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Author Archives: Inexplicable Ways

A day in the life

I love when other moms post their “day in the life” so here’s mine in all its mundane glory.

6:30am:  Made coffee and my husband’s lunch.  Kissed him good-bye and went back to bed where two little girls had slipped under the covers.

7:30am:  Out of bed, drank coffee, and fed the kids.  Perused facebook while the coffee took effect.

8am:  2nd coffee enabled me to answer emails.  Broke up a fight.  Dealt with a melt-down from Norah over I-can’t-remember-what.  I think it had to do with loom bands.

8:45am:  Out the door.  We did our Latin lesson in the car and I ate my breakfast.

9:30am:  Balcony seats at the Brooks Center to see a musical, “The Monster Who Ate My Peas.”

10:45am:  Back in the car.  We listened to a Lyrical Life Sciences song about digestion which turned into a discussion about the Pacific Northwest myth about raven stealing the sun which turned into a discussion about the reproductive system which led to listening to Rita Dove read her poetry.  That’s how we roll.

11:20am:  Met my mother-in-law in Easley so she could take the kids to lunch while I provided a new mama with 2 hours of postpartum care.

2pm:  Heading back home with the girls.  They told me all about fractions which Nana taught them in her craft room today.  Norah showed me how much she crocheted.  Is that really the past-tense of crochet?  I defined the words optimism and pessimism based on Norah’s not-great attitude which led to a discussion about their derivation from the Latin words, pessime and optime.

2:30-4:30pm:  I ate lunch.  Norah practiced violin and read her new book.  Cedar played with her babies.  Then the girls went outside to blow bubbles.  I made a meal to take to a postpartum mom.  Talked to another postpartum mom about her perineum.  Answered more emails.  P.S.  If you send me an email asking lots of questions that require I spend 15 minutes crafting a careful response, please follow-up with a “thank you.”  I’m shocked by the number of strangers who email me things like, “I want to be a doula…will you answer these 17 questions?” and then never reply.  Common courtesy, friends!

5pm:  Dropped meal off.  The girls sang their history songs in the car.

5:45pm:  The girls and I met Scott at Panera for dinner.  He took the girls home and I headed to an Upstate BirthNetwork meeting.  Answered a phone call about a funky umbilical cord and texted with a tired doula.

9pm-10pm:  Stood too long in the cold parking lot talking with my favorite childbirth educator.

10pm-10:45pm:  Cried on the phone with my mother about all the mistakes I’m making with my kids.

11:30pm:  Home in bed blogging with a mug of peppermint tea.

And now I’m laughing that I’m really going to post this “day in the life” on my blog!  Yeah, I pretty much “road-schooled” the kids today.  Tomorrow we’ll get to stay home almost all day and surely there will be math and spelling.

Newest Blooper

Did you know we really boil water at homebirths?  It’s true.

We boil water to steep herbs for postpartum care and to heat up the tub if needed.

Last week, I attended a homebirth in my childhood home.  It was my sister’s 2nd birth there.  I’m pretty comfortable in that home.

At 5am, I went downstairs to start water boiling.  I knew Noelle would get in the tub soon and sometimes the hot water runs out.  I was on top of it!

There were 3 large stockpots on the stove.  I checked one and it was water.  I checked another–water.  I didn’t check the third.  I turned the burners on high and walked away.

A little while later, it smelled like the house was on fire.  I ran into the kitchen and promptly busted it–sliding in a puddle of water in my socks.  A pot was smoking.  I grabbed it (burned my fingers) and took it outside.  Apparently, my mother was soaking lima beans for the vegetable soup Noelle requested to eat after her birth.

Have you ever smelled burnt beans?  Noelle actually thought I was smoking cigarettes!!  The house smelled horrible.  I smelled worse.  I had to find new clothes in my mother’s closet and rub sweet orange oil in my hair.  It was nasty.  Worse, I had to wake up my mother and ask her to clean the kitchen floor because Noelle needed me.

