Conversations with the Mogrunt

My oldest boy is now 5 and we are having some pretty fun conversations as of late. The kid is amazing - no really, I'm pretty sure you'd love him to if you met him. 

Of course, I'm his mom, so I'm legally required to say that. But don't trust me, trust an outside source: One of the leaders at his after school program came up to me last week and said, "You know, I really like having the Mogrunt around. He's a pretty great kid." Considering this woman sees 100s of kids every day, I consider this high praise. 

And I have to agree, he's a pretty great kid. He's kind and considerate, he looks out for others (his little brother included), he's only a little bit of a stinker and he loves his Mama. What's not to love? 

His imagination, his view of the world, his earnestness are apparent in our conversations. Listening to him, my heart feels the world again the way I did as a child and I get teary-eyed, wishing that the world could remain as innocent and wonderful as the one he sees. (The one where the only kinds of guns that people have are Nerf, squirt, and bubble.)

I thought I should make a regular habit of documenting our conversations so that I don't forget them. So, here, as part of an ongoing series:

Conversations with the Mogrunt 

Post Holiday concert (December 11):

Mogrunt: How come some of the girls' hair looked different tonight?

Me: Well, some of their moms would have curled the girls' hair or braided it. Is that what you mean?

Mogrunt: oh. Layla just had a ball of hair. Like a big dirt ball at the back of her head.

Me: *laughing uncontrollably* A dirt ball? 

Mogrunt: Yeah, it was a big ball of hair. Why are you laughing?

He has a keen eye for detail, but we need to work on his descriptions.

Translation (December):

Mogrunt: Mom, what's the word for leg in French?

Me: Jambe

Mogrunt: What's the word for go?

Me: Uh, vas-y?

Mogrunt: MOM! Jambe-vas-y! It's Lego in French!

On Canada (October):

Mogrunt: I really love Canada. Do you know what I love best about Canada?

Andrew: No, tell us what it is.

Mogrunt: We have really great libraries. 

Me: You're right about that, little man. 

On Gym Teachers and Their Unusual Names (October):

Mogrunt: Hey Mom, we have a new gym teacher.

Me: You do? What's her name?

Mogrunt: It's a guy, Mom. His name is Mr. Peabody.

Me: Really? Mr. Peabody? That's a fun name to say.

Mogrunt: It's pretty funny, isn't it, Mom? His name is Pee-potty!

Me, laughing: Bud, it's not Pee-potty, it's Peabody! Pee-potty isn't a name.

Mogrunt: What? It's not Pee-potty? Ba ha ha ha ha!

School Days, Part II: Communal Viruses & Perspective

With both of our boys starting school this year we have had what feels like "ALL THE SICK!".

Thankfully, with their dad being at home until early afternoon, we are able to tag-team the sick kids, but I've still had to take a lot of sick time this fall.  They were sick so often, that I started to dread calling my manager to inform her that I needed to leave work early yet again. I could write an entire post on the pressures of being a parent who works outside the home, but that's for another day.

I've had two calls from school for the Mogrunt. The first time I was able to go pick him up straight away. There he was, sitting on a chair in the admin office, looking so small with his backpack tucked behind him. I scooped him up and carried him to the car and deposited him at home with his dad. I felt like a crappy mom for sending him to school in the first place. I hadn't noticed the fever he had in the morning.

The second time I got a call from school, our car was in the garage for maintenance and I wasn't able to get him right away. He had to go to his after school program for an hour before I could pick up the car and then him. Thankfully, our car garage is really great - I let them know that I had a sick kid to pick up and they got my car finished quickly.

He was well for quite a while, but the Bunny, well, he is another story. He started daycare in September, and was sick within a week of being there. I feel like he spent more of September at home than he did in daycare. I've even had to pick him up and bring him to my office so I could complete my workday.

He has had a fever so many times this fall that not only have I lost count, but a few weeks ago, I had enough and took him to the children's hospital in the middle of the night. He had thrown up two nights in a row and his fever was really high.

After sleeping with him in my arms on the cot while waiting for him to pee, we were finally able to send off a sample to be tested. When the doctor came in with the results of a urine test (no infection), she had the standard protocol in hand - The "Treating Fevers in Children" brochure and the dosing for ibuprofen and acetaminphen.

I looked at her and said, "You're here to give me the talk on treating the symptoms, not the fever, right? About how I should watch for lethargy, for signs of dehydration, for febrile seizures, but not to worry about the temperature, right?"

