My HBAC (home birth after Cesarean) story

This post is three years in the making.

Yep, three years!

And because it involves so much of my life and history of the past few years it's bound to be complicated (and long!), which is rather daunting, but I'm going to do my best.

A little background info to begin -- our first child, Oliver, was delivered by Cesarean one week after his due date, August 12, 2008. My water had been broken a full week by this time, though it was only a very slow leak so plenty of amniotic fluid was still available. Because we were planning a home birth, our midwife at the time allowed us to use the watchful waiting approach; she came to our home each day to listen to the baby's heart beat and make sure all was well. If we had been working with an OB and planning a regular hospital birth we would have been told to come in immediately and I would have been put on Pitocin to cause labor to start. Instead we tried every natural intervention possible during that stressful week spent waiting for labor to begin, including lots of acupuncture, enemas, castor oil (taken orally), walking, nipple stimulation, etc. It was not a fun week. When regular cramps finally started on day 7 I thought for sure labor was finally here -- but my midwife checked and told me I was only 2cm dilated. She could feel Oliver's head, which was nice and low, but she said it was tipped sideways. My time had run out. We all drove to St. Vincent's in her car while I tried hard not to cry.

After a few hours on Pitocin, with strong regular contractions (no epidural -- they didn't feel that painful to me) I still hadn't dilated past 3cm. An epidural to help me relax, with the view of encouraging dilation, didn't do the trick either, and as the OB on staff at the time was impatient for a resolution to my situation I was given a c-section about 7-8 hours after admission.

This was NOT the birth experience I had wanted. The hospital experience was one thing (I couldn't get any sleep, Hugo wasn't allowed to stay, I wasn't permitted to have Oliver in the bed with me, I was attached to IVs and monitors and could hardly move around, I passed a clot the size of my hand, I ate awful food, I could barely walk...the list goes on), but recovery at home was really tough. I had a hard time getting off my pain medication (Percocet), not so much because of pain from the incision but because I was probably very dehydrated and anemic which made me ache all over. I was extremely emotional and told Hugo I felt like Oliver was sucking the life out of me. Those were my exact words, said about a newborn baby I adored! I can barely remember the first few months of Oliver's life in this world; I remember being in a haze and feeling depressed.

Oliver was a very hard baby to soothe so the first few months were also difficult from a parenting standpoint; I have since realized that he probably had lots of tummy aches ("colic") because he liked pressure on his belly. Many factors would have contributed to this: c-section birth (which doesn't allow the mom to pass on microflora from the birth canal, which establishes the first colony of healthy bacteria in the gut); all the antibiotics and drugs I was on during the hospital "labor," operation, and recovery; and the Hep B vaccine he received in the hospital before we knew better than to vaccinate.

I knew I didn't want a repeat performance if we had a second child, though VBACs (vaginal birth after Cesarean) are not the norm. When working with an OB, it is very common for an initial c-section to more or less doom a woman to a second. I planned that we would try again for a home birth next time, but felt helpless about how I could bring about a better result down the road.

A clue to how I could improve my chances next time came in a chance conversation with a wellness coach who is a self-made thyroid "expert." She informed me that my inability to dilate during labor may have had something to do with the Synthroid I was on, which is a synthetic thyroid hormone medication given to people with low thyroid function. (I read recently that this is one of the top three medications on the market with record numbers of women taking it. Low thyroid function is a HUGE and rampant problem today, and many more people have thyroid issues that are not detected by medical tests.) I decided that if there was any chance at all that the medication had interfered with my body's ability to go into labor and deliver a baby naturally then I simply had to get off it, though the endocrinologist I was seeing laughed at that idea. In her opinion (and this is the standard medical view) people don't get off thyroid medications; they stay on them for life. I really have no idea if Oliver's head position was the problem, if the medication interfered, or if the hypothyroidism itself was the real issue -- maybe it was a combination of all three factors, or maybe it was something else entirely.

Three months after Oliver's birth the work of the Weston A. Price Foundation came into our lives. I had read the book Solved: the Riddle of Illness to try and understand my thyroid issues, which was the first source to tell me that soy foods are bad for the thyroid and so are birth control pills. I cut out soy (which I had been consuming heavily as a vegetarian) and resolved never to go back on the pill. But that meant finding another method of birth control. My midwife recommended I read The Garden of Fertility, which teaches the Fertility Awareness Method, and it was there -- in that marvelous book -- that I first read about the research of Weston Price, and learned that traditional animal foods are essential for fertility, healthy babies, and overall good health. I spent the following year gradually and completely changing my diet, and by the following summer (only 10 months after I began this regimen) I was unable to tolerate any thyroid medication and stopped taking it. My symptoms did not return. (I was tested twice during this pregnancy and showed no thyroid problems.)

