Friday, September 19, 2008
Thursday, September 18, 2008
I LOVE SUNDAY BIRTHS!
It’s a perfect day to welcome a perfect sweet baby!
Be warned, it's a LONG story
Mom was having contx and some spotting, so she came to see me. I checked her to put her mind at ease. She wasn’t dilated yet, and spotting was very minimal. Baby’s heartbeat was strong. I explained that sometimes as you efface and dilate, small capillaries break and can cause small spotting. I teach mom’s to check their own cervix if they are comfortable with that, and sometimes this can irritate the cervix a little and cause spotting also. I liken effacement and dilation to sucking on a lifesaver. As the lifesaver gets thinner, this is like effacement, and as the hole gets bigger, this is like dilation.
After checking mom’s cervix this is what I felt was causing the spotting, it appeared to be very normal. The other advice I gave mom is to hydrate herself. Dehydration will cause contx prematurely and give you a false sense of labor. It is in everyone’s best interest if you don’t start into labor dehydrated.
I was pleasantly surprised to wake up Sunday morning with a good nights sleep. Contx continued all day and it was time for the midwife to come. As I turned down her street I had in my mind their house was the second one in. They told me to pull into the driveway and park under the basketball hoop. I thought it was kind of funny that they wanted to me park here, but didn’t have the garage door open like they said they would, they must have forgotten. I grabbed all my bags from the back of car; I try to only make one trip, which means I have full arms. I walked around to the front of the house, struggled to open the gate with full arms, went to the door and knocked. No one answered, but that doesn’t surprise me, I’m sure they are busy, so I knock and walk in with a “helloooooo”. Some women whom I didn’t recognize says, "Aaaa…...can I help you"? Instantly I realize I’m in the WRONG house! I’m tripping out the door over my apologies; I can’t believe I have just WALKED into some stranger's house hollering helloooo like I owned the place. Oh my goodness, I was sooooo embarrassed! This strange women is trying to help me with directions, I assure I know exactly where I’m going, NOT! It turns out these two houses are identical and I was supposed to go to the 2nd house from the end of the street, not the 2nd from the beginning of the street. Sure enough the house I supposed to be at had the garage door open for me, this time, as I’m a little skittish, I knocked and waited for an answer! I took a couple of deep breaths, and no one was any wiser.
So…now for the birth story.
4:30 PM - I checked mom’s cervix and I was excited to report that she was dilated 7-8 cm. and 90% effaced. She had a gush of water around 4:00 PM that we suspected was her bag of waters. I called my assistant to let her know it was time to come NOW and quickly. I prepared the room for the birth, and filled the garden tub as this is where she wanted to birth.
5:15 PM - Mom is feeling a VERY strong urge to push. I called my assistant again to affirm she was almost here. She said she was still about 20 minutes out. I encouraged mom to get in the tub to help her relax and get ready to welcome her baby. With the reality of her baby being born soon, fear came showing its face also. As we talked about what she might be afraid of, and I reassure her everything is going perfect. Baby has a strong, happy heartbeat, but fear is a strong emotion, and there is a shift.
6:00 PM - I checked her cervix to see what exactly was going on, and I was surprised to find she had closed down to 1 cm! Now, I can’t tell mom this, she would be devastated, I just said, she had closed down a bit, and so for the next several contx we would just breathe through them as we had before.
9:00 PM - Transition finally comes. Again, LOTS of hormones being released, mom is shaking uncontrollable, contx one on top of the other, with no break in between. Once again we set the room up for birth.
9:30 PM - Another shift, hormones gone, urge to push is gone, contx backed off. I check her cervix, (I’ve already done more vaginal exams in this one partial labor than I normally do in 2-3 complete labors) and find her cervix is 3 cm dilated! I can’t believe this is happening. The common thread in both shifts is FEAR. There is actually a lot of emotions playing out here. A little back ground history…mom and dad have been separated most of this pregnancy due to the military. When you are not with your partner through a pregnancy there can be some startling reality checks when you come together again. Mom has been through the physical part of pregnancy. It is her body that has changed drastically, she has experienced the aches and pains, the tiny bladder, the absent-minded memory, among many other physical changes, but dad hasn’t. This can cause mom to feel unappreciated for what she is going through, and dad is feeling left out of the loop and in denial.
I’m not saying this is what was going on emotionally with this mom and dad, because I really don’t know. But there was certainly something going on and it was powerful enough to digress labor from nearing the end to nearing the beginning.
