Well Rounded Birth Prep

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Saturday, July 31, 2010

Guest post: Amber's intense homebirth story

Or, "Posterior birth is a pain in the sacrum."

You can read Part 1 of Amber's story here (How Amber prevented anemia & hemorrhage through healthy diet).

Originally posted Tuesday, July 20, 2010 at 3:08am

I've finally pieced this birth together after copying my midwife's brief notes today. This is a very vivid account and not for anyone who is not prepared to hear it. Sorry it's disjointed...had to write it out in pieces.

It was the end of May when the braxton hicks really started kicking up and I was starting to get those first signs of my body getting ready for birth. My thoughts at the time were: Hmm, maybe I am supposed to be due in June after all, but I kept my mind open to that little nagging thought that I probably wouldn't go into labor for another month. The little one was still lying in various posterior positions, however, so I tried to focus on exercising and getting her to turn. I read dozens of stories and experiences with giving birth to a sunny-side up baby to help get myself mentally prepared for the thing I dreaded most: a hard, quick labor that would take me by surprise and not allow enough time for my midwife to make it to the birth.

Six weeks. Yes, six weeks passed of cramps, horrible nausea, back ache, hip ache, pelvic ache, and regular contractions that would start off strong and hard and then gradually dwindle away after a couple of hours. With every new burst of activity (every couple of days) I was having good strong signs of losing my plug. I knew it "could'nt" be long...right?

Looking back I can see know how I did gradually progress through labor. I remember noticing when the days of cramps turned into days of contractions 10 minutes apart into days of stronger contractions 6 minutes apart and so on. I remember the first night I was tempted to call my midwife. I'd had cramps all afternoon that turned into light contractions that suddenly stopped. Then everything suddenly picked up again around 11 that night and I labored for 2-3 hours, even getting into the shower to help with the pain. There is no doubt in my mind that they weren't "real". They were perfect textbook "real" early labor contractions.

Then there was the week that I was "due" and my energy and mood suddenly hit the floor. I was so exhausted and discouraged. Nothing happened. Not the slightest thing. Not even my daily mile walk would stir up more than a few braxton hicks. I wanted to have this baby, but it wasn't the "I'm ready to pop. Get this kid out of me now." kind of feeling. I was sick of being stuck at home, but I had no where to go and it was so hot and miserable even if I had had something to do besides wait, wait, wait.

The next week things picked up in full force. Now I had to sit and focus through my contractions. I LOVED that I decided to get an exercise ball. That helped tremendously. By now, my midwife, Donna, and I had discussed what to do if she didn't make it in time and I felt prepared for anything even though I knew that I wouldn't want to go through transition and birth alone, but I knew I could at least survive. She also told me that I would probably hit 6 or 7 cm dilation before I went into labor since I had been at 5 cm when I checked into the hospital with Joey. I kept myself busy still trying to get the little bean to turn. At this point she would engage and wiggle back up while I was sleeping and turn to whatever side I happened to be lying on that night over and over, but on the whole she was staying more and more directly OP. I had nightmares of her getting stuck in deep transverse arrest and worked so hard to try to get her forward, but was so extremely frustrated that she just wouldn't budge. I also started worrying about her head not being nice and flexed, so I tried to do things that would encourage her head to tuck too. I also worried about what we'd do if I hit post-term dates. I didn't think I really was that far along, but there was no way to prove otherwise. It just seemed to me that this baby still had a lot of wiggle room and was just starting to feel like a full-term-sized baby to me. I tried to comfort myself with the thought that if she had a smaller head, maybe giving birth to an OP baby wouldn't be "so" bad. Finally, however, I knew that I couldn't give birth under so much stress; and after feeling very convicted over all my complaining, I gave every single thing over to God totally and completely. Ah, to have the peace of God reigning in your heart once more!

The whole week before I gave birth was horrendous. Beside the fact that my energy finally came back, I was completely miserable. I couldn't eat. I couldn't sleep. I was approaching the 43 week mark and knew that I'd have to go into labor soon or things were going to turn ugly with my back up care getting in the way of the peaceful homebirth of my dreams. The last three days leading up to birth were so bad that I thought I'd die. Six weeks of soft bowel movements turned into something akin to the most excruciatingly miserable stomach flu of your worst nightmares. I'd have very strong cramps, back ache, and contractions all in a muddle for hours every afternoon until I felt like collapsing from exhaustion in the evenings. All I could feel was pressure. Pressure on my bladder. Pressure on my bowels. Pressure on my pelvic floor. Everywhere. I remember thinking: If I didn't know better, I'd sware I was in labor. All this pressure and feeling like I have to pee nonstop and finally being able to pee a little just to have another stronger contraction immediately after...that was how it felt when I was in labor with Joey...well, minus all the upset stomach. I tried to laugh it off by cracking jokes and hoped that if my stomach was empty maybe I wouldn't throw up during transition this time. Yet, the whole time I finally felt like it was getting close...I wasn't going to be pregnant forever. I knew that I was going to have a baby by the weekend and I kept clinging to the promise "my heart trusted in Him, and I am helped; therefore my heart greatly rejoiceth" from Psalm 28:7. I knew that the Lord had ordered my every step with this birth and He was going to work every detail out to the very end for His glory. I was miserable, yes, but I had a strong joy running beneath the surface.

The night before baby came I finally got tired of "wasting" my days focusing on contractions, hoping/waiting they'd stick around and ending up frustrated and disappointed every night. So I got up and went to Walmart. We needed some groceries and I was going to live life as usual until this baby decided to come. I put everything away when I got home and cleaned up the entire kitchen. This house was going to get clean. I got up the next morning and had a bout of upset stomach pretty early and I thought: Hmmm, that was off the norm, but whatever, I'm ignoring it all until I know that I'm in labor. I actually feel pretty good now though, so maybe I can finally eat.

I decided that I was going to get everything done that I possibly could. I really wanted to start out the day making our Saturday morning pancake breakfast that I hadn't done in so long. So I started on some sausage and mixed up some homemade buttermilk pancakes for my hubby and added blueberries for Joey and me. I ate and wasn't sick. I felt so much better, though I was getting tired and knew I needed to sit a bit and rest. This had been my norm for the past two months. Joe helped clean up the kitchen while we laughed at Joey saying "bue-bee pancocks". It was a nice morning.

Sometime during all this I became vaguely aware of this odd pain and pressure in my pubic bones. It would come quite sharply, almost like a cramp, but also like the baby's forehead was hitting up against my bones and trying to press its way out my front. They would leave as quickly as they came, yet they were so infrequent I could go about whatever I was doing. I mentally noted that the time was around 11am just in case something happened today.

After I had rested, I started on laundry and general pick up around the house. The pain I was having was increasing and by about 1:30pm I realized that they were coming more frequently. They were enough to make me instantly drop to my knees and moan. I couldn't do anything as long as I was in pain, but as soon as it was over I would get up and continue cleaning. I wasn't going to stop my plans because they weren't contractions per se. My mind was set: I was going to ignore everything as long as possible. Also in my mind's eye, I still clung to a labor very much like Joey's: obvious. I knew that it would probably be more intense and shorter this time around, but I still had convinced myself that though maybe it would be bad at first, she'd turn...and I'd still have time to get Joey taken care of and my midwife would get here, and I could labor just fine on my own until transition hit when I'd need someone to lean on. I still pictured a very peaceful birth in every way.

At 1:58pm I asked Joe to start timing contractions. I would have this pain, then a series of contractions--four or five at a time and then a minute or two pause before it started again. I was on my knees hugging my exercise ball rocking back and forth. It was all I could do to keep from crying. Joe started calling family telling them I was in labor which extremely irritated me (No clue that I really am in labor at all, right?) because I was still trying to get things done! Yeah, this hurt, but it would stop. It always did. All this pain was weird, but how was I to know if it was really labor? I did decide to have Joey help me pack his overnight bag to keep him distracted. I told him that he was going to go to Mama's house and he bounced back and forth from excited to leave and being scared for me. I was trying to play off all the pain as nothing for his sake now and trying desperately to be patient with his increasing fretfulness, but I just wanted everyone and everything to go away and leave me alone! I couldn't think! I was so aggravated! (And so the second clue that I really was in labor passed me by...)

