Friday, January 10, 2014

Kaylee and Alyssa's Birth Story

This is a twin birth story from my online mama friend, Lori. I love when a cesarean birth story ends with a perfectly happy mom who got everything she needed AND healthy babies. Goes to show that there is joy in every birth, no matter the mode of delivery!


We were told at our very first ultrasound that we were having twins. We had done IUI (a fertility procedure) and Clomid (a fertility drug) so we always knew there was a chance - but the surprise was that they were identical, which neither of those things can cause! From the next appointment on (and there were many many appointments and many ultrasounds) we were thoroughly explained the many risks of carrying not only twins, but monozygotic/diamniotic twins. I had been told that the hospital and doctors were willing to allow a vaginal birth in the case that: Baby A (the one presenting) was head down and that a doctor comfortable with a breech delivery (in case B was breech or flipped to breech during A’s delivery) was on staff and willing to do the delivery. I did every amount of planning and “type A” preparation that I could. I had a birth plan written out and my hospital bags packed and in the car by 28-ish weeks. They had both been head down for weeks, and at around 30 weeks, it seemed like something had “slipped”, causing me to be in enough pain to go into triage to be monitored - babies were okay, but were both now breech.


Contractions began on their own at 35+1. I kept a pretty good record of them via a phone app (highly recommended! the app will do the math for you, especially once they really start up, math is hard to do.) and I was only having them every 7-10 minutes, if that. Lots of yoga ball bouncing and trying to stay comfortable for the night and calling triage nurses to confirm when they wanted me to come in. We all agreed on “when they get closer together” because the hospital is about an hour from us (the closer to us does not have a NICU and weren’t able to deliver identical twins without the risk of being flight transferred to Seattle while I was stuck behind). The next afternoon they jumped pretty suddenly to being about 5-7 minutes apart, so we hopped in the car and went to the hospital.


Upon arrival, they hooked me up to the monitors and I was checked for dialation, at that point I was at 3cm. They weren’t all too sure about whether or not I would deliver or be sent home, but because of both babies still being breech, we filled out the c-section consent form so it didn’t need to be done in a rush of activity later. They let 2 hours go by and checked me again (while having constant back labor, all contractions showing on the monitor, and me stuck on a break away bed with the break right where the contractions were in my back, mind you!) - I was now a 6-7cm and Kaylee kicked the doctor!


This is where things became a blur; We were delivering that day and quick. They confirmed when the last time was that I had eaten, discussed giving me my epidural in the triage room so it had enough time to take effect before being rushed to the OR for a c-section (they didn’t end up doing this). Because I had dilated relatively quickly (and babies clearly wanted out!) they were concerned with both being breech that they would continue to try to come on their own before they could get in for the c-section. We were taken to a delivery room, epidural given, and moved to the OR pretty quickly.


From there, it really became a blur in the quickness of activity, the drugs, the hormones, and the emotions. We had arrived at triage around 4pm and Kaylee and Alyssa were born via c-section at 8:38 and 8:39pm, both with Apgar scores of 9! Kaylee (5lb 3oz) immediately came to the room with me, Alyssa (4lb 2oz) was admitted to the NICU per policy due to being low weight. She was able to room-in with me and her sister after overnight monitoring.


I went into my birth with a full researched plan of what I wanted in a best case scenario, but also knowing at that point I needed to “let go” and that the girls may have their own plans. I controlled what I could, I stood up for what I needed to, and the girls came out healthy and happy.



Sunday, January 5, 2014

Adventures in Placenta Encapsulation

Placentas are really cool. Like " Holy cow, I grew a new organ that grew a baby and then my body totally just got rid of it and now it's been in my freezer for four years because that is way too fascinating to just throw away" kind of cool. Seriously, I could just look at placentas all day long. They are bloody, messy, gross, slippery, slide-y and amazingly, astonishingly unequivically beautiful. A true testament to the power and wisdom of the human body.

