Becoming a Midwife

Introducing Emma Karis Heneise! Emma means complete or universal, and Karis means grace or undeserved gift. She is such a blessing, and we are so thankful that she is ours forever. As the judge said, we were just waiting for the court to make legal a commitment that was already made in all of our hearts.

Yesterday, Emma joined with over 60 other children at Austin’s Adoption Day. The Juvenile Justice Center was transformed into a huge party with games and celebrations for everyone. The courtrooms were packed with stuffed animals, and the judges happily made legal one adoption after another! It was incredible to be part of such a big event. It really made me excited to see all of the other families. I really hope to adopt again someday (when our girls are just a bit older!).

Here we are: Ryan, Bethany, Emma (almost 15 months), and Selah (4 months)

On Wednesday we had a court date for our foster daughter, and we are now officially in the process of adopting her! On November 15th, we will join over 80 other children at the courthouse for a day full of adoptions to celebrate National Adoption Day. Then, I can share a picture and introduce you to our beautiful toddler!

My good friend Simone pointed out that we have come a long way from desiring a family last year – in one year we have become foster parents, had our biological daughter, and are now adopting our foster daughter! What an incredible blessing! Also, God provided for many more miracles than we could have even expected. Because we are involved in this Adoption Day celebration, a pro-bono lawyer will be provided to us, and our adoption can be official in less than two months!

Praise God, and thank you to all of our family and friends who prayed, wrote letters, helped, and supported us!

Selah Sofia is already 2 months old! She had some fussy times as a newborn, but she is rapidly turning into a happy, chubby, cooing, smiling little baby. She loves to say “goo”, hear us sing the Alphabet song, get hugs from her big sister…and she also seems to love filling up her diaper!

Selah is a word from the Psalms that means “pause and reflect” or “a thoughtful pause”, and Sofia means “wisdom”. We are praying that this sweet girl will make people stop and think about God’s love and goodness wherever she goes!

I love you, Selah!

I couldn’t wait to start breast-feeding – I believe it is one of the most beautiful, loving, nurturing, and intelligent things you can do as a mother. I read several books, including the classic The Womanly Art of Breast-feeding (the La Leche League’s official book), and I’ve even had experience doing breast-feeding counseling during my time as a NICU nurse. I knew that breast-feeding can often take some learning and adjustment for both the mother and baby, but I was confident that it would work out just fine.

I knew to expect the common breast-feeding difficulties – latching on, engorgement, and sore nipples. But, I was not prepared for the problem of oversupply. It may be just as frustrating as some other problems, and unfortunately, there is a lack of support and advice for this issue. At about one week old, my daughter Selah became incredibly fussy. Family and friends began to use the dreaded description of “colic”, and we tried every soothing technique and remedy we could find. A lactation consultant watched me nurse and was amazed at the amount of milk and force of the spray. We talked about some interesting positions for holding the baby while nursing, burping techniques, cabbage leaves – meanwhile, milk soaked through several receiving blankets as Selah fussed and tried to burp. As days went by and I reported continued fussiness and crying while feeding (both baby and I), I was finally encouraged to cut dairy out of my diet and try other major dietary changes. However, my research and mother instincts told me otherwise – this was not colic, Selah was not crying for no reason, and there had to be something I could do to help my baby. I knew that I had an abundant milk supply, but I did not realize what an effect it can have on breast-feeding. When I found a La Leche League article and read a list of the characteristics of true oversupply, it was like reading a perfect description of my daughter and me! Here are some of those classic symptoms:

• crying, irritable, restless baby
• baby gulps, chokes, or coughs while nursing
• milk sprays when baby pulls away from the breast
• baby seems stiff, screams, and nurses fitfully off and on
• short breast-feeding sessions, only 5-10 minutes long
• “baby may seem to have a ‘love-hate’ relationship with the breast”
• frequent gas and explosive stools

