Let's talk about the use of the {Vitamin K + Vitamin C} Protocol to Treat Morning Sickness and Hyperemesis Gravidarum

 

This spring, I was super-excited about something that I hoped to publish next year - namely, that I had found something that helped my morning sickness.

If that's not earth-shattering, nothing is.

However, when we miscarried our baby in mid-May (at 11w4d), there were signs - no definites, but certainly strong indications - that our baby may have died long before the actual miscarriage, possibly at the very beginning of the pregnancy. This often results in a pregnancy with reduced pregnancy symptoms. Thus, I can no longer state with any authority that I have definite results for this method working for me.

However, I can say this:

(1) I did still have strong pregnancy nausea, starting at the usual time (3w4d), and

(2) I noticed definite improvement when I used this method - both when I started it, and again when I increased the dose.

That being the case, I wanted to present the data to my readers so that they can do the research themselves, and discuss it with their midwives/physicians. Let's get started.

Before we start, let's quickly differentiate between a remedy and a coping mechanism.

These are my terms, not taken from any source. 

In my personal terminology for pregnancy nausea, a remedy and a coping mechanism are different entities. A remedy is something that actually reduces my pregnancy nausea. A coping mechanism, on the other hand, is something that, while not reducing my absolute level of pregnancy nausea, helps me to cope at the nausea level where I am. Does that make sense?

Coping mechanisms are legion. Some that I use include a protein shake before bed, eating immediately upon getting up, getting more sleep, dropping outside activities, etc. We all have these.

Remedies, on the other hand - something that actually works to reduce my base level of nausea - are incredibly rare. That is, they are a dime a dozen - just check the internet! - but the ones that have actually worked for me are virtually zero. Here are some of the ones that I've tried:

• Bentonite clay
• Ginger
• Preggie pops
• Eating hardboiled eggs before bed
• Herbal morning sickness remedies
• Weekly B6/magnesium shots
• Probiotic therapy
• Basic dietary changes (Paleo, gluten-free, dairy-free, etc.)
• Dramamine

The only remedies that have worked so far for me would include the following:

• Very-low-carb diet, done for 6+ months pre-conception 
• Medications (Unisom, Zofran)

As I never want to do the very-low-carb diet again (and didn't have time anyway, as this pregnancy surprised us), and I hoped to avoid medication, finding another remedy that worked was super-exciting.

What "it finally worked" method are we talking about?

I refer to the Vitamin K + Vitamin C remedy.

If you've spent more than 30 seconds online researching morning sickness remedies, you have run across the Vitamin K + Vitamin C remedy for morning sickness. Trouble is, there's almost no information, details, or advice on how to make it work. It will inevitably be cited thusly:

"Vitamin K and vitamin C , taken together, may provide relief of symptoms for some women. In one study, 91% of women who took 5 mg of vitamin K and 25 mg of vitamin C per day reported the complete disappearance of morning sickness within three days."

I see that I actually posted that information on my blog when I discovered the reference - specifically in 2008 (over fifteen years ago!) - in the article Research: Vitamin K and Vitamin C.

But although I have known about this for many, many years, I have always feared to try it due to the high dose of vitamin K involved. (Daily dietary needs for vitamin K are usually listed in micrograms.)

However, this time around, I really wanted to stay off of medication. (Don't we always.) So I started researching to see if I could find out more - both about safety and efficacy. Firstly, I found this article giving some details about the protocol:

Morning Sickness: Vitamins C & K

Looking up the doctor mentioned in that article, I found a presentation of the detailed results of the study mentioned above - go to slide 35 in this presentation by Dr. Jeremiah Wright.

The basic results of the 1952 study were to have been as follows (quoted from the above presentation): 

"In the study, 70 women with mild to severe nausea and vomiting of pregnancy took simultaneously each day vitamin K3 (5 milligrams) and Vitamin C (25 milligrams).

                ▪ 64 reported complete remission in 72 hours.

                ▪ 3 were relieved of vomiting, but not nausea.

                ▪ 3 obtained no relief."

In it, he also gives the citation for the original study - here it is, for anyone who wants to look it up: 

Merkel RL. The use of menadione bisulfite and ascorbic acid in the treatment of nausea and vomiting of pregnancy: a preliminary report. Am J Obstet Gynecol 1952;64:416-418

I also found a podcast/radio show in which Dr. Wright discussed his efforts to publicize this method of pregnancy nausea control:

Nausea Caused By Pregnancy and Preventative Vitamins 

I also found another doctor discussing his use of K2 (in the form of intramuscular injections) for pregnancy nausea. He discusses a case in which K2 injections did not work - or did not work on their own - but his background experience was that this method almost always did work:

Hyperemesis Gravidarum: Reversing Autotoxic Hormone Reactivity/Antihormone Therapeutics

He writes:

"Until this year I have had nearly 100% success with intramuscular administration of vitamin K2 (menatetrenone) 2 cc at 10 mg/cc for nausea and vomiting (N/V) of pregnancy in scores of patients. Thanks to Jonathan Wright, MD, for teaching this many years ago... With N/V of pregnancy, I usually administer vitamin K2­ 2 cc daily for the first couple of days until the N/ V stops and then weekly or as needed. Sometimes one shot stops it for the whole pregnancy."

