Natural Miscarriage

There's a lot being said these days about natural childbirth. I really have little to add to the conversation beyond my hearty approval. Much less is being said about natural miscarriage. Truthfully, little is said about miscarriage at all...until you have one.

At the time I became pregnant with my first child, I knew about a dozen other women who were also pregnant. I wondered idly which of us would be the 1 in 4 that miscarry. In my 13th week, with no outward signs of trouble, I certainly didn't think it would be me. As no heartbeat could be found by Doppler in my midwife's office, I was sent to the hospital for an ultrasound. There it was confirmed that my baby had died several weeks prior, but the amniotic sac had continued to grow.

I asked for a picture of my baby from the ultrasound for my scrapbook. The technician didn't want to give me one, but the doctor in charge granted my request. There is little enough to hold on to in memory of a miscarried child. Some women are barely allowed to grieve the loss. For me the photographic evidence gave me something tangible to justify my grief, if only to myself, and to share with later children as I tell the story of our family.

Back in my midwife's office, I was given an option most women today are not. Most women, especially those who miscarry so far along, are promptly sent back to the hospital for a surgical procedure called a dilation and curettage or d&c. This is the same procedure used to remove the fetus in a first trimester abortion. Since I was involved with a program presenting a high school sex ed curriculum that explained the risks of these procedures, I knew that it wasn't just an easy fix without side effects. My midwife explained the reason for this procedure—fear of bits of the pregnancy being left behind and causing infection—but I asked if there were any other options.

A veteran of thousands of births, she shared my faith in my body to do what women's bodies have evolved to do over thousands of years. I tend to trust these natural processes over medical interventions that have only been around a few hundred years at the most. Especially pertaining to natural physical processes like reproduction that should not be considered illnesses or medical events in the first place. Because of that, she explained that I could just go home and wait for my body to birth this preterm, already deceased baby naturally.

Sound terrifying? I will admit that it would have been comforting to go through this process in a more typical prepared birth environment. It is just like childbirth only more painful and over more quickly. Unfortunately, the medical establishment highly disapproved of natural miscarriage at that time. In order to send me home my midwife had to delay reporting it and scheduling the d&c and hope that I delivered naturally before anyone caught on. Home I went, with a better than average understanding of birth thanks to my sex ed instructor history and Doula mom, and instructions to call if we needed any help.

A few days later I gave my husband the scare of his life. It was two in the morning when I started having contractions and, thinking it would be a while, I decided not to wake him. I was aching in my lower back and beginning to bleed so I climbed in the shower. The pain, worse than anything I had ever experienced or imagined, escalated quickly. He awoke in a panic to the sound of my agonizing vocalizations. He called the midwife who sympathized and explained that it should be over in about an hour and reminded him to either look to be sure everything had come out, or save it to bring to her to do so. In the meantime, the shower was probably the best place for me. Then, he paced helplessly in the hall, just being there for me.

In that hour I experienced gut wrenching pain compounded by soul rending grief. I saw the fear in my husband's face and understood the desire of doctors, husbands, and even women to try and avoid this agonizing scene. I also was able to release everything that hurt inside me at the loss of my first child.

Near the end of the hour I felt I couldn't sit on the floor anymore so I stepped out and sat on the toilet. I felt the urge to push and quickly delivered an intact amniotic sac the size of a large baking potato. Clearly everything was there, and the pain abruptly ceased. My mind and body were spent. My husband helped me get cleaned up and climb into bed. I slept for two days straight waking only briefly to eat and use the toilet.

And then I woke up. I woke up with renewed hope and renewed health. The process of natural miscarriage allowed me to grieve deeply and completely and I was done. I remember my baby's birthday every year but feel no compulsion to commemorate it, and I am comfortable talking about my loss with others. Through my experience I can better understand how some cultures incorporate forms of self flagellation in their grieving practices. There was something about experiencing physical pain in tandem with my emotional pain that helped me process it and let it go. Perhaps this is part of the appeal of running marathons in memory of loved ones lost to various diseases. It's not a guarantee of closure, but it is a more active path toward it.

