Birth: YOU can do it!

I screamed my head off during The Informant’s birth. From the minute labor got painful I shrieked, I cried, I yelled.

I can’t believe she’s 8.5yo!

Nobody did anything. I mean, the midwives and doula did stuff, but nobody had the baby for me, which was my subconscious goal. I, who enjoy being waited on hand on foot, did not like that labor and birth. I felt all alone despite the four people with me.

I’ve been thinking about birth a lot as one of my best friends is due soon. Also, as I’m starting my path to becoming a nurse. I don’t plan to be a labor/delivery nurse but if that’s a job available and I need a job, I’ll happily do it.

I was silent — and miserable — during My Masterpiece’s birth. I knew I could do it. I knew I had to do it. I knew nobody else could do it for me. But, man, I wished someone else could do it for me. I was very proud of myself — and shocked — when I had her in a bathtub in our Arizona home.

She’s actually nursing while I type this.

With Cousin It I knew what I had to do and when I was in labor I didn’t bother calling anyone til the very end. Or even waking up My Chemical Romance. (I will forever regret not calling Lora Denton of Lora Denton Photography though. Huge mistake.) Once again, I knew only I could do it but this time I tried… not to hate it so much, if not enjoy it. I was attended by my best friend, another best friend, my family. I asked for what I wanted. The birth went as well as I could imagine! (Except not having Lora there.)

My experiences are hospital birth, birth center birth and home birth but they’re all the same: I had to do it myself. It was scary and painful — and empowering each time.

An aside, I have a friend who lived in Australia during one of her births and she said the labor/delivery nurses there do not let you lay down during labor. Here in the States women are encouraged to stay in bed. It makes them easier to monitor, I guess.

Dear Doulas: Please Get Off Facebook

Yes, this is a huge pet peeve of mine, but I also think it gets into a gray area of HIPAA.

Here’s what HIPAA says (bolded part at the bottom is my emphasis):

Protected Health Information. The Privacy Rule protects all “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information “protected health information (PHI).”¹²

“Individually identifiable health information” is information, including demographic data, that relates to:

• the individual’s past, present or future physical or mental health or condition,
• the provision of health care to the individual, or
• the past, present, or future payment for the provision of health care to the individual,

and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.¹³  Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number).

I do not want to see a status update that you’re at a birth. Or heading out to a birth. I feel a liiiiiiiiittle sketchy reading that you’re just home from a birth — but I will give you the benefit of the doubt. I’ll assume that you asked the client if you could talk about it on Facebook and she gave you her blessing.

I will not give you credit for not mentioning the client’s name because COME ON NOW. Birthy people all know each other, especially in areas where homebirth isn’t legally recognized. If I know that three women are due around the same time, and are having homebirths and I happen to see that two of them recently updated their Facebook statuses and one hasn’t updated in a day or two, or I run into one at the grocery store… it’s just not that hard to figure out where you are and who you’re with.

I’m totally stalking you right now (Flickr: Simply.Jessi)

And yes, I’m a total stalker.

How did I learn to keep births off social media? Oh, you know me: the hard way.

I posted — not on Facebook, this was before Facebook, probably even before MySpace — once about a birth I was at where something REALLY weird happened. Nothing to do with the birth itself, just a weird thing happened. And a midwife saw my post and totally nailed me about sharing private information that was not my place to share. By sharing what had happened at the birth I’d shared the following

1. I was at a birth

2. It was a homebirth

3. This weird thing happened

Most of my doula-Facebook-friends are smarter than me. They do not post that they’re in the middle of a birth and something weird (or totally normal) is happening. But I do occasionally see a status about a great birth or a beautiful laboring mama or something birth-related. STFU, please! I don’t want to know! It’s not my business! (Which seems weird, right? Isn’t everything my business?!?!?) Let the mama post and let me hear it from the horse’s uterus.

Yes, I was at a birth. When “at” means, actively participating (although kind of against my will).

My Current Thoughts on Midwifery

I no longer blindly support homebirth midwives. I have to get that out there. I used to, but now I don’t. I used to put them up on a pedestal and revere them — doing WOMENS WORK, helping other women — but I know now that is not entirely true. Because I’ve seen some midwives who have harmed women.

I saw it years ago, when a homebirth midwife, a CPM who is still licensed and had two apprentices with her, left a pregnant woman whose labor had arrested. In retrospect, the midwife should have transferred her to the hospital for hydration and probably some pitocin. But instead she abandoned her. The mom ended up going to the hospital by ambulance.

My own first homebirth with a CPM did not go very smoothly. First of all, I wasn’t a great candidate for a homebirth, having had absolutely no prenatal care and being morbidly obese. I was probably anemic as well. Still, a CPM took me on and then after My Masterpiece was born I had a retained placenta and a postpartum hemorrhage. I also went to the hospital by ambulance.

my two homebirth babies

Cousin It’s homebirth was excellent — but I had a lot of medical intervention during my pregnancy. I saw a homebirth-friendly obstetrician. Because I’d had weight loss surgery between My Masterpiece and Cousin It, she kept an eye on Cousin It’s growth via several ultrasounds. I also had my labs drawn regularly, and I received iron infusions when my ferritin and hematocrit were dangerously low. (My awesome hematologist was supportive of homebirth.)

