Showing posts with label placenta. Show all posts
Showing posts with label placenta. Show all posts

Monday, April 18, 2011

The Parallel Paradox Part 3 - Dealing with Placenta Previa

Continued from parts one and two.

After getting off the phone, and calming down, I drove directly to my local natural parenting store, where I'd been going for cloth diapers, slings, and a home birth support group. Surely their abundant bookshelves would offer up some helpful and reassuring information, somewhere in all the books I'd been devouring for their information on natural/home birth and holistic pregnancy.

On the contrary. I looked in index after index after index. And each book in turn referred me to a page that mentioned the several universally-agreed-upon contraindications for a vaginal birth. I might as well be walking around with a pre-prolapsed cord. Some mentioned that placentas can migrate late in pregnancy, but offered no further information. All the crunchalicious books I had found so empowering were now shutting a door in my face, or so it felt.

One of the employees that I had become friendly with came over to offer some help, and I told her what was up. "I guess I'm just feeling pretty powerless right now," I said, fighting tears but still self-conscious that maybe I was blowing the whole thing out of proportion. She reiterated what the perinatologist had said about the likelihood of migration, and though she didn't know anyone who'd dealt with this personally, she had known of some women on a message board who had. I decided to check in on the message boards when I got home.

Before I logged on, though, I decided to browse through my own shelves and see if I found anything new. All of my own books produced the same result as the books at the store - "Previa, placenta, 176, contraindication to vaginal delivery"; "Placental abnormalities, 242, previa"; "Placenta previa, 52, reasons for cesarean"; "Previa, placenta, 67, abandon all hope" - except for one. One very unexpected resource.

When she got the news of her impending grandmahood, my birthmom ran right out and picked up what seemed to be THE book, the bible, even, for pregnant women, and was recommended as such by the bookstore employees: "What to Expect When You're Expecting". Now, as you'll gather from that snarky link of mine there, this is a book that, generally speaking, is not held in the highest regard by many naturally-minded people. Those on the spectrum of crunch tend to see it as very conventional, quite pro-intervention, and unnecessarily anxiety-provoking. Yet this book was the one place that went beyond listing placenta previa as a flashing red light, offered me some more information, and even managed to be reassuring.

It explained that previas are present at only 1 in every 200 births, that "A low-lying placenta is fairly common but as pregnancy progresses, the placenta usually moves upward and away from the cervix." It went on to say that nothing (nothing!) needed to be done about it - no mention of pelvic rest or limiting activity. "You don't even have to give your low-lying placenta a second thought." I wondered if I should have the authors call [insert Connecticut OB/CNM collaborative practice name here].

The book then mentioned a few risk factors for placenta previa, including smoking and previous uterine surgery. Though I had already quit, I did smoke for 15 years, and 'uterine surgery' does include D&C, which, as the perinatologist had so sensitively clarified in categorizing its non-spontaneous nature, was also true in my case. Enter guilt: because of mistakes and poor choices past, my baby was now at risk. Add that to my custom blend of fear and helplessness.

Yet despite feeling this guilt, I felt a little better about my odds, and a little more armed with information. I had a longer talk with Nancy, my midwife, about things I might be able to do for myself under the circumstances. "The worst part is that there's nothing that I can do about it!" I cried. "Oh, but there is," she said. No, she didn't know of any acupuncture or homeopathic treatments, as I had been wondering, but talked about visualization as a powerful tool, and explained how placentas tend to be attached to parts of the uterus with good, iron-rich blood supplies. I devised a regiment where I would take Floradix*, a natural and non-constipating liquid iron supplement, every day, and every night I would utilize my massage skills and use upward strokes on my belly to help me visualize my placenta migrating upwards. (This is not a medical treatment or even an official massage technique, simply a tactile aid to my own visualization and positive-thinking process.)

