Saturday, December 26, 2009

Per"Speck"tive During this Holiday Season


Yes, I said perSpecktive, as in my perspective on an event that happened to me a few months ago . I’d like to share this experience with you, during this Holiday Season, as we all celebrate and receive and give gifts and probably experience some slightly un-holiday like feelings about what we've received (or maybe not received) when we compare our booty to that of others.

Some time ago, a very, very sweet friend contacted me to tell me that she had something that she needed to tell me, but that she was afraid it would hurt my feelings. It was clear that she was uncomfortable with the subject matter, but I encouraged her to tell me, promising that there would be no hard feelings on my part, regardless of what was conveyed.

She proceeded to tell me that she had been privy to a conversation (between several ladies that I know) in the recent past, chief topic of which was me. (Come on, ladies, lovely as I am, I can think of several better subjects to occupy your time). In short, here’s what was said to me: This particular group of women had discussed that they would not come to my home because: 1. My house was too small; 2. I lived in a “bad/less-than-desirable” neighborhood; 3. My children did not wear the “right” clothes; and 4. I did not wear the right clothes. And here all this time I thought it was because of my sarcastic nature and warped sense of humor.

I thanked my friend for telling me, and assured her that none of what she had told me came as a surprise. Here’s a newsflash, ladies: Despite the fact that you may have never said any of those things to my face, you’ve communicated it to me non-verbally for some time now. My initial reaction to what had been said to me was—nothing—to not care. The whole “sticks and stones may break my bones . . .” technique.

As the day progressed, I rehashed what my friend had told me. My emotions began to shift. First I was sad, very, very sad. I felt like I was back in high school—being teased because I rode the “blue bus” to school, or because I had to shovel manure on a fairly regular basis on my dad’s farm. And then I began to get depressed, desperate to leave Missouri, feeling trapped in a hostile place. I began to cry. A few hours later, my emotions shifted again, this time to anger and bitterness. Thoughts of slitting tires, Molotov cocktails, and running over cherished pets crossed my mind. Yep, my mind works that way sometimes.

And then the emotions shifted again. I was done. Done. No more, I couldn’t take any more. I wanted to leave Missouri, “Misery” as old friends had teased me when we told them that we were leaving the beach to move out here six years ago. I needed to get out. I had a sling to drop in the mail, so leaving the kids with Adam, I jumped into his truck—ironically nicknamed “Inferno,” as it takes Adam to Hell (his job) and back each day-- and headed out to the post office.

I had intended to fume and fuss and feel sorry for myself during the drive to the post office, but the radio in “Inferno” had been left turned on to K-LOVE. A woman was on the air, and she was talking about how she was “done” with life. I perked up. I had just said those exact words to myself a mere hour ago. She said she was “done” with all the troubles that seemed to keep coming her way. She wanted to leave them all behind, escape. She was “just done.” I began to feel real camaraderie with this unknown woman, she who was commiserating with me in my troubles, whether she knew it or not. And she shared that she was frustrated with herself that she couldn’t respond to her hardships with a better attitude.

She began to elaborate about her troubles. She was “done” with having a head cold. What the flip?? A stupid head-cold? This woman was griping about a head cold?? Good grief, if that’s all she had to complain about in life, I had her beat in life a hundred times over. (And, yes, I think nice Christian thoughts like this frequently). A head cold, for cryin’ out loud. My disgust level rose and my respect for this woman with her imagined hardships in life quickly went down the toilet.

The woman continued on. She was “done” with her wheelchair not working right. Wheelchair?? I choked on my tongue. And she was “done” with her pen jamming up and not working when she was trying to sign books with her pen between her teeth. I think I threw up in my mouth at that point. Suddenly, like a flash of light, I recognized this woman’s voice and her amazing story. Joni Erickson Tada. And for those of you who are not familiar with Joni’s story, you need to read it,

I have never felt so ashamed in my entire life as I did at that moment of recognition. Nothing like a little perspective to pull your head out of your . . . ear. Wow, I didn’t have any problems suddenly. My “wheelchair” isn’t broken; in fact, I don’t have a wheelchair, and I’m blessed to not need one. And my pen works just fine, when I sign my name holding the pen IN MY HAND.

I began to reminisce, to think back over my life, to get myself some more per”SPECK”tive on my current situation. I thought back to a time almost 10 years ago, when I had been blessed enough to be able to work for a Christian organization that flew me all over the world. I remembered back to a period of two weeks in 2000, immediately following the massive conflict that had taken place in Kosova, ripping apart the lives of the people of that country, when I had been privileged to work in a small village, providing medical care to the inhabitants of the village. I remember flying into Macedonia, then driving across the border through the military customs check-point, seeing literally hundreds of thousands of homeless, panic-stricken Kosovars, begging for asylum in a border refugee camp. We drove through the black, starless night, and I remember seeing beautiful homes, belonging to the Kosovar people, in flames. Fire shooting up so high that it surpassed the heights of the massive pine trees found all over the rolling hills. And not a fire engine or fire-fighter in sight. I remember NATO tanks –German units—taking up residence in “our” village due to the fighting that was still going on. I remember lying on my mat on the floor at night, attempting to sleep, hearing nothing but constant fire-fighting behind the building we were housed in, as soon as the sun went down each night. I remember the smell of rotting bodies wafting through the air, and then attending a funeral for an Albanian military commander who had been killed during our time in Kosova. I can smell the stench of those rotting corpses still, as if it had just been yesterday. I remembered walking through the “Gypsy” part of the village, forced to hop over rivers of raw sewage that ran freely through the village. Per”Speck”tive--No, I don’t live in a “bad” neighborhood.

