Category Archives: Birth

The Right People at the Right Time

Posted on March 17, 2009 by juliebyers

I had such an unusual birth yesterday.

The mom hired me on Sunday. As in, the day before yesterday. She was beyond her due date, not feeling great about her OB group, and wondering if unmedicated birth was possible with her OBs. She was actually having steady contractions when she interviewed me! The next morning I joined her and her husband for their birth.

She was wonderful! Perfectly uncomplicated labor. She never complained or asked for pain medication. She just did the work of labor. She did ask for endorphins once. 🙂 She and her husband wanted to get to the hospital late to avoid interventions with their OB group. And she had one OB in particular that she hoped was not on call. He was…more on that in a minute. We spent the day at their home.

We arrived in triage at Greenville Memorial and she was already pushing. The triage nurse checked her, told her to stop or the baby would come in triage, grabbed a resident, and ran to the last bed available in L&D. Our nurse, Ashley, was one that I’d worked with before. So we trusted each other. And the best part–her OB was busy with a birth at another hospital, so we got the resident. I told this wonderful man, Dr. Palmer, what was important to the mom–immediate skin-to-skin, delayed cord clamping, no routine third stage pitocin, and vertical birth. He shrugs and says, “That’s fine.” And he remembered and followed her wishes exactly! I don’t think her chosen OB would go for most, if any, of those choices. Yay for Dr. Palmer.

Ashley brought the squat bar in. And this incredible woman pushed out a gorgeous baby girl.

It was as if all the people meant to be at her birth were brought together with such purpose and care.

Oh, and her OB arrived about 30 minutes after the birth to apologize for missing it…

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Posted in Birth and tagged birth story, greenville memorial hospital. Bookmark the permalink.

Brady’s Birth Story

Posted on March 5, 2009 by juliebyers

[shared with permission]

I had not thought a lot about birth before I became pregnant with Preston. All I did think about birth was mainly negative and never in my wildest dreams would I have thought it could be such a positive experience. I think if more women shared their positive birth stories, we would have a different view of the whole birthing process. Before I start I do believe that every woman is entitled to bring her child into this world how she wants to. So here is how Preston entered this world, hope you enjoy it and take something from it.

Tyler and I decided that we really wanted to bring Preston into this world without medication or interventions during labor. We started working with our doula, Julie, who educated us on how to follow through with the birth we wanted. Tyler and I read and read and researched and took classes and met with Julie and asked probably a million questions. We learned how to labor together and different methods to help ease the pain of labor. Finally the day was here!

January 24th, 2009
I woke up with a lot of back pain and just did not feel good. Tyler and I went for a long walk and still the pain did not ease up. Needless to say I spent a lot of time in the bath and having Tyler apply counter pressure to my back. We watched a movie and I tried to sleep but could not.

January 25th, 2009
We called Julie around 6:30 a.m. and she told us to try and get some rest. I got into bed and ended up sleeping for about 3 hours. Thank goodness I got at least that because little did I know I was about to do the hardest thing I have ever done in my life. Julie decided to come by and check Preston’s position (most posterior babies put a lot of pressure on the back during labor causing the mother to have back labor). Julie walked in at 11:54 and my water broke at 11:57. I remember being excited and scared all at once. We were going to have a baby and I was going to meet Preston, but at the same time I knew that I had a big job cut out for me. My labor progressed quickly. Julie wanted to try to see if Preston would rotate, so that he would be anterior and take some pressure off my back. After doing what she called the “rotisserie,” Preston flipped.

Labor was starting to get very challenging and I just kept pacing and had not gotten my rhythm down to get through my contractions. My personality is so independent and I think I can do everything myself but I realized that I needed Tyler and I needed to allow him to help me through these contractions. I finally got into a ritual during my contractions. I leaned on Tyler and held his hands over my face and rocked back and forth. Strange, but it seemed to work. My contractions were getting so intense; we decided to head to the hospital. I have to admit in the back of my head I was thinking that natural childbirth was for the birds and I was wondering what I was thinking doing it naturally! The car ride was interesting, my contractions seemed to be back to back and Tyler was driving like a race car driver to get me there. I think he was a little nervous about birthing a baby in the car. I remember not wanting to hear any noises, it was like I was so deep into myself that everything around me was a big blur.

