Sunday, February 7, 2016

4th Natural Birth - Story by Jenny Hardison - The day that Axel was evicted

Axel means "Father of Peace".
But "Peace" was the furthest thing I was feeling that day.
I remember the day, like it was yesterday. My husband came home from work with his usual, "how was your day?" question as he walked through the house tripping over puzzle pieces and blocks scattered across the floor, crunching old crackers under his feet as he navigated his way through the screams of 3 small toddlers excited to see their daddy while bouncing off the walls of our 1500 sq ft home.  
In this particular memory we were standing in the kitchen and I did not answer his question at all.

I just looked at him.


I went to reach into my back pocket, but before I could reach in and pull out the positive pregnancy test he GASPED!
"OH MY GOSH! YOU'RE PREGNANT!" He shouted. "I KNEW IT," he said!. And then he said something like, "I was just thinking four kids wouldn't be so bad."
What? Was he excited about this? Four kids wouldn't be so bad? What was he talking about? How in the world did he know I was pregnant? I didn't even know I was pregnant. I was in pure shock. This dumb little test had two extremely dark lines on it but I was convinced it was a mistake. The test must have been wacky!

Because this whole conversation was wacky! Why were we talking about this anyway?

It was just weeks ago we had celebrated our daughters 3rd birthday and our twins 1st birthday. How could he be excited about another one and how in the world did he already know about this?
I quickly began to think that he must have had something to do with this.
I threw the positive pregnancy test at him as he smiled from ear to ear. I wasn't sure I liked how happy he was about this. And when I accused him of having something to do with this his response was:

"I better have had!"

I should not have been embarrassed, but I was, as I wheeled my 3 itty-bitty's into the store to buy a pregnancy test earlier that day! At least my husbands response was so much better than the check out clerks response! She looked at my cart full of kids and looked at my purchase and asked me if I knew what caused babies.

And for the next 7 months I was in shock and maybe a bit of denial.

You see, I had just gotten down to a size 4! A size 4 people, after having twins! It was a huge accomplishment and back in my running shoes regularly and I was finally feeling that with the twins turning one I was ready to take care of myself again. I had cleaned out my closet of all things "maternity" and the thought of wearing another pair of maternity jeans made me want to gag!

I also had just given all of my baby stuff away in hopes that the twins would grow up faster than they should have.

You see, I loved being pregnant and I loved my babies more than life itself, but mentally I had just checked out of the "baby-stage". I had just finished nursing the twins and I mentally thought I was done. I had a 3 year old and two 1 year olds. How could I have another baby?

Not to mention we had just downsized our house. Two months prior we had moved into a smaller house to save money and here I was pregnant? I had 7 months to wrap my head around being a mom of 4 kids under the age of 4.

That's right, I said 7 months.

This was the shortest pregnancy ever for me.

Not because he was born early. As a matter of fact, he came late. It was the shortest pregnancy for me because when I finally realized I was pregnant this baby already measured larger than two months along.

I didn't really know when my due date was so when they gave me a due date of late January based on his size I took it and went with it.
But let's just go ahead and fast forward to February when this baby still had not been born.
My belly was just as large, if not larger than when I was pregnant with the twins less than two years prior. Someone seriously asked me if I was pregnant with triplets.

Is that even a question people ask? Bypass twins and "Hey, are you pregnant with triplets?"

My doctor was losing patience with me too. He did not want me to go further than a week past my "made up due date". Especially with this baby measuring as big as he was.

But here is the thing...

I really wanted to "go into labor" with this baby on my own. Like I REALLY wanted to. I hadn't asked for this pregnancy, but since he was here and coming I wanted a chance to "go into labor" on my own that I didn't have with my other two births.

I was induced with Pitocin when my first daughter was born because my water had torn and was leaking before labor was even close to starting.

Then with the twins I scheduled to have my water broken so I could get labor moving along. 

So I was determined to go into labor without being induced...
I spent days running up and down our basement stairs with toddlers in my arms for added weight. I bounced endlessly on our exercise ball (also known to some as a birthball) with a toddler on each leg and one clinging to my back as we watch Curious George reruns. 

It was February 2nd and while everyone was tuned into the TV to see if the groundhog saw his shadow and we'd have 6 more weeks of winter, I was only focused on one thing: trying to get this baby out of my womb.  
My husband’s alarm when off that Saturday morning at 5:00am. He planned to wake up and go swimming early before the kids got up.

But I had other plans.

I wanted this baby out weeks ago. And while my husband casually  joked with me that the “baby-getter-outter” was the same as the “baby-getter-inner”, it was no joke to me.

Not today anyway.

And while that "baby getter-in and baby getter-out" had not seemed to work yet I figured I’d try and try again until it did. 

Needless to say he never made it to his swim class and my contractions started almost immediately.

Eventually we got up and took the kids to Costco to stock up on some food for the third week in a row. I'm not kidding when I say that I thought this baby was going to be born three weeks ago! So every week I'd go stock up on groceries and make freezer meals with the anticipation that he was going to be born and then I'd never get to the store again with a new baby and 3 toddlers in tow.

After Costco, we stopped at the bike shop like every mom of three about to burst out a fourth child should do.
The shop owner asked me if I was going to have the baby on his shop floor.

I was not alarmed by his question. In fact at this point I'd gotten completely used to every stranger I ran into asking me some personal or rude question about my pregnancy, my body, my baby, my family, or my business.

I had been asked that very question for the last 4 years. Since I've been pregnant for what felt like an eternity, but actually has only been 4 short years with 4 amazing children!

I knew I made people uncomfortable.

Especially men.

They saw how enormous my belly was. And it was huge. Unnatural looking really. And they couldn't help but stare as my enormous belly got thrown about while I chased three small toddlers. I'm sure all they thought as soon as I lifted one of my 30 lb kids up I might drop a baby out in front of them! And honestly, I wish I would've.

