Showing posts with label Pain in Childbirth. Show all posts
Showing posts with label Pain in Childbirth. Show all posts

Wednesday, June 23, 2010

The positive impact of prenatal exercise

The following is a re-post of my August 2008 post Wanna Improve Your Odds?:

I mentioned back in April that I had been skimming the book Exercising Through Your Pregnancy, by James F. Clapp M.D. I was really impressed at that time with the amazing benefits of exercising through pregnancy. But I didn't read the book in-depth. I decided earlier this week that I wanted to take a closer look. Now that I've read several of the chapters and examined the data thoroughly, I am telling you... it absolutely blows me away.

There are risks inherent in pregnancy and childbirth, but we can do things to minimize those risks. We all know that good nutrition is essential for pregnant women. Poor nutrition often leads to pre-term and low-birthweight infants as well as pre-eclampsia in mothers. Eating well is one of the absolute best things you can do for your unborn child's physical and neurological growth. But now I'm convinced that exercise may be just as important.

I won't go into all the benefits of prenatal exercise here. I'd just like to focus on one set of benefits in particular--the effects of exercise on the course of labor. You might remember my very early post about the benefits of doulas. Having a doula assist your labor and delivery reduces many chidbirth risks significantly. Prenatal exercise has even more pronounced benefits.

Women who continue exercising regularly through the end of their pregnancies (three times a week for at least 20 minutes at a moderately hard to hard level of exertion) demonstrated the following reduced risks during the birth process...
* 35% decrease in the need for pain relief
* 75% decrease in the incidence of maternal exhaustion
* 50% decrease in the need to artificially rupture membranes
* 50% decrease in the need to induce or augment labor with pitocin
* 50% decrease in the need to intervene because of abnormalities in the fetal heart rate
* 55% decrease in the need for episiotomy
* 75% decrease in the need for operative intervention (forceps or cesarean section)
In addition, check these out...
* More than 65% of the exercising women delivered in less than four hours.
* 72% delivered before their due date (but fewer of them delivered before 37 weeks--preterm--than the control group). The exercising women delivered, on average, 5-7 days earlier than active women who did not exercise regularly.
* Significant reduction in the incidence of umbilical cord entanglement.
* Much lower incidence of fetus passing meconium from distress.
* Umbilical cord blood samples indicated that babies of exercising moms remained relatively stress-free with plenty of oxygen. They seemed to tolerate the stresses of labor and delivery better than the control group.
* The exercising mothers' infants were, on average, 14 oz lighter but overall growth was not compromised.
* Placentas of exercising mothers are larger, more efficient, and healthier-looking.
* Infants born to exercising mothers were more alert postpartum and needed less consolation from others.
(All of these results are taken from Dr. Clapp's studies as reported in Exercising Through Your Pregnancy. See this fabulous book for even more amazing benefits.)

It blows my mind.

Imagine how huge the risk reductions would be if you exercised through pregnancy AND had a doula. Whoah. We can do so much to avoid the pitfalls of pregnancy and birth. It gives me so much joy and hope to know that I am not at the mercy of chance. I have a great deal of power over my circumstances when it comes to pregnancy and birth. It is a wonderful thing to be able to choose to pro-actively reduce risks and bring so much benefit to myself and my babies. I love it!

Thursday, June 17, 2010

Rejoicing with a friend

We must not, in trying to think about how we can make a big difference, ignore the small daily differences we can make which, over time, add up to big differences that we often cannot foresee.  -Marian Wright Edelman
Back in January, I got a surprising email from a local friend.  I discovered:

1) She was pregnant with her first baby. 
2) She had been following my birth blog.
3) She had chosen a practice of fantastic nurse-midwives. 

She also said, "I've loved reading about your home birth... I just am not 'courageous' enough to go that route on a first (maybe our next?)." 

All of these discoveries made me giddy with excitement.

Then at the end of April, she and her husband attended my "Birth Coach Boot Camp" where I shared what I believed were the best ways husbands can help their wives in childbirth.  Her due date was right around the corner, so I sent her home with my birth ball and my copy of The Birth Partner, by Penny Simkin.  And then we waited. 

Nine days after her due date, she sent me an email announcing that her daughter "was born last night at 10:44 p.m.  She is 7lbs 14 oz and 20 inches long.  We're both doing well."  I couldn't wait to hear all about the birth, but I didn't want to pester her about it, so I waited.

A couple of weeks later, I got a knock at my door.  There was my friend.  She said, "I have a bunch of things for you," returned to her car, and came back with my birth ball, my book, an envelope, a typed document (multiple pages of birth details!), and a sweet treat.  We chatted for a few minutes while she told me about her birth.  With the exception of having her water broken, everything had gone as she had hoped--intervention-free and unmedicated.  She was full of thanks for my help.  I was full of giddiness with joy for her.  It made my day.

After she left, I opened the envelope.  It was a thank you card.  She said, "I feel like I owe you a big thanks for so many things.  I've appreciated your passion and encouragement during this pregnancy."  More warm fuzzies.

Then I read the document with all the wonderful birth details.  Oh what a joy to read.  Because her midwives had three clients in labor that night, it was a little chaotic for them.  In the end, my friend's baby was caught by the nurse.  Her thoughts afterward:  "I felt empowered, like we could really do this on our own--we practically had!"  When the midwives came back in, they began talking about her needing to be stitched-up and delivering the placenta, but my friend remembers "not caring what anybody was saying and just happy to have the baby on my stomach."  The very last thing she wrote in that document was that she remembers:
Feeling grateful for the birth coach class our friend had offered.  It helped me feel empowered to say what I needed without fear. . . . It also helped me to put special emphasis on making sure I provided positive feedback by telling them the things that helped.  Finally, it introduced us to techniques of providing counter-pressure.  That turned out to be the only pain relief we needed!
 There are days when I throw mini birth-tantrums, and say, "Forget it!  I'm wasting my time trying to make a difference!  Nobody even cares!"  And then there are days when I know that I can never stop sharing what I know and love about childbirth.  The day my friend said, "Thank you," was one of those days.  A magical day.  
Never stop sharing, my friends!  Never give up.  We are making a difference.  Maybe only for one woman here and another woman there, but those women are worth it.  And so are their babies.  And there is nothing in the world like rejoicing with them as they bathe in the joy and empowerment they feel from their positive birth experiences.  Nothing in the world.

Tuesday, June 15, 2010

Is water birth safe?

(Trying out our birth pool a week before my home birth.  
I labored in the water, but delivered on my bed.)

I realized several weeks ago that there was a fairly important gap in my personal research on the subject of water birth.  While I have read a lot about it in books, heard rave reviews from friends, and seen countless water birth YouTube videos, I hadn't personally delved into the scientific literature about water birth.  Anecdotal and second-hand evidence can be very helpful, but I wanted to see the nitty-gritty facts myself.  Especially after I did a google search and found an OB's blogpost slamming water birth and all its dangerousness.

