From midwife, Pamela Hines-Powell.  Note:  this is a BIRTH slideshow so it contains images of birth.

One of my favorite new blogs, Academic OB/GYN, has an interesting post up called Ten Thoughts on VBAC. I encourage you to read the entire post and comment thread. I was especially interested in #7 and #10, which said:

The single most important thing we can do to deal with VBAC issues is to not have them at all, by avoiding the first cesarean section. Many cesareans are absolutely necessary, but when possible we should achieve vaginal deliveries. I’m willing to push some grey cases that others might deliver by cesarean. Sometimes that means being more patients with a slow labor. Sometimes that means operative vaginal delivery. Because of that, more of my patients will have easy multiparous second labors rather than having to worry about VBAC issues. There is a receiver operator curve for cesarean necessity. Most OBs should push their needle a little towards “specificity”.

Here is my reply:

Thanks for a thoughtful post on a controversial issue.

When I selected an article on VBAC for our medical school ob/gyn interest group journal club, our faculty sponsor said we shouldn’t even waste our time, since no one is doing them any more. That is certainly true for our area, where most practices and hospitals refuse to allow trial of labor attempts for VBACs. We are hardly rural. I know of an ophthalmologist who had to hire a concierge obstetrician and pay $10,000 up front to get any obsterician to attend her VBAC. She had one prior successful spontaneous vaginal delivery and a cesarean for twins. Practice patterns are obviously not the same everywhere, especially when it comes to obstetrics. She had her cesarean in another part of the country, and was assured by her obstetrician that she would be a fine candidate for a future VBAC attempt. If she hadn’t moved, it probably wouldn’t have been an issue.

I have another local friend whose physician refused to attend a VBAC attempt she requested (her prior pregnancy ended in preeclampsia, a failed induction and a cesarean at full term). When she showed up a few days before her scheduled cesarean in spontaneous labor, they sectioned her anyway, even though an article in that month’s Green Journal found that emergent cesarean after onset of labor to be the most expensive choice in their study of VBAC with the worst maternal and fetal morbidity. Why not let her attempt the trial of labor, especially since she expressly asked to be able to do so, and prominent medical opinion found it to be not only a reasonable choice, but an easily defensible one?

And, the area primary cesarean rate, which is above 45% in most hospitals, means that less of our primips are “successful” at an attempted vaginal delivery (I put “success” in quotes because I think a safe delivery, even if by cesarean section, is still “successful”) than even the conservative estimates you quote as “success” rates for VBAC attempts in the original post in point #7. (I have usually read of a “success” rate of about 75% in several articles, but outcomes vary.)

But, ACOG’s Practice Bulletin on VBAC says women who are good candidates should be offered a trial of labor. And, practice patterns vary in different parts of the country, and many physicians and hospitals still offer VBACs, and the current literature seems to consider it to be a reasonable option and continues to publish articles on VBAC. But, when I did a history on a woman switching care to a midwife in her third trimester, she said her doctor told her he’d refer her to a psychiatrist before he’d let her attempt a VBAC. So, there’s obviously a wide range in opinions on how to interpret the risks.

This article on explaining obstetrical risk by Lyerly et al is one of my favorite articles I have read on the topic. It states that “Although rates of delivery-related perinatal death are indistinguishable between VBAC and primary vaginal delivery, there is a genuine differential in the rate of uterine rupture–related hypoxicischemic encephalopathy. Such perinatal morbidity is indeed devastating. It is also extremely rare. In a recent large prospective study, the probability of this outcome was 0.00046 in infants whose mothers underwent a VBAC trial at term compared with no cases in infants whose mothers underwent repeat cesarean delivery.” (Emphasis mine)

I think that indicated that there is some validity to the argument that anywhere that it is safe to allow a premip to labor and deliver, it should be safe to allow a good candidate to attempt a VBAC. However, some may disagree about where it is safe to deliver at all. Some may find the risk of a home birth not only acceptable but preferable to a medicalized birth experience. Others may only be comfortable with a delivery at a facility with on site 24 hour anesthesia and obstetricians, and a Level IIIC NICU.

I don’t want to paint all obstetricians with one brush, but neither do I want to disregard the possibility that out of hospital births can be safe. Well managed out of hospital births may have risks similar to real obstetrical care in many hospitals, which unfortunately is not always evidence based care optimizing good outcomes. But, women are not always given an unbiased view of true risk, whether it be the risks of a HBAC or the risks of an induced, augmented VBAC attempt or the risks of repeat cesareans. The Lyerly article concludes that “[T]hese tendencies in the perception, communication, and management of risk can lead to care that is neither evidence-based nor patient-centered, often to the detriment of both women and infants” when discussing the way obstetricians present these risks. I think the natural birth community can probably be equally possible of have members on the fringes who would de-emphasize the risks of a home birth VBAC or an unassisted VBAC.

The Citizens for Midwifery blog has so many great posts up today that I can’t pick just one to repeat here!  So, instead, I’ll give you a sneak peek and link them…this is for those of you who are lazy like me and don’t want to take the time to cut/paste.  Enjoy.

Up first is the recent radio program in Massachusetts discussing legislation for creating a Board of Registration of Midwifery.  You can listen to the  and then read comments.   CfM’s Susan Hodges chimes in with a great comment that can be read right at the blog.  She points out that  ACOG is a professional organization accountable only to their members.  Their insistence that hospitals are the safest place for all women to give birth is lacking in scientific evidence.  In fact, research shows that women with normal pregnancies who planned homebirth with a trained midwife are just as safe as those in the hospital AND have lower rates of interventions as well as morbidity for mothers and babies.  To read more, click here.

Next, an update from Grassroots Network concerning Childbirth Connection.  A new resource document called ‘United States Maternity Care Facts and Figures‘ is now available!  To get updates via email from Childbirth Connection, click here and scroll to the bottom of the page.  To read the full post on CfM, click here.