My story of raising Oliver from 3 months of age on traditional foods (first through breastmilk of course!) has been the subject of this blog, and if you've been reading along for any length of time you know about all the things that traditional foods and the GAPS diet have helped us with. [But just to recap: the health issues that were resolved by switching to a WAPF-style traditional foods diet included thyroid healing, improved immune function, better moods, blood sugar balancing (I had been severely hypoglycemic on a regular basis prior), relief of joint pain from past snowboarding injuries, and improved digestion; I also stopped ever having headaches. Later, after going on the GAPS diet, which is based on traditional foods but eliminates starches and sugars (with some exceptions), I effortlessly lost 8 lbs. of undesirable weight, the hair I had lost post-partum grew in with a vengeance, I stopped ever getting sick, my skin cleared entirely, my digestion improved even more, I saw my fertility cycles improve almost immediately, and I stopped having any premenstrual symptoms or cramps. I also found that I never felt even a hint of a "down" or depressed mood any longer.]

Now on to birth #2! (Interesting how I feel SO much happier as I commence writing this second part!)

Our midwife for Weston's birth was Joan Bryson, of Community Midwifery in Park Slope (Joan is pictured below, but this is an image I found online, not a picture of her with baby Weston). She works with Ellen Razgaitis, also a lovely and caring midwife who provided prenatal care along with Joan, but Joan was the one at the birth. Our doula, Jessi Bonilla (contact me for her info!), also provided amazing care, as well as placenta encapsulation services (read about the benefits here). Shara Frederick, birth assistant, doula, and childbirth educator was at the birth as well to assist Joan. I had never met her before, but was immediately comfortable with her and appreciated her help so much. [To learn about her services and fantastic array of childbirth preparation classes please visit Shara's website.]

My water broke early this time, too. Thursday night, December 1, I started a slow leak again, though there was more fluid initially than last time. I went to bed, confident that labor would begin during the night. I had been feeling Weston's head pressing down on my cervix for a few weeks, and some cramping as well. Instead, to my disappointment, I got a solid 9 hours of sleep.

The following morning I spoke with Ellen, Joan's partner. She recommended I see an acupuncturist to get labor going and gave me the name of a practitioner she often refers patients to. I went in for an appointment, but no dramatic changes occurred. I think Ellen and I spoke again that evening, because I remember feeling quite anxious and worried. She had mentioned that I should go in for an ultrasound to check the amniotic fluid level on Monday but I felt certain that simply setting foot inside a hospital would ruin my chances for a natural delivery. I remembered all too well the feeling of absolute disempowerment that overwhelmed me when I entered St. Vincent's on August 11, 2008.  I was anxious for labor to start naturally!

I decided to call my friend Rachel Koenig, of Aurora Healing Arts in Park Slope, and see if she had any Saturday openings. Rachel had been referring clients to me for traditional bone broth for about a year, as well as sharing my cooking class flyers with her patients. She has been an incredible blessing in our lives, ever-generous in word and deed, ready with uplifting words, smiles, and expressions of appreciation and comfort. I had intentionally not asked Rachel for treatment before because I had a feeling she would be too generous -- and I was right. She drove into Brooklyn on Saturday (12/3) to give me an acupuncture treatment in the comfort of my bedroom, well before her shift began at her office, and she offered to drive in on Sunday to treat me again if I needed it. When I asked how I could pay her, she said, "how about with a hug?" Best of all, she provided the reassurance I needed that all would go well with this delivery. I had never been treated by Rachel before, but by the end of our session I was convinced that she has a special gift. It turns out that she practices a classical form of acupuncture that she learned "underground," by studying from a master healer, before acupuncturists received licenses and formal schools of TCM and acupuncture were established in the U.S. A large part of what she does during an acupuncture session is feeling the patient's pulses, which tells her a great deal about their qi (chi) and overall health; it is because of what she observes in this way that she prescribes bone broths, which are healing and strengthening.

Rachel provided so much encouragement to me during our session -- she told me my pulses indicated that I was healthy and strong, without anemia or any other condition that would sap my strength. She said that the thyroid is a master gland and the fact that mine had recovered was a huge indicator that I had regained my health and was strong now, in a completely different place than I had been at Oliver's birth. She also told me how the acupuncture I had before Oliver's birth didn't work because my qi wasn't strong enough to pick up the signals it was sending to my body; as she described it, acupuncture provides a signal for what your body is supposed to do, but you have to be able to take the signal and carry on with it yourself. I have no way of knowing or measuring what either the first or the second session of acupuncture contributed to the birth outcome this time -- but I do know that her confidence and encouragement were exactly what I needed to relax and stop worrying. As Rachel told me, if you're worried and fearful your body can't produce oxytocin, which is needed for contractions!

Next was castor oil, which when taken internally is supposed to cause diarrhea after a few hours. This stimulates uterine contractions through the action of prostaglandins (I think -- not quite sure how exactly this works). At 3:15 that afternoon I took 2 oz. of castor oil in 2 oz. of fresh-squeezed orange juice and went back to organizing the bedroom and going through boxes of clothes to give away. By 5:30 I was having regular cramping, and at 7:30 the castor oil finally kicked in and started doing its work on my intestines. I was sitting on the toilet when I heard (or maybe felt) a "pop!" and saw a little bloody discharge. Suddenly the cramping was kicked up several notches; I called Joan and Jessi to give them a report. Just a few minutes later I was in the midst of painful contractions, which mixed with the intestinal cramping to make for a very fun early labor experience! Hugo began blowing up the birth pool and got Oliver packed up and sent off with our wonderful babysitter, but it wasn't long before I needed him with me full-time, so that I could grip his hands during contractions, which were now less than 2 minutes apart. He managed to call Joan and ask her to come over, but by the time she got there, around 8:40, I was fully dilated and still frozen on the toilet. It seemed the only position I could conceive of being in. The contractions were so intense and painful that I couldn't move or breathe -- in between I managed to tell Hugo how horrible the pain was and that I wasn't sure I would have done it this way if I had known! Labor came on so fast -- which can happen with castor oil -- that I didn't have time to build up endorphins which typically provide at least a little help with the pain of natural childbirth.

