February 25, 1989

On February 24, 1989, a little seven-year-old girl sat in the corner of her parents' bedroom, waiting to see her sister be born. She had been waiting all day. The babysitter had taken her and her siblings away for several hours during the day with assurances that no, the baby would not be here for a while, they would not miss it. The little girl was nervous every minute that she was gone that everybody was wrong and that she WOULD miss it. She had been there for her brother's birth when she was three, but she really didn't remember anything except getting to hold a flashlight. Then another brother had come, but for some reason mommy and daddy had to leave in a van and she had to go with her sister and other brother to someone elses house for the night, and when she got home her brother was already born. All she really remembered of that was being asked whether she ever wet the bed before being settled in with her sister in someone's guest bed for the night. This time, she was not going to miss the birth!
I was not going to miss this one.
But babies like to take their time apparently. All the siblings were going to watch the baby come, but one by one they got sleepy and went off to bed. Just I remained. I was stubborn. More stubborn than my exhaustion. Two hours past bedtime...three... It was near midnight, and I don't remember feeling tired, but mom was tired and decided she was going to get into bed just for a little while. Dad and Grandma both promised me that they would come wake me when the baby was close to coming so that I could still be there. Frustrated and disappointed, I went downstairs and crawled into the hidabed with my sister (our bed having been given to Grandma).
As I snuggled in I realized how tired I really was. I suspect I would have dropped right off to sleep if, within minutes, I had not heard Grandma trying to hurry down the stairs on her arthritic knees "Jenni, come quick!"
I missed the birth. Apparently mom's laying on the waterbed was what it took to entice Amethyst to come earthside. I can't say I really blame her. I was miffed at missing her birth though...and by only five minutes!
Nine months later another sleep-deprived night saw Amy back out of this world. I missed most of that too. But if I missed her entrance and exit, I did not miss the months in between, and Amethyst was--is--a precious jewel in our family. Today would be her 22nd birthday.

my sister Amethyst

My mother has an amethyst necklace. I have long thought that maybe I'd like a piece of jewelry with amethyst myself, but I had never really pursued it because, while I like purple, it's not a color I've usually worn very much. However, my recent work with The Amethyst Network, and subsequent learning about the meanings and attributes of the stone, solidified my desire for a pair of amethyst earrings (I picked earrings because I wear them more than any other type of jewelry). Plus I have two purple shirts now. ☺

I had some Christmas gift money so I started looking around etsy, and found these Amethyst hearts.
They are perfect.

Fulfillment

Jenni is very very grateful to be a mother; for the maturity and patience and laughs that come with parenting my boys, for the opportunity to adopt, for the empowering experience of giving birth, and for the fulfillment of watching my children grow and achieve. 
(My facebook status this morning~I've been posting things I'm grateful for every day leading up to Thanksgiving)

When I was a little girl, my sister and I used to play "baby." Other little girls may have played "house" but we played "baby." We started off by stuffing our dolls up our shirts and being pregnant for a while. Then we'd lay on our beds and give birth (because everyone gives birth laying on their own bed, right?! It's all we'd ever seen!) Then we would nurse our babies, use blankets to make slings to carry them around, change their (cloth) diapers, nurse them some more, and rock them to sleep in our little rocking chairs.
In other words, I have been looking forward to (and practicing) motherhood since I was too small to say the word.

Me with my dolly Polly, next to my mom holding my little sister.
We are 18 months apart, so I would have been about 2 in this photo.
Yes, I'm wearing a cloth diaper.

Through high school and college I looked forward to motherhood. My mother periodically reminded me to enjoy living in the season that I was in--to do what I wanted to do, because soon enough I would have a family to care for, and then it would not be my time anymore, but theirs. I did spend a lot of time focused on the future, but I did spend time on myself as well: I got a college degree and traveled to Europe among other things.
When I got married at 22, a toddler came with the package. (In fact, I started parenting him while we were still engaged--I stayed with him during the days while my then-fiance went to his college classes, rather than my finding a job and then our paying a babysitter.) So I never had that child-free 'newlywed' phase of  marriage. That has never bothered me, because motherhood was always what I wanted anyway, and I didn't mind the head start on it. Sometimes my husband has been saddened by missing that though, I think because he did have that phase with his first marriage, and he knows what we missed. He has expressed from time to time that he looks forward to our empty-nesting stage, when we will finally have time with just us.

Recently we've been talking about our family, and whether we will have more children. We have mixed feelings on this issue right now (and have not made a decision), but the possibility of being done having kids is on the table, and I am struggling with it. Sometimes I feel peace about the idea, but sometimes I feel a gaping hole inside, and I've realized that it's because I identify myself so completely as a 'mother' that I don't know what I will do with myself when that phase is over.
I realize that I have a while (although Wolf is 10!), and I know that I will still be a mother, no matter the age of our children. I know that there is a lot more to life than babies. But still, it's hard to think of letting this phase pass. Perhaps it's because biological motherhood did not come easily and so I treasure it an extra little bit? Perhaps it's because motherhood itself--both the physical processes of pregnancy, birthing, and breastfeeding, and also the emotional processes of raising my boys--fulfill and empower and complete me as nothing else ever has.
I have been thinking about this an extra lot this week, leading up to Eagle's first birthday (today!) and thinking back to his birth day and how it has affected my life. I know there are many ways to feel fulfilled, and I don't know that one is better than another. But I know that my experience of giving birth last year was transformative and climactic for me. I felt tuned-in to nature, to my body, to my soul, to God, to time, and to eternity. I learned to let go and let God, to surrender to the natural cycle of things, and felt all the more powerful for it. That experience has significantly affected and shaped me, my perceptions of life and spirituality, and my way of living. Motherhood in general--and that birth in specific--have made me who and what I am. Is it any wonder then when I say that I find my greatest fulfillment in motherhood?



And, for anyone who missed it last year, I just had to post this again (Happy Birthday Eagle!)

Make an on-line slide show at www.OneTrueMedia.com

(I'll have party/cake pictures to post tomorrow or after the weekend)

What Constitutes "Intervention" in Birth?

I had a really interesting conversation with a friend recently. She and I each had babies at home this last year. I was attended by a midwife, she gave birth unassisted (without a midwife). We were talking about why I chose to have a midwife, and discussing some of the things that happened during Eagle's birth. I mentioned when he became stuck, and my midwife reached out to work him loose. I (and my midwife I think) thought it was shoulder distocia, and thus felt that it was necessary for her to do something. As it turns out it was not shoulder distocia, but just a very short cord, which soon broke on its own and he came on out without assistance.
My friend said something about my midwife's putting her hands on him having been an unnecessary intervention. This raised a very interesting question for me--is having someone else catch the baby an 'intervention'? Sure, the baby doesn't have to be caught--he could slip out into the water or onto the bed (or onto the floor...it happens!) but isn't it gentler to be received into warm hands as he emerges? I suppose it is technically 'intervening' to cut the umbilical cord too, but even wild animals bite the cord to break it after the baby is born, don't they? How about using props for labor? A pool, a birth ball, a birthing stool--are those interventions? I think one could make the argument that something like a birthing stool 'intervenes' because it helps the mother maintain a position that she could probably not hold for long on her own...on the other hand, I don't think anyone would argue that it's a bad intervention. After all, being able to maintain an upright position can speed the progress of labor, and squatting shortens the birth canal which facilitates birth.

The Mother-Friendly Childbirth Initiative defines intervention as any "practices and procedures that are unsupported by scientific evidence." I don't exactly agree with that definition, as I'm more inclined to to agree with the dictionary and define intervention as "interfering with the outcome or course especially of a condition or process (as to prevent harm or improve functioning)." Intervention means interfering with the outcome or process, which obviously can be a bad thing; but sometimes something goes wrong and intervening is necessary, and not all such interventions are "unsupported by scientific evidence," but they are still interventions by definition because they change the condition or process.

