Sunday, July 31, 2011

Bump in the Road


So I don't know why I feel this way...
Every time I go to the Clark page to register - or even think about it - I get so "sick" inside. Not actually nauseous, but very dark and dread and doom feeling.
Actually I do know why I feel this way, because of this little beautiful angel:
Wait! Not that one, this one:

3 Months after these cutie pie was born, I was back to work. Twice a week I had to leave him with his grandma - which was a great deal for her, and essential for our budget - but it was a raw deal for my emotions and the want/need to be a Stay at Home Mom. Even now, he is almost 2, I still feel that ache every time I close the door.

As I was sitting here trying to analyze this doomsday feeling over registering, I realized that if I hate leaving my child then why would I purposefully set out on a path that would end up with me gone most of his childhood. I've never been through a Nursing Program, but I'm sure it's not a few hours a week - it's a big commitment. And I have such a hard time intentionally signing up for that. Plus at the moment I'm trying to have more children.... how is that going to work? I will schedule my classes around the babies nursing schedule (that's a little funny, since I'll be taking breaks from my nursing classes, to nurse - get it? no? that's ok.) and naps and still find the energy to study like crazy?

Speaking with Husband about these feelings doesn't really help resolve the issue. He thinks it would easier to go to school now while the the child we have is small and get it over with rather than trying to find time when we have more and they are older. And he's probably right. But I just can't bring myself to do it. It's been a week and a half since I've been eligible for registration.

One plan that does bring me hope is to become a Doula/Bradley instructor first. From my early research, it's not a 6-7 year timeline I'm looking at, more like a weekend seminar, logged hours, and paperwork (not to mention FEES). It seems a much more flexible option to have while in my baby- bearing/rearing years. Plus it will give me a lot of experience, which is really one of the best educators.

In my head it seems logical that I will be able to start school once all my children are in school, so that I can somewhat coincide my schedules with theirs. And hopefully at that point, Husband's work will also be at a point where income won't be a constant issue.

I just don't want to look back on my life and regret not spending more time with my kids, not hugging them enough, not playing fort and house enough, not having time to listen to their mini-recitals for the newest song they've learned, etc. While birth and all aspects of it still fascinate me and bring me joy, being a midwife does not even come near any of the above mentioned activities.

This post is a little scattered. I apologize, my thoughts are likewise scattered at the moment.

Friday, June 17, 2011

Options?

As the day draws nearer that I can register for classes, I start to get nervous and excited. I want to make sure this is the path that I really want to take.
I looked into the accelerated classes (all 3 Anat & Phys in 6 weeks, Yikes!) and I knew it wasn't for me. I wanted to make sure I really knew this stuff, not just passing it off with a grade so I can start the program faster. After talking with Tony, I knew it was better for me to take my time, understand it, and go with the flow of things. I'm under no specific deadline to become a midwife. It will happen when it happens.
So I feel a lot better about the time allotment, but while browsing through some home birth options in the Portland Area, I came across Right at Home Midwifery. I was really impressed with what I read and found on their site. Looking at their Bios, all 3 midwives are CPM or direct-entry Midwives. This got me thinking further: do I want to do this instead? Why not skip the whole nursing school thing and start directly into the Midwifery field?
This is something that when I first starting looking into midwives when I was pregnant with my son that confused me a lot. My first thoughts were "of course CNM's are better, they have nursing experience and are more qualified right?" and because of my insurance, I went with a CNM who is very helpful and I love working with her. However, now I'm not only looking into the difference in education between CNMs and CPMs, but the different regulations/restrictions put on CNMs and CPMs by the government.
I've been doing some research and reading around on this subject and this is a summary of what I've found:
- CNMs generally work in a hospital setting, they are great for low-risk pregnancies/deliveries, but the second anything goes wrong (i.e. breech, hemorrhaging, birth "taking too long") they are no longer qualified to help and an OB/GYN takes over. *This brings up another argument about birthing without interventions which I will talk about later* There seems to be less written restrictions on them, because of their background in Nursing and normal hospital/clinic regulations are already set in place.
- CPMs almost always work in a home and birth center setting, they are also best for low-risk pregnancies/deliveries, but are not deterred by slight complications. (I've read many stories of breech home births, hemorrhaging, twins home births etc that were successful and would've required more intervention had it taken place in a hospital). There are a LOT of regulations and restrictions put on them (more or less depending on the state), which makes sense to a degree since they want to make sure these professionals are qualified and knowledgeable before they start delivering babies and taking care of women. Also, after just surfing the internet to discover how to become a CPM, I'm still unsure and confused. There are so many different options and roads to take, that until I talk with a few CPMs, I will probably still be unsure.

