What a cochlear implant is NOT, what it IS, WHY we chose to implant our daughter, and our expectations for Heidi

As mentioned previously, our youngest daughter, Heidi, was born deaf. She is almost 15 months old, and received bilateral cochlear implants last week. I first heard of cochlear implants (CI's) a few years ago, but really didn't understand what they were, how they were used, or what they can or cannot accomplish until recently. And even now, I only have a rudimentary knowledge as to the range of outcomes for CI's and some of the pros and cons. We're still novices at this!

But given how little I used to know about CI's and given that I receive many many questions from friends and family that reflect a similar basic gap in understanding, I thought I'd write out some info that can hopefully clear up many of the questions people have regarding Heidi. I don't mind questions and always appreciate people caring enough about Heidi's journey to ask questions. . . even if they are very basic questions or questions based on a misunderstanding. That's okay! And for my friends-and-also-professionals who read this, feel free to make any corrections on my explanations :-D.

First of all, what a cochlear implant is NOT. This honestly is a really important thing to understand. CI's are absolutely NOT a cure for deafness. When I first heard of cochlear implant surgery (we had a deaf neighbor when we lived in Texas, who had CI surgery around age 6) it was explained to me as a way to correct deafness and let someone hear. Um, no. No, no, no. This is not like repairing a torn ligament or even like something such as corrective eye surgery. Cochlear implant surgery does not fix deafness. And I'm not mincing words here, or trying to hold onto a label of "deafness" that I somehow don't want to let go.

So what IS a cochlear implant? Basically, CI surgery implants a device into a person's cochlea (in the inner ear) that allows the auditory nerve to be stimulated through electronic means, to bypass the usual sound pathway of ear canal, eardrum, middle ear bones, etc. For whatever reason, one of the main causes of deafness (by no means the only cause) is a malfunction or absence of the microscopic hair cells in the cochlea. These hair cells are extremely crucial to hearing and the stimulation of them through the usual means are exactly HOW a person hears. Without these hair cells (or other many possible reasons why hearing is absent), sometimes a CI can be used to stimulate the cochlea in a mimicry way.

What was actually inserted into Heidi's head last week was two sets (one for each side) of electrode arrays that were slid into her cochleas and naturally coil up into the snail shell shape of a cochlea. Different pitches of sound in normal hearing stimulate different areas of this snail shell shape (and transmit this info to the auditory nerve, and in turn, the brain). In a similar way, with the technology of a CI, sound transmitted through an external microphone and processor then sends a signal to trigger electrodes along the inserted electrode array, which in turn stimulate the area of the cochlea corresponding to that sound.

In theory. Actually, it doesn't work out so perfectly for all cochlear implant recipients. The sounds perceived by a CI recipient APPROXIMATE actual sounds, but can be "off" in pitch by quite a bit, which matters some in learning to listen and/or speak, but much more in learning to listen to music, as pitch is more important in musical settings. A CI recipient goes through gradual therapy over several months, that introduces the brain to more and more of a range of sounds, as the brain accustoms to sound and perception of sound. And even after initial auditory-verbal therapy, most CI recipients will need additional speech therapy to groom their speech.

Some CI recipients never develop enough sound discrimination to develop speech, while others are indistinguishable in speech from a "hearing" person. Some CI candidates are very accustomed to sound and speech, and prefer using sound v. choosing silence and signing. Other CI candidates find their strength in sign language, visual perception and expression, and other non-auditory methods of exploring, communicating with, and viewing the world, and either benefit from a CI in more general ways (awareness of environmental noises, but not speech) or don't benefit from CI's at all. More on the varied "success" of CI's later. . .

But back to what a CI is not. Remember that I said CI surgery is not a cure for deafness? One of the very real reasons it is not is because a CI does absolutely nothing unless the outer processor is attached (with working batteries). If the outer processor is not being worn, no electrodes are stimulating the cochlea, the auditory nerve is not being stimulated, and no hearing is taking place. In other words, the person is still deaf. Cochlear implants are battery operated devices that can be turned on and off at will.

Post-surgery, one of the most common questions I've gotten is if we've noticed Heidi responding to sound yet. We haven't yet, for the very simple reason that she hasn't even been given her outer processors yet. In order to not associate the new experience of sound with potential pain, the surgery site has to fully heal before she's given her initial sound stimulation in a few weeks. In addition to the electrode array, also implanted directly under her skin is a magnet that will be used to attach her external processor in place when she's using her CI's to access sound.

Even when she's "turned on" at the end of March, her processors are programmed very low, to only stimulate a select range of sounds. As the months progress, the idea is to slowly program her to receive more and more sound input, as she becomes accustomed to sound and as her brain learns to process sound. Remember, as far as we can tell, she has probably never heard anything, so this is all new stuff for her brain! I've met one mom with a deaf daughter who was implanted about a decade ago, and the mom told me that her daughter didn't even respond to sound at the initial stimulation, because the program was turned so low initially. So it'll be interesting to see if Heidi even visibly "notices" her initial program, or if that'll wait until future programs that add more to the spectrum.

Okay, so here's the million dollar question and the most controversial: why did we choose to implant Heidi? For many people we have met, the assumption was that OF COURSE we'd implant her, because why wouldn't we want to use this amazing technology, and for other people we've met, they've been very leery of the use of cochlear implants and counseled us against or counseled us to wait and let Heidi decide. Why or why not?

Well, I'll start off with saying I totally "get" why someone would choose either path. We wrestled with a lot of pros and cons, and while we felt confident in the end with wanting to explore cochlear implants for Heidi and implant her early, we also understand the concerns with CI's and why others might choose other paths. Here is what it boiled down to for us:

On the con side, it really really gave us pause to consider allowing our child to go "under the knife" for a non-life-threatening reason. We didn't take this lightly. We know every surgical procedure has risks, and drilling into the skull (to be quite frank) certainly has some. So does having a permanently-implanted device in your body. We're okay with Heidi just the way she is. She doesn't NEED hearing, she can have a full life without it, and we believe that she could be just as content in her deafness as we are with it. Not just "okay" with deafness, but thrive with deafness.

Hearing loss is just that: a loss of hearing. Heidi's brain is fully functioning, she is in excellent health, and is poised to take on life to the fullest. As long as we pack language into her, she's fine. And we truly believe that. This is exactly why we've poured so much of our time and energy into sign language this past year, and why we will continue to make sign language part of our family culture and part of our means of communicating with Heidi.

The two major objections to CI's, especially to those in the Deaf community, as far as I can tell, revolve around concern with (1) neglect of sign language in order to focus on listening and speech and (2) perception of deafness as a "disability" that needs to be fixed.

As I already said, we don't plan to neglect sign language, as we simply don't know what Heidi's success with a cochlear implant will be. If a child is not given a full language by age 5, this language deprivation can have permanent repercussions on their mental and cognitive function, even if they're given language later. Because we don't know NOW if Heidi will have full access to language through a cochlear implant EVENTUALLY, we don't want to wait and wait and then find out after she's already language-deprived that she needed sign language and that we should have been learning it sooner.

To address the more controversial topic of deafness as a disability, one must understand that a culturally Deaf person not only is fine with their Deafness, but is happy they're Deaf and offended by terms such as "hearing disabled." This is why I use the term deaf to describe Heidi, because it simply isn't an offensive term. It's a perfectly acceptable label. A person who is culturally Deaf doesn't need or want pity, and is quite happy in a soundless world. For hearing parents to have the chutzpah to "fix" their deaf child without consulting the child is potentially offensive to many who consider themselves "capital D" culturally Deaf.

From the beginning of our journey with Heidi's deafness, I've sought to be very sensitive to the Deaf community, Deaf beliefs, and a Deaf perspective on what Heidi needs, listening to the voices of the Deaf community as well as medical professionals. I think both worlds have much to offer us, as hearing parents of a deaf child. I absolutely will not tolerate comments to this post that mock the Deaf community or Deaf beliefs. Period. I find their language beautiful and their love of who they are AS they are (rather than a discontent in who they are not) to be inspiring and comforting.