At 2:42pm, I struggled to update my facebook status while Joey clung to me crying and trying to kiss my boo-boo's while Joe tried to keep him off of me, only agitating him even more: "Okay so the past hour has been non-stop coupled contractions mixed in with this pain...it's been total chaos...I need to try to figure out how to get on top of this stuff. Wish me luck! ...and hopefully this baby will turn and some of this madness will stop!" This was still my frame of mind. I finally caved in and called my mom to come get Joey NOW and my midwife to tell her that I was in considerable pain, though I was still trying to laugh it off in my denial that I was so close. I still had convinced myself that I had a couple of hours to worry about it all.

Joe carried a screaming little boy out the door as I ran to the shower. He came back to ask if I were sure it was okay if he left me alone or if there were anything he could do for me and I practically screamed "No! Just leave me alone!" And alone I was. I regretted it all in about five minutes. Nothing was helping. I couldn't relax and breathe through the pain. I needed someone. Oh! I didn't want to be alone anymore! I was in a mental agony, but still I was sure I had time. This baby would turn and it would settle down and then I could gain control. I called my sister-in-law. I had to have someone help me to get control and I knew she could help. We talked for 8 glorious minutes as she helped me relax enough to vocalize properly through the contractions. In a passing thought I said "I feel like I'm in transition" though I was only now giving into the fact that I was in labor for real. I still felt sure I had time, but she suggested I call my midwife back to see how far away she was and told me to call back if I still needed her. She was as cool and calm as anything. It was wonderful! The time was 3:15pm. I had been having contractions for about an hour and 20 minutes. I could barely talk to my midwife, but got out between contractions "I'd really feel better if you were here right now." She was just headed out the door and would be another hour!

I vocalized through some more contractions until it hit me with a huge sinking in the pit of my stomach: my contractions were starting to spread out and I was starting to feel more pressure in my back and that same feeling that I had with Joey...I just needed to squat... "Oh, God!" I prayed, "Please let someone get here! I don't want to have this baby alone!" I HAD been in transition and I wasn't ready for what was coming. I started feeling like I was in a cage. I paced around and around in the shower like an animal trying to get comfortable and too afraid to leave the slight comfort of the warm shower. I did sort of laugh to myself as I recalled watching our dog in labor. She would do the same thing right before pushing another puppy out: pace around and around, squatting, coming over to Dad for a gentle pat of reassurance, pacing, pacing, squatting, pushing out a puppy finally...you know it's pretty "primal" when you can compare yourself to a dog...lol. If I had been at the hospital I would have given myself the epidural, yet at the same time I knew it was too late. There was nothing to be done now but to face the horror that was in front of me alone and without anything at all to help.

I'd been in the shower for half an hour and it suddenly ran cold. Well, I thought, I guess that's my cue to get out. I tried to dry off and a contraction hit me so hard that I fell to my knees and clung to the side of the bathtub as for dear life. There was no turning back and I was trying to stop fighting it, but I couldn't yet. My body was starting to push at the peaks of the contractions. They were so severe that, try as I might to keep from it, all I could do in the end was scream and growl like I didn't know was possible. This was the kind of labor that I dreaded...great...

I called Joe and waited for him to pick up. In my head: "Please, please, please! Another one's coming. (Oh, God! Please help me!) Hurry. Pick up the phone. Too late..." With the hello on the other end of the line came a full series of screams at the top of my lungs. It was uncontrollable, though I was laughing to myself that here I am calling my husband and screaming as though someone were torturing me to death...kind of a funny situation, don't you think? This was completely different from anything that either of us were prepared for. After the contraction was over I panted out that I needed him here NOW! He was 10 minutes away and was going to call our friend JoAnna to come just in case Donna didn't make it since she was trained in emergency birth and was 15 minutes away. I felt slightly better. I wouldn't be alone much longer. I moved around so that I could cling to the towel I was on. I alternated from being on my hands and knees to lying lower on my elbows with my butt in the air.

Though I know how worried and helpless he must have felt, I was super impressed with how Joe helped me once he got there. I kept screaming and crying that there was nothing he could do now, but he remembered how I'd had a cool clothe on my neck and forehead while in labor with Joey and he tried so hard to stay calm and tell me how well I was doing and it would be okay. God bless him! I could feel myself giving into the pain a little, and while he was gone to check to see if JoAnna or Donna had come yet, my water broke. The baby descended a little further and then I realized that my every nightmare was coming true: I was going to have one of those horror birth stories. I was so glad that I could scream with all my might in the privacy of my own bathroom and that the neighbors were too deaf to hear. Yes, I actually used this thought to help cope.

Joe called Donna at 4:06pm to tell her my water broke and I was pushing. She was about 10 minutes away! Hurray! Perhaps she would make it, but there was no JoAnna and she should have been there by then. Still all I could do was scream with every contraction. Sometimes I would wrap my whole stomach in my arms and just let my body push with all it had. I couldn't believe how strong my body could work without my input. I was so exhausted, but there was nothing to do. I couldn't fight the pushing, but I did fight with the pain. I couldn't relax. I couldn't breathe. I'd just start to catch my breath and try to calm down a bit when another contraction would slam me into the floor again and all I could do was scream literally as if someone were stabbing me to death or ripping me apart. I was as low on the floor as I could get with my pregnant belly, clinging to the towel I was on and trying to spread my hips out as wide as I could. This position helped, but as I felt the baby descend lower and lower the pain increased more and more until there was no respite between contractions at all. There was so much constant pressure that my screaming turned into a growl with pushing and then into huge sobs after it was over. I kept praying, "Oh, God! Please help me! Give me strength. Oh, God! Please! No! Not another one. Not yet. I'm not ready..." The scripture I'd clung to for days would answer back: "my heart trusted in Him, and I am helped; therefore my heart greatly rejoiceth." Honestly, in the midst of the most horrific pain I hadever felt in my life, I could say this was just so. I knew God had directed my paths concerning this birth; I had trusted Him completely; I knew He was helping me; and I was so glad that I was at home knowing that soon it would be over and the incredible blessing that God was bringing would be more than worth it all. My heart did rejoice.

Donna came at 4:16pm and I think JoAnna arrived about that time too. They made quick work at setting up all the supplies and as Donna came to my side, applied pressure on my sacrum, and gently talked to me, most of the tension I'd held onto instantly melted away. It hurt so badly, nothing let up, but I didn't have to fight the pain anymore alone. The baby kept moving and the pressure on my tailbone increased to the point where I knew it was hitting the maximum of its ability to stretch and make room. I poured out all my sorrows in broken sobs between contractions and Donna was so wonderful a motherly comforter! If I could have moved at that point, I think I would have climbed up into her arms. I thanked God so much that I'd found her and that she was finally there. Things were still getting worse pain-wise, but I was finally calming down and gaining some control. She handed me a rolled up towel at some point and I bit into it and screamed with all my might into it. It felt so good to let it all go; with Joey I calmly breathed out the pain, but with Leah, if I had to scream, at least I could finally scream out the pain.

Then her head was right there; it was time for crowning. I really was not ready for this yet, but I knew this was the last fight and the sooner I gave in, the quicker it would be over. It actually was an amazing feeling. I had missed out on this with Joey since I was laid on my back and told when to push. In the midst of the agony I was in awe. I could feel her moving forward and then sliding some back; with each fresh wave the burning increased and I struggled to let go so my body could stretch freely. Yet this pain was only a drop of the new level of pain that was mounting. Yes, it is true, it happens, and the only way to describe it is this: you feel like you are being ripped in half from the bottom up. My hips and tailbone were being stretched to their breaking point. I grabbed my bottom and screamed harder yet. I didn't know that little, quiet me had all that bound up inside her. It was the only time in my life I was tempted to shout profanities at the top of my lungs. How great the grace of God was upon me at that moment I could never tell you, but I know He was the only thing keeping me now. Greater and greater was the pain still until suddenly out came her head and instantly there was relief. Donna told me not to push. I knew the baby needed to rotate to get her shoulders out so I waited for my body to tell me what to do. Once I felt like pushing again and Donna gave the okay, I grabbed my stomach once more and felt all of her slide out of my body. Donna announced "It's a girl!". It was 4:44pm.