Joan managed to pry me off the toilet and get me set up on her brand new birth stool, right outside the bathroom door. I am so grateful that she had that birth stool with her, or I would have had to give birth to Weston on the toilet! It was really the only position I could manage. By now I was pushing, though it feels wrong to even say "I" was pushing since it was completely involuntary; I felt like I had no strength in my legs to brace myself with, and no ability to actively control anything that was happening. My body was entirely taken over by these incredible surging waves that made me feel like I was going to throw up, poop, and give birth all at once, while emitting awful involuntary groans. What an experience!! Joan propped up a hand-held mirror for me on the floor so I could see Weston's head emerge, and that was the only thing that offered some help to me in those 30 or so minutes of pushing.

Weston was born at 9:16pm, just an hour and 45 minutes after labor had really begun. The placenta wasn't delivered until an hour later, and the cord was allowed to continue pulsing that whole time, which is why he has such red skin -- all that extra blood! Jessi drained and prepared the placenta so she could take it home for encapsulation, which involves dehydrating it, grinding it, and putting the powder into capsules for me to take (to help balance hormones after birth, encourage milk production, promote healing, and boost mood). I was thrilled to hear Joan report that at most I could use 1 or maybe 2 stitches; the tearing was very minimal and since I wasn't in pain I opted out of the stitches.

I had just made a pot of oxtail broth and removed the meaty bones from the pot before labor kicked in, and after I got settled in bed I enjoyed delicious oxtail meat and a mug of broth while Hugo held Weston -- what a fabulous postpartum meal!

My milk seemed to come in immediately; I could hear Weston gulping it down! That had taken about 5 days to happen after Oliver's birth.

That night we slept with Weston between us, then spent the following day relaxing and enjoying time with our new little one. Oliver came home in time for dinner, a wonderful pastured chicken that Hugo roasted and served with mashed potatoes and salad. I was well enough to get up and make the dressing myself, and the next day I made fermented vegetable medley and chicken liver pate!

Weston has been a fairly easy baby, preferring to spend his days and nights alternating between nursing and sleeping. He is easy to soothe, and growing very well.

In a follow-up email Shara wrote, "It's not often that women just give birth to their babies (with no help, intervention, or intrusion) but that's what you did. Joan, Jessi, and I were just there in case you needed help."

All in all this has been an extraordinary experience. What a beautiful blessing our two boys are!

Question about thyroid health & blood sugar balancing

"I attended one of your workshops a few weeks back and would like to thank you for your effort and bravery for sharing your knowledge on traditional foods. I knew a few things about traditional foods from a friend who introduced me to your workshop, however your power point presentation brought it to much greater detail. You sold me on the story when your thyroid and blood sugar levels are normal within 1 years time frame. I am only 24 years of age and have hypothyroidism along with a borderline blood sugar level of 1.79 (Awkward because i lost 60 lbs within the past 2 years from heavy running, and a brown rice, low sugar diet). Is it okay for me to ask you how did you lower your blood sugar level? I'm really concerned about getting diabetes and slowly changing my diet now. There is a lot of contradiction between blood sugar levels and alcohol/caffeine. How do you feel about high blood sugar levels with alcohol/caffeine? Thank you very much."

Thyroid healing and blood sugar balancing are intricately related as the thyroid controls insulin production. To completely heal your body it is important to follow a low-carbohydrate diet where consumption of foods like starches (potatoes, beans), grains (such as rice, even brown), sugars (sugar, honey, etc), fruits, and even fresh milk (which is relatively high in sugar) are strictly limited. This means that you need to emphasize bone broths, meats, seafood, eggs, cultured/fermented dairy (cheeses, yogurt, etc.), fermented veggies, non-starchy vegetables of all kinds, traditional fats, nuts/seeds, and very small amounts of starches, grains, and low-sugar fruit (such as berries and sour apples). Everything you eat should be as unprocessed as possible and from the best sources-- grass-fed meat, raw dairy, etc. Of course this is easier said than done! But it is doable and will have a tremendous effect on properly nourishing your body so that it can come into balance. This is always the first step with any health condition; the body (especially of a young person!) has great potential to heal itself given the proper building blocks.

It is also important to look at beverages (alcohol and caffeine) as well as medications you may be taking. Alcohol and caffeine are absolutely terrible for the thyroid and for blood sugar levels because 1) alcohol turns into sugar in the body, while also providing highly toxic effects from the alcohol, and 2) caffeine stresses the adrenal glands (which are closely related to the thyroid) and will lead to the breakdown of many body systems over time. Caffeine has a very big impact on blood sugar as well since your body can go into panic mode when a caffeine kick is over, and end up with very messed up blood glucose levels.