For Unto Us A Child Is Born

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But there are carols
That carry phrases
Of the haunting music
Of the other world
A music wild and dangerous
As a prophet’s message

Or the fresh truth of children
Who though they come to us
From our own bodies
Are altogether new
With their small limbs
And birdlike voices

They look at us
With their clear eyes
And ask the piercing questions
God alone can answer.

–from Noel by Anne Porter

New Birth Story

I’m thrilled to share a new birth story with you!  Jenni shared her first birth a couple of years ago.  Now her husband is telling the story of their second birth.

Read on.

Focal Points for Birth

I had a beautiful focal point during my first birth.  It was a gorgeous piece of moss that my husband glued to a flat rock.  I let my eyes grow blurry and lazy as I stared at that moss.  Norah’s middle name is Moss.  I still have it sitting on a shelf in my bedroom though the moss has turned yellow.

For my second birth, I used plants and affirmation.  At my amazing blessingway, guests brought plants to surround me during my birthing time.

I see many focal points used during births.  I remember a woman who used a picture of herself sailing a boat.  That experience reminded her that she could do anything.  I’ve seen parents display their baby’s first outfit or an ultrasound photo.  Or, a couple who cut out a circle with the word, “Peace” and taped it over the clock in the hospital room.  Brady covered a wall in her home with individual affirmations.  Focal points can be fantastic reminders and affirmations during your birthing time.

But my favorite focal point ever was from Katy.  She traced a circle exactly 10 cm and used it in her affirmation.  See it here taped to her hospital bed.  It says, “Go ahead and let gO, Katy.  He’s almost here.”

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Did you use a focal point during your birthing time?

Birth Language

“Words are, of course, the most powerful drug used by mankind.”  –Rudyard Kipling

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Recently, I was asked to teach some lovely nursing students about hypnosis for childbirth.  I thought it would be an excellent time to slip in some suggestions for using positive language in the birthing room.  Regardless of whether a woman is using hypnosis for her birth, she is still in an altered state of consciousness.  Words become suggestions when we are in an altered state.  In other words, the power of language grows exponentially during our births.

Based on statements I have heard during births, I put together a hand-out for these nurses.  Here is a sampling of what I included.

General Language Suggestions

  • “You’re safe” instead of “Don’t be scared, you’re not in danger.”  When we are in an altered state of consciousness, our brain takes in only the prominent words in a statement.  So “you’re not in danger” becomes simply “Danger.”  In movies, I hear people saying, “Don’t die on me!” and think “No!  Say, live instead!”
  • “Your body is wise.”  The birthing mother is the expert on this birth.  We must never forget this nor should she.
  • “Feel your shoulders relax” instead of “Don’t tense your shoulders.”  Again.  If we speak in negatives, she might hear “tense your shoulders.”
  • For IV placement or injections, “I’m going to rub on some cold and then there might be some pressure” instead of “This will feel like a bee sting.”  No one likes a bee sting.
  • “Breathe your baby down” instead of “You’ll feel burning.”
  • “Special considerations” instead of “complications”
  • “You’ve dilated so much!” instead of “You’ve only dilated ½ cm.”
  • “When babies are in a posterior position, we can try to…” instead of “Your baby is posterior.” (distance the negatives, only personalize positives)
  • “You’ll have all the energy you need to birth your baby” instead of “I’m scared you’re going to wear yourself out.”   I hear this one all the time as a reason for women to get an epidural.  Women release a surge of adrenaline just before they begin pushing.  You’ve heard stories of what incredible feats people accomplish under the influence of adrenaline.
  • “You look so strong” instead of “You look like you’re in a lot of pain” or “What is your pain scale?”  When a perceived expert tells someone they look like they are in pain, then certainly that is going to influence pain.