I also found, when I looked up my own post from back in 2008, the following quote from another physician:

 "For morning sickness, I recommend 100 to 200 milligrams of B-6 and 10 milligrams of vitamin K a day. Occasionally, more than 200 milligrams is necessary, but this amount should be taken under a physician's supervision. I also give patients an initial injection of vitamin K, which works in a day or two. Taken orally, the Vitamin K takes somewhat longer to produce results - about ten days." - Superimmunity for Kids by Leo Gallard & Dian Dincin Buchman, p. 47

Safe and effective? This was super-exciting stuff. But...

Are high doses of vitamin K safe for pregnancy?

There are two questions: (1) Are high doses of vitamin K safe in general, and (2) Are high doses of vitamin K safe for pregnancy.

The research that I found was surprisingly reassuring. Besides the doctors quoted above (all of whom used very high doses of vitamin K with pregnant women, with great success and good outcomes), I found a number of physicians quoting the use of very high dosage vitamin K as safe for both pregnancy women and the general population. Here are some of them:

For the general population:

From LiveStrong:

"The recommended daily intake for vitamin K set by the Food and Nutrition Board of the National Academies of Medicine (FNB) is 120 micrograms for men and 90 micrograms for all women, including those who are pregnant and breastfeeding. These RDAs aren't hard to achieve through a balanced diet, and the National Institutes of Health reports that vitamin K deficiency is very rare.

"The FNB sets upper, tolerable intake levels (ULs) for vitamins that pose health risks when taken in excess. However, there is not a UL for vitamin K, because there have been no reported adverse effects from vitamin K excess in any amount from food or supplements in the general population." (emphasis added)

From National Biochemistry (NBI):

"The amount of MK4 (a type of vitamin K) used in studies is 45-135 mg, which is 500 to 1,500 times greater than the IOM adequate intake. Thus, an important question is whether or not it’s safe to consume vitamin K at this high dose. The short answer is unambiguously, Yes. MK4 is safe even at doses much higher than the top amount used in clinical trials.

"US Institute of Medicine (IOM) conclusion:

"The Tolerable Upper Limit (TUL) is the highest daily dose that is safe for almost all individuals in the general population to take on an ongoing basis. The IOM concluded that for natural forms of vitamin K, of which MK4 is one, there is no known TUL. This means that the IOM considers vitamin K to be extremely safe, even at very high doses." (emphasis added)

From WebMD:

"When taken by mouth: The two forms of vitamin K (vitamin K1 and vitamin K2) are likely safe when taken appropriately. Vitamin K1 10 mg daily and vitamin K2 45 mg daily have been safely used for up to 2 years. It's usually well-tolerated, but some people may have an upset stomach or diarrhea." (emphasis added)

 

 For pregnant women: 

 From Sanford Health, showing that high doses of vitamin K are used therapeutically during pregnancy already, for purposes other than pregnancy nausea:

"Vitamin K is important in helping blood clot. Though extra vitamin K is not needed during pregnancy, women who are pregnant and using anti-seizure medications are at increased risk of vitamin K deficiency in their baby. These women should take oral vitamin K, at a rate of 10 mg daily, from 36 weeks until delivery." (emphasis added)

From Oxford Academic (Volume 78, Issue 10, October 2020), regarding high doses of vitamin K for use in osteoporosis in pregnant women:

"Vitamin K2 at 45 mg/d has been used as a safe treatment option in a case series of pregnancy-associated osteoporosis... There is no known toxicity for vitamin K2, and no tolerable upper level has been set for either K1 or K2 in pregnancy as there have been no studies on reproductive or teratogenic risk." (emphasis added)

When you start looking at links, opinions do vary. Some do not recommend vitamin K supplementation during pregnancy. Some say it's okay up to a point. Some say that it's perfectly safe and that there is no upper limit on safety. For myself, I was confident from my reading that therapeutic doses of vitamin K were safe during pregnancy. 

Additionally, it has to be taken in perspective. If I do supplement with high doses of vitamin K, and it works, then I am exposed to a very-mostly-likely safe vitamin. If I don't supplement with vitamin K, then I will most certainly be taking Unisom (doxylamine succinate), which is an artificial drug and has been several times implicated in risks for the unborn child. I think I'd probably take my chance with an all-natural, already-present-in-the-human diet supplement if I have that choice. 

Who should not supplement with vitamin K:

The only firm contraindication seems to be for people who are taking the drug Warfarin. From the NBI article:

"People who take the drug warfarin (Coumadin) should not take MK4. Warfarin is a blood thinner that works specifically by blocking vitamin K’s actions in the blood clotting cascade. Providing vitamin K as a dietary supplement counteracts warfarin. People taking warfarin should absolutely not take MK4 and they shouldn’t take any vitamin K-containing products without first consulting their healthcare provider." 

What about the different forms of vitamin K?

Vitamin K is actually a family of closely-related vitamins, rather than a single compound. There are three forms of vitamin K:

Vitamin K1 and K2 (and there are two forms of K2) are found in nature and are naturally present in the human diet.

Vitamin K3 is an artificial form.

