Happy Birthday, Michella!

Happy Birthday, Michella! You're TWO today! What did you do today? Did you have a birthday cake?

I can't believe I still don't even know how your name is pronounced! It's been two weeks since we first learned about you. It will be another week till we are finally united. Your Daddy and I prayed for you this morning, and then we prayed for your birth mother. I wonder if she is thinking about you today.

Some friends gave me a baby shower last weekend. You should see how many cute dresses you have in your closet! You have a lot of books, too. Tomorrow I will buy a book case so you can have all your books in one place. Either Daddy or I will read to you every night. I wonder what your favorite book will be.

We have so much to learn about you, Michella. In time, you will get to know us as well. We know it might take you some time to learn to trust us, and that's okay. We will be around for as long as it takes.

Michella's Welcome Album

I finally finished Michella's welcome album yesterday. I want to show it to you.

Our social worker will receive it on Monday and will forward it to Michella's orphanage. This will be the first time Michella sees our faces and will hopefully become familiar with us so she will recognize us when we meet her for the first time on September 30th. I also sent her a birthday gift - a book and a knitted toy elephant made by Andrey's cousin, Katya. The elephant slept in our bed over the past week so it would smell like us.

Of course at two years old, Michella will not comprehend the concepts in this letter but this book will be a keepsake for her and I want her to know what we were thinking and feeling during this time.

Thanks to Andrew "Guy" Willms, we have these great professional shots to include. Thanks again for these, Guy! They continue to come in handy!

We were supposed to include photos of Michella's room and play area but it's not ready yet!

This is a letter I wrote months ago and posted on our blog. I want her to read this someday, too. After all, it was written to her, I just didn't know who she was yet.

Michella Update and How We Got our News

What day is it? I seriously am having difficulty keeping track. These days are a bit of a blur in the best possible sense. I haven't been this busy in I don't know how long. There is so much to do to get ready for our little girl. Honestly, my diet has been terrible; my meal pattern disastrous. Several nights this week Andrey came home and told him I had absolutely no plan for dinner and very little food in the house. I just get into these projects that need to get done and I'm neglecting my internal cues for food and my usual motivation to cook so there is something healthy to eat. What is this? This is not normal for me.

Tomorrow will be a week since we got the life-changing news of our daughter Michella's existence. It really felt like she was birthed that day.

Here's the time line of what's happened so far:

Thursday, September 9 - I was teaching a breastfeeding class to the clinic staff when the director's husband interrupted to tell me that there was a woman on the phone and that it was about something to do with our adoption. I thought he was joking. He assured me it was not a joke and that a woman was waiting on the phone. I walked over to the next building over where the main clinic phone was and sat down at the guard desk to take the call. My social worker didn't even say who she was so it took me a few sentences to realize that it was our social worker in Manila. She asked if the meeting I was in was important and do I need to get back to it. I said, "Well, uh, no actually, why? do you have some news for me?"

In the middle of that sentence I told myself that it was probably about something else and to not get my hopes up, but by the time I finished that sentence and she launched in with the news, I realized that this was it. She told me, "Well yeah! I bet you can guess that I have news!" I said, "Tell me!" Now, I don't remember the exact words as I was in complete shock but it was something like, You have a daughter, her name is Michella Pi-la-something Cast-a-something Esca-something. She'll be two this month on September 23rd. She's in Iloilo in an orphanage now but was in a foster home since birth. She's healthy. She had an upper respiratory tract infection before but it was treated.

By this time I have my hand over my mouth and I am crying. Let me mention that prenatal check-ups happened to be going on at the time and the waiting area was packed with pregnant women staring at me. I looked around searching for a staff member that I knew well but they were all next door where I was teaching the class! The only familiar face within eye-sight was the guard so I looked at him and shouted, "I have a daughter!!!" and proceeded to cry. I don't think the guard understood what was going on because I appeared to be in such distress. He acted like he wasn't sure if my proclamation was good or bad.

Our social worker proceeded to tell me how she had tried to call me at home and talked to our helper who told her I was at work. And then she paused and said something like, "Well..." I didn't know what to say. What was she asking me? I just had to tell her that I needed some time to let this sink in before I could even think straight and say anything coherent. I confirmed with her that she hadn't yet reached Andrey so getting the news to him became my priority. I told her I'd call her back asap.

I immediately called Andrey who I knew was in a meeting. My hands are visibly shaking at this point as I dial. The guard is still staring at me wondering what is going on. The phone rings and rings and rings. I stomp my foot and say, 'pick up the phone Andrey!' To my surprise, he did pick up the phone eventually and I fumbled all over my words. I hadn't thought it through what I was going to say. Do I just blurt it out or tell him I need to see him right away? Of course the latter was ridiculous come to think of it. I started with, "Where are you? I have news." He asked what it was. "Eva called Andrey! Eva called! Do you want me to go to you so I can tell you?" "No! tell me everything now!" I told him all I knew and I can't even tell you what he said. I honestly don't remember. I told him to meet me at home as our social worker was emailing us our daughter's file.