I was done in slightly under 3 hours. I was never so relieved in my life. Instantly, I could smile and chatter to my little girl after Donna passed her between my legs and I held her for the first time. She cried softly a moment and then was so quiet and alert. I leaned against the sink and marveled at what miracles my God can do as I watched her pink up and thought about all that was going on in her little body. All too soon the placenta came and it was time to get up. No hemorrhage. I knew there wouldn't be; that fear had left me long ago. I handed her away and Joe took her. He finally had his little girl. It was amazing to me that I only shook very slightly for a minute or two and instantly felt like I was able to get up, with help of course. I sat in the warm tub a few moments with her again as Donna started to clean up. Eventually we made it to the bed and we nursed away. It was so nice to curl up with a new baby at my breast and my husband by my side and truly relax while you were at total and complete libery the fall in love all over again. No strangers. No routines. Just time standing still--allowed to stand still--in one of the most important moments of your life. Plus, it was so nice to have someone walk in with a genuine smile and tell me how amazing I was, that I did a great job, and that how easily I delivered her showed how well I'd taken care of myself during pregnancy. (Donna told me the next day that not only was she OP but presented the crown of her head first as well...yeah, I guess that does make a difference...her head was barely molded at all.)

I lie awake staring at her all night while she lie in my arms--something I couldn't do with Joey and I had mourned so badly all this time. Finally, there was healing. Finally, God had brought to pass His promise to me: "Surely goodness and mercy will follow me all the days of my life..." For all the horror of her birth, the recovery was amazing. I didn't tear and I wasn't swollen. There was only one very slight little skid mark and by the time I made my third trip to the bathroom that night, I wasn't sore at all anymore. I bled heavy for only a little over 24 hours. Other than my tailbone aching if I sit too long and after birth pains to match the birth, I've been absolutely great! This little one is and will be the blessing that only God knows how badly we needed in our lives. "He gives beauty for ashes, strength for fear, gladness for mourning, peace for despair."

July 22 at 3:01 p.m. Amber posted in response to friends' comments on her birth story:

Thanks all, but really I can not accept the credit for being some special, strong person, because I'm not. I lay awake thinking about it all night. It bothered me so much to not say anything. This birth really was my worst nightmare in every way except God was merciful enough to let Donna get there just in time (her head was already showing) so I would have someone physically there to lean on...He knew I couldn't go any further without her. I seriously felt like He had to drag me kicking and screaming through the entire process. How do you like that? Can you picture our gentle Shepherd dragging that stubborn of a lamb? ...but He did see me through.

I'd forgotten until last night, but He also really impressed upon me that last week the scripture: "When thou passest through the waters, I will be with thee; and through the rivers, they shall not overflow thee" and really that whole passage of Isaiah 43. I knew it was going to be bad. I felt that my whole pregnancy; but I also had God's full assurance the entire time, and particularly at that moment of surrendering every fear over to Him, that He would work it all out in the end for such an amazing blessing to our lives. I can't tell you how it has been the beginning of bringing it all to pass! I'm still just as in awe as ever at how God works and just what He can do.

July 29 at 9:54 p.m. Amber's Facebook status:

The more I think about it, the more I wouldn't change a thing about Leah's birth. Not only have I gained a new level of confidence, but I can look someone squarely in the eye and say honestly that I know how painful labor can be...but I can also honestly say that to have those first precious hours fully alert, focused..., and unhindered in any way was 100% worth it for all the beauty and magic I could never articulate.

Amber and Leah, one hour after Leah's birth

Amber is my sister-in-law, and Leah is my brand new niece who I cannot wait to meet! Thank you, Amber, for sharing your incredible story and testimony.

Guest post: How Amber prevented anemia & hemorrage through healthy diet

My BabyFit Success Story by Amber DeGroff

first posted Thursday, April 15, 2010 at 1:31pm

My First Pregnancy

My husband and I found out we were expecting our first the day after Christmas [2007], 4 months after we were married during our last year of college. I was so excited to be a mommy right away! I drove over to campus during winter break to hunt down all my professors to tell them because I couldn't wait until the spring semester to start! ...but right away I felt horrible. I didn't know what was wrong with me. I could barely stand up without feeling dizzy or shaky. A week after our good news I started bleeding what I thought was pretty heavily. We went to the ER and thankfully everything was well (no signs of miscarriage), except I was severely dehydrated. After I stopped bleeding and was re-hydrated, I was free to go home, but I was already starting to swell badly from water retention and couldn't figure out why (once classes started) all the walking around campus wasn't enough exercise to help control it. That was the hardest semester of all.

I quickly grew so fatigued that I simply could not get out of bed to make it to class and the problem only grew worse and worse. Finally, blood work confirmed what I suspected...I was pretty anemic and still a bit dehydrated. They started me on iron pills and I lived on spinach and roast and drank so much water a day it would make me sick, yet I never felt any better. I finished the school year, so glad to not "have" to get out of bed anymore and looking forward to relaxing all summer.

By this time, I started to really gain weight badly (once I gained 6lbs in a week) and tried to walk in the evenings but I could not stand up more than a few minutes at a time. My feet were severely swollen so that they ached constantly and nothing that I read to help never seemed to make any bit of difference in my energy level. I knew I was still anemic, but I didn't know what else I could do about it. I spent half the summer staying with our parents because I was no longer able to take care of myself. I lay on the couch, read, and slept because that was just about all I could do. Finally, with one month to go and having developed PUPPPS, I gave up. If my CNM labeled it "normal pregnancy fatigue" after voicing my concerns repeatedly, then I'd just have to be miserable for the next month and pray that everything would end well.

It didn't. The night before my due date, suddenly my body's energy switched on! I'd never felt so great my entire pregnancy and I just knew it was because labor would start soon and my body would need all the energy it could muster. At my last prenatal appointment the next afternoon, my CNM told me that I was having regular contractions and asked if I wanted checked. I told her no because I honestly didn't even have a clue that anything was going on! I didn't even feel the slightest pressure at all. So we shrugged it off, but a few hours later my water broke and active labor started immediately afterward. I labored for 6 hours and my wonderful, big, chunky son was born! I was so glad because I thought that all my horrible anemia was finally over, but it was just the beginning.

I started hemorrhaging badly. I was so weak and my blood pressure so low the first day of my recovery that I couldn't elevate my bed at all. I couldn't lift my arms more than a few inches. I couldn't hold my son. I didn't know how I was still alive, but I was finally sent home (after 3 days) with a bottle of iron pills and told that I needed to take 3 pills a day! Still, it took 3 months before I could really get out of bed. My son was 6 months old before I stopped having dizzy spells. At 9 months postpartum, I finally started feeling like I was getting my energy back and I was determined that I'd never go through that again! I began researching frantically about herbals and other natural means to dealing with anemia and postpartum hemorrhage.

My Second Pregnancy

I had lost all my baby weight plus 20 lbs (thanks breastfeeding!) when I noticed that I missed my period. My son had just turned 13 months old. I didn't want to believe I was pregnant again; I didn't feel ready yet. I denied it for 2 months, but once some extremely light nausea started hitting me I could deny it no longer. After all the research I had done I was convinced that having a home birth midwife was just what I needed...someone who had a few clients and could therefore really help focus on my health concerns and be completely supportive to the idea of letting me birth my way without any interference. I knew that since my pregnancies were fairly close together I was at a higher risk of a repeat of my first pregnancy, but this I was certain would be vital to preventing anemia and hemorrhage again. It was Christmas time once more when I made that first phone call and instantly fell in love with the first lady on my list of midwives in the area!

I knew this pregnancy would be vastly different. I didn't even "feel" pregnant until I was able to feel those little baby wiggles around 18 weeks along and even then it didn't really sink in. I just wasn't exhausted, swollen, or nauseated at all! Was this what "normal pregnancy" really felt like? I told my midwife my long story in all its detail and together we poured over my medical records from my first pregnancy to figure out just what happened and how we could better prevent it from happening again. She cared! I was so happy! Right away I started on an herbal combination with loads of iron and other blood-building properties to build a good supply of iron and blood clotting agents. This was my first step in preventing anemia and hemorrhage from happening again.

I continued my research on a better, balanced diet and the benefits of exercise and joined BabyFit at the suggestion of my sister-in-law to help me keep track of it all. I knew that my body would absorb the natural iron from food better than those iron pills so this was vital! It took a few months to adjust my diet just right, but I finally worked out how to provide my body, my growing little one, and my nursing toddler with all the nutrients we needed. Wow! What a lot of hard work, but it's been totally worth it! I have the energy to exercise in the mornings and chase after my crazy toddler all day...well, most days! Plus, I'm gaining just the right amount of weight and hardly have any water retention...even at night.