We arrived at the hospital at 3:30 p.m. and instantly I wanted to push. It was a feeling that was welcomed and one you cannot resist. It is funny how your body just takes over and knows exactly what to do (if you allow it to). We walked in and got into the room and immediately I was pushing. The nurse tried to get my IV in, but she failed because my contractions were coming and I could not help but move. I was exhausted and I really wanted to just rest. I kept thinking if I could just rest then maybe I could do this, but I had to dig deep way down inside me and find the strength to continue pushing. Julie and Tyler were great and really helped me to find the strength I needed to get Preston here. I remember thinking that this was much harder than I ever thought it was going to be, but then I felt Preston start to crown and I knew that Tyler and I would be able to meet our son soon if I could just keep pushing. At 5:27 pm Preston was in my arms and it was the best feeling in the whole entire world. Tyler and I created this beautiful child and all that work during labor was what got him here.

Labor is not easy and it was the hardest task that I have ever done; however it was the most rewarding. After Preston’s birth I felt stronger than I have ever felt in my life. There were many times during my labor where I hit walls and I wanted to quit, but I did not. I climbed them and that feeling is a remarkable feeling. Tyler and I are closer today than we have ever been. Going through the labor experience together fused us together even more than we were before. It took “us” to a new level. Looking back at Preston’s birth it was one of those memories that I will treasure forever. Did it hurt? Yes. Was it hard? Yes. But I learned more about myself and what I am capable of in those 6 hours than I could ever imagine. So childbirth can be a positive experience and I cannot wait until I get to do it again! It is a beautiful part of life and I am blessed to have experienced it.

[I would like to add that Brady made many healthy choices in her pregnancy. She also made the difficult choice of switching care providers and hospitals in her last few weeks to a more natural birth-friendly practioner. When I saw Brady and Tyler at a postpartum home visit, they were beaming with respect for each other and adoration for their baby. It is such a pleasure to watch them grow into a family!]

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Posted in Birth and tagged birth stories, Cornerstone Family Medicine, Dr. Keith Stafford, Greer Memorial, natural birth. Bookmark the permalink.

Cesarean Practices

Posted on February 18, 2009 by juliebyers

I’m going to try to write this post without sounding like I’m on a rant. Deep breath and…

I want to talk about the immediate postpartum of a cesarean birth. First, let me mention, that I’ve only attended cesareans at Greenville Memorial. My experience is limited and what I’ve heard of other local hospitals is just that–hearsay.

What bothers me the most about preparing my clients for cesarean birth is the inconsistency of practices. I honestly don’t know what to tell them to expect anymore. Examples:

1) Sometimes I’m permitted in the operating room. If the doctor says I can attend, then the anesthesiologist must ok it. I receive that answer second-hand from a nurse. Sometimes after I’m already dressed in scrubs, I’m told “the anesthesiologist said ‘no’.”

2) In that case, I’m taken to the mom’s recovery room to await her arrival. Since Greenville Memorial doesn’t permit recovery room “rooming-in,” I stay with mom while dad goes with baby. Recently, however, I was not allowed in recovery at all. Like the anesthesiologist decision, it was at the say-so of one person–the recovery room nurse. In that situation, the mom was left alone in recovery while dad stayed with baby. I learned that if I was her immediate family, the nurse would let me in. I’ve never heard that one before. I wonder if it is written down anywhere?

3) If baby is healthy, he is taken to the nursery where inane people smile at the babies lying alone in isolettes behind the glass. I have so much trouble with this scene. The babies are alone. These newborns are not skin-to-skin with a parent, are lying on their back under bright lights, and are surrounded by unfamiliar open space and smells. Why are people smiling at this? But I digress. The inconsistency is how quickly and easily the dad is able to bust his newborn out of the nursery. Sometimes, it is no big deal. Dad walks over to the nursery door and requests his baby. Sometimes, he is told that the baby must be observed for an hour. Sometimes 2 hours. Sometimes he is told the baby must have a bath first. I’ve actually started suggesting my clients flirt or fib to get their baby. I watched one dad do both! Tip: go to the Mom/Baby info desk, ask for the room number of your wife, then go tell the nursery that you have been assigned a room and need to take your baby to his room.

