Telling Secrets

CELEBRATE WITH US!

SEPTEMBER 10
4 – 8 P.M.

THE SEELING HOME
10694 EAST ASBURY AVENUE #108
AURORA, COLORADO 80014

303.752.3844 (REGRETS ONLY)

BRING SOMETHING TO GRILL AND A SIDE TO SHARE
DRINKS AND DESSERT WILL BE PROVIDED

Home at last!

Expressive

Ameena's favorite spot

Acacia Lynn cruising in style

Ameena Renee enjoying the car ride

Cuddling with the Bro

Proud Big Brother

Hi all!For those who haven't heard, our GIRLS are finally here!They were born on August 19th at 12:16a and 12:26a. Their names are Acacia Lynn (7lbs, 20 1/2" long) and Ameena Renee (7lbs 1oz, 20 1/2 " long). We're back in Colorado and sooooo glad to be home.We are so richly blessed by our birth experience and can hardly believe all that transpired to make it happen.Thanks to all who were part of our journey! After a month in Utah and 41 weeks of pregnancy, I had my midwife (Suzanne Smith) check me to find that I was walking around at 5cm. We had tried acupuncture, homeopathy, EPO with zinc, other fun techniques ;) and still no labor pattern. So, at 5:30p on 8/18 I had her strip my membranes to get things going.She went home and said, call me with the first contraction ;)So, we went for a walk and contractions started during the walk. They were familiar so I didn't get my hopes up right away. We came home and had dinner during which I started timing contractions that were 7 minutes apart.By 7p I was having contractions 5 min apart and was ready for the tub to be filled.Caleb suggested we call Suzanne if I was ready for the tub and I agreed since I was already so dilated, though I didn't think she needed to be there yet. It was hard to believe labor had started and I was afraid the team would come flying in and then end up staring at me for hours, which did kind of happen. Things did kick in though. I got out of the tub and hid out in my room for awhile until the contractions got intense enough to get back in. The team (3 midwives and a student) had retired to a back bedroom and Suzanne came out to check on me and listen to heart tones periodically. Baby B had turned so that both babies were head down (thanks to a great chiropractor Dr. Michelle Orchard in Aurora - we weren't trying to turn baby b, but Webster technique for intrauterine constraint proved to be helpful), confirmed by ultrasound at 37 weeks. But, we had been suspicious based on where we were hearing heart tones recently. However, in labor, it seemed they were both very low and Suzanne even suspected maybe A and B switched positions.Malachi was with us for most of the labor and was so very sweet. My mom helped him understand by telling him I was working very hard and having contractions. He would come over and comfort me with hugs and kisses and by telling me he was sorry I was upset, sorry it's ouchy and asking "having traction mommy?" We sent him and my mom out for a drive in the van when he started getting very tired just after 10p and labor was getting very intense for me. So, off they went and mom came back holding a sleeping Malachi about 30 minutes later. At 11:41p I started pushing on my knees leaning over the birth tub. At 12:16 a.m. Acacia was born in the water, in the caul. They broke her bag and passed her through to me. (Apgars 8/10) I checked to see if she was a boy or girl and announced to Caleb that we had a girl!I then held her while Suzanne held my belly so that Baby B wouldn't turn in any funky positions. She then checked and confirmed she was indeed head down and ready anytime I was ready to push. I said "are you serious? her head is down that far?" I held Acacia in my arms while I pushed in semi-sitting position and at 12:26 a.m. Ameena was born in the water, in the caul. It took 2 people to break her bag. (Apgars 6/7) We had to stimulate her some and cleared her mouth once with a bulb syringe and she began breathing and her heart rate began to climb from 100 up. (I am so thankful for my neonatal res. training as I was so much more calm and instinctually began rubbing her back. And, so glad that no one was taking her away from me to work on her in a french fry warmer across the room!)When she perked up, Caleb checked to see if we had a boy or a girl and announced that she too was a girl! What a surprise, as we had both determined in our minds that it was one of each (for no particular reason).So, there I sat, in my birth tub, in a double wide trailer in Provo, Utah, holding my 2 gorgeous girls, bawling my eyes out. So thankful to have had such a wonderful birth, that they were both healthy and safe and so thankful for my husband who never left my side through this journey. In the words of Grandpa Wilson “God is good and he does answer prayer”.Both girls began nursing as soon as I got in bed and haven't stopped since. I had no more bleeding with the twin birth than I did with Malachi (I was taking alfalfa, yellow dock and chlorophyll during pregnancy and as labor was starting because I was determined not to hemorrhage!) and am feeling great, especially with a couple nights of sleep with 4 hour stretches between feedings.Life is challenging with a 2 year old and twins, and will be more so in a week when Caleb is at work and Brigitte and Andrei move out. But, we are so thankful and ready for a life of joy with these wonderful kids.Thanks again for all your support and love! We couldn't have done this without it.