What I found was that most of the scientific journal articles that come up through a water birth Google search were anecdotal reports and/or case studies of individual cases where doctors suspected that a water delivery contributed to a child's death or poor health.  The general sentiment among doctors is fairly well summed-up in this concluding statement (from an article in the journal Pediatrics) penned jointly by a pediatrician, nurse, and obstetrician:
After reviewing the literature, we stop to ponder: what evidence of harm would be enough to convince us to stop the practice? Should the report of a single drowning be enough? Apparently, it was not. At this point, we are convinced there is no evidence to support any benefit of underwater birth for the neonate, and plenty of evidence to suggest harm. (source)
Another doctor was so bold as to say:  "Water births currently provide no apparent benefit in childbirth" (source).  The introductory paragraph of his article had me chuckling to myself:
Despite an absence of supporting evidence, proponents of water births claim benefits and disregard concerns while continuing to fail to subject this approach to the rigors of scientific inquiry. This desire to ignore the facts may be particularly prevalent among individuals who prefer nontraditional delivery techniques.
I'm not about to suggest that water birth was the norm among our ancestors, but I would hardly call stirrups+hospital bed the "traditional" delivery technique.  Women have only been giving birth strapped to beds for a tiny portion of human existence.  And I won't waste my time addressing his claim that ignoring the facts is prevalent among those who prefer to deliver in "nontraditional" ways.

It can be frustrating and confusing trying to find the facts when it comes to water birth.  The most comprehensive review of the water birth research (that I'm aware of) is the Cochrane review.  Here's what the Cochrane researchers concluded in 2004:
There is evidence that water immersion during the first stage of labour reduces the use of analgesia and reported maternal pain, without adverse outcomes on labour duration, operative delivery or neonatal outcomes. The effects of immersion in water during pregnancy or in the third stage are unclear. One trial explores birth in water, but is too small to determine the outcomes for women or neonates.
So, basically, what we know from the scientific literature is that immersion in water can make labor less painful, but apparently we don't have rigorous enough scientific evidence to demonstrate the relative safety of water deliveries when compared with land deliveries. 

There are other studies demonstrating many benefits of water birth (though I can't personally vouch for the level of scientific scrutiny used by the researchers).  While these studies seem to have been primarily ignored or dismissed by the medical community, they can still be helpful as we strive to explore all the evidence. Here are some of them:

Waterbirths: a comparative study. A prospective study on more than 2,000 waterbirths.

Experience with water births: a prospective longitudinal study of 9 years with almost 4,000 water births

A retrospective comparison of water births and conventional vaginal deliveries.

Effects of water birth on maternal and neonatal outcomes.

Midwife Ronnie Falcao's website also contains a wealth of information on water birth safety.

I think it's helpful to keep in mind that adverse outcomes can occur regardless of mode/location of delivery, and that many modern obstetric practices have been shown by scientific study to be risky or questionable.  So I'm a little baffled by some doctors' outrage about water birth and their claims that it shouldn't be allowed to continue without rigorous scientific support.  If only they required the same standards for their own practices.  Back in April 2009, I quoted Jennifer Block from Pushed:  "A recent ACOG survey found that in 43% of malpractice suits involving neurologically impaired babies, Pitocin was to blame" (p. 137), and again: "Even Williams Obstetrics offers a sobering history: 'Oxytocin is a powerful drug, and it has killed or maimed mothers through rupture of the uterus and even more babies through hypoxia from markedly hypertonic uterine contractions'" (p. 138).  Yet many doctors still pump women full of Pitocin, often with little or no medical necessity.  Given that the percentage of women giving birth underwater is miniscule compared to the number of women being routinely administered Pitocin (a powerful drug with known and frightening side effects), I think tackling the Pitocin problem is far more urgent.

I would love to see a huge randomized controlled trial exploring water birth.  I would love to see this matter rigorously addressed.  In the meantime, what can we do?  I suppose each of us must use whatever tools available to us to determine what is best and safest for our individual circumstances.  For me, that includes my own intuition and Spiritual guidance from my Creator who knows the birth process and my body better than any other being.  I may not be able to determine, with certainty, that water birth is safe for you or anyone else.  But I feel confident I will be able to determine down the road whether it's right for me.

I'd appreciate any wisdom, stories, and insights you might have.

Thursday, April 29, 2010

Seeking your input

I'm doing a daddy-doula "boot camp" for two couples soon to embark on their first drug-free hospital births. If you had less than two hours to teach dads how to help their wives through labor, what would you say are the best things I could teach them?

Thursday, April 15, 2010

Calling all AZ Birth Junkies

My friend Cassie (who also happened to be the doula--in red--who counter-pressured, encouraged, and photographed me throughout my son's birth) is hosting a viewing of the film Orgasmic Birth at her house in Glendale on May 6th.  (I posted last year about the film.)

Don't let the title turn you off.  I haven't seen the film yet myself, but I appreciated Rixa's review of the film in which she explains:
I found myself particularly troubled with the word “orgasmic.” I think a number of other words describe more accurately what the filmmaker is trying to communicate in this film: ecstatic, empowering, or transformative come to mind. In our society, orgasmic is always used in the narrow, sexual sense. In that sense, orgasmic birth = having a literal orgasm during birth. But that isn’t really what the film is talking about at all. We do see at least one woman literally having an orgasm during her labor (she said it was very unexpected and quite lovely), but the other women experience something else, something more nuanced and more complex than simplistic sexual climax. . . .
The other day, I looked up “orgasmic” in the dictionary. . . . The second meaning, one not in circulation in our everyday language, is “intense or unrestrained excitement” or “a similar point of intensity of emotional excitement.”
I had an “aha!” moment. Debra Pascali-Bonaro is arguing that birth can be a peak emotional, physical, and spiritual experience. And given the right setting and preparation, birth can include moments of ecstasy, transcendence and occasionally even sexual pleasure. Her film explains the hormonal and environmental similarities between making babies and having babies. If we see birth not as just a narrow equivalent of sex, but rather sex and birth and breastfeeding as a continuum of important and inter-related life experiences, then the phrase “orgasmic birth” makes much more sense. Think of it this way: if women were expected to make love in the same kind of setting that they labor and birth in (in a clinical environment, observed by unfamiliar professionals, monitored and tethered to machines, and above all their biological rhythms forced to adhere to a strict timetable), they would undoubtedly have a high rate of sexual dysfunction and disappointment.
After watching the film three times, here's how Rixa's concludes:
In sum: the birth scenes are incredible and the movie is worth watching for that reason alone. They're not overly romanticized or sanitized. I found them incredibly realistic, in all their variety, about what giving birth normally is like. I'd like a different title, because I think that it will keep many people from watching it, but I also understand the rhetorical power of "orgasmic birth."
Rixa's review helped dispel any hesitancy I might have had about viewing the film.  And I have since heard multiple women describe Orgasmic Birth as their all-time favorite birth film.  Rixa also interviewed Orgasmic Birth's filmmaker, Debra Pascali-Bonaro, if you want to check that out. 

I am looking forward to seeing the film. Are you coming?

Tuesday, April 6, 2010

Hear me roar

After a few weeks of caring for her precious first-born baby, my friend Fig declared, "Motherhood is blood, sweat, and tears. Rinse and repeat." Are you nodding and chuckling at the same time? Fig's good at inducing the chuckle-nod. She's so witty. And right on.

So I've been thinking, of late, about how I focus so much on the intense physical challenge of labor (some, including me, call it "pain") that I have sort of neglected to give attention to other physical "pains" associated with bearing and nurturing children. For example...

* The cramping associated with ovulation and/or menstruation is painful for some women.
* PMS can cause painful bloating, headaches, etc.
* Love-making is painful for some women.
* Some women experience round-ligament twinges and/or cramping in early pregnancy.
* Morning sickness can range from mildly bothersome to excruciatingly miserable.
* Some pregnant women suffer with back pain, sciatic nerve pain, joint pain, etc.
* Preterm labor pains keep some women on bed rest for weeks or months.
* Then there are the after-pains (I think they get worse with each birth... wowza!).
* Some women endure general perineal tenderness, pain from perineal tears/episiotomies, or cesarean section wounds.
* Breastfeeding hurts like the (toe-curling) dickens in the beginning, being compounded initially by painful breast engorgement, painful milk let-down, and more intense after-pains due to the uterine contractions produced by suckling.
* The muscle strain from carrying around a 5 to 10 lb newborn can lead to sore arms and/or sore backs, especially with a first child.
* Once an infant has teeth that introduces a whole new kind of potential pain during breastfeeding.
* Back pain can continue and intensify from carrying increasingly hefty babies and toddlers.
* Rinse and repeat.

