Tuesday, November 29, 2011

Choosing a homebirth: My journey Part 1

I know some people wonder where the decision to birth at home comes from. Other people have moved past the wondering and are debating a homebirth for themselves. And still other have had homebirths in the past and continue to choose it for future births.

I can't give answers to all of the people wondering why except to tell them why I have personally done it. I know the journey of one can help the journey of others. I love to hear experiences, expectations, hopes and questions from other people. (Now I have the Yo Gabba Gabba song about sharing in my head!) I am SO thankful that other people shared with me. These people, unknowingly, gave me options

I was sitting with two other women and we were all nursing our new-ish babies. Two of us had typical hospital births, although mine had not gone as desired. I wasn't telling the story of my birth. I didn't even know enough to know what had happened or why. I couldn't even give a voice to my disappointment - I had a typical hospital birth for my area. The same most women had. How come it wasn't ok for me? One friend talked about her hospital birth. She was satisfied. The other friend talked about her homebirth. (WHAT?!?! People do that? Normal people? People with jobs and houses? WHY?! That's so dangerous and irresponsible!!) She was glowing. She was thrilled. She was happy. And I thought she was crazy!

Maybe a year and a half later I was reading the newspaper when I saw an article about doulas. I still have that article. It spoke to me and called me. I went to the website listed (DONA.org) and happily found out that their current headquarters were near me AND they had regular trainings in my area! I didn't know any other doulas. None of them in my area had websites. There was no facebook or myspace and doulas were still pretty new to the birth scene. Nobody had heard of them and a lot of people thought I was crazy. I bought the books I had to read and I started studying. I went to the training with a handful of other women. I was young, it was new, I had very little birth experience and zero natural birth experience. I had judgments and preconceptions. I was idealistic and there was a right way to do everything. (Time, growth, and experience have definitely tempered that for me!) I finally met other doulas and connected with families and I began to attend births.

I have learned so much. Women are strong. They know what to do. They love their babies. Some care providers are good. Some not so much. I also learned what was important to me for my own future births. These were just basic things. Honesty, dignity, privacy, security, confidence, and support. I watched doctors and midwives. I sat with nurses in the halls. I overheard conversations and saw treatment that bordered on abusive. How was I going to have that natural birth I wanted? It wasn't likely to happen.

Before I found out I was pregnant again I started reading about homebirth. I read articles by Henci Goer about the safety of planned homebirth. I already loved her book The Thinking Woman's Guide to a Better Birth and loaned it to most of my doula clients. I talked to other doulas and got the names of some midwives and started calling around. I read books and copied questions. I'm sure those midwives had heard it all a million times. The list below is a pretty accurate description of what I asked. There are probably a ton of these lists floating around online that are all very similar. This one is from San Diego Birth and Wellness. If you haven't checked it out, I would go read Barbara Herrera's (Navelgazing Midwife) awesome series about interviewing a homebirth midwife here. In part 2 I will talk about what made me personally decide on homebirth for children.

Midwifery Education and Experience
What is your philosophy about pregnancy and birth?
Why did you become a midwife?
How long have you practiced midwifery?
Approximately how many births have you attended?
How many of the births you've attended were homebirths?
How, when and where did you receive your education in midwifery?
Did you attend a formal midwifery education program or did you train by apprenticeship, or both?
Are you also a nurse? Are you a licensed midwife?
Are you a certified professional midwife?
Are you certified in Neonatal Resuscitation?
Would you provide me with the names of a few mothers as references?
Do you maintain statistics from your practice?
Have you had any poor outcomes for mothers or babies? Please explain.

Midwifery Practice
Do you work alone or with other midwives?
What arrangements do you have if you are sick or if two of your clients are in labor at the same time?
Will I be able to meet any other midwives who might be involved in my birth?
Do you participate in regular peer review?
What prenatal care do you provide?
What do your prenatal visits consist of?
Do you provide home visits?
What are your recommendations about my nutrition during pregnancy?
What protocols do you have regarding "going overdue" during the pregnancy?
How do you feel about waterbirth?
How many of your clients deliver in the water?
What are your views on episiotomy?
What is your episiotomy rate?
How often do your clients have an intact perineum after the birth?
Can you suture if a tear occurs?
Up to what degree do you suture?
How many third or fourth degree tears have you had?
Do you assist with cleanup after the birth?
How long do you usually stay after the birth?
How often will I see you after the birth?
What do you do during the postpartum visits?
Do you check the baby at each postpartum visit?

What equipment do you carry?
What neonatal resuscitation equipment do you carry? Do you have oxygen available?
What supplies do I need for a homebirth? Where can I purchase them?
Do you have supplies available in the event of a hemorrhage?
How skilled are you at placing IVs?

Practice Guidelines
Do you have a copy of the rules and regulations that pertain to midwifery practice in this state? Are certain policies and procedures for my care mandated by your licensure?
What prenatal tests do you require or recommend?
What conditions absolutely risk me out for homebirth?
How many weeks along must I be in order to be able to have a homebirth?
Are you willing to use a fetoscope instead of a doppler during my pregnancy?
How often do you listen to fetal heart tones during labor?
What are your standards regarding monitoring of the baby during pregnancy and labor?
How frequently do you do internal exams during labor?
How do you feel about having a doula at a homebirth?
Do you provide newborn metabolic screening after the birth?

