Posteriority

October 17, 2013 at 4:04 pm

Eight years ago today my second baby came into this world upside down, or “sunny side up” as some people say. And she has indeed been a ray of sunshine in my life.

133 Amber pics 153_edited-1

She was posterior (facing my front side) rather than the normal anterior position (facing my back). Her posteriority (I think I just invented a word!) brought with it some surprises. I had fully expected my second birth to happen very quickly. My sister’s labors were each roughly half as long as the previous. My first daughter’s birth lasted less than six hours, so I was expecting my second to come in less than three! I suspected she might be posterior, however, when that supposed-to-be-fast labor turned into an on-again-off-again roughly 28-hour labor.

Birth Boot Camp

June 13, 2013 at 8:57 pm

In 2003, when I was pregnant for the first time, the only prenatal classes my doctor’s office informed me about were those offered at the hospital where I would give birth. The class we took did give us a few helpful tools, but I wasn’t overly impressed. So much has expanded in the world of natural childbirth education since that time. Today I’m excited to share an interview with the lovely Sarah Clark about the recently-created natural childbirth preparation program Birth Boot Camp. Sarah is a mother of four, a natural childbirth instructor, and is on the management team for Birth Boot Camp. She blogs about natural birth and motherhood on her personal blog Mama Birth and writes for Mothering.com.

How did you become involved with Birth Boot Camp?

Natural Birth Classes 250 x 250 alt I had been a natural childbirth educator for a few years when a friend of mine, Donna Ryan, approached me about working with her on a new project. (Donna had been my inspiration for becoming a childbirth educator and was actually MY instructor when I was pregnant with my first child. Her class helped me have a natural birth with a very long first labor.)

So, in a way I feel like I just got lucky. Donna asked me to join them, and I flew out to Texas to start working with her and the other board members to get everything ready before the launch. I started out helping with writing some of the materials and relaxation practices, and I also help Donna in training our new instructors. I met some fabulous women, many of whom I now consider good friends, and we have all been working very hard ever since.

My Conversion Story

April 21, 2013 at 6:59 am

When I was a young girl, I went with my grandmother to visit a woman who lived in a tiny white house behind our family fruit orchard. She had added another newborn to her growing flock of little ones. We peeked at the baby, sleeping calmly amid the hubbub of the other children. This experience would likely have receded into the annals of forgotten experiences if it were not for one detail that blazed it into my memory. This woman had delivered her baby at home, on purpose. I don’t remember how old I was at the time, but I was old enough to know that babies were supposed to be born at the hospital. And, besides, why would anyone want to experience that pain?

Not long after I got married, I had a brief conversation with a young woman we knew. She was pregnant with her first child and carrying a stack of birth-related books from the library. The books prompted our conversation, and she mentioned that she was planning to give birth without drugs. I responded, in shock, “I didn’t know people still did that?!” She answered me with two sentences that changed my life forever: “My mom had all her babies that way. There are actually a lot of benefits.” In sincere curiosity and ignorance, I spent a few minutes drilling her about the benefits of natural childbirth. I’m pretty sure she mentioned the Bradley method and midwives in there somewhere. And then the conversation ended. I have since forgotten her name, but I will be forever grateful to this young woman for opening my mind to a path I never would have found or chosen on my own.

This is why I carry on

February 17, 2013 at 6:48 am

Every once in a while I start feeling weary of this “work.” Lately I haven’t even been able to muster the energy to blog about anything specifically birthy.

A few years ago, I was feeling discouraged, wondering whether I was wasting my time making a big fuss about nothing with my blog and all the time and energy I put into birth advocacy. Did it really matter as much as I thought it did? Then I got an email from a friend-of-a-friend that rekindled my passion to carry on in my cause.