(And that's not even getting into the emotional pains we endure.)

The other day a first-time pregnant woman I love told me she's pretty sure she'll get an epidural 'cause she's (and these were her exact words) "such a pansy." I couldn't help myself... I rushed toward her, grasped her face in my hands, and said, "No! You're not!" This woman has endured excruciating menstrual cramps every month for over a decade followed by miserable morning sickness for the last couple of months... and she thinks she's a "pansy!"

Look at the list above, ladies. Take a good, long look at it. Do you really think God would entrust those challenges to a bunch of pansies?



Nope.

We are women. We are strong. We can push ourselves to our absolute limit and somehow find the strength to push some more. And then rinse and repeat.

Don't you dare call yourself a pansy. 

 (Photo by Fife Photography, Fall 2005)

Thursday, March 11, 2010

This is why I carry on

I've been feeling somewhat discouraged since my last post. Wondering whether I'm wasting my time making a big fuss about nothing with this blog and all the time and energy I put into birth advocacy. Does it really matter as much as I think/feel it does?

Then I got an email from a friend-of-a-friend that made my day yesterday. She had discovered, two weeks before her due date, that a certain medication she was taking would prevent her from having an epidural. So she was scrambling to prepare herself for an unexpected drug-free birth at the last minute. A couple of friends alerted me to her predicament, and I quickly whipped-up an email with attachments and links and tips.

Her baby came early, before she felt as prepared as she would have liked to be, but her birth went beautifully. She had a very fast (2.5 hour) labor and arrived at the hospital ready to push. She said the thing that got her through was remembering this post relating running to birth. She was a runner in high school so she could relate. And, while coping with labor, she imagined herself doing 200 meter sprints with a running friend by her side, cheering her on. In the end, she said:
We were really blessed and I cried. To be truthful, labor was a lot easier than I expected. I suppose I was waiting for a feeling of daggers and swords all through my lower region. Thankfully, it wasn't quite like that. . . . It's very likely I will have to do natural birth every time from here on out, but if it is similar to what I just experienced, it won't be so bad. It was beautiful!
I don't know whether the birth process matters as much as I think it does. Perhaps it matters little for most women. But once in a while I have the privilege of helping a woman discover the strength and beauty of giving birth. I can't help everyone or change everything. But I can help one. And then another one. And then another. And hearing them say, one by one...

"I feel so much more informed and empowered to deliver naturally and feel strongly that I can absolutely make it!"

"You have inspired me!"

"I know now that I can do so much more than I thought I could... that my body is capable of so much more."

"I have never felt so much love before. I knew that this was one of those life changing and life affirming moments that couldn't be experienced any other way."

"It was beautiful!"

Those are the moments when I know birth matters... even if just for a few women. And they are the reason I carry on.

Saturday, February 6, 2010

Curvy

About two years ago I went to a chiropractor, hoping he could help me figure out why I had chronic pain in my right shoulder blade region. (It still plagues me to this day.)

Wow. That's what I thought when I saw the x-rays of my spine. Wow. Holy cow. Good grief!

Back when I was a teenager I was diagnosed with scoliosis, but they watched it for a while and it never became more than "mild" scoliosis, so they sent us on our way and I sort of stopped thinking about it. Until the pain started several years later. When I was lying "flat" on my back, things just didn't seem to be where they were supposed to be. I was definitely right! As we stood there looking at the x-rays, I thought to myself, hmmm... that doesn't look like "mild" scoliosis to me! The chiropractor concurred. Mommyhood had taken its toll and made my curvy spine even curvier.

What does this have to do with birth, you're asking?

A recent post by Rixa alerted me to something fascinating. It's totally logical... one of those things you learn and wonder how you never thought of it before. Scoliosis and epidurals aren't always compatible. Makes sense, huh? I really don't know how it never occurred to me before.

So I just googled "epidural scoliosis," and found quite a few stories from women with scoliosis on forums and Q&A sites. It seems to be hit or miss. Some women with scoliosis had no trouble, but they seem to be in the minority. Most of the women with scoliosis fell into one (or more) of these categories:
1) They forgot about their scoliosis until the anesthesiologist pointed it out. It took some time to place the epidural, but it worked fine.

2) Placing the epidural was extremely difficult. The anesthesiologist had to poke them multiple times, sometimes excessively, and they suffered back pain for days, weeks, or months after the birth.

3) The epidural only worked on one half of their body or only worked when they positioned their body a certain way. Most of these women went on to choose natural deliveries for subsequent children and raved about how much better they were compared to their complicated epidural experiences.

4) Their OB recommended meeting with the anesthesiologist in advance and bringing along x-rays to ensure everything would be smooth.

5) They were told an epidural would not be possible because of the severity of their scoliosis. They opted instead for a spinal, a c-section under general anesthesia (Seriously... one lady's doctor let her have an elective scheduled cesarean because her scoliosis was incompatible with an epidural. Seriously.), or a natural delivery.
I feel so fortunate that I didn't have to learn these things the hard way. What if I had gone into my first birth expecting the epidural to save me from the agony? I think an unmedicated birth is so much more painful and difficult when it is unwanted and the mother is completely unprepared for it. It never occurred to me to mention my scoliosis to my OB or hospital nurse. I wonder how many women with scoliosis have miserable births because, like me, they didn't realize it could impact their experiences.

I also discovered through my internet digging that scoliosis can affect fundal height measurements. One women was told she would give birth to a 10+ pound baby because she was measuring so "big." Her child came out a 7 pounder. If you have scoliosis and your doc starts pressing for an induction or cesarean for a suspected "big baby," keep this in mind. Spinal curvature just might be misrepresenting the size of your baby. When I imagine hours of bone-crunching pit-contractions followed by an epidural that only works on half of my body followed by months of back pain from the multiple insertion attempts... all for an unnecessary induction... Ugh. NO thanks.

Fascinating stuff.

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"?

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, 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...

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.

Wednesday, July 29, 2009

Inspired by Martha: Part Two

How to have a successful unmedicated hospital birth, Martha-style...

