Friday, July 26, 2013

The Beautiful Moments of Birth

birth (Photo credit: j.cliss)

Even within the most traumatic of birth experiences, there are joyful moments. I write this list for everyone who, like me, came out of a birth experience feeling less than, and as a reminder that childbirth is not all bad. This is dedicated to my children who made me who I am.

1st birth

Rocking in my grandfather's rocking chair in dark silence moving with the natural rhythm of my body's labor.

Pacing in my grandparent's front yard. Taking in openness. My grandmother's calm reminder that everything was okay after a little admonishment about being outside in the middle of the night (she didn't make me come inside).

Not once did anyone ever mention epidural. (I had meds but nothing that actually took away the pain. It was bad, but also good.)

Lying in the hospital bed in the dark, pain suddenly became bliss as my my body gently nudged my baby out of my body. For once, I was free of all thoughts, including any realization of what was happening. I felt powerful and animal-like with no concept of time or emotion. (The nurse that unfortunately walked in on the scene may have thought I was asleep until she saw my baby's head or maybe I was making noise that caused her to turn on the light. I really wouldn't know:)

My newborn daughter was sat on a pillow on my lap (I was too shaky to hold her). She had been shrieking frantically, but then she latched onto my breast all by herself and was quiet.

A few hours later, I was able to hold her and talk to her.

2nd birth

Alternating between pacing and lying on the floor in an overheated little apartment.

Sitting in the hospital bed drinking grape juice with my toddler daughter at my feet (waiting for a relative to pick her up).

Laughing when my son peed on the nurse attempting to put his first diaper on him.

Finally being left alone to hold my son.

3rd birth

Making love with my husband for closeness and pleasure (Knowing he'd probably have said no if I had told him that I had had contractions all afternoon.)

Pacing the floor by myself all night. (I thought about my husband needing to rest, but really wasn't concerned about the marathon I was running in my living room.) I ate yogurt and popsicles. With nobody bothering me or giving me reasons to be concerned, I wasn't feeling bothered or concerned.

Drinking tea and my husband feeding me a few bites of chocolate silk pie even though the nurse-midwife said I shouldn't have it.

In the hospital, on hands and knees on the bed while leaning on my husband. I felt my baby moving a lot so I knew she was doing just fine. (She was probably trying to get into a better position for birth, but not much luck.)

Being asked if I wanted an epidural, and honestly being able to say no. I didn't need labor to be faster or painless. I trusted my body even when the nurse-midwife didn't.

Finally, curled up behind my husband, napping between contractions a few minutes at a time. (Unfortunately, this only happened after leaving the hospital against medical advice and the cytotec induced contractions were abnormal and dangerous, but naps are absolutely essential during a long labor. After two nights with labor pain and no sleep, staying awake just to be harassed in the hospital was not an option.)

My husband laying our new little daughter beside me so I could cuddle and nurse her.


Notice that not all of these moments were without pain, but the joy far exceeded any pain.

Many women, like me, don't want constant attention during labor. Gentle support and a few reminders are sometimes all that is necessary.

With my last baby, I drank a lot of fluids and ate a little during labor, and vehemently refused pitocin and pain meds until the last hour (had I known I was that close I could have continued to refuse, but nobody knew or they probably would have said it was too late for an epidural). This was the only birth experience where I didn't vomit and dry heave violently.

I was seriously hoping for that urge to clean house some women speak of having before a baby is born. No such luck. The pacing was far different than the normal walk I might take for nervousness or to think. It was very mindless. (Because I was worn out, the hospital should have insisted I nap (even if it took a small amount of meds) rather than trying to speed things up with meds. Common sense.)

Being out of one's mind is by far the easiest way to cope with the intensity of childbirth.