What logic suggests it is best practice to keep baby alone in an isolette immediately after birth? When every medical journal is promoting immediate skin-to-skin and early initiation of breastfeeding, why this practice? Babies do best in arms. Why do newborn nurseries still exist? Now I’m sure Greenville Memorial has a logistical reason for this practice but I doubt it is based on logic.

What my issue boils down to is this: how your baby is handled after a cesarean birth is often determined by one person’s whim or mood.

Another example: one of my clients wanted the baby to be placed skin-to-skin on her chest following her cesarean. She and her doctor discussed how that would work. Everyone agreed. Doctor exited. OR nurse entered. She said “absolutely not. the OR is too cold for skin-to-skin.” And so ensued a tense discussion that ended with a sour OR nurse influencing much of what subsequently occurred in the OR and in recovery.

In some hospitals (even St. Francis), families remain in recovery together. In some hospitals, babies are routinely placed skin-to-skin on mom immediately and in a few hospitals, permitted to nurse in the operating room. I’ve heard of one Australian doctor who encourages the mother to “birth” her own baby during cesareans. He delivers the head and then guides the mom to pull the baby to her chest, cord still uncut. I’m not sure how the whole sterile field issue is handled in that situation. The point is that there are ways to make a cesarean birth feel more like, well, birth.

Step 4 of the Mother-Baby Friendly Hospital Initiative is to initiate breastfeeding within one hour of birth. And while I’ve had one client who nursed her baby immediately after leaving the OR (before baby was removed to the nursery), this is not the norm. On average, for the cesareans I’ve attended, the delay has been more like 2-4 hours.

And in case you’re wondering why breastfeeding within the first hour of birth is so important, here are a few reasons:

1) Mom’s body regulates the baby’s body temperature.

2) Baby is less stressed, calmer, and has steadier breathing and heart rates.

3) Baby is exposed to bacteria from the mother which are mostly harmless, or against which the mother’s milk contains protective factors. Mom’s bacteria colonizes the baby’s gut and skin. These compete with more harmful bacteria from health providers and the environment, and so prevent them from causing infection.

4) Baby receives colostrum which, among many other protective factors, stimulates the baby to have bowel movements so that meconium is cleared quick. This helps get rid of the substances in the baby’s body that produce jaundice and may help reduce it.

5) Touching, mouthing, and sucking at the breast stimulates oxytocin to release in the mom. Oxytocin causes the uterus to contract which may reduce maternal bleeding. It stimulates other hormones which cause a mom to feel calm, relaxed, and “in love” with her baby. And finally, it stimulates the flow of milk from the breast.

6) Mom experiences joy. The process of bonding is strengthened.

If you had a cesarean birth or attend cesareans, what has been your experience? What are the practices like at other hospitals?

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Posted in Birth, Blech, Breastfeeding and tagged cesarean, greenville memorial hospital. Bookmark the permalink.

Gaining Confidence from Labor

Posted on January 14, 2009 by juliebyers

I wanted to share (with permission) two beautiful pictures from a recent birth. Emily’s first birth left her feeling disappointed by all the interventions that were used and lack of support surrounding her. We talked about how a natural birth does not mean you have to grit your teeth and just suffer through it! For her second birth, she chose to stay at home for most of the labor. Here she is in active labor experiencing a contraction.

Yes, she is smiling. I have many more pictures of her smiling through contractions. She said to me, in between the waves, “Each contraction I go through and stay calm, I gain confidence.” And she pointed out that this experience would become a wonderful memory to savor.

Soon, we felt it was time to head to her birthplace. She paused a moment before rising from the tub to gain even more confidence from her labor.

Emily had been adamant that she did not want photos of her labor. I’m so glad she let me change her mind!

Beautiful.

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Posted in Beauty, Birth and tagged Birth, labor. Bookmark the permalink.

Work Blunders: A Year in Review

Posted on January 7, 2009 by juliebyers

The top 3 most ridiculous things I’ve done or said as a doula in the last year. WARNING: may not be for the weak-stomached and if you’re a current client, you might lose complete confidence in me.

1) I chased a placenta down a hospital hallway. It was almost midnight and I hadn’t had anything to drink or eat since noon. The client asked me to take her placenta home so she could get it later. Staggering under the glaring lights, I walked into the hall holding my birth ball, doula bag, and odd tupperware-like container of placenta. I dropped the container which then rolled an enormous distance past the nurse’s station. I dropped my bag and ball and bounded like a toddler after the container much to the amusement of one OB and several nurses. Thankfully the container remained closed. Could have been a disaster.

