Creating a circle of support during pregnancy and postpartum

We are pleased to welcome Tracy Wilson Peters, CLD, CLE, CCCE , to the Mother’s Advocate blog. Co-author of the soon-to-be released book, The Greatest Pregnancy Ever, Tracy has been a lifelong advocate for families and babies. 

“The main concern of those around pregnant women or for people who care for a pregnant woman should be to ensure their emotional wellbeing.” ~ Michel Odent

Who are the people closest to you? Did you know that the people who are around you the most are influencing the personality and development of your baby? New science has shown that every relationship that you have impacts who your child will become. A mother’s feelings deeply affect her baby. In fact, the baby learns about his world by the feelings his mother has. When a mother has a feeling of happiness, this triggers a hormone release that the baby also feels. The same thing happens when a mother feels stress. Chronic stress is non-supportive for your health and your pregnancy. Hormones associated with depression and anxiety, such as cortisol, can reduce blood supply to the placenta and induce premature labor. So, who is in your life really matters!

Pregnancy offers a great opportunity to take steps to decrease stress in your life. Emotions and attitudes are contagious. Every encounter that you have on a daily basis can be measured on a scale that goes from nourishing to toxic. Who are the people in your life that nourish you? Who are the people in your life that drain your energy? It may not be possible to eliminate all of the people in your life that cause you stress, but you can begin to create healthy boundaries by creating a circle of support. This circle should include people who are supportive and loving in their interactions with you. Your inner circle may or may not include family members. Your circle of support should be comprised of people who you can call on when you need help, have good listening skills, won’t judge you, and can offer you emotional support. This inner circle is a sacred place. Who in your life do you want to be in your circle of support? Is there someone that you have been allowing in your life that you need to step back from?

It may help you to take a few minutes and make a list of the people that you interact with on a regular basis, including family members, friends, co-workers, and neighbors – anyone that you spend a significant amount of time with. Next think of each person holding your new baby. What feelings come up for you?  Try to tune in to the feelings that come up during this visualization. Are changes needed?

Some things to keep in mind when creating your inner circle of support:

• It’s OK to say no. There are moments when we say “yes” to others, and, in fact, we are saying “no” to ourselves.

• You can love someone and still keep them at a distance.

• Shifting who you surround yourself with does not mean judging others. Nobody has to be wrong for you to make decisions that are right for you.

• You can change your circle of influence and love those not in it from a distance.

• It’s not about being judgmental. It’s about being where you feel comfortable.

• You are your world, so if you change, the world changes.

Mothers who foster a healthy internal relationship often have nourishing relationships with the people in their lives. You are at the center of your circle. You must take care of yourself, both physically and emotionally, in order to have healthy relationships with the people in your life. Taking time to love yourself will have a positive effect on everyone in your life. When you create healthy boundaries with the people in your life, you will be giving yourself and your child a great gift: the gift of self-love and the knowledge that you can move through your world making conscious decisions about who and what is right for you.

Pregnancy is a time of change. Change isn’t always comfortable but it is a necessary part of life. Your new life with your baby will undoubtedly bring many changes in the relationships that you have.  Your relationships will change because you will change. Becoming a mother will provide many opportunities for growth.  As you move into motherhood trust your instincts. Surround yourself with people who lift you up and you will be able to give your very best YOU to your new baby.

“There comes a time in your life, when you walk away from all the drama and people who create it. You surround yourself with people who make you laugh. Forget the bad, and focus on the good. Love the people who treat you right, pray for the ones who don’t. Life is too short to be anything but happy. Falling down is a part of life, getting back up is living” – Author unknown

Author, Tracy Wilson Peters, CLD, CLE, CCCE

Married for over 19 years and mother to two amazing sons, Tracy’s experience raising her own children led her to a love for supporting expectant families. This passion encouraged her to found CAPPA, Childbirth and Postpartum Professionals Association. Tracy serves as both the CEO and as a faculty member for CAPPA. CAPPA is the largest childbirth organization in the world. Internationally known as a pregnancy expert, she has authored numerous articles, and appeared on many television networks, including FOX, CBS, and NBC.  Tracy has worked with expectant women and families for nearly two decades, attending hundreds of births as a professional labor doula and teaching classes to more than 3000 families.

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Birth is the Teacher

This week we are thrilled to feature licensed midwife Maria Iorillo as she discusses the transformative power of birth. 

When I became a professional midwife 23 years ago I had an idealized version of transformation and how wonderful birth is. I just thought that birth was groovy and becoming a midwife was a wonderful way to change people’s lives. I didn’t have much experience with midwifery and hadn’t had a child then, either. 23 years later, I think I can finally answer that question based on what I’ve seen – it’s no longer just a philosophy.

I’ve seen it over and over again, women and their partners are telling me the same words after they have a really good, satisfying and empowering birth experience.  They say, “that was the most incredible moment of my life”, “that was the most powerful moment of my life”, “I feel so different”, “I feel so changed”, “I never knew that I was so strong, I never knew that I could do that”.

Pregnancy and birth are a process of growth and self-awareness, that’s where the transformation comes. Especially the first time; this woman who has never been through birth before comes out the other end as a mother.  Birth prepares us for everything that comes after. Suddenly, a mother is thinking, “I can do this – I can change a diaper. I can deal with a crying baby, I can work through the challenges that lay ahead of me because I went through pregnancy and labor and now I know how strong I am.”

I will also say that someone asked me recently to describe my birth philosophy. It was a great question. My birth philosophy is simply that women deserve to birth with respect and kindness and honoring.  The baby has the right to be born gently.  I believe that this kind of birth support is what allows transformation to take place. If you encourage each women to honor her own unique experience of birthing – then birthing is the teacher. We don’t have to add anything to that.

Just honor birth for what it is.  That’s where we learn about ourselves, that’s where we learn about our partners, that’s where we learn about our community, we learn about our babies.  You learn so much just being in the process.  Just being present in it.

Women are smart and they can make their own decisions. It’s important that a mother can honestly say, “I was never manipulated along the way”, “I was never pressured into doing anything that I didn’t want to do”, “This was my experience, I own this, I own the way that I went through this experience.”

