What Have I Gotten Myself Into?!

     So, after several conversations with different nursing friends, I decided to volunteer at, well, let's call it "Feel Better Hospital." I need to give it a pseudonym to get into the habit of thinking, HIPAA compliance, HIPAA compliance, gotta' always think about Almighty HIPAA compliance...
     So, I called up the Volunteer coordinator, then received an e-mail from her with attachments to fill out. After finishing the volunteer application, I then met with her. She e-mailed me saying that I needed to go to this certain website to fill out the paperwork electronically for my background check. A day later, she got back to me saying that I needed to proceed with the health clearance. OK. I then called the health office at FBH (Feel Better Hospital) and ask if I can come in to get my TB test. Umm...1 1/2 hours later, a TB shot, a urine drug screen, a trip to the building across the street for blood work, a quick stop by my car to feed the meter, then head over to yet another building for a physical exam by a doctor. Huh?! "I had a physical exam with my doctor about two months ago. Do I need another one?" Nod and serious look, "Yes." Ok. When the medical assistant brought me the gown and said, "Here, change into this..." I clarified that I could leave my undergarments on. I was NOT going to completely undress for a silly physical. He told me I didn't have to. Dr. Charming walked in and quickly determined that I had a pulse, didn't have pneumonia, and could walk and chew gum at the same time. Hooray! And, then, I went home, my arms bandaged from fluids going in and fluids going out.
     Yikes! I thought I was going in for a simple TB test. Tomorrow I return to FBH with proof of my negative TB test from my doctor's office done 4 months ago as well as the reading on my left forearm of this current test. Because, you see, they need a two-step TB test. Of course they do!
     But it's all okay. Hopefully I'll be volunteering on Labor and Delivery and Postpartum at FBH soon! And then the adventures will really begin!

Perhaps Necessity Determines Feasibility….

     In short order: it appears that our family need for a second income is propelling me in the direction that my intellect, curiosity, and passions are heading in anyway. Coincidence? I don’t know.

     The furlough days agreed upon by the Los Angeles Teachers Union and Los Angeles Unified School District have been financially challenging to our family budget. The declining enrollment starting several years back and the changeover from year-round schools to traditional schools is also pointing to one significant problem: a sharp drop in Tim’s income. He made tens of thousands of dollars less last year than in previous years.  For well over a decade excellent job opportunities were available and Tim took them. That hard working man of mine has always said, “Make hay while the sun shines.” Indeed it did and he did.

     The sun isn’t shining so brightly anymore.

     We’ve thought about all sorts of solutions to this impending problem; selling our house and moving out to a much less expensive area, or my returning to work full-time as a teacher, or even the nursing school option. The challenge with selling our home is that we’d have to move so far away to make an appreciable difference that Tim would hardly see the kids, we’d uproot our well-established, nurturing social lives, and we’d be farther from our aging fathers. None of these options seem wise.

     So, I thought about going back to work as a special education teacher. I spent years training for this field.  I called an advisor at my college and she was stumped. “Well, last year we made such  big program changes that you might have to take many classes over again.” When I compared the new requirements to my transcripts I counted about 12 classes I’d have to retake. In effect, redo all my credential coursework. And although I love teaching and working with kids, I really don’t feel inclined to take a job that limits me to a classroom full time away from my kids for a salary that would be mildly beneficial. With all of the cuts to every school district, the only jobs available for a new teacher would be the really rotten positions. Oh, no thanks! 

     We also thought about taking in a child or two for in-home daycare. The money, for the time and responsibility, is not significant. I feel weary at the prospect of being the full-time caregiver for an infant or toddler because that’s just about all I’ve done for the last 15+ years.  I would really NOT prefer to do that anymore at this point in my life. But, it still is a possibility and one I haven’t ruled out. 

     What seems most logical, for long-term flexibility (home school options), career options, and beneficial income possibilities is a nursing degree. Particularly, to advance on to a Masters of Science in Nurse-Midwifery. After much research on the internet I discovered that Cal State Fullerton has an exceptional, albeit competitive program. The total schooling and work experience to reach my goal would easily be about 8 years. Probably more. A couple of those years would be some intense time away from the girls. This is what weighs on my mind the most. However,  if I know that season has a clear beginning and an end, then I can prepare for that time. I know in the long run I will have greater flexibility as to when and how much I work while doing something that greatly interests me. I will also be  earning an income that is commensurate with our financial needs (raising six kids gets more expensive as they get older!) and that makes all the sacrifices more palpable. Tim and I see so many more benefits in this option than anything on the table currently.