After this cervical check, I told mom and dad straight up what was going on with her cervix. We talked about fear, about relationships, about any dynamic that could be going on subconsciously. I said, what we are doing isn’t working, so lets do something different. Go for a walk outside, away from everyone, just the two of them and talk or go to bed, again just the two of them, and go to sleep. She chose sleep. She took some valerian root tincture to help her relax and went to bed. This is where I took advantage and laid down too.
Rest didn’t last very long. I could hear mom cry so I went into check on her, she was sitting on the toilet crying in a child’s voice, “I want my mommy”. Again a bit of history here… her mom passed away a few years ago, and a schoolteacher took her in as her own and has been a surrogate mom to her every since. That being said, my heart ached for this mom…NOW I was beginning to see a small glimpse of what was going on for this young new mom to be.
I assured her that her mommy was here, she is here in spirit and she is helping her baby find it’s way to be born and would soon be in her arms. We talked about nicknames her mom called her, and songs she sang to her when she was a child. I went for my back of tricks (homeopathy) and found a remedy for fear and grief, two VERY powerful emotions. No wonder her cervix closed down.
Mom and dad settled into a rhythmic labor pattern, surrogate mom was a great help as she supported her and gave her the physical touch that a mom would give. Thank goodness for assistances to take turns laboring with mom so another can rest.
2:00 AM - Mom has been back and forth from bed, hands and knees, to side lying, on the toilet, and sleeping some in between contx. Mom is feeling that STRONG urge to push again, but I’m not about to check her cervix, as I still don’t know for sure that a vaginal exam isn’t what is causing her to shut down. We will know when it’s time when we see a head crowning!
4:00 AM - Mom can’t take it anymore, she can’t help not to push, so reluctantly I check for dilation one more time, she is 7 cm. I tell her no pushing, I encourage her to breathe through these contx and explain that pushing before she is fully dilated can cause the cervix to swell and close down. Then we will have to wait for the swelling to go down and the cervix to open again.
This focused breathing was very difficult and required a lot of help. She looked into my eyes and said, "I can’t do this anymore, it is too hard”. It was just she and I for the last couple of hours, as everyone else was resting. I looked right back at her and said, “Yes you can do this, you are doing this, and you only have to breathe through one contx at a time. When this one is finished, you don’t have to do that one again.” Each minute seemed like an hour. This is such hard work, and I was amazed at this young mom’s strength.
6:15 AM - Mom is begging me to check her AGAIN, so as I repeat in my mind, “I’m grateful she is 10 cm”! I check her cervix once again, and let out a sigh of relief and excitement, as I am dong the “happy dance” she IS complete! I rallied up the birth team, dad and surrogate mom, and finally give mom permission to gently push her baby out.
6:50 AM - We welcome a sweet baby girl weighing 7 lbs, 9 oz.
Wednesday, September 17, 2008
I Can Do ANYTHING!
One phrase among many that my clients hear me say is, “You really come to KNOW just how strong and powerful you are through natural childbirth, and that knowledge tells you, YOU CAN DO ANYTHING.” I often say, “Don’t ever doubt your strength, you have just proven to that YOU CAN DO ANYTHING?”
Each birth teaches me lessons and shows me how strong I am too. Each labor has lessons for me. Some are easier than others, and those hard ones reinforce the message personally to me that “I can do anything.”
Sometimes I wonder and ask myself why am I still doing this? Sometimes I think, “I don’t want this responsibility anymore. Sometimes I think I want my life back, but this is my life, my love, and my passion. A massage or a few days away with my family AKA vacation is when I forget about the hard times and this buoys me up to continue with my mission.
I am grateful for my amazing family. Many times I’m sure they have felt that they came second, to my clients, but I have only felt supported and encouraged by them. I’d like to think they are proud of what their mom/wife does, and I think they are. I could not do this without their genuine unconditional love and support.
I’m grateful for my assistants, for the bonds of trust we share. I’m grateful for their skills, as two brains in a stressful and sleep deprivation situation are always better than one.
I am grateful for my skills, I am grateful for my passion to empower women through education and choices. I am honored to have the divinely guided hands that welcome these perfect babies into this world.
Friday, September 5, 2008
Lactation Boosting - COOKIES
Lactation Boosting - Oatmeal, Chocolate Chip & Flaxseed Cookies
(6 dozen cookies)
* 1-cup butter
* 1-cup sugar * 1 cup brown sugar
* 4-tablespoons water
* 2-tablespoons flaxseed meal*
* 2-large eggs * 1 teaspoon vanilla
* 2-cups flour * 1 teaspoon baking soda
* 1-teaspoon salt
* 2 tablespoons of brewers yeast* (be generous)
* 3-cups oats, thick cut if you can get them
* 1-cup or more chocolate chips
* 1-cup chopped walnuts (optional)
Directions:
Preheat oven at 375 degrees F.