I eventually stopped paying attention to everyone around me unless spoken to.
But one afternoon when we took the kids to the Nature Center, I noticed a man staring at me and the kids. I said to my husband, "we need to get out of here that man is creeping me out. He keeps staring at me and the kids". My husband busted out laughing. He replied with, "have you looked at yourself lately? Everyone stares at you and the kids."
I loved being pregnant. But I was also tired of being pregnant. And I'm certain the world was tired of looking at me pregnant.
I smiled at the shop owner and said “Yes, It is possible considering his due date was last week. But he hasn't fallen out yet so I doubt he's coming now.”

He gave a little laugh and said, “Yeah, after having 3 you probably would know if he was coming.”

The truth is I did know he was coming. I was certain he was coming. I was hiding the intense contractions I was having all day and I hid the one I was having during my conversation with him.
I had not let on to anyone that I had been having intense contractions all day.

We got home and put the kids down for their nap.

And as I sat down to rest for a bit myself I felt my contractions slow down.

It had been 2  days earlier that I woken up with timed contractions minutes apart in the late night. I fell asleep only to wake up four hours later  to absolutely not one contraction. I was in tears that they had stopped and I called my doula right away. She told me that was my body getting ready and it would be any day now.

Her exact words were, "Jenny, no one has been pregnant forever, Axel will come soon". And I found those words so comforting because moments before I was certain I was going to be pregnant forever.
There is this strange pressure from people everywhere when you are pregnant that your baby isn't being born fast enough. My doctor refused to let me go a week past my due date before inducing me. My nurse told me every time I walked in for a check up that I was huge and needed to consider inducing. Friends and family constantly asked when my due date was and when it passed it was like the pressure from them just felt really intense. And then it seemed like people I didn't even know were asking me why I was still pregnant.

"Waiting" for this baby to come on his own was beginning to lose it's appeal as the pressure from all the people around me made me doubt that he ever was going to be born on his own.

But I was determined to go into labor on my own with this one.
As the kids napped, I decided I better not let my contractions slow down. I called for Paul's help as he rarely says no to an opportunity and didn't say no to this one. He didn't exactly say yes either, but without agreeing,  he agreed.  I was serious about getting this baby out today. 
It was now 2:00pm and my contractions were as intense as ever and they were now regular about every 15 minutes. Maybe the baby-getter-outter was actually working. 
I was however, not ready to acknowledge them just yet nor tell anyone about them. After having timed contractions two nights earlier 3 minutes apart that never intensified and dissolved after four hours I was not about to jinx this.

I left the house just after 3:00 to pick up my mom from the airport. I had several contraction now that were getting closer together but again, deep down I was worried they were going to go away so I didn’t want to get anyone excited, including myself. I hid them and ignored them the best I could. When I saw my mom, I lightly joked that "today could be the day" and deep down I was hoping I was right.

I decided I’d run errands with my mom before heading home.  I figured if I kept moving the contractions would keep coming. And it was easier to handle the contractions if I was busy doing other things rather than concentrating on the pain.

I saw a friend as we pulled into the parking lot of Target and we chatted through the car windows and right through a piercing contraction.

Later in Target a ran into my daughters friend and her dad. We chatted and I still wonder to this day if he noticed me squeezing the box of diapers in my hands as I was in the middle of a contraction during our conversation.
When my mom and I finally made it home, all the kids greeted her with pure joy and excitement. They love seeing their grandmother.

I began putting groceries away and started making dinner.

It was close to 5:30 and as I sat the kids down and began to serve their plates, I realized that I wasn't able to hide my contractions any longer.  I grabbed hold of the counter with a hot pan of lasagna in my hand and began to moan only that moan a pregnant lady in labor can do.

My mom and my husband looked right at me and both said, "Are you ok?" And then very dumbfoundly said,  "Are you having a...contraction?"
I think I finally was coming unraveled after an entire day of contractions.

"YES!" I shouted, "That was a contraction!!! I've been having them ALL DAY."

If I could've inserted something like, "you idiots", I would've.

Because something happens when I go into labor. I get sarcastic and a little passive aggressive. I was annoyed no one new I was having full blown contractions, and yet, I had worked so hard to hide them from everyone all day, including myself.

The kids started to get so excited. My mom started to get so excited. And I was just glad it was out in the open now and I was ready to to get this over with.

I knew what to do and was I was ready to do it.

There was no way I could show my mom where everything was so she could hold  down the fort while we headed to the hospital. My contractions were minutes apart and I was in noticeable pain and out of breath. I called our trusty babysitter Emily to come help my mom and then immediately called my doula, Wendy, to let her know this baby was coming.

My doula advised me to stay put and she was on her way to the house to help me time the contractions and labor with me until it was time to head to the hospital.  

My contractions were so intense. They were moments, sometimes seconds apart. I felt like I needed to get to the hospital. right away. So Paul and I got in the car and I called my doula back and told her to meet me at the hospital instead of coming to the house.

I hung up the phone and with out warning I began to cry. Uncontrollably cry.
I cried because I was in so much pain.

I cried because I had been in so much pain all day and was holding it in.

I cried because I had been hiding it from everyone and I finally felt that I could release it.

I cried because I felt free to be in pain and for the first time that day I could show someone else I was in pain.

I cried because I finally let myself know it was OK to be in pain.

I cried because I knew in the next minutes or hours I was going to meet this baby.

I cried in excitement to hold this baby boy in my arms.

I cried because I will never understand the miracle of life.

I cried because I was overwhelmed with the thought of a beautiful baby.

I cried the entire 5 minute drive to the hospital.

Paul foolishly tried to pull the car up to the labor and delivery roundabout at the hospital to drop me off. I gave him that look like you've got to know me better than that. The tears were gone and now I meant business.