I remembered traveling to southern India late in 1999. I remember caring for a little boy, about 7-years-old, who had a massive cleft lip and palate (due to poor nutrition during pregnancy). He was an outcast in his village. He would never hold a job, would never get married, would never even go to school, all because of his obvious deformity. The BBC was with us, filming about the lives of some the children in these poverty-stricken villages. I fell in love with this little guy, his sweet, gentle spirit, his ready smile, despite his lack of upper lip and jaw. I knew nothing of this village where he lived, as my job kept me some miles from his home, all I knew of him was what I learned during his time with me pre- and post-operatively. The BBC film crew traveled out to this little guy’s village to find him, as he neglected to show up on the day he was scheduled for surgery, the surgery that would change his life. Praise the Lord, they were able to find him and rushed him back to me to prep him for surgery. Imagine my delight when the BBC film crew presented me with a copy of their completed video. But imagine my shock when I saw for the first time where this little boy had lived, his home. His home was nothing more than a 10’x10’, maybe a 12’x12’ square room made out of crumbling cinder blocks. His family was large, quite large, and as I watched the video, I saw them sitting on the filthy dirt floor of their home, crowding aside to let the BBC film crew in to capture their poverty for all posterity. I saw this same little guy attempting to eat his one daily meal—rice—shoveling the food into his broken mouth with his filthy hands, the grains of rice falling out of the holes in his face onto the floor, chickens wandering in and out of the house, snatching up the bounty, I imagine. I still consider that video one of my most cherished possessions. Per”Speck”tive-- No, my house isn’t “too small.”

Must I go on?? I have memories of leaving all my clothing and shoes but what I was wearing with families in Ecuador, Brazil, Mexico, Gaza, Kenya, the Philippines, you name the country, because they had ONE SET OF CLOTHES. Per”Speck”tive—the clothes that my kids and I wear, despite their lack of proper “taggage,” are perfect, and considering that we all own vastly more than one set of clothing each, we are overloaded with clothing. I remember eating at a small sidewalk café in the mountains of a village in Bolivia, and watching an entire family walk silently and humbly amidst all of us sitting at the tables, a plastic bag in their hands. I couldn’t figure out what they were doing. They were making me uncomfortable, with all their dirtiness, their ragged clothing, their obvious poverty. I had no spare change to give them, I wanted them to go away from me. And then I gained per”Speck”tive, as I watched them rush to a table that had just seconds ago been vacated by a café patron. The family quickly scraped the refuse of the diner’s meal off the plate . . . and into their plastic bag. They were getting their supper. Feeding their many cold, hungry children. I couldn’t look them in the eye. Suffice it to say none of us were able to finish our meals, we all left our food nearly untouched for these starving people.

Perspective, or in my case, per”Speck”tive, can sure shed light on a situation. My wheelchair isn’t broken; my pen works just fine; there are not any military vehicles in my neighborhood; I don’t hear gunshots behind my home each night; there isn’t any sewage free-flowing through my town; I’ve never once smelled a rotting body during any of my walks through our neighborhood; my kids have faces and bodies that are fully and beautifully intact; my home, albeit small, is significantly larger than that of my little Indian friend; I have plenty of clothes to wear and to put on my children; and I can safely say that despite how tight our budget is, despite how we often wonder where the next meal will come from, I have never had to scrape food off a restaurant-goer’s plate to provide a meal for my family.

Perspective. It sure can change things. And, ladies, you’re still welcome to come to my home, I’ll even make a pot of coffee, Rhode Island style, if you can stand it.

Friday, December 11, 2009

Pork Butt Extraordinaire

I dragged my husband to the movie theater last week, the dollar theater, where all that is being shown are movies that "went out" months earlier. Having four small children and an income that's never quite enough leaves you fewer choices than those who've made the very middle-upper class choice of limiting their number of spawn to the standard 1.8 children. We weren't so smart; well, that's not completely true, we've just been exceptionally fertile and clearly have a much higher tolerance for chaos.

Let me get back to my story. Usually hubby coerces me into seeing all the shoot-'em-up, mutilate-'em-all, car chase, hacker story movies that most American men love. And since I usually have no preference for what movie we see, I usually coalesce. But this time the movie was my idea-- and my choice. Being a girl, and being a girl who occasionally enjoys indulging in girl movies, I chose "Julie & Julia," the movie that follows the lives of the famous "chef," Julia Child, and an average-underachieving-American named Julie Powell. I won't ruin the movie for you if you haven't seen it yet, but suffice it to say, it was well-worth the $2 we spent to see it. In fact, I've since bought (a used copy of) the book and the just-released DVD, as well as Julia Child's classic cookbook, "Mastering the Art of French Cooking."

