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Sunday, January 30, 2011

VBAC and Scrabble

A friend texted me a few days ago and told me that she was playing Scrabble (not sure whether it was online or on iPhone) and her entry was "VBAC," but Scrabble wouldn't accept it. We joked that Scrabble *should* accept VBAC and possibly VBAMC, VBA3C, HBAC, HBA2C, and others.

Then I got to thinking about it. Why *shouldn't* VBAC be accepted as a regular word--both in options for birth, and in our national conversations? Wouldn't it be nice American mothers had true informed choice of care for their pregnancy? Wouldn't it be great if evidence-based care were the rule rather than the exception? Wouldn't it be awesome if VBAC were such a mainstream term that every American of childbearing age knew what a VBAC is and that it's a “reasonable option” for most women with a previous cesarean section, according to the National Institutes of Health?

Radar, laser, and snafu are all acronyms which have become regular words in American vocabulary. Isn't it time for VBAC to go mainstream, for the safety of mothers and babies?

For the uninitiated,

VBAC = vaginal birth after cesarean

VBAMC = vaginal birth after multiple cesareans

VBA3C = vaginal birth after 3 cesareans

HBAC = homebirth after cesarean

HBA2C = homebirth after 2 cesareans

(All of which can be safe options, depending on individual circumstances, consult your medical charts and care provider, do your own research, and other disclaimers.)

Thursday, January 27, 2011

Wordless Wednesday: Trebor's "In Silent Prayer" maternity portrait

Trebor's name might be familiar to you. She shared her written birth story here of her home waterbirth VBA2C (vaginal birth after 2 cesareans), then shared her touching photo slideshow of her homebirth. Trebor has graciously given permission to use her beautiful maternity portrait, "In Silent Prayer."

Reflecting on this photo, Trebor said, "Prayer and Meditation are such an important part of my pregnancy and who I am. I often find myself by the window and decided one day to capture the moment. I love the silhouette created by the natural light and using no flash with camera." Trebor was 34 weeks pregnant with her soon-to-be homebirth VBA2C baby at the time of this portrait.

Saturday, January 22, 2011

Guest post: Margaret's 2-hour med-free labor & delivery

by Margaret

The day before my due date I saw my midwife for a regular check up and she did a stretch and sweep. I was hot, miserable and done. It had been an absolutely brutal summer, humidity of 90+% almost every day. Temps well over 100F. No a/c. (In Canada we only need it for a few months of the year, so most people don't bother) I was done. She promised that if it didn't work she would do another one a few days later. It did nothing. So on Friday (2 days after my EDD) I went in for another one. She did it, and then did it again...lol. She kept telling me that she was trying to make me bleed. Nice :P I was about 3cm by this point.
I had lots of cramping after leaving, but wasn't hopeful for any labour starting....

Over the weekend I lost my mucus plug in huge globs. Still no bloody show though. I still wasn't convinced that anything was going to happen. The weather had cooled off FINALLY and I was actually enjoying being pregnant.

Sunday night we went to a friends house for a bonfire. While I was there I had a few contractions. They were more intense then they'd been before, but still felt way too much like braxton hicks for me to think 'this is it'. But I was suspecting that I would be in labour that night or the next day for sure.

We came back home around 9 and I decided I was just going to go to bed. Everything had stopped anyway, not a twinge of a cramp or anything.

I woke at exactly 3am (on LABOUR DAY!!) with a contraction. It was a REAL contraction. I got up, went pee, noticed some bloody show finally, and then went back to bed. By 3:30, I'd had 4 more contractions in bed. I decided to let John sleep and take my 'breathing' elsewhere. I decided to stand in the shower for awhile. Within a few minutes the contractions were VERY intense and I knew 'this was it'. I was down on my hands and knees during every contraction and only stood up in between b/c my knees were sore...lol. I thought of getting a towel to kneel on and I thought of telling John to wake up...but I just couldn't move. I was so focused on the contractions that I couldn't do anything else. I knew I was in transition and was more than a little freaked out that I would be delivering the baby by myself in the shower.

Finally around 4am, only an hour after the contractions started, I managed to get out of the shower. (the hot water was running out anyway...lol) I waddled to our room and yelled at John, "wake up, call you dad to come over, call the MW! We're going to the hospital NOW!!"

He looked confused and no wonder, it was 4am, I had just woke him up from a dead sleep by running into the room yelling at him:P I almost killed him when he asked if he had time to take a shower first. "NO! NO WE DON'T HAVE ENOUGH TIME. AND I USED UP ALL THE HOT WATER ANYWAY." He got the point.

All the noise (especially the cow-like moaning I was doing during each contraction) woke up Megan, our oldest (almost 6yrs). John managed to get her right back in bed and told her that we were going to have the baby very soon. She told John that even though she was really hoping for a sister, it would be ok if we brought her another brother:) I was happy she went right back to bed, b/c I did NOT want her to see me in labour. It was moving so fast and I was making so much noise that I was worried it would scare her...heck, it was scaring me!

I managed to call the midwife and told her we were going to the hospital right away. She called her back-up and they left to meet us there. John's dad showed up around 4:15 and we were waiting in the car already. I was hanging over the back of my seat on my hands and knees. John drove, fast. I am pretty sure he went through some red lights, but I didn't care. I told him I felt like I was going to throw up, which worried me more than it did him, b/c I did NOT want to have the baby in the car.

Since it was night time, we had to go into the hospital through the ER. The nurses there looked pretty worried that I was going to give birth in the waiting room. I was on my knees on the floor leaning over the seat of a chair moaning away. Probably the dirtiest place in the world to be.... They tried to get me into a wheel chair to take me upstairs, but I told them right away that there was no way I could sit, I needed to be able to lean over things. So they helped me walk down to the elevator and made me promise NOT to have the baby in there, b/c its too small;)

I got up to my room and my MW wasn't there yet. A few minutes later, John (who had been parking the car) came in and it was still about 15 more minutes before the MW's got there. I was having contractions every 2 minutes by this point. I knew it was going to be very soon.

I was just trying to deal with the contractions. They were so close together and so intense I could barely stand it. I was even banging my head against the wall (lightly...lol) during some of the worst ones. I could feel myself tensing up and was trying so hard to relax, but just couldn't. John was standing next to me helpless. I didn't need him for anything...there was nothing he could have done for me anyway. I went into the bathroom at one point to splash some cool water on my face, but I only could get warm water out of the tap. I still can't figure out why I couldn't get it to go cold, but I remember wanting to rip the sink off the wall and hurl it across the room.