I reminded my midwife about my history of having a retained placenta and postpartum hemorrhage and I asked her to be very conservative about blood loss — and liberal with anti-hemorrhagic medications. With her during the birth was another CPM and a nurse. I was in good hands. It was a beautiful homebirth.

Cousin It was safe.

Meanwhile, I hear and read a lot of homebirth horror stories. I saw some scary stuff (to me) during my brief tenure as a CPM apprentice — one of the reasons I stopped was because it felt like too much pressure, having two lives in my hands. I’m not sure I would have ever felt qualified.

That brings me to a second issue: the lack of standards among CPMs. Because they are regulated by state, what’s allowed in one state isn’t allowed in another. What education and experience is necessary in one state isn’t necessary in another.

A great example is Oregon — a midwife in Oregon need not even complete an education in midwifery! And in Texas, midwives can attend breeches, multiples and VBACs; South Carolina midwives cannot attend any of those. What I’m saying is, there probably ARE some good, experienced, well-qualified CPM out there — but you can’t tell that just by the initials behind their names.

And I do not see women encouraged to ask a lot of questions of their homebirth providers, specifically about their experience (or lack of), their education, the circumstances in which they transfer, the back-up plans, or how much experience their apprentices have. It’s almost like questioning a midwife is some sort of red-light that the woman doesn’t TRUST BIRTH implicitly. And not just TRUSTING BIRTH is bad, according to many midwives and homebirthers.

I mean, I trust my driving but that doesn’t mean I don’t wear a seatbelt. I trust Whole Foods Market but that doesn’t mean I don’t cook a chicken thoroughly. Trusting birth blindly is not a point of view with which I agree.

Born at the hospital.

Right now I stand for more strict standards across the board for CPMs. More education and experience requirements, and apprenticeships with multiple midwives, if possible. A national standard so that the term CPM can actually mean something. And more transparency! MANA — the Midwives Alliance of North America — won’t even publicly release their death rates. That is shady.

Would I discourage my daughters — or daughters-in-law — from having a homebirth? No. But I would insist that they understand their midwives limits and experience and education. I do not want them to just TRUST BIRTH.

Stay skeptical, girls!

Update on North Carolina’s Certified Nurse Midwives

It’s been nearly two weeks since Dr. Henry Dorn informed the certified nurse midwives for whom he was providing physician back-up that he could no longer do so. When I wrote about this issue before, I said I didn’t know all the factors — and I still don’t.

I’ve heard that this was “in the works” for months between Dr. Dorn and the North Carolina board of medicine — and yet all of the affected certified nurse midwives were SHOCKED by his announcement email. I speculate that he knew something was happening and didn’t share information with his CNMs until it was official. However, nothing “official” exists yet: according to the North Carolina board of medicine, Dr. Dorn has no sanctions from them; he’s never even had a patient complain on record.

However, they cannot comment on pending complaints or investigations.

Just after Dr. Dorn’s announcement, I saw an email from the North Carolina board of medicine, sent to physicians, asking them to contact the NCBOM with evidence of adverse outcomes from homebirths — but only if it’s public record; no HIPAA violations, kthnxbai! (Note: I saw a picture of the email on Facebook, through a friend-of-a-friend, and I’ve searched in vain for it, but can’t find it right now.)

I haven’t heard of any particular incident that preceded Dr. Dorn’s decision and subsequent notice to the certified nurse midwives he was supervising. He has not made any public statement.

Today I read an article which noted that the Certified Nurse Midwives were given a 75-day “grace period” to continue practicing. Under the proposed law — which isn’t law yet, but is being followed as if a law — certified nurse midwives have 45 days to continue practicing after suddenly losing a supervising physician, while they search “diligently” for a new physician, and then can file for a 30-day extension.

So, this is a small victory for the certified nurse midwives — and more importantly, THEIR CLIENTS — but the problem is that the certified nurse midwife interviewed for the article said that she’d appealed to four obstetricians and had been turned down by all due to malpractice concerns. And I don’t think she’s in the minority; I think most of the certified nurse midwives will have a difficult time finding physician backup because of concerns about litigation.

Thus I bang my head on my parents’ lovely granite kitchen table (I’m on vacation. I’m typing this from my mom’s MacBook Pro. I have no idea how to cut/copy/paste, nor insert photos. Sorry!) Usually, North Carolina is busy insisting that certified professional midwives aren’t competent enough to legally attend homebirths (unlike in South Carolina, Tennessee and Virginia, to name just a few of our fellow southern states where certified professional midwives are legally recognized and allowed to attend homebirths). Nobody debates that a certified nurse midwife is a skilled attendant for homebirths. And yet, because of something that may or may not have happened, within legislation that is decidedly NOT transparent — the law is not very easy to read nor interpret regarding physicians supervising nurse-midwives — a lot of  pregnant women are without a provider come September.

