Making new tradtions

After writing the last post, I began to mourn our own loss of tradition and history in childbirth, so I came up with what I would like to see happen to include this in our lives today:)

Our baby shower: today we have baby showers, but I would love to see something more than just the passing out of gifts and little games played. This should be a time to honor and help lift up the mom to be, and I think it should be done with each child. Women invited would share positive birth stores. Stories from the new mothers ancestry could also be told. These stories should include stories of strength and courage, not just in birth, but throughout life. Friends and family could then also share examples of how the new mother herself has shown courage and strength. A quilt could be tied that has scrap pieces of cloth that each woman present brings. This quilt can then be brought with the new mom to the hospital (or where ever she is giving birth) and used as a reminder that, while not everyone is there, there are many women who love and support her.

At the beginning of labor, or when ever those darn braxtin hicks contractions start coming, a new mom will pull out a piece of paper and write a note to her unborn child about her love and joy she has for this child. This can be a continued project until labor gets so intense that she can no longer concentrate, or (if she has an epidural) she is ten centimeters dilated and is ready to push.

The father can help the new mom prepare by learning how to focus on her needs without her having to tell him. This may get a chuckle:), but that is exactly what they are going to need to do during labor. Both can use the few months before labor to spend extra time with each other and focusing on the fact that, together, they are going to bring a child into this world. Go on extra dates. Talk about future plans, expectations, desires for this child.

After birth, I really feel that the new mother should have at least a few days completely alone with her new baby once she is at home.

I need to come up with some ways that hospital staff can help support and strengthen tradition in birth. Maybe I'll post on that later. But for now, I think it would be neat if we could find some way to bring back birthing traditions...not just because it's neat, but as a way to strengthen and encourage the new mom in the great work that she is about to do as a mother. I would love to hear anyone else's ideas on this if you would care to post:)

Birth in Slovania

"I am from Slovenia (neighbour country to Italy and Croatia....).

We dont talk about giving a birth in that "pain" way. We are talking regarding what is the most natural and normal way of giving birth for mother and for baby. That is why we do not have so many epidurals, as they are saying that a lot of babies are then being born with a help of vacuum....possible complications...

My both grandmothers are still alive and one of them had 11 children and the other had 9 childer. They all gave birth at their home, alone, no midwifes....nothing....and all of my aunts and uncles are normal, succesfull people. So we all believe that womens body is "designed" to carry a baby and to give a birth and we shouldnt make out of that experience a mediacal procedure. In Slovenia, you can not have scheduled c-section, unless there is a medical health reason for it. A group of doctors, beside yours, will decide, if you need c-section or not. And it is really rare.

You are talking about mortality of babies...I dont remember if i have heard of maybe 2-3 babies in last 15 years, being born dead or died right after birth in Slovenia.

And another very important thing that my grandmothers told to me....lets say advices: when you feel that the proces of birthing had begun sit on a hot towel..it will help you open more easily, warm showers; move, move and move - walk.....; and for the last part of the birth, when you feel urge to push...go into sitting position, hold your self to something solid, and then push. They dont understand how a woman can give birth by lying in bed.

All of my girlfriends and the other women that I know, have given birth in hosptital, totally naturally, or in our meaning normally, with their housbant at their side and midwife. When you see a doctor during birthing process you know that there is something really wrong. Even when you have induced contractions, they dont give a women epidural.

When I was talking to a few friends and my mom that I am thinking about epidural...she told me why? Birthing a baby is a normal end of a carriing process, and why would I like to robb myself from that wonderful experience, of baby being put to your chest right after birth, and of knowing that you did your own birth. She sais that it is very empowering feeling at the end, and that she feels "sorry" for the man, that they do not have privilege to feel that, like we do. And my mom was under induced contractions for 12 hours with me.

And another thing. We also do not have a mesaument for 'timing' a normal birth. If a women is not dialeted at least 4-5 cm, they wont accept you into the hospital.....unless they diagnose, that something is not ok while checking you."*

I thought this was a fascinating look at how culture plays a part in how we view birth. In the US, I feel like birth, and the pains of birth are surrounded in fear. Many, many women fear the pain of birth, yet according to this lady from Slovenia, they don't there. I also thought how neat it was that she was able receive wisdom from her grandmothers regarding birth. Most of our grandparents were part of an era where they were drugged up for birth and don't even remember it. Not only that, but this was something women were often times forced to do. What a neat heritage of birth women can receive. Just having that would be awesome.