Last, MAMA Campaign update.  If you were unable to attend the webinar on December 3, you can now download it!  Click here to go.  In addition, there are the highlights of MAMA’s work for Certified Professional Midwives this year.  To view the complete post, click here.

So much information, so little time!

Even though the article I am sharing is geared for Canada, the principle applies around the world. There are providers who are well trained in delivering breech babies — is yours one of them? Was this one of the questions you asked as you made your selection process? I find it a little frightening to know that most OB/GYN’s haven’t even been trained to deliver a breech baby in the past decade.  What do they do when one presents as breech?

There are some slightly higher risks of problems if your baby is breech. A breech position is not the optimal way to deliver a baby, however, if baby’s position cannot be changed, make sure your provider can take care of you! Please note the one doctor’s commentary regarding surgical births NOT being as safe as normal births.

Article follows:

I recently wrote this entry for broccoli cupcake. I recently started following her through twitter @broccolicupcake and reached out when she asked for a guest post from a health expert.   Below is how it went down    I hope you enjoy!

Is “poop” a four letter word?

Colonics, Colon Hydrotherapy, Irrigating the Colon, what is it all about?
Guest post by Sarah Moore – Colon Hydrotherapist

I bet everyone has one friend that has had a colonic and they may never know it. Talking about “poop” and constipation is not usually a topic among friends, unless you are a friend of mine. When I have a friend say they have any symptom I ask, “When is the last time you went to the bathroom”? Nine times out of ten it wasn’t that day. Therein lies the problem, constipation is a symptom of, I would say, 95% of all Americans. It can cause headaches, trouble losing weight, back pain, gas, body odor, bad breath, sinus problems, hormone imbalance, depression and the list goes on.

A colonic can be a perfect first step to relief. Instantly after a session you will feel better. Some clients have said, they feel taller, less bloated, have a clearer mind, and a fresher face.

So, how is a colonic beneficial?

Over many years we have been building waste in our colon and it begins to become compacted to the colon wall. When this happens it prevents proper absorption of nutrients from food and vitamins. When we begin to clean the gut we begin to allow our intestines to start absorbing any vitamins we are taking in, we also allow the food we are eating to work for us, (assuming we are eating fruits and veggies).

Examine what medicines you are taking and see how many list constipation as a side effect. Now think about the first time you took one of those? Boom…that’s where it all began. At the time the medication was beneficial (hopefully), but if not followed up with a “corrective” plan, it killed our bad bacteria and our good bacteria, which is there to maintain a healthy intestinal tract and fight off further illness. The uncomfortable feeling of constipation came a long time ago, but we dismiss going only once a day, every other day or once a week, to focus on other issues with our health. At some point it cannot be ignored and you begin to have a symptom from the first paragraph and you realize how many times you visit the toilet is an issue.

You want a colonic, but where do you start?

I would start by asking your chiropractor or wellness physician. I would also ask a friend, you never know who has had one. Set up your budget and how much you have to spend. When you start to call around a few questions are good to ask to get the most benefit for your health and budget.

1. How much is a session? They can range from $65-$90 a session
2. How long am I on the table? You want them to say 45 min to an hour. Unfortunately they might say 35 min and for me that is not enough time, it is like a glorified enema, and I do not want to pay $90 for that. I want the water to work for me.
3. How much water will be used during a session? I use 5 5-gallon tanks of warm filtered water, which allows for usually two large releases and quite a bit of gas. The time question will give you an idea of how much water is being used.
4. See how you feel after talking to them on the phone. Like any personal service; hair, massage, chiropractor, there are a lot of great practitioners but you find the one you are comfortable with and enjoy being around. With a colonic it is no different, you are making an investment in your health and you need to enjoy who is sharing it with you.

What to expect from the appointment. (Warning: We’re being real here.)

All right, they answered all the questions right, you set an appointment and you are ready to go. Maybe you go by yourself, have a friend with you or even bolder your husband/boyfriend (I had my first session with my husband, he’s a keeper) ? to go with you. When you arrive you may be asked to fill out an intake form. Answer what you feel comfortable with, as a therapist their job is to simply irrigate the colon, they are not doctors and are not allowed to diagnosis treat or cure. As a therapist they cannot tell you how backed up you are or how many sessions it will take to get you cleaned out, everyone is different. They can help you figure out on your own how backed up you may be by discussing your lifestyle habits and various factors that may have gotten you to their office. The hydrotherapist is there to introduce you to a very beneficial and awesome procedure and help you walk on this journey to a better you.

When you start the procedure you may be wearing a gown or just asked to remove your pants and place a towel over you as you lay on a massage table. A disposable scope is inserted into the rectum and warm filtered water begins to enter the colon to start to get the “poop” out. One session can yield 5-10 bowel movements. WOW! Yes 5-10. During the session you may want to pick your therapist brain. Ask about your colon, ask how and why she became a therapist, how her first session was. You may not want to talk, but I have found it eases the nerves and also allows you to grow your knowledge of preventative medicine and realize everyone started somewhere.

Once the session has ended the scope will be removed and you will immediately want to sit on the toilet. At this time you will release extra water and possibly a lot more poop, multiple flushes is normal and you may need a little air freshener ?. I recommend when the client feels comfortable, to get dressed, walk around for a second to see if you may have to go again. You want to make sure you do not have any urges on your way home.

Now you have successfully had your first colonic and are certain to feel better.

Now what?

It is good to purchase 3-5 sessions and use them close together. It is also not a bad idea to get on a good probiotic and a multi vitamin. The probiotic will begin to restore the healthy flora and bacteria back into the intestines. This is what maintains a healthy colon and will aid in building your immune system and continue to keep you regular. One session will not solve all problems, but it will be one of the best first steps you can take to get your body back on the right track. As you continue to make positive choices what you put in your mouth is what will dictate how successful you are. Keep working hard, believe in yourself, and see the “You” you want to be, and it will fall into place.

