Archive for the 'dilation' Category

The secret weapon

Every once in awhile, someone will ask me this question:

“Is there anything you didn’t know about birth that you wish someone would have told you ahead of time?”

By the time I was 39 weeks pregnant with Animal, I was 100% sure that I knew everything there was to know about labor and birth. I had read everything I could get my hands on–books, articles, research studies, websites, etc. I had talked with countless women who were experienced in natural childbirth. I asked my midwife everything under the sun.

In the last month of pregnancy, I had covered one wall of my bedroom with pictures and descriptions of every position and comfort measure known to woman. I wanted to make sure I could easily reference these during labor. (And I did!) I walked a lot. I leaned on counters, sinks, and on my bed. I sat on the toilet to relieve the pressure of a 9lb baby impatiently pressing down into my pelvis. I sat on the birth ball and rocked. I slow danced with B. I swayed and moaned and hypnotized myself. I found my rhythm, my unique ritual. There were no surprises.

Until a few moments after my baby was born. Until the afterpains came.

I knew that there would be some mild-ish contractions, to expel the placenta. I knew there would be some cramping, as my uterus tightened up. I remembered the aching I felt every time I breastfed my firstborn. But in no way was I prepared for the pain that immediately followed birth. I later learned that afterpains can be more intense as you have more babies. I really had no idea that they even existed, considering I had been completely numbed from the epidural during my first two births. I wonder sometimes if the terrible cramping I experienced was due to the Cytotec my midwife gave me orally immediately following the birth. But what I really wonder is why I did not find these afterpains mentioned in any of the books I had read. Maybe everyone thinks, “Hey, you just went through the pain of childbirth, and now you have this beautiful infant on your chest and you’re so wrapped up in the bliss of Babyland that you just don’t notice too much.”

Well I did. That’s for sure. It hurt so badly that I wanted the baby off of me. In the video we took, you can hear me saying “This is so unfair! My baby has been born and I’m still having CONTRACTIONS!” For me, the contractions were all well and good when there was a baby coming out of the deal. But at that point in time, I really didn’t give a flying fuck what was going on with my uterus. It was terrible.

Somewhere along the line, someone (God bless your soul, whoever you are) brought in a hot rice sock and placed it on my lower abdomen. The relief it brought was amazing.

That rice sock got some serious use. Not only did I use it for the first week or so before EVERY nursing session, I also used it to ease the stiff neck that plagued me from trying to learn how to breastfeed. Later, I would wrap it around my breasts to encourage letdown while I pumped. I utilized it again and again during TWO boughts of mastitis when I came down with influenza and was bedridden for two weeks. The thing was a savior to me.

And so, I want to make sure my clients have the option of a rice sock. Since I don’t have the funds to go buying the fancy schmancy version, I searched the web for tips on how to make my own. Almost everything I read told me to use an old tube sock. Fill it with rice, tie up the end. Voila. Well folks, there is no way I’m pulling out an old sock for my clients to use on their most tender parts.

And so, today, I visited the thrift store and picked out some scraps of material. I came home, lifted the sewing machine that my mother-in-law gifted to me, and took it out of its case. I opened up the instruction manual, carefully following the directions on how to wind the bobbin, thread the machine (wow! complicated!) and sew a straight stitch and a blanket stitch. I cut the material, figuring out how exactly it would work. I sewed. I filled the long rectangular pillow full of rice. I sewed it shut. I SEWED. Amazingly, this thing came out looking really, really nice. I bet you would never guess that I don’t actually know how to sew.

All I can say is that I am totally addicted. And still, the thought of me sewing makes me crack up. Every time. Damn, I’m domesticated. And proud!

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A typical morning

Last night at my Childbirth Education classes, the instructor mentioned something about how nearly every other culture besides ours adopts squatting stances. American’s don’t squat, we sit. We’ve lost the ability/muscles to squat for long periods of time, which is one way in which we lose during childbirth. Squatting opens up the pelvis and allows more room for baby to come through. Anyway, she mentioned that if you observe small children, they are constantly squatting. They squat until we teach them not to, by giving them a chair to sit in. This tickled me, because my little Animal squats all day long. Here is this morning’s example:

Empty

PLEASE WATCH THE VIDEO HERE . Make sure to turn your speakers on!

In the United States, 30% of babies are born by cesarean. In 1970, the cesarean rate was a stable 5%. The World Health Organization advises that a cesarean rate higher than 10-15% is dangerous to women and babies. This means that OVER HALF of all cesareans performed in this country are UNECESSARY. To add insult to injury, hospitals around the country are banning a woman’s right to have a vaginal birth after cesarean (VBAC) even though it has been proven to be SAFER than repeat c-section.

