Saturday, December 19, 2009

(Re)birth

Giving birth for the first time is life-changing. I was reminded of this, once again, a few moments ago as I was reading through my maternal grandmother's life history. A couple of years ago I started typing her hand-written life story so it could be compiled with other family histories in a book for our families and future generations. Tonight I was thinking about her, feeling a need to refresh my memories of her past, and began reading the portions of her story I had previously typed. Then I came upon the section where she describes her feelings after giving birth for the first time. She says:
[T]here is absolutely nothing like that first-born baby. For me, that first birth, of our daughter Judy, represented a sort of “rebirth” for me, not withstanding my having assisted at a number of births in my nursing profession. I had this peculiar “psyche” that I couldn’t really actually give birth to a baby--I felt that I was a sort of unreal bystander or spectator in this big game of life, so when I did really actually give birth to a baby, I was brought to realize that I was first as real and able a player in this game of life as anyone else. When her daddy came into the room following her birth, I exclaimed “We did it!” (We have a baby).
I do not know the details of her birth experience. My mother was born in 1947, so it was during the horrific "twilight sleep" era, but I get the sense that my grandmother was aware during the birth process because of the way it changed her from feeling like a spectator to feeling like a "real and able player." I wish she were still alive so I could ask her. And I wish every woman's first time could be a beautiful, joyful memory and (re)birth just as my grandmother's was.

Friday, December 4, 2009

My little doula

The baby swing in the closet prompted a fun conversation with my 4-year-old (I call her "Monk" in the blogosphere):Monk: When you get another baby, I want to be your doula.

Busca: What would you do to be my doula?

Monk: You lay down, and I push on your bum!

Busca: Ha ha ha ha ha ha ha!

Monk: (chuckling) It helps!

Busca: (huge grin) You're right!

Monday, November 30, 2009

Away in a manger

We had a fun little family night this evening. We sang some Christmas songs around the piano, made a Christmas ornament, and then watched The Nativity--a short depiction of the birth of Jesus.
I've seen this short film many times before, but this time it was different. Perhaps it was different because I so recently gave birth myself. Or because I've got birth stories on the brain. For the first time, I was seeing it as a "birth movie" instead of just a "Christmas movie." As it came closer to the moment of birth, I found myself getting a little teary-eyed. While I'm not usually a crier, birth movies (and spiritual experiences) always get me. And then, as Mary neared the birth, probably in "transition"(3:40 in the youtube version), being comforted by her loving husband and midwife, I yelled at the screen, not unlike some men yell at the television when a football is fumbled. What did I yell?

"Oh, get off your back, for the love! She would not have been on her back!"

My husband's response? "Hey, at least she had a midwife!"

Yep. I yelled at the Virgin Mary... sort of. Then I couldn't help myself. I got wondering, and the gears in my head started going, and I had to know details.

My first question... would Joseph have even been with her? "The Nativity" depicts him tenderly touching her as she endures her labor. As it turns out, that would never have happened between a Jewish couple in those circumstances. Under Jewish law, once a woman has reached active labor, she gains the ritual status of yoledet. Her husband is then no longer able to physically touch her and is prohibited from seeing her naked (and from staring directly at her vaginal opening). She will remain in the ritual status of yoledet until she has had no bleeding for seven days and will then immerse in a ritual bath allowing her to resume physical contact with her husband. Some modern rabbis prohibit fathers from being present in the delivery room. The Bible itself does not specify where Joseph was, but, given the laws, I think it's unlikely he was present in the same space as Mary during the birth. However, the shepherds did find them together afterward.

My next question... who was with her then? The Bible does indicate that midwives delivered babies in the Jewish tradition. So this is one point that "The Nativity" got right. I think it's likely Mary was attended by at least one, probably several women. Some sources indicate that Joseph and Mary would actually have been staying with relatives in Joseph's ancestral home (probably on the first floor which was often used to house animals), so she would likely have had experienced aunts or cousins assisting her. If not relatives, then surely a few of Bethlehem's womenfolk would have been fetched.

How would she have given birth? Definitely not on her back! No ancient woman would have lain on her back to give birth. I think it's safe to say, without question, that it never would have occurred to them. Mary would have spent her labor doing whatever felt most comfortable. The Bible indicates that birthing stools (called ovnayim) were often used.

Would it really have been a "silent night"? Well it wasn't silent in "The Nativity," and it probably wasn't in reality. Between the animals and the typical birthing sounds, I'd wager it was pretty noisy in there all night long.

So now my mental image of Christ's birth has been completely renovated. I've been a birth-lover for over 6 years, so it's about time. I will no longer imagine Mary semi-recumbent or flat on her back pushing Jesus out in an open stable. Instead, I will envision her upright, surrounded and lovingly supported by women (and angels) beneath the shelter of a warm ancestral home where no doubt countless babies had been welcomed. It's going to take some getting-used-to, but I like it.

Friday, November 27, 2009

Re-post: Down with the I.V. league

Been busy with Thanksgiving fun. Here's a re-post of a piece I wrote almost exactly two years ago:

“You’re thirsty? Do you want some more ice chips?” Most women laboring in U.S. hospitals, no matter how thirsty or hungry they may be, must resign themselves to sucking and munching on ice. I munched my way through that rite of passage with my first baby. Enduring labor and birth has been compared to enduring and completing a marathon. Both feats are extremely physically taxing, but you would never expect a marathon participant to run without drinking or consuming any kind of fuel. Hospitals across the country expect laboring women to do just that, but is this deprivation really necessary?

When a patient must undergo general anesthesia for emergency surgery, there is a risk of stomach contents being inhaled into the lungs (also known as “aspiration”). Hospitals ask women to refrain from eating or drinking in order to reduce the risk of death from pulmonary aspiration. Even with these precautions in place, however, there is no guarantee that a woman’s stomach will be empty in the event that she needs general anesthesia. The risks of death from pulmonary aspiration are miniscule—1 in 1,250,000. Furthermore, deaths from pulmonary aspiration in these situations have more to do with anesthesiologists’ errors than whether a woman has had food or fluids recently. It is very uncommon for a laboring woman to require general anesthesia. Most of the problems arising in childbirth can be recognized and addressed without such extreme measures being taken.

What do hospitals offer as a “substitute” for food and drink? Intravenous fluids (IVs). Yes, IVs provide fluids, but quite often they provide too much, particularly when mother is given a “bolus” (large amount of fluid) before receiving an epidural (an attempt to prevent the blood pressure drop often resulting from epidural anesthesia). Fluid overload resulting from IV fluids can lead to other complications, among them:

* Fluid in mother’s and baby’s lungs.
* Diluted blood, leading to anemia and decreased oxygen supply to the uterus and fetus.
* Newborn jaundice, as excess fluid causes baby’s red blood cells to burst and release bilirubin (yellow product of red blood cell breakdown).

Aside from these issues, an IV will also hinder a laboring woman’s ability to move while in labor. Movement, particularly in early labor, is an effective way to cope with the pain of contractions. Lying strapped to a pole and a monitor in a bed will increase a laboring woman’s discomfort greatly. Additionally, when a laboring woman remains lying in a bed for an extended period of time, labor will not progress as effectively as when aided by movement and gravity.