A few weeks prior, she had discovered that a certain medication she was taking would prevent her from having an epidural. So she had begun scrambling to prepare herself for an unexpected drug-free birth two weeks before her due date. A couple of our mutual friends had alerted me to her predicament, so I had whipped-up an email with attachments and links and tips. I didn’t hear any more about what happened until she sent me her email. Here’s what she said…

Medical intervention

September 5, 2012 at 5:42 am

When I first started out as a birth blogger five-and-a-half years ago, I villainized epidurals and felt driven to encourage more women to try giving birth without them. As I’ve learned and grown, I’ve come to recognize that epidurals can be very useful and sometimes necessary. Someone I love spent many hours trying to push out a (large) persistently posterior baby without drugs, but after she had a brief rest with an epidural and a bit of Pitocin, baby quickly turned and came sliding out. Sometimes drugs are just the right thing.

Sometimes the very things we once felt certain we would never need or embrace can become right for us under new circumstances.

I suppose all of this is on my mind because I’ve been humbled by my own need for medical intervention. I wasn’t sure if, when, or how I wanted to proclaim to the world that I’m taking medication for my anxiety/depression, but here I am saying it now. I spent months trying to avoid drugs, believing I was strong enough to get better on my own, researching and trying a wide variety of natural remedies, but it wasn’t enough.

Doula ripples

February 1, 2012 at 7:33 pm

“Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth” -(Hodnett and colleagues 2011)

Jennifer just asked this question on my Birth Faith facebook page wall: “My friend’s OB told her that hiring a doula was ‘dangerous.’ What would you tell her?”

Good grief.

I’ve shared in a previous blogpost (Why hire a doula?) what a doula’s presence can do for a woman’s birth experience using my own experience and stats from scientific research. Let me reiterate that research quickly.

Gathering and analyzing the results of 15 studies, a team of researchers found that, compared to women laboring without a doula, women who labored with a doula were:

• 26% less likely to have a cesarean section
• 41% less likely to have a vacuum extractor or forceps delivery
• 28% less likely to use pain medication or epidurals
• 33% less likely to rate their birth experience negatively
(Hodnett E, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. The Cochrane Database of Systematic Reviews 2003. Issue 3. See DONA).

But did you know that the benefits of having a doula’s assistance don’t end at birth? There are significant ripples that can impact a woman, her baby, and her relationship with her baby’s father. 

Reducing childbirth pain?

June 30, 2011 at 6:08 am

It has never been easier getting from 0 to 9 centimeters as it was for me during my fourth birth. I couldn’t believe how comfortable I was at 7, 8, 9 centimeters.  I’ve thought a lot about that fact over the past four months, wondering… what made the difference? I can really only speculate, but these changes might at least partially explain the reduction of labor pain I experienced:

1) Prenatal exercise

I was in much better shape starting out this pregnancy than I have ever been in my previous pregnancies.  I continued running approximately three mornings a week until about halfway through my pregnancy.  Then I walked and hiked to keep myself active, though not as regularly.  As I’ve shared before, prenatal exercise has so many benefits, including: reduced need for pain relief, decrease in maternal exhaustion, and shortened labor.  It may not be safe for all pregnant women, but I was grateful to be able to exercise through my pregnancies and grateful to have midwives who urged me to keep running and walking.

Emergency Preparedness

January 29, 2011 at 4:56 pm

Regardless of what type of disaster may strike or how severe it is, there will always be pregnant women in need of special assistance. Pregnant women are among those most at risk in disaster situations, in part because severe stress can trigger premature labor, but also because so many women are forced to give birth under precarious circumstances. When hospitals may be over-flowing with sick and injured survivors, roads or transportation inaccessible, and electricity likely unavailable, women who would otherwise have given birth at the hospital will have to seek alternatives.  It is also a possibility that hospitals will only have resources for the most high-risk pregnant women, leaving low-risk mothers to give birth with little or no assistance from staff.   Even in the absence of a large-scale disaster, on just an ordinary day-to-day basis, sometimes a birth happens too quickly to make it to the planned location or before a qualified birth attendant can be present.