But that being said, yes, I consider hearing to be the normal way that God created man to communicate, and we believe God's promise in the Bible that He came to make the deaf man hear and the lame man leap for joy. Deafness is not a blessing to us (except in so much that we believe that God redeems everything for Himself and brings good for His people out of all circumstances), it is not something we sought, it is not something we would pray for in another child. But we would welcome another child who is deaf! And we wouldn't choose to prevent more biological children if we discovered Heidi's deafness is genetic. Our deaf child is a blessing! However we also do not have an objection to adding sound to our deaf child's world, if we think it could give her advantages.

And to address a side issue, why did we choose to implant Heidi NOW, v. waiting until she's older and letting her choose that herself? The biggest recommendation I've heard from the Deaf community is not to NEVER implant Heidi, but instead to wait until she's a bit older (anywhere from elementary age or older) and let HER decide if she wants to experience sound. This is her world, her body, and her experience. Let her decide.

And we considered that. But ultimately it boiled down to, for us, a realization that either way - whether we chose to implant her now or waited and let her decide - we already were deciding a major decision for her. We had to choose whether or not to give her that chance for sound access during her most crucial period of language development. She doesn't NEED that sound access, to be clear, but we did have to make the choice either way, to give it or to decline the option.

Getting a cochlear implant at age 7 or age 10 or adulthood - especially for someone like Heidi who is prelingually deaf - is simply NOT the same experience as for someone who is a baby or toddler. There are crucial developmental windows for developing speech that would be missed. Yes, a CI recipient who receives one later can often still get some use out of a CI, but not in the same way that an earlier recipient would. The longer the human brain does not have access to sound, the more the brain rewires itself (how cool is that?) and is "taken over" by the other senses, to compensate. If we waited until Heidi was older and let her decide, she would not have the option to go back and recapture that crucial developmental window for speech and language.

We do NOT believe that a family who doesn't choose early implantation is "depriving" their deaf child of sound or speech. Absolutely not. They are simply choosing a different emphasis and a different option for their child. But we also do not believe that by choosing implantation for Heidi, we are "depriving" her of her deafness. Our intentions, rather, are to give her the fullest opportunity to experience both the hearing and deaf worlds. In order to truly experience the closest that she can to the hearing world, she can best do that by early access to sound stimulation. Should she choose at an older age to "turn off" sound, she can simply stop wearing her outer processor. We would totally support that decision at an appropriate age. Yet another reason to have a sign language base of communication!

We live in a hearing world, and we live in an English-speaking world. And like most deaf children, Heidi was born into a hearing family. If possible, and according to Heidi's abilities, we feel that it will benefit Heidi over time to have tools that allow her to access both the hearing/spoken aspect of our family culture and especially (since the outside world cannot adapt in the same way our family can) to access spoken language and sound in the outside world.

Having access to sound, even electronic stimulated sound - and potentially having access to speech -might allow Heidi to be a much more independent communicator than if her main method of communication was sign language. This in no way is disparaging the use of sign language, either as A means of communication or the ONLY means of communication for her. This is simply recognizing that while living, communicating, and working in modern-day America, not having need of a sign language interpreter to go about daily business can be a huge asset to a deaf individual.

If Heidi was born into a fluently-signing deaf family, this would be completely different. Her language access would be complete and accessible from day one, and her family culture and her built-in close community of friends would already have her language and her culture. (Talking through walls and talking while doing eye-intensive tasks is a major part of our family habits! That's been really difficult to slowly adapt! We are a "hearing culture" family, for sure!)

But Heidi wasn't born into a fluent signing family. And her family, while trying to learn sign, will not be fluent anytime soon! If we choose a signing-only environment for Heidi, realistically she will have limited communication with most of our acquaintances, friends, and family. Yes, we plan to seek out deaf friends in the Deaf community, but we also have a very large foot in the hearing world. We and she don't NEED her to be part of our hearing world, but we'd like her to have as many ways as possible to feel that she belongs in our family and our world in every way. This means developing sign language so that we can communicate with her effectively, but it also means considering ways that we can include her in our inevitable hearing activities, as her ability allows.

There are SO many factors that affect the "success" of a CI, including if a person is deafened pre- or post-lingually, if they have multiple-challenges rather than "just deafness," if they receive adequate follow-up therapy, if they get appropriate language input, if their auditory nerve is fully-functioning, etc. And honestly, there are just a lot of mysteries and questions in medical research as to how to best predict the success of a cochlear implant, for the purpose of accessing sound and developing speech. It might work, it might not.

Our general expectation for Heidi is that she will soar. In her time, in her way. We expect LANGUAGE for her, not because language is automatic, but because it is so essential. We don't know what else to expect, and we're not sure what form that language will take - spoken, signed, written. . . some combination?

Honestly, this is really new ground for us. With our other 3 kids, they became extremely fluent talkers at a young age with ginormous vocabularies simply because their mother never shuts up, tele-commentates EVERYTHING to her babies, and because they were blessed with no communication barriers. With Heidi, language will take a lot more purposeful input than just her mother constantly talking. Factors like background noise, effectiveness of her CI's, therapy, how quickly her family learns sign language and how faithfully they sign with her and around her (it has to be in her field of vision!). . . so much more at play and so much more one-on-one attention needed!

We honestly don't know what to expect as far as what communication mode will work best for her, both short-term and long-term. We've been told by well-meaning people that she will definitely prefer sign language over sound and speech, and that might be what happens. We're okay with that! We've also been told by equally-well-meaning people that she will likely prefer sound and speech, because for most children implanted at her age, it comes easier for them than sign language. That might be true. We're okay with that!

We do not expect that she will be a fluent English speaker, though we are poised for that possibility and it is in the realm of realistic results. We also do not expect she will choose sign language as her primary means of communication, but we are okay if she does, and are working towards greater sign language fluency. We expect God's grace in the craziness and His direction each step of the way. We expect we'll make a lot of mistakes, learn a lot, pray a lot. We expect our whole family will continue to learn a lot and grow a lot through this whole process. And our prayer is that Heidi will thrive and learn to effectively communicate with us, with others, and with her Creator. That's quite enough for us. Anything else is icing on the cake.

Heidi Annaliese's Birth

Short G-rated version:

Our fourth-born child and second daughter, Heidi Annaliese, was born on December 30th at 12:16am weighing 8 lbs even. We are grateful to God for a swift and uncomplicated labor and birth, and a healthy baby and mommy.

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The longer version, for the dedicated among you who can outlast my ramblings:

My due date for this baby came and went. I was due Christmas Eve, though this was a "best guess" by an early ultrasound, as I could not remember my LMP for the life of me. Finalizing repairs on our house in Texas, a whirlwind of house showings, and a gradual return of health from our mold exposure can do that to a person ;-). Keeping track of dates was just not super-important to me ;-). I was vaguely aware of when I was pretty sure I'd ovulated and remember thinking "I should probably record my estimated ovulation, just in case I need it," but I never acted on that. The Christmas Eve due date did line up perfectly with my first positive test (and my negative test a few days earlier), so I'd say it was a reasonably accurate date.

I had really hoped to have this baby by Christmas, for no good reason except it fit my timeline. ;-) Up to that point, the baby had been in perfect LOA position for a few weeks, very low in the pelvis, and I felt pretty well physically, and aligned and ready for labor. My chiropractor had really helped with my tailbone alignment and core strength exercises the previous few months, and I'd had zero pubic bone pain or tenderness for the first pregnancy in my experience. Usually I spend the last month of pregnancy in pain when walking, because of the tenderness of the pressure of the baby on the pubic bone - even in Martin's pregnancy that overall had so much less chiropractic discomfort. So I was really feeling optimistic about my alignment and baby's chance of exiting without a huge deal.

