Thursday, October 7, 2010

Joel's Birth Story

Sunday--40 weeks GA

 We had been planning on a homebirth with our midwife Susan, but she told us at our prenatal the Sunday before Joel's birth, that her brother who had cancer was unexpectedly having surgery this week in Texas. They didn't know if he was going to make it, and she was leaving on Wednesday to see him and would be coming back the following Monday. I had been having regular, but false contractions that woke me up almost every night for about two weeks, so we hoped I would go into labor before she left. She stripped my membranes and used evening primrose. Contractions picked up about an hour later and became painful, but by Monday things had calmed down.

Susan had two backups: Dr Tami and Yolanda (a CPM who lived about an hour away). We decided to go with Tami...I had met her before, she lived nearby, had delivered a few of her own kids at home with a midwife, and she reminded me of Ate Elai (a well loved supervisor in the Philippines)...calm and quiet but with a strong sense of authority...someone who would know what to do in an emergency.

Tuesday went by uneventfully. Wednesday I woke up with a gush of fluid. "Sigh...of course...the day Susan leaves," I thought. I called Tami later that day when contractions weren't starting, and asked her what she wanted to do. We agreed to wait 24 hours and see if labor would start on its own. Thursday came...no labor. So we went and saw Tami at the hospital. She did an nst and ultrasound. Everything looked fine, and the ultrasound showed there was fluid still around Joel. Probably just a high leak, so we went home.

Friday, I woke up around 1am with contractions. I told myself it was probably just the false stuff again, grabbed my heating pad (Joel was OP so my back was giving me a lot of trouble), and went back to sleep. At 3am, I woke up with a contraction that HURT. Five minutes later, I had another, and another. Around 6, I asked Nate to call Tami. She said she'd be to our house around 7. I started vomiting between most of my contractions. I called my mom and started crying. I didn't think I could do it, and I couldn't stop throwing up. She told me I should call Kim, Nate's mom, and have her come over and help. I said I'd think about it.

When Tami arrived, contractions were still coming every 4-5 minutes, so painful I couldn't talk through them, and I threw up between nearly every one. I was really hoping I was at least 7cm...I thought surely I must be near transition with all the throwing up. Tami checked me: 3cm, 90% effaced. Great. I was one of those women who acts like she is in transition when she's still in early labor. It was going to be a VERY long day.

Tami recommended I get in the tub. She had to go check on a patient in the hospital, and she said to call her if anything changed. We called Kim and had her come over. She helped so much, talking me through it and calming me down. The water helped too, and around 8am, Joel moved out of the OP position...thank goodness. But, by 9am things were getting bad again. Throwing up was the worst part at this point. I would never get a break between contractions, so it felt like I was in pain all the time. We called Tami again, and she let us know that she couldn't leave the patient at the hospital, so we needed to either come to the hospital, or call Yolanda, the midwife I'd never even met.

I felt so angry at everything. Angry at the pain, angry at the throwing up, angry at the situation. This wasn't what we had planned. Tami said she would try to make everything as much like a homebirth as possible, we could leave the hospital at any time if we weren't happy, and she would make sure we had the nurse who had had all her births at home so she would understand. We decided the hospital was the best option at that point.

As I waddled through the hospital doors, I could almost hear the guard (the free parking valet in this case) yell "labor". Everything felt so unreal.

I assessed the hospital room. It didn't seem so bad...a bed, a sofa, a birth ball in the corner, and a big tub. No scary wires or tubing and no one rushing at me with IVs and needles. Our labor and delivery nurse, Monica, seemed really nice too. She had helped Kim with one of her deliveries years before. She checked me: 5cm. Tami came in and we talked about options for the vomiting. I was getting desperate for it to stop. We decided to start with an IM injection of Zofran, no IV for now. I got in the tub...the water helped so much! Monica gave me the injection.

