Thursday, March 10, 2011

Final reflections

To close the chapter on neonatal resuscitation, I wanted to share some final thoughts. I am still surprised that Inga's birth story took the turn it did. I never expected so much focus would fall on the mouth-to-mouth and so little on the rest of the birth! But that's the nature of writing and sharing our stories on the internet. We can choose the words and images but not the meaning that they take on once they are released "into the wild," so to speak.

To me, the two minutes where I assisted Inga in taking her first breaths were just that--two minutes, over and done with, and I moved on. They didn't dominate the birth experience (as they have the comments on this blog!).

I feel no need to create a tidy take-away lesson from my experience. I did not post Inga's birth story to advance an agenda or to teach about neonatal resuscitation. I simply wanted to share my experience of labor and birth with people I care about, and with those who care about me and my family, even if we don't know each other personally.

With those thoughts, I wanted to share these words from Tatiana of the Becoming Midwives blog (reposted with her permission).


~~~~~

I don't have a punchline

There is just this: an unplanned unassisted (but planned home birth) to a mother who, when her baby grew limp and breathless moments after her birth had the resuscitation training to calmly position her, breathe into her mouth, and repeat until her little arms curled up, she sputtered, and she cried. When I first watched the baby's arms grow limp, even though I anticipated it, having read the word "resuscitation" in Rixa's post, I panicked. My own baby was nursing to sleep as I watched this and I startled harshly enough that he pulled back, opened his eyes and looked at me, surprised. As I watched the baby grow dangly, I said to the screen, "No, no."

That was the first pit of the last 20 minutes, that full-body rejection of the sight of an unbreathing baby. (Qualifier: I am a mom with a still-young baby and some unresolved junk around his birth - I know I have no business bringing all of that to anyone's birth, and I am not attending births. But I'm allowed to watch youtube.)

And then, as I watched the aftermath, mama settling into the tub, baby squirming in the normal fashion, the bustling attendant arriving and then being asked to leave, and the new baby girl seeming fine, I filled with joyful exuberance. That this one precious, tender, incredibly sensitive new little person could be born needing help and receiving that help from her mother in the warm safety of a tub is a transcendently beautiful departure of what neonatal resuscitation normally looks like. Nothing jarring, nothing painful or invasive, nothing panicked, nothing even as upset as my own response watching on a screen so many miles away. No, just family, breath appropriately applied, and the rolling of time into life here among us other breathing people. I felt buoyant and celebratory.

But now I'm sad again. Because this exemplifies what Adrienne Rich said. I believe every baby is that tender, soft, new, sensitive and deserving of such gentleness. Especially when it needs extra help. But in our world, such gentleness is not a universal right but a privilege that becomes available based on the constraints of social, cultural and demographic factors, including educational privilege and a willingness to make a choice that our culture largely regards as reckless. That is an awful lot to ask of people, who are social, dynamic beings in constant relationship and flux with the people around us, carrying with us the vestiges of that sense that certainly we can't know everything about this world, so mightn't it be wise to defer to authority?

I love Rixa's bold and unapologetic grasp on her responsibility for the choices she makes for her family. I'm so glad for her, and for that sweet baby girl who may have had the world's most tender resuscitation. I'm so glad for my own children's relatively peaceful births, and for the so many that are held in that remarkably rare spirit of reverence and respect in this slowly growing trend of gentle birthing.

But it is a bittersweet gladness, indeed, when I let myself broaden the lens to the larger world.

I wish I could summarize it all with... "And here is our clear answer."

But where? Where is our clear answer? I don't live in a world that has any of those. Not really, anyway. We like to assume the stance of certainty and conviction, but not one answer seems to stand firm against the onslaught of every possible experience, every possible shred of information, and every possible circumstance. And as much as I don't like to leave a bit of writing dangling with this feeling of conflicted joy-sad-ambiguity, it's what I have. There is no punchline.

16 comments:

  1. yes. yes yes yes yes yes. been there. felt that. yes.

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  2. Rixa, I didn't read all these comments you mentioned where people were disappointed with your response to Inga's breathing trouble. Never even occurred to me anyone would be anything other than impressed with how you reacted! As a mother, former elementary teacher, aunt, sister and just generally someone who has seen emergencies among kids, I know the best thing is to stay calm and sometimes people view that as emotionless.

    I was impressed by your reaction, impressed that your husband stayed calm and trusted you, and encouraged to research and receive training in neonatal resuscitation myself. Never know if my next homebirth will be fast like yours! You've opened my eyes to one facet of homebirth I had not even researched or thought about yet! Years ago you taught me homebirth was wonderful and helped me on the path to my own. Now I think you will help my next one be a bit safer!!

    Thanks!

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  3. Beautiful! I am so glad you have shared your full birth story with us all. We all learn and grow from all the experiences, lived or read and I am sure this has broadened the world for all of us. It truly reminds us to trust birth, ourselves and our babies. :-)

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  4. Rixa,
    I have been a faithful reader / occasional commenter for years now.
    I watched your birth video and was awed and amazed and...wow, what a blessed baby girl is sweet Inga to have you as her mama. :)