I have learned to listen to and trust my body. If it's not feeling well, it's not and I need to step up my game a little (and sometimes a lot). For instance, a few weeks ago I started noticing I was dragging a little more and becoming slightly paler. This discouraged me at first because I had been working so hard, but I also knew that entering my third trimester would bring a greater demand upon my iron supply since baby would start building his/her own. I scheduled a blood test to see how my total blood count was holding up and to see just what sort of a fight lie ahead of me. I was encouraged to find that it wasn't nearly as bad as with my first pregnancy! Everything was normal, but just barely within range. This confirmed to me what I had thought all my first pregnancy: that "normal" for me is on the high end of the scale. So once again, I set about adjusting my diet to get more nutritional bang for my caloric buck. With a few suggestions from my midwife, I'm back in business. I have two months to go until I'm a mommy to two little ones and am a completely different person than I was two years ago.

This pregnancy has had it's other many ups and downs...I've had 4 colds, 2 battles with the stomach viruses, and an ear infection (among other stresses) that has gotten me off the feeling-great train...but overall I feel so incredibly better that there truly are no words to describe it! I'm now totally convinced that there is nothing that a proper diet and a little exercise can't fix...or at least help prevent...and BabyFit has played a major role in making that happen. Thank you for this website! It has been such a blessing! Everyone comments on how great I look this pregnancy and I have confidence in myself that I never had before. I AM able to take control of my health. I AM able to make a change for the better. I CAN live a life with the energy to care and serve my loved ones as I desire to and I don't have to settle for anything less!

Part 2, Amber's intense homebirth story with baby #2, can be found here. Amber is my sister-in-law, and I'm honored that she shared her story for my blog. (How cool is it that I got a niece and a nephew a week apart!)

For more information on helping prevent swelling, pre-eclampsia/toxemia/PIH and HELLP, see Dr. Brewer's site. A pregnant mother needs a minimum of 75-100 grams of healthy protein every day. Using a free site such as babyfit.com can be useful for its free meal tracker database that allows you to estimate how many grams of protein, iron, and other nutrients you have consumed in a day. Amber's experience may be different than your experience. Her story and these links are not to be misconstrued as medical advice. Research it for yourself, ask your care provider, etc.

Thursday, July 29, 2010

Guest post: Josee Meehan's home waterbirth

I'm honored to feature a guest post birth story. I received this e-mail from Josee Meehan:

I just found your blog through the Unnecesarean. I've had two home births and one birth center birth. I've attached my middle child's birth story (our first home birth). Feel free to use my name/location. Here's a link to a photo taken 12 hours after her birth:

Thursday, January 29, 2009

Mild contractions begin, a few an hour while I'm awake. Danny is on the floor, putting a Little People figure through a wide-mouth funnel and quietly chanting “Come out, baby, come out.”

He knew that his baby sister was on her way. The contractions stopped and I slept.

Friday, January 30, 2009

I carried on with errands while Danny was at Parents Morning Out. I began to pass the mucus plug that morning.

A sleepover with Nana and PopPop had already been planned for Danny on Friday night. That afternoon as we coaxed Danny "Who's coming to see you soon?," he answered "Baby Ona." We were expecting him to say “Nana.” He definitely knew.

After Danny left, the contractions began building slowly from about 4:30 to 8:30, manageable enough for Jim and I to take a walk and go out to eat at our favorite Mexican restaurant. They felt pretty strong while I was eating dinner and I looked over at Jim and said, “You may want to eat fast, boy.”

Back at home, by 9 p.m. the contractions were getting longer and stronger and I could no longer concentrate on anything but the contractions. I had been watching You've Got Mail on Oxygen while draping myself over an enormous exercise ball. By that time, I couldn't talk on the phone with the midwife.

I took some Valerian root pills and went up to rest for about an hour or so with a warm rice sock wrapped around me and my old security blanket tucked under my chin. When I got up, I knew it was time for Julia to come and told Jim to get her on her way.

Jim made the call and then came upstairs. He inflated the birth pool and set up the birth supplies on the dresser, saying “You don't want to be fumbling around in the tackle box when the fish are biting.”

I laughed. He kissed me as I sat in the rocking chair and said, “We're going to have a baby tonight.”

“Maybe,” I said.

The ghosts of Danny's marathon 40-hour labor still haunted me. I had thrown up twice already and was getting nervous that this labor would take a turn for the worse like Danny's labor did. Luckily, it didn't.

Labor progressed rather quickly from then on. Jim kept me eating graham crackers and peanut butter and drinking Smart Water. I spent some time in the bathtub and then in the shower while the contractions got stronger.

Saturday, January 31, 2009

The midwives were on their way to the house by midnight. They marched in around 1 a.m., a bag in each hand, loaded with oxygen tanks and other supplies, that landed with a reassuring thud on our bedroom floor.

I had dilated to 8 cm by the time they arrived. Jim, Debbie and Julia took turns rubbing my lower back during contractions. I kept telling Jim, “I'm not doing this again.”

At around 2 a.m., I was lying on the floor on my left side staring directly at the clock. Fiona's heart rate was dipping and Julia and Debbie urged me to get up before the next contraction. Her heart rate returned to normal as soon as I started moving around again.

Soon after, they started filling up the birth pool and when the water heater couldn't keep up, they began boiling pots of water to add to the half-full pool. From about 2:30 a.m. until shortly after her birth, I remained in the warm pool, switching positions from front to back and taking sips of cool water between contractions. Near the end, I started losing control and screaming. Jim encouraged me to keep my voice low (a tactic that Bradley recommends to help keep the mother calm). I began to groan low and slow. I was almost fully dilated when Julia encouraged me to just push gently with each contraction. Finally, I felt my water break and just minutes later out came Miss Fiona.

She was born at 4:22 a.m. The cord was around her neck, but Jim pulled it off. She pinked up right away and was breathing, but looked around for a few minutes before finally crying.

Julia and Debbie marveled at how they could hardly tell when I was having a contraction because I was so calm. She complimented us saying that were a perfect example of a Bradley method couple. They both said they wished we had videotaped the birth (maybe next time we will!).

After getting dried off and cleaned up, I curled up in my own bed, on my own sheets and my husband and I spent the next hour alone with our newborn daughter.

Josee Meehan (You can view Josee's blog here.)
Durham, NC


Thank you so much for sharing your beautifully written birth story with us, Josee! I loved how your son Danny had a special part in announcing his baby sister's upcoming arrival. It sounds as though the Bradley method worked wonderfully for you. I especially appreciated reading about the normal variations in labor and delivery that are not an emergency when handled properly. TV portrays birth so differently than reality.

If you would like to have your birth story featured on Well Rounded Birth Prep blog, please email your submission to me at wellroundedbirthprep (at) gmail (dot) com, with or without photos. Please let me know how you would like to be credited (anonymous, first and last name, initials only, location or no, etc.).

I welcome birth stories from hospitals, birth centers, or homebirths; whether medicated or unmedicated; vaginal or cesarean deliveries. Your birth story is special and deserves to be heard.

"Unnecesarean" vs. PREVENTABLE cesarean

Disclaimer: I am NOT anti-cesarean. Cesareans can be helpful or even lifesaving when appropriate. I'm thankful that cesareans are available for those who need them. I'm not trying to judge YOUR cesarean (or anyone else's, for that matter). This post is in response to Dr. Nicholas Fogelson/ The Academic OB/GYN's post today titled "The Myth of the Unnecessary Cesarean."

It would appear that Dr. Fogelson has gotten so wrapped up in the memorable blog name of Jill's popular site, The Unnecesarean, that he has overlooked the bottom line. The term "Unnecesarean" = "unnecessary" + "cesarean," get it? It's just a blog title, that's all! Those who have read extensively about births in general and cesareans in particular are aware that certain cesareans can be very *necessary* by the time they are performed, while some may have been utterly preventable. (If you still think that I'm talking about you, please read the above disclaimer.)

