birth

Just Show Up: A Love Story
Below is a story of a woman who suffered from Postpartum Depression (PPD) after the birth of her child. I posted this story because when I read it I was deeply and intimately reminded of the first few months of my child’s life as I, too, suffered from PPD. I have read many accounts of woman with PPD but this story is the one that has resonated with me the most. I felt that same desire to run away. I lived the anxiety, the fear, the guilt, and the deep shame at not feeling the way I was “supposed” to feel. I placed the picture of me to the right of her because I was immediately reminded of the picture of me and my newborn when I looked at her picture. I remember feeling so lost, sad and empty and not knowing why. The thing I had wished for most had finally come true and yet I was at the lowest point in my life. I thank her for sharing her story.

Joy with her son shortly after he was born momma in me

http://www.parents.com/baby/health/postpartum-depression/just-show-up-a-love-story/

Just Show Up: A Love Story

For months, I felt no connection whatsoever to my newborn son. Then one day an idea took hold that changed everything.
By Joy Peskin from Parents Magazine
Trying to remember the exact moment I fell in love with my son, Nathaniel, is hard. It might have been when he appeared to be listening intently as I read him my favorite book from childhood, The Velveteen Rabbit. It might have been during the walk when he reached out from his baby carrier and grabbed my finger. But I know for sure that it wasn’t the first time I held my child — and the shock I felt at not experiencing the rush of love I had anticipated upon becoming a mother was staggering.Even though I had a cesarean section, I still expected to see Nathaniel right away. I imagined he’d be lifted over the curtain and placed onto my chest. He’d open his eyes, and we’d look at each other, and the collective wisdom of generations of mothers who had come before me would beam into my heart.Instead, my son and I had our first meeting in the recovery room at the hospital, hours after his birth. My parents and my husband were there. A nice nurse kept asking me where I was on the pain scale from one to ten. Someone handed the baby to me at some point, but the memory is elusive, just beyond my reach.

The last thing I recall clearly was being in the operating room. The baby had just been delivered, but he wasn’t crying yet; the nurses were still clearing out his mouth. I was shaking violently, either from fear or from all the drugs that had been pumped into my system. I begged the anesthesiologist to do something for my nausea. Before she added another drug to my IV, I heard a nurse asking my doctor the reason for the C-section, presumably for hospital paperwork. “It’s late and I wanted to go home,” he said. I suppose he was joking, but after 36 hours of labor, I wasn’t really in the mood to laugh.

In the blurry weeks that followed, I went over the events of that day in my mind like a crime-scene investigator, trying to figure out exactly when something had gone horribly wrong. Because something was clearly horribly wrong. When I held Nathaniel, I felt a pounding, all-consuming anxiety. One word thrummed through my head like a drumbeat: escape. I wanted to put Nathaniel in his crib, walk out the door, and never come back. When we took him for his first checkup, I sincerely hoped the doctor would see that I was not up for the challenge of motherhood and allow us to leave the baby there.

What kind of mother was I? What kind of person was I? You’re a monster, I told myself. A monster who doesn’t love her own child. It didn’t make sense. I had always thought of myself as the kind of woman who was born to be a mother. But here I was, desperately plotting my escape from the role I had craved most in life.

When my husband took pictures of me with the baby, I tried to force my face into a smile, but my eyes told the truth. They were flat and empty. My voice sounded like it was coming from down a long tunnel. I had no appetite. Food tasted wrong.

A few friends suggested that I might have postpartum depression, but I didn’t think so. That felt like a crutch, an excuse. Besides, I wasn’t crying all the time. I wasn’t crying at all. I was just sitting there, either numb or panicking, incapable of doing anything right. I wasn’t sick. I was useless.

I can’t do this. I won’t do this. These words ran through my mind day after day, hour after hour, minute after minute. Every time the phone rang, I hoped it was someone calling to rescue me. Friends came and visited, but they always left. “Take me with you,” I remember begging one of them. I tried to pretend I was joking, but I wasn’t.

I was feeling worse after a few weeks, so I called a psychopharmacologist I had seen a few years back. She was straightforward and told me that with the right medication, I would feel just like my old self. I didn’t believe her. My old self was gone — I was sure of that.

I went back to a therapist I had seen before my marriage, but she had become, over time, more a friend than a counselor. I was ashamed for her to see me in my current state. I went once and didn’t return.

Next I tried an old-school psychoanalyst. Dr. Freud, as my husband called him, was warm and reassuring, but he wanted to talk about my childhood and I wanted to focus on the present. By this point, Nathaniel was more than 2 months old. I feared that if I didn’t get better soon, I’d never bond with him. Also, my maternity leave was coming to an end. I needed to take a more aggressive approach.

A friend had given me the phone number of a postpartum-depression hotline, and I carried it with me for weeks before I got up the nerve to call. When I finally did, a kind woman assured me that I did have PPD, and that it was surmountable. The other doctors I had seen told me that too, but she was the first one I really believed. She told me she heard women say exactly what I was saying all the time. I had felt so alone in my dark, ugly thoughts, but she had personally talked to other women who had gone through exactly what I was going through. They had gotten better, and I would get better too.

The woman from the hotline suggested a therapist specializing in PPD. When I called her, she told me that the fact that I experienced guilt over my negative feelings about motherhood was a good sign. It meant I didn’t want to feel that way. And she told me she had also had PPD, and she had gotten over it and had gone on to have a second child. On my first visit, she gave me her personal copy of Brooke Shields’s book about postpartum depression, Down Came the Rain. After reading the book and with the therapist’s counseling, I started to feel better. I went back on the antidepressant I’d been taking before I got pregnant, which made a big difference.

And something else helped me too: a line from an article I read about Rosanne Cash. When describing her work ethic, she said, “Just show up. Just do it. Even if you feel like s— and you think you’re terrible and you’ll never get better and it will never go anywhere, just show up and do it. And, eventually, something happens.” That spoke to me. I felt like a terrible mother and I didn’t know what I was doing. I couldn’t figure out which cry meant “I’m hungry” and which meant “I’m tired.” I couldn’t get the baby wrap to work. I didn’t know how often to bathe him, or when to put him down for a nap, or whether to put him in pajamas or to let him sleep in a diaper. I was sure that if left alone in my care, he would die. But when my mind started with its refrain of I can’t do this, I won’t do this, I thought of that quote from Rosanne Cash. Just show up, I told myself instead. Just do it. So I did. And she was right: Something happened. I started to get the hang of it.

I turned a corner when Nathaniel was 3 months old and I returned to work. I love my job, so going back to it — and going back to my pre-baby routine — made me happy. Ultimately, I rediscovered my confidence, which had felt as if it had been put into a car, driven into the middle of the desert, and set on fire.

It took me a while to come to terms with what happened during the earliest days of my child’s life. More than once, I’ve found myself wishing I had known him when he was first born. And of course that’s foolish, because I was right there. But also, I wasn’t. To see us together these days, you’d never know. When he smiles my heart bursts, like fireworks, into a thousand tiny stars. I love nothing more than snuggling with him or reading to him. And I guess I’ll never understand exactly what went wrong, whether I was traumatized by the C-section, or if I experienced some sort of hormonal crash, or if people with my type A personality — those of us who like to do things perfectly on the first try, who like to be in control — are just destined for a certain degree of panic when we become mothers and lose control of absolutely everything. I thought I would fall in love with my baby the first time he was in my arms. But that didn’t happen. It couldn’t happen until the thing that broke in me when he came into the world was fixed. But I love him now, boundlessly and without reservation. And maybe in the end what matters most isn’t the moment we fall in love, but what we do with that love once it takes hold.

Doctors, Choices, Homebirths

The Ties that Bind: How Belief Creates Birth Realities
 

http://www.midwiferytoday.com/articles/ties.asp

© 2003 by Kim Wildner. All rights reserved.

[Editor’s note: This article first appeared in Midwifery Today Issue 68, Winter 2003.]

There is a story told of a baby elephant in Tibet (1) tied about the ankle with a rope. The rope would not hold an adult elephant, but it holds the baby tight even as it struggles to free itself. The baby resigns itself to the fact that it cannot move outside of the parameters of the rope, no matter how hard it tries.