A couple hours went by. So much pain. Sometimes a contraction wouldn't completely go away before another one started. In and out of the tub, standing, sidelying, walking. One minute, I would be shivering with cold, wrapped in warm blankets. The next minute, I would be ripping off my gown, drenched in sweat. Sometimes it helped when people rubbed my back, sometimes I pushed their hands away saying "don't touch! don't touch!" The Zofran didn't help at all. I was SO thirsty, but every time I drank anything, I would throw it up, leaving my mouth dryer than before.

At 11am, Monica checked me again. Still 5cm. I mentioned an epidural, and Kim reminded me that I did not want one. At that point though, I was almost ready for anything to stop the pain. Tami recommended we try something else to stop the vomiting. Maybe if we could stop that, then I could deal with the contractions better. I got another injection, this time Phenergan. It didn't help either. Just made me really tired.

Around 1:00 after an especially horrible contraction that had me yelling at the top of my lungs, I told Kim that if I wasn't 6cm or more at the next check, then I was getting the epidural, and she WAS going to help me get it. She agreed. Monica checked me again about half an hour later: 7cm. We had a deal...no epidural.

More time in the tub, more walking, more pain. I started praying out loud that God would help me through this...I had nothing left to give. I remember looking into Nate's eyes, then Monica's, then Kim's. There was nothing else that they could do for me...nothing they could possibly do would help. I felt very alone.

2:30...8cm. 5:00....still 8cm. I was yelling for a c-section, but I don't really remember that part. I stood facing Nate, bracing myself against him during each contraction. Nate says I tried biting his stomach, but again, I don't really remember much of this part. Just lots and lots of pain. All I could think was "just kiay kiay....kiay kiay.....kiay kiay lang..." For some reason, I had to think in the words that I had told nearly every woman I had ever helped in labor.  Little did I know then how hard it actually is in labor just to rock your hips.

6:30. 9+cm with a lip. I remember moaning “No not a lip. Lord…I just want to be 10…make me 10” Monica asked if I wanted to keep going through contractions and wait for the lip to go away or if I wanted her to push the lip over the baby’s head. “Just get this baby out!!” She pushed the lip up through a couple contractions then suggested I try pushing a little. BOW bulging with the next contraction and Monica broke my water. I tried squatting to push but CRAMP. My whole hip cramped….it hurt just as bad as the contraction, and I couldn’t push.

After a few contractions with the cramping, Tami came in and had me get on my hands and knees so she could push on my hips during contractions and try to stop the cramping. It wasn’t helping. I reached inside and felt Joel’s head. He was right there…so close to coming out. I felt hair, and his head molding…..and the lip! It was still there! “Noooooo” I moaned. “The lip is still there…the baby won’t come out….the baby won’t come out,” I said over and over. I moved to sidelying…that helped the cramping some. Tami got some evening primrose and pushed the lip up some more. After a few more contractions, it was finally gone.

I tried pushing some while sidelying, but I wasn’t really progressing. Finally, I rolled onto my back. I was shocked…this was the best! No more cramping, and I could finally feel what I was doing to push. I didn’t have much of an urge to push, but pushing helped the pain of the contractions. About 30 minutes went by. 2cm head visible. Then there was SO much pressure and it scared me. I stopped pushing and started breathing through contractions. They told me I needed to keep pushing, but I couldn’t….I was too scared. Finally Monica said “Jordan…get angry at the pain. Get angry at it and push through it.” That helped. I WAS angry at the pain, and I really wanted it to be gone. I started pushing again.

Another 30 minutes or so and head was almost crowning. It felt like fire, but I was so happy to be almost done.  I reached down and slowly eased the head out myself. No tear. But then his shoulders wouldn’t rotate and got stuck. I found out later that Joel also had a nuchal hand. Tami had Nate hyperflex my legs. 30 seconds went by. Tami and Monica were telling me very urgently to push. This hurt WAY more than the head. After what seemed like forever but was only a little over a minute, I felt a little pop and even more burning, and then he was born!