So where does one draw the line? What constitutes 'help' (a good intervention) and what constitutes 'interference' (bad intervention)? I had never thought about this from this angle before, but it's a meaty topic. After all, I might see something as interference, but someone else (be it a mother or a provider) might see it as helpful. Take induction for example--I would avoid labor induction in all but the most extreme situations (and being 42weeks pregnant does not constitute an extreme situation in my book), but I know women who feel that they need medical assistance to go into labor. Obviously what I view as interference is an appreciated help in their eyes. On the other side, some women believe that having any birth professional present will interfere with their ability to birth ideally, and others practice lotus birth, and would view my cord cutting as interference. So I don't think it's easy--maybe not even possible--to draw a definitive line.

I believe that interventions--even big interventions such as epidurals or cesarean sections--definitely have a place. I had AROM (artificial rupture of membranes, aka my "water broken") when Bear was born. We discussed it and felt that it was a good idea considering the circumstances at the time. My water broke on its own minutes before Eagle's birth, which was nice, but I certainly don't think it was bad that we chose that intervention for Bear. During my first miscarriage I requested an IV painkiller and subsequently also got pitocin to move things along. I've had D&Cs for miscarriages too. One of my friends has her cervix sewn shut during pregnancy to prevent premature dilation--this is unquestionably an intervention, but it has prevented two of her children from being born dangerously early. Depending on the circumstances, I could imagine choosing any number of interventions for future situations.

In my mind, what separates 'interference' (bad intervention) from 'help' (a good intervention) or even just from the 'normal process' are two things:
First, the risks. Bad interventions have high potential for negative side effects, often outweighing any potential benefit. For example, pulling on the umbilical cord can help get the placenta out faster (though what is the need?), but it can also cause the cord to detach from the placenta, or cause the placenta to break, resulting in retained placenta, which then involves synthetic oxytocin (like pitocin) and/or the provider going in and literally scraping out the uterus. If the risks are substantial, then I view the intervention as an interference.
Second, evaluate what would happen without the intervention. Is this intervention unquestionably helping (improving the health or safety of mother or child?) or is it based on convenience, preferred timing, or lack of patience? Frequently, labor augmentation or cesarean sections are used because of "failure to progress" in labor, but since normal labors can last hours or even days, many natural birthers have begun to refer to this practice as "failure to wait" and consider those interventions unnecessary. Given some time, the vast majority of those "failure to progress" labors would result a vaginal birth (without drugs, and without surgery). On a related topic, many mothers choose induction of labor because they have reached or passed 40 weeks gestation. However I am not aware of any cases of a woman staying pregnant forever, so sooner or later labor will start! Some pregnancies just last 42 or even 43 weeks. 40 weeks is an average--an estimated delivery time--not an expiration date, (and while I appreciate that it is hard to wait, induction of labor is not warranted just because of a calendar date).

Using those two criteria, let me go back and evaluate the initial situation that started this whole thought process: my midwife's putting her hands on Eagle when he stalled in the birth canal.
Were there risks associated with her manipulating him? Possibly, though I believe they were minimal, as she was gentle and her intention was to 'unstick' him rather than to pull him out. What would have happened if she had done nothing? In this case, he still would have come on out. He likely would have broken his cord and been born into daddy's hands--which is what happened anyway. There is a small chance that he might not have broken his cord, and instead might have been born more slowly and brought the placenta with him. It would have meant he would have been underwater (and half-in/half-out) for longer, but so long as the cord is attached there is no danger in remaining underwater. Aside from the potential discomfort to me or stress to him of being wedged in the birth canal for an extended time, I think that nothing of significance would have been different.
Consider, however, if his stalling had been caused by what we thought it was caused by: shoulder distocia. In cases of shoulder distocia the baby is caught on the mother's pelvis, and will not come on out without assistance. If we had left him alone he would have remained stuck, and both he and I might have become quite distressed. At some point (later if not sooner) it would have been necessary for the midwife to reach in and work him loose.
So was she interfering or helping? Technically, her action was not necessary, or at least was not necessary in the timetable in which she acted (she could have waited and watched a bit before deciding to touch the baby). However, it was not harmful or risky. It did not really affect the overall process or outcome of the birthing. Finally, consider that she did not push Hubby aside when she reached over--he moved aside to invite her into the space. We chose and trusted her as our birth assistant, and in that moment he wanted her assistance. So I feel comfortable in designating her action as help rather than interference.

My Beliefs on Birthing Choices

I got some interesting responses when I posted my sister's story. Some I expected ("Those are familiar feelings!") and some not so much. They are all valid points though, so I wanted to take a couple of minutes to share why I shared her story here, and also to respond to my commenters.
First of all, I had pre-scheduled both her post and my response last weekend, and then my computer crashed for a couple of days (whole other story) anyway, I did not see any of the comments until this morning, otherwise I would have responded sooner.

The natural birthing community often spreads stories of 'painless birth' and even 'orgasmic birth.' They tout birth as a beautiful thing. I do believe that the entry of a child into the world is a beautiful event, but I know that not every woman experiences it as beautiful. I've shared my own stories so you probably know that my take is that "birthing is hard work, although it's totally manageable." My sister doesn't fall into either of those categories though--she has given birth in loving, supportive environments, and done everything 'right' as per being able to have peaceful gentle birth (hypno-classes, good support people, etc), and yet she describes her births with words like "difficult" "suffer" and "excruciating."
I shared her story here because I think it is important to share both sides of the natural birth coin--there are people who seem to glide through it, and others who struggle but still choose it because they deeply believe that it is a healthier, safer, better choice.

Now I want to respond to my commenters.
Liz spoke of being a survivor of childhood sexual abuse and rape. She--after careful thought and consultation with her provider--decided that the intensity of birthing sensations in the vaginal area would probably trigger all kinds of horrific emotions for her. She chose epidurals for her births, and I think that sounds like a very wise choice in her situation. I believe in something which BFW refers to as "the compassionate use of epidural" which is essentially that it's not healthy to make medication the default choice, but it's also not healthy to rule it out entirely, because there is a time and a place for it. I think Liz's situation is certainly an appropriate place for the compassionate use of an epidural.
I know a young woman whose first baby died in utero just a few days before her due date. She had planned to birth naturally, but once they learned of the baby's death she then was coping with the intensity of grief on top of the intensity of birthing. She also chose an epidural. I think this was another appropriate and compassionate use of epidural.
Another woman I know has twice tried to birth naturally, and both times had a very long, very painful labor with minimal dilation, and both times has ended up having to transfer to the hospital for a c-section. She is now expecting her third child, and has decided that this time she is going to try laboring with an epidural, to see if the reduction of pain will allow her to relax enough to dilate and give birth vaginally. Again, I see an appropriate use of an epidural.
Where I have a problem with epidurals is when the woman doesn't take the time to consider all the options. When she isn't willing to consider trying. When the intervention becomes the default and no one stops to question it. Liz concluded her comment with this thought: "I shouldn't ever have to justify my reasons for choosing to have an epidural. But I share the reason for my decision because it's a different point of view and might shed some light on the deeply personal experience that is birthing." and she's right. She should not have to justify her reasons to anyone except herself. But there again that is the key--she does have reasons for her choice, it was not just going with the flow or doing what everyone does, it was a carefully-thought-out choice. It's true that it is a deeply personal decision, but I (we) share our stories not so much to condemn as to stimulate critical thought. Because "Birth is not merely a means to an end, it is an event that [is] imprinted on a woman's life forever. The memories of their children's births are among the most vivid memories a woman will ever have."  So these choices should not be made lightly.


I also want to respond to Nicole. As usual, she has some perceptive thoughts to share. Thoughts that may be hard to hear, but which are valid all the same. She thought that the post seemed self-righteous, judgmental, and unkind. "This is exactly the attitude that bothers me about some women who choose to give birth naturally," she wrote. "I've given birth both ways, and I respect other women for whatever they choose to do. My ego or sense of self-worth is simply not based on how I chose to birth my babies." Her comment is a good reminder that no matter how strongly we may feel on a given topic, no matter how confident we are in our own views of the issue, the way we express our message is going to influence people at least as much as the message itself. Yes, I do genuinely believe that it is better to birth without medication. I don't see it as a choice between two equals (just as I feel about breastfeeding vs formula feeding). I do believe that there are valid exceptions to the rule, but that they are few and far between. But we must also remember that, as they say, "presentation is everything."

