Wednesday, July 11, 2018

Attachment Knows No Biology

A small, 10x10 NICU room has been my 2nd home for nearly the past 3 weeks. This is my view from the vantage point of the rocker recliner, as I rock, feed, love on, and cuddle our foster baby.

Not pictured: lots of wires, a monitor that incessantly beeps, alarms that ding, an uncomfortable vinyl sofa, and a thermostat that doesn’t actually control the temperature in the room. ❄️ There are medications every 3 hours and feeding times that feel like they come so soon after the last one. I’m both bored and I’m busy at the same time.

I sat with one of the Neonatal Nurse Practitioners this morning and talked about what the plan will be for the next few days. I struggle with feeling as though I have no place to ask too many questions, make suggestions, or express my opinion and desires. This is nothing that anyone at the hospital has put on me- this is my own insecurity and fear of judgement. Like, “Who is she and what does she know?” But I know if this were my own child, I would feel differently.

I choked back the tears as we talked this morning.

They tell me he’s a different baby when I’m not there.

I was staying with him during the daytime but yet he was struggling with nights. Then I began staying the night with him, and now he has good nights but struggles during the day.
During the day, the nurses tend to his needs, cuddle him, love on him, and even take him for stroller rides. (They are seriously so amazing.)

But here’s the thing- out of all of the awesome care providers he has and the people in his life, there has been and is only one constant. That’s me.

I’m not his blood. I can’t honestly even say I love him like a mother loves her child (yet), but what I can say and do feel is that I’m committed to him. I love him for the human being that he is. From the moment I said, “Yes” to the phone call, I was committed. It’s how I do things- all in or not at all.

And that’s the thing about attachment. It’s not defined by or limited to biology.

When people say they could never be foster parents because they’d get too attached, I understand what they are trying to say. I do. They’re saying it would be hard. They are saying it would hurt. I believe it. I can see that now. But, that’s the point of fostering.

The most significant relationship in a child’s life is the attachment to their primary caregiver- biologically connected, or not. Attachment and connection are so vital to brain development, emotional regulation, and our ability to form and maintain relationships.

If you foster- or parent- or live- without attachment, you’re missing the whole point. We can have all of the basic necessities, but if we lack love and attachment as children, our ability to feel secure, to be able to express emotion, to adjust, and to form meaningful relationships, will suffer for the rest of our lives.

Even in 3 short weeks, we can look to this little guy and see the power of attachment.

I shared my thoughts this morning- It’s my belief this baby needs to be home. We need to be home. It’s time. Very soon the morphine will be stopped, and once it’s stopped, the clock will start a 72 hour countdown. That 72 hours will be a test to see how he does without the morphine and assure us that he can be at home. It’s not uncommon for a baby to need to be “rescued” by being given a “rescue dose” of morphine, when withdrawal symptoms get to be too much. The downfall is that if a rescue dose is given, the 72 hours starts all over.

The prayers we have been covered with are so appreciated! It’s my prayer that this will not be our view for much longer!

💙

Tuesday, April 24, 2018

What 'Postpartum' Should Look Like

Gadgets, Gear, Spanx, and Make-up.

We have a culture that is often focused on which Boppy pillow, DokATot, and latest baby gadget is the best, rather than focusing on what birth is really about- a new life entering the world, and the power of the woman who grew and birthed that life. Our postpartum time is often filled with visitors wanting to hold the sweet baby- not necessarily help in any way- and mothers often go back to everyday expectations of life much too soon after giving birth. So, what can we do to support a new mom in her postpartum days? And what "stuff" really matters?

The “work” of labor and delivery is truly LABOR- hard labor in all aspects- emotional, mental, and physical. It is arguably the equivalent of running a marathon...that you have not trained for...which you have no idea if it is a 5k or a full marathon. To labor and give birth is to use every muscle fiber in your body (which you will likely feel the day afterward!). I have had moms whose shoulders ache, whose thigh muscles throb as if they have been doing repetitive squats, and who have broken blood vessels in their eyes from the physical exertion that it took to birth their baby. For the mommas who have a cesarean section, there is other trauma and healing from having had major abdominal surgery- and even sometimes a birth that wasn't what was planned. This isn't to portray birth as scary...but to speak to the challenge that is birth and the power that is the female body.

After delivery, the body shifts from growing life inside, to continuing to sustain and grow that life outside of the body, with breastfeeding. The task of producing rich breastmilk is another feat! For all these reasons and more, the postpartum time for a new momma is an important one- for her body and mind!