The MW's were rushing around getting things set up and told me that anytime I wanted they could check to see how far I was. I waited for a contraction to end (it was around 5am at this point) and quickly hopped onto the bed. The MW still had to get her gloves on, and it was just taking too long for my liking, so I hopped back off the bed as another contraction started. After that one ended, my MW said she could check me as I was standing, so she did. She said "Great! You're complete!" I thought, as another contraction started, "There is no way! If I were 10cm, I'd be holding my baby by now. I've never had to push my other babies out. I hit 10cm and out they fly. What is wrong??" As soon as it ended I hopped up on the bed for her to check me again, b/c I was still doubtful of being 10cm. and sure enough she said "yes, it is harder to check when you're standing...you're 7cm."

I was MAD! Pi$$ed!!!! ONLY 7cm???? AAARRRGGGHHH! She offered to break my water and I knew the baby would be there instantly, but I was still nervous about it. I'm not sure exactly what was holding me back, but I was scared to give birth again. I just wasn't embracing it like I had with my previous births. I kept tensing up and was not looking forward to what I knew was coming.

A few minutes later I could feel surges sort of rippling down my belly and I knew the baby was moving down and going to be there in a few minutes. I finally said "Ok, fine. Break my water." So I hopped back on the bed. (when I say 'hopped'...I mean hopped. I can only imagine what it looked like to see a half-naked MAD woman hopping up and down) She checked me first and I was 9cm now. She got the hook out and started to put it in, but I screamed at her to "Get out!" because I was having another contraction. I rolled on my side to try to ease the pain, but during that contraction I felt the baby on its way. She didn't need to break my water after all.

I was scared to push. I knew I had to, but I was holding back, which made the pain unbearable. I couldn't stop my body from pushing though...even though I tried. I screamed out "OH NO THE HEMORRHOIDS!" as I gave the first push. Not my finest moment...but I didn't care. I had horrible hemmorhoids with other births...and as I said before, I've never had to push any of them. It was very unfair:P
The other MW grabbed a warm compress to hold on my rear-end as I gave a push. It was more of a scream, but it did the job, the head was out.

At this point I screamed at the MW to "Just pull it out!!!" To which they laughed and said "We can't, you have to push!!" Yeah, again not something I'm proud of..hehe. They helped hold my legs way back to make more room for baby's shoulders and I gave one more big push and out popped my baby at 5:16am, just over 2 hours after the first contraction!!

I've never made so much noise in labour before. But I've never experienced something so intense or fast as that. I couldn't believe it when I looked at the clock and saw the time. Days later, I'm still sitting here in shock....I joke with people that I 'think I had a baby...I'm pretty sure I was there, but I don't really remember'.

It was absolute euphoria. I had my baby on my belly and lifted up a leg to see what we had. It was a GIRL! I was so excited I didn't believe it. I looked again and again, just to be sure. Yup, no penis there! lol.

I kept saying to John "It's a girl!! It's really a girl!!"... I was over the moon! I'd been hoping for a girl the whole time, but was pretty convinced near the end of my pregnancy that I was having a boy. He told me later that he saw she was a girl as she was being born, but didn't want to ruin the surprise for me so he didn't say anything until I had looked. We now had 2 girls and 2 boys:)

I birth the placenta within about 10 minutes. My MW's marveled over the length of the cord! They said they'd never seen such a long one. Everything was well and my bleeding was very minimal. I felt great. I got up and took a shower within the hour and really didn't even feel like I'd had a baby.

We left the hospital at about 8 am, only a few hours after arriving! Surprised my father-in-law who was just getting the older kids their breakfast when we walked in the door. He couldn't believe that we were home already!

Madelyn Faith was 7lbs 8oz and 20.5" long. I thought for sure that she would have been much closer to 9lbs b/c I'd never been so far past my EDD (she was 40w 5d).

She is absolutely beautiful and so content. I can't stop staring at her. Even in the middle of the night when I know I should be sleeping, I just sit and stare at her. God has given me a very mellow, easy baby, something I needed as having 4 kids under 6 years is a bit crazy to say the least.

I had intended to get John to take pictures during the labour and birth, but it was all so fast, I just didn't think of it.

People have said "Wow you're so lucky that it was so fast!"...I'm not sure what I prefer, fast and intense or longer and not so crazy.
All I know is that I have PRECIPITOUS LABOUR written in really big letters across the top of my records...as warning for next time. (Did I just say 'next time'???)

Friday, January 21, 2011

9 lb 8 oz hospital VBAC 1 yr after C-sec when 4 lb baby was "too big"

Remember January 6, my sister-in-law Candi DeGroff posted on our Well Rounded Birth Prep Wall asking for prayers and words of encouragement for her friend Christina who was in early/pre-labor with her VBAC. (You may remember Candi from her home waterbirth photos and firsthand birth story here on my blog.)

Here was Candi's message: "I didn't want to post this as my status, but I thought maybe this might be a good forum to ask for prayers and positive thoughts for a friend doing a VBAC soon! She's having irregular contractions and is at 2cm! The hospital sent her home (yay!) and she is laboring at home. Her C-sec was actually less than a year ago.... I've told her labor support that she is going to need LOTS of support and encouragement and to keep reminding her of her goal to have a un-medicated, natural birth with minimal medical intervention!"

From time to time over the next few days, I texted Candi to ask how Christina was doing. Every time she would say that Christina was about the same; her OB said to stay home and keep walking. She was just having a long pre-labor (which is sometimes called prodromal labor, or stop/start irregular contractions that can tire a momma out).

Jan. 18 (after 12 days of exhausting pre-labor), active labor began for Christina around 9:30 p.m. She labored at home until she, her hubby, and her doula went to the hospital at 4:30 a.m. By 9 a.m., Christina was exhausted got an epidural in hopes of getting a little bit of sleep so she could gather enough energy to make it through the end. By 2 p.m., she was getting discouraged and wasn't sure whether she would be able to progress. By 9 p.m., she was fully dilated and laboring down. She gave birth VAGINALLY to her ***9 pound 8 oz***, 20" daughter at 10:35 p.m. She did tear, but overall she was thrilled, and she and baby were both doing great. Baby was nursing like a champ. She was born exactly on her due date.

This VBAC is particularly incredible when you consider it in the context of her C-section birth. Christina was naive and trusting as a first time mom, and when her OB told her that she was measuring "too big" by the ultrasound estimate and that--I kid you not, he really said this-- her uterus would not stretch to accommodate the size of this "too big" baby, Christina believed him. He recommended a C-section at 37 weeks since there's no way that baby could have been born vaginally. Her firstborn baby was only ***4 pounds*** at birth, and while he did have some symptoms of a late preterm baby, including difficulty breastfeeding, it was a miracle that he was healthy overall and didn't have to stay in NICU.