Childbirth Education
Do you offer childbirth classes? If you refer out to other childbirth educators, which classes do you recommend and why?

Hospital or Physician Transfer of Care
Under what conditions do you transfer to the hospital setting?
Will you or an associate stay with me if I need to transfer to the hospital?
What is the plan of action if hospital transfer becomes necessary?
What consultation arrangements can be made in advance?
What problems or complications in pregnancy would require that a physician would become my primary caregiver?
What is your rate of hospital transfer?
What are the most common reasons for transfer to the hospital?
What is your cesarean rate?
What are the most common reasons for performing a cesarean section?

Complementary and Alternative Medicine
Do you have training or experience in alternative medicine? How did you obtain it?
Do you carry medications, homeopathic remedies or herbs for use during pregnancy, labor and the postpartum periods?
What do you recommend to deal with the common discomforts of pregnancy? Do you generally recommend alternative therapies before pharmaceutical ones?
Do you refer to other providers who give supportive care such as acupressure, acupuncture, chiropractic care, osteopathic treatment and massage?

Availability and Fees
What vacation plans do you have?
Do you have other mothers booked at the same time I am due?
What are your fees and what is included in your services?
Do you use a professional insurance billing person?
In terms of the midwifery fee, what happens if I have to transfer out of your care?
How do I reach you when I need to speak with you? Are you available at all times?
At what point in my labor will you come to me? How long will it take for you to arrive? How do we obtain a birth certificate?
Is there a fee for the newborn metabolic screen?

And finally, ask yourself ....
Do I want this person with me at this most intimate moment of my life?

Wednesday, November 23, 2011

14 weeks

I just figured out my log in info again so I hope to post more often. Wishful thinking :) In the past I have kept pregnancy and birth journals for some of my children. It's not common knowledge yet, but I am currently pregnant with baby #6! A few of my friends have mentioned how much they liked my pregnancy journals and I really hope I can keep up with this pregnancy! I have also had a few friends become interested in homebirth lately so I hope to document the process I go through so they can understand midwifery and homebirth.
My previous birth and pregnancy were unassisted. I have decided to use a midwife this time and am very comfortable and happy with that decision. I've had some anxiety this time about choosing a midwife and whether I wanted a homebirth. I know it's a very individual process and everyone cares about different things and has different ideas of what kind of birth they want. I really enjoyed Navelgazing Midwife's series on interviewing a homebirth midwife. Even though this is the 5th time I've considered these things I liked reading from the point of view of a homebirth midwife. There were a couple things that made a difference to me this time.
We have so many amazing midwives where I live and each one of them brings something different to a birth. I hope there is a midwife for each woman; someone they can work well with who will be a good mentor during the pregnancy and birth. I had a new option in my community this time. A midwife here has opened a small birth center. I don't feel like it's a good fit for me, but such a cool opportunity for women who aren't comfortable at their homes for whatever reason.
On to pregnancy news - I'm due the end of May. We are super excited to have a new baby. I am happy to have a baby at the end of spring. I have too many fall/winter babies and I don't love that time of year. I have been feeling small movement for a couple weeks now. We first found the heartbeat around 10 weeks or so. It was 169. I didn't start to feel very crappy until about 7 or 8 weeks. And then I got sick! I had a nasty cold/cough that kept me down for a couple weeks. I have a few lingering issues with it still, but overall I am feeling pretty good now! I have been anxiously focused on choosing where to birth and with whom and I feel a lot better about that now after talking with a few midwives over the past couple weeks.

