She is here!

I gave birth to a girl this morning at 11:23!! We weren't expecting her so early (she is 38 weeks on the nose) but we are thrilled. She weighs just shy of 7 lbs.

Labor lasted 10 hours. It was intense, challenging, and very fulfilling. She was born into my own hands in our master bathroom. Eric was a great help. Basically I labored on my own in another room and hollered if I needed anything. He respected my need for doing this without feeling watched. It was just what I wanted.

She's been nursing like a pro and cuddling up skin to skin the rest of the time. She has never left her parent's arms from the minute she was born.

Here she is less than 1 minute old:

Wiped out

Today I can claim to be a miserable pregnant woman (although my complaint probably has nothing to do with pregnancy). Last night I slept a grand total of about 6 minutes. Every time I would start to fall asleep, I would suddenly wake up to the sound of a very loud snorting/gagging sound. How did such a ladylike sound come out of my own mouth? Then I would lie in bed for a half hour or so until my heart stopped racing and try to get to sleep again. Then the whole snorting/gagging thing would start up again as soon as I fell back asleep.

It was really weird. I've never had anything like that happen before.

I went downstairs from 1:30-3:30 am thinking that lying on the couch would help. It didn't. So I went back upstairs until 5:30 am, when I finally gave up and went back downstairs to waste some time on the internet.

It was as if I had stopped breathing each time, or had a really congested airway. Only I am not congested...what is up?

I have been able to get about an hour of sleep total today, thanks to my Hypnobirthing CDs. They put me out like a light. Let's just hope that there is no more snorting tonight, because I don't know if I can take another night of no sleep. I am okay with waking up 5-6 times a night to pee--I've been doing that since month 1. But no sleep at all? NOT GOOD.

35 weeks gestation

Preparing for Labor

A woman on one of my internet birth groups recently posted these thoughts about how she prepared for labor:

When we decided to have a homebirth with a midwife, I (being an intellectual) bought as many books as I could, went to my childbirth class very early, read the corresponding book to the class, went to homebirth meetups, watched every video I could, including the ones on TV with hospital births. I wanted every possible tool in my bag for when the time came, uncertain which method would ultimately prove beneficial once in labor.

The last video I watched was at my childbirth class. It was, yet again, another South American video. I was disappointed with this after so many videos, because I couldn't understand what was being said in labor. I knew everything I felt I needed to know about the actual birth by then, but I wanted to know more about a natural LABOR at that point.

Well, as was typical in the Latin videos, the woman had her family there with her, both in and out of the tub, and she QUIETLY gave birth to her baby while her children watched her normal, natural birth. Then suddenly the video switched to an American home birth in a blow-up pool in the family's living room. The woman moaned and cried and wailed and had that typical wild-eyed, American labor look of "Who Is Going to Rescue Me Now????"

The stark contrast was what helped me know that every tool in my bag was completely unnecessary and useless. I was looking to trust everything but my baby and my body. I threw away my bag of birthing tricks. I understood then that we Americans are heavily convinced that birth is super difficult and have been indoctrinated into the mindset of we weak women need to be saved by the knight in shining armor. I was NOT going to be that. I believed thoroughly in the natural process of birth. I believed that my body was made to give birth. And, most importantly, I believed that just as my baby and body knew when it was time for my body to labor, my baby knew how to be born.

I was very quiet during the three days I was in labor. My midwife did not even come over until late the third morning. By then I was finally in active labor. I was quiet throughout the entire day until transition. After an hour of transition, during the last 30 minutes of transition I began to ask if I could really do this. My husband and my midwife's apprentice talked to me after every contraction and reminded me that I could and to stick with just one contraction at a time. (The transition contractions were the worst for me, because I thought I would throw up. What they didn't know was that I would rather have contractions any ole day than be forced to vomit. Just a personal preference thing.)