Maria Iorillo, Licensed Midwife Catching babies at home and assisting hospital births in the San Francisco Bay Area since 1986.

This is an excerpt from an interview conducted by Mindful Mama and is re-printed with permission from Mindful Mama.

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Cultural Definitions of Motherhood: The Butterfly Must Find Its Own Way Out of the Cocoon

There are several cultures where childbirth is understood to be a rite of passage. Beliefs surrounding this transformation are important because they inform the way in which women give birth.

The first culture that jumps to mind would be the Kung of the Kalahari Desert, where young men and women practice rituals that bring them into adulthood.  The most significant right of passage for the Kung men is to hunt and kill their first large animal. For women, the right of passage is giving birth. The Kung is a very subtle tribe who don’t honor bragging.  For example if a young man comes back from a hunt and boasts about making the big kill they will be ignored.  Instead they will quietly start passing out meat, indicating that they accomplished this feat.  For women to gain the same kind of honor, they go off on their own to give birth in the bush without saying anything to anyone. Once the child is born, they very quietly come back and start nursing their baby under a tree.  At this point everyone notices and comes by to congratulate her.  She is then honored for her stoicism and her warrior like abilities in her right of passage.

Another great example is Japan.  Most births still take place in the hospital, however there are maternity homes with live-in midwives where women go for pre-natal care and birth.  The Japanese and the midwives who work in these maternity homes have a specific saying about labor pain; they call it “metamorphic”.  They say that going through labor is a metamorphosis because it changes the woman into a mother the way that crawling out of the cocoon changes the caterpillar into a butterfly.  They adhere to an old story that states if you help the caterpillar out of its cocoon it will die.  It has to emerge by itself in order to survive and to be strong.

Japanese midwives approach birth with great patience.  They believe that the struggle and pain of labor helps the mother to grow and transform herself. The mother must look deep down inside herself and find out who she is.  The baby also needs the struggle of being born; the work is what transforms both the mother and the baby into separate beings with the power and the strength to go on and to be the mother-baby pair that they need to be.

The babies muscles will get exercised during birth which will prepare the baby to be ready to breastfeed.  This will also enable the baby to be aware of the smells and hormones needed to latch on.  If it’s born by cesarean section for example or if there are drugs at birth the baby’s consciousness will be reduced as well as the flow of necessary hormones.

The mother’s metamorphosis releases massive doses of oxytocin while she’s in early labor. Late in labor a flush of adrenaline gets her on a high and gives her the power and strength to push the baby out. Right after this stage comes another flush – the biggest flush of oxytocin she’ll ever get in her entire life.  This will transform her and the moment of suffering, pain and pushing.  If you watch women’s faces at this moment there’s a suffusion of joy and ecstasy in their expression.  Then the milk lets down, the prolactin comes and the hormones all work together to make the caterpillar turn into the most beautiful butterfly.

This excerpt is part of a video interview with Robbie Davis-Floyd and is being re-published with permission from Mindful Mama.

 

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Ani DiFranco on Birth and Motherhood

Ani DiFranco has written hundreds of songs, played thousands of shows and is no doubt an icon for strong and fearless women. This is why we are thrilled to share her thoughts on birth, motherhood and strength in this interview:

MA: Tell us about your decision to have a home birth.

Ani: Birthing is a very unique and profound event, and my choice to have a home birth was not because I’m independent (or something), it’s because essentially I’m an animal and I’m very affected by my environment. I’ve always got my feelers out and I know that the animal in me is very easily intimidated – I know this from making twenty records in awkward situations where I don’t feel comfortable, and then you have to sing and then there’s that moment when you’re not really in your own skin.  I didn’t want to give birth to my baby like I had given birth to some of my records thinking “help I’m alone among strangers in this alien environment”. The hospital environment would have been really counter-productive to me.

In retrospect I think that my midwife actually had a perception of me that I was very independent and knew how I wanted to birth because that’s my M.O., but having babies was something I had never done before and I had no idea how I wanted to do any of it.  I’m really happy that I did it at home, even though it was long and extremely challenging for me. In retrospect I think I would want more guidance.  No matter who you are, giving birth is going to kick your ass – in one way or another.

MA: So how did you get through it?

Ani: You know I think that I went into it with a lot of expectations about the power and the beauty and the transformation, and then when the labor really picked up, I was just scared and in pain. Then of course it was powerful and beautiful and transformative.

I think that one of the things that hurt the most afterwards was not my broken tailbone but my ego. I thought birth would be easy for me somehow and the fact that birth was (really) hard made me feel like “maybe I’m not as strong as I thought. Maybe I’m weak”. So, I had to go through an ego recovery process and address those feelings and my misconception of my role as a woman and myself as a part of nature.

MA: What’s it like to be a mama?  

Ani: It’s really something the way the babies teach us to nurture – to be nurturing and to transfer that sort of love and respect and caring to everybody’s babies. We’re all somebody’s baby and I think that everything we need to know about being mindful mamas our babies will teach us eventually, whether we want it or not.

Ani DiFranco has written hundreds of songs, played thousands of shows, captured the imaginations of legions of followers, and jammed with folkies, orchestras, rappers, rock and roll hall-of-famers, jazz musicians, poets, pop superstars, storytellers and a martial arts legend. Ani started her own music label Righteous Babe Records and because of this decision she’s been called “fiercely independent” (Rolling Stone), “inspirational” (All Music Guide), and “the ultimate do-it-yourself songwriter” (The New York Times).

This interview has been republished with permission from Mindful Mama

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Doulas: Support For Dads

Do you wonder how comfortable your husband will be with your doula? Good news: this week we brought back Micky Jones, an LLL Leader, doula, lactation trainer, conference speaker, IBCLC, Hypnobabies instructor, and author to guide you through her doula “cheat sheet” for Dads. 

“I’m just not sure if he’s going to be able to handle it. That’s one of the reasons we wanted to hire a doula.” If I had a nickel for every mom who said this during an interview for doula services, well, I would have a lot of nickels. Moms often wonder if their birth partner will truly be able to fulfill the role set before them in childbirth classes or birthing books. So much to remember. So much pressure for someone who is also deeply invested in the well-being of this special baby and mother.