1) Determination!
One of the things that makes Martha so inspiring is that she weathered her pregnancy and birth with TWO heart diseases (aortic valve stenosis and hypertrophic cardiomyopathy). This put her in a higher risk category than the average pregnant woman, but she was still determined to pursue a natural birth, despite the skepticism/concern of her cardiologist and OB. She said:
I left their offices many times over the next couple months sobbing all the way back to work. I felt trapped because I was in my final months of pregnancy and didn’t want to go to the trouble of changing doctors. I trusted them both to take care of the heart issues because they had worked together in the past on pregnant women with heart disease and that was very important to me. . . . [They] had no stats or studies to back it up, but their main concern was the risk natural childbirth would pose to my heart. I could never really get to the bottom of it, but I was CERTAIN natural childbirth would pose no extra risk to my heart. I felt just the opposite, actually.
2) Avoid being induced, if possible!
I remember the week or two before Martha gave birth. Our mutual friend mentioned that Martha's doctors were really pressuring her to be induced. I was so hopeful she would be able to avoid an induction! Pitocin would put an unmedicated birth virtually beyond reach (not to mention the stress it could put her body and her baby under). Here's what Martha had to say about that harrowing time:
The final month was the worst because they made me have extra fetal monitoring twice a week which made me anxious and worried because each visit threatened induction because my amniotic fluid levels were all over the map. I knew being induced would put all hopes of a natural childbirth out of my grasp so I prayed more fervently than ever to be spared from induction. . . . I also had many pep talks with Sienna. “Now, listen little lady. We can’t be induced. It’s not an option. So, I need you to just stay inside as long as possible and keep showing the doctors what you can do.” She was so obedient, I wanted to lean over and kiss her after every appointment but couldn’t reach my belly with my lips. Adam had to take care of that for me. The last couple weeks I was put on bed rest which nearly drove me to drink. I would not wish bed rest on my worst enemy. . . . The due date came and went. Due dates are a stupid, cruel thing. They mess with your mind and make everyone under the sun badger you about why your baby’s not here yet. Poop on due dates. I’m not telling anyone mine next time.
3) Faith!
I really believe one of the reasons Martha succeeded was because of her enormous faith. You really cannot tackle natural childbirth without faith... whether it be faith in God, faith in the birth process, faith in your body, or faith in yourself. Martha's deep faith is so inspiring to me:
I found great comfort in Ether chapter 12. The more I learned about faith, the more I knew it was my answer. Faith precedes miracles and I needed a major miracle. Faith brought about the impossible, like moving mountains, and I needed a mountain MOVED. Each time after fetal testing, I was sent home. Each time I KNEW it was a miracle. I still didn’t know what the end would bring, but I just kept my faith fine-tuned and told God what I wanted and left it up to Him.
4) Hang out at home as long as you (safely) can!
I really think the birth outcomes in our country would vastly improve if women would spend most of their labors at home. Rushing to the hospital too early is a mistake many women make. The artificial lighting, restrictive policies, and strange faces and environment lead many women's labors to stall or slow down, which leads hospital staff to either send her back home anyway or start intervening in the birth with Pitocin, etc. At home, a woman is on her own turf, can be upright and mobile, and can eat or drink as she wishes--all things that will facilitate her labor process. Martha was fortunately able to spend all but the very end of her labor at home. Here are some excerpts of her birth story. I hope you don't mind that I nearly pasted all of it, Martha! It was just so great, I couldn't help putting so much of it here:
Wednesday at 2 a.m. I got up to pee for the umpteen bajillionth time and also ate a plum and read my scriptures (Ether 12, I love you!). At 2:30 a.m. I peed again and heard a little PLOP. Water breakage, folks! This was the sign I was looking for. I woke up Adam and called Dr. Marralle’s operator. I told the operator my water had just broken and that I was ready to come in. The operator told me Dr. Marralle’s instructions were to come in when my water was broken AND when I was in active labor (contractions 5 minutes apart, lasting 60 seconds, for one complete hour). I thought this was odd because Dr. Marralle had told me several times that I’d need to come in if my water broke OR if I was in active labor. Huh. The operator seemed pretty confident so I agreed to call back when I was in active labor. Adam went back to sleep and I tried to lie down and wait for active labor.

Contractions did keep coming but they were quite irregular. I couldn’t get comfortable in bed and just walked around the house and leaned over the table or desk or wall, or knelt down over my ottoman when a contraction would hit. I timed and wrote down each contraction and from 5 – 6 a.m. they were in the ACTIVE zone. By this time I’d thrown up my plum – twice – and had much more water gushing out of me from below. Isn’t labor PRETTY? Adam awoke when he heard me groaning in the front room around 6 a.m. and came out to help. I hadn’t wanted to wake him up because I thought at least one of us should be well rested for the big day ahead. I also didn’t know how he could help me, since he couldn’t exactly BE me and that’s about all I wanted at that point. However, when he came in and started rubbing my back and encouraging me, it helped immensely.

I told him to call back the operator and she gave him the go-ahead to come in. We gathered our things, he ate breakfast and emptied the dishwasher (of course he did!) and we both showered. By this time my contractions were just a couple minutes apart, and I knew we needed to get this show on the road. I remember getting into the car and telling Adam, “I can do this,” signaling that I was ready to do this natural childbirth thing because I still felt in control of my contractions. However, in my head I thought, “But if this lasts all day, I CAN’T do this.”

I was making quite a bit of noise through my contractions and I liked it. Well, I wouldn’t say I liked it, I guess I just felt sort of cave-womanish, which freed the inner natural childbirth hippie in me, which I liked. Sitting in the car was totally uncomfortable. I did have a pillow behind my back which helped and a pillow in the front that I was squeezing to death. I closed my eyes and just wished away every bump on the road. Hoag Hospital is in Newport Beach, about 20 – 30 minutes from our house. We had two freeways to conquer but it was 7 a.m. and the traffic was moving great. I think I opened my eyes three times and knew we were making good time. We got there a bit before 7:30 a.m. Adam valet parked and I leaned against poles, walls, Adam, whatever I could to get me up to the 5th floor: Labor and Delivery! The nurses stared at me as I leaned against the wall and did this thing with my feet like a bull does when he’s getting ready to charge. I thought about that later and thought it was quite symbolic. Ha!

Adam was very calm in getting us checked in at the front desk and meanwhile the nurses could see they needed to get me to a room fast and acted accordingly. They tried to put me in the wheelchair but I declined. I didn’t want to have my grand entrance be as an invalid and, more than that, I did NOT want to sit. That is the LAST thing that felt good on my back. I got to the room and they made me strip down and throw on a gown. . . . They had me climb on the bed for fetal monitoring and a cervix check. I wanted to decline that up front as well and let them know from the start that I wanted to MOVE a lot and not be confined to the bed. But I figured we’d have a look to see how far I was dilated and then I’d voice up.

The nurse stuck her fingers up there and announced, “You’re dilated to a 9.5!” I looked at Adam and said, “That is the BEST news I’ve EVER heard.” We were both shocked. So were the nurses. The head nurse, Kim, tried to get to the bottom of why I had waited to come in so late. I told her my conversation with the operator. She wanted the name of the operator. I didn’t have it. In my mind I wanted to give that operator my first born, yes even the first born I was about to birth. I am convinced she was an angel sent from heaven and was the reason this natural childbirth was happening... and happening NOW! For some reason Kim asked if I wanted medication or an epidural. I answered no to both and thought it odd that she’d even ask since it was obviously too late. . . .

The nurse asked if I’d had an urge to push. I hadn’t put it together until she asked, but YES, in the car, I DID feel like I had to take a giant crap. I didn’t understand the urge, though, because I had thrown up all the food that would be necessary for a bowel movement. So THAT, my friends, is the urge to PUSH. Kim said, “Well, within the next half hour, you can push.”

Meanwhile, Dr. Marralle came in, the nurses (about five or six of them), were bustling around the room, hooking me up to all sorts of things, or just staring for general amusement. A sweet middle-aged nurse came to my bedside and introduced herself as Cindy, a student nurse that was on her first day here. I loved her immediately and grabbed her hand. I made her hold it the whole time while Adam was on the other side, holding my other one. When she let go at one point I grabbed it again. There was no way she was leaving my side. I needed her cold, thin, strong fingers as much as I needed Adam’s warm, bigger, strong fingers. . . .

I had about eight pushing sessions and it all lasted about 25 minutes. Adam was tremendously helpful throughout it all. Long ago we had established that he would be my “focal point” during labor and delivery and several times when it seemed like I was losing it, he would say, “Martha! Look at me! You’re doing great.” He was very reassuring and my #1 cheerleader. He just kept telling me how wonderful I was doing and I was believing it!