We each get to hold one!

Our new family - Provo, UT - getting ready to head home

More details to come, but here are the essentials:

Our LMP due date was August 8. Our due date from conception was August 11. We tried many non-invasive attempts to kickstart the labor (including 2 acupuncture sessions, homeopathics, and other more fun techniques) to no avail. So on August 18, we asked our midwife Suzanne to check Angela. She said that Angela was 5 cm dilated.

5:30 p.m. – We had Suzanne “strip the membranes.”

5:45 – On a little walk, Angela’s contractions began in earnest.

6:10 – We were sure labor had started.

~7:00 – Angela gets into the birth tub.

11:41 – Angela begins to push.

12:16 a.m. – Acacia is born with sac intact in the water.

12:26 a.m. – Ameena is born with sac intact in the water.

We are planning to leave for Colorado tomorrow (Sunday) and will arrive sometime on Monday.

That’s it for now! Check back soon for the rest of the story.

A watchful eye from the big bro

Stretch!

Too bright!

Sweet sisters

Daddy giving double love

Soooo sleepy

Malachi meeting his sisters for the 1st time.

Ameena Renee is born - 12:26am

Acacia Lynn is born - 12:16am

Breathing through intense contractions

Malachi filling the labor tub

I have found that trying to explain why we made the choice to come to Utah to deliver these babies is up there in the "potential for misunderstanding" category along with explaining why I believe what Jesus said over, say, what Joseph Smith said. My claim that Jesus is The Savior is, in the ears of many listeners who don't share the same conviction, also a statement that what they believe is worth nada. Whether or not I actually think this about them doesn't matter. I've already been pegged as a Jerry Falwell clone. Saying that my first son's home birth was the most incredible experience and that I couldn't imagine having a hospital birth could peg me as a doctor hating, granola munching Boulderite who would rather live off the grid completely and overthrow the Medical Establishment without a moment's thought.

Well, I have said this and I have been pegged like that. It's as if the choices I have made define other people's lives, or at least threaten them. If I had that kind of power, believe me, I could use it now. At the same time, there's some truth to the accusation. Any claim of exclusivity by definition excludes other beliefs. I think that Christianity has it in spades over Mormonism, Buddhism, and the rest. There are lots of great things about the other religions that I learn from, but ultimately I think Christianity makes the most sense. I'm not judging other people who think old Joe is the best, I just don't agree for lots of good reasons. I think that home, when the baby and mom are healthy, is the best place to give birth. I'm not judging other people who choose hospital births, I just wouldn't do it for lots of good reasons.

It's not that I hate Medicine either. I don't think that doctors are evil for prescribing drugs or for taking prudent steps to cover their well-trained asses from a lawsuit happy, consequence-avoiding society. I think that doctors are extremely valuable and handy when you need them.

And that's the big question, isn't it? “When do you need them?”

We were planning to have a homebirth again with our second pregnancy, right up to 32 weeks when we discovered we were having twins. This introduced a whole set of questions like, "What the fuh?!" and "Are you serious?" After the news settled in, other questions formed: "What do we do now? Any midwives in town willing to put their licenses on the line to deliver twins at home? Are midwives allowed to deliver anywhere else in the country? Is that really a good option? Aren't twins scary to deliver?"

The answer to the last question if you ask just about anyone is "yes." We talked with a truly wonderful OB who, after offering us an elective C-section, gave us statistics like "75% of twins born (in our hospital) are delivered by section" and "prolapsed cord and breech presentations are common and serious complications of delivering twin B." Experience-wise, she delivers one set of twins a year, about average for all the other OB's. She said that the doctors at our hospital like to think that they are prepared to do nothing and everything. But she gave every indication that they would most likely go ahead and do everything because "we don't sleep well when something goes wrong and we lose a baby or a mom. We really don't."