My Choice

Today I share a guest post from my sister. She has also chosen unmedicated birthing, but her experiences have been quite different from mine. Here she shares some of her thoughts and reflections on her birth choices.

My friend and neighbor had her fourth baby on Tuesday. She was induced one week early and had an epidural, just as she did with her other three kids. She just likes it that way. The whole idea of scheduling a birth, going to the hospital without any labor pains and having a baby a few hours later, just boggles my mind. It is so strange to me that I can’t stop thinking about it. I know that it is very common for women to be induced as well as for women to have epidurals, but this time, with this friend, it bothers me more. What bothers me? It’s hard to say. I have had many conversations with this friend and we agree about many things, but we do not agree on birth methods, and somehow that is a big thing. It is such a big thing that it’s almost as if it drives a wedge in our friendship, distancing us and preventing us from some more complete measure of friendship. This is the case with other friends as well. The opposite is also true. Many times I have learned that a new friend or acquaintance has natural births and immediately there is a connection, a pull toward friendship. There is a feeling of “you have felt it too!” For some reason birthing methods makes a big difference in the strength of understanding and friendship for me, probably because it’s something I am passionate about.

Yet there is something else that bothers me. What is this feeling that I get when I learn of someone’s medicated birth? Is it a feeling of self-rightness, a sense of “I’m right and she’s wrong”? No, I know women have their agency (and I wish more of them would use it instead of letting “health care professionals” make personal decisions for them! But that’s another topic). It’s not right and wrong; it’s just different. Then what is this feeling? Is it jealousy? Am I jealous that she had an easy, pain free experience when giving birth is so difficult for me? Is it that it’s not fair? But I know I have the choice, too. It’s just that I’ve done the research for myself and I know it’s statistically safer to do it naturally without intervention, and that is what I have chosen. Is it self doubt? Do I doubt my choice? I find myself thinking, “am I insane?” Why do I choose to suffer when there is a pain free option? I remind myself of the many reasons, but then I wonder if it’s worth all the fear that I feel. I never want to go through that again, and I think about it every day. Have I really made the right choice?

I watched my friend return home from the hospital today. I felt a great distance between us, despite the close proximity of our physical persons. I do not understand what she just experienced. And she does not understand what I have experienced at the most excruciating, life changing moments of my life. As I see it, she has not experienced the culmination of being a woman. She is choosing to miss it! The birth of my babies will be forever etched in my memory; moments of pain, yes, and also of relief, strength and power. I am a woman. I birth my babies the way God intended it to be. That makes me powerful. I watch my friend walk with her baby to their door. No, I do not comprehend what she just experienced, and I guess I never will.

Notes on Waterbirth

Waterbirths are touted as gentler than 'land births' because the baby emerges from a warm liquid to a warm liquid (rather than cold air). Water is also called 'the natural epidural' because it is so effective at relaxing and comforting the laboring woman. I have come to believe that the lubricative properties of the water help mother to stretch rather than tear, adding yet another aspect of gentleness.

"Waterbirth" by Cary York

Waterbirths have been practiced for years by tribes who routinely birthed in streams or lakes or even the ocean, however much of the western world has been scared to try them, fearing that the baby might drown, or, more especially, that it would be very inconvenient for the provider to try to assist a woman in a tub.
Let me begin by clearing up the 'drowning' myth. The baby has spent 9 months completely surrounded by fluid. He gets all his oxygen through the umbilical cord. So long as that cord is intact, he has no need to breathe air or use his lungs. Most midwives do bring the baby right to the surface of the water, but unless the cord has broken (which is rare), they don't really need to. Eagle's head emerged (underwater), and it was at least a full minute before the rest of him came out. During that time his head remained under water but he was fine because his cord did not break until the last moment, and the midwife brought him promptly to the surface and put him in my arms. He did not cough or sputter or anything. He just took a breath of air and stuck out his tongue at me. ☺
I very much hope to have all future babies in water as well. It was that awesome.

So, with that introduction, I thought I would share a few tips about waterbirthing.

THE POOL
First of all, you'll need a pool. Some women birth in their bathtub--this is ok, but tubs are narrow, and all the tub-birthing moms I've talked to have said that it was not very comfortable because it was just too crowded. Some women have a large jetted tub, or a hot tub to birth in. This works well, although the temperature of the hot tub should be lowered to something close to body temperature. It should be comfortably warm, but not hot. (Think about the temperature you use for a baby's bath, and go with that). The third--and most common--option is to rent or buy a birth pool. Some midwives bring the pool with them (and use disposable liners for each woman), some midwives require the mother to purchase her own pool. In my case, I needed to buy a pool.
There are a number of online stores that cater to waterbirth, and sell pools and accessories. There are several companies that manufacture pools specifically designed for birthing--they are large and have high sides. Some even have handles for the mother to hold on to, or a raised seat at one end (see below left). These official birth pools cost anywhere from $125-$450. Alternately, many mothers buy "fishy pools" which are regular inflatable wading pools that are relatively deep (though not quite as deep as the birth pools). The waterbirth stores carry these as well, and they usually cost $25-40. One downside is that pools are heavy, so in my case I picked out a $30 pool but then found that shipping was going to be another $25! A lot of people buy fishy pools from a local store, but that option was not available to me (especially in November!). I mentioned the dilemma to Hubby and he suggested I try amazon and their free shipping. Sure enough, I found the pool on the right for $38 and free shipping (photo is linked to the listing). I actually really liked the star shape, as it provided both flat spaces and 'corners' that I could lean into. It also has a padded floor, which most of the fishy pools do not. I highly recommend it as a birth pool!

One thing to keep in mind--many women want a larger pool so that daddy can get in the pool too, however if you get a pool that holds more than about 100 gallons, you may run out your hot water heater while filling it. So plan ahead and order something that will work with your space, your budget, and your water heater! (My pool held about 90 gallons and fit us both just fine, though it would have been nice to have about 4 more inches of water, Hubby used a pan to pour water over my back during contractions and it was fine.)


ACCESSORIES

• You will need a hose for filling your pool, and an adapter for attaching the hose to your sink faucet or shower head. The adapters cost just a few dollars, but the hose will be a little more. Some women are comfortable using a regular garden hose, but many prefer to buy a medical-grade (lead-free) hose from one of the waterbirth sites.
• It's worth investing in a good size pump for inflating the pool--a manual one is fine (if it's big) or an electric one might be nice if you have an especially big pool. You do not want to try to fill it by mouth!
• I strongly recommend a debris net. It is very common for things besides the baby to be pushed out during birth *ahem* and having a little net to clear them away is very nice. The net only costs a couple of dollars, so if you don't use it it wasn't a huge investment...but if you do need it you'll be glad you had it!
• A draining pump can be attached to the hose to siphon all the water back out of the pool (and down your tub or toilet) after the birth. I did not buy one of these because it was $50 and I had been told that it was easy to set up a manual siphon either into the tub or out the window...however we tried both those things and neither one worked so Hubby ended up having to empty the pool bucket-by-bucket, and got a very sore back in the process. He said next time we need to spring for the pump.

Some sites that offer waterbirthing supplies:
http://waterbirthsolutions.com
http://inhishands.com
http://www.yourwaterbirth.com


TIPS

• Lay a tarp or a plastic shower curtain on the floor under the pool (unless you have it in your kitchen or something). Make sure the plastic extends at least a foot beyond the pool on every side--I left about 6inches and we ended up with damp carpet in several places.
• Do a test run with your pool before your due date. Find out how long it takes to inflate the pool and make sure the space you have planned is large enough.
• After the test run, if you have the space to do so, leave the pool 80% inflated. Then when you are in labor it will be much faster to get it fully inflated and then filled.
• Usually very warm water feels best to the mother, but then there is potential for her to overheat. I did not encounter this myself, but my sister said she really recommends having an electric fan in the room in case mom is getting too hot, so that she doesn't have to get out of the water.
• If mom does get out of the water for a while, lay another shower curtain or tarp over the top of the pool. That will contain the steam so that the water will stay warm. If she is out for a while, the water may cool down and then she won't want to get back in, which more or less defeats the purpose of having the pool in the first place.
• Have a bunch of towels--ideally old ones that you don't mind leaving on the floor or getting dirty. Anytime mom (or anyone else) is in or out of the pool, water will get spread around...it's nice for mom to have a little path of towels to take to the toilet or the bed.
  