I could write an entire post about what was wrong with her first OB's diagnosis and recommendation. I don't even know where to start. Can I begin by saying that "Your uterus won't stretch enough to accommodate a big baby" is just about the most ludicrous statement I've ever heard? That's not even the same thing as CPD, which is misdiagnosed and overdiagnosed widely. Any OB who would say that is either 1) lying through his teeth and needs his license pulled for willingly violating his vow to "First, do no harm," or 2) so inept and ignorant about birth that he needs his license pulled for having such a misunderstanding of women's bodies and of birth. Let alone the fact that ultrasound estimates at or near full term have a plus-or-minus 2 pound margin of error (giving a guess range of 4 pounds). Augh, I have to stop there or else this birth story will morph into a rant about what Christina was told by her first OB.

What would the odds  have been for Christina to have a successful VBAC when her first baby was not even a year old when his baby brother was born? Thanks to determination, getting a second opinion, finding a VBAC-supportive OB, having a doula, and the love and support of her husband and family, Christina achieved her goal she has worked so hard for over her months of pregnancy. I'm so happy for Christina. What an amazing inspiration.

Tuesday, January 18, 2011

Part 2: Your replies to Obsolete: landline phones, film cameras, and... vaginal birth???

I recently posted about the rising cesarean rate (almost 1 in 3 and rising for the 13th consecutive year) and wondered, "Will the next generation think vaginal birth is obsolete?" I asked my readers, "What do you want *your* children to believe when they are grown about birth, cesareans, and women's bodies' ability (or inability) to give birth? What would you tell your child (in an actual or theoretical conversation)?"


Vaginal Child Birth From a Cesarean Mama's Viewpoint by Jamie
Blogger--  Parenting Three (When Can I Pee Alone?)
mother of 3 children, all born by cesarean

A close friend of mine is a birth instructor. She is very knowledgeable about everything related to birth, but a lot of her focus is on protecting normal vaginal child birth in our society, and teaching women how to make decisions that give them the best chance of achieving a good experience with their vaginal child birth. She's been working on a blog recently about how many things that we are all familiar with such as cameras with film, paper phone books, etc are all things that children born in 2011 will have no knowledge of. The premise of the blog is that, if the trends continue as they've begun, will children born in 2011 have any knowledge of what vaginal child birth is, or like encyclopedias, will that be something that's lost in time.

As preposterous as that might seem to some, if you've been paying any attention to the statistics, you know that despite the World Health Organization's repeated warnings that a cesarean section rate above 15% is doing more harm than good to our country's mothers and babies, America's most current cesarean rate is 32.9% (2008 statistics), which has climbed for the 13th consecutive year. If this trend continues, it's easy to see how cesarean births could tip the scales into being the standard method of birthing your babies. Particularly when we live in a culture of fear where television, movies, and grandmother's stories make birth something to fear, an emergency, and a punishment. The truth is that we've gotten so far away from our roots that no one seems to know what a natural vaginal birth looks like. We're in hospitals, surrounded by noisy monitors and machines, accosted by countless people who come in and tell us to relax while they invade our most personal areas with fingers and instruments, we're numb to the sensations of labor and birth, we're pumped full of chemicals, and we're told not to trust our own instincts, but to push, push, push on the flat of our backs, in time to the counting of the professionals. This is what normal birth looks like to us now, so why wouldn't women fear it?

So much of our maternal and obstetric care in this country is not evidence based. It's frightening how many women are grateful that their ob saved their lives and their babies' lives, never realizing that they would not have needed saving if that same dashing hero hadn't created a situation that was unsafe for them. Yes, they were saved, but not from the dangers of childbirth. They were saved from an emergency situation that never would have existed if they had been left to birth according to their own instincts and needs. Yes, there are instances where all of those interventions and emergency protocols are necessary, but for the vast majority of women birthing in America, we've been had.

I myself have had 3 cesarean sections. I feel that had I not had mismanaged care with my first pregnancy, I probably would have had no problem whatsoever giving birth vaginally to all 3 of my children. I'm okay with what happened, because it's in the past, and it does me no good to dwell on what might have been, or if only. I won't go into specifics, because there's not time or space here, but I now know that my situation was entirely mismanaged, my surgical births were almost certainly preventable, and there's no reason why, if I am blessed with another baby (And, no, I'm not planning on having more, but I wasn't planning the last one either.), that I can't attempt a natural vaginal birth again. I have done a lot of reading and research into vaginal child birth after repeat cesarean births, and I feel comfortable with the risks for me. I feel strongly that every woman should do just that. Research, research, research, then make the decision that she's comfortable with based on the facts, not on the pervasive fear that runs rampant in our culture when we discuss childbirth.

The close friend I mentioned at the beginning of this blog has asked me, “What would you want your kids to know about birth? Cesareans?” What would I want my children to know? I want my children to know the same thing that I want every woman to know. You are not broken. Your body is not broken. There are very few women on the face of the planet who are not physically capable of having a healthy vaginal child birth. There are no guarantees, but there's no reason to think that you couldn't have a wonderful experience giving birth vaginally. Do the reading, do the research, search your soul. Make the best decision that you can and let no one take your power to choose away from you. In a culture of fear, you have the power of facts. Use it. Nothing in life comes without risk, and it's a matter of looking at all of the risks to each option and deciding which set you're more comfortable with. Don't let anyone put you into a position where you decide in fear. Take comfort in knowledge and trust yourself. That's what I want my children to know. I also want them to know that regardless of how things turn out, they are strong and can overcome anything life throws at them. Things don't always turn out the way you hope for. You can do things to stack the deck in your favor, but there are no guarantees in life. We all just do the best we can with what we've got and move forward from there.

By Trebor Sutler, owner of Tre'Slings custom ring slings
mother of 4 children: 1 unplanned cesarean, 1 scheduled cesarean, 1 hospital VBAC with epidural, and 1 homebirth VBAC.

When having a VBA2C and Homebirth with my last two pregnancies, I have had to answer some questions that my older children have had, such as, "Why were we born at the hospital?" which led to "Why were cut from your belly?" This question my daughter seemed more interested in. The answer I gave her was similar to this. "When Mommy had you, I trusted that the doctors were acting with my best interest in mind. Later I learned that wasn't the case. My doctors didn't do the job the way the should have. They used medicine to control the way you were born, and Mommy's birth was medicalized rather than being normalized. So that is why Mommy decided to trust the way God made me to birth the next time and educate myself with the real facts about birth."

Michelle Jervis, mother of 3 children
first 2 children born vaginally, 3rd child born by cesarean

After having two vaginal births, my third child, a daughter, was born via c-section. My OB had sent me for an ultrasound at 38 weeks to check the position of the baby. Everything spiraled downhill from there. Within three hours of the ultrasound I was being prepped for an emergency c-section. Little did I know that this wasn't an emergency at all. It was truly one of the worst decisions of my life.