2) I made up a story about marshmallows. I had a client who seemed to respond well to mental imagery during contractions. I was doing ok at first with the usual “Imagine you’re in the center of a field on a breezy day…” Then, after so many of those, I went blank. She was lying on white sheets with fluffy white pillows so I said something so embarrassing like “You’re climbing a mountain and when you get to the top, you realize you’re on the edge of a bowl of marshmallows. And you spread your arms and fall into them. Smell the powdery sugar.” And if the image wasn’t bad enough, the client followed a kosher diet and I couldn’t remember if marshmallows were kosher! It was awful.

3) I wiped meconium poop with one hand while eating chick-fil-a with the other. I was starving. And the glorious saint of a dad called his mother to bring me a chick-fil-a sandwich. It didn’t arrive until the mom was pushing so it got dropped in the shuffle. During the birth, my entire chest got covered with amniotic fluid. As soon as baby was breastfeeding, I grabbed my sandwich and started munching. Then baby pooped on mom’s hand. So, wearing a saturated shirt and with my half-eaten sandwich in one hand, I used my other hand to clean her up with wet wipes. A few years ago, that scene would have really bothered me.

It was a good year.

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So you want to be a doula

Posted on December 30, 2008 by juliebyers

I frequently encounter women who say “I think I’d like to be a doula.” I get that. For those of us who love birth, what better profession to choose than midwife, l&d nurse, doula?

It does sound like fun–emotionally and physically supporting couples during one of the most important moments of their lives; being invited to witness such a stunning event. And it is. I love being a doula. It is the best job I’ve ever had. But…let me also share the reality of the profession. Just like any job, it has challenges. And I don’t think I really thought about these challenges before jumping headlong.

Looking over my births this year, the average amount of time I spent with a client in labor was 12 hours. So while that means I may have had one four hour labor, I also had a couple of 20+ hour labors. And I have no way to predict how long I will be gone when I kiss my toddler good-bye. And I bail on my friends all the time. Choosing this profession means that I commit to my clients that I will be with them through their labor. I look at it this way: What would it feel like to a mom who has been laboring 15 hours for her doula to leave? To call in a replacement?

I’m on call. Enough said. Ask my husband how he feels about that one.

I have a list a mile long of friends and family who can care for Norah. I regularly interrupt their lives with sentences like this “Hi friend. So I have this client who might be in labor. If she calls me before 6am, Scott will take Norah to person A. But if she calls after 6am, can I bring her to you? Oh, and I don’t know who will pick her up or when.”

My job is to support women who are feeling discomfort. For hours. At 4am, when I’ve been there for 10 hours already, I do sometimes question why I’m doing this.

Doulas must be physically lithe. Seriously. I contort into bizarre positions to apply counter pressure to a woman laboring in a tub. I crawl around on the floor, hold women carrying an extra 30lbs in a supported squat, climb on top of hospital beds, and let my hand be squeezed…really hard!

: Somewhere around hour 13. I kept sliding backward as I applied counterpressure.

We need to have strong stomachs and gracious hearts. I’ve been kicked in the face, covered with amniotic fluid, and I’ve cleaned up lots of poop and vomit. While I’ve not yet been cursed at, I have had a birth ball thrown in my general direction.

Sometimes (though not too often), the rest of the birth team doesn’t want you there. Sometimes nurses don’t like you. Or sometimes, the client’s family resents that you get to be at the birth instead of them.

Doulas must hang in there emotionally. It is hard to not get distracted by discouragement, hunger, the need to pee, conversations between nurses or midwives, a husband asking when are you coming home, or just fatigue. Our intuition is key and for that we must stay alert and in the moment.

Finally, after the joy of birth (which of course makes all the work worth it!), it is hard to leave. After the postpartum care is over, it is difficult to suddenly not see this family you’ve worked so closely with over the last weeks or months.

I’ve worked in non-profit, corporate, education, and ministry. Doula work is by far the most difficult. And the most rewarding. I take my definition of doula as Jesus and early Christians used the word: slave. The One I most want to emulate was described as emptying himself and taking on the form of a doulos–the male form of doula (Philippians 2:7). What better role model?

