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Miscarriage Questions: 10 Year Anniversary Interview Part 3
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Miscarriage Questions: 10 Year Anniversary Interview Part 3

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Interview Pt 3: Miscarriage

This month I’m continuing to answer questions that were submitted by readers for Gentle Delivery’s 10th anniversary “ask the midwife” series (feel free to check out Part One and Part Two if you haven’t read them yet!) There were several questions asking about miscarriage and how that affects future care, and I’ve decided to make that the focus for this month. Sadly, miscarriage is a reality for many moms, and I’ve had more moms than usual experience miscarriage throughout this past year. Hopefully some of these suggestions and this information can be a blessing to those of you walking through this valley, or those of you wondering what happens next…

What is your approach when a client has a miscarriage? What do you say or do to help her through the process, and if she gets pregnant again later, does your prenatal care for her and the baby look different in any way?

This is one of the “flipsides” of midwifery practice…it’s not always dealing with excitement and new babies. Oftentimes miscarriage occurs “out of the blue”, and usually there is no obvious explanation, even though we usually wish we knew why, or what happened.

Typically, a client will have just been in touch to let me know that they are excited to set up a time to talk about homebirth (or resume care if they were a previous client), and then they let me know that they are having some spotting. Spotting in and of itself can indicate an impending miscarriage, or it can be indicative of an irritated cervix, or it can be sign of a “subchorionic hematoma” (which usually results in spotting/bleeding without harming the baby, and resolves on its own). Quite honestly, if a miscarriage is going to occur, there really isn’t much that you can do, as oftentimes if it is indeed going to progress into a miscarriage then the baby has already died by the point you are experiencing spotting. But the unknown is not easy, as you want to KNOW what is going on. Our options at this point include doing labwork to see where the progesterone and Hcg levels are by now and going in to an OBGYN or an ER for an ultrasound (usually this is a vaginal ultrasound in order to get the best look at the uterus in early pregnancy). If the mom is 5 or 6 weeks or more, they should be able to visualize the baby, and be able to tell if the heart is beating, and labwork can reveal whether the pregnancy hormones are continuing to increase as they should. If mom prefers to wait, then there are some herbs that can be taken, and some moms choose to also use progesterone cream to help support the body until we know for sure what is going on.

If the ultrasound or labwork shows that miscarriage is inevitable, then I try to offer support and encouragement while the mom walks through the next several days. In most cases, mom is able to pass the baby on her own, and we stay in touch via phone or email. Spotting usually progresses into bleeding, and cramps accompany the bleeding as the cervix dilates enough to pass everything, which typically happens within a week of the initial spotting. In the event that it takes a longer amount of time, then we can use herbs to help encourage things to move along, we closely monitor for infection, and occasionally we need to transfer to an OBGYN for further care.

Once a miscarriage has taken place, I really encourage moms to take it easy, and make sure that they give their body time to heal both physically and emotionally. Oftentimes a mom can be left feeling very tired and anemic, as the body usually loses a significant amount of blood, and the intensity of labor can leave her worn out. There is also the emotional side of processing the loss, and this combined with the hormonal swings that go along with pregnancy followed by delivery can create quite a roller coaster of emotions to work with, and mom needs to know that this is normal and okay…and that her body is grieving and adjusting, which takes time!

The good news is that a previous miscarriage in and of itself does not negatively affect care for a future pregnancy. As I mentioned before, we usually don’t know what the root cause was, but there are many moms who go on to carry a healthy pregnancy following a miscarriage. Sometimes it can help a mom to relax more if she has more frequent monitoring during the early weeks of pregnancy after a miscarriage, and I am glad to do progesterone and Hcg testing to make sure that these levels are increasing like they should during the initial weeks. Oftentimes these moms also want to get an ultrasound performed earlier, in order to know that everything is looking good and that baby is growing like he should. Other than these factors, there isn’t much different for prenatal care, unless a mom has had several miscarriages in a row.

If a mom has had several repeat miscarriages, I highly recommend consulting with a NaPro Fertility Specialist (these providers concentrate on helping to achieve and maintain correct hormonal balance in order to prepare a mom’s body for and help in maintaining pregnancy). Many moms have inadequate progesterone levels, and having a specialist helping to monitor levels and provide prescription strength progesterone when needed can be a tremendous blessing, and prevent the trauma of further losses.