As the week wore on, I talked with others who offered comfort and support, and also valued the use of visualization. One of my wise massage therapy co-workers and mentors was especially adept at 'manifestation', and helped me fine-tune what I was going for. One important point was to work on visualizing and verbalizing things in the positive - in her view, the Universe doesn't respond to our negations of things in our statements, but to the things themselves. I know, I know, can I vague that up a little more? For example: in a birth plan, rather than asking for "no episiotomy", you would ask for and envision "an intact perineum." So, in my case, rather than asking for and focusing on "no placenta previa", I worked on manifesting "a clear and open cervix".

Does this all sound awfully "woo" to you? I know. It kind of is. I'm actually really not much of a woo person in general, but this was all I had. It helped me to think I was doing something for myself, being active in the process, and taking back some power in some small way, rather than sitting around feeling passive, powerless, and sorry for myself, victimized by a cruel combination of questionable past choices and lousy luck.

All this was prior to my next cervical check with the CNM practice. I had one more to go before they would give me the no-cerclage-necessary all-clear, and the perinatologist had sent them his recommendation to do all subsequent internal exams via transvaginal ultrasound. So I returned to the CNMs about a week after the Level II ultrasound that diagnosed the previa, a week that had started out as an emotional Space Mountain, but during which I had gradually found my way to feeling more stable and optimistic, however hesitantly. Assuming my cervix was still closed, I was planning on discontinuing the parallel care, but was a little uncertain now that my placenta had thrown a wild card into the mix.

I started with a trip to the ultrasound technician's room, where she confirmed the same placenta location, and also noted that my cervix was still long and closed - no sign of 'incompetency'. I then went into an exam room to wait for whoever the rotation assigned to me that day, feeling a little wary but fairly resolved, based on everything I had learned.

The CNM that entered the room was the one I had come to think of as Ms. Worst Case Scenario, the youngest one in the practice and also, in my experience, the most conservative. It had been she who raised the alarm about my cervix to begin with, and had exerted a substantial amount of pressure regarding prenatal testing. Now, she looked over my revised chart with its fresh new scarlet P, and reviewed all the precautions I needed to take, including pelvic rest and no strenuous exercise. I agreed to all of the precautions, and then started to explain what I was doing on my end, with visualization and positive thinking.

She cut me off with a shrug, saying, and I swear I quote this word for word, even after all this time, "Well, either it's going to move or it's not, and no amount of thinking you do is going to change that."

Long pause.

You know, you don't have to believe in what I was talking about. I had my own doubts. But my GOD, it was obvious that the whole placenta situation was really , really upsetting to me, and even more obvious that this was something that was helping me to feel better about it. Would it have &@#$!ing killed her to at least pretend to be - well, not supportive, because that was clearly beyond her, but to simply remain neutral? Sure, YOU might not think it would help, but there's also no way it would hurt, so what the hell was the problem? Even a noncommittal nod, a "Mmm-hmm . . ." and a change of subject would have been preferable to just dismissing me outright.

I shouldn't have let it affect me, but I was already on shaky ground. I tried to remind myself that, AGAIN, this was just the world that she came from, and she wished me no ill will; on the contrary, she was giving me the care that she believed in, and was trying to do what was best according to her belief system. A placenta previa WAS something to take seriously (none of my posts are intended to suggest that it isn't.). And again, in contrast with other major pregnancy complications, fetal OR maternal, things certainly could have been worse. I knew better. Already, I knew better, yet her words took the wind right out of my fragile fledgling sails.

Slowly, I was realizing how I had been swept along in a cascade of interventions, prenatally. Hospital tickets aren't only issued for the grand finale-ride of labor.

We went on to have a bit of an argument about whether or not it was okay for me to fly home for Christmas. I had mentioned my plans to visit family in Colorado, and she grimaced as though I was suggesting I take up jousting. Asking her to explain her concerns, as every book and website I visited stated that travel was fine at this point (it might be unpleasant when feeling nauseous in the 1st trimester, and that in the third, the concern was that IF one should happen to go into premature labor, one would be away from appropriate care - not that it caused premature labor), that 2nd trimester was the safest time of all. Did my previa make some kind of difference?

