Archive for September, 2011

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Selecting Maternal Health Care Partners

Friday, September 30th, 2011

When you discover you are pregnant, you face an array of important choices. It can be an overwhelming process at times to sort through all the information provided during pregnancy. The maternal health care partners that support you during this process have a big impact on your experience. Therefore be selective in the care providers you choose! Mothering begins during pregnancy! It is the first time you can consciously make decisions that directly affect your child. Prenatal care, labor, and birth can nurture a sense of empowerment in women and thus motherhood is positively impacted. You are able to approach mothering with a deeper awareness and a stronger consciousness.

Prenatal appointment with midwife done right in the comfort of my own bed

Maternal Health Care Partners include the following professionals:

Obstetrician
An obstetrician (OB) is a medical doctor and the most commonly used type of maternal health care provider by women in the United States.

Midwife
A midwife supports women during their childbearing years to provide health care during pregnancy, labor, birth, and post-partum. The word midwife literally means “with woman”. Rules and regulations for midwives vary widely per state so if you want to work with a midwife it’s important to understand your state’s guidelines for midwifery care. There are midwives who do homebirth, those who work at birth centers, and some who work in hospital settings. Check out Midwives Alliance of North America for more information.

Doula
A doula is a non-medical labor, birth, and post partum support person. They are educated and trained to provide a laboring mother physical and emotional support. There is a strong evidence base of positive birth outcomes and successful breastfeeding when a doula is used. Check out DONA International for more information about doulas.

Lactation Specialist
If you intend to breastfeed, creating a community of support is extremely beneficial. This can include professional support through a lactation consultant. A lactation consultant has training, knowledge, and expertise in helping you establish successful breastfeeding. If you are experiencing difficulties with breastfeeding, a Lactation Consultant can be a wonderful resource. Check out the International Board of Lactation Consultants Examiner for more information.

Childbirth Educator
A childbirth educator undergoes training and completes a certification process to provide pregnant woman with information about pregnancy, labor, and birth. Typically information is shared in a classroom-like format to a small group of women/couples who are at similar stages in their pregnancies. The information from a childbirth education class can help woman/couples better understand the changes that occur during pregnancy, the stages of labor, the pros/cons of medical interventions, and the basics of breastfeeding. Check out International Childbirth Education Association for more information.

An hour after birth...sharing in the joy and happiness with my midwife

Mutually reciprocated respect and trust is the foundation of a positive patient-provider relationship. As in all relationships, effective communication is a key ingredient. If you ever leave a prenatal appointment feeling discouraged, confused, or upset, honor those feelings as valid. Call your care provider and/or schedule another appointment in attempt to resolve any concerns as soon as possible. If you continually have negative interactions or experiences during prenatal appointments, consider choosing a new care provider.

Even if you are very far along in your pregnancy it is okay to make a change. I cannot emphasize this enough! So often I hear stories of a woman feeling discontent with the prenatal care they receive but unsure what to do about it. Then they often go on to have a dissatisfying birth experience with that care provider. If you are in that situation, grant yourself permission to explore all your options. Please don’t continue to receive less than optimal maternal health care. Pregnancy and childbirth are a sacred a time in your life; a time that deserves kind, compassionate, attentive, dedicated, and supportive health care partners. They exist abundantly and it’s worth the extra effort it may take to find the right match for your growing family.

What do you enjoy most about your health care partners? Did you have a doula, a childbirth educator and/or a lactation consultant? What was your experience?

-Sarah

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How to Create a Birth Plan

Thursday, September 29th, 2011

Creating a Birth Plan

Creating a birth plan can be a helpful way to communicate your desires for your birth experience. It can serve as an opportunity to make pro-active and conscious decisions regarding various aspects of childbirth. A birth plan can also help you prepare mentally and emotionally for the birth of your child. The process of creating a birth plan often helps clarify ideas about what you want as a mother and for your baby.

Sharing the birth plan with others allows you to effectively communicate your ideas about birth. Optimally this instills a sense of confidence and empowerment about the journey ahead. Occasionally I hear women become discouraged from writing a birth plan because it may attach them to a certain outcome. What happens if the birth goes differently than I ‘planned’? Perhaps a birth plan should more aptly be named a “statement of birth desires.” I believe a birth plan is simply a tool to cultivate your wishes and desires for your birth. I encourage you, the pregnant woman, to create a birth plan and openly share it with anyone who will be involved in your birth experience.