Midwives, lactation consultants, and well-meaning family and friends all had similar advice. They suggested pumping (I did hand-express milk, which helped, but I knew that regular pumping would just cause me to make more milk) and continued to suggest that it was a dietary issue (because Selah seemed so uncomfortable after eating). Conventional wisdom says that babies should nurse on both breasts at each feeding, often for about 10-15 minutes on each. However, I learned to dig deeper until I found a solution that actually made sense and worked for my baby and I. Just as I was beginning to doubt myself, and ready to begin the no-dairy diet, I found an amazing article from the Australian Breastfeeding Association. As much as I hated to admit it, Selah’s symptoms really did sound like lactose intolerance. Yet, this article explained that severe oversupply can lead to “Lactose Overload”, which actually mimics intolerance and is often misdiagnosed. The following paragraph from that article explained my experience perfectly, helped me realize what was causing Selah’s symptoms, and gave me the confidence to reduce my milk supply in the way they suggested.

“There is a vicious cycle here – a large-volume, low-fat feed goes through the baby so quickly that not all the lactose is digested. (More fat would help slow it down.) The lactose reaching the lower bowel draws extra water into the bowel, and is fermented by the bacteria there producing gas and acid stools. The latter often causes a nappy rash. Gas and fluid build-up causes tummy pain and the baby ‘acts hungry’ (wants to suck, is unsettled, draws up his legs, screams). Sucking is the best comfort he knows, and helps move the gas along the bowel. This tends to ease the pain temporarily, and may result in the wind and stool being passed. Since the baby indicates that he wants to suck at the breast, his mother, logically, feeds him again. Sometimes it is the only way to comfort him. Unfortunately this provides another large feed on top of the other one, which hurries the system further, and results in more gas and fluid accumulation. The milk seems to almost literally ‘go in one end and out the other’.”

I was able to solve my oversupply problem by nursing on only one breast at a time, often even focusing on just one breast for up to six hours at a time. This type of feeding signals the body that it does not need to produce so much milk. Engorgement is often a problem with oversupply, and may get much worse (with hard, hot, full breasts) when one breast is ignored for several hours. I found that the breast not being nursed on would leak profusely, solving much of the engorgement problem. If one really did become extremely uncomfortable, I would use a warm compress and express a small amount of milk – just enough to feel slightly more comfortable, without signaling my body to make more milk.

Selah’s extreme irritability, explosive stools, and screaming at the breast was mostly resolved within several days. She can still be fussy sometimes, and she still does not like that initial spray of milk during the letdown process, but she is now one of the happiest babies I have ever known. She often lays down after nursing, smiles, and talks sweet baby coos, as if to say “Yum, yum…Thanks, Mom!”.

My personal story is not a typical breast-feeding experience. If you experience an oversupply, talk to your midwife, doctor, or lactation consultant, do your own research, and decide what is right for you and your baby. If you do not have an extreme oversupply, use caution with this method of feeding, using cold compresses, or cabbage leaves – protect your precious supply of breast milk! I wrote this article primarily to remember my interesting experience with breast-feeding, and I hope that it will encourage others to do their own research and think for themselves! Feel free to write me with questions or for other breast-feeding encouragement.

After almost 9 months of ignoring my blog, I am finally back and ready to write again! I am still planning on becoming a midwife someday, but currently I’m interested in mothering, foster care, breastfeeding, and attachment parenting, so I will be writing about these things for a while.

Things have changed quite a bit at home – Ryan and I are now the parents of two sweet baby girls, and life is very busy and very fun. On January 5th, our foster daughter joined our family. She was four months old at the time, and now that she has just celebrated her first birthday, she is rapidly turning into a toddler (complete with walking, talking, and tantrums!). We are in the process of adopting this amazing little girl, so we hope and pray to share that wonderful news someday soon.

Then, on July 8th, I gave birth to another precious baby girl. Sweet little sisters, about 10 1/2 months apart! Life is so busy, especially when we’re trying to get them both to sleep at the same time! Our little girl has beautiful blue eyes, a huge smile, and loves to entertain us by talking sweet baby coos.