In closing, here are some suggestions if you are walking through a miscarriage:

  • Drink red raspberry leaf tea frequently in order to help balance your hormones and increase your iron as you recover (although stop drinking if you become pregnant again, until you reach the second trimester).
  • Take Evening Primrose Oil to help regulate hormones and support the body.
  • Consider taking an herbal-based iron supplement for several weeks to help restore your iron levels.
  • Take time to rest, don’t push yourself too hard, drink a lot of fluid, and take time to reflect on the short life you were given to carry, and allow yourself time to recuperate and heal before trying to resume your normal responsibilities.
  • Check out these sites that have further tips: Healing After Miscarriage and Healing Naturally.

And if you are preparing for pregnancy following a miscarriage, here are some ways to support your body:

  • Take folate (not synthetic folic acid!) and methylated B vitamins regularly.
  • Start taking a high-quality plant-based (not synthetic!) prenatal vitamin to build your body’s supply of needed vitamins and minerals.
  • Look into the benefits of using a quality, natural based over-the-counter progesterone cream to help promote healthy progesterone levels.
  • Consider having some herbal tincture on hand (such as C & B formula from Mountain Meadow Herbs) that you could take at the first sign of any cramping or spotting-this tincture helps to calm the uterus.
  • Check out this blog post for more practical tips: Preventing Miscarriage

In closing, would you have any suggestions you would add? If you have experienced a miscarriage, what was the best information and advice you were given? Any suggestions for moms hoping to get pregnant soon after going through a loss? I’d love to hear your answers if you would be willing to share!

 

The Birth Story of Baby Darius
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The Birth Story of Baby Darius

It’s hard to know where to start with Darius’ birth story, as there were several starts-and-stops along the way during the last week or so of my pregnancy. Joel will shake his head and say something along the lines of “shouldn’t a midwife know when she is in labor?”, but once again I had trouble figuring it out.

To give some background (especially if you’ve read my previous birth stories), we had used our dear friend Rose as our midwife with our girls, and she ended up being the first one on the scene after Matthias was born (she was home on a school break THAT weekend, and our midwife was on her way from Lancaster, but Matthias came in a hurry-read his birth story here). We love her, but due to a variety of reasons (especially the fact that Joel has no desire to ever catch one of his own babies again) we decided that this time we needed to use a midwife who lives closer to us. In the past two years I have been blessed to meet and work with Rose Marie Spicher, a midwife who lives half an hour away, and who worked for years in TX (where I did my midwifery training). She provided the “mothering” care I needed throughout my pregnancy, and it gave Joel a sense of relief to know she wasn’t too far away. With me being on maternity leave the month of May, and the fact that everyone else was expecting in May as well (I have NEVER received so many inquiries for one particular month!), I was just hoping that she wouldn’t be tied up whenever our baby decided to come!

So fast-forward through all the months of sickness, fatigue, finding out that we were expecting a baby brother (the children are still certain this was a direct result of their prayers, as I was convinced it had to be a girl given how sick I was!), and everything else until the beginning of May. By early May I was reaching that totally-done-being-pregnant stage where I wasn’t sleeping at night, having lots of cramps  & contractions, felt extremely emotional all the time, and we were wondering just when this little fellow would decide to make his appearance. Between 34-36 weeks I was experiencing enough cramps and contractions to know I needed to take it easy, and once we hit 36 weeks I had a couple of times where I thought perhaps we were getting started-I distinctly remember one night when I couldn’t sleep because of contractions, so Joel & I slipped outside to take a walk in the moonlight. It would have been so romantic if I hadn’t been so uncomfortable! But everything always fizzled away, and left me feeling tired and discouraged.

At this point we were preparing for a visit from my parents, who live in Kansas. My sister had her first baby the month before, and my mom wanted to come out to help her over the time my brother-in-law was graduating and they were preparing to move. So she flew into northern PA, spent a few days with my sister, and was then joined by my dad. The plan was that they would drive down to see us before they headed back to Kansas, and of course we hoped that baby would arrive before they left, though we knew it was entirely possible that he would wait until they were home again. However, with all the early labor signs I had been experiencing, I’ll admit that I was getting my hopes up! Mom & Dad planned to arrive on Mother’s Day, and the night before I was trying to encourage things along, and ended up with a night of contractions with no baby to show for it. Everything was regular enough that I actually called my midwife to give her a heads up, but then it all petered out.

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Mother’s Day 2017

I really had to work through the disappointment of knowing that perhaps my folks wouldn’t get to meet their grandson on this trip. We didn’t know when we would be seeing them next, and I hadn’t realized just how much I had my heart set on them getting to be here to see MY baby while he was new and tiny. It took some talking, praying, crying and processing with Joel to get to the point of being okay with the fact that perhaps this time with mom & dad was to be spent enjoying their company and not stressing over whether baby was here or not. So for the next few days, my parents helped to take my mind off of waiting for baby, and we enjoyed some lovely family time at the park, taking walks, picnics, a backyard barbeque, and some time for Joel & I to be together while our children were cared for.