My conclusion? One thing I did find is that CPMs schools require similar prerequisites to their programs as the nursing program. So at this point, my plan is still the same, get into those classes and learn! I still have a year or so before I really need to start seriously making decisions.

Any thoughts? Do you have experience with either CPM or CNM?

Wednesday, June 1, 2011

Back and Forth

The more I think about this, the more back-and-forth I go. I know this will be something I'll enjoy helping others in - and I'll love knowing more about my own body, but it's a huge time commitment for the next 6 or 7 years depending on how classes go and other unforeseeable things.
I had a meeting with an advisor and few other students who are also pursuing nursing and that was a little disappointing, although I'm very glad I went. I had taken for granted that I would be able to take the classes I wanted, when I wanted. I was planning on getting all my prerequisites done by spring, and starting in the fall for the Nursing Program. This will prove to be more difficult than I thought. Since I haven't attended Clark in over 5 quarters, I'm considered a new student, so while all continuing students got to register starting May 23rd, I have to wait until July 21st. The students/advisors at the meeting made it sound like it was more difficult to get into these classes than it was the actual program (which only accepts 40 students per quarter). That's one thing.
The other is actually getting into the program. In order for me to start in Fall 2012, I need to apply this October and have ALL my prerequisites completed. Soooooooo that's not going to happen according to plan.
Plus I don't know how I forgot in all of this that I want more kids! Which will be fine if I magically get pregnant with then next month or two and have the baby before I start the nursing program, but if not, I don't know how flexible Clark is on taking maternity breaks (even if only for a week or 2).
The good thing that happened is I better understand the program requirements and the application process, and one of the students there is taking classes from different community colleges in the area in order to get his prerequisites done faster - which is a great idea that I hadn't thought of before. There's even one out there that will cover all of my Anatomy and Physiology classes in 1 quarter, instead of 3.
eh. I don't know what I'm thinking now. I would love if there was a magic button that just gave me all the knowledge/experience/classes I needed in an instant so I could start and not have to go through this long and probably hard and painful process.
But if life were easy, then it wouldn't be hard.

Thursday, May 19, 2011

The Start

Having a baby was the biggest thing that has ever - or will ever - happen to me. It completely changed my life and my views on the world around me. This is my birthing story:

Preface: I wrote this the night after he was born, so not all of my modesty had returned to me yet, and it may be a little too descriptive. Also, I have since changed the word "natural" to "unmedicated", since all birth is natural - that's what we were made to do - and whether birth comes by pain medication, cesarean or nothing but your own endorphins, it's all natural.

My Birthing Story

Thomas Vibol Tan

October 3rd, 2009

Friday, October 2nd 2009 was like any other day. Tony and I had a lot of rental work to do that day: we had an entire kitchen floor to rip up (Jose and his crew did the work, we just facilitated), we had a Russian couple stop by and look at a 1 bedroom apartment, Joan came to visit with us and audit how we are doing. Then we went to work at Jo Ellen’s and from there to Tony’s parents. We had dinner with them and then went to the mall. We walked around, looked for nursing bras, stopped at the arcade so Tony could play a round of Marvel vs Capcom 2, then went home and played World of Warcraft together (we are big nerds). We got ready for bed around 11:30pm. A busy day, but good and we got a lot done. One important thing we got done was finish packing the hospital bag and putting it in the car along with the car seat and other necessary preparatory things. Since I wasn’t due until the 5th and first-time mothers are normally a week or so overdue, we thought we were getting things done with time to spare. Well… not as much time as we thought.

Tony fell asleep promptly after closing his laptop. I was less inclined and starting looking up ways to kill fleas. A week or two earlier I had found a couple that were lurking around. I think they entered our car after a nasty couch was removed from our new parking spot near the dumpster and from there entered our house. I was very perturbed and upset that they dared enter my new apartment with a baby soon to be there. But this is beside the point. While I was reading and tried a few of the home remedies (putting a bowl of warm water on the carpet and seeing how many jump in over the next day or so) about an hour had passed. I was just ready to settle down at 1:00am and go to sleep when I noticed a slight pain in my stomach. I had been having Braxton Hicks contractions for a week or so before, but had never had cramping in my abdomen until that day while at Jo Ellen’s. So, thinking this was just more practice, I did a few pelvic rocks and tried to sleep. When I noticed these pains were coming and going and felt exactly like I was starting my period. Not wanting to get my hopes up, I casually grabbed my phone and made note of when they started. It was very erratic: one started eleven minutes, then five, then nine and so on. But I couldn’t help noticing that these were definitely more real than my previous Braxton Hicks were.

