This week, we are absolutely thrilled to feature Science & Sensibility’s new Community Manager, Kimmelin Hull, on the Mother’s Advocate blog. Kimmelin was inspired by Lamaze’s recent press release about “free range” labor, and decided to visit Healthy Birth Practice #2: Walk, move around and change positions throughout labor on a personal level. Here, she shares the wise words of a woman who has recently undergone two different birth experiences — but committed to staying mobile during both.
One year ago, my best friend and physician assistant colleague, Liz, gave birth to her second child. Less than two years prior, she and her husband welcomed their first child into the world. Liz’s birth experiences occurred in two different states with two different providers. Her first pregnancy and birth were anything but normal — as she explains in her reference to a “highly medically-managed” pregnancy, which continued into birth. Her second birth was quite different and yet, she created the opportunity for herself to employ “free range labor” during both labor and birth experiences.
During both of Liz’s pregnancies, I was honored to help she and her husband prepare for the births of their children — through knowledge sharing, informal childbirth education discussions during a visit to them leading up to their first birth experience, and telephone labor support during Liz’s second labor. (I will never forget secreting away into the quiet guestroom of our house during the late-night hours while the rest of my family slept, verbally supporting Liz via telephone, as she worked through the transitional contractions that hit during their drive to the hospital.)
Liz graciously accepted my request to an interview in which she and I discussed and compared her two birth experiences, with a focus on the topic of movement during labor. Here are her insights:
Kimmelin: Can you describe the differences between your two labor and birth experiences?
Liz: In many ways, the two labor experiences were the same and in many ways different. With both pregnancies, I carried the babies until 39 weeks gestation. With both, I labored down from 4 centimeters to 8 centimeters in one hour. With both, I remained active and moving — until 8 centimeters with the first, and until birth with the second. With both, I had my husband present for support. And with both, the physician did not arrive in time for the birth of my child.
With the first, I had a highly medically-managed pregnancy, and I believe that alone contributed to my fear of having a natural childbirth. I had an IV, monitor, and my water was broken by nursing staff at 4 centimeters. I was not, however, in active labor pain. As mentioned above, I labored quickly, but found it difficult to maneuver in a hospital room with an IV attached. I opted for an epidural at 8 centimeters.
My second delivery was easier, as I was home when labor started and was able to move through my own familiar surroundings, my own clothes, my own bed, etc. When I did arrive at the hospital, I was fully dilated. I found recovery to be enormously easier with the second delivery.
Kimmelin: What factors do you think influenced the difference in your two babies’ births?
Liz: For the first birth, the biggest factor that made labor difficult for me was being hooked to an IV. I am GBS (Group B strep) positive, and was admitted to the hospital at 4 centimeters and dilated without painful contractions, but had to have IV antibiotic prophylaxis and have my water broken (basically augmenting labor!). When I finally went into labor, I found it difficult to move with the IV and monitor attached. For the second birth, I went into labor on my own — no induction or augmentation. The biggest factor that made labor easier for me was the ability to move within my home and surroundings before going to the hospital. I will add for both deliveries, I was fortunate to have tremendous support from the nursing staff to help facilitate my need to move during labor.
Last but not least, my husband and I were better prepared emotionally in meditation, reading, and undying support from a dear friend who is a childbirth educator to have a natural delivery the second time around. Even though I had this same support during my first pregnancy, the experience of already having a vaginal delivery helped to ease my fear the second time.
Kimmelin: Considering the speed and intensity of your second baby’s birth, what labor-coping techniques helped you through your labor? Why do you feel these things helped?
Liz: Moving! Hindsight reminds me that my contractions were erratic with intensity and timing, so I had no idea when the next would start or end. Unfortunately, I didn’t have the chance to “think” about which strategy I would use for the next contraction. However, my body naturally wanted to move through each contraction. I found myself getting on all fours; I had my husband push very hard on my sacrum as I bent forward on the counter; [I benefited from] receiving a giant bear hug from anyone willing while I stood; all of these techniques just came naturally to me to find comfort, as my body just knew what to do.
Kimmelin: Looking back on the births of your children, do you feel your physical behavior during labor and birth influenced your emotional experience? If so, in what way(s)?
Liz: Yes, I was able to move more during my second labor and birth, and I feel as though this reduced my stress and anxiety level, as opposed to the first labor and delivery where I wasn’t able to move as much. Looking back, I now realize having to lay still while being hooked to IV and monitor had caused more anxiety for me and my husband.
Kimmelin: What thoughts and/or advice (if any) would you offer health care providers and/or the partners of laboring women in terms of providing assistance for walking, moving and changing positions in labor?
Liz: To anyone in the presence of a laboring woman, they need to know that any position she can get comfortable in is acceptable. (I still remember the look of shock on my sister’s face when I was on all fours on the hospital bed). This goes for health care providers, as well. If the laboring woman cannot lay supine during a contraction for the monitor to be strapped on, please trust in her body — the baby is OK for those few minutes — and wait for the contraction to pass. Specifically to health care providers, respect the wishes of the mother’s/partner’s birth plan, and do everything in your power to facilitate a safe and comfortable environment for the laboring woman. Petition for a birthing bar, balance balls and bath tubs in your maternity ward, and practice medicine that goes “back to the basics” of allowing free movement during labor. After all, having a baby is the most powerful and natural act the human body can endure. Pain serves a purpose and doesn’t always need to be treated.
Elizabeth Posoli-Futch is a physician assistant practicing urgent care medicine at a community hospital in the Northern suburbs of Philadelphia. My deepest thanks go out to Liz and her family for sharing these insights surrounding the births of her beautiful daughters. Happy first birthday, baby M!
This blog was originally posted on Science & Sensibility, and has been repurposed and published with permission from Kimmelin Hull.
Kimmelin Hull, PA, LCCE, has been a Lamaze Certified Childbirth Educator since 2005, is trained as a physician assistant, and is the author of A Dozen Invisible Pieces and Other Confessions of Motherhood. Kimmelin has also written freelance articles for regional and international parenting magazines, and maintained her own blog site, Writing My Way Through Motherhood and Beyond since 2008. A member of Montana Childbirth Collective, Kimmelin has participated in numerous community education, normal birth and gentle parenting advocacy events. Ms. Hull joined Lamaze International’s research blog, Science & Sensibility, in early 2010 as a contributing writer, and now operates the site as the Community Manager, editor and chief contributor. A mother of three, Kimmelin and her husband raise their family in the beautiful Rocky Mountain town of Bozeman, Montana.