So, check back for some new articles in the next few days and weeks. I have some interesting articles planned!

I’m pregnant! I’m very late in updating this blog…on November 1st we took in our first 2 foster kids AND we found out that we’re pregnant. We only had those children with us for a week, but it was an incredible experience.

Now that I’m almost 14 weeks pregnant, it’s finally sinking in that it’s real, and I’m beginning to get a tiny bit of a belly bump! Our baby should arrive early in July. It’s so amazing. :)

It is kind of weird to be preparing to be foster parents when we don’t have any biological kids yet! But, I am confident that God will provide the strength and ability to be the parents our babies will need. So far, God has provided some very important tangible things. Thank you, especially to my good friend Debra for all of the wonderful baby supplies! It is so wonderful to have the basics provided for now.

Wow, our house is filling up with things – we’re getting closer to having a baby around!

I’ve combined several muffin recipes to try and make something both healthy and yummy…tonight I made some really good ones. Ryan tried one, and came up with this name – I think they are official now!

Cranbanoatsgurt Muffins

1 1/2 c. old-fashioned oats
1 1/4 c. flour (unbleached is best)
1 t. cinnamon
1 t. baking powder
3/4 t. soda

Blend the first 5 ingredients together, then add:

3/4 c. milk
1/2 c. packed brown sugar
2 T. yogurt (I used plain low-fat)
2 T. oil
3/4 c. dried cranberries
1 mashed banana

Mix just until blended, drop into greased muffin tin (paper liners won’t work as well) and bake at 400 degrees for 18-20 minutes

Enjoy!!

We just returned from a little trip to Fredericksburg, Texas for our 2nd anniversary! Fredericksburg is a little German town about 1 1/2 hours west of Austin in beautiful Hill Country. We’ve been missing those California mountains, and some of these hills and valleys really look quite a bit like California! We stayed at Camp David Bed & Breakfast, which is great – they bring breakfast right to your little cottage in the morning.

We were planning to go hiking at Enchanted Rock State Park, but we had a rainstorm, so we had to just walk and shop around town instead! We bought some Christmas gifts, and had fun exploring. Then, we had a wonderful romantic dinner to celebrate our anniversary at August E’s – we ate on the patio and watched the sunset over hill country. We’ve been thinking that Texas doesn’t have as many amazing restaurants as California, but this one was wonderful – fresh fish in the middle of Texas and incredibly tender steaks!

This was probably our last official romantic getaway before our home is filled with babies! We talked about and prayed for our babies, and we are really getting excited! I’m sure that our family will help us with baby-sitting so that we can still do these fun little trips, but life will be different!

These are some of the things we have been doing in the process of becoming foster parents:

• a health inspection of our home (first we had to baby-proof everything!)
• a fire inspection of our home
• creating a fire escape plan
• TB tests
• CPR certification (we made this fun: we hosted a class at our home – I provided childcare, and our friends and family learned first aid!)
• creating a list of house rules and rewards (that was a bit of a challenge, as we don’t have any kids yet, and we will be taking care of babies!)

There is still more paperwork to do, and we are attending several parenting classes this week. A social worker will be doing our home study tomorrow afternoon, so that is exciting! It is a lot of work, but as the director of our foster organization says, the kids are worth it!

Religion that is pure and undefiled before God, the Father, is this: to visit orphans and widows in their affliction. James 1:27

Ryan and I have been talking about adoption and foster parenting for years – before we were even married! Now, we have a house with an extra bedroom, family just minutes away, and a wonderful church family close by, and the longing to be parents…we are ready. We often talk about being parents, and all of the things we want to share with our children.

Adoption is such a beautiful picture of our relationship with God – how he has adopted us as his children into his kingdom. We have always wanted to adopt – but the challenges of time and money seemed impossible. Then, we learned about foster adoption…

Finally…here are some pictures from our new home. We had a lot of fun picking out colors and being creative (after years of living in white-walled apartments). The living room is painted a pale yellow/cream color called Havana Cream, and decorated with art and pictures from our travels to Haiti and Mexico. The colors of the walls get darker and more textured as you travel through the dining room and into the kitchen.