We also talked to a bunch of midwives about it and none of them were concerned. After hearing about our uncomplicated pregnancy and that the babies were both already over 4 pounds, the most common statement they made was, "No problem!" and "If mom is eating right and babies are healthy, you should go to term." All the midwives we talked to went through a fairly extensive screening process to make sure that any potential client expecting twins was healthy and eating the way she should. As a result, all of their twin births were successfully delivered vaginally at home or in the birth center with no emergency transports to the hospital. One midwife we considered seeing in Texas said that the key was diet. The clients (5 of them) who stuck with her throughout the pregnancy and ate the way she told them to all went to term (40 weeks) with their twins and delivered safely in the birth center. The clients (another 5) who didn't stick with her transferred their care to an OB, didn't stick with the diet she suggested, and all of them delivered pre-term and by Cesarean.

Different stories, different experiences. One perspective was fearful, the other confident. Knowing that Angela and the babies were as healthy as could be, we just couldn't swallow the enormous "high risk" pill, but we also couldn't accept the almost too easy "no problem" answer. How to choose? Our OB suggested I do the research on my own using the access I had through work to every medical journal and textbook available.

The conclusions I found were illuminating. Here are a few that were in the obstetrics textbook:

From Gabbe’s Obstetrics, 4th edition, 2002
"…In the series by Chervenak et al.,[261] 81.2 percent of the vertex-vertex twin gestations were delivered vaginally. These investigators, and several others cited in their article, believe that when both twins are in vertex presentation, a cesarean delivery should only be performed for the same indications applied to singletons...

…At birth weights above 1,500 g, there were no neonatal deaths or documented intraventricular hemorrhages and only three cases (5 percent) of 5-minute Apgar scores of less than 7 in the group of second twins delivered vaginally by breech extraction. Chervenak et al.[266] state that their data do not prove vaginal breech delivery of the low-birth-weight second twin to be more damaging than cesarean delivery…On the other hand, if a second twin weighs between 1,500 and 3,500 g and the criteria for vaginal delivery of a singleton breech are met, this series suggests that vaginal breech delivery is an acceptable option…

…The authors, therefore, suggest that primary breech extraction of the second nonvertex twin weighing more than 1,500 g is a reasonable alternative to either cesarean delivery or external version…

…Regardless of the estimated weight, they suggest that an attempt be made to convert the second twin to a vertex presentation by performing an external version after the first twin has been delivered. If this proves successful, a vaginal delivery can be anticipated. If the attempted version is unsuccessful and the EFW is between 2,000 and 3,500 g, a breech extraction can be performed unless the other criteria for a singleton vaginal breech delivery are not satisfied. Recent reports support these recommendations and have documented the efficacy and safety of either external cephalic version[272] or total breech extraction [273] , [274] for the delivery of second nonvertex twins weighing more than 1,500 g…"

At 32 weeks we knew that our babies were vertex/breech and weighed more than 1500 grams. These conclusions are also mostly the same as the ones I found in the other studies I read. There are problems with all the data presented in the textbook and in the studies, the most blatant being the age of the studies - many of them are 20 to 30 years old. Some of the data used was around 40 years old! They also don't extract healthy versus unhealthy pregnancies, IVF treatment (which carries increased risk of complications all around for twins), diet, etc. Also many of the studies draw from very small sample populations.

I found one very recent study that wasn't as encouraging as the conclusions presented in the textbook:

From “Yang Q - Am J Obstet Gynecol - 01-MAR-2005; 192(3): 840-7”
“The risk of asphyxia-related neonatal deaths and morbidity was increased in the group in which both twins were delivered vaginally and the group in which both twins were delivered by cesarean delivery. The increase in neonatal death in the group in which both twins were delivered vaginally was stronger in the birth weight of < 1500 g. In contrast, in the group in which both twins were delivered vaginally and the group in which the second twin was delivered by cesarean delivery after the first twin was delivered vaginally, the increase in neonatal morbidity was greater in the group in which the birth weight was 1500 to 4000 g. CONCLUSION: The risk of neonatal death and morbidity in second-born twins is higher in the group in which both twins were delivered vaginally and the group in which the second twin was delivered by cesarean delivery after the first twin was delivered vaginally compared with the group in which both twins were delivered by cesarean delivery.”


