I’d love to begin posting more birth stories.  Thanks, Courtney, for starting us off!  In honor of my daughter’s first birthday, I’d like to share her birth story.

In our family, we’ve started the tradition of sharing our kids’ birth stories with them on their birthdays.  I think it’s so important to validate our kids by sharing how they came in to the world, how much we anticipated their arrival and loved them from the day we met!  My nearly 3 year old son knows he came from Mama’s belly and loves to drive by and point our his “special” hospital where he was born.

Part of my birth journey with my daughter involved Rebozo sifting!  Read about how we used it during my labor below and look for more information about it here in the next few weeks!

Do you have a birth story?  We’d love for you to share it with us.  Leave a comment if you’re interested in sharing on Midwife&Mother!

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Just like my pregnancy with my son, my sister flew to Colorado to be with me during labor and delivery.  The timing of this was both crucial and impossible.  But we offered our best guess and she arrived just a few days before my “due date”, relying upon my “fast and on time” premonition for labor.  Once she arrived, we quickly gave in to every wives tale available in an attempt to encourage labor.  We took long walks, ate fresh pineapple, made final preparations for welcoming a newborn, painted toenails, ingested evening primrose oil and followed the advice of this informative website on optimal fetal positioning.  We made our final arrangements for my son’s care when I went into labor and packed bags.

During these days I experienced the normal aches, pains and contractions of late pregnancy.  I knew my body was slowly doing what it needed in order to prepare to labor.  I spent a good amount of time in hands-and-knees position because I felt that my baby was laying in a slightly OP position and knew that this could both delay the start of labor and make labor and delivery more challenging.

The day before my “due date”, I visited one of my midwives to be checked and have my membranes swept.  The midwife offered encouragement, told me I was already 2cm dilated with a thin cervix and a LOW baby.  She promised that if I could get my baby to change positions just slightly that I would labor soon and progress quickly.  We left the office encouraged and energized!  We had a dinner picnic in the park, enjoyed the sunshine, warm air and mountain views.

Before we left the park I began to feel some cramping and mild-but-regular contractions.  We went home to put my son to bed and enjoy what I felt would be the last moments with our first and only child.  Soon, my contractions were much more intense and getting closer together.  I spent time on my hands and knees and once I was convinced that this was truly labor, I told my husband and sister that we needed to clean the house!  They were both unbelievably sweet and didn’t hesitate to clean anything they could while taking breaks to stand with me or put pressure on my lower back during contractions.  I spent these couple of hours walking in the living room and kitchen, resting in hands and knees position and squatting.  My husband and I took a walk around the neighborhood (just like my labor with my son!).  It was such a relaxing and sweet time to be together before welcoming another baby.

I had recently read about a labor technique called Rebozo Sifting and was curious to try it out.  My husband and sister took my Maya wrap (baby sling) apart and used it to wrap around my belly while holding both ends of it behind me.  Between contractions while I leaned forward or resting on hands and knees, they would pull on the ends of the wrap and gently rock or “sift” my belly.  This took much of the weight of my belly off and helped me to fully relax between contractions.

By midnight I felt that I wanted to go to the hospital.  We called a good friend to come stay with my son.   Dreading the 20 minute car ride to the hospital, we armed ourselves with hot packs and a birthing ball in the backseat.  Overall the ride wasn’t awful as I was able to rock back-and-forth and breathe through my contractions knowing it would be just a few I needed to get through this way.

At the hospital, the nurse spent a few minutes monitoring my baby and checked me.   It was almost 2am and she seemed disappointed to inform me that I was still just 2-3cm dilated.  In fact, she encouraged me to consider going back home for a few hours.  (Which I DO usually consider to be a great suggestion for women in early labor!).  Luckily I was undeterred by this report and knew without doubt that this was labor and I would have a baby soon.  Looking back, I feel like my body was waiting until I arrived at the hospital (and felt safe under the care of my midwife and comfortable knowing my son was in good hands) to fully give in to labor and allow things to progress.