There are some concerns with toxicity from high doses of vitamin K3 - although the doctor mentioned above still used it very successfully for morning sickness treatment. 

Vitamin K3 is not available over the counter in this country at the present time (that I know of). Vitamin K1 and K2 are widely available and can be purchased over the counter (OTC).

How I put this protocol into practice, and how it worked for me:

This spring's pregnancy was a complete surprise - it was much sooner than expected, and at my age, I wasn't sure if another baby would be on the horizon at all for us. So I was not doing any preparations at all - no dietary changes, no supplements, no nothing. 

I got a positive test - quite randomly! - at about 3w4d. My pregnancy nausea started, much to my annoyance, later that same afternoon. While it may or may not have been as strong as with a healthy pregnancy, it was definitely present, strong, and followed my usual pattern. (Week 3 = nausea starts. Week 4 = I'm still okay. Week 5 = I need help.)

I immediately started researching the Vitamin K + Vitamin C method (for some reason, it came to mind strongly in a way that it hasn't in previous pregnancies). I believe that I started using it at 4w2d. And here's the thing: I felt an immediate and powerful improvement in my nausea levels. (Translation: I took the remedy at night, and felt much better the next day.) And while I continued to feel worse as the pregnancy progressed (which is normal), I was functional. I could get up on time, and eat most foods. I did not have to obsessively eat the same thing over and over until my cravings changed. I did not need to take medication. I could keep things down. While I had a lot more on-the-couch time, I was much more "okay" than usual. I didn't descend into the depths of despair. And I only threw up about five times, total. It wasn't a miraculous nausea-cleared-up-completely! sort of thing, but it was profoundly effective and positive. If I'd increased the dosage more - which, again, I wanted to do but was afraid to try - it is very possible that I would have seen even more awesome results. 

I ran into two snags with the protocol:

(1) The original protocol wording that I found said to use the method for a month. That landed me straight into week 8, when I was feeling pretty awful and was in no way ready to give it up cold turkey.

(2) During week 9, I started feeling that I need some extra help. My two options were to increase my dose of vitamin K, or to go back to using the Unisom protocol to some extent.

In an effort to get more information, I reached out via email to two of the doctors referenced in the articles above. To my surprise and dismay, I never heard back from either of them. This was a deep disappointment, as I would have greatly valued their input and advice regarding this method, and was willing to pay consultant fees. If I had felt more confident and energetic, I would have called up their offices to try to deal with the red tape involved in consulting them through their official practices. However, I was feeling (1) awful enough not to be up to the challenge, but (2) not awful enough to be desperate. So that didn't happen.

Another option for me would have been to go to the naturopathic college medical clinic that we have here in the Phoenix valley. However, the same attitude of "I feel too awful to go, and not awful enough to be desperate" kept me from trying it this time. However, I would definitely be up for that in the future. This would be a good way to consult a physician regarding dosage safety, as well as to have the IM injection method of delivery possible, which is often more effective than oral delivery, but which I cannot do at home. 

Some of this information above regarding the safety of super-high dosages of vitamin K I actually didn't see until writing this article, which I regret, because I would have continued to increase the dosage when I felt that I needed it if I had felt comfortable with the safety. As it was, I did increase my vitamin K dose during week 9 to about 7.5 mg, and again felt an immediate improvement. I held that dosage steady until our loss at 11w4d.

Some may wonder if the placebo effect had anything to do with my improved levels of nausea, and to that I will say that I am sure that there was no placebo effect going on. 

Some years ago, I read in "The Case for Miracles" (Lee Strobel) that some conditions are well-known for being vulnerable to improvement due to the placebo effect; other conditions are much less affected by it (in the book, the example given was hearing loss).

In my experience, I have found that pregnancy nausea is not at all affected by the placebo effect - I have tried so, so many nausea remedies, and no matter how much I want a given remedy to work, or how I believe that it is going to work, or how I know that it has worked for other people, pregnancy nausea just doesn't budge. It is implacable. I think other pregnancy nausea mamas will back me up on this one. So when I find something that I sense really works, I have no problem in being confident in my assessment, simply because I have seen how ruthless pregnancy nausea is, and how unaffected it is by my wishes and beliefs. 

A few details:

For vitamin K, I used the Super K supplement - two pills at first, and then three when I increased the dosage at 9 weeks.

For vitamin C, I just used an over-the-counter 1000 mg vitamin C pill. The protocol calls for an absurdly low amount of vitamin C (25 mg), but there is no absolute need (that I know of) to achieve that low dosage. 

My conclusions:

* I believe that the Vitamin K + Vitamin C combination is safe, and I have experienced that it is effective. 

* To say this authoritatively, though, I would have to use it throughout a healthy pregnancy with full symptoms.

* I do not believe that using this protocol caused our miscarriage, as physical evidence showed likelihood of a very early loss - possibly even before I began using the protocol.

* I do not know if this method could help HG sufferers - though several of the doctors above stated quite firmly that it could - but I believe that it would be a good auxiliary treatment even if other treatments were used at the same time. 

* As usual, I think that the best time to research all of this would be pre-conception, when one is not panicking over rising nausea levels. I plan to make some contacts and appointments to discuss this with caregivers, in order to be ready for next time, should there be a next time. (Very likely there won't be, at my age, but one likes to be prepared.)