Eventually, the elephant reaches adulthood, the same little rope about his ankle. Now, little effort would be required to snap the rope and walk away, but the elephant doesn’t even bother to try. He is bound only by his belief that he is unable to escape, which is just as effective as his captors.

Women giving birth today have more options than ever before, yet perceive very few. Information is available in unprecedented quantities at the touch of a fingertip, yet erroneous beliefs impact decision-making more than cold, hard facts.

Women believe that birth is a dangerous medical event. The fact is that normal birth is safer than many things we do each day without a thought (2).

Women believe that U.S. technology makes birth safe. The fact is that birth is much safer in countries where technology is more appropriately utilized (3).

Worse yet, women are often not making decisions at all. Like the elephant that cannot conceive that he has the power to walk away, women simply do not see the options before them.

A mother called me regarding private childbirth classes. During the course of the discussion, she explained that she wasn’t even sure the classes would help her, as she was planning a VBAC (vaginal birth after cesarean) and doubted it would “work.” Further discussion revealed that her doctor was insisting on certain “conditions” in order to “attempt” this VBAC.

  • The mother would be induced if she went “over due,” as determined by an ultrasound (4).
  • The mother would be induced if her baby got “too big,” as determined by an ultrasound estimation (5).
  • The mother must deliver between 7:00 a.m. and 5:00 p.m. when an anesthesiologist would be on hand. If that looked unlikely, induction or augmentation would be required. If she did not dilate steadily and quickly she would be augmented with Pitocin or Cytotec. If she were still laboring near the end of her given time frame, surgery would be inevitable (6).
  • The mother must labor with an epidural (7).

The reason for these restrictions was that the American College of Obstetricians and Gynecologists (ACOG) had issued new “guidelines” for VBAC, supposedly from a study that “proved” VBAC was unsafe (8).

However, what the study showed was that “obstetrically managed VBAC” was unsafe. The factors that made VBAC unsafe were mainly—hold on to your seat—pharmaceutical induction agents that are known to cause uterine rupture in non-scarred uteri (9). In other words, any woman in labor who gets them, not just VBAC mothers. Instead of investigating the drugs, which are not FDA-approved for nonmedical indications, the recommendation became to put restrictions on VBAC that bring about the very conditions that are singular to the drug/VBAC combination, not the VBAC itself. That “logic” is just lost on me, but it’s beside the point, anyway.

The story of the elephant mentioned above doesn’t parallel the illogic of ACOG; it parallels the thinking of the mother who contacted me. She was quite distraught that she probably wouldn’t be able to meet all of the conditions set by the doctor. She was right. She had as much control over them as she has over the tides, the moon or the sun.

She asked me if I thought she had a bad doctor. She asked me what I thought about the hospital policies. She asked me if she should change hospitals or doctors. None of this is my call to make, even if I knew her or her doctor, which I didn’t. I told her I thought she had some tough decisions to make. As a childbirth educator, I could provide her with the information she needed to weigh in order to make a sound decision, which I did. I gave her several book recommendations and links to studies showing the conditions she was being asked to meet were not only impossible, but flew in the face of science and plain old common sense.

I reminded her that the criteria for making sound decisions must include determining if the choice she was being asked to make was based on facts (it wasn’t), if it was in her and her baby’s best interest (it wasn’t) or if it would improve her experience (it wouldn’t) (10).

I heard from her again at a later date. She had read some of the material and she was getting anxious about her predicament because she didn’t feel she had any options. She ended her communication with the thought that she would probably just go with whatever her doctor wanted because, “What choice do I have?”

She didn’t believe she had options, so she didn’t have any. Perception is reality. While I refused to make her decisions for her, I felt I had given her enough information to broaden her options.

She could:

  • Present scientific references that challenge her doctor’s conditions and request that he provide evidence to support his stance.
  • Request that the hospital base its policies on the safety of her and her baby instead of concern over its liability.
  • If either or both refuse, find a doctor who did practice evidence-based care.
  • If one could not be found in her area she could
    • Choose a homebirth midwife;
    • Choose the nearest freestanding birthing center;
    • Choose a hospital/doctor in a neighboring county;
    • Choose to go out of state to somewhere like The Farm in Tennessee, where she could stay and safely birth her baby.

Granted, not all of these are easy choices to make, but other mothers have made them. It is not only the right, but also the responsibility, of women to ensure that the options they are offered are safe and in the best interest of their babies. If not, they need to seek new options. I’m sure there are others I haven’t thought of, but the point is she certainly not only had a choice, but several. The data I provided on evidence-based care and safe birth did nothing to illuminate this mother’s options because it wasn’t about facts, it was about belief.

In the last few months, I have received two other calls that illustrate this point just as well.

The first call came from a mother who had talked about hiring a midwife for her second birth because of her disappointing first birth. The first time around, she had done beautifully with HypnoBirthing® for most of the birth. Her caregivers had raised several red flags, however, during the course of her pregnancy, giving her warning that they would say what she wanted, then do what they wanted. Still, for some reason she thought it would be different for her. (There seems to be a common belief among pregnant women that somehow they will magically be able to change their caregivers when others have failed.)

Predictably, at the very end, the caregivers did what they promised they wouldn’t: they coached her to “purple push”—that horrid, harmful purple-faced pushing seen on those awful birthing shows. Amidst the yelling and counting, she couldn’t stay focused on “breathing the baby down,” not to mention the fact that she was afraid for her baby. They had promised they would only do this if it were necessary “for the sake of the baby.” The baby was never in peril. The mother (predictably) tore badly, which meant her early months of mothering were consumed with physical and emotional pain. Energy that should have gone to her child was wasted on trying to heal a relationship that struggled through the stress of a sexless existence.

In the years it took her to recuperate from this betrayal, she insisted she would have a homebirth with a midwife for the next baby. However, once she actually got pregnant, she went to an in-hospital birthing center, which started right away with routine ultrasounds scheduled at eight, 12 and 20 weeks. Knowing the suspected risks of ultrasound, this made her uncomfortable, but she was staying with the center because she said, “I have no choice. My insurance doesn’t cover homebirth.” Even if changing providers was impossible—though I believe nothing is impossible with enough determination—she still had choices. She could refuse the routine technology and let it be known that if there was a legitimate medical indication that could be substantiated (they had given her a “medical” reason for the intervention that, with a little research, was shown to be nonsense), she would surely cooperate for the sake of her baby.

Her insurance didn’t cover homebirth. That’s because it didn’t originate to help people get better care; it originated to help doctors get paid. Regardless, the co-pay for her hospital birth-center birth was about the same as what a homebirth midwife charges. If this woman ends up having surgery, the co-pay will be much more, not to mention the ripple effect of what it will cost during her recovery and in subsequent births, and the emotional toll.

She believed she had no choice, so she had no choice. Perception is reality.

The second call that illustrates this idea came from a woman who commissioned me to do some birth art for her. During the time I spent with the woman, she expressed anxiety about the fact that her doctor was starting to talk induction. She had read about the dangers of nonmedically indicated induction and wanted to avoid it “at all costs.”

She was a healthy woman with a healthy baby, two weeks away from her estimated delivery date, which could be as much as four weeks from actually delivering. She enjoyed being pregnant and had a lovely support system in her husband and family. Her doctor’s only reasoning behind mentioning induction was that she “looked about ready.”

This mother’s vehemence in her insistence that she wanted to avoid this intervention was impressive, but it didn’t translate into action. When I asked what she was going to do to avoid the induction, she replied, “I guess I’ll just have to do it. I don’t really have a choice.”

Have you any idea how often these words pass over an expectant mother’s lips?

Women always have a choice. The question is not whether they have a choice, but are they willing to make a choice. Changing a belief system, especially one that’s held collectively, like ideas about birth in the U.S., is a subject too complex for one article. I spend a great deal of time discussing how to identify our faulty assumptions so that we may make better birthing decisions in my book, Mother’s Intention: How Belief Shapes Birth (August 2003).