About the Author:
This article was written by guest contributor and Colon Hydrotherapist, Sarah Moore. Sarah is 28 year old wife and mother of two home-birthed all natural kids. She graduated from MTSU where she worked as a personal trainer at Gold’s gym. That is where her passion for health began. When Sarah met her husband her focus shifted from the outside to the inside and correcting her past food, medicine and health choices. She has been a certified colon hydrotherapist for 3 years and finds it harder to change a poopy diaper than give a colonic. Sarah lives in a log cabin in Thompson Station, this is where her home office is and where the magic of colon irrigation takes place. You can learn more about Sarah and Colonics at www.ColonicsWork.com.<!–em>

Believing in yourself. Of all the things in pregnancy and birth that are out of your control, your belief in yourself IS within your control. Cherish this belief, feed it, nourish it, fan the flames… and protect it at all costs. Create in your own mind how your labor and birth will proceed, each step, each process and phase. Talk to the growing life within you and convey your ease and belief in the natural ability of the body to gently birth. Protecting this belief is within your control also:

Choose your provider wisely. If you have to convince your provider of any of your desires for a natural birth, consider finding one already in sync with your ideology.

Avoid horror stories. Everyone loves to tell the story of the traumatic days long birth that ended up with every intervention in the medical books and a surgical birth. There is a time to listen and give your input–this is not the time. Remember that their birth is not your birth. Your last birth is not this current birth. Turn off the TV and media driven portrayal of birth.

Surround yourself with positivity. Birth affirmations, natural and holistic circles or communities, beautiful videos on YouTube of homebirths and VBAC’s, messages from the pioneers of taking birth back (Gloria Lemay, Ina May Gaskins, Polly Perez and more) as well as people in your own community (doulas, midwives, natural childbirth instructors). Create a vision board of belief in yourself. We believe in you–you can, too!

Celebrate your pregnancy. Some of the discomforts in pregnancy can make us forget the amazing blessing it is to carry life within us, to feel those kicks and flutters, to watch our bodies grow and change. We do not need to tell our body to increase fluid volume, or on what day to begin cervical dilation or effacement, but we can celebrate the journey.

Commit. Commit to a healthy lifestyle. Commit to spending time and honoring yourself and your family and new baby by nurturing your positivity. Commit to the birth you desire.

Baby model cuteness!!! Just thought I’d share pictures of some of my favorite baby models! Shirts are for purchase at http://etsy.com/shop/westmama

Born at Home Bodysuit- $15

Owl Shirt- $15

Bird and Tree (organic)-- $18

Bird and Tree-- $15

Last week in the mail I got my “medical” (the word just feels wrong in this context, somehow) records from my pregnancy and birth, courtesy of my midwife. It’s fascinating to read them over now–it’s very Rashoman-like, and now I’m having the weird experience of seeing something that I was so close to from a completely different perspective.

There’s the page with records of all my prenatal visits, giving a month-by-month (and, later, week-by-week) view of weight, size, blood pressure, etc.; that stuff I remember, basically, though it’s interesting to see it all laid out at once like that.

The really interesting part, though, is the labor record–the notes my midwife was making during the night and early morning I was in labor. There’s an entry for virtually every contraction at points, various notes, and recordings of all the Doppler readings (FHT–fetal heart tones): 

“11:50pm FHT 140s Mom side lie–shaking a lot”

“3:00am FHT 136 ‘I’m ready to move my baby’”

“4:45am FHT 144 SROM clr fluid–possible slight mec”

“5:42am FHR @ 90 following cx, but rises immediately”

“7:45am FHT 120-140 Decels not notes in previous 15 contractions”

Some of this I remember, some I don’t; some I remember like a dream or something that happened to someone else and I was told about. 

After that, there’s also a record of all the post-partum visits, from when my midwife returned that night, twelve hours after the birth (“Christina feeling weel + engaged in conversation; pulse 130–very tired; ate indian food; no dizziness”), through to my six-week post-partum visit (“Baby Marcus weight 10#2; excels developmentally”).

Have you read your midwife’s complete records of your pregnancy, labor, and birth? If not, I highly recommend it!

–Christina

http://apps.facebook.com/birthwatch/

How cool is this? An app on Facebook customized to the pregnant woman, with suggestions and tips for reading, providers, tips for comfort, etc!

The BirthWatch app allows you to:

• Share updates on your pregnancy with your friends, along with a visual ticker showing where you are in your pregnancy
• Receive timely emails containing tips and recommendations to prepare for your child’s birth
• You control how frequently updates are posted
• Don’t worry, we’ll keep things quiet in the first trimester if that’s what you want

This application was developed by Kim and Pat James. Kim James is a Lamaze International and ICEA certified childbirth educator and a DONA International certified birth doula who has helped prepare hundreds of parents for childbirth.

BirthWatch application content tends towards the practical and physiological. You won’t find a lot of fluff here, just sound information to help you prepare for the new addition to your family. We built this app because we believe effective parenting is one of the best ways to improve the world, and parenting begins with pregnancy and birth!

Get started by updating us with your due date and preferences on the Settings tab

Here is an example of a typical update that will be shared with your friends and appear on your Wall:

We had a planned home water birth. We had no ultrasounds. I was GBS+ but successfully used natural methods to become GBS-! It was nearly perfect! We had the baby 2 days after her “due” (guess) date…

(Please use your BOP…)

We were lazy on Sunday and watched a lot of TV. Paul (hubby) said he felt bad about being so lazy. I told him we were resting up for the baby. Little did I know it would be today. I wasn’t at all nervous about the birth itself (though I had been early on, before HB!) but was anxious to meet her and get the pregnancy part over with. I thought today may be the day but I really wasn’t sure. When we finally decided to go out to finish the horses’ fence (I was just keeping my husband, Paul, company), I went to the bathroom and there was a tiny bit of mucus plug. I also had some fluid leaking on the way to the bathroom on a previous trip, just a very little bit. I  told Paul that today may be the day, but I don’t think he believed me. He went on with the fence project plans as usual. I called my mom, then Marlene, our midwife, and I told them I had slight cramps w/ pressure waves and that today may be the day. I went down to the barn around 2:45 with my stopwatch and pad of paper. Paul thought I was making a “to-do” list. I told him I was timing PW’s.

