Friday, April 23, 2010

Who Do You Share Your Birth Plan With?

After yesterday's post that shares the birth plan for my upcoming 5th. c-section, I was asked, "Who do you share your birth plan with?" Here's my response:

Usually I make 3 copies of the birth plans. One copy for my O.B., one for the maternity coordinator at the hospital, and a copy for myself.

In the past, I would take the copy for my O.B. along during a prenatal appointment when I was around 7 1/2- 8 months pregnant. My doctor and I would discuss what was on the birth plan. I'd also find out if there was anything that I was asking for that was unreasonable and then I could make changes if I needed to. With this pregnancy, I didn't take a copy to my O.B. since everything on my birth plan had already been approved by him during my last c-section. Any questions I've had (regarding video taping the birth, holding the baby soon after birth, ect.), I've been able to bring up during previous appointments, so there really wasn't a need to go over the birth plan again.

Around 32-34 weeks pregnant, I have an appointment with the maternity coordinator at the hospital I plan to deliver at. At that time, I take my birth plan with me and go over it with the maternity coordinator. Along with signing all the consent or (non-consent) forms, we go over the birth plan and the coordinator takes notes and places them at the front of my chart. She also will inform me which things may or may not be doable on my birth plan, and sometimes makes suggestions.

As for the copy for myself, I just hold on to it so I can remember what I plan to fight for. The morning I go in for my c-section, there should be a chance to speak with the nurses who will care for my baby and myself, as well as the anesthesiologist and my O.B.. During this time I again bring up my preferences for the birth. We also go over any problems that I had during the previous c-sections.

If you're getting ready to create a birth plan of your own, I highly suggest that you find out ahead of time what your doctor already routinely does during/after the birth as well as what your hospital's standard procedures are. This is especially important when it comes to matters of what happens to your baby after birth. Try to keep your birth plan simple and stick to the things that are really important to you and leave off the things that your doctor or hospital already usually do.

Thursday, April 22, 2010

My 5th.C-Section Birth Plan

In preparation for my baby's birth, I've been working on writing a birth plan. Not everyone feels that writing a birth plan is worthwhile. In my experience, though, if you don't speak up for what you want with your baby's birth, than you will receive whatever your hospital does as standard procedure (the good and the bad).

For my 5th. baby's birth, I am using what I had on my last birth plan and changing it just a little. The hospital I deliver at is now very Mother/Baby friendly, so there is less that I have to fight for. Next week I'll be going over the birth plan with my hospital's maternity coordinator. They've been wonderful about respecting my wishes with my last two babies, so hopefully everything will go smoothly this time too. Here are the things I'm requesting for my upcoming baby's birth:

5th. C-Section Birth Plan

*If possible, I would like a patient and compassionate nurse who is good at helping patients stay calm.
*Lidacaine before IV
*Spinal before catheter
*Volume down on heart monitor as low as safely possible
*M. has permission from my Dr. *** and myself to photograph/video the birth. She is a LPN who is working on her RN and has done clinicals in the maternity ward at a local hospital
*Should I need general anesthesia during the birth, I would like my husband to stay in the O.R. to take pictures and be able to hold the baby.

*Warm Blankets during surgery
*OB will keep cord long for my husband to cut
*I would like to hold baby (with help) as soon as safely possible
*NO eye gel or Hep. B Vaccine for Baby. Vitamin K is okay.

*Unless medically necessary, we would like Baby to stay with us at all times
*I would like Baby to sleep with me in hospital bed (we've done this with our past 2 babies)
*Please ask me before bathing Baby. I will probably want to wait until late afternoon so we have time to bond first

*As soon as safely possible, I would like to be encouraged to walk so the leg compressors can be removed (walking has never been a problem after prior c-sections. I tend to recover very well)






Friday, April 16, 2010

How Our Family Got Out of Debt

3 days ago my husband and I paid off our student loans over 6 years early. With a lot of work, we were able to eliminate our debt while living off of 1-income and raising 4 young children. Other than what we owe on our house, we are now debt free!