Following the Bradley method, I got up and walked around a bit and went to the bathroom. While in the bathroom I had two or three more contractions just sitting there. Again, not wanting to get my hopes up, but getting more convinced that this might be the real deal, I woke up Tony at 2:30am to let him know what was happening and to inform him that I was going to eat something and rest some more and see where this took me. He immediately got up, got his watch, put some episodes of The Office on and laid down on the ground next to the couch to help me keep track of these contractions. By this time they were getting noticeably painful. Not terrible, but more intense than the 1:00am contractions. At one point they were coming every six minutes, but then would become erratic again and skip to eight, or ten or whatever. So we decided to go to sleep again. It was nice to get some rest in between, but they kept on coming. So at 7:00am we got up, took showers, grabbed our last minute hospital items and headed out to get breakfast. We were going to eat out, but the contractions kept coming and we decided better to grab some Sunrise Bagels and go straight to the hospital. At this point the contractions were difficult enough that I had to stop and focus on not clenching and would take very deep breaths. I had made a deal with myself that if the pain lasted longer than 30 deep breaths, I could use medication. I knew I’d never have to follow through with this because the longest any of them were lasting was about 6 or 7 long deep breaths.

When we got to the hospital I had only eaten about a third of a bagel and was full. I sat down at the check-in desk and signed myself in. I was a little anxious because just then I didn’t have a contraction for about twelve minutes. I began to doubt myself and prepared myself to be disappointed that this was just a false start and I had to go home and wait for the real deal to come later. However, once I stood up I was hit with one. Walking down the hallway was a little difficult but we made it to the prep room where they hooked me up to a monitor to check on the baby and on me. I was still worried that I was wasting everyone’s time, and I wasn’t really in labor. The second she hooked up the baby monitor, that worry was pushed past with a bigger worry. The nurse said, “this worries me.” Apparently the baby’s heart rate during my first contraction on the monitor was slowing down. She repositioned me and the monitor and checked again. This time he was fine. But the nurse still seemed a bit worried and informed me that we would need to have a fetal monitor and that I would need an IV in case of an emergency cesarean. This was not very comforting, but I was glad he was doing better. Next the nurse checked my “progress.” She looked at me in surprise and said “you’re about a six.” I immediately replied, “are you kidding me?!” I was so elated. If I was already at a six and it was only 8:30am, then surely I would be done and holding my baby by dinner. So I was introduced to my midwife for the day and my nurse and we set out to get to my birthing room. I was then given an IV, luckily didn’t need to have a continuous drip, and was hooked up to a portable monitor that let the nurse know when I was having a contraction and what the baby’s heart rate was. This proved to be more of a nuisance than anything. Baby was doing great and his heart stayed steady and awesome during my contractions, but with almost every move, the monitor would get thrown off or something would happen that it would need to be repositioned so it could have a proper reading. And with each repositioning, I would have a contraction because of the movement and pressure on my uterus. We called our friend Bethany, who had originally told us about the Bradley method and who graciously agreed to take some pictures of us. And Tony’s mom was present too, assisting when she could and just enjoying the fact that she was going to have a grandchild soon.

Labor progressed like I thought it would. The contractions were regular and intense and I would stop as each one came, breathe deep and hard, and focus. Tony was there with me every step. I enjoyed being in the relaxing position on the bed, but Tony would insist I walk around, and try the ball, or hands and knees position. I even spent time in the Jacuzzi tub, which was very relaxing. At around 1:30pm the midwife came in to see how I was doing. Considering I was at a 6 at 8:30, I figured I’d be pretty close to the big push and have this baby out soon. Unfortunately I was only at 7½ centimeters. I felt a little discouraged. She suggested breaking my bag of waters, but I was not convinced yet. She was a nice midwife and wanted to deliver me and I had wanted a midwife in the delivery as well. So I felt a little pressure because she was going off-call within the hour (which I didn't really appreciate). So Tony and I tried to speed things up (without the intervention). We walked a lot more and were pushing through the contractions. They were getting more intense and I was feeling a lot more pain in my back. At 2:30pm I felt pressure in my rear, similar to having to go use the bathroom. It wasn’t an urgent feeling, more of constipation? I was sure this was it. I must be getting ready. I told Tony “I think I can see the light at the end of this tunnel.”