And that's what brought me to my "Pork Butt Extraordinaire." The desire to cook food, not just any food, but good food. If you ask my husband, he will quickly tell you that I am a "foodie," by definition (at least per Princeton University's definition) "a person devoted to refined sensuous enjoyment (especially good food and drink)." Yep, that's me. But I have a small problem. On the other hand, my husband is a "non-eater." Basically he's one of those weird, should-have-died-off-years-ago individuals who really doesn't enjoy eating; he just eats to live. I affectionately refer to him as "the turkey sandwich." That's his favorite meal. He'd eat it everyday, even three times a day if he could. And not the kind of turkey sandwhich that I would make, utilizing the leftovers from Thanksgiving and then dripping with mayo and lettuce andstuffing and cranberry sauce and a slice of tomato and a piece of good cheese and . . . need I go on? No, my husband's idea of a "good" turkey sandwich involves two extremely dry slices of (gag) white bread, two dry slices of deli turkey, and . . . that's it. Yes, my husband is a turkey sandwich.

So what to do with this amazing pork butt that my generous neighbor gave to us? I'm dying to channel my inner Julia Child, but I have a husband who owns roughly 1.5 taste buds and rarely uses them. How do I come up with a recipe that's out-of-this-world delicious, but that both my boring (and picky) husband and four small children will eat? I fretted for a while, and then kicked into what can only be called "Tiffany Mode."

Now here's the deal with the meals that I cook. I LOVE to cook, I LOVE to eat, I LOVE to try new things, but I HATE to be stuck within what I perceive as the rigid guidelines of most recipes. Plus I almost never have in the house what a specific recipe is calling for; it doesn't help that I'm not really much of a planner either. I cook like I live, by the seat of my pants. So, I improvise quite often. Here's a perfect example that my husband still likes to bring up on occasion. We had been married just a few weeks, and I decided I wanted to make a wonderful recipe that I had found called "Lamb and Asparagus" stew. My husband was at work that day, so I spent all day cooking and cleaning the house, planning to surprise him when he got home with this savory stew recipe I had found. Supper time finally arrived, Adam was sitting at the table, anxiously awaiting the appearance of supper. "What are we having?", he called to me as I finished up the few last minute touches. "Lamb and asparagus stew," I replied, feeling very excited. I came into the dining room bearing the soup tureen, set it on the table, and waited for him to ladle his portion out to see his reaction. I was convinced he would be turned to "the foodie side" after this wonderful attempt at a new food. He opened the dish, reached in the ladle, filled his bowl, and then said, rather quizzically, "I thought we were having 'Lamb and Asparagus Stew'". "We are," I replied, a bit confused at his question. "Well, then why is there chicken and broccoli in this soup?" he then asked. "Oh," I replied, brightening a bit, "we didn't have any lamb or asparagus so I used chicken and broccoli instead." That, my friend, is cooking in "Tiffany Mode."

I digress again. So, I kicked into Tiffany Mode, hopped online, and began searching for a savory but safe recipe that I could use to doll up the pork butt in my deep freeze. Here's what I came up with. In true "Tiffany" style, I pulled ingredients from two recipes, used the ingredients I had on hand, left out the ones that didn't thrill my soul, and came up with my very own "Pork Butt Extraordinaire" which I am thrilled to be sharing with you here. Oh, one more side note, hubby LOVED the dish, as did all four of my kids, and I have to say, it's even tastier a day later.

Tiffany's Pork Butt Extraordinaire


5-6 lbs. pork butt, fully thawed
2 white onions, cut into slices
1 large can pineapple slices and all the juice
7 frozen peach slices
1/2 jar apricot preserves
1/2 cup white vinegar
1 heaping Tbsp. diced garlic from a jar (or 5-6 cloves fresh crushed garlic)
1 heaping Tbsp. brown sugar
1 Tbsp. mustard seeds
1 Tbsp. ground ginger (or a 1" segment of fresh ginger)
1 Tbsp. curry powder
1 tsp. cinnamon
1 tsp. mace (you may substituted nutmeg if you don't have mace, but mace is better in this one)
3 whole cloves
salt and pepper

Crock pot or slow cooker
Small saucepan
Large saucepan
Turkey baster

Make a "bed" for the pork butt in your crock pot by first laying 4-5 of the pineapple slices on the bottom of the crock pot, and then layering the two sliced onions of top of them. Sprinkle this bed generously with salt and pepper. Next, in a small saucepan over medium-high heat, mix together the apricot preserves, white vinegar, garlic, brown sugar, mustard seeds, ginger, curry powder, cinnamon, mace, and cloves, along with a splash or two of the reserved pineapple juice. Bring this mixture to a low boil, and let simmer while you follow the next steps.

In a good quality blender, add the remaining pineapple slices, the frozen peach slices, and the pineapple juice. Blend until fully liquid, adding a bit of warm water if needed to fully liquify. Pour this mixture into your ingredients in the saucepan, and let the entire mess cook down for about 15 minutes. If you don't have kids or you have kids and a husband that appreciate spicy foods, I would recommend the addition of a nice Indian chili to this bubbling mix for just a little bit of heat. As my dependents turn their noses up at all things spicy, I did not add one to my dish (but I will next time, hehehe!).