Additionally, 50% of women suffer complications from their cesarean and are 2-4 times likely to die than a woman giving birth vaginally.

Nearly half a million women every year are undergoing surgery to birth their babies. These surgeries aren’t saving lives. They are robbing women of the birth experiences they deserve, and making their obstetricians wealthy.

For more information, and to help support c-section awareneness and VBAC activism, please visit www.ican-online.org.

Being cheated

Last night I attended a Childbirth Ed class taught by the wonderful Hannah. She’s a fantastic educator, very entertaining and informative. We took a tour of the hospital where she took the bed apart, hoisted her little frame up into that bed and showed several different positioning examples, including all-fours and legs spread with feet up on the squatting bar. What a dynamic lady she is. I’m just not sure I could get in front of an entire roomfull of people and spread eagle. Lol. Very cool of her.

The whole experience was really neat, watching everything from an observation standpoint instead of being an expectant parent. I got warm fuzzies just seeing all of the couples, so excited and full of hope. The Daddy next to me was rubbing Mama’s belly and the one in front of me kept looking at his wife and smiling lovingly. It made me want another baby so bad I could taste it.

But when I got home and sat down to unwind, I was overcome with so many feelings that needed to be sorted out. Mostly, anger.

I’m angry that at 18 years old, I trusted my doctor when she told me at a prenatal appointment that “an epidural would be best for me.” I’m angry that I was always stuck in the waiting room for my appointments, that I could never get through on the phone, that everyone was too busy to answer my questions, and that she would fly in and out of the examining room before I had a chance to process the information she had given me. I’m angry that I was treated like cattle, along with the rest of her patients. In and out. Push them through. I’m angry that she sent me to Childbirth Ed classes, where I was taught how to be “a good patient”, to do exactly what they wanted me to do instead of giving me options. I’m angry that although my labor was only 6 hours long, she augmented with Pitocin. I’m angry that I was gripping the bed rails, curling up into a tiny ball and screaming from the pain. I’m angry that there were decels in my son’s heartrate, that there was distress and meconium that probably could have been avoided if my doctor would have been patient enough to keep the Pitocin out of my veins for a few hours longer. I’m angry that I never moved from the bed, strapped to monitors and an IV pole. I’m angry that I was numb from my breast bone to my toes, that I could feel nothing, that nurses were yelling, that I pushed so hard I bruised the sockets of my teeth and popped blood vessels in my eyes. I’m angry that my son was pushed too hard and too fast into the world and countless stitches were needed to repair the damage. I’m angry that my doctor tugged away at my placenta and that there was so much blood that she mentioned a transfusion, that I was anemic afterwards and had to keep my catheter in for the entire next day because I could not even stand. I’m angry that when breastfeeding went terribly wrong, the nurses, the lactation consultants, everyone gave up on me. And I’m angry that 18 months later, when my second child was born, everything happened all over again.

I almost feel like I need to grieve my first two births. Sure I had no major complications and my babies were healthy. But there was so much I missed, so much my boys missed. I feel so lucky to have had my last child be born at home. It was definitely a real healing experience for me. But in a way, it made things worse. I feel cheated. Even though I was reading everything I could get my hands on about pregnancy and birth and breastfeeding, the information that was presented to me was one sided. I was molded into my doctor’s perfect patient. She got paid for doing so very little, and now I forever pay the price for her lack of concern.

I guess it’s important for me to keep focusing on the fact that I was able to reclaim my motherhood, my instincts, myself. I have to remember that a year ago, I was in my own bed, watching my baby be born. I was letting him come, allowing my body to do the work as his head crowned so slowly and gently. I have to remember the waves of contractions that washed over me, the absence of fear and pain. I have to remember lifting his body to my chest, no one cheering or yelling, no bulb syringe, no gleam of the scissors to immediately sever him from me, no towels to scrub away his vernix. I have to remember that a year later, he still finds nourishment at my breast, that my child is still nursing when I was told again and again that I would never breastfeed. I have to remember it all, and be gracious for it, for the way I was given that one last opportunity to discover empowerment.

The First Birth

So I suppose I should probably announce that I have acquired my first client as a doula-in-training. Am I allowed to even call her a client if I’m not a certified doula yet and I’m not charging her? I wouldn’t want to be using improper doula etiquette.

