Mothering Through Adversity

“He’s the luckiest unlucky baby,” says his mother, Marina with a wide smile.  You wouldn’t know from talking with her that her infant son is recovering from major surgery.  Her optimism is as authentic as her love for her family.

More than six years ago, Marina and her husband, Robin, decided to have a family.  When things didn’t go as smoothly as planned, they turned to fertility treatment and were fortunate to have a healthy daughter.   A few years later their joy multiplied when another daughter joined their family.  Counting their blessings, Marina and her husband decided to graciously accept the gift of their daughters and considered their family complete.

I remember three years ago, sitting with Marina at a children’s consignment sale.  She was giddy at the thought of no more Exersaucers cluttering her family room and when I asked her if this meant that there were no more babies in her future, she emphatically replied, “Nope.  We’re a two-kid family.”

Life certainly does laugh at our plans.  Almost two years ago, Marina unexpectedly became pregnant for a third time.  She and her husband were overjoyed albeit a bit surprised.

“We were shocked!  I couldn’t believe it when I found out that I was pregnant.  How did that happen without fertility meds?” Marina says followed by a playful laugh.  “I guess you can’t plan everything!”

Marina endured the usual question during her third pregnancy: “Are you hoping for a boy?” to round out her family of girls and she answered people sincerely by saying that she didn’t care what the sex of the baby, all that she wished for was (s)he be healthy.

Secretly, Marina was anxious.  She felt as though she had tempted fate twice before and won.  She had two healthy babies.  What more could one ask for?  Marina’s fears were brushed aside by most everyone she talked to as “normal” especially for mothers with more than one child.  Nonetheless, she couldn’t let the suspicion go.

After a fairly uneventful pregnancy, Marina went ahead with her planned C-section.  Robin was by her side when they welcomed their baby boy into the world on an early June morning.

Immediately, Marina sensed something was wrong.  Having had two previous C-sections she knew what to expect and reading the expressions on the faces of the medical staff and her husband, she knew her worst fear had been realized.

“They definitely didn’t handle it well at all.  I guess everyone was in shock.  It’s not something you come across every day.” Marina says casually, having forgiven the medical team for their lack of composure.

At first glimpse her tiny son looked dark purple.  His skin wasn’t the pinky hue she’d been expecting and seen twice before.  Immediately the doctors began calling for specialists to make their way to the OR.  Marina felt helpless lying on the table, her stomach being tethered back together, watching her son being examined under lights on a table a few feet away from her.

What seemed like hours later, but in reality was probably minutes, a nurse handed Marina her son.  With her husband by her side, she held baby Niklas in her arms for the first time and instantly fell in love.  Their special moment abruptly came to an end when not even a minute later, Niklas was taken the Neonatal Intensive Care Unit (NICU) because he was experiencing difficulty breathing.  That turned out to be un-related to the skin condition, but Marina was unsure of what was happening and feared the worst.

An hour later in the recovery room, a young female doctor made her way over to the bedside and gently explained to Marina that her son was born with a very rare and potentially fatal disease, Giant Congenital Melanocytic Nevus.

“I didn’t know what to make of all she was saying.  All that I was heard cancer, and mortality.  I think that I blocked it out.”  Marina says of those first few minutes when she learned her son wasn’t born “perfect”.  In a daze of operative drugs and post-partum hormones, Marina continued to sit in the recovery room frightened that her son might not make it.  She was told that she wouldn’t see Niklas again for at least 24 hours because of his status in the NICU and that she was unable to sit in a wheelchair due to her c-section.

“I didn’t think, at first, that it was that bad until Robin went to speak with the doctors.  We had always agreed that immediately following the delivery; I would stay in the hospital with Niklas while Robin attended his graduation (from an MBA program) that afternoon just a few blocks away.  He’d come back to the hospital later and in a few days we had planned to head home.  But when Robin came back into the room after his meeting with the doctors and told me that he wasn’t going to the graduation, I knew something was wrong.”

Staying in the hospital to recover from her C-section ended up being a temporary reprieve for Marina.  Without Google at her fingertips she was able to digest what information the doctors had told her.  Keeping positive was easy without the evils of Wikipedia permeating her brain.  Robin wasn’t so fortunate.  He went home and preceded to do the very thing the doctors had advised against: he went online to research more about his son’s condition.

Marina explains to me that most people are not born with moles but acquire them over their lifetime.  By age 20 most people have 20 moles but because Niklas was born with so many birthmarks, particularly the large birthmark on his back, his propensity to develop skin cancer is much, much greater.

Congenital Melanocytic Nevus is a dark mole, which cover the body.  There is usually one main nevus that can have hundreds of satellites.  These moles have a high likelihood of either being cancerous or turning cancerous, even in childhood.