While your sauce mixture is bubbling down, rinse the pork butt, rub dry, and then place in the crock pot on top of the pineapple-and-onion bed and sprinkle the pork with a bit more salt and pepper. When the sauce has cooked down just a bit and thickened just a hair (not too much, because you want the volume of liquid for the crock pot), pour it over the pork. Cover and turn your crock pot onto high; cook for one hour on high, and then turn down to low heat and cook for an additional 4 hours or so. ( I recommend reading "Julie & Julia" while you wait for your lovely meal to cook, or better yet, shop!)

Once the pork is thoroughly cooked, use a turkey baster to pull off 3/4's of the liquid in the crock pot. Place the liquid into the large saucepan, bring it to a high boil; while the liquid is coming to a boil, using equal parts cornstarch and cold water, make a cornstarch mix. When the liquid arrives at a full boil, begin stirring continuously, and slowly add your cornstarch mix, just enough to thicken the sauce a little bit, you're not trying to make Jello, so don't use too much of the cornstarch mix.

The results of this gastronomical fair are amazing. Succulent, moist pork, a sweet but tangy curry sauce, and no complaints from my eaters! I served my pork butt up drizzled with the sweet and savory sauce I had made, and with some lovely petite peas with a hint of butter and a touch of salt, as well as some yummy baked acorn squash (seasoned with butter, a touch of salt and pepper, and just a dash of nutmeg) to round out the meal. Wonderful! We ate the pork leftovers for the next few days, served with my favorite Sweet Potato Wedges (dredged in a gluten-free all-purpose baking mix seasoned with salt, pepper, and Italian seasoning and then lightly sauteed in canola oil then popped in the oven to broil with a brushing of olive oil) and a cucumber salad (another favorite-- olive oil, white vinegar, a bit of white sugar, a dash of salt, a dash of pepper, and lots of cucumbers). It was equally good.

Happy eating!

And for those of you who would prefer the "real" recipes that I borrowed from, here they are:

Slow Cooker Chutney Pork Loin

Peach Chutney

Tuesday, December 8, 2009

The Power of a Mother's Intuition

I love to read, and I read almost anything I can get my hands on. Well, within reason. In the last year or so I've finished reading: all the Bronte sisters books, all the Jane Austen books, all books by F. Scott Fitzgerald, most of John Steinbeck's books, quite a few foreign authors (I love biographies), Three Cups of Tea (which is a book I would recommend to anyone wanting to learn more about the conflict in Afghanistan), and quite a few books about midwives, childbirth, pregnancy, and breastfeeding. I truly just love to read!

Last night I finished up yet another book, this one another midwifery book, but this time a biography (ooh, combining two favorite styles, yes!) by Jennifer Worth, simply entitled, "The Midwife." Ms. Worth was a nurse-midwife who practiced in a port city in England in the 1950's; this book is her recounting of some of the individuals she cared for as she attended them in their homebirths, as well as an interesting descriptor of post-WWII England. Right up my alley.

I truly enjoyed the book, and was getting a bit sad last night as I realized I only had one or two chapters left to read. And then I found IT. The story that brought tears to my eyes and made me, once again, want to climb up on my soap box and shout about the power of the amazing bond between mother and child.

The chapter was entitled, " A Premature Baby." Let me bring you up to speed and briefly summarize what had lead up to this particular chapter. The main character, Ms. Worth, who, mind you, was only in her very early twenties and only in her first year as a midwife, had been called in to see a mom who was in premature labor with her 25th child (yes, you've read correctly, 25th child; the Duggars have nothing on this woman!). The woman was roughly 28-weeks into her pregnancy; she fell outside due to ice and poor visual conditions, sustained a rather serious concussion (she was discovered several hours later by her school-aged children who were returning from school) and developed some sort of infectious process, both of which triggered her labor. She was delirious--screaming hysterically, scratching the people around her at her birth (at home, again) to the point of making them bleed, and throwing herself around the bed. The midwife was unable to auscultate any fetal heart tones (assuming that the baby was dead), and focused her care on the clearly very ill mother. The woman's blood pressure was dangerously low, her heart rate dangerously high, and her fever through the roof. A doctor had been called, but could not be reached. Ambulances were unreliable during this time, and also were unable to be reached. The midwife had just about given up hope on being able to save this poor woman's life, when suddenly the woman sat up in the bed, gave an unearthly howl, and in one push delivered baby, bag of waters, placenta, and a truck load of blood.

The midwife quickly checked the baby, found him to be blue, limp, and lifeless, so she simply scooped his teeny body up with the other "debris" of the birth and set it all aside, and again, focused on the mother. A few minutes later, the midwife and one of the woman's older children heard a strange scratching sound, and turned to see the little, teeny, fragile premature baby boy attempting to move around in the dish in which he had been tossed. The midwife was shocked, she grabbed the baby, turned him upside down and gently tapped his back in an attempt to gently clear his airway of mucus, and then wrapped him quickly in a cloth to prevent cold shock.