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Posted in Birth, Doula and tagged Doula. Bookmark the permalink.

Dr. Polo Shirt Makes a House Call

Posted on December 7, 2008 by juliebyers

I’ve had a wonderful streak of unmedicated hospital births lately. Strong mamas and papas who were prepared and thoughtful about their births.

I learn so much from each birth. My latest birth was unusual–days of prodromal labor, slow progression with intense contractions. We were laboring at home when Dr. Polo Shirt (you’ve read about him before here and here) stopped by the house to see how we were doing! What a great encouragement to this family for their doctor to step onto their turf, validate their progress, and then leave them to their privacy to continue laboring.

[Let me interject here: if you are pregnant, live in the area, and are planning a hospital birth, you will not find care like this anywhere else. I won’t promise you’ll get a house call, but I do promise you’ll be surprised by the personal care you’ll receive. I’ve seen many doctors in the delivery room. Trust me.]

I won’t go into all the details of this birth but I’ll sum up with: beautiful baby, happy mama, and proud papa.

I’ve also loved that all my recent births have involved immediate skin-to-skin contact with babies left on mama’s chest for at least the first hour. That sounds like such a reasonable request but sometimes it is so difficult to get in the hospital setting.

Now I’m lounging beach-front at Hilton Head. Lazing the days away for a little while. And I must turn off the ‘puter to take my tot swimming!

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Posted in Birth and tagged Cornerstone Family Medicine, Dr. Keith Stafford, unmedicated birth. Bookmark the permalink.

Elizabeth’s Hypnobirth

Posted on November 16, 2008 by juliebyers

[Shared with permission]

On February 18, 2008, I donated blood at the local blood connection. I randomly asked the phlebotomist, “What happens if you give blood and you are pregnant?” The response was, “You may miscarry?”. Well, you can guess that I took a test the next morning, February 19, 2008. I took a pregnancy test at 6:30 am, 7:30 am, 8:30 am, and 9:30 am. Interesting they all said that same thing, pregnant. I told my husband that night by putting a pregnancy test in the bottom of a chocolate tin. I told him I had something sweet for him. What an exciting time! We are going to be parents.

On June 9, 2008 we found out we were having a girl, wait, no a boy. The technician was in training and misread the ultrasound initially. Yeah, a little drummer boy. What a blessing to see a life growing inside you. Every precious flutter, kick, and roll made me more aware that I was going to be a mommy.

We had a lot of decisions to make. One conversation was taken care of for us, finances. On March 7, 2008, we became debt free thanks to prayer and God’s gift of teaching to Dave Ramsey. The next were labor options and support. We wanted no medical intervention so I needed to find different ways to deal with the pressure waves of labor and delivery. We tossed around the idea of a birthing doula for some time. I loved the concept, but pride stepped in. My independent self didn’t want any help. My husband, the free spirit, stated that you only give birth once to this child and the doula would help us both, especially him. He had a great point since I was more nervous about his response during labor and delivery than my own. Luckily I had a friend, Julie Byers, that is a doula so I automatically felt comfortable. I also wanted to integrate hypnobirthing. My employers contract psychologist, Dr. Wood, did sessions with several fellow employees that swear by this self-hypnosis technique. You use your natural instincts to bring about a safer, easier, more comfortable birthing experience. Hypnobirthing is incorporating deep relaxation techniques where some mothers report little or no pain. Dr. Wood is very limited about what clients he takes on, but prayerfully I was one of them. Last was our OB and hospital. In the beginning we put no thought into where to birth and what doctor, but after seeing five of the OB’s at Highlands Center for Women and taking the Greenville Memorial tour, we were very troubled. We received a negative vibe with these places because they advocate medical intervention and we were afraid that our birthing plan would not be carried out at these facilities. My doula recommended Dr. Stafford and Greer Memorial. I was nervous about a male doctor since I had never seen a male doctor and I was also nervous about the drive to Greer in the urgency of labor. After much prayer and research, we felt a peace that we cannot explain so we decided to change facilities.