My husband and sister, having both attended to me during my labor and delivery with my son, were a seamless doula team. (I’m a firm believer that no unmedicated woman should deliver without a doula!)  They offered timely suggestions and used relaxation and encouragement techniques that worked unbelievably well.  My sister offered comfort and support to both my husband and me.  My husband used his “counting backward” technique he is so proud of and it worked as well this time as it did last.  They were where I needed them when I needed them and I barely needed to communicate with them at all.  It was a surprisingly quiet and smooth labor.  We listened to my Hypno-birthing CD, walked the halls a little, used the birthing ball at the bedside, leaned forward on the bed and swayed during contractions, and (is this getting old yet?) labored on hands and knees.  I truly believe that all of the leaning forward to let my belly hang and resting in hands and knees allowed my baby to rotate into her perfect position.

The Rebozo Sifting was probably the most surprisingly helpful tool we had.   Unlike my labor with my son, during which each contraction would begin and slowly build in intensity before releasing, these contractions were like a freight train.  They came on with such an extreme intensity, peaking immediately rocking the core of my body before releasing.  It was much more challenging this time to not fight the contractions when it felt like they hit with such an unbelievable force.

By 5am I was beginning to lose my composure, I felt unable to “ride the wave” of each contraction without fighting back and my body began to shake uncontrollably.  I knew this must be transition.  I asked to be checked again because I knew that I needed some measure by which to pace myself and if I wasn’t near to delivery I was going to die.  (And now after my two deliveries I know that the feeling of imminent death means delivery will happen soon!)  I was thrilled when the nurse told me I was 9cm dilated and my bag of water was bulging.

Following the news that I was nearly 10cm dilated, we all enjoyed a HUGE sigh of relief followed by a flurry of excitement.  We had done it!  In just 3 hours!  I didn’t hesitate to ask to have my midwife break my water in order to deliver quickly.  (Although now I wonder how amazing it would have been to try to deliver en caul!) The first contraction I had to endure laying in the bed was excruciating.  I lost all ability to cope in this passive position and felt as if I was being absolutely run over by a train with each subsequent contraction.  Unfortunately, I was so overwhelmed that I also felt like I couldn’t move out of the bed.  Every movement hurt and every contraction tore me apart.

My midwife offered some encouraging words and let me know that I could push whenever I felt like it–then she stepped back.  (Both physically to do some preparations and symbolically to allow me to deliver how I wanted).  With the next contraction I was so overwhelmed with intensity that I knew I needed to push to be finished.  I pushed once and the baby moved down so much that we all realized that this was going to happen NOW!  My midwife quickly put on a glove, suggested I lay on my side (how I wanted to deliver) and with the next contraction she caught our beautiful daughter!

And here is where I stop because there are no words powerful enough to describe how it felt to hold my baby for the first time and bask in the accomplishment and honor of bringing her in to the world.

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reaching the (previously) unreachable

I love to hear how creativity and innovation are broadening the reach of healthcare.  Lack of access to medical care is a crisis in many un/underdeveloped areas of the world and I am truly inspired when I hear about regular people using their knowledge and skill to bring a new kind of health care to the world.

Yesterday I heard this story on NPR about how doctors and midwives are beginning to use common household vinegar as a way to diagnose cervical abnormalities and cancer in African women who do not have access to the costly but effective screening tests like we have in America.

This week I also came across this article on a very low-cost ultrasound that can be used with a laptop.  This innovation could improve prenatal care where basic ultrasound technology has previously been out of reach.  (Engineers for the win!)

I am in love with the idea behind Modernova!  Browse through the products they are helping to develop and be inspired.  Many are creative yet simple solutions to save the lives of moms and babies throughout the world!

A guest post

Phew! I just submitted my last 2 assignments to finish my third quarter of graduate school! It’s been a busy few weeks and I’m looking forward to a much needed break (from school at least). Anyone else headed to the pumpkin patch? Berry picking is on the agenda this week for our family–it’s a September tradition!