Even though my daughter is only 4, I have already started telling her about my birth experience. Of course due to her limited understanding at this point, the details are kept simple. Nonetheless, I want her to realize that Mommy didn't make the right decision. I allowed the doctor to "convince" me that this was necessary, when in fact it truly wasn't.

As my daughter grows older I will share with her in much more detail. I will tell her that I'm sorry she spent the first 12 hours alone in the nursery because Mommy was so sick from the medication in the spinal and unable to hold her. I believe this fact alone attributed to her being a high-needs child. She didn't receive the care and nurturing from me she so desperately needed so soon after birth. I will tell her that she should have been delivered vaginally and that God created women with the ability to do so. I will tell her that I should have said no to the doctor. I will tell her I should have researched things more and I would have known that her position at 38 weeks didn't qualify as an emergency at all. I will tell her that no matter how she came into this world, I love her more than anything. I will tell her that I want her to have the best possible experience when it comes to the birth of her own children and that if she listens to her own instincts, it won't even need to be in a hospital at all.

Dawn L. Meisenheimer Lewis

For my girls:

Birth is like all things in life, we have to be ready for any outcome.  However, there are patterns of birth and things that happen in a regular birth.  First, they need to know that under normative circumstances birth can happen vaginally and without medications.  Under normative circumstances they can stay home as long as they like, even have a baby at home.  If they do go to the hospital, under normative circumstances they do not need extra intervention, the help at the hospital is nice if needed but if not, then they have a right to be left untouched in birth.  When birthing, contractions are different for every woman, but it's always better to take one at a time.  Remember to be open to try different ways of movement, water, rocking, and such to cope.  Read about it, decide what you are willing to try (some things might go against your religious beliefs, don't do anything you are opposed to in this way).  Have a plan but remember birth is like a journey, sometimes things don't go as planned so just be prepared.   Have support with you, a husband, mother, sister, doula, whoever you need.  Pick your provider and don't worry if you have to change.  They are there to serve you.  Be polite but do stand up for what you think is right.  Get to know your provider and stay with the one you trust.  Once you trust the person, you will feel better if intervention is needed because you can be partners in deciding what is best.  Rest, eat, move, breathe to avoid panic, and often if it is less painful to do something it's what you need to do.  Sometime though, what hurts more is what you need to do, just sometimes.  Once the baby is born, again, be prepared for the unpredictable but know that in a normative circumstance, you can hold your baby right away and keep  your baby with you...even for assessments if in the hospital.  Hold your baby and nurse whenever.  Babies will let you know if they need you normally.  Mostly what they need is to be held, loved, nursed, cuddled, changed, and to rest.  Rest with your new baby.  When baby sleeps, you sleep.  Others should do your work for about 6 weeks if you can get help.  Plan ahead for this just like you did for labor and birth.

For my boys:

Birth is like all things in life, we need to be ready for any outcome.  The mother of your child needs you to research or at least listen to her as she teaches you.  Mostly, when she is in pregnancy, labor, and birth, be with her.  Pay attention to her, listen to her.  Encourage her.  In pregnancy, help her out and make meals for her, walk with her, encourage her to be healthy.  Encourage her to spend the time she needs preparing for the birth and the baby.  If she feels she's uncomfortable with her provider, help her find a new one if that's what is best.  Share your feelings with her too, and remember that she likes for you to be there most of all to lean on, to listen.  The day of labor, help her to stay home as long as she needs.  Walk with her, serve her food, listen to her, breathe with her, encourage showers, whatever.  Your goal is not to get to the hospital fast and hand off your responsibility to her.  Your goal is to help her have as peaceful a birth as possible.  Remind her with encouragement that she will see the baby soon, that she is doing well.  When she is tired, suggest rest, food, drink.  When she is talking, listen, talk back, keep her mind going.  When she is quiet, protect that silence.  If you're birthing at home, prepare the scene, keep the towels warm, rock with her, dance with her.  Rest when she rests, if she needs to be alone use the time to either prepare something or rest.  Keep everyone at a distance unless she wants them to come in.  If you are going to the hospital, be there for her.  Ask questions if an intervention is suggested.  Work with her on what she wants.  Be honest with her, and asses the situation.  Be on her side always.  Encourage her to move, be creative and if she's told to stay in bed that doesn't mean she cannot move.  Do break a silly rule if need be, be cool about it...(like you cannot get out of bed...well, it's okay to get out of bed to labor and you are not the children who have to obey).  Give her a drink (remember to bring drinks and crackers...or something to keep her nourishment up).  You can easily pick up a cup with a straw and let her drink any time she needs it, don't ask the doctor/midwife just do it.  If all is going normally, she will be able to labor without intervention no matter where.  Encourage position changes, encourage coping strategies like shower, massage, etc.  Hold her hand.  When she is pushing, let her push in any position possible.  If things seem stuck, you can suggest she try a different position, it might help.  When everyone is talking above her, make sure you tell her what she needs to know (example, your Dad has made sure to tell me things are going okay when people are talking over me, if baby has been taken to a warmer he runs, looks at the baby, comes back and says what actually is happening so I am in the loop).  Don't yell at her, don't count as she pushes unless there's a real medical reason.  Always tell her encouraging things while she is going through the pain, while she is pushing.  Get involved as much as you can.  Remind her how beautiful she is. Don't forget to kiss her.  If intervention is needed, help her transition.  Help her know she's still doing great, she has been trying hard, and she's doing what is right.  If her worst fears happen, hold her hand, be near her.  Be her best ally.  Once baby is born, momma wants the baby.  Do everything you can to unite mom and child.  After a nurse takes baby for any reason, be the first to suggest/remind to put baby back on momma.  Be the one to get the baby.  If momma cannot hold baby, you need to hold baby.  Keep baby warm and in contact with you or momma as much as possible.  If baby goes to the NICU, find out when momma and you can see baby...and insist on finding out when you can be with your child.  It is normative in birth for a baby to be okay and momma to be okay.  Most times this can all happen without interventions.  When interventions are needed, thank God for the technology that helps.  Things can happen that no one can help, and that's when you need to be real with her and also be there for her.  Love, that's the first thing...most important.

Oh, most important for the girls...pray.  I prayed during labor, in my head, out loud....and for the boys, offer to pray with her.  Prayer after a baby is born can be very special for a family.

Michele C.
mother of 3 children, all 3 born vaginally

The "what do you tell your kids" part reminded me of Lauren when I was pregnant with Hannah. She was only 3 when she asked me if the baby was going to, "come out your poo poo hole." LOL I cleared up the confusion. :) (We've always been very open and honest about sex and childbirth in our home, age appropriate, of course.)