In writing a birth plan, it may be helpful to organize using the four categories found below. Under each one I provide questions to provoke thought on the topic, as well as, a few example statements that you might see included on a birth plan. Generally a birth plan that is shared with others would be no more than a page in length and written in concise, easy-to-read bullet points. Additionally, it is more helpful to state what you DO want versus what you DON’T want. For example:  Delay cord cutting until it has stopped pulsating instead of don’t immediately cut cord, but it is ok to state a few things you don’t want too. Your birth plan will be unique to you and reflect your thoughts, ideas, beliefs, and desires regarding your birth.

Especially if this is your first birth, know that this is just a very helpful guide to prepare you and those around you as you go through this experience. Labor is an amazing experience and in the process, things may change, your desires may change, and that is OK.

Labor

Forget about what you see on TV. Think about how you want YOUR labor experience to occur. This is YOUR body, and YOUR birth experience and who better than YOU to make a plan for it!

Who is with you? What is their role? What is happening in the environment? Are people talking to you, touching you, comforting you? Or are you quietly in your own mental space? What pain management tools are you using? What type of monitoring is being used and what is the frequency of it?

Example statements:

  • Allow labor to begin and proceed spontaneously without augmentation
  • Access to drink and food throughout labor as desired
  • Vaginal exams to be conducted by mother’s request only

Birth

What is the role of your care provider as you push? Are they coaching you? Are they observing you? What tools are used to support you during the pushing phase? Who is present? Is someone taking pictures and/or video?

Example statements:

  • Birthing location and position is determined by mother and baby
  • I want to be able to move around and change positions during birthing
  • Father catches baby and immediately places baby on mother’s chest
  • Allow the placenta to be birthed on its own accord without pictocin

Immediate Post-Partum

What do you imagine those first few minutes of baby’s life outside of the womb to be like? Who is handling baby? What is being done to you? What is being done to baby?

Example Statements

  • Perform APGAR test and any similar newborn screens while mother holds baby
  • Baby is first weighed upon request of mother
  • All fluids from birth remain on baby until mother request baby is wiped down

 Post- Partum Mother and Newborn Care

The hours following birth are a sacred bonding time for mother and baby. Regardless of birth circumstance, this bonding time should be well-supported by health care providers. Ideally care providers employ evidence based practices that promote successful breastfeeding.

Example Statements:

  • Baby remains with mother at all times
  • Baby is exclusively breastfed
  • Mother and baby skin- to-skin time is strongly encouraged

An important part of creating a birth plan is having care providers that will support and respect your birth plan. Give a copy of this plan to your care provider. If you are birthing in a hospital, make sure to pack 2 copies in your hospital bag. Give one to the nurse when you check-in and have another with you in your room so that you and your significant other can reference it easily.

Tomorrow’s post will discuss selecting maternal health care partners.

Did you write a birth plan? Was it helpful to your birth experience? What do you feel important to include in a birth plan?

-Sarah

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What to do with the Placenta

Wednesday, September 28th, 2011

 

A placenta is truly an amazing organ that our body grows during pregnancy. It acts as a passage way for nutrients, oxygen and fetal waste. I give serious pause when I think about this…our body is capable of growing an organ?!  I think that’s a perfect example of the incredible design for pregnancy. Considering the placenta is so instrumental to baby’s growth in utero, I felt the need to honor its importance post birth. Here are some of the things we have done to celebrate the amazing placenta!

Placenta Prints: This is really easy to do but the tricky part is that it’s probably best to do immediately after birth if you want to do a fresh blood print. You simply and gently place the placenta on a piece of paper and then remove it. It will create a tree-like pattern which is fitting as some refer to the placenta as “The Tree of Life”. There are other methods that involve using ink or paints, however I prefer to use fluids from mommy and baby to create the design. Also since I like to preserve the placenta for further use, I don’t want inks or paints to come in contact with it.  If you want to do a fresh blood placenta print have paper put aside with your birthing supplies. It is also helpful to have the role of “placenta-print-maker” designated ahead of time. Here are my placenta prints on display. At first it felt kind of odd to hang them on the wall due to the personal nature of them, but I quickly realized most people don’t know what they are…and those that do will appreciate them.

Placenta Prints

 

Plant a tree: We have a tree planting ceremony about 6 months after the birth of each child. With my second son we wrapped a portion of his frozen placenta in a paper bag. On the paper bag we wrote messages of love to him. Then we buried the paper bag in the ground and planted his tree in that same spot.  You can do this idea at any time after your child is born. After the birth of your child, you can put the placenta in a ziplock bag and place it in the freezer until you are ready to bury it.