We had so much help from our church with painting and moving. At the time, we were very new to the church, and we felt so welcomed into the community. What a great way to make friends – thank you everyone!

I’m going to branch out and start sharing about things other than midwifery. So, check back soon…we have some exciting news coming up!

There are several websites that I look at almost every day. These are my favorite sites about midwifery, fertility, pregnancy, and parenting:

Mom Advice This website has it all – quick tips about running a household on a budget, cooking, cleaning, and parenting. There are interesting articles, recipes, and a community forum for talking to other women. It’s also beautifully designed!

Two Week Wait A woman named Elle created this site to offer hope and encouragement to other women while trying to get pregnant. It is full of wonderful tips and fun articles on how to get closer to that positive pregnancy test! The author also has her own blog, where she posts stories and pictures as she is currently pregnant with her first child.

Fertility Friend I use this site every day to chart my monthly cycles, temperatures, and ovulation. There is a chart gallery, helpful tips and answers about charting questions, and you can use it for free! They also offer a VIP service that provides even more information about fertility and charting. UPDATE – Fertility Friend now offers a free online course of 20 lessons to increase your knowledge of fertility and charting. Here is my certificate for passing the program:

Mothering Magazine Mothering is the magazine of “natural family living.” Their website provides many of the resources and articles from their magazine, on topics that I love (pregnancy and natural birth, babywearing, breastfeeding, parenting, and healthy cooking.

Spirit of Adoption I visit this blog every day to read the stories of this young family who has adopted two children, and are currently pregnant and expecting a third! I share their passion for adoption and parenting, and I love hearing their stories. If you look in the archive, you can read about their entire adoption process, a story that encourages me and makes me so excited to adopt someday soon!

I’m still here! It has been almost three months since my last article, but I am back!

We did not anticipate how stressful the move to Texas would be. Life has been crazy – quitting my job in California, driving out to Texas, moving into an apartment in Austin, getting lost in Austin just about every day, realizing that our apartment is way too small and falling apart, starting a new job, buying a house, trying to move our California corporation and re-incorporate in Texas, and getting ready to move again! Life is now beginning to settle down, and getting back into a sort of routine and rhythm. We are so blessed to have my family here, and we have also recently found a church family here.

I started my job as a NICU nurse here, and I have already learned so much! Soon I will get a chance to spend a day with the transport nurses, and attend some deliveries! Working with premature infants is totally different than anything else! I’ve had two years of experience as a pediatric nurse, but I feel like a brand new nurse again!

During my first week on the unit, I trained with a nurse by working with the “feeders and growers” (my husband calls them the “criers and poopers”!). These are the babies that are no longer sick, but just need some time to grow and learn how to either breastfeed or bottlefeed well enough to go home. I call this place the Baby Garden, because I felt like a very special gardener. Each baby is fed, assessed, changed, and repositioned every few hours, and they would just sleep the rest of the time! The room was usually completely quiet – just full of babies that do nothing but eat, sleep, and grow!

It is hard to find an area of nursing that interests me as much as my passion for midwifery. But, I have already grown so much in my ability to take care of newborns, and in my knowledge of the breastfeeding process. (Thank goodness my hospital is very devoted to encouraging all mothers to breastfeed!) The NICU is a challenging place to work, with so much to learn, but it is already incredibly rewarding. I am so fortunate to go to work in a place where I can see real living miracles.

• more stories about being a NICU nurse
• blogs that I read
• stories and pictures from our move to our new house!

I am getting ready to move to Austin, Texas where I will start a new job as a NICU (neonatal intensive care unit) nurse. I am so excited to have this opportunity to learn new skills and gain experience with this type of nursing. I have always been interested in any type of nursing that involves women’s health and babies!