I first ran upstairs to the delivery room where I knew Hilary and my good friend Mar were busy with a birth. I just had to tell them. I peeked my head in and whispered the news. They, very hushed, congratulated me ('cos the poor woman was pushing and deserved their focus and attention!) and I quickly left. I went next door to share the news to the staff who were waiting for me. I made my announcement and cried some more and everybody cheered. I told them I would not be able to finish the class and that I was sorry. I just had to get home as soon as possible!!

That drive home felt like the longest ever. I wanted to get home so bad to cheer and jump and celebrate with Andrey. On that trip home I remember talking to myself a lot - "Oh my God Oh my God, Oh my God, it's really happening! I can't believe it!" I cried and then I laughed and kept saying Thank you to Jesus and then yelled at the guy on the tricycle in front of me for not going fast enough! This went around and around till about 20 minutes later I was home.

Andrey was still on his way back from his meeting and I was able to pick him up on the road near our house. We rejoiced and talked about how great of a day this is! We pulled into our driveway and our house-helper greeted us. I shouted the news and we jumped up and down together while she yelped for us with joy.

We quickly read through Michella's profile and it was better than I ever expected! Apparently she is healthy and well-cared for, I couldn't believe it! I really couldn't believe it as I have tried to prepare myself for the worst and expected there to be at least a few obvious problems. I prayed for a healthy little girl but was very open and willing to take on whatever God would have for us in a child. I felt up for the challenge! Of course we don't know it all and how difficult or easy of a time Michella will have attaching to our family and what issues will present down the road, but the fact that there aren't any obvious health/developmental problems, wow, I am just blown away by that! And my prayers all along that she would be well cared for were answered as well!

We read about her birth parents and the circumstances that caused them to make the decision to give her up (3 other kids, meager fisherman's income, third child with significant health problems - a heart defect and cleft palate). Michella spent the first 24 hours with her birth mother. As soon as we finished reading it, we called our social worker. She asked if we had any questions. We said the only question we have is, When can we pick her up? Our social worker laughed. You could tell she was so very excited that this was happening for us. She has been advocating for us for months now. She said she actually knew the day before but had to wait to give us the news. She told us how hard it was for her to wait till the next day.

The rest from this point is a blur as we made the phone calls I had only daydreamed of making. We called my parents, Andrey's parents, all our siblings, our closest friends in Canada and the US... We sent out texts to our Cebu friends. We emailed. We facebooked. It's amazing how many people we were able to communicate with in such a short period of time.

Unfortunately we both had to get to work that afternoon but we were bombarded with communication right up until we had to leave. No time for lunch, and that's when the dissolving of my regular meal pattern disappeared. Never before in my life have I skipped meals. I hope this is just a temporary phase because I'm so hungry and I get quite grouchy when my blood sugar gets low. lol!

Friday, September 10th - All morning was spent talking, emailing, and getting the news out to more people before I worked from 2-10.

Saturday, September 11th - More busyness at home in the morning although I'm not sure with what. Attended a medical outreach that the clinic was involved in. In the evening we had a celebration dinner here with many dear friends from church. We had a wonderful time of worship, giving glory to God for what he had done and a time of prayer for Michella in her room. My lovely British friend Charlotte put a lot of thought and time into preparing for our worship time and it was wonderful. Many gave words and verses for us and Michella. A friend wrote everything down so we can remember later.

Sunday, September 12th - I worked my last shift at Glory Reborn and I felt a little sad about it. It was just so sudden and now I don't work there anymore.

Monday, Sept 13th - I was supposed to leave for Davao but delayed the trip so we could get a bunch of paperwork started. I worked on paperwork ALL DAY and started working on Michella's welcome album. I realized again how much more exhausting I find sitting behind a computer all day than any other kind of work I've done - especially when you are rushing around trying to get stuff done in the midst of answering calls and texts. For some reason I find this kind of work exhausting but by the end of the day I was delighted by how much I accomplished. Now I know what Andrey's life at the office is like. I don't know how he does it!

Tuesday, Sept 14th - Spent the entire morning on the welcome album for Michella. Finished it. Went to the mall to get it printed only to find that that was not possible. Frustrated and just wished there was a Kinko's nearby! Oh and here's the crazy thing! During the morning, our social worker called to see if we'd be ready to travel by September 23rd! Krikey that's next week! This was going way faster than I expected!! I cancelled my already-shortened trip to Davao for that midwifery internship. That will have to wait for another time.

After thinking about this and talking to Andrey about it, we decided to wait until September 30th to travel to Iloilo City to meet our daughter. We will stay for 3 days and bring her home on October 3rd. The reason for this is that Andrey is swamped busy till then and we both agree that as much as we want to bring her home next week, it is best for us all, and especially for her if both of us are available and free to focus on spending time as a family. There are some things that Andrey could probably get out of but he'd still have to work a ton from home as he has much to do before he can take some time off. We were already planning a trip to Canada (now canceled) on October 2 so Andrey was already prepared to be free by then. He'll just have to finish things up a few days early.

