Archive for the ‘Homebirth’ Category

Baby V’s Home Birth Story

My husband and I had our dear firstborn son back in October of 2010. We wanted for him to have a sibling relatively close in age, so we put it in our minds that we would like to have a baby sometime before he was three or so. A summer baby was appealing to both of us since Tim teaches middle school and would have a couple of months off available for “baby mooning.” So last fall we began trying for baby #2, and sure enough, we had a positive pregnancy test at the beginning of October 2012. My estimated due date was June 15th, 2013.

When I was first pregnant with J, we spent a long time researching our birth options and had decided on a home birth. Since we had such a lovely experience the first time, we planned on birthing our second at home as well. A brief period of financial uncertainty lead us to consider a hospital birth (since insurance would cover it), but a good tax return enabled us to pay our midwife in full and continue on with the home birth plans.

The pregnancy was quite different from J’s. I was sicker at the beginning, more emotional throughout, and faced more general pregnancy-related physical challenges. I knew that both the baby and I were healthy, and that this was a blessing I should never take for granted. The most disturbing emotion was a strange unsettledness that I was having a hard time shaking. I was worried about the “what-ifs” of labor, the concerns of mothering two children and loving them both well, the fear of returning late-onset postpartum depression, mild though it may have been.

I pushed off the feelings for a long time, believing in a way it was better not to pay them much attention. But they continued to resurface, sometimes overwhelmingly. In one way, I wanted to fast forward to the birth in order to just get it done with. In another way, I dreaded its coming since I was so nervous about my own mothering abilities.

I realized that I was neglecting to address my fears, and more importantly, I was not taking them up in prayer. I knew it was necessary for me to take time to do this. “Be anxious for nothing, but in everything by prayer and supplication, with thanksgiving make your requests known to God; and the peace of God, which surpasses all understanding, will guard your hearts and minds through Christ Jesus.” (Philippians 4:6-7) As long as I hung onto my fears, I was not entrusting them to the One who authors life and who could give me the peace I so longed for.

As I approached birth, I was reminded that it did not do me any good to worry. I needed to “seek first the kingdom of God and His righteousness,” and know that He would provide exactly what I needed (Matthew 6:25-34). I began voicing my worries to some women I trusted. Looking my fears in the face and talking them through brought both tears and great relief. I knew I was surrounded by prayer, faithful and supportive family and friends, and a skillful and compassionate birth team. All I had to do now was to rest in God’s sovereign hand and prayerfully await the onset of labor.

And wait and rest I did. The last few weeks of pregnancy was filled with more peace than I had experienced the whole time. I didn’t think that the challenges or fears would never actualize, but I knew that God would give me the grace I needed to handle each moment as it came. I took lengthy hot baths, read good birth stories and long passages of Scripture, and practiced breathing and releasing all my muscles. I drank pregnancy tea and ate dates, did the birth ball hula, and practiced squatting and kegels. I tried to mentally remember what crowning felt like and welcome it. I spent one on one time with my son and reminded myself that no matter how difficult mothering can be, the joy of knowing and loving each sweet soul was immensely worth every second of it. And as my due date approached, I finally felt ready.

During these last two or three weeks, I experienced light crampy contractions that would last for an hour or two here and there and then stop. I recognized all the usual pre-labor signs- diarrhea, loss of large hunks of mucus, and just feeling “off.” But the signs never went anywhere. I tried checking my own cervix, and it did seem that there was some softening and dilation occurring. As days went on, I could no longer find a distinct ring of cervix, so I decided that I didn’t really know what I was feeling and I probably was just feeling the vaginal wall. The day before my next appointment, I felt a lot of extra pressure in my bottom and assumed it was the baby “dropping.” I told myself not to get hopeful, and that I couldn’t possibly be significantly dilated. Better to expect nothing than think I had made progress, right?

On June 13th, 39 weeks and 5 days, my midwife, Jen, came to my house for our regular 10:30 am appointment. (Coincidentally, it was also Jen’s birthday.) We had discussed all of my “pre-labor” and she thought it would be prudent to perform an internal exam to see what was happening. Since she lived about an hour away, she was concerned about the possibility of a precipitous labor if I was already considerably dilated. After discussing our options, Tim and I decided that if we were pleasantly surprised by my progress, we would go ahead and have Jen sweep my membranes and see if we could get labor going while she was in the area.

As Jen was checking my cervix, she got a funny smile on her face and said, “Hmm! You’re about 60% effaced… and 5 cm dilated this way… and 4 and a half the other way…”

Five centimeters and not in labor?!? I just started laughing. Tim and I were in disbelief that I was already so far progressed! My son’s labor had been so “textbook,” so slow and steady, that I never thought I would end up dilating without any significant pain or long early labor. We also learned that the baby’s head was already at +1 or +2 station, so he or she was already coming into the birth canal. (Aha. That explained all that extra pressure.)