The minute his feet were born, I felt amazing! No more pain at all. It was like the “runner’s high” only a thousand times better. And I was holding the most perfect squirmy baby in my arms. He didn’t really cry, but he was very ready to eat! Nate told me he was a boy. I was so incredibly happy!

Tami waited about half an hour to cut the cord. She was really patient about everything. Everyone was guessing his weight…we all thought about 8lb something and couldn’t believe it when the scale said 9lb 13oz! I had only gained 24 lb with the pregnancy and measured small the whole time, so I’m not sure where he was hiding.

Tami sutured the 2nd degree perineal tear that Joel’s shoulders gave me right after the birth while I was breastfeeding. I was glad she sutured right away because nothing hurt for the first half hour, but everything hurt a LOT later. After about an hour, the placenta still hadn’t come. Tami tried cct…nothing. So she injected some pitocin into the cord vein. It was really fascinating. I had never seen that done before. I breastfed almost this entire time, but nothing happened with the placenta. I went to the toilet, but still nothing. My uterus was getting very uncomfortable. After more than an hour and a half, Tami said she might have to explore and see what was going on. I started to cry. I was so traumatized (left the room crying and nearly passed out) the first time I had ever seen this done on a woman. Tami said they would give me morphine first, but that wasn’t very reassuring. I started to pray that God would get the placenta out on its own. Tami tried cct one more time, and a couple minutes later, the placenta finally came.



Nate's dad (he was planting squash and had just come from the field)

Next day....aunts and uncles meeting Joel



Finally done! Nate and I were/are so incredibly happy….I can’t even describe the feeling. Nate is such a great dad! He changes all the diapers when he’s home and is so good at calming Joel down. Joel has been such an awesome baby too….breastfeeds so well and doesn’t cry much. Now if he would only sleep more at night….

Friday, September 25, 2009

Why I haven't been posting.....

Spending time with this awesome family I have


Hanging with the twins before they left for college in Texas

Dancing....we learned swing aerials!
Lots of frisbee

Huckleberry picking Studying for my final midwifery exam--the NARM
Went to Oregon, took the NARM with these two amazing girls from school, and passed!!


And....Engaged to the most amazing guy ever! :D

Nate Karnemaat...a childhood sweetheart from Michigan

Yeah....God is good!

Friday, June 12, 2009

Why?

This is why I do what I do....why I want to be a midwife.

Childbirth in Tanzania

Graduated!

Started off a perfect graduation day with swimming and slides


With our amazing coworkers and friends


almost everyone

Silly awards :D


1st year students giving us an amazing grad speech: "Every midwife needs at LEAST 2 cups of milo..."


Prayer tunnel


And....graduated!!

Friday, May 22, 2009

Jenecel

The picture that started it all....I took this picture last October in the village Ocapan (about 7 hours north of Davao city


This was taken in February as plans started to form for bringing Jenecel to Davao for surgery. This is her family: Dad--Joseph, Mom--Merlina, 5yo brother--Joel (a.k.a. Pull-pull), and 10yo Jenecel. Her family became Christians almost 2 years ago and have suffered from a lot of spiritual oppression.


She weighs less than her 5yo brother. She just wants to be able to walk and go to school. Right now, she sits at home with her puppy and sings and washes the dishes. Her relatives occasionally carry her places.

Last January, her family says that she became really sick and stopped breathing for 30 minutes. They were all mourning her death, when she suddenly opened her eyes and started singing about how amazing God is and quoting from Ephesians. She sang the song for me...all 30 people in the room (her family and 4 of us midwives on outreach) were in tears by the end.

She and her family traveled to Davao on May 16 and are now staying in a boarding house near the hospital. Jenecel is going through therapy. The doctors won't do surgery until they are convinced she can build enough muscle to stand. Right now, Jenecel can hardly lift her legs off the bed. Pray she can stick through the therapy and has the ability to build muscle.

The doctors are afraid she has a muscle disorder. Jenecel will get a muscle biopsy next week (June 15) which will be sent to Manila. We'll decide where to go from there.