My friend Trebor's first cesarean story is a classic example of a preventable cesarean. She has given me permission to relate what happened. To make a long story short, her OB said that induction at 37 weeks was necessary because of "low amniotic fluid," despite the fact that the best evidence does not support inductions for such a subjective measurement when mother and baby are otherwise healthy. (She didn't know that, at the time.) Her baby's fetal distress during her labor after the induction was a direct result of the preventable induction; it was a predictable side effect of the induction medications and process. At that point, Trebor's cesarean was undoubtedly necessary, however, she now states that it was preventable. It all began with the Cascade of Interventions that was not medically indicated, in her case. Trebor feels that she was pushed into her induction because she was told that it was the only option she had; she now helps educate other women on their birth options and evidence-based care. She and I both hope to help empower women to make *informed* decisions (even if they decide on an elective induction or elective cesarean), so that they won't look back on any situation and say, "I would have chosen something different if I had only known __________."

The World Health Organization has stated, “It should be noted that the proposed upper limit of 15% [cesarean rate] is not a target to be achieved, but rather a threshold not to be exceeded.” From Henci Goer's post on Lamaze Science and Sensibility, "The WHO supports the 15% upper limit precisely because cesarean rates above the 15% ceiling result in higher maternal and perinatal death and morbidity rates." How can we then reconcile America's 32.3% cesarean rate? How can it possibly be argued that a large number of cesareans are not preventable?

Can we please stop arguing over the semantics? TheUnnecesarean.com is a catchier blog name than ThePreventableCesarean.com or InformedDecisionsAndKnowingAllYourOptionsBeforeChoosingACesarean.com. It doesn't mean that Jill--or anyone else who uses the phrase "unnecesarean"--doesn't understand the facts about cesareans or support mothers' rights to birth choices that they feel are best for them.

Monday, July 26, 2010

My friend's 50 min, unmedicated VBAC labor!

I was driving the kids to Vacation Bible School this evening when I got a call from Adam at 5:45 p.m. He told me that Michelle's water had broken and they were at Subway. I wasn't sure exactly what was going on with the timeline, but here's what I did know:

  • Michelle had been fighting preterm labor since 25 weeks along this time. She was now 38.5 weeks along, which is "full term."
  • Michelle had been at 5 cm dilated for about 2 weeks, until her most recent checkup, when she was 6 cm.
  • Her cervix had been thinning for months.
  • Her last labor was about 4 hours total.
  • She wanted a non-medicated, as-intervention-free-as-possible delivery but has a rare blood clotting disorder which put her at certain risks (hemorrhage from her necessary blood thinners, etc.) and this was to be her 2nd VBAC as well.
I had figured for weeks that as soon as Michelle's water broke, it would be all over. That's all it would take. She would have him within an hour or something crazy like that.

I dropped the older three kids off at VBS, then dropped my 20-month-old at a friend's with all the kids' car seats, since Rick (my husband) was still at work and would have to come get the car seats then the kids after work.

I left immediately to meet Adam and Michelle at the hospital. I forget who called whom and when, but I told Adam I was dropping my kids off and would meet them there. Adam said the ambulance wasn't there yet and Michelle felt like pushing with each contraction.

Uh oh. At that point, I realized with a mixture of excitement and dismay that I was not going to make it to her birth.

I arrived at the hospital at 7 p.m. or a little earlier. This was not quite 1 hr 15 minutes from the notification that Michelle's labor began. I found my way to L&D only to be told by the nurses that I would be allowed back there in a little while; they were cleaning them up.

I missed it. But that's OK, Michelle said she feels like she missed it, too.

She filled in the blanks for me. She had been eating a Subway spicy Buffalo chicken sandwich in hopes of throwing herself into labor. (Her OB recommended an induction with AROM and a low dose of Pitocin for this upcoming Thursday if she hadn't delivered before then. Michelle so hoped to avoid an induction.) While they were eating, Michelle thought she may have felt her water break a tiny bit. She told Adam, who then called me first. They thought they had plenty of time. Why? I don't know. But they thought that since Michelle didn't have any contractions yet, they could finish their sandwiches, drive home, pick up their birth ball and a few other things. As soon as Michelle got up and went to the bathroom, her water broke the rest of the way and she was immediately in transition. Her contractions were close together and very intense--instantly.

Somebody called an ambulance (I forget who). Neither of the EMTs in the ambulance had ever attended a birth. Michelle did such an amazing job coping with this precipitous labor.

To make a long story short(ish), they pulled the ambulance over and parked it, one block from the hospital, while Michelle pushed out Zachary. He was 7 lb 4 oz, almost 2 lb bigger than her previous VBAC baby. Her labor was 50 minutes from start to finish. Amazing!

I got there about 20 minutes after the birth and felt a little helpless. I had brought my birth ball and doula bag, complete with every sort of massage tool, aromatherapy, battery-operated fake flickering candle for ambiance, you name it. I guess it was a moot point now.

I took a few photos for them. Michelle gave me permission to post her story and photos. At least I could make myself that little bit of useful. I know there's nothing more I could have done. I came to visit Michelle while she was on bed rest and gave her mini-versions of my childbirth classes, adapted for her needs. I called and checked in. I encouraged Adam and Michelle to draft a birth plan for their preferences. And you know what? They got almost everything on their birth plan. Maybe that's the way it needed to happen in order to achieve their goals.

Proud new parents.

Here I am in the corner, basking in Michelle's glow. I'm so proud of her! She did such a wonderful job! What a beautiful son! He's such a content baby and is nursing well.

Friday, July 23, 2010

Birth politics, breech, VBAC, and doula'ing--oh my!

I'm still over the moon about doula'ing my nephew's home waterbirth 5 days ago, but eagerly anticipating the three other births I'm on call for. Lord willing that I can make it to all three births, they should be very different experiences, and I'm so thankful for the (potential) opportunities to support my friends to have the best possible births for their situations.

One friend is low-risk and planning a homebirth with midwives. She had a hospital birth with her first child and didn't feel supported by the staff. She felt pushed (for the staff's convenience) into interventions that she didn't want or need, and she did not feel that she truly gave INFORMED consent. How is it possible, when the interventions were presented in a way that gave the impression that they were 1. necessary, 2. urgent, and 3. the only possible option? Sometimes interventions meet one, two, or all three of the criteria I just listed, but in her case they were not.

She hopes to have a healing birth this time, one where she is supported and encouraged, rather than coerced or made to feel fearful or pressured. I'm excited to attend another homebirth; it's what I love. However, homebirth is also what I know best. I'm coming to realize that I have the potential to learn and grow far more from the births I will attend that are far outside my realm of familiarity and experience.

I am also on call for the hospital birth of a mom who has been high-risk for all three of her pregnancies. She has a rare blood-clotting disorder which necessitates certain interventions for her safety and for baby's. Her first birth was cesarean; her second was hospital VBAC. She is preparing for another hospital VBAC, even though her heart yearns for a peaceful homebirth. Her circumstance is one of those for which I am thankful for the specialized skills of obstetricians. Midwives are experts in normal birth and a number of variations, whereas OBs are highly trained surgeons. Going to an OB for a normal, low-risk pregnancy is like going to a periodontist or oromaxillofacial surgeon for checkups instead of going to your regular dentist for checkups and maintenance. Your dentist is trained in normal oral health and care, and can perform a number of necessary procedures in his/her office. If a specialist is necessary, a dentist is trained to recognize the situation and refer the patient to the appropriate specialist. It's much the same with midwifery.

I digress. So, this friend of mine really needs an OB in a hospital because of various risks associated with her rare disorder. I'm trying to help her prepare for the best possible birth for her, including her preferences for Plan A (no interventions or as few as possible), Plan B (in the event that an induction becomes medically necessary--special considerations for VBAC), and Plan C (a family centered cesarean--no, that's not an oxymoron). In fact, I try to encourage all my clients to draft 3 plans that way. It's always better to be prepared. Murphy's Law and all that.

Anyway, this birth (provided that I make it on time--her last birth was very short!) will give me experience observing several categories of birth that are totally new to me: VBAC, high risk, and interventive hospital birth.

I'm so excited about the other birth I'm awaiting that I'm nearly ready to pee myself. Are you ready for this? I'M INVITED TO ATTEND A VAGINAL BREECH BIRTH!!!!!!!!!!! Do you realize that vaginal breech births are almost unheard of nowadays? Not because they're unsafe (they can be safe), but because care providers are no longer trained on how to attend breech births.

