Birth Plans, part 2

A reader comment from yesterday's post made me realize that I wanted to cover a bit more about birth plans and hospital birth in general.

She wrote:

I think that this whole "birth plan" era has also unfortunately ushered in a huge amount of antagonism between patients & nurses, which is just SO upsetting to me (as a nurse). Believe it or not, we WANT you to have the birth that you want, but sometimes things just don't go the way they are "planned." Welcome to parenthood, that's your first lesson that kids never stick to the plan!

Sometimes people have the impression that giving or receiving a birth plan is an opportunity for scorn and eye rolling. It certainly can be...I have clients ask me all the time if they will be annoying the staff with a birth plan. I've also heard care providers jokingly speculate that the people with the longest birth plans are the ones who get cesareans...and the implication is that it's all their own fault. I hate to hear this...the people saying it just have not met the right kind of birth plans (and the mindset that goes with them)! Just as I think birthing women should not be dogmatic, I would love it if care providers also took responsibility for not mentally penalizing people for their earnestness.

A big part of the equation that usually can't be planned for is the luck of the draw with the assigned nurse. Sure, some nurses can be invested in women having as few needs as possible, in them being quiet or not "suffering". However, I find that most nurses (and everyone really) can get on board with a just about any birth plan if they are approached from a place of respect and acknowledgment that they are there to help. Find your inner Dale Carngie: "We prefer that you don't offer us medication, but we sure would love some ice chips and another pillow!" or consider saying, "Here's what we would prefer/what is important to us...can you help us with that?". Most people are decent human beings.

When there is an adversarial approach, it is likely caused, in part, when people are not well matched with the care providers/birth place (you know what they say about not going to a fast food restaurant if it's fine dining you are after). But also when people are coming from a place of fundamental distrust. There is this fine balance, I think, between being prepared to advocate for yourself (as well you should) and going in looking for a fight. 'Cause if you look for a fight, you are more likely to find one. Hostility is not going to help anyone, including the birthing woman, who will surely need to be able to trust and surrender. An atmosphere of distrust or upset can actually stop labor from progressing...those stress hormones are like kryptonite to the hormones that progress labor.

Instead, iron out as many details before you go into labor and make sure you are comfortable with the answers you are getting from all your care providers. Ask what is typical, where there is wiggle room, under what sorts of circumstances interventions might be typical. Consider hiring a doula. Labor at home for a good long time if you can. And, as I have written before, picture your care provider telling you you need an intervention you really don't want...in your gut, do you trust them? If the answer is no, if you are finding that you are still anticipating an uphill battle, make peace with the fact that you may be with the wrong practice or planning to birth at the wrong place for you and then do something about it.

Again, I'm not suggesting you jump on a conveyor belt of unwanted interventions...I'm suggesting you find out whether the conveyor belt is there at all before you get there and then respectfully pick you battles.

space oddity

Last week at spin class the clock on the wall was not working. The realization of this brought up a tiny bit of panic in me. How would I know how much longer? I use the clock to mentally move myself along ("a third of the way done", "more than half way").

Riding, riding, riding...I was thinking about the timelessness of labor. How women so often plead "how much longer?". Some people do not have this need to know. For some, hearing that they are halfway through a contraction, that it won't get any stronger, does not help. But most people find it helpful. I find it helpful.

So I had to find a new way to cope...a new pain coping practice, just like labor (but with the benefit of knowing that it was only an hour, regardless of there not being a clock!).

More than ever, I lost myself in the music. Sang along in my head, matched my pace to the music. Slowed my breathing, in through the nose, out through the mouth. I was amused during David Bowie's "Space Oddity"...

This is major tom to ground control
Im stepping through the door
And Im floating in a most peculiar way
And the stars look very different today

The perfect song for timelessness and strangeness. Being alone, panic, letting go, peace. Perfect for me in this class. An apt description of labor for the mom and the baby - imagine the song from a baby's perspective!

Like labor, I couldn't tell if time was going quickly or if only a moment had passed. But in my discomfort, I found a new comfort zone...the place of being ok with not knowing. It was a relief to give over to it.

...The clock is back this week.

Groaning Cake

From Ami McKay's The Birth House (read it!):

Groaning Cake
The tradition of the groaning cake, or kimbly at (or following) a birth is an ancient one. Wives' tales say that the scent of a groaning cake being baked in the birth house helps to ease the mother's pain. Some say if a mother breaks the eggs while she's aching, her labour won't last as long. Others say that if a family wants prosperity and fertility, the father must pass pieces of the cake to friends and family the first time the mother and baby are "churched" (or the first time they go to a public gathering) after a birth. Many cultures share similar traditions…a special dish, bread, or drink, spiced with cinnamon, all spice, and/or ginger. At one time there was even a "groaning ale" made to go with it…

I made groaning cake the day of my son's home birth and my neighbour brought me "health bread" the day after the birth. This recipe is a combination of the two. It has apple, molasses, orange juice and spices and can really help to see a woman through a long labour, or give her strength after the birth!