I would love to hear thoughts, experiences, or input. As always, comments must be rational, conversational, and kind, and offered in the spirit of charity (i.e. no "you are an idiot, woman!" comments). 

I very much hope that this information can be of use to mamas out there. 

As always, this is not medical advice. Take the information and the articles to your midwife, OB, naturopath, or other physician. and get his/her take on it.  

Gorgeous Birth Video!

This is the first time I've put a video in my blog, and I'm so stinking proud of myself it's perfectly ridiculous!

This is an absolutely gorgeous birth - one of the most respectful hospital births I've ever seen - and a waterbirth, too! My favorite!! (Hopefully preview of coming attractions for Yours Truly....)

Not that this has anything to do with hyperemesis... And this really should go on my other blog! But I was in a hurry, and this will do as well as anything. Besides, whenever I see a beautiful birth video I'm chomping at the bit to share it with everyone! There's nothing more beautiful in the world.

Enjoy!

My first birth publication!

I am so excited!! My birth story was included in a book of Arizona birth stories/art, and I just received the book in the mail! So fun!! It's called "Our Stories, Our Births: A compilation of birth art, poetry, letters and intimate birth narratives told by mothers in Arizona."

Of course, it's nothing to be super-proud of, because there was no "selection" - everyone who submitted material was included!

But it's my first time any of my "childbirth writing" has been put in actual print, and I am just excited about that!! Hopefully it's not the only time I'll be able to write on the subject.

In other news....

We have a gigantic spider hanging out in our storage closet. Actually, he/she has been there for months, but I was reminded of it yesterday when my vacuum struck her web and she rushed out and attacked the vacuum cleaner! I did a pretty good version of Patrick McManus's "Modified Stationary Panic," but I forgot the Russian dance steps - I had to settle for leaping upwards, dropping the vacuum and shouting something like, "Eergghhh!"

I am not a fan of spiders. I wouldn't let DH kill the spider, because it's obviously not a black widow or a brown recluse, and I don't like any unnecessary killing. But I'm giving the storage shed a wide berth! Maybe I'll get my dad to relocate it when he's out next. I'm thinking it's a female Southern House Spider - that's the closest I could come to identification. Ergh.

Our house purchase still eludes us! Bid #11 seems also to be slipping away from us, but we still hope.

Personal Notes & A Waterbirth Video!

Thought I'd post this sweet waterbirth video that I loved!! As I think I've mentioned before, if we are blessed with another baby we are hoping to have a waterbirth. Our midwife is very experienced with waterbirth and does a ton of them, so unless there are complications, we've got a really good chance. Our friend's sister just had a waterbirth yesterday with one of our midwives - very exciting! Congratulations J.!

This has been a crazy week. A baby shower, baking cookies for said shower, playing at church, music rehearsal, church's semi-annual meeting, potluck, dinner guests, going-away party for some friends (we miss you guys already!), babysitting for said friends while they packed, volunteering, playgroup, errands - you name it, we've done it! I'm finally done with the busiest part and am looking forward to some down time!

I am once again not pregnant, and am sincerely thankful for that fact. Whenever I find out that I am not pregnant, I feel a twinge of disappointment followed by overwhelming waves of relief and gratitude. Apparently I am not ready for this experience yet! When I was pregnant and telling people that I was NEVER going to do this again, I always got variations of the same response - "Oh, wait till after you've had the baby. You won't be able to wait to do it again!" Well, I am somewhat gratified to note that I was right - I am NOT eager to do it again - although they were partially right, as I am kinda-sorta-maybe willing to at least try again. Well, we've got at least another month! I seem to be working my way up to a nice little luteal phase defect, so my fertility issues may be out of my control for now anyway!

It's probably also good that I am not pregnant because..... we may have a house!!! Yes, we have something like a provisional acceptance on a short sale - we won't have the definite paperwork for a couple of weeks, but it's at least tentative. Hurray!!

Well, I've let the Bug take advantage of my being distracted for long enough! Back to actual parenting!!

Just for fun....

I really do have a blog entry ready (in my mind) and waiting to be typed out, but having gotten up an hour and a half late, today is not going to be the day!! So instead, I wanted to post the birth pics of a birth-circle friend of mine, who just had her fifth baby. Congratulations, Stephanie! May my next birth be as easy as this one was!! (But with 5 kiddos, she's earned an easy birth!!)

http://www.soderblom.net/kasey/kaseybirth.htm

I am such a huge fan of birth stories and pictures and videos - hopefully I can get pictures as good as this next time!! (Ours were quite dark and grainy.... The effects of a really bad camera used in a big hurry.)

The Business of Being Born

This week I have an excuse for neglecting my blog!! Houseguests - my parents. They're in town to help us restart the home-search process for the umpteenth time. (*Sigh*)

But anyhow, I had to take a minute to post this link, because I am so excited about it.

Last fall, we went to see a screening of "The Business of Being Born," which is about the modern maternity and childbirth scene. It was an absolutely amazing, life-changing film, and we both loved it. This website has now posted the movie, so it can be viewed in its entirety - for free!!! I'm so excited. Here it is!!

http://quicksilvers%20creen.com/%20watch?video=

Movies like this are so awesome because they're informational as well as highly interesting and entertaining. I wish everyone could see this film!!!