Everyone is different. Everyone has different preferences and ways of being, which might change as we grow and learn.
Enhanced by Zemanta

Tuesday, July 23, 2013

“Don't be a hero” or Why Natural Childbirth Is Not Masochistic

Tip of 16G Portex Tuohy needle and epidural ca...
Tip of 16G Portex Tuohy needle and epidural catheter tip (Photo credit: Wikipedia)

How many times do you hear the sales pitch for the epidural? “Why be in pain if you don't have to?” “Don't be a hero.”

I'm totally not into pain. I've been known to try to hide under the covers from menstrual cramps and headaches. When I was in elementary school, spanking was still common, and I assure you the fear the paddle inspired was enough to keep me from being purposefully disobedient. No piercings or tattoos for me. By all accounts, I should have been the first one in line for drugs when it came to childbirth. If birth were only physical, I would totally agree that pain medication should be standard, but the reality is that birth is also emotional and even spiritual (or at least a deeply meaningful life event).

Nobody around me cared in the least how my babies were born so long as they were healthy. Still, I just had this sense that childbirth was sacred. My mother, and billions of mothers since humanity began, experienced childbirth without pain medication. My assumption was that unless labor was very long and/or complicated I wouldn't need medication to control the pain. Had I been encouraged to rest in the middle of labor instead of given labor augmenting drugs, I would have almost certainly had three drug-free births even with long labors and two babies in a posterior position.

It is possible for most women to actually enjoy the experience of labor. It's nearly shameful to admit that anything other than actually holding your baby was enjoyable. I'm not ashamed. I enjoyed natural labor (not medically augmented labor) so much more than the numbing epidural. The epidural made me so numb that I couldn't feel my legs for several hours after or even take a deep breath. Granted, when I requested not to be numb with my last child they were able to do that, but it was still bad for me. It calmed both the physical and emotional pain I was experiencing, but it took all positive physical and emotional feeling away too.

Birth is emotional. If you take nothing else away from my musings here, remember that. A woman in labor is often not pleasant to deal with. Doctors and nurses tend to appreciate the epidural because it makes a laboring woman much easier to examine and preform routine procedures on.

If we really care so much about “unnecessary pain” why should needles be standard in childbirth? During my third labor, I complained about the huge needle they stuck in my arm for IV antibiotics. The nurse couldn't believe I was worried about a needle rather than labor. The epidural needle (which I regretfully had twice because of unnatural drug induced pain) was like an electrical shock to my spine.

Hospital birth doctors and midwives are almost always way too quick to recommend induction or augmentation of labor, but don't talk about the pain it will cause because they can always call for an epidural to alleviate the pain, then more pitocin because the epidural slows down labor.

Pain and pleasure are separated by a very fine line. It is a delicate balance. (If this makes no sense to you, ask someone experienced in the kink community, but please don't read 50 Shades of Grey.)

Very very few moms who had a drug-free birth regret the experience, even it wasn't planned that way. A whole lot of moms who experienced medicated births do regret it, even some who planned it that way.
Enhanced by Zemanta

Friday, July 19, 2013

Breastfeeding Is Worth the Work!

English: A baby breastfeeding
English: A baby breastfeeding (Photo credit: Wikipedia)

Sore nipples. Leaky boobs. Breast pumps, pillows, and creams. Days when feeding your baby is all you get done. Hoping that the whole world isn't staring at your chest, especially when you're breastfeeding in public (or among friends and family who aren't used to nursing babies).

So why bother? You've heard that breast is best, but is it just nutritional balance?

It's life balance. You are setting up your baby's whole body for a healthy life. Your body makes exactly what your baby needs and it comes in a nice warm container! It's your time with your baby.

If you have problems or are told by a professional that you can't breastfeed, seek a second opinion. Very few medications and medical conditions actually make breastfeeding unsafe . See Find a Le Leche League leader. Breastfeeding is natural, but it doesn't always come naturally.

A natural birth experience sets you up for breastfeeding success, but many many moms breastfeed just as successfully after surgical or medicated births. Start as soon as possible after birth. If you can hold your baby immediately and postpone routines (immediate assessments can be done with your baby on you or next to you) all the better.