I remember how strange it was to me when I came home from the hospital after my first baby was born and found that my legs and feet were swollen with fluid for a few days. I had heard plenty of pregnant women complain of swollen ankles and feet, but I had not experienced any swelling while pregnant. It surprised me to see swelling afterward. I also noticed swelling in my face and hands in the pictures taken of me just after my daughter’s birth. I can’t prove that it was the result of I.V. fluids, but I feel fairly confident they were to blame. Here's a picture of me in my swollen post-partum state...Lovely, eh?

When I gave birth to my second child, I chose to see a group of nurse-midwives who delivered at a small community hospital where they had, finally, convinced administrators to allow laboring women to drink. Instead of being given an I.V., I received a “hep-lock” which is simply an I.V. needle inserted in a vein but without the fluids. They like to have an “open vein” in case of an emergency. I spent less than three hours of my labor in the hospital because I had already progressed to about 6 centimeters upon arrival, and my labor progressed quickly afterward. I think I took a few sips of water when I felt thirsty, but not a lot. It was wonderful, however, to not be tied to the I.V. pole. I was also pleased to notice that I experienced no swelling afterward. Here's a much less frightening post-partum picture...
Not every laboring woman will be given the option to bypass IV fluids. Some hospitals have strict policies, and women who are induced, given narcotics or epidurals, or a c-section will have no choice but to submit to an I.V. Every intervention alters the birth process, however, and the more interventions, the more complicated the birth process becomes. I encourage women to avoid unnecessary interventions and trust the process of birth. Seek out care providers who honor and respect the birth process and will advocate for your right to experience birth as you wish, including eating and drinking if you choose. You and your baby are worth the effort.

For more info, see the "Evidence Basis for the Ten Steps of Mother Friendly Care."

Saturday, November 21, 2009

Busca, CD (DONA) ?

Remember back in February when I was feeling unsure whether I really wanted to pursue doula certification? Well, I've got three friends giving birth boom, boom, boom next May, June, and July. And they've all expressed interest in having me for their doula.

And then last night I had a dream. I was doula-ing a woman I've never seen before. We were in a big hospital room with big windows on the east side. We were between two beds. She was sort of squatting and wailing. I got down right by her face, rubbing her back, and I starting making noise with her--moaning really deep, encouraging her to bring her sounds down deep instead of high-pitched and to loosen her jaw and keep it relaxed. It was amazing to watch her sort of melt into the contraction after making those two changes--deep sounds, relaxed jaw. And it was amazing how happy and energized and in-the-groove I was in that moment... like I was doing exactly what I was born to do.

Huh. I guess that settles things.

Thursday, November 19, 2009

Sacred place

Bringing my son forth in our own sacred space, in the very room where he was conceived, was incredible. I have told my husband since then, “We can never move away! Our son was born in this house. That room is sacred.” It’s amazing to me, now that I’ve experienced such an intimate birth, to imagine thousands of babies being born everyday in sterile, unfamiliar, factory-like hospital delivery rooms. Childbirth ought to sanctify its surroundings in the way my son’s birth sanctified my bedroom. Instead, delivery rooms must remove all traces of the birth that has occurred. Rather than sanctified, they are sterilized of the experience and made ready for the next fleeting inhabitants. God-willing, I intend to welcome all my future babies into our own home—a place that will grow more and more sacred with each miraculous welcome.

Monday, November 16, 2009

Divine Design

Back in October, I posed this question on the Birth Faith facebook fanpage: "Do you believe the birth process was divinely designed?" I got some great responses and decided that I'd write a full blogpost on that very topic soon. Well, "soon" came and went. Then a couple of weeks ago I took a poll of my facebook fans asking what they'd prefer to see next, and "spiritual roots" won. So here it is. At the risk of opening myself up too much, I'm going to share some of my most cherished and personal beliefs (interspersed with relevant quotations I like). Whether you agree or not, I ask that you please be respectful.

I believe the human body is a sacred temple, a masterpiece patterned after the divine. I believe the functions and processes of the human body, particularly the birth process, are magnificent.
I marvel at the miracle of the human mind and body. . . . No camera ever built can compare with the human eye. No method of communication ever devised can compare with the voice and the ear. No pump ever built will run as long or as efficiently as the human heart. No computer or other creation of science can equal the human brain. What a remarkable thing you are. . . . Look at your finger. The most skillful attempt to reproduce it mechanically has resulted in only a crude approximation. The next time you use your finger, watch it, look at it, and sense the wonder of it.

-Gordon B. Hinckley (“The Body Is Sacred)
I believe my female body was created in the image of my Heavenly Mother's body. I believe we are all spirit daughters of a divine Mother--the eternal companion and equal of our divine Father.
God is your father. He loves you. He and your mother in heaven value you beyond any measure. They gave your eternal intelligence spirit form, just as your earthly mother and father have given you a mortal body.

-Spencer W. Kimball, “Privileges and Responsibilities of Sisters”
I believe our Heavenly Mother can and does lend us her uniquely feminine help, strength, wisdom, and love.
[K]nowing how profoundly our mortal mothers have shaped us here, do we suppose [our Heavenly Mother's] influence on us as individuals to be less?

-Spencer W. Kimball
I believe the male-female pair has been the pattern for eternity. There could not have been a man without a woman to complement him. I do not believe the creation of Mother Eve was an afterthought. She was part of the picture before her physical body was ever brought into being.
Having looked over all of this, He declared it to be good. He then created man in His own likeness and image. Then as His final creation, the crowning of His glorious work, He created woman. I like to regard Eve as His masterpiece after all that had gone before, the final work before He rested from His labors.

-Gordon B. Hinckley, "Daughters of God"
I honor our glorious Mother Eve, for her courageous choice to bring about the conditions necessary for humankind to procreate through conception, pregnancy, and childbirth.
We all owe a great debt of gratitude to Eve. In the Garden of Eden, she and Adam were instructed not to eat of the tree of the knowledge of good and evil. However, they were also reminded, “Thou mayest choose for thyself.” The choice was really between a continuation of their comfortable existence in Eden, where they would never progress, or a momentous exit into mortality with its opposites: pain, trials, and physical death in contrast to joy, growth, and the potential for eternal life. In contemplating this choice, we are told, “And when the woman saw that the tree was good for food, … and a tree to be desired to make her wise, she took of the fruit thereof, and did eat, and also gave unto her husband with her, and he did eat.” And thus began their earthly probation and parenthood. . . . If it hadn’t been for Eve, none of us would be here.

-James E. Faust, "What It Means to Be a Daughter of God"
I do not believe the sensations of childbirth are a punishment inflicted on women.
The Hebrew word for “multiply” is rabah (raw-bah), meaning to repeat over and over. It does not suggest greater sorrow, but rather repeated sorrow. The Hebrew word for “sorrow” in the Genesis account (Genesis 3:16) is from atsab (aw-tsab), which means “labor” or “pain.” While these words suggest that toil and suffering would be a part of Eve’s life, Eve did not view the conditions that came upon her through the Fall to be a curse (see Moses 5:11). Moses 4:22 “is a great revelation to women. Eve and her daughters can become cocreators with God by preparing bodies for his spirit children . . . . Mothering would entail inconvenience, suffering, travail, and sorrow; these the Lord foretold as natural consequences and not as a curse" (Ellis T. Rasmussen, A Latter-day Saint Commentary on the Old Testament [1993],17). . . .

“If Eve must labor to bring forth, so too must Adam labor . . . to quicken the earth so it shall bring forth. Both of them bring forth life with sweat and tears" (Hugh Nibley, Old Testament and Related Studies, John W. Welch, Gary P. Gillum, and Don E. Norton, eds. [1986], 90).