Then I fell on our basement stairs and whacked my tailbone on Sunday, 5 days before Christmas, which set me back some in physical preparation for labor. My midwife's main concern (since the baby seemed fine and still plenty active, and I hadn't fallen on my front side) at this point was that my tailbone get a chance to heal some before going into labor, as laboring with an injured tailbone could be excruciatingly painful, particularly the pushing phase. So I went from poised-and-eager-to-go-into-labor to kind of in limbo, while waiting and wanting to have this baby, but really wanting to let my tailbone recover in the meantime.

In the 3 days after falling, I visited the chiropractor every day, which really helped. The baby had shifted its head sideways a bit after the fall and the head was no longer firmly engaged in the pelvis, but by Wednesday the 23rd, my tailbone and the rest of my skeletal system was holding alignment well, my tailbone tenderness was almost non-existent, and the baby's head was back in a nice location and sloped correctly. *phew* So we were back to the waiting game and thankful that I'd had the time I needed to get my rear back in gear, quite literally.

I was starting to get pretty discouraged a few days after Christmas, though, watching Adrian's school vacation tick slowly by and knowing when my dad and sister and brother-in-law were slated to leave (my mom had bought a one-way ticket and was able to be more flexible), and wondering if we'd spend all of Christmas break waiting and waiting. . . and I kept hoping I wouldn't have another super-late arrival like Martin.

I woke up Tuesday the 29th feeling like all the hypothetical ills of pregnancy, both physical and emotional, had descended on me. I knew this wasn't true, but it was really hard to fight off the discouragement and the intense grogginess (even after a good night's sleep) that about bowled me over and persisted throughout the day. I kept repeating to myself everything I KNEW, which is so much more true than what I FELT. I reminded myself how blessed I have been this pregnancy physically, how normal and totally within range it was to only be 5 days "late," etc., but I felt like I was fighting off demons of doubt all day. I hated it! I'd been hot-natured a lot the last month in pregnancy, but I was getting flushed and hot especially easily that day, and my fingers also were suddenly barely swollen enough to make my rings hard to get on and off. I was dragging physically and my brain was fogged, I kept messing up my words when talking. I was kind of a wreck.

It was so weird and sudden, and I had just been re-reading Baby Catcher, in which the author had the same thing happen with her pregnancies, where she would sail along just fine, loving being pregnant, and then BAM, the day before she went into labor, something happened and she felt physically and emotionally horrible, as if the weight of the world was on her, and then she woke up the next morning in labor. Anyway, I struggled through Tuesday, doing a lot of resting, and finally felt much more normal after a long late nap that afternoon.

I was feeling a lot more like myself at dinner and enjoyed playing Apples to Apples for a while after the kids went to bed. We started playing around 8pm and I had light contractions all through the game. I wasn't timing them and they weren't intense, but they were pretty often and definitely a bit more "real" feeling than all the painless Braxton-Hix contractions I'd had for weeks and weeks. But still extremely light cramping, nothing major.

After finishing our game we sat around and discussed other ideas for the evening, and we settled on watching a Poirot episode. We didn't start watching until about quarter of ten, which is rather late for me, but I said that I'd had a long good nap and knew I'd be wakeful for a while longer even if I tried to sleep, and "besides, I've been having a lot of light contractions the last couple of hours, so I'm wondering if I'm in labor."

That got everyone's attention! Adrian asked what he could do to help, and I told him the best thing he could do was leave me alone. Ha! This is so classically me in labor :-). I'm not mean or rude, but just don't want attention and certainly don't want the stroking and coaching and massaging, etc. I don't even want hand-holding or touching - from anyone. Which is why I've never invited friends or family  (except Adrian, of course!) to my births or had a doula. I want Adrian there, but he knows his main job is just to BE there, or help by getting me a drink or something. And everyone else (midwives, etc.) is there for strictly safety and other physical support reasons.

So we all sat down and got about an hour into a Poirot episode (Death on the Nile - great, calming birth episode, hehe). At some point past 10pm, I let Adrian "do something," meaning, I let him time several contractions, and then he called my midwife Kathy to let her know I was probably in labor. I was having to start concentrating some during contractions (though still wasn't noticeably acting differently and just sitting there calmly watching the movie) and they were about 5 minutes apart or so, and over a minute long. Kathy said they'd start heading our way.

One thing that was very different about how I mentally processed contractions with both this labor and with Martin's (v. Hans and Gretchen's labors) was in visualizing my cervix opening. With Hans and Gretchen, I tried (semi-successfully) to relax during each contraction, but I still had a mindset of that intense cramping being a somehow foreign thing happening to my body. (This was especially true with Hans' labor.) I really tried to recalibrate myself during Martin's pregnancy to think of the contractions as serving a very useful purpose. Not just a random collection of birth pangs that eventually ended in complete dilation, but as individual steps that were actively opening my cervix little by little. With each contraction I visually pictured the baby's head bearing down and slowly opening my cervix, and it really helped me to see each contraction as a means to an end and as a positive thing (although discomfortable and eventually painful, as labor progressed), not just something to endure.

Claire, one of the assistants, arrived maybe 30-45 minutes after Adrian called Kathy, and started getting stuff set up and getting out birth supplies - which was reassuring, as things were starting to pick up and I liked having someone on the premises who could catch a baby, if necessary. I'd offered that job to my brother-in-law, but he wasn't eager, go figure ;-). And actually, with about 30 minutes to go in the Poirot episode, with me getting up more frequently to head to the bathroom or such, Hannah and Justin just turned off the episode (we finished it the next day) and headed down to bed, without even asking us! The nerve ;-).

My parents and the kids were already settled down in the basement to sleep too, so we had the main floor to ourselves. We had vacated Martin's room, which is next to ours and has very little furniture in it, and moved the birth pool (which had been inflated but upright in our room for a few weeks) in there. I was still mainly in our bedroom for contractions, leaning a lot on the birth ball while kneeling, sometimes standing or swaying, and I was having to breathe deeply through each contraction now.

Our midwives, Kathy and Brandi, arrived before too much longer, maybe about 11:30? Not sure. And Adrian filled up the birth pool, but we quickly discovered that even our very HOT hot water heater (which we had turned on very high for the last few weeks to be ready, and had been burning our hands with for this purpose :-P) was just not enough to fill up our pool, so we ended up with a half-filled pool with tepid water at best. Kathy and Adrian started boiling water in our large stockpots to supplement, as my contractions got more intense and closer together.

I got in the water just a bit (to my waist) to get a feel for the temp, but quickly decided that I couldn't possibly relax through contractions in there, and Kathy had just checked me when she arrived, and I was at 8cm, and I didn't want to be in cold water when it came time to push. (With Martin, I went from 7cm to complete in a few minutes, and this birth was feeling like de ja vu in how it was progressing.) So I got out and moved to the bed, using the birth ball to kneel for a few more contractions. At this point they were really intense, I was having to vocalize/moan pretty loudly through them, and then I could feel the baby's head start to descend. Yep, I was definitely going to be having another land birth, not a water birth ;-).

Honestly, I still haven't figured out the best way for me to push in labor when on land. I delivered Hans in a big jacuzzi, and I didn't even have to think about positioning, which was the advantage of being buoyed up by the water. With Gretchen, I moved to the pool at 10cm, and although her birth pool dimensions and height weren't ideal and made for some positioning challenges, it was still easier than pushing out of the water. And for Martin's birth, he came so fast that I had the odd experience of not pushing at all. My body did all the work and he was out in a few pushes, and my job was basically to not add to the already-quick delivery. So I didn't know what to expect this time around.

This labor was definitely a bit different than previous ones, in that I could definitely tell that with the contractions, they stayed more productive and intense (even in transition) while I was upright, whereas with Martin's, for example, I labored on my side for most of the (short) labor, and birthed on my back, because there was no time to think about positioning and he just flew out before I could get up and get to the birth pool. I know some women like delivering in a side-lying position, but I quickly discovered with Heidi's birth that my legs were completely clamped together in that position when a contraction hit, and it would have taken a vise to get them apart during a contraction in that position. At least on my back, I had gravity to help open my pelvis, even if from many perspectives, back-delivery isn't ideal.