We agreed to have Jen sweep my membranes (a rather uncomfortable procedure, though not painful), and also decided to try some herbal augmentation to see if things would get going while she was still in the area. She left me some “labor prep” herbal pills and a black & blue cohosh tincture mixed into my morning’s green smoothie.  Off she went to some other appointments close to our home, leaving instructions to call her if I began contracting hard at any point. She would come back to check on me in a few hours.

Within 30 minutes of our appointment’s end- about 12:00 noon- I did begin experiencing some contractions. While they were more powerful than my Braxton Hicks, they were no more painful and were not accompanied by any cramps. They felt like strong waves of pressure that took my breath away, though I could still walk and talk through them. They developed into a pattern, coming about 3-5 minutes apart, but only lasting about 30-45 seconds long. I decided to eat a small but nourishing lunch for energy in case this turned into the “real deal.”

Jen called to check on me, but I told her that the contractions were nothing to write home about. She laughed because that was what I had been saying before- and I was obviously already dilated despite the fact that I wasn’t in pain. She said she would still come after her last appointment for the day.

Around 2:30, Jen arrived. My contractions had not progressed to be any longer or stronger. She observed me for a little while and suggested taking more of the tinctures. She said she would hang out at our house for a while because she “didn’t trust me.” She joked that as soon as she turned around and drove home, she knew I would be calling her in hard labor. Thus, even though we are all of the mindset that we would rather wait for labor to pick up on its own, we decided, given the circumstances, that it was still the wisest course of action to try to give it a little boost. (Plus I wasn’t really worried about any negative side effects of the herbal tinctures like I would be about Pitocin and other drug use.)

Since it was Jen’s birthday (and since J had gone down for his nap), I decided to bake a cake while we waited around for this labor thing to get painful. Too bad I didn’t have any white sugar… or powdered sugar… or cake mix… or frosting. I found a yellow cake recipe that I thought I could make successfully with raw sugar, so I put it together and stuck it in the oven. I searched the internet for a frosting recipe that used honey instead of sugar. We found one, but it turned out to be quite nasty as it called for a large amount of non-fat dry milk. We all laughed at my dismal frosting failure, and Jen suggested she run me to the store for frosting and sugar so that we could consume a palatable birthday cake. (Plus all that going up and down the store aisles might help progress the labor!)

I had to smile as we were going to the grocery store. I thought to myself, How cool is this? Most women’s care providers don’t even know their names without looking at their charts first, and here I am having a relaxing afternoon with my midwife, running errands while I’m in light labor. We selected our items and had a memorable checkout experience with an awkward cashier. (Let’s just say that there was story telling about an internet figure who drinks bottles of Pert shampoo and other household products.) After some laughs, we headed back home.

I was still having the contractions, but I barely noticed them now. I was beginning to feel doubtful that I was really in labor. I felt a little anxious about what we would do if it all stalled out. We decided we would frost and eat Jen’s birthday cake, and then she would check my cervix again.

One slice of cake later, at 5:30 p.m., I was lying on the bed expecting to hear that there had been no changes. Once again, Jen laughed as she performed the exam. “You’re about 80% effaced and 7 cm. Abi, I can stretch you to an 8!”

Eight centimeters and no pain to speak of? I never thought I’d be one of those women- the ladies who I thought of as the lucky ones!

The fact that I had dilated this far with very mild contractions was actually a bit of a concern for us. We knew I would need good strong contractions to help push that baby out- but also to help my uterus clamp down after birth to prevent hemorrhage. (I had experienced significant blood loss after the birth of my son. While it had never gotten out of control, we wanted to avoid a repeat if at all possible.) I agreed to homeopathic pills inserted vaginally to see if that would help move contractions along.

J woke up from his afternoon nap shortly after the exam. We called my sister-in-law, Michelle, and our birth photographer, Emily, to let them know what was happening and tell them they should come in case things moved quickly.

Within a half hour of the homeopathy, I began getting contractions that felt more “real.” They still seemed like early labor. I could talk through them easily, but at least they were mildly uncomfortable. Tim inflated the birth pool and began filling it; I put my pre-made freezer meal into the oven to heat up. Michelle arrived to help watch J, and Tim and I got ready to go for a walk to help progress the labor.