Having had no medical procedures, I had no complication or recovery issues. A few months later I was pregnant for the second time with a healthy baby girl. Nine months later I gave birth to her naturally in a free standing birth center with no complications.

In the wake of my miscarriage I was astounded by the number of women who opened up to me about their own miscarriages. Given the odds, most women who have three or more children have had one. Many of these women carry their grief for years if not a lifetime. In later years, as I became a practicing Doula, I saw the damage carried by women who had undergone d&c procedures for miscarriage. Not only did it leave scar tissue on the cervix that prolonged labor in future childbirth, but it seemed to have complicated the grieving process. The disconnect between the physical loss and the emotional loss seemed to leave something undone. Something that needed to be exorcised during labor before the mother could progress and deliver her healthy child.

As a result of my experience, I strongly believe that natural miscarriage should be permitted in a medical environment to reduce the risk/fear of complications. I also strongly believe that it should be encouraged by the medical profession whenever possible for the emotional health of the women who must experience this loss. I understand that further study would be required before such a recommendation could become established policy, but a study is warranted. While I would never suggest natural miscarriage be mandated (no woman should be forced to deal with this process if she is not ready for it), nor that it is a cure all for grief, I believe that in our efforts to avoid pain, we often overlook the higher goal of complete physical and emotional healing. We would rather schedule a procedure than give our bodies time to do what they can to heal themselves. We don't like to acknowledge that some types of pain are good for us.

I am interested in the thoughts of other women who have experienced a miscarriage, natural or with d&c. Please feel free to share them in the comments.

Thinking About Vaccination

I've always been a bit of a skeptic when it comes to medical advice. After all, modern medicine is relatively new and progressing at such a rapid pace that it is still accurately called "medical practice." It's not that I avoid doctors. I find their work fascinating. But I want to understand why standard procedures are standard and make the final decisions about some things myself.

It is impossible to have children these days and not enter the debate about vaccines. If only in the point of making the decision for your own children. There are scary arguments on both sides. And the FDA, AMA, and CDC, all once trusted completely, have not exactly proven that they have the best interests of the American people at heart in recent years. With questions about their motives, their money, and their members come questions about their policies and their recommendations.

As a parent, I read all the articles. Those forwarded by health nut friends, published in parenting mags and on the web sites of the aforementioned agencies, and distributed by the hospital and our doctor. I particularly appreciated the arguments of Dr. William Sears in my favorite parenting book of his, and followed his recommendation to research the history of vaccines. Then I did some math in my head to try and better understand the motivations of the various sources. Having done all this, I sat down for a conversation with our family doctor to find a reasonable solution for our family based on the following points...the arguments that mattered to me.

First, vaccines revolutionized the world of medicine and when given across the board save far more lives than they hurt. Yes, a few children will have deadly reactions to vaccines, but thousands more are saved by them. If you're the one whose child dies, there's no excuse that will satisfy you. But if you're the policy maker of a nation, you must look at the overall numbers and make a recommendation that saves the most lives. The recommendations that have saved hundreds of thousands of lives. If you have a family history of bad reactions to vaccines, you may rightly consider avoiding them. Otherwise, please consider that the complete eradication of a disease, and therefore the need for future generations to be vaccinated against it, is possible if we can achieve a high enough level of vaccination across the global population in two generations.

Second, not all vaccines need to be given in infancy. The rushed vaccine schedule is recommended by the AMA and CDC because of low follow through rates on well child care visits, especially in poorer regions of the nation. My doctor called it the "vaccinate 'em while you got 'em" policy. If you're the kind of conscientious parent who is doing research about vaccines online, you're probably also the kind that will follow through on your kids well child care visits and selectively delaying some of the vaccines will not harm, and may actually be better for your child. As with many policies, the bar is set to catch the least careful parents, even though a slower schedule would be better for most children.