These women may make up a small percentage of all the women who will have babies this year. But they matter. Their rights matter. They are not going to acquiesce on their home birth plans just because they are being strong-armed into a hospital birth — or being somewhat forced have a potentially-dangerous unassisted homebirth — just because their provider’s rights (and thus, their rights) are stripped. There must be a better way.

I hope to update again in the near future with more information.

Loving My Unnatural Birth Experience

Welcome to the June 2012 Carnival of Natural Parenting: Embracing Your Birth Experience

This post was written for inclusion in the monthly Carnival of Natural Parenting hosted by Code Name: Mama and Hobo Mama. This month our participants have written about at least one part of their birth experience that they can hold up and cherish.

***

I’ve written at length about homebirth – my own two homebirths, attending others’ homebirths, supporting homebirths – and so I want to go back and write about my first birth experience. That was Animal and Mineral, in 2003. It was NOT a homebirth. It was in a large teaching hospital, in an Operating Room full of maternity unit staff and NICU staff, and I could have only one person in the room with me (I was single and chose my mom).

Animal and Mineral are monozygotic (“identical”) twins who had Twin-to-Twin Transfusion Syndrome while in utero. I discovered via ultrasound at 18 weeks that I was having twins. A few days after my ultrasound, I received a call from a staff assistant at a high-risk Ob/Gyn office, with information from a doctor who had examined my ultrasound pictures. He had recognized that my twins had TTTS. I was instructed to transfer my care to their clinic immediately so the “twin expert” doc there could monitor my progress.

The doctor I saw suggested bedrest, drinking lots of Ensure or Boost, and a weekly appointment with a non-stress test or biophysical profile every other week to check their statuses. (Or statii. Google seems to have a lot of answers to the question, “What is the plural of status?”)

At a NST or BPP a few weeks before giving birth.

So I did that, from 18 weeks til 34 weeks: I drank my Ensure, I stayed on bedrest, I went to my appointments, I watched TV — this was before DVR and before high-speed internet connections were everywhere; I had dial-up. I worried about Animal and Mineral, although they remained stable every week and the doctor was very positive and encouraging.

I did not want a cesarean section. I was a single mom-to-be, I was going to be a single mom of twins, and I’d heard and read that recovering from a cesarean was painful and challenging. I already had enough challenges. I was not yet as crunchy and natural as I am today but I was practical.

I agreed to an induction of labor at 34 weeks because Mineral was showing signs of Intra-Uterine Growth Restriction, and had had several heart rate decelerations during one of my non-stress tests. My induction began with Cervidal — and was supposed to continue with pitocin the next day — and ended nine hours later when I gave birth to Mineral, and then about ten minutes later to Animal.

A few hours after the Cervidil was started. In eaaaaaaaaaaaarly labor, clearly, since I’m still smiling.

It was not natural. I was in an incredibly UNNATURAL setting: not just the hospital, but the high-risk maternity floor. Not just monitoring but continuous fetal monitoring — and that’s no small feat with two babies to monitor. (See the hand in that picture? It’s my friend Gretchen. She was my doula and she was incredibly helpful.) Not just an epidural but an epidural and a bunch of lidocaine for that my epidural “window,” where the spinal medication didn’t affect me. Not just flat on my back but flat on my back in an Operating Room. Not just full of maternity floor staff but also full of NICU staff, with everyone debating whether or not I needed a cesarean section because Animal was a foot-first breech. (You should have seen the looks on their faces when my water broke and his foot slid out. Priceless.)

I did it! With some random nurse who was probably nice while I was doing it!

I had never considered that giving birth could be an EXPERIENCE; I just thought of it as a means to an end. The boys would go from my uterus to outside my body, hopefully via my vagina. Yet, for me, it was an experience. Emotionally, I was not expecting that. I was shocked by how much I’d enjoyed and loved giving birth. I was surprised by how intensely I felt afterwards when I looked back on what I’d accomplished.

It was by far my least natural birth. Yet the experience was incredibly beautiful. Giving birth showed me I could do something I’d never done before. I could survive physical pain unlike anything I’d experienced before. Even though I was young, even though I was single, even though Animal and Mineral weren’t planned, I achieved something that day that I had never dreamed of before.

Not every woman considers birth an experience, but that’s how it felt to me. And I will always cherish that first experience.

***

Visit Code Name: Mama and Hobo Mama to find out how you can participate in the next Carnival of Natural Parenting!