It had been raining on and off all day, and sure enough, it began coming down harder once Tim and I went outside. No matter. I put up my hood, took Tim’s hand, and we began a brisk walk in the cool, wet evening. We remarked that this must be our labor tradition, as we had gone for a walk in the rain through transition during J’s labor as well. As we walked, we began humming and singing children’s folk songs during contractions. I knew that opening the mouth and throat through contractions helped to relax the mother and open the cervix. It seemed to be true- it made the contractions seem more manageable- much like strong pressure waves. I also helped myself through it by acting silly- I went on melodramatically about my cervix opening up like a flower to the sun and softening in the cool rain. Being ridiculous helped me to laugh and stay positive through the intensity of contractions. I think the fast walking also served as a welcome distraction. All of these were my pain management tools as we walked about a half a mile along our road under the trees.

The walk was definitely effective in helping contractions become stronger. During the twenty minutes or so that we were gone, I felt like I went from early labor to transition type contractions. As we neared our return, I could feel the baby pushing down lower. I told Tim that we had to get back quickly, or I would end up having the baby on the side of the road!

We returned to a welcoming house full of warmth and light and cheerful activity. Jen had prepared for the birth by pulling out supplies and monitoring the tub’s filling. Michelle had pulled the dinner out of the oven. Emily had arrived and was ready with her camera. Michelle was surprised by how much stronger my contractions were, and Jen asked me when I wanted to get into the pool. I replied that I was ready when the tub was.

Jen had a quick listen to the baby, and then I went to use the bathroom before getting in the pool. As soon as I sat down on the toilet, I felt that familiar pressure of the baby getting ready to be born. One heavy contraction passed. I tried to get up and another came on quickly. I attempted rising again and a third slammed me back down. I kept humming and breathing my way through them as best as I could. They were right on top of each other now, and I knew I had to make it out of the bathroom if I wanted to avoid a toilet birth.

I finally made it out of the bathroom. Jen asked me if I wanted to wear anything specific in the birth pool, and I told her yes, a sports bra and a tank top. She told me that I might want to go get that on if I wanted it. Yes, yes, I knew that, and I was trying, but I just couldn’t get a break between those contractions… Michelle offered to go get it, and I told her no- that going up the stairs would be good for me. But the stairs stopped me in my tracks again. Each step I tried to take stimulated another hard contraction, and I finally shouted at Tim to “just go!” and fetch my clothes for me.

At last, I got changed and made it into the pool. Jen asked me if it felt any better in the water, and I told her that I thought maybe it did, but I remember feeling disappointed that the water wasn’t hotter. In hindsight I recognized that of course I couldn’t birth a baby into Jacuzzi water temperatures, but it was still a let-down.

At this point the labor became a bit of an out-of-body experience. I kept humming with Tim through each contraction, but I knew that I would have to push soon. I thought to myself, this is why women get epidurals. Can I just wake up when it’s over? It wasn’t so much the pain that was overwhelming as the sheer intensity of it all. My hum turned into a low moan as I felt the baby begin to descend into the birth canal. Before the next contraction began I quickly told Tim, “no more song.” He said, “Okay,” and sat faithfully at the side of the pool by my head. J came in and out of the room a couple of times, wanting to show me a paper butterfly from his bug book. He seemed generally unfazed by my strange behavior, as we had prepared him in advance for the sights and sounds that accompany hard labor. I asked if we had towels for the baby once it was born. Yes, Jen had already done that. I asked if they had a garbage can for me in case I puked. No, but Tim scurried upstairs to fetch one. The doula in me was going through a mental checklist of necessities.

Now I had to keep a low moan sustained through each contraction. “I’mmmmmm gonna puuuuuuuush….” I groaned as I heard myself making those familiar grunty sounds.

“Okay, go ahead,” said Jen. And everyone attended me patiently and quietly.

Oh, what a simultaneously glorious and dreadful feeling it is to push a baby out! There’s nothing quite as satisfying, because you know that you’re almost done and you’ll get to meet your precious new life very soon. But there’s also nothing quite as terrifying because you know there’s just no way around it. You don’t want to do it because you know it’s going to hurt badly, but if you don’t just do it you’re going to remain in this pain even longer. So you have to just buckle down and sweat and grunt and moan and let it happen. With my son, I hadn’t felt an urge to push until the very end. And with this baby, I felt the urge overtaking me without my consent. It was like a freight train, like throwing up-only throwing down.

I was so conscious of everything. I could feel the baby’s descent, and I briefly thought about forcing harder to get it done with. But then I thought, no, you’ll tear. Slow down. It won’t be long. Slow down and breathe. I kept saying, “I’m sorry if I poop!” but everyone assured me that it didn’t matter if I did. (Miraculously, I didn’t.)