Finally, the human immune system is strengthened in childhood by overcoming disease. In other words, it's important for children to get sick and to get over it. Vaccination against deadly diseases is warranted. Vaccination against easily overcome infections is not. When I had this conversation with my doctor, the varicella vaccine for chicken pox had just been added to the recommended list and I was concerned that such an easily overcome childhood illness was being avoided. Also, flu vaccines we're beginning to be recommended for children. He was concerned also. His recommendation was that the varicella be held off in the hopes that an actual case of chicken pox could be had in early childhood. If that didn't happen, and it didn't because everyone else was vaccinating for varicella in infancy, then they should get the vaccine in their early teens as the infection was much more serious, and potentially life threatening, in teens and adults.

As for flu vaccines, he was appalled with the AMA's pressure to make them standard for children. He strongly believed that unless an individual had a compromised immune system, flu vaccines should be  avoided at least until after the childbearing years. Why? Research into the long term effects of bypassing the bodies natural process of immune system growth on such a massive scale was non existent. Since that system is passed in part from mother to child, he feared the overall weakening of the human ability to overcome disease and eventual vulnerability to a widespread plague. Bacteria and viruses are constantly mutating and adapting to overcome our medical treatments for them, but our bodies, through the marvel of the human immune system, also constantly adapt to overcome them. This happens much faster and far more accurately than the science of vaccination can create and predict artificial protections from new diseases. While we suffer more in the short term, we are building strength in our species to pass on to future generations. While this science of vaccination is a miracle for children whose immune systems have been compromised or who have a particular vulnerability to disease, the recommendation of flu vaccines for otherwise healthy children is destructive to the human species as a whole. Please note that all arguments I've read about individual vaccines have been about individual risks. Perhaps because self-centered arguments garner the most attention, but the risk to our entire species is far more compelling to me than the risk of individual bad reactions. It's also far more supportable by established science than individual anecdotal reports of bad reactions.

Ultimately, my children have been given the vaccines that are most important on a delayed schedule reflecting the value of immunity they received by breast feeding for more than a year and my doctors comfort with my commitment to regular well child care. Even though we've had to change doctors over the years, my ability to articulate this reasoning about vaccines has been acceptable and none of them have argued with or belittled me about this decision. I know this is not the case for parents who come in with articles that take extremist positions, have little scientific support, or take the position that the risks to the few outweigh the benefits to the many. Unless you have a strong reason to believe your child will be one of the few, a doctor must consider the risks of an unvaccinated child to the many. Remember what I said about comprehensive vaccination's ability to completely eradicate a disease.

At home I have focused my efforts on strengthening their bodies against disease rather than avoiding it. (You won't find bleach or many antibacterial cleaners and soaps in my home but hand washing etc. is practiced.) Our household usually goes through two good bouts of cold/flu a year, one in summer and one in the winter. It's miserable, but we come out stronger. I'd rather all get it and get it over with than try hard to avoid it and have one child at a time sick because there's really no avoiding it in the end. When I hear reports about companies requiring their employees to get flu vaccines because of statistics about economic loss due to sick days, I think how short sighted they are in their greed. As if a few billion dollars in the scope of our national economy is worth the gradual weakening of the species.

In the end, this is a decision every parent has to make for themselves. It puts doctors in an uncomfortable position as statistically "vaccinate 'em while you got 'em" is still the best policy for widespread success, while they are often more conservative about vaccines themselves. They face parents who want no vaccines and parents who demand every vaccine as soon as possible. There is an appropriate middle ground with some leeway for individual situations. I hope this is one of many articles you read as you determine the arguments that mean the most to you, and I would encourage you to approach your family doctor from a position of partnership in your families health rather than an adversarial position about the controversial subject of vaccination. You may find that they are very willing to adjust the schedule and delay or eliminate less important vaccinations for parents who are well informed and committed to regular well child care.  They will also have the most recent information on outbreaks of vaccine preventable diseases in your area so you can make informed decisions either way.

I am interested to hear which arguments most influenced your family's decision either way in the comments.

Responsibility and Regulations

A tragedy took place today in Connecticut, and already my Facebook page is full of calls for more gun regulations. The news will undoubtedly be full of articles and op eds by the end of the day, debating the subject in detail.

When I was seven and my little brother was five our dad took us out to the shooting range. He taught us gun safety and how to shoot straight. Then he braced us as we each took a turn firing his police handgun. There was no way for him as a police officer to not have a gun in our home. He taught us not only how to use one, but why not too. The power that slammed me back into his chest as I fired his gun kept me from even touching his locked gun box. It's still a vivid memory.