Please take time to read the submissions by the other carnival participants:

 

• I Had A C-Section. So What! — Jennifer at Hybrid Rasta Mama rewrites her birth story now that she has worked through the feelings of inadequacy and disappointment of not having the “perfect” birth.
• The Perfect Birth — Kellie at Our Mindful Life reflects on how a birth can be far from what we imagined, but still perfect.
• Own Your Birth: My Hope For All Expectant Moms — Andrea at Tales of Goodness shares how she owned her birth spiritually (while navigating it physically) in order to have a joyous experience.
• Carnival of Natural Parenting: My Birth Experience — It wasn’t what Lily at Witch Mom wanted, but it was everything she needed.
• The Painless Natural Homebirth of BabyE — Shannon at GrowingSlower wants women considering natural birth to know painless births are possible.
• Reflections on Jemma’s Birth … 20 Months Later — It took a second pregnancy for That Mama Gretchen to fully embrace her first birth experience.
• Loving My Unnatural Birth Experience — Erika at Cinco de Mommy cherishes her very first birth experience, in all its unnatural glory!
• Be Careful What you Wish for in Birth — Amber at Strocel.com had two births, and it was the one that went to plan that she struggled with embracing.
• Redeeming an unexpected hospital transfer — Lauren at Hobo Mama looks back at her first, interrupted home-turned-hospital birth, and finds the beauty in what happened.
• All of it — Laura from Pug in the Kitchen had to learn to embrace the whole experience of birth even though it meant being naked . . . with an audience.
• Birthing Dreams & Realities — Momma Jorje never had a “dream birth,” but she wouldn’t change a thing about her births.
• Memories of Birth: Calm Amidst the Storm — While neither of her children’s births had been quite what she expected, Cynthia at The Hippie Housewife cherishes one moment in particular from each of her birth experiences.
• Embracing Our Birth Stories — Luschka from Diary of a First Child shares a sensitive post on her recent birth which both did and didn’t go ‘to plan’, and writes about the journey of coming to terms with the good and the bad.
• Two Beautiful Births — Sheila at A Gift Universe remembers how her mother brought out the beauty in each of her children’s births, and tries to do the same with her sons’ birth stories.
• Embracing My Supernatural ChildBirth Experiences… — Jenny at I’m a full-time mummy shares her fond memories on both her supernatural childbirth experiences
• Embracing the Hospital Birth Experience — Jenn at Monkey Butt Junction believes that sometimes a medicated, induced hospital birth is the right choice for a natural parent.
• Carnival: Embracing Your Birth Experience — Stephanie at The Other Baby Blog embraces the birth experience from a paleobiologist’s point of view and takes a look at how humans defy their anatomy.
• Reflections on My First Birth and Preparing for a Second — Abbie at Farmer’s Daughter shares the strength she didn’t realize she had until she gave birth to her son.
• becoming a mama – embracing my birth experience — Meegs at A New Day remembers the birth of her daughter Gwenivere, and the empowered feeling it left her with.
• What About Us? A Poem About Birth — Kat at Loving {Almost} Every Moment shares a poem she wrote about healing from an unexpected and emotionally painful birth experience.
• Be a Man: One Father’s View of Birth — Mandy at Living Peacefully with Children shares her husband’s advice to other fathers and partners.
• A Birth Monologue — Kat at MomeeeZen shares a monologue she wrote during the process of healing from her birth experiences.
• Forgiveness: My Birth Journey — Leah at The Crunchy Farm Baby discusses what happens when her planned homebirth doesn’t end up the way she wanted, and explains her journey of forgiving herself for losing that “perfect” birth.
• Patching together a perfect birth — KrissyFair at Think Mama, Think learned that sometimes a perfect birth happens in pieces.
• Celebrating and Sharing the Possibilities of Perfect Birth — Terri from Child of the Nature Isle joyfully shares details of her perfect births and wishes to inspire a more positive cultural expectation about birth.
• Instinct – Embracing Your Birth Experience — Laura at Laura’s Blog reflects on instinctual moments during and after the births of her two daughters.
• I was Foolisn Then — ANonyMous at Radical Ramblings describes how foolish lack of preparation for childbirth led to a feeling of powerlessness and fear, but that in the end she had her baby in her arms, and that’s one thing she can celebrate.
• Sometimes no plan is the best plan — Tat at Mum in search contemplates that maybe she doesn’t need a birth plan for her upcoming birth.
• Disturbing the peace — Kenna at Million Tiny Things thought she would be a calm, quiet baby-haver. Ha!
• Accepting the Unexpected During Birth — Emily at S.A.H.M i AM imagined herself laboring on a birthing ball but she never imagined where she’d really be most comfortable when the time came…
• Sacred This Time, Too — Kimber at The Single Crunch learned enough to know that the way she birthed wasn’t they way she wanted to; but she also knew to enjoy it for what it was.
• The Birth Partner: A Great Natural Labor Companion — Justine at The Lone Home Ranger thinks that the secret to her pleasant natural labors was having a great support system.
• the Best Thing About My Labor Experience — Crunchy Con Mommy realizes that amidst all the things that seemed to go wrong with her labor, the love and support of her husband was the one thing she could always count on!
• Your Birth Was My Favorite — Dulce de leche describes some of the highlights from each of her four births and explains why despite the differences, they are all her favorites.
• Birth Story: Part One – Moon on a Stick! — Gentle Mama Moon tells the first part of her birth story to share some of the delight of labouring at home.
• Embracing My Birth Experience by Sharing My Birth Story — Dionna at Code Name: Mama made peace with her first birth by sharing the story with her son.
• Focusing on the Beauty of Birth — Julia at A Little Bit of All of It shares the beautiful aspects of her birth center water birth.
• A Joyful Induced Delivery — Amy Willa: Me, Mothering, and Making it All Work notes the meditations and perspective that helped her achieve an unmedicated birth despite being induced for medical reasons.
• Finding Joy in an Imperfect Childbirth Experience — Deb Chitwood at Living Montessori Now tells what she learned from her two very different childbirth experiences.
• What’s to like about a c-section? — Jessica at Crunchy-Chewy Mama is glad she her second child at home, but she also cherishes much about the c-section she had four years earlier.
• What Story Will I Tell? — Rachael at The Variegated Life realizes that the way she tells the story of her second child’s birth matters — and could be exhilarating.
• I Quietly Put My Hopes to Rest E — Erica at ChildOrganics shares her emotional ups and downs with the highly intervened birth of her special needs daughter, Bella.
• Tale of Six Births — Jessica at Instead of Institutions appreciates that unique challenges and joys of each of her births.
• Labouring naturally: nature’s gift — Caroline at stoneageparent describes the most beautiful, spiritual aspect of the labour of her son, the first stages along a bumpy road to giving birth.
• All The Woman I Am. — Lindsay at This Woman’s Work shares a poem about letting go and surrendering during the thralls of labor.
• A twin birth story: embracing the unexpected — Megan at The Boho Mama shares her twin birth experience and how she found the silver lining when faced with preterm labor, premature birth, and a two-week NICU stay.
• Giving Birth With Eminem — Kerry at City Kids Homeschooling shares how fiery rap music contributed to an empowered homebirth with her third baby.
• Two Different Births — Cassie at There’s a Pickle in My Life shares how she learned from her first birth experience and how to trust yourself and your body.
• Embracing Our Potential: Birth as a Metaphor — Sheila at A Living Family expresses how birth has served as a metaphor to help her through other experiences in life.
• Little Sister’s Birth Story: Our VBAC Adventure — Charise at I Thought I Knew Mama describes the recent birth story of her baby girl, her pride in an epidural-free VBAC, and how her story isn’t exactly the birth experience she had planned for.
• A Journey in Birth Confidence — Shannon at The Artful Mama shares her experiences with labor during both of her sons’ births.