Tomorrow we are going to Manila to renew our fingerprints at the US Embassy for the last time. Then Friday I will get the welcome album and our completed acceptance documents in the mail. As soon as we receive Michella's legal documents we can start processing the paperwork at the Embassy that will lead to Michella's visa to the US.

Maybe Saturday I will start shopping for a few things to get Michella's room ready. I want to get a bookshelf and a rocking chair. We learned that she still sleeps in a crib at night which is great because we already have that set up. Some friends here are having a baby shower for me on Sunday. My first baby shower! It's so exciting! Next week I'll be buying a few things, getting her room and closet organized, toddler-proofing the house, and flight/hotel arrangements made for our trip to Iloilo City.

It's nearly midnight so I guess that make it 14 days till we meet Michella. Let the countdown begin!

!!! IT'S A GIRL !!!

When I wrote my last post I had NO idea how close we were to getting the news I have dreamed of over the past few years!

It's really happening! We got the much anticipated but unexpected call on Thursday, September 9th. A referral of a sweet little girl named Michella who turns two this month. She lives in Iloilo City on Panay Island just two island west of Cebu. We are told we should be able to go pick her up in about a month!

Very, very soon I am going to write the whole story of how we got the news of our daughter and reflect on what I've been feeling these past few days. Come Monday I am free to focus on what needs to be done. It has been a whirlwind of excitement around here and I've been working every day so I haven't had time to just sit down and write. It has been full on. I am very happy but also very tired.

So here I am, it's after 11pm on Saturday night and I have to be to work by 6:45 in the morning. But it's MY LAST SHIFT at Glory Reborn for the foreseeable future. I was supposed to go to Davao on Monday but I'm not going, or at least not for the whole 10 days as originally planned. We were also planning to go to Canada in a few weeks and that's not going to happen but that's very okay because we now know of our daughter and will be with her very soon. Just days ago she was a mystery child that I knew existed but couldn't imagine. Now I've seen her face (in a photo) and know her name. She has been born into our hearts and lives already, this little Michella. It's amazing how life can change so suddenly.

Watch Out!! She's Gonna Pop!!

I can't help it! I get my feelings hurt when I'm not included in a reference to those who are expecting. Yeah, I know it's not the same as a nice round pregnant belly that calls for attention but my heart is feeling pretty plump these days...

like it's gonna burst...

an explosive rupture from the pressurized fullness of what's been growing inside for what seems like forever!

There is movement and kicking, achiness and discomfort, and brief moments of panic about what is to come...

there is impatience and craving; there is daydreaming about this mystery child, and sudden unexpected fits of crying that I can't always explain.

I am claiming my right to this group, damn it. That's how I feel today. Tomorrow may be different.

Right now I am grouchy from being overdue. I'm not talking weeks overdue, people. I'm talking MONTHS overdue - and I very likely have an unknown number of months to go. So don't mess with me. I'm giving birth to a toddler!! Maybe TWO! Let's see you real pregnant women do that!

An Afternoon at the Public Hospital

Warning: This story involves the death of an infant. I do not recommend reading if you are pregnant or for whatever reason do not need to think about a sad story today. Recording this helps me process it. The story is not graphic. It just highlights the reality of public health care for the poor in the Philippines.

I was at the public hospital on Saturday visiting a woman in our community who's 1-year-old son is sick with pneumonia. Thankfully, he is improving and will be discharged soon. I've been to the pediatric ward many times before but I usually do not stay for any length of time. On this day I stayed for hours and during that time watched a scene that I figure must be a common occurrence.

First I'll describe the setting. The pediatric ward is a huge open area in the shape of an I. Each length is lined with two rows of beds - some large beds and some elevated beds about the size of a crib. Most beds have two patients. The care-takers (usually a family member) of the children are either also lying on the bed or sitting or standing nearby. It is crowded. There is a huge nurse's station at one end of the ward. There are no curtains dividing the beds and everyone can see what is happening around them.

My friend, a young mother of four, stands at the bed where her son lies next to a six-month-old baby with a feeding tube and an oxygen mask. The baby also has pneumonia. When I first met this baby's mother, she was sitting on a piece of cardboard on the floor leaning her head against the crib sleeping, clearly very tired. She and my friend have gotten to know each other over the past 4 days in this place. These two women, as well as the two mothers of the children in the next bed over talk to each other as if they know one another well. They ask questions and discuss what the nurse's latest instructions tell of the status of their children.

When the nurse came by and without word handed a slip to a neighboring mother with "heplock" scribbled on it, the other mothers noticed and asked her, "He's getting off the dextrose? Maybe he's going home soon." Everything is public business and it's not rude to ask personal questions of strangers. In this place there is a strange sense of community. The concept of confidentiality is foreign. This is a big difference between my culture and the culture of the Philippines.