What about you? What do you want your children to know/believe about birth (both in general, and for themselves personally)? Which would you prefer that your children believe is the norm and which is the exception: vaginal or cesarean birth?

Wednesday, January 12, 2011

Wordless Wednesday: My daughter: good little mommy-to-be

This is my oldest daughter at age 5 1/2, when I was pregnant with my 4th baby. She and my then-4-year-old daughter walked around "pregnant" all the time. So cute! I thought it was funny that this time, my daughter's baby was frank breech. It didn't concern her.  :-)  Good thing! Like mother, like daughter.

Monday, January 10, 2011

Obsolete: landline phones, film cameras, and... vaginal birth??? Part 1

A friend posted this link to an article listing common, everyday items that today's adults used for years, which are now obsolete. Will babies born in 2011 know what any of the following items are: landline phones, film cameras, video tape, paper phone books, maps, or encyclopedias ("You mean like Wikipedia, Mom?" "No, dear, it's not the same thing.")?

It reminded me of an insightful blog post by childbirth educator Donna Ryan (Banned From Baby Showers). She told of an experience she had with her 9 year old daughter Abby's friend who was shocked to learn that Abby was born at home in a pool of water. Her response? "Did a doctor come to your house to get her out of your stomach?!"

This is all too common. The first time I heard something similar was 2004, when I was pregnant with my second baby. At a moms' group, one mom shared that she had had all four of her children by cesarean and she was very glad for that because it made explaining "The Facts of Life" a lot easier for her. All she had to say was simply that to get the baby out, mommy goes to the hospital and the doctor cuts the baby out. I didn't want to make waves, since I was the newcomer in the group and a fairly new mom to boot, so I didn't speak up, but is that what you want your children to think? That normal, average birth means major abdominal surgery?

With each of my pregnancies, I let my children watch natural birth videos with me (positive and less graphic ones) to help them understand how the new sibling would come out. I explained as much as they seemed ready to understand, and it was pretty simple when they were 3, 4, or 5 years old. "God makes a way for the baby to come out through Mommy's vagina like a tunnel. It's a lot of hard work. It hurts, but it's pain with a purpose, and there's nothing to be afraid of. With the pain is joy and love. It's totally worth it, and I look forward to it." How difficult is that?

Several friends lately have told me that their daughters, now coming into preteen ages of 8 through 10, have said that they don't want to have kids when they grow up because they don't want to have surgery. How sad is that? They really believe that surgery is the only way babies are born. Nobody can promise anyone who will or will not need a cesarean, but the World Health Organization has stated that the cesarean rate should not exceed 15% or else more harm is being done than good. America's most current cesarean rate is 32.9% (2008 statistics), which has climbed for the 13th consecutive year.

One mom has two older children (a son 10 years old and a daughter 8 years old), both of whom were born by cesarean. She realized after the fact that the first cesarean was likely preventable, and the second cesarean did not have to have been an elective repeat cesarean and said that if she had another baby, she would seek a VBAC. With her next pregnancy, she was fearful, and her OB pressured her to schedule a repeat elective cesarean. During discussions with her husband and children as to the pros and cons of trial of labor VBAC versus elective repeat cesarean, her son said, "Mom, you may as well schedule it. You know the baby isn't going to come out that way [vaginally]." Even though she *did* eventually choose an elective repeat cesarean, that comment still hurt her, the fact that her son had no faith in her body's ability to give birth normally.

What are we doing to the next generation? Will children born in 2011 think that vaginal birth is obsolete? In my geographic area, many hospitals have a 50% or higher cesarean rate. Will children automatically assume that if and when they have children, they or their spouse will have to undergo major surgery to give birth?

I'm not trying to belittle cesareans (nor mothers who have had them), no matter whether individual cesareans were elective or scheduled or emergency or life-saving, and this isn't the post to weigh risks versus benefits of cesarean or vaginal birth. Regardless of the parents' experiences, the next generation deserves to know the truth: normal, vaginal birth is possible and attainable for the majority of mothers...IF they want it.

The same story plays out with our beliefs on our bodies' abilities to go into labor on their own, to give birth vaginally, to breastfeed, and more. I've heard many variations of this from moms of my generation:
  • "My mom (sister, etc.) wasn't able to breastfeed, so I probably won't be able to, either."
  • "My two sisters didn't go into labor on their own and had to be induced, so I probably will have to as well."
  • and now that the cesarean rate is so high "My mom had to have cesareans with all three of us, so I will probably have to have a C-section, too."
There's no reason to put unnecessary fears into mothers-to-be. The majority of moms can, if they choose to, safely birth vaginally and breastfeed... with the right information, preparation, support, and encouragement.

 My question is this: What do you want *your* children to believe when they are grown about birth, cesareans, and women's bodies' ability (or inability) to give birth? What would you tell your child (in an actual or theoretical conversation)?

If you would like for your response to be included in the Part 2 post, email it to me at wellroundedbirthprep (at) gmail (dot) com. I'm accepting submissions until January 15. Your submission by email gives me permission to post your response. I can post your response with your name (first name, initials, or whole name) or withhold your name, at your request. The length is up to you, anywhere from 1 sentence to 1 paragraph to 1 page. Thanks!

Sunday, January 9, 2011

How to become a childbirth educator, doula, or breastfeeding counselor

I get this one a lot: "I'm fascinated with pregnancy/birth/breastfeeding. How do I get started if I want to become a childbirth educator/doula/breastfeeding counselor?" There are a lot of answers to that question. I'll try to touch upon a few options.

While you don't have to become certified to become a childbirth educator, doula, or breastfeeding counselor, the certification process will help you obtain breadth and depth of knowledge and experience on the subject, give you credibility, and open doors to opportunities and clients.  For instance, most hospitals and birth centers require accredited certification to be eligible to teach their birth classes. Independent doulas and instructors can be self-taught or find a mentor.

There are various levels of time commitment involved in becoming a birth or breastfeeding assistant. Take into consideration your current life stage. Do you have reliable childcare? Do you have someone who could watch your children at any hour if you are called to a birth? If not, you may still be able to become a childbirth educator, lactation specialist, or postpartum doula until a later stage of life. If your goal is to become certified but you can't afford the process, you could see what the reading requirements are for the certification organization that you will be joining, and start reading now. You can borrow the books through inter-library loan; from another doula, childbirth educator, or doula in your area; or partner with another birth professional who is working toward certification and split the cost of a lending library.

Some organizations offer multiple certifications, which can be helpful if you only want to pay annual dues to one organization (for instance, doula certification and childbirth educator certification).