All at once I felt a wave start from my head and flow through my body and out of my vagina, and my body pushed with it. It did it again on the next contraction, and I felt the ring of fire. I jumped up out of the bed and headed for the tub. My midwife reminded me that I didn't have to have a waterbirth just because that was what I had planned, but I didn't even listen for a second. I KNEW the water was where I needed to be.

The water eased the contractions remarkably. My friend, husband, midwife, and midwife's apprentice were all in the bathroom talking to each other while I was in the tub with my head at one end and my feet touching the other end. Absolutely NO ONE knew I was pushing (actually not even I knew). I asked for a rag that I instinctively held with my hand between my legs.

Suddenly I felt a "pop" and asked my midwife what it was. She turned around and looked down at me and said, "Oh! The head is out!!" She insisted that I pull my legs up then (my knees were still together when the head was pushed out), and Ania was born a few seconds after.

My point is that I turned into myself. I listened to my body. Found the position that worked for my body. Walked when my body knew I needed to walk.

It was the closest I've ever been to God. The world went quiet and faded away. I was in touch only with each breath of each second of each contraction. Two months of third trimester discomfort and swearing I would never ever never have a baby again had me wanting another almost immediately because of the childbirth.

Was it painful? Yes, in all honesty it was painful during that 1-1/2 of transition. Was it my mindset that got me through it? Absolutely. I welcomed the pain, knew it was natural, knew it was not permanent, knew labor pains would not be listed as the cause of my death. I just fell into labor, didn't fight it, didn't question it, didn't question the process. I trusted birth. THAT is the only real tool you need.

Posted with permission from M. Morrow.

A beautiful poem

Silence (Ciúnas) by Biddy Jenkinson
Tranlated by Pádraigín Riggs

How I welcome you, little salmon
who leapt the womb, impatient to commence life.
I undertake to be a river to you
as you follow your course from the haven of
my belly to far distant seas.

Let yourself go, and drink up your fill.
Suck sleep from me. By the terms of the breast-contract
I'll suck back from your puckered lips
love, with which I'll suckle another time, and for that
I'm grateful.

How I welcome you, salmon of sleep
who made a tranquil pool in my life-stream.
In the rhythm of your heartbeat
I hear the music of the Heavens,
and it guides my way.

Born in 1949, Biddy Jenkinson (pen name) is an Irish poet and dramatist.

My hospital rant

Last week I visited a hospital with a friend who is 7 months pregnant. She had an okay birth with an OB a few years ago, but during this pregnancy has realized that she wants—and deserves—so much more. I’ve been providing her with information about all of her options, from unassisted birth to hospital birth with a CNM. I loaned her two of my favorite books, Ina May’s Guide to Childbirth and The Thinking Woman’s Guide to a Better Birth, and several birth DVDs. She is most interested in homebirth but, like me, has had trouble finding an available midwife. So we took a trip to visit this hospital’s maternity wing and to chat with a CNM who comes highly recommended.

This hospital is one of two certified Baby Friendly facilities in the entire state, and its cesarean rate is half the national average. One of the on-call OB’s has a cesarean rate of 10%. (The other OB’s rates are around the national average of 30%.) If I had to go to a hospital, this is the one I would choose.

Still, what I saw was so disappointing. Not because I was expecting anything better—I am familiar enough with hospital birth rooms and routines—but because a hospital could easily offer an entirely different birth experience if they truly understood the physiology of birth. Michel Odent’s book Birth Reborn gives us a glimpse into what a hospital birth experience should be like, if a laboring women’s needs for privacy, security, warmth, darkness, and lack of feeling observed were truly understood and respected.

At this hospital was the standard high, narrow birth bed with stirrups and foot rests. Because women *still* give birth on their backs even though we know it’s a terrible position. There was the high-intensity spot light built into the ceiling so your perineum gets center stage (because of course you will be in bed on your back for the birth). Electronic fetal monitor—check. Never mind that every study done on fetal monitors has shown that they do NOT improve fetal outcomes at all. Their only documented effect is to dramatically raise the cesarean rate. Uncomfortable couch for the father—check. Lots of other medical equipment half-heartedly hidden by pastel wallpaper—check.