My hope is that my training as a NICU nurse will provide me with wonderful skills and experience for becoming a midwife in the future. I have heard that midwives who have been NICU nurses are more comfortable and confident in situations when the newborn needs special care.

If you know of any NICU nurses who have become midwives, then let me know!

As an aspiring midwife (and an aspiring mother!), I have researched many midwives and birth centers in Southern California. Now, my family is planning a big move to Austin, Texas, so my research continues!

I thought it would be simple: get pregnant, find a great midwife, and get started having a natural birth experience. Then, I realized how much there is to consider, and what a big decision it is to choose your birth assistant. A friend of mine is expecting her first child, and I am learning so much as I watch her make decisions about health insurance coverage, midwifery care, physician and hospital back-up, and more.

Several months ago, I visited the Austin Area Birth Center at their old location. I was very impressed by the facility and the midwives that I met during my tour. This birth center is just another reason why I am excited for my upcoming move to Austin!

Today, I visited Austin ABC’s website, and I was very pleasantly suprised! They have moved into a beautiful new facility, and their newly designed website includes pictures and descriptions of the rooms and services. In their review section, I was excited to watch a clip of the birth center featured on the local news! Austin ABC has presented midwifery in such a beautiful and professional way.

It may take time and persistence to obtain health insurance coverage for your midwife-attended birth! If you are planning to move or change health insurance soon (as I am), then it is a good time to investigate the type of plan that offers you the flexibility to choose the type of birth attendant that you want. Having a natural birth with a midwife is a priority for me, so I have many questions about health coverage.

Questions to consider:

• What midwifes and birth centers are in your area, and are they able to bill health insurance?
• Are you able to find a midwife in your insurance company’s network? If not, are you able to change your insurance provider?
• Will your insurance cover hospital and/or physician care if there are any complications during the pregnancy or labor?

Doula is a Greek word meaning “a woman who serves.” A doula refers to an individual who is specially trained to support women during pregnancy, childbirth, and the postpartum period. This care may include breastfeeding support, physical and emotional care during childbirth, and providing help to the mother and newborn in the first few days after birth.

One of my goals for 2006 is to attend a doula workshop and to begin the process of certification. There are several organizations that provide certification, but they are similar in what they provide:

10. Read books about birth and midwifery (There are so many books on my Christmas wish list!)

9. Attend a midwifery conference (I went to my first one this year!)

8. Visit midwives and birth centers (I visited 2 birth centers this year!)

7. Take a doula course (hopefully next year)

6. Find a job related to birth (hopefully next year)

5. Write articles about midwifery (New Years Resolution: write more blog articles!)

4. Research midwifery schools

3. Have babies of my own!

2. Have more babies!

1. I can’t wait to have children, and get firsthand experience about birth, midwifery, and everything related to babies. (hopefully next year!)

I was first interested in NFP as a way to postpone pregnancy, and the more I learned about it, the more I grew to like it. It is educational and empowering to learn about your body and to intimately understand the miraculous workings of your fertility.

I just returned from the Bahamas, where I attended Midwifery Today?��Ǩ�Ѣs international conference about ?��Ǩ?�Sharing the Culture of Birth.?��Ǩ? It was such an honor to learn from experienced midwives and to meet many people involved in birth all around the world.

• learning from Dr. Michel Odent, an incredible French obstetrician and author who supports natural birth
• meeting many Bahamian midwives and learning from their stories
• learning about the benefits of herbs and homeopathy in pregnancy from Lisa Goldstein, CPM, CNM
• meeting other midwives and doulas who share my passion for encouraging women to trust their bodies to birth naturally

• exploring the island on a motor scooter, and learning to drive on the left side of the road!
• famous Bahamian rum cake
• learning that ?��Ǩ?�grilled fish?��Ǩ? usually means an entire fish ?��Ǩ��� head and all!
• flying over the beautiful islands and water

Expect many articles to come as I absorb what I have learned!

This is my first book review! I read so many books about birth and midwifery that I will begin sharing my favorites here – please feel free to share your comments, and also suggest other books to read.