It's a pity that gun safety and respect is not a politically correct thing to teach your kids anymore. In me it shattered the fear factor that immobilizes most people in an emergency. Mine was the clear head that called 911 when shooting started in my neighborhood. None of the weapons involved were obtained legally by the way and the way the shooter ran across the street firing his weapon showed no one had ever taught him gun safety either. In my opinion, education is always a superior solution to regulation.

For personal safety I keep pepper spray around (I acquired it for bears when we lived in Alaska). In addition, we keep a couple of firearms locked away as a deterrent against a totalitarian government. Something I believe every law abiding citizen should do. Switzerland remained neutral during WW2 by requiring every citizen to bear arms. I don't think I'll ever have to use them. I'm not a conspiracy theorist. But that's why our founding fathers insured we have the right, and if we don't exercise it we take a serious risk.

More relevant to this tragic situation is the reality that psychos bent on destruction will find ways to achieve it, with or without guns. This is a human tragedy, which could only have had a human solution. Someone to see the distress of a lost screwed up person and care enough to intervene before he acted out in such a horrific way. We sideline the assholes in our society. No one has time to love them and figure out what's making them so screwed up.

Someone will argue that better funding of our state mental health facilities could result in reduced costs in state detention facilities. Maybe. But there will always be those who slip through the cracks because no one noticed they had a problem. We were all too busy.

I see other posts on Facebook that drive me crazy all the time. They masquerade as inspirational quotes about eliminating people from our lives who bring drama. Making it seem noble to look out for our own best interests at the expense of relationships where others depend on us.  In the wake of this tragedy, yes, we should hug our children close and treasure them. But maybe we should also take a moment to reach out to someone who drives us crazy. Especially within our own families. Maybe we should take a moment show them some love, to listen to what's going on in their heads. To be a human connection for someone at risk of losing their humanity. 

I'm not saying we have to let our lives be overrun by crazy people. But knowing our own boundaries and capability to act responsibly, reach out and love somebody who doesn't add anything to your life. Do it because someone you want to connect with, someone whose friendship has meant a lot to you, had nothing to gain from reaching out to you. Do it because you may be the one to prevent the next horrific tragedy from ever occurring. You'll never know. We only hear about the ones who slip through the cracks.

*** This post was featured in the Redwood Mpire Mensa Bulletin, June 2013 edition.

Going Stepford

Prerequisite: watch movie, The Stepford Wives, 2004 version, preferably on a date with your spouse.

Statistically speaking, the most important thing you can do for your children is keep your marriage strong. We are genetically wired to put our kids first, especially when they're babies. But if the best thing for your kids is happily married parents, then we may need to consciously reprioritize. One way to keep your marriage strong is to build memorable incidents of intimacy.

I don't know how the stereotype of intimacy at bedtime came to be, but I can think of nothing less inspiring than being attacked by my husband at the end of a long day of cleaning, errands and whining children who don't like what I made for dinner and can't sleep without a story. One of the tenets of a happy life is that you can't change other people, you can only change how you respond to them. I can't change the fact that he wants me anywhere and everywhere. He's male, and he married me. It goes with the territory. So I try to wear him out on my schedule, earlier in the day, as often as I can pull it off.

One of our favorites is what I call "Going Stepford". We're all modern women capable of doing anything a man can do. That's not in question. But on the rare occasions, when the house is really finally completely clean, it's fun to put on a dress and heels, set the table with candles and champagne flutes, send the kids to Grandma, and play the role of 50s domestic godess. If you can swing it and all the kids are in school, suggest he come home for "lunch". There's no way we could actually live the somewhat creepy Stepford ideals, and we wouldn't want to, but I doubt there is a man alive who hasn't fantasized about it.

Give him a memory he'll never forget to take him through the inevitable dry spells when you've been taking care of sick kids for two weeks and haven't bathed in nearly as long. Yes, that's how you make a marriage last for sixty years. Make sure the ups are up enough to carry you through the downs.