I was very wrong. The midwife checked me again. Not only had I not dilated further, but she noticed the baby was posterior. This was not only really disappointing but worried me as well. I knew that a baby could be delivered posterior, but it was very difficult and even more so for first time mothers. But I was going to prevail. I had spent money, time and emotional investment into having an unmedicated birth, and I was going to do all I could to do it. So we set out to change the position of this baby. I spent time in the Jacuzzi, alternating which sides I laid on. I spent a lot of time on hands and knees. My nurse, KC, tried one position, lying on my side, putting my leg in a stirrup. All the while, each contraction felt like a vice grip on my spine and back. I felt terrible and found it much more difficult now to breathe deep. Which each exhale I had to moan in a low rumble in order to keep me breathing. At 5:30pm, I was checked again as KC’s shift ended. I was only at 8. Why was this happening? Why wouldn’t the baby turn? It’s okay, I told myself, by tomorrow it will be over. But would it?

My next nurse was Crystal. She came in and encouraged me right away to get on the birth ball. She explained how we were trying to let gravity swing his back to the right position. As I sat on the ball, Tony sat across from me and I leaned forward into his arms. Crystal was at my back putting pressure on my pelvis and lower back. Each contraction felt like forever, but was so wonderful when each one ended. By this point I was tired. I’d been up basically since the previous day, with only minimal naps in between each contraction. Tony was tired too, but kept being there for me. I could not have done any of this without him. He was so supportive and did his very best to make me as comfortable as I could be. His reminders to breathe and relax are what made the contractions bearable and livable. While I was on the ball, my water broke. Then it got really painful. Without the extra cushion, the pressure to my pelvis was greater, and the contractions were coming more rapidly.

Around 8:00 or 9:00, I don’t remember when, I was feeling like this would never end and the only way to get him out was to cut him out of me. I was in a sort of trance or zone; in between contractions I was only half-awake and only half-aware of what was going. I remember saying a few times, “I just want this to end. I want to be done. I need to sleep. Etc.” I started contemplating drugs, and would make bargains with myself about a time limit or a pain limit or whatever. I was back on the bed with Tony sitting behind me and rubbing my back in between contractions. During this time I felt the definite urge to push. It would come fast and hard and I would resist as much as I could, but often would push and have to stop myself. Because I wasn't fully dilated they worried about damage to my cervix if I started pushing. The only thing that stopped me was Tony reminding me to relax my back and feet and shoulders and arms. It was a really wierd time - and though not completely aware of it then, I know now it was transition. I would get chills, I even had some hallucinations - weird designs in front of my eyes, and the weirdest of all was the Today Show announcer saying "Hoda Kotbe" over and over. I dreaded being checked. I had to lay back and with every poke and prod my uterus would vengefully tighten up and contract. And it never seemed to be good news. I was only checked three times during this time: once at 8 ½, once at 9 and then finally, one where I was almost completely dilated – there was only a slight lip on one side which Crystal massaged and smoothed out. I didn’t quite believe it when Crystal said, “ok, on this next contraction I want you to put your knees up and give me a push.” Up to that point I had to resist pushing in order to protect my cervix and the baby. I pushed and it felt as good as anything can feel after 22 hours of labor. I looked at the clock, it was 11:00pm. After so many hours of telling myself this little baby’s birthday was October 3rd, 2009, I was beginning to feel like it was a possibility. Crystal walked over to the phone and asked for Dr. Hogan for a delivery. I was so shocked, I looked at Tony and he looked at me with a grin and said “something is going on down there – it’s like a conveyer belt.” I didn’t quite understand, but I kept pushing on the contractions. The doctor was there after one or two more and was very excited to see me. He had stopped in before when he came on shift and apparently had worries that I would need a cesarean. He reassured me that I was doing well, Tony reminded me to breathe and I felt like I couldn’t push hard enough. I had no idea what was going on, only that I wanted this over as soon as possible. I asked to use the squat bar, but after a few minutes and contractions, my legs were tired and weak. I layed back down and used the bar to prop my feet up to help push. Tony looks down at me excited and says he can see the head. A mirror was brought from somewhere and I couldn’t believe what I was seeing. It was like watching a movie: there was no way this was me and that this was really happening. Also, it did not seem possible that I would be able to push that big head out of that small canal. But I kept trying because I knew that this was almost over and I wanted it to be over. A fetal monitor was being used at this time, and baby was being as strong and healthy as ever. He wanted out too.