Mix together 2 tablespoons of flaxseed meal and water, set aside for 3-5 minutes.
Cream (beat well) margarine and sugar.
Add eggs one at a time, and mix well.
Stir flaxseed mixture and add vanilla to the margarine mix.
Beat until blended. Sift together dry ingredients, except oats and chips.
Add to margarine mixture.
Stir in oats then chips.
Scoop or drop onto baking sheet, preferably lined with parchment.
The dough is a little crumbly, so it helps to use a scoop.
Bake 8-12 minutes, depending on size of cookies.
Tuesday, September 2, 2008
A VERY Narrow Pelvis
I’m so grateful for cell phones. My daughter is moving to a different state, and I wanted to help her get packed up and move. In February I my sweet husband bought me an iphone for Valentines. (Yes, I LOVE, LOVE, LOVE my iphone)! I had to switch carriers to support my new phone, and in doing so, I now have service where my daughter lived (until this weekend) and I could go help her with the ease of knowing my clients could call me if they needed something.
I got this call about an hour after returning home from saying good-bye to my oldest daughter and sweet granddaughter, (her hubby was already at their new destination).
Mom is having contx, but not very regular yet, so I encouraged her to get some rest and I planned on taking that advice also. I called my birth team to put them on alert. Thank goodness my partner was back in town from her two-week church camp out of state. I knew from this mom’s history I did not want to be at this birth without my whole birth team.
Active labor started to kick in around 10 PM. I count active labor from the time contx are regular, usually every 3-5 minutes and dilation is about 5 cm. I arrive at mom’s house at 11:30 pm. She is doing a super job relaxing in the tub through some very strong contx. Dad is right by her side softly coaching her through each contx with encouragement and affirming her amazing relaxation. This is dad's most important job during labor!
I am setting things up for the birth. On my list of supplies is a cookie sheet. Everyone asks what this is for, no I’m not usually going to be baking cookies at a birth, but you never know, I’ve done some pretty strange things at births before. Actually the cookie sheet is what I lay all the birth essentials on, like instruments, cord clamp, baby hat, etc. This makes it easy to transport from one room to another in case baby decides to come in a different room than first planned. It has come in handy many times! It also serves as a flat surface in case I have to do CPR on baby.
I check baby’s heart rate, and it is strong and happy. Mom is up to pee from the tub a couple of times during the next two hours. Around 1:15 AM she is feeling a little urge to push, so she gets out to pee one more time, and while she’s out I check for dilation to make sure she is complete. I was happy to tell mom she was complete with a bulging bag of water, she didn’t want me to break it, so I just pushed a small lip of cervix back behind baby’s head, and I know we were going to have a baby SOON! I asked mom if she wanted to have baby here on her bed, or in the birthing tub, she said, the tub, and with that, she QUICKLY got up and walked VERY fast to the birthing tub. Talk about strong; these pregnant moms can do ANYTHING!
She gave a couple of pushes, I listened to baby who still sounds great, and soon we see a head with lots of hair. Mom was amazing as she very slowly pushed her baby’s head out. I feel for a cord and there it is, but loose enough to not be a concern. This baby’s shoulders do not want to come out very easy, so I have mom turn to her hands and knees careful to keep baby under water so it doesn’t take a breathe yet. We have already talked about this scenario in our prenatals, so mom didn’t say, “you want me to do what??” It’s hard enough for a 40 week pregnant mom to roll over in bed in the night, let alone one in labor with her baby’s head out, but like a trooper, she did exactly what I told her and with grace and ease turned to her hands and knees. This usually opens mom’s pelvis another cm to allow room for baby to rotate out, but in this case it wasn’t quite enough. I think mom has a VERY narrow pelvis, and I know this because I had to go inside with both hands up to my wrists to gently rotate baby to help him come out. I resolved to reaching under his armpit to make the diameter of his shoulders a bit smaller. Try shrugging just one shoulder up toward you ear, and you can see this changes the diameter of your shoulder measurement. All in the same moment I am calling on ALL my ANGELS! What seems like 20 minutes, really was only about 2, but when challenged like this, the 0 is added on for intensity.
At 1:38 AM mom and dad welcome their 8 lb 13 oz son to their family!
A few hours later mom was tucked in bed happily nursing her baby, laundry was in the wash, the birth tub was emptied, and we head home. Grateful for my skills and for my amazing birth team, including our ANGELS, who assist us, and work overtime at births!