I made him drive out to the furthest parking spot he could find so I could walk and carry my own bags figuring the walk would help push the baby down more and keep things moving along. I wanted to walk into the hospital, get checked in, have the nurse look and say, "wow, you're a 10 and he's coming right now!"

But that of course did not happen.

I got checked in and my Doula arrived within minutes with her exercise ball in hand just like the previous two times she was with me for my births. She had her hair ties and headbands and her soothing voice and she right away summoned a nurse to bring me a cup full of crushed ice.

She reminded me to stay focused, keep my moaning tones low as not to scare the baby and she immediately began to rub the wrinkles out of my forehead telling me to relax and let my body to the work.

This was not our first rodeo together. Wendy was my Doula when Lucia was born and when the twins were born.

I give all the credit to her and my doctor and some really amazing nurses for why I was able to have Lucia and the twins natural, unmedicated, vaginal and without an epidural. And I while I was really hoping to accomplish the same thing with baby number 4, I also knew in my heart as long as we all came out on the other end alive and healthy nothing else really mattered.

So without any introductions we both got to work.

I was beyond thrilled when D'Neil walked into my room. I wanted to kiss him. He was my nurse when Lucia was born and he was fabulous. I couldn't have planned it better for him to be working that night and to be assigned to me. 
But then they gave me the discouraging news that my doctor was not on duty that weekend and a different doctor would be filing in for him. My doctor had delivered Lucia and the twins. He knew me and how I labored. He knew my birth plan and I didn't want someone I had never met before delivering my baby.
I wanted to cry.

My doula assured me that she knew the doctor on duty and I had nothing to worry about. I was relieved, but noticeably disappointed.  I began to scheme a way that I could get D'Neil and my Doula to deliver the baby before some unknown doctor I had never met showed up to take over. 
But  just as I began to morn the loss of my doctor not being there a nurse with an angel's halo ring glowing around her head came in and with what sounded to me like an angelic singing voice said sang these words: "they were able to get a hold of your doctor on the phone and even though he is not on duty this weekend he will be here to deliver your baby."

A sigh of relief came over me.

I was now ready. 
Until I felt disappointed again.

I really thought I was going to be 8-10 cm dilated when I arrived after all the intense contractions I had all day and now they were seconds apart.

Nurse D'Neil delivered the disappointing news that I was barely 5 cm and that I'd likely be there for a while. 
But here are the facts:

I checked into the hospital at 6:30pm...


Axel was born at 8:53pm.

So here is what happened in the next two and a half hours.

When I got the news I was barely 5 cm dilated I knew I had some work to do and I wanted this baby out so I was prepared to do whatever had to be done.
I squatted.

I yelled.

I pushed.

I walked.

I laid down.

I cried.

I squatted more.

I walked more.

I pushed more, I yelled more, I creid more.

And I took a lot of deep breaths in between.

I listened to my husband and my doula remind me over and over and over to focus and keep calm and get my composure together.
I told my nurse D'Neil that I was ready to be checked again because I was certain I had progressed.

He looked disappointed as he told me I was only about 8 cm. I felt disappointed too.

But he had a plan. He said, "I might be able to stretch you to a 9 during your next contraction." He shrugged his shoulders and said it in a tone like he knew I would never agree to that.

And well, he looked shocked when I shouted with more enthusiasm than anything to "please, please, please, stretch me to a 9 because I want this baby out."

My next contraction did not bring me to a 9.

It brought me to a 10.

Which also brought great panic in the laboring room.

The nursing staff frantically tried to get my doctor on the phone.

It looked like D'Neil was going to be delivering this baby after all.

The doctor on call wasn't even at the hospital, so they brought in an assistant for D'Neil and everyone began prepping the room for delivery.

A nurse came in and said that my Doctor was on the phone. He was out for an evening jog and as soon as he could get to his car he'd be there. His orders were for me not to push until he got there. 
I hate it when he says that. 
He told me that when Lucia was coming and when Lochman almost fell out of me.

"Whatever you do, don't push until we are ready"

Dumbest words ever.

And honestly, at this point I didn't care if he was there or not. I didn't care who the assistant was or if some new doctor came in to deliver this baby. I didn't care if D'Neil delivered my baby or if the baby just fell out and someone caught him.

I just knew I wanted this baby out. Because he was coming out no matter who was there to deliver him and there was nothing I could do about that or anyone else. 

D'Neil got the stirrups out and kept reminding me not to push while putting my legs up.
In my most sarcastic laboring voice ever I told him someone should put pepper up his nose and tell him not to sneeze. 

But in all honesty, I did try to wait. I tried not to push and I began to think how I had been laboring this whole time and it had not occurred to me until now that my water had not broken. I began to imagine this baby being born completely encased in his amniotic sac. It is very rare, but does happen and is supposed to be a sign of good luck or something.  
And just as these images of my baby being born in his amniotic sac began to fade from my imagination I yelled at D'Neil that I a contraction was coming and I had to push.

D'Neil got on his baby-delivering-gloves  that looked like normal blue gloves, and sat down right in front of the baby's crowning head.

And right at that moment my doctor swung open the door and walked in the room. A nurse opened up a hard shelled case where these oddly superhero-looking-gloves came out of and she put them on him one at a time. They were skin tight and as I watched them go on one finger at a time I began to imagine they had superhero baby birthing powers and the distraction of it all caused my contraction to pause. 
I couldn't think of anything witty to say about his yellow-skin-tight-superhero-gloves so instead I told him that I thought it was nice of him to show up. He did this with my other births, walked in right when the baby was already crowning. So I also mentioned that I thought he should change his name to Nick because it was ridiculous how he always arrived "just in the nick of time".

He laughed, sat down where D'Neil had gotten up from and told me I was now allowed to push whenever I felt the next contraction coming.
I felt it.

I pushed.

And with that one push I felt a massive explosion.

