Wednesday, March 28, 2007

Happy Anniversary to Us

As of last night I have been married to Hubby for 9 years. The first few years of marriage were challenging but we are finally at a point where we like each other (most days). We will be celebrating this weekend by going to a fancy restaurant for dinner.
Our actual anniversary was spent arguing over a personal training contract that I signed last month that he didn't know about. The contract is no longer in effect so, in my opinion, it should no longer be an issue, Right? OK, maybe not but I'm not interested in arguing over it.
I also went to dinner with my stepsister. Hubby laughs at me when I call her that because I refuse to call her dad my stepfather, I always call him "my mother's husband". She's visiting her dad who she hasn't seen in almost 12 years (when my mom and her dad got married). We had a nice time eating and talking about how much our fathers weren't there for us. The two of us have a lot in common. Hopefully we will keep in touch.
The most exciting part of my anniversary is the gifts our mothers gave us. My mom is having our house cleaned from top to bottom. Oh boy do we need that! My mother in law is buying us new pots and pans. Yipee!!
Oh boy, I am getting old. I get excited by housecleaning and cookware.

Monday, March 19, 2007

If Trouble Was Money

I think I have figured out the main lesson I was supposed to learn about the Twilight Zone birth. I can not be motivated by money when I take a birth. Every time I am it winds up being a not so pleasant experience. I can think of two other times that this has happened. This one was the worst.
My biggest reason for becoming a doula is wanting to care for and support birthing women. Most of the time, when I take a client, getting paid for my services is important, but money is really a secondary thing. This time the order was reversed.
I got the call requesting my help and my first thought was "I'm available and this is unexpected money, so why not?". As a matter of fact, that thought played a role in my deciding to discounted my fee by almost 50%. I knew they were calling at the last minute, had limited funds and had already been turned down by another doula. Of course I wanted to help them but I also saw it as an opportunity to make a quick buck.
I hate admitting that my primary motivation when agreeing to be their doula wasn't a strong desire to help. Of course, I don't feel that my misguided motive is the reason why the experience was as unfavorable as it was. I do think though, that it played a huge part in why I didn't pick up on all the red flags that surrounded the situation.
Even though I can look back and see the things I could have, and probably should have, done differently, not having my priorities in order is the biggest.

Friday, March 16, 2007

It was a gallbladder attack!

That's why I was so sick the night of the Twilight Zone episode. That whole "gas pain" thing had happened to me before. Even though it had kept me from sleeping many nights, I always thought it was just really bad gas. The attacks were so infrequent that I never figured out what might have been causing it. TZ night was so bad that I finally decided to get it checked out. I went to the doctor and was scheduled for an ultrasound yesterday morning. Unfortunately I had another attack in the middle of the night so Hubby took me to the hospital. I cried all the way there. I remember saying "I need a doula!" I almost called a couple of my doula sisters but Hubby reminded me that it was 3:30 in the morning. By the time I was finally seen, the pain had subsided and I was starting to feel a little bit silly for being in the ER. The doctor and nurse said that what I was experiencing was actually very common for gall bladder issues. The fact that the pain had gone away pretty much confirmed that it was my gall bladder. They ran a bunch of tests and I had an ultrasound. Sure enough, I have gallstones.
Now I have to figure out how I want to treat this. My conventional doctor said "Get thee to a surgeon so your gallbladder can be removed!" I really don't like the idea of removing an organ, even one that is causing this much pain. I'm waiting to hear back from my naturopathic doctor to see if he has a better solution.
Either way, I really want to figure out how I can avoid hurting as much as I have the last couple of nights.