And people just throw them away every day! I know a lot women think placentophagy (mammals consuming the placenta postpartum) is gross or off-putting, but really, it is no grosser than popping a vitamin. Unless you eat it raw and steaming straight from your vagina. That's pretty gross, in my opinion. Actually, just writing that grosses me out. Anyway...

A couple of weeks ago, I had the opportunity to learn how to encapsulate and tincture placentas. It's a pretty cool process, and since I am not sure how a paying client would feel about me documenting their placenta encapsulation, I decided to thaw my own two frosty life-popsicles and make some medicine. Since I had my kids, I have found that I have raging, horrifying, lock-myself-in-an-underground-bunker-for-a-week PMS. I'm hoping that if I take these capsules in during that hell week might make life easier...for my family. I also want that tincture, since it will likely last me through menopause, and if it is anything like my PMS, we are all gonna want a little help.

So here it is: Lucy and Malcolm's placentas, medicine-ized.

Lucy's placenta, with extra-long cord:

Malcolm's placenta was smaller, with a much shorter cord:

The first thing I did was thaw the placentas in the fridge for about 3 days. My intention was to get to them as soon as they were unfrozen enough to work with, but I needed to go to the liquor store to get some vodka for the tincture. This week, I discovered at the Montgomery County liquor stores don't open until noon, and stopping at the liquor store after picking up your kid from preschool is awkward. Perhaps less awkward than being the lady waiting at the door for the store to open and promptly buying the largest bottle of 100 proof vodka available, 4-year-old in tow. Maybe that's totally justifiable...

So, thawed placenta. I decided that since I had two placentas, I would use the two most common methods (maybe the only two?) for preparation: raw and Traditional Chinese Medicine-inspired. Lucy's was prepared raw, Malcolm's with TCM. First, I rinsed them and removed as much blood as possible. Lucy's had a lot of blood in it, Malcolm's looked as though it had been drained already, although there were several large clots on the maternal side. I set Mal's aside and worked with Lucy's. After rinsing, I removed the cord and patted it dry as thoroughly as I could with a paper towel.

One of the first memories I have of Lucy extra-utero is the midwife unwrapping the cord from around her neck two times. In my memory, she is swinging it around my slimy newborn like a lasso, though I highly doubt the cord was flying as widely as I am remembering.

But seriously, it was long enough to spell out LOVE:


One of my first memories of Malcolm was not being able to get him up very far on my chest, because his cord seemed short. It was pretty short, but I could still make a little heart with it. I placed the cords on the dehydrator.

I cut the placenta into smallish chunks. After slicing and dicing. I placed it on the dehydrator tray. Yum!

After the chop chop, I dropped a good-sized chunk of placenta into roughly 18 oz of vodka. This will sit in a cool dark place for about six weeks, after which I will strain it through cheesecloth and use it to tame the wild hormonal beast. I made a tincture from a piece of both placentas, since it can also be used for the child's hose placenta it was. I have heard it is like a "reset" button for a kid having a crappy day. I am hoping it is sort of like the "Easy" button from the Staples commercials, though I am sure to be disappointed in that regard, as I don't expect an army of nannies to arrive when I use it on the kids, nor do I expect they will bring me a million dollars. I tinctured Lucy's raw and Malcolm's after the steaming process (this one is Malcolm's):
Lucy decided she wanted to help, so of course, she had to wear gloves like Mama. It's pretty cool, though. I mean how many people can say they've seen and held their own placenta??!

She wasn't entirely sure she wanted to be holding it.

But while we are looking at pictures of my kid, is she not the cutest girl EVER?