I’m so excited to introduce you to my friend, Courtney, who has a really thoughtful post for us on dealing with a cesarean birth and bonding with your baby after surgery. Courtney is a fantastic labor and delivery nurse who is passionate about advocating for moms and babies. She also happens to be a rock star mom! Read her bio and then enjoy part of her story…

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Dealing with a Cesarean Delivery

I had no idea what to expect with the birth of my first son. I spent the last days of my pregnancy watching “A Baby Story,” imagining my perfect labor, birth, and breastfeeding experience. When I was told at 41 weeks I would need to be induced for oligohydramnios (low amniotic fluid) I stayed positive (and naïve) thinking I would still have this beautiful experience I had been imaging. Even after ten hours of little cervical change, an epidural, Pitocin, terbutaline, and oxygen, I never expected the doctor to come in and say “you need a c-section.”

I broke down, I cried, I called my Mom, and I slept until they wheeled me back to the operating room. I saw my son, Ethan for a couple minutes in the operating room and then I had to wait a couple of hours before I saw him again. They brought him in the recovery room and I attempted to breastfeed, though he had already received a bottle in the nursery. He would not latch right away (which, sadly, began our 6-month relationship with the nipple shield). Then he was taken away again.

I waited in my postpartum room for him for hours. I was told he was cold and needed to be under the warmer, I asked for the warmer to be brought into my room and I was told just to rest. How could I rest? I had been waiting to meet my son for ten months, feeling him kick at night, waiting to hold him. They finally brought Ethan in at 7am (he was born at 2am) and when I started feeling post-op pain, they hooked up a dilaudid PCA (a form of anesthesia I could control through my IV). I spent the rest of that first day so out of it I could barely hold him and breastfeeding was a nightmare.

For the next two days, doctors I had never met came in to do their rounds on me and asked me “why did you have a c-section?” When I expressed grief over my surgery everyone’s response was “you have a healthy baby and a healthy mom, that’s all that matters.” I wanted to scream! That is not how I felt and I didn’t know why people were not sympathetic to that.

I spent the next couple of years enjoying my beautiful son and dealing with the grief and depression I had over his birth. I started working as a labor nurse when Ethan was 2 years old and I was already 18 weeks pregnant with my second son. Working in labor and delivery gave me perspective on things and I felt a little better about my experience. When I was planning for my second son’s birth I took hypnobirthing classes (totally foreign at my hospital at the time!) and planned a natural VBAC (vaginal birth after cesarean). I was encouraged toward the end of my pregnancy to consider a repeat c-section due to his estimated large size and nuchal cord (cord wrapped around baby’s neck) that was seen on ultrasound but I stayed strong and believed in my body.

I had the birth I wanted. That experience helped me complete the grieving process.

I now feel that I was meant to have those experiences so that I can help my patients have the best experience possible. I have realized that the worst part of a cesarean is not the recovery or missing out on a vaginal birth… it’s not having your baby with you. There is no reason why a healthy baby cannot do skin-to-skin in the operating room. I feel blessed to have a new position at my hospital that allows me to do baby transitions so that I can facilitate bonding in the operating room.

Facilitating early skin-to-skin contact and bonding is still foreign for many providers and anesthesiologists but with each baby I put on mom’s chest, I feel like this practice will be the norm in the future! I encourage moms to ask for skin-to-skin contact in the operating room and to be proactive in insisting the baby stay with her if at all possible. As long as the baby is thoroughly dried off and her temperature taken often there is no reason the baby has to be whisked off to the recovery room with dad, leaving the mom all alone on the operating table. I encourage all mothers to talk to their health care provider in the office prenatally about skin-to-skin in the OR because it is often a reasonable request, backed by clear evidence that shows it is the best option for both mother and baby.