Here are some of the things we did to end the cycle of debt:

*My husband made the decision to work on a college degree he needed in order to receive a promotion with the fire department. Although he had college courses, most of them did not count towards this degree, which meant he had to start all over again. The years he spent in school were the hardest years I have ever been through (raising 3 children 3 and under and being pregnant with my 4th. while he was working at least 90 hours a week and going to school full-time).

*To pay for school without creating more student loan debt, (as we already had over $11k in student loans) my husband applied for grants through financial aid. With having such low-income to family size, he was able to not only finish school for free, he also received his books at no cost through the school!

*A family member gave us Dave Ramsey's Total Money Makeover book. Although we had already stopped keeping a revolving credit card debt, this book really gave both my husband and I the motivation to get rid of the rest of our debt. We don't use all the principals in the book, but we have used many of them. Had we not heard about Dave Ramsey, I'm not sure if we would have become debt free as quickly.

*We used our tax refunds towards paying off credit cards, putting money in the bank so we'd have enough to buy food and gasoline without having to use a credit card, and later to start a $1000 emergency fund.

*Once our credit cards were out of the way, we used tax refunds and stimulus checks towards our car loans.

*After my husband finished college and received his promotion at work, (and a raise), we put the extra money towards our car payment and paid the cars off over a year early!

*We made improvements to our house to increase equity knowing we would eventually sell. We used overtime and tax refunds to pay for the improvements.

*Last year, we sold our house and bought a bigger home that fit our growing family of 6. We found a foreclosure and acquired a low-interest rate which meant our new mortgage was not much more than we were paying before for our other house!

*With the car payments out of the way, we started focusing on our student loans. I upped our payments as much as I could, eventually increasing our payment to over triple what was required.

*This year, we put again put a large amount of our tax return towards student loans. We received money from a family member as a gift and put 100% of it towards the loans as well.

*2 days ago, I used savings to pay the remaining student loan balance off! I consider this to be only by God's grace as it would have been very easy to have continued on the path we had been early in our marriage. I'm thankful that he gave us the resources and wisdom to make a change when we did.

I believe the biggest help to getting out of debt is this: don't create more debt! Pay down debt as you can, and little by little you'll get rid of it. Buy only what you can afford right now, and if you can't afford it, don't buy it.

If you haven't checked out Dave Ramsey's site, do it now. The principals he teaches work, but you have to stay consistent. Things don't get better over night, it takes time and a lot of work. However, you can get out of debt. It was possible for us and I believe it's possible for others too.

Tuesday, April 13, 2010

Chewy Peanut Butter and Honey Granola Bars

Here's an easy (and tasty) recipe for Chewy Granola Bars. I've made granola bars in the past, but this version has been the best by far! The granola bars make a nice breakfast alternative, as well a healthier snack for me (verses the Easter candy I was snacking on before). They're full of protein and kid-approved!

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Chewy Peanut Butter and Honey Granola Bars

*1 Stick Butter
*1/2 cup Honey
*1 cup Brown Sugar
*1 Cup Peanut Butter
*2 Cups Crispy Rice Cereal
*4 Cups Quick Oats
*A few dashes of Cinnamon

Optional:
*Experiment and add in ingredients as you like!
Wheat Germ, Mini-Marshmallows, Fiber, Choc. Chips, Raisins, sunflower seeds, a teaspoon of vanilla, ect. Use less Crispy Rice Cereal if adding extra ingredients.


In a medium saucepan over medium heat, combine the stick of butter, honey, and brown sugar. Bring to a boil and turn off heat. *In the photos, the recipe is doubled

Add peanut butter to saucepan. Stir until smooth.


In a large mixing bowl, combine crispy rice cereal and quick oats.

Pour peanut butter mixture over the oats/cereal and mix well.

Press mixture into a 9"x13" greased pan (or 2 pans depending on how thick you want granola bars to be). Using your hands or a large spoon, press mixture down into pan (this will help granola stick together rather than fall apart).

Refrigerate granola bars for 1/2 an hour or so, slice, and serve!

Store granola bars in refrigerator to keep firm.

Enjoy!

*This recipe was inspired by something I saw on Rachael Ray's website and was adapted for my family. If you''re looking for granola bars without peanut butter, check her recipe out!

