Category Archives: Birth

Birth Story Part Two: Places Everybody

Where was I?  Oh yes, utterly deflated.  Late Saturday night, we went to Publix to buy groceries.  I had clipped all the coupons already so I had to go.  Right, coupon moms?   Then I stayed up too late.  And went to sleep listening to a Hypnobabies script.  During the night, I felt pressure waves come and go but ignored them.  At 6am, I thought I might time a couple–10 minutes apart.  No big deal then.  I listened to another script.  Around 7:45, Scott brought a warm rice sock and turned on some Fleet Foxes.  What a nice way to wake.

PhotobucketScott singing to meActive Labor

At 9am, it was like someone flipped a switch.  I was making breakfast when the pressure waves went from 10 minutes apart to a very serious 3 minutes apart.  The energy changed and I told Scott I was having a baby today.  I managed to eat my eggs and toast while standing and rocking.  Again, I noticed how much I was thinking like a doula.  What position should I take?  Should Scott sift me?  What about belly-lifting?  Do I need to do the rotisserie?  Argh, the voice in my head!

Then, without thinking, with the next pressure wave, I began reciting T.S. Eliot’s “The Love Song of J. Alfred Prufrock.”  Yes, a poem about a balding man’s mid-life crisis.  Yes, that is the focal point I chose folks.  Not a nice Psalm.  Not a beautiful song.  Not even a poet like Neruda or Rilke.  I could recite to line 22 (“curled once about the house, and fell asleep”) before the wave ended.  I did not feel pain just an intense squeezing sensation.

IMG_8648At 10:35am, Scott wrote in the birth log that I said a horrible curse word.  Friends–brace yourself.  At the end of a pressure wave during which I forgot the words to my poem, I said “Dad-gum.”  Time to get into the birth tub.  Ah, the birth tub.  Bliss.  I could drape over the sides and flip my Hypnobabies light switch to “off.”

Using hypnosis, I totally kicked transition’s butt.  Oh yeah.  Smiling and relaxing, this birth was a piece of cake.  Until at 1pm, I swore again.  Scott notes that I said “Yowzers.”  (Ahem, Kelley are you reading?  I will never pick on you again).

I should interject that Cedar was sounding beautiful.  She was actively involved and had a great heart rate the whole time.  Never gave us a worry.

I began feeling a little pushy.  I was really looking forward to pushing.  My firstborn, Norah, was so easy-breezy to push (although her 32 hour labor was challenging).  I pushed Norah out in 20-something minutes with barely a sound.  Ah, but Cedar.  My first tentative push with Cedar told me something was different.  And I began to fear.  Fear+birth=pain.  What was I afraid of?   Well the doula brain was happy to rush back into high gear and tell me.  I was afraid of a posterior baby.  A nuchal hand.  Tearing.  Having to transport for suturing.  Shut up, thinking brain!

Scott got into the tub at 1:20 and I tried pushing a few times while standing up.  Then squatting.  Both were overwhelming in sensation.  I birthed Norah while squatting and I was barely aware of her descent.  In fact, she took all of us by surprise when she tumbled out in between contractions.  Cedar.  Oh Cedar.  First to present was the bag of waters–yep, still intact.  I felt it with my hand and it was so hard.  Until it broke–nice gush of clear fluid.  Then, I felt Cedar descending like a freight train.  I was on my knees but moved to a knee-crouch kind of position.  Really, I think I was crouched because I was contemplating jumping out of the tub and just running away.  Scott applied counterpressure to my perineum.  I put pressure on my front and around the head.  Wow, the sensations were incredible.  And not incredible like orgasmic birth incredible.  Nope, none of that.  Scott said something later about feeling the energy and power of my uterus.  He said birth should be an olympic sport because of that powerful muscle.

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Cedar was born at 2:18.  Scott caught her and brought her to the surface.  She was not posterior.  No nuchal hand.  And I did not tear.  On my chest, I rubbed her and snuggled her.  She looked so healthy.  And she was.  I didn’t want to look to see if she was a girl or boy.  That took some time.

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After the placenta came, Scott clamped and cut the cord.  No one noted the time but I know Cedar was already nursing by then.  We got out of the tub.  I drank some OJ.  We examined Cedar (heart rate, respiration, temp, etc).  Unfortunately, my bleeding was a bit heavy and my uterus was not clamping down as well as it could have.  So I got a shot of pitocin, took some herbs, and had lots of “fun” fundal massage to get my uterus to contract.