She said yes.

I went on, "I know all those things. I'm the daughter of a pharmacist who worked in the pharmacy for many years. I know it. My kids have been sick more times than I can remember since the beginning of September. I was just done. When his temp hit 40.7C and he threw up twice again last night, I was done. I was done with my kids being sick. I was done with worrying that there was something I had missed and since he can't talk, I was done trying to figure out if he wasn't able to tell me what hurt. So I came here."

The very kind doctor, who was the attending physician (she informed me that the resident I had seen earlier had been sent home as she was sick), very compassionately smiled and said, "I get it. I've been there too. I have three kids and I remember a season like this. Here's the emergency number if you need it. It's the direct line to us in the emergency room."

That was what I needed. After all the yuck, I needed someone to say "I get it." I got the Bunny dressed and we headed out to our car. It was 7:30am. We had been in the hospital since 3am. The sun was rising. It was an incredibly rough day/weekend for all of us, but we managed. Mr. Happy was sick that weekend too. He spent three days in bed with a fever and aching all over.

So, last week, when I woke up at 5:30am to the Mogrunt calling for me, and we did the mad dash to the bathroom, I didn't feel like crying, like running away, the way I had the week before. I remembered that doctor telling me, "You're not alone. This happens sometimes. You'll all get through it."

The Mogrunt has spent a couple afternoons, tucked into a chair across my desk from me, either playing games on the iPad or drawing on the white board. My coworkers have been very kind in a. pretending he's not there, and b. finding treats for him in their office. (Kid's had more chocolate than a kid should really eat, healthy or ill). He's a great kid, but I've really got to work out some alternate care for when he's sick. My SIL has been able to help a couple times, but she isn't always available.

This whole thing, though, it's all about perspective.

The entire time our kids have been sick with colds and fevers this fall, I kept thinking about a childhood friend of mine, L. L's daughter, C, who is just 7 months older than the Mogrunt, has been receiving treatment for leukemia over the last 20 months. When I was worn out and feeling discouraged by yet another fever, I would think about her. C had to delay starting school by a year because of receiving treatment. We saw them at the local children's hospital a couple of times and my friend has been so thankful for the support of her community and in awe of her daughter's spirit. C was finally able to start school this fall, and had managed to steer clear of all the viruses at school until November. As she is still receiving maintenance chemotherapy, her immune system is compromised. A little chest cold had her in hospital for almost a week. C is fine now, back to her routine, but it's a good reminder to have some perspective. C's leukemia, which was caught very early, has responded well to treatment and she should be finished in the spring of 2015, I believe.

This past weekend was the first one since Thanksgiving weekend (October) that we have all been healthy. It was wonderful. We went out. We played. We had a friend over for a visit. We were silly. We had dance parties with the boys wearing the Mogrunt's undies on his head.

I'm just really hoping that they don't get sick over Christmas.

But if they do, it's ok. We'll get through it.

School Days - Part I

This fall we've had some pretty big changes in the lives of our family and this fall marked the start of a whole new adventure for all of us.

I feel like Inigo Montoya in "The Princess Bride" when Westley wakes up after being mostly dead:

Inigo: Let me explain [pause] No, there is too much. Let me sum up. 

- At the end of November 2013, while I was on maternity leave, Mr. Happy, also known as Andrew, was laid off from his job.
- When I went back to work in May, Andrew became a SAHD. Daycare on one income & EI payments didn't make financial sense. He was home with the boys from the beginning of May, job searching between diaper changes.
- We found out that one of the local community college campuses was offering a 22 week accelerated program in a course he had been interested in taking.
- Andrew applied for the course, got accepted, took a couple of prerequisite courses and thanks to a retraining program offered by the government, tuition is taken care of. Woo to the hoo!

School started the first full week of September for three out of the four people in our house.  Andrew started at the Community College, the Mogrunt started in Grade Primary* in the French Immersion program, and the Bunny started daycare.

To say that I was anxious about how our lives were going to change in the fall would have been an understatement. Some members of our family have to be awake closer to 6am in order to get everyone out the door on time.

In the past, before kids, I would roll out of bed at 7:30am to catch the bus at 7:45am. On days that I drove, I would roll out of bed as late as 8am and leave for work at 8:10am for an 8:30am start time (It takes 10 minutes for me to drive to work.)  I am a low maintenance person. I shower every other day and hate the weeks where my shower days fall on Monday, Wednesday, Friday.