My Fertility Awareness journey

This is more of an essay than a blog post, but I need to post this somewhere so I can link to it in my newsletter. Read on if you like!

As some of you may know, I have been working hard to organize an intro workshop to the Fertility Awareness Method as a resource for the parents’ group I lead. The workshop is happening this Sunday afternoon, which is very exciting to me! (register here) In spite of the difficulties I have encountered in getting this off the ground (finding a good presenter, obtaining a low-cost venue, discovering the workshop space donated has no chairs on the premises, changing the workshop venue...among other things!) it promises to be a great event and I’m really glad this is happening. To the best of my knowledge, there has been no such workshop in the NYC area in all the time that I have been practicing Fertility Awareness (nearly 2 years), though there is considerable interest in the method. It seems every week I meet someone (usually another mother) who is practicing or at least knows about FA.

I came to learn about Fertility Awareness in fall of 2008, after Oliver’s birth. I had been a longtime birth control pill user before the pregnancy, going on and off (but mostly on) the pill since I was 20. I tried the patch in there at one point, with unpleasant results, but always liked the reliability of the pill and not having to worry about getting pregnant. In grad school I worked for Planned Parenthood of New York City, both as a very privileged intern with a lot of interesting projects, and after graduation as a contracted researcher, performing qualitative research on doctors’ perceptions of the “morning-after” pill (emergency contraception/Plan B pill). My opinions about women’s access to the complete spectrum of contraceptive choices were very strong, but I knew next to nothing about how the pill and other hormonal methods affect a woman’s health and well-being. It didn’t matter to me then; I had too many other things I was thinking about.

Around the time I got pregnant, in fall of 2007, I learned that I had hypothyroidism, a condition where the thyroid gland, which is located in the neck, is underproducing thyroid hormone. I also had antibodies in my blood which were attacking the hormone I did have. Since thyroid hormone is essential for every cell in the body and lack thereof is implicated in problems like miscarriage and preterm delivery I was strongly admonished to take Synthroid (a synthetic thyroid hormone medication) and monitored regularly throughout my pregnancy for thyroid hormone levels.

During the pregnancy experience my world opened up and my interests and ideas began to take a new direction. I learned about the option of birthing at home for the first time in my life, and Hugo and I decided on a home birth. Our midwife came to our apartment for all my prenatal care which was incredibly relaxing and comfortable for me, especially since I worked from home at the time cooking for clients. She is the one who first told me about the option of using the Fertility Awareness Method and recommended The Garden of Fertility, though she herself had never read it. At the time I had a friend who kept raving about her IUD and I wanted to be extra sure about not getting pregnant again right away, so I was pretty much planning on getting an IUD put in after the delivery.

Well, that was before I had my cervix prodded during labor by three sets of health care practitioner hands. After the experience of labor and having a cesarean section (I was unable to dilate and deliver Oliver vaginally despite every intervention known to man) I really could not stomach having a needle put into my cervix and then having someone stick a pointy object up inside there. It all seemed too horrible and was going to prove impossible for me, especially since I couldn’t even hear the word “cervix” without wanting to pass out. I decided to look into this Fertility Awareness Method and see if that would be an alternative.

While reading The Garden of Fertility, by Katie Singer, I first learned about the Weston A. Price Foundation and the importance of nutrient-dense foods for fertility, pregnancy, babies, and women’s overall health (particularly reproductive health). It was the first time I had realized the connection between having a strong ovulatory cycle and being an overall healthy person. It was also the first I had heard that my body actually NEEDED animal fats! For years I had eaten low-fat as much as possible, and for the prior year I had focused entirely on a vegetarian diet which was very soy-heavy (the book enlightened me about soy’s highly goitrogenic, or anti-thyroid, properties). I also experienced extreme hypoglycemic episodes on a daily basis, and couldn’t leave the house for even a brief walk without carrying a snack with me. I was hungry all the time, and eating many meals throughout the day. I had issues with acne, PMS, anxiety, fatigue, irritability, digestion, cravings for lots of bad foods...the list goes on. Something really resonated for me in reading this section of Katie’s book and I began to delve into the work of the Weston A. Price Foundation. Her mention of thyroid conditions also prompted me to read the book Solved: the Riddle of Illness, which I remember vividly because it was there that I learned how deeply destructive birth control pills are for a woman’s body and thyroid in particular. Around the same time I spoke with a sort of amateur thyroid expert in passing who mentioned that the Synthroid I was taking had likely interfered with my ability to dilate and give birth to Oliver. All these factors made me absolutely determined to do something about this condition, to get off the medication, and to heal my body once and for all.

I should mention here that I tried repeatedly to get my endocrinologists (I saw 3 in all) to put me on the natural thyroid hormone replacement therapy known as Armour. If you must take medication for hypothyroidism this is really the only way to go; the Synthroid is terrible stuff. However, since Synthroid is heavily marketed by the drug companies almost no one will consent to prescribe Armour anymore, though it used to be the only therapy (and is actually very cheap to make). I also asked my 2nd endocrinologist, a local practitioner I really liked, if she could help me heal my thyroid so I could get off the medication. Her response was that there was nothing I could do and I would be taking meds the rest of my life. I was sure there was a better way, though!