Baby #3

This was written in December 2004.
The past few months of this pregnancy I had been worried that I would go into labor in the middle of the week during the day and Jay would miss it. We would also not be able to afford for him to take any time off from work so I was desperately hoping to go into labor late on a Friday afternoon. (I did with both of my girls) The Friday I was hoping for (the 10th) came and went. My due date(s) came and went. I made it to my last childbirth class and got a great foot rub from Jay. Friday (17th) we decided to put the girls to bed and watch a movie, eat junk food, and get a little lovin since we knew we would probably be busy with a baby soon (who am I kidding? I was convinced this kid wasn't coming. I hadn't done pregnancy pics or a belly cast!).
Olivia woke up around 4:30 and got into bed with us. We were going back to sleep when she asked for water. I got up and got the water and went back to bed. I was just falling asleep when I had a contraction. It just felt crampy and I cursed myself for eating so close to going to bed. I had another one and another and thought that maybe this was it. I decided to wait to have 2-3 more and then I would wake Jay up. (still convinced I was not having a baby). I lay in bed, snuggling Olivia and listening to Jay breathe beside me and I felt calm. The few weeks prior whenever I thought about actually going into labor I would feel a little panicked. I had 2 more contractions and by then I knew I wasn't going back to sleep and even though I wasn't super uncomfortable I needed Jay to get things ready while I rested. It was then that he mumbled something to me and I realized he wasn't asleep either. It was about 5:00 by this time. I told him the baby was coming and he said, "right on", and jumped out of bed and got dressed. He started setting the pool up and I stayed in bed hoping Olivia would stay asleep and trying to rest and relax as much as I could.
Olivia decided she was getting up so I decided to move around and try to find a comfortable position. I wanted to get in the shower and have the water spray my back but I didn't want to use all the hot water. I sat on the toilet instead and that felt good but I started to get cold. I walked around a little and then tried to lie down for a while. That didn't feel good at all so I got on my knees and leaned against my birth ball. I felt a little bit like I might throw up (again cursing the food I ate before bed) and went into the bathroom where I stayed on my knees leaning against the bathtub. Jay decided to time contractions and they were 2 minutes apart and a minute long. He called our midwife and left a message on her phone and we got back to business.
I was rocking through the contractions. They were coming fast and hard but I was still chatting nicely in between them and telling Jay how they felt and what was working and what wasn't and what I wanted to try. The pool had some water in it by this time and while I hadn't really been planning to definitely use it, I needed something else. I jumped in and even though it wasn't as hot or deep (yet) as I wanted it, it was nice. Jay started heating up more water and I just hung out. Olivia decided then to come get in the pool with me and Jay ran in to distract her and she got really upset. I wanted Jay with me and I didn't want Olivia upset so I had him call my mom to come sit with her. We gave her the video from the baby (Peanuts Christmas) and she went out to watch that.
Jay came and sat with me and pressed on my back and talked to me and held me. It was so incredible. I was feeling some weird pressure so I reached in and the baby's head was just two knuckles deep. I could feel the little head and the slipper bag of waters. I decided then that if the head were that low I was dilated enough to push. I told Jay I could feel the baby's head and asked him if he wanted to feel and he was just awestruck with it. He thought it was so awesome that he got to feel his baby before it was even born!
I was switching from being on my knees and leaning on the pool to a half kneel-squat. I pushed a little bit with a contraction to see what it did to the pressure but it didn't change a whole lot so I figured I would just wait. I was still talking to Jay and feeling like I was doing really well. My mom came sometime and I even joked with her a little bit and talked to Olivia during a contraction. Around this time whenever a contraction would end I would tell Jay how much it hurt. His arm was probably worn out pushing on my back but it felt so good. He turned on the hot water again and held the hose on my back and that felt great too. I told him I didn't want to do this right now I was tired and I wanted to go back to bed! I'd just finish later. It was then that I decided to just push the baby out. Jay felt for the baby again and it's head was only one knuckle deep this time! I was kneeling and started pushing but the pressure was just too much being that upright. I sat down and pushed a little bit but the pressure was sort of freaking me out. It was so incredibly intense and I wasn't expecting it to hurt but it was really uncomfortable. (go figure! I had a head in my vagina!) I just sat there for a minute and Jay asked if we should call the other midwife who said she would come. I told him to tell her I was pushing and he called her at about 6:30 and she got on her way. I tried a really big push then and I could feel the head trying to come out but I could also feel myself ripping apart front and back. I kind of started freaking out and thought that I could probably just claw the amniotic sac to pieces and then it would feel better. I could actually picture myself doing that and I had to just tell myself to calm down - it was going to be over soon. I laid kind of on my side and tried to slow myself down but then figured, what the heck - if I'm going to tear I'm just going to get this over with! And I did. I pushed and I could feel the pressure and my water wasn't breaking and I was pushing and the head was coming and I was pushing and my water was still not breaking and the head was still coming (how big is this head!?) and then the head was out and I expected that little relief and a rest but I was still being ripped apart and the pressure was still there and my water was still not breaking so I pushed again and the chest slipped out and the water broke and there was the baby! It was 6:35 and he was looking around and he snuggled into me and he was kind of trying to breathe and his cord was around his neck and his belly. Jay just started crying and I told him we needed to unwrap the cord so we did and while we were doing that I noticed it was a boy! I said, "hey! It's a boy!" and Jay was like, "a boy?!" and it was. It was a boy. And Jay held me and I held our boy and we all whispered to each other and smiled at each other and then he let out a loud cry and suddenly my mom was there and I just said, "ooops!" (being that there was no midwife there and she had been concerned about when one would show up) "oh, it's a boy!" and she got Olivia and Olivia saw her brother and told him she loved him and she was excited to touch his hands. My mom went to wake Anicka up but she just said, "tell mom I'll see him tomorrow", and she went back to sleep.
We snuggled and laughed and I told everyone a million times that it hurt to push him out. I had another contraction about 10 minutes later and I started to push but the placenta just kind of fell out. It was large and lovely and Jay put it in a bowl. He called our midwife then and she was on her way. We sat in the pool until it started cooling off and I handed the baby off to Jay. I was sitting in the water thinking about getting up to go into the bathroom when my midwife got there (20-30 minutes after the birth) and she helped me. That shower was wonderful and Jay and my midwife examined the placenta and it was nice and big and pretty with spots of calcification. An hour or so later after I was settled in bed I cut the (very goopy) cord, we weighed him (7 pounds 3 or 4 ounces), measured him (20.5 inches long) and dressed him. He was supposedly born 2 days after his due date but we think he was closer to 41 or 42 weeks. I'm very sure of my dates but my cycles were weird since I had just started ovulating again and then a miscarriage so that probably threw it all off.
So it was a wonderful birth and he is a wonderful baby. He sleeps well and eats well and he's calm and happy. My labor was great - easier than Olivia's but pushing was a lot harder even though it only lasted a couple minutes. I watched my video a couple of days ago and I was amazed at myself - how coherent, happy, calm, and involved I was the entire time. I'm excited and happy that I got my unassisted birth and my wonderful midwife to come take care of me afterward. All in all my labor lasted about an hour and a half and it was fun and exciting and so extremely cool to share it all alone with my husband. He was awesome, amazing, and perfectly wonderful throughout the entire thing. He makes cute babies and he says I am an amazing birth machine and it is utterly delightful that he is so proud of me.