Anyway, in order to complete my certification I am required to attend three births as the primary doula. I hadn’t really thought of this portion of certification yet, since I am mainly focused on the actual four day workshop I will attend in March that will hopefully teach me some necessary doula-ing skills. And so, I wasn’t keeping an eye on prospective clients. One just happened to fall in my lap. She’s an acquaintance of mine, pregnant with her third child, and due in early April. I was so shocked when she asked that I fumbled on the phone for quite some time. Obviously, I’m excited. I’m absolutely thrilled about it and I’m so very honored that she would think so highly of me that she would want me to be at the BIRTH of her CHILD! But mostly, I’m nervous as heck. And here’s why:

1. I’ve never attended any births. I narrowly missed my best friend’s labor and delivery, when my goddaughter decided to cannonball into the world at warp speed before Auntie Estella could make it to the hospital. Of course I’ve had three children of my own, but obviously, not the same experience. I realize that at some point there will be this first birth, but I would prefer to have at least observed one before I’m taking the main supportive role.

2. I never had a doula present at any of my births. And not just that, I didn’t even want a doula. When I’m in labor, I don’t allow anyone to talk to me or touch me during contractions. I don’t even want to look at anyone. I want to close my eyes and go to the Happy Place, and I don’t want you coming with me. When I was pregnant with Animal, I did some interviews with a few doulas thinking that I should just go with it, since it was the right thing to do. But in the end, I couldn’t fathom spending a few hundred bucks on a doula when I wouldn’t have even allowed her to speak. I also wanted to make sure that I was birthing in the exact way that my body wanted to birth. I didn’t want anyone suggesting positions or coping techniques. I wanted my body to tell me what to do. And in the end, it did. A little over two hours of silent-no-touching-me-contractions and we had ourselves a little Animal.

3. This particular momma desires a natural birth. Now normally this would be the ideal situation, right? I should be a wreck over the women who automatically plan for the narcotics, the epidural, the episiotomy, the purple pushing, and the whatever-else. But this momma has tried to go natural the past two times. During her last birth, she stalled at 8cm and she reports that her doula kept pushing her to resist the OB’s advice to break her water. She states the pain became too great, too long in transition and she caved on the epidural. She says that she’d still like to have a doula this time around, so that someone can “keep her butt in line.” It just makes me feel so terribly responsible for the outcome. And considering my inexperience, it’s stressing me out.

What if I ruin her birth experience? What if she hates the sound of my voice or my suggestions or the way I smell or something? What if she thinks I’m annoying and kicks me out of the birthing room, or even worse–what if she doesn’t have the courage to kick me out and she regrets having me there for the rest of her life? What if she ends up with another epidural and wishes that she would have called upon Patti Ramos instead of Estella the aspiring doula? It’s so huge. It really is just SO HUGE. Rationally, I know that these feelings are pretty normal. I know that there must be a First Birth. I know that there is probably some anxiety before every birth, and not just the first. I know that this is something that I will have to work through. I’d just like to start feeling a little less worried and a little more capable.

Animal’s birth story (Uncensored)

Today is Animal’s birthday. I think a birth story is appropriate. Here is what I was doing one year ago today.

October 30, 2005

It was one week until my due date. I was fucking miserable. I was 60 pounds heavier and I looked like the Stay Puft Marshmallow Man. Seriously, I just looked at that link from Wikipedia and started laughing my ass off because that IS EXACTLY HOW I LOOKED.

Anyway, I had been having “false labor” for 2 weeks. I begged my midwife to strip my membranes, and then to do “cervix stretching”, which let me assure you, is not a pleasant procedure. I never thought I would have demanded this sort of intervention, but by 39 weeks I was experiencing excruciating pain from a condition known as Symphisis Pubis Dysfunction. Now, I’m one tough broad, but the separation of your pubic bone during pregnancy is nothing to fuck around with. I couldn’t roll over in bed, get out of bed, or walk up the stairs without experiencing severe pain. Needless to say, I wanted the baby OUT. My midwife relented and started me on homeopathic versions of black and blue cohosh. I alternated between the two for 24 hours. Nothing happened. I was feeling restless and anxious and pissed off. I called my mom and told her that if I didn’t get out of the house PRONTO, I was going to have a panic attack.