The last night of their visit, they took our two oldest children back to stay the night with them in their cabin. In the interest of full disclosure, I had taken some castor oil in the afternoon, knowing full well that there was a good possibility nothing would come of it, and yet hoping that perhaps it would give my body the nudge it seemed to be waiting for. I was NOT going to get my hopes up, though, and I tried to just go to bed to get some sleep. I think it was around midnight or 1am when I woke up with a contraction, and yet I tried to sleep, as it sure wasn’t the first time that random contractions had woken me up at night! After an hour or so of not really sleeping, I figured I might as well get up to see if moving around made them go away or get stronger.

Joel sweetly got up with me, and fixed me sourdough toast with strawberry jam-his mom had given me jam and sourdough bread the week before, and it was becoming a regular midnight tradition to eat a piece when I couldn’t sleep! After another hour or so, Joel commented that these contractions seemed to be pretty regular and close together. I did NOT want to give another false alarm to anyone, and didn’t feel sure that this was anything more than what had happened on previous nights. Looking back, they were coming close together (every 2-4 minutes!), but they weren’t very intense, and they didn’t last long, so I wasn’t convinced they were doing anything. With my previous babies, my water had always broken either before labor began or at the start of active labor, so I kept waiting for that to be the clue that this was the “real thing”.

At 4:00am, Joel really felt like we should call Rose Marie, as he said he thought this seemed more serious, and he did NOT want to wait until it was too late! So I  called Rose Marie, and I told her I still wasn’t sure this was “it”, yet Joel would feel better if she came, but she didn’t need to rush. The contractions were starting to get a bit more of an “edge” to them that took my breath away, but I still felt like I could make myself talk through them, though I preferred not to. Another sign I should have paid attention to!

Within 15 min of calling Rose Marie, all of a sudden things kicked in with a vengeance. Up till now I had still been puttering around, but hadn’t gotten birth stuff out yet, as I had gotten it all out and then had to put it all away a few nights before. I wanted to make sure I was in REAL labor before getting everything set up again, and figured I could do it in between contractions as a distraction. Well, that’s not how things happened. Labor went from being “not sure this is it” to “we’re in seriously active labor” in a few minutes! Joel called Rose Marie back and told her to step on it, and then he promptly called Lynelle (my birth assistant who was planning to assist Rose Marie with our birth-she lives less than five minutes away) and told her to come. I think it was around 4:30am when Joel called Lynelle, and boy did she know how to get over to our place in a hurry! Joel said he has never in his life been so happy to see Lynelle walk into a room, and it was just in time.

By this point my contractions were one on top of another, and I felt like I didn’t have any time to collect myself, catch my breath or get a break in between. Joel kept encouraging me to breathe through them (he didn’t want me pushing!), and I was leaning over the birth ball squeezing his hands for all I was worth, just praying that God would make it stop so I could catch my breath. Lynelle quickly realized things were serious, and started pulling all the birth supplies together. All of a sudden I told them there was no way I could keep from pushing any longer. It had been taking everything I had to blow through contractions, and I was done. I distinctly remember saying “you all are just going to have to catch this baby ‘cause I can’t keep him in any longer!” Lynelle calmly replied that everything was okay, and with the next contraction my water broke. Now I can laugh about it-that was the clue I had been waiting for all along to tell me if I was actually in labor! With the next contraction Lynelle could see his head, and she did an awesome job of coaching me through as I tried to breathe him out. Right at the point his head was delivering, Rose Marie walked in the room! Lynelle started to move out of the way, but Rose Marie just smiled and said it looked like she was doing a great job, so she might as well continue. Rose Marie guided Lynelle through the rest of her “first catch”, and the official birth time was 4:56am.

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Those first moments after birth…

I can still remember the absolute relief that comes from being finished, and laying down with my baby on my chest. He cried just enough for us to know he was great, and then he snuggled on my chest, and we all exclaimed over his head full of strawberry blonde hair-that was a surprise! We had a really special next hour or so as we reflected over the crazy labor, the special-ness of the unplanned “first catch” for Lynelle, Rose Marie’s perfect timing, and Joel’s relief that he didn’t have to do this birth alone. We had invited another family friend to be present at the birth, and sadly she didn’t make it time, but her sweet & joyous spirit added to the atmosphere in the room as Joel fixed breakfast and baby Darius had his first meal. Thanks for coming, Mary!

