Archive for the ‘Labor’ Category

Silent Saturday | 3

Saturday, October 1st, 2011

Post Partum Herbal Bath

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

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

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