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...

Letter to our Child

Dear Sweet Child,

As we wait for you, I know you are already ours. I know you are out there. You may be just a few kilometers away or you may be on another island in a different part of this country. I don't know your name or your face yet but you already have life inside our hearts. There isn't a day that goes by that we do not think about you.

I often daydream about you. I wonder who is taking care of you and what you are doing and feeling. I wonder what hurts you are are carrying and how they have affected you. I think about the joy we will have when we see you grow and develop as you receive love and healing.

I think about what our days will be like when you and I have all day to spend together while your daddy is at work. I know that I will be the one to take care of you and we will find fun things to do together. I think about the weekends when both your daddy and I get to spend time with you and what good times we will have. Your daddy is very fun to be with. You are going to really like being with him. I know that we will do a lot of laughing together.

I pray for you every day. I pray that you know that you are loved and wanted, that you are special and have value, and that you have a home waiting for you. I pray that Jesus is very near to you, watching over you and speaking words of Life to you. I pray that you know you were created for a purpose and that Jesus and your Mommy and your Daddy love you very much. I pray that the people who are taking care of you are doing a good job and showing you love.

Your daddy and I have waited so long for you. We can't wait for the day we finally meet you and hold you in our arms. There is no other child that we want but you. It's only a matter of time till we are together.

Love,

Mommy

Jenifer Sawchenko, CPM... I like the look of that!

I'm a Certified Professional Midwife!!

Word of my official certification arrived in the mail this week to my parent's house. I am delighted to say that I'm a bona fide midwife and it feels good.

In case you were wondering, I have included a description of a CPM from the NARM website:

A Certified Professional Midwife (CPM) is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care. The CPM is the only international credential that requires knowledge about and experience in out-of-hospital settings.

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:

• monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle;
• providing the mother with individualized education, counseling and prenatal care, continuous hands-on assistance during labor and delivery and postpartum support;
• minimizing technological interventions; and
• identifying and referring women who require obstetrical attention.

The application of this model has been proven to reduce the incidence of birth injury, trauma and cesarean section.

Copyright © 1996-2001, Midwifery Task Force All Rights Reserved

Empty Nest

I have a new schedule at the clinic. I now only work on Friday and Sunday - usually night shift from 10 to 7. No more 12 hour shifts. This, along with the fact that we have pretty much done everything we can to get our home ready for our child, has left me with a bit of extra unexpected time on my hands lately. This past week I haven't known what to do with myself. For the first time in years I felt like I did during my first year in Thailand. Bored. A little lonely. Slightly depressed. I've avoided thinking about it much and have instead tried to push through with getting stuff done that I've been putting off and making plans to be useful during this strange period of time of unknown length till we become parents. (I do have a few things in the works, which are sure to keep me busy but just haven't gotten going yet.)

I think the extra alone time the past few weeks and the empty days have really magnified the state of our quiet, childless home. I was feeling quite positive about my last days of childlessness last week but this week, I have swung the other way - moping around the house thinking about our child, and feeling like my days are pointless. I think I am beginning to feel a real, tangible empty space in our home and hearts for this unknown child. Not that I am lacking something emotionally and in need of a child to fill in an unhealthy, co-dependent way - I don't think that's it. I don't know how else to describe it. It just feels so obvious that something is missing. Perhaps it's the knowing our child is out there. I am 90% sure he/she is alive and being cared for by someone else and here I am available, with empty arms in a quiet house.

I think I've done relatively well with the wait so far but if this week is any indication of how the rest of the wait is going to be, it may be safe to say that this is getting more difficult for me. But it's a different kind of difficult. Before it was us wanting children in general and having to wait but now it is us already having a child that just hasn't been given to us yet. It's as if I'm in this place of experiencing emptiness and lack so that the being filled is that much sweeter (this is the hopeful way of looking at it) - like when we sometimes go through times of desert and dryness spiritually only to be filled again, and how those dark times better enable us to experience joy. I suppose this undercurrent of sad emptiness is just the discernible presence of a vacancy designed for something wonderful, yet to come, soon to be filled. God I hope It's not long. I'm starting to get tired of hearing myself talk about this.

Rain and some Exercise Success

Oh thank God hot season has come to an end! For the past few weeks we haven't needed the electric fan in addition to the air-con in our bedroom at night. It's starting raining in the middle of the night and here and there during the day. The middle-of-the-night rains are heavy, loud downpours that usually wake us up. I usually find them a bit frightening but I think part of that is because of my half-asleep-half-awake state in which the forcefulness of the rain feels as if it is going to sweep us away. It's still really hot during the day but at least the trend of cloudy days is beginning. This is the Cebu I can handle.

On a totally different topic, for the past three weeks, I have been exercising almost daily. Yep, daily. I can't recall many times, if ever, in my life when I've exercised daily (except those long-gone high school days of running track, cheerleading and strength training classes, which is where I got these [insert sarcastic tone] sweet-looking biceps I still have - ha ha!!).