     The biggest challenge for me at this point is finding a junior college where I can take the pre-requisite science classes I need to even apply for nursing school. In the Los Angeles area that is no small feat. Wow! All the junior colleges are impacted. I have a plan, though, and I have some promising prospects. The helpful thing about this direction is that Tim and I are in agreement and will take the plan one semester at a time. There is not a significant financial or time cost with taking one class a semester at a junior college. At any time we could decide to stop the whole process and not much will be lost.  I am trying to approach this new development in my life with a very open mind and a guarded heart.

     Much prayer and communication will continue. I know God is faithful. Whatever he has planned for me and our family he will bring to pass. 

Too Late For Me?

     So I missed my calling. Years ago, as a nineteen year-old, I chose to pursue a career in teaching. I wasn't sure which career direction to pursue since law school had become quickly unappealing with 90 hour work weeks for a measly $30K a year. Besides, Los Angeles has too many lawyers anyway. (Sorry my lawyer friends - I don't mean you in particular). My mom was dying at the time as well and teaching seemed to be a secure job route that was somewhat appealing. I had no interest in medicine whatsoever. Blood-yuck. Body parts, especially mangled-totally gross. Bodily fluids - icky. Moaning, hurting, whining people - forget about it!
     And then I got pregnant with my 6th child. I knew she'd be my last. For some odd reason, I was intensely interested in all things pregnancy related. After she was born, her traumatic birth made me search high and low and far and wide for answers as to the medical nature of what happened. After reading countless posts from labor and delivery nurses, midwives, and obstetricians, as well as many books by birth professionals, I became intensely interested in pregnancy and childbirth, and women's health issues overall. How odd, it seemed. And yet my knowledge base grew and my interest in medical things increased significantly. This care and compassion toward women and their health issues became heightened in me. A woman would tell me an experience she had health -wise, or pregnancy and childbirth-wise, and I would be looking it up on the internet to understand more about it.
     I found myself looking into the nursing program at PCC and various doula programs. I started this blog. While continuing to read many websites and blogs about pregnancy and childbirth, I realized I would never have the patience or self-control to be a doula. I would be too tempted to speak up against dcotors and nurses about "suboptimal" care I felt my client was getting. But most of all....
     Once I saw a baby born I wouldn't be able to help myself. I would want to be those hands guiding that baby out, and encouraging the baby's father to be as involved as I could get him in catching his baby. I would want to help that woman and her husband own their birth experience as much as they could and be the guiding expertise and care in that woman's pregnancy, labor and delivery, and postpartum period. It would be one of the greatest joys and challenges I would ever do on a regular basis. Not unlike motherhood in general, actually.
     And yet, it's too late for me. I've done extensive research on this issue as well. I'd have a couple of pre-req's at PCC, and then I'd enter their two year nursing program. Then, the Nizhoni Midwifery Institutehttp://www.midwiferyatnizhoni.com/ would be another 3 intense years of midwifery training. The Nizhoni Institute, based in San Diego, is the only California Medical Board-approved midwife training school of its kind in the entire state.  I would want to be state certified and so I'd go there.
     However, these are all the reasons I don't ever foresee being a midwife:
1) Financial cost
2)Time Cost
3) Emotional Cost
4)Mental Cost
5)I have six daughters who need me to be present in their lives in all the ways mentioned above. I would not spend those costs on a career and sacrifice my daughters' well being and their needs. I don't pass judgement on woman who do choose careers - not at all. But that road is not for me. At least not now.
     I am open to all sorts of possibilities, however. You never know what the future might hold. For now, I'm holding my daughters close and putting their needs first. We'll see where my medical and women's health interests take me. In the big picture, whatever is meant to be will happen.

A Writing Activity to Help With Closure Regarding My Last Delivery

     In my mind’s eye, and my most vivid imagination, I replay the scene that could’ve been. It’s a warm, humid Sunday morning on July 13^th, 2008 and I’m lying in bed. I’m wearing my sleeveless pajama top and matching shorts, the one with red and pink roses on them. I’m hugely pregnant, lying on my left side, on the left side of the bed. The cheap white fan is slowly whirring cool air toward me. The house is quiet. Tim and the children have left for church about 10 minutes ago. I had been lying in bed all morning long and was relieved to finally have the house to myself. The peace and quiet enveloped my thoughts just as my soft, goose-down pillow cradled my head.

     Only an hour earlier, at around 8:30 am, Dr. ------ had called. “Hi Laura, it’s ----  ------. What happened?! They said you left the hospital shortly after arriving. I thought you were going to have your baby today.”

     “I wasn’t in labor, Dr. ------, and I didn’t want to be in the hospital. I had to convince my husband that all the contractions had stopped and that it was a false alarm. I was just really tired and wanted to be at home. Even now, I’m only having sporadic, weak contractions.”