The reason the medical staff cautioned against self directed research is that they were still uncertain the extent of Niklas’s diagnosis.  Statistics pummeled Marina and Robin.  Only 0.02 percent of babies are born with Congenital Melanocytic Nevus.  Of those, 1/3 will have nevi on their brain or spinal cord and a very small percent will develop complications that can result in death.

“He’s the luckiest unlucky baby!” Marina says again.  Niklas’s MRI determined that he does have a nevus on his brain but so far he has been developing like any normal infant and recently celebrated his first birthday.  However, it is the fear of the unknown that has weighed heavily on both Marina and her husband.

That is not to say that Niklas hasn’t had his share of challenges over the year.  He has had surgeries to remove nevi (called excision) and is going to undergo tissue expansion surgery.  Like a sci-fi movie, doctors insert a balloon under his skin that will cause it to stretch.  Once the skin has expanded enough, it will be stretched over the area where the birthmark will be removed.  Marina admits that she feels very lucky to live so close to Sick Kid’s Hospital home to some of the world’s leading physicians and surgeons.

In addition, Niklas must stay out of the sun, or completely covered and visit with a dermatologist every six months for the rest of his life.

In spite of this adversity, Marina and Robin remain optimistic and thankful that this all they have to contend with.  “Sitting in the waiting room for Niklas’s plastic surgeon or meeting with other specialists puts things into perspective.”

Please watch for Part Two of my interview with Marina as she shares how Niklas’s diagnosis has changed her family and how she has used social media as a support network.

photo credit: babygirlslipsonsshoes.co.cc

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From Hospital to Home Birth

Do you ever astonish yourself?  I don’t, very often.  But as I enter my eight month of pregnancy, an older version of me is more than bewildered at the current me.

Midwife.  Doula.  Breathing.  Voice.  Red raspberry leaf tea.  Birthing pool.  Natural birth.  And – wait for it – home birth.

I wasn’t always like this.

Five years ago, I gave birth to my first son prematurely by caesarean.  It was an emergency – at eight months, the placenta partly abrupted from my uterus.  It’s not the fact of the caesarean that bothers me, for I am forever indebted to the medical world for that surgery and the safe delivery of my baby.  But it’s the way in which I half expected to have a ceasarean that’s troubling, my own lack of confidence and professed disinterest in my body to carry a child to term.   I even requested general anaesthesia for the caesarean rather than regional because I didn’t want to be awake during the surgery.  (This request was refused.)  And when I overheard that a colleague at work was planning a natural (unmedicated) birth process to see whether she could do it, I responded with (and I quote), “Who cares?”.

Fast forward five years.  I have my heart set on a home birth.  What changed?  So very much.

Somewhere in between I had a second son.  In my eighth month of pregnancy, a friend recommended an inspiring book by a remarkable woman.  It was filled with stories of women who had had positive natural birth experiences.  I hadn’t heard anything like them in real life (just the opposite, actually), but I was moved.  I committed more firmly to having a vaginal birth after caesarean (VBAC), in spite of my OB’s nervousness.  And I hired a doula, and laboured with her for a long time at home.  Here is an excerpt of my thank you letter to her:

As you may remember, my birth experience wasn’t perfect.  I was and remain horrified at how things unraveled at triage at Mt. Sinai [the hospital].  This process, this birth, that had been so carefully and lovingly nurtured until then was so quickly taken out of our hands, and taken over, that I was stunned with sadness.  But I also have the memory of labouring at home with you until then, which is one of challenging satisfaction and accomplishment to me.  And to have been awake, wide awake, to watch Nathaniel come into the world and then take him to my chest – the memory of this can still leave me breathless.  It is the only birthing I have ever seen.

So I carry a basket of great things:  the labour at home; the vaginal birth; a process largely unmedicated; your companionship and guidance; the big, beautiful baby; my intact body; the ease and pleasure of breastfeeding.  I have joy.  These early experiences with Nathaniel cut such a sharp contrast against those with Sam, and only now do I understand how much I lost that first time. 

…

Now I know the [caesarean] scar will hold.  If I ever have another baby, I will seriously consider labouring at home, with midwives and with you, if you are still doing this work by then.  I’m 37, and more importantly, Ben seems to think two is enough (“If you want to have another baby, Carol, you’ll have to find another husband.”).  But for me, I wouldn’t rule it out, and often feel like I would love to have another baby.  This is such a far cry from what I felt equipped to do only a few years ago, it’s hard to express.

…

I imagine your work to be very challenging, especially because of the generally unreceptive climate in which you do it.  I guess that you see a lot of unfulfilled potential, of women, of their bodies, of the babies within.  So I wanted you to know that you have helped to reveal, one contraction at a time, my body’s potential – for me to want to birth at home, naturally, is a far distance to have come, and I want to claim it with you for its entire worth.