So when it became evident that this baby was coming NOW and the pool was not happening, I quickly settled into a back-lying position, for no other reason than the thought of increasing the intensity of pushing by squatting was NOT attractive. I did fine, though, but much like my contractions being stronger while upright, being on my back just wasn't producing very productive pushes. The baby wasn't stuck and was gradually descending, but it just wasn't as fast as it could be. After a few pushes Kathy said the baby would come either way, no worries, but it would be quicker and easier overall for me if we could just get me tilted up a bit. After my previous experience of not having to push with Martin, I had to re-calibrate the expectation that yes, I'd have to put forth some effort to push this baby out ;-).

I said I couldn't lean myself forward to be propped up so Adrian and Claire (I think?) leaned me forward and shoved some pillows behind me. It's amazing what just a little extra angle can do, and the next few pushes were definitely more efficacious, but Kathy suggested that it would be even better if I could grab my knees and lean forward, which I did. The baby's head quickly crowned after a few pushes and at that point the sensation was so intense that I couldn't hold onto my knees and asked the others to keep them in place (the only time I asked anyone to touch me the whole labor, I think!), which definitely helped. There is nothing quite like the relief of feeling a baby's head slip out, followed by the body!

Heidi immediately started wailing on exit, so we knew she had a good set of lungs! She was born at 12:16 am, and my parents and sister and brother-in-law could hear her healthy cries from the basement. They came up after a bit and waited in the living room to hear more news. We hadn't found out the gender beforehand, but as soon as she was lifted to rest on my abdomen, I could tell she was a girl. When she was weighed later, after placenta delivery and nursing and such, she was 8lbs even, which kind of cracked me up since she had measured so low in fundal height the last 6 weeks of pregnancy, for some unknown reason. Apparently she was just really low and really curled up or something! Martin was my next biggest baby at 7lbs 8oz.

The cord was a bit short, so I had to wait for the delivery of the placenta to latch her on, but then she nursed eagerly while we both got examined. I had a few minor skid marks, but didn't need stitching. I basically have had minor tears in the exact same place with all 4 deliveries. I've been stitched the other 3 times, but this time my midwife suggested letting it heal on its own and lessening the scarring as a result. So it was kind of nice not to have to pause for stitching up, and I've had very little tenderness and no swelling this time around.

For the first delivery in my experience, my midwives were also able to offer some easing and support with pushing. That's not as possible in a water birth (but the water can help with that), and Martin flew out too quickly, but this time as I started to push and as the baby's head crowned, our midwife Brandi gently stretched my perineum and massaged it with some arnica oil, which definitely was not a pleasant sensation, but I could definitely tell it helped, along with the hot compresses they used.

We are so grateful to God for an easy birth, and once again, I really enjoyed being able to stay at home and not worry about birthing in a car or anything. It's nice to settle into your own bed to rest after the birth. I've also birthed in a birth center (for Hans) and a hospital (for Gretchen), and they weren't horrid experiences and great options to have. I think a woman should pick a birth option with providers that are skilled and respectful of them, but that doesn't have to exclude non-homebirth options :-). But it's also nice that so many non-American nations ;-) recognize the safety and even benefits of homebirth for low-risk women. I'm grateful for the option for myself!

And for handy reference, my other birth stories:

Hans Friedrich

Gretchen Liesl

Martin Wilhelm

My Favorite Things (Baby Edition)

Prepping for Baby #4, and it's so fun to pull out baby items and clothes and remember using them with our previous kids, and anticipating using them again with this new little one :-). It reminds me of some of the things I've loved using the most over the years. And it reminds me of some of the things I used to love, but don't find as essential anymore. Or things I didn't used to own, that I'm glad I do now! My preferences change a bit with each baby.

I find it fun to find out what other moms use the most, what they don't use at all, and which things they consider optional. The point in this post is NOT to draw a line in the sand, act like someone is crazy for purchasing "unnecessary items," or is a bad mom if they use x, y, or z, or if they DON'T own and use t, u, or v. Good grief, we can be more mature, I think. This is purely for informational and interest purposes. No name calling, no "camps" that we need to place ourselves into, k? I just find the subject interesting :-).

So anyway, here are a few lists that I made, and I'm curious what you would put in each list. Feel free to share in comments.


My "If I Was Re-Acquiring All My Baby Stuff, This Is What I'd Get Again" List

• onesies, 2 dozen in the newborn size and 1 dozen in bigger sizes. All other clothes are optional, seriously. Fun, but optional. 
• burp rags, 1-2 dozen. Two of my babies did a lot of spitting up. 
• drool bibs, 2+ dozen. Because one of my babies was prolific in drooling, and one could go through up to a dozen bibs in a few hours from her spit-up. 
• a baby bath tub or baby bath holder. Because, yes, I can use the sink or larger tub, but babies are slippery and I don't have a good grip ;-D. Also 1-2 small baby towels, because newborns become engulfed in a full-size towel!  
• a carrier like an Ergo. We use ours many hours daily from about 5 months onward. LOVE. This is my #1 essential after onesies and diapers, seriously. 
• a newborn wrap, for the pre-Ergo stage. (Not a huge fan of the Ergo infant insert.) We own a Boba Wrap. 
• a stroller. We currently own a Sit 'n Stand. I prefer to hold/wear my babies, but it's also nice to have a stroller option, especially as they get older. 
• a baby bed. We co-sleep for the most part, but find that something like a co-sleeper or pack 'n play is still really nice to have, and gets used as well - currently we plan to use a pack 'n play for a back-up option with this baby. 
• a baby holder like a bouncer. I don't use it much, but it's nice to have one on hand :-). 
• cloth diapers. It's kind of an obsession; I like a mix of prefolds with covers, fitteds with covers, and a few pocket diapers for outings. Most of my stash is homemade, so I don't have particular brand recommendations, though I've tried a few "store-bought" types. 
• disposable diapers. Because I'm just not hard-core enough to care if I use some newborn diapers to help ease the transition with a new baby, for those nasty meconium poops, or when my baby gets a yeast rash, and also sometimes for outings. And for vacations. 
• large waterproof pads that work for diaper changes, crib liners, bed pads, and all manner of things. I have about 10 hospital-grade ones that a nursing home was getting rid of as they switched brands. These are in great condition after constant use by us for over 5 years! 
• a few warm blankets, and also a few thin woven cotton blankets for swaddling 
• nasal aspirator. Invaluable for one of my kids who cried a lot as a baby and was constantly stuffing up his nose! I get a new one with each baby, use for a few months and then TOSS. They do not get saved indefinitely. ICK. And people think the Nose Frida is unhygienic - ha! 
• a decent thermometer. I let low-grade fevers run their course, and my favorite thermometer is a kiss on the forehead, but it's really nice to know an exact temp sometimes, to gauge if intervention is needed! 
• a diaper cream. Because although I've found most rashes are prevented with frequent changes, sometimes it happens. I mainly use Butt Paste because it seriously works and it's easy to find and is relatively cheap. Sometimes I make my own salve with herbs. 
• basic mild baby soap. We use Dr. Bronner's Baby Mild for both body wash and shampoo. 
• nursing pads. I leak a lot the first 6 months or so. I have about 1 dozen pairs, most of which I made, A layer of waterproof fabric, a layer or two of absorbent, and a layer of suede or micro-fleece. 
• a carseat. We're using a convertible this time. But as long as it's rear-facing, properly installed, and your baby is over the minimum weight and under the maximum height, there are lots of safe options :-). 
• chocolate, always chocolate. And other food. Because I laugh when people say Mommy's Milk is "free." They've never seen the increase in my grocery budget because my metabolism doubles while nursing! 

