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A Rave About Midwives

by Amelia on May 21, 2009
category: Labor and Delivery,Pregnancy

1289283711_1d68423a87 I had my first prenatal appointment today with the midwife group that I see.  The birth center is downtown which is about 35 minutes from where we live.  As I was driving I got teary because I knew that when I got to the appointment I would feel very cared for.  I wouldn’t have to put on a positive, faith-filled front. I knew I could let my guard down and share my concerns and worries.  I wasn’t toting all the kids with me so I wouldn’t have to play mommy either.  It felt nice that I wouldn’t have to reciprocate any questions.  I had the luxury of going somewhere that was just for me.  

It sounds sort of selfish, I know.  It felt more like I was going to a counseling appointment than a prenatal appointment.  I have a lot on my plate right now.  We are downsizing in a MAJOR way, selling more things than we are keeping, and moving across the country back to Texas before moving to England later this summer. And we just moved up our leave date to Texas by about 11 days so the pressure to finish all that needs to be done has gone up a new notches. There are so many details that float through my head on an hourly basis it is exhausting.  I’ve been sick with a cold and sinus problems for the past 2 weeks–sometimes feeling okay and sometimes laid out on the couch.  I’m mindful of keeping the stress of the 2 upcoming moves as little as possible for all the kids.  And hubby and I are having a lot of conversations about all the details and trying to communicate well about them (a.k.a not argue and take the stress out on each other).

I walked into the appointment and was purely thankful because I knew that the midwife I was seeing was “with me”.  Midwife means with woman. And she is for me. One of the first things she said was, “I have a lot of things to ask, but first is there anything that you would like to talk about…any concerns or questions?”  There was no hurry, no pressed time.  She was all ears about any questions I had.  I did have a small list.  I’ve been having a little spotting the past few days so I wanted to talk about that.  I told her that although I have been thankful for much less nausea this pregnancy it did have me concerned because it has been so different from my last 3 pregnancies.  I mentioned that I don’t want to have another (almost) 12 lb. baby and would like some direction on what to do about that.  I also needed some guidance on what I could do with all the sinus headaches I’ve been having for the past week.  Even though I had my last baby with the group, she looked at my file and looked over any concerns about my last pregnancies and/or health issues.  We went through my health history together and I was free to share any new thoughts that came up during our conversation.  Through all of our conversation, she was very encouraging and reassuring.  I never felt stupid for asking questions and I never felt like I needed to rush.

3036272286_0336e0c399_m She asked me if I was comfortable with getting an ultrasound to help me feel better about how the baby is doing.  I agreed and made an appointment for early next week.  We tried to listen to the heartbeat but since I am still in my 10th week I knew it would be a slim shot.  We didn’t get to hear it but I knew it wasn’t something to worry about.   She did an exam to check my cervix and make sure it was closed and to look and see if there was any old/new blood.  As she did the exam she walked me through the whole thing (even though I totally know what to expect).  I still appreciate it because she is respecting me as a woman/mother.  We set up an another appointment right before we move even though it is a few days earlier than it would normally be.  I don’t think I’ll have prenatal care again until we get to England so having one more appointment just to check on me seemed important.  They will have my file ready so I can take it to England with me.  She was very encouraging about the prenatal care I will get in England.  She worked with a midwife who was trained in England, so is familiar with the system and how it works.  

Even though I am a birth teacher and I know a lot of information about pregnancy and birth, I still need to be cared for.  I don’t mean to imply that my husband doesn’t take care of me or look out for me, or that my friends and family don’t care. It’s just that there are many different hats I wear as a wife, friend, daughter, sister, mother etc.  Do you know what I mean?

I left my appointment feeling relaxed, uplifted and cared for.  And that is how it should be!  I love midwifery care! I love that one of the values of midwifery care is to look at my whole person–not just the baby growing inside me.  I find that I appreciate it more, the more children I have!  There are many women who choose midwifery care (from Certified Nurse Midwives-CNMs) even though they want epidurals during their labors or need to have c-sections for one reason or another.  You don’t have to be earthy-birthy to love the personalized care you often get from midwives.  Their job is to be “with woman” and to care for her where she is–not make her super granola.  

I’m sure that many of you have had similar experiences with ob/gyns but I have heard many, many stories where that is not the case.  I just like to throw out an alternative for anyone who might be looking for something different, who might need some extra attention during pregnancy and motherhood.  Midwives are wonderful and I hope that anyone who has been comtemplating switching practices might consider the midwifery model of care.  Most CNMs also do well-woman visits too!  

So what do you think?  Does that kind of care sound appealing to you?  What extras do you need when you are pregnant? Would you ever try going to a midwife?  Why or why not?