-Moses 4:20–32, The Consequences of the Fall
Rather than a curse, I believe the travail of childbirth is a blessing for our own and our babies' benefit.
* Pain in childbirth serves a physiological purpose. When a woman feels her labor, she can allow it to prompt her movements and changes of position. Women who can be mobile in labor will almost always move their bodies and adopt positions that will facilitate and speed-up the birth process.

* It facilitates the release of hormones which prime mother and baby for smoother delivery, bonding, and breastfeeding.

* It instills confidence and self-worth in a woman. Women who have given birth without drugs often describe the experience as life-changing. I believe God knew that new mothers would benefit from the trial of labor because it would allow them to see the strength and power within them. What better way to begin motherhood than on a springboard of power and strength?


-Me, "Nobody thinks you're a hero"
I believe our heavenly parents care a great deal about how (and even where) their spirit children are born into this world, and I believe they are eager for us to pray for guidance as we make those pivotal personal decisions.
Counsel with the Lord in all thy doings, and he will direct thee for good.

-Alma 37:37

Other posts you might enjoy:
Birth in the Bible
The Curse of Eve
Eve's "Curse"?

Monday, November 9, 2009

Birth Art

I've perused some of the birth art out there in google images and fantasized about starting a collection. I've contemplated which room or wall I would use to display my collection... my bedroom? I really don't know... But I guess I better figure it out because I just received my first two birth art pieces last Friday. Check these beauties out...Now the explanation...

On Friday, my daughters and I were looking at a picture of my oldest holding her little sister on the day she was born. Somehow that picture inspired my 4-year-old to draw a picture of herself being born. (Hers is the top one.)

First she drew me and the midwife. Then she added her daddy later when I reminded her that he was there. I asked her about the face I was making, and she explained it was me making this sound (and then she proceeded to imitate it... cracks me up every time). :-) Strangely enough, she drew herself coming out breech (feet first). She wasn't breech, but she did come out "upside down" or "sunny side up" or "posterior," if you want to get technical. :-) I wish I could say she was wrong about my birthing posture, but she was right on--semi-reclined in a hospital bed. Is it just me, or does it look like my husband is frowning? Coincidentally, he was on the verge of passing out when she came out. The nurses had to escort him over to the couch and wrap him in a blanket right after the delivery. No cord-cutting for him that time!

My older daughter, seeing all the attention her younger sister was getting from her birth drawing, decided to draw her birthday as well. Hers is much more a testament to the sheer number of birth videos she has watched with me than what actually happened on the day I pushed her into the world. In her birth fantasy, I pushed her dark head of hair (see the dark spot between my legs?) out in a pool with a midwife attending nearby. In real life, I pushed her dark head of hair out semi-reclined in a hospital bed with a resident wiping my poop away with each push. I think I'll let her keep her fantasy... at least for now. ;-)

I can't help but feel triumphant that they both assumed, as a matter of course, that they were caught by midwives, and I gathered from our conversation that they also assumed they were born at home (like their baby brother). In their eyes, that's just the way it's supposed to be. Midwives, birthing pools, doulas, and the "birth song" are permanent fixtures in their reality. I hope they will seek out the care of expert midwives when it comes time for their babies to be born, but perhaps they won't. For now I'll just revel in the beauty and innocence of their 4-year-old and 6-year-old visions of birth.

Thursday, November 5, 2009

Wrapping

Everywhere I go wearing Bubs in my wrap, people stop me and either comment about how great it is or ask me about it--where to get one, how to make it, and how in the world I get Bubs and myself into it.

Recently, in an email conversation that briefly touched on baby wraps, my friend, Fig, said: "I definitely want one. I'm just afraid I'll lose the baby in it and never be able to get [her] back out. Or strangle us both or something. They look SO intimidating to me." For her sake (and because so many people have asked me how), with the help of photographer Ax, I present to you my step-by-step wrap-tying photo demonstration...

(I cut my head out of most of the photos 'cause I have a tendency to produce embarrassing facial expressions. Click on the photos to see them larger.) :-)

Step One:
Find the middle of your wrap, place it across your belly, and pull the ends around behind your back and cross them.Step Two: Once you've got the ends pulled up over your shoulders, check the fabric crossed behind you to make sure there aren't any twists that will create uncomfortable pressure points. Cross the ends in front of you and tuck them inside the fabric across your belly.Step Three: Pull the ends around your waist behind you. Depending on the length of your wrap, either tie them in a secure knot in the back or wrap them around the front again and tie them at your belly. And you're done.(Since Bubs was in bed, I grabbed Mr. Teddy to demonstrate the child-insertion.) To hold the baby facing you, stick their legs through the fabric crossing your chest and spread it out over their bottom so it creates a secure little "seat." Strips of fabric should travel from your shoulder, underneath each of the baby's legs, and then behind you. The idea is to make sure they can't possibly slip out the bottom. Then pull up the fabric crossing your belly around the "seat" for extra support and security. I'll let the pictures mostly speak for themselves.You can use the same tie to carry the baby facing out as well, though this is less comfortable for the baby-wearer since the weight is less naturally distributed. I find I can wear Bubs far longer facing me than I can when he's facing out, but I still wear him out when he's wide awake and wanting to watch stuff. Same basic instructions, but the baby is turned out (obviously). :-)There are loads of other types of carries and ties that I haven't learned yet. I think as Bubs gets bigger, I may look into some of the carries with baby on the hip or back 'cause they're just more manageable with a heavier load. But this basic carry has been all I've needed so far.

I LOVE my wrap, and I love being a walking advertisement for babywearing! So let this serve as a warning: if you prefer to be "invisible" when you're grocery shopping, don't wear a baby in a wrap, 'cause people WILL stare at you and/or talk to you about it. :-)

One more tip: wearing baby down.

About six years ago I learned from Dr. Sears' Attachment Parenting Book about "wearing baby down." The idea is that sometimes the usual bedtime ritual doesn't do the trick and baby is still wide awake. If you put that baby cuddled-up to you in a wrap and go about your business with the dishes or making lunches or whatever it is you need to do, it's almost guaranteed that baby will soon be asleep. Worked like a charm last night with Bubs.Then I carefully stretched the fabric around and off of him and laid him in bed. Love it. :-)

Friday, October 30, 2009

Happy dispatch

My cousin(-in-law) has two adorable boys. She had hoped to give birth unmedicated with both of them, but pitocin threw a huge wrench in things and necessitated pain relief, so she's extremely determined to avoid induction/Pitocin with the birth of her current baby-in-utero. So I was positively giddy with excitement when I got this email from her this morning:

I had my first prenatal appointment today. Long story short, everything is great. She had no trouble finding the heartbeat - about 165 bpm, loud and strong. I love that noise. :)

And the practice I'm going to? GOLD MINE. Seriously, I could not be more impressed. They will let me go two weeks overdue without inducing, and when they do induce, pitocin is sort of a last resort. They had a sign up boasting their statistics (and I would too if I had their numbers):

* 7% cesarean rate
* 32% epidural rate
* 11% induction rate
* less than 1% of newborns are admitted to the NICU
* 6% vacuum delivery (no forceps)
* 72% intact perineum rate (no tears or cuts)
* jacuzzi tubs are encouraged for use during labor and delivery
* eat and drink whatever you want during labor
* no IVs unless medically necessary
* no routine episiotomies
* no continuous fetal monitoring unless medically necessary
* birth in any position you would like
* have as many family members and/or support people at your birth as you would like, including baby's siblings

I mean, seriously!? Are you kidding?! And this is at a HOSPITAL. I could not believe it. I actually asked if they do VBA2Cs, and while they don't advertise it, they will definitely sit down with women, look at why they had two previous cesareans, and the practice has attended successful VBA2Cs in the past. I think I might email [my 2-cesareans friend] about it, just in case she wants to have another kid and wants a hospital option - we're only like 1.5 hours away.