Wednesday, March 14, 2007

The Twilight Zone

I've always been a firm believer that I am at the births that I am supposed to be at, and that every birth I am at teaches me an important lesson. Last night I began to question that belief. I have no idea what I am supposed to learn from the experience I was a part of.
A little over a week ago I got a call from the mother of a pregnant woman. She was looking for a doula for her (married) daughter T. I though it was a bit weird that she was the one calling but I agreed to meet them. Another odd thing was that this woman was looking for a doula at the very last minute. T's EDD was less than a week away. She mentioned that her daughter and son in law didn't have much money but really needed support. I agreed to discount my fee.
The next day I met the three of them. It was a very brief meeting but it seemed to be a good fit. I felt excited about working with them. We talked a little about payment I told them that since she was due within the next few days that they could pay me any time before or at the birth. I also didn't have them sign a contract since it was such short notice (looking back, BIG mistake).
As the week went on, I stared to feel off about the upcoming birth. I know "off" isn't a very descriptive word but I don't know how to explain the feeling or why it was there. I think my biggest concern was that I hadn't really developed a relationship with this mom. I really like to get to know my clients so I can adjust to what they may or not need during the birth. What I had learned about them was that they were hiring a doula because they wanted someone who knew the hospital "system" and who could help them gather information about the care they would be receiving.
Another concern that popped up in the week after I initially met with them is I found out they didn't really have a care provider. T was getting prenatal care at a clinic but the doctor providing her prenatal care doesn't do births. He recommends that his patients call the hospital and try to develop a relationship with doctors that have privileges there. I'm still not clear on how that is supposed to work but that's how it was explained to me. The clinic doctor told T to go to Hospital A because the doctors there know him and work with is patients on a regular basis. For a reason I don't understand, T and her husband decided to go to a completely different hospital. She had been unable to establish a relationship with any doctor but she was determined to birth at Hospital B.
T's husband called me around 2:30am Tuesday morning to tell me that he thought her water broke. He asked me what should she do and I said it was up to them. I asked what they felt like doing and he said they were going to hang out at home for a little bit and would call me when things changed. I said "that sounds like a good idea" and went back to sleep. When I woke up I started to feel real uneasy about that conversation. Did I inadvertently give medical advice? I didn't think so but I called them back to find out what was going on. This time I talked to T. I asked her how she was feeling and what she planned to do. She said she just woke up and felt fine and that she was gonna hang out a bit longer. I told her to keep me posted but I still had a nagging feeling about the whole situation. I decided (with the help of a couple of wise doula sisters) to call her back to make sure she knew that what she was doing was outside of what most medical doctors would be comfortable with. She said that she knew that they would want her to come in but she didn't feel that it was necessary yet. I was relieved that she had come to this conclusion on her own and not because of something I may have said to her hubby at 2:30 in the morning. She then told me that she had a scheduled doctors appointment in a couple of hours and asked if I thought she should keep it. I told her it would be a great idea to see her care provider so that he knew what was going on and he could verify that she had actually ruptured. She agreed and I sigh another breath of relief.
About 5 minutes before her scheduled appointment she called me to say that her doctors office told her not to come in and to go straight to the hospital. I agreed to meet them there.
As I was on my way, I got a call from my client's mother telling me that they had stopped at a restaurant for lunch.
I got to the hospital first and waited a few minutes for them to get there. I still had a uncomfortable feeling about the whole situation but I just couldn't put my finger on what it was. T, her husband, and both of their mothers showed up and the chaos began. As T was being given a hard time by registration because she had no doctor and no insurance, her mother pulled me aside to tell me that the husbands mother was not to be allowed in the room because T didn't want her there. Then T's husband pulled me aside and told me that T's mother must be stressing her out because T just told him to "shut up and stop talking".
We got into triage and the nurses seemed like they didn't know what to do with her because she had no doctor, no insurance, and they didn't have her records. They finally figured out that T would be cared for by the on staff OB. He came in and immediately told her that because he doesn't know her, he couldn't guarantee her a healthy baby. Not that he's trying to scare her but because he knows nothing about her history, there could be all kinds of complications and her baby could have all kinds of health issues. What lovely things to say to a mom in labor!
I felt myself getting pissed off at this man which is probably the biggest mistake I made during this whole experience. He picked up her birth plan, which basically stated that they want a natural birth with minimal interventions, and told her that he would try to respect her wishes but he couldn't agree with many of the things on there. One example of what he didn't agree with was her request for dim lighting. He said he needed to be able to see what he's doing, which I understand to some extent, but him being able to see had nothing to do with her wish for dim lighting while laboring. At one point I asked him how much longer she would need to be on the monitor. I was hoping to be able to have her walk around to get things moving. He said she would need continuous fetal monitoring. Confused, especially considering that the standard is 20 minutes of monitoring an hour, I asked why. He said because babies can die in less than 5 minutes and if he were to let her get off the monitor for more than a few minutes, her baby could die and we wouldn't know it. The shock must have registered on my face so he then said "You and I have totally different beliefs about birth". He then went on to tell her that if she didn't progress a centimeter an hour that he would need to augment her labor.