Moving on. I got to work on Malcolm's next. Traditional Chinese Medicine says that we steam or simmer the placenta with warming herbs (lemon or lemongrass, ginger and a hot pepper). I sliced up a lemon, a good-sized chunk of ginger and a hot pepper, placing them in pot and filling with enough water to cover. My teacher said to lay the placenta on top of the herbs and gently simmer for an hour. I am pretty bad at remembering things on the stove for more than 20 minutes or so. Just ask my husband who more than once has come home to a house filled with burning something-or-other and me blithely taking a shower or napping or something else that didn't involve remembering stuff on the stove. My first attempt at TCM ended with a huge, stinky placenta mess all over the stove because the whole shebang boiled over. So I decided to steam instead of simmer, since steaming was a 12-15 minutes on one side, then flip over and steam for another 12-15 minutes kind of process. Better for my attention span.

So, I wrapped the placenta in the membranes, such as they were. I remember after the birth my midwife showed me that the two layers of amniotic sac had separated, and so it was a somewhat slippery mess, especially after 2+ years in the freezer.

Looks a little like a heart in an autopsy tray.
I brought the water to a boil and then turned it WAY way down, to minimize boil-over risk. I steamed it for 12 minutes, flipped it over they steamed for another 12 minutes.
The first placenta I prepared according to TCM started out the size of a salad plate and was about the size of my fist after I boiled it over. It should cook down a little bit, but not THAT much. After it cooled a bit, I removed the membranes and I cut it into little chunks. It was much easier to cut than the raw one (which, in restrospect, would have been better served by a good pair of kitchen shears than a knife).
I placed it on the dehydrator tray and set it for ~150 degrees. Basically, anything above 140 is fine. Anything below that temperature will not inhibit the growth of bacteria, and so...y'know...yuck.

Now, the part about TCM preparation that you don't hear about a lot is that the mom is supposed to drink the broth created by the steaming process. So...I strained the herbs and pepper out, poured a big steaming cup of placenta tea, put some honey in it and gave it a try!

And the verdict is...HOLY SHIT THAT'S SPICY!

Oh pepper...Damn. It was not expecting that at all. It really wasn't bad, per se...just...that was a lot of ginger and hot pepper and I was drinking it. I did manage to drink about a cup of it before it was just too spicy to continue. The taste definitely grew on me, but I froze the rest in an ice cube tray and plan to use it a cube or two at a time, diluted and (heavily) honeyed, during my cycle.

Back to the dehydrator! It ran for about 20 hours. Here is the end result:

A cord dehydrated fresh will be more of a tan translucent color after dehydrating. You can see the blood vessels better in a more translucent cord, but this one is really beautiful if you hold it up to the light.

After dehydrating, I put the dried placenta into a blender. It made a great deal of noise. And powder flies out like crazy. I would recommend putting a piece of parchment paper or Saran Wrap under the lid of the blender to keep the dust to a minimum, since I am pretty sure no one wants to breathe powdered placenta.

It turned out like this:

I loaded the capsule filler:

Scooped a heaping tablespoon of powder in:
Filled and tamped down the capsules:
Put the tops on:
And ejected the capsules into the waiting bin:
Malcolm's placenta yielded 73 capsules, which is a pretty skimpy number. Lucy's made 108, also a pretty small-ish number, though more in the range of average. I'm wondering if TCM preparation reduces the yield of capsules, since they were both pretty similar in size to begin with. The other TCM prepared placenta I did only yielded 86 capsules...though that may have had something to do with the fact that I boiled it to within an inch of its life. Or perhaps past an inch of its life. It was bad. At least I wasn't charging her for it.
See? Nothing gross about this!

I wish I had separated the raw from the TCM capsules, but I just went on autopilot and they all ended up in the same bin. I popped two of these suckers today, just to see what (if any) effect there would be. I felt a definite mood boost, though no difference in energy. The placenta broth/tea gave me a burst of energy.

So now I have two cord keepsakes...and what does one do with dried umbilical cords? Lucy really wants to keep hers, and I am inclined to let her. It is her cord, after all. Malcolm could care less, I'm sure. Maybe a shadow box? They are actually really pretty. Especially, I imagine, if you don't really know what they are.