My "I Really Like Having This, But Wouldn't Prioritize a Re-Purchase if I Had Limited Resources" List

• Baby Legs. I admit this was something I thought was SO silly with my first baby. But they've grown on me and I really love how easy they are to warm legs but not have to take off for diaper changes. I especially love them for little baby girls, but even used them for my younger boy. (They are WAY over-priced, though, and I'd never pay full price. They're actually easy to make from adult knee socks!) 
• A few headbands for a baby girl. Totally unnecessary, but adorable. 
• Aden + Anais blankets. The feel of these is just superior, they are breathable, lightweight, large, and great for so many things, from swaddling to a quick nursing cover. 
• Nose Frida. It's nice to have an alternative option to the bulb, but I wouldn't rate it up with super-important. 
• a few extra babywearing options. We currently own a mei tai and a woven ring sling, and both get some use, but not as much as our other options. 

My "I Can't Decide If I Like Or Hate This Item" List 

• nursing cover. Controversy aside, my babies kick, they flash me, and they're active. And depending on the stage they're in, the nursing cover can be more or less helpful. My aim is to nurse as discreetly as reasonable, and sometimes that means using a cover. But I don't nurse in bathrooms, and have been known to find a quiet room or hallway, or nurse in a worship service, depending on what works that day. I usually use this more for the itty bitty stage and use it less and less as they get older. Nursing a toddler with a cover has NEVER worked for me. 
• infant carrier seat. We've used one for our first 3, but are not for our fourth, for various reasons. They've gotten less convenient with each baby, as each has gotten fatter more quickly than the previous ones, and there are just more and more safety precautions (by the manufacturers and by the AAP) coming out that restrict many of the versatile ways we've used them in the past. They CAN be used safely, but there are a lot of unsafe ways to use them too! They are also an incredible expense for something that is only used for a few months and then expires after 6 years. And bulky to store for 2+ years between babies. 
• infant safety gates. We've owned them at times and not at others; they seem like they simultaneously create and solve safety issues - ha! 
• baby monitor. Basic sound-only option. Useful, and I've owned them for one baby and not two others, and we currently have one someone handed-us-down for this baby - but it's a not-oft-used item here, and just one more thing we own that takes up room. My babies often sleep in a wrap or the Ergo, so it's not even always helpful. But when we're in a multi-level house and they're napping on a bed/crib, it is sometimes nice to have. 
• breast pump. My babies have never taken bottles and it seems like a total waste of space to own a breast pump, but it's also been handy a handful of times to have a manual one around to help clear a really bad clog. So I keep it. *shrugs* 
• sippy cup. We've owned ONE sippy cup over the years and it's gotten very little use, but it's also nice to have for the rare occasion like a car trip. *shrugs* 
• nursing bras. Helpful, but kind of superfluous and regular ones adapt just fine ;-). 
• baby hats. My babies rarely need them, and they tend to fall off, but there are rare occasions when they're helpful. I'd honestly rather keep them warm by snuggling and kissing their head ;-). 
• I have similar sentiments regarding baby socks, and prefer baby booties (which are more likely to stay on) or footed onesies. 
• baby swing. Sort of useful, especially for babies who like motion, and those times when Mommy really does need some extra hands, but SUCH a short-lived use before baby outgrows, and takes up a lot of space on the floor. 

My "I Used to Own This, But Choose Not to Anymore" List 

• exersaucer. Someone passed me on a used one and I used it for a while, but it was SUCH a large footprint and didn't wow me, so I passed it on to someone else. 
• nursing stool. Can you say "tripping hazard"? And once I had a toddler, the toddler thought it was his own personal-sized stool, so who ended up using it? ;-P 
• nursing pillow. Invaluable for my first baby, and I'd recommend it for a first-time mom or a mom who had a baby with latch issues, multiples, etc. Virtually unused for my other two kids and just one more item to store. 
• single stroller. Very helpful for a single child! Semi-useful for a second child. Not so much after that. 
• velcro swaddle blanket. They never fit tightly enough (and isn't that the point of the swaddle?), and my first was our "Houdini" who always got out of them anyway. 
• diaper bag. A backpack serves the purpose and is more versatile. It also fits my babywearing contraptions better ;-). 
• crib. This never got much use and took up SO much room. 
• scratch mitts. Socks are so versatile and can be used for the same purpose. And they are already hard enough to keep track of. Why do I need to keep track of TWO types of tiny objects that need matches?! 
• plastic teether things. My first two babies never liked them, and I'd rather them not chew on plastic anyway ;-). They get enough plastic chewing with Duplos, without me encouraging the practice. Hehe. 
• baby powder 
• shopping cart cover. My oldest promptly pulled it aside and chewed on the cart handle, and I gave up. I just wear my babies while shopping until they're about 18 months old. They're happier (I get so many comments about my cheerful tag-alongs when they're worn!) and by 18 months, I figure their immune system can handle the cart germs. 
• Hyland's teething tablets. Never worked for my kids AT ALL. 
• an exercise ball. I actually really liked this and it was very helpful for my fussy first baby, and I'd kind of like another one. But I haven't replaced my old one (which had a good life), partially because I'm too cheap, and partly because it would just become a very large projectile toy with a 2, 5, and 7yo in the house. I try to pick my battles :-P. 

My "Popular Things I've Never Owned/Used" List 

• changing table. They make me nervous, and are another piece of furniture, and a bed works just fine. The floor and couch also work in a pinch. 
• pacifiers 
• formula. Blessed with a good milk supply! 
• baby food. My plate is available to them, and forks are handy mashers. 
• wipes warmer  
• crib mobile 
• Bumbo 
• baby shoes 
• Johnny-jump-up. I try to avoid crotch danglers because of chiro cautions. 
• Baby Bjorn, for the same reason :-). 
• nursing-specific tops/dresses. Because I nurse all the time. I really don't want to re-vamp my entire wardrobe, but would rather just adapt what I have. That's what 2-piece outfits are for :-). 
• amber teething necklace 
• baby oil and baby lotion. My babies haven't been rashy, and I don't bathe them over-much, so their skin doesn't get dry. 
• a nursery. Yeah, one of those special rooms for baby that is ADORABLE and has awesome decorations. My babies have all slept in our room for well over a year and they have yet to be in therapy for the general (non-baby) decor on the master bedroom walls ;-). My 2yo is actually my first toddler who has even had decorations on his wall. Oops. 

My "Trying Something New This Time" List 

• a pack 'n play with a bassinet insert. This option replaces our basic pack 'n play and our co-sleeper; less to store, and will hopefully still fit our needs well :-). 
• nursing camis 
• a slightly different kind of baby bath holder 
• maple teething ring. This was given to me by my chiropractor. Maple is supposed to be non-splintery. Any opinions or advice on using this? I haven't researched it yet. 

My "Items I Would Like to Try In The Future, But Don't Currently Own" List 

• a stretchy lightweight wrap 
• a good-quality strong-but-light woven wrap 
• a post-partum belly wrap 
• rubber teething toy like Sophie the Giraffe 

Jesse Tree

Isaiah 11

1There shall come forth a shoot from the stump of Jesse,
and a branch from his roots shall bear fruit.

We've done a Jesse Tree the last three years during the Advent season. The kids love it and look forward to it. We all do, actually!

If you've never heard of a Jesse Tree, it is a visual story of Christ, tracing the need for redemption from creation, through the fall, judgment in the flood, seeing glimpses of Him in the prophets, in Jonah, Samuel, His lineage through the kings, etc. Generally, each day in Advent, a family has a passage to read from the Bible, and then an ornament to hang on their "Jesse Tree" that symbolizes the passage. For the prophets, we hang a scroll, for the psalmist David, we hang a harp, etc. As the days progress, the passages narrow into the time of His birth. The term "Jesse Tree" comes from Isaiah 11, the prophecy that a shoot will come out of the stump of Jesse.

I grew up hearing of the concept, as my elementary Sunday school curriculum had a special Advent series that uses a Jesse Tree. It wasn't a regular part of growing up, but I was exposed to it, and liked the idea. Adrian had never heard of a Jesse tree before, and when I first approached him with the idea he was skeptical, wondering if it would be shallow (like a lot of popular "family devotion ideas"), etc., but he agreed to give it a try a few years ago. He was definitely impressed after we did it ourselves and doesn't need any more convincing :-).