*http://mybestbirth.ning.com/forum/topics/experience-from-europe?page=1&commentId=3120006:Comment:47088&x=1#3120006Comment47088

My do's, don'ts and hopes

I thought I would write out some of my do's, don'ts and hopes for those I speak to about childbirth. I got this idea from this site and loved the idea. So here's my list for my friends, associates and readers.

Things I don't care about:

I don't care where you give birth.

I don't care how you give birth.

I don't care what type of providers you use.

What do I care about then:) I mean, if I don't care about any of these things, then why do I write this blog.

I do care that you feel you made your choices based on what you want and desire, and that you received enough information to make informed decisions.

I do care that you feel you can look back at your decisions and learn from them.

I do care that both you and your baby are healthy, but that (more important, in my opinion), your cumulative life experiences have brought peace and joy.

I do care that you don't feel like you where stepped on, put down, or shoved around.

I do care that you have taken your birth experiences and used them to make you a better person.

My hope:

I hope that women can come to understand the great importance they play in bringing lives into this world, and that they can respect that in other women also. I hope that labor and birth can become of time rejoicing, overcoming, stretching, and finding the best in ourselves in preparation for motherhood. I hope all, at some point, can make peace with their choices.

I do advocate a natural approach for many reasons; medically, emotionally, and spiritually. But, I recognize that we are all different and at different points in our lives. Where we are at can largely determine how we experience pain and joy. That not only changes from person to person, but from time to time. Mostly I just encourage everyone to research their options, look at where they are at now, and learn from experiences they have had to become better women and mothers.

That good ol' placenta-fetal heart tones, part II

Now that we know what is normal, I think it would help to discuss how the baby is oxygenated before I move on to abnormal fetal heart tones.

The baby's lung does not function to deliver oxygen while it is in mom. Instead, mom delivers oxygen to the baby through the placenta. The blood of the mom and baby do not mix, just the oxygen transfers. Therefore, the health of the placenta before birth and during labor is very important. During labor, there is a temporary interruption of blood flow to the placenta during each contraction. Normally, the baby and placenta adapt fine to this and it is well tolerated. I'll go into more detail about what may cause problems in anther post.

References:

Obstetrics: Normal and Problem Pregnancies, 5th ed. Gabbe et al.

Fanaroff and Martin's Neonatal-Perinatal Medicine, 8th ed. Martin et al.

with woman

"What does the term 'With Woman' mean to you? I've been thinking about this phrase quite a bit, and I'm curious what others may think. I know the etymologists definition of midwife is "With Woman", but I'm more interested in what that means to each of us individually. Any suggestions?"

This was a question that was posed on a forum I subscribe to, and I found it interesting. Midwife is defined as "with woman", and that definition has played a role in how midwifes view themselves nowadays. I thought I'd just respond to this by relaying a few experiences I've had.

I think one of the neatest experiences I've had in being "with woman", was when I was working with a hospital based midwife. She stayed with the mother the whole time. As the mother was having a natural birth, both of our attention was undeniably on the mother. We watched her movements, tried to understand her needs, and spoke with her where she was at emotionally and physically at that time. I have never before experienced such an intense feeling of teamwork. Not only did we focus on the moms emotional needs, but there was a keen awareness of the need to focus on how the baby was doing also. There was no tension over whether there were too many interventions or not, because we were all on the same page. There was a sense of trust. And while there were some issues that were worrisome, there was no feeling of fear or adrenaline rush. We simply did what we needed to do. I think a lot of this was due to the fact that the focus was on the woman.

The other time I think of, was when I was laboring with a woman who had intended on going natural She had become exhausted by the time she got to eight centimeters. A decision was made at that time to get an epidural. She wanted to just have a light one so that she could feel a little bit more when she was pushing. Well, it came down to pushing time, and she pushed and pushed but that little baby just did not want to make his way down. So, me being the natural minded nurse I am, decided that having her push on her back the way I was taught she should, was ridiculous. I knew she was able to move a little bit more and we had lots of help, so we had her role over on her hands and knees and with support she pushed more.

She eventually was able to push her baby out, but the thing that was most memorable for me, was how I loved working with her to decide how she might be able to push better. I loved supporting her in her desire to push the baby out, and in her desire to try different positions (we even had her squatting on the bed with some support). I loved being able to make sure that her new baby was still ok by holding on the monitor while she pushed instead of having it strapped to her. To me, supporting her in this way was one of the things I love the most about my job.