 

North Carolina Limits Certified Nurse Midwives

I am not aware of every single detail in regards to this story. I am writing about what I know.

Yesterday I learned that the North Carolina Board of Medicine decided to limit women’s rights by telling Dr. Henry Dorn, obstetrician and homebirth supporter, that he could no longer provide back-up support to certified nurse-midwives who attend homebirths.

Certified nurse-midwives enjoy legal freedom in all 50 states. They are uniquely qualified to provide well-woman care, prenatal and postpartum care, and catch babies. Unlike certified professional midwives, few people debate the qualifications of certified nurse-midwives when it comes to birth. In fact, some people think that certified nurse-midwives are a little too akin to obstetricians when it comes to birth; they are often referred to as “medwives.”

Three or four times during my pregnancy with Cousin It (2010) I saw an obstetrician who practiced with a certified nurse midwife — and who supported my decision to homebirth.

Certified nurse midwives practice under supervision by a doctor; until yesterday, Dr. Henry Dorn supported many of them in North Carolina.

I do not know the incident that preceded this decree. I do not know exactly how many certified nurse-midwives Dr. Henry Dorn was able to support until yesterday, although I know the number is at least five, possibly more. Dr. Dorn’s reach is far and wide across North Carolina. Now these midwives are unable to legally attend homebirths. They are out of jobs. Women seeking legal homebirths have limited — if any — options.

I guess if they live near High Point North Carolina, they can have a homebirth with Dr. Dorn himself. If they live near High Point. If he has room in his practice. If, if, if…

And so women’s rights have been limited, yet again. For those who were planning a homebirth with a certified nurse-midwife under supervision by Dr. Dorn, their options are severely limited: hospital birth, or homebirth with a not-legally-recognized midwife, or unassisted (not attended by any type of healthcare provider) homebirth.

Presumably the North Carolina Board of Medicine wants to force women into hospitals that they deem safer. Yet this is a fallacy. I have had two homebirths and if I’d been told that I couldn’t have a homebirth, I would have had one anyway. Probably under less desirable, less safe circumstances. I would not have gone to the hospital to have a baby.

(41w+ pregnant with Cousin It, in 2010.) Cake or homebirth? I’LL TAKE HOMEBIRTH.

This is the apex of partisan politics: homebirth supporters versus non-homebirth (default: hospital) supporters. Both with lines drawn in the sand. Both refusing to back down. The non- homebirth supporters are bigger and stronger and can make the rules. The homebirth supporters can protest and refuse and fight.