Something that was making me lose a bit of focus was every time I put my head up to push, I could see three nurses in the back of the room just watching me. I think two were the baby nurses and one was a student nurse. I wanted to say, “Are you enjoying watching this? My crotch? My pooping and peeing all over the doctor while I try to push this impossible baby out? My head turning all sorts of shades as I nearly explode? Oh, good.” . . . I was annoyed, but tried to stay focused on the people that were helping me: Cindy, Kim, Adam and Dr. Marralle. I chalked it up to either it being protocol for baby nurses to wait in the room until the baby comes out or maybe, since Hoag has a 98% epidural rate and a 30% cesarean section rate, they had never seen the spectacle that is natural childbirth. I forgave them later as they helped me breastfeed and told me how amazingly I had done. One of their great compliments was, “I didn’t even hear one F-word!”

I didn’t feel the baby’s head pop out, I think because of the local anesthetic on my perineum. I was waiting for that infamous “ring of fire” feeling, but it didn’t come. Anyway, the head DID finally pop out, wouldn’t you know it. Adam said, “Martha, the head’s out!” I think I gave a little squeal of disbelief with a, “REALLY?” Just one more push and out came the slithery little body! It was incredible. Dr. Marralle held her up and I said possibly the dumbest thing ever, “It’s a baby!” Wow. Way to state the obvious, Marth. But there she was, seriously, a baby, a big baby, one that was just moments before making me totally miserable and ugly and grunty and fat and purple and crampy! She was out and it was allllll over. I immediately felt SO much relief. They put her on my chest and the first thing I noticed were her long scraggly nails. Baby nails are tiny miracles unto themselves. I just looked down at her head of black hair while the nurses wiped her off. Dr. Marralle asked me to give one more push and out came the placenta. I looked at Adam and said, “That felt gross.” He said, “That looked gross.” Dr. Marralle had Adam cut the umbilical cord, then she got busy sewing me up. Dr. Marralle’s comment after it all was, “Well, don’t plan on it being that simple next time, young lady.” Classic Dr. Marralle. I didn’t care, though. Nothing anyone could have said would have ruined that moment.
Are you feeling warm and fuzzy now? Me too. :-)

Friday, July 24, 2009

Conversion

Or we could call this "Part One" of the "Inspired by Martha" series. But not Martha Stewart. A different Martha. I'm finding, over time, that I hear variations on the same conversion story over and over again. My own story fits the pattern as well. Here's a rundown...

1) Woman feels certain she'll say, "Bring on the drugs!!" when she has children.
2) A friend/stranger (or two or three) recommend a "natural" birth book or plant little fact-seeds about the benefits of going natural.
3) Woman begins to let those seeds take root and proceeds to do her own reading/research.
4) Woman is astounded by what she discovers and is changed forever.
5) Woman feels certain she'll say, "No drugs for me!!" when she gives birth.

And, often, we can add a final...

6) Woman has successful, wonderful drug-free birth and feels driven to help other women achieve wonderful births as well.

Martha is a friend-of-a-friend whose own story fits this pattern to a T. I never tire of hearing these conversion stories. They make me happy and giddy and all warm and fuzzy. So I want to share her story with you, 'cause I figured you'd love the warm fuzzies too. :-) Here's what Martha had to say about her conversion:
It all began in about my sixth month of pregnancy when I was at a baby shower for two ladies [from church]. I was the only soon-to-be new mom and the others all had little kids. Someone asked me, “So, are you going to get the epidural?” I said, “Pshhh. Yes. That seems like a no-brainer.” The others laughed and agreed. About a week later I started reading The Birth Book by William and Martha Sears as recommended to me by my friend. When she handed it to me months earlier, I thought, “What’s there to know about birth? You just go to the hospital and the doctor takes care of everything.” Three pages into the book, I had an epiphany: I wanted to have a natural childbirth. No one was more surprised than me to discover this. Martha Sears was recounting each birth story of her seven kids. Her last six were without medication and the way she talked about those births in contrast to her first, where the doctor definitely “took care” of everything, was something else. It moved me spiritually and emotionally. I was on my lunch break reading the book and remember walking back to the office with tears in my eyes. For the next months I devoured that book and every other resource I could get my hands on. The two other helpful books I read were Natural Childbirth the Bradley Way by Susan McCutcheon, as recommended to me by my friend, and Birthing From Within by Pam England, as recommended to me by [another] friend. I also watched the documentary "The Business of Being Born" as recommended to me by [another] friend. Natural childbirth just made sense to me and the more I learned about it, the more my testimony of God’s greatest creation, the human body, grew. I had complete confidence in my body’s ability to do what nature intended, and I knew God would not give me an experience they couldn’t deal with. (Caveat: I also know that God made skilled doctors and drug makers who make and use miraculous drugs that many people have a great experience with. Still, I knew that route wasn’t for me.) I became obsessed with the topic of natural birth and it became all I wanted to talk about. Adam totally understood my desires but that didn’t mean he didn’t glaze over several times when I’d bring up the subject yet AGAIN. He was very supportive, but he wasn’t the one giving birth. I was. So I decided I would learn everything I could, give him the information he needed and be prepared to work together to make this happen.
I love this stuff! And it has inspired me to be more open. It's so easy for me to keep my mouth shut in conversations about birth. I don't want to offer unsolicited advice or offend anyone. I rationalize that I'm "doing my part" by blogging here and posting articles on facebook, but I could reach more people if I'd use my vocal cords as well. I always assume the women around me don't want to hear it, but how do I know? It could be as simple as asking a question, such as, "What are your plans for your birth?" It's a risk-free way to open a dialogue on the subject. Why don't I do that more often? I will be forever indebted to the woman who introduced me to the beauties of unmedicated birth. So, Martha, thank you for this reminder to open my mouth.

Stay tuned for "Part Two" where you'll get to hear how Martha's birth experience went.

Thursday, June 11, 2009

In praise of good birth attendants

I brought these mini rose bushes, thank you cards, and copies of my birth slideshow to my midwives today. It was my 10 week postpartum appointment. I was thrilled to see their new, gorgeous, and much larger office. Their practice is growing, and that makes me so happy.

This is the first time I've ever wanted to give a thank you gift to my birth attendant. And I'm feeling even more grateful today than I was a few weeks ago. Some scary complications following my sister-in-law's home birth have shaken me up over the last couple of weeks. And they have shown me more clearly than ever how valuable an experienced midwife is. I love midwives. I think more women should be attended by midwives. I think we need more midwives in this world. But I now know that I will never feel comfortable putting my or my future babies' lives in the hands of just any midwife.

I sat and talked with Mary today at my appointment. She held and admired my beautiful Bubby, of course. And we chatted for a bit about my birth and my sister-in-law's birth. Every midwife is so different. Not all midwives will handle a situation the same way. But I think one of the reasons Mary's outcomes have been so consistently good is that she can sense when something is going to happen... before it happens. She told me that most midwives develop that ability after they've practiced for more than 15 years. Mary's been a midwife for over 30 years, so her sense is especially in tune. And I'm so grateful for her gift. Because it kept my Bubby safe when she sensed he needed to be born quickly. I also think her years of experience have exposed her to nearly every possible complication, so she has witnessed and learned the best ways to handle those problems.