Musings on Powerful Birth

I have been thinking for two months now about what made Eagle's birth so different from my last one. I was not at all unhappy with Bear's birth--I did not feel bullied or ignored or disrespected or any of those other things that so many women talk about. On the contrary, I felt empowered. But something about this birth was, well, more empowering.

I tried to narrow down each birth to just a few words, and this was what I came up with:
Bear: relief, out-of-it, disconnected, tiring, fulfilling, empowering
Eagle: intense, personal, hyper-aware, primal, powerful, peaceful, beautiful

Both births were unmedicated. Both births were in the place of my choosing, and with a provider of my choosing who respected my birth plan. I went into each birth well-educated about the process and what to expect and what I would need to do. Each birth was proceeded by mental and emotional (as well as physical) preparation on my part. With both births there was a point where my care provider had to step in and help facilitate the baby's getting out. Both babies were healthy. Both times I had a relatively uncomplicated recovery.

Labor with Bear was 23 hours long--but when it started it started, and over the course of the day it gradually increased in intensity until he was born--just like the books say. Early labor with Eagle occurred in little fits and starts over the course of two weeks (causing me no small mental and emotional exhaustion because I kept thinking this was it...and then it wasn't). When the time came though, I was wakened in the night (by Bear actually), and within minutes was in active labor and Eagle was born a few short hours later. Eagle's labor was more intense--harder in many senses--and yet shorter. Ironically I spent the 'active' part of Bear's labor in bed (because I was tired). While laboring with Eagle I found I could not bear to lay down, I had to be upright and constantly moving. Even while I was pushing Bear out, I was sufficiently exhausted that my contractions were several minutes apart and I was falling asleep between them. While pushing with Eagle everything seemed to move very quickly, and even as he was coming through the birth canal it still seemed a bit surreal that this was finally happening.

Because Bear's coming had been preceded by so many losses, I spent much of my pregnancy connecting to him. I talked to him, sang to him, and during labor thought mostly about finally meeting him. Eagle's pregnancy was such a busy time that I didn't connect to him in the same way...on the other hand, I did get in tune with my body in a way I had not before. During labor I was excited to meet him of course, but I was mostly focused on myself, my body, and what I was doing. It was an entirely different perspective, and for the purposes of labor, I think a more effective one.

During my labor with Bear I was an active participant, but I was following directions. I was too tired and out-of-it to do anything else. While laboring with Eagle I was the leader, doing what felt right when it felt right, without being told to breathe this way or push that way or wait just a minute. I was hyper-aware of every sensation, but I also had the energy and presence to be able to respond to them, so they were more manageable in spite of seeming more intense.

Bear's birth was empowering and triumphant. Eagle's birth was a thing of beauty and peace...and a whole new kind of power.

"Cradle of Love" by NancyBright
used with her permission

"Birth is not merely a means to an end..."

"Birth is not merely a means to an end,
it is an event that changes a family and is imprinted on a woman's life forever.
♥
The memories of their children's births are among the most vivid memories a woman will ever have.
♥
Get any group of women together and ask them about their birth experiences, and you will hear of joy, pain, sorrow, triumph, and a myriad of other strong and powerful emotions."


~Andrea Lythgoe, doula and childbirth educator
(from her website, posted with her permission)

Just Call me Elastigirl

After our family saw “The Incredibles” in the theater we were talking about the movie, and someone commented that Elastigirl’s powers had a nice side-benefit when it came to the childbirth department. After all, she can streeeeeetch with ease!

As I mentioned in the birth story, after Eagle’s birth (with his big head, nuchal hand, stuck shoulders, and even the midwife’s hands in there with him working him loose) my midwife anticipated that I would have torn a lot and that she would have “a big sewing job.” Although I had not thought about it at all as I was actually giving birth, as soon as she mentioned it I realized that, since I’d had 5 stitches after Bear (who was smaller), I probably did need some stitching up. And yet, as you know if you’ve read the story, I didn’t have any tearing at all. Not even one of the tiny tears commonly referred to as a “skidmark.” I have spent some time pondering over why this was.
I don’t know the answers of course, but I thought I would share some of my speculations, and perhaps they will be helpful for others mamas preparing for birth.

Belief in the possible
In her book “Ina May’s Guide to Childbirth,” Ina May Gaskin tells the story of a first time mom who was nervous about labor and how a baby could fit through. Ina May taught her the physiology of birth, and explained “you’re going to get huge.” During labor Ina May noted that this woman dilated well and had plenty of room for her large baby to come through. Afterward she congratulated the new mother, who said, “I just repeated that mantra you told me ‘you’re going to get huge.’” Perhaps it’s a little easier to believe in your body’s stretchiness if you’ve done it before, or if you’ve seen it happen (especially in person). Perhaps simple affirmations are sufficient. In any case, I believe that a genuine belief that my body could do this—was made to be able to stretch this way without incurring damage—was an integral part of its doing so.

Fear --> Tension --> Pain...or not
If you have read any natural childbirth books then you are almost certainly familiar with the concept of the “fear-tension-pain cycle,” which states that a woman who feels fear will tense up, being tense (rather than relaxed) will make her pain more intense, and of course intense pain will increase her fear. The solution then is to break the cycle—many methods promote relaxation with the idea of breaking the cycle at the ‘tension’ point, but what if you could break the cycle at ‘fear’? If a woman can go into labor feeling comfort and love and support rather than fear, might not that reduce (or remove) the tension and thus the pain? In my experience, yes it can. It’s not that labor wasn’t intense (it was) or even hard (parts of it were), but I felt sufficiently comfortable with my environment and supporting team that I felt no fear, and felt no tension, and (depending I guess on your definition of the word) felt no pain. I’m not saying it was an orgasmic birth—it wasn’t—but it was genuinely fearless, and thus my body was loose and able to stretch as far as it needed to.
Fearless labor and birth may sound lovely but figuring out how to actually do it is another question of course. I think that being able to choose a birthing location and provider that made me comfortable was vital. I happened to choose to be at home with a hands-off midwife, but I don’t believe that there is a universal ideal: some women will be most comfortable with a hospital setting and OB, some will want to be alone in the woods. The people present at the birthing matter too. Many women want to have their mother and/or spouse present, but some do not. Some invite a friend or sister or hire a doula or have their other children there. Many women feel safer and more relaxed with low light, music, massage, water, or aromatherapy. The point is not to do any one certain thing, but rather to know yourself well enough to choose what makes you feel safe and comfortable.

Gentle, supported birthing
Gentle birthing in the physical sense means that the baby is able to descend gently through the birth canal and vaginal opening. When the mother is coached in “purple pushing’ (the chin-to-chest-and-hold-your-breath-while-we-count-to-ten kind of pushing) the results tend to be not so gentle. At a postpartum visit my midwife commented that I had brought him down very gently, which I think is accurate, but I can honestly say that I wasn’t doing it consciously; I was just going with instinct. Some labor techniques talk about “breathing the baby down” rather than pushing, and I can say that that is definitely not what I did. I pushed and I pushed hard. I put my chin on my chest. I probably even held my breath a little—though if I did it was of my own volition and not because I was told to do so. BUT I pushed when I felt the urge and not when I didn’t. I let the baby come down, then retreat a little, then come down some more, then another small retreat…two steps forward, one step back. That back and forth motion helps things stretch more gradually and therefore more gently. I knew he was coming, and while I was eager to have him out, I also knew that he WAS coming and that there wasn’t a point in trying to force him to come any faster. Basically I just went with the flow.
When I say ‘supported’ I mean it in two ways: first, the emotional support that comes from having the right people (and none of the wrong people) present. I already went into that. Second, the physical support of the vaginal opening as the baby (especially the head or presenting part) emerges. Most providers who promote natural birth will use their hand(s) to put gentle pressure on the perineum, however when Eagle was crowning there was more than one set of hands supporting me. I know her hands were there, and I believe Hubby’s were too, and I instinctively reached down as well, so I was supported all the way around rather than just at the back. Since tearing can occur in any direction, I think that the all-around support definitely helped. I’m glad that my environment and birth team were comfortable enough that I was able to be uninhibited enough to do that.