She said her concern was the possibility that an abrupt change in pressure, should there be an incident, could cause my water to break. I was learning to speak up, however hesitantly, and have fewer l'esprit d'escalier moments five minutes after leaving the office where I thought of all the things I wished I could have said in the moment, and I pointed out that this unlikely scenario could happen to ANY pregnant woman. So was she really suggesting that no pregnant woman should ever board a plane, period? She waffled a little, but essentially said yes. There was a risk, and if that risk came true, how would you live with yourself?

This is pretty much where I realized that East was East, West was West, and never the 'twain shall meet. I was trying to reconcile two very, very different worlds, and had fallen into a strange kind of mostly self-created trap as a result. The fact that I had been needing to decompress after every CNM visit had already demonstrated that there was a fundamental dissonance in mindsets. However unintentionally, I had bought the hospital ticket. I went into the situation thinking that parallel care would be "the best of both worlds", but it became ever clearer that it was not nearly as simple as that. The kind of care given (and sought) in pregnancy IS, in part, a manifestation of various sets of beliefs. I don't think it's remotely as black & white - or as polarizing - as "Trust Birth" vs. "Fear Birth", but there IS a spectrum between those two poles, and these particular CNMs** and I were clearly many, many miles apart.

I left that visit with a stamp of approval regarding my cervical competency, informed them that as a result of said competency, I was not planning to continue parallel care in general, but did need to return for a follow-up ultrasound at 28 weeks. The odds were totally with me. One more spin on the hospital ride, I hoped and prayed and visualized - to see if it had migrated.

Here I break with what would make the most sense in serial narrative form, and post a spoiler:

It hadn't.

*Note: I'm a fan of Floradix, but word to the wise, plan to have something in hand to 'chase' it with immediately. Great product, revolting taste. I always followed with orange juice.

**It bears reiterating that I am not at all trying to slam CNMs in general - this is, again, just my own experience.

Sunday, April 10, 2011

The Parallel Paradox Part 2 - Diagnosis of Placenta Previa

And so the stage was set.

Despite not having any health insurance, and despite my own reservations, I agreed to the CNMs' recommendation, returning to their practice to have my cervix checked every 2 weeks. As frustrating as this was, I only planned to continue this parallel care until week 20, when they had decreed we could stop the cervical checks. Once I got the all-clear, I was done with them, and would continue my care with Nancy and Gengi alone.

So began a pattern where after each visit to the CNMs, I would visit my CPMs to decompress from the experience (or make a lengthy phone call, if we had no appointment that week). Nancy and Gengi, who I thought of as my 'real' midwives - not because CNMs (a.k.a. nurse midwives) are not legitimate, but because I had started out with no intention of getting any care from them; I had just stumbled into it - did an admirable job of talking me down after each CNM experience.

Fortunately, as those who get CPM care know, these visits were always at least an hour long, sometimes more. The old joke is that with an OB you wait for an hour and see them for 5 minutes, and with a CPM you wait 5 minutes and see them for an hour. (In my experience, which is only my experience, with these particular CNMs, you'd get about 15 minutes rather than the OB's 5.) With Nancy and Gengi, sometimes the first half an hour or more would have to be devoted to therapeutically working through the damage from the last CNM visit. It mostly had to do with my potentially-incompetent cervix, but there were plenty of other opportunities to instill other doubts and insecurities, too. You've gained HOW much weight already? Aren't you getting any prenatal testing done? And what about those suspicious dates?

At week 14, I stayed after my cervical check to get a dating ultrasound, in order to clear up the discrepancy between my conception date and the extra centimeter or so my belly was measuring. I had only planned to get one anatomy scan at around week 20, but hey, what's one more compromise? I got my first glimpse of the precious, and determined that the dates were possibly a week off, though it was impossible to tell for sure (but hey, what's an extra cost for no reason at all?). I also was told that my amniotic fluid might be a little bit high (but hey, you PROBABLY don't need to worry about it yet).