I had a really hard time keeping my "birth faith" during and immediately after my sister-in-law's brush with catastrophe. I even contemplated quitting this blog altogether. But then I cooled down and got my head in order and realized that her experience didn't change what I already knew deep down. The birth process was beautifully designed, but that doesn't mean complications don't ever happen. No one ever said bad things don't happen in home births. What we do know is that home birth is just as safe for low-risk women as hospital birth, but there is always the "with a skilled attendant" to qualify that safety. Midwives have varying degrees of experience, skills, and credentials. So what exactly qualifies someone as a "skilled attendant"? I'm not really sure what the answer to that is. But I am grateful and fortunate that I chose Mary--without a doubt one of the most skilled attendants there is.

Fortunately, my sister-in-law is doing much better now. Thank heaven for doctors and hospitals when we need them! No doubt about it... we are so fortunate to have modern medical intervention at our service when we need it. And, fortunately, my sister-in-law's birth experience itself was wonderful and beautiful. In fact, to this day she can't remember feeling any labor pain. Now that's incredible! I guess I need to look into that hypnobirthing stuff!

Wednesday, June 10, 2009

"Nobody thinks you're a hero"

A comment from this site has got me on the defensive. So I'm going to spill my thoughts here.

I did NOT choose to give birth without drugs because...

* I wanted people to call me their "hero."
* I wanted to prove something.
* I wanted a reason to feel superior to other women.

As I've mentioned before, when I was a newlywed, I didn't even know people still had babies without drugs. The only experience I had with anything like that was the "crazy lady" who lived behind my grandma's house who had her babies at home. Ha ha. I didn't become interested in drug-free birthing until an acquaintance told me she was planning a natural childbirth and mentioned that there were benefits to avoiding drugs. It was the benefits that piqued my interest... not the dream of proving my supposed superiority to the world.

In fact, I don't know a single woman who chose natural childbirth for the reasons listed above. All of the women I know who have actively pursued a drug-less birth have done so because they recognize the many benefits. It may be controversial to say it, but I really do believe that the best way for (most) babies to be brought into this world--and for new mothers to be born--is through natural childbirth. (Before anybody gets upset, recognize I said MOST, not ALL.) I know that the birth process was designed as it was for our benefit.

I wish I could spend the day listing all those benefits with references to research backing them up. But I have two young children and a newborn, so my writing time is limited these days. But I do want to list some of the benefits I have experienced through my attempts to give birth as God and nature intended.

Choosing to give birth without drugs makes sense because...

* It reduces risks to both mother and baby. All of the drugs available for pain relief have very real (sometimes severe, sometimes long-term) side effects. Often one intervention leads to many (and more invasive) interventions. I know several women who traded the temporary pain of childbirth for long-term daily back pain after their epidurals.

* It enables a woman to be more aware of her instincts and urges. 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?

Now I realize that this last reason may appear similar to "proving something to the world." But I believe there is a clear distinction between 1) Choosing to take a difficult path because you believe it will be beneficial to you and teach you important things about yourself AND 2) Choosing to inflict pain on yourself for future bragging rights.

I chose to accept the birth process and the possibility of intense pain because I knew it was best for me and my baby. But I think it's impossible to come out the other end of natural childbirth without feeling the euphoria of achieving something beautiful. Childbirth is one of the most physically and emotionally difficult challenges many women face. How could a woman NOT feel enormously fulfilled and proud of herself for her labor of love and endurance? Why do so many fault us for that sense of fulfillment? Why do some want to belittle that achievement as merely "nuts"?

I do hold my children's births in my heart as some of my greatest accomplishments. Does that make me prideful, macho (but in a female way), or full of myself? I don't think so. Just like I don't fault my husband for the joy he feels in completing a marathon or anyone who tackles something difficult and feels gratified upon overcoming it. Aren't those kinds of achievements the makings of our heroes? Is it not in our witnessing of human strength and endurance that we find our own desire to reach higher and push further and grow stronger?

I didn't pursue natural childbirth so people would call me their hero. But people have. Does that make me feel superior to other people? Of course not. I feel honored that my experiences have inspired other people because I believe wholeheartedly that the same strength I drew upon to birth my children lies within all of us. We are all strong. We are all heroes-in-the-making. We all have opportunities to discover our strength. Childbirth just happens to be where I discovered mine.

Friday, April 24, 2009

Pitocin on the brain

I've got Pitocin and induction on the brain. In large part because I'm about halfway through Pushed, by Jennifer Block, and just finished reading about the consequences of Pitocin and labor induction. Here are some sobering excerpts...
"A British midwife told a researcher that the sounds women make when they're on artificial oxytocin [Pitocin] are hauntingly different: 'It's a panic, it's a scream and it's different from the noise they make when they're working with their bodies. . . . It sounds like someone's being murdered'" (p. 135).

"And with an epidural deadening the body's natural pain threshold, staff can keep upping the dose, which can lead to contractions that fire like a machine gun or that last for minutes, during which time the fetus is oxygen-deprived. This is called hyperstimulation. It is not uncommon and would be considered a trauma--beyond what is normal" (p. 137).

"A recent ACOG survey found that in 43% of malpractice suits involving neurologically impaired babies, Pitocin was to blame" (p. 137).

"Even Williams Obstetrics offers a sobering history: 'Oxytocin is a powerful drug, and it has killed or maimed mothers through rupture of the uterus and even more babies through hypoxia from markedly hypertonic uterine contractions'" (p. 138).

"A 2004 study out of Australia found that autistic children were twice as likely to have been born without natural labor, either by elective cesarean or induction" (p. 139).
Pitocin use in U.S. hospitals has increased alarmingly in the past couple of decades. In 1990, only 9.5% of labors were induced. In 2006, in a study of 5500 low-risk, first-time mothers, 40% were induced and 70% received Pitocin at some point during labor (see Pushed, p. 5-6).

I can see these stats reflected all around me. I know very few women who have given birth without Pitocin dripping through their veins. If it's true that 70% of low-risk first-time mothers are given Pitocin, then it's no wonder birth horror stories and epidural use are the norm. How strange that so few women know what normal birth actually feels like. Instead they have a warped and painfully skewed misrepresentation. We are human beings, but yet so far removed from the most basic human experience.

The truth is that we really don't know how these highly-medicalized births may be influencing and possibly damaging our society. Oxytocin is the hormone of bonding and love, so some suspect that these births (virtually devoid of natural oxytocin) may be partly to blame for the increased violence, autism, and other mental and psychological disorders running rampant in our modern world. Pitocin (and cesarean sections) may also influence how we bond and how we respond to our children as parents.

I've never had Pitocin in labor, but I was given Pitocin through my IV following my first daughter's birth to help slow my bleeding. It wasn't until a couple of weeks ago that I had an epiphany about that Pitocin drip. It's almost certain that once Pitocin was introduced into my system, my body stopped or slowed its own oxytocin production. Artificial oxytocin doesn't produce the same bonding effects as the hormone produced by our own bodies. It wasn't until roughly a week after her birth that I "fell in love" with my daughter. I thought there was something wrong with me... why didn't I love her right away? I'm now quite certain that Pitocin interfered.

There are certainly plenty of women who fell in love with their babies at first sight even with Pitocin or cesareans. But not all women do. Everyone's individual body chemistry is unique. If I could struggle even having had an unmedicated, wonderful birth experience, I have to wonder what it would have been like for me if I'd had drugs or a cesarean... I shudder to think where those paths might have taken me...

Then I contrast those struggles with my most recent birth, and I'm in awe. As my births have gotten progressively more "natural," bonding has gotten progressively easier. And my parenting style has gotten progressively more responsive. I spent the first couple of weeks after my son's birth feeling blissed-out and totally and madly in love with him. In fact, I could hardly bear to be separated from him. What a change from my Pitocin-jolted postpartum experience!