Let me be clear about this: We are not morning people. We do not function well as a team before 8am. We are also bad at getting ready to go places as a group. If one of us leaves the house alone, not a huge problem. As a group, we are a disaster of hurrying, hollering, and harried people. We forget stuff and have to go back to the house multiple times. Someone forgets to brush their teeth. Someone poops in their diaper just as we are about to leave. *eyes the baby* Someone melts down.

(See? Disaster! First day of school at the bus stop and the Bunny has no shoes on his feet!)

Andrew's course, as it turns out, is from 2:30pm to 9:30pm every week day. This has been both a good and bad thing for us.

Good:

He's there in the morning to get breakfast for the kids while I get ready and make lunches. He usually puts the Bunny in his car seat and then walks the Mogrunt to the bus stop. I then run out the door behind them, purse in hand, coat trailing behind me as I jump in the car and drive to the Bunny to daycare before going to work. Inevitably, I eat breakfast at my desk.

Andrew then spends part of his morning tidying the house, doing dishes, throwing in loads of laundry, and studying for his course. I am eternally grateful that he is a not only handsome, but handy as well. *wink to Red Green*

Bad:

At the end of the work day, I pick up the Bunny from daycare then head down to the Mogrunt's school to pick him up from the after school program. By the time we are all in the car together, headed home, it is usually about 5pm. We arrive home to rustle up supper, play a bit, do some tidying, read stories and head for bed. Without Andrew. All week.

We miss him awfully during the week, but are happy to have him around on the weekends. Life is much easier when I manage to get meals ready in advance, but I'm going to be honest, it's not gourmet at our house these days. There are plenty of nights when we eat scrambled eggs and toast for supper. 

I really don't know how single parents or spouses/partners of those in the military do it. Working all day and then coming home to look after the boys isn't easy. I've been exhausted - it seems that transitions exhaust me - so I often fall asleep with the boys. The Bunny sleeps in our bed and tends to wake if I try to sneak him into his crib so I can go downstairs. As a result I often allow myself to skip extra housework and instead, succumb to dreamland.

I have to keep reminding myself that it is only temporary. It's only 6 months, right? 

The Beginning: The Painful Part

So, here I am. Almost 15 months later, with no visible scars except the self-inflicted ones from bicycle accidents, cooking mishaps, and that weird line on my cheek you can only see in certain lights that I'm told came from an unfortunate interaction with the mean Siamese cat we had when I was a baby.

My recovery, though, wasn't a walk in the park.

In those first hours after leaving the OR, I had IV tubes everywhere. I was the colour of a sheet of paper with black holes for eyes. My sister-in-law brought the Mogrunt over to meet his baby brother in the morning. I was still in the delivery room at that point. I'll never forget his wild bed-head hair and his little concerned face when he saw his mama like that. It still breaks my heart. He was just two months shy of turning 4 at that point. He was and is a wise little soul. He was so gentle and sweet with his brother and a little intimidated by what was going on with me. I explained that the tubes were all medicine to help me feel better, which they all pretty much were, except that, as my little boy met his little brother, I suddenly realized I was gripping the rails on my bed and holding my body off the mattress.

I suggested, in what was possibly the most manic of voices, that he go and get a snack with his dad at the cafe and off the two of them went. That left me with my sister-in-law, to whom I turned and said, "I just realized how much pain I'm in and I can't let go of the bed rails, can you please ring for the nurse?" She paled, grabbed the button and did her best to comfort me while we waited.

Thankfully, I was a "special" case and the team was by my side in no time. When they arrived, I explained the problem to the on-call doctor, who had been my OB when I was pregnant with the Mogrunt. Dr. D tut-tutted when I told her I had chosen to take only one of the pain pills offered to me post-surgery. How was I to know that I would need more? I've never had any kind of surgery in my life. She ordered up some meds and left the nurses to it.

Moments later they were attempting to insert a small sub-cutaneous port into my arm, a new piece of equipment that they weren't quite sure how to use, but thought it would be useful should I need more than one injection. While I understand that teaching hospitals are important, at that very moment, I did not need them to take the time to make me a test subject. I needed the meds. I was still holding myself up off the bed at this point - only my heels and my hands were touching anything. I was just about to scream when they finally got everything working and gave me the medicine.

One moment, pain, the next, HIGH AS A BLOODY KITE! Awesome.

Later on, when my dad and SM arrived, I was still high, eyes crossing and all. The doctor came in and suggested that they weren't going to give me another injection as I had been quite "Fruit-loopy" and changed my orders to something less powerful, but equally effective. I was relieved.