For nearly a full year following Oliver's birth I gradually transformed my diet. My first big switch was replacing all the dairy in our diets with raw, local, grass-fed, organic dairy. I started eating a LOT of raw grass-fed butter and taking cod liver oil. These changes made a big difference. Other changes that I adopted over time included making nutrient-dense bone broths (including fish broth, especially good for the thyroid); cooking with traditional fats (including lard, chicken fat, and coconut oil); fermenting my own condiments, beverages, and vegetables; properly soaking and preparing whole grains; eating small amounts of organ meats; and getting all the processed junk out of my diet.

While changing my diet, maintaining my FA chart helped me begin to at last keep track of what my body was up to, and how it responded to certain foods. I learned very early on that I would become quite sick after having sugar, usually with a breakdown in my immune system that would lead to contracting a bad cold, sinus infection, or flu. My FA chart showed a clear picture of my daily state of health, whether bad or good. Since waking temperatures are charted daily, it was easy to see when I had a fever for several days. I was not ovulating for many months, since I was exclusively breastfeeding Oliver, so I knew the times of fever were not due to the rise in temperature that comes immediately following ovulation.

For a very long time it seemed my body was in a state of ambiguity, not sure about what it was doing or what it wanted to be doing, as far as fertility and ovulation go. Eventually I was able to observe an increase in estrogen (evidenced by some fertile-quality cervical mucus) but other signs were still ambiguous. As my body prepared to return to normalcy, my waking temperatures remained quite low, usually in the mid 96’s, which is generally a sign of hypothyroidism and adrenal fatigue. As the months went by, however, something magical began to happen: my temperatures gradually increased to the normal range, and one month at last I had my first normal ovulatory cycle -- and even more thrilling, I KNEW it! For the first time in my life I actually knew what was going on with my body; I could actually pinpoint the fertile days of my cycle. A few more months went by and my ovulatory cycles kept getting stronger until at last I experienced a textbook cycle, with a clear shift in temperature that stayed up above 98 degrees the way it was supposed to.

I am no expert on FA, I forget the rules and have to consult my book, I don’t remember what the luteal phase is off the top of my head, but I know enough now to be aware of what’s happening in my body. I know I can absolutely avoid pregnancy, or get pregnant whenever I want to--and all with only a sacrifice of a few minutes a day. No more wrangling with my HMO over covering my preferred brand of oral contraceptives, no more obsessing over taking a pill at the same time every day, no more wondering if I am really pregnant but just don’t know it. This is empowerment like I never got from birth control pills.

As my waking temperatures increased and my cycles became more stabilized I also began having difficulty tolerating my thyroid medication. I began to feel anxious and jittery when I took it, and even adjusting the dosage way down and skipping days in between taking the pills still led to the same feelings whenever I took the medication. At last I consulted someone who put me through a rigorous health questionnaire and informed me that I had absolutely no symptoms of hypothroidism. Furthermore, she told me, I rated better than anyone she had ever seen on symptoms of blood sugar imbalance, including hypoglycemia. By this time I was able to go many hours between meals, and had no need of snacks throughout the day. I felt healthy and empowered enough to completely go off my medication upon her recommendation, and have never had another symptom of hypothyroidism since.

I see my journey with FA as absolutely integral to my health recovery. If I hadn’t picked up that library copy of The Garden of Fertility I would likely have never learned about the Weston A. Price Foundation, about raw milk, about pastured butter, about local farms raising animals and produce in the old-fashioned and truly natural way, about eggs with yolks so bright they almost hurt your eyes. I would still be in a world of doctors’ waiting rooms and regular trips to the pharmacy, feeling too tired on some days to deal with life, wondering why I wasn’t healthy despite my low-fat diet. I would still feel that every day was potentially a fertile day, that sex was fraught with the danger of a too-early second pregnancy, that my body was a frustrating mystery I would never understand. The changes in my life and health are incredible; looking back I can’t believe I lived any other way.

Does any of this ring a bell for you? Please add your comments, and check out The Garden of Fertility by Katie Singer when you have a chance. If you're interested in our workshop this Sunday by all means come! For one-on-one coaching by phone with Ilene Richman, director of the Fertility Awareness Center (NYC), please email admin@fertaware.com or visit www.FertAware.com.

A discussion of carbs

Reader question: I wanted to let you know that I have started the GAPS book by Dr. Campbell-McBride and I just bought "Primal Body, Primal Mind" which was given 2 thumbs up in the last Wise Traditions. When you are done moving/have had a chance to look at them, I would love to chat with you about them. Both recommend almost no carbs- even oats, brown rice, etc because of their effect on blood sugar. I haven't finished the books yet so I don't know if they mention soaking, but I would assume that soaking the grains first mitigates their deleterious effects. Anyway, would love to know your opinion.

Response: In terms of carbs, yes it is very true that excess carbohydrate consumption is at the root of our modern health crisis (along with mass-consumption of rancid vegetable oils and a few other things as well). And it is particularly the refined carbs and sweeteners that are doing the most damage. The USDA Food Pyramid recommends 300 grams of carbohydrates from grains a day!! This is the amount that a marathon runner would need to run the marathon -- not the amount that a sedentary person needs. So yes, everything we have been taught about cereals, bread, and pasta being the "staff of life" is completely wrong.