Just for fun :)

Today I thought I'd take (another) break from hyperemesis gravidarum and try to post my birth story. Why? Because it's fun!!!! I love birth stories. When I was pregnant I read them compulsively (still do, actually, whenever I can get a minute). Just as a matter of form, here's my favorite site for birth stories:

http://www.birthdiaries.com/

Anyhow, my birth story. I don't think I'll get very far, as it's almost time for C. to get up, but it's worth a try - I can always do two installments.

I'm also going to write from memory rather than copying my own official birth story - something for which my faithful readership should be extremely grateful, considering that my "official" birth story is something like 15 pages, typed (or more!).

And those who are squeamish about birth stories should feel completely justified in moving on to the next entry and skipping this one. But I'll keep it modest. :)

We had my last prenatal on Monday, June 20, 2006 - my due date. We were worried because Wendi was leaving the country for six weeks that Saturday, and didn't want to have to have another midwife if we were a few days late. Wendi, bless her, wasn't a bit worried, and she was right. I lost my mucous plug the next day, so things were in motion.

(I should mention how I came to choose a midwife - When I got pregnant, we didn't have maternity coverage. In my cherubic innocence I thought that "no maternity coverage" meant that while our insurance wouldn't cover hospital birth, they would cover other services (such as homebirth midwifery). Well, I was wrong - they wouldn't cover any of it. But by that time I'd done enough research and read enough stories that I was hooked!!! I didn't care at that point - I knew I wanted a midwife.)

On Wednesday night I took a firm hold on Joe and told him that we were going to get our to-do list done, as I was tired of putting things off indefinitely. So we hung our clothesline, set up our bassinet, and did several other things. My one and only instance of nesting!!!

Thursday morning I awoke with a start at 4:28 a.m. with the odd dual sensations that (a) I really needed to use the restroom, and (b) I was already doing so! It didn't take me too long to realize that my water had broken. I was nervous and excited! I got up and cleaned like a maniac and then got dressed, being very careful to do my makeup and clothes nicely, since our midwives would be coming over! (Ha! As if that would last!!!)

My contractions immediately made themselves known. I had had rolling Braxton Hicks contractions since my second month of pregnancy, but as soon as my water broke they became much more intense and uncomfortable - labor had started.

When Joe got up, he immediately freaked out and insisted on calling Wendi. After that we had breakfast, and then I headed back to bed. Getting up at 4:30 a.m. and cleaning wildly had been tiring! So I slept lightly, waking up for contractions.

Sometime that morning the toilet decided to overflow, so there I was trying to help Joe clean up a flooded bathroom in between contractions. Rather amusing! We called for emergency maintenance help which, as expected, never came, so the carpet had to dry on its own. We were too busy to fuss with it anyway.

Our doula came over in the early afternoon. Sometime during the afternoon, Wendi came over to check on us. I asked her if I could labor in water, and she said yes, so I immediately headed to the bathroom and stayed there - first in the shower, and then in the bath.

I have to put in a plug here for laboring in water. This may sound weird, but when I got into the tub/shower, labor pain initially vanished. Completely. It was wonderful. Of course it built again from there, but I don't think I could have done it out of water. It is, after all, reputed to reduce labor pain by about 40%, and I highly concur.

Another amusing thing was my total loss of modesty. When I initially got in the tub and Joe asked if our doula could come in to say hi, I was really reluctant. Well, it went downhill from there! By the end of the night I was walking around stark naked in front of everyone and not caring a bit! So funny.

One thing I also learned about myself was that I am loud in labor. Very loud. Think male sea lion during mating season. Or maybe a wounded bull moose. Many women are. I'd read enough birth stories to know this, so I didn't try to fight it (couldn't have, probably, anyway). So I yelled my head off with each contraction! Thankfully, none of our neighbors seemed to notice.

Somewhere during early evening, Joe and Jennie set up the birth pool in our living room and filled it up with warm water. I immediately headed in there, and the relief was once again great. Wendi and her back-up, Sue, arrived about this time. However, I was never actually able to say hi to them. It is true that in labor you do loose a lot of functions you normally have - such as conversation. Your whole body is focused involuntarily on labor, and all extraneous functions cease. Makes sense.

However, after going through childbirth, I realize how important it is to have an advocate with one - an informed husband or doula. A woman is really helpless during a lot of childbirth - she is vulnerable to suggestion and unable to fight for her rights. If I'd been with an unscrupulous caregiver, he/she could have given me pitocin, an episiotomy, whatever they'd cared to, because I wouldn't have noticed and/or been able to stick up for what I wanted.

This last part of labor was not a lot of fun. Everyone just sat around quietly, giving support when needed, while I dealt with things (loudly!). During the worst part I had a massive throwing-up spell, signaling transition (gotta love it!). It was during this time that I broke out in the standard "I can't do this anymore, dang it!!!" lingo. However, I was giggling inwardly at being so stereotypical - breaking out the typical transition phraseology like I'd been reading it from a script!! LOL

Our cat was totally freaking out. She had no idea what was going on - we have some great pics of her going around sniffing everything.