Anyways, I was there for over an hour and a half, explaining my past experiences and what I'm hoping for this time. I met with the NP who does most of the prenatal visits (since the CNM is often busy doing deliveries), and she's great. I'll meet with the CNM (who does all of the deliveries) at least 2-3 times before I go in.

Oh, and the walls were covered with birth announcements (as you often see at OB/CNM clinics), and what struck me was how big these babies were - most were over 8 pounds, and there were quite a few that were over 10. I was so impressed to see these big babies next to this poster of amazing birth statistics and such a low cesarean rate. Seriously, can we never move?! If we lived [here] forever, I think I would end up having 15 babies with these people.

Anyways, all is well. I'm getting so excited about this little one. :)

Sunday, October 25, 2009

No medals here

Wow. Huge thanks to Jill (The Unnecesarean) for sharing this fabulous post by Arwyn: "Just like athletics: exploring a childbirth analogy." Jill described it as her "favorite breakdown of the childbirth-athletics analogy," and I have to agree that it is definitely my new favorite as well.

Arwyn eloquently discusses how our culture is quick and eager to praise, admire, and encourage those engaged in athletic feats--marathons, sporting events, and even local 5Ks, but when a woman attempts natural childbirth (a likewise challenging physical feat), she is lucky if she finds one or two supporters to cheer her on. Instead, far too often, it is those on the sidelines who should be her loudest cheerleaders who tell her she "can't do it."

I am personally saddened and disheartened when I (frequently) hear women tell me that it is their husbands who say, "You're definitely not tough enough for a natural birth," or who "can't bear to see her in pain," and thus push her toward an epidural. Would they also suggest that she's not tough enough for a marathon, if that was her goal, or stop her in the last grueling miles of the race and say, "You need to stop... I can't stand seeing you in so much pain"? I certainly hope they wouldn't. All this stuff has brought to mind this post from last June--"Nobody thinks you're a hero."

Here are a couple of teasers from Arwyn's post:
Everyone has heard of and no one doubts the existence of “runner’s high”, so why do we start plugging our ears and rolling our eyes and flapping our tongues when we speak of “birthing high”? Just as in athletics, in the absence of intolerable pain and unnecessary interferences (the latter of which is all too often responsible for the former), birthing has the potential to produce the most delicious chemical cocktail which feels good. (Divine even: I certainly felt like a birthing goddess afterward.) Even discounting that, or in its absence, there is potential for pride and a sense of accomplishment: something we value so much in athletics, yet scoff at in childbirth, where our effort benefits both us and another. We deny women that pride in accomplishment (for which support of athletics is so vital to girls’ sense of self and women’s equality), that boost in self-esteem and feeling of competency, right when we need it most: at the start of parenting, one of the most demanding journeys a person can undertake. . . .

But the current cultural construction of birth must change: not by moving backward to a time when women had no options in childbirth, and were expected — even encouraged — to suffer, and in which there were no medical interventions for when they were truly needed; but forward, to a time when our bodies are valued, our spirits are supported, and the work of birth is seen as hard, yes, and even sometimes painful, but within reach of most of us, and oh so worth it: just like athletics.
And some pics, for fun...

My dad (in the blue hat) finishing the Boston Marathon as a 50th birthday gift to himself, with his friend, and my (now deceased) brother, Steven, running the last 5 miles with him (behind my dad)...Me and my husband with his Boston Marathon finisher's medal (April '08)...My husband helping me run my first 10K, the longest race I've ever run...And then again, helping me through one of the most difficult (and best) experiences of my life (with my doula as another cheerleader)...So much better than a medal...

Tuesday, October 20, 2009

Ask Busca: Vitamin K?

Ali asked:
My first question is about Vitamin K injection given at birth. I had two [nursing] teachers tell me they are necessary to jump start the blood coagulation. They also said the dose given in 20,000 times the amount you need. This seems way out of control to me, and also unnecessary. so I was just wondering what you thought about it.
Busca's babble:

I should start off by saying that all three of my children have received a vitamin K injection at birth. I should also admit that except for the brief handout/consent form I received on from my midwives during my last pregnancy, I did zero research on the subject before my children were born. Sad, I know. I guess my only excuse is that I was so busy educating myself about other things that I just never got around to it. So I'm really glad you asked this question because it gave me a chance to do some digging.

The medical establishment's explanation for routine administration of vitamin K is that all babies are born with "low levels" of vitamin K. This begs the question: If all babies are born with "low levels," then aren't their levels of vitamin K "normal" for newborns?

Midwife Sara Wickham explains:
"The risk of a baby who is not given vitamin K developing HDN [Hemorrhagic Disease of the Newborn] is between 1 in 10,000 and 1 in 25,000 (Von Kries and Hanawa 1993). We also know that the babies most at risk from HDN are those who have traumatic births (clinically, this might include babies who are delivered by forceps, ventouse or emergency caesarean section, or babies who show bruising)" (from "Vitamin K - An Alternative Perspective," AIMS Journal, Summer 2001, Vol 13 No 2)
It doesn't surprise me that birth trauma would be highly associated with newborn bleeding disorders. Midwife Ronnie Falcao's gentlebirth.org has a wealth of helpful information. She starts her vitamin K discussion with these points:
Early or "Classic" HDN (also called Vitamin K Deficiency Bleeding) occurs in the first week of life. It is an iatrogenic condition, meaning that it is caused by medical care:

* premature clamping/cutting of the umbilical cord deprives babies of up to 40% of their natural blood volume, including platelets and other clotting factors
* the use of vacuum extractor or forceps often causes bruising or internal bleeding, which uses up the baby's available clotting factors
* the use of antibiotics inhibits the baby's generation of clotting factors
I'm always quick to believe that God/nature got things right, and it's us fallible humans who got things wrong, so this information just felt right to me.

She also shares fascinating bits of articles and research on vitamin K for newborns. Among the details I found most interesting and pertinent were...

* Colonization of the newborn gut with the mother's fecal matter and microflora is essential to jumpstarting vitamin K production in the newborn. Antibiotics and efforts to make the mother's perineum "sterile" will interfere with this important transfer of beneficial bacteria. "Babies are born next to the anus for a reason!" Yet another reason to avoid a cesarean whenever possible! (More info on how the newborn gut produces vitamin K here.)

* There is little clear-cut evidence that vitamin K injections are themselves harmful, but we can't ignore the fact that an injection will always be a potential avenue of infection. When administered in a hospital, the potential for serious infection is a cause for concern.

* There are situations where a vitamin K injection would be necessary. Some medications taken by the mother may interfere with vitamin K, babies who receive antibiotics have disrupted clotting mechanisms, and an extremely rare liver disorder can inhibit vitamin K production.

* Formula-fed babies receive sufficient vitamin K through feedings to supply their bodies' reserves, so it appears there is little need for these infants to receive vitamin K injections.

* Oral doses of vitamin K are sometimes even more effective at boosting newborn vitamin K levels than injections.