And then, literally as I was on my way out, the technician seemed to make a last-minute decision to share one more piece of information with me, something she had been hesitating about.

"Just so you know, right now it looks like your placenta is lying a little low." I must have looked alarmed, because she immediately added, "Most of the time it'll resolve by the end of your pregnancy. It's pretty common for it to be low this early.'

I left the office feeling uneasy, but decided to take her word for it and investigated no further at the time, focusing on the pictures of my sweet wiggly little being, the fetus we came to know as Samily - Sam if it was a boy, Lily if it turned out to be a girl.

More cervical exams with the CNMs, more ranting and railing therapy sessions with my midwives.

Eventually, week 18 arrived, time for the Level II ultrasound I had agreed to as my one concession to prenatal testing. For this, I went to the UCONN Health Center, where the most advanced technology and high-risk specialists were located. Somehow, walking in, I still looked forward to it, being as interested in all things pregnancy and birth as I was. Surely it would be objectively fascinating as well as personally moving to get such an in-depth look at my future baby. First, a friendly technician set me up, spreading the gel and connecting the computer screen to a larger screen where the images were projected on a huge wall in front of me.

There she was (though they complied in keeping the gender a secret), my gorgeous baby. I was captivated, glued to the screen as the technician took measurements and pointed out various parts. There may have been a point where she furrowed her brow and looked worried about something, but I'd be lying if I said I remembered or even noticed at the time - I was too enchanted by the black & white silent movie of my dream come true, shifting and squirming and already looking cuter than any ultrasound I'd ever seen - my motherly bias was already in evidence.

Then the perinatologist entered the room, a bearded and professionally aloof man in a long lab coat. After briefly greeting me, he turned to my chart, reviewing a few things like my age and how many weeks I was. Then he asked about number of pregnancies, seeing that his was not actually my first, and asked, about abortion, "Okay, was this a spontaneous abortion?"

Excuse me while I digress here for a minute. Not only was that completely unnecessarily awkward and uncomfortable, I am fully aware that the medical term for a miscarriage is "spontanous abortion". Is there ANY woman, ANYWHERE who would actually refer to her own miscarriage as a "spontaneous abortion"? For crying out loud. I realize that one's history is important, but there has to be a better way to clarify. Anyway, already off on the wrong foot, I begrudgingly confirmed that no, it was not.

After going over Samily's measurements, which all appeared to be perfectly normal, he moved on to the placenta. Which brings us back to where I opened.

"At this point, we're calling it a complete previa."

After a nanosecond of shock, I burst into tears. I could already see myself on the operating table, right then and there. My hopes of a home birth or even a natural hospital birth, dashed. My body, a betrayal. The doctor, to his credit, tried to reassure me. He explained that, as the technician had mentioned, the odds were in my favor that the placenta would migrate upward as my uterus grew, and that most previas diagnosed this early would 'resolve' by the end of the pregnancy.

There are varying degrees of placenta previas. There are complete previas, which refers to when the entire cervix is completely covered; then partial ones, where only part of the cervix is overlapped; and also marginal ones, where the edge of the placenta just barely borders the cervix but is still close enough to be a concern. My own, to be more specific, though it was complete, was not centered over the os (the 'mouth' of the cervix), as depicted here:

Rather, mine was positioned so the lowermost edge of the placenta lay over the cervix. A bit more like this:

He then used the analogy of drawing a dot close to the opening of a balloon before it's blown up all the way; the dot won't actually relocate, but it will appear to move upward as the balloon grows. This was likely to happen with me - likely, but not guaranteed. I nodded through my tears as he explained that a follow-up ultrasound would be scheduled for about 28 weeks, and this meant that I was on pelvic rest until it was determined that the placenta had cleared out of the way. No sexual activity of any kind at all, especially anything that could cause orgasm, and nothing in the vagina, period. For the next 10 weeks, I was also to avoid any exercise more strenuous than gentle yoga.