The Midwife: A Memoir of Birth, Joy, and Hard Times

41p0vy8-3ml_sl500_aa240_ Imagine yourself living in post WWII England. There are buildings that have been condemned due to safety hazards with people living in them anyway.  There are bomb shelters and buildings that have been damaged by bombings.  You live in London’s East End and you work with people who you have been sheilded from your whole life.  You are a nurse, training to be a midwife and living in a convent with nuns and other nurses.  You aren’t too big into religious things so living in a convent with nuns is interesting. You are thankful that you don’t have  to go to the services, and yet thankful for living in community with these fascinating women.  You go out on a bicycle, your only means of transportation, on daily calls to the people in the East End–mostly in the tennements (otherwise known as slums)–even in the rain.  You do prenatal care and help to deliver babies.  Sometimes you help the other nurse nun who you don’t get along with too well do patient care visits to the older, sick people in the community. You discover that a family with 10 children can live in a two bedroom flat and that laundry can be hung anywhere and everywhere. 

Jennifer Worth, a midwife from the 1950′s did all of these things.  This book, The Midwife, is a biography of her life as a midwife. She went to live in the London Docklands to serve a wide community of people as a nurse-midwife. The area she served dealt with fighting, drunkenness, and poverty.  The overcrowded area seemed to welcome crime.  The people were also hard working, trying to make a living and the men trying to provide for their families.    

Her memoir is definitely an interesting read.  The chapters are story clips of women whose births she attended, difficult births, families with domestic violence, families with great love for one another, a prostitute, and nuns she worked with.  She paints an amazing picture of what life was like back then. I enjoyed learning about some of the history of London and especially enjoyed learning about the Cockney dialect.  Her stories are engaging and easy to read.  

You don’t have to be a midwife or even particularly interested in “birthy things” to enjoy this book.  This book helped me to appreciate some of the modern day conveniences we have as mothers.  Indoor toilets, running water, washing machines!  Can you imaging having 10 children with no running water in your house and no washing machine?  Can you imagine how much of your day would be spent simply washing clothes?  It helped me to appreciate the amount of space we have for our own living quarters and that there aren’t abandoned bomb shelters nearby with people doing all sorts of terrible things while my children are outside playing.

One of my favorite chapters is about a woman from Spain, who only speaks Spanish, who is married to a man who only speaks English.  Oh, and they have 25 children!!!  25 children!  Can you imagine?  Their story is heartwarming and leaves you with your jaw dropped.  

If you go on Amazon and read the other reviews of the book, I think you’ll want to find your own copy to read.

A Day With Ina May Gaskin

by Amelia on April 9, 2009
category: Labor and Delivery,Practical Tips,Pregnancy

3408709456_c5672b505c_m I got to spend a whole day with Ina May Gaskin, well known midwife and author of books Ina May’s Guide to Childbirth and Spiritual Midwifery.  She came to Pittsburgh to speak to a group of doulas, childbirth educators, midwives, labor nurses, and anyone interested in the power of birth.  She gave several talks: Hands: Our Treasured Tools, Sphincter Law, Forgotten Powers of the Vagina, Demand Cesareans, and Post-Date Inductions.  

I was very interested in her talk on post-date inductions because this issue is one that is so common and one that many women have to face, either by doctors who are pushing inductions for various reasons (many unnecessary), or by women who do go past their due dates.  I rather enjoyed her talk on Sphincter Law.  Not only was it entertaining, but she highlighted the idea that bringing humor into the labor room can be freeing for the woman in labor and can also help her labor to chug along and be less painful.

A word about induction:  Did you know that first time moms who get induced are twice as likely to end up with a cesarean than mothers who go into spontaneous labor?  Did you know that there are many natural things you can try to get labor going instead of opting for pitocin first?  Did you know that many practices like to induce women with a drug called Cytotec (misoprostal) that has not been proven to be safe for pregnant mothers?  It is a great drug to use for post-partum hemorhage but when used to induce labor, there can be many complications.  Cytotec is a drug that cannot be counteracted, it can’t be turned off like pitocin can.  It can’t be removed from the body. One of the complications of the drug is that it can cause hyperstimulation of the uterus which can then distress the baby.  Using a drug that can’t be counteracted and can have harmful effect on both the mother and the baby is not wise.  Many women are not shared the possible risks when given this drug.  Ina May is very passionate about women knowing their options when it comes to birth.