This momma has done EVERYTHING UNDER THE SUN to get baby to flip head-down, yet he remains firmly frank breech. (Yes, we're aware that he may still flip vertex up until or even during labor.) She and her husband are not comfortable with a homebirth due to an issue that came up during their last two (hospital) births, so even though they found a homebirth midwife who volunteered to attend a vaginal breech homebirth for them, they really preferred to find a way to get support for their wishes in a hospital setting.

The couple discussed it with their OB, who agreed that she is the perfect candidate for a vaginal breech delivery! He was very supportive and encouraging, and told her she shouldn't worry, it wouldn't be likely to be any more difficult than a standard vertex (head-down) delivery. She's beside herself with joy, and I'm so happy that it looks as though she can have exactly what she feels is safest and most positive. I cannot WAIT to see how this story unfolds.

I'm beginning to think that this particular OB could possibly be WV's "Dr. Wonderful." Time will tell. I'm afraid to get my hopes up, but I've heard great things about this OB so far. He is rumored to be VBAC supportive as well as supportive of normal, physiological birth in general. He told this particular mom that she can absolutely attain her goal of a delivery without an epidural, and he reassured her that there is no reason for her to be stuck in bed in labor (that was one of her concerns; she wants to be mobile for comfort, for pain relief, and to allow gravity to assist in bringing her baby down). It sounds as though a normal physiological birth *can* possibly occur in a WV hospital, without a fight, after all!

This really is a basic issue of human rights and a woman's legal right to choose what is best for her circumstance. Recently, ACOG recanted their prior position of denying women the right to hospital VBACs, not out of acknowledgment of safety (the data have been there for years) nor out of compassion, but as always, for political and monetary reasons. They now admit what the birthing community has known for years: "Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans."

What does this say for the women who have been denied the opportunity to VBAC over the years? Shouldn't it be up to the expectant mother to make the decision what is best for her and her child? Consider this: if there is no allowance for informed refusal, then you may be assured that there is no such thing as true informed consent.

If you ask me, the same thing can be said for a mother's right to attempt a vaginal breech delivery, if she is a good candidate for it. It saddens me that so many women are denied the option. They are not even told they have choices. Many are not even told that there are more than a dozen methods to try to get a breech baby flipped head down, let alone that they may be able to successfully deliver a breech baby vaginally. Most are forced into scheduling a cesarean, denied even the option of attempting a trial of labor or of at least waiting until the labor begins on its own to perform the cesarean so that the baby receives the fullest benefits of labor (chemically, hormonally, etc.). When I say that mothers are "forced" into such a cesarean, I don't mean that they are handcuffed or that the doctor literally holds the woman's hand to the paper to sign the liability waivers for major abdominal surgery. No, it's more subtle than that. They're told that no good mother would risk her baby's life for the vaginal birth "experience." The risks of the cesarean are downplayed or ignored entirely.

It all comes down to true informed consent. If a mother is given all the most current information on breech vaginal birth or VBAC or whatever the situation is, including risks and benefits of doing nothing, interventions, C-section, or whatever, and still opts for the C-section, I can respect that. That's a personal decision, and only the mother and her partner can decide what is best for them. My beef is that many women are bullied or belittled and denied options.

I'm excited that so many of my friends are becoming educated about birth, learning their options, and claiming back the responsibility for their health and joint decision making. They are researching to find out which care providers (whether it's OBs or midwives) practice truly evidence-based care, and which are fearmongers and bullies. They come to their appointments having read up on their options so that they can ask intelligent questions. They want to be active participants in their birth experience, as opposed to having the entire delivery experience "done" to them.

I realize that I have such an incredible learning opportunity before me, in so many ways. I have the honor of being invited into the sacred and intimate space of a woman's birth (in fact, several!). I can learn how to better serve and care for a laboring woman and her birth partner. I have the privilege of supporting my friends in a vulnerable and memorable time. And what an amazing chance to see a wide range of birth experiences, and to become a better childbirth educator.

Monday, July 19, 2010

Doula-ing my nephew's gorgeous home waterbirth!

I'm so excited. I unexpectedly was invited to attend/doula the birth of my newest nephew last night! This blog is my memory of the very first birth I have attended that was not my own. I got to serve as sister-in-law, auntie, doula, and birth photographer and videographer.

Candi gave me permission to publish this blog along with the photos. I consider this a huge gift!

For the record: Blogger was EXTREMELY difficult to use with inserting these photos. What it showed as a preview was NOT what was published, thus, the captions are all off. I didn't want to compose a slideshow; I wanted a photo essay from top to bottom. I don't know how to fix this without spending all day on it, so I'm going to ask you to use your deductive reasoning skills to match up cockeyed captions with the appropriate photos. Thank you for your patience!

Jon and Candi had a birth center birth with their first child in 2006. This time, they planned a homebirth with midwives Angy Nixon and Dorothy Kaeck. Yesterday was Candi's due date, believe it or not, and I got a text from Jon at 7:56 p.m. asking if I wouldn't mind coming to "sit with Candi through this early stuff." I already had my doula bag in the van, ready for the other three births I'm on call for. I grabbed Gatorade and ginger ale for Candi and Pepsi for Jon and left my house at 8:12 p.m. (Jon and Candi already had childcare arranged for their older son.)

I arrived at their house around 8:40, expecting Candi to be in chatty-friendly-early-labor. Nope. She was sitting on her birth ball, actively working through and breathing through each contraction. Jon was just beginning to get the birth pool inflated, which then had to be filled. That took all of his time and attention. I was so glad I arrived when I did, so that Candi didn't have to cope with contractions by herself.

I stayed by Candi's side, helping massage her legs, hands, and back while Jon continued to fill the birth pool with a clean, new hose from their kitchen sink as well as with stock pots and sauce pans of water heated on their stove. The midwives had been alerted several hours before that Candi was in early labor and that they would call them to give them a heads up when to arrive. Candi asked me to call Angy back at 8:51 p.m. to make sure she knew things were picking up. (Aren't cell phone call and text logs handy?)

I'm not sure how long it was until Angy and Dorothy arrived, but 30-45 minutes is my guess. It's just as likely that it was only 20 minutes but felt that long because I've never been someone's primary labor support before. I hoped I was doing it right. I encouraged her with soft words and a gentle touch to help distract her from the pain, telling her she's doing a wonderful job, she's doing this, and reminding her to keep her jaw loose (loose jaw=open cervix, clenched jaw=ineffective dilation and more pain) and her tones low.

I felt relieved when Angy and Dorothy arrived. Their presence is so calming and reassuring. They checked baby's heart tones with the Doppler (in a good range throughout her labor) and took Candi's temperature (no fever, which they monitor in case of infection). They took Candi's blood pressure and pulse. Everything looked great and she was doing a stellar job coping with the intensity of the contractions.

A little while after that, Candi warned me that she felt like throwing up. I neglected to mention that I am phobic of vomit. I'm trying really hard not to let my phobia rule/ruin my life. You may see some humor in the fact that an emetophobe would have 4 kids. I may see humor in that, too, someday. I try to remember Psalm 56:3 (What time I am afraid, I will trust in thee.). I'm getting better about it, but I won't hold a puke bucket for my own kids, so there's no way I can do that for a laboring mom at this point. This is a pretty good indicator that I'm not ready to be a doula-for-hire yet, considering that Angy told me that about 75% of laboring women vomit in labor (especially as they approach transition).

At any rate, I hid in their bedroom for a while to give Candi a minute. Angy, Dorothy, and Jon were all three there for her, so it's not as though I left her all alone. I got her toothbrush ready for her and some cold washcloths for her face and forehead and waited for the all-clear sign to re-enter the living room. I didn't do too bad (I think). I didn't run out the door and drive off, never to return. That's good, right?

Left: Dorothy and Angy getting warm water for the birth pool. Right: Angy listens to baby's heart tones with the Doppler while Candi copes beautifully through a contraction.

The time frame is blurry after this. The next few hours consisted of Candi on and off the birth ball, changing positions, and waiting for the birth pool to HURRY UP AND FILL. She asked for an internal exam--was it 10:00 or so?--and was at 7 cm. Hurray! Progress! Candi kept asking if this was ever going to end. I whispered to her that she's making great progress and that her son was moving down, that he was almost in her arms now. Candi said that it was moving too fast because of the intensity of the contractions, and I told her that she could have her son in bed nursing with her by her normal bedtime. (I was right, by the way.)