As a bonus, the anticipatory turn on I now experience as my house gets near to completely clean, gives me the oomph I need to finish.

Feeling Sick

I found this little gem in my files and enjoyed the distance I have at this moment from the horror I felt when I wrote it. 

Flossy felt like she had been buried in vomit up to her elbows then smeared with diarrhea.  Or maybe that was the toilet.  This was not the romantic image of raising children she had dreamed of.  This was parenthood, the front lines of the war on disease. She was in the trenches, where it's not enough to have to care for four explosive children.  You do it while exploding yourself.  There was not enough hot water in the world to wash away the stench, and only what she could boil in the house.  The hot water heater went out just before this latest battle, and it would likely all be over before the repair guy arrived.

Staring blankly at her dim reflection in the sliding glass door, after finally settling all the children in bed, she didn't recognize herself.  Neon green pajama pants her oldest daughter had sewn for her and a rainbow tie dyed t-shirt, also the gift of a child, looked harmonious, in a twisted way, with the greasy sloppily tied up hair.   Then she remembered that quick trip to the grocery store for more ginger ale and bread.  She left the house dressed like this!

Just when she thinks the end is near, Dad gets sick.  Yes, the man with whom she built this incredibly romantic life was now known to her as Dad.  Not at all surprising.  Her own name had been cast off some time ago in favor of Mom.  He was waiting for her in bed, with his vomit bowl and his ginger ale.  The end of a long agonizing day and her haven of rest was...ugh.  She sighed and curled up on the couch for a little respite.

Feeling scuzzy didn't mean it was actually so.  Truly, the carpet needed professional shampooing, but the rest of the house was mostly clean.  Two kids were ready to return to school in the morning.  The laundry was slowly catching up, though she doubted the efficacy of washing vomit towels in cold water.  Dishes were not too far behind thanks to her emergency supplies of disposable tableware.  Dad wouldn't care about the lack of clean socks in the morning.  He was on schedule to be moaning and running to the bathroom by turns come sunup.

If only she could take a bath.  When had a bath become the highest luxury she could aspire to?  Fortunately, it was something accessible in her normal everyday life.  Though perhaps she had become a little too dependent on those hour long vacations.  Missing them so desperately seemed wrong somehow.  At least her period was holding off for the hot water.  Nothing could make this worse than feeling like a bloody mess too.  Her body held off that one last little torment for now.  It had been a while since her last forty day cycle, but they were not completely unusual.  Unfortunately, the PMS part was the bit that got extended.  Another reason to want a long soak in a hot bath.  Every time she boiled enough water there was another child covered in excrement who needed it more urgently.

Sweet motherhood!  There was only one cure for this disgusting malaise.  Wandering slowly through the house shutting off lights and locking doors she breathed deep cleansing breaths, putting the day behind her as best she could.  Finally, walking into the kids bedroom, she found her sanity again.  Or if not sanity, the insanity that makes this life tenable.  The sleeping faces of her children, magically transformed into angelic beings so sweet and beloved as to bring tears to her eyes and a wild tightening about her chest.  That is after initially panicking and then locating the one who decided sleeping in the stuffed animal bin was preferable to cleaning off her bed.

The best part of some days is saying goodnight.

Success

About a fourteen years ago, when I was pregnant wth my first daughter, I caught a rerun of the Oprah Winfrey Show that had a real impact on me. Interviewed were two women who had done significant research into the backgrounds of highly successful women, and written a book about it. I don't remember their names, or the name of the book. I do remember them talking about their research and a few of the common traits they found. One was that most of the highly successful women were early readers. Others factors were like that, things that seemed not so much externally influenced.

One significant factor they uncovered was external. This is what etched itself on my memory. The most important thing you can do to raise successful daughters is to be successful yourself. That doesn't mean you have to make a lot of money or be at the top of your field. That means, whatever you decide to do, do it well. Make up your mind to pursue something, and pursue it. Your example is more important than anything else in determining the level of success your daughters will achieve.