Thursday, July 21, 2011

Harrison's Birth Story

My baby is almost 2 years old! I'm trying to find my birth stories and post them here to have them all in one place. This was my last birth - Sep 30, 2009

I folded up the purple towels yesterday. Buried in the Moses basket was a baby blanket and my birth bag. All that was left in it was a single plastic drop cloth and two packets of Emergen - C. My corner of the neatly prepared birth supplies lay in a tangle on the floor - four weeks of stepping around it and glancing at what remained. I couldn’t pick it up and put everything away. It was like dismantling an altar - sacrilege. It meant moving on from the birth. It meant taking another step away from the miracle. It meant fading memories and sensations. It meant loss and grief and mourning for what was gone.

I love to cradle Harrison’s head and his little round bum. I know those same shapes - I held them inside of me and my body wrote the details of them on my soul. I knew at 39 weeks that we were close, 40 weeks closer, any day now. My body was stretched and tight and sore. I was ready to meet this baby. Even though we danced and talked together I needed more and the waiting to see this baby’s face and hear it’s cries and feel it’s breath on my cheek made me anxious.

Memories from my last birth had stayed with me. I was afraid of the pain and pushing and recovering. I thought of screams and blood and even at 41 weeks I didn’t feel ready. I expected the baby to come on the weekend. We inflated the pool, sorted through supplies again, and prepared my birth space. I made this birth space a shrine. I wanted to be surrounded by beauty and love.

My sweet friends held a mother’s blessing for me. Surrounded by candlelight they made charms and beads for me. I had a silhouette drawn and they decorated it with birth wishes and blessings. We feasted and laughed and the support I received that night stayed with my until my baby was in my arms. I placed their candles around my room along with tokens from previous pregnancies and births. A photo of a great grandmother, a belly cast from my pregnancy with Elliot, necklaces and bracelets adorned with beads from previous mothers blessings. I was ready.

Waiting is hard. Waiting to look into those new eyes and see that sweet spirit. Waiting to confirm whether it was a boy or girl. Wondering if that painful contraction meant something was happening. Hoping my husband would be home when labor started. Praying I would find the challenge and meet it and be refined.

After a few false alarms I resigned myself to surrender to the unknown. Labor would start eventually. There was certainty in a birth and a baby. And there was probably no way I was making it through another week so the certainty was soon.

I was just concerned about Jay working so far away and going to a conference in the mountains. He was too far away and a storm was coming and I was worried. He called as soon as he was done with his presentation and on his way. I was counting the minutes but at that point I knew it would all be fine. I have had short labors in the past but never under an hour and he would be home soon. I relaxed and took my heavy body off the couch where I had been quietly taking it easy all day. I went outside and watched my children play while the sky got darker. I chatted with neighbors and was relieved to see my husband pull up safely. Life was good! It was even better when Jay suggested Chinese food. He joked he would ask to get it extra spicy but I didn’t want heartburn so he picked up our regulars. I devoured the Mongolian beef and almost choked when the first bite went down - I guess we didn’t have to ask for extra spicy. The stars must have aligned because this was the spiciest we had ever had - and it was delicious.

We spent the evening relaxing and went to bed around 10. I woke up around midnight with a painful contraction. Another false alarm so I went back to sleep. There was another one, and another. I took nothing seriously because in the groggy semi-sleep state I was in time meant nothing. Had it been seconds between them? Or hours? I woke Jay up and told him to tell me how far apart the contractions were. He said they were about 4 minutes apart. I decided to stay in bed until I absolutely couldn’t deal with them anymore. That was pretty immediately though. Jay got up to get the birth pool ready and I got out of bed to wander around our dark quiet house.

I ended up in the dining room where I leaned on the counter and rocked back and forth with each contraction. They were very intense but I was still having a nice break in between them. I called to my baby and told him to come. I prayed and closed my eyes and tried to see the burning inside myself.

I went back into our bedroom to check on the progress of the pool. It wasn’t ready yet to I sat on the toilet to wait. Immediately contractions started coming stronger. Jay chatted with me through the open door and I leaned my head on our cold bathroom counter to moan through another contraction. These were strong and with every sensation I tried to look forward to the next. I knew each one was bringing me closer to the end. I felt deep pressure and reached in to feel how close my baby was. I could feel almost half of his head. I knew it wouldn’t be long until he was here. The pressure of the toilet was strong - too strong I thought. Even though I knew that position was helping I had to move.