Looking back, I probably should have kept my mouth shut but I just couldn't (besides, I had promised this family that I would ask questions for them if anything seemed out of the ordinary). I asked him how could we help labor progress if she wasn't allowed to get off of the monitor to move around. He then said that there is no evidence that proves that walking and moving around helps labor progress. I think a "wow" escaped from my lips and for the second or third time he said something about how different our beliefs about birth were. Even though this was true, it made me angry because I hadn't stated my beliefs I had simply asked him a couple of questions and this really wasn't about my beliefs, it was about what my client wanted for her birth. I told him "You don't know what I believe about birth".
Even as I'm writing this I am cringing at my reaction. My focus should have been my client, not arguing with the idiot doctor. In all his ranting about how dangerous birth was he also felt the need to say how he sees people try to have natural birth all the time and that he has to fix the mess that it causes. He said he's dealt with many transfers from midwives who just don't know what they are doing. He really seemed to have a big Hero/God complex.
A couple of hours went by and the OB checked her and she hadn't changed. He told her that he was going to start pitocin and she said no. This really bothered him. He said it had been at least 6 hours since her water broke and he'd let her go much longer than most doctors would allow. T's mother asked if mom and baby were fine and he did the whole "Yes, for now, but we don't know how long they will be". He kept talking about the risk of infection and that baby needed to be born 18 hours from the time her water broke.
T asked if they could wait an hour and he said "At what point are you going to listen to me? I know what I'm doing." I asked if we could compromise and try some other things first (which is what her birth plan requested). He looked at me and said "No, I don't compromise. I've delivered over 4000 babies, how many have you delivered?" My response was "I don't deliver babies" .
T and her husband asked for a few minutes to talk and think it over. I realized that the bad energy between the doctor and me was a problem so I went into the hall to talk to him. I told him that I felt that we had gotten off to a bad start and I explained that I wasn't there to argue with him, I was just trying to support the family and to help their wishes be respected. He said he could respect that but he may at some point decide that only the family would be allowed in the room because when I ask questions it undermines his authority. There was a huge part of me that wanted him to kick me out because I couldn't stand witnessing the disrespect he was showing this family.
T continued to refuse the Pit, OB continued to be an ass to her and I stopped asking questions. I tried to make myself invisible when he would come into the room. During all of this T's mom and husband started snipping at each other. T's mom told me that T really didn't want her husband there and T's husband told me that he wanted her mom to leave. It went as far as T's husband telling her she needed to get the hell out of the room and her saying "I'm not going anywhere". I swear it was the weirdest sh*t I've ever seen. I asked them to not do that in front of T and they both apologized. From then on they were nice to each other on the surface but you could feel the bad energy between them.
During all of this I started having really bad back and stomach pain. If felt like the worst gas ever. So not only is there craziness around me but my body seems to be reacting to it.
Finally, the OB agreed to give them 30 minutes (they asked for an hour) to try some nipple stimulation to get her contractions going. We all left the room and let T and hubby have some time alone. Her contractions really picked up during that time but came to a complete stop as soon as the OB came back in. He checked her again and she had changed just a little bit. It wasn't enough for him so he again insisted on the pit. I tried to get her to explain why she had such strong objections to this option and all she could say was "I just don't want it".
OB was completely ticked off by this and told her that he wasn't going to treat her anymore. He called in another doctor. T's husband said that while he was in the hall he heard the doctor tell someone that T was stupid and shouldn't even be there.
At around 9 or 10 pm the new doctor came in and was so patient an kind. She listened to T's concerns and explained the concerns of the doctors in a way that wasn't rude or condescending. Finally, T agreed to the pitocin. By this point my stomach pain was almost unbearable. Since T wasn't in active labor and the pit was just getting started, I asked them if they would mind if I left for a couple of hours to rest and recharge. I told them I would come back as soon as they called me. They all agreed that since I was only 20 minutes away that they felt comfortable with that.
I left and the pain continued to get worse. By the time I got home it was so bad I was throwing up.
At 2:30am I hadn't heard from them so I called to see how things were going. T's mom said everything was pretty much the same and they would call when they needed me to come back.
I tried to get some sleep. At 7am I called again and I could hear T really working through the contractions. I asked them if they were ready for me to come back to the hospital and her husband said not yet. It was shift change and they would know more once the new nurses and doctors came on. He said that he wanted to make sure things were progressing before they had me come back up there.
I was starting to get the feeling that they didn't plan on having me come back and to be honest, I was so sick I really didn't want to go back. After I got off the phone with them my hubby called the doctor's office. They said I needed to be seen right away. I called T's husband back and told him that I needed to go to the doctor but I would be more than happy to send a backup when they were ready for the additional help. Her husband said not to worry about it, they were just fine.
I found out later (from T's mom) that he told them I had quit.
After my doctor's appointment I called to see how things had gone. Dad told me that they had the baby via c-section because mom never progressed past 5 cms and the baby never moved down.
I'm so sad for this mom. I still haven't had a chance to talk to her. I barely had a chance to during the whole time I was there. I wish I had been able to be there for her more. I wish I knew her better so I could have cared for her instead of dealing with the strange energy of the doctor, her mom and her husband. I hate that I allowed that OB to push my buttons and that I brought negativity to this woman's experience as well. I also hate how unprofessional I was about taking them on as clients. No contract, no payment. I'm assuming that they don't plan on paying me since I wound up not being there the whole time. Never mind the fact I lowered my fee by $250, I was with them for more than 10 hours, continued to check in with them, offered to come back (even though I probably couldn't have) and was told twice "not yet", as well as offered to send another doula in my place.
Maybe there are multiple lessons I am supposed to learn from this birth experience. Those lessons will come to me as I continue to process the whole thing.