Water
The final thing that I think contributed to my stretching rather than tearing is that I labored and birthed in warm water. The warmth during labor definitely helped my body relax, and as I explained already being relaxed and loose increases stretchiness. I think that the water also provided some gentle lubrication for the baby as he came down the canal. We all know that a little lube can facilitate and increase the comfort of other vaginal activities, and I don’t see why birth should be any different. Many midwives use KY Jelly or olive oil on the perineum during birth, but being immersed in water provides a more, shall we say, complete lubrication.
For what it’s worth, while I loved birthing in water and hope to do it that way in the future, not everyone likes waterbirth, and many providers do not allow it. Don’t for a moment think that delivering “on land” precludes a tear-free-birth. Water is just one contributor of many, and it is my belief that while all of them may help, probably any of them is sufficient.


So there you have it: my thoughts on why I didn’t tear during Eagle’s birth (and why I did with Bear’s). I’m interested to hear your thoughts (or experiences) as well.

Pregnant in America

Recently I watched the film "Pregnant in America." I have to agree with all the netflix reviewers who said that it was somewhat of a B-grade movie, and in many ways inferior to "The Business of Being Born." With that said though, I still recommend it for a couple of reasons:
1--it is clean (no language, no nudity...BoBB has quite a bit of both, and while they are in context, they are still bothersome for many viewers).
2--the film features interviews with a broader range of people, ranging from experts to random people on the street.

One quote (played during the credits, so I don't know who said it) was particularly memorable:

We can only change things in two ways: either with litigation, or with education.

Obviously, I'm a proponent of the latter.
While this movie does have its flaws (it gets pretty dramatic--in melodramatic way--at the end; and they don't provide references for most of their statistics, so I don't know how precisely factual they are), it's still an effort at education, and for that I must applaud them...at least a little bit.

Oh yeah, we had a homebirth...

A couple of people commented that they thought I was planning a birth center birth, not a homebirth. It's true, at the beginning of this pregnancy I did talk about a birth center as my ideal. At the time it was. However, when we finally found out which city we were moving to, I discovered that the nearest birth center was 80 miles away (remember midwife K who arrived 10 minutes after the birth? She was from the birth center...) I actually considered going there but was hesitant about the distance particularly because my due date was in the wintertime and, well, this is Alaska! So I opted out of the birth center, which left me with either home or the hospital.
I didn't think that Hubby would be comfortable with home (since he wasn't last time), but I had heard such good things about the midwife here that I decided to meet her anyway. I also visited the L&D area of the local hospital, and actually it was quite nice: more birth center-like than I would have expected of a hospital, even in a pretty naturally-minded area. However I still just felt really good about midwife A. So I prayed about it--I told God that I liked the midwife and was feeling drawn to homebirth, but that I needed His go-ahead that this was an appropriate and safe choice for this birth. After all, the vast majority of births are safe at home, but occasionally one isn't, so I figured it made sense to get an ok from Someone who would know.
I continued to feel very peaceful about birthing at home, and as I started trying to visualize labor and birthing I always pictured myself at home (in the dark...see, I did know something!)
When I felt like I knew what I wanted, I talked with Hubby...I told him that I really liked the midwife, and that I wanted her to attend me at home, but that I needed him to be part of the choice, and to be comfortable with what we chose to do. He said that he "would be more comfortable at the hospital," but that he was "ok with home." So I started planning for a homebirth.
We basically adopted a "don't ask don't tell" policy about the homebirth plan though--we answered honestly if someone asked us (only a few people did), but otherwise we didn't volunteer the information. The reason for this was that we knew that some of our family members would worry a great deal over our choice, and we didn't want them to worry (nor to have to listen to their worries). So we simply waited until after Eagle was born and then called them and said "he's here, by the way, he was born at home...yes on purpose..." In the meantime, since we weren't telling our family our plans, it didn't seem appropriate to be telling the rest of the world either. So we didn't.
I used the term "midwife" here on my blog, but I guessed (and rightly) that many people would assume I was seeing a CNM who would attend me in a hospital or birth center. My mother and sister (both homebirthers themselves) saw the term "midwife" and assumed I was planning a homebirth, but I don't think anyone else did. ☺

At my 3-day postpartum home visit, Midwife A asked Hubby if he'd liked homebirth better than the hospital.
He said "yes."
☺

Eagle's Birth Story

I have a lot of thoughts and feelings that I want to put with this story, but it's taking me a while to get them all into words, and since the story part is actually fairly short, I decided to go ahead and post the facts and then I'll post the thoughtful part later on.


There is a standard which suggests that if mama has contractions that are one minute long, 5 minutes apart, and continue at that rate for an hour, then she is in active labor and should go to the hospital (or call the midwife). In the two weeks prior to Eagle's birth I achieved that status at least four different times, always in the evening. On each occasion, I thought hey, maybe this is finally it...but since the contractions never got closer together or more intense (and in fact always slowed when I laid down for bed, if not when I was snuggling in the kids) then I knew it was not really labor. After three days in a row of it however I did call my midwife just to let her know what was going on. I told her I felt a bit silly calling, because I knew this was not it, but I thought she should know that I was contracting a lot, and regularly. She said that probably my body was warming up, and that as soon as the baby's head engaged I would have a fairly fast labor. She encouraged me to do things that would help him engage (ie--drop down and put pressure on my cervix).

I spent two days doing belly lifts/hip tucks and hip circles (both on and off the ball) trying to get him to descend, but so far as I know he hadn't engaged when I went to bed on Wednesday (my due date). He may have started to engage though, because over the course of the evening I had a half dozen contractions that seemed different from the many previous ones. I can't explain how, they just seemed different... I had a gut feeling that I'd probably wake up in the middle of the night in labor, but since I'd had that feeling on several nights in the prior two weeks I didn't bother to say anything to Hubby, and just went to bed as normal.
Bear woke up around 3, so I got up to comfort him for a few minutes, and as I got back in my own bed I had a really uncomfortable contraction. Then 10 minutes later another--the kind where you think gosh, laying down is terrible, I have to move. 10 minutes later I had a third so I got out of bed to lean on the bathroom counter and do hip circles, and the contractions promptly switched to being 5 minutes apart. After all the false starts I decided to wait another 40 minutes to make sure they kept on consistently before I woke Hubby, but I knew they were going to.

Shortly after 4am I woke Hubby. I told him I was in labor and that I needed him to put up the pool. He didn't know yet that I'd been up for over an hour, and later admitted that he wondered if it was another false start and was very tempted to roll over and go back to sleep. But he got up and started puttering around. I felt terribly impatient at this point and started working on the pool myself--we had inflated it to about 80% two weeks prior so it was quick and easy to finish the job. I think my impatience in getting the pool out helped Hubby realize that I was not at all iffy on whether this was the real thing, and he quickly stepped in to get it done for me. As he was working on the pool he informed me that he was going to have to run in to his classroom briefly, as he'd been working on some things the afternoon before and would need to put them away if a substitute was coming in that day. (After two weeks of figuring that any day could be the day, I guess he had reached the "she's gonna be pregnant forever" state of mind too!) He said he would probably only be gone about 20 minutes, so as soon as he finished inflating the pool I told him to hurry and go because I knew I'd need him soon. We called the midwife to let her know that this was it, and she said to call her back as soon as anything changed and she would come right over. So Hubby left, and I took a shower, lit some candles, and started filling the pool.