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Friday, April 9, 2010

Aubrey's 5th. C-Section

Today I'm sharing the birth story of a blogging friend of mine, Aubrey, who had her 5th. child via c-section 7 weeks ago. In her birth story, Aubrey describes in detail what it was like to have a c-section as well as her feelings about having cesarean births. If you're facing a c-section, whether it's your 1st or your 5th., I encourage you to read Aubrey's story.

*******

Anticipating Maria's birth was both scary and exciting. Maria is my fifth child, my fifth cesarean. There were many things to be eager for: the first sight of our beloved child, first cries and cuddles. There were also many things to be frightened of: post-op pain, a complication in surgery or after, overall recovery, and the safety of future pregnancies. All of my children have been born via cesarean section
.

It started with Morgan, my 8 year old. After many hours of labor, her heart rate began to slow with each contraction. My doctor went for a second opinion and the second opinion said that Baby needed to come out now. My heart sank. Emotionally, I struggled with this birth for years before I realized that it had delivered me a healthy baby who otherwise could have been in danger. In our area, VBACs are discouraged; it is difficult to find a doctor who will help with a VBAC. We were also wary of the risks involved, especially since Baby #2 arrived 13 months after Baby #1. But I won't debate reasons for repeat cesareans now. I've had five and I'm still alive and kicking.

I'm not sure why you're reading this; maybe you're looking toward your first planned cesarean for a breech baby or looking for a little support (commiseration) if it's your second, third, fourth, or fifth cesarean. Maybe you're wondering if repeat cesareans are safe. I will share what my most recent cesarean was like. You'd have an idea of what to expect then. Afterward, I'll tell you how I feel now.

*Maria's Birth*

We arrive at the hospital at 5:30, 2 hours before surgery is scheduled. We check in and are taken to a labor and delivery room. The nurse comes in, introduces herself, and hooks me up to fetal monitors and the lovely sound of our baby's heartbeat fills the room. The phlebotomist comes in for blood draws. The nurse prepares my body for surgery--an IV, shaving, etc. I sign waivers and releases and other papers. Jeremy signs a paper promising that he will sit quietly in the Operating Room, do what he is told, and won't try to help with nor interfere with surgery. It is quiet and we watch dawn gradually overtake night outside. Snow is falling! What a pretty morning to have a baby.

My doctor comes in to check on us and soon after he arrives, the nurse comes in and says, "let's go have a baby!" It's 7:15 a.m. I make one last trip to the bathroom and gather up my IV cords and pole and the nurse drapes a blanket over my back so I don't have to close my gown. We walk across the hall to the operating room. There are already four people in the room. The addition of Jeremy, me, and the nurse makes seven. An intern arrives and introduces himself. The anesthesiologist comes in (we're up to 9 now, including two students) and begins setting up.

My nurse's phone rings. It is Dr. K (the surgeon) calling to say that he is in house, which means that the anesthesiologist can begin working his magic. I'm a little nervous and I shed a few tears. Jeremy is across the room and the won't let him come over to me yet. The nurses distract me with talk about what I think the baby will look like. I say that as long as she comes out with hair, I'll be happy. Soon he is finished.

Before I know it, there are 3 more people in the operating room, my gown has been removed, my feet are going numb, I feel warm all over, and the nurses are working on putting a catheter in. I feel a little humiliated, as there are now at least 12 people in the room and I'm the only one without pants on. My arms are stretched out in a T and there's a lot of motion in the room. Jeremy is allowed to come over and sit behind me holding my hand. It feels good to have him nearby and although I'd really like to have him closer, an arms length is better than nothing.

It's 7:30 a.m. Dr. K comes in and Dr. M (my primary/OB/family physician) is there. Everyone is cheerful and Dr. K says he's ready for a birthday party. The curtain goes up at my chest. The surgeons are standing at my hips but it feels like they're down at the other end of the room. The anesthesiologist tells me that I'm numb and that they're ready to get started. I say that I can feel Dr. K poking me but that it doesn't hurt. Is that normal? The doctors say it is and they begin working. I can feel--without pain--the first several steps of the surgery and I lay there thinking how weird it is. Soon I hear suction (that's the amniotic fluid) then they're tugging and pushing and tugging and then Dr. M pokes his head around the curtain, smiles, and says that Baby has a lot of hair. All of a sudden, I feel a great pulling sensation and then I feel very empty and I hear Maria cry. Jeremy and I are laughing and smiling and I squeeze his hand and tell him to go to her. It's 7:45 a.m.