I got up to check on the progress of the pool. The room was hot and I went to Jay’s arms for comfort. He whispered to me that it would be over soon and reassured me that I was doing a great job. He turned on some of my favorite music while I made sure the candles were glowing throughout the room and paced around the pool watching it fill up with steaming water.

Elliot woke up around this time and sat on the end of the bed just watching. He put his head in his hands and I looked into his big chocolate eyes and told him the baby was coming. He didn’t seem to concerned - he just smiled. I took him into my arms and enjoyed our last few moments with him as the baby of our family. I was worried now that he was awake. I didn’t want to be bothered while I was in the water but we were blessed and he just wanted to watch. He was quiet and helpful. He brought me cold drinks and rubbed my head.

Around 1am the contractions got much stronger and much closer together. I knew I would need the pool soon. It was almost full so I jumped in and it was instant sweet relief. I closed my eyes and relaxed my body. My arms were draped over the side of the pool. Elliot held one of my hands and Jay sat with his head next to mine. I took a deep breath at the start of each contraction, closed my eyes, and hummed along with my music. It was the same music Elliot was born to and I thought of each song and wondered which would be playing when this baby was born.

Jay offered counter pressure for my back but I wasn’t desperate for it yet. I wanted to wait until I felt it was absolutely necessary. I knew how exhausting for Jay it would be and I really needed him present. I didn’t want to waste it. I knew no measure of time. I didn’t know how long I had been working. I had no idea how long the contractions were or how close together they were. I was lost inside myself feeling a sense of warmth and peace deep within and knew I was close to that place where my baby was coming from. Was he ready? Was I ready? Who was he? Would I know him? I rubbed my big belly and breathed into another contraction. I hung on to Jay and buried my face into his neck. He was warm and familiar and whispered to me about our plans and hopes and thoughts for this birth and this baby. Elliot sat quietly just holding my hand. The breaks between my contractions got smaller and smaller and soon it seemed like I had no time to recover. Jay decided to call our friend Michelle at this point. She was coming to photograph the birth.

I was trying to think about the baby during these intense moments with the contractions coming on top of each other. I concentrated on his movements and my breathing, imagining I was sending him life and love with each breath. I talked to him and I felt like we were working together and conscious of each other. It was amazing. I could feel a lot more pressure and reached inside and I could feel his whole head with my bag of waters in front of his head pooling up like a limp water balloon. I had a lot of anxiety about the upcoming pushing stage and I was trying to stay positive. I prayed that I would have confidence and strength and health. I talked to the baby and in between contractions I would sit back and lean against Jay and smile to think of how close we were.

I started to put a little bit of pressure into a contraction to see how it would feel. I held my breath a few times with each contraction, not really pushing but putting a little bit of pressure into each sensation. I didn’t really feel any progress but the slight pushing eased the intensity of each contraction. It was around this time (1:45) that Michelle got there. The contractions were coming with very few seconds in between them. They were intense and I decided I was having this baby. I started pushing with intention and it didn’t feel like I was making much progress. I reached inside to feel the baby’s head come down but my bag of waters was still intact and when I pushed it just filled up with more water, creating more pressure, but not doing much to help the baby move down. While I gave some light pushes with the next contraction I broke the bag of waters and immediately the baby started moving a little bit. I felt his head and I could feel lots of hair. This was so exciting to me after a bunch of bald babies and I made Jay feel it. I could feel the baby working with me and slowly moving out. His head was right behind my pubic bone and it would slip back it would come down but slip back with each push. I had my hand on his head which felt so much better for some reason. I decided that it would be more effective if I moved to a squatting position. I apparently announced this to everyone and Jay tried to help me up but it felt horrible. I couldn’t move during the contractions and I wasn’t really getting a break between them and it felt all wrong. I told Jay no - no I wasn’t doing that and went back to my previous position.

I reclined on to my side again and braced my feet against the other side of the pool. Jay was holding me and trying to press on my back and I was being quite loud. Elliot started to get a little bit worried so Michelle went to grab Anicka to come sit with him. I told myself this was it. I needed to keep the pushing up. I couldn’t stop when I felt intense pressure. I thought of my mothers blessing and the strength my friends had shared with me. I thought of my previous births and I looked at the poster my friends had made. There was my big bellied silhouette and loving and powerful messages decorated it. We had talked about my birth fears - namely pushing. My friend had counseled me to just surrender and she had added that to my poster. I kept my eyes on the poster and told myself to surrender. Jay said I was whispering it while I was pushing. This gave me the strength and courage to really do it. I thought of my birth with Elliot and my midwife telling me to just use all my energy and push through it. I knew this was the only way out of course so I did. I gave in. I surrendered and I worked up all my energy and I pushed and he slid right down. I held his head in my hands as it was born. I stroked his hair with my fingers and started to say that I needed another contraction so I could push the rest of him out. It was so intense I didn’t feel like I could wait. Luckily I didn’t have to wait long because before I could really finish the thought another contraction was coming and I was pushing my baby out into my hands.

