homebirth is not about having a fun or amazing birth experience for the mom.  It is a choice we make because we believe that is where our baby can have the safest most gentle birth without being cumbered about with much hospital protocols.  Yes, complications can arise, but they don't happen as much at home.  Unnecessary interventions (often because of hospital protocols or impatient medical personnel) CAUSE complications that require more interventions.  The most common are inductions, and timing labor and delivery to the extent that they do.  There are so many more, but most women don't even know they are wrong because they've never been taught otherwise.

Malakai on the scale after his pretty amazing hospital birth.
It makes me sad that all his beautiful vernix is gone here.
He was covered with it when he was born!

Certified professional midwives in states such as Indiana, practice "underground".  They must if they are going to help women who are having homebirths.  They can be extensively trained and certified, but the state simply does not allow them to obtain a license.  This legal situation is wrong, and those who act against it do so because they believe they are doing what is right in spite of the law.  This is much like how many people would respond to an anti-gun law.  I can tell you without a doubt that there would be countless people who would refuse to bend to that law and would not allow the government to disarm them.  Another example would be if it became illegal to carry a Bible or meet as a church.  Christians would then have to make a choice to obey the law or continue to follow their beliefs in spite of it.

In the case of Carol Velasquez, the deputy prosecutor claims that the issue is with illegally administering prescription drugs.  Those are the charges against Carol.  If Carol was carrying the drugs she is accused of carrying, she is in good company.  It would be very hard to find a midwife who doesn't carry Pitocin (for example). These midwives are simply arming themselves for any possible complication that may arise and the natural remedies are found to be insufficient.  Homebirth midwives should have the legal safety to care for their clients the best they can, but that is not the case at this time.  So, they give their clients the very best care while putting themselves on the line.

What needs to happen is that people need to speak up on the issue of homebirth freedom.  Midwives need to have the freedom to provide optimal care without the threat of the nightmare Carol Velasquez is going through right now.

Honestly, my husband put it in much better words than I did:

"Here is the thing, it is not a simple black and white issue. Is it technically illegal for a midwife to administer drugs such as Pitocin? I would have to answer yes. However, in order for midwives to be able to give excellent care to their clients and avoid certain complications they NEED to be able to use these drugs. The real problem is that it SHOULD be legal for CPMs to be able to use these drugs. By not allowing them to use them we are forcing midwives to either choose to compromise their clients care by forcing them to wait until they get to the hospital to receive treatment which in some cases may be too late when it could have been resolved easily at home by the midwife or take the risk because they are more concerned about the welfare of the baby and mother over the governing legislative body. Most midwives will choose the latter. It really is no different than a missionary going into another country where Christianity is outlawed, and under the pretense of being an English teacher, using that as a way to get into the country to teach them about Jesus. As Christians, we know it is TECHNICALLY illegal for them to teach Jesus and carry/distribute Bibles, but yet we encourage them, support them, pray for them, and fight for them if they get caught, because we believe it is the right thing regardless of what a governing body has declared. The same principle is true in this situation. The problem lies in the legislation, and I think some serious changes need to made at that level so midwives are not forced to make the sacrifices they do for the good of their clients."

 ~Matt Reeves

Support Carol Velasquez CPM!

BWB family, I am posting this link hoping that some of you would be able to join me to support Carol Velasquez. Carol is a certified professional midwife who has over 20 years experience providing optimal care for women, babies, and families. She is a dear friend to me and my family. ~Sarah

PLEASE READ:

"On March 28th, 2013 Carol Velasquez, CPM was indicted by a grand jury for practicing midwifery during her time in Indianapolis. Carol is a Certified Professional Midwife with over 20 years experience attending births. The care that Carol provided her clients was unparalleled by the Obstetric community and hospitals in Indiana. The women she attended received prenatal care according to the same schedule and yet she spent an average of 700% more time with us! This was acheived by scheduling 2 hour long appointments (as opposed to the 15 minutes OB/GYN's allot for patients.) She provided women with detailed nutritional counseling, recommended supplements according to the individual needs of the mother, and practical as well as emotional support to women facing difficult circumstances (myself included). Because the State of Indiana refuses to license CPM's Carol put her freedom on the line for each of the families she helped. Let's show our support for this brave woman on Tuesday morning as she surrenders herself to the court!"

*I am going to try my best to be there. I may have all my children with me. If you are in or near Indianapolis and want to help, please meet me at the courthouse on Tuesday morning (4/2/13)! If you can't be there, please share this event in as many homebirth friendly circles as you can, and please please pray. ~Sarah

CLICK HERE TO VIEW THE EVENT ON FACEBOOK

Thank you all so much for reading this blog.  This is an unusual post calling you to action, but I wouldn't ask you if it wasn't important.