While he was gone my contractions continued to be 5 minutes apart. After a little while, needing to convince myself that I was making progress, I decided to do an internal check on myself. I had tried this several times throughout the pregnancy, and especially during the final weeks. During pregnancy the cervix is very high and also tipped to the back, so I was never able to reach it very well (I was familiar with what it felt like when I'm not pregnant because I check it regularly as part of my fertility awareness, but pregnancy is a whole different ballgame!) I had discussed with my midwife how I couldn't feel it, and she said that the height combined with the softness of it in those late weeks was probably why. This time when I reached in though I could clearly feel it: I guessed I was around 3cm dilated and I could feel the sack of waters bulging. The sack is the coolest thing to feel--sortof slippery and slimy but also obviously very strong. I couldn't feel the baby's head behind it, just the squishy edge of the sack, but I knew he must be right there since I was dilating.
I started really focusing myself into the labor. The body can (and will) do the work of birthing pretty much on its own, if mama will just relax and let it do so; on the other hand, if mama will work with her body (as opposed to merely stepping aside for it) then the whole process can be all the more effective and efficient. Ina May Gaskin talks about "integrating" contractions so that you can move forward and into the next level. Birthing From Within teaches a similar notion when it encourages the mother to go into the center of each contraction. So as I leaned against the counter and circled my hips I repeated words like "down" and "center" and "deeper." In the prior couple of weeks I had mentally stumbled upon the image of a drop or stream of water coming down onto a pool and the waves of ripples radiating out from it--so I took that image (with the downward and outward motion) and replayed it in my head over and over.

As soon as Hubby got home (around 5am) my contractions became noticeably more intense. I really think my body was just waiting for him to get home before it allowed labor to progress. I was needing to concentrate enough that I couldn't time them myself anymore, but Hubby said they were still 5 minutes apart. They were stronger though, so we called the midwife. Since my water had not broken, I'd had no bloody show, and they were still 5 minutes apart, she said she'd be over soon but we all understood that she wasn't rushing. Hubby got a quick shower and I got into the pool.
Wow!
I had planned to labor in the water with Bear (although at the hospital they'd have me get out for the actual delivery), but labor had been so long that by the time we got to the hospital I was too tired to do anything but lay on the bed. This time I had had a nap the prior afternoon, plus gotten half a night's sleep prior to waking up in active labor--I was awake enough that I was far more conscious of everything that was going on (I was falling asleep between contractions at the end of Bear's labor). I also had enough energy this time to be upright and moving around, which I believe helped labor progress rapidly...although I think this would have been a faster and more intense labor regardless. In any case, warm water felt fantastic on my hard-working middle and back. I sat down in the water between contractions, but during them I still needed to be up and moving, so I knelt up and leaned on the edge of the pool and continued my hip circles...the only problem was that this brought my hips out of the water (right when I wanted it most!). So Hubby got a saucepan and poured water over my lower back during contractions. I have to say, now that I have labored with water, I cannot fathom wanting to labor without it! I started vocalizing through the contractions--keeping a loose throat can help keep a loose bottom, so a low "ahhhh" while contracting can be helpful--and it simply came naturally.

Midwife A arrived sometime around 6am I think--I was far enough into laborland that I had no concept of time. I had recently checked myself again and estimated that I was around 5cm dilated--still with the bulging waters. Bear had recently wakened and Hubby put on a movie for him. A had me get out of the pool between a couple of contractions so that she could check my vitals and dilation. I knew I was in serious labor because I didn't feel the need to grab a towel or sarong when I got out (I'm normally a very modest person, and had those things on hand because I'd expected to want them). Modesty is one of those things that just goes out the window in labor, which is good because it would be terribly inconvenient if it didn't! I was pleasantly surprised when she reached in and said "you're about 8cm dilated" (she later told me I'd been "a stretchy 8"). I got back into the water for a contraction while she called her associate midwife K (who had a 90 min drive) and got her doppler ready, and then I sat on the birth ball so that A could listen to the baby's heartrate through a couple of contractions. During the first one his heartrate dropped dramatically, but during the second it stayed steady. Contractions can be stressful for the baby, though not usually dangerously so, but she needed to listen through a couple more to determine which result had been the anomaly. The next three contractions--two with Hubby holding under my arms (suspending me), and especially the one laying on the bed--were awful. Contractions are intense anyway, but without the mediating effect of the warm water they were harder to integrate. (Did I really spend an entire labor on a bed last time? Yikes!) Baby's heartrate was stable through the subsequent contractions, so I got back into the pool.

Getting back in the water felt glorious, and was just in time...the next few contractions were stronger and I was getting louder at the peaks. I wasn't focusing myself into them anymore, just trying to stay on top of them and let my body work. I remember thinking that this was awfully hard and I'd rather just stay pregnant, and even that I totally understood why epidurals are popular...and then it hit me that those kinds of thoughts are a sign of being in transition, and that it meant I was in the home stretch! (I don't recall having any of those sorts of thoughts during Bear's labor--presumably because I was too tired to have thoughts that conscious.) Between contractions I stretched out, laying my head on the side of the pool and letting my body float out behind me. (A commented "now that's a woman in labor!" so we took a picture, but I cropped it for the blog...I'm open but not quite that open!)
I guess I woke Wolf at this point--though 7 would have been his normal wake up time anyway--he joined Bear watching the movie. I started feeling pushy. I wasn't sure if it was my body pushing or my mind wanting to push, but I told A because I figured she'd want to check me again to make sure I was fully dilated. That's what they'd done in the hospital after all. But A just said "do what your body wants to do; don't do anything that hurts." What perfect advice for labor! I don't know if the timing was coincidental or if her "giving permission" freed me, but with the next contraction I was definitely pushing, and I was getting louder too. A asked if my water had broken yet, and it hadn't, but within a couple more contractions it did. If feeling the bulging sack with my finger was weird, feeling the sack break spontaneously was really strange! (Bear's water was broken by the OB.) It was something akin to blowing a bubble gum bubble and having it pop all over your face...except of course it wasn't on my face. I really thought there was an audible pop, but I guess in the midst of labor sensory perception is garbled because Hubby and A both said it didn't make noise.
The older boys' movie got over and they came in. Wolf sat back but Bear came right over, put his hand on mine, and started vocalizing with me.
Within another contraction or two I knew things were getting close so I turned over and leaned back against the side of the pool rather than staying on my knees leaning forward. I know a lot of women deliver on their knees or hands and knees, but I wanted to be able to look down and see what was happening. In retrospect this was pointless because I couldn't see around my belly, but at the time it seemed terribly important. I reached in and for the first time felt my baby's head: all soft and wrinkly and covered with hair! The mind definitely doesn't function normally in labor, because I had the momentary thought "he doesn't have a skull" (because I could only feel the soft wrinkles of his scalp). Fortunately the work of pushing distracted me before I had a chance to linger on that notion!
Interestingly, once I turned around I no longer felt contractions nor a physical urge to push. I had a huge mental urge to push, but nothing physical. However I could feel the baby's head coming down so I had no hesitation about pushing like crazy. I'd had a feeling for some time that this baby would be bigger than the last one, so I had mentally geared myself up for a 9 pound baby. As I felt his head begin to enter my birth canal I had the thought that it was impossibly big and would never fit, but there's not really any way but down and out at that point, so I pushed anyway and remarkably enough he slid on down without much trouble at all. Of course sliding down the canal is one thing, actually getting out is another. I don't recall the classic "ring of fire" as he crowned, but I was aware of many hands being there--Hubby was in the pool with me catching the baby, the midwife's hands were supporting my perineum, and I realized that I had reached down to support myself in the front as well. Being part of my own 'catching team' was something I don't think I ever would have done in a hospital, but it came instinctively and I think it helped me not tear. His head came out, but then he stopped at the shoulders. I was pushing but he wasn't budging. Hubby moved aside and A started working the baby back and forth to get him out. My mind started racing with thoughts of shoulder dystocia and I just knew that she was about to tell me to turn over (it's easier to get sd babies out if mama is on hands and knees) and I was just sure she was going to have to break his clavicle to get him out (that's the official procedure if the baby won't come unstuck). All within the moment I was already beginning to mourn my baby's broken shoulder...but A never asked me to flip over. I felt pulling and stretching that made delivering the head feel like birthing a pillow (A later told me that she had her hands "in there with him" to get him free), and then suddenly she was done and Hubby was handing me the baby and A was putting a towel around the little one.

The first moments after birth are so precious, just staring into the eyes of my new little one and realizing the blessing of being part of a miracle.