If things go wrong with breastfeeding, you can still keep trying. Even moms who have adopted a baby and not given birth can produce milk so anything is possible if you want to continue.

Don't let anyone tell you to stop sooner than you want to. I personally breastfed my youngest child for two years and have known other moms to nurse longer than that.

For those moms of older kids who didn't get to breastfeed, you did not fail. You are still the mom and can encourage healthy eating habits at any point in your child's life.

Always be supportive of breastfeeding moms. No giving unwanted bottles or pacifiers. No unsupportive advice, and for heavens sake no staring like it's something strange.
Enhanced by Zemanta

Tuesday, July 16, 2013

Your Body Is Beautiful

After Baby Belly
After Baby Belly (Photo credit: tanya_little)

Your Body Is Beautiful

I can't tell you this enough to make sure you believe it. It's up to you to do that. Set aside everything you've seen and look in amazement at your individual body.

The female body is absolutely amazing! Before we are even born ourselves, our bodies are made for creation and the welcoming of new things. Babies are only part of what our bodies are made for. Those who have not had children are no less amazing. There is a constant stream of new ideas and ways of being for us to incubate and give birth to. (Men do this too, but the creative and nurturing energy is primarily feminine. But that is a more spiritual discussion than I'm going for here.)

Our bodies change, usually in fits and starts. Growing up is change enough, but puberty for girls feels really unfair. (What? Bleeding every month? Oh, you gotta be kidding.) A girl's breasts seem to come in only two sizes: “Too noticeable” or “Not noticeable enough.” Sometimes the cycles ebb and flow like a gentle tide, and sometimes it's a tsunami. Eventually, the cycles stop, as they should. The changes continue. We have subtle or less subtle weight gains and/or losses throughout our entire lives. We have a healthy sex life with someone else, or not. We have a healthy sex life with ourself, or not.

Then, there is the body that has gone through childbirth. Some are scarred from a surgical birth. Some have a little stretching. Some vaginas have a straight scar from a cut. Some have a jagged scar from a tear (as strange as this may sound, these tend to actually heal better). The stomach may be striped with stretch marks. The muscles may be stretched apart. It's hard not to be jealous of the rare body that seems to fall right back together, but you can love the body you're in. It's a gift for a short time, and there is no reason to give it anything other than love.

To prove a point, I will tell you about my body. First, there is no reason to be sorry for what I've gone through because my body is amazing. My stomach is flabby and stretch marked. The muscles are separated so that the stomach can never be flat without being cut and sewn back together, and sit-ups can in fact do more damage (I didn't know that either, but it is fact for about 15% of women). My vaginal opening was cut, torn, and stitched. Then, when my youngest child was born, the spot that was cut tore open again. At the time, I couldn't handle the thought of stitches because I had just been through way too much. So years later, a small part of my perineum (the area from the vagina to the rectum) is still open. It can cause discomfort with excess pressure. I have, usually minor, stress incontinence. I could be surgically repaired (even laser resurface the stomach), but even if I had thousands of dollars would I really want to be “fixed” in that way?

I am not broken! I am still whole. I can still make love. My body is still beautiful. Yours is too!

Some days, we feel like the door mat, but let us be the bright welcome sign in the window of life.

Enhanced by Zemanta

Friday, July 12, 2013

Rhythm and Birth

Batuku rhythm model
Batuku rhythm model (Photo credit: Wikipedia)

Rhythm is inherent in the feminine cycle. Some women claim they could set a clock by their period. To them I can only give an envious laugh. I have done much to work with my body using herbs and am more in touch with my body every day, but I still am not in love with my feminine body. I'm hoping to get it figured out before menopause and be able to make that transition as gently as possible.

These body rhythms are essential to a normal birth. Some women's bodies go through labor with a perfect rhythm. They give birth relatively quickly. Again, all I can share with them is an envious laugh. My body went through uncoordinated but painful contractions. Labor was long and exhausting.