When I was wheeled up to my room, they hooked me up with this wonderful device to help prevent blood clots. Here, I took a video because I found them quite delightfu (in case the video doesn't work, click here)l:

My husband, on the other hand, didn't find them as enchanting. He was sleeping on a cot in the room with me and the pump for these things was running right by his head. All. night. long.

Surprisingly, I slept through it.

The Bunny was born in the wee hours on a Wednesday, and on Friday morning they were talking to me about going home. I was thrilled at the idea they felt I was ok to go home, but scared at the thought of going home.

My blood count was frighteningly low when they gave me blood and had dropped a bit after surgery before levelling out. Total blood volume of the average pregnant woman is around 6L. I am not average height, so my total blood volume was likely closer to 5L when I started bleeding. I lost about a litre of blood, so that's a pretty big percentage of my total volume. (This is the stuff I calculate when I want to freak myself out, knowing full well that people lose a lot more blood in more frightening circumstances like car accidents, and need many more units than I did before the doctors get the bleeding stopped.)

I was told to come back to the hospital immediately if I didn't feel well, but the thought of going home was wonderful. I wanted to be home in my own bed with my family. So off we went, with a tiny baby covered in handknit love.

That first night at home was not the best. I had a hard time getting to sleep as I was scared to shut my eyes. Sleep did come and nothing horrible came of me being at home. We passed the night as one does with a new baby in their bed, waking for feedings and changings, with nothing too eventful.

My concern, after losing so much blood, was about my milk supply. Thankfully, I had no troubles there and the Bunny nursed well.

The first six weeks of his life were a challenge for me. I was having problems as a result of nerve inflammation. Just walking across the room was incredibly painful. I felt pressure with every step and sunk into a depression. I started to have anxiety as I didn't know how I was going to look after both children when we pulled the Mogrunt out of daycare for the summer. I had spent almost all of the six weeks in bed at home. Friends would come to visit and would hang out with me and the baby in bed. The only time I was comfortable was when I was lying down. As a result, I spent a lot of time knitting and hating my bedroom with every fibre of my being. I redecorated that room so many times in my head!

During my 6-week checkup, I got a diagnosis of vestibulitis (you go ahead and Google it) from my doctor. She touched me with a swab and I scrambled backward on the examination table like a wounded animal. Yes, it hurt that bad. I went home with a couple of prescriptions in hand and a bit of optimism. That afternoon, back in my bed (going to the doctor's office and then the pharmacy had drained me), I spent some time researching it, crying over it and then realizing the cause of my inflammation was not trauma, but an allergic reaction.

I stopped using the product I was using and I was feeling better within a week. A month later and I was running and biking again. Ladies, if you ever have a need to use feminine hygiene products for an extended time, please be careful about your choices. The brand I was using is notorious for causing problems.

We had a wonderful summer - running away from home every chance we got, either to the cottage for extended long weekends, or on adventures close to home:

Our first family photo, taken by a tourist at Peggy's Cove, NS

I'm physically, for the most part, fine now. The scars you can't see, the ones that make me react to regular situations with my adrenaline already pumping before regular people are even off the couch, those aren't so nice. But I'm working on it. It doesn't happen all the time, but sometimes I feel like I've lost my ability to judge how to react to some situations.

I've read up a bit on traumatic birth events and stress disorders. And I'm working with my doctor, who, after reading through the surgery report with me said, "Huhn, I think maybe we should check some bloodwork to make sure you're doing ok after all that."

Yes, let's do that. And let's keep moving forward.

The Beginning - The Scary Part

I left off the story of our youngest son's birth alluding to the fact that things didn't go as expected after he was born. Here's the rest of the story:

A birthing room at hospital can be a busy place for a very short period of time. You go from hanging out in the room with your partner and your nurse and whomever you've elected to join you, to suddenly having extra nurses, a resident doctor, sometimes an attending physician and in more urgent cases, a neonatal team hovering nearby. When this little Bunny was born, I remember there being two nurses and the resident in the room and maybe the doctor and nurse who check on the babies after they are born. After he was born and everything seemed ok with him and me, it went back to being just me, my husband,  my nurse and this little tiny new person in the room. It was quiet. It was wonderful. I felt so good. I felt amazed at how much easier it had been. I felt like I could go out and bench press a car. I was a superhero.