Cedar weighed in at 8lbs 10oz and was 21 inches long.

Then we all went to bed.  And I pretty much stayed there for 5 days.  Snuggling and nursing and being visited by lovely family and friends.  The great Cassandra even came the next day to give me an acupuncture treatment!  And sweet midwives-to-be Carey and Crystal picked up my placenta the next day and encapsulated it for me.  I also discovered how wonderful coconut water is for restoring electrolytes.  More about amazing placentas and postpartum time later.

Fini.

Introducing Cedar Olivia

IMG_8756I promise to post a full birth story in a few days with strange details like how “The Love Song of J. Alfred Prufrock” played into my labor and how my stomach kept growling while I birthed.  And how I kept trying to doula myself–not a good thing.

In the meantime, the important stuff:

We have a girl!  8lbs 10oz.  She was born Sunday afternoon after a comfortable 5 hour labor.  Scott caught her in the water.  Everyone is doing well.  Cedar is such a healthy, strong dumpling.  And a GREAT nurser!

A Great Homebirth Article

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Jennifer Block has written another excellent article on homebirth.  A couple of tidbits from the article: 

The British government, in fact, is now nudging healthy women to stay home. ACOG, meanwhile, likes to pass out a bumper sticker to its members: “Home Deliveries are for Pizza.”

People deeply, deeply believe that a baby cannot be born without massive amounts of medical intervention, and it’s nearly impossible to overturn that cultural norm. There’s something blocking people from operating on the basis of the balance of evidence. There’s much more evidence on the safety of home birth than there is for elective cesarean section or so many of the other things that we do as a matter of course.

Interested in homebirth in SC?  Interview a midwife.

Preparing for a Smooth Hospital Birth

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Each hospital birth I attend is a learning experience.  Here are some common characteristics of the most positive hospital births I’ve attended:

Before Your Birthing Time:

Early communication with care provider:  There shouldn’t be any surprises between the couple and the care provider.  Communicate your desires and expectations early in your pregnancy.  I understand that more and more OB groups are now including multiple care providers and each OB may support different practices.  This challenge is even more reason for you to communicate clearly and ask the question, “Will the other OBs in the group also support ______?”   

Hire an independent doula:  You knew that was coming, right?  An independent doula (one who does not work for the hospital) knows the way hospitals work.  I cannot imagine laboring without the continuous support of a woman who is there only for my physical and emotional support.  Especially for a hospital birth.  Please don’t let financial concerns stop you from interviewing a few doulas.  Find a student doula, barter services, or use your flexible spending account.

Take an independent childbirth class:  By independent I mean a childbirth class that is not offered by the hospital.  I don’t think it really matters which class you take.  Pick one and stick with it.  Childbirth classes are as important for the birth partner as for the mom. 

Pack only one bag:  For the initial admission into the hospital, try to condense everything into one bag.  Triage rooms are tiny.  Leave all the postpartum supplies in the car.  Bring only what is needed for the labor and birth.  You don’t want your nurse rolling her eyes at the first-time couple bringing 5 bags into the room. 

During Your Birthing Time:

Stay home:  The couples I work with who report the most satisfaction in their births are the ones spend most of their labor at home.  Even more reason to hire a doula–she can help you feel comfortable about deciding when to go to the hospital.  At home you have privacy, hydrotherapy, familiarity, nourishment, and power.  My recommendation is once you feel it is time to go to the hospital (unless you are arriving very late in the game), take a moment to take a shower/bath or freshen up.  Use this time to gather your focus and repeat your affirmations.  This can also remove you from your birth partner’s fluster of loading the car!

Stay hydrated and nourished:  Your birth partner and doula should be on top of this task.  I’ve noticed that most of the time, if a confident mom is drinking or eating at the hospital, the nurse usually turns her head.  I remember during one birth, I simply blocked the nurse’s view and told her the mom was drinking some water.  The nurse replied, “Yeah, I can’t see that or I’ll lose my job.”  And that was that.  In this case, it is easier to ask forgiveness than permission. 

Stay cooperative and positive during admission:  The admission process is ridiculous.  The number of consent forms keeps growing.  When you have a pressure wave, simply stop signing forms and focus your attention.  Hold your hand up or make a “shhhh” sign if a nurse continues to talk.  You do not have to be hurried.  Some hospitals allow you to come in before your birthing time to sign forms.  Ask if this is possible. 