In her book, Ina May’s Guide to Childbirth, she goes over the theory of Sphincter Law thoroughly.  It was fun to hear her talk about it in person.  The basic premise behind Sphincter Law is that the cervix also functions like a sphincter.  Like our other well known sphincters (think toilet humor), the cervix doesn’t respond well to commands, pressure, or fear.  How many of you have had “stage fright” when it comes to pooping or peeing in front of someone or sitting next to someone in the next stall?  Our emotional state of relaxation can have a powerful effect on the cervix.  Fear and shame can keep the cervix closed.  Ina May talked extensively about how bringing in a sense of humor into the place of birth can help the body release endorphins that overrule the adrenaline that gets released when afraid.  Sometimes not understanding what is going on with your body while it is laboring can cause fear too.  Her suggestions for keeping that cervix open and able to open is to bring in humor and allowing your mouth and jaw to relax. Making low groaning sounds or making your lips vibrate like a horse can keep that jaw relaxed.  (Relaxing your jaw also helps  you to poop when it feels difficult to do so :) .) She recommends that kissing your husband while laboring can also help keep that jaw relaxed.  Of course, if you are laboring in the hospital, you might want to ask for some privacy ;) .

3407874325_94070d4265_m Ina May also talked about her project, The Safe Motherhood Quilt Project.  She started this project several years ago to try and waken the government to the need to decrease the maternal mortality rate here in the US.  Did you know that the maternal mortality rate has not decreased since 1982?  It is increasing, in fact. It is also thought to be grossly underestimated.  We are ranked behind 40 other countried for maternal mortality.  You would think that with all of our technology that the rate would be decreasing but that is not the case.  As the rate of Cesareans has risen, so has the maternal mortality rate.  

 

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Some of the deaths that happen every year of unpreventable, but many are not.  Ina May started making a quilt in honor of the mothers that have died from complications of birth. An interesting phenomenon is the increase of death from amniotic fluid embolism.  Some speculate that the increase of inductions is also increasing the number of deaths from amniotic fluid embolism.  There needs to be more studies done so to show why there is such an increase.

I cannot tell you how important it is to spread the word for women to know their options when it comes to birth.  I advocate giving birth where you feel the most comfortable.  For some women, that is at home.  For others, it is at a birth center or hospital.  It is so important to know the procedures that are done and what the risks and benefits are.  For example, when a woman show up in labor at the hospital, the staff will break her water, insert an internal fetal monitor, and even start her on a pitocin drip to speed up the labor.  A mom may not know that as long as her and the baby are okay, breaking the bag of waters and inserting an internal fetal monitor is going overboard.  Using pitocin when it is not needed is simply unnecssary and introduces risks to the mother and baby.  She may not know that it is okay to refuse those things.   

There are many resources available to help women make informed choices about childbirth.  Some of my favorite books are:

My Birth Story: 8.5 hours, a Birth Center, and a 9.1 Pound Boy

by Amanda on April 1, 2009
category: Labor and Delivery,Pregnancy

I had a great time enjoying my maternity leave from The Mom Crowd. Thank you so much for all the guest bloggers that filled in for myself, McKenna, Dawn, and Amelia while we either having a baby, going on vacation, or going to Eastern Europe to bring home a new adopted member of the family!

I LOVE hearing labor and delivery stories and I thought I would share how my second delivery went in my first post back. I love how having a blog forces me to write out my story. I know years from now I am going to be glad I wrote this story.

Roman’s Birth Story

I woke up March 3rd at 5:41 a.m. with my first contraction. I was already dilated to 3 cm and the baby was in -1 station before my labor began. The day before my lower back hurt really bad, but I still went walking with my friend Barb around an outdoor mall here in San Antonio to help induce my labor. Looks like walking worked!

dsc_3.jpg For the first hour my contractions were every 10 minutes apart. I woke up my husband after the first hour and he began to time them. I am super thankful that my 22-month-old daughter had Mother’s Day Out (MDO) that day and my husband managed to get her there on time. We also made arrangements for other people to take care of her the rest of the day after MDO. I laid in bed all morning watching t.v. in between contractions.

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Bringing Siblings To Your Birth

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Have you ever considered having your older children come to the birth of their newest baby brother/sister?  What is your first reaction when you think about having your children come to your next birth? If your first reaction was, “Never!” you aren’t alone.  Many people think children would be scared or scarred for life if they saw their moms (or anyone else for that matter) give birth.

I want to provide an alternative way of looking at bringing children to the birth of their new sibling.  Children are curious by nature and most children love babies.  Allowing a child to be part of the significant moment of introducing a new family member into the world can be a positive, unforgettable experience.