My water broke. It went everywhere. Well, my eyes were shut tight and so I didn't exactly see where it went, but I envisioned someone shaking up a soda can rapidly and then popping it open and I was pretty sure that is what had just occurred. I believe there was amniotic fluid on the ceiling. I squinted my eyes open just enough to see my doctor wiping his cheek.

He laughed and without mentioning the massive explosion he said, "great job, Jenny, the babies head is out! Now I need you to push again to get his shoulders out."

Was he serious? In my previous birthing experiences, I pushed once and when the babies head was out the rest of the baby just slid out...what was he talking about I needed to push again to get the babies shoulders out. He must be crazy.

But sure enough I could see Axel's head resting in the palms of my doctor's superhero yellow gloves.

So I pushed again.  
And again, my doctor said, "Great job Jenny! You got one shoulder out. Now I need you to push again so we can get this babies other shoulder out."
You've got to be kidding! What in the world was happening? Was this baby ever going to come out? I really began to think they were going to have to stuff him back inside and then I was going to be the first person to ever be pregnant forever. He was going to be the groundhog baby who saw his shadow and went back inside for another 6 weeks.

I was almost mad at the baby. But per my doctor's orders, I pushed for a third time. And that is when my doctor guided my hands down under the babies shoulders and let me pull the rest of him out. My doctor let me do this with Lucia also. What an amazing feeling.

Photo Credit to my Doula Wendy Robertson

And in that split second I was so completely overjoyed. It is a feeling that is completely indescribable. I brought my baby up to my chest and kissed him over and over and over and over.

He was perfect. Axel was perfect.  
I looked at this baby covered in blue and red and swollen in the face from being born so quickly and I thought to myself is it really possible to love him so much. And I was overwhelmed knowing this love I felt was just a hint of how much God loves us. 
Photo Credit to Wendy Robertson
I delivered Axel's placenta without much thought or warning because my attention was all on my beautiful baby in my arms. My doctor worked the blood in the umbilical cord toward the baby before directing Paul where to cut it. And while my doctor checked to make sure I didn't need any stitches, I thanked him, made a few jokes about his name and then spent the next two hours holding Axel and feeding him before anyone took him for his vitals.  Those first few hours of his life with the exception of his first weigh in were mine and Paul's alone.  

When they did his "quick" weigh in before I fed him, it wasn't as quick as I wanted.

He was 9lbs and 4 oz. They weighed him twice to be sure, then checked the scale and weighed him a third time. He apparently didn't look like a 9 lb baby so everyone was confused...that was until they measured him. He was 22" long.

The babies nurses they couldn't remember the last time they had a 22" baby born there. Lots of 21" babies and a few that made it close to 21.5" but never a 22" baby that they could remember.

Paul asked our babysitter to stay a little longer so he could bring my mom over to meet Axel. Axel was only minutes old when my mom got to see him. Of course I made her wait a few hours to hold him since I wanted him all to myself.

He was finally here.

My “Father of Peace”.

My Axel Andrew.

The kids came the next morning and spent hours with us.

Monday, November 22, 2010

Breastfeeding - From National Breastfeeding Month (Oct)

This is a wonderful article on Breastfeeding - from the perspective of the breasts... In honor of National Breastfeeding month (which I missed, I think it was October which is also Breastcancer awareness month).

Saturday, October 30, 2010

Prodromal labor - start and stop, start and stop...

A friend and very pregnant mommy, just wrote this post. It's really good.

Red Light, Green Light…A Tale of Prodromal Labor
October 30th, 2010 | Author: Ashley Sparks

I am not a very nice person these days. Just ask my poor husband. I mean, I try to be, but when you feel as though your uterus has declared war on the rest of your body, it’s kinda tough to be Little Miss Sunshine.

There is a term that, unless you have taken natural birth classes (Lamaze doesn’t really count, and we will discuss why another day) or birthed with a midwife, you are probably unfamiliar with. It’s called prodromal labor. Unfortunately, most OB’s and L&D nurses are quick to mislabel this “false labor” or, even worse “failure to progress”. It is neither. First, anyone who has experienced it or seen it will be quick to tell you that there is nothing false about it! Second, progress of some kind is indeed happening, but it just may not be the measurable progress on the timeline that women have somehow been pigeon-holed into as ‘normal’. In reality, ‘normal’ has been narrowed to such a small window that almost no one fits it, which is why we have so many interventions happening. I can show you ten different women with ten entirely different labors and all of them would qualify as normal. We have just forgotten what normal looks like because we no longer give it the opportunity to happen.

Prodromal labor is a funny thing. For some women, this phase of labor may last a day or two. For some particularly lucky women, like me, it may last for weeks.

Basically, your uterus is working hard, and you know it, but the docs may not see the cut-and-dried quantitative results they want to see. During prodromal labor, the types, intensity and regularity of the contractions are widely variable. Some women have what feel like intense Braxton-Hicks contractions with no real pattern for a day or two and then begin “active labor”. Some women have very time-able, regular, labor contractions that will reach regular intervals and then fade apart and die down. This may happen several times over a few days or a few weeks. And, of course, there are many different patterns. Some women will have regular contractions and Braxton-Hicks intermittently between the regular contractions. Some will have one episode lasting several hours and then go into active labor a few days later. Some women will have stop and go episodes for a week or two – or longer. The variations are endless. There are several reasons for this type of labor to happen.