The due date was set for October 24, 2008 and when that date rolled around and no baby, we became very disappointed, but what a time to reflect on God’s goodness. We were taught patience and trust as this little baby was 13 days post due. On the night of November 5, 2008, I was admitted to the hospital and was scheduled to begin the induction at 6:00 am on November 6, 2008. I kept telling everyone, that he would come on his own. My husband and I prayed and prayed he would. I was told if I went into labor before 6:00 am, they would cancel the pitocin. At 5:30 am, I started having contractions at 4-5 minutes apart lasting a minute. I told Russ to call our doula. When they checked me, I was at 4 cm. The pitocin was canceled. Thank you for answered prayers and what timing, thirty minutes before the dreaded pitocin.

What an amazing gift we have in our bodies. God has equipped us as women with everything we need to give birth. It is not a medical emergency, but a natural process. I learned to trust my body that day. I never stayed in the bed. I moved around the room, laboring on the birthing ball, in the tub, hands and knees, and even on the toilet and leaning against the rods in the bathroom. I learned to trust others that day. My support team was amazing. My husband stood by me the entire time. He sensed my needs through every pressure wave. This time of intimacy was like no other.

Our doula, was there to lead us through everything. She was very knowledgeable about natural labor and delivery, hospital procedures, and non-medical interventions (counter pressure, aromatherapy, etc). Julie would continually encourage us and the staff to stick to the birth plan. My doctor, Dr. Stafford, was like no other doctor. He is aware of the normality of birth and really has his patient’s best interest in mind. He encouraged me while I labored and pushed. He even helped hold me up while I pushed in the squatting position. He stuck to our birth plan and made sure that the nurse did as well. The nurse, Tammy, was great even though you could tell she was out of her comfort zone as she is used to her patients having an epidural, pitocin and staying in bed. She was open to our needs and that is what patient care should really be.

After 9 ½ hours of labor and 40 min of pushing we welcomed Elijah Russell Chapman to the world. He weighed 7 pounds 15 ounces and was 20 inches long. He was beautiful, perfect. What an honor to be trusted with one of God’s children. I experienced a feeling like no other that day, instant love.

Special thanks to all the people who helped make this experience perfect. You will never be forgotten.

I hope I do not offend anyone by my birth story. That was not my intention. The great thing about being parents is you have the opportunity to make your labor and delivery however you wish. You have to decide what is best for you and your baby. We all have the same goal and that is a healthy baby. We may just arrive there differently.

In awe of the gift of life,

Elizabeth

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Posted in Birth, Pregnancy and tagged birth story, Cornerstone Family Medicine, Dr. Keith Stafford, greer memorial hospital, hypnobirthing. Bookmark the permalink.

Pregnancy, Power, and Parenting

Posted on October 30, 2008 by juliebyers

I spoke yesterday at an Attachment Parenting Forum. The topic was how choices in childbirth were related to the first AP Principle: preparing for pregnancy, birth, and parenting. I joined a forum with a midwife and two childbirth educators.

In my classic style, I did not prepare at all. I had no idea what I was going to say. So I was pleasantly surprised when coherent words came out of my mouth. And I was even happier that when I finished speaking, I agreed with what I had said. Sounds schizophrenic, yes? Welcome to my public speaking technique.

I said that one of my primary roles as a doula is to guard power. I don’t care what kind of birth my clients choose or end up having; my concern is that they retain their power throughout. They are not bullied or undermined. They have informed consent. They understand and claim responsibility for their birth. The power of pregnancy and birth springboard us into confident parenting. When our friends and family question our AP methods or on a sleepless night 5 months postpartum, we question ourselves, we can draw on the strength and trust learned through birth.

Parenting is not rocket science. It is much harder. It calls for something more than mere instruction manuals. It demands an inner strength beyond anything else. Those 9 months of pregnancy and however many hours of labor and birth can lay a firm foundation for our parenting; particularly when our choices are questioned at every turn.

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Posted in Birth, Doula, Parenting, Pregnancy and tagged attachment parenting, Doula. Bookmark the permalink.

Inexplicable Ways

Category Archives: Birth

The Right People at the Right Time

Brady’s Birth Story

Cesarean Practices

Gaining Confidence from Labor

Work Blunders: A Year in Review

So you want to be a doula

Dr. Polo Shirt Makes a House Call

Elizabeth’s Hypnobirth

Pregnancy, Power, and Parenting

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