I asked the nurses what the standard admittance routine was: electronic fetal monitor strip, blood pressure, temperature, and IV. The nurses have NEVER seen a woman labor at this hospital without an IV or heplock. Never.

On the upside, they do have gigantic Jacuzzi tubs for laboring. I’d say they are even bigger than mine. They are actually so big and high that I don’t know how a pregnant woman would actually be able to climb in...

Like I mentioned, the hospital is Baby Friendly certified, which means it meets these 10 requirements as outlined by the WHO-UNICEF:
• Have a written breastfeeding policy that is routinely communicated to all health care staff;
• Train all health care staff in skills necessary to implement this policy;
• Inform all pregnant women about the benefits and management of breastfeeding;
• Help mothers initiate breastfeeding within a half-hour of birth;
• Show mothers how to breast feed and how to maintain lactation even if they should be separated from their infants;
• Give newborn infants no food or drink other than breast milk unless medically indicated;
• Practice rooming in: allow mothers and infants to remain together 24 hours a day;
• Encourage breastfeeding on demand;
• Give no artificial teat or pacifiers (also called dummies or soothers) to breastfeeding infants;
• Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics.

The sad thing is that only two hospitals in the entire state meet these fairly minimal requirements. Every hospital should automatically do these things!

Even more dismal is the tiny number of hospitals nationwide that meet the Mother-Friendly Childbirth Initiative, as outlined by the Coalition for Improving Maternity Services. Here are the basic requirements to be certified as Mother-Friendly:

1. Offers all birthing mothers: unrestricted access to the birth companions of her choice, including fathers, partners, children, family members, and friends; unrestricted access to continuous emotional and physical support from a skilled woman-for example, a doula or labor-support professional; access to professional midwifery care.
2. Provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.
3. Provides culturally competent care -- that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother's ethnicity and religion.
4. Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication), and discourages the use of the lithotomy (flat on back with legs elevated) position.
5. Has clearly defined policies and procedures for collaborating and consulting throughout the perinatal period with other maternity services, including communicating with the original caregiver when transfer from one birth site to another is necessary; linking the mother and baby to appropriate community resources, including prenatal and post-discharge follow-up and breastfeeding support.
6. Does not routinely employ practices and procedures that are unsupported by scientific evidence, including but not limited to the following: shaving, enemas, IVs, withholding nourishment, early rupture of membranes, electronic fetal monitoring.
Other interventions are limited as follows: induction rate of 10% or less; episiotomy rate of 20% or less, with a goal of 5% or less; total cesarean rate of 10% or less in community hospitals, and 15% or less in tertiary care (high-risk) hospitals; VBAC (vaginal birth after cesarean) rate of 60% or more with a goal of 75% or more.
7. Educates staff in non-drug methods of pain relief and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.
8. Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.
9. Discourages non-religious circumcision of the newborn.
10. Strives to achieve the WHO-UNICEF "Ten Steps of the Baby-Friendly Hospital Initiative" to promote successful breastfeeding.

These elements should be a given in any hospital service! The hospital I visited, which is by far the least interventive in the entire area, fails miserably in at least 4 of the 10 requirements (#2, 4, 6 & 7). This is my best choice??

The final irony is the brochure the nurse gave me at the end of the tour. The front page proclaims in big letters: "Just Right In Every Way."

The Nerve

Yesterday when I was at church an older woman asked to speak to me after the meeting. She had asked me last week to play my violin in church, so I assumed she wanted to talk more about what music I had picked out. Although I’ve been attending this congregation for a little over a year and know most of the people, I have never spoken with this particular woman until last week. I don’t even know her name.