However, before you jump on the Atkins bandwagon, it is really incredibly important to keep in mind the findings of Weston A. Price who discovered many "primitive" cultures who ate quite a lot of carbohydrates and were extremely healthy. The Scottish people living in the outer Hebrides are a perfect example: they ate as many as 1000 calories per day from oats, yet had almost no tooth decay (remember, tooth decay is the physical manifestation of recurring imbalances in blood sugar and blood mineral levels). It is my belief - based on everything I have read and observed - that certain carbohydrates work best for certain people based on their ethnic heritage and the way their ancestors evolved specifically. For example, oatmeal works great for me, and I eat it almost every morning, but it makes Hugo want to fall asleep immediately. I have Scottish/Irish and European ancestry (oats were also big in other cooler parts of Europe) and so it is my experience and belief (based on being in tune with my body) that oats properly prepared work well for me. However, Hugo's heritage is entirely Spanish and Mexican (including Indian), and oats were never eaten by his ancestors. He is also blood type O (as are many Mexicans) which means he requires and is able to digest a lot of protein, especially meat -- but this doesn't mean that he needs to avoid carbs. Rather, he also does really well with corn and beans, both very starchy carb-rich foods. I could go on to give you other examples of this, but I'm sure you get the point. If you can look to your genetic heritage and determine roughly what your ancestors would have been eating, this may help you to at least find modern equivalents.

If you are prone to hypoglycemia and adrenal issues, as I was, you will need to completely cut out alcohol (which turns immediately to sugar in the body), white flour (also white rice and white pasta), all refined sweeteners, and all but very small servings of natural sweeteners and fruit. You will also need to be sure to have adequate animal fat and protein intake, coupled with fermented foods and/or beverages at every meal, and bone broth taken before eating meat (as you are blood type A this will help you digest the protein properly). You may also need to strictly limit carbohydrate consumption in the form of bread and flour, even whole-grain, because flour is basically very small particles of carbohydrate and therefore very easily absorbed, which can still cause something of an imbalance in blood sugar (sourdough breads and soaked-flour home-baked items are something of an exception, though they will still need to be used in moderation -- I recommend no more than 1-2 servings daily of flour items of any kind). This will all help with adrenal issues and a tendency to hypoglycemia. You may even notice a difference in your response to oats in various forms -- i.e. steel-cut oats will likely keep you going much longer than Scottish oatmeal which is in a highly crushed/milled form. This is a sign that your body is working harder to break down the more fibrous parts of the oats, thereby releasing glucose into the blood stream more slowly, which is exactly what we want.

It is also worth noting that rice is uniquely starchy in comparison to most other whole grains; it has a much higher starch-to-fiber ratio. It's wise to keep rice consumption to a minimum, even brown rice consumption, because the pancreas of the average Westerner is simply not adapted to produce enough insulin to digest rice on a regular basis. Asian and Japanese people actually have larger pancreases to handle rice! Again, we can take a cue from what's available locally. You can indeed grow oats in our Northeast climate, but not rice!

The key is to 1) find which healthy sources of carbs work for your body, and 2) use them in moderation or in the proper balance that works for you. Signs of blood sugar imbalances may include things like acne, PMS, PCOS (poly-cystic ovary syndome) and breast cysts, reproductive disorders, adrenal stress, thyroid issues, insulin resistance (with its signature weight gain around the belly), hypoglycemia, fatigue after eating, tooth decay, unwanted hair growth, yeast infections, irritability, depression, and susceptibility to infection.

Happiest day of my (thyroid's) life!

Imagine that two years ago you had developed a serious medical condition which required that you take medication every day FOR THE REST OF YOUR LIFE. Imagine that you had serious misgivings about taking this type of synthetic medication every day, and that in recent months you had started feeling jittery and anxious every time you took it. Imagine further that this condition was related to having a compulsory c-section with your first child, that it put the chances of having a normal (vaginal) birth with any future children in jeopardy, and that it was affecting many aspects of your body chemistry, from sugar handling to dental health.

Now imagine that someone (in this case a nutritional therapist) told you that you showed absolutely no signs of hypothyroidism, that it didn't appear you actually had this condition anymore, and that you should listen to your body about what you felt was best as far as taking medication went. How great would you feel?

Well, this is what happened to me this week and let me tell you, I feel GREAT!!!! Being labeled with the condition of hypothyroidism and having to worry about all this stuff has not been fun at all. For the past 8-10 months I have worked really hard to get my diet under control. For those of you who have been following along, you know how much time and effort I put into creating our family's meals. It hasn't just been a philosophical exercise for me, though, and it hasn't been only about wanting to raise a healthy baby or about wanting to eat only foods from local farms. All these things have been part of it, but at the heart was my desire to be completely healthy and not have to go regularly to the doctor or take daily medications.