Even if a woman doesn’t instantly revise her beliefs about birth, the only factors that should have any importance are these: whether her choices are based on fact, if they are in her best interest and if they affect her experience positively or negatively. She need not concern herself with what is good for the hospital or doctor. Her only responsibility is to look out for the child, and by extension, herself.

<!– –>Kim Wildner is the author of Mother’s Intention: How Belief Shapes Birth (Harbor & Hill Publishing). She has been a childbirth professional for 12 years, holding certification with ALACE and the HypnoBirthing® Institute. She has one homeborn daughter.

Notes

  1. This universally understood story has many variations, with different locations and even different animals.
  2. Mortality statistics for motor vehicle accidents, heart disease, unintentional injury, cancer, HIV and other causes of death can be found at www.cdc.gov/nchs.
  3. The U.S. is rated 27th in the world for infant mortality and 13th in the world for maternal mortality (see www.savethechildren.org/mothers/report_2003/ for more information on the 2000 State of the World’s Mothers report).
  4. Ultrasound is only accurate to within two weeks on either side of an estimated due date. Only about 5 percent of babies are actually born on their “due date.” See www.birthsource.com/articlefile/Article86.html.
  5. Ultrasound is no more accurate than an educated guess at fetal weight. It is only accurate to within two pounds on either side of the actual weight. Considering that most obstetricians consider a normal eight-pound baby to be “too big,” if they induce because ultrasound estimates the baby is nearing eight pounds, the baby could really be only 5 lbs., 15 oz.
  6. See www.obgyn-wolfson.org.il/Content/Articles/ArticlePDF/AriclePDF655.pdf and www.midwiferytoday.com/enews/enews0326.asp.
  7. See www.childbirth.org/articles/episec.html.
  8. ACOG and other caregivers are now using a study found in the July 5, 2001 issue of the New England Journal of Medicine to suggest that VBAC is unsafe. See http://content.nejm.org/content/vol345/issue1/index.shtml.
  9. Visit www.hencigoer.com/articles and www.ican-online.org, where there are many articles that attest to the truth of this statement.
  10. Decision-making criteria adapted from Dr. Phil McGraw. See www.drphil.com/advice/advice.jhtml?contentId=1055_litmuslogic.xml.

References

  • Baum, J.D. et al. (2002, March). Clinical and Patient Estimation of Fetal Weight vs. Ultrasound Estimation. Journal of Reproductive Medicine 47 (3):194–98.
  • Lydon-Rochelle, M. et al. (2001, July 5). Risk of Uterine Rupture During Labor Among Women with a Prior Cesarean Delivery. New England Journal of Medicine 345 (1): 3–8.
  • U.S. Dept. of Health and Human Services. Maternal Child Health Bureau. (2001). Child Health USA 2001. Washington D.C.: Health Resources and Services, p. 22.

RELATED POSTS:
Everything You Need to Know About a Home Birth
Vaginal Birth After Cesarean – Make an Informed Choice

Everything You Need to Know About a Home Birth

WHY A HOME BIRTH?
When my husband I found out we were pregnant we simply basked in the wonder of growing humans in other humans. Miracles. I had had a baby 10 years previous in the hospital with a midwife so I wasn’t without some experience. It was funny, though, at about 10 weeks pregnant I said, “Babe, maybe we should get some prenatal care going…I should try to find someone.” And my husband said, “Do we really have to have the baby in a hospital? Can’t we just have our baby at home?” So it was with my husband’s initiative that lead us on the home birth path…and now we’re on a home birth high horse especially after having experienced both a hospital and a homebirth.

HOW TO FIND YOUR BIRTHING MIDWIVES
It is a matter of being your own advocate. Medical doctors generally don’t attend home births. Some midwives attend home births and some don’t.

USE THE INTERNET
Find the local midwifery services in your area. Googling “Homebirth midwives in [YOUR TOWN]” will likely lead to a local midwifery group. Set up appointments and interview a few midwifes until you find the one that fits best for you.

BIRTH KITS
Most midwives will have you purchase a birth kit for the big day. These kits can be bought on-line. You midwife might have a specific place they like to order from so talk to them about what you should get. Here is a sample birth kit and some on-line places to order from.

A Sample Birth Kit Includes:
10-23×24 Underpads, Economy
5-23×24 Underpads, Economy
2-40×60 Plastic Backed Sheets
1-Peri Bottle
1-Stockinette Newborn Hat
6-2.7gram Packets Sterile Lubrication
2-Plastic Cord Clamps
1-Paper Tape Measure
12-Alcohol Prep Pads
2-Flex Straws
1-Dozen Sanitary Pads
12-Sterile 4×4 Gauze Pads
1-Bulb Syringe 2.5 ounces
1-Mesh Brief
3-Pairs Sterile Gloves
6-Single Sterile Gloves
1-4 ounce Povidone Solution
1-“Welcome” Birth Certificate
1-Disposable Footprinter

http://www.midwifesupplies.com/Home-Birth-Kits-PEA0059-p-BirthKits.html
http://inhishands.com/

A SAMPLE CHECK LIST OF THINGS NEEDED FOR A HOME BIRTH
From http://pregnancy.about.com/od/homebirth/a/supplylist.htm

  • A bottle of isopropyl rubbing alcohol (70%)
  • A pint of 91% alcohol (or 99% alcohol, grain alcohol, or 180 proof Golden Grain
  • Cotton balls
  • A plastic drop cloth or plastic sheet (an old shower curtain or large plastic table cloth works wonderfully)
  • Plastic trash bags (AT LEAST 4 large) dark colored
  • 2 fitted bed sheets to fit your bed
  • 2 flat bed sheets to fit your bed (4 flat sheets is acceptable)
  • 4 bath towels
  • 4 wash cloths
  • 8 receiving blankets
  • Large mixing type bowl
  • Small mixing type bowl (prefer bowls not be glass)
  • Working flashlight and extra batteries
  • Extra toilet paper (at least 2 6-roll packs)
  • Several kinds of juice (at least one citrus and 1 non-citrus)
  • One extra bag of ice
  • Protein you like that is easy to fix (peanut butter, cheese, or eggs for example)
  • Clothes for you for after the birth (gown and panties)
  • Clothes for the baby (2 pair socks or booties, 2 onesies, 2 sleepers)
  • Diapers for the baby
  • Large cookie sheet
  • Silver duct tape (preferably new roll)
  • Thermometer (if digital, include probe covers)

We organized the kit and all the extra supplies she requested (towels, washcloths, etc) into 2 large Rubbermaid bins and stored them under a 4 foot table we set up in our room – also requested by midwife.  Once labor started, we made up the bed with plastic and a new set of sheets.  We purchased a roll of clear plastic, self-sticking carpet protector (like they use in model homes) and covered our carpeted bedroom floor with it.

Another mom was caught off guard with a 36 week labor and delivery:

We’d wanted a water birth at home but our little one arrived 4 weeks earlier than we thought so we were truly unprepared. In fact, the birth kit that we ordered arrived via UPS about 3 hours after our baby was born. Fortunately our midwives always have a birth kit on hand just for these types of situations.

DO YOU GO TO A REGULAR DOCTOR’S OFFICE FOR YOUR CHECK-UPS IF YOU ARE HAVING A HOME BIRTH?
Whether or not visits are in the midwives’ office or at your house likely depends on the midwife you choose.

  • If you choose prenatal screening or to have an ultrasound this would occur in a clinic and you will need a referral from your midwife for the procedure.

PEOPLE YOU MIGHT WANT PRESENT AT YOUR HOME BIRTH

  • Midwives
  • A doula
  • Back-up midwife (probably already arranged by your midwifery group)
  • Friends
  • Family

If there are other children in your family, you might arrange to have a friend or family member be on-call to care for the child or children during the birth.

WHEN TO CALL THE MIDWIVES
You and your midwives will discuss at what point they would expect for you to call them in. If you have a doula, she can help you with this decision as well. Some laboring at home before the arrival of the midwife is normal.

When my water broke and I had started having semi-regular contractions, we called the midwife.  She came over within an hour or so because she happened to be in the area. 