There was a sudden sharp pop and gush as my water broke. This was much less pleasant than I remembered it. It wasn’t long before I realized that Tim was in the pool with me. It must be close or he wouldn’t be in here yet. Jen told me gently to slow down.

“I’m trying!” I responded. Then self-doubt flooded me. “Am I doing okay? Am I doing good?” I breathed. (I mentally reminded myself that it should have been, “Am I doing well?”)

“Yes, Abi,” she affirmed me warmly. “You’re doing good.” (She didn’t correct my grammar, bless her.)

And much sooner than I expected, I felt that surreal stretch as the baby crowned- I held it there for just a moment- and oh! The head was out!

“Oh, that’s SO much better!” I exclaimed.

Jen and Tim remarked that there was a lot of hair. Suddenly there was an unexpected sharp pain.

“Whoa!” cried Jen and Tim together. “That’s a hand!” added Jen. It turns out that pain was my baby trying to “swim” its way out with a nuchal hand by its face.

And suddenly Jen was lifting me up onto my hands and knees, saying, “Okay, let’s get you out of the water.” I mentally  jumped to a shoulder dystocia diagnosis, but then just as quickly as I got up out of the water the baby slid out the rest of the way. (It turns out the baby was just about to try to breathe underwater, so that’s why Jen lifted me up. Phew, no major obstetrical emergencies here!) She was born at 7:12 p.m., and I had only pushed for 12 minutes.

I was eager to see this baby, so I sat back against the pool wall as quickly as I could. Tim and Jen brought the child to my chest and covered it with a towel. I admired our new little life, stroking its hair, rubbing in the vernix, quietly saying, “Hello, baby, you’re beautiful.”  Tim leaned over my shoulder and gazed into those bright blue-grey eyes and smiled.

“What is your baby, dad?” Jen asked.

We both realized that in the joy of meeting our child, we forgot to check the gender! Tim peeked up under the towel and announced that it was a girl!

She was still and calm and alert. She had only let out one little cry when she was lifted out of the water to be put on my chest. I was concerned about whether or not she was okay because she wasn’t crying, but Jen assured me that her breathing, heart rate, and color were perfect. She told us that water babies are often calm and quiet when they are born.

J came trotting in, followed by Michelle. (She had been watching him and playing with him in the living room.) He came up to Tim and the two of them shared a great big hug. We showed him his sister, and told him that the baby had come out and it was a little girl! He approached cautiously and looked at her coolly from across the pool. We didn’t force him to come closer- we figured he would do that in his own time. He seemed generally happy enough, however, and went back to playing as we continued to greet our little one.

Our baby girl began rooting, so I took off my tank top and tried to help her find the breast. She latched quickly and knew just what to do! As she was nursing, we watched for any bleeding and checked on the cord. Michelle began calling family members to share the good news.

Probably about 15- 20 minutes after birth, the cord had completely stopped pulsing. We invited J to help cut the cord (this was something we had talked about before the birth). At first he was excited- “With scissors?” he asked. Then when he saw that he had to come up close to the pool and his baby sister to use them, he said, “No thank you!” We laughed and told him he didn’t have to help, and Tim physically separated baby and mama for the first time with a snip.

Thankfully, the placenta came out with no problems, and I lost significantly less blood than I had with J! (I had lost about 900 ccs with him, and only 300 with this baby. 500 ccs is about average for a vaginal birth.) Tim took our baby girl while Jen helped me get to the shower to clean up.

Soon, our new family was snuggled on the roll-out mattress we had brought downstairs for the birth. Jen performed a full newborn exam and pronounced our little girl 8 lbs., 9 oz. and 20.5” long! She had a 14” head circumference, just like her brother. I continued nursing her skin to skin under a blanket while Jen went over postpartum information with us. Afterwards, Tim helped to dress the baby and I in comfortable pajamas. James wanted to have his little sister laid on his belly so he could hold her. He was finally smiling at her and wanting to see her- and he hasn’t stopped since! After warm hugs and thank you’s all around, Michelle, Jen, and Emily made their separate ways home.

Tim and I talked, and we confirmed our name choice for our little girl- I will call her V for the sake of privacy on the blog.

My family came shortly thereafter, and got to meet their new granddaughter- as well as help put J to bed! Unfortunately, Tim’s parents were on vacation with West coast family at the time, but they came in to meet her as soon as they arrived home a couple of days later.

As we reflected on the birth, we were amazed by how different it had been from J’s. His was a steady 14 hours of labor, but V’s was only about 8 hours total. Less than two hours of that had any pain, and only about a half hour at the end was truly difficult. I don’t entirely know why this was (though I have my theories), but I’m very thankful for the experience of an almost pain-free labor.