The presence of a doula can free a father (or other close emotional support people) to experience and enjoy the birth without needing to be a perfect “birth partner”. I suggest that the partner also must be free to be present, vulnerable and primal.  One dad might get in the birth tub with his partner and catch the baby while another might sit in a chair in the other side of the room and just try not to loose his lunch. Both can benefit from the encouragement of a doula’s support.  It is the right of the couple to determine the level and type of involvement he should give. Insisting that all fathers participate in a certain way is just as judgmental as assuming all women should birth in a particular way.

Obstetrician, Michel Odent has suggested that the influence of the father’s participation during the birth is far more complex than we have considered. In a Midwifery Today article from 1999 entitled, Is the Participation of the Father at Birth Dangerous, Odent raises questions including’ “Does the participation of the father aid or hinder the birth?” and, “Can all men cope with the strong emotional reactions they may have while participating in the birth?”.  Most of us would say, “Of course!”

But after witnessing the interactions between many couples during birth and postpartum, I believe we have put fathers in a position they were never meant to be in.

Make no mistake, I believe in women AND men attending childbirth classes. The father/birth partner needs to gain information, understand how the mother plans to labor and discuss options during pregnancy in order to be very connected and in agreement concerning plans for the birthing. Information given ranges from anatomy to the stages of labor to the smorgasbord of interventions and choices available today. That’s a lot of information to tuck into one’s brain cells. Not to mention that this is a pretty big day for dad too as he rides his own roller coaster of birth.

So, how can a doula help dad? Here are just five of the ways the support of a doula can free dad to offer support in a way that is comfortable and effective.

1. Doulas live, breathe, eat and sleep all that stuff from childbirth class you (dads) can’t remember. Doulas who have been through training and certification have a basis of information about pregnancy, birth and newborns that is more than most men know or want to know about birth. While a really smart doula knows her main job is to just “hold the space”  (provide emotional and physical support to mom) and assist her in gathering information from her care providers. A doula has a knowledge base of “birthy stuff” that takes the pressure off dad (and mom) to remember it all.
2. Doulas give dads a teammate. Birth is often compared to a marathon. It is important to keep the birthing mother hydrated, fueled and even rested periodically during her birthing event. Same goes for dad. Dads need to eat, drink, stretch, take naps and refresh themselves during labors that last more than a few hours. A doula gives dad someone to tag to come in the ring when he needs to bow out for a break. Dads often feel tremendous relief leaving mom with the support of someone who he knows will not leave her side and will support her choices.
3. Doulas allow dads to perform super-human feats they could never achieve on their own. Okay, perhaps I’m overstating a bit but have you ever tried to be there for a mom to lean on while simultaneously providing counter pressure to her hips? It’s pretty much impossible. With a doula, one person can be there for mom to lean on while another person can provide massage, counter pressure, hold warmth or cool on her back while she sways. A doula/dad team are able to put into practice a lot more of the techniques and tips learned in childbirth classes.
4. Doulas help dad know what she really means when she asks, “Do you think it might be time to go to the hospital?” Babies often like to get things started in the middle of the night. When mom rolls over for the 5th time to nudge you and whisper, “Honey, I think my contractions are getting closer together!”, you will want a doula to call so you can gauge whether or not to get up or attempt to close your eyes and pray there won’t be a 6th nudge. While a doula can’t tell a mom that she is definitely in her birthing time, she can offer her professional opinion as to what mom’s current signs might indicate. A doula can help get past those, “Holy macaroni, this is it!” feelings and relax knowing that someone experienced with birth is supporting them as a couple.
5. Doulas let dads relax and enjoy the birth of their baby.  In Hypnobabies, the childbirth class I teach, birth partners are given a special CD that helps them feel relaxed and confident during the birth. Occasionally, dads are resistant to listening to this. It’s as if they don’t feel as if they have the right to be relaxed and confident during the birth. Having the continuous support of someone who knows and understands birth, can help dad relax and let the process unfold. Dad is free to get in sync with his partner, be there for her without worrying and experience his emotions.

It’s important that mom AND dad have the support they need during labor and birth. And trust me, with the help of a doula you will both be able to handle it!

Resources

Odent, Michel, (1999). Is the Participation of the Father at Birth Dangerous?  Midwifery Today, Issue 51, Autumn.

Micky, a team member with 9 Months & Beyond, LLC  http://ninemonthsandbeyond.com/ (hyperlink) in Nashville, Tennessee,  has experience as a breastfeeding mother, LLL Leader, lactation trainer, conference speaker, and IBCLC. Her mother-baby experience includes a degree in child development and family studies, teaching as a Hypnobabies Childbirth Hypnosis Instructor, being a certified birth doula with two organizations and DONA Approved Birth Doula Trainer. She also trains for the COPE Program with Commonsense Childbirth based on the JJ Way developed by  Jennie Joseph, LM.

Author of, Keep the Fires Burning: Conquering Stress and Burnout as a Mother-Baby Professional (available at www.ibreastfeeding.com ), Micky is passionate about encouraging other professionals to understand that who they are is more important than the work they do. Learning to value themselves is a vital part of being able to serve women and babies for years to come.
Micky is also the wife of 14 years to her amazing hubby KC and the mother of three energetic school-age kiddos. She wanted to become a doula as soon as she found out what the word meant and had a doula for two of her three births.

How did you build your support team?

 

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Vaginal Birth After Cesarean: Saying ‘No’ To Interventions

This week we are thrilled to feature Desirre Andrews (midwife assistant & ICAN President) of Preparing for Birth as she discusses how to say no to interventions after a previous experience with cesarean birth.

Let me begin by saying I am a VBAC and Cesarean mother of 4 boys. Officially I am designated as a 2VBA2C mother. I too, have walked this path out just like countless other women. Many VBAC hopeful mothers are in a club they did not ask to be a part of regardless of why or how the cesarean occurred.  The first or last birth leaves not only a uterine scar but different possibilities for any subsequent future pregnancy and birth. It can be a very sobering, shocking, even overwhelming realization that there may never be a vaginal birth in the future or again.  The option at birthing versus repeat surgical delivery can be determined by accessibility and cultural expectations, needs and desires.