From my research into thyroid conditions I have learned about everything that can negatively affect our thyroid health (for me the two biggies were birth control pills and soy foods), and also about how to heal my thyroid. Focusing on high-quality animal fats has been an incredibly important part of this (butter from grass-fed cattle is a thyroid-supporting food); I've also recently started making stock from the carcasses of whole fish as the fish heads contain the thyroid gland and serve to nourish our own thyroids. Cutting out sugar, strictly limiting sweet foods (even natural ones like honey and fruit), avoiding soy, using only Celtic sea salt, and cutting out almost all white flour have been crucial as well. I also practice fertility awareness now instead of taking the Pill, and I feel much better physically than I have in years.

If you can believe this, in the past when patients were aging prematurely or always fatigued doctors would prescribe raw thyroid sandwiches and the patients would perk up in no time! I have no desire to eat raw thyroid glands from animals, but I think I can continue to incorporate butter, sour cream, the occasional grass-fed sirloin steak, and yummy eggs from pasture-raised chickens into my diet without too much misery. :)

Sugar Attack!

As most of you know, I struggled for years with hypoglycemia, which is basically episodes of low blood sugar characterized by weakness, shaking, light-headedness, irritability, etc. which usually occur a couple of hours after eating. During my worst times I would experience "sugar lows" immediately after eating which was kind of scary, and even the occasional extreme low in the middle of the night which was terrifying (it felt like I was having a panic attack). It's taken some pretty major dietary changes to get over this problem, but once I made these changes I saw results almost instantly (I will talk about overcoming hypoglycemia in my upcoming November workshop).

I generally go for a few months at a time now without eating sugar (or corn syrup), but after a while I forget why it is that I've been avoiding sugar so religiously and I end up getting into trouble. This usually happens on vacation where there is less healthy food available and lots more white flour and sugar everywhere I look! While away for 5 days I had the following (all things I would not usually eat):

• small piece of elephant ear pastry (about 1/4 of the whole thing)
• about 4 oz. of Mike's Hard Lemonade spread over a couple of occasions (this stuff is just sugar and alcohol, which breaks down into sugar anyway)
• "small" 1-scoop ice cream cone (butter crunch)
• 1 piece cherry-filled Austrian strudel (the absolute best strudel in the world -- this is the only treat I should have had on the trip)
  
• small piece of peanut butter & chocolate fudge
• 2 maple cookies (small cream-filled cookies from Canada)
• a few sips of Coke (maybe 2-3 swallows)
  
• white flour in various forms (mostly wraps, rolls, sugar cone, etc.). It was basically impossible to find whole wheat or whole grain anything on the menus.
  

Now that I actually write out this list it is clear to me why this proved to be such a problem for me -- this was a LOT of sugar for someone who never eats any! I felt fine while I was away, perhaps more sweet cravings than usual, but overall the sugar didn't affect me too much at the time.

Starting the day after the trip, though, I began having symptoms of hypoglycemia again a few hours after eating. This was frustrating because I have gotten used to being able to go several hours between meals and I really like the freedom of not having to carry snacks with me. The hypoglycemia was pretty mild, though, and gone after a week back on my usual diet. The really bad part of this whole thing was that all week following the vacation I felt very off: my heart was pounding, I had actual chest pains (no joke), I was breaking out, I felt overheated internally, I felt extremely jittery, keyed up and restless (a sign of adrenal over-stimulation from the sugar), and every time I saw sweets (pastries, ice cream, whatever) I wanted to eat them! I never have cravings for sugar usually so it was really strange for me to walk into Whole Foods and look longingly at the chocolate-filled croissants!

It has taken about a week of eating my usual diet to feel back to normal:

• oatmeal or brown rice for breakfast w/raw honey, butter & raw milk
• lunches of the following: toasted whole wheat sourdough bread w/butter & homemade pate and side of sliced cucumber; cottage cheese & fruit; scrambled eggs w/cheese; cured bologna (from Abner's farm) with raw milk cheese & greens on sourdough; tuna melt w/homemade mayo & celery on sourdough
  
• dinners of potatoes, veggies, meat or beans, brown rice (this past week I also made my special tuna-noodle casserole w/white flour elbow noodles! but there was plenty of cheese, butter, and tuna so it worked out okay as eating fat with a form of sugar (white flour in this case) slows its release into the blood stream)
  
• snacks like yogurt w/maple syrup or fruit, homemade ice cream (which is very mildly sweetened), corn chips & salsa, cucumber salad w/tomatoes, sliced watermelon, roasted eggplant with olive oil and sea salt
  

This was a great learning experience, so I'm not too upset that it happened. Now I will (hopefully) remember why I don't eat sugar! I still include raw honey, occasional blackstrap molasses, maple syrup, and occasional succanat (dehydrated cane sugar juice) in my diet, but refined sugar and corn syrup simply don't work for me. White flour has to be kept to a minimum as well. Of course, I am much more sensitive to sugar than the average person so it may actually seem like a disadvantage to never eat it because you will have a strong reaction. However, the symptoms I get (hypoglycemia, acne, heightened adrenaline response, chest pain) are simply the short-term indication that something is not right. Over time, and with continued use, sugar will cause cellular aging (including wrinkles), diabetes, severe hormonal imbalances (like poly-cystic ovary syndrome, and thyroid & adrenal problems), heart disease, cancer (did you know sugar feeds tumor growth?), wacky cravings, headaches, and mental disorders.