My friend points out a child nearby who looks to be about 3 or 4 years old. She tells me how earlier she saw the child convulsing uncontrollably and there were no family members to attend to her. The nurses couldn't do anything because there was no family member to send to buy whatever medicine could help her. She lies there in a coma alone.

Then she points out an infant in a bed about 20 feet away who was recently intubated. A family member is delivering air to the frail baby by squeezing an ambu bag every few seconds. I prayed that something would change but the situation did not look good. We looked away and tried to talk about other things.

Within the hour my friend brings my attention back to the failing child because now there is a doctor listening for a heart rate and soon the artificial respiration stops. I can see both the mother and the father clearly. The mother has her head in her hands crying and the father is leaning over the baby crying. I can not see the baby's face and can not bring myself to look more closely like others are doing. There is a crowd standing around watching in silence.

I turn away to avoid the cry that was ready to pour out. Everyone within eye shot is watching. Everyone knows what is happening. Many are quiet. The feel in the ward is heavy with sympathy and sorrow. Someone tells me the baby is four months old. I can hear the women around me talking about what may have happened. They don't seem to know but are confused why such a healthy looking baby (I heard them say the baby is fat, meaning healthy) could be so sick.

Occasionally I look and see that they are changing the clothes of the pale child. I can see that the mother is withdrawn and doesn't want to look or touch her child who is now gone. Someone is standing next to her with their hand on her back as she cries. The baby is wrapped in a blanket and held by what appears to be the grandmother. After about 30 minutes the whole family exits the ward and half the bed is empty.

I have been thinking about this family ever since, wondering what they must be going through and how difficult it must be. Over the past three years, many of the pregnant women I have cared for have lost a young child. It seems more common here than I want to admit.

20 months and 10 days...

Time is a-flyin' these days, I tell you! Sorry for the long lapse in blogging. I literally have about six drafts of blog posts buried in my blog that were all good ideas for posts but never got completed. And now those posts are outdated so I'll just move onto the present, I guess.

On the adoption front - since approval we have waited one year, eight months and 10 days. This is getting very exciting. If I let myself really think about it I get butterflies in my tummy and am overwhelmed with impatience! So my m.o. these days is to stay busy, continue to allow brief thoughts about my baby(ies) every day so I can pray for them, keep reading my adoption books but otherwise just keep my mind to other things. It's when I think about holding my child and daydream about what it's going to be like that I want to burst with emotional anticipation. It's like being a child on the night before Christmas when you feel so excited because you JUST_CAN_NOT_WAIT for morning to come! You want it to be morning NOW!

I just received an email from another woman on my online adoption group. She said she just heard that ICAB (adoption board) is currently working on matching applicants from the third quarter of 2008. Because I can be a bit air-headed sometimes, I initially thought that referred to us but then Andrey reminded me that that refers to those approved in July to September 2008. We were approved in December 2008. Oh well. Still though, we are closer than ever and it is exciting to me to be past the 20 month mark. I have heard of lots of families getting matched in the 20-something months. Anything is possible! Besides, we just recently sent in a letter to ICAB with a family update and some recent photos and revised medical checklists that gave, what I felt like was, LOTS of room to choose from in the numerous conditions/challenges we are willing to take on. C'mon!! This has got to affect something!

To be honest, lately the wait has not been too bad at all. I am enjoying the present so much these days that I'm fine to wait a few more months (I hope it's only a few more months!). We have traveled quite a bit since April. We've been to the US, India, Northern Philippines and Hong Kong. I plan to go to Davao, Mindanao (Southern Philippines) next month to work at a busy clinic for about 10 days. Then it is possible we'll take a short furlough in October as Andrey has a very small window for which he can be away. He is crazy busy with work between now and the start of 2011. He has work trips planned to Manila, Bangkok and DC all before the end of the year.

I'll end with sharing something I received recently that was VERY encouraging. While in Luzon at Abundant Grace Maternity Clinic I joined the staff for the their weekly devotional/prayer time. We went around the group and prayed for each person. When it was my turn, two midwives had words of encouragement received from the Holy Spirit for me about our children. The first was a picture of Jesus holding Andrey and I in one hand and our child(ren) in the other. The impression was, we are not yet together but Jesus is holding each one of us securely in his hands while we wait. The second word was that Jesus is very near to our child, caring tenderly for them and bonding with them in place of us (and in place of their birth parents).

When I heard this I started crying because I have prayed exactly this numerous times. It was Jesus encouraging my heart that what I have prayed and asked for, he is doing. I wrote those prayers in this post and this post. He really is answering our prayers and it's so nice to be reminded of that.

The Very Worst Missionary

A friend recently told me about this blog. Check it out. She's hilarious.

http://www.theveryworstmissionary.com/

First Days at Abundant Grace of God Maternity Clinic

I'm in Northern Luzon this week and next. I'm doing a short, 2-week internship at a charity clinic run by a Canadian midwife called, Abundant Grace of God Maternity Clinic. It's rustic and rural and really peaceful.