If the female body can grow, birth, and sustain life, what are we doing after such an accomplishment, to nurture that body? In our culture, we don't always hold this time- the postpartum period- in reverence. We fail to see and treat it as a sacred time. Yes, a baby has just been born. But so has a mother!

So, with all of that said, here is a list of a few things every postpartum momma should have, some material comfort items, and some not.

A lovely postpartum stash


1) Depends/Disposable adult underwear
Yes, I know. It's not the coolest, sexiest, most attractive garment, but I promise you, it will be worth it. The first couple of days when bleeding is heavier, it is so nice to not have to worry about pad placement and ruining your underwear. Go to the bathroom ---> take off--->toss in trash--->replace. It's comfy, it's hassle free. Just.do.it.

2) Frozen witch hazel pads. They feel like heaven on your bottom and perineum after you have given birth, particularly if you have stitches for a vaginal/perineal tear. It's cold and soothing, and helps to reduce swelling. Take a heavy absorbency sanitary pad, and moderately fill it with witch hazel. Be careful not to drench it...it will become a solid ice block in the freezer. Curve it slightly upward (as the curve of the body when it's in the underwear) and place it in the freezer. You can stack several. you can also do this with cotton rounds. They are particularly useful to put right on the perineum or up against hemorrhoids. Add in Lavender for a healing perineum or c-section incision and Cypress for hemorrhoid pads and it will make all the difference!

3) Essential Oils. Yes, I love essential oils! There is truly an essential oil for everything- from supporting every body system, to supporting mindset and emotions. From helping with skin healing to promoting circulation, there is an oil to ease those postpartum discomforts and help you through!

4) Rest. I'm not talking about rest in the immediate hours after giving birth. I'm talking days. Weeks. I tell my moms for the first 3 days, stay in the comfort of your own space- your bed. Stay nearly naked (refer back to #1), skin-to-skin with your new baby. Rest. Nurse. Rest some more. Bond. Limit your visitors. You see? These things are interrelated. You're nearly naked, looking like a beautiful mess of a new mother, so why have company over? We also need to keep in mind that company also brings unwelcome company- germs.

What more important task do you have than to establish breastfeeding, provide nutrients and antibodies to your baby, and get to know this precious new person? You can do it all by resting and staying close to one another!

5) Nourishment. In the immediate days after birth and through the postpartum period, the body needs to be nourished and replenished. Hot teas, infusions, broths, and hearty soups are staples for this! We always make homemade bone broth from our leftover bones and freeze it for soups and stews later. It can be made from beef bones, or a turkey or chicken carcass. It's simple to make and nourishing to the body and mind. Best of all, you can do this ahead of time and freeze in large quantities. It's also easy enough that anyone- including Dad- can do it. Recipe at the end!

6) Time. I see it as a midwife and I've lived it as a mother. The postpartum period isn't held in high regard as it should be. We aren't afforded Time. Such a simple thing, but yet not something we typically give and get after having a baby.

I was once leaving a 24 hour postpartum home visit and said to the new mom, "Just in case you were considering it, please do not go to church on Sunday. Stay home. Rest." The momma (who is from Guatemala) looked at me as if  I was crazy! "Ah...no. I stay home," she said. "In my culture, we do not go anywhere for 30 days after having baby." I was in awe. This is not the norm. Perhaps it should be.

Ever heard of the 4th trimester? It refers to the time from birth to the end of a baby's third month. At birth, the brain of the human infant is still immature. Human babies are fragile and vulnerable, depending on the constant care of their mother. At birth, they have innate reflexes and abilities- breathing, sucking, swallowing, pooping. Yep, just the basics! As the end of the 4th trimester nears, they become increasingly more able little beings- regulating their body temperature, interacting more, nursing less often, and being more alert. Shouldn't this vulnerable, dependent time of the newborn tell us something important about the 4th trimester for the mother as well? I think so!

So forget about fancy gear, breastpumps, and various other gadgets and 'nice-to-haves' for now, and consider this simple, short list. Let us not forget about the 4th trimester for both mom and baby, and all the ways in which we can comfort, nurture, and support them both. <3


Here's that recipe for the nourishing bone broth!