Being "with woman" is a very intense, emotional and physical job. It takes a lot of brain work, and emotional work to do. It is so much easier to not do it, really. I think if you can find a caretaker that takes this view on as part of their job description, you've found a gem.

Fetal heart rate monitoring-what are those squiggly lines anyways?

I am doing some research on fetal heart rate monitoring. For those who don't know what that means, that's the machine they hook you up to to look at your babies heart rate. I thought I'd organize my thoughts here. So, for those who want to know, here's the down and low on what those lines across the screen really tell us.

Basically when we look at the lines on the screen, we are trying to discern just how well oxygenated baby is. A normal tracing (that's what we call those lines), is between 120-160 beats per min. The beats vary between 6-25 each time. This is called moderate variability. There is also what is called accelerations, or a rise in the heart rate more than 15 beats per min longer than 15 sec, but less than 2 min. All these things indicate that the baby is receiving adequate oxygen.

FIGURE 1. Reassuring pattern. Baseline fetal heart rate is 130 to 140 beats per minute (bpm), preserved beat-to-beat and long-term variability. Accelerations last for 15 or more seconds above baseline and peak at 15 or more bpm. (Small square=10 seconds; large square=one minute)

Here's an image of a good normal tracing. Basically if you see these things, the baby is handling labor well. I'll go more into detail about the physiology behind it all in another post. For now, here's a good link I found if you are interested.

http://www.aafp.org/afp/990501ap/2487.html

References:

Obstetrics: Normal and Problem Pregnancies, 5th ed. Gabbe et al.

Fanaroff and Martin's Neonatal-Perinatal Medicine, 8th ed. Martin et al.

Guest Post-Cherylyn Douglas:My Birth Transformation

I credit my mother for instilling in me a desire to give birth naturally, without pain medication. She was having babies in a time when women were being confined to bed and separated from their husbands, and even being knocked out with ether or chloroform during labor and having their babies delivered by doctors with forceps. Often they would wake with no memory of birth and wonder if they had a boy or a girl. My mom felt strongly that birth is a natural process and she could do this without the medical interventions of the day. She took Lamaze classes with my dad and went on to give birth to 6 healthy babies, each without pain medication other than a paracervical injection to numb the cervix for the pushing stage. She spoke openly about this with me and my sister when we were growing up, and I wanted to have that experience for myself.

When I was pregnant with my first baby my husband and I took a childbirth class at the local county health department and they taught us some basic breathing techniques and comfort measures. However, the majority of the class was dedicated to educating us about the actual function of birth, complete with diagrams and charts and explanations of the stages of labor and when to go to the hospital. I joined online birthing websites and read books and tried to educate myself as much as possible about birth. I felt if I could be well-informed then there was no need to be afraid. Unfortunately, I was still not prepared for what I would experience.

My water broke spontaneously and I had no noticeable contractions. Of course, I had been told to immediately go to the hospital if my water broke, so I did as I had been told to do. The hospital staff immediately started me on pitocin to get my labor going. It was a long, hard battle. The pitocin did indeed get my labor going, but it also made the labor so intense and difficult that I didn't know how to handle it. I forgot everything I had learned in our childbirth class about breathing and working with the contractions. I had told myself that I wanted to birth naturally, but if it got too hard then I would get the epidural, and that's exactly what happened. The epidural slowed my labor, and then the baby's heartbeat was erratic. The doctor explained that they would stop the pitocin to give the baby a break from the onslaught of contractions and give him some time to recover. They would then start the pitocin again and see if my labor would progress after that. He used the dreaded c-word and explained that if my labor did not progress at that point, they would do surgery. My greatest fear was materializing and I was terrified. I cried, and my family comforted me.

Thankfully, the plan worked and a c-section was not necessary. My epidural wore off just in time to start pushing, and I went from feeling completely numb to feeling absolutely EVERYTHING. I was not prepared for that kind of pain, and I endured it for 90 minutes while I pushed my baby out. It was traumatic. He was born in the middle of the night, healthy, after a full day of hard labor, and we were both exhausted. The nurses told me they would take the baby to the nursery so that I could rest, and I complied because I thought they knew best. I slept fitfully, and then woke up around 6am in a panic without my baby! I paged the nurses and had them bring him in immediately, and I did not calm down until he was with me. Breastfeeding was a challenge because he was so sleepy. I hadn't had the chance to establish breastfeeding immediately after birth and the baby was tired and sluggish, and I didn't know what I was doing! The lactation consultant was not helpful, but thankfully we figured it out and I went on to breastfeed my son for over a year.