Dr. M holds Maria up for me as he moves from the operating table to the warming table. He puts Maria down and begins to check her over. He and the nurses wipe her down. Someone moves the curtain so that I can see her and he holds her up again for me, then continues to work. I watch him tickle her to get her to cry. Although she's pink and had been crying, she calmed quickly and will squawk and then lay quietly, moving only a little. A nurse asks Dr. M what he guesses her weight to be. He says 7-3 and when she weighs in at 7 lbs, 2 oz, they applaud. Everyone laughs. When they are sure she's doing well, they wrap her up and hand her to Jeremy. He brings her to me and I kiss her warm face, smell her skin, and admire the full head of hair that she worked so hard on.

Jeremy is holding Maria and follows me to the recovery room. She's crying, so Jeremy unwraps her and lays her on my chest. The nurses offer me water and I take oral Percocet. They push my abdomen (thank Heaven that I'm still numb) and monitor my heart rate and blood pressure. As I get a little more comfortable, I tell Jeremy to go ahead and take Maria to the nursery for her bath and meet me in our room, as I should have only 10 more minutes in recovery. After he goes, the nurses call Dr. K back because my incision is bleeding on one side--not an emergency, but not a good thing, either. He puts 3 or 4 more staples in, tells them to ice it, and explains to me why this is happening. This keeps me in the recovery room for another half hour. Finally, they decide that I'm okay and wheel my cart to my room where Jeremy is anxiously waiting with the baby, wondering what took so long and a little worried.

It's 9:45 now. They move me to my bed and my new nurse comes to introduce herself, help me into a nursing bra and T-shirt, asks about my pain (I'm still numb) and is in and out watching me closely for the next couple of hours. I begin to nurse Maria. When we are settled, we pick up the phone to share our good news.


*Recovery*

I've heard that recovery from a cesarean birth is harder and longer than recovery from a vaginal birth. I've only done it one way, so I've nothing to compare a cesarean recovery to. I'll stick to the physical aspect of it for now. The birth is painless, except for the insertion of the spinal, and once the spinal wears off, that's when the recovery begins. As I understand, many doctors administer post-op pain medications differently. I do believe that they (the drugs) are necessary in order to recover properly. Ibuprofen is mandatory, as it reduces swelling and helps the body to cope with a new incision. My surgeon explained that Morphine or Percocet (I've had both) allows the brain to not care about the pain so much. It all helps with healing. In spite of pain medication, there is quite a bit of pain after the spinal has worn off. Within 12 hours of surgery, I was expected to get into a chair next to the bed, with help. I was expected to shower and to begin walking short distances the next day. I was able to do all of these things. I walked out of the hospital and walked around my house. I filled the prescription for Percocet that my doctor wrote and took every last pill along with the ibuprofen that he recommended. I did not need to refill the prescription for Percocet. For the first couple of weeks, I woke up in the morning feeling as if I'd been hit by a truck but I'd always feel better within a few hours. By the end of the day, was always tired and uncomfortable again. The pain and/or discomfort gradually wore off until this week--six weeks after surgery--when I'm noticing that I feel very normal again. I took five kids to Super Target and to the park and even jogged a little today!

My method of birth still gets me down sometimes. I'm still a little disappointed, I think. When I start to feel this way, I remember that the first cesarean saved my daughter and me from more suffering and possible harm. The subsequent cesareans delivered four more healthy kids into our family. I am blessed to have the children that we have, regardless of which way they came out.

I can't wait for summer to get here, for my kids to be out of school, for days at the lake and hikes in the woods. I know I can handle it. So after five cesareans, would I do it again? Indeed, I would!

Visit me at Laughing All the Way. Click here to read posts specifically about my cesarean experiences.

Note: my surgeon said that it is safe for us to have more children. Each woman's case may be different. This surgeon, a maternal-fetal specialist in my city of 250K, said that of the thousands of women he's seen, he's told only three women that they should not try to have more children. He said that as medicine advances, the safety of cesareans increases. There are risks, no doubt, which increase with each subsequent surgery but they are small.