    All of this nonsense and criticism really amazes me. It reminds me of when I posted the video of my HBA3C, and I got people criticizing me, assuming I was some dumb schmuck that just woke up and decided to have a baby at home with no prior research, soul-searching, interviewing professionals in the field, etc.
    And then I was criticized because I had started doing Ironman triathlons, because I obviously must have been neglecting my other kids to train and lose all the weight / get in shape, and criticized for waiting after SROM, even though I was vigilantly (almost obsessively) monitoring all vital signs of myself and baby. Heck...I was even criticized for having HEADPHONES IN during the birth!!! It was all completely crazy and I knew how far off base these faceless strangers were, but it still stung a little, mainly because I had no idea what would make someone want to be that critical of another's situation, knowing so little about the facts.
    I think your instincts were spot on, you did exactly what you were supposed to do for Inga, even if it was completely counter to what the 'almighty flow chart' said (which it wasn't). I think that's how we have gotten ourselves (collective "we") in this birth mess to begin with. We've stopped respecting a mother's deep connection to her baby and her innate protective instincts, in favor of following charts, gauges, and timelines.
    I know when I had my homebirth and my baby was "blue-ish", I instinctively placed my mouth over his mouth and nose and sucked really hard, getting a mouth full of mucous. He pinked up, started breathing and all was well. That wasn't something I had learned about or even seen before, but it was done almost reflexively, instinctively. I knew what he needed and I did it. Just as you did, through your NRP training as well as through the innate imprinting of mothering behaviors and instincts.
    I wish you a beautiful, full babymoon with Inga and the rest of your family :)
    Teresa

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  5. Rixa -- I've been mentioning your birth posts each day to Tom at dinner and yesterday he said he'd watched the videos at work (with the sound off) and he was just really impressed by how beautiful and matter of fact they were, and how well you handled everything.

    Yes, the resuscitation is just a small part, but it's a little scary for me to watch (so I'm saying I understand the interest it's drawn, even if not some of the conclusions some have made). I also couldn't watch the grunting and the fast breaths near the end without having an almost visceral reaction, remembering my last birth.

    Thanks again for sharing all of this. To have my husband on his own watch your video and to have both of us able to react how we do now, from where we were two years ago in our thinking -- it's miraculous! And so is baby Inga!

    Since I'm done (oh yes) I can't wait to share this with my daughters -- in about thirty years . . .

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  6. What a lovely way to complete your thoughts and sharing about the small, yet important, part of the whole birth experience. What a great post by your friend!

    Thank you, thank you, THANK YOU for sharing what you have about your birth, your postpartum experience so far (particularly the awesome shrinking belly pics), and this. You're an amazing lady.

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  7. the arrival of Inga could have been my 1st daughters' arrival! Yes, I had 2 midwife/friends there, I was a midwife with 10 years experience at that point, but as I pulled my limp dau to me I had the same instinctual, calm and direct response and action as Rixa did. A few puffs, some mucus wipe (dry birth, not water), another puff or two and rubbing, then a good cry cleared out her lungs and she pinked up and got vigorous. No drama, no other intervention, just love and gratitude she was earthside and healthy. altho her birth was long and arduous, not fast like Inga, I have noticed that babes who arrive quickly do tend to need a little extra energy sometimes.... Lily

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  8. I never commented on your blog before but decided to for two reasons. First, to tell you that your posts about your daughter's birth were very informative and I'm shocked so many are criticizing you. I thought you looked like you knew what you were doing and were as in control of the situation as one can be. Also, as a person who is considering a home birth when I have a baby, it was a very good "lesson" on being prepared, remaining calm, trusting your instincts. You don't usually see this type of thing happening or being discussed and I like that it prepared me for the possibility of it happening.

    Second, I want to commend you for being honest and transparent. For allowing comments (even anonymous! I was shocked!) and "rude" discussions. I feel bloggers are overly sensitive these days and are quick to be offended by anyone not praising them, even if it was a polite comment or question that wasn't even disagreeing with them.

    I'm kind of tired of having to use an e-mail to comment on various blogs (sometimes you just want to be be anonymous!) or have my comment deleted just because I didn't say exactly what the person was hoping to hear, even though I was polite. Anyway, I just wanted to say I'm impressed and I hope you keep allowing this on you blog. Free speech is great.

    And finally, congratulations! You daughter is absolutely beautiful (as are your other children) and you seem to be a wonderful mother. That is all, sorry for the long comment! =)

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  9. Can I just start out by saying how amazing you were. I watched your birth video and was in awe. I actually felt quite inadeqate after watching!

    We had a homebirth too...and our little man came out purple and limp after 3 hours of pushing. He was breathing...just no tone and a heart rate less than 100. I did try to stimuilate, but wish I had thought to do some mouth to mouth to stim him as well. Our midwives actually ended up cutting his cord after a few minutes, when he still wasn't pinking up and giving him some ppd. In retrospect, I wish I would have thought to do mouth to mouth.