J with "his" tree

 

Placenta Encapsulation: There may be some mixed feelings on this one, but still wanted to put it out there as an option  because I think it carries great potential benefit for a mother during the post-partum period. Sometimes a midwife or doula will offer placenta encapsulation as part of their services. If not, placenta encapsulation is fairly easy to do yourself. There are various preparation methods you can choose from. The method used involved first steaming the preserved placenta with lemongrass, pepper, and ginger. Then we cut it into thin strips and dehydrated it in a food dehydrator  for about 12 hours. Next we grinded the dried placenta strips into a fine powder in our blender. Lastly using an encapsulation machine we filled empty gel caps. I took one daily in the first three months post-partum and then as needed.

If you intend to do both a tree planting ceremony and placenta encapsulation, be sure to  freeze a small portion of the placenta.

If you birth in the hospital the logistics of obtaining your placenta may take pre-thought and planning to secure. If for any reason you are unable to obtain your placenta or are uncomfortable with handling a placenta, here’s an alternative idea :

Bake a Birth Day cake in the shape of a placenta: A few days after each baby’s birth I have baked a cake to have a mini Birth Day celebration. With baby #3 I decided to make a placenta cake. To clarify there was not actual placenta in the cake…rather it was a cake that looked like a placenta.  It also might be helpful to note that I don’t have any skills when it comes to baking or cake decorating so mine wasn’t exactly the prettiest but it did (kind of) resemble a placenta. A few days before I went into labor I randomly found a disposable pumpkin shaped baking pan on clearance that looked rather “placenta-ish” to me when placed upside-down. Funny how a Halloween cake pan can become a placenta cake pan…goes to show how all-consuming pregnancy can be. At any rate after baking the cake and removing it from the pan, I used brown and red icing to create the look of a placenta. We sang Happy Birthday to baby and then enjoyed our placenta cake together!

What special things have you done to honor and celebrate your baby’s birth? Do you have any rituals or traditions in your family when a new baby arrives? Would love to hear your ideas!

Curious about how to write a birth plan? Check out tomorrow’s post for some inspiration!

-Sarah

 

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Birth Story (Part 2)

Tuesday, September 27th, 2011

…continued

While I labored alone in the bedroom, J followed hubby around as he filled up the pool, made the bed, and whatever else he did to get things ready. I laid on the bed in the dark softly humming to myself. This lasted for a while until I decided I wanted to take a shower. The water running over my body was soothing and I stayed there for quite some time, almost motionless except for my deep breaths. However I eventually started to feel overly restricted in the shower and needed to move. I returned to the bed; laying in a fetal position in between contractions and on all four during contractions. By this time the midwives had arrived (5:30ish). They eased in quietly, carefully, and respectfully. They knew this was my birthing space and they protected it, even from their own presence.


I was ready to get into the water and the water was ready for me in parallel timing. As I had suspected would be the case, J wanted to get into the water with me and I was fine with it. Actually I loved and cherished that special time we had together. It is my last memory of him as my only baby. Jack Johnson was playing softly in the background while I swayed in the water. J thought I was dancing and was saying “dancing momma, dancing”. He asked me to dance with him. We danced together for a while, until I needed him out of the tub. Hubby got J out of the pool, dried, dressed, and comfy with a snack and movie in the bedroom while I continued to labor in the water.

After a while I decided my body needed some upright movement. I got out of the tub, but still craving the soothing power of water I went into the shower again. I swayed in the shower signing lullabies to my baby. I sang loudly without any apprehensions. Eventually hubby came into the bathroom and warned me we would run out of hot water soon. I definitely did not want that to happen so I got out of the shower and back into the pool. As I walked back into the front room I noticed the midwives sitting on the couch. I thought to myself “Gee they are probably bored. There really isn’t anything for them to do except sit there. Maybe I should tell them to go home and come back when I am further along?”. That thought lasted only a second or two because the very next thought was “I don’t really care what they do or need. I’m busy”. That was when I realized birth was imminent; when I was able to let go of the propensity I have to take care of everyone else around me. I allowed my own needs to be the priority. I asked my midwife what time she thought the baby would be born. I think she understood what I needed to hear because her brilliant response was “Your baby will come at the perfect time”.

Things intensified and I become more vocal. My noises; low, deep grunts, drew J out of the bedroom full of curiosity. As he watched me he played with his Thomas train along the couch singing ‘Thomas, Thomas, Thomas”. Contrary to what one might assume, his presence was very calming to me. I believe he provided an important strength and love that was very beneficial to the birthing process. His ability to joyfully play with his beloved train while I gave birth offered an acute awareness that what was happening was perfectly natural. It was cyclical relationship. The energy in the room indicated what I was doing was fine so he accepted it as fine, thus acted normally, which in turn sent a positive message to me that everything was fine.