It actually reminds me of the house I used to stay in when I traveled to a small town in Thailand near the Burma border for my work with Babies at Risk. The bathroom is outside with a squat toilet and cold water shower. I did my laundry by hand today. No aircon, but we do have internet. There are lot of different kinds of creatures around - dogs, chickens, pigs, toads, lizards, cockroaches, flies, mosquitos, grasshoppers, centipedes and several other random creepy crawlies. I guess this is "roughing it" for me. I don't mind it. Today I really enjoyed the quiet as I did my washing by hand outside on a beautifully warm and sunny day. No need to hurry, just time to wring out the laundry and think about the three birth experiences I just had.

The staff here are wonderful. There are three Filipina midwives and three American midwives, including the director of the clinic. Everyone pretty much lives here and the midwives take turns caring for the women who arrive in labor. When it's your turn you do everything for that woman - from admission to discharge and all her postpartum check-ups.

I arrived on Monday in the afternoon and they were just finishing up with a birth. I hung out and got accustomed with the staff and clinic that first day. Tuesday morning when I woke up around 7:00 I was told a woman had just arrived and she was 9 cm dilated. The director initially offered me to take the first woman in labor but I opted to observe the first and take the second instead. I wanted to see how they do things here first.

So I got to observe that birth and it was beautiful. It was the woman's second baby. At around 8 a.m. she delivered in hands & knees position and didn't tear. The placenta was delivered by expectant management (as opposed to active management). She bled about 300 cc when pushing out her placenta so an IV injection of pitocin was given and the bleeding stopped. Baby was healthy and spent the first hour with his mom, breastfeeding like a pro.

Just before 10:00 a.m. a 17-year-old woman in labor with her first child arrived. It was my turn. Initial exam revealed she was 7 cm dilated so we admitted her. She was very calm and relaxed and stayed this way until the afternoon. Her pain seemed to not be increasing. Her next exam was done at 3 pm and she was still 7 cm but her cervix was thinner and the baby's head was lower and well engaged in her pelvis. We decided to wait another two hours before intervening. At 5:00 p.m. she was 8 cm dilated. We decided to do AROM (artificial rupture of membranes) as the patient was getting very tired. Her labor had started the previous night at midnight and she didn't get much sleep. We encouraged her to eat and drink throughout the day to keep her energy up.

After explaining the procedure to the woman and gaining her consent, AROM was done. The water was clear. A half an hour later there was a clear change in her disposition. The pain had really increased and she was having a hard time managing it. By 9:00 p.m., she was 9+ cm dilated, meaning there was a lip of cervix left. Although she had the urge to push, we encouraged her to breathe as best she could and wait for the rest of the cervix to move out of the way. We had her get into a kneeling position leaning forward on a birth ball. This seemed to do wonders. It wasn't before long that she had an even stronger, uncontrollable urge to push.

We let her push according to her urges and it was unclear that baby was moving down so I did a quite check just to confirm the lip was gone and it was. At 9:30 pm she was fully dilated. She was really tired and wanted to lie down. We encouraged her to at least lie on her side as it's a better position for many reasons but after trying it she felt really uncomfortable and pushing was difficult on her side. She wanted to lie on her back so she did.

She pushed like a pro! The only direction I gave was to listen to my instructions to pant when the head was crowning. (We explained this ahead of time.) She did several short pushes with each contraction and by 9:54 p.m. the head was crowning. I had her pant during a contraction and then when it was over encouraged her to give tiny little pushes to ease the baby's head out. She did this so well, the baby's head emerged slowly with only a first degree labial tear that would not require suturing. Perineum intact. I almost couldn't believe it! Baby was born at 9:55 p.m.

The delivery of the placenta was managed expectantly, meaning no prophylactic pitocin and no routine controlled cord traction. We waited till the mom had a contraction and the urge to push. During this time there were signs of placental separation and her fundus was monitored for signs of excessive bleeding. Eight minutes after birth her bleeding became concerning. We encouraged the patient to push and I gently pulled on the cord to assist. Her placenta was delivered one minute later and with it came a big gush of blood so an injection of pitocin was given. With fundal massage and the pitocin the bleeding stopped. The cord was clamped and cut after the placenta was delivered.

I think for me, after processing this birth, I would have given the pitocin earlier. Even though the mom wasn't anemic, it was unnecessary for her to lose that much blood. But I followed the advice of the other midwives because I wanted to do things the way they do here so I can learn other ways of doing things and in the end it turned out fine. This is my first experience with expectant management of third stage.

We got the mom and baby settled around 1:30 a.m. and I was able to rest till 3:00 when I got up to check my patient's vitals and bleeding and make sure she urinated. When I came downstairs there was a woman in active labor pregnant with her eighth child. Her midwife asked me if I could chart as she was pushing already. She told me that the head had just become visible with pushing. She also asked me to check the heart tones of the baby. I grabbed the chart and made the note. Then I grabbed the doppler and approached the patient to find that the head was already out. I think the mom only pushed twice.