Here are just a few of the organizations that offer education and certification for becoming a childbirth educator, doula, lactation specialist, postpartum doula, prenatal exercise consultant, or other.

In alphabetical order:

Birthing From Within. "mentor" (childbirth educator) and doula certification

Birthworks International. childbirth educator and doula certification

The Bradley Method of Husband-Coached Natural Childbirth. childbirth educator certification

Childbirth and Postpartum Professional Association (CAPPA). labor doula, postpartum doula, antepartum doula, childbirth educator, lactation educator, and teen educator certification. 

Doulas of North America (DONA). birth doula and postpartum doula certification

International Birth and Wellness Project. childbirth educator certification, doula certification, and midwifery training.

International Childbirth Educator Association (ICEA). childbirth educator, prenatal fitness educator, birth doula, and postpartum doula certification.

Lamaze International  childbirth educator certification.

Prepared Childbirth Educators, Inc offers certification for nurses only. Breastfeeding counselor, childbirth educator, infant massage instructor, labor doula, and prenatal/postnatal fitness instructor certification.  

If you're interested in being a breastfeeding counselor in some capacity, perhaps becoming a La Leche League leader would be a fit for you as an intermediary step or to complement your other roles. LLL leaders must have at least 9 months personal experience breastfeeding, must agree with LLL's philosophy, and complete accreditation requirements such as reading requirements, essays, interviews, and more. It's a volunteer position, but it's very rewarding.

Factors to consider when looking at organizations for certification:
  • Birth philosophy. Is it a fit for your beliefs? When you read their mission statement, do you feel as though you could identify with that organization?
  • Cost. Not just for certification for the program, but for initial joining fee, annual dues, cost of any workshops required for certification, and materials (books, etc., some of which you may be able to get from the library or used from amazon.com or half.com).
  • Location of training workshops. Proximity to your house, timing of workshops. Availability of a mentor to assist with your certification process and answer any questions along the way.
  • Continuing education requirements.
  • Community needs in your area. If there are already 3 Bradley certified instructors in your area, you could interview them to see whether they think the market demands could support a fourth Bradley certified instructor, or whether you might find more clients if you certified with a different organization.
  • Will you be independent (thus have control over the subjects you teach and discuss with clients) or will you look to work for an institution (and possibly be limited to teaching policies and routines of the institution, while being restricted from speaking on alternatives)? 
  • Do you have a location in mind for teaching? Possibilities include your home, your clients' homes, churches, senior centers, YMCAs, Pilates/yoga/dance studios, hospitals, birth centers, and more.
Here's how I selected ICEA (International Childbirth Education Association) to pursue certification as a childbirth educator. After having 4 pregnancies (3 homebirths and a loss at 15 weeks) with my midwife, we've spent so much time together that she's more than just a midwife: she's my friend. I call her when I have questions about something I read about birth or about cause-and-effect of birth problems I hear about. In March 2010, I told her that I really do want to become a real-live childbirth educator "some day when I have time." I knew that my scope and effectiveness in helping families would be greatly expanded if I were certified. My midwife suggested that ICEA could be a good fit for me and suggested I check out their website.

I immediately loved their motto: "Freedom of choice based upon knowledge of alternatives." That's really a fit for me. I can respect EDUCATED, INFORMED decisions even if they're not the decisions I personally would make. I want to help my clients make informed decisions from a position of knowing their options, no matter where their birth takes them.

Here's the path I'm taking to get ICEA certified:


Here's Birth Source owner Connie Livingston's article on becoming a childbirth educator:

Another great option is to find a local birth meetup group to learn more and network. To find one near you, if a Google search isn't coming up with an answer, ask around: moms' groups, La Leche League, babywearing moms, midwives, doulas, childbirth educators, homeschoolers, naturopaths, health food stores and/or chiropractors may know of a group. My midwife, Angy Nixon, CNM, organizes birth meetups in Scott Depot/Charleston and in Huntington, WV, that each meet once monthly. I blogged about the birth meetups here. At these birth meetups, anyone who is interested in learning more about pregnancy and birth is welcome to attend, no matter where or how (or even whether) they have given birth or plan to give birth. It's about learning what birth options are available and connecting with birth professionals and other moms (not about birth location).

If you can find a local contact who is an experienced childbirth educator, doula, or midwife who would be willing to mentor you and help you along your path, that can be very helpful. She may even have an established lending library and could possibly allow you to borrow books that you need for your certification.

Read, read, read! Read as many birth books as you can from the required reading lists from the organizations I posted above. I have a blog in progress with lists of birth and breastfeeding book suggestions. Read birth stories online.

Subscribe to free e-newsletters of professional birth and breastfeeding organizations. Follow them on Twitter and friend or "like" their pages on Facebook. If you would like a suggested starter list, you can see my favorite pages on Facebook on the lower left of the profile and who I follow on Twitter.

Most (all?) childbirth educator or doula certification organizations require you to attend a minimum number of births. Your role at the birth will be determined by what you are working toward (childbirth educator might be required merely to attend and witness a labor and birth, while a doula would have more requirements: physical and emotional labor support, working with staff, etc.) as well as what role the birthing couple want you to fulfill. Although you will have to register with a certification organization before any births you attend will count toward your certification requirements, the more births you can attend, the more you will learn. If you have any pregnant friends or family members who might let you attend their births, it would be a great opportunity if they'd allow you to attend. Read Penny Simkin's The Birth Partner  and other birth books for inspiration and what to expect, then discuss your role at the birth with the mother and her partner. Will you be there just to observe quietly, to photograph or videotape, to help mom's partner support her in the birth, to bring a goodie bag of massage tools? Just be sure that the couple understands that you are there to learn and to support, and that they are aware of your level of experience and education.

This isn't an exhaustive list of how to become a birth or breastfeeding professional, but it's a good start. I'm sure I'll add to the list. Best wishes on your journey to serve families in their childbearing year!

Those of you who are childbirth educators, doulas, midwives, or breastfeeding counselors of various sorts, how did you start your journey into your career? Did you mentor or certify (or both)?

Wednesday, January 5, 2011

Wordless Wednesday: Family Planners/Planning

You know you're a birth junkie when...

you see 3 shelves labeled "Family Planners" at Walmart...

and what goes through your mind instead is...

Image from flikr http://www.flickr.com/photos/perlgirl/2397837838/

"Family Planners"... heeheehee.

Tuesday, January 4, 2011

Gestational Diabetes Myth-conceptions via Pregnancy App for phone

Expectant momma Julie Ann Samples shared on Facebook today, "One of my pregnancy apps on my phone updated me to 24 weeks today and informed me that if I am found to have gestational diabetes, then my baby will have to be born by cesarean section, ugh!!! I'm glad it was a free app!" Thankfully, Julie knew that this advice was wrong.