When I would ask "Am I almost finished?", Wendi would wisely say, "Soon!" I'm so glad she didn't tell the truth - I couldn't have handled it. She also told me that the only way she could know for sure was to do a vaginal exam. I refused each time. I knew that I couldn't handle it emotionally if she said something like "2 centimeters!"

When my vocalizations changed from yelling to grunting, Wendi said she'd like to check to see how things were going. She did, and not only were we fully dilated, but Caleb was at a station of +4! Almost there!

I should say that it is one of the proudest points of my pregnancy that the first vaginal exam of my entire pregnancy was an hour before Caleb's birth. Wendi is so, so hands-off (not all midwives are), and I loved that about her. No fuss!!!!

She tried to help me push more effectively in the water, and then after a while suggested I get out. Wendi mentioned later that most primips (first-timers) don't end up giving birth in water, as they tend to find the lack of gravity confusing. I concur!

So we went in the bedroom and pushed in a variety of positions, ending up with seated. I pushed like heck for one or two hours. It hurt like anything!!!! At the very end I just gave up and pushed, because I wanted it to be over more than anything. And Caleb was born!! At 10:35 p.m. - 18 hours of labor. We'd refused prenatal ultrasound, so the first big excitement was finding out that he was a boy!! Joe had desperately wanted a girl, but he immediately fell in love with Caleb and hasn't looked back since.

We'd discovered mid-labor that our video recorder had quit, so our doula only caught the last minute or so on her camera. Big disappointment. Next time we're going to check it before labor starts!

One of my big disappointments was that I (through some odd act of divine intervention) missed out on the birth ecstasy - that "my baby, my baby!!" moment. I was really bummed. I wasn't actually that interested in Caleb. I just wanted to go to sleep! But he was pretty cute, and we spent the next couple of weeks falling in love.

Wendi and Sue and Jennie and Joe took turns cleaning up, getting rid of the birth pool, bathing Caleb, and doing a gentle newborn exam (we refused eye prophylaxis & vitamin K, and delayed newborn tests). I myself had only torn slightly (nothing to worry about), so I went and showered while they changed the sheets (after eating an enormous bowl of strawberries and cottage cheese, I should mention) and then went back to bed. They all left a couple of hours later.

(I should mention that midwives don't forbid eating during labor - in fact, they encourage it - but after breakfast, I hadn't wanted to eat anything. I just drank Gatorade. So I hadn't eaten since about 6 a.m. that morning!)

So that's my birth story! I have a feeling that I'm going to be coming back to my blog every couple of hours today to input little details I've forgotten, but that is the main!

Another Week Goes By

What a week! It's definitely been a busy one. I have, as usual, neglected my poor blog, but that seems to be the normal state of things rather than the exception to the rule, so I think I'll stop apologizing for it and start accepting it as the status quo. Hey, once a week isn't bad! I run across blogs all the time that haven't been updated since 2003 or so!

Last week's main project was a cake made for a friend's baby shower. I was very happy with the end product! It was definitely a harrowing experience, though. She wanted strawberry buttercream filling, something with which I hadn't worked before, and I couldn't find a recipe. So I ended up just folding fresh strawberries into vanilla buttercream, and it looked so delicious that I just piled it on! After covering the cake, I realized that (1) in culinary school we were taught to cover fondant cakes with only the lightest scraping of filling and masking (gulp), and (2) the leftover strawberry filling I had sitting on the counter was bleeding torrents of juice! (Strawberries + Sugar = What??? Juice!!!) Aackk!!

And then, about two hours after I'd finished the cake, I was standing near looking at it, and realized that one of the sides was not straight but rounded. And squishy to the touch! Aaackk!!!! I imagined the worst - mounds of watery filling squishing out of the sides, taking the cake down in a puddle of goo. So I ran around the house like a crazed maniac until I thought of using some wide ribbon to restrain it - so the cake spent the next 24 hours wrapped up in its own little girdle with me fervently praying that it wouldn't collapse. If it had, there would have been nothing to do about it - it was too late!

Thankfully the cake made it all the way over to the shower, and when we cut it, the filling looked just fine! Not watery or anything (I guess it reabsorbed the liquid). But it was a good lesson for me - don't use too much filling!! (Delicious as it may be.)

But I was a total stress case. Running out to the kitchen to check on a teetering cake every three minutes (not to mention waking up all night wondering if is still standing) can do that to one!

So one of my big projects for the spring is over - making K's shower cake. My second big project is being the wedding coordinator for an upcoming wedding. After that I can get pregnant at will (if I want to) and not disturb anyone's plans too greatly! Assuming, of course, that we wait until after our assumed upcoming move (haven't heard anything on house #3 yet) - beforehand would be a disaster. So I guess moving would be the third big project - we can pregnant after that.

I just can't work up any great enthusiasm for getting pregnant. Despite the fact that most of Caleb's contemporaries now have siblings (crazy, crazy women!) I just can't get that enthusiastic about getting pregnant again. I view it with something approaching fearful apathy (is there such a thing?). Don't get me wrong - I loved being pregnant - but it was such an awful experience at the same time that I can't dig up any great desire to repeat it. Of course I'd love to see Wendi (our midwife) more often, one of the benefits of being pregnant (and have her as a captive audience to peg with midwifery questions! heh heh heh), but the remembrance of hyperemesis is enough to make me want to wait indefinitely before plunging in again.