6:15PM
I blame (thank) my Mother for the true reason my labor started. She was driving me home from our quick shopping excursion, in her usual manner, which includes running red lights and veering off of the road. While I was gripping the door handle and trying to remind myself that she hadn’t killed herself yet, in 40+ years of driving experience, I felt a little *trickle*. I figured that it was just spotting, due to the aforementioned CERVICAL STRETCHING, but I joked to my mom that “I either just peed my pants or my water broke!” We got to the house and when I got out of the car, it just kept on trickling. I went to the bathroom and checked things out. No blood. Aha! Maybe this was it. I decided to call my midwife and see if she thought I was leaking amniotic fluid. She said “Usually when your water breaks, there is no doubt about it. Your socks will be soaked. Call me back in an hour.” I ate dinner and fiddled around on the computer for a bit. When I stood up again to call the midwife, a huge gush came spilling out of me like a goddamn waterfall. It was all the way down my pant leg—no mistaking what had happened! My midwife, Ann, said that she would be right over to administer my first round of antibiotics, since I had tested Group B Strep positive. By 9:30PM I had received the antibiotics, and was still not experiencing contractions. My midwife decided to go out to grab something to eat (which I later found out was just an excuse to leave me alone to relax). I was watching a rerun of Desperate Housewives. No sooner had her car backed out of the driveway and I felt a strange “pop” and a sharp pain in my crotch. Immediately, the first contraction began. Two minutes later, another contraction. They continued on every two minutes. They were uncomfortable, but not yet painful. I tucked my boys in for the night and cleaned up around the house. My husband called the midwife and she returned to start filling the birthing pool. During this time I sat on the birthing ball and leaned on my bed listening to Norah Jones while B rubbed my lower back. I also sat on the toilet for quite awhile-it felt so much better! The worst part about the whole thing (and one which I reiterate again and again in the birth video) is the fact that I had to wear Depends undergarments. . The amniotic fluid just kept coming and coming! At one point, I actually had to send someone to the store for a SECOND pack of those damn things! I had not prepared myself for the fact that during my entire labor, I would be feeling that I was continually pissing myself. And so, for awhile, I stationed myself on the john.

I noticed that standing during contractions intensified the pain, but my midwife told me that my labor would go quicker if I remained upright, despite the additional pain, so I walked and stopped and leaned on door frames, walls, and furniture during contractions. I didn’t want to get in the pool until my contractions were unbearable, for fear of slowing my progress, and so far they were completely manageable. Around this time, we realized that the pool (perfectly heated to 100 degrees) was leaking! It was spilling water onto the carpet and had to be drained, patched up, and refilled. Ann contemplated running home to get a new pool. She checked my cervix to see if she might have time, and I was 5cm, 100% effaced and baby was in 0 station. It was now midnight. She decided she’d better just stick around. She worked with B, patching and refilling the pool (and trying to get it back to a good temperature, since most of the hot water had now run out). I was in my room alone, and the contractions were beginning to intensify a bit. I was back on the birthing ball, but now making low moaning noises, which really helped. I decided to try lying on my left side, since I was getting a bit tired. The contraction that hit while I was lying on my side didn’t feel right at all. It felt very wrong to be lying down, and I couldn’t believe that I had labored with my last two children strapped into a hospital bed. I began to feel nauseous and as is usual for me during labor, the pukes started. My midwife came in the room and excitedly explained to me that “throwing up equals ten good contractions!” I had never seen anyone so excited about vomit. She sprinkled peppermint oil in the “puke bowl” and it made my nausea really fade. I was starting to think that I may want to get in the pool, so Ann decided to give me my last round of antibiotics. I was leaning on my bed, waiting for the antibiotics to end, and my next contraction came in a fierce wave of pain. It took me by surprise, and I started yelling. I remember Ann telling me to blow out the word SHUSH as loud and as hard as I could. I could hardly do anything but collapse on the bed. My legs completely gave out on me. I felt a pain in my crotch and the next contraction came right on top of the last. It was just as painful, except this time I could feel pressure in my ASSHOLE. I started screaming to Ann that “he is IN MY ASS!!” Seriously. I’m not kidding. I really told my midwife that I thought my baby was coming out of my ass. She asked me if I wanted to get in the tub, but I couldn’t move an inch. She pushed me up onto the bed. I was sideways and barely on the bed when she checked me and said “Oh yeah, we’ve got a head knuckle deep!” She rushed around, grabbing her materials and asking me to blow through the next contraction. It was the hardest thing I have ever done. The urge to push was so unbearably strong! The contractions didn’t even hurt anymore, I just wanted the baby out! I didn’t have to push at all. I grunted a bit and blew out some air and my uterus did the work for me. His head began crowning. This didn’t really hurt either, and I was surprised to not be feeling “the ring of fire” as Ann continued to rub KY jelly around and helped me stretch around the baby’s head. I grunted a little more and his head was out. Then I felt an overwhelming need to push and I felt his shoulders break through. This part really DID hurt, and I found out later that his hand had been up and his fist breaking through with his shoulders was the reason behind the super crazy pain. I screamed like a animal! Whenever we watch the birth video, B laughs like a hyena at that part. Like it’s really funny that I’m screaming like a banshee because A 9 POUND BABY WITH BIGASS SHOULDERS AND A FIST IS COMING THROUGH MY VAGINA. But it was quick, and as soon as his body slipped out, there was no more pain. The baby was immediately placed on my chest and began breathing. It was fifteen minutes after midnight on Halloween morning. He didn’t need to be suctioned. The cord was cut when it stopped pulsating and 10 minutes after the baby, the placenta was birthed. Animal scored a 10/10 on his Apgars. I was able to walk around immediately after his birth and he was alert and active enough that I was able to get him to successfully latch on to breastfeed within the first hour. Birthing my baby at home was an amazing, life changing event in my life. It empowered me beyond words and gave me the experience I had missed in my previous births. (Even if I did have to wear Depends, piss my pants for 4 hours, and have the terrifying thought that I was going to deliver my child rectally.)