For those of you who have never seen or held a premature baby of any gestation, let alone one at 28-weeks, let me try to give you an idea of how absolutely tiny they are. Their legs are no wider around than your smallest finger, their arms smaller still. Their tiny heads are only slightly bigger than say, a ping pong ball (which is how this midwife also described the baby in this account), their eyelids are often fused shut, their tiny mouths when open are no bigger than say, a dime (and possibly even smaller), their skin is translucent and truly tissue paper thin, every vein and artery clearly visible, and regardless of race, their skin is very ruddy. Most babies of this gestation weigh roughly 1 lb., some a bit less, and they would be swallowed up if held in my hand (and I have average to even small hands for a woman). But all perfectly formed. Here are a few photos I've snatched off the web to give you an idea of how small of a baby we are talking about (and since I have no idea how to contact the owners of these photos to obtain permission for usage, I have obliterated any kind of potentially identifying info found in the photos; also note, these photos, to my knowledge, are of three different babies at 28-weeks-gestation):

Now for the truly exciting part of the story (as if the first part wasn't exciting enough!). The doctor has finally arrived, an ambulance with a pediatrician and primitive NICU staff and isolette have arrived, the mother is unconscious with the baby on her chest, and the father is about to hand the baby over to the hospital staff for admission to the NICU. It is this part that is amazing to me. The dad leans over his comatose wife, attempts to pick up the baby, and the woman's hand comes up and covers the baby completely to prevent anyone from touching the baby. They try again, not to be deterred. The dad attempts to lift the woman's hand up and off the baby, but she bears down, holding the baby firmly to her chest. She's not even conscious, for crying out loud! Her older daughter attempts to explain to her that if she wants the baby to survive, she must relinquish the baby to the hospital staff. He needs a neonatologist, trained NICU nurses, an isolette, a feeding tube, around-the-clock blood draws, frequent vital signs, a ventilator, the works. The dad tries to explain, the midwife, the pediatrician, you name it, but no one can budge this mother's hands from her fragile baby boy. One last attempt by dad, and this time, without opening her eyes, the mother says, No, if you take him from me he will die. And here's the clincher. She doesn't even speak English. She's from Spain, ignorant, an uneducated peasant girl who was removed from her mother's home at the age of roughly 11 and has never even been able to communicate with her English husband until she bore children who were bilingual.

The dad gives in, tells the hospital staff to leave, that his wife is refusing to relinquish the baby, they will care for the baby at home, and if the baby dies, they will bury him. Can you imagine doing that nowadays? You'd have the police, a judge, a social worker, you name it, all dragging the mother to the hospital by her heels and then locking her up for refusing to accept medical treatment for her child! But in those days, the parents knew best, and so the pediatrician, the ambulance workers, the hospital staff all packed up and left.

And here's the absolute best part of the story. The baby lived. In fact, he thrived. For the next 5 months, this mother never let the baby out of her sight. In fact, here's what she did (and of course, I LOVE this part of the story): she made a rough sling, out of fine silk, ironically, and carried the baby between her breasts 24 hours a day. Every half hour--night and day, so the book says-- she expressed colostrum from her breasts and fed her baby as many drops as his little belly could hold from a pipette (an extremely narrow, very small glass tube). She didn't sterilize anything. She never checked a blood pressure or pulse or probably even his temperature, given her state of poverty, lack of education, and no understanding of any instruction given to her in English). (She did, however, perform a very primitive version of suctioning and chest PT on a regular basis). She didn't chart his progress in volumes of hospital paperwork. She never saw a lactation consultant, a social worker, a lab tech, or even a nurse. And yet the baby thrived.

No one knows how she knew how to do this with her baby-- we now refer to what this mother did as "Kangaroo Care"-- but at the time, no one in England had ever seen such a "crazy" thing done with any infant, let alone a premature infant. And the baby lived. Thrived, even. Makes me wonder if what we do with all of our infants-- let's not even consider the premature infants, let's just talk about the full-term, healthy ones that are induced into this world a few weeks before their "due date," roughly suctioned, removed from mom and placed on an isolette for a "necessary" examination to determine their state of health, then rubbed down, given a bath, a heel stick, and footprinted all before mom ever gets a chance to barely lay eyes on him. And then he's put on a feeding schedule, a pacifier is shoved into his mouth every time he opens it and mom is cautioned not to let him "use her as a pacifier." Mom is instructed not to "spoil" the baby by too much holding, he's forced to sleep by himself in his own bed (often in his own room), and then when it is determined that he does "need" holding, oftentimes it's by someone other than mom or he's "held" in a bouncy seat, a swing, or my absolute favorite, the car seat "carrier." (They're not carriers, BTW, they're simply carseats and belong in the car-- save your back and nurture your baby!). I often wonder how different our society would be if we practiced a more simple, more nurturing method of infant care.

Could wearing your baby change the world? It did for the little guy in this story, and I believe it could for all of our children as well.

"The Midwife,"
by Jennifer Worth.

Monday, December 7, 2009

Something to be Thankful For

I was intending to get a very nice post up prior Thanksgiving, listing all the things I was thankful for: my husband, Adam, who puts up with all my bad moods and stress when I put deadlines on myself; my four beautiful children, who also put up with my bad moods and stress; my few faithful friends, who have been patient and stuck by me as I've grown this business and have seemed to abandon the rest of the world; and Jesus, who loves me and forgives me, no matter how cranky and stressed I am. I am, indeed, thankful.