After church she brought me into an empty classroom, sat me down, and said, “You probably have no idea why I wanted to talk to you.” Nope. She looked at me and said, “I want you to tell me why you are not seeing a doctor or going to a hospital for your birth.” She then proceeded to tell me several horror stories about things going wrong at the last minute during birth. Her daughter bled a lot after having her baby and “had to be sedated” because she started panicking when she saw all the people in the room and asked what was going on. (This daughter also had one kidney and "half a uterus," whatever that means). She knows of another woman who bled to death after giving birth in the hospital. Yeah—great advertisement for hospital birth! She told me that she’s been worried sick about me ever since she learned that I am not planning on seeing a doctor or going to a hospital, and that I should really reconsider my plans.

I calmly explained my choices to her (statistics of home vs. hospital birth for healthy women, the importance of not disturbing a natural process, and how many routine hospital procedures can often cause complications to occur). I talked about how I’ve been researching birth for close to 4 years now, and that I’ve made this decision with a lot of thought and prayer. I then told her: “Frankly, you should never say those kind of things to a pregnant woman, especially to someone so close to giving birth.”

The whole conversation took about half an hour, most of it with her talking.

On the way home from church, I told my husband about this strange experience. He became very upset that a woman I don’t even know had the nerve to pry into my life and tell me what to do. He said “you are the one who has done years of research into birth, not her!”

The more I have thought about this conversation, the more it bothers me. It’s one thing for a close friend to ask me what my birth plans are, because they care for me and want to know what I will be doing. But for a virtual stranger to demand that I justify a very personal decision to her and then to try and scare me into doing what SHE feels more comfortable with—that is completely unacceptable.

I wish I had known what she was about to ask when she sat me down. I should have ended the conversation right then by saying, “This is a very personal decision between me, my husband, and God. And it is none of your business.”

Thanks Ellen for the pep talk last night! I felt much better afterwards.

33 weeks gestation

If you look closely at my hip, you will see 3 red marks. No, I was not stabbed by a giant fork! I think these are stretch marks. I have identical marks on the opposite hip. I also have these same "stab marks" very low on my abdomen. Weird, eh?

Pushed and Pulled

I’ve been following a recent discussion thread on MDC (Mothering Dot Commune) about unassisted birth. One of the posters wrote:

“It's one thing to be motivated by a desire to NOT have something happen. It's another to be motivated by a desire to HAVE something happen.

See the difference?
Pain pushes.
Vision pulls.”

Embracing what we DO want, rather than just avoiding what we DON'T, has really resonated with me. I've been thinking a lot about the term "unassisted birth." It's interesting that so many of the words we use for birth focus on what is absent:
un-assisted
un-medicated
un-hindered
un-inhibited

These words are important because they help identify what is wrong with our current birth culture. A great deal of my motivation to birth at home is to avoid unnecessary and harmful hospital procedures. I don’t want an IV, electronic fetal monitoring, artificial rupture of membranes, vaginal exams, Pitocin, epidural, narcotics, time limits on labor, forceps, vacuum extraction, cesarean section, immediate cord clamping, cord traction, sepatation from baby for bathing or measuring, bright lights, narrow hospital beds.... The list goes on.

I have a healthy fear of birthing in a hospital. Just a quick comparison of cesarean rates in healthy women planning home or hospital births is enough to keep me securely at home. In the year 2000, roughly 19% of healthy (or “low risk” in medicalese) women planning hospital births had cesarean sections. Cesarean rates among women planning home births are consistently between 1-4%.