Penny Simkin, doula and childbirth educator extraordinaire co-authored a book called Birth-Through Children’s Eyes several years ago.  I found a copy of it at half-price books when I was pregnant with my third child.  I thought it would make a great resource for my birth class lending library.  As I read the book, I started talking to my husband about having our oldest child (who had just turned 4) come with us to the birth center to be there for the birth.  He was skeptical at first but as I shared from the book he became open to the idea.

In Penny’s book, she did a (small scale) study with some children and compared the experiences of children who had been at their sibling’s birth and those who hadn’t.  She had the children draw pictures as a way for them to talk about the new addition to the family.  The biggest difference between the two groups is that the children who DID go to the births felt more accepting and less jealous of the new baby than those who did NOT go to the birth.  The siblings liked having a role in the birth and being one of the first people to hold the new baby.

All of the moms I know (myself included) who are having additional children ponder  and talk about whether or not the other child(ren) will be jealous of the baby and take it out on either the baby or the mommy.  Everyone in the family must readjust to the new family layout, that is true, and there are a lot of factors that can make that transition easier.  Having family/friend/church support to bring meals, help out with laundry, and some light cleaning can be a relief to any mom.  Talking with older siblings about how a new baby is coming and reading books about it together can help too.  What if inviting older children to the birth of the new baby was an additional help?

Most people balk at the idea because we bring in our own fears, scary stories, and ideas about birth which makes it hard to see birth the way a child would see it.  I mentioned before that children are curious by nature and love learning–and babies.  Having them at birth does open up potential conversations about how human reproduction, how babies are made, and where they come from.  True, those kind of conversations can make us nervous because we don’t want to say the wrong thing–my perspective is that I want my children to learn those things from me and I am willing to answer their questions.  I don’t feel the need to explain everything to them :) .

I have some suggestions on how to make it work if you do decide to have older children come to the birth of their new sibling.  Most of these come from Penny’s book and some other things I have read about it.

1. Have a friend/relative designated to be the child’s helper.  Your children should have a good relationship with the helper. This person is there to help the child(ren) with activities, answer questions, and to be supportive to the child.  They can watch the child and make sure that he/she is feeling comfortable or provide things to do during the labor (which can be boring to a child).  Pushing the baby out is much more exciting!  Preparing the child ahead of time so they know that daddy will be helping mommy and won’t be available to help him/her is important.

2. Plan activities ahead of time for the child: Bake a birthday cake or cupcakes and bring it to the birth so the child(ren) can frost and decorate while you labor.  Bring books, paper, markers, crayons, play-dough to help pass time.  Portable dvd players and movies with a sleeping bag can be a great way to settle down.  If you are birthing at home then you can wake the child up shortly before it is time to push.  If you are birthing in the hospital you can have the helper bring the child near the end of labor too–especially if it is in the middle of the night.

3. Help prepare the children coming to the birth by reading books about birth, show pictures, and watch some videos together. You tube is a great place to find some birth videos.  Explaining to the child that birth can be messy is a good thing.  It is good for them to know that they might see blood  and that the baby might look kind of slimy when it comes out.

4. Give the child space to decide when he or she wants to be in the room.  Forcing the child to be there when he doesn’t want to be will be distressing to him.  (This is why you bring in a special helper.)  Also if you, as the laboring mom, decide you don’t want the child there then you can tell your helper to take the child to another room.

We did have our oldest come to the birth and decided to have our middle child (who was almost 3)  stay home. We made arrangements with some friends to come and sleep at our house should labor happen in the middle of the night so someone would be with him.  My mom was our Ewan’s helper.  We had asked Ewan if he wanted to come to the birth a few months in advance.  He did so we started talking to him about how my mom was going to be his helper and pal at the birth center.  We told him about the different things he could do while we waited for the baby to come.

Labor started in the middle of the night and Ewan was very excited about getting to be up.  As I was pushing the baby out he saw a little blood and said, “I think I want to go watch a movie upstairs.”  So off he went and we got him after the baby was out.  We had a few complications (the baby’s shoulders got stuck and it was a little intense) so in the end we decided that it was probably a good thing that he decided to leave.  He has had a very strong bond with Graham (the baby) and still talks about being at his birth.  He remembers me making funny labor noises in the backseat of the car on the way, he remembers making cupcakes, he remembers holding Graham for the first time.  He loved being there.  Our middle child took longer to bond with the baby and warm up to him.  Some of it may have been his displacement as the baby, or age, but I do wonder if he would have warmed up quicker had he been at the birth.  If I could do it all over again I would have the same plan.  If we have another baby, I will invite both the older boys to come to the birth for sure.  I won’t know about Graham until we are closer to birth day.

So what do you think?  Did you go to any of your sibling’s births?  Were any of your children at any of your other births?

 

 

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