Do not say:

  • “Get mad at your baby.”  I cannot tell you how much this one bothers me.  I have strong beliefs that regardless of how babies come into the world (cesarean, forceps, on the side of the freeway), they should be welcomed with joy.  Why would you tell someone to get mad at your baby?  Or get mad at all?  Anger and birth don’t mix in my book.
  • “This is going to hurt.”  Don’t assume what she will feel.  Maybe it will/maybe it won’t.  But telling her it will hurt is a guarantee that she will expect pain and likely experience it.
  • “You’re not allowed/I can’t let you.”
  • “I’m going to be your worst enemy”  I’ve actually heard a nurse say, “Think of me as the Wicked Witch.”

Avoid:

  • Mentioning numbers (dilation, stats, time) unless she specifically asks.  During an unmedicated birth, the thinking brain slows way down.  Numbers, questions requiring cognitive answers, consent forms, bright lights may keep the thinking brain engaged.
  • Telling her what she’ll feel or trying to describe what you think she’s feeling
  • Negatives (Don’t tense your jaw)
  • Speaking during pressure waves/contractions
  • Unnecessary questions.  Questions wake up the thinking brain.

When in doubt:

  • Be silent.  Or murmur how well she is doing.  Be frugal with words.
  • Give yourself an affirmation such as “I am entering a sacred space and I will use my words and my skills for healing and comfort.  These are the gifts I bring.”

What would you add?  What language have you heard in the birthing room that hindered rather than enriched.

October 10 on 10

Ten pictures on the 10th

10am Porta potty. Yep. That’s how I’m kicking off the fun today!

Photo Oct 10, 10 31 22 AM

11am How many kids can you find in the apple tree?

Photo Oct 10, 10 59 44 AM

12pm Bringing in the harvest

Photo Oct 10, 11 07 46 AM

1pm Cedar and CeCe exploring together

Photo Oct 10, 11 46 32 AM

2pm New sunglasses

Photo Oct 10, 10 34 42 AM

3pm Coffee break with apple cider doughnut (of course)

Photo Oct 10, 2 30 06 PM

4pm Random constructs I find in my floor

Photo Oct 10, 4 25 30 PM

5pm I finally get to wear my new scarf from Cambodia

Photo Oct 10, 4 38 17 PM

6pm Quiet dinner in my classroom before Hypnobabies students arrive. Swamp Rabbit Cafe has the best sandwiches. The best.

Photo Oct 10, 5 35 45 PM

7pm Leftover treats from Hypnobabies break. Did I mention the baked goods from Swamp Rabbit Cafe? The best.

Photo Oct 10, 7 19 17 PM (HDR)

ten on ten button

Greenville Memorial and Family-Centered Cesarean

I guess Greenville Memorial didn’t want me to only blog about Greer. They one-upped Greer’s family-centered cesarean.

History: When I first started doula work, sometimes I was permitted in the operating room at Greenville Memorial with my client. It was still hit or miss. However in recent years, the “rule” is only one support person for cesarean births. Until now.

Much to my surprise, at my last Greenville Memorial birth, JoAnn the trailblazing midwife, told me I was going back. I threw on some (cloth!) scrubs and Louise, a favorite nurse of mine, insisted I go with my client as she was being wheeled back.

That was the one-up.

Whenever I’ve been allowed back, I’ve first waited with dad until mom was prepped. This time, I stayed with mom the entire time. I was able to wipe a few tears while she waited, hold her while she received her spinal anesthesia, and talk with her as the surgery began. After the surgery, when dad left for a little while with their baby, I stayed until she was wheeled into recovery.

True continuous care.

Even better? JoAnn says the policy has now changed to allow two support people into the operating room.

I’m not saying I’m responsible for that. I’m just saying I’m glad I didn’t trip and face plant on mom’s uterus or something. Ruin it for everybody, you know? :)

Now, look at this adorable poppet enjoying skin-to-skin time with daddy in the operating room. Don’t worry, she got lots of immediate skin-to-skin time with mama first. Mom voluntarily permitted dad a turn.