What are your experiences with sugar? What do you crave? How do you feel when you eat something sweet? How do you feel an hour or two later? Please weigh in on this important topic.

Lessons in Eating for your Body

This past week I learned an important lesson about eating in tune with what my body needs. As you may know, I have an underactive thyroid which I am trying to heal. One of the main influencing factors, of course, is diet, and I am always trying to gather more information on how I can do better. I ran into someone I knew as a thyroid "expert" at a talk I attended, and began discussing my thyroid condition with her afterward. She asked if I eat raw vegetables and I said yes, I do, mainly in the form of a big seasonal salad which I have a few times a week. She told me I needed to stop eating any raw vegetables because they contain goitrogens which attack thyroid hormone. I am not sure if she meant salad was taboo as well, but I took this to mean that I shouldn't have any type of raw green thing, and since I'm not into cooked lettuce I simply stopped eating salad. For the following week and a half I noticed a strange shift in my mood and energy level: I became very irritable, unmotivated, and fatigued. I wasn't keeping appointments or getting anything done at home which is totally unlike me. Friends heard me complain often about everything from my strange lack of energy to my odd desire to do absolutely nothing. I couldn't seem to stop griping and complaining about things in general! I was starting to have thoughts that maybe I had developed a food allergy or my thyroid medication wasn't working, etc.; I really couldn't figure out what was happening to me. Finally (after feeling pretty bad for a full week), I realized the only thing that had changed in my life was that I had STOPPED EATING SALADS. I spoke with my friend Sharon who reminded me that the woman I had consulted follows macrobiotic principles, which teaches that raw vegetables of any kind are very unhealthy. I realized I had misapplied information and made a drastic change that wasn't right for my body (something I warn other people against!). I began eating salads again as much as I wanted and began to feel better immediately. The change was dramatic. I don't know if somehow the nutrients I was missing are what was making me so miserable, or if it was that I was suppressing myself (I LOVE making --and eating-- beautiful salads of spring greens and to not eat them was to deny a part of myself). I suspect it was a mix of both. I have reached a point where I know what my body needs: it tells me when I need protein and what kind, when to eat fruit, when to have something lacto-fermented. I have to keep listening to that inner knowledge. This is what we all must do. Forget the so-called "experts;" they have their place of course, but the real expert on you is YOU.

Shouldn't we be fat by now?

If you've been following this blog at all you know how much I love cooking with butter and eating things like eggs, cheese, and ice cream. So you may be wondering by now why we aren't fat. We have all been told that fats in food (particularly animal fats) are what make people sick and overweight. However, while we won't touch trans fats at our house with a ten-foot pole, we are eating plenty of animal fats and some natural plant fats as well (such as those in things like nuts and olives) -- AND enjoying excellent health. Oliver and I also take daily high-vitamin cod liver oil (from Radiant Life) which provides excellent amounts of vitamins A and D, as well as the all-important omega 3 fats. [I take 2 tsp. daily, or 2500 IUs of D and 25,000 IUs of A, plus 1.6 grams omega 3 fatty acids in the form of EPA and DHA; Oliver receives about 1/2 tsp. which is important for his health since vitamin D does not come through in breastmilk. We both drink it mixed with raw milk - Oliver relishes his but I gulp mine quickly while holding my breath. Vitamins A and D are crucial for pretty much all types of development and for healthy immune function.]

It is my firm belief that refined carbs and processed foods (which are largely made of refined carbs) are what cause weight gain and innumerable health problems. At our house we try to avoid processed foods as much as possible. The most processed we get is occasional organic whole wheat pasta, Amy's canned refried beans (the black-bean version is eat-from-the-can delicious!), blue-corn taco shells from Whole Foods, and my favorite whole-grain Kavli crackers. And yes, now and then we eat things like potato chips or shortbread cookies, but these are few and far between and always the best quality (which are usually better for you). All these great high-quality fats are curing my hypothyroidism and long-time hypoglycemia, and making me even-tempered and consistently happy for the first time in my life. Plus they make for incredibly rich breastmilk and a happy, well-behaved baby. I have also noticed that since eating this nutrient-dense, high-fat diet I have totally stopped craving sweets and carbs.

When people look askance (or even shocked) at my suggestion that they eat things like (gasp!) butter or whole milk, I like to mention the Masai of Africa, who are reported to consume up to 400 grams of fat on a daily basis, mainly from meat and raw cultured milk. Granted these people are living a more or less traditional existence with plenty of daily exercise, but they are effortlessly slim and healthy - something most Americans cannot claim to be. Until the past century, in this country we ate plentiful amounts of butter, lard, eggs, raw full-fat dairy, liver, and fatty meats and enjoyed far better health, high fertility rates, and much smaller waistlines than the average American does today -- as well as enviably low rates of heart disease, diabetes, and cancer.

All this is to say, as long as we keep seeing positive effects of our new way of eating at our house, we will continue! Of course, I also believe firmly that we should buy the best quality we can possibly afford, and limit consumption of conventionally-produced animal foods and fats. Farmers' markets and local buying clubs are the best way to do this.