When I started timing them, they were consistently 5 min. apart and 45 sec. long! I timed maybe 2-3 of them in a row. They felt like mild menstrual cramps. Then suddenly, they were 3 min apart and 60 sec. long and getting stronger, though still pretty comfortable. I could still continue on with what I was doing easily. I told Paul that I was going to go start setting up the birthing supplies. We had everything ready, just not set out and we still had to blow up and fill the pool, which meant connecting the pool hose to the faucet in the shower, etc. I wanted to start my Hypnobabies relaxation so I would be nice and relaxed for the birth. Within a few minutes, Paul was up from the barn and was starting to help get things ready. He wanted to take a shower! I told him there was no time for that but he didn’t think I was serious. I guess, because I didn’t look like a typical woman in labor, as portrayed on TV and he thought it would still be several hours. He took a quick shower then started getting the birth pool ready. I decided to start listening to my HB CD’s. I went upstairs to sit on my birthing ball and listen to my relaxation tracks while he got the pool ready. I started on the Fear Clearing Session, but after remembering all I had to get ready, I quit, knowing it was progressing very quickly and that there wasn’t much time. I couldn’t concentrate because of all that still had to be done. I decided to listen after we got things ready. So, I came back downstairs and he had the pool almost full! I did put my HB on in the background, Easy First Stage. Waves were getting very intense! Paul was hanging the Christmas lights for nighttime birthing and joking around. I was in no mood for joking and I was thinking, “we’re not going to need those lights” but I didn’t say anything. He was so relaxed and helpful, I didn’t want to ruin the mood. I was lying on the bed trying to relax through the waves but they were getting so strong and close together that I had to quit helping get the supplies set up. He disappeared upstairs and I had a few more pressure waves and decided after this last one, that’s it! I have to get in the pool! When Paul came back downstairs a few minutes later, he was surprised to find me in the pool, not thinking it was time yet. I asked him to call my mom and tell her I was definitely in labor and that she should come soon. I don’t think I made it clear how close I thought it would be! (Of course, I wasn’t SURE how long it would take, so I was second-guessing myself). I must have been much more calm on the outside than I felt on the inside because I had to yell a few times for him to come back down again when I felt definite pushing during a pressure wave! He had been straightening up for our birth team and my mom so they would have a place to sleep that night while waiting for the birth and/or afterward. (I thought that was cute!) I got a little scared when the pushing started b/ I didn’t know if it was time yet. Was I dilated? My birth team wasn’t there yet! We thought we may have to catch this baby ourselves. Paul called the midwife and she was about 15-20 minutes away.

I know people have different experiences and sensations during birthing but pushing to me was very intense! To me, I don’t know how anyone could NOT push when a pressure wave came on! I couldn’t NOT do it. So, when the pushing happened, it happened! It felt like dry heaves. My body just took over and I was surprised how powerful my body was! Of course, I had been having practice pressure waves since at least week 20 pretty regularly. I had said that as many as I had, the baby ought to just shoot out! I don’t remember it being that painful, it just scared me a little how my body took over. When the pushing started, I was lying back in the pool. I just stayed in this position b/ it never occurred to me to move. Early on in the pushing, my water broke which, to me sounded like an explosion! Paul was still running around getting things ready or calling the midwife or something because he didn’t know it had broken and I didn’t ask him if he noticed until afterward. He hadn’t. At some point, Holly, the midwife’s apprentice, arrived. She looked shocked when she came in, not expecting us to be so far along. The look on her face was priceless. Marlene arrived soon after and they were busy setting up supplies they might need. I think she suggested I try a different position because I had been pushing for a little while and there was no head coming. (We think I probably pushed for about an hour??). Once I got on my hands and knees, it progressed much more quickly. A few more pushes and the head was crowning. A few pushes later, her head was out. Once her head was out, I was preparing for the same with the shoulders but I think one push and the shoulders were out. Then the rest of her slid out on its own. I thought someone was pulling her out but I found out later that that wasn’t the case. Marlene said “sit back” and when I did, the baby came floating up into my arms. She cried once or twice then opened her eyes and looked around! She latched on and nursed very quickly and was alert and calm. She has been a very quiet baby and many people comment on how quiet and alert she is. I think it has a lot to do with her gentle entry into the world! We estimated her arrival to be 5:45, about 3 hours after the PWs were apparent to me.

I had a brief second of the “ring of fire” when her head was emerging but it quickly faded as her head came out and exerted more pressure. The only sharp what-I-considered “pain” was I could feel myself tearing in the front, but I didn’t care. I just wanted to get the baby out! I didn’t think of changing positions. (I hadn’t done any perineal stretching on the front. All of the literature I had read on it said to stretch toward the back. Where I had stretched, I didn’t tear. However, I didn’t need stitches, fortunately.) Delivering the placenta was a piece of cake.

She is now 9 weeks old and worth it all a million times over! I don’t feel I really got to fully use my HB because of the speed at which the birth progressed. It was hard to get “into the zone” because it happened in such a rush, but obviously, it helped keep me calm, which allowed for a quick, relatively painless (though intense) birth. I recommend it to everyone!