WHO ASSISTED YOU WITH LABOR?
My husband and my midwives helped take me through all my rushes. We chose to call them rushes instead of labor since the word labor had some negative connotations for me. My daughter also helped with kind words, nice touches, and videotaping her brother’s birth, announcing the gender and the name!

WHAT WOULD YOU LIKE TO TELL SOMEONE CONSIDERING A HOME BIRTH?
I knew of women having their babies in places other than hospitals, but I honestly thought they were super hippies willing to have their babies in the woods, gnawing off the umbilical cord and eating the placenta on the spot. I had no idea that, for instance, where our home is situated has one of the highest rates of homebirths in the city.

It is SO much safer than hospital birthing. You can have your baby right at home and then you’re right there in your nest where you need to be. A home birth is intense and powerful. You don’t need to have a fancy house or apartment. You don’t need to have a clean house. There will be blood, there will be fluids, but the midwives know what they’re doing and they’ll clean up! Women need to know they can do it! People planning a home birth need to know that birth in a hospital is an odd new trend…birthing at home is the normal way to bring babies into the world. Women have been birthing babies in their “nests” since the beginning of time. In my opinion, hospitals have it all backwards and actually make birth harder. Home birth is simple. It un-complicates a very natural process.

ADVICE AND TIPS FOR THE HOME BIRTH

  • I would have planned a little earlier so I could have had a water birth.
  • I think I would have done a little more mental hypno-birthing preparation before my home birth.
  • I would also have liked to watch some home births on video.
  • We made the HUGE mistake of not hiring a doula!
  • Tour your local hospital in the event you need to transfer.
  • I also ate a high protein diet in an attempt to avoid pre-eclampsia and thus a birth too early for staying at home. 
  • I did pre-natal yoga and visited the chiropractor, though both not as often as I should have all during pregnancy and definitely not enough during those last few crucial weeks.

WATER BIRTHS AT HOME
Besides being a great comfort measure, a water birth can offer the following and more:

  • diminish stress hormones (called catecholamines) which increase pain and slow labor
  • reduce pain by increasing the body’s production of natural pain relievers (endorphins)
  • ease involuntary muscular tension, and enhance relaxation during and between contractions
  • lower blood pressure within minutes and decrease edema (swelling),
  • promote better circulation and increase the efficiency of uterine contractions
  • increase mobility so that it is easier to change positions to aid the progress of labor, especially when a woman is becoming tired

http://www.geneabirth.com/waterbirth.htm

If you want to have a water birth at home you will need to rent a BIRTHING TUB. Check with your birthing center or midwife to see where you can rent a birthing tub locally. Some birthing centers and midwife organizations will rent tubs, too.

In the Twin Cities these organizations will bring the tubs to your home, give you the instructions as to how to set it up, and will take the tub down for you after the birth. They also supply a list of things you will need for tub rental.

http://www.waterbirthresources.com/
http://bywaterbirth.com/
http://www.geneabirth.com/waterbirth.htm

BIRTHING STOOL

It is common for women giving birth at home to rent a birthing stool. They are made in all shapes and sizes. The above stool is a handcrafted wood stool.

 “A birthing stool is a stool which has been specifically designed for use during childbirth. It allows a woman to sit or squat while giving birth with support to help her if she begins to feel fatigued. Many advocates of natural birth support the use of a birthing stool, which may also be called a birth support stool or a birth stool. Such stools are available from companies which provide equipment to midwives, and they can also be handmade; some people have chosen to make their own to personalize the labor and delivery process.”

The concept of sitting or squatting during labor is ancient, and widely practiced in many cultures, and the use of the birthing stool is also quite old. A birthing stool is designed to bear up to a substantial amount of weight and pressure, and it is usually low to the ground so that a laboring mother can plant her feet firmly. Most importantly, a birthing stool has a hole in the middle, allowing a midwife to monitor the progress of the labor and providing a space for the baby to slide through.”

http://www.wisegeek.com/what-is-a-birthing-stool.htm

Your midwives might be able to advise you on were to go locally or on-line for this as well.

Video on the Birthing Stool: http://www.youtube.com/watch?v=RrXR7dK4Y2k

HOME VERSUS HOSPITAL: HANDLING POSSIBLE COMPLICATIONS

This labor and birth was way harder than my first due to what turned out to be a crooked (asynclitic) baby.  I know one thing for SURE—I would not have been as comfortable in a hospital as I was at home to birth in so many different positions, to walk around, to be naked, get in and out of tub, to vocalize, etc.  I think we would have had a very different outcome for this birth if we had NOT been at home.

I actually had some bleeding 3 days before I gave birth and because I was only 36 weeks, my midwives instructed me to meet them at the hospital because early bleeding could mean placenta previa…and if it was placenta previa I would need an emergency c-section. Placenta previa occurs when the placenta grows in the lower part of the womb and covers the cervix. This is very bad as you cannot push the life-giving placenta out first since both baby and mother would likely die. I hadn’t had any ultrasounds during my pregnancy, but I had to have one to ensure the placement of the placenta was at a safe location. It was. And even while I spent 10 hours in the hospital in contractions at only 36 weeks…I opted to return to my home though the MD there strongly advised me to remain at the hospital to have my baby. But I chose to voluntarily discharge. I felt like royalty walking out of the OB floor waving at the labor and delivery nurses as they stood with jaws dropped at a woman walking OUT of the hospital while in labor. 

FOR THE SIBLINGS

http://www.midwifesupplies.com/Were-Having-A-Homebirth-KM0050-p-BirthKits.html

 

LOCAL MINNESOTA BIRTH CENTERS AND MIDWIVES

Many thanks to Barbara Morgan and Claire DeBerg for their assistance with this article and for sharing their home birthing experiences and knowledge!

What is a Doula and Why Do I Need One?

So you’re having a baby? Great! You’ve decided on a doctor or a midwife, you’ve been taking your prenatal vitamins and you may even be starting to think about the birth itself. You’re in the beginning stages of developing a team of people who are going to support you through the birth process.

Regardless of whether you planning on delivering your baby home, at a birthing center or at a hospital, one of these people you might consider having present at your birth to support you is a DOULA.

A DOULA? WHAT IS A DOULA?
In essence, a doula is a fancy word for an old concept. In cultures all over the world, women attend births. Women have assisted other women in giving birth for thousands of years. With the onset of industrialization and the tendency for birth to be a medical procedure, rather than a naturally occurring event, the concept of a birthing assistant has fallen by the wayside. In recent years, the idea of employing women to attend births has come back into favor and thus enters the doula.

A doula (usually a woman) is a person who assists women with the birthing process. A birth doula is “a supportive companion professionally trained to provide physical and emotional support during labor and birth…She provides continuous support, beginning during early or active labor, through birth, and for approximately two hours following the birth. The doula offers help and advice on comfort measures such as breathing, relaxation, movement, positioning, and massage. She also assists families with gathering information about the course of labor and their options. Her most critical role is providing continuous emotional reassurance and comfort.”

http://www.transitiontoparenthood.com/ttp/Doula/doulahome.htm

Some hospitals are even starting to provide doulas to women when they come to the hospital in labor, but this is rare. Woodwinds Hospital, a local hospital in MN, has a volunteer program providing this service called Doulas at Woodwinds.

WHAT DOES A DOULA COST?
Most doulas charge a flat rate for the entire pregnancy and delivery and all services rendered during this time. As I recall, the cost generally ranges from somewhere around $800.00 – $1,500.00. (Just an estimate.)

WHAT DO YOU GET FOR THE COST?
Doulas general provide services for three purposes: (a) prenatal visits, (b) delivery of the baby, and (c) postnatal visits. The doulas are on call during your birth and will be there regardless of the day or the time of day, unless they have informed you otherwise. The frequency and content of the visits may vary from doula to doula so be sure to ask lots of questions when interviewing your doulas.

1. Doulas usually do a few prenatal visits and will help you prepare a birth plan. They will talk to you about what you want during your labor and delivery and go over some of the choices you might have (types of pain relief, cord cutting, membrane stripping, etc.)