The problem with this conclusion (without actually seeing the data, so I could be wrong) is that it doesn’t concede the increased risk of c-section for both twins or how much greater the risk is for vaginal and c-section after vaginal birth of twin A. Many studies I read did this. They begin by stating the current standard of practice which is pretty much "get ready for the inevitable c-section" and then present data that doesn't necessarily paint as bleak a picture. And they still don't tease out the healthy versus unhealthy pregnancies.

A big problem with these studies is they are replete with bias. I of course introduce my own bias when I read these studies because I'm coming from a different perspective. Bias is unavoidable if you're really honest. But I found myself encouraged by what I read. What I got from it all was that with as healthy as Angela and the twins were, their risks were not higher than a normal healthy singleton birth. And that meant that homebirth of the twins was fine, that we weren't taking any higher risk with the twins than we had with Malachi. With the perspective that home is a safer place to have healthy babies than the hospital, we were actually chosing the safest place for the twins to be born. Talk about counter-everything expected about twins!

The bottom line is that we met all the criteria for a safe vaginal birth of the twins, something we were pretty much assured no one at the hospital would be willing to do aside from letting Angela labor on a table in the OR "just in case," a great recipe for c-section. The natural birth community was more confident and offered the birth we wanted. Either way, we would be displaced.

So the question changed from "Is home birth safe for twins?" to "Who is more confident in their ability to deliver breech babies?" Gabbe's Obstetrics and many of the studies supporting vaginal delivery of twins warned that the delivery should only be performed by someone who was well-versed and comfortable with external version and breech extraction, otherwise you could end up with a life-threatening problem. Angela expressed this as her greatest concern too. Our OB said that breech extractions were becoming more common with the increase in twin births these days, but we had our doubts considering we would be in the OR prepped for Cesarean. Midwives deal with breech presentations a lot and have to be comfortable with version and extraction simply because there aren't any other options available, aside from going to the hospital.

Angela's comfort with midwives and lack of it for the OR was the deciding factor. Besides, we wouldn't be able to choose which OB would come to our birth - it would be a luck of the draw. Her anxiety around the very idea of the hospital predicted the downward spiral of interventions if we went that direction, skilled physicians or not.

So how did we end up in Utah? Angela first alerted the entire natural birth community of our problem and asked for suggestions. Then we turned to the First Lady of Midwifery, Ina May Gaskin, who salon.com credits as reintroducing midwifery to the United States after the highly patriarchal medical practice in the 1950's. She practices at The Farm in Tennessee. We were trying to figure out how to make this work when our midwife Christie suggested going to Dallas where she was trained. This was much closer to home, cheaper, and I had some family friends from when I lived there. Then, the midwife we chose there had a bad horse accident that took her out of commission. Simultaneously, a doula in Austin wrote Angela and suggested a midwife in Utah, where the laws were being re-written to make it possible for midwives to deliver twins at home. This was a much more appealing place to wait it out, closer to home, and even cheaper. Then someone else in the network said they just moved from Provo (where we needed to be) to Ohio and that we could stay in the double wide they were still trying to sell. From there, a cascade of people knowing people pulled everything together. We have furniture and dishes, my boss outfitted me with a computer so I could work long distance, some good friends sold us a mini-van for cheap, and on and on it goes.

We are sure it is all a sign that we are where God wants us. It should have been a Herculean effort to pull together so many details in just a couple of weeks, but it all fell together so easily.

Now if he would just kick start the labor for us. This has become the true test of our faith in God's hand and in the natural birth process.

"We rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not disappoint us, because God's love has been poured into our hearts through the Holy Spirit which has been given to us." -- Romans 5:3-5


...not that we're suffering in the way that Paul is really talking about. Not me, anyway. My wife, on the other hand...well, let's just say that she's ready for labor to begin. But, it is interesting that the process of hope production is so similar in other trying circumstances, such as voluntarily displacing yourself and your family for an unknown period of time to await the birth of 2 people who will greatly change your already crazy life.

So, nope, they aren't here yet.