But then life happened, and I didn't get my post done. But I think the negative events that happened over my Thanksgiving week can maybe be used for the positive. I think. Bear with me, and please try to hear my heart in this.

My parents flew out here to visit us this Thanksgiving, a major milestone, as my parents hadn't even met our two youngest children. We anticipated a good time, maybe a bit awkward at first, as our kids didn't really know my parents, but good nonetheless. And then a "long lost" cousin joined us as well. Even better. I love Thanksgiving, I love the food, the atmosphere, and I especially love all my family and friends coming together in my home, the fellowship, and celebrating together. The day went well-- lots of good food, lots of good conversation, my kids were getting to know their grandparents-- all was well. We went to bed that night content and very, very full.

I was awakened a few hours later, just after midnight, by my dad, telling me that my mom was very sick and needed to go to the emergency room. I was confused-- what was going on? "She has another bowel obstruction," said my dad, "this is her fourth or fifth." What?! We quickly got dressed, packed up my mom, and rushed to the nearest emergency room, where she was, indeed, diagnosed with a bowel obstruction. She spent a few days in the hospital with a tube down her nose decompressing her GI tract, an IV in her arm for fluids and pain medications, and without any food, as she waited for the obstruction to either resolve itself, or have it resolved via surgery. Thankfully, it resolved itself.

A time for some of my mom's history, to shed a bit of light on her "medical history", if you will, and explain why she has had chronic bowel obstructions. My mom is 63-years-old, an age where one should be retired and enjoying the fruits of their earlier years, correct? You've heard the saying, "You reap what you sow"-- my mom, unfortunately, is reaping what her doctor's sowed into her life when she was only in her early twenties and having her children.

My mom got married in 1968, just before she turned 22-years-old. She was young, healthy, happy and full of life. A little over a year later, she was having "exploratory surgery," because she had complained to her OB-GYN that she had very heavy periods and bad cramping each month. Hardly grounds for surgery, but, as my mom says, "that's what they did in those days." Surprise, surprise, they found nothing during the surgery. She was normal-- many women have heavy periods and bad cramping each month when their cycles start, especially young women who've never given birth. (My mom's mother died when my mom was just 13-years-old, I don't think much of the normalcy of the female body was ever communicated to her as she was growing up, so my mom has always relied on her male physician's to tell her what is the correct course of action and whether something "is wrong" with her body, subject for another blog). Fast forward to November 1971, and my mom was in "the" birthing hospital in our area, in labor with yours truly.

As my mom tells it, she went to the hospital as soon as her water broke, which was basically the start of her labor. She was examined and then placed on a guerney, and my dad was sent home. Gotta love the early 70's, women in labor were the property of the doctor/hospital and they were "delivered" of their babies, no dads needed, thank you very much. It was roughly 10 o'clock in the morning. My mom would lay on this same guerney all day long, curled up on her side, having no knowledge of the normal course of labor and certainly no knowledge of how to give birth. She knew nothing about changing her position to alleviate her discomfort or aid birth, she knew nothing about eating and drinking to keep her strength up during labor, she knew nothing about remaining ambulatory (i.e., walking around) for as long as possible during the labor to help keep the labor moving, she knew nothing about having a support person with her during her labor to provide her with both emotional and physical support. My mother laid there on that guerney and relied on her male doctor to tell her what to do. And he told her to lay there and be quiet, don't make a scene. Oooh, a scene, my mom hated scenes. She details how she could hear the screams and yells of the other women in labor in the ward around her, and she remembers not wanting to be like that. "I'd be so embarrassed to make noises like that." So she laid there, silently. A little over 12 hours later, she was examined again, found to not have "progressed" (I'd love to be able to get my hands on her hospital admission record), and so she was taken for an XRAY. Yes, you've read this correctly. My mom was in active labor with me and she was given an XRAY to determine if there was "cephalopelvic disproportion."

I get sick to my stomach every time I think about this happening, XRAY'ing a pregnant women, exposing her delicate baby to nasty radiation. My mom gets angry each time she recounts this part of the story for a different reason-- "those nurses made me get up and walk to the XRAY room and here I was in labor! Can you imagine making a woman in labor walk around? It's just barbaric!" Clearly we have a difference of opinion.

I digress. The radiologist on call determined that, indeed, my teeny infant head was too large to pass through my mom's pelvic outlet. An emergency C-section, or cesarean section, was necessary. My mom was anesthetized, intubated, and I was roughly removed through the gaping hole in my mom's abdomen, sent to the nursery, and didn't get returned to my mom until almost three days later. So much for establishing bonding or even getting a snowball's shot at breastfeeding. My mom remembers that when I was returned to her, I "didn't like" to breastfeed, and since she thought the whole breastfeeding process was rather "disgusting" anyway, she was given a shot to dry up her milk and then was the end of it.