I held him in my hands as he came towards me with his arms outreached. I pulled him right up into my arms. He was here and he was beautiful. Michelle and I said, almost at the same time, “he looks just like Jay!” while Jay was telling us it was a boy - something I hadn’t noticed or even thought to check. I immediately felt better. I was launched into a birth high by my flooding hormones and emotions. I was completely unaware of everything else in the room except for my husband’s arms around me and his tears and my sweet pink baby snuggling into my arms. It was thrilling and exciting and I felt amazing.

The placenta was birthed soon and it was intact and healthy and perfect. The room was warm and smelled like cinnamon from a candle a friend had given me. I felt surrounded my love and warmth from my friends and family and the candle seemed to symbolize that. I wrapped the baby up and passed him to Jay so I could have a quick shower. It felt so good to stand up and see my feet and stretch out. I got dry and warm and snuggled up with my new little guy in bed. He had been trying to eat his little fist so I nursed him and he ate for about an hour. I was eager to see how big he was so when he was done we weighed him 8lbs 9.5 ounces. We measured him the next day and he was 20inches long. A couple hours after he was born we cut his cord and dressed him and snuggled him up for bed. Blessedly the kids all went back to sleep and our first night was filled with rest for all.

Sunday, August 01, 2010

Maternity Leave Over!?

Prolonged blogging absence. We'll pretend it was maternity leave. I've had a while to stew over things and figure out where I'm going and what I want to contribute to the world. I'm sure things will continuously change but I do know this is a calling of service in my community and my voice is for preserving the gentle touch of a loving family and true health for mothers and babies. My great, great, etc. grandmother was an immigrant midwife and community healer. I'd like to think this work is in my blood :)

I know there are many voices championing the cause of evidence based health practices relating to the pregnancy, birth, and postpartum experience. While my blog has been around for some years – I've been such a slacker. I hope to add my words to the scales and hope that someday we tip the balance in favor of the gold standard.

Most of my archives have been purged here so a short intro might be in order. I have been attending births as a doula since 2001. I have also taught childbirth classes for almost that long. I have been both awed and appalled at births I have witnessed. I'm on the 10 year path (ha!) in studying midwifery. It has been on and off as I have put my family first and foremost and had my own babies. 5 births, 4 home waterbirths, 2 of them unassisted.

Monday, July 14, 2008

A Father

I spoke in church on Father's Day. I talked about my experience with fathers - my own and my husband. When I look back on my father so many things come to mind. Different emotions, different memories... I had a lot to speak about. I was a tiny bit mad at my husband that weekend ;) and I only had about a day to actually write the talk. Nothing seemed to be going right. I finally just wrote a bunch of memories that seemed to flow to me about my own dad. I had some ideas of what I wanted to say about my husband but I felt like when I went to give the talk that it didn't come out right. It didn't seem to really present my idea of my husband as a father. I've been thinking about this for a few weeks and I did have some distinct impressions about things I wanted to say about my husband but I got emotional and tongue tied and I was brief - also because they surrounded birth and I didn't want to offend anyone. You say natural birth, or home birth, and people draw their defenses around them. Maybe roll their eyes. You know. I've thought about it though and realized a way I could have presented it and now I'm a little bit sad I didn't take that opportunity. That I didn't try to humble myself and forgive my husband that weekend so that I was thinking happy thoughts about him, instead of just having this confusion hovering. So. Here is what I wish I would have said about him.

As my thoughts about my own father have changed over the years, I expect my thoughts of my husband's role as a father to change also. I expect this and I see how the difference in how he treats the kids as they mature, the difference between boys and girls, babies and 9 year olds, public and private. Sometimes he's a strong father, sometimes he's the funny dad. Sometimes he tries to be the authoritarian, sometimes he's patient and kind. When I think of my own father I smell fresh wood and sweat and think of long talks, certain music, warm and comfortable. When I think of my husband, I always think of a certain experience, whether I think of him as father, friend, or lover. It's an all encompassing feeling and stronger than any emotion or experience I've EVER had. We have had 4 babies. He has held me through 2 of those labors. He worked with me. I know how strenuous it can be to support a woman during labor. He didn't back down. He used all his strength. He was there with his hands on my back, whispering to me, wiping my forehead, giving me drinks, and touching me. We were truly one. As our third baby was born my husband took him into his hands and unwrapped him from a tangled cord. He helped bring him into this world; together we were the first hands to touch our boy. We sat, snuggled together, a new quiet family. I got up after a while and went to clean up. My husband sat on the floor with our baby in a soft warm towel pressed to his chest. I watched him snuggle that baby, in the dim light of an early winter morning. With tears in his eyes he whispered to our new son. They were glowing. Even in pictures taken of that morning they were glowing. This is who my husband is as a father. He is a strong nurturer. He starts out with faith in my body and a natural process. He has knowledge to be involved in that journey and strength to help me through the difficult parts. He was gentle and calm, welcoming this new baby into our home. He was tender, taking care of me so sweetly after the births of our home born babies. The level of responsibility and involvement a homebirth takes really developed these features in my husband and made him SUCH a strong protector and provider in his expectations that our family have something better.