Nourishing Bone Broth

One big pot of water
2 tablespoons vinegar (helps to draw the minerals out of the bones)
. Can be substituted with lemon juice.
3 carrots, peeled and coarsely chopped
3 celery stalks, coarsely chopped

1 large onion, coarsely chopped
1 bunch each of parsley and thyme
2 Bay leaves
About 8 peppercorns
Marrow Bones- we only use organic, hormone-free animal bones such as beef bones, whole turkey, or whole chicken. You can either use a whole chicken with the meat still intact, or use the remaining carcass, after you have already eaten the meat for a previous meal.

• If using a whole chicken, cut off the wings, remove the neck and cut both into pieces. Remove the gizzards from the cavity. Like mentioned above, an already eaten off of chicken or turkey carcass is fine. Throw it in!
• Place marrow bones or chicken and pieces in a pot with water, vinegar, and all vegetables and herbs.
• Bring slowly to a boil, and remove the scum that rises to the top.
• Reduce heat, cover and low simmer for 6 to 8 hours.
• Salt and pepper to taste, or wait until consumption
• Strain the stock into another large pot. Remove the bones and any meat pieces with a slotted spoon. You can save the loose meat to be used for chicken/turkey noodle soup, etc.
• Cool in an ice bath (or, as we do during the wintertime here in Alaska, stick it in the snow outside), and refrigerate until the fat rises to the top and congeals. Skim off the layer of fat. Refrigerate up to 3-4 days or freeze for future use.

<3

Wednesday, March 14, 2018

Birthday Birth

Last night was a first for me in 12 years of being in birth work- I got to assist a family in welcoming their baby on my birthday. ❤️

I sat quietly beside the tub, with our student midwife by my side, knowing that we would soon be meeting a baby. The only light in the room was from the glowing chandelier overhead, the only sound was the breathing of the laboring woman and the quiet garble of her own mother and grandmother whispering in excitement in the background. Dad sat in nervous silence, in witness to it all. 

No blinding overhead lights. No dings, bells, alarms. No repeat questions or pushed agendas. 

“I feel like I have to push!” Slight panic and a hint of doubt in her voice. “What do I do? What should I do??” 

Simple reassurance: “Listen to your body. If your body is pushing, then push.” 

Such a basic concept, but something birth has gotten so far from. 

How did we get here and why? 

She takes that thought and eases more into the water with it. She bears down with guttural pressure, and then starts to creep up in the water, her butt beginning to rise to the surface. 

“Keep your butt in the water.” My voice is soft and gentle, but there’s no if in what I’m saying. 

She doesn’t open her eyes but her body relaxes a little.

“Ease into the water and push into your pain. You’re almost done!”

A few pushes and the baby begins to crown, head slowly emerges. Megan reaches in to get ready to help this mom bring her baby up. 

A snap back from primal incoherence to once again cognizant- she asks, “Will the baby drown?!” 

Her baby’s head is in between her legs, submerged under water. 

Simple reassurance: “Your baby is being born from water, to water.” 

Megan reminds her of the purpose of the umbilical cord- giving oxygen-rich blood to the baby throughout birth. 

I sit overseeing, sitting on my hands to not interfere or disturb unless I’m needed. The baby is born and Megan slowly brings the baby up. He goes straight to his mother’s arms, onto her chest. 


Silence. That’s what we hear. 

The baby doesn’t cry, yet the family rejoices. 

Why? 

The baby has no clue he’s been born. His heart is excitedly beating. He’s breathing quietly. His lungs are clearing. He starts to open his eyes and looks at his momma. And yet he’s silent. 

A birth so gentle that the baby doesn’t even recognize that he is outside of his momma’s womb. Looking around, in awe of the world. 

Stop. It’s a science and an art. Imagine what would happen if you just stopped. And observed. And thought. 

We don’t wipe him off. 
We don’t routinely stimulate him. There’s no need. 
He’s kept warm by the warm water and his mother’s body. 
We don’t routinely suction him. There’s no need. 

That’s the beauty of midwifery. We are there, but not. There to support, there to safeguard, there to witness, there to intervene when it’s warranted and needed. 

The day before, another patient of ours had to deliver at the local hospital. She was abused, belittled, and threatened by the doctor. An episiotomy was pushed on her and she was told she was going to kill her baby for informly declining certain interventions. The stories aren’t mine to tell, but I will say this- we hear it time and time again, over and over and over. And yet, we are the crazy ones? 

I think to myself of this stark contrast, two different worlds that shouldn’t be so different.

How did we get here and why? 

How do we bring birth back to where it belongs and what it is suppose to be? 


One woman, one baby, and one birth at a time, just like this Birthday Birth.