A family in the States is helping to support her family and medical care. I attached below the letters they've sent out:
"I have mentioned this need to some of you, but some of you are hearing about this for the first time, so I'd like to introduce you to Jenecel. She is a 10 year old girl who lives on a mountain in the Philippines. I first saw her on a facebook page of a friend who has been studying in the Philippines for almost 2 years. She was in a picture.

All of the children in the village love to have their picture taken and when Jordan was taking pictures the children said, you need to go take a picture of our friend, she can't walk and she sits at her house all day with her dog. So Jordan went and took the picture. Since that time we have expressed an interest in helping Jenecel receive medical care in the hope that she could have corrections made that would allow her to walk.

We have definitely seen God at work as He orchestrated some events that eventually led to Jenecel and her family arriving in Davao to talk with a specialist there. We are continuing to pray and seek any advice regarding what steps to take in helping this little girl. Coming to the United States is an option, but there are a lot of hurdles to clear for that to happen.

Currently she was evaluated this past Monday, I don't have an official diagnosis, but this is what Jordan relayed. She has dislocated hips, impacted knees and club feet. There is concern with whether or not she has enough muscle tone to warrant surgery. This week they are doing physical therapy and wanting to see some improvment in her muscles. Depending on how that goes, the doctor there would like to consider surgery.

The current costs incurred are less than $500, we have set up a way for contributions to be made to Grace Community Church and then disbursement to the Philippinnes for Jenecel's care and expenses. So my reasons for sending this to you are at least four-fold.

1. We need people to pray that God would continue to direct in this girl's life and that it would be obvious how to proceed.

2. If you feel led and would like to contribute to the costs, we will have a fund set up through our church.

3. Any advice you might have, like has anyone ever been involved with bringing someone to the U.S. for medical reasons, or fundraisers, ideas??

4. If you would like to continue to receive updates on Jenecel, please let us know.

I've been studying Ephesians this past year, and our study directed us to these verses in 1 john. It happened to be the week before Easter.
1 john 3:16-18

This is how we know what love is; Jesus Christ laid down his life for us. And we ought to lay down our lives for our brothers. If anyone has material possessions and sees his brother in need but has no pity on him, how can the love of God be in him? Dear children, let us not love with words or tongue but with actions and in truth.

Jenecel is certainly an opportunity for some of us to express our love through actions.

Thanks for listening, praying and responding if that is how God directs.

Enjoying the journey,

Kent and Kim



Just wanted to touch base with you regarding Jenecel

She is doing well and continues to see doctors and have tests run to determine the course of action.

At this point it looks like she will be continuing to receive care in the Philippines. It allows her family to stay together and her father to continue to go back to his farm about once a month. We still don't know how long until a surgery will be needed or if it can be done. She is receiving physical therapy and most of the doctors in the Philippines are giving her care at a reduced rate or donating their time entirely.

I mentioned in the last e-mail that if you felt led to participate with money you could do so by donating to a fund at our church. The easiest way to do this would be to make the check out to Grace Community Church and then mail it to our address c/o 6846 S. Green Ave, Fremont, MI 49412.

The prayer needs remain the same...

1. wisdom for Jenecel and her family and the doctors that a clear course of action would be obvious.

2. Praise, I wish I could take the space to tell you all of the little and big ways we can see God working. Via connections here in the states...doctors who have given their opinions and assessments of Jenecel's condition. Doctors in the Philippines who have also expressed willingness to help this little girl.

3. Continue to pray for Jenecel as therapy and testing and perhaps surgery are difficult and painful.

Thanks for your willingness to pray and if God leads you to be involved in other ways...thanks in advance for that, too!

Finding Joy in Him today,

Kent and Kim

Sunday, April 5, 2009

Mmmm...Delish!

So....I finally found some food I DON'T think I could eat....
Exotic Food
Make sure you watch the video of the live octopus.