Be confident and make the first move:  It is important to present a confident demeanor.  This task can fall on the birth partner if it suits his personality.  The birth partner should make the first move when the nurse arrives (once you’re in a room and know who your nurse will be).  He should introduce the birth team–calling mom and baby by name; introducing the doula.  I call this move “disarm by charm.”  The birth partner should also use every opportunity to brag on the mom.  “Isn’t she amazing?” 

Bring goodies:  Nothing like a little surprise to woo your birth team.  Bring at least three gifts for nurses (there could be shift changes or a student nurse).  One nurse told me she loved 5.00 starbucks gift cards since there was a starbucks in the hospital lobby.  This is not bribery.  Oh no, no, no. 

Do not stay in bed:  A great nurse will examine you or perform procedures in alternate positions.  However, if your nurse is not comfortable with this, use the bed for the duration of an exam/procedure only.  If you are being monitored, sit or stand by the bed, use the birth ball, or request a telemetry unit (if available).  Your partner or doula can volunteer to hold the monitor in place for wiggly babies.  In my experience, once you are in the bed, the monitors and blood pressure cuff stay on.  If you would like to lie down, consider using the couch!   

Stay unhooked:  Each time you are hooked up to a monitor, ask the nurse for a time frame.  She will likely leave.  If she has not returned by the time she gave you, unhook yourself. 

Control the mood:  Keep the lights low.  Keep the door closed.  Have music playing.  Massage mom with some lavender oil.  Use a low tone of voice.  If you create an atmosphere of serenity, your nurses and care providers will usually join in.  At a recent birth, the nurse commented on how much she loved coming into our room because it was so peaceful.  She automatically relaxed and lowered her voice.  If your nurse forgets to turn the lights down or shut the door when she leaves, the birth partner or doula should jump on it. 

No one should talk during pressure waves:  Maybe the hospital staff will join in the silent tribute if the birth partner and doula are quiet during mom’s pressure waves.  I’ve noticed that hospital staff can be quite chatty during labors.  Staying quiet during waves reminds everyone to keep their focus on the mom.  The birth partner may “shhh” someone if needed.

Memorize BRAIN:  What are the Benefits?  What are the Risks?  What are the Alternatives?  What does my Intuition tell me?  And what if we do Nothing?

Order a squat bar:  If your hospital has one (or more), request it.  Sometimes it takes a while to find it (and dust it off). 

Have a SHORT birth plan and/or baby care plan:  I think a birth plan can be a positive tool.  Include the names of everyone on the birth team and include the baby’s name.  Keep it short.  Do not include things that are easy to speak up for in the moment–like freedom of movement or minimal vaginal exams.  I recommend focusing on 2nd stage and 3rd stage birthing practices–birth position, routine 3rd stage pitocin, cord care, pushing, immediate skin-to-skin, etc.  These are the times that mom needs lots of support and focus.  Your nurse can help facilitate your birth plan at this point.  What is a baby care plan?  I’ve noticed that it is tough to communicate with the baby nurse in advance.  She often arrives as “delivery is imminent.”  She doesn’t know you.  Doesn’t know what you want.  You can create a simple baby plan and place it in the newborn warmer for her to find as she sets up.  Include the things that are important to you:  immediate skin-to-skin, procedures that should be delayed at least an hour, procedures you are declining, etc. 

When you feel “pushy,” wait:  This one might be controversial.  Things seem to get a little wild in the hospital when it is “time to push.”  If you’re laboring quietly and you feel some spontaneous pushing sensations, try to ignore them or bear down a little.  It is a great time to hang out in a dark bathroom with the door closed.  There is no need to rush the drama that will come.  Sometimes you begin feeling “pushy” before you are fully dilated and you’ll end up with several vaginal exams, instructions not to push, words tossed around like “anterior lip,” and “you’ll tear your cervix.”  You really don’t need multiple fingers messing with your sphincter when you’re trying to release a baby.  If you’re comfortable, lie low and wait until you have the absolutely-can’t-help-myself-hurling-pushing waves to call in the staff. 

Don’t give up the baby:  Finally, your little one is in your arms.  Barring medical concerns, keep the sweetling in arms.  If the well-meaning baby nurse says “let me just take him for…” understand that it could be 15-30 minutes before you get the babe back.  Delay, delay, delay.  Eye ointment, shots, footprints, tagging–these things can be delayed and they can also be done in mama’s arms.  Keep your newborn skin-to-skin as long as possible.  Just say “no” with a disarming smile, of course.

Bravo Canada!