Birth is a complex and beautifully orchestrated process. The exact mechanisms that begin labor aren't well known. We know that the baby's placenta as well as the mother's brain release hormones that cause rhythmic uterine contractions.

It's not currently medically possible to give even a remote approximation of natural labor hormones. All that can be done is a continuous IV of synthetic oxytocin (pitocin) which is nothing like the short bursts of oxytocin a laboring woman would naturally produce.

Singing and dancing (or writing or listening to music) are known to contribute to a positive labor experience so I would have to guess that such things encourage healthy rhythm. Also, going outdoors (even birthing outdoors or near an open window) gets you more in touch with natural rhythms.
Enhanced by Zemanta

Tuesday, July 9, 2013

How to Deal With Long Labors

Past Childbirth Scene
Past Childbirth Scene (Photo credit: nep)

First and foremost, any form of labor augmentation (medical, herbal...) is cruel punishment for an exhausted mom. If mom is exhausted, activities that stimulate labor, such as walking or nipple stimulation (or sexual activity other than gentle touching), are also inappropriate. Having been in that situation three times, I have an excess of authority to declare that. Add to that adequate medical evidence to prove that speeding up a slow labor is not the best standard of care.

A long labor is defined differently in different contexts. Generally 24 hours of labor is considered very normal for a first time mom. Progress is frequently defined by how much cervical dilation occurs in a given amount of time. It's accepted that future babies “should” come faster. Given a calm, patient birth attendant and adequate support, laboring longer isn't a problem. It becomes an issue when a nurse, doctor, or midwife insists that it is an issue. If the amniotic sac is broken the risk of infection is greater (a good reason to not break it artificially), but that situation doesn't usually become life-threatening unless mom is running a fever. Medical problems occur when the mom is not allowed to rest, becomes dehydrated, and ultimately will spill protein in the urine and suffer acidosis. Labor could stop altogether at a late stage, and that can be serious.

Long labors have a lot of causes. Sometimes it is a malpositioned baby. Many times it is stress filled emotions. Sometimes it is a combination of factors. It is rare to have an actual case of obstructed labor where the baby physiologically cannot descend and a trained midwife can rule this out.

So what should be done? Ensure the mother's comfort. Hydration and nutrition are essential. Anybody will crash if they try to run a marathon without eating and drinking lots of fluids. Emotional issues may need to be let go of. Encourage mom not to fight contractions.

Now the biggest key: Rest! Mom should have private time by herself or with her partner. No harsh lighting. No noise unless mom wants soothing music.

Sleep is like a reset button for an uncoordinated labor that isn't progressing well. Hops tincture is a recommended midwifery remedy, but anything gentle that helps mom sleep without leaving her groggy later is good (a shot of wine is okay). In hospitals, an old medical standard of care was to give a small amount of morphine through the IV to ensure complete relaxation (This would have to be safer and less traumatic than hours of hard pitocin induced contractions and an epidural). When mom wakes up, her labor pattern will almost always be normal and she can go on to birth without complication.

Enhanced by Zemanta

Friday, July 5, 2013

Pitocin and the Evils of “Speeding Things Up” During Labor

Baby boy after birth
Baby boy after birth (Photo credit: Wikipedia)

First, I must add this caveat: Pitocin (synthetic oxytocin) can be life-saving if a woman is hemorrhaging after birth. An induction of labor can allow a healthy vaginal birth where complications make it dangerous or deadly to wait for labor to begin naturally.

Within the framework of my personal experiences, there is no room at all within my personal body for drugs to speed up childbirth. For myself, I would rather have a c-section in case of complications. I absolutely understand and respect moms who would make a different choice, but I feel that as part of informed consent there should be an offered choice between a c-section and induction. Why?