Pitocin has its time and place. But there's no question that it--and the droves of women and babies receiving it needlessly--are being abused. Will we stand by and let this abuse continue?

Sunday, April 5, 2009

My first home birth

Sorry to keep you waiting, but I ended up remembering more details I needed to add. And then the editor/perfectionist in me had to revise and rework it a few times. It's still not perfect, but I knew I'd be cruel to keep you waiting any longer. (I won't have the photos from my doula for a few days, but I will throw in a few of the snapshots we took.) Here it is... unabridged and uncensored with all the gory details... :-)

Wednesday, April 1, at about 3:30, the girls and I sat on my bed with a pile of books to read. At about 3:45, my three-year-old needed to use the bathroom. As I stood to go help her, I felt a trickle of warm fluid that had “ruptured membranes” written all over it. Over the next few minutes, I could feel my heart racing. After helping my daughter, I used the bathroom myself and felt more fluid come out into the toilet. I could see that it was tinged pink and had a distinct smell that immediately took me back to my previous births.

First, I called my husband and told him. “Are you serious?” he said. He said he’d be home as soon as he could. This wasn’t what either of us had expected. We had been so sure that this birth would get started in the middle of the night (like my other two births)—it never crossed our minds that it could be in the afternoon. When my water broke before my oldest daughter’s birth, my labor had started right away, so I thought I might start feeling contractions very soon. I hadn’t bargained on my girls being awake during the birth, so I started brainstorming what we’d do with them.

Then I called my midwife, Mary. She didn’t answer, but then she called me right back. I explained what had happened, and she said to call her back in twenty minutes and let her know if I had started feeling any contractions. We kept in touch every 20-30 minutes over the next while as I waited for labor to start and monitored the baby’s movements. I also called my doula, Cassie, and Kimball and Brooke (my brother and his wife), to let them know. They all said they’d come as soon as they could.

Meanwhile, I began a restless nesting frenzy—cleaning clutter off the countertops and wiping them, emptying and loading the dishwasher, starting a loaf of bread in the bread machine, tidying up the family room, and thawing some hamburger for meatloaf, etc. I also took a few moments to update my facebook status and blogs to let friends and family know my water had broken. After my husband returned home, I had him listen to the baby’s heartbeat to reassure me. He has always been able to hear my babies’ heartbeats by sticking his ear up against my belly. The baby sounded great and put my cord prolapse fears to rest.

Kimball and Brooke arrived at about 5:30 followed by Cassie at about 6:00. My husband kept the girls entertained and Kimball watched a movie while I finished getting dinner ready. Cassie and Brooke kept asking if they could help with anything, but I was so restless I just wanted to stay busy and didn’t know what to suggest for them to do. We chatted and enjoyed each other’s company, and I shared my mixed feelings—wanting labor to get started but simultaneously willing it to wait. As the sun began going down, I groaned jokingly, ‘cause I was sure that my labor would probably kick-in once it was dark, and I had to admit I was nervous about what I was in for. I paced around a lot, and kept asking everyone, “Is it hot in here?” I turned on the air conditioning.

Sometime between 5:30 and 6:00 I felt a mild contraction or two—very far apart and brief. I kept talking to the baby, “Wait… let me eat dinner first!” And I also hoped he’d wait until we could get the girls to bed. At about 6:30 I began having regular contractions, so Brooke and Cassie started timing and keeping track of them for me. After I’d had several within 7-10 minutes of each other, I called my midwife to let her know labor had begun. She said to call her back when they were regularly 6-7 minutes apart and lasting longer. It was about this time that we sat down to eat. I was cheerful but joked with everyone about my fears—“I know what I’m in for… and that’s why I’m scared!”

After dinner, my husband hurried the girls to bed, and I called my midwife. Cassie and Brooke helped me get the bedroom and bathroom ready for the birth—putting shower curtains and a set of unloved sheets on the bed, spreading plastic drop cloths on the floor, and moving the birth pool into the bathroom. My three-year-old walked out of her room as she was getting ready for bed and saw us putting the plastic on the floor. She said, “Mom, are you going to paint your room?” We got a kick out of that. I went in to have goodnight prayers with the girls and give them hugs, shouting across the house to let Cassie and Brooke know when I had a contraction. At that point, I turned down the thermostat quite a bit, and then changed out of my regular clothes and got into my pre-designated birthing outfit—sports bra for support, white tank top to stay cool and somewhat modest, and a loose and comfy skirt for “easy access.”

Labor started to really intensify at this point. Cassie suggested getting on the birth ball for some lunges or hands and knees to facilitate the baby’s rotation for optimum fetal positioning, but I was wary of encouraging labor to progress any faster until my husband was finished getting the girls to bed and my midwives had arrived. Between 8:40 and 9:00 I had several contractions about 4 minutes apart and lasting two minutes each. I decided to call my midwives again and let them know things were really progressing. They said they were only about a block away. At this point I realized it was too quiet, so we put my birthing cd on quietly. We played it through 3 or 4 times over the course of the birth.

I spent most of this time doing what my body told me to do… which was pacing the floor of my room back and forth. I took a bathroom break and found myself blind-sided by an intense contraction that necessitated some deep breathing as I sat on the toilet. It wasn’t much longer before my husband emerged from the girls’ room. Thank goodness… I needed him!

The midwives arrived at about 9:00 and began setting up their equipment and filling out paperwork. Now that everyone was present and everything was in place, I finally consented to getting some use out of the birth ball. I draped my upper body over it and rocked with my knees on the floor while my husband and Cassie applied counter-pressure to my back. After a bit, Nedra (my other midwife) wanted to check my cervix and listen to the baby during and after a contraction. Cassie had predicted earlier that I’d be 5 cm when the midwives came, and she was right.

Reclining on the bed while she checked my cervix was extremely uncomfortable, especially during a contraction. Being upright and mobile had made labor so much more manageable. It made me think of all the countless women who spend most of their labors strapped to a bed in the very position that had been most uncomfortable for me. No wonder they need epidurals!

I spent the next while pacing the floor some more. When contractions came, I would grab my husband and lean on him in a sort of slow dance. The midwives had gone downstairs to prepare some more things or give me my space. Cassie and Brooke sat on the bed and birth ball. I think they both felt a little unsure what to do… wanting to be helpful, but also wanting to respect my space. I was grateful for their supportive presence but felt, at that point, able to cope fairly easily with the contractions, so I didn’t really need them to engage in the labor much yet. We were all still cheerful and chatty between contractions at this point. Cassie and Brooke kept saying how quiet I was. I assured them they’d get to hear me make some noise… no question about that! I told them it wouldn’t be long before I’d be zoning out and unable to answer any questions.

Around this time I drank some Gatorade and ate some of the peanut-butter cookies Cassie had brought. Then a few intense contractions finally had me moaning as I leaned on my husband, so I asked for the midwives to check me. This was probably around 10:00. I was discouraged when they said I was still only a little more than 5 cm, but they started filling the birth pool. Mary suggested that I spend a few contractions on my left side on the bed and thought that would get me far enough along to get into the pool. Then the midwives headed back downstairs. So I lay on my left side facing my husband and holding onto him. Cassie put pressure on my right hip through the contractions—it made a big difference. Those few contractions on the bed were definitely moving things along. Mary was right. And I was getting louder! I guess the midwives could tell by the noises I was making that I was ready to get into the pool, so they sent up their assistant, Hayley, to let me know.