2. Doulas come to your house when you start to go into labor regardless of where you plan on giving birth. Their philosophy is geared towards laboring at home for as long as possible. If you go into labor quickly and are delivering at a hospital they will come as soon as you are admitted and will stay with you until the baby comes and for a few hours afterwards. Their rate includes your entire labor even if you labor for 48 hours, God forbid. If you deliver your baby in your home or in a birthing center, they would do the same thing, only in those places instead.

3. They also make one or two visits to your home after the baby has gone home with you. They will assist with breastfeeding, comforting your baby and adjusting to being a mom, if it’s your first time.

WHAT IS THE ROLE OF A DOULA DURING THE BIRTH?
The role of the doula is to assist the birthing mother with whatever it is that she needs. She is like a personal assistant. If you want her to clear the room of people, she will do that. If she wants you to get your husband or partner to help out or give a massage, she will do that. Basically she is at your beck and call throughout the labor. She will help you find good positions to labor in and will be very active or play a background role depending on what you want. If your partner is actively involved in the delivery she might provide gentle suggestions on helping you through the labor and delivery. Her main role is to act as your advocate and to see that you are getting your needs met such that the delivery is as comfortable as it possible can be.

If you end up having a Cesarean the doula can also enter the operating room. They usually have a limit on how many extra people can be there so you may have to choose between your birthing partner, if you have one, and the doula.

DO DOULAS HAVE MEDICAL TRAINING?
Doulas are not medically trained in the traditional sense. They do come with tons of knowledge about birth and labor and will provide you with suggestions about when to rest and when to move around and what positions you might try during labor. However, they are trained not to communicate with the medical staff directly regarding your medical condition. They will prompt you to communicate to the medical staff about a wish or desire that you had (such as not wanting the cord cut or skin-to-skin contact, etc.).

HOW DO I GO ABOUT FINDING THE RIGHT DOULA FOR ME?
1. The hospital where you are delivering may have a list of doulas that you can contact. In addition, you can read about them on the web (they may have their own websites) and if they look like someone you are interested in they will meet with you so that you can see if you like them and if you want to hire them.

2. On-line directories such as this one: http://doulanetwork.com/directory/Minnesota/ may be available in your area as well.

3. In Minnesota we have something called the Childbirth Collective and they have a “Meet the Doulas” night. It’s a great thing because you can meet a bunch of doulas all at one time and if you see one you like you can try to get an appointment set up for a meet and greet to see if you want to hire them.

From their website: The Childbirth Collective is a “collective of birth professionals who support women and families during the childbearing year. Perhaps you are looking for a birth doula, midwife, birth photographer, massage therapist or a postpartum doula. The Childbirth Collective is the place to connect with a growing and passionate community that cares about how you birth.”

Regardless of where you find your doula, make sure you interview a few so that you are comfortable with the one you choose. She is going to see you through one of the most challenging and amazing experiences of your life. Liking your doula will only make it a more positive experience.

WHAT ARE THE BENEFITS OF A DOULA?

From: “What is a Doula?

  • Reduces the need for forceps or vacuum extractor by 41%
  • Reduces need for Cesarean by 26%
  • Decreases medical intervention in labor
  • Reduces use of pain medication by 28%
  • Reduces dissatisfaction with birth by 33%
  • Reduces length of labor

Six weeks after birth, mothers who had doulas were:

  • Less anxious and depressed
  • Had more confidence with baby
  • More satisfied w/ partner
  • More likely to be breastfeeding

Homebirth Midwifery Care, Birth and Postpartum Doula Support and Massage Therapy Center http://www.geneabirth.com/

These two women look they provide a wonderful array of services. They provide Midwifery services, Doula services and Birth Massage.

They will also assist in at-home births for VBAC women, also known as the HBAC (Home Birth After Cesarean).

Awesome!

The massage service includes a two and a half hour massage during your labor with a certified prenatal massage therapist. Their massage therapist has also been a doula for eleven years and can guide you with the best positions to be in for early and active labor. The service includes meeting with the therapist to discuss the type of massage you would like to use in labor, and picking out the scents/s you would like to use in labor. She will then make an oil using Young Living Oils that you will bring home with you. In labor, the massage therapist will come to your home or visit you at the hospital/birth center for a two and a half hour massage that will help you to enter your labor in a calm and centered place. This massage is specifically tailored to you and your needs. She can come at any point during your labor, but early labor is usually the best.

NOTE: I know that for you around the country this particularly birth center might not be a possibility but perhaps there are other birth centers in your area that offer similar services. It’s good to know that places like this exist.

Additional Resources:

What is a Doula? (http://www.dona.org/mothers/index.php)
DONA International (http://www.dona.org/)
What is a Doula? (www.transitiontoparenthood.com/ttp/Doula/doulahome.htm)

I Have Two Names Now: Mommy and Christina

To My Daughter, on Her Third Birthday

Three years and two days ago, I had one name: Christina.

I wore it and I wore it well. I studied, I worked and I played. I danced and climbed mountains and ran like the wind. I was free and there was no one to stop me. I loved life and it loved me.

But then one July a little seed was planted inside me and it grew. It grew and it grew and it grew. That little seed was you.

Then forty-two weeks later, on the nose, with a big belly about to explode, out you came, quicker than I thought. No long labor, no deliberation. It was time and the doctors and nurses knew, even before I did.

Faster than I could blink an eye you were in the world. And there you were. They held you up and I saw you over the sheet. You were a baby. My baby! I couldn’t believe my eyes. 

They measured you and weighed you and then they brought you to me. They put you naked on my chest, just as I had asked, right next to the sheet that separated you and me from the men and women that had so carefully and attentively brought you into the world.

You cried and suckled and took to the world like it was yours to keep.

You stayed beside me while I healed. I never let you out of my sight. You lay on me and in the crook of my arm while I nursed you, watched you sleep, and nursed you some more. I learned how to swaddle you and to change your diaper and to feed you. I learned how to care for you.

Most importantly, I kept you next to me as much as I could. Not only had I read all of the books but I knew in my heart that that was where you belonged.

The little you, who was also a big part of me, lay beside me for four long days before I could take you home. 

At first I was uncertain about this new, crying being who needed so much from me and without a pause. Is this what I had wanted? Is this what I had asked for? Is this what I had expected?

Despite all the preparation, I did not feel prepared.

Oh sure, I had the co-sleeper and the swings and the bottles and the bibs and the onesies. It was all there. But somehow you can’t buy the one thing that one really needs: Experience.

I don’t think one can ever be truly prepared for what lies beyond the birth of a first child.

People had told me my life would change but I didn’t believe them. How can a little baby like that be so much work, I’d ask? My life will be the same; I’ll just have a baby along for the ride from now on.

They would just shake their head and smile. They knew it could not be explained. And they knew I was in for a shock.

After some time of getting used to you, I started to change.

“Here, give her to me. I know what to do,” I’d say to those who didn’t know.

We worked together—she at being in the world, and me at learning to give 100% of myself to someone other than myself.

We’ve seen some good times and some bad times. We’ve worked through some smiles and some tears. I’ve watched as she’s reached many milestones – usually without any help from me. I’ve had many sleepless nights and have cleaned up a number of messes in the middle of those long seemingly endless times. I’ve seen her grow from a little baby, into a toddler, and soon into a little girl.

After three years, I think I have finally made the transition.

Yes, it has taken that long.

Up until a few months ago, I was only known as “Momma!” “Momma!” “Momma!” Usually with arms stretched high. “Up!” she’d demand.

A few weeks ago, for the first time, my little girl looked at me and said something like “Mommy, what you doing?”

My heart melted. I almost cried.

Where had she learned this word? Where did “Mommy” come from? I knew it was me, but I still couldn’t believe it….Me? Mommy? Yes, I am Mommy!

So now I have two names: Christina AND Mommy.

And there are some things Mommy knows how to do better than Christina could have ever done them.

Mommy knows how to choose a cloth diaper, fit it, change it, and clean it.

Mommy knows how to call the doctor in the middle of the night and how to put a wheezing baby on the phone.

Mommy knows how to put an infant and a toddler to the breast.

Mommy knows how to soothe a colicky baby like nobody’s business! I lovingly refer to her as “The Baby Whisperer.”