Why would there be an issue of VBAC access by hospitals and providers? VBAC is not a procedure that requires specific training or skill, unlike surgery. In a nutshell, it is the usual extension of pregnancy and labor to push out a baby vaginally. In essence, it IS the biological norm and expectation. The uterus does have incredible resiliency in healing, like other muscles in the human body. It is also widely recognized by and large to be a safe, reasonable option for women and babies by the National Institute of Health  (NIH) and the American College of Obstetricians and Gynecologists (ACOG) as evidenced in 2010 statements all backed up by years of evidence.

Some issues in access availability are language in the previous practice guideline statements stating immediately available anesthesia is needed (this idea knocks out vast number of rural facilities from offering access), physician liability concerns (cost of liability insurance, thought of being sued), lack of true informed consent between mother and physician comparing repeat surgical risk and VBAC risk, physician fear and desire for making labor and birth a zero risk venture (life is not risk free, either is labor and birth and can never be), and overall physician/hospital culture (what pressures, protocols and practices are widespread in an area).

Yes even with all of these, some changes are being made toward more access, albeit very slowly in most area. Women are compelling providers and hospitals to offer access through determination, evidence, self-advocacy, exercising options, rights and open communication. It is possible. Another point to look at is women are more and more choosing alternate places to birth whether at free standing birth center or in the privacy of their own home (with a midwife or unattended) when access is declined in the hospital environment.  Women are increasingly saying no to those who refuse to give options and choice.

The culture in which a childbearing woman lives (family, friends, co-workers, faith community) affects decision making for the positive or negative. When some or all of those in these cultural areas are supportive of VBAC, she is more likely to choose going for it. When it is the opposite and she is told to just do the “easy” thing (for whom, surely not the one undergoing surgery), ask “Why would you WANT to labor? How lucky you are to be able to get out of it.” or “What does it matter anyway? All you want is an EXPERIENCE, A healthy baby is all that matter anyway….”  All of these negate the woman herself. It is more than okay to want the vaginal birth. It is good to look at what is the healthiest birth avenue. That goes a long way to seeing how the best experience is also the healthiest experience for both mom and baby.

I asked a recent VBAC mother, Katie Z. how her culture affected her decision to go for a VBAC. She stated “Friends and family were extremely supportive, especially after seeing what I went through with (my) cesarean and subsequent PTSD. The community (at large) most was surprised it was no longer once a cesarean, always a cesarean.”

She was able to more readily and easily pursue the desire and need to have a healthier experience because she was fully supported by those in her life. Conversely, some women are willing to buck the trend within their culture and have a VBAC. With lack of support, fear mongering and too often misguided advisement, it is much more a challenge to gestate peacefully and prepare for birth. It is possible, but much more difficult when those a woman cares most about are not be in her corner. I will share that with my fourth son; very few in my world shared my point of view. Thankfully my husband and certified nurse-midwife did. That was really all I needed. Frankly, it can be a dangerous thing to tell a determined woman “no”. She is very likely going to find a way.

Bottom line, there are options though to exercise them it may require much effort, research, relocation, financial planning, meeting with administrators, changing providers and more.

For more information on VBAC www.ican-online.org and www.prepforbirth.com

Desirre Andrews, CCCE, LCCE, CLD, CLE, Midwife Assistant & ICAN President. Preparing For Birth, LLC – http://www.prepforbirth.com.

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Loving Hands: Birth Through a Doula’s Eyes Part 2

This week we are delighted to bring back Cole Deelah to shares the second part of her insightful story of birth from her point of view as a Doula.  Cole has over 10 years of birthing experience and has created her own independent childbirth curriculum.

The atmosphere in the birth center was fabulous: dim lighting, candles by the tub, inspirational music softly playing when I wanted it, and temperature controlled to my liking…I truly don’t know how anyone achieves a natural birth in a brightly lit hospital. The half-darkness helped me to stay calm. In fact, for most of my labor, I kept my eyes closed and just wanted to be left alone with the comfort of the select few members of my birth team.

The midwives took turns monitoring my progress.  Every 15 min or so they were listening to the baby’s heartbeat with the Doppler. I was so glad I was not restricted in my movement in any way by an electric fetal monitor or by an IV.  They were also checking my blood pressure and my temperature often. Everything was normal, which was very reassuring.  I also remember how vastly important it was for me to have someone’s hands to hold during each contraction.

My husband was the best support I could have ever asked for.  He was calm and reassuring.  He held my hands and gave me water to drink.  When he needed a break, my doula was there, holding my hands, massaging my hands, telling me I was doing great.  I am forever grateful for the hands I held during each contraction.

I think the atmosphere in the room started to change around 3:00am (24 hours after my water broke), when I still was not pushing.  I remember Jackie telling me that another hour or two and they’d need to take me to the hospital.  I was so scared.  I did not want to end up with a C-section.  I’m not sure if the thought of going to the hospital motivated me or slowed things down, but soon after that I began pushing.  I felt an urge to push, but it was not an uncontrollable urge…I think I was rushing it because I was scared.

We encouraged you to tune into your body and push only when you couldn’t not push. You became very introspective at this point, totally tuning the world out and listening to your body. You moved your hips back and forth, side to side, and began lots of loud vocalization. We could all hear the slight push that began to appear at the peaks of some birthing waves. You were not quite ready, though, and chose to return to the warm water of the birthing tub.

At this point, I know I was in transition.  I was afraid I would not be able to push the baby out. Later, my doula told me a conversation I had with my husband during this time.  Me: “I’m scared.”  Him: “The baby is coming.”  Me: “The baby will come any day now.”  Him: “You are doing great.  The baby is going to come.”  Me: “The baby will come any hour now.”  Him: “You’re right.  The baby is coming.”  Me: “The baby is going to come any moment now.”

I also remember telling myself (silently) that I was NEVER going to have another baby again.  Then I said a prayer out loud,  and I thought about all the people who cared about me and the baby. It gave me strength and at that moment, I chose to surrender to miracle of birth.