At the IWK Maternity Hospital, you stay in the delivery room for a while after the birth. I assume this is for observation while the nurse finishes writing up your paperwork, encourages you to nurse the baby for the first time and probably does another Apgar scoring on the baby. I guess. I'm not an expert.

Not long after I fed the Bunny for the first time, I felt a gush of something being expelled from my body. This being my second birth experience, I knew to tell my nurse and have her check that everything was ok. I had passed a rather larger clot after the Mogrunt was born, and that's what I expected this time.

This is not what Denise saw when she pulled back the sheet. Instead, she saw a whole lot of blood. She grabbed the phone and called for assistance, then, (and this is where my memory gets a bit choppy), she changed the padding on the bed underneath me.

A moment later there was another gush. I told her but she had already seen it, grabbed the phone and shouted, "Tell the doctor to get here NOW!" As she was speaking, I could already hear the sound of sneakers racing down the hallway. The doctor burst into the room.

The next thing I knew, the back of my bed was dropped down and they were restarting my epidural. The doctor (resident), let's call her Dr. B., was checking to see if she could find the source of the bleeding and after checking around for what seemed only a few moments thankfully stated that she seemed to have found it.

The sides on my bed went up and they got ready to push me out of the room.

I turned to look at my husband, who was sitting there holding our baby with a startled look on his face, as if he couldn't quite believe what was going on.

"I love you." I said.

"I love you too." he said, "You're going to be ok." He told me he said it because he knew it was true, he had no doubts that I would be ok. I, on the other hand, wasn't so sure.

My bed burst through the door and they wheeled me to the OR, just down the hallway.To this day, I can close my eyes and still see the ceiling tiles and lights above me and hear the sound of their shoes squeaking as they pushed my bed as fast as they could.

"Please Mom," I said, "I really don't want to see you today."

A nurse, hearing me, and being the amazingly protective women that those nurses at the IWK are, said, "Is your mom here? Do you need us to do anything?" Imagining, perhaps, that I had a difficult mother who might cause me some sort of stress.

My nurse, with whom I had swapped stories all night, said, "Her mom is gone. She passed away. It's ok, Stephanie. You're not going to see her today. We'll take good care of you."

We burst through the next set of doors to the OR and immediately an entire team surrounded me.

The anesthesiologist, whose name was George, introduced himself and his assistant, whom I swear was named Denny, and got to work monitoring my vitals and ensuring I was comfortable. George and Denny were going to be my best friends.

"We are going to wrap you in towels ok? You lost a lot of blood and we don't want you to start shaking because you might feel cold or go into shock." This seemed unnecessary to me at the time, but as I was there with my legs propped up at angles which seemed indecent, I was happy that some parts of me were going to be covered up.

We had been met in the operating room by Dr. Z, the attending physician. At this point, Denise, who had positioned herself on my left hand side, said, "If you were to pick a doctor to work on you in this moment, you couldn't have picked two better." All I saw of Dr. B and Dr. Z for the next hour and a bit was tops of their heads.

While the two doctors toiled away at what I would later find out was a tear that required many, many stitches to fix (thanks to friable tissue that continued to tear when they stitched it), I alternated between a range of emotions. I was chatty at first, likely from the adrenalin running through my body.

I realized that George was trying to get blood from my earlobe.

George: "Nice earrings, but I'm having a hard time getting any blood from your ear. You have tiny earlobes."

Me: "Don't get any ideas, those earrings were my mom's, George. Maybe you should try my finger." I wiggled my ring finger on my left hand. "I always have success with that one."

George: "How would you know that one will work?"

Me: "I used to teach pharmacists how to use a point-of-care testing device. I've stuck that finger a lot. I'm a good bleeder. Unfortunately."

(He swabbed my finger, sliced it and sure enough, got his readings.)

George: "You're going to need blood. Are you ok with that?"

Me: "Yes. BRING IT ON!"

George asked someone to hang a bag of O negative. I told him "I'm a nerd, I have nerd blood: A+".

George laughed and of course, they checked my type to be sure, but the next bag they hung was A+.

Two bags of blood.

I asked Denise if she could get someone to ask Andrew to call three people - my dad and two of my friends:  Rebecca and Angela. Someone came back and informed me that he would do just that. Imagining him there, holding our baby, calling the two of them, yeah, I can't think about that. I've known the two of them, well, Angela I've known since I was 18 and Rebecca since I was 20, so we've been through some things together. From my perspective, at least, this was the worst thing.

I stared at the ceiling. I thought about stuff. A lot of stuff.