Oh, and (double-checking my charts) due to the need to continue checking my cervix for at least one more appointment, the exams would need to be done via transvaginal ultrasound, rather than fingers. Yes, that's right, I was on order to have nothing in my vagina, nothing, not even the gloved fingers of a conventional medical professional . . . unless it was a big expensive medical dildo-like medical instrument. THAT was fine. I agreed, of course, and tried my best to hold it together until I left the office.

As soon as I hit the elevator, I finally let myself sob and sob. The doors opened on a group of young doctors, and I quickly walked by their sympathetic looks, feeling ashamed. Even then, I had perspective. I knew that this medical center had seen more than its share of sobbing pregnant women, and the reason for that sobbing was often much more serious than my own. I knew that this very moment there were women receiving far worse news than I, news of terrible congenital defects or other heartbreaking outcomes. I knew that given the opportunity, plenty of women would trade places with me in a heartbeat. A mere c-section compared with one of the "incompatible with life" triosomy abnormalities, just for one example? No question.

But being aware of this, and trying to count my blessings, didn't quell my sorrow or my fear in that moment. I called the father from my car, followed by my midwife (my 'real' midwife), both of whom did their very best to reassure me. A for effort.

Part 3 coming soon.

Wednesday, April 6, 2011

The Parallel Paradox: My Experience With Placenta Previa, Part 1

"At this point we're calling it a complete previa."

The perinatologist stated this so casually, so technically, so matter-of-factly. A complete placenta previa, detected during the Level II ultrasound I had agreed to do at 18 weeks, as what I thought of as a fair compromise to all the other prenatal testing options offered (and encouraged, frankly) by the CNM practice I had been seeing in tandem with my home birth CPM. The quad screen produced too many false positives, the CVS seemed way too invasive and risky. But hey, I had thought about doing a basic anatomy scan at around 20 weeks anyway, so why not do a sonogram that would be a little more thorough? Including a consultation with a perinatologist to boot? What could be the harm?

Backing up for a moment: Unless you're brand-new to this blog, you already know the happy outcome of my pregnancy: I had an uncomplicated home water birth with a healthy baby girl. What I've never talked about here is the story of the pregnancy itself, including, yes, a placenta previa that cast a shadow over the whole experience, threatening to change my plans for not only a home birth, but any hope of a vaginal birth at all.

Periodically, I see moms posting about their own previa diagnoses, on message boards and Facebook and the like, and my heart goes out to them - I know just how uncertain and anxious and helpless the feeling can be. I always swore that I would someday write out my own story in order to offer up a positive spin on the whole angsty saga. Only 3 years later, I'm finally getting around to it.

The story has more to it than just the painstakingly slow migration of my placenta, however; the experience of getting what's commonly referred to as "parallel care" from a conventional medical practice has lessons - and pitfalls, in my case - of its own. It's hard to separate one aspect of the pregnancy from the other, I've found each time I begin to approach it, so I tell the two tales together.

So before we get back to the perinatologist delivering the bad news to me, a bit on how I, a mom who was planning on homebirth from day one, had even gotten there in the first place.

When I decided on my home birth midwife, Nancy, a wonderful CPM with a very experienced apprentice, I had no intention of getting any extra prenatal care. But in order to get my blood workup done, Nancy recommended I go to a practice in the area that was relatively friendly to the idea of home birth. Emphasis on the relatively; they did not formally offer parallel care, but knew that some of their patients would occasionally be doing this anyway, and so had a waiver on hand releasing them of responsibility. Fair enough - but I didn't go into their practice even expecting to go that far. The plan was just to get the blood work and be done.

But when I made the appointment, the receptionist asked if I wanted the CNM rotation or the OB rotation. I thought it was nice that they offered a choice, and asked for the CNMs, of course. When I arrived, it turned out that I had been scheduled for a full initial prenatal appointment, not just the tests. "Well, why not go ahead and get checked out?" I thought.