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The Society of Obstetricians & Gynecologists of Canada (SOGC) has announced that OBs should no longer perform automatic c-sections for breech presentations!  And they have planned a nationwide training program to equip physicians in safely assisting at breech births.  Whoa.  I hope ACOG is paying attention.

Some excerpts from The Globe and Mail’s C-Section not best option for breech birth:

“Our primary purpose is to offer choice to women,” said André Lalonde, executive vice-president of the SOGC.

“More women are feeling disappointed when there is no one who is trained to assist in breech vaginal delivery,” he adds.

The new approach was prompted by a reassessment of earlier trials. It now appears that there is no difference in complication rates between vaginal and cesarean section deliveries in the case of breech births

Accepting Your Birth Environment

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Earlier this year, I had a lovely client who was smart as a whip.  She was having her first baby and chose the hospital for her birthplace.  She made excellent choices during her pregnancy–selecting great care providers and preparing for an unmedicated birth.  Then her baby was breech.  A persistent breech.  Every trick in the book and still stubborn breech.  Of course she wanted a vaginal birth.  And we talked about available options to deliver a breech vaginally.  She knew that her current care providers would not deliver a vaginal breech.  She chose to continue care with them, labor spontaneously, and hope that baby might turn in labor.  She waited until the last possible moment for baby to turn (literally about to push) and when baby didn’t, my client had a c-section.  Did my client fight the c-section?  No.  Because she knew going into her birthplace the limitations of her environment. 

If I choose a homebirth, I understand that I’m not going to get an epidural.

If I write in my hospital birth plan that I want a waterbirth, it isn’t going to happen.  In fact, someone might laugh at me.

Some things are what they are. 

When choosing the hospital as a birthplace, it is helpful to understand the culture and expectations of this environment.  Even hospital to hospital, policies and procedures are different.  But there are some basic norms.  In my region, the norms include–no eating/drinking during labor, bloodwork done upon admittance, intermittent monitoring, hep-lock, loads of consent forms, a vaginal exam in triage.  I realize that the patient can decline procedures AMA or refuse consent.  But some refusals, in real life, play out very ugly.  I know.  I’ve seen them.  Do you really want to be angry, defensive, and fighting during your birth?  If you decline a bath for your newborn, it usually isn’t a big deal.  If you decline to have any fetal monitoring, it is a pretty big deal.  You’re in for a bumpy birthing. 

Take the hep-lock.  Not many people go to the hospital for ANY procedure without getting an IV or hep-lock.  My husband had a 15 minute diagnostic procedure at the hospital and guess what?  He got an IV.  Hep-locks give hospital workers quick access in case of emergency.  Is it necessary in a normal birth?  Probably not.  Is it policy?  Absolutely.  Is it your right to refuse?  Sure.  Is it easy to refuse?  No. 

I’m planning for my own birth now.  I am making choices and preparing for what I expect to happen.  Still I realize that I get the birth I get.  If I go into labor at 34 weeks, my experience will be wildly different from what I planned.  If I were to have a cord prolapse, I would not waste a breath questioning a c-section.  We make the best decisions we can in the environment we birth and with the birth we get.   

What I’m encouraging is a sense of reality and compromise when it comes to birth settings.  Most expectant couples do have choices when it comes to choosing a birthplace and choosing a care provider.  Not sure what your choices are?  Email me.  Ask around.  Call a midwife.  Post on a natural birth message board.   

Please don’t get me wrong.  I am all about informed consent.  And my job as a doula requires that I support my clients in their choices (even when I don’t agree).  But my files aren’t reviewed by hospital administration.  I don’t have JHACO or whomever reviews the hospital looking over my shoulder.  Nurses and doctors are human–they want patients to be happy.  They also want to keep their jobs and they don’t want to be sued.  Open communication with your care provider early in pregnancy can go a long way to either smoothing the path to a gentle birth or clueing you in that maybe you need to find another care provider.   

In my next post, I’ll discuss some ways to have a smoother hospital birth.

ETA:  I do not think we should stop trying to change outdated obstetric practices like refusing food and drink to laboring women.  However, I’m not sure your own birthing is the best time to change the hospital policy.

Blessingways

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Please come to our Blessingway this weekend!  We have one of my favorite mamas sharing her positive hospital birth story.  You might remember my post about Emily.  She’s the one smiling through her contractions.  And, her doctor is joining us as our special guest. 

Dr. Keith Stafford will do something really daring.  He’s letting us grill him on all the things we’ve ever wanted to ask about obstetrics, pediatrics, and family medicine.  So come with your questions.