If I could do anything over, (you may want to consider this for your birth) I’d have had a deeper birthing pool (ours was 22″, of course, water was probably about 16″ high). I’d have it at least 6″ higher next time. Would have been able to get into a better position(s), been more boyant, etc. I would have also been doing HB THAT DAY when I first suspected that it would be the day of birthing so I could get into my off switch and center switch better and could practice with them when PWs weren’t intense. I would have also tried the exercise my natural healer gave me for menstrual cramps that works like magic to see if that helped lessen the pressure sensations of the PWs. And, I would have had everything set out weeks in advance, just in case.

More good news: I had symphysis pubis discomfort throughout much of pregnancy but it didn’t bother me at all in labor or delivery!…
I wish all of you the best! It’s been great having you on our “team”. You can do it! Your baby will thank you one day for giving them the best start and being proacitve in their care! Remember to get your baby to a good chiro who is experienced in children. It keeps the nervous system functioning well which makes your baby healthier.

“Wherever and however you intend to give birth, your experience will impact your emotions, your mind, your body, and your spirit for the rest of your life.”  – Ina May Gaskin

With pregnancy, you normally get more than your fair share of questions from people whether they be your friends, family or complete strangers.  A random gentleman just the other day asked me if he could buy me a drink.  Seriously, he was older than my grandpa and smelled like a used gym sock.  I digress, moving right along.

Most people ask when I’m due or if it’s a boy or a girl.  Some people ask me if I’ve picked out a name yet. Occasionally, I get asked what hospital I’m using and who my obstetrician is.  Since I’m choosing to have the baby at home with a midwife, this is where the conversation usually goes one of two ways – the person reacts happily in support or they shoot me a blank stare in pure disbelief at what’s just come from my mouth. I know there’s a lot of confusion surrounding the idea of homebirth and some people think I’m crazy and I’m cool with that.  But, please don’t get me confused with someone who’s going to attempt to “free birth” and I assure you, I’m not going to eat my placenta.  Promise.

So, for those of you who want to know, here are just some reasons why I’m choosing to birth at home.

1.  Pregnant Ladies Like to Eat – And when we’re in labor, it’s no different.  Having a baby is like putting your body through a marathon.  Who wants to run a marathon just on ice chips?  Not me, thanks.  At home, I’ll be encouraged to take in the proper nutrition via real food.

2.  Lean On Me – Support is key.  I mean, come on – I’m having a baby.  Our military hospital has a policy that only allows two people in the room with you during delivery.  I need my friends and family to help me through for reals.

3.  My BFF, the Midwife - Our midwife takes her time during my appointments.  She always makes sure she’s covered all the bases, I don’t feel rushed to get in and out of her office and most importantly – she includes my daughter.  She explains things to my three year old and even lets her be a “helper” in the office.   It’s also comforting to know who exactly is going to be there when I deliver and not just getting seen by whoever is on call at labor & delivery at the time.  Starting at 36 weeks, she will start coming to my house for appointments.  This means, I don’t have to leave the couch.  Holla.

4. No Car Ride – I like riding in a car, but I like laying in bed better.  Riding in a car while having contractions is just not my cup of tea. 

5. My House, My Rules – No worries about hospital policies.  I’ll be able to get in the tub when I want, lay in bed when I want, take a walk when I want, and have visitors when I want.  I don’t even have to worry about wearing those totally un-flattering hospital gowns. 

6. No Pressure – Okay, there will be pressure but not where it doesn’t need to be.  No one is going to try and pressure me into getting pain medications if I’m at home.  Not even a little Tylenol.

7.  Internet Access – This is where it gets crazy.  I can blog live updates during my labor.  Yes, I said during my labor.  Little girl is due in February so keep checking back to follow right along on our special day.  You’re welcome.

Got questions and want answers?  Ask and you shall receive.  Leave a comment and I would love to try and answer them.

Susanna, Kelsey and Heidi

A sweet little girl arrived safely this past weekend. Here pictured is the great birth team I worked with-it’s wonderful to have such helpful assistants that are a joy to work with!

There are many ways to afford a doula..

1.  If you are not yet pregnant, start saving a little now!

2. Most doulas, myself included, ask for a deposit and then will arrange payment options. I ask for a deposit and then accept payments, with the full amount being paid in full by the end of the 37th week of pregnancy.

3.  Put it on your baby registry! Most registries now have a spot for “miscellaneous” or donations… ASK for a doula! Are multiple outfits the baby won’t even wear more important than having a doula for labor and birth, or postpartum?

4.  Let your friends and family know this is something you truly desire. They won’t know if you don’t tell them.

5.  Insurance — I have applied for my provider # to help you file insurance. Not all insurance covers doulas, or the full fee, but it’s worth a try! My capability to file insurance should be here by the beginning of 2010. While we are on the subject of insurance, go to your human resources department and see if doula services are covered. If they aren’t, let them know in writing that you want this service covered!

6.  Barter… do you offer a service that a doula could use?

7.  Determine having a doula is a necessity. In most cases, the cost of a doula is HALF of what an epidural costs.. and a mere fraction of what a surgical birth costs.

Have the birth you desire and deserve! If you have any questions, please email me at beautifulbirths2003@yahoo.com

When writing my 2nd birth story and this last birth story, the most difficult part for me was to figure out where to start… my last two births both had a clear-cut “beginning,” but most of my laboring was done before the “beginning” which is why I can’t really call it an actual beginning. It’s a bit muddling when figuring out how to put it down on paper/computer screen!

For my last birth though… I suppose the real beginning was the day before my third beautiful daughter was born. I had been laboring for several days at this point, but my prodromal labor, while very effective, didn’t interfere with my life much at all – which is what happened with my second daughter’s birth as well. The contractions weren’t difficult or very uncomfortable at all and yet they got me more than halfway dilated before active labor ever began.

Anyhow, back to the day before my daughter – I’ll call her “Little Anne” – was born. I was done. I was more done than a burned Thanksgiving turkey. There was no room in my midsection whatsoever. My ribs were sore from the baby pressing against them constantly and kicking the right side. Every time I had a contraction, the upper part of my uterus felt sore just like my ribs did. The space was maxed-out to the extreme.