(On a side note, two other non-Jesse-tree resources that have similar themes of the entire Biblical story building up to the birth of Christ: I recommend Andrew Peterson's album "The Lamb of God," and also this short film by the Skit Guys. I gotta admit the Skit Guys butchered a much-beloved hymn - "Come, Though Long-expected Jesus" - but I like the film for the amazing progressive painting showing the story from creation to the birth of Christ.)

So basically, there is no exact "one way" to do a Jesse tree. If you search online, you will find different lists of passages and corresponding events/people/objects. Some lists stick strictly with the lineage of Christ, but most will delve into the prophets as well and other events that point to Christ. The main thing is to tell God's preparations for bringing His Son into the world.

I basically combined the best of several lists, if I remember correctly. I also chose to keep ours to 25 days, which allows us to start December 1st and end on Christmas. Some suggestions have more or fewer days. Here is what I ended up doing (much of this came from blog posts I cut/pasted from, but that was a few years ago, so I don't have the original links to share and can't remember how much I altered and what was original):

1. Tree (Jesse's lineage)	I Samuel 16: 1-13 Jesse was King David's father Isaiah 11:1,10 Prophecy about Christ coming from the “stump of Jesse”; from his roots a Branch will bear fruit.
2. Globe (creation)	Genesis 1 Creation John 1: 1-5 Jesus was from the beginning with God; Jesus is light
3. Apple (Adam and Eve, fall)	Genesis 3 Sin entered the world, but God promised to send Someone to crush Satan Romans 5:12-19 Sin came into the world through Adam, but God gives us life through Christ
4. Ark and rainbow (Noah)	Genesis 7:1-9:17 God's promises and covenant
5. Stars (Abraham)	Genesis 12:1-7, 15:1-6 God's promise to bless the earth through Abraham
6. Bundle of sticks (Isaac)	Genesis 22:1-14 Abraham's willingness to sacrifice his only son points to God sending His only Son to be the perfect sacrifice for us
7. Ladder (Jacob)	Genesis 27:41-28:22 Jesus is our ladder to God
8. Coat of many colors (Joseph)	Genesis 37:1-36, 50:15-21 God used Joseph to save His people
9. Lamb (Moses, passover)	Exodus 12:1-30 The blood of a lamb on the doorposts of the Israelites' houses was the sign for God to spare His people John 1:29 Jesus is the Lamb of God, who takes away the sin of the world Mark 14:12-16 Celebration of Passover becomes the celebration of the Lord's Supper
10. Bread (Moses, manna)	Exodus 16 God gave His people manna to eat in the wilderness, to save them from hunger John 6:46-51 Jesus is the bread of life
11. Law tablets (Moses, 10 commandments)	Exodus 20:1-21 God gave His people His law Romans 10:4 Christ is the fulfillment of the law
12. Wheat (Ruth)	Ruth 4:9-22 Ruth was not born into God's people, but she loved God and was humble and obedient. She became David's grandmother, part of the lineage of Christ
13. Ear (Samuel)	I Samuel 3 As a little boy, Samuel heard God and believed Him
14. Shepherd's staff (Jesse)	I Samuel 16:1-13 Samuel annointed Jesse's youngest son, David, because God looks at the heart, not the outward appearance Isaiah 53:2 A prophecy that Christ would not attract us by His appearance
15. Slingshot (David – warrior)	I Samuel 17:17-51 David remembered God's provision in the past, trusted God, and would not stand for Goliath insulting God
16. Harp (David – psalmist)	Psalm 23 God teaches us how to praise Him in the Psalms; the Psalms point to the Savior
17. Crown (Solomon)	I Kings 3:1-14 God gave Solomon wisdom
18. Altar (Elijah)	I Kings 18:16-46 Israel was worshipping false gods; God showed His people that He was the true God
19. Scroll (prophecy)	Isaiah 9:1-7 God sent prophets to tell Israel of the promised Redeemer
20. Lion (Daniel)	Daniel 6 Daniel trusted in the Lord; God protects His people
21. Fish (Jonah)	Jonah 1-3 Jonah was in the belly of the fish for three days and nights; God's desire was for the people of Ninevah to repent
22. Hammer (Joseph)	Matthew 1:18-25 Joseph was a carpenter who listened to the angel of the Lord and was obedient in faith
23. Angel (virgin birth foretold to Mary)	Luke 1:26-38, 46-55 Mary had faith and obedience; she praised God for His plan
24. Donkey (Bethlehem)	Luke 2:1-5 Mary and Joseph go to Bethlehem
25. Manger (birth of Jesus)	Luke 2:1-20 Jesus is born.

I also took pictures to show you the ornaments I made/obtained to go along with the passages. Once again, there is a lot of flexibility. For example, for your Jesse tree you can draw a tree on a poster board (which we've done before) and hang the ornaments on with thumb tacks. Or you can purchase an artificial mini tree to use each year for your Jesse tree. You could even just add the ornaments to your regular Christmas tree, though I think there is something special about having a separate tree. What we're doing this year is using a branch from our yard, stuck in a vase with rocks to weight it down and hold it erect. We'll hang the ornaments off the different twigs branching off of the main branch. We'll see how it goes :-). 

For the ornaments, there are plenty of options online for printing off pre-made images and pasting them onto discs to make your ornaments. You can make or purchase objects/ornaments, collecting from various stores or using craft supplies you have. It's up to you. You'll see in the pictures that we kind of did a little of everything. I worked on collecting and making the ornaments over several weeks. I don't think I actually had to buy anything, but used a lot of what we already had. The lamb was a toy that I turned into an ornament. The harp was already an ornament, but I plucked off the bear that was attached. I made Joseph's coat from felt, Jonah's fish was an embellished washcloth that I converted, etc. I'm particularly proud of my Lego ark, I have to admit :-).

Don't feel like you have to have the "perfect ornaments" for it to be a meaningful experience. You can go easy with pre-printed options, and then you can always branch out and replace with more intricate ones as the years progress. There are a few we have that I'd still like to replace with "better" options if I find them, but I'm using what I have until then. For example, the three stars to represent the Abrahamic covenant. . . not exactly awe-inspiring :-P. I want to make/get something that has LOTS of stars, but I just haven't yet.

Also, you can use artistic license and decide that instead of a crown to represent Solomon, you want to use a mini replica of the temple. Or instead of a fruit to represent the fall in the garden, you could use a serpent or a little tiny tree ornament. Whatever. Use your imagination and work with what you have or can find/make easily :-).

Here is our current collection:

The tree (1) and globe (2).



Apple (3), ark/rainbow (4), stars (5).



Bundle of sticks (6), ladder (7), coat of many colors (8).



Lamb (9), bread (10), law tablets (11).



Wheat (12), ear (13), shepherd's staff (14).



Slingshot (15), harp (16), crown (17).



Altar (18), scroll (19), lion (20).



Fish (21), hammer (22), angel (23).



Donkey (24) and manger (25).