Birth Story

I have attended a few Mother's Blessing ceremonies during this past week. They have been SO nice. Can I say that they sure beat out your typical baby shower?! They are such joyous loving occasions! I was privileged to have had two of them. My friends are awesome! I'd like to write more about them specifically another time, but I really wanted to share a poem that I love. I pulled this out to give to my friends this week. I've found it a couple of places on other blogs and it's just beautiful.

Birth Story

(I'm drowning)

And the midwife holds me in her arms and says
Yes, it's hard, isn't it? You're doing so well!
(I'm surfacing)
And she says you're doing it exactly right
(And I'm drowning)
And she says you're taking such good care of your baby
(And I'm surfacing)
And she says yes this is how it is, you'll live, you're good and strong
(And I'm drowning)
And she says, good, good, that's good!
(and I'm surfacing)
And part of me says damn you, I'm dying here!
(And I'm drowning)
And part of me says, Oh God, I am doing this, aren't I?
(And I'm surfacing)
And part of me says leave me alone save me help me
(And I'm drowning)
And part of me says this is the most incredible thing I've ever done
I can't believe I'm actually doing this yes yes yes
(And I'm surfacing)

And the baby comes in a long, sea salt waterfall flood ocean of sweat and tears and birth waters and blood and I take her slippery warm wide-eyed amazed and knowing little self against my created~and~moved~the~universe warm and billowy belly and tell her she's wonderful and safe. And I follow her with a red and glorious afterbirth.

And I think "I did it. I am totally incredible!! We want some prizes and news coverage in here." Did you see that? Was that great or what?!?!?”

(And the Doctor writes:
32 year old gravida II Para I presents in active labor. Normal, spontaneous vaginal delivery of a viable female LOA over intact perineum. Apgars 9 & 10.
Uneventful delivery.........)

~ by Barbara Kozlowski, CNM

Wednesday, May 28, 2008

Hello again

Hello internet and my poor neglected blog.

Life has been loaded lately. I was just put in the primary presidency so that's been taking a chunk of time. Also finishing up the (home)schooling year and getting ready for next. Meeting with clients. I have a couple of births lined up for this summer and I'm excited to attend a mom that is a repeat client :) I've also been trying to get exhibitors signed up for our baby fair this fall. It should be great!

We headed out to California. Back home. It was great! We had such a good time and the kids were wonderful and they had so much fun. I LOVE watching the kids enjoy themselves. We hit up Legoland and they were all so cute. I could hardly stand it. My boys loved Sea World. Even the baby watched Shamu. His favorite was the beach though. It made me sad to think that my kids won't grow up around the ocean. It was so nice to live so close to it growing up and have it be a normal, regular part of life. I feel like my kids are lacking. A lake is just not the same.

We're heading out on another little trip to Mount Rushmore. I'm really looking forward to getting away again! This is a big family trip so my parents, brother, and my sister and her family are also going. I'm sure the cousins are going to have a blast together!

Little Baby E will be 11 months next week. He's walking all over the place now. He's our latest walker. Our first baby was 10 months, next 9 months, next 8.5 months. E's been walking for a couple weeks but is just now getting confident about it and choosing to use it as his mode of transportation. Now when he has to crawl he does his little stinkbug crawl.

When I was pregnant with E there were a couple months when we suspected twins. When we were able to get in for an ultrasound and it showed just one BIG baby I was disappointed. I had all these hopes built up and I felt like I lost something. I figured I could always have another baby, but after the birth I couldn't even think of doing that again. After my other homebirthed babies were born I almost immediately looked forward to giving birth again. Not this time. It's been almost 11 months and I still shudder to think of contractions and pushing and the immediate postpartum period. Until the other day. I've seen so many brand new babies in the past 11 months but the other day I saw a man snuggling his new baby and it just sent shivers through me. All of a sudden it was like a weight was lifted as the chills ran up my spine and immediately the air was cleared of all those painful physical memories of his birth. Maybe not cleared - but more like those misty walls went up so I could think about the positive physical sensations instead of the negative. I finally feel like I have the strength and desire to do that again. And I want another baby girl so so so badly. I could definitely do more boys and I think I could try a couple more times to get that girl, but at least I know now that I can do it again and it will be ok. Do we assign too much meaning to this? Analyze it too much? Dream about it too much? Is it crazy to plan a birth that is years in the future? Whatever - I'm doing it. :) I'm content to hope that in a couple years I'll have another sweet baby.

Friday, March 14, 2008

Why it matters

If you haven't seen the movie The Business of Being Born I highly recommend it. If you visit the link you can watch a trailer of the movie. If you're a netflix member you can go there and rent it or view it online.

I've read all kinds of different reviews all over the internet. We had a screening of it here and it was so neat. I especially loved the part when Marsden Wagner said that if you want to have a normal birth, you had better get the hell out of the hospital. Everyone cheered.