If Joe only wanted one kiddo, I probably wouldn't put up a fight for another. The only reason that I am open to considering another baby is simply that my experience as an only child was not a particularly positive one. I was shy and lonely and desperately wanted a sibling, and I don't want to do that to Caleb - especially as the women in my family tend to be really overprotective as mothers, something that's probably been made worse by the fact that most of them only had one child. Also, we're planning on homeschooling Caleb, and contemplating keeping him in that kind of isolation is just depressing. I'm not the kind of mom who wants to be out in the car running every which-way with activities, so a little in-home socialization would be good.

Also, I think that only-children (speaking from experience) tend to feel smothered with attention. There's a great desire to get away, to hide oneself and one's activities from parental notice, to have privacy and time to oneself. That doesn't happen too much as an only child! So I do want to provide a sibling for Caleb at some point.

But other than those reasons, one would be enough for me!

I guess that another of the reasons why I am reluctant to have another baby is simply that I am just tired. It took me a good 15 months to feel better after the havoc that hyperemesis + pregnancy wreaked on my body; also, I've always had struggles with fatigue. I could easily sleep eight hours a night and take two naps a day and still be tired most of the time. I've always been that way. And running after an extremely active toddler adds to that! So the thought of dealing with hyperemesis, pregnancy, childbirth, an active toddler, and tne exhaustion of the round-the-clock newborn schedule makes me tired just to think about!

I just read a great little article on natural childbirth, and I think I'll write about it in my next blog entry. Natural childbirth is really a paradox - it was the most pain I've ever experienced in my life, but it was also a completely transformational experience - I wouldn't trade it for the world. I think I'll try to explore my thoughts on that in my next blog entry. I'm wandering rather far from hyperemesis gravidarum, but one must take a break sometime! I think I deserve a break after the stress of last week!!

I would like to conclude with two just-learned life lessons:

(1) You know you have too many bananas in your house when there are fruit flies having mating orgies on your kitchen counter.

(2) Never, ever, EVER cut strawberries with a knife that you've just used to cut raw garlic.

Love to all!!

Various Musings

Wow, what a week!

This week has been incredibly busy. Many things have been going on, but the main thing was having my parents over to stay for a week of intense house-hunting. Nothing turned up, but it was a good experience and I think we have a bit more knowledge to go on now. We're going to try to keep it up on our own. With our price limits, this is not an easy process! Our poor realtor is doing a ton of work for what is going to be an absurdly small profit.

I have not been able to give this poor blog nearly all the love and attention that I want to, this week or any week. I've just been too busy!!! But I have been thinking a hundred miles an hour on topics and research that I want to post. Perhaps it's best that I don't have unlimited time! I'd probably run through all my ideas in a week or so and then have nothing to say (not likely, but possible). But for now, I have ideas and thoughts absolutely overflowing. Hopefully I'll be able to post at least twice a week or so. Some of my ideas for posts: Disease as a social phenomenon, HG and spirituality/faith, The myth of "it's all in your head," HG and Grief, etc. I still have a ton of research to post also. One of the main beasts that I need to tackle is homeopathy - I have a small volume-worth of homeopathy info for HG, and I need to start posting it.

I've also decided that I need to start using the phrase "hyperemesis gravidarum" at least once or twice per blog to make it more "out there" for internet search engines. So I'll try to do that. After all, this blog was started to give out info - which is hard to do if no one can find it!

I have been corresponding with a fellow hyperemesis gravidarum (HG) mum (the one mentioned in an earlier post), and it has been absolutely creepy - her emails to me read like pages from my own diary. It is so cool to know that one is not alone! We all go through the same stuff. She has given me permission to post from her emails, so I am going to start posting her story soon as well.

Today I thought I'd make a brief mention of the pregnancy notebook that I started a month or two ago. I needed to have a way to file all of my research, so I got a huge notebook and put three sets of dividers in it - one each for hyperemesis gravidarum, pregnancy, and childbirth. I thought this might be of interest to some obscure person out there (???), so here is how I have it organized:

I. Hyperemesis Gravidarum

1. Hyperemesis - General Information
2. Supplements - Herbs, Drugs
3. Homeopathy
4. Naturopathic Options - Chiropractic Care, etc.
5. Other - Tandem Nursing, etc.

II. Pregnancy

1. Pregnancy Notes - Notes from past pregnancies to share with care providers
2. Records from Wendi (our midwife)
3. Records from OB - this and #2 are so that I'll have records from each to show to the other during times when I'm under co-care
4. Nutrition
5. Pregnancy Herbs & Homeopathy
6. Pregnancy Complications
7. Prenatal Test Research - Mostly my compendium of articles showing why I choose to refuse all prenatal tests!
8. Shower Ideas - Next time, if I am able to have a shower, I want to do more of a Mother Blessing ceremony than a traditional shower, so I'm collecting ideas. Things like bead ceremonies, handing out candles, etc.