But birthing at home merely to avoid the hospital is only part of the picture. I love words that focus on what we're gaining, not just what we're leaving behind, when we reject the rituals and confinements of institutional birth:
freebirth
empowered birth
ecstatic birth
autonomous birth (see Linda Hessel’s blog for an excellent discussion of this term, especially her posts titled “Laura Shanley” and “Terminology”)

Early books about unassisted childbirth often use the term “Do-It-Yourself childbirth.” I like that term--I'm a big DIY girl myself. Over the past several years I've learned how to do plumbing, electricity, framing, plastering, drywall, roofing, tiling.... Almost anything you can do to a house, my husband and I have done it! A DIY-er isn't afraid to get dirty, to make mistakes, to make a mess at times. I trust myself to do the job right, whereas when I hire someone (which I've done twice, once for a big job and once for a little job) I'm always fretting about whether or not it's good enough. Plus there's something so satisfying about accomplishing a big task and having professionals come over and admire the quality of your work! Or when people ask you which contractor you hired, seeing the look on their face when you say, "oh, I did it all myself. Piece of cake."

Home repair manuals are filled with dire warnings about leaving certain jobs up to professionals—anything from refinishing wood floors to electrical work. And yes, there are certain things that I will hire out, such as working on gas lines. I’m sure that I could figure it out if I wanted to, but it’s not worth the hassle. But most of these things we have done ourselves, and the results were fantastic.

On the other hand, DIY also conjures up images of Bob Vila and middle-aged men wearing toolbelts and red plaid shirts. It’s probably why the term “DIY childbirth” fell out of vogue.

But enough talk of home repairs. I think freebirth speaks to me the most. Because there's nothing attached to it. There is no "right" way to freebirth. Just you and the baby and the freedom to do whatever is necessary to have that baby.

I don’t have any one particular vision of how this birth should unfold. Perhaps I will labor at night in our fireplace nook, warmed and lit by a fire. Maybe I will give birth by candlelight in our oversized Jacuzzi tub. I might push the baby out kneeling on our bed, at mid-day, with sunlight streaming in from the seventeen windows in our bedroom. (Can I say that our house has good birthing vibes?? So many nice places to labor in.) I may have a “wham, bam, thank you ma’am” labor that leaves me feeling somewhat stunned. Or labor could be long and slow. The point of freebirth is that there is no script I have to follow, no rules for what is right or wrong. In the end, what I really want is to be able to experience birth on my own terms, on my own power. I want my baby to emerge in an atmosphere of love and peace, and to know only the warmth of his parent’s arms. I want to come away feeling exhilarated and to be able to say "Don't mess with me. I can do anything now!"

Belly Heaving

This is a fantastic timelapse collection of babies moving around in utero. I don't have a video camera of my own, but my baby does similar acrobatics all the time. I love it!

Naming My Fears

These are my biggest fears. I am going to list them no matter how silly they might seem on paper. Instead of pretending they don’t exist, I am going to broadcast them to whoever wants to read them.

In no particular order:

1. Having a cesarean section. Even if it was truly “necessary.” (I would be skeptical of that diagnosis for anything but a very small number of reasons, including: complete placenta previa, cord prolapse, shoulder/transverse presentation that doesn’t resolve with labor, or massive placental abruption.)

2. Having an operative delivery (forceps or vacuum extraction).

3. Transferring to a hospital and having to fight for what I want.

4. “Losing it” during labor and transferring to a hospital and later regretting it.

5. Taking pain medications and then having people smirk and say “I told you so.” Obviously I would have to be in a hospital for that.

6. Making the wrong decision about where to birth, and whom to invite. I honestly cannot say I know 100% that planning to birth unassisted is the right choice. I’d say it’s more like 90%. I cannot think of any more appealing alternatives though. I do have a good midwife friend who might be able to come, but it’s not certain. She also lives 3 hours away so I cannot plan on having her there on time.

7. Wanting a certain kind of birth so much that I will ignore what is really best for me. Maybe I would have a better experience with a “low profile midwife” (I love Michel Odent’s term!!). Or maybe I invite a midwife for the birth, but I would have been better off by myself.

8. My husband freaking out when I am in labor and disrupting me. Let’s face it—adrenaline is not a good thing for laboring women to be around.

9. Losing the baby and having people blame me for it. My husband especially.

Those are my biggest fears. Now what to do about them...comments or suggestions appreciated!