Your baby may not be in great position and your body may be helping baby get into a more favorable position for birth.
Your cervix may be posterior and the contractions may be helping to ease your cervix into a better position.
You may be effacing or “thinning out” which is just as critical as dilation.
You may actually be slowly dilating. I’ve heard of women doing this up to as much as six centimeters!
As you can imagine, this particular type of labor can be very, very draining. It can drain you physically, emotionally, and mentally. Physically, this is the equivalent of lifting a weight every few minutes for hours, days or weeks. After a while, you would get pretty darn tired! Emotionally, you may find yourself getting discouraged, wondering if you will ever really go into labor, and wondering if you will have the stamina to make it through the ‘real thing’. You might feel helpless, frustrated, overwhelmed, angry, impatient, and just generally upset. This is the hardest part for many women. Finally, you may struggle mentally. You may begin over-analyzing every contraction for it’s duration, intensity and frequency. You may begin giving yourself ultimatums, or even doing your best to get labor going by any means necessary. You may start searching the internet for a magical answer to when you will go into labor… I mean, I’ve never done that, but somebody might… ok, I totally have. But the point here is that prodromal labor is very real and very hard to deal with. This is one of the reasons that women often give in to induction, pain relief and even cesareans – because they are just plain exhausted.

Here at the Frazzy house, prodromal labor has kind of been our nemesis of late. My husband has already come home once thinking that this was the real thing and that was two weeks ago! And I’m not even a first time mom! My Bradley teacher has a saying “Labor is a retrospective diagnosis. Once you are holding the baby, you can say ‘yep, that was labor!’” Oh, how true that is!

So, as far as my personal situation, here’s where we are: I am apparently really good at this prodromal labor thing. I have been having the stop and go labor for several weeks now. At one point I was having contractions every 3-4 minutes, over a minute long, for over and hour. Then…it stopped. Just stopped. No slowing down and gradually spacing out. *sigh* Since then I have reached five minutes apart and over a minute long several times, but they keep backing off. Now, I know at one point Baby Bug was decidedly posterior, so I am certain that these episodes have helped her to get into the position she’s in now. I’m sure other things are happening, but since my GBS (Group B Strep) screen came back positive, I am not doing any more exams until I hit active labor. Even then, they will be minimal to reduce the risk of transmission to the baby. (I have another post ready about GBS that I will put up later this week.) So at this point, I am just trusting that my body is doing what it is supposed to be doing and that it’s all for the best. Someone may need to remind me of that if you see a tweet that says something like “I think I might jump off of the roof if I have one more episode of this!” or ”I’m going to choke the next person who asks me if I’ve had the baby!”. Don’t take anything I say personally, I’m just a little on edge. I’ve outlined the reason for that in pretty good detail here. However, I apologize in advance for any ‘tude I throw out there! I promise, it will be over by Thanksgiving at the latest!

Posted in Baby #2, Midwifery, Natural Birth, Pregnancy

Tuesday, October 5, 2010

Home Birth and Midwifery in the News...

There have been several articles in the news lately regarding Birth, Midwives, and Out of Hospital Birth, specifically Home Births.

This year the CDC released a report on births, and they have seen that Homebirths are on the rise.
"The number of Alabama families giving birth
out of hospital without regulated maternity care providers is
increasing faster than the national average." In AL the rise was 18% compared to 3-5% nationally.
Jennifer Block wrote an article about a study (a very poorly done study), that said HB is 3 times deadlier than hospital birth... This is part of what she had in her article...
*The medical community calls home births unsafe, but recent large studies comparing home to hospital show why women with uncomplicated pregnancies would choose the former: They are much more likely to avoid the complications of surgery or tearing, they are more likely to breastfeed, and they are happier.

...Meanwhile, rival journal The Lancet took the study at face value, publishing an editorial under the headline “Home Birth—Proceed with Caution,” with a stern warning: “Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk.”

“That was really offensive,” said Marjorie Greenfield, M.D., a professor of OB/GYN at Case Western Reserve who submitted a letter to The Lancet along with several other physicians. “But you know, I can understand, because there’s such a deep, deep belief that it is unsafe to have a baby at home. I used to believe that! But when you look at the good studies of home birth, there’s no difference in baby outcomes, and probably improved outcomes for mothers.” Still, she added, “most people I work with think it’s self-indulgent and risky.”

Last week here in Alabama we had families from all over the state gather in 7 cities and we Walked for Midwives, in an effort to help bring awareness to the issue, and to garner support. The Alabama Birth Coalition is trying to help get legislation passed to allow and License Certified Professional Midwives.
Here in our fair city... we caused a stir!

In response to this -
The President of the Alabama Chapter of the American Academy of Pediatrics wrote an article

This was then written in response to the article:
*The president of the Alabama Chapter of the American Academy of Pediatrics displayed his woeful ignorance of birth, midwifery and the current proposed legislation to provide Alabama women with birth options.
I urge people to learn the facts and then educate him on the topic.
This is the official response from the Alabama Birth Coalition to the specific article written by Dr James C. Wiley.
They make sure to explain that ABC is not trying to get licensure for untrained 'lay' midwives, but are seeking recognition and licensure for Highly Trained and skilled Certified Professional Midwives.

Things have certainly been heating up... Now if we can just get the law passed here in Alabama, so many mom's would be so happy, and planning for their births would be so much nicer as well!

Wednesday, September 29, 2010

A Metaphor for Breastfeeding...

A friend on facebook posted this link.
It is a wonderful 'description' of breastfeeding. In it this mom breaks it up into phases to describe it. I will say that I think she describes the potential pain as lasting a bit too long, but I know that some mom's do have various issues that cause it to be a little rougher than others. I do encourae mom's to 'get help' so that they can correct whatever may be a bit off (I'm NOT saying you are dong something wrong, it can even be a physical issue of your baby's mouth, or whatever, but it helps to get that issue 'fixed') so that you can move on with confidence and comfort to the next phase. Even then... it's is so worth it.

Her description of the nursing relationship and then the time of weaning almost made me cry. Very nice writing.

I do think back to those days sometimes; it's been 2 years since my 'baby' weaned, at 2 1/2 yrs... and I miss them. It is sad when you know that a very big part of your life, is over forever... It was time to move on, but oh... this message reminded me of all those memories, from each of my 6 babies, and I miss it a little bit.