She said that the app is an Android app called Pregnancy Assistant. When she went to their website to leave a review, she saw that her fellow pregnant mommas gave it 4 1/2 stars! Augh! Most of the moms using the app are likely not reading all the Cochrane Reviews or Medscape journals or even ACOG's own recommendations and have NO IDEA what advice is evidence-based and what is thoroughly fabricated, such as advising a 24 week pregnant mother that if she is diagnosed with gestational diabetes, that a cesarean birth would be necessary.

The fact of the matter is that gestational diabetes alone is not a medical indicator for cesarean section. Cesarean birth has serious risks both to mother and baby. If gestational diabetes is poorly controlled or not managed at all, baby can possibly grow too large and need a cesarean. If gestational diabetes is well managed (by diet, exercise, and/or medicine under advisement of OB), mom and baby have the best chance for a vaginal delivery. Isn't it far better to empower mothers to know what their options are to safely control and manage their gestational diabetes from the earliest point possible and decrease their risks of needing a C-section?

It's easy to say, "Don't look a gift horse in the mouth," or "You get what you pay for," but I don't think this applies to a free pregnancy phone app. This is a damaging lie, one with far-reaching consequences. It would really be better to have NO ADVICE AT ALL than to have advice that's contrary to the evidence when it comes to your health and safety. This app needs to get their act together and give factual information or get out of the business of advising pregnant women altogether.

If any of you have tried out pregnancy apps for iPhone or Android, I'd be interested in hearing a product review in the comments here. Which are neutral ("Your baby is now 24 weeks along and has such-and-such abilities and characteristics"), which are helpful, and which dispense flat-out lies?

Childbirth Connection full chapter on Gestational Diabetes from A Guide to Effective Care in Pregnancy and Childbirth (pdf printable)

Edited to add: I just sent the following email to Pregnancy Assistant app's customer service address, along with the link to this blog:

"To whom it may concern,

"I am a childbirth educator. One of my clients informed me that she was using your Pregnancy Assistant app and received dangerously incorrect information in the 24 week gestation pregnancy notification. You have the duty and legal responsibility to include evidence-based information. I have blogged about this incorrect information with the hopes that pregnant women can learn the truth and avoid unnecessary major surgery.

"Sarah DeGroff
Well Rounded Birth Prep"

If you would like to send them a (professional, courteous, non-flaming) email, you may do so at info@apps.dzieciowo.pl

Sunday, January 2, 2011

Unmedicated vaginal breech hospital birth story in photos!

If you know this fabulous couple and their story, their doctor or hospital, please don't post their real names in the comments. This momma gave me permission to share her incredible story and photos so long as I blurred their faces and withheld their names. She has told her story far and wide and is proud of her accomplishments, but would like to not be associated with the photos as far as Google searches for her name and things like that. If it were me, I wouldn't want high school friends seeing pics like this, either. Maybe she will comment anonymously and fill in any details that I miss. (I'm still waiting for her to write her own birth stories!)


We'll call them Jessica and Eric. I met Jessica early in her pregnancy and we became fast friends. She was pregnant with her 3rd baby and was thirsty for info. I forget how our first conversation about birth came about, but it's probably not a surprise to you that birth and/or breastfeeding just happen to come up often when I'm around. It's funny how it works out that way. :-)

I try to sow seeds gently and see how much interest moms have. If they get defensive or change the subject, I (try to) drop it. It's better to leave it be and let them know I am here if they want to talk about it later. But Jessica took interest right away. I explained the Cascade of Interventions to her and some of the risks of some of the most common interventions. She was intrigued and wanted to know how it was that so many birth interventions were pushed on her without any of the risks being explained.

With her previous two births, she went into labor on her own (around here, it's a major feat to escape induction), and everything that was done to her in the hospital was done because of routine. She didn't want the epidural but had one both times because the staff told her, "Now it's time to get your epidural." She was led to believe that was safest for her baby, and that it was what everyone does. She did manage to have vaginal births both times, but she had quite a few side effects that she didn't realize were results of the epidural and other medications that were subsequent interventions (such as Pitocin). With her first baby, she pushed for 10 minutes and the OB gave her a deep episiotomy and pulled her son out with forceps. With her 2nd baby, she had told the OB that she did not want an episiotomy and did not receive one, but tore badly due to the epidural. Both times, Jessica had blood pressure problems as a side effect of the meds, as well as PPD, a disconnected feeling from the birth and her babies, and difficulties breastfeeding. Once she learned the cause-and-effect, she wanted to avoid duplicating her previous experiences.

Over the next few months, I recommended a lot of great books and articles for Jessica, including The Thinking Woman's Guide to A Better Birth by Henci Goer, Ina May's Guide to Childbirth by Ina May Gaskin, and Birth Your Way by Sheila Kitzinger. (There are plenty of other great birth books--see my Amazon.com widget to the right of my blog for others--but these are the ones I had on hand at the time.) I lent her my DVD copy of The Business of Being Born and asked her if Eric would be willing to watch it with her. I find that a lot of husbands are more willing to sit through an 84 minute documentary on birth and the failure of the American maternity system than to read a thick book on the topic. Besides, The Business of Being Born is short, riveting and easy to follow and hold attention for a layperson--even for a husband.

Jessica learned about birth plans and options and normal, physiologic birth. She and her husband were my first clients in my birth classes for my ICEA certification as a childbirth educator. She asked me if I would attend her birth as her doula. She started attending birth meetups to network with midwives, doulas, childbirth educators, homebirthers, and other birth advocates to learn what their birth options were. 

Jessica left her OB when she asked a few questions that led her to believe that her OB would be less-than-supportive of an unmedicated birth this time around. She interviewed several other care practices and started seeing a CNM (certified nurse midwife) with an OB practice at the hospital with the lowest cesarean rate around.

Things went along smoothly until her baby flipped breech at 35 weeks along. This was unexpected! I wanted to make sure that Jessica knew what her options were: even if her baby stayed breech, breech vaginal birth *was* a real, safe possibility. The most current research says that vaginal breech birth can be the safest option for some moms and babies. Jessica read everything she could find on breech and did everything she could to encourage her baby to flip vertex. Avoiding a cesarean (unless it was an absolute medical necessity) was very important to her.