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It looks like family-centered cesarean birth will be standard care now at Greenville Memorial.

Now, let’s keep that cesarean rate on the decline!

Another Family-Centered Cesarean Birth

This post contains pictures of cesarean birth. 

I am more and more impressed with Greer Memorial’s cesarean practices.  If I had to plan a cesarean, that’s the place I’d give birth.

There are four OBs who attend cesarean births at Greer so the policy and practice is fairly cohesive.  None of the “well, if you get dr. so and so, then expect x, y, z.”

I was honored to attend a repeat client’s planned cesarean.  I use the term “planned” loosely since her darling boy decided to come early.  Just to keep us on our toes!  Come to think of it…her last “planned cesarean” also had me rushing to the hospital.  Her babies don’t like to be told what to do, I suppose.

Here is her birth in pictures.  I only took 150 snapshots so it was easy to narrow it down to a few.  Hehe.

Top reason I prefer Greer?  Doulas can enter the sacred operating room.  And I dig the nurse’s scrubs instead of the paper ones.  In this picture, I’m waiting with dad.  The mom goes back first and there is about a 30 minute wait while she receives her spinal anesthesia and her stats are monitored.  Dad was nervous even though it wasn’t his first rodeo so we talked about our kids while we waited.

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Now we’re in the operating room.  Notice mom’s arms are not strapped down.

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Dr. Danielle Harris is the OB.  She is lovely; relaxed and accessible.   I remember my first birth with her four years ago.  I suggested something wildly uncommon and she responded with a “hey, let’s try it!”

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The sweet baby grabs an arm and says, “Wait!  I want delayed cord clamping!”  No, actually, Dr. Harris delays cord clamping because it’s not a big deal to delay cord clamping.

(which is interesting because I’ve heard all sorts of reasons from other OBs as to why they can’t delay cord clamping during a cesarean)

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So, who’s this guy?  He’s the pediatrician on call.  Typically, the pediatrician or neonatologist examines the baby in the warmer immediately after birth.  When he walks in, Dr. Harris tells him, “Mom would like immediate skin-to-skin with her baby.”  And he says, “Fine by me.”

(again, I’ve heard all sorts of interesting reasons why this can’t happen:  a nurse will have to rotate out in order to hand baby to mom or it’s too darn cold in the operating room).

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Now you’ll see how fantastic it is that mom’s arms are free.

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Beautiful.  Mom will never forget this moment.  And perhaps, just as important, significant aspects of bonding, breastfeeding, heartrate and thermal regulations are happening in this moment.

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A little while later, that laid back pediatrician asks if he can just take a quick listen to baby’s heartbeat.  He does so without disturbing mom or baby and then steps back once more.

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Twenty minutes after the birth, as they prepare to transfer mom to her room, Dad gets in on the skin-to-skin.

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Focus on the calm, alert baby.  Do not focus on the bloody gauze behind him.

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Then mom is transferred to her hospital bed via a clever inflatable people-mover blown up with a shop vac.  Fascinating stuff, hospital ingenuity.  Side-note, many nurses wrap hep-locks in Glad press ‘n seal wrap so they won’t get it wet in the shower.  Necessity is the mother of invention.  

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The hospital bed returns to mom’s original room where she will stay until she goes home.  There are no recovery or postpartum rooms at Greer.  There is no nursery either.

Mom gets down to the first order of business.

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I don’t attend many cesarean births.  I’m honored when I am invited to a planned cesarean as part of the team.  Many thanks to this sweet family for sharing their positive birth experience with the community.

Another family-centered cesarean birth is featured here.

Doulas as pacers

Truth?  Sometimes I’m baffled by my work as a doula.  I’m confused by the mystery that my presence makes an impact.  Especially when I don’t *do* anything.

Take Julia’s birth.  I left Julia’s birth feeling like her three year old did more than I did.  I mean, really.  What did I possibly offer to that family?  And then later, Julia’s husband says I was worth every penny.