V has been a true joy to us. We are enjoying getting to know her little personality and learning more about her each day. I am reminded by her birth and life so far that time does go so quickly, and that it is most important to soak up every minute with your children and fill each day with love for them. Before I know it, years will fly by, and they will be grown and gone. If anything, our daughter’s life has increased my love for both her and J deeply.

I am grateful for my wonderful midwife who cared for me physically and personally during this pregnancy and birth. I am grateful for an excellent birth team who came just at the right time and was so helpful to us. I am grateful for a loving and supportive husband- I could never fulfill my role as wife and mother without his patient and gracious help. I am grateful for my two sweet children, who we love more than the world. We are so, so blessed in every way. Praise God for his gracious gifts!

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Lessons from My Second Home Birth

Two weeks ago today we welcomed our second child into the world- a daughter! She was born into the water alert and calm, and weighed in at 8 lbs, 9 oz and  20.5″ long. Here she is on her first morning earthside:

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Isn’t she lovely? 🙂

I am working on typing out her entire birth story, but in the meantime, I thought I would share some things I learned from experiencing labor and birth at home for the second time. These are in no particular order of importance. Here it goes!

1) It’s really important to trust your care provider!

This came out really strongly to me during this labor. As you’ll read once I publish the birth story, we made use of several herbal concoctions to kick start and strengthen this labor. I’ll be honest- as much as I’ve researched pitocin, epidurals, and c-sections, I really don’t know a whole lot about black and blue cohosh and other natural inducers/augmenters. But because I feel very comfortable with my midwife and because I know we are on the same page regarding birth philosophy, I felt comfortable saying yes to her suggestions without going and Googling it during labor.

(Remember, I never recommend blind trust without researching your options first. But there will always be times that your care provider knows more than you do. In this case, it’s better to know that you can trust that they will only suggest what is both comfortable for you and safe for your labor. If you don’t at least know whether or not you have a similar birth philosophy beforehand, you won’t be able to determine this in the midst of it!)

2) Birth works.

More than ever, I am convinced that in most cases, birth works. As Ina May Gaskin is famously quoted, your body is not a lemon.” Yes, there are medical circumstances and health conditions that can change this. Yes, there can be true emergencies. Yes, sometimes you should make use of natural tricks or medical tools to help your labor in some way. Please don’t think I am ignoring these situations. But in the grand majority of cases, when birth and the laboring mother are left well enough alone and relieved of artificial restrictions, it is simple (albeit challenging at times). Your uterus will work, your cervix will open, and the baby will descend and be born.

3) Your mental attitude towards birth is just as important (or even more so!) than your physical preparation.

Deciding to surrender to the birth process and releasing your fears can be even more effective than training your body as a marathon runner through your pregnancy. Yes, physical preparation is important and can help you to deal with the rigors of birthing. However, if you are mentally resistant, you can actually make the process slower, more difficult, or more painful. Adrenaline can slow or stop contractions. Fear and tension can literally close the cervix and hold up the opening that needs to happen for the baby to be born. And fighting the contractions is fighting the work the uterus needs to do, making each one more painful and difficult.

I’ve found that in both my two labors, when I decide to welcome the contractions as a sign that I am getting closer to meeting my baby, they become easier. When I decide to joke about them, or fake smile, or be silly just to distract myself, I am able to relax more and deal with each wave as it comes. I truly believe that accepting the birth process- rather than resisting it with misery- is probably the most effective secret to getting through a natural labor.

4) As goes the mouth, so goes the cervix!

I read Ina May’s Guide to Childbirth for the first time this pregnancy. (What? I’ve been a birth junkie for this long and haven’t read it yet?!? I know, it’s weird, but at least I finally got to it.) While I don’t endorse everything she says, I felt like I learned a lot from reading it. She talks about law of the sphincter in her book- that sphincters don’t work on command, that they are tied into how a person is feeling, and that they work with each other. She mentioned how keeping your mouth and throat open and relaxed helps to open your cervix as well.

I took this to heart and tried singing through contractions this time- and it made SUCH a difference!!! I felt so much more relaxed than I did during my first labor, and it was much easier to deal with the intensity of each wave. I felt like I honestly could call contractions “pressure waves” for a lot of it. I also made use of low moaning vocalization during pushing, and it really helped me to get through it. I think it was much easier than when I was trying to hold my breath and push out my son.

5) Labors can be completely different. 

I knew this beforehand, but wow, what a different experience this was for me compared to birthing my son! You’ll get to read all about it, but here’s a quick comparison:

My son:

  • 14 hours total.
  • No false starts. I woke up to a clear, established pattern of early labor.
  • Slow, steady contractions that gradually increased in frequency, length, and intensity.
  • 3.5 hours of pushing.