Any drugs to induce or augment labor throw everything out the window in terms of natural childbirth. They not only intensify contractions, but can totally obliterate that all important space inbetween contractions. With an unnatural forced labor there is no way for the body to keep up production of natural pain killers or any other natural reaction (and we don't know everything that the body produces in reaction to labor).

To put this in human terms, for me it was the difference between feeling like moving around and generally being an active participant in the birth process and curling up in a ball of pain too horrible for any sort of screaming or thrashing. I vomited and dry heaved violently and had to be given medication to stop it, leaving me sedated and even less capable of coping. Not everyone reacts so badly, but these are all known risks.

What I didn't really know then was that I was put at risk of hemorrhaging and other horrific deaths. Even worse, my babies were being put at risk of dying or being brain damaged.

ACOG: Study Finds Adverse Effects of Pitocin in Newborns

With my last baby I absolutely refused pitocin, but I had PROM (water broke before an active labor pattern) and the CNM (a hospital midwife who was not adhering to the midwifery standard of care) kept insisting that progress needed to be faster. After epic arguments, I, defeated and exhausted, took two doses of a drug called cytotec. I was given no info on the risks. When it finally worked, contractions were shooting pains from my scalp to my toes. I thought my back was going to break apart (posterior baby) and eventually I felt odd ripping/cutting and stinging sensations inside my lower abdomen. This was a possible small uterine tear (only a rupture with blood loss or fetal distress would be detectable).

Finally, here's what you won't hear from a doctor or pharmacist. There are emotional side effects. For me, natural labor was a balance between “sh** this f******* hurts” and “my body is amazing.” Once pitocin or cytotec took over, there was no amazement. I no longer connected what I was experiencing to the fact that I was about to meet my child. When it was finally over, I couldn't feel joy. I could care for my babies, but I wasn't excited or happy. I was angry at everyone (except my children). Something was just dead wrong inside. I felt like something inside me was missing, but there was nothing I could do except focus on my baby. The first few days of breastfeeding were difficult. It was like the colostrum (premilk) wasn't flowing (an affect of hormones unbalanced).

Granted, most women won't have quite as bad an experience, but please be aware of the physical and emotional risks of this form of tampering with labor.

Enhanced by Zemanta

Monday, July 1, 2013

Healing Birth Trauma

The Genil river, near its birth, Sierra Nevada...
The Genil river, near its birth, Sierra Nevada, Granada Province, Spain (Photo credit: Wikipedia)

Part of my journey in becoming a midwife is healing from my own traumatic birth experiences. I have come to accept the deep anger and sadness that come with what many people are calling “birth rape.” Some people feel that calling any birth experience, no matter how violent, “rape” diminishes victims of a violent sexual crime. I think that there just isn't a word to adequately describe the crime of forcing unwanted interference on a woman during childbirth. I was coerced with lies, touched with hands and needles, and even cut (into my vagina) against my wishes. Make no mistake, it should be criminal.

I believe we have incredible creative power in life. We are not mere victims of chance. My experiences were part what my society has created collectively and part what I had created. I had a very negative attitude towards birth, especially hospital birth. I had irrational thoughts about the intentions of the hospital staff. I didn't welcome the support that was available to me (My mom wanted to be there, but I didn't want her help. I irrationally and incorrectly assumed she would only encourage me to be obedient to hospital routines.)

If you too have been disappointed or traumatized by a birth experience, your feelings are valid. Anger, guilt, and sadness are normal. It's okay to feel like you lost or missed out on something special. Acknowledging those feelings is an important part of healing. Know too that you are not alone. Other women have been there.

Find the support you weren't given during childbirth. Be as gentle with yourself as possible. You are in charge of every moment from now on. It's important that you don't let the negativity cloud your life, but that doesn't mean you forget or stop talking about what went wrong. It's important that we hear about what happened so it doesn't keep happening. There is much to learn from positive stories, but there is something to be learned from negative stories too. Some people may not want to listen, but others will hear you.

Enhanced by Zemanta