Mommy knows how to give really big hugs and how to kiss really little toes.

Mommy knows what it’s like to have a baby sleep on her chest all night long while keeping one eye open, just in case.

Mommy knows that a cookie can fix just about anything and that a song can soothe most of what ails.

And Christina knows a thing or two, too.

Christina isn’t climbing rocks much these days. Christina isn’t running as fast as the wind anymore.

But Christina knows that special feeling of having a baby kick the inside of her stomach, and that amazing “thump, thump” when the doctor checks for a heartbeat.

Christina also knows what it’s like to go to work every day while still remembering that there’s a very little girl out there who needs her Mommy.

And Christina knows when it’s time to take her baby from some other caring adult just because her girl will only be soothed by her.

And, most importantly, Christina knows to bend down when she picks her baby girl up from school because there she’ll be, a little girl now, grinning from ear to ear, running towards her, reaching out, calling “Mommy, Mommy!”

And Christina knows, that no matter how much she may miss parts of who she used to be, the little girl who calls her Mommy fills an amazing spot in her heart that no one else can ever replace.

Happy birthday, Baby Girl.

Love, Your Mommy.

The Newborn Latch: Instructional Breastfeeding Video

http://snbsonline.net/id11.html

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On this site there is a series of three videos with a male physician teaching the mother how to get her baby to latch on. The videos are wonderful. (It will say 1 of 3, 2 of 3, and 3 of 3 for a total of three mini videos in the series. Each are about 3-4 minutes long.)

One of the things that this physician says is that he has worked around the world in Africa and South America. He states that in these countries the babies are on the breast for hours but in North America people become horrified if a mother is nursing for more than 20 mintues a side. This is actually something that my doctor had advised me against as well. Inform yourself about the possibilities related to breastfeeding. He also states that mothers aren’t taught how to properly breastfeed while in the hospital and promotes more education around breastfeeding properly.

Here is information in a text form if you like from a website I found.

http://www.childfun.com/breastfeeding/latch.shtml

“Attaching the baby to the breast correctly is the first and most important step towards successful breastfeeding. The vast majority of breastfeeding problems are caused by improper latch-on (the second leading cause of breastfeeding problems is feeding on a schedule instead of on demand). Here are some problems that incorrect latch-on may cause:

  • Sore nipples. These result when the baby holds just the nipple in her or his mouth instead of opening up her or his mouth wide and taking in a good mouthful of breast tissue.
  • The baby cannot milk the breasteffectively unless she or he is latched on properly. The milk reservoirs are located behind the nipple under the areola. A baby who is sucking on just the nipple cannot compress the milk reservoirs to get the milk out. This may lead to:
    • Engorgement. Your milk comes in and the baby can’t remove it from the breast. Your breasts can become engorged.
    • Mastitis. Engorgement that is left untreated can lead to plugged milk ducts and mastitis. The treatment for engorgement is emptying the breast. If your baby does not latch on correctly, she or he cannot empty the breast.
    • Poor weight gain. If your baby does not latch on correctly, she or he does not get enough milk. Furthermore, most of the milk she or he gets will be the thin foremilk. Your baby may fail to thrive.
    • Insufficient milk. Your breasts make more milk as they are emptied. Milk left in the breast tells your body to slow down milk production. If your baby is not latching on properly, you may lose your milk supply.

OK, so it’s really important to latch the baby on properly. Fortunately, it’s not very hard (although it takes practice; it might take anywhere from a few days to two months for your baby to become a pro at this). Here are a few things to pay attention to:

  • Take full advantage of your baby’s rooting reflex.
    • The rooting reflex has two parts: turning and opening the mouth.
      1. When you touch your baby’s cheek or lip lightly, she or he will turn her or his head towards the touching object.
      2. She or he will also open her or his mouth really wide, as in a big yawn.
      3. Soon, your baby will learn that your breasts are her or his source of comfort and nourishment, and she or he will turn her or his head from side to side and open her or his mouth whenever she or he wants to nurse.
    • If your baby is already facing your nipple, you can just tickle her or his lip with your nipple until she or he opens up really wide.
    • If the baby is facing away from the breast, tickle her or his cheek with your nipple When she or he turns toward your breast, tickle the lip with your nipple.
    • Make sure you continue tickling until your baby opens up reallywide. Don’t try to attach a baby whose mouth is only slightly open, or you might have sore nipples and all the other problems associated with improper latch-on.
    • A very common mistake is to try to push and turn a baby’s head towards your breast. The rooting reflex makes the baby want to turn towards the pushing object. Many people interpret this to mean that the baby is turning away from the breast. They say the baby “rejects” the breast, and resort to artificial feeding. Don’t fall into this trap! Just tickle the baby’s cheek with your nipple, and she or he will turn towards the breast.
    • When the baby opens up really wide, pull him towards your breast all the way to your chest. It’s important to pull the baby close to make sure she or he gets a good mouthful of breast instead of just the nipple.
  • When a baby is correctly latched on:
    • Her or his lips should be flanged out, not sucked in. You should be able to see the inner surfaces of the lips on your breast.
    • Her or his tongue should be covering the lower gum. You can see this by pulling the lower lip slightly out.
    • Her or his cheeks should not be dimpled. Dimpled cheeks during sucking indicate poor latch-on and suction.
    • Her or his nose should be touching your breast. If the baby’s nose is away from your breast, she or he is sucking on just the nipple. You’ll have sore nipples, and the baby won’t get enough milk.
  • You might wonder whether you should hold your breast with one hand while you are breastfeeding.
    • You can hold your breast to make it easier for the baby to latch on.
    • If you do, make sure your thumb and fingers are well behind the areola.
    • Many people do a good job of keeping the thumb way back, but they put their fingers too close to the areola, just behind the nipple. Avoid this! Your baby needs to take in as much breast tissue as she or he can comfortably fit into her or his mouth. If your hand is too close to the nipple, the baby will just take the nipple in. You’ll get sore nipples.
    • Avoid the “scissor hold” in which you hold your breast between your index finger and ring finger. This style of holding the breast very often causes the baby to latch on to the nipple instead of to the breast.
    • Use the “C” or “U” hold, where you form a C or U shape with your thumb and fingers (as if you are holding a water glass). Hold your breast so that its compressed shape is in line with the baby’s open mouth (remember, you are doing this to make it easy for the baby to take in as much of the breast tissue as possible).
    • You can also hold and lift your breast to bring it to the level of the baby’s mouth. This is useful for mothers with large soft breasts.
    • You don’t need to worry about pulling the breast back from the baby’s nose to let the baby breathe. Babies’ faces are made for nursing. They can breathe with no problems with their faces smushed right into your breast. Pulling the breast away from the baby can lead to improper latch-on and sore nipples.
    • If you have flat or inverted nipples that stand out when you squeeze the areola, hold your breast so your nipple protrudes until your baby is latched on.
    • Once the baby is latched on and nursing, you can usually let go of the breast.
    • If your baby is able to latch on correctly without your holding your breast, you don’t need to hold it. Women with smaller breasts are more likely to be able to nurse a young baby without holding the breast. As your baby grows, you’ll probably find that you won’t need to hold your breast, no matter how large or soft it may be.
  • If your baby is not latched on correctly, remove her or him from the breast and try again. You should keep trying until the baby gets it right, even if you have to try twenty times. Pretty soon, your baby will learn to latch on properly, and will be able to do it without any help.”

RELATED POSTS:

https://singlemomontherun.com/2012/05/25/my-breastfeeding-story/
https://singlemomontherun.com/2012/06/17/choosing-a-pediatrician-its-like-going-on-a-date-2/

Rediscovering Myself: The Momma in Me

When I had my baby almost three years ago, I felt trapped, scared, and alone. The forty-one years prior to my child’s birth had been all about me: my schooling, my jobs, my love life, my friends, my travel. I was a busy woman and I liked it that way. I came and went as I pleased. I enjoyed the world and a myriad of activities. I ate and slept when I wanted. Flexibility in my day was mine, and I LOVED it that way!

But then came a day when that all changed. It was the day my little, tiny, needy, crying baby girl was born.