It made no sense.

Or Melissa’s birth.  I fanned her.  With a manilla folder.  That’s about all I did.  And then later, she says she couldn’t have done it without me.

It made no sense.

I read about the early studies on doula support.  In those double-blind randomized controlled trials, the laboring women had no idea that the extra woman in the room was a doula.  They’d never met before.  Yet, their birth outcomes were significantly better than the births that did not get the “extra person.”

It made no sense.

Nearly 8 years into this gig, I think I’m maybe beginning to understand how doulas work.

We’re pacers.

I’m reading an incredible book titled The Worst Is Over:  What to Say When Every Moment Counts.  I bought the book thinking it would help with my kids.  Norah has an anxious tummy and Cedar is ever catapulting from high places.  I never imagined how it might relate to my birth work.  But, of course, women in childbirth are in an altered state of consciousness just like people who experience trauma.  Childbirth is NOT trauma and not always even painful but the brain does go into an altered state.  Women in childbirth are often dreamy, time becomes hazy, thoughts may be confusing, suggestions plant deeply.  I already knew how important language is for birthing women but this book took it up 10 notches.  And it taught me about pacers.

So what’s a pacer?

You know how you modify your body language, voice, words to become more in sync with others?  It’s a normal part of communication.  Or sometimes a strong personality can change the entire mood of the room when that person is having a bad day.  The author describes pacing as “our natural human tendency to tune in to others nearby by matching our words and our behaviors to theirs.”

The author talks about the importance of pacers when people are afraid, hurting, in shock, etc.  Pacing builds confidence, healing, comfort, rapport, and cooperation.

supportHow does this work in childbirth?

Nancy is deep in the birth zone.  She is in an altered state of consciousness.  She is barefoot in the hospital shower–a state that would disturb her any other time.  Usually a very modest woman, Nancy is naked.  Her husband, in swim trunks, supports her physically in the shower.  What am I doing?  I’m leaning against the wall, offering a sip of water from time to time.  I don’t say a word.  But here is the non-verbal pacing that is happening:  Nancy locks eyes with me as she welcomes each surge.  My eyes are confident, grounded, and full of love.  She knows I’ve done this before.  My eyes tell her everything is normal.  What else?  My posture is relaxed.  I’m not carrying tension or shedding adrenaline.  As we lock eyes, I take a deep cleansing breath and release it slowly.  She mimics me.  I smile.

IMG_2632Sarah sits on her birthing ball leaning on her king-sized bed.  Her husband rubs her back.  Bon Iver plays in the background and the rain is falling outside.  There is nothing for me to do so I sit in the corner and knit.  Sometimes, Sarah looks over at me and I smile.  My calm, slow knitting reassures her that all is progressing perfectly and there is no rush.

Heather’s labor is showing signs that baby is not in an optimal position.  I show her a technique to lunge during her waves.  Her husband stands behind her providing extra support.  I stand in front of her and lunge with her.  We are exactly in sync as we lunge and lunge and lunge some more.

What makes doulas uniquely suited for pacing?

The doula’s focus is entirely on the mom.  Midwives are amazing pacers but they sometimes have other important tasks that may come first or interrupt:  monitoring baby, checking mom’s blood pressure, etc.  Particularly in those rare cases of emergency, it is vital to have a pacer who can remain focused on mom.

Dads, close friends, family members are not always the best pacers.  Why?  They’re emotionally caught up with the experience.  They should be!  I remember catching a glimpse of my mother’s concerned face at my first birth.  It did not reassure me.  Sometimes dad isn’t sure if what his wife is feeling is normal and his face can mirror it.  And the birthing mom’s spidey senses can smell fear and uncertainty.

Giving name to this intuitive process has helped to deepen my understanding of what seems so mysterious–how the presence of a doula-who-does-nothing can be enriching and often crucial to the birth.

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