Expect the unexpected when it comes to childbirth. Have a flexible birth plan and talk to your provider about it before you go into labor. Be educated but not defensive. Being relaxed and positive is going to be your biggest asset in labor. For those considering a VBAC, go for it!!! The last hospital I worked for had a 91% success rate for VBACs; ask what your hospital’s VBAC rate is. If your provider/hospital does not offer this option, considering switching to one that does.

VBAC is a safe choice for most women! #VBAC #skin-to-skin

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Thanks so much for sharing your story, Courtney!

We’d love to hear from you, dear readers: Have you had a similar experience? For those of you who have had a c-section birth, how was your postpartum bonding experience?

If you have any questions or comments for Courtney, please post them!

a birth revolution

“…birth has been stolen, by a powerful institutionalized system, that is born of fear, a system that inherently believes that birth is dangerous, and must be managed and controlled by modern technology.”

“… how we birth has a huge impact on early bonding and attachment, breastfeeding, PND rates and more…which in turn has long term impact on the mental and physical health of both mother and child…which in turn affects the human race.”

Get off your back for a birth revolution!

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gestating

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This week I came across an interesting article by NPR on why human pregnancy lasts 9 months. I can’t deny that in those bleary early months of newborn-ness I have considered the ingenious possibility of giving birth to an 18 month old.  (Anyone else in for skipping frequent night feedings?  Explosive infant diapers?  No?)  And then I realize that the nearly 9 pound newborn I was blessed with had definitely maxed out my fetal size threshold (according to the article, it was also maxing out my metabolic threshold).  I’d say it’s a decent trade off.  Come to think of it, I’d hate to miss out on that sweet newborn smell.  And, of course, nursing and babywearing.  I’ll gladly take the 9 month gestation and enjoy the heck out of both my newborn and eventually the toddler.

 

 

Cascade of intervention

The “cascade of intervention” is widespread in American birthing practice.  Birth has become a medical problem to be treated.  It starts with unrealistic expectations about childbirth, fear of pain, leads to an induction (suggested by the mother and/or doctor and often not medically necessary), makes an easy transition to an epidural, increases the risk for an instrumented or surgical delivery.  I think Prof. Tracy is right on by saying we’re moved away from  the “natural rhythm of women giving birth”.

Well-trained midwives play a huge part in helping mothers avoid the cascade of intervention through education and empowerment.  In fact, as stated in the video below, countries that employ nurse-midwives as first-line care providers for pregnant women have the best outcomes!

The Journal of Midwifery and Women’s Health recently published an excellent handout on how (and why!) to prevent a cesarean delivery.  This is an invaluable resource for women who feel pulled in to the cascade (downward spiral!) of intervention!

(no) Breast self exams

I’m nearing the end of the 3rd quarter of my graduate school program to become a nurse-midwife.  Nearly 1/3 of the way finished!

One of my current classes discusses preventive medicine and screening tests.  We were introduced to a tool for primary care providers developed by the U.S. Preventive Service Task Force identifying preventive services which offer significant health benefits and are backed by evidence. For example, screenings for high blood pressure and sexually transmitted infections or counseling for obesity. The nice thing about this tool (it’s available as a free app!) is that it bases its screening and counseling recommendations on gender, age and predisposing conditions.

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For me, the most notable recommendation was AGAINST teaching women to do breast self exams as a screening tool for breast cancer.  The evidence does not indicate that doing monthly breast self exams catches breast cancer earlier or decreases mortality. In fact, the high number of false positives (women who find lumps and bumps that end up being benign) causes more emotional distress for the woman, unnecessary testing and higher cost in the end.

This change in screening recommendation does not mean that women should not take responsibility for their health!  There are many things you can do to decrease your risk and follow screening tests which have been proven effective.  The Susan G Komen for the Cure website has some great guidelines:

Breast cancer screening and awareness

I urge you to take a look for yourself!  FYI:  knowing your personal risks, getting regular recommended screenings (such as yearly mammograms after age 40) and BREASTFEEDING as protection are on the list!

Do you know anyone who discovered their breast cancer using a breast self exam?  Has this been part of your regular preventive health routine?

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