We are pretty much counting on God to pour his love into us so that we can keep loving each other and loving Malachi through his two-year-oldness and as he tries to cope with missing friends and home. He has been a real trooper, though we have seen some regression in certain behaviors. Nap and bed times have been real trials. Angela spends a good 2 hours most days in battle with either no nap at all or a nap in the car on the way to picking me up from work. Bedtime isn't much better, but he does at least eventually go to sleep. He's been having more "accidents" too. But, from what I understand, these regressions are also fairly normal two year old things too. He still grows sad now and then and has some mood swings, but these are beginning to even out and he is his normal cheerful self more times than not.

Andrei and Brigitte returned to Colorado last Saturday. It was a very sad day. They kept us company and were good playmates for Malachi. Malachi seemed a little lost that day and I felt like I was really beginning the work of actually moving to Utah. I became melancholy and felt like a last tie to home was severing.

Angela's mom arrived the day before to be here for the birth and help drive us home. Her presence has helped ease the loss of Brigitte and Andrei and actually hightens the anticipation we feel toward the imminent arrival of the twins.

Another blessing that came our way was the arrival last night of our Colorado midwife Christie. Her husband Bryce and daughter Olivia came with her. Now our birth team is complete and Malachi has a playmate his age.

Christie came to this morning's midwife appointment with us to meet Suzanne. The babys are still head down and looking good. And bigger. Hopefully this was our last prenatal visit, but we made one more for next week with the anticipation of the pleasure of canceling it.

Well, folks, that's the latest. Here are a few pictures of our double wide, Provo, and our beautiful trip to Strawberry Reservoir:

andrei climbing the aptly named "rock canyon"





















a future climber at play





















one of the sweetest moves i've ever seen!





















the once and future climber

view of provo canyon and mt. timpanogos from the falls
















brigitte and andrei (my sister and brother-in-law)
















hiking the beautiful, fly-ridden side of mt. timpanogos

a brave face in a new place















cool dude at "bridal veil falls"





















flouting the lds patriarchy

Just a quick update.
Brigitte and Andrei are here now and Malachi is loving it. So nice to have others to help care for him. Now I know why it takes a village to raise kids ;) I don't think we're meant to do it alone.

Another great thing! - They were able to drive our new mini van out (well, it's not technically ours yet) that we're buying from Vaun and Barry Swanson. As you know, this was a big prayer request as we drove the Saturn out with 3 of us in it and somehow need to get 5 of us (plus my mom) home . The night of the Xylem party at their house, Vaun asked if there was anything they had that would make our trip easier. At the time, I couldn't think of anything....until I was pulling out of the driveway and noticed their Toyota Previa sitting there. I told Caleb about it and he called her the next day. Turns out, they have been planning to sell it. So, they got us a temporary tag, oil change, washed it, and sent it on it's way with Brigitte and Andrei. Thank you so much Vaun and Barry!

It has been so amazing to watch the Lord open so many doors through this process. I don't think I've ever experienced anything like it and sure does humble me in a lesson of faith.

So, I'm 38 weeks today, we had a midwife appointment yesterday - pretty uneventful but good. It's a good opportunity to get to know her. It's also neat for me to make this connection because she's the academic dean of the midwifery school that I've been looking into out here (not that I'll be doing that anytime soon with twins;).

So, now, Christie's other client just needs to have her baby ;) so she can come out and join us and I'll be ready for labor ;) I'm happy to wait until the babies are ready, just hoping I'm not one of those odd people (which we already know I am) that goes past her due date with twins.

Malachi is really struggling with naps and bedtime. Definitely pushing his boundaries in his new environment. But, we're just trying to love him through it and stay consistent as we sometimes spend 2 hours and a few timeouts to get him to lay down. We have lots of talks about why we're here and reassuring him that we are going back home, sometime soon. Please do keep him in your prayers.

Well, that's all I can think of for now. I'm on short leave while Malachi stays with Brigitte and Andrei so I could go to the chiropractor - better get back!