My daughter:

  • Less than 8 hours total on the day of birth, and less than 2 hours with any pain.
  • Lots of “false starts.” I got bouts of crampy contractions for an hour or two at a time over weeks. Turns out I dilated to 5 cm before I ever started “real labor,” so I guess they weren’t so false.
  • Extremely mild contractions for a long time, then a precipitous, intense labor at the end. (Had my midwife not already been at my house for an appointment, we would’ve ended up with an accidentally unassisted birth. Had we been planning a hospital birth, I would’ve had my baby in the car en route.)
  • 12 minutes of pushing.

What have you learned from your different labors? Can you relate? Looking forward to sharing more and hearing back from you!

When Using a Kiddie Pool as a Birth Pool

Some people like to rent actual birth pools for a set time frame from their midwife, doula, or a birth pool rental company. While this definitely has its advantages, there are many of us who like to go the less expensive route and purchase a kiddie pool to birth in.

I purchased this pool from Amazon for $29.55 for birthing my second baby. So far, it looks like it will meet my needs very well, and it has really great reviews from other home birthers.

So what should you look for in a kiddie pool when you want to use it as a birth pool?

1)      Depth

The pool must be deep enough that the water will cover your entire abdomen. If it’s not, that negates one of the main points of having a water birth- helping that uterus relax into its work and bringing more pain relief during contractions! My pool is 24” deep, and that seems sufficient for me to sink down in comfortably.

2)      Diameter

Make sure that the pool is large enough that you can stretch out to your liking. In mine, I can sit against one wall and stretch my legs out all the way with room to spare.

3)      Support

The walls must be strong & thick enough to support my weight leaning against them- and remember that your husband, midwife, or doula may be leaning against them at some point too. You want to be able to lean into it during a contraction comfortably. The last thing you want is to lean against a pool wall and start spilling your water over the edge!

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Testing out the wall strength of my birth pool.

 

4)      Comfort

Your birth pool must be comfortable! One thing I really like about mine is that the bottom inflates. It adds a nice layer of padding when I sit or kneel in it. Consider also softness of the walls- I much prefer thick inflatable walls over the stiff walls held in place by water weight. I just think it’s cushier.

5)      Aesthetics

This may be more important for some than others. Some may prefer a calm, plain pool in soothing blue or green. My pool has colorful fish & seaweed all over it! While it might be nice to keep things a little tamer, I’m not worried about the design becoming too much of a distraction during labor for me. 😉 Still though, if looks matter to you, shop for a different pool that will help you stay in your zone a little better!

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Ready to go! Now all we have to do is wait for that baby to come… 

The Best of Both Worlds

One of the most common questions I’ve heard posed by those who oppose home birth is this:

“Which is more important to you- the birth experience? Or the baby?”

It implies that mothers who choose home birth are irresponsible. That they care more for low lighting, eating and drinking, and romantic photographs of labor than having the possibility and convenience of immediate medical care. That they are making the choice to birth at home as a trade-off- “Well, I understand my baby might die, but I really like my house better than that cold, sterile room.”

Of course those women who chose home birth cringe at the accusation. We love our babies just as much as those who chose the hospital. And home birth moms cry out that it’s not just the experience that draws them to home birth-it’s also the medical advantages that home birth offers.  It’s the lowered risk of hospital-based infections, the probability of faster, easier labor, the less likelihood of unnecessary interventions that can cause even more problems. They challenge the idea that the hospital is the safer place to be for low-risk mothers.

And both sides pull out studies. Both sides pull out horror stories or anecdotal evidence to support their own position. It seems that either you risk a life or you compromise your healthy, calm labor experience.

But I challenge you all.

My question is, why can’t you have both a beautiful and safe birth experience in either setting?

Why can’t home birth midwifery be legalized in all 50 states so that it wouldn’t fly under the radar, creating unqualified providers and dangerous birth settings?

Why can’t there be standardized training for those legal home birth midwives so that all mothers can get the safest care available?

Why couldn’t there be traveling OR units for cesareans at home in a true emergency, as one birth blogger suggested?

Why not require OB’s to have more training and experience with completely natural births? How about having to witness some home births before beginning practice?

Why not allow a mother to have a “home birth in the hospital?” All it would require is to allow a mother to labor freely under midwifery care, just as she would at home- only just down the hall from OB’s & the OR as needed.

Why can’t OBs provide the quality and continuity of care that mothers love when hiring a midwife- longer appointments, a holistic view of woman’s health, having the same doctor from prenatals to birth to postpartum care?

Why do money and legalities rule our health care decisions?