Three years later I was pregnant with my second child, and I had decided that childbirth was just too much for me to handle without an epidural. When my doctor told me we could schedule an induction, I thought it was wonderful that we could plan it out and know when the baby would be born! I didn't know anything other than induction and epidural, and this was my way of taking control of the situation. It was a wonderful experience, and I remember chatting and laughing with my husband and the obstetrician while I was pushing. It was 4 ½ hours from the time they started the pitocin until my beautiful baby boy was born, compared to over 14 hours with my first. I was in a smaller community hospital this time, and the atmosphere was calmer and I felt I got more attention from the staff. I was able to hold my baby very soon after he was born, after the staff had checked him out and weighed and measured him. I had him latched on and breastfeeding before the doctor even left the room. I didn't like how long it took for my epidural wore off after he was born. I wanted to be able to move around and enjoy my baby and the birth being over, and that was an annoyance.

Two years passed and I was expecting our third baby. My husband, Matthew was in massage therapy school and he worked at the front desk of a massage clinic. He told me that one of the therapists there was a doula and she wanted to work with me and provide support for me at the baby's birth. I didn't know what a doula was, but I wanted to talk with her because I had many questions and I thought maybe she could help me. Mandy and I immediately bonded. I told her I had always wanted to give birth without medication but I didn't know how to do it! She told me she would help, and she answered all of my questions and helped me feel at ease about approaching birth in a new way. She helped me write a birth plan, outlining my wishes for childbirth. I realized that I had choices and could let the doctor and hospital staff know how I wanted to handle things rather than let them take the lead and tell me what to do. My obstetrician was very open to my wishes and willing to work with me, and I checked with hospital policies to ensure that my desires were feasible within their limitations.

I didn't know what to expect because I had never experienced my body starting labor on its own. I was sent home from the hospital three times because I wasn't progressing enough to be admitted, but I was determined not to be induced. I had early labor for about two days, and Mandy taught me how to breathe with the contractions and work with my body. The third time I was sent home from the hospital I decided to go home and sleep. My labor stopped for about a day, and I rested as much as I could. The next morning, my water broke while I was in bed, and Mandy met up with us at the hospital. It was beautiful! Because of the practice I'd had with my early labor, I knew how to breathe and focus.

Mandy and Matt worked together to provide comfort measures for me, including acupressure points and counter pressure on my hips, knees and lower back. I wasn't hooked up to an IV pole or monitors, and I could move around as I wanted to, leaning on the birth ball or walking around. I even got into the tub in my room for a little while, but it was too shallow to give me much comfort. I focused through the contractions and enjoyed the company of my husband and my doula between them. Only once during transition did I feel I couldn't do it, and Mandy told me “You ARE doing it!” She kept me focused and helped me through it all, and the hard part was relatively short. My healthy baby boy was born within a few hours of arriving at the hospital, and I felt like a super hero! I was energetic and happy, and I had never before experienced such euphoria after giving birth. I was able to breastfeed my baby immediately after his birth, and we spend some quiet time with him in our room without any interruptions from hospital staff. The nurses were very curious and asked me which birth method I preferred (epidural or no medication) and I told them I would do natural birth again without a doubt!

When I got pregnant with my fourth baby, I knew what I wanted. I had been permanently converted to unmedicated birth. My husband had a client who was a home birth midwife, and she offered her services if I wanted to have my baby at home. I politely declined, explaining that I had my OB, my doula, and my birth plan and I knew what I wanted. This time I was determined not to be sent home from the hospital, and I intentionally labored as long as possible at home. Again I had two days of early labor, and the labor stopped for a few hours while I attended my baby shower and then started up again later that night. My husband and I were watching TV, and when I got up to use the bathroom I felt a leak. I told him that either I had wet myself or my water had broken.

We called Mandy and made arrangements to meet her at the hospital. I was admitted in the middle of the night and labored for a few hours, using focused breathing and trying to rest between contractions. The doctor arrived in the morning and suggested that he could break my water to get labor going faster. It turned out the leaking I had was a forebag and not the actual bag of waters. I was ready to have a baby, so I agreed and he ruptured the bag. After that things went quickly and our beautiful baby girl was born within a few hours. Once again my husband and my doula worked together to give me the support I needed, and it was a wonderful, empowering experience. The baby latched on immediately and we bonded. My baby was beautiful, and I was thrilled to finally have a little girl, but there was a subtle nagging feeling in the back of my mind. I felt like something was missing.