"What could be the harm?"


In that first appointment, the CNM I happened to get was the youngest in the practice, and in my experience, the most conservative. She looked over my history, and with great concern, noted that I had needed a cone biopsy on my cervix due to moderate dysplasia, a full 15 years prior (with no abnormal pap smears since). This was something I had discussed with Nancy and Gengi already, who thought there was a small the scar tissue might be an issue when it came time to dilate, but otherwise saw no need for additional concern. They had worked with plenty of other moms with similar procedures in their pasts and had no issues during pregnancy or in labor.

This CNM, however, saw only the worst case scenario, recommending that I have my cervix checked for "incompetency" every two weeks, until I reached 20 weeks, and if it should show signs of prematurely dilating, they would put a cerclage in place, essentially stitching it closed until late pregnancy. The fear was put in me. My body was flawed, my baby at risk. How could I say no, and risk a miscarriage? Never mind that this was at an extreme additional expense: I should also note that this was all going to be out of pocket, since try as we did to get me health insurance, not one company would take me once I was already knocked up, since pregnancy was a pre-existing condition. We were already planning on paying Nancy her fee out of pocket, but hoped to at least get something for any additional care that was needed. To no avail.

In that same initial visit, the alarm was raised about my dates. Despite knowing exactly when I had conceived, I was "measuring large" for what was supposed to be a 12 week pregnancy, and I was more or less ordered to get a dating ultrasound, even though I had been hoping to get only one anatomy scan at around 20 weeks - again, just to be on the "safe side". I tried to reason my way out of this early ultrasound, hoping that we could just wait until 20 weeks and get a date estimate then, but apparently the sonogram's dating accuracy declines as time goes by, and she insisted that without accurate dates, they couldn't properly continue my care.

I reluctantly agreed to return in 2 weeks for this, along with my next cervical examination, and with some additional strong words encouraging me to decide on a variety of prenatal testing options, we finished the visit. I walked out feeling shaken and manipulated. Not because she meant me any harm - on the contrary, she was just recommending what, according to her training, was the safest course of action. She was only doing her job. But my feelings about my pregnancy were permanently changed, my belief in my body was shaken, and I found myself unable to stand up for what I believed and wanted.

To be continued.

Monday, October 25, 2010

My first encapsulation, with bonus Buffy reference. GRAPHIC!

(Note to self, make sure I don't accidentally post this on my food blog . . . )

SECOND WARNING: This is going to be graphic.

I've been touting the potential benefits of placenta consumption, specifically in the form of encapsulation, which is by far the most palatable means of so doing for most, myself included. Check out the site Placenta Benefits for tons of information, including articles on its benefits (such as reducing bleeding and lochia, helping to prevent postpartum depression, and aiding abundant lactation), how to get one's placenta released from the hospital if you birthed there, collected scientific research and so on. I missed out on the chance to do this with my own placenta, sadly, but I'm currently working with a postpartum client who was not only game to give this a try, but also gave me permission to both write about and share photographs of the whole process. DID I MENTION THIS WAS GOING TO BE GRAPHIC?

P.S. This is going to be graphic!


I was alerted to the happy birth of her second daughter within hours of the happy event, I hightailed it over to her house to pick up the goods as soon as possible, and set to work.

And here's the healthy specimen. I like my Culinary Institute of America logo on the cutting sheet there, don't you? Anyway, her midwives had already removed the umbilical cord and wrapped it up neatly, storing it in the refrigerator until I could get there to pick it up. (This was a home birth, so we didn't have to worry about obtaining it from the hospital.)

I donned gloves and got down to business. The process involves three major steps: steaming the placenta, then drying it either in a dehydrator or an oven on a very low setting, and then grinding it into a powder. First it was thoroughly rinsed, then cut into several pieces in order to fit manageably into the steamer.