On some level, when this precious soul entered the world, the previous version of me packed up her suitcase and left. Or perhaps, part of me simply moved over and made room for her little soul to join mine to create a new and better version of myself. Either way, this 7 pound, larger-than-life being had taken my life over like an alien in Star Trek forcing me, a forty-one year old, seasoned woman to completely change my life.

The fact that the person I had known as myself was gone scared me immensely: “Who is this screaming child robbing me of my sleep and my life?” and “Who am I and what is to become of me now?”

It felt as if everything I had known was gone and would never return.

My mother gave me some sage advice that kept me going. “It won’t be like this forever, Christina. She’s an infant. In a few years, she’ll be less dependent on you and you’ll get back some of what you feel you have lost. Those things are not gone forever.” I held onto the hope and belief that someday I would be me again.

The past three years since her birth have been spent assessing my life and who I thought I was. What do I keep of my former self? What do I let go of? What do I gain in its place? How do I mother while maintaining my identity as an independent woman?

Compartmentalize & Focus
I was so used to multitasking that it was extremely frustrating to be so incapacitated while caring for my infant. She was also a difficult-to-soothe, colicky baby that did not like to sleep at night. This is all exacerbated by the fact that I was doing all of the nighttime care because I’m an NMSM (Never Married Single Mother).

To cope, I learned to compartmentalize my thinking. In these early months, I realized that in order to be the kind of mother I wanted to be, I would had to give myself over to parenting during those precious hours that I was with her. So, when I got home from work, I would make a radical mental shift and clearly accept that the next twelve hours would be baby time. I would repeat to myself over and over, “This is baby time . . . This is baby time,” as I walked down the sidewalk towards our townhouse.

Be Present
There was no use wishing that I could parent an infant and continue to do the things I used to do. I realized that I had to be present for my baby and wholeheartedly accept my role as a mother–no matter how difficult those hours might be. At the same time, I had to temporarily leave my transforming identity in the car until the next time I went off on my own.

Me Time
When I did leave the house it was ‘me time’, and I rejoiced in that. Granted I was working, and most of the time I wanted to put my head on my desk and take a nap, but there were those intermittent times when I felt like my old self again. I would deliberately seize those few minutes to just relax and enjoy life. This came in the form of stopping by the YMCA for a soak in the hot tub for fifteen minutes or taking a bike ride around the block for ten minutes before the babysitter had to leave.

The New Me
Now that she is almost three, things have gotten much better, just like my momma said they would. I have not reclaimed myself completely, and I’m not sure that I ever will or even want to do so. In short, I simply don’t see the world the same way I once did.

For instance, I recently signed up for a pottery class and claimed it as a delicately carved out period of time that I could spend doing something just for me. It was meant to be a visceral, creative, non-stressful endeavor where I could explore myself through art. What more could I ask for?

Lo and behold, what did I do in my ceramics class for the first three weeks? I’ll tell you what. I threw little tiny baby pots on the potting wheel so my little girl would have a miniature clay tea set that she could call her own. One day she could say her momma lovingly and solely made them for her.

The old me would’ve thrown five bowls all for myself. But now, as a mommy with a little two year old living in my heart, I am thinking of tiny hands and small smiles.

There is a new and better version of me that is still evolving, one which I am daily discovering, developing and nurturing. Every day I strive to find out what parts of me remain, what parts are only meant for my daughter, and what parts are some combination of the two of us. There was a former Christina and she may be gone forever. But in her place is a person defined by both me and my little girl, the little girl who brings out the momma in me.

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I was thrilled that  “The Power of Moms: A Gathering Place for Deliberate Mothers” published a guest piece that I wrote.

I hope you enjoyed it. And thank you, my little girl, for the opportunity to recreate myself, as difficult as that may be at times.

Skin-to-Skin Contact Following a Cesarean: Fight for It – It’s Your Right

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This piece is about the importance of mothers staying with their babies after birth and of experiencing immediate skin-to-skin contact, even if a C-section is warranted. In my case, I was holding out for a vaginal birth but ended up with a c-section. This is the story about how I was able to get skin-to-skin contact following a C-section despite my first doctor telling me that it would not be possible.

As I’ve mentioned in a previous post on the birth of my child, the first OB that I sought care under was mandating that I have a cesarean at 36 weeks, mostly due to CYA policies. Not knowing any better I originally went along with her decision.

However, one day I was talking over my situation with a well-published neuroscientist who had recently had a child of his own. He was appalled that my doctor would recommend a c-section at 36 weeks. He suggested that I start researching my options immediately. His opposition to the C-section was not just medically-based. He felt that C-sections could have negative side effects on a mother’s emotional well being and he was worried about the lack of skin-to-skin contact. He stated that skin-to-skin contact (which might not be available with a cesarean) following the birth of the child was a crucial element in mother-child bonding, to nursing, and important for the health and well being of the child.

What is Skin-to-Skin Contact?
When a baby is born vaginally, he or she is ideally taken from the birth canal and placed on the mother’s belly immediately following the delivery. The babe is covered with a blanket to keep her warm. Babies lay on their mothers and begin to regulate their body’s temperatures in synch with their mother. They exhibit pre-feeding behavior and start to learn to latch on and nurse. In some research studies, scientists have filmed the babies as they literally army-crawl up their mother’s chest to reach the breast where they can start breastfeeding! It may take an hour but they make it and with any luck they latch on and start to nurse. This is skin-to-skin contact at its best. The mother and baby are united skin-to-skin immediately following birth.

Of course, there may be times when the mother is what they call “medically unavailable.” In these cases, skin-to-skin contact with Dad or another caregiver has been proven to be equally as beneficial to baby.

Why is skin-to-skin contact so good for your baby?

  1. The sooner the baby starts nursing, the more likely it is that the baby will successfully nurse and will latch on well. With skin-to-skin contact it is also more likely that the baby will nurse exclusively for a longer period of time. During the first few minutes of life the baby is not eating per se but is practicing the act of nursing and demonstrating pre-feeding behaviors. These behaviors are crucial to long term successful breastfeeding.
  2. Skin-to-skin contact with the mother (or even a father or substitute caregiver) helps the baby to regulate its temperature more quickly and without the use of a warmer. Many babies are put into a warmer directly following birth. Research shows that skin-to-skin contact is more effective in regulating the temperature of the new born than swaddling or being put in warmer. Research also shows that when a baby’s temperature drops, the mother’s temperature rises to compensate for the loss of body heat in the baby. The mother’s body is designed to regulate her baby’s temperature. She literally becomes her baby’s thermostat.
  3. With skin-to-skin contact babies breathing rates and heart rates are more stable and the baby’s blood sugar is higher.
  4. Babies who have skin-to-skin contact cry less than babies who are placed beside the mother/father in a bassinet. This is true even for babies that receive skin-to-skin contact from their fathers when the mother is medically unavailable. The infants become calmer faster and reach a drowsy state faster than babies who are put in a warming cot next to the parent’s bed. If you are medically unavailable ask the doctors and nurses to allow you or your husband or partner or family member to provide skin-to-skin contact or create a lang in advance so that your birth partner or doula can make this happen. This is better than no skin-to-skin contact and can have beneficial effects on the well-being of the infant.
  5. Babies born prematurely recover more quickly when they have skin-to-skin contact. Skin-to-skin contact is being promoted more and more in NICU’s (neonatal intensive care units) to help babies who are born prematurely to thrive. Skin-to-skin contact can reduce the infant’s need for hospital-supplied oxygen.
  6. Can you still have skin-to-skin contact if you are having a C-section?
    When I found out how important skin-to-skin contact was for the baby, I immediately wanted this for my child and me despite the fact that I was scheduling a c-section. I approached my OB about it which led to many conversations, discussions and tears. I brought in research articles supporting my desire and outlining the importance of skin-to-skin contact. The OB responded “Don’t worry. There’s plenty of time for bonding later.”