I got to assist for the rest of the birth, wiping and covering the baby and bulb suctioning the mouth and nose, assigning apgar scores and monitoring vitals signs while the baby breastfed. I couldn't believe it when this woman, considered high-risk because of how many babies she's had, only bled about 100cc and pitocin was never given. It wasn't needed. I was literally shocked at this. Her third stage was truly physiological. With the first contraction after the birth, she pushed her placenta out. Amazing.

I could go home happy with what I experienced in my first 36 hours at this clinic. I was so high on these births that even though I only slept for a few hours that night I felt energetic all day the next. This is exactly what I was looking for. To get to experience another way of doing things that is truer to the midwifery model of care. I may not adapt everything I see here as my own personal approach but I am learning that the type of midwifery I want to practice is definitely closer to what they do here and it is possible in a developing country. I sense my recent disillusionment with birth disintegrating and my trust in birth returning.

Adoption Update

As of July 8, we have been waiting 19 months since approval of the adoption board of the Philippines. I just heard about a non-Filipino family that was recently matched with a child. They waited 21 months. To my knowledge however, there are still numerous families waiting for a match that have already waited close to two years. We still have no idea when our day will come but there have been a few encouraging developments lately that I will share at the end of this note. Before I do that, I need to vent a little about something we are working on.

Our agency in the US recently informed us that the Adoption Board of the Philippines created a new form titled, "Type of child acceptable to Family." They encouraged us to fill out this new form and submit it to them so they can forward it to the adoption board for us. We filled a similar form out during our first home study. The new form has been updated and expanded and is more specific, listing more than double the number of conditions included on the original form.

This form was probably my least favorite thing about this adoption process so far, besides the long wait. Just look at the title - type of child acceptable?? I despise the thought of having to think through and decide the type of child we find acceptable.

Here is the list, word for word (there's a box to check next to each condition either 'accept' or 'not accept':

Birth Condition - Premature, undescended testicle, umbilical hernia, physical abnormalities (cleft lip, cleft palate)

Eye Condition - Visual acuity abnormalities, strabismus

Ear Condition - Hearing impairment, ear deformity

Heart Problems - heart murmur, heart defect (may require surgery)

Hematologic Disorder - G6PD, thalasemia, others

Infectious Disease - Hepatitis B, First degree infection under medication

Orthopedic Problems - Hand anomalies, leg anomalies (bowed leg), foot anomalies (requiring cane, leg braces, or splint), facial feature anomalies

Emotional and Social Development - Autism, ADHD, known history of physical/sexual abuse

Developmental Delays - Cerebral palsy, seizures, speech related problems (stuttering, lisps, etc.), gross motor delay, hyperactivity, slight developmental delay, global developmental delay, speech delay, metal retardation (mild)

Parental Background - No known information; History of: drug use, alcohol use, emotional illness (e.g. depression), mental illness (e.g. schizophrenia, psychosis), mentally challenged, with criminal record, child of rape, child of incest

Other - lactose intolerance, skin conditions (eczema, dermatitis), bronchial asthma, hypo/hyperthyroidism, needing surgical procedure(s), large hemangioma (which will disappear over time), dental carries

I have so many problems with this form! My mind just goes berserk when I read each condition. Premature? Are we talking 3 months or 3 weeks premature? Alcohol/drug abuse in the mother - was this during pregnancy? If so, how much alcohol? What kind of drugs? How was the child affected? Cerebral palsy - Is this really considered a developmental delay? What degree are we talking? Seizures? What is the underlying condition causing them? How severe? How often? Hematologic disorders - what does "others" refer to? Infectious disease - Do I only need to consider Hep B? What about HIV & TB? Why aren't those on the list? I could go on....

Aside from these things, and the over-arching dislike for such a list is the problem I have with playing God, so to speak. I mean, I understand why we have to fill out such form but geez, this has got to be my least favorite part of the adoption process because of the knowing that by checking a 'not accept' box, I am eliminating an actual child in need of a family. It just seems wrong to have to choose.

Now it would be fine if the choice was between a child considered to be "normal" and a child with certain special needs but these aren't the options (I was naive early on to think it was this black and white) and even if they were, who are we to limit our choice to a "normal" child? Of course parents of biological children would choose to give birth to a healthy, normal child but given the option of having a child with some form of challenge (as is the case in all adoptive children), who would want the responsibility to pick and choose that which they would be faced with? Normally, you get pregnant, you pray for the best, do the best you can to take care of yourself and then be prepared to take on whatever your child presents with, because that child is your child.

Whatever boxes we check, we have to be willing to take a child with such a condition. If we check the box and then we're presented with a child with that condition, we have very little grounds to reject that referral. So we'd better be darned sure we are willing to take whatever we check "accept." But how do we know? We are not familiar with many of these conditions and what impact they have on the child. I have some research to do.

Besides, even if I fill out a form and feel pretty confident that I can "handle" the conditions I checked off, the child we get is not just a list of conditions. He/she is a child with complex genetic and environmental make-up that blend together into something unique. You just truly have no idea what you are going to get! So I guess in the end, all we can do is fill out the form the best we can and trust God with the result, knowing that ultimately, what we receive will be from Him and we will accept and deal with whatever we are faced with, because that child will be our child. Still, I don't have to like the process.