I decided I wanted to use the toilet before I got in. As soon as I sat down, a giant double-peaked contraction rolled through me. I grabbed onto my husband, who was standing in front of me, and moaned my way through it. As soon as it was over, I stripped down to my sports bra and hopped in the warm water. My husband knelt outside the edge and Brooke and Cassie also joined us in the bathroom. Not long after I got into the water, Mary asked if I felt more strongly about avoiding a tear or giving birth in the water. I told her I really didn’t want to tear, but I didn’t have an agenda about where I gave birth. She recommended delivering on the bed so they could more easily protect my perineum. She came in periodically to listen to the baby’s heartbeat during contractions. I knelt in the water with my legs spread out, leaning on the edge of the pool and holding onto my husband. During contractions I moaned and breathed (or tried to keep breathing). Cassie put counter-pressure on my lower back. She kept telling me over and over, “You’re doing so awesome, [Busca].” I don’t think I reacted much, but her positive words really helped. Mary asked at one point if I felt like I was getting ready to push. I didn’t yet.

I could tell I was in transition when I found myself reaching my limit. It was at this point that I turned to God. I don’t think there is any other physical experience that brings a person closer to the veil between earth and heaven than childbirth—particularly the 7 cm to delivery span. I silently cried to God: “Help me!” My mind wandered back and forth between my present physical surroundings and an otherworldly distant space. Somewhere in that space I found myself pleading, “Catheryn, I need you now!” I don’t know if it was her voice or my own that whispered in my head, “It’s almost over. You’re almost finished.”

After a few long double-peaked contractions, and my loudest noises yet, one of the midwives asked me to turn onto my back in the water so they could check me during a contraction and listen to the baby. (My eyes were closed for most of this period, so I don’t recall who was doing a lot of things.) The combination of my position and the midwife’s fingers inside me made the contraction horrendous. I writhed and wailed through it. I remember feeling my husband massaging my shoulder and I grabbed the hand I found at my left (apparently it was Cassie’s). I was 8 centimeters at that point. Mary suggested having two more contractions in the water and then moving to the bed. They also said I could turn back onto my knees, but another contraction hit me almost immediately, and I was in too much pain to try to move. My husband’s soothing touch and the words “It’s almost over” playing over and over in my head are what carried me through to the end.

Mary listened to the baby again during a contraction. Then she left the room and came back in and said, “This baby’s telling us he needs to come out, so after the next contraction let’s get you into the bed. We need to get this baby out.” As soon as I was able, I lunged out of the pool, tore off my sports bra (Mary said we wouldn’t want any wet clothes to touch the baby), and crawled on hands and knees across the bed as people threw towels over me. I moaned and wailed as more contractions rolled through me. Mary firmly got my attention, had me turn onto my bottom so she could check me and listen to the baby, and reiterated calmly again, “This baby is telling us he needs to come out now. You only have a lip of cervix left, so with the next contraction I want you to push. I’m going to protect your perineum, don’t worry.” My husband sat to my left and Cassie was at my right. The midwives had her putting a tube of oxygen by my nose. I kept turning away because it was irritating me, but then my rational mind kept telling me to stop it because obviously the baby and I needed it if they were having her give it to me. Really bizarre tug of war between my animal and rational minds!

I remember Mary saying something about the umbilical cord. But she was calm and cool, so we weren’t overly alarmed. My gut told me everything would be fine as long as I followed her instructions. My visions of what the delivery would be like were definitely out the window. At this point I really didn’t care if I tore or what position I was in or waiting for the “urge to push.” She said my baby needed to come out fast, so I was willing to do whatever it took to make that happen. I was also just so glad that the process was nearly over that I was thrilled to do anything to make it end faster.

Mary squirted olive oil over my perineum and applied warm washcloths. In between pushes she tugged around the edge of the opening, stretching the skin with her finger. She told me again to really push so we could get the baby out quickly… even urging me to keep pushing between contractions. I was making lots of noise, clutching onto my husband and Cassie (my brother downstairs joked later about the “dying cat” he heard). Soon I heard everyone commenting on the baby’s hair… “Lots of hair! He’s right there, [Busca]!” Perhaps it was Mary’s oil and hot compresses, but I never really felt the “ring of fire.” I didn’t even really know the head was out until I heard someone say, “His head is out!” Then Mary said (smiling), “He’s doing great, he’s rotating now…” and I did feel his shoulders come out… wondering to myself for a moment if they were going to get stuck ‘cause they felt so big. I pushed a bit harder and they slid out just fine. Then Mary said, “Reach down and pull out your baby!” I grasped onto his warm, slippery shoulders and pulled him up onto my chest. It was 10:55 pm on April 1—an April Fool’s day baby!

At first all I could see was the top of his dark-haired head and his slippery arms and back. My husband and I touched and rubbed him—alternating between smiling at each other and staring at our baby—as the midwives draped a towel over him. I breathed quickly in and out, saying something like, “Oh my gosh!” and then, “Is he OK? Is he OK?” Mary smiled and calmly said, “He’s just fine! He’s doing great!” Everyone started talking and smiling and taking photos. My husband said he felt a wet tear roll down his cheek and watched it land on my shoulder.

(Mary later told me that the first thing he did after he came out was poop—an indication that he had been stressed—but his APGARs were good… 8 and 9. She also said she really didn’t know why his heart rate was dipping with the last few contractions, but she said it’s possible his umbilical cord was getting pinched somewhere. She said there was only a very subtle indication of distress, but after 30 years of experience she has learned how to recognize those little indicators very early on and how to take swift action to prevent major complications. Thanks to her expertise, everything went beautifully.)

After a couple of moments, my baby boy started making little noises and let out a little cry. When I flipped him over to cradle him in my arms, he peed on me! That’s when I mentally verified that he was, in fact, a boy. Around this time, Cassie commented on the music: “What a perfect song for this moment!” (or something like that). I hadn’t even been paying attention to the music, but then I listened… it was “Calling All Angels” (Jane Siberry/k.d. Lang).

Mary examined my perineum, and I was flooded with relief when she said, “No tears! What a great looking bottom!” I was so incredulous, I had to ask, “I didn’t tear?!” She said, “No! Just a tiny little scratch! Look at that beautiful bottom, Nedra!” I looked at my husband and smiled with every ounce of my being. He smiled right back, “You did it!” Woohoo! Even after pushing fast and hard for less than five minutes!

Mary and Nedra monitored the umbilical cord and helped my husband cut it when it stopped pulsating. Within a few minutes, I pushed out the placenta and Mary checked it and showed it to us. Then we began our first feeding while Mary, Nedra, and Hayley cleaned-up and emptied the pool. While I nursed, I ate a piece of warm buttered bread from the fresh loaf out of the bread machine. Yum!

After we finished nursing, Nedra did the newborn exam and weighed and measured him. He was just the size Mary had predicted at my last prenatal appointment—7 lbs, 8 oz and 19 and ¾” long. My husband put a diaper on him and held him officially for the first time with a huge smile beaming on his face. We took some more photos and thanked the midwives again and again. It had been my fastest (about 4 and a half hours) and easiest birth yet. It was the best and easiest for my husband as well. He was so proud of himself that he never once felt light-headed or queasy, even when he looked at the placenta.Hours later, after Cassie and the midwives had gone home, and we finally went to bed, my husband crashed instantly, and our baby boy slept between us, but I was wide awake and riveted. No doubt the lingering cocktail of birth hormones flooding my system were responsible—adrenaline, endorphins, oxytocin, prolactin, etc. Instead of sleeping, I spent the night watching every movement, listening to every breath, memorizing the shape of every feature on my little sleeping son’s face. With every moment that passed, I fell further and further in love with him. And the more I hold him, gaze at him, and feed him, the deeper that love grows. I don’t know if I’ve ever been so happy.