Shortly afterward, we started to really hear pushing noises from you for longer durations. You moved to the edge of the bed and squatted… really feel more pressure and starting to ‘wish push’ with each peak. We reminded you  to conserve your energy until you had no choice but to push. Like magic, within the next two contractions, your pushing changed, your body had taken the reigns and you were submitting to the power of bring your baby forth.

Now I was definitely feeling the urge to push, and push I did.  For pretty much the whole time, I remained in a full-squat position with my arms supported on the edge of the bed and my hands squeezing my husband’s hands.  I was beginning to feel progress, and I continued to be encouraged by the midwives and my doula saying “Great job Lynnette.”  “This is normal.”  “You’re doing great.”

Then, the midwife got a mirror and placed it under me to see if she could see even just a little part of the baby during one of my pushes. I was elated when I heard that the baby was crowning. The whole atmosphere of the room changed, and I knew in my heart that I would indeed be willing to have more children and I would definitely choose this same route.  I was going to have this baby at the birth center after all!

This indeed was the most painful part of labor, but without a doubt the most joyous.  I had been so afraid of this part, but it was the best and easiest part (mentally and emotionally) of labor.  Real progress was being made and my baby was coming into the world.

I was impatient at this point and was trying to wait for a strong contraction before pushing, but I just pushed and pushed, wanting my baby to be born. Looking back, I should have taken more time with this part and waited for the peak of contractions to push…I think this is why I ended up with a tiny first degree tear requiring 2 stitches).

Before I knew it, my daughter’s head and then shoulders emerged from me. And with one final and amazingly awesome feeling, her body came forth.  She was born at 8:05 am (29 hours after my water broke). I was told, reach down and take your baby, which I did!

Your eyes popped over, you cooed ‘oooh!’, broke into a smile, and took your baby by the arms, lifting her out of your body and into your loving embrace.

I brought her to my chest and smiled and looked in her beautiful eyes and knew that I was blessed beyond measure.  She was perfect.  Her skin was amazingly pink and she looked into my eyes and let out some beautiful baby sounds.  She weighed 7 pounds 2 ounces and was 20 inches long.

I cried with joy and exclaimed, “Oh my gosh, she’s my baby!  Oh my goodness.  Hi sweetie.  Hi sweetie.  Oh my goodness.  I love you so much.  I love you so much.  Hi sweetie.  Hi sweetie. She’s so cute!  My baby girl; I love you.”

The midwives and my doula all helped me with breastfeeding within 20 or 30 minutes of the birth.  My baby latched on right away with no issues whatsoever. She never left my arms. This was the most amazing bonding time, completely uninterrupted by the routine things (bath, shots, baby warmers, etc.) that would have been done at a hospital.  Instead of all these procedures, I got to hold my baby skin to skin and bond with her.

The placenta was birthed and then my family came in to see the baby. My husband played his guitar and sang a beautiful version of “Somewhere Over the Rainbow”. Our baby stayed awake and alert for a good 2 hours after the birth, staring into our eyes.  Afterward, we were left alone with her in the peace and quiet of the birthing room.  We were told to nap, but I was so happy, so high on life, that I could not sleep a wink.  I did rest. I did smile.

Our journey into parenthood had begun.

Beautiful family! What a blessed event! The laughter in that room, the joy and triumph, love and peace! It was an honor to attend you during the birth of your beautiful baby girl!

Cole Deelah is the mother of 5 beautiful, home schooled children and the wife of one feisty entrepreneur. She resides and works in the Houston area as a birth doula, childbirth educator, and midwife apprentice. She has over 10 years experience in the birth field and has written an independent childbirth curriculum and head’s up a local cooperative of doulas. Cole has authored articles in such publications as Midwifery Today, the International Doula magazine, and others. She has plans to become a practicing midwife and travel the world with her husband and children, supplying basic life skills and maternal and neonatal healthcare to underdeveloped and developing countries.

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Loving Hands: Birth Through a Doula’s Eyes

This week we are delighted to introduce Cole Deelah, who shares an insightful story of birth from her point of view as a Doula.  Cole has over 10 years of birthing experience and has created her own independent childbirth curriculum.

Lynnette and Doug, you are a wonderfully delightful couple! Your beautiful daughter is so lucky to have such amazing parents. Your journey began long before your daughter’s birth day and, on that journey, you made so many amazing choices.

You chose to take an independent childbirth class, to hire a doula, to attend the play “Birth”, to interview midwives, and to change your care from a hospital-based midwife to a birth center midwife.

Saturday, January 29, 2011: Doug and I went to Laura’s house on the eve that my labor began.  Laura and some of her friends were planning on running the Houston half-marathon the next day, so we “carbo-loaded” for dinner by having spaghetti and meat sauce, bread, salad, Girl Scout cookies, and ice cream.

Little did I know that this would be the last full meal I ate before my baby was born. Good thing it was full of carbohydrates for the long, hard work ahead.

When we lay down to sleep around 10:30, I felt my baby moving inside me rather wildly.  The movements were huge and you could see their impression from the outside.  Doug fell asleep with his hands on my belly, feeling our little girl dance.  He was in awe of the miracle inside me, and so was I.

I feel asleep with a smile on my face.

Sunday, January 30, 2011: I woke suddenly at 3:00 in the morning and waddled as quickly as possible to the restroom, but my underwear was completely soaked by the time I got there. Then I sat on the toilet and felt a gush of fluid. Is this my water breaking?  The fluid was clear and odorless and my heart started racing as I contemplated the possibility that my water had broken, but I still wasn’t sure.

I had read that only 1 in 10 women start labor with their water breaking and was not expecting my labor to start this way. I changed clothes and went back to bed. 30-minutes later, the same exact thing happened.  Now, I was 99% sure that my water truly had broken. I lay in bed after this, feeling surprised.

I tried to go back to sleep. I knew this was important because labor could last a long time.  But then I started feeling very mild contractions.  I remember that they were only about 20 seconds long, but would happen every 5 to 10 minutes.