Jessica re-read the full chapter on pros and cons of breech vaginal birth versus breech cesarean risks in The Thinking Woman's Guide to a Better Birth, as well as positive breech vaginal birth stories. In the meanwhile, she did *everything that could be done* to encourage baby to turn head-down on his own. She practically memorized the breech section of SpinningBabies.com. Jessica practiced inversion of various sorts as often as she could at home, including inversion over an ironing board leaned against her couch and inversion in a swimming pool. She tried hot/cold therapy and lights and music to coax baby head-down. She started regularly seeing a chiropractor who specialized in the Webster technique to encourage baby to turn head-down. She crawled down stairs head-first. One of the OBs at her midwife's practice attempted an external version. All to no avail. This baby was persistently frank breech, but fortunately, this is the safest breech position for vaginal breech birth, and one of the OBs at the practice said that Jessica was an excellent candidate for breech vaginal birth. I couldn't believe she found a hospital OB who would agree to take her on as a client! (Well, "patient," not "client," technically, but I get so miffed about perfectly well mothers being called "patients" when they are not sick! I digress.)

The OB was pleased that Jessica was planning for an unmedicated birth and told her that this would give her the best odds of having a vaginal breech birth. With a vertex birth, it's important to feel your body's cues to help baby rotate and descend, but it is even more important to feel and respond to those sensations with a vaginal breech birth. I was pleased that everything Jessica said that her OB said, lined up with the research. This sounds obvious but you would be amazed at how many times OBs' advice is contrary to evidence-based information.

I had my doula bag packed and ready and was on call for Jessica once she reached 37 weeks. Jessica had had sporadic stretches of contractions that kept her up at night for about a week and a half (commonly known as prodromal labor). At 38-and-a-half weeks, I received a phone call at 3:40 a.m. Jessica sounded calm but told me that this was probably it and her contractions were about 4-5 minutes apart and that she and Eric were leaving for the hospital after the drop their other children off with a family member. I had almost an hour's drive to the hospital and was out the door less than 10 minutes after receiving the call.

Jessica later told me that she had been managing to cope through the contractions with techniques I had taught her in her birth class, from a little after midnight until 3:30 a.m. so well that she didn't even bother waking Eric. Once they got closer together, that's when she awoke him and they got ready to go to the hospital, but she still felt that the contractions were manageable and tolerable. Once they got in the car, Jessica's contractions intensified suddenly. She was in transition and didn't know it.

I didn't know any of that. I arrived at the hospital at 4:40 a.m. and came to the OB floor front desk. I asked the nurses which room was Jessica's, and introduced myself as her labor support, then handed them a goodie bag with Baked Tostitos, salsa, and chocolate chip cookies as bribery of sorts. (I've read mixed reviews as to whether this will *actually* get a patient preferential treatment over the next 2-3 days that they will be admitted, but it was an inexpensive insurance policy just in case. Plus, nurses are underappreciated in general. It doesn't hurt to thank them and bring them food.) They told me Jessica's room number and looked a bit confused; they told me they've been trying to keep her from pushing. Whaaaat?

When Jessica arrived at L&D and explained who she was and that her baby was breech, there was a bit of confusion, and one of the nurses asked if she was here for a C-section ("Um, no! I'm here for a planned vaginal breech birth!"). Thankfully, her OB who had been on call specifically for her *had* been notified and was on the way. When the nurses checked Jessica, she was at 10 cm and the nurses begged her not to push until her OB arrived. Even in the midst of that chaos, the nurses tried to talk Jessica into getting the routine IV, which Jessica had already discussed with her OB. She asked for the hep lock instead. She had the presence of mind to advocate for herself at 10 cm!

I turned toward her room and saw the OB walk in seconds before me. Here I was with my bulky doula backpack loaded up with a camcorder ready to record the birth, a tripod, fake battery-operated candle for aromatherapy and visual comfort, heating pad, massage tools, my Labor Progress Handbook, and more. None of it mattered! Jessica was in the zone and already involuntarily pushing. The whole thing happened so quickly that there wasn't even time to turn down the bedsheets. Jessica was pushing on a chux pad on top of the blankets and sheets and everything. There was no time to move anything. I was up against the door--literally--camera in my hand and my hands shaking with excitement and adrenalin.

Folks, I realize that my photography is disappointing. I was nervous and rushed and cramped and at the foot of the bed. I was trying to take these photos with the camera raised overhead like you would at a concert. I didn't feel that it would be appropriate for me to ask that nurse to please move so I could get a better shot. But Jessica gave me permission to post her photos and I'm over the moon! I'm sad to say that attending a vaginal breech delivery is probably a once-in-a-lifetime opportunity. I remembered about my camcorder that was in my backpack, ready to go, and Jessica wanted me to record with it, but I literally could not reach it and could not set my backpack down. Things were going so quickly that I knew that I'd miss it if I moved at all.

Jessica started out pushing on her side. What you see is her bulging bag of waters--still intact!

Soon her water broke on its own. The rump started rumping (I guess you can't call it crowning?). What you see here is baby's testicles on the left (the darker part) and his bottom on the right, emerging.

More of baby's rump is emerging. His testicles are at 9 o'clock. He's passing meconium, which is normal for a breech birth, since he's being squeezed that direction.

OB gets ready to help rotate baby a little as he emerges.

OB is supporting/rotating baby a bit. His legs have emerged and baby is born as far as his belly. The rest of him just slid on out easily, after a grand total of about 10 minutes of pushing!

Congratulations, Momma! You did an amazing job! Jessica enjoyed skin-to-skin contact with baby and rooming in to help establish breastfeeding. With the right information and support, Jessica has been able to exclusively breastfeed her son, which she wanted to do but did not know how with her others. I love seeing Eric's hand lovingly stroking his wife's forehead in this pic.

First nursing

Dad Eric gets ready to cut the cord after about 25 minutes of delayed cord clamping.

After that, they weighed and measured baby while Jessica pushed out the placenta (on her body's cues, despite the nurse's INSISTENCE that she get it done in the first 10 minutes postpartum). Jessica's bleeding was so minimal that she did not need a shot of Pitocin. Isn't it neat to see baby's legs piked in the frank breech position with which he was so familiar?

This is Jessica's favorite photo from the birth, with her son's inky little feet from getting stamped on the birth certificate. (Gee, you don't want to frame the one with your son's rump "crowning"?)

This proves I was there.

Oh and by the way, Jessica didn't tear A BIT this time! She felt great and said she would do it again in a heartbeat! What a victory!

On one hand, I was thrilled and honored to witness this beautiful, rare natural breech birth. On the other hand, I was saddened--why should this be such a rare event? I heard one nurse say to the other, "Gosh, how long has it been since we've had a vaginal breech birth here?" to which the other nurse replied, "There was that one vaginal breech birth about 10 years ago," and the first nurse said, "No, I think that was more like 15 years ago."

Yeah. That ONE.

Edited to add: "Jessica" has posted in the comments below. If you have any questions or comments that you would like to post for her, I'll email her to let her know.