2 ½ Cups Flour
3 eggs
2 tsp. Baking powder
½ Cup oil
1 tsp. Baking soda
½ Cup orange juice
2 tsp. Cinnamon
¼ Cup molasses
½ tsp. Ground cloves
1 1/3 Cups sugar
1 ½ cups apple (grated, no skin)
1 tsp. Almond extract

Sift dry ingredients together. Add apple. Beat eggs. Add oil, orange juice, molasses and sugar. Add to dry ingredients. Mix well. Add almond extract. Bake at 350 F. for 35-40 minutes. Makes two 9 X 5 loaves or about 18 muffins.

Additions: raisins, dates, dried fruits, or nuts.

Happy Day Out Of Time

My friend Jill, also a doula, came for a visit today (& brought me my favorite carrot muffin - thanks Jill!). She mentioned that tomorrow (now today) is the Day Out Of Time, and how wonderful it would be to attend or give birth on this day. What a perfect description of birth - timelessness, only this contraction, only now, a fresh start. And then there is that whole connection to how estimated due dates are calculated on a 28 day lunar month...
I thought it was such a cool concept that I decided to look it up & share:

as blogged on Verbal Viagra:
July 25th is the Gregorian Calendar’s date known as The Day Out of Time because it’s the 365th day of the Thirteen Moon Calendar. This harmonic timing standard measures the year in thirteen even months of 28 days each, a perpetual calendar of 52 perfect weeks, making a total of 364 days. The 365th day is technically not a day of the week or month at all, but truly ‘A Day Out of Time’. For this reason, this special day is observed as the day to cancel debts, to pardon and forgive, and to celebrate life through art and culture… So Happy Day out of Time, it’s a good day to make a fresh start! Make it a good one.

So to all the birthing women, to those who love and support them, to all the babies born, and to Jill, happy Day Out Of Time!

Like Oxytocin For Chocolate

I was just speaking with a pregnant mom who was beating herself up for her chocolate cravings and hunger level in general. She's fit and quite slim, but her current care provider (wrongly) suggested to her that pregnant women should gain no more than 20 - 25 pounds...well, that's a topic for another day, but I assured her that she should not be restricting healthy food, as she's growing a human being, so it makes sense that she's hungry!...And some chocolate can actually be good for us. Not only that, but it can help get our brain in the blissful place it needs to be to conceive, give birth to and mother a baby. It's all about the oxytocin!
Plus, doesn't it make sense that experiencing joy is good for growing a baby?

perfect day

I have lots of ideas about how a perfect day could be spent. Yesterday was one of those days.

I was woken up by an early morning call that a labor was happening. Hooray - Sunday & kids were covered since my husband was home. It would take some juggling with his tennis game, but no big deal. I knew they had fun plans to spend the day at the pool and Maplewoodstock. And no one else due at the moment so no conflicts - just this birth to consume me for how ever long it lasts. All extra special because I leave for Ann Arbor tomorrow and really wanted to be at this birth.

Contractions had been happening on and off since around her July 4th due date and I felt pretty certain it would all work out and I would get to be there. Thanks, perhaps, to acupuncture, massage, homeopathics and some special castor oil eggs,things were moving. Although it was a somewhat unique VBAC where lots of people could name all sorts reasons it shouldn't work out, I felt calm that it would go well and fairly fast; not sure why. Having a client who is so upbeat and just willing is a joy and I think it helps the birth.

Funny thing: A childbirth class was taking a tour and thought we were part of the show. They actually followed us to the room, so I snapped their picture.

Throughout the birth, even though it was amazingly hard work for the momma, she manifested gratitude throughout. Thankful for her super husband and the spaces in between. The nurse & doctor commented that they were the most friendly & grateful people to come through in a long time.

The birth, as noted below, was fantastic. And I made it home in time to see my family and sleep in my own bed...perfect. I love it when it all works out, as it so often does.

Mabel

Good things come to those who wait...welcome to the world baby Mabel...your momma sure worked long & hard to have you but it was worth the wait - you're lovely! (even your footprints are excellent!)
Could I be any luckier? After attending your wondrous birth I went out into the sunshine, got coffee and headed to a favorite soon-to-be birthing momma (owner of the henna tattooed belly seen here) to give her some encouragement and care. All the while, knowing that my husband had successfully gotten the kids settled in bed last night and up and out to camp this morning, with a little help from (our) friends.
Life is good. I need a nap.