Enjoy -

A pregnant friend called last week. We talked about co-sleepers, and pants with expandable waistlines, and what types of excretions to expect during labor. As we said goodbye we made plans to speak again soon. “Next time,” she declared, “I want you to tell me what nursing is like.”

I hung up the phone with a mission. I was going to come up with the ultimate breastfeeding metaphor. This was a friend who had been with me throughout every step of my pregnancy, she listened to my freak-outs, brought me crackers when I felt nauseous and offered feedback on my endless lists of three-syllable baby names.

But then I moved, and now we live in two different cities, we don’t have the daily contact that we used to. We’ve lost touch. I wanted to give her something spectacular to make up for the distance; something that would paint a perfectly perfect vision of the bonding, and the sensations, and the mechanics of it all. Like the way Shakespeare summed up the journey of human existence simply by saying” All the world’s a stage, and all the men and women merely players.”

Like that…but with boobs

Try as I might every attempt turned into a horrendously epic run-on sentence. I could not distill the experience into a concise statement. There was no metaphor that would capture the many phases I went through as a first time nursing mom. I decided I’d make a list- sort of like the “ages and phases” stuff that baby center offers the expecting parent.
It would be my Eriksonian attempt at capturing the mammary glands in all their glory.

The first three days - were like puberty. I was massively sweaty and my shirts were way too tight. My breasts felt suddenly powerful yet completely overwhelming. I cried all the time.

Days 4-6 – were like assembling a bookshelf from IKEA. I knew if I could just get the DANG positioning right it would all come together. I looked at diagram after diagram and it appeared so easy in the pictures. But each new attempt left me bruised, demoralized, and frustrated.

Days 7-18 -were like S&M. The pain was so bad I wanted to puke but I went back for more every two hours. Many people told me that my experiences did not sound normal; they speculated that perhaps there was something very wrong with what I was doing. They suggested I seek professional help.

Days 19-50 – were like learning the guitar chords to your very favorite song. It was hard, there were blisters, but they weren’t too bad; certainly nothing that would stop me. Each day it got easier. Eventually the blisters were gone, my hands moved with ease, I just knew what to do. I could finally experience it, like a song. I felt so proud, I felt like telling everyone, “Do you see this! Check me out. I’m going to do this everywhere. I’m going to do this right in your face! I’m a total rock star!”

Fifty-one days to two years – were like one amazing conversation. Like the kind of chat that leaves you knowing everything about someone. The kind that ends with you staring into someone’s eyes and feeling like the entire world is being held somewhere in-between your gaze.
Two years to two years, four months- were like the last two hundred pages of a very good book. I slowed down, I paid very close attention, I did not want it to end. I was not sure what would happen after I finished. I sensed that I would feel a little bit empty.

The other night was like saying goodbye to a very close friend who suddenly has to move.

After stressing over whether or not to finally wean my daughter, she announced while nursing, “Mommy, your boobies aren’t working any more.”

And just like that, the entire experience shifted



The distance.

edited for language

Tuesday, September 21, 2010

Perineal Massage, Episiotomy, Perineal Support...
This link is to a story lied further down my rambling post and the purpose of this post. Please check it out.

When I had my first baby I was so unprepared in so many areas. I remember reading about episiotomy and thinking I did NOT want that.
So, there I was in labor, and in the overseas hospital I was at, they did a partial shave, which I thought odd, then all of the sudden I noticed the OB coming at me with a large pair of scissors! I remember screaming -in my head- STOP! No! Don't cut me! and more specifically, "Can you just give me a minute! I'm in the middle of a contraction!"

Being the 'good little patient', I said nothing, and the cut was made. Granted, I didn't particularly feel it at the time (he did what is called a pressure episiotomy - when the pressure of the baby's head is there during crowning, the tissues have a sense of numbing, and so you don't actually feel the episiotomy, and you don't need to have a local anesthetic, until they stitch you up). After the birth however I had very bad swelling, pain and tenderness. I learned that they had done a Mediolateral episiotomy, which in fact do cause more swelling and pain than a midline episiotomy. Mediolateral Episiotomy is common in Europe, where the cut is made at an angle into the labia, rather than straight down into the perineum. The theory is that if the mediolateral cut tears further, it will not end up in the anal sphincter, like a midline episiotomy can have a tendency to do.

With my second baby, I did not have an episiotomy, and would have been fine, if I'd been allowed to listen to my own body as I pushed. However, this Dr. -a tall man- tilted the bed, up and back, so that I was literally pushing up hill, and then I was being yelled at, with counting and pushing, and counting. I had a minor labial skidmark/tear, probably only because of the small size of that baby... but I had a lot of bruising and postpartum pain from the way the birth was 'managed'.

The most helpful things that I personally have had that helped to stretch the perineum, was the use of Warm compresses during pushing with two of my babies. The moist warmth helped soften and stretch the tissues and helped me to feel my body to be able to push slowly and ease the head out, and caused less stress and trauma to the tissues of the perineum. The other thing that was a helpful thing as well was having waterbirths. My level of postpartum discomfort/pain from birth was dramatically different and lessened after the use of warmth and moisture.

As a labor doula I have witnessed many births where the OB or even the nurses employed the use of 'perineal massage, or more often I've heard it called 'Ironing out' the Perineum. I have watched as this very vigorous, intense 'massage' is done during the pushing stage of labor. I have watched the tissues swell and subsequently tear during the birth of the baby's head or shoulders, and in one case, before the head was even crowned, just due to the ironing out of the tissues. Some Dr's have commented when I have had clients/patients ask about this procedure/process that the Dr. had for a period of time stopped performing this 'perineal massage' and reported that they had an increased incidence of perineal tearing, so they had gone back to the massage/ironing out of the perineal tissues during pushing. What I have have witnessed is that nearly EVERY single mother that has had this done, has torn and needed stitches after the birth.

**********************************************************************************The link tells detail about what this is like.