I don’t think I’ve ever been *that* done with a pregnancy before. I thought I was done with my other two, but I wasn’t. Not really. Not like I was this time. I honestly, for the first time, doubted that the baby would ever come out. She was just going to stay in there, getting bigger and bigger until I popped a few ribs or needed a c-section or something. I knew that I was about 6-7cms dilated because I checked, but even that didn’t help the feeling in my mind that I would be pregnant forever.

At the same time though, I had the feeling in my body that if I moved too quickly or rode in the car over too many bumps the baby would just fall right out. I knew that feeling… it’s the same way I felt a few hours before the precipitous (fast) birth of my second daughter. So, that evening, I called my midwife to give her some warning. My body felt as though labor was going to start that night or the next day at the same time as my mind was convinced that it would never begin. Ever.

Needless to say, this was very confusing and I probably wasn’t particularly convincing when I called my midwife because I wasn’t completely convinced myself.

We went out fairly late that night to pick up some good Chinese food and to get a few things from Wal-Mart that we needed before the baby could be born. Then we came home and ate some Chinese food. My husband set up the birth tub and then we went to bed.

I woke up the next morning at 5:24am with a quite strong contraction. I had another one about 8 minutes or so later and decided to get in a nice warm-hot bathtub to see if they calmed down so I could go back to sleep or if they got stronger and closer together in which case, it was probably the real thing.

My husband woke up as I was filling the tub and he helped me keep track of the timing because I really wasn’t able to do much in that area. I would forget the previous time by the time another one would start. The contractions were still not particularly close together or regular (ranging from 5-15 minutes apart), but they were definitely getting stronger and not calming down at all.

At around 6:30am I called my midwife and told her that I was pretty sure the baby was coming. I still wasn’t 100% sure, but by the time she arrived at our house about 15 minutes later, I was definitely in transition and was working through very intense contractions that were just a couple minutes apart.

My mom and my midwife’s assistant arrived not long afterwards. When my mom arrived, I was out of the bathtub because the birth tub was full. I made a stop at the toilet to make sure my bladder was empty and *WHOOSH* my water broke. On the toilet. Perfect! Just like last time I felt stuck on the toilet for a bit – whether because of the contractions or because my legs just wouldn’t work, I don’t remember. I didn’t think I could walk, but my husband helped me and somehow (I don’t remember exactly how) I made it into the birthing tub where I knelt, leaning against the side and held onto my husband’s hands through every contraction.

I didn’t push for very long before the baby’s head crowned. It crowned for what felt like forever, but was really only about 4 minutes. I was able to reach down and feel the baby’s head – complete with hair! – as it crowned. I had to go slowly because it was quite a large little head and I didn’t want to tear, but it was extremely difficult to keep from pushing as hard as possible to finish up my least favorite part – the crowning – ASAP. I tried doing some panting-type breathing that helped to slow things down a lot. When the head finally came out, it only came out part-way because there was a little hand on the little cheek so I had to push an extra time to get the chin out. I had a wonderful short break between pushing the head out and pushing the body out – no crowning sensation anymore!

When the baby’s body came out, at 7:24am, I was able to catch her and bring her up to find out that she was a gorgeous little girl! Not so little either… she weighed 9lbs. 10oz. I still have a hard time believing that I – not quite 5′4″ tall and 110lbs when not pregnant – pushed out a 9.5 lb baby with a nuchal hand! Without tearing. Before I got pregnant last time, I could still fit into a size FOUR (might never be able to again though!). It’s no wonder that I felt there to be no room in my womb – there really wasn’t any!

The rather corpulent placenta came out 9 minutes after Little Anne was born and my husband cut the cord about two hours after that.

I remember my older daughters (2-yo and 4-yo) asking me questions periodically – “Is the baby coming out?” throughout this whole time. They woke up soon after I got in the bath and were very excited about the baby coming! My mom stayed with them and read them books while I was pushing. I think they were more interested in what was going on though. They also wanted to stay in the room. I think my mom suggested going into the living room, but they wanted to see the baby come out.

Before my baby came, I watched birth videos and slide-shows online with both girls so they’d know what was going on and I think that helped a lot. They weren’t worried or scared at all and afterwards they were thrilled to have a brand new baby sister! They both wanted to hold her as soon as possible and my oldest told me that I was very strong and brave to push that baby out!

It’s so amazing to me still that this birth even happened… the baby came out! And she was huge! Still is, actually There’s so much of her to love and she’s the snuggliest, chubbiest little baby ever <3 At least, she's the snuggliest and chubbiest that I've ever had! She's a good little sleeper (whether I'm next to her or not) and she nurses like a champ.

Welcome to our family, little Anne! We're so glad to have you with us!

~B.

One of my facebook “friends” posted her birth pictures on YouTube to help educate people about normal, physiologic birth.  Included are some fabulously detailed crowning pictures.  Thanks Emma for allowing us a peek into your joyous birth.  Enjoy!

*Warning: These are NOT censored and do show a wide open view of a vagina.

Check out this great, midwife-friendly homebirth article on WBUR.org–it’s a quick read, and very nicely done. Apparently it’s the companion piece to today’s Radio Boston piece on midwifery in MA.

–Christina

Have you ever considered becoming a doula or childbirth educator?

Have you wondered what a doula is? How having a doula present at your birth, or for postpartum, is advantageous and beneficial?

Come for some light refreshments and an informal class on what a doula is, what a doula does and does not do, information regarding training as a doula, the benefits of having a doula…followed with Q&A. Handouts provided containing local birth, pregnancy, and newborn resources, as well as national organization program information.

Feb 13, 2010 1pm to 2 pm
RSVP required, as space is limited.
Email: beautifulbirths2003@yahoo.com to reserve your spot

Cost: $5 suggested donation; all proceeds will go to ICAN of Knoxville. ICAN stands for International Cesarean Awareness Network and is a 501c non-profit organization.