I then steamed it with a sliced lemon and a few chunks of ginger, for both preservation and odor. The scent of this has been remarked upon; it's not unpleasant. One friend of mine found the scent disturbing specifically because she thought it actually smelled quite tasty; like, she kept thinking "Mmm, pot roast," and then remembering immediately what it actually was. Others have described it as rather gamey, like cooking elk or deer, if you have experience of that. I wonder if it might not be best described as the scent of offal cooking. Big game offal. With Asian flavor profiles, due to the citrus and ginger.

OKAY, if you're still with me, after steaming the placenta for 15 minutes on each side, I sliced it into smaller strips and placed it into my preheated low oven. There it remained overnight, and because it wasn't quite done yet in the morning and I had to depart for work, on the advice of my friend Justine (who you might remember from our placenta playdate), I cranked the oven up for just a few minutes and then turned it off altogether. Perfect.

And there it is! All that was left to do was grind it up. Lucky for me, I have a Vita-Mix blender, the Cadillac of blenders, but a good food processor would do the trick just fine. It pulverized it in about 10 seconds.

I then made the mistake of not letting the dust settle before opening. Clouds of placenta dust poofed out the top, and I couldn't help inhaling quite a bit, then having a huge coughing fit. Suddenly I knew exactly how Buffy feels when she dusts a vamp and accidentally gets a lungful.

That's all there is to it! I filled a few capsules just to get her started, but there's no need to do all of them at once, and I'm told they can actually get sticky if left too long. The rest went into a ziploc baggie along with some fenugreek and blessed thistle (not a huge amount of either), and I brought it right over to mama, who has been taking them regularly ever since!

I'm so grateful to her for allowing me to have this experience, as it's definitely something I want to be able to offer to all my clients in the future, and I'm also glad to have been able to share it with you! (If you made it to the end of this, you're officially a member of the birthgeek club. Check your inbox for the secret handshake and exclusive decoder ring.)

Saturday, September 18, 2010

Placenta Playdate

Unless you plan to encapsulate or otherwise consume your placenta shortly after birth (pun so intended), chances are, if you're a homebirther, this amazing, miraculous, life-sustaining yet disposable organ is liable to spend a good amount of time in your freezer, awaiting the day the parents get their act together enough to do something meaningful with it. I believe there's even a t-shirt out there to that effect. Let's see . . .


WARNING: The rest of this post is not for the faint of heart, if you're not an avowed birthnerd, this is liable to squick you out in a serious way. Ok, read on:

Up until yesterday, Lily's placenta had been residing in the deep recesses of my freezer for just shy of 2 and a half years, awaiting symbolic closure. I figured I would eventually bury it, but had yet to find a suitable final resting place for this incredible organ which had both caused me so much anxiety during pregnancy (it was a persistent previa, not cleared for delivery until week 34) and also sustained my precious baby, passing along the good and filtering out the bad, acting as the gateway between our bodies - maybe even our souls. I couldn't bring myself to leave it somewhere random.

Obviously the time has long since passed to encapsulate it, though I fully plan to do so next time (and had I known more about encapsulation, I definitely would have done so - it may have done a lot to help me cope with my postpartum period). I figured all I could really do with it is eventually find a burial spot - but it turns out that there was one thing that I definitely could still do with it.

I was thrilled to learn that my friend Justine had defrosted her daughter's at about 18 months and it was still in good enough shape to make placenta prints! I had assumed the tissue wouldn't hold up to being frozen that long, but I was wrong! So we set up a date for the most organic crafting activity ever, and I transferred it from the freezer to the fridge. Once it had a chance to defrost almost completely, I took it out to lay it a little flatter and lay some towels beneath it, as it would be giving of a lot of excess moisture, in preparation for the big day. I found it wrapped in several layers, even within the outer layer of heavy-duty freezer bag:

Then, there were several plastic bags, and finally, the original Chux pad it had been laid in. I then opened it up (and shall spare you the picture, though there is one) to find there was a plastic glove and a piece of gauze from the big day. It definitely makes me an official weirdo to admit this, but the Chux pad, the gauze and the glove all made me feel overwhelmed with nostalgia. Anyway, here it is, the specimen itself:

This is the maternal side you're looking at, the side that attaches directly to the uterine wall. It would be the opposite side we'd be dealing with, with its lovely, branch-like veining patterns. Here's Justine getting things set up for me, her daughter Tillie looking on:

We initially did just a 'blood print', using just the blood rather than any paints. This is a nice thing to do if you have a fresh placenta, but once frozen, it'll be pretty faint, as there isn't much blood left. We also tried using a watercolor first, but acrylics are definitely the way to go. Here I am painting Lily's first apartment, with former resident Lily standing by:

Once painted, you gently lay the paper or canvas over the placenta and GENTLY smooth your hand over the surface.

Then you slowly . . .

. . . sloooooooowly peel the paper back . . .

. . . et voila!

The tree of life.

We made a whole bunch of prints on construction paper, and chose the best color combinations for the three canvas boards I picked up.

Behold: Art!

Once we were done, I rinsed it clean of the paint (mostly), and had one last look.

I don't care what it says about me, I think this is just beautiful. And I now have three finished canvases - one for me and one for Lily, which I hope she will keep with her always. The fate of the third is yet to be determined, perhaps I'll just hang it somewhere as well. I'd like to send one of the paper prints to my midwife, and maybe one to my unofficial doula, Patty.

As for what I'm doing with the placenta, now that I've had my moment of artistic closure? You can probably guess.

Yep, it's back in the freezer. I just couldn't let it go. I KNOW, I KNOW, eventually it's gotta happen. And I will bury it, probably soon, before the ground freezes. But for now, I could still wear the t-shirt with pride.

Saturday, October 31, 2009

Two rare and stunning (GRAPHIC) views of birth in photography

My attention was just drawn to some absolutely stunning photographs by birth doula, childbirth educator and photographer Patti Ramos. Here she gets seriously up close for some crystal-clear shots of the crowning, emerging head:

To me, this is just gorgeous, not scary or off-putting in the least. It looks like everything is working just exactly as it's meant to, tissues slowly spreading, fanning - taut, yes, but not out of proportion in any way. On the contrary, it seems perfectly proportioned. (I might add that mom's grooming skills are rather remarkable here. Forgive me, but I couldn't help noticing and being pretty impressed.)

I just love seeing how the fontanels overlap here. How beautifully designed!

Almost outta there . . .

The 9 pound, 6 ounce boy (take that, CPD scaremongers) reaches for mama with some peppy jazz hands.

Look at that amazing umbilical cord, pulsing away!

And at last, the placenta, the Tree of Life, as Ramos points out. She has some great shots of it emerging, too, as well as more of the birth overall - please make sure to check out the whole thing.

So after seeing those gorgeous, enlightening shots, I started poking around her site for some more great sets, of which there were plenty. Particularly intriguing to me was this series, showing the unusual presentation of the intact amniotic sac, which emerged FIRST! I never even knew such a thing was possible, did you? Wow!

I then came across this photograph of a uterus just after a c-section, which I had never, ever seen. She aptly titles it "The Wounded Womb". I've seen plenty of c-section-in-progress shots and even a few videos of varying degrees of graphicness, but never a shot of the uterus itself. In fact, I've never seen an actual UTERUS, just representations of them. Even in the cadaver lab I did as a massage therapist, I didn't get to see the uterus. So this was a revelation.

Warning, again, extremely graphic. I will give a little space in case you aren't sure you want to see this.








It is resting on the mother's abdomen, just after the first layer of suturing. Patti points out that the fallopian tubes are visible on either side of the uterus - another revelation; I had never been able to fully visualize them. They kind of look like headphones or Princess Leia buns. But I don't meant to trivialize this. It's both a sobering and a monumental sight.

All these glimpses here, dramatically different as they are, renew my awe of the mighty female body and the resilient glory of childbirth. Thank you Patti, for sharing these.