I read through some material from the childbirth class we had taken with Cole Deelah (my doula), just to try to figure out what was going on.  I then realized I really needed to rest, even if I just lay there and couldn’t sleep. At 6:00am I called my midwife and told her what was happening.  She advised me to let her know when my contractions lasted longer (at least 1 min) and were 5 min apart consistently.

Early on, you called to let me know that your water had broken in the early hours of the morning. You were patiently waiting for your contractions to begin and, in the mean time, you went for a walk and carried on as normal.

Doug and I went to the Stevenson park at 8:00 am to go for a walk.  It was a drizzly, dreary looking day.  I contemplated how appropriate it was that the marathon was going on that day and I considered how I had run a marathon 7 years ago and how if I could do that, then surely I could handle whatever lay ahead of me for labor and birth.

Sometime after 10:00am, I went to the birth center to check my vitals. My blood pressure and the baby’s heartbeat were fine.  My midwife gave me an herbal tincture of Cottonwood bark extract to take every hour with a little orange juice to try to speed up labor since my contractions still had not gotten any longer or intense.

In the afternoon, you went to visit your midwife, who prescribed Cotton Root Bark to hopefully establish some contractions. Around 3 in the afternoon, you called to find out my thoughts on it. I reminded you to let your body start labor when it was ready, to not worry, and to take the cotton root if you felt comfortable with it.

I began taking the herbs immediately, knowing that there is some random “time limit” in which doctors and nurses want the baby to be born in after the water breaks.  Jackie told me she was comfortable with a long amount of time as long as mom and baby are doing fine, but that her referring physician has a real issue if a woman goes past 24 hours after the water breaking and the baby is still not born.

Into the evening, my contractions still had not changed and I notified my midwife.  She suggested I take some Castor oil. I was starting to become emotionally drained and I doubted that I should take the Castor oil.  This conversation with Cole was pivotal in the progression of my labor.

Around 6:30pm, you called discouraged and worried. You were still not feeling much in the way of labor and talked about the use of castor oil. We also talked about the fact that, though your midwife was comfortable waiting on labor, her back-up OB wasn’t. I knew, in my heart, that your body was in protection mode. I encouraged you to go on a date with Doug, forget about what your body ‘should be doing’, and allow it to start in it’s own time.

She assured me that many women have given birth to completely healthy babies even DAYS after their water had broken.  She explained to me the risks, but also reassured me: I was not Group B strep positive, so infection from that was not an issue, I was healthy, I was staying very sanitary, and I was not running a fever.  All good things were on my side.

So, we completely cut off communication with our family and friends for awhile. We took a walk, held hands and played cards. And you know what?  By the end of our card game, my contractions were actually requiring my attention.  I began sitting on the birthing ball and holding onto Doug during contractions. After a few “big” ones, I was certain I wanted to make the car ride before it became more intense, so we headed to the birth center.

At 10pm that evening, I received the call that you were heading to the birthing center, your labor pattern was well established and you were in good spirits, but really working at labor.I arrived at the birth center within 40 minutes and found you in the bathroom, nauseous, and working through a strong labor pattern about 4-5 minutes apart.

You came from the bathroom and sat on the ball, rocking through contractions, moving your hips in a figure 8, and grasping the hands of whoever was nearest to you. Doug held your hands most often, praying with you, brushing the hair back from your eyes, and whispering strength and encouragement to you.

I had a ton of nausea at the beginning of active labor, making frequent trips to the bathroom with diarrhea and vomiting (really, really glad I had not taken castor oil…these issues would have probably been worse).  I also had a lot of uncontrollable shaking in my legs and sometimes arms throughout the remainder of labor.

It was more annoying than anything, especially between contractions when I was trying to rest.  I was able to drink water and Gatorade but did not have an appetite.

It was not long before you were active again, moving through your contractions and beginning to vocalize in deep hums and open ‘aaah’s. You asked for Doug to play for you and he brought out his guitar, weaving beautiful melodies throughout the room. You both sand a duet – Lynnette in the melody of birth, and Doug, in the melody of praise.

The first day ended with Doug playing his guitar and singing to me while I labored.

Monday, January 31, 2011: I labored in all sorts of positions: side lying, sitting on a birthing ball with my arms draped over the footboard of the bed, a modified sort of hands and knees position on the bed with my arms resting on a stack of pillows, standing, squatting, birth stool (which was uncomfortable to me so that didn’t last long), and in the water mainly on my hands and knees.

I remember thinking how important it was to me to be able to constantly change positions.  I would get in a position during a contraction and then rest in sidelying or stand and sway between contractions.  My body knew what it needed and I was constantly reassured by my midwife and doula that I was helping the baby get in the optimal position.

When the contractions truly began to come on you with insistence, you walked for a short bit, tried sitting on bed, but ultimately moved back to the ball after a short trip to the bathroom. You asked for a bath, which we drew for you, and soon you were lowering your beautifully ripe belly into the warm waters of the birthing pool.

You stayed in frog squat/kneel mostly, although sometimes you moved to all fours. Blissfully, you and Doug were both able to rest for short periods, and your body continued working toward the moment of birth. 

Cole Deelah is the mother of 5 beautiful, home schooled children and the wife of one feisty entrepreneur. She resides and works in the Houston area as a birth doula, childbirth educator, and midwife apprentice. She has over 10 years experience in the birth field and has written an independent childbirth curriculum and head’s up a local cooperative of doulas. Cole has authored articles in such publications as Midwifery Today, the International Doula magazine, and others. She has plans to become a practicing midwife and travel the world with her husband and children, supplying basic life skills and maternal and neonatal healthcare to underdeveloped and developing countries.

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Nothing to Fear: Finding Faith Amidst Fable

As any pregnant women with a burgeoning belly can attest, there are a preponderance of frightening birth stories out there, and little apparent reluctance in sharing them. Birth is perhaps the one unequivocal commonality we all share; everyone on earth today was born.  It is a completely normal physiological process with generations of proof of efficacy and yet many, if not most couples in our culture today approach their births with some degree of fear.  And yet, the mere word- BIRTH- seems to have the power to conjure fear in western women. Men, too.