The hardest part now was just waiting for contractions. I wanted to push constantly, but only with the help of contractions did it really make a difference. At one point I noticed that I was being very vocal – there were screams and shouts and random words. It didn’t even sound like me. During the stretching and burning they put olive oil on, trying to prevent tears. What was slightly discouraging, but only made me push harder, was seeing the baby’s head slightly recede whenever I would stop pushing. At one point I felt like yelling, “can’t you just grab him out already?!” But it eventually came, it was intense burning and I remember an immediate relief right after, the doctor told me to grab him. And with that I had my baby boy in my arms. He was crying and slimy and we both had plenty of blood on us, but I didn’t care. I had done it. The time was 11:54pm. It was the hardest but best thing I’ve ever done in my life. He was perfect.

After wiping him down and trying to calm him down and keep him warm, Dr. Hogan showed us the placenta and the cord. It was crazy that all that plus this baby was inside of me. I tore twice and had a few stitches, it wasn’t til later that I learned he hadn't completely turned and that his hand had been up by his face which mostly attributed to me tearing. I didn’t care. Already the memory of those painful hours were deteriorating. I was wide awake and didn’t think I could ever sleep. Tony cut the cord and the baby was eventually taken and weighed and measured and put into a diaper. He was 7lbs, 3.9 oz and was 19 ½ inches long. A tiny little guy. Then he was passed around, first to Daddy, then to grandma, then Bethany, then back to Mommy. Tony’s mom and Bethany went home. The doctor congratulated us and left. Crystal helped me clean up a bit and use the bathroom. House keeping came, changed the sheets, cleaned up the blood and gunk off the floors and took all the nasty linens and rags away. Tony gave Thomas Vibol his first bath. He was so alert, his eyes were open and he was moving around and looking around. Tony was in love, he sat there and whispered to him for half an hour.

Then there was the busy work of getting footprints and talking about breastfeeding, the menu for the next day, how much I should be bleeding, etc…

When all was calm, Tony fell asleep and so did Tommy Vibol. All I could do was look at this beautiful, healthy little boy in awe. What a marvelous blessing from Heavenly Father. I’m so grateful for eternal families, because I know that this boy is mine forever. Eventually I slept too, relaxed and content. What a wonderful day.



Epilogue:

Here I am, almost 2 years later, thinking I want to do this again! My husband and I have been trying for almost 6 months now with no results and seemingly no reason for it. This last month looked like a shining ray, I was 11 days late! But on day 12, I started. I still don't know what happened, none of the home pregnancy tests I used said positive, so I can either assume this was my body having a crazy month or an early miscarriage that ended before enough hcg registered on the tests. I can tell you, it really sucks trying to have a baby and failing. It makes me feel like dirt, like my body isn't good enough anymore for reproducing. BUT I can say that it has been a really thought provoking and self progressing experience. I have been learning everything I can about reproductive cycles, about pregnancies, and have read a LOT of other people's birthing stories (it's like a drug, just can't get enough). And what has this taught me? I LOVE everything BABY and BIRTH! This makes me happy. This is what I want to do for the rest of my life (not having babies per say). A friend suggested I be a Bradley Instructor and a doula. I was taken back, what? Me? that's silly. I'm a bookkeeper/office manager. But it made perfect sense. I've always known I needed to pick a career that would make me happy and bless my family. This felt like it. I talked to my husband about it. I was nervous because over the course of the last 4 years, I have "decided" on about 15 different careers ranging from music teacher to civil engineer. He was, however, very supportive. He understood how passionate I was about it, but he said this, "Amber, you are so smart, you should be a midwife." He didn't mean that doulas/bradley instructors aren't smart, but that if I wanted to do this, why not go all the way? Put that extra work in and be the pathway to help women and children have a better birth experience. So after a lot of prayer and study, I'm doing it! I'm going to be a midwife. This is just a journal, a collection of my thoughts/struggles/achievements on my Journey to Midwifery!