I thought about my mom. About how much I missed her. About how mad I was that she wasn't able to be here. I hated cancer more in that moment than I have hated it in a long time.

I thought about my son, at home, still asleep. I missed him. I wanted nothing more than to hold him and snuggle him and run with him. We had been talking about how Mommy couldn't really run because of the heavy baby in her belly. He could hardly wait for me to have the baby so we could have fun running and biking again.

I thought about Andrew, sitting there with our baby and hoped that they were ok. I wondered if anyone told him how I was doing. I was upset at being separated from him and the baby.

Suddenly I thought about my brother. He's not mentally well. He hadn't spoken to me in a year at that point. I got angry thinking I might die and he wouldn't even know I was at the hospital to have a baby.  I got really angry then and I started to cry.

George wiped my tears. George, I'm forever grateful.

Denise sidled up to me again. "Don't you cry on me. You're going to be fine. They've got things under control now. I thought you were going to be my easy patient tonight."

"Me too," I said, "me too."

I looked at her, "Denise, it's almost 7, you're off your shift soon. You need to go home." I know, it's weird that I thought that. Because I really didn't want her to leave me. I felt like I would be alone without her.

Denise said, "Don't you worry. I've got two nurses coming in to take my place. And I'll check in to see how you made out, ok?"

Not long after that, Denise brought two wonderful nurses to my side. For the life of me, right now I can't remember their names, but I know that one of them was a graduating student and it was her birthday. She asked all sorts of questions about the Bunny to help distract me from what was going on. They told me that as maternity nurses, it's always fun to meet babies that are born on their birthdays.

The doctors finished up and announced that I would be ok. They were going to watch me to make sure my blood levels didn't drop but they had fixed the issue.

I was lucky the tear wasn't higher - I could have ended my night with a hysterectomy. Instead, I ended it with a whole lot of stitches, about a thousand, as Dr. Z told me later. Do doctors exaggerate? I kind of hope that they sometimes do.

Eventually I was wheeled back into the room where my husband waited with our little baby. I smiled weakly at them and started to cry. Andrew rushed to my side, kissed me and smoothed my hair.

It would be another day before I got a look at myself in the mirror. I was unbelievably pale with huge black circles under my eyes. I had tubes everywhere. Me, the person who gets the heebie-jeebies when looking at IVs had needles sticking in both hands and pieces of surgical tape stuck to me everywhere.

But I was alive.

This photo is in black and white, but let me tell you, 

I was pretty much the same shade in full colour.

I think about this all the time. I think about what might have happened had the situation been different:

• What would have happened had I not had a previous birth experience?
• I knew to tell the nurse about the feeling of passing a clot, what about women who don't know to do that?
• What if I had been younger, less confident? I am an open book when it comes to speaking with health care professionals, some women, younger perhaps, more shy, yes, might not have said anything.
• What if I had had the baby at home? I asked my doctor about this last week after asking her to review the report from this day. I would likely not have made it, she told me. There's a good chance I would have died trying to get to the hospital.

So, while I support a woman's right to choose where she gives birth and who she involves in her birthing experience, I want my story to serve as a reminder that it doesn't always go the way you plan. There were no warning signs. There was no intervention in this birth that could have caused that laceration. The birth was not the problem. We don't know what caused the tear.

Women still die as a result of childbirth. It is horrible. But it happens. In Canada, in 2013, the rate was 11 in 100 000. In the United States, in 2013, the rate was 28 in 100 000.  Those rates have actually RISEN in the last 20 years. Meanwhile, many European countries have death rates in the single digits:

"Globally, most maternal deaths are caused by severe bleeding, high blood pressure, infections and obstructed labour. More than one in four is caused by malaria, HIV/AIDS, obesity or diabetes. Abortion complications account for 8 per cent of deaths."

"In 1990, 23 countries had at least 1,000 maternal deaths per 100,000 live births. By 2013, only Sierra Leone remained above that threshold, but it had still managed to more than halve its death rate over the period." 

{via}

We should all be so fortunate as to have the access to medical care that I had, but let's face it, some of us choose not to have it and some have no choice but to go without it. Please, if you make the decision to give birth at home with a midwife or a doula, please understand the risks and be prepared for them. Have alternate plans. Be ready to accept those alternate plans for both your baby's safety and your own. There's a lot at stake here.

And for those women who have no choice but to go without medical care, let us all do what we can to support them and the organizations that endeavour to help them.