III. Childbirth

1. Childbirth General
2. Childbirth Prep - Class materials, exercises, etc.
3. Birth Plans, with research - One for home, one for hospital (this one not to be used, God willing)
4. Birth Complications
5. Birth Herbs and Homeopathy
6. Postpartum
7. Breastfeeding
8. Midwifery

*****

I know I shouldn't have too many topics, but I'm making up for lost time. And this next topic, which I shall attempt to keep brief, is more for myself. I am so tired of the fear that accompanies each end-of-the-month "am I pregnant?" question. Of course, I don't think that I will ever be able to be rid of this fear. The HG mum with whom I am corresponding wrote that when she found out she was pregnant with her third baby, after having experienced one HG pregnancy, she grew despondent to the point of suicidal thoughts - so much so that she had to spend a brief period in a psychiatric ward. I know how she felt (to a lesser extent). I will never be rid of that fear. But to alleviate at least some of it, I thought that I would write out the advantages that I would have going into a third pregnancy which would make things (hopefully) a bit easier. Here goes:

(1) I am not naive. I am not expecting an easy pregnancy (how I wish!). I am expecting HG, and know that it could very possibly (even probably) be worse than last time. So it's not going to take me off-guard. I am not going to waste time with idiotic morning sickness remedies (dry crackers, etc.). I can go straight to the big guns - homeopathy, herbs, liquid diet, drugs, etc.

(2) I know what to do - Kind of like the last one. I don't have to try to research this when I am sick as a dog. I know what I have and what my options are. I've done my reading and my research and have my resources set up.

(3) We have maternity coverage - Last time it was only emergency-only maternity care, and as insurance companies are notorious for ignoring pleas for help from HG mums, we couldn't risk it unless it was a true emergency. I am set up with an OB who knows my situation and we are ready to go. I am not crazy about using prescription meds, but if necessary, I will go willingly down that path.

(4) I have my caregivers in place - I have an OB for HG-care. I also have a wonderful midwife (last time we were searching for our midwife at the beginning of HG) who knows my history and is ready and willing to help. Her partner is also skilled with homeopathy, so that's a big plus.

(5) I have a great support system - If and when we do get a positive test, I am going to mobilize all of my support network (church family, biological family, etc.) and let them know that I may need help.

Of course the main problem with a second pregnancy would be the result of the first pregnancy - Caleb!! Someone said to me, "When you have your second baby you don't have the option of laying around all day being sick." Hmmm. Well, it's hard to tell people, but with HG, you don't have the option of getting up. If I get as sick or sicker, I will have no choice but to utilize outside resources to care for Caleb. Not to mention that I wasn't able to handle food. so feeding him would be an issue.

I find it odd that I am delving so deeply into my experience with HG so long after the fact. Thinking back, it has been over for almost two years! Wow! It seems like yesterday! But I can see a couple of reasons: (1) At the time, I just couldn't "process" the experience. First, I was too sick, then too busy, then preoccupied with childbirth prep and then dealing with a baby. Women always need to "work out their feelings," and it seems that I am no different. (2) I am a different person, for good and for ill, after coming through this experience, and I need to work through this. My religious faith is what has been most deeply affected, and this needs to be dealt with. (3) This experience is not "over." The threat of recurrence will be there until I cease to have the ability to bear children, and as we do want to give Caleb a sibling, the menace is a constant overshadowing presence. Thus I can't just bundle this into "past experience" and move on, because it is (mostly likely) just as much in my future as it is in my past. Even if I never get pregnant again, though, the fear of it will always be there.

But anyway, enough blogging! This is enough for the great American Novel, and I don't have time to waste anyway - when Caleb is asleep, things need to happen!!

Lots of love to everyone!!

Wonderful Water Birth Video

Someone posted this birth video on the Arizona Birth Network, and I just had to share it - it is one of the most beautiful births I've seen. (And the lighting is great, so it's clearer than most homebirth videos.) What's even greater is that it is a birth center birth, so it shows that institutional births don't have to be disrespectful and full of interventions. I was definitely crying by the end of this one:

http://www.youtube. com/watch? v=-ct8MyqhC2c

I'm a complete sucker for birth videos - I cry at them all. But I'm talking about the good ones - not the ones where the mother is strapped down to every device imaginable and the baby is basically manhandled by disrespectful delivery staff. Those make me cry too - but with rage rather than joy. Birth is the most (or at least one of the most) sacred moment in a woman's life, and attendants can really make or break it.

Anyhow, this is a keeper!! It's a waterbirth, and it's really rare to see waterbirths as clearly as you can see this one. Most waterbirths you only get to see the baby as it comes out of the water, but you get the whole show with this one, and it's just great. We tried to have a waterbirth with Caleb, but didn't quite make it. But I labored the entire time in water! I just got out for the last hour. Our midwife says we'll have a better chance next time - that primips sometimes have a hard time with waterbirth, but it's totally easy for multips. I hope so! That's definitely my goal for my next baby - a waterbirth. Not to mention that water is GREAT for easing pain. When I got into the labor pool it was totally like the contractions disappeared (for a while, that is!!!!!). I don't think I could do a birth without the help of water. After all, it is called "the midwife's epidural."

Well, gotta go! Toddler typing at the same time is NOT making this easy!!