Martin Wilhelm's birth story

Edited edition for male readers or others who want "just the facts, ma'am":

Martin Wilhelm was born on June 24th, 2013 at 7:29 a.m, weighing 7lb. 8oz. He's adorable and a voracious eater.

~~~~~~~~~~~~~~~~~~~~

Longer version:

(If you just want the birth story and not pregnancy ramblings, start reading a few paragraphs further down.)

This pregnancy was SO different than previous ones. Beginning with not getting a strong positive pregnancy test until several days later in my cycle than normal for me, fluctuating hormones that had never "normalized" from my miscarriage 6 months previous, and a marked difference in morning sickness and exhaustion (much less debilitating than with Hans and Gretchen!).

An early ultrasound supported my intuition and observation that I had ovulated later than the "usual" 14 days post-LMP (explaining the delayed positive pregnancy test!) - approximately 6 days later, in fact - and I adjusted my due date mentally from June 7 to June 13th. (My care provider in CT wouldn't "officially" accept the due date change, despite the evidence, but said it would be "taken into account" - not sure what that means!) I then settled into the first trimester with all its wonders and worries, especially with my previous 2 miscarriages. Despite the hormonal fluctuations and the lighter morning sickness, we made it into the second trimester. In retrospect, I suspect at least part (if not all) of the lighter morning sickness and tiredness was due to eliminating wheat and sugar from my diet some months previous. I've found too many carbs to contribute to my own morning sickness, and eliminating wheat and sugar (both intolerances for me) probably kept my blood sugar more stable. Merely a theory, but I've read similar stories from others.

At the beginning of the second trimester we moved from CT to TX, and I began looking for a new care provider. The idea of a homebirth had always been in the back of my mind for a future birth, but I'd never pursued it previous to now for a few reasons. But when the birth center in TX that I'd planned to use announced its closing the month we moved there, and when we opted to join Samaritan Ministries rather than sign up for the group insurance offered by Adrian's new job, a homebirth sounded like a very viable option. Adrian was supportive of the idea if I found a qualified midwife who satisfactorily answered my long list of interview questions :-D. I ended up interviewing 3 midwives and chose one about 20 minutes from me who had a vast wealth of experience and knowledge. I told Adrian after interviewing all 3, "My birth could go smoothly, in which case any of the three would be fine," (they were all basically qualified, as well as nice people), "but if something went wrong, Alice is the one I'd want to be there!"

My midwife Alice ended up being a wonderful resource for this pregnancy. The debilitating hip and lower back pain I'd experienced in the third trimester of Hans' and Gretchen' pregnancy was almost non-existent this time! (If I did something dumb with my posture, over-exerted myself, or took a long car trip, I suffered some, but it was temporary, not pervasive like before.) I'd thought it had all stemmed from a tail bone injury I'd sustained when I was 12, and while I'm sure that injury contributed to my previous pain, Alice helped me pinpoint a calcium deficiency, and found me a highly-absorable supplement that absorbs like a food and doesn't carry the risks of calcification that many calcium supplements do. (I highly recommend Vita-Mist Cal-Mag!) I also was much more conscious to be more careful with my posture, opted to squat instead of bend to pick things up (good for birth prep anyway), etc. This pregnancy, when I groaned as I rolled over in bed, I told Adrian that unlike previous pregnancies, I'm not groaning because of pain; it's just difficult work to turn a beached whale :-D.

This was also the first pregnancy where I didn't have to use a chiropractor for alignment and relief. And Martin behaved and stayed head down, unlike transverse-Hans and breech-Gretchen, both whom flipped head down before delivery, but only after giving me some angst :-). I had had misalignment that seemed to contribute to my uterus hanging abnormally, and my chiropractor used the Webster Technique to balance it properly. Didn't need that this time!

Hans' birth was 4 days before his due date and Gretchen's was 4 days "late," so I'd anticipated not going really early for this birth, but also not having a super-late baby. Ha! My due date passed, then Hans' birthday 5 days later (he'd really hoped for a birthday-mate!), then the one-week mark. . . I was beginning to wonder when this baby would show up! And I was very grateful that my midwife here had accepted my ultrasound due date of June 13th as more accurate, instead of the original LMP-based June 7th date, and that she wasn't trigger-happy on induction unless there was good cause. I was also thankful that my energy levels remained manageable (once I started using Floravital + B12 at 36 weeks) and I wasn't in great discomfort - going so many days late with previous pregnancies would have been much harder!

I had a lot of Braxton Hicks contractions the week after my due date, the baby was very low, cervix thin, but no labor. I did several long walks in air-conditioned stores with either Adrian or my dad (my parents had driven from Georgia and waited. . . and waited. . . with us.)  Finally, 11 days after my due date (17, by LMP!), I woke up about 2:30 a.m. with some contractions that felt slightly more real than the Braxton Hicks I'd experienced. But they weren't strong or regular. so after using the bathroom I fell back asleep in bed for another hour, waking again at 3:30. A few more contractions, but still nothing definite. I slept and woke again at 4:30, after a strange dream in which I'd been in labor, the cord had prolapsed, but then I got hands-and-knees and the baby was out in one push, born in the caul. (An impossible scenario, for the record.)

This time when I woke up (at 4:30), I decided to stay up and see if these contractions got stronger or more regular. At 5am I woke Adrian and asked him to make me breakfast (scrambled eggs and green beans), so I'd have a good protein-rich meal behind me in case labor sped up. I sat down to start eating breakfast around 5:30, finishing around 6:00. By the end of the meal I was having to pause every few bites to breathe through contractions. They were coming at irregular intervals, but probably every 3 minutes was the average. Some lighter, some a bit more intense. Adrian had called Alice, who said she was going to grab coffee and head our way as she "didn't trust me" ;-).

After eating I headed to the bedroom and found to my surprise that the toilet was NOT the most comfortable place to labor for me this time around, unlike Hans' and Gretchen's labors :-). It was an okay position, but I really didn't want to be upright this time (didn't like the additional force of gravity while dealing with forces of contractions), instead preferring a side-lying position on the bed, which I HATED in active labor in times past. But I was actually able to relax with each contraction in this position this time. My parents started getting the kids ready to head out for breakfast and a mall walk. They left around 6:45 and Alice got to our place around 7:00.

Alice asked me some questions between contractions, checked Martin's heartrate during a contraction to make sure he was handling them well, and started getting out some birth supplies. I spent about 10 minutes making it through some contractions and a bathroom run, so she could finally check me. 7cm. Adrian started filling the pool, which didn't take long. I planned to move to the pool after my next contraction, but then I had three contractions right on top of each other without spacing between - no time to get out of bed between - then when I started to get out of bed after that string of three, I was caught by yet another contraction; my waters broke and I had that sudden urge to push, which I resisted. Um. Yeah, I did not waltz down the hall to the pool at that point ;-). Basically I had the option to be literally carried down the hall to the pool by Adrian and Alice, or birth in our bedroom, and while I have always appreciated the ease of positioning for pushing in the tub, I opted to stay put ;-). I could barely move, so I asked them to push me from my perched-on-edge-of-bed position backwards onto my back, then they rotated me onto the bed. It's not easy to move one's self when your baby's head is descending with every contraction :-D.

I did not have to exert one ounce of effort towards pushing Martin out. It was a strange experience. Basically I just tried NOT to exert any additional effort (but I didn't fight it), and my body pushed him with each contraction. A few contractions and his head was out, staring up at Alice and Adrian and looking around. Alice told me not to push for a second while she slipped a cord loop from around his neck (not that I was pushing anyway!), then his body slid out at 7:29 am. My land baby!

Adrian announced it was a boy (we hadn't known the gender during pregnancy) - Martin Wilhelm Keister - and Alice grabbed the nearest clean-looking towel (after checking with us to confirm) to wrap him in, as most of the birth supplies, including towels and blankets, were still down the hall :-). After delivering the placenta and nursing, and such, Alice took his measurements. 7lb. 8 oz., 20 3/4" long, 14 1/4" head. And a bundle of sweetness :-). He has been a good nurser and was drunk with happiness when my milk came in last night (about 36 hours after birth). Nothing like those contented newborn gurgles after eating :-).

I had tested positive for Group B Strep for this pregnancy, and had used Hibiclens washes thrice daily for over a month, which had reduced the growth but not eradicated it (this protocol eradicates it for the vast majority of my midwife's clients, but it didn't quite do that with me - probably due to a compromised gut/deeper issues). Because of my history of long-term digestive issues with antibiotics (still recuperating from the IV abx given me in Gretchen's labor in 2010 and Hans' in 2008) and also my relatively-short previous labors (general protocol is two rounds of antibiotics, 4 hours apart - didn't manage to make it to the second dose with either Hans or Gretchen), we did not opt for antibiotics. GBS is primarily a concern for preemies (my 11-day late baby was not that!), children of smokers (again, not a concern for us!) or in the case of prolonged rupture of membranes (18-24 hours). My waters broke at 10 cm and Martin was born 5-10 minutes later. Perfect scenario. If I'd planned a hospital birth, I might have barely made it to the hospital (or birthed on the way!), but there is no way one round of abx would have been delivered, let alone the "required" two doses. (With Gretchen, from time of ordering the first round to all of the round being delivered by IV through my bloodstream was about an hour.)

Hans and Gretchen LOVE their new brother ("my new baby," as Gretchen calls him) and are eager to hold him and verbally soothe him when he cries. He's a pretty calm baby so far, easy to soothe, and looks just like his older brother looked at birth. Hilariously similar, in fact! We are enjoying this fleeting time and soaking up the cuddles. We praise God for this blessing from Him.

Unbloomed Rose

Silent bud in sheath of green,
Waits in dark for bloom of spring.
Early frost steals promised flow'r;
Early wilt, untimely hour.

Knitted life in vessel dark.
Tiny form with Maker's mark.
Frame in view from Him above.
Treasured here, welcomed in love.

Life's ev'ry day written, planned
By the Master's gentle hand.
What if days were short, life brief?
Early frost - a lifeless leaf.

Eyes are dimmed ere light has shone;
Silent cry, no time to tone.
Shepherd is no helpless man;
All is in His 'ternal plan.

He gently hugs weeping lambs,
Wipes the tears, comforts rams.
Whispers promises, holds close
His little child, grieving rose.

Time long-past, another place,
God's only Son, tears on face,
Pleads release from task ahead -
Nail-pierced hands, wounded head.

Willingly on lonely hill,
God in flesh is lifeless, still.
Death conquered through death toll chime;
Promise sealed for better time.

Perished Lamb lives in glory,
Happy end to saddest story.
Every tear is wiped away
On that joyful final day.

So now weeping, grieving one,
Recollect God's only Son.
For those of faith, light has dawned -
Eternal sun, life beyond.

- S.G.K. April 2012
In memory of two loves lost, 12/2009 and 3/2012

Gretchen's birth story

I should be sleeping because it's before 6:00 a.m. and my baby is passed out in the crib next to me, but the biological need for food is competing with my biological need for sleep, and the lure of the food service in the hospital opening in 10 minutes is definitely deciding the winner ;-). Hungry! Feeding another human being takes a lot of calories.