Blessingways are held monthly at Earth Fare on Pelham Rd. from 2pm-4pm, always on the 4th Saturday.  It is an informal group with babies and toddlers crawling about.  Dads, friends, grandmothers–all are welcome.  The purpose of this event is to offer positive birth stories and to provide mindful information to new and expectant families.  We encourage *experienced* families to also attend so that they may share their wisdom with new couples. 

The event is free and light refreshments are served.  There is always a small treat for each expectant woman who attends. 

See you there!

A new mom

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Just in time for Mother’s Day, a new mom met her baby!  Here are the highlights:

  • She spent most of her labor at home listening to good music, changing positions often, walking outside, using water therapy, and resting.
  • Her doctor made a surprise house-call to check-in and reassure. 
  • Her husband caught the baby over an intact perineum–hoorah! 
  • Baby had uninterrupted skin-to-skin contact with his mama.  When I left, he was still warm and snuggled–having never left mom’s chest.

Happy Mother’s Day to a precious new family!

Just another pregnancy update

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img_7711-21I’m 24 weeks or is it 25?  I don’t remember.  I usually cheat and hop over to Jenny’s blog to check–she’s due the same day as me. 

Pregnancy-wise, everything is normal.  Nothing much to report.  My belly seems huge and I feel like I’m carrying high.  No more sleeping on my tummy.  I wish I grew those cute basketball bellies. 

I crave belly-rubs and my friend, Carey, obliges weekly with a heavenly rose-lavender oil massage.  This child is almost always moving which has become irritating at night–it keeps me from sleep.  I was never irritated by Norah moving. 

My only food cravings lately have been swiss cheese and crushed ice.  I continue to drink oatstraw/nettle/red raspberry leaf tea daily.  I’ve added DHA/EPA to the prenatal routine.  Like a good girl, I take my cal/mag before bed and drink some chlorophyll in my oj each morning.  I won some prenatal chewable vitamins which I was super-stoked about.  Until I tasted them.   

Some of you have asked about my birth plans.  I’m not really keen on sharing much online at this point.  I promise to post all the details after Cedar is born.  I will say that I am excited about birthing again.  I’m trying out Hypnobabies since I’m currently training as an instructor.  My one worry is that Hypnobabies is notorious for short labors and I don’t want mine to be too quick!  But Cedar will come as Cedar is meant to come. 

Scott has beautifully kept the gender a secret.  I don’t have a clue or an intuition.

In terms of doula-ing, I have a busy, busy summer ahead!  I have such a diverse group of clients in the next couple of months.  And I’ve already had inquiries about hypnobabies classes this fall.

I had the worst heartburn of my life today while out shopping.  Thankfully, I had some papaya tablets in my doula bag.  I’ve never taken anything for heartburn and I’m happy to report that the papaya worked withing minutes!  I know it doesn’t work for everyone.  But I won’t be separated from it for the duration of this pregnancy!

Currently reading:  Obstetrics Illustrated, Natural Pregnancy Book, The Art of Hypnosis, Holistic Guide to Embracing Pregnancy and Birth, and Eve.                  

Oh, and a fun little book I found at the flea market this week:

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To every season turn, turn, turn

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I witnessed my first external cephalic version (EVC) today.  My client has been trying to encourage her breech baby to turn for 7 weeks now.  And while she and the baby handled it wonderfully, the ECV that she’d hoped to avoid proved unsuccessful. 

In googling all the information about turning breeches, I keep thinking about how I would feel and what I would do with a persistent breech.  Feel:  it would be difficult to keep the stress levels down with the multitude of techniques to try.  Seriously, you could easily spend hours a day trying all the techniques out there.  And it would be difficult not to feel some blame with all the messages of “you must relax and let your baby turn” or “what fears are holding your baby from turning?”  Do:  20 years ago, it wasn’t unusual to birth a breech vaginally.  Now, however, at least in my neck of the woods–I don’t know a care provider who would give it a go.  I suppose I would cross into another state or head to The Farm.

I don’t really know where I’m going with this post.  I guess I have lots of sympathy right now– with all the things to *do* to get a baby to turn.  My head spins and I don’t even have a breech.  I know that this family has only a short time before baby will arrive one way or another.  And I know they have been hard at work trying out all those ways to make a baby turn (including acupuncture, moxibustion, chiropractic, inversion, now ECV, etc).  I’m praying their baby will spontaneously flip soon.   

If you’re interested in ECV, you can watch a youtube clip.