Almost three years later to the day, my mom was again in labor in the same hospital, this time with my sister. As my mom recounts it, she was angry again, this time because she had been given a due date sometime in the first week of December and she had been given a date for a scheduled C-section, and here she was in labor again almost three weeks early. She wanted to avoid labor and just have her surgery. Her doctor couldn't have been more happy to comply. Fast-forward another seven years, same hospital, and my mom was happily under the knife-- her third C-section, and, thank God she hadn't gone into labor before her scheduled surgery this time-- this time being delivered of my youngest sister. This time the doctor gave her news after the surgery that should have chilled her to the core-- he had had to remove quite a bit of scar tissue from my mom during her surgery. It was due to her first two C-sections, and it had wrapped around her intestine and appeared to have been adhering to her bladder as well. I don't think my mom ever understood what those words meant, nor do I think she attributed all the GI problems and abdominal pain that she had been having to it. All she cared was that he had tied her tubes and she was forever done with being pregnant and having babies, an activity she had never really enjoyed.

Fast-forward yet another seven years, it's now 1988, and my mom is again in the hospital, this time she's had to schedule surgery because she is having tremendous abdominal pain and bowel problems due to more scar tissue growth. Again, a direct result of the three "benign" C-sections. They must have been benign, harmless, normal, right? After all, depending upon which state you live in, anywhere between 35-45% of childbearing women are having C-sections. If it was dangerous or abnormal, your doctor wouldn't be carving young healthy women up like a Thanksgiving Day turkey, would he? Again, I digress.

Fast-forward again, this time to about 1993 or so. My mom is again having surgery, what we in the medical field refer to as a "LOA" or "lysis of adhesions," AKA removal of yet more scar tissue resulting from her three C-sections. This time I'm driving her down for the surgery, and I'm working at the hospital where she's having the surgery, as I'm finishing up nursing school. Even at this point I don't think it occurred to me that there was something terribly wrong with this picture. I don't think I understood the connection between all the pain and GI problems that my mom was having and her previous C-sections. This time the doctor informed her that the scar tissue had wrapped itself around her intestine and had attached itself to her bladder and was clearly working hard to take over her entire abdominal cavity.

This is really the first time that my mom had surgery where I can remember the events leading up to it and her recovery afterwards. I remember the intense pain she would have for months and months at a time, her lying in bed, curled up on her side, as I imagine she did when she was in labor with me. The pain would be worse when she had her menses as I recall. I remember her doctor calling in prescriptions for pain pills, telling her to just "deal with it," as he did when she was in labor with me. I remember her, foolishly, listening to him, afraid to complain about the pain, afraid "to make noise," as she has always called it. I remember finally even her doctor caving in and saying she needed surgery yet again if her GI problems and pain were ever to be resolved. And then I vividly remember her coming out of surgery, screaming in pain, thrashing about, and then just crying for hours after the anesthesia had worn off and she was back in her hospital bed. She would finally get sent home, where she would limp around for weeks as she attempted to take care of the house and her family, no one to help her, again, reminiscent of her recovery times after she had had her three C-sections.

I also have vivid memories of being with many women in labor while I was in nursing school doing my "labor and delivery" rotation (notice the "delivery" part of that-- women don't give birth, they are delivered, of their infants, a total reliance on their physician being more than implied). I was always excited when a "delivery" turned into a C-section and I got to go to the OR. I loved the OR, I loved the excitement of an emergent "delivery," right down to the blue, limp, apparently lifeless babies that were shoved up and out of the birth canal, back into the abdominal part of the uterus, and then to where they were "rescued" by the heroic OB who had quickly and effortlessly slit open the baby's mother to "save" them from imminent danger. It was amazing. I loved it. I had no concept of what contributed to all those C-sections or to the dangers the babies faced from having been put through that or to the long-term consequences of those C-sections on both the mothers and their babies.

Fast-forward now to 2002. I am almost 31, and pregnant with MY first child.
My middle sister had had a C-section a few years back (she will go on to have two more), and my youngest sister will have one herself a few years later. At this point I am beginning to think differently about this whole pregnancy and birth "thing." I have chosen a midwife to provide me with my prenatal care and to "deliver" my baby. I am blessed to be living in an area that has a birthing center available to me for the birth of my oldest child. During one of my first prenatal visits, I gave our midwife my family history--the obstetric history of my closest female relatives, including my mom and my sister and their history of C-sections. I told my midwife that I wanted a "natural birth," not just a vaginal birth, but one devoid of having been induced, drugged, or medically compromised in any way. She kind of snorted, told me that based on the mere fact that both my mom and my sister had had C-sections, I would "probably" require one as well, but then begrudgingly suggested that my husband and I take a Bradley Childbirth class if we "really" wanted to do this. (In hindsight, I think she told us to take the Bradley class in an attempt to scare us away from the idea of a natural childbirth, because as the months went on and we grew more and more in love with the Bradley classes, our midwife got more and more frustrated with our desire to have a natural childbirth.)

I have much to be thankful for, as those Bradley classes "saved my life" as it were. Honestly, we took the Bradley classes for my husband. I'm a nurse, I really believed that I knew all that I needed to know about pregnancy, birth, and breastfeeding. I thought my husband would benefit from the childbirth classes, as he will quickly tell anyone who's listening that he's "not medical" and has knows nothing about anything "medical." What I didn't know at that point in my life is that childbirth ISN'T medical. It's normal, it's healthy, it's not a deviation from health in a woman's life cycle. A C-section, on the other hand, IS medical (actually it's surgical), and it is a deviation from health in a woman's life cycle. I cannot even begin to detail how much I learned about the normal course of pregnancy, labor, and birth-- I would take the class again if I could, and recommend it for any pregnant couple, regardless of how they think they want to give birth.