Why doesn’t the minority have the same opportunity to birth naturally and safely, just as women have the opportunity to birth with pain medication and/or in a more medicalized environment?

And why can’t these things change?

I know many of my hopes are only far off dreams… things that seem impossible now. But in reality, why not?  Why can’t we live in a world where we can have the option of more natural and peaceful hospital births, or the opportunity for a qualified home birth care provider for every woman who wants one?

Most of these ideas aren’t even on the horizon yet. But hey, a girl can dream, can’t she?

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How to Keep Your Home Birth Tidy

One of the most common protests (oddly) that I’ve heard to home birth is, “I wouldn’t want to clean all that up!” The idea that home birth will leave your dwelling looking as though a murder just happened is actually a myth. You can have quite the tidy home birth- so long as you prepare for it. Here are some tips for you to remember when preparing to have your baby in your own house.

1) Make your bed- really well!

Make your bed in the following order:

  • Put on sheets that you like.
  • Cover it with a large sheet of plastic. Tuck the ends under the mattress, if you can.
  • Put on sheets that you don’t like that you’re happy to throw out.

Then, after the birth, have your midwife strip the top layer of sheets and the plastic off and throw them in a garbage bag. Voila! You now have a clean bed, all ready to snuggle in with your newborn.

2) Purchase a birth kit, or make sure your midwife brings everything you need.

My own midwife had me purchase a birth kit (from Precious Arrows) for about $70 that included everything for the birth that we would need- gloves, cord clamps, chux under pads, a thermometer for the baby, peri-bottle, pads, peri- cold packs, mesh panties, etc. Having these supplies shipped to you well in advance can ensure that your midwife will have the supplies she needs to keep the mess and all procedures managed in an orderly way.

The disposable chux pads are the key to a clean birth. (They’re those giant rectangular absorbent thingers that soak up all the blood and goop that comes with having a baby.) Keep one under you on your chair, on your birth ball, on your bed, or wherever you go. If your water breaks, you can also try a mesh panty and a heavy-flow pad for when you are up walking around without a chux. This should help to keep the drips contained! (Granted, you may have to change the pad frequently, but it will help to protect your home.)

3) If you’re having a water birth, rehearse it once!

Practice filling and emptying the tub once well before you go into labor. All the way. You can read the saga of our attempt to use a birthing tub here in my son’s birth story. It was really rather ridiculous. If you don’t want to read the whole thing, I’ll cut right to the chase- basically, we didn’t test our pump before hand. And we didn’t try to fill the tub. Our hot water heater was apparently empty at the bottom, and the pump we had chosen to empty the pool didn’t work properly- SO we had a tub full of lukewarm rusty water to clean up and a myriad of different jury-rigged equipment laying about to try to get the tub empty- all in the middle of labor. Not ideal, to say the least.

So learn from my lesson. Rehearse your water birth early to identify any problems before your baby is coming. It will make your labor much more pleasant, and easier to clean up afterwards.

Also, make sure that if you’re using your own tub that you get a tub liner. This will really cut down on the amount of clean up post-birth. If you’re renting a tub specifically for water birth, they usually come with these already to maintain sanitary conditions from customer to customer.)

4) Ask your midwife or doula to do a double check before they leave.

Have your birth team walk through the house once to see if you missed anything before they leave. That way you won’t find a mess when you’re by yourself at home for the first time with the baby.

The key to having a tidy home birth is to prepare ahead of time. If you have done this, then any left over mess should be minimal and easy to catch later. Home birth doesn’t have to be a disgusting mess!

Okay, home birth mamas, what else would you recommend doing to keep your home nice and clean for your birth? Leave a comment!

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You, The Consumer.

You are a mother. You are also a patient, or a client, depending on your care provider’s terminology. But, primarily, you are a consumer.

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Most of us don’t think of maternity care in this way- deciding to pay a specific birthplace and provider, rather than just going to the place that’s cheapest or where your friends went. But primarily, you are purchasing a service, not merely sitting under nonnegotiable care.

I am not writing this to undermine trust in your provider, or to encourage being a “bad” patient who is never satisfied. However, I think that there is enough variance in opinions, management styles, and routines among qualified providers to say that it’s fair to search for one who jives the most with your ideals. Let’s look at some examples.