I asked hubby to talk to me. I just needed to hear his voice. He quietly told me a story about a perfectly beautiful snowy day in the mountains. As he spoke he lovingly stroked my back and arms. His voice, his words, and his touch were especially comforting.
I expressed feeling scared. The midwife said to me “It’s okay to feel afraid”. I repeated that to myself aloud a few times. As I entered transition I used a great deal of self-talk as I repeated the various labor/birth affirmations I had reflected upon throughout my pregnancy. I told myself aloud and internally…I CAN do this. I AM doing this. This is what I want. Everything that I am feeling is important and purposeful.

Rather suddenly, I felt the urge to push. It almost took me by surprise how powerful it was. When I felt that raging sensation, I worked with it. I pushed and grunted. No one told me what to do. No one needed to because my body knew. I stayed on my hands and knees in the water to push. Hubby was behind me ready to catch our baby. One midwife sat near him while the other sat near my head. J stayed near daddy to watch the baby ease out of my body.


In between contractions I felt ecstatic, almost euphoric. As baby crowned I looked up at the midwife with a wide smile. I felt as though laughter echoed throughout my whole body. “The baby is coming!” I exclaimed, “The baby is going to be born at home!” She smiled right back at me. Her smiling face was kind and encouraging. As I pushed my baby out, my bag of water broke open. Hubby caught our baby in his very own hands, with a little help from big brother, J.

Bonding
Immediately after baby emerged, the midwives helped me turn over and hubby passed the baby to me. Some people refer to the moments after birth as “meeting your baby”. But to me it felt like reuniting.


As I sat there in the water, holding my baby for the first time, it was as if time stood still; as though we were the only two people in the room. I was aware of the presence of my husband, my firstborn, and the midwives, but it felt like they were observing us through a glass window…peering in, with great admiration for the infinite love they witnessed unfolding before them.

There was no rush. We could stay in this moment for as long as we wanted to. No one was going to take my baby from my arms or hurry me along. I would decide when I was ready to move on. And so we stayed there for a while: the two of us, in our own private world, bonding as only a mother and newborn are capable of. I inhaled every feature of my baby’s face, scent, skin, and body. I checked and announced we had a baby boy. The midwives asked permission to check our newborn son. Ever so gently, as he laid across my chest, they took his vitals.

I started to feel cold and wanted to move into the bedroom to snuggle up in our bed. They carefully helped us out of the pool, as baby was still attached to the placenta which I had not birthed yet. In the bedroom I had a few more contractions and pushed out the placenta. The midwives wrapped it up and set it next to me and baby. I put baby to my breast to nurse him for the first time. I found his cord to be somewhat interfering with my ability to comfortably hold him to my breast and asked to cut it. Together the midwife and hubby cut the umbilical cord. It was a sensitive moment for me, as we will never again be attached in that way. Although I knew we would discover and develop a different kind of attachment throughout the journey ahead of us.

 

Reflecting
The shedding, the unleashing that occurs during an unmedicated, unmanaged, uninhibited birth is transformative. First I experienced an emotional release, then a mental, and then a physical. In doing so, I was able to be fully present, on all levels (mentally, physically, emotionally, and spiritually) for the birth of my son. The sense of empowerment that I experienced during the course of his pregnancy and birth I have carried (and will continue to) with me into motherhood. He has taught me to trust my instincts, to follow my heart, to cultivate beliefs, and to embrace life.

 Did you have the birth you desired? What did you learn from your birth experience(s)?

Want to know what I did with the placenta? Read tomorrow’s post to find out!

-Sarah

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Birth Story (Part 1)

Monday, September 26th, 2011


Strangely enough Abraham’s birth story began many years before he was even conceived. His birth was not a moment in time. Rather it was a process; a process of discovery, of healing, of desire, and of joy. I am exceptionally thankful for the impact that process has had on me as a mother and as a woman.

When we found out we were expecting our second child, our first baby was 16 months old. His birth still resonated strongly in my heart and in my mind. I knew I wanted a different experience this time. I knew how I wanted to feel. I wanted to feel empowered. I wanted to feel strong and capable. I wanted to feel connected to the generations of women past and present who believed in the amazing capabilities of the female body. Essentially, I wanted to feel; to experience and embrace the full sensations of birth without interference from a health care provider, birth attendant, medical intervention or the like.

The experiences with my firstborn left me feeling rather vulnerable. It was as if I needed to protect myself and this baby from the pervasive, unfounded fears that typically surround pregnancy and childbirth. I turned inward to reflect upon my desires for this birth. Free from external measurements, I embraced pregnancy wholeheartedly. I became the authority on my body and my baby. It was a truly liberating experience not having prenatal care. I felt a special connection to my baby because I had to be more attune to both of us. Slowly over the course of the pregnancy I began to trust in nature’s perfect design for pregnancy and birth.