Robbie Prepas, a certified nurse-midwife, saw many such births first-hand during the Hurricane Katrina disaster.  She delivered five babies in the New Orleans airport, twins in an ambulance, and provided impromptu care to hundreds of pregnant and postpartum women, checking fetal heart tones, etc.  She explains, “There were no policies or procedures in place to care for pregnant women or mothers and their babies after Katrina.  We even lacked such basics as diapers, formula, baby bottles and clean clothes” (“Disaster Preparedness for Mothers & Babies: Getting Prepared”).  Midwife Mary Callahan, CNM, MS, also assisted in the Hurricane Katrina relief effort, providing midwifery services to displaced women in a large shelter and assembling emergency birth and prenatal kits for use in other area shelters (“Chicago Midwives Travel to Baton Rouge”).   While we may be fortunate to cross paths with a doctor, midwife, or paramedic with birth supplies in an emergency childbirth situation, we can’t be certain of such luck. Given all of the possibilities, the best course is to have plans and supplies in place so that we can meet our specific needs in emergency situations.

Improving your epidural birth

November 18, 2010 at 8:46 am

Back in August, a close friend from college specifically requested that I do some posts for women like her who plan to have epidurals. So I wrote the first in a supposed series of “Improving your epidural birth” posts, encouraging pregnant women to “hire wisely” when choosing a care provider.

This morning I got feeling bad that I haven’t written any more posts for that series, and I suddenly realized that I have! In fact, the vast majority of the posts I’ve written over the last six months are on topics that would be of interest to all women, not just those who choose to forgo pharmaceutical pain relief in childbirth. And scanning three+ years of posts on my old blog brought up many more.

So, with all of that in mind, I give you some of my best tips for improving your epidural birth (besides carefully choosing a care provider), gleaned from my blog (and other helpful sites) over the years.

1) Prepare your body for pregnancy.

The more I learn, the more I realize that the groundwork for a really wonderful birth experience must be laid long before labor begins. When you nourish and take care of yourself, your body will be stronger and better able to perform its vital functions in pregnancy and childbirth. A strong, healthy body is much less likely to suffer complications that can have a detrimental and traumatic impact on your birth experience.

Many of the same things that will best prepare your body for a healthy pregnancy will also improve your chances of conceiving—eating a diet rich in fruits and vegetables and low on processed foods, maintaining a healthy weight, optimizing your body’s levels of key nutrients (vitamin d, magnesium, essential fatty acids, and folate).  Making these dietary and lifestyle changes habits before conception will make them much easier to maintain throughout the coming pregnancy and beyond. 

Protecting your perineum (from the inside out)

November 9, 2010 at 9:04 am

IMG_36311Someone I love gave birth last week for the first time. We talked on the phone about her experience a few days later. While she felt really good about how everything went, she was hurting. An episiotomy+tearing, back pain from her epidural, plus the normal pain associated with initiating breastfeeding were wearing on her. Having experienced some severe tearing with my first birth, I gave her my solidarity. Recovering from perineal trauma was some of the most excruciating physical pain I’ve ever experienced! I’d take labor pains over that any day.

During our phone conversation, she mentioned that one of the nurses at the hospital had asked her if she ate meat (she does eat a little, mostly chicken). Seems like a strange question, but apparently the nurses at that hospital had noticed a trend among the women they attended in labor: in their experience, women who were vegetarians were more likely to tear. A statement like that calls for some follow-up research, no? I jumped on it and starting digging around in the scientific literature to see what dietary substances are associated with increased skin elasticity. I never really found a clear-cut answer to the vegetarian question, but I did find lots of other cool information.

I’ve posted before about how to prevent tears from the outside in, but now I know a whole slew of ways we may be able to protect our perineums from the inside out. These are some dietary additions you may want to make if you’re hoping to prevent tears (and improve your skin and health in general):

Improving your epidural birth: Hire wisely

August 17, 2010 at 9:13 pm

A former college roommate and beloved friend came into town this past weekend and stayed with us Saturday night. As we chatted late into the night, she made a request. Could I created some more basic posts for women like her who don’t spend all their free time devouring birth-related media… women who aren’t sold on the “natural” bit (at least not yet)… women who plan to get epidurals but still want to improve their birth experiences? I thought that was a great idea. I think I’ll call this series: “Improving your epidural birth.” And here’s the first installment…

The first, and perhaps most important, tip I would offer to pregnant women (whether they want epidurals or not) is this:

Hire your care provider wisely.