-----> PLEASE SEE UPDATED POST HERE!

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!!

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!!

To My Husband with Much Love

Thank you, Honey. 

Thank you for being my best friend.  Thank you for your love and support through everything these last 9+ years. 

When we first found out about Faith, and then couldn't keep her, you held me together through all of that.  The worry, the confirmation that our tiny baby was no longer living, the pain, the hospital, the incredible grief. . .  We came through that together with God as our strength.

Thank you for 7 1/2 years of successful breastfeeding.  I couldn't have done it without you.  When Isaiah was born, and had trouble latching on, you never suggested I give up and just give him a bottle.  Those first nights of pumping colostrum and spoon feeding him every 2 hours were so hard, but you were so strong right with me.  You even rocked him between feedings so I could sleep.  A few days later when the roof of his mouth smoothed out and he nursed with no problem at all, it was a victory for all three of us.  We all worked very hard for that.  Also, you've always been very supportive through all the (often difficult) tandem nursing months and years with each of our 4 children. 

You love me through all my hormonal mood swings.  You always look at me like I'm the most beautiful girl in the world no matter if I'm a size 4 or I'm 8 months pregnant and no longer fitting into my maternity clothes because I've gained 50 or 60 lbs!  You are an excellent birth assistant.  If you are with me, I know everything will be ok.  Our births have been so amazing mostly because of you.  I could never have been so relaxed and at ease if you had not set that tone for me. 

You are such a great daddy.  I am so thankful our children have you.  No matter how busy you are, you make time for them.  You are a patient teacher and love them with the love of Jesus.  I love seeing you wear each of our babies in the sling or baby wrap.  You have become just as much of a breastfeeding, baby-wearing, gentle birthing advocate as I am, and sometimes even more than I am!   

I am so proud of you.  When Eli was diagnosed with severe hemophilia, a seed was planted in your heart, and now you are working very hard to earn your nursing degree so that you can help other children and families with bleeding disorders. 

I love how you love being a daddy.  You are even more baby crazy than I am!!  It doesn't even matter to you if we have more children with hemophilia.  On the possibility of having multiple little hemophiliacs, you just say, "Line 'em up!" (for infusions).  You just smile on the idea of caring for each child with their own unique needs. 

 As we anticipate the arrival of our fifth child any day now, I wanted you to have the spot light.  You are the greatest husband and daddy I've ever known.  I love you.  Thank you so much for everything. 

Love,                    

Me                  

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! 

I Have a Dream. . .

Well, it is very late, and I should be dreaming in my sleep.  Instead, here I write on this blog that holds so much of my heart.  We are officially 38 weeks now that it has hit midnight.  Birth is on my mind even more than usual.  Why do I do this?  Why did I even start Bubble Wrapped Birth?  Why bother?  I'll tell you why.  This is something I believe in with all my heart.  I learned about gently birthing my babies before I knew what the word hemophilia meant.  I want to get the attention of those who have a voice that can make a difference or be that voice myself.  There is a better way, a safer way to protect our little ones through the birth process.  I have a dream that someday our recommendations for delivery will include more than they do now.  Things like:  no pitocyn, avoiding epidurals, getting us up off of our backs, keeping the mom comfortable and making freedom of movement an essential priority, considering water birth, and no forceful pushing.  We can work with our bodies.  We do not need to fear birth.  God did create our bodies to do this.  We are strong.  Our babies are affected so much from birth.  Birth does matter!  Someday, my little girl may have the honor of motherhood, and she will need to choose what is the safest way to birth a possible hemophiliac.  I am doing this for me, for you, but mostly for her.  Goodnight, dear readers.  Sweet Dreams. . .

"Pushing" for a Gentle Birth

My husband and I have had 4 beautiful all natural water births, and are looking forward to our 5th in the next few weeks.  If you've read my birth plan, then you may have noticed #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."  I want to use this BWB post to talk about my experiences with pushing.

Isaiah still in water seconds after his birth

With Isaiah, our first born, I pushed with every contraction as soon as I found out I was 10 cms dilated.  I felt like I was pushing against a brick wall.  Now, I know that I should've waited until my body started pushing on its own.  Of course, my midwife wasn't intending on my forced pushing.  She told me to push if it felt good.  I was pushing because I thought that my baby would get into my arms faster if I did.  Well, that pushing lasted for 4 hours.  Isaiah was fine.  Our midwife kept a close watch on his heartrate, and when he started crowning, she kept a close eye on his skin coloring.  The only issue he had was that the plates in his skull were very overlapped, and even caused the roof of his mouth to not be smooth which effected his ability to latch on well.  Isaiah does not have hemophilia, and I am so glad because I think all that time in the birth canal may have caused problems if he had hemophilia.  As it was, the overlapping issue was resolved in a few days, and he was just fine.