And while we're talking about food....let's just say this story was *slightly* concerning: The Other White Meat

Sometimes when I'm eating chicken here....I can't really tell exactly what part of the chicken the meat is from...

hmmmmm

Monday, March 23, 2009

Beautiful Bugnay

3 days in the most amazing place I've ever been. Can't really capture the setting of a place or the roots of the culture using just images and words. You really have to be there in person! But here are a few pictures and thoughts I had throughout the trip.
We drove with Georgia, her husband Achao (originally from Bugnay), and their son Emmaus

"Whoops...six hour trip just became 7 hours due to a massive land slide...

"Houses built over cliffs. I wonder if the three year old has ever come close to falling off the edge...


"Mar-o, town just outside of Bugnay (our destination). Great reception but I wonder what the guys with the guns are for...


"Awesome! Everyone wants to help carry our stuff to wherever Bugnay is. Had to hike down one cliff...can it get any more gorgeous than this???


"Yes...it can. Still hiking....


"Still hiking. Awesome rice terraces....I wonder how many generations have been carving them out of the mountains.


"Whoa! There's even a hanging bridge way out here...


"Whew! done hiking...beautiful Bugnay


Achao's dad and mom-- But-but people traditionally don't smile for pictures


Achao's grandpa snapping beans similar to soy beans. Such a sweet man, but he was convinced we spoke fluent But-but and would chatter away to us for hours about the importance of marrying a strong But-but man.


Wow..four generations


Learned more about the rice...


The sprouts are grown together in one huge clump until they are strong. They are then uprooted and carried in baskets on people's heads to the rest of the fields.


The women do all the planting while the men stay in the village to watch the kids and cook. Later, the men harvest all the rice while the women stay home to watch the kids and cook.


Learned about the intricate tattooing on the people. The tattooing is done by tapping thorns into the skin. The more beautiful a woman is considered to be, the more tattooing she is allowed to have. Although killing is not as common in this tribe anymore, the men still get a tattoo for each person they have killed. The But-but tribe don't have a word in their language for "handsome", only words like "brave" and "strong".

This woman's name is Takay, but she loves to pretend her name is Sandraya and falls over laughing when she calls herself that. She got married when she was 14 and is now over 80 years old. She tells incredible stories about their history and culture.


Yum! Dinner! They killed a "prize native chicken" for us...such sweet people. Anatomy 101: try to find the head, lungs, underdeveloped eggs, bladder, feet, etc. Nothing is wasted.


Around the village...


Everyone has pigs that live under the stilt houses. They feed the pigs leftover


Made some friends: Marsha and Julex. Called them the "as they say girls" because they constantly used "American phrases" such as: "As they say....home is where the heart is." "As they say...where you're happy, there you are." "As they say....I love music...but it doesn't love me!"

They were our official tour guides...

Sometimes I wish I could be a little naked kid playing in the river again


Hiked about two miles down the river, bumped into Achao and all his friends, fished for little tadpoles, fishes, and crabs with them using spears and goggles, then ate all that we had caught. Delish!

>
They even brought rice in a banana leaf

No matter how remote you get in the Philippines, there will always be a basketball court

Prenatals and baby checks

This grave was just outside the house we stayed in. The older sister of the woman who owned the house. Her sister was 23 years old and died due to pregnancy related complications....would the outcome have been different if there were midwives in the area?

Going home. Achao's dad escorted us. He has to wear a hoodie and carry a gun because he has been part of a clan conflict for over 20 years. There are always people watching and waiting to kill him if he leaves his village. Tribal wars, family feuds, and clan conflicts are still an issue in this area.

Sweet! We get to ride on top of a jeepney all the way back!

Bother flat tires in the heat of the day

Stopped at an outhouse halfway there....this HUGE (six inches) tarantula was sitting at eye level less than a foot from my face. HEART ATTACK!!

Ah Bugnay....As they say "a picture is worth a thousand words," but it would take a thousand pictures to even begin to describe this place.