After her exam, Candi wanted to lie in bed with Jon for a bit to rest and regroup. Meanwhile, her water broke on its own (over a chux pad; cleanup was no issue), and Candi was ready to get into the birth pool. I noticed that Candi was getting the shakes, too, and reminded her that her water breaking and the shakes were signs of progress and what a fabulous job she was doing.

Candi seemed to feel relief from getting in the water. Many women report that being in a pool or tub cuts the pain and intensity of the contractions. By the time Candi was in transition, the contractions were necessarily intense, and she seemed pretty uncomfortable regardless of position changes, but I guess that's to be expected. We massaged her hands and back. Dorothy applied counterpressure to Candi's lower back. It wouldn't be long now. That's the great thing about transition. Yes, it's the most difficult part of labor, but it's also the shortest.

That's midwife Angy on the left, a quiet guardian of safety.

That's me by Candi's side.

The timing couldn't have been more perfect. Candi's mother and her best friend each had more than a 3 hour drive to get there, and both arrived in time for the birth! Candi's friend arrived maybe 30 minutes before baby's arrival, and her mom got there literally 30 seconds after Candi said, "I think I have to push."

Candi did such an awesome job bringing her son down slowly and gently, allowing time for her to stretch and remain intact. I helped her continue to breathe through these contractions too, reminding her that when she takes good deep breaths, she's giving oxygen to her baby. She followed her body's cues for pushing. Nobody had to tell her what to do or how to push or when. She just did what she needed to do!

How perfect is this moment that was captured???

Baby's cord was wrapped around his neck twice, but that's not a problem. It occurs in about 30% of births. Midwife Angy checked for nuchal cord after his head was delivered, felt it, then slipped the first loop of it gently over his head. The second loop had plenty of slack and didn't pose any danger, and was unwound after the birth. His cord was looooong.

What a gorgeous, peaceful waterbirth. I'm tearing up looking at these photos again.

*This* was what she had been waiting for, the culmination of hours--no, months--of work. In her difficult moments in labor, Candi asked us, "When will it ever end?" and Angy and I reassured her that every contraction was one contraction closer to holding her son. This is it!

I think this is around the time I asked Candi how she feels. "Like a million bucks!" she replied.

Here I am, Auntie Sarah, holding my newest nephew. Welcome to the world, Little Man! We love you!

Far left: Midwives Dorothy and Angy are inspecting Candi's placenta in a WVU serving bowl. It was intact and looked very healthy.

Near left: Midwife Angy weighs baby. 7 lb 14 oz after he already pooped once!

Far left: Admiring sweet baby. Dorothy has olive oil ready for wiping baby's bum to make meconium cleanup easier.

Near left: Proud mommy is on Cloud 9. She's ready to nurse sweet baby in her own cozy bed.

<3 <3 <3
Baby Love
<3 <3 <3

Mommy holds baby's precious, teensy feet. *sigh* Bliss.

I left Jon and Candi to enjoy their babymoon around 1:10 a.m., got home around 1:35 or 1:40, and couldn't sleep a wink all night! I was exhausted but on an endorphin high from the pure joy and blessing.

And, oh yeah, did I mention that Angy let me sign their memento (footprint) birth certificate as the second witness? That HAS to give me some sort of "Best Aunt Ever" award. I'm so honored and thankful to have the privilege of being a part of this amazing birth. I'll never forget it! Thank you, Candi and Jon, and congratulations on your newest son!

Edited to add: Here is Candi's first-hand birth story.

Saturday, July 17, 2010

Dreams of a doula-to-be

Let me clarify. I'm a childbirth educator, not a doula. Yet. My ICEA childbirth educator certification requires that I attend a minimum of two births, so I've found myself in a quasi-unofficial-doula status. I have three pregnant friends due over the next three weeks, all of whom have told me I can attend their births. Two of these moms are delivering at hospitals an hour or more away from here, and I have to procure childcare before leaving for their births, AND these are both 3rd time moms. I fear I may not make it to both! (The other mom is planning a homebirth and lives about 30 minutes away from me.) (P.S. I live in WV and we measure how far things are in how long it takes to drive there. Miles mean nothing in a state full of winding 2-lane roads.)

Last night, I couldn't sleep because I kept dreaming about my friend who is due any second now and was 5 cm dilated at her last checkup. I kept waking up, thinking she was already in labor and I was late to get there, or that I had to shower before leaving and that would set me too far behind and I'd be late. I also forgot to pack my dry erase board for my Well Rounded Birth Prep private, in-home class today, even though I packed everything else I needed for the class, so I was worried that I'd forget it. I was also certain that she would go into labor in the night and that I'd need to pull an all-nighter to doula her birth, change clothes, then go straight to the class I had to teach this morning. None of those worries happened, fortunately.

The only births I've attended thus far have been my own. Yes, I have a vast amount of book knowledge about births, along with a fair amount of personal experience, but do these qualify me to be my friends' doula? Apparently, yes. I worry that I will let them down. I'm a perfectionist, and I want to do my best to support them. I want to fulfill any role they want me to fulfill. If they want me quiet in a corner, I can do that. If they want me applying counterpressure to the Magic Spot on their lower back, I'll be willing to do that, too. Ideas for changing positions? Reminders to take sips of Gatorade? I can do that.

A lot of people have asked me whether I want to be a doula now that I'm a childbirth educator. The idea intrigues me, but for right now, lack of childcare limits my options. I have four children, the oldest of whom is seven. In seven more years, we will have a reliable babysitter (my oldest). I can't be on call as a labor doula for an expecting mother if I can't promise that I can be there.

I'm really excited for my three friends' births, and I hope that I can be a help and a blessing to them. I wonder how I'll feel about doula-ing after I try it.

Wednesday, July 14, 2010

Huntington Homebirth Meetup

Angy Nixon, CNM, coordinates both a Scott Depot Homebirth Meetup (locations alternate) and a Huntington Homebirth Meetup (usually hosted by midwife Sue Hovemeyer). I usually attend the Scott Depot Homebirth Meetup, but hadn't yet made the voyage to west Huntington to Sue's for that Homebirth Meetup until last Friday.

There seems to be a growing interest in our area in wanting to know birth options and alternatives. Lots of ladies have asked me whether they would be welcome at the meetups because they're interested in birth, hearing and sharing birth stories, and discussion of birth politics; however, they have not had nor plan to have a homebirth. I'd like to explain that these ladies and anyone interested in birth options are welcome to attend. Here's a sampling of demographics of attendees of Friday's meetup.

Angy Nixon, CNM (Certified Nurse Midwife), homebirth midwife and hospital doula/montrice.

Sue Hovemeyer, DEM (Direct Entry Midwife), homebirth midwife and expert on prenatal nutrition and wellness.

Dorothy Kaeck, CPM (Certified Professional Midwife), homebirth midwife and hospital doula/montrice.

A mother of 3 who had all 3 by C-section, who does not plan to have any more children but is an advocate for informed birth options.

A mother of 2 whose children were born vaginally in the hospital. Her children are preteens and she doesn't plan to have more children, but enjoys the discussions.

A mother of 2 who is a doula and certified childbirth educator in KY. She recently returned to the area after a few years away, and is currently accepting clients in the Ashland/Huntington area.

A mother of 2 who is expecting baby #3 and planning a hospital birth. She experienced complications from what she feels were preventable birth interventions with her first two deliveries and is preparing to have an unmedicated birth this time in hopes of avoiding the difficulties she had the first two times.

A newlywed who is not yet pregnant, but has recently become fascinated with birth and babies, and wants a homebirth with midwives someday when it's her turn. She enjoys sharing information about safe, normal birth with her friends.

A teenage girl who became interested in preventing the cascade of birth interventions and looks forward to marriage, birth and babies someday.

A mother expecting her third baby who is planning a birth center birth. She had her other two babies at the birth center as well.

A mother with her 6 week old baby. She had a planned homebirth which turned into a hospital transfer and an eventual C-section. Both mom and baby are fine.

A mother of 6 who has seen one of just about every kind of birth experience, from hospital births to birth center births to homebirths.

A labor and delivery nurse who works at a local hospital with an outrageous C-section rate. She moved here from another state where the practices were far more evidence-based and had better outcomes. She is extremely frustrated with the way moms and babies are treated where she works.