There are directions for perineal massage, it is to be done prenatally, and can potentially help the tissues stretch during birth.
Then at the birth the mother can massage and help ease the tissues as the baby is born. Some people swear by it. I tried it for one birth, where my caregiver performed the massage, NOPE, that was not for me! However during my waterbirth, I instinctively reached down and eased the tissues around my baby' head. No tearing or cutting and no need for stitches.

I have witnessed a few hosp births without a mother tearing, one even that the Dr. was pushing very hard to perform an episiotomy, "because the mother was going to tear horribly", and the mother refused the cut and birthed her baby, amazingly, over an intact perineum! I have only witnessed one or two episiotomies. I have seen many a mother however birth in an out of hospital environment, and when she is supported, births in an upright or hands and knees position, listens to her body, pushes when she feels the need, not because she is being yelled at to push to a count of ten... mother after mother birth their babies, over intact perineums! The average is 8 lbs or over. I've seen mothers birth 10 and even one 12 pound baby, without even a skid mark, let alone a tear! Yes, I've seen a few tears at OOH births as well, but the way the birth is watched, supported and guided is so different from the managed way of birth in hosp. it wasn't for lack of trying, and few OOH have been as severe as the one's that I believe are caused by the way of birth and perineal massage/ironing, that is used.

I love to have a warm pot of water filled with a bag of healing herbs that I can put cloths into and then use for perineal support. I think it helps the mother.

I have desired to start a dialog about this practice of the 'new episiotomy',for a long time. I'm glad that someone has written about this. Lets get more dialog going, and try to let birth be a more gentle process, no matter your location.

Thursday, September 16, 2010


At Alliance for the Imporvement of Maternity Services (AIMS) you can find this great resource to help you with


Prepared by Doris Haire, President

American Foundation for Maternal and Child Health

Below is a wonderful article on how to get what you want, with lists of things to be aware of and to ask for to get the birth you want.
(I have added bold or italics some of the things in the list that I think are really important).

A good childbirth experience should be happy and gratifying, as well as safe. You are much more likely to have a good experience if you establish early a good communication with your physician or midwife. Sometimes it is the expectant parents who must take the lead in establishing a rapport, but don't let that hold you back. It's your childbirth experience. It's up to you to let the doctor or midwife know what you want. If he or she is not in agreement with your wishes, it is far better to find that out while you still have time to shop around for a doctor or midwife who does agree with you.
Most of the common practice patterns employed in the obstetric care of an essentially healthy pregnant woman and her baby have not been shown to be in the best interests of the woman or her baby. Unless there is a medical indication for the procedure there is no scientific support for routinely:
a. confining the mother to bed during labor and birth,
b. placing an IV or saline lock,
c. shaving the mother's pelvic area or administering an enema,
d. chemically "ripening" her cervix or inducing labor,
e. artificially rupturing the amniotic sac,
f. administering analgesia or regional anesthesia (epidural, spinal, pudendal, etc),
g. prohibiting the mother from eating lightly and drinking fluids during labor,
h. placing the mother's legs in stirrups for delivery,
i. performing an episiotomy or proctoepisiotomy,
j. directing the mother to bear down longer than 5-6 seconds,
k. applying fundal pressure,
l. extracting the baby by forceps or vacuum extractor,
m. clamping the umbilical cord before pulsation stops,
n. putting the baby in a baby warmer, rather than putting the baby with the mother, inside a prewarmed blanket, and
o. prohibiting the baby from breast feeding in the delivery room.

Since all of the practices listed above pose a risk to the mother and/or her baby it is important that the mother discuss these risks with her doctor or midwife.
• Ask the office nurse about the fee for vaginal delivery, and also for cesarean section, in case one should become necessary. If you have health insurance, ask if it will fully cover the fee for vaginal delivery or cesarean section.
• To make sure that your doctor or midwife is sympathetic with your wishes ask, "How do you usually conduct labor and delivery?"
• If you are planning a home birth make sure that your provider has sufficient skill and backup to take care of an emergency.
• Ask other mothers who have had that doctor or midwife about their experiences. Find out if he or she honored the mothers' requests they made during their office visits. Did they find their requests denied once they got into labor/delivery? If so, which requests were denied and why?
• If you have any doubt that the doctor or midwife is the right one for you, you may wish to keep your options open to find someone more compatible. Think twice if the doctor or midwife insists that you must pay the full fee early in your prenatal care. This locks you in to an arrangement that you might later regret. After all, you might want to move before your due date. By paying at the end of each visit you preserve your flexibility. This also gives you the freedom to walk out of the office without paying for the visit if you are kept waiting for an hour or more in the office.
• If the doctor or midwife does seem right for you, ask about his or her "call schedule". Ask if it is possible, or likely, that another person will actually attend your delivery. If yes, ask about that person's philosophy regarding labor and delivery. Request a visit with the alternative doctor or midwife on one of your prenatal visits.
• Some doctors and midwives are very sensitive, and some are even annoyed when expectant parents ask questions about obstetric procedures and drugs. Therefore, TACT is very important. For example, to question a procedure you might say, "I realize that you are interested in my welfare, but I'm concerned about................................
TAKE ALONG A "SUPPORT PERSON" FOR YOUR PRENATAL VISITS. It is often very helpful to have a "support person" along on prenatal visits. If the physician or midwife seems defensive about your companion's presence, explain:
"I've brought along my (friend, mother, etc.) because I may not always remember everything you tell me."
If you want to question the safety of a procedure or drug, ask:
• "What is the scientific documentation for using this procedure (or drug)? Please let me read some literature which guarantees that there are no harmful effects to me or my baby from .......... "
If you are questioning the safety of a proposed drug, ask to see the FDA package insert for the drug.
OTHER IMPORTANT QUESTIONS TO ASK YOUR PHYSICIAN OR MIDWIFE INCLUDE:• "What % of your patients ambulate during labor?"
• "I do not want to be fed intravenously during labor since it will interfere with my ambulation and may result in hypoglycemia in my newborn baby. Will I be allowed to drink liquids and eat lightly during labor in order to keep up my stamina?"
• "What % of your patients have no drugs at all during labor and birth?
• "What drugs do you commonly give women during labor?
• "What are the risks of those drugs to me and my baby?
• "Could I read the manufacturers' package inserts (information sheets) of those drugs?"
• "Has the FDA specifically approved of these drugs as safe for my unborn baby?" (Many drugs, including terbutaline, used in obstetric care have not been so approved.)
• "When you listen to the fetal heart rate during pregnancy and labor, do you use a fetoscope or ultrasound?"
• "Since the FDA has acknowleged that no one knows the delayed, long term affects of ultrasound on human development when it is used in obstetric care, I would like to be monitored by a fetoscope. Will you please check with the hospital labor/delivery unit to be sure they have a fetoscope, rather than an ultrasound doppler?"
• "What % of your patients have no episiotomy?"
• "What % of your patients have cesarean sections?"
If you do not want a sonogram, ask the following questions:
• "Why do you consider this procedure necessary? What are you looking for? Is the sonogram being carried out solely to establish fetal age or multiple fetuses?"
• "How would you alter the course of my treatment if the sonogram discloses the condition you are looking for?"
• "If I am sure of the dates of my last menstrual period, what advantage is there in performing the sonogram at this stage in my pregnancy?"
• "Will one sonogram give you the information you need, or do you expect to do additional sonograms later in my pregnancy?"
• Since the FDA has recently acknowledged that no one knows the delayed, long-term effects of diagnostic ultrasound on the subsequent development of the exposed offspring, shouldn't we wait until my baby is bigger?"
• Expressions of concern regarding the safety of ultrasound are often met with assurances such as "Sonograms are not x-rays", or "Sonograms are just bouncing sound waves".
If the doctor or midwife continues to insist on a sonogram then ask:
• "Can you give me information from the company which will guarantee that the ultrasound will have no adverse effects on my child's subsequent physical and neurologic development?"
(The doctor or midwife will be unable to provide you with such a guarantee because there have been no properly controlled, long-term studies to evaluate the effects of diagnostic ultrasound on subsequent human development - but the mental exercise will make him or her stop and think carefully before exposing your baby to ultrasound via a sonogram or electronic fetal monitoring.)