By the way, I still have a couple of wonderful births to write about.

Wednesday, March 7, 2007

Oh no, I'm sick!

I was playing around with this Disease Mongering Engine and found out I have IPGD!

Intermittent Premature Gender Dysfunction (IPGD)

IPGD is found in people with unpredictable episodes or experiences surrounding an unplanned, temporally-distorted physiological response regarding sexual partner preferences.

Oh no, what ever will I do? Well, the site does give me some ideas on how to get rich off of it:
  1. Patent a dangerous chemical as a "treatment" for IPGD.
  2. Invent fictitious trial results that prove the drug is effective in treating IPGD.
  3. Bribe FDA officials into approving the drug as safe for everyone! (Even if it kills people.)
  4. Submit to the American Psychiatric Association for inclusion in their DSM-IV (the standard reference guide of psychiatric disorders).
  5. Create an emotional TV ad that shows unhappy, confused people being transformed into perfect beings after they take your drug.
  6. Issue press releases to mainstream media outlets who will run your propaganda as news with zero skepticism.
  7. Bribe doctors with vacations, extravagant meals and "consulting fees" in order to get them to prescribe your drug to as many patients as possible.
  8. Buy off politicians and legislators to block alternative medicine and enforce a pharmaceutical monopoly.
  9. Sit back and rake in the dough** while Americans go broke buying your drug to treat IPGD!
  10. When the lawsuits roll in from the families of dead patients, simply use a small portion of your windfall profits to settle out of court, admitting no guilt.
Pretty funny, huh? Now go off and discover some lovely new diseases of your own!