* Eating lots of fresh, leafy green vegetables will boost the vitamin K content of breastmilk and further protect newborns from late-onset HDN.

When/If I have more babies, I hope to do what I can to prevent HDN by giving birth in an environment where my baby will be exposed to beneficial bacteria to jumpstart vitamin K production, avoid birth trauma, delay cord clamping/cutting, and boost my own vitamin K levels through nutrition to increase my breastmilk's vitamin K content. As long as all of these preventative measures are achieved, I think it's unlikely that my future babies' "low" vitamin K levels will be problematic, but I plan to consider oral vitamin K as opposed to an injection if I feel it is necessary.

If all babies could be born under such natural/normal circumstances, I'd wager there would only very rarely be a need for vitamin K administration. As Sara Wickham argues, perhaps newborns and breastmilk are "low" in vitamin K for a reason? Should we really be messing with nature? Ronnie Falcao aptly concludes, "Until we have the definitive answers to these questions, parents have to choose between a system that's been in place for less than a hundred years and one that's been in place for thousands of years."

Any other research, facts, tips, and/or experiences from my readers?

Sunday, October 11, 2009

Pacifier

As I rocked and nursed my baby boy to sleep about an hour ago, I got thinking about something an OB said to me the morning after my first daughter was born. He was an OB I had never met before. I can't even remember his name. But he was one of the doctors from the practice where I had received my prenatal care. I suppose he was the one on-call that morning, so he was doing the postpartum hospital check-up rotation (or whatever they'd call it).

It was early in the morning, still dark. Dr. Whatshisname was asking how breastfeeding was going, I think. We'd had a rough start and some latching troubles, but I don't think my response to his question was an unusual one: "I'm feeling some nipple soreness." Of course I was! Nursing hurts like the dickens in the beginning. Even when you're doing it right. At least it has for me. Every time. Maybe it's not painful for everyone, but I have met very few women who haven't experienced soreness in the beginning.

I was still drugged-up on Perkacet and Tylenol with Codeine, and too fresh and naive to realize how ridiculous Dr. Whatshisname's response was to my extremely-common-sore-nipple-ness. I can still hear his pompous, patronizing tone saying:

"You're not a pacifier, you know."

Looking back on that moment, I feel such a surge of mixed emotions... indignation, pain, shock, irritation... it makes me want to cry and vomit at the same time. I don't know why I have such a strong negative response to it, but I do. I suppose it's because his statement was a powerful indication of the way he viewed my body and my purpose as a mother. I'm "not a pacifier?" How can he say that?

Could there really be a more fitting description for a mother than that? Pacifier. Yes. It is exactly what our bodies, hearts, and souls were designed to be. We--our arms, our bodies, our kisses, our breasts--are the ultimate and best source of peace and comfort for our children. We allay, soothe, settle, restore to a tranquil state, calm. A mother's smell and touch are life-giving, healing, and far more soothing than anything else in a baby's world. We are peace-givers and peacemakers. We are the original, supreme, and ultimate pacifiers.

I wish I could stand before Dr. Whatshisname now with my three nursed-on-demand-and-to-sleep children around me and in my arms and boldly and proudly declare to him:

"Yes, I am a pacifier. I am a mother."

Saturday, October 10, 2009

Precious motherhood

May I never, ever, take it for granted...(Thanks for sharing, Amber!)

Thursday, October 1, 2009

Speaking of the rising cesarean rate...

Rixa shared this article from right here in AZ. Joy, a mother of three, pregnant with her fourth, has only one hospital in her vicinity, and they will court order a cesarean delivery if they must... even though Joy delivered her third child via VBAC at the very same hospital two years ago. The hospital says they are no longer equipped to handle VBACs because of reduced staffing. Joy says their logic doesn't hold up:
"They don’t want to allow VBACs because she said they aren’t equipped for emergency c-sections, but if they can’t do emergency c-sections, they shouldn’t be having labor and delivery at all. That’s why women go to the hospital to have their babies – in case there is an emergency."
Can you really argue with that? If there's one place in our culture where women are told they should feel "safe" giving birth, it's the hospital. The hospital is supposed to be the place you can count on in an emergency. Have they informed the women of Page that they're no longer that equipped safety-net women think they are? I somehow doubt it.

Joy has her feelings painted in protest on the back of her minivan: "Page Hospital enter my body without my permission... sounds like rape to me." (Read the article here.)

Sunday, September 27, 2009

Snapshot of the state of things

I attended a large gathering of women from church last night. During the dinner portion, one of my table-mates asked me, "So you're into the au naturale birth stuff, right?" I responded, "Yeah, actually it's more of an obsession. You probably don't want to get me started." But then the conversation topic remained with birth for most of the rest of the evening. Over the course of the conversation, I was shocked (but not really) to discover that I was surrounded by cesarean moms. Here were the stats at our table...

Friend A: one primary emergency cesarean (general anesthesia) prior to start of labor for reduced fetal activity and distressing heart tones.

Friend B: three planned cesareans for breech, transverse, etc.

Friend C: one primary cesarean during pushing phase for non-reassuring fetal heart tones, posterior presentation, "stuck" baby.

Friend D: one emergency cesarean for her second baby (I'm not sure the details).

Friend E: currently pregnant with her second baby (I don't know the details of her births).

Friend F: four unmedicated vaginal births attended by nurse midwives.

Me: three unmedicated vaginal births (two of them attended by midwives).

So... four (possibly five) out of seven women at that table had scars on their uteruses. I was almost tempted to get the attention of the rest of the women in that large gathering and ask, by the show of hands, how many others had cesarean scars. But I'm almost too frightened to find out the answer.

Friend A described how strange it was to be put under and then have her baby brought to her several hours later... "Who is this?! Where did you come from?" She said she kind of wants to have the childbirth experience, having her baby placed immediately on her chest and all... but wonders if it's "stupid" to feel like she wants to experience that. I shook my head and told her "No, it's not stupid." But I didn't feel comfortable getting into it too deeply for fear of offending all the women at the table. I think it's sometimes hard for cesarean moms to hear about the magic of normal birth. All births are miracles, of course.

I spent quite some time, later in the evening, discussing the dinner discussion with my carpool driver (from another dinner table, Friend G: survivor of three cesareans--one of them an attempted VBAC). We both sadly agreed that, as much as we'd like to see cesarean rates decline, we just really don't think it's going to happen. At least not as long as trained surgeons remain the primary care providers for 99% of pregnant American women.

There's some birth faith for ya, eh?

Tuesday, September 22, 2009

The Birth Song

I found this video via Kathy at Woman to Woman Childbirth Education, via Jill at Unnecesarean's "Best of" week. Watching it brought me back to my births instantly. For those of you who've never experienced an unmedicated birth, this is a great video to give you an idea of what normal birth is like. The "song" this woman sings is nearly identical to the "song" I have sung three times as I have given birth. To the unseasoned, it may sound frightening. But I think it sounds beautiful...