    I don't know why anyone would come down on you. You were amazingly calm, and collected and knew just what to do. You should feel proud...very, very proud!
    Thanks for sharing your beautiful birth with us all.

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  10. I just posted a comment, but I think blogger ate it, let me try again:

    I never commented on your blog before but decided to for two reasons. First, to tell you that

    your posts about your daughter's birth were very informative and I'm shocked so many are

    criticizing you. I thought you looked like you knew what you were doing and were as in control

    of the situation as one can be. Also, as a person who is considering a home birth when I have a

    baby, it was a very good "lesson" on being prepared, remaining calm, trusting your instincts.

    You don't usually see this type of thing happening or being discussed and I like that it

    prepared me for the possibility of it happening.

    Second, I want to commend you for being honest and transparent. For allowing comments (even

    anonymous! I was shocked!) and "rude" discussions. I feel bloggers are overly sensitive these

    days and are quick to be offended by anyone not praising them, even if it was a polite comment

    or question that wasn't even disagreeing with them.

    I'm kind of tired of having to use an e-mail to comment on various blogs (sometimes you just

    want to be be anonymous!) or have my comment deleted just because I didn't say exactly what the

    person was hoping to hear, even though I was polite. Anyway, I just wanted to say I'm impressed

    and I hope you keep allowing this on you blog. Free speech is great.

    And finally, congratulations! You daughter is absolutely beautiful (as are your other children)

    and you seem to be a wonderful mother. That is all, sorry for the long comment! =)

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  11. Ugh, I'm so sorry about the bad formatting on my comment! :(

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  12. Some of the commenters might be interested in this: by a CNM also trained by Karen Strange, about a neonatal resus at a homebirth http://chicomidwife.blogspot.com/2011/03/first-breaths-of-life.html

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  13. My last birth, my second planned UC ended up with my unexpected 10 pounder stuck at the shoulders. I asked for my mother's help to resolve the very stuck shoulders and after lots of position changes and manipulation, my daughter was born. I have never written nor posted a birth story because I know many people would have negative comments about what happened. I see it as you did--a fact of the birth, nothing more. Additionally, I was prepared and dealt with it accordingly and in a calm fashion.

    Don't let anybody else drag you down. Your story is beautiful and another example of the falsehood that laboring/birthing women cannot act in any manner other than hysteria. Good for you, I say!

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  14. Becoming Midwives is so right on with the statement that babies are so tender and soft, new, sensitive and most importantly deserving of gentle and loving care! After having Elizabeth the nurses wanted to do the PKU test the next day and I was not ready to go with her to the nursery at that moment because I wanted to shower first. So I made them wait, which ticked off the nurse. When we went into the nursery I began to nurse my sweet new baby and they pricked her heal and not the slightest whimper or jolt from my baby. They had to prick her again to get more blood as I was still nursing- again no response from Lizzie except wonderful nursing bliss. It made me happy. The nurse said to me that the reason they like the babies to get all worked up and cry is that they get more blood and don't have to poke them again! I was aghast! I said that even though they had to poke her twice it didn't bother her because she was distracted nursing and was happy. And I was glad she didn't cry and her happiness was more important than how many times they had to poke her. I also said that babies deserve kindness and making them or letting them go on crying was cruel. She then said "that's where we have a difference of opinion!" I promptly said "I'm glad we are going home in a few hours because I don't ever want you to touch my child again." And I never let her! I will point out that this was not a baby friendly certified hospital and i was doing a VBAC and our only BFH didn't have staffing to allow VBAC's so my midwife and I were forced to use the only major hospital in our area because it would allow VBACs. My second child was born at the baby friendly Pekin Hospital and they were wonderful very kind and my son never left my side! They did the PKU right in my room as I nursed him, not a peep from him or any flack from the nurses either!
    I love my children more than anything in this world. I never believed in love at first sight until I became a mother. I am so glad Inga has you for a mother because she deserves that gentleness! The kind sweet care your gave her shows the magnitude of your love and wonderful motherhood! And I feel bad for all babies who don't receive that came gentle care! Our Heavenly Father entrusts these special spirits into our lives and it is up to us to take care of them the way He would want us to, and I believe He was very pleased with your loving care for Inga!
    Safe return to Eric! But I can't help wishing it rains for the rest of his trip! LOL Hehe.

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  15. Wow! That was a long post! Sorry Hon! Much love!

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  16. Thank you very much for Inga's story and video! I'm Geman and birthed 3 of my 4 kids unassisted. I'm having my own blog about (unasssisted) childbirth for German speaking people. I, too, got a lot of critics for in my eyes unimportant details when I posted my two birth videos on youtube. I've learned not to care about such comments. Mostly these people are either uninformed or ignorant. Still watching your video will help, teach and reassure many more people than you might think. Even if I get many stupid comments, too, I don't step back. Some things are worth standing for. And I'm giving birth standing. ;-)

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