And then it was SO amazing to call my parents and tell them that their grandson had arrived! Having them able to bring our oldest two over first thing that morning was so special. They were able to watch the newborn exam, meet our midwives, and see the children as they delighted in meeting their new sibling. It was the “icing on the cake” to have them around, and able to snuggle their newest grandbaby that morning, before they had to leave that afternoon to catch their flight home.

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Yoanna & Matthias and Grandma & Grandpa meeting baby Darius. Yoanna was delighted to help Lynelle give him his first bath!

We had struggled with finding the right name for our little guy, and settled on Darius Rafael just a few weeks before his birth. Darius means “Upholder of Good” and Rafael means “God is Healer”.  It is our prayer that our little son will grow into a man who does good, and is used to provide God’s healing to others. He checked out at 8# 10 oz, and measured 20 in long. Matthias was absolutely delighted to have a baby brother, and they continue to have a special relationship as brothers.

Here’s a few more snapshots of Darius’ “birth” day…enjoy this glimpse into our little family’s life, and feel free to check out the birth stories of our girls, Talitha & Yoanna.

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Big sister Talitha was pretty excited to wake up and find that baby brother had “come out!”

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Rose Marie checking baby out

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Our amazing birth team-thanks so much for everything!!

Birth Photographers: Local Options!
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Birth Photographers: Local Options!

If you’ve been following the Gentle Delivery Facebook page (go like and follow here), you’ll remember seeing some photos this month of adorable newborns. April has brought some really cute babies! And there is something so precious and amazing about how these babies look in the first minutes and hours that can’t be captured at any other time. I am personally SO grateful for the dear ladies who took photos during those initial moments with my babies (one of my highlights of my baby born last year!), and it’s been something that I wish more women could have access to.

However, when I moved to State College, I was quite surprised to find out that birth photography itself isn’t a “thing” in this area. There are some great photographers willing to do newborn and “Fresh 48” sessions, but there’s not options for the mom who wants professional photos taken immediately before, during and after delivery. Now, to be fair, birth photography is a challenge-you’re asking someone to be on call, drop what they’re doing whenever you call, and to commit without knowing when, how long, and all of those details that make planning challenging.

But today I’m delighted to introduce you to some local options for birth photography that have very recently surfaced in this area! So, if you’re interested in hiring a photographer for your birth (one that can take lovely photos instead of the inexperienced shots that your midwife and her assistant get!), hopefully this list can help you by giving you some leads. If you’re wondering what all is possibly entailed in having a birth photographer at your birth, or what types of photos, etc., I would highly recommend you check out the sites of a few birth photographers that work in other areas of the country. A few of my favorites are T. Marie Photography , Monet Nicole, and Lyndsey Stone.

Catherine Malizia: Catherine recently contacted me, telling me of her interest in the area of birth photography. She stopped in my office for a visit, and I had a delightful time chatting with her and hearing about her vision to capture the amazing and special moments of birth for families. She is acquainted with birth in various settings, especially after spending some time serving with Midwives for Haiti. I think Catherine would do a beautiful job of respecting a family’s space and wishes in a birth setting-she definitely had the type of rapport that I think many moms would connect with. If you’re interested in hiring her, I’d recommend getting in touch and asking questions…she may be running some specials as she gets her “birth side” of her photography business off the ground! Besides her website (linked in her name), you can also contact via email: catherine@CatherineMaliziaPhotography.com

Denae Vigilante: Denae also works as a doula with the Doulas of Central PA agency. I had the privilege of attending a birth with Denae, and was impressed by her kind, gentle mannerisms. Birth photography is something Denae is doing more of these days, and you can check out some of her albums on her website!

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Photo Credit: Denae @ Vilgilante Photography

Sara Blose: Sara has recently joined the State College community, and is exited to offer the option of birth photography to her photography options beginning with due dates in November. I’m looking forward to meeting Sara in person, but am glad that there is yet another option for families in this area.

Are you planning to hire a birth photographer for your birth? Or are you local to the Central PA area, and you used a birth photographer? I’d love to hear about your experiences, how you chose your photographer, and what you’re looking forward to the most, or what you appreciated the most about utilizing a photographer. I’m sure other families would love to hear of your experiences, too, so thanks for sharing!!

Natural & Nutritious Formula Options: Resources & Info for Families Needing a Healthy Alternative to Breastmilk
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Natural & Nutritious Formula Options: Resources & Info for Families Needing a Healthy Alternative to Breastmilk

Before I had children, I would have said that breastmilk is the absolute best choice for feeding a baby, and that a mom should try everything possible to breastfeed…and that if you tried hard enough, you would be able to succeed. However, once I entered the realm of motherhood, and actually experienced the things I had only previously read/observed/seen, I have learned that ideals are not always reality. My youngest baby just turned 10 months old, and I have once again faced the challenges of tongue-ties, latch issues, lack of sufficient supply, colic, fussiness, food sensitives, and more. Some of those subjects will be material for future posts, but I mention them to give you the background as to what inspired this post. As we have worked through these challenges, my husband has encouraged me that perhaps the things we learned will benefit others, so this is an attempt to do just that!