~~~

I woke up Thursday morning (October 7th) at 2:00 a.m. from dreams of having contractions to find that I was. . . having contractions ;-). I was 4 days "past due". The contractions were really mild, though, so I didn't get super-excited, but instead emptied my bladder to see if they would keep up. Yep, and pretty steadily 8 or 9 minutes apart.

I tried to go back to sleep, but yeah right. I gave up around 3:30 a.m. and headed downstairs to putter around, to see if movement would increase or decrease the intensity/duration/happening. Adrian came downstairs around 4:00 a.m. to see if I was in labor, to which I shrugged and said "I think maybe." He started timing them for me (he said there was no way he was going to be able to go back to sleep!), and they were now closer to 5 minutes apart, but very mild and only 20-30 seconds long, so I had no intention of rushing to the hospital right then. My labor with Hans didn't have a clearly established contraction pattern, but I was also worried this time about getting to the hospital in time, as Hans' labor was fast once it picked up, and with this pregnancy I was Group B strep positive, so I was supposed to get 2 doses of antibiotics by i.v. in me before giving birth. . . 4 hours apart, so I needed a 4 hour lead gap from when I got my first dose to when I delivered. But I also didn't want to get to the hospital prematurely :-P.

Finally around 6:00 a.m., with the contractions still around 5 minutes apart most times, they were starting to get slightly more intense, and I was having to pause during some of them, so we called our friends up the street, to heads-up them that we'd be dropping off Hans soon. We dropped him off around 7:00 and headed 1/2 hour north to our hospital, checking in a little before 8:00 a.m.

The contractions slowed down some on the drive, to about 7 or 8 minutes apart on the drive. . . ugh. Then first thing they wanted before I could labor freely was a 20 minute fetal monitor strip, which I was fine with, but after closer to 45 minutes (Gretchen wasn't performing for them with enough heart rate accelerations at first, until I downed some cranberry juice. . . bleh), I'd only had about 3 contractions, 5 total since getting out of the car at the hospital an hour+ before. Hmm. The midwife checked me at 9:00 a.m., when I got off the monitor, and I was between a 3 and 4 (90% effaced) and the few contractions I was now having were very mild. Dilemmas, dilemmas. I did not want to be stuck here forever with a putsy labor!

We opted to walk around the hospital campus to see if we could get my labor moving, and this definitely did the job. We came back to the room about an hour later when the contractions starting spiking in intensity and getting closer. . . but still no established pattern. Although I was hesitant to declare "yes, this is it," I did opt to order the antibiotics at that point, because I knew we were up against the 4-hour window, and I knew I went fast with Hans once contractions got established. It was 10:00 a.m. when I ordered the antibiotics, but it took a while for them to actually get there -around 11:00 when I actually got them in me. By this time the contractions were definitely more intense, but still doable. I wasn't quite ready for the tub, as I didn't want my labor to slow down, and I'd made it to 8 cm without needing it with Hans.

The next hour was rather a blur. The contractions escalated to very intense so quickly, and much quicker than I expected I started getting that light-headed "I'm going to faint" feel that I got just before transition with Hans, that was only relieved by the tub. Before I even had time to act on the desire for a tub I was now having a hard time talking even between contractions. Then I had a super-intense contraction, and gasped "I'm having a premature urge to push! Get Mary (the midwife). And I want the tub." So they started filling up the tub and Mary came in to check me, but it was a few more contractions (slightly milder, no urge to push) before she could check me, just because moving anywhere was slow work and a lot of effort with the very intense contractions. My water broke as I finally got on the bed to be checked, and I got another urge to push, which I fought. Mary said she couldn't feel any cervix, so I could push whenever I felt like it. I was a complete 10! I really wanted to make it to the tub, though!

Thankfully, the tub was right across the hall, but I still needed a wheelchair just to get there. Thankfully the contractions did slow at this point a tad, allowing me to get in the tub just fine. The warm water felt SO good. My only complaint with this tub versus the one I birthed Hans in was that the water was much more shallow (very different style tub!), but I also did like the seat in this one, which was good for positioning options.

I was totally in my own zone at this point, just focusing, and not terribly aware of who was around me most of the time. I was pretty out of it ;-). Just like with Hans, I really didn't have any desire to pop this baby out super-fast, so I went with urges to push, but didn't bear down super-hard, wanting to ease her out to minimize tearing. I've never understood when women say that pushing is almost a relief from the contractions, because they get to channel their anger/momentum into pushing. I just don't find pushing fun AT ALL. Gretchen was born at 12:29 p.m., screaming and hollering and NOT liking this whole outside-world thing ;-). She was 7 lb. 1 oz. with a very rounded head from such a quick delivery, golden fuzz for hair just like her brother. . . and in most other ways looking like a miniature Hans!

We snuggled in the tub wrapped in lots of towels until the cord stopped pulsing and was clamped, then we moved to the bed for placenta delivery and to repair a small tear. Then she latched right on and nursed like a champ (has barely stopped since!). SO much easier to establish breastfeeding with her than with Hans! She's such a good and determined little nurser that she had already brought my milk in by 30 hours postpartum, and at 36 hours after birth, she's already back 3 oz. above her birth weight(!).

With only 1 1/2 hours between the antibiotics (and only one dose, at that!) to delivery, we are held 48 hours at the hospital (just for precaution), rather then my original hope of an early discharge at 24 hours. But thankfully Gretchen's vitals have been great and her blood labs came back clear, with no signs of GBS complications, for which we are very thankful!

Adrian and I laughed after delivery that we didn't even have time to think about getting out all the birth music we'd brought. Ah well. Anonymous 4 (beautiful medieval chants!) still sounds nice post-delivery ;-).

Praise God for such a safe and quick delivery, and for a healthy little one!

There are many more pictures posted to my photo blog.