     “So you‘re not cramping anymore?”

     “No. That kind of tapered off.”

     “Okay. Well, if things start up again, or you start bleeding, call me. Okay?”

     “All right. Thanks for calling. And I’ll let you know if I start contracting again regularly or something changes.”

     “Good. Well, have a nice day.”

     “You, too. Keep Cool.”

     With that, I help Tim get the kids ready for church and then head back to bed to doze off. After the house is totally quiet, and I’ve gone pee for the 10^th time that morning, I fall into a deeper sleep. I have strange, wake- up- prematurely- and- then- go- back- to- sleep- again dreams. In this dream I’m riding a bicycle down an empty country road. There are storm clouds up ahead and I keep thinking, “I better get home before the rain starts. I don’t have a rain jacket. I keep cycling, all the while thinking, “Laura, get home! It’s going to rain soon! Get home!” And yet, I keep riding. For some reason, I felt compelled to stay on that road and reach my destination, although I had no clear idea where that was. I just kept riding absent-mindedly, all the while thinking, “Laura, you don’t have a rain jacket! It’s going to rain soon! Get out of the rain!” The dream ends and then what seems like moments later I wake up feeling so refreshed. I lay in bed for about 10 minutes enjoying the sweet feelings of restful sleep. I feel Julia moving inside me and I talk to her. “Hey baby! We almost ejected you last night. But you just weren’t ready yet.” As I was feeling my belly and smiling at the thought of having a little extra time to enjoy this last baby of mine inside me, I had a tightening around my abdomen. Humh…I thought…Maybe today will be the day after all. But, really, I didn’t think so.

     With that, I rolled out of bed and got dressed, admiring my huge, very pregnant belly in the mirror. I hopped in the Corolla and went to McDonald’s for an extra large diet Coke. I arrived back home and delved into the yummy, scrumptious lemon meringue tarts from Costco that were left over from my trip to Newport Beach on Friday. I perused the Sunday paper, ate tasty bite after bite of lemon meringue tart, and washed it down with big gulps of diet Coke. Yum! Totally heavenly! (Perhaps not the most nutritious meal for my baby, but it’s a hard habit to break. And all my girls have been very healthy, besides.) And I enjoyed the quiet of my home. So quiet, so peaceful….

     And then Tim came home with the girls. I made them sandwiches and then told the girls that after a nap I would take them swimming at Bumpa’s. They were willing to rest quietly. Tim headed for a nap immediately after eating. The sleepless night and busyness at church totally wiped him out, like I knew it would. After settling Daisy down for a nap, and putting on a movie for the other girls, I lay down again with Tim and drifted off.

    About an hour or so later, while listening to the murmuring of the girls in the other room chatting, arguing, and whining while watching their movie, I decide to get up. I’m feeling tired and groggy, but know that getting out and spending time with Dad and Karen will be good for me. I can tell them what happened last night and get their take on it, as well as their reassurance and comfort.

     So, after rounding up all the girls' swim things and towels, we head out the door. I arrive at Dad and Karen’s and the girls mill around for a little bit while I talk to Dad and Karen. I explain the false alarm, Tim’s unbearable anxiety, my 1:30 am call to Dr. ------, my trip to the hospital, and then my decision to go back home. They listen attentively, smile, nod their heads, and offer their care and support. Someone says something, and then we all laugh. I head out the door to sit and watch the girls swim. Karen joins me about 15 minutes later and we chat about false labor, “frequent fliers” in the hospital during her nursing days, and lots of labor and delivery stuff. I always love those conversations. And then it was time to go. I collect the girls and all their stuff, we give hugs and kisses to Bumpa and Grandma Karen, and then head to In-N-Out for some burgers and fries, and another diet Coke for me, and then head home.

     Tim is home, awake, and reading. I plop the food on the kitchen table and then begin to serve the girls, Tim, and myself. I eat quickly and then tell Tim that I’d like to lay down and rest. I had felt more sporadic contractions throughout the day and was feeling very uncomfortable at this point. So I lay down and watched some TV. While watching TV over the next 2 hours, and letting Tim get the girls ready for bed, I feel more contractions. They’re painless, but increasing in that tightening feeling. I begin to time them – every 10-17 minutes is their range. I think, “Should I get up and walk around?” Yes, so I get up, use the bathroom, and talk to the girls as they’re getting ready for bed.