Make a list of your preferences. Begin the list by writing: "If there are no medical contraindications, I would like the following:
1 ........................
2 ............................
3 ........................ , etc."
Make three copies. Keep one for yourself to take with you to the hospital. Give two copies to your doctor or your midwife, one to remain in his/her files. Ask that the second copy of your requests and preferences be attached to the copy of your prenatal records which are sent to the hospital prior to your due date.

During the latter part of your pregnancy write to the hospital's Public Relations Office and ask for a copy of the consent form used for obstetric patients. On admission to the hospital, write in above your signature on the consent form, "Subject to my informed consent at the time." Keep in mind, if you don't give your informed consent, you have not consented.
If you are refused admission unless you sign the consent form "as is", go ahead and sign the form. Once you are in the obstetric unit give your nurse a copy of your previously written instructions which reads:
• "I hereby withdraw my consent to all non-emergency drugs or procedures unless you obtain my informed consent at the time. Neither I nor my baby shall be used as a teaching or research subject without my informed consent at the time..".
• "I realize that you feel I should have the .............. "or "would like to make me more comfortable, but I will wait until my doctor or midwife arrives so I can talk it over with him/her personally. I want to discuss the alternatives with him/her."
• "If you insist on monitoring me, give me some literature from the manufacturer which guarantees that the procedure will not jeopardize my baby."
To make the provider think about what he or she is offering you, ask:
• "Why do you suggest that? Has something gone wrong?"
Remember, directions have legal connotations; requests can be ignored.
• Example: Don't say, "I'd rather not be shaved." Say, "Do not shave me.""Do not put my legs in stirrups."
"Do not send my husband out of the room."
"Do not take my baby out of my room."
"Do not feed my baby water or formula in the nursery"
"Bring my baby to breast feed when he or she is hungry", etc.
If you are being made miserable by a nurse or doctor who insists that
"Hospital rules require that .............",
Tell the caregiver that you will sign a waiver to release the hospital from responsibility for your refusal.
If the caregiver continues to hassel you ask to see a copy of the hospital regulation or protocol that deals with the issue in question. It's doubtful that the regulation actually exists.

Your obstetric records are an important part of both your and your baby's health histories. Well before your due date, during one of your prenatal visits, tell the doctor or midwife that you want a copy of your and your baby's hospital medical records including nursing notes. Nursing notes are important because many notations in your records are made by staff members who are not nurses.
The following statements and questions are examples:
• "I would like a copy of my and my baby's prenatal and hospital medical records, including nursing notes, monitor strip, etc., to keep for my own records. May I have them?"
• "How much will it cost me to obtain a copy of these records?" (Copies should cost approximately 50c a page.) If the cost seems too high, ask what they charge when another authorized physician requests a copy of your records.
• "What do I do now to clear this request with the hospital?"
• "I don't want to wait until the last minute to find out that...."
If you are offered a summary or abstract of your records, rather than the complete records, keep in mind that a summary can OMIT information which you may later find desirable to have. If your doctor or midwife refuses your request for a copy of your and your baby's hospital/medical records you are justified in refusing the hospital's request for your authorization to allow your health insurance company to review your records for payment. To make sure the hospital complies, write in above your signature,
"My and my baby's records may be reviewed by my health insurance company only after my personal inspection of those records and I have received a copy of our records."

We hope that the above suggestions will help to eliminate any misunderstanding that might mar your birth experience. We wish you a happy, healthy birth and baby.
Prepared by Doris Haire, President
American Foundation for Maternal and Child Health

© 2000, Doris Haire