Archive for the ‘Normal Birth’ Category

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!

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Quotes from The Trenches

As a passionate birth advocate, I occasionally begin to wonder if I’m completely crazy. If a lot of the medical profession disagrees with us nutty doulas, then should we even be opening our mouths? Have we gone off the deep end?

I am grateful to receive continuing confirmation from the medical world that what I advocate for is indeed evidence-based, and that I am not obnoxious or ridiculous (at least not because of my beliefs about birth!). Here are some real quotes from nurses and doctors at births I have attended that have brought me great encouragement.

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“We used to turn up Pitocin very quickly, but now we’ve learned that it takes time for the body to adjust to its effects and so we do it much more slowly now.” -OB to mother.

“We break the water far too much these days. There’s no real advantage to it.” -Nurse to me.

“There are two schools of thought about the episiotomy, but most of the evidence does show that it’s better to risk tearing than it is to be cut.” -Nurse to mother.

“You can eat or drink whatever you want during labor if I’m there.” -OB to mother, during a prenatal visit.

“That’s exactly how a birth should go.” -Non-natural friendly OB to mother after witnessing an unmedicated, calm VBAC.

“You can tell your baby was unmedicated because she’s so much healthier [e.g., more alert, less weight loss, no jaundice, better nurser].” -Baby nurse to mother after a drug-free birth.

“I  hate to say it, but a lot of things do happen because of time, not because of medical reasons. I’m not nervous about it taking a while, but who knows what the OB’s schedule is? ” -Nurse during a mother’s labor.

“Studies show that most cesareans happen at shift change. It’s true.” -Nurse to me after a birth.

“A vaginal breech birth can be safe if it’s done under the right circumstances. And you want an older OB who knows how to do it. Most of the younger ones are too nervous to try it.” -Nurse during a discussion about normal birth.

“I would never have my baby there [at our local hospital]. I see what they do there, and it’s crazy. Next time I’m pregnant I’m having my baby at home.” -OB nurse to my husband at a middle school career day.

“Tell your story. So many women wouldn’t even know how to advocate for themselves or their birth. It’s so important that women hear what you did to achieve this.” – Nurse to VBAC mother who negotiated with her OB many times. For example, she fought to buy more time at the end of her pregnancy to avoid a scheduled repeat c-section, to gain freedom of movement, permission to consume clear fluid foods, to keep her membranes intact to avoid a time clock, etc., etc. She stood up for her rights gracefully and respectfully. I believe this is what led her OB to work so well with her, despite his initial resistance. In the end, it was a perfect balance of the family respecting medical opinion and the OB respecting the mother’s desires.

These are just a few examples of quotes I’ve heard that show me I am not alone in my desire for evidence-based birth practices. And it also shows that change is happening, right in my own backyard! I am so grateful for these wonderful hospital staff members who are also striving to change the face of over-medicalized birth as we know it. It may not be quick, and it may not be easy, but one mother, one doula, one nurse, one OB, one midwife at a time, change is happening. Birth is beginning to be seen more and more as a normal event that should be supported, not forced, interrupted, or “rescued.” Keep up the great work- always with passion, gentleness, and self-control.

Pain Vs. Suffering in Labor

Here is Penny Simkin lending us some great insight on pain vs. suffering in labor. What do you think about her points? Anything you disagree with? Agree with wholeheartedly? Enjoy.

Stalled Labor: A Toolbox of Options

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In a stalled labor, you can feel frustrated, helpless, and like you REALLY want that baby to make his way out. You may feel external pressures to “get things moving,” or have family constantly disappointed that “nothing’s happening yet.”  Remember though, a stalled labor in and of itself is not necessarily a problem for mom and baby. But when it happens to you, what do you do?

Here is a “toolbox” of ideas. The choices you make will obviously depend upon your individual situation- medical factors, the mother’s energy, the position of the baby, etc.- but this list will give you a starting point.

  • Rest.
  • Go home.
  • Stay nourished and hydrated.
  • Pick a distraction (movie, music, company, children, etc.).
  • Walk.
  • Climb stairs.
  • Intercourse (only if your membranes are intact!).
  • Use nipple stimulation.
  • Shower.
  • Take a bath (again, if your membranes are intact).
  • Sway, dance, move, change positions.
  • Try lunges.
  • Get on hands and knees.
  • Use a birth ball.
  • Try tricks for turning a posterior baby.
  • Try acupressure for labor.
  • Change the environment if something’s bothering you.
  • Avoid vaginal exams. Sometimes they create more of an emotional hurdle than anything else.
  • Talk through relevant concerns. Strong emotions, such as stress or discouragement, can be enough to stall labor.
  • Wait.  Recognize that this could be an example of a Natural Alignment Plateau, when labor is still progressing but dilation doesn’t necessarily increase. Sometimes a mom can seem to be “stuck” for many hours, only to rapidly progress to pushing after a long wait. Recognize that this could be prodromal labor, or a long “practice labor” pattern. Rest and nourishment are in order in this case. If mom and baby are fine, there is no reason that the baby has to be born right away.

Any other suggestions? Please share your experiences with stalled labor. I love to hear birth stories!

What’s Happening, Part 2 (E.g., “The Mechanisms of Labor”)

Some of you may have seen last week’s animated video displaying a window into the womb and birth canal as a baby is birthed. For those of you who are curious about what you saw (beyond the obvious), here is an explanation of what happens during a vaginal birth.

“Beginning with engagement [otherwise known as 0 station- the baby’s head is low and set in the pelvis] and continuing until birth, the baby engages in a series of actions, called “the mechanisms of labor” or “cardinal movements:

1) Descent– [a.k.a., moving downwards] Begins with engagement and continues as the baby is passed through the birth canal. Occurs due to the downward pressure of contractions, mom’s pushing, and (hopefully) the force of gravity.

2) Flexion– The baby’s chin tucks to touch his chest.

3) Internal Rotation- The head enters the pelvis in a transverse (diagonal) position. When it reaches the pelvic floor, the occiput [top of the baby’s head] rotates to the front.

4) Extension– After occiput emerges from the pelvis, the head extends and crowning occurs.

5) External Rotation (Restitution)- After the head is born, it turns to one side or the other. The shoulders internally rotate. Usually the anterior [front] shoulder is born first, then posterior [back], then body.”

-Taken from Sudharma Birth Services Doula Training, “A Mother is Born: Labor Stages 2 & 3”

Pretty neat, right? It may look like a lot of fancy terminology, but if you read it through, some of these “mechanisms” may already sound familiar to you. Of course, there is always the possibility that for one reason or another, the baby may not engage in each one of these five movements, sometimes causing variations and challenges in the birthing process. However, this series of movements is what will usually happen in a vaginal delivery.

Head back one post to What’s Happening Down There?!? and watch the animation again. See if you can spot all five mechanisms of labor during this video. Remember: descent, flexion, internal rotation, extension, external rotation. Can you see them happen? How amazing the birthing process, and so cool how God designed it to work!