     I go to sleep that night and drift in and out of the awareness that I keep having contractions. They next day ensues with sporadic and increasing contractions. Finally, on Tuesday early morning they feel more intense and I think that this is the day. At round 4:30 am I call Dr. ------. I tell him things are getting more intense and he recommends I come in right away. We call Ann, who comes over and then 1 hour later, we leave for the hospital. My labor progresses well, I walk around, have my H20 broken, and then things get really intense until the epidural is administered. Relief! At 10:00 am I have Ann bring the girls in. Around 10:20 I feel the pressure intensify and I tell the nurse. She calls Dr. ------. About 10 minutes later he shows up, says hello to the girls, and then I begin to push about 5 minutes later. As the baby is crowning, I ask if Tim can catch the baby. Dr. ------ says, “Sure!” and Tim puts his hands over Dr. ------’s and they both guide Julia out together. The girls are on the side of me watching with big eyes and even bigger smiles. Julia is brought out, I let out a yelp of relief, she’s placed on my belly, and her cord is then clamped shortly after. Tim cuts the cord, the girls gather around, oohing and ahhing, and I smile and whimper in delight. My sweet little Julia! She looks so much like Leanne! Those big, round lips and that sweet little cry! Oh! What joy! 

     It is an intensely beautiful and sweet family moment. Such beauty and healing and redemption. Dr. ------ delivers the placenta, mentioning that everything looks fine. He then leaves the room. About 10 minutes later he returns and they prepare to take me to surgery. Prior to that, I try to put Julia on the breast and she is only a little interested in nursing. She suckles a little, and then kind of slips off the breast. I gaze down at her so in awe of her arrival and the beautiful birth that had occurred.My precious last baby - this baby that I had so wanted.

     This is what I imagined it could have been like. In my heart, I hold onto this picture. Somehow it helps. The 13 page grievance I filed against the doctor and the hospital tells a very different story, however. I’ll just hold on to this one, though.

Pregnancy Surprise?

  Wednesday, August 11th, 2010

     My period is 4 days late. It has not been even one day late in over two years since I had Julia. Like clockwork, every  25-26 days without fail. However, it is now day 31 and no period.
     Hmmm....
     I had my tubes tied about 30 minutes after I delivered Julia. I have the 1 1/2 inch scar above my belly button to prove it. Could I be the .003% of women that get pregnant after a tubal ligation? My obstetrician was clear that he totally cuts the tubes - not ties them, but a hard and definite cut.
     Hmmm....
     Could it be stress that is causing the delay in my period's arrival? This summer has been challenging in quite a few ways since Tim is not working and is home full time. But I don't think it's been stressful enough to cause a delay in my period starting. I've been sick, too, and have taken antibiotics this last month as well as used my inhaler several times. It's possible those are factors delaying the start of my period.
      I got to thinking. I always do in these situations. What would I do if I really was pregnant? First of all, I'd be ecstatic. I'd praise God! How hilarious and wonderful of God to surprise me and give me another sweet, precious, delightful baby and all this time I never had to worry about birth control. Really cool. The really pressing question, though....
      Who would I choose for my prenatal care and delivery of this baby?
     As I tossed and turned last night, trying to get comfortable next to Daisy, who's been sick this week, I pondered that process of finding care. This is what I became adamant in my mind about: other than an emergency, I would only go to a midwife for prenatal care and childbirth help. I would look into a homebirth and get recommendations for several midwives, whom I would interview. I would also call my health insurance company and look at coverage with midwives, which facilities, which health insurance options would most closely suit my desires, and inquire about an insurance-reimbursed  home birth.
     I can't afford $4,000 for a certified nurse midwife to deliver my baby at home. However, I would find out under which conditions my insurance would cover a home birth, even partial reimbursement. I would argue the case, with professional documentation, that I suffered PTSD with my last delivery in a hospital and could not risk that again.
     And I did suffer Post Traumatic Stress Disorder (see http://www.angelfire.com/moon2/jkluchar1995/) with my last delivery. My step-sister-in-law, a trained psychotherapist who specializes in PTSD, diagnosed me early on. My therapist who saw me before and after Julia's birth would verify the same findings as well. (Although, I doubted it at first because I had no desire to harm Julia or myself. I just felt extremely depressed and "broken", and cried a lot. I still cry over the whole thing.) I would argue that point with as much medical data and information that I could to see how far that would take me with my insurance. My back up plan would be a midwife-attended delivery at a birth center, and then last resort would be a hospital. But one hospital would absolutely not even be included in that possibility.
     And I would pray. I would pray before any conversation or decision was made. I would pray with every piece of information gathered, before and after every conversation regarding the whole decision-making process, and I would get counsel from trusted advisors.
     I would trust God, because, with my last pregnancy I did more fact-finding and thoughtful decision-making than praying. But still, I did ask God for help, I did choose wisely the facility and obstetrician after much thorough research, and had trusted friends advise me throughout the process. So, I have learned, that no matter how careful you are in these decisions, God has his way. He is good, he can be trusted, and he works all things out for his good.
     That being said, I'm sure I'll get my period today or tomorrow. If not, then I'll be praying! A lot!
Thursday, August 12, 2010
     My period arrived this morning - after I bought a pregnancy test which was, of course, negative. I knew it would be. But - 5 days late is unbelievable for me. I'm getting older, though, and I've been sick this month with a horrible bout of bronchitis. So....interesting couple of days looking at that whole possibility of being pregnant at age 40 with six kids. I was certain that I would only do a home birth in the event I ever found myself pregnant again. How I would pay for it would be a whole other matter, and convincing Tim. But I really believe that I will never be pregnant again.
     However, if anyone came to me for advice on these issues, I would most likely discuss the range of choices they had, advise them to pray and talk to others about it, and then direct them to a reputable midwife. I'd encourage them to consider a home birth, or at least a delivery with a midwife at a birth center, or deliver at a hospital and HIRE A DOULA. I would always encourage a woman to have a doula or someone they trusted, other than DH, with them at their delivery if it will be in a hospital. I'm relieved to not have these decisions anymore. Hopefully I can be of some help to someone else down the road some day.