Wednesday, September 16, 2009

Bugs and Guts

I've been wanting to post about birth and healthy guts for a while now. Years ago I read an article that had a profound impact on me. It was Jeff Leach's "C-sections, breastfeeding, and bugs for your baby." His piece changed the way I viewed the birth canal. Cesareans aren't just another way to give birth. Being born through an incision bypasses an extremely important step in the birth process--being colonized by the "base population" of the mother's vaginal and fecal microflora. Following birth, breastfeeding continues the transfer of healthy microflora (probiotics) from the mother to the infant. Jeff Leach explains:
Studies have shown that at one month of age, both breast-fed and formula-fed infants possess bifidobacterium but population densities in bottle-fed infants is one-tenth that of breast-fed infants. The presence of a healthy and robust population of bifidobacterium throughout the first year or two of life contributes significantly to the child’s resistance to infection and overall development of defense systems – not to mention the physical development of the intestinal system in general. Aside from the substances secreted by these specific bacteria that are known inhibit the growth of pathogenic bacteria, they also work to make the intestinal environment of the infant more acidic, creating an additional barrier against invading pathogens. In short, breast-fed babies are sick less, are less fussy, have fewer and shorter duration of bouts of diarrhea, and have more frequent – and softer – bowel movements. (source)
Cesareans can save lives, but they also put babies at increased risk for infections, allergies, asthma, intestinal problems, skin problems (such as eczema) and future health problems. When there is an absence of breastmilk, those potential problems can become exacerbated.

What are the best ways to ensure a healthy and strong population of gut microflora for your baby?

* Give birth vaginally.
* Keep baby and mother together immediately following birth (to prevent the colonization of harmful bacteria, especially when giving birth in the hospital).
* Breastfeed as soon as possible following birth and frequently thereafter.
* Consume probiotics (in foods or supplements) yourself during pregnancy and while breastfeeding.
* Avoid giving your infant antibiotics, if possible.
* Give birth in a location far-removed from harmful bacteria, if possible.

I was delighted (not long after giving birth to my son at home) to discover a study whose results indicated: "Term infants who were born vaginally at home and were breastfed exclusively seemed to have the most 'beneficial' gut microbiota (highest numbers of bifidobacteria and lowest numbers of C difficile and E coli)" (Penders, J, et al, Factors influencing the composition of the intestinal microbiota in early infancy). I wasn't surprised by those findings one bit. It has been informative and eye-opening to see how much impact the events following birth can have.

My first daughter was born vaginally in the hospital, lifted-up briefly for me to see following her birth, taken to the other side of the room to be weighed, poked, smeared, wrapped, and finally brought to me. We were talked into giving her formula during her first night because she wasn't latching well. We did establish a good latch with the help of the lactation consultants and some contraptions. We stayed in the hospital an extra day largely because of my perineal trauma (we spent two nights there). Of all my children, she was the most irritable/fussy. She was also the only one to experience troublesome eczema and diaper rash as well as frequent bouts of croup throughout infancy and childhood. She is also the only one of my children to exhibit a possible food allergy.

My second daughter was born vaginally in the hospital, placed immediately on my chest, breastfed exclusively following birth, and spent barely over 24 hours in the hospital. She experienced only minor diaper rashes, no eczema, has never developed croup, and rarely gets sick.

My son was born vaginally at home, placed immediately on my chest, spent his first hours at my chest and breast, and never entered a hospital. He developed a skin infection a week after birth, but recovered quickly (through oral and topical antibiotics, but I chugged probiotics to prevent thrush and other problems). I have consumed more probiotics while breastfeeding him than I ever have before. He has been my least fussy baby and has never needed diaper ointment nor developed eczema.

The more I learn, the more convinced I am that what happens during and after birth matters A LOT. Do you think you baby's postpartum gut microflora had an impact on his/her behavior or health short-term or long-term?

Related links:

Allergies, Asthma, and Eczema: Response to Disturbance of the Microbiota of the Newborn Gut

The potential for probiotics to prevent bacterial vaginosis and preterm labor

Improved appetite of pregnant rats and increased birth weight of newborns (following probiotic feeding)

Probiotics may aid postpartum weight loss

Probiotics during pregnancy, postpartum, breastfeeding, and their impact on immunity

Probiotics in infants for prevention of allergic disease and food hypersensitivity

Saturday, September 12, 2009

Time Warp

Has it really been five and a half months??

Friday, September 11, 2009

First baths, etc.

I've got this new theory. I'm not going to suggest that I'm the first to come up with this. It's only "new" in the sense that it's "new" to me. I'd love to see it tested with some research on mothers and infants.

A few weeks ago I got thinking about the profoundly intense bond I developed with my son following my home birth. I had never experienced anything like it. Sure, I developed a deep love for my daughters, but it took much longer and came far less naturally. I have come up with many possible explanations for the intensity of the bond with my son...

* No Pitocin to interfere
* More intense oxytocin rush being in a comfortable, private setting
* Immediate and prolonged skin-to-skin contact
* First feeding within 15 minutes of birth (I can't remember exactly, but it was the first thing we did after holding him and delivering the placenta.)
* No hospital staff coming in and out of our room at all hours

As I was thinking, I realized another factor I hadn't thought of before...

Read the rest of this post over at my new website!

Friday, September 4, 2009

My birthday comes early...

I was ordering a book for my little brother and decided I might as well get something else (I'm a sucker for Amazon's Super Saver Shipping). And I told my husband it could be part of my birthday present. 'Cause I simply had to have my own copy. And it came in the mail today...Isn't it lovely? :-)

Tuesday, September 1, 2009

More information on the Canada Home Birth Study

Per Amy Romano's exellent explanatory post:
The researchers compared outcomes in the planned home birth group with those of two groups of women who met eligibility requirements for home birth but planned to give birth in hospitals instead. One of the two comparison cohorts had planned hospital births with midwives (n=4752); the other with physicians (n=5331).
Now that changes things! I was wrong in my last post. Apparently they did weed out the high risk women!

So... go read the rest of Amy Romano's post. Great info in there. Thanks, Amy!

More evidence on home birth safety

A friend shared a link to a news article reporting a new study out of Canada. The headline: "Home Birth With Midwife As Safe As Hospital Birth: Study." Here's an excerpt with a summary of the study's findings:
The authors of the new study compared three different groups of planned births in British Columbia from the beginning of 2000 to the end of 2004: home births attended by registered midwives (midwives are registered in Canada), hospital births attended by the same group of registered midwives, and hospital births attended by physicians. In all, the study included almost 13,000 births.

The mortality rate per 1,000 births was 0.35 in the home birth group, 0.57 in hospital births attended by midwives, and 0.64 among those attended by physicians, according to the study.

Women who gave birth at home were less likely to need interventions or to have problems such as vaginal tearing or hemorrhaging. These babies were also less likely to need oxygen therapy or resuscitation, the study found.

The authors acknowledge that "self-selection" could have skewed the study results, in that women who prefer home deliveries tend to be healthier and otherwise more fit to have a home birth. (Source)
The study doesn't appear to distinguish between low-risk and high-risk births--something most doctors would raise a red flag about. Doctors attend more high-risk births, so it's not surprising to see a higher mortality rate under their care. It's a tricky thing trying to compare different types of births because so many factors are involved in birth outcomes. But I still find this news encouraging.

As for the "self-selection" factor, I can definitely attest that I took a far more proactive role in my health during my home birth pregnancy than I ever had before. I exercised, I ate much more healthy food, and was more educated than ever about how to make my pregnancy and birth smooth and healthy. I wanted to do everything I possibly could to increase my odds of a healthy outcome for me and my baby. Whether home birth inspires women to be healthier or healthier women choose home birth, I say it's a win-win either way.

Sunday, August 30, 2009

No-sew Baby Wrap Instructions

I made a stop at the clearance fabric table Friday night and scored some great stuff. So yesterday I enlisted the help of my wee ones in making two no-sew wraps. One for me and I haven't decided who to give the other one to. :-)

Here are the (extremely easy) directions (I consulted this site to figure out the details)...