She explained that the operating room was not designed for skin-to-skin contact; that there was a drape that came up to the mother’s neck which would prevent skin-to-skin contact; and that additional staff would be necessary to help me have skin-to-skin contact with my baby. She explained that there was a sterile field that could not be crossed and that having the baby on my chest could compromise the integrity of the sterile field. She also maintained that the possibility of skin-to-skin contact would depend on who would be available at the hospital on the day of my surgery and although she could try, no promises could be made.

This news led me to an all out search for a hospital that would allow skin-to-skin contact following a c-section.

Usual Practice
Until recently, usual practice involves separating the baby from the mother as soon as the baby is surgically removed from the mother. The mother is shown the baby over the drape, the baby is then weighed and treated and swaddled and placed under the warmer. That baby is taken to the mother’s room until the mother is finished being stitched up and returns to her room after a stay in the recovery room. The baby and mother are reunited in the mother’s room with the mother only have briefly viewed her baby.

Advocate for Yourself
After determining that skin-to-skin contact was a must-have for me in the case of a cesarean, I contacted three hospitals and asked them about their OR procedures with a c-section and whether I would be able to have the skin-to-skin contact I desired.

The doctors and nurses that I spoke with were all supportive of skin-to-skin contact. I recall one doctor saying that it would be against hospital policy but that rules were made to be broken. This same group of hospitals were changing their delivery practices and training their staff on the importance of in-room boarding (meaning the baby stays with the mother for as much time as possible rather than going to the nursery).

Be Persistent
I finally found an OB who was willing to honor my desire for skin-to-skin contact. The last thing he said to the accompanying nurse before I went into the operating room was “Make sure she gets her skin-to-skin contact.”

The idea of having my baby whisked away from me after the surgery that brought her into the world was devastating to me. I knew that this could not be right. I had carried this baby for nine months and they were going to show her to me over a drape and then take her away. How could this be healthy for the infant and the child?

Obviously, allowing skin-to-skin contact is not an insurmountable request. The obstetrician that I switched to at 28 weeks was Dr. Hartung of Hudson Hospital. He did not hesitate to honor my wishes. He ended up being my greatest advocate and allowing me to get my birthing desires met.

I want to thank Nurse Jessica and Dr. Hartung for providing me with the best birth possible with my cesarean and for helping me get the skin-to-skin contact with my baby that I so desired.

In the meantime, if you are planning a C-section, ask about the possibility of skin-to-skin contact. If the doctor refuses, stand your ground. If the doctor continues to resist, call other hospitals and find a doctor that will honor your wishes.

And, of course, remember that most births do not go as one plans. Even in cases where skin-to-skin contact doesn’t occur due to uncontrollable circumstances, the baby will still thrive and bond with his or her mother. And just because one doesn’t have skin-to-skin contact right away does not mean that breastfeeding isn’t possible. What in theory is the BEST for our baby doesn’t always match with the reality of mothering. We can only take what we know to be best and do with that what we can.

Things to Think About:

As a society, how can we advocate for change among OB’s such that they are open and willing to the idea and practive of skin-to-skin contact even in the case a planned or unplanned C-section?

How can mothers advocate for themselves with OB care such that they can get the type of birth experience that they desire?

How can we be proactive in attempting to create change at the hospital level?

What can we do in our own community to educate OB’s and hospitals about the importance keeping babies united with their mothers especially during the first few hours following birth?

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Vaginal Birth After Cesarean – Make an Informed Choice

When I was 28 weeks pregnant I ended up changing obstetricians.

A year before getting pregnant, I had surgery on my uterus. Basically, my situation as a pregnant woman was similar to that of a woman who had previously given birth via cesarean and was pregnant again.

When I went to the doctor I assumed I would be able to have a vaginal delivery because my surgical report stated that it was not contraindicated. In other words, the surgeon said there is no reason this woman can’t give birth vaginally. However, during the first ten minutes of my first OB visit the female doctor I had chosen informed me that a cesarean at 36 weeks was mandatory in order to reduce all risk of uterine rupture (which is reported as less than .01%).

Full term is 40 weeks.

The doula I later hired was appalled. She said, “That’s like planning to deliver a baby prematurely.”  

As this was my first pregnancy I assumed the doctor was making a sound medical decision and that this was my only option. However, it was only after I began searching for hospitals that allow skin-to-skin contact following a cesarean (something my doctor would also not agree to) that I learned I had other options and that my first doctor was taking THE most conservative approach.

I was furious that it took me 28 weeks to learn that I had options.

During my interviews with other doctors, I learned that some doctors would not even think of performing a cesarean at 36 weeks. I learned that many women choose to have trials of labor, to attempt vaginal deliveries, and still others, after weighing the risks, to have cesareans, usually around 39 weeks. At no point during the many months I was treated by my original doctor was I informed of these options or given any autonomy in this decision.

Why didn’t my doctor explain my options to me? Why didn’t she explore what was medially possible rather than just taking the most conservative approach? Why wasn’t I involved in the process of making this decision?

This doctor’s fear-based approach to this health care decision was less than empowering.  She basically gave me the impression that I could die in my living room at the first onset of contractions if I chose not to deliver by cesarean at 36 weeks. I was panicked at the thought of making a decision contrary to her’s. She was seemingly prioritizing the hospital’s and the clinic’s liability over the health of the baby.

In addition, she was not open to other opinions. When I informed my doctor that I would be getting an opinion from a perinatologist (a doctor who specializes in high risk pregnancy), she stated, “I’m sure he will have the same opinion as I do.” When asked if a differing opinion would change her mind she stated that it would not.

Contrary to the information she gave me, I learned that from other doctors that a uterine rupture was a very unlikely event and that a later cesarean could easily be scheduled with little risk to me or the baby. There was a general consensus that attempting labor following uterine surgery involves risks and if I was motivated to take that risk then these other doctors would be willing to accompany me on that journey. At the same time, they would all be just as comfortable scheduling and performing a cesarean at 39 weeks or even later if that was what I wanted. It was a hard decision, but I felt better knowing that I had been given all the information in a non-biased way and that the decision was mine. From all of these providers I was left with the impression that we would be negotiating a treatment plan and that we would be working together as a team.

The medical treatment I received at the women-only clinic was not consistent with their motto. The website stated, “At [our clinic], we strive to help you be as informed as possible while you make your health care decisions.” I question the ethics of an approach that withholds information and options available to women. I would encourage all clinics to adopt such a motto and to take it to heart as all women deserve to make personal, informed choices about their healthcare.

I chose my original clinic because of its all-female staff and because I thought I would be treated from a woman-centered approach. However, my experience was quite the contrary. I did not experience my treatment as woman-centered, nor did I experience my treatment as being respectful of my rights and autonomy regarding choices around my healthcare. A health care clinic that prides itself on an all-female staff should provdie a practice that empowers women and values her right to free choice and information regarding her delivery options.

In sum, there are many women who would prefer to attempt labor following uterine surgery or a prior c-section. However, a woman must have all of the facts and options available to her so that she can make an informed choice.

Unfortunately, cesareans are on the rise because doctors shy away from VBACs (Vaginal Birth After Cesarean). If you are pregnant and have received an opinion from a doctor that recommends an early c-section or a repeat c-section, consider seeking a second opinion. The last four weeks of development for the infant are crucial in regards to its long terms health and well being. The lungs are still developing and there is evidence to suggest that babies born before 36 weeks are more likely to have asthma. Get all the information you can and make the best decision for you and your baby.

http://ican-online.org/

http://www.vbac.com/

At 42 weeks Dr. Hartung, of Hudson Hospital and Clinics, delivered my beautiful baby girl via cesarean due to medical issues unrelated to my prior surgery. She was a happy and healthy baby.

Dr. Hartung


Here I am with my baby’s doctor right after everything was over with. Dr. Hartung was amazing! (He practices at Hudson Hospital in Hudson, Wisconsin.) We live in the Twin Cities (Minneapolis) so we drove about 1/2 hour to each appointment with thim.

He was open to me making the birth experience whatever it was that I wanted it to be. Even though it ended up in a c-section, he encouraged me to try for a vaginal birth but left the decision up to me. After meeting with many people who were motivated only by risk management, it was refreshing to have a doctor that was motivated by birth being as natural an experience as possible while having respect for medical issues that could arise.