Epidural Risks

The question has been asked, “What are the possible effects of an epidural on the baby?”

-Epidurals can slow labor, and as a result, oxytocin (Pitocin) will be administered through an IV. Pitocin brings on unnaturally strong contractions and almost always causes fetal distress. Pitocin also increases the chance of a forcep or vacuum assisted delivery, as well as cesarean section. (All of which can cause even more unpleasant side effects to the baby.)

-An epidural will also require electronic fetal monitoring, which I believe is highly inaccurate and prone to error. Inaccurate signs of fetal distress picked up through electronic fetal monitoring can lead to an obstetrician’s hasty decision for an unecessary c-section.

-An epidural requires that a precautionary IV be put in place. Any fluid overload from this IV can cause fluid in the baby’s lungs and/or blood chemistry disturbances.

-Epidurals can cause a considerable drop in maternal blood pressure, which may endanger the baby.

-Anesthetic is delivered into the cerebrospinal fluid, then passes into the maternal blood vessels, crosses into the placenta, and into the baby’s circulation. It may act directly to slow the fetal heartrate.

As Henci Goer states in her book “The Thinking Woman’s Guide to a Better Birth” :

“By the time you are hooked up to an IV, an oxytocin delivery pump, a fetal monitor, an automated blood pressure cuff, an epidural pump, and have a bladder catheter, what was a perfectly normal labor has been transformed into a high tech event.”

Congratulations, you have now pretty much sealed the deal on an “emergency” cesarean.

Ladies, there are REASONS why God created us to experience pain during labor, and it ain’t just because Eve ate the forbidden fruit.

Pain during labor tells your body what to do. Pain will drive you into the most comfortable position, and that position is the one which is perfectly suited to effectively bring your baby into the world. Your body responds to labor pain by secreting massive amounts of adrenaline and endorphins. Adrenaline gives you stamina, keeps you going, gives you strength to push through. Endorphin levels at the time of your baby’s birth will be THIRTY TIMES HIGHER than normal. Natural oxytocin secreted in your brain will elevate your mood and will cause amnisiac properties. (This is why we forget the pain of childbirth and want to do it again!) The pain also prepares your baby for life, readying his lungs to breathe, mobilizing glucose for energy, protecting your baby against lack of oxygen during labor, and pushing blood into the baby’s brain and heart. THE PAIN IS SUPPOSED TO BE THERE, IS HAS A PURPOSE!

As a young, uneducated mother, I birthed my first two babies with the aid of an epidural. I was completely paralyzed from my breastbone to the tips of my toes. I felt nothing, and I thought that was a good thing! I couldn’t walk until the following day, couldn’t go to the bathroom on my own, had extensive tearing and bleeding, was exhausted, and felt like shit. My babies were sleepy and jaundiced. I failed at breastfeeding both times.

My last baby was born at home, completely natural. My body felt strong and alive. I could feel my baby’s head as it crowned. I felt in control of my body. When he was born, I felt like I was on Cloud 9. I felt energized. I was able to get up right away and walk around. I had minimal bleeding. My baby was alert and healthy, and scored perfect on his Apgar’s. And maybe best of all…We are now into the 10th month of breastfeeding.

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