Pregnant women are the ones who lose. Families are the ones who lose, when birth options are taken away and homebirth becomes less transparent. I’d argue this only makes homebirth less safe. I’d argue that hospitals are not going to be filled with those former planned-homebirthers, happily rushing to the maternity wards.

I would NEVER have chosen a hospital birth over this (yes, I gave birth on the toilet. Intentionally.)

I’m shocked because until now, the debate has always been whether or not certified professional midwives were qualified “enough” to attend homebirths safely. The debate was not if certified nurse midwives could attend homebirths. Now there is almost no debate. Hospital birth — or else!

I cannot even imagine what the “or else” is, but I bet we’ll find out soon.

 

A Midwife’s Birth Story

The writer of this beautiful birth story is a midwife. She gave me permission to share it. I thought it was a really unique birth story — she really describes her feelings of being both a midwife (not her own) AND a pregnant woman in labor. Clients will be lucky to have her!

As a childless midwife, you think that when you finally get pregnant and give birth, you’ll be more prepared than most. After all, you’ve seen this journey and you’ve been privileged enough to be allowed to walk with so many during such an amazing moment in time. You imagine that when it’s your turn to carry and birth a child, you’ll be a fabulous testament to the power of women’s bodies. You will be a natural rockgoddess, a shining example of pregnant and birthing fabulocity. Or at least I did. But nothing could prepare me for the intensity of CJ’s birth or the insanity which we call love that could propel me to do it all over again in a heartbeat.

I’d been having mild contractions on and off for weeks, but they were nothing to write home about. It got to the point that I pretty much put them at the back of my mind unless they were strong enough to stop me in my tracks. I’d been having ever-increasing lower abdominal/pelvic pain (which I later found out was caused by a separation of my pubic symphysis) the last trimester as the baby grew bigger. It was so bad, in fact, that getting dressed in the morning was so painful that I’d be in tears at times. So, the day before I went into labor, I woke up and declared aloud that I was DONE!!! I was only 38 weeks and a few days, but I woke up feeling like my body and baby were getting ready for labor and, frankly, I was tired of being in such pain on a daily basis. That night, I took an herbal tincture at regular intervals for a couple hours, had some nice contractions, and inserted some evening primrose oil capsules before bed.

The next morning, I went about my errands and then went to my prenatal appt. While listening to the baby’s heartbeat, my midwife and I immediately noticed his heartrate was slower than usual. Too slow. I turned to my left side. Still slow. Turned on my right. Still slow but picking up. It went back to normal shortly thereafter. Nothing like that had ever happened with him before and I was worried despite my midwife’s reassuring words. I drove home nervously and planned to use my doppler to listen again when I got home. Well, when I got home, I found his heartrate was slow again. With position change, it came back up and was great. An hour later, it was slow yet again and wasn’t increasing with position change. I called my midwife and my husband and we went to the hospital for evaluation. Turns out, my amniotic fluid was low, but baby was otherwise fine. The attending doc recommended I.V. fluids and a repeat ultrasound in 3 hours to see if there was any change. My midwife checked my cervix and told me it was soft and dilated to 2cm. Baby was moving well and his heartrate was normal. A few hours later, the ultrasound revealed my fluid level was back to normal and we were discharged around 2am.

On the way home, I noticed that I was having contractions every 12 min or so but I dismissed it as being due to a full bladder. I couldn’t possibly be in labor yet! After we got home, the contractions began to intensify a bit. I looked at my watch and thought, “Every 5 min? And this increasing pressure? Maybe I just need to go to the bathroom and then they’ll stop.” Because I just COULDN’T be in labor! The house was a mess and I hadn’t gone grocery shopping yet! I called my husband around 2:30am (He’d gone back to the office to wrap up a few things that he’d left when I’d called him frantically to take me to the hospital) and told him to come home so we can get some sleep “just in case I go into labor in the morning”. He came home and we got ready for bed. As soon as he turned the light off, the contractions got STRONG and were every 2 min. So much for sleep. It’s like my body was screaming, “DO YA BELIEVE ME NOW???” and yeah, I finally admitted to myself that I was in “early” labor. At first, I didn’t want to call my midwife because I knew she hadn’t slept much, if at all, either. But the contractions were intense enough that I knew she should be heading over. She arrived in less than half an hour while I was in the shower and proceeded to call the 2nd midwife over as well.

In the bathroom, I was mentally giving myself a pep talk that went kinda like this: “Get a hold of yourself, girlie! Why are you shaking? Cuz shaking comes with transition and you are NOT in transition yet. You’ve got about 12 more hours of this, so you’d better get a grip and hang on. What was that? An epidural? Ain’t no epidurals IN YOUR BATHROOM!!! You can do this. Breathe and hang the fuck on! Do not cry. DO. NOT. CRY.” I cried. Then, I threw up and cried some more. After leaving the bathroom, I asked my midwife to check me. I was 9 and a half centimeters! Holy shitballs! I was totally expecting her to tell me I was 4 – 5cm. Turns out, I was 4cm when she checked me earlier at the hospital! She didn’t want to state that I was 4cm because she knew I wanted a home birth and she knew there was a chance they might’ve wanted to keep me and induce labor.