And me. I'm not sure what demographic in which to slot myself. Childbirth educator and mother of four: 1 hospital birth and 3 homebirths.

Quite a variety of backgrounds and stories, yes? All who are interested in birth are invited and welcome. This is a great community in which to network and learn options.

The calendars for meeting times and places are on the Homebirth Meetup sites (linked in the first paragraph of this post.) We hope to see you there!

Thursday, July 8, 2010

What to wear for a hospital birth?

Question from a mother expecting her third baby (who gave me permission to post this):

"I haven't asked yet if it is even possible, but I have been thinking about what to wear for L & D at the hospital. I HATED the hospital gowns b4 and never even thought about wearing something different. Anyway I was just wondering if you had any ideas about what I could wear. I was thinking about easy access after birth too for skin-to-skin and nursing?? Thanks!"

My answer to her:

Anything goes. So long as you're not in a unitard, you should be good.

Whatever you're wearing, you can strip off or unbutton for skin-to-skin contact after birth.

Some options:

Your pjs. Your favorite Saturday-morning-loungewear (track pants and t-shirt). A long nightgown. A nursing gown.

A 2 piece swimsuit (great for laboring in tub or shower).

A long skirt (comfy cotton like a circle skirt, broomstick skirt or Binsi skirt) with a T-shirt, cami, sports bra, swimsuit top, or tank top.

Nothing at all. Many moms feel hot and don't like the feeling of clothes constraining them during labor or pushing.

Layers are good (tank top or swim top w/ shrug or cardigan) because it's common to feel too hot then too cold. Your bathrobe from home. Non-slip houseslippers. Socks with rubberized grips.

I've also heard you can go somewhere like Gabe's to the Big & Tall Men's section and buy a short sleeved button up shirt. Long enough to be modest, short sleeves don't burn you up, and easy to unbutton for breastfeeding.

If the clothes are dark (navy, black, brown, etc.), they will not stain. If any blood does get on your own clothing, it will usually come out with cool water (hot water will set the stain) and hydrogen peroxide. Don't stick it in the dryer until the stain is fully gone, or else the heat will set the stain.

For those who do want to wear the hospital gown, some moms ask for two of them and put one on frontways (it's a word, I promise) and the other one on backwards. That way the tushie is covered. Another option is to wear underthings under the gown. Some hospitals or providers balk at the idea, saying it doesn't allow quick enough access in case of an emergency, but they can cut through any fabric if they had to in a true emergency. Some moms wear any of the layering ideas from above under a hospital gown, including swimsuit top and/or bottom, bra and/or undies, camisole or tank top, whatever floats your boat.

Does this give you a springboard for ideas?

Readers: what have you worn for your hospital or birth center birth(s)?


Watch a 2 minute 38 second video on the benefits of skin-to-skin contact after birth here.

Wednesday, July 7, 2010

WV's cesarean rate vs. World Health Organization recommendations

How many moms research the cesarean rate of the hospital where they are planning to give birth? If you're delivering in the Kanawha-Cabell region of WV, here's what you're up against.

The World Health Organization has stated that the cesarean rate for any region (including the US) should not exceed 10-15%. Note that this figure is not a goal to achieve, but rather a threshold which should never be exceeded. If the cesarean rate exceeds 10-15%, more harm is being done than good.

That being said, the following statistics are the most recent which are available online for West Virginia (2005). The link includes the statistics for all WV hospitals. For brevity, here are our local tri-county hospitals.

Cesarean rates for

CAMC (Women's and Children's): 41.9%

Thomas Memorial: 54.8%

Cabell-Huntington: 35.3%

St. Mary's: 26.3%

Bear in mind that these numbers represent 2005 cesarean rates. The cesarean rate has risen nationwide for the past 12 years straight, so it's fairly safe to say that the current C-section rates are higher than these, but these are the most current numbers we have to assess.

WV has the 5th highest cesarean rate in the country.

Aaaaaaaaaaand: discuss.

P.S. Childbirth Connection explains why the US cesarean rate continues to rise as well as dispels 2 prominent myths about the rising cesarean rate here. What are some of the many factors causing WV's rates to be among the worst in the country? Clearly, it cannot be blamed on obesity or maternal request, as Childbirth Connection stated. It's a complex problem.

Tuesday, July 6, 2010

About Me--or, How I Became a Birth Junkie.

I'm such a perfectionist that I sat here with a blank blog for weeks, waiting for the time to draft the "perfect" first post. Since my house isn't quiet until the kids are in bed, at which point my brain is mush and I'm ready to melt into the couch, I'm just running with this.

How did I get to the point that I read birth research for fun? I had my first baby in 2002 in a hospital, and thought I had a "normal" birth. I didn't prepare much, and by the grace of God, I did not end up with much in the way of unnecessary birth interventions. To make a long story short, I had an unmedicated labor and delivery with a bad perineal tear thanks to doing what the nurse told me to do. Recovery was miserable for months. Later I learned that what happened to me was preventable, and I sought midwives and a homebirth with my subsequent pregnancies. I really started researching birth when I took personal responsibility for my pregnancy and my health during my second pregnancy. By the time I was pregnant with my third and fourth children, I spent a lot of time on pregnancy and birth message boards, reading the latest articles and research on pregnancy and birth safety. (I'll try to post my birth stories another day.)

I read hundreds of birth stories and started seeing a pattern. I now know that it's called The Cascade of Interventions, and it's well documented. One intervention necessitates another, which causes another side effect necessitating more intervention or medication, and ultimately, it ends in fetal distress or diagnosis of FTP (Failure To Progress) or CPD (Cephalopelvic Disproportion) and either instrument delivery or cesarean. By that point, the final intervention *was* necessary, but it was likely preventable and caused by the previous interventions. Many people are vaguely aware that "too many cesareans are being done," but they are unaware of the cause-and-effect that lead to preventable cesareans and other interventions. I know this because almost every woman who has had a cesarean, thinks that *her* cesarean was necessary/life-saving/not preventable. Statistically, over half a million preventable cesareans are performed annually in the US, so SOMEBODY'S cesarean was preventable.

I mentioned to my midwife that I might actually like to become a real childbirth educator some day instead of just sitting around complaining about the state of affairs. She gave me the link for ICEA (International Childbirth Education Association), and I checked their upcoming schedule of childbirth educator workshops. There was a two-day, 16 contact hour workshop not far from me, coming up three weeks from the day I looked it up. It took a lot of finagling to procure childcare, but I made it happen!

I'm currently working toward ICEA certification. The childbirth educator workshop was the first step; I've applied with and joined ICEA, and I taught a childbirth class series (meeting once weekly for a month) with four couples, which was videotaped to submit to my ICEA mentor for approval. I also need to attend two births and complete a huge reading list before I can take my 150-question written exam, then I'll be certified.

As a childbirth educator, I love ICEA's motto: "Freedom of choice based on knowledge of alternatives." I want for my clients never to have to say, "I would have chosen something different if I had known that X is a common consequence of Y." Sadly, while 2/3 of expecting mothers watch birth dramas on TV, fewer than 25% of American pregnant couples attend childbirth class today, and moms are coming into their deliveries with an almost laughable misconception of birth and their bodies. I hope to bring couples a better understanding of how birth works along with confidence that mothers' bodies were perfectly designed to birth and breastfeed their babies.

Among other things, I'd like for this blog to be an extension of my childbirth classes, elaborating on things we don't have enough time to cover. I'd like to blog to warn moms how not to become a statistic of preventable complications with birth and breastfeeding. I'd like to keep you updated on the latest and most fascinating birth safety research. I might even share some of my own birth and breastfeeding stories, from time to time.

I would also like to make this blog a place to bring forth information on standard birth and postpartum policies of WV hospitals. I don't think anything like this has been done before, and I've had a lot of clients ask me about the differences among local hospitals and their policies. How can expecting parents make informed decisions, if this info isn't public? I'd like to facilitate that discussion.

I've been interrupted no less than ten times by four different kids over the course of four hours as I attempt to write this, and I know it sounds fragmented, but I hope you'll bear with me and get to know me over time. I really do have some innovative ideas for promoting physiologic birth and empowering families to have birth their way. Now if you'll excuse me, the baby is writing on herself with Crayola markers, so I think it's time to close for now.