One degree of separation

I got a nice call today from a reader of The MotherHood. She is a new to the magazine and thought I might be able to help her find a pediatrician who will meet her where she is and will listen to her concerns respectfully. I shared with her my experiences of our family pediatrician, also a columnist for the magazine. I gave her other names as well.
We chatted a bit and she told me that her first three births were in a (now closed) NYC birthing center and that her last birth was at home...with the same midwife who attended me at my own last birth...small world!

Labor, virtually

I was checking out a (natural) birth website & saw this Virtual Labor game. Why not take a few trial runs & be reminded of some comfort measure options?
It's fun & you could even play some nice music, dim the lights and drink some RRL tea to set the mood!

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.

"Home delvery is a mother's birthright"

OK - lame headline that calls to mind pizza or Chinese food. But nonetheless, it's the headline of an editorial by "Pushed" author, Jennifer Block, in today's New Jersey Star Ledger (along with a huge drawing of a mother and baby). It originally appeared in the Los Angeles Times yesterday under a different (better) headline.

It's worth the read for the opening sentence alone!

"You'd think the healthcare establishment would have bigger fish to fry than Ricki Lake. (The 47 million uninsured, maybe?)"

Check it out. You can let the Star Ledger know what you think at Eletters@starledger.com

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.

cue Tom Petty

"...the waaaiting is the hardest part..."

I'm waiting to hear back from a client in labor today.
I try to manifest patience, really I do. But the life of a birth doula includes a lot of waiting by the phone. It's not like my pride is on the line, waiting for a boy to call me as a teenager - I know my clients will eventually call. But until they do, I'm on endless hold, only with better music playing and more adrenaline pumping.

Once I know someone is in a little bit of labor, but not ready for support, I'm on pins and needles waiting for THE call - the call to join them. Until it comes, I'm a bit of an OCD juggler, going over my plans for childcare and pickups and backup doulas (oh my!). Should I sleep or have more coffee? Is my stuff ready? Any more calls to make? Has my phone rung? Is the ringer even on? OM.

Sometimes I try to invoke Murphy's Law and start a recipe or project that's involved, so hopefully I'll get called at an inopportune moment, which is actually what I wanted to have happen in the first place.

But mostly I just wait, trying to practice what I preach and trust that it will happen the way it's supposed to.

Maybe Mary had it better than we thought!

Something to think about: when preparing for birth, we need to find ways to have the environment suit us and not the other way around...if we do so, there will likely be less distress and less need for interventions. I'm just sayin'...

Excerpted from "Safer Birth in a Barn?" Beth Barbeau
Midwifery Today Issue 83

"The protocols in the world of animal husbandry to protect an offspring at the time of birth - no strangers, dimmed lights, freedom of movement, familiar environment, unlimited nourishment, respectful quiet, no disruptions - are done without hesitation because to do otherwise invites "unexplained distress" or sudden demise of the offspring. These thoughtful conditions are the norm, along with careful observation to determine when to use the technological expertise in true emergencies. When we have veterinarians in our childbirth education classes, they always start to smile and nod when I tell this story. These are givens - instinctive givens, even, for animals of all descriptions!

Yet what are the "givens" for the human who births not in a barn, but in a "modern and advanced" hospital? In many cases, 100% the opposite! Usually a minimum of a dozen strangers pass through the world of the laboring mother in her first 12 hours in the hospital - security officer, patient transporter, triage secretary, admission clerk, triage nurse, resident and/or doctor on call, admitting nurse, first shift nurse, break nurse, additional nurse at delivery, doctor or midwife plus possibly students, anesthesiologist, pediatrician, etc. Bright lights in the triage and labor rooms are challenging to dim. Mothers are tethered to monitors or IV poles and are moved through a bright hall with unfamiliar sounds to a new room in a building devoted to illness/trauma that most have visited once briefly if at all. They receive poor quality "clear liquids only." They are exposed to voices of others in the hall or chatting by the attendants during contractions and endless disruptions throughout! But then, do we ever find that we have an offspring experience "unexplained distress?" Of course, and at frightening rates! Yet, oddly, many of these disruptions are promoted as minor inconveniences or necessary to "protect" the baby.

Curiously, while veterinarians commonly have to defend interventions in light of the additional cost and the risks associated with interfering with nature, providers caring for human mothers within the medical system more commonly are forced to defend why they did NOT intervene! Consider the high rates of inductions, epidurals, artificial rupture of membranes, immediate cord cutting, cesareans and the vigorous defense necessary to fight for anything different, especially if time is involved (time to go into labor, to progress, to push, to allow the cord to stop pulsation or to get "done" bonding). I've recently seen outstanding CNMs and obstetricians sacrifice their own political reputations and suffer departmental reprimands for births with great outcomes where they protected the mothers' yearning for privacy, allowed extended pushing time with great vital signs or, during a healthy normal birth, followed their intuition and honored the mother's begging to check heart tones frequently by hand during pushing instead of what the mother considered the massive intrusion of wearing the monitor belt. Interventions are considered to be the ultimate protection from litigation in human care, yet they contribute mightily to the high rates of distress in mothers and babies!

In animal husbandry, the first line of defense for protecting the unborn is to protect and nurture the nutritional needs and comfort of the birthing female. In the case of institutionalized birth for humans, however, in spite of evidence to the contrary, the norm is to act as if the nutritional needs and the comfort of the birthing mothers are of concern to, at most, the marketing and public relations department! It's an affront to common sense that as a society we are currently more accepting of the needs of foaling mares, whelping poodles and high-producing cows than of our birthing humans. From the high rates of fetal distress, meconium staining and breastfeeding problems, the consequences are clearly devastating to our infants, just as any decent horseman would predict."

Home Sweet Home

There is a great new statement on Huffington Post about birth which begins,

"Ladies, the physicians of America have issued their decree: they don't want you having your babies at home with midwives.

We can't imagine why not. Study upon study have shown that planning a home birth with a trained midwife is a great choice if you want to avoid unnecessary medical intervention..."
http://www.huffingtonpost.com/ricki-lake-jennifer-block-and-abby-epstein/docs-to-women-pay-no-atte_b_107845.html

Check out two responses to this resolution to limit women’s autonomy in how, where, and with whom they give birth. http://www.pushedbirth.com/ The first is from Canadian physician and researcher Andrew Kotaska, the second is from the National Childbirth Trust in England, where the government is encouraging women to consider home birth!

Home birth not for you? Fine by me. But please, we need to speak out and protect a women's right to choose (her birth place)! Elective cesarean is being held out as a matter of women's choice by the very doctors who seek to deny women the right to choose home birth. This in spite of the fact that home birth is repeatedly shown to be as safe or safer for healthy women than hospital birth - something that can not be said for all cesareans.
http://www.ipetitions.com/petition/birthathome/index.html

Still not convinced?
http://observantmidwife.blogspot.com/2008/06/response-to-acogs-amas-resolve-to.html

Why We Must Stand Together