Hospitals & Birthing Centers- First, look at the time limitations of  your hospital or birthing center. For example, our local hospital is the only one in about a 30-45 minute radius that provides maternity care, and only has 16 OB/GYNS who practice there, delivering around 3000 babies a year (at a 36.9% c-section rate). This means that this place is, in the words of several women I know who have birthed there, “a baby factory.” There is nothing wrong with choosing to have a baby there, but the implications of doing so must be considered. When there are literally not enough beds in the mother/baby unit and new moms are being made to share rooms with elderly men in the general sick patient area, you know that the hospital might be too busy. You know you won’t be receiving care from newborn nurses. You know there’s a possibility of  exposing your newborn to strange germs. You know you will lack privacy. You know you will lack sufficient one-on-one care. Yes, this hospital has a good NICU, round-the-clock anesthesiologist and cesarean availability, and a history of generally good outcomes (by American hospital standards), but does the high number of healthy babies at the end justify the means of care in helping them arrive?

Let it be known that not all hospitals are like this. I attended one about 2 hours from me that was much less busy, had only a 21.6% c-section rate, was quiet and calm, and had enough staff that the nurses could pop in whenever mom wanted them. Which of these two hospitals would I rather pay for their services? Certainly the latter.

One must also consider monetary influences on practices. (Before I write this, you must know that I don’t think all doctors/hospitals only want more money! I really do believe that they DO care about their patient’s well being!) It is worth noting that c-section rates are notably higher at for-profit hospitals than at non-profit institutions. Check out this news story for one example of this disturbing trend.

Home Birth Midwives

Time and money are also considerations for your midwife, though not as frequently as a big organization. How much does she charge? Does this correspond to her training and experience? How many clients does she take on a month? What is her back-up plan if she has two women in labor at once? You must know the answers to these questions before you hire her for your birth.

When hiring a home birth midwife, I think the most important consideration is finding out if you are paying for a qualified provider. As much as I support home birth midwifery,you  must remember that there are different breeds of midwife (CNM, CPM, and DEM), and there is currently no standard of certification for direct entry midwives. I’m not saying you shouldn’t hire one (my own midwife was direct entry), but you should make darn well sure that she is qualified to attend your birth before doing so. Find out her training and experience. Where and with whom did she complete her apprenticeship? Does she have references? Does she have a back-up doc?What is her hospital transfer rate, and what percentage is emergencies? What is her relationship to local hospitals? What are her maternal/infant/perinatal mortality rates, and for what reasons? How would she handle a hemorrhage? What equipment does she bring to a birth? Does she practice with legal integrity? I am not trying to scare anyone out of a home birth, but the safety of a home birth has been shown to depend upon the presence of a qualified attendant. Make sure that yours is.

Birth Philosophies– Remember, you are consuming services. Would you pay for a protestant pastoral education at a local college where the professors are Buddhist? Would you go to McDonald’s to purchase an organic beef hamburger? Would you go to the chiropractor’s office for heavy painkillers? No! Of course these are silly propositions.

Yet we do this over and over again when purchasing birth services. You might want a VBAC, but your provider’s successful VBAC rate is only 15%. “Too bad,” you say. “This is where our insurance takes us. I guess we’ll just work with it.” You have to think through how important your birth preferences are to you, and then choose (and sometimes actually pay for) a provider with a similar birth philosophy as you. You, the consumer, are responsible for picking a provider and birth place that support your desires. If you do not, then it shouldn’t be a surprise when things go differently than you’d hoped. Of course there are always aspects beyond your control, but you can make every effort within your power to ensure that you have purchased like-minded maternity care.

It has been said before that most people put more research into choosing a car or a stereo system than they do in choosing a care provider or birth place. Don’t let this statement be true of you. Make every effort to be an informed consumer.

I recently heard one of these statements myself: “If I were at home, my baby wouldn’t have made it.” While tragic outcomes can happen in any location, it is important to remember that one cannot extrapolate hospital events to home birth situations, nor home to hospital. The environments and practices of caregivers are far too different to make a judgement call as to whether or not you and your baby would have survived elsewhere.
I find that one of the most difficult challenges as a doula is knowing when to dispel the myriad of birth myths floating around, and when to quietly listen to a mother’s story without speaking up. There is a time and place for everything, and I am working on knowing the right times for each role. Any suggestions, anyone? Please read the whole post over at erinmidwife.com

erin ellis midwife

A midwife in North Carolina was recently charged with practicing midwifery without a license because her state does not offer licensure for  Certified Professional Midwives (CPMs) and other direct entry midwives.  There was some local news coverage of the arrest and the ongoing efforts of North Carolina families to legalize CPMs.  One of the local news stories included a mother’s birth story from the “If I were at home, I would have died” perspective.

When I hear statements like this I cringe on the inside.  Being a midwife, I hear it a lot.  Women love to talk about their birth stories, as they should; Storytelling is a natural and beautiful part of our collective journey as women and mothers. In the park, at mom’s groups, among new friends, anywhere women gather there are stories of births and babies being told.  When I hear a story being told from the “I…

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