Right after Ana's birth

Ana, our second, was another story!  I didn't mention in the previous paragraph that Isaiah was 9#8oz at birth!  Well, Ana was only 7#4oz.  That is a significant difference!  My midwife would not tell me when to push.  She said, I would let them know when it was time for me to push.  So, I waited.  It didn't take long at all until all of a sudden I was pushing with a contraction.  It just happened!  I wasn't trying to push or anything.  It was a natural response to my body's birthing process.  Within 6 minutes, she was born.  It was amazing!  Ana is a carrier of severe hemophilia A like I am, and did not have any issues at birth.

Elijah hours after delivery

Our third birth, Elijah was very different from Ana's birth.  If you read his story, you'll get a better idea.  One thing I did right was that I "tested" pushing with a few contractions, not a lot, just a very little start of a push.  It did not feel right.  So, I did not push.  I only started pushing when it felt right.  Which brings up the issue of epidurals.  Yes, they occasionally have their place, but they should be avoided for so many reasons.  Knowing when it feels right to push being one of those main reasons.  I learned in my first birth, that you can push too soon even after you're dilated to 10cms!  Ok, off the soapbox and back to Eli's birth.  When it did feel right to push, I quickly realized that this baby was BIG.  He wasn't coming out easy like Ana did, and I didn't want him to be in the birth canal as long as Isaiah was.  So, I P-U-S-H-E-D harder than I had ever pushed before!  When his head came out, my body rested as it always does.  It felt like forever!!  When I began pushing again and his shoulders and torso came out, I thought he was totally out, and went to scoop him into my arms.  "One more push! one more push!" my midwife and husband said.  I gave another little push, and that big 10#14oz bubba was in my arms!!  He was pink, and had no bruising at all.  If you read this blog, you know that Eli is our hemohiliac.  We didn't know until he was 4 months old that he had hemophilia.  I believe with all my heart that God's grace, the gentleness of his birth and my management of the pushing stage of his birth are credited with his safety.  It blows me away that our severe hemophiliac was the one that was almost 11#s at birth! 

Malakai just minutes after delivery

Malakai's birth was a breeze.  Like Ana, I didn't have to actually push at all.  My body just pushed him right out.  He was only 7#12oz.  He did have a meconium issue after his birth, and he was fine once they got it all suctioned out of him.  If you would like to see one of our births for yourself, we have a very non-graphic video of Malakai's birth on youtube.  His birth was the first one that we planned in the knowledge that our baby had a 50% chance of having hemophilia. 

All of our births have been water births.  I am a true believer in water birth.  I think it is a major cause of the gentleness of our births.  I have blogged about this before in:  Why I Love Water Birth:part 1 and Why I Love Water Birth: part 2.

The conclusions I draw from all my various pushing experiences are these:

1.  Don't push just because you are 10 cms.

2.  Focus on relaxing and staying "on top" of the intensity of your contractions.  If you are working with your body, your body will naturally start pushing on it's own, and you may not have to push at all.

3.  Only push when it feels right.  Sometimes, with very large babies, it may be necessary to push with your body.  I personally do not believe it is good for a hemophiliac to stay in the birth canal for a long time based on seeing what happened to Isaiah's head.  So, I do believe I did the right thing in pushing very hard with my body to get Eli out as soon as possible.

4.  Being as relaxed as possible, and in a position that allows gravity to help the process helps the pushing stage be much easier on mom and baby.

Thank you for your interest in Bubble Wrapped Birth.  As always, please don't just take my word for anything.  Do your own research.  Talk to your doctor or midwife.  This is what I believe and what I know works for me.  However, I do hope I have sparked some thoughts about the 2nd stage of labor that you may not have had before.  Thanks for reading!

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!

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!~

If I ever needed a c-section. . .

This is one of the most beautiful birth videos I've ever seen, and it's a c-section!  This hospital in the UK has made a great effort in making a cesarean birth as gentle and family oriented as possible.  The baby is handled so gently, they delay cord clamping/cutting, and there is no separation from mother until she has to be moved to the recovery bed.  Even then, there is no separation from father.  If I ever needed a c-section, I would insist it be handled like this one! 

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.