When my daughter was still a newborn I decided to become a birth doula. I wanted to help other women as my doula had helped me. I felt she was indispensable in my achieving the beautiful natural birth experience I had always wanted. I started reading all the required books and took the doula training. I couldn't get enough information about birth! I watched The Business of Being Born, and learned that some women still safely give birth at home rather than at a hospital. Within a year I found I was pregnant, expecting my fifth child. I felt that I had some different choices to make, and I started thinking about planning a home birth. I researched it and thought about it and prayed about it. I felt peace, and it was a wonderful overwhelming peace. I knew I wanted to have this baby at home.

I called the midwife whose services I had declined for my daughter's birth, and started going to regular prenatal visits with her. I went to my obstetrician's office a few times during the pregnancy for certain things like an ultrasound, blood work and screenings, but the rest of my prenatal care was provided by my midwife. I trusted her and her 15 years of experience with home birth. I also met her birth attendants who were all doulas and midwives.

I had early labor, on and off, for over a week. I was anxious to meet my baby, but I had to practice more patience than ever before. I used the time to prepare things in our home for the birth. Four days past the due date, my midwife brought the birthing tub to our house and did a brief check for the baby's heartbeat, with my four children watching. Later that evening, my contractions were coming closer together and stronger. My midwife came over and set things up and we settled in to have a baby. I was focusing and breathing through the contractions and leaning on my birth ball. I labored in the bed and rested between contractions, and in the birth tub immersed in water up to my neck. The water dissolved the discomfort of the contractions and my husband pressed acupressure points while I breathed through them. We chatted with the midwife and enjoyed the quiet and peaceful atmosphere. I have never experienced such peace in the hospital.

As things progressed, a second midwife came to assist, and she cleaned my kitchen and helped get the kids settled when they started waking up in the morning. At one point while I was resting in bed, my water broke in a small leak and my midwife ruptured the bag the rest of the way. The kids went to play at grandma's house and things really picked up! We called the two oldest boys to come home and I as I was pushing we realized the baby was coming out breech! His bottom was coming out first. I was in the birth tub, and it felt really good to stretch my body out as I pushed. His bottom came out, then one leg, and then the other leg. Then his torso was delivered, followed by an arm, and then the other arm. And then, as my 6 year-old described it, “he put the hands and the feet on the bum cheeks, and he pushed his head out!” I only pushed for a few minutes, and my beautiful baby boy was here! He was healthy and perfect. I held him in the tub with me for a couple of minutes before the midwives helped me out to deliver the placenta, and then into bed. We cuddled and bonded as a family, and our oldest son cut the umbilical cord.

I've realized since my home birth that if I had planned a hospital birth for my breech baby, it would have ended in a cesarean section. If that was the only benefit of having him at home, it was definitely worth it, but there were many other blessings of having our baby at home as well.

I don't consider my home birth to have been a painful birth. I felt intense pain with my hospital births, and there were moments of discomfort during my home birth but never what I would describe as pain. I think it had to do with the peace I felt and the confidence I had gained from my previous birth experiences. I am no longer the meek woman willing to submit to whatever the doctor tells me I should do. I know exactly what I want and how to achieve my goals. I know what I am capable of, and I feel stronger than I ever have in my life.

I used to regret my earlier birth experiences, wishing I had experienced unmedicated birth from the first rather than the traumatic experience it was. Now I'm grateful for those earlier experiences for the way they've shaped me as a person and as a mother. My first birth experience was an important catalyst in motivating me to find a better way for me to give birth. I don't feel that there is one birth choice that is best for every woman, but I hope that each woman can know that birth is beautiful and empowering, and if you don't experience it that way then find out how you can.

Experiencing support

"Last night I had a dream that I was laboring in a strange place with people I didn't know, and I had no doula or midwife to support me... not even my husband. Some strange man was telling me what to do. THAT was scary"*

I'm afraid that too many birthing women have this experience. I have found it to be so important that we give women a better experience than that. In fact, one of Lamaze International's healthy birth practices is continuous support. You can read their recommendations regarding this at this link: Healthy Birth Practice #3

Some of my favorite experiences have centered around being supported and providing support during labor. I thought I'd compile some of my posts centered around support and post them. So here they are for those who are interested.

http://thebeginningofmotherhood.blogspot.com/search/label/support

*This dream was sent to me by a friend of mine. You can find her blog at http://mamasandbabies.blogspot.com/