So where does it come from? In previous generations, women had a healthy reverence for the intensity of birth.  Compared to women today, they were much more familiar with the sights, sounds and smells of labor, but had a very limited understanding of why some women survived child labor and others did not. First time mothers also struggled to grasp  how something that looked so intense, would feel.

With technological advances, antibacterial soap and more prevalent hand washing, the possibility of death has become as remote as our direct experiences with childbirth. Very few people actually experience a birth other than their own, but we are inundated with conflicting and scary representations of birth.  Thus, we fear what we think we know. Our collective understanding has shifted from a very real concern for life and safety to a second-hand anxiety.

A woman has merely to suspect pregnancy, and suddenly find herself  overwhelmed with information — from ‘reality’ birth on numerous television programs and its more humorous Hollywood caricature, to an endless stream of products and contraptions marketed to parturient women claiming to ease, soothe, simplify, (read: correct) her birthing process. Taken separately, each of these influences has the potential to undermine a woman’s confidence in her inherent capabilities; the cumulative effect can corrode it entirely. It is in the absence of this confidence that fear absolutely thrives!

But, how do we heal this pervasive cultural influence?

The simplest answer is that the antidote to fear is faith. It matters not wherein the faith is placed; be it a Most High entity, or basic physiological science,  it simply boils down to how deeply a woman believes in her ability to give birth to her child. Whether she borrows her faith from a greater spiritual practice and views her experience as merely an extension of this greater understanding, or whether she simply studies the facts of the body’s process in labor and the statistical likelihood of safe delivery and is duly assuaged by belief in her own body’s capabilities, a woman coming to the experience with a trust fortified in fundamental understanding is much more likely to have a successful birth.  She’ll enjoy her birth more.

Happy birthing is completely subjective, but it’s probably safe to say that not spending the entire experience in terror is more pleasurable — and more conducive to surrender, which is critical.  Armed with a fundamental belief that birth can be achieved or that whatever takes place will lend to a higher purpose, a woman can more fully give herself  to the process. This is the shift of faith. The entire spectrum of variables — prenatal care model, childbirth education methodology, labor support, etc — cannot overcome the significance of the role that sheer faith plays in the labor experience.

So perhaps the most important preparation for birthing is bolstering faith; cultivating a sense of independent, sustainable trust. Of course, we must also embrace fear as part of the gift, in that it teaches us how to better connect to and prepare for the process and we can also participate in a paradigm supportive of birth (choosing the best support team possible) –  but these things cannot supplant a woman’s core beliefs. Only she has the power to choose faith.

In time, each woman empowered by her a pleasurable birth experience contributes to a shift in the collective consciousness — gradually reframing fear. Every woman within herself, and all women within their communities. Men, too.

Piper Sunshine Lovemore is a Certified Doula, Organic Birth participant and consultant, Lamaze Certified Childbirth Educator, Placenta Encapsulation provider and all-around natural childbirth advocate. Her core belief is that an informed experience is empowering, no matter the particular outcome. To that end, her goal is to educate and support families through their birth experience primarily through reconnecting them with their own embodied wisdom. Piper believes deeply in the importance of community and the richness of a diverse support network. She strives to nurture her community by organizing and attending activities with her family in her free time. She and her partner, Chaz, live in Hawaii with their three children: Che’ Pax, Plum and Rocket, and they look forward to expanding their family further. Take a moment to be inspired by Orgasmic Birth. Watch the trailer… www.orgasmicbirth.com.

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Global Perspective: Birth in the Guatemala Highlands

This week, Mother’s Advocate speaks with Sarah Proechel, a Certified Professional Midwife working in Guatemala on Fulbright Scholarship. In this inspiring interview, Sarah discusses her perspective on hospital interventions in Guatemala, preservation of Mayan culture, and her own endeavor to open a midwifery school in the Guatemala highlands.

MA: There are a lot of women in the United States who become involved in the birthing community because they feel compelled in a in some larger way – as though supporting mothers through the birthing process is a part of their life purpose or destiny.

SP: For me that’s very true.  I had things like this happen to me when I was very young but it was never confirmed.  It was a big struggle for me to own that calling as an adult – until recently.  If I had had somebody saying “oh yeah you’re supposed to be a midwife and that’s why you’re having all these dreams and these feelings”, I think it would have made a difference in my life.

Things are different here in Guatemala.  Most women who become midwives are aware of their calling from a very young age.  One of the typical stories you hear is that a woman was born “in the caul,” which means with the bag of waters intact at birth and that is sign of destiny, that she will be a midwife.  She grows up with that story and that begins to live into it as life presents its opportunities.  She may also or alternatively experience a series of dreams involving babies, pregnant women, dolls, or coins.  There are many things associated with pregnancy and birth that show up in dreams that can point to a calling.  She is therefore validated and called “comadrona” before she has any experience or training whatsoever.  I find this so beautiful and life-affirming.  A boy who is born in the caul is said to be a “curandero”, or healer.

There was a doctor in the room at the first birth I attended here, and he wanted to break the bag of water.  I asked the mother if she wanted the bag broken and she said “no”. Eventually the doctor was asked to leave.  That day, the baby was a boy and he was born in the bag – so it was meant to be.  What if we had intervened? It would have literally changed the course of that boy’s life.

MA: You are working with a group of midwives and activists from Guatemala and the United States to open a midwifery school. Tell us about your vision for this school.

SP: Our vision is to have a training center/midwifery school that will serve the local women who are chosen as midwives — and also provide a unique educational opportunity for student midwives from the United States, Canada and beyond. The philosophy of the school is one of leadership and collaboration – this is not a top down model. It is the vision of Ester Pop Tuch who is a traditional midwife from San Pedro – a really competent midwife who has attended hundreds of births.   Jumping off from Ester’s original vision many talented people have joined the project and it is becoming a truly visionary model that has the potential to really shift the discourse and the direction of midwifery in developing countries, beginning here in Guatemala, where home birth is still the norm.