Think about It

The always wonderful Dr. Christiane Northrup is asking American women to “Reclaim Your Right to Birth Right,” in a Huffington Post article by the same name. She says:

“As an obstetrician/gynecologist, I have spent the last 30 years educating women about the wisdom of their bodies, including their innate ability to birth normally. Yet our so-called healthcare system, which is a direct reflection of the beliefs of our culture, sees the female body and its processes (like labor) as an accident waiting to happen. Media images of birth as an emergency play right into this. The truth is that labor and birth need not be the emergencies we think they are. And the medicalization of birth actually does more harm than good.”

Appearing as it does on a well-read and fairly mainstream Web site, the more than 400 comments that follow the article are almost as educational as the article itself.

Read the full article and comments at: http://www.huffingtonpost.com/christiane-northrup/c-section-or-natural-birt_b_323422.html

It is with great pleasure and excitement that I am announcing the first ICAN of Knoxville support meeting. ICAN stands for International Cesarean Awareness Network and their website can be found at www.ican-online.org. Knoxville, TN has a local chapter that has just begun and the first support meeting is scheduled for:

Wednesday, January 6th, 2010
6 pm -7 pm
Earth Fare, Turkey Creek location in West Knoxville
Cost: Free

If you have had a cesarean section, are facing one, or just in the beginning stages of planning a pregnancy, we invite you to come to this informative meeting. ICAN is a 501c non-profit organization dedicated to raising awareness regarding surgical births, informing women of their options, providing support, preventing C-sections, working with local providers to ensure a better, safer birth experience, and more.

This first meeting will be an explanation of what ICAN is and does.. and how you can benefit. There will be time for Q&A, along with handouts of information.  Birth providers are also welcome, but should remain observers.

If you are a health provider and are interested in speaking at a future meeting, you may let us know what topic you are interested in speaking about. If anyone wishes to volunteer in any capacity (posting flyers, making copies, donating printer paper.. we welcome this and thank you in advance.

ICAN is run entirely by volunteers, most of whom are busy moms with other jobs. It is a warm and wonderful organization…and look forward to meeting you in person!

Should you have any questions regarding this meeting, please email Icanknoxville@yahoo.com or call Kimberly Sebeck, Chapter Leader of ICAN of Knoxville at (865)705-7734.

Finally have enough time to tell you wonderful hypno moms about Maia’s birth, she’s 7 weeks old now and is amazing everyday.

I’m 43 and Maia is my 5th baby, my other children are 20, 17, 11 and 10.  The first 2 births were in hospital on my back and were manageable but with hindsight, not the wonderful events they should have been.  My third was an unintentional homebirth with my holding DD3’s head in while the midwife ran in the house.  My son’s birth was meant to be a homebirth but we had a flu epidemic that year and there was 1 midwife to come out and assess me and escort me into hospital because there were simply not enough able staff.

Maia’s father is not the father of my other children so she was a bit of an unknown quantity as far as my pregnancy went and therefore also the labour.  I had horrendous morning sickness for the first time and was not impressed.. Horrible PSD that got me a few appointments with the physio but not much relief.. and of course I am so much older than I was for the last birth with a new father to boot! He took some persuading but once I had shown him the stats for poor hospital experiences and had him read some of the horror stories, he came round to my way of thinking and we started to plan a homebirth with a birthing pool.

We would still have to use an NHS midwife because we couldn’t afford an ndependant midwife but I managed to come up with the next best thing.  My son has a friend in his class, who’s mother had not long qualified as a midwife and I phoned her to ask if she would be my midwife and she said yes, brilliant!!! All my ante natals were done in my own home, none of these rushed affairs in a sterile office

My guess date was 16th October and we had a 3D scan done because Daddy was working away and couldn’t be here for either of the others, it’s so weird seeing your baby as a black and white photo before she’s born.

I have asymptomatically high BP and we had a few dodgy ante natals when the results were a little high for comfort but then I’d use my hypnobabies techniques and would get it right down, once I got it so low Paula, my midwife, was panicking about it being TOO low lol. I did, however, end up in hospital once for an hour for continous monitoring because it wouldn’t come down but I just worked harder on my hypnobabies from then because I was determined to keep my home water birth.

Maia got into head down position when she was meant to but was really active and when I worked out which bit was which I realised she was posterior, my placenta was anterior and it turned out that her cord was quite short so all my attempts to turn her were in vain. I admit to worrying myself about back labour and  panicked when I read ‘let birth be born again’ by Jean Sutton.  Paula started to refuse to discuss the baby’s position with me, I could tell from my shape that all my pelvic tilts were having no effect.  I borrowed a Rebozo but didn’t get round to trying it.

I’m self employed as a driving instructor and finished working 2 weeks before Maia was born, by that time I was using my hypnobabies to help me sleep and to keep my BP down, the pregnancy affirmations was my favourite.  I never got round to doing a fear release until I was in labour but I knew that transition was the thing I was most concerned about.  I should tell you that I’d had no pain relief with any of my other births and fully expected to manage this birth in the same way but I always found transition so intense.  Added to that, I’d read somewhere older women labour for longer too, hypnobabies HAD to help me.

So we got to 14th and bearing in mind Maia’s position and how posterior babies ‘usually’ go past guess dates, I was mildly surprised to see a tiny bit of the plug on the toilet tissue just before going to bed, I never did get into the habit of doing finger drops on those midnight runs…

Thursday 15th, my waters broke at 11am, just little dribbles when I moved about but no waves, I texted Paula to let her know and of course she wanted to be kept informed of any developements but said she’d come down later anyway to check my BP.  She came down at 1pm, still no waves and my BP was fine but now we have a time limit, she told me current protocols are 24 hours but we both knew I’d be doing my own monitoring if we went past 24 hours.