At this point, I went back into the bathroom to seek refuge from the contractions by standing in the shower and sitting on the toilet. I distinctly remember thinking, “So, THIS is why women get epidurals. I totally get it now…How am I ever going to have the strength to do this again?” After leaving the bathroom, I asked the midwife to break my bag of waters. She was reluctant but she did it after I insisted. I was SO convinced that if she released my waters I would be able to begin pushing within minutes. Apparently, being in hard labor can cloud one’s judgement. Surprise, surprise. Thankfully, I had clear waters, baby had moved down, and his heart rate remained normal. Yay! Now the fun could begin. I wish I could say that the contractions were noticably stronger after releasing my water, but to be honest, I think my brain went into survival mode. I distinctly remember feeling desperation like I’d never felt before. I wanted to reach out and grab onto someone, anyone, to anchor me. My midwife urged me to push and I tried but it hurt so badly. It felt like something inside me was coming apart, like my internal landscape was being restructured with a wrecking ball. I yelled, “I CAN’T!” The two midwives and my husband encouraged me, gave me the old “Yes, you can! You’re doing it! You’re doing such an awesome job!” And I wanted to kick them all. Instead of resorting to violence, I yelled back, “NO, I CAN’T. IT HURTS. SOMETHING’S IN THE WAY!!!”

I was right. I had an anterior cervical lip that had started to swell. My midwife had me blow “horse lips” for what felt like 3 years (really only about 30 min) until, suddenly, the urge to bear down became involuntary. My body was on autopilot. I had to give in and go where my body needed to go. It still hurt a bit to push, but I mentally coached myself, as I had done with so many other moms, to push past that spot. I looked up at our bedroom ceiling and recalled the many women before me who had to dig deep and find the strength to get through what I was currently experiencing. I called on my own mother, who died when I was 11, for strength. “I know you’re up there watching, so you’d better help me, dammit!”, I thought. By this point, I had lost all ability to speak coherently. I was delirious thanks to the oxytocin and the fact that I hadn’t slept all night. Between contractions, I’d fall asleep and actually dream! I pushed with every ounce of strength I had and, after what felt like 8 years, his head began to emerge. Somehow, I had the presence of mind to notice that CJ had an early deceleration of his heart rate as I was pushing and I knew he was moving in the right direction. My midwife brain was still working! In fact, I placed my hand between my legs to guard my lady parts and I birthed his head into my own hands. Without anyone telling me when or how to push, I instinctively waited for him to turn his head and shoulders before finally pushing out his body at 9:26am. My baby was out! All 6lbs 1oz of him!

Welcome to the world, CJ!

One of the midwives lifted Caleb up onto my belly while the other filmed the birth on her iPhone (Thank you, Dale!). Within minutes of his birth, Caleb was able to latch on and nurse successfully. I couldn’t believe he was out. To describe what I felt as happiness would be an understatement. I was beyond ecstatic! By far, giving birth to my son was the hardest and most incredibly amazing accomplishment of my life. As I’ve said to moms many times, giving birth naturally doesn’t make you a better woman or better mother. It’s what you are able to learn from your birth experience, whatever that may be, that does that. I hope that for me the lessons not only serve to make me a good mom, but also a better and more compassionate midwife.

What I Would Tell New Moms

1. It doesn’t matter how you gave birth — you have a baby now.

That may sound surprising for someone who has had two homebirths and advocates strongly for midwifery care, but once the baby is out, it’s kind of a moot point. However, for your sake I hope you didn’t have to have cesarean surgery, or if you did, I hope that the recovery is easy and it doesn’t interrupt your nursing relationship.

2. You need more clothes and diapers than you think — but less of the other stuff.

Things I found essential include a My Breast Friend, a Miracle Blanket, a Moby wrap carrier and nipple shells to protect your nipples from anything touching them… and that’s about it. I had two My Breast Friends, one for upstairs and one for downstairs. Newborn babies poop and spit up a lot, though, and I’ve always been shocked at how much laundry I do each day. So get some extra clothes.

3. Nursing can be very challenging — but gets better after a while.

I’ve been lucky enough to have two really good experiences with nursing, but my first three kids were barely breastfed at all. I regret that tremendously. I wish I’d been armed with more knowledge than I have breasts and they have mouths. There’s a lot more to it than that! I wish I’d been more supported by family members, and I’d been more confident — or even insistent — in my decision to breastfeed. Because at 3:00AM when your baby is crying and has been nursing for the last seven hours in a row, it’s easy to think that making a bottle will be okay just this once. And there’s so much SUPPORT for bottle feeding. Dad can help! Mom can rest! Grandma can feed the baby! Mom can get away from the house without baby! Bottle feeding is awesome!