So with this, I am asking for your support in prayer in the next day or so as Andrey and I fill out this new form. Our hope is that we will be led by the Holy Spirit to check those boxes that we feel we are willing to take on, even if it is something we'd rather not deal with.

It's not realistic to just check 'not accept' on most boxes as I really believe it eliminates 90% of children waiting for a family. We also know that regardless of what may be said of a child's health status, there may be other conditions present and in different degrees than stated. Frankly, we are prepared for some challenges and feel ready to take on whatever our child presents with. Maybe it's not even about what we feel we can handle but about what we feel led by God to be open to taking on. As I write, I realize this may be a attitude in which to approach this list. So really, it's up to the Lord to guide us! Simple as that! There is just no way I can rely on my own human wisdom in this. What we need is divine wisdom and discernment and as you pray with us for that, I will expect to be lead. Okay, I feel better about this now.

I have two more (positive) things I want to mention. Our agency also encouraged all families who have been waiting longer than a year to write a brief card to the adoption board including a few updated family photos, that says something like, "We are eagerly awaiting the referral of our child... here are some recent photos." We are happy to get the chance to do this and have already printed three photos to include in our note. One of Andrey with his (Filipino) staff, one of me at work at the clinic with my (Filipino) co-workers and one of us together on our recent trip to India. If you couldn't tell, the choice of photos is very strategic for us and hope they will show that we are well integrated into Philippines society and familiar with Asian culture in general.

Now I've saved the best for last. Something very encouraging came to our attention a few days ago. Our social worker in Manila who works for Holt's partner agency emailed us to tell us that she recently wrote a letter to the adoption board, "appealing to the Board to consider [us] soonest for a referral due to [us] have been living in Cebu, Philippines since 2007."

Our social worker actually wanted us to write a letter to the adoption board like this many months ago but our agency in the US said we'd better not as we hadn't waited even 18 months yet at that time. Well the day after our 19 months mark, our social worker took the liberty (likely with the approval of the US agency), to send such a letter. I got very excited when I read that!

Thanks for your support and prayers! We so blessed to have so many family and friends supporting us in this journey. Lord bless you today!

Feet in Two Worlds

So here we are in an unreal place - the Shangri La Resort in Cebu. We're here because some visitors (staff and supporters of the work my husband does) are treating us to two nights here.

(photo taken from Shangri La Cebu website)

Now, don't get me wrong because I am very thankful to be here, I just feel the need to reflect on my experiences this past week and how the disparity between two worlds makes me feel.

It's as if the other world, the world known by the poor, is the reality. And this, here, is just contrived and made up to anesthetize one's self to the true reality that exists just beyond this estate.*

In the past week,

• I went with two women to the hospital for a check up to have IUDs removed. One woman was found to have extremely high blood pressure. We were sent to the ER and I was able to help with some meds to try to get her BP down (not effective). The woman eventually signed out of the hospital against medical advice with dangerously high blood pressure because she has no money for the recommended admission and lab tests. I was unable to convince her to check in at a less expensive hospital where we could assist in the cost. She said she felt fine. We prayed together and I took her home.

• I walked around a slum area alone, a little lost when I didn't have a way to meet up with friends I had meant to connect with. Friends meet in this community several times a week to get to know people there and disciple new believers. I've been joining lately and have been able to help with some medical needs of some of the women there. I felt insecure and embarrassed as I walked around and asked for directions. People stared and smiled and said something like, "Look! There's an Americana." I was concerned about the mud created from the last rain getting on my jeans. I almost lost my rubber flip flop to the mud that attempted to swallow it. I eventually found someone I knew and she took me to a shack of a home where the woman with high B/P lived, who I had taken to the hospital the day before. We visited for a while and we prayed together for healing. Then I went home feeling pleased with myself for not giving up and trying to find my way for the first time by myself in an unfamiliar place and was happy it at least resulted in something small.

• I visited a woman who lives near some fish ponds in a place that regularly gets flooded during rainy season. I got to give my first depo shot as a certified professional midwife. She told me I could post the following photo (It felt significant that I was administering family planning for the first time as an autonomous midwife). To get there, we walked on raised bamboo paths that were built over muddy, stagnant, garbage-filled water. I walked carefully for fear that I'd fall in.

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• I joined in a bible study with new believers who live in either a neighborhood like the photos below or on the street. We read together from Psalm 107 and asked them to share what part they could relate to. Two women in particular said they could relate to this: "Some wandered in desert wastelands, finding no way to a city where they could settle. They were hungry and thirsty, and their lives ebbed away. Then they cried out to the Lord in their trouble, and he delivered them from their distress." I heard stories how these women and their children hadn't eaten all day and how they cried out to God and suddenly, seemingly out of nowhere, they had food. One of the women shared how her 9-month-old son had become extremely ill. His eyes were rolling in the back of his head, he wouldn't eat, and was vomiting. She prayed. A friend of mine from our church community happened to be in the area at an unusual time and suddenly ran into this woman and her child. They were able to admit the child at the public hospital where he received treatment for potassium deficiency. For this woman, this was a clear answer to her prayer for help. Thank you, Jesus!