I don't think that birth belongs in hospitals. What I see as ideal is homebirth as a choice for everyone. For the women who do not choose it they should have a birthing center to go to. It should be specialized. It's not an illness and hospitals are dirty places where people go who need medical help. I am also increasingly frustrated with how women are treated. And this is normal. Women expect it and don't question it because it's just how it is.

What is normal birth? It's what nature, evolution, God, intended. It's how our bodies were created to function. It's what is best for our bodies; emotionally and physically. Lamaze has adopted the World Health Organizations standards of care to promote normal birth. They have six care practices that promote the gold standard and are based on evidence and research. Imagine that! I really need to find this article again, but I believe it was in a national newspaper (I'm thinking Wall Street Journal or New York Times). It was an editorial and the author talked about how in all branches of medicine if they find things that work well - they do them, and if they find things that don't work well (harm, kill, or have too much risk to patients) then they don't do them anymore. The author mentioned that obstetrics is the laughing stock of the medical community because they do not follow evidence based research. It's alarming that our bodies are being put on the chopping block because of convenience for someone else. It's time for us to own our bodies, and our births.

These six care practices are
*Labor should begin on it's own. Your body and your baby will work together and when it is time you will go into labor. There are so many incredible risks to induction that it's disgusting that these methods are used in upwards of 75% of births in the US. I've heard a few women say lately that they just don't go into labor naturally. If labor is so broken, if birth is so dangerous, if our bodies really fail us that much - WHY is the human species thriving? Birth works, and it's not an accident how it works.
*Freedom of movement throughout labor. If you have had a baby, specifically in a hospital, where did you end up spending most of your time? I was in bed, tied to an IV, a blood pressure cuff, a contraction monitor, and an electronic fetal monitor. Later an epidural catheter in my back. Even before the epidural moving about was not a choice. I had no idea it would be easier, beneficial to me and my baby.
*Continuous labor support. Was your nurse or midwife rubbing your back? Massaging your feet? Telling you that you were wonderful? Supporting you, inspiring you, helping you, serving you? Most nurses are sitting at the nurse station in front of a computer watching 4 laboring moms at a time on their monitor. It's true that you may get a superb care provider who does stay with you continually and keep your best interests at heart. They are few and far between but they are brilliant people.
*No routine interventions during labor and birth. What exactly are these "interventions"? This is not a problem with mothers who have other issues in labor who may truly find these things necessary. This is a problem with the conveyor belt routine that all women who enter a hospital door are pushed through - without reason. These things are not beneficial and can actually be quite harmful. In a recent survey of women these were the findings:
Continuous electronic fetal monitoring (EFM)(93 percent)
Restrictions on eating (87 percent)
IV fluids (86 percent)
Restrictions on drinking (66 percent)
Episiotomy (35 percent)
Epidural anesthesia (63 percent)
Artificially ruptured membranes (55 percent)
Artificial oxytocin augmentation (53 percent)
Cesarean surgery (24 percent)
Just as an example we'll use the EFM. When this was introduced into the hospitals it had only one affect. It didn't save babies. It didn't help mothers. It significantly raised the cesarean rate. It has never shown any benefit, but only shown risk. And we have done it for decades while more and more women have been scarred from surgery and barred from having a future normal birth.
*Women should not give birth on their backs. I just read a wonderful blog post over at Rixa's and she has some great references. In the recent issue of Mothering magazine there is an article about a woman finding true info and acting on it and going on to leave her OB practice and birth at a birthing center. The midwife tells her in a tour that she can give birth any way she wants, except on her back because it's dangerous. Hallelujah! What a wonderful midwife. It is dangerous. It's also inefficient and painful. But it's easier for the doctor right? What are we paying these people for? 5 minutes of their time to come sit on a stool with a scalpel in hand in between your spread eagled legs? Is that worth thousands of dollars?
*No separation of mother and baby with unlimited opportunity for breastfeeding. Breastfeeding is one of my hot buttons. There really is no debate about what is best for you and your baby. Breastmilk is normal and created specifically for your baby. Formula is inferior and was created with a farmer's pocketbook in mind when he had all the waste product from his dairy production. With half of it made from high fructose corn syrup... The minutes after birth are so important for bonding. A mother and baby need continuous skin to skin contact. The bath can wait. Anything that needs to be done to the baby can be done with the baby on your chest.

We would save millions of dollars and have healthier and happier mothers and babies if we followed these suggestions from the World Health Organization. Unfortunately most hospitals in the
US don't. For convenience or litigation worries, it doesn't matter. Women and their babies matter. And why? We are building future generations and what happens when a baby is born will affect him and his mother for the rest of their lives.

I hate to feel like I'm shoving anything down someone's throat. I'm passionate about pregnancy and birth because we are hurting women and babies. I'm stamping my feet and shouting, "It's not fair!". It matters - it matters so much. These things they do to women are not normal, they are not safe, they do not benefit moms or babies. It says something about our society when we examine how we treat the delicate and innocent. Look what we do to them! We spend more money on maternity care - doing all this unnecessary stuff - and we have the worst outcomes for any developed nation for mothers and babies. We need to do something. Birth is not the means to an end - it is a beginning. And it is important.