I prepared diligently for my natural childbirth, unafraid of any potential pain or discomfort, and waited patiently for "my day to come." On December 29th, 2002, at 4:30 a.m., I, too, started my labor just as my mother and my sister had, with waters breaking and waking me out of a sound sleep. Unlike my mother and my sister, I did not immediately rush off to the hospital, although my labor intensified and progressed so quickly that I soon was at the hospital-based birth center, being told I was dilated to 8 cm already and would soon be pushing. I looked forward to it with happy anticipation. I was up for the challenge!

What I didn't know was that I would quickly progress to 10 cm, begin the second stage of labor (the "pushing stage"), and that I would push futilely for four solid hours. I kept feeling like something was wrong, and told the midwife so, but she brushed it off and told me everything was fine. I was exhausted, dehydrated (I had spent most of my labor vomiting), and felt I couldn't push anymore. The midwife told me that our son hadn't budged one bit in all those hours of pushing, but that since he wasn't in distress, I could either elect to push for another hour at which point I would have a C-section if he still wasn't out, or if our son went into distress he would be emergently "sectioned." I didn't like either of those options; nobody had prepared me for this possibility, the whole "done-everything-right-now-going-nowhere-and-no-good-options" stage. I tried to think clearly and have a rational conversation with my husband at this point, but let's be real, any woman who's been in active labor for almost 10 hours, four hours of which were spent grunting and pushing, will agree that there isn't much rational thinking and objective planning that can be done at that point. There had to be another option. I wracked my brains, trying to remember all that we had learned in our Bradley classes. What about suction? Could we transition out of the birth center, into the hospital labor and delivery unit, and have the OB come in and use suction to get our baby out? The midwife agreed that this was a possibility, but she cautioned me that I would be forced to received IV pain med (Nubain) as the doctor wouldn't agree to use the suction without it. I was torn; I had worked so hard to avoid any medications up to this point, as I was trying to protect my baby. But I also knew I didn't have the physical or emotional energy to push for another hour, only to find out that they wanted to do a C-section. I was adamant about one thing-- I WAS NOT having a C-section! I agreed to the drug, only a half dose, and off we went.

It was crazy how things progressed at that point. I was whisked to the labor and delivery unit, where I was transferred into a labor bed complete with the drop-down bottom, an IV was started and the Nubain given (to tell you the truth I was kind of looking forward to the drug at that point because I was so exhausted and in so much pain). The OB arrived, I was given an episiotomy (against my wishes but the OB stated she "had to" in order to use the suction, I found out later this is not true), and the work of "delivering" me of my son was begun. My husband still gets outraged when he recounts how he remembers it all happening. Here's what I remember: the doctor couldn't get my baby out, either. He was lodged in there, stuck, for some reason (a good vaginal exam should have given them the answer as to why he was "stuck," but clearly that wasn't done, I was instead, in need of "delivery"), and while not in distress, still needed to be extricated (the idea of using the Jaws of Life were at this point crossing my mind). The OB tried and tried to draw him downwards using "just" the suction. He still didn't budge. She finally brought out "the big guns": she commanded a large (mean) nurse to lay across the upper part of my abdomen and use all of her body weight and strength to push my son down from above, she herself reached her hand up inside of me and physically grabbed ahold of my son with her hand, she commanded someone else to utilize the suction, and then she ordered me to "PUSH!!!!!" I have never in my entire life experienced pain that intense or torturous, and I hope to never experience anything like that ever again. My son was "delivered," finally-- and I avoided the "inevitable" C-section. What my son and I later suffered as a result of all that is yet another subject for yet another blog.

But I am thankful. I have not had any C-sections. I went on to have three more births, none of which were anything like my first one. I learned after the birth of our oldest daughter, our second born, that the right side of my pelvis is angled inward. Most likely why during my labor with my son neither he nor I seemed to be progressing during the second stage (ie, why I did so much pushing without any progress). A chiropractor quickly took care of that problem, and I've never had a problem since. It's probably the reason why both my mother and both of my sisters have ended up having C-sections. It might account for the diagnosis my mom received when she was in labor with me, "cephalopelvic disproportion" (or CPD), which, incidentally, is exceptionally rare. (My mom didn't really have CPD, most women who are told they do, don't).

Back to my mom and her bowel obstructions. As my mom left to go back home after her Thanksgiving hospital stay, she grabbed my arm and said, "Oh, Tiff, make sure you don't end up like this. You don't want to go through this like I have all my life." I assured that I wouldn't, at least not for the same reasons that she has. I tear up as I write this, because my mom shouldn't have had to go through this, either. And I hope and pray that my sisters don't, either.

And I am thankful.

To learn more about C-sections, the complications arising from them, the possibility of a VBAC (vaginal birth after cesarean), and how to minimize the possibility of the actual need for a C-section, simply click on the title of this blog to be taken to the International Cesarean Awareness Network website.