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• I toured the public hospital with 30 American teenaged volunteers from Texas. I walked around the hospital feeling disgusted like I sometimes do when I walk through other parts of the city that feel spiritually oppressive and dark. We spent much time in the pediatric ward, praying for families and children. I met a young man in a stairwell whose girlfriend just lost their baby at only 6 months gestation. I saw an old woman in the ER on whom the staff was performing CPR and nobody seemed to make the effort to cover her body clothed only in undergarments. There was a crowd that gathered to watch and I couldn't bear to take in the show or know what may eventually happen. The whole scene just felt so undignified. I felt totally unprepared to walk around and minister to people so I just translated for the volunteers. I struggled with a strong desire to leave as soon as possible and not think about this place.

• On my last night shift I assisted the delivery of a growth-restricted baby who weighed only 2.1 kg (4 lbs, 10 oz) and watched his young parents look utterly hopeless because they only had 200 pesos and they were going to need money to pay for meds/supplies/care for their baby. I knew they already had a special needs child who was also growth-restricted in the womb. I noticed during delivery that the corners of the mom's mouth were bleeding possibly due to vitamin B and/or vitamin C deficiency while she had to forcefully and quickly push her baby out because his heart slowed down to 50 as his cord was trapped between his head and the mother's pelvis and then was born completely white and floppy with a heart rate of only 70 (normal is 120-160) and us resuscitating him with an ambu bag. He survived and we stayed up all night monitoring him.

So these are some of the places and events that filled my week and now I'm here at the Shangri La and it feels like a fantasy land - so not real! Life just goes on satisfying one's need for pleasure, perhaps to pacify the need for something greater, while the reality for the poor carries on with no end in sight. I recognize my own feelings of inadequacy and selfishness. I can not be satisfied any longer with such pleasures in excess - for in the darkness of the night lately I wake and sense the struggles of the poor and suffering and I can do nothing but carry their burdens to the Father and pray for wisdom regarding my role in it all.

*I am not judging those who take time to rest in a beautiful place, as we often do. I am speaking against the portion of the world that seems to carry on with a fantasy life oblivious to the plight of the poor, which is also a life I have tasted.

Anniversary Week (8 years!)

Yikes! How does this happen? Weeks go by and I haven't blogged. After about a month of slower days things suddenly became busy. There is much to update and I'm not sure where to start. Well I wanted to post about our anniversary so I'll start with that.

Andrey and I had a nice anniversary. A bit strange, but nice. Strange in that it was an all around untypical day. I worked all night at the clinic the night before and stayed late well into the morning to help as there were three women in labor (including the woman I was up with all night; poor thing was having a very long difficult labor making just enough progress for us to be able to keep her in the clinic), four postpartum moms and their babies, about five women waiting for a pap smear and tetanus shots, and new patients waiting to be interviewed. I stuck around to help as long as I could but eventually had to leave to get some rest. There were several extra staff around by then to help. I was disappointed I wasn't physically able to stick around long enough to see my patient deliver. I haven't had a birth in SO LONG so I was really hoping to get to deliver her baby. Okay, so that was beside the point. Needless to say I was tired.

Andrey was tired because he was up in the middle of the night to watch the World Cup final at 2:30 am. He had a few friends over. So he slept a bit in the morning then went to work when I arrived home around 11. Then I slept while he worked for a few hours. When he came home he woke me up and I stumbled out of our bedroom in a fog to find some beautiful lilies and roses in a vase on the table. What a nice surprise!

The afternoon was strange because we just puttered around the house and were a bit lazy together. By the evening we finally decided to go out for dinner, which we did and shared a bottle of wine that just about put me to sleep, but it was nice to get out.

After eight years, I'd say, we don't look half bad. It's our love that keeps us looking youthful. ;-)

I just have to give props to my wonderful husband. He is still my favorite person to be with. We laugh together often, get along great and make a great team. I knew he was the right one to marry but I didn't know how perfect he was for me until after we got married. Since then, I have been amazed at how the Lord gave me something even better than I could have asked for or imagined. Wow. I'm still blown away by that.

Andrey continually amazes me at how kind he is to me when I'm not the most lovable. He just seems to know what I need. He is affectionate and encouraging. He speaks loving, kind words to me daily - especially first thing in the morning when I am too sleepy to return the kindness.

He is a joy and a blessing and I am so very thankful for him. The lesson? Delight yourself in the Lord (and wait for His plan to unfold) and he will give you the desires of your heart (Psalm 37), even before you even know what those true desires are. God is good. We experience His goodness and love in each other daily.

So I guess this has turned into an anniversary post. Will update the rest soon...