Giving Birth by Catherine Taylor is a narrative of the author’s journey through pregnancy, becoming a doula, and learning about birth through the eyes of midwives. Taylor writes in such a friendly and honest way, and provides intimate examples of births at hospitals, birth centers, and at home.

Although it does not seem like the author is planning on becoming a midwife, her passion for natural birth and midwifery is apparent. After having her second child, she writes about not compromising her dreams to have a natural birth. She concludes that dreams matter; they are the way change begins Taylor, p. 300.

This book was such an encouragement to me as I begin my journey in midwifery! Next month, I will share about the book I am currently reading: Ina May’s Guide to Childbirth.

Birthing Table in Haiti

I can remember my days spent in the maternity ward in Haiti so clearly. In some ways, I imagine this is how birth was in the United States only a few years ago – no men allowed, no home-like atmosphere, no freedom of choice for the women. It was a time of frustration and inspiration.

It was incredible to observe the Haitian women birthing. Their cries of “mezami” (“oh my goodness”) and “m’ap sufri” (“I’m suffering”) were shouted between peaceful moments of caring between mothers and daughters, siblings, and friends. I spent many hours waving makeshift fans on a hot afternoon, or rubbing the back of a laboring woman. I often heard the words “vini, blan” (“come, white girl”) as the women craved gentle touch and attention.

I was never fortunate enough to observe a home birth – and that is the way the vast majority of births take place in Haiti. However, I did assist at a local clinic on infant vaccination day, and I saw newborn infants with their umbilical cord stumps tied tightly with a piece of cloth by the local midwife or birth assistant. I watched the love that women had for their children, and I knew that they wanted the best for them – everything they had to offer and more.

It is my dream to open a birth center in Haiti. I envision a place where midwives are professionally trained, where classes are offered to birth assistants and family members, and women are provided with a safe and loving place to give birth. That is the primary goal in my journey to become a midwife.

You can click on the picture to see my photo album of birth in Haiti.

I am quickly realizing that midwifery is my passion – the one thing that I can learn about with boundless energy and excitement. For as long as I can remember, I have been amazed by pregnancy and childbirth. When I was studying to be a nurse, I felt honored to be present in the hospital with women during the birth of their child. However, something kept me from pursuing a job as a labor and delivery nurse. I felt uncomfortable with the impersonal, medical way that birth is often treated in the hospital.

After I graduated from nursing school, I spent several months volunteering as a nurse at a small hospital in Haiti (in the Caribbean West Indies). There, I observed as women in the hospital would lay flat on a table during the birthing process, and accept routine episiotomies and other procedures – typically without pain medication. In a country where poverty and sickness are enormous problems, hospital birth appears the only way to protect the safety of the mother and child – but must they sacrifice their desire for a personal, compassionate birth experience in which they have the freedom to make their own decisions?

I have a strong feeling that birth is much more powerful, intimate, and wonderful than these medical processes I had witnessed. In my searching, I have found women who desire their births to be treated as the normal event their bodies were created to do, and not simply a medical diagnosis that must be treated.

It is my passion to become a midwife who can combine in-depth knowledge and experience with gentle support of the woman’s natural ability. I am excited to begin the journey to becoming a midwife, and especially to someday experience the amazement of birth myself!

I hope to begin my midwifery education next year! I have been interested in childbirth and midwifery for as long as I can remember, and in the last few months I have been researching the type of education I want to pursue.

As I begin my search for an education program, here are some things I have learned:

1. Research what kind of certification you will need to practice in your state (the State of California’s website has a detailed description of the necessary licensure)
2. Spend some time on Google searching for schools, midwives, and birth centers
3. Visit midwives’ websites or in person, and find out where they went to school
4. Learn as much as possible – read books, attend conferences, etc.
5. Look for experience you can obtain now (for example, I started volunteering at a local birth center)

Share your ideas, and we can all learn from each other as we continue the journey toward becoming a midwife!