Somewhere in the last couple of years, my husband’s stance on a third child cracked, and here I am, with a belly full of baby and over the moon with gratitude.  And part of that gratitude is being gifted with the chance to have a baby intentionally, governed by my own values and experiences, rather than fear.  Part of the blessing of growing this child is the excitement I feel about being able to experience labour again.

I’m not foolish; I know there are no guarantees.  If I need medical intervention, I will accept it and be thankful.  But I’d basically be denying my own life experience if I were to fail to try to have a home birth this time around.  Plus I’m a researcher by trade and I’ve done my homework, so I know that the statistics repeatedly demonstrate that home birth for low-risk women cared for by midwives is at least as safe as hospital birth.  (More pragmatically, the data on this point would have to be rock solid in order for the government to fully fund home births attended by midwives in Ontario, which it does).

If you’d told me five years ago that I would be a home birth enthusiast, I would have said you were crazy.  But then again, if you’d told me back then, when I had the unbridled freedom to go for a walk without telling a soul, that I’d find my greatest happiness tethered to two tykes wrapped around my knees, only partly visible under my watermelon tum, I’d not have believed you either.   So maybe stranger things have happened.

A Mother’s Body

A Mother’s Body

The skin is pulled tautly over my rounded belly and my full breasts sit high on my chest.  The photo of my pregnant body in its ninth month is displayed on the bookshelf above my bathtub.  I look at that picture almost nightly.  Not only do I find the curves and silhouette of my maternal frame captivating, I am drawn to the expression on my face.   There are no lines indicating worry or discomfort, my lips rest lightly together, and slightly curl at the ends but it is the eyes that speak to me.  There is a peaceful calm exuding from my stare, owning my nakedness with a confidence that I had never felt before, or for that matter, since.

Many women feel at their most beautiful when they are pregnant.  Sarah, a mother of three from Ottawa, loved being pregnant and describes her first pregnancy as though it felt like an experience she was waiting her entire life for.  “My wide hips helped make my first birth a relatively easy process (as far as births go).  I just loved never having to suck in my belly – I could let it all hang out!  I really do feel like I never felt better than when I was pregnant the first time.”  Sarah is not alone in admiring how awesome a woman’s body truly is.  Mirielle, a Toronto mother of two, says of her pregnant body, “I was in awe of its incredible capacity every passing week… it was truly one of the best experiences of my life where I could focus on myself and the needs of my unborn baby without feeling guilty for neglecting something else.”

Some nights, when my self-confidence is wavering, I look at those pictures and long for that unbridled self-love.  Soaking in the bath water, I admire the toll three pregnancies have taken on my body.  Like battles scars the silvery stretch marks tell a story.  The long spindly looking one running up the left side of my abdomen is from the first time my belly stretched to cradle an unborn child.  The series of red claw-like indentations along my pubic bone are the newest markings to my canvas.  My breasts and stomach sag, the skin like a deflated balloon and a thickness has settled around my waist.

I knew that pregnancy would forever alter my body and most days I wear these changes with pride but living in a culture where celebrity baby bumps has become a spectator sport and images of lithe post-baby bodies are plastered across virtually every glossy tabloid magazine, I would be liar to say my body image hasn’t taken a hit.

I remember being shocked at how my body looked in the days following the birth of my eldest son.  I wasn’t prepared that I would still look pregnant.  The experts at Just The Facts Baby say that when a woman leaves the hospital after giving birth her uterus is still as large as when she was twenty weeks pregnant and Baby Centre reports that post-baby a woman’s body can appear rounder in the hips, thicker in the waist and softer in the tummy after she has bore a child.

Sarah’s first pregnancy was a singleton and she found that she was able to bounce back into shape pretty quickly but after the C-section she experienced with her twins her post-baby body image wasn’t as positive.  “Between carrying two babies to term and having a c-section my stomach is a mess of yucky, saggy skin and stretch marks.  I sometimes look in the mirror and wonder whose belly that is!”  While Mirielle was forewarned, by her mommy-friends that she wouldn’t be slipping back into her skinny jeans a few weeks post-partum she remembers being surprised by the length of time it took for her to fit back into her shirts due to breastfeeding.

A Mother’s Energy

Since having my third child a few months ago, in addition to the changes in my body, I have noticed a change in my energy.  Exercise and alone time used to re-charge me but now I find that the demands of having three young children under the age of four take up most of day and energy, leaving little left over for myself.  Sarah, Mirielle and many other mothers report the same thing.

This post is the first in a series.  Next week will explore how to incorporate exercise into busy lives, the benefits of exercise for a healthy body image, and how parents can use exercise to provide the ultimate self-care.

How has your body image changed since having children?  Or has it?

photo credit: http://www.blogcdn.com/www.parentdish.com/media/2009/08/naked-pregnant-woman-240js080509.jpg