1) Buy about 4-6 yards of stretchy fabric (Jersey knit cotton is probably best, but I just grabbed the cheapest stretchy stuff I could find). If you need help gauging how much to buy, this site gives some good direction on the amount of fabric you will need/want. After you get the fabric, you'll want to wash it. After it's washed, check to make sure the edges haven't frayed. (No fraying means you don't need to sew. Fraying means you'll want to turn the edges under and stitch them so it will stop fraying.)...
Read the rest of this post over at my new website!

Tuesday, August 25, 2009

Ask Busca: Breaking Water?

Elizabeth asked:
I have a question I'd love you to explore on your blog. In many of the birth stories I've read, Moms mention having their water deliberately broken by their midwife or doctor. Can this ever contradict a woman's internal timetable for the birth? Does water sometimes not break when it should, stalling labor? Is this practice ever considered an unnecessary intervention?
Busca's babble:

Artificial rupture of membranes (AROM, or amniotomy) is very common. Some care providers routinely break the bag of waters in an attempt to speed labor, especially in women who "fail" to follow the standard labor progress curve (at least one centimeter every hour). AROM is also used to induce labor, sometimes accompanied by prostaglandin gel and/or Pitocin. When an internal electronic fetal monitor is needed (to check baby's oxygen levels), AROM is performed to gain access to the fetal scalp. Sometimes AROM helps doctors or midwives determine whether a baby is in distress--as indicated by meconium in the amniotic fluid.

Can AROM ever contradict a woman's internal timetable for the birth? Certainly. Henci Goer, in her book The Thinking Woman's Guide to a Better Birth, explains, "[I]f left alone, two-thirds of laboring women reach full cervical dilation with membranes intact, and there are advantages to this" (p. 101). The amniotic sac and fluid serve a valuable purpose--not just during pregnancy, but during labor as well. Once a woman's bag of waters is ruptured, the chance of infection increases. Because of this, doctors and hospitals generally require that a woman with ruptured membranes give birth within 24 hours. (The chance of infection is much lower if vaginal exams are avoided.) So the membranes protect both mother and baby from infection. The fluid cushions the fetus and umbilical cord. Once the membranes rupture, the risks of cord compression and abnormal fetal heart rate patterns increase.

Early amniotomy also carries the frightening risk of umbilical cord prolapse. When a baby's head has not descended well into the pelvis, the gush of fluid can carry the umbilical cord into the vaginal canal where it will be compressed by the descending fetal head. This is an obstetric emergency requiring an immediate cesarean. My blogfriend, Sarah, recently shared her experience witnessing a doctor perform an unnecessary early amniotomy resulting in a cord prolapse and emergency cesarean. Oh that story made me seethe!

Does it hurt to leave the membranes intact? A recent Cochrane review of research assessing the use of AROM in spontaneous labors came to this conclusion:
Evidence does not support the routine breaking the waters for women in spontaneous labour. . . . Amniotomy has been standard practice in recent years in many countries around the world. In some centres it is advocated and performed routinely in all women, and in many centres it is used for women whose labours have become prolonged. However, there is little evidence that a shorter labour has benefits for the mother or the baby. There are a number of potential important but rare risks associated with amniotomy, including problems with the umbilical cord or the baby's heart rate. . . . The evidence showed no shortening of the length of first stage of labour and a possible increase in caesarean section. Routine amniotomy is not recommended for normally progressing labours or in labours which have become prolonged (Smyth RMD, Alldred SK, Markham C. Amniotomy for shortening spontaneous labour. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD006167. DOI: 10.1002/14651858.CD006167.pub2, emphasis added).
So, AROM carries known risks and apparently few benefits, at least when used routinely as it so often is.

When left alone, sometimes the amniotic sac never ruptures--births "in the caul." I sometimes wonder whether my second daughter would have been born in the caul since my sac remained intact until my CNM broke it at 9 centimeters. Navelgazing Midwife says this about AROM and births in the caul:
I'd heard about an OB that was so disgusted with AROM that he offered a $50 bounty for every caul birth and shelled out thousands before calling the game... proving that it is possible and isn't dangerous and not AROMing did not slow labors down, but, in fact, helped women cope better.
She also shares some of her fascinating experiences witnessing births in the caul. When handled correctly, there is no harm to being born in the caul. Navelgazing Midwife's conclusion? "I find, as time goes by, that I touch membranes less and less. I believe they are there for a reason... will break when ready... and serve a purpose we might never know" (source).

For two out of my three births, my membranes ruptured before the onset of labor. In the future, should my sac remain intact (as with my second birth), I think I'll request that it be left alone.

Saturday, August 22, 2009

What do you THINK?

I was sitting at the table eating dinner the other day, and my baby boy started acting like he was ready to nurse. I started thinking about taking him over to the couch to meet his request, and BOOM my milk let-down. I'd wager most nursing moms have experienced this chain of events hundreds of times.

That experience got me thinking. All I have to do is think about nursing my baby and my body responds within seconds. The salivation reflex is similar. You start thinking about something delicious and BAM... your mouth is ready for it with a gush of saliva.

And that got me thinking about how interconnected our thoughts and our biological processes are. Our thoughts can create almost instantaneous physical reactions! How amazing is that?! And how frightening too. It all depends on what you are thinking about.

So let's take this concept into the realm of birth. How can our thoughts affect the birth process? Michel Odent was the first to apply the phrase "fetal ejection reflex" to human birth. Odent has observed that when childbirth is undisturbed, delivery is an involuntary, reflexive process occurring extremely quickly and effortlessly. In order for this reflexive process to occur, a woman must be in a certain type of environment. A California College of Midwives bulletin explains:
For many mothers her need to be undisturbed is balanced by an equally powerful need to be in the “right” place and have family members of great psychological importance, as well as the doctor or midwife present, before she can “permit", at least at a subconscious level, that dynamic labor process to unfold. For those who prefer hospital care, these mothers must have arrived at the hospital before the Maternal-FER [Maternal-fetal ejection reflex] can complete itself (source).
Being at a hospital (or an interventive home birth) can also produce the opposite effect--essentially shutting-down this reflexive process:
One theory explaining M-FER is the role of primitive brain in facilitating the spontaneous processes of labor and birth. This theory also identifies as negative the influence of the neo-cortex . . . and a host of institutionally-originating disruptions such as bright lights, loud noises, coming and going or milling about of unfamiliar people, unnatural, anti-gravitational positions and frequent disruptions provided by invasive procedures such as vaginal exams, catherizations, fussing with EFM belts, etc. The “intensive care” nature of intrapartum nursing in hospitals means most women experiencing the exact opposite of “secure and unobserved” – all these nursing and medical ministrations and application of technology signal the potential for problems. They worry about themselves and their baby and feel very much like a bug under a microscope (source).
Where we are, who is with us, what they are doing, what we are thinking (or not thinking) about... all of these things have an impact on the birth process.

I saw this truth first-hand with my 2nd and 3rd births. My second daughter's posterior on-again-off-again labor didn't kick into gear until I finally said, "This has to be the real thing. We're going to the hospital!" And she was born (still posterior) within 3 hours of that thought. As I labored with my son, I am certain that my thoughts and psychological state slowed the process until my midwives had arrived and my husband was finished putting my daughters to bed. Once all the essential players were present, I surrendered to my body. My son was born less than 2 hours later. Though I wouldn't describe either of these births as fetal-ejection-reflex experiences, they did demonstrate the profound power of our thoughts and emotions as we give birth. (I hope to experience the true fetal-ejection reflex someday!)