I'm on a bit of a roll, I guess. It finally occurred to me about a month or so ago that exercise just isn't going to be convenient. I have to prioritize it and go out of my way to make it happen. Ideally, if consistent enough, it will become a habit. I know several people who are good at this and I've always convinced myself that those people have some special skill or ability that I don't. But then I started watching The Biggest Loser. I love this show. It is so inspiring. It's caused me to have a new dialogue. I now say to myself, If the people on that show can do it, then I for sure can do it!! No excuse, Jenifer!

And then I discovered exercise videos that can be purchased and downloaded on itunes. I mean, of course exercise videos are available on itunes, it's just that I never thought about it before. I was so happy to realize this because history has shown that I am much more likely to exercise regularly if I don't have to get in my car and drive somewhere to do it.

I am currently doing the "30 Day Shred" video and essentially have been working out for 20 minutes a day, 5-6 days a week. I am hoping I can keep it up. After joining my friend in India for a 20 minute workout led by Jillian Michaels (trainer on The Biggest Loser) in her home on her computer, I was inspired to do the same in my home. Doing that video also showed me how weak I really am. My irregular workouts at the gym and occasional jog-walks at the local running track just weren't cutting it. Go figure.

Andrey and I recently went to a local business park for a run. Andrey previously mapped out a 2.5km route. He has gone a few times without me to run around it twice. I went along for the first time a few weeks ago and was able to run once around the loop without stopping. Yes, I know 2.5 km, which is about 1.5 miles, may not seem like much but considering I usually never run for longer than a few minutes at a time without having to stop, I felt pretty good about running the whole thing without stopping. I have always despised running but I suppose it's something I can do if I work at it. For now, I am aiming to run the same route a week and try to improve on my time and eventually distance. I get bored pretty easily and need variety in exercise, so the occasional run is a nice break from the Jillian Michaels (ass-kicker) "shred."

Training with Jillian has been good for me. When I was running I had some Jillian-inspired self-talk that kept me running to the end. "I am strong and awesome. I can do this. When I get tired, my strong legs will carry me." I just have a disastrous history with exercise but it's something I've really, really wanted to get better at for a really long time. Not because I think I need to lose weight or anything (although I'll be delighted if I can lose 5 pounds so I have a little breathing room in some of my pants that have recently gotten a bit tight) but because it is just SO. EFFING. IMPORTANT! I've known this, of course, for a really long time, but haven't been able to carry through and be consistent.

But now (ever since I identified and treated the anemia I was dealing with unknowingly for many years), I am experience some success when I exercise. I feel stronger and my energy levels have gone up. I am so stoked about this! I wasn't noticing much change at first and I was beginning to get discouraged and then Andrey and I played tennis together last weekend and I was able to play longer with less need for breaks to catch my breath. Yes! All this motivates me to keep it up.

So the fact that my goal is a mere 20 minutes a day, it helps me push through and get it done. When I try to put it off and my lazy mind starts to kick in, I just tell myself, It's TWENTY minutes. It will be over soon. And then I think about drinking a delicious post-workout banana and yogurt milkshake (yummy!) as a reward and so I push through and get it done.

The Last Days of Childlessness (0-12 months to go!)

I realized something this morning. These are the last days of childlessness. These are the last days in this unexpectedly long journey to become a mommy. You could say this journey started six years ago when Andrey and I decided we were ready to start trying for a child, but in reality this journey began when I realized as a child that I would one day be a mommy. Of course I would. The desire has been there for decades and I never considered it being any other way.

I recall being in my early-mid 20's and experiencing for the first time a physical ache to bear a child whenever I was around a baby. I guess that was the biological clock chiming in. I always knew I'd have a child someday. I just didn't think it would take this long.

So this realization I had this morning, that these are the LAST DAYS of childlessness, brought to mind the fact that although this wait is long, it WILL come to an end - likely in the next six months! And if not in the next 6 months, then in the next year for SURE*. In the big picture, and considering how long we've waited so far, this is not much time left. The light at the end of the tunnel is in view and is steadily getting bigger as we get closer.

*On June 8th, we will be 18 months into our projected wait of 18-30 months (we were previously told 12-24 months but that has recently changed). Several families in the past month were matched after waiting ~24 months. We are hoping that will be the case for us as well.

In these days, I am praying that God would prepare us for the child(ren) he has planned for us, and that he would be preparing that child for our family. I am not expecting a "normal" child. I believe all adopted children have some degree of special needs, considering the amount of loss they have experienced in the process of becoming an orphan. Most adopted children have some level of developmental delay and many have attachment issues. I believe with good care, most of these children can catch up and learn to bond effectively (these things are very interrelated, as a child's ability to bond and attach set up the necessary context in which they are able to properly grow and develop). Aside from the best-case scenario described above, I have learned that there may be some more severe "special needs" present, such as mild to severe physical and neurological disabilities. On our adoption group, I have heard of many families who applied for a "normal" child and learned some time after they received their child that one or more significant conditions were present - that were either unidentifiable at a young age or were not discovered due to lack of adequate medical care. Some of these conditions are such that if known previously, would classify the child as "special needs."