I loved being pregnant and I welcomed my growing belly; it made me feel beautiful. Carrying a child in my womb gave me a new purpose. At 33 weeks gestation the answers unfolded as we selected a kind and gentle midwife team to attend our baby’s birth. Ironically we had initiated prenatal care with them at almost the same time during my pregnancy with J. While that may appear a confusing choice, (after all if I was unsatisfied with my first birth experience, why would I select the same birth attendants?) I felt completely confident it was the perfect choice. I knew I brought a different dynamic with me this time. I believed this force within me was the missing piece of the puzzle during J’s birth.
During one of our initial visits, the midwife asked me what I wanted from prenatal care. I couldn’t imagine a more perfect question from a care provider. From the start she empowered us to make choices and lead the way in this journey. Her sudden presence at the end of my pregnancy did not interfere with the connectedness I had developed with my body/baby (something I was afraid of in choosing a care provider). Actually quite the opposite; her support and belief in us only strengthened the existing bond between a mother and her unborn child. There were many people I kept at bay during this pregnancy, but I let her into that intimate space within my soul. I trusted her because she trusted birth.

Preparing
My subconscious mind knew there was a baby growing in my womb and it told me so in a dream. I had a dream that I gave birth to a baby at home after a relatively easy 6 hour labor. I believe that dream allowed me to cultivate the birth I desired and prepared me for a journey of openness and discovery during the months that ensued. About a week after having that dream, I took a home pregnancy test to confirm what my subconscious already knew; I was carrying a new life inside me.

There were a few important, perhaps seemingly subtle, but ultimately monumental differences during my second pregnancy. Rather than attach to a calculated due date, I anticipated a due “time”. I understood that baby would arrive at the perfect time and I completely let go of any expectations around baby’s birth date. From 28 weeks on I practiced daily meditations. This was a little space in my day devoted to me and baby. It was our time to bond, to connect, to communicate, and to develop trust with one another. In doing so, I revealed the benefits of mindfully and intentionally focusing on our unborn child’s existing presence in our lives. It was through these daily meditations that I grew surprisingly excited about giving birth. I began to look at it as an opportunity. A rare opportunity to be my true self by tapping into the inner strength and wisdom I innately possessed but rarely used. Labor wasn’t something to get through; it was something to be revered.

Birthing
Thursday night I experienced irregular contractions through the night. I listened to my pregnancy affirmations CD to keep relaxed so I could sleep. I did not want approach labor feeling tired. Friday morning hubby questioned if he should stay home, but I sent him to work. I knew that I still had some time before baby would make his/her arrival. Additionally I wanted time alone with J before he became a big brother. I wanted to savor our final time together with him as my only.

We went about our day staying busy cooking meals to freeze, cleaning the house, and simply enjoying one another. We took a long, peaceful nap together. I experienced mild contractions on and off throughout the day. I would stop to notice them, but then continue on with whatever is was I was doing. Hubby checked in with me on the phone frequently throughout the day. Without me explicitly saying so, he understood the baby would be arriving soon.

Later that afternoon (2:00ish) things started to pick up in intensity. J was still sleeping and I was outside cleaning up the yard. The contractions were starting to take more and more of my attention. I decided to call hubby to ask him to come home. A short time later J woke up. By that time I was experiencing more regular contractions and actively working with them by squatting, rocking, and swaying. J followed me around the house and imitated what I was doing. He kept asking me “what are you doing momma?” And I would say “I’m getting ready to push the baby out”. As much as I cherished this private time we had together, I was thankful when hubby got home because it was getting harder for me to take care of J as labor progressed.

Hubby called the midwife when he arrived home (4:00ish). She asked him if they should come over. Hubby called to me as I rocked on my hands and knees during a contraction “Do you want them to come over?” That is when I started to cry. I realized it was time: time to birth our baby. This evoked an extraordinary emotional response from me. Through my tears, I simply nodded “yes”. These tears did not carry sadness, excitement, fear, joy, or any other label I could attach to them; rather they were pure, raw…almost reflexive in nature. They felt good. I let them flow and they stopped nearly as quickly as they had started. It was as though I had to release something in order to really focus on the amazing work my body was about to do. That is when I felt like active labor started….

To be continued…Part 2 coming tomorrow…

What did you do mentally, physically, emotionally, spiritually to prepare for birthing your baby? Birth is one of my favorite topics so I hope you’ll share your ideas!!

-Sarah

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