It makes me all the more wishful that we could guard all women from negative influences or comments in their labors. A friend told me this week that she had planned and hoped for a drug-free birth with her first daughter, but her nurse told her, "Honey, you can't do it." Imagine what kind of thoughts that negative statement produced in her! Of course she got an epidural. (And chronic back pain at the epidural site to go with it... still bothering her over two years later. Fortunately she was able to have her son without drugs and had a vastly better experience.) Women in labor internalize what they hear. What might be a simple statement can have a huge impact on her thoughts and thus her body.

I'm looking forward to exploring this topic further. What do you think about when you're in labor and giving birth? Do you think it affects the process? I'd love to hear your experiences.

Friday, August 21, 2009

Thursday, August 20, 2009

Pick and Choose

I've been stuck on the topic of sleep lately. This morning I turned to Google when I started wondering whether my 3- and 5-year-old were getting enough sleep. I found this WebMD site listing the amount of sleep children need at various stages. It also gives tips. Knowing how I feel about cosleeping and night nursing, you can probably imagine how I reacted to this advice from WebMD:
Allowing your child to soothe herself and put herself to sleep unassisted are critical to establishing good sleep habits, sleeping soundly, and preventing future sleep problems. As Mark Weissbluth, MD, says in his book Healthy Sleep Habits, Happy Child, "The failure of our children to fall asleep and stay asleep by themselves is the direct result of parents' failure to give their child the opportunity to learn . . . self-soothing skills. . . . Some parents can't leave their kids alone long enough for them to fall asleep by themselves. . . . The major sleep problems in babies 4-12 months old develop and persist because of the inability of parents to stop reinforcing bad sleep habits" (source).
Dr. Weissbluth wouldn't think too highly of us! I might start feeling like a failure... except that my 3-year-old and 5-year-old take a mere 3-10 minutes to fall asleep most nights (without crying) and then stay peacefully asleep until 10-12 hours later. Perhaps I haven't irreparably damaged their "healthy sleep habits" by soothing them to sleep as infants (and toddlers) after all? (Can a 4-month-old really have "bad sleep habits" to reinforce?) Some of my fondest early childhood memories are of my dad singing us lullabies while we fell asleep and my grandma lying down with me until I fell asleep so I wouldn't be scared. Those were moments when I felt an intense sense of peace, security, and love... things I desperately needed at that time in my life (I had an emotionally traumatic early childhood). I'm so grateful my caregivers didn't fret over "reinforcing bad sleep habits" when I needed or wanted their assistance falling asleep.

Thank goodness we can pick and choose our experts! Isn't it funny how you can find opposing "expert" opinions on just about any topic? In terms of infant sleep, I much prefer Dr. James J. McKenna's take on things! He says:
[I]rrepressible (ancient) neurologically-based infant responses to maternal smells, movements and touch altogether reduce infant crying while positively regulating infant breathing, body temperature, absorption of calories, stress hormone levels, immune status, and oxygenation. In short, . . . cosleeping (whether on the same surface or not) facilitates positive clinical changes including more infant sleep and seems to make, well, babies happy. In other words, unless practiced dangerously, sleeping next to mother is good for infants. The reason why it occurs is because... it is supposed to ("Cosleeping and Biological Imperatives: Why Human Babies Do Not and Should Not Sleep Alone").
Of course I couldn't help feeling smug about this one:
Western parents are taught that "co-sleeping" will make the infant too dependent on them, or risk accidental suffocation. Such views are not supported by human experience worldwide, however, where for perhaps millions of years, infants as a matter of course slept next to at least one caregiver, usually the mother, in order to survive. At some point in recent history, infant separateness with low parental contact during the night came to be advocated by child care specialists, while infant-parent interdependence with high parental contact came to be discouraged. In fact, the few psychological studies which are available suggest that children who have "co-slept" in a loving and safe environment become better adjusted adults than those who were encouraged to sleep without parental contact or reassurance ("Babies Need Their Mothers Beside Them").
Thank goodness for access to information. With libraries and the internet, we can examine the differing view points about child-rearing (or childbirth or any other topic) and find what feels right for us. I'm grateful to have found what works for me and my family.

Sunday, August 16, 2009

Breaking the rules

When my first daughter was a newborn, I was getting multiple free baby magazine subscriptions and piles of baby-related junk-mail. I guess that's what happens when you pop-up on on the baby-marketing radar screen. And, like most new moms, I was utterly blind-sided by the whiplash of sleep-deprivation and was positively desperate for sleep. So I devoured those baby magazines each month--hoping each time that this issue would contain the secret that would give me back my sleep.

At the same time I was fishing for advice from other women, both experienced and new moms. My grandma urged, "Just let her cry. Eventually she'll go to sleep." Another new mom recommended On Becoming Babywise, by Gary Ezzo, adding that it was the reason her small baby had learned to sleep through the night at 6 weeks.

If there was one cardinal rule of infant sleep among all the experts and moms I consulted, it was this: do not, I repeat, do not nurse (or rock) your baby to sleep!

The problem was that I was already nursing my baby to sleep. I felt right nursing my baby to sleep. I liked nursing my baby to sleep. And I felt wrong letting her cry. In the end, my heart won out over the "experts."

Now, almost six years later, I have nursed-to-sleep and slept-with three babies. Fortunately, I ended my subscriptions to those baby magazines early-on and found my own parenting niche with Mothering Magazine, all things Dr. Sears, and helpful books such as Our Babies, Ourselves, by Meredith Small, and The No-Cry Sleep Solution, by Elizabeth Pantley.

I love this excerpt from Elizabeth Pantley's book:
Your baby . . . has learned to associate sucking (having your nipple or his bottle or pacifier in his mouth) with sleeping. I have heard a number of sleep experts refer to this as a “negative sleep association.” I certainly disagree, and so would my baby! It is probably the most positive, natural, pleasant sleep association a baby can have. The problem with this association is not the association itself, but our busy lives. If you had nothing whatsoever to do besides take care of your baby, this would be a very pleasant way to pass your days and nights until he naturally outgrew the need. After all, this is natural. You may not even see this as a problem, in which case it is not. It's all a matter of your perception and your personal needs. (Click here for more excerpts)
I couldn't agree more. It definitely is all a matter of our perceptions and personal needs. And those perceptions and needs can change over time as our children grow older or our circumstances shift.

So I broke the rules. Did it take a long time for my daughters to learn to sleep through the night? You betcha it did! Do I still need to help them fall asleep at night? Yes. (My husband and/or I lie down in my daughters' bedroom almost every night until they fall asleep.) Do I regret my decision to nurse them to sleep and respond to their night-time cries? Absolutely not.

I share this not because I believe my way is the "right" way, but because I want to encourage other parents to "break the rules." Whether it be your grandma's rules, your next-door-neighbor's rules, the baby magazine rules, or your pediatrician's rules... don't let them dictate how you choose to parent your child. When it comes to your baby's needs, YOU are the expert. Follow your heart.

If you're anything like me, it will tell you that there's absolutely nothing wrong with rocking that sweet, precious baby (or toddler, or big kid) in your arms or cuddling them to sleep. In fact, in my view, it's the greatest thing in the world.

P.S. You get used to the sleep-deprivation. :-)