Why hire a doula?

July 19, 2010 at 6:41 pm

[Re-post from the old blog.  Originally published in April of 2007.]

When I gave birth for the first time, I didn’t know what a doula was, but I recently realized that the care and support of a “doula” is what actually carried me through that birth.

Her name was Eve. She was the labor and delivery nurse assigned to me when I entered the hospital for my oldest daughter’s birth. She was gentle, unassuming, and kind. When I told her that I was hoping to “go natural,” she mentioned that she could offer positions to try and techniques to cope with the pain of labor. She said she had given birth without drugs before, and knowing she was supportive and experienced gave me courage.

As labor progressed, Eve showed my husband how to provide counter-pressure to ease the discomfort of contractions. She pulled out the rarely-used, water-proof telemetry monitor so my husband could spray my back with hot water in the shower. When I got out of the shower, she brought in a birth ball and helped me to sit and rock on it. Later, she coached me to keep my vocalizing low, deep, and relaxed instead of high-pitched and tense. When I doubted myself and contemplated drugs as I struggled through the hardest contractions, she said, “Why don’t I check you first—you might be almost fully dilated.” Sure enough, I was only a couple of centimeters from the end. She told me that, in her experience, it felt good once you could push (and she was right). She rubbed my feet and sat by my side through those last intense contractions, encouraging me with her reassuring words. Although her shift ended before the pushing started, she chose to stay with me until after the birth. Ultimately, I did it! Giving birth for the first time without complications or drugs was one of the most empowering experiences of my life.

Avoiding tearing and episiotomies

July 19, 2010 at 3:39 pm

Giving birth for the first time was one of the most empowering experiences of my life. My water broke, my contractions started, everything progressed smoothly, and, less than six hours later, my baby girl was born. It was an ideal birth experience, except for one thing. That one thing made my next few weeks of recovery extremely painful. I tore. I really tore.

Despite the painful recovery, this was actually the lesser of two evils for me. Though some caregivers continue to cut episiotomies in as many as 80% of their patients, medical research does not support routine episiotomies. Studies from as far back as the 80s made it clear that routine episiotomies have no benefits and carry real risks. One of the most detrimental risks is that episiotomies can lead to further tearing, sometimes extending into the anus. These fourth degree anal tears almost never occur without an episiotomy. In addition, a spontaneous tear may only reach into the surface layers of skin, while an episiotomy cuts into far more layers. Episiotomies are rarely warranted and should be reserved for those unusual emergency cases. Ultimately, even without all the evidence, I just didn’t want someone cutting me. I knew, going into my first birth experience, that if I had to choose between them, I would choose to tear. And, tear I did.

“Nobody thinks you’re a hero”

July 18, 2010 at 10:55 pm

A comment from this site has got me on the defensive. So I’m going to spill my thoughts here.

I did NOT choose to give birth without drugs because…

* I wanted people to call me their “hero.”
* I wanted to prove something.
* I wanted a reason to feel superior to other women.

Epidurals and scoliosis

July 18, 2010 at 10:15 pm

About two years ago I went to a chiropractor, hoping he could help me figure out why I had chronic pain in my right shoulder blade region.

Wow. That’s what I thought when I saw the x-rays of my spine. Wow. Holy cow. Good grief!

Back when I was a teenager I was diagnosed with scoliosis, but they watched it for a while and it never became more than “mild” scoliosis, so they sent us on our way and I sort of stopped thinking about it. Until the pain started several years later. When I was lying “flat” on my back, things just didn’t seem to be where they were supposed to be. I was definitely right! As we stood there looking at the x-rays, I thought to myself, hmmm… that doesn’t look like “mild” scoliosis to me! The chiropractor concurred. Mommyhood had taken its toll and made my curvy spine even curvier.

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