4. Take All the Time That You Need — don’t worry about bouncing back.

Having a baby is a big deal. It takes more than two weeks — or even two months — to get used to it. People seem to expect that a new mom should just bounce back in every way: physically, emotionally, intellectually. But you don’t have to think that way. Having a baby changes your entire life, and puts you in charge of someone else’s life. It’s a big deal. Don’t let anyone make you feel bad if you take months to get used to your new life.

5. Ignore the Advice — Even the well-meaning advice.

Just focus on meeting your baby’s needs. Everyone — including me! — has suggestions on how to make your life easier, better, less stressful and things that worked perfectly for our children (or didn’t work at all, so you should avoid it). Try to tap into your mom intuition. Remember that crying is the only way a baby can communicate with you, and baby truly doesn’t want you to be a sleep deprived, bloody-nippled zombie.

End of the Doula Charlotte era

Just before we left for San Diego, I got a new license plate. A random number-letter combo. I turned in my old license plate, which I’d had since I first registered my car in North Carolina, which said Doula Charlotte. (Not in so many letters — that wouldn’t fit on a license plate.)

Flickr/out of ideas

I haven’t had a doula client in two years. At this point, I don’t plan to take any birth clients. I would/will be there for any of my friends or family, but I am not interested in continuing birth work.

First of all, I have five kids of my own. And I know I’ve been saying this for a while, but five has pushed me over the edge. Four was so much more manageable! Then there’s the availability/cost of childcare for five kids. Availability = anytime, day or night; therefore cost = a lot. It takes a lot to entice someone to answer the phone at 6:00AM and care for five children.

I’m new to this area, and I don’t know the hospitals or care providers. I know there’s a freestanding birth center, and I’ve met a few of the local CNMs. I know one doula/childbirth educator here, and she’s lovely, and I’m sure I could refer people to her and she could find good doulas for them.

"Tiny Doula" (Flickr/Squant)

That’s another thing: there are a lot of doulas here. There were — are — a lot of doulas in Charlotte. Probably more doulas than women who were interested in having a doula. Honestly, I don’t think I bring anything to the table that a woman couldn’t find with another doula. Which is not to say I’m not awesome. I am still awesome! But there are awesome doulas everywhere.

You may, however, have to look for them.

Try to avoid the doula who is a midwife wannabe. Doulas are not junior midwives, nor are they apprentices or midwives-in-training. Try to avoid the doula who demonizes doctors and hospitals. They’re not all evil. They are often necessary — and even if they’re not necessary necessary, if the client feels comfortable with a doctor and having a baby in a hospital, then they’re necessary necessary necessary. Avoid the doula who has an agenda or pushes ideas on you. Also, try to avoid the doula who doesn’t have any suggestions. Although you’re the one who actually has to labor and birth, she is there to help you. (As a doula, it’s a fine balance between offering helpful advice and stepping back when the client has no intention of taking the advice. For example, I had a client who wanted an unmedicated birth and yet chose a practice that had a very high c-s rate. I suggested several times that she switch practices but she was not interested. She did have a medication-free birth, but she also ended up with a lot of interventions, including an episiotomy.)

In my former life — this is actually a Juglet baby!

 

A Season of Jugs

I’m totally typing this from my new iPhone!

I’m really looking forward to visiting Charlotte the Charlotte area this weekend. (I stay at Miss Manners house, which is not actually in Charlotte.) I’m specifically going back for Stitches’ and Nice-Nice’s baby shower/blessing ceremony — and we’re also celebrating our new Jug, who had her baby in January.

Yes, we have a new Jug! She was originally introduced to us last spring by Miss Manners, as they went to school together. She fit right in, and she is moving to Charlotte in June.

She does not have a nickname yet — just like my friend Alia who has been begging for one. The thing is, you can’t make a nickname; a nickname just comes to you.

But I digress — we have a new Jug! And she has a new Juglet. And two Jugs are having babies soon. And Mary F Poppins moved to Portland. And I live in Raleigh.

Jugs has evolved.

There was some concern when I moved away that Jugs would end. I didn’t think it would end, but it has definitely changed. Life moves on, as Mary F Poppins’ mother-in-law said recently. (For the record: unhelpful.)

Soon there will be two new Juglets. Stitches and Nice-Nice will get to experience the absolute freaking insanity joy of having more than one child (something I’ve been enjoying experiencing since nine minutes after Mineral was born, when Animal came into the world, foot first. And it just gets better with each kid. Ha!)

After this trip, my next visit will be after Stitches and Nice-Nice have their babies! They are so lucky to have babies with Jugs nearby, just like I was when Cousin It was born. Jugs came over and cleaned my house and brought me food and held my baby and did dishes and laundry and NURSED MY BABY (it’s doubtful either of them will have that particular need, but just in case, there’s nothing like Jugs’ jugs!)

Our motto has always been “it’s all just ‘I'” — as in, there is no TMI among Jugs — but at this point we could probably trademark a new phrase: “Jugs: Bridging the gap between evolution and creation.”

From the Museum of Creationism (Flickr/williac)

I can’t wait to see my Jugs and celebrate this weekend!