Love, Angela (Caleb, Malachi, MaxA and MaxB)

well, here i am in my new office at the holiday inn. hopefully i can stay here for a couple of days before they boot me out. why the trouble? let me tell you.

it all started back in the 1820 when god the father and jesus christ appeared to a guy named joe smith. they told him he was going to be the prophet to restore the REAL church after the Church was withdrawn from the world after the apostles died. three years later the angel moroni told him to look under some rocks where joe found an ancient record of the old peoples of america written in a strange language on gold plates. he translated these and they became the book of mormon: another testament of jesus christ. he started his church and trained another guy named brigham young who became an apostle to the prophet joe. after joe was killed in 1833, young decided to move his family and 1000 others to utah. soon he supervised the movement to utah of 70,000 more people from the east coast and europe.

his supervision continues to this day. apparently jesus told these people that they have to be nice to everyone and that they can't drink alcohol or caffeine. this was problematic with a lot of the youth as you can imagine. with the founding of his university in provo, he was able to socialize the youth to his standards with the following honor code:

"all students are required to abstain from possessing, serving, or consuming alcoholic beverages, tobacco, tea, coffee, or harmful drugs." they also can't say bad words or have bad grooming.

so for a while there were cafe's in provo that served and did these things, including offering wireless access to the internet. but, young decided that he'd better regain control over these matters. so he offered wireless internet services to his students (with proper passwords and a hefty filtering system) and then somehow influenced all the cafes to shut down their internet access. which they did. they also must have closed up shop because there is only TWO coffee shops here, one of which is an einsteins. the other is NOT a starbucks. there is not a green insignia anywhere--probably not within 20 miles.

so that lead me to a long trek and many bootings off of servers--from the public library to the mall. now, here i am, in the empty continental breakfast room of a smallish holiday inn, hoping i can stay here for at least a couple of days before they figure out i'm not renting a room.

well, that's all for now. angela's tired, malachi is adjusting well but is a little hyper, the babies are fine and moving around, our double wide is comfortable and cool, and we see our new midwife tomorrow morning.

feel free to email or leave a message on my work phone because i'm checking them regularly.

until the second coming,
joe

To catch everyone up on goings on here in Utah, I am reprinting Angela's two updates and my one. I will also include some pictures to illustrate. Fun reading!


our first meal in the double-wide















Hi there!
Just wanted to let you all know that we arrived safely in beautiful Utah. It is hot - well over 100 every day, but thankfully, we have a/c in our nice little double wide trailer. We're learning a little bit about the mormon community, but no one has tried to convert us yet.

The trip was good. We got in early afternoon on Monday and Caleb has spent the last couple of mornings trying to find a good wireless connection (see his entertaining email to his work team at the end of my note). He finally ended up today at Borders in the town over from us where our midwife is (about 10-15 minute drive) which is where he'll be daily until the twins are born.
Malachi and I are having fun exploring the little towns. We found a shaded park with a creek that runs through it to play in. We're getting settled but I think Malachi said it all when he told us last night and today "Sad, miss friends". We do miss you all, friends and family and we're sad to not be home for this big event. We do feel good about our decision though, and are pretty relaxed now that we're here.

God is good and we have been well cared for since the moment we arrived. We walked in to our temporary home that had been furnished with a card table, 4 folding chairs and 2 camping chairs.

Since then, someone has stopped by daily with dishes, an airbed, a couch, 2 twin beds to make into a king, lemon cake and lots of blessings and well-wishes.

We also found out that one of Karen's good friends is here while her dad recovers and has offered to help us in any way should we need it. So, should we go into labor before Brigitte and Andrei come next weekend (which I think is highly unlikely as I have no signs of labor) we'll have help. What a relief!

My mom is also planning to fly out as soon as I go into labor (or when Brigitte and Andrei leave) and help us with the drive home a few days later.

I'm 37 weeks today, regaining energy after our drive and after a visit to the chiropractor this morning (which I've been doing weekly for over a month now) I feel pretty good. Christie checked my hemoglobin levels before we left and found them to be a little low (but still great according to Utah standards ;), so I've been taking some additional supplements to help with possilble anemia, which I think is helping. We met our new midwife this morning and she's great. We now have our birth kit, labor tub and other supplies and we're ready to go anytime! We have a 2nd ultrasound scheduled for this Friday just to verify the position of the babies so I'll let you know how that goes.

We're going to look into a local play group to try and meet some new friends and do some fun things. The mountains are beautiful and we look forward to exploring the area a little more this weekend.

We'll keep you posted! I will probably only respond to email 1 time a day at the most when I pick Caleb up from Borders each afternoon.

Love,
Caleb, Angela, Malachi, MaxA and MaxB

we all invent ourselves,
and, uh, you know me.
--REM