I hadn't been able to see it, but Eagle had a nuchal hand (his hand was by his face as he was born, so although his head measurement was 36cm, the addition of his hand made it 38cm--15 inches). Hubby and A were discussing the nuchal hand when I felt a uterine twinge and knew it was time to deliver the placenta. I started to hand Eagle off to someone when I realized we hadn't cut his cord so he was still attached to me. I pulled back the towel to expose the cord and discovered that it had broken on its own! I had never heard of such a thing (and I have read a lot of birth stories). A said that it happens occasionally, but is very rare. She clamped it to make sure he did not lose any blood through it, and then turned to help me with the placenta. Delivering the placenta is easy--it doesn't have any bones. ☺
An unmedicated birth is followed by a rush of adrenalin, so I climbed out of the pool and took a quick shower. While I was showering midwife K arrived. Both A and K commented that I seemed very lively for someone who had given birth just minutes before...I wasn't trying to be lively or anything else, I just felt fantastic and ecstatic (and very glad to have the baby on the outside!). I climbed into my bed (how wonderful to be able to get right into my own bed!) and tried to get Eagle to nurse. He wasn't interested for a while, in spite of Bear telling him that nurn was good and he should try it. Wolf cut the umbilical cord (closer to his navel, as the break was several inches down). After we'd all had a chance to cuddle the baby a bit A examined me. She said that between the nuchal hand, the big head, and the stuck shoulder she'd expected to have a big sewing job, but somehow I had no tearing at all. I don't know if it was being in water, being well-supported, being relaxed, my prenatal diet, or something else, but A pronounced that I had "a beautiful vagina" and after double-checking that there was not even a skidmark, she tucked me back into bed with my baby.

B C Brighton
Born on November 12, 2009 at 8:03am
8lbs even, 20.75inches long, 36cm (14.5in) head (Bear was 7lb1oz, 19.5in, but his head was the same size!).


This labor was shorter but more intense than my last one. I was more conscious of everything, but also more in control. I do not have regrets over my choices nor the events of my first birth; in fact Bear was not even an hour old when I told Hubby "I could do that again!" (a sentiment I did not feel for a couple of days this time). However if I could choose one labor & birth to repeat in the future, it would definitely be Eagle's.

Announcing...

...that Eagle arrived this morning at 8:03 after 5ish hours of labor.
He was born at home, in the water, into daddy's hands.
8lbs even

all the details will be in the birth story which I will get to sometime in the near future. ☺

Banking Cord Blood

I have to thank Miche over at Coordinated Chaos for sharing this post about cord blood banking. A lot of us have heard about cord blood banking, but what a lot of us may not realize is that there are two different types of banking: one is to bank it for your own family (for which you pay a pretty penny, usually around $2000 to start plus annual storage fees) and the other is to donate it to science. Cord blood contains embryonic stem cells and is therefore valuable for research even if you have no need or desire to store it for yourself. It also can be used in transfusions, and is somewhat comparable to bone marrow in that way--except that it's not painful to extract the way bone marrow is. And, of course, donation is free.
When I was expecting Bear I asked my OB about donation and he didn't know anything about it. I did a little poking around online but was unable to find anything, and admittedly I did not pursue it at much length. As it turned out, because the cord was around his neck so tightly, we had to cut it in the middle (to finish getting him out) and then cut it again closer to his navel. So I think it wouldn't have been possible to save or donate it anyway. But I still think it's an issue worth considering!!

Here are a few links for further reading (Thanks to Miche for sharing them first!):
Some basic information about cord blood banking (both personal banking or donation), with lots of links to additional information
How to donate cord blood--including information about who is eligible, where you can donate, and how the process works.
Frequently Asked Questions--including what is done with the cord blood, privacy issues, and what you can do if your hospital isn't currently set up for donations.
CordBloodRights--a site encouraging action for legislation to make saving/donating cord blood the default (instead of just throwing it away which is what usually happens unless you specifically request that it be saved). (This site is run by Cord Blood Registry, so it's not truly unbiased, but it does have some good information.)


There are those who prefer to leave the cord uncut until it has stopped pulsing (which means that all the blood has drained into the baby), or even those who do a "lotus birth" (which means that they don't cut the cord at all, but merely pack the placenta in herbs and then carry it around with the baby until the cord detaches naturally). If you believe in those things, then obviously cord blood banking isn't something that's going to work for you. However, for most standard births--particularly in hospitals--the cord is cut within minutes or seconds of birth, and there is plenty of blood still in the cord. If this is your plan for birth, then please take the time to check out some of these links and consider making a donation that could literally save lives!

40 Weeks

It's here: that big official estimated due date! Of course, it doesn't really mean anything except that I'm now halfway through the period during which my baby is considered "on time." Thanks to the two weeks of prodromal labor I am feeling like he'll never come. It's frustrating and tiring and I feel sore and I'm sick of all the false starts. If I add up all the hours of contractions I've had over the last two weeks I'm sure I've clocked a good 12-15 hours of early labor. Most days I have minimal appetite and it's difficult to maintain my attempts to stay well-hydrated, avoid sugar, eat lots of protein, and take all my vitamins/supplements every day.

Bear was born at 39w1d (have I mentioned that yet?!) and of course laborish things started with this kiddo at 38w2d, so I've been anticipating birth any day now for a while. That is mentally exhausting in and of itself...plus the physical discomforts of loose hips and a big belly. I think I mentioned before that there have been several nights where I was so sure that I'd be wakened in the middle of the night with hard labor that when I woke in the morning and found myself still pregnant it was a bit befuddling.

About a week ago there was a rainstorm all night long...every time I woke to go to the bathroom or settle my toddler I heard the rain pattering on the roof and thought "that would be perfect for laboring...tonight would have been a good night to have a baby."
Last Saturday we woke up to a dusting of snow, and throughout the morning more gently wafted down, and I thought "this is so beautiful, this would be a good day to have a baby."
Yesterday was 11/10/09, and I thought (as I have been thinking for several weeks) "this is such a neat date, it would be a great day for a birthday."
But Eagle has not come on any of those perfect days. I don't know why, but apparently the time is not yet right. I am having contractions--even regular ones that come close together for several hours at a time--but they never progress. We know that the baby is floating pretty high, and until he comes down and his head engages then my cervix isn't likely to dilate because it has no pressure on it...so all these contractions are essentially unable to progress into active labor because of his position.
Ironically, most labor encouragements focus on stimulating contractions--and I'm already getting plenty of those--so they are useless to me. Even a pitocin drip would probably do me no good, since it merely causes contractions, and I have plenty of those! If I were to go in for a traditional induction I would probably spend several hours hooked to an IV with hard contractions but little or no dilation, then they'd conclude that my labor was not progressing so they'd break my water, (which brings the risk of prolapsed cord since the baby's head isn't covering the cervix, and that's an automatic c-section...) If the cord didn't prolapse then the birth would probably follow shortly BUT then one still has to ask the question--if this baby is not engaging on his own, why not?! And is it really a healthy idea to force him out if he's not ready yet?
So instead I am spending time doing hip tuck/belly lifts, hip spirals on the birth ball, and some lunges. All those positions are supposed to encourage the baby to drop into position, and once he does that I suspect that labor will come on and move quickly. For now it's just a matter of waiting for baby to come down (because I can only encourage and facilitate, not force him down!) so I keep talking to him about it and sooner or later he'll decide he's ready.

Until then, I have only one pair of pants left that fits, I have managed to accumulate more stretch marks (in spite of being well-striped already from last time), and I am feeling very very large. I keep crashing into things with my belly because I'm just not used to sticking out so far (need a cup from the cupboard? I'll need to grab a step stool cuz my belly holds me out so far from the counter that I can't reach the shelf any other way!) I'm tired, I'm sore, I'm cranky, and it's entirely possible that I'm losing my mental acuity at least a little bit (remember how I keep waking up confused at still being pregnant? Yeah, that...)

Here are a couple of pictures taken today (please forgive them being slightly fuzzy...it's hard to take pictures of myself in the mirror one-handed, but I consistently forget to remember to ask Hubby to take the pictures on the right day, so this is what ya get!):

(No, I did not wear my shirt tucked into my pants all day--I may be losing my mind but I'm not THAT geeky! It was just easier to get an accurate profile that way.)

And the belly in all it's big stripey roundness:

(The other night Hubby put his hand on it as I was having a contraction and commented at how hard it was "it's like a basketball" he said "I could palm it!" Yeah, but betcha he couldn't throw it through a hoop!)