The school curriculum will combine the midwifery model of care with Mayan healing traditions – herbal medicine, spiritual cleansings, spiritual guides and birth wisdom. We can really help this community by training the midwives in the midwifery model of care and emergency medicine so that the midwives know how to handle complications and when to transport to the hospital. They Mayans have a rich tradition of midwifery and home birth, which has been eroded away. There’s a long history of discrimination and abuse and colonialism and war; and midwives during the war were picked off because they were community leaders, so they were the targets. We want to scoop that tradition back up into a container where it can be passed on to future generations, ideally in a way that is healthier, stronger, and more sustainable than it has been.

MA: How will this project improve birth outcomes and lower intervention rates in Guatemala?

SP: I came here to research high maternal mortality rates in Guatemala. On the surface it looks like women are having their babies at home and that’s why they’re dying. There is a relationship there, but it’s much more complicated then it would appear on the surface. Here’s what I’ve seen:

People in this area, on the whole, prefer home birth.  It’s culturally expected – anyone who comes to the clinic to visit me for a prenatal is expecting to have a baby at home.  They don’t have any desire to go to the hospital and deal with the scene there or be operated on.  You don’t see people who are like “oh just cut me open, that will be easier.” They really value home birth; they really value their midwives.

However, women are being told that they must visit the health post during their pregnancy – which is outside of the midwives sphere of influence. Theoretically that could be OK, except for the fact that the health centers uphold a medical model of care. Women who go to the health post – I’ve seen this over and over – are much more likely to be told, for one reason or another, that they need to go to the hospital for the birth.  They reasons given are things U.S. midwives would balk at, like being over 40 weeks, being diagnosed with a “narrow pelvis,” or a baby that’s too big, being told that the baby won’t come out because the cervix is posterior or because the baby is posterior, to name a few.  All of these things are utterly absurd and the sad part is that most of them do not seem to make it out of the hospital without a c-section.

When mothers end up at the hospital, they have to be alone – no partners, no midwives allowed.  No support person.  Absolutely none.  That’s hospital policy across the board. This is problematic on many levels. There was this really fantastic study that was done my Nicole Berry, which correlates high death rates to a fear of going to the hospital (among other things) – women don’t want to go even if they know they need to go. They wait too long, so it’s a last-ditch effort going to the hospital, and then it’s too late. I have definitely seen this playing out but I have also seen almost the opposite.  I have seen many women that are easily convinced that they should go to the hospital even though the reasons given to them are bogus.  They just don’t seem to have enough knowledge about their own bodies and normal birth to know otherwise and often times the midwives don’t know any better either.  It’s not that different than in the U.S. actually, where women are given umpteen reasons why they need a c-section and they don’t really protest.

There are also situations where the midwife doesn’t know her stuff, but this environment makes it especially challenging for a midwife who might say “this is outside of my parameters, we should go to the hospital”—because then the family has a big discussion about whether to go or not, knowing that they will be treated very badly once they get there.  Then the question becomes, at what point is it worth it to go?

I have also experienced the loss of a beautiful baby boy due to the utter incompetence of the health care system I dutifully referred the family to.  Instead of being treated, the situation was dismissed (by the local health post doctor) as a result of the evil eye.  A few days later the baby died.  I am still grieving over the recent loss of this baby, my first as a midwife, and dumbfounded at the whole situation.  Healthy women with healthy pregnancies are being told there is something wrong and a sick baby, who needs urgent attention, is dismissed.  It makes no sense.

On a more positive note, I have attended some really triumphant home births, where women have had their babies at home with me and a “comadrona” attending, against all pressure to go to the hospital.  The depth of gratitude I have received from the women and their husbands, often the most from their husbands, makes everything I am doing worthwhile.  I can really, really feel how deeply important it is to these people to have their babies at home with their families and their midwives.  It’s deep stuff.

For me, I care deeply about woman and babies surviving the birth process.  But the point I want to get across is that birth, and life, for that matter, is not just about survival. All of life is here to be cherished.  Birth is one of life’s most exquisite experiences, or I should say it can be.  For some women, maintaining their dignity and freedom is more important than staying alive.  Others are willing to sacrifice the home birth and endure the hospital experience in favor of what they believe is their safety.  They should not have to make that choice.  They can have their babies in safety, dignity, and freedom, all at the same time.

The goal of the midwifery school  is not only to equip midwives with knowledge; it is to elevate the status of midwives so that we can improve birth outcomes and lower intervention rates.  Ideally, we would like to offer a comprehensive three-year midwifery education to younger midwives just starting out so that there can be a group of professionally trained midwives who are well-steeped in the midwifery model of care as well as their own culture.  These midwives would fill a huge void in the community between birth with a traditional midwife, or “comadrona,” who has minimal training, and a c-section in the hospital.  These women could serve as bridge builders with a valuable knowledge base of normal birth and the ability to communicate in both the indigenous communities and the medical world.  We hope our students will be the leaders of the future of midwifery in Guatemala.

MA: You have described this project as a dream-come-true. It is inspiring to hear. Tell us about that.

SP: The more this project develops the more I have deep faith in the process and what will be the product.  It feels to me like there is a spiritual force that has created an energetic blueprint of what it wants to create.   Each of us holds a piece of the manifestation of that blueprint and have joined the effort because we are somehow aligned with it.  For myself I feel like I’m just following instructions.  I just feel like I trust everything that shows up and the more I do that the more I see results that blow my mind.  Every meeting is productive, every action moves us forward.  Every door knocked on is opened.  It’s crazy and awesome.

Sarah Proechel is a Certified Professional Midwife from the U.S. She has had a private home birth practice in western Massachusetts since 2005 and is currently working in Guatemala as a 2010-2011 Fulbright fellow.  Her project, a cultural exchange with traditional midwives in San Marcos La Laguna, Guatemala, has rapidly evolved into a joint initiative to create an international professional midwifery school.  Sarah holds a bachelor’s degree from Goddard College in Health Arts and Sciences with a focus on Mayan midwifery and herbal medicine and is currently enrolled in a Master of Midwifery program at Midwives College of Utah.  She is author of Voices of Maya Midwives:  Oral Histories of Practicing Midwives from the Mam Region of Guatemala, Lulu press, 2005. When she’s not in Guatemala, she lives in the Hudson Valley of New York State with her husband, two young children, and one teenager.

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