If you’ve struggled with nursing challenges, you totally understand the emotional roller coaster that is included. For some reason, the inability to feed and nurture your baby via the way in which you were designed to nourish him cuts deeply into our mother-hearts. As we tried one thing after another, I also felt like I was mourning a loss…I WANTED to nurse my baby, and I wanted to feed him the best, and know that I was nurturing him both emotionally and physically. I mean, breast milk is the best, right?!? And on top of those emotions (and who is not hormonal and emotional when you have a baby, aren’t sleeping, and are worried about your baby’s health?!?), there are all the questions about what to do, and if you’re going to supplement, what are you going to use??

This is where I want to help! While I know it can take a while before you can look at your situation objectively, there ARE other options available by which you can feed your baby and know that you are giving him something that is actually going to help him thrive and will meet his nutritional needs. I think that moms in the midst of feeding challenges have enough on their plates that they don’t need to add sorting through all the supplement information on top of it. My hope is that I can give you some pointers, and put some information at your fingertips in order to simplify your quest to figure out what is best for you and your baby.

As I spent time researching different options available, here are the three categories that I would recommend checking out:

  1. Weston Price Foundation Home-Made Formula: (find info here) This is what I used with my second child, who had similar nursing challenges and needed to supplement. At the time of his baby-hood, we lived in a rural area and had access to organic, raw milk from a dairy I trusted. He did really, really well on this formula, and I liked the fact that I knew exactly what was in it, and that it was REAL food. It took a bit to get the rhythm down and purchase all the ingredients, but once the pantry was stocked it didn’t take long to whip it up, and was actually a low-cost option long term. When he reached 6 months he used this formula exclusively until he was eating table foods, and was healthy and happy.  Once I used this, I figured my quest for a good supplement was over, but I didn’t count on the individual baby involved! My current baby could not tolerate it made with the milk I had available, and was also unable to tolerate it when made with goats milk. So the research continued as I tried to figure out how to help THIS baby and his own personal needs…
  2. Mt. Capra Goat Formula: (Info here) As I was continuing to research my options, I came across a number of recommendations for this formula. While it is not made using raw milk, you still assemble it yourself according to a specific recipe, thus allowing you to know exactly what it is in it, and still sticking close to the “real food” ideal. There is a kit available to simplify the process of acquiring all the ingredients, and the Mt. Capra website supplies high quality resources. After my baby didn’t tolerate the goat’s milk, I decided against the investment needed to try this, but it still looks like a really good, healthful option, and I’ve heard that there are many happy, thriving babies using this formula!
  3. European Formulas: I eventually stumbled across the realm of imported baby formulas from Europe. I’ll warn you, they aren’t cheap. And they are powered (that part still bugs me if I think about it long-what about feeding your children REAL food?!?). But they have been a literal answer to prayer for me and this baby. One of my big objections to using traditional formula is the fact that most of them are sweetened using corn syrup solids. Corn syrup!?!? We don’t even eat that ourselves, so why would I feed it to my little baby? And then there are the issues of soy, additives, and the list goes on. So I was amazed when I realized that there are several options of formula available that are made from organic milk, sweetened with lactose, have pre/probiotics, and are soy free. Instead of repeating information about these formulas myself, I’m going to include some links where you can see the brands available, along with their features and ingredients:

I will admit, too, that while powdered formula might not fit my ideal, it has been a helpful simplification to our life! My baby actually really liked the taste, and I happily observed that his diapers were hardly different in texture/smell than the usual breastmilk diapers. At 10 months (he started using formula exclusively at 7 months) he is a solid little guy that is SO much happier than he was before. There are several different suppliers in the US, and I have been happy purchasing from www.buyorganicformula.com.  Their customer service has been excellent, and my order always arrives promptly, and I’d highly recommend checking out their site. If you sign up for their mailing list, they will frequently send you coupon codes that can be quite helpful!

My happy fellow at 9 months!

My hope is that my experience and time spent searching can help to lift the load for another mom wading through her options! May you be encouraged today, and remember that you can still have a special bond with your baby AND know that you are meeting his/her nutritional needs even if you need do it in a different way than nursing.

I’d love to hear your thoughts-and what worked for you. Please feel free to comment with your own resources, experiences, stories and information-it’s great when we can help each other this way. Thanks for your contribution!