Thoughts on Inductions and Encouraging Labor

As you can probably tell from some of my recent posts (particularly my facebook friday one) I'm getting ancy for this kiddo to be born. Ironically I'm not even to my due date yet, but my body keeps giving signs of labor, and I'm past the date where I delivered Bear, so I'm feeling overcooked even if I'm not really. I confess this last week I've given some thought to inductions, and feel like I have some understanding for why women choose that route. (I confess I even had a dream wherein I got one of my crochet needles and broke my own water!!) I never felt this way with Bear, first because I was prepared to go past 40 weeks because I know that's common for first-time moms, but secondly because I didn't have ongoing prodromal labor as I have this time. When labor started with Bear, it started and it continued until he was born. This time has, obviously, been very different!

There are two types of "induction," but they're not really the same at all, so I prefer to think of them as "inductions" verses "encouragements." The former will stimulate labor forcefully, the latter will simply encourage it to move along if (and only if) it is ready to happen anyway.

Standard inductions include administering synthetic hormones (such as pitocin) via IV, or via vaginal suppository (such as cytotec, which by the way, commonly causes birth defects, uterine rupture, and maternal death--if you don't look at any other links in this post at least look at this third one here!).  Inductions of this sort are commonly done because the woman is "overdue," or because either the woman or her doctor had a schedule to keep and just wanted to get the baby out already. A friend of mine put together an excellent post on why "Overdue is NOT an Emergency" and she cites many references to back up that stance.

Dangers of Induction
In my opinion, one of the biggest problems with having an induction based on dating is that estimated due dates (EDDs) are just that--estimates--and are wrong at least as often as they are right. A woman who has anything other than a 28 day cycle (or who ovulates on any day other than day 14) will have an inaccurate EDD if she bases it on her last menstrual period--which is what most providers do.
Secondly, EDDs are based on average gestations, but some women gestate for 38 weeks and some gestate for 42, and there are differences from one child to the next as well as from one woman to the next. So even if you know that your dates are correct (because you know your date of ovulation) you still can't really know how long your baby needs.
Inductions do not always work--particularly if the mother's body was not showing signs of readiness (dilation and effacement) prior to the induction. As mentioned in the post I linked above, when first time moms with no dilation and no effacement are induced at 41wks (merely because of the date), they have about a 50% chance of ending up with a c-section for failure to progress. In other words, half of them will not go into labor in spite of the induction, so their babies will have to be delivered surgically.
Finally, there is evidence to support the idea that every week (even every day) that a baby spends in utero prepares him for life outside the womb. It is true that medical science has found ways to save the lives of babies born very very prematurely, but ask any of those premie's moms and they will tell you that they would have preferred that the babies be full-term. Just because the babies are able to live does not mean that it is in any way desireable for them to have been born so early! Babies who are even just a couple of weeks premature often have under-developed lungs, insufficient fat stores, eating problems, immature livers (leading to jaundice), and underdeveloped/undersized brains. But don't we also need to worry about the baby getting too big? Nope, we really don't.
I believe that inductions are terribly overused, and not nearly as appropriate (or as safe) as we are led to believe.


Encouragements are quite different from inductions, in that they will stimulate contractions, help ripen the cervix, or facilitate the baby's head engaging with the cervix, but they will not really force labor to start. I am comfortable with encouraging labor--particularly when the woman's body has already been giving signals that it's about ready.
Here is a short list of labor encouragements and how they work:

1. Walking--being upright and in motion can encourage the baby to descend into the pelvis and engage his head with mama's cervix, thus stimulating dilation. Many women find that physical activity brings on contractions as well.  (Safety feature--if mama's body isn't ready for labor, the contractions will usually stop once she stops walking.)
2. Doin' the Deed--yep, you got it, the same thing that got the baby in can encourage the baby to come out. This actually works in four ways: A--daddy's semen contains prostoglandins (the hormone that softens the cervix), B--if mama orgasms then those contractions can stimulate labor contractions, C--nipple stimulation releases oxytocin (which is explained more fully below), and D--getting mama relaxed and increasing her blood flow to her pelvic area can be helpful as well. There is really a lot more in common between getting babies in and getting babies out than what most of us have been told, but all the organs and muscles are the same, and many of the sensations are comparable, so it's only logical that they should work together so nicely.
   
3. Nipple Stimulation--I've heard a few mothers say that nursing their toddler got labor up and rolling, or of course daddy can help out, or mama can do it herself with a breast pump (it does need to be a sucking type of motion). The reason it works is that it releases oxytocin, as mentioned above, and oxytocin causes uterine contracting--this is exactly why immediate breastfeeding helps to get the placenta out and reduces the risk of postpartum hemmorage (because it causes the uterus to clamp down).
   
4. Consuming Castor Oil--basically castor oil will stimulate the bowels, and since the bowels and uterine muscles are ajacent, stimulating one often stimulates the other. (Loose bowels is a common symptom of early labor, as the body tries to get everything out of the way to make as much room as possible for the baby to get through.) Theoretically any laxative could cause this result, but obviously laxatives also carry the potential danger for dehydration, and castor oil is sufficiently nasty that I doubt the average mama would take enough of it to overdose! Incidentally, on top of castor oil being nasty, it doesn't always work, so you may be taking a dose of nasty for no reason...just something to keep in mind. ☺ (If you do want to try it, I'm told it can be chugged in a glass of orange juice to cover the taste, or try mixing it with some scrambled eggs (before frying them), and you'll get greasy eggs but they won't taste too bad.)
   
5. Eating Spicy Foods--these can stimulate the digestive system, which may stimulate contractions. Of course, spicy foods may also stimulate heartburn, so attempt this at your own risk! I have heard that garlic may work this way too.
   
6. Squatting--my midwife recommends spending time in a deep squat (like a yoga squat--lean against the front of a couch or hang on an exercise ball if you need some support). Essentially this position can help encourage the baby's head to engage with the cervix.
7. Dance--get your hips moving in as wide a range as you can, especially in circles (like belly dancing or hula). The wide stance opens your pelvis, and the movement can encourage the baby to descend...sortof like a combination of the walking and squatting. Whether or not you utilize this to encourage labor, it is also a very helpful thing to do during labor.  (edited to add: this is what got this baby to engage and come out. After 2 1/2 weeks of solid "early labor" every night, but no progress, literally a day and a half of hip circles every 30-60 minutes got his head engaged and moved him right down. I did hip circles during almost every contraction in labor too, and he was out in less than 5 hours. Your mileage may vary of course, but I have become a BIG proponent of hip circles!)
8. Evening Primrose Oil--this can be consumed in capsule form or applied to the cervix directly. Either way, many midwives advise it during the final month or so of pregnancy, and it is supposed to help soften the cervix, which in turn should facilitate dilation when labor does start.
   
9. Acupuncture or acupressure--it's important to do this with someone who is trained specifically for it, but some women report rapid results. Of course some women also report that nothing happened.
10. Chiropractic Adjustment, Massage, or Reflexology--some women say it works, some say it doesn't... rubbing the lower half of mamas calves (in the back) is supposed to get things going...
    
11. Consuming Red Raspberry Leaf--RRL is a uterine toner, so consuming it throughout pregnancy is a good idea anyway. Consuming increased amounts of it in the final weeks will not generally stimulate contractions, but can help the uterus prepare to work effectively when labor does start.
12. Consuming Blue & Black Cohosh--these herbs are commonly touted in the naturopathic world as a "natural induction" but they do carry risks. I am not comfortable with them myself at this point, but if you are inclined to try them make sure you read up on them first!
13. Get busy doing something else. Really. Stop focusing on being not in labor, and go find something productive to do--once the baby comes you'll be too busy to do anything else for a while, so use your time now to clean the house, play with your other kids, spend time with your spouse, pamper yourself, or change the world. ☺
14. This site also has a great list of suggestions (with additional links with additional info) http://wrylilt.hubpages.com/hub/Ways-to-induce-Labour-Naturally
    

If any of my readers know of other methods (or references) that I have neglected here, please leave them in the comments and I'll edit them into the post!!