The driving force in my mother's life was to be an excellent wife and mother. She cooked five meals a day, kept her house clean and laundry done, knew what was going on in her children's lives, and not only raised her own five well adjusted kids, but half a dozen others that landed on her doorstep over the years. She thrived on this and did not have outside ambitions to distract her from it. She was so successful that today many young mothers look to her for wisdom to apply to their own situations. My parents have found themselves counseling couples on the brink of divorce, and bringing them back into a healthy relationship. Wise counsel flows naturally out of their own struggles and experiences. Being raised in their home was like serving an apprenticeship in building a family.

The goals I have are a little different from my mother's. I care about being a good wife and mother, but it's not the only ambition that adds enthusiasm and purpose to my life. I'm not going to iron my kids blue jeans, and I can live with a slightly messier house. My passion is writing, and extending that love for family building outside of my own household. That's why I write this blog. When I get discouraged, I remind myself that if I move forward toward my goals even a little bit every day, I am doing the best thing I can to raise my daughters to achieve success in their own lives. What I might not do for myself, I am willing to do for my children.

So often we think of success in terms of our big dreams. My mom dreamed of running an orphanage, caring for hundreds of children instead of just a few. She's still pursuing that dream by supporting missions work overseas. I dream of changing the way displaced children are cared for in America. Of curbing the trauma often inflicted by our overburdened foster care system. Of putting the needed resources into the hands of young couples who have the passion and energy to raise families of hard to place children. That's too far off to be the thing I measure my success against, but it's still out there as the point on my horizon where my heart's compass directs me. The four lovely girls I am raising, dream of rescuing the orphans of India and Africa. Each generation is dreaming bigger. It gets me excited about their futures.

When we pursue something, we lay a track towards it that may never go all the way, but others will come behind, and ride the rails to their end, and begin to lay more track, until the dreams we thought impossible are achieved. That is how success flows from mother to child. That is how we have hope for our dreams. This is why I have to pick myself up when I get discouraged and lay another peice of track. I won't be the one to halt construction on a better future for my children, and for the world they will live in.

Maybe your mother wasn't successful. Half of my generation has divorced parents. I remember an article in my daughter's Teen Vogue about the pressure teens are under, taking care of irresponsible parents who refuse to grow up. You don't have to achieve something great in your life to be successful. You just have to lay the first tracks. Set your heart toward that thing out on the horizon
that calls to it, figure out a place on that path you can reasonably achieve, then move one small step in that direction. When your passion isn't enough to keep you going, here's your backup motivation; your success is a gift you pass on to your children, no matter what course you pursue.

No Heat

My heaters went out this week. All of them. Two wall heaters and the water heater. It made me realize how much I've grown up. I didn't call my dad to come help. He's too far away now. I managed to keep calm and call for repairs without getting emotional over the phone. I remembered that I know how to boil water on a stove for baths and that laundry doesn't have to be done with warm water. It was a conscious decision to let the dishes pile up and wait for hot water again. I do have some disposables to keep it under control. I am a grown up. Funny the things that make you realize it all over again.

It doesn't make it easier. The stress drove me out of the house yesterday. Sitting at home waiting for a phone call from the repair company is not my strong suit. Thanks to cell phones I don't have to. The emotional slump that hits with this kind of setback is real, and must be counteracted with Christmas music and baking. A particularly good idea since I'm heating the house with the oven right now anyway.

In the big picture this is good. Unsafe appliances are being fixed and most of the cost is still covered by our new home warranty. It would be a bummer to have our first year go by uneventfully and think we didn't need that warranty any longer, only to have a bad second year. Life is like that. Bad things can sometimes be good, and good things can feel like a major bummer.

Fortunately it will all be over within a week. Which only leads me to ponder, how blessed am I?!? I don't live in some dreadful part of the country where pipes freeze. I'm not dependent on a well anymore, so I don't have to worry about the pump going out and having no water at all. I have family close if I really needed to go somewhere to take a shower. I have electricity if I wanted to try bringing in a space heater. I'm stressing over the added strain to our budget as usual around the holidays, but I'm still richer than 99% of the global population. How odd those protesters are on Wall Street, railing against themselves. Okay, I'm feeling better now. I'm still gonna bake though, because my caramel corn is awesome!