Monday, March 5, 2007

The Sister Bond

Even though we weren't raised in the same home and we live thousands of miles apart, my oldest sister and I have a very special connection. Thing 1 and Thing 2 were conceived within hours of her middle child being conceived. I remember calling to tell her that Hubby and I weren't as careful as we should have been. I was looking for reassurance that everything would be just fine. Instead I got, "You too?!" Two or three weeks later I called her to tell her my pregnancy test was positive. She refused to take a test claiming that I had jinxed her. Of course when she finally took one hers was positive too. Our boys were due at the same time but the twins decided to come a few weeks early so they are 3 weeks apart.
Fast forward 3 years. I started feeling early pregnancy symptoms and was very confused (because I had my tubes tied when Thing 1 and 2 were born). I couldn't understand why my boobs were so sore and why I felt so nauseous. When Sis and I spoke, I told her about how I had been feeling. She got very quiet and told me she would call me back. She called a few days later and told me that I had gotten her pregnant. Immediately my symptoms disappeared. At first I thought that it was a quirky coincidence but as the pregnancy continued I felt more and more connected to her and her new baby. I would joke with her and tell her that she was having my baby. I was as involved with this pregnancy as I could be considering we live a couple of time zones away from each other.
We decided that I would have to be there for the birth. We worried a little about getting me there in time, but I think we all new deep down that there was no way I would miss it. I left Hubby and the Things in good hands (my mother in law's with my mom as backup) and flew across the country.
The timing was perfect. I got there a few days before my niece was born. The first day I was there I did Sis' belly cast. The second night we just hung out but when she went to bed I gave her and her man orders to get busy so we could get things moving. She seemed to have the look I see many moms get when they are close to going into labor. The next morning we went to her OB visit. She was 4cm and had some show (I'm sure the action the night before helped). Even though she wasn't contracting much, it was easy to see that she was in early labor. As we were leaving the office, her OB and midwife gave us instructions on what to do if she had the baby in the car. I loved hearing care providers talk about birth as something normal and not something to freak out about. We stopped at Trader Joe's on the way home to pick up snacks and stuff. That night we watched movies while I massaged her feet and belly with lavender oil. She woke me up around 3am and told me contractions were about 4-5 minutes apart. We left for the hospital about a half an hour later. When we got there Sis threw up as soon as she got in her room. She was checked and was 6 cm. We turned on her Hypnobirthing cd. For the next few hours we listened to the cd over and over. Sis seemed completely relaxed except for the occasional request for counter pressure on her back. Her man and I took turns holding her hand and pressing on her back. After a while we turned the cd off (I can't remember why we did). Sis got up and moved around a bit. It was amazing to watch her be so in tuned with her body and move exactly how her body and baby needed. Within moments Sis felt the urge to push. When they checked her she was complete but baby was still high. Sis pushed for a while but since Baby was posterior she wasn't moving down very quickly. The OB suggested getting Sis to lay on her belly to help baby turn (did I mention how much I loved this OB?) . Baby got into a good position pretty quickly and Sis had an even stronger urge to push. We were using a squat bar and while she was pushing she seemed to be afraid of the feeling. With each push she would jump from a squatting position to a standing position. I know I shouldn't laugh at any birthing mom, let alone my sister but, it was pretty funny to see her standing on the bed, holding on to the squat bar for dear life. Every time she would stop herself from pushing she would beg each of us to help her, to do something. She seemed to need to be reminded that none of us could do the work for her. At one point I asked her what she wanted us to do? She replied Take her out!". I asked her if she wanted a c-section (not because I thought she needed or would get one but to show her that she had to help herself). No one else seemed to know where I was going with this question because I heard at least two horrified "No!"s coming from her man and either the OB or the nurse. Sis was starting to lose her focus and I decided that she needed me to get firm with her. I told her to "Get down here and start pushing". That's when she hit me!
Ok, she didn't really hit me, she just slapped at my hand and her man's hand and told us to stop it. It worked though, she got back into a squat, bore down and pushed. For some reason none of us were looking at her during this push. I had been reaching for a washcloth (I don't know what the OB, her man, and the nurse were doing) when I turned back around, half of my niece's head was out. We all yelled for her to wait. The OB didn't even have her gloves on! Of course there was no waiting and one push later, her head was out. She leaned back onto the bed and pushed her the rest of the way out.
My beautiful niece was born at 8:37am. She was 6 lbs 14 oz and 19 inches long.
The OB waited patiently for Sis to birth the placenta. While she waited we chatted about her twins and how more than 20% moms in her practice have unmedicated births.
Baby Girl breastfed right away and was skin to skin with her mommy for the first hour of her life. Then she had bonding time with her Daddy. When I finally got to hold her I looked at her and immediately felt a connection I can't really explain. It was like I already knew her, like she had been a part of me too.
I stayed with this wonderful new family for a few more days and then came back home to my own. It was so wonderful to be able to be a part of this birth. I didn't think it was possible but, this experience made my connection to my sister even stronger.

Friday, March 2, 2007

I promise!

I have so many ideas for posts running through my head. If I just had a laptop I would write more frequently. I hate sitting at my makeshift computer desk. It is not conducive to creative writing.
I have 4 births to write about as well as my many other "deep" thoughts.
I know that I'm on the verge of some serious power blogging. Just bear with me, please.

By the way, Thing 1 and Thing 2 recently turned 4. I can't believe my youngest children have grown up so quickly!

O.T. (Original Thing) taught Thing 1 to call people Fart Gas. It's not a nice name but it's not the worst thing you could call someone, unless you do not speak clearly and it come out sounding like F*ck @ss (try it yourself, just take the "rt" out of the phrase). I'm not sure I want to stop him from saying it because it just sounds so wrong but cute at the same time. Bad Mommy!