Peggy Vincent and Her Amazing Birth Stories

     Several months back, my sister-in-law, Gillie, recommended Peggy Vincent's book, Baby Catcher.  I immediately requested it from the library and could barely put it down. This was one of the most riveting, fascinating, informative, and memorable books I have ever read. (And I love to read and read a lot, so that should tell you something).
     In Peggy's memoir of her years as a home birth midwife, she related the most incredible stories in the most rich and expressive writing I have read in a long time. She highlights some hilarious stories from the nervous, meddlesome physician father of the birthing mama to a hair-raising birth on a little boat during a wild storm. There's the heart-rending story of the young stud father-to-be who, after coming on to Peggy numerous times,  broke down after the delivery of his baby when he realized how powerfully affected he was by his child's birth.  There were accounts of dramatic hospital transfers and the politics of unhappy people and unfortunate circumstances. How her interaction with the obstetrical community in the Bay area to lawyers and hospitals shaped her career was incredibly compelling and saddening.
     I was so affected by the book that I would like to read it again. Quite frankly, I don't have time. But I would love to hear your comments about this book. Even if you're not interested in home birth, treat yourself to this book for an enjoyable literary experience. I'd greatly value any input or discussion of your favorite stories from the book. It's available in your local library.

My new blog! First entry...

     So this is it! I can't believe I'm starting a new blog but I'm so excited to get the ball rolling after I chose a name. I love "childbirth cheerleader" because it's so positive and upbeat. Birth should be a blast; a fun, exciting and wonderful event that is not so dissimilar to a sporting event. Women work hard to birth babies! They expend tremendous amounts of energy, sweat, tears, and some really prepare long and hard - like athletes do - for the big birth day. So, cheerleader seems totally appropriate.

     I went to the DONA International (DONA) web site some weeks back to look at how to become a certified doula. I started with their required reading list and have been getting those books from the library. I loved Ina May's Guide to Childbirth book. The amazing stories of complicated births that were resolved safely with wise, experienced midwifery care was astounding to me. I also was so enlightened by the concept that birth is well, rather sexual. The whole orgasmic birth thing has some merit to it. The blood flow needed in the perineum to help it stretch to avoid tearing as the baby crowns and is delivered is effectively accomplished by some hot and heavy kissing from dear hubby. Ina May and her midwife colleagues recommend this. It's an endearing concept that the way a baby first got into the woman is also a very helpful way to get them out.  That is, affectionate touch and cuddling is relaxing and invigorating regarding blood flow to the right places. What a phenomenal way to help a couple bond, too. I wonder how many husbands would be comfortable with this idea in a hospital setting. The whole issue of privacy might make a couple, or a man perhaps, uneasy. (My husband would NEVER have done this in the hospital and he was not a home birth enthusiast in any way. So, our births were  rather "Victorian" shall I say.) It's an idea I have tucked away and will inquire and explore at a later date with some other birth professionals.
     Anyway, for now I need to contact the right person to look into volunteering at the Pasadena Health Department as a doula or breastfeeding mentor. Any help I can give to prenatal or postpartum women would thrill me. I'm going to work my way through my reading list and evaluate my schedule to see what I can offer and when. This process might take years as my husband and six kids come first on my list of priorities. But I'm eager to explore this area of need in my community - something so close to my heart: mamas birthin' their babies.