These stories and others remind me that, just like with a biological child, you do not know what you will be faced with. And while we hope and pray that our child will have the least issues possible, the prayer I pray more frequently is that we would be prepared to accept and love our child regardless of his/her issues and that we would have the grace, wisdom, compassion and strength it will take to properly care for that child. For we are not guaranteed an easy road. What this long wait has taught me is that my joy and fulfillment in life is not contingent on things working out the way I expect. My joy is rooted in faith in my God who is good, loving, faithful, all-powerful and who will equip me with everything I need to accomplish and fulfill what he has prepared for me. He is my anchor and my hope is in him.

Let us hold unswervingly to the hope we profess, for he who promised is faithful.
Hebrews 10:23

Blind Beggar Recovers Sight!

Tonight we were approached at a stop light by a woman who appeared to be blind begging with the assistance of a young boy. We rolled down the window and greeted them and offered some packages of peanuts. "Hello! Would you like some peanuts?" They both smiled and I could see the "blind" woman's eye crack open a little to see where these strange voices were coming from. Then she tilted her head and squinted both eyes open just enough to really check us out as she walked away. I guess the sounds of two foreigners were just too interesting not to get a good look at. Andrey and I found this very amusing. Your gig is up lady but we would have given you peanuts anyway.

Correction

Please excuse my mistake. 1,156,897,766 is over 1 billion, not over 1 trillion as I originally posted in my list of facts about India. Clearly I get lost when there are more than a few zeros. For all I know there are a kazillion people around here! It's crowded!

The Republic of India

Andrey and I are going to India for two weeks on Monday. We've known for a little while that Andrey would be traveling to four cities in India this month to visit other offices with his boss. It never occurred to me to go with him until a spouse of one of the directors encouraged me to come. It didn't take long to realize this was a great opportunity that wouldn't be easy to pass up. I certainly won't have the same freedom once the kiddos come along. Besides, more stuff to keep me distracted while we wait, the better. The trip will take us to Mumbai, Bangalore, Chennai, and Kolkata.

Neither of us have ever been to India. We both feel it is something we just need to experience. I'm so glad we'll get to do that together. Andrey will be busy most days with work stuff, which means I'll have a lot of free time to explore and hang out with the few people I know. Fortunately, I've had the opportunity to get to know a few of the spouses of other field directors in Chennai and Bangalore, and they both have offered to host us and hang out with me while we're in town. In Mumbai we'll get to meet and hang out with a couple of women introduced to us by some of our friends in our church community here in Cebu. They have a midwifery/doula business in Mumbai and are involved in numerous outreaches to the poor. They have agreed to let us join them for a few days and see what they do. We'll have some time in Mumbai at the end of our trip when Andrey is finished with work and we can explore the city together before we head back to Cebu.

For a country that represents such a huge proportion of the world's population (and the world's poor), I figure I should know a few things about it.

India Facts
(taken from The CIA World Factbook: www.cia.gov/library/publications/the-world-factbook/ unless otherwise noted)

• India's population of 1,156,897,766 (that's over 1 trillion!) is second only to China for the world's most populated country (July 2009 est.)

• India has 3.75 times as many people as the US in about a third the amount of land as the US

• Maternal mortality rate: 540 per 100,000 live births (Compare to 200 in the Philippines, 14 in the US, 5 in Canada) World Health Organization
  

• Infant mortality rate: 50.78 per 100,000 live births (Compare to 20.56 in the Philippines, 6.22 in the US, 5.04 in Canada)

• Fertility rate (average number of children per woman): 2.68 (Compare to 3.27 in the Philippines, 2.05 in the US, 1.58 in Canada. The country with the highest fertility rate is Niger, 7.75)

• Religions: Hindu 80.5%, Muslim 13.4%, Christian 2.3%, Sikh 1.9%, other 1.8%, unspecified 0.1% (2001 census)

• Languages: English enjoys the status of subsidiary official language but is the most important language for national, political, and commercial communication; Hindi is the most widely spoken language and primary tongue of 41% of the people; there are 14 other official languages: Bengali, Telugu, Marathi, Tamil, Urdu, Gujarati, Malayalam, Kannada, Oriya, Punjabi, Assamese, Kashmiri, Sindhi, and Sanskrit; Hindustani is a popular variant of Hindi/Urdu spoken widely throughout northern India but is not an official language (2001 census)

• Capitol of India: New Delhi

• Government type: Federal republic

• Gained independence from the UK in 1947

• Legal system: Based on English common law; judicial review of legislative acts; separate personal law codes apply to Christians, Hindus, and Muslims