The pressure waves finally started a couple of hours later but were intermittent and more than manageable. I did my first fear clearing session and the birth day affirmations, and I think I listened to Deepening too. Paula came back at 4 and checked my BP and temperature again, both were fine but she said that she would have to let the hospital know what was going on and they would expect to see me at 11 the following morning.  She left telling me to take it easy to keep my BP down but to do what I could to get the PW’s going.  I have to tell you that I was up and down our stairs more than I had been my whole pregnancy that evening, it worked to keep them going but would peter away when I stopped, needless to say I was fairly breathless.

My OH and my 2 youngest had a walk around to my dad’s at about 7pm and by now I was having to stop walking and concentrate between each PW, still not anything other than pressure and tightening. I’d been rocking on all fours when I was on the phone to a friend and although I couldn’t talk to her when I had a PW, I found that if I pushed my hips as far forward as I could, I could almost feel nothing!!!

We got home about 9pm and started baking brownies and cookies, as much to distract the kids as anything, and although I didn’t help out, I was now it established labour and phoned Paula to tell her that.  The PW were still around 10 mins apart but were lasting for more than a minute.
Once the baking was done, I got in the bath to help relax me and to pass the time, the kids came in to say good night at 1130 and I put on birth day affirmations again I think, it’s 50 mins long whichever 1 it was, then I resumed getting through each of the Pw’s pushing my hips forward, yes I was lying on my front in the bath and it was all working great!!  My OH came in a couple of times and he took the only photos on Maia when she was still ‘Bunny’, so we have to look at my naked ass when looking at photo’s of my bump lol, not nice BTW!! I was using nipple stimulation to keep the PW’s going as I felt they were still not that well established.

So now it’s nearly 1am and I decide I’d better get out of the bath, no idea how close the PW’s are, but I do know that I have no problem dealing with them or using hypnobabies to deal with them.  However, as I stand to get out of the bath, my concentration slips and I have 3 PW’s one after the other, no pain but now I realise we have very little time and the birth pool hasn’t been filled yet!!

I shout at OH to get my phone so I can get Paula’s number for him to call, ‘how far apart are your contractions?’ he asks, so much for keeping to the script…. ‘every minute’ I reply not wanting to panic him or her but in reality they are less than 30 seconds apart. And I shout that we need to get the pool filled NOW!

So I get a tank top on and some underwear to wait her arrival, she lives 2 min drive from me, and with me shouting at OH the kids have disappeared upstairs not really sure what to do with themselves.

The pool took me 45 mins to fill during the rehearsals and Im pretty damn sure that I’m not gonna get in there…but OH has other ideas and blasts water into it, unfortunately he doesn’t put the tap adaptor on tight enough and it blows off, I remember walking into the kitchen and wondering why the ceiling is dripping lol.

Paula arrives about 1.10 and starts to take my BP and tries to take ,my temperature but I have to get on my knees to deal with the PW’s and she loses the thermometer….and now I know I’m in transition, no position is comfortable and I’m starting to moan through each of them.

I still have my undies on and on the other side of the room the birth pool beckons, still not full but sooooo far away I don’t think I’m gonna be able to get in, and now I’m feeling pushy which I tell Paula. So I turn and face the back of the sofa but the cushion slides as I brace for the next PW and I know that I HAVE to get in somehow.  As 1 PW dies away, I make my move and have my undies off and HOP into the birth pool before the next 1 starts.  The uncontrollable urge to push takes over and now I’m loud which feels great but which freaks the kids out so they stay upstairs, we hadn’t made any definate plans about them being in attendance so if this is where they want to be then I’m wasn’t going to force them.

I now gather my wits and know that I have to calm down to breath this baby out, I’d have stitches with each of my other babies and wasn’t looking forward to having them again.  I reached under the water to her head and gave Paula a scare when she saw my finger tips in the dim light and thought they were toes, and she asked OH to get her a mirror so she could see better.  He disappears upstairs to try and get the shaving mirror off the wall and has to be shouted back down as Maia’s head comes out, no ring of fire and the other midwife came in then and I actually said to her that it was nice to see her lol.  She’s the supervisor of midwives at the hospital Paula works at and had put herself on call because there are so few home births in this area and she wasn’t about to miss out!!

1 more push and I lift my baby to the surface and welcomed her to the world, her Daddy was just coming into the lounge as I lifted her up and so he did see her but didn’t catch her which was what we had hoped for.     Within 10 seconds her brother and sisters greeted her and I sat back whilst gazing into the face of our new arrival. She was born at 0145 on her guess date with NO labour in my back, with no problems, with no pain, with no meds in our own home with our own family around us.

We waited till the cord stopped pulsing, Daddy cut it and we used a cord tie made by a doula friend instead of those plastic clamps, yuck. I had tried to lift her out of the water so that Paula could wrap her in in a dry towel because she was very blue but her cord was so short I was struggling to get her to my chest, so no wonder she hadn’t turned!

Within 20 minutes Granny and Gramps had arrived and even my daughter’s boyfriend came back to see Maia, all the while I’m still in the pool!

I had a physiological 3rd stage,  it took an hour and then we went through to my bedroom to be checked for tears and this was the only time that my under carriage was looked at, I had no internals at all as per my birthplan ) I also needed no stitches yay!

Maia weighed 6lbs13oz, my smallest baby and was 50cm long, she’s the apple of all our eyes and even the dog likes her, the smelliest springer spaniel on the planet.

I thoroughly recommend hypnobabies, if only to get you through your pregnancy, if you stay calm and choose to use your ‘tools’ then you will give yourself the best chance of getting the birth you want.

Good luck to all you moms to be, especially Kathy mommyryn, I have followed your situation through all it’s twists and turns and hope you are holding your sweet baby soon.

Sorry this is sooo long but I wanted to make sure I remembered it all

Hugs

Debs xx